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PubMed1994

Occupational cumulative trauma disorders of the upper extremity.

The umbrella term cumulative trauma disorders (CTDs) (also known as repetitive strain injuries, overuse syndromes, and repetitive motion disorders) covers a number of similar conditions arising from overuse of the joints or soft tissues of the upper extremity. Occupational CTDs have become a common problem in the workplace. These disorders are costly to the employer, the worker, and society in terms of time lost from work and resulting disability. Within the past decade, occupational therapists and physical therapists specializing in rehabilitation of work-related musculoskeletal injuries have seen an increase in the incidence of CTDs of the upper extremity in the workplace. Therapists are called upon not just to treat these injured workers, but also to help them regain a functional level for work reentry and to educate them to prevent reinjury. This article reviews the literature on the epidemiology, etiology, pathophysiology, and management of upper-extremity occupational CTDs. Because the ultimate goal of the workplace is to maintain the health and safety of the employee, an educational approach to hand, wrist, elbow, and shoulder use is essential to prevent, decrease, or eliminate the risk of occupational CTDs of the upper extremity.

Arm Injuries↗
PubMed2003

A study on upper extremity cumulative trauma disorder in different unorganised sectors of West Bengal, India.

Cumulative trauma disorder (CTD) is a term used to describe a class of soft tissue injuries that result due to a number of occupational activities. These disorders commonly occur among workers who are engaged in highly repetitive jobs involving continuous hand exertion, vibration and localized mechanical pressure. In the present investigation, an attempt was made to evaluate the prevalence of CTD among workers associated with strenuous hand intensive jobs in unorganized sectors in India and to highlight the unsafe working conditions to which these workers have been exposed for several years. For this purpose, an experiment was performed on 25 male workers from each group. The groups were classified into meat cutters, typists, tailors, visual display terminal (VDT) operators & weavers. For the symptom survey, a questionnaire and checklist method was implemented. Along with these, a detailed time study was performed among the workers during different activities in the total work cycle. For this study a two-tail chi-square test of independence was applied to determine whether or not the feeling of discomfort had any significant association with the repetitiveness of the work. From the observations and analysis of the results, it was revealed that all the activities are repetitive, i.e. over 50% of the work cycle of each activity involved the respective main activity where similar kinds of motion patterns were performed. Therefore it can be concluded that high repetitiveness, prolonged work activity and remaining in static posture for a prolong period of time may be regarded as the causative factors in the occurrence of CTD.

Adult↗
PubMed1998

[Ergonomic aspects in the prevention of occupational cumulative trauma disorders of the locomotor system].

In recent years, a rapid increase in the number of cumulative trauma disorders (CTDs) induced by repeatability of certain functions in the course of work performance has been observed. In the United States, a twenty-fold increase in the number of registered CTDs of upper limbs has been noted during the last ten years. For example in 1993, CTDs constituted 60% of all occupational diseases. A similar observation was made in Australia, Canada, Japan, Sweden, the United Kingdom and other European countries. It is thought that this high incidence of cumulative trauma disorders result, to a great extent, from changes in technologies leading finally to almost unilateral involvement of the human locomotor system. Ergonomics plays a key role in the prevention of the locomotor system occupational traumas, since as the only one discipline, it is able to provide criteria for securing safety work without disturbing its inherent sense, namely the efficiency. Risk factors reported in Western countries will also emerge in Polish economy in the near future. In Poland like in other countries, employers, managers of work posts, safety and hygiene services, as well as occupational physicians frequently fail to identify CTD risk factors which occur in the working environment. In this paper, the author presents the literature data on CTD etiology, and the criteria for identifying occupational risk factors. The literature review clearly indicates that the studies of cumulative trauma disorders of the musculoskeletal system has recently been intensified. But the evaluation criteria, nomenclature and analytical methods still needs to be standardized.

Ergonomics↗
PubMed2002

Work-related cumulative trauma disorders of the upper extremity: navigating the epidemiologic literature.

BACKGROUND: Cumulative trauma disorder of the upper extremity (CTDUE) is an umbrella term used to describe disorders resulting from repeated use of the upper extremity over time rather than a specific incident. The primary purpose of this article is to summarize the literature regarding the rate of work-related CTDUE, while drawing attention to the various factors contributing to the wide range of reported findings. METHODS: The Cumulative Index to Nursing and Allied Health and Medline databases were searched for articles focusing on etiology or rates of occurrence of work-related CTDUE and their findings were summarized. RESULTS: Potential reasons for rising rates, a gender differential, and the substantial range in rates and rate ratios are delineated and important factors to consider when interpreting rates derived from workers' compensation data are detailed. CONCLUSIONS: Future research should attempt to correctly identify more specific categories of CTDUE in well-defined and accurately-quantified "at risk" populations to provide more meaningful information regarding the epidemiology of CTDUE and the effectiveness of control activities.

Adult↗
PubMed1989

Cumulative trauma disorders: their recognition and ergonomics measures to avoid them.

Cumulative Trauma Disorders, CTD, are the summary results of many microtrauma. Though known since the early 1800s, they have become a matter of urgent ergonomics concern in the 1980s. They are usually caused by repeated and/or forceful exertions, often in the hand-arm-shoulder region. They predominantly occur to soft tissues, such as tendons and ligaments, and to nerves and blood vessels. They are commonly associated with certain occupational and leisure activities. Many CTD can be avoided by a set of fairly simple and straightforward ergonomics procedures.

Journal Article↗
PubMed1987

Proposed screening tool for the detection of cumulative trauma disorders of the upper extremity.

The incidence of cumulative trauma disorder (CTD) has become noteworthy in plants that rely on automated production. This rise was evident in an Ohio poultry company. The purpose of this study was to develop a screening tool to detect employees who might be at risk of sustaining a CTD injury and to identify trends of CTD at specific workstations. Thirty-five employees at three workstations completed a questionnaire and underwent a physical examination. Results identified 24 employees with a potential for CTD, and these employees were recommended for remediation. Job modifications and supportive devices were placed in the workplace. A newly designed industrial wrist splint was developed for this study. The personnel department has noted that employee complaints of upper extremity discomfort have decreased.

Accidents, Occupational↗
PubMed2000

The effectiveness of intervention strategies used to educate clients about prevention of upper extremity cumulative trauma disorders.

The increased prevalence of work-related cumulative trauma disorders (CTDs) of the upper extremity highlights the need for effective prevention programs. This paper examines the effectiveness of different intervention strategies used to educate workers about the prevention of upper extremity CTDs. The articles reviewed include primary prevention and reinjury prevention interventions in both clinical and workplace settings. The current research findings are inconclusive. Intervention strategies may include discussion, demonstration, or practice of proper posture and body mechanics. Practice of correct techniques may not be necessary to achieve improved hand-use patterns in assembly-line workers. However, practice with intensive feedback may be necessary to achieve the best performance of hand-wrist position, but not sitting posture, in computer operators. The effects of practice on correct hand use may depend on the type of job task. Further research is needed to clarify the role of practice and feedback in CTD prevention.

Journal Article↗
PubMed2001

Tracking ability in subjects symptomatic of cumulative trauma disorder: does it relate to disability?

Symptoms of upper extremity cumulative trauma disorders (CTDs) often include weakness, discomfort, pain, numbness and stiffness, which are generally assessed clinically by using static tests or isolated movements. Little is known about the dynamic, functional ability of the upper extremity in CTD, yet, more than impairment, performance variables may relate to disability. The objectives of this study were to determine whether a manual tracking task was sensitive to the presence of symptoms associated with CTD and whether tracking performance related to disability. Forty-five volunteers who had frequently experienced one or more symptoms consistent with upper extremity CTD for at least 1 year and 22 control subjects performed the manual tracking task. Using a hand-held stylus over a digitizing tablet, subjects tracked a target that moved pseudo-randomly and was displayed on a computer screen. The root mean square error of the linear difference between target and stylus positions provided a measure of overall performance accuracy. Quadrant specific performance was also calculated to determine whether the location of the target (hence hand and wrist position) influenced performance. Additionally, the symptomatic group completed the Disability of the Arm, Shoulder and Hand (DASH) questionnaire reflecting physical disability level. Performance accuracy was poorer in symptomatic subjects than controls (p<0.001) and was influenced by target location (p<0.0001). The overall performance was associated with physical disability (r = 0.54). The findings suggest that tracking performance is sensitive to the presence of CTD symptoms and related to disability level. Further validation is required to determine whether the performance measure is sensitive to disease progression or intervention-induced changes.

Adolescent↗
PubMedDate not supplied

Cumulative trauma disorder risk for children using computer products: results of a pilot investigation with a student convenience sample.

OBJECTIVES: Cumulative trauma disorder is a major health problem for adults. Despite a growing understanding of adult cumulative trauma disorder, however, little is known about the risks for younger populations. This investigation examined issues related to child/adolescent computer product use and upper body physical discomfort. METHODS: A convenience sample of 212 students, grades 1-12, was interviewed at their homes by a college-age sibling or relative. One of the child's parents was also interviewed. A 22-item questionnaire was used for data-gathering. Questionnaire items included frequency and duration of use, type of computer products/games and input devices used, presence of physical discomfort, and parental concerns related to the child's computer use. RESULTS: Many students experienced physical discomfort attributed to computer use, such as wrist pain (30%) and back pain (15%). Specific computer activities-such as using a joystick or playing noneducational games-were significantly predictive of physical discomfort using logistic multiple regression. Many parents reported difficulty getting their children off the computer (46%) and that their children spent less time outdoors (35%). CONCLUSIONS: Computer product use within this cohort was associated with self-reported physical discomfort. Results suggest a need for more extensive study, including multiyear longitudinal surveys.

Adolescent↗
PubMed1992

Management of upper extremity cumulative trauma disorders.

1. Elements critical to a successful medical management program include cumulative trauma disorder (CTD) surveillance, conditioning and rehabilitation programs, and familiarity with OSHA recordkeeping requirements, in addition to recognition, evaluation, and treatment. 2. Occupational health care providers (HCPs) can identify high risk departments, production lines, or jobs through the passive and/or active surveillance systems. 3. The HCP should perform a CTD evaluation of employees assigned to jobs with known ergonomic hazards or areas found to have CTD problems by the surveillance system. These evaluations should consist of a medical and occupational history, and a physical examination of the upper extremities. 4. The treatment algorithm emphasizes that a) symptomatic employees need follow up to determine the effectiveness of the prescribed treatments, b) employees with severe symptoms, positive physical findings, or disorders resistant to treatment need to be referred to a physician for further evaluation, and c) conservative therapy deserves an adequate trial before surgical intervention is contemplated.

Algorithms↗
PubMed2002

Industrial medicine and acute musculoskeletal rehabilitation. 3. Cumulative trauma disorders of the upper limb in computer users.

UNLABELLED: This self-directed learning module highlights various cumulative trauma disorders of the upper limb that may be seen in computer users. The biomechanics and ergonomics of computer users are addressed in relationship to specific neurologic and musculoskeletal conditions within the neck and upper limbs. In addition to a general overview of these conditions, a case presentation is used to show the evaluation and treatment of a computer user who has carpal tunnel syndrome and concomitant de Quervain tenosynovitis. OVERALL ARTICLE OBJECTIVES: (a) To review the important anatomic and ergonomic basis for upper limb cumulative trauma disorders in computer users and (b) to provide an example of evaluation and treatment.

Acute Disease↗