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Workload and injury
Prognostic impact of physical workloads on symptom severity among patients examined for ulnar neuropathy
  1. Poul Frost1,
  2. Birger Johnsen1,
  3. Anders Fuglsang-Frederiksen1,
  4. Susanne Wulff Svendsen2
  1. 1Aarhus University Hospital, Aarhus, Denmark
  2. 2Regional Hospital West Jutland, Herning, Denmark

Abstract

Objectives Ulnar neuropathy is the second most frequent focal peripheral neuropathy. Sparse information exists on the persistence of symptoms and prognostic factors. We wished to evaluate relations between forceful and repetitive work and work with awkward arm postures and symptom severity of ulnar neuropathy (UNE) and ulnar neuropathy-like symptoms using a modified version of the UNE questionnaire (UNEQ) (Mondelli et al, 2006).

Methods Patients, examined on suspicion of UNE between 2001 and 2007 at the Department of Neurophysiology, were in 2008 included in a case control study of risk factors for UNE and ulnar neuropathy-like symptoms in which 59% participated. Individual exposure measures were allocated using job title the year before neurophysiologic examination (index year) in combination with a Job Exposure Matrix based on expert judgement. The severity of symptoms of ulnar neuropathy assessed by UNEQ was categorised based on quartiles. Ordinal logistic regression was used to analyse symptom severity in relation to index year, gender, age, body mass index, smoking, alcohol consumption, confirmed neuropathy (yes/no), and the three work exposures.

Results The analyses comprised 580 patients with complete information. Symptom severity was related to confirmed neuropathy, highest category of forceful work (OR=1.6 (95% CI: 1.03 to 2.54)), and unrelated to repetitive work and work with awkward arm postures.

Conclusions Forceful work but not repetitive work and work with awkward arm postures may have negative prognostic influence on symptom severity of ulnar neuropathy. This result could guide clinicians on advice about work to this patient group.

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