Measuring functional outcomes in work-related upper extremity disorders. Development and validation of the upper extremity function scale.
Pransky G; Feuerstein M; Himmelstein J; Katz JN; Vickers-Lahti M
J Occup Environ Med 1997 Dec; 39(12):1195-1202
The validity of a psychometric scale for evaluating upper extremity disorders (UEDs) was examined. The scales, known as the Upper Extremity Function Scale (UEFS), was an eight item self administered questionnaire that asked the respondents to rate their level of difficulty in performing activities such as opening jars, opening a door, or washing dishes on a 10 point scale, ranging from 1 'no problem' to 10 'major problem - can't do it at all'. The UEFS was evaluated in a group of 108 patients with work related UEDs and 165 patients with carpal tunnel syndrome (CTS) who were evaluated prospectively over a 2 year period at the University of Massachusetts Medical Center Occupational UEDs Clinic and the University of Massachusetts Orthopedic Hand Service, respectively. The subjects also completed subscales on the Arthritis Impact Measurement Scale (AIMS) that pertained to the arm and hands. The UEFS responses of the CTS patients were compared with the results of clinical tests such as those measuring maximum grip and pinch strength and median nerve conduction across the wrist and changes in their symptoms. The UEF scores showed relatively few 'floor responses' (the lowest possible response on every question) compared to the AIMS responses. In the CTS group, 'floor responses' on the AIMS were 30% greater than on the UEFS. The UEFS showed excellent internal consistency, as indicated by Cronbach alpha (CA) values ranging from 0.83 to 0.93, which were comparable to that of the AIMS, CA of 0.93. The UEFS scores were highly correlated with the AIMS scores in both the UED and CTS patients, correlation coefficient of 0.81. The UEFS scores could also be correlated with changes in symptom severity and clinical function in both patient groups. In the CTS patients, the UEFS scores were better correlated with significant improvements in symptomatology over time than in the results of the clinical tests. The authors conclude that the UEFS is a practical, reliable instrument for assessing changes in physical function of workers with UEDs. Further investigations are needed to determine its diagnostic capability particularly for workers with UEDs who have not yet sought medical treatment.
NIOSH-Publication; NIOSH-Cooperative-Agreement; Musculoskeletal-system-disorders; Questionnaires; Psychophysiology; Hand-injuries; Statistical-analysis; Safety-research; Carpal-tunnel-syndrome
University of Massachusetts Medical Center, Department of Family and Community Medicine, Occupational and Environmental Health Program, 55 Lake Avenue North, Worcester, MA 01655-0309
Journal of Occupational and Environmental Medicine
University of Massachusetts, Worcester, Massachusetts