Prevalence of Body Area Work-Related Musculoskeletal Disorders among Healthcare Professionals: A Systematic Review

Impact of architecture students' study-rest schedules on pain and upper extremity functionality

BACKGROUND

The intensity of architecture students' work-rest schedules can cause work-related musculoskeletal pain and upper extremity disfunction.

OBJECTIVE

The aim of this study is to examine the influence of architectural students' study-rest schedules on the musculoskeletal pain and upper extremity functionality.

METHODS

A total of 174 architectural students (99 female, 75 male) were included in the study. The questionnaire initially recorded demographic information. Data were collected using the body diagram of the Cornell Musculoskeletal Discomfort Questionnaire. The body diagram of the Cornell Musculoskeletal Discomfort Questionnaire was integrated with the Visual Analogue Scale. Pain intensity in the marked regions on the body diagram was evaluated with the VAS, and upper extremity functionality was assessed with the Quick Disabilities of the Arm, Shoulder and Hand questionnaire.

RESULTS

There was a difference in the pain intensity between male and female students (p < 0.05). Students who had longer study duration and longer uninterrupted study duration experienced higher levels of pain intensity in most region of body and more effect on the functionality of the upper extremities (p < 0.05). Conversely, there was a reduction in both pain intensity and upper extremity functionality impairment with increasing total rest time (p < 0.05).

CONCLUSIONS

According to the data obtained from the study indicated that students' study-rest schedules were associated with musculoskeletal pain and upper extremity functionality.

Mixed adverse ergonomic factors exposure in relation to work-related musculoskeletal disorders: a multicenter cross-sectional study of Chinese medical personnel

Exposure to adverse ergonomic factors is associated with elevated risk of work-related musculoskeletal disorders (WMSDs) in medical personnel. We aimed to reveal how different adverse ergonomic factors act individually and in combination to influence the risk of WMSDs in medical personnel. From June 2018 to December 2020, we applied multistage cluster random sampling to select a total of 6,099 medical personnel from 54 hospitals in 12 cities in China. All participants were aged over 18 years and had at least one year of hospital working experience. The weighted quantile sum (WQS) model was employed to evaluate the effect of mixed exposures of multiple adverse ergonomic factors on the risk of WMSDs. Compared to a single factor, multiple adverse ergonomic factors significantly increased the risk of WMSDs across body parts, with an OR ranging from 2.83 (95% CI: 2.33, 3.43) to 6.92 (95% CI: 4.91, 9.74). "Working in awkward positions" had the greatest impact on the risk of WMSDs in the neck, shoulder, upper back, and lower back, while "standing for prolonged periods of time" mostly affected the risk of WMSDs in the foot, leg, and knee. Compared with single factor exposure, mixed exposure resulted in a higher risk of WMSDs.

Responsible CVD screening with a blockchain assisted chatbot powered by explainable AI

Cardiovascular disease (CVD) is rising as a significant concern for the healthcare sector around the world. Researchers have applied multiple traditional approaches to making healthcare systems find new solutions for the CVD concern. Artificial Intelligence (AI) and blockchain are emerging approaches that may be integrated into the healthcare sector to help responsible and secure decision-making in dealing with CVD concerns. Secure CVD information is needed while dealing with confidential patient healthcare data, especially with a decentralized blockchain technology (BCT) system that requires strong encryption. However, AI and blockchain-empowered approaches could make people trust the healthcare sector, mainly in diagnosing areas like cardiovascular care. This research proposed an explainable AI (XAI) approach entangled with BCT that enhances healthcare interpretability and responsibility to cardiovascular health medical experts. XAI is significant in addressing cardiovascular prediction issues and offers potential solutions for complex communication and decision-making in cardiovascular care. The proposed approach performs better, with the highest accuracy of 97.12% compared to earlier methods. This achievement shows its ability to tackle complex issues, accessible during healthcare sector communication and decision processes.

Use of Wearable Inertial Sensors to Assess Trunk and Cervical Postures Among Surgeons: Effect of Surgical Specialties and Roles

This study aimed to quantitatively assess trunk and cervical non-neutral postures assumed by surgeons during the performance of routine open procedures. Indeed, musculoskeletal disorders are frequently reported by surgeons, especially at the head and neck level, due to the prolonged time spent in ergonomically challenging postures. Therefore, the posture of fourteen surgeons was monitored using wearable inertial sensors (and processed according to the ISO 11226 standard) by considering the effect of different surgical specialties (thyroid vs. breast) and roles (primary vs. assistants). Overall, surgeons spent most of their time in a standing posture, remaining within the acceptable limits of trunk flexion. More concerning results were observed analyzing the time spent in static head flexion and lateral bending (~72% and 48% of the time, respectively). Assistants, compared with primary surgeons, spent more than twice as much time in extreme neck flexion, although this was only when performing thyroid surgeries. The opposite was observed during breast surgeries. By spending most of their time in a standing posture with extreme forward neck flexion, surgeons are exposed to a high ergonomic risk, especially when frequently performing thyroid surgeries. The assumed role appeared to influence postural loading, with an effect that varies according to the surgical specialty.

COVID-19 Pandemic Impact on Sickness Absences Among Healthcare Workers: A Cohort Study in a Spanish Hospital (2018-2023)

BACKGROUND

Like other European systems, the Spanish national health system (NHS) is reaching a critical point. This article analyses sickness absence (SA) trends, as a direct indicator of this crisis, among healthcare workers (HCWs) in Spain, comparing the pre-pandemic, pandemic, and post-pandemic periods.

METHODS

This study was based on a retrospective cohort of HCWs (n=7.918) hired at Hospital del Mar in Barcelona for at least three months during 2018-2023. The primary outcome was incident SA episodes. Incidence rates (IR) per 1,000 persons-day and 95% confidence intervals (95% CI) were calculated by sex, period, and occupational variables. Longitudinal entropy regression models were estimated to identify the factors influencing the frequency of transitions between the different HCWs' employment states (active or on SA).

RESULTS

Increasing trends in IR (95%CI) were observed, rising from 1.77 (1.71; 1.83) episodes of SA per 1,000 workers-day during the pre-pandemic period to 5.04 (4.93; 5.15) during the post-pandemic among women, and from 1.23 (1.14; 1.31) to 3.79 (3.64; 3.95), respectively, among men. Nurses, nurse aides, orderlies/technicians, workers under 30, and those in intensive care units and emergency rooms showed the highest IR during and after the pandemic, with longitudinal entropy analysis revealing increased state changes, primarily affecting these groups.

CONCLUSIONS

This study demonstrates a significant rise in SA incidence among HCWs during and after the pandemic and identifies vulnerable groups with higher incidence. Several hypotheses, such as poor working conditions, burnout, and patient complexity, have been suggested to explain these results. Urgent interventions are needed to safeguard HCWs' health, thus maintaining the sustainability and safety of the NHS.

Feasibility and Effects of Exercise During Working Hours in Acute Hospital Staff - A Non-Randomized Controlled Trial

PURPOSE

Workplace health interventions with exercise have positive effects on musculoskeletal pain and well-being at work, however, effectiveness is questioned due to low adherence. In hospitals participation is challenged by shiftwork and unpredictable workload. Our aim was to investigate the feasibility of exercise during working hours in an acute hospital, herein to estimate the health impact to guide management decisions on implementation.

METHODS

A clinical trial in a public hospital, offering staff supervised group-based individualized exercise with combined aerobic and strength training during working hours twice weekly for 20 weeks. Delivery, acceptance, and adherence were investigated. Subjective outcomes were social capital, well-being, quality of life, and musculoskeletal pain were assessed. Objective outcomes were blood pressure, body composition, and cardiorespiratory fitness.

RESULTS

Twenty-three percent of the employees (n = 617) accepted participation (92% female, median age was 50 years, 38% nurses). Adherence was 29% with no difference between employees with clinical versus non-clinical functions. Non-clinicians participated during working hours, while clinicians participated outside of working hours in 50% (IQR 5-87) of the sessions. Positive changes were seen in systolic and diastolic blood pressure (decreased 2.0 [0.9; 2.2] and 0.9 [0.1; 1.7] mmHG, respectively), aerobic capacity 2.3 ml/O2/min/kg [1.7; 2.9], and in waist-hip ratio, social capital, well-being, quality of life, and musculoskeletal pain.

CONCLUSION

Exercise during working hours in an acute hospital staff was feasible, but strategies to increase acceptance and adherence are necessary for a successful implementation. Despite low adherence, the intervention was associated with improvements of physical and mental health.

REGISTRATION

The study protocol has been uploaded on www.

CLINICALTRIALS

gov (NCT04988724).

Work-Related Musculoskeletal Disorder Prevalence by Body Area Among Nurses in Europe: Systematic Review and Meta-Analysis

Background/Objectives: Nurses are highly exposed to work-related musculoskeletal disorders (WMSDs). Global prevalence exceeds 80%, and several body areas are equally at risk. Numerous studies have assessed the exposure in many countries, but few have provided an overview by continent. The aim of this study was to propose a literature review and meta-analysis to investigate the overall and body area prevalence of WMSDs among nurses in Europe. Methods: A systematic review and a meta-analysis were conducted between September and November 2024. Five databases were scanned without a date limit: ScienceDirect, PubMed/Medline, Google Scholar, Science.gov, and Mendeley. The article selection, review, critical appraisal, and data extraction were performed by two authors independently. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used for reporting the search results. Results: Among the 15,751 unique identified records, 12 studies met the inclusion criteria and were included for data extraction. The studies reported a total of 5153 nurses in Europe. High heterogeneity (Cochran's Q test and I2 statistic) was observed between studies. The results of the meta-analysis based on the random-effects model showed an overall prevalence of 87.8% (95% CI: 83.3-92.2%). The highest prevalence was found for lower back 61.4% (95% CI: 55.1-67.7%), neck 49.9% (95% CI: 42.9-56.8%), and upper back 46.3% (95% CI: 42.4-50.2%). Conclusions: Nurses are highly exposed to WMSDs, with a prevalence of over 30% for three-quarters of body areas. Due to the multitude of risk factors associated with nurses' work, the development of recommendations is a complex multifactorial issue, requiring the exploration of different strategies to reduce the prevalence of MSDs in nurses.

The Impact of Work-Related Musculoskeletal Pains on Routine Tasks Among Operating Room Nurses: A Multicenter Cross-Sectional Study

PURPOSE

To determine work-related musculoskeletal pain (MSP) among 105 operating room nurses (ORNs) and its effect on their routine work.

DESIGN

Multicenter cross-sectional design.

METHODS

This study was conducted with 105 nurses working in operating rooms of five different hospitals between December 15, 2021, and February 15, 2022. Data were collected using the "Nordic Musculoskeletal Questionnaire." SPSS 22.0 was used for data analysis, and a significance level of p < .05 was established.

RESULTS

Among the nurses, 75.2% were female, 78.1% had undergraduate education, and 59% worked >40 hours/week. In the previous 12 months, 69.5% of ORNs experienced lower back pain; 68.6%, neck pain; and 61.9%, back pain. The duration spent working as a scrub nurse increased the possibility of experiencing pain in the hands, wrists, back, shoulders, and lower back region (p < .05), and women had an increased risk of lower back and back pain (p < .05). Neck, lower back, back, wrist, and hand pain increased the risk of being unable to perform daily tasks (p < .05).

CONCLUSIONS

Extended work hours as a scrub nurse increase the risk of MSP, including lower back region, neck, and back pain among ORNs. Women have a higher risk of lower back and back pain. Addressing musculoskeletal issues in this profession is crucial.

CLINICAL IMPLICATIONS

Addressing musculoskeletal discomfort is vital because of its impact on nurses' job performance and potential patient harm. Providing ergonomic equipment, training nurses on musculoskeletal health, and raising awareness can help. It is also important to encourage regular breaks.

Organisational-level risk and health-promoting factors within the healthcare sector-a systematic search and review

Introduction

The healthcare sector is globally experiencing increasing demands and workplace interventions on an organisational level is sought to create healthy workplaces. The aim of this study was to provide an overview of Nordic research on the work environment and health of healthcare professionals, with a focus on identifying organisational-level risk and health-promoting factors.

Methods

This systematic search and review was based on an analysis of studies published in peer-reviewed journals between 1 January 2016 and 3 January 2023. The selected studies investigate the relationships between organisational-level risk and health-promoting factors and measures of health and well-being among healthcare professionals during ordinary operations. To increase applicability, this systematic search and review was limited to the Nordic countries as they share the same context with a publicly-funded widely accessible healthcare system. A total of 2,677 articles were initially identified, with 95 original studies meeting the criteria for relevance and quality.

Results

Identified organisational risk and health-promoting factors were categorised into five categories: work schedule distribution, operations design and work methods, ergonomic conditions, working conditions and personnel policies, and the organisation's ethical environment. In addition, two themes across the categories emerged, providing further insight into the implications for practice. The first theme emphasises risk and health-promoting factors in the actions that employers take to fulfil the organisation's goals. The second theme emphasises risk and health-promoting factors in connection with the ability of employees to do their jobs at a level of quality they deem acceptable.

Conclusion

Several organisational-level risk and health-promoting factors were identified, and the results indicate that the actions that employers take to fulfil the health-care organisation's goals and promote the ability of employees to provide high-quality care are important for the health and wellbeing of healthcare employees.

Ergonomic Challenges and Musculoskeletal Pain During Remote Working: A Study of Academic Staff at a Selected University in South Africa During the COVID-19 Pandemic

The COVID-19 pandemic led to a rapid shift to remote working, which affected ergonomic conditions and increased the risk of upper body musculoskeletal pain (MSP). This study assessed the prevalence and impact of upper body MSP (affecting the head, neck, shoulders, and back) among academic staff at a University of Technology during the pandemic. Data were collected from 110 participants through an online, descriptive, cross-sectional survey adapted from the Dutch Musculoskeletal Questionnaire, the Standardized Nordic Questionnaire, and the McCaffrey Initial Pain Assessment Tool. The survey examined demographics, ergonomic practices, MSP, and psychological well-being before and during the pandemic. The sample included 59.1% female participants, with most being middle-aged. Persistent MSP was common, with 54.5% reporting neck pain and 59.1% experiencing back pain during the pandemic, alongside a significant decline in wrists in neutral position ergonomics (p = 0.012). Psychological well-being also worsened, as participants reported lower levels of cheerfulness, calmness, and energy than before the pandemic. While 81.9% of 90.9% participants with pre-existing MSP continued to experience pain, a small (9%) but notable proportion saw a decline in MSP during this period. These findings highlight a strong relationship between remote working conditions and MSP, with poor ergonomics and psychological distress contributing significantly to persistent pain. The results emphasise the need for institutions to provide ergonomic support, such as appropriate equipment and workstation adjustments, alongside mental health resources to mitigate the long-term impacts of remote working on physical and mental health.

The impact of the COVID-19 pandemic on musculoskeletal disorders-related sick leave among healthcare workers: a retrospective analysis of Slovenian national data

Purpose

Musculoskeletal disorders (MSDs) are one of the main causes of health-related absenteeism. MSDs were a known problem among healthcare workers (HCWs) even before COVID-19. The pandemic, with its associated stresses and changes in working conditions, may have influenced the incidence and duration of MSDs-related sick leave (SL) among HCWs. The aim of this study was to compare the incidence and duration of MSDs-related SL among HCWs before and during the COVID-19 pandemic, with a focus on differences between age and gender groups.

Methods

A retrospective analysis was conducted using Slovenian national SL data on work-related MSDs within NACE Rev. 2 "Human health activities" for 2019, 2020, and 2021, categorized by gender and age.

Results

The study found that older HCWs, particularly women, consistently had a higher incidence of work-related MSDs SL than their younger counterparts. However, during the pandemic, MSDs were more common among younger men, while the average duration of SL was longer among younger women. On the other hand, in older HCWs, the average SL incidence decreased during the pandemic, while the SL duration substantially increased.

Conclusion

The dynamics of MSDs related SL among HCWs are complex and influenced by several factors, including the challenges posed by the COVID-19 pandemic. Healthcare managers should implement tailored strategies to address MSDs-related absenteeism among specific groups of HCWs to promote a healthier workforce and ensure a resilient healthcare system during health crises.

Health behaviours and work-related musculoskeletal pain among Polish physiotherapists and nurses

BACKGROUND

Physiotherapists and nurses play crucial roles in healthcare, often requiring them to adopt physically demanding positions. However, these positions can lead to joint stress and an increased risk of injury, as well as work-related musculoskeletal disorders (WRMSDs). These disorders can significantly impact the performance of their duties, which can negatively affect patient recovery.

OBJECTIVE

This study assessed and compared health behaviour and work-related musculoskeletal pain among Polish physiotherapists and nurses.

METHODS

The study encompassed a group of 304 participants. The methodology consisted of a survey addressing pain-related questions and the Health Behaviour Inventory (HBI). The HBI evaluates health behaviour in four categories.

RESULTS

The average HBI score was 5.05 (±1.96) points for physiotherapists and 4.50 (±1.86) points for nurses (P = .01). When analysing the HBI components, a statistically significant difference was observed in positive mental attitude and health practices (P <  .05). Regarding work-related musculoskeletal pain, 92% of nurses and 79% of physiotherapists reported experiencing pain while working (P <  .01). Pain intensity, measured with the VAS, was 3.77 (±2.37) for physiotherapists and 4.73 (SD 2.04) for nurses (P <  .01). Physiotherapists more often suffered from upper limb pain (57% vs 49%), while nurses experienced middle/lower back pain (82% vs 63%) and lower extremity pain (38% vs 23%) more frequently.

CONCLUSIONS

Both professional groups experience WRMSDs, with nurses suffering more regularly and severely. In contrast, physiotherapists exhibit superior health behaviour practices, potentially mitigating musculoskeletal pain. Nonetheless, the prevalence of pain related to WRMSDs remains alarmingly high in both professions.

An assessment of musculoskeletal disorders and physical activity levels in dentists: A cross-sectional study

BACKGROUND

Dentistry is a physically and mentally demanding profession that involves long periods of muscle imbalance and asymmetrical postures when performing delicate procedures. This can lead to a high incidence of work-related diseases. However, physical activity may prevent or minimize the incidence of musculoskeletal discomfort and pain.

OBJECTIVE

The present study aimed to determine the association between musculoskeletal disorders and physical activity levels in dentists practicing in Turkey.

METHODS

This cross-sectional study was conducted between March and June 2023 with dentists from Turkey actively practicing dentistry. The short form of the International Physical Activity Questionnaire was used to determine dentists' physical activity levels, and the Extended Nordic Musculoskeletal Questionnaire was used to assess musculoskeletal disorders. IBM SPSS 20 software was used for statistical analysis. Data were presented as mean, standard deviation, median, minimum, maximum, percentage, and number. Chi-square, Mann-Whitney U, One-Sample Chi-Square tests, and an ordinal logistic regression test were used. The statistical significance level was taken as p <  0.05.

RESULTS

A total of 116 dentists (63 females 53 males) between the ages of 24 and 60 (36.37±7.32) were included in the study. Forty-eight participants had a low level of physical activity, 56 had a moderate level of physical activity (MLPA), and 12 had a high level of physical activity (HLPA). There was no significant difference between the gender (p = 0.224) and age (p = 0.469) of the participants and levels of physical activity. Musculoskeletal discomfort was reported by 93.1% (n = 108) of the participants in one or more body parts (p <  0.001) and 55.6% (n = 60) of them were female. The number of dentists with neck (p <  0.001) and shoulder (p = 0.05) problems was significantly higher. There was no significant effect of gender (p > 0.05) on musculoskeletal conditions. However, the relationship between musculoskeletal conditions and physical activity levels was inconsistent. The HLPA group reported the lowest discomfort for all body parts, except the elbows and knees (p <  0.05). The MLPA group reported higher discomfort in the neck, shoulder, upper back, wrists/hands, lower back, and knees. The group with the lowest physical activity exhibited the highest discomfort in the elbow and ankle/feet regions.

CONCLUSION

This study found that the prevalence of musculoskeletal disorders was high among dentists, many of whom reported either low or moderate physical activity levels. The results of this study may enhance dentists' understanding of work-related musculoskeletal diseases and promote their participation in physical activities.

Manual handling and back pain among health care professionals in neurological inpatient and outpatient settings: a mixed methods study

BACKGROUND

The number of patients with neurological disorders and severe disability is increasing globally. These patients often need help with positioning and the amount of support varies with their level of impairment. High rates of work-related musculoskeletal disorders are observed among healthcare professionals (HCP) with patient contact due to injuries during manual handling. There is insufficient research on manual handling by nurses and other HCP.

OBJECTIVES

The primary aim of this study was to explore manual handling strategies by HCP in neurological inpatient and outpatient settings. A secondary aim was to explore pain during and post manual handling activities.

DESIGN

A convergent parallel mixed methods design.

METHODS

A quantitative survey was combined with qualitative semi-structured telephone interviews of HCP. The inclusion criteria were licensed allied HCP with at least seven years of experience with neurological patients in inpatient and/or outpatient settings and expertise in manual handling. Exclusion criteria included insufficient proficiency in German and pre-existing illness prior to start of professional education. The survey data were analysed using descriptive statistics and interviews were evaluated through inductive-reflexive thematic analysis.

RESULTS

Ten nurses, 10 occupational, 12 physiotherapists participated. Survey findings showed moderate time pressure, body strain, and low back and neck pain during patient transfers. HCPs spent an average of 7.3 (± 5.5) hours per week on personal endurance and strength training. They considered transfer aids moderately important and accessible, predominantly using the transfer board. Interdisciplinary collaboration in patient transfers was reported as crucial and usually available. We identified three themes from interviews: (1) individualised manual handling; (2) facilitating active patient participation during transfers; (3) maintaining personal physical fitness.

CONCLUSIONS

Neurological symptoms, patient fears, and goal setting necessitated personalised transfer strategies. Patient characteristics, lack of space and time complicated transfers, prompting HCPs to use perception-oriented techniques, leverage, gravity, and momentum.

Prevalence of work-related musculoskeletal disorder and ergonomic risk practice among medical laboratory professionals at health facilities of eastern Ethiopia

Background

Musculoskeletal disorders represent a significant occupational problem due to poor ergonomic workstations among medical laboratory professionals; however, there is limited information regarding ergonomic-related musculoskeletal disorders among laboratory personnel in Ethiopia, particularly in eastern Ethiopia.

Methods

An institutional-based cross-sectional study design was implemented among 241 Medical Laboratory Professionals (MLPs) from December 20, 2023, to January 20, 2024. A standardized questionnaire adapted from the Nordic musculoskeletal questionnaire and a combination of self-administered surveys and direct observational techniques was used for data collection. Bivariate and multivariable logistic regression analyses were used to determine factors associated with musculoskeletal disorders with findings presented through Odds ratios and a 95% Confidence Interval (CI), and statistical significance was declared at p-value <0.05.

Result

This study showed that over the past 12 months, 142 (58.9%; 95% CI: 52.0, 65.0) Medical Laboratory professionals reported work-related musculoskeletal disorders at least in one of the nine body parts. Age 36 and above years (AOR = 1.51; 95% CI: 1.02, 6.01), being female (AOR = 1.89; 95% CI: 1.09, 5.04), work experience 10-15 years (AOR = 3.99; 95% CI: 1.6, 9.4), work experience >15 years (AOR = 4.13; 95% CI: 1.52, 10.81), sitting time 4 and above hours (AOR = 2.25; 95% CI: 1.10, 4.63), patient load >300 (AOR = 2.67; 95% CI: 1.12, 7.46), and being overweight (AOR = 1.67; 95% CI: 1.04, 6.03) were factors significantly associated.

Conclusion

The prevalence of work-related musculoskeletal disorders was found to be higher among Medical Laboratory Professionals as compared to previous research conducted in Ethiopia. It is recommended to regularly evaluate workstations to reduce strain through adjustments in the chair and bench heights and implement task rotation to reduce repetitive movements and distribute physical demands among staff, in addition to that, adjust work schedules to include intermittent breaks. Tailored ergonomic solutions and flexible arrangements should be provided for female professionals who are at a higher risk for work-related musculoskeletal disorders. Furthermore, conducting routine health screenings to detect early signs of musculoskeletal disorders for timely intervention, as well as enhancing awareness among Medical Laboratory Professionals, are essential measures to mitigate ergonomic risk practice.

Work-Related Musculoskeletal Disorders in Endoscopic Sinus and Skull Base Surgery: A Systematic Review With Meta-analysis

OBJECTIVE

Endoscopic sinus and skull base surgery has led to significant improvements in patient outcomes, yet may have come at a cost to surgeons' musculoskeletal (MSK) health. We aimed to determine the prevalence and characteristics of work-related MSK disorders (WRMDs) in endoscopic sinus and skull base surgeons; to investigate contributing factors for WRMD in this population; and to evaluate the effectiveness of ergonomic interventions on the severity or prevalence of WRMD in this population.

DATA SOURCES

Medline, Embase, CINAHL, Web of Science, and Scopus from inception to April 2, 2024. A bibliographic examination was performed for further papers.

REVIEW METHODS

Inclusion criteria included original peer-reviewed papers with work-related MSK outcomes (prevalence, contributing factors, and interventions) relating to endoscopic sinus and/or skull base surgeons in any language.

RESULTS

Of 25,772 unique citations, 37 studies met the inclusion criteria. The pooled lifetime, point, and 12-month prevalences of WRMD were 75.9% (95% confidence interval; I2, 67.2%-83.6%, I2 95.6%), 80.8% (77.0%-84.3%, I2 98.0%), and 82.0% (71.8%-90.3%, I2 60.96%) respectively. The neck, lumbar spine, and thoracic spine were the most commonly involved areas. One of 9 studies on contributing factors investigated discomfort as an outcome. The remainder focussed on surrogate outcomes (eg, posture, hand dysfunction). Two of the 13 intervention studies investigated pain or fatigue as an outcome. The remainder targeted posture, muscle activity, or workload.

CONCLUSION

WRMDs are highly prevalent in endoscopic sinus and skull base surgeons. Further studies focusing on the direct outcomes of WRMD such as pain are needed.

Musculoskeletal disorders among bank workers: a systematic review and meta-analysis

PURPOSE

Bank employees are among the workers who are at a high risk of suffering from musculoskeletal disorders (MSDs) due to inactivity and prolonged sitting as well as static and poor postures. This study was conducted with the aim of systematic review and meta-analysis of the prevalence of MSDs among bank employees.

MATERIALS AND METHODS

This review followed the PRISMA guidelines and its protocol is registered in PROSPERO with the code CRD42024509728. Using several databases including PubMed, Scopus, Web of Science, Science Direct, SID, ISC, and Google Scholar, related studies were extracted without time limit until February 7th 2024. Simple random effects model and I2 index were used respectively for performing meta-analysis and determining heterogeneity between studies. Finally, data analysis was done using the software STATA version 14.

RESULTS

After conducting the initial search, 1837 studies were identified in the information sources. After careful consideration, 28 studies were included in meta-analysis. The meta-analysis results revealed that 67.84% (95% CI: 61.21-74.47, I2 = 97.4%, P < 0.001) of bank employees suffer from MSDs. These disorders affect various areas of the body with the following prevalence rates in the low back (49.19%), neck (46.11%), upper back (42.08%), shoulder (34.88%), hand (25.40%), hip/thigh (19.29%), knee (17.86%), ankle/foot (16.37%), and elbow (12.53%).

CONCLUSIONS

The high prevalence of MSDs among bank employees is a concern, especially due to their sedentary behavior. It is important to increase awareness among bank employees about the risk factors of MSDs and design interventions to reduce their sitting time. Additionally, adjusting workstations according to ergonomic recommendations can help prevent MSDs in this occupational group.

Effect of exoskeleton devices on work-related musculoskeletal disorders (WMSDs) among healthcare workers: a scoping review

Work-related musculoskeletal disorders (WMSDs) have been a concern among healthcare workers, impacting their well-being and patient safety. Exoskeleton technologies have gained a growing interest as an ergonomic intervention for WMSDs. This scoping review explores exoskeleton effects on WMSDs among healthcare workers. A comprehensive search identified 9 eligible studies published in English between 2013 and 2023. Exoskeletons showed promising effects on objective measures, selectively reducing muscle activation in a task-dependent manner. They also improved force exertion and body posture parameters in specific scenarios. Subjectively, exoskeletons reduced discomfort, pain, fatigue, and received positive perceptions with acceptable usability. However, the impact on perceived exertion varied with tasks. While exoskeletons have shown potential in enhancing healthcare workers' well-being and performance, more work is required to refine their effectiveness and maximise benefits in different healthcare settings. The study revealed the need for standardised methodologies, consideration of participant characteristics, and optimisation of exoskeleton design.

A Study on the Job Characteristics of Police Officers and the Status of Musculoskeletal Disorders

Musculoskeletal disorders occur frequently in industrial settings, and police officers in particular are at high risk of developing musculoskeletal disorders due to the nature of their work, but research on this is lacking. Therefore, the purpose of this study was to examine the prevalence and risk factors of musculoskeletal disorders according to the job functions of police officers. A survey was conducted, targeting active-duty police officers, and data were collected from 4268 respondents who answered all items on the questionnaire. As a control group, we used the general population dataset from the 2020 National Health and Nutrition Examination Survey conducted in Korea. The survey included general information such as gender, age, working hours, and type of work. It also investigated medical utilization, including the frequency of medical visits and hospitalizations. The assessment of musculoskeletal disorders was analyzed using pain NRS, VAS, SPADI, and ODI. The working characteristics of police officers were found to be more irregular in terms of working hours and involved a higher intensity of work activities compared with the general population. However, there was a lack of precise diagnoses and continuous treatment for these disorders. These results imply that police officers' occupational characteristics are related to musculoskeletal disorders. Considering the direct relationship between police officers' health and public safety, systematic evaluation and management of their musculoskeletal disorders are needed.

Recovering Work Productivity in a Population With Chronic Musculoskeletal Pain: Unveiling the Value and Cost-Savings of a Digital Care Program

OBJECTIVE

To investigate potential savings obtained from restoring productivity in employees with chronic MSK pain through a digital care program (DCP).

METHODS

Secondary analysis of a prospective longitudinal study assessing cumulative savings overall or across several industry sectors by analyzing changes in Work Productivity and Activities Impairment (WPAI questionnaire).

RESULTS

Employees from 50 U.S. states started the program ( n = 5032). Significant improvements in productivity impairment were observed across all industries, yielding median cumulative savings from $151 (95% confidence interval [CI], 128-174) to $294 (95% CI, 286-303) per participant at treatment end. Twelve-month projections estimated median savings of $2916 (95% CI, 2861-2972). Additionally, significant improvements in non-work-related daily activities were observed.

CONCLUSIONS

This study underlines the burden of MSK-related productivity loss on employers' financial balance, illustrating the importance of a DCP to assist patients to recover quality of life and succeed professionally.

Musculoskeletal Disorders in the Clinical Practice of Dental Hygienists and Dentists, Prevention and Awareness among Italian Professionals: Focus on Enlarging Systems

(1) Background: Musculoskeletal disorders of the upper limbs are a common medical condition among dental hygienists and dentists, making them a common occupational risk for dental professionals. The purpose of the work was to collect information about the dental professions and their habits to highlight what can be good practices to be carried out to prevent any musculoskeletal disorders. (2) Methods: To identify habits and problems inherent in the professional activity of dental hygienists and dentists, a questionnaire was formulated on the use of enlarging systems. (3) Results: The questionnaire was completed by 241 dental professionals. As for the use of magnifiers, 72.6% of participants use them: among dental hygienists, 67.8% use magnifiers, among dentists, 80.9% use magnifiers; there is a statistically significant difference. There is no statistically significant difference between professions regarding muscle disorders. (4) Conclusions: For a clearer assessment, it would be appropriate to submit the questionnaire to a wider sample of professionals, to define better the correlation between musculoskeletal disorders, work activity and the type of enlarging systems used.

Ergonomic Considerations for Practicing Massage Therapists

The physical demands and repetitive movements performed by massage therapists during a treatment increase the risk for work-related musculoskeletal disorders. While massage therapy meets the level of heavy physical demand, the ergonomic risk of performing a massage was previously unknown. The Massage Therapy Foundation undertook a job task analysis to be used by educators, employers, and clinicians to create an optimal work environment. Data collected via survey were used to create the protocol for an onsite data collection where massage therapists were evaluated on the ergonomic risk factors by trained ergonomists. The results of the job task analysis found the highest variability in movement when the massage therapist was treating the neck prone, neck supine, and leg prone. When the massage therapists did not change positions during a stroke, there was increased forward flexion of the trunk which increased postural stress on the extensors of the back and neck. Strokes such as effleurage which can span the entire length of the body part had the highest cumulative load, requiring postures that put mild biomechanical stress on the shoulders (90% of the time), neck (70% of the time), and trunk (60% of the time). The forward-bending posture of the massage therapist increases the eccentric demands of the therapist's neck and back musculature, thereby increasing fatigue and leading to an increase in the chance of overuse injury. The job task analysis recommends the massage therapist monitor the duration of application in an unsupported position, take more time between sessions, work in an optimum environment, including correct table height, and have a healthy, active lifestyle to maintain career longevity.

Work-Related Musculoskeletal Disorders: A Systematic Review and Meta-Analysis

Background: Musculoskeletal disorders (MSDs) involve muscles, nerves, tendons, joints, cartilage, and spinal discs. These conditions can be triggered by both the work environment and the type of work performed, factors that, in some cases, can also exacerbate pre-existing conditions. This systematic review aims to provide an overview of the impact that different work-related activities have on the musculoskeletal system. Methods: A global search of publications was conducted using the following international bibliographic web databases: PubMed and Web of Science. The search strategies combined terms for musculoskeletal disorders and workers. In addition, a meta-analysis was conducted to estimate the prevalence of MSDs within the healthcare sector. Results: A total of 10,805 non-duplicated articles were identified, and finally, 32 studies were reviewed in this article. Once the literature search was completed, occupational figures were categorized into healthcare, farming, industrial, and computer sectors. In the healthcare sector, the prevalence estimate for degenerative diseases of the lumbar spine was 21% (497 out of 2547 physicians and dentists) (95% CI, 17-26%), while for osteoarthritis of the hand, it was 37% (382 out of 1013 dentists) (95% CI, 23-51%). Conclusions: Musculoskeletal disorders significantly impair workers' quality of life, especially in healthcare sector. These conditions are also associated with high costs for employers, such as absenteeism, lost productivity, and increased costs for healthcare, disability, and workers' compensation.

Work-related musculoskeletal disorders in oral health professionals: an umbrella review protocol

OBJECTIVE

The objective of this review is to synthesize the evidence on the prevalence, incidence, risk factors, and preventive and management interventions for work-related musculoskeletal disorders (MSD) in oral health professionals.

INTRODUCTION

Oral health professionals face a considerable risk of developing work-related MSD due to the nature of their work. These disorders can lead to loss of employment, reduced job quality, increased occupational injuries, and early retirement. They can also lead to significant financial burdens for employers and society.

INCLUSION CRITERIA

This umbrella review will include systematic reviews and meta-analyses that have oral health professionals as a population group and address at least one of the following topics: the prevalence or incidence, risk factors, and the efficiency or effectiveness of interventions for the prevention or management of work-related MSD.

METHODS

A systematic search will be conducted across CINAHL Complete (EBSCOhost), Dentistry and Oral Sciences Source (EBSCOhost), MEDLINE (EBSCOhost), Cochrane Library (Ovid), Scopus, PsycINFO (Ovid), AMED Allied and Complementary Medicine (Ovid), Epistemonikos, Ergonomics Abstracts Online (EBSCOhost), and Google Scholar (first 200 articles). The search will be limited to articles published in English, with no restrictions on geographical location. Two independent reviewers will screen the titles and abstracts against the inclusion criteria. The reviews will be assessed using the JBI critical appraisal instrument for systematic reviews and research syntheses, and data will be extracted from each review using a modified version of the JBI data extraction tool. A narrative summary and tables will be used to describe the review characteristics and findings. Results will be presented in a table using visual indicators (traffic light system) to represent beneficial, neutral, and negative effects with each risk factor and intervention. The GRADE approach will be used to rate the overall quality and strength of the evidence.

REVIEW REGISTRATION

PROSPERO CRD42023388779.

Barriers and facilitators to engaging with a digital self-management programme for painful distal upper limb musculoskeletal disorders: A qualitative exploratory study

INTRODUCTION

People living with a painful distal upper limb musculoskeletal disorder (DUL-MSD) often experience pain, difficulty in doing everyday tasks and a reduced quality of life. Currently, there are challenges in the treatment of DUL-MSDs, highlighting the need to develop innovative approaches to rehabilitation. A potential solution is to develop and implement a digital self-management rehabilitation programme focussing on optimising recovery, improving function and reducing pain. Before developing this programme, we aimed to identify the barriers and facilitators to using a digital health intervention (DHI) for self-management of DUL-MSDs.

OBJECTIVE

This study aimed to investigate the potential barriers and facilitators to using a DHI with people living with DUL-MSDs and healthcare professionals (HCPs).

METHODS

A qualitative exploratory study was carried out with purposely selected participants consisting of 15 participants with DUL-MSDs and 13 HCPs. Three focus groups (FGs) and four semistructured interviews with DUL-MSD participants and semistructured interviews with 13 HCPs were conducted. FGs and interviews were digitally recorded, transcribed and analysed using reflexive thematic analysis.

RESULTS

To address challenges in the care and management of DUL-MSDs, both HCPs and people living with a DUL-MSD welcomed the development of a DHI. This study identified several barriers and facilitators that would influence engagement with a digital intervention. Findings suggest that in developing a DHI, attention needs to be paid to digital design features, usability, tailoring, personalisation and consideration of how well usual care could be replicated digitally without direct HCP involvement.

CONCLUSION

The identified digital design features of importance to participants will inform the design of a digital self-management rehabilitation programme for people living with DUL-MSDs. Addressing the barriers and facilitators to engagement with a DHI is essential in ensuring its relevance and acceptability to those who will use it.

PATIENT OR PUBLIC CONTRIBUTION

Patient and Public Involvement and Engagement (PPIE) was integral throughout the study. PPIE members contributed to the development and planning of this study, checked and confirmed the relevance of the findings and are involved in the dissemination plans.

Risk assessment of healthcare workers' exposure to physical load in relation to patient handling and movement: a feasibility study of the instrument TilThermometer

BACKGROUND

Work-related musculoskeletal disorders are common among healthcare workers (HCWs) but might be prevented by risk assessment and further promotion of occupational safety and health. The aim of this study was to investigate if the risk assessment instrument TilThermometer can be used to identify risk profiles of physical exposure in HCWs working with patient handling and movement (PHM). Further aims were to describe HCWs' perceptions and experiences of using the TilThermometer.

METHODS

This feasibility study has a mixed design methodology. In total, 54 HCWs from 17 Swedish care units participated and performed risk assessments with the TilThermometer. Data collected from the risk assessments were used to identify risk profiles of physical exposure. HCWs' experiences of using the TilThermometer were collected from activity logs and analysed qualitatively. Three questionnaires were used to assess perceived acceptability, appropriateness, and feasibility of the risk assessment, and eight study specific questions were used for perceived usefulness.

RESULTS

The TilThermometer was used at the care units by assessing each care recipient, and when compiling the data at a group level, a summarized risk profile for the care unit could be provided. Risk for physical exposure was reported as high in two work tasks; no care unit used the high-low adjustable seat when showering care recipients sitting down, and 13% used the recommended assistive devices when putting compression stockings on. However, 99% used high-low adjustable assistive devices when caring and bathing care recipients lying down. TilThermometer was described as easy to use, enabling team reflections and providing an overview of the care units' recipients and workload, but difficulties in categorizing for mobility groups were also reported. The TilThermometer was, on a five-point scale, perceived as acceptable (mean 3.93), appropriate (mean 3.9), and feasible (mean 3.97). These scores are in line with questions evaluating usefulness.

CONCLUSION

The risk assessment provided risk profiles with potential to contribute to care units' development of a safe patient handling and movement practice. The findings suggest that the TilThermometer can be used to assess risks for physical exposure in relation to patient handling and movement in care units at hospital and nursing homes.

Prevalence and factors associated with lateral epicondylitis among hospital healthcare workers

Background

Hospital healthcare workers have been reported to have a high prevalence of musculoskeletal disorders, but their association with lateral epicondylitis (LE) is unknown. This study aimed to clarify the prevalence of LE and its associated factors among hospital healthcare workers.

Methods

The present study included all staff members of a secondary emergency hospital who provided their consent to participate. Participants with a history of elbow joint trauma were excluded from this study. The diagnostic criteria for definite LE were: (1) pain in the elbow joint within 2 weeks of the study; (2) pain in the lateral epicondyle region on resisted extension of the wrist with the elbow extended; and (3) tenderness in the lateral epicondyle. The diagnosis of LE was defined by meeting all criteria. Age, height, weight, sex, dominant hand, occupation, years of employment, smoking history, drinking history, personal computer usage history, and smartphone usage history were investigated using a questionnaire. A physical examination, in addition to evaluation of pain in the lateral epicondyle, grip strength and wrist extension strength were measured. A statistical analysis was used to assess the prevalence of LE and its associated factors. All investigations, including the diagnosis of LE, were performed by a single orthopedic specialist.

Results

We evaluated 544 individuals, corresponding to approximately 80% of all staff members. The median age was 39 years (interquartile range, 30-48). The study population included 154 males and 390 females. The occupations of the participants were as follows: nurses (n = 265), doctors (n = 47), clerks (n = 93), therapists (n = 27), certified care workers (n = 23), medical technologists (n = 22), pharmacists (n = 19), and others (n = 48). LE was diagnosed in 30 limbs/30 individuals with a prevalence of approximately 5.5%. There was no difference in the prevalence of LE among occupations (P = .85). A logistic regression analysis revealed that age (odds ratio, 1.05; 95% confidence interval 1.01-1.1; P = .01) and smoking history (odds ratio, 2.94; 95% confidence interval 1.01-8.56; P = .04) were independently associated with LE.

Conclusion

This study was conducted to evaluate the prevalence of LE among hospital healthcare workers. The prevalence of LE was 5.5%, and LE was independently associated with age and smoking history.

Occurrence of musculoskeletal disorders, burnout, and psychological suffering in Brazilian nursing workers: A cross-sectional study

Background

Musculoskeletal disorders (MSDs) pose a pervasive concern among nursing professionals due to the high physical workload. Simultaneously, the complex relationship between MSDs and mental health outcomes in this population remains an area of significant interest and importance.

Objective

This study aimed to investigate the occurrence of MSDs and their relationships with burnout and psychological suffering within the nursing workforce.

Methods

A cross-sectional study was conducted in 2020 involving 291 nursing professionals in Brazil. Standardized questionnaires were employed to gather information on MSDs, mental health outcomes, and pertinent work-related factors. Robust statistical analyses were conducted to ascertain the prevalence of MSDs, establish associations between MSDs and mental health outcomes, and delineate the influence of work-related factors on these associations. Statistical analysis was performed using the R software.

Results

The study revealed a significant prevalence of musculoskeletal injuries (MSIs) among nursing workers, focusing on regions that include the lower back, upper back, neck, and shoulders. Individuals with MSIs in the lower back showed a marked increase in emotional exhaustion (p = 0.02), as did those with MSIs in the upper back (p <0.01) and depersonalization (p = 0.07). On the other hand, nursing professionals who reported MSIs in the neck and shoulders had considerably higher scores in emotional exhaustion (p <0.01 and p = 0.01, respectively) and depersonalization (p = 0.05 and p = 0.05, respectively). However, no significant correlations emerged between MSIs and depression or work-related factors.

Conclusions

This study highlights the urgency of implementing proactive measures to prevent and manage MSDs within the nursing profession. Moreover, it emphasizes the critical need to enhance working conditions and provide robust support mechanisms to safeguard the mental health of nursing professionals.Open AccessOpen Access.

Ergonomic Analysis of Dental Work in Different Oral Quadrants: A Motion Capture Preliminary Study among Endodontists

BACKGROUND

Dentists, including endodontists, frequently experience musculoskeletal disorders due to unfavourable working postures. Several measures are known to reduce the ergonomic risk; however, there are still gaps in the research, particularly in relation to dental work in the different oral regions (Quadrants 1-4).

METHODS

In this study (of a pilot character), a total of 15 dentists (8 male and 7 female) specialising in endodontics were measured while performing root canal treatments on a phantom head. These measurements took place in a laboratory setting using an inertial motion capture system. A slightly modified Rapid Upper Limb Assessment (RULA) coding system was employed for the analysis of kinematic data. The significance level was set at p = 0.05.

RESULTS

The ergonomic risk for the entire body was higher in the fourth quadrant than in the first quadrant for 80% of the endodontists and higher than in the second quadrant for 87%. For 87% of the endodontists, the ergonomic risk for the right side of the body was significantly higher in the fourth quadrant compared to the first and second quadrant. The right arm was stressed more in the lower jaw than in the upper jaw, and the neck also showed a greater ergonomic risk in the fourth quadrant compared to the first quadrant.

CONCLUSION

In summary, both the total RULA score and scores for the right- and lefthand sides of the body ranged between 5 and 6 out of a possible 7 points. Considering this considerable burden, heightened attention, especially to the fourth quadrant with a significantly higher ergonomic risk compared to Quadrants 1 and 2, may be warranted.

World Trends in Dental Ergonomics Research: A Bibliometric Analysis

Dental ergonomics provides an overview of dentists' work efficiency. The objective of this study was to obtain quantitative information and produce a visualization of the network of scientific publications on the topic of ergonomics and dentistry using bibliometric analysis. Data mining was conducted using the Scopus database and Boolean expressions (ergonom* AND dentist*) on 14 April 2023. Data extraction and analysis were performed using Open Refine version 3.5.2., VOSviewer version 1.6.17., VOSviewer thesaurus, Microsoft Excel, and Tableau Professional version 2020.1.2. A total of 682 documents were identified, with the United States having the largest number of documents and citations (89 documents, 1321 citations). Work, Dentistry Today, and the International Journal of Environmental Research and Public Health were the top three sources. Ergonomics and musculoskeletal disorders (MSDs) are two of the very prominent keywords, with research topics covering prevalence, causes, factors related to causes, prevention, assessment, rehabilitation, evaluation, and intervention. There was no research on ergonomic interventions that collaborated with human factors and ergonomics (HFE). We conclude that the trending topic of dental ergonomics research topics around the world is centered on MSDs. The future research challenge is to apply HFE science to improve the health, safety, efficiency, and quality of dentists' work.

CLINICIANS' PERCEPTIONS OF MANUAL HANDLING POLICIES IN STROKE REHABILITATION: A QUALITATIVE FOCUS GROUP STUDY

Objectives

The professional literature guides manual handling in numerous health care settings. The effects of these guidelines on stroke rehabilitation and the clinical communication of health care professionals are unknown. This paper aims to investigate the perspectives of nurses and physiotherapists on handling guidelines in their professions to identify conflicts in opinions to provide optimum care to people with stroke.

Design

A qualitative focus group study.

Methods

Three focus groups were conducted. The participants were physiotherapists or nurses with 1 year of stroke care experience. The data were thematically analysed.

Results

Nineteen participants (12 physiotherapists and 7 nurses) were interviewed. The data analysis revealed 3 themes. First, "The application of handling in stroke rehabilitation" includes clinical reasoning and real-world handling practices. The second theme, "Physical Effects on Therapists," examines the long-term effects of manual handling on therapists, including work-related musculoskeletal disorders. The final theme, "Conflicts among health care professionals," investigates stroke rehabilitation equipment conflicts between nurses and physiotherapists.

Conclusion

The study concludes that stroke transfer guidelines in the specialised literature may impact health care professionals' perspectives. Conflicts among health care professionals can impair teamwork. Thus, health care professionals should work together as stroke rehabilitation teams to develop unified transfer guidelines that aid rehabilitation and avoid work-related musculoskeletal disorders.

A systematic review of work related musculoskeletal disorders among physical therapists and physiotherapists

Physical therapists and physiotherapists (PPTs) perform and repeat physical tasks that can lead to work-related musculoskeletal disorders (WMSD). The aim was to study the main research concerning this problem, i.e. the risk factors, activities that exacerbate WMSD symptoms, alterations in work habits and the proposed responses, and to estimate mean value (±standard deviation, STD) for the most studied parameters. This review was conducted according to the PRISMA guideline. Five databases (Pubmed, ScienceDirect, Google Scholar, Medeley and Science.gov) were scanned to identify works investigating the different aspects of WMSD among PPTs. Two reviewers independently selected relevant studies using inclusion/exclusion criteria, critically appraised, and extracted data. To homogenize the data, prevalence were reported to the total sample studied when necessary. Among the 9846 articles identified, 19 articles were included. The WMSD prevalence was over 50 %. The areas most affected were the lower back, neck and thumb. An exhaustive list of parameters were constructed for job risk factors (n = 19), activities that exacerbating symptoms (n = 13), altered work habits (n = 15), responses and treatments (n = 26). The mean prevalence (±STD) was calculated for the major parameters. Nine main job risk factors were extracted with an average prevalence of about 30 % and a relatively high variability. Seven activities exacerbating WMSD symptoms and five altered work habits were identified with a homogeneous rate (5-20 %). Three main responses and treatments were found with heterogeneous prevalence. This review provides useful results for the development of future protocols to prevent the occurrence of WMSD among PPTs and meta-analyses.

Investigating the Risk of Patient Manual Handling Using the Movement and Assistance of Hospital Patients Method among Hospital Nurses in Botswana

BACKGROUND

Evidence on the prevalence of lower back pain (LBP) among nurses is widespread in the literature, with several risk factors being reported. These include manual handling of patients, repetitive bending and twisting movements, and long working hours. It is reported that LBP has negative health outcomes and causes poor work performance among healthcare workers (HCWs). The magnitude of ergonomic risks associated with these healthcare activities has not been adequately investigated in Botswana. Thus, this study aimed to investigate the ergonomic risk levels associated with the manual handling of patients and its association with the prevalence of LBP among nurses in Botswana.

METHODS

This was an observational cross-sectional hospital-based study conducted in a Botswana public tertiary hospital from March to April 2023. The Movement and Assistance of Hospital Patients (MAPO) tool was used to collect data on ergonomic risk levels. Data on the demographic characteristics of participants were collected using a tool adapted from the Nordic Musculoskeletal Questionnaire (NMQ). Odds ratios and 95% confidence intervals were estimated to determine the association between ergonomic risk levels and the prevalence of LBP.

RESULTS

A total of 256 nurses participated and completed the study. The self-reported prevalence of LBP in this study was 76.6%. The risk of acquiring LBP was high (90.5%) based on the MAPO index. Although the frequencies of self-reported LBP were high among nurses, these did not show any significant association with the MAPO index data. This could be partly due to the small sample size.

CONCLUSIONS

There was a high prevalence of LBP in this study, which was corroborated by the MAPO index data. This has demonstrated the value of the MAPO index in forecasting the risk of patient manual handling. The findings might help Botswana formulate policies intended to address ergonomic preventive measures, directed towards reducing the MAPO index score by addressing the single risk determinants.

Don't Just Stand There. Rethinking the Ideal Body Posture for Otorhinolaryngologists

Surgeons have a high rate of work-related musculoskeletal injuries; an area that has received little attention. These injuries result in surgeons performing less efficiently, needing to take time off work, suffering higher rates of burnout, and may ultimately lead surgeons to retire earlier than planned. Otorhinolaryngologists are at particular risk for work-related musculoskeletal injuries. Beyond the clinician, sustaining such injuries can negatively impact patient safety. Ergonomic interventions have been used effectively to reduce work-related musculoskeletal injuries in other professions, yet not in surgery. With traditional teachings of ideal body postures to avoid injury and manual handling training being re-evaluated, it is important to explore evidence based interventions for reducing work-related musculoskeletal injuries in otorhinolaryngologists. New research encourages us to shift the focus away from the traditional one-size-fits-all approach to ergonomics and toward postural recommendations and education that promote a dynamic, individualized approach to avoiding sustained, static and awkward postures.

Wearables for Monitoring and Postural Feedback in the Work Context: A Scoping Review

Wearables offer a promising solution for simultaneous posture monitoring and/or corrective feedback. The main objective was to identify, synthesise, and characterise the wearables used in the workplace to monitor and postural feedback to workers. The PRISMA-ScR guidelines were followed. Studies were included between 1 January 2000 and 22 March 2023 in Spanish, French, English, and Portuguese without geographical restriction. The databases selected for the research were PubMed®, Web of Science®, Scopus®, and Google Scholar®. Qualitative studies, theses, reviews, and meta-analyses were excluded. Twelve studies were included, involving a total of 304 workers, mostly health professionals (n = 8). The remaining studies covered workers in the industry (n = 2), in the construction (n = 1), and welders (n = 1). For assessment purposes, most studies used one (n = 5) or two sensors (n = 5) characterised as accelerometers (n = 7), sixaxial (n = 2) or nonaxialinertial measurement units (n = 3). The most common source of feedback was the sensor itself (n = 6) or smartphones (n = 4). Haptic feedback was the most prevalent (n = 6), followed by auditory (n = 5) and visual (n = 3). Most studies employed prototype wearables emphasising kinematic variables of human movement. Healthcare professionals were the primary focus of the study along with haptic feedback that proved to be the most common and effective method for correcting posture during work activities.

Do Sex and Age Influence Scapular and Thoracohumeral Kinematics During a Functional Task Protocol?

There is mixed evidence on the role that biological sex plays in shoulder biomechanics despite known differences in musculoskeletal disorder prevalence between males and females. Additionally, advancing age may contribute to shoulder kinematic changes. The purpose of this study was to determine if sex and age influenced scapular and thoracohumeral kinematics during a range of functional tasks. Sixty healthy participants aged 19-63 years (30 males; 30 females) completed a functional task protocol while their upper limb motion was recorded. Scapular and humeral angles were calculated and compared with multiple linear regressions to assess the interaction effects of sex and age. Shoulder kinematics were not different between sex and age groups for many of the functional tasks. However, females had lower humeral external rotation in the overhead lift task (15°, P < .001), and less scapular anterior tilt angles in the forward transfer task (6°, P < .001) than males. Age was positively associated with humeral elevation (R2 = .330, P < .001) and scapular rotation (R2 = .299, P < .001) in the Wash Axilla task. There exist some kinematic differences between sex and with advancing age for select functional tasks, which should be considered for musculoskeletal disorder development.

Compensation Method for Missing and Misidentified Skeletons in Nursing Care Action Assessment by Improving Spatial Temporal Graph Convolutional Networks

With the increasing aging population, nursing care providers have been facing a substantial risk of work-related musculoskeletal disorders (WMSDs). Visual-based pose estimation methods, like OpenPose, are commonly used for ergonomic posture risk assessment. However, these methods face difficulty when identifying overlapping and interactive nursing tasks, resulting in missing and misidentified skeletons. To address this, we propose a skeleton compensation method using improved spatial temporal graph convolutional networks (ST-GCN), which integrates kinematic chain and action features to assess skeleton integrity and compensate for it. The results verified the effectiveness of our approach in optimizing skeletal loss and misidentification in nursing care tasks, leading to improved accuracy in calculating both skeleton joint angles and REBA scores. Moreover, comparative analysis against other skeleton compensation methods demonstrated the superior performance of our approach, achieving an 87.34% REBA accuracy score. Collectively, our method might hold promising potential for optimizing the skeleton loss and misidentification in nursing care tasks.

Translation, cultural adaptation and assessment of psychometrics properties of the Extended Version of the Nordic Musculoskeletal Questionnaire (NMQ-E) in Persian language speaking people

BACKGROUND

To translate and cross-culturally adapt the Extended Version of the Nordic Musculoskeletal Questionnaire (NMQ-E) into Persian (NMQ-E-P) and evaluate the psychometric properties in a general population with different occupational tasks across nine body regions.

METHODS

This cross-sectional study was designed according to the standard guidelines and the COSMIN checklist. The NMQ-E-P was achieved through forward and backward translation methods and consensus to produce the final draft. A Persian-speaking population (n = 571, age 38.24 ± 7.65 years, female = 46.2%) was recruited from industries and office workers with three occupational task inclusion criteria: assembly, office, and lifting. Psychometric properties included validity for face (from confirmed clarity, simplicity, and readability), content (via the content validity index); and construct (through known group validity); additionally, the properties of internal consistency (Cronbach's α); and test-retest reliability (Kappa coefficient of agreement) were considered.

RESULTS

No significant issues during the translation process were found. The NMQ-E-P showed adequate internal consistency for all regions (α ≥ 0.87). The test-retest reliability was examined with Kappa agreement correlation coefficient and all items, except ankle regions, showed very good agreements (Kappa coefficient = 0.87-1.0). Excellent ICC values were obtained for quantitative variables (ICC > 0.88) and good construct validity was revealed (p < 0.001).

CONCLUSION

The Persian version of the NMQ-E has very good validity and reliability and can be used by researchers and professionals to evaluate the prevalence of MSDs in nine body regions simultaneously.

Identification of prevalence of musculoskeletal disorders and various risk factors in dentists

Purpose

The awkward and repetitive movements lead to tissue straining, potentially leading to painful musculoskeletal disorders (MSDs). MSDs in dentists result in work inefficiency and a reduction in work hours. A survey was conducted to assess the prevalence of MSDs amongst the dental population of interest.

Methods

Customized individual detail questionnaires, Standard Nordic Musculoskeletal questionnaires, and Level of Pain estimation using the Likert Scale were used to deduce the various responsible risk factors for the occurrence of MSDs in dentists. Inferential statistical analysis was done to identify the prevalence and severity of the MSDs. The Chi-Square test (95 % confidence interval) was used to identify and compare the association of risk factors involved in MSDs with the occurrence of the Effect of MSDs, the presence of MSDs, and the severity of the MSDs.

Results

The results of the study deduced that the dentists followed the sedentary work practices. The dentists experienced maximum discomfort in the neck region, which was accompanied by the discomfort experienced in the lower back, hands and wrists, making the upper extremity being more susceptible to the MSDs. Gender risk factors the, the prevalence of MSDs in the dentist's upper back, and the severity of pain in the upper back region showed a significant association level.

Conclusion

The wrist posture, the prevalence of MSDs and the severity of pain in the dentists' neck, shoulder and upper back showed a significant association level.

Musculoskeletal disorders among dental assistants: a cross-sectional study

BACKGROUND

This study aims to investigate the prevalence of musculoskeletal disorders (MSDs) and associated sociodemographic and work-related factors among dental assistants (DAs) in the hail province, Saudi Arabia.

METHODS

Participants were 119 DAs with an average age of 28.9 years (SD ± 4.8 years), of whom 86.6% were females. A self-administered questionnaire which included Nordic Musculoskeletal questionnaire and questions on socio-demographic and work-related factors was used. Descriptive statistics were used to calculate the prevalence of MSDs during the past 12 months and 7 days. Multivariate binary logistic regression statistical tests were used to calculate the association between MSDs and socio-demographic and work-related factors.

RESULTS

The overall prevalence of MSDs among DAs was significantly high, with 85.7% reporting symptoms during the past 12 months and 47.9% during the past 7 days. The shoulders, followed by the lower back, were the most common complaints among participants in the past 12 months and 7 days, followed by the upper back and neck. Multivariate binary logistic regression analysis results show significant associations between MSDs and age, Body-Mass-Index (BMI), physical demands during working hours, work environment and posture awareness, and years of experience.

CONCLUSIONS

The prevalence of MSDs among DAs is high, and sociodemographic and work-related factors play an important role in exacerbation of MSDs in DAs.

Physical, functional and personal variables affecting shoulder complaints in healthcare workers

BACKGROUND

Work-related shoulder disorders adversely affect the quality of life and lead to increased costs related to decreased productivity and injury treatment. Therefore, understanding the relationship between strength, upper extremity function and work ability contributes to the development of interventions aimed to improve the well-being of healthcare workers.

OBJECTIVE

Correlate shoulder abduction and handgrip strength with upper extremity function and work ability in healthcare workers with shoulder complaints.

METHODS

67 workers with shoulder pain in the last year were assessed by Disability of Arm, Shoulder and Hand (QuickDASH), Work Ability Index (WAI), isokinetic shoulder strength and isometric handgrip strength dynamometers. Data were analysed with Spearman's Correlation Coefficient (ρ= 0.05), SPSS 20.0®.

RESULTS

52% males, mean age 48.4 years, 42% physically active, most administrative and general services workers. Low correlation between handgrip strength and QuickDASH (r=-0.359; p = 0.004); low correlation between handgrip strength and WAI (r = 0.359; p = 0.003) and between shoulder abduction strength and the QuickDASH (r = -0.267; p = 0.049); no significant correlation between shoulder abduction strength and WAI (r = 0.001; p = 0.997).

CONCLUSIONS

Handgrip and shoulder abduction strength were inversely associated with upper extremity dysfunction. Shoulder abduction strength was associated with work ability. The inclusion of strength assessment in workers is important to guide strategies to prevent musculoskeletal disorders.

Musculoskeletal disorders and diseases in healthcare workers. A scoping review

BACKGROUND

The impact of work-related tasks with potential biomechanical overload on the musculoskeletal system represents an essential socio-economical challenge.

OBJECTIVE

This scoping review aimed to map the current literature to identify musculoskeletal disorders and diseases among healthcare professionals and define the approaches used to assess these problems.

METHODS

The analysis was developed according to the JBI methodologies for scoping reviews and reported following the PRISMA-ScR framework.

RESULTS

We conducted specific searches on online databases; of the 357 articles initially identified, only 118 met the inclusion criteria.

CONCLUSIONS

Despite some discrepancies in their unambiguous identification, the presence of work-related musculoskeletal disorders in healthcare professionals is unequivocal. On the other hand, using technology as a supporting evaluation tool still needs to be explored. Furthermore, several improvements are required to enhance the quality of work and simplify the analysis across studies.

Validation of a modified visual analogue scale to measure user-perceived comfort of a lower-limb exoskeleton

User perceived exoskeleton comfort is likely important for device acceptance, but there is currently no validated instrument to measure it. The Visual Analogue Scale (VAS) is an existing tool to measure subjective human feedback by asking the user to mark a point on a line with each end of the line representing an opposing anchor statement. It can be modified to show the previous response, allowing the subject to directly indicate if the current condition is better or worse than the previous one. The goal of this study was to determine how well the modified VAS could measure user-perceived comfort as the exoskeleton control parameters were varied. To validate the survey, 14 healthy subjects walked in a pair of ankle exoskeletons with approximately ten distinct sets of control parameters tested in a prescribed order. Each set of control parameters was tested twice. After each trial, user-perceived comfort was measured using a two-question VAS survey. The repeatability coefficient was approximately 40 mm, similar to the total range of responses. The results were also inconsistent, with relative rankings between consecutive pairs of conditions matching for approximately 50% of comparisons. Thus, as tested, the VAS was not repeatable or consistent. It is possible that subject adaptation within the trial and over the course of the experiment may have impacted the results. Additional work is needed to develop a repeatable method to measure comfort and to determine how perceived comfort varies as subjects' gain exoskeleton experience.

Prevalence, Patterns, and Associated Factors for Musculoskeletal Disorders Among the Healthcare Workers of Northern Saudi Arabia: A Multicenter Cross-Sectional Study

Background

Musculoskeletal disorders (MSDs) have emerged as a pressing concern among healthcare workers (HCWs), gaining significant attention, particularly in the aftermath of the COVID-19 pandemic. This study evaluated the prevalence, pattern, and associated factors for MSDs among HCWs in northern Saudi Arabia.

Participants and Methods

Employing a cross-sectional study design, the standardized Nordic Musculoskeletal Questionnaire (NMQ) was used to collect data from participants. Systematic sampling method was employed to select 384 HCWs from diverse healthcare settings. Multivariate logistic regression analysis was conducted to identify factors associated with MSDs.

Results

Among the participants, 72.4% reported one or more NMQ-listed MSDs. The most commonly affected body regions were the neck, shoulder, and lower back. MSDs showed significant associations with physical activity (adjusted odds ratio [AOR]= 0.72, 95% confidence interval [CI] = 0.53-0.93, p = 0.024), obesity status (AOR = 3.08, 95% CI = 1.56-4.71, p = 0.003), and ergonomic training (AOR = 0.38, 95% CI = 0.23-0.55, p < 0.001).

Conclusion

Implementing preplacement and periodic ergonomic training for HCWs is recommended. This proactive measure holds the potential to alleviate MSD-related discomfort, reduce sickness absenteeism, and enhance overall productivity. Future longitudinal studies across different regions of Saudi Arabia are essential to establish causal links between risk factors and MSDs.

Assessment of dental ergonomics among dental students: A retrospective study

INTRODUCTION

Musculoskeletal (MSK) disorders account for 11%-98% of occupational health issues for dental professionals, with an onset as early as in dental school. Dental ergonomics is among the risk factors; thus, a prompt assessment is crucial in preventing future MSK pain. The aim of this study was to retrospectively assess dental ergonomics of second-year dental students after dedicated lectures were introduced in the predoctoral curriculum.

METHODS

Three cohorts of second-year dental students were evaluated during preclinical activity in July 2019, January 2022, and December 2022 by an Occupational Therapy (OT) faculty and calibrated OT students. Dental ergonomics was assessed with the Rapid Upper Limb Assessment (RULA). Dental student cohorts were compared with one-way analysis of variance (ANOVA).

RESULTS

The average RULA final score of 409 participants was 5.1 ± 0.9, with no difference between the three cohorts (p = 0.676). The January 2022 cohort scored significantly lower in wrist-arm score than that of 2019 (p = 0.001) and December 2022 (p = 0.046). Neck and lower limb posture were significantly higher in January 2022 cohort than in 2019 (p = 0.001 and 0.013) and December 2022 (p = 0.001 and 0.005) cohorts. The December 2022 cohort revealed a medium, high and extremely high risk of developing MSK of 40.2%, 37.1%, and 21.6%, respectively, with no difference between sexes.

CONCLUSION

The risk of developing MSK pain was medium-high in predoctoral dental students and was not related to sex. The overall dental ergonomics required attention and rapid change. Further implementation of varied forms of teaching and monitoring of dental ergonomics from the early years of education is recommended to prevent development of MSK pain at young age and foster better postural habits.

Effect of Assisted Surgery on Work-Related Musculoskeletal Disorder Prevalence by Body Area among Surgeons: Systematic Review and Meta-Analysis

Surgeons are highly exposed to work-related musculoskeletal disorders (WMSDs). The objective of this review was to summarize the WMSD prevalence by body area with and without assistive devices. The underlying question was whether there is an effect of assistive device use (robot, video, or other) during surgery on WMSD prevalence by body area among surgeons, regardless of their specialty. The systematic review was conducted according to the PRISMA guidelines. The Google Scholar, Pubmed/Medline, and ScienceDirect databases were scanned to identify relevant studies. The article selection, review, critical appraisal, and data extraction were performed by two authors independently. Among the 34,854 unique identified records, 77 studies were included. They were divided into two groups: 35 focused on robotic- and video-assisted surgery (RVAS) and 48 concerning surgery without video/robotic assistance (WAS) (6 studies evaluated the prevalence for both groups). WMSD prevalence was reported for 13 body areas: the neck, back, upper back, mid-back, lower back, shoulders, elbows, wrists, fingers, thumbs, hips, knees, and ankles. The results showed that WMSD prevalence was significantly higher (unpaired t-test, p < 0.05) for RVAS in the shoulders (WAS: 28.3% vs. RVAS: 41.9%), wrists (WAS: 20.9% vs. RVAS: 31.5%), and thumbs (WAS: 9.9% vs. RVAS: 21.8%). A meta-analysis was performed for 10 body areas (with 4 areas including more than 25 studies). No sufficient data were available for the mid-back, thumbs, or hips. A high heterogeneity (Cochran's Q test and I² statistic) was observed. A random-effects model revealed that the highest worldwide prevalence was in the neck (WAS: 41% and RVAS: 45.3%), back (WAS: 37.7% and RVAS: 49.9%), lower back (WAS: 40.0% and RVAS: 37.8%), and shoulders (WAS: 27.3% and RVAS: 41.4%). Future work could focus on work environment design, particularly the positioning and adjustment of equipment, and on postural analysis to reduce the appearance of WMSDs. Recommendations are proposed for future reviews and meta-analyses.

Global prevalence of musculoskeletal disorders among physiotherapists: a systematic review and meta-analysis

BACKGROUND

Musculoskeletal disorders (MSD) are one of the most important problems among physiotherapists worldwide. However, there is no meta-analysis of the MSD prevalence in all body areas among physiotherapists.

OBJECTIVES

The purpose was to investigate and estimate the worldwide prevalence of MSD among physiotherapists using a systematic review-, meta-analysis and meta-regression.

METHODS

The systematic review, meta-analysis and meta-regression were performed in 2022 using the PRISMA guidelines.

DATA SOURCES

The search was performed on PubMed/Medline, ScienceDirect, Google Scholar, Medeley and Science.gov databases.

STUDY APPRAISAL

The quality appraisal of the included articles was assessed using the critical appraisal tool for cross-sectional studies AXIS.

RESULTS

A total of 722 articles were found. After screening and comparison with the inclusion criteria, 26 studies were retained. Based on the random-effects model, the worldwide MSD prevalence in neck, upper back, mid back, lower back, shoulders, elbows, wrists/hands, thumb, hips/thighs, knees/legs, and ankles/feet was 26.4% (CI 95%: 21.0-31.9%), 17.7% (CI 95%: 13.2-22.2%), 14.9% (CI 95%: 7.7-22.1%), 40.1% (CI 95%: 32.2-48.0%), 20.8% (CI 95%: 16.5-25.1), 7.0% (CI 95%: 5.2-8.9), 18.1% (CI 95%: 14.7-21.5%), 35.4% (CI 95%: 23.0-47.8), 7.0% (CI 95%: 5.2-8.8), 13.0% (CI 95%: 10.3-15.8), and 5% (CI 95%: 4.0-6.9) respectively. The neck and shoulder prevalence of four continents were close to the world prevalence. No effect of continent was found on MSD prevalence. The heterogeneity of the results obtained in the meta-analysis and meta-regression was discussed.

CONCLUSIONS

Based on the random effects model, the results of the worldwide meta-analysis showed that lower back pain, thumb, neck and shoulder were the area most at risk for MSD and were therefore those to be monitored as a priority. Recommendations were proposed for future reviews and meta-analyses.

Construction of a Musculoskeletal Discomfort Scale for the Lower Limbs of Workers: An Analysis Using the Multigroup Item Response Theory

Musculoskeletal symptoms are a major occupational health problem in workers, and these can affect all professional occupations. Previous studies have proposed metrics capable of evaluating the musculoskeletal discomfort experienced by workers. However, no study has developed a metric that considers professional groups. Thus, this study aimed to develop a scale for musculoskeletal discomfort in the lower limbs to compare self-reported symptoms among education, health, and industry professionals. The sample included 159 teachers, 167 health professionals, and 401 industrial operators who relayed their symptoms using a diagram of the hips, thighs, knees, lower legs, and feet. Factor and multigroup item response theory analyses were used to construct a musculoskeletal discomfort scale consisting of seven levels and to assess and compare the identified symptoms. The results showed that the progressive evolution of discomfort differed for each profession, demonstrating that each context and work environment affects workers differently, which may explain the different patterns of symptom responses among professional groups.

Three-month work-related musculoskeletal disorders assessment during manual lymphatic drainage in physiotherapists using Generic Postures notion

OBJECTIVES

The aim of this work was to quantify the postures and to assess the musculoskeletal disorders (MSDs) risk in physiotherapists repeating a manual lymphatic drainage (MLD) over a three-month period. The underlying hypothesis was that there would be Generic Postures (GP) that would be repeated and could be used to more simply describe repetitive and long-duration complex activities.

METHODS

The posture of five physiotherapists performing five 20-min MLD at their workplace was captured by two cameras. From the recordings, the adopted postures were extracted every 5 s and quantified through 13 joint angles, that is, 6594 analyzed postures. Rapid Upper Limb (RULA) and Rapid Entire Body Assessment (REBA) were used to assess MSDs risks. A hierarchical analysis was used to define GP.

RESULTS

Seven GP were identified through mean values and standard deviation. GP ergonomic assessment showed a low to moderate MSD risk (RULA between 3 and 6 and REBA between 2 and 7). High neck (>20°) and trunk (>15°) flexion were observed for all GP. High shoulder abduction and flexion (>40°) were evidenced for GP3 to GP5. GP1 was the most used (34%) and presented the lowest ergonomic scores (RULA: 4.46 ± 0.84; REBA: 5.06 ± 1.75). GP3 to GP6 had frequency of between 10 and 20%. GP5, GP6, and GP7 obtained the highest ergonomic scores (RULA>5; REBA>7). All physiotherapists use different GP combinations to perform MLD.

CONCLUSION

MLD could be described as a combination of GP. Ergonomic analysis showed that MLD exposes physiotherapists to low at moderate MSD risks.