Allied Health Professionals and Work-Related Musculoskeletal Disorders: A Systematic Review

Comparison of the effectiveness of assisted turning mattresses and conventional air mattresses in relieving body pressure in different lying positions

Pressure ulcers are a common problem among individuals who, for medical reasons, must spend most of their day in bed. Manually turning a person's body is labor intensive and can easily cause occupational injuries. To compare the effectiveness of a new assisted turning mattress in pressure management with that of a conventional air mattress. This is a single-session crossover trial study. Twenty-four participants confined to bed were transferred onto the selected mattress (assisted turning or conventional air mattresses) in the selected position. Average interface pressures of bony prominences were measured after the participants laid on the mattress in different positions. After the data collection, they were transferred to the second mattress, and the process was repeated. Subjective feedback from participants and caregivers was also acquired immediately following a one-week trial period of assisted turning mattresses. The mean interface pressures were comparable for most body parts between two mattresses. Subjective feedback showed that assisted turning mattresses could relieve caregivers' workload but at the cost of patients' decreased feelings of safety. Assisted turning mattresses are equal to conventional air mattresses in pressure distribution. Proper pressure management through scheduled positional changes is required in assisted turning mattresses.

Toward the design of persuasive systems for a healthy workplace: a real-time posture detection

Persuasive technologies, in connection with human factor engineering requirements for healthy workplaces, have played a significant role in ensuring a change in human behavior. Healthy workplaces suggest different best practices applicable to body posture, proximity to the computer system, movement, lighting conditions, computer system layout, and other significant psychological and cognitive aspects. Most importantly, body posture suggests how users should sit or stand in workplaces in line with best and healthy practices. In this study, we developed two study phases (pilot and main) using two deep learning models: convolutional neural networks (CNN) and Yolo-V3. To train the two models, we collected posture datasets from creative common license YouTube videos and Kaggle. We classified the dataset into comfortable and uncomfortable postures. Results show that our YOLO-V3 model outperformed CNN model with a mean average precision of 92%. Based on this finding, we recommend that YOLO-V3 model be integrated in the design of persuasive technologies for a healthy workplace. Additionally, we provide future implications for integrating proximity detection taking into consideration the ideal number of centimeters users should maintain in a healthy workplace.

Prevalence and Risk Factors Associated with Chronic Occupational Low Back Pain among Healthcare Professionals Working at Hospitals: Exploratory Survey Study

Objective  This study aimed to describe the methodological process for developing a questionnaire to identify the prevalence and risk factors for chronic occupational low back pain in healthcare professionals working at hospitals. Method  An exploratory crossectional survey study was carried out in Belo Horizonte, MG, Brazil, and its metropolitan region, in two stages. Initially, the authors prepared a questionnaire based on the Roland Morris disability questionnaire and sent it to a committee of low back pain specialists for validation using the Delphi technique. The second stage consisted of sending the final questionnaire to health professionals working in a hospital environment for at least 2 years and presenting chronic low back pain for at least 3 months. Results  Validation occurred in two rounds of questionnaire adjustments by a panel consisting of physical therapists and physician experts in the field (orthopedists with more than 3 years of experience). Both rounds had 13 participants. The questionnaire initially consisted of 27 items, and, after validation, it had 19 items. The study included 65 subjects, with an average age of 40.91 years old and an average time working at a hospital of 40 hours per week. The total sample had 76.9% of physicians, 10.8% of physical therapists, and 12.3% of nurses or nursing technicians. Most (52.3%) subjects reported staying in uncomfortable positions affecting the lower back for 5 to 10 hours per day. Conclusion  We developed and validated, using the Delphi technique, a questionnaire on the prevalence and risk factors associated with chronic occupational low back pain among healthcare professionals working at hospitals. This unprecedented tool can benefit the population studied since the questionnaires currently used to evaluate chronic low back pain are not specific for investigating the occupational cause of this condition.

The compatibility of exoskeletons in perioperative environments and workflows: an analysis of surgical team members' perspectives and workflow simulation

Surgical team members in perioperative environments experience high physical demands. Interventions such as exoskeletons, external wearable devices that support users, have the potential to reduce these work-related physical demands. However, barriers such as workplace environment and task compatibility may limit exoskeleton implementation. This study gathered the perspectives of 33 surgical team members: 12 surgeons, four surgical residents, seven operating room (OR) nurses, seven surgical technicians (STs), two central processing technicians (CPTs), and one infection control nurse to understand their workplace compatibility. Team members were introduced to passive exoskeletons via demonstrations, after which surgical staff (OR nurses, STs, and CPTs) were led through a simulated workflow walkthrough where they completed tasks representative of their workday. Five themes emerged from the interviews (workflow, user needs, hindrances, motivation for intervention, and acceptance) with unique subthemes for each population. Overall, exoskeletons were largely compatible with the duties and workflow of surgical team members.

The Potential Relationship Between a Cognitive Dissonance State and Musculoskeletal Injury: A Systematic Review

OBJECTIVE

The objective of this systematic review was to investigate the potential link between cognitive dissonance or its related constructs (emotional dissonance, emotional labor) and musculoskeletal disorders.

BACKGROUND

The etiology of musculoskeletal disorders is complex, as pain arises from complex interactions among physical, social, and psychological stressors. It is possible that the psychological factor of cognitive dissonance may contribute to the etiology and/or maintenance of musculoskeletal disorders.

METHOD

MEDLINE, APA PsycInfo, and CINAHL Plus databases were searched for studies investigating cognitive dissonance or its related constructs as exposure(s) of interest and outcomes related to physical health (including, but not limited to, musculoskeletal pain). Risk of bias was assessed using the Appraisal tool for Cross-Sectional Studies (AXIS) tool.

RESULTS

The literature search yielded 7 studies eligible for inclusion. None of the included studies investigated cognitive dissonance directly but instead investigated dissonance-related constructs of emotional dissonance and emotional labor, in which a mismatch between required and felt emotions might elicit a psychological response consistent with the cognitive dissonance state. Moderate effect sizes between dissonance-related constructs and musculoskeletal disorders were noted (OR 1.25-2.22).

CONCLUSION

There is likely a relationship between the two factors studied. However, as the included studies were cross-sectional in nature, a causal relationship between cognitive dissonance-related constructs and musculoskeletal disorders cannot be inferred. Therefore, future study proposing and validating a causal pathway between these variables is warranted.

APPLICATION

Cognitive dissonance and its related constructs may serve as risk factors for musculoskeletal disorders that have not been considered previously.

Prevalence of shoulder pain and its correlates in Jeju agricultural population: A retrospective cross-sectional study

The aim of this study was to investigate the prevalence of shoulder pain and analyze its association with socio-demographic factors, agricultural work-related conditions, and biomechanical factors among farmers on Jeju Island. We utilized initial survey data from the Safety for Agricultural Injury of Farmers' cohort study involving adult farmers on Jeju Island. The presence and characteristics of shoulder pain, socio-demographics, agricultural work-related conditions, and biomechanical factors were assessed using semi-structured questionnaires. A total of 1206 participants were analyzed for prevalence and associated risk factors using frequency and multivariate logistic regression analyses. The overall prevalence of shoulder pain was 17%. Multivariate logistic regression analysis, adjusted for significant socio-demographic and agricultural work-related condition variables, revealed that stress level, type of farming, and experiencing an agricultural injury within the preceding year were significantly associated with shoulder pain (stress level: "occasional," adjusted odds ratio [aOR], 1.581; 95% confidence interval [CI], 1.079-2.318; "frequent," aOR, 1.964; 95% CI, 1.205-3.200; and "extreme," aOR, 2.999; 95% CI, 1.480-6.074 vs "rarely"; type of farming: "orchard," aOR, 0.82; 95% CI, 0.597-1.124; "livestock," aOR, 0.225; 95% CI, 0.079-0.641 vs "field"; and experienced an agricultural injury within the past year: "yes," aOR, 2.078; 95% CI, 1.269-3.405). In addition, 3 biomechanical factors significantly contributed to shoulder pain: activities requiring significant power such as shoveling, pickaxing, and hammering; repetitive use of a particular body part; and constant elevation of the arm above the head. The findings highlight the importance of postural education, injury prevention, and psychological support in managing shoulder pain among farmers.

Prevalence and risk factors of work-related musculoskeletal disorders among physical therapists in Ho Chi Minh City, Vietnam

BACKGROUND

Understanding risk factors linked to work-related musculoskeletal disorders (WMSDs) is crucial for enhancing health promotion and ensuring workplace safety among healthcare professionals particularly physical therapists (PTs). However, in Vietnam, there has been lack of an investigation. Therefore, this study was to determine whether potential risk factors contributed to the occurrence of WMSDs among PTs in Ho Chi Minh City.

METHOD

An online self-reported questionnaire for WMSDs comprising the Nordic Musculoskeletal Questionnaire (NMQ), Job-risk and Environmental factors, the Perceived Stress Scale (PSS-4) and the coping strategies, were distributed to PTs. They were enrolled if they had: age ≥ 22 years, graduated from PT program, a full-time job with ≥1 year of experience. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were determined using Logistic regression.

RESULTS

Our study found that within the past 12 months, the prevalence of WMSDs was 76.4% (n = 204/267): neck 58.4% and lower back 57.3%. PTs aged 22-29 years, < 4 years of education, and < 7 years of working experience were more likely to have WMSDs 2-3 times than those who did not. After adjusting for age, education, and work experience, PTs who engaged in manual techniques/exercises, lifting/transferring patients, and maintaining awkward postures were 5-7 times more likely to have WMSDs in the neck and lower back than those who did not. Environmental and psychological factors, such as number of treatment tables, size of electrotherapy rooms, using PTs modalities, and stress were significantly associated with WMSDs. More than 50% of PTs used modified positions and new treatment/techniques that did not aggravate their symptoms, as coping strategies.

CONCLUSIONS

This study indicates potential risk factors associated with WMSDs, affecting the neck and lower back among PTs in Vietnam. These risk factors should be addressed to improve overall PTs health, retain skilled workers, and encourage them to continue working.

Assessment and evaluation of work-related musculoskeletal disorders among nuclear medicine professionals in India: A cross-sectional study

BACKGROUND

Musculoskeletal disorders (MSDs) are a severe occupational health issue among medical radiation practitioners. It is mostly linked to personal protective wear, working posture, tools employed and ergonomics.

OBJECTIVE

To assess and evaluate the musculoskeletal disorders among nuclear medicine professionals (NMP) in India.

METHODS

An online survey was distributed to 455 NMP throughout India between November 2021 and March 2022 covering the demographic characteristics and questions for evaluation of musculoskeletal symptoms using the Standardized Nordic Musculoskeletal Questionnaire (NMQ). Participants with any pre-existing musculoskeletal disorder or trauma were excluded. Descriptive statistics summarized the data from the demographics, discomfort, aches and work-related musculoskeletal injuries. Chi-square test was used to examine the association between the obtained values.

RESULTS

91 out of 124 respondents were included based on the inclusion and exclusion criteria. Results shows that there is a significant association between the height of the individual and neck pain, body mass index and elbows pain, age and low back pain, experience in the current work and upper back pain, the weight of the individual and knee pain, use of mobile lead screens and shoulder pain, use of gonad shield, trouble in the ankles and use of lead screens, and QC phantoms for gamma camera / PET and wrists/hands pain.

CONCLUSION

Work-related musculoskeletal disorders among NMP are resulting from factors of individual demographic variables (such as age, height, weight, body mass index), years of experience at the current workplace and of using instruments in their work area.

The association between adverse ergonomic factors and work-related musculoskeletal symptoms among medical staff in China: a cross-sectional study

We investigated the prevalence of work-related musculoskeletal symptoms (WMSs) among medical staff and evaluated the associations of different levels of adverse ergonomic factors with WMSs. A total of 6099 Chinese medical staff were asked to complete a self-reported questionnaire to assess the prevalence and risk factors of WMSs from June 2018 to December 2020. A prevalence rate of 57.5% was observed for WMSs among overall medical staffs, which mainly affected the neck (41.7%) and shoulder (33.5%). 'Keeping sitting for long hours very frequently' (OR = 1.26, 95% CI: 1.04, 1.53) was positively associated with WMSs in doctors, while 'keeping sitting for long hours occasionally' (OR = 0.91, 95% CI: 0.85, 0.97) was identified as a protective factor of WMSs in nurses. The associations of adverse ergonomic factors, organisational factors, and environmental factors with WMSs were different among medical staff in different positions.Practitioner summary: We conducted a multi-city study concerning the risk factors of WMSs by carrying out a face-to-face one-to-multiple questionnaire survey among medical staff in China. As a risk factor of WMSs in medical staff, adverse ergonomic factors should be paid more attention by the standard setting department and policy makers.Abbreviations: WMSDs: work-related musculoskeletal disorders; WMSs: work-related musculoskeletal symptoms; MSDs: musculoskeletal disorders; NMQ: Nordic Musculoskeletal Questionnaires; DMQ: Dutch Musculoskeletal Questionnaires; NIOSH: National Institute for Occupational Safety and Health; ORs: odds ratios.

Efficacy of Interventions in Reducing the Risks of Work-Related Musculoskeletal Disorders Among Healthcare Workers: A Systematic Review and Meta-Analysis

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) are prevalent among healthcare professionals, including nurses, therapists, doctors, and paramedics, due to the potential injuries incurred during patient transfer and handling. This review aimed to assess the effectiveness of existing interventions in reducing the risks of WMSDs in this population.

METHODS

Four databases including PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect were searched to identify randomized and nonrandomized controlled trials, as well as studies with pre-post design. Two reviewers independently extracted data and assessed the quality of the included studies using the Effective Public Health Practice Project criteria. A meta-analysis was performed to obtain quantitative results.

RESULTS

A total of 40 studies were included in the review. Among the interventions, motorized assistive devices showed the most significant relative reduction in WMSD risks (p < .0000; standardized mean difference [SMD] = -3.32, 95% confidence interval [CI] = [-4.53, -2.12]), followed by combined interventions of cognitive and exercise (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), combined intervention of cognitive and assistive device intervention (p = .02; SMD = -0.77, 95% CI = [-1.42, -0.12]), nonmotorized assistive device (p = .02; SMD = -0.63, 95% CI = [-1.15, -0.12]), cognitive intervention (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), and physical exercise (p = .06; SMD = -0.16, 95% CI = [-0.32, 0.00]) intervention.

CONCLUSION

The overall evidence indicates that interventions have a significant effect in reducing the risk of WMSDs among healthcare workers, with motorized assistive devices showing the most promising results. The findings from this review can provide valuable guidance for hospital administrators, policymakers, and other experts in implementing effective strategies to prevent WMSDs among healthcare professionals.

Facilitators and barriers for using outdoor areas in the primary work tasks of eldercare workers in nursing homes

BACKGROUND

Eldercare workers in nursing homes report high musculoskeletal disorders, stressful work, and sickness absence. Initiatives that can accommodate these issues are needed. Current studies point out that nature contact may offer a range of human health benefits, potentially promoting healthier work among eldercare workers. Therefore, this study aimed to investigate facilitators and barriers for using outdoor areas as part of the daily work among eldercare workers in Danish nursing homes.

METHODS

In this multiple case study, we collected data from three nursing homes, conducting three semi-structured focus group interviews with eldercare workers and three individual interviews with nursing home managers. Furthermore, we conducted observations of the daily work and mappings of the nursing homes' outdoor environments to gain in-depth knowledge of eldercare workers' and managers' perspectives on using outdoor areas in their daily work. The data was thematically analysed using 'The Behaviour Change Wheel' (BCW), more specifically the COM-B model, as a theoretical foundation for exploring facilitators and barriers for the use of outdoor areas.

RESULTS

Frequently mentioned facilitators were facilities, traditions or repetitive events, positive experiences with residents ('star moments'), and knowledge about the residents. Frequently mentioned barriers were insufficient staffing, hierarchy in the work tasks, professional identity, and lack of ideas.

CONCLUSIONS

The identified facilitators and barriers should be considered when designing initiatives for increased use of outdoor areas or activities of eldercare workers.

TRIAL REGISTRATION

According to the Danish ethics committee (Law of committee, (komitéloven) paragraph 14, Sect. 2), qualitative interviews, which do not include human biological materials, do not need neither approval by ethical and scientific committee or informed consent (The Danish National Centre for Ethics).

Association of electronic learning devices and online learning properties with work-related musculoskeletal disorders (WMSDs): A cross-sectional study among Thai undergraduate students

Computers and mobile devices are becoming the primary instruments used by students worldwide in all facets of their working and learning activities. This study aimed to investigate the relationship between the use of electronic devices, the characteristics of learning properties, and the potential predictors of work-related musculoskeletal disorders (WMSDs) among Thai undergraduate students. In this cross-sectional study, data were collected using Microsoft Forms with an online self-administered scale. The research instrument comprised four categories: demographic and health history characteristics, online learning properties, psychological health, and perceived WMSDs. Using multistage sampling, 4,618 samples were collected from 18 schools nationwide. A total of 3,705 respondents were eligible for the analysis. Descriptive statistics, chi-square, and binary logistic regression analyses were used for the data analysis. The results showed that the majority of the respondents had online learning only in some semesters/subjects (67.3%), used mobile phones for learning (43.3%), had an appropriate desk workstation (66.1%), used non-office chairs (76.0%), spent prolonged periods sitting (91.6%), had a bent posture while sitting (78.2%), had a private working space/room (92.4%), had proper lighting (85.4%), and experienced normal levels of stress (81.1%). Overall, 42.1% of Thai university students experienced WMSDs in any area of the body in the prior 6 months. Six significant predictors (p = 0.05) of WMSDs were obtained from the multivariate analysis, including stress, use of electronic devices, bent posture, prolonged sitting, year of study, and online learning classes (The adjusted odds ratio ranged from 1.43 to 3.67). High-risk students who mostly used mobile learning devices should be prescribed interventions to reduce stress, develop postural awareness and skills, emphasize positioning solutions, and reduce extended sitting time. The results indicated that preventive measures are warranted and required because the risk predictors were identified as preventable.

Development of an Evaluation System for Transfer Care Skills Using Embroidered Body Pressure and Proximity Sensor

OBJECTIVE

It is important to improve caregiving skills to help reduce the strain on inexperienced caregivers. Previous studies on quantifying caregiving skills have predominantly relied on expensive equipment, such as motion-capture systems with multiple infrared cameras or acceleration sensors. To overcome the cost and space limitations of existing systems, we developed a simple evaluation system for transfer care skills that uses capacitive sensors composed of conductive embroidery fibers. The proposed system can be developed with a few thousand US dollars.

METHOD

The developed evaluation system was used to compare the seating position and velocity of a care recipient during transfers from a nursing-care bed to a wheelchair between groups of inexperienced and expert caregivers. To validate the proposed system, we compare the motion data measured by our system and the data obtained from a conventional three-dimensional motion-capture system and force plate.

RESULTS

We analyze the relationship between changes in the center of pressure (CoP) recorded by the force plate and the center of gravity (CoG) obtained by the developed system. Evidently, the changes in CoP have a relation with the CoG. We show that the actual seating speed ([Formula: see text] measured by the motion-capture system is related to the speed coefficient calculated from our sensor output. A significant difference exists in [Formula: see text] between the inexperienced group and the physical therapists/occupational therapists' group.

CONCLUSIONS

The proposed system can effectively estimate a caregiver's skill level in transferring patients from a bed to a wheelchair in terms of the seating position and velocity.

Effects of different bed heights on the physical burden of physiotherapists during manual therapy: an experimental study

This study aimed to determine the effect of physiotherapists' physical burden caused by different bed heights during manual therapy. Thirty-three male physiotherapists performed tasks simulating lumbar massage and passive hip abduction range-of-motion exercise (ROM) on the beds with low height (LH) and adjusted height (AH), with each task performed three times. The anterior inclination angle of the physiotherapist's trunk was measured, the surface electromyograms of the erector spinae and trapezius muscles were recorded, and perceived stress was assessed. The indexes obtained were statistically compared for different bed heights. Additionally, the lumbar disc compression force and flexion torque were estimated. The lumbar burden caused by the excessive bending and the biomechanical burden and perceived stress were stronger at LH than AH. In ROM tasks using the right hand, the muscle activity was lower at the left lumbar region at LH than at AH. At LH, the anterior inclination angle increased and the lumbar muscle activity declined as the number of tasks increased. The burden on the shoulders was not significantly different by bed heights. Our results showed that, when physiotherapists perform manual therapy, it is necessary to adjust the bed height to reduce physical burden and ensure higher quality of service.

Characterization of upper limb use in health care workers during regular shifts: A quantitative approach based on wrist-worn accelerometers

Despite the high prevalence of upper limb (UL) work-related musculoskeletal disorders (WRMSD) among health care workers (HCWs), little is known about their relationship with exposure to biomechanical risk factors. This study aimed to assess UL activity features under actual working conditions using two wrist-worn accelerometers. Accelerometric data were processed to obtain duration, intensity, and asymmetry of UL use in 32 HCWs during the execution of commonly performed tasks (e.g., patient hygiene, transfer, and meal distribution) within a regular shift. The results show that such tasks are characterized by significantly different patterns of UL use, in particular, higher intensities and larger asymmetries were observed respectively for patient hygiene and meal distribution. The proposed approach appears, thus, suitable to discriminate tasks characterized by different UL motion patterns. Future studies could benefit from the integration of such measures with self-reported workers' perception to elucidate the relationship between dynamic UL movements and WRMSD.

Prevalence, workplace risk factors and coping strategies of work-related musculoskeletal disorders among healthcare workers in tertiary care hospitals

BACKGROUND

Musculoskeletal disorders cause a significant occupational problem for healthcare workers (HCWs).

OBJECTIVE

This study aimed to measure the prevalence, associated occupational risk factors and coping strategies for work-related musculoskeletal disorders among HCWs working in five hospitals in Faisalabad, Pakistan.

METHODS

A previously used validated questionnaire, which consisted of four sections, including demographic information, occupational health questions, and associated occupational risk factors and coping strategies, was used as a survey tool to collect data on health workers working in five hospitals located in the Faisalabad District.

RESULTS

The finding of this study revealed that 7-day and 12-month prevalence rates of WMSDs were 1226 (83.45%) and 1107 (75.35%) respectively among HCWs and most common WMSDs was low back pain 576 (39.2%) followed by the neck 217 (15%) and ankles 186 (13%) according to body sites. The probability of developing WRMSDs was higher among physiotherapists (OR = 3.63, 95% CI: 1.39-9.51), participants with rank 18 (OR = 4.17, 95% CI: 2.18-7.96), and HCWs who work in primary care (OR = 8.94, 95% CI: 3.47-23.04). The most important risk factor reported was treating an excessive number of patients in one day (66.8%). The main coping strategies reported in this study were to get someone else to help in handling a heavy patient (90%).

CONCLUSIONS

This study found that the most prevalent WMSD among HCWs was lower back pain. Sedentary lifestyle was shown to be a positive risk factor for acquiring WMSDs. Additionally, the primary risk factor discovered was treating an excessive number of patients, probably owing to a shortage of healthcare staff.

Risk factors for neck pain-induced disability among primary healthcare workers: A pilot study

BACKGROUND

Neck pain (NP) is associated with high disability rates among healthcare workers.

OBJECTIVE

To determine the potential risk factors associated with disability due to NP among healthcare staff working in primary care settings.

METHODS

This 30-day prospective cross-sectional study involved a survey of 63 healthcare personnel (55 women and 8 men aged 45.30±12.34 years) of two primary healthcare centers in Serbia, who completed a general questionnaire developed for this purpose along with the Neck Disability Index (NDI), whereby the potential predictors of NP-related disability were assessed using the statistical package SPSS ver. 24.

RESULTS

Female healthcare workers achieved a higher score on the NDI scale (Me = 8.00, p < 0.05), as did older respondents (r = 0.260, p < 0.05), those with longer work experience (r = 0.323, p < 0.05), and those that wear prescription glasses (Me = 9.00, p < 0.01). Higher NDI scores were also achieved by respondents that suffered from neck pain at the time of the study (Me = 12.50, p < 0.001), especially if they relied on pain medication (Me = 13.00, p < 0.05), and topical analgesic creams (Me = 12.50, p < 0.05) for treating neck pain.

CONCLUSION

Female sex, older age, greater work experience, current neck pain, use of pain-relieving medications and creams, and need for prescription glasses to correct vision increase the risk of disability due to pain in the cervical spine among healthcare workers.

Effects of stretching intervention on musculoskeletal pain in dental professionals

OBJECTIVE

This study aimed to quantitatively confirm the effects of dental specialists' work and stretching on musculoskeletal pain.

METHODS

The pain pressure threshold was divided into five parts (neck, shoulder, trunk, lower back, and hand/arm) of the upper body and measured at 15 muscle trigger points. The pain pressure threshold before and after work was measured, and 30 min of stretching and rest were stipulated as an intervention.

RESULTS

The pain pressure thresholds reduced significantly in all muscles after work (P < .05). In the stretching group, the pain pressure thresholds increased significantly in all muscles (P < .05). In particular, the iliocostalis lumborum (lower back), rhomboid (trunk), transverse carpal ligament (hand/arm), levator scapulae-superior angle (neck), and upper trapezius (shoulder) muscles showed the greatest decrease in pain pressure threshold after work and the greatest increase after stretching.

CONCLUSIONS

Stretching helps immediately relieve musculoskeletal pain in dental professionals and can prevent and manage work-related musculoskeletal disorders.

Shoulder work-related musculoskeletal disorders and related factors of workers in 15 industries of China: a cross-sectional study

Background

Changes in modern industrial production practices can easily lead to shoulder work-related musculoskeletal disorders (WMSD). The current reports on shoulder WMSD are limited to some industries are less well studied, and the sample size is usually small. This study aimed to describe the prevalence and severity of shoulder WMSD in a large sample of Chinese workers from 15 industries, analyze the possible correlations with sociodemographic and work-related variables, and compare the differences between industries.

Methods

A cross-sectional study was conducted among a sample of 55,749 participants from 252 enterprises in 15 industries throughout China. A Chinese version of the musculoskeletal disease questionnaire was used to collect the demographic factors, shoulder symptoms in past 12 months, and work-related factors including posture-related factors, repetition, vibration, work organization, job control, and environmental factors as independent variables. Descriptive statistics were used, and the binary logistic regression analysis was performed to explore the association between shoulder WMSD and potential demographic and work-related factors.

Results

Nearly 35.5% of participants reported shoulder pain and discomfort in the previous 12 months. Biopharmaceutical manufacturing (56.2%), medical services (54.4%), and aviation services (50.1%) were the three industries with the highest prevalence of shoulder WMSD. The pain score of aviation services workers was the highest. The related factors for shoulder WMSD varied among the different industries.

Conclusion

Our study found a relatively high prevalence of shoulder WMSD in China. There were large differences in the prevalence of shoulder WMSD among industries, and the related factors were particular to each industry. Such information is useful to help occupational health practitioners and policymakers conduct preventive programs to reduce shoulder disorders in these working populations.

Experimental Analysis of Handcart Pushing and Pulling Safety in an Industrial Environment by Using IoT Force and EMG Sensors: Relationship with Operators' Psychological Status and Pain Syndromes

Non-ergonomic execution of repetitive physical tasks represents a major cause of work-related musculoskeletal disorders (WMSD). This study was focused on the pushing and pulling (P&P) of an industrial handcart (which is a generic physical task present across many industries), with the aim to investigate the dependence of P&P execution on the operators' psychological status and the presence of pain syndromes of the upper limbs and spine. The developed acquisition system integrated two three-axis force sensors (placed on the left and right arm) and six electromyography (EMG) electrodes (placed on the chest, back, and hand flexor muscles). The conducted experiment involved two groups of participants (with and without increased psychological scores and pain syndromes). Ten force parameters (for both left and right side), one EMG parameter (for three different muscles, both left and right side), and two time-domain parameters were extracted from the acquired signals. Data analysis showed intergroup differences in the examined parameters, especially in force integral values and EMG mean absolute values. To the best of our knowledge, this is the first study that evaluated the composite effects of pain syndromes, spine mobility, and psychological status of the participants on the execution of P&P tasks-concluding that they have a significant impact on the P&P task execution and potentially on the risk of WMSD. The future work will be directed towards the development of a personalized risk assessment system by considering more muscle groups, supplementary data derived from operators' poses (extracted with computer vision algorithms), and cognitive parameters (extracted with EEG sensors).

Interventions to prevent and reduce work-related musculoskeletal injuries and pain among healthcare professionals. A comprehensive systematic review of the literature

INTRODUCTION

Work-related musculoskeletal disorders (WMSDs) are among the main causes of injury and pain in healthcare professionals. Previous reviews provided a fragmented view of the interventions available for WMSDs. This review aims to provide a comprehensive description of interventions for preventing and reducing work-related musculoskeletal injuries and/or pain among healthcare professionals, and to assess the methodological quality of studies.

METHODS

A systematic literature review was performed, based on the Effective Public Health Practice Project process. A comprehensive search was conducted on six peer-reviewed databases and manually. The methodological quality of the studies included was rated as weak, moderate, or strong. The studies were organized based on the 2019 classification of the interventions by Oakman and colleagues.

RESULTS

Twenty-seven articles were included reporting individual (n = 4), task-specific (n = 4), work organization and job design (n = 2), work environment (n = 1), and multifactorial (n = 16) interventions. Overall quality rating was strong for 6 studies, moderate for 16, and weak for 5. Individual interventions such as neuromuscular and physical exercise were effective in reducing pain. Task-specific and work organization interventions could prevent certain injuries. Significant reduction of both injuries and pain resulted from multifactorial interventions, which were reported by the majority of strong (n = 5) and moderate (n = 10) quality articles.

CONCLUSIONS

This review provides healthcare professionals with evidence-based information to plan interventions targeted towards reducing WMSDs. In particular, more efforts are needed to implement and extend effective multifactorial interventions. Moreover, studies about each professional healthcare target group are needed.

PRACTICAL APPLICATION

Our results can guide policy-makers, healthcare managers and professionals to choose the best strategies to prevent and reduce WMSDs and to shape continuous education programs. This study prompts clinicians to develop inter-professional collaborations and to practice physical activities in order to reduce WMSDs.

Rasch analysis of the Oxford shoulder score in a non-surgical occupational population

BACKGROUND: The Oxford shoulder score (OSS) questionnaire for measuring patient perception of shoulder disability, has not tested specifically in a non-surgical population and no study has assessed the OSS with modern psychometrics based on Rasch model (RM). OBJECTIVE: To assess the psychometric properties of the OSS using RM among health-care workers with shoulder disorders and to verify its interest in a non-surgical population. METHODS: In an occupational health department of a French hospital center, a retrospective review was performed of the medical records from June 2019 to October 2020. Responses to 110 questionnaires were examined from 55 subjects (97% of women). A polytomous Rasch model based on the Partial Credit Model was used. RESULTS: Overall fit was satisfactory, the reliability coefficient was high and an ascending order was observed with the 5 categories of the scale. Analysis of the residuals supports unidimensionality and the local independence assumption. Item performance remained stable across the subgroup examined (DIF measures). Scale to-sample targeting indicated a substantial floor effect, and the mildest impairments were not well discriminated. CONCLUSIONS: OSS presents good psychometric qualities. However, it does not clearly discriminate subjects presenting the lowest levels of impairment. Its use in a non-surgical population is questionable.

Investigating factors affecting musculoskeletal disorders: Predictive models for identifying caregivers at risk

BACKGROUND: Musculoskeletal disorders (MSDs) are the most common work-related injuries identified among caregivers in the health sector as a high-risk group. OBJECTIVES: The study aimed to investigate the factors that influence musculoskeletal disorders among caregiver and to evaluate the relationship between work and non-work related factors with MSDs. METHODS: Data were collected from 104 caregivers using descriptive design and stratified cluster sampling. The survey included a demographic questionnaire and a Nordic Standardized Musculoskeletal Questionnaire. Logistic regression was performed to determine the risk factors associated with MSDs. The Odds ratio (OR) was calculated to define the influence of each risk factors. In addition, we used forward logistic regression analysis to validate the predictive model. RESULTS: In this cross-sectional survey, the results showed that 70 (67.3%) participants reported MSDs. MSD was highest at the lower back (46%), then knee (15.4%) and shoulder (11.5%). The overall success of the prediction is 90.4% (94.6 for having MSDs). The most important risk factors were manual handling (p < 0.001, odds ratio = 45.64) followed by bending (p = 0.008, odds ratio = 39.4). CONCLUSIONS: The results of this study reaffirmed the high prevalence of work-related MSD among caregiver’s primarily in the lower back. The most important risk factors were manual handling, followed by bending / twisting, and handling of an excessive number of patients. Therefore, it is necessary to consider appropriate policies for managing MSDs among caregivers.

Work-related musculoskeletal complaints in massage practitioners

BACKGROUND: Work-related musculoskeletal complaints (WMSCs) are induced or aggravated by work activities and/or work conditions. OBJECTIVE: The aim was to evaluate the impact of work as a massage practitioner, with a special emphasis on WMSCs. METHODS: Massage practitioners were invited to participate in the study through an advert in the rehabilitation medical clinics. The participants completed a self-administered questionnaire, collecting general data and questions about WMSCs. RESULTS: Thirty-seven subjects (88.09%) reported pain in at least one body part in the last 4 weeks. The most common WMSCs was pain in the neck region (69.04%), followed by pain in the shoulder region (54.76%), upper back (52.38%), lower back (40.48%), wrist-hand (33.33%) and elbow (21.43%). The massage practitioners aged between 21 and 30 years old reported significantly more frequently WMSCs localized in neck, shoulders, wrist-hand, upper back and lower back. CONCLUSIONS: This study shows that WMSCs are widely reported among massage practitioners. The most common complaints were reported in the neck and shoulder regions, especially in younger massage practitioners.

Frequency of musculoskeletal complaints and their associated risk factors among computer workers

BACKGROUND: Computer-related work has become a part of the daily routine of workers of many occupations which leads to pains of multiple parts of the musculoskeletal system. OBJECTIVES: To examine the frequency and severity of musculoskeletal complaints of different regions of the body, and to examine the relationship between work-related risk factors with musculoskeletal complaints. METHODS: Three hundred and twenty-six computer workers were selected by non-probability purposive sampling from three clusters of computer sectors. The study design was a descriptive cross-sectional study. Respondents were interviewed and their height and weight were measures. Confidentiality was assured. RESULTS: The most common musculoskeletal complaints were shoulder (45%), neck (43%), and upper-middle back (36%) pain. The complaints were related to the female gender, increase duration of computer and using a computer at home. CONCLUSIONS: Musculoskeletal complaints and psychosocial stresses were related to increasing the duration of computer work.

Prevalence of and prevention for work-related upper limb disorders among physical therapists: a systematic review

Background

Physical therapists (PTs) are at increased risk for development of work-related upper limb disorders (WRULDs) due to the physically intensive, constant hands-on nature of the profession. The objectives of this systematic review were to examine the literature on WRULDs among PTs, specifically the (1) 1-year prevalence, (2) workplace risk factors, (3) consequences, and (4) coping strategies utilized to mitigate WRULDs.

Methods

A comprehensive search of the literature was performed using PubMed, CINHAL, EMBASE, and Google Scholar. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for conducting this systematic review. Studies that reported the 1-year prevalence of WRULDs among PTs, workplace risk factors for WRULDs, consequences of WRULDs, and coping strategies utilized by PTs were included.

Results

Twelve studies met the inclusion criteria. The 1-year WRULDs prevalence rates varied widely, with thumb disorders having the highest prevalence (7.6-52.5%), followed by wrist and hand disorders (5-66.2%), shoulder disorders (3.2-45.2%), and elbow disorders (4-16%). Reported risk factors included treating a high volume of patients and frequent performance of manual therapy techniques. Consequences included interference with PTs’ personal and professional activities while coping strategies involved alterations to the work environment, techniques used, and workload.

Conclusions

WRULDs remain a persistent threat to the PT workforce, likely due to the hands-on, physically intensive nature of professional activities. An essential strategy to reduce WRULDs is to improve clinicians’ awareness of WRULDs, workplace risk factors, and subsequent consequences of WRULDs. Effective coping strategies are critical to preserve, protect, and prolong PTs’ use of the upper limbs.

The association between work-related physical and psychosocial factors and musculoskeletal disorders in healthcare workers: Moderating role of fear of movement

Objectives

Knowledge is lacking on the interaction between fear of movement (FOM) and work‐related physical and psychosocial factors in the development and persistence of musculoskeletal disorders (MSDs).

Methods

In this cross‐sectional study, 305 healthcare workers from several Belgian hospitals filled out a questionnaire including sociodemographic factors, work‐related factors (social support, autonomy at work, workload, and physical job demands), FOM, and MSDs for different body regions during the past year. Path analysis was performed to investigate (1) the association between the work‐related factors, FOM and MSDs, and (2) the moderating role of FOM on the association between the work‐related factors and MSDs among healthcare workers.

Results

Complaints were most frequently located at the neck–shoulder region (79.5%) and lower back (72.4%). Physical job demands (odds ratio [OR] 2.38 and 95% confidence interval [CI] 1.52–3.74), autonomy at work (OR 1.64 CI [1.07–2.49]) and FOM (OR 1.07 CI [1.01–1.14] and OR 1.12 CI [1.06–1.19]) were positively associated with MSDs. Healthcare workers who experienced high social support at work (OR 0.61 CI [0.39–0.94]) were less likely to have MSDs. Fear of movement interacted negatively with workload (OR 0.92 CI [0.87–0.97]) and autonomy at work (OR 0.94 CI [0.88–1.00]) on MSDs.

Conclusions

Work‐related physical and psychosocial factors as well as FOM are related to MSDs in healthcare workers. FOM is an important moderator of this relationship and should be assessed in healthcare workers in addition to work‐related physical and psychosocial factors to prevent or address MSDs.

The Experiences of Ghanaian Midwives on the Use of Nonadjustable Delivery Beds: A Qualitative Study

Background

Hospital beds are of great assistance to both clients and caregivers as they give lots of choices to the users. More often, clients have difficulty getting in and out of beds, but the adjustable features of the beds make it possible for them to be comfortable, regardless of their condition. This situation may not be the same if nonadjustable delivery beds (NADBs) are used in conducting deliveries at health care facilities. This study explored the experiences of midwives using NADBs in selected Christian Health Association of Ghana (CHAG) hospitals in the Volta Region of Ghana.

Methods

The study employed an exploratory qualitative research design with purposive sampling. Semistructured interview data were audio recorded. The inclusion criteria were professional midwives with at least 1 year of working skills and the midwives should have conducted deliveries using NADBs during their practice. Data were collected concurrently with data transcription and analyzed using content analysis. Saturation was reached after the 20th interview.

Results

Three themes emerged from the study: NADBs not comfortable to work with, assumption of awkward postures, and the nature of the delivery beds.

Conclusion

The findings of the study show that midwives experience several setbacks in the use of NADBs in conducting deliveries as they sacrifice their health for work.

Work-related musculoskeletal pain in prosthetists and orthotists: a comparison between Australia and other countries

BACKGROUND

Musculoskeletal pain (MSP) is a substantial societal and personal burden resulting in loss of employment and reduced productivity. Prosthetics and orthotics professionals working in Australia have previously reported a high prevalence of MSP; however, little is known about the prosthetic and orthotic communities in other countries.

OBJECTIVES

To explore the prevalence and range of workplace exposures associated with MSP in a convenience sample of the international prosthetic and orthotic profession.

STUDY DESIGN

A cross-sectional study using a convenience sample was conducted with prosthetists and orthotists worldwide.

METHODS

Prosthetists and orthotists were invited to participate in a survey to explore work-related factors associated with MSP. Bivariate and regression modelling was used to examine associations between self-reported demographic and workplace characteristics including job satisfaction, work-life balance, and physical and psychosocial hazards.

RESULTS

Seventy-six percent of respondents (n = 173) reported MSP in the previous 6 months. However, MSP was associated with different factors in Australia compared with other countries. Among Australia-based prosthetists and orthotists, MSP was associated with sex, physical hazards, and psychosocial hazards. For the international sample, MSP was only associated with length of employment.

CONCLUSIONS

Three-quarters of all respondents reported having MSP. Differences in associations between MSP and other factors by respondents' geographical location suggest the need for context-specific identification of hazards to enable the development of targeted and contextually appropriate prevention strategies.

Prevalence of musculoskeletal injury and pain of UK-based podiatrists and the impact of enforced altered working practices

Background

Occupational musculoskeletal injuries are prevalent in healthcare workers and are reported to be profession-specific. There is, however, a paucity of information around the injuries sustained from working as a podiatrist. This paper looks at the incidence of injury from working as a podiatrist, the aggravating factors to sustain these injuries and whether the changes in workload due to the COVID-19 pandemic altered the incidence.

Methods

A modified work based musculoskeletal injury questionnaire was distributed in the UK via podiatry led social media platforms. Open and Closed questions explored the demographics of the sample, perceived injury 12 months prior to the COVID-19 pandemic and then 6 months into the lockdown. Pre and post COVID-19 data were analysed for differences and thematic analysis was included to categorise reported experiences.

Results

148 podiatrists representing 3 % of HCPC registered practitioners responded to the questionnaire. Employment status altered as a result of the COVID-19 pandemic with a 13 % reduction in those working full time. Environments also changed with domiciliary and telehealth significantly increasing (p > 0.00) and non-clinical roles being extended (p > 0.002). Pain frequency and intensity significantly (p > 0.04) increased as a result of the pandemic with shoulder pain being most frequent before lockdown altering to the neck during the lockdown. Two main themes were identified that were attributed to the causes of pain including physical demands and working in awkward spaces.

Conclusions

Work-related musculoskeletal pain in podiatrists is common with the shoulder and neck being the most frequently affected. Changes in work practices due to the restrictions enforced from the COVID-19 pandemic increased the frequency and intensity of pain mostly associated with increased domiciliary and telehealth working environments.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13047-021-00491-7.

Quality of life in dental hygienists using complementary alternative medicine approaches for work-related musculoskeletal disorders

OBJECTIVES

The use of conventional treatment for work-related musculoskeletal disorders (WRMSDs) reduces the prevalence of pain, but with popularity of complementary alternative medicine (CAM) therapies for treatment, it is important to explore their use and impact on dental hygienists (DHs) quality of life (QoL).

METHODS

A cross-sectional survey research design was used with a non-probability sample of dental hygienists (n = 85) with WRMSDs who used CAM therapies. The WHOQOL-BREF was used to assess quality of life and compared with CAM use and frequency. Analysis included descriptive, t-tests, correlation and chi-square tests of independence.

RESULTS

The most commonly used CAM types were massage (81%) and chiropractic manipulation (67%) with 66% of respondents using two or more CAM therapies. Participants using five or less different CAMs (n = 46), compared with those using more than five CAM types (n = 35, M = 2.3, SD = 1.5), t (79) = 2.7, p = 0.01, had a higher average number of years before they noticed their WRMSD (M = 3.3, SD = 1.9). Participants reporting use of a higher number of CAM types also had lower QoL physical health domain scores (rho = -0.2, p = 0.03).

CONCLUSIONS

Dental hygienists used a variety of CAM approaches to manage WRMSDs and had a lower QoL across all domains (physical health, psychological health, social relationships and environment) than the normative mean. More research is needed to explore the use of CAM approaches, such as yoga, for prevention and management of WRMSDs to improve QoL.

Individualized ergonomic wellness approach for the practicing gastroenterologist (with video)

BACKGROUND AND AIMS

The prevalence and burden of ergonomic-related musculoskeletal injury are well established in the literature, but data are scarce on techniques that can be used to avoid injury. This pilot study aimed to develop a new method of endoscopist wellness assessment. The technique presented here is an intervention by a physical therapist assessing ergonomic position and posturing during endoscopy to create an individualized wellness plan.

METHODS

Volunteer endoscopists were identified in a single ambulatory surgical center. Demographics, previous injury, current pain, and posture were evaluated. A comprehensive assessment was developed by the physical therapist while observing endoscopists performing at least 2 colonoscopies and while working at their computer workspace. The detailed personalized wellness program included recommendations for individualized exercises, static and dynamic posture re-education during and between procedures, optimization of procedure suite setup, pain education, and an opportunity for follow-up 1-on-1 sessions with the physical therapist. Endoscopists were later interviewed regarding their perception of and compliance with the wellness plan. Specific outcomes evaluated included changes in musculoskeletal pain, acceptance, and incorporation of wellness recommendations and procedure suite alterations into clinical practice.

RESULTS

As we developed this new method of endoscopic wellness assessment, 8 endoscopists representing a wide range of ages and clinical experience were assessed. Twenty-two pain sites were identified among 5 subjects, with back and neck pain the most common pain sites. A variety of ergonomic inefficiencies and suboptimal movement patterns was observed, resulting in highly variant wellness plans. By the end of the study, 63% of pain sites were reduced in intensity or resolved, whereas 32% of pain sites were unchanged and 4% increased in intensity. Seven of 8 participants found the pictures depicting their posture that supported their movement analysis helpful, and 3 participants requested reassessment by the physical therapist. All participants reported static and dynamic postural education and procedure suite setup recommendations to be impactful to their ergonomic performance.

CONCLUSIONS

Ergonomic assessment and instruction by a physical therapist was well received and resulted in improvement of musculoskeletal complaints among a cohort of endoscopists reporting baseline pain associated with performing endoscopy. In addition, this intervention provided ergonomic education that can be carried forward throughout their professional endoscopic career. We believe that ongoing individualized assessment and optimization of ergonomics is necessary because generalized wellness programs or even modifications to endoscopic equipment would not target all the unique ergonomic challenges faced by each physician. Ergonomic programs using the new method presented here could potentially contribute to career longevity, decrease burnout, reduce lost days of work, and, most importantly, reduce pain and fatigue among practitioners.

The effect of forearm position on elbow flexion strength in nursing, occupational, and physical therapy students

BACKGROUND

Novice nurses, occupational and physical therapist's injury rates are alarming.

OBJECTIVE

To test for differences in peak elbow flexion forces (PEFF) by profession using different forearm positions.

METHODS

Entry-level RN, OT, and PT students performed 3-repetitions of standing PEFF in forearm supination, pronation, and neutral. A one-way repeated measures ANOVA determined the forearm position with the greatest PEFF. A one-way ANOVA assessed differences in PEFF between professions. The alpha level was set at p≤0.05 for all analyses.

RESULTS

Thirty 30 RN, 25 OT, and 30 PT students (x = 23.27 + /-3.29 yrs.) were studied. A one-way repeated measures ANOVA revealed a significant difference in PEFF between positions (F(2,168) = 144.3, p < 0.0001). A significant (p < 0.0001) pairwise comparison revealed neutral produced the greatest (28.15 + /-12.64 kg) and pronation the least PEFF (17.27 + /-7.40). PEFF was significantly different between position by profession (supination: F(2,82) = 10.14, p < 0.0001; pronation: F(2,82) = 10.33, p < 0.0001; neutral: F(2,82) = 13.39, p < 0.0001). PTs were significantly stronger than OTs and RN students in all forearm positions (p < 0.01).

CONCLUSIONS

Neutral PEFF was greatest and PT students demonstrated greater PEFF than OT and RN students.

Work-related musculoskeletal disorders among Egyptian physical therapists

Background

Physical therapists (PTs) are frequently exposed to work-related musculoskeletal disorders (WMSDs). There is limited evidence on the prevalence of these injuries and their potential risk factors in Egyptian PTs. This study aimed at estimating the prevalence of WMSDs among Egyptian PTs as well as potential risk factors and therapists’ coping strategies. Further, it investigated the association between WMSDs and socioeconomic factors.

Results

Three hundred eighty-five eligible participants completed a survey. The prevalence of WMSDs was 99.5%. The five top affected anatomic regions were lower back (69.1%), neck (65.7%), shoulder (47.7%), wrist/hand (39.1%), and upper back (37.0%). Therapists rated awkward positions and handling of heavy patients as the most common predisposing factors for sustaining injuries. Regarding coping strategies, seeking informal help from peers to treat injuries-related symptoms and changing the posture of therapists and patients while working were mostly used by PTs. Overall, female therapists had higher injury prevalence than males (Cramer’s V < 0.5, p ≤ 0.05); except for upper back (p > 0.05). Education and working in multiple facilities simultaneously (public and private clinics) correlated significantly to sustaining injuries in the upper back (V = 0.14, p = 0.049 and V = 0.178, p = 0.002, respectively) and neck (V = 0.16, p = .019 and V = 0.142, p = 0.020, respectively). WMSDs were not associated with therapists’ experience or specialty (p > 0.05).

Conclusion

WMSDs injuries in PTs are prevalent in Egypt, especially in females, therapists with lower academic education, and those working in multiple facilities simultaneously.

Workplace musculoskeletal problems in occupational therapy students

Background

Workplace musculoskeletal disorders are the leading cause of morbidity and disability in the Australian workforce. Over one in five occupational therapists report workplace musculoskeletal disorders, with almost half reporting workplace musculoskeletal symptoms. In other health professions, students and novice clinicians (≤5 years practice) experience greater risk but little is known about occupational therapy students.

Methods

In this cross-sectional study, a survey including the self-reported Standardised Nordic Musculoskeletal Questionnaire was administered to occupational therapy students post work-based training. Musculoskeletal problems were defined as aches, pains, numbness or discomfort. Questions explored body sites affected, prevalence, impact on activity, need for medical assistance, demographic and workplace information. Prevalence was reported using descriptive statistics. Factors associated with workplace musculoskeletal problems over the previous 12 months and last 7 days were examined using logistic regression modelling.

Results

Response rate was 53% (n = 211/397). One-third of respondents (33.6%, n = 71/211) reported a workplace musculoskeletal problem over 12 months. Nearly half (47.9%, n = 34/71) of these students reported a problem over the last 7 days. Neck was the most commonly affected area reported for musculoskeletal problems over the past 12 months (24.2%, n = 51/211) and shoulder areas affected over the past 7 days (10.9%, n = 23/211). Musculoskeletal problems preventing daily activities were reported most commonly from lower back problems over 12 months (23.9%, n = 17/71) and for shoulder problems over the last 7 days (21.9%, n = 7/32). Shoulders and knees were the most common body areas requiring medical attention. Previous musculoskeletal problems and female gender were associated with reported problems over 12 months and last 7 days (p < 0.05). Non-standard joint mobility (OR = 3.82, p = 0.002) and working in psychosocially focused caseloads (including mental health or case management) (OR = 3.04, p = 0.044) were also associated with reporting musculoskeletal problems over the last 7 days.

Conclusions

One in three occupational therapy students already experience workplace musculoskeletal problems impacting daily activities and requiring medical assistance prior to graduation. High prevalence of musculoskeletal problems in this study calls for educators and researchers to find sustainable strategies to address these problems, with particular consideration to the impact of previous disorders and working in psychosocially focused caseloads on musculoskeletal health.

Pre-placement examinations for newly recruited health care support staff

Objective

While musculoskeletal disorders (MSD) and physical strength have been extensively studied in health care professionals, little attention has been paid to health care support staff, such as patient care assistants and operation patient assistants, whose jobs are physically demanding. The purpose of this paper was to examine the musculoskeletal symptoms and physical strength of newly recruited health care support staff.

Method

Convenience sampling was conducted on 111 newly employed health care support staff in a public hospital. A custom-made pre-placement examination was performed. Data were analysed using descriptive, correlation, and regression analyses.

Results

Nearly one-third (32%) of the newly recruited health care support staff had experienced musculoskeletal symptoms in at least one body part during the preceding 12 months. Two-thirds (68%) of subjects were physically inactive, and sixty percent was overweight or obese. Handgrip strength was weaker than the local norm. The subjects’ dominant handgrip strength, bilateral lifting, pushing, and pulling force were significantly correlated. Only bilateral lifting was significantly associated with MSD among the newly recruited health care workers.

Conclusions

This study reports the baseline prevalence of MSD symptoms in the newly recruited health care support staff. Their sedentary lifestyle and suboptimal physical strength may render them susceptible to occupational injuries and disease. An effective occupational health programme that provides periodic health surveillance should be considered for high-risk health care workers to allow proper interventions in a timely manner.

Making music to making lives better: A transition from musician to health professional

The day my pain specialist told me I would never be pain-free again, I knew my music career was over. I was 21 years old, and had been in constant pain for about two years. I had experienced intermittent jaw pain for about 10 years, but having braces on my teeth, and later having my wisdom teeth removed was supposed to fix it. It did not. The day of my surgery was the last time I had been pain free, even for a second. The years that followed were horrible, and my life was turned upside down.

Physical exposure during patient transfer and risk of back injury & low-back pain: prospective cohort study

BACKGROUND

Work-related musculoskeletal disorders (MSDs) are common among healthcare workers. Because frequent patient transfer has been associated with increased risk of MSDs, we aim to quantify the physical load associated with commonly-used assistive devices and to investigate associations between accumulated physical exposure and risk of MSDs.

METHODS

By applying an exposure matrix based on objective measurements of electromyography and trunk flexion on a large (n = 1285) prospective cohort, intensity of low-back pain (LBP) and odds of back injury at 1-year follow-up were modelled using linear models and logistic regressions, respectively. The cohort was divided into groups according to physical exposure; i.e. low (1st quartile), moderate (2nd and 3rd quartiles) and high (4th quartile) exposure.

RESULTS

Exposure profiles are provided for 9 groups of assistive devices, with ceiling lifts and intelligent beds eliciting the lowest physical exposure. In the fully-adjusted model, we report differences in LBP intensity at follow-up between the low and moderate exposure groups (p = 0.0085). No difference was found between the moderate and high exposure groups (p = 0.2967). Likewise, we find no associations between physical exposure and odds of back injury at 1-year follow-up, with a prevalence of 11, 13 and 11% for the three groups, respectively.

CONCLUSIONS

Low physical exposure during patient transfer was prospectively associated with lower intensity of LBP. Consistent use of assistive devices associated with low physical exposure, namely ceiling-lifts and intelligent beds, may play a role in reducing the incidence of MSDs among healthcare workers.

Reported 1-year prevalence of occupational musculoskeletal disorders in Ontario chiropractors

Background

Chiropractors are a particular subset of health care professionals that reportedly suffer occupational musculoskeletal disorders (MSDs), yet they have received minimal attention to date regarding mitigating risks of occupational injury. Our study determined the prevalence of occupationally-related MSDs in the preceding year, their bodily distribution, severity, and practice-related changes in practicing chiropractors in the province of Ontario.

Methods

We conducted a cross-sectional survey of chiropractors who were members of the Ontario Chiropractic Association (OCA) from January to March 2019. A three-part online survey was developed to ask chiropractors about specific details of MSDs they experienced in the past year and any practice-related changes they made as a result. Responses from participants provided both quantitative and qualitative data. Prevalence estimates were derived for quantitative data. Qualitative data were stratified by themes that were further divided into categories and subcategories. Demographic variables of the respondents and OCA membership were compared to determine representativeness.

Results

From the 432 responses (11.8% response rate), 59.1% reported experiencing an occupationally-related MSD in the past year. Survey respondents were demographically representative of the OCA membership. MSDs were most commonly reported for the lower back (38.3%), wrists/hands (38.1%) and neck (37.4%). Positioning/performing manipulation was the most common occupational activity for MSD of the upper extremity (53.1%) and lower back (34.8%). Chiropractors largely reported their MSDs did not prevent them from doing their normal work (77.4%), despite the fact that 43.2% reported experiencing their MSDs for more than 30 days in the previous year. Common reported work modifications were grouped under themes of practice and physical changes. Practice changes included reducing patient volume, hiring personnel and scheduling. Physical changes included using different office equipment, selecting different techniques requiring lower force and altering their hand contacts or body position when treating patients.

Conclusions

One-year prevalence of occupational MSDs from this study are comparable to previously reported estimates in chiropractors. These data suggest that chiropractors continue with their regular workload despite their MSDs, thereby increasing their chances of presenteeism. Chiropractors changing technique or technique parameters due to their MSDs provides direction for future research to reduce exposure to occupational MSD risk factors.

Musculoskeletal pain amongst Australian sonography students and recent graduates and an evaluation of the use of ergonomic education for prevention

Introduction/Purpose

Sonographers develop pain whilst scanning and may not consistently adhere to ergonomic recommendations. The aim was to quantify this within Australian sonography students and recent graduates and to determine whether a relationship exists between: (i) pain and failure to adhere to ergonomic recommendations; and (ii) theoretical and practical ergonomic education during university and clinical placement, and the adherence to recommendations.

Methods

Online questionnaire distributed to Australian student sonographers and sonographers until two years post-graduation.

Results

During scanning, 33/39(84.62%) experienced musculoskeletal pain, and 21/33 (63.64%) experienced pain less than 1.76 full-time equivalent (FTE) days during the two FTE week period. The majority, 37/39 (94.87%), were not consistently adhering to recommendations, with 25/37 (67.57%) only doing so for less than 2.1 FTE days during two FTE weeks. Failure to adhere to ergonomic recommendations and development of musculoskeletal scanning pain was positively correlated (r = 0.7 (P = 0.01)).All participants had received some form of ergonomic education. This education was theoretical and practical during university and clinical placement for 24/39 (61.54%); however, receiving this resulted in no difference for adherence to ergonomic recommendations. Qualitative data demonstrated high workloads, scanning patients with increased body habitus or limited mobility were potential barriers to adherence to ergonomic recommendations.

Discussion

Ergonomic education occurs, yet a lack of knowledge and adherence to recommendations continues. Considerations for other potential barriers are required.

Conclusion

Ensuring students adhere to ergonomic recommendations post-graduation and identifying relevant barriers within the clinical environment are important. Future research to investigate potential barriers around ergonomic adherence is suggested.

Quality of life among district hospital nurses with multisite musculoskeletal symptoms in Vietnam

Background

Nurses are one of the population groups with the highest prevalence of musculoskeletal disorders (MSDs). At many sites, musculoskeletal symptoms (MS) represent a major health‐care burden, adversely affecting nurses' quality of life and giving rise to mental health issues.

Objectives

This study measured the prevalence of multi‐body‐site (two or more anatomical sites) musculoskeletal symptoms (MMS), and the association between MMS, a number of demographic and work characteristics, psychological distress, and the quality of life among district hospital nurses.

Material and Methods

A cross‐sectional study was performed with 1179 nurses in Haiphong City using three questionnaires: the Modified Nordic; Quality of Life Enjoyment and Satisfaction Short Form (Q‐LES‐Q‐SF); and the Kessler Psychological Distress Questionnaire (K6).

Results

Women have a higher MMS prevalence than men (57.1% in women vs 37.6% in men, P < .001). Having a higher number of anatomical sites of MS appears to be associated with a worse quality of life among nurses. Linear regression analysis found a number of other factors negatively associated with the nurses' quality of life: gender (female), age (50‐60 years old vs 19‐29 years old), and psychological distress.

Conclusions

This study shows a high prevalence of MMS and the relationship between, on the one hand, MMS, gender, age, as well as psychological distress and, on the other hand, the quality of life among nurses in Vietnam. Further in‐depth studies are needed to investigate the causal relationships between these indicators.

Musculoskeletal Complaints in Occupational Therapists Compared to the General Population: A Cross-Sectional Study in Germany

Occupational therapists (OTs) are exposed to physical factors at work, which can lead to an increased risk of musculoskeletal disorders. Most studies examining musculoskeletal complaints in OT report that the neck, shoulders, and lower back are most often afflicted. The aim of the present study was to examine the impact of work as an OT (focusing on specific work tasks) on specific musculoskeletal complaints compared to the general working population. A cross-sectional study involving a self-administered standardized questionnaire was conducted from January until October 2015 in Germany. In OT and the comparison group, the highest 12-month prevalence of musculoskeletal disorders were observed for the lower back, the neck, and the shoulders. In contrast, elevated prevalence ratios (PR) were found for OT in the thumbs (PR = 2.7; 95% CI = 1.9-3.8), the wrists (PR = 1.4; 95% CI = 1.1-1.8), and the elbows (PR = 1.5; 95% CI = 1.0-2.2). OTs were particularly exposed to high exertion hand activity and several stressful postures at work. In conclusion, OTs seem to be at risk of developing work-related musculoskeletal complaints in the thumbs, wrists, and elbows. Preventive measures should help to reduce the exposures caused by highly repetitive and forceful hand activities.

Prevalence and Characteristics of Multisite Musculoskeletal Symptoms among District Hospital Nurses in Haiphong, Vietnam

Background

Musculoskeletal disorders (MSDs) are commonly observed among workers around the world. These diseases not only affect the health of workers, their quality of life, and their performance, but the effects of such diseases also represent a great burden for the health and social systems. These issues are even more prevalent in developing countries, and nurses are no exception. Many studies worldwide have shown a high prevalence of work-related MSDs in each body position among nurses. However, there are very few studies that have mentioned multisite musculoskeletal symptoms (MMS).

Objectives

To describe the prevalence and characteristics of MMS among district hospital nurses in Haiphong, Vietnam. Material and Methods. A cross-sectional study was carried out on 1179 nurses working in all 15 district hospitals using the Modified Nordic Questionnaire at 9 anatomical sites on the body (neck, shoulder/upper arm, elbow/forearm, wrist/hand, upper back, lower back, hip/thigh, knee/lower leg, and ankle/foot). The following main indicators were calculated: the prevalence of musculoskeletal symptoms (MS) (at least 1 of 9 sites), MMS (two or more sites), and widespread musculoskeletal symptoms (WMS) (MS of the upper limb, the lower limb, and the back or the neck).

Results

The prevalence of MS during the past 12 months and symptoms lasting for at least 30 days was 60.6% and 17.2% in men and 77.6% and 21.5% in women, respectively. The lower back, neck, upper back, and shoulder/upper arm were the most common sites affected. In terms of MMS, the prevalence was 37.6% in men and 57.1% in women during the past 12 months while 8.6% of men and 11.3% of women reported that symptoms lasted for at least 30 days. The prevalence of MMS tended to increase with age, seniority, having a history of musculoskeletal diseases, and in nurses working in district hospitals located in urban areas. Nearly 90% of MMS concerned two or three anatomical regions during the past 12 months, and almost 80% of MMS lasting at least 30 days involved two or three anatomical regions. The prevalence of WMS was 10.4% in men and 18.6% in women during the past 12 months and 0.9% in men and 2.1% in women lasting at least 30 days.

Conclusions

This study showed the high prevalence of MMS and WMS among nursing staff. Further and more extensive research is needed to improve our understanding of multisite musculoskeletal symptoms and act as the foundation for developing preventive measures for nurses.

[Prevention of musculoskeletal disorders among nurses of a provincial hospital in Vietnam: Issue and health policy context]

OBJECTIVE

To study the situation of MSDs among nursing staff and the barriers to implementing an MSD preventive intervention in Vietnamese hospitals.

METHODS

A mixed design has been devised. The quantitative component aimed to study the prevalence of MSDs, the associations between MSDs and potential risk factors and consequences of MSDs; the qualitative component focused on the study of facilitators/barriers to the implementation of a MSDs prevention program in Vietnamese hospitals.

RESULTS

The prevalence of lower back, neck and shoulders MSDs, over the past 12 months, was the highest in the neck (59%) and then in lower back (49%), shoulders (40%). Factors associated with these disorders are mainly the presence of stress, being a woman and work intensity. MSD-related pain has an impact on the ability to work and the quality of life. The lack of knowledge on MSDs by health care administrators inside and outside the hospitals and the lack of human resources with expertise in MSD management are important barriers to the implementation of an MSD prevention program in Vietnamese hospitals.

CONCLUSIONS

MSDs represent a serious occupational health problem in hospitals. Reducing the prevalence of MSDs requires not only an increased awareness about this serious problem among administrators, but also the development of expertise in MSD management.

Importance of Frequency and Intensity of Strength Training for Reduced Musculoskeletal Pain in the Back, Neck-Shoulder, and Arm-Hand Among Physical Therapists

BACKGROUND

Musculoskeletal pain (MP) is common among health care professionals, including physical therapists (PTs). The physically demanding nature of their work might contribute to increase MP rates. Strength training has a positive effect on musculoskeletal health and MP. However, no studies have evaluated the association of strength training during leisure time on MP among PTs. This study aims to analyze the association between frequency and intensity of strength training during leisure time and MP in the back, neck-shoulder, and arm-hand among PTs.

METHODS

Data on MP and intensity and frequency of strength training were obtained using a questionnaire responded by 1006 PTs. The odds for having lower level of MP as a function of intensity or frequency of the strength training were estimated using binary logistic regression.

RESULTS

High-intensity strength training showed strong associations with lower intensity of MP in neck-shoulder (odds ratio = 5.08; 95% confidence interval, 1.36-18.92), arm-hand (odds ratio = 5.22; 95% confidence interval, 1.11-24.51), and back (odds ratio = 5.22; 95% confidence interval, 1.41-19.28). However, frequency and lower intensities were not significantly associated with MP in any body part.

CONCLUSIONS

High-intensity strength training is strongly associated with lower levels of MP in arm-hand, neck-shoulder, and back, whereas no association was found with frequency or lower intensities.

Work- and stress-related musculoskeletal and sleep disorders among health professionals: a cross-sectional study in a hospital setting in Switzerland

Background

Musculoskeletal and sleep disorders have been reported to be very common among health care and hospital workers and particularly nurses. They are assumed or found to be a result of psychological stress and/or physical strain or pain. However, no other study so far – at least in a hospital setting and for Switzerland – has considered and investigated musculoskeletal as well as sleep disorders in consequence of or rather in association with both physical workload and psychological stress.

Methods

Cross-sectional survey data of 1232 health professionals were used and analysed. Data were collected in 2015/16 among the health care workforces of three public hospitals and two rehabilitation clinics in the German-speaking part of Switzerland. Musculoskeletal and sleep disorders were assessed by three items taken from the Swiss Health Survey, a 2-item measure of accumulated low back, back, neck and shoulder pain and a single-item measure of problems in getting to sleep or sleeping through. Stratified and adjusted bivariate logistic and multivariate linear regression analyses were performed to calculate measures of association (adjusted odds ratios, z-standardized beta coefficients), to control for potential confounders, and to compare different health professions (nurses, physicians, therapists, other).

Results

Almost every fourth of the studied health professionals reported severe or even very severe musculoskeletal disorders (MSDs) and nearly every seventh severe sleep disorders (SDs). These prevalence rates were significantly or at least slightly higher among nurses than among physicians and other health care workers. General stress, work stress, physical effort at work, and particularly a painful or tiring posture at work were found to be clear and strong risk factors for MSDs, whereas only general and work-related stress were found to be significantly associated with SDs. There was no or only weak association between MSDs and SDs.

Conclusions

This study found MSDs to be largely a result of physical workload or rather poor posture at work and only secondarily a consequence of (general) stress, whereas SDs were revealed to be primarily a consequence of stress on and particularly off the job. Preventive strategies therefore have to differentiate and combine measures for the reduction of both psychological stress and physical strain.

Manual handling: the challenges of different care environments

Work-related musculoskeletal disorders (WRMSDs) continue to be a problem in the health and social care setting, despite staff receiving mandatory manual handling training for many decades. The author discusses WRMSDs, with a focus on various nursing roles. The principle of manual handling as solely 'person moving' or 'transferring' is challenged because a range of activities can cause musculoskeletal problems. The legislation and regulations are explored in relation to practice. The benefits of introducing a specific risk-assessment tool designed for nurses working in neonatal wards is discussed.