title: Musculoskeletal Complaints in Transverse Upper Limb Reduction Deficiency and Amputation in The Netherlands: Prevalence, Predictors, and Effect on Health.
abstract: (1) To determine the prevalence of musculoskeletal complaints (MSCs) in individuals with upper limb absence in The Netherlands, (2) to assess the health status of individuals with upper limb absence in general and in relation to the presence of MSCs, and (3) to explore the predictors of development of MSCs and MSC-related disability in this population.
  
  
  
  Cross-sectional study: national survey.
  
  
  
  Twelve rehabilitation centers and orthopedic workshops.
  
  
  
  Individuals (n=263; mean age, 50.7±16.7y; 60% men) ≥18 years old, with transverse upper limb reduction deficiency (42%) or amputation (58%) at or proximal to the carpal level (response, 45%) and 108 individuals without upper limb reduction deficiency or amputation (n=108; mean age, 50.6±15.7y; 65% men) (N=371).
  
  
  
  Not applicable.
  
  
  
  Point and year prevalence of MSCs, MSC-related disability (Pain Disability Index), and general health perception and mental health (RAND-36 subscales).
  
  
  
  Point and year prevalence of MSCs were almost twice as high in individuals with upper limb absence (57% and 65%, respectively) compared with individuals without upper limb absence (27% and 34%, respectively) and were most often located in the nonaffected limb and upper back/neck. MSCs were associated with decreased general health perception and mental health and higher perceived upper extremity work demands. Prosthesis use was not related to presence of MSCs. Clinically relevant predictors of MSCs were middle age, being divorced/widowed, and lower mental health. Individuals with upper limb absence experienced more MSC-related disability than individuals without upper limb absence. Higher age, more pain, lower general and mental health, and not using a prosthesis were related to higher disability.
  
  
  
  Presence of MSCs is a frequent problem in individuals with upper limb absence and is associated with decreased general and mental health. Mental health and physical work demands should be taken into account when assessing such a patient. Clinicians should note that MSC-related disability increases with age.
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands. Electronic address: S.G.Postema@umcg.nl.
authors.forename: Sietke G
authors.initials: SG
authors.lastname: Postema
authors.affiliation: University of Groningen, University Medical Center Groningen, Center of Human Movement Sciences, Groningen, The Netherlands.
authors.forename: Raoul M
authors.initials: RM
authors.lastname: Bongers
authors.affiliation: Rehabilitation Center De Hoogstraat Revalidatie, Utrecht, The Netherlands.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Brouwers
authors.affiliation: University Rehabiltiation Institute, Linhartova 51, Ljubljana, Slovenia; Medical Faculty, University of Ljubljama, Ljubljana, Slovenia.
authors.forename: Helena
authors.initials: H
authors.lastname: Burger
authors.affiliation: Faculty of Medicine and Health, School of Health and Medical Sciences, Örebro University, Örebro, Sweden; Department of Prosthetics and Orthotics, Region Örebro County, Sweden.
authors.forename: Liselotte M
authors.initials: LM
authors.lastname: Norling-Hermansson
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.
authors.forename: Michiel F
authors.initials: MF
authors.lastname: Reneman
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands; University of Groningen, University Medical Center Groningen, Department of Oral and Maxillofacial Surgery, Groningen, The Netherlands.
authors.forename: Pieter U
authors.initials: PU
authors.lastname: Dijkstra
authors.affiliation: University of Groningen, University Medical Center Groningen, Department of Rehabilitation Medicine, Groningen, The Netherlands.
authors.forename: Corry K
authors.initials: CK
authors.lastname: van der Sluis
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000671:Amputation, Surgical / Q000523:psychology / Q000534:rehabilitation*; D001186:Artificial Limbs; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008603:Mental Health; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology* / Q000523:psychology; D009426:Netherlands / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology / Q000523:psychology; D026741:Physical Therapy Modalities; D012047:Rehabilitation Centers; D012720:Severity of Illness Index; D034941:Upper Extremity; D055815:Young Adult
keywords: Amputation; Cumulative trauma disorders; Rehabilitation; Upper extremity; Upper extremity deformities; congenital