Article

OBJECTIVE: To evaluate predictors of hand symptoms and functional impairment
after 3 years of follow-up among workers with different types of hand symptoms
including carpal tunnel syndrome (CTS). Functional status and job limitations
were also analyzed as key secondary objectives. DESIGN: Cohort design of 3 years
duration. SETTING: Working population-based study. PARTICIPANTS: Newly employed
workers without a preexisting diagnosis of CTS (N=1107). Subjects were
categorized into 4 groups at baseline examination: no hand symptoms, any hand
symptoms but not CTS (recurring symptoms in hands, wrist, or fingers without
neuropathic symptoms), any hand symptoms of CTS (neuropathic symptoms in the
fingers and normal nerve conduction study), or confirmed CTS (CTS symptoms and
abnormal nerve conduction study). Among workers with hand pain at baseline,
subject and job characteristics were assessed as prognostic factors for outcomes,
using bivariate and multivariate regression models. INTERVENTIONS: Not
applicable. MAIN OUTCOME MEASURE: The primary outcome assessed by questionnaire
at 3 years was "severe hand pain" in the past 30 days. RESULTS: At baseline, 155
workers (17.5% of 888 followed workers) reported hand symptoms, of which 21 had
confirmed CTS. Presence of hand pain at baseline was a strong predictor of future
hand pain and job impairment. Subjects with confirmed CTS at baseline were more
likely than workers with other hand pain to report severe hand pain (adjusted
prevalence ratios 1.98 [95% confidence interval 1.11-3.52]) and functional status
impairment (adjusted prevalence ratios 3.37 [95% confidence interval
1.01-11.29]). Among subjects meeting our case definition for CTS at baseline,
only 4 (19.1%) reported seeing a physician in the 3-year period. CONCLUSIONS:
Hand symptoms persisted among many workers after 3-year follow-up, especially
among those with CTS, yet few symptomatic workers had seen a physician.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS