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Garcia G, Arauz PG, Alvarez I, Encalada N, Vega S, Martin BJ. Impact of a passive upper-body exoskeleton on muscle activity, heart rate and discomfort during a carrying task. PLoS One 2023; 18:e0287588. [PMID: 37352272 PMCID: PMC10289366 DOI: 10.1371/journal.pone.0287588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Accepted: 06/08/2023] [Indexed: 06/25/2023] Open
Abstract
OBJECTIVE The goal of this study was to compare erector spinae muscle fatigue, upper limb muscle activity, body areas discomfort, and heart rate during a 10-min carrying task with and without a passive upper-body exoskeleton (CarrySuitⓇ) while considering sex influences. BACKGROUND Passive exoskeletons are commercially available to assist lifting or carrying task. However, evidence of their impact on muscle activity, fatigue, heart rate and discomfort are scarce and/or do not concur during carrying tasks. METHOD Thirty participants (16 females and 14 male) performed a 10-min, 15kg load-carrying task with and without the exoskeleton in two non-consecutive days. Heart rate, and erector spinae, deltoid, biceps and brachioradialis muscle activity were recorded during the carrying tasks. In addition, erector spinae electromyography during an isometric hold test and discomfort ratings were measured before and after the task. RESULTS While without the exoskeleton upper limb muscle activity increased or remained constant during the carrying task and showing high peak activation for both males and females, a significant activity reduction was observed with the exoskeleton. Low back peak activation, heart rate and discomfort were lower with than without the exoskeleton. In males muscle activation was significantly asymmetric without the exoskeleton and more symmetric with the exoskeleton. CONCLUSION The tested passive exoskeleton appears to alleviate the physical workload and impact of carrying heavy loads on the upper limbs and lower back for both males and females.
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Affiliation(s)
- Gabriela Garcia
- Departamento de Ingeniería Industrial, Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Paul Gonzalo Arauz
- Departamento de Ingeniería Mecánica, Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Isabel Alvarez
- Departamento de Ingeniería Industrial, Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Nicolas Encalada
- Departamento de Ingeniería Industrial, Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Shirley Vega
- Departamento de Ingeniería Industrial, Colegio de Ciencias e Ingenierías, Universidad San Francisco de Quito USFQ, Quito, Ecuador
| | - Bernard J. Martin
- Department of Industrial and Operations Engineering, University of Michigan, Ann Arbor, Michigan, United States of America
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Godek P, Szczepanowska-Wolowiec B, Golicki D. Comparison of Analgesic Efficacy between Epidural and Perineural Administration of Autologous Conditioned Serum in the Conservative Treatment of Low Back Pain Due to Lumbar Degenerative Disc Disease: A Randomized, Open-Label, Controlled Clinical Trial. Brain Sci 2023; 13:brainsci13050749. [PMID: 37239221 DOI: 10.3390/brainsci13050749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 04/24/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
Lumbar degenerative disc disease (LDDD) is widely acknowledged as a significant contributor to low back pain (LBP), which is a prevalent and debilitating health condition affecting millions of individuals worldwide. The pathogenesis of LDDD and associated pain mechanisms are thought to be mediated by inflammatory mediators. Autologous conditioned serum (ACS, Orthokine) may be used for symptomatic treatment of LBP due to LDDD. This study aimed to compare the analgesic efficacy and safety of two routes of ACS administration, perineural (periarticular) and epidural (interlaminar), in the conservative treatment of LBP. This study used an open-label, randomized, controlled trial protocol. A group of 100 patients were enrolled in the study and randomly allocated into two comparative groups. Group A (n = 50) received the epidural (interlaminar) approach-2 ultrasound-guided injections as control intervention (each containing two doses of ACS-8 mL). Group B (n = 50) received the perineural (periarticular) approach-2 ultrasound-guided injections as experimental intervention at 7-day intervals (the same volume of ACS). Assessments consisted of an initial assessment (IA) and control assessments at 4 (T1), 12 (T2), and 24 (T3) weeks after the last intervention. Primary outcomes comprised Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), Roland Morris Questionnaire (RMQ), and Euro Quality of Life-5 Dimensions-5 Levels (EQ-5D-5L): Index, Visual Analogue Scale (VAS), and Level Sum Score (LSS). Secondary outcomes included differences between groups in specific endpoints for the above-mentioned questionnaires. In conclusion, this study revealed that both perineural (periarticular) and epidural ACS injections tended to perform in a very similar way. Both routes of Orthokine application show significant improvement in the primary clinical parameters, such as pain and disability, and therefore, both methods can be considered equally effective in managing LBP due to LDDD.
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Affiliation(s)
- Piotr Godek
- Sutherland Medical Center, 04-036 Warsaw, Poland
| | | | - Dominik Golicki
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-091 Warsaw, Poland
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Bernardes JM, Spröesser Alonso M, Gómez-Salgado J, Ruiz-Frutos C, García-Navarro EB, Dias A. The impact of manual patient handling on work ability: A cross-sectional study in a Brazilian hospital. Nurs Open 2022; 9:2304-2313. [PMID: 35609217 PMCID: PMC9374414 DOI: 10.1002/nop2.1228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/10/2021] [Accepted: 04/17/2022] [Indexed: 11/20/2022] Open
Abstract
Aim To investigate the level of self‐reported work ability and its association with manual patient handling in healthcare workers. Design Cross‐sectional study adhering to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Methods A total of 320 healthcare workers answered a self‐administered questionnaire regarding manual patient handling, work ability, occupational factors, occurrence of low back pain and sociodemographic and lifestyle factors from November 2016 to March 2017. The association between manual patient handling and low back pain was analysed with Poisson regression models. Results The prevalence ratio of inadequate work ability was 43.42%. Manual patient handling (PR 1.375, 95% CI 1.038–1.821), bachelor education (PR 2.150, 95% CI 1.272–3.632), less than bachelor education (PR 2.166, 95% CI 1.218–3.855), seniority (PR 1.049, 95% CI 1.024–1.086), poor sleep quality (PR 1.425, 95% CI 1.13–1.796) and presence of low back pain (PR 2.003, 95% CI 1.314–3.052) were all positively associated with an inadequate work ability.
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Affiliation(s)
- João Marcos Bernardes
- Graduate Program in Collective/Public Health, Botucatu Medical School, Universidade Estadual Paulista/UNESP, Botucatu, São Paulo, Brazil.,Department of Public Health, Botucatu Medical School, Universidade Estadual Paulista/UNESP, Botucatu, São Paulo, Brazil
| | - Melissa Spröesser Alonso
- Graduate Program in Collective/Public Health, Botucatu Medical School, Universidade Estadual Paulista/UNESP, Botucatu, São Paulo, Brazil
| | - Juan Gómez-Salgado
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain.,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Carlos Ruiz-Frutos
- Department of Sociology, Social Work and Public Health, Faculty of Labour Sciences, University of Huelva, Huelva, Spain.,Safety and Health Postgraduate Programme, Universidad Espíritu Santo, Guayaquil, Ecuador
| | - Esperanza Begoña García-Navarro
- Department of Nursing and Health Sciences, University of Huelva, Huelva, Spain.,Research Group ESEIS, Social Studies and Social Intervention, Center for Research in Contemporary Thought and Innovation for Development (COIDESO), University of Huelva, Huelva, Spain
| | - Adriano Dias
- Graduate Program in Collective/Public Health, Botucatu Medical School, Universidade Estadual Paulista/UNESP, Botucatu, São Paulo, Brazil.,Department of Public Health, Botucatu Medical School, Universidade Estadual Paulista/UNESP, Botucatu, São Paulo, Brazil
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Distribution Patterns of Degeneration of the Lumbar Spine in a Cohort of 200 Patients with an Indication for Lumbar MRI. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063721. [PMID: 35329406 PMCID: PMC8951543 DOI: 10.3390/ijerph19063721] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/16/2022] [Accepted: 03/19/2022] [Indexed: 11/29/2022]
Abstract
Lower back pain is one of the most common causes of a reduced quality of life. Magnetic resonance imaging (MRI) is the best suited imaging technique to detect causes of that pain. We retrospectively evaluated the MRIs of the lumbar spine for 200 patients in order to describe the distribution of signs of degeneration with regard to age, sex, and position of the disc affected. The number of spinal segments affected by degeneration increased with age, as did the number of signs of degeneration per segment. In patients aged between 21 and 30, 38.8% of discs were affected, while for patients aged between 51 and 60, 91.6% of discs were affected. There was no statistically significant gender difference. The lower two segments were most commonly affected by degeneration. The most common were structural changes to the discs, which affected 88.4% of patients over 50. Spondylosis was the most common bone-related change, found in 60.4% of patients over the age of 50. A reduction in disc height increases the likelihood of structural changes to the disc and bone-related changes. When investigating risk factors for developing disc-related diseases, the complex disc degeneration patterns described here should be taken into account.
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Lee T, Roy A, Power P, Sembajwe G, Dropkin J. Ergonomic exposures and control measures associated with mass fatality decedent handling in morgues and body collection points in a New York healthcare system during COVID-19: A case series. INTERNATIONAL JOURNAL OF INDUSTRIAL ERGONOMICS 2022; 88:103260. [PMID: 35039703 PMCID: PMC8755464 DOI: 10.1016/j.ergon.2022.103260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 12/06/2021] [Accepted: 01/01/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION In April 2020, novel coronavirus SARS-CoV-2 (COVID-19) produced an ongoing mass fatality event in New York. This overwhelmed hospital morgues necessitating emergent expansion of capacity in the form of refrigerated trucks, trailers, and shipping containers referred to as body collection points (BCPs). The risks for musculoskeletal injury during routine and mass fatality mortuary operations and experiences of decedent handlers throughout the "first wave" of COVID-19 are presented along with mitigation strategies. METHODS Awareness of the high rates of musculoskeletal injury among health care workers due to ergonomic exposures from patient handling, including heavy and repetitive manual lifting, prompted safety walkthroughs of mortuary operations at multiple hospitals within a health system in New York State by workforce safety specialists. Site visits sought to identify ergonomic exposures and ameliorate risk for injury associated with decedent handling by implementing engineering, work practice, and administrative controls. RESULTS Musculoskeletal exposures included manual lifting of decedents to high and low surfaces, non-neutral postures, maneuvering of heavy equipment, and push/pull forces associated with the transport of decedents. DISCUSSION Risk mitigation strategies through participatory ergonomics, education on body mechanics, development of novel handling techniques implementing friction-reducing aides, procurement of specialized equipment, optimizing BCP design, and facilitation of communication between hospital and system-wide departments are presented along with lessons learned. After-action review of health system workers' compensation data found over four thousand lost workdays due to decedent handling related incidents, which illuminates the magnitude of musculoskeletal injury risk to decedent handlers.
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Key Words
- BCP, Body Collection Point
- Charnel
- Dead
- Deceased
- EMS, Emergency Medical Services
- Expired
- FD, Funeral Director
- FRP, Fiberglass reinforced panel
- Funeral
- ME, Medical Examiner
- Morgue
- Mortem
- Mortuary
- Musculoskeletal injury
- NA, Nursing assistant
- RN, Registered nurse
- SPHM, Safe Patient Handling & Mobility
- WC, Workers' compensation
- WFS, Workforce Safety
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Affiliation(s)
| | - Asha Roy
- Northwell Health, Lake Success, NY, USA
| | | | - Grace Sembajwe
- Northwell Health, Lake Success, NY, USA
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, USA
| | - Jonathan Dropkin
- Northwell Health, Lake Success, NY, USA
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, NY, USA
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Latent Tuberculosis Infection among Health Workers in Germany-A Retrospective Study on Progression Risk and Use of Preventive Therapy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18137053. [PMID: 34280988 PMCID: PMC8297349 DOI: 10.3390/ijerph18137053] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 06/24/2021] [Accepted: 06/28/2021] [Indexed: 01/29/2023]
Abstract
Despite the decline in tuberculosis incidence (TB) in Germany, health workers (HW) are at greater risk of becoming infected with Mycobacterium tuberculosis. To date, little is known about the risk of progression of latent tuberculosis infections (LTBI) and the use of Tuberculosis Preventive Therapy (TPT) among HW. Routine data from the German Statutory Institution for Accident Insurance and Prevention for Health and Welfare Services (BGW) were analysed and a retrospective survey was conducted. A self-administered questionnaire was sent to 1711 HW who had received recognition of an LTBI as an occupational disease between the years 2009 and 2018. The response rate was 42.3% after correcting for those with no actual address (20.4%). We included 575 HW in the data analysis of the retrospective survey. The cumulative incidence of progression, the incidence density and the associated 95% confidence interval (95% CI) were calculated. Three progressive cases were identified in the analysis of the routine data. In the survey cohort, three HW developed TB during the observation period of 5.4 years on average (standard deviation: 2.8 years; interquartile range: 5.0 years). The cumulative TB incidence was 0.52% in the survey group (95% CI: 0.14% to 1.65%). The incidence density was 0.97 cases per 1000 person years (95% CI: 0.25 to 3.10). One-third of the respondents underwent TPT. Significant differences were observed between age and activity groups in the use of TPT, but not between the genders, year of diagnosis or the reason for performing the screening. The data indicate that the risk of progression of an LTBI is low for HW. However, one-third of the HW had undergone TPT. Information about the expected progression risk is important so that it can be weighed against the risk of side effects of TPT.
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