Musculoskeletal pain is one of the most common illnesses among the people in NE Thailand which is commonly treated by self-medication. Ya-chud (several medicines together in a small plastic bag) for the treatment of musculoskeletal pain is an illegal treatment but has been used by lay people for more than 20 years. A better understanding of the people's perception of and behaviour in taking Ya-chud for treatment of musculoskeletal pain should help in designing an effective implementation programme to reduce the taking ofYa-chud. The study group was 15 years old and over and lived in 2 rural (N = 619) and 2 urban (N = 494) areas of NE Thailand. The study method used individual interviewing. The study aimed to investigate self-treatment of musculoskeletal pain with and without Ya-chud in the urban and rural areas. The attitudes of Ya-chud users in the urban (N = 136) and the rural (N = 128) were measured using a 6 point Likert Scale with a Conbach's alpha coefficient of 0.7509. Comparative analyses of variables between these two areas and between the users and non-users were conducted. Indepth interviews and laboratory analysis of Ya-chud samples were carried out to obtain more detailed information. The study found that Ya-chud for musculoskeletal pain was often used as the alternative treatment to treat pain which occurred at many locations of the body at the same time when the previous outcome had been unsatisfactory. The discriminant stepwise analysis showed that 85.9 percent of Ya-chud users in both rural and urban areas were 25 years old and over and had an education level of primary/secondary school. The overall prevalence of Ya-chud users in the rural areas was higher than in the urban areas but the prevalence of those who had taken Ya-chud within one year was greater in the urban areas. Ya-chud use varied with the season. It peaked during periods of heavy work such as harvesting. The main source of Ya-chud was groceries (82.3 percent in the urban and 79.6 percent in the rural). People had the perception that Ya-chud was a potent drug, cheap and had beneficial effects. They also perceived that the specific name of Ya-chud was easy to remember and described their symptoms. Attitudes towards Ya-chud were positive in the rural areas but negative in the urban areas (p < 0.01). Most of the respondents did not know the harmful effects of Ya-chud. The study showed that the locations of pain for nonusers were not different from the users and also that the treatment outcome after taking Ya-chud was predominantly 'no change' (46.2 percent in the rural and 44.6 . percent in the urban) (p < 0.01). The results from the Ya-chud users in-depth interviews indicated that in the urban areas there was more use of massage, rest and health services for the treatment of musculoskeletal pain but in the rural areas medicines from the drug stores were more often used (p < 0.01). Only 10.9 percent of the respondents could be cured by the above treatments in the urban areas and 4.4 percent in the rural areas (p > 0.05). After taking Ya-chud the result of treatment was a 'cure' for 45.5 percent of users in the urban and for 35.3 percent of users in the rural areas (p > 0.05). Identification of the medicines contained in a packet showed that steroids, NSAIDs and tranquillisers were most often combined in a package. It can be concluded that Ya-chud for musculoskeletal pain is not only unnecessary but also a dangerous use of these hazardous medicines which mask the symptoms rather than cure the illness. Intensive and continuous education campaigns together with legal enforcement should be beneficial for a short term programme to reduce Ya-chud use. Long term programmes should focus on providing licensed dispensers in every drug store so that the lay people can gain more helpful knowledge about medicines and so that legal enforcement can be better implemented since pressure could then be brought to ensure such licensed dispensers complied with legislation.

<p>Syftet med studien var att undersöka förekomst av smärta som hindrade aktivitet hos barn och ungdomar med övervikt eller fetma. Samt att se förekomst av obehagskänslor inför och under fysisk aktivitet. Studien gjordes på 26 barn och ungdomar i åldrarna 8-19 år med övervikt eller fetma samt en grupp med 26 normalviktiga barn och ungdomar i åldrarna 10-19 år. Data samlades in genom en enkätundersökning på Överviktsenheten för barn och ungdomar på Akademiska sjukhuset i Uppsala och genom dietister i primärvården i Uppsala läns landsting samt genom personliga kontakter. Studien visade att smärta förekom i båda grupperna och ingen skillnad kunde påvisas mellan de båda. Däremot visade resultaten  att barnen och ungdomarna med övervikt eller fetma skattade att de inte kunde delta i aktivitet på grund av smärta i större utsträckning än barnen och ungdomarna med normalvikt. Barnen och ungdomarna med övervikt eller fetma skattade också mer obehag inför och under fysisk aktivitet i jämförelse med normalviktiga barn och ungdomar.</p>

Syftet med studien var att undersöka förekomst av smärta som hindrade aktivitet hos barn och ungdomar med övervikt eller fetma. Samt att se förekomst av obehagskänslor inför och under fysisk aktivitet. Studien gjordes på 26 barn och ungdomar i åldrarna 8-19 år med övervikt eller fetma samt en grupp med 26 normalviktiga barn och ungdomar i åldrarna 10-19 år. Data samlades in genom en enkätundersökning på Överviktsenheten för barn och ungdomar på Akademiska sjukhuset i Uppsala och genom dietister i primärvården i Uppsala läns landsting samt genom personliga kontakter. Studien visade att smärta förekom i båda grupperna och ingen skillnad kunde påvisas mellan de båda. Däremot visade resultaten  att barnen och ungdomarna med övervikt eller fetma skattade att de inte kunde delta i aktivitet på grund av smärta i större utsträckning än barnen och ungdomarna med normalvikt. Barnen och ungdomarna med övervikt eller fetma skattade också mer obehag inför och under fysisk aktivitet i jämförelse med normalviktiga barn och ungdomar.

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INTRODUCTION: While strengthening and aerobic exercise have been shown to decrease chronic knee and hip pain, little is known about the effectiveness of Egoscue corrective exercises, which are intended to reduce musculoskeletal pain by bringing the body into postural alignment. PURPOSE: An experimental study to determine the acute effect following one treatment and the short-term effect after a 2 week program of Egoscue corrective exercises on knee pain, hip pain, and whole-body postural alignment. METHODS: Forty participants with chronic knee and/or hip pain (defined as pain on most days of the week for at least the previous 12 weeks) were randomly assigned and equally divided between an exercise group (n = 20) and a control group (n = 20). The exercise group completed a corrective exercise routine, as per the Egoscue Method, at least 5 d/wk for two weeks. The control group simply maintained their current lifestyle for the 2-week duration of the study. All participants kept a daily log of their average pain levels at rest and during movement using a Visual Analog Scale (VAS). Standing posture was assessed using PostureScreen Mobile® and pain and function were recorded using the Western Ontario and McMaster Universities Arthritis Index (WOMAC) at baseline and at the end of week 1 and 2. RESULTS: The exercise group experienced a significant decrease in pain during everyday movement as reported in daily VAS logs (p = 0.019). After controlling for age, BMI, past surgeries, arthritis status, and location of pain, there was a significant group x time interaction in WOMAC scores (p = 0.015). At week 2, WOMAC scores were significantly lower in the exercise group (p = 0.001) but not the control group (p > 0.05). Pain was not significantly different after one treatment. No significant changes in posture were observed in this study. CONCLUSION: Two weeks of corrective exercises significantly decreased knee and hip pain and improved function. Although an observable change in posture was not detected, further research is warranted to investigate the effects of Egoscue corrective exercises on posture over longer periods of time.

Bakgrund: Stillasittande under längre perioder associeras med smärta i bland annat ländrygg. Med covid-19 pandemin blev hemarbete ett faktum och all kommunikation var tvungen att ske via en dator. Detta bidrog till att stillasittandet ökade drastiskt och forskning har visat på att detta var en bidragande faktor till uppkomsten av muskuloskeletala smärtor. Syfte: Syftet med studien var att kartlägga muskuloskeletal smärta vid hemarbete under covid-19 pandemin avseende kön, ålder och antal suttna timmar. Metod: En enkät utformades i Google Forms som därefter publicerades på författarnas facebookprofiler samt skickades ut till ett företag. Respondenterna var 46 stycken fördelat på 31 kvinnor, 14 män och 1 “annat”. Enkäten var öppen i 4 veckor. Efter avslutad svarstid sammanställdes och analyserades datan i ett valt analysprogram. Resultat: Kvinnor och mäns medelvärde på Numeric Rating Scale (NRS) skilde sig ytterst lite. Det framkom att det inte var någon skillnad mellan antalet suttna timmar på en arbetsdag hos män och kvinnor. 14 deltagare hade tidigare skador som påverkade dem. Personer mellan 18-40 år hade högre medelvärde på NRS än personerna i åldersgruppen 41-64 år. Konklusion: Resultatet gav en indikation på att personer upplevt smärta vid hemarbetet på grund av covid-19. Dock finns ett behov av att utföra fler studier kring korrelationen mellan kön och smärta samt hur hemarbete påverkar de olika åldersgrupperna. Dessa studier bör ha ett större deltagarantal.

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Background: Firefighters (FFs) are exposed to life-threatening conditions while carrying out their tasks. These strenuous conditions predispose them to a high rate of disability, morbidity and mortality. These hazardous conditions put them at risk for work limitations, but the literature is scarce in this matter. Objective: The overarching objective of this thesis is to determine the role of FFs health as predictors of work limitations in fire service. Specifically, the first objective is to determine whether work limitations differ among FFs based on the location or number of painful sites. The secondary objective is to determine whether non-musculoskeletal comorbid health condition predict work limitations among FFs. Participants: A convenience sample of FFs between the age of 18-60 years working in the province of Ontario, Canada. Methods: Participants completed either an online or paper-based survey including a work limitation questionnaire(WLQ-26) and a self-reported comorbidity questionnaire. For the first objective, a one-way ANOVA and post hoc test was used to determine the differences in work limitations among FFs based on the number or location of painful sites. For the secondary objective, a univariate linear regression was used to evaluate whether non-MSK comorbid health condition predict work limitations among FFs. Results: FFs with three or more painful sites had more physical limitations than FFs without pain, (Mean difference=1.03/10; 95% CI: 0.16-1.62; p=0.02). FFs with pain at the region of the spine experienced more physical limitations compared to FFs with no pain (Mean difference=0.89/10; 95% CI: 0.17-1.62; p=0.007). For the secondary objective, univariate analysis showed that having at least one comorbidity(p=0.04) had a small, but significant association with greater mental work limitations (F2,316=2.94; p=0.05; R2=0.02). Separate univariate analysis showed that women FFs having one comorbidity had a small but significant association with physical (R2=0.07; F2,97=3.92, p=0.02) and mental work limitations (R2=0.04; F2,101=1.89, p=0.15) than women without non-MSK comorbidity. Conclusion: Having multiple painful sites or pain at the spinal region influenced work limitations among FFs. Also, non-MSK comorbidity impacted mental limitations among FFs; especially among women FFs. Therefore, managing MSK and on-MSK comorbidities is a necessary health care goal to prevent work limitations. / Thesis / Master of Science (MSc)

Professional drivers of off-road vehicles, driving on irregular terrain such as in forestry, agriculture and mining, are exposed to whole-body vibration and mechanical shocks. These driver groups have reported severe musculoskeletal problems in the spine, but the association to seated postural reactions is not fully understood. One assumption is that unexpected shocks may create excessive load on spinal joints. The driver’s posture and exposure to mechanical shocks are required to be included in work risk assessments, but muscle activity and body kinematics are not included. The overall aim of this thesis was to describe and analyse seated postural reactions to mechanical shocks and to evaluate measuring of seated postures with relevance for risk assessment and the prevention of musculoskeletal disorders among drivers. The thesis includes four studies, all laboratory-based using a repeated-measures design. Postural reactions were recorded from 23 (Paper I) and 20 (Paper II &amp; III) young, healthy male participants who were seated on a movable platform. The platform delivered mechanical shocks with peak accelerations up to 14 m/s2 in lateral directions during different conditions. Furthermore, twenty participants (Paper IV) were tested by four testers for analysis of test-retest reliability within and between testers measuring seated postures. Kinematics were here detected by means of a motion analysis system (MoLabTM) and described for the spine as angular displacements or range of motion (ROM) using a three-segment model of neck, trunk and pelvis (Paper I–III) and as a more specific model (Paper IV). Surface electromyography (EMG) was recorded bilaterally on the following muscles; trapezius upper part, upper neck, erector spinae and external oblique (Paper I–III). The general findings show that EMG amplitudes normalised to maximum voluntary contractions (MVC) did not exceed 2% in the trapezius, 8% in the upper neck and erector spinae and 18% in the external oblique. The EMG amplitudes and the angular displacements in the neck were significantly reduced from the first compared to the fifth mechanical shock. Adding a cognitive task significantly increased angular displacements. The largest ROM with approximately 20° in each segment was found during a double-sided mechanical shock (shock that changes direction). The reliability within one tester measuring seated postures was mostly considered good and superior to the reliability between several testers, but still insensitive to changes of less than 10°. Exposure to single-sided or double-sided mechanical shocks with accelerations up to 14 m/s2 seem not to cause postural reactions to such an extent that overload of muscles or joint structures should be expected. There seems to be a quick adaptation that causes an improved readiness. The external obliques were most active when restoring equilibrium and seem important for stabilising the whole spinal column. Stability training, in order to improve neuromuscular control of the external obliques could, therefore, be a possible recommendation. The angular displacement in the neck increases if the subject solves a cognitive task of why such activities should be avoided when driving in difficult terrains. Since accurate descriptions of the spinal posture seems difficult even when advanced technical equipment is used, simpler models seem more appropriate. The results show that postural control is maintained even when exposed to considerable mechanical shocks. On the basis of these results, there is no need to change established risk assessment models.

Thesis (MScPhysio (Physiotherapy))--Stellenbosch University, 2008. / The Western Cape Education Department initiated a project that aims to provide all the learners from the province with computer access and to promote computer use in schools. Prolonged sitting in front of computers and psychosocial factors have been associated with musculoskeletal symptoms internationally. However, the impact of computer use on musculoskeletal pain among South African high school learners is yet to be determined. Objective The objective of the study was to determine whether sitting postural alignment and psychosocial factors contribute to the development of upper quadrant musculoskeletal pain in grade ten high school learners working on desktop computers. Study design An observational analytical study was performed on a sample of 104 asymptomatic high school learners. Methodology Six high schools in the Western Cape metropole were randomly selected 322 grade ten learners who are using desktop computers, were screened for upper quadrant musculoskeletal pain. Measurements at baseline were taken of the 104 asymptomatic learners, 49 girls and 55 boys. The sitting postural alignment was measured by using the Portable Posture Analysis Method (PPAM), which measured head tilt; cervical angle; shoulder pro- and retraction angle and thoracic angle in the sagittal plane. Depression and anxiety were described by using the Beck Depression Inventory (BDI) and the Multidimensional Anxiety Scale for Children (MASC) respectively. The exposure to computer use was described in terms of duration and frequency of daily and weekly computer use. At three and six months post baseline, the onset and area of upper quadrant musculoskeletal pain was determined by using the Computer Usage Questionnaire. Results After six months, 27 of the 104 learners developed upper quadrant musculoskeletal pain due to seated or computer-related activities. There was no difference in computer exposure between the learners who developed upper quadrant musculoskeletal pain symptoms and the learners who remained asymptomatic. An extreme cervical angle (<34.75° or >43.95°; OR 2.6; 95% CI: 1.0-6.7) and a combination of extreme cervical and thoracic angle (<63.1° or >71.1°; OR 2.19; 95% CI: 1.0-5.6) were significant postural risk factors for the development of upper quadrant musculoskeletal pain. There was a tendency for boys to be at a greater risk for upper quadrant musculoskeletal pain than the girls (OR 1.94; 95% CI: 0.9-4.9). Weight greater than 54.15kg and a depression score greater than 11 was found to be significantly associated with a poor posture (OR 3.1; 95% CI: 1.0-9.7; OR 1.02; 95% CI: 1.0-1.1). Discussion and conclusion The study concluded that poor posture, relating to extreme cervical and thoracic angles, is a risk factor for the development of upper quadrant musculoskeletal pain in high school learners working on desktop computers. South African boys were at a greater risk of developing upper quadrant musculoskeletal pain than the girls. However the study found no causal relationship between depression, anxiety and upper quadrant musculoskeletal pain among South African high school learners and computer usage.