Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine, Taipei, Taiwan.
Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Eur J Phys Rehabil Med. 2023 Oct;59(5):564-575. doi: 10.23736/S1973-9087.23.07889-9. Epub 2023 Aug 4.
Ultrasound imaging has emerged as one of the most useful tools for evaluating shoulder disorders. To date, the association between shoulder ultrasonography and a patient's work status has rarely been explored by antecedent studies.
This study aimed to investigate the association between sonographically diagnosed shoulder pathologies and job discontinuation and return to work.
A cross-sectional study.
Outpatient clinic in the university hospital.
Fifty-nine patients who were older than 20 years of age and had worked in a full-time job within the past three years.
All participants underwent clinical evaluation using the visual analog scale (for pain), Shoulder Pain and Disability Index, Pittsburgh Sleep Quality Index, and shoulder ultrasound examination. The work-related ergonomic risks, including dealing with heavy objects, repeated use and requiring forceful motion of the affected upper extremity, were assessed. The ultrasound-identified shoulder pathologies associated with job discontinuation, that is, sick leave due to painful shoulder for more than two consecutive months, were considered as the primary outcome. In the job discontinuation subgroup, we further investigated the association between return to work and the clinical/sonographic findings.
Univariate analysis revealed a positive association between job discontinuation and shoulder surgery or work types requiring forceful upper-limb movements. Multivariate analysis demonstrated that job discontinuation was positively associated with supraspinatus tendon full-thickness tears (risk ratio, 8.80; 95% CI, 1.77-10.56; P=0.018). Of the patients who received shoulder surgery, 46.6% had recurrent rotator cuff tears. Return to work was likely to be related to pain scores during overhead activities and shoulder function impairment but not to sonographic findings.
Job discontinuation is associated with shoulder surgery, work that necessitates forceful upper-extremity movements and supraspinatus tendon full-thickness tears detected by ultrasound.
Sonographic findings should not be used as the only standard for evaluating the patient's work capability.
超声成像已成为评估肩部疾病最有用的工具之一。迄今为止，很少有先前的研究探讨过肩部超声检查与患者工作状态之间的关系。
本研究旨在探讨超声诊断的肩部病变与离职和重返工作岗位之间的关系。
横断面研究。
大学医院的门诊诊所。
59 名年龄大于 20 岁且在过去三年中从事全职工作的患者。
所有参与者均接受临床评估，包括视觉模拟量表（用于疼痛）、肩痛和残疾指数、匹兹堡睡眠质量指数和肩部超声检查。评估了与工作相关的人体工程学风险，包括处理重物、反复使用和需要患侧上肢用力运动。将因肩部疼痛而连续缺勤超过两个月的离职（病假）视为超声识别的肩部病变与离职之间的主要结局。在离职亚组中，我们进一步研究了重返工作岗位与临床/超声发现之间的关系。
单因素分析显示，离职与肩部手术或需要用力上肢运动的工作类型之间存在正相关。多因素分析表明，离职与冈上肌腱全层撕裂呈正相关（风险比，8.80；95%可信区间，1.77-10.56；P=0.018）。接受肩部手术的患者中，46.6%的人有复发性肩袖撕裂。重返工作岗位可能与头顶活动时的疼痛评分和肩部功能障碍有关，但与超声检查结果无关。
离职与肩部手术、需要用力上肢运动以及超声检查发现的冈上肌腱全层撕裂有关。
超声检查结果不应作为评估患者工作能力的唯一标准。
