The influence of work and treatment related factors on clinical status and disability in patients with non-specific work-related upper limb disorders
Objective: To assess the influence of work- and treatment-related factors on clinical status and functional disability in patients with non-specific work-related upper limb disorders (WRULD). Participants: 182 computer workers with non-specific WRULD, 18–50 years old, not having specific WRULD nor incomplete medical records. Methods: Retrospective cohort study among computer workers with non-specific WRULD; average follow-up 4 years. Medical records at time of diagnosis and during treatment period and a follow-up questionnaire were used. Setting: Outpatient department of Rehabilitation Medicine, University Hospital Maastricht. Outcome measures: Non-specific WRULD (clinical status) and Disabilities of Arm, Shoulder and Hand (DASH) at follow-up. Results: 103 patients (57%) returned the questionnaire. Of these, 14% developed a chronic pain syndrome, 9% recovered, 77% worsened slightly. None of the selected work- and treatment-related factors were significantly associated with clinical status. "Number of working hours per week before diagnosis" was negatively (b=−0.66, p=0.00) and "other therapies during treatment" (b=8.76, p=0.02) positively associated with DASH. Conclusions: Computer workers with non-specific WRULD have a poor prognosis. Working more hours before diagnosis seems not predictive for disability while having undergone other therapies during treatment period does. Prospective cohort studies are recommended to unravel the associations found.