ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 2262

A Novel Study Instrument to Identify Household Work Related Musculoskeletal Disorders – Development and Validation

Priyanga Ranasinghe1, Inoshi Atukorala2, Sachitra Illangatilaka3 and Nalika Gunawardena4, 1Public Health, Medical Officer, Family Health Bureau, COLOMBO 8, Sri Lanka, 2Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Consultant Rheumatologist and Senior Lecturer in Medicine, COLOMBO 8, Sri Lanka, 3Department of Rheumatology and Medical Rehabilitation, Senior Registrar, COLOMBO 8, Sri Lanka, 4Faculty of Medicine, University of Colombo, Senior Lecturer in Community Medicine, COLOMBO 8, Sri Lanka

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords:

Session Information

Date: Tuesday, November 10, 2015

Title: Epidemiology and Public Health Poster III (ACR): Gout and Non-Inflammatory Musculoskeletal Conditions

Session Type: ACR Poster Session C

Session Time: 9:00AM-11:00AM

Background/Purpose:

Household work is significant cause of musculoskeletal pain, particularly in the South Asian setting where household work is labour intensive and manually performed.  But, the burden of this problem is unknown with the lack of a valid screening tool cited as a reason for this shortfall. This project develops and validates a novel study instrument to identify household work related musculoskeletal disorders (HWMSD) in the following nine anatomical regions – the neck, shoulder, elbow, wrist/hand, upper back, low back, hip/thigh, knee and ankles/feet.

Methods:

An interviewer -administered tool the Household Work related Musculoskeletal Disorders Questionnaire (HWMQ)) was developed. It assessed the presence/absence of musculoskeletal symptoms and household work-relatedness of these symptoms. This tool was developed by a multidisciplinary panel of experts using the Nordic Musculoskeletal Questionnaire as the base. Identification of the HWMSD was done if all absolute criteria were present for a given region in the presence of 2 or more probable symptom related and one or more probable household work related criteria(Table 1). The criterion validity against the diagnosis of a rheumatologist was the gold standard. Subsequently, test-retest reliability and acceptability was assessed in a sample of Sri Lankan housewives.

Results: The study cohort contained 250 full time housewives (median age 40 years, Interquartile range 35-45 years) from Colombo, Sri Lanka.  77% were engaged in household work for >10 years with a mean of 11.3 hours (±2.8) spent daily on household work. Household work included cooking (96 %), washing clothes by hand (83.6%), sweeping and cleaning (96.4%) carrying water/firewood (72.8%) and childcare (52.8%). Acceptability was high with a response rate of 83.3%. Average time taken to complete the HWMQ was 12min (± 3min). Psychometric properties of the HWMQ were as follows: sensitivity was highest in ankle/feet and lowest in hip/thigh region and specificity was highest in low back assessment and lowest in the knee region (Table 2). Reliability by Cohen’s Kappa was above 0.8 for each region.

Conclusion:

The household work related musculoskeletal disorders questionnaire is a valid and reliable instrument to screen the housewives for musculoskeletal disorders related to housework.

Table 1 Absolute and Probable Criteria to Diagnose HWMSD among Housewives

 

  Absolute criteria        

Probable criteria

Symptoms related criteria

  • Pain/ache/ discomfort for minimum of 3 consecutive days during last 3 months

(For low back region only)

  • No identifiable pattern with menstruation
  • The pain not related to /associated with pain of sexual intercourse
  • Burning sensation in abdomen
  • Pain on passing urine
  • Constipation 
  • Pain, ache or discomfort  restricts movements
  • Pain, ache or discomfort  has limited household activities performed
  • Pain, ache or discomfort has worsened intermittently or continuously over time
  • Pain, ache or discomfort with soreness of 5 or more in the visual analogue scale of (1-10)

Household work related criteria

  • The site not subjected to any  injury other than household work related injury

 

  • Onset of pain, ache or discomfort  after performing household work as a housewife
  • Pain, ache or discomfort  worsen when performing household work
  • pain, ache or discomfort  subsides when having rest from household work

Table 2:  Sensitivity and specificity of the HWMQ by region

 

Sensitivity (%)(95% CI)

Specificity (%)(95% CI)

Neck

80(75.0-85.0)

99.5 (98.6-100)

Shoulder

97 (94.9-99.1)

98.6 (97.1-100)

Elbow

93.7(90.7-96.7)

98.7 (97.3-100)

Wrist/Hand

89.1 (85.2-93)

99.0 (97.8-100)

Upper back

95.5(92.9-98.1)

98.7 (97.3-100)

Lower back

94.5(91.7-97.3)

99.3 (98.3-100)

Hip/Thigh

80 (75-85)

98.0(96.3-99.7)

Knee

93.6(90.6-96.6)

89.7(85.9-93.5)

Ankle/Feet

97.6(95.7-99.5)

99 (97.8-100)

* CI- confidence interval

Disclosure: P. Ranasinghe, None; I. Atukorala, None; S. Illangatilaka, None; N. Gunawardena, None.

To cite this abstract in AMA style:

Ranasinghe P, Atukorala I, Illangatilaka S, Gunawardena N. A Novel Study Instrument to Identify Household Work Related Musculoskeletal Disorders – Development and Validation [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/a-novel-study-instrument-to-identify-household-work-related-musculoskeletal-disorders-development-and-validation/. Accessed .

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