Effects of exercise on pain of musculoskeletal disorders: a systematic review

Work-related musculoskeletal disorder and its associated factors among bank workers in Ethiopia: A systematic review and meta-analysis

INTRODUCTION

Work-related musculoskeletal disorders are among the major global public health problems and contributors to disability and workers' absence in occupational areas which certainly disrupts work productivity and expected results. In Ethiopia, different studies investigated work-related musculoskeletal disorders. However, the findings were not consistent and conclusive enough, and there is no nationwide data representing this growing public health concern. This in turn hinders the efforts of intervention activities. Therefore, this study aimed to estimate the pooled prevalence of and factors associated with work-related musculoskeletal disorder among bank workers in Ethiopia.

METHODS

To retrieve all the relevant studies, international databases such as PubMed/MEDLINE, CINAHL, LIVIVO, African Journals Online, African Index Medicus (AIM), HINARI, Science Direct, Cochrane Library, Google Scholar, Semantic Scholar, and Google were used. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guideline was followed for this study. The extracted data were analyzed using STATA 17 software. The heterogeneity of the included studies was determined by the Higgs I2 statistics. With a 95% confidence interval, this meta-analysis with the random-effects model was carried out to determine the pooled prevalence of work-related musculoskeletal disorder.

RESULT

In this meta-analysis, eight articles in total with 3399 study participants were included. The overall pooled prevalence of work-related musculoskeletal disorder was 57.41% (95%; CI: 38.87%, 75.95%; I2 = 99.4%; P = 0.000). Gender, job stress, physical activity, and work experience were found to be factors significantly associated with work-related musculoskeletal disorder.

CONCLUSION

A high prevalence of work-related musculoskeletal disorder among bank workers in Ethiopia was recorded. This underscores the importance of implementing effective intervention measures such as job rotation, job enrichment, extended breaks, mitigating negative social factors, and establishing physical exercise facilities to address the underlying issues.

Special Issue "Role of Exercises in Musculoskeletal Disorders-4th Edition"

This fourth edition of the Special Issue titled "Role of Exercises in Musculoskeletal Disorders" significantly enriches the discourse on the effectiveness and feasibility of physical activity in managing patients with musculoskeletal disorders [...].

Special Issue "Role of Exercises in Musculoskeletal Disorders-6th Edition"

The sixth edition of the Special Issue entitled "Role of Exercise in Musculoskeletal Disorders" has been collated, substantially advancing the conversation on the effectiveness and practicality of exercise-based interventions for individuals with musculoskeletal conditions [...].

Effects of Physical Activity and Exercise Interventions on Health Outcomes in Occupational Drivers: A Systematic Review

BACKGROUND

Occupational drivers are exposed to a wide range of risk factors, including sedentary behavior and physical inactivity, which can contribute to various chronic diseases. However, exercise interventions are likely to alleviate the negative associations and reduce chronic disease risks. This systematic review aimed to inventorize research studies investigating the effects of physical activity and exercise interventions on health outcomes in occupational drivers, and to assess interventions that have demonstrated effectiveness on health outcomes in occupational drivers.

METHODS

The electronic databases "Web of Science," "Scopus," and "PubMed" were searched using keywords related to "occupational drivers," "exercise," and "health outcomes." Studies were included if they examined the effects of physical activity and exercise among occupational drivers on the following health outcomes: pain, disability, lifestyle factors (sleep, weight, physical activity, nutrition), fatigue, stress, and cardiometabolic risk factors. The methodological quality of the studies was assessed by the Cochrane Risk of Bias tools for randomized and non-randomized studies.

RESULTS

Fourteen articles were included (three randomized and 11 non-randomized controlled trials). All studies were judged to have an overall risk of bias as "some concerns, low, moderate or serious." Evidence suggests that stretching and isometric exercises have significantly improved pain, disability, and fatigue. In contrast, multicomponent lifestyle interventions have enhanced physical activity levels, cardiometabolic risk factors, anthropometrics (body mass index, weight, waist circumference), sleep, and dietary intake among occupational drivers.

CONCLUSION

The available evidence indicates the potential benefits of exercise interventions and physical activity for health outcomes in occupational drivers. However, high-quality studies are needed in the future to establish stronger evidence supporting the effect of the exercise intervention.

Effects of Exercise in Adults With Cancer Pain: A Systematic Review and Network Meta-Analysis

CONTEXT

Pain is one of the most common symptoms of cancer patients, affecting the patient's physical, psychological, behavioral, social relations and other aspects. Previous studies have demonstrated that exercise is effective for cancer pain, and the optimal exercise is still unknown.

OBJECTIVES

This study aimed to compare the effects of different exercise interventions on cancer pain in adults.

METHODS

Randomized control trials identified from medical literature databases that reported effects of exercise in adults with cancer pain were included in this study. Literature screening and data extraction were conducted independently by 2 researchers. Cochrane Bias Assessment 2.0 was used to assess the quality of the literature, and Stata 15.0 software was used for Network meta-analysis.

RESULTS

Forty-one studies were included, involving 3537 patients with cancer pain. The types of exercise involved included aerobic exercise, medium intensity continuous training, high-intensity interval training, resistance exercise, mind-body exercise and comprehensive exercise program (CEP). The results suggested that CEP was more effective than the usual care in relieving pain intensity in cancer patients [SMD = -1.96,95% CI (-3.47, -0.44)] (SUCRA = 97.9%). Mind-body exercise outperformed usual care in reducing pain interference in cancer patients [SMD = -0.65, 95% CI (-1.21, -0.09)] (SUCRA = 83.8%).

CONCLUSION

Current evidence shows that CEP is the best way to relieve the pain intensity of cancer patients, and mind-body exercise is the best way to reduce pain interference of cancer patients. Due to the limited number and quality of the included studies, the above conclusions need to be further verified by more high-quality studies.

Clinical and sociodemographic determinants of older breast cancer survivors' reports of receiving advice about exercise

PURPOSE

Exercise offers various clinical benefits to older breast cancer survivors. However, studies report that healthcare providers may not regularly discuss exercise with their patients. We evaluated clinical and sociodemographic determinants of receiving advice about exercise from healthcare providers among older breast cancer survivors (aged ≥65 years).

METHODS

We used data from the Surveillance, Epidemiology, and End Results cancer registries linked to the Medicare Health Outcomes Survey (MHOS) from 2008 to 2015. We included female breast cancer survivors, aged ≥65 years, who completed the MHOS survey ≥2 years after a breast cancer diagnosis in a modified Poisson regression to identify clinical and sociodemographic determinants of reportedly receiving advice about exercise from healthcare providers.

RESULTS

The sample included 1,836 breast cancer survivors. The median age of the sample was 76 years (range: 72-81). Overall, 10.7% of the survivors were non-Hispanic Black, 10.1% were Hispanic, and 69.3% were non-Hispanic White. Only 52.3% reported receiving advice about exercise from a healthcare provider. Higher body mass index (BMI) and comorbid medical history that included diabetes, cardiovascular, or musculoskeletal disease were each associated with a higher likelihood of receiving exercise advice. Lower education levels, lower BMI, and never having been married were each associated with a lower likelihood of receiving exercise advice.

CONCLUSIONS

Nearly half of breast cancer survivors aged ≥65 years did not report receiving exercise advice from a healthcare provider, suggesting interventions are needed to improve exercise counseling between providers and survivors, especially with women with lower educational attainment who have never been married.

Technologies and Sensors for Artificial Muscles in Rehabilitation

Muscles are very important parts of the human body. When there is an injury to a muscle that causes long-term dysfunctionality, sensors and artificial muscles can be used to help alleviate problems. Muscles have complex structures; thus, ultrasound and other types of scans may be needed to determine their parameters and model their shapes. Additionally, the measurement of chemicals in muscles plays a significant role in analyzing their performance and potential diseases in humans. All the above-mentioned components are needed for understanding the structure and function of muscles. The areas studied in this review include artificial muscles and exoskeletons, determining muscle parameters and modelling, assessing musculoskeletal functions, chemicals in muscles, and various applications, including those of wearable sensors. In future studies, we would like to understand the link between the brain and muscles and develop technologies that can assist in augmenting the motor skills of individuals affected by various debilitating conditions.

Identifying the risk of exercises, recommended by an artificial intelligence for patients with musculoskeletal disorders

Musculoskeletal disorders (MSDs) impact people globally, cause occupational illness and reduce productivity. Exercise therapy is the gold standard treatment for MSDs and can be provided by physiotherapists and/or also via mobile apps. Apart from the obvious differences between physiotherapists and mobile apps regarding communication, empathy and physical touch, mobile apps potentially offer less personalized exercises. The use of artificial intelligence (AI) may overcome this issue by processing different pain parameters, comorbidities and patient-specific lifestyle factors and thereby enabling individually adapted exercise therapy. The aim of this study is to investigate the risks of AI-recommended strength, mobility and release exercises for people with MSDs, using physiotherapist risk assessment and retrospective consideration of patient feedback on risk and non-risk exercises. 80 patients with various MSDs received exercise recommendations from the AI-system. Physiotherapists rated exercises as risk or non-risk, based on patient information, e.g. pain intensity (NRS), pain quality, pain location, work type. The analysis of physiotherapists' agreement was based on the frequencies of mentioned risk, the percentage distribution and the Fleiss- or Cohens-Kappa. After completion of the exercises, the patients provided feedback for each exercise on an 11-point Likert scale., e.g. the feedback question for release exercises was "How did the stretch feel to you?" with the answer options ranging from "painful (0 points)" to "not noticeable (10 points)". The statistical analysis was carried out separately for the three types of exercises. For this, an independent t-test was performed. 20 physiotherapists assessed 80 patient examples, receiving a total of 944 exercises. In a three-way agreement of the physiotherapists, 0.08% of the exercises were judged as having a potential risk of increasing patients' pain. The evaluation showed 90.5% agreement, that exercises had no risk. Exercises that were considered by physiotherapists to be potentially risky for patients also received lower feedback ratings from patients. For the 'release' exercise type, risk exercises received lower feedback, indicating that the patient felt more pain (risk: 4.65 (1.88), non-risk: 5.56 (1.88)). The study shows that AI can recommend almost risk-free exercises for patients with MSDs, which is an effective way to create individualized exercise plans without putting patients at risk for higher pain intensity or discomfort. In addition, the study shows significant agreement between physiotherapists in the risk assessment of AI-recommended exercises and highlights the importance of considering individual patient perspectives for treatment planning. The extent to which other aspects of face-to-face physiotherapy, such as communication and education, provide additional benefits beyond the individualization of exercises compared to AI and app-based exercises should be further investigated.Trial registration: 30.12.2021 via OSF Registries, https://doi.org/10.17605/OSF.IO/YCNJQ .

Effect of Structured Exercise-Based Intervention on Upper Quadrant Dysfunction among Fish Processing Workers with Work-Related Musculoskeletal Disorders

Background

Musculoskeletal disorders (MSDs) are one of the major causes of morbidity, which affect particularly the upper quadrant in industrial settings and so upset the quality of life (QoL). The influence of the protocol of exercise-based programs at the workplace on the well-being of the worker is contradictory. The objective of the study was to find the effect of the structured exercise-based intervention on upper quadrant dysfunction among fish processing workers with work-related MSDs.

Methods

The intervention group (n = 91) participated in an individually tailored structured exercise-based intervention (SEBI) program for three months, which consisted of stretching, strengthening, and active exercises. The control group (n = 93) was instructed to continue routine daily activities. The outcome measures of the cluster-randomized controlled trial were Neck Disability Index (NDI), Disabilities of Arm, Shoulder, and Hand (DASH), Visual Analog Scale (VAS), and Short Form-36, used to evaluate at baseline, eighth, and twelfth week. The data were analyzed by repeated analysis of variance and Student's t-tests.

Results

The results for the overall perception of upper quadrant dysfunction showed statistically significant differences (P < 0.0001) for NDI, DASH, and VAS. Further, we obtained a significant difference in QoL between the intervention and control groups for physical and psychological health sub-domains.

Conclusion

SEBI effectively enhanced the general health of fish processing workers by showing improvements in the measures of NDI, DASH, VAS, and QoL. Hence, SEBI can be recommended in the fish processing industries to achieve potential impact on upper quadrant dysfunction and improve the QoL.

Don't Just Stand There. Rethinking the Ideal Body Posture for Otorhinolaryngologists

Surgeons have a high rate of work-related musculoskeletal injuries; an area that has received little attention. These injuries result in surgeons performing less efficiently, needing to take time off work, suffering higher rates of burnout, and may ultimately lead surgeons to retire earlier than planned. Otorhinolaryngologists are at particular risk for work-related musculoskeletal injuries. Beyond the clinician, sustaining such injuries can negatively impact patient safety. Ergonomic interventions have been used effectively to reduce work-related musculoskeletal injuries in other professions, yet not in surgery. With traditional teachings of ideal body postures to avoid injury and manual handling training being re-evaluated, it is important to explore evidence based interventions for reducing work-related musculoskeletal injuries in otorhinolaryngologists. New research encourages us to shift the focus away from the traditional one-size-fits-all approach to ergonomics and toward postural recommendations and education that promote a dynamic, individualized approach to avoiding sustained, static and awkward postures.

Evading Musculoskeletal Conditions Using Qigong as a Rescue Technique

Classically, Qigong is a Chinese technique that has been practiced in China for the past 3,000 years for healing the inner self. Qigong, wherein "Qi" means body energy and "Gong" denotes cultivation, regulates the energy flow in the body. The Qigong technique comprises a package of deep breathing training, gentle and rhythmic movement, and muscle-strengthening exercises that heal the body to activate one's internal soul energy. It has demonstrated its efficacy by inducing relaxation, building up stamina, strengthening immunity, appreciating muscle conditioning, and minimizing anxiety and depression. Furthermore, it has been beneficial in improving awareness of joint and movement senses. Specifically, Qigong brings healing by regulating energy flow in the whole-body systems. Moreover, it has exhibited a variety of regenerating effects by inducing emotional and mental relaxation. In today's world, Qigong exercises are being used for treating musculoskeletal disorders that are work- and stress-related by nature. Qigong is practiced globally as deep breathing exercises, and meditation is practiced for peace of mind and spirituality, whereas vigorous practice includes martial arts.

A systematic review of work-related musculoskeletal disorders and risk factors among computer users

Introduction

Rapid technological developments, especially in the use of electronic devices, have affected workers. MSDs are a major burden for both employees and employers, and in contemporary society. Millions of computer workers suffer musculoskeletal diseases and it is the most common cause of occupational illness in the USA and result in medical costs and absenteeism that cost the sector between $45 and $54 billion annually. A single review was done about WMSDs, however it only investigated neck and upper extremities disorders. Therefore, this study aimed to review epidemiological evidence about the prevalence and risk factors of overall WMSDs among computer user bankers and office workers.

Methods

An extensive literature search was undertaken in the PubMed, Web of Sciences, Google Scholar, and Scopus databases. Articles published in peer-reviewed English-language journals were considered for inclusion criteria. Articles published in conference proceedings, reports, abstracts, and not full text were excluded. After a thorough search of databases, a total of 90 articles were discovered, and finally, 25 of them met the inclusion criteria and were investigated in detail.

Result

The magnitude of WMSDs ranged from 33.8 to 95.3 %. The lower back, neck, upper back, and shoulder were the most affected body parts, and the elbow, hip/thigh, knee, wrist/hand, and ankle/feet were the least affected body parts. Prolonged computer use, being older, repetitive moments, female sex, working in awkward posture, low educational status, a lack of physical exercise, and ergonomics training were significantly affected by MSDs.

Conclusion

and recommendation: The prevalence of WMSDS was very high, and as a result, an interventional study should be conducted. Reducing prolonged use of computers and working in the right posture will reduce the magnitude of MSD among computer users.

Prevalence of work-related musculoskeletal disorders and its associated factors among traditional cloth weavers in Chencha district, Gamo zone, Ethiopia, an ergonomic study

Musculoskeletal disorders at work are common in the majority of African countries. Weaving is very important in Ethiopia for the national economy and for enhancing the country's cultural values. However, the prevalence of musculoskeletal disorders in developing countries is significantly higher in common informal or small-scale enterprises such as weaving. Moreover, little is known about the prevalence and risk factors for musculoskeletal disorders in the weaving industry in Ethiopia. Therefore, the purpose of this study was to determine the prevalence of work-related musculoskeletal disorders and associated factors among traditional cloth weavers in Chencha district, Gamo zone, Ethiopia. A community-based cross-sectional study was conducted in Chencha district from November 1 to December 30, 2021, using a simple random sampling technique. A total of 420 traditional cloth weavers working in individual households were interviewed. Multivariable logistic regressions were performed on variables with p-values less than 0.025 in the bivariate analysis. Work-related musculoskeletal disorders had been reported in the previous 12 months by approximately 97 (46.9%) of respondents. Work-related musculoskeletal disorders were reported by 76.1% of weavers in the shoulder region, 64.2% in the low back, 56.3% in the neck, and 0.2% in the upper back. Working for more than 10 years (AOR = 5.05, 95%CI: 1.23, 20.77), working with prolonged sitting (AOR = 4.77, 95%CI: 1.37, 16.62), and job dissatisfaction (AOR = 2.41, 95%CI: 1.04, 5.55) were among the determinants of work-related musculoskeletal disorders. As a result, ergonomically oriented weaving workstations are required because the majority of musculoskeletal disorders are caused by poorly designed workstations.

The Role of Exercise in the Alleviation of Neuropathic Pain Following Traumatic Spinal Cord Injuries: A Systematic Review and Meta-analysis

OBJECTIVE

The objective of this systematic review and meta-analysis was to assess the efficacy of exercise in neuropathic pain following traumatic spinal cord injuries.

METHODS

The search was conducted in MEDLINE, Embase, Scopus, and Web of Science by the end of 2022. Two independent researchers included the articles based on the inclusion and exclusion criteria. A standardized mean difference was calculated for each data and they were pooled to calculate an overall effect size. To assess the heterogeneity between studies, I2 and chi-square tests were utilized. In the case of heterogeneity, meta-regression was performed to identify the potential source.

RESULTS

Fifteen preclinical studies were included. Meta-analysis demonstrated that exercise significantly improves mechanical allodynia (standardized mean difference [SMD], -1.59; 95% confidence interval [CI], -2.16 to -1.02; p < 0.001; I2 = 90.37%), thermal hyperalgesia (SMD, 1.95; 95% CI, 0.96-2.94; p < 0.001), and cold allodynia (SMD, -2.92; 95% CI, -4.4 to -1.43; p < 0.001). The improvement in mechanical allodynia is significantly more in animals with a compression model of SCI (meta-regression coefficient, -1.33; 95% CI, -1.84 to -0.57; p < 0.001) and in mild SCI (p < 0.001). Additionally, the improvement was more prominent if the training was started 7 to 8 days postinjury (coefficient, -2.54; 95% CI, -3.85 to -1.23; p < 0.001) and was continued every day (coefficient, -1.99; 95% CI, -3.07 to -0.9; p < 0.001). Likewise, voluntary exercise demonstrated a significantly more effect size (coefficient, -1.45; 95% CI, -2.67 to -0.23; p = 0.02).

CONCLUSION

Exercise is effective in the amelioration of neuropathic pain. This effect in mechanical allodynia is more prominent if voluntary, continuous training is initiated in the subacute phase of mild SCI.

Magnitude and influencing factors of work-related low back pain among high school teachers in West Arsi zone, Southwest Ethiopia: evidenced from multicentred cross-sectional study

OBJECTIVE

This study aimed to investigate the prevalence of low back pain and its associated factors among high school teachers in the West Arsi zone, Southwest Ethiopia.

DESIGN

A school-based cross-sectional study was conducted from February to March 2020. A self-administered structured Nordic Musculoskeletal questionnaire was used to assess low back pain during the past 12 months. Bivariate and multivariable binary logistic regression analysis was carried out using Stata V.14. The degree of significance was obtained at a 95% CI and p<0.05.

SETTING

The study was conducted in the West Arsi zone, Ethiopia.

PARTICIPANTS

A total of 602 teachers participated in this study.

OUTCOME MEASURES

The primary outcome is the prevalence of low back pain.

RESULTS

The prevalence of low back pain during the last 12 months was found to be 63.73% (95% CI 59.77% to 67.70%). About 225 (39.61%) teachers experienced moderate pain, and (89.79%) of them had a minimal disability. Being unmarried (adjusted OR (AOR) 0.47, 95% CI 0.28 to 0.79), prolonged standing (AOR 2.31, 95% CI 1.16 to 4.60), sleeping disturbance (AOR 3.22, 95% CI 1.41 to 7.36), regular physical activity (AOR 0.52, 95% CI 0.33 to 0.84), current smoker (AOR 2.83, 95% CI 1.04 to 7.67), lifting heavy load (AOR 1.96, 95% CI 1.17 to 3.28), psychological job demand (AOR 2.86, 95% CI 1.69 to 4.84) and job satisfaction (AOR 0.46, 95% CI 0.27 to 0.79) were associated with low back pain.

CONCLUSION

The prevalence of low back pain was high in this study. Prolonged standing, sleep disruption, heavy load lifting, cigarette smoking and psychological job demand were risk factors for low back pain. Physical exercise and workplace satisfaction were effective interventions. Emphasis should now be put on ergonomics, regular physical activity and psychosocial factors to lessen the problem.

Effectiveness of warm-up interventions on work-related musculoskeletal disorders, physical and psychosocial functions among workers: a systematic review

OBJECTIVES

The aim of this systematic review was to identify from published literature the available evidence regarding the effects of warm-up intervention implemented in the workplace on work -related musculoskeletal disorders (WMSDs) and physical and psychosocial functions.

DESIGN

Systematic review.

DATA SOURCES

The following four electronic databases were searched (from inception onwards to October 2022): Cochrane Central Register of Controlled Trials (CENTRAL), PubMed (Medline), Web of Science and Physiotherapy Evidence Database (PEDro).

ELIGIBILITY CRITERIA

Randomised and non-randomised controlled studies were included in this review. Interventions should include a warm-up physical intervention in real-workplaces.

DATA EXTRACTION AND SYNTHESIS

The primary outcomes were pain, discomfort, fatigue and physical functions. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and used the Grading of Recommendations, Assessment, Development and Evaluation evidence synthesis. To assess the risk of bias, the Cochrane ROB2 was used for randomised controlled trial (RCT) and the Risk Of Bias In Non-randomised Studies-of Interventions was used for the non-RCT studies.

RESULTS

Three studies met the inclusion criterion, one cluster RCT and two non-RCTs. There was an important heterogeneity in the included studies principally concerning population and warm-up intervention exercises. There were important risks of bias in the four selected studies, due to blinding and confounding factors. Overall certainty of evidence was very low.

CONCLUSION

Due to the poor methodological quality of studies and conflicting results, there was no evidence supporting the use of warm-up to prevent WMSDs in the workplace. The present findings highlighted the need of good quality studies targeting the effects of warm-up intervention to prevent WMSDs.

PROSPERO REGISTRATION NUMBER

CRD42019137211.

The Prevalence of Musculoskeletal Pain (MSP) Among Orthopedic Surgeons and Residents in Saudi Arabia's Eastern Area

BACKGROUND

 Orthopedic surgery is a tiring specialty both physically and mentally. Surgeons tend to hold strenuous postures for long periods of time. Orthopedic surgery residents are affected just as much as their seniors by the difficult ergonomics. More care should be aimed toward healthcare professionals to improve patient outcomes and decrease the burden on our surgeons. The goal of this study is to pinpoint the areas of musculoskeletal pain among orthopedic surgery physicians and residents and its prevalence in the eastern province of Saudi Arabia.

METHODS

 A cross-sectional study was conducted in the Eastern region of Saudi Arabia. A simple random selection of 103 male and female orthopedic surgery residents from Saudi Commission for Health Specialties accredited hospitals was enrolled in the study. Residents enrolled from the first to fifth year. Data were collected using a self-administered online questionnaire based on the musculoskeletal Nordic questionnaire activated in 2022-2023.

RESULTS

 Out of 103, a total of 83 completed the survey. The majority (49.9%) were junior residents from residency year (R) 1-R3 and exactly 52 (62.7%) residents were males. The majority of the participants, which were 35 physicians (55.6%), perfume less than six operations as average operations per week, and duration stay in the operating room (OR) per operation there were 29 physicians (46%) stay in the OR for 3-6 h. The most reported sites of pain included lower back pain (46%), followed by neck pain (39.7%) and then upper back pain (30.2%). About 27% of the participants had the pain for more than 6 months, however, only 7 (11.1%) residents seek for medical help. Considering the associated factors with MSP, smoking, and residency year were significantly associated with having musculoskeletal pain (MSP). The presence of MSK pain among R1 residents represents 89.5%, in comparison with R2 residents Who reported 63.6% and 66.7% among R5 residents. This finding indicates a decrease in MSP among residents over the 5 years of residency programs. Additionally, the majority of the participants with MSP reported being smokers 24 (88.9%), controversy, only three of the participants represent (11.1%) without MSP and smokers.

CONCLUSIONS

 Musculoskeletal pain is a serious issue that needs to be addressed. The results indicate that the most reported areas of MSP were the low back, neck, and upper back. Only a minority of the participants went to seek medical help. Residents from R1 experienced more MSP than their seniors and this could indicate an adaptive behavior from senior staff. More research should be done on the topic of MSP in order to promote health among caregivers across the kingdom.

Resistance Training-Induced Acute Hypoalgesia in Women With Persistent Pain After Breast Cancer Treatment

ABSTRACT

Fogh Rasmussen, GH, Madeleine, P, Arroyo-Morales, M, Voigt, M, and Kristiansen, M. Resistance training-induced acute hypoalgesia in women with persistent pain after breast cancer treatment. J Strength Cond Res 37(3): e16-e24, 2023-The aim of this study was to determine whether a single bout of resistance training (RT) produces acute exercise-induced hypoalgesia (EIH) in breast cancer survivors (BCS) suffering from persistent pain ≥1.5 years after treatment. Twenty individuals with self-reported pain ≥3 on a 0-10 Numerical Rating Scale after treatment for breast cancer completed 3 experimental sessions, (a) familiarization; (b) 1 repetition maximum (1RM) normalization, and (c) training, consisting of 3 sets of 10 repetitions at 60% of 1 repetition maximum. Pressure pain thresholds (PPTs) were measured before and after training for the dorsal and ventral shoulder regions of the affected side. Movement-evoked pain (MEP) and rating of perceived exertion (RPE) were collected immediately after each set. A p -value less than 0.05 was considered statistically significant. The results demonstrated a significant increase in PPTs of the ventral shoulder region after a single bout of RT ( p ≤ 0.05), indicating a localized analgesic response for this area. By contrast, no change was detected in PPTs on the dorsal shoulder region. No significant differences were found in MEP between sessions despite a significant increase in load and RPE during 1RM assessment ( p ≤ 0.05), indicating that MEP was not affected by increase in absolute and relative intensity. In conclusion, a single bout of submaximal RT reduced PPTs for the ventral shoulder region of BCS with persistent pain after treatment and was well tolerated. Hence, RT may be a useful therapeutic tool for managing persistent pain after breast cancer treatment in clinical practice.

Magnitude of Work-Related Musculoskeletal Disorders and its Associated Factors Among Computer User Bankers in South Gondar Zone, Northwest Ethiopia, 2021

INTRODUCTION

Musculoskeletal disorders (MSDs), which are the leading cause of workplace health problems; affect workers, employers, and society as a whole following direct and indirect cost. Bankers are expected to perform at computer workstations for long periods of time. As a result, they are at risk of developing musculoskeletal disorders. Hence, this study intends to assess magnitude of work related musculoskeletal disorders and its predictors among computer user bankers in this study area.

MATERIAL AND METHODS

Institutional based cross-sectional study was conducted from September to December 2021. A total of 422 private and Public own computer user bankers were participated. Simple random sampling technique was used to select the study participants. Binary logistic regression model was used to investigate the relationship between dependent and independent variables. P value less than .05 at 95% CI was considered as a significant association between dependent and independent variables.

RESULT

Overall, 245 (58.8%) of computer-user bankers were suffered work-related musculoskeletal disorders in the previous 12 months. Aged 30 and above [AOR:6.5 (1.7-24.6)], no regular physical exercise [AOR: 6.03 (2.2-16.3)], not received ergonomics training [AOR: 5.46 (2.2-13.1)] and working in awkward posture [AOR: 8.76 (2.9-25.9)] were significantly associated to work related musculoskeletal disorders in the previous 12 months.

CONCLUSION

The magnitude of musculoskeletal disorders among computer user bankers was high. Implementing proper working posture, regular physical exercise, avoiding prolonged use of computer and receiving ergonomics training will reduce the burden of musculoskeletal disorders among computer user bankers. The implications of the findings enhance the need for training supervision, cascading tasks taking the age of workers in to account, sustained supply of work station materials and promoting physical exercise by banks to their workers uninterruptedly.

Work-related musculoskeletal disorders among physiotherapists and physiotherapy students in Croatia and their association with physical fitness

Introduction

Among physiotherapists, work-related musculoskeletal disorders (WMSDs) are the most common health problem. This study aimed to provide evidence for planning evidence-based health promotion programmes for ensuring and maintaining adequate physical fitness (PF) to decrease WMSDs among physiotherapists which would have started already during the study.

Methods

A cross-sectional study involved the participation of a total of 100 physiotherapy students and 62 physiotherapists. Observed variables were prevalence of WMSDs in the last 12 months, lasting >3 days during physiotherapeutic activities and five PF components: body composition, cardiorespiratory and muscle endurance, muscle strength, and flexibility. A chi-square test and binary logistic regression were used as the main analytical methods.

Results

Prevalence of WMSDs in physiotherapists was 63.9% (the most common locations: lower back, shoulders, neck), while in physiotherapy students it was 46.5% (the most common locations: lower back, neck, upper back) (p=0.031). Among the PF components, the results showed statistically significantly worse flexibility among students compared to physiotherapists (about two thirds of students had poor or very poor results of flexibility testing) (p=0.002) in comparison to physiotherapists. A statistically significant positive association between WMSDs and PF was observed only between knee pain and poor cardiorespiratory endurance (OR=4.03 with 95% CI 1.12-14.58; p=0.033).

Conclusion

The study showed poor flexibility among students indicating that it is necessary to direct them to perform activities that will increase the extensibility of muscles. The awareness of this problem should be increased. A specific role should be played by staff involved in clinical practice.

Musculoskeletal disorders related to dental hygienist profession

Objectives

Musculoskeletal disorders (MSDs) are occupational illnesses concerned with different classes of professionals; dental hygienists are among those. The aim of this trial is to evaluate MSDs prevalence and significance of the symptoms in a sample of dental hygienists.

Materials and Methods

A 20‐question questionnaire was administered to a sample of dental hygienists, via social networks. The variables taken into consideration were personal data, hours of sport, working habits, years of professional activity, working hours and number of patients per week, presence or absence of pain.

Statistical Analysis

Data were evaluated using standard statistical analysis software, and an Excel database was created. Descriptive statistics were calculated for each variable. Group comparison was assessed by the chi‐square test of homogeneity and Fisher's exact test. (p‐value <0.05 as significant).

Results

468 questionnaires were examined: 396 females (85%) and 72 males (15%). The prevailing age was between 25 and 35. Among them, 91% referred to be suffering or have suffered MSDs. The most relevant affected muscular areas are neck (30.6%), shoulder (25.0%) and lumbosacral region (23.3%); the remaining 21.1% is divided among the other regions. Association and statistical analysis among the different variables showed how presence of MSDs negatively influences absenteeism and work performance; further research regarding ergonomics, type of seat, stretching and workout prevention would be important to strengthen the results collected.

Conclusions

Musculoskeletal disorders diffusion among dental hygienists is particularly high due to lack of information; the majority of interviewees showed very little awareness of it; this led to a lack of effort in facing or possibly preventing these pathologies.

The Development of ICT-Based Exercise Rehabilitation Service Contents for Patients with Musculoskeletal Disorders and Stroke

Exercise rehabilitation services connecting hospitals and communities increase patient participation and improve quality of life by reducing medical expenses. South Korea’s multi-ministerial governments have been working together to develop ICT-based hospital-community-linked services to create an exercise program that the public can easily use. This study aims to develop the exercise rehabilitation service components for the application and prescription of ICT-based exercise programs implemented in hospitals and communities. A literature review was conducted, and an expert committee was comprised to classify the components of exercise rehabilitation services. As a result, we classified the first components as functional classification, rehabilitation area, equipment uses, exercise type, frequency, and intensity. Subsequently, exercise programs were developed by applying the first components. Based on the purpose of exercise rehabilitation, we classified the representative standard exercise and grouped the same exercise movements using tools and exercise machines. The finding of this study will help to give the correct exercise prescription and manage patients’ improvement process for exercise instructors. In addition, it guides patients in need of exercise rehabilitation to participate in an accurate and safe exercise in the community. This study is a novel attempt to develop ICT based hospital-community-linked exercise rehabilitation service for patients.

The impact of ergonomic-educational interventions on reduction of musculoskeletal symptoms among employees of oil and gas installations in Iran

BACKGROUND: Musculoskeletal disorders can cause increased absenteeism, costs, and injuries. OBJECTIVE: The present study was aimed to investigate the impact of ergonomic-educational interventions on the reduction of musculoskeletal symptoms among employees of oil and gas installations. METHODS: This interventional study was conducted on 1243 male workers of oil and gas installations in the south of Iran. The Nordic questionnaire and quick exposure check (QEC) method were used to evaluate the risk of developing musculoskeletal disorders in the participants. Then, the educational interventions via training sessions, designed educational booklets and leaflets, and prepared educational film were performed. Data were collected at the times of two months before and six months after the interventions. RESULTS: The prevalence of musculoskeletal symptoms, at least in one of the body areas, was equal to 71.28%. The results showed that the prevalence of these symptoms significantly decreased in all body areas after the educational interventions (P <0.028). The highest reduction rate occurred in the regions of wrists and hands (52.77%), knees (47.17%), and waist (47.13%), respectively. Moreover, the results indicated that the mean value of the total score of quick exposure check (QEC) had a meaningful decrease from 0.92 to 0.54 after the educational interventions (P <0.0001). CONCLUSION: The planned educational interventions efficiently reduced the prevalence of musculoskeletal symptoms and the ergonomic risk levels estimated by QEC in the research population.

Effectiveness of workplace exercise interventions in the treatment of musculoskeletal disorders in office workers: a systematic review

OBJECTIVE

To determine the effectiveness of workplace exercise interventions in the treatment of musculoskeletal disorders.

DESIGN

Systematic review of randomised controlled trials (RCTs).

DATA SOURCES

The bibliographical databases PubMed, CINAHL Plus, Cochrane, Scopus, ISI WoS and PeDRO were searched, with studies from 1 January 2010 to 31 December 2020 eligible for inclusion.

ELIGIBILITY CRITERIA

We included RCTs, reported in English or Spanish, with at least an intervention group performing workplace exercises among office workers with musculoskeletal disorders.

DATA EXTRACTION AND SYNTHESIS

Two independent reviewers extracted data and assessed the risk of bias. A narrative synthesis was carried out with a tabular method specifying the study characteristics following the SWiM (Synthesis Without Meta-Analysis) guideline for synthesis without meta-analysis. The revised Cochrane Risk of Bias (RoB-2) tool was used to analyse the risk of bias of the included studies.

RESULTS

Seven studies with a total of 967 participants met the inclusion criteria and were included in this review. Due to heterogeneity in different workplace exercise interventions, outcome measures and statistical analyses, it was not possible to conduct a meta-analysis and a narrative synthesis was performed. The interventions were classified into three categories: multiple body regions, neck and shoulder, and lower back. The seven studies concluded that workplace exercise interventions were effective in reducing musculoskeletal disorders and pain compared with other types of interventions or with control groups with no interventions. The RoB-2 tool found a high risk of bias in six of the seven studies.

CONCLUSIONS

The findings of the RCTs on workplace exercise interventions suggest that interventions were effective in treating musculoskeletal disorders among office workers. However, due to the high risk of bias of the included studies, no firm conclusions could be drawn and more high-quality studies are needed.

PROSPERO REGISTRATION NUMBER

CRD42020177462.

A Study on the Correlations between Musculoskeletal Disorders and Work-Related Psychosocial Factors among Nursing Aides in Long-Term Care Facilities

BACKGROUND

Among the nursing aides employed at long-term care facilities (LTCFs), those with musculoskeletal disorders (MSDs) are most likely to experience disability or develop an intention to leave. The purpose of this study was to investigate the association of work-related psychological factors among nursing aides in LTCFs with MSDs in Taiwan.

METHODS

Purposive sampling was used in this cross-sectional study to enrol 308 nursing aides from residential LTCFs in Taiwan as research subjects. A demographic and job background survey, a job content questionnaire (JCQ), and the Nordic musculoskeletal questionnaire (NMQ) were used to collect data.

RESULTS

Lower job control associated with higher psychological job demands, and lower social support was associated with more severe MSDs for the nursing aides (p < 0.001). Among the MSDs reported by nursing aides in LTCFs, lower back pain was the most serious. In addition, nationality, age, exercise habits, chronic diseases, worksite, lack of rest time, lack of assistive devices, low coworker support, and high psychological job demands were significant factors affecting MSDs. In total, 42.1% of the variance in MSDs among nursing aides in LTCFs was explained.

CONCLUSIONS

Work-related psychological factors among nursing aides in LTCFs have an important association with MSDs. For nursing aides, coworker support should be improved, and their psychological demands at work should be reduced.

Do behaviour change techniques increase adherence to home exercises in those with upper extremity musculoskeletal disorders? A systematic review

OBJECTIVES

To investigate whether behaviour change techniques (BCTs) can influence adherence to home exercise in people with upper extremity musculoskeletal disorders (UEMD).

DESIGN

A systematic review of randomised control trials, non-randomised control trials, case-control studies and cohort studies. Results were presented narratively. Participants were those with UEMD. The intervention was any home exercise programme, alongside a BCT designed to increase exercise adherence. Any duration of intervention was accepted. The main outcome sought was adherence to home exercise. A systematic search was performed on four online databases. Grey literature was searched.

RESULTS

The search resulted in 28,755 titles. 77 full-text articles were assessed for eligibility. Six studies were included in the qualitative synthesis. Four studies had Some Concern of Bias, whilst two studies had High Risk of Bias. Three studies found statistically significant differences in exercise adherence (p < 0.05) between the Intervention group and Control group. The BCT 'Social Support (unspecified)' was used within all studies that found significant differences in adherence levels at outcome. However, multiple BCTs were received by the Intervention groups within all studies, making it impossible to identify the effects of any single BCT upon adherence levels.

CONCLUSION

Social support may be relevant in patients' adherence levels to HEPs. However, confidence in the results is uncertain given the small number of studies found, and their High RoB. Future studies should validate their measurement and definition of adherence, as well as the number of BCTs they use, to provide reproducible evidence.

Predictors for Clinical Outcomes Related to Upper Extremity Musculoskeletal Disorders in a Healthy Working Population

A wide range of endpoints and methods of analysis can be observed in occupational health studies in the context of work-related musculoskeletal disorders (WMSDs). Comparison of study results is therefore difficult. We investigated the association between different clinical endpoints and the presence of upper extremity WMSDs in a healthy working population. Furthermore, the influence of socio-demographic, work-related, and individual predictors on different endpoints was examined. Two self-administered questionnaires were distributed to 70 workers and employees. In addition, a standardized physical examination and an industry test were performed in this cross-sectional study. Correlations between WMSDs and clinical endpoints were analyzed with the Spearman method and prediction ellipses. Multiple regression models were used to study the strength of associations with a pre-defined set of potential influencing factors. The prevalence of WMSDs was 56% (39/70). Disabilities of Arm, Shoulder, and Hand (DASH) score/pain under strain showed the strongest correlations with WMSDs. When analyzing the correlation between WMSDs and pre-selected predictors, none of the predictors could be identified as a risk factor. The DASH score remains a close candidate for best surrogate endpoint for WMSDs detection. Standardized analysis methods could improve the methodological quality of future occupational health studies.

Effects of the COVID-19 lockdown on musculoskeletal pain, physical activity, and work environment in Estonian office workers transitioning to working from home

BACKGROUND

COVID-19 lockdown caused a sudden change in the work culture and environment.

OBJECTIVE

The aim of this study was to evaluate the impact of COVID-19 lockdown caused changes in musculoskeletal pain (MSP), physical activity (PA), workplace properties, and their in-between relationships among office workers.

METHODS

A total of 161 office workers (64.6%female) with a mean age of 38.2±9.5 years participated. The study was conducted as an online form. Baecke Physical Activity Questionnaire, NORDIC Questionnaire, and questions about the work environment were used. The participants were asked to describe the current situation and retrospectively the situation 3 months before.

RESULTS

We found no significant differences in the prevalence of MSP or between the mean number of body regions suffering from MSP before and during the lockdown. During the lockdown, a significant (p < 0.001) reduction in total PA and sport-related PA and a significant (p < 0.001) increase in work-related PA was noted. A significant drop in both workplace comfort rating (p < 0.05) and workplace ergonomics rating (p < 0.001) was suggested during the lockdown. Our data also suggested several individual factors influencing the MSP among office workers during the lockdown.

CONCLUSIONS

Maintaining habitual physical activity level and preparing a more comfortable and ergonomic workspace can play a role in a healthier transition to working from home.

Using Telerehabilitation to Deliver a Home Exercise Program to Youth With Arthrogryposis: Single Cohort Pilot Study

BACKGROUND

Arthrogryposis multiplex congenita (AMC) is characterized by joint contractures and muscle weakness, which limit daily activities. Youths with AMC require frequent physical therapeutic follow-ups to limit the recurrence of contractures and maintain range of motion (ROM) and muscle strength; however, access to specialized care may be limited because of geographical distance. Telerehabilitation can offer a potential solution for delivering frequent follow-ups for youth with AMC, but research on the use of telerehabilitation in children with musculoskeletal disorders is scarce.

OBJECTIVE

The study aims to evaluate the feasibility of delivering a home exercise program (HEP) by using telerehabilitation for youth with AMC. We also aim to explore the effectiveness of the HEP as a secondary aim.

METHODS

Youths aged between 8 and 21 years with AMC were recruited at the Shriners Hospitals for Children-Canada. The participants completed baseline and post-HEP questionnaires (the Physical Activity Questionnaire for Adolescents, Pediatrics Outcomes Data Collection Instrument, and Adolescent and Pediatric Pain Tool), and clinicians assessed their active ROM using a virtual goniometer. Clinicians used the Goal Attainment Scale with the participants to identify individualized goals to develop a 12-week HEP and assess the achievement of these goals. Follow-ups were conducted every 3 weeks to adjust the HEP. Data on withdrawal rates and compliance to the HEP and follow-ups were collected to assess the feasibility of this approach. The interrater reliability of using a virtual goniometer was assessed using the intraclass correlation coefficient and associated 95% CI. Nonparametric tests were used to evaluate feasibility and explore the effectiveness of the HEP.

RESULTS

Of the 11 youths who were recruited, 7 (median age: 16.9 years) completed the HEP. Of the 47 appointments scheduled, 5 had to be rescheduled in ≤24 hours. The participants performed their HEP 2.04 times per week (95% CI 1.25-4.08) and reported good satisfaction with the approach. A general intraclass correlation coefficient of 0.985 (95% CI 0.980-0.989) was found for the web-based ROM measurement. Individualized goals were related to pain management; endurance in writing, standing, or walking; sports; and daily activities. In total, 12 of the 15 goals set with the participants were achieved. Statistically significant improvements were observed in the pain and comfort domain of the Pediatrics Outcomes Data Collection Instrument (preintervention: median 71; 95% CI 34-100; postintervention: median 85; 95% CI 49-100; P=.08) and Physical Activity Questionnaire for Adolescents (preintervention: median 1.62; 95% CI 1.00-2.82; postintervention: median 2.32; 95% CI 1.00-3.45; P=.046).

CONCLUSIONS

The remote delivery of an HEP for youth with AMC is feasible. Promising results were found for the effectiveness of the HEP in helping youths with AMC to achieve their goals. The next step will be to assess the effectiveness of this exercise intervention in a randomized controlled trial.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.2196/18688.

Barriers and opportunities for prolonging working life across different occupational groups: the SeniorWorkingLife study

Background

Increasing retirement age is a pivotal issue in labour market reforms. This study analyses factors conditioning retirement intentions.

Methods

In SeniorWorkingLife, 11 444 employed workers ≥50 years replied to questions in random order about expected reasons for leaving and potential reasons for staying longer at the labour market. Respondents were stratified based on the Danish version of International Standard Classification of Occupations (ISCO). Representative estimates were produced using the SurveyFreq and SurveyLogistic procedures of SAS combined with model-assisted weights based on national registers.

Results

For ISCO groups 1–4 (seated work) main expected reasons for retiring were freedom to choose and desire for more leisure time, but many would consider staying longer if there were better possibilities for additional senior days, longer vacations and flexible working hours. For ISCO groups 5–9 (physical work), poor physical health and not being capable of doing the job were common expected reasons for retiring, but many would consider staying longer if the work were less physically demanding and there were more senior days. Possibility for pension was a general expected reason for retiring. Expected reasons differed to a less extent between genders than between ISCO groups, e.g. economic factors were more important for men and high work demands more important for women.

Conclusion

Different barriers and opportunities for prolonging working life exist across different occupational groups of the labour market—with most consistent differences between those with seated and physical work. Targeting these specifically seems opportune for policy makers and future interventions.

Epidemiology of Musculoskeletal Disorders among the Teaching Staff of the University of Douala, Cameroon: Association with Physical Activity Practice

The aim of this study was to assess the epidemiology of musculoskeletal disorders (MSDs) among the teaching staff of the University of Douala and determine their association with physical activity (PA) practice. The Nordic questionnaire was used to assess MSDs. Ricci-Gagnon questionnaire was used to determine the level of PA. We recruited 104 participants mean-aged 42 ± 8 years, 80% male. Previous 7 days and 12 months prevalence were 56.7% and 80.8%, respectively. The most affected body regions were neck, shoulders and lower back. No significant association was found between MSDs and PA. Celibacy was significantly associated with previous 7-days MSDs (p = 0.048) while age ≥ 45 years and job seniority ≥ 10 years were significantly associated with a reduced risk of previous 12-months MSDs (p = 0.039 and p = 0.016, respectively). The prevalence of MSDs among university of Douala teaching staff showed no significant effect with the practice of PA.

Work-related musculoskeletal disorders amongst undergraduate nursing students at the University of Johannesburg

Background

Work-related musculoskeletal disorders (WRMSDs) present as pain or discomfort in the musculoskeletal system that individuals experience from work-related activities. Substantial research evidence exists on qualified nurses with WRMSDs, but there is a distinct lack of research regarding nursing students and their work environment in South Africa.

Aim

The primary aim of this study was to establish a baseline prevalence of musculoskeletal disorders (MSDs) amongst undergraduate nursing students. The secondary aim was to identify the role of certain occupational and biopsychosocial factors in the development of MSDs.

Setting

The University of Johannesburg, Health Sciences Faculty, Doornfontein Campus, Johannesburg, South Africa.

Method

A cross-sectional quantitative study conducted through a questionnaire (from 24 June to 29 July 2019) was initiated amongst the undergraduate nursing students at the University of Johannesburg, South Africa. All 250 undergraduate nursing students were given the opportunity to participate by completing the Nordic Musculoskeletal Questionnaire-Extended (NMQ-E). A total of 125 questionnaires were collected and used in the study. Data analysis consisted of frequencies, descriptives and custom tables. The Chi-square test for association was used to test the associations between variables.

Results

The study found an 83% prevalence of MSDs. Musculoskeletal disorders occurred most commonly in the lower back (81.1%), neck (65.9%) and shoulder (63.6%) regions. Factors that showed associations with overall MSDs were female gender (p = 0.002), height (p = 0.009) and studying at home (p = 0.040). Stress and tablet or smartphone use had significant associations with certain body regions.

Conclusion

The findings indicate a high prevalence of MSDs in undergraduate nursing students in this sample, substantially higher than in other similar studies in which lower back disorders were most prevalent.

How much do we know about the effectiveness of warm-up intervention on work related musculoskeletal disorders, physical and psychosocial functions: protocol for a systematic review

INTRODUCTION

Work-related musculoskeletal disorders (WMSDs) are a growing worldwide burden and effective interventions to prevent them are needed. Physical activity at the workplace is now recognised as a relevant component of WMSDs prevention. Along these lines, warm-up interventions are now offered in a large number of companies to manage WMSDs. Although benefits of warm-up have been previously documented in sports context, to the best of our knowledge, the effectiveness of such intervention in workplaces still remains to be established. Within this context, the aim of the present review is to identify from published literature the available evidence regarding the effects of warm-up on WMSDs and physical and psychosocial functions.

METHODS

The following electronic databases will be searched (from inception onwards to June 2020): Cochrane Central Register of Controlled Trials, PubMed (Medline), Web of Science and Physiotherapy Evidence Database. Randomised and non-randomised controlled studies will be included in this review. Participants should be adult employees without specific comorbidities. Interventions should include a warm-up physical intervention in real-workplaces. The primary outcomes will be pain, discomfort or fatigue. The secondary outcomes will be job control or motivation at work. This review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and two team members will independently screen all citations, full-text articles and abstract data. A systematic narrative synthesis will be provided with information presented in the text and tables to summarise the characteristics and findings of the included studies.

ETHICS AND DISSEMINATION

The approval of an ethical committee is not required. All the included studies will comply with the current ethical standards. The results of this review will summarise the effects of warm-up intervention on WMSDs, physical or psychosocial functions. This information could help professionals in decision making related to the use of these interventions to prevent WMSDs. Findings will be disseminated to academic audiences through peer-reviewed publications, as well as to policy-makers.

PROSPERO REGISTRATION NUMBER

CRD42019137211.

Is low-back pain a limiting factor for senior workers with high physical work demands? A cross-sectional study

BACKGROUND

Low-back pain (LBP) is highly prevalent among senior workers and may affect work ability, especially among those with hard physical work. This study determined the joint association of LBP intensity and physical work demands with work limitiations due to pain in senior workers.

METHODS

In the SeniorWorkingLife study (2018), 11,738 senior workers (≥50 years) replied to questions about physical work demands, LBP intensity, and work limitations due to pain. Using logistic regression analyses and controlling for potential confounders, associations between the physical work demands and LBP intensity (interaction) with work limitiations due to pain (outcome) was modeled.

RESULTS

Higher LBP intensity, as well as higher physical work demands, significantly increased the odds of experiencing work limitiations due to pain, and these two factors interacted with each other (p < 0.0001). In analyses stratified for LBP intensity, higher physical work demands gradually increased the odds of experiencing work limitiations due to pain.

CONCLUSIONS

Senior workers with a combination of physically demanding work and LBP are more affected by their pain during everyday work tasks compared to workers with similar LBP-intensity in sedentary occupations. Accommodation of work demands seems especially relevant for this group of workers.

Work-related musculoskeletal disorders among Saudi orthopedic surgeons: a cross-sectional study

INTRODUCTION

Studies have addressed the issue of increasing prevalence of work-related musculoskeletal (MSK) pain among different occupations. However, contributing factors to MSK pain have not been fully investigated among orthopaedic surgeons. Thus, this study aimed to approximate the prevalence and predictors of MSK pain among Saudi orthopaedic surgeons working in Riyadh, Saudi Arabia.

METHODS

A cross-sectional study using an electronic survey was conducted in Riyadh. The questionnaire was distributed through email among orthopaedic surgeons in Riyadh hospitals. Standardized Nordic questionnaires for the analysis of musculoskeletal symptoms were used. Descriptive measures for categorical and numerical variables were presented. Student's t-test and Pearson's χ2 test were used. The level of statistical significance was set at p ≤ 0.05.

RESULTS

The response rate was 80.3%, with a total number of 179 of Saudi orthopaedic surgeons (173 males and six females). Of our sample, 67.0% of the respondents complained of having MSK pain. The most commonly reported MSK pain was lower back (74.0%), followed by neck (58.2%). Age and body mass index were implicated in the development of more than one type of MSK pain. Increased years of experience (≥ 6 years) was linked to shoulder/elbow, lower back, and hip/thigh pain. Smoking is widely associated with lower back pain development, whereas physicians who do not smoke and exercise regularly reported fewer pain incidences. Excessive bending and twisting during daily practice have been correlated with increased neck pain.

CONCLUSION

MSK pain was found to be common among Saudi orthopaedic surgeons. Further extensive research should be conducted to understand and analyze the risk factors involved and search for possible improvements to avoid further complications. However, ergonomics education during surgical training could be effective at modifying behaviors and reducing MSK pain manifestations.

Forced treadmill running reduces systemic inflammation yet worsens upper limb discomfort in a rat model of work-related musculoskeletal disorders

BACKGROUND

Musculoskeletal disorders can result from prolonged repetitive and/or forceful movements. Performance of an upper extremity high repetition high force task increases serum pro-inflammatory cytokines and upper extremity sensorimotor declines in a rat model of work-related musculoskeletal disorders. Since one of the most efficacious treatments for musculoskeletal pain is exercise, this study investigated the effectiveness of treadmill running in preventing these responses.

METHODS

Twenty-nine young adult female Sprague-Dawley rats were used. Nineteen were trained for 5 weeks to pull a lever bar at high force (15 min/day). Thirteen went on to perform a high repetition high force reaching and lever-pulling task for 10 weeks (10-wk HRHF; 2 h/day, 3 days/wk). From this group, five were randomly selected to undergo forced treadmill running exercise (TM) during the last 6 weeks of task performance (10-wk HRHF+TM, 1 h/day, 5 days/wk). Results were compared to 10 control rats and 6 rats that underwent 6 weeks of treadmill running following training only (TR-then-TM). Voluntary task and reflexive sensorimotor behavioral outcomes were assessed. Serum was assayed for inflammatory cytokines and corticosterone, reach limb median nerves for CD68+ macrophages and extraneural thickening, and reach limb flexor digitorum muscles and tendons for pathological changes.

RESULTS

10-wk HRHF rats had higher serum levels of IL-1α, IL-1β and TNFα, than control rats. In the 10-wk HRHF+TM group, IL-1β and TNFα were lower, whereas IL-10 and corticosterone were higher, compared to 10-wk HRHF only rats. Unexpectedly, several voluntary task performance outcomes (grasp force, reach success, and participation) worsened in rats that underwent treadmill running, compared to untreated 10-wk HRHF rats. Examination of forelimb tissues revealed lower cellularity within the flexor digitorum epitendon but higher numbers of CD68+ macrophages within and extraneural fibrosis around median nerves in 10-wk HRHF+TM than 10-wk HRHF rats.

CONCLUSIONS

Treadmill running was associated with lower systemic inflammation and moderate tendinosis, yet higher median nerve inflammation/fibrosis and worse task performance and sensorimotor behaviors. Continued loading of the injured tissues in addition to stress-related factors associated with forced running/exercise likely contributed to our findings.

Strong Labour Market Inequality of Opportunities at the Workplace for Supporting a Long and Healthy Work-Life: The SeniorWorkingLife Study

Most European countries are gradually increasing the state pension age, but this may run counter to the capabilities and wishes of older workers. The objective of this study is to identify opportunities in the workplace for supporting a prolonged working life in different groups in the labour market. A representative sample of 11,200 employed workers ≥ 50 years responded to 15 questions in random order about opportunities at their workplace for supporting a prolonged working life. Respondents were stratified based on the Danish version of the International Standard Classification of Occupations (ISCO). Using frequency and logistic regression procedures combined with model-assisted weights based on national registers, results showed that the most common opportunities at the workplace were possibilities for more vacation, reduction of working hours, flexible working hours, access to treatment, further education and physical exercise. However, ISCO groups 5–9 (mainly physical work and shorter education) had in general poorer access to these opportunities than ISCO groups 1–4 (mainly seated work and longer education). Women had poorer access than men, and workers with reduced work ability had poorer access than those with full work ability. Thus, in contrast with actual needs, opportunities at the workplace were lower in occupations characterized by physical work and shorter education, among women and among workers with reduced work ability. This inequality poses a threat to prolonging working life in vulnerable groups in the labour market.

The magnitude and factors associated with work-related back and lower extremity musculoskeletal disorders among barbers in Gondar town, northwest Ethiopia, 2017: A cross-sectional study

BACKGROUND

Work-related back and lower extremity disorders often present remarkable health and economic burdens on societies. Occupational barbers are usually neglected in research and policy actions, mainly in developing countries, and are hence more vulnerable to the conditions. So far, information about the factors influencing back and lower extremity disorders among barbers in Ethiopia is unknown. Therefore, the aim of this study was to determine the prevalence and factors affecting back and lower extremity disorders among barbers in Gondar town, Ethiopia.

METHODS

A cross-sectional study was conducted from April to May 2017. A sample of 434 barbers recruited using the systematic random sampling technique. A pre-tested standardized Nordic Musculoskeletal questionnaire was interviewer-administered for data collection. Data were analyzed using statistical package for social sciences (SPSS) version 20. The significance of associations was evaluated at ≤0.05 p-value with a 95% confidence intervals (CI) and adjusted odds ratios (AOR).

RESULTS

The response rate was 98.8% (N = 429). The mean age and mean length of employment were 26.38 (standard deviations (SD) ± 4.78) and 4.91 years, respectively. The prevalence of work-related low back pain in the previous 12 months and in the last 7 days was 55.7% (N = 239) [95% CI (51.0, 60.4)] and 32.6% (N = 140), respectively. About 40.6% (n = 97) of the participants with back pains indicated their activities were limited. The prevalence of knee/leg and ankle pain was 39.4% (N = 169) and 25.6% (N = 110), respectively. Out of the participants, 17% (n = 41) sought treatment services. Less than half, 40.6% (n = 97) said they perceived high disability, while 38.1% (n = 91) explained their pain was intense (severe). Age [AOR: 2.001; 95% CI (1.174, 4.346)], alcohol use [AOR: 2.283; 95% CI (1.376, 3.789)], lack of safety training [AOR: 0.110; 95% CI (0.032, 0.271], working posture [AOR: 0.142; 95% CI (0.045, 0.215)], and length of employment [AOR: 1.650.132; 95% CI (1.107, 2.140] were significantly associated factors.

CONCLUSIONS

Back and lower extremity musculoskeletal pain and disability were found to be prevalent among Ethiopian barbers and to be associated with age, alcohol use, safety training, work postures, and length of employment. We believe that programs for management of musculoskeletal disorders need to address these factors.

Risk Factors Associated with Upper Extremity Musculoskeletal Disorders among Barbers in Gondar Town, Northwest Ethiopia, 2018: A Cross-Sectional Study

Background

Work-related upper extremity musculoskeletal disorders (WUEDs) often present remarkable health and economic burdens on society. Occupational barbers are usually neglected both in research and policy actions, mainly in developing countries, and hence are likely subjected to the conditions. So far, information about factors that influence WUEDs among barbers in Ethiopia is inconclusive. Therefore, this study aimed to evaluate prevalence and factors associated with WUEDs among barbers in Gondar town, Ethiopia.

Methods

We conducted a cross-sectional study from March to April 2018. A sample of 424 participants were recruited using systematic random sampling technique. A standardized Nordic Musculoskeletal Questionnaire was pretested and interviewer-administered for data collection. The data were analyzed by SPSS version 20 software. We set statistical significances at <0.05 p value with 95% confidence intervals (CI) and computed odds ratios to evaluate strength of associations.

Results

The response rate was 98.3% (N=417). The mean age was 26.39 (SD + 4.805) years. The prevalence of upper extremity musculoskeletal disorders over the past 12 months was 56.8% (N=237). Upper back pain was observed in 38.8% (N=162) participants, whereas shoulder (27.1% (N=113)), neck pain and elbow/forearms (each 29.3% (N=122)), and wrists/hand disorders (32.4% (N=135)) were the common body sites indicated. Age (AOR: 2.614; 95% CI (1.287, 5.307)), alcohol use (AOR: 3.556; 95% CI (2.212, 5.717)), frequent standing (AOR: 1.536; 95% CI (1.006, 2.346)), physical exercises (AOR: 1.938; 95% CI (1.216, 3.089)), and low monthly salary (AOR: 3.125; 95% CI (1.157, 5.441)) were factors associated with work-related upper extremity disorders.

Conclusions

Work-related upper extremity disorder is common among hairdressing professionals. Worksite health promotions targeted to lifestyle behaviors, like physical exercise and alcohol consumption require urgent public health actions in Ethiopia. Moreover, adaption of flexible work postures and proper management of workplace conditions related to aging workforces are also imperative to trace the complaints.

Self-reported Home Exercise Adherence: A Validity and Reliability Study Using Concealed Accelerometers

BACKGROUND

Accurate measurement of adherence to prescribed exercise programs is essential. Diaries and self-report rating scales are commonly used, yet little evidence exists to demonstrate their validity and reliability.

OBJECTIVES

To examine the concurrent validity of adherence to home strengthening exercises measured by (1) exercise diaries and (2) a self-report rating scale, compared to adherence measured using an accelerometer concealed in an ankle cuff weight. Test-retest reliability of the self-report rating scale was also assessed.

METHODS

In this clinical measurement study, 54 adults aged 45 years or older with self-reported chronic knee pain were prescribed a home quadriceps-strengthening program. Over 12 weeks, participants completed paper exercise diaries and, at appointments every 2 weeks, rated their adherence on an 11-point numeric rating scale. A triaxial accelerometer was concealed in the ankle cuff weight used for exercises. Self-reported adherence rating scale data over each 2-week period were analyzed using descriptive statistics, the Wilcoxon signed-rank test, and a Bland-Altman plot to assess agreement, Spearman correlations for validity, and intraclass correlation coefficients for test-retest reliability.

RESULTS

Exercise adherence was significantly overestimated in diaries during the 12 weeks (diary median, 220 exercises; accelerometer, 176; P<.001) and was moderately correlated with accelerometer data (r = 0.52; 95% confidence interval: 0.26, 0.69). A Bland-Altman plot indicated large between-participant variability in agreement between these measures. Self-reported adherence showed poor to fair correlations with accelerometer data (mean r = 0.23-0.39), and less than acceptable reliability (intraclass correlation coefficient = 0.79; lower 1-sided 95% confidence limit, 0.68).

CONCLUSION

Exercise diaries showed questionable validity and variable levels of agreement compared with accelerometer-measured exercise completion. A self-reported adherence rating scale had limited validity and less than acceptable test-retest reliability. J Orthop Sports Phys Ther 2018;48(12):943-950. Epub 27 Jul 2018. doi:10.2519/jospt.2018.8275.

The effects of Clinical Pilates exercises on patients with shoulder pain: A randomised clinical trial

AIM

The purpose of this study was to determine the effect of Clinical Pilates exercises on patients with shoulder pain.

MATERIAL AND METHODS

Thirty-three patients, experiencing shoulder pain continuously for at least four weeks were selected as study subjects. The patients were randomly divided into two groups, namely Clinical Pilates exercise (n = 17) group and conventional exercise (n = 16) group. The patients were treated for five days a week, the total treatment being carried out for 10 days. The assessment of pain and disability amongst the patients were done at the baseline and at the end of the treatment sessions, using Visual Analogue Scale (VAS) and Shoulder Pain and Disability Index (SPADI).

RESULTS

The clinical Pilates exercise group showed a significant improvement in all scores used for assessment (p < 0.05), while the conventional exercise group demonstrated a significant improvement only in the SPADI total score (p < 0.05). A comparison of scores for the VAS, SPADI-Pain and SPADI-Total between the two groups, revealed a significant improvement in the Clinical Pilates exercise group (p < 0.05).

CONCLUSION

It was demonstrated by the study that Clinical Pilates exercise is an efficient technique for patients experiencing shoulder pain, as it helps reduce pain and disability among them.

Influence of a community-based stretching intervention on the health outcomes among Korean-Chinese female migrant workers in South Korea: A randomized prospective trial

AIM

To investigate the long-term effectiveness of stretching exercises on the health outcomes of Korean-Chinese female migrant workers.

METHODS

This study was a randomized prospective trial. The study's participants (n = 80) were middle-aged, Korean-Chinese women who had worked full-time during the previous 6 months. They were assigned randomly to an enhanced stretching intervention group or a standard stretching intervention group. Both groups were instructed to carry out a structured 6 min stretching exercise program for at least three times per day and 5 days per week. The enhanced intervention group received additional interventions to increase exercise adherence through individual phone counseling and short message service during the 12 weeks, followed by three sets of acculturation workshops during the period of weeks 13-24. Musculoskeletal fitness, symptoms, and acculturative stress were assessed at baseline, week 12, and week 24. Linear mixed-models were used to test the interventions' effects.

RESULTS

The amount of stretching that was carried out, as a percentage of the recommended amount, was not significantly different between groups. There were significant improvements in flexibility of the back and work-related musculoskeletal disorder symptoms after completing the 24 week intervention but no significant difference existed between the groups. Acculturative stress decreased at week 12 but there was no significant change at week 24.

CONCLUSIONS

The 24 week, community-based stretching program for the Korean-Chinese female migrant workers was effective in increasing their flexibility and decreasing work-related musculoskeletal disorder symptoms. Culturally adaptive augmented interventions to increase social support are suggested in order to reduce acculturative stress.

Quality and acceptability of measures of exercise adherence in musculoskeletal settings: a systematic review

Objective

To recommend robust and relevant measures of exercise adherence for application in the musculoskeletal field.

Method

A systematic review of measures was conducted in two phases. Phase 1 sought to identify all reproducible measures used to assess exercise adherence in a musculoskeletal setting. Phase 2 identified published evidence of measurement and practical properties of identified measures. Eight databases were searched (from inception to February 2016). Study quality was assessed against the Consensus-based Standards for the Selection of Health Measurement Instruments guidelines. Measurement quality was assessed against accepted standards.

Results

Phase 1: from 8511 records, 326 full-text articles were reviewed; 45 reproducible measures were identified. Phase 2: from 2977 records, 110 full-text articles were assessed for eligibility; 10 articles provided evidence of measurement/practical properties for just seven measures. Six were exercise adherence-specific measures; one was specific to physical activity but applied as a measure of exercise adherence. Evidence of essential measurement and practical properties was mostly limited or not available. Assessment of relevance and comprehensiveness was largely absent and there was no evidence of patient involvement during the development or evaluation of any measure.

Conclusion

The significant methodological and quality issues encountered prevent the clear recommendation of any measure; future applications should be undertaken cautiously until greater clarity of the conceptual underpinning of each measure is provided and acceptable evidence of essential measurement properties is established. Future research should seek to engage collaboratively with relevant stakeholders to ensure that exercise adherence assessment is high quality, relevant and acceptable.

Factors affecting pain relief in response to physical exercise interventions among healthcare workers

The aim of this study is to identify factors associated with musculo-skeletal pain reduction during workplace-based or home-based physical exercise interventions among healthcare workers. Two hundred female healthcare workers (age: 42.0, BMI: 24.1, average pain intensity: 3.1 on a scale of 0-10) from three hospitals participated. Participants were randomly allocated at the cluster level (18 departments) to 10 weeks of (i) workplace physical exercise (WORK) performed in groups during working hours for 5 × 10 minutes per week and up to five group-based coaching sessions on motivation for regular physical exercise, or (ii) home-based physical exercise (HOME) performed alone during leisure-time for 5 × 10 minutes per week. Linear mixed models accounting for cluster identified factors affecting pain reduction. On average 2.2 (SD: 1.1) and 1.0 (SD: 1.2) training sessions were performed per week in WORK and HOME, respectively. The multi-adjusted analysis showed a significant effect on pain reduction of both training adherence (P=.04) and intervention group (P=.04) with participants in WORK experiencing greater reductions compared with HOME. Obesity at baseline was associated with better outcome. Leisure-time exercise, daily patient transfer, age, and chronic pain did not affect the changes in pain. In conclusion, even when adjusted for training adherence, performing physical exercise at the workplace is more effective than home-based exercise in reducing musculo-skeletal pain in healthcare workers. Noteworthy, obese individuals may especially benefit from physical exercise interventions targeting musculo-skeletal pain.

Change in Musculoskeletal Pain in Patients With Work-Related Musculoskeletal Disorder After Tailored Rehabilitation Education: A One-Year Follow-Up Survey

OBJECTIVE

To apply tailored rehabilitation education to video display terminal (VDT) workers with musculoskeletal pain and to assess changes in musculoskeletal pain after rehabilitation education.

METHODS

A total of 8,828 VDT workers were screened for musculoskeletal disorders using a self-report questionnaire. Six hundred twenty-six VDT workers selected based on their questionnaires were enrolled in musculoskeletal rehabilitation education, which consisted of education on VDT syndrome and confirmed diseases, exercise therapy including self-stretching and strengthening, and posture correction. One year later, a follow-up screening survey was performed on 316 VDT workers, and the results were compared with the previous data.

RESULTS

Compared with the initial survey, pain intensity was significantly decreased in the neck area; pain duration and frequency were significantly decreased in the low back area; and pain duration, intensity, and frequency were significantly decreased in the shoulder and wrist after tailored rehabilitation education. In addition, pain duration, intensity, and frequency showed a greater significant decrease after tailored rehabilitation education in the mild pain group than in the severe pain group.

CONCLUSIONS

This study found that work-related musculoskeletal pain was reduced after tailored rehabilitation education, especially in the shoulder, wrist, and low back.