Frequency of Upper Limb Functional Limitations Among Standing Passengers Holding Hand Rails

Background: Standing passengers in urban public transport commonly hold hand rails for balance during acceleration and deceleration, which may increase repetitive or sustained upper-limb loading and contribute to functional limitation. Objective: To determine the frequency of upper limb functional limitations among standing passengers holding hand rails during public transport travel in Lahore. Methods: A cross-sectional study was conducted at metro and Speedo bus stops and Orange Line stations in Lahore. Adults aged 18–35 years who had been traveling for at least six months and typically traveled standing while holding rails were recruited using convenience sampling. Upper-limb function was assessed using the Upper Extremity Functional Index (UEFI-15), and scores were categorized as lowest (80) functional status. Descriptive statistics were summarized as means, standard deviations, frequencies, and percentages. Results: A total of 270 participants were included (51.5% male, 48.5% female). Mean age was 25.67 ± 4.29 years. Mean UEFI-15 score was 55.64 ± 21.77. The frequency of lowest functional status was 28.9% (n=78), moderate functional status 47.0% (n=127), and highest functional status 24.1% (n=65). Conclusion: Most standing passengers holding hand rails demonstrated moderate upper-limb functional status, while nearly one-third showed low function, indicating a substantial burden of functional limitation in this commuting context.