Structural validity of the Arabic version of the disabilities of the Arm, Shoulder and Hand (DASH) using Rasch measurement model

Background The disabilities of the arm, shoulder and hand (DASH) is a commonly used region-specific patient-reported outcome measure (PROM) that quantify upper extremity function (activity limitation) and symptoms. Current evidence suggests that measurement properties of the adapted versions of the DASH are not sufficiently examined. The Arabic DASH has evidence supporting its internal consistency, test–retest reliability, construct validity and responsiveness. On the other hand, the validity of the assumed unidimensionality of the Arabic DASH has not been examined previously. The aim of this study was to examine the structural validity of the Arabic DASH in patients with upper extremity musculoskeletal disorders using Rasch measurement model. Methods Patients with upper extremity musculoskeletal disorders were recruited and were asked to complete the Arabic DASH at their initial visit to physical therapy departments. The overall fit of the Arabic DASH to the requirement of the Rasch measurement model was examined using chi-square statistics for item-trait interaction, mean item and person fit residuals. The fit of individual items, thresholds ordering, local dependency, differential item functioning (DIF), and unidimensionality using the t-test approach were also examined. Results The Arabic DASH did not fit the Rasch measurement model initially (χ2 = 179.04, p < 0.001) with major breach of local item independence and a pattern of high residual correlations among the activity-related items and among the impairment-related items. Combining items into activity-limitation and impairment testlets accommodated the local dependency and led to satisfactory fit of the Arabic DASH to the requirement of the Rasch measurement model (χ2 = 3.99, p = 0.41). Conclusions Rasch measurement model supports the structural validity of the Arabic DASH as a unidimensional measure after the accommodation of local dependency.

Proportion and Number of Upper-Extremity Musculoskeletal Disorders Attributable to the Combined Effect of Biomechanical and Psychosocial Risk Factors in a Working Population

The objective of this paper is to assess the combined effect of occupational biomechanical and psychosocial risk factors on the incidence of work-related upper-extremity musculoskeletal disorders (UEMSDs) and estimate the proportion and number of incident cases attributable to these risk factors in a working population. Using data from the French COSALI (COhorte des SAlariés LIgériens) cohort (enrolment phase: 2002–2005; follow-up phase: 2007–2010), a complete case analysis including 1246 workers (59% men, mean age: 38 years ± 8.6 at baseline) was performed. All participants underwent a standardized clinical examination at enrolment and 1611 workers were re-examined at follow-up. Population attributable fractions and the number of UEMSD cases attributable to occupational risk factors were calculated. During follow-up, 139 UEMSD cases were diagnosed, representing an estimated 129,320 projected incident UEMSD cases in the working population. After adjusting for personal factors, in model 1, 8664 cases (6.7%) were attributable to low social support, 19,010 (14.7%) to high physical exertion, and 20,443 (15.8%) to co-exposure to both factors. In model 2, 16,294 (12.6%) cases were attributable to low social support, 6983 (5.4%) to posture with arms above shoulder level, and 5043 (3.9%) to co-exposure to both factors. Our findings suggest that many cases of UEMSD could be potentially prevented by multidimensional interventions aimed at reducing exposure to high physical exertion and improving social support at work.

Highly anisotropic and flexible piezoceramic kirigami for preventing joint disorders

The prevention of work-related upper extremity musculoskeletal disorders (MSDs; e.g., neck pain and shoulder fatigue) requires frequent exercises of neck and shoulder that primarily rely on the assistance of joint motion monitoring devices. However, most available wearable healthcare sensors are rigid, bulky, and incapable of recognizing the full range of human motions. Here, we propose a kirigami-structured highly anisotropic piezoelectric network composite sensor that is able to monitor multiple information of joint motions, including bending direction, bending radius, and motion modes, and to distinguish them simultaneously within one sensor unit. On the basis of the modified template-assisted processing method, we design a functional piezoceramic kirigami with a honeycomb network structure that is stretchable (~100% strain), highly sensitive (15.4 mV kPa−1), and highly anisotropic to bending directions (17.3 times from 90° to 0°). An integrated monitoring system is further established to alarm the prolonged sedentary behaviors, facilitating the prevention of upper extremity MSDs.

Upper extremity musculoskeletal disorders and exposure to Ergonomic risk factors among handicraft workers

Objective: To determine the association of Upper extremity musculoskeletal disorders and Exposure to Ergonomic risk factors among handicraft workers. Methods: This cross-sectional survey was conducted in a 12 weeks’ duration i.e. from November 2018 till January 2019. Nordic musculoskeletal questionnaire was used to determine the frequency of upper limb musculoskeletal disorders. Postural analysis was done using Rapid Upper Limb Assessment (RULA). Data was collected from 100 Handicraft workers and the type of work included Art work (n=18), Ada Work (n=7), botanical arrangement (n=11), Textile, fashion designing and stitching (n=38), Fine arts (n=20), embroidery and knitting (n=6). Results: The frequency distribution of Rapid upper limb assessment (RULA) score for exposure to risk factors showed that 47 participants were at a high risk and required implementation of change. Most of the participants (n=35) reported pain in neck and shoulder (n=29). The chi square test for association between pain in upper extremity and exposure to risk factors showed that only wrist pain had statistically significant association with overall RULA score (p-value<0.05). Conclusion: The study concluded that neck and shoulder are more frequently affected among handicraft workers. The frequency of workers who were at high ergonomic risk and required implementation of change in working conditions was high. doi: https://doi.org/10.12669/pjms.37.2.749 How to cite this:Mahmood W, Bashir MS, Ehsan S, Qureshi MA. Upper extremity musculoskeletal disorders and exposure to Ergonomic risk factors among handicraft workers. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.749 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.