Abstract
BackgroundThe aim of this study was to identify case definitions of diagnostic criteria for specific musculoskeletal disorders (MSDs) for use in occupational healthcare, surveillance or research.MethodsA scoping review was performed in Medline and Web of Science from 2000 to 2020 by an international team of researchers and clinicians, using the Arksey and O’Malley framework to identify case definitions based on expert consensus or a synthesis of the literature. Seven MSDs were considered: non-specific low back pain (LBP), lumbosacral radicular syndrome (LRS), subacromial pain syndrome (SAPS), carpal tunnel syndrome (CTS), lateral or medial elbow tendinopathy, and knee and hip osteoarthritis (OA). Case definitions for occupational healthcare or research were charted according to symptoms, signs and instrumental assessment of signs, and if reported, on work-related exposure criteria.ResultsIn total, 2404 studies were identified of which 39 were included. Fifteen studies (38%) reported on non-specific LBP, followed by knee OA (n = 8;21%) and CTS (n = 8;21%). For non-specific LBP, studies agreed in general on which symptoms (i.e., pain in lower back) and signs (i.e., absence of red flags) constituted a case definition while for the other MSDs considerable heterogeneity was found. Only two studies (5%), describing case definitions for LBP, CTS, and SAPS and lateral and medial elbow tendinopathy respectively, included work-related exposure criteria in their clinical assessment.ConclusionWe found that studies on non-specific LBP agreed in general on which symptoms and signs constitute a case definition, while considerable heterogeneity was found for the other MSDs. For prevention of work-related MSDs, these MSD case definitions should preferably include work-related exposure criteria.
Highlights
The aim of this study was to identify case definitions of diagnostic criteria for specific musculoskeletal disorders (MSDs) for use in occupational healthcare, surveillance or research
Because this scoping review serves as a basis for further research leading to the development of an overall framework for consensus criteria regarding the clinical assessment of work-related MSDs and for reaching consensus on case definitions used in occupational cohort studies, we were only interested in recent insights
For lateral and medial elbow tendinopathy work-related exposure criteria included: extreme flexion of the elbow, posture with extended elbows, posture with extreme pronation or supination of the elbow, high repetition of movements of the elbow, grasping or lifting of objects with high forces and/or combination of postures, movements and forces [7]. In this scoping review, we found that studies on nonspecific low back pain (LBP), agreed in general on which symptoms and signs constitute a case definition, while considerable heterogeneity was found for the other MSDs
Summary
The aim of this study was to identify case definitions of diagnostic criteria for specific musculoskeletal disorders (MSDs) for use in occupational healthcare, surveillance or research. As reported by Verbeek in 2012, a case definition consists of a minimum set of symptoms, signs and other data that are needed to establish a diagnosis [3], which can be used in clinical care, health surveillance or research. This variation in case definitions hinders comparison between studies and prevents the combining of studies in meta-analyses. One of its goals is to harmonise occupational exposure and health outcome information For this reason, we aimed to harmonise case definitions of MSDs in occupational cohort studies
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