title: Functional Measures Developed for Clinical Populations Identified Impairment Among Active Workers with Upper Extremity Disorders.
abstract: OBJECTIVE
  Few studies have explored measures of function across a range of health outcomes in a general working population. Using four upper extremity (UE) case definitions from the scientific literature, we described the performance of functional measures of work, activities of daily living, and overall health.
  
  
  METHODS
  A sample of 573 workers completed several functional measures: modified recall versions of the QuickDASH, Levine Functional Status Scale (FSS), DASH Work module (DASH-W), and standard SF-8 physical component score. We determined case status based on four UE case definitions: (1) UE symptoms, (2) UE musculoskeletal disorders (MSD), (3) carpal tunnel syndrome (CTS), and (4) work limitations due to UE symptoms. We calculated effect sizes for each case definition to show the magnitude of the differences that were detected between cases and non-cases for each case definition on each functional measure. Sensitivity and specificity analyses showed how well each measure identified functional impairments across the UE case definitions.
  
  
  RESULTS
  All measures discriminated between cases and non-cases for each case definition with the largest effect sizes for CTS and work limitations, particularly for the modified FSS and DASH-W measures. Specificity was high and sensitivity was low for outcomes of UE symptoms and UE MSD in all measures. Sensitivity was high for CTS and work limitations.
  
  
  CONCLUSIONS
  Functional measures developed specifically for use in clinical, treatment-seeking populations may identify mild levels of impairment in relatively healthy, active working populations, but measures performed better among workers with CTS or those reporting limitations at work.
authors.affiliation: Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Avenue, Saint Louis, MO, 63110, USA.
authors.forename: Bethany T
authors.initials: BT
authors.lastname: Gardner
authors.affiliation: Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Avenue, Saint Louis, MO, 63110, USA. adale@dom.wustl.edu.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Dale
authors.affiliation: Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Avenue, Saint Louis, MO, 63110, USA.
authors.forename: Skye
authors.initials: S
authors.lastname: Buckner-Petty
authors.affiliation: Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Avenue, Saint Louis, MO, 63110, USA.
authors.forename: Robert
authors.initials: R
authors.lastname: Rachford
authors.affiliation: Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Avenue, Saint Louis, MO, 63110, USA.
authors.forename: Jaime
authors.initials: J
authors.lastname: Strickland
authors.affiliation: Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Avenue, Saint Louis, MO, 63110, USA.|Program in Occupational Therapy, Washington University School of Medicine, Campus Box 8505, 4444 Forest Park Avenue, Saint Louis, MO, 63108, USA.
authors.forename: Vicki
authors.initials: V
authors.lastname: Kaskutas
authors.affiliation: Division of General Medical Sciences, Washington University School of Medicine, Campus Box 8005, 660 S. Euclid Avenue, Saint Louis, MO, 63110, USA.
authors.forename: Bradley
authors.initials: B
authors.lastname: Evanoff
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D002349:Carpal Tunnel Syndrome / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000175:diagnosis* / Q000503:physiopathology; D009784:Occupational Diseases / Q000175:diagnosis* / Q000503:physiopathology; D011788:Quality of Life; D011795:Surveys and Questionnaires; D034941:Upper Extremity / Q000503:physiopathology*; D014938:Work Capacity Evaluation
keywords: Case definitions; Functional measures; Health outcomes; Occupational injuries; Work