Yonsei Med J.  2018 Jul;59(5):669-676. 10.3349/ymj.2018.59.5.669.

Common Upper Extremity Disorders and Function Affect Upper Extremity-Related Quality of Life: A Community-Based Sample from Rural Areas

Affiliations
  • 1Department of Orthopedic Surgery, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea. hscspine@hanmail.net parkks@gnu.ac.kr
  • 2Department of Preventive Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Jinju, Korea. hscspine@hanmail.net parkks@gnu.ac.kr
  • 3Department of Radiology, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea.
  • 4Department of Internal Medicine, Institute of Health Sciences, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju, Korea.

Abstract

PURPOSE
Upper extremity musculoskeletal disorders (UEMDs), such as rotator cuff tear, epicondylitis, and hand osteoarthritis, have a negative impact on quality of life (QOL). In this study, we evaluated the prevalence of rotator cuff tear, lateral and medial epicondylitis, and hand osteoarthritis in the dominant side and the impact of these UEMDs on the disabilities of the arm, shoulder, and hand (DASH) outcome measure, which assesses upper extremity-related QOL.
MATERIALS AND METHODS
In 2013-2015, 987 participants from rural areas completed a questionnaire and underwent physical examinations, laboratory tests, simple radiographic evaluations of bilateral upper extremities, and magnetic resonance imaging studies of bilateral shoulders. Based on data from these participants, researchers evaluated DASH and performed a functional assessment of each region of the dominant side and related UEMDs.
RESULTS
The prevalences of epicondylitis, rotator cuff tear, and hand osteoarthritis were 33.7%, 53.4%, and 44.6%, respectively. Univariate regression analysis results revealed that epicondylitis, epicondylitis+rotator cuff tear, epicondylitis+hand osteoarthritis, and epicondylitis+rotator cuff tear+hand osteoarthritis were significantly associated with DASH score. Multiple regression analysis, including DASH, UEMD, and regional functional assessments, showed that only epicondylitis and epicondylitis+rotator cuff tear were associated with DASH score.
CONCLUSION
Epicondylitis significantly affected QOL, while other UEMDs, such as hand osteoarthritis and rotator cuff tear, had no significant impact. When a patient's QOL is affected by a UEMD, there is an increased possibility of the simultaneous presence of other UEMDs.

Keyword

Upper extremities; musculoskeletal disorders; function; quality of life

MeSH Terms

Arm
Hand
Magnetic Resonance Imaging
Osteoarthritis
Outcome Assessment (Health Care)
Physical Examination
Prevalence
Quality of Life*
Rotator Cuff
Shoulder
Tears
Upper Extremity*

Figure

  • Fig. 1 DASH scores according to UEMD. The model was adjusted for primitive variables (age, sex, educational level, marital status, depression, hypertension, waist circumference, hemoglobin, HbA1c, and cholesterol) that produced significant difference in outcomes. a, b, c, d: post-hoc analysis. UEMD, upper extremity musculoskeletal disorder; DASH, disabilities of the arm, shoulder, and hand; Epi, epicondylitis; RCT, rotator cuff tear; HOA, hand osteoarthritis.


Reference

1. Huisstede BM, Bierma-Zeinstra SM, Koes BW, Verhaar JA. Incidence and prevalence of upper-extremity musculoskeletal disorders. A systematic appraisal of the literature. BMC Musculoskelet Disord. 2006; 7:7. PMID: 16448572.
Article
2. Huisstede BM, Wijnhoven HA, Bierma-Zeinstra SM, Koes BW, Verhaar JA, Picavet S. Prevalence and characteristics of complaints of the arm, neck, and/or shoulder (CANS) in the open population. Clin J Pain. 2008; 24:253–259. PMID: 18287832.
Article
3. Walker-Bone K, Palmer KT, Reading I, Coggon D, Cooper C. Prevalence and impact of musculoskeletal disorders of the upper limb in the general population. Arthritis Rheum. 2004; 51:642–651. PMID: 15334439.
Article
4. McDonald M, DiBonaventura Md, Ullman S. Musculoskeletal pain in the workforce: the effects of back, arthritis, and fibromyalgia pain on quality of life and work productivity. J Occup Environ Med. 2011; 53:765–770. PMID: 21685799.
5. Spreeuwers D, de Boer AG, Verbeek JH, van Beurden MM, de Wilde NS, Braam I, et al. Work-related upper extremity disorders: one-year follow-up in an occupational diseases registry. Int Arch Occup Environ Health. 2011; 84:789–796. PMID: 21274724.
Article
6. Boocock MG, Collier JM, McNair PJ, Simmonds M, Larmer PJ, Armstrong B. A framework for the classification and diagnosis of work-related upper extremity conditions: systematic review. Semin Arthritis Rheum. 2009; 38:296–311. PMID: 18280546.
Article
7. da Costa JT, Baptista JS, Vaz M. Incidence and prevalence of upper-limb work related musculoskeletal disorders: a systematic review. Work. 2015; 51:635–644. PMID: 26409936.
Article
8. Razmjou H, Bean A, van Osnabrugge V, MacDermid JC, Holtby R. Cross-sectional and longitudinal construct validity of two rotator cuff disease-specific outcome measures. BMC Musculoskelet Disord. 2006; 7:26. PMID: 16533405.
Article
9. Roquelaure Y, Ha C, Leclerc A, Touranchet A, Sauteron M, Melchior M, et al. Epidemiologic surveillance of upper-extremity musculoskeletal disorders in the working population. Arthritis Rheum. 2006; 55:765–778. PMID: 17013824.
Article
10. Slatkowsky-Christensen B, Mowinckel P, Loge JH, Kvien TK. Health-related quality of life in women with symptomatic hand osteoarthritis: a comparison with rheumatoid arthritis patients, healthy controls, and normative data. Arthritis Rheum. 2007; 57:1404–1409. PMID: 18050180.
Article
11. Hegmann KT, Thiese MS, Wood EM, Garg A, Kapellusch JM, Foster J, et al. Impacts of differences in epidemiological case definitions on prevalence for upper-extremity musculoskeletal disorders. Hum Factors. 2014; 56:191–202. PMID: 24669553.
Article
12. Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, et al. The Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA. 2003; 289:2560–2572. PMID: 12748199.
Article
13. Marathe PH, Gao HX, Close KL. American Diabetes Association Standards of Medical Care in Diabetes 2017. J Diabetes. 2017; 9:320–324. PMID: 28070960.
Article
14. Lee SY, Park HS, Kim DJ, Han JH, Kim SM, Cho GJ, et al. Appropriate waist circumference cutoff points for central obesity in Korean adults. Diabetes Res Clin Pract. 2007; 75:72–80. PMID: 16735075.
Article
15. Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003; 41:1284–1292. PMID: 14583691.
16. Bellamy N, Campbell J, Haraoui B, Buchbinder R, Hobby K, Roth JH, et al. Dimensionality and clinical importance of pain and disability in hand osteoarthritis: Development of the Australian/Canadian (AUSCAN) Osteoarthritis Hand Index. Osteoarthritis Cartilage. 2002; 10:855–862. PMID: 12435330.
Article
17. Constant CR, Murley AH. A clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987; 214:160–164.
Article
18. Morrey BF. The elbow and its disorders. 2nd ed. Philadelphia: Saunders;1993.
19. 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; 29:602–608. PMID: 8773720.
20. Reinus WR, Shady KL, Mirowitz SA, Totty WG. MR diagnosis of rotator cuff tears of the shoulder: value of using T2-weighted fatsaturated images. AJR Am J Roentgenol. 1995; 164:1451–1455. PMID: 7754891.
Article
21. 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.
22. Kellgren JH, Lawrence JS. Radiological assessment of osteo-arthrosis. Ann Rheum Dis. 1957; 16:494–502. PMID: 13498604.
Article
23. Haugen IK, Englund M, Aliabadi P, Niu J, Clancy M, Kvien TK, et al. Prevalence, incidence and progression of hand osteoarthritis in the general population: the Framingham Osteoarthritis Study. Ann Rheum Dis. 2011; 70:1581–1586. PMID: 21622766.
Article
24. 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). J Orthop Sports Phys Ther. 2014; 44:30–39. PMID: 24175606.
Article
25. Sorensen AA, Howard D, Tan WH, Ketchersid J, Calfee RP. Minimal clinically important differences of 3 patient-rated outcomes instruments. J Hand Surg Am. 2013; 38:641–649. PMID: 23481405.
Article
26. Constant CR, Gerber C, Emery RJ, Søjbjerg JO, Gohlke F, Boileau P. A review of the Constant score: modifications and guidelines for its use. J Shoulder Elbow Surg. 2008; 17:355–361. PMID: 18218327.
Article
27. Hochberg MC, Vignon E, Maheu E. Session 2: clinical aspects. Clinical assessment of hand OA. Osteoarthritis Cartilage. 2000; 8(Suppl A):S38–S40. PMID: 11156493.
Article
28. Lawrence JS, Bremner JM, Bier F. Osteo-arthrosis. Prevalence in the population and relationship between symptoms and x-ray changes. Ann Rheum Dis. 1966; 25:1–24. PMID: 5905334.
29. Minagawa H, Yamamoto N, Abe H, Fukuda M, Seki N, Kikuchi K, et al. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: from mass-screening in one village. J Orthop. 2013; 10:8–12. PMID: 24403741.
Article
30. Andrianakos AA, Kontelis LK, Karamitsos DG, Aslanidis SI, Georgountzos AI, Kaziolas GO, et al. Prevalence of symptomatic knee, hand, and hip osteoarthritis in Greece. The ESORDIG study. J Rheumatol. 2006; 33:2507–2513. PMID: 17143985.
31. Gumina S, Carbone S, Campagna V, Candela V, Sacchetti FM, Giannicola G. The impact of aging on rotator cuff tear size. Musculoskelet Surg. 2013; 97(Suppl 1):69–72. PMID: 23588834.
Article
32. Kloppenburg M, Kwok WY. Hand osteoarthritis--a heterogeneous disorder. Nat Rev Rheumatol. 2011; 8:22–31. PMID: 22105244.
Article
33. Parsons IM, Apreleva M, Fu FH, Woo SL. The effect of rotator cuff tears on reaction forces at the glenohumeral joint. J Orthop Res. 2002; 20:439–446. PMID: 12038616.
Article
34. Descatha A, Albo F, Leclerc A, Carton M, Godeau D, Roquelaure Y, et al. Lateral epicondylitis and physical exposure at work? A review of prospective studies and meta-analysis. Arthritis Care Res (Hoboken). 2016; 68:1681–1687. PMID: 26946473.
Article
35. Mora DC, Miles CM, Chen H, Quandt SA, Summers P, Arcury TA. Prevalence of musculoskeletal disorders among immigrant Latino farmworkers and non-farmworkers in North Carolina. Arch Environ Occup Health. 2016; 71:136–143. PMID: 25454715.
Article
36. Pullopdissakul S, Ekpanyaskul C, Taptagaporn S, Bundhukul A, Thepchatri A. Upper extremities musculoskeletal disorders: prevalence and associated ergonomic factors in an electronic assembly factory. Int J Occup Med Environ Health. 2013; 26:751–761. PMID: 24264438.
Article
37. Jeong J, Shin DC, Kim TH, Kim K. Prevalence of asymptomatic rotator cuff tear and their related factors in the Korean population. J Shoulder Elbow Surg. 2017; 26:30–35. PMID: 27497789.
Article
38. Zhang Y, Xu L, Nevitt MC, Niu J, Goggins JP, Aliabadi P, et al. Lower prevalence of hand osteoarthritis among Chinese subjects in Beijing compared with white subjects in the United States: the Beijing Osteoarthritis Study. Arthritis Rheum. 2003; 48:1034–1040. PMID: 12687546.
Article
39. Dahaghin S, Bierma-Zeinstra SM, Hazes JM, Koes BW. Clinical burden of radiographic hand osteoarthritis: a systematic appraisal. Arthritis Rheum. 2006; 55:636–647. PMID: 16874787.
Article
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