No description available.

Background: A recent shift in the global burden of disease from communicable to noncommunicable has shown that a third of the global burden of disease is attributable to noncommunicable disease, with the heaviest burden affecting poor communities in urban areas. Musculoskeletal disease (MSD) is the most common cause of severe chronic or persistent pain, functional limitations, and physical disability, affecting 20-50% of adults. Globally, disability due to musculoskeletal disease is estimated to have increased by 45% from 1990 to 2010 accounting for 6.8% of total years lived with disability. Research has highlighted a possible co-existence of musculoskeletal disease and chronic noncommunicable diseases of lifestyle, however, there is inadequate South African evidence regarding these inter-relationships and possible risk factors. This highlights a gap in research as management may not be appropriately targeted toward risk factors and thus may not reduce the high prevalence rates of musculoskeletal disease. Aim: The main aims of this study were firstly to determine the prevalence and patterns of acute and chronic musculoskeletal disease. The secondary aim was to explore the relationship between these factors by examining the patterns of onset of musculoskeletal disease, chronic diseases of lifestyle, and risk factors across gender and six age categories (from 18 years to 70 years and older) in patients seeking medical services at a community health centre in Cape Town, South Africa. It was hypothesised that if some conditions were found to have an earlier onset, these conditions might lay the foundation for the development of other chronic diseases of lifestyle and musculoskeletal disease. Methodology: A descriptive, cross-sectional, analytical study design was used at primary health care level at a community health centre in Cape Town, South Africa. All males and females aged 18 years and older, except those who were pregnant or unable to answer the English, Afrikaans, or isiXhosa versions of the selected questionnaires, were eligible to participate. The outcome measures were the Community Orientated Program for Control of Rheumatic Diseases (COPCORD) screening tool for musculoskeletal disease, the Brief Pain Inventory (BPI), the European Quality of Life-5 Dimensions (EQ-5D) health-related quality of life measure, the International Physical Activity Questionnaire (IPAQ), and anthropometric measures of weight, height, and waist and hip circumference. Data were collected via interview and anthropometric measurement. Responses were captured by online questionnaires on mobile devices using the mobile data collection application Magpi by DataDyne Group, LLC. Data were exported to Microsoft Office Excel spreadsheets for descriptive and inferential statistical analysis. Ethical permission was obtained from the University of Cape Town. Results: This study recruited 1115 participants, with a mean age of 48.7 ± 16.8 years. A prevalence rate of 33.6% (95% Confidence Intervals; CI: 30.1-36.5%) for acute MSD and 43.3% (CI: 40.4-46.3%) for chronic MSD was found. The number of participants reporting an overall prevalence of any MSD was 505 (45.7%; CI: 42.8-48.7%). The highest prevalence of MSD was found in females aged 40-59 years. The most common anatomical sites of chronic MSD were the knees (35.6%; CI: 31.5-39.9%), low back/pelvis (33.8%; CI: 29.8- 38.0%), shoulders (26.8%; CI: 23.1-30.9%), and hands/fingers (21.9%; CI: 18.5-25.7%). Of those with MSD, exercise was reported as the best management strategy for musculoskeletal pain (35.6% of 191 respondents; CI: 29.1-42.6%). Hypertension was found to be the most prevalent chronic disease of lifestyle (47.8%; CI: 44.8-50.7%), followed by type 2 diabetes mellitus (21.4%; CI: 19.1-23.9%), and hypercholesterolaemia (20.2%; CI: 17.9-22.6%). All chronic diseases, except chronic obstructive airway disease (COAD), increased with age, while COAD and both acute and chronic MSD peaked around the 50-59 age category and then decreased with age. Most females reported to be highly physically active (46.0%) while males reported mostly low physical activity levels (47.8%). Around the 50-59 year old age group the proportion of participants with a ‘high’ physical activity level decreased while that of participants with a ‘low’ physical activity level increased at the same age group. A higher proportion of those without MSD reported ‘high’ levels of physical activity (41% compared to 32%). In the 30-39 and 40-49 age groups, low levels of physical activity were associated with chronic MSD (70.6% compared to 37.5% of those. with high levels; Chi-Square=13.833; df=2; p=0.001). Body mass index (BMI) category was found to be associated with MSD (p< 0.001) with 73% of those with MSD being overweight or obese and 27% being extremely obese. There were significant differences in BMI between those with and without hypertension (p< 0.001), hypercholesterolaemia (p <0.001), and type 2 diabetes mellitus (p< 0.001). A trend of increasing obesity, high waisthip ratio and low levels of physical activity with age was observed. In smokers, being 30 years of age or older was associated with an increased risk of MSD (42% compared to 21.1%). Gender emerged as a risk factor in the 40-49 and 50-59 age categories with 76.2% of females in these categories reporting chronic MSD compared to 45.1% of the males. However, no risk factor seemed to track the plot of MSD. Age emerged as having the highest association with chronic MSD (Chi-Square=136.6; p< 0.001). Conclusions: Bivariate associations of musculoskeletal disease and chronic diseases of lifestyle were detected because they all become more prevalent with age. The comorbidity of musculoskeletal disease and chronic disease of lifestyle appeared to almost entirely be due to the aging process, rather than the mutual influence that musculoskeletal disease and chronic diseases of lifestyle may have. Low levels of physical activity were only associated with musculoskeletal disease among those in the 30-49 age categories. As previous evidence has shown that increased levels of physical activity can reduce pain in chronic or persistent musculoskeletal disease, a window of opportunity is suggested where increasing physical activity levels in the 30-49 age group may result in a decrease in the prevalence of musculoskeletal disease in the older age group. The only factor that emerged as being predictive in the group with the highest prevalence of musculoskeletal disease, the 40-59 age categories, was gender. Although gender is clearly not modifiable, this finding should inform the development of culturally appropriate intervention strategies. Implications: Although it was not possible to detect any evidence supporting causation, the co-existence of chronic musculoskeletal disease, chronic diseases of lifestyle, and risk factors highlights the need for holistic care to address the multiple problems experienced by adults, specifically as age progresses. The impact of chronic musculoskeletal disease is large, both in terms of prevalence and impact on health-related quality of life. The management of chronic musculoskeletal disease should thus focus on the most effective and affordable intervention strategies and healthcare systems and coherent policies for dealing with this condition should be developed. This management should not only be based on a pharmacological model but on biopsychosocial integration emphasising self management.

Bakgrund: Muskuloskeletal smärta är vanligt förekommande bland postarbetare, ofta på grund av tunga lyft och repetitivt arbete. Tidigare forskning har främst fokuserat på att identifiera förekomsten och utbredningen av smärta bland postarbetare. Det råder dock brist på kvalitativ forskning som syftar till att förstå postarbetares upplevelser av smärta och deras erfarenheter av att hantera smärta på arbetet. Syfte: Syftet med studien var att utforska postarbetares upplevelser och erfarenheter av att arbeta med muskuloskeletal smärta. Metod: En kvalitativ design användes, där semistrukturerade intervjuer genomfördes med fem deltagare. Urvalet av deltagare skedde genom en kombination av bekvämlighetsurval och snöbollsurval. Databearbetningen utfördes med hjälp av kvalitativ innehållsanalys. Resultat: Deltagarna beskrev varierade upplevelser och erfarenheter av smärta på arbetet. Analysen ledde fram till tre teman och nio subteman. De teman som identifierades var: “Smärta har flera dimensioner”, “Arbetsmiljöfaktorer påverkar smärta” och “Möjliggörare för att arbeta med smärta”. Konklusion: Studien visade att muskuloskeletal smärta påverkade deltagarnas fysiska och psykiska välmående och att arbetsbelastningen var en betydande faktor bakom smärtan. Deltagarna använde strategier som pauser, stretching och massage för att hantera smärtan, men betonade även att besök hos fysioterapeut var viktigt för att kunna fortsätta arbeta. Trots att ergonomiska åtgärder ansågs viktiga för att minska smärtan, kunde hög arbetsbelastning och stress hindra implementeringen av ergonomiska åtgärder. Organisatoriskt stöd betonades som avgörande för att förbättra arbetsmiljön och minska smärta bland postarbetare. / Background: Musculoskeletal pain is common among postal workers, often due to heavy lifting and repetitive work. Previous research has focused primarily on identifying the prevalence of pain among postal workers. However, there is a lack of qualitative research aimed at understanding postal workers' experiences and management of pain at work. Purpose: The purpose of the study was to explore postal workers’ experiences and perceptions of working with musculoskeletal pain. Method: A qualitative design was used, where semi-structured interviews were conducted with five participants. The selection of participants took place through a combination of convenience sampling and snowball sampling. The data processing was carried out using qualitative content analysis. Results: The participants described varied experiences of pain at work. The analysis led to three themes and nine subthemes. The themes identified were: “Pain has several dimensions”, “Work environment factors affect pain” and “Facilitators for working with pain”. Conclusion: The study revealed that musculoskeletal pain affected the participants' physical and psychological well-being, and that the workload was an important factor contributing to the pain. The participants used strategies such as breaks, stretching and massage to manage the pain, but also emphasized that visits to the physiotherapist were important to be able to continue working. Although ergonomic measures were considered important to reduce pain, high workload and stress could hinder the implementation of ergonomic measures. Organizational support was emphasized as critical to improve the work environment and reduce pain among postal workers.

Introduktion: Yrkesförare som grupp uppvisar hög prevalens av kardiovaskulära sjukdomar och muskuloskeletala besvär. Yrkets ogynnsamma arbetsförhållanden leder ofta till ohälsosamma levnadsvanor och få förare når upp till rekommendationerna för fysisk aktivitet. Trots yrkesgruppens låga hälsostatus är forskningsfältet förhållandevis outforskat, i synnerhet inom området för muskuloskeletal hälsa och fysisk aktivitet.  Syfte: Denna scoping review syftar till att beskriva vilka hälsofrämjande interventioner som studerats för att förbättra yrkesförares hälsa, med specifikt fokus på åtgärder för fysisk aktivitet. Metod: I detta arbete användes SBU:s metodbok och PRISMA för att följa de riktlinjer som finns för systematiska litteraturöversikter. Artikelsökning gjordes i databaserna PubMed och Web of Science under våren 2024. Kvalitetsgranskning gjordes enligt granskningsmallar från SBU. Resultat: Sex studier inkluderades i denna scoping review. Interventioner av livsstilsförändring, styrketräning och utbildning i fysisk aktivitet kunde alla bidra till ökad fysiska aktivitet. Styrketräning, utbildning i fysisk aktivitet, raster och stretching kunde minska muskuloskeletala besvär. Effekter på kost, sömn, antropometriska mått, kardiovaskulära hälsomarkörer och self-efficacy visade varierade resultat. Konklusion: Trots stora variationer på interventionerna fick de flesta av studierna positiva resultat på förbättrad hälsa eller hälsofrämjande beteenden i någon form, vilket visar på en bredd av möjligheter inför framtida interventioner och åtgärder. Fysisk aktivitet, som är en av hörnstenarna för kardiovaskulär och muskuloskeletal hälsa, behöver finnas med som komponent i det hälsofrämjande arbetet och där har fysioterapeuter med sin kompetens en viktig roll. Framtida forskningsprojekt behöver titta på fler potentiella åtgärder och hitta möjligheter att kringgå de utmaningar som föreligger i branschen för att bättre kunna möta yrkesgruppens behov av hälsofrämjande insatser.