Role of yoga and physical activity in work-related musculoskeletal disorders among dentists

The Knowledge and Attitude of Undergraduate Dental Students toward Dental Ergonomic Principles in Occupational Health

BACKGROUND

Undergraduate dental curricula and courses containing ergonomic principles are introduced to students from the very beginning of dental education. Still, dentists present a high prevalence of musculoskeletal disorders, which are a direct burden on quality of life, leading to early retirement from the profession. This study aimed to assess the state of students' knowledge and awareness regarding the role of ergonomics in dentistry and its practical implementation.

METHODS

a cross-sectional study using a predesigned self-administered questionnaire was conducted among fourth- and fifth-year dental students of the Medical University of Silesia in Katowice, Poland (response rate of 69.2%).

RESULTS

A total of 94.6% of students declared a good, fair, or moderate level of knowledge of the subject, with a significant difference in favor of the fifth-year students (p = 0.008). Moreover, 76.1% of respondents showed a good or very good attitude toward ergonomics as a university curriculum subject. A total of 72.3% of respondents declared that the practical application of ergonomic rules in clinical dentistry is very important (five in a five-point scale). Women found dental ergonomics more important than men (p < 0.001). However, 79.3% of participants admitted not following basic ergonomic principles during clinical procedures.

CONCLUSION

The research revealed a discrepancy between theoretical knowledge and awareness and the practical application of ergonomics in a clinical environment. Only by inculcating correct occupational standards and abiding by them from the commencement of dental education can consistency between theory and practice be achieved. This will hopefully ensure the health and well-being of dental team members throughout their professional lives.

Ergonomic interventions and endodontic treatment outcomes: An analysis of dentist working posture and error rates

Purpose

Dentists spend a long time the day in the position. It is possible that this leads to discomfort that may translate to procedural errors during treatment, such as root canal treatment. This study aims to investigate the relationship of working posture and procedural errors in endodontic manipulations.

Materials and Methods

32 dentists (17 men, 53.13%, and 15 women, 46.88%) from the University Dental Polyclinic of Uzhhorod National University (Uzhhorod, Ukraine) were included in the study. REBA, RULA, frequency of procedural errors were analysed using regression.

Results

This study revealed a surprising trend where a decrease in errors during endodontic treatment was associated with higher RULA and REBA scores, contrary to the expected increase in errors with higher ergonomic stress. Additionally, the research highlighted the significant impact of a dentist's handedness and tooth position in the dental arch on treatment ergonomics and efficiency, as observed and analyzed through ergonomic assessments and statistical methods.

Conclusions

The study conclusively demonstrated that optimal positioning and alignment during dental procedures significantly contribute to a reduction in procedural errors, underscoring the importance of ergonomics in clinical dentistry.

Work-related musculoskeletal disorders among United Arab Emirates schoolteachers: an examination of physical activity

OBJECTIVE

To estimate the prevalence of work-related musculoskeletal disorders and their association with physical activity among schoolteachers in the United Arab Emirates.

METHODS

This observational cross-sectional study involved 209 schoolteachers (aged 20-60) with a minimum of two years of experience. Data, including demographics (gender, age), Nordic Musculoskeletal Questionnaire (NMQ) for WMSD prevalence and pain sites, and Global Physical Activity Questionnaire (GPAQ) for physical activity levels, were collected. Six schools were visited for data collection, with consent from school heads and participants. Schedules were tailored to participant availability, allowing up to three attempts for participation. Non-respondents were identified after three unsuccessful attempts.

RESULTS

Of the total 206 participants, 149 were female, while the remaining 57 were male. Age distribution analysis revealed that 18% of individuals were within the 20 to 30 years range, 26.2% fell within the 30 to 40 years, and 36.9% had 40 to 50 years age brackets. The responses were obtained in Arabic (90%) and English (10%). The study identified a high prevalence (71.4%) of work-related musculoskeletal disorders (WMSD) in UAE schoolteachers, with neck pain being the most common (74.3%). Major risk factors included age, workload, and low physical activity. The data was normally distributed, and Pearson's Correlation test revealed weak positive correlation (r: 0.14), but statistically significant (p value = 0.04) between WMSD and PA, indicating that it was a contributing factor but other factors beyond PA influenced WMSD prevalence in this cohort. The findings of the study are based on certain limitations such as cross-sectional design and convenient sampling which could have potential selection bias and affect generalizability of the results.

CONCLUSION

Findings suggest the need to promote physical activity and reduce workload for teachers, considering their age and gender. Additionally, there is a need to raise awareness regarding ergonomics and the importance of taking short breaks for stretching or physical movement to enhance the overall well-being of schoolteachers in the UAE and similar contexts. Diverse prevalence rates across different body areas underscore the necessity for individualized treatments.

Yoga for musculoskeletal pain, discomfort, perceived stress, and quality of sleep in industry workers: a randomized controlled trial

BACKGROUND AND OBJECTIVES

Work-related musculoskeletal pain and discomfort are due to repetitive, unnatural, continuous movements and postures. Yoga therapy is beneficial for pain and disability in occupational settings. The current study aims to investigate the effect of yoga on musculoskeletal pain, stress, and sleep quality among industry workers.

METHODOLOGY

The study was conducted as a parallel randomized controlled open-label trial. An allocation ratio of 1:1 was followed for randomization. A health survey was used to recruit 90 male workers in machinery manufacturing industries from Bengaluru. A specially designed yoga module was administered five days a week for eight weeks to yoga group. The waitlisted control group received lifestyle suggestions. Cornell Musculoskeletal Discomfort Questionnaire (CMDQ), Perceived Stress Scale (PSS), and Pittsburgh Sleep Quality Index (PSQI) were administered at baseline, at the fourth week and eighth weeks. Repeated Measures Analysis of Variance (RM-ANOVA) was conducted to elicit the group*time interactions.

RESULTS

Ninety participants (Yoga = 45, Control = 45) with age 40.57 ± 6.85 were randomized. Significant interactions were found in CMDQ, VAS, PSS and PSQI scores. Further, between group comparison demonstrate significant difference between the groups at the end of 8 weeks for CMDQ, VAS and PSS scores.

CONCLUSIONS

Yoga can be used to reduce musculoskeletal pain, discomfort, perceived stress and improve sleep quality among industry workers.

TRIAL REGISTRATION NUMBER

CTRI/2022/03/040894.

An ergonomic focus evaluation of work-related musculoskeletal disorders amongst operators in the UAE network control centres

Work-related musculoskeletal disorders (WMSDs) have rapidly increased during the last decade, but only a few descriptive surveys have been conducted in the United Arab Emirates (UAE). This study investigated the prevalence of WMSDs and analysed their ergonomic risks amongst operators in the network control rooms across two government organisations, X and Y, in the UAE. Essential data were collected by the Nordic Musculoskeletal Questionnaire (NMQ) and the Maastricht Upper Extremity Questionnaire (MUEQ) from online surveys and direct observations based on the Rapid Office Strain Assessment (ROSA) and the Rapid Upper Limb Assessment (RULA) form and ergonomic measurements for the working environments, respectively. Fifty-three and eighteen operators participated from Organisations X and Y. This study found a high presence of WMSDs in both organisations over the past 12 months. In Organisation X, individual, work-related physical and psychosocial risk factors of high BMI, educational level, morning work shift, high job duration, lack of exercise habit, awkward body posture, high job demand, low job control, and low work social support were associated with WMSDs in different body areas (p < 0.05). In Organisation Y, older age, high BMI, high job duration, lack of exercise habits, unergonomic workstations, awkward body posture, low break time, high job demand, and stress level were associated with WMSDs in different body areas (p < 0.05). The control room operators' most affected body areas were the back, eyes, and neck. Several efficient ergonomic intervention ideas were explored to lessen the detrimental effects of WMSDs and preclude the development of WMSDs amongst the control centre operators.

Quality of Life and Stress Management in Healthcare Professionals of a Dental Care Setting at a Teaching Hospital in Rome: Results of a Randomized Controlled Clinical Trial

In the healthcare environment, more and more people experience work-related stress. The Faculty of Medicine and Dentistry of Sapienza University of Rome, having observed the need to take care of healthcare professionals, has set itself the objective of providing useful tools such as additional and necessary personal protective equipment for healthcare professionals.

OBJECTIVE

To promote health through better management, skills, and the use of strategies and solutions to identify, decompress, and neutralize those responsible for work-related stress mechanisms in order to take care of those who care (CURARE CURANTES).

MATERIALS AND METHODS

A randomized controlled clinical trial was conducted. The participants were enrolled by three departments of the Department of Dental and Maxillofacial Sciences of Rome; in consideration of emotional involvement of health professionals who work there. A motivational program was offered.

RESULTS

There were 17 and 16 healthcare professionals in the intervention and control groups, respectively. Levels of the mental composite score (MCS) varied both in the pre-post phase of the intervention group (p = 0.002), and between the intervention group and control group in the post phase (p = 0.006). No significant differences were observed for the physical composite score (PCS). Similarly, there were no significant differences regarding the positivity scale (PS) and the two dimensions of work-related stress (job demand and decision latitude).

CONCLUSION

This study demonstrates the efficacy of yoga training practiced directly in the workplace and wearing work clothes, entering the work context, not weighing further on the healthcare workload, and being a way to carry out physical activity even in those cases in which professionals do not have the time to do it in their free time.

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.

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

Objective

Although many findings on occupational musculoskeletal complaints are available from American and European dentists, the corresponding data from Germany are still scarce. Therefore, the aim of this study was to provide additional information on the prevalence of and risk factors for musculoskeletal disorders of the upper extremity, particularly the shoulder in this specific population.

Methods

A written survey was carried out among 600 dentists in the state of North Rhine-Westphalia, Germany. Questionnaire items included physical and psychosocial workload, general health, and the occurrence of musculoskeletal symptoms during the previous 12 months that led to sick leave and medical care according to a modified version of the Nordic Musculoskeletal Questionnaire (NMQ). Regression analysis was used to evaluate relevant risk factors for severe musculoskeletal disorders.

Results

A total of 229 dentists were participated in the study (response rate 38%). Overall, 92.6% of the participants had already suffered from musculoskeletal symptoms in at least one body region. Symptoms were mostly reported in the neck (65.1%) and in the shoulder (58.1%). Limitations in daily activities were experienced by 15.9% due to neck pain and by 15.4% due to shoulder pain. Medical care was sought by 23.7% because of neck pain and by 21.1% due to shoulder pain. Risk factors for symptoms in the upper extremity regions were gender (female), increased physical load, and numerous comorbidities.

Conclusion

There is a high prevalence of musculoskeletal disorders among dentists. Suitable interventions are therefore needed to prevent musculoskeletal diseases and pain among dental professionals, with particular attention to female dentists.

Training Benefits and Injury Risks of Standing Yoga Applied in Musculoskeletal Problems: Lower Limb Biomechanical Analysis

Standing yoga poses strengthen a person’s legs and helps to achieve the goal of musculoskeletal rehabilitation, but inadequate exercise planning can cause injuries. This study investigated changes in the electromyogram and joint moments of force (JMOFs) of lower extremities during common standing yoga poses in order to explore the feasibility and possible injury risk in dealing with musculoskeletal problems. Eleven yoga instructors were recruited to execute five yoga poses (Chair, Tree, Warrior 1, 2, and 3). The results revealed significant differences in hip, knee, and ankle JMOFs and varying degrees of muscle activation among the poses. Among these poses, rectus femoris muscle activation during the Chair pose was the highest, Warrior 2 produced the highest muscle activation in the vastus lateralis of the front limb, while Warrior 1 had the highest muscle activation in the vastus medialis of the back limb. Therefore, all three poses can possibly be suggested as a therapeutic intervention for quadriceps strengthening. Warrior 1 was possibly suggested as a therapeutic intervention in order to reduce excessive lateral overload of the patella, but the possible adverse effects of Warrior 2 with the highest knee adductor JMOF in the back limb could raise joint reaction forces across the medial condyles. In single-leg balance postures, Warrior 3 had unique training effects on the hamstring, and is therefore suggested as a part of hamstring rehabilitation exercises. The Tree pose induced low lower-extremity JMOFs and a low level of thigh muscle activations when it was performed by senior instructors with excellent balance control; however, for yoga beginners with insufficient stability, it will be a useful training mode for strengthening the muscles that help to keep one upright. This study quantified the physical demands of yoga poses using biomechanical data and elucidated the structures and principles underlying each yoga movement. This is crucial for yoga practitioners.

Influence of design of dentist's chairs on body posture for dentists with different working experience

BACKGROUND

Musculoskeletal disorders (MSD) are a common health problem among dentists. Dental treatment is mainly performed in a sitting position. The aim of the study was to quantify the effect of different ergonomic chairs on the sitting position. In addition, it was tested if the sitting position of experienced workers is different from a non-dental group.

METHODS

A total of 59 (28 m/31f) subjects, divided into two dentist groups according to their work experience (students and dentists (9 m/11f) < 10 years, dentists (9 m/10f) ≥ 10 years) and a control group (10 m/10f) were measured. A three-dimensional back scanner captured the bare back of all subjects sitting on six dentist's chairs of different design. Initially, inter-group comparisons per chair, firstly in the habitual and secondly in the working postures, were carried out. Furthermore, inter-chair comparison was conducted for the habitual as well as for the working postures of all subjects and for each group. Finally, a comparison between the habitual sitting posture and the working posture for each respective chair (intra-chair comparison) was conducted (for all subjects and for each group). In addition, a subjective assessment of each chair was made. For the statistical analysis, non-parametric tests were conducted and the level of significance was set at 5%.

RESULTS

When comparing the three subject groups, all chairs caused a more pronounced spinal kyphosis in experienced dentists. In both conditions (habitual and working postures), a symmetrical sitting position was assumed on each chair. The inter-chair comparisons showed no differences regarding the ergonomic design of the chairs. The significances found in the inter-chair comparisons were all within the measurementerror and could, therefore, be classified as clinically irrelevant. The intra-chair comparison (habitual sitting position vs. working sitting position) illustrated position-related changes in the sagittal, but not in the transverse, plane. These changes were only position-related (forward leaned working posture) and were not influenced by the ergonomic sitting design of the respective chair. There are no differences between the groups in the subjective assessment of each chair.

CONCLUSIONS

Regardless of the group or the dental experience, the ergonomic design of the dentist's chair had only a marginal influence on the upper body posture in both the habitual and working sitting postures. Consequently, the focus of the dentist's chair, in order to minimize MSD, should concentrate on adopting a symmetrical sitting posture rather than on its ergonomic design.

The Role of Yoga in Treating Stress-Related Symptoms in Dental Hygiene Students

Context:

Research has provided evidence for yoga's effectiveness in the prevention and treatment of pain and stress, both of which have been implicated as significant negative moderators of student performance and experience.

Aims:

This study investigated the feasibility and preliminary impact of a 10-week yoga intervention with dental hygiene students to reduce perceptions of stress and stress-related symptoms.

Settings and Design:

Students self-selected into a yoga treatment versus control condition. They completed stress and pain measures at four time points during and after the intervention or control period of 10-weeks.

Methods:

Participants were students enrolled in a dental hygiene program. All 77 participants completed a 10-week study, self-selecting into an intervention or control group. They completed three self-report questionnaires assessing pain and stress, administered at baseline, mid-point, postintervention, and two follow-ups. The 10-week yoga intervention consisted of 10 90-min yoga sessions that provided check-ins, breathing exercises, sequences of postures, relaxation exercises, and closing meditations.

Statistical Analysis Used:

Independent samples t-tests were used to compare perceived stress levels of participants in the control versus treatment groups. Paired t-test was used to assess differences in stress-related symptom levels across time.

Results:

Results suggested that a yoga intervention is feasible for this group and that active yoga practice can lower perceived stress across multiple domains and across time.

Conclusions:

A specially adapted and designed 10-week yoga protocol appears to be an accessible option for dental hygiene programs that seek to support their students in improving overall wellbeing.

Evaluation of the Cervical Physiotherapeutic Treatment Needs, Work Ergonomics, and Necessity for Physical Activity Among Students of Dentistry at a Medical University. A Pilot Study

INTRODUCTION

A lot of general dental practitioners suffer from job-related health problems. They are more prone to numerous different physical and psycho-emotional triggers that aggravate their working conditions.

THE AIM

The aim of the study was to evaluate cervical physiotherapeutic treatment needs, daily ergonomic habits and the necessity for physical activity among students of dentistry at a medical university.

MATERIALS AND METHODS

112 generally healthy dentistry students (73 women, 39 men) were enrolled for the study. The age range was 20-32, with an average of 22.88 ± 2.7. The study included subjects in their second to fifth year of studies. The survey was conducted with respect to the questionnaires about possible physiotherapeutic treatments, physical activities, imaging tests and diagnoses as well as statements regarding the respondents' knowledge and ergonomics habits. To estimate the association between the risk factor and neck disability as well as chronic pain, the Neck Disability Index, Perceived Stress Scale and the Graded Chronic Pain Scale were additionally applied.

RESULTS

35.71% of dentistry students had undergo physiotherapy in the preceding year. 26.79% of the respondents declared that they underwent rehabilitation on a regular basis. The most common reasons for treatment were complaints of the cervical (7.14%), lumbar (3.57%), and thoracic spine (1.79%) as well as a combination of these symptoms. 6.25% of the subjects had started rehabilitation due to muscle relaxation. 34.82% of the study participants did not do any physical activity. Females exercised more often than males (p = 0.02; 1-β = 0.65). Therapeutic exercises contributed to the improvement of well-being of 56% of students. 64.29% of the respondents chose a sitting position during pre-clinical and clinical classes and 26.79% of the subjects worked in sitting and standing postures.

CONCLUSION

26.79% of dentistry students required periodic therapeutic rehabilitation. 34.82% of the respondents were advised to implement systematic physical activity. Due to professional conditions, dental students are exposed to an early cervical spine disorders. The main factor influencing an early onset of such dysfunctions is increased stress level. An average level of pro-health awareness may be the reason for elevated cost of rehabilitation among this group of patients.

Prevention of Musculoskeletal Diseases and Pain among Dental Professionals through Ergonomic Interventions: A Systematic Literature Review

Musculoskeletal diseases and pain (MSDs) are prevalent among dental professionals. They cause a growing inability to work and premature leaving of the occupation. Thus, the objective of this review was to summarize the evidence of ergonomic interventions for the prevention of MSDs among dental professionals. This review was conducted using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The literature search was carried out in May 2018, with an update in April 2019. Scientific databases such as MEDLINE, CINAHL, PubMed and Web of Science as well as reference lists of the included studies were used. Relevant data were extracted from the studies and summarized. The quality assessment was performed using a validated standardized instrument. Eleven studies were included in this review, of which four are of high quality. Eight studies focused on setting prevention strategies. Of those, in five studies, magnification loupes or prismatic spectacles were the subject of ergonomic interventions. Further subjects were the dental chair (n = 2) and dental instruments (n = 1). Three studies evaluated ergonomic training. In all studies, the ergonomic interventions had positive effects on the study outcome. Several ergonomic interventions to prevent MSDs among dental professionals were found to exert a positive effect on the prevalence of MSDs or working posture. This systematic review adds current evidence for the use of prismatic spectacles in order to prevent MSDs among dental professionals. Further intervention studies about the role of ergonomics for the prevention of MSDs among dental professionals are warranted.

The precedence and viability of yoga in the lives of D3-dental students, dental practitioners, and dental patients

Dentistry as a profession is quite demanding and challenging and is also associated with occupational hazards like musculoskeletal disorders and stress-related problems. The practice of yoga has been proven to be efficacious in management of quite a lot of stress and lifestyle disorders. It strengthens one physically, mentally, and emotionally. Moreover, yoga can also be used in the management of dental patients for stress-related oral conditions like lichen planus, burning mouth syndrome, aphthous ulcers, etc., Yoga has also been found to have antiinflammatory, antianxiety effect, and also a lot of other beneficial effects. This review emphasizes on the relevance of yoga in the dental profession, from the practitioners, students, and patients viewpoint. Data pertaining to the subject was obtained after a thorough search of the PubMed literature and Google search engine.

Prevention and rehabilitation of musculoskeletal disorders in oral health care professionals: A systematic review

BACKGROUND

The authors' objective in this systematic review was to describe the evidence for preventive and rehabilitative interventions for musculoskeletal disorders in oral health care.

TYPES OF STUDIES REVIEWED

The authors conducted systematic search, screening, and eligibility processes to identify experimental, quasiexperimental, observational, and survey research studies in which the investigators either directly evaluated or predicted the effects of preventive or rehabilitative interventions on the reduction of musculoskeletal symptoms in oral health care professionals.

RESULTS

The authors identified and screened 3,571 unique abstracts, assessed 256 full-text articles for eligibility, and included 34 articles in the review. Investigators in 17 experimental studies described the results of preventive or rehabilitation interventions and in 17 survey research studies predicted or correlated preventive or protective techniques to a reduction in musculoskeletal symptoms. The primary techniques evaluated in the studies included equipment modification, ergonomic training, and physical exercise.

CONCLUSIONS AND PRACTICAL IMPLICATIONS

The evidence suggests that magnification loupes and indirect-vision techniques have a positive effect on the reduction of musculoskeletal symptoms. In terms of evaluating intervention efficacy, other techniques have mixed evidence or are limited by low-level study design.

Prevalence and occupational risk factors of musculoskeletal diseases and pain among dental professionals in Western countries: A systematic literature review and meta-analysis

Background

This review aimed at examining the prevalence of musculoskeletal diseases and pain among dental professionals in Western countries. Furthermore, possible occupational risk factors were analyzed.

Methods

The literature search was conducted from June to July 2016, with an update in December 2017 using the databases MEDLINE, CINAHL, LIVIVO, Science Direct, PubMed, and Web of Science. The quality assessment was performed with a standardized instrument consisting of 10 items. A meta-analysis was carried out to compute pooled prevalence rates for musculoskeletal diseases and pain.

Results

A total of 41 studies were included in this review; 30 studies met the criteria for the meta-analysis. Prevalence rates of musculoskeletal diseases and pain among dental professionals ranged from 10.8% to 97.9%. The neck was the body region affected most often (58.5%, 95% CI = 46.0–71.0) followed by the lower back (56.4%, 95% CI = 46.1–66.8), the shoulder (43.1%, 95% CI = 30.7–55.5) and the upper back (41.1%, 95% CI = 32.3–49.9). Potential occupational risk factors included an awkward working posture, high number of treated patients, administrative work, vibration, and repetition.

Conclusions

Musculoskeletal diseases and pain are a significant health burden for dental professionals. This study showed high prevalence rates for several body regions. Therefore, suitable interventions for preventing musculoskeletal diseases and pain among dental professionals are needed.

Pain-related encephalic regions influenced by yoga meditation: An integrative review

INTRODUCTION

The mechanisms underlying the use of yoga in pain relief are still unclear. This study reviewed literature reports on encephalic activity related to analgesia induced by yoga meditation practice.

METHODS

This integrative review examined studies published in the Pubmed, LILACS and MEDLINE databases without restriction of the year of publication. The research involved 16 descriptors related to the words: yoga, pain and neuroimaging methods. Inclusion criteria involved only the publications available online, with free access and written in English.

RESULTS

2 case studies and 1 pilot study met the criteria. Yoga meditation practice induces analgesia primarily through attenuation of the medial pain perception system including the Anterior Cingulate Cortex and Insula regions, as well as the lateral system including the Secondary Sensory Cortex and Thalamus.

CONCLUSION

Yoga induced analgesia is a potentially important adjunct to current pain management. This integrative review revealed that there is a need for further research that analyzes the encephalic regions related to analgesia induced by yoga practice.

The Feldenkrais Method improves functioning and body balance in people with intellectual disability in supported employment: A randomized clinical trial

Loss of functioning and age-related health problems tend to appear earlier in individuals with intellectual disability (ID) than in their non-disabled peers. The Feldenkrais method (FM) is a movement-based form of learning that enhances body balance and physical functioning. We carried out an intervention based on Awareness Through Movement, a form of the FM. Thirty-two middle-aged (48.94±6.01years old) adults with ID who were in supported employment were recruited and randomly assigned to the experimental group (EG) or control group (CG). The EG received 30 Awareness Through Movement classes while the CG did not receive any movement-based intervention. Physical functioning (body balance, gait speed and chair stands) was assessed with the Short Physical Performance Battery (SPPB) and balance by stabilometry. After 30 FM classes, individuals in the EG had significantly improved their chair stand test score (p<0.005) and SPPB total score (p<0.005), and reduced their sway area (p<0.05) in the stabilometric test. These results indicate that the FM could be a good tool for the prevention of loss of functioning and body balance in middle-aged individuals with ID.

Sustaining a career in surgery

Surgery is a demanding career with great rewards and equally great challenges. In order to sustain our careers as well as the careers of our colleagues, it is important to understand and address the physical, psychological and spiritual challenges of surgery. With rare exception, the majority of surgery residents and practicing surgeons who prematurely leave surgery do so because they find the work to be physically, emotionally or spiritually incompatible with the vision they have for their life. Understanding these issues and providing solutions to improve surgeon wellness can help prevent societal loss of these highly trained professionals and suffering for surgeons and their families.

Effects of yogic intervention on pain scores and quality of life in females with chronic pelvic pain

Context:

Chronic pelvic pain (CPP) is a common condition of women of the reproductive age group. It has a negative impact on a woman's personal health and quality of life (QOL). Practicing yoga has shown numerous benefits in various chronic painful conditions.

Aim:

To study the effects of yogic intervention on pain scores and quality of life in females of reproductive age group with CPP, on conventional therapy.

Settings and Design:

It is a follow-up, randomized case-control study done in a tertiary care hospital.

Subjects and Methods:

Sixty female patients of CPP in the age group of 18–45 years were randomly divided into Group I (n = 30) and Group II (n = 30). Group I received only conventional therapy in the form of NSAIDS and Group II received yoga therapy in the form of asanas, pranayama, and relaxation along with the conventional therapy for 8 weeks. They were assessed twice (pre- and post-treatment) for pain scores through visual analog scale (VAS) score and QOL by the World Health Organization quality of life-BREF (WHOQOL-BREF) questionnaire.

Statistical Analysis Used:

Repeated measure ANOVA followed by Tukey's test. P < 0.05 was considered significant.

Results:

After 8 weeks of yogic intervention, Group II patients showed a significant decrease in intensity of pain seen by a decrease in VAS score (P < 0.001) and improvement in the quality of life with a significant increase (P < 0.001) in physical, psychological, social, and environmental domain scores of WHOQOL-BREF.

Conclusions:

The practice of yoga causes a reduction in the pain intensity and improves the quality of life in patients with chronic pelvic pain.