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Akkarakittichoke N, Jensen MP, Sitthipornvorakul E, Janwantanakul P. Mediators and moderators of a walking intervention to prevent neck pain among high-risk office workers: a secondary analysis of a randomized controlled trial. Musculoskelet Sci Pract 2024; 71:102939. [PMID: 38547548 DOI: 10.1016/j.msksp.2024.102939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 02/04/2024] [Accepted: 03/11/2024] [Indexed: 05/13/2024]
Abstract
OBJECTIVES To test hypothesized mediators and moderators of the benefits of an app-provided walking intervention for preventing neck pain in high-risk office workers. METHODS Ninety-one office workers at risk for developing neck pain participated in the primary clinical trial. Two hypothesized mediators (the total number of steps taken and the number of days that participants exceed the number of recommended steps) were tested using a smartphone application every month during a 6-month period. Four hypothesized moderators (number of working hours, level of work psychological demands, chair height adjustability, and body mass index) were assessed at baseline. Parallel mediation and moderation analyses were conducted using the Hayes PROCESS macro, model 4 and 1, respectively, with post-hoc Johnson-Neyman techniques. RESULTS The number of days that participants exceeded the recommended steps ‒ the specific number was tailored to each participant, but averaged 7735 steps/day ‒ mediated the benefits of the walking intervention for reducing the risk for neck pain at each of six assessment points (B's range -0.63 to -0.89, all p's < 0.05) over 6-month period. None of the hypothesized moderators evidenced statistically significant moderator effects of the walking intervention. CONCLUSION Workers should walk at rates greater than recommended levels on as many days as possible, rather than attempt to maximize walking within a limited number of days. Given that the walking program studied appeared to be similarly effective across multiple groups of workers, the findings suggest that regular walking can reduce the risk for developing neck pain among high-risk office workers.
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Affiliation(s)
- Nipaporn Akkarakittichoke
- Inter-Department Program of Biomedical Sciences, Faculty of Graduate School, Chulalongkorn University, Bangkok, Thailand.
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA.
| | - Ekalak Sitthipornvorakul
- Department of Physical Therapy, School of Integrative Medicine, Mae Fah Luang University, Chiang Rai, Thailand.
| | - Prawit Janwantanakul
- Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Bangkok, Thailand.
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Gidumal S, Saade M, Schwam ZG, Govindan A, Mavrommatis M, Wong K, Perez ER, Wanna GB, Cosetti MK. Use of Soft Cervical Collar Improves Surgeon Ergonomics During Simulated Otologic Surgery. Otol Neurotol 2024; 45:266-272. [PMID: 38238911 DOI: 10.1097/mao.0000000000004097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To determine whether surgeon use of a soft cervical collar during endoscopic and microscopic otologic surgery is feasible and impacts surgeon ergonomics as measured by inertial sensors. STUDY DESIGN Prospective crossover trial. SETTING US-based otolaryngology training program. PATIENTS Otolaryngology residents and fellows. INTERVENTIONS Therapeutic-use of a soft cervical collar during simulated otologic surgery. MAIN OUTCOME MEASURES Time spent in high-risk angles of neck and back flexion and extension; average angle of neck flexion, extension, rotation, and lateral bending; validated assessment of neck pain; average daily phone use. RESULTS Fifteen subjects met criteria for inclusion. Ten of 15 (67%) were male. Seven of 15 (47%) were postgraduate year 1-2. Seven of 15 (47%) reported a history of neck pain. None reported prior spinal steroid injections or surgery. Across all subjects, use of the soft cervical collar significantly reduced time spent in high-risk angles of neck flexion/extension during both endoscopic (56% vs. 35%, p < 0.05) and microscopic (60% vs. 32%, p < 0.05) otologic surgery. There was no effect on back flexion or extension. There was no difference in time spent in high-risk neck or back angles between endoscopic and microscopic surgery. Average angles of neck or back flexion, extension, lateral bending, and rotation were not significantly different for subgroups with more operative experience, increased phone use, perception of good posture, or history of neck pain. CONCLUSIONS Use of a soft cervical collar during simulated otologic surgery significantly reduced time spent in high-risk neck positions. These data support feasibility of soft collar use during otologic surgery and hold promise for reduction in the high rates of neck pain reported by neurotologists. PROFESSIONAL PRACTICE GAP AND EDUCATIONAL NEED Improving surgeon ergonomics for otologic surgery. LEARNING OBJECTIVE To identify a therapeutic intervention to mitigate neck pain in surgeons caused by assumption of high-risk cervical neck flexion and extension. DESIRED RESULT To demonstrate that use of a readily available soft cervical collar reduces risk of neck pain in otologic surgeons. LEVEL OF EVIDENCE II. INDICATE IRB OR IACUC Exempt.
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Affiliation(s)
- Sunder Gidumal
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
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Lindegård A, Grimby-Ekman A, Wahlström J, Gustafsson E. Can biofeedback training in combination with ergonomic information reduce pain among young adult computer users with neck and upper extremity symptoms? - A randomized controlled intervention study. Appl Ergon 2024; 114:104155. [PMID: 37883913 DOI: 10.1016/j.apergo.2023.104155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 09/22/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023]
Abstract
The aim of this randomized controlled study was to explore if an intervention with biofeedback training in combination with ergonomic discussions, could improve working technique and work postures, and reduce pain intensity and perceived exertion in young adult computer users with ongoing neck and upper extremity symptoms. 39 participants were divided into an intervention group and a control group. The intervention consisted of 4 sessions during a three-month period. Working technique, working postures, rated perceived exertion, pain intensity, and duration of computer use were measured at baseline and follow ups after 6 and 12 months. The intervention did not significantly improve working technique and working postures, nor reduce pain intensity and perceived exertion in the intervention group compared to the control group. However, there was a statistically significant reduction in reported pain intensity in the neck/shoulder for the whole group. Also, there was a trend that time spent with computer work without breaks was more reduced in the intervention group than in the control group.
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Affiliation(s)
- A Lindegård
- Institute of Stress Medicine, Göteborg, Sweden
| | - A Grimby-Ekman
- Biostatistics, School of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, Sweden
| | - J Wahlström
- Department of Public Health & Clinical Medicine, Faculty of Medicine, Umeå University, Sweden
| | - E Gustafsson
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Teichert F, Karner V, Döding R, Saueressig T, Owen PJ, Belavy DL. Effectiveness of Exercise Interventions for Preventing Neck Pain: A Systematic Review With Meta-analysis of Randomized Controlled Trials. J Orthop Sports Phys Ther 2023; 53:594–609. [PMID: 37683100 DOI: 10.2519/jospt.2023.12063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
OBJECTIVE: To update the evidence on the effectiveness of exercise interventions to prevent episodes of neck pain. DESIGN: Systematic review with meta-analysis. LITERATURE SEARCH: MEDLINE, Embase, CENTRAL, CINAHL, SPORTDiscus, PEDro, and trial registries from inception to December 2, 2022. Forward and backward citation searches. STUDY SELECTION CRITERIA: Randomized controlled trials (RCTs) that enrolled adults without neck pain at baseline and compared exercise interventions to no intervention, placebo/sham, attention control, or minimal intervention. Military populations and astronauts were excluded. DATA SYNTHESIS: Random-effects meta-analysis. Risk of bias was assessed using the Cochrane RoB 2 tool. The certainty of evidence was judged according to the GRADE approach. RESULTS: Of 4703 records screened, 5 trials (1722 participants at baseline) were included and eligible for meta-analysis. Most (80%) participants were office workers. Risk of bias was rated as some concerns for 2 trials and high for 3 trials. There was moderate-certainty evidence that exercise interventions probably reduce the risk of a new episode of neck pain (OR, 0.49; 95% confidence interval: 0.31, 0.76) compared to no or minimal intervention in the short-term (≤12 months). The results were not robust to sensitivity analyses for missing outcome data. CONCLUSION: There was moderate-certainty evidence supporting exercise interventions for reducing the risk for an episode of neck pain in the next 12 months. The clinical significance of the effect is unclear. J Orthop Sports Phys Ther 2023;53(10):1-16. Epub: 8 September 2023. doi:10.2519/jospt.2023.12063.
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Affiliation(s)
- Florian Teichert
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | - Vera Karner
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | - Rebekka Döding
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
| | | | - Patrick J Owen
- Institute for Physical Activity and Nutrition (IPAN), School of Exercise and Nutrition Sciences, Deakin University, Geelong, Australia
| | - Daniel L Belavy
- Division of Physiotherapy, Department of Applied Health Sciences, Hochschule für Gesundheit (University of Applied Sciences), Bochum, Germany
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Anitha V, Madkaikar A, Venkatachalam K, Ravindran M. The third eye: Retool to prevent back and neck pain! Indian J Ophthalmol 2023; 71:2917-2919. [PMID: 37417150 PMCID: PMC10491064 DOI: 10.4103/ijo.ijo_422_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Affiliation(s)
- Venugopal Anitha
- Cornea and Refractive Services, Aravind Eye Hospital and Post graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
| | - Aditee Madkaikar
- Cornea and Refractive Services, Aravind Eye Hospital and Post graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
| | | | - Meenakshi Ravindran
- Paediatric and Strabismology Services, Aravind Eye Hospital and Post graduate Institute of Ophthalmology, Tirunelveli, Tamil Nadu, India
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Lee MS, Briggs R, Scheirer V, Kearby G, Young BA. Exercise Effects on Neck Function Among F-15E Aircrew. Aerosp Med Hum Perform 2021; 92:815-824. [PMID: 34642002 DOI: 10.3357/amhp.5824.2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND: Neck pain (NP) is common among high performance aircrew, yet evidence remains insufficient to guide examination, treatment, and prevention. The purpose of this randomized pilot study was to collect baseline data for neck function for F-15E aircrew and determine efficacy and feasibility of two separate exercise protocols in measuring short-term outcomes of subjective and objective neck function in order to inform future study design. METHODS: Randomized to either progressive (PRO) or general (GEN) exercise groups were 41 F-15E aircrew. Data collection occurred at baseline, 3 wk, and 3 mo. RESULTS: At baseline, 39% of the subjects reported current NP, 79.5% reported a history of NP attributed to flying, 12.8% reported being removed from flying duties due to NP, and 10% reported receiving medical care for NP. PRO and GEN group randomization showed similar baseline assessment data. Blinding was successful and exercise logs showed 31.6% compliance with prescribed exercise regimens. There were small but statistically significant increases in neck range of motion in both groups over the course of the study. Aircrew with current NP had significantly higher F-15E flight hours. DISCUSSION: This study supports the high prevalence of NP in aircrew, yet low frequency of seeking care for NP. Future studies to assess NP prevention and treatment in aircrew require an integrated approach that includes operational exercise policy and long-term data collection in flying units with dedicated resources for assessment and analysis. Lee MS, Briggs R, Scheirer V, Kearby G, Young BA. Exercise effects on neck function among F-15E aircrew. Aerosp Med Hum Perform. 2021; 92(10):815824.
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Aldhafian OR, Alsamari FA, Alshahrani NA, Alajmi MN, Alotaibi AM, Nwihadh NB, Saleh AK. Musculoskeletal pain among male faculty members of the College of Medicine and College of Dentistry. Medicine (Baltimore) 2021; 100:e26176. [PMID: 34032779 PMCID: PMC8154493 DOI: 10.1097/md.0000000000026176] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 05/07/2021] [Indexed: 01/04/2023] Open
Abstract
We aimed to establish the local prevalence of musculoskeletal pain among faculty members in Saudi Arabia and describe the patient's risk factors and preventive measures that may reduce its burden.An observational, quantitative, cross-sectional study was carried out to evaluate the prevalence of musculoskeletal pain and its risk factors among male faculty members in the College of Medicine and Dentistry, using a designed questionnaire based on the Standardized Nordic Musculoskeletal Questionnaire. Chi-square testing at a significance level of P < .05, was used for comparative analysis. SPSS version 26 was used for all analyses.Ninety responders participated in the survey analysis. The prevalence of musculoskeletal pain among faculty members was 77.8%, and the most common site of musculoskeletal pain occurred at two different sites of the three (low back, neck, and shoulder), with a prevalence of 38.9%. As for risk factors of musculoskeletal pain, only age group showed a significant correlation with the site of musculoskeletal pain (P = .024), where patients in the younger age group (25-35 years old) were at higher risk of lower back pain, while participants in the older age group (36 to 44 years old and 45 years or older) were at higher risk of musculoskeletal pain in two different sites.Musculoskeletal pain affects more than two-thirds of faculty members. In particular, low back pain is a common problem among faculty members. Age is a significant risk factor for the occurrence of musculoskeletal pain, with more than one site involvement in older age.
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Affiliation(s)
- Osama R. Aldhafian
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Faisal A. Alsamari
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Naif A. Alshahrani
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Mohammed N. Alajmi
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Abdulelah M. Alotaibi
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Naif Bin Nwihadh
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
| | - Ayman K. Saleh
- Department of Surgery, College of Medicine, Prince Sattam Bin Abdulaziz University, Al-Kharj, Kingdom of Saudi Arabia
- Department of Orthopaedics, faculty of Medicine for girls, Alazhar university, Cairo, Egypt
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de Donato G, Pasqui E, Panzano C, Guerrieri MW, Benevento D, Cappelli A, Setacci C, Palasciano G. Mini-Skin Incision for Carotid Endarterectomy: Neurological Morbidity and Health-related Quality of Life. Ann Vasc Surg 2020; 71:112-120. [PMID: 32768532 DOI: 10.1016/j.avsg.2020.07.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/13/2020] [Accepted: 07/14/2020] [Indexed: 11/18/2022]
Abstract
BACKGROUND Cranial and cervical nerve (CCN) injury is recognized as a possible complication after carotid endarterectomy (CEA), which may result in minor local neurologic deficiencies and significant discomfort for the patient. The aim of this study is to investigate the effect of a mini-skin incision (<5 cm) on the CCN injury after CEA in comparison to standard longitudinal incision of 12-15 cm in a high volume center, and to evaluate health-related quality of life (HRQOL) outcomes in those patients who had undergone both types of the skin incision. METHODS From January 2013 to December 2019, 446 CEAs (47.3%) were performed through a standard neck incision of 12-15 cm (group A), while 496 (52.7%) were performed through a mini-skin incision (<5 cm) (group B). Sixty-two patients underwent standard neck incision on one side and mini-skin incision on the other side (subgroup B). The main outcome measures were stroke, death, CCN injuries, cervical hematoma rates, and reinterventions. The HRQOL was assessed at baseline and after 30 days using Medical Outcomes Study Short-Form 36 and 6 disease-specific modified Likert scales. RESULTS The stroke and death rate at 30 days was 1.12% in group A and 1% in group B (P = 1). The incidence of CCN deficits was significantly lower in group B (5.1%) in comparison to group A (13.4%) (P < 0.001). The cervical hematoma was more common after standard incision (4.9% vs. 1.2%, P = 0.02). HRQOL at 1 month showed that the outcomes after mini-skin incision were significantly better for less difficulty with eating/swallowing and neck pain (P < 0.01). CONCLUSIONS CEA through a small incision (<5 cm) may reduce CCN complications without additional perioperative neurologic risks. As validated by patients with bilateral disease who experienced both surgical techniques, mini-skin incision is also associated with better HRQOL at 1 month, particularly with regard to eating/swallowing and neck pain.
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Affiliation(s)
- Gianmarco de Donato
- Division of Vascular Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy.
| | - Edoardo Pasqui
- Division of Vascular Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Claudia Panzano
- Division of Vascular Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | | | - Domenico Benevento
- Division of Vascular Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Alessandro Cappelli
- Division of Vascular Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Carlo Setacci
- Division of Vascular Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
| | - Giancarlo Palasciano
- Division of Vascular Surgery, Department of Medicine, Surgery and Neuroscience, University of Siena, Siena, Italy
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Safiri S, Kolahi AA, Hoy D, Buchbinder R, Mansournia MA, Bettampadi D, Ashrafi-Asgarabad A, Almasi-Hashiani A, Smith E, Sepidarkish M, Cross M, Qorbani M, Moradi-Lakeh M, Woolf AD, March L, Collins G, Ferreira ML. Global, regional, and national burden of neck pain in the general population, 1990-2017: systematic analysis of the Global Burden of Disease Study 2017. BMJ 2020; 368:m791. [PMID: 32217608 PMCID: PMC7249252 DOI: 10.1136/bmj.m791] [Citation(s) in RCA: 216] [Impact Index Per Article: 54.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To use data from the Global Burden of Disease Study between 1990 and 2017 to report the rates and trends of point prevalence, annual incidence, and years lived with disability for neck pain in the general population of 195 countries. DESIGN Systematic analysis. DATA SOURCE Global Burden of Diseases, Injuries, and Risk Factors Study 2017. MAIN OUTCOME MEASURES Numbers and age standardised rates per 100 000 population of neck pain point prevalence, annual incidence, and years lived with disability were compared across regions and countries by age, sex, and sociodemographic index. Estimates were reported with uncertainty intervals. RESULTS Globally in 2017 the age standardised rates for point prevalence of neck pain per 100 000 population was 3551.1 (95% uncertainty interval 3139.5 to 3977.9), for incidence of neck pain per 100 000 population was 806.6 (713.7 to 912.5), and for years lived with disability from neck pain per 100 000 population was 352.0 (245.6 to 493.3). These estimates did not change significantly between 1990 and 2017. The global point prevalence of neck pain in 2017 was higher in females compared with males, although this was not significant at the 0.05 level. Prevalence increased with age up to 70-74 years and then decreased. Norway (6151.2 (95% uncertainty interval 5382.3 to 6959.8)), Finland (5750.3 (5058.4 to 6518.3)), and Denmark (5316 (4674 to 6030.1)) had the three highest age standardised point prevalence estimates in 2017. The largest increases in age standardised point prevalence estimates from 1990 to 2017 were in the United Kingdom (14.6% (10.6% to 18.8%)), Sweden (10.4% (6.0% to 15.4%)), and Kuwait (2.6% (2.0% to 3.2%)). In general, positive associations, but with fluctuations, were found between age standardised years lived with disability for neck pain and sociodemographic index at the global level and for all Global Burden of Disease regions, suggesting the burden is higher at higher sociodemographic indices. CONCLUSIONS Neck pain is a serious public health problem in the general population, with the highest burden in Norway, Finland, and Denmark. Increasing population awareness about risk factors and preventive strategies for neck pain is warranted to reduce the future burden of this condition.
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Affiliation(s)
- Saeid Safiri
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
- Social Determinants of Health Research Center, Department of Community Medicine, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Damian Hoy
- Global Alliance for Musculoskeletal Health
- Institute of Bone and Joint Research, The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Rachelle Buchbinder
- Monash Department of Clinical Epidemiology, Cabrini Institute, Melbourne, Australia
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Mohammad Ali Mansournia
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Deepti Bettampadi
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Ahad Ashrafi-Asgarabad
- Department of Epidemiology, School of Health, Bam University of Medical Sciences, Bam, Iran
| | - Amir Almasi-Hashiani
- Department of Epidemiology, School of Health, Arak University of Medical Sciences, Arak, Iran
| | - Emma Smith
- Institute of Bone and Joint Research, The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
- Pain Management Research Institute, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
| | - Mahdi Sepidarkish
- Department of Biostatistics and Epidemiology, School of Public Health, Babol University of Medical Sciences, Babol, Iran
| | - Marita Cross
- Institute of Bone and Joint Research, The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Mostafa Qorbani
- Non-Communicable Diseases Research Center, Alborz University of Medical Sciences, Karaj, Iran
| | - Maziar Moradi-Lakeh
- Preventive Medicine and Public Health Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Anthony D Woolf
- Royal Cornwall Hospital and University of Exeter Medical School, Truro, UK
| | - Lyn March
- Global Alliance for Musculoskeletal Health
- Institute of Bone and Joint Research, The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Gary Collins
- Centre for Statistics in Medicine, NDORMS, Botnar Research Centre, University of Oxford, Oxford, UK
| | - Manuela L Ferreira
- Institute of Bone and Joint Research, The Kolling Institute, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Vijendren A, Devereux G, Tietjen A, Duffield K, Van Rompaey V, Van de Heyning P, Yung M. The Ipswich Microbreak Technique to alleviate neck and shoulder discomfort during microscopic procedures. Appl Ergon 2020; 83:102679. [PMID: 29735161 DOI: 10.1016/j.apergo.2018.04.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 03/19/2018] [Accepted: 04/27/2018] [Indexed: 06/08/2023]
Abstract
Neck and shoulder disorders are a considerable health problem amongst frequent microscope users. We aimed to investigate the neck and shoulder discomfort experienced during prolonged microscopic activity and to assess the benefits of minibreaks. A prospective crossover study was performed on 17 healthy volunteers sitting still while looking down a bench with and without the Ipswich Microbreak Technique (IMT). We used a subjective measure of time to fatigue and pain in the neck and shoulder regions as well as objective readings from a surface electromyogram (sEMG). The IMT delayed the sensation of pain in the neck and shoulder region while reducing the overall sEMG muscle activation. In conclusion, IMT is a useful strategy in reducing and delaying the pain in neck and shoulder from prolonged working under the microscope. This technique can be incorporated in other activities that involve a sustained stationary position.
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Affiliation(s)
| | - Gavin Devereux
- Department of Science and Technology, University of Suffolk, IP4 1QJ, UK
| | - Aaron Tietjen
- Department of Science and Technology, University of Suffolk, IP4 1QJ, UK
| | | | - Vincent Van Rompaey
- Faculty of Medicine and Health Sciences, University of Antwerp, Belgium; Department of Otorhinolaryngology & Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp, Belgium
| | - Paul Van de Heyning
- Faculty of Medicine and Health Sciences, University of Antwerp, Belgium; Department of Otorhinolaryngology & Head and Neck Surgery, Antwerp University Hospital, Wilrijkstraat 10, 2650 Edegem, Antwerp, Belgium
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Sitthipornvorakul E, Sihawong R, Waongenngarm P, Janwantanakul P. The effects of walking intervention on preventing neck pain in office workers: A randomized controlled trial. J Occup Health 2020; 62:e12106. [PMID: 31849170 PMCID: PMC6970409 DOI: 10.1002/1348-9585.12106] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/24/2019] [Accepted: 12/02/2019] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the efficacy of increased daily walking steps on the 6-month incidence of neck pain among office workers. METHODS Healthy office workers with high risk of neck pain were recruited into a 6-month prospective cluster-randomized controlled trial. Participants were randomly assigned at the cluster level, into either intervention (n = 50) or control (n = 41) groups. Participants in the intervention group were instructed to increase their daily walking steps to a designated level for a duration of 6 months. Participants in the control group received no intervention. The outcome measures included the 6-month incidence of neck pain as well as its pain intensity and disability level. Analyses were performed using multivariable logistic regression model. RESULTS Of the participants in the intervention and control groups, 22% and 34% reported a 6-month incidence of neck pain, respectively. After adjusting for confounders, a significant preventive effect of walking intervention was found (adjusted odd ratio 0.22, 95% confidence interval 0.06-0.75). No significant difference in pain intensity and disability level was found between those in the intervention and control groups. CONCLUSION An intervention to increase daily walking steps reduced onset neck pain in high-risk office workers. However, the walking interventions did not decrease pain intensity and disability in those increasing the number of daily walking steps compared to the control group.
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Affiliation(s)
- Ekalak Sitthipornvorakul
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
| | - Rattaporn Sihawong
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
| | - Pooriput Waongenngarm
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
| | - Prawit Janwantanakul
- Department of Physical TherapyFaculty of Allied Health SciencesChulalongkorn UniversityBangkokThailand
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Slungaard E, Green NDC, Newham DJ, Harridge SDR. Content Validity of Level Two of the Royal Air Force Aircrew Conditioning Programme. Aerosp Med Hum Perform 2018; 89:896-904. [PMID: 30219117 DOI: 10.3357/amhp.4994.2018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
INTRODUCTION The prevalence of flight-related neck pain in all Royal Air Force (RAF) aircrew is 66% and 70% in UK fast-jet aircrew. The RAF Aircrew Conditioning Programme (ACP) has been designed to enhance pilot performance through reducing fatigue and strain injuries, particularly to the neck. Content validity of the ACP was assessed to determine the appropriateness for delivery to aircrew. METHODS Six international medical experts reviewed level two of the ACP, which is delivered to student aircrew who have completed basic instruction in cervical spine stability, core stability and initial technique instruction for strength training. Content validity on overall exercise approach (5 items) and specific exercise session (24 items) was rated on a 4-point Likert-type ordinal scale for Relevance and Simplicity. Four reviewers had experience of delivering an exercise program to aircrew. The item-content validity index (I-CVI) was the proportion of experts rating an item/exercise as acceptable (score 3-4) while protocol-CVI was the average I-CVI across items. RESULTS Of the suggested exercise sessions, 20 reached an excellent I-CVI (1.00) for Relevance (4 reached acceptable I-CVI (0.83)), and 21 reached an excellent I-CVI (1.00) for Simplicity (3 reached acceptable I-CVI (0.83)). Protocol-CVI for the ACP was excellent for Relevance (0.90) and good for Simplicity (0.83). The need for sufficient supervision during the exercises was recommended for safe exercise execution and to maintain adherence. CONCLUSION The ACP demonstrated excellent relevance for the target population. The aircrew require additional supervision with the more complex neck exercises to enhance simplicity with the ACP.Slungaard E, Green NDC, Newham DJ, Harridge SDR. Content validity of level two of the Royal Air Force Aircrew Conditioning Program. Aerosp Med Hum Perform. 2018; 89(10):896-904.
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Abstract
INTRODUCTION Inappropriate design eye point (DEP) will lead to nonstandard sitting postures, including nonneutral head positions and other uncomfortable sitting postures, which are high risk factors for neck pain in fighter pilots exposed to high G forces. Therefore, application of a 3D measurement method to collect data regarding eye position while in the cruising sitting posture in the aircraft cockpit to guide the design eye point has been proposed. METHODS A total of 304 male fixed wing aircraft pilots were divided into two groups. Subgroup A (N = 48) were studied to define the cruising posture during flight. Subgroup B (N = 256) were studied with Romer 3D measurement equipment to locate the cruising eye position of the pilots in a simulated cockpit. The 3D data were compared to DEP data in the current standard cockpit. RESULTS According to 3D measurement, the vertical distance from the cruising eye point to the neutral seat reference point was 759 mm, which is 36 mm lower than that of the Chinese standard DEP and also lower than the U.S. military standard. The horizontal distance was 131 mm, which is 24 mm shorter than that of the Chinese standard. CONCLUSIONS The current DEP data cannot fulfill the needs of fighter pilots and should be amended according to the results of the 3D measurement so that pilots can acquire the optimal cruising posture in flight. This new method has the value of practical application to investigate cockpit ergonomics and the measurement data can guide DEP design.Wang Y, Guo X, Liu Q, Xiao H, Bai Y. Three-dimensional measurement applied in design eye point of aircraft cockpits. Aerosp Med Hum Perform. 2018; 89(4):371-376.
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Nikles J, Keijzers G, Mitchell G, Schug S, Ware R, McLean SA, Connelly L, Gibson S, Farrell SF, Sterling M. Pregabalin versus placebo in targeting pro-nociceptive mechanisms to prevent chronic pain after whiplash injury in at-risk individuals - a feasibility study for a randomised controlled trial. Trials 2018; 19:44. [PMID: 29343280 PMCID: PMC5773126 DOI: 10.1186/s13063-018-2450-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Accepted: 01/03/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Whiplash-associated disorders (WAD) are an enormous and costly burden to Australian society. Up to 50% of people who experience a whiplash injury will never fully recover. Whiplash is resistant to treatment and no early management approach has yet been shown to prevent chronic pain. The early presence of central sensitization is associated with poor recovery. Pregabalin's effects on central sensitization indicate the potential to prevent or modulate these processes after whiplash injury and to improve health outcomes, but this has not been investigated. This paper describes the protocol for a feasibility study for a randomised controlled trial of pregabalin plus evidence-based advice compared to placebo plus evidence-based advice for individuals with acute whiplash injury who are at risk of poor recovery. METHODS This double blind, placebo-controlled randomised feasibility study will examine the feasibility and potential effectiveness of pregabalin and evidence-based advice (intervention) compared to placebo and evidence-based advice (control) for individuals with acute whiplash injury at risk of poor recovery. Thirty participants (15 per group) aged 18-65 years with Grade II WAD, within 48 hours of injury and currently experiencing at least moderate pain (NRS: ≥ 5/10) will be recruited from Emergency Departments of public hospitals in Queensland, Australia. Pregabalin will be commenced at 75 mg bd and titrated up to 300 mg bd as tolerated for 4 weeks followed by 1 week of weaning. RESULTS The feasibility of trial procedures will be tested, as well as the potential effect of the intervention on the outcomes. The primary outcome of neck pain intensity at 3 months from randomisation will be compared between the treatment groups using standard analysis of variance techniques. DISCUSSION Feasibility and potential effectiveness data will inform an appropriately powered full trial, which if successful, will provide an effective and cost-effective intervention for a costly and treatment resistant condition. It will also have implications for the early management of other traumatic conditions beyond whiplash. TRIAL REGISTRATION Clinical Trials Primary Registry: Australian and New Zealand Clinical Trials Registry. CLINICAL TRIAL REGISTRATION NUMBER ACTRN12617000059369 . Date of Registration: 11/01/2017. Primary Trial Sponsor: The University of Queensland, Brisbane QLD 4072 Australia.
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Affiliation(s)
- J. Nikles
- Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Australia
| | - G. Keijzers
- Department of Emergency Medicine, Gold Coast Hospital and Health Service, Gold Coast, Queensland Australia
- School of Medicine, Bond University, Gold Coast, QLD Australia
- School of Medicine, Griffith University, Gold Coast, QLD Australia
| | - G. Mitchell
- Faculty of Medicine, The University of Queensland, Herston, Australia
| | - S. Schug
- School of Medicine and Pharmacology, The University of Western Australia, Perth, Australia
| | - R. Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - S. A. McLean
- Institute for Trauma Recovery, Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill, USA
| | - L. Connelly
- Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Australia
- Centre for the Business and Economics of Health, University of Queensland, Brisbane, Australia
- Dipartimento di Sociologia e Diritto dell’Economia, University of Bologna, Bologna, Italy
| | - S. Gibson
- Caulfield Pain Management and Research Centre, Melbourne, Australia
| | - S. F. Farrell
- Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - M. Sterling
- Recover Injury Research Centre, NHMRC Centre of Research Excellence in Recovery Following Road Traffic Injuries, The University of Queensland, Herston, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
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Childress MA. Spine Conditions: Occupational Spine Conditions. FP Essent 2017; 461:26-29. [PMID: 29019642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Neck and back conditions have significant effects on employee health and productivity. More than $7 billion in lost revenue in the United States annually can be attributed to workplace back pain among employees ages 40 to 65 years. According to the Bureau of Labor Statistics, in 2012 back pain was the most prevalent musculoskeletal condition resulting in workplace absenteeism. The incidence of these conditions is higher among individuals in certain professions, such as bus drivers, police officers, and correctional officers. Risk factors include obesity, depression, nicotine dependence, and alcohol abuse. There is limited evidence about whether modifying risk factors decreases the incidence of neck and back conditions. Specific efforts to reduce the burden in the workplace have shown mixed results. Use of simple interventions, such as braces and orthotics, has not consistently shown benefit. In addition, limited data show minimal or no evidence of effective prevention or management with back school programs and instruction on lifting techniques. The most consistent data support regular exercise as a method to prevent back pain. However, attempts to include exercise in workplace activities have shown mixed results. Lower rates of workplace absenteeism have been show to result from employee education on these issues.
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Affiliation(s)
- Marc A Childress
- Virginia Commonwealth University Fairfax Family Medicine Residency Program, 3650 Joseph Siewick Drive Suite 400, Fairfax, VA 22033
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Abstract
OBJECTIVES Several studies have found that inappropriate workstations are associated with musculoskeletal disorders. The present cross-sectional study aimed to identify the risk factors of non-specific neck pain (NP) and low back pain (LBP) among computer-using workers. DESIGN Observational study with a cross-sectional sample. SETTING This study surveyed 15 companies in Zhejiang province, China. PARTICIPANTS After excluding participants with missing variables, 417 office workers, including 163 men and 254 women, were analyzed. OUTCOME MEASURES Demographic information was collected by self-report. The standard Northwick Park Neck Pain Questionnaire and Oswestry Low Back Pain Disability Index, along with other relevant questions, were used to assess the presence of potential occupational risk factors and the perceived levels of pain. Multinomial logistic regression analysis, adjusted for age, sex, body mass index, education, marital status and neck/low back injury, was performed to identify significant risk factors. RESULTS Compared with low-level NP, the computer location (monitor not in front of the operator, but on the right or left side) was associated with ORs of 2.6 and 2.9 for medium- and high-level NP, respectively. For LBP, the computer location (monitor not in front) was associated with an OR of 3.2 for high-level pain, as compared with low-level pain, in females. Significant associations were also observed between the office temperature and LBP (OR 5.4 for high vs low), and between office work duration ≥5 years and NP in female office workers (OR 2.7 for medium vs low). CONCLUSIONS Not having the computer monitor located in front of the operator was found to be an important risk factor for NP and LBP in computer-using female workers. This information may not only enable the development of potential preventive strategies but may also provide new insights for designing appropriate workstations.
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Affiliation(s)
- Sunyue Ye
- Chronic Disease Research Institute, Zhejiang University, Hangzhou, China
- Physical Activity and Health Research Institute, Zhejiang Financial College, Hangzhou, China
| | - Qinglei Jing
- Physical Activity and Health Research Institute, Zhejiang Financial College, Hangzhou, China
| | - Chen Wei
- Chronic Disease Research Institute, Zhejiang University, Hangzhou, China
| | - Jie Lu
- Physical Activity and Health Research Institute, Zhejiang Financial College, Hangzhou, China
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Murray M, Lange B, Chreiteh SS, Olsen HB, Nørnberg BR, Boyle E, Søgaard K, Sjøgaard G. Neck and shoulder muscle activity and posture among helicopter pilots and crew-members during military helicopter flight. J Electromyogr Kinesiol 2016; 27:10-7. [PMID: 26852114 DOI: 10.1016/j.jelekin.2015.12.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 12/16/2015] [Accepted: 12/19/2015] [Indexed: 11/17/2022] Open
Abstract
Neck pain among helicopter pilots and crew-members is common. This study quantified the physical workload on neck and shoulder muscles using electromyography (EMG) measures during helicopter flight. Nine standardized sorties were performed, encompassing: cruising from location A to location B (AB) and performing search and rescue (SAR). SAR was performed with Night Vision Goggles (NVG), while AB was performed with (AB+NVG) and without NVG (AB-NVG). EMG was recorded for: trapezius (TRA), upper neck extensors (UNE), and sternocleido-mastoid (SCM). Maximal voluntary contractions (MVC) were performed for normalization of EMG (MVE). Neck posture of pilots and crew-members was monitored and pain intensity of neck, shoulder, and back was recorded. Mean muscle activity for UNE was ∼10% MVE and significantly higher than TRA and SCM, and SCM was significantly lower than TRA. There was no significant difference between AB-NVG and AB+NVG. Muscle activity in the UNE was significantly higher during SAR+NVG than AB-NVG. Sortie time (%) with non-neutral neck posture for SAR+NVG and AB-NVG was: 80.4%, 74.5% (flexed), 55.5%, 47.9% (rotated), 4.5%, 3.7% (lateral flexed). Neck pain intensity increased significantly from pre- (0.7±1.3) to post-sortie (1.6±1.9) for pilots (p=0.028). If sustained, UNE activity of ∼10% MVE is high, and implies a risk for neck disorders.
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Affiliation(s)
- Mike Murray
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark.
| | - Britt Lange
- Department of Anesthesia and Intensive Care Medicine, Odense University Hospital, Denmark
| | - Shadi Samir Chreiteh
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Henrik Baare Olsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | | | - Eleanor Boyle
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark; Dalla Lana School of Public Health, University of Toronto, Canada
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
| | - Gisela Sjøgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Denmark
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Murray M, Lange B, Nørnberg BR, Søgaard K, Sjøgaard G. Specific exercise training for reducing neck and shoulder pain among military helicopter pilots and crew members: a randomized controlled trial protocol. BMC Musculoskelet Disord 2015; 16:198. [PMID: 26286707 PMCID: PMC4544796 DOI: 10.1186/s12891-015-0655-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 07/31/2015] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Flight-related neck/shoulder pain is frequent among military helicopter pilots and crew members. With a lifetime prevalence of 81% for pilots and 84% for crew members, the prevalence of neck pain is considered high compared to the general population. The aim of this study was to investigate whether a specifically tailored exercise intervention would reduce the prevalence and incidence rate of neck/shoulder pain among helicopter pilots and crew members. METHOD This study used a prospective, parallel group, single blinded, randomized controlled design. Participants were military helicopter pilots and crew members recruited from the Royal Danish Air Force. Inclusion criteria were: 1) employed within the Royal Danish Air Force as a helicopter pilot or onboard crew member (technician, systems-operator, tactical helicopter observer and/or navigator), 2) maintaining operational flight status at enrollment, and 3) operational flying within the previous 6 months. Primary outcome was change in neck and shoulder pain assessed by 1) a modified version of the "Standardized Nordic questionnaire for the analysis of musculoskeletal symptoms" and by 2) pressure pain threshold measurements. Secondary outcomes included: postural balance, strength, stability, and rate of force development for neck and shoulder muscles. Measurements at baseline and follow-up were conducted at four air force bases in Denmark. Sixty-nine participants were individually randomized to either a training group (TG) or a reference group (RG). Participants in the TG performed 20-weeks of physical exercise training divided into sessions of 3 × 20 min per week. Training was completed within working hours and consisted of specific exercise training for the neck and shoulder muscles based on the principles of "Intelligent Physical Exercise Training". The RG received no training. DISCUSSION In spite of the high prevalence of flight related neck/shoulder pain among military helicopter pilots and crew members there are currently no evidence based guidelines for the prevention or clinical handling of neck pain among these occupational groups. Results from this study may therefore be beneficial for future establishment of such guidelines. TRIAL REGISTRATION Ethical committee of Southern Denmark (S-20120121) 29 August, 2012. Clinical Trail Registration (NCT01926262) 16 August, 2013.
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Affiliation(s)
- Mike Murray
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.
| | - Britt Lange
- Department of Anesthesia and Intensive Care Medicine, Odense University Hospital, Odense C, Denmark.
| | | | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.
| | - Gisela Sjøgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense M, Denmark.
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Abstract
With the ever-growing number of people who work at visual display terminals, the work-related musculoskeletal disorders of the upper body are believed to be an important problem all over the world. The forearm support, which can keep the forearm and wrist in biomechanical posture, is a possible protective factor of the development of upper body syndrome. This meta-analysis examines the efficacy of forearm support in reducing upper body syndrome. The Cochrane Library, EMBASE, Ovid, ScienceDirect, SpringerLink, Google Scholar, CNKI database, and Wanfang database were searched from inception until May 29, 2013. Relevant studies were included after the screening of title, abstract, and the full text. Impact of bias was assessed independently by 2 authors. Four studies that met all the inclusion criteria were included finally. The combined results based on all studies suggested that statistically the forearm support had a nonsignificant effect on upper body syndrome (odds ratio [OR] = 0.70, 95% confidence interval [CI]: 0.49, 1.02). The result of subgroup analysis suggested that forearm support has a significant effect on neck or shoulder syndrome (OR = 0.70, 95% CI: 0.43, 1.14) and the effect on upper extremity syndrome (OR = 0.76, 95% CI: 0.49, 1.19) is not significant. This meta-analysis suggested that the forearm support had statistically nonsignificant effect on preventing upper body syndrome on the whole.
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Affiliation(s)
- Jingtong Lyu
- a Department of Orthopaedics , West China Hospital, Sichuan University , Chengdu , China
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Varatharajan S, Côté P, Shearer HM, Loisel P, Wong JJ, Southerst D, Yu H, Randhawa K, Sutton D, van der Velde G, Mior S, Carroll LJ, Jacobs C, Taylor-Vaisey A. Are work disability prevention interventions effective for the management of neck pain or upper extremity disorders? A systematic review by the Ontario Protocol for Traffic Injury Management (OPTIMa) collaboration. J Occup Rehabil 2014; 24:692-708. [PMID: 24522460 DOI: 10.1007/s10926-014-9501-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention (WDP) interventions in workers with neck pain, whiplash-associated disorders (WAD), or upper extremity disorders. METHODS We searched electronic databases from 1990 to 2012. Random pairs of independent reviewers critically appraised eligible studies using the Scottish Intercollegiate Guidelines Network criteria. Scientifically admissible studies were summarized and synthesized following best-evidence synthesis methodology. RESULTS Of the 6,359 articles retrieved, 16 randomized controlled trials were eligible for critical appraisal and five were admissible. We found that a return-to-work coordination program (including workplace-based work hardening) was superior to clinic-based work hardening for persistent rotator cuff tendinitis. Workplace high-intensity strength training and workplace advice had similar outcomes for neck and shoulder pain. Mensendieck/Cesar postural exercises and strength and fitness exercises had similar outcomes for non-specific work-related upper limb complaints. Adding a brief job stress education program to a workplace ergonomic intervention was not beneficial for persistent upper extremity symptoms. Adding computer-prompted work breaks to ergonomic adjustments and workplace education benefited workers' recovery from recent work-related neck and upper extremity complaints. CONCLUSIONS At present, no firm conclusions can be drawn regarding the effectiveness of WDP interventions for managing neck pain, WAD, and upper extremity disorders. Our review suggests a return-to-work coordination program is more effective than clinic-based work hardening. Also, adding computer-prompted breaks to ergonomic and workplace interventions benefits workers' recovery. The current quality of evidence does not allow for a definitive evaluation of the effectiveness of ergonomic interventions.
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Affiliation(s)
- Sharanya Varatharajan
- UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation, University of Ontario Institute of Technology (UOIT), 6100 Leslie Street, Toronto, ON, M2H 3J1, Canada,
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Eijckelhof BHW, Huysmans MA, Blatter BM, Leider PC, Johnson PW, van Dieën JH, Dennerlein JT, van der Beek AJ. Office workers' computer use patterns are associated with workplace stressors. Appl Ergon 2014; 45:1660-1667. [PMID: 25005311 DOI: 10.1016/j.apergo.2014.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 04/09/2014] [Accepted: 05/26/2014] [Indexed: 06/03/2023]
Abstract
This field study examined associations between workplace stressors and office workers' computer use patterns. We collected keyboard and mouse activities of 93 office workers (68F, 25M) for approximately two work weeks. Linear regression analyses examined the associations between self-reported effort, reward, overcommitment, and perceived stress and software-recorded computer use duration, number of short and long computer breaks, and pace of input device usage. Daily duration of computer use was, on average, 30 min longer for workers with high compared to low levels of overcommitment and perceived stress. The number of short computer breaks (30 s-5 min long) was approximately 20% lower for those with high compared to low effort and for those with low compared to high reward. These outcomes support the hypothesis that office workers' computer use patterns vary across individuals with different levels of workplace stressors.
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Affiliation(s)
- Belinda H W Eijckelhof
- Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands; Body@Work Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, PO Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands; Body@Work Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
| | - Birgitte M Blatter
- Body@Work Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, PO Box 7057, 1007 MB Amsterdam, The Netherlands; Netherlands Organization for Applied Scientific Research, TNO, Postbus 718, 2130 AS Hoofddorp, The Netherlands
| | - Priscilla C Leider
- Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
| | - Peter W Johnson
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Box 357234, Seattle, USA
| | - Jaap H van Dieën
- Body@Work Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, PO Box 7057, 1007 MB Amsterdam, The Netherlands; MOVE Research Institute Amsterdam, Faculty of Human Movement Sciences, VU University Amsterdam, Van der Boechorststraat 9, 1081 BT Amsterdam, The Netherlands
| | - Jack T Dennerlein
- Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands; Department of Environmental Health, Harvard School of Public Health, 665 Huntington Avenue, Boston, USA; Department of Physical Therapy, Bouvé College of Health Sciences, Northeastern University, 360 Huntington Avenue, Boston, USA
| | - Allard J van der Beek
- Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands; Body@Work Research Center on Physical Activity, Work and Health, TNO-VU/VUmc, PO Box 7057, 1007 MB Amsterdam, The Netherlands.
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Józefiak-Wójtowicz A, Stolarczyk A, Deszczyński JM, Materek M, Pietras M, Bażant K. Use of cervical collar after whiplash injuries. Pol Orthop Traumatol 2014; 79:132-137. [PMID: 25104609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Whiplash injuries, also known as neck sprains and strains, are currently some of the most common injuries of the cervical spine. Mechanism of injury is still controversial and current treatment methods do not provide satisfactory results. In this article we present QTF classification of related disorders, epidemiological data and treatment methods. We described basic principles of using a soft collar, goals and effects of collar use and potential complications ensuing from immobilization. Authors reviewed publications comparing the effects of collar use with other methods of treatment and physiotherapy following whiplash injury.
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Affiliation(s)
- Anna Józefiak-Wójtowicz
- Department of Orthopedics and Rehabilitation, 2nd Faculty of Medicine, Medical University of Warsaw, Brodnowski Hospital, Warsaw, Poland
| | - Artur Stolarczyk
- Department of Orthopedics and Rehabilitation, 2nd Faculty of Medicine, Medical University of Warsaw, Brodnowski Hospital, Warsaw, Poland
| | - Jarosław Michał Deszczyński
- Department of Orthopedics and Rehabilitation, 2nd Faculty of Medicine, Medical University of Warsaw, Brodnowski Hospital, Warsaw, Poland
| | - Magdalena Materek
- Department of Orthopedics and Rehabilitation, 2nd Faculty of Medicine, Medical University of Warsaw, Brodnowski Hospital, Warsaw, Poland
| | - Marta Pietras
- Department of Orthopedics and Rehabilitation, 2nd Faculty of Medicine, Medical University of Warsaw, Brodnowski Hospital, Warsaw, Poland
| | - Katarzyna Bażant
- Department of Orthopedics and Rehabilitation, 2nd Faculty of Medicine, Medical University of Warsaw, Brodnowski Hospital, Warsaw, Poland
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Relief dos and don'ts for that nagging neck pain. Adjusting your position and posture can help. Harv Health Lett 2014; 39:4. [PMID: 25073189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Lange B, Murray M, Chreiteh SS, Toft P, Jørgensen MB, Søgaard K, Sjøgaard G. Postural control and shoulder steadiness in F-16 pilots: a randomized controlled study. ACTA ACUST UNITED AC 2014; 85:420-5. [PMID: 24754203 DOI: 10.3357/asem.3783.2014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND During maneuvering, fighter pilots experience loads of up to 50-70 kg on their necks. Neck disorders are common and have been linked to impairment in muscle control. We conducted an intervention study introducing targeted training for 24 wk that reduced neck pain. The current study reports the results of the secondary objective, which was to increase the understanding of possible mechanisms underlying such neck pain and its intervention-related relief. METHODS In a parallel, single-blinded, randomized controlled study, 55 F-16 pilots were evaluated at baseline and randomized to a control group (CG; N = 28) or training group (TG; N = 27). Postural control was tested in four different settings: Romberg with open and closed eyes, unilateral stance, and perturbation. Maximal voluntary contraction and force steadiness was measured for shoulder elevation. RESULTS At follow-up, there was a significant between-group difference in the Romberg test with closed eyes only (95% confidence ellipse area; CG: 761 +/- 311 mm2; TG: 650 +/- 405 mm2). Prior to randomization, there were no significant differences in postural control and steadiness between 30 pilots who experienced neck pain within the previous 3 mo and 25 pilots without such pain. DISCUSSION Impaired postural control and steadiness may only be quantifiable in individuals experiencing acute neck pain of certain intensity, and there may be a ceiling effect in the ability to improve these parameters. For individuals with highly developed physiological capacity, a battery of tests with more stringent demands should be considered, e.g., increased number of repetitions, prolonged duration of the tests, or testing with eyes closed.
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Ding H, Xue Y, Tang Y, He D, Li Z, Zhao Y, Zong Y, Wang Y, Wang P. Laminoplasty and laminectomy hybrid decompression for the treatment of cervical spondylotic myelopathy with hypertrophic ligamentum flavum: a retrospective study. PLoS One 2014; 9:e95482. [PMID: 24740151 PMCID: PMC3989326 DOI: 10.1371/journal.pone.0095482] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Accepted: 03/26/2014] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To report the outcomes of a posterior hybrid decompression protocol for the treatment of cervical spondylotic myelopathy (CSM) associated with hypertrophic ligamentum flavum (HLF). BACKGROUND Laminoplasty is widely used in patients with CSM; however, for CSM patients with HLF, traditional laminoplasty does not include resection of a pathological ligamentum flavum. METHODS This study retrospectively reviewed 116 CSM patients with HLF who underwent hybrid decompression with a minimum of 12 months of follow-up. The procedure consisted of reconstruction of the C4 and C6 laminae using CENTERPIECE plates with spinous process autografts, and resection of the C3, C5, and C7 laminae. Surgical outcomes were assessed using Japanese Orthopedic Association (JOA) score, recovery rate, cervical lordotic angle, cervical range of motion, spinal canal sagittal diameter, bone healing rates on both the hinge and open sides, dural sac expansion at the level of maximum compression, drift-back distance of the spinal cord, and postoperative neck pain assessed by visual analog scale. RESULTS No hardware failure or restenosis was noted. Postoperative JOA score improved significantly, with a mean recovery rate of 65.3 ± 15.5%. Mean cervical lordotic angle had decreased 4.9 degrees by 1 year after surgery (P<0.05). Preservation of cervical range of motion was satisfactory postoperatively. Bone healing rates 6 months after surgery were 100% on the hinge side and 92.2% on the open side. Satisfactory decompression was demonstrated by a significantly increased sagittal canal diameter and cross-sectional area of the dural sac together with a significant drift-back distance of the spinal cord. The dural sac was also adequately expanded at the time of the final follow-up visit. CONCLUSION Hybrid laminectomy and autograft laminoplasty decompression using Centerpiece plates may facilitate bone healing and produce a comparatively satisfactory prognosis for CSM patients with HLF.
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Affiliation(s)
- Huairong Ding
- Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Yuan Xue
- Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China
- * E-mail:
| | - Yanming Tang
- Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Dong He
- Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Zhiyang Li
- Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Ying Zhao
- Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Yaqi Zong
- Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Yi Wang
- Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China
| | - Pei Wang
- Department of Orthopedics, Tianjin Medical University General Hospital, Heping District, Tianjin, China
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Shi R, Li J, Liu H, Ding C, Hu T, Li T, Gong Q. Clinical comparison of 2 implantation systems for single-level cervical disk replacement. Orthopedics 2014; 37:e161-8. [PMID: 24679203 DOI: 10.3928/01477447-20140124-20] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 09/05/2013] [Indexed: 02/03/2023]
Abstract
The safety and effectiveness of 2 implantation systems for single-segment cervical disk replacement-the Bryan Cervical Disc System (Medtronic Inc, Minneapolis, Minnesota) and the ACCEL system (Medtronic Inc)-have not been clinically compared. A prospective, nonrandomized controlled study in consecutive patients with a minimum 2-year follow-up was performed. Fifty patients with single-level cervical disk degeneration who responded poorly to conservative treatment and underwent Bryan Cervical Disc replacement were involved. Fifty patients were included (24 in group A [Bryan Cervical Disc System] and 26 in group B [ACCEL system]).The patients' visual analog scale scores, Neck Disability Index (NDI) scores, Short Form 36 (SF-36) scores, Odom scores, operative time, blood loss, and complications were compared. Patients' baseline statuses were similar (P>.05). Visual analog scale for neck and arm pain, NDI, and SF-36 were significantly improved postoperatively (P<.05) in both groups, and no clinical differences were found between the groups (P>.05). All Odom scores were better than good. Mean operative time and average blood loss in group A (173±42.5 minutes and 250±159.8 mL, respectively), were both significantly higher than the values in group B (137.5±19.3 minutes and 138.1±86.7 mL, respectively) (P<.05). Complications included intraoperative bleeding, temporary throat discomfort, and slight migration of the prosthesis; there was no significant difference in the total complication rates between the 2 groups (P>.05). The 2 implantation systems displayed equal clinical effectiveness and safety, but the ACCEL system appears to have the advantages of shorter operative time and less blood loss.
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The best options for different types of neck pain. Prompt treatment can help prevent long-term problems. Johns Hopkins Med Lett Health After 50 2014; 26:1-2. [PMID: 25118357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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Vaněk P, Votavová M, Ostrý S, Beneš V, Pavelka K. [Correction of kyphotic deformity of the cervical spine in ankylosing spondylitis using pedicle subtraction osteotomy of the seventh cervical vertebra]. Acta Chir Orthop Traumatol Cech 2014; 81:317-322. [PMID: 25514339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
PURPOSE OF THE STUDY The aim of the study is to present the technique of pedicle subtraction osteotomy (PSO) of the seventh cervical vertebra (C7) for correction of rigid kyphotic deformity of the cervicothoracic junction (C/Th) in patients with severe ankylosing spondylitis (AS).. MATERIAL AND METHODS The PSO technique for correction of rigid deformity of the C/Th spine was used in five patients with the aim to restore their ability of horizontal vision. The follow-up in all patients lasted two years at least. Clinical assessment of treatment results was based on the patients' neurological status and their satisfaction with the correction achieved. Improvement in a vertical 2) line of sight was evaluated using the angle measured between the forehead-chin line and the vertical (FCv angle) in a lateral view photograph of the standing patient. The achieved correction of kyphotic deformity was assessed by comparing the pre-operative Cobb's angle between the second cervical and the fourth thoracic vertebra with the post-operative one. RESULTS The average operative time was 4 hours (range, 3.5 to 5 h). The average blood loss was 1600 ml (range, 800 to 2100 ml). On the average, the FCv angle was reduced by 45.2° and Cobb's angle was corrected) by 54.6°. All patients were satisfied with the degree of correction achieved and reported alleviation of neck pain. none of the patients showed any significant loss of correction or neurological deterioration at two-year follow-up. DISCUSSION The theoretical and technical principles of corrective osteotomy at the C7 level performed for rigid kyphotic deformity of the spine at the C/Th junction are presented in our group of patients. Our results give support to the superiority of instrumented PSO used currently over the previous techniques. In accordance with the relevant literature data, attention is drawn to a relatively higher risk of this procedure in comparison with corrective surgery performed at the other spinal levels. CONCLUSIONS Corrective osteotomy of a rigid kyphotic deformity at the C/Th spine level in AS patients involves a complex reconstructive surgical procedure. The PSO technique reduces the risk of injury to the visceral structures ventral to the spine, and provides optimal conditions for bone healing at the site of vertebral body resection. If the patient heals well, a successful PSO procedure will markedly improve the quality of his/her life.
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Affiliation(s)
- P Vaněk
- Neurochirurgická klinika 1. lékařské fakulty Univerzity Karlovy a Ústřední vojenské nemocnice, Praha
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Lee J, Kwon IS, Bae EH, Chung WY. Comparative analysis of oncological outcomes and quality of life after robotic versus conventional open thyroidectomy with modified radical neck dissection in patients with papillary thyroid carcinoma and lateral neck node metastases. J Clin Endocrinol Metab 2013; 98:2701-8. [PMID: 23678034 DOI: 10.1210/jc.2013-1583] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Robotic total thyroidectomy (TT) with modified radical neck dissection (MRND) using a gasless transaxillary approach has been reported safe and effective in patients with N1b papillary thyroid carcinoma (PTC), with notable cosmetic benefits when compared with conventional open TT. We have compared oncological outcomes and quality of life (QoL) in PTC patients undergoing robotic TT and MRND and those undergoing conventional open procedures. MATERIALS AND METHODS Between March 2010 and July 2011, 128 patients with PTC and lateral neck node metastases underwent TT with MRND, including 62 who underwent robotic and 66 who underwent open TT. We compared oncologic outcomes and safety as well as functional outcomes such as postoperative subjective voice and swallowing difficulties. We also evaluated neck pain, sensory changes, and cosmetic satisfaction after surgery using various QoL symptom scales. Neck and shoulder disability was assessed using arm abduction tests (AAT) and questions from the neck dissection impairment index (NDII). RESULTS Although the mean operating time was significantly longer in the robotic (mean, 271.8 ± 50.2 min) than in the open group (mean, 208.9 ± 56.3 min) (P < .0001), postoperative complication rates and oncologic outcomes, including the results of radioactive iodine scans and postoperative serum Tg concentrations, did not differ significantly. Subjective voice outcomes and postoperative AAT and neck dissection impairment index were also similar, but postoperative swallowing difficulties (P = .0041) and sensory changes (P < .0001) were significantly more frequent in the open than in the robotic group. In particular, mean cosmetic satisfaction score was significantly higher in the robotic than in the open group (P < .0001). CONCLUSIONS Robotic TT with MRND yielded similar oncologic outcomes and safety as conventional open procedures, with similar recovery of neck and shoulder disability. However, the robot technique resulted in better QoL outcomes, including better cosmetic results and reductions in neck sensory changes and swallowing discomfort.
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Affiliation(s)
- Jandee Lee
- Department of Surgery, Eulji University College of Medicine, 139-872 Seoul, Korea
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Abstract
CONTEXT Recurrence rate, after aspiration, in cystic thyroid nodules is very high. Interstitial laser photocoagulation (ILP) is a minimally invasive procedure that reduces the need for surgery in patients with a benign solid thyroid nodule. OBJECTIVE The aim of the study was to evaluate the efficacy of ILP on remission rates in recurrent, predominantly cystic thyroid nodules. DESIGN AND METHODS Forty-four consecutive outpatients with a symptomatic, recurrent, and cytologically benign cystic (cyst volume ≥ 2 mL) thyroid nodule were randomized to a single aspiration with (n = 22) or without (n = 22) subsequent ILP and followed up after 1, 3, and 6 months. RESULTS Successful outcome (cyst volume ≤ 1 mL) was obtained in 15 of 22 (68%) patients in the ILP group, compared to 4 of 22 (18%) in the aspiration group (P = .002). In the ILP group, the solid part of the nodule was reduced from a median of 1.8 to 1.0 mL (P = .02). In the aspiration-alone group, neither the cyst volume nor the solid nodule volume was significantly reduced. The reduction in median visual analog score (0-10 cm) for pressure symptoms was significantly higher in the ILP group (from 3.0 to 0.0 cm) than in the aspiration-alone group (from 4.0 to 3.5 cm) (P = .006, between groups). No major side effects occurred, and thyroid function was unaffected throughout. CONCLUSIONS US-guided aspiration and subsequent ILP of benign recurrent predominantly cystic thyroid nodules is safe. It significantly reduces recurrence rate, the volume of the solid nodule component, and pressure symptoms. ILP constitutes an important alternative to surgery in such patients.
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Affiliation(s)
- Helle Døssing
- Department of Otorhinolaryngology and Neck Surgery, Odense University Hospital, DK-5000 Odense C, Denmark
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Sanders MJ, Turcotte CM. Posture makes perfect. Todays FDA 2013; 25:62-65. [PMID: 23691618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Miedema HS, Feleus A. [Guideline 'Non-specific symptoms of arm, neck and/or shoulders']. Ned Tijdschr Geneeskd 2013; 157:A6249. [PMID: 23693013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Complaints of arm, neck and/or shoulder (CANS) constitute an important health problem. Over one third of Dutch adults reported CANS in the past year, and over a quarter were suffering from CANS at the time of interview. Over 10% of sick leave days are also attributed to CANS. At the end of 2012 a multidisciplinary guideline was published with recommendations for diagnostic and therapeutic interventions, care pathway and work participation for patients with non-specific CANS. The purpose of this guideline is to improve the care process and necessary multidisciplinary cooperation while facilitating communication with patients. The guideline starts with an update of the CANS model, resulting in an extension of the list of specific disorders to 36 diagnostic categories. A care pathway has also been developed, aimed at optimal timing of diagnosis and treatment and multidisciplinary cooperation. Through better diagnosis, patients with specific CANS get targeted treatments sooner. Better insight into treatment results will lead to the choice for effective treatments in cases of non-specific CANS, resulting in more patients receiving the most promising therapies.
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Affiliation(s)
- Harald S Miedema
- Hogeschool Rotterdam, Kenniscentrum ZorgInnovatie, Rotterdam, the Netherlands.
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Smith SC. Computer vision syndrome. Insight 2013; 38:23. [PMID: 24319826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Sarah C Smith
- Eye Clinic, Department of Ophthalmology, University of Iowa Healthcare, Iowa City, IA, USA.
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35
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Badalian VA, Kulakov AA. [Ergonomics in oral surgery and dental implantology]. Stomatologiia (Mosk) 2013; 92:34-37. [PMID: 23752835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The study objective was to reveal incidence, location and intensity of musculoskeletal pain in 88 dentists working in various units of Central Research Institute of Dentistry and Maxillofacial Surgery, as well as to identify pain predisposing factors and preventive measures. High rate (95.9 ± 5.03%) of musculoskeletal pain was revealed, mostly located in cervical region. The pain occurred more often in younger dentists. High incidence of musculoskeletal pain proves the necessity for preventive measures including optical magnification devices.
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Avoiding a pain in the neck. This common affliction can limit your daily activities if you don't take steps to prevent it. Harv Womens Health Watch 2012; 20:1, 7. [PMID: 23342665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
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Michaleff ZA, Lin CWC, Maher CG, van Tulder MW. Spinal manipulation epidemiology: systematic review of cost effectiveness studies. J Electromyogr Kinesiol 2012; 22:655-62. [PMID: 22429823 DOI: 10.1016/j.jelekin.2012.02.011] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2011] [Revised: 02/15/2012] [Accepted: 02/17/2012] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Spinal manipulative therapy (SMT) is frequently used by health professionals to manage spinal pain. With many treatments having comparable outcomes to SMT, determining the cost-effectiveness of these treatments has been identified as a high research priority. OBJECTIVE To investigate the cost-effectiveness of SMT compared to other treatment options for people with spinal pain of any duration. METHODS We searched eight clinical and economic databases and the reference lists of relevant systematic reviews. Full economic evaluations conducted alongside randomised controlled trials with at least one SMT arm were eligible for inclusion. Two authors independently screened search results, extracted data and assessed risk of bias using the CHEC-list. RESULTS Six cost-effectiveness and cost-utility analysis were included. All included studies had a low risk of bias scoring ≥16/19 on the CHEC-List. SMT was found to be a cost-effective treatment to manage neck and back pain when used alone or in combination with other techniques compared to GP care, exercise and physiotherapy. CONCLUSIONS This review supports the use of SMT in clinical practice as a cost-effective treatment when used alone or in combination with other treatment approaches. However, as this conclusion is primarily based on single studies more high quality research is needed to identify whether these findings are applicable in other settings.
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Affiliation(s)
- Z A Michaleff
- The George Institute for Global Health, The University of Sydney, Missenden Road, Sydney, NSW 2050, Australia.
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Lindegård A, Gustafsson M, Hansson GÅ. Effects of prismatic glasses including optometric correction on head and neck kinematics, perceived exertion and comfort during dental work in the oral cavity--a randomised controlled intervention. Appl Ergon 2012; 43:246-253. [PMID: 21664603 DOI: 10.1016/j.apergo.2011.05.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Revised: 05/12/2011] [Accepted: 05/18/2011] [Indexed: 05/30/2023]
Abstract
AIM To quantify the effects of using prismatic glasses including optometric correction, on head and neck kinematics, perceived exertion and comfort, during work in the oral cavity. METHODS The study population consisted of forty-five participants. After a basic ergonomic education, baseline measurements of head and neck kinematics were made using inclinometers. Perceived exertion and comfort were rated by the participants. An intervention group (n = 25), selected at random from the participants, received prismatic glasses and optometric correction when needed and were compared with a control group (n = 20). Follow up assessments were made after the intervention. RESULTS At follow up there was a reduction in both the intervention group (8.7°) and in the control group (3.6°) regarding head flexion. Neck flexion was reduced by 8.2° in the intervention group and 3.3° in the control group. The difference between the intervention and the control groups, i.e. the effect of the intervention, was statistically significant for both head (5.1°; p = 0.009) and neck (4.9°; p = 0.045) flexion. No effect of the intervention was seen regarding perceived exertion and comfort. CONCLUSION The reduction in head and neck flexion achieved by the prismatic glasses is likely to reduce the risk of neck pain during dental work. The effect of the prismatic lenses could not be separated from the effect of the optometric correction. The possible effect of the ergonomic education was not evaluated.
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Affiliation(s)
- A Lindegård
- Institute of Stress Medicine, Carl Skottsbergsgatan 22 B, SE-413 19 Gothenburg, Sweden.
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Abstract
Conclusions: No positive effects of early preventive rehabilitation could be identified. The results do not contradict the proposition that rehabilitation based on self-care can be effective but it is important to establish evidence-based training programs and identify proper instruments for selection of patients and evaluation of intervention. Objectives: Patients with head and neck cancer suffer from functional impairments due to intense treatment. In this study, we investigated the effectiveness of an experimental early preventive rehabilitation using hard, objective end points in a nonselective, longitudinal, prospective cohort study. Methods: In all, 190 patients were included in the program and received instructions for training before the start of treatment with the aim of reducing swallowing problems and reducing mouth opening and stiffness in the neck. A control group of 184 patients was recruited. Results: There was no difference in weight loss and 2-year survival between the two groups. No positive effects concerning functional impairments were found in patient-reported outcome measures.
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Affiliation(s)
- Alexander Ahlberg
- Department of Otolaryngology, Karolinska University Hospital, Stockholm, Sweden.
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Cheng H, Wang Z, Liu S, Yang Y, Zhao G, Cong H, Han X, Liu M, Yu M. [Research, design and application of model NSE-1 neck muscle training machine for pilots]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi 2011; 28:387-391. [PMID: 21604507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
Pain in the cervical region of air force pilots, who are exposed to high G-forces, is a specifically occupational health problem. To minimize neck problems, the cervical muscles need specific strength exercise. It is important that the training for the neck must be carried out with optimal resistance in exercises. The model NSE-1 neck training machine for pilots was designed for neck strengthening exercises under safe and effective conditions. In order to realize the functions of changeable velocity and resistant (CVR) training and neck isometric contractive exercises, the techniques of adaptive hydraulics, sensor, optic and auditory biological feedback, and signal processing were applied to this machine. The training system mainly consists of mechanical parts (including the chair of flexion and extension, the chair of right and left lateral flexion, the components of hydraulics and torque transformer, etc.), and the software of signal processing and biological feedback. Eleven volunteers were selected for the experiments of neck isometric contractive exercises, three times a week for 6 weeks, where CVR training (flexion, extension, right, left lateral flexion) one time a week. The increase in relative strength of the neck (flexion, extension, left and right lateral flexion) was 70.8%, 83.7%, 78.6% and 75.2%, respectively after training. Results show that the strength of the neck can be increased safely, effectively and rapidly with NSE-1 neck training machine to perform neck training.
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Affiliation(s)
- Haiping Cheng
- Biomechanical Laboratory, Institute of Aviation Medicine of Chinese PLA Air Force, Beijing 100142, China.
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Andersen LL, Zebis MK, Pedersen MT, Roessler KK, Andersen CH, Pedersen MM, Feveile H, Mortensen OS, Sjøgaard G. Protocol for work place adjusted intelligent physical exercise reducing musculoskeletal pain in shoulder and neck (VIMS): a cluster randomized controlled trial. BMC Musculoskelet Disord 2010; 11:173. [PMID: 20687940 PMCID: PMC2921353 DOI: 10.1186/1471-2474-11-173] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2010] [Accepted: 08/05/2010] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Neck and shoulder complaints are common among employees in sedentary occupations characterized by intensive computer use. Specific strength training is a promising type of physical exercise for relieving neck and shoulder pain in office workers. However, the optimal combination of frequency and exercise duration, as well as the importance of exercise supervision, is unknown. The VIMS study investigates in a cluster randomized controlled design the effectiveness of different time wise combinations of specific strength training with identical accumulated volume, and the relevance of training supervision for safe and effective training. METHODS/DESIGN A cluster randomized controlled trial of 20 weeks duration where employed office workers are randomized to 1 x 60 min, 3 x 20 min, 9 x 7 min per week of specific strength training with training supervision, to 3 x 20 min per week of specific strength training with a minimal amount of training supervision, or to a reference group without training. A questionnaire will be sent to 2000 employees in jobs characterized by intensive computer work. Employees with cardiovascular disease, trauma, hypertension, or serious chronic disease will be excluded. The main outcome measure is pain in the neck and shoulders at week 20. TRIAL REGISTRATION The trial is registered at ClinicalTrials.gov, number NCT01027390.
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Affiliation(s)
- Lars L Andersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
| | - Mette K Zebis
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
| | - Mogens T Pedersen
- Institute of Exercise and Sport Sciences, University of Copenhagen, Denmark
| | - Kirsten K Roessler
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Christoffer H Andersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
| | - Mette M Pedersen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
| | - Helene Feveile
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
| | - Ole S Mortensen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK 2100 Copenhagen Ø, Denmark
- Department of Occupational and Environmental Medicine, Bispebjerg University Hospital, Bispebjerg Bakke DK 2400 Copenhagen, Denmark
| | - Gisela Sjøgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Wang PC, Harrison RJ, Yu F, Rempel DM, Ritz BR. Follow-up of neck and shoulder pain among sewing machine operators: The Los Angeles garment study. Am J Ind Med 2010; 53:352-60. [PMID: 20017187 DOI: 10.1002/ajim.20790] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The aim of the present study is to explore factors affecting or modifying self-reported neck/shoulder pain in sewing machine operators. METHODS We investigated self-report neck/shoulder pain in 247 workers who participated in a 4-month prospective intervention study for musculoskeletal disorders. All participants were immigrants. We examine the influence of individual and work-related factors on changes in neck/shoulder pain during follow-up employing linear mixed models with time-spline functions. RESULTS We observed a dramatic decline (72%) in self-reported pain intensity in the first month of follow-up, followed by a small increase from the first to fourth month (4% per month). Workers who perceived and reported their physical workload as high or worked overtime experienced less overall pain reduction. Higher baseline pain intensity, being of Hispanic ethnicity (vs. Asian), and taking cumulative daily rest time during work of 35 min or more allowing for muscles to rest were associated with a larger pain reduction in the first month, but not thereafter. CONCLUSION Our findings indicate that some work-related factors may be of clinical relevance for reducing neck/shoulder pain. Having lower physical workloads and less overtime work should be considered when treating patients or planning workplace interventions for managing work-related musculoskeletal disorders in this underserved immigrant population.
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Affiliation(s)
- Pin-Chieh Wang
- Department of Epidemiology, School of Public Health, University of California, Los Angeles, California 90095-1772, USA
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Abstract
In the construction sector, overhead drilling into concrete or metal ceilings is a strenuous task associated with shoulder, neck and back musculoskeletal disorders due to the large applied forces and awkward arm postures. Two intervention devices, an inverted drill press and a foot lever design, were developed then compared to the usual method by construction workers performing their normal overhead drilling activities (n = 14). While the intervention devices were rated as less fatiguing than the usual method, their ratings on usability measures were worse than the usual method. The study demonstrates that the intervention devices can reduce fatigue; however, additional modifications are necessary in order to improve usability and productivity. Devices designed to improve workplace safety may need to undergo several rounds of field testing and modification prior to implementation.
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Affiliation(s)
- David Rempel
- Department of Bioengineering, University of California at Berkeley, Berkeley, CA 94720, USA.
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Kuijper B, Tans JTJ, Beelen A, Nollet F, de Visser M. Cervical collar or physiotherapy versus wait and see policy for recent onset cervical radiculopathy: randomised trial. BMJ 2009; 339:b3883. [PMID: 19812130 PMCID: PMC2758937 DOI: 10.1136/bmj.b3883] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To evaluate the effectiveness of treatment with collar or physiotherapy compared with a wait and see policy in recent onset cervical radiculopathy. DESIGN Randomised controlled trial. SETTING Neurology outpatient clinics in three Dutch hospitals. PARTICIPANTS 205 patients with symptoms and signs of cervical radiculopathy of less than one month's duration INTERVENTIONS Treatment with a semi-hard collar and taking rest for three to six weeks; 12 twice weekly sessions of physiotherapy and home exercises for six weeks; or continuation of daily activities as much as possible without specific treatment (control group). MAIN OUTCOME MEASURES Time course of changes in pain scores for arm and neck pain on a 100 mm visual analogue scale and in the neck disability index during the first six weeks. RESULTS In the wait and see group, arm pain diminished by 3 mm/week on the visual analogue scale (beta=-3.1 mm, 95% confidence interval -4.0 to -2.2 mm) and by 19 mm in total over six weeks. Patients who were treated with cervical collar or physiotherapy achieved additional pain reduction (collar: beta=-1.9 mm, -3.3 to -0.5 mm; physiotherapy: beta=-1.9, -3.3 to -0.8), resulting in an extra pain reduction compared with the control group of 12 mm after six weeks. In the wait and see group, neck pain did not decrease significantly in the first six weeks (beta=-0.9 mm, -2.0 to 0.3). Treatment with the collar resulted in a weekly reduction on the visual analogue scale of 2.8 mm (-4.2 to -1.3), amounting to 17 mm in six weeks, whereas physiotherapy gave a weekly reduction of 2.4 mm (-3.9 to -0.8) resulting in a decrease of 14 mm after six weeks. Compared with a wait and see policy, the neck disability index showed a significant change with the use of the collar and rest (beta=-0.9 mm, -1.6 to -0.1) and a non-significant effect with physiotherapy and home exercises. CONCLUSION A semi-hard cervical collar and rest for three to six weeks or physiotherapy accompanied by home exercises for six weeks reduced neck and arm pain substantially compared with a wait and see policy in the early phase of cervical radiculopathy. Trial registration Clinical trials NCT00129714.
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Affiliation(s)
- Barbara Kuijper
- Department of Neurology, Medical Centre Haaglanden, The Hague, Netherlands.
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Pillastrini P, Mugnai R, Bertozzi L, Costi S, Curti S, Mattioli S, Violante FS. Effectiveness of an at-work exercise program in the prevention and management of neck and low back complaints in nursery school teachers. Ind Health 2009; 47:349-354. [PMID: 19672007 DOI: 10.2486/indhealth.47.349] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The aim of the study was to determine the effectiveness of an extension-oriented exercise program in the prevention and management of low back/neck pain in nursery school teachers. A Cluster Randomized Controlled Trial was utilized. Seventy-one nursery school teachers working in nine school buildings were randomly divided into two groups, with each school as a unit of randomization. All the teachers in both groups received an ergonomic brochure; teachers in the experimental group also received an extension-oriented exercise program, conducted by a physical therapist. Data were collected at baseline and at a two-month follow-up. The primary outcome measure recorded was the level of disability (Roland Morris Disability Questionnaire and Oswestry Disability Index), while secondary outcome measure included the evaluation of cervical and lumbar physical discomfort (Visual Analogue Scale). At follow-up, a significant improvement was registered in the experimental group as compared to the control group for all the outcomes evaluated. In conclusion an extension-oriented exercise program may be a useful strategy to prevent low back and neck complaints and to reduce consequent LBP functional disability among nursery school teachers.
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Affiliation(s)
- Paolo Pillastrini
- Occupational Medicine Unit, S. Orsola-Malpighi Hospital, Alma Mater Studiorum, University of Bologna, 40138 Bologna, Italy
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Malmström EM, Karlberg M, Melander A, Magnusson M, Moritz U. Cervicogenic dizziness – musculoskeletal findings before and after treatment and long-term outcome. Disabil Rehabil 2009; 29:1193-205. [PMID: 17653993 DOI: 10.1080/09638280600948383] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE To explore musculoskeletal findings in patients with cervicogenic dizziness and how these findings relate to pain and dizziness. To study treatment effects and long-term symptom progress. METHOD Twenty-two patients (20 women, 2 men; mean age 37 years) with suspected cervicogenic dizziness underwent a structured physical examination before and after physiotherapy guided by the musculoskeletal findings. Questionnaires were sent to the patients six months and two years after treatment. RESULTS Dorsal neck muscle tenderness and tightness was found in a majority of the patients. Zygapophyseal joint tenderness was found at all cervical levels. Cervical range of motion was equal to or larger than expected age and gender matched values. The cervico-thoracic region was often hypomobile. Most patients had postural imbalance. Dynamic stabilization capacity was reduced. Suboccipital muscles tightness correlated with posture imbalance and poor neck stability. The treatment resulted in reduced tenderness in levator scapula, high and middle paraspinal and temporalis muscles and zygapophyseal joints at C4-C7 and increased cervico-thoracic mobility. Reduction of middle paraspinal muscle tenderness correlated with neck pain relief. Postural alignment improved, as did dynamic stabilization in trunk, neck and shoulders. After 6 months, 13 of the 17 patients had still no or less neck pain and 14 had no or less dizziness. After 2 years, 7 patients had no or less neck pain and 11 no or less dizziness. CONCLUSION Patients with suspected cervicogenic dizziness have some musculoskeletal findings in common. Treatment based on these findings reduces neck pain as well as dizziness long-term but some patients might need a maintenance strategy.
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Affiliation(s)
- Eva-Maj Malmström
- Department of Rehabilitation, Lund University Hospital, Lund, Sweden.
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Breen PP, Nisar A, Olaighin G. Evaluation of a single accelerometer based biofeedback system for real-time correction of neck posture in computer users. Annu Int Conf IEEE Eng Med Biol Soc 2009; 2009:7269-7272. [PMID: 19965101 DOI: 10.1109/iembs.2009.5334726] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The worldwide adoption of computers is closely linked to increased prevalence in neck and shoulder pain. Many ergonomic interventions are available; however, the lifetime prevalence of neck pain is still estimated as high as 80%. This paper introduces a biofeedback system using a novel single accelerometer placement. This system allows the user to react and correct for movement into a position of bad posture. The addition of visual information provides artificial proprioceptive information on the cranial-vertebral angle. Six subjects were tested for 5 hours with and without biofeedback. All subjects had a significant decrease in the percentage of time spent in bad posture when using biofeedback.
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Affiliation(s)
- Paul P Breen
- The National Centre for Biomedical Engineering Science and Electrical & Electronic Engineering, National University of Ireland Galway, University Road, Galway, Ireland.
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Zejda JE. [Collinearity in multivariable analysis: causes, detection and control measures]. Przegl Epidemiol 2009; 63:333-337. [PMID: 19799271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The paper reviews principal effects of collinearity on the results of multivariate regression analysis. The discussion focuses on the definition of the problem and on practical means of its recognition, as well as on preventive measures aiming at control of collinearity. In addition to the literature-based review the paper includes the presentation of a case study involving assessment of the relationship between pain in arms and age, years of work, daily duration of work in men and women regularly using personal computers at work. Case-study data were used to show the effect of collinearity (interdependence of two independent variables: age and years of work) on the coefficients of regression in a saturated model, followed by demonstration of the changes resulting from restriction measures (either age or years of work in the model). In addition, in relation to the case-study, the paper shows the results of practical means of detection of collinearity, including analysis of linear correlation and tolerance diagnostics.
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Affiliation(s)
- Jan E Zejda
- Katedra Epidemiologii Slaski Uniwersytet Medyczny w Katowicach.
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Snodgrass SJ, Rivett DA, Robertson VJ. Measuring the posteroanterior stiffness of the cervical spine. ACTA ACUST UNITED AC 2008; 13:520-8. [PMID: 17910931 DOI: 10.1016/j.math.2007.07.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2006] [Revised: 06/14/2007] [Accepted: 07/22/2007] [Indexed: 11/27/2022]
Abstract
An essential part of improving manual therapy treatment for cervical spine disorders is the identification of the mechanical effects of manual techniques. The aims of this research were to develop a reliable and safe instrument for measuring cervical spine stiffness, and to document stiffness in a group of asymptomatic individuals. A device for measuring cervical spine stiffness was designed and tested. The stiffness of the cervical spine of 67 asymptomatic individuals was measured at C2 and C7 on one or more occasions. Stiffness was defined as the slope of the linear region of the force-displacement curve (coefficient K). For C2, the linear region of the force-displacement curve was from 7 to 40 N, and for C7, 20-70 N. The mean stiffness (coefficient K) on the first measurement occasion at C2 was 4.58 N/mm (95% CI 4.30-4.85), and at C7 was 7.03 N/mm (95% CI 6.50-7.57). ICC(2,1) for repeated measurements was 0.84 (95% CI 0.74-0.90). Stiffness measurements in the cervical spine were generally lower than those previously reported for the lumbar spine. Age was positively associated with C2 stiffness (p=0.01). Males were stiffer at C7 than females (p<0.001). This research provides a basis for future studies investigating the effects of manual techniques on cervical spine stiffness, potentially leading to improved outcomes for patients treated by manual therapy.
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Affiliation(s)
- Suzanne J Snodgrass
- Discipline of Physiotherapy, The University of Newcastle, Box 24, Callaghan, NSW, Australia.
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