Cluster Analysis of Symptoms Among Patients with Upper Extremity Musculoskeletal Disorders

• Published in: Journal of occupational rehabilitation Vol. 20; no. 4; pp. 526 - 536
• Main Authors: Gold, Judith E., Piligian, George, Glutting, Joseph J., Hanlon, Alexandra, Frings-Dresen, Monique H. W., Sluiter, Judith K.
• Format: Journal Article
• Language: English
• Published: Boston Springer US 01-12-2010; Springer; Springer Nature B.V
• Subjects: Adult; Alzheimer's disease; Carpal tunnel syndrome; Chronic Disease; Clinical Psychology; Cluster Analysis; Cohort Studies; Complaints; Cumulative Trauma Disorders - classification; Disability management; Discriminant analysis; Elbow; Environmental Health; Factor analysis; Factor Analysis, Statistical; Female; Health care industry; Health Psychology; Humans; Male; Medicine; Medicine & Public Health; Middle Aged; Musculoskeletal diseases; Musculoskeletal Diseases - classification; Musculoskeletal Diseases - diagnosis; Musculoskeletal system; Natural history; Netherlands; Occupational Diseases - diagnosis; Occupational Medicine/Industrial Medicine; Orthopedics; Pain; Pain Measurement; Patients; Principal components analysis; Questionnaires; Rehabilitation; Repetitive stress injury; Studies; Surveys; Surveys and Questionnaires; Upper Extremity - injuries; Upper Extremity - physiopathology; Work-related injuries; Netherlands; RSI; Factor analysis; Case definition; Non-specific; Classification; MSD
• ISSN: 1053-0487; 1573-3688
• DOI: 10.1007/s10926-010-9240-x

Introduction
Some musculoskeletal disorders of the upper extremity are not readily classified. The study objective was to determine if there were symptom patterns in self-identified repetitive strain injury (RSI) patients.
Methods
Members (
n
 = 700) of the Dutch RSI Patients Association filled out a detailed symptom questionnaire. Factor analysis followed by cluster analysis grouped correlated symptoms.
Results
Eight clusters, based largely on symptom severity and quality were formulated. All but one cluster showed diffuse symptoms; the exception was characterized by bilateral symptoms of stiffness and aching pain in the shoulder/neck.
Conclusions
Case definitions which localize upper extremity musculoskeletal disorders to a specific anatomical area may be incomplete. Future clustering studies should rely on both signs and symptoms. Data could be collected from health care providers prospectively to determine the possible prognostic value of the identified clusters with respect to natural history, chronicity, and return to work.