Characterization of upper limb use in health care workers during regular shifts: A quantitative approach based on wrist-worn accelerometers

Despite the high prevalence of upper limb (UL) work-related musculoskeletal disorders (WRMSD) among health care workers (HCWs), little is known about their relationship with exposure to biomechanical risk factors. This study aimed to assess UL activity features under actual working conditions using two wrist-worn accelerometers. Accelerometric data were processed to obtain duration, intensity, and asymmetry of UL use in 32 HCWs during the execution of commonly performed tasks (e.g., patient hygiene, transfer, and meal distribution) within a regular shift. The results show that such tasks are characterized by significantly different patterns of UL use, in particular, higher intensities and larger asymmetries were observed respectively for patient hygiene and meal distribution. The proposed approach appears, thus, suitable to discriminate tasks characterized by different UL motion patterns. Future studies could benefit from the integration of such measures with self-reported workers' perception to elucidate the relationship between dynamic UL movements and WRMSD.

Assessment of Exoskeletons on Nurses' Quality of Work Life: A Pilot Study at Foch Hospital

BACKGROUND

The prevention of occupational risks is part of the quality of work life and it is a component that improves the physical work environment. The purpose of the present study was to investigate how to maintain posture and to reduce pain and fatigue for nurses, with an exoskeleton adapted to the work at hospital.

METHODS

The exoskeleton was used between 2022 to 2023 at Foch Hospital, France. Phase 1 consisted of the selection of the exoskeleton, and Phase 2 included the testing of the device by the nurses and a questionnaire to assess it.

RESULTS

The "active" ATLAS model from JAPET, ensuring lumbar protection, was selected because it corresponds to all the specification criteria to tackle the nurses' unmet need. Among the 14 healthcare professionals, 86% were women; the age of the nurses was between 23 years old and 58 years old. The global median satisfaction score of the nurses relative to the use of the exoskeleton was 6/10. The median impact of the exoskeleton on nurses' fatigue was 7/10.

CONCLUSIONS

The implementation of the exoskeleton received global positive qualitative feedback from the nurses concerning the improvement of posture and the reduction in fatigue and pain.

Early career demanding psychosocial work environment and severe back pain and neck/shoulder pain in experienced nurses: A cohort study

AIMS

Back pain and neck/shoulder pain are common among nurses. The aim of this study was to investigate the association between nurses' exposure to a demanding psychosocial work environment during the first three years after graduation and the occurrence of severe back pain and neck/shoulder pain in the longer term, 11-15 years later.

METHODS

The Longitudinal Analysis of Nursing Education (LANE) study (nursing graduates from 26 Swedish universities in the years 2002, 2004 and 2006) was used to create two risk cohorts of nurses not reporting severe back pain (n=1764) or neck/shoulder pain (n=1707). Nurses exposed to a demanding psychosocial work environment for one, two or three of the first three years in their career were compared to nurses not having a demanding psychosocial work environment for any of these three years regarding the incidence of severe back pain or neck/shoulder pain at follow-up, 11-15 years later. Relative risks (RR) with 95% confidence intervals (CI) were calculated using binomial regression.

RESULTS

The RR (95% CI) of having severe back pain for nurses who had a demanding psychosocial work environment for one of the three years was 1.36 (0.82-2.28) and 2.08 (1.21-3.57) for two of the three years and 2.82 (1.43-5.55) for all three years. Corresponding RRs (95% CIs) for severe neck/shoulder pain were 1.35 (0.87-2.10), 1.49 (0.88-2.51) and 1.41 (0.62-3.20), respectively.

CONCLUSIONS

Nurses who were repeatedly exposed to a demanding psychosocial work environment early in their career reported severe back pain to a higher extent in the longer term.

Development and evaluation of a new assistive device for low back load reduction in caregivers: an experimental study

Low back pain among healthcare professionals is associated with the manual handling of patients. Some bed features for turning and repositioning have been developed; however, the load during patient care remains heavy. We developed a device to reduce low back load in caregivers during patient bedside care and evaluated it objectively and subjectively from a caregiver's perspective using a randomised crossover study. Overall, 28 clinical nurses and care workers were randomly assigned to two interventional groups: administering care with (Device method) and without (Manual method) the device in an experimental room. We measured the caregiver's trunk flexion angle using inertial measurement units and video recording during care and then defined a trunk flexion angle of > 45° as the threshold; the variables were analysed using linear mixed models. Subsequently, participants responded to a survey regarding the usability of the device. Trunk flexion time and percentage of time were 26.5 s (95% confidence interval: 14.1 s, 38.9 s) (p < 0.001) and 23.0% (95% confidence interval: 16.4%, 29.6%) (p < 0.001) lower, respectively, in the Device group than in the Manual group. Furthermore, caregivers evaluated the care they could administer with the device as being better than that associated with manual care.

A Review of Exoskeletons Considering Nurses

Daily tasks of nurses include manual handling to assist patients. Repetitive manual handling leads to high risk of injuries due to the loads on nurses' bodies. Nurses, in hospitals and care homes, can benefit from the advances in exoskeleton technology assisting their manual handling tasks. There are already exoskeletons both in the market and in the research area made to assist physical workers to handle heavy loads. However, those exoskeletons are mostly designed for men, as most physical workers are men, whereas most nurses are women. In the case of nurses, they handle patients, a more delicate task than handling objects, and any such device used by nurses should easily be disinfected. In this study, the needs of nurses are examined, and a review of the state-of-the-art exoskeletons is conducted from the perspective of to what extent the existing technologies address the needs of nurses. Possible solutions and technologies and particularly the needs that have not been addressed by the existing technologies are discussed.

What affects musculoskeletal risk in nursing assistants and orderlies?

BACKGROUND: There are many musculoskeletal disorders in staff members at health centres, given the specific characteristics of their work. OBJECTIVE: The objective was to analyse the postural risk of patient handling tasks performed by nursing assistants and orderlies, as well as task factors, individual or organisational, that may be associated with increased postural risk. METHOD: This is a cross-sectional observational study. Analysis was done on 170 postures in five different tasks performed by 39 participants at three hospitals in Andalusia (Spain). The questionnaires collected sociodemographic variables, the task done, and REBA were used for assessment of postural risk. RESULTS: Overall the average REBA score was 9.0±2.4. Moving the patient to the head of the bed was the task with the highest risk (9.8). Handling involving more than two participants at once increased postural risk. Using mechanical aids were associated with high risk in the legs. Logistic regression analyses showed that age, stature, and not having adjustable beds available were associated with postural risk (p < 0.05). CONCLUSION: Health centre staff perform many tasks with high musculoskeletal disorder risk. Age, stature of the participants, and adjustment of bed height were associated with postural risk.

Work-related musculoskeletal complaints among haemodialysis nurses: An exploratory study of the work situation from an ergonomic perspective

BACKGROUND:

Haemodialysis nurses have a high prevalence of musculoskeletal complaints, but the reason for this is yet unknown.

OBJECTIVE:

The aim of this study was to carry out an exploratory analysis of the work situation of haemodialysis nurses from an ergonomic perspective.

METHODS:

Non-participant observations and reflective discussions to assess the work environment and explore possible potential hazards contributing to musculoskeletal complaints were conducted among nineteen nurses at five haemodialysis centres. Additional reflective notes from the observer’s experiences and progress in the field were made. Analytic integration was applied to merge the collected data.

RESULTS:

Eight haemodialysis work tasks believed to increase the risk of developing work-related musculoskeletal complaints were identified. Different types of musculoskeletal complaints, mainly in the upper extremity, were mentioned. The design of the dialysis machine used and the physical demands of repetitive work procedures were implicated.

CONCLUSIONS:

Our findings add to the understanding of the work-related factors that contribute to musculoskeletal complaints among haemodialysis nurses. The findings support the hypothesis that there might be an association between materials used and the development of work-related complaints involving the fingers, hands and wrists of this population. Repetitive work tasks that have an impact on the development of musculoskeletal problems need to be further investigated.

Does Postural Feedback Reduce Musculoskeletal Risk?: A Randomized Controlled Trial

Background: There is a high prevalence of musculoskeletal disorders among personnel working in the healthcare sector, mainly among nursing assistants and orderlies. Objective: The objective is to analyze the effectiveness of a multi-component intervention that included postural feedback in reducing musculoskeletal risk. Method: A total of 24 nursing assistants and orderlies in a hospital setting were randomly assigned to an intervention group or a control group. After collecting sociodemographic information, a selection of tasks was made and assessed using the REBA (rapid entire body assessment) method. A multi-component intervention was designed combining theoretical and practical training, including feedback on the postures performed by the professionals involved, especially those involving high musculoskeletal risk. This program was applied only to participants in the intervention group. Subsequently, eight months after the first assessment and intervention, the second assessment was carried out using the same method and process as in the first evaluation. Results: The results indicate that the musculoskeletal risk in the second assessment in the intervention group was significantly reduced. However, no significant changes were observed in the control group. Conclusion: The multi-component intervention applied can significantly reduce the musculoskeletal risk of nursing assistants and orderlies. In addition, it is a low-cost intervention with great applicability.

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.

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.

The psychosocial work environment, musculoskeletal disorders and their functional consequences among pediatric healthcare providers

OBJECTIVE

The goal of this study was to examine the association between aspects of the psychosocial work environment and prevalence of musculoskeletal disorders (MSDs) and associated functional consequences among pediatric healthcare providers.

BACKGROUND

The psychosocial work demands make pediatric care providers susceptible to MSDs and subsequent functional consequences, but research on this at-risk group is lacking.

METHODS

Randomly selected pediatric registered nurses, behavioral health specialists, and patient care assistants (N = 569) completed a survey assessing psychosocial factors, MSDs, and functional consequences (e.g., missing work). Logistic regression was used to assess associations between psychosocial factors and outcomes.

RESULTS

The analysis yielded moderate-to-strong, significant associations between psychosocial environment factors and MSDs and their functional consequences. The odds of MSDs increased nearly three-fold in the highest quartile of the psychosocial summary score vs. the lowest (OR: 2.7, 95% CI: 1.6-4.5). The highest quartiles of the psychosocial environment measures were significantly associated with functional consequences of MSDs.

CONCLUSION

Results confirm knowledge about the association between the psychosocial environment and MSDs and demonstrates the association also exists among pediatric providers. Our study highlights the importance of studying the functional consequences of MSDs, which characterize the impact of MSD burden at work and elsewhere.

Light-emitting diode photobiomodulation therapy for non-specific low back pain in working nurses: A single-center, double-blind, prospective, randomized controlled trial

BACKGROUND

Low back pain (LBP) affects approximately 51% to 57% of hospital nurses and nurses' aides in Europe. New high-risk groups include home- and long-term-care nurses and physiotherapists. A number of European countries are experiencing a shortage of healthcare workers. Light therapy has been shown to be an effective treatment for various musculoskeletal disorders, including lateral epicondylitis, temporomandibular joint pain, carpal tunnel syndrome, and delayed-onset muscle soreness. A systematic review and meta-analysis demonstrated that low-level laser therapy is an effective method for relieving non-specific chronic low back pain (NSCLBP). However, the efficacy of light-emitting diode (LED) therapy for NSCLBP is disputed. This study aims to evaluate the effect of LED therapy on NSCLBP.

METHODS AND ANALYSIS

We conducted a prospective, double-blind, randomized placebo-controlled trial of 148 patients with NSCLBP. The patients were randomly assigned to 2 groups: intervention group, where patients received LED photobiomodulation therapy 3 times a week for 2 weeks, and the sham group, where patients had sham therapy 3 times a week for 2 weeks. Primary outcome measures included the visual analog scale for pain, lumbar active range of motion assessments, and chair-rising times. Secondary outcome measures included a multidimensional fatigue inventory, fear-avoidance beliefs questionnaire, and the Oswestry disability index. The outcome measures were assessed before therapy and 2weeks, 4 weeks, 8 weeks, 12 weeks, and 6 months after the first interventions were completed.

DISCUSSION

This study is a prospective, single-center, double-blind, randomized, controlled study. This study aims to research the efficacy of a 2-week LED program for NSCLBP working nurse. Our results will be useful for patients, working nurses, nurses' aides, and other healthcare workers with chronic low back pain.

TRIAL REGISTRATION NUMBER

NCT04424823.

Predictors of musculoskeletal symptoms in radiology technologists in Austria, Europe

BACKGROUND

Musculoskeletal symptoms (MSS) are a major health problem in health professionals. However, there is very little evidence about predictors of MSS in the group of radiology technologists.

OBJECTIVES

The aim of this study was to identify prevalence and predictors of MSS in radiology technologists working in Austrian Hospitals.

METHODS

272 radiology technologists completed a self-report questionnaire including MSS, work demands, work strain and well-being (WHO-5 questionnaire).

RESULTS

Lower back pain and upper back pain are the most frequent MSS in radiology technologists. A high proportion of participants experience these symptoms every day (20.1% and 19.8%, respectively). Work strain, age and well-being were the best predictors for MSS in a regression model.

CONCLUSIONS

MSS is a major health issue for radiology technologist working in hospitals. Our results provide evidence for the assumption that psychological factors play an important role in development of MSS. Thus, beside physical health promotion programs (e.g. safe patient handling), psychological intervention may have positive effects on MSS.

Work- and stress-related musculoskeletal and sleep disorders among health professionals: a cross-sectional study in a hospital setting in Switzerland

Background

Musculoskeletal and sleep disorders have been reported to be very common among health care and hospital workers and particularly nurses. They are assumed or found to be a result of psychological stress and/or physical strain or pain. However, no other study so far – at least in a hospital setting and for Switzerland – has considered and investigated musculoskeletal as well as sleep disorders in consequence of or rather in association with both physical workload and psychological stress.

Methods

Cross-sectional survey data of 1232 health professionals were used and analysed. Data were collected in 2015/16 among the health care workforces of three public hospitals and two rehabilitation clinics in the German-speaking part of Switzerland. Musculoskeletal and sleep disorders were assessed by three items taken from the Swiss Health Survey, a 2-item measure of accumulated low back, back, neck and shoulder pain and a single-item measure of problems in getting to sleep or sleeping through. Stratified and adjusted bivariate logistic and multivariate linear regression analyses were performed to calculate measures of association (adjusted odds ratios, z-standardized beta coefficients), to control for potential confounders, and to compare different health professions (nurses, physicians, therapists, other).

Results

Almost every fourth of the studied health professionals reported severe or even very severe musculoskeletal disorders (MSDs) and nearly every seventh severe sleep disorders (SDs). These prevalence rates were significantly or at least slightly higher among nurses than among physicians and other health care workers. General stress, work stress, physical effort at work, and particularly a painful or tiring posture at work were found to be clear and strong risk factors for MSDs, whereas only general and work-related stress were found to be significantly associated with SDs. There was no or only weak association between MSDs and SDs.

Conclusions

This study found MSDs to be largely a result of physical workload or rather poor posture at work and only secondarily a consequence of (general) stress, whereas SDs were revealed to be primarily a consequence of stress on and particularly off the job. Preventive strategies therefore have to differentiate and combine measures for the reduction of both psychological stress and physical strain.

Associations between materials used and work-related musculoskeletal hand complaints among haemodialysis nurses

BACKGROUND

One in every two haemodialysis nurses has reported musculoskeletal complaints concerning their hands, which is twice that reported for hospital nurses in general. It is possible that there is an association between the materials used by haemodialysis nurses and the occurrence of hand complaints.

OBJECTIVES

To examine the association between the type of dialysis machine and disposables used with the occurrence of hand complaints among haemodialysis nurses. To compare occupational risks of developing work-related musculoskeletal disorders based on the materials used for haemodialysis.

DESIGN

Cross-sectional.

PARTICIPANTS

Two hundred and eighty-two nurses working in 27 haemodialysis centres in Sweden participated in a survey, and 19 nurses at five centres were observed during priming procedures.

MEASUREMENTS

Nurses supplied demographic data and answered the Nordic Musculoskeletal Questionnaire. Centre level data regarding machines and disposables used for haemodialysis during the past year were also collected.

RESULTS

There were no differences in the prevalence of hand complaints based on the type of haemodialysis machines, dialysers or tubing used. There were no differences found in physical exposure to the hands during priming, based on machine type used.

CONCLUSION

The results of this study could not reveal any association between disposable materials used and the occurrence of hand complaints among haemodialysis nurses. Additionally, there were no occupational risks detected based on the types of machines used. Hence, the results of the present study strongly indicate that a deeper ergonomic analysis of the work environment is needed to understand the prevalence of hand complaints among nurses working in haemodialysis settings.

Efficacy of six months neuromuscular exercise on lumbar movement variability - A randomized controlled trial

INTRODUCTION

Lumbar movement variability during heavy, repetitive work may be a protective mechanism to diminish the progression of lumbar disorders and maintain neuromuscular functional integrity. The effect of neuromuscular exercise (NME) on the variability of lumbar movement is still to be determined.

METHODS

A randomised controlled trial was conducted on a population of nursing personnel with subacute LBP. Following randomization, the NME group participants completed an NME program of six months duration. The participants in the control group only attended the assessment sessions. The outcomes were assessed at: baseline; after six months intervention; 12 months. The primary outcome was lumbar movement variability based on angular displacement and velocity.

RESULTS

A positive treatment effect on lumbar movement variability was seen after six months of NME intervention. Angular displacement improved, and angular velocity remained constant. At the 12-month follow up, however, the effect faded in the NME group. Lumbar movement variability worsened in the control group over all time periods.

CONCLUSION

NME may improve lumbar movement variability in the short term and may indicate improved neuromuscular functional integrity. The design of an optimal NME program to achieve long-term improvement in lumbar movement variability is a subject worthy of further research.

The Back College for nurses - an evaluation of intermediate effects

BACKGROUND

Nursing staff and care workers run an increased risk of work related musculoskeletal disorders such as low back pain. The Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) offers its insured persons the opportunity to participate in a three-week Back College with the aim of preventing them having to abandon their profession due to back problems. The aim of the study was to record the effectiveness and sustainability of the Back College on an intermediate basis (6 months).

METHODS

As part of a single-group pre-post measurement on three survey dates - at the start (T0) and end (T1) of rehabilitation and 6 months later (T2) - in 2013 all participants in the Back College at three locations were surveyed using a standard questionnaire. Wilcoxon signed-rank tests were performed to evaluate statistically significant changes.

RESULTS

For measurement dates T0 to T2 we had 570 complete datasets (response rate 70.81%). There was a significant decrease in reported back pain and the general state of health and quality of life index improved. Participants' emotional strain decreased and they showed an improved understanding of illness as well as of having acquired knowledge-based abilities and skills for dealing with the disease. After training, they recorded back-friendly behaviour in everyday life and opportunities to relieve strain on the spinal column were utilised at work more often. Participants' subjective assessment of their ability to work (Work Ability Index) improved.

CONCLUSION

The present study proved the intermediate effectiveness of the Back College curriculum. Whether these effects remain stable in the long term will be tested on the subsequent measurement date (T3, after 24 months).

A Cross-Sectional Survey of Low Back Pain in Nurses Working in Orthopedic Departments

The study aimed to gain knowledge about low back pain (LBP) in nurses working in the orthopedic departments of tertiary hospitals in Sichuan province, China. We used a cross-sectional survey to examine the prevalence of LBP among 797 inpatient nurses who had worked for 1 year in an orthopedic department in one of 29 hospitals (Grade 3A) in Sichuan province. The survey included a questionnaire to determine the prevalence of LBP and factors related to LBP, a screening graph of LBP symptoms, the Roland Morris Disability Questionnaire (RMDQ), and the Fear Avoidance Beliefs Questionnaire (FABQ) for LBP. The 1-year period prevalence of LBP in the nursing population was 66.8% and the point prevalence was 51.3%. Among the 523 nurses who had experienced LBP, the mean total number of days that LBP had been experienced during the past year was 20.2 ± 16.3 days (range = 1-90 days). The annual number of episodes of LBP was 5.7 ± 4.5 times/year (range = 1-20 times/year). More than half the orthopedic nurses (51.1%) planned to quit, and 5.8% thought of leaving their job due to LBP. These study findings indicate that nurses in this region experience a burden of LBP similar to those in other regions in the world.

Evaluation of body posture in nursing students

OBJECTIVE

To investigate the body posture of nursing students before and after clinical practice.

METHOD

The study was developed in two stages. Initially the body posture of students of the 2nd, 4th, 6th, and 8th periods were assessed through photogrammetry. All images were analyzed in a random and masked manner with CorporisPro® 3.1.3 software. Three evaluations were performed for each angle and then the mean value was calculated. Two years later, when the 4th period students had developed their clinical internships, their body posture was again evaluated.

RESULTS

The total sample consisted of 112 students. Comparison of their posture with the normality pattern showed that all the angles presented significant differences (p< 0.00), except for the angle of the Thales triangle. Reassessment of these students evidenced significant differences in the angles of the acromioclavicular joint (p=0.03), knee flexion (p< 0.00) and in the tibiotarsal angle (p< 0.00).

CONCLUSION

All the students presented alterations when compared to the normality values. The segments that presented significant differences between before and after practice were the acromioclavicular angle, knee flexion, and tibiotarsal angle; the latter two were in the rolling position.

OBJETIVO

Investigar a postura dos estudantes de enfermagem antes e após a prática clínica.

MÉTODO

O estudo foi desenvolvido em duas etapas, inicialmente com estudantes (2º, 4°, 6° e 8º períodos) tiveram sua postural corporal avaliada por meio da fotogrametria. Todas as imagens foram analisadas, de maneira aleatória e mascarada, por meio do software CorporisPro® 3.1.3. Foram realizadas três avaliações para cada ângulo e calculada a média. Dois anos depois, quando os estudantes do 4º período desenvolveram os estágios clínicos, foram novamente avaliados quanto à postura corporal.

RESULTADOS

A amostra total foi composta por 112 estudantes. Comparando-se os estudantes com o padrão de normalidade, todos os ângulos apresentaram diferença significativa (p< 0,00), com exceção do ângulo triângulo de Tales. Reavaliando os mesmos estudantes, houve diferença significativa nos ângulos da articulação acromioclavicular (p=0,03), da flexão de joelhos (p< 0,00) e no ângulo tibiotársico (p< 0,00).

CONCLUSÃO

Todos os estudantes apresentaram alterações, comparadas aos valores de normalidade. Os segmentos com diferença significativa, comparando-se antes e após a prática, foram o ângulo acromioclavicular, flexo de joelho e ângulo tibiotársico, sendo os dois últimos na posição de rolamento.

Prevalence and Associated Factors of Musculoskeletal Disorders among Young Dentists in Indonesia

Introduction: Musculoskeletal problems are often work related. Dentists have been reported to have a high prevalence of musculoskeletal problems. Dentists have to perform repetitive tasks, often in awkward and nonergonomic positions in their practice. Materials and Methods: This is a cross-sectional study. Five-hundred copies of Nordic Musculoskeletal Questionnaire were distributed to dentists who participated in a congress of a regional branch of the Indonesian Dentist Association. Data such as sex, length of practice, the presence of assistance, smoking, occupational stress, body mass index, hand dominance, and exercise were collected. Dentist who had practised for more than five years were excluded. Results: Two hundred and forty-one respondents fulfilled the research criteria. Musculoskeletal symptoms occurred in 63.5% respondents. Fatigue and pain were the most common manifestations of musculoskeletal symptoms among dentists (36.5 and 24.9% respectively). Prolonged sitting was the most common aggravating factor (26.6%) while exercise successfully relieved symptoms in 35.3% of respondents. Neck, upper back and lower back were the most common sites involved with prevalence of 25.7, 22.4, and 20.7% respectively. Neck was also the most common site of the symptoms preventing normal work during the preceding 12 months (8.3%). Exercise and stress are associated with the presence of musculoskeletal symptoms (p=0.01 and p<0.01 respectively). Exercise is associated with fatigue (p<0.01) and click (p<0.01), stress is associated with pain (p=0.00), stiffness (p=0.00), fatigue (p<0.01), and discomfort (p<0.01). Conclusions: The prevalence of musculoskeletal disorders in young dentists is 63.5%. Neck is the most common affected region. Stress and exercise are the main associated factor for musculoskeletal problems in dentists.

Working postures and physical activity among registered nurses

Nurses report a high prevalence of musculoskeletal discomfort, particularly of the low back and neck/shoulder. This study characterized the full-shift upper arm and trunk postures and movement velocities of registered nurses using inertial measurement units (IMUs). Intensity of occupational physical activity (PA) was also ascertained using a waist-worn PA monitor and using the raw acceleration data from each IMU. Results indicated that nurses spent a relatively small proportion of their work time with the arms or trunk in extreme postures, but had few opportunities for rest and recovery in comparison to several other occupational groups. Comparisons between nurses in different PA groups suggested that using a combination of accelerometers secured to several body locations may provide more representative estimates of physical demands than a single, waist-worn PA monitor. The findings indicate a need for continued field-based research with larger sample sizes to facilitate the development of maximally effective intervention strategies.

Neuromuscular exercise and back counselling for female nursing personnel with recurrent non-specific low back pain: study protocol of a randomised controlled trial (NURSE-RCT)

Introduction

Nursing personnel have high risk for incidence of low back pain (LBP) followed by development of chronic pain and disability. Multiple risk factors such as patient handling, night shift work and lack of supporting work culture have been identified. In subacute LBP, high-fear avoidance is prognostic for more pain, disability and not returning to work. Lack of leisure-time physical activity predicts long-term sickness absence. The purpose of this study is to compare effectiveness of 6-month neuromuscular exercise and counselling in treating back pain in female nursing personnel with recurrent non-specific LBP pain compared with either (exercise or counselling) alone and a non-treatment control group.

Methods and analysis

The design is of a double-blinded four-arm randomised controlled trial with cost-effectiveness evaluation at 12 and 24 months. The study is conducted in 3 consecutive substudies. The main eligibility criteria are experience of LBP during the past 4 weeks with intensity of at least 2 (Numeric Rating Scale 0–10) and engagement in patient handling. Sample size was estimated for the primary outcome of pain intensity (visual analogue scale). Study measurements are outlined according to the model of International Classification of Functioning, Disability and Health, which incorporates the biopsychosocial processes assessed.

Ethics and dissemination

This study is carried out conforming to the guidelines of good scientific practice and provisions of the declaration of Helsinki. Increasing physical and mental capacity with interventions taking place immediately after working hours near the worksite may reduce development of chronic LBP and work disability in female nursing personnel with recurrent non-specific LBP.

Trial registration number

NCT04165698.

Lower extremity musculoskeletal disorders in nurses: A narrative literature review

AIMS

The aim of the narrative review was to describe and analyze lower extremity musculoskeletal disorders (MSDs) in nurses and to identify factors associated with these disorders. The ultimate goal was to promote lower extremity health in nurses by recognizing factors that could improve their well-being at work.

METHODS

A systematic search on the Medline, CINAHL, and PsychInfo databases was conducted, producing altogether 945 citations, of which 35 were selected for this review. The studies were analyzed by content analysis.

RESULTS

Nurses have different MSDs in their lower extremities, with which the knee, foot, and ankle being most commonly affected. These problems are often correlated, and problems in the ankle can first appear as knee problems.

CONCLUSIONS

Musculoskeletal disorders in lower extremities and their resulting disability are common within the nursing workforce worldwide, representing a major cause of sick leave absence and often leading to long-term absence.

Comparisons of musculoskeletal disorders among ten different medical professions in Taiwan: a nationwide, population-based study

Objective

Medical personnel are at risk of musculoskeletal disorders but little is known whether the risk of musculoskeletal disorders were different among various medical professions. Therefore, this study compared the risk of musculoskeletal disorders among personnel of 10 different medical professions in Taiwan using a nationwide health claims database.

Methods

Data from the 2000–2010 Taiwan National Health Insurance Research Database were used to identify personnel of 10 different medical professions. Diagnoses based on the International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) were used to identify eight different musculoskeletal disorders that occurred after the license issuance date. Cox proportional hazards model was used to compare the risk of eight musculoskeletal disorders among the 10 different medical professions using dentists as the reference category.

Results

A total of 7,820 medical personnel were included in the analysis. Using dentists as the reference category, physical therapists showed a significantly higher risk of all eight musculoskeletal disorders (ranging from 1.59 [p = 0.032] in sprains and strains of other and unspecified parts of back to 2.93 [p < 0.001] in spondylosis and allied disorders).

Conclusions

Compared with dentists, a profession that already known to suffer from high rates of work-related musculoskeletal disorders, physical therapists, registered nurses, and doctors of Chinese medicine showed an even higher risk of musculoskeletal disorders.