Disorders Of Upper Extremity Research Articles

Psychometric properties of the global rating of change scales in patients with low back pain, upper and lower extremity disorders. A systematic review with meta-analysis

ObjectiveThe purpose of this systematic review was to critically appraise and synthesize the psychometric properties of the Global Rating of Change (GRoC) scales on the assessment of patients with low back pain (LBP), upper extremity and lower extremity disorders. MethodsA search was performed in 4 databases (MEDLINE, EMBASE, CINAHL, SCOPUS) until February 2019. Eligible articles were appraised using Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) checklist and the Quality Appraisal for Clinical Measurement Research Reports Evaluation Form. ResultsThe 8 eligible studies included participants with orthopedic lumbar spine impairments (n = 52,767), patients with work-related musculoskeletal disorders (n = 1944), patients with low back pain (n = 183) and individuals with upper extremity disorders (n = 151). Risk of bias was ranging from “adequate” to “very good” and quality was found excellent for all studies. Based on pooled data, test-retest reliability of 11-item GRoC for patients with low back pain was found excellent ICC = 0.84, 95% CI: 0.65 to 0.94. Test-retest reliability in patients with shoulder pain was found fair to good ICC of 0.62 in a 15-point GRoC scale. Seven studies (n = 7) examined the convergent validity between GRoC and another outcome measure. Minimum important change on the Portuguese version of Global Perceived Effect (GPE) for patients with LBP was 2.5 points out of 11 points. ConclusionsThe current pool of clinical measurement studies indicates that the GRoC has excellent test-retest reliability for patients with low back pain, shoulder pain and with lumbar spine disorders. However, the validity of it as a reference standard in responsiveness studies or as an accurate overall assessment of change has been questioned. While future studies might provide more insight into its measurement properties, this limitation is unlikely to change. Therefore, we suggest that future responsiveness in the studies that want a global indicator measure need to use an additional measure to mitigate recall bias. Prospero registration numberCRD 42020149122.

Association between upper extremity dysfunction and sleep disturbance in an elderly general population.

Objective:Several upper extremity disorders are associated with sleep disturbance in patient populations. This study evaluated the relation between self-assessment of upper extremity function and sleep disturbance in an elderly general population.Methods:A total of 159 participants (56 men, 103 women, 38–88 years old, mean age of 66.4 years) completed a self-administered questionnaire including items for sex, weight, height, and dominant hand. Upper extremity dysfunction was investigated using Quick Disabilities of the Arm, Shoulder, and Hand of the Japanese Society for Surgery of the Hand. The sleep disturbance severity was evaluated using a Japanese version of the Athens Insomnia Scale. Quality of life was assessed using the EuroQol-5-dimension-3-level, Japanese version. We measured the bilateral hand grip as an indicator of hand muscle function. Statistical tests were applied to clarify the association between upper extremity dysfunction and screening results for sleep disturbance.Results:Of 159 participants, 45 (28.3%) had sleep disturbance as assessed using Japanese version of the Athens Insomnia Scale (11 men and 34 women; mean age of 68.1 years). Japanese version of the Athens Insomnia Scale scores correlated with the EuroQol index; EuroQol visual analog scale; and Quick Disabilities of the Arm, Shoulder, and Hand scores. The Quick Disabilities of the Arm, Shoulder, and Hand score and dominant grip strength of the participants with sleep disturbance were significantly higher than those of the no sleep disturbance group. The EuroQol index score and visual analog scale of those reporting a sleep disturbance were significantly lower than those of the no sleep disturbance group.Conclusion:Self-administered upper extremity health condition as assessed using Quick Disabilities of the Arm, Shoulder, and Hand correlated with sleep disturbance. Our results suggest a link between upper extremity conditions and sleep disturbance.

Interference of the Carpal Tunnel syndrome symptoms on occupational performance

ABSTRACT BACKGROUND AND OBJECTIVES: The Carpal Tunnel syndrome is characterized as the compression syndrome with the highest incidence in the population, impairing the upper limbs and, consequently, occupational performance. The objective of this study was to identify the symptoms of the compression syndrome and the impact of the disease on upper extremity disorders in relation to occupational performance. METHODS: This is a quantitative study with a descriptive approach, conducted with adults, both male and female, diagnosed with Carpal Tunnel syndrome. There was an initial evaluation to identify pain, edema, paresthesia, sensitivity alteration, and muscle weakness. The Disabilities of the Arm, Shoulder and Hand was used to assess the performance of fine motor activities as well as broader movements that require motor skills. This study used only the part of the instrument that evaluates the severity of symptoms concerning the week before the interview and other implications as pain, discomfort and weakness, difficulty in moving the upper limb, and to sleep. RESULTS: Fifteen adults diagnosed with the Carpal Tunnel syndrome participated in this study (27 affected limbs), being the dominant side the most undermined. The main complaint was pain, with higher intensity at night, followed by paresthesia. The Carpal Tunnel syndrome also compromises occupational performance, especially in activities using hands, and in sleep quality. CONCLUSION: It was noticed that the Carpal Tunnel syndrome interferes with occupational performance, as well as that pain is the main complaint.

Exposure to heavy physical work from early to later adulthood and primary healthcare visits due to musculoskeletal diseases in midlife: a register linked study

ObjectivesTo examine whether exposure to heavy physical work from early to later adulthood is associated with primary healthcare visits due to cause-specific musculoskeletal diseases in midlife.DesignProspective cohort study.SettingNationally representative Young...

Relationships and Mechanisms Between Occupational Risk Factors and Distal Upper Extremity Disorders.

The relationships between workplace risk factors and upper extremity injuries from epidemiological and laboratory studies were examined. Epidemiological studies are associated with several limitations, affecting the strength of association between risk factors and the development of injuries. In this narrative review, we identified epidemiological and laboratory studies (published primarily since 1997) investigating exposure to workplace risk factors (force, repetition, posture, vibration) and risk of hand/wrist tendon-related disorders, epicondylitis, and carpal tunnel syndrome (CTS). Forceful exertions are strongly associated with hand/wrist tendon-related disorders, epicondylitis, and CTS. Dose-response relationships were found for epicondylitis (repetition) and CTS (posture). Interactions demonstrate multiplicative effects of risk factors for injury risk. Laboratory studies display clear associations between task demands and biomechanical measures linked to mechanisms for upper extremity injuries with animal models providing further evidence of a dose-response between risk factors and injury. Forceful, repetitive work requiring non-neutral postures are associated with increasing risk of hand/wrist tendon-related disorders, epicondylitis, and CTS as evidenced by epidemiology studies and laboratory-based investigations of humans and animals. Understanding the relationship between exposure levels of workplace risk factors and upper extremity disorders can improve injury prevention and rehabilitation strategies.

Awareness of limited joint mobility in type 2 diabetes in general practice in the Netherlands: an online questionnaire survey

BackgroundNext to the well-known micro- and macrovascular complications, type 2 diabetes mellitus (T2DM) is associated with musculoskeletal disorders of the upper extremities referred to as limited joint mobility (LJM), e.g. carpal tunnel syndrome (CTS) and adhesive capsulitis. Unrecognized and untreated LJM can lead to poor quality of life and non-compliance to diabetes treatment which aggravates LJM. Despite its reported higher prevalence in international prevalence studies, examination of the upper extremities is still no part of the regular diabetes mellitus (DM) check-ups. The primary aim of this study was therefore to evaluate the awareness of Dutch GPs and nurse practitioners concerning LJM. Secondary aims were to evaluate the current management of a patient with LJM, and to assess opinions regarding the question of who should screen for LJM if this is done in the near future.MethodsAn online survey was conducted among 390 general practitioners (GPs) and 245 nurse practitioners (NPs) of three diabetes care groups in The Netherlands to assess their awareness of the association between DM and LJM.ResultsMost GPs are not aware that LJM is a DM complication, with an unawareness for specific upper extremity disorders ranging from 59 to 73%. Of the NPs, 76% is not aware either. Only 41% of GPs would advise the most optimal treatment for diabetes patient with CTS. Finally, only 25% of the GPs believe that screening for LJM should be performed during the regular diabetes check-up compared to 63% of the NPs.ConclusionThe majority of GPs and NPs are not aware of LJM as a T2DM complication. In contrast to NPs, most GPs do not believe that screening for LJM should be performed during the regular diabetes check-up.

Workplace Interventions can Reduce Sickness Absence for Persons With Work-Related Neck and Upper Extremity Disorders: A One-Year Prospective Cohort Study.

The objective of this study was to investigate whether workplace interventions are effective in reducing sickness absence in persons with work-related neck and upper extremity disorders and whether disorder improvement after intervention reduces sickness absence. This study was a prospective cohort study of workers with work-related neck pain or upper extremity disorders. Data were obtained from the Swedish "Work-related disorders" and "Work environment" surveys. Register data on sickness-absence 1 year after the surveys were made and obtained from the Swedish health insurance database. A significant lower number of sickness-absence days were found for workers reporting improvement after intervention. The findings in this study suggest that workplace intervention can reduce sickness absence for workers with neck or upper extremity disorders only if the intervention improves the disorder. The interventions were most effective in reducing medium long sickness absence periods.

Postural and muscular adaptations to repetitive simulated work

Complex repetitive tasks are common in the workplace and have been associated with upper extremity disorders. The purpose of this study was to examine the progressive effects of highly repetitive work on joint kinematics and muscle activity of the trunk and upper extremity. Fifteen healthy men performed 60 one-minute cycles of 4 simulated automotive-related tasks. Electromyography of eight muscles and kinematics of the trunk and right upper extremity were collected. Data were analysed at 12-min intervals and divided into a complete work cycle. The time to complete the work cycle decreased by 6.3 s over the trials. Peak shoulder flexion decreased and peak elbow flexion increased during the work cycle. Muscle activity magnitude and variability was influenced by time during the repetitive tasks. This study found adaptations to highly repetitive but light work in only 1 h; redistributing muscle demands within the shoulder over time may reduce muscle fatigue development.Practitioner Summary: While the work was not strenuous, we were able to demonstrate muscular and postural adaptations in a single hour of simulated work. By evaluating both the whole work cycle and the sub-tasks, we aim to develop new methods for evaluating the risk of complex tasks in prolonged repetitive work.

What Role Does Positive Psychology Play in Understanding Pain Intensity and Disability Among Patients with Hand and Upper Extremity Conditions?

A large body of research shows that psychologic distress and ineffective coping strategies substantially contribute to more severe pain and increased physical limitations among patients with orthopaedic disorders. However, little is known about the relationship between positive psychology (constructs that enable individuals to thrive and adapt to challenges) and pain and physical limitations in this population. (1) Which positive-psychology factors (satisfaction with life, gratitude, coping through humor, resilience, mindfulness, and optimism) are independently associated with fewer upper-extremity physical limitations after controlling for the other clinical and demographic variables? (2) Which positive-psychology factors are independently associated with pain intensity after controlling for relevant clinical and demographic variables? In a cross-sectional study, we recruited patients presenting for a scheduled appointment with an orthopaedic surgeon at a hand and upper-extremity clinic of a major urban academic medical center. Of 125 approached patients, 119 (44% men; mean age, 50 ± 17 years) met screening criteria and agreed to participate. Patients completed a clinical and demographic questionnaire, the Numerical Rating Scale to assess pain intensity, the Patient-reported Outcomes Measurement Information System (PROMIS) Upper Extremity Physical Function computerized adaptive test to assess physical limitations, and six measures assessing positive-psychology constructs: The Satisfaction with Life Scale, the Gratitude Questionnaire, the Coping Humor Scale, the Brief Resilience Scale, the Cognitive and Affective Mindfulness Scale-Revised, and the Life Orientation Test-Revised. We first examined bivariate associations among physical limitations, pain intensity, and all positive-psychology factors as well as demographic and clinical variables. All variables that demonstrated associations with physical limitations or pain intensity at p < 0.05 were included in two-stage multivariable hierarchical regression models. After controlling for the potentially confounding effects of prior surgical treatment and duration since pain onset (step1; R total = 0.306; F[7,103] = 6.50), the positive-psychology variables together explained an additional 15% (R change = 0.145, F change [5, 103] = 4.297, p = 0.001) of the variance in physical limitations. Among the positive-psychology variables tested, mindfulness was the only one associated with fewer physical limitations (β = 0.228, t = 2.293, p = 0.024, 4% variance explained). No confounding demographic or clinical variables were found for pain intensity in bivariate analyses. All positive-psychology variables together explained 23% of the variance in pain intensity (R = 0.23; F[5,106] = 6.38, p < 0.001). Among the positive-psychology variables, satisfaction with life was the sole factor independently associated with higher intensity (β = -0.237, t = -2.16, p = 0.033, 3% variance explained). Positive-psychology variables explained 15% of the variance in physical limitations and for 23% of the variance in pain intensity among patients with heterogenous upper extremity disorders within a hand and upper extremity practice. Of all positive-psychology factors, mindfulness and satisfaction with life were most important for physical limitations and pain intensity, respectively. As positive-psychology factors are more easily modifiable through skills-based interventions than pain and physical limitations, results suggest implementation of such interventions to potentially improve outcomes in this population. Skills-based interventions targeting mindfulness and satisfaction with life may be of particular benefit. Level II, prognostic study.

Risk Factors Associated with Upper Extremity Musculoskeletal Disorders among Barbers in Gondar Town, Northwest Ethiopia, 2018: A Cross-Sectional Study.

Background Work-related upper extremity musculoskeletal disorders (WUEDs) often present remarkable health and economic burdens on society. Occupational barbers are usually neglected both in research and policy actions, mainly in developing countries, and hence are likely subjected to the conditions. So far, information about factors that influence WUEDs among barbers in Ethiopia is inconclusive. Therefore, this study aimed to evaluate prevalence and factors associated with WUEDs among barbers in Gondar town, Ethiopia. Methods We conducted a cross-sectional study from March to April 2018. A sample of 424 participants were recruited using systematic random sampling technique. A standardized Nordic Musculoskeletal Questionnaire was pretested and interviewer-administered for data collection. The data were analyzed by SPSS version 20 software. We set statistical significances at <0.05 p value with 95% confidence intervals (CI) and computed odds ratios to evaluate strength of associations. Results The response rate was 98.3% (N=417). The mean age was 26.39 (SD + 4.805) years. The prevalence of upper extremity musculoskeletal disorders over the past 12 months was 56.8% (N=237). Upper back pain was observed in 38.8% (N=162) participants, whereas shoulder (27.1% (N=113)), neck pain and elbow/forearms (each 29.3% (N=122)), and wrists/hand disorders (32.4% (N=135)) were the common body sites indicated. Age (AOR: 2.614; 95% CI (1.287, 5.307)), alcohol use (AOR: 3.556; 95% CI (2.212, 5.717)), frequent standing (AOR: 1.536; 95% CI (1.006, 2.346)), physical exercises (AOR: 1.938; 95% CI (1.216, 3.089)), and low monthly salary (AOR: 3.125; 95% CI (1.157, 5.441)) were factors associated with work-related upper extremity disorders. Conclusions Work-related upper extremity disorder is common among hairdressing professionals. Worksite health promotions targeted to lifestyle behaviors, like physical exercise and alcohol consumption require urgent public health actions in Ethiopia. Moreover, adaption of flexible work postures and proper management of workplace conditions related to aging workforces are also imperative to trace the complaints.

Effectiveness of individualized physical rehabilitation programs for upper extremity disorders in women with post-mastectomy syndrome

Objective: The aim of this study was to determine the effectiveness of individualized physical rehabilitation programs targeted at improving functional state of upper extremity in women with post-mastectomy syndrome.&#x0D; Method: Eighty five women with late symptoms of post-mastectomy syndrome were enrolled in the study. The participants were randomly enrolled for the first individualized program (Main Group, n=45) and for the second individualized program (Comparison Group, n=40). The first program included aqua aerobics (aqua jogging, aqua building, aqua stretching), conditional swimming, and recreational aerobics; the second program included conditional swimming and Pilates exercises.&#x0D; Results: It was found that most of the investigated anthropometry and goniometry parameters in both groups steadily improved during the year of rehabilitation. After 6 months of rehabilitation the average values of active range of flexion and abduction were statistically higher in women Main Group compared with Comparison Group by 10 degrees (p&lt;0.001) and 6.43 degrees (p&lt;0.01), respectively. The severity of lymphedema in the Main Group was significantly lower at the area of forearm by 0.39 cm (p&lt;0.05) compared with Comparison Group.&#x0D; Conclusions: Findings have suggested that developed individualized physical rehabilitation programs could be considered as effective methods for improvement of the shoulder range of motion and decrease breast cancer-related lymphedema in patients with post-mastectomy syndrome.

Congenital and Pediatric Upper Extremity Disorders

Congenital and Pediatric Upper Extremity Disorders

Cheiroarthropathy: A Common Disorder in Patients in the T1D Exchange

Diabetic cheiroarthropathy is a long-term complication of diabetes that causes significant morbidity and can impair functional abilities. It has not been well studied in individuals with type 1 diabetes (T1D). The T1D Exchange registry provided an opportunity to assess the frequency of cheiroarthropathy and related characteristics. An internet-based survey was sent to 6,199 registry participants ≥18 years old, with 1,911 (31%) responding (62% female, 90% non-Hispanic White, mean age 40 years, median diabetes duration 20 years, mean glycated hemoglobin [HbA1c] 7.7% [61 mmol/mol]). A total of 586 (31%) adults reported a diagnosis of ≥1 upper extremity disorder: 293 (15%) reported frozen shoulder, 293 (15%) trigger finger, 261 (14%) carpal tunnel, and 92 (5%) Dupuytren contracture, with 281 (15%) reporting ≥2 disorders. Those with upper extremity joint disorders were more likely older ( P<.001) and had longer duration of diabetes ( P<.001) than those without. HbA1c levels at the time of survey completion were 7.6% in participants with cheiroarthropathy versus 7.8% (62 mmol/mol) in participants without cheiroarthropathy. Cheiroarthropathy is common in adults with T1D. Additional research is needed to understand the pathogenesis and risk factors for this disorder. Standards of care for early recognition and treatment of diabetic cheiroarthropathy are also needed, particularly for adults with long-term diabetes. Improved awareness of cheiroarthropathy signs and symptoms of is needed so that patients can be identified and seek treatment before the condition causes disability. BMI = body mass index; CGM = continuous glucose monitor; DCCT/EDIC = Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications; HbA1C = glycated hemoglobin; T1D = type 1 diabetes; T2D = type 2 diabetes.

Evaluation of ergonomic working conditions among standing sewing machine operators in Sri Lanka

BackgroundStanding Sewing Machine Operators (SSMOs) are engaged in highly repetitive operations, and work while standing during their entire working hours. This leads to discomforts and Musculoskeletal Disorders (MSDs). However, there is a dearth of research in SSMOs’ working conditions.Objective: Aim of the study is to evaluate the prevalence of MSDs and related ergonomic risk factors among SSMOs in the Sri Lankan textile industry.Methods: The sample included 552 female sewing machine operators. Data were collected through self-reported questionnaires which included demographic, job-related factors and Cornell Musculoskeletal Discomfort Questionnaire [CMDQ], along with the application of validated ergonomic tools (Rapid Entire Body Assessment [REBA] and Strain Index [SI]) to assess the ergonomic risks amongst them. The inter-rater reliability test ensured the reliability among observers. An individual regression model was developed for each body parts to assess the associated risk factors.Results: The highest occurrence of musculoskeletal symptoms were in knee, foot, thigh, lower leg and lower back of SSMOs. REBA grand score (4–11) indicated that workers’ postures were at medium, high and very high risk levels necessitating evaluation to change. Moreover, SI indicated medium and high risk of upper extremity disorders. Finally, regression models revealed associated risk factors with musculoskeletal symptoms among various body parts including age, Body Mass Index (BMI), marital status, SSMO experience, job satisfaction, job stress, daily walking distance to the boarding place/factory, interest in job rotation and satisfaction with the design of sewing machine.Conclusion: The findings highlighted that the prevalence of discomfort and MSDs in the lower limbs were higher than in the upper limbs among SSMOs. The findings revealed the working conditions of SSMO and emphasised the need for ergonomic interventions to minimise the MSDs among them. Relevance to industryThe findings highlighted ergonomic risks among SSMOs and associated risk factors which will help managers and researchers better understand the working conditions of SSMOs. The identified risk factors could be considered during the implementation of standing sewing operation layouts and during the selection and allocation of new employees.

The investigation of Relationship between Functional Disorders of Upper Extremity with Independence in Activities of Daily Living and Depression in Elderly

The investigation of Relationship between Functional Disorders of Upper Extremity with Independence in Activities of Daily Living and Depression in Elderly

Impact of Handedness on Disability After Unilateral Upper-Extremity Peripheral Nerve Disorder.

Background: Impairment of the dominant hand should lead to greater disability than impairment of the nondominant hand, but few studies have tested this directly, especially in the domain of upper-extremity peripheral nerve disorder. The aim of this study was to identify the association between hand dominance and standardized measures of disability and health status after upper-extremity peripheral nerve disorder. Methods: An existing database was reanalyzed to identify the relationship between affected-side (dominant vs nondominant) on individuals with unilateral upper-extremity peripheral nerve disorder (N = 400). Primary measure of disability was the Disabilities of the Arm, Shoulder, and Hand (DASH) questionnaire. Results: We found no differences in standardized measures of disability or health status between patients with affected dominant hand and patients with an affected nondominant hand. However, a post hoc exploratory analysis revealed that patients with an affected dominant hand reported substantially reduced ability to perform 2 activities in the DASH questionnaire: "write" and "turn a key." Conclusions: Following unilateral upper-extremity peripheral nerve disorder, impairment of the dominant hand (compared with impairment of the nondominant hand) is associated with reduced ability to perform specific activities, but this reduced ability is not reflected in standardized measures of disability and health status. To adequately identify disability following unilateral impairment of the dominant hand with the DASH, individual items must be used instead of the total score. New or alternative measures are also recommended.

Determining functional activity profiles in patients with upper extremity disorders: is there effect modification by hand-grip strength?

PurposeThe purposes of this study were to investigate the effect of hand-grip strength (HGS) on the Disabilities of the Arm, Shoulder, and Hand (DASH) score in women with upper extremity musculoskeletal disorders (UEMDs) living in rural communities and examine whether upper extremity diseases affected upper extremity functional activity in each group (normal/low HGS) and whether grip strength (GS) was an effect modifier in upper extremity functional activity.MethodsA total of 239 women older than 60 years who had completed a medical workup for epicondylitis, rotator cuff tears, and/or hand osteoarthritis were included in the final study. Functional activity was assessed by DASH, and muscle strength was measured by GS. Low HGS was defined according to the Asian Working Group for Sarcopenia (HGS <18 kg in women). Pearson correlation analysis was performed to evaluate the relationship between HGS and the DASH score. A multiple regression analysis was performed after defining DASH as a dependent variable and dividing subjects into two groups (low HGS and normal HGS). Statistical analyses were performed using SPSS Statistics V.24.ResultsHGS in the participants correlated with the DASH score (r=−0.320, P<0.001). In the low HGS group, waist circumference (B=−0.526, P=0.010) and the DASH score were significantly correlated. In addition, DASH scores were statistically significantly increased as the number of upper extremity diseases increased to 2 (B=11.592, P=0.016) and 3 (B=15.716, P=0.001). The DASH score in the normal HGS group was correlated with the Patient Health Questionnaire-2 score (β=2.680, P<0.001) after adjusting covariates.ConclusionWe found that HGS in UEMD patients affected health-related quality of life as measured by the DASH. Maintaining hand muscle strength may improve patient functional activity in age-related UEMDs.

Patient Experiences of Participating in Mind–Body Interventions in an Outpatient Rehabilitation Setting

Abstract Date Presented 4/20/2018 This study explored the experiences of eight patients with upper extremity disorders who participated in mind–body interventions in outpatient rehabilitation. Using a qualitative descriptive method, four themes emerged, alluding to multiple benefits of holistic practice. Primary Author and Speaker: Sandy Takata Contributing Authors: Shawn C. Roll

WHO disability assessment schedule 2.0 is related to upper and lower extremity disease-specific quality of life.

We evaluated whether two disease-specific quality of life instruments (Disabilities of the Arm, Shoulder and Hand, DASH and Western Ontario & McMaster Universities Osteoarthritis Index, WOMAC) reflect a patient's perception of general disability using the WHO Disability Assessment Schedule 2.0 (WHODAS 2.0) and determined whether disability components are explained by upper and lower extremity HRQOL. We recruited 421 participants, 50years or older without stroke, cancer, or history of surgery for musculoskeletal disease, who participated in the NAMGARAM Cohort. Upper extremity HRQOL was determined with the DASH score and lower extremity HRQOL with the WOMAC; as a measure of disability, we obtained WHODAS 2.0 component. Multiple regression modeling was used to assess the relative contributions made by upper and lower extremity HRQOL to disability. When adjusted for covariates, the DASH total score was correlated with getting around (β = 0.217, p < 0.001) and social participation (β = 0.226, p < 0.001), and the WOMAC total score was correlated with getting around (β = 0.363, p < 0.001), life activation (β = 0.363, p < 0.001), and social participation (β = 0.301, p < 0.001). QOL significantly correlated with upper extremity disorders (β = 0.081, p = 0.018) or lower extremity disorders (β = 0.095 p = 0.004). We found that in a community-based population, perceived activity limitation and social participation were associated with upper and lower extremity HRQOL. Since the WHODAS 2.0 does not target a specific disease (as opposed to DASH and WOMAC), it can be used to compare disabilities caused by different diseases.

WOrk-Related Questionnaire for UPper extremity disorders (WORQ-UP): Factor Analysis and Internal Consistency

ObjectiveTo test a 17-item questionnaire, the WOrk-Related Questionnaire for UPper extremity disorders (WORQ-UP), for dimensionality of the items (factor analysis) and internal consistency. DesignCross-sectional study. SettingOutpatient clinic. ParticipantsA consecutive sample of patients (N=150) consisting of all new referral patients (either from a general physician or other hospital) who visited the orthopedic outpatient clinic because of an upper extremity musculoskeletal disorder. InterventionsNot applicable. Main Outcome MeasuresNumber and dimensionality of the factors in the WORQ-UP.Results: Four factors with eigenvalues (EVs) >1.0 were found. The factors were named exertion, dexterity, tools & equipment, and mobility. The EVs of the factors were, respectively, 5.78, 2.38, 1.81, and 1.24. The factors together explained 65.9% of the variance. The Cronbach alpha values for these factors were, respectively, .88, .74, .87, and .66. ConclusionsThe 17 items of the WORQ-UP resemble 4 factors—exertion, dexterity, tools & equipment, and mobility—with a good internal consistency.