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Soussahn S, Buckwalter K, Sayegh R, Soliman S, Weadock W, Gaetke-Udager K. Ergonomic considerations for the modern radiology practice: An update. Curr Probl Diagn Radiol 2024; 53:738-744. [PMID: 39003121 DOI: 10.1067/j.cpradiol.2024.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2024] [Accepted: 07/08/2024] [Indexed: 07/15/2024]
Abstract
The average post-pandemic modern radiology practice is experiencing an ever-increasing workload volume with overall relatively similar staffing levels, regardless of practice setting. This has resulted in an increased workload demand for the average diagnostic radiologist, which in many cases translates to longer working hours. It is now more important than ever to be cognizant of various work-related injuries, including repetitive-stress injuries and vision-related ailments as examples, in relation to the working conditions of the radiologist. This article will discuss commonly occurring conditions and ergonomic considerations that the radiologist can employ to reduce the risk of work-related injuries.
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Affiliation(s)
- Samer Soussahn
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA.
| | | | - Rony Sayegh
- Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Steven Soliman
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
| | - William Weadock
- Department of Radiology, University of Michigan, Ann Arbor, MI, USA
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Ho E, Tran J, Fateri C, Sahagian C, Sarton K, Glavis-Bloom J, Houshyar R. Work-related musculoskeletal disorders affecting diagnostic radiologists and prophylactic physical therapy regimen. Curr Probl Diagn Radiol 2024; 53:527-532. [PMID: 38514284 DOI: 10.1067/j.cpradiol.2024.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2024] [Accepted: 03/07/2024] [Indexed: 03/23/2024]
Abstract
The shift from film to PACS in reading rooms, coupled with escalating case volumes, exposes radiologists to the issues of the modern computer workstation including computer work posture and work-related musculoskeletal disorders (WMSD). Common WMSDs affecting the neck and upper extremities include cervical myofascial pain, shoulder tendonitis, lateral epicondylitis, carpal tunnel syndrome, and cubital tunnel syndrome. This review examines each pathology along with its pathogenesis, clinical features, physical exam findings, and potential risk factors. Furthermore, a comprehensive 11-part physical therapy regimen that is both prophylactic and therapeutic is illustrated and described in detail. One of the objectives of this review is to advocate for the inclusion of a physical therapy regimen in the working routine of diagnostic radiologists to prevent WMSDs. A brief daily commitment to this regimen can help radiologists remain healthy and productive in order to deliver optimal patient care throughout their careers.
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Affiliation(s)
- Erwin Ho
- University of California, Irvine School of Medicine, Irvine, CA, USA.
| | - Julia Tran
- University of California, Irvine School of Medicine, Irvine, CA, USA
| | - Cameron Fateri
- Department of Radiological Sciences, University of California, Irvine Medical Center, Orange, CA, USA; University of California, Irvine School of Medicine, Irvine, CA, USA
| | | | - Kyle Sarton
- Department of Physical Therapy, University of California, Irvine Medical Center, Orange, CA, USA
| | | | - Roozbeh Houshyar
- University of California, Irvine School of Medicine, Irvine, CA, USA
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Valenti J, Bukowiec LG, Rhee P. Effects of the COVID-19 Pandemic on Hand and Arm Dysfunction: A Google Trends Analysis. Cureus 2024; 16:e62369. [PMID: 39006657 PMCID: PMC11246766 DOI: 10.7759/cureus.62369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/09/2024] [Indexed: 07/16/2024] Open
Abstract
Introduction The COVID-19 pandemic prompted individuals to make a number of lifestyle alterations. Few studies have examined the development of any hand and/or arm dysfunctions that may have resulted. The purpose of this study was to identify hand and/or arm overuse injuries that may have occurred as a result of the stay-at-home orders during the COVID-19 pandemic. Methods A Google Trends analysis of the terms "hand pain," "carpal tunnel syndrome," "cubital tunnel syndrome," "trigger finger," "de Quervain tenosynovitis," "elbow pain," "tennis elbow," "golfer's elbow," "thumb base arthritis," and "extensor carpi ulnaris tenosynovitis" in the United States, United Kingdom, Canada, and India was performed from June 2019 to January 2023. The noted timeframe was divided into quarters of 47 weeks, with the first quarter (June 2, 2019, through April 19, 2020) serving as a pre-pandemic baseline. The analysis compared initial results noted in the first quarter to individual results from the second, third, and fourth quarters. Results The most notable findings were the upward trends of the terms "hand pain," "carpal tunnel," and "trigger finger." Specifically, India showed a significant increase in the terms "hand pain" and "carpal tunnel syndrome" in the second, third, and fourth quarters. The United States additionally showed a significant upward trend in the terms "carpal tunnel syndrome" and "trigger finger" in the second, third, and fourth quarters. The United Kingdom also reported a significant upward trend in the term "trigger finger" in the second, third, and fourth quarters. Conclusion Numerous factors likely contributed to the increased interest in these terms, such as the increase in telework and associated mobile device usage due to lockdown during the COVID-19 pandemic. Movements associated with performing these tasks may have led to an increased prevalence of hand pain, thus prompting increased queries of these terms through an online search engine.
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Affiliation(s)
- Jasmin Valenti
- School of Medicine, Hackensack University Medical Center, Nutley, USA
| | | | - Peter Rhee
- Orthopedic Surgery, Mayo Clinic, Rochester, USA
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Hesam F, Khatibi AA, Vafaeenasab M, Tirandazi B, Sharifi Dorcheh F. Local ozone injection compared to local glucocorticoid injection in carpal tunnel syndrome: A randomized controlled trial. Turk J Phys Med Rehabil 2024; 70:251-258. [PMID: 38948651 PMCID: PMC11209334 DOI: 10.5606/tftrd.2024.12590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 10/31/2023] [Indexed: 07/02/2024] Open
Abstract
Objectives This study aimed to compare the effectiveness of local ozone (O3) injection versus corticosteroid injection in the treatment of mild to moderate carpal tunnel syndrome (CTS). Patients and methods This double-blind randomized controlled trial was performed on 42 patients (9 males, 33 females; mean age: 46.7±2.1 years; range, 18 to 70 years) with mild to moderate CTS between May 2021 and June 2021. The corticosteroid group (n=21) was injected with 40 mg triamcinolone, and in the O3 group B (n=21), 4 mL of a 10 mcg/mL oxygen (O2)-O3 mixture was injected. Symptom severity and functional impairments were assessed using a Visual Analog Scale and Boston Carpal Tunnel Questionnaire. Electrodiagnostic and ultrasonographic parameters were obtained at baseline and eight weeks after the procedure. Results The O2-O3 solution improved pain and Boston Carpal Tunnel Questionnaire score after eight weeks (p<0.001); however, the change was nonsignificant compared to the corticosteroid group (p>0.05). Sensory nerve and compound muscle action potential latencies were not significantly changed eight weeks after O2-O3 injection (p>0.05), while both were significantly decreased in the steroid injection group (p<0.001). Volar bulging and median nerve cross-section surface area were not improved after O2-O3 injection, while the improvement was significant in the corticosteroid arm (p=0.02). Conclusion Symptoms in patients with mild to moderate CTS may be alleviated by local O2-O3 injection; however, electrodiagnostic and ultrasonographic indices may be unchanged. Corticosteroid local injection may alleviate patient symptoms along with electrodiagnostic and ultrasonographic parameters.
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Affiliation(s)
- Farnaz Hesam
- Department of Physical Medicine and Rehabilitation, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amid-Aldin Khatibi
- Department of Physical Medicine and Rehabilitation, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Mohamadreza Vafaeenasab
- Department of Physical Medicine and Rehabilitation, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Behnaz Tirandazi
- Department of Physical Medicine and Rehabilitation, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Wang W, Zhao Z, Ning H. A tree-based corpus annotated with Cyber-Syndrome, symptoms, and acupoints. Sci Data 2024; 11:482. [PMID: 38730023 PMCID: PMC11087536 DOI: 10.1038/s41597-024-03321-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2024] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
Prolonged and over-excessive interaction with cyberspace poses a threat to people's health and leads to the occurrence of Cyber-Syndrome, which covers not only physiological but also psychological disorders. This paper aims to create a tree-shaped gold-standard corpus that annotates the Cyber-Syndrome, clinical manifestations, and acupoints that can alleviate their symptoms or signs, designating this corpus as CS-A. In the CS-A corpus, this paper defines six entities and relations subject to annotation. There are 448 texts to annotate in total manually. After three rounds of updating the annotation guidelines, the inter-annotator agreement (IAA) improved significantly, resulting in a higher IAA score of 86.05%. The purpose of constructing CS-A corpus is to increase the popularity of Cyber-Syndrome and draw attention to its subtle impact on people's health. Meanwhile, annotated corpus promotes the development of natural language processing technology. Some model experiments can be implemented based on this corpus, such as optimizing and improving models for discontinuous entity recognition, nested entity recognition, etc. The CS-A corpus has been uploaded to figshare.
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Affiliation(s)
- Wenxi Wang
- School of Computer & Communication Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Zhan Zhao
- School of Computer & Communication Engineering, University of Science and Technology Beijing, Beijing, 100083, China
| | - Huansheng Ning
- School of Computer & Communication Engineering, University of Science and Technology Beijing, Beijing, 100083, China.
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Aguilar KN, Smith ML, Payne SC, Zhao H, Benden M. Digital human ergonomics training for remote office workers: Comparing a novel method to a traditional online format. APPLIED ERGONOMICS 2024; 117:104239. [PMID: 38295672 DOI: 10.1016/j.apergo.2024.104239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 01/04/2024] [Accepted: 01/17/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVE This randomized controlled trial investigated the effectiveness of an online ergonomics training program with a digital human compared to an online ergonomics training program without a digital human. METHOD Remote office workers (n = 138) were randomly assigned to either a digital human training, a traditional webpage training without a digital human, or a control group. Musculoskeletal discomfort, knowledge retention, and behavior change were measured. RESULTS The overall group differences for increased behavior change and knowledge retention were statistically significant (p < 0.05). For knowledge retention, the digital human training group showed comparable improvement in knowledge scores compared to the traditional training group. For behavior scores, the traditional training showed improvement compared to the control group. Decreases in musculoskeletal discomfort for all groups were not statistically significant (p > 0.05). CONCLUSION Digital humans have the potential to meet large-scale remote worker training needs.
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Affiliation(s)
- Kaysey N Aguilar
- Texas A&M University, School of Public Health, Department of Environmental & Occupational Health, 212 Adriance Lab Road, College Station, TX, 77843, USA.
| | - Matthew Lee Smith
- Texas A&M University, School of Public Health, Department of Health Behavior, 212 Adriance Lab Road, College Station, TX, 77843, USA.
| | - Stephanie C Payne
- Texas A&M University, College of Arts and Sciences, Department of Psychological and Brain Sciences, 230 Psychology Building, 4235 TAMU, College Station, TX, 77843, USA.
| | - Hongwei Zhao
- Texas A&M University, School of Public Health, Department of Epidemiology and Biostatistics, 212 Adriance Lab Road, College Station, TX, 77843, USA.
| | - Mark Benden
- Texas A&M University, School of Public Health, Department of Environmental & Occupational Health, 212 Adriance Lab Road, College Station, TX, 77843, USA.
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Çupi B, Šarac I, Jovanović JJ, Jovanović S, Petrović-Oggiano G, Debeljak-Martačić J, Jovanović J. Occupational and non-occupational risk factors correlating with the severity of clinical manifestations of carpal tunnel syndrome and related work disability among workers who work with a computer. Arh Hig Rada Toksikol 2023; 74:252-272. [PMID: 38146761 PMCID: PMC10750320 DOI: 10.2478/aiht-2023-74-3754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Revised: 07/01/2023] [Accepted: 12/01/2023] [Indexed: 12/27/2023] Open
Abstract
The contribution of certain occupational and personal factors to the development of carpal tunnel syndrome (CTS) is still uncertain. We investigated which specific occupational and non-occupational factors correlate with the level of clinical manifestations and work disability related to CTS. The study included 190 workers who work with a computer and have diagnosed CTS (100 men, 90 women, aged 20-65 years). Subjective experience of CTS-related impairments was assessed with the Symptom Severity Scale (SSS) and the Functional Status Scale (FSS) of the Boston Carpal Tunnel Syndrome Questionnaire (BCTQ). The objective, neural impairments were tested with electrodiagnostics (EDX), whereas CTS-related work disability data were collected from medical records. We found a high inter-correlation between BCTQ, EDX, and work disability data. These also showed high correlations with certain occupational factors (duration of computer-working in months and hours spent daily in computer-working, certain ergonomic, microclimatic, and other occupational conditions) and non-occupational factors (demographic and lifestyle factors: nutritional status, diet, smoking, alcohol consumption, and physical activity). Despite its limitations, our study has identified occupational and non-occupational risk factors that can aggravate CTS and work disability, but which can also be improved with workplace and lifestyle preventive and corrective measures. More research is needed, though, to establish the possible causal relationships and the independent influence of each of those risk factors.
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Affiliation(s)
- Blerim Çupi
- Besa Meditor Primary Healthcare Centre, Oslomej, Kičevo, North Macedonia
- University of Niš Faculty of Medicine, Department of Occupational Health, Niš, Serbia
| | - Ivana Šarac
- University of Belgrade Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, Belgrade, Serbia
| | | | - Stefan Jovanović
- University of Niš Faculty of Medicine, Department of Occupational Health, Niš, Serbia
| | - Gordana Petrović-Oggiano
- University of Belgrade Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, Belgrade, Serbia
| | - Jasmina Debeljak-Martačić
- University of Belgrade Institute for Medical Research, National Institute of Republic of Serbia, Centre of Research Excellence in Nutrition and Metabolism, Belgrade, Serbia
| | - Jovica Jovanović
- University of Niš Faculty of Medicine, Department of Occupational Health, Niš, Serbia
- Institute of Occupational Medicine, Niš, Serbia
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Digital rehabilitation for hand and wrist pain: a single-arm prospective longitudinal cohort study. Pain Rep 2022; 7:e1026. [PMID: 36003064 PMCID: PMC9394689 DOI: 10.1097/pr9.0000000000001026] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/10/2022] [Accepted: 06/25/2022] [Indexed: 11/26/2022] Open
Abstract
Supplemental Digital Content is Available in the Text. This study supports that a fully remote digital care program is feasible and able to promote high patient engagement in the telerehabilitation of patients with wrist and hand pain. Introduction: Wrist and hand represent the third most common body part in work-related injuries, being associated with long-term absenteeism. Telerehabilitation can promote access to treatment, patient adherence, and engagement, while reducing health care–related costs. Objective: Report the results of a fully remote digital care program (DCP) for wrist and hand pain (WP). Methods: A single-arm interventional study was conducted on individuals with WP applying for a DCP. Primary outcome was the mean change in the Numerical Pain Rating Scale after 8 weeks (considering a minimum clinically important change of 30%). Secondary outcomes were: disability (Quick Disabilities of the Arm, Shoulder, and Hand questionnaire), analgesic intake, surgery intention, mental health (patient health questionnaire [PHQ-9] and generalized anxiety disorder [GAD-7]), fear-avoidance beliefs (FABQ-PA), work productivity and activity impairment, and engagement. Results: From 189 individuals starting the DCP, 149 (78.8%) completed the intervention. A significant pain improvement was observed (51.3% reduction (2.26, 95% CI 1.73; 2.78)) and 70.4% of participants surpassing minimum clinically important change. This change correlated with improvements in disability (52.1%), FABQ-PA (32.2%), and activities impairment recovery (65.4%). Improvements were also observed in other domains: surgery intent (76.1%), mental health (67.0% in anxiety and 72.7% in depression), and overall productivity losses (68.2%). Analgesic intake decreased from 22.5% to 7.1%. Mean patient satisfaction score was 8.5/10.0 (SD 1.8). Conclusions: These findings support the feasibility and utility of a fully remote DCP for patients with WP. Clinically significant improvements were observed in all health-related and productivity-related outcomes, alongside very high patient adherence rates and satisfaction. This study strengthens that management of WP is possible through a remote DCP, decreasing access barriers and potentially easing health care expenditure.
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Abstract
Importance Carpal tunnel syndrome, trigger finger, de Quervain tenosynovitis, and basilar (carpometacarpal) joint arthritis of the thumb can be associated with significant disability. Observations Carpal tunnel syndrome is characterized by numbness and tingling in the thumb and the index, middle, and radial ring fingers and by weakness of thumb opposition when severe. It is more common in women and people who are obese, have diabetes, and work in occupations involving use of keyboards, computer mouse, heavy machinery, or vibrating manual tools. The Durkan physical examination maneuver, consisting of firm digital pressure across the carpal tunnel to reproduce symptoms, is 64% sensitive and 83% specific for carpal tunnel syndrome. People with suspected proximal compression or other compressive neuropathies should undergo electrodiagnostic testing, which is approximately more than 80% sensitive and 95% specific for carpal tunnel syndrome. Splinting or steroid injection may temporarily relieve symptoms. Patients who do not respond to conservative therapies may undergo open or endoscopic carpal tunnel release for definitive treatment. Trigger finger, which involves abnormal resistance to smooth flexion and extension ("triggering") of the affected finger, affects up to 20% of adults with diabetes and approximately 2% of the general population. Steroid injection is the first-line therapy but is less efficacious in people with insulin-dependent diabetes. People with diabetes and those with recurrent symptoms may benefit from early surgical release. de Quervain tenosynovitis, consisting of swelling of the extensor tendons at the wrist, is more common in women than in men. People with frequent mobile phone use are at increased risk. The median age of onset is 40 to 59 years. Steroid injections relieve symptoms in approximately 72% of patients, particularly when combined with immobilization. People with recurrent symptoms may be considered for surgical release of the first dorsal extensor compartment. Thumb carpometacarpal joint arthritis affects approximately 33% of postmenopausal women, according to radiographic evidence of carpometacarpal arthritis. Approximately 20% of patients require treatment for pain and disability. Nonsurgical interventions (immobilization, steroid injection, and pain medication) relieve pain but do not alter disease progression. Surgery may be appropriate for patients unresponsive to conservative treatments. Conclusions and Relevance Carpal tunnel syndrome, trigger finger, de Quervain tenosynovitis, and thumb carpometacarpal joint arthritis can be associated with significant disability. First-line treatment for each condition consists of steroid injection, immobilization, or both. For patients who do not respond to noninvasive therapy or for progressive disease despite conservative therapy, surgical treatment is safe and effective.
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Affiliation(s)
- Kelly Bettina Currie
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Kashyap Komarraju Tadisina
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri
| | - Susan E Mackinnon
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, Missouri
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Kurtul S, Mazican N. Prevalence and risk factors for self-reported symptoms of carpal tunnel syndrome among hospital office workers: a cross-sectional study. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2022; 29:461-465. [PMID: 35296224 DOI: 10.1080/10803548.2022.2054580] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVES We aimed to determine the prevalence of self-reported symptoms of carpal tunnel syndrome (CTS) and associated risk factors among hospital office workers. MATERIAL AND METHODS This cross-sectional study was carried out between May and August 2021 with office workers actively working in a hospital in Izmir, Turkey. The Boston Carpal Tunnel Syndrome Questionnaire was used to evaluate the severity of self-reported CTS symptoms and their effect on the functional status of the participants. RESULTS The study included 151 people, 68.2% of whom were women. The CTS symptoms were reported by 74.1% of the participants, the majority of whom (73.2%) were women. These reported symptoms were mild in 43%, moderate in 24.5%, severe in 5.3%, and very severe in 1.3%. Significant differences were found between those with and without CTS symptoms regarding the age, body-mass index, a previous diagnosis of CTS, daily work hours, using a wrist-supported mousepad, and perceived workload (p < 0.05). CONCLUSION It was found that the CTS symptoms of office workers in the hospital were associated with occupational characteristics as well as individual factors. These risk factors should be taken into account while planning for future preventive and interventional measures in workplaces.
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Affiliation(s)
- Seher Kurtul
- Medical Doctor, Occupational Diseases Physician, University of Health Sciences, Bozyaka Training And Research Hospital, Department of Occupational Disease, Izmir, Turkey
| | - Nejdiye Mazican
- Medical Doctor, Occupational Diseases Physician, Department of Occupational Disease, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Sirisena D, Lim I, Sim S, Tong PY, Rajaratnam V. Can the Boston Carpal Tunnel Syndrome Questionnaire Be Used as a Screening Tool Among a Potentially High-Risk Population in Singapore? J Hand Microsurg 2022; 14:39-46. [PMID: 35256827 PMCID: PMC8898153 DOI: 10.1055/s-0040-1710412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
Introduction Carpal tunnel syndrome (CTS) causes significant morbidity with delayed diagnosis or management. The Boston Carpal Tunnel Questionnaire (BCTQ) is validated for monitoring CTS following diagnosis; however, it has not been trialed in a screening capacity. The study aimed to determine whether it can be utilized when screening a focused population in Singapore. Materials and Methods A single-center survey-based study was undertaken prospectively to identify whether positive symptoms could be identified among nursing and administrative staff. Results A total of 605 staff responded. Positive symptoms were identified in 317 (52.4%) of participants and 23 (3.8%) reported them to be severe. Functional limitations were detected in 157 (26.0%) of participants with 5 (0.8%) reporting these as severe. Positive symptoms (84.9%) and functional limitations (81.5%) were more prevalent among nursing staff. Cronbach's α scores (0.896 for symptoms and 0.84 for functional limitations) suggested good reliability in matching symptoms and functional limitations. Conclusion The BCTQ can potentially be implemented as a screening tool for CTS among those without a prior diagnosis. It has a greater depth of questioning with symptomatic and functional limitations considered, and in situations where a formal diagnosis is subsequently made, the same tool can be subsequently used for progression tracking pre- and post-treatment. Level of Evidence This is a Level II study.
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Affiliation(s)
- Dinesh Sirisena
- Department of Orthopedics and Sports Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Ivan Lim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Shauna Sim
- Department of Orthopedics and Sports Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Pei-Yein Tong
- Department of Orthopedics and Sports Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
| | - Vaikunthan Rajaratnam
- Department of Orthopedics and Sports Medicine, Khoo Teck Puat Hospital, Singapore, Singapore
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Battista EB, Yedulla NR, Koolmees DS, Montgomery ZA, Ravi K, Day CS. Manufacturing Workers Have a Higher Incidence of Carpal Tunnel Syndrome. J Occup Environ Med 2021; 63:e120-e126. [PMID: 33394876 DOI: 10.1097/jom.0000000000002122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE It is unclear whether clerical or labor-type work is more associated with risk for developing work-related carpal tunnel syndrome (WrCTS). METHODS National employment, demographic, and injury data were examined from the Bureau of Labor Statistics databases for the years 2003 to 2018. Injuries for clerical and labor industries were compared using linear regression, two-group t test, and one-way analysis of variance (ANOVA) analysis. RESULTS WrCTS injuries are decreasing over time (B = -1002.62, P < 0.001). The labor industry demonstrated a significantly higher incidence of WrCTS when compared with the clerical industries (P < 0.001). Within labor industries, the manufacturing industry had the highest incidence of WrCTS over time (P < 0.001). CONCLUSIONS Our study showed WrCTS injuries have declined over time. Additionally, our findings may suggest that the labor industry has a stronger association with WrCTS than the clerical industry.
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Affiliation(s)
- Eric B Battista
- Henry Ford Health System, Detroit, Michigan (Dr Day); Wayne State University School of Medicine, Ann Arbor, MI (Mr Battista, Mr Yedulla, Mr Koolmees, Mr Montgomery, Dr Day); University of Michigan (Mr Ravi), Detroit, Michigan
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Scalise V, Brindisino F, Pellicciari L, Minnucci S, Bonetti F. Carpal Tunnel Syndrome: A National Survey to Monitor Knowledge and Operating Methods. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041995. [PMID: 33670831 PMCID: PMC7922196 DOI: 10.3390/ijerph18041995] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 02/09/2021] [Accepted: 02/12/2021] [Indexed: 11/21/2022]
Abstract
The aim of this article was to investigate the knowledge, management, and clinical practice of Italian physiotherapists concerning patients with carpal tunnel syndrome (CTS). A national cross-sectional survey consisted of 24 questions was administered from December 2019 until February 2020. A Chi-squared independence test was run to study any difference between subgroups of the sample and responses to the questionnaire. Five hundred and eight respondents completed the survey. Most respondents (n = 225/508; 44.3%) are under 29 years old, female (n = 256/508; 50.4%) and have been working as physiotherapists for less than 5 years (n = 213/508; 41.9%). Most of respondents correctly knows about the cause (n = 455/508, 89.6%), main signs and symptoms of CTS (n = 415/508, 81.70%) and administer education, manual therapy, myofascial techniques and therapeutic exercises (n = 457/508, 89.88%). Three hundred and sixty-four (71.68%) respondents were aware of the influence of psychosocial factors on the patient’s outcomes. The survey showed greater adherence to evidences by physiotherapists holding a master’s degree. The results are mostly comparable with other surveys structured all over the world on the same topic. Italian physiotherapists management of the CTS was not always in line with current evidence. Interventions such as education, manual therapy, therapeutic exercise, nerve and tendon glide techniques are widely used, while the orthotic is only offered by half of the sample.
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Affiliation(s)
- Valentina Scalise
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, I-00133 Rome, Italy; (V.S.); (F.B.); (S.M.); (F.B.)
| | - Fabrizio Brindisino
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, I-00133 Rome, Italy; (V.S.); (F.B.); (S.M.); (F.B.)
- Department of Medicine and Health Science “Vincenzo Tiberio”, University of Molise, I-86100 Campobasso, Italy
| | - Leonardo Pellicciari
- Neurorehabilitation Research Laboratory, IRCCS San Raffaele Pisana, I-00166 Rome, Italy
- Correspondence: or ; Tel.: +39-32-8568-2656
| | - Silvia Minnucci
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, I-00133 Rome, Italy; (V.S.); (F.B.); (S.M.); (F.B.)
| | - Francesca Bonetti
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, I-00133 Rome, Italy; (V.S.); (F.B.); (S.M.); (F.B.)
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Feng B, Chen K, Zhu X, Ip WY, Andersen LL, Page P, Wang Y. Prevalence and risk factors of self-reported wrist and hand symptoms and clinically confirmed carpal tunnel syndrome among office workers in China: a cross-sectional study. BMC Public Health 2021; 21:57. [PMID: 33407293 PMCID: PMC7789363 DOI: 10.1186/s12889-020-10137-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 12/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background Carpal tunnel syndrome (CTS) is a common cause of pain, numbness and tingling in the wrist and hand region and is associated with repetitive wrist and hand use in office workers. However, scarce knowledge exists about the epidemiology of clinically confirmed CTS among Chinese office workers. This study aimed to investigate the prevalence of wrist/hand symptoms and CTS in office workers in China and to identify associated risk factors. Methods A cross-sectional survey was carried out in a metropolitan city in China involving 969 respondents (aged 17–49 years) from 30 workplaces. A questionnaire was distributed to each participant to collect their demographic, work-related physical and psychosocial factors, and wrist and hand symptoms. The wrist and hand pain/numbness symptoms were marked on a body chart and the nature and intensity of symptoms, nocturnal symptoms, as well as aggravating activities were also recorded. Clinically confirmed CTS cases were screened based on the history, Phalen’s test, Tinel Sign and skin sensation testing among symptomatic respondents. Logistic regression was employed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for the occurrence of self-reported wrist and hand symptoms and clinically confirmed CTS. Results The clinically confirmed CTS prevalence was 9.6%. The prevalence of wrist and hand symptoms were 22 and 15%, respectively. Frequently working in pain was associated with higher odds of CTS. Multivariate modelling adjusted for age and gender showed that prolonged computer use time and working without breaks were associated with presence of wrist/hand symptoms (adjusted ORs: 1.11 (95% CI 1.02–1.22) and 1.88 (95% CI 1.12–3.14)). Educational level was inversely associated with CTS and smoking was associated with wrist/hand complaints (adjusted OR: 2.20 (95% CI 1.19–4.07)). Conclusions The prevalence of work-related clinically confirmed CTS symptoms among young office workers in China is high. Frequently working in pain is closely associated with clinically confirmed CTS. Intense computer use and no breaks at work are associated with wrist and hand symptoms.
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Affiliation(s)
- Beibei Feng
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, China.,Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, SAR, China
| | - Kedi Chen
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, China
| | - Xiaoxia Zhu
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, China
| | - Wing-Yuk Ip
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, SAR, China.
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Phil Page
- Doctor of Physical Therapy Program, Franciscan Missionaries of Our Lady University, Baton Rouge, Louisiana, USA
| | - Yuling Wang
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, China.
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15
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Gondim Teixeira PA, Leplat C, Lombard C, Rauch A, Germain E, Waled AA, Jendoubi S, Bonarelli C, Padoin P, Simon L, Gillet R, Blum A. Alternative PACS interface devices are well-accepted and may reduce radiologist’s musculoskeletal discomfort as compared to keyboard-mouse-recording device. Eur Radiol 2020; 30:5200-5208. [DOI: 10.1007/s00330-020-06851-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Revised: 03/10/2020] [Accepted: 03/31/2020] [Indexed: 10/24/2022]
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Abstract
The Academy of Orthopaedic Physical Therapy and the Academy of Hand and Upper Extremity Physical Therapy have an ongoing effort to create evidence-based clinical practice guidelines (CPGs) for orthopaedic and sports physical therapy management and prevention of musculoskeletal impairments described in the World Health Organization's International Classification of Functioning, Disability and Health (ICF). This particular guideline focuses on hand pain and sensory deficits in carpal tunnel syndrome. J Orthop Sports Phys Ther 2019;49(5):CPG1-CPG85. doi:10.2519/jospt.2019.0301.
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Bhanderi DJ, Mishra DG, Parikh SM, Sharma DB. Computer Use and Carpal Tunnel Syndrome: A Case-control Study. Indian J Occup Environ Med 2018; 21:109-114. [PMID: 29618909 PMCID: PMC5868084 DOI: 10.4103/ijoem.ijoem_66_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Context: Carpal tunnel syndrome (CTS) is one of the musculoskeletal disorders that is often described as an occupational hazard, including occupations involving computer use. However, clear consensus is lacking as far as the association between the use of computer and risk of possible CTS is concerned. Aim: To assess the association between CTS and computer use. Settings and Design: A case-control study. Materials and Methods: A sample size of 411 (137 cases and 274 controls) was calculated using Epi Info (version 6). Thus, 137 confirmed cases of CTS and 274 controls (matched for age and sex) were studied using a structured questionnaire. Statistical Analysis Used: Odds ratio (OR) with 95% confidence interval was calculated between the two groups to analyze the association. For control of confounding factors, logistic regression analysis was done. Results: Current use of computer was found to be significantly higher in controls rather than cases (OR = 0.47, CI = 0.27–0.84, P = 0.009). Similarly, past use of computer was also found to be higher in controls. However, the difference was not statistically significant (OR = 0.38, CI = 0.11–1.35, P = 0.20). On applying logistic regression, variables found to be significantly associated with CTS were education (OR = 0.79, CI = 0.66–0.94, P = 0.01), obesity (OR = 3.11, 95%CI = 1.92–5.04, P = 0.00), and short stature (OR = 1.06, 95%CI = 1.02–1.1, P = 0.00). Although current use of computer (OR = 0.33, CI = 0.16–0.67, P = 0.00) was significantly associated with CTS in multivariate model, OR of value less than one does not indicate positive association between this variable and CTS. Conclusion: The study did not demonstrate any positive association between computer use and CTS.
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Affiliation(s)
- Dinesh J Bhanderi
- Department of Community Medicine, Pramukhswami Medical College, Karamsad, Gujarat, India
| | - Daxa G Mishra
- Department of Musculoskeletal and Kinesiotherapy, KM Patel Institute of Physiotherapy, Karamsad, Gujarat, India
| | - Shweta M Parikh
- Department of Neurophysiotherapy, KM Patel Institute of Physiotherapy, Karamsad, Gujarat, India
| | - Deepak B Sharma
- Department of Community Medicine, Pramukhswami Medical College, Karamsad, Gujarat, India
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Bosch LM, van der Molen HF, Frings-Dresen MHW. Optimizing implementation of interventions in agriculture for occupational upper extremity musculoskeletal disorders: Results of an expert panel. Work 2018; 61:413-420. [PMID: 30373985 PMCID: PMC6311361 DOI: 10.3233/wor-182806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Upper extremity musculoskeletal disorders (UEMSD) is reported worldwide as the second-largest occupational musculoskeletal disorder in agriculture. OBJECTIVE The objective of the study is to identify facilitators and barriers for employers and workers for implementing interventions to reduce work-related risk factors associated with occupational UEMSD in the agricultural sector, according to health and safety consultants. METHODS An expert panel was used comprising nine health and safety consultants from the Dutch agricultural sector. RESULTS Facilitators and barriers for employers and workers were categorized in the following themes: knowledge, skills, attitude, culture, costs, loss of income, facilitation and employability. There were no differences in facilitators and barriers between UEMSD. CONCLUSIONS Facilitators and barriers for implementing preventive interventions in agriculture were on organizational level, like diversity in choice of preventive devices, and personal level such as willingness if there is no work disability.
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Affiliation(s)
- Lucas M Bosch
- Amsterdam UMC, University of Amsterdam, Department: Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Henk F van der Molen
- Amsterdam UMC, University of Amsterdam, Department: Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Monique H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Department: Coronel Institute of Occupational Health, Netherlands Center for Occupational Diseases, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Padua L, Coraci D, Erra C, Pazzaglia C, Paolasso I, Loreti C, Caliandro P, Hobson-Webb LD. Carpal tunnel syndrome: clinical features, diagnosis, and management. Lancet Neurol 2016; 15:1273-1284. [PMID: 27751557 DOI: 10.1016/s1474-4422(16)30231-9] [Citation(s) in RCA: 391] [Impact Index Per Article: 48.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 08/05/2016] [Accepted: 08/12/2016] [Indexed: 12/16/2022]
Abstract
Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome worldwide. The clinical symptoms and physical examination findings in patients with this syndrome are recognised widely and various treatments exist, including non-surgical and surgical options. Despite these advantages, there is a paucity of evidence about the best approaches for assessment of carpal tunnel syndrome and to guide treatment decisions. More objective methods for assessment, including electrodiagnostic testing and nerve imaging, provide additional information about the extent of axonal involvement and structural change, but their exact benefit to patients is unknown. Although the best means of integrating clinical, functional, and anatomical information for selecting treatment choices has not yet been identified, patients can be diagnosed quickly and respond well to treatment. The high prevalence of carpal tunnel syndrome, its effects on quality of life, and the cost that disease burden generates to health systems make it important to identify the research priorities that will be resolved in clinical trials.
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Affiliation(s)
- Luca Padua
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy; Don Carlo Gnocchi Onlus Foundation, Milan, Italy.
| | - Daniele Coraci
- Don Carlo Gnocchi Onlus Foundation, Milan, Italy; Board of Physical Medicine and Rehabilitation, Department of Orthopaedic Science, "Sapienza" University, Rome, Italy
| | - Carmen Erra
- Department of Geriatrics, Neurosciences and Orthopaedics, Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | | | - Pietro Caliandro
- Institute of Neurology, Policlinico A Gemelli Foundation University Hospital, Rome, Italy
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Affiliation(s)
- R Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
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Shiri R, Pourmemari MH, Falah-Hassani K, Viikari-Juntura E. The effect of excess body mass on the risk of carpal tunnel syndrome: a meta-analysis of 58 studies. Obes Rev 2015; 16:1094-104. [PMID: 26395787 DOI: 10.1111/obr.12324] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 07/24/2015] [Accepted: 08/24/2015] [Indexed: 12/31/2022]
Abstract
We aimed to estimate the effects of overweight and obesity on carpal tunnel syndrome (CTS), and to assess whether sex modifies the associations. Literature searches were conducted in PubMed, Embase, Web of Science, Scopus, Google Scholar and ResearchGate databases from 1953 to February 2015. Fifty-eight studies consisting of 1,379,372 individuals qualified for a meta-analysis. We used a random-effects meta-analysis, assessed heterogeneity and publication bias, and performed sensitivity analyses. Overweight increased the risk of CTS or carpal tunnel release 1.5-fold (pooled confounder-adjusted odds ratio [OR] = 1.47, 95% CI 1.37-1.57, N = 1,279,546) and obesity twofold (adjusted OR = 2.02, 95% CI 1.92-2.13, N = 1,362,207). Each one-unit increase in body mass index increased the risk of CTS by 7.4% (adjusted OR = 1.074, 95% CI 1.071-1.077, N = 1,258,578). Overweight and obesity had stronger effects on carpal tunnel release than CTS. The associations did not differ between men and women, and they were independent of study design. Moreover, the associations were not due to bias or confounding. Excess body mass markedly increases the risk of CTS. As the prevalence of overweight and obesity is increasing globally, overweight-related CTS is expected to increase. Future studies should investigate whether a square-shaped wrist and exposure to physical workload factors potentiate the adverse effect of obesity on the median nerve.
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Affiliation(s)
- R Shiri
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - M H Pourmemari
- School of Health Sciences, University of Tampere, Tampere, Finland
| | - K Falah-Hassani
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, Canada
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Mediouni Z, Bodin J, Dale AM, Herquelot E, Carton M, Leclerc A, Fouquet N, Dumontier C, Roquelaure Y, Evanoff BA, Descatha A. Carpal tunnel syndrome and computer exposure at work in two large complementary cohorts. BMJ Open 2015; 5:e008156. [PMID: 26353869 PMCID: PMC4567686 DOI: 10.1136/bmjopen-2015-008156] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES The boom in computer use and concurrent high rates in musculoskeletal complaints and carpal tunnel syndrome (CTS) among users have led to a controversy about a possible link. Most studies have used cross-sectional designs and shown no association. The present study used longitudinal data from two large complementary cohorts to evaluate a possible relationship between CTS and the performance of computer work. SETTINGS AND PARTICIPANTS The Cosali cohort is a representative sample of a French working population that evaluated CTS using standardised clinical examinations and assessed self-reported computer use. The PrediCTS cohort study enrolled newly hired clerical, service and construction workers in several industries in the USA, evaluated CTS using symptoms and nerve conduction studies (NCS), and estimated exposures to computer work using a job exposure matrix. PRIMARY AND SECONDARY OUTCOME MEASURES During a follow-up of 3-5 years, the association between new cases of CTS and computer work was calculated using logistic regression models adjusting for sex, age, obesity and relevant associated disorders. RESULTS In the Cosali study, 1551 workers (41.8%) completed follow-up physical examinations; 36 (2.3%) participants were diagnosed with CTS. In the PrediCTS study, 711 workers (64.2%) completed follow-up evaluations, whereas 31 (4.3%) had new cases of CTS. The adjusted OR for the group with the highest exposure to computer use was 0.39 (0.17; 0.89) in the Cosali cohort and 0.16 (0.05; 0.59) in the PrediCTS cohort. CONCLUSIONS Data from two large cohorts in two different countries showed no association between computer work and new cases of CTS among workers in diverse jobs with varying job exposures. CTS is far more common among workers in non-computer related jobs; prevention efforts and work-related compensation programmes should focus on workers performing forceful hand exertion.
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Affiliation(s)
- Z Mediouni
- Inserm, Population-Based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
- Versailles St-Quentin University, UMS 011, Villejuif, France
- AP-HP, Occupational Health Unit/EMS (Samu92), University hospital of West suburb of Paris, Poincaré site, Garches, France
| | - J Bodin
- Laboratory of Ergonomics and Epidemiology in Occupational Health (LEEST), LUNAM University, University of Angers, Angers, France
| | - A M Dale
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - E Herquelot
- Inserm, Population-Based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
- Versailles St-Quentin University, UMS 011, Villejuif, France
| | - M Carton
- Inserm, Population-Based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
- Versailles St-Quentin University, UMS 011, Villejuif, France
| | - A Leclerc
- Inserm, Population-Based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
- Versailles St-Quentin University, UMS 011, Villejuif, France
- Inserm, UMR-S VIMA, Villejuif, France
| | - N Fouquet
- Laboratory of Ergonomics and Epidemiology in Occupational Health (LEEST), LUNAM University, University of Angers, Angers, France
- Department of Occupational Health, French Institute for Public Health Surveillance, Saint-Maurice, France
| | - C Dumontier
- Hand Center, Clinique les eaux claires, ZAC Moudong Sud, Baie Mahault, France
| | - Y Roquelaure
- Laboratory of Ergonomics and Epidemiology in Occupational Health (LEEST), LUNAM University, University of Angers, Angers, France
- CHU Angers, Angers, France
| | - B A Evanoff
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, Missouri, USA
| | - A Descatha
- Inserm, Population-Based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
- Versailles St-Quentin University, UMS 011, Villejuif, France
- AP-HP, Occupational Health Unit/EMS (Samu92), University hospital of West suburb of Paris, Poincaré site, Garches, France
- Inserm, UMR-S VIMA, Villejuif, France
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Saint-Lary O, Rébois A, Mediouni Z, Descatha A. Carpal tunnel syndrome: primary care and occupational factors. Front Med (Lausanne) 2015; 2:28. [PMID: 26000277 PMCID: PMC4419845 DOI: 10.3389/fmed.2015.00028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 04/17/2015] [Indexed: 12/04/2022] Open
Abstract
Carpal tunnel syndrome (CTS) affects about 1% of working-aged people and is the commonest cause of hand pain in manual workers. CTS is a clinical diagnosis and does not warrant any further investigation in the presence of mild and suggestive CTS. Although the recommended non-surgical management is still a matter of debate, nocturnal splinting or steroid injection are recommended in most countries, with strong to moderate level of evidence for short-term efficacy. Patients with an uncertain diagnosis or severe symptoms, should undergo nerve conduction studies with referral to a hand specialist.
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Affiliation(s)
- Olivier Saint-Lary
- Department of Family Medicine, Faculty of Health Sciences Simone Veil, Université de Versailles Saint-Quentin-en-Yvelines , Montigny le Bretonneux , France ; Centre de Recherche en Épidémiologie et Santé des Populations (CESP) - INSERM U1018 Team 1 , Villejuif , France
| | - Arnaud Rébois
- Medical Home Primary Care of Montcient , Oinville , France
| | - Zakia Mediouni
- Occupational Health Unit/EMS (Samu92), Assistance Publique - Hôpitaux de Paris, Poincaré University Hospital , Garches , France ; Population-Based Epidemiologic Cohorts Unit, UMS 011, INSERM , Villejuif , France ; UMS 011 UMR-S 1168, Université de Versailles Saint-Quentin-en-Yvelines , Versailles , France
| | - Alexis Descatha
- Occupational Health Unit/EMS (Samu92), Assistance Publique - Hôpitaux de Paris, Poincaré University Hospital , Garches , France ; Population-Based Epidemiologic Cohorts Unit, UMS 011, INSERM , Villejuif , France ; UMS 011 UMR-S 1168, Université de Versailles Saint-Quentin-en-Yvelines , Versailles , France ; VIMA: Aging and Chronic Diseases, Epidemiological and Public Health Approaches, U1168, INSERM , Villejuif , France
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