Repeatability and validity of an upper limb and neck discomfort questionnaire: the utility of the standardized Nordic questionnaire

Impact of Impaired Fasting Glucose on Musculoskeletal Pain Among Female-Dominated Healthcare Workers

Introduction: In 2021, 10.5% of people aged 20-79 had diabetes, projected to rise to 12.2% by 2045, causing early deaths and straining healthcare systems. Musculoskeletal (MS) pain is common, affecting many workers and the general population. Prediabetes, notably impaired fasting glucose (IFG), is linked to increased MS pain risk. Objective: This study aims to assess IFG's impact on MS pain and specific pain sites to aid prevention strategies. Methods: This cross-sectional study used the '2023 Employee Occupational Safety and Health Management Database' from a Taichung hospital. It included health checks, demographics, living and work data, and MS pain surveys. Out of 2369 staff members contacted, 1039 valid responses were analyzed, excluding incomplete data, diabetes history, or fasting blood glucose levels above 125 mg/dL. Data on sex, age, marital status, coffee and alcohol consumption, sleep duration, exercise habits, height, weight, chronic diseases, profession, work hours, shift work, and education level were collected. Fasting blood glucose was verified using American Diabetes Association criteria (100-125 mg/dL). The Nordic Musculoskeletal Questionnaire (NMQ) measured MS pain frequency and severity, creating a pain degree index. Results: Overall, 21.17% had IFG. Participants were mostly female (85.18%), averaging 37.50 years. Neck and shoulder pain risk was linked to sex, coffee and alcohol consumption, sleep, exercise, chronic diseases, work hours, and IFG. Ankle pain risk was linked to coffee and alcohol consumption. IFG, coffee, alcohol, sleep under 6 h, chronic diseases, and work hours were independent risk factors for neck and shoulder pain. IFG was a risk factor for those without overweight or obesity. A mediation model tested IFG's indirect effect on neck and shoulder pain among overweight or obese individuals, showing that IFG mediates the relationship between being overweight or obese and increased neck and shoulder pain risk. Conclusions: Among female-dominated healthcare workers, IFG, daily coffee, recent alcohol consumption, less than 6 h of sleep, chronic diseases (excluding diabetes), and longer work hours are independent risk factors for neck and shoulder pain. IFG mainly affects these areas, increasing pain risk regardless of body weight. Healthy blood glucose levels are associated with a lack of musculoskeletal pain, suggesting a novel prevention approach needing further study.

Low Back Pain Among Health Sciences Undergraduates: Results Obtained from a Machine-Learning Analysis

Background and objective. Low back pain (LBP) is considered the most common and challenging disorder in health care. Although its incidence increases with age, a student's sedentary behavior could contribute to this risk. Through machine learning (ML), advanced algorithms can analyze complex patterns in health data, enabling accurate prediction and targeted prevention of medical conditions such as LBP. This study aims to detect the factors associated with LBP among health sciences students. Methods. A self-administered modified version of the Standardized Nordic Questionnaire was completed by 222 freshman health sciences students from May to June 2022. A supervised random forest algorithm was utilized to analyze data and prioritize the importance of variables related to LBP. The model's predictive capability was further visualized using a decision tree to identify high-risk patterns and associations. Results. A total of 197/222 (88.7%) students participated in this study, most of whom (75%) were female. Their mean age and body mass index were 23 ± 3.8 and 23 ± 3.5, respectively. In this group, 46% (n = 90) of the students reported having experienced LBP in the last month, 15% (n = 30) were smokers, and 60% (n = 119) were involved in prolonged sitting (more than 3 h per day). The decision tree of ML revealed that a history of pain (score = 1), as well as disability (score= 0.34) and physical activity (score = 0.21), were significantly associated with LBP. Conclusions. Approximately 46% of the health science students reported LBP in the last month, and a machine-learning approach highlighted a history of pain as the most significant factor related to LBP.

Nonspecific cervical spine pain/neck pain/in medical personnel of north-eastern Poland-A cross-sectional study

Both mechanical and psychological overload are inherent to the work of nurses and paramedics, resulting spondylogenic pain.

Aim of the study

To identify potential risk factors influencing the prevalence of non-specific cervical spine pain in professionally active nurses and paramedics.

Material and methods

324 nurses (53.2% of the total) and 285 paramedics (46.8%) were included in the study-609 people in total. The study was carried out using an auditorium survey technique supervised by the researchers. The methods used were: Nordic Musculoskeletal Questionnaire, a spinal pain questionnaire validated according to IEA guidelines, a short version of the IPAQ and the author's survey questionnaire, concerning sociodemographic data, chronic diseases including metabolic syndrome (MetS). A univariate logistic regression model was used in the statistical analysis. The level of statistical significance was taken as p < 0.05.

Results

Recurrent NP was significantly more common in paramedics compared to nurses (29.5 % vs. 9.3 %; p < 0.0001). In a univariate logistic regression model, the risk of NP was significantly increased by: length of service > 15 years (p < 0.024), presence of: low back pain (p < 0.0001), type 2 diabetes (p = 0.013), hypertension (p < 0.001), depression (p < 0.01). Of the modifiable factors, the risk of NP was significantly increased by high physical activity and short sleep <7 h (p < 0.001).

Relationship between Marriage and Prediabetes among Healthcare Workers: Mediating Effect of Triglycerides

Background and Objectives: In the literature, relationships between being married and having prediabetes or diabetes are inconsistent. We aimed to investigate whether marriage is a protective or risk factor for prediabetes and to uncover new insights into its impact on prediabetes. Materials and Methods: In this cross-sectional observational study, questionnaires were distributed by email to 1039 staff members who participated in an employee health check from a hospital affiliated with a medical university in Taiwan. Fasting blood glucose and triglyceride (TG) levels were checked and the questionnaires elicited basic demographic characteristics and included the Copenhagen Burnout Inventory and Nordic Musculoskeletal Questionnaire. The chi-square test or Fisher's exact test, logistic regression, and mediation analysis were conducted for statistical analysis. Results: Among the group aged 20-37 years, married (OR = 1.89, 95%CI: 1.08, 3.33), obesity (OR = 2.95, 95%CI: 1.49, 5.83), neck and shoulder pain (OR = 1.31, 95%CI: 1.01, 1.69), and elevated TG levels (OR = 1.01, 95%CI: 1.00, 1.01) were independent risk factors for prediabetes (impaired fasting glucose). For those >38 years old, overweight (OR = 2.08, 95%CI: 1.27, 3.43), obesity (OR = 4.30, 95%CI: 2.38, 7.79), and elevated triglyceride (TG) (OR = 1.003, 95%CI: 1.00, 1.01) were the independent risk factors for impaired fasting glucose. Increased TG levels serve as a mediating factor (Zm = 2.64, p < 0.01) linking marriage to an increased risk of prediabetes for the group aged 20-37 years. Conclusions: TGs play a significant role in the association between marriage and prediabetes among the group aged 20-37 years. Therefore, dietary habits, especially those of young adult couples should be considered. Our findings connect marital status to prediabetes, facilitating advances in diabetes prevention.

The Value of Strength as a Predictor of Musculoskeletal Injury in Canadian Armed Forces Basic Infantry Candidates

INTRODUCTION

Musculoskeletal injuries (MSKI) impact military organizations by threatening their operational readiness, warranting investigation into relevant factors to inform risk reduction strategies. While several self-reported and physical performance measures have been associated with MSKI among military personnel, few have been validated and none have been reported in Canadian basic infantry candidates. The purpose of this study was to investigate associations between self-reported and physical performance measures and MSKI, and determine their validity as predictors of MSKI, in Canadian basic infantry candidates.

METHODS

This was a planned secondary analysis of a study tracking MSKI at a basic infantry training facility in Ontario, Canada approved by Defence Research & Development Canada. Before the basic infantry training, consenting candidates completed a baseline testing session including self-reported questionnaires, measures of anthropometry, and physical performance previously associated with MSKI (ankle dorsiflexion test, Y-Balance Test, Isometric Mid-Thigh Pull, and the Fitness for Operational Requirements of CAF Employment (FORCE) evaluation). All MSKI reported by candidates were diagnosed by licensed healthcare providers. From a total sample of 129 candidates, 76% (n = 98) were used to determine any associations between baseline testing variables and MSKI and to develop a predictive model (Development Sample), while 24% (n = 33) were used to offer preliminary validation of the same predictive model (Validation Sample). The binary logistic regression and independent sample t-testing determined independent associations with MSKI in the Development Sample. All continuous variables and dichotomous variables previously associated with MSKI risk (Smoker Yes/No, previous history of MSKI, and physical inactivity) were entered into a backward stepwise logistic regression analysis to assess the predictive association with MSKI incidence in the Development Sample. The regression model was then applied to the Validation Sample.

RESULTS

A total of 35 MSKI were diagnosed by Health Services Centre staff. The majority of the MSKI were acute (63%), sustained to the hip, knee, and ankle (74%). The most common diagnoses were strains and sprains (71%). Uninjured participants performed significantly better on the Relative Isometric Mid-Thigh Pull, FORCE 20 mR, FORCE ILS, and FORCE Estimated VO2peak compared to injured participants. Logistic regression analysis showed that the only variable with significant independent association with diagnosed MSKI incidence was self-reported previous history of MSKI. However, the backward stepwise logistic regression analysis retained self-reported previous history of MSKI, FORCE SBD, FORCE Estimated VO2peak, and Isometric Mid-Thigh Pull Peak Force as predictors of MKSI. The logistic regression model including these variables could predict MSKI with an accuracy of 79% in the Development Sample and 67% in the Validation Sample.

CONCLUSION

This study provides preliminary support for the value of measures of absolute muscular strength and cardiorespiratory fitness as predictors of MSKI in Canadian basic infantry candidates. Given the associations between physical performance measures and MSKI, and their necessity during occupational tasks, it is recommended that Canadian basic infantry training facilities integrate resistance training with external loads to best prepare their candidates to meet their occupational demands and potentially minimize MSKI. Further investigations to confirm the predictive capacity of these variables in a larger sample across additional facilities are warranted.

Stand-Capable Workstations Reduce Occupational Sedentary Time Among Administrative Workers

OCCUPATIONAL APPLICATIONSIn this study, we found that workers who use stand-biased desks stood more and sat less during their workday compared to workers who use traditional desks. Stand-biased users also experienced significantly less lower back discomfort compared to both traditional and sit-stand workstation users. Based on these findings, we recommend that the use of stand-biased workstations be considered when designing or renovating work office workspaces. The health risks of sedentary behavior are inherent in most office work, but these risks can be alleviated with intentional equipment choices. Using stand-biased desks can encourage workers to move more throughout the workday without their productivity or comfort being disturbed.

Home schooling during the COVID-19 pandemic: A randomized controlled trial of online exercise and ergonomics advice protocols on upper body symptoms

BACKGROUND

Understanding of students' musculoskeletal health under home-schooling during the COVID-19 pandemic is limited.

OBJECTIVES

(1) To investigate the prevalence and severity of musculoskeletal symptoms in home-schooled adolescents during the COVID-19 pandemic. (2) To evaluate the effect of an online exercise + ergonomics advice protocol on symptoms, compared with ergonomics advice alone.

DESIGN

Cross-sectional symptom survey identifying eligible participants, followed by a pragmatic randomized controlled trial.

SETTING

Online classes.

PARTICIPANTS

Survey: 354 students (mean 16.6 years).

TRIAL

188 students with upper body musculoskeletal symptoms.

INTERVENTIONS

Randomization to three groups (physical therapy exercises + ergonomics postural advice, ergonomics postural advice alone, nonintervention control) stratified by the site of symptoms (neck, shoulder, upper back). Interventions were orally delivered online (via WhatsApp) supplemented with written/illustrative material. Follow-up occurred at 8 weeks.

OUTCOME MEASURES

Survey: prevalence of symptoms (Nordic Questionnaire).

TRIAL

primary outcome = change in intensity of upper body symptoms (visual analogue scale); secondary outcome = number of participants reporting improvement in upper body symptoms.

RESULTS

The 12-month prevalence of musculoskeletal disorders in the survey was 38% neck, 28% shoulder, and 35% upper back, with mean pain intensity of 3.6, 3.9, and 3.8, respectively, on 0-10 visual analogue scale: Two-thirds reported symptoms in multiple anatomical regions. In the trial, there was no statistically significant difference between the exercise + ergonomics group and ergonomics alone group on the primary outcome, yet both groups showed reduced symptom intensity compared with control (p < .001). More participants in the exercise + ergonomics group reported improvement than in the ergonomics advice alone group (p < .02).

CONCLUSIONS

The prevalence of musculoskeletal symptoms was relatively high in home-schooled adolescents. Symptoms can be reduced by ergonomics advice with or without exercises, but the effect is enhanced by the addition of physical therapy exercises. The latter approach may be considered for improving schoolchildren's musculoskeletal health in the usual classroom setting.

The effect of commuting time on burnout: the mediation effect of musculoskeletal pain

OBJECTIVES

This study explores the relationship among commuting, musculoskeletal (MS) pain, and burnout.

METHODS

An observational and cross-sectional study was conducted at a medical university-affiliated hospital in Taichung, Taiwan in 2021. The two questionnaire was used and they included the Copenhagen Burnout Inventory (CBI) and the Nordic Musculoskeletal Questionnaire (NMQ). All participants were invited to complete the cross-sectional survey. A multiple linear regression was assessed correlations between commuting, MS pain, and burnout.

RESULTS

After excluding those with missing data, 1,615 healthcare workers were deemed valid as research participants. In multiple linear regression, commuting time longer than 50 min was associated with personal burnout (PB) in the presence of adjusted confounders; however, long commuting time was not associated with work-related burnout (WB). Furthermore, the choice of commuting method did not affect PB or WB. Notably, both neck and shoulder pain (NBSP) and ankle pain (BAP) increase the risk of PB and WB. The mediation analysis demonstrated that NBSP is a mediating factor, increasing the level of PB and WB for commuting times longer than 50 min.

CONCLUSIONS

Healthcare workers who commute for more than 50 min should be considered part of a high-risk group for burnout and musculoskeletal pain. They should also be provided with resources and programs focused on burnout prevention and MS pain relief.

Physical Ergonomic Assessment in Cleaning Hospital Operating Rooms Based on Inertial Measurement Units

Workers involved in hospital operating room cleaning face numerous constraints that may lead to musculoskeletal disorders. This study aimed to perform physical ergonomic assessments on hospital staff by combining a continuous assessment (RULA) based on inertial measurement units with video coding. Eight participants performed cleaning tasks while wearing IMUs and being video recorded. A subjective evaluation was performed through the Nordic questionnaire. Global RULA scores equaled 4.21 ± 1.15 and 4.19 ± 1.20 for the right and left sides, respectively, spending most of the time in the RULA range of 3-4 (right: 63.54 ± 31.59%; left: 64.33 ± 32.33%). Elbows and lower arms were the most exposed upper body areas with the highest percentages of time spent over a risky threshold (right: 86.69 ± 27.27%; left: 91.70 ± 29.07%). The subtask analysis identified 'operating table moving', 'stretcher moving', and 'trolley moving' as the riskiest subtasks. Thus, this method allowed an extensive ergonomic analysis, highlighting both risky anatomical areas and subtasks that need to be reconsidered.

Minimal clinical datasets for spine-related musculoskeletal disorders in primary and outpatient care settings: a scoping review

OBJECTIVES

Effective measurement and monitoring of health status in patients with spine-related musculoskeletal (MSK) disorders are essential for providing appropriate care and improving outcomes. Minimal clinical datasets are standardized sets of key data elements and patient-centered outcomes that can be measured and recorded during routine clinical care. Our scoping review aimed to identify and map current evidence on minimal clinical datasets for measuring and monitoring health status in patients with spine-related MSK disorders in primary and outpatient healthcare settings.

STUDY DESIGN AND SETTING

We followed the JBI (formerly Joanna Briggs Institute) methodology for scoping reviews. MEDLINE, CINAHL, Cochrane Library, Index to Chiropractic Literature, MANTIS, ProQuest Dissertations and Theses Global, and medRxiv preprint repository were searched from database inception to August 1, 2021. Two reviewers independently screened titles and abstracts, full-text articles, and charted the evidence. Findings were synthesized and summarized descriptively.

RESULTS

After screening 5,583 citations and 301 full-text articles, 104 studies about 32 individual minimal clinical datasets were included. Most minimal clinical datasets were developed for patient populations with spine-involving inflammatory arthritis, nonspecific or degenerative spinal pain, and MSK disorders in general. The minimal clinical datasets varied substantially in terms of the author-reported time-to-complete (1-48 minutes) and the number of items (5-100 items). Fifty percent of the datasets involved healthcare professionals in their development process, and only 28% involved patients. Health domain items were most frequently linked to the components of activities and participation (43.9%) and body functions (28.6%), according to the International Classification of Functioning, Disability, and Health. There is no standardized definition of minimal clinical datasets to measure and monitor health status of patients with spine-related MSK disorders in routine clinical practice. Common core elements identified were practicality, feasibility in a busy routine practice, time efficiency, and the capability to be used across different healthcare settings.

CONCLUSION

Due to the absence of a standard definition for minimal clinical datasets for patients with spine-related MSK disorders, there is a lack of consistency in the selection of key data elements and patient-centered outcomes that should be included. More research on the implementation and feasibility of minimal clinical datasets in routine care settings is warranted and needed. It is essential to involve all relevant partners in the development process of minimal clinical datasets to ensure successful implementation and adoption in routine primary care.

Work-related musculoskeletal complaints of physiotherapists working in intensive care units: Frequency analysis, risk factors, management and prevention strategies

BACKGROUND

Intensive care physiotherapists are exposed to situations that may cause physical and mental overload, which can lead to the onset of work-related musculoskeletal complaints.

OBJECTIVE

The objective was to analyze these complaints and to identify activities causing greater overload, factors associated with complaints, and management and prevention strategies.

METHODS

Cross-sectional study. Data were collected from 125 physiotherapists in the Intensive Care units (ICU) of a tertiary hospital. The questionnaire used was formulated from questionnaires validated in the literature such as Nordic Questionnaire and Bork Questionnaire. Chi-square test was performed to compare the groups with and without complaints. Logistic regression was used to assess the association effects of the variables on the presence of complaints.

RESULTS

Of those interviewed, 76% had a work-related complaint in the last year, with the "lower back" being the most affected region. Eighty percent had complaints for more than one site. "Transfer" was considered the activity causing the greatest overload. Female sex (p = 0.023), lack of physical activity (p = 0.028), inadequate ventilation (p = 0.001) and inadequate furniture (p = 0.006) showed a statistically significant association effect with the presence of complaints. Inadequate ventilation (p = 0.003) and female sex (p = 0.004) influenced the number of affected areas. Physical activity was considered the main strategy for prevention.

CONCLUSION

Musculoskeletal complaints accounted for a high percentage of the analyzed sample, mainly in the lower back. The extent of complaints suggests that strategies should be developed and changes in work dynamics should be carried out.

Factors associated with increased risk of playing-related disorders among classical music students within the Risk of Music Students (RISMUS) longitudinal study

Playing-related musculoskeletal disorders (PRMDs) are common among musicians but longitudinal data on risk factors are limited. The aim of the study was to longitudinally identify the factors associated with increased risk of PRMD onset among music students enrolled in different pan-European music institutions. A further goal was to assess the occurrence of PRMDs during a 12-month period. A total of 442 students without PRMDs from 56 European music universities completed a web-based questionnaire on lifestyle and practice habits, health history, physical activity, psychological distress, perfectionism, and fatigue. PRMD onset was assessed prospectively at 6 and 12 months. Logistic regression analysis showed that changes in physical activity level (6-month AOR = 2.343, 12-month AOR = 2.346), increased levels of fatigue (6-month AOR = 1.084, 12-month AOR = 1.081) and socially-prescribed perfectionism (6-month AOR = 1.102) were significantly associated with PRMD onset, which had occurred in 49% of participants during 12 months. Musculoskeletal complaints reported at baseline (6-month AOR = 0.145, 12-month AOR = 0.441) and changes to BMI (12-month AOR = 0.663) limited the onset of PRMDs. The study's novel longitudinal findings were appraised critically within the contexts of potential factors for PRMD onset and evidence-based preventive strategies to minimise the impact of PRMDs.

Temporal stability in the prevalence and pattern of co-occurring musculoskeletal pain among people with persistent low back pain: population-based data from the Norwegian HUNT Study, 1995 to 2019

ABSTRACT

People with persistent low back pain (LBP) often report co-occurring persistent musculoskeletal (MSK) pain in other body regions that may influence prognosis as well as treatment approaches and outcomes. This study describes the prevalence and patterns of co-occurring persistent MSK pain among people with persistent LBP based on consecutive cross-sectional studies over 3 decades in the population-based HUNT Study, Norway. The analyses comprised 15,375 participants in HUNT2 (1995-1997), 10,024 in HUNT3 (2006-2008), and 10,647 in HUNT4 (2017-2019) who reported persistent LBP. Overall, ∼90% of participants in each of the HUNT surveys with persistent LBP reported persistent co-occurring MSK pain in other body sites. The age-standardized prevalence of the most common co-occurring MSK pain sites was consistent across the 3 surveys: 64% to 65% report co-occurring neck pain, 62% to 67% report shoulder pain, and 53% to 57% report hip or thigh pain. Using latent class analysis (LCA), we identified 4 distinct patterns of persistent LBP phenotypes that were consistent across the 3 surveys: (1) "LBP only," (2) "LBP with neck or shoulder pain," (3) "LBP with lower extremity or wrist or hand pain," and (4) "LBP with multisite pain," with conditional item response probabilities of 34% to 36%, 30% to 34%, 13% to 17%, and 16% to 20%, respectively. In conclusion, 9 of 10 adults in this Norwegian population with persistent LBP report co-occurring persistent MSK pain, most commonly in the neck, shoulders, and hips or thighs. We identified 4 LCA-derived LBP phenotypes of distinct MSK pain site patterns. In the population, both the prevalence and pattern of co-occurring MSK pain and the distinct phenotypic MSK pain patterns seem stable over decades.

Comparative ergonomic assessment of manual harvesting of un-lodged and lodged paddy crops post-tropical cyclone in India

OBJECTIVE

In recent times, increased rainfall from tropical cyclones due to climate change affects the agricultural sector, mainly the paddy fields. High windspeed with excessive rain causes lodging of paddy crops, which is difficult to harvest. Mechanized harvesting systems are ineffective in this situation due to waterlogging in the fields. Manual harvesting with a traditional sickle is the only way to harvest lodged crops to save food security crises and economic losses. Collecting the lodged paddy stems lying on the ground for harvesting manually is time-consuming and harvesters need to maintain an awkward posture for a prolonged period compared to harvesting un-lodged crops.

METHODS

Seventy-five female harvesters aged 35-75 years were selected for the study from both lodged and un-lodged small-scale farming lands of Kerala, a southwestern coastal state of India. A comparative ergonomic assessment was conducted to measure body pain, perceived exertion, postural risks, and rate of production under both harvesting conditions.

RESULTS

The harvesters reported significant higher rates of body pain, perceived exertion, high postural risks, and low productivity in lodged conditions compared to un-lodged condition.

CONCLUSION

Harvesting lodged crops involves high risks with low productivity and needs immediate ergonomic design intervention for the well-being of the harvesters.

The association between physical activity and musculoskeletal disorders-a cross-sectional study of teachers

Purpose

Combined with insufficient physical activity (PA) prolonged and improperly performed sedentary work can lead to musculoskeletal disorders (MSDs). The aim of this study was (I) to evaluate the self-reported level of PA and the prevalence of MSDs in male and female teachers, and (II) to investigate the association between PA and MSDs in teachers in Polish primary and secondary schools.

Methods

The study included 254 teachers from primary and secondary schools from Upper Silesia, Poland, excluding physical education teachers. The level of PA was assessed using the Seven-Day Physical Activity Recall (SDPAR). A standardized Nordic Musculoskeletal Questionnaire (NMQ) was used to assess the prevalence of MSDs.

Results

A similar percentage of female (80%) and male (90%) teachers met the WHO recommendations on moderate-intensity PA. The recommendations on performing vigorous-intensity PA were met by significantly (p = 0.002) less female than male teachers (50% and 75% respectively). Lower back disorders during the last 12 months and the last 7 days (57% and 45%, respectively) were the most commonly reported MSDs by teachers, followed by neck (53%, 40%), upper back (39%, 28%), and knee disorders (37%, 26%). The highest pain intensity was experienced by the teachers in the lower back and neck. Teachers with a greater number of MSDs were less likely to engage in vigorous-intensity PA and total PA than those with fewer painful areas of the body. Pain intensity in the neck, knees, upper- and lower back, and wrists/hands was negatively related to moderate and total PA. BMI negatively correlated with total PA, moderate-intensity PA vigorous-intensity PA, and high vigorous-intensity PA.

Conclusions

The study revealed the association between PA and MSDs in studied teachers. The most of the studied teachers met the WHO recommendation, and women were less likely to perform vigorous and high-vigorous PA than men. The lower back and neck disorders were the most common among the teachers.

Prevalence, risk factors and quality of life impact of work-related musculoskeletal disorders among school teachers in Cairo, Egypt

BACKGROUND

School teachers constitute an occupational group which reported a high prevalence of work-related musculoskeletal disorders (WRMSDs). Different individual, occupational and psychosocial factors have been identified to influence the complex process of WRMSDs. WRMSDs represent an important and costly occupational health problem being responsible for a poor quality of life (QOL) of teachers. This study aimed to determine the prevalence, the risk factors, and the impact of WRMSDs on the QOL of teachers.

METHODS

310 full-time teachers from 15 public schools were surveyed using an interview questionnaire about their sociodemographic and occupational characteristics, the Nordic Musculoskeletal Questionnaire and the SF-36 Health Survey (SF-36).

RESULTS

Self-reported prevalence of WRMSDs at any body part over the past 12 months among teachers was 66.77%. Neck pain (56.1%) was the most prevalent WRMSD followed by shoulders (53.2%), low back (53.2%) and knees (50.6%) pain. Female gender, body mass index, the number of students per classroom, the number of classes per week, different adapted awkward postures and the lack of enough supervisor's psychological support at work were among the risk factors positively associated with WRMSDs. WRMSDs had a negative impact on the physical and mental QOL of teachers with WRMSDs as reflected by their lower scores on all scales of the SF-36 compared to their counterparts without WRMSDs (p ˂ 0.05).

CONCLUSION

WRMSDs were a highly prevalent problem among teachers in Cairo, Egypt and negatively influencing their physical and mental QOL. Different individual, occupational and psychosocial factors had been shown to be significant predictors for the occurrence of WRMSDs reflecting their complex nature and multifactorial etiology.

Shoulder work-related musculoskeletal disorders and related factors of workers in 15 industries of China: a cross-sectional study

Background

Changes in modern industrial production practices can easily lead to shoulder work-related musculoskeletal disorders (WMSD). The current reports on shoulder WMSD are limited to some industries are less well studied, and the sample size is usually small. This study aimed to describe the prevalence and severity of shoulder WMSD in a large sample of Chinese workers from 15 industries, analyze the possible correlations with sociodemographic and work-related variables, and compare the differences between industries.

Methods

A cross-sectional study was conducted among a sample of 55,749 participants from 252 enterprises in 15 industries throughout China. A Chinese version of the musculoskeletal disease questionnaire was used to collect the demographic factors, shoulder symptoms in past 12 months, and work-related factors including posture-related factors, repetition, vibration, work organization, job control, and environmental factors as independent variables. Descriptive statistics were used, and the binary logistic regression analysis was performed to explore the association between shoulder WMSD and potential demographic and work-related factors.

Results

Nearly 35.5% of participants reported shoulder pain and discomfort in the previous 12 months. Biopharmaceutical manufacturing (56.2%), medical services (54.4%), and aviation services (50.1%) were the three industries with the highest prevalence of shoulder WMSD. The pain score of aviation services workers was the highest. The related factors for shoulder WMSD varied among the different industries.

Conclusion

Our study found a relatively high prevalence of shoulder WMSD in China. There were large differences in the prevalence of shoulder WMSD among industries, and the related factors were particular to each industry. Such information is useful to help occupational health practitioners and policymakers conduct preventive programs to reduce shoulder disorders in these working populations.

Mediation Effect of Musculoskeletal Pain on Burnout: Sex-Related Differences

Burnout occurs when people are exposed to emotionally demanding work situations over an extended period, resulting in physical, emotional, and mental exhaustion. This study adopted the personal burnout (PB) and work-related burnout (WB) scales of the Copenhagen Burnout Inventory to measure burnout levels. Musculoskeletal (MS) pain is one factor influencing burnout. Previous studies have demonstrated that male and female hormones may contribute to sex-related differences in MS pain. This was an observational and cross-sectional study conducted at a medical-university-affiliated hospital in Taichung, Taiwan, in 2021. Data were collected for demographic characteristics, family structure, living habits, occupation, physical health, Nordic Musculoskeletal Questionnaire score, and Copenhagen Burnout Inventory score. Of the 2531 questionnaires that were distributed, 1615 (63.81%) valid questionnaires remained after those with missing data were excluded. The results demonstrated neck and shoulder pain (NBSP) is commonly associated with burnout among healthcare workers, with a higher prevalence among women than among men. With confounders being controlled for, women were found to experience substantially higher levels of personal and work-related burnout than men did. NBSP is a mediating factor; therefore, it is a key reason why women are more likely than men to experience burnout.

Pain and fatigue in adults with Loeys-Dietz syndrome and vascular Ehlers-Danlos syndrome, a questionnaire-based study

The purpose was to study self-reported chronic pain and fatigue symptoms among adults with molecularly verified Loeys-Dietz and vascular Ehlers-Danlos syndrome using a cross-sectional questionnaire design. Seventy adults were invited through a National Resource Centre for Rare Disorders. A study specific questionnaire including Brief Pain Inventory, Standardized Nordic Questionnaire, Fatigue Severity Scale, Hospital Anxiety & Depression Scale, questions on physical activity, and disease burden was used. Fifty-two persons participated, n = 34 with Loeys-Dietz and n = 18 with vascular Ehlers-Danlos syndrome, aged 18-68 years, 58% women. Chronic pain (79%) and fatigue (58%) symptoms were common. Half developed pain during childhood/adolescence. Sleep problems and high multi-organ burden were significantly associated with chronic pain (p = 0.004, p = 0.014) and high fatigue (p < 0.001, p < 0.001). Chronic pain was associated with higher scores of fatigue (p = 0.002). Higher scores of fatigue were associated with lower level of physical activity (p = 0.014), higher cardiovascular burden (p = 0.025), and higher symptoms of anxiety (p = 0.001). In this study, symptoms of chronic pain, fatigue, sleep problems, and disease burden seemed to mutually reinforce each other. Initiatives should consider interventions aimed at postponing the onset and reducing symptoms of pain, fatigue, and sleep problems and thus reduce the total disease burden at an early stage in patients with these complex conditions.

Are music students at 'high-risk' of experiencing musculoskeletal symptom outcomes compared with other students?

Musicians have been described as a 'high-risk' group for experiencing musculoskeletal symptoms (MSSs), yet few studies have tested this assumption. We aimed to determine whether the prevalence and profile of MSS outcomes differed between university music students and a reference group (science students). A survey was conducted with university music and science students. Reported MSS outcomes among the two groups were compared using regression analyses. The majority of participants in both groups reported experiencing MSSs in the last 12 months and 7 days. Music students reported a higher prevalence of wrist/ hand MSSs compared with science students. Compared with symptomatic science students, music students reported a higher emotional impact of MSSs. We recommend prioritising research into interventions for music students that address MSSs in the wrist/ hand region, and the emotional impact of MSSs. Addressing these MSS outcomes could reduce the MSS burden for musicians during and beyond their studies.

Sitting less and moving more for improved metabolic and brain health in type 2 diabetes: 'OPTIMISE your health' trial protocol

BACKGROUND

Clinical practice guidelines recommend that adults with type 2 diabetes (T2D) sit less and move more throughout the day. The 18-month OPTIMISE Your Health Clinical Trial was developed to support desk-based workers with T2D achieve these recommendations. The two-arm protocol consists of an intervention and control arms. The intervention arm receives 6 months health coaching, a sit-stand desktop workstation and an activity tracker, followed by 6 months of text message support, then 6 months maintenance. The control arm receives a delayed modified intervention after 12 months of usual care. This paper describes the methods of a randomised controlled trial (RCT) evaluating the effectiveness and cost-effectiveness of the intervention, compared to a delayed intervention control.

METHODS

This is a two-arm RCT being conducted in Melbourne, Australia. Desk-based workers (≥0.8 full-time equivalent) aged 35-65 years, ambulatory, and with T2D and managed glycaemic control (6.5-10.0% HbA1c), are randomised to the multicomponent intervention (target n = 125) or delayed-intervention control (target n = 125) conditions. All intervention participants receive 6 months of tailored health coaching assisting them to "sit less" and "move more" at work and throughout the day, supported by a sit-stand desktop workstation and an activity tracker (Fitbit). Participants receive text message-based extended care for a further 6-months (6-12 months) followed by 6-months of non-contact (12-18 months: maintenance). Delayed intervention occurs at 12-18 months for the control arm. Assessments are undertaken at baseline, 3, 6, 12, 15 and 18-months. Primary outcomes are activPAL-measured sitting time (h/16 h day), glycosylated haemoglobin (HbA1c; %, mmol/mol) and, cognitive function measures (visual learning and new memory; Paired Associates Learning Total Errors [adjusted]). Secondary, exploratory, and process outcomes will also be collected throughout the trial.

DISCUSSION

The OPTIMISE Your Health trial will provide unique insights into the benefits of an intervention aimed at sitting less and moving more in desk-bound office workers with T2D, with outcomes relevant to glycaemic control, and to cardiometabolic and brain health. Findings will contribute new insights to add to the evidence base on initiating and maintaining behaviour change with clinical populations and inform practice in diabetes management.

TRIAL REGISTRATION

ANZCTRN12618001159246 .

Evaluation of Workloads of Package Deliverers Focusing on Their Pickup and Delivery Tasks in Republic of Korea

Package deliverers are facing increasing workloads due to a rapid increase in online shopping caused by the recent outbreak of COVID-19 in the Republic of Korea. The purpose of this study was to evaluate the physical workload of package deliverers during pickup and delivery tasks. Heart rate reserve (HRR), metabolic equivalent of task (MET), standardized Nordic questionnaire (SNQ), and visual analogue scale (VAS), measured on site using a wristband, were used as indicators of their workload. Twenty deliverers participated in this study. Work analysis was performed to categorize their tasks into sorting inside a truck, delivering, picking up, driving, and resting. Statistical analysis showed that participants spend 4.3 h per day picking up and delivering 331.9 packages per day. Their work requires about 29.7% of HRR and 4.7 of MET, which are thus considered as of “moderate level” difficulty. SNQ and VAS revealed that their lower back and wrist/hand were the most painful body parts due to repetitive trunk bending and small package handling. The use of a cart would be recommended as it has the advantage of handling many packages at once with less physical effort in deliverers.

Evaluation of the bio-dynamic response of the hand-arm system and hand-tool designs - A brief review

Hand-operated tools transmit a high magnitude of vibration exposure to the hand-arm system that causes occupational diseases. The health effects caused in various countries for the past years due to usage of hand tools are necessary to identify the occupational disorders. Researchers have conducted various studies on biological effects, hand-transmitted vibration exposure and biodynamic responses throughout the years. This article goes over each of these studies in detail, as well as identifying areas where more research is needed. The majority of studies deal with the following topics: general guidelines for hand-transmitted vibrations; assessment techniques of vibration exposure; hand-tool evaluation methods; influence of hand-tool design to overcome the biomechanical effects; and finite element modelling for quantifying vibration exposure. In response to this, understanding the biodynamic behaviour of the hand-arm system is useful for better ergonomic intervention in hand tools to reduce fatigue and increase comfort.

Reliability of a self-administrated musculoskeletal questionnaire: The fourth Trøndelag health study

BACKGROUND

The reliability of the Nordic Musculoskeletal Questionnaire (NMQ) has not been evaluated in an unselected general population. The aim of this population-based follow-up study was to estimate the reliability between a self-administered NMQ-based questionnaire and a face-to-face interview performed approximately two months later. To interpret the results, we assessed the 1-year prevalence of various pain musculoskeletal pain locations.

METHODS

A random sample of 1201 participants in the fourth wave of the Trøndelag Health Survey were invited to a follow-up interview focusing on sleep and pain. A total of 232 (19%) participated a semi-structured interview, and the agreement with the corresponding answers in the musculoskeletal questionnaire in HUNT4 were evaluated by Cohen's kappa statistics with 95% confidence interval (CI). The 1-year prevalence of the various pain sites was stratified by age and gender.

RESULTS

The reliability was good for chronic musculoskeletal pain (CMSP), chronic widespread musculoskeletal pain (CWMSP) and pain in hip and knee (kappa values between 0.63 and 0.68). Moderate kappa values between 0.51 and 0.60 were found for pain in the neck, shoulder, elbow, wrist/hand, upper back, lower back, calf, ankle/feet, and ≥7 pain sites. The 1-year prevalence was 54.3% for CMSP and 17.2 for CWMSP, substantially higher for women and among those aged 50 years or more.

CONCLUSION

In this population-based study the reliability between interview and questionnaire was good to moderate for most pain locations. In particular, the self-administered musculoskeletal questionnaire seems to be a useful tool in identifying individuals with CMSP, CWMSP, and pain in hip and knee.

Musculoskeletal complaints and associated factors among dental practitioners of Nepal: a nationwide survey

Musculoskeletal disorders (MSDs) constitute a significant occupational hazard among dental practitioners. An online-based e-survey was conducted among 252 registered dentists of Nepal using the Nordic musculoskeletal questionnaire (NMQ) to assess musculoskeletal complaints and work-related characteristics. Musculoskeletal complaints in lower regions were found to be highly prevalent among dental practitioners with prevalence of 76, 27 and 28.2% in the last 12 months, 1 month and 7 days, respectively, followed by musculoskeletal complaints in the neck, wrist/hand and shoulder. Musculoskeletal complaint during the last 12 months was significantly associated with age, years in dental practice after graduation and leave from duty in the past 12 months. Similarly, educational qualification, medical comorbidities and leave from duty were associated with complaints in the last 1 month. Musculoskeletal complaint during the last 7 days was associated with gender, working hours in a day, practice of four-handed dentistry and patients examined in a day.

Mental and physical health-related quality of life and their associated factors among students of a comprehensive allied health institution

BACKGROUND

Healthcare students are subjected to critical levels of mental and physical stress that might hinder their quality of life.

OBJECTIVES

This study comprehensively investigated physical and mental Health-related Quality of Life (HR-QoL) and their associated factors among Allied Health (AH) students of nine academic majors.

METHODS

Participants completed anonymous questionnaire included demographics and life style, HR-QoL measured by the 12-item Short-Form Health Survey (SF-12), Depression Anxiety Stress Scale (DASS21), and Nordic Musculoskeletal Questionnaire. SF-12 Physical (PCS) and Mental (MCS) Components Summary scores were compared between gender and between academic majors. Multiple linear regressions were conducted to examine factor associated with PCS and MCS scores.

RESULTS

A total of 838 students (77.4% females) participated in the study. The overall PCS was 45.64±7.93 and statistically different between majors (P < 0.001). The Overall MCS score was 39.45±10.86 and statistically greater in males (P < 0.001). PCS scores were significantly associated with anxiety score, GPA, diet self-evaluation, and upper back and hip musculoskeletal pain. MCS scores were significantly associated with weekly clinical training hours, stress score, depression score, gender, university year, GPA, sleep self-evaluation, diet self-evaluation, and neck musculoskeletal pain.

CONCLUSIONS

Low levels of mental and physical HR-QoL were observed among AH students and were associated with academic-related, health-related, and lifestyle-related factors. Longitudinal studies are needed to assess effective approaches to improve HR-QoL among AH students.

Sit Less and Move More-A Multicomponent Intervention With and Without Height-Adjustable Workstations in Contact Center Call Agents: A Pilot Randomized Controlled Trial

OBJECTIVE

To pilot a multicomponent intervention to sit less and move more, with (SLAMM+) and without (SLAMM) height-adjustable workstations, in contact center call agents.

METHODS

Agents were individually randomized to SLAMM or SLAMM+ in this 10-month, parallel, open-label, pilot trial. Mixed-methods assessed response, recruitment, retention, attrition and completion rates, adverse effects, trial feasibility and acceptability, preliminary effectiveness on worktime sitting, and described secondary outcomes.

RESULTS

The participant recruitment rate, and randomization, data collection, and interventions were mostly acceptable. Refinements to organization recruitment were identified. High staff turnover negatively impacted retention and completion rates. The multicomponent intervention with height-adjustable workstations has potential to reduce sitting time at work.

CONCLUSIONS

The demonstrated findings will help prepare for a future randomized controlled trial designed to assess the effect of the interventions.

Individualized ergonomic wellness approach for the practicing gastroenterologist (with video)

BACKGROUND AND AIMS

The prevalence and burden of ergonomic-related musculoskeletal injury are well established in the literature, but data are scarce on techniques that can be used to avoid injury. This pilot study aimed to develop a new method of endoscopist wellness assessment. The technique presented here is an intervention by a physical therapist assessing ergonomic position and posturing during endoscopy to create an individualized wellness plan.

METHODS

Volunteer endoscopists were identified in a single ambulatory surgical center. Demographics, previous injury, current pain, and posture were evaluated. A comprehensive assessment was developed by the physical therapist while observing endoscopists performing at least 2 colonoscopies and while working at their computer workspace. The detailed personalized wellness program included recommendations for individualized exercises, static and dynamic posture re-education during and between procedures, optimization of procedure suite setup, pain education, and an opportunity for follow-up 1-on-1 sessions with the physical therapist. Endoscopists were later interviewed regarding their perception of and compliance with the wellness plan. Specific outcomes evaluated included changes in musculoskeletal pain, acceptance, and incorporation of wellness recommendations and procedure suite alterations into clinical practice.

RESULTS

As we developed this new method of endoscopic wellness assessment, 8 endoscopists representing a wide range of ages and clinical experience were assessed. Twenty-two pain sites were identified among 5 subjects, with back and neck pain the most common pain sites. A variety of ergonomic inefficiencies and suboptimal movement patterns was observed, resulting in highly variant wellness plans. By the end of the study, 63% of pain sites were reduced in intensity or resolved, whereas 32% of pain sites were unchanged and 4% increased in intensity. Seven of 8 participants found the pictures depicting their posture that supported their movement analysis helpful, and 3 participants requested reassessment by the physical therapist. All participants reported static and dynamic postural education and procedure suite setup recommendations to be impactful to their ergonomic performance.

CONCLUSIONS

Ergonomic assessment and instruction by a physical therapist was well received and resulted in improvement of musculoskeletal complaints among a cohort of endoscopists reporting baseline pain associated with performing endoscopy. In addition, this intervention provided ergonomic education that can be carried forward throughout their professional endoscopic career. We believe that ongoing individualized assessment and optimization of ergonomics is necessary because generalized wellness programs or even modifications to endoscopic equipment would not target all the unique ergonomic challenges faced by each physician. Ergonomic programs using the new method presented here could potentially contribute to career longevity, decrease burnout, reduce lost days of work, and, most importantly, reduce pain and fatigue among practitioners.

The effect of long-term poor sleep quality on risk of back-related disability and the modifying role of physical activity

Sleep problems and regular leisure time physical activity (LTPA) are interrelated and have contrasting effects on risk of back pain. However, no studies have investigated the influence of long-term poor sleep quality on risk of back-related disability, or if LTPA modifies this association. The study comprised data on 8601 people who participated in three consecutive surveys over ~ 22 years, and who reported no chronic back pain at the two first surveys. Adjusted risk ratios (RRs) for back-related disability were calculated at the last survey, associated with the joint effect of changes in sleep quality between the two first surveys and meeting physical activity guidelines at the second survey. Compared to people with long-term good sleep, people with long-term poor sleep had nearly twice the risk of back-related disability (RR 1.92, 95% CI 1.48-2.49). There was no statistical interaction between sleep and LTPA but people who reported long-term poor sleep and meeting the physical activity guidelines had 35% lower risk of back-related disability compared to people with same level of sleep problems, but who not met the guidelines. These findings suggest that long-term poor sleep quality contributes to a substantially increased risk of chronic and disabling back pain irrespective of LTPA.

The prevalence of upper quadrants work-related musculoskeletal disorders and their predictors among registered nurses

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) represent a significant health challenge facing nurses. However, very few studies investigated the prevalence of WMSDs among nurses and their predictors comprehensively using a valid and reliable set of standardized outcome measures.

OBJECTIVE

This study aimed to investigate the prevalence WMSDs of upper quadrants and their predictors among registered nurses in Jordanian hospitals.

METHODS

A cross-sectional study recruited 597 registered nurses from different hospitals in Jordan. A self-administered survey distributed in targeted hospitals wards. Outcome measures included Nordic Musculoskeletal Questionnaire (NMQ), Depression Anxiety Stress Scale (DASS), Pittsburgh Sleep Quality Index (PSQI), International Physical Activity Questionnaire (IPAQ), sociodemographic data, and manual handling and work habits. Prevalence of musculoskeletal complaints was reported using descriptive analysis. Logistic regression analyses were used to identify predictors of WMSDs at each upper quadrant body site.

RESULTS

Twelve-month WMSDs prevalence was the highest at the neck (61.1%), followed by the upper back (47.2%), shoulders (46.7%), wrist and hands (27.3%), and finally at the elbow (13.9%). Being a female, poor sleep quality, high physical activity level, poor ergonomics, increased workload, and mental stress were significant predictors of increased upper quadrant WMSDs among nurses.

CONCLUSIONS

Upper quadrant WMSDs among nurses in Jordan are highly prevalent. Identified significant predictors of these WMSDs should be given full consideration by clinicians and health policymakers. Future studies are needed to reveal the progressive nature of upper quadrant WMSDs and strategies to modify their risk factors.

Long-term changes in self-reported sleep quality and risk of chronic musculoskeletal pain: The HUNT Study

We examined the association between long-term (~10 years) changes in self-reported sleep quality and risk of any chronic musculoskeletal pain and chronic widespread pain. The study comprised data on 6,033 people who participated in three consecutive surveys in the Norwegian HUNT Study (1995-1997, 2006-2008 and 2017-2019) and who were without chronic musculoskeletal pain at the first two surveys. We used a modified Poisson regression model to calculate adjusted risk ratios for chronic pain at follow-up (2017-2019) associated with categories of poor and good sleep quality reported in 1995-1997 and 2006-2008. Compared with people who reported good sleep at both surveys (crude absolute risk: 32.4%), the risk ratios of any chronic pain were 1.20 (95% confidence interval: 1.02-1.41) for those who changed from poor to good sleep; 1.25 (95% confidence interval: 1.12-1.39) for those who changed from good to poor sleep; and 1.41 (95% confidence interval: 1.21-1.63) for those who reported long-term poor sleep. The corresponding risk ratios for chronic widespread pain were 1.35 (95% confidence interval: 0.82-2.23), 1.55 (95% confidence interval: 1.14-2.12) and 2.09 (95% confidence interval: 1.38-3.17), respectively. In conclusion, these findings indicate that people with long-term poor sleep quality have a markedly higher risk of chronic musculoskeletal pain and chronic widespread pain, compared with people who remain good sleep quality.

Predictors and prevalence of lower quadrant work-related musculoskeletal disorders among hospital-based nurses: A cross-sectional study

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) represent a significant problem for nurses. It is thus important to investigate nurses' WMSDs prevalence and comprehensive predictors including motor, mental, and lifestyle factors.

OBJECTIVES

To investigate the prevalence and predictors of lower quadrant WMSDs among Jordanian nurses.

METHODS

A cross-sectional design, using self-administered questionnaires, was utilized. Outcome measures included Nordic Musculoskeletal Questionnaire (NMQ), Depression Anxiety Stress Scale (DASS21), Pittsburgh Sleep Quality Index (PSQI), sociodemographic data, and self-reported work ergonomics. Descriptive analyses were used to determine lower quadrant WMSDs prevalence and regression analyses were used to assess their predictors.

RESULTS

A total of 597 nurses participated in the study. Twelve-month prevalence of lower quadrant WMSDs were 77.4% in lower back, 22.3% in hips, 37.5% in knees, and 28.5% in ankles and feet. Older age, longer years of experience, high workload, poor work habits and ergonomics, high physical activity level, availability of patient handling equipment, handling policies, stress, and anxiety were significant predictors (p< 0.05) of lower quadrant WMSDs.

CONCLUSIONS

Jordanian nurses have a high prevalence of lower quadrant WMSDs. Many modifiable risk factors of WMSDs were identified. Future studies need to design effective treatment and preventive strategies for nurses' WMSDs to improve their work efficiency and wellbeing.

What do musicians think caused their musculoskeletal symptoms?

Objectives. The purpose of this study was to determine the factors that university music students and professional musicians believe caused their musculoskeletal symptoms (MSSs). Methods. Data were collected using a questionnaire distributed to university music students and professional musicians. Using a musician-driven data collection approach, musicians with MSSs were asked to nominate their top three perceived causes of their symptoms. Responses were categorized, and percentages reported for the main categories. Results. Of the 213 musicians, 37.6% reported biological factors, 21.1% reported external, physical factors, 93.9% reported behavioural factors, 18.8% reported psychosocial factors and 9.9% reported 'other' factors (e.g., accidents) as the perceived causes of their MSSs. Conclusion. This study is the first to investigate perceived causes of musicians' MSSs across a diverse range of musicians, using musician-driven methods. By using open response data collection strategies, a comprehensive, unbiased list of perceived causes of MSSs was compiled. Perceived causes not identified in previous research included manual handling, physical activity and sleep problems. Future research should consider the association between perceived causes and MSSs, and barriers and enablers of behaviour changes that may prevent MSSs. This research may guide the development of new strategies to reduce the burden of MSSs in musicians.

Sleep quality and its predictors among hospital-based nurses: a cross-sectional study

PURPOSE

Sleep disorders are common among nurses and may have negative effects on their performance and well-being. This study aimed to investigate the level of sleep quality and its possible associated factors among hospital-based nurses in Jordan.

METHODS

A cross-sectional design targeting Jordanian hospital-based nurses. In addition to demographics and work habits, the outcome measures included Pittsburgh Sleep Quality Index (PSQI), Nordic Musculoskeletal Questionnaire (NMQ), and Depression Anxiety Stress Scale (DASS). Data were analyzed descriptively and by a multiple variable linear regression analysis to identify predictors of sleep quality.

RESULTS

In total, 597 nurses with a mean age of 32.1 (± 5.7) years participated in this study and 47% were men. PSQI mean score was 7.8 (± 3.7) and 68% of the participants showed sleep quality deficits. Stress (β = 0.15 [95%CI 0.13 to 0.19, P < 0.001), depression (β = 0.05 [95%CI 0.009 to 0.08], P = 0.015), the number of joints with 12 months musculoskeletal pain (β = 0.25 [95%CI 0.15 to 0.36], P < 0.001) positively predicted decreased sleep quality. Manual handling training (β = - 0.48 [95%CI -0.96 to 0.003], P = 0.048) and years of experience (β = - 0.05 [95%CI -0.09 to 0.002], P = 0.039) negatively predicted decreased sleep quality.

CONCLUSIONS

Nurses reported poor levels of sleep quality, high levels of mental health symptoms, and musculoskeletal pain complaints. Sleep quality among nurses and its predictors should be carefully considered by administrations of healthcare services.

Prevalence of postural musculoskeletal symptoms among dental students in United Arab Emirates

Background

The purpose of the present study was to determine the prevalence of neck, shoulder, and low-back pain and to examine factors associated with musculoskeletal pain (MSP) among dental students at Ajman University and Ras Al Khaimah College of Dental Sciences in United Arab Emirates (UAE).

Method

A cross-sectional study was conducted among dental students using an online questionnaire, which was a modified version of the Standardized Nordic questionnaire, focused on neck, shoulder and low-back pain in the past week and the past year.

Results

A total of two hundred and two dental students (out of 368) responded to the questionnaire. The majority were female 75.2%. The prevalence of MSP in at least one body site in the past week, and in the past year was 48.5 and 68.3% respectively. The factors significantly associated with MSP in at least one body site at any time were having history of trauma (P = 0.009), lack of exercise (P = 0.001), longer clinical sessions (P = 0.000), and higher BMI (P = 0.010).

Conclusion

The present study indicates that the prevalence of MSP among dental students in the UAE is high. Careful attention from dental colleges is needed to increase students’ awareness of this problem. This study contributed to better understanding of MSP among dental professionals.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12891-020-03887-x.

Short sleep and chronic neck and shoulder discomfort in nurses

OBJECTIVE

Short sleep duration is common among nurses. Sleep restriction has been associated with musculoskeletal discomfort. However, studies on the effect of short sleep duration on chronic neck and shoulder discomfort in nurses have been lacking. The aim of this study was to determine whether short sleep duration is related to chronic neck and shoulder discomfort.

METHODS

We conducted a cross-sectional survey of female nurses in secondary referral health centers in Taiwan. We applied stratified sampling based on region (north, central, south, and east) to select representative centers for this study. A self-administered structured questionnaire, including demographic data, the psychological working environment, and musculoskeletal symptoms, was administered to nurses. Multiple logistic regression and population attributable risk analyses were performed to assess the effect of average sleeping hours per working day on chronic neck and shoulder discomfort.

RESULTS

A total of 1602 (78.9%) questionnaires were eligible for final analysis. The prevalence rates of chronic neck and shoulder discomfort were 33.9% and 34.7%, respectively. Population attributable risk estimation revealed that a sleep duration of <7 hours per working day was the most crucial factor for chronic neck and shoulder discomfort in the nurses, accounting for 8.8% of chronic neck discomfort and 8.6% of chronic shoulder discomfort respectively.

CONCLUSION

Our study found that sleep duration on working days was associated with chronic neck and shoulder discomfort in female nurses. Further interventions are warranted for maintaining nurses' sleep hygiene.

The Danish Spinal Cord Injury Shoulder (DanSCIS) cohort: methodology and primary results

STUDY DESIGN

Cross-sectional study.

OBJECTIVES

To describe the socio-demographics, injury characteristics, prevalence of shoulder and neck symptoms, weekly participation in leisure time physical activity (LTPA) and quality of life (QoL) of individuals with spinal cord injury in Denmark (SCI).

SETTING

Nation-wide community survey, Denmark.

METHODS

Individuals with SCI for >2 years were included from three SCI rehabilitation departments. Questionnaire data regarding socio-demographic details, SCI injury characteristics, medical history, shoulder and neck symptoms, LTPA and QoL were collected.

RESULTS

Of 2454 potential participants, 1517 (62%) responded to the survey (mean age = 56.2, SD 16.1, 37% female, 42% tetraplegia, 23% complete SCI, mean time since injury = 16.9, SD 13.5). 75% used some form of assistive mobility device. Responders and non-responders showed no sex or injury type/severity differences. Shoulder and neck symptoms within the past 3 months were reported by 63 and 67% respectively, with 51% reporting shoulder symptoms within the past week. Among those with symptoms, 61% had experienced shoulder symptoms and 56% neck symptoms, for more than 30 days during the previous 3 months. Symptoms often prevented participants from performing their usual activities (due to shoulder symptoms 46%, neck symptoms 41%).

CONCLUSIONS

A high prevalence of self-reported shoulder and neck symptoms was found, which may limit physical function and social activities. We succeeded in generating the Danish Spinal Cord Injury Shoulder (DanSCIS) dataset, which comprised a substantial proportion of Danish adults with SCI. Future studies using data from this cohort will investigate patterns and associations between shoulder/neck symptoms, use of assistive mobility devices, LTPA and QoL.

Do intensity of pain alone or combined with pain duration best reflect clinical signs in the neck, shoulder and upper limb?

OBJECTIVES

It is important to validate self-reported musculoskeletal pain used in epidemiological studies for evaluation of pain outcome measures. The main objective of this paper was to assess the association between self-reported neck/shoulder/upper limb pain and clinical signs of disorders in the region, especially by comparing a measure that only used pain intensity with a measure that combined pain intensity and pain duration.

METHODS

Four hundred and twenty technical school students of both genders were included with a median age of 17 years (16-28). The students stated the pain in four intensity grades and the pain duration in four period lengths within the preceding four weeks period. A pain severity index was calculated by multiplying the pain intensity (0-3) and the duration (1-4). A clinical examination was performed within a week after completing the form. The associations were evaluated by agreement, correlation and symmetric strength of association (contingency).

RESULTS

The study found low correlation and low positive agreement for neck/shoulder and upper limb pain related to clinical signs of disorders in the region. However, the relationship showed high negative agreement and high contingency. The negative agreement increased for the neck/shoulder region with higher cut-off points for dichotomization, but not for the upper limb region. The index combining reports of pain intensity with pain duration, do not improve agreement, correlation or contingency with clinical signs compared to use of pain intensity alone.

CONCLUSIONS

This study showed an association between self-reported neck/shoulder/upper limb pain intensity and clinical signs of musculoskeletal disorders of the region. An index combining pain intensity and duration (Pain Severity Index) did not increase this association. From the results we suggest using pain intensity reports alone and if dichotomizing is wanted, choosing a cut-off point at high pain levels, especially for neck and shoulder pain.

Prevalence and predictors of work-related musculoskeletal disorders among workers of a gold mine in south Kivu, Democratic Republic of Congo

BACKGROUND

Work-related musculoskeletal disorders (WRMSDs) are a major constraint to worker performance and health. However, research on their prevalence and associated factors among workers at gold mines in the Democratic Republic of Congo (DRC) is insufficient. The present study aimed to determine the prevalence and predictors of WRMSDs among workers of a Gold Mine in South Kivu, DRC.

METHODS

Cross sectional data on prevalence of WRMSDs and risk factors was collected using a modified Nordic questionnaire and upper limb Core QX checklist from 196 workers of a gold mine. WRMSDs were defined as pain or injury(ies) or discomfort, numbness or limitation of movement in the musculoskeletal system at any time in the past 12 months which lasted at least 24 h. These had to be either induced or aggravated by work and circumstances of its performance. A generalised linear model of the Poison family with link log and robust error variances was used to generate prevalence ratios (PRs) and 95% confidence intervals (CIs) for the factors associated with WRMSDs. The effect of individual, ergonomic and psychosocial factors on WRMSDs were investigated while controlling for known confounders.

RESULTS

Most workers were males 187 (95.4%) and their age ranged between 23 and 60 years with mean of 36.3 years. Of the 196 workers, 49 (25.0%) reported having at least one WRMSD during the previous 12 months. WRMSDs with highest occurrence rate were the lower back pain (14.8%), followed by thighs/hip pain (9.2%) and shoulder pain (8.2%). Prolonged heavy lifting/shovelling shovelling (PR = 1.69, 95% CI [1.32, 3.24] and longer work shifts (> 9 h) (PR = 3.56, 95% CI [1.76, 16.58]) were predictive for WRMSDs while jobs with low demands were protective against WRMSDs (PR = 0.18, 95% CI [0.08, 0.44]).

CONCLUSION

The prevalence of WRMSDs is high and associated with prolonged heavy lifting/shovelling, longer work shifts and job demands. We recommend lowering workload and job demands and improving work ergonomics to mitigate and prevent the WRMSDs among workers in goldmines.

Work-related musculoskeletal disorders among occupational fishermen: a systematic literature review

BACKGROUND

Commercial fishing constitutes an increased risk of musculoskeletal disorders (MSD), as it consists of heavy workloads and uncontrollable strenuous settings. The aims of this systematic review were to describe the prevalence of MSD among occupational fishermen and to identify risk factors for onset work-related MSD.

METHODS

All studies investigating MSD in occupational fishermen were systematically identified and reviewed. Searched databases were PubMed/MEDLINE, EMBASE and CINAHL. Two independent researchers performed the quality assessments of the studies.

RESULTS

From 292 articles identified, 16 articles consisting of 13 studies were suitable for inclusion. Prevalence of overall MSD ranged from 15% to 93%. The only consistent work-related risk factor was 'working part time', while other risk factors, such as vessel and job type showed conflicting results.

CONCLUSION

MSDs in occupational fishermen are common across countries. Variations observed in MSD prevalence might be due to differences in methodology, populations and definitions of MSD. Evidence on work-related risk factors for MSD is sparse and most studies were of poor methodological quality. Only working part time was identified as a consistent risk factor for MSD possibly caused by a healthy worker effect. There is a need for investigating causality in longitudinal studies, including both active and retired fishermen to better understand the complexity of MSD.

PROSPERO REGISTRATION NUMBER

CRD42020147318.

Cross-Sectional Survey of Musculoskeletal Disorders in Workers Practicing Traditional Methods of Underground Coal Mining

Background: In subcontinental underground mines, coal mining is carried out manually and requires many laborers to practice traditional means of coal excavation. Each task of this occupation disturbs workers’ musculoskeletal order. In order to propose and practice possible ergonomic interventions, it is necessary to know what tasks (drilling and blasting, coal cutting, dumping, transporting, timbering and supporting, loading and unloading) cause disorder in either upper limbs, lower limbs, or both. Methods: To this end, R-programming, version R 3.1.2 and SPSS, software 20, were used to calculate data obtained by studying 260 workers (working at different tasks of coal mining) from 20 mines of four districts of Punjab, Pakistan. In addition, a Standard Nordic Musculoskeletal Questionnaire (SNMQ) and Rapid Upper Limb Assessment (RULA) sheet were used to collect data and to analyze postures respectively. Results: In multi regression models, significance of the five tasks for upper and lower limb disorder is 0.00, which means that task based prevalence of upper and lower limb disorders are common in underground coal mines. The results of the multiple bar chart showed that 96 coal cutters got upper limb disorders and 82 got lower limb disorders. The task of timbering and supporting was shown to be dangerous for the lower limbs and relatively less dangerous for the upper limbs, with 25 workers reporting pain in their lower limbs, and 19 workers reporting pain in their upper limbs. Documented on the RULA sheet, all tasks got the maximum possible score (7), meaning that each of these tasks pose a threat to the posture of 100% of workers. The majority of participants (182) fell in the age group of 26 to 35 years. Of those workers, 131 reported pain in the lower limbs and slight discomfort (128) in the upper limbs. The significance value of age was 0.00 for upper limb disorder and was 0.012 for lower limb disorder. Frequency graphs show age in direct proportion to severity of pain while in inverse proportion with number of repetitions performed per min. Conclusions: All findings infer that each task of underground coal mining inflicts different levels of disorder in a workers’ musculoskeletal structure of the upper and lower limbs. It highlighted the need for urgent intervention in postural aspects of each task.

Functional incapacity related to rotator cuff syndrome in workers. Is it influenced by social characteristics and medical management?

STUDY DESIGN

Survey.

INTRODUCTION

Rotator cuff syndrome (RCS) is one of the most common musculoskeletal disorders reported in workers. The functional incapacity related to RCS may vary according to the sociodemographic context and to the medical management.

PURPOSE OF THE STUDY

The purpose of this is to analyze the RCS-related functional incapacity assessed by the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaires in workers according to their sociodemographic characteristics and the use of care.

METHODS

A cross-sectional study was carried out on a French sample of workers diagnosed with RCS. The DASH and DASH-work scores were studied according to the sociodemographic factors, musculoskeletal symptoms, and RCS medical management during the preceding 12 months.

RESULTS

Two hundred seven workers who suffered from RCS filled out the questionnaire of which 80% were still working. The DASH score was significantly higher in women (24.0 vs 17.4; P < .01; effect size (d) = 0.39), in patients over the age of 50 years (23.6 vs 11.3; P < .005) and in case of another upper limb musculoskeletal disorder (P < .0001; d ≥ 0.4). The DASH and DASH-work scores were significantly higher in case of use of care for RCS (P < .005; d > 0.6).

DISCUSSION

The demographic factors and the RCS medical management influenced the overall incapacity assessed by the DASH questionnaire. Work incapacity was more especially related to the use of care for RCS.

CONCLUSION

The sociodemographic and medical parameters added to other established predictors could help guide clinicians in managing their patients.

Parental Multisite Chronic Pain and the Risk of Adult Offspring Developing Additional Chronic Pain Sites: Family-Linkage Data From the Norwegian HUNT Study

We investigated if parental multisite chronic pain increases the risk of adult offspring developing additional chronic pain sites, and if offspring body mass index (BMI) and leisure time physical activity modify this association. We used longitudinal data on 7,654 offspring linked with their parents who participated in the population-based HUNT Study (Norway) in 1995 to 1997 and 2006 to 2008. Logistic regression was used to estimate odds ratios (ORs) with 95% confidence interval (CI). One-third of offspring (n = 2,573) developed additional chronic pain sites. Having both parents with 1-2 chronic pain sites increased the risk of developing additional pain sites compared to having parents free of chronic pain (OR = 1.33; 95% CI 1.05-1.68), with larger effects observed when both parents had ≥3 chronic pain sites (OR = 1.46; 95% CI 1.17-1.82). These associations were largely driven by maternal pain, that is, there was no association between paternal chronic pain and risk of additional pain sites in offspring. The parent-offspring transfer of additional pain sites (when both parents had ≥3 pain sites) strengthened when offspring were obese (OR = 2.56; 95% CI 1.75-3.75) or physically inactive (OR = 1.73; 95% CI 1.33-2.27). In conclusion, parental multisite chronic pain increases the risk of offspring developing additional chronic pain sites, particularly those with obesity or inactivity. PERSPECTIVE: This longitudinal analysis investigated the parent-offspring transmission of multisite chronic pain, and whether lifestyle behaviors in offspring modify this association. The findings suggest that having parents with multisite chronic pain increases the risk of offspring developing additional chronic pain sites, particularly if offspring are obese or inactive.

How do we assess musicians' musculoskeletal symptoms?: a review of outcomes and tools used

Recent reviews of musicians' musculoskeletal symptoms (MSS) have reported heterogeneity in the outcomes reported and data collection tools used, making it difficult to compare and synthesise findings. The purpose of this present review was to improve the consistency of future research, by documenting the outcomes reported in recent studies of musicians' MSS and the data collection tools used. All English language, peer-reviewed studies, published 2007-2016 that reported musicians' self-reported MSS outcomes were identified. Details of the types of outcomes reported and the tools used were extracted, and synthesised descriptively. A range of MSS outcomes were reported, including MSS with a temporal relationship to activities performed, and the consequences of symptoms. Only 24% of studies used standardised questionnaires, with the Nordic Musculoskeletal Questionnaire (NMQ) being the most commonly used. To improve the homogeneity of outcomes and data collection tools when investigating musicians' MSS, we recommend using the NMQ, where appropriate. Recall periods of 12-months and 7-d are the most appropriate for prevalence, and 7-d recall periods for ratings. Importantly, outcomes and the tools used to collect data should be reported in sufficient detail to ensure that the study can be replicated, critiqued, and accurately interpreted.

A multi-component intervention to sit less and move more in a contact centre setting: a feasibility study

BACKGROUND

Call agents spend ~ 90% of their working day seated, which may negatively impact health, productivity, and wellbeing. This study aimed to explore the acceptability and feasibility of a multi-component workplace intervention targeting increased activity and decreased prolonged sitting in the contact centre setting prior to a full-scale effectiveness trial.

METHODS

An 8-week non-randomised pre-post feasibility study was conducted. Using a mixed methods approach, focus groups and interviews were thematically analysed to explore the acceptability and feasibility of key study phases, and provide context to agents' process evaluation and survey responses. The multi-component intervention, conducted in a single call centre, included height-adjustable workstations, emails, education and training sessions, and support from team leaders and a workplace champion.

RESULTS

Six (of 20) team leaders were recruited, with 17 of 84 call agents (78% female, 39.3 ± 11.9 years) completing baseline assessments and 13 completing follow-up. High workload influenced recruitment. Call agents perceived assessments as acceptable, though strategies are needed to enhance fidelity. Education sessions, height-adjustable workstations and emails were perceived as the most effective components; however, height-adjustable hot-desks were not perceived as feasible in this setting.

CONCLUSIONS

This study has identified unique, pragmatic considerations for conducting a multi-level, multi-component PA and SB intervention and associated evaluation in highly sedentary call agents in the challenging contact centre setting. The intervention was largely perceived positively, with call agents and team leaders describing numerous perceived positive effects on behavioural, health and work-related outcomes. Findings will be of value to researchers attempting to intervene in contact centres and will be used by the current authors to design a subsequent trial.

Standing working posture and musculoskeletal pain among Citrus sinensis workers in a low-income country

Background. Work-related musculoskeletal pain (WRMP) among Citrus sinensis farm workers has barely been studied. Yet most work tasks in such farms are manually performed using awkward standing postures that can contribute to WRMP. Aim. This study assessed the standing working posture in relation to WRMP among C. sinensis workers. Methods. Ninety-two workers engaged in manual tasks participated in this cross-sectional study. Postures at the upper limbs were analysed using the rapid upper limb assessment (RULA) method. Data were analysed using SPSS version 20. Results. Analyses generally showed statistically significant associations (p < 0.05) between a body part RULA score and WRMP at the concerned body part. The upper arm score was >1 in 77.2% of the workers and caused upper arm pain in 66.3%; the association between the upper score and upper pain was statistically significant (χ ²= 20.57; p < 0.05). Similarly, significant associations were found between: (a) wrist score and wrist pain; (b) neck score and neck pain; (c) trunk score and back pain. Conclusions. C. sinensis workers use unsafe postures which contribute to WRMP at the upper arm, trunk, neck and wrists. Ergonomics measures are required to improve their working posture.

Work-Related Upper Limb Symptoms in Hand-Intensive Health Care Occupations: A Cross-Sectional Study With a Health and Safety Perspective

BACKGROUND

Research with physical therapists reveals high rates of work-related musculoskeletal injuries, especially low back pain, with early career onset. Less focus has been given to upper limb disorders (ULDs) in these professionals, who frequently perform repetitive arm/hand and precision finger motions during work.

OBJECTIVE

The objective was to estimate prevalence of body-site-specific upper limb (UL) symptoms and diagnosed ULDs in Irish chartered physical therapists, physiotherapists, and athletic therapists, with adjustment for leisure time injury, and document first onset of specific UL symptoms.

DESIGN

The design was a cross-sectional survey (N = 347) using random sampling (physiotherapists in private practice), proportionate cluster sampling (hospital-based physiotherapists), and all-population sampling (physical therapists and athletic therapists).

METHODS

The methods used were a postal questionnaire with annual, current, and incapacitating UL symptoms (neck, shoulders, elbows, wrists, fingers, thumbs) (Nordic Questionnaire); symptom onset; diagnosed UL disorders; and sociodemographics; prevalence with 95% CIs, and adjusted prevalence (general linear modeling).

RESULTS

Adjusted annual prevalence of UL symptoms in at least 1 body site was 78.1% (95% CI = 71.4-82.2), and of incapacitating symptoms was 21.0% (95% CI = 16.4-27.0). Shoulder (53.2%, 95% CI = 47.9-58.7), neck (49.4%, 95% CI = 44.2-55.0), and thumbs (46.1%, 95% CI = 40.7-51.5) were mostly affected. Hospital-based therapists had a significantly higher prevalence of incapacitating symptoms compared with others (35.7% vs 23.3%). Respondents totaling 28.2% had at least 1 lifetime diagnosis of ULD, most commonly shoulder tendonitis (12.5%, 95% CI = 8.4-15.3) and overuse syndrome (11.8%, 95% CI = 8.4-15.3). First onset was mostly after 5 years working as a therapist; however, this differed by anatomical site.

LIMITATIONS

A cross-sectional study design limited interpretation of symptoms as work-related causes.

CONCLUSIONS

The high prevalence of ULD and symptoms warrants attention from occupational health and safety personnel. Training in injury prevention and risk assessment should be provided during education and as part of continuing education.

The correlation between upper extremity musculoskeletal symptoms and joint kinematics, playing habits and hand span during playing among piano students

Objective

We aimed to investigate the correlations between Upper Extremity Musculoskeletal Symptoms (MSD) and joint kinematics while playing the piano, as well as correlations between MSD and psychosocial, professional and personal habits, and bio-demographic risk factors of piano students.

Method

This cross-sectional study included 15 piano students. The research tools included 3D motion capture, anthropometric measurements, and questionnaires for obtaining data about MSD, psychological, and personal factors.

Results

The piano students recruited for this study experienced a variety of MSD during the past 12 months, with a particularly high prevalence of neck pain (80%). Extreme wrist extension and/or elbow flexion while playing the piano also correlated with MSD. Additionally, this study identified correlations between MSD and hand span (r = -.69, p≤.004) and number of playing hours per week (r = .58, p≤.024).

Conclusions

Anthropometric factors and playing patterns should be considered together with well-known MSD risk factors, like extreme and repetitive movements. However, considering each joint singularly might not be sufficient to prevent the development of MSD when instructing the piano player; accordingly, joint synchronization should also be considered.