The effects of a medical hypnotherapy on clothing industry employees suffering from chronic pain

Electromyographic analysis of bilateral upper trapezius muscles at different levels of work-pace among sewing machine operators

Workers are driven to work faster in the industrial work environment to meet high productivity targets. An increased work pace leads to increased muscle activation. However, the effect of work pace on bilateral upper trapezius muscles during sewing machine operation in an industrial work environment has not been thoroughly investigated in experimental studies. Therefore, this research aims to conduct an experimental study to analyze the bilateral upper trapezius muscle activity of industrial sewing machine operators at different levels of work pace. Thirty subjects (15 males, and 15 females) continuously performed the sewing operation for two hours in an industrial work environment. Experiments were conducted for two levels of work pace i.e. low pace (100% of standard cycle time) and high pace (120% of standard cycle time). Electromyographic signals were recorded from the bilateral upper trapezius muscles. The EMG amplitude (RMS) among the muscles was computed. A statistically significant (p < 0.05) increase in muscle activity was observed with an increased work pace. In this study, right upper trapezius muscle activity increased by 30.4% during high work pace tasks compared to low pace, while the left upper trapezius showed a 24.12% increase. The right upper trapezius showed a mean difference of 0.696 (%MVC), and the left upper trapezius showed 0.399 (%MVC), both indicating greater activity during high-pace tasks. The increase in muscle activity with time indicated the presence of muscle fatigue among sewing machine operators. Furthermore, higher muscular activity was observed among females than males. This research highlights the critical need to balance productivity goals with the health and safety of workers, reducing the risk of muscle fatigue and associated work-related musculoskeletal disorders.

Economic analysis of patient-related effects of an interdisciplinary pain self-management program

ABSTRACT

Active Day Patient Treatment (ADAPT) is a well-established 3 week intensive cognitive-behavioural, interdisciplinary pain management program for patients with disabling chronic pain. The aim of this analysis was to conduct an economic analysis of patient-related effects of ADAPT using hospital administrative data, specifically, to compare the costs and health outcomes for patients 1 month after participating in the program, with the preprogram period when they were receiving standard care. This retrospective cohort study included 230 patients who completed ADAPT (including follow-ups) between 2014 and 17 at the Pain Management and Research Centre at the Royal North Shore Hospital in Sydney, Australia. Data on pain-related healthcare utilization and costs before and after the program were assessed. Primary outcome measures were labour force participation for patients' average weekly earnings and cost per clinically meaningful change in Pain Self-efficacy Questionnaire, Brief Pain Inventory (BPI) Severity, and BPI interference scores (n = 224). We estimated patients, on average, earned $59 more each week at 1 month follow-up compared with baseline. The cost per clinically meaningful change in pain severity and interference score based on the BPI severity and BPI interference were AU$9452.32 (95% CI: $7031.76-$12,930.40) and AU$3446.62 (95% CI: $2851.67-$4126.46), respectively. The cost per point improvement and per clinically meaningful change in the Pain Self-efficacy Questionnaire were $483 (95% CI: $411.289-$568.606) and $3381.02, respectively. Our analysis showed a better health outcome, reduced healthcare services' cost, and reduced number of medications taken 1 month after participating in ADAPT.

Ergonomic Assessment of Physical Load in Slovak Industry Using Wearable Technologies

The physical tasks of workers are demanding, particularly when performed long-term in unsuitable working position, with high frequency, heavy load, after injury, with developing damage of health or reduced performance due to advanced age. Work-related musculoskeletal disorders (WMSDs) result from overuse or develop over time. Work activities, which are frequent and repetitive, or activities with awkward postures, cause disorders that may be painful during work or at rest. There is a new technology in the market, occupational exoskeletons, which have the prerequisites for minimizing the negative consequences of workload on WMSDs. We provided pilot quantitative measurements of the ergonomic risk at one selected workplace in a Slovak automotive company with four different workers to prove our methodology using wearable wireless multi-sensor systems Captiv and Actigraph. At first, the test was performed in standard conditions without an exoskeleton. The unacceptable physical load was identified in considerable evaluated body areas—neck, hip, and shoulder. Next, the passive chair exoskeleton Chairless Chair 2.0 was used in trials as an ergonomic measure. Our intention was to determine whether an exoskeleton would be an effective tool for optimizing the workload in selected workplaces and whether the proposed unique quantitative measurement system would give reliable and quick results.

Effectiveness of hypnosis for pain and health-related quality-of-life among people with hemophilia: Three-month outcomes of a randomized controlled pilot trial

BACKGROUND AND PURPOSE

Pain is a common condition among people with hemophilia (PWH), negatively impacting quality of life. However, effective treatment remains a challenge. This two-arm, parallel randomized controlled pilot trial aimed to examine the three-month effects of hypnosis intervention on clinical and psychosocial variables, and on the inflammatory profile of PWH.

MATERIALS AND METHODS

The study was conducted between January and October 2018, in a Reference Center for Congenital Coagulopathies. Adult (age ≥18) patients were randomized to experimental group (EG) or control group (CG). The EG received four weekly hypnosis sessions plus treatment-as-usual, and the CG maintained treatment-as-usual only. Outcomes were evaluated at one week and three months post-intervention and included pain, joint status, health-related quality of life (HRQoL), emotional state and inflammatory profile (leukocytes, C-reactive protein, cytokines). The randomization sequence was computer-generated, and allocation was concealed until enrolment. The outcome assessor was blind to allocation, but blinding of the participants was not possible due to the differences in procedure.

RESULTS

Twenty patients were randomized to EG (n = 10; 8 analyzed) or CG (n = 10; 10 analyzed). Two-way mixed ANOVA showed significant time × group interactions on pain interference with normal work and with relations with other people, and on perception of health status. The EG significantly improved in pain interference with normal work and perception of health status. There was no report of harm.

CONCLUSION

Hypnosis may be a promising intervention to manage hemophilia-related pain and promote HRQoL, with benefits lasting up to three months.

Evaluating the Changes in the Functional Status of the Musculoskeletal System before and after an Intervention among Sewing Machine Operators with Partial Work Ability

Musculoskeletal disorders are the most common occupational diseases in Estonia and in the European Union as a whole. Sewing machine operators’ work is very monotonous, in continuous sitting position, with repetitive one-side movements of the upper limbs and legs. Working in an awkward posture and doing the same movements for a long period of time increases the risk of musculoskeletal system disorders, and in longer perspective, could cause work disability. The aim of the study was to analyse the prevalence of musculoskeletal disorders, intensity and duration of pain in a different body regions and to assess the changes of the functional status of the musculoskeletal system before and after the intervention among workers with partial work ability. The target group was 57 sewing machine operators, who were presented with an anonymous online questionnaire and agreed to participate in the intervention program. The study group was 12 sewing machine operators with partial work ability. RULA (Rapid Upper Limb Assessment) method was used for evaluating ergonomic workstations. The pain assessment was studied by NPRS, Numeric Pain Rating Scale. Online questionnaires were based on BQ (Baecke Physical Activity Questionnaire) and NMQ (The Nordic Musculoskeletal Questionnaire). The results showed that musculoskeletal status among workers with partial work ability improved after the intervention. Associations between individual and job related factors and musculoskeletal pain were observed. The research allows to make actual proposals for workplace layout of sewing machine operators, to provide ergonomic deployment and offer suitable exercise movements for rest breaks.

Efficacy and cost-effectiveness: A study of different treatment approaches in a tertiary pain centre

BACKGROUND

Chronic pain is considered to be a complex phenomenon, involving an interrelation of biological, psychosocial and sociocultural factors. Currently, no single treatment or therapy can address all aspects of this pathology. In our expert tertiary pain centre, we decide to assess the effectiveness of four treatments for chronic pain classically proposed in our daily clinical work: physiotherapy; psycho-education; physiotherapy combined with psycho-education; and self-hypnosis/self-care learning.

METHODS

This study included 527 chronic pain patients, with a mean duration of pain of 10 years. Patients were allocated either to one of the four pre-cited treatment groups or to the control group. Pain intensity, quality of life, pain interference, anxiety and depression were assessed before and after treatment.

RESULTS

This study revealed a significant positive effect on pain interference and anxiety in patients included in the physiotherapy combined with psycho-education group, after 20 sessions spread over 9 months of treatment. The most prominent results were obtained for patients allocated to the self-hypnosis/self-care group, although they received only six sessions over a 9-month period. These patients showed significant benefits in the areas of pain intensity, pain interference, anxiety, depression and quality of life.

CONCLUSIONS

This clinical report demonstrates the relevance of biopsychosocial approaches in the improvement of pain and psychological factors in chronic pain patients. The study further reveals the larger impact of self-hypnosis/self-care learning treatment, in addition to a cost-effectiveness benefit of this treatment comparative to other interventions.