Abstract : OBJECTIVE To assess the course of nonspecific work-related upper limb disorders (WRULD) and the inf
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Abstract : 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.|
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