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.

Ce travail de thèse s’intéresse à l’estimation des angles articulaires et des positions segmentaires du membre supérieur à partir de capteurs inertiels (MIMU). Malgré l’intérêt grandissant de la communauté scientifique pour cette technologie, plusieurs questions de recherche restent en suspens. Ce travail de thèse contribue à l’avancée de connaissances scientifiques à la fois au niveau de la modélisation cinématique du membre supérieur associée aux capteurs inertiels et au niveau de la validation même des données cinématiques de sortie (angles articulaires et positions segmentaires). Au travers d’une approche méthodologique complète, des recommandations de calibration anatomique sont avancées. De plus, des valeurs clefs de caractérisation sont proposées, telles qu’une reproductibilité des données angulaires de l’ordre de 5-10° et une erreur de positionnement de la main de 7-15 cm. La finalité de ce travail de thèse est la mise à disposition d’un système ambulatoire pour l’évaluation des postures et des mouvements du membre supérieur dans une optique d’évaluation des risques de troubles musculo-squelettiques en milieu professionnel. Une modélisation cinématique avancée prenant en compte un capteur inertiel sur la scapula et la caractérisation du système en milieu perturbé magnétiquement apparaissent comme une suite logique à ce travail de thèse / This PhD work is focused on the estimation of joint angles and segment positions of the upper limb based on inertial sensor technology (MIMU). Despite much interest from the scientific community in this topic, several aspects of research deserve more investigation. This work contributes to the enhancement of scientific knowledge related to (1) the kinematic modeling associated to MIMU and (2) the validation of final kinematic outputs (joint angles and segment positions). Based on an exhaustive methodological approach, recommendations related to the anatomical calibration of MIMU are highlighted. Moreover, key-values related to the characterization of kinematic outputs are proposed, such as a precision of joint angles of 5-10° and a hand positioning error of 7-15 cm. The aim of this study is the development of an ambulatory system for the assessment of postures and movements of the upper limb, in a general context of musculoskeletal disorders risk assessment at work. From now on, an advanced kinematic modeling that uses a MIMU placed on the scapula as well as a characterization of the system under magnetic disturbances represent two of the main scientific questions to explore

ABSTRACT Title: Laterality influence on the violinists locomotor system disorders Objectives: The main object of this work is to find relation between laterality (dominance, preferences body) and forced left-sided activities - playing the violin, and to authenticate if the forced lateral activity indicate greater effect on musculosceletal disorders in the nondominant laterality. Methods: Questionnaire includes questionnaire part, preference task and performance task, it's anonymous. Probands are students of music conservatory and professionals violinist of chambre and symphony orchestra. The final number of probands who have involved the questionnaire is 110 (66 womens and 44 mens). Results: The hypothesis hasn't been confirmed. Results showed better subjective evaluation of potential musculoskeletal disorders by probands left-handers Keywords: playing the violin, laterality, dominance, musculoskeletal disorders

Title The prevalence of musculoskeletal disorders among wind instrument players Objectives The aim of this thesis is to determine the prevalence of playing-related musculoskeletal disorders (PRMD) in players on wind instruments in the Czech Republic, to determine their consequences and to identify related factors. Methods This thesis has the character of a cross-sectional study with a questionnaire survey. The study included 308 players on wind musical instruments. Outcomes The prevalence of PRMD was 55 % for the whole music group and 62 % for professional players. The higher prevalence of PRMD was statistically significantly associated with the student status (p=0.001), female sex (p=0.026), playing time on the dominant instrument weekly (p=0.001), and earlier incidence of PRMD (p=0.000). 31 % of players confirmed wrist/hand problems, 31 % confirmed problems in the neck area and 28 % confirmed problems in the upper back area. Because of PRMD, participants most frequently visited a health specialist such as a physical therapist and when dealing with their difficulties alone, most often they did some kind of physical activity. Conclusion The prevalence of PRMD in professional players was at a lower level than in foreign literature. Students, women, players playing more hours per week and players...

Although the level of automation in the automotive industry is currently high, real humans are still required for assembly tasks, for example, during overhead tasks. This type of work can cause injuries in workers in this sector, especially musculoskeletal disorders (MSDs), being a cause for the inability to work in developed countries and, in turn, becoming a significant health problem. There is an aim to reduce the risk for these type of injuries during the development processes of this type of assembly operations. Various options are currently being considered where technology and the human factor can be combined. Among them, we find the object of study for this project, an exoskeleton.The aim of this project is to study the biomechanical effects as well as the ergonomics of a passive exoskeleton called Paexo Shoulder, developed by the company Ottobock, with the aim of relieving tensions in the shoulder joints and upper part of the shoulders, during its use in assembly tasks. For this purpose, an experiment will be designed in which several participants will carry out a series of tasks both with and without the exoskeleton, in such a way that the effects of its use and how they affect the users of the product can be observed. For this purpose, an experiment was designed to evaluate the effects of the use or non-use of this exoskeleton on 10 participants when performing a task similar to an overhead task in an assembly line. For the evaluation of the product, the Xsens motion capture system, in particular the Awinda model, was used together with the ScaleFit software to evaluate the results obtained through the motion capture recordings. In addition, in order to improve Digital Human Modelling (DHM) tools, the same task was simulated with the IPS-IMMA software, where the results were later analysed and compared with the motion capture results through ScaleFit.The results showed relatively large improvements in the respective moment reduction at the shoulder joint when using the exoskeleton. However, it was also observed that due to the upward force exerted by the exoskeleton on the arms, participants spent less time in low-risk areas evaluated by ScaleFit and therefore, this effect needs to be studied further.

Appropriate sampling strategies for estimation of exposure to physical risk factors require knowledge of exposure variability over time. Limited information is available about the variability of exposure to physical risk factors for upper extremity musculoskeletal disorders, especially during non-cyclic work activities. We investigated the magnitude and relative contributions of several sources of variance to the total exposure variance among office, custodial, or maintenance workers (N = 5 per group). In addition, we examined the homogeneity of exposure within each group of workers and exposure contrast between groups of workers. Activation of the flexor carpi radialis and upper trapezius muscle groups was assessed with surface electromyography (EMG) and wrist motion was assessed with electrogoniometry. Exposure information was collected continuously over a complete work shift on two occasions. We observed a substantial contribution of the within-day-within-subject variance component to the total exposure variance for all EMG and electrogoniometer summary measures. We also observed limited exposure contrast between the occupational groups in summary measures of upper trapezius EMG and most electrogoniometry summary measures. The large within-day-within-subject variance suggests the need for prolonged measurement durations (e.g., more than 1 hr) in future epidemiologic investigations of associations between exposure to physical risk factors and upper extremity musculoskeletal disorders.

Although the automation level is high within the automotive industry, there is still a high number of manual labour tasks such as in assembly areas. Taking ergonomics programs into account is essential to improve the workstation designs and conditions, which should result in increases in worker output and reductions of discomfort. Work-related musculoskeletal disorders continue to be one of the main problems in the industry today. Exoskeletons are a new technology becoming increasingly important due to its potential reducing loads, they suppose a possible promising solution to advantage in manufacturing environments. The purpose of this study is to evaluate and compare how the use of three different models of exoskeletons affects the range of motion of workers at overhead assembly operations. EksoVest from EksoBionics, Paexo from Ottobock and MATE from Comau have been the passive upper body exoskeletons involved in the present project. To develop the comparison analysis an experiment was designed in which seventeen subjects participated including factory operators and students. The experiment consists of performing three different tasks (drilling operation and stretching) four times, one with each of the exoskeleton models and another without them. Observations, interviews and video and motion capture (Xsens equipment) recordings have been the elements involved in collecting the data. The results have shown that all the subjects agree that exoskeletons help in this specific overhead task, on the contrary, for tasks requiring a larger range of motion the performance decreases. Paexo was the preferred model followed by EksoVest and MATE respectively. However, none of the models got a complete positive valuation. In addition, statistical analysis of the motion capture recorded data have described a trend of keeping the arms raised when using the exoskeletons during the tasks than performing it without them. Positive and negative aspect, activation zone and uses of each of the exoskeleton models are also discussed. To conclude, the results of this thesis highlight the need for design improvements in order to allow a full range of movement to workers and increase user performance in a broader number of applications or tasks as well as to assure a more suitable implementation.

July 2010. "Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy in Occupational Therapy, Occupational Therapy Department, College of Allied Health and Nursing, Nova Southeastern University, Fort Lauderdale, Florida" Objective. The following research questions were posed: (1) Does participatory ergonomic education and programming influence occupational performance among cosmetologists? (2) Does ergonomic education and programming influence quality of life among cosmetologists? (3) Does ergonomic education and programming influence pain among cosmetologists? (4) Does ergonomic education and programming influence numbness and tingling in the upper extremities of cosmetologists? The purpose of this study was to: (1) implement a participatory ergonomic program for cosmetologists and (2) to examine the effectiveness of the implemented program in decreasing signs and symptoms associated with work-related musculoskeletal disorders. Method. A multiple baseline, single subject design was used. Data were collected from seven subjects for a total of 12 weeks. The intervention was introduced to subjects at different times throughout the study and consisted of general ergonomic education, a participatory ergonomic interview session, and basic range of motion stretches. Outcome measures included the QuickDASH, a 10-point pain scale, and a 10-point numbness and tingling scale. Data were analyzed using visual analysis techniques including the two-standard deviation band method and the binomial test method. Data trends were assessed to further support the results. Results. The results of this study indicate that ergonomic programming improved occupational performance, improved quality of life, decreased upper extremity pain, and decreased upper extremity numbness and tingling for several of the participants. The results of this study also produced statistically significant changes in QuickDASH scores indicating improved quality of life and improved occupational performance. Statistically significant change in pain scores and numbness/tingling scores indicated that several participants experienced decreased pain, numbness, and tingling in the upper extremity. Conclusion. The results of this study support the assumption that cosmetologists experience symptoms consistent with work-related musculoskeletal disorders and respond to participatory ergonomic programming similar to other working groups. The results of this study support the main principles of the participatory ergonomic approach which focus on involvement of the worker. The participatory ergonomic approach used in this study aligns with the client-centered principles found in the practice of occupational therapy and therefore provides evidence of effective occupational therapy intervention.

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