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工作及治疗相关因素对非特异性工作相关上肢疾病患者临床状况及残疾的影响。

The influence of work and treatment related factors on clinical status and disability in patients with non-specific work-related upper limb disorders.

作者信息

van Eijsden-Besseling Marjon D F, van den Bergh Karien A M, Staal J Bart, de Bie Rob A, Smeets Rob J E M, van den Heuvel Wim J A

机构信息

Care and Public Health Research Institute, Maastricht University, Department of Rehabilitation Medicine, University Hospital Maastricht, Maastricht, The Netherlands.

出版信息

Work. 2010;37(4):425-32. doi: 10.3233/WOR-2010-1096.

Abstract

OBJECTIVE

To assess the influence of work- and treatment-related factors on clinical status and functional disability in patients with non-specific work-related upper limb disorders (WRULD).

PARTICIPANTS

182 computer workers with non-specific WRULD, 18-50 years old, not having specific WRULD nor incomplete medical records.

METHODS

Retrospective cohort study among computer workers with non-specific WRULD; average follow-up 4 years. Medical records at time of diagnosis and during treatment period and a follow-up questionnaire were used.

SETTING

Outpatient department of Rehabilitation Medicine, University Hospital Maastricht.

OUTCOME MEASURES

Non-specific WRULD (clinical status) and Disabilities of Arm, Shoulder and Hand (DASH) at follow-up.

RESULTS

103 patients (57%) returned the questionnaire. Of these, 14% developed a chronic pain syndrome, 9% recovered, 77% worsened slightly. None of the selected work- and treatment-related factors were significantly associated with clinical status. "Number of working hours per week before diagnosis" was negatively (b=-0.66, p=0.00) and "other therapies during treatment" (b=8.76, p=0.02) positively associated with DASH.

CONCLUSIONS

Computer workers with non-specific WRULD have a poor prognosis. Working more hours before diagnosis seems not predictive for disability while having undergone other therapies during treatment period does. Prospective cohort studies are recommended to unravel the associations found.

摘要

目的

评估工作及治疗相关因素对非特异性工作相关上肢疾病(WRULD)患者临床状况和功能残疾的影响。

参与者

182名年龄在18 - 50岁之间、患有非特异性WRULD的计算机工作者,无特定WRULD且病历完整。

方法

对患有非特异性WRULD的计算机工作者进行回顾性队列研究;平均随访4年。使用诊断时、治疗期间的病历以及一份随访问卷。

地点

马斯特里赫特大学医院康复医学门诊。

观察指标

随访时的非特异性WRULD(临床状况)和手臂、肩部和手部残疾程度(DASH)。

结果

103名患者(57%)返回了问卷。其中,14%发展为慢性疼痛综合征,9%康复,77%略有恶化。所选的工作及治疗相关因素均与临床状况无显著关联。“诊断前每周工作小时数”与DASH呈负相关(b = -0.66,p = 0.00),“治疗期间的其他疗法”与DASH呈正相关(b = 8.76,p = 0.02)。

结论

患有非特异性WRULD的计算机工作者预后较差。诊断前工作时间较长似乎不能预测残疾情况,而治疗期间接受其他疗法则可以。建议进行前瞻性队列研究以阐明所发现的关联。

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