Article

OBJECTIVE: To assess the course of nonspecific work-related upper limb disorders
(WRULD) and the influence of sociodemographic factors, psychologic factors, and
physical fitness on clinical status and functional disability. DESIGN:
Retrospective cohort study with cross-sectional analysis among computer workers
with several stages of nonspecific WRULD; average follow-up 4 years.
Sociodemographic and medical characteristics were assessed based on medical
records at onset and diagnosis. After informed consent at follow-up, participants
received a questionnaire assessing psychologic and physical fitness
characteristics. SETTING: Outpatient department of rehabilitation medicine,
University Hospital Maastricht; tertiary referral center for nonspecific WRULD.
PARTICIPANTS: Computer workers (N=182) with nonspecific WRULD, 18 to 50 years,
first consultation 1998 to 2001; those with specific WRULD and incomplete medical
records and treatment charts were excluded. INTERVENTIONS: Not applicable. MAIN
OUTCOME MEASURES: Stage of nonspecific WRULD (clinical status) and Disabilities
of Arm, Shoulder and Hand questionnaire [DASH] (functional disability). RESULTS:
A total of 104 patients (57%) returned the completed questionnaire at follow-up
(November 2003). Fourteen percent developed chronic benign pain syndrome, 9%
recovered. The remaining (77%) worsened slightly. A higher DASH score was
associated with being elderly (unstandardized regression coefficient [B=.64]),
being a woman (B=10.42), having a lower educational achievement (B=9.72), and
poorer self-reported physical fitness level (B=1.68); lower educational
achievement and poorer self-reported physical fitness were associated with a more
severe clinical status. Psychologic factors did not influence disability or
clinical status. CONCLUSIONS: The prognosis of computer workers with nonspecific
WRULD is not favorable. Those with a lower educational achievement and poorer
self-reported physical fitness are at risk for a more severe clinical status and
functional disability. Being elderly and a woman are also risk factors for
further disability. A prospective cohort study is needed to unravel these
relationships. Nevertheless, computer workers with nonspecific WRULD should be
encouraged to enter fitness programs.
CI - Copyright 2010 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS