Disability burden due to musculoskeletal conditions and low back pain in Australia: findings from GBD 2019

Characteristics of bowen therapy practitioners and practice in Australia: An exploratorysecondary analysis of the practitioner research and collaboration initiative (PRACI) practice-based research network

INTRODUCTION

Bowen Therapy (BT) is a non-invasive manual therapy used to treat muscle pain and discomfort, poor flexibility and imbalances in the body's tissues. Globally, the BT profession comprises a small, but widely dispersed, network of practitioners. While a small pool of preliminary clinical research has begun to investigate the effectiveness of BT for a range of conditions, the investigation of the practice of BT remains extremely limited.

METHODS

This study employs secondary analysis of a national cross-sectional workforce survey of complementary medicine practitioners, to describe the characteristics of BT professionals and their practices in Australia. The study sampled data collected from individuals with qualifications in Bowen Therapy involved in the Practitioner Research and Collaboration Initiative (PRACI). Data were analysed using descriptive statistics.

RESULTS

Study participants (n = 80), primarily female (71.3%) and with a mean age of 52.9 years, reported commonly using a range of assessment tools, discussing a range of health topics with their clients, and using diverse manual therapy techniques in their practice. Participants most commonly reported consulting with clients reporting stress (84.9%), neck pain (75.0%) and sciatica (66.0%). Participants reported treating middle aged (93.4%) and older people (63.3%) most frequently.

DISCUSSION AND CONCLUSION

BTs provide care to a range of clients experiencing a number of conditions and symptoms. Further research should explore the rich details and establish the outcomes of BTs' care with a view to helping inform safe, effective, coordinated patient care across the wider primary care team.

Formulation and investigation of hydrogels containing an increased level of diclofenac sodium using risk assessment tools

Transdermal delivery of active ingredients is a challenge for pharmaceutical technology due to their inadequate penetration properties and the barrier function of the skin. The necessity of painless, effective, topical therapy for the aging population is growing, and a variety of diclofenac sodium-containing semi-solid preparations are available to alleviate the symptoms of these ailments. Our purpose was to formulate a novel composition with higher drug content to enhance drug release and permeation, thereby providing more effective therapy. Another goal was to maintain the concentration of the organic solvent mixture below 30%, to protect the skin barrier. Firstly, literature and market research were conducted, based on which the appropriate excipients for the target formulation were selected. Solubility tests were conducted with binary and ternary mixtures. As a result, the optimal ternary mixture was chosen. Hydrogels containing 1, 5, and 7% of diclofenac sodium were prepared and the stability of the formulations were studied by microscopic measurements and cytotoxicity test were carried out of the components also. The release and permeation of diclofenac sodium were investigated in different concentrations. It can be concluded that we have succeeded in preparing a topically applicable stable diclofenac sodium hydrogel with higher concentration, drug release, and improved skin permeation than the formulations available on the market.

Handgrip strength and work limitations: A prospective cohort study of 70,820 adults aged 50 and older

The purpose of the study was to investigate the association between handgrip strength and the incidence of work limitations in European adults aged 50 and older. We conducted a prospective cohort study among adults aged 50 and older from 27 European countries and Israel. Data were collected from the Survey of Health, Ageing and Retirement in Europe (SHARE) waves 1, 2, 4, 5, 6, and 7. Handgrip strength was measured using a hand dynamometer (Smedley, S Dynamometer, TTM) and participants replied to questions about work limitations. Cox regression was conducted for statistical analyses. A total of 70,820 older adults (mean age 61 ± 7.7 years; 54.3 % women) were followed during a mean of 3.8 ± 2.9 years. The fully adjusted model showed that participants with low handgrip strength (<16 kg in women and <27 kg in men) had a significantly higher risk of work limitations compared with participants with normal values of handgrip strength (hazard ratio: 1.36; 95 % confidence interval: 1.28-1.44). Kaplan-Meier trajectories revealed that the survival probability to experience work limitations in the normal handgrip category was 20 % lower than in the low handgrip category in most of the follow-up period. We identified low level of handgrip strength as a risk factor for work limitations in adults aged 50 years or older. This could be used as an accessible measure to screen workers at risk of developing work limitations.

Global Burden of Disease Study 2019: an opportunity to understand the growing prevalence and impact of hip, knee, hand and other osteoarthritis in Australia

BACKGROUND

Understanding population-level trends in osteoarthritis (OA) is critical for planning health services and disease prevention initiatives.

AIM

To examine trends in the burden of hip, knee, hand and other OA related conditions in Australia from 1990 to 2019 and consider the OA burden in the context of other common conditions associated with older age.

METHODS

Global Burden of Disease Study 2019 data for Australia on OA prevalence, OA-related years lived with disability (YLDs) and OA-related YLDs attributable to high body mass index (BMI) were sourced for 1990-2019. Age-standardised YLD data for ischaemic heart disease, stroke, dementia, type 2 diabetes and chronic obstructive pulmonary disease were obtained for comparison.

RESULTS

Overall, 3.20 million Australians were estimated to have OA in 2019, with substantial growth in the prevalence of hip (+171%), knee (+126%), hand (+110%) and other types of OA (+130%) from 1990 to 2019. Age-standardised prevalence rates reflect the contribution of population ageing. Concomitant growth in OA-related YLDs was also evident; knee OA and hand OA demonstrated the highest disease burden in 2019 (59 684 and 41 893 YLDs respectively). The proportion of knee OA burden attributable to high BMI was 36% in 2019. In 2019, age-standardised YLD rates were higher for OA (313 per 100 000 population) than other common conditions (range: 47 per 100 000 (ischaemic heart disease) to 284 per 100 000 (type 2 diabetes)).

CONCLUSIONS

OA is an increasingly prevalent, impactful condition with a high non-fatal disease burden relative to other health conditions. Growth in OA populations and OA-related disability underscore the need for enhanced investment in prevention and management.

Certainty of the Global Burden of Disease 2019 Modelled Prevalence Estimates for Musculoskeletal Conditions: A Meta-Epidemiological Study

Objectives: To describe and assess the risk of bias of the primary input studies that underpinned the Global Burden of Disease Study (GBD) 2019 modelled prevalence estimates of low back pain (LBP), neck pain (NP), and knee osteoarthritis (OA), from Australia, Brazil, Canada, Spain, and Switzerland. To evaluate the certainty of the GBD modelled prevalence evidence. Methods: Primary studies were identified using the GBD Data Input Sources Tool and their risk of bias was assessed using a validated tool. We rated the certainty of modelled prevalence estimates based on the GRADE Guidelines 30-the GRADE approach for modelled evidence. Results: Seventy-two primary studies (LBP: 67, NP: 2, knee OA: 3) underpinned the GBD estimates. Most studies had limited representativeness of their study populations, used suboptimal case definitions and applied assessment instruments with unknown psychometric properties. The certainty of modelled prevalence estimates was low, mainly due to risk of bias and indirectness. Conclusion: Beyond the risk of bias of primary input studies for LBP, NP, and knee OA in GBD 2019, the certainty of country-specific modelled prevalence estimates still have room for improvement.

Prevalence and factors associated with low back pain in warehouse workers: A cross-sectional study

BACKGROUND

Low back pain is a highly prevalent musculoskeletal disorder that leads to functional incapacity and absence from work.

OBJECTIVE

To analyze warehouse workers' prevalence and factors associated with low back pain.

METHODS

Cross-sectional study design with 204 male warehouse workers (stocker, separator, checker, and packer) from motor parts companies. Age, body mass, marital status, education, the practice of physical exercise, presence of pain, low back pain intensity, comorbidities, time away from work, handgrip strength, flexibility, and trunk muscle strength were collected and analyzed. Data are presented as mean, standard deviation, absolute and relative frequency. A binary logistic regression was performed, with low back pain (yes or no) as the dependent variable.

RESULTS

24.0% of the workers reported low back pain with an average intensity of 4.7 (± 2.4) points. The participants were young, had completed high school education, were single and married, and had normal body weight. There was a more likely low back pain presence in separator tasks. Greater handgrip strength in the dominant (right) hand and trunk muscle is associated with no low back pain.

CONCLUSION

Low back pain prevalence was 24% among young warehouse workers, more likely in separation tasks. A greater handgrip and trunk strength can be a protective factor to no low back pain.