M.Tech.

Faculty of Medicine School of Physiotherapy 82-29610 Tel: 011 452 3175 / Physiotherapists commonly assess head and shoulder posture and correct poor posture on the grounds that there is an association between the patients’ cervical symptoms and their posture. The aims of this study were firstly to compare the sagittal head and shoulder posture and demographic variables of patients with chronic cervical pain to those of “healthy” volunteers. Secondly, to investigate the relationship between the frequency and severity of pain and the sagittal head and shoulder posture of patients with chronic cervical pain. Lateral view photographs were taken of nineteen patients (experimental group) and eighteen “healthy” volunteers (control group) in a supported sitting position. The following five static postural positions were assessed: (1) neutral or natural head and shoulder posture (2) maximum head protraction (3) maximum head retraction (4) maximum shoulder protraction and (5) maximum shoulder retraction. The active range of anteroposterior glide (total excursion) of the participants’ head and shoulders was also assessed. The participants completed a questionnaire that included their demographic variables, medical history and leisure time activities. Differences in head and shoulder posture were observed between the two groups. Some of these differences supported postural relationships that have been described in the literature. The experimental group had a more forward head resting position than the control group. The range of motion (total excursion) of the head and shoulders of the experimental group was less than the control group. In contrast to clinical assumptions that have been described in the literature, a forward resting head posture was not related to a protracted shoulder position or to upper cervical spine extension when measured in the sagittal plane. A relationship was observed between the frequency and severity of pain in certain body regions and selected postural measurements in the experimental group. It is suspected that most of the findings might be the result of poor cervical and scapular muscle control caused by chronic pain. This emphasises the need to assess the influence of tissue and joint extensibility and muscle control on head and shoulder posture. Analysis of the questionnaires demonstrated that the experimental group’s ability to carry out activities of daily living was significantly affected by pain (p=0,001). There was no significant difference in the number of hours worked per week between the experimental and control groups (p=1,000). There was a tendency (p=0,118) for the control group to devote a greater number of hours to “active” leisure time activities. The control group might have been less symptomatic as a result thereof. This highlights the necessity to further investigate the effect of exercise on postural correction and prevention of cervical symptoms.

Objective: To determine the association between perceived stress and the presence of musculoskeletal disorders in physicians at La Caleta de Chimbote Hospital and Eleazar Guzmán Barrón Regional Hospital in Ancash, Peru. Methods. An exploratory cross-sectional analytical study was conducted in 116 physicians. The Nordic Questionnaire was used to determine the areas of musculoskeletal pain and the Perceived Stress Scale (PSS-10) to assess the level of stress. The sociodemographic and occupational characteristics of the population were evaluated from the measurement of proportions and measures of central tendency and dispersion. For the bivariate analysis, Fisher's exact test and Chi2 were used. Finally, the multivariate analysis, based on a Logistics Regression model, was calculated with the crude and adjusted Odd Ratio (OR) [95% Confidence Intervals (CI)]. Results: The responses of 71 evaluations from a group of people between ages 34 to 59 (median 48) with a higher predominance of males (72%) were analyzed. No statistically significant association was found between the presence of non-specific musculoskeletal disorders and the perception of stress (p = 0.066); However, cervical, lumbar, hip / leg and ankle / foot pain specifically did show a significant association (p = 0.009; p = 0.033; p = 0.033 and p = 0.034, respectively). Finally, the cervical area maintained its association when performing the crude analysis and adjusted to physical activity (ORc = 7.29; 95% CI = 1.51-35.21 / ORa = 7.29 95% CI = 1.25-42.37). Anatomical areas such as lumbar, hip / leg and ankle / foot showed a non-significant association when performing the multivariate analysis. / Objetivo: Determinar la asociación entre el nivel de estrés percibido y la presencia de trastornos musculoesqueléticos en médicos del hospital La Caleta de Chimbote y Hospital Regional Eleazar Guzmán Barrón en Ancash, Perú. Métodos. Se realizó un estudio exploratorio de tipo transversal analítico en 116 médicos. Se utilizó el cuestionario nórdico para determinar las zonas de dolor musculoesqueléticos y la Escala de Estrés Percibido (EEP-10) para valorar el nivel de estrés. Se evaluaron las características sociodemográficas y ocupacionales de la población a partir de la medición de proporciones y medidas de tendencia central y dispersión. Para la realización del análisis bivariado se utilizó la prueba exacta de Fisher, Chi2. Finalmente, el análisis multivariado, a partir de un modelo de Regresión de Logística, se calculó con el Odd Ratio (OR) crudo y ajustado [Intervalos de Confianza (IC) al 95%]. Resultados: Se analizaron las respuestas de 71 evaluaciones de un grupo de personas de entre 34 a 59 años (mediana 48) con mayor predominio del sexo masculino (72%). No se encontró asociación estadísticamente significativa entre la presencia de trastornos musculoesqueléticos de manera inespecífica y la percepción de estrés (p=0.066); sin embargo, el dolor cervical, lumbar, cadera/pierna y tobillo/pie específicamente sí mostraron asociación significativa (p=0,009; p=0.033; p=0.033 y p=0.034, respectivamente). Finalmente, la zona cervical mantuvo su asociación al realizar el análisis crudo y ajustado a la actividad física (ORc=7.29; IC95%=1.51-35.21 / ORa=7.29 IC95%=1.25-42.37). Zonas anatómicas como lumbar, cadera/pierna y tobillo/pie mostraron asociación no significativa al realizar el análisis multivariado. / Tesis