Musculoskeletal complaints, physical work demands, and functional capacity in individuals with a brachial plexus injury: An exploratory study.
Tallie M J van der Laan, Sietke G Postema, Siawash A Alkozai and 2 others
PMID 37781839WHAT IT FOUND
For people with one working arm, four video-based ergonomic tools agreed on workload scores, but their risk ratings did not.
A self-report questionnaire did not match any tool. Pain in the healthy arm was not linked to workload or measured capacity, so these tools cannot explain who develops pain.
Key findings
01The four observation tools (OCRA, SI, RULA, Hand activity TLV) correlated moderately to strongly on raw scores, but their risk-level ratings correlated only fairly, so the tools are not interchangeable when judging risk.
02The self-reported Upper Extremity Work Demands questionnaire showed only weak to fair correlations with every other method and was dropped from the second part of the study.
03Musculoskeletal complaints were not related to physical work demands, to functional capacity, or to the mismatch between the two.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 16 people were analysed, and the authors state the study was underpowered. They treated a p-value below 0.1 as significant and did not correct for multiple comparisons, so the few 'significant' findings (such as the hand-grip mismatch difference) could be chance. Nine of the sixteen participants did administrative work, so the results say little about physically demanding jobs. The rater who scored the videos knew the other methods' results, which can bias agreement. The pain questionnaire cannot separate musculoskeletal pain from neuropathic pain, and the authors classified pain in the injured arm as neuropathic, which may have removed real complaints from the count. For three participants not all daily tasks were filmed, so their true workload may be underestimated. The functional capacity tests were compared against reference values from the general two-handed population, and the authors note these reference values may be too low for people who must compensate with one arm.
Declared interests
No funding or conflict-of-interest declaration appears in the supplied text.
The easy way to misread this
Do not read the finding that 12 of 16 participants were in an increased-risk band as proof that high workload causes pain in this group. The study found no relationship between complaints and any workload measure, and the risk thresholds themselves were inconsistent across the four tools.