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<h1>Publikation Lieb</h1>
<p>International Journal of Environmental Research and Public Health Article Predictors for Clinical Outcomes Related to Upper Extremity Musculoskeletal Disorders in a Healthy Working Population Oliver Lotter 1,* , Tobias Lieb2, Jochen Molsner 3 and Viktor Breul 4 Citation: Lotter, O.; Lieb, T.; Molsner, J.; Breul, V. Predictors for Clinical Outcomes Related to Upper Extremity Musculoskeletal Disorders in a Healthy Working Population. Int. J. Environ. Res. Public Health2021, 18, 9171. https://doi.org/10.3390/ ijerph18179171 Academic Editor: César Fernández De Las Peñas Received: 11 May 2021 Accepted: 26 August 2021 Published: 31 August 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1 Department of Plastic, Aesthetic, Hand and Reconstructive Surgery, Academic District Hospital, Zeppelinstrasse 21, 78532 Tuttlingen, Germany 2 Office for Occupational and Hand Therapy, Neuhauser Strasse 85, 78532 Tuttlingen, Germany; tobiaslieb@gmx.de 3 IAS-Group for Occupational Health Management, Koenigstrasse 6, 78532 Tuttlingen, Germany; Jochen.Molsner@ias-gruppe.de 4 Department of Medical Scientific Affairs, Aesculap AG, Am Aesculap Platz, 78532 Tuttlingen, Germany; viktor.breul@aesculap.de * Correspondence: oliver.lotter@googlemail.com; Tel.: +49-7424-950-4491; Fax: +49-7424-950-4499 Abstract: A wide range of endpoints and methods of analysis can be observed in occupational health studies in the context of work-related musculoskeletal disorders (WMSDs). Comparison of study results is therefore difficult. We investigated the association between different clinical endpoints and the presence of upper extremity WMSDs in a healthy working population. Furthermore, the influence of socio-demographic, work-related, and individual predictors on different endpoints was examined. Two self-administered questionnaires were distributed to 70 workers and employees. In addition, a standardized physical examination and an industry test were performed in this cross-sectional study. Correlations between WMSDs and clinical endpoints were analyzed with the Spearman method and prediction ellipses. Multiple regression models were used to study the strength of associations with a pre-defined set of potential influencing factors. The prevalence of WMSDs was 56% (39/70). Disabilities of Arm, Shoulder, and Hand (DASH) score/pain under strain showed the strongest correlations with WMSDs. When analyzing the correlation between WMSDs and pre-selected predictors, none of the predictors could be identified as a risk factor. The DASH score remains a close candidate for best surrogate endpoint for WMSDs detection. Standardized analysis methods could improve the methodological quality of future occupational health studies. Keywords: work-related musculoskeletal disorders (WMSDs); upper extremity; repetitive work; surgical device mechanics; DASH score; Purdue Pegboard Test; multiple analysis; correlation; predictors 1. Introduction Work-related musculoskeletal disorders (WMSDs), also known as cumulative trauma disorders (CTD), repetitive strain injuries (RSI), or occupational overuse syndromes (OOS), account for more than 48% of work-related disorders [1,2]. The overall global prevalence for such conditions ranges from 4.0% to 30%, increasing with age, and the annual prevalence lies between 0.14% and 14.9% across different industries and work processes [3–6]. Treatment costs for WMSDs are estimated at 1.3% of the US gross national product and between 0.5% and 2.0% in Scandinavian countries [7,8]. WMSDs are of multifactorial origin. The work environment contributes significantly to the condition and/or the condition is aggravated by the work activity [9]. Such disorders are caused by the accumulation of microtraumatic events in the musculoskeletal system over a long period of time and represent a broad spectrum of inflammatory and degenerative diseases, jeopardizing the quality of life and functional capacity of those affected [10,11]. They are a significant occupational health problem among industrial and clerical workers with a strong medical, economic, and social impact in terms of absences Int. J. Environ. Res. Public Health2021, 18, 9171. https://doi.org/10.3390/ijerph18179171 https://www.mdpi.com/journal/ijerph</p>
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