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Putnam JG, Kerkhof FD, Shah KN, Richards AW, Ladd A. Helping Surgeons' Hands: A Biomechanical Evaluation of Ergonomic Instruments. J Hand Surg Am 2024; 49:933.e1-933.e6. [PMID: 36746690 DOI: 10.1016/j.jhsa.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 11/29/2022] [Accepted: 12/14/2022] [Indexed: 02/08/2023]
Abstract
PURPOSE "Ergonomic" is a common descriptor for a desk or computer workspace but is a term rarely used to describe a surgical instrument. Instead, surgeons spend many hours in inconvenient positions, often using instruments that are not ergonomic. Improving the ergonomics of surgical instruments may decrease the required force for simple tasks and allow for more efficient surgery. METHODS To evaluate the impact of ergonomic surgical instruments, the authors developed ergonomic screwdriver handles. The shape and size of these handles were engineered using previous dental studies and 3-dimensional modeling to create an ideal handle for specific glove sizes. Participants were recruited to test 3 different ergonomic handle sizes against a standard screwdriver while assessing digital peak force, digital contact area, and participant preference. Ten participants (3 women) with glove sizes ranging from 6 to 8 were evaluated. RESULTS Ergonomic screwdriver handles sized for glove sizes 6 and 7 required significantly less thumb peak force than the standard screwdriver for all participants (702 N for glove size 6 and 567 N for glove size 7 ergonomic screwdrivers, vs 1780 N for "one size fits all" standard screwdriver). Participants consistently preferred screwdrivers that required lower thumb and index finger forces. All ergonomic handles required lower thumb and index finger force. Eighty percent of participants preferred a screwdriver modeled within 1 glove size of their own. CONCLUSIONS Improved ergonomic handles require less force and are preferred by surgeons. CLINICAL RELEVANCE The significant decrease in thumb peak force for glove sizes 6 and 7 suggests that there is room for ergonomic improvement in instruments, especially for surgeons with smaller hands. Manufacturing ergonomic screwdriver handles and using the evolving convenience of 3-dimensional printing may help to develop a more comfortable work environment for surgeons.
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Affiliation(s)
- Jill G Putnam
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA.
| | - Faes D Kerkhof
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
| | - Kalpit N Shah
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
| | - Alexander W Richards
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
| | - Amy Ladd
- Department of Orthopaedic Surgery, Stanford University School of Medicine, Redwood City, CA
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2
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Greggi C, Visconti VV, Albanese M, Gasperini B, Chiavoghilefu A, Prezioso C, Persechino B, Iavicoli S, Gasbarra E, Iundusi R, Tarantino U. Work-Related Musculoskeletal Disorders: A Systematic Review and Meta-Analysis. J Clin Med 2024; 13:3964. [PMID: 38999528 PMCID: PMC11242534 DOI: 10.3390/jcm13133964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2024] [Revised: 06/24/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
Background: Musculoskeletal disorders (MSDs) involve muscles, nerves, tendons, joints, cartilage, and spinal discs. These conditions can be triggered by both the work environment and the type of work performed, factors that, in some cases, can also exacerbate pre-existing conditions. This systematic review aims to provide an overview of the impact that different work-related activities have on the musculoskeletal system. Methods: A global search of publications was conducted using the following international bibliographic web databases: PubMed and Web of Science. The search strategies combined terms for musculoskeletal disorders and workers. In addition, a meta-analysis was conducted to estimate the prevalence of MSDs within the healthcare sector. Results: A total of 10,805 non-duplicated articles were identified, and finally, 32 studies were reviewed in this article. Once the literature search was completed, occupational figures were categorized into healthcare, farming, industrial, and computer sectors. In the healthcare sector, the prevalence estimate for degenerative diseases of the lumbar spine was 21% (497 out of 2547 physicians and dentists) (95% CI, 17-26%), while for osteoarthritis of the hand, it was 37% (382 out of 1013 dentists) (95% CI, 23-51%). Conclusions: Musculoskeletal disorders significantly impair workers' quality of life, especially in healthcare sector. These conditions are also associated with high costs for employers, such as absenteeism, lost productivity, and increased costs for healthcare, disability, and workers' compensation.
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Affiliation(s)
- Chiara Greggi
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Virginia Veronica Visconti
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Marco Albanese
- Department of Statistics, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Beatrice Gasperini
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Angela Chiavoghilefu
- Department of Orthopaedics and Traumatology, "Policlinico Tor Vergata" Foundation, Viale Oxford 81, 00133 Rome, Italy
| | - Caterina Prezioso
- Department of Orthopaedics and Traumatology, "Policlinico Tor Vergata" Foundation, Viale Oxford 81, 00133 Rome, Italy
| | - Benedetta Persechino
- Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, 00078 Rome, Italy
| | - Sergio Iavicoli
- Italian Workers' Compensation Authority (INAIL), Monte Porzio Catone, 00078 Rome, Italy
| | - Elena Gasbarra
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
- Department of Orthopaedics and Traumatology, "Policlinico Tor Vergata" Foundation, Viale Oxford 81, 00133 Rome, Italy
| | - Riccardo Iundusi
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
- Department of Orthopaedics and Traumatology, "Policlinico Tor Vergata" Foundation, Viale Oxford 81, 00133 Rome, Italy
| | - Umberto Tarantino
- Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
- Department of Statistics, University of Rome Tor Vergata, 00133 Rome, Italy
- Faculty of Medicine, University "Our Lady of Good Counsel", 1000 Tirana, Albania
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3
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Chan VCH, Ross GB, Clouthier AL, Fischer SL, Graham RB. The role of machine learning in the primary prevention of work-related musculoskeletal disorders: A scoping review. APPLIED ERGONOMICS 2022; 98:103574. [PMID: 34547578 DOI: 10.1016/j.apergo.2021.103574] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Revised: 08/22/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
To determine the applications of machine learning (ML) techniques used for the primary prevention of work-related musculoskeletal disorders (WMSDs), a scoping review was conducted using seven literature databases. Of the 4,639 initial results, 130 primary research studies were deemed relevant for inclusion. Studies were reviewed and classified as a contribution to one of six steps within the primary WMSD prevention research framework by van der Beek et al. (2017). ML techniques provided the greatest contributions to the development of interventions (48 studies), followed by risk factor identification (33 studies), underlying mechanisms (29 studies), incidence of WMSDs (14 studies), evaluation of interventions (6 studies), and implementation of effective interventions (0 studies). Nearly a quarter (23.8%) of all included studies were published in 2020. These findings provide insight into the breadth of ML techniques used for primary WMSD prevention and can help identify areas for future research and development.
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Affiliation(s)
- Victor C H Chan
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, Ontario, K1N 6N5, Canada
| | - Gwyneth B Ross
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, Ontario, K1N 6N5, Canada
| | - Allison L Clouthier
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, Ontario, K1N 6N5, Canada
| | - Steven L Fischer
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
| | - Ryan B Graham
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, 200 Lees Avenue, Ottawa, Ontario, K1N 6N5, Canada; Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada.
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4
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Shah K, Cai H, Lane JCE, Collins GS, Arden NK, Furniss D, Filbay SR. Prognostic factors for finger interphalangeal joint osteoarthritis: a systematic review. Rheumatology (Oxford) 2021; 60:1080-1090. [PMID: 33253392 DOI: 10.1093/rheumatology/keaa735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/16/2020] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Radiographic hand OA affects one in five adults. Symptomatic hand OA can result in functional impairment, pain and reduced quality of life. A prevalent form of hand OA is IP joint OA, however prognostic factors for IP joint OA remain poorly understood. This systematic review aimed to identify prognostic factors for IP joint OA, and to summarize the diagnostic criteria for IP joint OA in prognostic studies. METHODS EMBASE, MEDLINE, Scopus and The Cochrane Library were searched from inception until 19 February 2020 (PROSPERO CRD42019116782). Eligible studies described diagnostic criteria defining IP joint OA, and assessed potential prognostic factors for IP joint OA. Risk of bias was assessed using a modified Quality in Prognosis Studies (QUIPS) tool and a best evidence synthesis was used. RESULTS Eighteen studies were included (risk of bias: eight high, three moderate, seven low). All defined OA radiographically, and three studies incorporated clinical symptoms into their definition of OA. Forty-nine potential prognostic factors were assessed. Eight were prognostic: older age in women, female gender (both moderate evidence); family history of Heberden's nodes, Kashin-Beck disease, older age in men, dental occupation in men, finger fracture, parity (all limited evidence). Higher BMI in women (limited evidence) was prognostic for symptomatic radiographic OA. No prognostic factors for symptomatic OA were identified. CONCLUSION IP joint OA is most commonly defined radiographically, yet criteria were heterogeneous. Eight prognostic factors for radiographic IP joint OA and one for symptomatic radiographic IP joint OA were identified, all with limited or moderate evidence. Further studies on causality and on prognostic pathways are needed.
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Affiliation(s)
- Karishma Shah
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - He Cai
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,West China Hospital of Stomatology, State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Sichuan University, Chengdu, China
| | - Jennifer C E Lane
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Gary S Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Nigel K Arden
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Dominic Furniss
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Department of Plastic and Reconstructive Surgery, Nuffield Orthopaedic Centre, Oxford, Oxford, UK
| | - Stephanie R Filbay
- Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Centre for Sport, Exercise and Osteoarthritis Research Versus Arthritis, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.,Centre for Health, Exercise and Sports Medicine, Department of Physiotherapy, Melbourne University, Melbourne, Victoria, Australia
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Prevalence of Musculoskeletal Disorders among Dentists and Dental Students in Germany. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238740. [PMID: 33255491 PMCID: PMC7727829 DOI: 10.3390/ijerph17238740] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/15/2020] [Accepted: 11/20/2020] [Indexed: 12/04/2022]
Abstract
Background: Dentists are at a higher risk of suffering from musculoskeletal disorders (MSD) than the general population. However, the latest study investigating MSD in the dental profession in Germany was published about 20 years ago. Therefore, the aim of this study was to reveal the current prevalence of MSD in dentists and dental students in Germany. Methods: The final study size contained 450 (287 f/163 m) subjects of different areas of specialization. The age of the participants ranged from 23 to 75 years. The questionnaire consisted of a modified version of the Nordic Questionnaire, work-related questions from the latest questionnaire of German dentists, typical medical conditions and self-developed questions. Results: The overall prevalence showed that dentists suffered frequently from MSD (seven days: 65.6%, twelve months: 92%, lifetime: 95.8%). The most affected body regions included the neck (42.7%–70.9%–78.4%), shoulders (29.8%–55.6%–66.2%) and lower back (22.9%–45.8%–58.7%). Overall, female participants stated that they suffered from pain significantly more frequently, especially in the neck, shoulders and upper back. Conclusion: The prevalence of MSD among dentists, especially in the neck, shoulder and back area, was significantly higher than in the general population. In addition, women suffered more frequently from MSD than men in almost all body regions.
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Prevalence of self-reported musculoskeletal disorders of the hand and associated conducted therapy approaches among dentists and dental assistants in Germany. PLoS One 2020; 15:e0241564. [PMID: 33156851 PMCID: PMC7647093 DOI: 10.1371/journal.pone.0241564] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 10/19/2020] [Indexed: 12/24/2022] Open
Abstract
Background Dental professionals are subjected to higher risks for musculoskeletal disorders (MSDs) than other professional groups, especially the hand region. This study aims to investigate the prevalence of hand complaints among dentists (Ds) and dental assistants (DAs) and examines applied therapies. Methods For this purpose, an online questionnaire analysed 389 Ds (240female/149male) and 406 DAs (401female/5male) working in Germany. The self-reported data of the two occupational groups were compared with regard to the topics examined. The questionnaire was based on the Nordic Questionnaire (self-reported lifetime, 12-month and 7-day MSDs prevalence of the hand, the conducted therapy and its success), additional occupational and sociodemographic questions as well as questions about specific medical conditions. Results 30.8% of Ds affirmed MSDs in the hand at any time in their lives, 20.3% in the last twelve months and 9.5% in the last seven days. Among DAs, 42.6% reported a prevalence of MSDs in the hand at any time in their lives, 31.8% in the last 12 months and 15.3% in the last seven days. 37.5% of the Ds and 28.3% of the DAs stated that they had certain treatments. For both, Ds and DAs, physiotherapy was the most frequently chosen form of therapy. 89.7% of Ds and 63.3% of DAs who received therapy reported an improvement of MSDs. Conclusion Although the prevalence of MSDs on the hand is higher among DAs than among Ds, the use of therapeutic options and the success of therapy is lower for DAs compared to Ds.
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7
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Gignac MAM, Irvin E, Cullen K, Van Eerd D, Beaton DE, Mahood Q, McLeod C, Backman CL. Men and Women's Occupational Activities and the Risk of Developing Osteoarthritis of the Knee, Hip, or Hands: A Systematic Review and Recommendations for Future Research. Arthritis Care Res (Hoboken) 2020; 72:378-396. [PMID: 30762317 PMCID: PMC7065017 DOI: 10.1002/acr.23855] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Accepted: 02/12/2019] [Indexed: 12/24/2022]
Abstract
Objective To systematically review the evidence for an increased risk of osteoarthritis in the hip, knee, hand, wrist, finger, ankle, foot, shoulder, neck, and spine related to diverse occupational activities of men and women and to examine dose‐response information related to the frequency, intensity, and duration of work exposures and the risk of osteoarthritis (OA). Methods Established guidelines for systematic reviews in occupational health and safety studies were followed. MEDLINE, Embase, CINAHL, and Cochrane Library were searched from inception to December 2017. Studies were reviewed for relevance, quality was appraised, and data were extracted and synthesized. Results Sixty‐nine studies from 23 countries yielded strong and moderate evidence for lifting, cumulative physical loads, full‐body vibration, and kneeling/squatting/bending as increasing the risks of developing OA in men and women. Strong and moderate evidence existed for no increased risk of OA related to sitting, standing, and walking (hip and knee OA), lifting and carrying (knee OA), climbing ladders (knee OA), driving (knee OA), and highly repetitive tasks (hand OA). Variability in dose‐response data resulted in an inability to synthesize these data. Conclusion Evidence points to the potential for OA occupational recommendations and practice considerations to be developed for women and men. However, research attention is needed to overcome deficits in the measurement and recall of specific work activities so that recommendations and practice considerations can provide the specificity needed to be adopted in workplaces.
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Affiliation(s)
- Monique A M Gignac
- Institute for Work and Health and Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Emma Irvin
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Kim Cullen
- Institute for Work and Health, Toronto, and School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | | | | | - Quenby Mahood
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Chris McLeod
- Institute for Work and Health, Toronto, Ontario, and School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada
| | - Catherine L Backman
- University of British Columbia and Arthritis Research Centre of Canada, Vancouver, British Columbia, Canada
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8
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Prevalence of Muscular Skeletal Disorders among Qualified Dental Assistants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17103490. [PMID: 32429484 PMCID: PMC7277800 DOI: 10.3390/ijerph17103490] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 05/11/2020] [Accepted: 05/11/2020] [Indexed: 12/19/2022]
Abstract
The occupation of dental assistants (DAs) involves many health risks of the musculoskeletal system due to static and prolonged work, which can lead to musculoskeletal disorders (MSDs). The aim of the study was to investigate the prevalence of MSDs in DAs in Germany. Methods: For this purpose, an online questionnaire analyzed 406 (401 female participants and 5 male participants, 401w/5m) DAs. It was based on the Nordic Questionnaire (lifetime, 12-month, and seven-day MSDs’ prevalence separated into neck, shoulder, elbow, wrist, upper back, lower back, hip, knee, and ankle), and occupational and sociodemographic questions as well as questions about specific medical conditions. Results: 98.5% of the participants reported complaints of at least one body region in their lives, 97.5% reported at least one complaint in the last 12 months and 86.9% affirmed at least one complaint in the last seven days. For lifetime, 12-month and seven-day prevalence, the neck was the region that was most affected followed by the shoulder, the upper back and the lower back. Conclusion: The prevalence of MSDs among German (female) DAs was very high. The most affected area is the neck, followed by the shoulder, the lower back, and the upper back. It, therefore, seems necessary to devote more attention to ergonomics at the working practice of DAs as well in education and in dental work.
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9
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Prevalence and occupational risk factors of musculoskeletal diseases and pain among dental professionals in Western countries: A systematic literature review and meta-analysis. PLoS One 2018; 13:e0208628. [PMID: 30562387 PMCID: PMC6298693 DOI: 10.1371/journal.pone.0208628] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 11/20/2018] [Indexed: 11/21/2022] Open
Abstract
Background This review aimed at examining the prevalence of musculoskeletal diseases and pain among dental professionals in Western countries. Furthermore, possible occupational risk factors were analyzed. Methods The literature search was conducted from June to July 2016, with an update in December 2017 using the databases MEDLINE, CINAHL, LIVIVO, Science Direct, PubMed, and Web of Science. The quality assessment was performed with a standardized instrument consisting of 10 items. A meta-analysis was carried out to compute pooled prevalence rates for musculoskeletal diseases and pain. Results A total of 41 studies were included in this review; 30 studies met the criteria for the meta-analysis. Prevalence rates of musculoskeletal diseases and pain among dental professionals ranged from 10.8% to 97.9%. The neck was the body region affected most often (58.5%, 95% CI = 46.0–71.0) followed by the lower back (56.4%, 95% CI = 46.1–66.8), the shoulder (43.1%, 95% CI = 30.7–55.5) and the upper back (41.1%, 95% CI = 32.3–49.9). Potential occupational risk factors included an awkward working posture, high number of treated patients, administrative work, vibration, and repetition. Conclusions Musculoskeletal diseases and pain are a significant health burden for dental professionals. This study showed high prevalence rates for several body regions. Therefore, suitable interventions for preventing musculoskeletal diseases and pain among dental professionals are needed.
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10
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Thumb base osteoarthritis: A hand osteoarthritis subset requiring a distinct approach. Best Pract Res Clin Rheumatol 2018; 31:649-660. [PMID: 30509411 DOI: 10.1016/j.berh.2018.08.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Hand osteoarthritis (OA) is usually a polyarticular disease, preferentially affecting the thumb base (TB) and interphalangeal joints. TB OA alone is generally not addressed separately, but as a part of hand OA. Studies have shown that OA in the TB joints clusters together, as does OA in the interphalangeal joints, supporting it as a distinct subset. Further support for this view comes from a specific risk profile, influence on clinical burden, impact of synovial inflammation on local joint pain, and specific treatment interventions. Therefore, clinical care and future hand OA research should not only address hand OA in general but also should focus on the different subsets separately, including TB OA.
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11
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Taipale M, Solovieva S, Leino-Arjas P, Männikkö M. Functional polymorphisms in asporin and CILP together with joint loading predispose to hand osteoarthritis. BMC Genet 2017; 18:108. [PMID: 29233086 PMCID: PMC5727665 DOI: 10.1186/s12863-017-0585-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 12/07/2017] [Indexed: 01/07/2023] Open
Abstract
Background Osteoarthritis (OA) is the most common degenerative joint disease afflicting people in the Western world and has a strong genetic influence. The aim of this study was to examine the association of two known functional polymorphisms in the TGF-β inhibiting genes, asporin (ASPN) and cartilage intermediate layer protein (CILP), with hand OA and potential gene-occupational hand loading interaction. Results Statistically significant interaction of the CILP rs2073711 T and ASPN D15 alleles with hand OA was observed (OR = 2.48, 95% CI 1.27–4.85, p = 0.008) in a Finnish hand OA cohort of 543 women (aged 45–63). When stratified by variation in working tasks, low variation of working tasks increased the risk further (OR = 3.00, 95% CI 1.35–6.66, p = 0.007). Based on the analysis of ASPN and CILP protein-coding regions, functional studies were performed with one observed variant, rs41278695 in the ASPN gene. Analyses showed that bone morphogenetic protein 2 (BMP2) mediated expression of aggrecan (Agc1) and type II collagen (Col2a1) was significantly suppressed (p = 0.011 and p = 0.023, respectively) in a murine chondrocytic cell line (ATDC5) with cells stably expressing ASPN rs41278695. Conclusions The carriage of either ASPN D15 or CILP rs2073711 TT is associated with increased risk of symmetrical hand OA, particularly in individuals with low variation in work tasks. ASPN rs41278695 SNP had an effect on Agc1 and Col2a1 gene expression when induced with BMP-2 suggesting an effect on the cartilage extracellular matrix composition.
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Affiliation(s)
- Mari Taipale
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Aapistie 5, 90220, Oulu, Finland.,Biocenter Oulu and Faculty of Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland
| | - Svetlana Solovieva
- Department of Epidemiology and Biostatistics, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Päivi Leino-Arjas
- Department of Epidemiology and Biostatistics, Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Minna Männikkö
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Aapistie 5, 90220, Oulu, Finland. .,Biocenter Oulu and Faculty of Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu, Finland.
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12
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Leider PC, Boschman JS, Frings-Dresen MHW, van der Molen HF. Effects of job rotation on musculoskeletal complaints and related work exposures: a systematic literature review. ERGONOMICS 2014; 58:18-32. [PMID: 25267494 DOI: 10.1080/00140139.2014.961566] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The aim of this systematic review was to summarise evidence on the effects of job rotation on musculoskeletal complaints, exposures related to musculoskeletal complaints and sustainable working life parameters. A total of 16 studies were included. No studies on sustainable working life parameters were found. The quality of the studies was assessed using a checklist; eight field studies and three laboratory studies of sufficient quality were used to summarise the following evidence: one field study showed positive results and one field study showed negative results for musculoskeletal complaints, two field studies showed positive results and two field studies showed inconsistent results for exposures, and two field studies showed inconsistent results for musculoskeletal complaints and exposures. Two laboratory studies showed inconsistent results and one laboratory study showed no changes for exposures. In conclusion, there is currently inconsistent evidence for positive or negative effects of job rotation on musculoskeletal complaints and exposures related to musculoskeletal complaints. Practitioner's Summary: Currently, there is inconsistent evidence for recommending job rotation as a strategy for preventing musculoskeletal complaints. Exposures from all involved work activities and body regions should be identified and assessed first, to determine if job rotation provides increased exposure variation and/or beneficial changes in mean exposures related to musculoskeletal complaints.
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Affiliation(s)
- Priscilla C Leider
- a Coronel Institute of Occupational Health, Academic Medical Center, University of Amsterdam , Amsterdam , The Netherlands
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13
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de Ruijter RAG, Stegenga B, Schaub RMH, Reneman MF, Middel B. Determinants of physical and mental health complaints in dentists: a systematic review. Community Dent Oral Epidemiol 2014; 43:86-96. [DOI: 10.1111/cdoe.12122] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 07/17/2014] [Indexed: 12/01/2022]
Affiliation(s)
- Rolf A. G. de Ruijter
- Center for Dentistry and Oral Hygiene, Department of Oral Health and Clinical Epidemiologie; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| | - Boudewijn Stegenga
- Center for Dentistry and Oral Hygiene, Department of Oral Health and Clinical Epidemiologie; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| | - Rob M. H. Schaub
- Center for Dentistry and Oral Hygiene, Department of Oral Health and Clinical Epidemiologie; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| | - Michiel F. Reneman
- Center for Rehabilitation, Department of Rehabilitation; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
| | - Berrie Middel
- Center for Dentistry and Oral Hygiene, Department of Oral Health and Clinical Epidemiologie; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
- Health Sciences, Community and Occupational Medicine; University Medical Center Groningen, University of Groningen; Groningen The Netherlands
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Occhionero V, Korpinen L, Gobba F. Upper limb musculoskeletal disorders in healthcare personnel. ERGONOMICS 2014; 57:1166-1191. [PMID: 24840049 DOI: 10.1080/00140139.2014.917205] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The literature on upper limb musculoskeletal disorders (UL-MSD) in different groups of healthcare workers was reviewed: 65 relevant studies were collected. In dentists, the neck was the most frequently affected segment, with prevalences up to 73% and exceeding 50% in 7 out of 12 studies. In dental hygienists and in laboratory technicians, the hand/wrist had the highest prevalence in the majority of the studies. In nurses, the most seriously affected anatomic sites were the neck and shoulders. Physiotherapists had the lowest prevalence of UL-MSD. A high prevalence of upper limb disease, mainly carpal tunnel syndrome, was reported in dentists, dental hygienists, anesthesia nurses and endoscopists. The high prevalence of upper limb disorders/diseases reported in health personnel supports the hypothesis of a significant risk in these workers. However, the possible role of biomechanical overload, as much as that of stress or other personal factors, cannot be currently assessed. Practitioner Summary: Published studies support the hypothesis of a significant risk of upper limb musculoskeletal disorders in healthcare activities. The neck was the most frequently affected segment in dentists, the hand/wrist in dental hygienists and in laboratory technicians, and the neck and shoulders in nurses. Lower prevalence was reported in physiotherapists. A high prevalence of carpal tunnel syndrome was also observed in various healthcare activities.
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Affiliation(s)
- Vincenzo Occhionero
- a Department of Diagnostic , Clinical and Public Health Medicine, University of Modena and Reggio Emilia Italy , Modena , Italy
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15
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Goislard de Monsabert B, Vigouroux L, Bendahan D, Berton E. Quantification of finger joint loadings using musculoskeletal modelling clarifies mechanical risk factors of hand osteoarthritis. Med Eng Phys 2013; 36:177-84. [PMID: 24210852 DOI: 10.1016/j.medengphy.2013.10.007] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2013] [Revised: 10/01/2013] [Accepted: 10/13/2013] [Indexed: 11/28/2022]
Abstract
Owing to limited quantitative data related to the loadings (forces and pressures) acting upon finger joints, several clinical observations regarding mechanical risk factors of hand osteoarthritis remain misunderstood. To improve the knowledge of this pathology, the present study used musculoskeletal modelling to quantify the forces and pressures acting upon hand joints during two grasping tasks. Kinematic and grip force data were recorded during both a pinch and a power grip tasks. Three-dimensional magnetic resonance imaging measurements were conducted to quantify joint contact areas. Using these datasets as input, a musculoskeletal model of the hand and wrist, including twenty-three degrees of freedom and forty-two muscles, has been developed to estimate joint forces and joint pressures. When compared with the power grip task, the pinch grip task resulted in two to eight times higher joint loadings whereas the grip forces exerted on each finger were twice lower. For both tasks, joint forces and pressures increased along a disto-proximal direction for each finger. The quantitative dataset provided by the present hand model clarified two clinical observations about osteoarthritis development which were not fully understood, i.e., the strong risk associated to pinch grip tasks and the high frequency of thumb-base osteoarthritis.
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Affiliation(s)
| | - Laurent Vigouroux
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France
| | - David Bendahan
- Aix-Marseille Université, CNRS, CRMBM UMR 7339, 13005 Marseille, France
| | - Eric Berton
- Aix-Marseille Université, CNRS, ISM UMR 7287, 13288 Marseille cedex 09, France
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16
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Marshall M, Peat G, Nicholls E, van der Windt D, Myers H, Dziedzic K. Subsets of symptomatic hand osteoarthritis in community-dwelling older adults in the United Kingdom: prevalence, inter-relationships, risk factor profiles and clinical characteristics at baseline and 3-years. Osteoarthritis Cartilage 2013; 21:1674-84. [PMID: 23954700 PMCID: PMC3819994 DOI: 10.1016/j.joca.2013.08.004] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 07/04/2013] [Accepted: 08/03/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To compare the population prevalence, inter-relationships, risk factor profiles and clinical characteristics of subsets of symptomatic hand osteoarthritis (OA) with a view to understanding their relative frequency and distinctiveness. METHOD 1076 community-dwelling adults with hand symptoms (60% women, mean age 64.7 years) were recruited and classified into pre-defined subsets using physical examination and standardised hand radiographs, scored with the Kellgren & Lawrence (K&L) and Verbruggen-Veys grading systems. Detailed information on selected risk factors was obtained from direct measurement (Body Mass Index (BMI)), self-complete questionnaires (excessive use of hands, previous hand injury) and medical record review (hypertension, dyslipidaemia, type 2 diabetes). Hand pain and disability were self-reported at baseline and 3-year follow-up using Australian/Canadian Osteoarthritis Hand Index (AUSCAN). RESULTS Crude population prevalence estimates for symptomatic hand OA subsets in the adult population aged 50 years and over were: thumb base OA (22.4%), nodal interphalangeal joint (IPJ) OA (15.5%), generalised hand OA (10.4%), non-nodal IPJ OA (4.9%), erosive OA (1.0%). Apart from thumb base OA, there was considerable overlap between the subsets. Erosive OA appeared the most distinctive with the highest female: male ratio, and the most disability at baseline and 3-years. A higher frequency of obesity, hypertension, dyslipidaemia, and metabolic syndrome was observed in this subset. CONCLUSION Overlap in the occurrence of hand OA subsets poses conceptual and practical challenges to the pursuit of distinct phenotypes. Erosive OA may nevertheless provide particular insight into the role of metabolic and cardiovascular risk factors in the pathogenesis of OA.
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Affiliation(s)
- M. Marshall
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom
| | - G. Peat
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom
| | - E. Nicholls
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom
| | - D. van der Windt
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom
| | - H. Myers
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom
| | - K. Dziedzic
- Arthritis Research UK Primary Care Centre, Primary Care Sciences, Keele University, Keele, Staffordshire ST5 5BG, United Kingdom
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17
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Ding H, Leino-Arjas P, Murtomaa H, Takala EP, Solovieva S. Variation in work tasks in relation to pinch grip strength among middle-aged female dentists. APPLIED ERGONOMICS 2013; 44:977-981. [PMID: 23601435 DOI: 10.1016/j.apergo.2013.03.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 03/07/2013] [Accepted: 03/11/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVES We aimed to investigate the relationship of task variation during dental work history with pinch grip strength among dentists. METHODS We measured pinch grip strength among 295 female Finnish dentists aged 45-63 years. Variation in dental work tasks during work history was empirically defined by cluster analysis. Three clusters of task variation emerged: low (most work time in restoration treatment/endodontics), moderate (about 50% in the former and 50% in prosthodontics/periodontics/surgery), and high (variable tasks including administrative duties). Hand radiographs were examined for the presence of OA in the wrist and each joint of the 1-3rd fingers. Information on hand-loading leisure-time activities, and joint pain was obtained by questionnaire. Glove size was used as a proxy for hand size. BMI (kg/m2) was based on measured weight and self-reported height. RESULTS Dentists with low variation of work task history had an increased risk of low pinch grip strength in the right hand (OR 2.3, 95% CI 1.2-4.3), but not in the left (1.13, 0.62-2.08), compared to dentists with high task variation, independent of age, hand size, hand-loading leisure-time activities, BMI and symptomatic hand OA. CONCLUSION The dentists with the most hand-loading tasks were at an increased risk of low pinch grip strength, independent of e.g. symptomatic hand OA. It is advisable among dentists to perform as diverse work tasks as possible to reduce the risk of decreased pinch grip strength.
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Affiliation(s)
- Hebo Ding
- Finnish Institute of Occupational Health, Centre of Expertise for Health and Work Ability, Topeliuksenkatu 41 a A, FIN-00250 Helsinki, Finland.
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18
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Abstract
Hand osteoarthritis (OA) is a prevalent disorder. Hand OA is not one single disease, but a heterogeneous group of disorders. Radiographic signs of hand OA, such as osteophytes or joint space narrowing, can be found in up to 81% of the elderly population. Several hand OA subsets--such as nodal interphalangeal OA, thumb base OA and erosive OA--can be discriminated. Furthermore, the experience of symptoms and the course of the disease differ between patients. Studies that used well-defined study populations with longitudinal follow-up have shown that similarities and differences can be observed in the pathogenesis, epidemiology and risk factors of the various hand OA subsets. Erosive OA in particular, characterized by erosive lesions on radiographical images, has a higher clinical burden and worse outcome than nonerosive hand OA. Imaging modalities (such as ultrasonography) have increased our knowledge of the role of inflammation of the disease. Our understanding of the heterogeneous nature of hand OA can eventually lead to increased knowledge of the pathogenesis of, and ultimately new treatment modalities for, this complex disease.
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Affiliation(s)
- Margreet Kloppenburg
- Department of Rheumatology, Leiden University Medical Center, Albinusdreef 2, PO Box 9600, 2300 RC Leiden, The Netherlands.
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19
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Abstract
Osteoarthritis occurs with the highest prevalence in the distal interphalangeal joint of the hand and has been divided into an erosive and a nonerosive form. The pathogenesis of the early stages of osteoarthritis is poorly understood, but considerable emphasis has been placed on the role of cartilage and subchondral bone as well as soft tissue structures such as collateral ligaments and tendons. Radiographic evaluation represents the most standardized method to quantify disease progression, with different systems having been developed for defining and grading radiographic features. This current concepts article examines the recent knowledge base regarding the etiology, pathogenesis, and evaluation of osteoarthritis of the distal interphalangeal joint.
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de Fleurian G. Étude d’un cas de rhizarthrose parmi les pêcheurs de poulpes en Méditerranée. Presse Med 2010; 39:398-402. [DOI: 10.1016/j.lpm.2009.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2009] [Revised: 10/20/2009] [Accepted: 11/20/2009] [Indexed: 10/19/2022] Open
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COLE WILLIAM. IL1 Polymorphisms May Predispose Distal Interphalangeal Joints of the Hands to Effects of Mechanical Overload. J Rheumatol 2009; 36:1864-5. [DOI: 10.3899/jrheum.090554] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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SOLOVIEVA SVETLANA, KÄMÄRÄINEN OLLIPEKKA, HIRVONEN ARI, HÄMÄLÄINEN SATU, LAITALA MARI, VEHMAS TAPIO, LUOMA KATARIINA, NÄKKI ANNU, RIIHIMÄKI HILKKA, ALA-KOKKO LEENA, MÄNNIKKÖ MINNA, LEINO-ARJAS PÄIVI. Association Between Interleukin 1 Gene Cluster Polymorphisms and Bilateral Distal Interphalangeal Osteoarthritis. J Rheumatol 2009; 36:1977-86. [DOI: 10.3899/jrheum.081238] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Objective.To examine the association of the interleukin 1 gene (IL1) cluster polymorphisms and their haplotypes with bilateral distal interphalangeal joint osteoarthritis (DIP OA).Methods.Radiographs of both hands of 295 dentists and 248 teachers were examined and classified for the presence of OA using reference images. Bilateral DIP OA was defined by the presence of radiographic findings of grade 2 or more in at least 1 symmetrical pair of the DIP joints. We genotyped 10 single-nucleotide polymorphisms (SNP) in theIL1R1, IL1RL2, IL1A, IL1B,andIL1RNgenes using polymerase chain reaction-based methods. Haplotypes were statistically reconstructed using the PHASE program. The association between the genotypes/diplotypes and bilateral DIP OA was examined with logistic regression analysis.Results.TwoIL1BSNP (rs1143634 and rs1143633) were associated with bilateral DIP OA. The carriers of theIL1Brs1143634 minor allele had an increased OA risk [odds ratio (OR) 1.6; 95% confidence interval (CI) 1.08–2.26] compared to the noncarriers. The association was stronger in the dentists. The distribution of theIL1Brs1143633 genotype fit a recessive mode of inheritance (OR 3.03, 95% CI 1.35–6.83, p = 0.006). TwoIL1B-IL1RNextended haplotype alleles (211-1 and 121-1) were associated with bilateral DIP OA. An interaction between theIL1Brs1143634 and theIL1R1-IL1RL2andIL1B-IL1RNextended haplotypes and occupation (increased risk of OA among dentists only) was observed.Conclusion.Our results provide further evidence for the role ofIL1gene cluster polymorphisms in the etiology of OA and suggest that some of these may predispose DIP joints to the effects of mechanical overload.
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Marshall M, Dziedzic KS, van der Windt DA, Hay EM. A systematic search and narrative review of radiographic definitions of hand osteoarthritis in population-based studies. Osteoarthritis Cartilage 2008; 16:219-26. [PMID: 17646114 DOI: 10.1016/j.joca.2007.06.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Accepted: 06/05/2007] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Currently there is no agreed "gold standard" definition of radiographic hand osteoarthritis (RHOA) for use in epidemiological studies. We therefore undertook a systematic search and narrative review of community-based epidemiological studies of hand osteoarthritis (OA) to identify (1) grading systems used, (2) definitions of radiographic OA for individual joints and (3) definitions of overall RHOA. METHODS The following electronic databases were searched: Medline, Embase, Science Citation Index and Ageline (inception to Dec 2006). The search strategy combined terms for "hand" and specific joint sites, OA and radiography. Inclusion and exclusion criteria were applied. Data were extracted from each paper covering: hand joints studied, grading system used, definitions applied for OA at individual joints and overall RHOA. RESULTS Titles and abstracts of 829 publications were reviewed and the full texts of 399 papers were obtained. One hundred fifty-two met the inclusion criteria and 24 additional papers identified from screening references. Kellgren and Lawrence (K&L) was the most frequently applied grading system used in 80% (n=141) of studies. In 71 studies defining OA at the individual joint level 69 (97%) used a definition of K&L grade > or = 2. Only 53 publications defined overall RHOA, using 21 different definitions based on five grading systems. CONCLUSION The K&L scheme remains the most frequently used grading system. There is a consistency in defining OA in a single hand joint as K&L grade > or = 2. However, there are substantial variations in the definitions of overall RHOA in epidemiological studies.
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Affiliation(s)
- M Marshall
- Primary Care Musculoskeletal Research Centre, Keele University, Keele, Staffordshire ST5 5BG, UK.
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Finger osteoarthritis and differences in dental work tasks. Br Dent J 2006. [DOI: 10.1038/sj.bdj.4813911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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