The management of work-related musculoskeletal injuries in an occupational health setting: the role of the physical therapist

Fostering the discussion of planetary health in occupational therapy and physiotherapy

INTRODUCTION

Occupational therapists and physiotherapists aim to promote health, prevent various diseases and help people in their rehabilitation processes. So far, there is a paucity of understanding of the big picture of how the new paradigm of planetary health (PH) is connected to the education and practice of these professionals.

METHODS

This research aimed to address this gap by investigating and deploying a bibliometric analysis to elucidate the pivotal role of occupational therapists and physiotherapists in addressing PH challenges. The ultimate goal is to construct a comprehensive framework crosschecking the bibliometric analysis and the collection of 10 case studies selected by experts to outline how best practices in occupational therapy and physiotherapy, related to the three pillars of sustainability and the UN's Sustainable Development Goals (SDGs), can contribute to increasing PH.

RESULTS

The bibliometric analysis revealed four major research strands: 1) enhancing patient care and quality of life; 2) integrating sustainability in health care and rehabilitation; 3) professional development and clinical competence; and 4) evidence-based practice and quality improvement. Moreover, further temporal analysis revealed how the topic evolved, from advancing evidence-based practice and clinical effectiveness, exploring the strengthening of health care and person-centred practices, to connecting the topic to aspects also predicted by the SDGs, such as integrating environmental and climate concerns in therapy and addressing psychological and self-care impacts on health. The case studies confirmed this trend, and a framework of PH in occupational therapy and physiotherapy through the lens of the SDGs was developed to support future research and practitioners in advancing this research field.

CONCLUSIONS

Occupational therapists and physiotherapists are essential players in public health and can integrate sustainability at every level of practice, from using resources during therapy sessions to advocating for more sustainable lifestyles.

Generalizability of a Musculoskeletal Therapist Electronic Health Record for Modelling Outcomes to Work-Related Musculoskeletal Disorders

PURPOSE

Electronic Health Records (EHRs) can contain vast amounts of clinical information that could be reused in modelling outcomes of work-related musculoskeletal disorders (WMSDs). Determining the generalizability of an EHR dataset is an important step in determining the appropriateness of its reuse. The study aims to describe the EHR dataset used by occupational musculoskeletal therapists and determine whether the EHR dataset is generalizable to the Australian workers' population and injury characteristics seen in workers' compensation claims.

METHODS

Variables were considered if they were associated with outcomes of WMSDs and variables data were available. Completeness and external validity assessment analysed frequency distributions, percentage of records and confidence intervals.

RESULTS

There were 48,434 patient care plans across 10 industries from 2014 to 2021. The EHR collects information related to clinical interventions, health and psychosocial factors, job demands, work accommodations as well as workplace culture, which have all been shown to be valuable variables in determining outcomes to WMSDs. Distributions of age, duration of employment, gender and region of birth were mostly similar to the Australian workforce. Upper limb WMSDs were higher in the EHR compared to workers' compensation claims and diagnoses were similar.

CONCLUSION

The study shows the EHR has strong potential to be used for further research into WMSDs as it has a similar population to the Australian workforce, manufacturing industry and workers' compensation claims. It contains many variables that may be relevant in modelling outcomes to WMSDs that are not typically available in existing datasets.

In-hospital complications of work-related musculoskeletal injuries

BACKGROUND, OBJECTIVES

Work-related musculoskeletal (MSK) injuries are a major contributor to morbidity worldwide and frequently result in hospitalisation. Hospital complications are common, costly, and largely preventable, but relevant data is required to address this. This study aimed to identify the incidence and factors associated with in-hospital complications of work-related MSK injuries.

METHODS

This study is based on work-related MSK hospital admission data from Victorian Admitted Episodes Database, 2016-2022. Complications were identified based on ICD-10-AM coding using CHADx (Classification of Hospital Acquired Diagnoses). Negative binomial and logistic regression analyses were performed to identify factors related to in-hospital complications.

RESULTS

In-hospital complications occurred in 6.3 % of work-related MSK injury admissions. In the adjusted models, ages ≥45 years, female sex, and area-level disadvantage were associated with in-hospital complications. Stay at public (vs private) hospitals, comorbidity, emergency admissions, and general anaesthesia were also associated. Complication rates were higher in hospitalised workers with direct head, neck, and trunk injuries and cumulative MSK disorders than those with direct extremities injuries and acute MSK conditions. The most common complications were cardiovascular, gastrointestinal complications and adverse drug events.

CONCLUSION

This study identified patient, injury and hospital-related characteristics associated with in-hospital complications of work-related MSK injuries for informing prevention strategies and risk estimation by hospital staff and workers' compensation schemes. The results demonstrate a sizable rate of complications given the relatively young and healthy study population.

Occupational health and safety activities undertaken by physiotherapy students: A retrospective review of industry placement reports

BACKGROUND

The University of South Australia's Bachelor of Physiotherapy course, 'Work Health and Safety (WHS) Practice', provides students with introductory practical WHS experience. Students undertake 80-hour effort WHS projects for industry, culminating in a report for hosts.

OBJECTIVE

To establish the types of industry that host WHS undergraduate physiotherapy placements and the nature of activities that students conduct.

METHODS

Reports were retrospectively, systematically classified using a descriptive, document content analysis approach. Demographic data were collected: report and student numbers, placement locations and industry types. Selected reports were used as a subset for further analysis with definitions created to classify the nature of placement activities.

RESULTS

Most reports were written by a pair of students (88%, n = 269), with placements based in metropolitan Adelaide (91%, n = 284). Various industries hosted students, including healthcare and social assistance (40%, n = 117) and manufacturing (30%, n = 89). Reports primarily included risk management activities as required by WHS legislation (97%, n = 229).

CONCLUSION

Physiotherapy student WHS activities maintain close links with industry, involving stakeholders (workforce, students, University of South Australia and academics). At an entry-level standard, the student WHS activities align well with some criteria set as key competencies for Australian Occupational Health physiotherapy practitioners.

A systematic model to identify and reduce work-related musculoskeletal disorders in firefighters, and improve their function

INTRODUCTION

Firefighting is a high-risk job with a high prevalence of work-related musculoskeletal disorders (WMSDs). The aim of his study was to determine the prevalence of WMSDs, estimate the likelihood of subsequent disorders, and investigate the effect of NASM-based training protocol on firefighters function.

METHOD

First, prevalence and region of WMSDs in all 524 male Isfahan firefighters were determined by Medical-history-questionnaire. Then, functional movement screen (FMS) separated firefighters to the 2-dimension FMS score (FMSCS≤14 or FMSCS>14) to show at risk firefighters. Finally, 40 Participants with both FMSCS≤14 and common WMSDs randomly assigned to either an intervention (IG) (n = 20) or control (CG) (n = 20) group. The IG received NASM-based training, while the CG engaged in daily activities. Outcomes included movement efficiency during landing error scoring system-real time, Y balance, single-leg squat, and deep squat, which were assessed in pretest and posttest.

RESULTS

The prevalence of disorders was 52.1%, which lower limb, back, upper limb, and neck were the highest prevalence respectively. Only lower limb and back disorders could identify individuals at disorder risk with a likelihood of 89% and 71%, sequentially. Also, movement performance significantly improved in all functional tests in IG relative to CG.

CONCLUSIONS

Considering high disorder rate in firefighters, the value of our study lies in alleging a systematic model periodically to reduce WMSDs and risk of subsequent disorders. Not only our model determined the prevalence of WMSDs, but it also identified those who are at risk. In addition, our model represents exercise therapy as a solution.

Effects of Corrective Exercises on Work-Related Musculoskeletal Disorders and Quality of Life in Surgical Residents: A Pilot, Quasi-Experimental Study

PURPOSE

Work-related musculoskeletal disorders (WMSDs) are one of the most important reasons for absenteeism, high costs of health care and human injuries; the latter are very common in medical staff. The present study was designed to evaluate the effects of corrective exercises on quality of life and work-related musculoskeletal disorders in surgical residents.

METHODS

In a quasi-experimental study with a one-group pretest-posttest design, we assessed the eligibility of 135 surgical assistants. All recruited participants performed corrective exercises and were followed for 12 months. The primary outcome of the study was any change in the surgical residents' work-related musculoskeletal disorders, which was assessed using the Nordic Musculoskeletal Questionnaire (NMQ) and the Numerical Pain Rating Scale (NPRS) prior to, and 3, 6, and 12 months after intervention. The secondary outcome was any change in the surgical residents' quality of life (QOL) score, which was assessed at baseline, 6 and 12 months after the intervention using the World Health Organization Quality of Life - BREF (WHOQOL-BREF) questionnaire.

RESULTS

One hundred eligible surgical residents were enrolled, of whom 67 (67%) completed the study. At baseline the majority of the participants were female and >30 years of age. Fifty-five percent of them used analgesic drugs. The use of analgesic drugs per week fell by 14.7% from baseline to 12 months; the change was statistically significant (p = 0.042). The effect of corrective exercises on the intensity of pain in the shoulder (p = 0.002), hand/wrist (p = 0.001), upper back (p = 0.03), lower back (p = 0.02) and knee (p = 0.01) was significant. Corrective exercises also led to a significant rise in the quality-of-life score (p < 0.019).

CONCLUSIONS

This study demonstrated the effectiveness of corrective exercises in reducing work-related musculoskeletal disorders and improving quality of life among surgical residents.

Family caregivers' experience of care with a child with cerebral palsy: the lived experiences and challenges of caregivers in a resource-limited setting in northern Ghana

INTRODUCTION

Caring for a child with cerebral palsy may be more emotionally and physically exhausting than caring for a typical growing child. The family caregivers' perspective of this phenomenon needs exploring to facilitate the development of services. Our study explored the challenges family caregivers face with children with cerebral palsy in a resource-limited context in northern Ghana.

METHODS

We conducted a qualitative study underpinned by phenomenological principles where it is believed that the reality of a phenomenon is tied to caregivers' perspectives of their own experiences. In this study, we unearthed caregivers' experiences/challenges from their own perspectives. The method of data analysis used was to allow the issues to emerge from the data (inductive process) using the content analysis approach. We recruited 13 caregivers of children with cerebral palsy from the physiotherapy unit at Tamale Teaching Hospital, and conducted individual in-depth interviews supported by an open-ended topic guide. Interviews were audio recorded, transcribed, and translated and coded inductively before conducting a content analysis of the data when grouped into themes.

RESULTS

We have identified barriers to managing a child with cerebral palsy, including sociocultural barriers (values, attitudes and belief systems within society), economic challenges and immediate physical care burdens. Specific barriers included discrimination and isolation, lack of family and societal support, with poor access to health information and formal education. Others were lack of information on the cause and course of cerebral palsy, caregivers' loss of jobs, increased healthcare expenditure and struggles in lifting and moving children, which resonate with evidence-based multidimensional model of caregiving process and caregiver burden.

CONCLUSION

Caregivers have the arduous task of caring for a child with cerebral palsy. Social support interventions and policy initiatives that seek to ameliorate caregivers' finances and make formal education accessible to this marginalised child population may be beneficial in this context.

Occupational Health: Physical Activity, Musculoskeletal Symptoms and Quality of Life in Computer Workers: A Narrative Review

Computer work has assumed a very important role for many companies, but specific occupational and health symptoms associated with the use of computers can appear. According to the literature, physical activity is considered a key player in the prevention and control of work-related musculoskeletal symptoms, contributing to a better quality of life in computer workers. The principal aims of this review are to contribute to a better understanding of the relationship among sedentary behavior, physical activity and quality of life of computer workers; to outline the importance of promoting the development of an educational program for Occupational Health directed at computer workers at the level of quality of life, musculoskeletal symptoms, and physical activity; and to call for attention to the factors needed to initiate and maintain a health program that involves the active participation of workers who must be concerned about their health. This review demonstrates the important role of workplaces in health promotion and the opportunities that workplaces provide to establish and continue successful health-promotion programs for computer workers, generating important benefits for the health and quality of life of individuals and groups.

The Effects of Early Physiotherapy Treatment on Musculoskeletal Injury Outcomes in Military Personnel: A Narrative Review

The risks and incidence rates of musculoskeletal injuries among military personnel are high, and the importance of physiotherapy in treating these injuries is well established. However, what is less clear is whether the timing of commencement of physiotherapy treatment affects musculoskeletal injury outcomes in military personnel. This lack of clarity is exacerbated by the known underreporting of injuries among military personnel, and the resulting self-management of musculoskeletal injuries using analgesics, non-steroidal anti-inflammatories and other means. This narrative review was designed to identify and synthesize current evidence regarding the effects of timing of physiotherapy treatment on musculoskeletal injury outcomes, focusing on potential benefits of early versus typical or delayed commencement of physiotherapy treatment. Overall, current evidence suggests early physiotherapy treatment of musculoskeletal injuries offers distinct advantages over typical or delayed commencement of physiotherapy treatment in military settings. Specifically, it appears early treatment expedites recovery in early phases following injury onset and benefits longer term mental health and well-being. It may also reduce the need for more invasive and costly health care interventions and enable earlier return to training and operational service. Importantly, a cultural shift within military contexts to ensure early reporting of musculoskeletal injuries is required if the benefits of early commencement of physiotherapy treatment are to be achieved.

Utilization rates of Active Release Techniques® in the workplace: A descriptive study

BACKGROUND: Workplace safety is a necessary and frequent topic of discussion for researchers, employers, and workers. It is estimated that annual losses caused by work-related injuries cost the United States $140 to $145 billion. Specifically, work-related musculoskeletal disorders (WMSD) have risen from just over 10% to 50% of the total claims from 1952 to 1996, accounting for more than 345,00 days lost and more than $57 million in WSIB costs in 2015. Novel approaches to managing WMSDs, such as Active Release Techniques®, need to be explored to ensure the ongoing health of workers. OBJECTIVE: This descriptive study provides the details of the 697,002 onsite treatments across 448 sites in North America between 2014–2018 provided by Active Release Techniques® Corporate Solutions (ARTCS) practitioners. The objective was to calculate the total number of treatments, cost per closed case, percent improvement, and the number of cases referred to worker’s compensation. METHODS: All charting was done on the ARTCS EMR portal. The lead author was given a spreadsheet of the results sanitized of all identifying data in order to perform the aforementioned calculations. RESULTS: From 2014 to 2018, ARTCS providers opened 199,077 new cases, with an average cost to the employer of $306.69 USD per case and an average percent improvement in pain (VNPS) of 87.2%. The most frequently treated areas were the shoulder (32,574 cases), hip (6,633 cases), and low back (27,873 cases), respectively. A total of 48,946 cases were work-related pain/discomfort, of which 1,110 (2.27%) went on to worker’s compensation. CONCLUSION: ARTCS in the workplace has shown a positive trend in terms of reducing pain intensity. The cost was low as compared to worker’s compensation claims, as was the rate of cases (2.27%) referred to worker’s compensation. Additional studies, including prospective data collection and a control group, are warranted to substantiate this.

Management of Chronic Musculoskeletal Disorders in the Workplace from the Perspective of Older Employees: A Mixed Methods Research Study

(1) Background: This mixed methods research (MMR) study explored older employees’ experiences of chronic musculoskeletal disorders (CMSDs) in relation to their employment, their perspectives on managing these conditions in the workplace and the strategies used to facilitate and maintain their roles and responsibilities. The services offered to them were also identified. (2) Methods: A mixed methods exploratory sequential design was implemented. In the first qualitative phase, 16 semi-structured interviews gathered in-depth information from older employees. The findings informed the development of an online questionnaire in the survey phase, which was administered to older employees (N = 107). Both sets of findings were then integrated using a narrative joint display. (3) Results: The phenomena of presenteeism and leaveism were important components of employees’ strategies for managing their condition. The integrated findings highlighted the roles of employers, managers and social support in encouraging disclosure and supporting the management of CMSDs. The results also emphasised how self-management and professional health services are crucial for sustaining employability. (4) Conclusions: Current challenges call for employers to identify effective ways to support the ageing workforce and invest in training opportunities for managers and collaborative opportunities with healthcare professionals and other stakeholders. A flexible, empathetic and resourceful work environment is optimal for supporting sustained employability for an ageing workforce.

Determining the musculoskeletal problems of academicians who transitioned to distance education during the COVID-19 pandemic

BACKGROUND: Musculoskeletal disorders are a significant public health issue that negatively affects individuals and society both socially and economically, and increases the cost of care and cure. OBJECTIVE: This study aimed to determine the musculoskeletal problems and risk factors of academicians who transitioned to provide distance education during the COVID-19 pandemic. METHODS: The population of this descriptive cross-sectional study included academicians who worked in two public universities in Turkey. Ethical committee approval and institutional permissions were obtained between 1 and 28 February 2021. Data were collected using a personal information form, the Work Environment Evaluation Questionnaire, and the Musculoskeletal Pain Intensity Assessment Questionnaire. The data were analyzed using the number, percentage, independent group t-test, ANOVA test, and linear regression analysis (forward method). The analysis was interpreted at the 95% confidence level and 0.05 error margin. RESULTS: Of the academicians, 78% were women, 54.6% were married, 80.6% did not regularly exercise, and 73.5% had more workload during the distance education period. Academicians mostly experienced discomfort about their eyes, necks, and waists, and an increase at a significant level was detected in their musculoskeletal system problems during the distance education period. Increasing workload, duration of mobile phone use, active time, having an ergonomic chair, and gender predicted the musculoskeletal system pain intensity by 20%. CONCLUSION: Musculoskeletal system problems are a significant public health issue. Academicians should be informed and consulted for the protection of musculoskeletal system health during the distance education period.

Positive Effects of an Online Workplace Exercise Intervention during the COVID-19 Pandemic on Quality of Life Perception in Computer Workers: A Quasi-Experimental Study Design

Computer workers' sedentary work, together with less active lifestyles, aggravated by the COVID-19 pandemic, represents a high risk for many chronic diseases, leading to a decrease in health-related quality of life (QoL). Workplace exercises consist of a set of physical exercises, implemented during work breaks, that have multiple benefits for workers' health.

AIM

To assess the impact of online workplace exercises on computer workers' perception of quality of life.

METHODS

Quasi-experimental study with two groups: a control group (n = 26) and an intervention group (n = 13). The inclusion criteria were that participants must be aged between 18 and 65 years old and the exclusion criteria included diagnosis of non-work-related medical conditions. The interventions consisted of workplace exercises, which were applied for 17 consecutive weeks, each session lasting 15 min, three times a week. The exercise programme, performed online and guided by a physiotherapist, consisted of mobility exercises, flexibility and strength exercises, with the help of a TheraBand® for elastic resistance. The control group were not subjected to any intervention. A socio-demographic questionnaire and the Health Survey Questionnaire (SF-36v2) were used in two assessment stages (M0-baseline and M1-final of intervention). A mixed ANOVA with interaction time*group was used to evaluate the effect of the exercise programme.

RESULTS

A good perception of the QoL was obtained in both stages. The exercise programme had a positive effect in the domains of Pain (ptime*group = 0.012, η2p = 0.158), Physical Function (ptime*group = 0.078, η2p = 0.082), Physical Performance (ptime*group = 0.052, η2p = 0.098), and Emotional Performance (ptime*group = 0.128, η2p = 0.061).

CONCLUSION

After 17 weeks of workplace exercises, it became clear that the intervention group positively increased their QoL perception, with this improvement being significant in the Pain domain, which resulted in an improvement in their health condition. Therefore, further studies are needed to determine the optimal exercise for CWs, with detailed exercise types, different intensities and focused on various health conditions.

Chairless Chairs for Orthopedic Surgery Purpose – A Literature Review

Musculoskeletal disorders are often found in various types of work, including surgeons. Standing working position is immobile and rigid when performing surgical operations. The equipment used is less ergonomic which is the main parameter. The surgeon profession belongs to the category of the high-risk profession and has the potential to experience musculoskeletal disorders. Surgeons who suffer musculoskeletal disorders sense disease start from mild-to-severe due to the muscles receiving static loads frequently in the long-term. The emergence of musculoskeletal disorders can be caused by working environment conditions and standing position while working, causing injury to joints, vertebral discs, nerves, cartilage, tendons, and muscles. This paper describes in extensive the potential for reducing musculoskeletal problems with the use of a chairless chair for surgeons in carrying out operations. Musculoskeletal problems in surgery and the use of chairless chairs have been further explored to close the existing research gap.

Telerehabilitation of acute musculoskeletal multi-disorders: prospective, single-arm, interventional study

Background

Acute musculoskeletal (MSK) pain is very common and associated with impaired productivity and high economic burden. Access to timely and personalized, evidence-based care is key to improve outcomes while reducing healthcare expenditure. Digital interventions can facilitate access and ensure care scalability.

Objective

Present the feasibility and results of a fully remote digital care program (DCP) for acute MSK conditions affecting several body areas.

Methods

Interventional single-arm study of individuals applying for digital care programs for acute MSK pain. Primary outcome was the mean change between baseline and end-of-program in self-reported Numerical Pain Rating Scale (NPRS) score and secondary outcomes were change in analgesic consumption, intention to undergo surgery, anxiety (GAD-7), depression (PHQ-9), fear-avoidance beliefs (FABQ-PA), work productivity (WPAI-GH) and engagement.

Results

Three hundred forty-three patients started the program, of which 300 (87.5%) completed the program. Latent growth curve analysis (LGCA) revealed that changes in NPRS between baseline and end-of-program were both statistically (p < 0.001) and clinically significant: 64.3% reduction (mean − 2.9 points). Marked improvements were also noted in all secondary outcomes: 82% reduction in medication intake, 63% reduction in surgery intent, 40% in fear-avoidance beliefs, 54% in anxiety, 58% in depression and 79% recovery in overall productivity. All outcomes had steeper improvements in the first 4 weeks, which paralleled higher engagement in this period (3.6 vs 3.2 overall weekly sessions, p < 0.001). Mean patient satisfaction score was 8.7/10 (SD 1.26).

Strengths and limitations

This is the first longitudinal study demonstrating the feasibility of a DCP for patients with acute MSK conditions involving several body areas. Major strengths of this study are the large sample size, the wide range of MSK conditions studied, the breadth of outcomes measured, and the very high retention rate and adherence level. The major limitation regards to the absence of a control group.

Conclusions

We observed very high completion and engagement rates, as well as clinically relevant changes in all health-related outcomes and productivity recovery. We believe this DCP holds great potential in the delivery of effective and scalable MSK care.

Trial registration

NCT, NCT04092946. Registered 17/09/2019;

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-021-04891-5.

Occupational Health Physiotherapy (OHP) Practice: A Comparison between Japan and Australia

OBJECTIVE

This study aimed to adapt a pre-existing cross-country comparison (CCC) model to Occupational Health Physiotherapy (OHP) practice as a basis for locating and examining contextual factors that may influence OHP practice in Japan and Australia.

METHOD

A secondary analysis was conducted of existing publicly-available data on OHP and related influential factors, following the five components of the CCC model: work-related legislation; labor market characteristics; culture; physiotherapy practice norms; and organization of OHP practice.

RESULTS

Legislation in both countries promotes safe work and rehabilitation of work injured/ill workers. 2019 unemployment was lower in Japan with higher employment protection than Australia. Both countries have an ageing workforce and rising retirement age. Cultural differences relate to higher long-term orientation and uncertainty avoidance in Japan. Australia has higher individualism and physiotherapists are autonomous practitioners with direct access, which differs from Japan. Both countries have a national OHP subgroup, to date only Australia has OHP professional practice standards.

DISCUSSION

This study is the first to compare OHP practice in Japan and Australia. Contextual similarities and differences observed may underpin OHP practitioner role and its enhancement in work-related musculoskeletal disorder prevention and management strategies, the return-to-work process, and development of this physiotherapy discipline nationally.

CONCLUSION

Adapting the CCC model to OHP practice enabled a structured exploration of resources and data, from which to extract and compare contextual factors that may shape OHP practice in Japan and Australia. This in turn may provide a useful springboard for further discussion about OHP practice internationally.

Occupational Health: Does Compliance with Physical Activity Recommendations Have a Preventive Effect on Musculoskeletal Symptoms in Computer Workers? A Cross-Sectional Study

A lack of physical activity in computer workers (CW) can contribute to the development of musculoskeletal symptoms (MSS). Aim: (i) Evaluate MSS over a 12 month and 7 days period, (ii) determine physical activity (PA) levels and compliance with World Health Organization (WHO) PA recommendations, and (iii) assess the relationship between compliance with WHO PA recommendations and MSS. Methods: A cross-sectional observational study comprising 119 computer workers. The Nordic Musculoskeletal Questionnaire (NMQ) was used to evaluate the MSS and the International Physical Activity Questionnaire (IPAQ) was used to analyse the perception of the level of PA. Results: MSS occurred in the lumbar region (56.3%), neck (43.7%), and shoulders (39.5%). 44.7% of the participants reported a low level of PA. The percentage of compliance was similar among women and men (62.2% vs. 58.5%, respectively). Negative correlations were found between pain intensity and metabolic equivalent values. The participants who followed the WHO PA recommendations reported a lower frequency of MSS compared to those who did not, but the differences were not statistically significant. Conclusion: It was possible to conclude that computer workers presented a higher frequency of MSS in the lower back, neck, and shoulders. Regarding the level of PA, participants were mostly classified as low. Participants who followed the WHO PA recommendations reported lower MSS than those who did not. This finding could be important in obtaining successful programs that promote health-oriented physical activity in this group of workers.

The Contribution of Onsite Physiotherapy to an Integrated Model for Managing Work Injuries: A Follow Up Study

Purpose As part of an integrated system to manage work injuries, some organisations utilise the skills of an onsite physiotherapist. Onsite physiotherapy can provide benefits for the workers and organisation when delivered as part of an early intervention injury prevention program (IPP) at a poultry meat processing plant. However, once established, the sustainability of this service on work injury and compensation outcomes without ongoing physiotherapy contribution is unknown. Methods Through analysis of two large secondary datasets of workplace injuries and compensation claims, outcome measures of injury rates, cost per workers' compensation claim and duration of work absence were compared over a 36-month period where onsite physiotherapy contributed to the IPP and was later removed. Results 3951 injuries and their 781 resultant compensation claims were analysed within a 36-month analysis period. A small but non-significant rise in injury rates and duration of work absence was associated with the removal of onsite physiotherapy. There was also a shift towards more compensations claims with work absence after physiotherapy was removed. However, there was a significant reduction in adjusted mean costs per claim of $847 for all injury types (p < 0.001) and $930 for musculoskeletal disorders (p < 0.001) after the removal of onsite physiotherapy. Conclusions Once an IPP was embedded within an organisation, onsite physiotherapy services were able to be discharged without significantly and negatively impacting demonstrated benefits and injury outcomes. There was also cost savings to the insurer through reduced mean claim costs and to the employer by not funding the onsite physiotherapy service.

Workplace physiotherapy for musculoskeletal pain-relief in office workers: A pilot study

BACKGROUND

Musculoskeletal pain is highly prevalent among office workers and causes high costs to the public health system. Strategies including education and exercise are recommended, with major benefits when conducted by physical therapists in the occupational environment. However, the required investment is uncommon among companies. This study aimed to evaluate the efficacy of a multimodal physiotherapy intervention to relieve musculoskeletal pain in office workers.

MATERIALS AND METHODS

The study employed a single group study with a pre-post study design and was conducted at Universidad San Jorge in 2018. Outcome variables were: workplace ergonomics (INSHT Guide), existence and severity of musculoskeletal disorders (Nordic Musculoskeletal Questionnaire), musculoskeletal pain intensity (Numeric Rating Scale), and Clinical Global Impression Scale. Office workers in a university setting (n = 24, 19 females) were assessed at baseline, after 4 weeks of in-person sessions and following 3 weeks of autonomous performance. The physiotherapy program included education, ergonomic supervision, self-treatment, strengthening, and stretching exercises. A repeated-measures ANOVA or Friedman test (with post hoc comparisons) and Chi-squared test were used to compare the study variables.

RESULTS

At baseline, cervical spine (54%), shoulder (42%), and lumbar regions (37.5%) were the most symptomatic regions according to the Nordic Musculoskeletal Questionnaire. Even if the proportion of symptomatic areas did not decrease significantly after the intervention, a great reduction of musculoskeletal pain intensity was observed after the program in the cervical (P < 0.001), lower back (P = 0.005), shoulder (P = 0.006) regions, and in the overall pain level (P < 0.001).

CONCLUSIONS

These results support that a multimodal physiotherapy program can relieve work-related musculoskeletal pain in office workers and serve as a basis for future controlled trials.

Morphological Characteristics and Correction of Long Tubular Bone Regeneration under Chronic Hyperglycemia Influence

Introduction

Unsatisfactory consequences of bone regeneration disorders in diabetes mellitus (DM) patients, their high prevalence, complication number, and difficulties in treatment require further study and deeper understanding of reparative osteogenesis mechanisms under chronic hyperglycemia and finding new effective and affordable approaches to their treatment. Therefore, the aim of our work was to study the histological, ultramicroscopic, and histomorphometric features of reparative osteogenesis in rats with chronic hyperglycemia (CH), as well as to investigate the possibility of platelet-rich plasma (PRP) use in a fracture area in order to correct the negative effects of CH on reparative osteogenesis processes. Study Object and Methods. The studies were performed on 70 white laboratory rats, mature males, which were divided into the following groups: control group, animals with posttraumatic tibial defect under conditions of CH exposure, rats with experimental CH that were administered with PRP into the bone defect, and animals for the assessment of glucose homeostasis and confirmation of simulated CH. Light microscopy was performed using an Olympus BH-2 microscope (Japan). Ultramicroscopic examination was performed using REM-102 scanning electron microscope. The statistical analysis was performed using SPSS-17 software package.

Results

The formation of new bone tissue in animals with CH did not occur after two weeks. Only on the 30th day of reparative osteogenesis the newly formed woven bone tissue was 61.54% of the total regenerated area. It was less than the reference value by 22.89% (P < 0.001). On the 14th day of reparative osteogenesis, the regenerated area in a group of animals with CH and PRP injection consisted of connective tissue by 68.94% (4.94% less than in animals with CH (P < 0.001)) and woven bone tissue by 31.06%, (13.51% less than in the control group (P < 0.001)). On the 30th day, the area of woven bone tissue in a regenerate of this group was less than that of the control group by 12.41% (P < 0.001).

Conclusion

Thus, chronic hyperglycemia contributes to inflammation delay within the bone defect site, which makes the process of reparative osteogenesis more prolonged. The results of chronic hyperglycemia effect on bone regeneration are also impairment of osteogenic cell proliferation and shift of their differentiation towards the fibrocartilage regenerate formation. The PRP corrects the negative impact of chronic hyperglycemia on reparative osteogenesis, promoting more rapid inflammatory infiltrate removal from the bone defect site and osteogenic beam formation and remodeling of woven bone into lamellar membranous bone tissue.

Effects of Ergomotor Intervention on Improving Occupational Health in Workers with Work-Related Neck-Shoulder Pain

(1) Background: Work-related neck and shoulder pain (WRNSP) are common problems, and past occupational research has focused on ergonomic interventions such as adjusting workstations while physiotherapists have traditionally focused on teaching exercises to improve posture and movement control in the clinical setting. The current study aimed to integrate these two approaches and evaluate the immediate and long-term effects of such interventions on occupational exposure outcomes. (2) Methods: A total of 101 patients diagnosed with WRNSP were randomized into 2 groups: Control (CO) group (n = 50) and ergomotor (EM) group (n = 51). Participants in the control group had 12 weeks of usual care (conventional physiotherapy) while participants in the EM group received an integrated program with tailor-made motor control training and ergonomic advice for 12 weeks. (3) Results: Both groups achieved significant improvement in pain and functional outcomes at post-intervention. The EM group also reported significantly improved scores in terms of perceived exertion in the job-related physical demands (JRPD) and the short form workstyle questionnaires compared to the control group. (4) Conclusions: The results suggest that ergomotor intervention may be more effective in producing favorable occupational health outcomes compared to conventional physiotherapy.