This paper is only available as a PDF. To read, Please Download here.
Computer users experience high rates of injury and disability, broadly termed repetitive strain injury (RSI). With more than 60 million Americans using computers in offices and homes, the potential magnitude of the RSI problem indicates a need for increased attention to prevention and treatment. The purpose of this article is to: 1) present a conceptual model of RSI as a kinetic-chain, multifactorial disorder; 2) outline the salient features of the clinical evaluation of the RSI patient; 3) describe the role of postural deviation in the pathogenesis of RSI; 4) present the principles of individual manual therapy; and 5) discuss the rationale, admission criteria, educational principles, and outcome of a multidisciplinary group intervention.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Journal of Hand Therapy
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Occupational cumulative trauma disorders of the upper extremity.Am J Occup Ther. 1994; 48: 411-420
- Putz-Anderson V Cumulative Trauma Disorders: A Manual for Musculoskeletal Diseases of the Upper Limbs. Taylor & Francis, Bristol, PA1988
- Diagnosis of cumulative trauma disorders.in: Advances in Operative Orthopedics, I. C.V. Mosby, St. Louis, MO1993: 227-242
- Cumulative trauma disorders and compression neuropathies of the upper extremities.in: Kasdan ML Occupational Hand and Upper Extremity Injuries and Diseases. Hanley & Belfus, Philadelphia, PA1991: 353-402
- Ergonomics and cumulative trauma disorders of the hand and wrist.in: Hunter JM Schneider LH Mackin EJ Callahan AD Rehabilitation of the Hand. 2nd ed. C.V. Mosby, St. Louis, MO1984: 1175-1191
- Ergonomic considerations in hand and wrist tendonitis.J Hand Surg. 1987; 12A: 830-837
- Fingertip forces while using three different keyboards.in: Proceedings of the 35th Annual Meeting of the Human Factors Society. 1991
- Work-related cumulative trauma disorders of the upper extremity (special communication).JAMA. 1992; 267: 838-842
- Classical syndromes in occupational medicine: peripheral nerve entrapment syndromes and ergonomic factors.Am J Ind Med. 1983; 4: 661-681
- Lewis Publishers/CRC Press, Boca Raton, FL1992 Cumulative Trauma Disorders. Current Issues and Ergonomie Solutions: A Systems Approach.
- Ergonomie considerations and job design.in: Kasdan ML Occupational Hand and Upper Extremity Injuries and Diseases. Hanley & Belfus, Philadelphia, PA1991: 539-567
- Ergonomie job analysis: a structured approach for identifying risk factors associated with overexertion injuries and disorders.Appl Occup Environ Hygiene. 1991; 6: 353-363
- Repetitive strain in the workplace.J Hand Surg. 1977; 22A(1): 2-18
- Survey of occupational injuries and illnesses by selected characteristics. U.S. Department of Labor, Washington, DC1994 (Publication no. USDL94-213)
- Detection of cumulative trauma disorders of the upper extremities in the workplace.J Occup Med. 1986; 28: 674-678
- Crippled by computers.Time Magazine. 1992 Oct; 12: 70-72
- How technologic change can increase the risk of repetitive motion injuries.Semin Occup Med. 1987; 2: 25-31
- Cumulative trauma disorders in the workplace.Am Occup Ther Assoc. June 1995; 9 (Special interest section newsletter)
- The new risk in ergonomie solutions.Risk Management. 1994; 41: 22-30
- Fingertip kinematics and forces during typing.in: Proceedings of the 17th Annual Meeting of the American Society of Biomechanics. 1993
- Computer-related injuries: legal and design issues, I: Designing healthier computerized offices..Managing Office Technology [newsletter]. 1993;
- When the work you do ends up costing you an arm and a leg.Smithsonian. 1994; 6: 90-101
- The handling of an epidemic.Working Woman. 1993; 2: 60-65
- Costs soar for on the job injuries. 11. The New York Times, 1991 April: D5-D6
- Multidisciplinary rehabilitation of chronic work-related upper extremity disorders.J Occup Med. 1993; 35: 396-403
- Incidence of overuse syndrome in the symphony orchestra.Med Probl Perform Art. 1986; 1: 51-55
- Treatment of tendinitis, tenosynovitis and other cumulative trauma disorders of musicians' forearms, wrists and hands: restoring function with hand therapy.J Hand Ther. 1992; 5: 84-90
- Overuse syndromes in instrumentalists.Med Probl Perform Art. 1986; 3: 7-11
- Rehabilitation of the injured dancer.in: Ryan A Stephens R Dance Medicine: A Comprehensive Guide. Pluribus Press, Chicago, IL1987: 302-319
- The rehabilitation of overuse foot injuries in athletes and dancers.Clin Sports Med. 1988; 7: 175-191
- Classical ballet: balancing the costs of artistry and athleticism.Med Probl Perform Art. 1991; 6: 39-44
- Treatment of musical hands: redesign of the interface.Hand Clin. 1990; 6 (In: Amadio PC (ed.): Hand Injuries in Sports and Performing Arts): 525-542
- Functional movement impairment in dancers.J Back Musculoskel Rehab. 1995; 5: 219-233
- Technique and the physics of dance.Kines Med Dance. 1991; 13: 25-34
- Ergonomics and cumulative trauma disorders.Hand Clin. 1986; 2: 553-565
- An investigation of the relationship between displacements of the finger and wrist joints and extrinsic finger flexor tendons.J Biomech. 1978; 11: 229-238
- Chronic tendinitis: pathomechanics of injury, factors affecting the healing response and treatment.J Orthop Sports Phys Ther. 1992; 16: 248-261
- Physiological and biomechanical factors for understanding repetitive motion injuries.Semin Occup Med. 1987; 2: 11-17
- Medical management of cumulative trauma disorders.in: Proceedings of the 14th Annual Meeting of the American Society of Hand Therapists. 1991: 1-9
- CRC Press, Boca Raton, FL1993 Tunnel Syndromes.
- Brachial plexus traction injuries.Hand Clin. 1991; 7: 547-556
- Neurovascular entrapment in the regions of the shoulder and posterior triangle of the neck.Phys Ther. 1986; 66: 1894-1899
- Entrapment neuropathies about the elbow.J Back Musculoskel Rehabil. 1994; 4: 31-43
- Evaluation and management of thoracic outlet syndrome.in: Donatelli R Clinics in Physical Therapy: Physical Therapy of the Shoulder. 2nd ed. Churchill-Livingstone, New York1991: 151-191
- Williams & Wilkins, Baltimore, MD1983 Myofascial Pain and Dysfunction. The Trigger Point Manual: The Upper Extremities.
- Proposed screening tool for the detection of cumulative trauma disorders of the upper extremity.J Hand Surg. 1987; 12A: 931-985
- Lower kinetic chain and human gait.J Back Musculoskel Rehabil. 1992; 2: 1-11
- Upper quarter evaluation: structural relationships and interdependence.in: Donatelli R Wooden M Orthopedic Physical Therapy. Churchill-Livingstone, New York1989: 43-58
- The levator scapulae: making the con-necktion.J Manual Manip Ther. 1994; 2: 43-54
- Understanding “RSI”: a review of the role of peripheral neural pain and hyperalgesia.J Manual Manip Ther. 1993; 1: 99-105
- John Wiley & Sons, New York1991 Occupational Biomechanics.
- The biomechanics of prehension.Am J Occup Ther. 1989; 43: 302-307
- Churchill-Livingstone, New York1991 Mobilization of the Nervous System.
- A patient with De Quervain's tenosynovitis: a case report using an Australian approach to manual therapy.Phys Ther. 1994; 74: 314-326
- Double and multiple “crush” syndromes: double and multiple entrapment neuropathies.Hand Clin. 1992; 8: 369-390
- The double crush in nerve entrapment syndromes.Lancet. 1973; 2: 359-362
- Double crush syndrome: cervical radiculopathy and carpal tunnel syndrome (abstract).J Hand Surg. 1986; 11: 766
- Longitudinal sliding of the median nerve during hand movements: a contributory factor in entrapment neuropathy.Lancet. 1975; 1: 633-634
- The diagnosis of tendon and tendon sheath injuries.Semin Occup Med. 1987; 1: 1-6
- Muscles, central nervous motor regulation and back problems.in: Korr I The Neurobiological Mechanisms in Manipulative Therapy. Plenum Press, New York1977: 27-41
- Butterworth, London1983 Muscle Function Testing.
- Muscles and motor control in low back pain: assessment and management.in: Twomey L Physical Therapy of the Low Back. Churchill-Livingstone, New York1987: 253-278
- Spinal Publications, Waikanae, New Zealand1990 The Cervical and Thoracic Spine: Mechanical Diagnosis and Therapy.
- Myofascial release technique and mechanical compromise of peripheral nerves of the upper extremity.Chiropractic Sports Med. 1992; 6: 139-149
- Examination and treatment of muscle imbalances.in: Bourdillon JF Day EA Bookhout MR Spinal Manipulation. 5th ed. Butterworth-Heinemann, Oxford, England1992: 312-322
- Examination and treatment of muscle imbalances.in: Bourdillon JF Day EA Bookhout MR Spinal Manipulation. 5th ed. Butterworth-Heinemann, Oxford, England1992: 335-356
- Butterworth-Heinemann, Oxford, England1991 Manipulative Therapy in Rehabilitation of the Locomotor System. 2nd ed.
- Neurology of the cervical spine joints.Physiotherapy. 1979; 85: 3
- Traumatized nerves, roots and ganglia: musculoskeletal factors and neuropathic consequences.in: Korr M The Neurobiologic Mechanisms in Manipulative Therapy. Plenum Press, New York1987: 87
- Recovery time needs for repetitive work.Semin Occup Med. 1987; 2: 19-24
- Shoulder posture and localized muscle fatigue and discomfort.Ergonomics. 1989; 32: 211-237
- Ergonome, New York1993 The Hand Book: Preventing Computer Injury.
- Review of lengthassociated changes in muscle.Phys Ther. 1982; 62: 1799-1808
- Churchill-Livingstone, Edinburgh, Scotland1981 Common Vertebral Joint Problems.
- Williams & Wilkins, Baltimore, MD1993 Muscles Testing and Function. 4th ed.
- Evaluation and treatment of brachial plexus lesions.in: Donatelli R Clinics in Physical Therapy: Physical Therapy of the Shoulder. 2nd ed. Churchill-Livingstone, New York1991
- Thieme Medical, New York1988 Surgery of the Peripheral Nerve.
- Stenosing tendovaginitis of abductor pollicis longus and extensor pollicis brevis at the radial styloid.Clin Orthop. 1964; 33: 201
- W.B. Saunders, Philadelphia, PA1987 Orthopedic Physical Assessment.
- Soft-tissue injuries related to use of the computer keyboard.J Occup Med. 1993; 35: 522-532
- Conservative management of the trigger finger: a new approach.J Hand Ther. 1988; 1: 59-68
- Anatomical study of the median nerve in the carpal tunnel and etiologies of the carpal tunnel syndrome.J Bone Joint Surg. 1963; 45: 953
- C.V. Mosby, St. Louis, MO1993 Clinical Mechanics of the Hand. 2nd ed.
- Cumulative trauma disorders: an iatrogenic concept.J Occup Med. 1990; 32: 38-41
- The return to work phase for the patient with cumulative trauma.in: Hunter JM Schneider LH Mackin EJ Callahan AD Rehabilitation of the Hand: Surgery and Therapy. 3rd ed. C.V. Mosby, St. Louis, MO1990: 1192-1196
- Role of the physician in worker's compensation injuries.J Hand Surg. 1987; 12A(5): 826-829
- Butterworths, London, England1986 Vertebral Manipulation. 5th ed.
- Basmajian J Nyberg R Rational Manual Therapies. Williams & Wilkins, Baltimore, MD1993
- Using myofascial techniques to treat musicians.J Hand Ther. 1992; 5: 97-101
- Brachial plexus tension tests and the pathomechanical origin of arm pain.in: Glasgow EF Twomey LT Aspects of Manipulative Therapy. Churchill-Livingstone, Melbourne, Australia1979: 105-110
- The elbow flexion test: a clinical test for the cubital tunnel syndrome.Clin Orthop. 1988; 233: 213-216
- Sensibility testing. Current concepts.in: Hunter JM Mackin EJ Callahan AD Rehabilitation of the Hand: Surgery and Therapy. 4th ed. C.V. Mosby, St. Louis, MO1995: 115
- Baillière Tindall, London, England1978 Textbook of Orthopaedic Medicine, I: Diagnosis and Soft Tissue Lesions. 7th ed.
- Stenosing tendovaginitis at the radial styloid process.J Bone Joint Surg. 1930; 12: 509-540
- A manual therapy approach to evaluation and treatment of a patient with chronic lumbar nerve root irritation.Phys Ther. 1994; 7: 548-560
- Work capacity analysis.in: Scully RM Barnes MR Physical Therapy. J.B. Lippincott, Philadelphia, PA1989
- Work pace, stress and cumulative trauma disorders.J Hand Surg. 1987; 12A(suppl): 866-869
- Electromyographic biofeedback evaluation of a computer keyboard operator with cumulative trauma disorder.J Hand Ther. 1994; 1: 25-27
- Tendon gliding exercises.Am J Occup Ther. 1987; 41: 164-167
- Ergonomic approaches in the clinical assessment of occupational musculoskeletal disorders.in: Turk DC Melzack R Handbook of Pain Assessment. Guilford Press, New York1992: 71-99
- 1995;Mar 9: 18-19 Teaching what you know. Occupational Therapy Week.
- Basic Books, New York1975 The Theory and Practice of Group Psychotherapy. 3rd ed.
- Self-efficacy: toward a unifying theory of behavioral change.Psycho Rev. 1977; 84: 191-215
- Enhancing occupational performance through an understanding of perceived self-efficacy.Am J Occup Ther. 1991; 48: 452-461
- Grip and pinch strength: normative data for adults.Arch Phys Med Rehab. 1985; 66: 69-74
- The design of rest breaks for video display terminal work: a review of relevant literature. U.S. Government Printing Office, Washington, DC1992 (Publication no. 648-179/40018)
- The reliability validity of self-reported exercise.Can J Public Health. 1986; 77: 359-362
© 1998 Hanley & Belfus, Inc. Published by Elsevier Inc. All rights reserved.