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Gandolfi MG, Zamparini F, Spinelli A, Prati C. Āsana for Back, Hips and Legs to Prevent Musculoskeletal Disorders among Dental Professionals: In-Office Yóga Protocol. J Funct Morphol Kinesiol 2023; 9:6. [PMID: 38249083 PMCID: PMC10801568 DOI: 10.3390/jfmk9010006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/29/2023] [Accepted: 12/18/2023] [Indexed: 01/23/2024] Open
Abstract
Dental professionals are exposed to significant unavoidable physical stress, and theoretical ergonomic recommendations for a sitting workplace are inapplicable in many dental activities. Work-related musculoskeletal disorders (WMSDs) represent a serious health problem among dental professionals (prevalence: 64-93%), showing involvement of 34-60% for the low back and 15-25% for the hips. Muscle stress; prolonged sitting; forward bending and twisting of the torso and head; unbalanced working postures with asymmetrical weight on the hips and uneven shoulders; and others are inevitable for dental professionals. Therefore, the approach for the prevention and treatment of WMSDs must be therapeutic and compensatory. This project was conceived to provide a Yoga protocol for dental professionals to prevent or treat WMSDs from a preventive medicine perspective, and it would represent a Yoga-based guideline for the self-cure and prevention of musculoskeletal problems. METHODS Specific Yoga positions (āsana, such as Virāsana, Virabhadrāsana, Garudāsana, Utkatāsana, Trikonāsana, Anuvittāsana, Chakrāsana, Uttanāsana, Pashimottanāsana) have been selected, elaborated on and adapted to be practiced in a dental office using a dental stool or the dental office walls or a dental unit chair. The protocol is specifically devised for dental professionals (dentists, dental hygienists and dental assistants) and targeted for the low back, hips and legs (including knees and ankles). The protocol includes Visranta Karaka Sthiti (supported positions) in sitting (Upavistha Sthiti) and standing (Utthistha Sthiti) positions, twisting/torsions (Parivrtta), flexions/forward bend positions (Pashima) and extensions/arching (Purva) for musculo-articular system decompression and mobilization. RESULTS Over 60 Yogāsana-specifically ideated for back detensioning and mobilization, lumbar lordosis restoration, trunk side elongation, hip release and leg stretches and decontraction-are shown and described. The paper provides a meticulous description for each position, including the detailed movement, recommendations and mistakes to avoid, and the breathing pattern (breath control) in all the breath-driven movements (āsana in vinyāsa). An exhaustive analysis of posture-related disorders affecting the lower body among dental professionals is reported, including low-back pain, hip pain and disorders, piriformis syndrome and quadratus femoris dysfunction (gluteal pain), iliopsoas syndrome, multifidus disorders, femoroacetabular and ischiofemoral impingement, spinopelvic mobility, lumbopelvic rhythm, impairment syndromes, lower crossed syndrome, leg pain, knee pain and ankle disorders. CONCLUSIONS A detailed guideline of āsana for low-back decompression, hip joint destress, piriformis and gluteal muscle release, lumbar lordosis recovery and a spinopelvic mobility increase has been elaborated on. The designed Yogāsana protocol represents a powerful tool for dental professionals to provide relief to retracted stiff muscles and unbalanced musculoskeletal structures in the lower body.
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Affiliation(s)
- Maria Giovanna Gandolfi
- Program in Ergonomics, Posturology and Yoga Therapy for the Degree in Dentistry and for the Degree in Dental Hygiene, School of Medicine, University of Bologna, 40125 Bologna, Italy
- Program in Yoga Therapy for the Specialization Course in Sports Medicine, School of Medicine, University of Bologna, 40125 Bologna, Italy
- Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy (A.S.); (C.P.)
| | - Fausto Zamparini
- Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy (A.S.); (C.P.)
| | - Andrea Spinelli
- Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy (A.S.); (C.P.)
| | - Carlo Prati
- Dental School, Department of Biomedical and Neuromotor Sciences, University of Bologna, 40125 Bologna, Italy (A.S.); (C.P.)
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Claus BB, Stahlschmidt L, Dunford E, Major J, Harbeck-Weber C, Bhandari RP, Baerveldt A, Neß V, Grochowska K, Hübner-Möhler B, Zernikow B, Wager J. Intensive interdisciplinary pain treatment for children and adolescents with chronic noncancer pain: a preregistered systematic review and individual patient data meta-analysis. Pain 2022; 163:2281-2301. [PMID: 35297804 DOI: 10.1097/j.pain.0000000000002636] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 03/10/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT Chronic noncancer pain in children and adolescents can be impairing and results in substantial health care costs. Intensive interdisciplinary pain treatment (IIPT), an inpatient or day hospital treatment delivered by a team of 3 or more health professionals, may be an effective intervention for these children and adolescents. Based on previous reviews and meta-analyses, we updated findings regarding the description of available treatments and estimated the effectiveness of IIPT, overcoming methodological shortcomings of previous work by requesting and analyzing individual participant data. On June 26, 2021, we searched 5 literature databases (PubMed, PsycINFO, Web of Science, Cochrane Library, and PubPsych) for studies examining the effectiveness of IIPT. Included studies used a pre-post design, assessed patients younger than 22 years, and presented their results in English, German, French, or Spanish. We used standard methodological procedures expected by Cochrane to pool treatment effects and assess risk of bias. We identified 13 different treatment sites with similar treatment inclusion criteria and treatment components, but the descriptions of those treatments varied widely. Regarding treatment effectiveness, IIPT may result in large improvements in the mean pain intensity ( g = -1.28), disability ( g = -1.91), and number of missed school days at the 12-month follow-up ( g = -0.99), as well as moderate improvements in anxiety ( g = -0.77) and depression ( g = -0.76). The certainty of the evidence, however, was graded from very low to low. We recommend that future researchers use more scientific rigor to increase the certainty of the evidence for IIPT and standardize treatment outcomes for children and adolescents with chronic pain.
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Affiliation(s)
- Benedikt B Claus
- PedScience Research Institute, Datteln, Germany
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
| | - Lorin Stahlschmidt
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health, School of Medicine, Witten, Germany
| | - Emma Dunford
- Oxford Centre for Children and Young People in Pain (OXCCYPP), Oxford University Hospitals, Oxford, United Kingdom
| | - János Major
- Paediatric Pain Centre, HRC Bethesda Children's Hospital, Budapest, Hungary
- Institute of Behavioural Sciences, Semmelweis University, Budapest, Hungary
| | | | - Rashmi Parekh Bhandari
- Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University Medical Center, Palo Alto, CA, United States
| | - Ardith Baerveldt
- Get Up and Go Persistent Pediatric Pain Service, Holland Bloorview Kids Rehabilitation Hospital, Toronto, ON, Canada
- Bloorview Research Institute, Toronto, ON, Canada
| | - Verena Neß
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health, School of Medicine, Witten, Germany
| | - Kamila Grochowska
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health, School of Medicine, Witten, Germany
| | - Bettina Hübner-Möhler
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health, School of Medicine, Witten, Germany
| | - Boris Zernikow
- PedScience Research Institute, Datteln, Germany
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health, School of Medicine, Witten, Germany
| | - Julia Wager
- PedScience Research Institute, Datteln, Germany
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Witten/Herdecke University, Faculty of Health, School of Medicine, Witten, Germany
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