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Occup Environ Med 59:664-670 doi:10.1136/oem.59.10.664
  • Review

A review of functional status measures for workers with upper extremity disorders

Table 1

Description of selected functional status instruments tested among workers

Description Validity Reliability Responsiveness to change
VAS, visual analogue scale; SRM, standardised response mean; CTS, carpal tunnel syndrome; PT, physical therapist; N/A, not available.
1 Neck Disability Index (NDI): 10 items Pain intensity, personal care, lifting, reading, headaches, concentration, work, driving, sleeping, recreation. Response: 1 (poorest) to 5 (best) [Vernon and Mior, 1991] Peer review, patient feedback. Correlation of 0.6 between changes in scores pre- and post-treatment compared to VAS for activity levels. Correlation of 0.7 between NDI and McGill Pain Questionnaire. Pearson correlation: 0.89 Cronbach alpha: 0.80 total index Cronbach alpha: each item above 0.76 33% change in pre- v post-treatment scores
2 Disability Rating Index (DRI): 12 items Dressing, outdoor walks, climbing stairs, sitting long time, standing over sink, carrying bag, making bed, running, light work, heavy work, lifting heavy objects, exercise/sports. Response: 10 cm VAS: without difficulty – not at all [Salén et al, 1994] Construct validity: median scores very low (0.9% and 8.8%) in healthy groups, high (50–65%) among patients with arthritis. Pearson intraclass correlation to observers' assessment of performance=0.48. Test-retest reliability 0.92 for 3 day interval 0.95 for 1 day interval Inter- 0.99 and intra-rater: 0.98 Cronbach alpha 0.84 16% change in median pre- v postoperative scores
3 Upper Extremity Function Scale: 8 items Sleeping, writing, opening jars, picking up small objects with fingers, driving car >30 min, opening door, carrying milk jug from refrigerator, washing dishes. Response: 1 (no problem) to 10 (major problem) [Pransky et al, 1997] Able to discriminate between levels of severity (significant t test value) for working status, duration of symptoms, effect on job ability, Phalen's test. Correlation with average pain level r=0.67, fear of pain, r=0.44, pinch strength r=−0.40 Cronbach alpha: 0.83 to 0.93 Upper extremity cohort SRM range: −1.33 to −0.53 CTS cohort SRM range: −1.03 to 0.92
4 Nordic Musculoskeletal Questionnaires: 27 items 3 questions: Have you had trouble (ache, pain, discomfort, numbness), Had trouble during last seven days; Been prevented from normal activities in 9 body areas (neck, shoulder, elbows, wrists/hands, upper back, lower back, hips/thighs/buttocks, knees, ankles/feet). Response: Yes/No, multiple choice [Kuorinka et al, 1987] Tests with clinical history: non-identical answers varied between 0–20%. Comparison to PT assessment: percentage of disagreement varied between 0–13%. Neck-shoulder questionnaire disagreeing responses varied from 0–30% Low back questionnaire disagreeing responses varied from 0–4% (1 item had 25% variance and reformulated in the final version) N/A
5 Upper Extremity Questionnaire: 123 items Medical history, exercise, symptoms (burning, stiffness, pain, cramping, tightness, aching, soreness, tingling, numbness) in 3 body areas (neck/shoulder/upper arm, elbow/forearm, and wrist/hand/finger); frequency, severity, interference with work. Response: Yes/No, 10 cm VAS, multiple choice [Franzblau et al, 1997; Salerno et al, 2001] N/A Kappa: 0.56–1 medical history Symptom kappa values 0.39–0.86 neck/shoulder/upper arm 0.44–0.86 elbow/forearm 0.44–0.84 wrist/hand/fingers N/A
6 Neck and Upper Limb Index (NULI): 20 items
 7 physical activity items, 4 work-related, 6 psychosocial, 2 sleep related, 1 item related to negative effects of evaluation or treatment.
 Response: 7 pt scales
 [Stock et al, 2000] Correlation to Sickness Impact Profile, question on overall functional status, PT perception of functional status, hand grip strength, shoulder abduction, scratch test. Test-retest: ICC=0.88 Ontario cohort; ICC=0.83 Quebec cohort. Cronbach alpha: 0.90 Ontario Cronbach alpha: 0.93 Quebec SRM: 1.48 Ontario cohort SRM: 1.63 Quebec cohort

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