Perspectives of subjects with upper limb absence on the risk factors for musculoskeletal complaints.

Abstract

Background: Musculoskeletal complaints (MSCs) are a highly prevalent problem in subjects with upper limb absence (ULA). Studies have been conducted to better understand the risk factors for the development and persistence of MSCs, and show relations with psychological and work-related factors. The opinions of patients with ULA have not been taken into account so far. Their perspectives can contribute to address important factors and aid in the improvement of treatments. This study therefore executed a focus group with subjects with ULA, to get insight in the patient perspectives and to develop a framework of all factors involved in the development and persistence of MSCs.

Methods: A focus group was held with adult individuals with ULA. With open questions, the general topic of MSCs and the main topic of the risk factors for MSCs were addressed. The transcript of the focus group was used to build a framework, by formulation (sub)categories of risk factors in an inductive way. The final set of categories was entered in the Atlas.ti software to identify sections of the transcript corresponding to a (sub)category.

Results: Eleven subjects with ULA participated in the focus group, of which three experienced no MSCs and eight had MSCs in the previous year. The opinions of the participants resulted in five main categories containing 29 subcategories: prosthesis-related, psychological & cognition, environment, general, and activities. Especially the factors in the ‘psychological & cognition’ and ‘activities’ category were deemed important.

Conclusion: The outcomes of the focus group regarding the categories ‘psychological & cognition’ and ‘activities’ cannot be endorsed with current literature, as literature on these categories is limited. Future research should therefore address the gaps between the patient perspectives and the literature, to fill the gap and to extend the knowledge on risk factors for MSCs.