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Work-related musculoskeletal disorders (WMSDs) negatively impact worker's health, ability to work, and their quality of life. Non-invasive methods for assessing the physiological responses to workload may provide information on physiological markers leading to increased risk of WMSDs. The following study aimed to evaluate the feasibility of using thermography to quantify differences in thermal readings of participants during and following a data entry task and assess the repeatability of thermal readings. Skin surface temperature measurements of the dorsal forearm were obtained from 12 participants (6 females, 6 males) during a data entry task (35 minutes) and a 30-minute post-task period. Participants also reported their perceived forearm discomfort during data entry and recovery. Three forearm analysis regions were analyzed based on statistical findings; Upper Left, Lower Left and Right regions. Temperature trends were found to increase during data entry and decrease during recovery. The Upper Left region was warmer during both data entry and recovery phases in comparison to the other regions. Repeatability of surface temperatures, based on intraclass correlations (ICCs), was found to be fair for magnitudes and trends during data entry, and poor for magnitudes and trends during recovery, despite higher significant correlations in the latter. Positive correlations were evident between subjective feelings of forearm discomfort trends and temperature trends in response to workload. No gender differences were found with regard to temperature measurements. This work contributes to the understanding of surface responses of the forearm during and following an applied stress, and to the literature supporting thermography as a non-invasive evaluative tool for assessing physiological responses during job tasks. / Master of Science

When implementing a managed healthcare intervention among a working population, evidence-based healthcare is critical. In the current study, the change of work posture of sewing-machine operators from seated to stand-up (the intervention) was managed within a physiotherapy and ergonomics programme (programme) in Johnson Controls Automotive S.A. (Pty) Ltd (company) without local evidence to guide the postural transition. The management of the intervention, implemented over a period of 4.5 years, presented the opportunity for a retrospective longitudinal study. The study determined the impact of the change in work posture on the incidence of work-related musculoskeletal disorders (WRMSDs) from June 2004 to January 2009 (period). The role of the physiotherapist in the programme was to deliver manual therapy to all sewing-machine operators with WRMSDs, and to provide a clinical - ergonomics service, as a member of a multidisciplinary team, to the company. The population of sewing-machine operators (n=123) was described in terms of personal factors (e.g. age, medical history, musculoskeletal history, and body mass index (BMI)), ergonomic risk factors (e.g. work posture, force and duration) and overall incidence of WRMSDs. The associations of risk factors (personal and ergonomic) with WRMSDs, and work posture with WRMSDs among sewing-machine operators were statistically determined. The majority of the population (97.6%) was female, with mean age 42.3± 8 years. At baseline, 17.9% were hypertensive, 3.3% had arthritis, 6.5% were diabetic, and the mean BMI was 29.7 kg/m² (22% of BMIs was normal). The largest proportion of the sewing-machine operators were sewing cloth and leather (79.7%) (compared to sewing cloth and vinyl), and the remainder performed forceful precision stitching (20.3%), including headrest covers, airbags and top stitching on the final product. Job rotation took place between forceful precision stitching and straight stitching (for 36.6% of the sewing-machine operators).p> The intervention was implemented within the study period. At baseline 100% of sewing machine operators were sewing in the seated work posture. Early in the study, 17.9% of them changed their work posture from seated to stand-up, 30.1% changed to the stand-up work posture in January 2007, and 34.9% a year later. The last 17.1% remained seated till the last year of the study period. From July 2008, 100% of the sewing-machine operators were sewing in the stand-up work posture. The results indicated two strong associations of risk factors and a change in work posture with WRMSDs. Obesity (specifically morbid obesity) was a personal risk factor for upper limb disorders and working in the stand-up work posture was protective for spinal disorders, compared to working in the seated work posture. Furthermore, the results indicated a high incidence of disorders (specifically of the spinal area and upper limb) during the first three months of the programme, as well as an increased incidence of lower leg disorders for the first and consecutive month of the change in work posture from seated to standing up. Lower limb disorders were specifically associated with obesity. The increase of lower limb disorders during the postural adaptation phase was temporary, and was addressed within the programme with proper shoe wear, silicone innersoles, supportive stockings and exercises. The combination proved to be effective in preventing and/or managing lower limb disorders. The outcome of the current study provided evidence on the incidence of WRMSDs, and associations between risk factors and work posture, and WRMSDs among sewing machine operators managed within the programme. / Dissertation (MPhysT)--University of Pretoria, 2013. / Physiotherapy / unrestricted

According to the World Health Organization, physical inactivity is the fourth largest cause of global mortality. To promote health, reduce the risk of disease, prevent premature death, and maintain/improve exercise capacity it is recommended that all adults are physically active for at least 150 minutes/week of moderate intensity. Employers have an important role to encourage employees to a healthy lifestyle. Regularly physically active have higher physical resistance, higher stress tolerance, better performance, increased motivation and higher productivity. Machine operators has a sedentary job, repetitive movements and long shifts and are exposed to whole body vibrations which could contribute to musculoskeletal disorder. The aim was to survey machine operators’ physical activity and the prevalence and cause of functional limitation in work due to pain. A further purpose was to investigate if and how the machine operators believe that the employer can promote physical activity? The method was quantitative method. The results show that 8/9 of the machine operators in the study are physically active for more than 150 min/week of moderate intensity. There is pain and functional limitation in the work but this can´t be explained by sex, age, BMI or activity level. Respondents believe that the employer can promote physical activity through smaller grants, access to the gym and exercise during working hours.

Syfte. Att kartlägga förekomsten av muskuloskeletala besvär hos kvinnlig och manlig ambulanspersonal och att analysera muskuloskeletala besvär i relation till kön, ålder, anställningstid, utbildning och självskattad fysisk belastning. Bakgrund. Arbetsbelastningen för ambulanssjukvården ökar världen över. Arbetet i ambulans innefattar hög fysisk belastning vilket medför hög risk för muskuloskeletala besvär där smärtor i nedre delen av ryggen är dominerande. Design. En kvantitativ tvärsnittstudie med deskriptiv och jämförande design. Metod. Studien genomfördes genom en webbaserad enkät som besvarades av kvinnlig (n=24) och manlig (n=62) ambulanspersonal verksamma på fyra orter i Sverige. Enkäten omfattade bakgrundsinformation om deltagarna. Frågor om de upplevt besvär i nacke, bröstrygg, ländrygg eller axlar/skuldror de senaste sju dagarna samt självskattad fysisk belastning vid stationsarbete och utryckning. Analyser gjordes i statistikprogrammet SPSS 23.0 med t-test och chi 2-test. Resultat. Kvinnlig ambulanspersonal rapporterade 8 (33 %) att de upplevt besvär i nacke, 6 (25 %) i bröstrygg, 11 (46 %) i ländrygg och 6 (25 %) i axlar/skuldror. Manlig ambulanspersonal rapporterade 18 (29 %) att de upplevt besvär i nacke, 15 (24 %) i bröstrygg, 31 (50 %) i ländrygg och 19 (31 %) i axlar/skuldror. Totalt rapporterade 53 (62 %) deltagare att de upplevt besvär. Resultatet visar högre grad av självskattad fysisk belastning vid stationsarbete hos deltagarna med muskuloskeletala besvär. Slutsats. Muskuloskeletala besvär är vanligt förekommande hos ambulanspersonal. Det finns ett behov om ökad kunskap om orsaker till muskuloskeletala besvär och hur dessa kan förebyggas för att främja god hälsa hos ambulanspersonal. Forskning kan fokusera på hur ambulanspersonal med muskuloskeletala besvär upplever sin hälsa och om ambulanspersonalen upplever begränsning i arbetet relaterat till besvären. / Aim. To identify the prevalence of musculoskeletal disorders among female and male ambulance personnel and analyze musculoskeletal disorders in relation to gender, age, employment and rate of perceived exertion. Background. Workload for the ambulance service increases worldwide. Working in an ambulance includes high physical strain that leads to high risk of musculoskeletal disorders where pain in the lower part of the back is dominant. Design. A quantitative cross-sectional study with descriptive and comparative design. Method. The study was conducted using an online survey answered by female (n=24) and male (62) ambulance personnel working in four ambulance stations in Sweden. The questionnaire included background information about the participants and questions about self-reported musculoskeletal disorder in neck, upper back, lower back or shoulders for the last seven days as well as physical strain at station work and emergency call outs. Analyses were conducted in SPSS 23.0 whit independet t-test and chi-square test. Results. Of the female ambulance personnel eight (33 %) reported discomfort in the neck, 6 (25 %) at the upper back, 11 (46 %) at the low back and 6 (25 %) in the shoulders. Among male ambulance personnel reported 18 (29 %) discomfort at the neck, 15 (24 %) at the upper back, 31 (50 %) at the low back and 19 (31 %) in the shoulders. Totally 53 (62 %) reported some form of musculoskeletal disorder. The results show higher levels of self-reported physical strain at station work among participants with musculoskeletal disorders than those without. Conclusion. Musculoskeletal disorders are common among ambulance personnel. There is a need for more knowledge about the causes of musculoskeletal disorders and prevention of these to promote good health among ambulance personnel. Research may focus on how ambulance personnel with musculoskeletal disorders perceive their health, and if ambulance personnel are experiencing limitation in work related to musculoskeletal disorders or not.

A good work environment is important for the individual, for industry and for society. The work environment research has, predominantly, targeted identification of problems and the measurement of the size of these problems. Innovations to reduce the incidence of musculoskeletal disorder, MSD, have been introduced in different branches of industry, but with limited success. Few of the ergonomic innovations developed for the building and construction industry have reached a sufficient level of adoption. Ergonomic innovations in the health care sector are of an incremental character and seem to have similar problems of adoption as the ones in the building and construction industry. Three examples of ergonomic innovation are examined in the thesis: a glue spreader for floor layers a four-wheel walker with a lifting device a sonographer’s scanning support device The studies show that an ergonomic innovation is not adopted for prevention of occupational injury unless the innovation also has other relative advantages apart from the ergonomic ones. For the group who already has sustained an injury, it is enough that the ergonomic problems are solved, while the other, symptom-free group, requires other advantages in order to adopt the innovation; increased production economy seems to be the most prominent potential advantage. / <p>QC 20150114</p>

Background Musculoskeletal disorders (MSDs) are one of the most important causes of temporary and permanent disability, causing acute or persistent pain, resulting in reduced and/or lost ability to work. Return to work (RTW) is multidimensional problem including many different factors and aspects. Few recent studies have analyzed factors predicting RTW after multimodal rehabilitation (MMR). Identification of predictors for RTW may help to improve the planning and optimization of the RTW strategy. The REHSAM II project is a randomized controlled trial with the aim to evaluate if MMR together with a web Behavior Change Program for Activity could increase work ability among persons with persistent MSDs as compared to MMR. Therefore the aim of this study was to identify factors explaining RTW 12 month after baseline in the REHSAM II project. Methods The present study is a secondary assessment of the data from the randomized controlled trial REHSAM II. A total of 97 participants with persistent musculoskeletal pain were randomly allocated to MMR + web-based education or only MMR group. The subjects were followed from baseline to 12 months. Information on potential predictors was obtained from self-administered questionnaires. Data were analyzed with univariate and multiple logistic regression models. Results In the final multiple regression model RTW was predicted by the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ score) (p=0.003, OR=0.961) and EuroQol (EQ-5D index) (p=0.017, OR=7.283). The univariate regression analyses showed that pain and disability level, the capacity to perform a task in relation to pain and other symptoms, hospital and psychiatric care, medication for insomnia, catastrophizing, self-assessed work ability compared with the lifetime best, satisfaction with life, ability for coping and controlling work situation, ability for coping with life outside work and sense of responsibility for managing health condition were significantly associated with RTW. Conclusion In conclusion, psychosocial pain-related variable and health-related quality of life predicted RTW in the final model. The result confirms the fact that RTW is a multidimensional problem involving a complex interaction of many factors.

Title: Evaluation of musculoskeletal disorders in pianists Background: Musculoskeletal (MS) disorders are common in pianists. Allsop and Ackland (2010) in their study describe that pianists suffer from MS disorders in 42 %. However, the prevalence of MS disorders differs depending on the region. There has not been done yet any evaluation of prevalence of MS disorders in pianists in Czech republic. This evaluation is crutial to make a comparison of our national results internationally. Furthermore, it is required to establish well-prepared preventional program for starting pianists. Aims: The purpose of this study is to evaluate prevalence of musculoskeletal disorders in pianists. Methods: Our data were collected using questionnaire survey. We distributed questionnaires among czech profesional pianists, piano teachers, and piano students by emails who were older than 18. Results: We sent 390 questionnaires by emails and received 78 of them completed. We revealed that the prevalence of musculoskeletal disorders of all respondents was 72 %. The prevalence was the highest in the group of the age from 18 to 60 reaching 90 %. The most common locality of musculoskeletal disorder was in the forearm. The group of pianists who started to play piano at the age from 3 to 4 were more prone to present with...

Os trabalhadores de enfermagem submetem-se constantemente às condições de trabalho inadequadas, o que os sujeita às lesões musculoesqueléticas, principalmente nas unidades de cuidado a pacientes críticos e com alto grau de dependência. Assim, este estudo tem por objetivo apreender os sintomas de Distúrbios Osteomusculares Relacionados ao Trabalho (DORT) entre os trabalhadores de enfermagem, seus determinantes e possibilidades de prevenção. O estudo caracteriza-se como de caso, descritivo, de abordagem quanti-qualitativa, fundamentado na determinação social do processo saúde-doença. A população de estudo foi de 61 trabalhadores de enfermagem de uma unidade de terapia intensiva geral, em um hospital público e universitário do estado de São Paulo. Os dados foram coletados por meio de um formulário composto por três partes: Dados de Identificação, Questionário Nórdico de Sintomas Musculoesqueléticos e Relação Trabalho x DORT. A análise dos dados quantitativos foi realizada segundo a estatística descritiva e os dados qualitativos foram submetidos à análise temática. Foram realizadas 27 entrevistas (44,26%), optando-se por complementar a parte quantitativa da pesquisa com mais 17 trabalhadores que responderam apenas as duas primeiras partes do formulário, totalizando 44 participantes (72,13%). Como resultados, obtivemos que 32 participantes (72,72%) são do sexo feminino, 19 (43,18%) trabalham no período noturno e 23 (52,28%) são técnicos de enfermagem. A média de idade foi de aproximadamente 37 anos, o IMC médio foi de 26,33 kg/m², e a média de tempo de serviço na instituição foi de 8,94 anos, sendo que 10 trabalhadores (22,73%) possuem mais de um vínculo empregatício. O Questionário Nórdico evidenciou que todos os trabalhadores entrevistados apresentaram algum sintoma musculoesquelético nos últimos 12 meses, sendo a região superior das costas (65,90%), a região inferior das costas (63,63%) e os ombros (61,36%) os locais mais afetados. Apesar dessa freqüência, poucas pessoas foram impedidas de realizarem suas atividades diárias (38,63%), e essa mesma porcentagem de trabalhadores procurou algum profissional de saúde por causa desses sintomas. Os dados evidenciam que a população, apesar de sintomática, continua trabalhando e convivendo com os sintomas musculoesqueléticos, referindo fazer uso de analgésicos sem prescrição médica, para conseguir trabalhar ou descansar após a jornada. A análise dos discursos permite verificar que a maioria dos trabalhadores entende que as condições de trabalho são os fatores determinantes para o surgimento desses sintomas osteomusculares, como a manipulação de peso excessivo, as posturas inadequadas, o trabalho repetitivo, dentre outros. Dentre as propostas de intervenção citadas pelos trabalhadores, estão a melhora da postura através de treinamentos, trabalho em equipe, ginástica laboral e técnicas de relaxamento, mudanças de equipamentos, entre outras. A análise dessas propostas subsidiou a criação do manual Prevenindo Sintomas Musculoesqueléticos no ambiente hospitalar, para ser utilizado no treinamento da equipe sobre as posturas corretas durante o trabalho. Outras medidas são sugeridas, dentre elas, o re-estudo do dimensionamento do pessoal de enfermagem e a sua adequação, a criação de um programa de ginástica laboral e de um local de descanso para os trabalhadores. Após a implementação dessas mudanças, sugerimos um estudo comparativo sobre a ocorrência de sintomas musculoesqueléticos na população de estudo, para avaliar a efetividade da intervenção. / Nursing professionals are constantly subject to inadequate working conditions, mostly in units with critically ill patients with a high degree of dependence, making them more inclined to develop musculoskeletal injuries. The present study aims to understand the symptoms of Work Related Musculoskeletal Disorders (WRMD) among nursing workers, their determinants and possible prevention. This study is a descriptive case, with a quantitative and qualitative approach, based on the social determinants of the health-disease process. The studied population included 61 nurses working at an intensive care unit in a public university hospital in Sao Paulo state. Data were collected based on a three-part form: Personal Data, Nordic Musculoskeletal Questionnaire, and Work x WRMD Relation. The quantitative analysis was performed using descriptive statistics, and the qualitative data were subjected to thematic analysis. 27 interviews were performed (44.26%), and to complement the quantitative analysis 17 additional workers were chosen to answer only the two first parts of the form, concluding with a total of 44 participants (72.13%). The data analysis indicates that 32 participants are female (72.72%), 19 works at night (43.18%), and that 23 are nursing technicians (52.28%). Mean age was approximately 37 years, the Body Mass Index (BMI) mean was 26.33 kg/m², and the average length of service at the institution was 8.94 years. 10 workers (22.73%) declared that they have more than one job. The analysis of the Nordic Questionnaire revealed that all interviewed nurses presented some musculoskeletal symptoms in the past 12 months, and that the most affected body regions were the upper back (65.90%), the lower back (63.63%) and shoulders (61.36%). Despite the fact that all workers presented symptoms, only a few of them were not able to carry on with their daily activities (38.63%). The same percentage of workers looked for a professional of health due to these symptoms. The data showed that the population continues to work and to live with the musculoskeletal symptoms, in spite of the pain. They prefer to make use of pain killers without medical prescription to be able to work or to rest after the work journey. The interviews revealed that the majority of workers know that working conditions such as handling of overweight, poor posture, repetitive work, and others, are the determining factors for the emergence of musculoskeletal symptoms. Nursing workers proposed several interventions to improve their working conditions. For example, the development of a training to improve their posture, team work, gymnastics and relaxation techniques, replacement of equipments, among others. The analysis of these proposals supported the creation of a Preventing Musculoskeletal Symptoms in the hospital environment manual, to be used when training the nurses team to have a good posture during work. Additional proposals were suggested, such as the re-study of nurses dimensioning and appropriateness, and the generation of a gymnastic program and a resting place for workers. After the adoption of these proposals, we suggest that a study is performed to compare the occurrence of musculoskeletal symptoms within the studied population, to evaluate the outcome of the intervention.

INTRODUÇÃO: A dor pélvica crônica (DPC) é uma condição comum, de etiologia complexa e pouco compreendida. Há evidências de que o sistema musculoesquelético possa estar comprometido, embora estudos que avaliem o padrão de movimento deste grupo ainda sejam escassos. OBJETIVO: Avaliar objetivamente a marcha de mulheres com DPC através de variáveis cinemáticas e espaço-temporais, e verificar possíveis correlações das alterações encontradas. MÉTODOS: Estudo de coorte transversal, incluindo 20 mulheres com diagnóstico de DPC, que foram recrutadas no Hospital das Clínicas da Universidade de São Paulo, e 20 voluntárias saudáveis (grupo controle). Utilizou-se a análise de marcha tridimensional para obtenção dos dados referentes à amplitude de movimento, arco de movimento, momento e potência dos segmentos de pelve, quadril, joelho, tornozelo e pé, além de variáveis espaço-temporais. O teste não paramétrico de Mann-Whitney foi aplicado para comparar a distribuição dos grupos em relação às variáveis quantitativas, e a correlação de Spearman foi utilizada entre as variáveis que apresentaram diferença significativa e as variáveis com tampa, escala visual analógica (EVA), tempo de dor, escala de medida de ansiedade e depressão (HAD) e índice McGill de dor (McGill). RESULTADOS: Mulheres com DPC apresentaram alterações na marcha quando comparadas ao grupo controle. As variáveis cinemáticas comprometidas foram: momento de extensão, flexão e rotação interna de quadril; flexão, extensão, rotação interna e externa de joelho; dorsiflexão e adução de tornozelo e rotação interna e externa de pé; potência de quadril e tornozelo; amplitude de movimento de desvio valgo e varo de joelho, dorsiflexão e flexão plantar de tornozelo e arco de movimento de flexão à extensão de joelho e de dorsiflexão à flexão plantar de tornozelo. Já as variáveis espaço-temporais alteradas foram: velocidade da marcha, comprimento da perna e do passo. Notamos ocorrência de correlação eventual, mas não sistemática. CONCLUSÃO: Mulheres com DPC apresentam alterações na marcha quando comparadas a mulheres saudáveis, sendo que as mais expressivas referem-se às variáveis cinemáticas e espaçotemporais. Notamos correlações eventuais, mas não sistemáticas em nossa amostra. Estes achados sugerem a necessidade de uma avaliação mais detalhada, para que se obtenha melhores diagnósticos e tratamentos mais eficazes. / INTRODUCTION: Chronic pelvic pain (CPP) is a common condition of complex etiology and poorly understood. There is evidence that the musculoskeletal system may be compromised although studies evaluating the motion pattern of this group are poorly. OBJECTIVES: To evaluate objectively the progress of women with CPP throught kinematic and spatiotemporal variables and verify possible correlations of the changes found. METHODS: A cross-sectional cohort study included 20 women with CPP diagnosis, who were recruited at the Hospital of the University of São Paulo, and 20 healthy volunteers (control group). We used the three-dimensional gait analysis to obtain data on the range of motion, range of movement, momentum and power of the pelvis segments, hip, knee, ankle and foot, and spatiotemporal variables. The nonparametric Mann-Whitney test was used to compare the distribution of the groups in relation to quantitative variables, and the Spearman correlation was used between the variables that showed a significant difference and the variables with tampa, VAS (visual analogue scale), time pain, McGill and HAD (measure scale anxiety and depression). RESULTS: Women with CPP present changes in gait when compared to the control group. Kinematic variables compromised were: moment extension, flexion and internal rotation of the hip; flexion, extension, internal and external rotation of the knee; dorsiflexion and adduction of the ankle and internal and external rotation of the foot; Power hip and ankle; deviation of motion valgus and varus knee, dorsiflexion and plantar flexion of the ankle and range of movement knee extension to flexion and dorsiflexion plantar flexion of the ankle. Already spatio-temporal variables altered were: gait speed, leg length and Step. We note occurrence of any correlation, but unsystematic. CONCLUSION: Women with CPP have gait changes compared to healthy women, and the most significant refer to kinematic and spatiotemporal variables. We note possible correlations, but not systematic in our sample. These findings suggest the need for further evaluation, in order to get better more effective diagnosis and treatment.