Orthopedic & Muscular System: Current Research
Open Access
ISSN: 2161-0533
+44-20-4587-4809
ISSN: 2161-0533
+44-20-4587-4809
Harald S Miedema
Keynote: Orthop Muscul Syst
Background: Over one third of Dutch adults report complaints of arm, neck and/or shoulder (CANS) in one year and over a quarter at the moment of questioning. Over 10% of sick leave days are attributed to CANS. In November 2012, a multidisciplinary guideline was produced with recommendations for diagnostic and therapeutic interventions and (work) participation, in order to improve the medical accompaniment, multidisciplinary cooperation and patient communication. Methods: The project started with an update of the CANS-model, developed in 2004 and providing a framework for terminology of disorders that occur in the neck, shoulder and arm region. The guideline was developed by a multidisciplinary team and additional experts from 15 professional and 2 patient organisations, following the evidence based guideline development protocol. Basis of each conclusive statement and recommendation was an extensive search and analysis of relevant scientific literature. Results: The update resulted in an extension of the initial list of 23 diagnostic categories to 36. Complaints that cannot be assigned to a specific diagnosis category are labelled as aspecific CANS. The literature-searchand input from experts about physical signs and diagnostic tests was summarized in ascheme for diagnosis of specific disorders. Consequently, analysis of efficacy of treatment options for aspecific CANS resulted in recommendations for therapeutic interventions. Finally, a clinical pathway was developed for medicaland occupational accompaniment. Conclusions: Improved diagnostic approach result in prompt recognition of patients with specific and aspecific CANS and targeted treatments, resulting in more patients receiving optimal accompaniment
Harald S Miedema is professor at the Research Centre Innovations in Care at Rotterdam university of Applied Sciences in the Netherlands since 2005. His main topics are Work and Health, especially Musculosketal Disorders, and Evidence Based Physiotherapy. In 2014 he plans to finish his PhD at Erasmus University Medical Centre (Erasmus MC) in Rotterdam. From 2000-2010 he was director of the Knowledge Centre for Workrelated Musculoskeletal Disorders at Erasmus MC. Before that he worked at Netherlands Organization for Health Research and Development (ZONMw) in the Hague and Netherlands Organization for Applied Scientific Research (TNO) in Leiden