Les troubles musculo-squelettiques de l’épaule constituent un problème majeur de santé au travail. Le principal mécanisme à l’origine de ces pathologies est le conflit sous-acromial, dont le développement est intimement lié à la qualité du contrôle neuromusculaire de l’épaule. Nos données montrent que les tâches expérimentales classiquement utilisées pour l’exploration des facteurs de développement du conflit sous-acromial sont insuffisantes pour rendre compte de la complexité du contrôle neuromusculaire mis en jeu lors des tâches industrielles. Il semble primordial que les actions de lutte contre les TMS considèrent la réalité de l’organisation motrice à l’origine de leur développement. L’application dans ce travail de la technique d’enregistrement électromyographique au secteur industriel met en évidence la pertinence de cet outil afin d’orienter et d’évaluer les actions ergonomiques qui visent à réduire la charge musculo-squelettique. Un moyen complémentaire de lutte contre les TMS a été proposé afin de pallier aux limites propres à la démarche ergonomique. Il s’agit d’un exercice de recentrage dynamique de la tête humérale exécuté en chaîne cinétique fermée, déployé lors d’un programme d’intervention destiné aux opérateurs ayant des symptômes de conflit sous-acromial. Nos données mettent en évidence une diminution de la douleur et une amélioration de la fonction de l’épaule suite à cette intervention. Les bénéfices associés à cette démarche répondent au double enjeu de santé et de performance, essentiel pour les individus comme pour l’entreprise. Finalement, l’ensemble des contributions expérimentales et des applications industrielles présentées dans ce travail de thèse souligne le rôle central que peuvent jouer les spécialistes de la motricité humaine dans la démarche de lutte contre les TMS. Leur intégration dans les équipes pluridisciplinaires de prévention constitue un réel enjeu pour la réduction de ce risque professionnel majeur / Shoulder disorders represent a major health problem at the workplace. The most common shoulder disorder is the subacromial impingement syndrome. Shoulder neuromuscular control has a critical role in the development of shoulder disorders. Our data show that the experimental tasks generally use to investigate subacromial impingement causative factors are insufficient to represent the complexity of shoulder neuromuscular control involved during industrial tasks. It is essential that workplace interventions take into consideration the actual motor control associated with the development of work-related musculoskeletal disorders. The use of the electromyography in the industrial context, during this thesis work, highlights the interest of this tool in order to conduct and evaluate ergonomic interventions that aimed to reduce exposure to physical risk factors. Another work-related musculoskeletal disorder management way was proposed as a supplement to ergonomic interventions. It is about a dynamic closed chain humeral head centering exercise performed by assembly line workers with clinical signs of subacromial impingement syndrome. Our data demonstrated that the intervention program was effective in decreasing shoulder pain as well as improving shoulder function. This study underlined the relevance of therapeutic exercises for shoulder disorders management at the workplace. Finally, the whole of this thesis work highlights the decisive role of specialists in human motor analysis for work-related musculoskeletal disorders management

INTRODUÇÃO: A urbanização tem sido acompanhada por um crescente aumento no volume e na diversidade de resíduos sólidos produzidos. O reaproveitamento desses resíduos vem sendo feito desde o início do século XX, inicialmente pela figura do \"velho garrafeiro\", até que em 2003 ocorre o reconhecimento da profissão do \"catador de materiais recicláveis\" na Classificação Brasileira de Ocupações. O problema ambiental decorrente da geração e do descarte de resíduos fez com que fosse instituída a Política Nacional de Resíduos Sólidos, sendo que entre suas diretrizes há o estimulo à participação do catador na cadeia produtiva da reciclagem. Não obstante a ocorrência de avanços nas condições de trabalho dos catadores persistem exposições penosas às cargas biomecânicas, tais como esforços físicos, posições viciosas e movimentos repetitivos. Adicionalmente, a organização do processo produtivo e o modo com que os catadores desenvolvem suas tarefas, são situações que predispõem a riscos e danos à saúde. OBJETIVO: Identificar a ocorrência de dor/desconforto osteomusculares relacionados ao trabalho em catadores que atuam em cooperativas de triagem na Região Metropolitana de São Paulo. MÉTODO: Estudo transversal, com amostra constituída por 250 catadores distribuídos em quatro cooperativas, com entrevista dirigida por um instrumento de coleta de dados padronizado. RESULTADOS: Entre os catadores predominou o gênero feminino (62%), a idade entre 41-59 anos (53%), a raça negra/parda (66,4%) e abaixa escolaridade (77% com menos de oito anos de estudo). A dor/desconforto osteomuscular foi referida por 163 (65%) dos catadores, entre esses, a localização na coluna foi a mais frequente (50%), seguida dos membros superiores (45%) e membros inferiores (31%). Os resultados encontrados na análise multivariada mostraram que dor/desconforto estava associado aos meios de produção da cooperativa (p<0.000), ao fato de ter tido outra ocupação (p=0.007) e ter tido acidente de trabalho (p=0.043). CONCLUSÕES: As condições de trabalho observadas eram extremamente precárias e constituíam importante fator de risco para distúrbios osteomusculares. Catadores estão expostos à mesma posição de trabalho por longo período, posturas inadequadas, monotonia, esforço físico, repetitividade e manuseio de materiais cortantes. As condições em que desempenham suas tarefas são prováveis fatores a problemas osteomusculares / INTRODUCTION: Urbanization has been accompanied by a growing increase in the volume and diversity of solid waste produced. The practice of reusing these wastes has been carried out since the beginning of the XX century, initially by the figure of the \"bottle dealer\", up to 2003 when we had the recognition of the profession of \"recyclable materials collector\" in the Brazilian Classification of Occupations. The environmental problem caused by the production and disposal of waste led to the establishment of the National Solid Waste Policy, and among its guidelines there is an stimulus to the participation of the waste collector in the recycling chain. Despite the improvements in the working conditions of the waste collector, exposures to biomechanical loads, such as physical stresses, vicious positions and repetitive movements persist. In addition, the organization of the production process and the way in which the collectors perform their tasks are situations that predispose to risks and damages to health. OBJECTIVE: To identify the occurrence of musculoskeletal pain / discomfort related to the work of recyclable materials collector working in sorting cooperatives in the Metropolitan Region of São Paulo. METHOD: A cross-sectional study with a sample of 250 collectors distributed in four cooperatives, with an interview conducted by a standardized data collection instrument. RESULTS: Among the recyclable materials collector, the majority were women (62%), with age between 41-59 years (53%), of black / brown race (66.4%) and low education (77% with less than 8 years of schooling). Musculoskeletal pain / discomfort was reported by 163 (65%) of the recyclable materials collector, among them, the location in the spine was the most frequent (50%), followed by upper limbs (45%) and lower limbs (31%). The results found in the multivariate analysis showed that pain/discomfort was associated with the means of production of the cooperative (p < 0.000), having had another occupation (p=0.007) and having had a work accident previously (p = 0.043). CONCLUSIONS: The working conditions observed are extremely precarious and constitute an important risk factor for musculoskeletal disorders. Waste pickers are exposed to the same work position for long periods, inadequate postures, monotony, physical effort, repetitiveness and handling of sharp materials. The conditions under which they perform their tasks are likely factors to musculoskeletal problems

<p>This study aimed at identifying the factors contributing towards work related neck pain amongst university administrative staff, its impact on everyday life activities and in turn its prevalence. A quantitative descriptive cross sectional study design was used amongst the administrative staff at the University of The Western Cape, South Africa. Data collection was carried out with the help of a questionnaire which was administered by the researcher in person. Data was analysed with both descriptive and inferential statistics using SPSS and SAS for windows. Chi-square test and logistic regression analysis was done. The results of this study revealed a very high prevalence of work related neck pain amongst university administrative staff. </p>

<p>This study aimed at identifying the factors contributing towards work related neck pain amongst university administrative staff, its impact on everyday life activities and in turn its prevalence. A quantitative descriptive cross sectional study design was used amongst the administrative staff at the University of The Western Cape, South Africa. Data collection was carried out with the help of a questionnaire which was administered by the researcher in person. Data was analysed with both descriptive and inferential statistics using SPSS and SAS for windows. Chi-square test and logistic regression analysis was done. The results of this study revealed a very high prevalence of work related neck pain amongst university administrative staff. </p>

The aims of the thesis were (i) to investigate the impact of repetitive low-intensity work exposure on proprioception and (ii) to examine effects of muscle stretching (especially sensory effects and effects on muscle nociception) and to relate its application to the prevention, alleviation and/or treatment of work-related neuromuscular disorders. The effects of low-intensity repetitive work on the shoulder proprioception were tested in healthy subjects. The effect of working time on the retention of subjective fatigue and their relation to changes in proprioception, and the immediate effect of stretching on shoulder proprioception were investigated. A new method to test the stretchability of the rectus femoris muscle was investigated for reliability and validity and used to assess the effects of a two-week stretching regimen on range of motion and on subjective stretch sensation. Finally, the interactions between innocuous muscle stretch and nociceptive chemical stimulation on discharge behavior of nociceptive dorsal horn neurons in the feline spinal cord were explored. The main findings were as follows: 1) The repetitive low-intensity work to fatigue diminished the shoulder proprioception; the working time as well as the retention of subjective fatigue were partly related to the extent of changed proprioception. 2) There was no effect of acute muscle stretching on the proprioception. 3) The new method for testing muscle stretchability proved valid and reliable. A two-week stretching regimen increased the tolerance to stretch torque, but the range of motion remained unchanged. 4) Half of the nociceptive dorsal horn neurons that responded to close arterial injections of bradykinin were modulated by muscle stretching applied directly after the injections. Altogether, the results give credence to the hypothesis of an involvement of sensory information distortion due to repetitive low-intensity work exposure in the development of work-related neuromuscular disorders. Increased tolerance to stretch torque may be an important mechanism in explaining improvements following stretch treatment. The spinal interactions between innocuous stretch and nociceptive muscle afferent inputs indicate a possible mechanism involved in stretching-induced pain alleviation.

Made available in DSpace on 2016-06-02T20:18:14Z (GMT). No. of bitstreams: 1 3866.pdf: 6310029 bytes, checksum: 1dbae2c10aceb4a83b1489edc0b7fb1d (MD5) Previous issue date: 2011-10-24 / Universidade Federal de Minas Gerais / Electrical energy is an essential good that may affect people s life and the economy. Overhead line workers and construction electricians are the workers responsible for the availability of this good. To perform their occupational tasks these workers are exposed to fatal accidents and musculoskeletal overload. Although of high rates of accidents and musculoskeletal injuries among these workers, few studies evaluated the presence of risk factors in the occupational settings of line workers and electricians. In this sense, it is necessary to identify the risk factors in the electricians activities (Study 1), quantify the exposure using valid direct methods (Study 2, 3 and 5) and verify the importance of the found results for clinical applications (Study 4 and 5). Study 1 was developed to determine the prevalence of musculoskeletal symptoms among line workers and to identify the risk factors for musculoskeletal disorders. The results of this study showed postural overload and high prevalence of musculoskeletal symptoms at shoulders and neck. Based on these results, Study 2 was purposed to quantify the postural overload in the five main tasks performed by line workers. Loading and unloading the ladder on the vehicle support was deeply investigated by means of posture and force measurements in Study 3, due its higher frequency in line workers schedule. Postures and movements were recorded by four inclinometer sensors at a sampling rate of 20Hz. Inclinometer sensors were previously calibrated and them attached at workers head, upper back and right and left upper arms. Study 2 and 3 identified that line workers are exposed to shoulder and neck awkward postures during all evaluated tasks. However, both studies were performed in simulated settings. By this way, Study 4 was developed to verify if the postures recorded in the simulated conditions are representative of the posture recorded in occupational environment. The results of Study 4 showed that whether the tasks are possible to be reproduced in simulated conditions the postural overload is representative of occupational overload. Besides the representativeness, Study 5 focused the comparison between posture exposure among Brazilian and Norwegian electricians to verify whether the same job type evaluated by the same method under the same procedures would present the same overload disregard the culture differences. The results of this study would allow inferring about external validity of the recordings. According to the found results, Brazilian and Norwegian posture exposure is similar. The results of Study 5 also indicated the high postural overload that these workers are submitted. Therefore, the present thesis showed the need for ergonomic interventions to reduce biomechanical risk factors presented at electricians work activity and the representativeness of the found results to occupational environmental conditions and to other populations. / A disponibilidade de energia elétrica é um serviço básico que afeta diretamente a vida e a economia da população. Para a manutenção deste serviço, eletricistas das empresas de distribuição de energia e eletricistas de construção são expostos aos riscos de acidentes fatais e à alta sobrecarga musculoesquelética. Apesar do reconhecimento dos altos índices de acidentes e de lesões musculoesqueléticas nestes trabalhadores, poucos estudos que avaliam a exposição destes sujeitos aos fatores de risco presentes no ambiente ocupacional estão disponíveis na literatura. Neste sentido, é necessário conhecer os fatores de risco presentes na atividade ocupacional (Estudo 1), quantificá-los por medidas diretas válidas (Estudos 2, 3 e 5) e verificar a importância dos resultados encontrados para a prática clínica (Estudos 4 e 5). O Estudo 1 foi desenvolvido para determinar a prevalência de sintomas musculoesqueléticos em eletricistas de distribuição e identificar os fatores de risco para desordens musculoesqueléticas presentes nas atividades mais freqüentemente desenvolvidas por estes. Os resultados deste estudo mostraram alta prevalência de sintomas musculoesqueléticos em ombros e cervical associados à alta sobrecarga postural, identificada por observação. Com base nestes resultados foi proposto o Estudo 2 para quantificar a sobrecarga postural a que estes trabalhadores estão submetidos durante cinco das atividades freqüentemente realizadas. Maior detalhamento da atividade de remoção e reposição da escada foi realizado no Estudo 3, que envolveu, além do registro postural, a medida da força e esforço requeridos. As posturas e movimentos da cabeça, tronco superior, cervical e ombros direito e esquerdo foram registrados por inclinometria por meio de 4 transdutores previamente calibrados e fixos na cabeça, tronco superior e braços direito e esquerdo, respectivamente. Os Estudos 2 e 3 identificaram a exposição dos eletricistas de distribuição a posturas inadequadas para ombros e cervical nas atividades avaliadas. No entanto, como estes dois estudos foram realizados em ambiente simulado, foi realizado o Estudo 4, para verificar a representatividade destes resultados encontrados em ambiente simulado quando comparados ao registro realizado em ambiente ocupacional real. Os resultados do Estudo 4 mostraram que as atividades desenvolvidas em ambiente simulado podem apresentar a mesma sobrecarga postural do ambiente ocupacional desde que a atividade possa ser simulada. Além da representatividade, no Estudo 5 foi realizada a comparação da exposição postural entre eletricistas de construção Brasileiros e Noruegueses, para verificar se o mesmo tipo de trabalho, avaliado pelo mesmo instrumento a partir dos mesmos procedimentos, indicam a mesma exposição independente da cultura, o que permite inferir sobre a validade externa dos resultados encontrados. De acordo com os resultados encontrados, a exposição de eletricistas Brasileiros e Noruegueses é similar. Os resultados do Estudo 5 também indicam a alta sobrecarga postural a que os eletricistas de construção estão expostos. Portanto, a presente tese revelou a necessidade de intervenções ergonômicas para redução dos fatores de riscos biomecânicos presentes na atividade de eletricistas e a representatividade dos resultados encontrados para situações ocupacionais reais e para outras populações.

Made available in DSpace on 2016-06-02T20:19:21Z (GMT). No. of bitstreams: 1 DissTOS.pdf: 1026563 bytes, checksum: 3084e32eb13447dd885b2643417f39a5 (MD5) Previous issue date: 2005-02-22 / Financiadora de Estudos e Projetos / Work-related musculoskeletal disorders (WMSDs) constitutes a group of disturbs, with multifactorial origin, mainly promoted by workplace factors (physical, organizational and psychosocial). WMSDs cause high human, social and economic costs, which justifies effort to determine more efficient prevention strategies. However, for an effective prevention is necessary to establish the main risk factors, and create or aprimorate assessment tools. It was proposed a new tool for risk assessment Checklist for musculoskeletal risk assessment (RARME). The objective of this study was to evaluate the consistency of this checklist in relation to other physical load indicators: discomfort and exertion ratings, sick leave and Ergonomic Workplace Analysis. Thirty-one subjects took part in this study. They performed fifteen different tasks involving repetitive motion pattern and manual material handling. Checklist was applied by direct observation in the workplace. No relation between the results from checklist and the other physical load indicators was identified. Several factors might have contributed to the lack of consistency between indicators. Exposure variability, cognitive overload of the observer, bias in observation methods, and instruments for risk measurement are important factors to be considered when analyzing the present results. Thus, although it was not possible to check the protocol validity, relevant methodological aspects when using theses types of checklists were discussed. Besides this, an improved version of RARME protocol is presented. / As Lesões por Esforços Repetitivos/Distúrbios Osteomusculares Relacionados ao Trabalho (LER/DORT) constituem um grupo de distúrbios, de origem multifatorial, promovidos ou agravados por características do local de trabalho (físicas, organizacionais ou psicossociais). As LER/DORT causam alto custo humano, social e econômico, o que justifica esforços para determinar estratégias de prevenção mais eficazes. Porém, para uma prevenção efetiva é necessário que se identifique as principais causas destes distúrbios, além de se criar ou aprimorar ferramentas de avaliação dos riscos presentes no trabalho. Diante disto foi proposto o Roteiro para Avaliação de Riscos Músculo-Esqueléticos (RARME). O objetivo deste estudo foi avaliar a consistência deste Roteiro em relação a outros indicadores de sobrecarga física: escalas de desconforto e esforço, afastamento do trabalho e Análise Ergonômica do Local de Trabalho. Foram avaliados 31 indivíduos que realizavam 15 atividades diferentes com padrões de movimento repetitivos e manuseio de cargas. A aplicação do RARME foi feita por observação direta. Não foi identificada relação entre o RARME e os outros indicadores de sobrecarga física. Vários fatores podem ter contribuído para esta inconsistência. A variabilidade da exposição; sobrecarga cognitiva do observador e erros inerentes à observação; e características dos instrumentos usados para medir o risco são fatores importantes a serem considerados quando se analisam os presentes resultados. Portanto, embora não tenha sido possível checar a validade deste novo Roteiro, foi possível determinar uma série de considerações metodológicas importantes para o uso de protocolos de registro postural. Além disso, uma versão aprimorada do RARME foi proposta.

INTRODUÇÃO: A urbanização tem sido acompanhada por um crescente aumento no volume e na diversidade de resíduos sólidos produzidos. O reaproveitamento desses resíduos vem sendo feito desde o início do século XX, inicialmente pela figura do \"velho garrafeiro\", até que em 2003 ocorre o reconhecimento da profissão do \"catador de materiais recicláveis\" na Classificação Brasileira de Ocupações. O problema ambiental decorrente da geração e do descarte de resíduos fez com que fosse instituída a Política Nacional de Resíduos Sólidos, sendo que entre suas diretrizes há o estimulo à participação do catador na cadeia produtiva da reciclagem. Não obstante a ocorrência de avanços nas condições de trabalho dos catadores persistem exposições penosas às cargas biomecânicas, tais como esforços físicos, posições viciosas e movimentos repetitivos. Adicionalmente, a organização do processo produtivo e o modo com que os catadores desenvolvem suas tarefas, são situações que predispõem a riscos e danos à saúde. OBJETIVO: Identificar a ocorrência de dor/desconforto osteomusculares relacionados ao trabalho em catadores que atuam em cooperativas de triagem na Região Metropolitana de São Paulo. MÉTODO: Estudo transversal, com amostra constituída por 250 catadores distribuídos em quatro cooperativas, com entrevista dirigida por um instrumento de coleta de dados padronizado. RESULTADOS: Entre os catadores predominou o gênero feminino (62%), a idade entre 41-59 anos (53%), a raça negra/parda (66,4%) e abaixa escolaridade (77% com menos de oito anos de estudo). A dor/desconforto osteomuscular foi referida por 163 (65%) dos catadores, entre esses, a localização na coluna foi a mais frequente (50%), seguida dos membros superiores (45%) e membros inferiores (31%). Os resultados encontrados na análise multivariada mostraram que dor/desconforto estava associado aos meios de produção da cooperativa (p<0.000), ao fato de ter tido outra ocupação (p=0.007) e ter tido acidente de trabalho (p=0.043). CONCLUSÕES: As condições de trabalho observadas eram extremamente precárias e constituíam importante fator de risco para distúrbios osteomusculares. Catadores estão expostos à mesma posição de trabalho por longo período, posturas inadequadas, monotonia, esforço físico, repetitividade e manuseio de materiais cortantes. As condições em que desempenham suas tarefas são prováveis fatores a problemas osteomusculares / INTRODUCTION: Urbanization has been accompanied by a growing increase in the volume and diversity of solid waste produced. The practice of reusing these wastes has been carried out since the beginning of the XX century, initially by the figure of the \"bottle dealer\", up to 2003 when we had the recognition of the profession of \"recyclable materials collector\" in the Brazilian Classification of Occupations. The environmental problem caused by the production and disposal of waste led to the establishment of the National Solid Waste Policy, and among its guidelines there is an stimulus to the participation of the waste collector in the recycling chain. Despite the improvements in the working conditions of the waste collector, exposures to biomechanical loads, such as physical stresses, vicious positions and repetitive movements persist. In addition, the organization of the production process and the way in which the collectors perform their tasks are situations that predispose to risks and damages to health. OBJECTIVE: To identify the occurrence of musculoskeletal pain / discomfort related to the work of recyclable materials collector working in sorting cooperatives in the Metropolitan Region of São Paulo. METHOD: A cross-sectional study with a sample of 250 collectors distributed in four cooperatives, with an interview conducted by a standardized data collection instrument. RESULTS: Among the recyclable materials collector, the majority were women (62%), with age between 41-59 years (53%), of black / brown race (66.4%) and low education (77% with less than 8 years of schooling). Musculoskeletal pain / discomfort was reported by 163 (65%) of the recyclable materials collector, among them, the location in the spine was the most frequent (50%), followed by upper limbs (45%) and lower limbs (31%). The results found in the multivariate analysis showed that pain/discomfort was associated with the means of production of the cooperative (p < 0.000), having had another occupation (p=0.007) and having had a work accident previously (p = 0.043). CONCLUSIONS: The working conditions observed are extremely precarious and constitute an important risk factor for musculoskeletal disorders. Waste pickers are exposed to the same work position for long periods, inadequate postures, monotony, physical effort, repetitiveness and handling of sharp materials. The conditions under which they perform their tasks are likely factors to musculoskeletal problems

Magister Scientiae (Physiotherapy) - MSc(Physio) / This study aimed at identifying the factors contributing towards work related neck pain amongst university administrative staff, its impact on everyday life activities and in turn its prevalence. A quantitative descriptive cross sectional study design was used amongst the administrative staff at the University of The Western Cape, South Africa. Data collection was carried out with the help of a questionnaire which was administered by the researcher in person. Data was analysed with both descriptive and inferential statistics using SPSS and SAS for windows. Chi-square test and logistic regression analysis was done. The results of this study revealed a very high prevalence of work related neck pain amongst university administrative staff. / South Africa

When implementing a managed healthcare intervention among a working population, evidence-based healthcare is critical. In the current study, the change of work posture of sewing-machine operators from seated to stand-up (the intervention) was managed within a physiotherapy and ergonomics programme (programme) in Johnson Controls Automotive S.A. (Pty) Ltd (company) without local evidence to guide the postural transition. The management of the intervention, implemented over a period of 4.5 years, presented the opportunity for a retrospective longitudinal study. The study determined the impact of the change in work posture on the incidence of work-related musculoskeletal disorders (WRMSDs) from June 2004 to January 2009 (period). The role of the physiotherapist in the programme was to deliver manual therapy to all sewing-machine operators with WRMSDs, and to provide a clinical - ergonomics service, as a member of a multidisciplinary team, to the company. The population of sewing-machine operators (n=123) was described in terms of personal factors (e.g. age, medical history, musculoskeletal history, and body mass index (BMI)), ergonomic risk factors (e.g. work posture, force and duration) and overall incidence of WRMSDs. The associations of risk factors (personal and ergonomic) with WRMSDs, and work posture with WRMSDs among sewing-machine operators were statistically determined. The majority of the population (97.6%) was female, with mean age 42.3± 8 years. At baseline, 17.9% were hypertensive, 3.3% had arthritis, 6.5% were diabetic, and the mean BMI was 29.7 kg/m² (22% of BMIs was normal). The largest proportion of the sewing-machine operators were sewing cloth and leather (79.7%) (compared to sewing cloth and vinyl), and the remainder performed forceful precision stitching (20.3%), including headrest covers, airbags and top stitching on the final product. Job rotation took place between forceful precision stitching and straight stitching (for 36.6% of the sewing-machine operators).p> The intervention was implemented within the study period. At baseline 100% of sewing machine operators were sewing in the seated work posture. Early in the study, 17.9% of them changed their work posture from seated to stand-up, 30.1% changed to the stand-up work posture in January 2007, and 34.9% a year later. The last 17.1% remained seated till the last year of the study period. From July 2008, 100% of the sewing-machine operators were sewing in the stand-up work posture. The results indicated two strong associations of risk factors and a change in work posture with WRMSDs. Obesity (specifically morbid obesity) was a personal risk factor for upper limb disorders and working in the stand-up work posture was protective for spinal disorders, compared to working in the seated work posture. Furthermore, the results indicated a high incidence of disorders (specifically of the spinal area and upper limb) during the first three months of the programme, as well as an increased incidence of lower leg disorders for the first and consecutive month of the change in work posture from seated to standing up. Lower limb disorders were specifically associated with obesity. The increase of lower limb disorders during the postural adaptation phase was temporary, and was addressed within the programme with proper shoe wear, silicone innersoles, supportive stockings and exercises. The combination proved to be effective in preventing and/or managing lower limb disorders. The outcome of the current study provided evidence on the incidence of WRMSDs, and associations between risk factors and work posture, and WRMSDs among sewing machine operators managed within the programme. / Dissertation (MPhysT)--University of Pretoria, 2013. / Physiotherapy / unrestricted