The relationship between leisure time, physical activities and musculoskeletal symptoms and disability in worker populations

Prevalence of musculoskeletal disorders among Polish white-collar workers: the role of physical activity and risk factors

Objective

This study evaluated the prevalence of self-reported musculoskeletal disorders (MSDs) among white-collar workers and investigated their associations with physical activity (PA) levels, time spent sitting, sleep duration, and BMI.

Methods

The study included 440 white-collar workers (355 female and 85 male) aged 20-64 years, from randomly selected public institutions, companies, and corporations in the Upper Silesia region, Poland. Participants completed the Nordic Musculoskeletal Questionnaire and the Seven-Day Physical Activity Recall. Statistical analysis included comparisons of PA between workers with and without MSDs and between genders, correlations between MSDs, PA, and sleep duration, and logistic regression assessing associations between potential predictors and MSD presence. Independent variables included age, BMI, daily and occupational sitting time, sleep duration, and PA.

Results

The 12-month prevalence of MSDs was highest for lower back pain (65.9%), neck pain (59.8%), and upper back pain (43.9%), with a similar pattern observed over 7 days. Workers reporting neck pain over the past 12 months engaged in significantly less vigorous PA and high vigorous PA compared to those without neck pain (p = 0.019, r = 0.11), while those with knee pain reported higher levels of moderate PA (p = 0.018, r = 0.11). Age and BMI significantly influenced pain in multiple regions, including the neck, shoulder, back, hip/thigh, knee, and ankle/foot. Daily sitting time was a significant predictor for most MSDs, except for hip pain, while sitting during work specifically predicted lower back pain over 12 months. Each additional year of age, unit increase in BMI, and hour of sitting increased the likelihood of pain. Sleep duration and PA levels were not significant predictors.

Conclusion

These findings emphasize the importance of BMI management and reducing prolonged sitting as key workplace interventions, particularly in sedentary occupations.

Micro-gyms as a catalyst for healthy aging in university and healthcare settings: applications for the Semmelweis-EUniWell Workplace Health Promotion Model Program

Europe is experiencing a significant demographic shift, with aging populations posing economic and social challenges due to increased healthcare costs and a higher prevalence of age-related diseases. Hungary, in particular, faces these challenges acutely due to higher morbidity and mortality rates from a range of chronic age-related diseases and behavioral risk factors. Addressing these issues requires innovative approaches to promote healthy aging. Semmelweis University, the largest healthcare provider and leading health sciences university in the region, is developing a comprehensive healthy aging program. A critical pillar of this program is the Semmelweis-EUniWell Workplace Health Promotion Model Program, a pioneering initiative aimed at tackling unhealthy aging within Hungary's workforce by leveraging the workplace as a platform for health promotion. Central to this program's goal of combating sedentary lifestyles-a significant contributor to age-related health issues-is the innovative use of micro-gyms and motivational interviewing. Micro-gyms, with their compact size and accessibility, provide convenient exercise opportunities, while motivational interviewing fosters intrinsic motivation and personalized counseling to encourage sustained physical activity. Through concerted efforts and innovative approaches, including the implementation of micro-gyms, the Semmelweis-EUniWell Workplace Health Promotion Model Program aims to set a benchmark for workplace health promotion, fostering a healthier and more resilient aging population in Hungary. This program not only enhances the well-being of employees at Semmelweis University and its EUniWell partner institutions but also catalyzes broader transformations in workplace health promotion and healthy aging nationwide.

[The benefits of physical activity in the workplace for maintaining employee health]

Some jobs, particularly in the service sector, involve little physical activity on the part of employees. To improve their health, several areas or periods could be used to increase the amount of daily physical activity. Active transport to and from work is one such initiative, but physical activity can also be envisaged outside and during working hours. The aim of this article is to provide insights and research perspectives to better measure the importance of physical activity in the workplace.

Musculoskeletal disorders among dental students: a survey from Saudi Arabia

BACKGROUND

Work-related musculoskeletal disorders (WMSD) are injuries affecting bones, joints, muscles, and tendons due to improper working conditions with serious consequences on health and career. Dentists were found to be at greater risk of developing WMSD compared to other healthcare providers. This study aimed to investigate the prevalence and risk factors of WMSD among dental students in Saudi Arabia.

METHODS

This cross-sectional survey-based study recruited dental students across the kingdom using respondent-driven sampling technique. Data was collected using the Nordic Musculoskeletal scale and a validated, self- administered, close-ended questionnaire which assessed WMSDs predisposing factors, enabling factors and musculoskeletal disorders consequences and management. The questionnaire was administered in both Arabic and English languages and was distributed online using google forms. Data analysis was performed using SPSS, Chi-square test or Fisher Exact test was used where appropriate and Multivariate Logistic regression analysis was performed to identify predictors of developing WMSDs.

RESULTS

The prevalence of WMSD was 87% (95% CL; 83.9% to 90.3%) among the 462 respondents. Gender, study year, type of practice, having clinics for left-handed, hours of clinical practice, sitting in the proper position while working, use of coping strategies were significantly associated with WMSD prevalence (P < 0.05). Males were OR = 10 times at higher risk of WMSD compared to females (P = 0.0001). Those with daily clinical practice were OR = 5 times at higher risk of WMSD than those who have weekly practice. Those practicing walking, workout, and yoga showed lower prevalence of WMSD (OR = 0.377 & 0.323, p = 0.015, 0.010 respectively).

CONCLUSIONS

The prevalence of WMSD among dental students in KSA was high. Males and those with prolonged clinical sessions were at greater risk of WMSD. There is a need for awareness campaigns to educate dental students about risk factors of WMSD. Collegesy, dental colleges should adopt policies in reducing WMSD among their students.

The association between physical activity and musculoskeletal disorders-a cross-sectional study of teachers

Purpose

Combined with insufficient physical activity (PA) prolonged and improperly performed sedentary work can lead to musculoskeletal disorders (MSDs). The aim of this study was (I) to evaluate the self-reported level of PA and the prevalence of MSDs in male and female teachers, and (II) to investigate the association between PA and MSDs in teachers in Polish primary and secondary schools.

Methods

The study included 254 teachers from primary and secondary schools from Upper Silesia, Poland, excluding physical education teachers. The level of PA was assessed using the Seven-Day Physical Activity Recall (SDPAR). A standardized Nordic Musculoskeletal Questionnaire (NMQ) was used to assess the prevalence of MSDs.

Results

A similar percentage of female (80%) and male (90%) teachers met the WHO recommendations on moderate-intensity PA. The recommendations on performing vigorous-intensity PA were met by significantly (p = 0.002) less female than male teachers (50% and 75% respectively). Lower back disorders during the last 12 months and the last 7 days (57% and 45%, respectively) were the most commonly reported MSDs by teachers, followed by neck (53%, 40%), upper back (39%, 28%), and knee disorders (37%, 26%). The highest pain intensity was experienced by the teachers in the lower back and neck. Teachers with a greater number of MSDs were less likely to engage in vigorous-intensity PA and total PA than those with fewer painful areas of the body. Pain intensity in the neck, knees, upper- and lower back, and wrists/hands was negatively related to moderate and total PA. BMI negatively correlated with total PA, moderate-intensity PA vigorous-intensity PA, and high vigorous-intensity PA.

Conclusions

The study revealed the association between PA and MSDs in studied teachers. The most of the studied teachers met the WHO recommendation, and women were less likely to perform vigorous and high-vigorous PA than men. The lower back and neck disorders were the most common among the teachers.

Prevalence status and associated factors of wrist postural injury in the Chinese occupational population

Objective

This study investigated the prevalence of wrist injuries in 15 industries and different types of work in China. Study on the associated factors of wrist injuries provides a scientific basis for prevention and treatment of wrist diseases in occupational workers.

Methods

A cross-sectional study of musculoskeletal symptoms of related practitioners in 15 industries, including automobile manufacturing, was conducted to retrieve worker demographic information, working wrist posture, and pain conditions. Multivariable binary logistic regression analyses were performed to identify factors associated with work-related musculoskeletal disorders (WMSDs).

Results

The prevalence of wrist injuries among the study population was 13.2%. Toy manufacturing, animal husbandry, automobile manufacturing, shoe manufacturing, and biopharmaceutical manufacturing had the highest wrist injury rates at 29.1, 19.1, 14.9, 14.9, and 14.0%, respectively. Among the types of jobs, enamel workers (63.0%), butchers (43.6%), combers (32.5%), welders (31.3%), and scaffolders (26.5%) had the highest prevalence rates. Based on the final multivariate logistic regression analysis: female [odds ratios (OR) = 1.24; 95% confidence interval (CI), 1.15-1.35], 6-10 years of service (OR = 1.11; 95% CI, 1.03-1.18), >10 years of service (OR = 1.15; 95% CI, 1.06-1.25), frequent upward and downward flexion in wrist posture at work (OR = 1.81; 95% CI, 1.84-2.11), and frequent wrist placement on the edge of angular objects increased the OR of injury (OR = 1.52; 95% CI, 1.44-1.61). Need to squeeze objects tightly while working (OR = 1.72; 95% CI, 1.57-1.89), prolonged wrist flexion (OR = 1.86; 95% CI, 1.75-1.97), and work hand position above the shoulder for prolonged periods (OR = 1.11; 95% CI, 1.04-1.19) also suggested the relationship between these factors and the higher prevalence of wrist injury in the workers. The associated factor was physical activity (OR = 0.86; 95% CI, 0.80-0.94).

Conclusion

This study suggested the relationship between these factors and the higher prevalence of wrist injury in the toy manufacturing, animal husbandry, automobile manufacturing, and shoe-making industries, enamel workers, butchers, and combers. And are work types that require special attention. Females, working age, physical activity, and abnormal posture of the wrist were factors significantly associated with WMSDs.

Ergonomic and individual risk factors for musculoskeletal pain in the ageing workforce

Background

The present study aimed to investigate the possible association between specific ergonomic and individual risk factors and musculoskeletal pain (MSP) in the back, shoulder, hip and knee region in workers aged 50-65y.

Methods

The study was a population based cross-sectional survey. The study population comprised citizens born between 1952–1966, living in Esbjerg municipality, Denmark, ultimo 2016 (n = 23,463). A questionnaire was sent electronically or by mail. The analysis included the working population only. A multivariate logistic regression was used for each of the following dependent variables; musculoskeletal pain for the past 3 months in the back, shoulder, hip and knee, where independent variables included ergonomic exposure, age, sex, body mass index (BMI) and leisure time physical activity (LTPA).

Results

The overall response rate was 58% and the data of individuals at work (n = 9,263) demonstrated several ergonomic exposures with increased odds for pain in specific regions. Exposure to back twisted or bend, squatting or lying on knees and to carrying or lifting were associated with musculoskeletal pain in the back, whereas exposure to back twisted or bend, arms above shoulder and repeated arm movement were associated with pain in the shoulder. Exposure to back twisted or bend, repeated arm movement, squatting or lying on knees and to carrying or lifting were associated with musculoskeletal pain in the hip. Important individual risk factors were also identified. Increasing age was significantly associated with increased pain in the hip but associated with less risk for pain in the back and shoulder. Males had higher odds for pain in the back and knee compared to females but lower odds for pain in the hip. BMI was particularly important for knee pain. The level of LTPA did not have an important association with MSP in any region.

Conclusion

There is a significant positive association between ergonomic exposures and musculoskeletal pain, which were specific for the back, shoulder, hip and knee. In addition, the data demonstrated a differential association with age, sex and BMI. This needs to be considered for the treatment and classification of musculoskeletal pain and for future preventive initiatives.

Association between spinal disorders and different domains of physical activity among young adult men

Background

There is limited evidence of how physical activity (PA) associates with low back pain (LBP) and neck pain (NP). Particularly, the association between occupational or commuting PA and LBP/NP is unclear. The aim of the present cross-sectional study was to investigate the association between spinal disorders and different physical activity domains in young and healthy adult men.

Methods

Self-reported leisure time, occupational and commuting PA, as well as LBP and NP, were studied using questionnaires among young Finnish males (n = 1,630). Logistic regression analysis was used to study the associations of PA domains, physical fitness, and spinal disorders. Regression models were adjusted for age, education, smoking, waist circumference, and the other PA domains.

Results

There was a positive association between moderate leisure-time PA and both LBP (OR: 1.51, 95% CI: 1.18–1.95) and NP (OR: 1.29, 95% CI: 1.00–1.66) compared to low PA. Furthermore, moderate (OR: 1.31, 95% CI: 1.00–1.71) and high (OR: 1.53, 95% CI: 1.15–2.02) leisure time PA groups had a higher likelihood of lumbago. Moderate (OR: 0.67, 95% CI: 0.51–0.90) and high (OR: 0.68, 95% CI: 0.48–0.95) occupational PA groups had lower likelihood for radiating LBP, while high occupational PA (OR: 0.72, 95% CI: 0.52–0.99) had lower likelihood for lumbago.

Conclusions

The associations between physical activity and LBP or NP seem to vary between different domains of physical activity among young healthy men. Commuting and occupation-related PA appear not to be harmfully associated with LPB or NP, whereas moderate-level leisure time PA may be associated with increased LBP and NP, and the respective high level may be associated with an increase in the prevalence of lumbago.

Musculoskeletal symptoms in patients with long COVID: A cross-sectional study on Iranian patients

Background and objectives

Latest studies have revealed that an increasing number of Corona Virus Disease of 2019 (COVID-19) patients may continue to feel symptoms after the acute phase. This study aimed to evaluate the prevalence of musculoskeletal symptoms after the acute phase of COVID-19 and its associated factors.

Methods

We designed a cross-sectional study from January 2021 to April 2021. An online questionnaire was designed and sent to patients who had recovered from COVID-19. The questionnaire contained questions on participants' demographic characteristics, COVID-19 course at its acute phase, and musculoskeletal symptoms after recovering from COVID-19. Musculoskeletal symptoms associations with patients' characteristic and COVID-19 course was evaluated.

Result

239 patients, including 72 (30.1%) males and 167 (69.9%) females with a mean age of 37.96 years (SD = 11.19), were included in the study. 98.74% of our patients had experienced at least one musculoskeletal symptom after recovering from COVID-19, and the most common symptom was fatigue, as 91.2% of participants experienced this symptom, followed by myalgia, headache, and low back pain. High BMI, hospitalization, and ICU admission were associated with a higher risk of musculoskeletal symptoms.

Conclusion

This study indicated a high prevalence of persistent musculoskeletal symptoms among patients who recovered from COVID-19. Modifiable factors, such as BMI, can be targeted to reduce the prevalence of musculoskeletal symptoms in COVID-19 survivors and reduce its burden.

Low back pain and risk factors among Taxi drivers in Turkey: a cross-sectional study

BACKGROUND

Taxi drivers have an increased risk of low back pain due to both physical and occupational conditions. This study aims to determine the prevalence of low back pain and occupational risk factors among taxi drivers working in İzmir, Turkey.

METHODS

This study was conducted with 447 taxi drivers at randomly selected taxi stands between April and September 2021. The questionnaire included demographic, individual, and work-related questions; the Nordic Musculoskeletal Questionnaire; and the Back Pain Functional Scale (BPFS).

RESULTS

The prevalence of low back pain in the last year was 49.7%. In multivariate logistic regression analyses, the risk factors for low back pain included having a body mass index of 25-29.9 kg/m2 (OR= 1.67, 95% CI 1.01-2.76) or ≥30 kg/m2 (OR= 2.15, %95 CI 1.19-3.87), no physical activity (OR= 1.66, 95% CI 1.06-2.62), years of work >10 (OR= 3.23, 95% CI 1.89-5.53), no weekly rest period (OR= 3.11, 95% CI 1.42-6.81), having no lumbar support on the driver's seat (OR:1.67, 95% CI:1.05-2.66), or undecisive job satisfaction (OR= 2.07, 95% CI 1.17-3.66). Being undecided about job satisfaction (OR= 2.34, 95% CI 1.15-4.92) and not having physical activity (OR= 2.10 CI 1.08-4.08) were found to be risk factors for reduced BPFS scores.

CONCLUSION

A strong correlation was found between the frequency of low back pain and the BPFS score and occupational factors. Early detection and management of low back pain are critical to avoid increased low back pain and related injuries among taxi drivers.

Standing time and daily proportion of sedentary time are associated with pain-related disability in a one month accelerometer measurement in adults with overweight or obesity

OBJECTIVES

The association between the subjective experience of pain-related disability (PRD) and device-measured physical activity (PA) and sedentary behavior (SB) in overweight and obese adults is not well known. The aim of this study was to investigate the associations of pain markers with accelerometer-measured SB duration and different intensities of PA among physically inactive middle-aged adults with overweight or obesity.

METHODS

This cross-sectional analysis included 72 subjects (27 men) with mean age of 57.9 (SD 6.7) years and mean BMI of 31.6 (SD 4.1) kg/m2. SB and standing time (ST), breaks in sedentary time, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were measured for four consecutive weeks (mean 25 days, SD 4) with a hip-worn triaxial accelerometer. Headache, musculoskeletal pain, back pain, and PRD were assessed by visual analog scales (VAS) and using the Oswestry disability index (ODI). RAND-36 questionnaire was applied to assess health-related quality of life. The associations were studied by linear models.

RESULTS

ST was positively and SB proportion was negatively associated with PRD when adjusted for age, sex, BMI, accelerometry duration, MVPA, pain medication use, and general health perceptions assessed by RAND-36. No associations were found between ST and back pain. SB or different PA intensities were not associated with pain experience at specific sites.

CONCLUSIONS

Longer daily ST, but not LPA or MVPA is associated with higher level of PRD. Correspondingly, higher proportion of SB is associated with lower level of PRD. This suggests that individuals with PRD prefer to stand, possibly to cope with pain. These results may highlight the importance of habitual standing behaviors in coping with experienced PRD in adults with overweight or obesity.

Association of Physical Activity and Quality of Life with Work-Related Musculoskeletal Disorders in the UAE Young Adults

Background: Work-related musculoskeletal disorders (WRMSDs) pose threat to the global economy and work productivity. Though growing evidence shows physical activity and quality of life are major determinants for WRMSDs, the association between physical activity and the quality of life among the young adults of the United Arab Emirates (UAE) remains unclear. Methods: In a cross-sectional study, a total of 507 young adults who were between the ages 18–35 years were administered an interviewer-based survey on musculoskeletal disorders, physical activity, and quality of life. The association between the potential determinants and the WRMSDs was analyzed using linear and logistic regression models. Results: High prevalence (75%) of WRMSDs was found among the UAE young adults. Participants with low leisure-time physical activity had few WRMSDs. There was no significant association between physical activity or quality-of-life scores with the incidence of WRMSDs although physical activity time was highly associated with the quality of life, especially the social domain. Conclusion: Though a high prevalence of WRMSDs among UAE men and women was found, neither physical activity nor the quality-of-life scores determined the incidence of WRMSDs.

Associations between pain and physical activity among older adults

Objectives

Chronic pain is a significant societal problem and pain complaints are one of the main causes of work absenteeism and emergency room visits. Physical activity has been associated with reduced risk of suffering from musculoskeletal pain complaints, but the exact relationship in an older adult sample is not known.

Methods

Participants self-reported their physical activity level and whether they were often troubled by bone, joint, or muscle pain. Logistic regression analyses revealed the nature of the relationship between musculoskeletal pain and physical activity cross-sectionally and longitudinally over the course of 10 years. Data were taken from the English Longitudinal Study of Ageing, comprising of 5802 individuals residing in England aged 50 or older.

Results

Only high levels of physical activity were associated with a reduced risk of suffering from musculoskeletal pain compared to a sedentary lifestyle longitudinally. In addition, having low wealth, being female, and being overweight or obese were found to be risk factors for suffering from musculoskeletal pain.

Conclusions

The development of interventions aimed at alleviating and preventing musculoskeletal pain complaints might benefit from incorporating physical activity programs, weight loss, and aspects addressing wealth inequality to maximise their efficacy.

Predicting surgical outcomes for chronic exertional compartment syndrome using a machine learning framework with embedded trust by interrogation strategies

Chronic exertional compartment syndrome (CECS) is a condition occurring most frequently in the lower limbs and often requires corrective surgery to alleviate symptoms. Amongst military personnel, the success rates of this surgery can be as low as 20%, presenting a challenge in determining whether surgery is worthwhile. In this study, the data of 132 fasciotomies for CECS was analysed and using combinatorial feature selection methods, coupled with input from clinicians, identified a set of key clinical features contributing to the occupational outcomes of surgery. Features were utilised to develop a machine learning model for predicting return-to-work outcomes 12-months post-surgery. An AUC of 0.85 ± 0.08 was achieved using a linear-SVM, trained using 6 features (height, mean arterial pressure, pre-surgical score on the exercise-induced leg pain questionnaire, time from initial presentation to surgery, and whether a patient had received a prior surgery for CECS). To facilitate trust and transparency, interrogation strategies were used to identify reasons why certain patients were misclassified, using instance hardness measures. Model interrogation revealed that patient difficulty was associated with an overlap in the clinical characteristics of surgical outcomes, which was best handled by XGBoost and SVM-based models. The methodology was compiled into a machine learning framework, termed AITIA, which can be applied to other clinical problems. AITIA extends the typical machine learning pipeline, integrating the proposed interrogation strategy, allowing to user to reason and decide whether to trust the developed model based on the sensibility of its decision-making.

Musculoskeletal pain and sedentary behaviour in occupational and non-occupational settings: a systematic review with meta-analysis

BACKGROUND

Sedentary behaviour (SB; time spent sitting) is associated with musculoskeletal pain (MSP) conditions; however, no prior systematic review has examined these associations according to SB domains. We synthesised evidence on occupational and non-occupational SB and MSP conditions.

METHODS

Guided by a PRISMA protocol, eight databases (MEDLINE, CINAHL, PsycINFO, Web of Science, Scopus, Cochrane Library, SPORTDiscus, and AMED) and three grey literature sources (Google Scholar, WorldChat, and Trove) were searched (January 1, 2000, to March 17, 2021) for original quantitative studies of adults ≥ 18 years. Clinical-condition studies were excluded. Studies' risk of bias was assessed using the QualSyst checklist. For meta-analyses, random effect inverse-variance pooled effect size was estimated; otherwise, best-evidence synthesis was used for narrative review.

RESULTS

Of 178 potentially-eligible studies, 79 were included [24 general population; 55 occupational (incuding15 experimental/intervention)]; 56 studies were of high quality, with scores > 0.75. Data for 26 were meta-synthesised. For cross-sectional studies of non-occupational SB, meta-analysis showed full-day SB to be associated with low back pain [LBP - OR = 1.19(1.03 - 1.38)]. Narrative synthesis found full-day SB associations with knee pain, arthritis, and general MSP, but the evidence was insufficient on associations with neck/shoulder pain, hip pain, and upper extremities pain. Evidence of prospective associations of full-day SB with MSP conditions was insufficient. Also, there was insufficient evidence on both cross-sectional and prospective associations between leisure-time SB and MSP conditions. For occupational SB, cross-sectional studies meta-analysed indicated associations of self-reported workplace sitting with LBP [OR = 1.47(1.12 - 1.92)] and neck/shoulder pain [OR = 1.73(1.46 - 2.03)], but not with extremities pain [OR = 1.17(0.65 - 2.11)]. Best-evidence synthesis identified inconsistent findings on cross-sectional association and a probable negative prospective association of device-measured workplace sitting with LBP-intensity in tradespeople. There was cross-sectional evidence on the association of computer time with neck/shoulder pain, but insufficient evidence for LBP and general MSP. Experimental/intervention evidence indicated reduced LBP, neck/shoulder pain, and general MSP with reducing workplace sitting.

CONCLUSIONS

We found cross-sectional associations of occupational and non-occupational SB with MSP conditions, with occupational SB associations being occupation dependent, however, reverse causality bias cannot be ruled out. While prospective evidence was inconclusive, reducing workplace sitting was associated with reduced MSP conditions. Future studies should emphasise prospective analyses and examining potential interactions with chronic diseases.

PROTOCOL REGISTRATION

PROSPERO ID # CRD42020166412 (Amended to limit the scope).

Musculoskeletal disorders and the physical activity of territorial army soldiers during the COVID-19 pandemic

BACKGROUND

The aim of this study was to assess the occurrence of self-reported musculoskeletal disorders (MSD) among Polish territorial army soldiers during the COVID-19 pandemic and to investigate whether there was a relationship between occupational physical activity (OPA), leisure time physical activity (LTPA), and MSD.

METHODS

The study used a cross-sectional design with a sample of 373 territorial army soldiers ages 18-55 who had not previously suffered from COVID-19 and were not convalescents. The symptoms prevalence data was collected using the standardized Nordic Musculoskeletal Questionnaire. OPA and LTPA data was collected using the Seven-Day Physical Activity Recall (SDPAR).

RESULTS

The OPA, LTPA, and total physical activity (PA) among the studied soldiers was very diverse and the mean level of PA was relatively high. A total of 56 and 40% of territorial army soldiers had experienced pain or other discomfort in one or more of nine body regions during the past 12 months and during the past 7 days, respectively. The most common MSD among Polish territorial army soldiers were low back pain, followed by pain in the neck and knees.

CONCLUSIONS

The study revealed that the OPA of the studied soldiers, especially vigorous-intensity and high vigorous-intensity OPA, was associated with a higher prevalence of MSD in several regions of the body, i.e. the lower back, elbows, wrists or hands, hips or thighs, and ankles or feet. Along with the increase in energy expenditure on total PA, a greater percentage of respondents experienced low back pain. Vigorous and high vigorous-intensity PA may contribute to the occurrence of MSD.

Prevalence of postural musculoskeletal symptoms among dental students in United Arab Emirates

Background

The purpose of the present study was to determine the prevalence of neck, shoulder, and low-back pain and to examine factors associated with musculoskeletal pain (MSP) among dental students at Ajman University and Ras Al Khaimah College of Dental Sciences in United Arab Emirates (UAE).

Method

A cross-sectional study was conducted among dental students using an online questionnaire, which was a modified version of the Standardized Nordic questionnaire, focused on neck, shoulder and low-back pain in the past week and the past year.

Results

A total of two hundred and two dental students (out of 368) responded to the questionnaire. The majority were female 75.2%. The prevalence of MSP in at least one body site in the past week, and in the past year was 48.5 and 68.3% respectively. The factors significantly associated with MSP in at least one body site at any time were having history of trauma (P = 0.009), lack of exercise (P = 0.001), longer clinical sessions (P = 0.000), and higher BMI (P = 0.010).

Conclusion

The present study indicates that the prevalence of MSP among dental students in the UAE is high. Careful attention from dental colleges is needed to increase students’ awareness of this problem. This study contributed to better understanding of MSP among dental professionals.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-020-03887-x.

Musculoskeletal disorders and level of physical activity in welders

BACKGROUND

Welders demonstrate a high prevalence of musculoskeletal disorders (MSDs), as indicated by high rates of illness-related absenteeism. Leisure time physical activity (LTPA) could be a preventive strategy. However, little is known about LTPA prevalence and its association with MSDs among welders.

AIMS

The aim of this study was to analyse the prevalence of MSD and LTPA levels among welders and to identify risk factors for the main disorder of low back pain (LBP).

METHODS

The following data were collected from 145 welders from 34 companies in the German steel industry: individual factors (demographics, health behaviour), job-related factors (welding process, welding hours per day, employment years, shift work, ergonomic tools) and MSD (Nordic questionnaire). LTPA (International Physical Activity Questionnaire) was calculated to determine the metabolic equivalent of task (MET) per week as an objective measure of energy expenditure. Prevalence and multivariate regression analysis were calculated to determine odds ratios (ORs).

RESULTS

The 12-month prevalence of LBP was 71%, for neck pain 61% and for shoulder pain 55%. Forty-two per cent of the participants accumulated <600 MET/week. The multivariate regression model revealed LTPA <600 MET/week (OR 3.4, 95% CI 1.05-10.85) and neck pain in the previous 12 months (OR 5.2, 95% CI 2.02-13.56) to be significantly associated with LBP.

CONCLUSIONS

The results show a high prevalence of MSDs and thus a strong requirement for intervention. Therefore, LTPA should be prioritized and employers should encourage access to regular activity.

Self-Reported Musculoskeletal Disorders and Quality of Life in Supermarket Cashiers

Supermarket cashiers face a significant amount of stress, including time constraints, mental pressure, and physical demands that require repetitive movements. The job description of a supermarket cashier involves work-related risk factors that may lead to musculoskeletal disorder (MSD) symptoms. This study aimed to investigate supermarket cashiers to determine the prevalence of MSD symptoms and their quality of life. Data were collected from a convenience sample of supermarket cashiers working in Saudi Arabia. Information included direct questions on pain in the previous 12 months, demographic data, and health- or occupation-related factors. Moreover, data was collected based on the 36-item short form survey (SF-36), and descriptive statistics were computed. A total of 193 supermarket cashiers participated in this study. The sample included 140 men (72.5%) and 53 women (27.5%), with a mean age of 27.2 ± 6.4 years. The majority of the participants (90%) had MSD symptoms in at least one body region, with the neck (66.84%) and lower back (65.80%) constituting the most prominent regions. The mean SF-36 scores were higher in participants without pain compared to participants with pain in all domains, except for the physical functioning domain. The high prevalence of MSD symptoms among young cashiers suggest the need for additional investigations to determine the risk factors of these disorders. Additionally, this study recommends preventive procedures to reduce the prevalence of MSD symptoms among cashiers.

Health, Physical Activity and Musculoskeletal Symptoms among Stone, Sand, and Gravel Mine Workers: Implications for Enhancing and Sustaining Worker Health and Safety

There is little data delineating relationships between health and worker musculoskeletal symptoms (MSS), particularly among stone, sand, and gravel mine (SSGM) workers. There is also little data detailing the relationships between physical activity and MSS among these workers. A cross-sectional study using data from 459 SSGM workers was completed. Logistic regression analyses assessed relationships between health factors, physical activity, and low back, neck, shoulder, and knee MSS. Those who reported their health as very good/excellent were less likely to suffer low back and knee MSS. Those who indicated their health was poor/fair were more likely to suffer shoulder, neck, and knee MSS. Obese workers were more likely to experience knee MSS and those who smoked in the past had higher odds of neck MSS. Vigorous physical activity was mostly protective, but those performing more than 5 h of moderate physical activity each week had greater odds of shoulder and neck MSS. Given these results, workers in SSGM may benefit from targeted interventions that bolster vigorous physical activity and improve health. Further, health protection efforts need to be initiated by SSGM operations to address work issues and to sustain health as job roles and work hours impacted MSS as well.

Physical Activity of the Population of the Most Obese Country in Europe, Hungary

Introduction: Physical activity is inversely proportional to mortality, so it has an important role in disease prevention. The aim of our study was to characterize the physical activity of Hungarians, the most obese population in Europe. Materials and methods: In a cross-sectional study the physical activity of the Hungarian population was characterized in a sample (n = 1,295) which was representative of the sex, age and geographical location of the adult population aged 18 years and above by using the long form of the International Physical Activity Questionnaires (IPAQ) as an instrument. Based on the metabolic equivalent (MET) rates three categories of physical activity (low, moderate, and high) were defined. Two-step cluster analysis was used to explore physical activity characteristics of participants using sex, age, settlement type and BMI categories as categorical variables, and MET values related to the Work, Transportation, Domestic and Garden, and Leisure Time domains of physical activity as continuous variables. Results: The study showed that 63.39% of the adult Hungarian population took part in high, and 24.78% in moderate activity, and only 11.73% of the sample belonged to the category of low physical activity. By cluster analysis six clusters of people with typical lifestyles could be identified in the Hungarian adult population. In all the six groups participants achieved moderate or high activity levels through work and housework. Physical activity in relation to transportation is very low, similarly to leisure-time sporting activities. In the case of elder people, severe overweight/obesity problems can be detected in married city-dwellers. Discussion: Although Hungary has the highest obesity rate in Europe our research has proved that Hungarians lead physically active lives. The dominant forms of their physical activity are linked to work and housework. Our findings draw attention to the need to examine other risk factors in addition to physical inactivity. Our findings also suggest that the type of physical activity should be more severely considered when defining factors protective against obesity.

Prevalence of work related musculoskeletal disorders among occupational bus drivers of Karnataka, South India

BACKGROUND

Work-related health problems result in an economic loss of 4-6% in GDP (Gross domestic Product) of the most countries. In the industrialized countries, 1/3rd of the health-related absence to duty are due to musculoskeletal disorders. Professional driving is one such occupation which looks like sedentary occupation, but involves many risk factors that contribute to work-related musculoskeletal disorders (WMSD) due to its nature of working and work environment. This research describes the various risk factors associated with WMSDs and their effects on drivers health.

OBJECTIVE

To assess the prevalence of WMSD and its associated risk factors among the bus drivers of Karnataka State Road Transport Corporation (KSRTC), Karnataka.

METHODS

Subjects considered in this study are 301 full-time bus drivers from the central division KSRTC which consists of 6 depots in Bengaluru. Information regarding reported WMSD symptoms during immediate past 7 days to 12 months, the intervention of WMSD in their day-to-day life and the overall comfort of the body are determined through Standardized Nordic Questionnaire and also by direct observation. The survey questionnaire is conducted by face to face interview.

FINDINGS

From the statistical analysis, it is found that around 55.8% of the study population has experienced WMSD. The prevalence of WMSD is most common in the age group of 29-39 years (53.5%) followed by the age group of >40 years.

CONCLUSION

In this study, some of the work-related and lifestyle/health-related factors show significant association with WMSD in bus drivers of Karnataka. Musculoskeletal disorders can be prevented by designing the driver's workspace ergonomically so that the design suits to all sorts of drivers and the drivers should also be trained on basics of vehicle ergonomics (posture, seat adjustments, in-vehicle controls adjustments).

INTERPRETATION

KSRTC should educate drivers on the basics of vehicle ergonomics, harmful use of tobacco/alcohol, unhealthy food habits and also to involve in physical exercise at least 75-150 mins weekly. If not, the trend of drivers suffering from WMSD belonging to mid-age will increase exponentially.

SCOPE FOR FUTURE WORK

Statistical result and direct observation insist on undertaking further studies on ergonomic interventions at driver's cabin, lifestyle/occupational health factors which mitigate WMSD in different parts of the body during driving.

Prediction of Health-Related Leave Days among Workers in the Energy Sector by Means of Genetic Algorithms

In this research, a model is proposed for predicting the number of days absent from work due to sick or health-related leave among workers in the industry sector, according to ergonomic, social and work-related factors. It employs selected microdata from the Sixth European Working Conditions Survey (EWCS) and combines a genetic algorithm with Multivariate Adaptive Regression Splines (MARS). The most relevant explanatory variables identified by the model can be included in the following categories: ergonomics, psychosocial factors, working conditions and personal data and physiological characteristics. These categories are interrelated, and it is difficult to establish boundaries between them. Any managing program has to act on factors that affect the employees’ general health status, process design, workplace environment, ergonomics and psychosocial working context, among others, to achieve success. This has an extensive field of application in the energy sector.

Electronic Skin Wearable Sensors for Detecting Lumbar-Pelvic Movements

Background: A nanomaterial-based electronic-skin (E-Skin) wearable sensor has been successfully used for detecting and measuring body movements such as finger movement and foot pressure. The ultrathin and highly sensitive characteristics of E-Skin sensor make it a suitable alternative for continuously out-of-hospital lumbar–pelvic movement (LPM) monitoring. Monitoring these movements can help medical experts better understand individuals’ low back pain experience. However, there is a lack of prior studies in this research area. Therefore, this paper explores the potential of E-Skin sensors to detect and measure the anatomical angles of lumbar–pelvic movements by building a linear relationship model to compare its performance to clinically validated inertial measurement unit (IMU)-based sensing system (ViMove). Methods: The paper first presents a review and classification of existing wireless sensing technologies for monitoring of body movements, and then it describes a series of experiments performed with E-Skin sensors for detecting five standard LPMs including flexion, extension, pelvic tilt, lateral flexion, and rotation, and measure their anatomical angles. The outputs of both E-Skin and ViMove sensors were recorded during each experiment and further analysed to build the comparative models to evaluate the performance of detecting and measuring LPMs. Results: E-Skin sensor outputs showed a persistently repeating pattern for each movement. Due to the ability to sense minor skin deformation by E-skin sensor, its reaction time in detecting lumbar–pelvic movement is quicker than ViMove by ~1 s. Conclusions: E-Skin sensors offer new capabilities for detecting and measuring lumbar–pelvic movements. They have lower cost compared to commercially available IMU-based systems and their non-invasive highly stretchable characteristic makes them more comfortable for long-term use. These features make them a suitable sensing technology for developing continuous, out-of-hospital real-time monitoring and management systems for individuals with low back pain.

Association between physical activity and Nocturnal Leg Cramps in patients over 60 years old: a case-control study

Nocturnal Legs Cramps are a frequent disorder, which have a negative impact on quality of life, particularly among patients over 60 years old. Lifestyle factors such as alcohol consumption have been shown to be associated with Nocturnal Leg Cramps. This study aimed to explore the association between nocturnal leg cramps and a sedentary lifestyle among elderly patients. A case-control study was conducted with a Bayesian approach for sensitivity analysis. Patients over 60 years old consulting their family doctor were recruited in the Alsace region, France. Cases were matched with controls free from cramps for age, sex, medical history and medications known to trigger cramps. The level of physical activity was assessed using the Dijon Physical Activity Score (DPAS). We performed univariate and multivariate analyses adjusting for alcohol consumption. 272 participants were matched into 136 pairs. 11% of all were sedentary persons. Adjusting for alcohol consumption, we observed an association between Nocturnal Leg Cramps and a sedentary lifestyle OR = 9.84 (95% credibility interval [1.74; 101.9]; posterior probability 99.68%). Our findings represent an additional argument to promote physical activity to patients over 60 years old. They also highlight the need to develop and evaluate physical activity interventions in the treatment of Nocturnal Legs Cramps.

Upper Limb Work-Related Musculoskeletal Disorders in Operating Room Nurses: A Multicenter Cross-Sectional Study

This study aimed to evaluate the association between personal and job characteristics and the risk of upper limb work-related musculoskeletal disorders (WMSDs) among operating room nurses (ORNs). To this end, we collected data from 148 ORNs working at 8 Italian hospitals and measured any upper limb disabilities experienced in the previous year using the Italian version of the disabilities of the arm, shoulder and hand (DASH) questionnaire. The associations between personal and job characteristics and risk of upper limb WMSDs were estimated by unconditional logistic regression models. The prevalence of upper limb WMSDs was 45.9%. Multivariate analysis showed the "female gender" and "monthly hours spent working as a scrub nurse" to be directly associated with a higher DASH score (adjusted OR for gender = 5.37, 95% CI: 1.65-17.51, p < 0.01; adjusted OR for monthly hours as scrub nurse = 3.09, 95% CI: 1.33-7.19, p < 0.01). Overall, our findings indicate that a full-time job (>120 h/month) as a scrub nurse significantly increases the risk of developing upper limb WMSDs among female ORNs. Thus, to reduce such risk in this particularly sensitive population, we recommend urgent implementation of ergonomic interventions on surgical equipment alongside job rotation and medical surveillance programs.

Physical-work ability and chronic musculoskeletal complaints are related to leisure-time physical activity: Cross-sectional study among manual workers aged 50–70 years

Aims: To investigate the associations between both high- and low-intensity leisure-time physical activity on physical-work ability and chronic musculoskeletal complaints among manual workers aged 50–70 years. Methods: In this cross-sectional study, 1763 manual workers (mean age 57.1, SD ± 4.7 years) replied to questions about leisure-time physical activity, physical-work ability, chronic musculoskeletal complaints as well as health and lifestyle factors. Ordinal and binomial logistic regression models were constructed to assess the influence of the duration of both low- and high-intensity physical activity on physical-work ability and chronic musculoskeletal complaints, respectively. Models were adjusted for gender, age, smoking, alcohol intake, body mass index, physical-work demand, work experience, chronic disease and, regarding physical-work ability, also for chronic musculoskeletal complaints. Results: A statistically significant association between greater physical-work ability and high-intensity physical activity was found for workers engaged in 3–4 h/wk and ⩾ 5 h/wk (OR 1.59, 95% CI 1.15–2.19 and OR 1.56, 95% CI 1.10–2.22, respectively). For both high- and low-intensity physical activity, a duration of 3–4 h/wk was associated with lower odds of reporting chronic musculoskeletal complaints in the knees (OR 0.65, 95% CI 0.42–1.00 and OR 0.61, 95% CI 0.38–0.99, respectively). Conclusions: Engaging in ⩾ 3 h/wk of high-intensity leisure-time physical activity was associated with greater physical-work ability among manual workers aged 50–70 years. Both high- and low-intensity physical activity related to lower odds of having chronic musculoskeletal complaints in the knees.

Physical Activity of Workers in a Hospital

Purpose: This study aims to evaluate the physical activity of healthcare personnel and the affecting factors of physical activity (PA) in a hospital using an accelerometer device (Actigraph wGT3X-BT). Method: A total of 63 subjects (22 physicians, 19 nurses, and 23 supporting staff) participated and wore an accelerometer for seven days. Among the outputs, the mean counts for a minute, time spent for light, moderate, and vigorous intensity PA, and step count were extracted. As a secondary study, 16 subjects continued for one more week after feedback on their PA of the previous week and counseling to encourage PA. Result: Most of (62/63) the participants fulfilled the recommended amount of PA, which is more than 300 min of moderate to vigorous physical activity (MVPA). Physicians showed significantly less PA than nurses or supporting staffs: Mean counts per minute (210.4 vs. 476.0 and 441.8 respectively), time in MVPA per week (904.7 min vs. 1471.3 min and 1451.0 min), and step counts per week (69,029 vs. 87,119 and 84,700) (p < 0.001). Nurses and supporting staff were not statistically different. There was no significant difference in the PA of workers in the hospital regarding gender and marital status. However, the average calorie expenditure of the child raising group was significantly higher. There was no statistically significant difference in PA before and after counseling. No participants reported a vigorous degree of exercise intensity over the study period. Conclusion: Most of the healthcare personnel met the recommended PA, however, only 57% (36/63) recalled having engaged in MVPA during the study period. The group of physicians showed less PA compared to nurses or supporting staff. Single check-up and counseling were not found to increase PA.

Longer sitting time and low physical activity are closely associated with chronic low back pain in population over 50 years of age: a cross-sectional study using the sixth Korea National Health and Nutrition Examination Survey

BACKGROUND CONTEXT

There is increasing evidence supporting an association between sitting time and low back pain (LBP). However, the degree of the association between the total daily sitting time and LBP in the general population is poorly understood.

PURPOSE

The present study aimed (1) to analyze the association between the duration of sitting time and LBP, and (2) to examine this association according to the degree of physical activity in population over 50 years of age with a nationally representative sample of Korean adults.

STUDY DESIGN

This is a cross-sectional study.

PATIENT SAMPLE

Data from version VI-2, 3 of the Korea National Health and Nutrition Examination Survey (KNHANES) performed in 2014 and 2015 were analyzed.

OUTCOME MEASURES

Multiple logistic regression was performed to find the rates of association between chronic LBP, level of sitting time, and physical activity.

METHODS

Nationwide health surveys and examinations were conducted in general Korean representative populations (n=7,550 in 2014, n=7,380 in 2015). Chronic LBP was defined as self-reported LBP lasting for more than 30 days during the past 3 months in a health survey. Sitting time and daily physical activity were evaluated using the long version of the International Physical Activity Questionnaires (IPAQ). The duration of sitting time was divided into two categories according to the median value (7 hours) and further divided into four categories using quartiles. Physical activity was also divided into low and high physical activity according to duration of mid- to high-intensity activities. There were no sources of funding and no conflicts of interest associated with the present study.

RESULTS

On multiple logistic regression analysis, sitting time more than 7 hours/day was significantly associated with LBP (adjusted odds ratio 1.33, p<.001). The risk of LBP increased with increasing duration of sitting time. In participants with low levels of physical activity, the duration of sitting time showed more positive association with LBP than that in all the participants and participants with high levels of physical activity.

CONCLUSIONS

Longer duration of sitting time is a risk factor for LBP. Furthermore, long duration of sitting time with low physical activity further increases the risk of LBP.

Association Between Chronic Pain and Leisure Time Physical Activity and Sedentary Behavior in Schoolteachers

Chronic pain (CP) is a public health problem with harmful social and individual effects, and its relationships with physical activity (PA) and sedentary behaviors are unclear. This study examined the relationship between CP and PA and time spent watching television as an indicator of leisure time sedentary behavior, and explored the effects of major confounding factors. The information was obtained between 2012 and 2013 from individual interviews with 943 teachers from public schools in Londrina, Brazil. Statistical analysis was performed in 2014 using a logistic regression model adjusted for sociodemographic, lifestyle, depression, and working conditions variables. The prevalence of CP was 31.9%. No statistically significant association was observed between PA and CP. In the adjusted analyses, CP was associated with time > 60 minutes/day spent watching television (odds ratio [OR] = 1.39, 95% confidence interval [CI] 1.03, 1.89) on weekdays. In analyses stratified according to body areas affected by CP, only pain in the lower limbs was associated with more time watching television (OR = 1.62, 95% CI 1.06, 2.47). Watching television on a weekday for > 60 minutes is a sedentary behavior associated with a greater likelihood of teachers having chronic pain, especially in the lower limbs. This association was observed independently of the main confounders such as sex, age, leisure time physical activity, depression and working conditions.

Relationships of Musculoskeletal Symptoms, Sociodemographics, and Body Mass Index With Leisure-Time Physical Activity Among Nurses

Nurses have a high prevalence of musculoskeletal symptoms from patient handling tasks such as lifting, transferring, and repositioning. Comorbidities such as musculoskeletal symptoms may negatively affect engagement in leisure-time physical activity (LTPA). However, limited data are available on the relationship between musculoskeletal symptoms and LTPA among nurses. The purpose of this study was to describe musculoskeletal symptoms and LTPA, and to examine the relationships of musculoskeletal symptoms, sociodemographics, and body mass index with LTPA among nurses. Cross-sectional data on sociodemographics, employment characteristics, musculoskeletal symptoms, body mass index, and LTPA were collected from a statewide random sample of 454 California nurses from January to July 2013. Descriptive statistics, bivariate and multiple logistic regressions were performed. We observed that non-White nurses were less likely to engage in regular aerobic physical activity than White nurses (odds ratio [OR] = 0.61; 95% confidence interval [CI] = [0.40, 0.94]). Currently working nurses were less likely to engage in regular aerobic physical activity than their counterparts (OR = 0.48; 95% CI = [0.25, 0.91]). Nurses with higher body mass index were less likely to perform regular aerobic physical activity (OR = 0.93; 95% CI = [0.89, 0.97]) or muscle-strengthening physical activity (OR = 0.92; 95% CI = [0.88, 0.96]). This study found no evidence that musculoskeletal symptoms may interfere with regular engagement in LTPA. Physical activity promotion interventions should address employment-related barriers, and particularly target racial minority nurses and those who have a high body mass index.

What is the effect of prolonged sitting and physical activity on thoracic spine mobility? An observational study of young adults in a UK university setting

OBJECTIVE

Sedentary behaviour has long been associated with neck and low back pain, although relatively little is known about the thoracic spine. Contributing around 33% of functional neck movement, understanding the effect of sedentary behaviour and physical activity on thoracic spinal mobility may guide clinical practice and inform research of novel interventions.

DESIGN

An assessor-blinded prospective observational study designed and reported in accordance with Strengthening the Reporting of Observational Studies in Epidemiology.

SETTING

UK university (June-September 2016).

PARTICIPANTS

A convenience sample (18-30 years) was recruited and based on self-report behaviours, the participants were assigned to one of three groups: group 1, sitters-sitting >7 hours/day+physical activity<150 min/week; group 2, physically active-moderate exercise >150 min/week+sitting <4 hours/day and group 3, low activity-sitting 2-7 hours/day+physical activity <150 min/week.

OUTCOME MEASURES

Thoracic spine mobility was assessed in the heel-sit position using Acumar digital goniometer; a validated measure. Descriptive and inferential analyses included analysis of variance and analysis of covariance for between group differences and Spearman's rank correlation for post hoc analysis of associations.

RESULTS

The sample (n=92) comprised: sitters n=30, physically active n=32 and low activity n=30. Groups were comparable with respect to age and body mass index.Thoracic spine mobility (mean (SD)) was: group 1 sitters 64.75 (1.20), group 2 physically active 74.96 (1.18) and group 3 low activity 68.44 (1.22). Significant differences were detected between (1) sitters and low activity, (2) sitters and physically active (p<0.001). There was an overall effect size of 0.31. Correlations between thoracic rotation and exercise duration (r=0.67, p<0.001), sitting duration (r=-0.29, p<0.001) and days exercised (r=0.45, p<0.001) were observed.

CONCLUSIONS

Findings evidence reduced thoracic mobility in individuals who spend >7 hours/day sitting and <150 min/week of physical activity. Further research is required to explore possible causal relationships between activity behaviours and spinal musculoskeletal health.

Association Between Walking and Low Back Pain in the Korean Population: A Cross-Sectional Study

Objective

To investigate if walking is independently associated with low back pain (LBP) in the general population.

Methods

This cross-sectional study used public data from the Fourth and Fifth Korean National Health and Nutrition Examination Survey. Subjects included 5,982 community-dwelling adults aged ≥50 years. Presence of current LBP was defined as LBP for 1 month or more in the past 3 months. Walking was measured as total walking duration for the past week and subjects were divided into four quartiles. Independent effect of walking on LBP was determined using odds ratios (OR) adjusted for age, sex, osteoporosis, depression or anxiety, and radiographic lumbar spondylosis.

Results

Prevalence of LBP was 26.4% in this population. Older people and women had higher prevalence of current LBP. Prevalence of obesity and osteoporosis was higher in subjects with current LBP and quality of life was poorer in subjects with current LBP. Adjusted logistic regression model revealed that older age (OR, 1.655; p=0.018), female sex (OR, 2.578; p<0.001), radiographic lumbar spondylosis (OR, 2.728; p<0.001), depression or anxiety (OR, 5.409; p<0.001), and presence of osteoporosis (OR, 1.467; p=0.002) were positively associated with current LBP. Walking decreased prevalence of current LBP proportionally (2nd quartile OR, 0.795; 3rd quartile OR, 0.770; and 4th quartile OR, 0.686 compared with the 1st quartile of walking).

Conclusion

Walking was negatively associated with LBP. Further studies are needed to reveal causal relationship of this phenomenon.

Back pain in physically inactive students compared to physical education students with a high and average level of physical activity studying in Poland

BACKGROUND

The aim of the study was (1) to characterise back pain in physically inactive students as well as in trained (with a high level of physical activity) and untrained (with an average level of physical activity) physical education (PE) students and (2) to find out whether there exist differences regarding the declared incidence of back pain (within the last 12 months) between physically inactive students and PE students as well as between trained (with a high level of physical activity) and untrained (with an average level of physical activity) PE students.

METHODS

The study included 1321 1st-, 2nd- and 3rd-year students (full-time bachelor degree course) of Physical Education, Physiotherapy, Pedagogy as well as Tourism and Recreation from 4 universities in Poland. A questionnaire prepared by the authors was applied as a research tool. The 10-point Visual Analogue Scale (VAS) was used to assess pain intensity. Prior to the study, the reliability of the questionnaire was assessed by conducting it on the group of 20 participants twice with a shorter interval. No significant differences between the results obtained in the two surveys were revealed (p < 0.05).

RESULTS

In the group of 1311 study participants, 927 (70.7%) respondents declared having experienced back pain within the last 12 months. Physically inactive students declared back pain frequency similar to the frequency declared by their counterparts studying physical education (p > 0.05). Back pain was more common in the group of trained students than among untrained individuals (p < 0.05). Back pain was mainly located in the lumbar spine.

CONCLUSIONS

A frequent occurrence of back pain (70.7%) was noted in the examined groups of students. The percentage of students declaring back pain increased in the course of studies (p < 0.05) and, according to the students' declarations, it was located mainly in the lumbar spine. No significant differences regarding the incidence of back pain were found between physically inactive students and physical education students (p > 0.05). The trained students declared back pain more often than their untrained counterparts (p < 0.05).

Does sedentary behavior increase the risk of low back pain? A population-based co-twin study of Spanish twins

BACKGROUND

The relationship between sedentary lifestyle and low back pain (LBP) remains unclear and previous research has not accounted for genetic and early environmental factors.

PURPOSE

Our aim was to investigate if sedentary behavior is associated with the lifetime prevalence of persistent LBP and the risk of developing persistent LBP, care-seeking due to LBP, and activity limiting LBP when genetics and early environmental factors are accounted for.

STUDY DESIGN

Both cross-sectional and longitudinal designs with a within-pair twin case-control were implemented.

PATIENT SAMPLE

There were 2,148 twins included in the cross-sectional analysis whereas 1,098 twins free of persistent LBP at baseline were included in the longitudinal analysis.

OUTCOME MEASURES

Sedentary behavior was the explanatory variable. Lifetime prevalence of LBP was the outcome variable in the cross-sectional analysis. The incidence of persistent LBP, care-seeking due to LBP, and activity limiting LBP were the outcome variables for the longitudinal analysis.

METHODS

This observational study was supported by a grant in 2012. No competing interests were declared.

RESULTS

In the cross-sectional analysis, sedentary behavior was slightly associated with an increased prevalence of persistent LBP in females but not in males. This association was not apparent when genetics and early environmental factors were accounted for. We acknowledge that the small sample included in the co-twin analyses have yielded wide confidence intervals, and that caution should be exercised when interpreting and an association may not be ruled out. In the longitudinal analysis, sedentary behavior did not significantly increase the risk of persistent LBP, care-seeking due to LBP, or activity limiting LBP.

CONCLUSIONS

Sedentary behavior is associated with concurrent LBP. However, this association is weak; it only appears in females and decreases when accounting for genetics. Future studies using a twin design with larger samples should be conducted to further test these findings.

Investigation of musculoskeletal symptoms in a manufacturing company in Brazil: a cross-sectional study

•

Upper limb MSD were prevalent among manual manufacturing workers.

•

Shoulder was the body region with the highest prevalence of symptoms.

•

Repetitive work and lack of rest breaks are influential risk factors for MSD.

•

Performing work pause was identified as a significant variable.

•

MSD had a significant negative impact on workers’ general health.

Background

Musculoskeletal disorders are prevalent and represent the most common health problem among the working population in industrially-developing countries, with considerable costs and impact on quality of life. Despite the high incidence of disability insurance claims among Brazilian manufacturing-sector workers, only a few studies assessed musculoskeletal disorders prevalence.

Objective

To provide information on the prevalence of musculoskeletal disorders among manufacturing-sector workers and to explore the relationship between musculoskeletal disorders and sociodemographic and occupational characteristics in a medium metallurgical company located in Brazil.

Methods

A cross-sectional study was carried out. Data was collected through the use of a specifically-designed questionnaire and the items used to collect musculoskeletal disorders data were based on the Nordic Musculoskeletal Questionnaire. Descriptive statistics were used and multivariate logistic regression analysis (p < 0.02) was performed to explore the associations between musculoskeletal disorders and potential risk factors.

Results

The upper limb was the most frequently affected body region among manufacturing-sector workers: shoulder (24.8%), elbow and/or forearm (15.5%), wrist and/or hand (19.0%). Adjusted logistic regression analysis showed that company experience (p = 0.02), presence of sleep disorders (p = 0.00), self-reported general health state (p = 0.00) and perform work pause (p = 0.00) were significant risk factors for development of musculoskeletal disorders.

Conclusion

Sociodemographic and work-related aspects are influential risk factors for musculoskeletal disorders. These results add comprehension about musculoskeletal disorders prevalence and suggest a need for greater emphasis on prevention strategies.

Trapezius muscle activity and body movement at the beginning and the end of a workday and during the lunch period in female office employees

The aim of this study was to analyze the activity of the trapezius muscle and the arm acceleration during the course of a workday in office employees. It was examined if there are significant changes in trapezius muscle activity in the afternoon compared to the morning work period and relationships to the level of arm acceleration during lunchtime. Nineteen female office employees were recruited. A one hour period of the work in the morning, afternoon, and lunchtime were compared. The measures of the trapezius muscle activity and muscle rest time (TR) did not significantly differ between working in the morning (TR: median 10%; range 1%-49) or working in the afternoon (TR: median 18%; range 2%-34%). The 90^th percentile of arm acceleration during lunch time significantly correlated with less trapezius muscle activity in the afternoon compared to the morning values (RT: Spearman R=0.80; p<0.01). Differences in the duration and level of trapezius muscle activity were bigger between the subjects than between different work periods or between lunchtime and work. Furthermore it seems that higher arm accelerations during lunch may be beneficial in reducing trapezius activity in the afternoon compared to the morning values.

Objectively measured physical activity and 12-month trajectories of neck–shoulder pain in workers: A prospective study in DPHACTO

Aims: This study aimed to investigate the association between objectively measured physical activity at work and leisure and the intensity (mean level and time course) of neck–shoulder pain (NSP) over 12 months among male and female blue collar workers. Methods: Data were obtained from 625 blue collar workers from the Danish cohort DPHACTO. Physical activity was measured objectively at baseline using accelerometers. The percentage of time spent in physical activity (walking, climbing stairs, running and cycling) was calculated for both work and leisure time. Longitudinal data on the intensity of NSP (numerical rating scale 0–10) were collected using text messages every fourth week over 12 months. Linear mixed models were used to investigate the associations between occupational physical activity (OPA) and leisure time physical activity (LTPA) and the trajectories of the intensity of NSP, adjusted for individual, biomechanical and psychosocial factors, and baseline pain. Results: OPA was not associated with the mean intensity of NSP over 12 months. LTPA was negatively associated with the mean intensity of NSP both among men ( B=−0.71, 95% CI −1.31 to −0.11) and women ( B=−0.85, 95% CI −1.57 to −0.13). Sex interactions on the 12-month trajectories of NSP showed that higher physical activity was associated with a slower reduction in NSP among men for OPA only ( B=0.03, 95% CI 0.01-0.05) and women for LTPA only ( B=0.05, 95% CI 0.00-0.09). Conclusions: We found that more time in LTPA was associated with a lower overall intensity of NSP over 12 months among blue collar workers. However, depending on sex and domain, high physical activity had an unfavourable effect on the course of NSP over 12 months.

Chapter 6. Sickness absence due to back and neck disorders

The scientific evidence on the causes for sick leave attributed to back and neck disorders was reviewed. Categories were established for acute, recurring, and chronic problems based on the duration of the sick leave period. Forty-eight articles were found to be relevant, whereof two were of high quality and 26 were of medium or low quality. Quality was assessed exclusively in relation to the aim of this systematic review. The results reveal limited published research on causes for sick leave from back and neck disorders. The generalisability of the findings is also limited since most of the subjects were men and employees in manufacturing industries. Women, white-collar workers, employees in the public sector (care, social services, schools, etc) were underrepresented in the studies. Hence, these groups and areas should be studied further to verify conclusions and enhance knowledge about the causes for sick leave from back and neck disorders. The following factors were found to have consistent, but limited, support as regards their influence on the risk for sick leave due to back and neck disorders: (a) heavy physical workload, bent or twisted working position, and low work satisfaction increases the risk for short-term and long-term sick leave; (b) specific back diagnoses and previous sick leave due to back disorders increases the risk for short-term and long-term sick leave; (c) female gender, smoking, exposure to vibration, and deficient social support were not found to significantly increase the risk for short-term and long-term sick leave; (d) self-reported pain and functional impairments were associated with a high risk for long-term sick leave; (e) longer employment periods reduced the risk for short-term sick leave; (f) perceived demands at work did not influence short-term sick leave; (g) female gender and higher age increases the risk for disability pension.

Toward a Mechanism-Based Approach to Pain Diagnosis

The past few decades have witnessed a huge leap forward in our understanding of the mechanistic underpinnings of pain, in normal states where it helps protect from injury, and also in pathological states where pain evolves from a symptom reflecting tissue injury to become the disease itself. However, despite these scientific advances, chronic pain remains extremely challenging to manage clinically. Although the number of potential treatment targets has grown substantially and a strong case has been made for a mechanism-based and individualized approach to pain therapy, arguably clinicians are not much more advanced now than 20 years ago, in their capacity to either diagnose or effectively treat their patients. The gulf between pain research and pain management is as wide as ever. We are still currently unable to apply an evidence-based approach to chronic pain management that reflects mechanistic understanding, and instead, clinical practice remains an empirical and often unsatisfactory journey for patients, whose individual response to treatment cannot be predicted. In this article we take a common and difficult to treat pain condition, chronic low back pain, and use its presentation in clinical practice as a framework to highlight what is known about pathophysiological pain mechanisms and how we could potentially detect these to drive rational treatment choice. We discuss how present methods of assessment and management still fall well short, however, of any mechanism-based or precision medicine approach. Nevertheless, substantial improvements in chronic pain management could be possible if a more strategic and coordinated approach were to evolve, one designed to identify the specific mechanisms driving the presenting pain phenotype. We present an analysis of such an approach, highlighting the major problems in identifying mechanisms in patients, and develop a framework for a pain diagnostic ladder that may prove useful in the future, consisting of successive identification of 3 steps: pain state, pain mechanism, and molecular target. Such an approach could serve as the foundation for a new era of individualized/precision pain medicine. The Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION)-American Pain Society (APS) Pain Taxonomy (AAPT) includes pain mechanisms as 1 of the 5 dimensions that need to be considered when making a diagnostic classification. The diagnostic ladder proposed in this article is consistent with and an extension of the AAPT.

PERSPECTIVE

We discuss how identifying the specific mechanisms that operate in the nervous system to produce chronic pain in individual patients could provide the basis for a targeted and rational precision medicine approach to controlling pain, using chronic low back pain as our example.

Risk Factors for Upper Extremity Musculoskeletal Disorders Among Office Workers in Qom Province, Iran

Background

The identification of the risk factors for musculoskeletal disorders (MSDs) is the first step in designing effective preventive interventions.

Objectives

To investigate the association between individual, organizational, physical, and psychological factors and upper extremity MSDs (i.e., shoulder, elbow and hand/wrist).

Materials and Methods

In this cross-sectional study, the study population was comprised of office workers from Qom Province, Iran. Of the 1630 Iranian office workers who were selected via a random multistage cluster sampling method, 1488 completed a comprehensive data collection form designed to investigate the individual, organizational, physical, and psychological factors related to MSDs (response rate: 91.3%).

Results

The predictors of shoulder MSDs in the past 12 months were uncomfortable sitting posture (β = 0.42, P = 0.04), limited rest breaks (β=0.73, P = 0.012), and no access to adjustable desks (β = 0.43, P = 0.018). Working on a computer for more than five hours (β = 0.61, P = 0.004) and an uncomfortable sitting posture (β = 0.79, P = 0.001) predicted hand/wrist symptoms.

Conclusions

Various risk factors in the workplace may contribute to MSDs in different upper extremities. Preventive interventions should hence include ergonomic and office equipment modifications.

Is there a U-shaped relationship between physical activity in leisure time and risk of chronic low back pain? A follow-up in the HUNT Study

Background

Physical activity in leisure time is often considered to have favourable effects on the risk of low back pain (LBP), but demonstrating a definite association in epidemiological studies has proven difficult. The purpose of the present study was to explore associations between physical activity and risk of chronic LBP in an adult population and to investigate whether relationships are limited to certain age groups or to females or males. A particular objective was to determine whether support could be found for a U-shaped relationship, with both low and high activity levels carrying greater risk.

Methods

The relationship between physical activity and risk of chronic LBP was examined in a Norwegian prospective study using data from the community-based HUNT2 and HUNT3 surveys. Participants were 9616 women and 8452 men without LBP at baseline, who reported after 11 years whether they suffered from LBP. Associations between baseline physical activity in leisure time and risk of chronic LBP at end of follow-up were evaluated by generalized linear modelling with adjustment for potential confounders.

Results

Significant associations between leisure time physical activity and risk were observed in both sexes after age adjustment, mainly suggesting inverse relationships. Women participating in hard physical activity 1–2 h per week had a relative risk (RR) of chronic LBP of 0.81 (95 % CI 0.71–0.93) compared to those with only light physical activity less than 1 h per week. The corresponding RR in men was 0.71 (95 % CI 0.60–0.85). After adjustment for education, employment, occupational activity, body mass index (BMI) and smoking, significant relationships could only be demonstrated in those aged 50 years or more at baseline. The associations differed between female educational groups, with more U-shaped relationships being observed among women with basic education only.

Conclusion

No strong support was found overall for U-shaped relationships. However, no further general decrease in risk was seen among those with 3 h or more of hard physical activity per week. The contrasts observed between female educational groups may reflect different preferences regarding specific strenuous activities. Men aged 50 years or more seem in particular to benefit from hard physical activities.

Temporal patterns of sitting at work are associated with neck-shoulder pain in blue-collar workers: a cross-sectional analysis of accelerometer data in the DPHACTO study

Background

Our aim was to examine the extent to which temporal patterns of sitting during occupational work and during leisure-time, assessed using accelerometry, are associated with intense neck–shoulder pain (NSP) in blue-collar workers.

Methods

The population consisted of 659 Danish blue-collar workers. Accelerometers were attached to the thigh, hip, trunk and upper dominant arm to measure sitting time and physical activity across four consecutive days. Temporal sitting patterns were expressed separately for work and leisure by the proportion of total time spent sitting in brief bursts (0–5 min), moderate (>5–20 min) and prolonged (>20 min) periods. The peak NSP intensity during the previous 3 months was assessed using a numerical rating scale (range 0–10) and dichotomized into a lower (≤4) and higher (>4) NSP score. Logistic regression analyses with multiple adjustments for individual and occupational factors were performed to determine the association between brief, moderate and prolonged sitting periods, and NSP intensity.

Results

Time in brief bursts of occupational sitting was negatively associated with NSP intensity (adjusted OR 0.68, 95 % CI 0.48–0.98), while time in moderate periods of occupational sitting showed a positive association with NSP (adjusted OR 1.32, 95 % CI 1.04–1.69). Time in prolonged periods of occupational sitting was not associated with NSP (adjusted OR 0.78, 95 % CI 0.78–1.09). We found no significant association between brief, moderate or prolonged sitting periods during leisure, and NSP.

Conclusion

Our findings indicate that the association between occupational sitting time and intense NSP among blue-collar workers is sensitive to the temporal pattern of sitting.

Evaluation of four sensor locations for physical activity assessment

Direct measurements of physical activity (PA) obtained with inertial measurement units (IMUs) secured to the upper arms and trunk of 36 registered nurses working a full shift were compared to measurements obtained with a commercially-available PA monitor (ActiGraph wGT3X-BT) worn at the waist. Raw accelerations from each device were summarized into PA counts/min and metabolic equivalent (METs) categories using standard definitions. Differences between measurements were examined using repeated measures one-way analyses of variance (ANOVA) and agreement was assessed using Bland-Altman plots. Statistically significant differences were observed between all sensor locations for all PA summary metrics except for between the left and right arm for percentages of work time in the light and moderate counts/min categories. Bland-Altman plots suggested limited agreement between measurements obtained with the IMUs and measurements obtained with the wGT3X-BT waist-worn PA monitor. Results indicate that PA measurements vary substantially based on sensor location.

Implementing an Integrated Health Protection/Health Promotion Intervention in the Hospital Setting: Lessons Learned From the Be Well, Work Well Study

OBJECTIVE

This study reports findings from a proof-of-concept trial designed to examine the feasibility and estimates the efficacy of the "Be Well, Work Well" workplace intervention.

METHODS

The intervention included consultation for nurse managers to implement changes on patient-care units and educational programming for patient-care staff to facilitate improvements in safety and health behaviors. We used a mixed-methods approach to evaluate feasibility and efficacy.

RESULTS

Using findings from process tracking and qualitative research, we observed challenges to implementing the intervention due to the physical demands, time constraints, and psychological strains of patient care. Using survey data, we found no significant intervention effects.

CONCLUSIONS

Beyond educating individual workers, systemwide initiatives that respond to conditions of work might be needed to transform the workplace culture and broader milieu in support of worker health and safety.

Systemic differences in serum metabolome: a cross sectional comparison of women with localised and widespread pain and controls

Chronic musculoskeletal pain exists either as localised to a single region or as widespread to multiple sites in several quadrants of the body. Prospective studies indicate that widespread pain could act as a far end of a continuum of musculoskeletal pain that started with chronic localised pain. The mechanism by which the transition from localised pain to widespread occurs is not clear, although many studies suggest it to be an altered metabolism. In this study, systemic metabolic differences between women with chronic localised neck-shoulder pain (NP), women with chronic widespread pain (CWP) and women who were healthy (CON) were assessed. Blood samples were analysed taking a metabolomics approach using gas chromatography mass spectrometry (GC-MS) and orthogonal partial least square discriminant analysis (OPLS-DA). The metabolomics analysis showed a clear systematic difference in the metabolic profiles between the subjects with NP and the CON but only a weak systematic difference between the subjects with CWP and the CON. This most likely reflects a difference in the portion of the metabolome influenced by the two pain conditions. In the NP group, the overall metabolic profile suggests that processes related to energy utilisation and lipid metabolism could be central aspects of mechanisms maintaining disorder.

Biomechanical constraints remain major risk factors for low back pain. Results from a prospective cohort study in French male employees

BACKGROUND CONTEXT

Low back pain (LBP) is a major public health problem, with a considerable impact on workers.

PURPOSE

To model the risk of LBP in the male general working population.

STUDY DESIGN/SETTING

Repeated cross-sectional surveys in a wide occupational setting.

PATIENT SAMPLE

A random sample of 2,161 men working in various occupations in a French region participated in a first survey in 2002, and 1,313 of these (60.8%) participated in a second survey in 2007.

OUTCOME MEASURE

The self-reported prevalence of LBP during the previous week in the second survey.

METHODS

Twenty-one biomechanical, organizational, psychosocial, and individual factors were assessed in the first survey. The association between these potential risk factors and the prevalence of later LBP (in the second survey) was studied, using multistep logistic regression models.

RESULTS

Three hundred ninety-four men reported LBP in the second survey (prevalence 30.0%). The final multivariate model highlighted four risk factors: frequent bending (odds ratio [OR], 1.45, 95% confidence interval [CI], 1.07-1.97 for bending forward only; and OR, 2.13, 95% CI, 1.52-3.00 for bending both forward and sideways), driving industrial vehicles (OR, 1.35; 95% CI, 1.00-1.81), working more hours than officially planned (OR, 1.38; 95% CI, 1.05-1.81), and reported low support from supervisors (OR, 1.35; 95% CI, 1.02-1.79).

CONCLUSIONS

These results emphasize that biomechanical factors remain worth considering, even when psychosocial factors are taken into account, and provide a significant contribution to preventive strategies.

Is objectively measured sitting time associated with low back pain? A cross-sectional investigation in the NOMAD study

Background

Studies on the association between sitting time and low back pain (LBP) have found contrasting results. This may be due to the lack of objectively measured sitting time or because socioeconomic confounders were not considered in the analysis.

Objectives

To investigate the association between objectively measured sitting time (daily total, and occupational and leisure-time periods) and LBP among blue-collar workers.

Methods

Two-hundred-and-one blue-collar workers wore two accelerometers (GT3X+ Actigraph) for up to four consecutive working days to obtain objective measures of sitting time, estimated via Acti4 software. Workers reported their LBP intensity the past month on a scale from 0 (no pain) to 9 (worst imaginable pain) and were categorized into either low (≤5) or high (>5) LBP intensity groups. In the multivariate-adjusted binary logistic regression analysis, total sitting time, and occupational and leisure-time sitting were both modeled as continuous (hours/day) and categorical variables (i.e. low, moderate and high sitting time).

Results

The multivariate logistic regression analysis showed a significant positive association between total sitting time (per hour) and high LBP intensity (odds ratio; OR=1.43, 95%CI=1.15-1.77, P=0.01). Similar results were obtained for leisure-time sitting (OR=1.45, 95%CI=1.10-1.91, P=0.01), and a similar but non-significant trend was obtained for occupational sitting time (OR=1.34, 95%CI 0.99-1.82, P=0.06). In the analysis on categorized sitting time, high sitting time was positively associated with high LBP for total (OR=3.31, 95%CI=1.18-9.28, P=0.03), leisure (OR=5.31, 95%CI=1.57-17.90, P=0.01), and occupational (OR=3.26, 95%CI=0.89-11.98, P=0.08) periods, referencing those with low sitting time.

Conclusion

Sitting time is positively associated with LBP intensity among blue-collar workers. Future studies using a prospective design with objective measures of sitting time are recommended.