Читать книгу Musculoskeletal Disorders - Sean Gallagher - Страница 21

MSDs of the distal UE are prevalent in the working world and have substantial economic costs (Dale et al., 2013; Descatha, Leclerc, Chastang, & Roquelaure, 2003; Gerr et al., 2002; Silverstein et al., 2010; Tanaka, Petersen, & Cameron, 2001). These MSDs can affect each segment of the upper extremity, from the shoulder to the hand. Risk factors for wrist and hand MSDs include repetitive pushing, hand force, combined exposure to both force and repetition, sustained gripping (e.g., computer or hand tool use), repetitive redundant movement of the thumb and digits (e.g., typing or texting), sustained or repeated static loading of the weight of an instrument or tool, and use of vibrating tools (Barr, Barbe, & Clark, 2004; Fry, 1986; Gold, Mohamed, Ali, & Barbe, 2014; Gupta & Mahalanabis, 2006; Kakosy, Nemeth, Kiss, Laszloffy, & Kardos, 2006).

Hand‐intensive jobs that feature forceful and repetitive activities are associated with both the onset and severity of hand and wrist MSDs (Barr et al., 2004; Viikari‐Juntura & Silverstein, 1999). Other physical risk factors shown to exacerbate risk include adoption of non‐neutral wrist and forearm postures, sustained gripping, sustained or repeated static loading of the weight of an instrument or tool, high impact jolting, exposure to hand‐arm vibration (HAV), and exposure to cold temperatures (NIOSH, 1997; NRC‐IOM, 2001). Continuous movement of a joint into end of range, for example, with repeated hyperextension of metacarpophalangeal joints, may be another causative factor due to enhanced inflammation in joint and tendon tissues (Gold et al., 2014; Walsh, Delahunt, & McCarthy, 2011). Individuals with prolonged heavy or one‐sided hand workloads or increased high impact “jolting” of the hand show increased incidence of hand osteoarthritis, with higher incidence in females (Bernard, Wilder, Aluoch, & Leaverton, 2010; Blumenfeld et al., 2014; Rossignol et al., 2005). The following sections discuss some of the more common UE disorders, their characteristics, prevalence and incidence, anatomy and pathology, and risk factors.