BackgroundHand-arm vibration syndrome (HAVS) is a well-known disease among workers using hand-held vibrating tools. These patients experience major symptoms from their upper limbs. However, there are few studies on disability in this patient group. In this study we wanted to describe the disability of HAVS patients.MethodsAll HAVS patients diagnosed at Haukeland University Hospital in Bergen, Norway in a five-year period were invited. The disabilities of the arm, shoulder and hand (DASH) questionnaire was sent by mail. Clinical data were extracted from their hospital journals. Descriptive statistics and regression analyses were performed.ResultsThirty-eight patients were recruited. Mean DASH score was 41.2, while the mean of a normal population is 10. Ability to perform tasks related to work and everyday life was affected in these patients. We found a significant association between the DASH score, hand grip strength and tendinitis, also after adjustment for age and smoking in pack-years.ConclusionHAVS patients demonstrate a high level of upper limb disability as assessed by the DASH score. Ability to perform tasks related to work and everyday life was affected. We found a significant association between the DASH score, hand grip strength and tendinitis. This should be focused upon in future research.

Background: Workers exposed to bullying often report musculoskeletal symptoms. In this study we have clinically evaluated the prevalence and nature of musculoskeletal dysfunction among a group of workers exposed to bullying and studied the relationship between clinical findings and self-reported musculoskeletal and mental symptoms. Materials and methods: In a cross-sectional study, 144 patients admitted to an outpatient clinic for victims of workplace bullying were assessed with the Global Physiotherapy Examination 52 (GPE-52), a standardised test battery examining posture, respiration, movement, muscle and skin. The patients filled in self-report questionnaires regarding musculoskeletal symptoms (MSI), anxiety and depression (The Hospital Anxiety and Depression Scale, HADS) and post-traumatic stress symptoms (Impact of Events Scale revised version, IES-R). Results: Patients victimised by bullying showed reduced flexibility, reduced ability to relax, restricted respiration and tense and painful muscles. The total GPE-52 sum-score and the main domains Movement and Muscle had significant correlations with most self-reported health variables, strongest between the subdomain Flexibility and HADS-D (r ¼ 0.37) and HADS-A (r ¼ 0.36). Conclusions: Victims of bullying have clinically evident musculoskeletal dysfunctions that were further found to have a relationship with self-reported mental symptoms. Future health services for these patients should be multi-dimensional and include a bodily assessment by a physiotherapist and relevant treatment when needed.

Background – The study was designed to examine whether patients exposed to workplace bullying have clinically evident dysfunction in their musculoskeletal system. Furthermore, we wanted to explore the relationship between clinical findings and self-reported data on mental and musculoskeletal symptoms in the included patients. Methods – Targets of workplace bullying referred to an occupational outpatient clinic in Norway in the period August 2011 to February 2017 were invited to participate in the study. The included patients had a high degree of post-traumatic stress symptoms; mean score on the IES-R was 42.9, well above the suggested cut-off at 33 points for Posttraumatic stress disorder (PTSD). The patients underwent a clinical program, and a physiotherapist used the Global Physiotherapy Examination 52 (GPE-52), a standardized test battery with 13 sub-domains, and five main domains examining posture, respiration, movement, muscle and skin. Self–report questionnaires were used to assess subjective musculoskeletal (MSI) and psychological symptoms (PI), as well as anxiety and depression (HADS) and post-traumatic stress symptoms (IES-R). Results – Altogether 144 patients were included in the study, whereof 65 (45%) had an ongoing musculoskeletal disorder (MSD). Mean scores on the physiotherapy examination showed dysfunction in nine of 13 subdomains. The total GPE-52 sum-score was comparable to patients sick-listed with long-lasting MSD, and significantly higher (worse) than in healthy persons. The physical examination indicated that the bullied patients had reduced flexibility and ability to relax, as well as restricted respiration and tense and painful muscles. The total GPE-52 sum-score as well as the main domains Movement and Muscle had significant correlations with all self-reported health variables. The strongest correlations were found between Movement and Muscle, and PI and HADS (r ≥ 0.32). Conclusions – Patients exposed to workplace bullying had a high degree of clinically evident dysfunction in the musculoskeletal system, comparable to patients with MSD. These findings confirm previous questionnaire studies on physical health in workers exposed to workplace bullying. The extent of the musculoskeletal problems revealed in our study clearly indicates that future health services to these patients should be multi-dimensional and include bodily assessment.

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