An assessment of neck and upper extremity disorders by questionnaire and clinical examination

Abstract

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.

The importance of work organization on workload and musculoskeletal health – Grocery store work as a model

“…In 13 of the stores, a physical examination of the neck and upper limbs (Ohlsson et al, 1994) was performed on all subjects, resulting in data from 212 female employees. In terms of their 7 individual factors, these subjects did not differ from the study group as a whole.…”

“…In terms of their 7 individual factors, these subjects did not differ from the study group as a whole. Diagnoses were reached according to a set of predefined criteria (Ohlsson et al, 1994;Nordander, 2004;Nordander et al, 2009).…”

“…The work presented here also included a physical examination, with a definition of diagnoses (Ohlsson et al, 1994;Nordander, 2004;Nordander et al, 2009). The number of subjects was too small for statistical calculations between the different work groups, but one of our most common diagnoses was carpel tunnel syndrome, which has also been shown to be frequent in other studies, along with other nerve entrapments, especially among cashiers (Panzone et al, 1996;Bonfiglioli et al, 2007;di Pede et al, 2011).…”

Concurrent validity of questions on arm, shoulder and neck symptoms of the RSI QuickScan

“…However, the validity of questionnaires compared to more objective methods of assessment, such as physical examinations, has been questioned in the following papers. In a population of 165 female workers, 94 workers (57 %) reported symptoms in a questionnaire and were given diagnoses in physical examinations (Ohlsson et al 1994). The sensitivity for the diagnoses was 66-92 %, while the specificity was 64-88 %.…”

“…The internal consistency, reliability and concurrent validity of questions on work-related exposure were found to be acceptable (Speklé et al 2009). The symptom-related questions of the RSI QuickScan still need to be validated by comparing outcomes with physical examinations by occupational physicians (Ohlsson et al 1994;Zetterberg et al 1997;Nordander et al 1999;Toomingas et al 1995;Bjorksten et al 1999;Salerno et al 2000;Stål et al 1997;Akesson et al 1999;Kaergaard et al 2000;Juul-Kristensen et al 2006), usually recognized as more objective than questionnaires (Perreault et al 2008). Therefore, the main objective of the present study was to determine the concurrent validity of the symptom-related questions of the RSI QuickScan by assessing the agreement between the results of these self-administered questions and the physical examination by occupational physicians on the presence of arm, shoulder or neck symptoms in computer workers with and without arm, shoulder or neck symptoms.…”