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Published in:

01-03-2016

Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders

Authors: Bethany T. Gardner, Ann Marie Dale, Skye Buckner-Petty, Robert Rachford, Jaime Strickland, Vicki Kaskutas, Bradley Evanoff

Published in: Journal of Occupational Rehabilitation | Issue 1/2016

Abstract

Purpose Few studies have explored measures of function across a range of health outcomes in a general working population. Using four upper extremity (UE) case definitions from the scientific literature, we described the performance of functional measures of work, activities of daily living, and overall health. Methods A sample of 573 workers completed several functional measures: modified recall versions of the QuickDASH, Levine Functional Status Scale (FSS), DASH Work module (DASH-W), and standard SF-8 physical component score. We determined case status based on four UE case definitions: (1) UE symptoms, (2) UE musculoskeletal disorders (MSD), (3) carpal tunnel syndrome (CTS), and (4) work limitations due to UE symptoms. We calculated effect sizes for each case definition to show the magnitude of the differences that were detected between cases and non-cases for each case definition on each functional measure. Sensitivity and specificity analyses showed how well each measure identified functional impairments across the UE case definitions. Results All measures discriminated between cases and non-cases for each case definition with the largest effect sizes for CTS and work limitations, particularly for the modified FSS and DASH-W measures. Specificity was high and sensitivity was low for outcomes of UE symptoms and UE MSD in all measures. Sensitivity was high for CTS and work limitations. Conclusions Functional measures developed specifically for use in clinical, treatment-seeking populations may identify mild levels of impairment in relatively healthy, active working populations, but measures performed better among workers with CTS or those reporting limitations at work.

World Health Organization. The International Classification of Functioning, Disability, and Health. Geneva: World Health Organization; 2001.

Stewart WF, Ricci JA, Chee E, Morganstein D, Lipton R. Lost productive time and cost due to common pain conditions in the US workforce. JAMA. 2003;290(18):2443–54. doi:10.1001/jama.290.18.2443.CrossRefPubMed

Tang K, Pitts S, Solway S, Beaton D. Comparison of the psychometric properties of four at-work disability measures in workers with shoulder or elbow disorders. J Occup Rehabil. 2009;19(2):142–54. doi:10.1007/s10926-009-9171-6.CrossRefPubMed

Amick BC, Lerner D, Rogers WH, Rooney T, Katz JN. A review of health-related work outcome measures and their uses, and recommended measures. Spine. 2000;25(24):3152–60.CrossRefPubMed

Beaton DE, Kennedy CA. Beyond return to work: testing a measure of at-work disability in workers with musculoskeletal pain. Qual Life Res. 2005;14(8):1869–79. doi:10.1007/s11136-005-3865-9.CrossRefPubMed

Lofland JH, Pizzi L, Frick KD. A review of health-related workplace productivity loss instruments. Pharmacoeconomics. 2004;22(3):165–84. doi:10.2165/00019053-200422030-00003.CrossRefPubMed

Loeppke R, Hymel PA, Lofland JH, Pizzi LT, Konicki DL, Anstadt GW, et al. Health-related workplace productivity measurement: general and migraine-specific recommendations from the ACOEM expert panel. J Occup Environ Med. 2003;45(4):349–59.CrossRefPubMed

Schultz IZ, Stowell AW, Feuerstein M, Gatchel RJ. Models of return to work for musculoskeletal disorders. J Occup Rehabil. 2007;17(3):327–52. doi:10.1007/s10926-007-9071-6.CrossRefPubMed

Terwee CB, Bot SDM, de Boer MR, van der Windt DAWM, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol. 2007;60(1):34–42. doi:10.1016/j.jclinepi.2006.03.012.CrossRefPubMed

10.

Mokkink LB, Terwee CB, Knol DL, Stratford PW, Alonso J, Patrick DL, et al. Protocol of the COSMIN study: COnsensus-based Standards for the selection of health Measurement INstruments. BMC Medical Research Methodology. 2006;. doi:10.1186/1471-2288-6-2.PubMedCentralPubMed

11.

Beaton DE, Katz JN, Fossel AH, Wright JG, Tarasuk V, Bombardier C. Measuring the whole or the parts? Validity, reliability, and responsiveness of the Disabilities of the Arm, Shoulder and Hand outcome measure in different regions of the upper extremity. Hand Ther. 2001;14(2):128–46. doi:10.1016/S0894-1130(01)80043-0.CrossRef

12.

Levine DW, Simmons BP, Koris MJ, Daltroy LH, Hohl GG, Fossel AH, et al. A self-administered questionnaire for the assessment of severity of symptoms and functional status in carpal tunnel syndrome. J Bone Joint Surg Am. 1993;75(11):1585–92.PubMed

13.

Stratford PW, Kennedy DM, Hanna SE. Condition-specific Western Ontario McMaster Osteoarthritis Index was not superior to region-specific Lower Extremity Functional Scale at detecting change. J Clin Epidemiol. 2004;57(10):1025–32. doi:10.1016/j.jclinepi.2004.03.008.CrossRefPubMed

14.

Kennedy CA, Beaton DE, Smith P, Van Eerd D, Tang K, Inrig T, et al. Measurement properties of the QuickDASH (Disabilities of the Arm, Shoulder and Hand) outcome measure and cross-cultural adaptations of the QuickDASH: a systematic review. Qual Life Res. 2013;22(9):2509–47. doi:10.1007/s11136-013-0362-4.CrossRefPubMed

15.

Beaton DE, Wright JG, Katz JN, Group UEC. Development of the QuickDASH: comparison of three item-reduction approaches. J Bone Joint Surg Am. 2005;87(5):1038–46. doi:10.2106/JBJS.D.02060.CrossRefPubMed

16.

Mehta S, MacDermid JC, Carlesso LC, McPhee C. Concurrent validation of the DASH and the QuickDASH in comparison to neck-specific scales in patients with neck pain. Spine. 2010;35(24):2150–6. doi:10.1097/BRS.0b013e3181c85151.CrossRefPubMed

17.

Mintken PE, Glynn P, Cleland JA. Psychometric properties of the shortened disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) and Numeric Pain Rating Scale in patients with shoulder pain. J Shoulder Elbow Surg. 2009;18(6):920–6. doi:10.1016/j.jse.2008.12.015.CrossRefPubMed

18.

Niekel MC, Lindenhovius AL, Watson JB, Vranceanu AM, Ring D. Correlation of DASH and QuickDASH with measures of psychological distress. J Hand Surg Am. 2009;34(8):1499–505. doi:10.1016/j.jhsa.2009.05.016.CrossRefPubMed

19.

Fan ZJ, Smith CK, Silverstein BA. Assessing validity of the QuickDASH and SF-12 as surveillance tools among workers with neck or upper extremity musculoskeletal disorders. Hand Ther. 2008;21(4):354–65. doi:10.1197/j.jht.2008.02.001.CrossRef

20.

Fan ZJ, Smith CK, Silverstein BA. Responsiveness of the QuickDASH and SF-12 in workers with neck or upper extremity musculoskeletal disorders one-year follow-up. J Occup Rehabil. 2011;21(2):234–43. doi:10.1007/s10926-010-9265-1.CrossRefPubMed

21.

Stover B, Silverstein B, Wickizer TM, Martin DP, Kaufman J. Accuracy of a disability instrument to identify workers likely to develop upper extremity musculoskeletal disorders. J Occup Rehabil. 2007;17:227–45. doi:10.1007/s10926-007-9083-2.CrossRefPubMed

22.

House R, Wills M, Liss G, Switzer-McIntyre S, Lander L, Jiang D. DASH work module in workers with hand–arm vibration syndrome. Occup Med Oxford. 2012;62(6):448–50. doi:10.1093/occmed/kqs135.CrossRef

23.

Kitis A, Celik E, Aslan UB, Zencir M. DASH questionnaire for the analysis of musculoskeletal symptoms in industry workers: a validity and reliability study. Appl Ergon. 2009;40:251–5. doi:10.1016/j.apergo.2008.04.005.CrossRefPubMed

24.

Dale AM, Gardner B, Buckner-Petty S, Kaskutas V, Strickland J, Evanoff B. Responsiveness of a 1-year recall modified DASH Work module in active workers with upper extremity musculoskeletal symptoms. J Occup Rehabil. 2015;. doi:10.1007/s10926-015-9571-8.

25.

de Carvalho Leite JC, Jerosch-Herold C, Song F. A systematic review of the psychometric properties of the Boston Carpal Tunnel Questionnaire. BMC Musculoskelet Disord. 2006;7:78. doi:10.1186/1471-2474-7-78.CrossRef

26.

Ware JE, Kosinski M, Dewey JE, Gandek B. How to score and interpret single-item health status measures: a manual for users of the SF-8 Health Survey. Lincoln: QualityMetric Incorporated; 2001.

27.

Turner-Bowker DM, Bayliss MS, Ware JE, Kosinski M. Usefulness of the SF-8 Health Survey for comparing the impact of migraine and other conditions. Qual Life Res. 2003;12(8):1003–12. doi:10.1023/A:1026179517081.CrossRefPubMed

28.

Salerno DF, Copley-Merriman C, Taylor TN, Shinogle J, Schulz RM. A review of functional status measures for workers with upper extremity disorders. J Occup Environ Med. 2002;59(10):664–70. doi:10.1136/oem.59.10.664.CrossRef

29.

Evanoff BA, Dale AM, Descatha A. A conceptual model of musculoskeletal disorders for occupational health practitioners. Int J Occup Med Environ Health. 2014;27(1):145–8. doi:10.2478/s13382-014-0232-5.PubMedCentralCrossRefPubMed

30.

Beaton D, Cole D, Manno M, Bombardier C, Hogg-Johnson S, Shannon H. Describing the burden of upper-extremity musculoskeletal disorders in newspaper workers: what difference do case definitions make? J Occup Rehabil. 2000;10(1):39–53. doi:10.1023/A:1009489712094.CrossRef

31.

Sluiter JK, Rest KM, Frings-Dresen MH. Criteria document for evaluating the work-relatedness of upper-extremity musculoskeletal disorders. Scand J Work Environ Health. 2001;27(Suppl 1):1–102. doi:10.5271/sjweh.637.CrossRefPubMed

32.

Gardner BT, Dale AM, Vandillen L, Franzblau A, Evanoff BA. Predictors of upper extremity symptoms and functional impairment among workers employed for 6 months in a new job. Am J Ind Med. 2008;51(12):932–40. doi:10.1002/ajim.20625.CrossRefPubMed

33.

Johnson AM, Dale AM, Strickland JR, Venditti P, Evanoff BA. Employers’ concerns regarding research participation. Int J Occup Environ Health. 2008;14(1):11–7. doi:10.1179/oeh.2008.14.1.11.CrossRefPubMed

34.

Armstrong T, Dale A, Franzblau A, Evanoff B. Risk factors for carpal tunnel syndrome and median neuropathy in a working population. J Occup Environ Med. 2008;50(12):1355–64. doi:10.1097/JOM.0b013e3181845fb1.CrossRefPubMed

35.

Dale AM, Descatha A, Coomes J, Franzblau A, Evanoff B. Physical examination has a low yield in screening for carpal tunnel syndrome. Am J Ind Med. 2011;54(1):1–9. doi:10.1002/ajim.20915.PubMedCentralCrossRefPubMed

36.

Armstrong TN, Dale AM, Al-Lozi MT, Franzblau A, Evanoff BA. Median and ulnar nerve conduction studies at the wrist: criterion validity of the NC-stat automated device. J Occup Environ Med. 2008;50(7):758–64. doi:10.1097/JOM.0b013e3181645425.CrossRefPubMed

37.

Evanoff B, Zeringue A, Franzblau A, Dale AM. Using job-title-based physical exposures from O*NET in an epidemiological study of carpal tunnel syndrome. Hum Factors. 2014;56(1):166–77. doi:10.1177/0018720813496567.PubMedCentralCrossRefPubMed

38.

Dale A, Agboola F, Yun A, Zeringue A, Al-Lozi M, Evanoff B. Comparison of automated versus traditional nerve conduction study methods for median nerve testing in a general worker population. PM R. 2015;7(3):276–82. doi:10.1016/j.pmrj.2014.10.003.CrossRefPubMed

39.

Gummesson C, Ward MM, Atroshi I. The shortened disabilities of the arm, shoulder, and hand questionnaire (QuickDASH): validity and reliability based on responses within the full-length DASH. BMC Musculoskelet Disord. 2006. doi:10.1186/1471-2474-7-44.

40.

Beaton DE, Tang K, Gignac MAM, Lacaille D, Badley EM, Anis AH, et al. Reliability, validity, and responsiveness of five at-work productivity measures in Patients with rheumatoid arthritis or osteoarthritis. Arthritis Care Res. 2010;62(1):28–37. doi:10.1002/acr.20011.CrossRef

41.

Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29(6):602–8. doi:10.1002/(SICI)1097-0274(199606)29:6<602:AID-AJIM4>3.0.CO;2-L.CrossRefPubMed

42.

Institute for Work and Health. The QuickDASH outcome measure: information for users. Toronto: Institute for Work and Health; 2006.

43.

Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sørensen F, Andersson G, et al. Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon. 1987;18(3):233–7. doi:10.1016/0003-6870(87)90010-X.CrossRefPubMed

44.

Rempel D, Evanoff B, Amadio PC, de Krom M, Franklin G, Franzblau A, et al. Consensus criteria for the classification of carpal tunnel syndrome in epidemiologic studies. Am J Public Health. 1998;88(10):1447–51. doi:10.2105/AJPH.88.10.1447.PubMedCentralCrossRefPubMed

45.

Dale AM, Harris-Adamson C, Rempel D, Gerr F, Hegmann K, Silverstein B, et al. Prevalence and incidence of carpal tunnel syndrome in US working populations: pooled analysis of six prospective studies. Scand J Work Environ Health. 2013;39(5):495–505. doi:10.5271/sjweh.3351.PubMedCentralCrossRefPubMed

46.

Calfee RP, Dale AM, Ryan D, Descatha A, Franzblau A, Evanoff B. Performance of simplified scoring systems for hand diagrams in carpal tunnel syndrome screening. J Hand Surg Am. 2012;37A(1):10–7. doi:10.1016/j.jhsa.2011.08.016.CrossRef

47.

Silverstein BA, Fan ZJ, Bonauto DK, Bao S, Smith CK, Howard N, et al. The natural course of carpal tunnel syndrome in a working population. Scand J Work Environ Health. 2010;36(5):384–93. doi:10.5271/sjweh.2912.CrossRefPubMed

48.

Franzblau A, Salerno DF, Armstrong TJ, Werner RA. Test–retest reliability of an upper-extremity discomfort questionnaire in an industrial population. Scand J Work Environ Health. 1997;23(4):299–307. doi:10.5271/sjweh.223.CrossRefPubMed

49.

Salerno DF, Franzblau A, Armstrong TJ, Werner RA, Becker MP. Test–retest reliability of the Upper Extremity Questionnaire among keyboard operators. Am J Ind Med. 2001;40(6):655–66. doi:10.1002/ajim.10024.CrossRefPubMed

50.

Gardner BT, Dale AM, Descatha A, Evanoff B. Natural history of upper extremity musculoskeletal symptoms and resulting work limitations over 3 years in a newly hired working population. J Occup Environ Med. 2014;56(6):588–94. doi:10.1097/JOM.0000000000000179.PubMedCentralCrossRefPubMed

51.

Taylor R. Interpretation of the correlation coefficient: a basic review. J Diagn Sonogr. 1990;6(1):35–9. doi:10.1177/875647939000600106.CrossRef

52.

Institute for Work and Health. The DASH and QuickDASH outcome measures e-bulletin. Toronto: Institute for Work and Health; 2012.

53.

Franchignoni F, Vercelli S, Giordano A, Sartorio F, Bravini E, Ferriero G. Minimal clinically important difference of the disabilities of the arm, shoulder and hand outcome measure (DASH) and its shortened version (QuickDASH). Orthop Sports Phys Ther. 2014;44(1):30–9. doi:10.2519/jospt.2014.4893.CrossRef

54.

Stepan JG, London DA, Boyer MI, Calfee RP. Accuracy of patient recall of hand and elbow disability on the QuickDASH questionnaire over a two-year period. J Bone Joint Surg Am. 2013;95-A(22):e176(1–8). doi:10.2106/JBJS.L.01485.

55.

Jester A, Harth A, Germann G. Measuring levels of upper-extremity disability in employed adults using the DASH Questionnaire. J Hand Surg Am. 2005;30(5):1074.e1–10. doi:10.1016/j.jhsa.2005.04.009.CrossRef

56.

Changulani M, Okonkwo U, Keswani T, Kalairajah Y. Outcome evaluation measures for wrist and hand-which one to choose? Int Orthop. 2008;32(1):1–6. doi:10.1007/s00264-007-0368-z.PubMedCentralCrossRefPubMed

57.

Norquist JM, Girman C, Fehnel S, DeMuro-Mercon C, Santanello N. Choice of recall period for patient-reported outcome (PRO) measures: criteria for consideration. Qual Life Res. 2012;21:1013–20. doi:10.1007/s11136-011-0003-8.CrossRefPubMed

58.

Keller SD, Bayliss MS, Ware JE, Hsu MA, Damiano AM, Goss TF. Comparison of responses to SF-36 Health Survey questions with one-week and four-week recall periods. Health Serv Res. 1997;32(3):367–84.PubMedCentralPubMed

59.

Stull DE, Leidy NK, Parasuraman B, Chassany O. Optimal recall periods for patient-reported outcomes: challenges and potential solutions. Curr Med Res Opin. 2009;25(4):929–42. doi:10.1185/03007990902774765.CrossRefPubMed

Title: Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders
Authors: Bethany T. Gardner
Ann Marie Dale
Skye Buckner-Petty
Robert Rachford
Jaime Strickland
Vicki Kaskutas
Bradley Evanoff
Publication date: 01-03-2016
Publisher: Springer US
Published in: Journal of Occupational Rehabilitation / Issue 1/2016
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI: https://doi.org/10.1007/s10926-015-9591-4

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Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders

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