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Musculoskeletal complaints in major upper limb defects in the Netherlands: prevalence, influence on health status and work and risk factors
University Medical Centre Groningen, the Netherlands.
University Medical Center Groningen, the Netherlands.
University Rehabilitation Institute, Slovenia.
Örebro University, School of Health and Medical Sciences, Örebro University, Sweden.ORCID iD: 0000-0003-4247-2236
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2014 (English)In: MEC'14: Redefining the Norm, Frederiction, Canada: University of New Brunswick, Fredericton, Canada , 2014Conference paper, (Refereed)
Abstract [en]

Objectives: (1) To compare the prevalence of self-reported musculoskeletal complaints (MSC) in individuals with major upper limb defects (ULD) in the Netherlands with a control group, (2) to explore the influence of MSC on health status and work and (3) to assess predictors of MSC, disability and work productivity in ULD.

Methods: A national survey among individuals with ULD and controls was performed, using the databases of rehabilitaA national survey among individuals with ULD and controls was performed, using the databases of rehabilitation centers and orthopedic workshops in the Netherlands. A questionnaire was designed based on known risk factors for MSC, and it included validated (subscales of) existing questionnaires, such as SF36 and the Pain Disability Index (PDI). Inclusion criteria were ≥ 18 years and major ULD at or proximal to the carpal level. Controls were recruited by convenience and matched on age and sex.

Results: Of the 263 individuals with ULD that completed the questionnaire, 42% had a congenital transversal defect and 58% had an amputation. The mean age was 50.7±16.7 years and 60% was male. A prosthesis was used by 79%. In total 108 controls were included (mean age 50.6±15.7; 65% male). Year prevalence of MSC (lasting for at least four consecutive weeks) was 65% in individuals with ULD, compared to 34% in controls. The most common location of MSC was the dominant or non-affected limb (46% in patients and 17% in controls), followed by upper back/neck (43% in patients and 19% in controls). Presence of MSC was associated with lower scores on scales of general health perception, mental health, work productivity and higher scores on disability. Prosthesis use did not differ between individuals with and without MSC. Predictors for presence of MSC were deficiency of the right limb, higher upper extremity work demands and being divorced or widowed. More pain, lower mental health and higher age were associated with a more severe disability. Predictors for lower work productivity were presence of MSC and more pain.

Discussion: Presence of MSC is a common problem in individuals with ULD. Mostly affected were the non-affected limb and upper back/neck. More research on employment of the affected and non-affected limb, and its relation with MSC, is therefore warranted. Interestingly, presence of MSC was not related to prosthesis use. Associations with disability and work productivity add extra relevance to the study results, because of its relevance for individuals and society.

Conclusion: Prevention and treatment of MSC deserves an important role in rehabilitation medicine of individuals with ULD.

Place, publisher, year, edition, pages
Frederiction, Canada: University of New Brunswick, Fredericton, Canada , 2014.
National Category
Medical and Health Sciences Occupational Therapy
Identifiers
URN: urn:nbn:se:oru:diva-40571ISBN: 978-1-55131-176-0 (print)OAI: oai:DiVA.org:oru-40571DiVA: diva2:777555
Conference
MEC'14 - Redefining the Norm, Frederiction, New Brunswick, Canada, August 19-22, 2014.
Available from: 2015-01-08 Created: 2015-01-08 Last updated: 2017-03-26Bibliographically approved

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Norling Hermansson, Liselotte M. N.
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