Identifying an Optimal Cut-Off Point for Musculoskeletal Pain in the Upper Extremities to Prevent Lowered Work Performance.

Abstract

This study identified when musculoskeletal pain (MSP) in the upper extremities indicates lowered work performance to gauge when secondary prevention of musculoskeletal disorders is needed. Seven hundred thirty-three subjects from 12 manufacturing or healthcare facilities in Washington state participated. Work performance was measured by the Disabilities of the Arm, Shoulder and Hand work module (DASH-Work). Each DASH-Work score was compared to the mean among U.S. workers to determine if workers had lowered work performance. ROC curve analysis was conducted to find the cut-off in a composite MSP index (summing MSP intensities in shoulders, elbows/forearms, and hands/wrists; range 0 to 24) to detect lowered work performance. The MSP index score of 2 achieved the best balance between sensitivity (0.79) and specificity (0.69) in detecting lowered work performance. To prevent reduced work performance, moderate or multisite pain may require proper management.