Effects of a workplace exercise program on physical capacity and lower back symptoms in hospital nursing assistants: a randomized controlled trial

Effectiveness of an ergonomic training with exercise program for work-related musculoskeletal disorders among hemodialysis nurses: A pilot randomized control trial

INTRODUCTION

Hemodialysis nurses suffer a high prevalence of work-related musculoskeletal disorders due to the nursing job contents and high repetition. A practical ergonomic program was expected to improve their occupational health and musculoskeletal discomfort. This study developed an ergonomic training program with exercise and examined its effectiveness for musculoskeletal discomfort and muscle strength in hemodialysis nurses.

METHOD

A cluster pilot randomized control trial was conducted. Participant nurses were from two hemodialysis units at two medical centers in Taiwan in 2019 and 2020. A 12-week ergonomic program with exercise customized by the job analysis of hemodialysis nursing tasks applied to the intervention group (n = 14). A mobile messenger application was adopted to remind, monitor, and consult the implementation of exercises. The musculoskeletal discomfort degree and muscle strength were measured before and after training as well as the follow-up after another 12 weeks. The training effect between the intervention group and the control group (n = 20), was analyzed by the generalized estimating equations model.

RESULTS

The significant improvements in muscle strength of the wrist and pinch power of the dominant hand were identified after training. The sustaining effect showed significant decreases in musculoskeletal discomfort degrees in the elbows, wrists/hands, knees, and ankles/feet. Training participants achieved an 80% adherence rate to the exercise program, facilitated by a convenient mobile messenger application. They also responded with very high satisfaction with all the ergonomic education, exercise regimen, and use of resistance devices.

CONCLUSIONS

This trial approves the effectiveness of the developed program for hemodialysis nurses and its feasibility in clinical practice.

PRACTICAL APPLICATIONS

This ergonomic training with a customized exercise program for hemodialysis nurses can serve as a valuable educational resource for hemodialysis nurses to mitigate work-related musculoskeletal disorders and improve occupational strength. Integrating the support of remote technology can enhance program adherence in hectic work environments.

Gamification as a Tool for Promoting Physical Exercise and Healthy Eating Habits in Healthcare Worker Women: Effects on Cardiometabolic Health and Physical Fitness at Workplace

PURPOSE

To evaluate the effectiveness of gamified versus nongamified health promotion interventions on cardiometabolic health and fitness parameters in healthcare worker women.

DESIGN

Randomized parallel group trial.

SETTING

A public outpatient health center in Brazil.

SUBJECTS

Women employees (included: n = 29; lost to follow-up: n = 1; analyzed: n = 28).

INTERVENTIONS

8 weeks of gamified (n = 15) or nongamified (n = 13) interventions, consisting of health lectures, nutritional counseling, and supervised exercise training. The gamified group was divided into teams that received points based on completion of health goals/tasks.

MEASURES

Anthropometric, cardiometabolic and physical fitness parameters.

ANALYSIS

Two-way ANOVA with repeated measures (group vs. time), and Bonferroni post hoc tests.

RESULTS

Body mass (-1.5 ± 1.5 kg), waist circumference (-1.6 ± 3.0 cm), HbA1C (-.2 ± .3%), triglycerides (-21.5 ± 48.2 mg/dl), systolic (-11.1 ± 7.9 mmHg) and diastolic (-7.1 ± 5.8 mmHg) blood pressure, as well as sit and reach (3.9 ± 3.0 cm) and six-minute walking (56 ± 37 m) performance improved (P < .05) only after the gamified intervention. Sit-to-stand performance improved after both the gamified (-1.18 ± 1.24 s) and nongamified (-1.49 ± 1.87 s) interventions.

CONCLUSION

The gamified intervention was more effective than the nongamified intervention for improving cardiometabolic and physical fitness parameters, suggesting that gamification may be an effective tool for promoting health in healthcare worker women.

Effectiveness of exercise programs to reduce low back pain among nurses and nursing assistants: A systematic review and meta-analysis

INTRODUCTION

Nurses have a high prevalence of low back pain due to ergonomic hazards in healthcare workplaces. While exercise programs have been suggested as an intervention strategy, the effectiveness of low back pain programs has been inconsistent in the research literature. The purpose of study is to determine the effect of exercise programs to reduce low back pain among nursing staff.

METHODS

A systematic review and meta-analysis was conducted with five databases and systematically searched. Following the PRISMA guidelines, included studies evaluated low back pain relief among nurses or nursing assistants and described the exercise program. Two reviewers independently appraised, extracted, and synthesized all available studies. The study protocol was registered in PROSPERO (CRD42022359511).

RESULTS

A total of 296 articles with 1,355 nursing staff from nine countries were obtained. Nine randomized controlled trials with a moderate to low risk of bias quality were included. Exercise programs had a small but significant effect on low back pain of nursing staff (SMD = -0.48; 95% CI = -0.76 to -0.19; p = 0.03, I2 = 62%, p = 0.001). A subgroup analysis of nurses and nursing assistants showed moderate and small effects, respectively (I2 = 0% p < 0.0001, SMD -0.73 CI 95% [-0.97 to -0.48], p = 0.76, and I2 = 0% p = 0.002, SMD -0.23 CI 95% [-0.38 to -0.08], p < 0.88). Exercise for back and trunk exhibited a moderate effect on low back pain (SMD -0.56 CI 95% [-0.86 to -0.25], p = 0.01, I2 = 66%, p < 0.0004). A subgroup analysis comparing age, under 40 years old revealed a moderate effect size (SMD = -0.59; 95% CI = -0.83to -0.35; p = 0.06; I2 = 64%, p < 0.0001).

CONCLUSIONS

Exercise programs are an effective treatment to reduce low back pain in nurses and nursing assistants, especially among younger staff.

PRACTICAL APPLICATION

Back and trunk exercise programs should be recommended for nursing staff with low back pain.

The effects of Core Stability Exercises and Mulligan's mobilization with movement techniques on sacroiliac joint dysfunction

Purpose

Sacroiliac joint dysfunction (SIJD), while being the primary contributor to low back pain, is still disregarded and treated as low back pain. Mulligan's Mobilization with Movement (MWM) Techniques and Core Stability Exercises (CSE) are often used to treat low back pain. There is not much evidence that it is effective in SIJD. To evaluate the effectiveness of CSE coupled with MWM (CSE + MWM) in the treatment of SIJD.

Methods

39 patients with SIJD were recruited and randomly divided into distinct groups as follows: control group (n = 13), CSE group (n = 13) and CSE + MWM group (n = 13). The Numerical Pain Rating Scale (NPRS), the Roland Morris Disability Questionnaire (RMDQ), the Range of Motion (ROM), the Pressure Pain Threshold (PPT) and the pelvic tilt angle asymmetry ratio in the sagittal plane (PTAR) were used to gauge the intervention's success both before (M0) and after (M1) it. All experimental data were statistically analyzed.

Results

The SIJ-related pain metric significantly decreased in both the CSE + MWM group and the CSE group between M0 and M1, as determined by the NPRS and RMDQ. Between M0 and M1, The CSE group's left axial rotation ROM and lumbar flexion ROM were significantly decreased. The CSE + MWM group's extension ROM and left lateral flexion ROM both significantly increased between M0 and M1. In the difference variable (M1-M0), the CSE + MWM group substantially outperformed control group in the left lateral flexion ROM and outperformed the CSE group in the left axial rotation ROM.

Conclusion

In individuals with SIJD, CSE + MWM is beneficial in lowering pain, disability, and function. Treatment with CSE and MWM approaches for SIJ appears to boost this efficacy.

Current Concept of Quantitative Sensory Testing and Pressure Pain Threshold in Neck/Shoulder and Low Back Pain

In recent years, several published articles have shown that quantitative sensory testing (QST) and pressure pain threshold (PPT) are useful in the analysis of neck/shoulder and low back pain. A valid reference for normal PPT values might be helpful for the clinical diagnosis of abnormal tenderness or muscle pain. However, there have been no reliable references for PPT values of neck/shoulder and back pain because the data vary depending on the devices used, the measurement units, and the area examined. In this article, we review previously published PPT articles on neck/shoulder and low back pain, discuss the measurement properties of PPT, and summarize the current data on PPT values in patients with chronic pain and healthy volunteers. We also reveal previous issues related to PPT evaluation and discuss the future of PPT assessment for widespread use in general clinics. We outline QST and PPT measurements and what kinds of perceptions can be quantified with the PPT. Ninety-seven articles were selected in the present review, in which we focused on the normative values and abnormal values in volunteers/patients with neck/shoulder and low back pain. We conducted our search of articles using PubMed and Medline, a medical database. We used a combination of “Pressure pain threshold” and “Neck shoulder pain” or “Back pain” as search terms and searched articles from 1 January 2000 to 1 June 2022. From the data extracted, we revealed the PPT values in healthy control subjects and patients with neck/shoulder and low back pain. This database could serve as a benchmark for future research with pressure algometers for the wide use of PPT assessment in clinics.

Workplace exercise program in a hospital environment: an effective strategy for the promotion of employees physical and mental health. A randomized controlled study

PURPOSE

The demanding and exhausting working hours, as well as the bad and unsuitable working conditions that prevail in several hospitals, affect employees' physical and mental health. The purpose of this study was to examine the effectiveness of a daily 6-week supervised workplace exercise program on health indices, functional capacity, overall fitness, subjective vitality, and life satisfaction in health professionals.

METHODS

A randomized controlled study was used. 50 health professionals (40-55 years), working in a hospital environment, were divided into two groups: exercise (EG) and control group (CG). EG performed a 6-week supervised concurrent chair-based exercise program (stretching, strength, balance exercises, aerobic dance; 5 days/week, 30-40 min/day, 2 workouts/day lasted 15-20 min) in the hospital. Health indices (body composition, blood pressure, respiratory function), functional capacity (flexibility, balance), physical fitness (strength, cardiorespiratory fitness), subjective vitality, and life satisfaction were measured before and after the completion of the program. Additionally, after the completion of the program, EG participants' enjoyment was assessed.

RESULTS

EG significantly increased (p < 0.001) lean body mass and respiratory function (range of mean increase 3.5-4.5%, depending on the variable), functional capacity (range of mean increase 18-40%, depending on the variable), lower and upper libs maximal strength (range of mean increase 10-25%, depending on the variable), subjective vitality (41.3%) and life satisfaction (21.5%); while significantly decreased (p < 0.001) heart rate during submaximal test (- 14%), body fat and blood pressure (range of mean decrease - 3.5% to - 5.5%, depending on the variable). In CG, all the above variables did not change. Furthermore, a great percentage of employees (95%) reported high levels of enjoyment.

CONCLUSION

A workplace exercise program may be safely used for the promotion of employees' physical and mental health.

Does Postural Feedback Reduce Musculoskeletal Risk?: A Randomized Controlled Trial

Background: There is a high prevalence of musculoskeletal disorders among personnel working in the healthcare sector, mainly among nursing assistants and orderlies. Objective: The objective is to analyze the effectiveness of a multi-component intervention that included postural feedback in reducing musculoskeletal risk. Method: A total of 24 nursing assistants and orderlies in a hospital setting were randomly assigned to an intervention group or a control group. After collecting sociodemographic information, a selection of tasks was made and assessed using the REBA (rapid entire body assessment) method. A multi-component intervention was designed combining theoretical and practical training, including feedback on the postures performed by the professionals involved, especially those involving high musculoskeletal risk. This program was applied only to participants in the intervention group. Subsequently, eight months after the first assessment and intervention, the second assessment was carried out using the same method and process as in the first evaluation. Results: The results indicate that the musculoskeletal risk in the second assessment in the intervention group was significantly reduced. However, no significant changes were observed in the control group. Conclusion: The multi-component intervention applied can significantly reduce the musculoskeletal risk of nursing assistants and orderlies. In addition, it is a low-cost intervention with great applicability.