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PubMed1991

A model to predict canine pelvic limb musculoskeletal geometry.

We developed a model to predict the three-dimensional canine pelvic limb muscular geometry (i.e., all muscle moment arms during any instant in gait). Forty-one muscle origins and insertions, as well as external landmarks (to obtain anthropometric dimensions) were marked on both pelvic limbs of five dogs and digitized on biplanar radiographs. Reference frames in the pelvis, femur, and tibia established the three-dimensional coordinates of each origin, insertion, and landmark. A set of dimensionless 'scaled coordinates' was created by dividing the actual origin and insertion coordinates by selected anthropometric dimensions of each animal. Combining scaled coordinates from all ten limbs produced an averaged 'template' of scaled coordinates. To provide limited validation of the scaling procedure, we measured the anthropometric dimensions between externally palpable landmarks of two additional pelvic limbs. The anthropometric dimensions were multiplied by the averaged template coordinates to calculate two new sets of hindlimb muscle coordinates within the three bony reference frames. The two limbs then were dissected, muscle endpoints were marked, and biplanar radiographs of each of the limb segments were digitized. The actual coordinates so obtained were similar to those predicted by the template and anthropometric measures.

Animals↗
PubMed1993

Individual and work-related risk factors associated with symptoms of musculoskeletal complaints.

Individual and work-related risk factors in the development of occupational musculoskeletal complaints were investigated in a cross-sectional study of 52 female production workers and 34 female office workers. The work tasks of the production workers were considered to generate shoulder muscle loads of low amplitude and high repetitiveness, and the work tasks of the office workers, muscle loads of low amplitude and low repetitiveness. The symptom scores were similar in the two groups, with the highest score for both groups in the shoulder-neck region. Previous pain symptoms were an important risk factor for musculoskeletal pain in all body regions, whereas psychosocial problems at work were a risk factor for complaints in the shoulder-neck region. For the office workers, 27% of the variance in shoulder-neck symptoms was explained by the variance in the parameters "previous pain symptoms" and "psychosocial problems" in a multilinear regression model. In three groups of workers with different physical loads on the shoulder muscles the symptom scores for workers without previous pain symptoms and psychosocial problems were related to the physical load. For workers with previous pain symptoms and psychosocial problems, the symptom scores were high and similar for all three groups.

Adult↗
PubMed2006

The impact of childhood obesity on musculoskeletal form.

Despite the greater prevalence of musculoskeletal disorders in obese adults, the consequences of childhood obesity on the development and function of the musculoskeletal system have received comparatively little attention within the literature. Of the limited number of studies performed to date, the majority have focused on the impact of childhood obesity on skeletal structure and alignment, and to a lesser extent its influence on clinical tests of motor performance including muscular strength, balance and locomotion. Although collectively these studies imply that the functional and structural limitations imposed by obesity may result in aberrant lower limb mechanics and the potential for musculoskeletal injury, empirical verification is currently lacking. The delineation of the effects of childhood obesity on musculoskeletal structure in terms of mass, adiposity, anthropometry, metabolic effects and physical inactivity, or their combination, has not been established. More specifically, there is a lack of research regarding the effect of childhood obesity on the properties of connective tissue structures, such as tendons and ligaments. Given the global increase in childhood obesity, there is a need to ascertain the consequences of persistent obesity on musculoskeletal structure and function. A better understanding of the implications of childhood obesity on the development and function of the musculoskeletal system would assist in the provision of more meaningful support in the prevention, treatment and management of the musculoskeletal consequences of the condition.

Adult↗
PubMed2001

Developing ergonomic solutions for prevention of musculoskeletal disorder disability.

Numerous models have been proposed to help understand the relationship between personal and work factors that affect participation in work. The authors use a generic version of these models as a framework for identifying gaps between job demands and worker capacities. They describe metrics for assessing factors associated with causing or aggravating musculoskeletal disorders. Two case examples are presented to illustrate the hierarchical assessment of jobs and the evaluation of gaps between job demands and worker capacities. Finally, the authors describe the development of a job database to facilitate future evaluations.

Adult↗
PubMed2006

The attitudes to back pain scale in musculoskeletal practitioners (ABS-mp): the development and testing of a new questionnaire.

OBJECTIVES: Little is known about practitioners' beliefs and attitudes to the treatment of low back pain, and whether these influence their clinical decisions, intervention strategies, and patient-centered outcomes. This study aimed to develop, test, and explore the underlying dimensions of a new questionnaire, the Attitudes to Back Pain Scale (ABS), in a specific group of clinicians, practitioners who specialize in musculoskeletal therapy. METHODS: Items for the draft questionnaire were derived from interviews with practitioners (chiropractors, osteopaths, and physiotherapists). The draft questionnaire (52 items) sought to assess practitioners' attitudes concerning role and self-image plus their beliefs about treatment goals and prognosis of low back pain. The questionnaire was sent to a random selection of 300 practitioners from each professional group, and 546 (61%) responded. Split-sample analyses were performed using exploratory and confirmatory factor analysis. RESULTS: Separate exploratory analyses were done for attitudes concerned with personal interaction (34 items) and attitudes about treatment orientation (18 items), producing six domains: limitations on sessions, psychologic, connection to health care system, confidence and concern, reactivation, and biomedical. Confirmatory analyses indicated that the model tested presented a good fit. Validity interviews revealed high agreement of categorization and low levels of difficulty in categorizing the items. CONCLUSIONS: The internal structure of the new questionnaire not only shows excellent psychometric properties and good face validity, but also has the added advantage of being developed with a specific clinical context in mind. Additional evaluation is required to fully describe the psychometric integrity of this instrument.

Adult↗
PubMed2006

The Chronic Pain Coping Inventory: confirmatory factor analysis of the French version.

BACKGROUND: Coping strategies are among the psychosocial factors hypothesized to contribute to the development of chronic musculoskeletal disability. The Chronic Pain Coping Inventory (CPCI) was developed to assess eight behavioral coping strategies targeted in multidisciplinary pain treatment (Guarding, Resting, Asking for Assistance, Task Persistence, Relaxation, Exercise/Stretch, Coping Self-Statements and Seeking Social Support). The present study had two objectives. First, it aimed at measuring the internal consistency and the construct validity of the French version of the CPCI. Second, it aimed to verify if, as suggested by the CPCI authors, the scales of this instrument can be grouped according to the following coping families: Illness-focused coping and Wellness-focused coping. METHOD: The CPCI was translated into French with the forward and backward translation procedure. To evaluate internal consistency, Cronbach's alphas were computed. Construct validity of the inventory was estimated through confirmatory factor analysis (CFA) in two samples: a group of 439 Quebecois workers on sick leave in the sub-acute stage of low back pain (less than 84 days after the work accident) and a group of 388 French chronic pain patients seen in a pain clinic. A CFA was also performed to evaluate if the CPCI scales were grouped into two coping families (i.e. Wellness-focused and Illness-focused coping). RESULTS: The French version of the CPCI had adequate internal consistency in both samples. The CFA confirmed the eight-scale structure of the CPCI. A series of second-order CFA confirmed the composition of the Illness-focused family of coping (Guarding, Resting and Asking for Assistance). However, the composition of the Wellness-focused family of coping (Relaxation, Exercise/Stretch, Coping Self-Statements and Seeking Social Support) was different than the one proposed by the authors of the CPCI. Also, a positive correlation was observed between Illness and Wellness coping families. CONCLUSION: The present study indicates that the internal consistency and construct validity of the French version of the CPCI were adequate, but the grouping and labeling of the CPCI families of coping are debatable and deserve further analysis in the context of musculoskeletal and pain rehabilitation.

Adaptation, Psychological↗
PubMed1998

Muscle and tendon morphogenesis in the avian hind limb.

The proper development of the musculoskeletal system in the tetrapod limb requires the coordinated development of muscle, tendon and cartilage. This paper examines the morphogenesis of muscle and tendon in the developing avian hind limb. Based on a developmental series of embryos labeled with myosin and tenascin antibodies in whole mount, an integrative description of the temporal sequence and spatial pattern of muscle and tendon morphogenesis and their relationship to cartilage throughout the chick hind limb is presented for the first time. Anatomically distinct muscles arise by the progressive segregation of muscle: differentiated myotubes first appear as a pair of dorsal and ventral muscle masses; these masses subdivide into dorsal and ventral thigh, shank and foot muscle masses; and finally these six masses segregate into individual muscles. From their initial appearance, most myotubes are precisely oriented and their pattern presages the pattern of future, individual muscles. Anatomically distinct tendons emerge from three tendon primordia associated with the major joints of the limb. Contrary to previous reports, comparison of muscle and tendon reveals that much of their morphogenesis is temporally and spatially closely associated. To test whether reciprocal muscle-tendon interactions are necessary for correct muscle-tendon patterning or whether morphogenesis of each of these tissues is autonomous, two sets of experiments were conducted: (1) tendon development was examined in muscleless limbs produced by coelomic grafting of early limb buds and (2) muscle development was analyzed in limbs where tendon had been surgically altered. These experiments demonstrate that in the avian hind limb the initial morphogenetic events, formation of tendon primordia and initial differentiation of myogenic precursors, occur autonomously with respect to one another. However, later morphogenetic events, such as subdivision of muscle masses and segregation of tendon primordia into individual tendons, do require to various degrees reciprocal interactions between muscle and tendon. The dependence of these later morphogenetic events on tissue interactions differs between different proximodistal regions of the limb.

Animals↗
PubMed2003

Advanced modeling environment for developing and testing FES control systems.

Realistic models of neuromusculoskeletal systems can provide a safe and convenient environment for the design and evaluation of controllers for functional electrical stimulation (FES) prior to clinical trials. We have developed a set of integrated musculoskeletal modeling tools to facilitate the model building process. Simulink models of musculoskeletal systems are created using two software packages developed in our laboratory, Musculoskeletal Modeling in Simulink (MMS) and virtual muscle, in addition to one software package available commercially, SIMM (Musculographics Inc., USA). MMS converts anatomically accurate musculoskeletal models generated by SIMM into Simulink(R) blocks. It also removes run-time constraints on kinetic simulations in SIMM, and allows the development of complex musculoskeletal models without writing a line of code. Virtual muscle builds realistic Simulink models of muscles responding to either natural recruitment or FES. Models of sensorimotor control systems can be developed using various Matlab (Mathworks Inc., USA) toolboxes and integrated easily with these musculoskeletal blocks in the graphical environment of Simulink.

Computer Simulation↗
PubMed1999

The influence of birth weight, rate of weight gain and final achieved height and sex on the development of osteochondrotic lesions in a population of genetically predisposed Warmblood foals.

The influence of inherent variables (sex, birth weight, final achieved height, monthly weight gain rates and osteochondrosis (OC) status of the parents) on the occurrence of osteochondrotic lesions in the femoropatellar and tarsocrural joints in a group of foals was investigated as part of a research project aimed at the study of the development of osteochondrosis and the influence of exercise on the development of the musculoskeletal system in Warmbloods. The foals were genetically predisposed to develop OC, being offspring of sires that all had radiographically proven OC in either the femoropatellar or the tarsocrural joint. In the mare population the incidence of femoropatellar OC was 16% and of OC in the tarsocrural joint 7%. Foals (n = 43) were weighed at birth, and thence every second week until euthanasia at 5 (n = 24) or 11 (n = 19) months. Height at the withers was taken twice, at birth and at euthanasia. Weight gain rates were calculated for months 1, 2, 3, 4, 5, 7, 9 and 11 and for the entire 5 or 11 month period. Osteochondrosis status of the parents in the 2 joints with respect to the distal tibial sagittal and lateral femoral trochlear ridges was determined radiographically. In all foals, radiographs were taken from the same sites prior to euthanasia. After euthanasia the joints were examined macroscopically and histologically for the presence of osteochondrotic lesions and classified as OC positive (OC+) or negative (OC-). No influence of sex on the prevalence of OC in either of the joints could be established. Also, no relationship between the prevalence of tarsocrural OC and any of the growth variables was found. Foals positive for femoropatellar OC had a significantly higher weight gain rate in the third and fifth month. Animals killed at 11 months that were OC+ in the femoropatellar joint had a significantly higher weight gain rate over the 11 month period, weighed more at 11 months, and were taller at the withers and at the croup than non affected animals. Offspring of tarsocrural OC- parents did not have a lower number of lesions in this joint than foals of which at least one of the parents was affected, but no foals that were offspring of femoropatellar OC- parents themselves showed lesions. It was concluded that, in this selected group, sex had no influence on the occurrence of OC lesions. Even in this relatively homogenous group weight gain rate affected the occurrence of lesions in the femoropatellar joint, but not in the tarsocrural joint. This corresponds with the different time-frames in which the lesions develop in the various joints and with the existence of windows of 'susceptibility'.

Animals↗
PubMedDate not supplied

Exposure assessment of upper limb repetitive movements: a consensus document developed by the Technical Committee on Musculoskeletal Disorders of International Ergonomics Association (IEA) endorsed by International Commission on Occupational Health (ICOH).

This consensus document intends to supply a set of definitions, criteria and procedures useful to describe and, wherever possible, to assess the work conditions that can represent a physical overload for the upper limbs. The document is aimed at all the operators, i.e. occupational doctors but mainly technicians, who are, involved in risk exposure assessment and management. The document intends to provide methods and procedures easily applicable in the field, possibly not requiring sophisticated instrumentation and when possible based on observation procedures. The proposed methods shall be based as far as possible on knowledge and data from scientific literature: should they be contradictory or deficient, reference will be made to standards or pre-standards issued by national and international agencies and bodies, with the experience of researchers involved and common sense. In this regard, it is to be emphasized that the potential users increasingly demand an easily applicable method for description and assessment of work with repetitive movements. The group intends to give a response even if there are still uncertainties from a strictly scientific standpoint: however the group commits itself to perform subsequent validations especially of as yet unconsolidated issues. This document focuses specifically on identification of risk factors and describes some of the methods that have been developed for evaluating them. There is a rapidly developing body of literature on job analysis and not yet agreement on a single best way to analyze jobs. Professional judgement is required to select the appropriate methods. Analysis and design of jobs should to be integrated into an ongoing ergonomics program that includes management commitment, training, health surveillance, and medical case management. In summing up this report, space must be given to the check lists that are so often seen in the medical press, although this is not the occasion to propose a detailed analytical review.

Arm↗
PubMed2000

A Method for Numerical Simulation of Single Limb Ground Contact Events: Application to Heel-Toe Running.

The objective of this work was to develop a method to simulate single-limb ground contact events, which may be applied to study musculoskeletal injuries associated with such movements. To achieve this objective, a three-dimensional musculoskeletal model was developed consisting of the equations of motion for the musculoskeletal system, and models for the muscle force generation and ground contact elements. An optimization framework and a weighted least-squares objective function were presented that generated muscle stimulation patterns that optimally reproduced subject-specific movement data. Experimental data were collected from a single subject to provide initial conditions for the simulation and tracking data for the optimization. As an example application, a simulation of the stance phase of running was generated. The results showed that the average difference between the simulation and subject's ground reaction force and joint angle data was less than two inter-trial standard deviations. Further, there was good agreement between the model's muscle excitation patterns and experimentally collected electromyography data. These results give confidence in the model to examine musculoskeletal loading during a variety of landing movements and to study the effects of various factors associated with injury. Limitations were examined and areas of improvement for the model were presented.

Journal Article↗
PubMed1993

Depressive and distress symptoms as predictors of low back pain, neck-shoulder pain, and other musculoskeletal morbidity: a 10-year follow-up of metal industry employees.

Six-hundred-seven employees in 3 metal industry plants were studied for depressive and distress symptoms, musculoskeletal symptoms, and findings in the musculo-skeletal system made by a physiotherapist. Measurements were made 3 times at 5-year intervals. The mean distress and depressive symptom scores of the first 2 examinations predicted the change in several musculo-skeletal symptom measures during the second 5-year period, when the effects of age and occupational class were accounted for in multiple regression analysis. They also predicted the development in clinical musculoskeletal findings in men. The proportions of variance explained by the depressive and distress symptoms were modest in magnitude. Analogous analyses were made with reference to the reverse temporal sequence: musculoskeletal disorders were considered as predating the development in depressive and distress symptoms. The musculoskeletal symptom scores were associated with the change in the stress symptoms in men, as did the clinical findings in the neck-shoulder and low back regions. None of the musculoskeletal morbidity scores predicted the change in the depressive symptoms in either sex. We conclude that depressive symptoms predict future musculoskeletal disorders, but not vice versa, whereas the association of stress symptoms and musculoskeletal disorders is reciprocal.

Adult↗
PubMed1995

FDDI information management system for centralizing interactive, computerized multimedia clinical experiences in pediatric rheumatology/Immunology.

This paper describes the design, authoring, and development of interactive, computerized, multimedia clinical simulations in pediatric rheumatology/immunology and related musculoskeletal diseases, the development and implementation of a high speed information management system for their centralized storage and distribution, and analytical methods for evaluating the total system's educational impact on medical students and pediatric residents. An FDDI fiber optic network with client/server/host architecture is the core. The server houses digitized audio, still-image video clips and text files. A host station houses the DB2/2 database containing case-associated labels and information. Cases can be accessed from any workstation via a customized interface in AVA/2 written specifically for this application. OS/2 Presentation Manager controls, written in C, are incorporated into the interface. This interface allows SQL searches and retrievals of cases and case materials. In addition to providing user-directed clinical experiences, this centralized information management system provides designated faculty with the ability to add audio notes and visual pointers to image files. Users may browse through case materials, mark selected ones and download them for utilization in lectures or for editing and converting into 35mm slides.

Allergy and Immunology↗
PubMed1992

Questionnaire development: an examination of the Nordic Musculoskeletal questionnaire.

This paper describes the outcome of user trials of the Nordic Musculoskeletal Questionnaire which encompassed the views of the following groups: data entry clerks, technical staff, administrative clerks and 481 subjects employed in 10 supermarkets. A significant number of improvements was identified, especially concerning its wording, layout and administration. This has led to a standardized version being produced for use in studying the prevalence of reported symptoms in many types of occupational groups.

Journal Article↗
PubMed2003

Musculoskeletal disorders in Russia at the end of the 20th century.

The situation with musculoskeletal disorders in Russia is described. Developments include markedly increased musculoskeletal morbidity in both adults and children. The burden of disease has also increased both from a medical and socioeconomic standpoint, as the numbers of disabled continue to grow. Recent initiatives under the auspices of the Institute of Rheumatology of the Russian Academy of the Medical Sciences, as well as state support for the Bone and Joint Decade, are highlighted.

Age Factors↗
PubMed1992

Individual and work related factors associated with symptoms of musculoskeletal complaints. II. Different risk factors among sewing machine operators.

Individual and work related risk factors in the development of occupational musculoskeletal complaints were studied in a group of 210 female production workers, mainly sewing machine operators. Another group of 35 female employees performing secretarial or laboratory duties were also included. The production workers had significantly higher symptom scores with respect to self reported musculoskeletal complaints than the group with more varied work tasks for the head, neck, shoulders, and arms, but not for the low back, hips, and the lower extremities. No significant differences were found in symptom level between geographically separate groups of production workers with similar work tasks. The main individual risk factor identified in this study was the experience of previous, similar symptoms in the same body region, but this factor only accounted for 2-3% of total variance in symptom score for the neck and shoulders. Other individual factors of importance for symptoms in the neck and shoulders were "signs of psychological problems" and "tendency of muscle tension," but these only account for about 1% of total variance in symptom score. Symptoms in the head and low back showed complex relations with individual parameters.

Absenteeism↗