<p>Playing related musculoskeletal disorder (PRMD) is common among instrumentalists, professionals, amateurs and music students with a prevalence ranging from 39-47% with an impact on playing and performance. This is synonymous to the prevalence of musculoskeletal disorders among other work population. Risk factors such as lack of warm ups, awkward posture, long playing hours and bad techniques has been consistently indicated as risk factors influencing the incidence of PRMDs among instrumentalists. The aim of this study is to design a warm up programme for instrumentalists. The study population and sample are instrumentalists at the Centre for Performing Arts, University of the Western Cape. A cross sectional study design with a quantitative approach was utilized in this study to determine the prevalence, severity, distribution of PRMDs and its association with quality of life. All the instrumentalists learning or playing a musical instrument of the Centre for Performing Arts was approached to participate in this study. In the first phase of the study, a self administered questionnaire was used to collect data regarding prevalence, distribution and the severity of PRMDs and health related quality of life. The instruments for this study are the standard NORDIC questionnaire for musculoskeletal disorders to determine pain distribution and prevalence, the visual analogue scale to determine the pain severity and the WHOQOL &ndash / BREF, a quality of life questionnaire and an adapted questionnaire to determine the knowledge of instrumentalists about injury prevention strategies. The second phase of the study, a systematic review of evidence was done on the pattern of warm up and practice habits of instrumentalists. The third phase of the study to design the content of the study was done using a Delphi study. The Statistical Package for Social Sciences (SPSS) was used for descriptive and inferential statistics. Chi square was used to determine the association of prevalence, distribution and severity on quality of life. Alpha level was set at 0.05. Ethical clearance and permission to conduct study was sought, written informed consents from participants was sought clearly stating the right to participate and withdraw from study was respected and anonymity and confidentiality was be ensured. The results of the study show that 82.4 % lifetime prevalence and current prevalence of 23.5 % among instrumental musicians in a Centre for Performing Arts. The shoulder (41.2 %), neck (29.4 %) and the wrists and hands (29.4%) are the mostly affected region on the body. The most common symptoms are tightness and soreness. However, the results of the systematic review shows that there is a lack of operational term for warm up in the performing arts and this therefore could be responsible for the variations in the influence of warm up on the prevention of PRMDs. The content of the warm up programme was designed using a Delphi study and stretching and postural awareness were included with musical warm up as part of a regular warm up exercise, although, consensus was not reached on the duration of the warm up programme. Strengthening and conditioning were included to in a different exercise program done three times per week. Education on injury prevention strategies were also included in the programme and the mode of instruction agreed on was active learning and group instruction in classroom. The role of warm up exercise in the prevention of PRMDs using this model could reduce the incidence of PRMDs. However, it is important to note that the programme should be tested in order to determine the overall effect it has on PRMDs.</p>

<p>Playing related musculoskeletal disorder (PRMD) is common among instrumentalists, professionals, amateurs and music students with a prevalence ranging from 39-47% with an impact on playing and performance. This is synonymous to the prevalence of musculoskeletal disorders among other work population. Risk factors such as lack of warm ups, awkward posture, long playing hours and bad techniques has been consistently indicated as risk factors influencing the incidence of PRMDs among instrumentalists. The aim of this study is to design a warm up programme for instrumentalists. The study population and sample are instrumentalists at the Centre for Performing Arts, University of the Western Cape. A cross sectional study design with a quantitative approach was utilized in this study to determine the prevalence, severity, distribution of PRMDs and its association with quality of life. All the instrumentalists learning or playing a musical instrument of the Centre for Performing Arts was approached to participate in this study. In the first phase of the study, a self administered questionnaire was used to collect data regarding prevalence, distribution and the severity of PRMDs and health related quality of life. The instruments for this study are the standard NORDIC questionnaire for musculoskeletal disorders to determine pain distribution and prevalence, the visual analogue scale to determine the pain severity and the WHOQOL &ndash / BREF, a quality of life questionnaire and an adapted questionnaire to determine the knowledge of instrumentalists about injury prevention strategies. The second phase of the study, a systematic review of evidence was done on the pattern of warm up and practice habits of instrumentalists. The third phase of the study to design the content of the study was done using a Delphi study. The Statistical Package for Social Sciences (SPSS) was used for descriptive and inferential statistics. Chi square was used to determine the association of prevalence, distribution and severity on quality of life. Alpha level was set at 0.05. Ethical clearance and permission to conduct study was sought, written informed consents from participants was sought clearly stating the right to participate and withdraw from study was respected and anonymity and confidentiality was be ensured. The results of the study show that 82.4 % lifetime prevalence and current prevalence of 23.5 % among instrumental musicians in a Centre for Performing Arts. The shoulder (41.2 %), neck (29.4 %) and the wrists and hands (29.4%) are the mostly affected region on the body. The most common symptoms are tightness and soreness. However, the results of the systematic review shows that there is a lack of operational term for warm up in the performing arts and this therefore could be responsible for the variations in the influence of warm up on the prevention of PRMDs. The content of the warm up programme was designed using a Delphi study and stretching and postural awareness were included with musical warm up as part of a regular warm up exercise, although, consensus was not reached on the duration of the warm up programme. Strengthening and conditioning were included to in a different exercise program done three times per week. Education on injury prevention strategies were also included in the programme and the mode of instruction agreed on was active learning and group instruction in classroom. The role of warm up exercise in the prevention of PRMDs using this model could reduce the incidence of PRMDs. However, it is important to note that the programme should be tested in order to determine the overall effect it has on PRMDs.</p>

Congenital Talipes Equinovarus is the commonest congenital musculoskeletal disorder with an incidence of 1 in 1000 live births. Although there has been much research into various aspects of the condition, there are still many unanswered questions. CTEV shows a spectrum of severity. In practice, a small percentage of cases resolve completely shortly after birth, but the remainder require further management with surgery in up to 80% of patients in some series. In children under the age of 6, soft tissue operations are often all that is required. After that age however, bony procedures are often necessary as the growing bones adapt to their abnormal environments. A number of factors have been investigated to assess the results of initial management and predict which patients will require further treatment, but there is little agreement between authors as to what variables should be studied. Outcome and the assessment of different management strategies is also contentious. This study describes the assessment of 204 families identified as having at least one child with congenital talipes. Outcome was initially assessed using a subjective scoring system. This was then used to evaluate a number of proposed objective and clinical outcome measures. On the basis of this, an objective system of assessment is proposed using measurement of foot length discrepancy, calf circumference, and range of movement at the ankle. Management was then evaluated objectively showing that in the medium term, a prolonged period of conservative management with Denis Browne splints and boots produced the best outcome. Despite a number of family studies looking at inheritance patterns in CTEV, the mode of genetic transmission remains unclear, and, while a number of environmental factors have been linked to CTEV, scientific methodology, in particular lack of a control group, limits the conclusions which can be drawn. Analysis of 176 family pedigrees demonstrates that CTEV may have an autosomal dominant mode of inheritance in a subgroup of cases. This study also presents the results of a case control study of epidemiological factors in CTEV, demonstrating a link between smoking and CTEV.

The effects of pain suffered from musculoskeletal disorders by dental professionals may lead to reduced work hours, loss of production, and early retirement. Although third- and fourth-year dental students are provided lectures about musculoskeletal disorders, proper positioning and ergonomics, they are at an increased risk of developing MSD. This study was conducted to evaluate the prevalence on musculoskeletal disorders in third- and fourth-year dental students and to determine if third-year dental students experience more MSD pain than fourth-year dental students at the University of Tennessee Health Science Center College of Dentistry. A total of 50 third- and fourth- year dental students responded to the online questionnaire, 21 third-year dental students and 29 fourth-year dental students. Both third- and fourth-year dental students report experiencing MSD pain over the last twelve months. There was no statistically significant difference between MSD pain felt between third- or fourth-year dental students.

Magister Public Health - MPH / Background: Protecting and promoting health in the workplace is imperative, both for individual employee health and workplace productivity. High rates of workplace injuries, particularly in environments where high levels of physical activity are required, point to the need for effective occupational interventions, minimization of workplace inhibitors that increase the risk of developing musculoskeletal disorders (MSDs), and occupational management checks to reduce the onset of MSDs in the workplace. However, for these measures to be successful, it would be important to identify individual and workplace-related factors associated with the development and duration of MSDs. Aim: To determine potential risk and protective factors associated with MSDs among employees in a workplace where heavy lifting is a key job function.

WORK-RELATED MUSCULOSKELETAL DISORDERS AMONG DENTISTS AND ORTHODONTISTS A thesis submitted in partial fulfillment of the requirements for the degree of Master of Science in Dentistry at Virginia Commonwealth University. by Natalie R. La Rochelle Thesis Director: Dr. Eser Tüfekçi, D.D.S., M.S., Ph.D., M.S.H.A. Professor, Department of Orthodontics Virginia Commonwealth University Richmond, Virginia May 2017 The practice of dentistry is physically demanding due to static and dynamic postures sustained daily throughout careers. Previous literature suggests that work-related musculoskeletal disorders (WMSD) are not solely the result of work habits, but also due to the individual, his or her physical makeup, genetics, and personal lifestyle. A 33-question survey was distributed to 1000 general dentists and 2300 orthodontists. The overall prevalence of work-related musculoskeletal disorders was greater among dentists and most often reported as self-limiting. Dentists were three times more likely than orthodontists to report WMSD; females were twice as likely to report WMSD than males; those who sought alternative medical remedies were two times more likely to have WMSD; and practitioners 6-10 years in practice were least likely to report WMSD. Dentists reported sitting in static positions longer than orthodontists; and those with WMSD indicated exercising, stretching, and seeking alternative health remedies more than dentists without WMSD.

Este estudo objetivou a adaptação transcultural do questionário Cultural Study of Musculo-Skeletal and Other Symptoms and Associated Disability - CUPID Questionnaire, para a língua portuguesa falada no Brasil e a validação do seu conteúdo. O estudo é do tipo metodológico e foi realizado obedecendo aos procedimentos internacionais recomendados e aos procedimentos específicos indicados pelo autor do Questionário, uma vez que será aplicado em estudo multicêntrico por ele coordenado. A adaptação transcultural foi realizada seguindo as etapas de tradução, retrotradução, avaliação destas versões por um comitê de juízes e pré-teste da versão pré-final. O pré-teste foi realizado no Departamento de Enfermagem do Hospital Universitário da Universidade de São Paulo com 40 trabalhadores de enfermagem. Ajustes foram feitos após a análise das traduções pelo comitê de juízes quando o Índice de Validade de Conteúdo foi inferior a 80%. A versão resultante do questionário foi então pré-testada para verificar a capacidade compreensão e preenchimento pelos sujeitos e a possibilidade de ajustes, considerando o indicativo de ajustes quando 15% destes apresentassem dificuldades em relação ao preenchimento. Os resultados do pré-teste apontam um número significativo de trabalhadores de enfermagem com dores em região lombar, ombro, cotovelo, punho e/ou mão e joelho, associados a sintomas psicossociais e demais incapacidades. A análise das respostas dos sujeitos aos itens do Questionário não evidenciou dificuldades de compreensão e entendimento na totalidade dos itens, indicando a validade de seu conteúdo para a língua portuguesa falada no Brasil. Conclui-se que a versão Brasileira do CUPID Questionnaire é um instrumento adequado para identificar os sintomas musculoesqueléticos, indicados pelos trabalhadores de enfermagem, relacionados às atividades ocupacionais, aspectos psicossociais e outras incapacidades associadas / The objective of this study was to adapt the Transcultural Questionnaire Cultural Study of Muscular-Skeletal and Other Symptoms and Associated Disability CUPID Questionnaire, to the Portuguese language spoken in Brazil and to validate its contents. This methodological study was performed in accordance with internationally recommended procedures and the specific procedures indicated by the Questionnaires author since it will be applied in a multicenter study coordinated by the author. The transcultural adaptation was performed following the steps of translation, back-translation, evaluation of these versions by a committee of judges and pre-test version of the pre-final. The pre-test was performed in the Nursing Department of University Hospital at the University of Sao Paulo with 40 nursing workers. Adjustments were made after an analysis of the translations by a committee of judges when an index of content validation was less than 80%. The resulting version of the questionnaire was then pre-tested to verify the capacity of comprehension and form completion by the subjects and the possibility of adjustments considering an adjustment indicator when 15% of them presented difficulty related to form completion. The results of this pre-test showed that a significant number of Nursing workers complained of pain in the regions of lumbar, shoulder, elbow, wrist and or hand and knee, symptoms associated with psychosocial and other disabilities. Analysis of the subjects responses to items of the questionnaire revealed no difficulty in the comprehension and total understanding of the items indicating a validity of its contents for the Portuguese language spoken in Brazil. It can be concluded that the Brazilian Version of the CUPID Questionnaire is an adequate instrument for the identification of musculoskeletal symptoms indicated by nursing workers related to occupational activities, psychosocial aspects and other associated incapacities

Although skin disease and musculoskeletal disorders are believed to be common among nursing home workers, to date there have been no coordinated international studies of these occupational issues. Therefore, it was considered appropriate to conduct one of the first cross-cultural investigations of occupational dermatology and ergonomic complaints among nursing home workers in Australia, Japan, South Korea and Taiwan using a standardised methodology. This thesis documents a 4-year investigation of skin disease and musculoskeletal disorders conducted among 465 nursing home staff in Australia, Japan, South Korea and Taiwan. Skin diseases were diagnosed by specialist physicians during medical examinations, while information on musculoskeletal disorders was collected by means of a self-reported questionnaire. There were major differences in both the location and type of skin disease between the 4 groups. Overall, the Australian group suffered a generally higher prevalence of skin disease than in the other three countries investigated, most likely due to their significantly higher rate of sun-induced skin damage. The high prevalence of cutaneous fungal disease seen within the Taiwanese subjects most probably arose from the comparatively higher temperature and relative humidity of Taiwan. Other potentially important skin disease risk factors included previous skin disease and a history of allergy, both of which are consistent with current knowledge. Although musculoskeletal disorders were found to be most prevalent among the Japanese nursing home staff at almost all body sites, the reasons for this are not clear. It may have related to a generally higher musculoskeletal rate, or a higher degree of self-reporting on their questionnaires. Individual MSD risk factors included moving patients, washing patients, working as an assistant nurse and daily alcohol consumption. Interestingly, MSD was found to be a co-factor for current skin disease. Overall, this study indicated that certain occupational health issues consistently affect nursing home staff in the 4 countries, but the prevalence and rank order varies from nation to nation. It was also shown that nursing home work incurs a reasonable degree of risk and that skin disease and musculoskeletal disorders are important occupational issues within these facilities.

Este estudo objetivou a adaptação transcultural do questionário Cultural Study of Musculo-Skeletal and Other Symptoms and Associated Disability - CUPID Questionnaire, para a língua portuguesa falada no Brasil e a validação do seu conteúdo. O estudo é do tipo metodológico e foi realizado obedecendo aos procedimentos internacionais recomendados e aos procedimentos específicos indicados pelo autor do Questionário, uma vez que será aplicado em estudo multicêntrico por ele coordenado. A adaptação transcultural foi realizada seguindo as etapas de tradução, retrotradução, avaliação destas versões por um comitê de juízes e pré-teste da versão pré-final. O pré-teste foi realizado no Departamento de Enfermagem do Hospital Universitário da Universidade de São Paulo com 40 trabalhadores de enfermagem. Ajustes foram feitos após a análise das traduções pelo comitê de juízes quando o Índice de Validade de Conteúdo foi inferior a 80%. A versão resultante do questionário foi então pré-testada para verificar a capacidade compreensão e preenchimento pelos sujeitos e a possibilidade de ajustes, considerando o indicativo de ajustes quando 15% destes apresentassem dificuldades em relação ao preenchimento. Os resultados do pré-teste apontam um número significativo de trabalhadores de enfermagem com dores em região lombar, ombro, cotovelo, punho e/ou mão e joelho, associados a sintomas psicossociais e demais incapacidades. A análise das respostas dos sujeitos aos itens do Questionário não evidenciou dificuldades de compreensão e entendimento na totalidade dos itens, indicando a validade de seu conteúdo para a língua portuguesa falada no Brasil. Conclui-se que a versão Brasileira do CUPID Questionnaire é um instrumento adequado para identificar os sintomas musculoesqueléticos, indicados pelos trabalhadores de enfermagem, relacionados às atividades ocupacionais, aspectos psicossociais e outras incapacidades associadas / The objective of this study was to adapt the Transcultural Questionnaire Cultural Study of Muscular-Skeletal and Other Symptoms and Associated Disability CUPID Questionnaire, to the Portuguese language spoken in Brazil and to validate its contents. This methodological study was performed in accordance with internationally recommended procedures and the specific procedures indicated by the Questionnaires author since it will be applied in a multicenter study coordinated by the author. The transcultural adaptation was performed following the steps of translation, back-translation, evaluation of these versions by a committee of judges and pre-test version of the pre-final. The pre-test was performed in the Nursing Department of University Hospital at the University of Sao Paulo with 40 nursing workers. Adjustments were made after an analysis of the translations by a committee of judges when an index of content validation was less than 80%. The resulting version of the questionnaire was then pre-tested to verify the capacity of comprehension and form completion by the subjects and the possibility of adjustments considering an adjustment indicator when 15% of them presented difficulty related to form completion. The results of this pre-test showed that a significant number of Nursing workers complained of pain in the regions of lumbar, shoulder, elbow, wrist and or hand and knee, symptoms associated with psychosocial and other disabilities. Analysis of the subjects responses to items of the questionnaire revealed no difficulty in the comprehension and total understanding of the items indicating a validity of its contents for the Portuguese language spoken in Brazil. It can be concluded that the Brazilian Version of the CUPID Questionnaire is an adequate instrument for the identification of musculoskeletal symptoms indicated by nursing workers related to occupational activities, psychosocial aspects and other associated incapacities

Magister Scientiae (Physiotherapy) - MSc(Physio) / Playing related musculoskeletal disorder (PRMD) is common among instrumentalists, professionals, amateurs and music students with a prevalence ranging from 39-47% with an impact on playing and performance. This is synonymous to the prevalence of musculoskeletal disorders among other work population. Risk factors such as lack of warm ups, awkward posture, long playing hours and bad techniques has been consistently indicated as risk factors influencing the incidence of PRMDs among instrumentalists. The aim of this study is to design a warm up programme for instrumentalists. The study population and sample are instrumentalists at the Centre for Performing Arts, University of the Western Cape. A cross sectional study design with a quantitative approach was utilized in this study to determine the prevalence, severity, distribution of PRMDs and its association with quality of life. All the instrumentalists learning or playing a musical instrument of the Centre for Performing Arts was approached to participate in this study. In the first phase of the study, a self administered questionnaire was used to collect data regarding prevalence, distribution and the severity of PRMDs and health related quality of life. The instruments for this study are the standard NORDIC questionnaire for musculoskeletal disorders to determine pain distribution and prevalence, the visual analogue scale to determine the pain severity and the WHOQOL –BREF, a quality of life questionnaire and an adapted questionnaire to determine the knowledge of instrumentalists about injury prevention strategies. The second phase of the study, a systematic review of evidence was done on the pattern of warm up and practice habits of instrumentalists. The third phase of the study to design the content of the study was done using a Delphi study. The Statistical Package for Social Sciences (SPSS) was used for descriptive and inferential statistics. Chi square was used to determine the association of prevalence, distribution and severity on quality of life. Alpha level was set at 0.05. Ethical clearance and permission to conduct study was sought, written informed consents from participants was sought clearly stating the right to participate and withdraw from study was respected and anonymity and confidentiality was be ensured. The results of the study show that 82.4 % lifetime prevalence and current prevalence of 23.5 % among instrumental musicians in a Centre for Performing Arts. The shoulder (41.2 %), neck (29.4 %) and the wrists and hands (29.4%) are the mostly affected region on the body. The most common symptoms are tightness and soreness. However, the results of the systematic review shows that there is a lack of operational term for warm up in the performing arts and this therefore could be responsible for the variations in the influence of warm up on the prevention of PRMDs. The content of the warm up programme was designed using a Delphi study and stretching and postural awareness were included with musical warm up as part of a regular warm up exercise, although, consensus was not reached on the duration of the warm up programme. Strengthening and conditioning were included to in a different exercise program done three times per week. Education on injury prevention strategies were also included in the programme and the mode of instruction agreed on was active learning and group instruction in classroom. The role of warm up exercise in the prevention of PRMDs using this model could reduce the incidence of PRMDs. However, it is important to note that the programme should be tested in order to determine the overall effect it has on PRMDs. / South Africa