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Work-related musculoskeletal disorders of the hand and wrist: epidemiology, pathophysiology, and sensorimotor changes.

Authors
Barr-AE; Barbe-MF; Clark-BD
Source
J Orthop Sports Phys Ther 2004 Oct; 34(10):610-627
NIOSHTIC No.
20029004
Abstract
The purpose of this commentary is to present recent epidemiological findings regarding work-related musculoskeletal disorders (WMSDs) of the hand and wrist, and to summarize experimental evidence of underlying tissue pathophysiology and sensorimotor changes in WMSDs. Sixty-five percent of the 333 800 newly reported cases of occupational illness in 2001 were attributed to repeated trauma. WMSDs of the hand and wrist are associated with the longest absences from work and are, therefore, associated with greater lost productivity and wages than those of other anatomical regions. Selected epidemiological studies of hand/wrist WMSDs published since 1998 are reviewed and summarized. Results from selected animal studies concerning underlying tissue pathophysiology in response to repetitive movement or tissue loading are reviewed and summarized. To the extent possible, corroborating evidence in human studies for various tissue pathomechanisms suggested in animal models is presented. Repetitive, hand-intensive movements, alone or in combination with other physical, nonphysical, and nonoccupational risk factors, contribute to the development of hand/wrist WMSDs. Possible pathophysiological mechanisms of tissue injury include inflammation followed by repair and/or fibrotic scarring, peripheral nerve injury, and central nervous system reorganization. Clinicians should consider all of these pathomechanisms when examining and treating patients with hand/wrist WMSDs.
Keywords
Animal-studies; Laboratory-animals; Muscular-disorders; Musculoskeletal-system-disorders; Muscle-tissue; Muscle-function; Repetitive-work; Ergonomics; Neuromuscular-function; Neuromuscular-system; Neuromuscular-system-disorders; Cumulative-trauma; Cumulative-trauma-disorders
Contact
Physical Therapy Department, College of Health Professions, Temple University, Philadelphia, PA 19140
CODEN
JOSPDV
Publication Date
20041001
Document Type
Journal Article
Funding Type
Grant
Fiscal Year
2005
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-003970
Issue of Publication
10
ISSN
0190-6011
Source Name
Journal of Orthopaedic and Sports Physical Therapy
State
PA
Performing Organization
Temple University
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