Musculoskeletal fitness and health-related quality of life characteristics among sedentary office workers affected by sub-acute, non-specific low back pain: a cross-sectional study

Comparison of trunk muscle endurance between women with and without chronic neck pain

PURPOSE

To compare trunk flexor, extensor, and lateral flexor muscle endurance between women with moderate to severe disability due to chronic neck pain (CNP) and asymptomatic women.

DESIGN

Observational case-control study.

METHODS

Thirty women with CNP and Neck Disability Index scores ranging from 30% to 70% and 28 asymptomatic women were included. The visual analog scale was used to assess neck pain intensity at rest and during activity. To assess trunk muscles endurance, trunk flexor endurance test, Sorensen test, and side bridge endurance test were performed.

RESULTS

Analysis of covariance indicated that neck pain group had lower body mass index-adjusted endurance times of trunk flexor, extensor, and lateral flexor muscles with large effect sizes (p < .001, η2 = 0.378-0.696). Trunk flexor endurance time showed a moderately negative correlation with neck pain intensity at rest and a weakly negative correlation with neck disability score (r = -460 and -365, p < .05).

CONCLUSIONS

Women with moderate to severe disability due to CNP exhibited decreased trunk muscle endurance, which may be a predisposing factor for low back pain. Also, trunk flexor endurance was related to neck pain complaints. A holistic approach, addressing the entire spine rather than focusing solely on the cervical region, might be useful for managing CNP.

CLINICAL IMPLICATIONS

The findings of reduced endurance in trunk muscles should consider incorporating interventions in the management of CNP to effectively address pain and disability.

The effect of a suspension training on physical fitness, lower extremity biomechanical factors, and occupational health in Navy personnel: a randomized controlled trial

Optimal physical fitness is essential for military personnel to effectively meet their rigorous physical demands. This study aimed to investigate the effectiveness of a suspension training program on physical fitness, biomechanical risk factors for lower extremity injury, mental health, and work-related factors in Navy personnel. A total of 50 young men participated in a randomized controlled trial. The participants were randomly assigned to two groups (n = 25): the intervention group and the control group. The intervention group performed an eight-week suspension training session three times per week, while the control group maintained their daily duties. The primary outcome was physical performance. The secondary outcomes were determined biomechanical risk factors for lower extremity injuries, mental health, and work-related factors. The data were analyzed using the analysis of covariance (ANCOVA). Compared with the control group, the intervention group showed significant improvements in physical performance, biomechanical risk for lower extremity injuries, and work-related factors from baseline to follow-up (p ≤ 0.05). However, there was no improvement in mental health. Based on these findings, suspension training positively impacted physical fitness, reduced injury risk, and enhanced the work-related factors of Navy personnel. This study provides new insights for various related experts and military coaches because it is an easy-to-use and feasible method with minimal facilities.

Acute Effects of a Warm-Up Intervention on Pain, Productivity, Physical Capacities and Psychological Perceptions Among Vineyard Workers: a Cluster Randomized Trial

PURPOSE

Agriculture is one of the sectors that are the most concerned by musculoskeletal disorders (MSDs). Workplace physical activity programs are one of the most promising solutions to prevent adverse consequences of MSDs such as pain or impairment in physical capacities. The aims of this study were twofold: (1) to investigate the acute effect of a warm-up session on pain, work performance, physical capacities and psychosocial perceptions among vineyard workers; (2) to determine the most beneficial warm-up modality for vineyard workers.

METHODS

A cluster randomized study was implemented among 92 French vineyard workers. A 15 min single session of warm-up was implemented among four groups corresponding to four different conditions: (1) hybrid warm-up intervention (HWU); (2) dynamic warm-up intervention (DWU); (3) stretching warm-up intervention (SWU); (4) no warm-up intervention (CONTROL).

RESULTS

DWU showed significant increased performance (p < 0.05), increased heart rate (p < 0.001), better readiness to work (p < 0.05) and lower workload (p < 0.05) than the CONTROL. HWU showed a better readiness to work (p < 0.01). SWU showed better work quality (p < 0.05). However, the three different warm-up protocols did significantly not differ from the CONTROL group in terms of perceived pain intensity, and physical capacities.

CONCLUSION

The present findings confirm some beneficial acute effects on performance, heart rate and psychological perceptions of a single warm-up session performed before pruning. The DWU seems to be the most beneficial warm-up modality.

TRIAL REGISTRATION

NCT05425693. Registered 06/16/2022 in www.

CLINICALTRIALS

gov .

The Effect of Motor Imaginary Combined with Transcranial Direct Current Stimulation (tDCS) on Balance in Middle-Aged Women with High Fall Risk: A Double-Blind Randomized Controlled Trial

Introduction. The risk of falling and its subsequent injuries increases with aging. Impaired balance and gait are important contributing factors to the increased risk of falling. A wide range of methods was examined to improve balance, but these interventions might produce small effects or be inapplicable for this population. The current study aimed at investigating the effect of motor imaginary (MI) training combined with transcranial direct current stimulation (tDCS) over the cerebellum on balance in middle-aged women with high fall risk. Methods. Thirty subjects aged 40-65 years old were divided into two groups including intervention ( $n=15$ ) and sham control ( $n=15$ ). The participants completed a 4-week program 3 times per week. The intervention group performed MI training combined with tDCS over the cerebellum, and the control group performed MI training combined with sham tDCS over the cerebellum. Static and dynamic balance were measured at baseline and after completing the 4-week program using balance error scoring system (BESS) and Y balance testing, respectively. Result. A one-way analysis of covariance and paired $t$ -tests were used to analyze the data. Significant improvement was observed in both balance tests in the intervention group after the implementation of the 4-week intervention program compared to the control group. The within-group analysis showed that both static and dynamic balance improved significantly from the baseline values only in the intervention group ( $p<0.05$ ) and not in the control group ( $p>0.05$ ). Conclusion. The results of the study indicate that MI training combined with tDCS over the cerebellum can lead to balance improvement in middle-aged women with high fall risk.

Effects of a warm-up intervention at the workplace on pain, heart rate, work performance and psychological perception among vineyard workers

OBJECTIVES

Warm-up sessions before physical activity are widely used in sports to help prevent injury and improve performance. Nowadays, companies assume that the effects observed in a sport context can be transferred to the workplace, particularly among workers exposed to biomechanical strain. Yet research on the use of warm-up interventions at the workplace is rather scarce and, when available, leads to conflicting results due to the low quality of the studies. To the best of our knowledge, there are no published studies to date assessing the effects of warm-up sessions among vineyard workers. The present study was designed to investigate if and how a single supervised warm-up session could be effective on perceived pain intensity, heart rate, work performance, and psychological perceptions among vineyard workers.

METHODS

A total of 31 vineyard workers completed a randomized crossover study at the workplace. They were observed in real work settings, i.e. during the pruning activity. Each participant performed the activity under two conditions: 1) with a warm-up session beforehand (WU) and 2) without any warm-up (NWU). Heart rate (HR) was assessed continuously before and during the warm-up, and during the first hour of pruning. Perceived pain intensity over fifteen anatomical locations was assessed before (T0) and immediately after (T1) warm-up, and after the first hour of work (T2). Readiness to work was assessed at T1. Work performance was assessed in terms of the number of completed tasks (number of pruned vines). Perceived work quality and perceived work ability were assessed at T2.

RESULTS

Perceived pain intensity over the lumbopelvic region was significantly higher at T2 than at T0, and at T2 than at T1, in both WU and NWU. Perceived pain intensity was not significantly different at T2 in WU and NWU. HR at T1 was significantly higher in WU than in NWU. Work performance, readiness to work, and perceived work ability were significantly higher in WU than in NWU.

CONCLUSION

This study showed that offering vineyard workers a supervised warm-up session at the workplace can lead to promising results where work performance and psychological perception are concerned.

The effectiveness of the comprehensive corrective exercise program on kinematics and strength of lower extremities in males with dynamic knee valgus: a parallel-group randomized wait-list controlled trial

Background

Dynamic knee valgus (DKV) is a prevalent movement impairment widely regarded as a risk factor for lower extremity disorders such as patellofemoral pain syndrome. The present study aimed to investigate the effectiveness of the comprehensive corrective exercise program (CCEP) on kinematics and strength of lower extremities in males with DKV.

Methods

Thirty asymptomatic young men with DKV between the ages of 18 and 28 years participated in this study. They were randomly assigned to the intervention (n = 15) and control groups (n = 15). The intervention group performed the CCEP for three sessions per week for eight weeks, while the control group only did activities of daily living. Hip external rotator and abductor muscle strength and three-dimensional lower extremity kinematics consisting of knee varus/valgus, femur adduction/abduction, femur medial/lateral rotation, and tibial medial/lateral rotation were measured at the baseline and post-test. The data were analyzed using the analysis of covariance (ANCOVA).

Results

There were significant improvements in all kinematics variables in the intervention group after the 8-week CCEP. Moreover, the strength of abductor and external rotator muscle improved in the intervention group (P < 0.05).

Conclusions

The CCEP led to substantial improvements in the selected variables of lower extremity kinematics and muscle strength in participants with DKV during a single-leg squat. These results imply that practitioners should adopt a comprehensive approach to pay simultaneous attention to both proximal and distal segments for improving DKV.

Trial registration

The protocol has been approved in the Registry of Clinical Trials (Registration N: IRCT20180821040843N1) on 2018-12-30.

Exploring acute effects of workplace warm-up intervention on pain, physical capacities, and productivity in agriculture:- A study protocol

BACKGROUND: Physical activity programs at the workplace have shown positive results on physical capacities and pain for several years. Due to the duration of the training session or the need for an instructor, these supervised programs are rather difficult to implement. For this reason, numerous companies, especially companies in manual sectors, are turning to another solution, i.e. warm-up intervention before the work shift. These interventions present various advantages such as short duration and the possibility to perform exercises in working clothes. Surprisingly, while the positive effects of warm-up interventions on pain, performance, and physical and psychological capacities are expansively reported in the sport context, effects of workplace warm-up intervention are lacking. OBJECTIVE: The aim of this study is to assess the acute effects of three different warm-up interventions on physical (pain, strength, flexibility) and psychological (workload) functions and also on work-related outcomes (work performance, readiness to work) among vineyard workers. METHODS: A cluster randomized study will be implemented among French vineyard workers. Four groups of 30 participants will be constituted; corresponding to four different conditions: (1) hybrid warm-up intervention (HWU); (2) dynamic warm-up intervention (DWU); (3) stretching warm-up intervention (SWU); (4) no warm-up intervention (NWU). A total of 120 vineyard workers will be recruited to participate in the study. CONCLUSION: The results will provide more evidence about the short-term effects of warm-up interventions at the workplace and will provide more evidence on which warm-up modality is the most effective on pain, performance, and physical and psychological capacities among vineyard workers.

Quality of life in working populations with and without musculoskeletal pain in Saudi Arabia

BACKGROUND

Musculoskeletal (MSK) pain can negatively affect work life and quality of life (QoL).

OBJECTIVE

This study characterizes the QoL of workers in Saudi Arabia and compares it between adults of working age with and without MSK pain.

METHODS

This is a descriptive cross-sectional study. The Short Form-36 (SF-36) instrument was used to measure eight domains that describe QoL among workers with and without MSK pain. Descriptive statistics and parametric tests enabled comparisons between the two sets of workers.

RESULTS

A total of 2042 workers participated in the study. The majority of them had experienced MSK pain during the last 12 months. In addition, the results for most SF-36 domains varied significantly across age and gender groups. Workers who lacked MSK pain over the last 12 months reported higher means for all SF-36 domains, with the exception of the physical function domains.

CONCLUSION

This study found that the majority of workers experience MSK pain. In all bodily regions, neck and back pain are the most frequently reported areas of discomfort for these employees. Workers without MSK pain experience better QoL. This observation suggests the need for managers to pay closer attention to workers with MSK pain, as these employees experience significantly lower QoL. To prevent or reduce MSK pain, workers should undergo routine medical examination and early intervention for MSK pain. These preventative measures can help to increase workers' QoL.

Chiropractic Care and Quality of Life Among Office Workers With Nonspecific Pain: A Cross-Sectional Study

Objective

The aim of this study was to evaluate the quality of life by a self-administered World Health Organization Quality of Life short version survey (WHOQoL-BREF) among office workers with nonspecific pain receiving chiropractic care in Istanbul, Turkey.

Methods

This cross-sectional study included 77 office workers (age interval, 18-65) with nonspecific neck, thoracic, back and/or extremity pain who underwent chiropractic care. Two weeks later, the quality of life was evaluated by a self-administered WHOQoL-BREF. The Numeric Pain Scale to evaluate the perceived pain was administered to all of the participants in the beginning and at the end of the study. Group-level changes on WHOQoL-BREF total score and subdimensions were compared according to descriptive data of office workers. The significance level was set at P ≤ .05.

Results

WHOQoL-BREF scale scores after chiropractic care (mean ± standard deviation) were 71.21% ± 7.91% (total score), 81.49% ± 14.43% (general health), 80.38% ± 10.49% (physical health), 73.16% ± 11.68% (psychological), 70.41% ± 12.43% (social), and 65.58% ± 10.91% (environment). Numeric Pain Scale scores decreased in a statistically significant way when compared with baseline (P ≤ .05). The descriptive statistical analysis of WHOQoL-BREF dimensions revealed that women had significantly higher scores than men, the 18-to-35 age group had higher scores compared with the 50-to-65 age group, and those married had significantly higher scores than those who were not married (P ≤ .05).

Conclusion

The findings of our study suggest that chiropractic care had positive effects on the quality of life of office workers.

Trunk muscle function and its association with functional limitations in sedentary occupation workers with and without chronic nonspecific low back pain

BACKGROUND

The function of trunk muscles in chronic nonspecific low back pain (CNLBP) is controversially discussed, and trunk muscle function in sedentary occupation workers is poorly understood.

OBJECTIVE

To investigate whether muscle function differs between sedentary occupation workers with and without CNLBP and to determine the association between functional limitations and muscle function.

METHODS

This study included 32 sedentary occupation workers (16 workers with CNLBP and 16 age- and sex-matched workers without CNLBP). Group differences in isokinetic trunk flexion-extension strength, muscle cocontraction, endurance time (Biering-Sorensen test) and electromyographic muscle fatigue were assessed. The association of these parameters and Oswestry Disability Index (ODI) score were examined in the CNLBP group.

RESULTS

Participants with CNLBP had lower trunk extensor (-20%) and flexor (-18%) strength and less cocontraction (-22%) than participants without CNLBP, but due to large variability in both groups these differences were not statistically significant. Trunk muscle endurance and fatigue were comparable between groups. Variance in endurance time explained 28% of variance in the ODI-score in the CNLBP group (R2= 0.277).

CONCLUSIONS

In patients with CNLBP, greater functional disability was associated with lower endurance. Further evidence is necessary to elucidate whether specifically training endurance performance may be beneficial for sedentary occupation workers.

Influence of Anterior-Posterior External Surface Perturbation on Trunk Stability During Abdominal Stabilization Strategies While Sitting

Background

Spinal and pelvic injuries during an unexpected perturbation are closely related to spinal stability, which is known to be controlled by abdominal stabilization maneuvers. This study aimed to evaluate the effects of unexpected perturbations on trunk stability and abdominal stabilization strategies in 42 sedentary adults while sitting.

Material/Methods

Abdominal stabilization strategies consisted of bracing and hollowing maneuvers. Abdominal bracing maneuvers (ABM) were focused on the abdominal wall muscles [inferior oblique (IO), exterior oblique (EO)], and abdominal hollowing maneuvers (AHM) were focused on deep muscle (TrA) activation. The subjects were instructed in abdominal stabilization maneuvers. Afterward, subjects were seated in a chair that could be moved forward or backward suddenly with the support surface.

Results

Angular displacements of the upper thorax, lower thorax, and lumbopelvic during unexpected perturbation, with different abdominal stabilization maneuvers, were measured. During forward perturbation (d=0.71, F=10.324, P=0.001) and backward perturbation in high speed (d=0.62, F=9.265, P=0.011), there were significant differences in angular displacements of the upper thorax between hollowing and bracing maneuvers. Additionally, significant differences were found in the lumbopelvic angular displacement between the hollowing and bracing maneuvers (d=0.62, F=4.071, P=0.044).

Conclusions

Our findings indicate that the ABM is a better stabilizing technique for the upper thorax, and the AHM is a better stabilizing technique for the lumbopelvic region during unexpected perturbations at high speed in the seated position.

Temporal trends in trunk flexor endurance and intra-abdominal pressure in postpartum women

Objectives: To describe change in trunk flexor endurance and intra-abdominal pressure (IAP) associated with trunk flexor assessment and explore factors associated with change in trunk flexor endurance during the first postpartum year.Design: Ancillary analysis of an ongoing prospective cohort study.Methods: Participants (N = 282) were primiparous women delivered vaginally. They completed trunk flexor endurance testing while assessing IAP, body habitus measures (body mass index, waist circumference, and body composition), and questionnaires 5-10 weeks and 11-15 months postpartum. We investigated change in trunk flexor endurance by quartile of improvement and factors associated with improvement (Q4 vs. Q1-Q3) using multivariable models, adjusted for baseline endurance.Results: Mean age was 28 ± 5 years. The median (IQR) trunk flexor hold time increased from early to late postpartum (129/IQR = 68, 217 vs 148/IQR = 80, 265 seconds, p = .01) and mean (SD) IAP decreased (55/SD = 13 vs 48/SD = 14 cmH20, p < .0001). The most improved group (Q4) increased endurance time by 176 seconds (95% CI = 103, 254), were less likely to be Hispanic, more likely to be older, more educated, and have lower measures of body habitus than women in Q1-Q3. Conclusion: Trunk flexor endurance increased and IAP decreased over one year postpartum. Lower body habitus and higher age early postpartum predicted greatest improvement in trunk flexor endurance at 1 year.

Association between Relative Handgrip Strength and Chronic Lower Back Pain: A Nationwide Cross-Sectional Analysis of the Korea National Health and Nutrition Examination Survey

Lower back pain (LBP) is the most common musculoskeletal complaint and significantly reduces the quality of life. Muscle weakness is a major cause of LBP. Handgrip strength (HGS) is widely used to determine general muscle strength. Relative HGS (RHGS) incorporates body mass and provides a more accurate estimation of muscle strength and health status. We analyzed the data from Korea National Health and Nutrition Examination Survey to investigate the association between RHGS and chronic LBP. We identified 14,930 participants and excluded a total of 9553 participants with age < 50 years, with incomplete LBP information, and with incomplete HGS information. We analyzed the data of 5377 participants: 1086 (20.19%) with chronic LBP and 4291 (79.8%) without chronic LBP. Multivariate regression analysis with adjustment for covariates identified an association between weak RHGS and chronic LBP (odds ratio 1.31; CI 1.07-1.61; p = 0.01). This article demonstrated a significant association between RHGS and chronic LBP. Therefore, RHGS should be measured for patients with chronic LBP.

Estimation of Health-Related Physical Fitness Using Multiple Linear Regression in Korean Adults: National Fitness Award 2015-2019

Continuous health care and the measurement of health-related physical fitness (HRPF) is necessary for prevention against chronic diseases; however, HRPF measurements including laboratory methods may not be practical for large populations owing to constraints such as time, cost, and the requirement for qualified technicians. This study aimed to develop a multiple linear regression model to estimate the HRPF of Korean adults, using easy-to-measure dependent variables, such as gender, age, body mass index, and percent body fat. The National Fitness Award datasets of South Korea were used in this analysis. The participants were aged 19-64 years, including 319,643 male and 147,600 females. HRPF included hand grip strength (HGS), flexibility (sit and reach), muscular endurance (sit-ups), and cardiorespiratory fitness (estimated VO_2max ). An estimation multiple linear regression model was developed using the stepwise technique. The outlier data in the multiple regression model was identified and removed when the absolute value of the studentized residual was ≥2. In the regression model, the coefficient of determination for HGS (adjusted R ²: 0.870, P < 0.001), muscular endurance (adjusted R ²: 0.751, P < 0.001), and cardiorespiratory fitness (adjusted R ²: 0.885, P < 0.001) were significantly high. However, the coefficient of determination for flexibility was low (adjusted R ²: 0.298, P < 0.001). Our findings suggest that easy-to-measure dependent variables can predict HGS, muscular endurance, and cardiorespiratory fitness in adults. The prediction equation will allow coaches, athletes, healthcare professionals, researchers, and the general public to better estimate the expected HRPF.

Empirical study of the 30-s chair-stand test as an indicator for musculoskeletal disorder risk of sedentary behaviour in Japanese office workers: a cross-sectional empirical study

Objectives

Sedentary behaviour among office workers and the risk of adverse health outcomes are public health problems. However, risk indicators for these outcomes require invasive biochemical examination. A proactive screening tool using a non-invasive, easy-to-use method is required to assess the risk focused on musculoskeletal health for primary prevention. However, middle-aged adults have insufficient awareness of musculoskeletal disorders. This study examined to determine whether the 30-s chair-stand test (CS-30) can be used as a proactive screening index for musculoskeletal disorder risk of sedentary behaviour in office workers.

Design

Cross-sectional study using self-administered questionnaires and physical measurements.

Setting

Four workplaces located in a metropolitan area of Japan.

Participants

431 Japanese office workers aged 20–64 years. 406 valid sets of results remained (valid response rate: 94.2%).

Primary and secondary outcome measures

Musculoskeletal function was measured using the CS-30, quadriceps muscle strength. Receiver operating characteristic curve analysis was used to determine the sensitivity, specificity and optimal cut-off value for the CS-30. The risk of future incidence of musculoskeletal disorders was calculated using current quadriceps muscle strength.

Results

In total participants, 47.0% were male and the mean sitting time in work duration was 455.6 min/day (SD=111.2 min). The mean lower limb quadriceps muscle strength was 444.8 N (SD=131.3 N). For the optimum cut-off value of 23 on the CS-30 for all participants, sensitivity was 0.809 and specificity was 0.231. For men, the optimum cut-off was 25, with a sensitivity of 0.855 and a specificity 0.172. For women, the optimum cut-off was 21, with a sensitivity of 0.854 and a specificity 0.275.

Conclusions

Sensitivity was high, but specificity was insufficient. The CS-30 may be a potential proactive screening index for musculoskeletal disorder risk of sedentary behaviour, in combination with other indicators.

Can lower extremity anatomical measures and core stability predict dynamic knee valgus in young men?

INTRODUCTION

Dynamic knee valgus (DKV) is a risk factor for lower extremity injuries such as anterior cruciate ligament and patellofemoral pain syndrome. Purpose of the current study was to investigate the relationship between lower extremity anatomical measures (LEAM) and core stability with DKV during the single-leg squat.

METHODS

Thirty healthy men aged between 18 and 28 years participated in this cross-sectional biomechanical study.DKV was assessed using a 6-camera motion analysis system during a single-leg squat task. Anteversion of hip, hip internal and external rotation, Q-angle, knee hyperextension, tibial torsion, tibia vara, plantar arch index, and core stability were measured using standard clinical procedures. To predict DKV, a multiple linear regression model was used.

RESULT

The stability index negatively and plantar arch index positively predicted greater DKV during the single-leg squat task (P = 0.001 and P = 0.09, respectively). Research variables together predicted 82% of the variance in DKV (F(4,26) = 28.09, p < 0.001). However, relationships between other variables and DKV were not found.

CONCLUSION

The core stability index and plantar arch index were associated with observed DKV during the single-leg squat. These results suggested that proximal and distal variables to the knee should be considered when evaluating individuals who present DKV during the single-leg squat.

Do Measures of Muscular Fitness Modify the Effect of Intra-abdominal Pressure on Pelvic Floor Support in Postpartum Women?

OBJECTIVE

This study aimed to determine whether measures of muscular fitness modify the effect of intra-abdominal pressure (IAP) during lifting on pelvic floor support.

METHODS

Participants, primiparous women 1 year after vaginal delivery, underwent the Pelvic Organ Prolapse Quantification examination, measurement of IAP via a vaginal sensor while lifting a weighted car seat, pelvic floor muscle force assessment using an instrumented speculum, grip strength using a hand dynamometer, and trunk flexor endurance by holding an isometric contraction while maintaining a 60-degree angle to the table. We dichotomized pelvic floor support as worse (greatest descent of the anterior, posterior, or apical vagina during maximal strain at or below the hymen) versus better (all points above the hymen).

RESULTS

Of 825 participants eligible after delivery, 593 (71.9%) completed a 1-year study visit. Mean (SD) age was 29.6 (5.0) years. One year postpartum, 55 (9.3%) demonstrated worse support. There were no differences in IAP during lifting or in other measures of pelvic floor loading between women with better and worse support. In multivariable analyses, neither grip strength nor pelvic floor muscle force modified the effect of IAP on support. In women with trunk flexor endurance duration ≥13 minutes, the odds of worse support increased significantly as IAP increased. No fitness measure modified the effect of other measures of pelvic floor loading on support.

CONCLUSIONS

Primiparous women with higher IAP during lifting and greater muscular fitness did not have reduced odds of worse pelvic floor support compared with those with lower IAP at the same muscular fitness.

Injuries and physical characteristics affecting swimmer participation in the Olympics: A prospective survey

OBJECTIVE

To identify injuries and physical characteristics affecting swimmers' performance.

DESIGN

Prospective study.

SETTING

Laboratory-based.

PARTICIPANTS

Sixty-four Rio Olympic candidates (36 men, 28 women), who were high level swimmers ranked among the top 32 in the 2014 World Ranking in swimming. The participants were categorized into the Olympian group (n = 25), swimmers who were consecutively selected for the Olympic team, and the non-Olympian group (n = 39), swimmers who were not.

MAIN OUTCOME MEASURES

Four months prior to the Olympic qualification in 2016, an orthopedist and two physical therapists evaluated injuries and 11 physical characteristics of the swimmers. The prevalence of total overuse injuries, shoulder and low back injury, and physical characteristics were compared between the two groups.

RESULTS

The female swimmers in the non-Olympian group had a 53.3% prevalence of total overuse injuries, which was significantly higher than that of those in the Olympian group with 15.4% (p = 0.037). The prevalence of total over use injuries in male swimmers in both the Olympian and non-Olympian groups was 41.7%. Female Olympian group showed that the shoulder external rotation range of motion was significantly less than that of non-Olympian group (97.8 ± 5.7 and 103.6 ± 7.3, p = 0.046).

CONCLUSIONS

In female swimmers, total overuse injuries four months before an important competition influence their performance at the event.

Work Ability and Quality of Life in Patients with Work-Related Musculoskeletal Disorders

This study aimed to investigate level of work ability and quality of life (QOL) as well as the relationship between them among patients suffering from work-related musculoskeletal disorders (WMSDs) in Taiwan. A cross-sectional study design with continuous sampling and a questionnaire were used to obtain the research data. Controlling for personal characteristics, pain, psychological distress, and social support, multiple linear regressions were adopted to explore the relationship between work ability and overall QOL. Further analyses were also made to clarify the relationships between work ability and each domain of QOL. In total, 165 patients with WMSDs were recruited. Compared with general workers, the participants reported a lower level of work ability and overall QOL. Work ability was significantly associated with overall QOL when covariates were controlled. Among the four domains of QOL, work ability was significantly associated with both the physical and psychological domains. The conclusion was that work ability is a definite factor of QOL for patients with WMSDs; the essence of work ability may be beyond economic function or social support. Strategies to help workers with WMSDs enhance their work ability to fit their new or temporary jobs would be beneficial to their QOL.

Influence of the wearable posture correction sensor on head and neck posture: Sitting and standing workstations

BACKGROUND

Flexed head and neck postures are associated with the development of neck pain in the office environment. There is little evidence regarding whether a wearable posture sensor would improve the head and neck postures of office workers.

OBJECTIVE

The aim of this study was to evaluate the effect of the wearable posture sensor on the posture and physical demands on the head and neck during office work.

METHODS

Nineteen participants performed a typing task with and without the wearable sensor in the sitting and standing positions. They were allowed to adjust their workstation during the experiment based on a psychophysical method. The flexion angles of the head and neck, the gravitational moment on the neck, and the positions of the workstation components were measured.

RESULTS

On average, participants with the wearable sensor had 8% lower neck flexion angles and 14% lower gravitational moments on the neck than those of participants without the wearable sensor. The effect of the wearable sensor on reducing postural stress of the neck was more significant when using the standing workstation compared to the sitting workstation.

CONCLUSIONS

The wearable posture sensor could be an effective tool to alleviate the postural stress of the neck in the office setting.

Prevalence rate of neck, shoulder and lower back pain in association with age, body mass index and gender among Malaysian office workers

BACKGROUND

Malaysian office workers often experience Musculoskeletal Discomfort (MSD) which is typically related to the low back, shoulders, and neck.

OBJECTIVES

The objective of this study was to examine the occurrence of lower back, shoulder, and neck pain among Malaysian office workers.

METHODS

752 subjects (478 women and 274 men) were randomly selected from the Malaysian office workers population of 10,000 individuals. The participants were aged between 20-50 years and had at least one year of work experience. All participants completed the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Instructions to complete the questinnaire were given to the participants under the researchers supervision in the morning before they started a day of work. The participants were then classified into four categories based on body mas index (BMI) (BMI:≤18.4, 18.5-24.99, 25-29.99, ≥30) and age (Age: 20-29, 30-39, 40-49, ≥50).

RESULTS

There was a significant association between pain severity in gender and right (p = 0.046) and left (p = 0.041) sides of the shoulders. There was also a significant association between BMI and severity of pain in the lower back area (p = 0.047). It was revealed that total pain score in the shoulders was significantly associated with age (p = 0.041).

CONCLUSIONS

The results of this study demonstrated that a significant correlation existed between pain servity for gender in both right and left shoulder. These findings require further scientific investigation as do the identification of effective preventative stratgies.

A comparative assessment of static muscular strength among female operative's working in different handicraft occupations in India

An ergonomic assessment of static muscular strength like hand grip-and pinch strength in handicraft occupation was made. In total, 170 female participants were selected for the case-control study, out of which 120 handicraft and 50 office workers were examined as exposed and control groups. Their maximum static handgrip- and pinch strength were measured using hand and pinch dynamometers. We analyze our findings to indicate static muscular strength varies significantly due to repetitive use of hand tools. The decrement in pinch grip strength was evident due to long cycle repetitive pinching movements of distal phalanx during hand knotting and pearl drilling. Based on our results we propose the need for ergonomically designed hand tool interventions that may reduce the accumulation of loss in static muscle strength.

Measuring static muscular strength among female operatives: a cross-sectional comparison in different handicraft occupations

Purpose. Loss of static muscular strength is the most common work-related problem among handicraft workers involved in hand-intensive jobs. A cross-sectional comparative assessment was carried out to determine the muscular strength among workers involved in the manufacturing of three different crafts: weaving, hand block printing and imitation jewelry. Methods. 120 female operatives were selected, and digital grip dynamometers were used to measure their maximum hand grip and pinch strength. Results. Static muscular strength varies significantly among the different occupational groups of workers. The difference in grip strength in the right and left hands shows that exposure to hand tools for a prolonged period plays a vital role in muscle strength. These findings indicate that static muscular strength varies significantly due to repetitive use of hand tools. The observed values of muscle strength in the dominant hand were significantly lower in jewelry workers while block printing workers had the highest strength. Conclusion. The decrement in pinch grip strength was evident due to long-cycle repetitive pinching movements of the distal phalanx during hand knotting and pearl drilling. This study proposes the need for ergonomically designed hand tool interventions that may reduce the accumulation of loss in static muscle strength.

Acupuncture and Neural Mechanism in the Management of Low Back Pain-An Update

Within the last 10 years, the percentage of low back pain (LBP) prevalence increased by 18%. The management and high cost of LBP put a tremendous burden on the healthcare system. Many risk factors have been identified, such as lifestyle, trauma, degeneration, postural impairment, and occupational related factors; however, as high as 95% of the cases of LBP are non-specific. Currently, LBP is treated pharmacologically. Approximately 25 to 30% of the patients develop serious side effects, such as drowsiness and drug addiction. Spinal surgery often does not result in a massive improvement of pain relief. Therefore, complementary approaches are being integrated into the rehabilitation programs. These include chiropractic therapy, physiotherapy, massage, exercise, herbal medicine and acupuncture. Acupuncture for LBP is one of the most commonly used non-pharmacological pain-relieving techniques. This is due to its low adverse effects and cost-effectiveness. Currently, many randomized controlled trials and clinical research studies have produced promising results. In this article, the causes and incidence of LBP on global health care are reviewed. The importance of treatment by acupuncture is considered. The efforts to reveal the link between acupuncture points and anatomical features and the neurological mechanisms that lead to acupuncture-induced analgesic effect are reviewed.

Muscle Atrophy Measurement as Assessment Method for Low Back Pain Patients

Low back pain is one of the most common pain disorders defined as pain, muscle tension, or stiffness localized below the costal margin and above the inferior gluteal folds, sometimes with accompanying leg pain. The meaning of the symptomatic atrophy of paraspinal muscles and some pelvic muscles has been proved. Nowadays, a need for new diagnostic tools for specific examination of low back pain patients is posited, and it has been proposed that magnetic resonance imaging assessment toward muscle atrophy may provide some additional information enabling the subclassification of that group of patients.

Prevalence rate of neck, shoulder and lower back pain in association with age, body mass index and gender among Malaysian office workers

BACKGROUND

Malaysian office workers often experience Musculoskeletal Discomfort (MSD) which is typically related to the low back, shoulders, and neck.

OBJECTIVES

The objective of this study was to examine the occurrence of lower back, shoulder, and neck pain among Malaysian office workers.

METHODS

752 subjects (478 women and 274 men) were randomly selected from the Malaysian office workers population of 10,000 individuals. The participants were aged between 20-50 years and had at least one year of work experience. All participants completed the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Instructions to complete the questinnaire were given to the participants under the researchers supervision in the morning before they started a day of work. The participants were then classified into four categories based on body mas index (BMI) (BMI:≤18.4, 18.5-24.99, 25-29.99, ≥30) and age (Age: 20-29, 30-39, 40-49, ≥50).

RESULTS

There was a significant association between pain severity in gender and right (p = 0.046) and left (p = 0.041) sides of the shoulders. There was also a significant association between BMI and severity of pain in the lower back area (p = 0.047). It was revealed that total pain score in the shoulders was significantly associated with age (p = 0.041).

CONCLUSIONS

The results of this study demonstrated that a significant correlation existed between pain servity for gender in both right and left shoulder. These findings require further scientific investigation as do the identification of effective preventative stratgies.

Effects of a Worksite Supervised Adapted Physical Activity Program on Trunk Muscle Endurance, Flexibility, and Pain Sensitivity Among Vineyard Workers

OBJECTIVES

In viticulture, the prevalence of low back pain is particularly high among vineyard workers exposed to sustained and awkward postures. One promising setting for low back pain prevention resides in the implementation of workplace physical activity.

METHODS

This nonrandomized pilot study aims at evaluating the effects of a worksite supervised adapted physical activity program among 17 vineyard workers volunteered to enter either an intervention group (n = 10) or a control group (n = 7).The intervention group followed a physical activity program for 8 weeks involving (1) 15 minutes of warm-up every working day and (2) two weekly 1-hour adapted physical activity sessions targeting trunk muscle endurance and flexibility. The control group was advised to continue normal physical activity. Evaluations were carried out at weeks 0, 4, 8, and 12. Physical capacity was assessed using flexibility tests for the trunk, along with trunk muscle flexor and extensor endurance tests. Finally, pain sensitivity was evaluated by assessing pressure pain thresholds over 14 anatomical locations in the low back region.

RESULTS

For the intervention group, the endurance of the trunk extensor and flexor significantly increased from baseline to week 8 as well as the pressure pain thresholds. No change was observed for the control group over the same period.

CONCLUSIONS

These encouraging results in combination with the high adherence rate set interesting foundations for the promotion of worksite supervised adapted physical activity and, most likely, offer a new promising approach to prevent low back pain among vineyard workers.

Atrophy of gluteus maximus among women with a history of chronic low back pain

BACKGROUND

Although the relationship between low back pain (LBP) and the size of certain trunk muscles has been extensively studied, the relationship between gluteus maximus (GM) size and LBP has been only minimally examined. Determining whether such a relationship exists would help improve our understanding of the etiology of LBP, and possibly provide a rationale for the use of therapeutic exercise interventions targeting GM with LBP patients. The objective of this study was to compare gluteus maximus cross-sectional area in individuals with chronic LBP, and in a group of individuals without LBP. Our hypothesis was that individuals with LBP would have greater atrophy in their gluteus maximus muscles than our control group.

MATERIALS AND METHODS

For this case-control study, we analyzed medical history and pelvic computed tomography (CT) scans for 36 female patients with a history of chronic LBP, and 32 female patients without a history of LBP. Muscle cross-sectional area of gluteus maximus was measured from axial CT scans using OsiriX MD software, then was normalized to patient height, and used to compare the two groups. The number of back pain-related medical visits was also correlated with gluteus maximus cross-sectional area.

RESULTS

Mean normalized cross-sectional area was significantly smaller in the LBP group than in the control group, with t = 2.439 and P<0.05. The number of back pain-related visits was found to be significantly correlated with normalized cross-sectional area, with r = -0.270 and P<0.05. The atrophy seen in the present research may reflect incidental disuse atrophy seen with LBP, which is present in many muscle groups after prolonged immobilization or with a sedentary lifestyle.

CONCLUSIONS

This research demonstrated a previously only minimally explored relationship between gluteus maximus cross-sectional area and LBP in women. Further research is indicated in individuals with varying age, sex, and LBP diagnoses.

Acute joint pain in the emerging green collar workforce: Evidence from the linked National Health Interview Survey and Occupational Information Network (O*NET)

BACKGROUND

Green jobs are a rapidly emerging category of very heterogeneous occupations that typically involve engagement with new technologies and changing job demands predisposing them to physical stressors that may contribute to the development of joint pain.

METHODS

We estimated and compared the prevalence of self-reported acute (past 30 days) joint pain between green and non-green collar workers using pooled 2004-2012 National Health Interview Survey (NHIS) data linked to the Occupational Information Network Database (O*NET).

RESULTS

Green collar workers have a higher prevalence of acute joint pain as compared to non-green collar workers. Green collar workers with pain in the upper extremity joints were significantly greater than in the non-green collar workforce, for example, right shoulder [23.2% vs 21.1%], right elbow [13.7% vs 12.0%], left shoulder [20.1% vs 18.2%], and left elbow [12.0% vs 10.7%].

CONCLUSIONS

Acute joint pain reported by the emerging green collar workforce can assist in identifying at risk worker subgroups for musculoskeletal pain interventions.

Relationships among Disability, Quality of Life, and Physical Fitness in Lumbar Spinal Stenosis: An Investigation of Elderly Korean Women

STUDY DESIGN

A cross-sectional, case-control study.

PURPOSE

To investigate associations between physical fitness measures and disabilities related to back pain and quality of life (QOL) by the presence of symptomatic lumbar spinal stenosis (LSS) in elderly Korean women.

OVERVIEW OF LITERATURE

LSS leads to decreased functioning and reduced QOL. However, correlations among physical fitness, disability, and QOL have not been investigated in elderly women with LSS.

METHODS

Participants included women aged 65 years and older (n=192), divided into a study group (n=38) and a control group (n=154) based on the presence/absence of LSS. All participants underwent physical function and fitness tests. Oswestry disability index (ODI) scores and EuroQol five-dimensional questionnaire (EQ-5D-5L) scores were used to assess disability and health-related QOL.

RESULTS

The results for the handgrip strength, sit-and-reach, functional reach, and timed up and go (TUG) tests were significantly higher in the control group than the LSS group. ODI scores were significantly higher and EQ-5D-5L scores significantly lower in the LSS group. TUG and functional reach test scores were significantly correlated with ODI scores, and handgrip strength was strongly interrelated with ODI and EQ-5D-5L scores in the LSS group. No other physical fitness measures showed statistically significant relationships with ODI or EQ-5D-5L scores.

CONCLUSIONS

In elderly Korean women with LSS, back pain-related disability and QOL are significantly associated with some physical fitness parameters such as handgrip strength. Handgrip strength reflects general muscle strength, which is significantly interrelated with the level of disability and QOL. Our results suggest that enhancing generalized muscle strength helps to reduce disability due to back pain and improve QOL in patients with LSS.

What are the Facilitators and Obstacles to Participation in Workplace Team Sport? A Qualitative Study

Working age adults are failing to meet physical activity recommendations. Inactive behaviours are increasing costs for diminished individual and organisational health. The workplace is a priority setting to promote physical activity, however there is a lack of evidence about why some employees choose to participate in novel workplace activities, such as team sport, whilst others do not. The aim of this study was to explore the complexity of facilitators and obstacles associated with participation in workplace team sport. Twenty-nine semi-structured face-to-face and telephone interviews were conducted with office workers (58% female) (36 ± 7.71) from manufacturing, public services, and educational services. Data was analysed through template analysis. Five sub-level (i.e., intrapersonal, interpersonal, organisational, community and societal influences) facilitate participation or create obstacles for participants. Participants were challenged by a lack of competence, self-efficacy, negative sporting ideals and amotivation. Unhealthy competition, an unstable work-life balance and unsupportive colleagues created obstacles to participation. An unsupportive organisation and workplace culture placed demands on workplace champions, funding, facilities and communication. Healthy competitions, high perceptions of competence and self-efficacy, and being motivated autonomously enabled participation. Further, relatedness and social support created a physical activity culture where flexible working was encouraged and team sport was promoted in accessible locations within the organisation. Researchers should consider accounting for complexity of these influences. A participatory approach may tailor interventions to individual organisations and the employees that work within them. Interventions whereby autonomy, competence and relatedness are supported are recommended. This may be achieved by adapting sports and training workplace champions.

Pain and functional outcomes after outpatient physiotherapy in patients with low back pain

BACKGROUND

Physiotherapy treatment programs are recommended in the rehabilitation of low back pain (LBP). Rehabilitation institutions are increasingly asked to demonstrate the outcomes of their intensive physiotherapy services.

AIM

To describe pain and functional outcome measures following a 6-month outpatient physiotherapy treatment program in patients with LBP.

METHODS

A total of 85 patients were analysed after being treated with a combination of physiotherapeutic treatment modalities 2-3 days weekly. Pain and disability were measured before, 3 and 6 months after the onset of treatment. Isometric trunk muscle strength for flexion and extension and flexibility of dorsal trunk and thigh structures were measured before and 6 months after treatment.

RESULTS

After 6 months, pain at rest decreased from a median of 4.0 to 0.0 (p < 0.01) and pain during activity from a median of 5.5 to 2.0 on the numeric rating scale (p < 0.001). The Roland-Morris Disability (RMDQ) score decreased from a median of 7.0 to 3.0 (p < 0.001). Mean trunk muscle flexion strength increased from 133.7 to 156.0 Nm and for extension from 235.5 to 278.3 Nm (p < 0.001). Flexibility was improved from a mean of -5.9 to -1.4 cm (p < 0.001). A moderate correlation between pain at rest and RMDQ score was found after 3 (r = 0.532, p < 0.01) and 6 months (r = 0.508, p < 0.01).

CONCLUSIONS

Patients with LBP who were treated with the physiotherapeutic treatment program showed a clinically relevant reduction of pain and disability with improved trunk muscle strength and flexibility. Reductions in pain and disability do not seem to correlate with increased trunk muscle strength and flexibility. No conclusions can be declared about long-term changes after the intervention.

A tailored workplace exercise program for women at risk for neck and upper limb musculoskeletal disorders: a randomized controlled trial

OBJECTIVE

The aim of this study was to evaluate a tailored physical activity protocol performed in a work environment with a group of female workers employed in manual precision tasks to reduce upper limb pain.

METHODS

Sixty female subjects were randomly assigned to an intervention group or a control group. The IG was administered of a 6-month, twice-a-week, tailored exercise program, whereas the CG received no intervention.

RESULTS

The IG showed a reduction on shoulder pain accompanied by increases on the range of motion measures. In addition, reductions in upper limb pain and neck disability were detected with concomitant increases in grip strength.

CONCLUSIONS

This study indicated positive effects of a tailored workplace exercise protocol in female workers exposed to moderate risk for work-related musculoskeletal disorders, showing clinically meaningful reductions of pain symptoms and disability on upper limb and neck regions.

Health status and health-related quality of life of municipal waste collection workers - a cross-sectional survey

Background

Waste collection workers are exposed to several occupational stressors which may affect their quality of life. Our aim was to assess the health status and health-related quality of life (HRQoL) of municipal waste collection workers of a big German city.

Methods

Cross-sectional study with a non-random sample of 65 (62 male, 3 female) workers of the Hamburg sanitation department, volunteering to participate in the study. We assessed the prevalence of reported health complaints and health problems. HRQoL was assessed with the self-administered EQ-5D-5L questionnaire and its visual analogue scale (VAS).

Results

The most common health problems were musculoskeletal complaints (back pain reported by 67.2 %, other musculoskeletal complaints 15.4 %). Asthma or chronic obstructive pulmonary disease (COPD) was reported by 15.4 % of the workers. All participants reporting having a diagnosis of asthma or COPD had been or were active smokers. Our findings indicate an impaired HRQoL among the investigated occupational group. Regarding EQ-5D 68.3 % reported at least “slight” problems in one or more dimensions, and almost one third (31.7 %) reported “no problems” in any dimension. Problems were most frequently reported in the dimension “pain/discomfort” (64.1 % of the workers). The mean VAS value was 80.9 (13.2). The presence of back pain was associated with limitations in HRQoL (RR 3.1; 95 %-CI 1.5-6.1). The EQ5D VAS score was statistically significantly lower among waste collectors with back pain (77.9 SD 14.1) compared to those with no back complaints (88.0 SD 7.6, p < 0.01).

Conclusions

Back complaints are common among municipal waste collectors and are associated with considerable impairments in their HRQoL. Interventions to enhance ergonomic work are needed in order to reduce back complaints and enhance HRQoL in this occupational group.

Abdominal muscle strength is related to the quality of life among older adults with lumbar osteoarthritis

The aim of the present study was to determine the association between abdominal muscle strength and quality of life among older adults with lumbar osteoarthritis. A blind, cross-sectional study was conducted involving 40 older adults: 20 with lumbar osteoarthritis (12 women and 8 men, mean age of 65.90 ± 4.80 years) and 20 controls (14 women and 6 men, mean age of 67.90 ± 4.60 years). The volunteers were submitted to an abdominal muscle strength test. Quality of life was evaluated using the SF-36 questionnaire. Both abdominal muscle strength and quality of life scores were significantly lower in the group with lumbar osteoarthritis in comparison to the controls (p < 0.05). Moreover, significant and positive associations were found between abdominal muscle strength and the subscales of the SF-36 questionnaire (p < 0.05, 0.421 ≥ rs ≤ 0.694). Based on the present findings, older adults with lumbar osteoarthritis with greater abdominal muscle strength have a better quality of life.

Is physiotherapy self-referral with telephone triage viable, cost-effective and beneficial to musculoskeletal outpatients in a primary care setting?

OBJECTIVE

The aim of the present study was to establish if physiotherapy self-referral (SR) is viable, cost effective and beneficial to musculoskeletal outpatients in a primary care setting.

SETTING

In an urban National Health Service (NHS) primary care physiotherapy service, waiting times, attendance rates and treatment ratios (thus, episode-of-care costs) were deemed unsustainable. The introduction of 'Any Qualified Provider' is imminent and will drive NHS physiotherapy services to compete directly with private counterparts. Current literature, healthcare policy and the Chartered Society of Physiotherapy strongly advocate SR to promote value for money and improve the patient experience.

DESIGN

A repeated measure prospective cohort study introduced an SR pathway parallel to existing general practice (GP) referrals and compared costs, attendance and data relating to the patient experience across groups.

RESULTS

SR referral groups were found to have a higher proportion of female patients presenting with acute conditions. Cost minimization analysis indicated an average 32.3% reduction in episode-of-care cost with an SR-initiated intervention. An estimated cost minimization of between £84,387.80 and £124,472.06 was calculated if SR were to be expanded service-wide. SR referral reduced waiting times and improved patient satisfaction relating to waiting times and communication compared with traditional pathways.

CONCLUSIONS

The results of the present study showed that the introduction of the described SR pathway was feasible, cost-effective and offered comparable care. Certain aspects of the SR patient experience compared more favourably than those studied in traditional GP referral routes. They also added to an existing body of evidence supporting SR with a variety of administrative processes in various socioeconomic settings.