Self-Reported MSK Injury Limitations


Lead Author(s): 

Jaimo Ahn, MD, PhD, FACS
Arvind D Nana, MD
Gudrun Mirick, MD
Anna N Miller, MD, FACS

Supporting Author(s): 

Sylvia I Watkins-Castillo, PhD

The annual National Health Interview Survey asks participants if they are limited in activities of daily living (ADL), such as the ability to dress oneself, to get in or out of bed or a chair, or to work, due to health issues. Depending on the NHIS dataset used, the specific limitation items are different. The Person file includes activities such as dressing, eating, and working. The Injury file focuses on ability to socialize, walk, and lift/carry items. Both include only persons age 18 and over, and both are based on a “yes” response to “fracture or bone/joint injury” as the cause of the limitation.

In the Injury file, one in four or five persons report limitations with all activities included unless special equipment is available. Reaching over the head is the most limited activity (30%), while grasping small objects the least limited (20%). (Reference Table 5A.5.1 PDF CSV)

Inability to work at all (52%) or limited in kind of work (27%) is the major limitation for adults in the Person file reporting a fracture or bone/joint injury. While one in three (31%) reported needing help with routine needs, the specific ADL varied. Women reported higher levels of need than men, and age was also a factor. One in four (25%) of persons age 65 and over reported needing help with personal care after a fracture or bone/joint injury. (Reference Table 5A.5.2 PDF CSV)

In addition to needing help with activities, persons suffering a fracture or bone/joint injury report high levels of bed days and lost work days. A bed day is defined as 1/2 or more days in bed due to injury or illness in past 12 months, excluding hospitalization. A mean of 28 bed days were reported by 4.5 million persons with a fracture or bone/joint injury, for a total of 122.6 million days. Mean bed days were slightly higher for women (28 days), persons aged 45 to 64 years (30 days), non-Hispanic whites (30 days), and persons living in the Midwest (35 days).

A missed work day is defined as absence from work due to illness or injury in the past 12 months, excluding maternity or family leave. A mean of 23 lost work days were reported by 2.5 million persons with a fracture or bone/joint injury, for a total of 55.9 million days. Mean lost work days were similar between sexes, by age, and regionally, but considerably higher for Hispanic persons with a fracture or bone/joint injury (33 days) and much lower for non-Hispanic others (10 days).

The share of bed days and lost work days reported by a demographic group is impacted by both the mean days reported and their share of the total population. However, variations can be seen. For example, non-Hispanic whites accounted for 80% of bed days but only 60% of lost work days, while Hispanics were 10% and 17%, respectively. Female injured had a higher share of bed days (59%), while lost work days were evenly split between female and male individuals. Persons age 45 to 64 reported half (49%) of total bed days, with the balance split between younger and older persons. However, due to a representing a small share of the workforce, persons age 65 and over accounted for only 4% of lost work days. (Reference Table 5A.5.3 PDF CSV)



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