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Sample records for analyzing musculoskeletal neck

  1. Analyzing musculoskeletal neck pain, measured as present pain and periods of pain, with three different regression models: a cohort study

    PubMed Central

    Grimby-Ekman, Anna; Andersson, Eva M; Hagberg, Mats

    2009-01-01

    Background In the literature there are discussions on the choice of outcome and the need for more longitudinal studies of musculoskeletal disorders. The general aim of this longitudinal study was to analyze musculoskeletal neck pain, in a group of young adults. Specific aims were to determine whether psychosocial factors, computer use, high work/study demands, and lifestyle are long-term or short-term factors for musculoskeletal neck pain, and whether these factors are important for developing or ongoing musculoskeletal neck pain. Methods Three regression models were used to analyze the different outcomes. Pain at present was analyzed with a marginal logistic model, for number of years with pain a Poisson regression model was used and for developing and ongoing pain a logistic model was used. Presented results are odds ratios and proportion ratios (logistic models) and rate ratios (Poisson model). The material consisted of web-based questionnaires answered by 1204 Swedish university students from a prospective cohort recruited in 2002. Results Perceived stress was a risk factor for pain at present (PR = 1.6), for developing pain (PR = 1.7) and for number of years with pain (RR = 1.3). High work/study demands was associated with pain at present (PR = 1.6); and with number of years with pain when the demands negatively affect home life (RR = 1.3). Computer use pattern (number of times/week with a computer session ≥ 4 h, without break) was a risk factor for developing pain (PR = 1.7), but also associated with pain at present (PR = 1.4) and number of years with pain (RR = 1.2). Among life style factors smoking (PR = 1.8) was found to be associated to pain at present. The difference between men and women in prevalence of musculoskeletal pain was confirmed in this study. It was smallest for the outcome ongoing pain (PR = 1.4) compared to pain at present (PR = 2.4) and developing pain (PR = 2.5). Conclusion By using different regression models different aspects of neck

  2. Evaluation of Transcutaneous Electrical Nerve Stimulation as a Treatment of Neck Pain due to Musculoskeletal Disorders

    PubMed Central

    Maayah, Mikhled; Al-Jarrah, Mohammed

    2010-01-01

    Background This study was designed to evaluate transcutaneous electrical nerve stimulation (TENS) as a treatment for neck pain due to musculoskeletal disorders within the context of a physiotherapy treatment. Methods Thirty subjects with neck pain were randomly allocated to two groups, treated with either TENS (n = 15) or placebo (n = 15). Each subject received one session for one hour. All subjects were evaluated before, during treatment, after switch off and again a week after by using Myometer machine. All subjects completed the follow-up assessment. Subjects referred for out-subjects' physiotherapy department, fulfilling the inclusion and exclusion criteria, took part in the study. Results The assessments were compared and used to measure outcome treatment. Improvement in their condition was measured in terms of a reduction in the individual's level of pain during the week after the end of the first session. At the end of the first session, the study showed that 11 subjects (73%) in the treatment and 7 subjects (43%) in the control groups had gained marked improvement. These results are statistically highly significant, (P = 0.01) at the end of the follow-up assessment. Conclusions A conclusion could be drawn that a single intense TENS treatment is an effective treatment for neck pain due to musculoskeletal disorders. On the other hand, TENS showed an effective pain relief with subjects who have a mild neck pain rather than those with severe symptoms. Keywords Musculoskeletal disorders; Transcutaneous electrical nerve stimulation; Neck pain PMID:21629525

  3. Effectiveness of Selected Fitness Exercises on Stress of Femoral Neck using Musculoskeletal Dynamics Simulations and Finite Element Model.

    PubMed

    Qian, Jing-Guang; Li, Zhaoxia; Zhang, Hong; Bian, Rong; Zhang, Songning

    2014-06-28

    The purpose of the study was to establish a dynamics model and a three-dimensional (3D) finite element model to analyze loading characteristics of femoral neck during walking, squat, single-leg standing, and forward and lateral lunges. One male volunteer performed three trials of the five movements. The 3D kinematic data were captured and imported into the LifeMOD to establish a musculoskeletal dynamics model to obtain joint reaction and muscle forces of iliacus, gluteus medius, gluteus maximus, psoas major and adductor magnus. The loading data LfeMOD were imported and transformed into a hip finite-element model. The results of the finite element femur model showed that stress was localized along the compression arc and the tension arc. In addition, the trabecular bone and tension lines of the Ward's triangle also demonstrated high stress. The compact bone received the greatest peak stress in the forward lunge and the least stress in the squat. However, the spongy bone in the femoral neck region had the greatest stress during the walk and the least stress in the squat. The results from this study indicate that the forward lunge may be an effective method to prevent femoral neck fractures. Walking is another effective and simple method that may improve bone mass of the Ward's triangle and prevent osteoporosis and femoral neck fracture. PMID:25114732

  4. Effectiveness of Selected Fitness Exercises on Stress of Femoral Neck using Musculoskeletal Dynamics Simulations and Finite Element Model

    PubMed Central

    Qian, Jing-Guang; Li, Zhaoxia; Zhang, Hong; Bian, Rong; Zhang, Songning

    2014-01-01

    The purpose of the study was to establish a dynamics model and a three-dimensional (3D) finite element model to analyze loading characteristics of femoral neck during walking, squat, single-leg standing, and forward and lateral lunges. One male volunteer performed three trials of the five movements. The 3D kinematic data were captured and imported into the LifeMOD to establish a musculoskeletal dynamics model to obtain joint reaction and muscle forces of iliacus, gluteus medius, gluteus maximus, psoas major and adductor magnus. The loading data LfeMOD were imported and transformed into a hip finite-element model. The results of the finite element femur model showed that stress was localized along the compression arc and the tension arc. In addition, the trabecular bone and tension lines of the Ward’s triangle also demonstrated high stress. The compact bone received the greatest peak stress in the forward lunge and the least stress in the squat. However, the spongy bone in the femoral neck region had the greatest stress during the walk and the least stress in the squat. The results from this study indicate that the forward lunge may be an effective method to prevent femoral neck fractures. Walking is another effective and simple method that may improve bone mass of the Ward’s triangle and prevent osteoporosis and femoral neck fracture. PMID:25114732

  5. Computer work and musculoskeletal disorders of the neck and upper extremity: A systematic review

    PubMed Central

    2010-01-01

    Background This review examines the evidence for an association between computer work and neck and upper extremity disorders (except carpal tunnel syndrome). Methods A systematic critical review of studies of computer work and musculoskeletal disorders verified by a physical examination was performed. Results A total of 22 studies (26 articles) fulfilled the inclusion criteria. Results show limited evidence for a causal relationship between computer work per se, computer mouse and keyboard time related to a diagnosis of wrist tendonitis, and for an association between computer mouse time and forearm disorders. Limited evidence was also found for a causal relationship between computer work per se and computer mouse time related to tension neck syndrome, but the evidence for keyboard time was insufficient. Insufficient evidence was found for an association between other musculoskeletal diagnoses of the neck and upper extremities, including shoulder tendonitis and epicondylitis, and any aspect of computer work. Conclusions There is limited epidemiological evidence for an association between aspects of computer work and some of the clinical diagnoses studied. None of the evidence was considered as moderate or strong and there is a need for more and better documentation. PMID:20429925

  6. INTER-INDIVIDUAL VARIATION IN VERTEBRAL KINEMATICS AFFECTS PREDICTIONS OF NECK MUSCULOSKELETAL MODELS

    PubMed Central

    Nevins, Derek D.; Zheng, Liying; Vasavada, Anita N.

    2014-01-01

    Experimental studies have found significant variation in cervical intervertebral kinematics (IVK) among healthy subjects, but the effect of this variation on biomechanical properties, such as neck strength, has not been explored. The goal of this study was to quantify variation in model predictions of extension strength, flexion strength and gravitational demand (the ratio of gravitational load from the weight of the head to neck muscle extension strength), due to inter-subject variation in IVK. IVK were measured from sagittal radiographs of twenty-four subjects (14F, 10M) in five postures: maximal extension, mid-extension, neutral, mid-flexion, and maximal flexion. IVK were defined by the position (anterior-posterior and superior-inferior) of each cervical vertebra with respect to T1 and its angle with respect to horizontal, and fit with a cubic polynomial over the range of motion. The IVK of each subject were scaled and incorporated into musculoskeletal models to create models that were identical in muscle force- and moment-generating properties but had subject-specific kinematics. The effect of inter-subject variation in IVK was quantified using the coefficient of variation (COV), the ratio of the standard deviation to the mean. COV of extension strength ranged from 8 – 15% over the range of motion, but COV of flexion strength were 20 – 80%. Moreover, the COV of gravitational demand was 80 – 90%, because the gravitational demand is affected by head position as well as neck strength. These results indicate that including inter-individual variation in models is important for evaluating neck musculoskeletal biomechanical properties. PMID:25234351

  7. Psychosocial indicators among aircraft maintenance workers with and without neck and shoulder musculoskeletal symptoms.

    PubMed

    Oliveira, A; Nogueira, H; Diniz, A; Barbieri, D

    2012-01-01

    In the aircraft maintenance industry, most of workers performs manual handling tasks of different materials, varying from small objects up to large pieces of the aircraft. It can increase the occurrence of work-related musculoskeletal disorders (WMSDs), which are strongly associated with high physical demands required by the task. Moreover, psychosocial demands are considered as risk factors for musculoskeletal disorders in both the upper limbs and lumbar spine. Thus, the objective of this study was to assess psychosocial indicators among aircraft maintenance workers according to the presence of neck and shoulder musculoskeletal symptoms. Eighty workers of an aircraft maintenance company were evaluated (32.69 ± 8.25 years, 79.8 ± 13.4 kg, 175 ± 7 cm). According to physical examination, 50 workers were classified as asymptomatic (AS - 4.1 ± 3.17 positive signs) whilst 30 workers were classified as symptomatic (SS - 26.72 ± 11.44 positive signs). AS and SS have shown similar profile of demand (p = 0.62), control (p = 0.66) and social support (p = 0.74) according to the Job Content Questionnaire. However, the groups are different when considering work engagement variables. In general, SS have higher scores than AS (p < 0.05). PMID:22317657

  8. Dynamic tensile failure mechanics of the musculoskeletal neck using a cadaver model.

    PubMed

    Yliniemi, Eno M; Pellettiere, Joseph A; Doczy, Erica J; Nuckley, David J; Perry, Chris E; Ching, Randal P

    2009-05-01

    Although the catapult phase of pilot ejections has been well characterized in terms of human response to compressive forces, the effect of the forces on the human body during the ensuing ejection phases (including windblast and parachute opening shock) has not been thoroughly investigated. Both windblast and parachute opening shock have been shown to induce dynamic tensile forces in the human cervical spine. However, the human tolerance to such loading is not well known. Therefore, the main objective of this research project was to measure human tensile neck failure mechanics to provide data for computational modeling, anthropometric test device development, and improved tensile injury criteria. Twelve human cadaver specimens, including four females and eight males with a mean age of 50.1+/-9 years, were subjected to dynamic tensile loading through the musculoskeletal neck until failure occurred. Failure load, failure strain, and tensile stiffness were measured and correlated with injury type and location. The mean failure load for the 12 specimens was 3100+/-645 N, mean failure strain was 16.7+/-5.4%, and mean tensile stiffness was 172+/-54.5 N/mm. The majority of injuries (8) occurred in the upper cervical spine (Oc-C3), and none took place in the midcervical region (C3-C5). The results of this study assist in filling the existing void in dynamic tensile injury data and will aid in developing improved neck injury prevention strategies. PMID:19388771

  9. Miniscalpel-Needle Treatment Is Effective for Work-Related Neck and Shoulder Musculoskeletal Disorders

    PubMed Central

    Li, Shuming; Shen, Tong; Liang, Yongshan; Bai, Bo; Zhang, Ying

    2016-01-01

    Background. Work-related musculoskeletal disorders (MSDs) are a group of painful disorders of muscles, tendons, and nerves, such as neck and shoulder MSD. This study was designed to use miniscalpel-needle (MSN) technique as an intervention for work-related MSDs. Methods. Thirty-one patients with work-related MSDs and 28 healthy subjects were enrolled as controls in this study. The MSD symptoms of each patient were assessed by visual analog scale (VAS) and neck disability index (NDI). Blood samples were collected from control subjects and MSD patients before and after treatment. Serum levels of C-reactive protein (CRP) and tumor necrosis factor (TNF) were measured using ELISA. Results. Prior to MSN treatment, serum levels of CRP and TNF were significantly higher in the MSD patients than the healthy controls. Serum CRP levels correlated with VAS and NDI scores, and serum TNF levels correlated with NDI scores. Compared to pretreatment, VAS and NDI scores were significantly lower in MSD patients after MSN treatment, while serum CRP and TNF levels were significantly lower compared with the healthy control levels. Conclusions. Our results indicate that MSN may be an effective intervention for work-related MSDs and be associated with lower serum levels of inflammatory biomarkers. PMID:27382406

  10. Musculoskeletal system of the neck of the polar bear (Ursus maritimus) and the Malayan bear (Helarctos malayanus).

    PubMed

    Endo, H; Kakegawa, Y; Taru, H; Sasaki, M; Hayashi, Y; Yamamoto, M; Arishima, K

    2001-01-01

    The gross anatomical study was undertaken in the musculoskeletal system of the neck of the polar bear, and the findings were compared with those of the Malayan bear. The Musculus splenius and the M. trapezius were well-developed in the polar bear. The long neck of the polar bear consisted mainly of the M. splenius with the M. biventer cervicis and the M. complexus lying tightly underneath. The cervical vertebrae possessed huge ventral tubercle in the ventral part of the transverse process in the polar bear. These morphological characteristics suggest that the polar bear may rotate and bend the skull and the long cervical vertebrae. We postulate that the polar bear has evolved the high-mobility long neck to adapt for swimming. Unlike the polar bear, the Malayan bear has not specialized in the neck structure. PMID:11206987

  11. Perceived work demands, felt stress, and musculoskeletal neck/shoulder symptoms among elderly female computer users. The NEW study.

    PubMed

    Larsman, P; Sandsjö, L; Klipstein, A; Vollenbroek-Hutten, M; Christensen, H

    2006-01-01

    The aim of the present study was to test a structural model of the relationship between the perceived quantitative (time pressure and unevenly distributed workload) and emotional work demands and self-reported musculoskeletal symptoms from the neck and shoulder region with felt stress (rested, relaxed, calm, tense, stressed, and pressured at the end of a normal workday) as a mediating variable. As part of the NEW (Neuromuscular assessment in the Elderly Worker) study, a European case-control study, the present cross-sectional study was based on a questionnaire survey among Danish, Dutch, Swedish and Swiss female computer users aged 45 or older (n =148). The hypothesized structural model was tested using structural equation modelling. The results indicate that perceived work demands influence neck/shoulder musculoskeletal symptoms through their effect on felt stress. The results further indicate complete mediation, which means that all of the effect of the perceived work demands on symptoms could be attributed to the stress mechanism. As regards the percentage of explained variance in the endogenous variables, 36% of the variation in felt stress was explained by the perceived work demands, and about 20% of the variation in musculoskeletal neck/shoulder symptoms was explained by the combination of the perceived work demands and the felt stress. PMID:15609027

  12. A Serious Exergame for Patients Suffering from Chronic Musculoskeletal Back and Neck Pain: A Pilot Study

    PubMed Central

    Huis in ’t Veld, Rianne M.H.A.; Schönauer, Christian; Kaufmann, Hannes; Hermens, Hermie J.; Vollenbroek-Hutten, Miriam M.R.

    2013-01-01

    Abstract Introduction Over recent years, the popularity of videogames has gone beyond youth and gamers and is slowly entering the field of professional healthcare. Exergames are an attractive alternative to physical therapy. The primary aim of this pilot study was to explore the user experience (usability, satisfaction, level of motivation, and game experience) of the patient with the “PlayMancer” exergame. The secondary aim was to explore the progression of the performed motor skills (walking velocity, overhead reach ability, and cervical range of motion) and the clinical changes (to physical condition, disability, and pain intensity) in a group of patients with chronic musculoskeletal pain using an exergame for 4 weeks. Materials and Methods In the European PlayMancer project, an exergame for physical rehabilitation of chronic pain patients was developed. This exergame is controlled by relevant motions of the patient's body captured by a motion suit and several infrared cameras. In three different integrated minigames, the patient can train the following motor skills: Walking velocity, overhead reaching, and neck mobility. Results Ten patients participated in this study and completed the 4 weeks of gaming. Patients rated the usability of the exergames as good (score of 78.5 [standard deviation 9.7; range, 60.0–97.5]) on the System Usability Scale, and the game motivated all patients to perform their exercises. Patients enjoyed playing and were pleased with both the game environment and the game play. Overall, the patients made a progression in the examined motor skills during the minigames over the 4 weeks of gaming. Conclusions The “PlayMancer” exergame is a potential tool for achieving physical rehabilitation because it motivates patients to perform their exercises and as a result increases their motor skills and physical condition. PMID:24761327

  13. Self-Reported Musculoskeletal Disorders of the Distal Upper Extremities and the Neck in German Veterinarians: A Cross-Sectional Study

    PubMed Central

    Kozak, Agnessa; Schedlbauer, Grita; Peters, Claudia; Nienhaus, Albert

    2014-01-01

    Background Veterinary work is a physically demanding profession and entails the risk of injuries and diseases of the musculoskeletal system, particularly in the upper body. The prevalence of musculoskeletal disorders (MSD), the consequences and work-related accidents in German veterinarians were investigated. Work-related and individual factors associated with MSD of upper extremities and the neck were analyzed. Methods In 2011, a self-reporting Standardized Nordic Questionnaire was mailed to registered veterinarians in seven federal medical associations in Germany. A total of 3174 (38.4%) veterinarians responded. Logistic regression analysis was used to determine the association between risk factors and MSD-related impairment of daily activities. Results MSD in the neck (66.6%) and shoulder (60.5%) were more prevalent than in the hand (34.5%) or elbow (24.5%). Normal activities were affected in 28.7% (neck), 29.5% (shoulder), 19.4% (hand) and 14% (elbow) of the respondents. MSD in the upper body occurred significantly more often in large animal practitioners. Accidents that resulted in MSD were most frequently reported in the hand/wrist (14.3%) or in the shoulder (10.8%). The majority of all accidents in the distal upper extremities were caused by animals than by other factors (19% vs. 9.2%). For each area of the body, a specific set of individual and work-related factors contributed significantly to severe MSD: Older age, gender, previous injuries, BMI, practice type, veterinary procedures such as dentistry, rectal procedures and obstetric procedures as well as high demands and personal burnout. Conclusion From the perspective of occupational health and safety, it seems to be necessary to improve accident prevention and to optimize the ergonomics of specific tasks. Our data suggest the need for target group-specific preventive measures that also focus on the psychological factors at work. PMID:24586718

  14. Occupational musculoskeletal disorders in the neck and upper limbs of forestry workers exposed to hand-arm vibration.

    PubMed

    Bovenzi, M; Zadini, A; Franzinelli, A; Borgogni, F

    1991-05-01

    An epidemiologic and clinical study of neck and upper limb musculoskeletal disorders was carried out on 65 vibration-exposed forestry operators using chain-saws and 31 comparable control subjects (maintenance workers) performing manual activity and not exposed to vibration. Upper limb function was evaluated by measuring finger and wrist circumference size, maximal hand grip strength and range of motion manoeuvres in both the controls and the exposed workers. Vibration from two chain-saws was measured, and vibration exposure for each forestry worker was assessed in terms of 4 h energy-equivalent frequency-weighted acceleration according to ISO 5349. Job analysis indicated a slight excess risk of upper extremity cumulative trauma disorders (CTDs) in the forestry operators compared with the control workers. After adjustment for age and body constitution, significantly higher prevalence rates of persistent upper limb pain, muscle-tendon syndromes and carpal tunnel syndrome were observed among the forestry workers than among the controls. In the forestry operators, the occurrence of upper limb musculoskeletal disorders increased with increasing vibration exposure. Upper limb function was found to be impaired in the forestry workers compared with the controls. Vibration exposure was significantly related to increased finger circumference size, diminished muscle force and reduced joint function. Even though it is difficult to establish the relative importance of vibration and ergonomic factors in the aetiology of CTDs, nevertheless the results of this study indicate that musculoskeletal impairment to the upper limbs was more severe in the forestry operators than in the controls who did solely manual work. This finding and the observed dose-effect relationships suggest that vibration stress is an important contributor to the development of musculoskeletal disorders in workers using hand-held vibrating tools. PMID:1653132

  15. Exposure-response relationships for work-related neck and shoulder musculoskeletal disorders--Analyses of pooled uniform data sets.

    PubMed

    Nordander, Catarina; Hansson, Gert-Åke; Ohlsson, Kerstina; Arvidsson, Inger; Balogh, Istvan; Strömberg, Ulf; Rittner, Ralf; Skerfving, Staffan

    2016-07-01

    There is a lack of quantitative data regarding exposure-response relationships between occupational risk factors and musculoskeletal disorders in the neck and shoulders. We explored such relationships in pooled data from a series of our cross-sectional studies. We recorded the prevalence of complaints/discomfort (Nordic Questionnaire) and diagnoses (physical examination) in 33 groups (24 female and 9 male) within which the workers had similar work tasks (3141 workers, of which 817 were males). In representative sub-groups, we recorded postures and velocities of the head (N = 299) and right upper arm (inclinometry; N = 306), right wrist postures and velocities (electrogoniometry; N = 499), and muscular activity (electromyography) in the right trapezius muscle (N = 431) and forearm extensors (N = 206). We also assessed the psychosocial work environment (Job Content Questionnaire). Uni- and multivariate linear meta-regression analysis revealed several statistically significant group-wise associations. Neck disorders were associated with head inclination, upper arm elevation, muscle activity of the trapezius and forearm extensors and wrist posture and angular velocity. Right-side shoulder disorders were associated with head and upper arm velocity, activity in the trapezius and forearm extensor muscles and wrist posture and angular velocity. The psychosocial work environment (low job control, job strain and isostrain) was also associated with disorders. Women exhibited a higher prevalence of neck and shoulder complaints and tension neck syndrome than men, when adjusting for postures, velocities, muscular activity or psychosocial exposure. In conclusion, the analyses established quantitative exposure-response relationships between neck and shoulder disorders and objective measures of the physical workload on the arm. Such information can be used for risk assessment in different occupations/work tasks, to establish quantitative exposure limits, and for the

  16. A conceptual model for work-related neck and upper-limb musculoskeletal disorders.

    PubMed

    Armstrong, T J; Buckle, P; Fine, L J; Hagberg, M; Jonsson, B; Kilbom, A; Kuorinka, I A; Silverstein, B A; Sjogaard, G; Viikari-Juntura, E R

    1993-04-01

    This paper presents a conceptual model for the pathogenesis of work-related musculoskeletal disorders. The model contains sets of cascading exposure, dose, capacity, and response variables, such that response at one level can act as dose at the next. Response to one or more doses can diminish or increase the capacity for responding to successive doses. The model is used as a framework for discussing the development of work-related muscle, tendon, and nerve disorders. It is intended as a beginning, to be modified to explain new findings as they become available. In research, it can help to identify areas needing additional data for the development and expression of work-related musculoskeletal disorders. Researchers can use it to design laboratory and field studies. In practice, it demonstrates the relationship between common exposure factors and different responses. This information can be used to evaluate and design jobs for the prevention of work-related musculoskeletal disorders. PMID:8316782

  17. Musculoskeletal neck and back pain in undergraduate dental students at a UK dental school - a cross-sectional study.

    PubMed

    Vijay, S; Ide, M

    2016-09-01

    Objective Limited data exist on musculoskeletal problems within dental students: we aimed to determine the prevalence of these disorders.Design Single centre cross-sectional study.Setting A UK Dental School 2015.Methods Students completed a modified Nordic pain questionnaire.Main outcome measures Self-reported frequency and severity of pain, fitness and coping strategies.Results 63% of 390 respondents were female and 75% aged under 23. Seventy-nine percent experienced pain with 42% experiencing pain for 30 or more days in the past year. Lower back pain was most common (54%) and was most frequently the worst area of pain (48%). Thirty-six percent reported pain lasting at least four hours. The mean 'average pain intensity' VAS score was 3.81/10 (sd = 1.75) and mean 'worst pain intensity' was 5.56 (sd = 2.10). More females reported neck pain (58% versus 37%, P <0.001) and higher 'average pain intensity' (mean 4.02, sd 1.82 versus 3.43 sd 1.55, P = 0.012. Daily stretching was used by 55.7% of respondents, and this positively correlated with 'average' and 'worst pain intensity' (P = 0.096 and P = 0.001) scores. Eighteen percent sought professional help to manage pain.Conclusion Musculoskeletal pain is a problem for dental students. Education in self-care may be helpful; however, assessments of possible interventions are needed. PMID:27608577

  18. Musculoskeletal disorders of the neck and upper limb among sewing machine operators: a clinical investigation.

    PubMed

    Andersen, J H; Gaardboe, O

    1993-12-01

    One hundred and seven women participated in a clinical study of an age-stratified random sample of sewing machine operators compared to a group of auxiliary nurses and home helpers. Four groups, according to years of being a sewing machine operator, consisted of: (controls) 25; (0-7 years) 21; (8-15 years) 25; and (more than 15 years) 36. The numbers of the main clinical diagnoses in the four groups were: cervicobrachial fibromyalgia (myofascial pain syndrome) 2, 4, 11, 24; cervical syndrome 0, 1, 3, 10; and rotator cuff syndrome 1, 1, 6, 11. The observed exposure-response relationship between clinical outcomes and years as a sewing machine operator was maintained when adjusting for current exposure to musculoskeletal strain and other potential confounders. Muscle palpation proved to be a reproducible examination with kappa values around 0.70. PMID:8311099

  19. A model of the upper extremity for simulating musculoskeletal surgery and analyzing neuromuscular control.

    PubMed

    Holzbaur, Katherine R S; Murray, Wendy M; Delp, Scott L

    2005-06-01

    Biomechanical models of the musculoskeletal system are frequently used to study neuromuscular control and simulate surgical procedures. To be broadly applicable, a model must be accessible to users, provide accurate representations of muscles and joints, and capture important interactions between joints. We have developed a model of the upper extremity that includes 15 degrees of freedom representing the shoulder, elbow, forearm, wrist, thumb, and index finger, and 50 muscle compartments crossing these joints. The kinematics of each joint and the force-generating parameters for each muscle were derived from experimental data. The model estimates the muscle-tendon lengths and moment arms for each of the muscles over a wide range of postures. Given a pattern of muscle activations, the model also estimates muscle forces and joint moments. The moment arms and maximum moment-generating capacity of each muscle group (e.g., elbow flexors) were compared to experimental data to assess the accuracy of the model. These comparisons showed that moment arms and joint moments estimated using the model captured important features of upper extremity geometry and mechanics. The model also revealed coupling between joints, such as increased passive finger flexion moment with wrist extension. The computer model is available to researchers at http://nmbl.stanford.edu. PMID:16078622

  20. Occupational Risk Factors for Upper-limb and Neck Musculoskeletal Disorder among Health-care Staff in Nursing Homes for the Elderly in France

    PubMed Central

    PELISSIER, Carole; FONTANA, Luc; FORT, Emmanuel; AGARD, Jean Pierre; COUPRIE, Francoise; DELAYGUE, Beatrice; GLERANT, Valerie; PERRIER, Catherine; SELLIER, Brigitte; VOHITO, Michel; CHARBOTEL, Barbara

    2014-01-01

    This study investigated the relation between working conditions, in terms of physical and psychological demand, and upper-limb and neck musculoskeletal disorders (ULNMD) in female staff working in direct contact with the elderly in nursing homes. A cross-sectional survey was conducted in 105 nursing homes in France. Data on nursing-home working conditions were collected by questionnaire from occupational physicians and by self-administered questionnaire from staff. Psychosocial demand at work was assessed on Siegrist’s questionnaire and ULNMD on the Nordic questionnaire. 2,328 employees were included: 628 housekeepers, 1,372 nursing assistants and 328 nurses. During the previous 12 months, 50% of the subjects (1,160) had presented with a musculoskeletal complaint concerning the neck, 38% (881) the shoulders, 10% (246) the elbows and 22% (520) the wrists. 9% (219) reported effort/reward imbalance on the 2004 Siegrist questionnaire and 42% were in a situation of over-commitment. ULNMD complaints were associated not only with physical occupational factors but also with psychosocial factors (effort/reward imbalance and over-commitment), both before and after adjustment on individual and occupational factors. Prospective studies are needed to clarify the causal role of occupational, including, organizational, psychosocial factors in ULNMD outcomes. Preventive approaches should take account of both physical and psychosocial occupational factors. PMID:24807124

  1. Effect of physical activity on musculoskeletal discomforts among handicraft workers

    PubMed Central

    Shakerian, Mahnaz; Rismanchian, Masoud; Khalili, Pejman; Torki, Akram

    2016-01-01

    Introduction: Handicrafts seems to be one of the high-risk jobs regarding work-related musculoskeletal disorders (WMSDs) which necessitate the implementation of different corrective intervention like regular physical activities. This study aimed to investigate the impact of physical activity on WMSDs among craftsmen. Methods: This cross-sectional study was an analytical – descriptive study carried out on 100 craftsmen working in Isfahan, Iran, in 2013. The sampling method was census, and all workshops involved with this job were included. Information on demographic parameters and physical activity was collected by demographic forms. The data related to worker's musculoskeletal discomforts were conducted using Cornell Musculoskeletal Discomfort Questionnaire. The data were analyzed using statistical tests including independent t-test, Chi-square, and ANOVA. The statistical analysis was performed using SPSS 18. Results: The highest percentages of complaints related to severe musculoskeletal discomfort were reported in right shoulder (%36), right wrist (%26), neck (%25), and upper right arm (%24), respectively. A significant relationship was observed between physical activity and musculoskeletal discomforts of left wrist (P = 0.012), lower back (P = 0.016), and neck (P = 0.006). Discussion and Conclusion: Based on the study results, it can be inferred that regular but not too heavy physical activity can have a positive impact on decreasing the musculoskeletal discomforts. PMID:27512700

  2. Musculoskeletal Injection

    PubMed Central

    Wittich, Christopher M.; Ficalora, Robert D.; Mason, Thomas G.; Beckman, Thomas J.

    2009-01-01

    Patients commonly present to primary care physicians with musculoskeletal symptoms. Clinicians certified in internal medicine must be knowledgeable about the diagnosis and management of musculoskeletal diseases, yet they often receive inadequate postgraduate training on this topic. The musculoskeletal problems most frequently encountered in our busy injection practice involve, in decreasing order, the knees, trochanteric bursae, and glenohumeral joints. This article reviews the clinical presentations of these problems. It also discusses musculoskeletal injections for these problems in terms of medications, indications, injection technique, and supporting evidence from the literature. Experience with joint injection and the pharmacological principles described in this article should allow primary care physicians to become comfortable and proficient with musculoskeletal injections. PMID:19720781

  3. Musculoskeletal Disorders among Cosmetologists

    PubMed Central

    Tsigonia, Alexandra; Tanagra, Dimitra; Linos, Athena; Merekoulias, Georgios; Alexopoulos, Evangelos C.

    2009-01-01

    A cross-sectional study was performed to investigate the relationships between physical, psychosocial, and individual characteristics and different endpoints of low back, neck, shoulder, hand/wrist and knee musculoskeletal complaints among cosmetologists in Athens, Greece. The study population consisted of 95 female and seven male beauty therapists (response rate 90%) with a mean age and duration of employment of 38 and 16 years, respectively. Neck pain was the most prevalent musculoskeletal complaint, reported by 58% of the subjects, while hand/wrist and low back complaints resulted more frequently in self-reported consequences (chronicity, care seeking and absenteeism). Significant relationships were found between self-reported physical risk factors like prolonged sitting, use of vibrating tools, reaching far and awkward body postures and the occurrence of musculoskeletal disorders at various body sites. Among psychosocial variables co-worker support and skill discretion seem to be the most important reflecting organizational problems and cognitive-behavioral aspects. The study results also suggest that effective intervention strategies most likely have to take into account both ergonomic improvements and organizational aspects. PMID:20049238

  4. Musculoskeletal disorders among cosmetologists.

    PubMed

    Tsigonia, Alexandra; Tanagra, Dimitra; Linos, Athena; Merekoulias, Georgios; Alexopoulos, Evangelos C

    2009-12-01

    A cross-sectional study was performed to investigate the relationships between physical, psychosocial, and individual characteristics and different endpoints of low back, neck, shoulder, hand/wrist and knee musculoskeletal complaints among cosmetologists in Athens, Greece. The study population consisted of 95 female and seven male beauty therapists (response rate 90%) with a mean age and duration of employment of 38 and 16 years, respectively. Neck pain was the most prevalent musculoskeletal complaint, reported by 58% of the subjects, while hand/wrist and low back complaints resulted more frequently in self-reported consequences (chronicity, care seeking and absenteeism). Significant relationships were found between self-reported physical risk factors like prolonged sitting, use of vibrating tools, reaching far and awkward body postures and the occurrence of musculoskeletal disorders at various body sites. Among psychosocial variables co-worker support and skill discretion seem to be the most important reflecting organizational problems and cognitive-behavioral aspects. The study results also suggest that effective intervention strategies most likely have to take into account both ergonomic improvements and organizational aspects. PMID:20049238

  5. Musculoskeletal chest wall pain

    PubMed Central

    Fam, Adel G.; Smythe, Hugh A.

    1985-01-01

    The musculoskeletal structures of the thoracic wall and the neck are a relatively common source of chest pain. Pain arising from these structures is often mistaken for angina pectoris, pleurisy or other serious disorders. In this article the clinical features, pathogenesis and management of the various musculoskeletal chest wall disorders are discussed. The more common causes are costochondritis, traumatic muscle pain, trauma to the chest wall, “fibrositis” syndrome, referred pain, psychogenic regional pain syndrome, and arthritis involving articulations of the sternum, ribs and thoracic spine. Careful analysis of the history, physical findings and results of investigation is essential for precise diagnosis and effective treatment. ImagesFig. 3Fig. 4Fig. 5 PMID:4027804

  6. Musculoskeletal Pathology.

    PubMed

    Peat, Frances J; Kawcak, Christopher E

    2015-08-01

    The current understanding of pathology as it relates to common diseases of the equine musculoskeletal system is reviewed. Conditions are organized under the fundamental categories of developmental, exercise-induced, infectious, and miscellaneous pathology. The overview of developmental pathology incorporates the new classification system of juvenile osteochondral conditions. Discussion of exercise-induced pathology emphasizes increased understanding of the contribution of cumulative microdamage caused by repetitive cyclic loading. Miscellaneous musculoskeletal pathology focuses on laminitis, which current knowledge indicates should be regarded as a clinical syndrome with a variety of possible distinct mechanisms of structural failure that are outlined in this overview. PMID:26037607

  7. Prevalence of Musculoskeletal Pain in Construction Workers in Saudi Arabia

    PubMed Central

    Alghadir, Ahmad; Anwer, Shahnawaz

    2015-01-01

    The objective of this study was to find out the prevalence, characteristics, and distribution of musculoskeletal pain among construction workers in Saudi Arabia. A questionnaire about musculoskeletal pain in different parts of the body was completed by 165 construction workers from the construction industries in Dammam and Riyadh cities. The descriptive data were analyzed using chi-square test. The level of statistical significance was set at P < 0.05. Eighty (48.5%) of the responding workers had pain in neck, shoulders, lower back, hand, knee, or ankle. The majority of respondents had low back pain (50%) followed by knee pain (20%). The average intensity of pain at all sites during activity and rest was 6.65 and 3.59, respectively. Thirty-four (42.5%) respondents had dull aching pain and 24 (30%) had cramping pain. There was an association between years of experience, duration of break during work, and use of protective equipment with the prevalence of musculoskeletal pain in construction workers (P < 0.05). Most of the workers complaining of pain got medical treatment (62.5%) and only 25% received physical therapy. It can be concluded from this study that the prevalence of musculoskeletal pain among construction workers in Saudi Arabia is high. PMID:25811043

  8. Prevalence of musculoskeletal pain in construction workers in Saudi Arabia.

    PubMed

    Alghadir, Ahmad; Anwer, Shahnawaz

    2015-01-01

    The objective of this study was to find out the prevalence, characteristics, and distribution of musculoskeletal pain among construction workers in Saudi Arabia. A questionnaire about musculoskeletal pain in different parts of the body was completed by 165 construction workers from the construction industries in Dammam and Riyadh cities. The descriptive data were analyzed using chi-square test. The level of statistical significance was set at P < 0.05. Eighty (48.5%) of the responding workers had pain in neck, shoulders, lower back, hand, knee, or ankle. The majority of respondents had low back pain (50%) followed by knee pain (20%). The average intensity of pain at all sites during activity and rest was 6.65 and 3.59, respectively. Thirty-four (42.5%) respondents had dull aching pain and 24 (30%) had cramping pain. There was an association between years of experience, duration of break during work, and use of protective equipment with the prevalence of musculoskeletal pain in construction workers (P < 0.05). Most of the workers complaining of pain got medical treatment (62.5%) and only 25% received physical therapy. It can be concluded from this study that the prevalence of musculoskeletal pain among construction workers in Saudi Arabia is high. PMID:25811043

  9. Coping with Musculoskeletal Pain: Implications for Office Workers

    ERIC Educational Resources Information Center

    Oztug, Ozhan; Cowie, Helen

    2011-01-01

    The aim of the present research was to understand how office workers cope with back, neck and upper limb musculoskeletal disorders at work (and their implications for work). A small (N = 120) questionnaire survey collected information about potential participants' background and history of musculoskeletal disorders. These data were used to inform…

  10. Prevalence of musculoskeletal pain of the neck, upper extremities and lower back among dental practitioners working in Riyadh, Saudi Arabia: a cross-sectional study

    PubMed Central

    Al-Mohrej, Omar A; AlShaalan, Nouf S; Al-Bani, Waad M; Masuadi, Emad M; Almodaimegh, Hind S

    2016-01-01

    Objectives Studies have shown that dentists have a higher incidence of work-related musculoskeletal (MSK) pain than those in other occupations. The risk factors contributing to MSK pain among Saudi dentists has not been fully studied so this study aims to estimate the prevalence of MSK pain and investigate its associated risk factors among dentists in Saudi Arabia. Setting and participants A cross-sectional survey was carried out in the capital city Riyadh, Saudi Arabia, using random cluster sampling. 224 surveys were distributed among dentists with a 91.1% response rate (101 women and 103 men). Outcomes The prevalence of MSK pain and its associated risk factors were investigated. Results 184 (90.2%) respondents reported having MSK pain. Lower back pain was the most commonly reported MSK pain (68.1%). Gender and age were reported to be predictors for at least one type of MSK pain. Older age was associated with lower back pain (OR 1.23; 95% CI 1.00 to 1.50) and women had double the risk of shoulder pain (OR 2.52; 95% CI 1.12 to 5.68). In addition, lower back pain was related to the time the dentist spent with patients (OR 0.28; 95% CI 0.14 to 0.54), while shoulder pain (OR 1.03; 95% CI 1.00 to 1.06) and lower back pain (OR 1.06; 95% CI 1.03 to 1.10) were significantly related to years of experience. Conclusions MSK pain is common among older and female Saudi dentists. Research on the impact of exercise and the ergonomics of the workplace on the intensity of MSK pain and the timing of its onset is required. PMID:27324712

  11. Musculoskeletal MRI.

    PubMed

    Sage, Jaime E; Gavin, Patrick

    2016-05-01

    MRI has the unique ability to detect abnormal fluid content, and is therefore unparalleled in its role of detection, diagnosis, prognosis, treatment planning and follow-up evaluation of musculoskeletal disease. MRI in companion animals should be considered in the following circumstances: a definitive diagnosis cannot be made on radiographs; a patient is nonresponsive to medical or surgical therapy; prognostic information is desired; assessing surgical margins and traumatic and/or infectious joint and bone disease; ruling out subtle developmental or early aggressive bone lesions. The MRI features of common disorders affecting the shoulder, elbow, stifle, carpal, and tarsal joints are included in this chapter. PMID:26928749

  12. Analysis of the risk factors of musculoskeletal disease among dentists induced by work posture

    PubMed Central

    Park, Hyun-Suk; Kim, Jin; Roh, Hyo-Lyun; Namkoong, Seung

    2015-01-01

    [Purpose] The purpose of this study was to ergonomically evaluate the work posture of dentists to examine their subsequent risk of developing musculoskeletal diseases. [Subjects and Methods] Scenes in which the three dentists performed procedures at their dental clinics were videotaped. The videotapes of the dentists’ work postures were evaluated and analyzed by using the Rapid Upper Limb Assessment (RULA) and Quick Exposure Check (QEC). [Results] The RULA analysis of the dentists’ work posture indicated, “improvement required” in the posture used to treat the anterior and “instant improvement required” in the posture used to treat the maxillary second molar. Of all the work postures studied, the risk was considered particularly high in the lower back and neck, implying prominent problems in these body parts. The QEC analysis showed that the worst work posture was that required to treat the maxillary second molar, which led to a high risk of neck problems and vibrations. [Conclusion] The neck area has the highest risk of developing musculoskeletal disease. Hence, regular rests and the provision of information regarding muscle strengthening exercise for the neck are necessary. PMID:26834324

  13. Analysis of the risk factors of musculoskeletal disease among dentists induced by work posture.

    PubMed

    Park, Hyun-Suk; Kim, Jin; Roh, Hyo-Lyun; Namkoong, Seung

    2015-12-01

    [Purpose] The purpose of this study was to ergonomically evaluate the work posture of dentists to examine their subsequent risk of developing musculoskeletal diseases. [Subjects and Methods] Scenes in which the three dentists performed procedures at their dental clinics were videotaped. The videotapes of the dentists' work postures were evaluated and analyzed by using the Rapid Upper Limb Assessment (RULA) and Quick Exposure Check (QEC). [Results] The RULA analysis of the dentists' work posture indicated, "improvement required" in the posture used to treat the anterior and "instant improvement required" in the posture used to treat the maxillary second molar. Of all the work postures studied, the risk was considered particularly high in the lower back and neck, implying prominent problems in these body parts. The QEC analysis showed that the worst work posture was that required to treat the maxillary second molar, which led to a high risk of neck problems and vibrations. [Conclusion] The neck area has the highest risk of developing musculoskeletal disease. Hence, regular rests and the provision of information regarding muscle strengthening exercise for the neck are necessary. PMID:26834324

  14. Changes of Musculoskeletal Deformity in Severely Disabled Children Using the Custom Molded Fitting Chair

    PubMed Central

    Kim, Myeong Ok; Lee, Jun Ho; Yu, Ju Young; An, Pil Suk; Hur, Do Hang; Park, Eun Seo

    2013-01-01

    Objective To know the effectiveness of a custom molded fitting chair between pre- and post-chair status through comparison of musculoskeletal indices in severely disabled children. Methods We researched 34 severely disabled patients who had used a custom molded fitting chair continuously for more than a year. There were 27 cerebral palsy patients and 7 patients with other kinds of diseases that affect the brain such as chromosomal disease or metabolic disease. By radiographic studies, Cobb's angle, the femoral neck-shaft angle of the femur, and Reimers migration percentage were measured. The indices are analyzed before and after application. Results The average period of application was 24 months. There was a significant reduction in the angles of femur neck-shaft, 163.4 degree before and 158.2 degree after the use of the chair (p<0.05), and 23 of 34 had demonstrated a reduced angle. Cobb's angle and Reimers migration percentage increased but the difference of pre- and post-chair status was not statistically significant. Seventeen of 33 children showed reduced Cobb's angle. Also, 19 of 37 showed a reduced degree of dislocation of the hip joints. Conclusion In spite of the use of a custom molded fitting chair, a significant improvement did not emerge for musculoskeletal deformity indices in severely disabled children. However, there was no significant aggravation of Cobb's angle or Reimers migration percentage in developing children. Therefore, it is thought be helpful to prevent rapid aggravation of musculoskeletal deformities. PMID:23524955

  15. Risk factors for musculoskeletal symptoms among Korean radiation workers.

    PubMed

    Cho, Jae-Hwan; Cho, Moo-Seong; Ahn, Jae-Ouk

    2015-01-01

    The first aim of this study was to determine the prevalence of musculoskeletal symptoms. The second aim was to study the association between musculoskeletal symptoms and factors in radiation workers from the active lists of clinics and hospitals and then to provide basic data for a systematic and effective resource management of radiation workers' musculoskeletal problems in the future. A questionnaire survey was conducted on radiation workers in clinics, general hospitals, and Dong-A university hospitals around the Korean city Buscan from July 10 to 31, 2011. The results showed that the rate of musculoskeletal symptoms was higher in the shoulder, waist, neck, leg/foot, hand/wrist/finger than arm/elbow. The probability of neck pain was 2 times higher in patients with a disease. PMID:24219636

  16. Work-related musculoskeletal disorders in truck drivers and official workers.

    PubMed

    Mozafari, Abolfazl; Vahedian, Mostafa; Mohebi, Siamak; Najafi, Mohsen

    2015-07-01

    Work-related musculoskeletal disorders (WMSDs) are common among drivers and official workers. Musculoskeletal disorders are frequent causes of absenteeism in many countries. The aim of this study was to determine the prevalence of musculoskeletal disorders and risk factors associated with these symptoms. A total of 346 workers and truck drivers were participated in this case-control study. All the participants were interviewed using a self- administered questionnaire containing demographic data and a Nordic questionnaire about presence site and characteristics of pain. Then the data were gathered, and the prevalence of the mentioned parameters and the relationship between variables in the questionnaire were analyzed statistically. The results of this study revealed that 78.6% out of truck drivers and 55.5% out of official workers had musculoskeletal disorders in on-year and there was a significant difference between two groups in this regard (P<0.001). On the whole, the most common symptoms were neck 47 (27.2%), followed by lumbar pain 42 (24.3%) in truck drivers and knee 63 (36.4%) and lumbar symptom 21 (12.1%) in one-year in official workers. In this study, musculoskeletal disorders showed statistically significant association with work duration, age and BMI (P<0.001). Within the limits of this study, it can be concluded that the musculoskeletal troubles have a high frequency among the drivers and official workers. Both groups usually remain on a prolonged uncomfortable postures and high static muscle load which may imply a risk for development of the troubles. PMID:26520631

  17. A comparative study on the prevalence of musculoskeletal complaints among musicians and non-musicians

    PubMed Central

    2013-01-01

    Background Research comparing the frequency of musculoskeletal complaints between musicians and non-musicians is scarce. The aim of this study was to compare the prevalence of musculoskeletal complaints between musicians and non-musicians. Methods A cross-sectional study in 3215 students from three music academies (n = 345) and one medical school (n = 2870) in The Netherlands was performed, using an electronic questionnaire. The questionnaire included socio-demographic characteristics, use of music instruments and the occurrence of musculoskeletal complaints in six body regions. Questions were related to musculoskeletal complaints over the last twelve months and at the time of the questionnaire. Chi-square, t-tests and Kruskal-Wallis tests were used for comparison between the two groups. The association between musculoskeletal complaints and possible predictors was analyzed using a logistic and Poisson regression. Results Eighty-seven music academy students and 503 medical students returned the questionnaire, of which respectively eighty-three and 494 were included in the study. Seventy-four music academy students (89.2%) reported one or more musculoskeletal complaints during the last twelve months, compared to 384 (77.9%) medical students (p = 0.019). Moreover 52 music academy students (62.7%) and 211 medical students (42.7%) reported current musculoskeletal complaints (p = 0.001). The Odds ratio (OR) for the development of musculoskeletal complaints during the last twelve months in music academy students versus medical students is 2.33 (95% CI 1.61–3.05, p = 0.022). The OR at the time of the questionnaire is 2.25 (95% CI 1.77–2.73, p = 0.001). The total number of complaints have been modeled by employing a Poisson regression; the results show that non-musicians have on average less complaints than musicians (p = 0.01). The adjusted means are 2.90 (95% CI 2.18–3.63) and 1.83 (95% CI 1.63–2.04) respectively for musicians and non

  18. The relationship between smartphone use and subjective musculoskeletal symptoms and university students

    PubMed Central

    Kim, Hyo-Jeong; Kim, Jin-Seop

    2015-01-01

    [Purpose] The purpose of this study was to investigate the use of smartphones by university students in selected areas, their musculoskeletal symptoms, and the associated hazard ratio. [Subjects and Methods] This involved the completion of a self-administered questionnaire by dental hygiene students in Seoul, Gyeonggido, and Gyeongsangbukdo. The 292 completed copies of the questionnaire were then analyzed. [Results] The most painful body regions after the use of smartphones were found to be the shoulders and neck. In the musculoskeletal system, back pain was found to have a positive correlation with the size of the smartphone’s liquid crystal display (LCD) screen, and pain in legs and feet were found to have a negative correlation with the length of time that the smartphone was used. As a result, it was revealed that the use of a smartphone was correlated with musculoskeletal symptoms. [Conclusion] Therefore, in today’s environment, where the use of smartphones is on the rise, it is necessary to improve the ways that they are used and to develop a preventive program to alleviate the symptoms of musculoskeletal damage. PMID:25931684

  19. The relationship between smartphone use and subjective musculoskeletal symptoms and university students.

    PubMed

    Kim, Hyo-Jeong; Kim, Jin-Seop

    2015-03-01

    [Purpose] The purpose of this study was to investigate the use of smartphones by university students in selected areas, their musculoskeletal symptoms, and the associated hazard ratio. [Subjects and Methods] This involved the completion of a self-administered questionnaire by dental hygiene students in Seoul, Gyeonggido, and Gyeongsangbukdo. The 292 completed copies of the questionnaire were then analyzed. [Results] The most painful body regions after the use of smartphones were found to be the shoulders and neck. In the musculoskeletal system, back pain was found to have a positive correlation with the size of the smartphone's liquid crystal display (LCD) screen, and pain in legs and feet were found to have a negative correlation with the length of time that the smartphone was used. As a result, it was revealed that the use of a smartphone was correlated with musculoskeletal symptoms. [Conclusion] Therefore, in today's environment, where the use of smartphones is on the rise, it is necessary to improve the ways that they are used and to develop a preventive program to alleviate the symptoms of musculoskeletal damage. PMID:25931684

  20. Musculoskeletal Pain in Gynecologic Surgeons

    PubMed Central

    Adams, Sonia R.; Hacker, Michele R.; McKinney, Jessica L.; Elkadry, Eman A.; Rosenblatt, Peter L.

    2013-01-01

    Objective To describe the prevalence of musculoskeletal pain and symptoms in gynecologic surgeons. Design Prospective cross-sectional survey study (Canadian Task Force classification II-2). Setting Virtual. All study participants were contacted and participated via electronic means. Participants Gynecologic surgeons. Interventions An anonymous, web-based survey was distributed to gynecologic surgeons via electronic newsletters and direct E-mail. Measurements and Main Results There were 495 respondents with complete data. When respondents were queried about their musculoskeletal symptoms in the past 12 months, they reported a high prevalence of lower back (75.6%) and neck (72.9%) pain and a slightly lower prevalence of shoulder (66.6%), upper back (61.6%), and wrist/hand (60.9%) pain. Many respondents believed that performing surgery caused or worsened the pain, ranging from 76.3% to 82.7% in these five anatomic regions. Women are at an approximately twofold risk of pain, with adjusted odds ratios (OR) of 1.88 (95% confidence interval [CI], 1.1–3.2; p 5 .02) in the lower back region, OR 2.6 (95% CI, 1.4–4.8; p 5 .002) in the upper back, and OR 2.9 (95% CI, 1.8–4.6; p 5 .001) in the wrist/hand region. Conclusion Musculoskeletal symptoms are highly prevalent among gynecologic surgeons. Female sex is associated with approximately twofold risk of reported pain in commonly assessed anatomic regions. Journal of Minimally Invasive Gynecology (2013) 20, 656-660 PMID:23796512

  1. Musculoskeletal Ultrasound in Pediatrics.

    PubMed

    Harcke, H. Theodore

    1998-01-01

    Ultrasound is ideally suited to the evaluation of the pediatric musculoskeletal system because of the increased ratio of cartilage to bone in the immature skeleton. The purpose of this article is to review the current uses of musculoskeletal ultrasound in pediatric patients. Hip sonography is widely accepted; other applications are increasing in popularity. PMID:11387111

  2. PSYCHOLOGICAL AND PSYCHOSOCIAL DETERMINANTS OF MUSCULOSKELETAL PAIN AND ASSOCIATED DISABILITY

    PubMed Central

    Vargas-Prada, Sergio; Coggon, David

    2015-01-01

    Although much attention has been given to the physical determinants of common musculoskeletal complaints such as back and arm pain, research points to a stronger influence of psychological factors. Multiple studies have implicated poor mental health and somatisation (a tendency to worry about common somatic symptoms) in the incidence and chronicity of musculoskeletal pain and associated disability. Also important are adverse beliefs about the prognosis of such disorders, and about the role of physical activity in their development and persistence. Differences in societal beliefs may have contributed to major variation in the prevalence of disabling musculoskeletal pain that has been observed between countries and in the same countries over time. Psychosocial aspects of work have also been linked with musculoskeletal pain, although relative risks have generally been smaller. There is a need to take account of psychological factors in the clinical management of patients with back, neck and arm pain. PMID:26612236

  3. Evaluation of the Relationship Between Musculoskeletal Discomforts and Occupational Stressors Among Nurses

    PubMed Central

    Azma, Kamran; Hosseini, Alireza; Safarian, Mohammad Hasan; Abedi, Masoumeh

    2015-01-01

    Background: Stress in nurses may increase the prevalence of musculoskeletal discomforts. Aim: The aim of this study was to determine the prevalence of musculoskeletal discomforts and job stress among nurses and to investigate the association between musculoskeletal discomforts and occupational stressors. Materials and Methods: In this cross-sectional study, 144 nurses in one of the main referral hospitals of Tehran-Iran were randomly selected and studied. Data were collected by HSE job stress questionnaire and The Cornell Musculoskeletal Discomfort Questionnaire through interviews with nurses in their workplace. Results: Most reported musculoskeletal discomforts localized in the neck, back, knee and shoulder and the minimal discomforts were in wrist and elbow. On the other hand, stressors such as demand, changes in workplace, control and responsibilities had significant effect on increasing musculoskeletal discomforts of organs such as neck, shoulders and back (P < 0.001). Conclusion: There was a significant association between stressors such as demand, control, responsibilities and changes in workplace and reported musculoskeletal disorders, especially in neck, shoulders and back. It is suggested to use defined programs for management and control of stressors to control occupational stress in nurses. Moreover, prevention of musculoskeletal discomforts due to their high prevalence in the study population is important. PMID:26258080

  4. [Deep neck infections].

    PubMed

    Nowak, Katarzyna; Szyfter, Witold

    2006-01-01

    Deep neck infection is relatively rare but potentially life threatening complication of common oropharyngeal infections. This retrospective study was aimed at analyzing the occurrence of complications, diagnostic methods and proper management of deep neck infection. A review was conducted in 32 cases who were diagnosed as having deep neck infection from 1995 to 2005. The causes of deep neck infections were tonsillitis (16 cases), tooth diseases (6 cases), paratonsillar abscess (4 cases), parotitis (1 case), pussy lymphonodes after tonsillectomy (2 cases), pussy congenital neck cyst (1 case), chronic otitis media (1 case), parotitis (1 case), foreign body of the esophagus (1 case). All the puss bacterial cultivation were positive. All the patients were treated by different ways of chirurgical drainage and use of large dosage of antibiotics. Deep neck infection should be suspected in patients with long lasting fever and painful swelling of the neck and treatment should begin quick as possible. PMID:17152800

  5. Risk factors associated with musculoskeletal symptoms in Korean dental practitioners.

    PubMed

    Cho, KiHun; Cho, Hwi-Young; Han, Gyeong-Soon

    2016-01-01

    [Purpose] The purpose of this study was to investigate the association between psychosocial stress, occupational stress, and musculoskeletal symptoms in Korean dental practitioners. [Subjects and Methods] Self-reported questionnaires were distributed to 401 dental practitioners in Korea. To assess the risk factors related to musculoskeletal disorders, the Nordic Musculoskeletal Questionnaire, the Korean Occupational Stress Scale, and Psychosocial Well-Being Index Short Form were used. General and work-related characteristics of the subjects consisted of seven items, including age, career, height, weight, working days/week, working hours/day, and physical strain levels. [Results] In this study, 86.8% of the practitioners experienced musculoskeletal symptoms (shoulders, 72.8%; neck, 69.3%; waist, 68.3%; wrist, 58.4%; back, 44.1%; ankle, 38.7%; knee, 36.9%; hip, 20.4%; and elbows, 9.2%). Moreover, psychosocial and occupational stress can affect the occurrence of musculoskeletal disorders. In particular, we found that psychosocial stress has significant influence on the occurrence of musculoskeletal disorders. [Conclusion] To increase the quality of life and provide high-quality medical service for dental practitioners, risk factors for musculoskeletal disorders must be managed. Accordingly, dental practitioners must maintain good posture, get an appropriate amount of rest, and perform regular stretching exercise to reduce psychological stress and improve the work environment. PMID:26957728

  6. Risk factors associated with musculoskeletal symptoms in Korean dental practitioners

    PubMed Central

    Cho, KiHun; Cho, Hwi-young; Han, Gyeong-Soon

    2016-01-01

    [Purpose] The purpose of this study was to investigate the association between psychosocial stress, occupational stress, and musculoskeletal symptoms in Korean dental practitioners. [Subjects and Methods] Self-reported questionnaires were distributed to 401 dental practitioners in Korea. To assess the risk factors related to musculoskeletal disorders, the Nordic Musculoskeletal Questionnaire, the Korean Occupational Stress Scale, and Psychosocial Well-Being Index Short Form were used. General and work-related characteristics of the subjects consisted of seven items, including age, career, height, weight, working days/week, working hours/day, and physical strain levels. [Results] In this study, 86.8% of the practitioners experienced musculoskeletal symptoms (shoulders, 72.8%; neck, 69.3%; waist, 68.3%; wrist, 58.4%; back, 44.1%; ankle, 38.7%; knee, 36.9%; hip, 20.4%; and elbows, 9.2%). Moreover, psychosocial and occupational stress can affect the occurrence of musculoskeletal disorders. In particular, we found that psychosocial stress has significant influence on the occurrence of musculoskeletal disorders. [Conclusion] To increase the quality of life and provide high-quality medical service for dental practitioners, risk factors for musculoskeletal disorders must be managed. Accordingly, dental practitioners must maintain good posture, get an appropriate amount of rest, and perform regular stretching exercise to reduce psychological stress and improve the work environment. PMID:26957728

  7. Neck pain

    MedlinePlus

    ... Alternative Names Pain - neck; Neck stiffness; Cervicalgia; Whiplash Images Neck pain Whiplash Location of whiplash pain References ... pubmed/19272509 . Read More Diskectomy Foraminotomy Laminectomy Spinal fusion Patient Instructions Spine surgery - discharge Update Date 3/ ...

  8. Developmental biomechanics of neck musculature

    PubMed Central

    Lavallee, Amy V.; Ching, Randal P.; Nuckley, David J.

    2012-01-01

    Neck mechanics is central to head injury prevention since it is the musculoskeletal neck, which dictates the position and movement of the head. In the US, traumatic injury is the leading cause of death for children; however prevention is hampered by the lack of data concerning the mechanics of the immature head-and-neck. Thus, the objective of this study was to quantify neck muscle strength and endurance across the maturation spectrum and correlate these with head-and-neck anthropometry. A factorial study was performed on 91 human subjects measuring head-and-neck anthropometry and neck strength and endurance in three bending directions (flexion, extension, and lateral) as a function of age (6–23 years). Using a custom device, neck maximum voluntary contraction (MVC) force was measured in triplicate. Next, neck muscle endurance (sustained effort) was measured as the subjects’ ability to maintain 70% of peak force over 30 s. Linear regression of peak force and endurance as a function of age revealed each direction to significantly (p<0.0001) increase with age. The MVC force, averaged across all directions and normalized to the adult values, exhibits the following maturation curve: %MVC Force= −0.0879(age)2+6.018(age)+8.120. Neck muscle strength, similar between young males and females, becomes disparate in adolescence and adulthood with males exhibiting greater strength. Bending direction differences were also found with extension strength being the greatest regardless of age and sex. Furthermore, neck circumference appears predictive of neck strength and endurance in children. Together, these relationships may facilitate improved design of injury prevention interventions. PMID:23127787

  9. Musculoskeletal discipline science plan

    NASA Technical Reports Server (NTRS)

    1991-01-01

    Life sciences research in the musculoskeletal discipline must identify possible consequences of weightlessness on this system, understand the mechanisms of these effects, and develop effective and operationally practical countermeasures to protect crewmembers. The musculoskeletal system is highly plastic in that is possesses the inherent capability to adapt its structural and functional properties in accordance with the type and degree of stimuli imposed on it. Prolonged space travel is essentially a period of significant unloading of the musculoskeletal system. This results in adaptive responses in the structure and function of this system, placing it on the low end of a continuum from one of complete disuse to one of maximal use. There is a high probability that the musculoskeletal system is functionally impaired with increasing duration of weightlessness. The purpose of this Discipline Science Plan is to provide a conceptual strategy for NASA's Life Sciences division research and development activities in the area of musculoskeletal function. This document summarizes the current status of the program, outlines available knowledge, establishes goals and objectives, identifies science priorities, and defines research opportunities, which encompass critical questions in the subdiscipline areas (e.g., muscle, bone, and other musculoskeletal connective tissues). These science activities include ground-based and flight; basic, applied, and operational; and animal and human research and development. This document contains a general plan that will be used by both NASA Headquarters Program Offices and the field centers to review and plan basic, applied, and operational intramural and extramural research and development activities in this area.

  10. The effect of three ergonomics interventions on body posture and musculoskeletal disorders among stuff of Isfahan Province Gas Company

    PubMed Central

    Habibi, Ehsanollah; Soury, Shiva

    2015-01-01

    Background: Prevalence of work-related musculoskeletal disorders (WMSDs) is high among computer users. The study investigates the effect of three ergonomic interventions on the incidence of musculoskeletal disorders among the staff of Isfahan Province Gas Company, including training, sport, and installation of software. Materials and Methods: The study was performed in the summer of 2013 on 75 (52 men, 23 women) Isfahan Province Gas Company employees in three phases (phase 1: Evaluation of present situation, phase 2: Performing interventions, and phase 3: Re-evaluation). Participants were divided into three groups (training, exercise, and software). The Nordic Musculoskeletal Questionnaire (NMQ) and rapid upper limb assessment (RULA) were used. Data collected were analyzed using SPSS software and McNemar test, t-test, and Chi-square test. Results: Based on the evaluations, there was a decrease in musculoskeletal symptoms among the trained group participants after they received the training. McNemar test showed that the lower rate of pain in low back, neck, knee, and wrist was significant (P < 0.05). The results obtained from the RULA method for evaluation of posture showed an average 25 points decrease in the right side of the body and 20 points decrease in the left side of the body in the group subjected to training. Based on t-test, the decrease was significant. Conclusion: The study demonstrated that majority of the participants accepted interventions, which indicates that most of the people were unsatisfied with the work settings and seeking improvement at the workplace. Overall, the findings show that training, chair adjustment, and arrangement in workplace could decrease musculoskeletal disorders. PMID:26430692

  11. [Prevalence of musculoskeletal disorders in nursing professionals].

    PubMed

    Ribeiro, Natália Fonseca; Fernandes, Rita de Cássia Pereira; Solla, Davi Jorge Fontoura; Santos Junior, Anivaldo Costa; de Sena Junior, Antonio Santos

    2012-06-01

    A cross-sectional study estimated the prevalence of work-related musculoskeletal disorders among nursing assistants in Salvador, Bahia. Three hundred and eight workers, randomly selected, answered a questionnaire applied by trained interviewers during working hours. The majority of respondents worked the day shift and did not usually work overtime. About 34% reported having another regular job. Average time in the formal or informal labor market was 19 years. There was high occupational exposure to repetitive hand movements, standing posture, walking, inadequate postures of the trunk and manual handling of loads. The prevalence of work-related musculoskeletal disorders in at least one body segment was 83.4%.The most affected body segments were: low back (53.9%), legs (51.9%), neck (36.4%), upper back (35.7%) and shoulders (33.8%). There was high prevalence of work-related musculoskeletal disorders in the studied population, which points out to the need for improvements in the working conditions of those professionals. PMID:22782108

  12. Patterns of work-related musculoskeletal disorders among workers in palm plantation occupation.

    PubMed

    Henry, Leonard Joseph; Jafarzadeh Esfehani, Ali; Ramli, Ayiesah; Ishak, Ismarulyusda; Justine, Maria; Mohan, Vikram

    2015-03-01

    This study investigated the patterns of ongoing work-related musculoskeletal disorders (WRMDs) and exposure risk to musculoskeletal injuries for various body regions among palm plantation workers. Standard Nordic Musculoskeletal Questionnaire (SNMQ) was used to assess the prevalence of musculoskeletal disorders symptoms. The Quick Exposure check (QEC) was used to assess the exposure risk of farmers to WRMDs. The common pattern of WRMDs was back pain (40%), followed by shoulder pain (19%). The QEC revealed high exposure risk for neck (56%), followed by back (45.6%). The results from the SNMQ showed that 58% reported pain in 1 region, followed by 2 regions (10.7%) and 3 regions (3.6%). Back pain and shoulder pain were found to be common among workers in palm plantation occupation. Nevertheless, the neck region appeared to have the highest risk of exposure to injuries. PMID:23417907

  13. Schoolbag weight and musculoskeletal symptoms in New Zealand secondary schools.

    PubMed

    Whittfield, J; Legg, S J; Hedderley, D I

    2005-03-01

    The weight of schoolbags and the prevalence of musculoskeletal symptoms amongst 140 students (70 third form students comprising 35 females and 35 males, and 70 sixth form students comprising 35 females and 35 males) from five New Zealand secondary schools was investigated. Schoolbag weight for third form students (mean age 13.6 years) was 13.2% of their body weight, while for sixth form students (mean age 17.1 years) it was 10.3% of their body weight. These weights may exceed the recommended guideline load limits for adult industrial workers. Musculoskeletal symptoms were reported by 77.1% of the students. Symptoms were most prevalent in the neck, shoulders, upper back and lower back. Although musculoskeletal symptoms are believed to be multifactorial in origin, the carriage of heavy schoolbags is a suspected contributory factor and may represent an overlooked daily physical stress for New Zealand secondary school students. PMID:15694073

  14. [MRI-guided musculoskeletal biopsy].

    PubMed

    Daecke, W; Libicher, M; Mädler, U; Rumpf, C; Bernd, L

    2003-02-01

    MRI-guided musculoskeletal biopsy has been mentioned to be a minimally invasive method to obtain specimens for diagnostic purposes in bone tumors. To evaluate the viability, to assess the accuracy, and to record possible complications of this method, clinical data of 19 MRI-guided biopsies were analyzed. Interventions were performed on 18 patients (1-78 years) as an outpatient procedure: 15 skeletal and 4 soft tissue biopsies were taken from the pelvis, upper limb,or lower limb. We used T1-weighted gradient echoes (GE) for locating the puncture site and T2-weighted turbo spin echoes (TSE) for visualization of needle position. In 14 of 18 MRI-guided biopsies, a definite histological diagnosis was obtained. According to the pathologist, the inadequate size of the specimen was the main reason for missing the diagnoses in four cases.Long intervention time and inappropriate biopsy tools proved to be the main disadvantages of MRI-guided biopsy, but technical improvement might solve these technical problems in future.A postbiopsy hematoma was the only complication observed. Once technically improved, MRI-guided biopsy could be a precise alternative routine method for musculoskeletal biopsies in future. PMID:12607083

  15. Ergonomic intervention, workplace exercises and musculoskeletal complaints: a comparative study

    PubMed Central

    Mehrparvar, Amir Houshang; Heydari, Mohammad; Mirmohammadi, Seyyed Jalil; Mostaghaci, Mehrdad; Davari, Mohammad Hossein; Taheri, Mahmoud

    2014-01-01

    Background: Musculoskeletal disorders are among the most prevalent occupational disorders in different jobs such as office work. Some interventions such as ergonomic modifications and workplace exercises are introduced as the methods for alleviating these disorders. In this study we compared the effect of ergonomic modifications and workplace exercises on musculoskeletal pain and discomfort in a group of office workers. Methods: In an interventional study on office workers, the effect of two interventions was compared. Ergonomic modification consisted of correcting the arrangement of workstation and changing some equipment; workplace exercises included stretching exercises focusing on neck, shoulders, low back, and hand and wrist. Musculoskeletal complaints were assessed and compared before and after 1 month interventions. Results: The frequency of musculoskeletal complaints was high before the study. Both interventions significantly reduced complaints in a similar manner except for low back pain which was reduced in exercise group more than the other group. Conclusion: In this study we found a beneficial short-term effect for both ergonomic modifications and stretching work-place exercises on reducing musculoskeletal pain in office workers. PMID:25405134

  16. Becoming a musculoskeletal ultrasonographer.

    PubMed

    Iagnocco, Annamaria; Naredo, Esperanza; Bijlsma, Johannes W J

    2013-04-01

    Over the last decade, increasing numbers of rheumatologists have incorporated musculoskeletal ultrasound (MSUS) as a valuable diagnostic tool into their clinical practice. Some countries have established training programmes for MSUS. The European League Against Rheumatism has developed education guidelines for the content and conductance of MSUS courses and it would be useful to standardise rheumatology MSUS training worldwide. A thorough knowledge of anatomy, US physics and technology, US scanning methods, US pattern of normal and pathological musculoskeletal tissues, definitions for US pathology, artefacts and pitfalls in both greyscale and Doppler modalities is necessary to perform efficient MSUS. MSUS training includes attending theoretical-practical and online courses, as well as studying textbooks and using digital video discs (DVDs). Having access to US equipment and performing supervised normal and pathological MSUS examinations for a training period are mandatory for consolidating MSUS learning. A proposal to accredit and certificate competence in MSUS is now being discussed. PMID:23731935

  17. Factors Affecting the Musculoskeletal Symptoms of Korean Police Officers

    PubMed Central

    Cho, Taek-Sang; Jeon, Woo-Jin; Lee, Jin-Gu; Seok, Jong-Min; Cho, Jae-Hwan

    2014-01-01

    ] This study was conducted to investigate efficient, systematic management of the Korean police and to examine the status and prevention of musculoskeletal disorders in Korean police officers. [Subjects and Methods] A survey of police officers (353 subjects) who visited the National Police Hospital from March 2013 to May 2013 was conducted using a structured questionnaire. [Results] The incidence of pain was 44.2% in the shoulder, 41.4% in the waist, 31.2% in the neck, 26.1% in the legs/foot, 16.7% in the hand/wrist/finger, and 14.7% in the arm/elbow. The comparative risk of the relevant part factors was analyzed by multiple regression analysis. The shoulder had a 4.87 times higher risk in police lieutenants compared with those under the rank of corporal and a 1.78 times higher risk in people with chronic diseases than those without chronic diseases. The arm/elbow had a 2.37 times higher risk in people who exercised than those who did not exercise and a 1.78 times higher risk in people with a chronic disease than those without chronic diseases. Generally, people with a chronic disease showed a higher risk than those without chronic diseases. [Conclusion] The results of this study could be useful as basic data for improvement of police welfare, specialized treatment for the health safety of the police, and efficient management of police resources. PMID:25013298

  18. Musculoskeletal problem”: Its prevalence among Iranian dentists

    PubMed Central

    Nokhostin, Mohammad Reza; Zafarmand, A. Hamid

    2016-01-01

    Objectives: Musculoskeletal problems (MSPs) are a major complication for practitioners in the field of dentistry. The present study is designed to define the prevalence of MSPs among Iranian dentists. Materials and Methods: This was a cross-sectional survey conducted on 600 dentists. The questions were about demographic characteristics, headache, and physical problems of different parts of the body. Data were analyzed using logistic regression analysis. Results: Of all dentists studied, 67.5% had physical problems. These MSPs were observed in neck (51.87%), wrist (92.96%), waist (11.11%), and shoulder (7.40%) of the practitioners. Some practitioners took leave of absence (18.52%), while others (7.40%) underwent medical care. There was a direct correlation between age (P = 0.0001), high body mass index (BMI; P = 0.021), total number of daily under-care patients (P = 0.002), and little physical activity (P = 0.0001) with MSPs. Conclusion: The prevalence of MSPs is very high among dentists. Awareness about preventive care is necessary for dentists. The dental curriculum also should address ergonomic issues for dental educators. PMID:27195226

  19. Musculoskeletal Aspiration Procedures

    PubMed Central

    Hansford, Barry Glenn; Stacy, Gregory Scott

    2012-01-01

    With advances in imaging technology, there has been a significant increase in the number and range of interventional musculoskeletal image-guided procedures. One of the most commonly performed image-guided musculoskeletal interventions is the diagnostic and therapeutic percutaneous aspiration and drainage of multiple types of intra-articular, juxta-articular, and intramuscular pathologic fluid collections. These procedures may be performed under fluoroscopic, ultrasound, computed tomography, or even magnetic resonance guidance depending on the location to be accessed, type of pathology, patient characteristics, and operator preference. Musculoskeletal image-guided aspiration and drainage procedures are minimally invasive and generally very safe while offering valuable diagnostic information as well as therapeutic benefit. This article focuses on the appropriate indications, contraindications, and general technique for accessing the major joints via imaging guidance. For each joint, we discuss pertinent anatomy, appropriate imaging modalities, and preferred approaches to gaining intra-articular access. Additionally, the article discusses some of the more frequently encountered juxta-articular and intramuscular fluid collections that can be accessed and aspirated via percutaneous intervention, with mention of the importance of recognizing extremity sarcomas that can mimic these benign collections. PMID:24293800

  20. The Burden of Musculoskeletal Conditions

    PubMed Central

    Palazzo, Clémence; Ravaud, Jean-François; Papelard, Agathe; Ravaud, Philippe; Poiraudeau, Serge

    2014-01-01

    Objective Despite the burden of rheumatic and musculoskeletal diseases (RMDs), these conditions probably deserve more attention from public health authorities in several countries including developed ones. We assessed their contribution to disability. Methods Data on disabilities associated with RMDs were extracted from the national 2008–2009 Disability-Health Survey of 29,931 subjects representative of the population in France. We used the core set of disability categories for RMDs of the World Health Organization's International Classification of Functioning, Disability and Health for analysis. Diagnosis and disabilities were self-reported. We assessed the risk of disability associated with RMDs using odds ratios (ORs) and the societal impact of RMDs using the average attributable fraction (AAF). Results Overall 27.7% (about 17.3 million people) (95% CI 26.9–28.4%) of the population reported having RMDs. The most prevalent RMDs were low back pain (12.5%, 12.1–13.1) and osteoarthritis (12.3%, 11.8–12.7). People reporting osteoarthritis were more disabled in walking (adjusted OR 1.9, 1.7–2.2) than those without. People reporting inflammatory arthritis were more limited in activities of daily living (from 1.4, 1.2–1.8 for walking to 2.1, 1.5–2.9 for moving around). From a societal perspective, osteoarthritis was the main contributor to activity limitations (AAF 22% for walking difficulties). Changing jobs was mainly attributed to neck pain (AAF 13%) and low back pain (11.5%). Conclusion RMDs are highly prevalent and significantly affect activity limitations and participation restrictions. More effort is needed to improve care and research in this field. PMID:24595187

  1. Assessment of musculoskeletal and other health complaints in female hospital staff.

    PubMed

    Bru, E; Mykletun, R J; Svebak, S

    1994-04-01

    Musculoskeletal and other health complaints were investigated in a sample of 586 female hospital staff. Health complaints, including musculoskeletal pain, were assessed by the Ursin Health Inventory (UHI). Factor analyses of the UHI favoured a seven-factor solution in which musculoskeletal pain emerged as an independent factor of complaints. Other complaint factors could be labelled lower digestive, upper digestive, cardiorespiratory, allergy, cold/influenza and headache. Factor analyses of the extended version of the Nordic Questionnaire (NQ-EV), which focuses specifically on musculoskeletal pain from nine body areas, favoured a three-factor solution in which complaints from the upper back, low back and extremities emerged as the independent factors. Product-moment coefficients of correlation between factor-based sum scores in the two survey measures stated that the UHI factor 'musculoskeletal pain' and the NQ-EV factor 'upper back' were significantly correlated. This indicated an orientation of the UHI 'musculoskeletal pain' factor to pain in the upper part of the back. Only very moderate coefficients of correlation emerged between the NQ-EV factor scores and the remaining UHI scores. The results support the assumption that musculoskeletal complaints are not closely related to other types of health complaints, and that musculoskeletal complaints among female hospital staff should be assessed with separate items for upper back (neck/shoulders), low back and the extremities. PMID:15676956

  2. Musculoskeletal conditions and complementary/alternative medicine.

    PubMed

    Ernst, E

    2004-08-01

    Complementary/alternative medicine (CAM) is immensely popular for musculoskeletal conditions. It is, therefore, essential to define CAM's value for such indications. This chapter summarises the trial data for or against CAM as a symptomatic treatment for back pain, fibromyalgia, neck pain, osteoarthritis and rheumatoid arthritis. Collectively the evidence demonstrates that some CAM modalities show significant promise, e.g. acupuncture, diets, herbal medicine, homoeopathy, massage, supplements. None of the treatments in question is totally devoid of risks. By and large the data are not compelling, not least due to their paucity and methodological limitations. It is, therefore, concluded that our research efforts must be directed towards defining which form of CAM generates more good than harm for which condition. PMID:15301985

  3. Prevalence of musculoskeletal discomfort among the workers engaged in jewelry manufacturing

    PubMed Central

    Salve, Urmi Ravindra

    2015-01-01

    Background: The workers engaged in jewellery manufacturing exposed to various occupational risk factors that lead to development of musculoskeletal disorders. But there is scarcity of reporting the prevalence of the musculoskeletal disorders among them. Aims: To evaluate the prevalence of musculoskeletal discomfort among the workers engaged in jewellery manufacturing in India. Setting and Design: Case Control Study. Materials and Methods: This study was divided into two phases. First phase: prevalence rate were calculated using Modified Nordic musculoskeletal questionnaire and compared with the control group. Second phase: strength, flexibility and tightness of the muscle groups (neck, lower back and knee) were evaluated through physical examination for the subjects who reported positive prevalence. Statistical Analysis: A comparative inferential statistics was used. Results: This study was divided into two phases. First phase: prevalence rate were calculated using Modified Nordic musculoskeletal questionnaire and compared with the control group. Second phase:strength, flexibility and tightness of the muscle groups (neck, lower back and knee) were evaluated through physical examination for the subjects who reported positive prevalence. Conclusions: The musculoskeletal disorders among the workers engaged in jewellery manufacturing were found to be specific to the occupation. PMID:26023271

  4. Scintigraphic evaluation in musculoskeletal sepsis

    SciTech Connect

    Merkel, K.D.; Fitzgerald, R.H. Jr.; Brown, M.L.

    1984-07-01

    In this article, the mechanism of technetium, gallium, and indium-labeled white blood cell localization in septic processes is detailed, and the method of interpretation of these three isotopes with relationship to musculoskeletal infection is outlined. Specific clinical application of technetium, gallium, and indium-labeled white blood cell imaging for musculoskeletal sepsis is reviewed.

  5. Musculoskeletal Disorders in the Elderly

    PubMed Central

    Gheno, Ramon; Cepparo, Juan M.; Rosca, Cristina E.; Cotten, Anne

    2012-01-01

    Musculoskeletal disorders are among the most common problems affecting the elderly. The resulting loss of mobility and physical independence can be particularly devastating in this population. The aim of this article is to present some of the most frequent musculoskeletal disorders of the elderly, such as fractures, osteoporosis, osteoarthritis, microcrystal disorders, infections, and tumors. PMID:22919553

  6. Physical and psychosocial risk factors for musculoskeletal disorders in Brazilian and Italian nurses

    PubMed Central

    Carugno, Michele; Pesatori, Angela Cecilia; Ferrario, Marco Mario; Ferrari, Andrea Lepos; da Silva, Fábio Jose; Martins, Aline Caldas; Felli, Vanda Elisa Andres; Coggon, David; Bonzini, Matteo

    2012-01-01

    As part of the international CUPID investigation, we compared physical and psychosocial risk factors for musculoskeletal disorders among nurses in Brazil and Italy. Using questionnaires, we collected information on musculoskeletal disorders and potential risk factors from 751 nurses employed in public hospitals. By fitting country specific multiple logistic regression models, we investigated the association of stressful physical activities and psychosocial characteristics with site-specific and multisite pain, and associated sickness absence. We found no clear relationship between low back pain and occupational lifting, but neck and shoulder pain were more common among nurses who reported prolonged work with the arms in an elevated position. After adjustment for potential confounding variables, pain in the low back, neck and shoulder, multisite pain, and sickness absence were all associated with somatizing tendency in both countries. Our findings support a role of somatizing tendency in predisposing to musculoskeletal disorders, acting as an important mediator of the individual response to triggering exposures, such as workload. PMID:23033179

  7. Musculoskeletal Pain Disorders among Secondary School Saudi Female Teachers

    PubMed Central

    Darwish, Magdy A.; Al-Zuhair, Shatha Z.

    2013-01-01

    Objective. This study was conducted to estimate prevalence and pattern of musculoskeletal pain disorders among secondary school Saudi female teachers in Al-Khobar area and the psychodemographic and psychosocial factors that may affect them. Material and Method. A cross-sectional study was conducted using sample of secondary schools teachers (governmental and private school) in Al-Khobar area, Saudi Arabia (KSA). Data were collected using a structured self-administered questionnaire. Result. Prevalence of musculoskeletal pain disorders was 79.17%. Main sites of pain were lower back (63.8%) followed by shoulder (45.4%), neck (42.1%), leg (40.0%), wrist (16.2%), and elbow joint (10.0%). Factors that showed significant relationship were type of school (p value 0.038), age (p value 0.002), weight (p value 0.007), number of children (p value 0.006), shoe type (p value 0.000), teaching years (p value 0.003), and working daily hours (p value 0.027). Conclusion. Secondary school female teachers showed high prevalence of musculoskeletal pain disorders in most anatomic sites, namely, the back, shoulder, neck, legs, wrist, and elbow joint. Risk factors associated with significant pain were type of school, age, weight, number of children, and number of teaching years. PMID:23970968

  8. Musculoskeletal involvement in sarcoidosis*, **

    PubMed Central

    Nessrine, Akasbi; Zahra, Abourazzak Fatima; Taoufik, Harzy

    2014-01-01

    Sarcoidosis is a multisystem inflammatory disorder of unknown cause. It most commonly affects the pulmonary system but can also affect the musculoskeletal system, albeit less frequently. In patients with sarcoidosis, rheumatic involvement is polymorphic. It can be the presenting symptom of the disease or can appear during its progression. Articular involvement is dominated by nonspecific arthralgia, polyarthritis, and Löfgren's syndrome, which is defined as the presence of lung adenopathy, arthralgia (or arthritis), and erythema nodosum. Skeletal manifestations, especially dactylitis, appear mainly as complications of chronic, multiorgan sarcoidosis. Muscle involvement in sarcoidosis is rare and usually asymptomatic. The diagnosis of rheumatic sarcoidosis is based on X-ray findings and magnetic resonance imaging findings, although the definitive diagnosis is made by anatomopathological study of biopsy samples. Musculoskeletal involvement in sarcoidosis is generally relieved with nonsteroidal anti-inflammatory drugs or corticosteroids. In corticosteroid-resistant or -dependent forms of the disease, immunosuppressive therapy, such as treatment with methotrexate or anti-TNF-α, is employed. The aim of this review was to present an overview of the various types of osteoarticular and muscle involvement in sarcoidosis, focusing on their diagnosis and management. PMID:24831403

  9. Work related risk factors for musculoskeletal complaints in the spinning industry in Lithuania

    PubMed Central

    Gamperiene, M.; Stigum, H.

    1999-01-01

    OBJECTIVES: To describe the prevalence of self reported musculoskeletal complaints in the back, arms or neck, and legs among workers in the spinning industry, and to investigate the relations between these complaints and work related variables. METHODS: An interview based questionnaire survey was carried out in two spinning industry factories in Lithuania. RESULTS: The study group consisted of all workers in production (n = 363). Symptoms of the legs were the musculoskeletal symptom reported most often (61%). Many subjects had arms or neck (55%) or back problems (28%). 20% had experienced pain from all three sites. Almost 25% had had musculoskeletal pain every day and 16% had experienced constant pain during previous year. Packers had the highest risk of arms or neck problems whereas spinners had the highest risk of back or leg problems. Working in a strained posture (bending, work with arms raised up above shoulder level, and repetitive movements of the fingers) was associated with all three complaints. Only arms or neck complaints were associated with age. CONCLUSIONS: Musculoskeletal disorders are a common problem among workers producing gobelin or synthetic thread in Lithuania and working in a strained posture is a risk factor for developing musculoskeletal disorders in three body sites: legs, arms or neck, and back. To better understand the different aspects of physical load as risk factors, a more detailed study of the frequency of postural changes as well as an observation of individually adopted postures would be necessary. This applies to intervention studies in factories of the spinning industry to prevent complaints of the legs and shoulders.   PMID:10474538

  10. Computed tomography of the musculoskeletal system

    SciTech Connect

    Scott, W.W. Magid, D. Fishman, E.K. )

    1987-01-01

    This book contain 10 chapters. The chapter titles are: Soft Tissue Masses; Primary Bone Tumors; The Role of CT in the Therapeutic Management of Soft Tissue Sarcomas; Assessment of Musculoskeletal Inflammation; Assessment of Musculoskeletal Trauma; The Foot and Ankle; The Shoulder; Measurement of Bone Mineral for Early Detection of Osteoporosis; MRI of the Musculoskeletal System; and Advances in CT Imaging of Musculoskeletal Pathology.

  11. Persistent of Neck/Shoulder Pain among Computer Office Workers with Specific Attention to Pain Expectation, Somatization Tendency, and Beliefs

    PubMed Central

    Sadeghian, Farideh; Raei, Mehdi; Amiri, Mohammad

    2014-01-01

    Background: Neck and shoulder pains are the prevalent complaints among computer office workers. The purpose of this study was to assess the relationship of somatization tendency, expectation of pain, mental health and beliefs about causation of pain with persistence of neck/shoulder pains among computer office workers. Methods: This research is a kind of prospective cohort study with 1-year follow-up. It has done among all eligible computer office workers of Shahroud universities (n = 182) in 2008-2009 and 1-year later. Data were collected using the Cultural and Psychosocial Influences on Disability questionnaire. Multiple logistic regression analysis was used to analyze the data through SPSS (P < 0.05). Results: At the baseline 100 (54.9%) of participants reported neck/shoulder pains and at follow-up 34.3% of them reported persistence pains. Significant relationships were found between persistence of neck/shoulder pains and negative expectation about pain in next 1-year P = 0.002, (odds ratio [OR] =8.3, 95% confidence interval [CI]: 2.1-32.9) and somatization tendency P = 0.01, (OR = 6.5, 95% CI: 1.6-27.4). Conclusions: Pain expectation and somatization tendency recognized as associated risk factors of persistent neck/shoulder pain among computer operators. This confirmed some other similar studies on work-related musculoskeletal disorders in Europe countries in recent years. PMID:25317301

  12. Musculoskeletal involvement in systemic sclerosis.

    PubMed

    Lóránd, Veronika; Czirják, László; Minier, Tünde

    2014-10-01

    Musculoskeletal (MSK) involvement is a very frequent manifestation of patients with systemic sclerosis (SSc). There are several reports about clinical trials assessing musculoskeletal involvement in SSc. However, only few controlled studies have been conducted. The prevalence of musculoskeletal symptoms, clinical and radiographic findings has been assessed. The most important articular (arthralgia, synovitis, contractures), tendon (tendon friction rubs, tenosynovitis) and muscular manifestations (myalgia, muscle weakness, myositis) should be carefully evaluated during the assessment of SSc patients, because these are not only common, but substantially influence the quality of life and some of them also have predictive value concerning disease activity and severity. PMID:25179276

  13. [Fiddler's neck].

    PubMed

    Knierim, C; Goertz, W; Reifenberger, J; Homey, B; Meller, S

    2013-10-01

    The fiddler's neck is an uncommon variant of acne mechanica in violinists and violists. It is a single firm red-brown dermal nodule usually on the left side of neck. This special form of acne mechanica represents a therapeutic challenge since the triggering mechanical factors persist, unless they can be corrected by changes in positioning or modifications of the chin pad. A 72-year-old woman who had played the violin since childhood presented with a red-brown nodule on her neck for 18 months. Cushioning provided no relief. Excision of the affected area with primary closure represented one therapeutic option. Further supportive measures include improved posture to reduce the pressure between skin and instrument and interposing a neck cloth. PMID:23989244

  14. Neck pain

    MedlinePlus

    ... falls can cause severe neck injuries, such as vertebral fractures, whiplash, blood vessel injury, and even paralysis. Other ... fibromyalgia Cervical arthritis or spondylosis Ruptured disk ... spine from osteoporosis Spinal stenosis (narrowing of the spinal ...

  15. Association of Painful Musculoskeletal Conditions and Migraine Headache With Mental and Sleep Disorders Among Adults With Disabilities, Spain, 2007–2008

    PubMed Central

    Dueñas, María; Ojeda, Begoña; Failde, Inmaculada

    2014-01-01

    Introduction The aim of this study was to determine the prevalence of painful musculoskeletal conditions and migraine headache or any other headache in a sample of Spanish adults with disabilities and their association with anxiety, depression, and sleep disorders. Methods This cross-sectional study analyzed data from the Spanish national disability and dependence survey (2007–2008) of 16,932 adults aged 18 or older who have disabilities. The prevalence (95% confidence interval [CI]) of painful musculoskeletal conditions was determined according to a diagnosis of arthritis, osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, muscular dystrophy, and neck or back pain. The prevalence of migraine or other headache was also calculated. Factors associated with these painful conditions were analyzed separately for men and women by using a logistic regression model. Results The prevalence of painful musculoskeletal conditions was 66.9% (95% CI, 66.2%–67.6%) and that of migraine or other headache was 23.4% (95% CI, 22.8%–24.1%), both of which were higher in women than in men. Factors associated with these conditions in both men and women included older age, a sleep disorder, and concomitant chronic anxiety and/or depression. Conclusion The prevalence of painful musculoskeletal conditions and migraine or other headache is high in people with disability in Spain, especially in women, and these conditions often coexist with depression, anxiety, and/or a sleep disorder. To design programs for rehabilitating and improving the quality of life of adults with disability and painful conditions, treatments for mental and/or sleep disorders should be considered in addition to conventional treatments. PMID:24576397

  16. Co morbidities of Myofascial Neck Pain among Information Technology Professionals

    PubMed Central

    2014-01-01

    Objectives The objective of this study was to identify the musculoskeletal co-morbidities of neck pain of myofascial origin among IT professionals. Methods A retrospective report analysis of 5357 IT professionals from various IT companies in India was conducted. Demographic details, type and intensity of the musculoskeletal problems, employee feedbacks on status of musculoskeletal health and physician’s diagnosis were analysed. Descriptive statistics were used to describe the age, gender, body area affected and nature of work. Chi square test was used to find the association between musculoskeletal co-morbidities and myofascial neck pain (MNP). Results The study participants were predominantly males (71%). 41% of the population used laptops, 35% desktops and 24% both. Neck pain was the commonest reported symptom, followed by low back, shoulder and arm pain respectively. Statistical analysis also revealed that low back pain and shoulder pain, had a significant association with neck pain. Further analysis revealed that there was a significant association between the presence of MNP and thoracic outlet syndrome (p < 0.001) and fibromyalgia syndrome (p < 0.001). Other than the listed co-morbidities, eye strain was also found to be associated with MNP. Conclusions Low back pain and shoulder pain was found to be co morbid symptoms noted among IT professionals with MNP. Thoracic outlet syndrome and fibromyalgia were found to be the most commonly associated disorders with MNP among IT professionals. PMID:25852935

  17. Musculoskeletal Symptoms among Drivers of All-Terrain Vehicles

    NASA Astrophysics Data System (ADS)

    REHN, B.; BERGDAHL, I. A.; AHLGREN, C.; FROM, C.; JÄRVHOLM, B.; LUNDSTRÖM, R.; NILSSON, T.; SUNDELIN, G.

    2002-05-01

    The aim of this cross-sectional study was to characterize the risk of experiencing musculoskeletal symptoms in the region of the neck, shoulders and upper and lower back for professional drivers of various categories of all-terrain vehicles and to assess the association between symptoms and duration of exposure to whole-body vibration (WBV) and shock from driving all-terrain vehicles. The study group consisted of 215 drivers of forest machines, 137 drivers of snowmobiles and 79 drivers of snowgroomers and a control group of 167 men randomly selected from the general population. The subjects were all from one of the four most northern counties in Sweden and they were all men. Musculoskeletal symptoms were assessed by use of a standardized questionnaire. In addition, the questionnaire held items about the driving time with all-terrain vehicles and a subjective estimation of exposure to unpleasant movements (shock, jolt, irregular sway). The job strain was measured according to Karasek's demands/control model. The prevalence ratios were adjusted for age, smoking and job strain. Among drivers, significantly increased prevalence ratios within the range of 1∂5-2·9 were revealed for symptoms from the neck-shoulder and thoracic regions during the previous year. None of the driver categories had a statistically significantly increased risk of low back pain. Forest vehicles were those most reported to cause unpleasant movements. In conclusion, drivers of all-terrain vehicles exhibit an increased risk of symptoms of musculoskeletal disorders in the neck-shoulder and thoracic regions. The increased risk is suggested to be related to physical factors such as exposure to whole-body vibration (WBV) and shock, static overload or extreme body postures. However, since symptoms of low back pain were not significantly increased, it appears that factors other than WBV would explain the occurrence of symptoms in the group of all-terrain drivers.

  18. Musculoskeletal injuries in Homer's Iliad: the War of Troy revisited.

    PubMed

    Kömürcü, Erkam; Tok, Fatih; Simşek, Ayşe; Ozçakar, Levent

    2014-04-01

    Homer's Iliad--the most famous and influential epic poem--has been previously reviewed with respect to head, craniomaxillofacial, neck, thoracic, and hand injuries in the literature. However, to the best of the authors' knowledge, there are no data regarding musculoskeletal injuries. This article describes the musculoskeletal injuries that had ensued during the war of Troy. The Turkish translation of the original epic poem Iliad was reviewed for musculoskeletal injuries, that is, their descriptions, outcome, the weapons used, and the engaged warriors. Extremity injuries were evaluated as regards the affected bones. The pertinent treatment methods were also recorded. In total, 103 musculoskeletal injuries were detected during 81 combats. The most commonly involved areas were the shoulder (15.5%), the head (14.5%), the cervical vertebrae (14.5%), and the thoracic vertebrae (8.7%). The weapons used were spear (n = 52); sword (n = 9); arrow (n = 9); stone (n = 8); and cane, animal, the hand, Chariot race, and broken yoke (n = 1 for each). Fifty-four combats (66.6%) resulted in death. Therapeutic herbs, compound of milk, and essence of fig were used as treatment alternatives. While providing a historic snapshot on the war of Troy, in this article, the authors have reviewed the musculoskeletal injuries and their management in those ancient times. Despite the long period in between, unfortunately, physicians/surgeons are still faced with war injuries in current medical practice. The authors strongly hope that, at least in the near future, physicians will be left with only natural health problems and without those artificially generated by human beings. PMID:24406735

  19. The prevalence of musculoskeletal complaints among women in Tijuana, Mexico: sociodemographic and occupational risk factors.

    PubMed

    Harlow, S D; Becerril, L A; Scholten, J N; Sánchez Monroy, D; Sánchez, R A

    1999-01-01

    The authors interviewed an age- and occupation-stratified sample of 466 women, aged 18-40, from 12 Tijuana neighborhoods, about sociodemographic characteristics, work and reproductive history, and musculoskeletal complaints. A total of 29.8% reported experiencing aches or pain in the low back, 38.3% in the upper back, 26.4% in the neck/shoulders, 18.2% in the hand/wrist, and 28.3% in the legs in the preceding year. Both sociodemographic and occupational factors were associated with these complaints. Very low educational attainment, having substandard housing, being the head of household, and being a migrant were each associated with an increased prevalence of one or more musculoskeletal complaints. In general, working outside the home increased the risk of musculoskeletal complaints. Compared with women who had not worked in the preceding 30-month period, those working in the maquiladora had 40-90% higher risks of upper back, neck/shoulder, and hand/wrist pain. Compared with women working outside the maquiladora, maquiladora women workers had 20% higher risks of low back, upper back, and neck/shoulder complaints. More detailed studies of the incidences of musculoskeletal disorders and of specific etiologic risk factors within the maquiladora industry are warranted. Future studies should concurrently evaluate sociodemographic risk factors. PMID:10633243

  20. Musculoskeletal pain in children and adolescents

    PubMed Central

    Kamper, Steve J.; Henschke, Nicholas; Hestbaek, Lise; Dunn, Kate M.; Williams, Christopher M.

    2016-01-01

    ABSTRACT Introduction Musculoskeletal (MSK) pain in children and adolescents is responsible for substantial personal impacts and societal costs, but it has not been intensively or systematically researched. This means our understanding of these conditions is limited, and healthcare professionals have little empirical evidence to underpin their clinical practice. In this article we summarise the state of the evidence concerning MSK pain in children and adolescents, and offer suggestions for future research. Results Rates of self-reported MSK pain in adolescents are similar to those in adult populations and they are typically higher in teenage girls than boys. Epidemiological research has identified conditions such as back and neck pain as major causes of disability in adolescents, and in up to a quarter of cases there are impacts on school or physical activities. A range of physical, psychological and social factors have been shown to be associated with MSK pain report, but the strength and direction of these relationships are unclear. There are few validated instruments available to quantify the nature and severity of MSK pain in children, but some show promise. Several national surveys have shown that adolescents with MSK pain commonly seek care and use medications for their condition. Some studies have revealed a link between MSK pain in adolescents and chronic pain in adults. Conclusion Musculoskeletal pain conditions are often recurrent in nature, occurring throughout the life-course. Attempts to understand these conditions at a time close to their initial onset may offer a better chance of developing effective prevention and treatment strategies. PMID:27437719

  1. Predictive risk factors for chronic regional and multisite musculoskeletal pain: a 5-year prospective study in a working population.

    PubMed

    Herin, Fabrice; Vézina, Michel; Thaon, Isabelle; Soulat, Jean-Marc; Paris, Christophe

    2014-05-01

    The role of psychosocial and physical factors in the development of musculoskeletal pain (MSP) has now been clearly demonstrated. However, it is unclear whether these factors contribute to specific regional MSP or to multisite pain. The main goal of this study was to assess the impact of work-related factors according to gender on the development of regional and multisite MSP. A total of 12,591 subjects (65% men and 35% women) who were born in 1938, 1943, 1948, and 1953 and were participating in a French longitudinal prospective epidemiological survey (ESTEV) in 1990 to 1995 were eligible. Personal factors and work exposure were assessed by self-administered questionnaires. Statistical associations between chronic MSP (regional body site or multisite), personal factors, and occupational factors were analyzed using logistic regression modeling. The incidence of regional MSP and multisite pain in 1995 were, respectively, 17% and 25.6%. For women, highly repetitive movements predicted neck/shoulder pain; posture and vibrations predicted arm and low back pain; and effort with tools predicted arm pain. For men, forceful effort and vibrations predicted neck/shoulder pain; posture and forceful effort predicted lower limb and low back pain; and forceful effort and effort with tools predicted arm pain. Physical constraints (ie, forceful effort or vibrations) were associated with multisite pain in both genders. Only for women, psychological factors were risk factors predictive of upper limb pain and in 3 or 4 painful anatomical sites. These results support the hypothesis that some physical and psychological work-related factors are predictive of regional or multisite MSP but differ according to gender. Gender differences and risk factors for work-related musculoskeletal pain should be also taken into account to more effectively target preventive measures. PMID:24561229

  2. Neck Pain

    MedlinePlus

    ... get better. No 7. Did you have a whiplash-type injury in the past, or do you have pain and/or stiffness every day in your neck, hands, knees, hips or other joints? Yes Your pain may be from DEGENERATIVE CERVICAL ARTHRITIS, a disorder that affects the bones and ...

  3. Association between shift working and musculoskeletal symptoms among nursing personnel

    PubMed Central

    Attarchi, Mirsaeed; Raeisi, Saeed; Namvar, Mohamad; Golabadi, Majid

    2014-01-01

    Background: Some health problems are more prevalent in shift workers than day workers. Musculoskeletal disorders are considered as one of the most common health-related problems that can cause disability among health care workers. The aim of this study was to assess the associations between shift working and the prevalence of musculoskeletal symptoms (MSs) among nursing personnel. Materials and Methods: This study was conducted among 454 health care workers including nurses and nurses’ aides in a general hospital in Iran. A Nordic musculoskeletal questionnaire was used to evaluate the prevalence of MSs. Logistic regression analysis with adjusting for confounding factors was performed to evaluate the associations between shift working and the prevalence of MSs. Results: Lower back, knees, and upper back symptoms with the prevalence of 57.4%, 48.4%, and 47%, respectively, were the most common MSs. The prevalence of MSs in eight regions of the body (lower back, neck, knees, upper back, shoulder, wrist, buttock, and ankle) was higher among shift workers than day workers. The differences were statistically significant only in the lower back and ankle regions (P < 0.05). Odds Ratio for lower back symptoms in shift workers was 1.94 compared to day workers (P = 0.003). Conclusion: Findings of this study suggested that shift working could be associated with increased prevalence of lower back disorders among nursing personnel. This study emphasizes on the importance of proper work planning and regulating working hours for nursing personnel. PMID:24949072

  4. Neck pain

    PubMed Central

    2008-01-01

    Introduction Non-specific neck pain has a postural or mechanical basis and affects about two thirds of people at some stage, especially in middle age. Acute neck pain resolves within days or weeks, but may become chronic in about 10% of people. Whiplash injuries follow sudden acceleration–deceleration of the neck, such as in road traffic or sporting accidents. Up to 40% of people continue to report symptoms 15 years after the accident, although this varies between countries. Methods and outcomes We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of treatments for people with non-specific neck pain without severe neurological deficit? What are the effects of treatments for acute whiplash injury? What are the effects of treatments for chronic whiplash injury? What are the effects of treatments for neck pain with radiculopathy? We searched: Medline, Embase, The Cochrane Library, and other important databases up to May 2007 (BMJ Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). Results We found 91 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of the evidence for interventions. Conclusions In this systematic review we present information relating to the effectiveness and safety of the following interventions: acupuncture, biofeedback, drug treatments (analgesics, antidepressants, epidural steroid injections, muscle relaxants, non-steroidal anti-inflammatory drugs [NSAIDs]), early mobilisation, early return to normal activity, exercise, heat or cold, manipulation (alone or plus exercise), mobilisation, multimodal treatment, patient education, percutaneous radiofrequency neurotomy

  5. Management of chronic musculoskeletal pain.

    PubMed

    Uhl, Richard L; Roberts, Timothy T; Papaliodis, Dean N; Mulligan, Michael T; Dubin, Andrew H

    2014-02-01

    Chronic musculoskeletal pain results from a complex interplay of mechanical, biochemical, psychological, and social factors. Effective management is markedly different from that of acute musculoskeletal pain. Understanding the physiology of pain transmission, modulation, and perception is crucial for effective management. Pharmacologic and nonpharmacologic therapies such as psychotherapy and biofeedback exercises can be used to manage chronic pain. Evidence-based treatment recommendations have been made for chronic pain conditions frequently encountered by orthopaedic surgeons, including low back, osteoarthritic, posttraumatic, and neuropathic pain. Extended-release tramadol; select tricyclic antidepressants, serotonin reuptake inhibitors, and anticonvulsants; and topical medications such as lidocaine, diclofenac, and capsaicin are among the most effective treatments. However, drug efficacy varies significantly by indication. Orthopaedic surgeons should be familiar with the widely available safe and effective nonnarcotic options for chronic musculoskeletal pain. PMID:24486756

  6. Ultrasound elastography for musculoskeletal applications

    PubMed Central

    Drakonaki, E E; Allen, G M; Wilson, D J

    2012-01-01

    Ultrasound elastography (EUS) is a method to assess the mechanical properties of tissue, by applying stress and detecting tissue displacement using ultrasound. There are several EUS techniques used in clinical practice; strain (compression) EUS is the most common technique that allows real-time visualisation of the elastographic map on the screen. There is increasing evidence that EUS can be used to measure the mechanical properties of musculoskeletal tissue in clinical practice, with the future potential for early diagnosis to both guide and monitor therapy. This review describes the various EUS techniques available for clinical use, presents the published evidence on musculoskeletal applications of EUS and discusses the technical issues, limitations and future perspectives of this method in the assessment of the musculoskeletal system. PMID:23091287

  7. Musculoskeletal ageing and primary prevention.

    PubMed

    Nedergaard, Anders; Henriksen, Kim; Karsdal, Morten A; Christiansen, Claus

    2013-10-01

    Loss of musculoskeletal mass and function is a natural ageing trait, reinforced by an unhealthy life style. Loss of bone (osteoporosis) and muscle (sarcopaenia) are conditions whose prevalence are increasing because of the change in population distribution in the western world towards an older mean age. Improvements in lifestyle factors, such as diet, smoking and exercise, are the most powerful tools to combat this decline efficiently; however, public health interventions aimed at tackling these problems have shown abysmal success at the population level, mostly due to failure in compliance. With these issues in mind, we believe that the primary prevention modality in coming decades will be pharmacological. We review the basic biology of musculoskeletal ageing and what measures can be taken to prevent ageing-associated loss of musculoskeletal mass and function, with particular emphasis on pharmacological means. PMID:23891483

  8. Change in Musculoskeletal Pain in Patients With Work-Related Musculoskeletal Disorder After Tailored Rehabilitation Education: A One-Year Follow-Up Survey

    PubMed Central

    Lee, Dong Hun; Kang, Boram; Choi, Seungyoung; Kim, Taikon; Jang, Seong Ho; Lee, Kyu Hoon; Kim, Mi Jung; Park, Si-Bog

    2015-01-01

    Objective To apply tailored rehabilitation education to video display terminal (VDT) workers with musculoskeletal pain and to assess changes in musculoskeletal pain after rehabilitation education. Methods A total of 8,828 VDT workers were screened for musculoskeletal disorders using a self-report questionnaire. Six hundred twenty-six VDT workers selected based on their questionnaires were enrolled in musculoskeletal rehabilitation education, which consisted of education on VDT syndrome and confirmed diseases, exercise therapy including self-stretching and strengthening, and posture correction. One year later, a follow-up screening survey was performed on 316 VDT workers, and the results were compared with the previous data. Results Compared with the initial survey, pain intensity was significantly decreased in the neck area; pain duration and frequency were significantly decreased in the low back area; and pain duration, intensity, and frequency were significantly decreased in the shoulder and wrist after tailored rehabilitation education. In addition, pain duration, intensity, and frequency showed a greater significant decrease after tailored rehabilitation education in the mild pain group than in the severe pain group. Conclusions This study found that work-related musculoskeletal pain was reduced after tailored rehabilitation education, especially in the shoulder, wrist, and low back. PMID:26605170

  9. [Working women with chronic musculoskeletal pain: a case series].

    PubMed

    Ordóñez-Hernández, Cecilia Andrea; Contreras-Estrada, Mónica Isabel; Soltero-Avelar, Ruben

    2015-10-01

    This study aimed to analyze the experience of working women suffering from chronic musculoskeletal pain, using a qualitative design with a phenomenological approach. The technique drew on in-depth interviews with five working women that presented to the orthopedics and neurosurgery departments of a hospital in Guadalajara, Mexico, with a complaint of musculoskeletal pain for more than six months. The study showed that the women felt rejection, segregation, discrimination, lack of support at the workplace, and feelings of frustration and powerlessness related to their health condition. The women also perceived as a barrier the lack of efficiency in disability proceedings and job reintegration or relocation. Financial and family responsibilities were their main reason for continuing to work despite their chronic musculoskeletal pain. PMID:26735388

  10. Proton MR Spectroscopy in Metabolic Assessment of Musculoskeletal Lesions

    PubMed Central

    Subhawong, Ty K.; Wang, Xin; Durand, Daniel J.; Jacobs, Michael A.; Carrino, John A.; Machado, Antonio J.; Fayad, Laura M.

    2014-01-01

    OBJECTIVE The purposes of this review are to describe the principles and method of MR spectroscopy, summarize current published data on musculoskeletal lesions, and report additional cases that have been analyzed with recently developed quantitative methods. CONCLUSION Proton MR spectroscopy can be used to identify key tissue metabolites and may serve as a useful adjunct to radiographic evaluation of musculoskeletal lesions. A pooled analysis of 122 musculoskeletal tumors revealed that a discrete choline peak has a sensitivity of 88% and specificity of 68% in the detection of malignancy. Modest improvements in diagnostic accuracy in 22 of 122 cases when absolute choline quantification was used encourage the pursuit of development of choline quantification methods. PMID:22194493

  11. Playing-related musculoskeletal disorders among Indian tabla players.

    PubMed

    Mishra, Wricha; De, Amitabha; Gangopadhyay, Somnath; Chandra, Ananga M

    2013-06-01

    Playing a percussion instrument demands great force and effort, which may make percussionists prone to playing-related musculoskeletal disorders (PRMDs). Of all of the percussion instruments in India, tabla is the most popular. The present study was undertaken to investigate the prevalence of discomforts among professional tabla players. Eighty-five professional tabla players voluntarily participated in the study. The Nordic Musculoskeletal Questionnaire and visual analog scale were administered to all the participants. Demographic details, music-related activities, and symptoms of discomfort were also recorded. It was found that prone anatomical areas were the low back, right shoulder, neck, left shoulder, upper back, and knees. The frequency of discomfort was found to be mostly weekly for the shoulders and monthly for neck, low back, and knees. There was an association between visual analog scale and prevalence of self-reported discomforts in some body parts. It can be said that the prolonged, unsupported, folded-knee sitting posture may be the cause of discomforts. PMID:23752286

  12. Pharmacologic Therapies in Musculoskeletal Conditions.

    PubMed

    Loveless, Melinda S; Fry, Adrielle L

    2016-07-01

    Musculoskeletal conditions are common, and there are many options for pharmacologic therapy. Unfortunately, there is not strong evidence for the use of many of these medications. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are generally first-line medications for most musculoskeletal pain, but there is more evidence these medications are not as safe as once thought. Other analgesic and antispasmodic medications can be effective for acute pain but generally are not as effective for chronic pain. Antidepressants and anticonvulsants can be more effective for chronic or neuropathic pain. Topical formulations of NSAIDs can be effective for pain with fewer side effects. PMID:27235619

  13. Musculoskeletal manifestations of endocrine disorders.

    PubMed

    Boswell, Stephanie B; Patel, Dakshesh B; White, Eric A; Gottsegen, Christopher J; Forrester, Deborah M; Masih, Sulabha; Matcuk, George R

    2014-01-01

    Endocrine disorders can lead to disturbances in numerous systems within the body, including the musculoskeletal system. Radiological evaluation of these conditions can demonstrate typical appearances of the bones and soft tissues. Knowledge of these patterns can allow the radiologist to suggest a diagnosis that may not be clinically apparent. This review will highlight the typical musculoskeletal findings of acromegaly, hypercortisolism, hyperthyroidism, hypothyroidism, hyperparathyroidism, pseudo- and pseudopseudohypoparathyroidism, and diabetes mellitus. The radiological manifestations of each of these endocrine disorders, along with a brief discussion of the pathophysiology and clinical implications, will be discussed. PMID:24642251

  14. Prevalence of musculoskeletal symptoms in hospital nurse technicians and licensed practical nurses: associations with demographic factors

    PubMed Central

    Moreira, Roberta F. C.; Sato, Tatiana O.; Foltran, Fabiana A.; Silva, Luciana C. C. B.; Coury, Helenice J. C. G.

    2014-01-01

    Objective : This cross-sectional study aimed at analyzing: 1. the main musculoskeletal symptoms (MSS) presented by hospital nursing workers and; 2. personal, occupational, and health factors related to MSS among them. Method : Two questionnaires were filled in by 245 nurse technicians (NTs) and licensed practical nurses (LPNs) (response rate 95%) associated with direct patient care sectors from a hospital. These questionnaires were: the standardized version of the Nordic Musculoskeletal Questionnaire (NMQ) and one including questions on 15 demographic independent variables potentially related to outcomes from the NMQ. Univariate analyses and binary logistic regression analyses were performed to identify which variables would explain the occurrence of MSS in different body regions. Results: The low back (57%), shoulder (52%), and neck (48%) were identified as the most affected regions. The logistic regression analysis showed that low back symptoms in the last 12 months were significantly associated with LPN activities (OR=2.36; CI=1.24-4.5) and previous sick leave due to MSS (OR=5.97; CI=1.2-29.1). Smoking was significantly associated with symptoms in the low back (OR=2.77; CI=1.13-6.8) and thoracic spine (OR=2.37; CI=1.04-5.40). Physical exercise showed a protective effect on the cervical spine (OR=0.42; CI=0.23-0.77). Previous sick leave was significantly associated with pain in the knees (OR=4.24; CI=1.33-13.5) and in the upper limbs (OR=5.36; CI=1.07-26.7). Conclusions: The nursing workers who were evaluated presented a high prevalence of MSS. Previous history of sick leave was strongly associated with the presence of symptoms in various body regions. These results indicate the need for preventive programs in the hospital environment in order to control more severe MSS in nursing professionals. PMID:25054385

  15. Musculoskeletal Fitness and Risk of Mortality.

    ERIC Educational Resources Information Center

    Katzmarzyk, Peter T.; Craig, Cora L.

    2002-01-01

    Quantified the relationship between musculoskeletal fitness and all-cause mortality in Canada, using measures of musculoskeletal fitness (situps, pushups, grip strength, and sit- and-reach trunk flexibility) from adult male and female participants in the Canadian Fitness Survey. Results indicated that some components of musculoskeletal fitness,…

  16. [Musculoskeletal medicine--strategies towards a "good musculoskeletal consultation"].

    PubMed

    Vulfsons, Simon

    2011-03-01

    The burden of musculoskeletal disease and disability is huge. The direct costs of diagnosis and treatment are dwarfed by the indirect costs to society comprised of sick leave, early retirement, pension funds and disability allowances. Chronic musculoskeletal pain and dysfunction account for the most common cause for chronic pain and for up to 25% of all consultations to family practitioners in the developed world. It is therefore surprising to find that education and training in musculoskeletal medicine has been given short shrift by medical schools, specialist training programs for family practitioners and post graduate continuing medical education. This has been shown quite comprehensively by Mashov and Tabenkin in this edition of the journal. At the close of the Bone and Joint Decade 2000-2010, as declared by the WHO, it is timely to see what has been achieved in terms of the original goals for this decade. There has been a major effort for increasing awareness both in the health community and the general public towards managing chronic musculoskeletal pain. Much has been written, but far less performed in changing the priorities of medical schools and family practice programs towards teaching and training doctors to adequately recognize and treat patients suffering from chronic musculoskeletal problems. In Israel, it is estimated that the indirect costs through lost productivity amount to up to 1.15 billion shekels a year. Investing time and money in training programs for medical students and doctors, together with building an incentive program for primary care physicians to adequately treat this huge chronically disabled population is not only feasible, but can also make great inroads towards easing suffering while curtailing costs. PMID:21574355

  17. Repeated survey on changes in musculoskeletal complaints relative to age and work demands.

    PubMed Central

    de Zwart, B C; Broersen, J P; Frings-Dresen, M H; van Dijk, F J

    1997-01-01

    OBJECTIVES: To examine changes in musculoskeletal complaints over four years in groups of employees relative to age and work demands. METHODS: Repeated questionnaire data of male employees in heavy physical work (exposed group, n = 7324) and mental work (control group, n = 4686), stratified for age (20-9, 30-9, 40-9, 50-9), were analysed. For each employee, data on the occurrence of musculoskeletal complaints from two surveys with a mean interval of around four years were available. Changes in prevalences over the follow up interval were analysed. Proportions of new, recovered, and chronic cases as well as those free of complaints at both surveys were studied. RESULTS: For most complaints, there were significantly greater increases in prevalences in the exposed group compared with the control group over the follow up interval particularly within the group aged 40-9 for back, neck, and several sites of the upper and lower limbs. The 20-9 year age group also had significantly greater changes for several musculoskeletal complaints. Within the oldest age group (50-9) exposure to heavy physical work demands only affected changes in prevalences of neck and upper arm complaints. After four years in the cohort free of complaints at the start of the follow up the group aged 40-9 had the highest prevalence of complaints of the back, neck, and the upper and lower limbs. CONCLUSIONS: Middle aged and younger employees develop musculoskeletal complaints as a result of exposure to heavy physical work. In the oldest age group health related selection seems to mask the occupational health risks under study. To prevent the expected increase in musculoskeletal disorders and related work disability in our aging workforce, preventive measures should be taken at all stages of a working life. PMID:9538351

  18. Musculoskeletal adverse drug reactions: a review of literature and data from ADR spontaneous reporting databases.

    PubMed

    Conforti, Anita; Chiamulera, Christian; Moretti, Ugo; Colcera, Sonia; Fumagalli, Guido; Leone, Roberto

    2007-01-01

    The musculoskeletal system can be a target organ for adverse drug reactions (ADRs). Drug-induced muscle, bone or connective tissue injuries may be due to, i), primary direct drug action, or, ii), undirected consequence of generalized drug-induced disease. Musculoskeletal ADRs may be only temporarily disabling, such as muscle cramps, as well as in other cases may be serious and life-threatening, such as rhabdomyolysis. In the last few years there has been an increasing awareness of musculoskeletal ADRs. Some recent drug safety issues dealt with serious or uncommon musculoskeletal reactions like rhabdomyolysis associated to statins and tendon rupture associated to fluoroquinolones. In this review, we firstly selected those drug classes having a significantly high percentage of musculoskeletal disorder reports in the WHO adverse drug reaction database, maintained by the Uppsala Monitoring Centre. Secondly, the different musculoskeletal ADRs were closely analyzed through the data obtained from an Italian interregional ADRs spontaneous reporting database. The findings on drugs associated to different musculoskeletal disorders, have been integrated with a review of the epidemiological data available in the literature. For the most involved drugs (HMG-CoA reductase inhibitors, fluoroquinolones, corticosteroids, bisphosphonates, retinoids) the underlying musculoskeletal ADR mechanisms were also reviewed and discussed. PMID:18690950

  19. Neck Injuries and Disorders

    MedlinePlus

    ... another common cause of neck pain. Whiplash, a soft tissue injury to the neck, is also called neck sprain or strain. Treatment depends on the cause, but may include applying ice, taking pain relievers, getting physical therapy or wearing ...

  20. Work-Related Musculoskeletal Symptoms among Building Construction Workers in Riyadh, Saudi Arabia

    PubMed Central

    Ayoub Meo, Sultan; Alsaaran, Zaid Fahad; Alshehri, Moayad Khalid; Azam Khashougji, Mohammed; Almeterk, Abdul Aziz Zayed; Almutairi, Saif Fraj; Alsaeed, Saad Fahad

    2013-01-01

    Objectives: To investigate the work-related musculoskeletal symptoms among building construction workers. Methods: Total 389 apparently healthy, male volunteers were selected with mean age 34.56±8.33 years and a mean working duration in building construction as 5.76±2.68 years. Musculoskeletal complaints were recorded through a detailed clinical interview and comprehensive questionnaire. Results: Substantial number of building construction workers developed musculoskeletal symptoms including neck pain 29 (7.5%), shoulder pain 41(10.5%), upper back pain 24(6.2%), lower back pain 64 (16.5%), legs pain 93 (23.9%), feet pain 52 (13.4%), head heaviness 44 (11.3%) and whole body fatigue 78 (20.1%). These complaints were significantly associated with long-term duration-response in building construction industry. Furthermore, cigarette smokers had little higher percentage of musculoskeletal complaints compared to non-smoker companions. Conclusions: Building construction occupation is a prolific source of musculoskeletal ailments and complaints were significantly increased with long-term working duration in building construction industry. PMID:24550961

  1. [How do physical fitness and heavy physical work interact in the occurrence of musculoskeletal disorders?].

    PubMed

    Mascarenhas, Adauto Luis Moreira; Fernandes, Rita de Cássia Pereira

    2014-10-01

    A cross-sectional study investigated the association between self-reported physical fitness and musculoskeletal disorders in the neck, shoulder, or upper back among workers in 14 plastics factories in Salvador, Bahia State, Brazil. Physical fitness was assessed on a scale from 0 to 5. Cases were defined as self-reported pain in the previous 12 months, lasting more than a week or having monthly minimum frequency, with restrictions at work or seeking medical care, or where respondents' severity was greater than 2 (on a scale from 0 to 5). Logistic regression was performed to investigate statistical interaction between physical fitness and physical demands from work in the occurrence of musculoskeletal disorders. Precarious physical fitness resulted in 3.19 times greater odds of musculoskeletal disorders among workers exposed to light physical demands on the job. Among workers exposed to heavy physical demands, physical fitness failed to protect against musculoskeletal disorders. Heavy physical work was always associated with high prevalence of musculoskeletal disorders. Despite the importance of physical fitness, physical exercise programs should not be used to replace improvements in working conditions. PMID:25388321

  2. Subjective musculoskeletal symptoms in winter and summer among indoor working construction electricians.

    PubMed

    Inaba, Ryoichi; Mirbod, Seyed Mohammad

    2010-01-01

    To evaluate the effects of cold exposure on the musculoskeletal system, two surveys on the subjective musculoskeletal symptoms among male electricians working in the buildings under construction were performed in winter (N=74) and summer seasons (N=83). A self-administered questionnaire was used to collect information on age, occupational career, working habit, present illness, and subjective musculoskeletal symptoms. Mean age, occupational career and daily smoking of the supervisors were significantly higher than those of the other subjects. In general, prevalence rates of stiffness, numbness, pain and Raynaud's phenomenon in the fingers, finger cold sensation, dull movement of the fingers, pain in the wrist, knee joint pain, pain and numbness in the foot and foot cold sensation in winter were significantly higher than those in summer. These results were marked especially in the workers except supervisors. In winter, there were no significant differences in the prevalence rates of subjective musculoskeletal complaints between the supervisors and the other workers. On the other hand, in summer, prevalence of stiffness and pain in the shoulder, stiffness and pain in the neck, dullness and pain in the arm, finger cold sensation, low back dullness and low back pain in the supervisors were significantly higher than those in the other workers. These results suggest that effects of cold on the musculoskeletal symptoms markedly appeared in the workers except supervisors. PMID:20160405

  3. Ageing, musculoskeletal health and work.

    PubMed

    Palmer, Keith T; Goodson, Nicola

    2015-06-01

    Changing demographics mean that many patients with soft tissue rheumatism, osteoarthritis, inflammatory arthritis, large joint prostheses and age-related co-morbidities are seeking to work beyond the traditional retirement age. In this chapter, we review the evidence on musculoskeletal health and work at older ages. We conclude that musculoskeletal problems are common in older workers and have a substantial impact on their work capacity. Factors that influence their job retention are described, together with approaches that may extend working life. Many gaps in evidence were found, notably on the health risks and benefits of continued work in affected patients and on which interventions work best. The roles of physicians and managers are also considered. PMID:26612237

  4. Ageing, musculoskeletal health and work

    PubMed Central

    Palmer, Keith; Goodson, Nicola

    2016-01-01

    Changing demographics mean that many patients with soft tissue rheumatism, osteoarthritis, inflammatory arthritis, large joint prostheses, and age-related co-morbidities are seeking to work beyond the traditional retirement age. In this chapter we review the evidence on musculoskeletal health and work at older ages. We conclude that musculoskeletal problems are common in older workers and have a substantial impact on their work capacity. Factors that influence their job retention are described, together with approaches that may extend working life. Many gaps in evidence were found, notably on the health risks and benefits of continued work in affected patients and on which interventions work best. The roles of physicians and managers are also considered. PMID:26612237

  5. Radiology of musculoskeletal stress injuries

    SciTech Connect

    Keats, T.E.

    1989-01-01

    With the new emphasis on physical fitness, musculoskeletal stress injuries are being seen with greater frequency in children and adults, and in locations that are not widely associated with stress injury. Some of the injuries continue to be mistaken for signs of more serious illnesses, such as infection and neoplasm, and this may lead to unnecessary investigative effort. This book covers both the classic stress injuries and the new manifestations.

  6. Palliative Care in Musculoskeletal Oncology.

    PubMed

    Gulia, Ashish; Byregowda, Suman; Panda, Pankaj Kumar

    2016-01-01

    Patients in advanced stages of illness trajectories with local and widespread musculoskeletal incurable malignancies, either treatment naive or having recurrence are referred to the palliative care clinic to relieve various disease-related symptoms and to improve the quality of life. Palliative care is a specialized medicine that offers treatment to the disease-specific symptoms, places emphasis on the psychosocial and spiritual aspects of life and help the patients and their family to cope with advance stage cancer in a stronger and reasonable way. The overall outcome of musculoskeletal malignancies has improved with the advent of multidisciplinary management. Even then these tumors do relapse and leads to organ failures and disease-specific deaths in children and young adults in productive age group thus requiring an integrated approach to improve the supportive/palliative care needs in end-stage disease. In this article, we would like to discuss the spectrum of presentation of advanced musculoskeletal malignancies, skeletal metastasis, and their management. PMID:27559251

  7. Palliative Care in Musculoskeletal Oncology

    PubMed Central

    Gulia, Ashish; Byregowda, Suman; Panda, Pankaj Kumar

    2016-01-01

    Patients in advanced stages of illness trajectories with local and widespread musculoskeletal incurable malignancies, either treatment naive or having recurrence are referred to the palliative care clinic to relieve various disease-related symptoms and to improve the quality of life. Palliative care is a specialized medicine that offers treatment to the disease-specific symptoms, places emphasis on the psychosocial and spiritual aspects of life and help the patients and their family to cope with advance stage cancer in a stronger and reasonable way. The overall outcome of musculoskeletal malignancies has improved with the advent of multidisciplinary management. Even then these tumors do relapse and leads to organ failures and disease-specific deaths in children and young adults in productive age group thus requiring an integrated approach to improve the supportive/palliative care needs in end-stage disease. In this article, we would like to discuss the spectrum of presentation of advanced musculoskeletal malignancies, skeletal metastasis, and their management. PMID:27559251

  8. Working conditions and musculoskeletal pain among Brazilian pottery workers.

    PubMed

    Melzer, Adriana Cristina de Souza; Iguti, Aparecida Mari

    2010-03-01

    In the municipality of Pedreira in São Paulo State, Brazil, a large number of workers from the ceramic industry have left their jobs because of work related musculoskeletal disorders. The objectives of this study were to describe the work conditions pertaining to the ceramic industry, to determine the prevalence of musculoskeletal pain and to identify the associations between symptoms and organizational, biomechanical, psychosocial and individual variables. Nine ceramic manufacturers participated. The activities of 18 individuals were analyzed through direct observation. All workers answered a questionnaire about work and health (n = 235). The results found that the general working conditions in the pottery manufacturers were poor. A 38.5% prevalence of musculoskeletal pain was found. Repetition, tool use, lack of control over decisions, worries regarding work demands, relationship issues, work dissatisfaction and the wish to move on to another function were all associated with pain. We concluded that musculoskeletal pain is one of the outcomes of elevated human requirements resulting from working conditions and organization in the ceramic industry. PMID:20464068

  9. The Relationship Between Neck Pain and Physical Activity

    PubMed Central

    Cheung, Janice; Kajaks, Tara; MacDermid, Joy C.

    2013-01-01

    Neck pain is a significant societal burden due to its high prevalence and healthcare costs. While physical activity can help to manage other forms of chronic musculoskeletal pain, little data exists on the relationship between physical activity and neck pain. The purpose of this study was to compare physical activity levels between individuals with neck pain and healthy controls, and then to relate disability, fear of movement, and pain sensitivity measures to physical activity levels in each of the two participant groups. 21 participants were recruited for each of the two participant groups (n = 42). Data collection included the use of the Neck Disability Index, the Tampa Scale for Kinesiophobia, electrocutaneous (Neurometer® CPT) and pressure stimulation (JTech algometer) for quantitative sensory testing, and 5 days of subjective (Rapid Assessment of Physical Activity) and objective (BioTrainer II) measurements of physical activity. Analysis of Variance and Pearson’s Correlation were used to determine if differences and relationships exist between dependent variables both within and between groups. The results show that individuals with mild neck pain and healthy controls do not differ in subjectively and objectively measured physical activity. While participants with neck pain reported higher neck disability and fear of movement, these factors did not significantly relate to physical activity levels. Perceived activity level was related to pain threshold and tolerance at local neck muscles sites (C2 paraspinal muscle and upper trapezius muscle), whereas measured activity was related to generalized pain sensitivity, as measured at the tibialis anterior muscle site. PMID:24133553

  10. Gravitational demand on the neck musculature during tablet computer use.

    PubMed

    Vasavada, Anita N; Nevins, Derek D; Monda, Steven M; Hughes, Ellis; Lin, David C

    2015-01-01

    Tablet computer use requires substantial head and neck flexion, which is a risk factor for neck pain. The goal of this study was to evaluate the biomechanics of the head-neck system during seated tablet computer use under a variety of conditions. A physiologically relevant variable, gravitational demand (the ratio of gravitational moment due to the weight of the head to maximal muscle moment capacity), was estimated using a musculoskeletal model incorporating subject-specific size and intervertebral postures from radiographs. Gravitational demand in postures adopted during tablet computer use was 3-5 times that of the neutral posture, with the lowest demand when the tablet was in a high propped position. Moreover, the estimated gravitational demand could be correlated to head and neck postural measures (0.48 < R(2) < 0.64, p < 0.001). These findings provide quantitative data about mechanical requirements on the neck musculature during tablet computer use and are important for developing ergonomics guidelines. Practitioner Summary: Flexed head and neck postures occur during tablet computer use and are implicated in neck pain. The mechanical demand on the neck muscles was estimated to increase 3-5 times during seated tablet computer use versus seated neutral posture, with the lowest demand in a high propped tablet position but few differences in other conditions. PMID:25643042

  11. Small Molecule based Musculoskeletal Regenerative Engineering

    PubMed Central

    Lo, Kevin W.-H.; Jiang, Tao; Gagnon, Keith A.; Nelson, Clarke; Laurencin, Cato T.

    2014-01-01

    Clinicians and scientists working in the field of regenerative engineering are actively investigating a wide range of methods to promote musculoskeletal tissue regeneration. Small molecule-mediated tissue regeneration is emerging as a promising strategy for regenerating various musculoskeletal tissues and a large number of small molecule compounds have been recently discovered as potential bioactive molecules for musculoskeletal tissue repair and regeneration. In this review, we summarize the recent literature encompassing the past four years in the area of small bioactive molecule for promoting repair and regeneration of various musculoskeletal tissues including bone, muscle, cartilage, tendon, and nerve. PMID:24405851

  12. Musculoskeletal demands on flamenco dancers: a clinical and biomechanical study.

    PubMed

    Bejjani, F J; Halpern, N; Pio, A; Dominguez, R; Voloshin, A; Frankel, V H

    1988-04-01

    The flamenco dancer acts on the floor like a drummer. The percussive footwork and vibration patterns created during dancing impose unusual demands on the musculoskeletal system. This study investigated the clinical and biomechanical aspects of this task. Using the electrodynogram and skin-mounted accelerometers, foot pressures as well as hip and knee vibrations were recorded in 10 female dancers after a thorough clinical evaluation. A health questionnaire was also distributed to 29 dancers. Foot pressures and acceleration data reveal the percussive nature of the dance. Some clinical findings, like calluses, are related to pressure distribution. Urogenital disorders, as well as back and neck pain, may be related to the vibrations generated by the flamenco dance form. The hip joint seems to absorb most of the impacts. "Vibration-pressure" diagrams are suggested as a useful tool for evaluating a dancer's biomechanical behavior, as well as the effect of floors and footwear on this behavior. PMID:3366430

  13. Review of Musculoskeletal Injuries and Prevention in the Endoscopy Practitioner

    PubMed Central

    2014-01-01

    Practitioners of endoscopy often experience musculoskeletal pain and injury (most often in the back, neck, shoulders, hands, wrists, and thumbs) that are associated with the minute and repetitive strain that is placed on these areas during endoscopic procedures. This review of the current documentation of endoscopy-related pain and injuries among practitioners finds that such problems are widespread and specific in kind as well as strongly correlated with high procedure volume and procedure duration. Research on the nature and impact of cumulative trauma and overuse syndromes in other professions such as dentistry, pianists, production labor, and athletics is brought to bear on the work of the endoscopist. A more thorough understanding of the nature and prevalence of work-related pain and injury sustained by endoscopists should inform further development of ergonomic practices and equipment design. This article reviews current recommendations for ergonomic design in the endoscopy procedure space and finds that reported compliance with those recommendations is quite low. Strategies for the management of the risk of musculoskeletal injuries related to the practice of endoscopy include compliance with currently recommended ergonomic practices, education of trainees in ergonomic technique when practicing endoscopy, and research toward the modification and development of more ergonomic endoscopes and procedure spaces. PMID:24798940

  14. Review of musculoskeletal injuries and prevention in the endoscopy practitioner.

    PubMed

    Harvin, Glenn

    2014-08-01

    Practitioners of endoscopy often experience musculoskeletal pain and injury (most often in the back, neck, shoulders, hands, wrists, and thumbs) that are associated with the minute and repetitive strain that is placed on these areas during endoscopic procedures. This review of the current documentation of endoscopy-related pain and injuries among practitioners finds that such problems are widespread and specific in kind as well as strongly correlated with high procedure volume and procedure duration. Research on the nature and impact of cumulative trauma and overuse syndromes in other professions such as dentistry, pianists, production labor, and athletics is brought to bear on the work of the endoscopist. A more thorough understanding of the nature and prevalence of work-related pain and injury sustained by endoscopists should inform further development of ergonomic practices and equipment design. This article reviews current recommendations for ergonomic design in the endoscopy procedure space and finds that reported compliance with those recommendations is quite low. Strategies for the management of the risk of musculoskeletal injuries related to the practice of endoscopy include compliance with currently recommended ergonomic practices, education of trainees in ergonomic technique when practicing endoscopy, and research toward the modification and development of more ergonomic endoscopes and procedure spaces. PMID:24798940

  15. Musculoskeletal disorders in professional violinists and violists. Systematic review.

    PubMed

    Moraes, Geraldo Fabiano de Souza; Antunes, Adriana Papini

    2012-01-01

    Due to the high physical and psychological demands of their work, musicians have a high risk of developing a range of health problems. The main causes of musculoskeletal disorders seen in instrumentalists are overuse, nerve compression and focal dystonia. The aim of this paper is to identify the musculoskeletal disorders that most frequently affect professional violinists and violists. 50 articles were read, of which 24 were used. The PEDro scale was used to determine the quality of the articles. The definition of risk factors can help in the development of prevention programs. Playing a musical instrument involves a combination of actions, including rapid, repetitive and complicated movements of the hands and fingers. The chairs used offer no other option than to adapt to the demands of body posture. To achieve the necessary skills to become a musician of a high standard, many hours of training and perfection are required. The neck, shoulder and temporomandibular joints are the most commonly affected areas, due to prolonged flexion of the head and shoulder required to hold the violin. The elbow and fingers are also common sites of disorders. It is necessary to warn musicians of the initial symptoms, and how they can prevent the disorder from worsening. Level I Evidence (Centre for Evidence-Based Medicine, Oxford, UK). PMID:24453580

  16. Musculoskeletal disorders in professional violinists and violists. Systematic review

    PubMed Central

    Moraes, Geraldo Fabiano de Souza; Antunes, Adriana Papini

    2012-01-01

    Due to the high physical and psychological demands of their work, musicians have a high risk of developing a range of health problems. The main causes of musculoskeletal disorders seen in instrumentalists are overuse, nerve compression and focal dystonia. The aim of this paper is to identify the musculoskeletal disorders that most frequently affect professional violinists and violists. 50 articles were read, of which 24 were used. The PEDro scale was used to determine the quality of the articles. The definition of risk factors can help in the development of prevention programs. Playing a musical instrument involves a combination of actions, including rapid, repetitive and complicated movements of the hands and fingers. The chairs used offer no other option than to adapt to the demands of body posture. To achieve the necessary skills to become a musician of a high standard, many hours of training and perfection are required. The neck, shoulder and temporomandibular joints are the most commonly affected areas, due to prolonged flexion of the head and shoulder required to hold the violin. The elbow and fingers are also common sites of disorders. It is necessary to warn musicians of the initial symptoms, and how they can prevent the disorder from worsening. Level I Evidence (Centre for Evidence-Based Medicine, Oxford, UK). PMID:24453580

  17. Burden of major musculoskeletal conditions.

    PubMed Central

    Woolf, Anthony D.; Pfleger, Bruce

    2003-01-01

    Musculoskeletal conditions are a major burden on individuals, health systems, and social care systems, with indirect costs being predominant. This burden has been recognized by the United Nations and WHO, by endorsing the Bone and Joint Decade 2000-2010. This paper describes the burden of four major musculoskeletal conditions: osteoarthritis, rheumatoid arthritis, osteoporosis, and low back pain. Osteoarthritis, which is characterized by loss of joint cartilage that leads to pain and loss of function primarily in the knees and hips, affects 9.6% of men and 18% of women aged > 60 years. Increases in life expectancy and ageing populations are expected to make osteoarthritis the fourth leading cause of disability by the year 2020. Joint replacement surgery, where available, provides effective relief. Rheumatoid arthritis is an inflammatory condition that usually affects multiple joints. It affects 0.3-1.0% of the general population and is more prevalent among women and in developed countries. Persistent inflammation leads to joint destruction, but the disease can be controlled with drugs. The incidence may be on the decline, but the increase in the number of older people in some regions makes it difficult to estimate future prevalence. Osteoporosis, which is characterized by low bone mass and microarchitectural deterioration, is a major risk factor for fractures of the hip, vertebrae, and distal forearm. Hip fracture is the most detrimental fracture, being associated with 20% mortality and 50% permanent loss in function. Low back pain is the most prevalent of musculoskeletal conditions; it affects nearly everyone at some point in time and about 4-33% of the population at any given point. Cultural factors greatly influence the prevalence and prognosis of low back pain. PMID:14710506

  18. Relationship between Comorbid Health Problems and Musculoskeletal Disorders Resulting in Musculoskeletal Complaints and Musculoskeletal Sickness Absence among Employees in Korea

    PubMed Central

    Baek, Ji Hye; Kim, Young Sun; Yi, Kwan Hyung

    2015-01-01

    Background To investigate the relationship between musculoskeletal disorders and comorbid health problems, including depression/anxiety disorder, insomnia/sleep disorder, fatigue, and injury by accident, and to determine whether certain physical and psychological factors reduce comorbid health problems. Methods In total, 29,711 employees were selected from respondents of the Third Korean Working Conditions Survey and categorized into two groups: Musculoskeletal Complaints or Musculoskeletal Sickness Absence. Four self-reported health indicators (overall fatigue, depression/anxiety, insomnia/sleep disorder, and injury by accident) were selected as outcomes, based on their high prevalence in Korea. We used multiple logistic regression analysis to determine the relationship between comorbid health problems, musculoskeletal complaints, and sickness absence. Results The prevalence of musculoskeletal complaints and musculoskeletal sickness absence due to muscular pain was 32.26% and 0.59%, respectively. Compared to the reference group, depression/anxiety disorder and overall fatigue were 5.2–6.1 times more prevalent in the Musculoskeletal Complaints Group and insomnia/sleep disorder and injury by accident were 7.6–11.0 times more prevalent in the Sickness Absence Group. When adjusted for individual and work-related physical factors, prevalence of all four comorbid health problems were slightly decreased in both groups. Conclusion Increases in overall fatigue and depression/anxiety disorder were observed in the Musculoskeletal Complaints Group, while increases in insomnia/sleep disorder and injury by accident were observed in the Sickness Absence Group. For management of musculoskeletal complaints and sickness absence in the workplace, differences in health problems between employees with musculoskeletal complaints and those with sickness absence as well as the physical and psychological risk factors should be considered. PMID:26106512

  19. Analysis of deep tissue hypersensitivity to pressure pain in professional pianists with insidious mechanical neck pain

    PubMed Central

    2011-01-01

    Background The aim of this study was to investigate whether pressure pain hyperalgesia is a feature of professional pianists suffering from neck pain as their main playing-related musculoskeletal disorder. Methods Twenty-three active expert pianists, 6 males and 17 females (age: 36 ± 12 years) with insidious neck pain and 23 pianists, 9 males and 14 females (age: 38 ± 10 years) without neck pain the previous year were recruited. A numerical pain rate scale, Neck Disability Index, hand size and pressure pain thresholds (PPT) were assessed bilaterally over the C5-C6 zygapophyseal joint, deltoid muscle, the second metacarpal and the tibialis anterior muscle in a blinded design. Results The results showed that PPT levels were significantly decreased bilaterally over the second metacarpal and tibialis anterior muscles (P < 0.05), but not over C5-C6 zygapophyseal joint and deltoid muscle (P > 0.10), in pianists with neck pain as compared to healthy pianists. Pianists with neck pain had a smaller (P < 0.05) hand size (mean: 181.8 ± 11.8) as compared to pianists without neck pain (mean: 188. 6 ± 13.1). PPT over the tibialis anterior muscles was negatively correlated with the intensity of neck pain. Conclusions Our findings revealed pressure pain hypersensitivity over distant non-symptomatic distant points but not over the symptomatic areas in pianists suffering from neck pain. In addition, pianists with neck pain also had smaller hand size than those without neck pain. Future studies are needed to further determine the relevance of these findings in the clinical course of neck pain as playing-related musculoskeletal disorder in professional pianists. PMID:22111912

  20. Artifacts in musculoskeletal MR imaging.

    PubMed

    Singh, Dinesh R; Chin, Michael S M; Peh, Wilfred C G

    2014-02-01

    MR imaging has become an important diagnostic tool in the evaluation of a vast number of pathologies and is of foremost importance in the evaluation of spine, joints, and soft tissue structures of the musculoskeletal system. MR imaging is susceptible to various artifacts that may affect the image quality or even simulate pathologies. Some of these artifacts have gained special importance with the use of higher field strength magnets and with the increasing need for MR imaging in postoperative patients, especially those with previous joint replacements or metallic implants. Artifacts may arise from patient motion or could be due to periodic motion, such as vascular and cardiac pulsation. Artifacts could also arise from various protocol errors including saturation, wraparound, truncation, shading, partial volume averaging, and radiofrequency interference artifacts. Susceptibility artifact occurs at interfaces with different magnetic susceptibilities and is of special importance with increasing use of metallic joint replacement prostheses. Magic angle phenomenon is a special type of artifact that occurs in musculoskeletal MR imaging. It is essential to recognize these artifacts and to correct them because they may produce pitfalls in image interpretation. PMID:24515878

  1. Musculoskeletal pain in Arctic indigenous and non-indigenous adolescents, prevalence and associations with psychosocial factors: a population-based study

    PubMed Central

    2014-01-01

    Background Pain is common in otherwise healthy adolescents. In recent years widespread musculoskeletal pain, in contrast to single site pain, and associating factors has been emphasized. Musculoskeletal pain has not been examined in Arctic indigenous adolescents. The aim of this study was to explore the prevalence of widespread musculoskeletal pain and its association with psychosocial factors, with emphasis on gender- and ethnic differences (Sami vs. non-Sami), and the influence of pain related functional impairment. Methods This is a cross-sectional study based on The Norwegian Arctic Adolescent Health Study; a school-based survey responded by 4,881 10th grade students (RR: 83%) in North Norway, in 2003–2005. 10% were indigenous Sami. Musculoskeletal pain was based on reported pain in the head, shoulder/neck, back and/or arm/knee/leg, measured by the number of pain sites. Linear multiple regression was used for the multivariable analyses. Results The prevalence of musculoskeletal pain was high, and significantly higher in females. In total, 22.4% reported 3–4 pain sites. We found a strong association between musculoskeletal pain sites and psychosocial problems, with a higher explained variance in those reporting pain related functional impairment and in females. There were no major differences in the prevalence of musculoskeletal pain in Sami and non-Sami, however the associating factors differed somewhat between the indigenous and non-indigenous group. The final multivariable model, for the total sample, explained 21.2% of the variance of musculoskeletal pain. Anxiety/depression symptoms was the dominant factor associated with musculoskeletal pain followed by negative life events and school-related stress. Conclusions Anxiety/depression, negative life events, and school-related stress were the most important factors associated with musculoskeletal pain, especially in those reporting pain related functional impairment. The most important sociocultural aspect

  2. Risk Factors of Work-related Upper Extremity Musculoskeletal Disorders in Male Shipyard Workers: Structural Equation Model Analysis

    PubMed Central

    Park, Byung-Chan; Kim, Eun-A; Kim, Soo Geun

    2010-01-01

    Objectives This study was conducted to develop a model describing the interaction between lifestyle, job, and postural factors and parts of the upper extremities in shipyard workers. Methods A questionnaire survey was given to 2,140 workers at a shipyard in Ulsan City. The questionnaire consisted of questions regarding the subjects' general characteristics, lifestyle, tenure, physical burden, job control, posture and musculoskeletal symptoms. The overall relationship between variables was analyzed by a structural equation model (SEM). Results The positive rate of upper extremity musculoskeletal symptoms increased in employees who worked longer hours, had severe physical burden, and did not have any control over their job. Work with a more frequent unstable posture and for longer hours was also associated with an increased positive rate of musculoskeletal symptoms. Multiple logistic regression analysis showed that unstable posture and physical burden were closely related to the positive rate of musculoskeletal symptoms after controlling for age, smoking, drinking, exercise, tenure, and job control. In SEM analysis, work-related musculoskeletal disease was influenced directly and indirectly by physical and job stress factors, lifestyle, age, and tenure (p < 0.05). The strongest correlations were found between physical factors and work-related musculoskeletal disease. Conclusion The model in this study provides a better approximation of the complexity of the actual relationship between risk factors and work-related musculoskeletal disorders. Among the variables evaluated in this study, physical factors (work posture) had the strongest association with musculoskeletal disorders. PMID:22953172

  3. Use of Traditional Korean Medicine by Patients with Musculoskeletal Disorders

    PubMed Central

    Wang, Bo-Ram; Choi, In Young; Kim, Kwang-Jum; Kwon, Young Dae

    2013-01-01

    Background South Korea has maintained a dual healthcare delivery system that incorporates both traditional Korean and Western medicine. In this research, we identified the determinants of the frequency of using traditional Korean medicine among musculoskeletal patients, who are known to be the most frequent users of complementary and alternative medicine. Methods In this research, we reviewed 2 consecutive years of nationally representative survey data from the 2008 and 2009 Korea Health Panel Survey. We analyzed the utilization of outpatient services by musculoskeletal patients within 12 months of the 2009 survey date. A two-part model was used because some patients did not use traditional Korean medicine and skewness was present in the data on traditional Korean medicine use. In the first part, logistic regression analysis was performed to investigate the use of traditional Korean medicine. In the second part, multiple regression analysis was performed to analyze the frequency of traditional Korean medicine usage among the subjects who visited traditional Korean medical institutions. Results The frequency of traditional Korean medicine usage was positively associated with ages of 40–49 years and over 60, restrictions on daily life, a greater number of chronic diseases, not being hospitalized, and more frequent visits (more than five times) to conventional hospitals or clinics for musculoskeletal disorders. Conclusions The important determinants of the frequency of traditional Korean medicine usage were age, activity restrictions, the number of chronic diseases, hospitalization history, and the number of visits to conventional hospitals for musculoskeletal disorders. The results contribute to our understanding of the characteristics of traditional Korean medicine users and may be used as a basic resource for related policymaking by government officials and medical professionals. PMID:23658811

  4. Correlation between Trunk Posture and Neck Reposition Sense among Subjects with Forward Head Neck Postures

    PubMed Central

    Lee, Han Suk; Chung, Hyung Kuk; Park, Sun Wook

    2015-01-01

    Objective. To assess the correlation of abnormal trunk postures and reposition sense of subjects with forward head neck posture (FHP). Methods. In all, postures of 41 subjects were evaluated and the FHP and trunk posture including shoulder, scapular level, pelvic side, and anterior tilting degrees were analyzed. We used the head repositioning accuracy (HRA) test to evaluate neck position senses of neck flexion, neck extension, neck right and left side flexion, and neck right and left rotation and calculated the root mean square error in trials for each subject. Spearman's rank correlation coefficients and regression analysis were used to assess the degree of correlation between the trunk posture and HRA value, and a significance level of α = 0.05 was considered. Results. There were significant correlations between the HRA value of right side neck flexion and pelvic side tilt angle (p < 0.05). If pelvic side tilting angle increases by 1 degree, right side neck flexion increased by 0.76 degrees (p = 0.026). However, there were no significant correlations between other neck motions and trunk postures. Conclusion. Verifying pelvic postures should be prioritized when movement is limited due to the vitiation of the proprioceptive sense of neck caused by FHP. PMID:26583125

  5. Head, Neck, and Oral Cancer

    MedlinePlus

    ... Neck and Oral Pathology Head, Neck and Oral Pathology Close to 42,000 Americans will be diagnosed ... Neck and Oral Pathology Head, Neck and Oral Pathology Close to 42,000 Americans will be diagnosed ...

  6. Effects on musculoskeletal pain, work ability and sickness absence in a 1-year randomised controlled trial among cleaners

    PubMed Central

    2011-01-01

    Background Only a few workplace initiatives among cleaners have been reported, even though they constitute a job group in great need of health promotion. The purpose of this trial was to evaluate the effect of either physical coordination training or cognitive behavioural training on musculoskeletal pain, work ability and sickness absence among cleaners. Methods A cluster-randomised controlled trial was conducted among 294 female cleaners allocated to either physical coordination training (PCT), cognitive behavioural training (CBTr) or a reference group (REF). Questionnaires about musculoskeletal pain and work ability were completed at baseline and after one year's intervention. Sickness absence data were obtained from the managers' records. Analyses were performed according to the intention-to-treat-principle (ITT). Results No overall reduction in musculoskeletal pain, work ability or sickness absence from either PCT or CBTr compared with REF was found in conservative ITT analyses. However, explorative analyses revealed a treatment effect for musculoskeletal pain of the PCT. People with chronic neck/shoulder pain at baseline were more frequently non-chronic at follow-up after PCT compared with REF (p = 0.05). Conclusions The PCT intervention appeared effective for reducing chronic neck/shoulder pain among the female cleaners. It is recommended that future interventions among similar high-risk job groups focus on the implementation aspects of the interventions to maximise outcomes more distal from the intervention such as work ability and sickness absence. Trial registration ISRCTN: ISRCTN96241850 PMID:22044549

  7. Neck Injuries and Disorders

    MedlinePlus

    ... the neck, is also called neck sprain or strain. Treatment depends on the cause, but may include applying ice, taking pain relievers, getting physical therapy or wearing a cervical collar. You rarely need surgery.

  8. Neck dissection - discharge

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000659.htm Neck dissection - discharge To use the sharing features on this page, please enable JavaScript. Neck dissection is surgery to remove the lymph nodes in ...

  9. Head and Neck Cancer

    MedlinePlus

    Head and neck cancer includes cancers of the mouth, nose, sinuses, salivary glands, throat, and lymph nodes in the ... increases your risk. In fact, 85 percent of head and neck cancers are linked to tobacco use, including smoking ...

  10. Head and Neck Cancer

    MedlinePlus

    Head and neck cancer includes cancers of the mouth, nose, sinuses, salivary glands, throat, and lymph nodes in the ... swallowing A change or hoarseness in the voice Head and neck cancers are twice as common in men. Using ...

  11. Association between psychosocial, organizational and personal factors and prevalence of musculoskeletal disorders in office workers.

    PubMed

    Piranveyseh, Peyman; Motamedzade, Majid; Osatuke, Katerine; Mohammadfam, Iraj; Moghimbeigi, Abbas; Soltanzadeh, Ahmad; Mohammadi, Heidar

    2016-01-01

    The purpose of this study was to investigate the relationship between organizational and personal (individual) factors with the prevalence of musculoskeletal disorders (MSDs) in office workers of the Iranian Gas Transmission Company. The participants rated two questionnaires - the standardized Nordic Musculoskeletal Questionnaire to measure the prevalence of MSDs, and the Veterans Healthcare Administration All Employee Survey questionnaire (2004 version) - to measure psychosocial, organizational and individual aspects of job satisfaction and workplace climate. The highest prevalence of MSDs was found in the lower back (49.7%) and neck (49.0%) regions. Results of the logistic regression models showed that some psychosocial and organizational factors and also some individual factors were associated with prevalence of MSDs (p < 0.05).These findings illustrate the need to consider all elements of the work system as a whole in future studies and in organizational planning. PMID:26757785

  12. Musculoskeletal trauma: the baseball bat.

    PubMed Central

    Bryant, D. D.; Greenfield, R.; Martin, E.

    1992-01-01

    Between July 1987 and December 1990 in Washington, DC, 116 patients sustained 146 fractures and seven dislocations due to an assault with a baseball bat. The ulna was the most common site of trauma (61 fractures), followed by the hand (27 injuries) and the radius (14 injuries). Forty-two of the 146 fractures were significantly displaced and required open reduction and internal fixation to restore satisfactory alignment. Twenty-nine of the 146 fractures were open fractures. Treatment protocol for open fractures consisted of irrigation and debridement, antibiotic therapy, and bone stabilization with either internal or external fixation, or casting. Recognition of the severity of the soft tissue and bone damage is important in the management of musculoskeletal trauma secondary to the baseball bat. Images Figure 1 Figure 2 Figure 3 PMID:1460683

  13. [Advances in musculoskeletal MR imaging].

    PubMed

    Ho, Michael; Andreisek, Gustav

    2015-09-01

    Musculoskeletal imaging is a rapidly developing field offering several new techniques. MR neurography provides an additive value with complementary and precise information about peripheral nerves. Hereby, MR neurography not only enables the radiologist to differentiate between a mononeuropathic or a polyneuropathic process, but also helps to find nerve compression syndromes by visualizing the nerve surrounding structures as well. An additional administration of contrast agent enables detection of tumors and inflammation of peripheral nerves. Whole body MRI opens new possibilities for detection and follow-up in oncological disorders, systemic diseases, in pediatric diagnostics and in preventive medicine. Guidelines are useful for an evidence-based application of this technique. MRI is generally considered to be the gold standard in diagnostic imaging of the spine. Continuous technical developments have led to a better image quality. New guidelines for standardized image interpretation and reporting have been published and should be used to avoid loss of information from high resolution imaging to effective treatment. PMID:26331202

  14. [Musculoskeletal hydatidosis: an unusual location].

    PubMed

    Pleguezuelo Navarro, M; Iglesias Flores, E M; Domínguez Jiménez, J L; González Galilea, A; Abad Lara, J A; Jiménez Sánchez, C; De Dios Vega, J F

    2006-05-01

    Hydatidosis is a zoonosis with a continuing high prevalence in our environment. The most commonly affected organs are the lungs and the liver, with the musculoskeletal location being considered an unusual one. We comment the case of a patient who presented a series of lesions in his left iliac crest and middle left buttock with spontaneous fistulization to the skin surface. In this case a combined treatment was given; prior to the surgical operation we administered a cycle of albendazol. Following removal of the lesion, the patient was given two further cycles of albendazol in order to minimize the risk of a recurrence of the illness. This patient is currently free of any symptoms relating to this illness. PMID:16817701

  15. Musculoskeletal imaging insight 2015: Kenya.

    PubMed

    Stevens, Kathryn J; Mutiso, Kavulani; Sconfienza, Luca Maria; Monu, Johnny

    2016-07-01

    Over the past 6 years the International Skeletal Society (ISS) outreach programs have become popular amongst the various radiology organizations in sub-Saharan Africa. So much so that that the ISS outreach is now routinely expected to participate in many of the international radiology conferences in that part of the world. The organizational planning for an outreach visit to Kenya took place over a 3-year period. Eventually a double-headed event; the seventh and eighth sub-Saharan outreach efforts were organized in Nairobi and in Mombasa, Kenya. The Nairobi outreach was an educational course on musculoskeletal imaging at the University of Nairobi and the Aga Khan University in Nairobi from 26 to 28 May 2015. The Mombasa outreach was organized in collaboration with the African Society of Radiology (ASR) at their annual meeting in Mombasa from 30 May to 2 June 2015. PMID:27115883

  16. Perspectives in ultrasound-guided musculoskeletal interventions

    PubMed Central

    Daftary, Aditya Ravindra; Karnik, Alpana Sudhir

    2015-01-01

    Ultrasonography (USG) is a safe, easily available, and cost-effective modality, which has the additional advantage of being real time for imaging and image-guided interventions of the musculoskeletal system. Musculoskeletal interventions are gaining popularity in sports and rehabilitation for rapid healing of muscle and tendon injuries in professional athletes, healing of chronic tendinopathies, aspiration of joint effusions, periarticular bursae and ganglia, and perineural injections in acute and chronic pain syndromes. This article aims to provide an overview of the spectrum of musculoskeletal interventions that can be done under USG guidance both for diagnostic and therapeutic purposes. PMID:26288519

  17. Prevalence and Characteristics of Musculoskeletal Pain in Korean Farmers

    PubMed Central

    Min, David; Baek, Sora; Park, Hee-won; Lee, Sang-Ah; Moon, Jiyoung; Yang, Jae E.; Kim, Ki Sung; Kim, Jee Yong

    2016-01-01

    Objective To investigate the prevalence and characteristics of musculoskeletal pain (MSK) pain in Korean farmers using initial survey data of Farmers' Cohort for Agricultural Work-Related MSK pain (FARM) study. Methods Farmers (534 females and 479 males; mean age 57.2±7.5 years) who owned or rented a farm and belonged to an agricultural cooperative unit were recruited. Presence of pain for each body part (neck, shoulder, arm/elbow, wrist/hand/finger, low back, leg/foot), and characteristics of MSK pain (prevalence, location, duration, severity, and frequency) during the last year was assessed. Additionally, demographic data such as farming duration, history of prior injury, and workload (low, moderate, somewhat hard, or hard) were collected using structured questionnaires. Results Almost all subjects (n=925; 91.3%) complained of pain in more than one body part. The frequency order was low back (63.8%), leg/foot (43.3%), shoulder (42.9%), wrist/hand/finger (26.6%), arm/elbow (25.3%), and neck (21.8%). Low back pain was more frequent in those with over 30 years of farming experience (odds ratio [OR], 1.40; 95% confidence interval, 1.08–1.81). MSK pain was related to history of prior injury (OR, 2.18–5.24; p<0.05) in all body parts except for leg/foot, and very hard workload was associated with low back, leg/foot, neck, shoulder, and wrist/hand/finger pain (OR, 2.88–10.83; p<0.05). Conclusion Most Korean farmers experience MSK pain; furthermore, there is a significant association between pain, history of prior injury, and workload, suggestive of the necessity of coping and preventive strategies to reduce injury or workload. PMID:26949663

  18. Chest pain in focal musculoskeletal disorders.

    PubMed

    Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

    2010-03-01

    The musculoskeletal system is a recognized source of chest pain. However, despite the apparently benign origin, patients with musculoskeletal chest pain remain under-diagnosed, untreated, and potentially continuously disabled in terms of anxiety, depression, and activities of daily living. Several overlapping conditions and syndromes of focal disorders, including Tietze syndrome, costochondritis, chest wall syndrome, muscle tenderness, slipping rib, cervical angina, and segmental dysfunction of the cervical and thoracic spine, have been reported to cause pain. For most of these syndromes, evidence arises mainly from case stories and empiric knowledge. For segmental dysfunction, clinical features of musculoskeletal chest pain have been characterized in a few clinical trials. This article summarizes the most commonly encountered syndromes of focal musculoskeletal disorders in clinical practice. PMID:20380955

  19. Associations among temporomandibular disorders, chronic neck pain and neck pain disability in computer office workers: a pilot study.

    PubMed

    Bragatto, M M; Bevilaqua-Grossi, D; Regalo, S C H; Sousa, J D; Chaves, T C

    2016-05-01

    Neck pain is the most common musculoskeletal complaint among computer office workers. There are several reports about the coexistence of neck pain and temporomandibular disorders (TMD). However, there are no studies investigating this association in the context of work involving computers. The purpose of this study was to verify the association between TMD and neck pain in computer office workers. Fifty-two female computer workers who were divided into two groups: (i) those with self-reported chronic neck pain and disability (WNP) (n = 26) and (ii) those without self-reported neck pain (WONP) (n = 26), and a control group (CG) consisting of 26 women who did not work with computers participated in this study. Clinical assessments were performed to establish a diagnosis of TMD, and craniocervical mechanical pain was assessed using manual palpation and pressure pain threshold (PPT). The results of this study showed that the WNP group had a higher percentage of participants with TMD than the WONP group (42·30% vs. 23·07%, χ(2) = 5·70, P = 0·02). PPTs in all cervical sites were significantly lower in the groups WNP and WONP compared to the CG. Regression analysis revealed TMD, neck pain and work-related factors to be good predictors of disability (R(2) = 0·93, P < 0·001). These results highlighted the importance of considering the work conditions of patients with TMD, as neck disability in computer workers is explained by the association among neck pain, TMD and unfavourable workplace conditions. Consequently, this study attempted to emphasise the importance of considering work activity for minimising neck pain-related disability. PMID:26732204

  20. Complications in Musculoskeletal Intervention: Important Considerations

    PubMed Central

    Wang, David T.; Dubois, Melissa; Tutton, Sean M.

    2015-01-01

    Musculoskeletal (MSK) intervention has proliferated in recent years among various subspecialties in medicine. Despite advancements in image guidance and percutaneous technique, the risk of complication has not been fully eliminated. Overall, complications in MSK interventions are rare, with bleeding and infection the most common encountered. Other complications are even rarer. This article reviews various complications unique to musculoskeletal interventions, assists the reader in understanding where pitfalls lie, and highlights ways to avoid them. PMID:26038623

  1. The musculoskeletal effects of perioperative smoking.

    PubMed

    Argintar, Evan; Triantafillou, Kostas; Delahay, John; Wiesel, Brent

    2012-06-01

    Although the carcinogenic consequences of smoking are well known, further research is needed on the effects of smoking on musculoskeletal health and surgical outcomes. Orthopaedic perioperative complications of smoking include impaired healing, increased infection, delayed and/or impaired fracture union and arthrodesis, and inferior arthroplasty outcomes. The incorporation of smoking cessation protocols such as transdermal patches, chewing gum, lozenges, inhalers, sprays, bupropion, and varenicline in the perioperative period may result in substantial benefits for patients' musculoskeletal and general health. PMID:22661565

  2. Frequency, severity and predictors of playing-related musculoskeletal pain in professional orchestral musicians in Germany.

    PubMed

    Steinmetz, A; Scheffer, I; Esmer, E; Delank, K S; Peroz, I

    2015-05-01

    Playing-related musculoskeletal disorders (PRMD) in professional musicians are common. Existing literature demonstrates that up to 86 % of musicians are affected. The aim of the study was to evaluate the frequency of musculoskeletal pain in professional orchestral musicians with regard to their instrument affiliation. Of special interest were pain intensity and its association with predictors such as gender, instrument group, age or stage fright. Professional orchestra players completed a self-report questionnaire to assess playing-related musculoskeletal pain and its frequency and intensity in various body regions on a numeric rating scale (NRS). Relative frequencies and prevalence ratios for different instrument groups were estimated. Out of 720 approached musicians, 408 were included in the sample (response rate 57 %); overall, 89.5 % had been affected by current or past playing-related musculoskeletal pain, 62.7 % reported pain in the previous 3 months, and 8.6 % reported current pain. Pain distribution and frequency varied between instrument groups. For all instrument groups, the neck was the most common pain region. About 43 % of musicians presented more than five pain regions, in particular violin players. Approximately 40 % of musicians indicated frequent or permanent pain. Average pain intensities increased from NRS 3.8 up to a range of 5.9 and 7.4 for frequent and permanent pain, respectively. Female gender and stage fright were proven to be predictors for musculoskeletal pain. Professional orchestral musicians are greatly affected by PRMD, often experiencing frequent or permanent pain, high pain levels and pain in various body regions. As PRMD might contribute considerably to performance disability, sick leave and the possibility of premature termination of a musicians' career, this study highlights the necessity for tailored therapeutic and preventive strategies in performing arts medicine. PMID:24389813

  3. Statistical analysis of 4 types of neck whiplash injuries based on classical meridian theory.

    PubMed

    Chen, Yemeng; Zhao, Yan; Xue, Xiaolin; Li, Hui; Wu, Xiuyan; Zhang, Qunce; Zheng, Xin; Wang, Tianfang

    2015-01-01

    As one component of the Chinese medicine meridian system, the meridian sinew (Jingjin, (see text), tendino-musculo) is specially described as being for acupuncture treatment of the musculoskeletal system because of its dynamic attributes and tender point correlations. In recent decades, the therapeutic importance of the sinew meridian has become revalued in clinical application. Based on this theory, the authors have established therapeutic strategies of acupuncture treatment in Whiplash-Associated Disorders (WAD) by categorizing four types of neck symptom presentations. The advantage of this new system is to make it much easier for the clinician to find effective acupuncture points. This study attempts to prove the significance of the proposed therapeutic strategies by analyzing data collected from a clinical survey of various WAD using non-supervised statistical methods, such as correlation analysis, factor analysis, and cluster analysis. The clinical survey data have successfully verified discrete characteristics of four neck syndromes, based upon the range of motion (ROM) and tender point location findings. A summary of the relationships among the symptoms of the four neck syndromes has shown the correlation coefficient as having a statistical significance (P < 0.01 or P < 0.05), especially with regard to ROM. Furthermore, factor and cluster analyses resulted in a total of 11 categories of general symptoms, which implies syndrome factors are more related to the Liver, as originally described in classical theory. The hypothesis of meridian sinew syndromes in WAD is clearly supported by the statistical analysis of the clinical trials. This new discovery should be beneficial in improving therapeutic outcomes. PMID:25980049

  4. A musculoskeletal model for the lumbar spine.

    PubMed

    Christophy, Miguel; Faruk Senan, Nur Adila; Lotz, Jeffrey C; O'Reilly, Oliver M

    2012-01-01

    A new musculoskeletal model for the lumbar spine is described in this paper. This model features a rigid pelvis and sacrum, the five lumbar vertebrae, and a rigid torso consisting of a lumped thoracic spine and ribcage. The motion of the individual lumbar vertebrae was defined as a fraction of the net lumbar movement about the three rotational degrees of freedom: flexion-extension lateral bending, and axial rotation. Additionally, the eight main muscle groups of the lumbar spine were incorporated using 238 muscle fascicles with prescriptions for the parameters in the Hill-type muscle models obtained with the help of an extensive literature survey. The features of the model include the abilities to predict joint reactions, muscle forces, and muscle activation patterns. To illustrate the capabilities of the model and validate its physiological similarity, the model's predictions for the moment arms of the muscles are shown for a range of flexion-extension motions of the lower back. The model uses the OpenSim platform and is freely available on https://www.simtk.org/home/lumbarspine to other spinal researchers interested in analyzing the kinematics of the spine. The model can also be integrated with existing OpenSim models to build more comprehensive models of the human body. PMID:21318374

  5. Prevalence and consequences of musculoskeletal symptoms in symphony orchestra musicians vary by gender: a cross-sectional study

    PubMed Central

    2011-01-01

    Background Musculoskeletal symptoms are common in the neck, back, and upper limbs amongst musicians. Playing-related musculoskeletal disorders have been found to range from 32% to 87% with a tendency for female musicians to have more problems than males. Studies of musculoskeletal problems in instrumentalists have generally involved pre-professional musicians or populations comprising musicians of different levels. The objective of this study was therefore to investigate the prevalence, duration and consequences of musculoskeletal symptoms in professional symphony orchestra musicians. Methods A cross-sectional questionnaire study. The study population comprised of 441 musicians from six Danish symphony orchestras; 342 (78%) completed the questionnaire. Results During the last year 97% of the women and 83% of the men experienced symptoms in at least one of nine anatomic regions (neck, upper and lower back, shoulders, elbows, and hands and wrists). 86% of the women and 67% of the men experienced symptoms for more than seven days, while 63% of the women and 49% of the men had symptoms for more than 30 days. Woodwind players had a lower risk for musculoskeletal symptoms and a lower risk for the consequences. Among consequences were changed way of playing, reported by 73% of the musicians, difficulty in daily activities at home, reported by 55%, and difficulty in sleeping, reported by 49%. Their health behaviour included taking paracetamol as the most used analgesic, while physiotherapists and general practitioners were reported as the most consulted health care professionals concerning musculoskeletal problems. Results regarding symptoms in six anatomic regions were compared to results for a sample of the general Danish workforce. Symptoms were more frequent in musicians and lasted longer than in the general workforce. This applied to both genders. Conclusions Within the last year most symphony orchestra musicians experienced musculoskeletal symptoms in the neck, back

  6. Workplace Bullying as a Risk Factor for Musculoskeletal Disorders: The Mediating Role of Job-Related Psychological Strain

    PubMed Central

    Vignoli, Michela; Guglielmi, Dina; Balducci, Cristian; Bonfiglioli, Roberta

    2015-01-01

    Workplace bullying is considered by the European Agency for Safety and Health at Work one of the emerging psychosocial risk factors that could negatively affect workers' health. Thus, the aim of this study was to analyze the process that leads from bullying to negative health (such as musculoskeletal disorders (MSDs)), testing the mediating role of job-related strain. Data were collected on 512 workers (62.9% female; mean age = 43.6 years) of a retail chain who filled in a self-report questionnaire after a one-hour training session on work-related stress. Data analyses were performed controlling for potentially confounding variables (i.e., gender, age, organizational role, type of contract, and perceived physical job demands). Preacher and Hayes analytical approach was used to test the indirect relationship between bullying and MSDs. Results showed that work-related strain mediates the relationship between bullying and MSDs considered (low back, upper back, and neck) except for MSDs of the shoulders. Our study confirms the role played by bullying and job-related strain in determining workers' MSDs. PMID:26557693

  7. Improving musculoskeletal health: global issues.

    PubMed

    Mody, Girish M; Brooks, Peter M

    2012-04-01

    Musculoskeletal (MSK) disorders are among the leading reasons why patients consult a family or primary health practitioner, take time off work and become disabled. Many of the MSK disorders are more common in the elderly. Thus, as the proportion of the elderly increases all over the world, MSK disorders will make a greater contribution to the global burden of disease. Epidemiological studies have shown that the spectrum of MSK disorders in developing countries is similar to that seen in industrialised countries, but the burden of disease tends to be higher due to a delay in diagnosis or lack of access to adequate health-care facilities for effective treatment. Musculoskeletal pain is very common in the community while fibromyalgia is being recognised as part of a continuum of chronic widespread pain rather than a narrowly defined entity. This will allow research to improve our understanding of pain in a variety of diffuse pain syndromes. The availability of newer more effective therapies has resulted in efforts to initiate therapy at an earlier stage of diseases. The new criteria for rheumatoid arthritis, and the diagnosis of axial and peripheral involvement in spondyloarthritis, permit an earlier diagnosis without having to wait for radiological changes. One of the major health challenges is the global shortage of health workers, and based on current training of health workers and traditional models of care for service delivery, the global situation is unlikely to change in the near future. Thus, new models of care and strategies to train community health-care workers and primary health-care practitioners to detect and initiate the management of patients with MSK disorders at an earlier stage are required. There is also a need for prevention strategies with campaigns to educate and raise awareness among the entire population. Lifestyle interventions such as maintaining an ideal body weight to prevent obesity, regular exercises, avoidance of smoking and alcohol

  8. The Relationship between Musculoskeletal Symptoms and Work-related Risk Factors in Hotel Workers

    PubMed Central

    2013-01-01

    Objectives To identify work-related musculoskeletal symptoms and any associated work-related risk factors, focusing on structural labor factors among hotel workers. Methods A total of 1,016 hotel workers (620 men and 396 women) were analyzed. The questionnaire surveyed participants’ socio-demographics, health-related behaviors, job-related factors, and work-related musculoskeletal symptoms. Work-related musculoskeletal symptoms were assessed using the Nordic musculoskeletal questionnaire. All analyses were stratified by gender, and multiple logistic regression modeling was used to determine associations between work-related musculoskeletal symptoms and work-related risk factors. Results The risk of developing work-related musculoskeletal symptoms was 1.9 times higher among male workers in the kitchen department than males in the room department (OR = 1.92, 95% CI = 1.03-3.79), and 2.5 times higher among male workers with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.52, 95% CI = 1.57-4.04). All of the aforementioned cases demonstrated a statistically significant association with work-related musculoskeletal symptoms. Moreover, the risk of developing work-related musculoskeletal symptoms was 3.3 times higher among female workers aged between 30 and 34 than those aged 24 or younger (OR = 3.32, 95% CI = 1.56-7.04); 0.3 times higher among females in the back office department than those in the room department (OR = 0.34, 95% CI = 0.12-0.91); 1.6 times higher among females on shift schedules than those who were not (OR = 1.60, 95% CI = 1.02-2.59); 1.8 times higher among females who performed more intensive work than those who performed less intensive work (OR = 1.88, 95% CI = 1.17-3.02), and; 2.1 times higher among females with lower sleep satisfaction than those with higher sleep satisfaction (OR = 2.17, 95% CI = 1.34-3.50). All of the aforementioned cases also displayed a statistically significant association with work

  9. Noninvasive analysis of human neck muscle function

    NASA Technical Reports Server (NTRS)

    Conley, M. S.; Meyer, R. A.; Bloomberg, J. J.; Feeback, D. L.; Dudley, G. A.

    1995-01-01

    STUDY DESIGN. Muscle use evoked by exercise was determined by quantifying shifts in signal relaxation times of T2-weighted magnetic resonance images. Images were collected at rest and after exercise at each of two intensities (moderate and intense) for each of four head movements: 1) extension, 2) flexion, 3) rotation, and 4) lateral flexion. OBJECTIVE. This study examined the intensity and pattern of neck muscle use evoked by various movements of the head. The results will help elucidate the pathophysiology, and thus methods for treating disorders of the cervical musculoskeletal system. SUMMARY OF BACKGROUND DATA. Exercise-induced contrast shifts in T2 has been shown to indicate muscle use during the activity. The noninvasive nature of magnetic resonance imaging appears to make it an ideal approach for studying the function of the complex neuromuscular system of the neck. METHODS. The extent of T2 increase was examined to gauge how intensely nine different neck muscles or muscle pairs were used in seven subjects. The absolute and relative cross-sectional area of muscle showing a shift in signal relaxation was assessed to infer the pattern of use among and within individual neck muscles or muscle pairs. RESULTS. Signal relaxation increased with exercise intensity for each head movement. The absolute and relative cross-sectional area of muscle showing a shift in signal relaxation also increased with exercise load. Neck muscles or muscle pairs extensively used to perform each head movement were: extension--semispinalis capitis and cervicis and splenius capitis; flexion--sternocleidomastoid and longus capitis and colli; rotation--splenius capitis, levator scapulae, scalenus, semispinalis capitis ipsilateral to the rotation, and sternocleidomastoid contralateral; and lateral flexion--sternocleidomastoid CONCLUSION. The results of this study, in part, agree with the purported functions of neck muscles derived from anatomic location. This also was true for the few

  10. Work activities and musculoskeletal complaints among preschool workers.

    PubMed

    Grant, K A; Habes, D J; Tepper, A L

    1995-12-01

    The potential for musculoskeletal trauma among preschool workers has been largely unexplored in the United States. This case report describes an investigation conducted to identify and evaluate possible causes of back and lower extremity pain among 22 workers at a Montessori day care facility. Investigators met with and distributed a questionnaire to school employees, and made measurements of workstation and furniture dimensions. Investigators also recorded the normal work activities of school employees on videotape, and performed a work sampling study to estimate the percentage of time employees spend performing various tasks and in certain postures. Questionnaire results from 18 employees indicated that back pain/discomfort was a common musculoskeletal complaint, reported by 61% of respondents. Neck/shoulder pain, lower extremity pain and hand/wrist pain were reported by 33, 33 and 11% of respondents, respectively. Observation and analysis of work activities indicated that employees spend significant periods of time kneeling, sitting on the floor, squatting, or bending at the waist. Furthermore, staff members who work with smaller children (i.e. six weeks to 18 months of age) performed more lifts and assumed more awkward lower extremity postures than employees who work with older children (3-4 years of age). Analysis of two lifting tasks using the revised NIOSH lifting equation indicated that employees who handle small children may be at increased risk of lifting-related low back pain. Investigators concluded that day care employees at this facility are at increased risk of low back pain and lower extremity (i.e. knee) injury due to work activities that require awkward or heavy lifts, and static working postures. Recommendations for reducing or eliminating these risks by modifying the workplace and changing the organization and methods of work are presented. PMID:15677041

  11. Musculoskeletal manifestations of chronic anemias.

    PubMed

    Martinoli, Carlo; Bacigalupo, Lorenzo; Forni, Gian Luca; Balocco, Manuela; Garlaschi, Giacomo; Tagliafico, Alberto

    2011-07-01

    This article provides an overview of the current use of diagnostic imaging modalities in the evaluation of a heterogeneous group of disorders causing chronic anemias by impaired blood cell production (inherited bone marrow failure syndromes of childhood, aplastic anemia and myelodysplastic syndromes, β-thalassemia) or increased blood cell destruction (sickle cell disease). During the course of these disorders, various musculoskeletal abnormalities can be encountered, including marrow hyperplasia, reversion of yellow marrow to red marrow, growth disturbances, and, occasionally, extramedullary hematopoiesis. Diagnostic imaging may help the clinician to identify specific complications related to either the disease (e.g., bone infarction and acute osteomyelitis in sickle cell disease) or transfusion (e.g., iron overload due to increased hemolysis) and iron chelation (e.g., desferrioxamine-related dysplastic bone changes and deferiprone-related degenerative arthritis) treatments. In this field, magnetic resonance imaging plays a pivotal role because of its high tissue contrast that enables early assessment of bone marrow changes before they become apparent on plain films or computed tomography or metabolic changes occur on bone scintigraphy or positron emission tomography scan. Overall, familiarity with the range of radiological appearances in chronic anemias is important to diagnose complications and establish appropriate therapy. PMID:21644200

  12. Approach to managing musculoskeletal pain

    PubMed Central

    Hunt, Richard H.; Choquette, Denis; Craig, Brian N.; De Angelis, Carlo; Habal, Flavio; Fulthorpe, Gordon; Stewart, John I.; Turpie, Alexander G.G.; Davis, Paul

    2007-01-01

    OBJECTIVE To provide family physicians and pharmacists with practical, evidence- and expertise-based guidance on choosing the safest approach to using analgesics to manage patients with musculoskeletal pain. SOURCES OF INFORMATION Health care providers from family practice, rheumatology, gastroenterology, hepatology, internal medicine, and pharmacy participated in an educational needs assessment regarding the management of pain and the safety of commonly used analgesics. Feedback from one-on-one interviews was compiled and distributed to participants who selected key topics. Topics chosen formed the basis for the discussions of this multidisciplinary panel that reviewed data on the safety of analgesics, particularly in regard to comorbidity and concurrent use with other therapies. MAIN MESSAGE Treatment should begin with an effective analgesic with the best safety profile at the lowest dose and escalate to higher doses and different analgesics as required. Acetaminophen is a safe medication that should be considered first-line therapy. Nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with potential adverse gastrointestinal, renal, hepatic, and cardiovascular effects. Physicians should not prescribe NSAIDs before taking a careful history and doing a physical examination so they have the information they need to weigh the risks (adverse effects and potential drug interactions) and benefits for individual patients. CONCLUSION Taking a complete and accurate history and doing a physical examination are essential for choosing the safest analgesic for a particular patient. PMID:17872814

  13. Mini Treadmill for Musculoskeletal Health

    NASA Technical Reports Server (NTRS)

    Humphreys, Bradley

    2015-01-01

    Because NASA's approach to space exploration calls for long-term extended missions, there is a pressing need to equip astronauts with effective exercise regimens that will maintain musculoskeletal and cardiovascular health. ZIN Technologies, Inc., has developed an innovative miniature treadmill for use in both zero-gravity and terrestrial environments. The treadmill offers excellent periodic impact exercise to stimulate cardiovascular activity and bone remodeling as well as resistive capability to encourage full-body muscle maintenance. A novel speed-control algorithm allows users to modulate treadmill speed by adjusting stride, and a new subject load device provides a more Earth-like gravity replacement load. This new and compact treadmill offers a unique approach to managing astronaut health while addressing the inherent and stringent challenges of space flight. The innovation also has the potential to offer numerous terrestrial applications, as a real-time daily load stimulus (DLS) measurement feature provides an effective mechanism to combat or manage osteoporosis, a major public health threat for 55 percent of Americans over the age of 50.

  14. CLINICIAN PROFICIENCY IN DELIVERING MANUAL TREATMENT FOR NECK PAIN WITHIN SPECIFIED FORCE RANGES

    PubMed Central

    Gudavalli, Maruti Ram; Vining, Robert D.; Salsbury, Stacie A.; Corber, Lance; Long, Cynthia R.; Patwardhan, Avinash G.; Goertz, Christine M.

    2015-01-01

    Background Context Neck pain is a common musculoskeletal complaint responsive to manual therapies. Doctors of chiropractic commonly use manual cervical distraction, a mobilization procedure, to treat neck pain patients. However, it is unknown if clinicians can consistently apply standardized cervical traction forces, a critical step toward identifying an optimal therapeutic dose. Purpose The purpose of this study was to assess clinicians’ proficiency in delivering manually applied traction forces within specified ranges to neck pain patients. Study Design/Setting Observational study nested within a randomized clinical trial. Sample Two research clinicians provided study interventions to 48 participants with neck pain. Outcome Measures Clinician proficiency in delivering cervical traction forces within three specified ranges (low force <20 newtons (N); medium force 21–50N; and high force 51–100N). Methods This study was funded by a grant from the National Center for Complementary and Alternative Medicine, National Institutes of Health (Grant # 1 U19AT004663-01), and conducted in a facility funded by National Center for Research Resources, National Institutes of Health (Grant # C06 RR15433-01), and approved by an Institutional Review Board for the protection of human subjects. Senior author receives approximately $400–600 travel reimbursements per year for giving research presentations at certification seminars. The table manufacturer (Haven Innovations) sold the treatment table at a discounted price ($5000 discount) for research purposes. Participants were randomly allocated to three force-based treatment groups. Participants received five manual cervical distraction treatments over two weeks while lying prone on a treatment table instrumented with force sensors. Two clinicians delivered manual traction forces by treatment group. Clinicians treated participants first without real-time visual feedback displaying traction force and then with visual feedback

  15. Forgotten triangles of neck

    PubMed Central

    Singh, Manpreet; Vashistha, Arpit; Chaudhary, Manoj; Kaur, Gagandeep

    2016-01-01

    The purpose of this manuscript is to add some more information in the present scientific literature on these nearly forgotten triangles of surgical importance. The neck is an area that lends itself to anatomical geometry, such as triangles. Many triangles of the neck have been described, and some are well-known, yet, some have been nearly forgotten, i.e., Lesser's triangle, Farabeuf triangle, Pirogoff's triangle, and Beclard's triangle. From the anatomic and surgical point of view, the neck is an amazingly interesting place. It is like a connection where crucial functional units meet and pass. Added surgical landmarks are always helpful to the surgeon while dealing with the neck. Described triangles of neck in this article are always reliable and constant landmarks for head and neck surgeons

  16. American Head and Neck Society

    MedlinePlus

    American Head & Neck Society Head and Neck Cancer Research & Education American Head & Neck Society | AHNS Head and Neck Cancer Research & Education About AHNS ... and Announcements Copyright ©2016 · American Head and Neck Society · Privacy and Return Policy Managed by BSC Management, ...

  17. Neck skin rejuvenation.

    PubMed

    Duplechain, J Kevin

    2014-05-01

    The author of this article uses the pulsed ablative CO2 laser for resurfacing of the neck and face, based on the gold standard status of the CO2 laser and a novel post-treatment plan that greatly reduces adverse effects traditionally associated with fully ablative resurfacing. The croton oil peel is an inexpensive and effective modality for rejuvenating neck skin. The use of either technique as an adjunct to neck lift surgery, with or without facelift surgery, permits surgeons to fulfill the expectations of patients who want the skin of their face and neck to be homogeneous and more attractive. PMID:24745383

  18. Use of Complementary and Alternative Medicine for Work Related Musculoskeletal Disorders Associated With Job Contentment in Dental Professionals: Indian Outlook

    PubMed Central

    Gupta, Devanand; Bhaskar, Dara John; Gupta, Kumar Rajendra; Karim, Bushra; Kanwar, Alpana; Jain, Ankita; Yadav, Ankit; Saini, Priya; Arya, Satya; Sachdeva, Neha

    2014-01-01

    Background High prevalence rates of work-related musculoskeletal disorders (WRMSD) among dentists have been reported. Complementary and alternative medicine (CAM) therapies can be helpful in managing and preventing work-related musculoskeletal disorders. The purpose of this study was to determine if dental professionals are using CAM for work-related musculoskeletal disorders. Who have greater job satisfaction: dentist who uses Complementary and alternative medicine (CAM) or conventional therapy (CT) as a treatment modality for WRMSD Method Dentists who registered in Uttar Pradesh state, India under Indian Dental Council, Uttar Pradesh branch (n=1134) were surveyed. Data were analyzed using univariate and bivariate analyses and logistic regression. Result A response rate of 53% (n=601) was obtained, revealing that 82% (n=487) of the respondents suffered from work-related musculoskeletal disorders. The use of complementary and alternative medicine or conventional therapy was reported among 80% (n=390) of the dentists with work-related musculoskeletal disorders. Complementary and alternative medicine users reported greater overall health compared to conventional therapy users (P<0.001). Of those with work-related musculoskeletal disorders, 35.5% (n=172) considered a career change for once, and 4.0% (n=19) reported having left dentistry. Conclusion Complementary and alternative medicine therapies may improve quality of life, reduce work disruptions and enhance job satisfaction for dentists who suffer from work-related musculoskeletal disorders. It is important that dentists incorporate complementary and alternative medicine strategies into practice to facilitate musculoskeletal health that will enable longer and healthier careers, increase productivity, provide safer workplace and prevent musculoskeletal disorders. PMID:24795512

  19. Health Care System Changes and Reported Musculoskeletal Disorders Among Registered Nurses

    PubMed Central

    Lipscomb, Jane; Trinkoff, Alison; Brady, Barbara; Geiger-Brown, Jeanne

    2004-01-01

    Objectives. We evaluated the impact of health care system changes on nurses’ health, and we studied reported musculoskeletal disorders associated with these changes. Methods. This cross-sectional study (n = 1163) defined a musculoskeletal disorder case as moderate pain that lasted at least 1 week or occurred monthly during the past year. Nurses were asked about changes in the health care system in the past year, and responses to 12 changes were summed and were categorized as low, moderate, or high changes. Results. When the changes were summed, the adjusted odds ratios for musculoskeletal disorders for more than 6 versus 0 to 1 changes were (1) neck: 4.45 (95% confidence interval [CI] = 1.97, 10.08), (2) shoulder: 2.63 (95% CI = 1.17, 5.91), and (3) back: 3.42 (95% CI = 1.61, 7.27). Conclusions. The adverse impact on health caused by the changing health care system must be addressed to prevent further injuries among nurses. PMID:15284055

  20. Postoperative ultrasonography of the musculoskeletal system

    PubMed Central

    Chun, Kyung Ah; Cho, Kil-Ho

    2015-01-01

    Ultrasonography of the postoperative musculoskeletal system plays an important role in the Epub ahead of print accurate diagnosis of abnormal lesions in the bone and soft tissues. Ultrasonography is a fast and reliable method with no harmful irradiation for the evaluation of postoperative musculoskeletal complications. In particular, it is not affected by the excessive metal artifacts that appear on computed tomography or magnetic resonance imaging. Another benefit of ultrasonography is its capability to dynamically assess the pathologic movement in joints, muscles, or tendons. This article discusses the frequent applications of musculoskeletal ultrasonography in various postoperative situations including those involving the soft tissues around the metal hardware, arthroplasty, postoperative tendons, recurrent soft tissue tumors, bone unions, and amputation surgery. PMID:25971901

  1. Advances in Musculoskeletal MRI – Technical Considerations

    PubMed Central

    Shapiro, Lauren; Harish, Monica; Hargreaves, Brian; Staroswiecki, Ernesto; Gold, Garry

    2012-01-01

    The technology of musculoskeletal MRI imaging is advancing at a dramatic rate. MR imaging is now done at medium and higher field strengths with more specialized surface coils and with more variable pulse sequences and post processing techniques than ever before. These numerable technical advances are advantageous as they lead to an increased signal to noise ratio and increased variety of soft tissue contrast options. However, at the same time they potentially produce more imaging artifacts when compared with past techniques. Substantial technical advances have considerable clinical challenges in musculoskeletal radiology such as postoperative patient imaging, cartilage mapping, and molecular imaging. In this review, we consider technical advances in hardware and software of musculoskeletal MR imaging along with their clinical applications. PMID:22987756

  2. Silk scaffolds for musculoskeletal tissue engineering.

    PubMed

    Yao, Danyu; Liu, Haifeng; Fan, Yubo

    2016-02-01

    The musculoskeletal system, which includes bone, cartilage, tendon/ligament, and skeletal muscle, is becoming the targets for tissue engineering because of the high need for their repair and regeneration. Numerous factors would affect the use of musculoskeletal tissue engineering for tissue regeneration ranging from cells used for scaffold seeding to the manufacture and structures of materials. The essential function of the scaffolds is to convey growth factors as well as cells to the target site to aid the regeneration of the injury. Among the variety of biomaterials used in scaffold engineering, silk fibroin is recognized as an ideal material for its impressive cytocompatibility, slow biodegradability, and excellent mechanical properties. The current review describes the advances made in the fabrication of silk fibroin scaffolds with different forms such as films, particles, electrospun fibers, hydrogels, three-dimensional porous scaffolds, and their applications in the regeneration of musculoskeletal tissues. PMID:26445979

  3. Musicians' Medicine: Musculoskeletal Problems in String Players

    PubMed Central

    Lee, Han-Sung; Park, Ho Youn; Yoon, Jun O; Kim, Jin Sam; Chun, Jae Myeung; Aminata, Iman W.; Cho, Won-Joon

    2013-01-01

    There is increasing attention to medical problems of musicians. Many studies find a high prevalence of work-related musculoskeletal disorders in musicians, ranging from 73.4% to 87.7%, and string players have the highest prevalence of musculoskeletal problems. This paper examines the various positions and movements of the upper extremities in string players: 1) basic postures for holding instruments, 2) movements of left upper extremity: fingering, forearm posture, high position and vibrato, 3) movements of right upper extremity: bowing, bow angles, pizzicato and other bowing techniques. These isotonic and isometric movements can lead to musculoskeletal problems in musicians. We reviewed orthopedic disorders that are specific to string players: overuse syndrome, muscle-tendon syndrome, focal dystonia, hypermobility syndrome, and compressive neuropathy. Symptoms, interrelationships with musical performances, diagnosis and treatment of these problems were then discussed. PMID:24009899

  4. Association of Parental Awareness of Using Schoolbags with Musculoskeletal Symptoms and Carrying Habits of Schoolchildren

    ERIC Educational Resources Information Center

    Dianat, Iman; Karimi, Mohammad Ali

    2014-01-01

    The association between parental awareness of using schoolbags and the occurrence of musculoskeletal symptoms and carrying habits of children was investigated in a cross-sectional study in Tabriz, Iran. Data on 454 students aged 11-14 years and their parents (n = 358) were analyzed. The awareness of the recommended weight limit, appropriate method…

  5. [Socioeconomic position and duration of disability benefit due to work-related musculoskeletal disorders].

    PubMed

    Souza, Norma Suely Souto; Santana, Vilma Sousa

    2012-02-01

    This study estimated the effect of socioeconomic position on the duration of disability benefits due to musculoskeletal disorders affecting the neck and/or upper limbs. A cohort study including 563 insured workers from the city of Salvador, Bahia, Brazil, registered in the General Social Security System and who received temporary disability benefits due to musculoskeletal disorders affecting the neck and/or upper limbs, was performed in 2008 using data from the National Social Security Institute. The results show that among union member workers with high psychosocial demands at work, those with low socioeconomic status are almost twice as likely to receive benefit for a shorter period of time compared to those with a higher socioeconomic position (RR = 1.89; 95%CI: 1.25-2.87). These results reveal an inequitable situation or unnecessary use of insurance for workers with a higher socioeconomic position. Future research aimed at elucidating the differences in the use of benefits are needed so that social insurance system managers may take the appropriate steps to resolve this issue. PMID:22331158

  6. Baggage handler seniority and musculoskeletal symptoms: is heavy lifting in awkward positions associated with the risk of pain?

    PubMed Central

    Bern, Stine Hvid; Brauer, Charlotte; Møller, Karina Lauenborg; Koblauch, Henrik; Thygesen, Lau Caspar; Simonsen, Erik Bruun; Alkjær, Tine; Bonde, Jens Peter; Mikkelsen, Sigurd

    2013-01-01

    Objectives Heavy lifting is associated with musculoskeletal disorders but it is unclear whether it is related to acute reversible effects or to chronic effects from cumulated exposure. The aim of this study was to examine whether musculoskeletal symptoms in Danish airport baggage handlers were associated with their seniority as baggage handler, indicating chronic effects from cumulated workload. Methods We established a group of baggage handlers employed at Copenhagen Airport during the period 1983–2012 (n=3092) and a reference group of men in other unskilled occupations with less heavy work (n=2478). Data regarding work history, lifestyle and musculoskeletal symptoms were collected using a self-administered questionnaire (response rate 70.1% among baggage handlers and 68.8% among the reference group). Results The ORs of self-reported musculoskeletal symptoms during the last 12 months in the neck/upper back, lower back, shoulders, elbows, wrists, hips and knees were significantly higher in baggage handlers than in the reference group. These differences were explained by significant linear effects of baggage handler seniority for six anatomical regions. Adjustment for age, body mass index, smoking and leisure-time physical activity did not change these results. The findings were stable over age strata and among present and former baggage handlers. Conclusions The risk of musculoskeletal symptoms in six anatomical regions increased with increasing seniority as a baggage handler. This is consistent with the assumption that cumulated heavy lifting may cause chronic or long-lasting musculoskeletal symptoms. However, we cannot exclude that other factors related to baggage handler seniority may explain some of the associations. PMID:24293209

  7. Musicians' illness perceptions of musculoskeletal complaints.

    PubMed

    Kok, Laura M; Vliet Vlieland, Theodora P M; Fiocco, Marta; Kaptein, Ad A; Nelissen, Rob G H H

    2013-04-01

    The purpose of this study is to know the views of people about their illness, i.e., illness perceptions, determine coping strategies, and outcome. Previous research suggests a higher prevalence and a different perception of musculoskeletal complaints between musicians and nonmusicians. The aim of this study is to compare illness perceptions related to musculoskeletal complaints between musicians and nonmusicians. In this cross-sectional study, students from three music academies (n = 345) and one university medical center (n = 2,870) in the Netherlands received an electronic questionnaire concerning questions on sociodemographic characteristics, use of musical instruments, occurrence and characteristics of musculoskeletal complaints in the past year, and the Brief Illness Perception Questionnaire (B-IPQ). Baseline and B-IPQ scores were compared between the samples by means of t tests, chi-square tests, and regression models to adjust for differences in sociodemographic characteristics. Eighty-three music academy students and 494 medical students completed the questionnaire (response rates, 25.5 and 17.6 %, respectively). Seventy-four (89 %) persons in the musician group and 382 (78 %) persons in the nonmusician group reported occurrence of musculoskeletal complaints during the last 12 months. Adjusted for sociodemographic characteristics, the B-IPQ scores of the domains consequences (my illness is a serious condition), concern (I am extremely concerned about my illness), and emotions (my illness makes me scared) were significantly higher among musicians, whereas personal control (there is little I can do to improve my illness), identity (number of symptoms patient sees as part of illness) were not significantly different. Music academy students had a significant more positive score on treatment control. Music academy students report more negative perceptions of their musculoskeletal complaints compared to medical students. Although some selection bias is

  8. Integrated musculoskeletal service design by GP consortia

    PubMed Central

    2011-01-01

    Background Musculoskeletal conditions are common in primary care and are associated with significant co-morbidity and impairment of quality of life. Traditional care pathways combined community-based physiotherapy with GP referral to hospital for a consultant opinion. Locally, this model led to only 30% of hospital consultant orthopaedic referrals being listed for surgery, with the majority being referred for physiotherapy. The NHS musculoskeletal framework proposed the use of interface services to provide expertise in diagnosis, triage and management of musculoskeletal problems not requiring surgery. The White Paper Equity and Excellence: Liberating the NHS has replaced PCT commissioning with GP consortia, who will lead future service development. Setting Primary and community care, integrated with secondary care, in the NHS in England. Question How can GP consortia lead the development of integrated musculoskeletal services? Review: The Ealing experience We explore here how Ealing implemented a ‘See and Treat’ interface clinic model to improve surgical conversion rates, reduce unnecessary hospital referrals and provide community treatment more efficiently than a triage model. A high-profile GP education programme enabled GPs to triage in their practices and manage patients without referral. Conclusion In Ealing, we demonstrated that most patients with musculoskeletal conditions can be managed in primary care and community settings. The integrated musculoskeletal service provides clear and fast routes to secondary care. This is both clinically effective and cost-effective, reserving hospital referral for patients most likely to need surgery. GP consortia, in conjunction with strong clinical leadership, inbuilt organisational and professional learning, and a GP champion, are well placed to deliver service redesign by co-ordinating primary care development, local commissioning of community services and the acute commissioning vehicles responsible for secondary

  9. Raman Spectroscopy of Soft Musculoskeletal Tissues

    PubMed Central

    Esmonde-White, Karen

    2015-01-01

    Tendon, ligament, and joint tissues are important in maintaining daily function. They can be affected by disease, age, and injury. Slow tissue turnover, hierarchical structure and function, and nonlinear mechanical properties present challenges to diagnosing and treating soft musculoskeletal tissues. Understanding these tissues in health, disease, and injury is important to improving pharmacologic and surgical repair outcomes. Raman spectroscopy is an important tool in the examination of soft musculoskeletal tissues. This article highlights exciting basic science and clinical/translational Raman studies of cartilage, tendon, and ligament. PMID:25286106

  10. Musculoskeletal complications of neuromuscular disease in children.

    PubMed

    Driscoll, Sherilyn W; Skinner, Joline

    2008-02-01

    A wide variety of neuromuscular diseases affect children, including central nervous system disorders such as cerebral palsy and spinal cord injury; motor neuron disorders such as spinal muscular atrophy; peripheral nerve disorders such as Charcot-Marie-Tooth disease; neuromuscular junction disorders such as congenital myasthenia gravis; and muscle fiber disorders such as Duchenne's muscular dystrophy. Although the origins and clinical syndromes vary significantly, outcomes related to musculoskeletal complications are often shared. The most frequently encountered musculoskeletal complications of neuromuscular disorders in children are scoliosis, bony rotational deformities, and hip dysplasia. Management is often challenging to those who work with children who have neuromuscular disorders. PMID:18194756

  11. The Effects of Workplace Physical Activity Programs on Musculoskeletal Pain: A Systematic Review and Meta-Analysis.

    PubMed

    Moreira-Silva, Isabel; Teixeira, Pedro M; Santos, Rute; Abreu, Sandra; Moreira, Carla; Mota, Jorge

    2016-05-01

    This article reviews the effectiveness of physical activity (PA) interventions at the workplace to reduce musculoskeletal pain among employees and assesses the effect size of these programs using meta-analysis. Four databases (i.e., PubMed, EBSCO, Web of Science, and Cochrane) were searched for research trials, which included comparison groups of employees that assessed PA programs, musculoskeletal pain, and health-related behaviors, published between January 1990 and March 2013. The meta-analysis estimates of standardized mean differences (Hedges' g) present significant evidence of less general pain (g = -.40 with a 95% confidence interval [CI] = [-0.78, -0.02]) and neck and shoulder pain (g = -.37 with a 95% CI = [-0.63, -0.12]) in intervention groups. The few studies of low back pain and arm, elbow, wrist, hand, or finger pain did not present sufficient statistically significant evidence. Consistent evidence demonstrates that workplace PA interventions significantly reduce general musculoskeletal pain and neck and shoulder pain. More studies are needed to determine the effectiveness of work-related PA interventions for arm, elbow, wrist, hand or finger, and low back pain. PMID:27147634

  12. Work Related Psychosocial and Organizational Factors for Neck Pain in Workers in the United States

    PubMed Central

    Yang, Haiou; Hitchcock, Edward; Haldeman, Scott; Swanson, Naomi; Lu, Ming-Lun; Choi, BongKyoo; Nakata, Akinori; Baker, Dean

    2016-01-01

    Background Neck pain is a prevalent musculoskeletal condition among workers in the United States. This study explores a set of workplace psychosocial and organization-related factors for neck pain. Methods Data used for this study comes from the 2010 National Health interview Survey which provides a representative sample of the US population. To account for the complex sampling design, the Taylor linearized variance estimation method was used. Logistic regression models were constructed to measure the associations. Results This study demonstrated significant associations between neck pain and a set of workplace risk factors including work-family imbalance, exposure to a hostile work environment and job insecurity, non-standard work arrangements, multiple jobs and long work hours. Conclusion Workers with neck pain may benefit from intervention programs that address issues related to these workplace risk factors. Future studies exploring both psychosocial risk factors and physical risk factors with a longitudinal design will be important. PMID:27184340

  13. Correlation among scapular asymmetry, neck pain, and neck disability index (NDI) in young women with slight neck pain

    PubMed Central

    Kim, Su-Rim; Kang, Mi-Hee; Bahng, Sun-Young; An, Jin-Kyoung; Lee, Ji-Young; Park, Sang-Young; Kim, Seong-Gil

    2016-01-01

    [Purpose] This study aimed to investigate the correlations among scapular asymmetry, neck pain, and neck disability index in women in their 20s with slight neck pain. [Subjects and Methods] A total of 60 female students at U university in Gyeongsangbuk-do, South Korea, participated in this study. The lateral scapular slide test, which measures the distance between the thorax and scapula, was used to analyze the scapular asymmetry. The lateral scapular slide test was performed in three positions. The visual analogue scale and neck disability index were used to measure neck pain. [Results] In the lateral scapular slide test in position 3 (shoulder abduction at 90 degrees), the scapular left-right asymmetry and VAS showed a moderate positive linear relationship, with r=0.344. The VAS and NDI showed a moderate positive linear relationship, with r = 0.632. [Conclusion] Scapular asymmetry indicates imbalance of surrounding muscles of the scapula and is related to neck pain based on the results of measuring the distance from the thorax to the scapula. PMID:27313361

  14. The effects of office ergonomic training on musculoskeletal complaints, sickness absence, and psychological well-being: a cluster randomized control trial.

    PubMed

    Mahmud, Norashikin; Kenny, Dianna T; Md Zein, Raemy; Hassan, Siti Nurani

    2015-03-01

    This study explored whether musculoskeletal complaints can be reduced by the provision of ergonomics education. A cluster randomized controlled trial study was conducted in which 3 units were randomized to intervention and received training and 3 units were given a leaflet. The effect of intervention on knowledge, workstation practices, musculoskeletal complaints, sickness absence, and psychological well-being were assessed at 6 and 12 months. Although there was no increment of knowledge among workers, significant improvements in workstation practices in the use of monitor, keyboard, and chair were observed. There were significant reductions in neck and upper and lower back complaints among workers but these did not translate into fewer days lost from work. Workers' stress was found to be significantly reduced across the studies. In conclusion, office ergonomics training can be beneficial in reducing musculoskeletal risks and stress among workers. PMID:21878465

  15. Work-related musculoskeletal disorders among dental professionals in Saudi Arabia

    PubMed Central

    Alghadir, Ahmad; Zafar, Hamayun; Iqbal, Zaheen A.

    2015-01-01

    [Purpose] Musculoskeletal disorders are common causes of work-related disability in different professions involving the frequent practice of lifting, stooping, twisting, prolonged sitting, or standing. The dental profession is one such profession. Our aim was to determine the prevalence of work-related musculoskeletal disorders among dental professionals in Saudi Arabia, the factors associated with them, and their consequences and to propose preventive measures for them. [Subjects and Methods] A self-administered online questionnaire was sent to 225 members of the Saudi Dental Association. It included questions on demographic and professional characteristics, general medical history, and history of work-related musculoskeletal disorders before and after joining the dental profession. [Results] The questionnaire was completed by 65% of the respondents. Among them 85% reported that they had developed some pain due to work after joining the dental profession, and 42% reported that they were suffering pain at the time of the survey. Besides lower back, shoulder, and neck regions, the hands, upper back, and other regions like the elbows, buttocks, thighs, leg, and feet were areas in which they pain. [Conclusion] The prevalence of work-related musculoskeletal disorders among dental professionals in Saudi Arabia is high, affecting their daily activities, sometimes even forcing them to change their work setting. Age, gender, specialty of work, work setting, number of contact hours with patients, etc., were all found to be related to their work-related pain. We need to emphasize the role of ergonomics, counseling, proper techniques of patient handling, etc., during the training of dental professionals so that they can work efficiently. PMID:25995567

  16. Musculoskeletal training: are GP trainees exposed to the right case mix for independent practice?

    PubMed

    Goff, Iain; Wise, Elspeth Mary; Coady, David; Walker, David

    2016-02-01

    Musculoskeletal conditions are common in general practice, but clinicians express poor self confidence in dealing with them. Training in general practice relies on clinical exposure to a range of presentations in order to gain competence. It has been suggested that trainees are exposed to a different case mix from qualified general practices (GPs), due to seeing more minor illness and less chronic disease and that this may be responsible in part for their subsequent lack of confidence. The aims of this study were to analyse the case mix of musculoskeletal conditions encountered by general practice trainees and to compare this to the overall population consulting behaviour. This is a prospective observational study. Thirteen general practices in North East England were recruited. Musculoskeletal disorders encountered by 13 GP trainees (7 junior and 6 senior) were prospectively recorded using a handheld diary. Disorders were classified according to working diagnosis or body region if diagnosis was unclear. Musculoskeletal (MSK) disorders comprised 17 % of consultations, and the distribution of diagnoses of these was in proportion to epidemiological studies of MSK disorders in the UK as they present in primary care. Back pain was the most frequent label with 141 (29 %) consultations with a further 43 (9 %) for neck pain. Inflammatory arthritis accounted for the same number 43 (9 %). Individual joint problems were 115 (24 %) with knee being most common. A specific diagnosis was more likely to be applied when symptoms were more distal and less likely when axial. Trainees are exposed to the same spectrum of MSK disorders as are present in the population as a whole. Case mix does not appear to be a significant factor in low confidence levels in dealing with MSK disorders. PMID:25190366

  17. Work related musculoskeletal disorders and ergonomic stressors in the South African workforce.

    PubMed Central

    Schierhout, G H; Meyers, J E; Bridger, R S

    1995-01-01

    OBJECTIVES--The main objective of this study was to investigate exposure-response relations between adverse musculoskeletal outcomes and ergonomic exposure variables. METHODS--A cross sectional analytical study was conducted in 11 factories from seven sectors of manufacturing industry in South Africa. Exposure to workplace ergonomic stressors was assessed in factory floor jobs (n = 46) with a simple low technology observational model. Repetition, force, static posture, dynamic movement, and other job exposures were measured. Data of adverse musculoskeletal outcome and data on potential confounders and effect modifiers were obtained from subjects (n = 401) randomly sampled from each job category with a questionnaire given by interviewers. RESULTS--High prevalences of regional musculoskeletal pain were found with substantial variability between industries. Sex was the only individual risk factor (after adjustment for potential confounders and effect modifiers) that was significantly associated with regional pain. Ergonomic exposures in the workplace were significantly associated with musculoskeletal pain of the neck and shoulders odds ratio (OR) 5.38 (95% confidence interval (95% CI) 1.16 to 25.0) for repetition, and OR 3.91 (95% CI 1.11 to 13.7) for seated compared with standing work; pain of the wrists and hands OR 10.2 (95% CI 1.39 to 75.6) for high summed score of dynamic postures of the wrist). CONCLUSIONS--This study indicates good predictive ability to reduce ergonomic stress with the exposure model, simple surveillance methods, and educational programmes in the workplace. Further study on sampling strategies and refinement of dimensions of ergonomic stressors are needed. PMID:7697140

  18. Association of individual and work-related risk factors with musculoskeletal symptoms among Iranian sewing machine operators.

    PubMed

    Dianat, Iman; Kord, Madeh; Yahyazade, Parvin; Karimi, Mohammad Ali; Stedmon, Alex W

    2015-11-01

    This cross-sectional study evaluated working conditions and the occurrence of self-reported musculoskeletal symptoms among 251 Iranian sewing machine operators. A questionnaire and direct observations of working postures using the rapid upper limb assessment (RULA) method were used. A high prevalence of musculoskeletal symptoms, particularly in the neck/shoulders, back and hands/wrists were found. The mean RULA grand score of 5.7 highlighted a poor sewing workstation design and indicated that most operators (with posture assessed at action level 3) needed an investigation and changes in their working habits soon. Work-related factors (including number of years worked as an operator, prolonged working hours per shift, long duration of sitting work without a break, feeling pressure due to work and working postures) and individual factors (including age, gender, BMI and regular sport/physical activities) were associated with musculoskeletal symptoms in multiple logistic regression models. The findings add to the understanding of working conditions of those jobs involving sewing activities and emphasise the need for ergonomic interventions to reduce musculoskeletal symptoms in the future. PMID:26154216

  19. A randomised controlled trial evaluating the effects of two workstation interventions on upper body pain and incident musculoskeletal disorders among computer operators

    PubMed Central

    Rempel, D M; Krause, N; Goldberg, R; Benner, D; Hudes, M; Goldner, G U

    2006-01-01

    Background Call centre work with computers is associated with increased rates of upper body pain and musculoskeletal disorders. Methods This one year, randomised controlled intervention trial evaluated the effects of a wide forearm support surface and a trackball on upper body pain severity and incident musculoskeletal disorders among 182 call centre operators at a large healthcare company. Participants were randomised to receive (1) ergonomics training only, (2) training plus a trackball, (3) training plus a forearm support, or (4) training plus a trackball and forearm support. Outcome measures were weekly pain severity scores and diagnosis of incident musculoskeletal disorder in the upper extremities or the neck/shoulder region based on physical examination performed by a physician blinded to intervention. Analyses using Cox proportional hazard models and linear regression models adjusted for demographic factors, baseline pain levels, and psychosocial job factors. Results Post‐intervention, 63 participants were diagnosed with one or more incident musculoskeletal disorders. Hazard rate ratios showed a protective effect of the armboard for neck/shoulder disorders (HR = 0.49, 95% CI 0.24 to 0.97) after adjusting for baseline pain levels and demographic and psychosocial factors. The armboard also significantly reduced neck/shoulder pain (p = 0.01) and right upper extremity pain (p = 0.002) in comparison to the control group. A return‐on‐investment model predicted a full return of armboard and installation costs within 10.6 months. Conclusion Providing a large forearm support combined with ergonomic training is an effective intervention to prevent upper body musculoskeletal disorders and reduce upper body pain associated with computer work among call centre employees. PMID:16621849

  20. Sharp neck injuries in suicidal intention.

    PubMed

    Biétry, Damien; Exadaktylos, Aristomenis; Müller, Thomas; Zbären, Peter; Caversaccio, Marco; Arnold, Andreas

    2015-12-01

    Sharp neck injuries in suicidal intention often present as serious emergency situations with the need for an immediate diagnosis and treatment. We report our study of the clinical evolution of this emergency condition. This study investigates the cases of sharp neck injuries in suicidal intention treated at our institution between 2000 and 2010. Patient records were collected in a retrospectively reviewed and analyzed database. The current literature was compared to our findings. We found 36 cases (10 female and 26 male). The neck injuries were superficial and profound in 16 and 20 patients, respectively. Twenty-two patients were seen by the Head and Neck surgeon. A surgical neck exploration was necessary in 19 cases. Tracheal, laryngeal, pharyngeal and vascular injuries were found in one, five, three and three cases, respectively. The hospital stay ranged from 1 to 47 days. All the patients underwent emergency psychiatric assessment and were subsequently referred for psychiatric treatment. One patient died in the emergency room from an additional arterial injury to the wrist. Sharp neck injuries in suicidal intention treated with an interdisciplinary medical, surgical and psychiatric emergency assessment and treatment have low mortality and morbidity. PMID:25543307

  1. Limb Salvage Surgery for Musculoskeletal Oncology

    PubMed Central

    Wan Ismail, Wan Faisham Nu’man Bin

    2015-01-01

    The management of musculoskeletal tumours has progressed tremendously over the past few decades. Limb salvage surgery has become a standard practise without compromising the oncological outcome. Patients generally will benefit with superior function and a better quality of life compared with definitive amputation. The multidisciplinary approach and advancement of surgeries are important to achieve patient survival and optimum function. PMID:26715902

  2. Musculoskeletal pain in overweight and obese children

    PubMed Central

    Smith, S M; Sumar, B; Dixon, K A

    2014-01-01

    This review seeks to provide a current overview of musculoskeletal pain in overweight and obese children. Databases searched were Academic Search Complete, CINAHL, Medline, Proquest Health and Medical Complete, Scopus, Google Scholar, SPORTDiscuss and Trove for studies published between 1 January 2000 and 30 December 2012. We used a broad definition of children within a 3- to 18-year age range. The search strategy included the following terms: obesity, morbid obesity, overweight, pain, musculoskeletal pain, child, adolescent, chronic pain, back pain, lower back pain, knee pain, hip pain, foot pain and pelvic pain. Two authors independently assessed each record, and any disagreement was resolved by the third author. Data were analysed using a narrative thematic approach owing to the heterogeneity of reported outcome measures. Ninety-seven records were initially identified using a variety of terms associated with children, obesity and musculoskeletal pain. Ten studies were included for thematic analysis when predetermined inclusion criteria were applied. Bone deformity and dysfunction, pain reporting and the impact of children being overweight or obese on physical activity, exercise and quality of life were the three themes identified from the literature. Chronic pain, obesity and a reduction in physical functioning and activity may contribute to a cycle of weight gain that affects a child's quality of life. Future studies are required to examine the sequela of overweight and obese children experiencing chronic musculoskeletal pain. PMID:24077005

  3. Musculoskeletal pain in overweight and obese children.

    PubMed

    Smith, S M; Sumar, B; Dixon, K A

    2014-01-01

    This review seeks to provide a current overview of musculoskeletal pain in overweight and obese children. Databases searched were Academic Search Complete, CINAHL, Medline, Proquest Health and Medical Complete, Scopus, Google Scholar, SPORTDiscuss and Trove for studies published between 1 January 2000 and 30 December 2012. We used a broad definition of children within a 3- to 18-year age range. The search strategy included the following terms: obesity, morbid obesity, overweight, pain, musculoskeletal pain, child, adolescent, chronic pain, back pain, lower back pain, knee pain, hip pain, foot pain and pelvic pain. Two authors independently assessed each record, and any disagreement was resolved by the third author. Data were analysed using a narrative thematic approach owing to the heterogeneity of reported outcome measures. Ninety-seven records were initially identified using a variety of terms associated with children, obesity and musculoskeletal pain. Ten studies were included for thematic analysis when predetermined inclusion criteria were applied. Bone deformity and dysfunction, pain reporting and the impact of children being overweight or obese on physical activity, exercise and quality of life were the three themes identified from the literature. Chronic pain, obesity and a reduction in physical functioning and activity may contribute to a cycle of weight gain that affects a child's quality of life. Future studies are required to examine the sequela of overweight and obese children experiencing chronic musculoskeletal pain. PMID:24077005

  4. X-pinch dynamics: Neck formation and implosion

    SciTech Connect

    Oreshkin, V. I.; Chaikovsky, S. A.; Artyomov, A. P.; Labetskaya, N. A.; Fedunin, A. V.; Rousskikh, A. G.; Zhigalin, A. S.

    2014-10-15

    We propose a model that describes the neck formation and implosion in an X-pinch. The process is simulated to go in two stages. The first stage is neck formation. This stage begins with an electrical explosion of the wires forming the X-pinch, and at the end of the stage, a micropinch (neck) is formed in the region where the wires are crossed. The second stage is neck implosion. The implosion is accompanied by outflow of matter from the neck region, resulting in the formation of a “hot spot”. Analytical estimates obtained in the study under consideration indicate that these stages are approximately equal in duration. Having analyzed the neck implosion dynamics, we have verified a scaling which makes it possible to explain the observed dependences of the time of occurrence of an x-ray pulse on the X-pinch current and mass.

  5. White matter involvement in chronic musculoskeletal pain

    PubMed Central

    Lieberman, Gregory; Shpaner, Marina; Watts, Richard; Andrews, Trevor; Filippi, Christopher G.; Davis, Marcia; Naylor, Magdalena R.

    2014-01-01

    There is emerging evidence that chronic musculoskeletal pain is associated with anatomical and functional abnormalities in gray matter. However, little research has investigated the relationship between chronic musculoskeletal pain and white matter (WM). In this study, we used whole-brain tract-based spatial statistics, and region-of-interest analyses of diffusion tensor imaging (DTI) data to demonstrate that patients with chronic musculoskeletal pain exhibit several abnormal WM integrity as compared to healthy controls. Chronic musculoskeletal pain was associated with lower fractional anisotropy (FA) in the splenium of corpus callosum, and left cingulum adjacent to the hippocampus. Patients also had higher radial diffusivity (RD) in the splenium, right anterior and posterior limbs of internal capsule, external capsule, superior longitudinal fasciculus, and cerebral peduncle. Patterns of axial diffusivity (AD) varied: patients exhibited lower AD in the left cingulum adjacent to the hippocampus and higher AD bilaterally in the anterior limbs of internal capsule, and in the right cerebral peduncle. Several correlations between diffusion metrics and clinical variables were also significant at a p<0.01 level: FA in the left uncinate fasciculus correlated positively with Total Pain Experience and typical levels of pain severity. AD in the left anterior limb of internal capsule and left uncinate fasciculus were correlated with Total Pain Experience and typical pain level. Positive correlations were also found between AD in the right uncinate and both Total Pain Experience and Pain Catastrophizing. These results demonstrate that WM abnormalities play a role in chronic musculoskeletal pain; either as a cause, predisposing factor, consequence, or compensatory adaptation. PMID:25135468

  6. Neck kinematics and sternocleidomastoid muscle activation during neck rotation in subjects with forward head posture

    PubMed Central

    Kim, Man-Sig

    2015-01-01

    [Purpose] The present study investigated differences in the kinematics of the neck and activation of the sternocleidomastoid (SCM) muscle during neck rotation between subjects with and without forward head posture (FHP). [Subjects and Methods] Twenty-eight subjects participated in the study (14 with FHP, 14 without FHP). Subjects performed neck rotation in two directions, left and right. The kinematics of rotation-lateral flexion movement patterns were recorded using motion analysis. Activity in the bilateral SCM muscles was measured using surface electromyography. Differences in neck kinematics and activation of SCM between the groups were analyzed by independent t-tests. [Results] Maintaining FHP increased the rotation-lateral flexion ratio significantly in both directions. The FHP group had significantly faster onset time for lateral flexion movement in both directions during neck rotation. Regarding the electromyography of the SCM muscles during neck rotation in both directions, the activity values of subjects with FHP were greater than those of subjects without FHP for the contralateral SCM muscles. [Conclusion] FHP can induce changes in movement in the frontal plane and SCM muscle activation during neck rotation. Thus, clinicians should consider movement in the frontal plane as well as in the sagittal plane when assessing and treating patients with forward head posture. PMID:26696712

  7. Early-onset dropped head syndrome after radiotherapy for head and neck cancer: dose constraints for neck extensor muscles

    PubMed Central

    Inaba, Koji; Nakamura, Satoshi; Okamoto, Hiroyuki; Kashihara, Tairo; Kobayashi, Kazuma; Harada, Ken; Kitaguchi, Mayuka; Sekii, Shuhei; Takahashi, Kana; Murakami, Naoya; Ito, Yoshinori; Igaki, Hiroshi; Uno, Takashi; Itami, Jun

    2016-01-01

    Dropped head syndrome (DHS) is a famous but unusual late complication of multimodality treatment for head and neck carcinoma. We reported this early-onset complication and analyzed the dose to the neck extensor muscles. We examined the records of three patients with DHS after radiotherapy. The doses to the neck extensor muscles were compared between three patients with DHS and nine patients without DHS. The mean dose to the neck extensor muscles of the three patients with DHS were 58.5 Gy, 42.3 Gy and 60.9 Gy, while the dose was <50 Gy in all nine patients in the control group. The onset of this syndrome was 5 months, 6 months and 15 months. The early-onset DHS may have something to do with dose to the neck extensor muscles. The proposed dose to the neck extensor muscles might be <46 Gy (or at least <50 Gy). PMID:26684338

  8. Musculoskeletal Injuries and Training Patterns in Junior Elite Orienteering Athletes

    PubMed Central

    Roos, Lilian; Taube, Wolfgang; Zuest, Peter; Clénin, German; Wyss, Thomas

    2015-01-01

    Findings about the relation between musculoskeletal injuries and training patterns in orienteering athletes are sparse. Therefore, the musculoskeletal injuries and training patterns of 31 Swiss elite orienteering athletes aged 18-19 years were analyzed in a retrospective study. Individual training diaries and medical records were used to assess training data and injury history, respectively. Group comparisons and a multiple linear regression (MLR) were performed for statistical analysis. The junior elite orienteering athletes performed 7.38 ± 2.00 training sessions weekly, with a total duration of 455.75 ± 98.22 minutes. An injury incidence rate (IIR) of 2.18 ± 2.13 injuries per 1000 hours of training was observed. The lower extremity was affected in 93% of all injuries, and the knee (33%) was the most commonly injured location. The MLR revealed that gender and six training variables explained 60% of the variance in the injury severity index in this study. Supported by the low IIR in the observed age group, the training protocol of the junior elite orienteering athletes was generally adequate. In comparison to elite track, marathon, and orienteering athletes, the junior elite athletes performed less high-intensity interval training (HIIT). However, more frequent HIIT seems to be a protective factor against injuries. PMID:26258134

  9. Musculoskeletal Injuries and Training Patterns in Junior Elite Orienteering Athletes.

    PubMed

    Roos, Lilian; Taube, Wolfgang; Zuest, Peter; Clénin, German; Wyss, Thomas

    2015-01-01

    Findings about the relation between musculoskeletal injuries and training patterns in orienteering athletes are sparse. Therefore, the musculoskeletal injuries and training patterns of 31 Swiss elite orienteering athletes aged 18-19 years were analyzed in a retrospective study. Individual training diaries and medical records were used to assess training data and injury history, respectively. Group comparisons and a multiple linear regression (MLR) were performed for statistical analysis. The junior elite orienteering athletes performed 7.38 ± 2.00 training sessions weekly, with a total duration of 455.75 ± 98.22 minutes. An injury incidence rate (IIR) of 2.18 ± 2.13 injuries per 1000 hours of training was observed. The lower extremity was affected in 93% of all injuries, and the knee (33%) was the most commonly injured location. The MLR revealed that gender and six training variables explained 60% of the variance in the injury severity index in this study. Supported by the low IIR in the observed age group, the training protocol of the junior elite orienteering athletes was generally adequate. In comparison to elite track, marathon, and orienteering athletes, the junior elite athletes performed less high-intensity interval training (HIIT). However, more frequent HIIT seems to be a protective factor against injuries. PMID:26258134

  10. Musculoskeletal allograft risks and recalls in the United States.

    PubMed

    Mroz, Thomas E; Joyce, Michael J; Steinmetz, Michael P; Lieberman, Isador H; Wang, Jeffrey C

    2008-10-01

    There have been several improvements to the US tissue banking industry over the past decade. Tissue banks had limited active government regulation until 1993, at which time the US Food and Drug Administration began regulatory oversight because of reports of disease transmission from allograft tissues. Reports in recent years of disease transmission associated with the use of allografts have further raised concerns about the safety of such implants. A retrospective review of allograft recall data was performed to analyze allograft recall by tissue type, reason, and year during the period from January 1994 to June 30, 2007. During the study period, more than 96.5% of all allograft tissues recalled were musculoskeletal. The reasons underlying recent musculoskeletal tissue recalls include insufficient or improper donor evaluation, contamination, recipient infection, and positive serologic tests. Infectious disease transmission following allograft implantation may occur if potential donors are not adequately evaluated or screened serologically during the prerecovery phase and if the implant is not sterilized before implantation. PMID:18832599

  11. Head and Neck Cancer

    MedlinePlus

    ... head and neck cancer. Poor oral and dental hygiene . Poor care of the mouth and teeth has ... sore throat Foul mouth odor not explained by hygiene Hoarseness or change in voice Nasal obstruction or ...

  12. Talar neck fractures.

    PubMed

    Berlet, G C; Lee, T H; Massa, E G

    2001-01-01

    Clinical management of talar neck fractures is complex and fraught with complications. As Gaius Julius Caesar stated: "The die is cast"; often the outcome of a talar neck fracture is determined at the time of injury. The authors believe, however, that better results can be achieved by following some simple guidelines. The authors advocate prompt and precise anatomic surgical reduction, preferring the medial approach with secondary anterolateral approach. Preservation of blood supply can be achieved by a thorough understanding of vascular pathways and efforts to stay within appropriate surgical intervals. The authors advocate bone grafting of medial neck comminution (if present) to prevent varus malalignment and rigid internal fixation to allow for joint mobilization postoperatively. These guidelines may seem simple, but when dealing with the complexity of talar neck fractures, the foot and ankle surgeon needs to focus and rely on easily grasped concepts to reduce poor outcomes. PMID:11465133

  13. Neck-Tongue Syndrome.

    PubMed

    Hu, Nancy; Dougherty, Carrie

    2016-04-01

    Neck-tongue syndrome (NTS) is a headache disorder often initiated by rapid axial rotation of the neck resulting in unilateral neck and/or occipital pain and transient ipsilateral tongue sensory disturbance. In this review, we examine reported cases of NTS since its initial description in 1980 to highlight the significance of this condition in the differential diagnosis of headache in patients presenting with neck pain and altered tongue sensation. The anatomical basis of NTS centers on the C1-C2 facet joint, C2 ventral ramus, and inferior oblique muscle in the atlanto-axial space. NTS may be categorized as complicated (secondary to another disease process) or uncomplicated (hereditary, related to trauma, or idiopathic). Diagnosis is based on clinical suspicion after a thorough history and physical without a pathognomonic radiologic finding. It is typically treated conservatively with medications, local injections, immobilization with cervical collars, or physical therapy; rarely is surgical intervention pursued. PMID:26984539

  14. Melanoma - neck (image)

    MedlinePlus

    This melanoma on the neck is variously colored with a very darkly pigmented area found centrally. It has irregular ... be larger than 0.5 cm. Prognosis in melanoma is best defined by its depth on resection.

  15. Torticollis (wry neck) (image)

    MedlinePlus

    Torticollis is a form of dystonia (prolonged muscle contractions) in which the neck muscles, particularly the sternocleidomastoid muscle, contract involuntarily causing the head to turn. Torticollis may occur without known cause (idiopathic), ...

  16. TCGA head Neck

    Cancer.gov

    Investigators with The Cancer Genome Atlas (TCGA) Research Network have discovered genomic differences – with potentially important clinical implications – in head and neck cancers caused by infection with the human papillomavirus (HPV).

  17. J incision in neck dissections.

    PubMed

    Acar, A; Dursun, G; Aydin, O; Akbaş, Y

    1998-01-01

    Metastasis in the neck lymph system of primary tumours of the head and neck is frequently seen. In order to prevent this metastasis, neck dissection is carried out by various types of skin incisions. In this study, types of skin incision used in neck dissections were defined, and the advantages, disadvantages and results of J incisions, which have been performed on 320 radical neck dissection patients in our clinic between 1985-1996, were compared with those of other incision types. PMID:9538447

  18. Polymorphisms in the glucocorticoid receptor co-chaperone FKBP5 predict persistent musculoskeletal pain after traumatic stress exposure

    PubMed Central

    Bortsov, Andrey V.; Smith, Jennifer E.; Diatchenko, Luda; Soward, April C.; Ulirsch, Jacob C.; Rossi, Catherine; Swor, Robert A.; Hauda, William E.; Peak, David A.; Jones, Jeffrey S.; Holbrook, Debra; Rathlev, Niels K.; Foley, Kelly A.; Lee, David C.; Collette, Renee; Domeier, Robert M.; Hendry, Phyllis L.; McLean, Samuel A.

    2013-01-01

    Individual vulnerability factors influencing the function of the hypothalamic-pituitary-adrenal (HPA) axis may contribute to the risk of the development of persistent musculoskeletal pain after traumatic stress exposure. The objective of the study was to evaluate the association between polymorphisms in the gene encoding FK506 binding protein 51, FKBP5, a glucocorticoid receptor co-chaperone, and musculoskeletal pain severity six weeks after two common trauma exposures. The study included data from two prospective emergency department-based cohorts: a discovery cohort (n=949) of European Americans experiencing motor vehicle collision and a replication cohort of adult European American women experiencing sexual assault (n=53). DNA was collected from trauma survivors at the time of initial assessment. Overall pain and neck pain six weeks after trauma exposure were assessed using a 0–10 numeric rating scale. After adjustment for multiple comparisons, six FKBP5 polymorphisms showed significant association (minimum p <0.0001) with both overall and neck pain in the discovery cohort. The association of rs3800373, rs9380526, rs9394314, rs2817032, and rs2817040 with neck pain and/or overall pain six weeks after trauma was replicated in the sexual assault cohort, showing the same direction of the effect in each case. The results of this study indicate that genetic variants in FKBP5 influence the severity of musculoskeletal pain symptoms experienced during the weeks after motor vehicle collision and sexual assault. These results suggest that glucocorticoid pathways influence the development of persistent post-traumatic pain, and that such pathways may be a target of pharmacologic interventions aimed at improving recovery after trauma. PMID:23707272

  19. EPIDEMIOLOGY OF MUSCULOSKELETAL DISORDERS IN PRIMARY SCHOOL CHILDREN IN BOSNIA AND HERZEGOVINA

    PubMed Central

    Azabagic, Selma; Spahic, Razija; Pranjic, Nurka; Mulic, Maida

    2016-01-01

    Introduction: Musculoskeletal disorders represent a significant problem of modern society which are more pronounced in young people and school children. Etiology of these disorders is found in inadequate ergonomic conditions, too heavy school bag, school furniture inadequate to age, poor posture, sedentary lifestyle, reduction of physical activity and lack of exercise. Material and methods: This cross-sectional study included 1315 pupils aged 8- 12 years. As a method was used “cluster sample” in the selection of subjects. The survey was conducted by questionnaire containing information on the demographic and individual characteristics of participants (age, gender, class), the manner and style of life and the performance of school tasks, followed by standardized Nordic questionnaire. The following parameters were measured: body height and weight for each student, and the weight of full and empty school bag that students that day brought to class. Results: The incidence of musculoskeletal pain regardless of localization was 48%. There is a statistically significant correlation between acute pain in the right shoulder and total weight of school bags, duration of caring the bag in school and time of wearing bag from school to home but not with the manner in which school bag was carried. Acute pain in the right shoulder and acute neck pain were significantly associated with the duration of sitting in school or in front of a computer at home. Acute pain in the shoulder negatively correlated with BMI percentile value of the respondents. Acute pain in the neck is also significantly associated with the weight of a full school bags, as well as time spent sitting at home doing homework. Acute back pain is statistically significantly correlated with the weight of school bags and duration of sitting periods in school. Conclusion: The prevalence of musculoskeletal pain, particularly chronic pain in school children aged 8-12 years is high. Weight of school bags, manner in

  20. High intensity physical exercise and pain in the neck and upper limb among slaughterhouse workers: cross-sectional study.

    PubMed

    Sundstrup, Emil; Jakobsen, Markus D; Jay, Kenneth; Brandt, Mikkel; Andersen, Lars L

    2014-01-01

    Slaughterhouse work involves a high degree of repetitive and forceful upper limb movements and thus implies an elevated risk of work-related musculoskeletal disorders. High intensity strength training effectively rehabilitates musculoskeletal disorders among sedentary employees, but less is known about the effect among workers with repetitive and forceful work demands. Before performing randomized controlled trials it may be beneficial to assess the cross-sectional connection between exercise and musculoskeletal pain. We investigated the association between high intensity physical exercise and pain among 595 slaughterhouse workers in Denmark, Europe. Using logistic regression analyses, odds ratios for pain and work disability as a function of physical exercise, gender, age, BMI, smoking, and job position were estimated. The prevalence of pain in the neck, shoulder, elbow, and hand/wrist was 48%, 60%, 40%, and 52%, respectively. The odds for experiencing neck pain were significantly lower among slaughterhouse workers performing physical exercise (OR = 0.70, CI: 0.49-0.997), whereas the odds for pain in the shoulders, elbow, or hand/wrist were not associated with exercise. The present study can be used as general reference of pain in the neck and upper extremity among slaughterhouse workers. Future studies should investigate the effect of high intensity physical exercise on neck and upper limb pain in slaughterhouse workers. PMID:24527440

  1. High Intensity Physical Exercise and Pain in the Neck and Upper Limb among Slaughterhouse Workers: Cross-Sectional Study

    PubMed Central

    Sundstrup, Emil; Jakobsen, Markus D.; Jay, Kenneth; Brandt, Mikkel; Andersen, Lars L.

    2014-01-01

    Slaughterhouse work involves a high degree of repetitive and forceful upper limb movements and thus implies an elevated risk of work-related musculoskeletal disorders. High intensity strength training effectively rehabilitates musculoskeletal disorders among sedentary employees, but less is known about the effect among workers with repetitive and forceful work demands. Before performing randomized controlled trials it may be beneficial to assess the cross-sectional connection between exercise and musculoskeletal pain. We investigated the association between high intensity physical exercise and pain among 595 slaughterhouse workers in Denmark, Europe. Using logistic regression analyses, odds ratios for pain and work disability as a function of physical exercise, gender, age, BMI, smoking, and job position were estimated. The prevalence of pain in the neck, shoulder, elbow, and hand/wrist was 48%, 60%, 40%, and 52%, respectively. The odds for experiencing neck pain were significantly lower among slaughterhouse workers performing physical exercise (OR = 0.70, CI: 0.49–0.997), whereas the odds for pain in the shoulders, elbow, or hand/wrist were not associated with exercise. The present study can be used as general reference of pain in the neck and upper extremity among slaughterhouse workers. Future studies should investigate the effect of high intensity physical exercise on neck and upper limb pain in slaughterhouse workers. PMID:24527440

  2. Elevated [11C]-D-Deprenyl Uptake in Chronic Whiplash Associated Disorder Suggests Persistent Musculoskeletal Inflammation

    PubMed Central

    Linnman, Clas; Appel, Lieuwe; Fredrikson, Mats; Gordh, Torsten; Söderlund, Anne; Långström, Bengt; Engler, Henry

    2011-01-01

    There are few diagnostic tools for chronic musculoskeletal pain as structural imaging methods seldom reveal pathological alterations. This is especially true for Whiplash Associated Disorder, for which physical signs of persistent injuries to the neck have yet to be established. Here, we sought to visualize inflammatory processes in the neck region by means Positron Emission Tomography using the tracer 11C-D-deprenyl, a potential marker for inflammation. Twenty-two patients with enduring pain after a rear impact car accident (Whiplash Associated Disorder grade II) and 14 healthy controls were investigated. Patients displayed significantly elevated tracer uptake in the neck, particularly in regions around the spineous process of the second cervical vertebra. This suggests that whiplash patients have signs of local persistent peripheral tissue inflammation, which may potentially serve as a diagnostic biomarker. The present investigation demonstrates that painful processes in the periphery can be objectively visualized and quantified with PET and that 11C-D-deprenyl is a promising tracer for these purposes. PMID:21541010

  3. Elevated [11C]-D-deprenyl uptake in chronic Whiplash Associated Disorder suggests persistent musculoskeletal inflammation.

    PubMed

    Linnman, Clas; Appel, Lieuwe; Fredrikson, Mats; Gordh, Torsten; Söderlund, Anne; Långström, Bengt; Engler, Henry

    2011-01-01

    There are few diagnostic tools for chronic musculoskeletal pain as structural imaging methods seldom reveal pathological alterations. This is especially true for Whiplash Associated Disorder, for which physical signs of persistent injuries to the neck have yet to be established. Here, we sought to visualize inflammatory processes in the neck region by means Positron Emission Tomography using the tracer (11)C-D-deprenyl, a potential marker for inflammation. Twenty-two patients with enduring pain after a rear impact car accident (Whiplash Associated Disorder grade II) and 14 healthy controls were investigated. Patients displayed significantly elevated tracer uptake in the neck, particularly in regions around the spineous process of the second cervical vertebra. This suggests that whiplash patients have signs of local persistent peripheral tissue inflammation, which may potentially serve as a diagnostic biomarker. The present investigation demonstrates that painful processes in the periphery can be objectively visualized and quantified with PET and that (11)C-D-deprenyl is a promising tracer for these purposes. PMID:21541010

  4. Occurrence and co-existence of localized musculoskeletal symptoms and findings in work-attending orchestra musicians - an exploratory cross-sectional study

    PubMed Central

    2012-01-01

    Background Due to ergonomic exposure musicians are at risk of work-related musculoskeletal disorders in the neck, back, and upper extremities. The literature confirms musculoskeletal problems in these anatomic regions among orchestra musicians. Methods An explorative cross-sectional study among 441 musicians from six Danish symphony orchestras; 216 underwent a clinical examination constructed for the purpose. Prior to the examination the musicians rated their maximally perceived trouble within the last week on a scheme blinded to the examiner. Accessibility to the clinical examination differed between orchestras. The aims were to assess the prevalence of 1) perceived symptoms within the previous week in the neck, back and limbs and of 2) clinical findings in the neck, back, and upper extremities, and 3) to investigate the co-existence of the perceived symptoms and clinical findings. Results Symptoms and findings were most common in the neck, back, and shoulders. Due to a poor co-existence between self-reported symptoms and clinical findings musicians experiencing bodily trouble could not be identified through this clinical examination. Free accessibility to the examination was of major importance to participation. Conclusions In compliance with the purpose, perceived symptoms within the previous week and present clinical findings were assessed. Although both symptoms and findings were most frequent in the neck, back, and shoulders the co-existence of anatomically localized symptoms and findings was generally quite poor in this study. Discrepancy between symptoms and findings might be caused by the participants currently attending work and therefore being relatively healthy, and the fluctuating nature of musculoskeletal problems. Furthermore from a comparison of different measuring units - self-reported symptoms being period prevalence rates and clinical findings point prevalence rates; a bias which may also be inherent in similar studies combining self

  5. Musculoskeletal manifestations of the antiphospholipid syndrome.

    PubMed

    Noureldine, M H A; Khamashta, M A; Merashli, M; Sabbouh, T; Hughes, G R V; Uthman, I

    2016-04-01

    The scope of clinical and laboratory manifestations of the antiphospholipid syndrome (APS) has increased dramatically since its discovery in 1983, where any organ system can be involved. Musculoskeletal complications are consistently reported in APS patients, not only causing morbidity and mortality, but also affecting their quality of life. We reviewed all English papers on APS involvement in the musculoskeletal system using Google Scholar and Pubmed; all reports are summarized in a table in this review. The spectrum of manifestations includes arthralgia/arthritis, avascular necrosis of bone, bone marrow necrosis, complex regional pain syndrome type-1, muscle infarction, non-traumatic fractures, and osteoporosis. Some of these manifestations were reported in good quality studies, some of which showed an association between aPL-positivity and the occurrence of these manifestations, while others were merely described in case reports. PMID:26923284

  6. Operational and Research Musculoskeletal Summit: Summit Recommendations

    NASA Technical Reports Server (NTRS)

    Scheuring, Richard A.; Walton, Marlei; Davis-Street, Janis; Smaka, Todd J.; Griffin, DeVon

    2006-01-01

    The Medical Informatics and Health Care Systems group in the Office of Space Medicine at NASA Johnson Space Center (JSC) has been tasked by NASA with improving overall medical care on the International Space Station (ISS) and providing insights for medical care for future exploration missions. To accomplish this task, a three day Operational and Research Musculoskeletal Summit was held on August 23-25th, 2005 at Space Center Houston. The purpose of the summit was to review NASA#s a) current strategy for preflight health maintenance and injury screening, b) current treatment methods in-flight, and c) risk mitigation strategy for musculoskeletal injuries or syndromes that could occur or impact the mission. Additionally, summit participants provided a list of research topics NASA should consider to mitigate risks to astronaut health. Prior to the summit, participants participated in a web-based pre-summit forum to review the NASA Space Medical Conditions List (SMCL) of musculoskeletal conditions that may occur on ISS as well as the resources currently available to treat them. Data from the participants were compiled and integrated with the summit proceedings. Summit participants included experts from the extramural physician and researcher communities, and representatives from NASA Headquarters, the astronaut corps, JSC Medical Operations and Human Adaptations and Countermeasures Offices, Glenn Research Center Human Research Office, and the Astronaut Strength, Conditioning, and Reconditioning (ASCR) group. The recommendations in this document are based on a summary of summit discussions and the best possible evidence-based recommendations for musculoskeletal care for astronauts while on the ISS, and include recommendati ons for exploration class missions.

  7. The WISTAH hand study: A prospective cohort study of distal upper extremity musculoskeletal disorders

    PubMed Central

    2012-01-01

    Background Few prospective cohort studies of distal upper extremity musculoskeletal disorders have been performed. Past studies have provided somewhat conflicting evidence for occupational risk factors and have largely reported data without adjustments for many personal and psychosocial factors. Methods/design A multi-center prospective cohort study was incepted to quantify risk factors for distal upper extremity musculoskeletal disorders and potentially develop improved methods for analyzing jobs. Disorders to analyze included carpal tunnel syndrome, lateral epicondylalgia, medial epicondylalgia, trigger digit, deQuervain’s stenosing tenosynovitis and other tendinoses. Workers have thus far been enrolled from 17 different employment settings in 3 diverse US states and performed widely varying work. At baseline, workers undergo laptop administered questionnaires, structured interviews, two standardized physical examinations and nerve conduction studies to ascertain demographic, medical history, psychosocial factors and current musculoskeletal disorders. All workers’ jobs are individually measured for physical factors and are videotaped. Workers are followed monthly for the development of musculoskeletal disorders. Repeat nerve conduction studies are performed for those with symptoms of tingling and numbness in the prior six months. Changes in jobs necessitate re-measure and re-videotaping of job physical factors. Case definitions have been established. Point prevalence of carpal tunnel syndrome is a combination of paraesthesias in at least two median nerve-served digits plus an abnormal nerve conduction study at baseline. The lifetime cumulative incidence of carpal tunnel syndrome will also include those with a past history of carpal tunnel syndrome. Incident cases will exclude those with either a past history or prevalent cases at baseline. Statistical methods planned include survival analyses and logistic regression. Discussion A prospective cohort study of

  8. Functional imaging of the musculoskeletal system

    PubMed Central

    2015-01-01

    Functional imaging, which provides information of how tissues function rather than structural information, is well established in neuro- and cardiac imaging. Many musculoskeletal structures, such as ligaments, fascia and mineralized bone, have by definition a mainly structural role and clearly don’t have the same functional capacity as the brain, heart, liver or kidney. The main functionally responsive musculoskeletal tissues are the bone marrow, muscle and nerve and, as such, magnetic resonance (MR) functional imaging has primarily addressed these areas. Proton or phosphorus spectroscopy, other fat quantification techniques, perfusion imaging, BOLD imaging, diffusion and diffusion tensor imaging (DTI) are the main functional techniques applied. The application of these techniques in the musculoskeletal system has mainly been research orientated where they have already greatly enhanced our understanding of marrow physiology, muscle physiology and neural function. Going forwards, they will have a greater clinical impact helping to bridge the disconnect often seen between structural appearances and clinical symptoms, allowing a greater understanding of disease processes and earlier recognition of disease, improving prognostic prediction and optimizing the monitoring of treatment effect. PMID:26029633

  9. Magnetic resonance--guided musculoskeletal interventional radiology.

    PubMed

    Carrino, John A; Blanco, Roberto

    2006-06-01

    As an imaging modality, magnetic resonance (MR) guidance has great potential to direct diagnostic and therapeutic procedures performed in the musculoskeletal region and influence patient management. MR-guided interventional procedures involving bone, soft tissue, intervertebral discs, and joints are safe and sufficiently effective for use in clinical practice. This article discusses and illustrates the procedural characteristics and techniques when performing MR-guided musculoskeletal interventions. Biopsy procedures are similar to other modalities for bone and soft tissue lesions. MR guidance is advantageous if the lesion is not visible by other modalities and for regions adjacent to hardware and implants, subselective targeting, intra-articular locations, and periarticular cyst aspiration. MR guidance has also been used for a host of spine injections and pain management procedures such as sacroiliac joint injections, discography, transforaminal epidural injection, selective nerve block, sympathetic block, celiac plexus block, and facet joint cryotherapy neurotomies. Future directions of clinical applications include tumor ablation and multimodality procedure suites. MR-guided musculoskeletal procedures will continue to be a growth area particularly for the diagnosis and treatment of bone and soft tissue neoplasia. PMID:16586322

  10. Musculoskeletal health, frailty and functional decline.

    PubMed

    Milte, R; Crotty, M

    2014-06-01

    Frailty in older people is associated with a vulnerability to adverse events. While ageing is associated with a loss of physiological reserves, identifying those with the syndrome of frailty has the potential to assist clinicians to tailor treatments to those at the risk of future decline into disability with an increased risk of complications, morbidity and mortality. Sarcopenia is a key component of the frailty syndrome and on its own puts older people at risk of fragility fractures; however, the clinical syndrome of frailty affects the musculoskeletal and non-musculoskeletal systems. Hip fractures are becoming a prototype condition in the study of frailty. Following a hip fracture, many of the interventions are focused on limiting mobility disability and restoring independence with activities of daily living, but there are multiple factors to be addressed including osteoporosis, sarcopenia, delirium and weight loss. Established techniques of geriatric evaluation and management allow systematic assessment and intervention on multiple components by multidisciplinary teams and deliver the best outcomes. Using the concept of frailty to identify older people with musculoskeletal problems as being at the risk of a poor outcome assists in treatment planning and is likely to become more important as effective pharmacological treatments for sarcopenia emerge. This review will focus on the concept of frailty and its relationship with functional decline, as well as describing its causes, prevalence, risk factors, potential clinical applications and treatment strategies. PMID:25481423

  11. Mitigation of musculoskeletal problems and body discomfort of agricultural workers through educational intervention.

    PubMed

    Vyas, Rekha

    2012-01-01

    Farming is a physically arduous occupation that places farm workers' at potential risk of musculoskeletal disorders, which has been observed to impose a greater impact on their health. Each activity in agriculture brings about certain stress and strain on bones and muscles leading to work-related musculoskeletal disorders which can lead to several permanent diseases and disabilities. The purpose of analyzing musculoskeletal problems among male and female workers engaged in agriculture was to know about the risk factors dangerous to health so that interventions can be planned for mitigating them thereby increasing the efficiency of work. Educational intervention included audio-visual aids as well as printed literature. It was hoped that awareness of these factors through dissemination of information would contribute at preventing hazards amongst farmers and their families. The results revealed that the workers reported very severe to severe pain in low back while performing agricultural activities. Weeding was the most strenuous activity for females and threshing crop for males. Training and education on MSDs through educational intervention proved that the knowledge of the farm workers could be enhanced and can help reduce risk of many musculoskeletal problems. It can be help in empowering the community and mitigate MSDs in agriculture. PMID:22317076

  12. Impact of joint laxity and hypermobility on the musculoskeletal system.

    PubMed

    Wolf, Jennifer Moriatis; Cameron, Kenneth L; Owens, Brett D

    2011-08-01

    Excessive joint laxity, or hypermobility, is a common finding of clinical importance in the management of musculoskeletal conditions. Hypermobility is common in young patients and in general is associated with an increased incidence of musculoskeletal injury. Hypermobility has been implicated in ankle sprains, anterior cruciate ligament injury, shoulder instability, and osteoarthritis of the hand. Patients with hypermobility and musculoskeletal injuries often seek care for diffuse musculoskeletal pain and injuries with no specific inciting event. Orthopaedic surgeons and other healthcare providers should be aware of the underlying relationship between hypermobility and musculoskeletal injury to avoid unnecessary diagnostic tests and inappropriate management. Prolonged therapy and general conditioning are typically required, with special emphasis on improving strength and proprioception to address symptoms and prevent future injury. Orthopaedic surgeons must recognize the implications of joint mobility syndromes in the management and rehabilitation of several musculoskeletal injuries and orthopaedic disorders. PMID:21807914

  13. Musculoskeletal modelling in dogs: challenges and future perspectives.

    PubMed

    Dries, Billy; Jonkers, Ilse; Dingemanse, Walter; Vanwanseele, Benedicte; Vander Sloten, Jos; van Bree, Henri; Gielen, Ingrid

    2016-05-18

    Musculoskeletal models have proven to be a valuable tool in human orthopaedics research. Recently, veterinary research started taking an interest in the computer modelling approach to understand the forces acting upon the canine musculoskeletal system. While many of the methods employed in human musculoskeletal models can applied to canine musculoskeletal models, not all techniques are applicable. This review summarizes the important parameters necessary for modelling, as well as the techniques employed in human musculoskeletal models and the limitations in transferring techniques to canine modelling research. The major challenges in future canine modelling research are likely to centre around devising alternative techniques for obtaining maximal voluntary contractions, as well as finding scaling factors to adapt a generalized canine musculoskeletal model to represent specific breeds and subjects. PMID:27102147

  14. Frequency of neck and shoulder pain and use of adjustable computer workstation among bankers

    PubMed Central

    Shabbir, Maryam; Rashid, Sajid; Umar, Bilal; Ahmad, Aqeel; Ehsan, Sarah

    2016-01-01

    Background & Objective: Neck and shoulder are the most susceptible areas for developing musculoskeletal symptoms among computer users. The modifiable risk factors for these work related musculoskeletal disorders include physical office environment and psychosocial work related factors. Computer workstation layout had been shown to be an important physical aspect of work environment that influences the upper quadrant symptoms. Our objective was to find the frequency of neck and shoulder pain and use of adjustable computer workstation among bankers of Islamabad/Rawalpindi/Multan Methods: A cross sectional study was conducted and 120 participants were questioned. Purposive sampling technique was used in this study. Maastricht Upper Extremity Questionnaire (MUEQ) was remodeled and important questions were extracted from its detailed version. The tool was then validated by taking expert opinion. Frequencies and percentages were calculated for categorical variables. Results: Pain in the neck during working hours was experienced by 71.67% of the respondents and 48.33% of the participants had experienced shoulder pain during working hours. Adjustable keyboards were used by 16.67% of respondents. Back care material was used by 40% bankers. Adjustable chairs were used by 95.83% of the participants. Only 3% of the bankers did not have chairs with adjustable heights. Chairs with adjustable armrests were used by 25% bankers. Conclusion: Neck and shoulder pain are common occurrences among bankers. Most of the components of workstations of bankers were adjustable but some of them still need attention. PMID:27182253

  15. Clinical impact of radiographic carotid artery involvement in neck metastases from head and neck cancer.

    PubMed

    Teymoortash, A; Rassow, S; Bohne, F; Wilhelm, T; Hoch, S

    2016-04-01

    The treatment of lymph node metastases involving the carotid artery is controversial. The aim of the present study was to determine the outcomes of head and neck cancer patients with radiographic carotid artery involvement in neck metastases. A total of 27 patients with head and neck cancer and radiologically diagnosed advanced metastases involving the common carotid artery or internal carotid artery were enrolled. All patients underwent a primary or salvage neck dissection and surgical carotid peeling. The oncological outcome and survival of all patients were analyzed. Loco-regional control was observed in 13 of the 27 patients (48.1%). During follow-up, five patients (18.5%) developed second primaries and 11 (40.7%) developed distant metastases. The survival time was poor independent of regional control. The median overall survival was 1.55 years and disease-free survival was 0.71 year. Radiographic carotid artery involvement in neck metastases in head and neck cancer appears to correlate with a poor long-term prognosis, with a high rate of distant metastases despite loco-regional control. PMID:26723499

  16. DIFFERENTIAL ANALYZER

    DOEpatents

    Sorensen, E.G.; Gordon, C.M.

    1959-02-10

    Improvements in analog eomputing machines of the class capable of evaluating differential equations, commonly termed differential analyzers, are described. In general form, the analyzer embodies a plurality of basic computer mechanisms for performing integration, multiplication, and addition, and means for directing the result of any one operation to another computer mechanism performing a further operation. In the device, numerical quantities are represented by the rotation of shafts, or the electrical equivalent of shafts.

  17. The role of platelet rich plasma in musculoskeletal science

    PubMed Central

    Ahmad, Zafar; Howard, Daniel; Brooks, Roger A; Wardale, John; Henson, Fran MD; Getgood, Alan; Rushton, Neil

    2012-01-01

    The idea of using platelet rich plasma (PRP) in medicine has been around since the 1970s. It is only more recently that its use has been employed in the area of musculoskeletal science. Platelet rich plasma in this area has received much media attention being used by many celebrity sports athletes for musculoskeletal injuries. Therefore it is important for the musculoskeletal practitioner to be aware of the concepts surrounding its use and application. In this article we cover what platelet rich plasma is, how it is prepared and administered, its potential clinical application, and what the current literature discusses in the various areas of musculoskeletal science. PMID:22768374

  18. Effect of Neurocognition and Concussion on Musculoskeletal Injury Risk

    PubMed Central

    Herman, Daniel C.; Zaremski, Jason L.; Vincent, Heather K.; Vincent, Kevin R.

    2015-01-01

    Research regarding musculoskeletal injury risk has focused primarily on anatomical, neuromuscular, hormonal, and environmental risk factors; however, subsequent injury risk screening and intervention programs have been largely limited to neuromuscular factors and have faced challenges in both implementation and efficacy. Recent studies indicate that poor neurocognitive performance, either at baseline or in the aftermath of a concussion, is associated with elevated risk of musculoskeletal injury. Despite the relatively limited current understanding regarding the nature of the relationship between different aspects of neurocognitive performance and musculoskeletal injury risk, this is a promising area of research that may yield significant advances in musculoskeletal injury risk stratification, rehabilitation, and prevention. PMID:25968852

  19. [Cumulative annual incidence of disabling work-related musculoskeletal disorders in an urban area of Brazil].

    PubMed

    Souza, Norma Suely Souto; Santana, Vilma Sousa

    2011-11-01

    This study focused on the annual cumulative incidence (ACI) of disabling work-related musculoskeletal disorders affecting the neck and/or upper limbs (ULMSD) among workers covered by the National Social Insurance System in the city of Salvador, Bahia State, Brazil. Cases were workers who received disability compensation benefits when unable to work due to ULMSD, during the year 2008. The data were obtained from the administrative systems of the National Social Insurance Institute and Ministry of Labor and Employment. ACI was 15 per 10,000 workers. Increased ACI of ULMSD was associated with female gender, lower income, and work in financial activities or manufacturing. Women earning the minimum wage (US$ 64.00 per month) or less had the highest ACI of ULMSD (123 per 10,000), suggesting inequalities in the occurrence of these disorders. The study indicates the need to prioritize preventive actions focusing on ergonomics and work organization, early diagnosis, treatment, and rehabilitation. PMID:22124490

  20. Using peer-assisted learning to teach and evaluate residents' musculoskeletal skills.

    PubMed

    Martinez, Johanna; Harris, Christina; Jalali, Cathy; Tung, Judy; Meyer, Robert

    2015-01-01

    Although direct observation and corrective feedback are established methods of increasing select aspects of residents' musculoskeletal (MSK) clinical skills, the evaluation and management of patients with MSK complaints remains an underemphasized part of internal medicine training. This paper reports on the development of an innovative peer-assisted learning (PAL) model to teach five MSK areas (back, knee, shoulder, neck, or hip pain). Based on data from 42 participating interns and 44 senior residents from an urban US academic medical center, results from an objective structured clinical exam (OSCE) demonstrate gains in both knowledge and self-reported confidence in MSK skills. Moreover, subsequent focus group results reveal a strong preference for the PAL model. In conclusion, an educational module that utilizes the OSCE format holds much promise for teaching MSK skills to both intern and senior residents. PMID:26028495

  1. Work-related musculoskeletal disorders, job stressors and gender responses in foundry industry.

    PubMed

    Sharma, Rohit; Singh, Ranjit

    2014-01-01

    The main aim of this paper was to identify job stressors, gender responses and association of psychosocial work stressors with prevalence of work related musculoskeletal disorders (MSDs) among foundry workers. The data were obtained with ergonomics checklist using Likert scale. The results of this study showed a high prevalence of MSDs among workers. The male workers were more prone to pain in neck while the female workers were more prone to MSDs in upper back and shoulders. Correlation analysis showed significant relationship of dimensions of work aspects with pain and discomfort. It proved that the work-related MSDs are the results of interaction of multiple stressors associated with work and work environment, and other personal factors. ANOVA indicated that the perception of work aspects as stressors differed significantly between male and female workers. PMID:24934431

  2. Prevalence of work-related musculoskeletal disorders among the brick field workers of West Bengal, India.

    PubMed

    Das, Banibrata

    2014-01-01

    Brick field industry is one of the most important and oldest industries in India, where millions of workers suffered from work-related musculoskeletal disorders (WMSDs). The main aim of the present investigation was to assess the prevalence of WMSDs among brick field workers. A cross-sectional study was conducted on 216 brick field workers. A modified Nordic questionnaire was applied among them. In brick making industry, the workers adopt different unfavorable actions, such as frequent bending; bending and twisting of the body; and working above shoulder height, which may lead to severe pain in different parts of the body, especially lower back (brick carriers: 90%; moulders: 92%; fireman: 75%; stackers: 88%) and neck (brick carriers: 89%; moulders: 88%; fireman: 54%; stackers: 72%), It was concluded from the study that health of the brick field workers was highly affected due to working in different awkward postures for long periods. PMID:24499251

  3. Gas Analyzer

    NASA Technical Reports Server (NTRS)

    1989-01-01

    The M200 originated in the 1970's under an Ames Research Center/Stanford University contract to develop a small, lightweight gas analyzer for Viking Landers. Although the unit was not used on the spacecraft, it was further developed by The National Institute for Occupational Safety and Health (NIOSH). Three researchers from the project later formed Microsensor Technology, Inc. (MTI) to commercialize the analyzer. The original version (Micromonitor 500) was introduced in 1982, and the M200 in 1988. The M200, a more advanced version, features dual gas chromatograph which separate a gaseous mixture into components and measure concentrations of each gas. It is useful for monitoring gas leaks, chemical spills, etc. Many analyses are completed in less than 30 seconds, and a wide range of mixtures can be analyzed.

  4. Process Analyzer

    NASA Technical Reports Server (NTRS)

    1994-01-01

    The ChemScan UV-6100 is a spectrometry system originally developed by Biotronics Technologies, Inc. under a Small Business Innovation Research (SBIR) contract. It is marketed to the water and wastewater treatment industries, replacing "grab sampling" with on-line data collection. It analyzes the light absorbance characteristics of a water sample, simultaneously detects hundreds of individual wavelengths absorbed by chemical substances in a process solution, and quantifies the information. Spectral data is then processed by ChemScan analyzer and compared with calibration files in the system's memory in order to calculate concentrations of chemical substances that cause UV light absorbance in specific patterns. Monitored substances can be analyzed for quality and quantity. Applications include detection of a variety of substances, and the information provided enables an operator to control a process more efficiently.

  5. Musculoskeletal Symptoms in Nurses in the Early Implementation Phase of California's Safe Patient Handling Legislation.

    PubMed

    Lee, Soo-Jeong; Lee, Joung Hee; Gershon, Robyn R M

    2015-06-01

    Musculoskeletal injuries and symptoms are prevalent in nurses and are largely associated with strenuous patient handling. In 2011, California enacted legislation that required acute-care hospitals to implement safe patient handling (SPH) policies and programs. To assess the early phase of this legislation, we conducted an epidemiological assessment of organizational SPH practices, musculoskeletal symptoms, and perceptions in a random sample of 396 registered nurses. Among those who worked in hospitals and had patient handling duties (n = 220), the 12 month prevalence of work-related musculoskeletal symptoms was 69% (lower back 54%, neck 41%, shoulders 34%, and hands/wrists 26%). Twenty-two percent of the nurses reported that their hospitals had a "no-lift" policy, 37% reported that their hospitals had lift teams, and 61% reported the availability of mechanical lift equipment such as floor or ceiling lifts. Nurses whose facilities employed lift teams were significantly less likely to report low back pain (OR = 0.54, 95% CI [0.30-0.97]). Nurses whose units had ceiling lifts were significantly less likely to report shoulder pain than nurses with no access to lifts (OR = 0.32, 95% CI [0.10-0.98]). Roughly 60% of respondents were aware of the SPH law, and 33% reported changes in their hospital's patient handling policies or programs since the law went into effect. Hospital SPH practices reported by the nurses in our sample were generally sub-optimal, but our findings suggest positive effects of elements required by SPH legislation. These data will serve as the baseline for future evaluation of the impact of this law in California. PMID:25914203

  6. Work-Related Musculoskeletal Disorders at Two Textile Factories in Edirne, Turkey

    PubMed Central

    Berberoğlu, Ufuk; Tokuç, Burcu

    2013-01-01

    Objective: “Work-related musculoskeletal disorders” (WMSDs) is a term used to describe a painful or disabling injury to the muscles, tendons or nerves caused or aggravated by work. WMSDs are preventable or at least can be delayed. The aim of this study to determine the work related musculo-skeletal disorders and risk levels of the these factory workers. Study Design: Cross sectional study. Material and Methods: This is a cross-sectional study conducted at two textile factories in Edirne, Turkey and it involved 381 workers. The questionnaire used for data collection consisted of two parts. The first part described some socio-demographic features, working conditions and health problems of workers in the previous four weeks. In the second part, a Rapid Upper Limb Assessment (RULA) Employer Assessment worksheet was used. Results: In the assessment of the upper limbs of the workers, the arm/wrist score (AWS) is 5.9±1.7 (3–11); neck, trunk, legs score (NTLS) is 5.3±2.5 (3–11); and total score (TS) is 5.5±1.3 (3–7). The ages of the workers are significantly associated with higher RULA scores (r=0.207, p=0.000). AWS, NTLS and TS of the women workers were found to be statistically significantly lower than for the men. Conclusion: Musculoskeletal disorders are a common problem among textile workers. Employers can prevent WMSD hazards by properly designing the jobs or workstations and selecting the appropriate tools or equipment. PMID:25207064

  7. Work related and psychological determinants of multi-site musculoskeletal pain

    PubMed Central

    Solidaki, Eleni; Chatzi, Leda; Bitsios, Panos; Markatzi, Irini; Plana, Estel; Castro, Francesc; Palmer, Keith; Coggon, David; Kogevinas, Manolis

    2011-01-01

    Objectives Musculoskeletal pain is associated with occupational physical activities and psychosocial risk factors. We evaluated the relative importance of work-related and psychological determinants of the number of anatomical sites affected by musculoskeletal pain in a cross-sectional survey. Methods The survey focused on musculoskeletal pain in six body regions (low-back, neck, shoulder, elbow, wrist/hand and knee) among 224 nurses, 200 office workers and 140 postal clerks in Crete (response rate 95%). Information was collected about demographic characteristics, occupational physical load, psychosocial aspects of work, perceptions about causes of pain, mental health, tendency to somatize, and experience of pain in the past 12 months. Poisson regression was used to assess associations of risk factors with the number of painful anatomical sites and interactions were explored using classification and regression trees (CART). Results Two-thirds of the study sample reported pain in at least two body sites during the past 12 months, and in 23%, more than three sites were affected. The number of painful anatomical sites was strongly related to both physical load at work and somatizing tendency (with relative risks increased five-fold or more for frequent and disabling multisite pain) , and was also significantly associated with work-related psychosocial factors, and beliefs about work causation. The CART analysis suggested that in the population studied, the leading determinant of the number of painful body sites was somatizing tendency. Conclusions In the population studied, pain at multiple anatomical sites is common, and is strongly associated with somatizing tendency, which may have a more important influence on multi-site pain than on pain that is limited to a single anatomical site. PMID:20011982

  8. Reliability and Validity of the Visual, Musculoskeletal, and Balance Complaints Questionnaire

    PubMed Central

    Lundqvist, Lars-Olov; Zetterlund, Christina; Richter, Hans O.

    2016-01-01

    ABSTRACT Purpose To evaluate the reliability and validity of the 15-item Visual, Musculoskeletal, and Balance Complaints Questionnaire (VMB) for people with visual impairments, using confirmatory factor analysis (CFA) and with Rasch analysis for use as an outcome measure. Methods Two studies evaluated the VMB. In Study 1, VMB data were collected from 1249 out of 3063 individuals between 18 and 104 years old who were registered at a low vision center. CFA evaluated VMB factor structure and Rasch analysis evaluated VMB scale properties. In Study 2, a subsample of 52 individuals between 27 and 67 years old with visual impairments underwent further measurements. Visual clinical assessments, neck/scapular pain, and balance assessments were collected to evaluate the convergent validity of the VMB (i.e. the domain relationship with other, theoretically predicted measures). Results CFA supported the a priori three-factor structure of the VMB. The factor loadings of the items on their respective domains were all statistically significant. Rasch analysis indicated disordered categories and the original 10-point scale was subsequently replaced with a 5-point scale. Each VMB domain fitted the Rasch model, showing good metric properties, including unidimensionality (explained variances ≥66% and eigenvalues <1.9), person separation (1.86 to 2.29), reliability (0.87 to 0.94), item fit (infit MnSq’s >0.72 and outfit MnSq’s <1.47), targeting (0.30 to 0.50 logits), and insignificant differential item functioning (all DIFs but one <0.50 logits) from gender, age, and visual status. The three VMB domains correlated significantly with relevant visual, musculoskeletal, and balance assessments, demonstrating adequate convergent validity of the VMB. Conclusions The VMB is a simple, inexpensive, and quick yet reliable and valid way to screen and evaluate concurrent visual, musculoskeletal, and balance complaints, with contribution to epidemiological and intervention research and

  9. Blood Analyzer

    NASA Technical Reports Server (NTRS)

    1992-01-01

    In the 1970's, NASA provided funding for development of an automatic blood analyzer for Skylab at the Oak Ridge National Laboratory (ORNL). ORNL devised "dynamic loading," which employed a spinning rotor to load, transfer, and analyze blood samples by centrifugal processing. A refined, commercial version of the system was produced by ABAXIS and is marketed as portable ABAXIS MiniLab MCA. Used in a doctor's office, the equipment can perform 80 to 100 chemical blood tests on a single drop of blood and report results in five minutes. Further development is anticipated.

  10. Incidence and Prevalence of Musculoskeletal Injury in Ballet

    PubMed Central

    Smith, Preston J.; Gerrie, Brayden J.; Varner, Kevin E.; McCulloch, Patrick C.; Lintner, David M.; Harris, Joshua D.

    2015-01-01

    Background Most published studies on injuries in the ballet dancer focus on the lower extremity. The rigors of this activity require special training and care. By understanding prevalence and injury pattern to the musculoskeletal system, targeted prevention and treatment for this population can be developed. Purpose To determine the incidence and prevalence of musculoskeletal injuries in ballet. Study Design Systematic review; Level of evidence, 4. Methods A systematic review registered with PROSPERO was performed using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Level 1 through 4 evidence studies reporting incidence of musculoskeletal injuries in male and female ballet dancers were included, with the numbers and types of injuries extracted from each. Injury rates were recorded and calculated based on professional status, sex, and nature of injury. Incidence was defined as number of injuries sustained over a specific time. Prevalence was defined as proportion of subjects with an injury at a given point in time. Results The studies analyzed reported injury incidence or prevalence in more than 1365 amateur and 900 professional dancers. The mean age was 16.2 years among amateur and 27.0 years among professional dancers. The incidence of injury among amateur dancers was 0.99 and 1.09 injuries per 1000 dance hours in males and females, respectively; 75% of injuries were overuse, with similar rates among males and females. In professional dancers, the incidence of injury was 1.06 and 1.46 injuries per 1000 dance hours in males and females, respectively, and 64% of female injuries were overuse, compared with 50% in males (P < .001). Only 3 studies provided prevalence data, including 62% prevalence of lumbosacral pain, 58% painful snapping hip, and 29% patellofemoral pain. Lower extremity injuries comprised 66% to 91% of all injuries, with the foot and ankle accounting for 14% to 57%. Conclusion The overall incidence of injury

  11. Development of a taxonomy to describe massage treatments for musculoskeletal pain

    PubMed Central

    Sherman, Karen J; Dixon, Marian W; Thompson, Diana; Cherkin, Daniel C

    2006-01-01

    Background One of the challenges in conducting research in the field of massage and bodywork is the lack of consistent terminology for describing the treatments given by massage therapists. The objective of this study was to develop a taxonomy to describe what massage therapists actually do when giving a massage to patients with musculoskeletal pain. Methods After conducting a review of the massage treatment literature for musculoskeletal pain, a list of candidate techniques was generated for possible inclusion in the taxonomy. This list was modified after discussions with a senior massage therapist educator and seven experienced massage therapists participating in a study of massage for neck pain. Results The taxonomy was conceptualized as a three level classification system, principal goals of treatment, styles, and techniques. Four categories described the principal goal of treatment (i.e., relaxation massage, clinical massage, movement re-education and energy work). Each principal goal of treatment could be met using a number of different styles, with each style consisting of a number of specific techniques. A total of 36 distinct techniques were identified and described, many of which could be included in multiple styles. Conclusion A new classification system is presented whereby practitioners using different styles of massage can describe the techniques they employ using consistent terminology. This system could help facilitate standardized reporting of massage interventions. PMID:16796753

  12. Effects of environmental intervention on sedentary time, musculoskeletal comfort and work ability in office workers.

    PubMed

    Gao, Ying; Nevala, Nina; Cronin, Neil J; Finni, Taija

    2016-09-01

    Sit-stand workstations offer a potential strategy to reduce prolonged occupational sitting. This controlled intervention study examined the effects of an environmental intervention on occupational sedentary time, musculoskeletal comfort and work ability, and the usability of sit-stand workstations in office work via a self-reported questionnaire. The intervention group (n = 24) used sit-stand workstations during the 6-month intervention period, and the control group (n = 21) used traditional sitting workstations. The results showed that working at sit-stand workstations can reduce sitting time significantly compared to control workstations (-6.7% vs. 5.0%, p = .019), which is reallocated mostly to standing (r = -0.719, p < .001). Sit-stand workstations improved perceived musculoskeletal comfort in the neck and shoulders (p = .028), as well as work ability (p = .022). The majority of intervention subjects rated sit-stand workstation adjustability as good (83.3%), and 75.0% were satisfied with the workstation. About 41.7% of the intervention participants, who were exclusively female, used the sit-stand function on a daily basis. While the environmental change alone was effective, it is likely that promoting the daily use of sit-stand workstations with counselling would lead to even more substantial positive effects. PMID:26529590

  13. Musculoskeletal disorder risk as a function of vehicle rotation angle during assembly tasks.

    PubMed

    Ferguson, Sue A; Marras, Williams S; Gary Allread, W; Knapik, Gregory G; Vandlen, Kimberly A; Splittstoesser, Riley E; Yang, Gang

    2011-07-01

    Musculoskeletal disorders (MSD) are costly and common problem in automotive manufacturing. The research goal was to quantify MSD exposure as a function of vehicle rotation angle and region during assembly tasks. The study was conducted at the Center for Occupational Health in Automotive Manufacturing (COHAM) Laboratory. Twelve subjects participated in the study. The vehicle was divided into seven regions, (3 interior, 2 underbody and 2 engine regions) representative of work areas during assembly. Three vehicle rotation angles were examined for each region. The standard horizontal assembly condition (0° rotation) was the reference frame. Exposure was assessed on the spine loads and posture, shoulder posture and muscle activity, neck posture and muscle activity as well as wrist posture. In all regions, rotating the vehicle reduced musculoskeletal exposure. In five of the seven regions 45° of vehicle rotation represented the position that reduced MSD exposure most. Two of the seven regions indicated 90° of vehicle rotation had the greatest impact for reducing MSD exposure. This study demonstrated that vehicle rotation shows promise for reducing exposure to risk factors for MDS during automobile assembly tasks. PMID:21163463

  14. STEM CELL HOMING IN MUSCULOSKELETAL INJURY

    PubMed Central

    Fong, Li Shan E.; Chan, Casey K.; Goodman, Stuart B.

    2010-01-01

    The regenerative potential of injured adult tissue suggests the physiological existence of cells capable of participating in the reparative process. Recent studies indicate that stem-like cells residing in tissues contribute to tissue repair and are replenished by precursor bone marrow–derived cells. Mesenchymal stromal cells (MSC) are among the candidates for reparative cells. These cells can potentially be mobilized into the circulation in response to injury signals and exert their reparative effects at the site of injury. Current therapies for musculoskeletal injuries pose unavoidable risks which can impede full recovery. Trafficking of MSC to the injury site and their subsequent participation in the regenerative process is thought to be a natural healing response that can be imitated or augmented by enhancing the endogenous MSC pool with exogenously administered MSC. Therefore, a promising alternative to the existing strategies employed in the treatment of musculoskeletal injuries is to reinforce the inherent reparative capacity of the body by delivering MSC harvested from the patient’s own tissues to the site of injury. The aim of this review is to inform the reader of studies that have evaluated the intrinsic homing and regenerative abilities of MSC, with particular emphasis on the repair of musculoskeletal injuries. Research that supports the direct use of MSC (without in vitro differentiation into tissue-specific cells) will also be reported. Based on accruing evidence that the natural healing mechanism involves the recruitment of MSC and their subsequent reparative actions at the site of injury, as well as documented therapeutic response after the exogenous administration of MSC, the feasibility of the emerging strategy of instant stem-cell therapy will be proposed. PMID:20933277

  15. Use of botulinum toxin in musculoskeletal pain

    PubMed Central

    Singh, Jasvinder A

    2013-01-01

    Chronic musculoskeletal pain is a common cause of chronic pain, which is associated with a total cost of $635 billion per year in the U.S. Emerging evidence suggests an anti-nociceptive action of botulinum toxin, independent of its muscle paralyzing action. This review provides a summary of data from both non-randomized and randomized clinical studies of botulinum toxin in back pain and various osteoarticular conditions, including osteoarthritis, tennis elbow, low back pain and hand pain. Three randomized controlled trials (RCTs) of small sizes provide evidence of short-term efficacy of a single intra-articular injection of 100 units of botulinum toxin A (BoNT/A) for the relief of pain and the improvement of both function and quality of life in patients with chronic joint pain due to arthritis. Three RCTs studied intramuscular BoNT/A for tennis elbow with one showing a significant improvement in pain relief compared with placebo, another one showing no difference from placebo, and the third finding that pain and function improvement with BoNT/A injection were similar to those obtained with surgical release. One RCT of intramuscular BoNT/A for low back pain found improvement in pain and function compared to placebo. Single RCTs using local injections of BoNT in patients with either temporomandibular joint (TMJ) pain or plantar fasciitis found superior efficacy compared to placebo. One RCT of intramuscular BoNT/B in patients with hand pain and carpal tunnel syndrome found improvement in pain in both BoNT/B and placebo groups, but no significant difference between groups. Most evidence is based on small studies, but the use of BoNT is supported by a single, and sometimes up to three, RCTs for several chronic musculoskeletal pain conditions. This indicates that botulinum toxin may be a promising potential new treatment for chronic refractory musculoskeletal pain. Well-designed large clinical trials are needed. PMID:24715952

  16. Management of musculoskeletal dysfunction in infants

    PubMed Central

    YAO, DAN; DENG, XINGQIANG; WANG, MINGGUANG

    2016-01-01

    Excessive crying (or infant colic) is a common pain syndrome of infancy without any specific known aetiology or effective management. Many cases result in long-term poor sleep, behavioral problems and parental stress. The biomechanical aspects of this condition lack adequate investigation despite its strong link with assisted and/or difficult births. The present review focused on the current trends in the management of this mal-musculoskeletal health of infants associated with the condition of excessive crying. In addition, the risk factors associated with therapeutic procedures used to manage the above conditions were also discussed. PMID:27284288

  17. Fast musculoskeletal registration based on shape matching.

    PubMed

    Gilles, Benjamin; Pai, Dinesh K

    2008-01-01

    This paper presents a new method for computing elastic and plastic deformations in the context of discrete deformable model-based registration. Internal forces are estimated by averaging local transforms between reference and current particle positions. Our technique can accommodate large non-linear deformations, and is unconditionally stable. Moreover, it is simple to implement and versatile. We show how to tune model stiffness and computational cost, which is important for efficient registration, and demonstrate our technique in the complex problem of inter-patient musculoskeletal registration. PMID:18982681

  18. Emergency Magnetic Resonance Imaging of Musculoskeletal Trauma.

    PubMed

    Kumaravel, Manickam; Weathers, William M

    2016-05-01

    Musculoskeletal (MSK) trauma is commonly encountered in the emergency department. Computed tomography and radiography are the main forms of imaging assessment, but the use of magnetic resonance (MR) imaging has become more common in the emergency room (ER) setting for evaluation of low-velocity/sports-related injury and high-velocity injury. The superior soft tissue contrast and detail provided by MR imaging gives clinicians a powerful tool in the management of acute MSK injury in the ER. This article provides an overview of techniques and considerations when using MR imaging in the evaluation of some of the common injuries seen in the ER setting. PMID:27150325

  19. Atmosphere Analyzer

    NASA Technical Reports Server (NTRS)

    1982-01-01

    California Measurements, Inc.'s model PC-2 Aerosol Particle Analyzer is produced in both airborne and ground-use versions. Originating from NASA technology, it is a quick and accurate method of detecting minute amounts of mass loadings on a quartz crystal -- offers utility as highly sensitive detector of fine particles suspended in air. When combined with suitable air delivery system, it provides immediate information on the size distribution and mass concentrations of aerosols. William Chiang, obtained a NASA license for multiple crystal oscillator technology, and initially developed a particle analyzer for NASA use with Langley Research Center assistance. Later his company produced the modified PC-2 for commercial applications Brunswick Corporation uses the device for atmospheric research and in studies of smoke particles in Fires. PC-2 is used by pharmaceutical and chemical companies in research on inhalation toxicology and environmental health. Also useful in testing various filters for safety masks and nuclear installations.

  20. Oxygen analyzer

    DOEpatents

    Benner, W.H.

    1984-05-08

    An oxygen analyzer which identifies and classifies microgram quantities of oxygen in ambient particulate matter and for quantitating organic oxygen in solvent extracts of ambient particulate matter. A sample is pyrolyzed in oxygen-free nitrogen gas (N/sub 2/), and the resulting oxygen quantitatively converted to carbon monoxide (CO) by contact with hot granular carbon (C). Two analysis modes are made possible: (1) rapid determination of total pyrolyzable obtained by decomposing the sample at 1135/sup 0/C, or (2) temperature-programmed oxygen thermal analysis obtained by heating the sample from room temperature to 1135/sup 0/C as a function of time. The analyzer basically comprises a pyrolysis tube containing a bed of granular carbon under N/sub 2/, ovens used to heat the carbon and/or decompose the sample, and a non-dispersive infrared CO detector coupled to a mini-computer to quantitate oxygen in the decomposition products and control oven heating.

  1. Oxygen analyzer

    DOEpatents

    Benner, William H.

    1986-01-01

    An oxygen analyzer which identifies and classifies microgram quantities of oxygen in ambient particulate matter and for quantitating organic oxygen in solvent extracts of ambient particulate matter. A sample is pyrolyzed in oxygen-free nitrogen gas (N.sub.2), and the resulting oxygen quantitatively converted to carbon monoxide (CO) by contact with hot granular carbon (C). Two analysis modes are made possible: (1) rapid determination of total pyrolyzable oxygen obtained by decomposing the sample at 1135.degree. C., or (2) temperature-programmed oxygen thermal analysis obtained by heating the sample from room temperature to 1135.degree. C. as a function of time. The analyzer basically comprises a pyrolysis tube containing a bed of granular carbon under N.sub.2, ovens used to heat the carbon and/or decompose the sample, and a non-dispersive infrared CO detector coupled to a mini-computer to quantitate oxygen in the decomposition products and control oven heating.

  2. Process Analyzer

    NASA Technical Reports Server (NTRS)

    1993-01-01

    Under a NASA Small Business Innovation Research (SBIR) contract, Axiomatics Corporation developed a shunting Dielectric Sensor to determine the nutrient level and analyze plant nutrient solutions in the CELSS, NASA's space life support program. (CELSS is an experimental facility investigating closed-cycle plant growth and food processing for long duration manned missions.) The DiComp system incorporates a shunt electrode and is especially sensitive to changes in dielectric property changes in materials at measurements much lower than conventional sensors. The analyzer has exceptional capabilities for predicting composition of liquid streams or reactions. It measures concentrations and solids content up to 100 percent in applications like agricultural products, petrochemicals, food and beverages. The sensor is easily installed; maintenance is low, and it can be calibrated on line. The software automates data collection and analysis.

  3. MULTICHANNEL ANALYZER

    DOEpatents

    Kelley, G.G.

    1959-11-10

    A multichannel pulse analyzer having several window amplifiers, each amplifier serving one group of channels, with a single fast pulse-lengthener and a single novel interrogation circuit serving all channels is described. A pulse followed too closely timewise by another pulse is disregarded by the interrogation circuit to prevent errors due to pulse pileup. The window amplifiers are connected to the pulse lengthener output, rather than the linear amplifier output, so need not have the fast response characteristic formerly required.

  4. Treatment of Neck Pain

    PubMed Central

    Hurwitz, Eric L.; Cheng, Ivan; Carroll, Linda J.; Nordin, Margareta; Guzman, Jaime; Peloso, Paul; Holm, Lena W.; Côthé, Pierre; Hogg-Johnson, Sheilah; van der Velde, Gabrielle; Cassidy, J. David; Haldeman, Scott

    2008-01-01

    Study Design Best evidence synthesis. Objective To identify, critically appraise, and synthesize literature from 1980 through 2006 on surgical interventions for neck pain alone or with radicular pain in the absence of serious pathologic disease. Summary of Background Data There have been no comprehensive systematic literature or evidence-based reviews published on this topic. Methods We systematically searched Medline for literature published from 1980 to 2006 on percutaneous and open surgical interventions for neck pain. Publications on the topic were also solicited from experts in the field. Consensus decisions were made about the scientific merit of each article; those judged to have adequate internal validity were included in our Best Evidence Synthesis. Results Of the 31,878 articles screened, 1203 studies were relevant to the Neck Pain Task Force mandate and of these, 31 regarding treatment by surgery or injections were accepted as scientifically admissible. Radiofrequency neurotomy, cervical facet injections, cervical fusion and cervical arthroplasty for neck pain without radiculopathy are not supported by current evidence. We found there is support for short-term symptomatic improvement of radicular symptoms with epidural corticosteroids. It is not clear from the evidence that long-term out comes are improved with the surgical treatment of cervical radiculopathy compared to non operative measures. However, relatively rapid and substantial symptomatic relief after surgical treatment seems to be reliably achieved. It is not evident that one open surgical technique is clearly superior to others for radiculopathy. Cervical foramenal or epidural injections are associated with relatively frequent minor adverse events (5%–20%); however, serious adverse events are very uncommon (<1%). After open surgical procedures on the cervical spine, potentially serious acute complications are seen in approximately 4% of patients. Conclusion Surgical treatment and limited

  5. Physical therapists should integrate illness perceptions in their assessment in patients with chronic musculoskeletal pain; a qualitative analysis.

    PubMed

    van Wilgen, Paul; Beetsma, Anneke; Neels, Hedwig; Roussel, Nathalie; Nijs, Jo

    2014-06-01

    In the past decade, scientific evidence has shown that the biomedical model falls short in the treatment of patients with musculoskeletal pain. To understand musculoskeletal pain and a patient's health behavior and beliefs, physical therapists should assess the illness perceptions of their patients. In this quantitative study, we audiotaped the assessments of 19 primary care physical therapists on 27 patients and analyzed if and how illness perceptions were assessed. The Common Sense Model was used as the theoretical framework. We conclude that some of the domains of the Common Sense Model were frequently asked for (identity, causes and consequences), while others (timeline, treatment control, coherence, emotional representation) were used less frequently or seldom mentioned. The overall impression was that the assessments of the physical therapists were still bio-medically oriented in these patients with chronic musculoskeletal pain. PMID:24389339

  6. Dynamic Ultrasound Imaging Applications to Quantify Musculoskeletal Function

    PubMed Central

    Sikdar, Siddhartha; Wei, Qi; Cortes, Nelson

    2014-01-01

    Advances in imaging methods have led to new capability to study muscle and tendon motion in vivo. Direct measurements of muscle and tendon kinematics using imaging may lead to improved understanding of musculoskeletal function. This review presents quantitative ultrasound methods for muscle dynamics that can be used to assess in vivo musculoskeletal function when integrated with other conventional biomechanical measurements. PMID:24949846

  7. Epidemiology of Musculoskeletal Injuries among Sedentary and Physically Active Adults.

    ERIC Educational Resources Information Center

    Hootman, Jennifer M.; Macera, Carol A.; Ainsworth, Barbara E.; Addy, Cheryl L.; Martin, Malissa; Blair, Steven N.

    2002-01-01

    Examined types and frequencies of musculoskeletal injuries among adults with above average activity levels enrolled in the Dallas Aerobics Center Longitudinal Study. Participant surveys and examinations indicated that one-quarter of all respondents reported musculoskeletal injuries (most of which were activity- related). Sport participants had the…

  8. Gas Analyzer

    NASA Technical Reports Server (NTRS)

    1983-01-01

    A miniature gas chromatograph, a system which separates a gaseous mixture into its components and measures the concentration of the individual gases, was designed for the Viking Lander. The technology was further developed under National Institute for Occupational Safety and Health (NIOSH) and funded by Ames Research Center/Stanford as a toxic gas leak detection device. Three researchers on the project later formed Microsensor Technology, Inc. to commercialize the product. It is a battery-powered system consisting of a sensing wand connected to a computerized analyzer. Marketed as the Michromonitor 500, it has a wide range of applications.

  9. Metabolic analyzer

    NASA Technical Reports Server (NTRS)

    Lem, J. D.

    1977-01-01

    The metabolic analyzer was designed to support experiment M171. It operates on the so-called open circuit method to measure a subject's metabolic activity in terms of oxygen consumed, carbon dioxide produced, minute volume, respiratory exchange ratio, and tidal volume or vital capacity. The system operates in either of two modes. (1) In Mode I, inhaled respiratory volumes are actually measured by a piston spirometer. (2) In Mode II, inhaled volumes are calculated from the exhaled volume and the measured inhaled and exhaled nitrogen concentrations. This second mode was the prime mode for Skylab. Following is a brief description of the various subsystems and their operation.

  10. Contamination Analyzer

    NASA Technical Reports Server (NTRS)

    1994-01-01

    Measurement of the total organic carbon content in water is important in assessing contamination levels in high purity water for power generation, pharmaceutical production and electronics manufacture. Even trace levels of organic compounds can cause defects in manufactured products. The Sievers Model 800 Total Organic Carbon (TOC) Analyzer, based on technology developed for the Space Station, uses a strong chemical oxidizing agent and ultraviolet light to convert organic compounds in water to carbon dioxide. After ionizing the carbon dioxide, the amount of ions is determined by measuring the conductivity of the deionized water. The new technique is highly sensitive, does not require compressed gas, and maintenance is minimal.

  11. An overview of recent patents on musculoskeletal interface tissue engineering.

    PubMed

    Rao, Rohit T; Browe, Daniel P; Lowe, Christopher J; Freeman, Joseph W

    2016-02-01

    Interface tissue engineering involves the development of engineered grafts that promote integration between multiple tissue types. Musculoskeletal tissue interfaces are critical to the safe and efficient transmission of mechanical forces between multiple musculoskeletal tissues, e.g., between ligament and bone tissue. However, these interfaces often do not physiologically regenerate upon injury, resulting in impaired tissue function. Therefore, interface tissue engineering approaches are considered to be particularly relevant for the structural restoration of musculoskeletal tissues interfaces. In this article, we provide an overview of the various strategies used for engineering musculoskeletal tissue interfaces with a specific focus on the recent important patents that have been issued for inventions that were specifically designed for engineering musculoskeletal interfaces as well as those that show promise to be adapted for this purpose. PMID:26577344

  12. Mechanoresponsive musculoskeletal tissue differentiation of adipose-derived stem cells.

    PubMed

    Trumbull, Andrew; Subramanian, Gayathri; Yildirim-Ayan, Eda

    2016-01-01

    Musculoskeletal tissues are constantly under mechanical strains within their microenvironment. Yet, little is understood about the effect of in vivo mechanical milieu strains on cell development and function. Thus, this review article outlines the in vivo mechanical environment of bone, muscle, cartilage, tendon, and ligaments, and tabulates the mechanical strain and stress in these tissues during physiological condition, vigorous, and moderate activities. This review article further discusses the principles of mechanical loading platforms to create physiologically relevant mechanical milieu in vitro for musculoskeletal tissue regeneration. A special emphasis is placed on adipose-derived stem cells (ADSCs) as an emerging valuable tool for regenerative musculoskeletal tissue engineering, as they are easily isolated, expanded, and able to differentiate into any musculoskeletal tissue. Finally, it highlights the current state-of-the art in ADSCs-guided musculoskeletal tissue regeneration under mechanical loading. PMID:27103394

  13. Stereotactic Body Radiotherapy for Head and Neck Tumors

    ClinicalTrials.gov

    2016-04-18

    Squamous Cell Carcinoma of the Head and Neck; Nasopharyngeal Carcinoma; Salivary Gland Cancer; Head and Neck Sarcoma; Paraganglioma of Head and Neck; Chordoma of Head and Neck; Chondrosarcoma of Head and Neck; Angiofibroma of Head and Neck

  14. Musculoskeletal interventional radiology: ultrasound and CT.

    PubMed

    Martel Villagrán, J; Bueno Horcajadas, Á; Agrela Rojas, E

    2016-05-01

    We aim to describe imaging-guided (ultrasound and CT) interventional techniques in the musculoskeletal system that can be performed by general radiologists, whether in hospitals, primary care clinics, private offices, or other settings. The first requirement for doing these procedures is adequate knowledge of the anatomy of the musculoskeletal system. The second requirement is to inform the patient thoroughly about the technique, the risks involved, and the alternatives available in order to obtain written informed consent. The third requirement is to ensure that the procedure is performed in accordance with the principles of asepsis in relation to the puncture zone and to all the material employed throughout the procedure. The main procedures that can be done under ultrasound guidance are the following: fine needle aspiration cytology (FNAC), core needle biopsy (CNB), diagnostic and/or therapeutic arthrocentesis, drainage of juxta-articular fluid collections, drainage of abscesses, drainage of hematomas, treatment of Baker's cyst, treatment of ganglia, treatment of bursitis, infiltrations and treatment of plantar fasciitis, plantar fibrosis, epicondylitis, Achilles tendinopathy, and Morton's neuroma, puncture and lavage of calcifications in calcifying tendinopathy. We also review the following CT-guided procedures: diagnosis of spondylodiscitis, FNAC of metastases, arthrography, drainages. Finally, we also mention more complex procedures that can only be done in appropriate settings: bone biopsies, treatment of facet joint pain, radiofrequency treatment. PMID:27134018

  15. Musculoskeletal pain syndromes that affect adolescents.

    PubMed

    Szer, I S

    1996-07-01

    Musculoskeletal pain is one of the most common pains of adolescence, along with headache and abdominal pain, and arthralgia is the single most common reason for referral to the pediatric rheumatologist. Not surprisingly, the pediatric rheumatologist is frequently called to distinguish organic from functional symptoms. During the past decade, the pediatric rheumatology community has been evaluating increasing numbers of adolescents and preadolescents who experience musculoskeletal symptoms presumably as a defense against emotional stress from achievement either in academic work or in sports. To complicate the challenge further, coexistent organic and psychologic disturbance is not rare. Clearly, organic illness does not protect a patient from emotional plan, and it may be most difficult to differentiate nonorganic pain in a patient with a known organic illness. Conversely, adolescents with organic illness may use their disease for secondary gain. Fear of misdiagnosis of physical illness as psychiatric and the notion that all of the patient's complaints should be explained by a unifying diagnosis cause diagnostic error in both psychogenic illness with physical manifestations and physical illness with psychogenic symptoms. PMID:8673201

  16. Radionuclide Imaging of Musculoskeletal Infection: A Review.

    PubMed

    Palestro, Christopher J

    2016-09-01

    There are numerous imaging tests for diagnosing musculoskeletal infection. Radiographs are routinely performed, because even when not diagnostic, they provide an anatomic overview of the region of interest that could influence subsequent procedure selection and interpretation. MRI is sensitive and provides superb anatomic detail. Bone scintigraphy accurately diagnoses osteomyelitis in bones not affected by underlying conditions. (67)Ga is used primarily for spondylodiskitis. Although in vitro labeled leukocyte imaging is the radionuclide test of choice for complicating osteomyelitis such as diabetic pedal osteomyelitis and prosthetic joint infection, it is not useful for spondylodiskitis. Antigranulocyte antibodies and antibody fragments have limitations and are not widely available. (111)In-biotin is useful for spondylodiskitis. Radiolabeled synthetic fragments of the antimicrobial peptide ubiquicidin are promising infection-specific agents. (18)F-FDG is the radiopharmaceutical of choice for spondylodiskitis. Its role in diabetic pedal osteomyelitis and prosthetic joint infection is not established. Preliminary data suggest (68)Ga may be useful in musculoskeletal infection. (124)I-fialuridine initially showed promise as an infection-specific radiopharmaceutical, but subsequent investigations were disappointing. The development of PET/CT and SPECT/CT imaging systems, which combine anatomic and functional imaging, has revolutionized diagnostic imaging. These hybrid systems are redefining the diagnostic workup of patients with suspected or known infection and inflammation by improving diagnostic accuracy and influencing patient management. PMID:27390160

  17. Helpful tips for performing musculoskeletal injections.

    PubMed

    Metz, John P

    2010-01-01

    Injections are valuable procedures for managing musculoskeletal conditions commonly encountered by family physicians. Corticosteroid injections into articular, periarticular, or soft tissue structures relieve pain, reduce inflammation, and improve mobility. Injections can provide diagnostic information and are commonly used for postoperative pain control. Local anesthetics may be injected with corticosteroids to provide additional, rapid pain relief. Steroid injection is the preferred and definitive treatment for de Quervain tenosynovitis and trochanteric bursitis. Steroid injections can also be helpful in controlling pain during physical rehabilitation from rotator cuff syndrome and lateral epicondylitis. Intra-articular steroid injection provides pain relief in rheumatoid arthritis and osteoarthritis. There is little systematic evidence to guide medication selection for therapeutic injections. The medication used and the frequency of injection should be guided by the goal of the injection (i.e., diagnostic or therapeutic), the underlying musculoskeletal diagnosis, and clinical experience. Complications from steroid injections are rare, but physicians should understand the potential risks and counsel patients appropriately. Patients with diabetes who receive periarticular or soft tissue steroid injections should closely monitor their blood glucose for two weeks following injection. PMID:20052957

  18. Musculoskeletal injections: a review of the evidence.

    PubMed

    Stephens, Mark B; Beutler, Anthony I; O'Connor, Francis G

    2008-10-15

    Injections are valuable procedures for managing musculoskeletal conditions commonly encountered by family physicians. Corticosteroid injections into articular, periarticular, or soft tissue structures relieve pain, reduce inflammation, and improve mobility. Injections can provide diagnostic information and are commonly used for postoperative pain control. Local anesthetics may be injected with corticosteroids to provide additional, rapid pain relief. Steroid injection is the preferred and definitive treatment for de Quervain tenosynovitis and trochanteric bursitis. Steroid injections can also be helpful in controlling pain during physical rehabilitation from rotator cuff syndrome and lateral epicondylitis. Intra-articular steroid injection provides pain relief in rheumatoid arthritis and osteoarthritis. There is little systematic evidence to guide medication selection for therapeutic injections. The medication used and the frequency of injection should be guided by the goal of the injection (i.e., diagnostic or therapeutic), the underlying musculoskeletal diagnosis, and clinical experience. Complications from steroid injections are rare, but physicians should understand the potential risks and counsel patients appropriately. Patients with diabetes who receive periarticular or soft tissue steroid injections should closely monitor their blood glucose for two weeks following injection. PMID:18953975

  19. Predicting pain outcomes after traumatic musculoskeletal injury.

    PubMed

    Rosenbloom, Brittany N; Katz, Joel; Chin, Kelly Y W; Haslam, Lynn; Canzian, Sonya; Kreder, Hans J; McCartney, Colin J L

    2016-08-01

    Traumatic musculoskeletal injury results in a high incidence of chronic pain; however, there is little evidence about the nature, quality, and severity of the pain. This study uses a prospective, observational, longitudinal design to (1) examine neuropathic pain symptoms, pain severity, pain interference, and pain management at hospital admission and 4 months after traumatic musculoskeletal injury (n = 205), and (2) to identify predictors of group membership for patients with differing moderate-to-severe putative neuropathic pain trajectories. Data were collected on mechanism of injury, injury severity, pain (intensity, interference, neuropathic quality), anxiety (anxiety sensitivity, general anxiety, pain catastrophizing, pain anxiety), depression, and posttraumatic stress while patients were in-hospital and 4 months after injury. A third of patients had chronic moderate-to-severe neuropathic pain 4 months after injury. Specifically, 11% of patients developed moderate-to-severe pain by 4 months and 21% had symptoms immediately after injury that persisted over time. Significant predictors of the development and maintenance of moderate-to-severe neuropathic pain included high levels of general anxiety while in-hospital immediately after injury (P < 0.001) and symptoms of posttraumatic stress 4 months after injury (P < 0.001). Few patients had adequate pharmacological, physical, or psychological pain management in-hospital and at 4 months. Future research is needed among trauma patients to better understand the development of chronic pain and to determine the best treatment approaches. PMID:27058677

  20. Standard reference values for musculoskeletal ultrasonography

    PubMed Central

    Schmidt, W; Schmidt, H; Schicke, B; Gromnica-Ihle, E

    2004-01-01

    Objectives: To determine standard reference values for musculoskeletal ultrasonography in healthy adults. Methods: Ultrasonography was performed on 204 shoulders, elbows, hands, hips, knees, and feet of 102 healthy volunteers (mean age 38.4 years; range 20–60; 54 women) with a linear probe (10–5 MHz; Esaote Technos MP). Diameters of tendons, bursae, cartilage, erosions, hypoechoic rims around tendons and at joints were measured with regard to established standard scans. Mean, minimum, and maximum values, as well as two standard deviations (2 SD) were determined. Mean values ±2 SD were defined as standard reference values. Results: Hypoechoic rims were normally present in joints and tendon sheaths owing to physiological synovial fluid and/or cartilage. Similarly, fluid was found in the subdeltoid bursa in 173/204 (85%), at the long biceps tendon in 56 (27%), in the suprapatellar recess in 158 (77%), in the popliteal bursae in 32 (16%), and in the retrocalcaneal bursa in 49 (24%). Erosions of >1 mm were seen at the humeral head in 47 (23%). Values for important intervals were determined. The correlation between two investigators was 0.96 (0.78–0.99). The reliability of follow up investigations was 0.83 (0.52–0.99). Conclusions: Fluid in bursae as well as hypoechoic rims within joints and around tendons are common findings in healthy people. This study defines standard reference values for musculoskeletal ultrasonography to prevent misinterpretation of normal fluid as an anatomical abnormality. PMID:15249327

  1. Common musculoskeletal problems in the performing artist.

    PubMed

    Hansen, Pamela A; Reed, Kristi

    2006-11-01

    In this chapter we touched on a wide variety of unique musculoskeletal conditions in the musician and dancer. We outlined generalized methods of evaluation that stress the importance of the interdisciplinary approach in this highly specialized patient population and stressed the importance of specific involvement of the music or dance instructor in evaluation and management. We sought to emphasize the need to refer to specialized care early when in doubt of diagnosis or when usual first-line treatments fail. We gave examples of specific injury patterns common in these subgroups and suggestions for early management. Finally, we described some general principals for prevention of musculoskeletal injury in this group. A physician treating the performing artist must always keep in mind that in this unique patient population, their occupation is not only a means of earning a living, it is their passion. Artists make great sacrifice both physically and mentally to bring the world such immeasurable beauty. It is our responsibility to care for them in the most comprehensive and compassionate manner possible while informing them as honestly as possible about their treatment options. PMID:17097480

  2. Analyzing Orientations

    NASA Astrophysics Data System (ADS)

    Ruggles, Clive L. N.

    Archaeoastronomical field survey typically involves the measurement of structural orientations (i.e., orientations along and between built structures) in relation to the visible landscape and particularly the surrounding horizon. This chapter focuses on the process of analyzing the astronomical potential of oriented structures, whether in the field or as a desktop appraisal, with the aim of establishing the archaeoastronomical "facts". It does not address questions of data selection (see instead Chap. 25, "Best Practice for Evaluating the Astronomical Significance of Archaeological Sites", 10.1007/978-1-4614-6141-8_25) or interpretation (see Chap. 24, "Nature and Analysis of Material Evidence Relevant to Archaeoastronomy", 10.1007/978-1-4614-6141-8_22). The main necessity is to determine the azimuth, horizon altitude, and declination in the direction "indicated" by any structural orientation. Normally, there are a range of possibilities, reflecting the various errors and uncertainties in estimating the intended (or, at least, the constructed) orientation, and in more formal approaches an attempt is made to assign a probability distribution extending over a spread of declinations. These probability distributions can then be cumulated in order to visualize and analyze the combined data from several orientations, so as to identify any consistent astronomical associations that can then be correlated with the declinations of particular astronomical objects or phenomena at any era in the past. The whole process raises various procedural and methodological issues and does not proceed in isolation from the consideration of corroborative data, which is essential in order to develop viable cultural interpretations.

  3. Optical analyzer

    DOEpatents

    Hansen, A.D.

    1987-09-28

    An optical analyzer wherein a sample of particulate matter, and particularly of organic matter, which has been collected on a quartz fiber filter is placed in a combustion tube, and light from a light source is passed through the sample. The temperature of the sample is raised at a controlled rate and in a controlled atmosphere. The magnitude of the transmission of light through the sample is detected as the temperature is raised. A data processor, differentiator and a two pen recorder provide a chart of the optical transmission versus temperature and the rate of change of optical transmission versus temperature signatures (T and D) of the sample. These signatures provide information as to physical and chemical processes and a variety of quantitative and qualitative information about the sample. Additional information is obtained by repeating the run in different atmospheres and/or different rates or heating with other samples of the same particulate material collected on other filters. 7 figs.

  4. Speech analyzer

    NASA Technical Reports Server (NTRS)

    Lokerson, D. C. (Inventor)

    1977-01-01

    A speech signal is analyzed by applying the signal to formant filters which derive first, second and third signals respectively representing the frequency of the speech waveform in the first, second and third formants. A first pulse train having approximately a pulse rate representing the average frequency of the first formant is derived; second and third pulse trains having pulse rates respectively representing zero crossings of the second and third formants are derived. The first formant pulse train is derived by establishing N signal level bands, where N is an integer at least equal to two. Adjacent ones of the signal bands have common boundaries, each of which is a predetermined percentage of the peak level of a complete cycle of the speech waveform.

  5. Irxl1 mutant mice show reduced tendon differentiation and no patterning defects in musculoskeletal system development.

    PubMed

    Kimura, Wataru; Machii, Masashi; Xue, XiaoDong; Sultana, Nishat; Hikosaka, Keisuke; Sharkar, Mohammad T K; Uezato, Tadayoshi; Matsuda, Masashi; Koseki, Haruhiko; Miura, Naoyuki

    2011-01-01

    Irxl1 (Iroquois-related homeobox like-1) is a newly identified three amino-acid loop extension (TALE) homeobox gene, which is expressed in various mesoderm-derived tissues, particularly in the progenitors of the musculoskeletal system. To analyze the roles of Irxl1 during embryonic development, we generated mice carrying a null allele of Irxl1. Mice homozygous for the targeted allele were viable, fertile, and showed reduced tendon differentiation. Skeletal morphology and skeletal muscle weight in Irxl1-knockout mice appeared normal. Expression patterns of several marker genes for cartilage, tendon, and muscle progenitors in homozygous mutant embryos were unchanged. These results suggest that Irxl1 is required for the tendon differentiation but dispensable for the patterning of the musculoskeletal system in development. PMID:21254332

  6. Screening Method Based on Walking Plantar Impulse for Detecting Musculoskeletal Senescence and Injury

    PubMed Central

    Fan, Yifang; Fan, Yubo; Li, Zhiyu; Newman, Tony; Lv, Changsheng; Zhou, Yi

    2013-01-01

    No consensus has been reached on how musculoskeletal system injuries or aging can be explained by a walking plantar impulse. We standardize the plantar impulse by defining a principal axis of plantar impulse. Based upon this standardized plantar impulse, two indexes are presented: plantar pressure record time series and plantar-impulse distribution along the principal axis of plantar impulse. These indexes are applied to analyze the plantar impulse collected by plantar pressure plates from three sources: Achilles tendon ruptures; elderly people (ages 62–71); and young people (ages 19–23). Our findings reveal that plantar impulse distribution curves for Achilles tendon ruptures change irregularly with subjects’ walking speed changes. When comparing distribution curves of the young, we see a significant difference in the elderly subjects’ phalanges plantar pressure record time series. This verifies our hypothesis that a plantar impulse can function as a means to assess and evaluate musculoskeletal system injuries and aging. PMID:24386288

  7. A prospective twin cohort study of disability pensions due to musculoskeletal diagnoses in relation to stability and change in pain.

    PubMed

    Ropponen, Annina; Svedberg, Pia; Kalso, Eija; Koskenvuo, Markku; Silventoinen, Karri; Kaprio, Jaakko

    2013-10-01

    Pain is known to play an important role in the pathway to becoming work disabled, in particular for award of disability pensions (DP) due to musculoskeletal diagnoses (MSD). This prospective cohort study investigated MSD-related pain stability and/or changes as predictors for DP during a 23-year follow-up. Additionally confounding factors were examined to elucidate whether familial effects (including genetics and family background) or socioeconomic status, other pain, or use of medication would affect the associations between pain and DP. Data were available on 11,224 twins (4399 complete pairs) born before 1958 surveyed through questionnaires about background factors and musculoskeletal (low back, neck, and shoulder) pain impairing work ability in 1975 and 1981. The follow-up data were collected from pension registers until 2004. Cox proportional hazards regression models were used. During the 23-year follow-up, 508 DPs due to MSD, 166 DPs due to osteoarthritis (OA), and 162 DPs due to low back diagnoses (LBD) were granted. Musculoskeletal pain impairing work ability both measured at 1 time point and 6 years apart, and either 1 pain location or multiple locations, predicted increased risk for DP due to MSD, OA, and LBD. The associations were independent of familial confounding factors and of several influential background factors, including headache; migraine; use of analgesics, hypnotics, or tranquillizers; life satisfaction; and education and marital status. This study concluded that musculoskeletal pain impairing work ability is an early and direct predictor for DP due to MSD, OA, and LBD. PMID:23711476

  8. A systematic review of interventions aimed at increasing physical activity in adults with chronic musculoskeletal pain—protocol

    PubMed Central

    2014-01-01

    Background Chronic musculoskeletal pain is highly prevalent, affecting around one in five people across Europe. Osteoarthritis, low back pain, neck pain and other musculoskeletal disorders are leading causes of disability worldwide and the most common source of chronic pain. Exercise and/or physical activity interventions have the potential to address not only the pain and disability associated with chronic pain but also the increased risk of morbidity and mortality seen in this population. Although exercise and/or physical activity is widely recommended, there is currently a paucity of research that offers an evidence base upon which the development or optimisation of interventions can be based. This systematic review will investigate the components of interventions associated with changes in physical activity levels in adults with chronic musculoskeletal pain. Methods/Design This systematic review will be reported in line with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidance. Randomised and quasi-randomised controlled trials of interventions aimed at increasing physical activity in adults with chronic musculoskeletal pain will be included. Articles will be identified through a comprehensive search of the following databases: CENTRAL in the Cochrane Library, the Cochrane Database of Systematic Reviews (CDSR), MEDLINE, Embase, CINAHL, PsycINFO and AMED. Two review authors will independently screen articles retrieved from the search for eligibility, extract relevant data on methodological issues and code interventions according to the behaviour change technique taxonomy (v1) of 93 hierarchically clustered techniques. As complex healthcare interventions can be modified by a wide variety of factors, data will be summarised statistically when the data are available, are sufficiently similar and are of sufficient quality. A narrative synthesis will be completed if there is insufficient data to permit a formal meta

  9. Optical analyzer

    DOEpatents

    Hansen, Anthony D.

    1989-02-07

    An optical analyzer (10) wherein a sample (19) of particulate matter, and particularly of organic matter, which has been collected on a quartz fiber filter (20) is placed in a combustion tube (11), and light from a light source (14) is passed through the sample (19). The temperature of the sample (19) is raised at a controlled rate and in a controlled atmosphere. The magnitude of the transmission of light through the sample (19) is detected (18) as the temperature is raised. A data processor (23), differentiator (28) and a two pen recorder (24) provide a chart of the optical transmission versus temperature and the rate of change of optical transmission versus temperature signatures (T and D) of the sample (19). These signatures provide information as to physical and chemical processes and a variety of quantitative and qualitative information about the sample (19). Additional information is obtained by repeating the run in different atmospheres and/or different rates of heating with other samples of the same particulate material collected on other filters.

  10. Optical analyzer

    DOEpatents

    Hansen, Anthony D.

    1989-01-01

    An optical analyzer (10) wherein a sample (19) of particulate matter, and particularly of organic matter, which has been collected on a quartz fiber filter (20) is placed in a combustion tube (11), and light from a light source (14) is passed through the sample (19). The temperature of the sample (19) is raised at a controlled rate and in a controlled atmosphere. The magnitude of the transmission of light through the sample (19) is detected (18) as the temperature is raised. A data processor (23), differentiator (28) and a two pen recorder (24) provide a chart of the optical transmission versus temperature and the rate of change of optical transmission versus temperature signatures (T and D) of the sample (19). These signatures provide information as to physical and chemical processes and a variety of quantitative and qualitative information about the sample (19). Additional information is obtained by repeating the run in different atmospheres and/or different rates of heating with other samples of the same particulate material collected on other filters.

  11. ABSORPTION ANALYZER

    DOEpatents

    Brooksbank, W.A. Jr.; Leddicotte, G.W.; Strain, J.E.; Hendon, H.H. Jr.

    1961-11-14

    A means was developed for continuously computing and indicating the isotopic assay of a process solution and for automatically controlling the process output of isotope separation equipment to provide a continuous output of the desired isotopic ratio. A counter tube is surrounded with a sample to be analyzed so that the tube is exactly in the center of the sample. A source of fast neutrons is provided and is spaced from the sample. The neutrons from the source are thermalized by causing them to pass through a neutron moderator, and the neutrons are allowed to diffuse radially through the sample to actuate the counter. A reference counter in a known sample of pure solvent is also actuated by the thermal neutrons from the neutron source. The number of neutrons which actuate the detectors is a function of a concentration of the elements in solution and their neutron absorption cross sections. The pulses produced by the detectors responsive to each neu tron passing therethrough are amplified and counted. The respective times required to accumulate a selected number of counts are measured by associated timing devices. The concentration of a particular element in solution may be determined by utilizing the following relation: T2/Ti = BCR, where B is a constant proportional to the absorption cross sections, T2 is the time of count collection for the unknown solution, Ti is the time of count collection for the pure solvent, R is the isotopic ratlo, and C is the molar concentration of the element to be determined. Knowing the slope constant B for any element and when the chemical concentration is known, the isotopic concentration may be readily determined, and conversely when the isotopic ratio is known, the chemical concentrations may be determined. (AEC)

  12. Corticosteroid Injections for Common Musculoskeletal Conditions.

    PubMed

    Foster, Zoë J; Voss, Tyler T; Hatch, Jacquelynn; Frimodig, Adam

    2015-10-15

    Family physicians considering corticosteroid injections as part of a comprehensive treatment plan for musculoskeletal diagnoses will find few high-quality studies to assist with evidence-based decision making. Most studies of corticosteroid injections for the treatment of osteoarthritis, tendinopathy, bursitis, or neuropathy include only small numbers of patients and have inconsistent long-term follow-up. Corticosteroid injections for the treatment of adhesive capsulitis result in short-term improvements in pain and range of motion. For subacromial impingement syndrome, corticosteroid injections provide short-term pain relief and improvement in function. In medial and lateral epicondylitis, corticosteroid injections offer only short-term improvement of symptoms and have a high rate of symptom recurrence. Corticosteroid injections for carpal tunnel syndrome may help patients avoid or delay surgery. Trigger finger and de Quervain tenosynovitis may be treated effectively with corticosteroid injections. Patients with hip or knee osteoarthritis may have short-term symptom relief with corticosteroid injections. PMID:26554409

  13. Neck pain and anxiety do not always go together

    PubMed Central

    2010-01-01

    Chronic pain and psychosocial distress are generally thought to be associated in chronic musculoskeletal disorders such as non-specific neck pain. However, it is unclear whether a raised level of anxiety is necessarily a feature of longstanding, intense pain amongst patient and general population sub-groups. In a cohort of 70 self-selected female, non-specific neck pain sufferers, we observed relatively high levels of self-reported pain of 4.46 (measured on the 11 point numerical pain rating scale (NRS-101)) and a longstanding duration of symptoms (156 days/year). However, the mean anxiety scores observed (5.49), fell well below the clinically relevant threshold of 21 required by the Beck Anxiety Inventory. The cohort was stratified to further distinguish individuals with higher pain intensity (NRS>6) and longer symptom duration (>90 days). Although a highly statistically significant difference (p = 0.000) was subsequently observed with respect to pain intensity, in the resulting sub-groups, none such a difference was noted with respect to anxiety levels. Our results indicate that chronic, intense pain and anxiety do not always appear to be related. Explanations for these findings may include that anxiety is not triggered in socially functional individuals, that individual coping strategies have come into play or in some instances that a psychological disorder like alexithymia could be a confounder. More studies are needed to clarify the specific role of anxiety in chronic non-specific musculoskeletal pain before general evidence-driven clinical extrapolations can be made. PMID:20222957

  14. In-111 WBC imaging in musculoskeletal sepsis

    SciTech Connect

    Thompson, L.; Ouzounian, T.J.; Webber, M.M.; Amstutz, H.C.

    1984-01-01

    This study evaluated the accuracy and utility of the In-111 labeled WBC imaging in a series of patients who were suspected of having musculoskeletal sepsis. The labeling of the WBCs was patterned after a method previously described, in which the WBCs are labeled with In-111 oxine in plasma. The WBCs from 100 ml of blood are separated and incubated with In-111 oxine complex, and then 500 ..mu..Ci. of the labeled cells were reinjected into the patient. Images of the areas in question were obtained at 24 hrs. In some instances, 48 hour images were also obtained. Images were interpreted using consistent criteria. Forty imaging procedures were done on 39 patients. These included 39 total joint protheses, and 17 other images to evaluate possible osteomyelitis, septic arthritis or deep abscesses. Of these studies, 15 were positive, and 42 negative. The findings were then correlated with operative culture and pathology in 21, aspiration cultures and gram stains in 14, and with clinical findings in the remaining 21. This correlation showed 41 true negatives, 12 true positives, 1 false negative, and 2 false positives. The sensitivity was 92.9% and the specificity was 95.2%l. The false negative occurred in a patient on chronic suppressive antibiotic therapy for an infected total hip replacement. The false positive images occurred in a patient with active rheumatoid arthritis and in a patient imaged one month post operative placement of the prosthesis. These images were very useful in several septic patients who had many possible sites of infection. The authors conclude that In-III imaging is an accurate and useful non-invasive method of evaluating musculoskeletal sepsis.

  15. Tailored exercise program reduces symptoms of upper limb work-related musculoskeletal disorders in a group of metalworkers: A randomized controlled trial.

    PubMed

    Rasotto, Chiara; Bergamin, Marco; Simonetti, Alberto; Maso, Stefano; Bartolucci, Giovanni B; Ermolao, Andrea; Zaccaria, Marco

    2015-02-01

    Work-related musculoskeletal disorders (WRMDs) are a leading cause of work-related disability and loss of productivity in the developed countries; these disorders may concur with the indirect costs of an illness or injury included losses of potential output. Literature on workplace physical activity program provided a mixed but positive impact on health and important worksite outcomes. Therefore, programs of physical activity organized and performed in the workplace could reveal as essential tool to reduce musculoskeletal symptoms. This investigation aimed to assess the effectiveness of a tailored physical activity program, performed in a work-environment, to reduce the symptoms in upper extremities and neck with the novelty in personalizing the approach applied to the exercise protocol, basing on pain and disability levels, to reduce the onset and symptoms in upper extremity and neck WRMDs increasing upper-limb strength and flexibility. 68 metalworkers were recruited, 34 were randomly allocated to an intervention group (IG), while the other 34 to a control group. Primary outcomes concerned pain symptoms measured with visual analog scales while disability was measured by DASH (Disability of the Arm, Shoulder and Hand), and NPDS-I (Neck Pain and Disability Scale) questionnaires. Grip strength, upper-limb mobility, neck and shoulder range of motion were also assessed. After the 9-month intervention, IG reduced pain symptoms on neck, shoulders, elbows and on wrists. Grip strength and upper-limb mobility improved as well as scores on questionnaires. This protocol suggests that performing a tailored physical activity program is beneficial to reduce pain and disability on upper-limb WRMDs. PMID:25027479

  16. Up-front neck dissection followed by concurrent chemoradiation in patients with regionally advanced head and neck cancer

    PubMed Central

    Paximadis, Peter A.; Christensen, Michael E.; Dyson, Greg; Kamdar, Dev P.; Sukari, Ammar; Lin, Ho-Sheng; Yoo, George H.; Kim, Harold E.

    2013-01-01

    Background The appropriate management of the neck in patients with regionally advanced head and neck cancer remains controversial. The purpose of this study was to retrospectively analyze our institutional experience with up-front neck dissection followed by definitive chemoradiotherapy. Methods Fifty-five patients with radiographic evidence of large or necrotic lymph nodes underwent up-front neck dissection followed by definitive chemoradiation. Results The 5-year overall survival (OS) and progression-free survival (PFS) rates were estimated at 71.3% and 64.7%, respectively. There were 2 failures in the dissected neck, for a control rate of 96.7%. There were 7 locoregional failures and 12 distant failures, for locoregional and distant control rates of 87.3% and 78.2%, respectively. Conclusion Up-front neck dissection followed by chemoradiotherapy resulted in excellent locoregional control, OS, and PFS. Utilization of this strategy should be considered in carefully selected patients with regionally advanced head and neck cancer. PMID:22307819

  17. A Rare Case of Parkinson's Disease with Severe Neck Pain Owing to Crowned Dens Syndrome

    PubMed Central

    Takahashi, Teruyuki; Tamura, Masato; Osabe, Keiichi; Tamiya, Takashi; Miki, Kenji; Yamaguchi, Mai; Akira, Kanno; Kamei, Satoshi; Takasu, Toshiaki

    2014-01-01

    Background Pain is regarded as one of the most common nonmotor symptoms in Parkinson's disease (PD). In particular, musculoskeletal pain has been reported as the most common type of PD-associated pain. Crowned dens syndrome (CDS), related to microcrystalline deposition in the periodontoid process, is the main cause of acute or chronic cervical pain. Case Presentation This report describes the case of an 87-year-old woman who had severe bradykinesia, muscle rigidity, gait disturbance and neck pain. Laboratory examination revealed marked elevations of white blood cells (10,100/µl) and C-reactive protein (CRP; 8.63 mg/dl). She was primarily diagnosed with severe and untreated PD, corresponding to Hoehn and Yahr scale score IV, with musculoskeletal pain and urinary tract infection. The patient was treated with antiparkinsonism drugs, antibiotic agents and nonsteroidal anti-inflammatory drugs, but they had only limited effects. Cervical plain computed tomography (CT) scanning detected remarkable crown-like calcification surrounding the odontoid process. Based on CT findings, the patient was diagnosed as having CDS with PD, and was immediately treated with corticosteroid. The severe neck rigidity with pain and the serum CRP level (0.83 mg/dl) of the patient were drastically improved within a week by the additional corticosteroid therapy. Conclusion Severe neck rigidity and bradykinesia in this patient might have strengthened the chondrocalcinosis around the odontoid process. Cervical plain CT scan is necessary and useful for the definitive diagnosis of CDS. CDS should be considered as a differential diagnosis of a possible etiology for musculoskeletal pain related to rigidity and bradykinesia in PD. PMID:24926265

  18. Interventional radiology neck procedures.

    PubMed

    Zabala Landa, R M; Korta Gómez, I; Del Cura Rodríguez, J L

    2016-05-01

    Ultrasonography has become extremely useful in the evaluation of masses in the head and neck. It enables us to determine the anatomic location of the masses as well as the characteristics of the tissues that compose them, thus making it possible to orient the differential diagnosis toward inflammatory, neoplastic, congenital, traumatic, or vascular lesions, although it is necessary to use computed tomography or magnetic resonance imaging to determine the complete extension of certain lesions. The growing range of interventional procedures, mostly guided by ultrasonography, now includes biopsies, drainages, infiltrations, sclerosing treatments, and tumor ablation. PMID:27138033

  19. Drugs Approved for Head and Neck Cancer

    MedlinePlus

    ... Professionals Questions to Ask about Your Treatment Research Drugs Approved for Head and Neck Cancer This page ... and neck cancer that are not listed here. Drugs Approved for Head and Neck Cancer Abitrexate (Methotrexate) ...

  20. Head and Neck Cancer: Symptoms and Signs

    MedlinePlus

    ... Symptoms and Signs Request Permissions Print to PDF Head and Neck Cancer - Symptoms and Signs Approved by the Cancer. ... Cancer Research and Advocacy Survivorship Blog About Us Head and Neck Cancer Guide Cancer.Net Guide Head and Neck ...

  1. Musculoskeletal impairments and physical disablement among the aged.

    PubMed

    Jette, A M; Branch, L G; Berlin, J

    1990-11-01

    This article summarizes the results of a longitudinal investigation of the progression of sight, hearing, and musculoskeletal impairments and their association with change in physical disability, in 10 ADLs among members of the Massachusetts Health Care Panel Study. The findings confirm widely held clinical beliefs that specific types of musculoskeletal decrement are an important cause of physical disability among older persons. Decrement in hand function is a significant musculoskeletal impairment influencing limitations in Basic ADL, and progression of Instrumental ADL dysfunction is influenced by progression of lower extremity impairments. Progression of sight and hearing impairments was not associated with change in physical disability. Musculoskeletal impairments, one of the most prevalent and symptomatic chronic complaints of middle and old age, deserve increased attention from epidemiologists, disability researchers, and clinicians seeking ways to prevent disablement among the aged. PMID:2229943

  2. Global core recommendations for a musculoskeletal undergraduate curriculum

    PubMed Central

    Woolf, A; Walsh, N; Akesson, K

    2004-01-01

    Objective: To develop core recommendations for the learning outcomes of an undergraduate curriculum in musculoskeletal conditions for any parts of the globe. Methods: Recommendations were developed by wide consultation with experts in orthopaedics, rheumatology, osteoporosis, and rehabilitation from all parts of the world who had interest and experience in these specialties, with the support of international and national societies. All possible knowledge, skills, and attitudes that might be of relevance to musculoskeletal conditions were initially considered and then reduced to those considered essential for all doctors. Results: The recommendations focus on (a) basic skills to assess and diagnose musculoskeletal problems; (b) the competency to assess specific common or urgent musculoskeletal problems; (c) the theoretical background of the conditions and their management; and (d) the core knowledge necessary to support diagnosis and management, including basic sciences. At the end of the course, all students should be able to differentiate normal from abnormal locomotor symptoms in a patient, determine the relevant investigations and interpret the results, formulate a limited differential diagnosis, recognise the impact of the problem on the individual patient, and make an appropriate management plan. Conclusions: The recommendations set global standards for the minimum level of competence in managing patients with musculoskeletal problems. They define what all doctors should know when graduating from medical school, regardless of further specialisation. They are intended to form the basis of a curriculum for a musculoskeletal course and can be adapted for any medical school in any country throughout the world. PMID:15082481

  3. Diagnostic and interventional musculoskeletal ultrasound: part 2. Clinical applications.

    PubMed

    Smith, Jay; Finnoff, Jonathan T

    2009-02-01

    Musculoskeletal ultrasound involves the use of high-frequency sound waves to image soft tissues and bony structures in the body for the purposes of diagnosing pathology or guiding real-time interventional procedures. Recently, an increasing number of physicians have integrated musculoskeletal ultrasound into their practices to facilitate patient care. Technological advancements, improved portability, and reduced costs continue to drive the proliferation of ultrasound in clinical medicine. This increased interest creates a need for education pertaining to all aspects of musculoskeletal ultrasound. The primary purpose of this article is to review diagnostic ultrasound technology and its potential clinical applications in the evaluation and treatment of patients with neurological and musculoskeletal disorders. After reviewing this article, physicians should be able to (1) list the advantages and disadvantages of ultrasound compared to other available imaging modalities; (2) describe how ultrasound machines produce images using sound waves; (3) discuss the steps necessary to acquire and optimize an ultrasound image; (4) understand the difference ultrasound appearances of tendons, nerves, muscles, ligaments, blood vessels, and bones; and (5) identify multiple applications for diagnostic and interventional musculoskeletal ultrasound. Part 2 of this 2-part article will focus on the clinical applications of musculoskeletal ultrasound in clinical practice, including the ultrasonographic appearance of normal and abnormal tissues as well as specific diagnostic and interventional applications in major body regions. PMID:19627890

  4. Diagnostic and interventional musculoskeletal ultrasound: part 1. Fundamentals.

    PubMed

    Smith, Jay; Finnoff, Jonathan T

    2009-01-01

    Musculoskeletal ultrasound involves the use of high-frequency sound waves to image soft tissues and bony structures in the body for the purposes of diagnosing pathology or guiding real-time interventional procedures. Recently, an increasing number of physicians have integrated musculoskeletal ultrasound into their practices to facilitate patient care. Technological advancements, improved portability, and reduced costs continue to drive the proliferation of ultrasound in clinical medicine. This increased interest creates a need for education pertaining to all aspects of musculoskeletal ultrasound. The primary purpose of this article is to review diagnostic ultrasound technology and its potential clinical applications in the evaluation and treatment of patients with neurologic and musculoskeletal disorders. After reviewing this article, physicians should be able to (1) list the advantages and disadvantages of ultrasound compared with other available imaging modalities, (2) describe how ultrasound machines produce images using sound waves, (3) discuss the steps necessary to acquire and optimize an ultrasound image, (4) understand the different ultrasound appearances of tendons, nerves, muscles, ligaments, blood vessels, and bones, and (5) identify multiple applications for diagnostic and interventional musculoskeletal ultrasound in musculoskeletal practice. Part 1 of this 2-part article reviews the fundamentals of clinical ultrasonographic imaging, including relevant physics, equipment, training, image optimization, and scanning principles for diagnostic and interventional purposes. PMID:19627875

  5. Trend-Centric Motion Visualization: Designing and Applying a New Strategy for Analyzing Scientific Motion Collections.

    PubMed

    Schroeder, David; Korsakov, Fedor; Knipe, Carissa Mai-Ping; Thorson, Lauren; Ellingson, Arin M; Nuckley, David; Carlis, John; Keefe, Daniel F

    2014-12-01

    In biomechanics studies, researchers collect, via experiments or simulations, datasets with hundreds or thousands of trials, each describing the same type of motion (e.g., a neck flexion-extension exercise) but under different conditions (e.g., different patients, different disease states, pre- and post-treatment). Analyzing similarities and differences across all of the trials in these collections is a major challenge. Visualizing a single trial at a time does not work, and the typical alternative of juxtaposing multiple trials in a single visual display leads to complex, difficult-to-interpret visualizations. We address this problem via a new strategy that organizes the analysis around motion trends rather than trials. This new strategy matches the cognitive approach that scientists would like to take when analyzing motion collections. We introduce several technical innovations making trend-centric motion visualization possible. First, an algorithm detects a motion collection's trends via time-dependent clustering. Second, a 2D graphical technique visualizes how trials leave and join trends. Third, a 3D graphical technique, using a median 3D motion plus a visual variance indicator, visualizes the biomechanics of the set of trials within each trend. These innovations are combined to create an interactive exploratory visualization tool, which we designed through an iterative process in collaboration with both domain scientists and a traditionally-trained graphic designer. We report on insights generated during this design process and demonstrate the tool's effectiveness via a validation study with synthetic data and feedback from expert musculoskeletal biomechanics researchers who used the tool to analyze the effects of disc degeneration on human spinal kinematics. PMID:26356978

  6. [Musculoskeletal disorders and housework in Italy].

    PubMed

    Rosano, A; Moccaldi, R; Cioppa, M; Lanzieri, G; Persechino, B; Spagnolo, A

    2004-01-01

    The housework exposes to the risk of musculoskeletal disorders, which may appear as disabling diseases, both temporary and permanent ones. To evaluate the epidemiology of the phenomenon a retrospective survey was conducted by administering a mail questionnaire to a sample of 1,000 families residing in the whole national territory. The participation rate was 31.7%. Among respondents 20.5% reported spinal pain, 65.6% of them with continuous pains (41.4% assumed pain-killer drugs). 37.0% of the interviewed persons reported to disorders in upper limbs. It was analysed the association between the presence of disorders and the frequency in making some housework duties. Washing clothes (OR=1.8; C.I. 95%: 0.6-4.5), making beds (OR=1.5; C.I. 95%: 0.2-13.1), and taking care of pets (OR=1.4; C.I. 95%: 0.6-3.4) were associated, even if not in a statistically significant way, with the presence of spinal pain. Upper limbs disorders were associated with duties naturally related to such a disorder, like washing dishes (OR=4.6; C.I. 95%: 1.3-16.5), cleaning clothes (OR=3.1; C.I. 95%: 1.3-7.0), cleaning up carpets (OR=2.3; C.I. 95%: 1.3-3.9). To assist the relatives in state of need was identified as risk factor for both the body areas (OR=2.9; C.I. 95%: 1.2-6.7 for the spine, OR=2.6; C.I. 95%: 1.3-5.2 for upper limbs), putting in evidence the physical stress attributable to the duty. The exact identification of the typology of housework which can induce musculoskeletal disorders, and the level of related risks, are essential information to devise campaigns and protocols of health education aimed at the prevention of chronic pathologies caused by the housework. PMID:15368941

  7. Adult Head and Neck Soft Tissue Sarcomas: Treatment and Outcome

    PubMed Central

    Singh, Rabindra P.; Grimer, Robert J.; Bhujel, Nabina; Carter, Simon R.; Tillman, Roger M.; Abudu, Adesegun

    2008-01-01

    We have retrospectively analysed the experience of a musculoskeletal oncological unit in the management of adult head and neck soft tissue sarcomas from 1990 to 2005. Thirty-six patients were seen, of whom 24 were treated at this unit, the remainder only receiving advice. The median age of the patients was 46 years. Most of the sarcomas were deep and of high or intermediate grade with a median size of 5.5 cm. Eleven different histological subtypes were identified. Wide excision was possible only in 21% of the cases. 42% of the patients developed local recurrence and 42% developed metastatic disease usually in the lungs. Overall survival was 49% at 5 years. Tumour size was the most important prognostic factor. Adult head and neck soft tissue sarcomas have a high mortality rate with a high risk of local recurrence and metastatic disease. The rarity of the disease would suggest that centralisation of care could lead to increased expertise and better outcomes. PMID:18382622

  8. Primary Hydatid Cyst: An Unusual Cause of a Mass in the Supraclavicular Region of the Neck

    PubMed Central

    Iynen, Ismail; Sogut, Ozgur; Guldur, Muhammet E; Kose, Rustu; Kaya, Halil; Bozkus, Ferhat

    2011-01-01

    Hydatid disease, also known as echinococcosis or hydatidosis, is an infectious disease caused by the cestode Echinococcus. Echinococcus granulosus is the most common Echinococcus species affecting human beings. It may affect any organ and tissue in the body, in particular the liver and lung. Musculoskeletal or soft tissue hydatidosis accounts for about 0.5% 5% of all echinococcal infections in endemic areas, and is almost always secondary to the hepatic or pulmonary disease. Even in regions where echinococcosis is endemic, hydatidosis of cervicofacial region is extremely rare. Herein, we present exceptionally rare case with an unusual localization of primary hydatid cyst in the left supraclavicular region of the neck. Keywords Hydatid cyst; Supraclavicular region; Neck; Unusual localization PMID:22043272

  9. NASA Musculoskeletal Space Medicine and Reconditioning Program

    NASA Technical Reports Server (NTRS)

    Kerstman, Eric; Scheuring, Richard

    2011-01-01

    The Astronaut Strength, Conditioning, and Rehabilitation (ASCR) group is comprised of certified strength and conditioning coaches and licensed and certified athletic trainers. The ASCR group works within NASA s Space Medicine Division providing direction and supervision to the astronaut corp with regards to physical readiness throughout all phases of space flight. The ASCR group is overseen by flight surgeons with specialized training in sports medicine or physical medicine and rehabilitation. The goals of the ASCR group include 1) designing and administering strength and conditioning programs that maximize the potential for physical performance while minimizing the rate of injury, 2) providing appropriate injury management and rehabilitation services, 3) collaborating with medical, research, engineering, and mission operations groups to develop and implement safe and effective in-flight exercise countermeasures, and 4) providing a structured, individualized post-flight reconditioning program for long duration crew members. This Panel will present the current approach to the management of musculoskeletal injuries commonly seen within the astronaut corp and will present an overview of the pre-flight physical training, in-flight exercise countermeasures, and post-flight reconditioning program for ISS astronauts.

  10. Estimating cranial musculoskeletal constraints in theropod dinosaurs

    PubMed Central

    Lautenschlager, Stephan

    2015-01-01

    Many inferences on the biology, behaviour and ecology of extinct vertebrates are based on the reconstruction of the musculature and rely considerably on its accuracy. Although the advent of digital reconstruction techniques has facilitated the creation and testing of musculoskeletal hypotheses in recent years, muscle strain capabilities have rarely been considered. Here, a digital modelling approach using the freely available visualization and animation software Blender is applied to estimate cranial muscle length changes and optimal and maximal possible gape in different theropod dinosaurs. Models of living archosaur taxa (Alligator mississippiensis, Buteo buteo) were used in an extant phylogenetically bracketed framework to validate the method. Results of this study demonstrate that Tyrannosaurus rex, Allosaurus fragilis and Erlikosaurus andrewsi show distinct differences in the recruitment of the jaw adductor musculature and resulting gape, confirming previous dietary and ecological assumptions. While the carnivorous taxa T. rex and Allo. fragilis were capable of a wide gape and sustained muscle force, the herbivorous therizinosaurian E. andrewsi was constrained to small gape angles. PMID:26716007

  11. Estimating cranial musculoskeletal constraints in theropod dinosaurs.

    PubMed

    Lautenschlager, Stephan

    2015-11-01

    Many inferences on the biology, behaviour and ecology of extinct vertebrates are based on the reconstruction of the musculature and rely considerably on its accuracy. Although the advent of digital reconstruction techniques has facilitated the creation and testing of musculoskeletal hypotheses in recent years, muscle strain capabilities have rarely been considered. Here, a digital modelling approach using the freely available visualization and animation software Blender is applied to estimate cranial muscle length changes and optimal and maximal possible gape in different theropod dinosaurs. Models of living archosaur taxa (Alligator mississippiensis, Buteo buteo) were used in an extant phylogenetically bracketed framework to validate the method. Results of this study demonstrate that Tyrannosaurus rex, Allosaurus fragilis and Erlikosaurus andrewsi show distinct differences in the recruitment of the jaw adductor musculature and resulting gape, confirming previous dietary and ecological assumptions. While the carnivorous taxa T. rex and Allo. fragilis were capable of a wide gape and sustained muscle force, the herbivorous therizinosaurian E. andrewsi was constrained to small gape angles. PMID:26716007

  12. HIV and Orthopaedics: Musculoskeletal Manifestations and Outcomes.

    PubMed

    Pretell-Mazzini, Juan; Subhawong, Ty; Hernandez, Victor H; Campo, Rafael

    2016-05-01

    ➤Advances in combined antiretroviral therapy (cART) in recent years have transformed HIV infection into a chronic disease when treatment is available, increasing a patient's life expectancy and the chances that orthopaedic surgeons will encounter such patients in their clinical practice.➤Musculoskeletal manifestations in patients with HIV infection are common and sometimes are the initial presentation of the disease. Knowledge about neoplasms and associated conditions affecting muscle, bones, and joints is essential for successful management.➤Since the advent of cART, total joint arthroplasty has been shown to be a safe procedure; however, perioperative infection is still a small risk in patients with uncontrolled viral loads or CD4 counts of <400 cells/mm(3).➤With regard to trauma surgery, the rates of early and late infection around implants, as well as union rates, are comparable with those in the HIV-negative population; however, there is an increased risk of pulmonary, renal, and infectious or septic complications in the polytrauma setting.➤Factors such as CD4 count, nutritional status, cART therapy, viral load count, and other comorbidities (hemophilia, infection among intravenous drug users, etc.) should be considered when treating these patients in order to optimize their clinical outcomes. PMID:27147691

  13. Musculoskeletal disorders in labor-intensive agriculture.

    PubMed

    Fathallah, Fadi A

    2010-10-01

    This paper gives an overview of the extent of musculoskeletal disorders (MSDs) in agriculture, and a historical perspective on how ergonomics has been used to reduce the health effects of labor-intensive agriculture. A summary of exposure to MSD physical risk factors within various classes of crops, along with various administrative and engineering controls for abating MSDs in agriculture is given. These controls range from programmed rest breaks to mechanized or partially-mechanized operations. Worker-based approaches such as prone carts and platforms, and load transfer devices hold promise in combating the prevalent stooped work in agriculture. Including the worker as an integral contributor to all aspects of developing and implementing an intervention, and considering the psychosocial and socio-cultural aspects of the work environment are crucial elements of effective interventions for reducing MSDs. Despite the advent progress in new technologies in agricultural practices, reliance on labor, especially in fresh market fruits and vegetables, will always be a major cornerstone of agriculture for at least the foreseen future. It is encouraging to see the increased interest among health and safety professionals, epidemiologists, engineers, social scientists, and ergonomists throughout the world who are committed to the plight of reducing MSDs and other health problems among agricultural workers. PMID:20398891

  14. Musculoskeletal and neuromuscular conditions of instrumental musicians.

    PubMed

    Bejjani, F J; Kaye, G M; Benham, M

    1996-04-01

    Performing Arts Medicine is a broad field that includes the study of medical conditions and injuries incurred by dancers, instrumental musicians, and vocalists. This article summarizes the most relevant literature of approximately the past 10 years concerning the musculoskeletal and neuromuscular conditions of musicians. A literature search was done for relevant articles in English by physicians or scientists. Some older, but fundamental, articles are included; incidental case reports were excluded to the extent possible. Included were articles on incidence, prevalence, pathophysiology, diagnosis, treatment, and biomechanical studies in musicians. Although nearly all of these conditions are the same ones seen in the general work force, it is clear that their occurrence patterns in the professional musician are unique, as is their impact on the life and livelihood of the patient. The content of the Arts Medicine literature does not permit a truly critical review. Research in the last 10 years appears not to have been done in a true blinded, random case-controlled fashion. Many authors support their statements with only their respective clinical experiences. The research cited here includes 58 series, 9 case studies, 5 surveys, 2 pre/post intervention studies, and 1 double-blind crossover clinical trial. PMID:8607768

  15. Clinical Results of Internal Fixation of Subcapital Femoral Neck Fractures

    PubMed Central

    Moon, Kyoung Ho; Shin, Joong Sup; Shin, Eun Ho; Ahn, Chi Hoon; Choi, Geon Hong

    2016-01-01

    Background Subcapital femoral neck is known to cause many complications, such as avascular necrosis (AVN) of the femoral head or nonunion, compared with other femoral neck fractures. The purpose of this study was to analyze the incidence of AVN and fixation failures in patients treated with internal fixation using cannulated screws for the subcapital femoral neck fractures. Methods This study targeted a total of 84 cases of subcapital femoral neck fractures that underwent internal fixation using cannulated screws. The average follow-up time after surgery was 36.8 months (range, 24 to 148 months). Results Nine hips (10.7%) showing AVN of the femoral head and 6 hips (7.1%) showing fixation failures were observed. The factors affecting the incidence of AVN of the femoral head after sustaining fractures correlated well with fracture types in the Garden classification (p = 0.030). The factors affecting fixation failure were the degree of reduction (p = 0.001) measured by the Garden alignment index and firm fixation (p = 0.009) assessed using the technique of 3-point fixation through the inferomedial cortical bone of the femoral neck. Conclusions The complication rates for subcapital femoral neck fractures were lower than those previously reported; hence, internal fixation could be a primary treatment option for these fractures. PMID:27247738

  16. Bladder neck contracture

    PubMed Central

    Simhan, Jay; Ramirez, Daniel; Morey, Allen F.

    2014-01-01

    Bladder neck contracture (BNC) is a well-described complication of the surgical treatment of benign and malignant prostate conditions. Nevertheless, etiologies of BNC development are highly dependent on the primary treatment modality undertaken with BNC also occurring after pelvic radiation. The treatment options for BNC can range from simple, office-based dilation procedures to more invasive, complex abdomino-perineal reconstructive surgery. Although numerous strategies have been described, a patient-specific approach is usually necessary in the management of these complex patients. In this review, we highlight various therapeutic maneuvers described for the management of BNC and further delineate a tailored approach utilized at our institution in these complicated patients. PMID:26816768

  17. High prevalence of neck, shoulder and back pain among nursing graduates warrants preventive strategies during the degree and into working life.

    PubMed

    Yassi, Annalee

    2015-04-01

    Implications for practice and research: Physical, organisational and social aspects of work significantly contribute to musculoskeletal pain in nurses, along with nonoccupational contextual and personal factors. Measures to prevent neck, shoulder and back pain in nurses should be implemented for nurses from the very beginning of their training programmes, while modifications to overtime work and physical loads should be seriously considered. Preventive measures targeting overtime work, physical workload and psychosocial factors need investigating further. PMID:25121936

  18. Improved education in musculoskeletal conditions is necessary for all doctors.

    PubMed Central

    Akesson, Kristina; Dreinhöfer, Karsten E.; Woolf, A. D.

    2003-01-01

    It is likely that everyone will, at some time, suffer from a problem related to the musculoskeletal system, ranging from a very common problem such as osteoarthritis or back pain to severely disabling limb trauma or rheumatoid arthritis. Many musculoskeletal problems are chronic conditions. The most common symptoms are pain and disability, with an impact not only on individuals' quality of life but also, importantly, on people's ability to earn a living and be independent. It has been estimated that one in four consultations in primary care is caused by problems of the musculoskeletal system and that these conditions may account for up to 60% of all disability pensions. In contrast, teaching at undergraduate and graduate levels--and the resulting competence and confidence of many doctors--do not reflect the impact of these conditions on individuals and society. Many medical students do not have any clinical training in assessing patients with bone and joint problems. Under the umbrella of the Bone and Joint Decade 2000-2010, experts from all parts of the world with an interest in teaching have developed recommendations for an undergraduate curriculum to improve the teaching of musculoskeletal conditions in medical schools. The goal for each medical school should be a course in musculoskeletal medicine concentrating on clinical assessment, common outpatient musculoskeletal problems and recognition of emergencies. Improving competency in the management of musculoskeletal problems within primary care settings through improved education is the next aim, but there are needs for improvement for all professionals and at all levels within the health care system. PMID:14710510

  19. Prevalence and Risk Factors Associated with Musculoskeletal Discomfort in Spay and Neuter Veterinarians

    PubMed Central

    White, Sara C.

    2013-01-01

    Simple Summary This study examined musculoskeletal pain and discomfort in spay and neuter veterinarians using an internet-based questionnaire. Hand pain was most common in the right thumb and wrist, and body pain was most common in the lower back, shoulders, and neck. Several work-related risk factors for discomfort were discovered, including long career in spay and neuter, increasing weekly hours in surgery, and decreasing job satisfaction. Although most respondents felt posture during surgery was important, few spay and neuter veterinarians have received any instruction in posture or ergonomics in surgery. Abstract A cross-sectional study to investigate musculoskeletal discomfort (MSD) surveyed 219 veterinarians who currently or previously perform spays and neuters at least 4 hours per week. Participants were asked about the presence and severity of hand and body MSD during the previous month, whether MSD interfered with work or daily activities, whether they attributed their MSD to their spay/neuter work, and whether MSD had ever necessitated absence from work. The period prevalence of MSD was 99.1%, with 76.7% experiencing hand or wrist pain and 98.2% experiencing body pain. Hand discomfort was most commonly reported in the right thumb and/or thumb base (49.8%) and the right wrist (37.9%). Body discomfort was most commonly reported in the lower back (76.7%), shoulders (72.6%), and neck (71.7%). Increasing career length, increasing weekly hours in surgery and decreasing job satisfaction were the work-related factors with the greatest relative contribution accounting for variation in hand pain severity and total pain. Although 94.4% of respondents felt that posture during surgery is important, only 30.6% had received any instruction in posture and positioning for surgery. Future interventions should aim to optimize surgical efficiency, surgeon work schedules, and working environment. Analysis and intervention studies are required to determine further causes of

  20. Alterations in 18F-FDG accumulation into neck-related muscles after neck dissection for patients with oral cancers

    PubMed Central

    Kito, Shinji; Koga, Hirofumi; Kodama, Masaaki; Habu, Manabu; Kokuryo, Shinya; Oda, Masafumi; Matsuo, Kou; Nishino, Takanobu; Matsumoto-Takeda, Shinobu; Uehara, Masataka; Yoshiga, Daigo; Tanaka, Tatsurou; Nishimura, Shun; Miyamoto, Ikuya; Sasaguri, Masaaki; Tominaga, Kazuhiro; Yoshioka, Izumi; Morimoto, Yasuhiro

    2016-01-01

    Background 18F-fluoro-2-deoxy-D-glucose (18F-FDG) accumulations are commonly seen in the neck-related muscles of the surgical and non-surgical sides after surgery with neck dissection (ND) for oral cancers, which leads to radiologists having difficulty in diagnosing the lesions. To examine the alterations in 18F-FDG accumulation in neck-related muscles of patients after ND for oral cancer. Material and Methods 18F-FDG accumulations on positron emission tomography (PET)-computed tomography (CT) in neck-related muscles were retrospectively analyzed after surgical dissection of cervical lymph nodes in oral cancers. Results According to the extent of ND of cervical lymph nodes, the rate of patients with 18F-FDG-PET-positive areas increased in the trapezius, sternocleidomastoid, and posterior neck muscles of the surgical and/or non-surgical sides. In addition, SUVmax of 18F-FDG-PET-positive areas in the trapezius and sternocleidomastoid muscles were increased according to the extent of the ND. Conclusions In evaluating 18F-FDG accumulations after ND for oral cancers, we should pay attention to the 18F-FDG distributions in neck-related muscles including the non-surgical side as false-positive findings. Key words:18F-FDG, PET-CT, oral cancers, muscles. PMID:27031062

  1. Cancer in the neck: Evaluation and treatment

    SciTech Connect

    Larson, D.L.; Ballantyne, A.J.

    1986-01-01

    This book contains 21 selections. Some of the titles are: Role of radiation therapy in the treatment of melanoma; Basic principles of radiobiology in head and neck oncology; Head and neck cancer: Radiotherapeutic precepts in the management of the neck; and Morbidity of modified neck dissection.

  2. Investigation of Risk Factors of Work-Related Upper-Limb Musculoskeletal Disorders in a Pharmaceutical Industry or Research Article

    NASA Astrophysics Data System (ADS)

    Pourmahabadian, Mohammad; Akhavan, Mehdi; Azam, Kamal

    This study was performed among workers of an Iranian pharmaceutical industry with the aiming to determine WRMDs prevalence and exposure assessment of WRMDs risks. In this cross-sectional study, 84 female and male workers randomly selected from five packing operations. Modified Nordic Musculoskeletal Questionnaire (NMQ) was applied to study the prevalence of WRMDs and Rapid Upper Limb Assessment (RULA) method was used for the evaluation of the exposure to risk factors associated with work-related upper limb disorders. Results showed a significant association exists between neck, lower arm and A scores group with those obtained by self-reported pain (p<0.01). Similar RULA grand scores of 3 and 4 and action level of 2 were found for workers in five packing operations. Also, the results of this study revealed that RULA method is a fairly suitable tool for the evaluation of WRMDs among packing workers in pharmaceutical industry.

  3. Principles of prehospital care of musculoskeletal injuries.

    PubMed

    Worsing, R A

    1984-05-01

    Prehospital management of musculoskeletal injuries in the traumatized patient is based on the application of a few basic principles in an orderly but expeditious manner. The patient must be assessed for immediate life-threatening conditions involving airway, respiratory, and circulatory functions while the cervical spine is protected. Resuscitative efforts to reestablish and preserve an adequate circulating volume of oxygenated blood must follow, using airways, oxygen therapy, and fluid replacement through MAST trousers and intravenous fluids. Cardiac function must be maintained as well. Respiratory function must be monitored and assisted as required. Finally, neurologic status must be assessed and monitored. Secondary assessment of all pertinent history and physical findings is made to delineate all other injuries that do not pose an immediate threat to the life or limb of the patient. Definitive care follows but is limited to basic resuscitation, stabilization, and immobilization techniques under medical control through telemetry and radio communication. Immediate definitive care of the traumatized patient requires the expeditious intervention of the trauma team in a hospital setting with surgical, blood banking, radiographic, laboratory, and other hospital-based capabilities available. Field management of the traumatized patient is directed at the expeditious delivery of the viable patient to the trauma team. In the multiply traumatized patient with severe injuries to several organ systems, prehospital care may need to be expedited to provide this patient the in-hospital care required to save his or her life. Appropriate treatment in such life-threatening trauma situations will consist of a rapid primary assessment, airway and cervical spine control, appropriate respiratory and cardiovascular assistance, gross whole body fracture immobilization using a backboard, and immediate transport. For less severely injured patients, primary assessment, resuscitation

  4. Endovascular occlusion of intracranial aneurysms with electrically detachable coils: Correlation of aneurysm neck size and treatment results

    SciTech Connect

    Zubillaga, A.F.; Guglielmi, G.; Vinuela, F.; Duckwiler, G.R.

    1994-05-01

    To devise a method to measure aneurysm neck size on angiographic films, and to correlate the sizes obtained with the extent of endovascular aneurysm occlusion, performed with electrically detachable coils. The angiograms of 79 intracranial aneurysms treated by endovascular occlusion using electrically detachable coils were retrospectively analyzed. A method using the average reported caliber of the major intracranial vessels was applied to determine the aneurysm neck sizes on the diagnostic angiograms. The cases were divided into two groups according to neck size, 4 mm being the discriminative value for small and wide necks. The posttreatment angiogram of each case was analyzed to evaluate the degree of occlusion achieved by the technique. Necks were successfully measured in 95% of the aneurysms. Complete aneurysm thrombosis was observed in 85% of the small-necked aneurysms and in 15% of the wide-necked aneurysms. Accurate angiographic measurements of neck diameter can be obtained in most aneurysms. The size of an aneurysm neck correlates well with the results of the endovascular treatment. Small-necked aneurysms can be satisfactorily occluded with this technique. In wide-necked aneurysms this technique should be reserved for lesions having a high surgical risk. 10 refs., 1 fig., 1 tab.

  5. Role of Health Literacy in Self-Reported Musculoskeletal Disorders

    PubMed Central

    Hill, Catherine L.; Appleton, Sarah L.; Black, Julie; Hoon, Elizabeth; Rudd, Rima E.; Adams, Robert J.; Gill, Tiffany

    2015-01-01

    Self-report of musculoskeletal conditions is often used to estimate population prevalence and to determine disease burden and influence policy. However, self-report of certain musculoskeletal conditions is frequently inaccurate, suggesting inadequate communication to the patient of their diagnosis. The aim of this study is to determine the association between functional health literacy (FHL) and self-reported musculoskeletal conditions in a representative population survey. FHL was measured using Newest Vital Sign in 2824 randomly selected adults. Participants also self-reported medically diagnosed arthritis, gout, and osteoporosis. Multiple logistic regression was adjusted for age and sex. The prevalence of self-reported arthritis, gout, and osteoporosis was 25.2%, 4.9%, and 5.6%, respectively. The prevalence of those at risk for inadequate FHL was 24.0% and high likelihood of inadequate FHL was 21.0%. However, over 50% of respondents with arthritis or gout had at risk/inadequate FHL, increasing to 70% of those self-reporting osteoporosis. After adjustment for age and sex, respondents in the arthritis subgroup of “don't know” and self-reported osteoporosis were significantly more likely to have inadequate FHL than the general population. This study indicates a substantial burden of low health literacy amongst people with musculoskeletal disease. This has implications for provider-patient communication, individual healthcare, population estimates of musculoskeletal disease, and impact of public health messages. PMID:26357571

  6. Low-severity Musculoskeletal Complaints Evaluated in the Emergency Department

    PubMed Central

    Mehta, Samir; Hollander, Judd E.; Shofer, Frances; Bernstein, Joseph

    2008-01-01

    Patients with musculoskeletal disorders represent a considerable percentage of emergency department volume. Although patients with acute or high-severity conditions are encouraged to seek care in the emergency department, patients with nonacute, low-severity conditions may be better served elsewhere. This study prospectively assessed patients presenting to the emergency department with nonacute, low-severity musculoskeletal conditions to test the hypothesis that these patients have access to care outside the emergency department. One thousand ten adult patients with a musculoskeletal complaint were identified, and a detailed questionnaire was completed by 862 (85.3%) during their emergency department stay. Three hundred fifty (40.6%) patients presented with nonacute, low-severity conditions. Patients with nonacute, low-severity problems were less likely to have a primary care physician (62.5% versus 72.3%) or to have medical insurance (82.5% versus 87.7%), but a majority had both (59.3%). Only 14.3% had neither. Forty-four percent of all patients with primary care physicians believed their primary care physician was incapable of managing musculoskeletal problems. Appropriate use of the emergency department by patients with musculoskeletal disorders may require not only increased access to insurance and primary care, but also improved public understanding of the scope of care offered by primary care physicians and the conflicting demands placed on emergency department providers. Level of Evidence: Level I, prognostic study. See the Guidelines for Authors for a complete description of levels of evidence. PMID:18496728

  7. Members of the human body prone to musculoskeletal damages: a comparison between the sector of transportation and footwears production.

    PubMed

    Gomes de Lima, Jeane F; Colaço, Geraldo; da Silva, Ricardo; Masculo, Francisco

    2012-01-01

    This study present areas of the body more prone to develop diseases by musculoskeletal efforts, ie, RTD, in two companies of Paraiba, Brazil. To this end, was made a comparative analysis with respect to the type of work performed (standing, sitting) and the parts that suffer most discomfort after a day's work in a footwear industry and a bus transportation company. The quanti-qualitative research was conducted through semi-structured interviews with 227 employees in the period 2008 to 2009, having as methodological the tool diagram of painful areas of Corlett and Manenica. It was concluded that the areas most affected by musculoskeletal disorders are located in the neck (9,2%), backs (23,6%), shoulders (14,5%) and legs (11,3%), being usually caused by inappropriate postures, repetitive movements and work station no adequate the anthropometry of the users. Thus, we recommend the adoption of ergonomic measures that enable a healthy and safe environment for workers. PMID:22316940

  8. The importance of work organization on workload and musculoskeletal health--Grocery store work as a model.

    PubMed

    Balogh, I; Ohlsson, K; Nordander, C; Björk, J; Hansson, G-Å

    2016-03-01

    We have evaluated the consequences of work organization on musculoskeletal health. Using a postal questionnaire, answered by 1600 female grocery store workers, their main work tasks were identified and four work groups were defined (cashier, picking, and delicatessen work, and a mixed group, who performed a mix of these tasks). The crude odds ratios (ORs) for neck/shoulder complaints were 1.5 (95% CI 1.0-2.2), 1.1 (0.7-1.5) and 1.6 (1.1-2.3), respectively, compared to mixed work. Adjusting for individual and psychosocial factors had no effect on these ORs. For elbows/hands, no significant differences were found. Technical measurements of the workload showed large differences between the work groups. Picking work was the most strenuous, while cashier work showed low loads. Quantitative measures of variation revealed for mixed work high between minutes variation and the highest between/within minutes variation. Combining work tasks with different physical exposure levels increases the variation and may reduce the risk of musculoskeletal complaints. PMID:26464034

  9. A cross-country comparison of short- and long-term effects of an ergonomic intervention on musculoskeletal discomfort, eyestrain and psychosocial stress in VDT operators: selected aspects of the international project.

    PubMed

    Horgen, Gunnar; Aarås, Arne; Dainoff, Marvin J; Konarska, Maria; Thoresen, Magne; Cohen, Barbara G F

    2005-01-01

    Three groups of data entry female visual display terminal (VDT) workers from Norway (n = 30), Poland (n = 33) and the USA (n = 29) were compared. Before intervention, the Norwegian group reported more neck pain compared with the Polish group. The Polish group reported less shoulder pain than both the U.S. and the Norwegian groups. The clinical examination documented fewer symptoms and signs of musculoskeletal illness among the Polish participants compared with the Norwegian and the U.S. groups. After intervention, the Norwegian group reported a reduction in neck pain while the U.S. group reported a reduction in shoulder pain. The Polish group reported an increase in neck, shoulder and forearm pain at follow-up compared to after intervention. The Polish group recorded higher flexion of the upper arm at follow-up parallel with an increase of pain in the upper part of the body. Visual discomfort showed variable results in the 3 countries. PMID:15794875

  10. National survey of back & neck pain amongst consultant ophthalmologists in the United Kingdom.

    PubMed

    Hyer, Jonathan N; Lee, Richard M; Chowdhury, Haziq R; Smith, Henry B; Dhital, Anish; Khandwala, Mona

    2015-12-01

    Repetitive tasks, awkward or prolonged working postures, and high cognitive load are risk factors for occupational musculoskeletal disorders. Ophthalmologists may be vulnerable given that they are exposed to a combination of these factors. This national study assesses the prevalence, severity and associations of back and neck pain amongst UK consultant ophthalmologists. A postal survey was conducted using addresses supplied by the Royal College of Ophthalmologists. Statistical analysis was performed using Pearson correlation coefficient, two-tailed probability testing, analysis of variance (ANOVA) and Dunn's multiple comparison test. 518 responses were received (50.3 % response rate). Back and neck pain were reported by 50.6 % (262/518) and 31.8 % (165/518) of respondents, respectively, with 62.4 % (323/518) reporting one or both. 33.6 % (174/518) reported pain whilst operating, of whom 78.7 % (137/174) found operating exacerbated their pain. 31.7 % (164/518) reported pain when using the slit lamp, of whom 71.3 % (117/164) found it exacerbated their pain. Individual subspecialties showed a significant relative risk of back or neck pain in some circumstances, when compared to ophthalmologists as a whole. Occupational back and neck pain remains a problem amongst ophthalmologists. Recommendations are made for modifications to the working environment, and consideration should be given to improving education for trainees. PMID:25609503

  11. Advances in Supportive Care for Late Effects of Head and Neck Cancer.

    PubMed

    Murphy, Barbara A; Deng, Jie

    2015-10-10

    As the population of head and neck cancer survivors increases, it has become increasingly important for health care providers to understand and manage late complications of therapy. Functional deficits can be categorized as general health deficits resulting in frailty or debility, head and neck-specific functional deficits such as swallowing and speech, and musculoskeletal impairment as a result of tumor and treatment. Of critical importance is the growing data indicating that swallow therapy and physical therapy may prevent or ameliorate long-term functional deficits. Oral health complications of head and neck therapy may manifest months or years after the completion of treatment. Patients with hyposalivation are at high risk for dental caries and thus require aggressive oral hygiene regimens and routine dental surveillance. Swallowing abnormalities, xerostomia, and poor dentition may result in dietary adaptations that may cause nutritional deficiencies. Identification and management of maladaptive dietary strategies are important for long-term health. Follow-up with primary care physicians for management of comorbidities such as diabetes and hyperlipidemia may help to limit late vascular complications caused by radiation therapy. Herein, we review late effects of head and neck cancer therapy, highlighting recent advances. PMID:26351334

  12. Investigation of the relationship between carrying school bags (handbags and backpacks) and the prevalence of musculoskeletal pains among 12-15 year old students in Shiraz.

    PubMed

    Arghavani, Farshad; Zamanian, Zahra; Ghanbary, Ali; Hassanzadeh, Jafar

    2014-04-01

    Inappropriate school bags put students at risk of musculoskeletal problems and early fatigue. Heavy bags can change the body posture and the musculoskeletal system must react appropriately in order to compensate for this stress. It is recommended that the weight of a school bag must not be more than 10% of the student's body weight and the weight must be placed on both shoulders. The present study aimed to identify the risk factors associated with musculoskeletal disorders by comparing the prevalence of musculoskeletal pains among the students. The present descriptive, cross-sectional study was conducted in different educational districts of Shiraz. The study samples were selected using cluster sampling method. In this study, 800 students marked their painful areas on body maps and the SPSS statistical software (v. 11.5) was used to analyze the data. The results showed that among the students who used backpacks, 48.9% carried the weight on both shoulders, 40.4% carried the weight on their right shoulders, and 10.6% used their left shoulders. Besides, 68.02% of the students carrying handbags often used their right shoulders, while 31.98% used their left shoulders. The study results showed that similar to other countries, Iranian students also mostly made use of backpacks. Moreover, the musculoskeletal pains were most prevalent in the shoulders, which is in line with many other studies conducted on the issue. PMID:25911845

  13. Prevalence of musculoskeletal symptoms among agricultural workers in the United States: an analysis of the National Health Interview Survey, 2004-2008.

    PubMed

    Lee, Soo-Jeong; Tak, Sangwoo; Alterman, Toni; Calvert, Geoffrey M

    2014-01-01

    Ergonomic risks from agricultural tasks can compromise musculoskeletal health of workers. This study estimated prevalence of musculoskeletal symptoms in a sample representing almost 2 million US agricultural industry workers. This study used National Health Interview Survey data from 2004 to 2008. Weighted prevalence was calculated by demographic and employment factors. Prevalence ratios were calculated using generalized linear models with the Poisson distribution assumption. Prevalence rates of low back and neck pain in the previous 3 months were 24.3% and 10.5%, respectively, among agricultural workers. Monthly prevalence of joint pain was 17.0% for hips/knees, 9.8% for shoulders, 9.5% for wrists/hands, 5.4% for elbows, and 4.7% for ankles/toes. Agricultural workers had a significantly higher prevalence of shoulder pain than all other industry workers (prevalence ratios [PR] = 1.28, 95% confidence interval [CI]: 1.02-1.61). This study provides detailed national estimates of musculoskeletal symptom prevalence to understand the burden and the need for intervention among agricultural workers. PMID:24959759

  14. Physical Activity and Musculoskeletal Injuries in Women: The Women's Injury Study

    PubMed Central

    DeFina, Laura F.; Leonard, David; Custodio, Michelle A.; Morrow, James R.

    2013-01-01

    Abstract Background Increased injury rates have been associated with physical activity (PA). The differences in musculoskeletal injury (MSI) characteristics resulting from PA, versus those unrelated to PA, are unknown. We describe the pattern of PA and non-PA MSI incurred by community-dwelling women. Methods Data were extracted from the Women's Injury Study, a web-based observational study that tracked weekly PA behaviors and self-reported MSI of 909 community-dwelling women ages 20–83 years. The primary outcome was self-reported MSI that interrupted daily activities ≥2 days and/or required treatment from a health care provider. Follow-up telephone reporting of MSIs allowed further description of injuries. Mixed effects logistic regression was used to identify injury sites associated with PA, controlling for age, body mass index, previous injury, and use of alcohol. Results Incidence of PA and non-PA MSIs were comparable; some differences in injury characteristics were evident across 83,241 person-weeks of reporting. Non-PA MSIs were more likely to come on “suddenly” (54% vs. 8%) and commonly involved head/jaw/neck injuries. Reported PA-related MSIs were less likely to require health care provider treatment (60% vs. 80%) and resulted in less missed days of work/school (11%) versus non-PA MSIs (17%). Compared to non-PA related injuries, PA-related injuries were more likely to involve the lower (odds ratio [OR]=3.10, p=0.002) or upper limbs (OR=2.54, p=0.01) and less likely to involve the head/jaw/neck (OR=0.21, p=0.002). Conclusion There are some differences in mechanisms of injury, the distribution of injuries by anatomical location, and the treatment of injuries depending on aerobic activity participation, although absolute rates of MSI were comparable. PMID:24117001

  15. High and specialty-related musculoskeletal disorders afflict dental professionals even since early training years

    PubMed Central

    YI, Jianru; HU, Xiangxiang; YAN, Boxi; ZHENG, Wei; LI, Yu; ZHAO, Zhihe

    2013-01-01

    Objective To determine how early musculoskeletal disorders (MSDs) develop in dental professionals and to explore the potential differences among distinct dental specialties. Material and Methods 271 dental postgraduates majoring in five dental specialties were recruited, i.e., orthodontics, prosthodontics, endodontics, periodontics and alveolar surgery. 254 age-matched non-dental postgraduates served as the control. The standardized Nordic questionnaire on MSDs and a self-report questionnaire regarding correlative factors (only for dental postgraduates) were answered through emails. Reliability of responses was assessed applying test-retest method. Results The intraclass correlation coefficient of participants' answers ranged from 0.89 to 0.96. Dental postgraduates had significantly higher prevalence of MSDs than the control group, especially at neck, upper back and lower back. In all dental specialties included, high prevalence of MSDs was reported at neck (47.5%-69.8%), shoulders (50.8%-65.1%), lower back (27.1%-51.2%) and upper back (25.6%-46.5%), with lower prevalence at elbows (5.1%-18.6%), hips (3.4%-16.3%) and ankles (5.1%-11.6%). Periodontics students reported the worst MSDs in most body regions except wrists and knees, which were more prevalent for prosthodontic and alveolar surgery students, respectively. Furthermore, year of clinical work, clinical hours per week and desk hours per week were found as risk factors for MSDs, whereas physical exercise and rest between patients as protective factors. Conclusions High and specialty-related MSDs afflict dental professionals even since very early stage of careers. Prevention aimed at the specialty-related characteristics and the risk/protective factors revealed in this study should be introduced to dental personnel as early as possible. PMID:24037079

  16. Work-Related Musculoskeletal Symptoms Among Batik Workers in Kelantan

    PubMed Central

    Musa, Razlan; Kyi, Win; Rampal, K.G

    2000-01-01

    A cross sectional study was carried out to evaluate the extent of occupational health problems focusing on some aspects of musculoskeletal symptoms among batik workers in Kelantan, Malaysia. The workers selected must have been in that industry for at least one year. Using cluster sampling, 202 workers were selected from 21 factories. More than half (60.2%) of the workers had been troubled with musculoskeletal symptoms at work. The most common symptoms were pain over the shoulders (41.0%), lower back (34.4%) and ankle (34.4%). Duration of employment, younger age group, prolonged standing and awkward working task were among contributing factors. It is therefore necessary to improve on both ergonomic and psychosocial environments of batik workers in order to prevent these musculoskeletal symptoms. PMID:22977385

  17. Novel Musculoskeletal Loading System for Small Exercise Devices

    NASA Technical Reports Server (NTRS)

    Downs, Meghan; Newby, Nate; Trinh, Tinh; Hanson, Andrea

    2016-01-01

    Long duration spaceflight places astronauts at increased risk for muscle strain and bone fracture upon return to a 1-g or partial gravity environment. Functionally limiting decrements in musculoskeletal health are likely during Mars proving-ground and Earth-independent missions given extended transit times and the vehicle limitations for exercise devices (low-mass, small volume, little to no power). This is particularly alarming for exploration missions because astronauts will be required to perform novel and physically demanding tasks (i.e. vehicle egress, exploration, and habitat building activities) on unfamiliar terrain. Accordingly, NASA's exploration roadmap identifies the need for development of small exercise equipment that can prevent musculoskeletal atrophy and has the ability to assess musculoskeletal health at multiple time points during long-duration missions.

  18. An Overview of Systematic Reviews on Prognostic Factors in Neck Pain: Results from the International Collaboration on Neck Pain (ICON) Project

    PubMed Central

    Walton, David M; Carroll, Linda J; Kasch, Helge; Sterling, Michele; Verhagen, Arianne P; MacDermid, Joy C; Gross, Anita; Santaguida, P. Lina; Carlesso, Lisa

    2013-01-01

    Given the challenges of chronic musculoskeletal pain and disability, establishing a clear prognosis in the acute stage has become increasingly recognized as a valuable approach to mitigate chronic problems. Neck pain represents a condition that is common, potentially disabling, and has a high rate of transition to chronic or persistent problems. As a field of research, prognosis in neck pain has stimulated several empirical primary research papers, and a number of systematic reviews. As part of the International Consensus on Neck (ICON) project, we sought to establish the general state of knowledge in the area through a structured, systematic review of systematic reviews (overview). An exhaustive search strategy was created and employed to identify the 13 systematic reviews (SRs) that served as the primary data sources for this overview. A decision algorithm for data synthesis, which incorporated currency of the SR, risk of bias assessment of the SRs using AMSTAR scoring and consistency of findings across SRs, determined the level of confidence in the risk profile of 133 different variables. The results provide high confidence that baseline neck pain intensity and baseline disability have a strong association with outcome, while angular deformities of the neck and parameters of the initiating trauma have no effect on outcome. A vast number of predictors provide low or very low confidence or inconclusive results, suggesting there is still much work to be done in this field. Despite the presence of multiple SR and this overview, there is insufficient evidence to make firm conclusions on many potential prognostic variables. This study demonstrates the challenges in conducting overviews on prognosis where clear synthesis critieria and a lack of specifics of primary data in SR are barriers. PMID:24115971

  19. Occupational Respiratory and Musculoskeletal Symptoms among Egyptian Female Hairdressers.

    PubMed

    Hassan, O M; Bayomy, H

    2015-08-01

    Hairdressing is associated with exposure to a variety of harmful agents which have been linked to respiratory and musculoskeletal disorders in hairdressers. This study aimed to identify respiratory and musculoskeletal disorders in hairdressers compared to office workers. A cross-sectional study was conducted on 80 female hairdressers and 50 matched controls. A structured questionnaire was used to collect information on personal and occupational data, hairdressing activities, the presence of respiratory symptoms and the prevalence of musculoskeletal pain in the past 12 months. Reported symptoms were compared between hairdressers and controls. The associations between self-reported symptoms and hairdressing activities were investigated. Hairdressers were more likely to report symptoms than controls particularly for those who were older, with higher body mass index and longer duration of work as hairdresser. There were significant associations between frequent hair treatments (bleaching, dye and wave) and hand dermatitis (P < 0.001), running nose (P < 0.05), eye irritation (P < 0.01) and phlegm (P < 0.05). Elbow pain and shoulder and back pain were the most prevalent musculoskeletal pains in the past 12 months (13.8 and 12.5% respectively), back and knee pains were the most frequent chronic pain (7.5%), hand and wrist pain led 12.5% of hairdressers to visit a doctor and shoulder pain and back pain indicated a period of sickness absence in 13.8% of hairdressers. Musculoskeletal disorders were associated with manual handling, prolonged standing, strenuous shoulder movements and awkward body posture. Hairdressing is associated with increased risk to respiratory and musculoskeletal disorders due to adverse work conditions. PMID:25663369

  20. Recommendations from NASA's Operational and Research Musculoskeletal Summit

    NASA Technical Reports Server (NTRS)

    Jones, J. A.; Johnson-Throop, K. A.; Scheuring, R. A.; Walton, M. E.; Davis-Street, J. E.; Smaka, T.; McCulley, P. A.; Jones, J. A.; Stokes, C. R.; Parker, K. K.; Wear, M.; Johnson-Throop, K. A.

    2006-01-01

    Introduction: Continuously evolving medical standards of care, limited crew training time, and the inherent constraints of space flight necessitate regular revisions of the mission medical support infrastructure and methodology. A three-day Operational and Research Musculoskeletal Summit was held to review NASA s current strategy for preflight health maintenance and injury screening, risk mitigation for musculoskeletal injuries or syndromes, treatment methods during flight, and research topics to mitigate risks to astronaut health. The Summit also undertook consideration of the best evidence-based terrestrial musculoskeletal practices to recommend their adaptation for use in space. Methods: The types and frequencies of musculoskeletal injuries sustained by short- and long-duration astronauts were obtained from the Longitudinal Study of Astronaut Health. The Summit panel was comprised of experts from the clinical and research communities, as well as representatives from NASA Headquarters, the Astronaut corps, and the offices of JSC Medical Operations, JSC Human Adaptation and Countermeasures, Glenn Research Center Human Research, and Astronaut Strength Conditioning and Rehabilitation. Before the summit, panelists participated in a Web-based review of NASA s Space Medical Conditions List (SMCL). Results: The Summit generated seventy-five operational and research recommendations to the NASA Office of Space Medicine, including changes to the SMCL and to the musculoskeletal section of the ISS debrief questionnaire. From these recommendations, seven were assigned highest value and priority, and could be immediately adopted for the exploration architecture. Discussion: Optimized exercise and conditioning to improve performance and forestall musculoskeletal damage on orbit were the primary area of focus. Special attention was paid to exercise timing and muscle group specificity. The panel s recommendations are currently in various stages of consideration or integration

  1. Angelman syndrome: A review highlighting musculoskeletal and anatomical aberrations.

    PubMed

    Sachdeva, Rohit; Donkers, Sarah J; Kim, Soo Y

    2016-07-01

    Angelman's syndrome (AS) is a genetic neurodevelopment disorder. The cause is a known abnormality involving the maternal inherited ubiquitin-protein ligase (UBE3A) gene. Clinical characteristics universal to the disorder are well documented in the literature and include developmental delay, seizures, ataxia, altered tone, severely impaired speech and intellect, as well as an overall happy demeanor, frequent bouts of laughter, and hypermotoric behavior. Associated with this disorder are several musculoskeletal aberrations. To date, a review of case studies reporting on these musculoskeletal changes has not been carried out. Thus, the purpose of this paper was to provide an overview of the musculoskeletal changes present in individuals with AS. In our review of 21 case reports from 1965-2013, the most consistently reported anatomical changes were of the craniofacial region. These include microcephaly, brachycephaly, a palpable occipital groove, prognathism, and wide spaced teeth. Other musculoskeletal abnormalities less frequently reported in the literature include scoliosis, excessive lumbar lordosis, and pes planus. Given that the majority of the case reports reviewed was of young children, the possibility of underreporting musculoskeletal changes which may manifest in the later years of life may be present. Early diagnosis and interventions to minimize secondary complications are crucial to maintain quality of life. An overall multidisciplinary approach is emphasized to maximize developmental potential for these individuals. Future prospective studies that follow patients into adulthood are needed to better understand the prevalence and development of secondary musculoskeletal changes, which in turn can inform intervention techniques and preventative measures. Clin. Anat. 29:561-567, 2016. © 2015 Wiley Periodicals, Inc. PMID:26480021

  2. The role of MRI in musculoskeletal practice: a clinical perspective

    PubMed Central

    Dean Deyle, Gail

    2011-01-01

    This clinical perspective presents an overview of current and potential uses for magnetic resonance imaging (MRI) in musculoskeletal practice. Clinical practice guidelines and current evidence for improved outcomes will help providers determine the situations when an MRI is indicated. The advanced competency standard of examination used by physical therapists will be helpful to prevent overuse of musculoskeletal imaging, reduce diagnostic errors, and provide the appropriate clinical context to pathology revealed on MRI. Physical therapists are diagnostically accurate and appropriately conservative in their use of MRI consistent with evidence-based principles of diagnosis and screening. PMID:22851878

  3. The effect of relaxin on the musculoskeletal system

    PubMed Central

    Dehghan, F; Haerian, B S; Muniandy, S; Yusof, A; Dragoo, J L; Salleh, N

    2014-01-01

    Relaxin is a hormone structurally related to insulin and insulin-like growth factor, which exerts its regulatory effect on the musculoskeletal and other systems through binding to its receptor in various tissues, mediated by different signaling pathways. Relaxin alters the properties of cartilage and tendon by activating collagenase. This hormone is also involved in bone remodeling and healing of injured ligaments and skeletal muscle. In this review, we have summarized the literature on the effect of relaxin in musculoskeletal system to provide a broad perspective for future studies in this field. PMID:24283470

  4. A musculoskeletal model of the elbow joint complex

    NASA Technical Reports Server (NTRS)

    Gonzalez, Roger V.; Barr, Ronald E.; Abraham, Lawrence D.

    1993-01-01

    This paper describes a musculoskeletal model that represents human elbow flexion-extension and forearm pronation-supination. Musculotendon parameters and the skeletal geometry were determined for the musculoskeletal model in the analysis of ballistic elbow joint complex movements. The key objective was to develop a computational model, guided by optimal control, to investigate the relationship among patterns of muscle excitation, individual muscle forces, and movement kinematics. The model was verified using experimental kinematic, torque, and electromyographic data from volunteer subjects performing both isometric and ballistic elbow joint complex movements. In general, the model predicted kinematic and muscle excitation patterns similar to what was experimentally measured.

  5. A Planned Neck Dissection Is Not Necessary in All Patients With N2-3 Head-and-Neck Cancer After Sequential Chemoradiotherapy

    SciTech Connect

    Soltys, Scott G.; Choi, Clara Y.H.; Fee, Willard E.; Pinto, Harlan A.; Le, Quynh-Thu

    2012-07-01

    Purpose: To assess the role of a planned neck dissection (PND) after sequential chemoradiotherapy for patients with head-and-neck cancer with N2-N3 nodal disease. Methods and Materials: We reviewed 90 patients with N2-N3 head-and-neck squamous cell carcinoma treated between 1991 and 2001 on two sequential chemoradiotherapy protocols. All patients received induction and concurrent chemotherapy with cisplatin and 5-fluorocuracil, with or without tirapazamine. Patients with less than a clinical complete response (cCR) in the neck proceeded to a PND after chemoradiation. The primary endpoint was nodal response. Clinical outcomes and patterns of failure were analyzed. Results: The median follow-up durations for living and all patients were 8.3 years (range, 1.5-16.3 year) and 5.4 years (range, 0.6-16.3 years), respectively. Of the 48 patients with nodal cCR whose necks were observed, 5 patients had neck failures as a component of their recurrence [neck and primary (n = 2); neck, primary, and distant (n = 1); neck only (n = 1); neck and distant (n = 1)]. Therefore, PND may have benefited only 2 patients (4%) [neck only failure (n = 1); neck and distant failure (n = 1)]. The pathologic complete response (pCR) rate for those with a clinical partial response (cPR) undergoing PND (n = 30) was 53%. The 5-year neck control rates after cCR, cPR{yields}pCR, and cPR{yields}pPR were 90%, 93%, and 78%, respectively (p = 0.36). The 5-year disease-free survival rates for the cCR, cPR{yields}pCR, and cPR{yields}pPR groups were 53%, 75%, and 42%, respectively (p = 0.04). Conclusion: In our series, patients with N2-N3 neck disease achieving a cCR in the neck, PND would have benefited only 4% and, therefore, is not recommended. Patients with a cPR should be treated with PND. Residual tumor in the PND specimens was associated with poor outcomes; therefore, aggressive therapy is recommended. Studies using novel imaging modalities are needed to better assess treatment response.

  6. Clinical effects of deep cervical flexor muscle activation in patients with chronic neck pain

    PubMed Central

    Kim, Jin Young; Kwag, Kwang Il

    2016-01-01

    [Purpose] The purpose of this study was to investigate clinical effects of deep cervical flexor (DCF) muscles exercise on pain, Neck Disability Index (NDI), and neck and shoulder postures in patients with chronic neck pain. [Subjects and Methods] Twenty-eight patients with chronic neck pain were randomly assigned into either the general strengthening exercise (GSE) group or the DCF activation group as control and experimental groups, respectively. All exercises were performed three times per week over 4 weeks. NDI and numeric rating scale (NRS) score for pain were determined and radiological assessment of neck-shoulder postures (head tilt angle [HTA], neck flexion angle [NFA], and forward shoulder angle [FSA]) was performed before (baseline), 4 weeks after, and 8 weeks after exercise in order to directly compare the exercise effects between the groups. [Results] In the DCF group, the NDI, NRS score, and neck-shoulder postures (analyzed by uisng HTA, NFA, and FSA) were significantly improved. [Conclusion] DCF activation exercise was effective to alleviate pain, recover functions, and correct forward head posture in the patients with neck pain. Hence, it might be recommended in the rehabilitation of patients with chronic neck pain. PMID:26957772

  7. 78 FR 40486 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-07-05

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases Special Emphasis Panel; Arthritis and Musculoskeletal and Skin Diseases...

  8. Musculoskeletal Disorders and Working Posture among Dental and Oral Health Students.

    PubMed

    Ng, Andrew; Hayes, Melanie J; Polster, Anu

    2016-01-01

    The prevalence of musculoskeletal disorders (MSD) in the dental professions has been well established, and can have detrimental effects on the industry, including lower productivity and early retirement. There is increasing evidence that these problems commence during undergraduate training; however, there are still very few studies that investigate the prevalence of MSD or postural risk in these student groups. Thus, the aim of this study was to determine the prevalence of MSD and conduct postural assessments of students studying oral health and dentistry. A previously validated self-reporting questionnaire measuring MSD prevalence, derived from the Standardised Nordic Questionnaire, was distributed to students. Posture assessments were also conducted using a validated Posture Assessment Instrument. MSD was highly prevalent in all student groups, with 85% reporting MSD in at least one body region. The neck and lower back were the most commonly reported. The final year dental students had the highest percentage with poor posture (68%), while the majority of students from other cohorts had acceptable posture. This study supports the increasing evidence that MSD could be developing in students, before the beginning of a professional career. The prevalence of poor posture further highlights the need to place further emphasis on ergonomic education. PMID:27417601

  9. Work-related Musculoskeletal Disorders in Korea and Japan: A Comparative Description

    PubMed Central

    2014-01-01

    Objectives Work related Musculoskeletal disorders (WMSD) is one of the most important problem in occupational health system of Korea and Japan, where the OHS system developed in similar socio-cultural environment. This study compared WMSD in Korea and Japan to review similarities and differences in their historical background, and development of prevention policies. Methods Scientific articles, government reports, and related official and non-official statistics on WMSD since the 1960s in Japan and Korea were reviewed. Results The historical background and basic structure of the compensation system in Korea and Japan largely overlapped. The issuing of WMSD in both countries appeared as upper limb disorder (ULD), named occupational cervicobrachial diseases (OCD) in Japan, and neck-shoulder-arm syndrome (NSA) 30 years later in Korea, following the change from an industrial structure to automated office work. Both countries developed manuals for diagnosis, guidelines for workplace management, and prevention policies. At present, compensation cases per covered insurers for WMSD are higher in Korea than in Japan, due to the social welfare system and cultural environment. Prevention policies in Korea are enforced more strongly with punitive measures than in Japan. In contrast, the Japanese system requires autonomous effort toward risk control and management, focusing on specific risky processes. Conclusions WMSD in Korea and Japan have a similar history of identification and compensation structure, yet different compensation proportions per covered insurer and prevention policies. Follow-up study with international cooperation is necessary to improve both systems. PMID:25024844

  10. The effects of compensatory workplace exercises to reduce work-related stress and musculoskeletal pain1

    PubMed Central

    de Freitas-Swerts, Fabiana Cristina Taubert; Robazzi, Maria Lúcia do Carmo Cruz

    2014-01-01

    OBJECTIVES: to assess the effect of a compensatory workplace exercise program on workers with the purpose of reducing work-related stress and musculoskeletal pain. METHOD: quasi-experimental research with quantitative analysis of the data, involving 30 administrative workers from a Higher Education Public Institution. For data collection, questionnaires were used to characterize the workers, as well as the Workplace Stress Scale and the Corlett Diagram. The research took place in three stages: first: pre-test with the application of the questionnaires to the subjects; second: Workplace Exercise taking place twice a week, for 15 minutes, during a period of 10 weeks; third: post-test in which the subjects answered the questionnaires again. For data analysis, the descriptive statistics and non-parametric statistics were used through the Wilcoxon Test. RESULTS: work-related stress was present in the assessed workers, but there was no statistically significant reduction in the scores after undergoing Workplace Exercise. However, there was a statistically significant pain reduction in the neck, cervical, upper, middle and lower back, right thigh, left leg, right ankle and feet. CONCLUSION: the Workplace Exercise promoted a significant pain reduction in the spine, but did not result in a significant reduction in the levels of work-related stress. PMID:25296147

  11. Risk factors of musculoskeletal disorders among oil palm fruit harvesters during early harvesting stage.

    PubMed

    Ng, Yee Guan; Mohd Tamrin, Shamsul Bahri; Mohd Yusoff, Irwan Syah; Hashim, Zailina; Deros, Baba M D; Abu Bakar, Shahriman; How, Vivien

    2015-01-01

    This cross-sectional study intends to investigate the associations of musculoskeletal disorders (MSDs) among foreign labourers on a socio-economic background, occupational exposure, social lifestyle, and postures adopted during harvesting tasks. A total of 446 male respondents (263 FFB cutters; 183 FFB collectors) were studied using an interview-assisted questionnaire. OWAS was used to determine the severity of awkward posture based on videos of harvesting tasks recorded for each respondent. Analysis found that increasingly educated respondents had higher risk of developing MSDs. Shorter daily work duration and longer resting duration appear to increase the risk of neck and shoulder disorders among harvesters, which may be attributable to organizational work design. Awkward posture was a particularly significant risk factor of MSDs among FFB collectors. Among the results of the study, occupational exposure, postures and certain socio-demographic backgrounds explained some, but not all, the risk factor of MSDs among harvesters. An in-depth investigation, preferably a longitudinal study investigating the dynamic of work activities and other risk factors, such as psychosocial risk factors, are recommended. PMID:26094525

  12. Psychosocial and individual characteristics and musculoskeletal complaints among clinical laboratory workers.

    PubMed

    Sadeghian, Farideh; Kasaeian, Amir; Noroozi, Pirasteh; Vatani, Javad; Taiebi, Seiyed Hassan

    2014-01-01

    Musculoskeletal disorders (MSDs) are an important health problem among healthcare workers, including clinical laboratory ones. The aim of the present study was to investigate the prevalence of MSDs and individual and psychosocial risk factors among clinical laboratory workers. A cross-sectional study was carried out among 156 workers of 30 clinical laboratories in 3 towns of Iran. The Nordic questionnaire with individual and psychosocial risk factors was used to collect data. Multiple logistic regression analysis was performed. The prevalence of reported MSDs among the study population was 72.4% in the past 12 months. The most prevalent MSDs were pain in the lower back and neck; 42.7% and 33.3%, respectively. Significant relations were found between MSDs and age, gender, heavy work at home and job control (p < .05). MSDs among laboratory workers were high and associated with age, gender, heavy work at home and job control. More research into measuring these factors and workplace physical demands is suggested. PMID:24934430

  13. Musculoskeletal Disorders and Working Posture among Dental and Oral Health Students

    PubMed Central

    Ng, Andrew; Hayes, Melanie J.; Polster, Anu

    2016-01-01

    The prevalence of musculoskeletal disorders (MSD) in the dental professions has been well established, and can have detrimental effects on the industry, including lower productivity and early retirement. There is increasing evidence that these problems commence during undergraduate training; however, there are still very few studies that investigate the prevalence of MSD or postural risk in these student groups. Thus, the aim of this study was to determine the prevalence of MSD and conduct postural assessments of students studying oral health and dentistry. A previously validated self-reporting questionnaire measuring MSD prevalence, derived from the Standardised Nordic Questionnaire, was distributed to students. Posture assessments were also conducted using a validated Posture Assessment Instrument. MSD was highly prevalent in all student groups, with 85% reporting MSD in at least one body region. The neck and lower back were the most commonly reported. The final year dental students had the highest percentage with poor posture (68%), while the majority of students from other cohorts had acceptable posture. This study supports the increasing evidence that MSD could be developing in students, before the beginning of a professional career. The prevalence of poor posture further highlights the need to place further emphasis on ergonomic education. PMID:27417601

  14. The musculoskeletal diagnosis cohort: examining pain and pain care among veterans.

    PubMed

    Goulet, Joseph L; Kerns, Robert D; Bair, Matthew; Becker, William C; Brennan, Penny; Burgess, Diana J; Carroll, Constance M; Dobscha, Steven; Driscoll, Mary A; Fenton, Brenda T; Fraenkel, Liana; Haskell, Sally G; Heapy, Alicia A; Higgins, Diana M; Hoff, Rani A; Hwang, Ula; Justice, Amy C; Piette, John D; Sinnott, Patsi; Wandner, Laura; Womack, Julie A; Brandt, Cynthia A

    2016-08-01

    Musculoskeletal disorders (MSDs) are highly prevalent, painful, and costly disorders. The MSD Cohort was created to characterize variation in pain, comorbidities, treatment, and outcomes among patients with MSD receiving Veterans Health Administration care across demographic groups, geographic regions, and facilities. We searched electronic health records to identify patients treated in Veterans Health Administration who had ICD-9-CM codes for diagnoses including, but not limited to, joint, back, and neck disorders, and osteoarthritis. Cohort inclusion criteria were 2 or more outpatient visits occurring within 18 months of one another or one inpatient visit with an MSD diagnosis between 2000 and 2011. The first diagnosis is the index date. Pain intensity numeric rating scale (NRS) scores, comorbid medical and mental health diagnoses, pain-related treatments, and other characteristics were collected retrospectively and prospectively. The cohort included 5,237,763 patients; their mean age was 59, 6% were women, 15% identified as black, and 18% reported severe pain (NRS ≥ 7) on the index date. Nontraumatic joint disorder (27%), back disorder (25%), and osteoarthritis (21%) were the most common MSD diagnoses. Patients entering the cohort in recent years had more concurrent MSD diagnoses and higher NRS scores. The MSD Cohort is a rich resource for collaborative pain-relevant health service research. PMID:27023420

  15. Are subject-specific musculoskeletal models robust to the uncertainties in parameter identification?

    PubMed

    Valente, Giordano; Pitto, Lorenzo; Testi, Debora; Seth, Ajay; Delp, Scott L; Stagni, Rita; Viceconti, Marco; Taddei, Fulvia

    2014-01-01

    Subject-specific musculoskeletal modeling can be applied to study musculoskeletal disorders, allowing inclusion of personalized anatomy and properties. Independent of the tools used for model creation, there are unavoidable uncertainties associated with parameter identification, whose effect on model predictions is still not fully understood. The aim of the present study was to analyze the sensitivity of subject-specific model predictions (i.e., joint angles, joint moments, muscle and joint contact forces) during walking to the uncertainties in the identification of body landmark positions, maximum muscle tension and musculotendon geometry. To this aim, we created an MRI-based musculoskeletal model of the lower limbs, defined as a 7-segment, 10-degree-of-freedom articulated linkage, actuated by 84 musculotendon units. We then performed a Monte-Carlo probabilistic analysis perturbing model parameters according to their uncertainty, and solving a typical inverse dynamics and static optimization problem using 500 models that included the different sets of perturbed variable values. Model creation and gait simulations were performed by using freely available software that we developed to standardize the process of model creation, integrate with OpenSim and create probabilistic simulations of movement. The uncertainties in input variables had a moderate effect on model predictions, as muscle and joint contact forces showed maximum standard deviation of 0.3 times body-weight and maximum range of 2.1 times body-weight. In addition, the output variables significantly correlated with few input variables (up to 7 out of 312) across the gait cycle, including the geometry definition of larger muscles and the maximum muscle tension in limited gait portions. Although we found subject-specific models not markedly sensitive to parameter identification, researchers should be aware of the model precision in relation to the intended application. In fact, force predictions could be

  16. Are Subject-Specific Musculoskeletal Models Robust to the Uncertainties in Parameter Identification?

    PubMed Central

    Valente, Giordano; Pitto, Lorenzo; Testi, Debora; Seth, Ajay; Delp, Scott L.; Stagni, Rita; Viceconti, Marco; Taddei, Fulvia

    2014-01-01

    Subject-specific musculoskeletal modeling can be applied to study musculoskeletal disorders, allowing inclusion of personalized anatomy and properties. Independent of the tools used for model creation, there are unavoidable uncertainties associated with parameter identification, whose effect on model predictions is still not fully understood. The aim of the present study was to analyze the sensitivity of subject-specific model predictions (i.e., joint angles, joint moments, muscle and joint contact forces) during walking to the uncertainties in the identification of body landmark positions, maximum muscle tension and musculotendon geometry. To this aim, we created an MRI-based musculoskeletal model of the lower limbs, defined as a 7-segment, 10-degree-of-freedom articulated linkage, actuated by 84 musculotendon units. We then performed a Monte-Carlo probabilistic analysis perturbing model parameters according to their uncertainty, and solving a typical inverse dynamics and static optimization problem using 500 models that included the different sets of perturbed variable values. Model creation and gait simulations were performed by using freely available software that we developed to standardize the process of model creation, integrate with OpenSim and create probabilistic simulations of movement. The uncertainties in input variables had a moderate effect on model predictions, as muscle and joint contact forces showed maximum standard deviation of 0.3 times body-weight and maximum range of 2.1 times body-weight. In addition, the output variables significantly correlated with few input variables (up to 7 out of 312) across the gait cycle, including the geometry definition of larger muscles and the maximum muscle tension in limited gait portions. Although we found subject-specific models not markedly sensitive to parameter identification, researchers should be aware of the model precision in relation to the intended application. In fact, force predictions could be

  17. Work-Related Musculoskeletal Disorders among Nurses in Ibadan, South-west Nigeria: a cross-sectional survey

    PubMed Central

    2010-01-01

    Background Musculoskeletal disorders represent a significant occupational problem among nurses; however, data on musculoskeletal health of nurses in Sub-Sahara Africa are sparse. This study sought to determine the lifetime, 12-months period and point prevalence of work-related musculoskeletal disorders (WMSDs); the associated job risk factors and the coping strategies toward reducing the risk among nurses from selected hospitals in Ibadan, South-west Nigeria Methods A previously validated self administered questionnaire which sought information on demographics, prevalence and pattern of WMSDs, associated job risk factors and coping strategies was employed as the survey instrument. A total of 160 questionnaires were distributed to nurses in the different hospitals but 128 questionnaires were returned yielding an 80% response rate. 10 of the returned questionnaires were excluded because of incomplete data. Results Eighty-four point four percent of the nurses have had WMSDs once or more in their occupational lives. The 12-months period and point prevalence rate of WMSDs at any body region was 78% and 66.1% respectively. WMSDs occurred mostly in low back (44.1%), neck (28.0%), and knees (22.4%). 30.3% treated themselves or had visited other health practitioners for care. Nurses with > 20 years of clinical experience are about 4 times more likely to develop WMSDs (OR 3.81; CI 1.08-13.4) than those with 11-20 years experience. Working in the same positions for long periods (55.1%), lifting or transferring dependent patients (50.8%) and treating an excessive number of patients in one day (44.9%) were the most perceived job risk factors for WMSDs. Getting help in handling heavy patients (50.4%), modification of nursing procedures in order to avoid re-injury (45.4%), and modifying patient's/nurse position (40.3%) were the top three coping strategies. Conclusions A high proportion of Nigerian nurses reported WMSDs at some body site in their occupational lives with the low

  18. Backrest Shape Affects Head-Neck Alignment and Seated Pressure.

    PubMed

    Ukita, Atsuki; Nishimura, Shigeo; Kishigami, Hirotoshi; Hatta, Tatsuo

    2015-01-01

    Unstable back support against gravity results in a forward head posture and contributes to buttocks pressure ulcers. However, the association between these health problems and a wheelchair backrest is unclear. Our newly developed wheelchair (N-WC) supports the back of the pelvis and thorax from obliquely underneath. The purpose of this study was to investigate the effect of different backrest shapes on head-neck alignment and seated pressure. Data from 28 healthy subjects were analyzed. Outcome measures were head-neck alignment angles, support angles of the backrest, and pressure distributions on the supporting surfaces. Compared with a typical wheelchair that has a flat backrest, the seat pressure decreased and the center of pressure was located in the middle of both the seat and backrest in the N-WC. Moreover, the head-neck alignment when seated in the N-WC was upright. These results highlight the importance of the shape of the wheelchair backrest. PMID:26288886

  19. Therapeutic applications of botulinum neurotoxins in head and neck disorders

    PubMed Central

    Alshadwi, Ahmad; Nadershah, Mohammed; Osborn, Timothy

    2014-01-01

    Objective The aim of this article is to review the mechanism of action, physiological effects, and therapeutic applications of botulinum neurotoxins in the head and neck area. Study design An extensive literature search was performed using keywords. The resulting articles were analyzed for relevance in four areas: overview on botulinum neurotoxins, the role of botulinum neurotoxins in the management of salivary secretory disorders, the role of botulinum neurotoxins in the management of facial pain, and the role of botulinum neurotoxins in head and neck movement disorders. Institutional review board approval was not needed due the nature of the study. Results Botulinum neurotoxin therapy was demonstrated to be a valuable alternative to conventional medical therapy for many conditions affecting the head and neck area in terms of morbidly, mortality, and patient satisfaction with treatment outcomes. Conclusion Botulinum neurotoxin therapy provides viable alternatives to traditional treatment modalities for some conditions affecting the head and neck region that have neurological components. This therapy can overcome some of the morbidities associated with conventional therapy. More research is needed to determine the ideal doses of botulinum neurotoxin to treat different diseases affecting the head and neck regions. PMID:25544809

  20. Effect of seat and table top slope on the biomechanical stress sustained by the musculo-skeletal system.

    PubMed

    Hamaoui, Alain; Hassaïne, Myriam; Watier, Bruno; Zanone, Pier-Giorgio

    2016-01-01

    The purpose of this study was to assess the effect of table and seat slope on the biomechanical stress sustained by the musculo-skeletal system. Angular position of the head and trunk, and surface electromyography of eleven postural muscles were recorded while seated under different conditions of seat slope (0°, 15° forward) and table slope (0°, 20° backward). The specific stress sustained by C7-T1 joint was estimated with isometric torque calculation. The results showed that the backward sloping table was associated with a reduction of neck flexion and neck extensors EMG, contrasting with a concurrent overactivity of the deltoideus. The forward sloping chair induced an anterior pelvic tilt, but also a higher activity of the knee (vasti) and ankle (soleus) extensors. It was concluded that sloping chairs and tables favor a more erect posture of the spine, but entails an undesirable overactivity of upper and lower limbs muscles to prevent the body from sliding. PMID:26669951

  1. The phenotypic and genetic signatures of common musculoskeletal pain conditions.

    PubMed

    Diatchenko, Luda; Fillingim, Roger B; Smith, Shad B; Maixner, William

    2013-06-01

    Musculoskeletal pain conditions, such as fibromyalgia and low back pain, tend to coexist in affected individuals and are characterized by a report of pain greater than expected based on the results of a standard physical evaluation. The pathophysiology of these conditions is largely unknown, we lack biological markers for accurate diagnosis, and conventional therapeutics have limited effectiveness. Growing evidence suggests that chronic pain conditions are associated with both physical and psychological triggers, which initiate pain amplification and psychological distress; thus, susceptibility is dictated by complex interactions between genetic and environmental factors. Herein, we review phenotypic and genetic markers of common musculoskeletal pain conditions, selected based on their association with musculoskeletal pain in previous research. The phenotypic markers of greatest interest include measures of pain amplification and 'psychological' measures (such as emotional distress, somatic awareness, psychosocial stress and catastrophizing). Genetic polymorphisms reproducibly linked with musculoskeletal pain are found in genes contributing to serotonergic and adrenergic pathways. Elucidation of the biological mechanisms by which these markers contribute to the perception of pain in these patients will enable the development of novel effective drugs and methodologies that permit better diagnoses and approaches to personalized medicine. PMID:23545734

  2. NSAIDs and Musculoskeletal Treatment: What is the Clinical Evidence?

    ERIC Educational Resources Information Center

    Stovitz, Steven D.; Johnson, Robert J.

    2003-01-01

    Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for musculoskeletal injuries because the conditions are considered inflammatory in nature. However, because inflammation is a necessary component in healing, decreasing inflammation may be counterproductive. Also, many tendon injuries are, in fact, degenerative and not…

  3. Prevalence of musculoskeletal disorders among Norwegian female biathlon athletes

    PubMed Central

    Østerås, Håvard; Garnæs, Kirsti Krohn; Augestad, Liv Berit

    2013-01-01

    The purpose was to examine musculoskeletal disorders in Norwegian female biathlon athletes (age ≥ 16), both juniors and seniors. The design was a retrospective cross-sectional study. In all, 148 athletes (79.1%) responded; of these, 118 athletes were 16–21 years (juniors) (77.6%), and 30 athletes were 22 years or older (seniors) (20.3%), and mean age was 19.1. A validated questionnaire was used to collect the data. The prevalence of musculoskeletal disorders was 57.8%. The most affected parts were the knee (23.0% of the total injuries), calf (12.2%), ankle/foot (10.8%), lower back (10.8%), and thigh (10.1%). The disorders resulted in training/competition cessation for 73.5% of athletes, in alternative training for 87.8%. Fifty percent of the athletes had one or several musculoskeletal disorders. Most of the problems occurred preseason, and the duration of symptoms was often prolonged. Few differences between the juniors and seniors were found. This study showed the prevalence of musculoskeletal problems among female biathlon athletes. The results indicate that prevention of lower limb problems must be prioritized, especially during the preseason. PMID:24379711

  4. The coming of age of musculoskeletal tissue engineering and regeneration

    PubMed Central

    Tuan, Rocky S.

    2016-01-01

    Standfirst Tissue engineering and regenerative medicine have advanced rapidly towards the development of therapeutic solutions for musculoskeletal disorders. In 2012, breakthroughs have been made in the guidance of adult stem cell homing, the tissue regenerative activity of stem-cell-derived extracellular matrix has been tested, and novel, mechanically superior biomaterials have been fabricated. PMID:23321611

  5. Bacteriology laboratories and musculoskeletal tissue banks in Australia.

    PubMed

    Varettas, Kerry

    2012-11-01

    In Australia, there are six Therapeutic Goods Administration-licensed clinical bacteriology laboratories providing bacterial and fungal bioburden testing of allograft musculoskeletal samples sent from 10 tissue banks. Musculoskeletal swab and/or tissue biopsy samples are collected at the time of allograft retrieval and sent to bacteriology laboratories for bioburden testing, in some cases requiring interstate transport. Bacteria and fungi may be present within the allograft at the time of retrieval or contaminated from an external source. The type of organism recovered will determine if the allograft is rejected for transplant, which may include all allografts from the same donor. Bacteriology staff also provides unpaid support of tissue banks through meeting involvement, consultations, licence-related activities, validations and research funded by their organisation and not part of any contractual agreement. Bacteriology laboratories and tissue banks must be compliant to the Code of Good Manufacturing Practice - Human Blood and Tissues and regulated by the Therapeutic Goods Administration. Clinical bacteriology laboratories also require mandatory accreditation to Standards Australia International Organisation for Standardisation (ISO) 15189:2009 medical laboratories - particular requirements for quality and competence, and may also attain Standards Australia/New Zealand Standard ISO 9001:2000 quality management systems certification. Bacteriology laboratories and musculoskeletal tissue banks are integral partners in providing safe allograft musculoskeletal tissue for transplant. PMID:22882601

  6. Body mass index and musculoskeletal pain: is there a connection?

    PubMed Central

    2013-01-01

    Background Back pain is one of the most common complaints that patients report to physicians and two-thirds of the population has an elevated body mass index (BMI), indicating they are either overweight or obese. It was once assumed that extra body weight would stress the low back and lead to pain, however, researchers have reported inconsistencies association between body weight and back pain. In contrast, more recent studies do indicate that an elevated BMI is associated with back pain and other musculoskeletal pain syndromes due to the presence of a chronic systemic inflammatory state, suggesting that the relationship between BMI and musculoskeletal pains be considered in more detail. Objective To describe how an elevated BMI can be associated with chronic systemic inflammation and pain expression. To outline measurable risk factors for chronic inflammation that can be used in clinical practice and discuss basic treatment considerations. Discussion Adiposopathy, or “sick fat” syndrome, is a term that refers to an elevated BMI that is associated with a chronic systemic inflammatory state most commonly referred to as the metabolic syndrome. The best available evidence suggests that the presence of adiposopathy determines if an elevated BMI will contribute to musculoskeletal pain expression. It is not uncommon for physicians to fail to identify the presence of adiposopathy/metabolic syndrome. Conclusion Patients with an elevated BMI should be further examined to identify inflammatory factors associated with adiposopathy, such as the metabolic syndrome, which may be promoting back pain and other musculoskeletal pain syndromes. PMID:23687943

  7. Musculoskeletal symptom survey among cement and concrete workers.

    PubMed

    Goldsheyder, David; Weiner, Shira Schecter; Nordin, Margareta; Hiebert, Rudi

    2004-01-01

    Work in construction is associated with a high risk for musculoskeletal disorders and injuries. The symptom survey was conducted to determine the magnitude and musculoskeletal injury characteristics among the cement and concrete workers and identify the most problematic work-related activities and job factors that might have contributed to the occurrence of these disorders. Findings revealed that a large proportion of the laborers (77%) experienced at least one musculoskeletal disorder in the last year. Low back pain was reported as the most frequently experienced symptom (66%). 'Working while in pain' the concrete workers perceived as the major problem in the trade. Other problematic work-related activities included 'bending or twisting the back', 'work in hot, cold or wet conditions', and 'handling heavy objects'. Most of the laborers (82%) requested on-the-job safety training. Survey results combined with the outcomes of focus groups discussions and work site observations were used in the design of a training program aimed at the prevention of musculoskeletal morbidity in the trade. The program incorporated ergonomics principles, hazard recognition, safe work practices, problem solving and personal protection in the training curriculum for membership of the trade. PMID:15502291

  8. Case-control study of risk factors for disease in the neck and shoulder area.

    PubMed

    Ekberg, K; Björkqvist, B; Malm, P; Bjerre-Kiely, B; Karlsson, M; Axelson, O

    1994-04-01

    A case-control study was performed to elucidate the strength of the relation between musculoskeletal disorders in the neck and shoulders and physical, organisational, and psychosocial aspects of the work environment. Cases were identified as those persons who consulted a physician in a community in southern Sweden for new musculoskeletal disorders in the neck and shoulders during a study period from August 1988 to the end of October 1989. One hundred and nine cases were collected and clinically examined. The cases also answered the Nordic questionnaire on symptoms as well as a questionnaire on work conditions and background factors. Controls were drawn as a random sample of the working population in the community where the cases appeared. A total of 637 controls answered the same questionnaires as the cases. Odds ratios (ORs) were calculated by logistic regression. The odds ratios were 11.4 for women, 4.9 for immigrant background, and 3.7 for current smoking. To exercise rarely, compared with often, appeared as a preventive factor with an OR of 0.3. The ORs for various determinants of physical work load were 7.5 for repetitive movements demanding precision, 13.6 for light lifting, 3.6 for uncomfortable sitting positions, 4.8 for work with lifted arms, and 3.5 for a rushed work pace. Regarding work organisational determinants, the ORs were 16.5 for ambiguity of work role (uncertainty whether the person could manage the work) 2.6 for low quality work, and 3.8 for high demands on attention. Several of the determinants showed a significant dose-response relation with disease. It seems that work organisation and psychosocial work conditions are as important determinants for disease in the neck and shoulders as are the physical work conditions. PMID:8199669

  9. Neck/shoulder and low-back disorders in the forestry industry: relationship to work tasks and perceived psychosocial job stress.

    PubMed

    Hagen, K B; Magnus, P; Vetlesen, K

    1998-10-01

    In a national cross-sectional study, the prevalence of neck/shoulder and low-back disorders and their relationship to work tasks and perceived psychosocial job stress was studied among forestry employees. The data were collected by occupational health service staff using Karasek's demand/control questionnaire for the psychosocial measures and the Standardized Nordic questionnaire for the analysis of musculoskeletal disorders. Based on data about past and present work tasks, the study population was classified into three groups: 645 manual workers, 66 machine operators and 124 administrative workers. Low-back disorders were more common among the manual workers than among the administrative workers [odds ratio (OR) = 1.98]. For the machine operators and manual workers, an increasing level of psychological demands was significantly associated with an increased prevalence of low-back disorders. The prevalence of neck/shoulder disorders was significantly higher among the machine operators (OR = 3.37) and manual workers (OR = 2.34) than among the administrative workers. An increasing level of psychological demands combined with a decreasing level of intellectual discretion was associated with an increased prevalence of neck/shoulder disorders. Authority over decisions was not associated with musculoskeletal disorders. In conclusion, musculoskeletal disorders were associated with both physical and psychosocial work factors. The modest strength of the associations between each individual independent variable and the outcome measure shows, however, that a substantial reduction in the prevalence of musculoskeletal disorders may be difficult to achieve. Nevertheless, the study clearly suggests that in the forestry industry attention should be paid to psychosocial work factors in future organizational changes and preventive programmes. PMID:9802255

  10. Musculoskeletal evaluation in severe haemophilia A patients from Latin America

    PubMed Central

    Ozelo, M C; Villaça, P R; Pérez-Bianco, R; Candela, M; Garcia-Chavez, J; Moreno-Rodriguez, B; Rodrigues, M B; Rodriguez-Grecco, I; Solano, M H; Chumpitaz, G; Morales-Gana, M M; Ruiz-Sáez, A

    2013-01-01

    Summary There is a paucity of literature on haemophilia treatment in Latin American countries, a region characterized by rapidly improving systems of care, but with substantial disparities in treatment between countries. The aim of this study was to evaluate the musculoskeletal status of haemophilia patients from Latin America and to examine the relationship between musculoskeletal status and treatment practices across countries. The Committee of Latin America on the Therapeutics of Inhibitor Groups conducted a survey of its member country representatives on key aspects of haemophilia treatment in 10 countries. Musculoskeletal status of patients was obtained during routine comprehensive evaluations between March 2009 and March 2011. Eligible patients had severe haemophilia A (factor VIII <1%) without inhibitors (<0.6 BU mL−1) and were ≥5 years of age. Musculoskeletal status was compared between three groups of countries, based primarily on differences in the availability of long-term prophylaxis. Overall, 143 patients (5–66 years of age) were enrolled from nine countries. In countries where long-term prophylaxis had been available for at least 10 years (Group A), patients aged 5–10 years had significantly better mean World Federation of Hemophilia clinical scores, fewer target joints and fewer affected joints than patients from countries where long-term prophylaxis has been available for about 5 years (Group B) or was not available (Group C). In Latin America, the musculoskeletal status of patients with severe haemophilia without inhibitors has improved significantly in association with the provision of long-term prophylaxis. As more countries in Latin America institute this practice, further improvements are anticipated. PMID:24354487

  11. Role of yoga and physical activity in work-related musculoskeletal disorders among dentists

    PubMed Central

    Koneru, Suneetha; Tanikonda, Rambabu

    2015-01-01

    Background: Work-related musculoskeletal pain is one of the occupational hazards in dentists. Aims: To find the prevalence and severity of musculoskeletal pain in dentists, to compare musculoskeletal pain among dentists practicing yoga, those practicing physical activities, and those without any physical activity, and also to know the effects of sex, age, and workload on musculoskeletal pain. Materials and Methods: A self-reporting work-related questionnaire and the Nordic questionnaire for analysis of musculoskeletal disorders were given to graduated dentists attending Indian dental conference in Mumbai, to know the musculoskeletal pain experienced in the last 12 months and feedback was obtained from 220 dentists. Results: The prevalence of musculoskeletal pain in dentists was 34.5%. Prevalence of musculoskeletal pain was 10.5%, 21.7%, and 45.6% in dentists with regular yoga practice, other physical activity, and no physical activity, respectively. There was statistically significant difference in the prevalence of musculoskeletal pain among dentists who were practicing yoga when compared with those in no regular activity group. Conclusion: Within the limitations of the study, there was significant role of physical activity on the quality and quantity of work-related musculoskeletal disorders experienced by dentists. Yoga was found to be more effective than other modes of physical activities. More research is needed on musculoskeletal problems in dentists, with an emphasis on larger sample sizes and correlating other factors like age and sex of the dentists, duration of practice, years of practicing yoga, and working hours per week. PMID:26236679

  12. Less may be more: nodal treatment in neck positive head neck cancer patients.

    PubMed

    Studer, Gabriela; Huber, Gerhard F; Holz, Edna; Glanzmann, Christoph

    2016-06-01

    Ongoing debates about the need and extent of planned neck dissection (PND), and required nodal radiation doses volumes lead to this evaluation. Aim was to assess nodal control after definitive intensity modulated radiation therapy (IMRT ± systemic therapy) followed by PND in our head neck cancer cohort with advanced nodal disease. Between 01/2005 and 12/2013, 99 squamous cell cancer HNC patients with pre-therapeutic nodal metastasis ≥3 cm were treated with definitive IMRT followed by PND. In addition, outcome in 103 patients with nodal relapse after IMRT and observation only (no-PND cohort) were analyzed. Prior to PND, PET-CT, fine needle aspirations, ultrasound and palpation were assessed regarding its predictive value. Patterns of nodal relapse were assessed in patients with isolated neck failure after definitive IMRT alone. 70/99 (70 %) PND specimens showed histopathological complete response (hCR), which translated into statistically significantly superior survival compared with partial response (hPR) with 4-year overall survival, disease specific survival and nodal control rates of 90/83/96 vs 67/60/78 % (p = 0.002/0.001/0.003). 1/99 patient developed isolated subsequent nodal disease. 64/2147 removed nodes contained viable tumor (3 %). Predictive information of the performed diagnostic investigations was not reliable. 17/70 hCR patients showed true negative findings in available three to four investigations (0/29 hPR). 27/103 no-PND patients developed isolated neck disease (26 %) with successful salvage in 21/24 [88 %, or 21/27 (78 %)]. Nearly all failures occurred in the prior nodal gross tumor volume area. A more restrictive approach regarding PND and/or nodal IMRT dose-volumes may be justified. PMID:25920604

  13. Outcomes of Induction Chemotherapy for Head and Neck Cancer Patients

    PubMed Central

    Chen, Jin-Hua; Yen, Yu-Chun; Liu, Shing-Hwa; Yuan, Sheng-Po; Wu, Li-Li; Lee, Fei-Peng; Lin, Kuan-Chou; Lai, Ming-Tang; Wu, Chia-Che; Chen, Tsung-Ming; Chang, Chia-Lun; Chow, Jyh-Ming; Ding, Yi-Fang; Lin, Ming-Chin; Wu, Szu-Yuan

    2016-01-01

    Abstract The use of induction chemotherapy (CT) is controversial. We compared the survival of head and neck cancer patients receiving docetaxel- or platinum-based induction CT before concomitant chemoradiotherapy (CCRT) with the survival of those receiving upfront CCRT alone. Data from the National Health Insurance and cancer registry databases in Taiwan were linked and analyzed. We enrolled patients who had head and neck cancer between January 1, 2002 and December 31, 2011. Follow-up was from the index date to December 31, 2013. We included head and neck patients diagnosed according to the International Classification of Diseases, Ninth Revision, Clinical Modification codes 140.0–148.9 who were aged >20 years, at American Joint Committee on Cancer clinical cancer stage III or IV, and receiving induction CT or platinum-based CCRT. The exclusion criteria were a cancer history before head and neck cancer diagnosis, distant metastasis, AJCC clinical cancer stage I or II, receipt of platinum and docetaxel before radiotherapy, an age <20 years, missing sex data, docetaxel use during or after RT, induction CT for >8 weeks before RT, induction CT alone before RT, cetuximab use, adjuvant CT within 90 days after RT completion, an RT dose <7000 cGy, curative head and neck cancer surgery before RT, nasopharyngeal cancer, in situ carcinoma, sarcoma, and head and neck cancer recurrence. We enrolled 10,721 stage III–IV head and neck cancer patients, with a median follow-up of 4.18 years (interquartile range, 3.25 years). The CCRT (arm 1), docetaxel-based induction CT (arm 2), and platinum-based CCRT (arm 3; control arm) groups comprised 7968, 503, and 2232 patients, respectively. Arm 3 was used to investigate mortality risk after induction CT. After adjustment for age, sex, clinical stage, and comorbidities, the adjusted hazard ratios (aHRs) (95% confidence interval [CI]) for overall death were 1.37 (1.22–1.53) and 1.44 (1.36–1.52) in arms 2 and 3, respectively. In a

  14. Relationship between mental workload and musculoskeletal disorders among Alzahra Hospital nurses

    PubMed Central

    Habibi, Ehsanollah; Taheri, Mohamad Reza; Hasanzadeh, Akbar

    2015-01-01

    Background: Musculoskeletal disorders (MSDs) are a serious problem among the nursing staff. Mental workload is the major cause of MSDs among nursing staff. The aim of this study was to investigate the mental workload dimensions and their association with MSDs among nurses of Alzahra Hospital, affiliated to Isfahan University of Medical Sciences. Materials and Methods: This descriptive cross-sectional study was conducted on 247 randomly selected nurses who worked in the Alzahra Hospital in Isfahan, Iran in the summer of 2013. The Persian version of National Aeronautics and Space Administration Task Load Index (NASA-TLX) (measuring mental load) specialized questionnaire and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was used for data collection. Data were collected and analyzed by Pearson correlation coefficient and Spearman correlation coefficient tests in SPSS 20. Results: Pearson and Spearman correlation tests showed a significant association between the nurses’ MSDs and the dimensions of workload frustration, total workload, temporal demand, effort, and physical demand (r = 0.304, 0.277, 0.277, 0.216, and 0.211, respectively). However, there was no significant association between the nurses’ MSDs and the dimensions of workload performance and mental demand (P > 0.05). Conclusions: The nurses’ frustration had a direct correlation with MSDs. This shows that stress is an inseparable component in hospital workplace. Thus, reduction of stress in nursing workplace should be one of the main priorities of hospital managers. PMID:25709683

  15. Prevalence of musculoskeletal disorders among orthopedic trauma surgeons: an OTA survey

    PubMed Central

    AlQahtani, Saad M.; Alzahrani, Mohammad M.; Harvey, Edward J.

    2016-01-01

    Background Occupational injuries and hazards have gained increased attention in the surgical community in general and in the orthopedic literature specifically. The aim of this study was to assess prevalence and characteristics of musculoskeletal disorders among orthopedic trauma surgeons and the impact of these injuries on the surgeons’ practices. Methods We sent a modified version of the physical discomfort survey to surgeon members of the Orthopaedic Trauma Association (OTA) via email. Data were collected and descriptive statistics were analyzed. Results A total of 86 surgeons completed the survey during the period of data collection; 84.9% were men, more than half were 45 years or older and 40.6% were in practice for 10 years or more. More than 66% of respondents reported a musculoskeletal disorder that was related to work; the most common was low back pain (29.3%). The number of body regions involved and disorders diagnosed was associated with increasing age and number of years in practice (p = 0.033). Time off work owing to these disorders was associated with working in a private setting (p = 0.045) and working in more than 1 institute (p = 0.009). Conclusion To our knowledge, our study is the first to report a high percentage of orthopedic trauma surgeons sustaining occupational injuries some time in their careers. The high cost of management and rehabilitation of these injuries in addition to the related number of missed work days indicate the need for increased awareness and implementation of preventive measures. PMID:26812408

  16. Military Chronic Musculoskeletal Pain and Psychiatric Comorbidity: Is Better Pain Management the Answer?

    PubMed

    McGeary, Cindy A; McGeary, Donald D; Moreno, Jose; Gatchel, Robert J

    2016-01-01

    Chronic musculoskeletal pain, such as low back pain, often appears in the presence of psychiatric comorbidities (e.g., depression, posttraumatic stress disorder (PTSD)), especially among U.S. military service members serving in the post-9/11 combat era. Although there has been much speculation about how to best address pain/trauma psychiatric symptom comorbidities, there are little available data to guide practice. The present study sought to examine how pre-treatment depression and PTSD influence outcomes in a functional restoration pain management program using secondary analysis of data from the Department of Defense-funded Functional and Orthopedic Rehabilitation Treatment (FORT) trial. Twenty-eight FORT completers were analyzed using a general linear model exploring how well depression and PTSD symptoms predict post-treatment pain (Visual Analog Scale (VAS) pain rating), disability (Oswestry Disability Index; Million Visual Analog Scale), and functional capacity (Floor-to-Waist and Waist-to-Eye Level progressive isoinertial lifting evaluation scores) in a sample of active duty military members with chronic musculoskeletal pain and comorbid depression or PTSD symptoms. Analysis revealed that pre-treatment depression and PTSD symptoms did not significantly predict rehabilitation outcomes from program completers. Implications of these findings for future research on trauma-related pain comorbidities are discussed. PMID:27417626

  17. Global Postural Reeducation for patients with musculoskeletal conditions: a systematic review of randomized controlled trials

    PubMed Central

    Ferreira, Giovanni E.; Barreto, Rodrigo G. P.; Robinson, Caroline C.; Plentz, Rodrigo D. M.; Silva, Marcelo F.

    2016-01-01

    ABSTRACT Objectives To systematically review randomized controlled trials that assessed the effects of Global Postural Reeducation (GPR) on patient-reported outcomes in conditions of the musculoskeletal system. Method An electronic search of MEDLINE (via PubMed), EMBASE, Cochrane CENTRAL, and SciELO was performed from their inception to June 2015. Randomized controlled trials that analyzed pain and patient-reported outcomes were included in this review. The Cochrane Collaboration’s Risk of Bias Tool was used to evaluate risk of bias, and the quality of evidence was rated following the GRADE approach. There were no language restrictions. Results Eleven trials were included totaling 383 patients. Overall, the trials had high risk of bias. GPR was superior to no treatment but not to other forms of treatment for pain and disability. No placebo-controlled trials were found. Conclusion GPR is not superior to other treatments; however, it is superior to no treatment. Due to the lack of studies, it is unknown if GPR is better than placebo. The quality of the available evidence ranges from low to very low, therefore future studies may change the effect estimates of GPR in musculoskeletal conditions. PMID:27437710

  18. Trial of Postoperative Radiation, Cisplatin, and Panitumumab in Locally Advanced Head and Neck Cancer

    ClinicalTrials.gov

    2016-06-28

    Cancer of Head; Cancer of Head and Neck; Cancer of Neck; Cancer of the Head; Cancer of the Head and Neck; Cancer of the Neck; Head and Neck Cancer; Head Cancer; Head Neoplasms; Head, Neck Neoplasms; Neck Cancer; Neck Neoplasms; Neoplasms, Head; Neoplasms, Head and Neck; Neoplasms, Neck; Neoplasms, Upper Aerodigestive Tract; UADT Neoplasms; Upper Aerodigestive Tract Neoplasms

  19. Effectiveness of Iyengar yoga in treating spinal (back and neck) pain: A systematic review

    PubMed Central

    Crow, Edith Meszaros; Jeannot, Emilien; Trewhela, Alison

    2015-01-01

    Considerable amount of money spent in health care is used for treatments of lifestyle related, chronic health conditions, which come from behaviors that contribute to morbidity and mortality of the population. Back and neck pain are two of the most common musculoskeletal problems in modern society that have significant cost in health care. Yoga, as a branch of complementary alternative medicine, has emerged and is showing to be an effective treatment against nonspecific spinal pain. Recent studies have shown positive outcome of yoga in general on reducing pain and functional disability of the spine. The objective of this study is to conduct a systematic review of the existing research within Iyengar yoga method and its effectiveness on relieving back and neck pain (defined as spinal pain). Database research form the following sources (Cochrane library, NCBI PubMed, the Clinical Trial Registry of the Indian Council of Medical Research, Google Scholar, EMBASE, CINAHL, and PsychINFO) demonstrated inclusion and exclusion criteria that selected only Iyengar yoga interventions, which in turn, identified six randomized control trials dedicated to compare the effectiveness of yoga for back and neck pain versus other care. The difference between the groups on the postintervention pain or functional disability intensity assessment was, in all six studies, favoring the yoga group, which projected a decrease in back and neck pain. Overall six studies with 570 patients showed, that Iyengar yoga is an effective means for both back and neck pain in comparison to control groups. This systematic review found strong evidence for short-term effectiveness, but little evidence for long-term effectiveness of yoga for chronic spine pain in the patient-centered outcomes. PMID:25558128

  20. Simulation of the effects of different pilot helmets on neck loading during air combat.

    PubMed

    Mathys, R; Ferguson, S J

    2012-09-21

    New generation pilot helmets with mounted devices enhance the capabilities of pilots substantially. However, the additional equipment increases the helmet weight and shifts its center of mass forward. Two helmets with different mass properties were modeled to simulate their effects on the pilot's neck. A musculoskeletal computer model was used, with the methods of inverse dynamics and static optimization, to compute the muscle activations and joint reaction forces for a given range of quasi-static postures at various accelerations experienced during air combat. Head postures which induce much higher loads on the cervical spine than encountered in a neutral position could be identified. The increased weight and the forward shift of the center of mass of a new generation helmet lead to higher muscle activations and higher joint reaction loads over a wide range of head and neck movements. The muscle activations required to balance the head and neck in extreme postures increased the compressive force at the T1-C7 level substantially, while in a neutral posture the muscle activations remained low. The lateral neck muscles can reach activations of 100% and cause compressive joint forces up to 1100N during extensive rotations and extensions at high 'vertical' accelerations (Gz). The calculated values have to be interpreted with care as the model has not been validated. Nevertheless, this systematic analysis could separate the effects of head posture, acceleration and helmet mass on neck loading. More reliable data about mass properties and muscle morphometry with a more detailed motion analysis would help to refine the existing model. PMID:22840756

  1. Classification of neck/shoulder pain in epidemiological research: a comparison of personal and occupational characteristics, disability, and prognosis among 12,195 workers from 18 countries.

    PubMed

    Sarquis, Leila M M; Coggon, David; Ntani, Georgia; Walker-Bone, Karen; Palmer, Keith T; Felli, Vanda E; Harari, Raul; Barrero, Lope H; Felknor, Sarah A; Gimeno, David; Cattrell, Anna; Vargas-Prada, Sergio; Bonzini, Matteo; Solidaki, Eleni; Merisalu, Eda; Habib, Rima R; Sadeghian, Farideh; Kadir, M Masood; Warnakulasuriya, Sudath S P; Matsudaira, Ko; Nyantumbu, Busisiwe; Sim, Malcolm R; Harcombe, Helen; Cox, Ken; Marziale, Maria H; Harari, Florencia; Freire, Rocio; Harari, Natalia; Monroy, Magda V; Quintana, Leonardo A; Rojas, Marianela; Harris, E Clare; Serra, Consol; Martinez, J Miguel; Delclos, George; Benavides, Fernando G; Carugno, Michele; Ferrario, Marco M; Pesatori, Angela C; Chatzi, Leda; Bitsios, Panos; Kogevinas, Manolis; Oha, Kristel; Freimann, Tiina; Sadeghian, Ali; Peiris-John, Roshini J; Sathiakumar, Nalini; Wickremasinghe, A Rajitha; Yoshimura, Noriko; Kelsall, Helen L; Hoe, Victor C W; Urquhart, Donna M; Derrett, Sarah; McBride, David; Herbison, Peter; Gray, Andrew; Salazar Vega, Eduardo J

    2016-05-01

    To inform case definition for neck/shoulder pain in epidemiological research, we compared levels of disability, patterns of association, and prognosis for pain that was limited to the neck or shoulders (LNSP) and more generalised musculoskeletal pain that involved the neck or shoulder(s) (GPNS). Baseline data on musculoskeletal pain, disability, and potential correlates were collected by questionnaire from 12,195 workers in 47 occupational groups (mostly office workers, nurses, and manual workers) in 18 countries (response rate = 70%). Continuing pain after a mean interval of 14 months was ascertained through a follow-up questionnaire in 9150 workers from 45 occupational groups. Associations with personal and occupational factors were assessed by Poisson regression and summarised by prevalence rate ratios (PRRs). The 1-month prevalence of GPNS at baseline was much greater than that of LNSP (35.1% vs 5.6%), and it tended to be more troublesome and disabling. Unlike LNSP, the prevalence of GPNS increased with age. Moreover, it showed significantly stronger associations with somatising tendency (PRR 1.6 vs 1.3) and poor mental health (PRR 1.3 vs 1.1); greater variation between the occupational groups studied (prevalence ranging from 0% to 67.6%) that correlated poorly with the variation in LNSP; and was more persistent at follow-up (72.1% vs 61.7%). Our findings highlight important epidemiological distinctions between subcategories of neck/shoulder pain. In future epidemiological research that bases case definitions on symptoms, it would be useful to distinguish pain that is localised to the neck or shoulder from more generalised pain that happens to involve the neck/shoulder region. PMID:26761390

  2. Musculoskeletal pain and effort-reward imbalance- a systematic review

    PubMed Central

    2014-01-01

    Background Musculoskeletal pain may be triggered by physical strains and psychosocial risk factors. The effort-reward imbalance model (ERI model) is a stress model which measures psychosocial factors in the working world. The question is whether workers with an effort-reward imbalance report musculoskeletal pain more frequently than those with no effort-reward imbalance. A systematic review using a best evidence synthesis approach was conducted to answer this question. Methods A literature search was conducted for the period from 1996 to 2012, using three databases (Pubmed, Embase and PsycINFO). The research criteria related to psychosocial, work-related stress as per the ERI model and to musculoskeletal pain. A quality score was developed using various quality criteria to assess the standard of the studies. The level of evidence was graded as in (Am J Ind Med 39:180–193, 2001). Results After applying the inclusion criteria, a total of 19 studies were included in the review: 15 cross-sectional studies, three prospective studies and one case–control study. 74% of all studies exhibited good methodological quality, 53% collected data using the original ERI questionnaire, and in 42% of the studies, there was adequate control for physical working conditions. Furthermore, different cut-off points were used to classify exposed and non-exposed individuals. On the basis of 13 studies with a positive, statistically significant association, a moderate level of evidence was inferred for the association between effort-reward imbalance and musculoskeletal pain. The evidence for a role of over-commitment and for its interaction with effort-reward imbalance was rated as inconclusive - on the basis of eight and five studies, respectively. Conclusions On the basis of the available evidence, no reliable conclusion may be drawn about any association between the psychosocial factors ascertained using the ERI model and musculoskeletal pain. Before a reliable statement can be made on

  3. Neck control after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancers

    PubMed Central

    2012-01-01

    Background The purpose of this study was to evaluate neck control outcomes after definitive radiochemotherapy without planned neck dissection in node-positive head and neck cancer. Methods We retrospectively reviewed medical records of fifty patients with node-positive head and neck cancer who received definitive radiochemotherapy. Twelve patients subsequently underwent neck dissection for suspicious recurrent or persistent disease. A median dose of 70 Gy (range 60-70.6) was delivered to involved nodes. Response evaluation was performed at a median of 5 weeks after completion of radiotherapy. Results Neck failure was observed in 11 patients and the 3-year regional control (RC) rate was 77.1%. Neck dissection was performed in 10 of the 11 patients; seven of these cases were successfully salvaged, and the ultimate rate of neck control was 92%. The remaining two patients who received neck dissection had negative pathologic results. On univariate analysis, initial nodal size > 2 cm, a less-than-complete response at the primary site, post-radiotherapy nodal size > 1.5 cm, and post-radiotherapy nodal necrosis were associated with RC. On multivariate analysis, less-than-complete primary site response and post-radiotherapy nodal necrosis were identified as independent prognostic factors for RC. Conclusions The neck failure rate after definitive radiochemotherapy without planned neck dissection was 22%. Two-thirds of these were successfully salvaged with neck dissection and the ultimate neck control rate was 92%. Our results suggest that planned neck dissection might not be necessary in patients with complete response of primary site, no evidence of residual lesion > 1.5 cm, or no necrotic lymph nodes at the 1-2 months follow-up evaluation after radiotherapy. PMID:22313843

  4. Exercise Prescriptions to Prevent Musculoskeletal Disorders in Dentists

    PubMed Central

    Kumar, Dodda Kiran; Mohan, Sreevalli; Begum, Mohammadi; Prasad, Bhanu; Prasad, Eswar Ravi Vara

    2014-01-01

    Since the number of dental patients is increasing day by day dentists are forced to spend longer times in dental chairs. This is increasing the prevalence of musculoskeletal disorders in dentists. This article reviews the mechanisms causing musculoskeletal disorders among dentists and also covers the exercises that can be done to prevent them. Exercises that increase the fitness of a dentist are divided into aerobic exercises – concentrating on total body fitness, stretching exercises – that concentrate on the muscles that tend to tighten in prolonged dental postures and strengthening exercises – that concentrate on the muscles that are opposite to the tight muscles. These exercises are made simple and of minimal intensity so that a dentist can practice them independently. PMID:25177661

  5. Exercise prescriptions to prevent musculoskeletal disorders in dentists.

    PubMed

    Kumar, Dodda Kiran; Rathan, Neelima; Mohan, Sreevalli; Begum, Mohammadi; Prasad, Bhanu; Prasad, Eswar Ravi Vara

    2014-07-01

    Since the number of dental patients is increasing day by day dentists are forced to spend longer times in dental chairs. This is increasing the prevalence of musculoskeletal disorders in dentists. This article reviews the mechanisms causing musculoskeletal disorders among dentists and also covers the exercises that can be done to prevent them. Exercises that increase the fitness of a dentist are divided into aerobic exercises - concentrating on total body fitness, stretching exercises - that concentrate on the muscles that tend to tighten in prolonged dental postures and strengthening exercises - that concentrate on the muscles that are opposite to the tight muscles. These exercises are made simple and of minimal intensity so that a dentist can practice them independently. PMID:25177661

  6. Usefulness of strain elastography of the musculoskeletal system

    PubMed Central

    2016-01-01

    Ultrasound elastography is a widely used technique for assessing the mechanical characteristics of tissues. Although there are several ultrasound elastography techniques, strain elastography (SE) is currently the most widely used technique for visualizing an elastographic map in real time. Among its various indications, SE is especially useful in evaluating the musculoskeletal system. In this article, we review the SE techniques for clinical practice and describe the images produced by these techniques in the context of the musculoskeletal system. SE provides information about tissue stiffness and allows real-time visualization of the image; however, SE cannot completely replace gray-scale, color, or power Doppler ultrasonography. SE can increase diagnostic accuracy and may be useful for the follow-up of benign lesions. PMID:26810195

  7. Origin of a Musculoskeletal Guideline: Caring for Older Workers.

    PubMed

    Delloiacono, Nancy

    2016-06-01

    Today's employers are hiring a more age-diverse workforce. As Americans work longer, age-related changes often create activity limitations. Musculoskeletal disorders affect many older workers heightening their risk of workplace injury. Compounded by multiple comorbidities, older workers will need occupational health nurses with expert knowledge to maintain safe and productive workplaces. Older workers do not experience as many injuries as younger workers, but when they are injured, recovery is longer. The author developed and conducted a survey of New Jersey occupational health nurses. The results showed that overexertion injuries are the most frequently treated injuries in employee health offices. For occupational health nurses to keep employees safe, best practices must be delineated; this musculoskeletal safety guideline provides recommendations for evidence-based care of older workers. PMID:27154746

  8. Developmental process of musculoskeletal integration in ostracod antenna.

    PubMed

    Kaji, Tomonari

    2012-03-01

    The functional morphology of arthropod appendages shows remarkable diversity. Plausible functional integrations, particularly between muscles and the exoskeleton, must be achieved in these diverse morphologies. This study provides an insight into the evolutionary pathway of diversified appendages from a functional point of view. The musculoskeletal structure and development of antennae in five species of Cypridocopina were compared. The muscle and skeletal systems are integrated in several ways: The integration in Propontocypris attenuata occurs during various stages of the molting growth, whereas that in Fabaeformiscandona breuili occurs during the myogenesis. These two types of developmental processes have notable similarities, despite their occurrence during different developmental phases. From the overview of the molecular phylogeny presented by earlier studies, it is suggested that the integrated musculoskeletal system has reappeared repeatedly in cypridoid lineages as an atavism. This study demonstrates how arthropod appendages evolve without losing the integrity of the functional whole. PMID:22305643

  9. Prevalence of minor musculoskeletal anomalies in children with congenital hypothyroidism.

    PubMed

    El Kholy, Mohamed; Fahmi, Marwa E; Nassar, Ayman E; Selim, Samia; Elsedfy, Heba H

    2007-01-01

    In the last decade a high frequency of extrathyroidal congenital anomalies has been reported in infants with congenital hypothyroidism (CH) detected by neonatal screening. In the present study the occurrence of additional congenital malformations (CM) in a cohort of children with confirmed primary CH due to thyroid dysgenesis was investigated. A high prevalence of extrathyroidal major congenital anomalies (15.9%), more than 5-fold higher than that reported in the Egyptian population (2.7%), was found. The cardiac and musculoskeletal systems were the most commonly involved, comprising 9.09 and 47.72% of all anomalies, respectively. The high prevalence of musculoskeletal anomalies in this study was mostly due to minor anomalies as brachydactyly and digitalization of thumbs. The type of dysgenesis (i.e. aplastic, ectopic or hypoplastic) as well as the severity of hypothyroidism, as assessed by TSH and T(4) levels at diagnosis, had no relation with the occurrence of extrathyroidal abnormalities. PMID:17587855

  10. Risk factors for the onset and persistence of neck pain in undergraduate students: 1-year prospective cohort study

    PubMed Central

    2011-01-01

    Background Although neck pain is common in young adulthood, studies on predictive factors for its onset and persistence are scarce. It is therefore important to identify possible risk factors among young adults so as to prevent the development of neck pain later in life. Methods A prospective study was carried out in healthy undergraduate students. At baseline, a self-administered questionnaire and standardized physical examination were used to collect data on biopsychosocial factors. At 3, 6, 9, and 12 months thereafter, follow-up data were collected on the incidence of neck pain. Those who reported neck pain on ≥ 2 consecutive follow-ups were categorized as having persistent neck pain. Two regression models were built to analyze risk factors for the onset and persistence of neck pain. Results Among the recruited sample of 684 students, 46% reported the onset of neck pain between baseline and 1-year follow-up, of whom 33% reported persistent neck pain. The onset of neck pain was associated with computer screen position not being level with the eyes and mouse position being self-rated as suitable. Factors that predicted persistence of neck pain were position of the keyboard being too high, use of computer for entertainment < 70% of total computer usage time, and students being in the second year of their studies. Conclusion Neck pain is quite common among undergraduate students. This study found very few proposed risk factors that predicted onset and persistence of neck pain. The future health of undergraduate students deserves consideration. However, there is still much uncertainty about factors leading to neck pain and more research is needed on this topic. PMID:21756362

  11. Immunotherapy With MK-3475 in Surgically Resectable Head and Neck Squamous Cell Carcinoma

    ClinicalTrials.gov

    2016-07-11

    Cancer of Head and Neck; Head and Neck Cancer; Neoplasms, Head and Neck; Carcinoma, Squamous Cell of Head and Neck; Squamous Cell Carcinoma of the Head and Neck; Squamous Cell Carcinoma, Head and Neck

  12. Musculoskeletal trauma in four-wheeled all-terrain vehicles.

    PubMed

    Rios-Reboyras, Luis A; Grovis, Jorge E; Ramirez, Norman; Zierenberg, Charles; Otero, Antonio; Vilella, Fernando E

    2002-10-01

    A longitudinal study of four-wheeled all-terrain vehicle-related musculoskeletal injuries requiring orthopedic surgery was performed. Avoidable risk factors such as alcohol intake, lack of helmets, inexperience, and excess speed were identified. This study also shows that the quantity, severity, cost, and frequency of preventable accidents while riding continue to be the same as prior to a Consent Decrees issued by the Consumer Products Safety Commission > 10 years ago. PMID:12401015

  13. Musculoskeletal Modeling Component of the NASA Digital Astronaut Project

    NASA Technical Reports Server (NTRS)

    Lewandowski, B. E.; Pennline, J. A.; Stalker, A. R.; Mulugeta, L.; Myers, J. G.

    2011-01-01

    The NASA Digital Astronaut Project s (DAP) objective is to provide computational tools that support research of the physiological response to low gravity environments and analyses of how changes cause health and safety risks to the astronauts and to the success of the mission. The spaceflight risk associated with muscle atrophy is impaired performance due to reduced muscle mass, strength and endurance. Risks of early onset of osteoporosis and bone fracture are among the spaceflight risks associated with loss of bone mineral density. METHODS: Tools under development include a neuromuscular model, a biomechanical model and a bone remodeling model. The neuromuscular model will include models of neuromuscular drive, muscle atrophy, fiber morphology and metabolic processes as a function of time in space. Human movement will be modeled with the biomechanical model, using muscle and bone model parameters at various states. The bone remodeling model will allow analysis of bone turnover, loss and adaptation. A comprehensive trade study was completed to identify the current state of the art in musculoskeletal modeling. The DAP musculoskeletal models will be developed using a combination of existing commercial software and academic research codes identified in the study, which will be modified for use in human spaceflight research. These individual models are highly dependent upon each other and will be integrated together once they reach sufficient levels of maturity. ANALYSES: The analyses performed with these models will include comparison of different countermeasure exercises for optimizing effectiveness and comparison of task requirements and the state of strength and endurance of a crew member at a particular time in a mission. DISCUSSION: The DAP musculoskeletal model has the potential to complement research conducted on spaceflight induced changes to the musculoskeletal system. It can help with hypothesis formation, identification of causative mechanisms and

  14. Burdensome problems of chronic musculoskeletal pain and future prospects.

    PubMed

    Ushida, Takahiro

    2015-11-01

    According to a recent survey, about 15 % of the Japanese population suffers from moderate-severe chronic musculoskeletal pain persisting for at least 6 months. Social factors and related psychological factors (including depression) thus appear to greatly affect chronic musculoskeletal pain. This suggests the need for measures that take these factors into account. Treatment for musculoskeletal pain at present is generally based on a biomedical model that has been used for many years in this field, and modern medical imaging technologies have been a high priority to support this model and treatment strategy. Under the concept of the biomedical model, nonsteroidal antiinflammatory drugs, channel blockers and opioid analgesics are generally used as pharmacotherapy to alleviate chronic pain. However, these drugs are commonly associated with problems such as adverse effects, drug dependency and drug abuse, and they must be used with care. Surgery may also be effective in treating certain diseases, but studies have shown that many patients suffer residual chronic pain even after such treatment. Besides, exercise therapy has been found to be effective in treating many different types of chronic pain. Lately, various countries have been launching interdisciplinary pain centers that use a multidisciplinary approach to treat chronic musculoskeletal pain. Treatment in these centers is provided by a team of specialists in anesthesiology, psychiatry and orthopedics as well as the relevant paramedical professionals. The therapeutic strategy is based on a cognitive-behavioral approach, and patients are taught about methods for restoring physical function and coping with pain, mostly with drugs and exercise therapy, so that any pain present does not impair function and the patient can reintegrate into society. PMID:26260256

  15. Implicit methods for efficient musculoskeletal simulation and optimal control

    PubMed Central

    van den Bogert, Antonie J.; Blana, Dimitra; Heinrich, Dieter

    2011-01-01

    The ordinary differential equations for musculoskeletal dynamics are often numerically stiff and highly nonlinear. Consequently, simulations require small time steps, and optimal control problems are slow to solve and have poor convergence. In this paper, we present an implicit formulation of musculoskeletal dynamics, which leads to new numerical methods for simulation and optimal control, with the expectation that we can mitigate some of these problems. A first order Rosenbrock method was developed for solving forward dynamic problems using the implicit formulation. It was used to perform real-time dynamic simulation of a complex shoulder arm system with extreme dynamic stiffness. Simulations had an RMS error of only 0.11 degrees in joint angles when running at real-time speed. For optimal control of musculoskeletal systems, a direct collocation method was developed for implicitly formulated models. The method was applied to predict gait with a prosthetic foot and ankle. Solutions were obtained in well under one hour of computation time and demonstrated how patients may adapt their gait to compensate for limitations of a specific prosthetic limb design. The optimal control method was also applied to a state estimation problem in sports biomechanics, where forces during skiing were estimated from noisy and incomplete kinematic data. Using a full musculoskeletal dynamics model for state estimation had the additional advantage that forward dynamic simulations, could be done with the same implicitly formulated model to simulate injuries and perturbation responses. While these methods are powerful and allow solution of previously intractable problems, there are still considerable numerical challenges, especially related to the convergence of gradient-based solvers. PMID:22102983

  16. [Deleterious effects of smoking on the musculoskeletal system].

    PubMed

    Duthon, V B; Ozturk, M; El-Achachi, S; Menetrey, J

    2014-07-16

    Tobacco smoking has important negative effects on the musculoskeletal system: decrease of bone mineral density, increase of the risk of injury, illness, and perioperative complications such as fracture-healing complications and wound complications. Orthopaedic surgeons should inform all patients of the increased risks associated with active smoking in the perioperative period and should encourage them to quit smoking four to eight weeks in advance of the proposed procedure. PMID:25141568

  17. Etodolac: analgesic effects in musculoskeletal and postoperative pain.

    PubMed

    Pena, M

    1990-01-01

    Numerous clinical trials have shown etodolac to be an effective analgesic. The purpose of the present report is to review results of 14 studies that demonstrate the effectiveness of etodolac in a variety of painful conditions. Presented are the results of four postsurgical pain studies, one study of acute gouty arthritis and nine studies of acute musculoskeletal disorders: acute low back pain, acute painful shoulder, tendinitis and bursitis, and acute sports injuries. A single oral dose of etodolac (25, 50, 100, 200, or 400 mg) was compared with aspirin (650 mg) or a combination of acetaminophen (600 mg) plus codeine (60 mg) for the relief of pain up to 12 h following oral, urogenital or orthopedic surgery. In multiple dose studies of acute gouty arthritis and musculoskeletal conditions, etodolac 200 or 300 mg twice a day (b.i.d.) or 200 mg three times a day (t.i.d.) was compared with naproxen 500 mg b.i.d. or t.i.d., diclofenac 50 mg b.i.d. or t.i.d., and piroxicam 20 or 40 mg once a day (o.d.) administered over 5 to 14 days. The efficacy of etodolac was at least equal and in some ways superior to aspirin and acetaminophen plus codeine in the relief of postsurgical pain. In studies of acute gouty arthritis, significant improvement from baseline were seen for all efficacy parameters evaluated for both the etodolac- and naproxen-treated patients. All the present studies of musculoskeletal conditions have shown etodolac to be effective and comparable in analgesic efficacy to naproxen, diclofenac or piroxicam. In summary, etodolac therapy for pain following surgery, in acute gouty arthritis and in acute musculoskeletal conditions resulted in analgesia comparable to that provided by several well-established analgesic or anti-inflammatory agents. PMID:2150571

  18. Musculoskeletal Sepsis Associated with Deep Vein Thrombosis in a Child.

    PubMed

    Lee, Chih-Ying; Lee, Yu-Sheng; Tsao, Pei-Chen; Jeng, Mei-Jy; Soong, Wen-Jue

    2016-06-01

    Deep vein thrombosis (DVT) is a rare disease in pediatric patients. We report a pediatric patient who developed DVT in association with methicillin-resistant Staphylococcus aureus (MRSA) bacteremia complicated with septic arthritis, osteomyelitis, and myositis extensively. It is crucial to consider musculoskeletal infection associated with DVT in any child who presents with severe swollen limbs and limitations of motion. Prompt antibiotic and anticoagulant treatments should be initiated to reduce the risk of fatal complications. PMID:24279976

  19. Neck after vertical hemilaryngectomy: computed tomographic study

    SciTech Connect

    DiSantis, D.J.; Balfe, D.M.; Hayden, R.; Sessions, D.; Sagel, S.S.

    1984-06-01

    Computed tomographic scans in 22 postoperative vertical hemilaryngectomy patients were analyzed retrospectively to determine the normal postoperative appearance and to evaluate the role of CT in assessing recurrent neoplasm. Twelve patients without clinical evidence of recurrence illustrated the normal postoperative changes. In the six patients with recurrent neoplasm, the CT manifestations included increased width of the remaining true vocal cord, convexity of the surgically formed pseudocord at glottic level, subglottic tumor, and extralaryngeal neck masses. Recurrence was mimicked in four patients by bulky soft tissue at the endolaryngeal operative site at both CT and laryngoscopy. CT supplemented the physical examination and indirect laryngoscopy, providing information regarding the presence and extent of tumor that was useful in planning the mode or scope of subsequent therapy.

  20. Musculoskeletal training for orthopaedists and nonorthopaedists: experiences in Nepal.

    PubMed

    Banskota, Ashok K

    2008-10-01

    Orthopaedic surgical training in Nepal began in 1998, and four major centers now produce between 15 and 20 graduates annually. The duration of the training is four years in one center and three years in the remaining centers. Trainees have adequate trauma exposure. The major challenges include: tailoring training to suit local needs, avoiding the dangers of market driven orthopaedic surgery, adequately emphasizing and implementing time honored methods of closed fracture treatment, and ensuring uniformity of exposure to the various musculoskeletal problems. Training in research methods needs to be implemented more effectively. The evaluation process needs to be more uniform and all training programs need to complement one another and avoid unhealthy competition. Training for nonorthopaedists providing musculoskeletal care is virtually nonexistent in Nepal. Medical graduates have scant exposure to trauma and musculoskeletal diseases during their training. General surgeons provide the majority of trauma care and in the rural areas, health assistants, auxiliary health workers and physiotherapy assistants provide much needed basic services, but all lack formal training. Traditional "bone setters" in Nepal often cater to certain faithful clientele with sprains, minor fractures etc. A large vacuum exists in Nepal for trained nonorthopaedists leading to deficiencies in prehospital care, safe transport and basic, primary emergency care. The great challenges are yet to be addressed. PMID:18626724

  1. Musculoskeletal injuries and pain in dancers: a systematic review update.

    PubMed

    Jacobs, Craig L; Hincapié, Cesar A; Cassidy, J David

    2012-01-01

    The objective of this study was to assemble and synthesize the best available literature from 2004 to 2008 on musculoskeletal injury and pain in dancers. MEDLINE and CINAHL were the primary sources of data. Indexed terms such as dance, dancer, dancing, athletic injuries, occupational injuries, sprains and strains, musculoskeletal diseases, bone density, menstruation disturbances, and eating disorders were used to search the databases. Citations were screened for relevance using a priori criteria, and relevant studies were critically reviewed for scientific merit by the best-evidence synthesis method. After screening, 19 articles were found to be scientifically admissible. Data from accepted studies were abstracted into evidence tables relating to: prevalence and associated factors; incidence and risk factors; intervention; and injury characteristics and prognosis of musculoskeletal injury and pain in dancers. Principal findings included: a high prevalence and incidence of lower extremity, hip and back injuries; preliminary evidence that psychosocial and psychological issues such as stress and coping strategies affect injury frequency and duration; history of a previous lateral ankle sprain is associated with an increased risk of ankle sprain in the contralateral ankle in dance students; fatigue may play a role in ACL injury in dancers; acute hamstring strains in dancers affect tendon more than muscle tissue, often resulting in prolonged absence from dance. It is concluded that, while there are positive developments in the literature on the epidemiology, diagnosis, prognosis, treatment, and prevention of MSK injuries and pain in dancers, much room for improvement remains. Suggestions for future research are offered. PMID:22687721

  2. Musculoskeletal Hydatid Cysts Resembling Tumors: A Report of Five Cases.

    PubMed

    Toğral, Güray; Arıkan, Şefik M; Ekiz, Timur; Kekeç, Ahmet F; Ekşioğlu, Mehmet F

    2016-05-01

    Although challenges in treatment of musculoskeletal hydatid cysts (HC) lesions have been documented, data regarding the musculoskeletal HC lesions resembling tumor is scarce. This paper presented 5 patients (3 males, 2 females) with a mean age of 41.6 years with tumor-like lesions of HC. Three of them had left ilium and acetabulum involvement, one involved left femur, and one involved left thigh muscle compartments. Pain was the main symptom and was seen in all patients. Clinical examination, radiologic evaluation, and histologic analysis were performed for diagnosis. Patients were treated through different surgical options, including simple debridement, bone cement filling with or without internal fixation, hip arthrodesis, reconstruction using hemipelvic replantation with femoral prosthesis and distal femur endoprosthetic replacement. After surgery, the operation region was washed by 20% hypertonic saline, and debridement was performed carefully without contamination. All patients received albendazole treatment. Cases were followed up 1 to 9 years for the recurrence. Walking difficulty and pain were the main symptoms during the follow-up. One patient was symptom-free. A reoccurrence in the perioperative soft tissue was detected in only one patient and control visits with antihelmintic treatment were recommended. We would like to emphasize that HC should be kept in mind for the differential diagnosis of the cystic or tumoral lesions of the musculoskeletal system, particularly in the endemic regions. Prompt diagnosis is of paramount importance for preventing destruction and complications. PMID:27384735

  3. Diffusion-weighted MR imaging for characterizing musculoskeletal lesions.

    PubMed

    Subhawong, Ty K; Jacobs, Michael A; Fayad, Laura M

    2014-01-01

    Diffusion-weighted (DW) imaging is a functional magnetic resonance (MR) imaging technique that can readily be incorporated into a routine non-contrast material-enhanced MR imaging protocol with little additional scanning time. DW imaging is based on changes in the Brownian motion of water molecules caused by tissue microstructure. The apparent diffusion coefficient (ADC) is a quantitative measure of Brownian movement: Low ADC values typically reflect highly cellular microenvironments in which diffusion is restricted by the presence of cell membranes, whereas acellular regions allow free diffusion and result in elevated ADC values. Thus, with ADC mapping, one may derive useful quantitative information regarding the cellularity of a musculoskeletal lesion using a nonenhanced technique. The role of localized DW imaging in differentiating malignant from benign osseous and soft-tissue lesions is still evolving; when carefully applied, however, this modality has proved helpful in a subset of tumor types, such as nonmyxoid soft-tissue tumors. Studies of the use of DW imaging in assessing the treatment response of both osseous and soft-tissue tumors have shown that higher ADC values correlate with better response to cytotoxic therapy. Successful application of DW imaging in the evaluation of musculoskeletal lesions requires familiarity with potential diagnostic pitfalls that stem from technical artifacts and confounding factors unrelated to lesion cellularity. Further investigation is needed to evaluate the impact of DW imaging-ADC mapping on management and outcome in patients with musculoskeletal lesions. PMID:25208274

  4. Crucial Role of Vitamin D in the Musculoskeletal System.

    PubMed

    Wintermeyer, Elke; Ihle, Christoph; Ehnert, Sabrina; Stöckle, Ulrich; Ochs, Gunnar; de Zwart, Peter; Flesch, Ingo; Bahrs, Christian; Nussler, Andreas K

    2016-01-01

    Vitamin D is well known to exert multiple functions in bone biology, autoimmune diseases, cell growth, inflammation or neuromuscular and other immune functions. It is a fat-soluble vitamin present in many foods. It can be endogenously produced by ultraviolet rays from sunlight when the skin is exposed to initiate vitamin D synthesis. However, since vitamin D is biologically inert when obtained from sun exposure or diet, it must first be activated in human beings before functioning. The kidney and the liver play here a crucial role by hydroxylation of vitamin D to 25-hydroxyvitamin D in the liver and to 1,25-dihydroxyvitamin D in the kidney. In the past decades, it has been proven that vitamin D deficiency is involved in many diseases. Due to vitamin D's central role in the musculoskeletal system and consequently the strong negative impact on bone health in cases of vitamin D deficiency, our aim was to underline its importance in bone physiology by summarizing recent findings on the correlation of vitamin D status and rickets, osteomalacia, osteopenia, primary and secondary osteoporosis as well as sarcopenia and musculoskeletal pain. While these diseases all positively correlate with a vitamin D deficiency, there is a great controversy regarding the appropriate vitamin D supplementation as both positive and negative effects on bone mineral density, musculoskeletal pain and incidence of falls are reported. PMID:27258303

  5. Musculoskeletal adaptations to weightlessness and development of effective countermeasures

    NASA Technical Reports Server (NTRS)

    Baldwin, K. M.; White, T. P.; Arnaud, S. B.; Edgerton, V. R.; Kraemer, W. J.; Kram, R.; Raab-Cullen, D.; Snow, C. M.

    1996-01-01

    A Research Roundtable, organized by the American College of Sports Medicine with sponsorship from the National Aeronautics and Space Administration, met in November 1995 to define research strategies for effective exercise countermeasures to weightlessness. Exercise was considered both independently of, and in conjunction with, other therapeutic modalities (e.g., pharmacological nutritional, hormonal, and growth-related factors) that could prevent or minimize the structural and functional deficits involving skeletal muscle and bone in response to chronic exposure to weightlessness, as well as return to Earth baseline function if a degree of loss is inevitable. Musculoskeletal deficits and countermeasures are described with respect to: 1) muscle and connective tissue atrophy and localized bone loss, 2) reductions in motor performance, 3) potential proneness to injury of hard and soft tissues, and 4) probable interaction between muscle atrophy and cardiovascular alterations that contribute to the postural hypotension observed immediately upon return from space flight. In spite of a variety of countermeasure protocols utilized previously involving largely endurance types of exercise, there is presently no activity-specific countermeasure(s) that adequately prevent or reduce musculoskeletal deficiencies. It seems apparent that countermeasure exercises that have a greater resistance element, as compared to endurance activities, may prove beneficial to the musculoskeletal system. Many questions remain for scientific investigation to identify efficacious countermeasure protocols, which will be imperative with the emerging era of long-term space flight.

  6. Crucial Role of Vitamin D in the Musculoskeletal System

    PubMed Central

    Wintermeyer, Elke; Ihle, Christoph; Ehnert, Sabrina; Stöckle, Ulrich; Ochs, Gunnar; de Zwart, Peter; Flesch, Ingo; Bahrs, Christian; Nussler, Andreas K.

    2016-01-01

    Vitamin D is well known to exert multiple functions in bone biology, autoimmune diseases, cell growth, inflammation or neuromuscular and other immune functions. It is a fat-soluble vitamin present in many foods. It can be endogenously produced by ultraviolet rays from sunlight when the skin is exposed to initiate vitamin D synthesis. However, since vitamin D is biologically inert when obtained from sun exposure or diet, it must first be activated in human beings before functioning. The kidney and the liver play here a crucial role by hydroxylation of vitamin D to 25-hydroxyvitamin D in the liver and to 1,25-dihydroxyvitamin D in the kidney. In the past decades, it has been proven that vitamin D deficiency is involved in many diseases. Due to vitamin D’s central role in the musculoskeletal system and consequently the strong negative impact on bone health in cases of vitamin D deficiency, our aim was to underline its importance in bone physiology by summarizing recent findings on the correlation of vitamin D status and rickets, osteomalacia, osteopenia, primary and secondary osteoporosis as well as sarcopenia and musculoskeletal pain. While these diseases all positively correlate with a vitamin D deficiency, there is a great controversy regarding the appropriate vitamin D supplementation as both positive and negative effects on bone mineral density, musculoskeletal pain and incidence of falls are reported. PMID:27258303

  7. Severe neck infections that require wide external drainage: clinical analysis of 17 consecutive cases.

    PubMed

    Horváth, Tamás; Horváth, Barnabás; Varga, Zsuzsa; Liktor, Bálint; Szabadka, Hajnalka; Csákó, László; Liktor, Bálint

    2015-11-01

    Infections in the neck layers and spaces are potentially life-threatening diseases causing further complications, like mediastinitis, airway obstruction, or sepsis. Despite of the need for a conservative approach, they still regularly require surgical intervention. Records of 17 patients with severe neck infections that were treated by wide external incision and open wound management were retrospectively analyzed. The aim of the study was to clinically characterize these most serious neck infections. The most common presenting symptoms were neck pain and tense neck mass (94-94%) regularly with fever (65%), always accompanied by a marked elevation of C reactive protein level (average 192 uG/l). These findings were constant and very similar among both the deep neck infection and necrotizing fasciitis cases. More than half of the patients (53%) had at least one systemic co-morbidity. The parapharyngeal space was most commonly affected (83%), but extended disease involving more than two major neck regions was found in 13 cases (76%). Dental (29%) was the most common primary infection, followed by peritonsillar abscess (23%), Microbiological results showed a wide variety of corresponding bacteria. Mediastinitis was developed in three cases (18%), and airway obstruction requiring tracheostomy in two cases (12%). All the patients survived. Severe neck infections are a heterogenous group of diseases regarding to the primary site of infection, microbiology, localisation and host reaction. However, rapidly developed, painful, tense neck mass with a highly elevated CRP level should always alert for an extended or phlegmonous process in the layers or spaces of the neck. PMID:25359195

  8. Pain and Disability in the Jaw and Neck Region following Whiplash Trauma.

    PubMed

    Häggman-Henrikson, B; Lampa, E; Marklund, S; Wänman, A

    2016-09-01

    The relationship between whiplash trauma and chronic orofacial pain is unclear, especially with regard to the time elapsed from trauma to development of orofacial pain. The aim was to analyze prevalence of jaw pain and disability, as well as the relationship between pain and disability in the jaw and neck regions in the early nonchronic stage after whiplash trauma. In this case-control study, 70 individuals (40 women, 30 men, mean age 35.5 y) who visited an emergency department with neck pain following a car accident were examined within 3 wk of trauma (group 1) and compared with 70 individuals (42 women, 28 men, mean age 33.8 y), who declined to attend a clinical examination but agreed to fill in questionnaires (group 2). The 2 case groups were compared with a matched control group of 70 individuals (42 women, 28 men, mean age 37.6 y) without a history of neck trauma. All participants completed questionnaires regarding jaw pain and dysfunction, rating pain intensity in jaw and neck regions on the Numerical Rating Scale, the Neck Disability Index, and Jaw Disability Checklist. Compared with controls, individuals with a recent whiplash trauma reported more jaw pain and dysfunction. Furthermore, there was a moderate positive correlation between jaw and neck pain ratings for group 1 (r = 0.61, P < 0.0001) and group 2 (r = 0.59, P < 0.0001). In the logistic regression analysis, cases showed higher odds ratios (range, 6.1 to 40.8) for jaw and neck pain and disability compared with controls. Taken together, the results show that individuals with a recent whiplash trauma report more jaw pain and disability compared with controls without a history of neck trauma. Furthermore, the correlation between jaw and neck pain intensity implies that intensity of neck pain in the acute stage after whiplash trauma might be a possible risk factor also for development of chronic orofacial pain. PMID:27307051

  9. Musculoskeletal ultrasound image denoising using Daubechies wavelets

    NASA Astrophysics Data System (ADS)

    Gupta, Rishu; Elamvazuthi, I.; Vasant, P.

    2012-11-01

    Among various existing medical imaging modalities Ultrasound is providing promising future because of its ease availability and use of non-ionizing radiations. In this paper we have attempted to denoise ultrasound image using daubechies wavelet and analyze the results with peak signal to noise ratio and coefficient of correlation as performance measurement index. The different daubechies from 1 to 6 is used on four different ultrasound bone fracture images with three different levels from 1 to 3. The images for visual inspection and PSNR, Coefficient of correlation values are graphically shown for quantitaive analysis of resultant images.

  10. Kinematics of a Head-Neck Model Simulating Whiplash

    NASA Astrophysics Data System (ADS)

    Colicchia, Giuseppe; Zollman, Dean; Wiesner, Hartmut; Sen, Ahmet Ilhan

    2008-02-01

    A whiplash event is a relative motion between the head and torso that occurs in rear-end automobile collisions. In particular, the large inertia of the head results in a horizontal translation relative to the thorax. This paper describes a simulation of the motion of the head and neck during a rear-end (whiplash) collision. A head-neck model that qualitatively undergoes the same forces acting in whiplash and shows the same behavior is used to analyze the kinematics of both the head and the cervical spine and the resulting neck loads. The rapid acceleration during a whiplash event causes the extension and flexion of the cervical spine, which in turn can cause dislocated vertebrae, torn ligaments, intervertebral disc herniation, and other trauma that appear to be the likely causes of subsequent painful headache or neck pain symptoms. Thus, whiplash provides a connection between the dynamics of the human body and physics. Its treatment can enliven the usual teaching in kinematics, and both theoretical and experimental approaches provide an interesting biological context to teach introductory principles of mechanics.

  11. The global burden of musculoskeletal conditions for 2010: an overview of methods.

    PubMed

    Hoy, Damian G; Smith, Emma; Cross, Marita; Sanchez-Riera, Lidia; Buchbinder, Rachelle; Blyth, Fiona M; Brooks, Peter; Woolf, Anthony D; Osborne, Richard H; Fransen, Marlene; Driscoll, Tim; Vos, Theo; Blore, Jed D; Murray, Chris; Johns, Nicole; Naghavi, Mohsen; Carnahan, Emily; March, Lyn M

    2014-06-01

    The objective of this paper is to provide an overview of methods used for estimating the burden from musculoskeletal (MSK) conditions in the Global Burden of Diseases 2010 study. It should be read in conjunction with the disease-specific MSK papers published in Annals of Rheumatic Diseases. Burden estimates (disability-adjusted life years (DALYs)) were made for five specific MSK conditions: hip and/or knee osteoarthritis (OA), low back pain (LBP), rheumatoid arthritis (RA), gout and neck pain, and an 'other MSK conditions' category. For each condition, the main disabling sequelae were identified and disability weights (DW) were derived based on short lay descriptions. Mortality (years of life lost (YLLs)) was estimated for RA and the rest category of 'other MSK', which includes a wide range of conditions such as systemic lupus erythematosus, other autoimmune diseases and osteomyelitis. A series of systematic reviews were conducted to determine the prevalence, incidence, remission, duration and mortality risk of each condition. A Bayesian meta-regression method was used to pool available data and to predict prevalence values for regions with no or scarce data. The DWs were applied to prevalence values for 1990, 2005 and 2010 to derive years lived with disability. These were added to YLLs to quantify overall burden (DALYs) for each condition. To estimate the burden of MSK disease arising from risk factors, population attributable fractions were determined for bone mineral density as a risk factor for fractures, the occupational risk of LBP and elevated body mass index as a risk factor for LBP and OA. Burden of Disease studies provide pivotal guidance for governments when determining health priority areas and allocating resources. Rigorous methods were used to derive the increasing global burden of MSK conditions. PMID:24550172

  12. Work-related musculoskeletal disorders among physical therapists: A comprehensive narrative review.

    PubMed

    Milhem, Mohammad; Kalichman, Leonid; Ezra, David; Alperovitch-Najenson, Deborah

    2016-01-01

    Healthcare workers, especially those with direct patient contact are amongst professions with the highest rate of workrelated musculoskeletal disorders (WMSDs), physical therapists (PTs) being one of them. Our objective was to review current knowledge relating to the prevalence, risk factors and prevention of WMSDs among PTs. Pubmed, Google Scholar and PEDro databases were searched for terms relating to WMSDs in PTs from inception to 2015. The prevalence of WMSDs among PTs was high, with lifetime prevalence reported as 55-91%, and 12-month prevalence ranges 40-91.3%, and the lower back as the most frequently affected, with estimates of a lifetime prevalence ranging 26-79.6%, and a 12-month prevalence ranging 22-73.1%, followed most often by the neck, upper back and shoulders. The major risk factors for workrelated low back pain (LBP) were: lifting, transferring, repetitive movements, awkward and static postures, physical load, treating a large number of patients in a single day and working while injured. Low back pain seems to be age- and genderrelated with a higher prevalence in females, younger PTs and PTs working in rehabilitation settings. Physical therapists, as a consequence of work-related LBP, may seek treatment, modify their daily living and leisure (lifestyle) activities, use aids and equipment or change their specialty area either within the profession or by leaving it. Skills and knowledge as to correct body mechanics do not prevent work-related injuries. Mechanical aids used for a patient transfer should be adopted by PTs and new strategies should be developed to reduce their WMSDs without compromising the quality of treatment. Int J Occup Med Environ Health 2016;29(5):735-747. PMID:27518884

  13. Explaining sex differences in chronic musculoskeletal pain in a general population.

    PubMed

    Wijnhoven, Hanneke A H; de Vet, Henrica C W; Picavet, H Susan J

    2006-09-01

    Many studies report a female predominance in the prevalence of chronic musculoskeletal pain (CMP) but the mechanisms explaining these sex differences are poorly understood. Data from a random postal questionnaire survey in the Dutch general population were used to examine whether sex differences in the prevalences of CMP are due to sex differences in the distribution of known potential risk factors for CMP (exposure model) and/or to the different importance of risk factors for CMP (i.e. show different strength of association) in men and women (vulnerability model). In the present analyses, 909 men and 1178 women aged 25-65 were included. CMP was defined as pain lasting longer than 3 months and was assessed for 10 anatomical locations (neck, shoulder, higher back, elbow, wrist/hand, lower back, hip, knee, ankle, foot). Sex differences in CMP could not be explained by a different distribution of age, educational level, smoking status, overweight, physical activity, and pain catastrophizing. Having no paid job was associated with CMP, explaining part of the sex differences, but its role seems complex. Risk factors with a sex-specific association were: overweight (all pain locations) and older age (lower extremities)--both having only an effect among women--and pain catastrophizing (upper extremities), which was stronger associated with CMP among men than among women. In conclusion, sex differences in prevalence of CMP may partly be explained by sex differences in vulnerability to risk factors for CMP. Future research towards sex-specific identification of risk factors for CMP is warranted. Eventually this may lead to sex-specific prevention and management of CMP. PMID:16716517

  14. Long-Term Outcomes in Patients Surviving Large Burns: The Musculoskeletal System.

    PubMed

    Holavanahalli, Radha K; Helm, Phala A; Kowalske, Karen J

    2016-01-01

    The authors have previously described long-term outcomes related to the skin in patients surviving large burns. The objective of this study was to describe the long-term musculoskeletal complications following major burn injury. This is a cross-sectional descriptive study that includes a one-time evaluation of 98 burn survivors (mean age = 47 years; mean TBSA = 57%; and mean time from injury = 17 years), who consented to participate in the study. A comprehensive history and physical examination was conducted by a senior and experienced Physical Medicine and Rehabilitation physician. In addition to completing a Medical Problem Checklist, subjects also completed the Burn-Specific Health Scale (Abbreviated 80 item), a self-report measure used to review the level of functional adaptation. Joint pain, joint stiffness, problems walking or running, fatigue, and weak arms and hands are conditions that continue to be reported at an average of 17 years from the time of burn injury. Seventy-three percent (68 of 93) of the study sample were found to have a limitation of motion and areas most affected were the neck (47%), hands (45%), and axilla (38%). The global (Burn-Specific Health Scale-total) score for the overall sample was 0.78. Subjects with limitation of motion had significant difficulty in areas of mobility, self-care, hand function, and role activities. This study underscores the importance of long-term follow-up care and therapeutic interventions for survivors of major burn injury, as they continue to have significant and persistent burn-related impairments even several years following injury. PMID:26056761

  15. Head and Neck Sarcomas: A Comprehensive Cancer Center Experience

    PubMed Central

    Tejani, Mohamedtaki A.; Galloway, Thomas J.; Lango, Miriam; Ridge, John A.; von Mehren, Margaret

    2013-01-01

    Head/neck sarcomas are rare, accounting for about 1% of head/neck malignancies and 5% of sarcomas. Outcomes have historically been worse in this group, due to anatomic constraints leading to difficulty in completely excising tumors, with high rates of local recurrence. We retrospectively analyzed cases of head/neck soft tissue sarcomas (STS) and osteogenic sarcomas managed in a multi-disciplinary setting at Fox Chase Cancer Center from 1999–2009 to describe clinicopathologic characteristics, treatment, outcomes, and prognostic factors for disease control and survival. Thirty patients with STS and seven patients with osteogenic sarcoma were identified. Most STS were high grade (23) and almost all were localized at presentation (28). Common histologies were synovial cell (6), rhabdomyosarcoma (5), angiosarcoma (4), liposarcoma (4) and leiomyosarcoma (3). The type of primary therapy and disease outcomes were analyzed. Cox proportional hazards regression analysis was performed to identify predictors of disease-free survival (DFS) and overall survival (OS). The HR and 95% CI for Cox model and median DFS/OS analyzed by Kaplan-Meier curves were calculated. PMID:24202325

  16. The mediating role of work-related musculoskeletal disorders on the link between psychosocial factors and absenteeism among administrative workers.

    PubMed

    Abdullah, Mohd Zulkifli; Othman, Abdul Kadir; Ahmad, Mohamad Fahimi; Justine, Maria

    2015-01-01

    This study aimed to investigate the association between psychosocial factors (i.e., job demand, decision latitude, social support, physical environment, and personal risk factors), work-related musculoskeletal disorders (WRMDs), and productivity as measured by workers' perceived absenteeism. Data were collected from the selected administrative workers (administrative assistant) and analyzed using cross tabulation. The results indicate that all psychological factors are not significantly associated with WRMDs, except for the association between personal risk factors and hip/thigh disorders. Subsequently, WRMDs do not significantly contribute to explaining absenteeism. The managerial and research implications of this study are deliberately discussed. PMID:25375935

  17. Head and neck position sense.

    PubMed

    Armstrong, Bridget; McNair, Peter; Taylor, Denise

    2008-01-01

    Traumatic minor cervical strains are common place in high-impact sports (e.g. tackling) and premature degenerative changes have been documented in sports people exposed to recurrent impact trauma (e.g. scrummaging in rugby) or repetitive forces (e.g. Formula 1 racing drivers, jockeys). While proprioceptive exercises have been an integral part of rehabilitation of injuries in the lower limb, they have not featured as prominently in the treatment of cervical injuries. However, head and neck position sense (HNPS) testing and re-training may have relevance in the management of minor sports-related neck injuries, and play a role in reducing the incidence of ongoing pain and problems with function. For efficacious programmes to be developed and tested, fundamental principles associated with proprioception in the cervical spine should be considered. Hence, this article highlights the importance of anatomical structures in the cervical spine responsible for position sense, and how their interaction with the CNS affects our ability to plan and execute effective purposeful movements. This article includes a review of studies examining position sense in subjects with and without pathology and describes the effects of rehabilitation programmes that have sought to improve position sense. In respect to the receptors providing proprioceptive information for the CNS, the high densities and complex arrays of spindles found in cervical muscles suggest that these receptors play a key role. There is some evidence suggesting that ensemble encoding of discharge patterns from muscle spindles is relayed to the CNS and that a pattern recognition system is used to establish joint position and movement. Sensory information from neck proprioceptive receptors is processed in tandem with information from the vestibular system. There are extensive anatomical connections between neck proprioceptive inputs and vestibular inputs. If positional information from the vestibular system is inaccurate or

  18. Efficacies of surgical treatments based on Harris hip score in elderly patients with femoral neck fracture

    PubMed Central

    Liang, Chengwei; Yang, Fengjian; Lin, Weilong; Fan, Yongqian

    2015-01-01

    Aim: To compare the efficacies of four surgical treatments, i.e., total hip arthroplasty (THA), internal fixation (IF), hemiarthroplasty (HA), and artificial femoral head replacement (artificial FHR), by performing a network meta-analysis based on Harris hip score (HHS) in elderly patients with femoral neck fracture. Methods: In strict accordance with specific inclusion and exclusion criteria, randomized controlled trails (RCTs) were screened and selected from a larger group of studies that were retrieved through a comprehensive search of scientific literature databases, further complimented by manual search. The resultant high-quality data from final selected studies were analyzed using Stata 12.0 software. Results: A total of 3680 studies were initially retrieved from database search, and 15 RCTs were eventually incorporated into this meta-analysis, containing 1781 elderly patients who had undergone various surgical treatments for femoral neck fracture (THA group = 604; HA group = 604; IF group = 495; artificial FHR group = 78). Our major result revealed a statistically significant difference in HHS of femoral neck fracture when HA and IF groups were compared with THA. No differences were detected in the HHS of femoral neck fracture undergoing artificial FHR and THA. The surface under the cumulative ranking curves (SUCRA) value of HHS, in elderly patients with femoral neck fracture after surgery, revealed that IF has the highest value. Conclusions: The current network meta-analysis results suggest that IF is the superlative surgical procedure for femoral neck fracture patients, and IF significantly improves the HHS in femoral neck fracture patients. PMID:26221216

  19. Low Back Pain and Other Musculoskeletal Pain Comorbidities in Individuals with Symptomatic Osteoarthritis of the Knee: Data from the Osteoarthritis Initiative

    PubMed Central

    Suri, Pradeep; Morgenroth, David C.; Kwoh, C. Kent; Bean, Jonathan F.; Kalichman, Leonid; Hunter, David J.

    2010-01-01

    Objective To examine the association of concurrent low back pain (LBP), and other musculoskeletal pain comorbidity, with knee pain severity in symptomatic knee osteoarthritis (OA). Methods 1389 individuals from the Progression Cohort of the Osteoarthritis Initiative, age 45-79 with symptomatic tibiofemoral knee OA, were studied. Participants identified pain in the low back, neck, shoulder, elbow, wrist, hand, hip, knee, ankle, or foot. The primary outcome was the pain subscale of the Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) applied to the more symptomatic knee. We examined WOMAC pain score in persons with and without LBP, before and after adjusting for other musculoskeletal symptoms. Results 57.4% of participants reported LBP. WOMAC pain score (possible range 0-20) was 6.5±4.1 in participants with LBP, and 5.2±3.4 in participants without (p<0.0001). In multivariate analyses, LBP was significantly associated with increased WOMAC knee pain score (β[SE]=1.00[0.21]; p=<.0001). However, pain in all other individual musculoskeletal locations demonstrated similar associations with knee pain score. In models including all pain locations simultaneously, only LBP (β[SE]=0.65[0.21];p=.002), ipsilateral elbow pain (0.98 [0.40]; p=.02), and ipsilateral foot pain (1.03[0.45]; p=.02) were significantly associated with knee pain score. Having more than one pain location was associated with greater WOMAC knee pain; this relationship was strongest for individuals having four (β[SE]= 1.83[0.42]; p<0.0001), or five or more pain locations (1.86[0.36]; p<0.0001). Conclusions LBP, foot pain, and elbow pain are significantly associated with WOMAC knee pain score, as are a higher total number of pain locations. This may have implications for clinical trial planning. PMID:20799265

  20. Fusobacterial head and neck infections in children.

    PubMed

    Brook, Itzhak

    2015-07-01

    Fusobacterium species are increasingly recognized as a cause of head and neck infections in children. These infections include acute and chronic otitis, sinusitis, mastoiditis, and tonsillitis; peritonsillar and retropharyngeal abscesses; Lemierre syndrome; post-anginal cervical lymphadenitis; and periodontitis. They can also be involved in brain abscess and bacteremia associated with head and neck infections. This review describes the clinical spectrum of head and neck fusobacterial infection in children and their management. PMID:25980688

  1. Paragangliomas of the Head and Neck.

    PubMed

    Woolen, Sean; Gemmete, Joseph J

    2016-05-01

    Paragangliomas of the head and neck are rare vascular skull-base tumors derived from the paraganglionic system with an estimated incidence of 1:30,000 accounting for 3% of all paragangliomas. The most common paraganglioma locations of the head and neck in descending order are the carotid body, jugular, tympanic, and vagal paragangliomas. This article discusses the clinical characterics, normal anatamy, imaging findings and protocols, pathology, staging, and differential diagnosis for paragangliomas of the head and neck. PMID:27154608

  2. The combined effect of physical, psychosocial/organisational and/or environmental risk factors on the presence of work-related musculoskeletal symptoms and its consequences.

    PubMed

    Widanarko, Baiduri; Legg, Stephen; Devereux, Jason; Stevenson, Mark

    2014-11-01

    This study assessed the combined effect of physical and psychosocial/organisational and/or environmental factors on the presence of musculoskeletal symptoms (MSS) and its consequences (reduced activities and absenteeism due to MSS) in a random sample of 3003 workers in New Zealand. By telephone interview, participants reported their current workplace exposures and MSS (neck/shoulder, arm/elbow, wrist and low back) and its consequences. Data were analysed using multivariable logistic regression. Combined exposure to physical and psychosocial/organisational and/or environmental factors increased the odds of MSS in the neck/shoulder (OR 3.14, 95% CI 1.79-5.52), arms/elbow regions (OR 4.14, 95% CI 2.21-7.76) and low back (OR 1.74, 95% CI 1.28-2.37) and its consequences, i.e. reduced activities due to neck/shoulder symptoms (OR 5.45, 95% CI 2.28-13.00), absenteeism due to neck/shoulder symptoms (OR 5.19, 95% CI 2.24-12.01) and absenteeism due to low back symptoms (OR 4.37, 95% CI 2.92-6.53). In contrast, favourable psychosocial/organisational work conditions reduced the odds of wrist symptoms due to poor physical work conditions (OR 2.19, 95% CI 1.44-3.34). We conclude that to reduce MSS and its consequences, employers need to adopt a multifaceted approach: concentrate on improving physical conditions as well as the psychosocial/organisational and environmental aspects of the working environment. PMID:24934982

  3. Musculoskeletal pain among women of menopausal age in Puebla, Mexico.

    PubMed

    Sievert, Lynnette Leidy; Goode-Null, Susan K

    2005-06-01

    Worldwide, complaints of musculoskeletal pain are more frequent than complaints of hot flashes amongst women of menopausal age. The purpose of this study was to examine musculoskeletal pain among women of menopausal age in the city of Puebla, Mexico. An opportunity sample was recruited from public parks and markets, with representation from all social classes (n=755). Mean age was 50.1 years, and the majority were employed as saleswomen in small businesses. Symptom frequencies were collected by open-ended interviews and with a structured symptom list that queried symptom experience during the two weeks prior to interview. In response to open-ended questions, "dolores de huesos" (bone pain) was volunteered by 47% of respondents as a symptom associated with menopause, second only to hot flashes (53%). From the structured symptom list, 55.8% and 55.6% reported back pain and joint stiffness during the two weeks prior to interview. Women with back pain and joint stiffness were less likely to report being active during their leisure time (p<.01). The results of backwards stepwise logistic regressions indicate that women with back pain were more likely to be older, with less education, a higher BMI, and ate less meat. Women with joint pain were more likely to be post-menopausal, with less education, more children, a higher BMI, and were likely to drink milk and coffee more than once/week but less than once/day. While menopause is not necessarily a risk factor for musculoskeletal pain, it is important to recognize the pervasiveness of this complaint among women of menopausal age. PMID:16917748

  4. Surgical Management of Orthopedic and Musculoskeletal Diseases of Feedlot Calves.

    PubMed

    Anderson, David E; Miesner, Matt D

    2015-11-01

    Injuries, infections, and disorders of the musculoskeletal system are common in feedlot calves. These conditions often are amenable to surgical treatment with return of the calf to productivity. Weight gain and carcass quality are expected to be significantly adversely affected by pain and debilitation. The goal of surgical management of disorders of the joints, muscles, and feet should be resolution of the inciting cause, mitigation of pain, and restoration of form and function. If these are achieved, calves should return to acceptable, if not normal, feed intake, rate of gain, and carcass quality. PMID:26210767

  5. Economic impact of musculoskeletal disorders (MSDs) on work in Europe.

    PubMed

    Bevan, Stephen

    2015-06-01

    Musculoskeletal disorders (MSDs) are the leading cause of work disability, sickness absence from work, 'presenteeism' and loss of productivity across all the European Union (EU) member states. It is estimated that the total cost of lost productivity attributable to MSDs among people of working age in the EU could be as high as 2% of gross domestic product (GDP). This paper examines the available evidence on the economic burden of MSDs on work across Europe and highlights areas of policy, clinical and employment practice which might improve work outcomes for individuals and families and reduce the economic and social costs of MSDs. PMID:26612235

  6. Developing ergonomic solutions for prevention of musculoskeletal disorder disability.

    PubMed

    Armstrong, T J; Franzblau, A; Haig, A; Keyserling, W M; Levine, S; Streilein, K; Ulin, S; Werner, R

    2001-01-01

    Numerous models have been proposed to help understand the relationship between personal and work factors that affect participation in work. The authors use a generic version of these models as a framework for identifying gaps between job demands and worker capacities. They describe metrics for assessing factors associated with causing or aggravating musculoskeletal disorders. Two case examples are presented to illustrate the hierarchical assessment of jobs and the evaluation of gaps between job demands and worker capacities. Finally, the authors describe the development of a job database to facilitate future evaluations. PMID:12530835

  7. How intraoperative navigation is changing musculoskeletal tumor surgery.

    PubMed

    Satcher, Robert L

    2013-10-01

    Computer-assisted orthopedic surgery (CAOS) was introduced, developed, and implemented in musculoskeletal tumor surgery recently to enhance surgical precision in resecting malignant and benign tumors. The origins of computer-assisted surgery were in other subspecialties including maxillofacial surgery, spine surgery, and arthroplasty. Early studies have shown that CAOS can also be used safely for bone tumor resection surgery. Additional technological improvements may allow use of CAOS in soft tissue tumor surgery. It has the potential to improve surgical precision and accuracy, but more study is needed to evaluate clinical efficacy and long term results. PMID:24095079

  8. Musculoskeletal disorders. When are they caused by hormone imbalance?

    PubMed

    Brick, J E; Brick, J F; Elnicki, D M

    1991-11-01

    Often, the source of a musculoskeletal problem can be traced to an endocrine disorder. For example, carpal tunnel syndrome is not uncommon in patients who are pregnant or have diabetes, hypothyroidism, or acromegaly. Joint problems and arthritis are other common findings in diabetes, pregnancy, and hyperparathyroidism. Muscle weakness or stiffness is seen in both hypothyroidism and hyperthyroidism, and muscle wasting is a characteristic of adrenocorticoid insufficiency. Bone disorders are common with glucocorticoid excess, acromegaly, and hyperparathyroidism. Some presentations are a classic picture of a specific endocrine condition and are readily recognized if the index of suspicion is appropriately high. PMID:1946104

  9. Musculoskeletal Sonopathology and Ultrasound-Guided Regional Anesthesia

    PubMed Central

    Macfarlane, Alan J. R.; Sites, Brian D.; Sites, Vincent R.; Naraghi, Ali M.; Chan, Vincent W. S.; Singh, Mandeep; Antonakakis, John G.

    2010-01-01

    The use of real-time ultrasound guidance has revolutionized the practice of regional anesthesia. Ultrasound is rapidly becoming the technique of choice for nerve blockade due to increased success rates, faster onset, and potentially improved safety. In the course of ultrasound-guided regional anesthesia, unexpected pathology may be encountered. Such anomalous or pathological findings may alter the choice of nerve block and occasionally affect surgical management. This case series presents a variety of musculoskeletal conditions that may be encountered during ultrasound-guided regional anesthesia practice. PMID:22294960

  10. Musculoskeletal Disease in Aged Horses and Its Management.

    PubMed

    van Weeren, Paul René; Back, Willem

    2016-08-01

    Musculoskeletal disorders are the most prevalent health problem in aging horses. They are not life threatening, but are painful and an important welfare issue. Chronic joint disease (osteoarthritis) and chronic laminitis are the most prevalent. Treating osteoarthritis in the elderly horse is similar to treating performance horses, but aims at providing a stable situation with optimal comfort. Immediate medical treatment of flare-ups, long-term pain management, and adaptation of exercise and living conditions are the mainstays of treatment. Laminitis in the geriatric horse is related often to pituitary pars intermedia dysfunction, which may be treated with additional pergolide. PMID:27449390

  11. Musculoskeletal Changes, Injuries and Rehabilitation Associated with Spaceflight

    NASA Technical Reports Server (NTRS)

    Scheuring, Richard A.

    2010-01-01

    The in-flight musculoskeletal database provides the foundation for directing operationally-relevant research in space medicine. This effort will enable medical operations to develop medical kits, training programs, and preventive medicine strategies for future CxP missions: a) Quantify medications and medical supplies for next-generation spacecraft. b) Objective data for engineers to determine weight requirements. Flight surgeons can make specific recommendations to astronauts based on injury data, such as emphasizing hand protection while in-flight. EVA and spacecraft engineers can examine evidence-based data on injuries and design countermeasures to help prevent them.

  12. Musculoskeletal adaptation to mechanical forces on Earth and in space

    NASA Technical Reports Server (NTRS)

    Whalen, Robert

    1993-01-01

    A major concern of the US and Russian space programs is the health and safety of astronauts and cosmonauts. One of the areas receiving the most attention has been the effects of long duration space flight on the musculoskeletel system. After three decades of space flight and research, questions continue. Can exercise in space maintain musculoskeletal tissue mass and function in an adult? The objective of this paper is to address this question in a way that hopefully provides a rational basis for quantifying and evaluating the influnence of daily activities on muscle and bone on Earth and in space.

  13. Managing Minor Musculoskeletal Injuries and Conditions Bradley David Managing Minor Musculoskeletal Injuries and Conditions 394pp £32.99 Wiley Blackwell Publishing 9780470673102 0470673109 [Formula: see text].

    PubMed

    2014-12-01

    IT WAS a great pleasure to review this book, which is a comprehensive collection of musculoskeletal minor injuries and conditions that are seen on a daily basis in emergency departments throughout the UK and Ireland. PMID:25466742

  14. The Musculoskeletal System. Instructional Materials in Anatomy and Physiology for Pennsylvania Health Occupations Programs.

    ERIC Educational Resources Information Center

    National Evaluation Systems, Inc., Amherst, MA.

    This instructional modular unit with instructor's guide provides materials on aspects of one of the major systems of the human body--the musculoskeletal system. Its purpose is to introduce the student to the structures and functions of the human musculoskeletal system--and the interrelationships of the two--and to familiarize the student with some…

  15. National Training Course. Emergency Medical Technician. Paramedic. Instructor's Lesson Plans. Module IX. Musculoskeletal.

    ERIC Educational Resources Information Center

    National Highway Traffic Safety Administration (DOT), Washington, DC.

    This instructor's lesson plan guide on the musculoskeletal system is one of fifteen modules designed for use in the training of emergency medical technicians (paramedics). Five units of study are presented: (1) the major bones, joints, and muscles of the body; (2) patient assessment of a musculoskeletal injury; (3) pathophysiology and management…

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    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases, Special Emphasis Panel, Small Grants Research Review. Date: October 13,...

  1. 78 FR 64509 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-10-29

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... unwarranted invasion of personal privacy. Name of Committee: Arthritis and Musculoskeletal and Skin...

  2. 75 FR 27352 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

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    2010-05-14

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... unwarranted invasion of personal privacy. Name of Committee: Arthritis and Musculoskeletal and Skin...

  3. 77 FR 12605 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

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    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... invasion of personal privacy. Name of Committee: Arthritis and Musculoskeletal and Skin Diseases...

  4. 75 FR 1792 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-01-13

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases Special Emphasis Panel, Small Research Grants Review. Date: February 4,...

  5. 77 FR 1702 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-01-11

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases, including consideration of personnel qualifications and performance, and...

  6. 77 FR 51544 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-24

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases Special Emphasis Panel: Tissue Engineering and Regenerative Medicine....

  7. 77 FR 9671 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-02-17

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee... Musculoskeletal and Skin Diseases Special Emphasis Panel; Career Development, Research Training & Pathways...

  8. 78 FR 38065 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-25

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... unwarranted invasion of personal privacy. Name of Committee: Arthritis and Musculoskeletal and Skin...

  9. 77 FR 20646 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

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    2012-04-05

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases Special Emphasis Panel, Program Project Grant Review. Date: April 25, 2012....

  10. 75 FR 70679 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-11-18

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee... Musculoskeletal and Skin Diseases Special Emphasis Panel, Clinical Trials Review. Date: December 2, 2010. Time:...

  11. 77 FR 39714 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-07-05

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases, Special Emphasis Panel, Clinical Trials Applications. Date: July 25, 2012....

  12. 78 FR 7790 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

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    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... unwarranted invasion of personal privacy. Name of Committee: Arthritis and Musculoskeletal and Skin...

  13. 77 FR 66853 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-11-07

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases Special Emphasis Panel; Multidisciplinary Clinical Research Centers....

  14. 76 FR 61722 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-10-05

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases Special Emphasis Panel, Career Development, Research Training & Pathways...

  15. 78 FR 29144 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-05-17

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases Special Emphasis Panel; Ancillary Studies to Large Clinical Projects...

  16. 75 FR 54897 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-09-09

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee... Musculoskeletal and Skin Diseases Special Emphasis Panel; Muscle Physiology Review. Date: September 15, 2010....

  17. 78 FR 58320 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

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    2013-09-23

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... unwarranted invasion of personal privacy. Name of Committee: Arthritis and Musculoskeletal and Skin...

  18. 76 FR 28440 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-05-17

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... unwarranted invasion of personal privacy. Name of Committee: Arthritis and Musculoskeletal and Skin...

  19. 78 FR 9933 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

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    2013-02-12

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases Special Emphasis Panel; Ancillary Studies To Large Clinical Projects...

  20. 77 FR 35988 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

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    2012-06-15

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... unwarranted invasion of personal privacy. Name of Committee: Arthritis and Musculoskeletal and Skin...

  1. 76 FR 6806 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-02-08

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee... Musculoskeletal and Skin Diseases Special Emphasis Panel; Ancillary Studies Grant Review. Date: February 22,...

  2. 76 FR 35225 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-16

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases, Special Emphasis Panel. Clinical Trials Planning Pilot and Research. Date:...

  3. 77 FR 59937 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meetings

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-10-01

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meetings Pursuant to section 10(d) of the Federal Advisory Committee... Musculoskeletal and Skin Diseases Special Emphasis Panel; NIAMS Small Grant Program for New Investigators...

  4. 75 FR 26762 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2010-05-12

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases Special Emphasis Panel, Ancillary Clinical Studies Review. Date: June 10,...

  5. 76 FR 31968 - National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-02

    ... HUMAN SERVICES National Institutes of Health National Institute of Arthritis and Musculoskeletal and Skin Diseases; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory Committee Act... Musculoskeletal and Skin Diseases Special Emphasis Panel; Ancillary Studies to Large Ongoing Clinical...

  6. Workplace Accommodations for Persons with Musculoskeletal Disorders. Implementing the Americans with Disabilities Act Series.

    ERIC Educational Resources Information Center

    Morosky, Frank N.

    This brief paper summarizes requirements of the Americans with Disabilities Act (ADA) of 1990 related to workplace accommodations for persons with musculo-skeletal disorders. The following topics are addressed: (1) the relevance of the ADA to people with musculo-skeletal disorders; (2) employment provisions of the ADA to protect individuals with…

  7. Leclercia adecarboxylata Musculoskeletal Infection in an Immune Competent Pediatric Patient: An Emerging Pathogen?

    PubMed Central

    Grantham, W. Jeffrey; Funk, Shawn S.; Schoenecker, Jonathan G.

    2015-01-01

    Case. An immune competent pediatric patient presented with a persistent lower extremity infection with Leclercia adecarboxylata after a penetrating injury. This case report details the presentation, clinical course, and treatment. Conclusion. Leclercia adecarboxylata has increasing reports in immunosuppressed and adult patients with musculoskeletal infection. This case now indicates that Leclercia adecarboxylata is a potential pathogen in immune competent children in musculoskeletal tissue. PMID:26609458

  8. Effects of job rotation on musculoskeletal complaints and related work exposures: a systematic literature review.

    PubMed

    Leider, Priscilla C; Boschman, Julitta S; Frings-Dresen, Monique H W; van der Molen, Henk F

    2015-01-01

    The aim of this systematic review was to summarise evidence on the effects of job rotation on musculoskeletal complaints, exposures related to musculoskeletal complaints and sustainable working life parameters. A total of 16 studies were included. No studies on sustainable working life parameters were found. The quality of the studies was assessed using a checklist; eight field studies and three laboratory studies of sufficient quality were used to summarise the following evidence: one field study showed positive results and one field study showed negative results for musculoskeletal complaints, two field studies showed positive results and two field studies showed inconsistent results for exposures, and two field studies showed inconsistent results for musculoskeletal complaints and exposures. Two laboratory studies showed inconsistent results and one laboratory study showed no changes for exposures. In conclusion, there is currently inconsistent evidence for positive or negative effects of job rotation on musculoskeletal complaints and exposures related to musculoskeletal complaints. Practitioner's Summary: Currently, there is inconsistent evidence for recommending job rotation as a strategy for preventing musculoskeletal complaints. Exposures from all involved work activities and body regions should be identified and assessed first, to determine if job rotation provides increased exposure variation and/or beneficial changes in mean exposures related to musculoskeletal complaints. PMID:25267494

  9. Management of Urinary Incontinence in Complete Bladder Duplication by Injection of Bulking Agent at Bladder Neck Level into the Proximal Urethra

    PubMed Central

    Khorramirouz, Reza; Ladi Seyedian, Seyedeh Sanam; Keihani, Sorena; Kajbafzadeh, Abdol-Mohammad

    2016-01-01

    Bladder duplication is a rare entity in children. The term encompasses a wide spectrum of anomalies from isolated bladder duplication in coronal or sagittal planes to duplicated bladder exstrophy and associated musculoskeletal and visceral anomalies. Given this wide variability, the treatment of these patients is not standardized. We hereby present a female patient with chief complaint of long-standing urinary incontinence who had complete bladder and urethral duplication and pubic diastasis. The patient was treated with bulking agent injection at the incompetent bladder neck and proximal urethra with resolution of incontinence, obviating the need for extensive surgeries. PMID:26904349

  10. Current philosophy in the surgical management of neck metastases for head and neck squamous cell carcinoma

    PubMed Central

    Coskun, H. Hakan; Medina, Jesus E.; Robbins, K. Thomas; Silver, Carl E.; Strojan, Primož; Teymoortash, Afshin; Pellitteri, Phillip K.; Rodrigo, Juan P.; Stoeckli, Sandro J.; Shaha, Ashok R.; Suçrez, Carlos; Hartl, Dana M.; de Bree, Remco; Takes, Robert P.; Hamoir, Marc; Pitman, Karen T.; Rinaldo, Alessandra; Ferlito, Alfio

    2016-01-01

    Neck dissection is an important treatment for metastases from upper aerodigestive carcinoma; an event that markedly reduces survival. Since its inception, the philosophy of the procedure has undergone significant change from one of radicalism to the current conservative approach. Furthermore, nonsurgical modalities have been introduced, and, in many situations, have supplanted neck surgery. The refinements of imaging the neck based on the concept of neck level involvement has encouraged new philosophies to evolve that seem to benefit patient outcomes particularly as this relates to diminished morbidity. The purpose of this review was to highlight the new paradigms for surgical removal of neck metastases using an evidence-based approach. PMID:24623715

  11. Musculoskeletal Workforce Needs: Are Physician Assistants and Nurse Practitioners the Solution? AOA Critical Issues.

    PubMed

    Day, Charles S; Boden, Scott D; Knott, Patrick T; O'Rourke, Nancy C; Yang, Brian W

    2016-06-01

    Growth estimates and demographic shifts of the population of the United States foreshadow a future heightened demand for musculoskeletal care. Although many articles have discussed this growing demand on the musculoskeletal workforce, few address the inevitable need for more musculoskeletal care providers. As we are unable to increase the number of orthopaedic surgeons because of restrictions on graduate medical education slots, physician assistants (PAs) and nurse practitioners (NPs) represent one potential solution to the impending musculoskeletal care supply shortage. This American Orthopaedic Association (AOA) symposium report investigates models for advanced practice provider integration, considers key issues affecting PAs and NPs, and proposes guidelines to help to assess the logistical and educational possibilities of further incorporating NPs and PAs into the orthopaedic workforce in order to address future musculoskeletal care needs. PMID:27252443

  12. Radiation therapy for head and neck neoplasms

    SciTech Connect

    Wang, C.C.

    1990-01-01

    This book presents the clinical manifestations of disease, applied anatomy pertaining to the management of head and neck tumors, and results of conventional radiation therapy for uncommon tumors have been explored. It also contains an additional chapter on altered fractionation radiation therapy pertaining to irradiation of major head and neck tumors.

  13. 49 CFR 572.33 - Neck.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 7 2010-10-01 2010-10-01 false Neck. 572.33 Section 572.33 Transportation Other Regulations Relating to Transportation (Continued) NATIONAL HIGHWAY TRAFFIC SAFETY ADMINISTRATION, DEPARTMENT OF TRANSPORTATION (CONTINUED) ANTHROPOMORPHIC TEST DEVICES Hybrid III Test Dummy § 572.33 Neck....

  14. 49 CFR 572.33 - Neck.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... sensor of the six axis neck transducer and Fx is the force measured in lbs by the “X” axis force sensor... Fx is the force measured in lbs by the “X” axis force sensor (Channel Class 600) of the six axis neck... is vertical and coincides with the plane of motion of the pendulum's longitudinal axis....

  15. Preventable Sternocleidomastoid Muscular Atrophy after Neck Dissection

    PubMed Central

    Yamamoto, Nao; Sawai, Natsuko Yoshimura; Ishimoto, Shunsuke; Ogura, Hide; Aikawa, Tomonao; Kogo, Mikihiko

    2015-01-01

    Background: Modified radical neck dissection (mRND) [preserving the sternocleidomastoid muscle (SCM) and the spinal accessory nerve] and supraomohyoid neck dissection have become common surgical procedures for treating head and neck cancer. Postoperative severe asymmetry of the neck and severe atrophy of the SCM, however, have been demonstrated. Methods: Using computed tomographic images, cross-sectional areas of the SCMs were measured in 99 patients with carcinoma of the oral cavity who underwent unilateral mRND or supraomohyoid neck dissection. An asymmetry index was used. Results: Innervation to the SCM was preserved in 91 patients. The spinal accessory nerve and the innervation were sacrificed in 3 patients; the innervation was repaired in 5 patients. Sacrifice of innervation to the SCM resulted in extremely severe asymmetry. Repair of the innervation prevented severe asymmetry in 40%. Preservation of the innervation prevented severe asymmetry in 75% at the middle portion of the neck and in 56% at the lower portion after mRND. Conclusion: Preserving innervation to the SCM and gentle handling of the nerve during neck dissection could prevent severe asymmetry after neck dissection. PMID:26495217

  16. 49 CFR 572.113 - Neck assembly.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ...) Using neck brackets 78051-303 and -307, mount the head/neck assembly to the part 572 pendulum test... to the plane of motion of the pendulum's longitudinal centerline (see § 572.33, Figure 20, except... (horizontal surface at the base of the skull) rotation with respect to the pendulum's longitudinal...

  17. 49 CFR 572.113 - Neck assembly.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ...) Using neck brackets 78051-303 and -307, mount the head/neck assembly to the part 572 pendulum test... to the plane of motion of the pendulum's longitudinal centerline (see § 572.33, Figure 20, except... (horizontal surface at the base of the skull) rotation with respect to the pendulum's longitudinal...

  18. 49 CFR 572.113 - Neck assembly.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ...) Using neck brackets 78051-303 and -307, mount the head/neck assembly to the part 572 pendulum test... to the plane of motion of the pendulum's longitudinal centerline (see § 572.33, Figure 20, except... (horizontal surface at the base of the skull) rotation with respect to the pendulum's longitudinal...

  19. 49 CFR 572.113 - Neck assembly.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ...) Using neck brackets 78051-303 and -307, mount the head/neck assembly to the part 572 pendulum test... to the plane of motion of the pendulum's longitudinal centerline (see § 572.33, Figure 20, except... (horizontal surface at the base of the skull) rotation with respect to the pendulum's longitudinal...

  20. 3 T magnetic resonance imaging of the musculoskeletal system.

    PubMed

    Guglielmi, G; Biccari, N; Mangano, F; Toffanin, R

    2010-06-01

    The increasing distribution of high-field (3 T) magnetic resonance (MR) systems for clinical use has been accompanied by the need to fully understand the advantages and disadvantages that the increase in signal quality confers. Continuous development of the coils is required to fully express the potential of these systems, especially given the synergy between parallel imaging and the recent multichannel phased-array coils, which are able to improve image quality, spatial resolution and diagnostic accuracy in musculoskeletal imaging. The increase in signal offered by the high field makes possible improved visualisation of bone, cartilage, tendons and ligaments. This advantage, together with increased spatial resolution, is particularly useful when studying joints or some of their components, the evaluation of which has produced suboptimal results in non arthrographic examinations such as the glenoid labrum of the shoulder and the articular cartilage of the knee. Thanks to the greater signal-to-noise ratio and improved spatial resolution, MR imaging at 3 T is able to notably increase diagnostic performance in the musculoskeletal setting, with a consequent improvement in patient treatment and management. PMID:20177987

  1. Musculoskeletal-induced Nucleation in Altitude Decompression Sickness

    NASA Technical Reports Server (NTRS)

    Pollock, N. W.; Natoli, M. J.; Conkin, J.; Wessel, J. H., III; Gernhardt, M. L.

    2014-01-01

    Musculoskeletal activity has the potential to both improve and compromise decompression safety. Exercise enhances inert gas elimination during oxygen breathing prior to decompression (prebreathe), but it may also promote bubble nuclei formation (nucleation), which can lead to gas phase separation and bubble growth and increase the risk of decompression sickness (DCS). The timing, pattern and intensity of musculoskeletal activity and the level of tissue supersaturation may be critical to the net effect. There are limited data available to evaluate cost-benefit relationships. Understanding the relationship is important to improve our understanding of the underlying mechanisms of nucleation in exercise prebreathe protocols and to quantify risk in gravity and microgravity environments. Data gathered during NASA's Prebreathe Reduction Program (PRP) studies combined oxygen prebreathe and exercise followed by low pressure (4.3 psi; altitude equivalent of 30,300 ft [9,235 m]) microgravity simulation to produce two protocols used by astronauts preparing for extravehicular activity. Both the Phase II/CEVIS (cycle ergometer vibration isolation system) and ISLE (in-suit light exercise) trials eliminated ambulation to more closely simulate the microgravity environment. The CEVIS results (35 male, 10 female) serve as control data for this NASA/Duke study to investigate the influence of ambulation exercise on bubble formation and the subsequent risk of DCS.

  2. Effects of Deployment on Musculoskeletal and Physiological Characteristics and Balance.

    PubMed

    Nagai, Takashi; Abt, John P; Sell, Timothy C; Keenan, Karen A; McGrail, Mark A; Smalley, Brian W; Lephart, Scott M

    2016-09-01

    Despite many nonbattle injuries reported during deployment, few studies have been conducted to evaluate the effects of deployment on musculoskeletal and physiological characteristics and balance. A total of 35 active duty U.S. Army Soldiers participated in laboratory testing before and after deployment to Afghanistan. The following measures were obtained for each Soldier: shoulder, trunk, hip, knee, and ankle strength and range of motion (ROM), balance, body composition, aerobic capacity, and anaerobic power/capacity. Additionally, Soldiers were asked about their physical activity and load carriage. Paired t tests or Wilcoxon tests with an α = 0.05 set a priori were used for statistical analyses. Shoulder external rotation ROM, torso rotation ROM, ankle dorsiflexion ROM, torso rotation strength, and anaerobic power significantly increased following deployment (p < 0.05). Shoulder extension ROM, shoulder external rotation strength, and eyes-closed balance (p < 0.05) were significantly worse following deployment. The majority of Soldiers (85%) engaged in physical activity. In addition, 58% of Soldiers reported regularly carrying a load (22 kg average). The deployment-related changes in musculoskeletal and physiological characteristics and balance as well as physical activity and load carriage during deployment may assist with proper preparation with the intent to optimize tactical readiness and mitigate injury risk. PMID:27612352

  3. Shoulder complex linkage mechanism for humanlike musculoskeletal robot arms.

    PubMed

    Ikemoto, Shuhei; Kimoto, Yuya; Hosoda, Koh

    2015-12-01

    The shoulder complex in the human body consists of the scapula, clavicle, humerus, and thorax and bears the load imposed by arm movements while at the same time realizing a wide range of motions. To mimic and exploit its role, several musculoskeletal robot arms with shoulder complex mechanisms have been developed. However, although many research groups have tried to design the structures using links and joints that faithfully correspond to the bones and joints in the human shoulder complex, its function has not been successfully reproduced because biologically plausible designs seriously compromise engineering plausibility. In this paper, we propose a linkage mechanism that can reproduce complex three-dimensional scapulo movements and considers the trade-off between biological and engineering plausibilities. Subsequently, the design was validated by driving the mechanism using pneumatic artificial muscles (PAMs) placed similarly to muscles in humans. Further, we present experiments in which the robot was controlled by surface electromyographic signals from a human. We show that the proposed design, due to its kinematic similarity with human musculoskeletal systems, eases the conversion between the surface electromyogram signals and the PAMs control inputs. PMID:26539726

  4. The current state of scaffolds for musculoskeletal regenerative applications.

    PubMed

    Smith, Benjamin D; Grande, Daniel A

    2015-04-01

    Musculoskeletal disease and injury are highly prevalent conditions that lead to many surgical procedures. Autologous tissue transfer, allograft transplantation and nontissue prosthetics are currently used for the surgical treatment of critical-sized defects. However, the field of tissue engineering is actively investigating tissue-replacement solutions, many of which involve 3D scaffolds. Scaffolds must provide a balance of shape, biomechanical function and biocompatibility in order to achieve tissue replacement success. Different tissues can have different requirements for success, which has led to the development of various materials with unique characteristics. Articular cartilage scaffolds have the most robust clinical experience, with many scaffolds, mostly constructed of natural materials, showing promise, but levels of success vary. Tendon scaffolds also have proven clinical applications, with human-dermis-derived scaffolds showing the most potential. Synthetic and naturally derived meniscus scaffolds have been investigated in few clinical studies, but the results are encouraging. Bone scaffolds are limited to amorphous pastes and putties, owing to difficulties achieving adequate vascularization and biomechanical optimization. The complex physiological function and vascular demands of skeletal muscle have limited the widespread clinical use of scaffolds for engineering this tissue. Continued progress in preclinical study, not only of scaffolds, but also of other facets of tissue engineering, should enable the successful translation of musculoskeletal tissue engineering solutions to the clinic. PMID:25776947

  5. Musculoskeletal Pain Management Among Dentists: An Alternative Approach.

    PubMed

    Gupta, Devanand; M, Devaki; Dommaraju, Neelima; Srinivas, Kavuri Teja; Patil, Atul A; Momin, Rizwan K; Jain, Ankita; Gupta, Rajendra Kumar

    2015-01-01

    Musculoskeletal disorders (MSDs) are one of the most important occupational health issues in health care workers. Musculoskeletal pain is an occupational health problem for dental professionals, particularly dentists. Complementary and alternative medicine (CAM) can be helpful in managing and preventing these MSDs. The purpose of this study was to determine the prevalence of MSDs among dentists residing in east India and the use of CAM therapies for the management of MSDs among dentists. Dentists (N = 1082) residing in east India, registered under the Dental Council of India, were surveyed. A questionnaire comprising demographic profile, questions related to MSD among dentists, use of CAM therapies for MSD management, source of CAM information. Data analysis was done using SPSS (version 17), and data were presented in tabular and graphic forms. Univariate and bivariate analyses were done, with P < .05 considered as significant. A response rate of 81% (n = 877) was obtained, revealing that 71% (n = 623) of dentists suffered from MSD. The use of CAM was reported among 83% (n = 517) and conventional therapy among 15% (n = 94) of dentists, and 2% (n = 12) of dentists with MSD do not use any type of treatment modality. Complementary and alternative medicine represents a group of diverse medical and health care systems, practices, and products that are not considered to be part of conventional medicine. CAM therapies have improved quality of life and have given a new meaning to it, especially to dentists who suffer from MSD. PMID:26067590

  6. Delay in treatment of primary malignant and aggressive musculoskeletal tumours.

    PubMed

    Pan, K L; Zolqarnain, A; Chia, Y Y

    2006-02-01

    Patients with aggressive musculoskeletal tumours often arrive at specialised treatment centres late. Such a delay could mean disfavour for potentially curable or long-term disease-free outcome of limb preserving surgery. This study was undertaken to identify the underlying problem-related delay with a view to propose solution for solving it. We reviewed 30 patients to determine the periods of delay between onset of the first symptom and the definitive treatment. The delays were categorized as 'patient' delay, 'referral' delay and 'treatment' delay. There was 'patient' delay in 57% of patients (n=17), ranging from 1 to 18 months; 'referral' delay in 67% of patients (n=20) ranging from 1 to 19 months and 23% of patients (n=7) had treatment delay (average 23 days) at the treatment centre. The causes of late arrival are not solely patient-related but are multifactorial. Measures to minimize such delays include enhancing awareness only with high index of suspicion among primary care practitioners, creating a special lane specialized imaging studies and establishing a dedicated musculoskeletal tumour unit. PMID:17042231

  7. Computed tomography findings of paracoccidiodomycosis in musculoskeletal system

    PubMed Central

    Lima Júnior, Francisco Valtenor Araújo; Savarese, Leonor Garbin; Monsignore, Lucas Moretti; Martinez, Roberto; Nogueira-Barbosa, Marcello Henrique

    2015-01-01

    Objective To evaluate musculoskeletal involvement in paracoccidioidomycosis at computed tomography. Materials and Methods Development of a retrospective study based on a review of radiologic and pathologic reports in the institution database. Patients with histopathologically confirmed musculoskeletal paracoccidioidomycosis and submitted to computed tomography were included in the present study. The imaging findings were consensually described by two radiologists. In order to avoid bias in the analysis, one patient with uncountable bone lesions was excluded from the study. Results A total of seven patients were included in the present study. A total of 18 bone lesions were counted. The study group consisted of 7 patients. A total number of 18 bone lesions were counted. Osteoarticular lesions were the first manifestation of the disease in four patients (57.14%). Bone lesions were multiple in 42.85% of patients. Appendicular and axial skeleton were affected in 85.71% and 42.85% of cases, respectively. Bone involvement was characterized by well-demarcated osteolytic lesions. Marginal osteosclerosis was identified in 72.22% of the lesions, while lamellar periosteal reaction and soft tissue component were present in 5.55% of them. One patient showed multiple small lesions with bone sequestra. Conclusion Paracoccidioidomycosis can be included in the differential diagnosis of either single or multiple osteolytic lesions in young patients even in the absence of a previous diagnosis of pulmonary or visceral paracoccidioidomycosis PMID:25798000

  8. Musculoskeletal Health, Kidney and Liver Function in Retired Jockeys.

    PubMed

    Cullen, S; Donohoe, A; McGoldrick, A; McCaffrey, N; Davenport, C; Byrne, B; Donaghy, C; Tormey, W; Smith, D; Warrington, G

    2015-11-01

    The long-term implications of making-weight daily on musculoskeletal health and functioning of the kidney and liver remain unknown. This study aimed to investigate musculoskeletal health and kidney and liver function in a group of retired jockeys. 28 retired male jockeys (age 50-70 years) provided fasting blood samples for markers of bone metabolism and kidney and liver function. A dual-energy x-ray absorptiometry (DXA) scan was performed for the assessment of bone mineral density (BMD). Established reference ranges were used for interpretation of results. Comparisons were made between retired jockeys based on the professional racing licence held: Flat, National Hunt or Dual. Mean whole-body osteopenia was reported, with no differences between groups. Bone markers, micronutrients, electrolytes and associated hormones, and markers for kidney and liver function were within clinical normative ranges. No differences existed between groups. Results indicate the retired jockeys in this study do not demonstrate compromised bone health or kidney and liver function. However, the retired jockeys may not have undergone chronic weight cycling in the extreme manner evident in present-day jockeys, indicating the next generation of jockeys may face more of a problem. Jockeys should be tracked longitudinally throughout their racing career and beyond. PMID:26212243

  9. Prevalence of Musculoskeletal Symptoms among Dental Health Workers, Southern Thailand.

    PubMed

    Decharat, Somsiri; Phethuayluk, Piriyalux; Maneelok, Supandee

    2016-01-01

    Objectives. The objective of this study was to describe the socioeconomic situation of dental health work and work characteristics and to evaluate the prevalence of musculoskeletal symptoms among dental health workers. Material and Methods. A cross-sectional study was conducted with 124 dental health workers and 124 persons in the reference group, matched to dental health workers by gender, were recruited from the workers who worked at the same 17 community hospitals in Nakhon Si Thammarat province, Thailand. Information was collected by using questionnaire. Data analysis comprised descriptive and analytical components. Results and Discussion. 75.8% were female and 24.2% were male dental health workers. 91.9% of subjects had worked >5 years. Most subjects worked for >8 hours per day and worked >6 days per week, at 63.7% and 53.2%, respectively. 100% of subjects worked in public institutions, and 68% also worked in both public and private institutions. Most subjects (52.4%) did not exercise. Daily activity, gender, duration of work, hours worked per day, days worked per week, and physical activity were significantly associated with musculoskeletal symptoms at <0.001. Conclusion. The prevention and reduction of MSDs among dentists should include improving their education in dental ergonomics. PMID:27597901

  10. Metatarsal Loading During Gait-A Musculoskeletal Analysis.

    PubMed

    Al-Munajjed, Amir A; Bischoff, Jeffrey E; Dharia, Mehul A; Telfer, Scott; Woodburn, James; Carbes, Sylvain

    2016-03-01

    Detailed knowledge of the loading conditions within the human body is essential for the development and optimization of treatments for disorders and injuries of the musculoskeletal system. While loads in the major joints of the lower limb have been the subject of extensive study, relatively little is known about the forces applied to the individual bones of the foot. The objective of this study was to use a detailed musculoskeletal model to compute the loads applied to the metatarsal bones during gait across several healthy subjects. Motion-captured gait trials and computed tomography (CT) foot scans from four healthy subjects were used as the inputs to inverse dynamic simulations that allowed the computation of loads at the metatarsal joints. Low loads in the metatarsophalangeal (MTP) joint were predicted before terminal stance, however, increased to an average peak of 1.9 times body weight (BW) before toe-off in the first metatarsal. At the first tarsometatarsal (TMT) joint, loads of up to 1.0 times BW were seen during the early part of stance, reflecting tension in the ligaments and muscles. These loads subsequently increased to an average peak of 3.0 times BW. Loads in the first ray were higher compared to rays 2-5. The joints were primarily loaded in the longitudinal direction of the bone. PMID:26719905

  11. Prevalence of Musculoskeletal Symptoms among Dental Health Workers, Southern Thailand

    PubMed Central

    Phethuayluk, Piriyalux; Maneelok, Supandee

    2016-01-01

    Objectives. The objective of this study was to describe the socioeconomic situation of dental health work and work characteristics and to evaluate the prevalence of musculoskeletal symptoms among dental health workers. Material and Methods. A cross-sectional study was conducted with 124 dental health workers and 124 persons in the reference group, matched to dental health workers by gender, were recruited from the workers who worked at the same 17 community hospitals in Nakhon Si Thammarat province, Thailand. Information was collected by using questionnaire. Data analysis comprised descriptive and analytical components. Results and Discussion. 75.8% were female and 24.2% were male dental health workers. 91.9% of subjects had worked >5 years. Most subjects worked for >8 hours per day and worked >6 days per week, at 63.7% and 53.2%, respectively. 100% of subjects worked in public institutions, and 68% also worked in both public and private institutions. Most subjects (52.4%) did not exercise. Daily activity, gender, duration of work, hours worked per day, days worked per week, and physical activity were significantly associated with musculoskeletal symptoms at <0.001. Conclusion. The prevention and reduction of MSDs among dentists should include improving their education in dental ergonomics. PMID:27597901

  12. Modelling human musculoskeletal functional movements using ultrasound imaging

    PubMed Central

    2010-01-01

    Background A widespread and fundamental assumption in the health sciences is that muscle functions are related to a wide variety of conditions, for example pain, ischemic and neurological disorder, exercise and injury. It is therefore highly desirable to study musculoskeletal contributions in clinical applications such as the treatment of muscle injuries, post-surgery evaluations, monitoring of progressive degeneration in neuromuscular disorders, and so on. The spatial image resolution in ultrasound systems has improved tremendously in the last few years and nowadays provides detailed information about tissue characteristics. It is now possible to study skeletal muscles in real-time during activity. Methods The ultrasound images are transformed to be congruent and are effectively compressed and stacked in order to be analysed with multivariate techniques. The method is applied to a relevant clinical orthopaedic research field, namely to describe the dynamics in the Achilles tendon and the calf during real-time movements. Results This study introduces a novel method to medical applications that can be used to examine ultrasound image sequences and to detect, visualise and quantify skeletal muscle dynamics and functions. Conclusions This new objective method is a powerful tool to use when visualising tissue activity and dynamics of musculoskeletal ultrasound registrations. PMID:20492648

  13. Effect of helium-neon laser on musculoskeletal trigger points

    SciTech Connect

    Snyder-Mackler, L.; Bork, C.; Bourbon, B.; Trumbore, D.

    1986-07-01

    Cold lasers have been proposed recently as a therapeutic tool for treating a wide variety of pathological conditions, including wounds, arthritis, orthopedic problems, and pain. These proposed therapeutic effects largely have been unsubstantiated by research. A randomized, double blind study was undertaken to ascertain the effect of a helium-neon (He-Ne) laser on the resistance of areas of skin overlying musculoskeletal trigger points. These areas usually demonstrate decreased skin resistance when compared with the surrounding tissue. Thirty patients with musculoskeletal trigger points were assigned randomly to either an experimental or a placebo group. In addition to standard physical therapy, each patient received three 15-second applications of a He-Ne laser or placebo stimulation from an identical unit that did not emit a laser. The results of a two-way analysis of covariance with one repeated measure showed a statistically significant increase (p less than .007) in skin resistance. This increase in an abnormal skin resistance pattern may accompany the resolution of pathological conditions.

  14. Musculoskeletal Deterioration and Hemicorporectomy After Spinal Cord Injury

    PubMed Central

    Dudley-Javoroski, Shauna

    2014-01-01

    Background and Purpose The long-term management following an hemicorporectomy (HCP) is not well documented in the scientific literature. The purpose of this case report is to describe the 25-year history of a man with a spinal cord injury who experienced severe musculoskeletal deterioration and hemicorporectomy. Case Description The client sustained T10 complete paraplegia at age 18 years, developed severe decubitus ulcers, and required an HCP as a lifesaving measure 13 years later. The authors describe the chronology of several rehabilitation and prosthetic strategies and speculate on factors that may have contributed to their successes and failures. Outcomes The client survived 12 years after the HCP and returned to independent mobility, self-care, and schooling despite complications with continued skin breakdown. Over the 12 years following discharge from the hospital after the spinal cord injury, he spent 749 days in the hospital. During the 12 years he lived after discharge from the hospital following the HCP, he was hospitalized 190 days. Discussion The authors discuss factors contributing to the client’s musculoskeletal deterioration including chronic wounds, postural deviations, and incomplete adherence to pressure-relief recommendations and raise considerations for physical therapists who treat patients after HCP. PMID:12620090

  15. Legal changes necessitate proactive management of Musculoskeletal Disorders: the role of electrodiagnostic functional assessment Soft Tissue Management program.

    PubMed

    Cusimano-Reaston, MaryRose; Carney, Brendan

    2011-01-01

    Musculoskeletal Disorders (MSD) often classified as sprains and strains to the low back, neck, shoulder or knee are the leading cost drivers in the workers compensation system. In 2009, soft tissue muscle injuries accounted for 40% of total injury cases requiring days away from work. The demand on U.S. employers to comply with all applicable mandates has exponentially increased as the regulatory landscape grows more complex evidenced by recent legislation from Equal Employment Opportunity Commission (EEOC), American With Disability Act 2.0 and Center for Medicare and Medicaid Services (CMS) Mandatory Reporting Act. Employers should revisit their return to work policies and engage in the interactive process to stay in compliance and avoid legal quagmire. EFA Soft Tissue Management (STM) is a comprehensive and compliant risk management program for objective diagnosis of work-related injuries that directs timely and proper allocation of resources to optimize injured worker (IW) outcomes. This bookend solution comparing pre- and post-loss data is a best practice to accurately determine between compensable acute workplace injury and exacerbation of a preexisting injury from chronic unrelated conditions. The EFA is an evidenced-based objective tool to assist in measuring functional status of the IW and make return to work determinations. PMID:22256090

  16. Psychosocial work characteristics, need for recovery and musculoskeletal problems predict psychological distress in a sample of British workers.

    PubMed

    Devereux, J J; Rydstedt, L W; Cropley, M

    2011-09-01

    From an original sample of 2454 participants free of self-reported psychological distress, 1463 workers completed a 15-month follow-up. Baseline measures included exposure to job demands, decision latitude, social support and need for recovery. Psychological distress was assessed using the General Health Questionnaire at baseline and at follow-up. The findings showed that medium and high exposure to job demands and social support increased the risk of reporting psychological distress at 15-months (relative risk (RR) = 1.65, 1.45). The highest adjusted RR was observed for workers reporting a high need for recovery after work (RR 2.12, 1.90) and this finding was independent of the effects of job demands, decision latitude and social support. Neither decision latitude, nor low back problems increased the risk of reporting future psychological distress, although neck problems (RR = 1.66) and hand/wrist problems (RR = 1.45) did. It was concluded that need for recovery appears to be an important indicator of individual workers who are at risk of developing psychological distress long term. STATEMENT OF RELEVANCE: This paper reports the findings of a longitudinal study showing that need for recovery from work was the strongest predictor, relative to psychosocial work characteristics (job demands, decision latitude and social support), and musculoskeletal problems, of psychological distress 15 months later in individuals initially free from distress. PMID:21851291

  17. Cross-sectional study of risk factors for symptoms in the neck and shoulder area.

    PubMed

    Ekberg, K; Karlsson, M; Axelson, O; Malm, P

    1995-05-01

    This study was performed in order to evaluate how individual characteristics, as well as ergonomic, organizational and psychosocial factors in the work situation are associated with early symptoms in the neck and shoulder area. Nine hundred randomly drawn subjects of the working population in a semi-rural community in Sweden were mailed a questionnaire comprising the Nordic questionnaire on musculoskeletal symptoms, questions on ergonomic, organizational and psychosocial work conditions, life style factors, and background factors. The total response rate was 73% (n = 637). Questions on ergonomic work conditions and on organizational and psychosocial work conditions provided the measures of exposure. Prevalence ratios (PR) were calculated for symptoms in the neck and shoulder area as reported by 303 subjects. Significant determinants for early symptoms were being a female and being an immigrant, as were repetitive movements demanding precision. High work pace, low work content and work role ambiguity were significant organizational risk factors while life style characteristics did not appear as risk factors. The results suggest that symptoms are signals not only of ergonomic deficiencies in the work situation, but in particular of work organizational conditions. Special attention should be given to the work conditions of women and immigrants in preventive interventions. PMID:7737106

  18. Job strain, effort-reward imbalance and neck, shoulder and wrist symptoms among Chinese workers.

    PubMed

    Yu, Shanfa; Nakata, Akinori; Gu, Guizhen; Swanson, Naomi G; He, Lihua; Zhou, Wenhui; Wang, Sheng

    2013-01-01

    The purpose of this study was to examine the association between psychosocial job stress (by the Job Control-Demand (JCD) model and Effort-Reward imbalance (ERI) model) and musculoskeletal (MS) symptoms among workers in China. Overall, 3,632 male and 1,706 female workers from 13 factories/companies participated in this study. Perceived job stress was evaluated by the Chinese version of the Job Content Questionnaire (JCQ) and ERI Questionnaire. Neck, shoulder and wrist symptoms were assessed by self-report during the past year. Workers reporting high job demands and low job control or high effort and low rewards had moderately increased risk for all MS symptoms. Odds ratios (ORs) were higher in workers reporting both high effort and low rewards. The combination of high physical job demands with low job control showed significant associations with MS symptoms. The effects of psychological demands on symptoms in women, effort and effort-reward imbalance on symptoms among both genders were increased as the number of regions with symptoms increased. These results suggest that high job strain and ERI are associated with neck, shoulder and wrist symptoms in Chinese factory workers independent of individual factors, physical factors, and other psychological variables. PMID:23268836

  19. Teaching Musculoskeletal Physical Diagnosis Using A Web-based Tutorial and Pathophysiology-Focused Cases

    PubMed Central

    Modica, Renee F; Thundiyil, Josef G; Chou, Calvin; Diab, Mohammad; Von Scheven, Emily

    2009-01-01

    Objective: To assess the effectiveness of an experimental curriculum on teaching first-year medical students the musculoskeletal exam as compared to a traditional curriculum. Background: Musculoskeletal complaints are common in the primary care setting. Practitioners are often deficient in examination skills and knowledge regarding musculoskeletal diseases. There is a lack of uniformity regarding how to teach the musculoskeletal examination among sub-specialists. We propose a novel web-based approach to teaching the musculoskeletal exam that is enhanced by peer practice with pathophysiology-focused cases. We sought to assess the effectiveness of an innovative musculoskeletal curriculum on the knowledge and skills of first-year medical students related to musculoskeletal physical diagnosis as compared to a traditional curriculum. The secondary purpose of this study was to assess satisfaction of students and preceptors exposed to this teaching method. Methods: This quasi-experimental study was conducted at a single LCME-accredited medical school and included a convenience sample from 2 consecutive classes of medical students during the musculoskeletal portion of their physical diagnosis class. We conducted a needs assessment of the traditional curriculum used to teach musculoskeletal examination. The needs assessment informed the development of an experimental curriculum. One class (control group) received the traditional curriculum while the second class (experimental group) received the experimental curriculum, consisting of a web-based musculoskeletal tutorial, pathophysiology-focused cases, and facilitator preparation. We used multiple-choice questions and musculoskeletal OSCE scores to assess differences between knowledge and skills in the 2 groups. Results: The sample consisted of 140 students in each medical school class. There were no statistically significant differences between the 2 groups. One hundred seven students from the control group and 120 students

  20. Physiological Evaluation of Childcare-Associated Muscle Load on the Neck and Shoulder Region in Japanese Women.

    PubMed

    Yoshinaga, Saori; Kiyokawa, Takuma; Kuramoto, Eriko; Kinoshita, Hiroe; Nemoto, Seiji

    2016-01-01

    The awkward movements and postures associated with childcare activities can lead to musculoskeletal symptoms in the neck and shoulders. "Dakko" is a method for carrying a child in Japan, and recently it has been reported to cause shoulder stiffness. To our knowledge, the relationship between childcare activities and the physical load on the neck and shoulders is poorly understood. The present study aims to clarify the muscle load on the neck and shoulder region through dakko simulations. First, the association between dakko movements and trapezius muscle activity is clarified by image and electromyogram analyses. Based on this clarification, the distributions and intensity of the muscle load from repetitive dakko movements are clarified using myogenic potential topography. During dakko movements, trapezius muscle activity was observed when lifting up and setting down the child, but not when holding the child. For the repetitive movements, myogenic electrical potentials were observed in the trapezius region after movement load, and individual characteristics of participants were revealed in both the load distributions and the recovery process. Repetitive dakko movements likely induced sustained muscle tonus in the trapezius, which may be a factor related to shoulder stiffness. PMID:27064421