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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Neck pain in women : effect of tailored treatment and impact of work environment / Nacksmärta hos kvinnor : effekten av individanpassad rehabilitering och betydelsen av arbetsmiljöfaktorer

Svedmark, Åsa January 2017 (has links)
Introduction: Musculoskeletal pain is a common problem in the working population. In Sweden, 40% of women and 30% of men report suffering from neck and shoulder pain weekly. The underlying cause for neck pain is often not known and the treatment is commonly guided by the individual’s symptoms. However, there is a lack of knowledge on how to receive the best effect based on the individual’s symptoms and functional limitations, and therefore this has been scarcely evaluated in research. Furthermore, the impact of work exposure and stress on long-term treatment for persons with neck pain is not clear. Aims: To develop (paper 1) and to evaluate a decision model for tailored treatment in women with neck pain (paper 2). Moreover, to determine if risk factors at work and stress influence intermediate and long-term treatment results (paper 3). Further, to investigate if changes in self-reported pain and disabilities are associated with changes of physical test outcomes of the neck and shoulder region after treatment (paper 4). Methods: In an RCT, 120 working women with non-specific neck pain were randomized to three different groups – tailored treatment (TT), non-tailored treatment (NTT) or treatment-as-usual (TAU) for an 11 weeks intervention with short-term, intermediate-term and long-term follow-ups. The TT group was guided by a decision model with cut-off levels to indicate impairments. The NTT group received two established treatment components randomly from those not indicated, and TAU group did not receive any treatment within the study. The RCT primary outcomes were self-reported neck pain and neck disability. A linear mixed model was used for analysing the effects. One week after the end of intervention work exposure and stress were assessed at a work-place visit and associations to treatment results were tested for, and mixed models were used to estimate longitudinal associations. Associations between self-reported neck problems and physical outcomes were estimated with univariate and multiple regressions analysis. Results: No differences between TT and NTT were revealed for neck pain and disability. In comparison to TAU, the TT and NTT groups both showed improvements at short-term follow-up, but not at intermediate and long-term follow-up. High stress level and low self-estimated control at work were associated with more pain and disability at the intermediate and long-term follow-ups. After intervention and at the intermediate-term follow-up, reduced neck pain, disability and frequency of symptoms were associated with increased peak speed of head rotation and cervical range of motion. Conclusion: Tailored treatment according to the decision model was not superior to the non-tailored treatment in women with non-specific neck pain. One explanation for this can be the weak relationships found between neck pain and disability and physical test outcomes. Further, perceived stress and psychosocial work exposure were associated with self-reported neck problems and should be taken into account to optimize the effects in neck pain rehabilitation. / Bakgrund: Nack- och skulder-smärta är ett vanligt tillstånd som förekommer över hela världen. I Sverige skattar 30-40% besvär från nacke och skuldror mätt under en veckas tid. Generellt rapporterar kvinnor mer nack- och skulder-besvär än män. I avhandlingen är det ospecifik nacksmärta som har studerats, det inkluderar inte t.ex. Whiplash-skador, diskbråck eller andra mer specifika diagnoser. Den bakomliggande orsaken till ospecifik nacksmärta är, precis som beteckningen antyder, ofta inte känd och individens symptom och funktion är istället vägledande i undersökning och behandling samt utvärdering av behandling. Studier har visat att i jämförelse med friska har individer med ospecifika nackbesvär ofta sämre muskulär nackstyrka, minskad rörlighet i nacken och är något långsammare vid test av huvudrörelser. Behandlingen riktar sig ofta mot något av dessa fynd med bl.a. styrketräning av nackmuskler och/eller manuella tekniker för rörelseökning. Studier har dock visat att behandlingen endast ger måttliga resultat och att de positiva resultaten bara är kortvariga. I kliniken försöker man individanpassa behandlingen utifrån patientens behov men det finns väldigt lite forskning om detta utan studier utvärderar likadan behandling för hela grupper. Det saknas fortfarande kunskaper om hur man på bästa sätt individanpassar behandling så att den blir skräddarsydd utifrån individens symptom och funktion samt utvärderar detta. Syftet med avhandlingen var att undersöka om en intervention med skräddarsydd behandling (som också innehöll specifik aktiv träning) utifrån en beslutsmodell med fysiska tester och frågor om symtom är effektivt för att uppnå positiva effekter i självskattad smärta och funktion (artikel 1 och 2).  Den skräddarsydda behandlingen jämfördes mot en grupp som fick samma upplägg men inte skräddarsydd behandling. Vidare undersöktes om båda dessa behandlingsgrupper var effektivare än en grupp som inte fick någon behandling i studien. Dessutom undersöktes om påverkan från arbetsmiljön i form av fysisk och psykosocial belastning samt upplevd stress påverkade behandlingsresultaten efter interventionen (artikel 3). Slutligen undersöktes om de fysiska testerna och den självskattade smärtan, funktionen och symptomen hade koppling till varandra dels före interventionen och dels i termer av förändringar efter interventionen (artikel 4). Metod: I en randomiserad kontrollerad interventionsstudie (RCT) inkluderades 120 kvinnor i åldrarna 20-65, alla i arbete, och som hade ospecifika nackbesvär.  De lottades till tre grupper, (1) skräddarsydd behandling (Tailore treatment, TT), (2) icke-skräddarsydd behandling (Non-tailored treatment, NTT) och (3) en kontrollgrupp (Treatment-as-usual, TAU) som inte fick någon behandling i studien men var fria att söka vård på egen hand. Kvinnorna i TT-gruppen fick behandlings-komponenter utifrån testresultaten i beslutsmodellen. Det kunde läggas till någon behandlingskomponent om det visade sig behövas utifrån individens behov i vardagen. Detta undersöktes genom en strukturerad intervju-teknik som kallas Problem Elicitation Technique (PET). Kvinnorna i NTT-gruppen fick två lottade behandlings-komponenter som inte matchade deras behov utifrån testerna i beslutsmodellen. För båda behandlings-grupperna var interventionen 11 veckor med inbokade behandlingstillfällen 2-3 gånger per vecka, samtliga tillfällen vägledda av fysioterapeut. Data för alla tre grupper samlades in innan interventionen samt 3, 9 och 15 månader efter start av interventionen. Gruppskillnaderna analyserades med en ”linear mixed model”. En vecka efter intervention gjordes ett arbetsplatsbesök hos individerna i alla tre grupper. En erfaren ergonom observerade individernas fysiska arbetsbelastning med ett ergonomiskt bedömningsinstrument, Quick Exposure Check (QEC), och individerna skattade också den psykosociala arbetsmiljön i ett frågeformulär, QPS Nordic, samt upplevd stress. För att undersöka om den fysiska och psykosociala arbetsbelastningen samt stress påverkade resultaten från interventionen analyserades data med linjär regression och mixed model. För att undersöka om de fysiska testerna och den självskattade smärtan, funktionen och symptomen hade något samband användes linjär regressionsanalys. Resultat: Att skräddarsy behandlingen utifrån den testade beslutsmodellen var inte effektivare än att inte skräddarsy. I jämförelse med kontrollgruppen självskattade båda behandlingsgrupperna mindre smärta, bättre funktion och mindre symptom efter interventionen. I de länge uppföljningarna (9 och 15 månader) var dock skillnaderna mellan grupperna inte längre signifikanta förutom att båda behandlingsgrupperna, till skillnad från kontrollgruppen, upplevde sig bättre än innan behandling. Det visade sig att upplevd hög stressnivå och låg kontroll på arbetet hade samband med mer självskattad nacksmärta, sämre funktion och lägre arbetsproduktivitet. De fysiska testerna och självskattade nackbesvär hade bara svaga samband. På baslinjenivå, innan interventionen, fanns det samband mellan hög nackstyrka och låg självskattad funktion och låg frekvens på symptomen, samt mellan att vara långsam i testet av snabba huvudrörelser och hög smärta. Efter interventionen hade individernas förändring i självskattad smärta fortfarande bara samband med snabba huvudrörelser. Förbättring i självskattad funktion och symptom hade samband till ökad hastighet i snabba huvudrörelser och ökat rörelseutslag nackrotation. Sammanfattning: För kvinnor i arbete med ospecifika nackbesvär var det inte mer effektivt att skräddarsy behandling/träning utifrån en beslutsmodell jämfört med att slumpmässigt välja ut behandlingskomponenter från samma behandlingsarsenal. En förklaring kan vara att det fanns endast låga samband mellan självskattad smärta och funktion och de fysiska testerna. Upplevd stress och kontroll i arbetet visade sig ha samband med självskattad smärta, funktion och arbetsproduktivitet och bör tas i beaktande i framtida interventioner för individer med nacksmärta.
2

Development and validation of a novel iOS application for measuring arm inclination

Yang, Liyun January 2015 (has links)
Work in demanding postures is a known risk factor for work-related musculoskeletal disorders (MSDs), specifically work with elevated arms may cause neck/shoulder disorders. Such a disorder is a tragedy for the individual, and costly for society. Technical measurements are more precise in estimating the work exposure, than observation and self-reports, and there is a need for uncomplicated methods for risk assessments. The aim of this project was to develop and validate an iOS application for measuring arm elevation angle. Such an application was developed, based on the built-in accelerometer and gyroscope of the iPhone/iPod Touch. The application was designed to be self-exploratory. Directly after a measurement, 10th, 50th and 90th percentiles of angular distribution and median angular velocity, and percentage of time above 30°, 60°, and 90° are presented. The focused user group, ergonomists, was consulted during the user interface design phase. Complete angular datasets may be exported via email as text files for further analyses. The application was validated by comparison to the output of an optical motion capture system for four subjects. The two methods correlated above 0.99, with absolute error below 4.8° in arm flexion and abduction positions. During arm swing movements, the average root-mean-square differences (RMSDs) were 3.7°, 4.6° and 6.5° for slow (0.1 Hz), medium (0.4 Hz) and fast (0.8 Hz) arm swings, respectively. For simulated painting, the mean RMSDs was 5.5°. Since the accuracy was similar to other tested field research methods, this convenient and “low-cost” application should be useful for ergonomists, for risk assessments or educational use. The plan is to publish this iOS application on Apple Store (Apple Inc.) for free. New user feedback may further improve the user interface.
3

Effects of Work Exposure on Maximum Acceptable Repetition Rates in a Manual Torquing Task

Kant, Ravi 30 August 2007 (has links)
Repetitive and forceful exertions have been dentified as an important risk factor for occupational injuries. One method used to determine appropriate exposures to these and other risk factors is psychophysics, which is based on individual perceptions of task demands and/or risk. Effects of work exposure have been indicated as of potential importance, but have not been well studied. Indications from an earlier study related to psychophysical limits for a repetitive manual torquing task were that five days of work conditioning had minimal effects on resulting Maximum Acceptable Repetition Rates (MARR). However, it is unknown whether and how longer work exposure durations might influence MARRs. The current study investigated the effects of work exposure on MARR and adjustment time over 10 working days (two weeks) with two days of rest after five days. Ten participants (five males and five females) performed a manual torquing (45 Nm load) task at mid-chest level in the coronal plane for a one hour test session. Starting repetition rate for each participant was set at single high and low rate on alternate days. Temporal (exposure) effects were determined, where day of exposure was the independent variable, and MARR and adjustment time were the dependent variables. Final MARRs were relatively lower during the first few exposure days (14 - 15 repetitions/min) and increased for days 5 - 7 (16 - 18 repetitions/min). On average participants made four adjustments to reach MARR . Day was not found to significantly affect MARR, though week affected both MARR and adjustment time. Thus, an exposure of two weeks may be needed to obtain stable and valid psychophysical limits for manual torquing and, perhaps, related tasks. / Master of Science
4

Management of National Certificate Vocational curriculum in addressing skills shortage in Newcastle, KwaZulu-Natal

Selepe, Olpha Nkosingiphile 06 1900 (has links)
The aim of this study was to investigate how the National Certificate Vocational (NCV) curriculum is being managed at Majuba TVET College in ensuring that it impacts positively in addressing skills shortage in the Newcastle area. The following was the main question for the study: How is Majuba TVET College managing the National Certificate Vocational (NCV) curriculum in addressing skills shortage in the Newcastle area? A comprehensive literature review was conducted to provide strong arguments as presented by different authors who wrote on the topic after conducting research about Technical Vocational Education and Training (TVET) Colleges A qualitative method was chosen by the researcher to gather data on the management of the NCV curriculum in addressing skills shortage. The main aim was to discuss the methods the researcher used in the study to collect data meant to acquire the impact of the NCV curriculum management in addressing skills shortage. Data was collected through face-to-face interviews, non-participant observation and literature review. It was then put together and analysed according to themes aligned to the main study problem and the sub problems in order to realise the main aim of the study and the sub-aims. On the basis of the findings and the recommendations, the researcher proposed the importance of the college to review the NCV curriculum so that it is aligned with practical exposure enhanced by NCV students from the industry. In conclusion, the findings pointed out that NCV students’ practical exposure may have a big impact in addressing skills shortage and combating the high unemployment rate in the Newcastle area. / Educational Leadership and Management / M. Ed. (Education Management)

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