Journal of Occupational Rehabilitation

, Volume 20, Issue 3, pp 340–348 | Cite as

Correlates of Upper Extremity Disability in Medical Transcriptionists

  • Russell GelfmanEmail author
  • Timothy J. Beebe
  • Peter C. Amadio
  • Dirk R. Larson
  • Jeffrey R. Basford


Objective To investigate the association between disability and personal/lifestyle, medical, and psychosocial risk factors for upper extremity musculoskeletal symptoms and disorders (UEMSDs) in medical transcriptionists. Methods A web-based survey involving the Disabilities of the Arm, Shoulder and Hand (DASH), Perceived Stress Scale (PSS) and Overall Job Satisfaction (OJS) questionnaires of all medical transcriptionists working at a large healthcare facility. Results Responses were received from 80% (251 of 314) possible participants. Mean DASH, PSS, and OJS scores for those working at their current position for at least 1 year were 8.5 ± 10.1, 14.3 ± 6.7 and 5.3 ± 0.9. Personal/lifestyle factors including age (P < 0.001), lower educational level (P = 0.014), current or previous smoking (P = 0.012), and limited exercise (P = 0.013); medical conditions including diabetes mellitus (P = 0.015), carpal tunnel syndrome (P < 0.001), prior treatment for upper extremity symptoms (P < 0.001); prior workstation evaluation (P < 0.001) and psychosocial factors of perceived stress (P < 0.001), are associated with increased DASH scores. In these workers, multivariate analysis suggests that medical conditions (finger or other upper extremity symptoms requiring treatment or workstation evaluation; and diabetes mellitus) have a larger effect on the DASH than personal/lifestyle or psychosocial factors (age; previous or current smoking; and perceived stress). Conclusions Prior upper extremity musculoskeletal symptoms requiring treatment or ergonomic assessment, high perceived stress and a history of smoking are associated with self-reported disability. Diabetics have significantly higher levels of upper extremity disability than non-diabetics. Prospective studies are needed to see if interventions addressing these factors will prevent future work disability.


Disability Upper extremity Psychological stress Job satisfaction Diabetes mellitus 



The authors would like to thank James G. Koshy, PhD, Thomas J. Welch, III, James T. Fuelberth and Sandra J. Stevens for their assistance with this study. We would like to thank L. Joseph Melton, III, MD for his suggestions with the manuscript.


This publication was made possible by Grant Number 1 UL1 RR024150 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and the NIH Roadmap for Medical Research. Its contents are solely the responsibility of the authors and do not necessarily represent the official view of NCRR or NIH. Information on NCRR is available at Information on Reengineering the Clinical Research Enterprise can be obtained from

Conflict of interest statement

The authors report no conflicts of interest.


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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • Russell Gelfman
    • 1
    Email author
  • Timothy J. Beebe
    • 2
  • Peter C. Amadio
    • 3
  • Dirk R. Larson
    • 4
  • Jeffrey R. Basford
    • 1
  1. 1.Department of Physical Medicine and RehabilitationCollege of Medicine, Mayo ClinicRochesterUSA
  2. 2.Health Sciences ResearchCollege of Medicine, Mayo ClinicRochesterUSA
  3. 3.Department of OrthopedicsCollege of Medicine, Mayo ClinicRochesterUSA
  4. 4.Division of BiostatisticsMayo ClinicRochesterUSA

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