As lombalgias têm influenciado no absenteísmo e no presenteísmo de trabalhadores de enfermagem. O objetivo geral deste estudo foi identificar os fatores do trabalho associados à lombalgia não específica, caracterizada no âmbito da resistência da musculatura extensora lombar, em trabalhadoras de enfermagem de Unidades de Terapia Intensiva. Trata2se de um estudo exploratório do tipo transversal com abordagem quantitativa dos dados, realizado em Unidades de Terapia Intensiva. A amostra foi composta por 48 trabalhadoras (enfermeiras, técnicas e auxiliares de enfermagem) atuantes há mais de seis meses na Unidade de Terapia Intensiva de um hospital público (HA) (n=32) e um hospital privado (HB) (n=16) da cidade de Ribeirão Preto2SP. Os instrumentos utilizados para coleta dos dados foram: Questionário de caracterização dos sujeitos (características sociodemográficas e ocupacionais), Questionário Nórdico de Sintomas Osteomusculares - adaptado (caracterização dos sintomas osteomusculares, segundo as regiões do corpo), Fatores do trabalho que podem contribuir para os sintomas osteomusculares 2 adaptado, Teste de Sorensen (identificação da resistência da musculatura extensora lombar) e Escala RPE de Borg (identificação do esforço percebido). Os dados foram coletados em 2011, nos hospitais, pelo pesquisador, após a aprovação do projeto de pesquisa pelo Comitê de Ética em Pesquisa (Processo 122/2011) e permissão dos chefes dos serviços. Resultados: as participantes do estudo eram mulheres, na faixa etária entre 20 e 56 anos, a maioria se declarava branca, solteira (58,3%), com filhos (52,1%), sedentária (64,6%), com acúmulo de trabalho profissional e doméstico (89,6%). As enfermeiras executam tarefas gerenciais e assistenciais, com predomínio das gerenciais, e os técnicos e auxiliares de enfermagem executam o cuidado direto aos pacientes, tarefas que são consideradas desgastantes. O sintoma lombar foi a principal queixa osteomuscular (66,7%), seguido dos segmentos ombros (54,2%), pescoço (47,9%) tornozelos (41,7%) e região dorsal (41,7%). As trabalhadoras com sintoma lombar atingiram um tempo menor (93,06 s.) de resistência da musculatura extensora da coluna no teste de Sorensen, em comparação às trabalhadoras assintomáticas (116,30 s), e o esforço percebido após o teste foi intenso (15) para todos os sujeitos. Os principais fatores do trabalho que contribuem para os sintomas lombares identificados pelas trabalhadoras de enfermagem foram relacionados a aspectos posturais (torção e flexão de coluna, curvar as costas, postura estática) e organizacionais (repetitividade, horas extras, falta de descanso e velocidade do trabalho). Concluímos que os sintomas lombares são frequentes entre as trabalhadoras de enfermagem das unidades estudadas, embora a resistência da musculatura extensora da coluna não tenha apresentado diferenças estatisticamente significativas entre os grupos de sujeitos sintomáticos e assintomáticos. Os resultados obtidos e os fatores identificados pelas trabalhadoras como contribuintes aos sintomas lombares são indicadores da inadequação das condições de trabalho e de que ações de intervenção no ambiente e na organização do trabalho são necessárias. O estudo contribuiu para o avanço do conhecimento das áreas de Saúde do Trabalhador, Fisioterapia e Enfermagem. / Low back pain is a condition that has influenced absenteeism and presenteeism of nursing workers. The overall goal of the present study was to identify the work2related factors associated to nonspecific low back pain characterized by the resistance of lumbar extensor muscles among female nursing workers of Intensive Care Units. This is an exploratory cross2 sectional study under a quantitative approach held in Intensive Care Units. The sample consisted of 48 workers 2 nurses, nursing technicians and assistants2 who had been active for over six months in the Intensive Care Unit of a public hospital (HA) (n=32) and a private hospital (HB) (n=16) in the city of Ribeirão Preto, São Paulo, Brazil. The tools used for data collection were; Subject characterization questionnaire (sociodemographic and occupational), Nordic Musculoskeletal Questionnaire - adapted (characterization of musculoskeletal symptoms according to body regions), Job risk factors that may contribute to musculoskeletal symptoms - adapted, Sorensen test (identification of resistance of lumbar extensor muscles) RPE on Borg scale (perceived exertion rating).The data were collected in 2011 in hospitals, by the researcher, thereafter the Research Ethics Committee had approved the project (petition 122/2011) and Chief Service Officials had granted their permission. Results: The participants in the study were females aged between 20 to 56 years old, self reported as Caucasian, single (58.3%), with children (52.1%), sedentary (64.6%), both professionally and housework overloaded (89.6%). Tasks Performed: Nurses perform both care and, predominately, managerial activities. Nursing technicians and assistants perform direct care of patients. These latter tasks are considered more overwhelming. The major musculoskeletal complaints relied on the Lower back system (66.7%), followed by shoulder segments (54.2%), neck (47.9%) and dorsal region (41.7%).The workers presenting low back symptoms reached a shorter resistance time on the spinal extensor muscles when compared to asymptomatic workers using the Sorensen test (93.06 s. versus 116.30 s). All subjects (15) perceived intense exertion after the test. The main job factors that contribute to low back symptoms identified by the subjects were related to both postural (spine torsion and bending, back bending, static posture) and organizational (repetitiveness, excessive work hours, lack of rest, and work pace) aspects. Conclusion: We conclude that lumbar symptoms are frequent among the female nursing workers of the studied units. In addition, although spinal extensor muscles resistance has not shown significant statistical differences between the symptomatic and asymptomatic groups, the obtained results and factors identified by the workers as contributing to low back symptoms are indicators of inadequate labor conditions. Therefore, interventions on the work organization and environment are needed. Finally, the present study contributes to the progress of knowledge in the areas of Occupational Health, Physiotherapy and Nursing.

Bakgrund Det är välkänt att musiker, studerande såväl som praktiserande, ofta drabbas av smärtproblematik och det finns en hög prevalens för smärta i nacke, skuldra, arm och handområden hos violinister.   Syfte Syftet var att belysa och beskriva violiniststudenters upplevelser av att spela med smärtor/skador och upplevelser om underlättande och försvårande faktorer för spel samt deras upplevelser om behandlingar/möjlighet till behandlingar.   Design och metod Studien har en kvalitativ ansats med en explorativ design med semistrukturerade intervjuer som datainsamlingsmetod.   Resultat Ur analysen identifierades fem kategorier: ”Konsekvenser av smärta och skada vid spel”, ”smärtans påverkan i vardagen”, ”underlättande faktorer för spel”, ”försvårande faktorer för spel”, och ”upplevelser av behandling”. God kunskap hos musikläraren, ergonomi och fysisk träning upplevdes som underlättande faktorer och minskade smärtan. Instrumentets utformning och höga krav upplevdes som försvårande faktorer för spel och påverkade smärtproblematiken negativt. Deras upplevelser av behandling var att vården var oförstående för deras problematik och att mer kunskap om hur de kan få hjälp behövs.   Konklusion Fysisk träning, ergonomi och coping är exempel på faktorer som underlättat för spel och minskat smärtproblematiken hos studenterna. Detta kan vården och specifikt fysioterapeuter hjälpta till med men det behöver utforskas ytterligare för att kunna utveckla anpassade behandlingar för att minska smärtproblematik hos violiniststudenter. / Background It is well known that musicians, both students and working professionals, often are affected by pain related problems and there is a high prevalence for violinists to get pain in the neck, shoulders, arms and hands.   Purpose The purpose of the study was to describe the violin student experiences of pain and/or injuries whilst playing, experiences of aggravating and mitigating factors for playing music and their experiences with therapy/possibilities for therapy.   Design and method The design used was a qualitative and explorative design with semi-structured interviews as the method to collect the data.   Result From the analysis five categories were identified: “Consequences of pain and injurie when playing”, “the pains effect in day to day life”, “aggravating factors for playing”, “mitigating factors for playing” and “experiences with treatments”. The music teacher’s knowledge, ergonomics and physical training was perceived as aggravating factors. The instruments form and high demands was described by the students as mitigating factors for playing music and that it had a negative impact on their pain. Their experiences with therapy/possibilities for therapy was of the sort that the healthcare professionals were uncomprehending about their complex of problems and that more knowledge about how to sufficiently help the students is needed.   Conclusion Physical training, ergonomics and coping are examples of factors that is aggravating for playing and that it has decreased the pain for the students. Healthcare and especially physical therapy can help with this but further research is needed to develop proper treatments to minimize pain for violinist students.

Epidemiological evidence suggests an association between exposure to non-neutral working postures and work-related musculoskeletal disorders (MSDs) of the low back and shoulder. Accurate and precise quantitative estimation of exposure to non-neutral working postures is, therefore, essential for evaluating worker risk, developing and testing ergonomic interventions, and improving worker health and well-being. Current methods used to directly estimate occupational exposure to non-neutral postures may be obtrusive, often lack sufficient portability for field use, and have limited accuracy and precision when used to measure dynamic or complex motions. Inertial measurement units (IMUs) are emerging instrumentation devices that measure and report an object's orientation and motion characteristics using multiple electromechanical sensors (i.e., accelerometers, gyroscopes, and/or magnetometers). They have been observed to accurately monitor body kinematics over periods of relatively short duration in comparison to laboratory-based optical motion capture systems. Limited research, however, has been performed comparing exposure information obtained with IMUs to exposure information obtained with other field-capable direct measurement exposure assessment methods. Furthermore, insufficient information on the repeatability of IMU-based estimates over a substantial time period (e.g., a full work shift) and inadequate knowledge regarding the effects of different IMU sensor configurations and processing methods on the accuracy and repeatability of estimates of exposure obtained with IMU systems contributes to a lack of their use in epidemiological field studies. This thesis was designed to address these issues and expand upon the current scientific literature regarding the use of IMU sensors as direct measurement devices for assessing exposure to non-neutral working postures in the field. Chapter I provides a background and justification for the work. Chapter II presents the findings of a laboratory-based, manual material handling study that was performed to compare estimates of thoracolumbar trunk motion obtained with a commercially available IMU system with estimates of thoracolumbar trunk motion obtained with a field-capable reference system, the Lumbar Motion Monitor (LMM). The effects of alternative sensor configurations and processing methods on the agreement between LMM and IMU-based estimates of trunk motion were also explored. Chapter III presents the results of a study performed to evaluate the accuracy and repeatability of estimates of trunk angular displacement and upper arm elevation obtained with the IMU system examined in Chapter II over the course of an eight-hour work shift in both a laboratory and field-based setting. The effects of alternative sensor configurations and processing methods on the accuracy and repeatability of estimates of trunk angular displacement and upper arm elevation obtained with the IMU system were also studied. Chapter IV presents the results of a randomized, repeated measures intervention that demonstrates the utility of the IMU system examined in Chapters II and III as a direct measurement instrument for comparing "ergonomic" and conventional examination equipment commonly used by ophthalmologists. Finally, Chapter V summarizes the major findings, discusses their practical implications, and provides suggestions for future research.

The objective of the three studies in this dissertation was to improve methods to prevent musculoskeletal disorders among workers in high-risk occupations. The first two studies, Strain Index (SI) Studies I & II, addressed this problem by better characterizing the performance of a commonly used observational method of estimating potentially hazardous biomechanical exposures, the SI. The SI combines measures of several biomechanical risk factors into a single value (SI score). Strain Index scores are usually categorized into four ordinal SI "risk categories." In Strain Index Study I, multivariate survival analysis models were compared to evaluate the predictive validity of the original SI risk category cut-points to a new set of empirically derived cut-point values among 276 manufacturing workers. The results from this prospective study indicated that the empirically derived cut-points were a better predictor of incident hand-arm symptoms than the original cut-points, especially among women. In Strain Index Study II, Aim 1, exposures to forceful exertions, repetition and non-neutral wrist posture estimated with SI methods were compared to analogous exposures estimated with alternate methods. Statistically significant associations between separate methods designed to assess specific risk factors were observed only for those measuring non-neutral wrist posture. In Aim 2, a multivariate survival analysis model examining associations between incident hand-arm symptoms and biomechanical exposures estimated with the SI was compared to a model examining associations between incident hand-arm symptoms and biomechanical exposures estimated with separate estimates of biomechanical risk factors. Results favored the SI risk category metric to characterize biomechanical exposures compared to separate measures of exposure. he third study, light-weight block (LWB) Intervention Study, was a repeated measures laboratory study of 25 bricklayers performed to estimate the effect of block weight (LWB vs. standard-weight block (SWB)) and course height on low back disorder (LBD) risk factor exposure. Mixed-effect models showed that LWB was associated with reduced exposure for percent time spent in sagittal flexion >30°, lifting rate, LBD risk probability score, and non-dominant upper trapezius muscle activity. Bricklaying at ankle or chest heights was generally associated with higher exposure to risk factors than bricklaying at knuckle height.

This study appears to be one of few intervention studies with focus on eyestrain and lighting on non-computer workplaces. Previous studies have shown strong connections between eyestrain and musculoskeletal strain. The eyes “lead the body” and if the picture on the retina is unfocused the body adjusts the posture, trying to improve the image through changing the viewing distance. This can lead to an unnatural body posture which can contribute in the development of musculoskeletal disorders. A good visual environment with proper illuminance, good luminance contrast relationship, good uniformity value of the illuminance and no glare are the best conditions in order to function well at a visually demanding work. Sorting mail is a task that needs good visual ergonomics and can therefore be improved by a change in the visual environment. The overall purpose of this thesis is to investigate if a good visual environment have an impact on eyestrain, musculoskeletal strain, productivity, wellbeing, and work induced stress. This thesis is based on a literature review and a lighting intervention, with one part before the intervention and two follow-up parts, summer and winter. The results are based on objectively measurements; lighting, time studies, and optometric eye examinations, and two questionnaires. The first questionnaire concerned visual ergonomics and the second had a focus on wellbeing and experience of work related tasks. The postmen experienced the new lighting and labeling as improvement. A small decrease in the amount of eyestrain was present, and the younger postmen had a decrease of the musculoskeletal strain. The postmen with eyestrain got a small improvement of the sorting time. When the lighting was improved another factor that could cause strain appeared, the need for good correction in their glasses was identified as the main remaining factor that could cause the observed strain. / Report code: LiU-Tek-Lic-2008:8.

This thesis analyzes the relationship between upper extremity musculoskeletal disorders and longtime computer usage. Firstly / maastricht upper extremity questionnaire is applied to Financial Control and Information Technology Departments of Turk Telekom. Results are analyzed by using spss 16.0 tool by conduction of ordinal logistic regression analysis to determine the significance between work environment and postural information and upper extremity musculoskeletal complaints. Then / development of a new tool, namely PACU (postural analysis of computer users), takes place aiming to determine the factors of disorders, by mainly focusing on work-related neck and upper limb disorders, for long time computer users of Financial Control and Information Technology Departments of Turk Telekom. Results of the PACU are analyzed by using the methods of correlation, chi square goodness of fit test, factor analysis, and ordinal logistic regression.

<p>This study appears to be one of few intervention studies with focus on eyestrain and lighting on non-computer workplaces. Previous studies have shown strong connections between eyestrain and musculoskeletal strain. The eyes “lead the body” and if the picture on the retina is unfocused the body adjusts the posture, trying to improve the image through changing the viewing distance. This can lead to an unnatural body posture which can contribute in the development of musculoskeletal disorders.</p><p>A good visual environment with proper illuminance, good luminance contrast relationship, good uniformity value of the illuminance and no glare are the best conditions in order to function well at a visually demanding work. Sorting mail is a task that needs good visual ergonomics and can therefore be improved by a change in the visual environment.</p><p>The overall purpose of this thesis is to investigate if a good visual environment have an impact on eyestrain, musculoskeletal strain, productivity, wellbeing, and work induced stress.</p><p>This thesis is based on a literature review and a lighting intervention, with one part before the intervention and two follow-up parts, summer and winter. The results are based on objectively measurements; lighting, time studies, and optometric eye examinations, and two questionnaires. The first questionnaire concerned visual ergonomics and the second had a focus on wellbeing and experience of work related tasks.</p><p>The postmen experienced the new lighting and labeling as improvement. A small decrease in the amount of eyestrain was present, and the younger postmen had a decrease of the musculoskeletal strain. The postmen with eyestrain got a small improvement of the sorting time. When the lighting was improved another factor that could cause strain appeared, the need for good correction in their glasses was identified as the main remaining factor that could cause the observed strain.</p> / Report code: LiU-Tek-Lic-2008:8.

Ziel der vorliegenden Untersuchung war es, Aussagen über Häufigkeit von Beschwerden im Bereich des Bewegungsapparates, deren Lokalisation und den möglichen Einfluss beruflicher und außerberuflicher Faktoren (Sport) bei Augenärztinnen und –ärzten zu gewinnen, um die Abhängigkeit möglicher aktueller Beschwerden im Bewegungsapparat von individuellen und berufsspezifischen Einflüssen zu evaluieren. Die Auswertung – insbesondere im Vergleich zur Allgemeinbevölkerung – lässt Erkenntnisse zu einem Augenheilkunde- spezifischen Beschwerdespektrum erwarten.

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<p>Diss. (sammanfattning) Umeå : Umeå universitet, 2002, Härtill 5 uppsatser.</p> / digitalisering@umu