Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Cumulative Trauma Disorders”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 379 records · Page 21Linked to original sources
PubMed2004

[Anterior knee pain in the absence of patellofemoral instability].

A wide range of disorders other than patellofemoral instability may be responsible for anterior knee pain and should therefore be included in the differential diagnosis in children and adolescents. The role of overuse and repetitive trauma is of utmost importance in these disorders. Moreover, systemic or local malignancies, referred pain especially from the hip, and psychiatric features specific to this age group should always be kept in mind. This article revisits anterior knee pain in the absence of patellofemoral instability with regard to etiology, examination methods, diagnosis, and treatment in the light of recent data and clinical experience.

Adolescent↗
PubMed2006

Inflammation and the pathophysiology of work-related musculoskeletal disorders.

Work-related musculoskeletal disorders (MSDs) have accounted for a significant proportion of work injuries and workers' compensation claims in industrialized nations since the late 1980s. Despite epidemiological evidence for the role of repetition and force in the onset and progression of work-related MSDs, complete understanding of these important occupational health problems requires further elucidation of pathophysiological mechanisms of the tissue response, particularly in the early stage of these disorders. Results from several clinical and experimental studies indicate that tissue microtraumas occur as a consequence of performing repetitive and/or forceful tasks, and that this mechanical tissue injury leads to local and perhaps even systemic inflammation, followed by fibrotic and structural tissue changes. Here we review work linking inflammation and the development of work-related MSDs. We also propose a conceptual framework suggesting the potential roles that inflammation may play in these disorders, and how inflammation may contribute to pain, motor dysfunction, and to puzzling psychological symptoms that are often characteristic of patients with work-related MSDs.

Cumulative Trauma Disorders↗
PubMed1992

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↗
PubMed2001

Upper-limb disorders in repetitive work.

OBJECTIVES: A longitudinal study was conducted to determine the predictability of personal and occupational factors with respect to the incidence of upper-limb disorders in occupations requiring repetitive work. METHODS: A sample of 598 workers in five activity sectors completed a self-administered questionnaire; the workers were examined by an occupational health physician in 1993-1994 and 3 years later. Three disorders were considered, carpal tunnel syndrome (CTS), lateral epicondylitis and wrist tendinitis. RESULTS: The results of this longitudinal study indicated that the following three sets of risk factors independently affect the incidence of upper-limb disorders: (i) biomechanical constraints, (ii) psychosocial factors, and (iii) personal factors. The combination of risk factors differed between CTS, lateral epicondylitis, and wrist tendinitis. The presence of psychosomatic problems was a strong predictor of wrist tendinitis. Social support at work was also associated with the incidence of wrist tendinitis. The presence of depressive symptoms and other upper-limb disorders predicted the first occurrence of lateral epicondylitis. Age was associated only with epicondylitis. The results were consistent with those concerning the role of forceful movements of the elbow for epicondylitis and confirmed the role of forceful movements for CTS. CONCLUSIONS: This study considered different sets of risk factors simultaneously with a longitudinal approach, in a population with a high level of occupational exposure. The results indicate that three sets of risk factors independently affect the incidence of upper-limb disorders. In addition to biomechanical constraints, psychosocial and personal factors play a role.

Adult↗
PubMed2005

Risk factors for visiting a medical department because of upper-extremity musculoskeletal disorders.

OBJECTIVES: This study followed 279 auto assembly workers over 1 year to identify which factors influenced whether a worker would visit the plant medical department because of an upper-extremity musculoskeletal problem. METHODS: Incident cases were defined as involving workers who had not gone to the plant medical department in the preceding 6 months and then subsequently visited the medical department with a work-related musculoskeletal disorder that was potentially due to repetitive work activity (acute fractures or lacerations were excluded). RESULTS: There were 45 cases identified during the study period. Based on Cox regression analysis, significant predictors for visiting a medical department included exceeding the threshold limit value for hand activity and peak force, a history of diabetes, a current diagnosis of carpal tunnel syndrome, elbow tendonitis, and age under 40 years. CONCLUSIONS: The results of this study are consistent with those of other prospective studies that showed that both ergonomic and past medical history are risk factors for an upper-extremity musculoskeletal disorder and suggests that there is a healthy worker or survivor effect among older workers.

Automobiles↗
PubMed1995

[A syndrome caused by separating rags in textile industry: a new clinical entity?].

A group of 104 workers were examined. They were employed in selecting rags and separating the lining from wollen fabrics to be used again as thread waste in the textile industry. The aim of the study was to point out tendon and joint related disorders of the upper limb due to repetitive and forced movements. Twenty-eight (26.9%) workers complained of hand and wrist echography and thermography. In 19 patients (67.8%) clinical carpal tunnel syndrome was diagnosed. Eight workers (28.5%) had Dupuytren's contracture. Swelling of the fingers was found in 23 (82.1%). 14.2% and 28.5% of the workers showed respectively acro-osteolysis and acrosclerosis. The textile industry of Prato shows peculiar characters: the workers employed in selecting rags out a manual job which causes soft tissues and skeletal disorders in a great number of them. The acro-osteolytic and acrosclerotic changes of the fingers seem alike the bone disorders of chronic inflammatory rheumatic diseases as seronegative spondyloarthritis.

Carpal Tunnel Syndrome↗
PubMed2000

Reliability of physical examination of the upper extremity among keyboard operators.

BACKGROUND: Physical examination is a traditional outcome measure in epidemiological research. Its value as a reliable measure depends, in part, on the prevalence of positive findings. The purpose of this paper is to determine the empirical reliability of physical examination and anthropometry in a field study of upper extremity disorders among keyboard operators. METHODS: Two experienced examiners independently performed common provocative tests and procedures in physical examinations of the neck and upper extremity among 160 keyboard operators. Two additional examiners conducted anthropometric surveys among 137 workers. Inter-examiner reliability was assessed with observed agreement, kappa statistics, and intra-class correlations (ICC). RESULTS: Observed agreement was between 96% and 100% for neck and upper extremity signs, muscle stretch reflexes, and muscle strength, however, with the exception of provocative tests, reliability statistics were unstable. Among the provocative tests, Phalen and Tinel tests had modest agreement after adjusting for chance (kappa range: 0.20-0.43). The carpal compression test had the best reliability (kappa=0.60 and kappa=0.67, left and right side, respectively). The ICCs for anthropometry ranged from 0.36-0.91. CONCLUSIONS: Results from the study showed that statistically, except for the carpal compression test, physical examination contributed minimal reliable information. This was attributed mainly to the low prevalence of positive findings, and generally mild nature of upper extremity disorders in this population. The results are the best estimate of what would be found in a field study with experienced examiners. While it may reduce bias, separating physical examination from medical history may contribute to the poor reliability of findings. With a shift toward reliable measures, resources can be allocated to more effective tools, like questionnaires, in epidemiological research of upper extremity disorders among keyboard operators.

Adult↗
PubMed2006

Patient selection.

Patient selection is the process by which an evaluating surgeon decides whether to accept responsibility for the care and treatment of a potential patient. It is assumed the physician has the requisite knowledge to assess the anatomic disorder and the technical ability to render appropriate care if needed. The aim of this article is to help the less experienced health care professional sort out which patients, either by true psychological disorder or personality and behavioral traits, pose the highest risk of a poor outcome. An unsatisfactory outcome can be measured not only by failure to resolve the disorder but also by expenditure of a disproportionate amount of practice resources in achieving resolution of the problem.

Arm Injuries↗
PubMed2006

Pathophysiology of writer's cramp.

Writer's cramp is a task-specific focal hand dystonia. The abnormality of task specificity is a curious one and indicates that we need to learn more about the coupling of motor programs and their effectors. Writer's cramp appears to be triggered by spending much time writing by an individual with a fertile physiological substrate for producing the disorder. The fertile background, which is likely genetic, may be a decrease of inhibition, an increase of plasticity or an impairment in sensory function. Recent pathophysiological findings have implications for new therapies.

Cumulative Trauma Disorders↗
PubMedDate not supplied

Comparative study of hands-on therapy with active exercises vs education with active exercises for the management of upper back pain.

OBJECTIVE: The aim of this study was to compare hands-on therapy, including heat, massage, and active exercises with postural education that emphasized increased self-efficacy and postural self-awareness along with education about the physiology of the disorder, and prescribed daily active exercises. SUBJECTS: Twenty-four randomly selected women, 12 custodians and 12 students, with neck and shoulder pain and stiffness. METHODS: All subjects received a medical examination and x-ray before the study to rule out any pre-existing neurologic deficits and an evaluation that included history taking and self-reporting of pain according to a numeric pain scale. Student participants received education and exercise instructions to be continued daily. The custodial workers received once-per-week hands-on treatment. RESULTS: Data were compared using a nonparametric analysis (Wilcoxon signed rank test) and showed evidence of statistically significant reductions in neck, shoulder, and back stiffness and shoulder muscle tension for most of the study subjects. CONCLUSION: Treatment of repetitive stress injuries that combines maintenance of daily active exercises prescribed and modeled by a professional therapist, which emphasize postural awareness to correct poor posture and provide a basic physiological understanding of the disorder, is as crucial to reducing upper back and neck pain and stiffness as hands-on therapy with active exercise provided in a clinical setting.

Adult↗
PubMedDate not supplied

[Repetitive movements of the upper limbs: results of exposure evaluation and clinical investigation in the manual sanding of wood in the Valdichiana region].

The aim of this study was to evaluate the level of risk exposure deriving from repetitive movements of the upper limbs, among a population of female workers manually sand papering timber products. The study also included an anamnestic and clinical assessment for the purpose of detecting and diagnosing WMSDs in the study population. The authors report a distinct prevalence of such disorders among the female workers exposed to a high level of risk, also in view of the total absence of recovery periods.

Adolescent↗
PubMedDate not supplied

Ambiguities in office-related injury: the poverty of present approaches.

This is a straightforward entry into the fray over the association of upper extremity disorders with the modern workplace. The authors point out that successful intervention and prevention efforts are underway around the world, despite the continuing debate on theory.

Arm Injuries↗
PubMed1999

The impact of lean production and related new systems of work organization on worker health.

New systems of work organization, such as lean production and total quality management, have been introduced by employers throughout the industrialized world to improve productivity, quality, and profitability. However, few studies have examined the impact of such systems on occupational injuries or illnesses or on job characteristics related to job strain, which has been linked to hypertension and cardiovascular disease. The studies reviewed provide little evidence to support the hypothesis that lean production "empowers" auto workers. In fact, auto industry studies suggest that lean production creates intensified work pace and demands. Increases in decision authority and skill levels are modest or temporary, whereas decision latitude typically remains low. Thus, such work can be considered to have job strain. In jobs with ergonomic stressors, intensification of labor appears to lead to increases in musculoskeletal disorders. The evidence for adverse health effects remains inconclusive for related new work systems in other industries, such as modular manufacturing or patient-focused care.

Automobiles↗
PubMed2006

Comparison of three computer office workstations offering forearm support: impact on upper limb posture and muscle activation.

The aims of the study were: 1) to determine whether resting the forearms on the work surface, as compared to chair armrests, reduces muscular activation; 2) to compare the sensitivity of different electromyographic (EMG) summary parameters. Eighteen healthy subjects performed computer work (with keyboard and mouse alternately) for 20 min while resting their forearms on a work surface adjustable in height (Workstation A), on the chair's armrests with an adjustable workstation (Workstation B) or on their chair's armrests with a non-adjustable workstation (Workstation C). The EMG amplitude of the trapezius and deltoid muscles was little influenced by the workstations, whereas their EMG variability increased with Workstation A, which was interpreted as a positive effect. However, the EMG amplitude of the mouse-side extensor digitorum muscle was higher with Workstation A. Alternating between resting the forearms on the work surface and on the chairs' armrests could solicit different muscles during computer work, and could be considered as a strategy for preventing musculoskeletal disorders. The new exposure variation analysis summary parameters used were sensitive to small workstation changes, thus supporting their use in future studies.

Adult↗
PubMedDate not supplied

[Repetitive movements of the upper limbs: results of exposure evaluation and clinical investigation in the production and packaging of ice cream].

An evaluation was made of the degree of exposure to risk and the frequency of disorders attributable to biomechanical overload of the upper limb in workers employed on packaging in an ice cream factory. The risks were first evaluated against a checklist, then subsequently an assessment was made of the tasks found to feature the highest risks, using an ergonomic analysis method. The method identified several jobs, such as placing ice cream coupes and such like in boxes, as requiring a large number of actions per minute (> 30) and considerable muscular strength. The 59 female workers performing the packaging operations were given a risk-targeted physical examination. The clinical test detected an extremely high frequency of carpal tunnel syndrome, (7.1%) epicondylitis (5.2%) and scapulo-humeral periarthritis (3.5%) in the over 35 years age group, with respect to a control population not exposed to risk. The authors conclude that the repetitiveness of the actions, the use of gloves due to prolonged contact with frozen products and the effects of the low temperatures themselves, may have favoured the spread of the disorders that appeared in this population of workers. These findings must be further supported by more in-depth epidemiological studies.

Adult↗
PubMed1997

Diagnostics of hand-arm system disorders in workers who use vibrating tools.

A hand-arm vibration syndrome occurs in some workers who use hand held vibrating tools. It is recognised to consist of white fingers, diffusely distributed finger neuropathy, pain in the arm and hand, and a small excess risk of osteoarthrosis from percussion to the wrist and elbow. Carpal tunnel syndrome is mainly due to ergonomic factors other than vibration, but certain factors related to vibration may contribute to its development. A decrease in muscle power induced by vibration, and excessive hearing deficit have been postulated. The assessment of a disorder suspected of being induced by vibration includes deciding whether there is a disorder and, if so, whether the symptoms can be caused by vibration. To decide whether the symptoms can be caused by vibration epidemiological documentation and pathogenically reasonable theories must exist. A causal diagnosis finally requires and epidemiological decision whether or not the factual exposure has elicited the patient's symptoms. Epidemiological data on the quantitative association between vibration and excessive risks of white fingers and diffusely distributed neuropathy are incomplete. The symptomatic diagnosis of white fingers is still mainly based on anamnestic information. Available laboratory tests are incapable of grading the severity of individual cases. Recording the finger systolic blood pressure during cold provocation is a method of symptomatic diagnosis with reasonable levels of specificity, sensitivity, and predictive value. For diffusely distributed neuropathy these levels are lower than desired. Electrodiagnostic tests for carpal tunnel syndrome have sufficient validity. Proper exposure evaluation must be based on an appreciation of the character of the vibration as well as effective duration and intermittency. If this is not taken into account, the number of hours of exposure and intensity of vibration are likely to be non-commensurable variables, and the simple product of them is a questionable dose measure. Separate models for risk evaluation of vascular and neurological disorders related to work with different tools and processes will have to be established. Ongoing research to obtain further data on exposure-response relations for neurological disturbances begins to yield encouraging results.

Arm↗
PubMed2005

[Evaluation of a secondary preventive ergonomic project: the button must be on].

The aim of this study was to evaluate a secondary preventive ergonomic programme to musculoskeletal disorders among dentists. Over 50% of the 57 dentists did implement the recommendations fully or nearly fully, and 40% did it partially. Barriers for a change included changing old routines and financial aspects. Important facilitators were motivation, pain and tailor-made advice. The dentists did see a clear relation between the implementation of recommendations and a reduction in musculoskeletal disorders. The study showed that even in a highly motivated group recommendations to reduce musculoskeletal disorders will often be partially implemented. Improving the understanding of barriers and facilitators may result in a class of guidelines dealing with implementation issues leading to more effective prevention.

Cumulative Trauma Disorders↗
PubMed2006

Occupational and physical therapy for work-related upper extremity disorders: how we can influence outcomes.

Upper extremity disorders in the workplace continue to be an economic strain on society. Physical and occupational therapy plays a crucial role in the management of the disorders. Medical providers should use therapists whose treatments demonstrate improvement in function and provide superior outcomes. Skilled therapy intervention requires that a therapist be able to identify and treat an injured worker in a holistic manner by looking at the whole individual, including issues that involve mechanical dysfunctions, psychosocial issues that include job satisfaction, and other age-related organic comorbidities. Therapists who work with injured employees must be highly skilled in identifying behavioral and organic disorders and must be confident in communicating these findings to various members of the health care team to help facilitate further medical testing.

Arm Injuries↗