Prevalence of Musculoskeletal Diseases of the Upper Extremity Among Dental Professionals in Germany

Cross-Cultural Adaptation and Validation of the German Version of the Upper Limb Functional Index

CONTEXT

The Upper Limb Functional Index (ULFI) is a popular tool with valid psychometric properties to assess upper limb function in patients with musculoskeletal conditions. The aim of the study was to cross-culturally adapt and validate the German version of the ULFI.

DESIGN

Cross-cultural validation.

METHODS

A 2-stage cross-cultural adaptation of the ULFI was performed according to international guidelines through consecutive forward and backward translations. Psychometric properties of internal consistency, test-retest reliability, criterion, face and content validity, and factor structure were determined from the included German participants suffering from upper limb conditions (n = 100), who fulfilled the following inclusion criteria: (1) older than 18 years old, (2) German as native language, and (3) medical diagnosis of musculoskeletal upper limb condition. Participants completed the ULFI; Disabilities of the Arm, Shoulder, and Hand; EuroQol Health Questionnaire 5 Dimensions; and Short Form-12 questionnaires.

RESULTS

The ULFI-G showed good internal consistency (α = .88); excellent test-retest reliability (intraclass correlation coefficient2:1 = .98); directly strong correlation with Disabilities of the Arm, Shoulder, and Hand (r = .84); fair correlation with Disabilities of the Arm, Shoulder, and Hand-sport (r = .54); inversely fair correlation with EuroQol Health Questionnaire 5 Dimensions (r = -.62); and Short Form 12's physical health domain (r = -.7). A single-factor structure was revealed.

CONCLUSIONS

The ULFI-G showed adequate psychometric properties and proved to be a valid tool for upper limb functional assessment in German population.

An assessment of musculoskeletal disorders and physical activity levels in dentists: A cross-sectional study

BACKGROUND

Dentistry is a physically and mentally demanding profession that involves long periods of muscle imbalance and asymmetrical postures when performing delicate procedures. This can lead to a high incidence of work-related diseases. However, physical activity may prevent or minimize the incidence of musculoskeletal discomfort and pain.

OBJECTIVE

The present study aimed to determine the association between musculoskeletal disorders and physical activity levels in dentists practicing in Turkey.

METHODS

This cross-sectional study was conducted between March and June 2023 with dentists from Turkey actively practicing dentistry. The short form of the International Physical Activity Questionnaire was used to determine dentists' physical activity levels, and the Extended Nordic Musculoskeletal Questionnaire was used to assess musculoskeletal disorders. IBM SPSS 20 software was used for statistical analysis. Data were presented as mean, standard deviation, median, minimum, maximum, percentage, and number. Chi-square, Mann-Whitney U, One-Sample Chi-Square tests, and an ordinal logistic regression test were used. The statistical significance level was taken as p <  0.05.

RESULTS

A total of 116 dentists (63 females 53 males) between the ages of 24 and 60 (36.37±7.32) were included in the study. Forty-eight participants had a low level of physical activity, 56 had a moderate level of physical activity (MLPA), and 12 had a high level of physical activity (HLPA). There was no significant difference between the gender (p = 0.224) and age (p = 0.469) of the participants and levels of physical activity. Musculoskeletal discomfort was reported by 93.1% (n = 108) of the participants in one or more body parts (p <  0.001) and 55.6% (n = 60) of them were female. The number of dentists with neck (p <  0.001) and shoulder (p = 0.05) problems was significantly higher. There was no significant effect of gender (p > 0.05) on musculoskeletal conditions. However, the relationship between musculoskeletal conditions and physical activity levels was inconsistent. The HLPA group reported the lowest discomfort for all body parts, except the elbows and knees (p <  0.05). The MLPA group reported higher discomfort in the neck, shoulder, upper back, wrists/hands, lower back, and knees. The group with the lowest physical activity exhibited the highest discomfort in the elbow and ankle/feet regions.

CONCLUSION

This study found that the prevalence of musculoskeletal disorders was high among dentists, many of whom reported either low or moderate physical activity levels. The results of this study may enhance dentists' understanding of work-related musculoskeletal diseases and promote their participation in physical activities.

Musculoskeletal disorders and risk indicators for pain chronification among German dentists: A cross-sectional questionnaire-based study

OBJECTIVES

The aim of this study was to determine the prevalence of musculoskeletal (MS) disorders in practicing German dentists and identify risk factors for pain chronification.

METHODS

This was a cross-sectional, quantitative, questionnaire-based study in which the validated German version of the Örebro Musculoskeletal Pain Questionnaire was sent out to practicing German dentists.

RESULTS

Of the 8,072 questionnaires sent out, 576 dentists responded (60.2% men, 39.8% women; mean [SD] age, 50 [10.1] years; response rate, 7.1%). Overall, 344 dentists had current pain at 719 pain sites (point prevalence, 59.7%). The risk of chronic pain in dentists with current MS pain was high in 28.5% (n = 98), moderate in 30.5% (n = 105), and low in 41% (n = 141). The multivariate logistic regression analysis showed that specialization in restorative dentistry was associated with a significantly higher risk of experiencing pain chronification (odds ratio [OR], 3.94; P = .008), followed by specialization in pediatric dentistry (OR, 0.35; P = .048). A history of current pain, particularly current leg pain, was predictive of higher chronification risk (OR, 22.0; P < .001) and neck pain (OR, 4.51; P = .001).

CONCLUSIONS

Almost two-thirds of practicing German dentists have MS pain, and one-third of these have a moderate through high risk of developing pain chronification. These health problems have an adverse impact on their ability to successfully perform dental services, with the potential for prolonged sick leave, disability, and early retirement. Accordingly, these problems deserve greater attention from the scientific community (identification of risk factors), universities (sensitization and education), and policy makers (development and implementation of appropriate countermeasures for MS disorders in the dental profession).

PRACTICAL IMPLICATIONS

Knowing the risk factors associated with acute and chronic MS pain may help dentists take preventive measures and thereby improve their physical well-being and work-related quality of life.

Musculoskeletal Pain in the Neck and Lower Back Regions among PHC Workers: Association between Workload, Mental Disorders, and Strategies to Manage Pain

Scientific evidence indicates that workers in the health sector are commonly exposed to work-related musculoskeletal pain.

OBJECTIVES

We aimed to identify the relationship between the presence and intensity of musculoskeletal pain in the neck and lumbar regions reported by Primary Health Care (PHC) workers with workloads and occupational risks, analyze musculoskeletal pain in the presence and absence of self-reported mental disorders based on a medical diagnosis, and identify workers' strategies to manage pain.

METHOD

This cross-sectional study addressed 338 health professionals working in PHC outpatient services in the extreme South of Brazil. One questionnaire addressed sociodemographic questions concerning occupation, occupational risks, and mental disorders. The Nordic Musculoskeletal Questionnaire was used to assess self-reported musculoskeletal pain. The National Aeronautics and Space Administration Task Load Index (NASA-TLX) measured the workload. A descriptive and inferential analysis was performed using SPSS version 21.0.

RESULTS

Most (55.3%) participants reported neck and (64.5%) lower back pain in the previous 12 months, and 22.5% and 30.5% reported intense neck and lower back pain, respectively, in the previous 12 months. The results showed different independent associations with increased musculoskeletal pain among health workers. Dentists presented the highest prevalence of neck pain, while female workers presented the highest prevalence of lower back pain. Furthermore, the perception of ergonomic risk and virtually all self-reported mental disorders (except panic syndrome for neck pain) were associated with pain in the neck and lower back regions and a higher frustration level (mental demand). Additionally, professionals with graduate degrees, nurses, and professionals working the longest in PHC services reported seeking complementary therapies more frequently, while physicians and those with self-reported mental disorders self-medicated more frequently.

How Does the Use of an Intraoral Scanner Affect Muscle Fatigue? A Preliminary In Vivo Study

The purpose of this study was to evaluate muscle activation and fatigue in the operator during tooth preparation and intraoral scanning by simulating these tasks in two types of dental unit chair systems (UCS). Six participants were recruited, and the above tasks were simulated. Electrodes were placed on the skin over five types of muscles (arm, neck, and shoulder muscles), and the maximal voluntary contraction (MVC) was measured. Electromyography (EMG) was assessed during the simulation, and EMG values were normalized using MVC. The root mean square (RMS) EMG (%MVC) and muscle fatigue (%) were calculated. Owing to a lack of normal distribution of the data, Mann−Whitney U test and Kruskal−Wallis H test were performed for statistical comparison, and Bonferroni adjustment was performed for multiple comparisons (α = 0.05). There was no significant difference in RMS EMG between the two types of dental UCS (intraoral scanning, p = 0.237; tooth preparation, p = 0.543). Moreover, the RMS EMG and muscle fatigue were not significantly different between the two tasks (p > 0.05). There was significant muscle fatigue after the intraoral scanner use was simulated thrice (p < 0.001). It is necessary to refrain from performing continuous intraoral scanning and tooth preparation and to take appropriate rest to reduce the incidence of musculoskeletal disorders in dentists in clinical settings.