[Spinal manipulation is only a part of total care].
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Back Pain↗
Biomedical subjects
U Moritz
Publications and source records attributed to U Moritz.
Electromyographic fatigue in neck/shoulder muscles and endurance in women with repetitive work.
EMG was recorded with surface electrodes from the trapezius and deltoid muscles during a static endurance test at approximately 20% of maximal voluntary contraction. Objective parameters for localized muscular fatigue were derived from the time course of the root mean square (RMS) and mean power frequency (MPF) of the EMG recordings. Isotonic regression is introduced as a tool for assessment of such parameters. The most pronounced sign of fatigue for trapezius was an increase in the RMS values, while for deltoid it was a decrease in the MPF values. This could be explained by the different functions of the two muscles. The endurance time for a group of 11 women in industrial work with repetitive short-cycled work tasks who were diagnosed with neck/shoulder disorders (tension neck) was significantly shorter (p less than 0.05) than for a group with the same work, but without neck/shoulder disorders (n = 11), and shorter than for a control group (n = 11). Regarding the EMG fatigue measures, there were no significant differences between the three groups. We did not find any relationships between endurance time and the EMG parameters. The results indicate that neck/shoulder disorders were not associated with divergent mechanisms for developing fatigue in the muscles, as recorded with surface EMG.
Adult↗
Effects of lumbar belts on trunk muscle strength and endurance: a follow-up study of construction workers.
The effects on maximal isometric trunk muscle strength and endurance after wearing a soft heat-retaining lumbar belt or a weightlifter's belt were studied. The soft belt (SB) study group comprised 12 construction workers with healthy backs, and the weightlifter's belt (WB) group comprised 24 construction workers with current or previous low back pain. The strength and endurance measurements were performed before the start of belt use, and after 1 and 2 months. The SB group increased the trunk flexor strength by 13% (p less than or equal to 0.01) after 2 months. The WB group increased the trunk flexor strength and endurance by 12% and 29%, respectively (p less than or equal to 0.001). No significant decrease of trunk muscle strength and endurance was found at the end of the follow-up period.
Adult↗
Low back and neck/shoulder pain in construction workers: occupational workload and psychosocial risk factors. Part 1: Relationship to low back pain.
The prevalence rate of musculoskeletal problems, especially low back pain and severe low back pain in a randomly selected sample of 1,773 construction workers was studied. Its relationship to physical and psychosocial factors was analyzed. The workers answered a postal questionnaire. Workload was measured by means of eight manual materials handling indices and ten psychosocial indices, based on results from factor analyses. The 1-year prevalence rate of low back pain was 54% and of severe low back pain 7%. The relationship to heavy manual materials handling differed with age in such a manner that it could be interpreted as a healthy worker effect. Between severe low back pain and both stooping or kneeling a dose-response relationship was found. The most prominent of the psychosocial factors associated with low back pain and severe low back pain were the stress index and the psychosomatic and psychic indices. The age-standardized prevalence rate ratio of low back pain was 1.6 (95% confidence interval 1.4-1.8) and for severe low back pain 3.1 (95% confidence interval 2.3-4), when workers reporting "high" stress were compared to workers reporting "low" stress.
Adult↗
Low back and neck/shoulder pain in construction workers: occupational workload and psychosocial risk factors. Part 2: Relationship to neck and shoulder pain.
The prevalence rate of neck and shoulder trouble and considerable neck and shoulder pain in a randomly selected sample of 1773 construction workers were studied. The relationship to physical and psychosocial factors was analyzed. The workers answered a postal questionnaire. Workload was measured by means of eight manual materials handling indices and ten psychosocial indices, based on results from factor analyses. The 1-year prevalence rate of considerable neck and shoulder trouble was 56% and of neck and shoulder pain 12%. To work with hands above shoulder level showed a dose-response relationship to both neck and shoulder trouble and neck and shoulder pain. The psychosocial factors were more prominently associated with neck and shoulder trouble and neck and shoulder pain than the physical workload factors. The psychosocial indices; psychosomatic and psychic symptoms, stress and job satisfaction showed the highest age-standardized prevalence rate ratios for both neck and shoulder trouble and neck and shoulder pain.
Adult↗
Trunk muscle strength and back muscle endurance in construction workers with and without low back disorders.
The aim of this study was to test the hypothesis that male workers exposed to heavy work and with no lifetime history of a low back disorder (group A) have better trunk muscle strength and back muscle endurance compared to male workers with the same work exposure but with a probable (group B) or definite low back disorder (group C). Group A (n = 42) was clinically negative on physical examination. Group B (n = 75) was clinically negative or uncertain and group C (n = 86) was clinically positive, with current or previous low back disorders occurring in both groups. Group A had a significantly higher mean intraindividual extension/flexion ratio, namely 1.29 versus 1.19, in group C. The mean values for maximum isometric trunk extension and flexion strength did not differ between the groups. The isometric trunk extensor endurance was significantly lower in group C than in both group A and group B.
Adult↗
Muscle training in chronic anterior cruciate ligament insufficiency--a comparative study.
The aim of the investigation was to study and compare the effect of two basically different training methods on muscle strength and knee function on a consecutive and prospective series of 26 conservatively treated patients with chronic anterior cruciate ligament injury. The two training models were: model Q directed towards specific training of knee extensor muscle strength and model F aiming at training of the lower extremity and trunk muscles in functional weightbearing patterns. The parameters evaluated were: isometric and isokinetic muscle strength, a performance test (one-leg hop test), and a functional score. The results after a three-month training period showed in both groups a significant increase of muscle strength in both knee extensors and knee flexors. No significant difference of isokinetic strength values between the two groups was observed. The isometric gain of knee extension was significantly higher in the Q group. The one-leg hop test value and the functional score were also significantly increased in both groups. However, the hop test indicated a more favourable result in the group who were trained functionally.
Adult↗
[Good American experiences with early rehabilitation of occupational injuries].
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Accidents, Occupational↗
Occupational cervico-brachial disorders among dentists. Psychosocial work environment, personal harmony and life-satisfaction.
The aim of the investigation was to compare dentists with and without occupational cervico-brachial disorders with regard to some psychosocial variables (work environment, personal harmony and life-satisfaction) and professional position. The investigation is based on a questionnaire sent to 143 randomly selected official dentists in Malmöhus District and the Municipality of Malmö. Of these, 96 dentists had symptoms while 47 had not. Dentists with symptoms showed less satisfaction with their work environment than dentists without. Those with symptoms experienced their work load as being more unsatisfactory, were more burdened by anxiety, had poorer psychosomatic health and less confidence in the future than dentists without symptoms. These differences were significant between the groups. It was found that specialists, both with and without cervico-brachial symptoms, were more satisfied with their psychosocial work environment than general practitioners, especially regarding their personal control over their work and the stimulation of their work. The specialists also had more self-confidence and experienced less anxiety than general practitioners and head dentists.
Adult↗
Low back pain--correspondence between questionnaire, interview and clinical examination.
The aim of this study was to analyse the correspondence between answers to a questionnaire about trouble from the musculoskeletal system, answers in a personal interview and clinical findings indicating low back disorder. The questionnaire was answered by 1,773 construction workers. Out of those, 206 workers underwent interview and clinical examination. Among those who reported no lifetime LBT in the questionnaire 63% gave the same report in the personal interview and those were all assessed negative at a blind clinical examination. Of those reporting current LBT in the interview 80% (47/59) were clinically positive. The clinical criteria used in the examination seemed to indicate lumbar painful structures. Answers to a question about functional impairment were in conformity with clinical findings. As regards answers to a question about frequency of pain and a question, in the specific Nordic questionnaire for the low back, concerning inability to do normal work the correlation to clinical findings was less apparent. Reported inability to do normal work in the questionnaire corresponded only to 43% with reported sick-leave in the interview.
Absenteeism↗
Pain and discomfort in the musculoskeletal system among dentists. A prospective study.
The aim of this prospective study was to follow the pain and discomfort among dentists in the Public Dental Service in Malmöhus District and the Municipality of Malmö. In this investigation 311 dentists, who had answered questionnaires in 1987 and in 1990, took part. The prevalence of musculoskeletal pain and discomfort had increased, except the lower back pain and headache. However, the only significant difference was found with respect to the shoulders. As in 1987, female dentists had also in 1990 a higher prevalence of pain and discomfort in the neck and shoulders than their male colleagues. Of the 311 dentists, 262 had symptoms both in 1987 and in 1990. In 1987 forty-nine dentists were free of symptoms, while 24 of them reported symptoms in the locomotor system in 1990. Of the 262 dentists with symptoms in 1987 twenty-four were without symptoms at the follow-up in 1990. The aim of the investigation was also to study the influence of some ergonomic factors on the course of symptoms. However, these ergonomic variables showed a low predictive value for recovery or for the development of pain and discomfort in the locomotor system.
Absenteeism↗
Occupational cervico-brachial disorders among dentists. Analysis of ergonomics and locomotor functions.
The aim of the investigation was to compare dentists with and without occupational cervicobrachial disorders with regard to the mobility of the neck and shoulders and the static endurance of the shoulder muscles. Further, differences in working position and the task performance on a stimulated case were to be analysed. The investigation was carried out during a visit to the workplace of 143 dental officers in the Public Dental Service in Malmöhus District and the Municipality of Malmö. Of these dentists, 96 had signs of cervico-brachial disorders and discomfort while 47 had not. The ergonomic examination showed, that significantly more dentists without symptoms of pain applied a wedge cushion under the upper part of the back of the patient to get an optimum view (p less than 0.05). It was also found that significantly more dentists without symptoms were aware of and utilised the naturally arising pauses in their work than dentists with pain and discomfort. Further dentists with cervico-brachial disorders kept their head sidebent and rotated to a greater extent than dentists without symptoms (p less than 0.01). No significant difference was found between the two groups concerning mobility of the neck and shoulders. Significant differences were found between women with and without cervico-brachial systems.
Adult↗
Neck and shoulder disorders in medical secretaries. Part I. Pain prevalence and risk factors.
420 medical secretaries took part in a cross-sectional study at examining the prevalence of musculoskeletal disorders as well as the relationship between neck and shoulder pain and possible risk factors. Sixty-three percent had experienced neck pain sometime during the previous year and while 15% had suffered almost constant pain 32% had experienced neck pain only occasionally. Shoulder pain during the previous year had been experienced by 62%, 17% had suffered almost constant pain while 29% experienced pain only occasionally. Fifty-one percent had experienced low back pain. Age and length of employment were significantly related to neck and shoulder pain. Furthermore, working with office machines 5 hours or more per day was associated with a significantly increased risk for neck pain (OR 1.7), shoulder pain (OR 1.9) and headache (OR 1.8). Finally, a poorly experienced psychosocial work environment was significantly related to headache, neck, shoulder and low back pain. The results of this study suggest that work with office machines as well as the psychosocial work environment are important factors in neck and shoulder pain.
Academic Medical Centers↗
Neck and shoulder disorders in medical secretaries. Part II. Ergonomical work environment and symptom profile.
Seventy-nine medical secretaries with neck and shoulder pain were included in a study aimed at an in-depth description of the ergonomical work environment and the participant's symptom profile, as well as analysing relationships between ergonomical factors and symptoms. Data were collected by daily ratings, questionnaires, and direct observation. The symptom profile showed low mean daily ratings of perceived fatigue and pain, a low medicine consumption, and few stress symptoms. A mean number of 2.1 undesirable work postures was observed. The correlations between perceived fatigue, pain, and well-being with number of shifts from sitting to standing and time spent typing, were generally small. This study suggests that risk factors for neck and shoulder pain are individual and multifactorial.
Academic Medical Centers↗
Anterior-cruciate-insufficient knees treated with physiotherapy. A three-year follow-up study of patients with late diagnosis.
To evaluate a functional neuromuscular training program focusing on strength, endurance, postural control, and agility, 26 patients with a rupture of the anterior cruciate ligament (ACL) diagnosed late were examined before starting a training period and then followed for three years. During the study period, four of the patients had an ACL reconstruction. Twenty-two patients treated without surgery were satisfied with the improvement in their knee function and activity level after three to six months of physiotherapy. Compliance with the rehabilitation program was good and the improvement achieved on completion of the training period was maintained for three years in this group of recreational sportsmen and women. Quadriceps strength, functional knee score, activity level, and functional performance were all improved after training and were maintained during the follow-up period.
Adolescent↗
Cervico-brachial disorders in dentists. A comparison between two kinds of physiotherapeutic interventions.
We have evaluated two kinds of physiotherapy treatment for dentists with occupational cervico-brachial disorders. Group A received treatment with a psychosomatic approach and individual ergonomic instruction and group B received ergonomic instruction only. A reduction of the cervico-brachial disorders after the intervention was observed in both groups. In group A there was a significant decrease of pain and discomfort in the neck (p less than 0.05), and a significant improvement was also found concerning the experience of well-being (p less than 0.05). Five weeks after the intervention the feeling of self-confidence had increased significantly in group A (p less than 0.05). Both groups of dentists experienced that their control over the work had decreased (p less than 0.01 in group A and p less than 0.05 in group B). In group B it was also found that the dentists' confidence in the future had decreased, compared with the answers given a year before.
Adult↗
[Can lasers relieve pain? Few controlled studies and uncertain results].
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Chronic Disease↗
Intraarticular corticosteroid injection into rheumatoid arthritis knees improves extensor muscles strength.
Eleven arthritic knee joints in seven patients with rheumatoid arthritis were studied before and after intraarticular injection of a corticosteroid preparation. Extensor muscle torque and quantitative electromyography increased on days 7 and 14 after treatment, indicating that muscle function had been inhibited by synovitis. Clinical signs of synovitis, such as pain, range of motion and knee circumference, also improved. Synovial fluid withdrawal alone improved extensor muscle torque. Joints with instability and/or radiological cartilage involvement also improved.
Adrenal Cortex Hormones↗