To study the usefulness of a screening questionnaire for neck/upper extremity complaints, 165 women in either repetitive industrial, or mobile and varied work, were studied by the questionnaire and by a detailed clinical physical examination. A total of 94 subjects recorded complaints in the questionnaire. In 140 subjects findings were recorded at the examination. Most subjects with findings at the clinical examination of shoulders reported complaints in the questionnaire (sensitivity 80%). For the other anatomical regions, the sensitivity was rather low (42-65%). For all regions, most subjects without findings reported no complaints (specificity 77-97%). A total of 75 subjects were given clinical diagnoses according to a set of predetermined diagnostic criteria. The capacity of the questionnaire to identify diagnoses of shoulders was higher (sensitivity 92%) than for the other regions (66-79%). Of subjects who did not qualify for diagnosis, a majority (specificity 71-81%) did not report complaints in the questionnaire. We conclude that the questionnaire approach gives a fairly good picture of the neck/upper extremity status of a working female population. However, a clear view of the size of a problem is obtained only by a detailed clinical examination, particularly as regards the neck, elbows and hands, for which the questionnaire gave an underestimate.

Dental personnel had an increased risk of developing musculoskeletal disorders as verified by symptoms and diagnoses and more painful or persistent conditions. This led to a selection out of work. The questionnaire and the present pain rating gave a relatively good picture of the prevalence of musculoskeletal disorders arising from the neck, shoulders, and hips and would be useful as screening tools. Their sensitivity in detecting disorders was higher for diagnoses than for findings. However, these methods were not as sensitive for disorders involving the elbows/wrists/hands. Physical examinations gave more detailed information.

A cross-sectional study was performed in which physical examinations of the neck and upper limbs were conducted on 82 currently working female industrial workers with exposure to repetitive work tasks and on 64 currently working referent subjects without exposure to repetitive work tasks. Associations between results of symptom questions and physical examination were sought with variables related to the work environment and to the individuals. In a multivariate model, there were statistically significant associations between exposure to repetitive work and diagnoses in both the neck/shoulders (prevalence odds ratio, POR = 4.6) and elbows/hands (POR = 3.5). In addition, age (POR = 1.9, 75th vs. 25th percentiles), tendencies towards subjective muscular tension (POR = 2.3), and stress/worry (POR = 1.9) were also associated with diagnoses in the neck/shoulders; however, there was not an association between these variables and the prevalence of diagnoses in elbows/hands. Standardized evaluation of videotape recordings in 74 of the industrial workers revealed significant associations between neck flexion, and elevation and abduction of the arm and the prevalence of neck/shoulder diagnoses. In the multivariate model, neck flexion was significantly associated with diagnoses in the neck/shoulders (p = 0.005). In addition, low muscle strength, lack of emotional well-being at work, and a variety of psychosomatic symptoms were associated with diagnoses in the neck/shoulders (all p < 0.001). Lack of strength was also associated with disorders of elbows/hands (p = 0.007). This study demonstrated a substantial prevalence of neck and upper limb disorders associated with repetitive work performed with a flexed neck and elevated and abducted arms, as well as a possible potentiation of these ergonomic factors by certain personal traits in some workers.

To explore milkers' state of health with regard to symptoms in the wrists and hands, a study of 80 female milkers was carried out 12 months after a Nordic questionnaire study of these subjects. Of these 80, 41 had reported pain and discomfort in the wrists and hands at the time of the questionnaire study, whereas the remaining 39 had had no such symptoms. To determine the sensitivity and specificity of the Nordic questionnaire, the follow-up study included examination by an unbiased clinician. The occurrence of symptoms in the wrists and hands during the preceding 12 months was found to have been rather stable-30 of the 41 milkers still reported pain, aching, and discomfort, and eight new cases were recorded. On clinical examination, symptoms including numbness, tingling, and coldness in the forearms and hands were reported by 51 of the 80 milkers, 14 of whom had clinical symptoms and signs indicating median nerve entrapment. Peritendinitis was diagnosed in four subjects and a ganglion cyst in one. The findings in the remaining group did not meet diagnostic criteria. All subjects with wrist and hand symptoms were still at work a year after the initial study. The sensitivity of the Nordic questionnaire when it came to identifying subjects with clinical findings was found to be unsatisfactory. The actual incidence of wrist and hand disorders may be underestimated if the Nordic questionnaire is used as the only instrument in epidemiologic screenings.

The aim of the investigation was to compare dentists with and without occupational cervico-brachial disorders with regard to some psychosocial variables (work environment, personal harmony and life-satisfaction) and professional position. The investigation is based on a questionnaire sent to 143 randomly selected official dentists in Malmöhus District and the Municipality of Malmö. Of these, 96 dentists had symptoms while 47 had not. Dentists with symptoms showed less satisfaction with their work environment than dentists without. Those with symptoms experienced their work load as being more unsatisfactory, were more burdened by anxiety, had poorer psychosomatic health and less confidence in the future than dentists without symptoms. These differences were significant between the groups. It was found that specialists, both with and without cervico-brachial symptoms, were more satisfied with their psychosocial work environment than general practitioners, especially regarding their personal control over their work and the stimulation of their work. The specialists also had more self-confidence and experienced less anxiety than general practitioners and head dentists.

The objectives of the study were, in a working population, to standardize and evaluate a set of clinical tests on impairment level related to the low back with reference to intra- and inter-rater reliability. The study was undertaken in two steps. In step 1, 15 tests were examined for inter-rater reliability by three pairs of physiotherapists and for intra-rater reliability by one physiotherapist. Intra-rater reliability was acceptable (kappa > 0.40) for 14 of the 15 tests. Inter-rater reliability was acceptable for 7 of the 15 tests. In step 2, the tests, indicating a non-acceptable inter-rater reliability (kappa < 0.40) were further standardized and retested by two of the physiotherapists. This further standardization procedure resulted in an acceptable inter-rater reliability for all of these tests. Clinical tests of a working population should preferably be performed by the same rater. However, when tests are performed by different raters, it is suggested that test procedures should be regularly standardized, and in pain provocation tests, the magnitude of the applied pressure should be checked regularly and compared with co-raters, in order to improve inter-rater reliability.

No abstract

No abstract