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At least 415 records · Page 23Linked to original sources
PubMed2002

Biomechanical strains on the hand-wrist system during grapevine pruning.

OBJECTIVES: In order to understand the high prevalence of musculoskeletal disorders of the hand among vineyard workers, we conducted a study to evaluate biomechanical strains on the hand-wrist system during grapevine pruning. METHODS: Surface electromyography (sEMG) activity of the right flexor digitorum muscle and wrist posture were analysed in six healthy vineyard workers using the same hand-powered pruning shears during grapevine pruning. RESULTS: The biomechanical strains on the hand-wrist system were high during grapevine pruning. Mean sEMG activity during pruning was high [23.5% (standard error of the mean (SEM): 0.4) in the maximal voluntary handgrip contraction (MVC)], as was the mean cutting frequency per minute (38; range=24-48). Approximately 14% of cuts were performed with the wrist in extreme flexion/extension (F/E) (>60% of the maximum range). Numerous cuts required moderate (20%-40% of the maximum range) or extreme (>50% of the maximum range) ulnar deviation (17% and 12% of cuts, respectively). Approximately 18% of cuts required both high muscular activity (sEMG >15% MVC) and extreme ulnar/radial (U/R) deviation of the wrist (>50% of the maximum range). CONCLUSION: Pruning imposes high biomechanical strains on the hand-wrist system in view of the repetitiveness of the task. The magnitude of physical exposure during pruning explains the high prevalence of hand disorders among vineyard workers. The use of ergonomic pruning shears is advised to lower force exertion and to reduce the frequency of awkward wrist postures during pruning.

Adult↗
PubMed1998

Claims incidence of work-related disorders of the upper extremities: Washington state, 1987 through 1995.

OBJECTIVES: This study examined the claim incidence rate, cost, and industry distribution of work-related upper extremity disorders in Washington. METHODS: Washington State Fund workers' compensation claims from 1987 to 1995 were abstracted and categorized into general and specific disorders of gradual or sudden onset. RESULTS: Accepted claims included 100,449 for hand/wrist disorders (incidence rate: 98.2/10,000 full-time equivalents; carpal tunnel syndrome rate: 27.3), 30,468 for elbow disorders (incidence rate: 29.7; epicondylitis rate: 11.7), and 55,315 for shoulder disorders (incidence rate: 54.0; rotator cuff syndrome rate: 19.9). Average direct workers' compensation claims costs (medical treatment and indemnity) were $15,790 (median: $6774) for rotator cuff syndrome, $12,794 for carpal tunnel syndrome (median: $4190), and $6593 for epicondylitis (median: $534). Construction and food processing were among the industries with the highest rate ratios for all disorders (> 4.0). CONCLUSIONS: Upper extremity disorders represent a large and costly problem in Washington State industry. Industries characterized by manual handling and repetitive work have high rate ratios. The contingent workforce appears to be at high risk.

Absenteeism↗
PubMed1998

Upper limb disorder due to manual pipetting.

This case report describes the occurrence of non-specific upper limb symptoms, in a 47-year-old female scientific officer, associated, with manual pipetting. The discussion considers the difficulty of risk assessment and reduction for this common procedure.

Arm↗
PubMedDate not supplied

[Repetitive movement of the upper limbs: results of a current exposure evaluation and a clinical investigation in workers employed in the preparation of pork meat in the province of Modena].

Exposure assessment tests were undertaken to measure the biomechanical overload factors affecting the upper limbs. The tests were carried out on a group of 86 workers employed on the cutting, boning and trimming line of a pork meat processing plant. Anamnestic screening and clinical tests targeted at correlated disorders were also performed and were followed by instrumental tests. The results are reported with respect to frequency of repetitive technical actions, degree of muscular involvement, postural risk, several complementary factors and distribution of recovery periods. The clinical investigation showed a high prevalence of carpal tunnel syndrome, tendon disorders of the hand and epicondylosis of the elbow, in addition to other disorders. The report confirms the presence of additional risks for the workers, both in the past and under present circumstances, and suitable preventive measures are formulated.

Adolescent↗
PubMed1997

Etiology and pathophysiology of chronic tendon disorders in sports.

In sports medicine, a chronic overuse injury is defined as a long-standing or recurring orthopedic problem and pain in the musculoskeletal system, which started during exertion due to repetitive tissue microtrauma (1). Repetitive microtrauma, which is basically repeated exposure of the musculoskeletal tissue to low-magnitude forces, results in injury at the microscopic level, and no single acute trauma is normally involved in the pathogenesis of an overuse injury. In chronic tendon disorders, 'overuse' implies that the tendon has been strained repeatedly to 4-8% strain until unable to endure further tension, whereupon injury occurs (2). The structure of the tendon is disrupted micro- or macroscopically by this repetitive strain, i.e. collagen fibrers begin to slide past one another, causing break-age of their cross-linked structure, and denaturate; inflammation, edema and pain result. Thus, tendinitis, peritendinitis, tenosynovitis, insertion tendinitis, tendinous bursitis or apophysitis is the earliest clinically recognizable manifestation of overuse tendon injury (3).

Athletic Injuries↗
PubMed2003

Does computer use pose an occupational hazard for forearm pain; from the NUDATA study.

AIMS: To determine the occurrence of pain conditions and disorders in the forearm and to evaluate risk factors for forearm pain in a cohort of computer workers. METHODS: A total of 6943 participants with a wide range of computer use and work tasks were studied. At baseline and at one year follow up participants completed a questionnaire. Participants with relevant forearm symptoms were offered a clinical examination. Symptom cases and clinical cases were defined on the basis of self reported pain score and palpation tenderness in the muscles of the forearm. RESULTS: The seven days prevalence of moderate to severe forearm pain was 4.3%. Sixteen of 296 symptom cases met criteria for being a clinical forearm case, and 12 had signs of potential nerve entrapment. One year incidence of reported symptom cases was 1.3%; no subjects developed new signs of nerve entrapment. Increased risk of new forearm pain was associated with use of a mouse device for more than 30 hours per week, and with keyboard use more than 15 hours per week. High job demands and time pressure at baseline were risk factors for onset of forearm pain; women had a twofold increased risk of developing forearm pain. Self reported ergonomic workplace factors at baseline did not predict future forearm pain. CONCLUSION: Intensive use of a mouse device, and to a lesser extent keyboard usage, were the main risk factors for forearm pain. The occurrence of clinical disorders was low, suggesting that computer use is not commonly associated with any severe occupational hazard to the forearm.

Adult↗
PubMed1989

The pain of RSI. The central issue.

In this paper RSI (repetition strain injury) is used to refer to those diffuse neck and arm pain syndromes that appear to be directly related to occupational factors; for example, occupational overuse syndrome (OOS) and occupational cervicobrachial disorder (OCD). The author examines the clinical evidence that suggests the involvement of neural tissues in the pathogenesis of these conditions. He also speculates on the possible underlying pathophysiological mechanisms that may explain their development and persistence.

Biomechanical Phenomena↗
PubMed2006

Epidemiology of work-related upper extremity disorders: understanding prevalence and outcomes to impact provider performances using a practice management reporting tool.

In 2001, the number of repeated trauma cases accounted for 4% of total workplace injuries and 65% of all occupational illnesses, with work-related upper extremity disorders accounting for most cases. Because chronic disability leads to the highest cost, systematic evaluation of this growing occupational condition is needed. This article sheds light on work-related upper extremity disorders by understanding the prevalence and pattern for these diagnoses, their impact on outcomes influenced by age, gender and geography on metrics such as utilization, duration, disability status, and costs. To assess these types of outcomes measurements, a good reporting and management system must be in place to allow for ongoing evaluation and analysis of data and in the construction of intervention programs to improve provider performances and, ultimately, patient outcomes.

Adult↗
PubMed2000

Work-related upper extremity musculoskeletal disorders.

Upper extremity musculoskeletal disorders such as DeQuervain's tendonitis, carpal tunnel syndrome, and rotator cuff tendonitis have become increasingly common among working people in the United States. Extensive epidemiological investigation indicates that the adverse ergonomic exposures of force, repetition, vibration and certain postures are risk factors for development of many of these disorders. Assessment of patients with possible work-related upper limb disorders requires eliciting information about the illness, performing an examination about the illness, and obtaining information about adverse ergonomic exposures on and off from work. Treatment can only be successful when exposure to adverse ergonomic risk factors is reduced or eliminated.

Arm↗
PubMedDate not supplied

[Methodological issues in epidemiological studies of repetitive strain injuries].

Repetitive strain injuries (RSI) are a major public health problem with social and economic repercussions. This article presents a critical review of the published literature on RSI. The vast majority of the studies conducted in the last two decades were cross-sectional and exploratory. Results are difficult to interpret due to such methodological problems as lack of standardization and accuracy in identification of cases, inclusion of cases with potentially different diseases, varying levels of severity in the same study, lack of distinction between prevalent and incident cases, lack of precision in the definition and measurement of exposure, and confounding, besides the built-in constraint of cross-sectional studies for inferring causality. Some of these problems result from our insufficient knowledge of upper-limb soft tissue disorders and the absence of reliable diagnostic tests. Such problems could be addressed by studies whose design considered and stratified cases according to certainty and specificity of diagnosis.

Carpal Tunnel Syndrome↗
PubMed1992

[Specific rheumatologic disorders in musicians].

The author reviews the locomotor problems observed in performing musicians. The overall frequency of these problems is high. Three presentations exist: overuse, entrapment and dystonic syndromes. Treatment of these problems implies not only a technical approach, but also consideration of life experience and individual personality.

Arthritis, Rheumatoid↗
PubMed2003

[Reasons why musicians consult hand surgeons].

PURPOSE OF THE STUDY: Musicians occasionally consult orthopedic surgeons, particularly upper limb specialists. We wanted to learn more about the reasons why musicians attend orthopedic clinics. MATERIAL AND METHODS: We analyzed retrospectively 227 case files of musicians who consulted our center between 1994 and 2001. We noted patient related factors (age, gender, musical experience, level of performance, daily practice schedule) and their reasons for consulting (pain, discomfort, advice). We studied the medical history of the patients and searched for predisposing or triggering elements. We also recorded therapeutic options proposed. RESULTS: Our series included 119 men (52%) and 108 women, mean age 35 years with 27 years of musical experience on the average. Instruments played were mainly the piano (41%), the violin (19%), and the guitar (15%). Patients playing wind instruments, who consult more often for ENT problems, were exceptional. On the average, the patients played their instrument 4 hours daily. One-third of the patients were high-level amateurs, one-third were professionals, and one-quarter were lower-level amateurs. There was a small proportion of soloists or professors. Two-thirds of the musicians presented disorders of the musculoskeletal system, particularly trauma sequelae. Signs of overuse were present in 18% of the patients, mainly women, signs of misuse due to inappropriate or defective technique in 8.8%, and dystonia in 5.7%. Psychological problems were noted in 4 patients. More than one half of the patients had obtained medical advice prior to consulting an orthopedic surgeon and the very large majority had been referred by specialized physical therapists. A surgical procedure was proposed for only 19% of the patients presenting an orthopedic disorder. DISCUSSION: This study presents a diversified panel of musicians consulting orthopedic surgery clinics. Practicing schedules varied in the study population from one to five hours daily. More than half the patients complained of pain but 18% consulted because they perceived a problem when playing and 17% consulted simply for advice. Our findings recall that musicians comprise a sensitive population requiring careful overall management. Unlike series published to date, we had a majority of men. Problems involving an orthopedic disorder or trauma and trauma sequelae predominated. In the literature, diagnosis has been oriented by the specialty of the consulting physician. We found that our patients who suffered from overuse had often recently changed their habitual practicing methods or conditions. The diagnosis of misuse was facilitated when the patient was examined with his/her instrument. The low rate of dystonic disorders was probably related to the fact that nearly half of our patients were followed regularly by a physical therapist. We did not observe any case of excessive laxity or Linburg Comstock syndrome which exceptionally have functional impact. The very large majority of our patients were referred by physical therapists and when surgery was necessary, the procedure was performed in accordance with accepted rules concerning the therapeutic management of musicians.

Adolescent↗
PubMed2002

Specific orofacial problems experienced by musicians.

BACKGROUND: Patients who play musical instruments (especially wind and stringed instruments) and vocalists are prone to particular types of orofacial problems. Some problems are caused by playing and some are the result of dental treatment. This paper proposes to give an insight into these problems and practical guidance to general practice dentists. METHOD: Information in this paper is gathered from studies published in dental, music and occupational health journals, and from discussions with career musicians and music teachers. RESULTS: Orthodontic problems, soft tissue trauma, focal dystonia, denture retention, herpes labialis, dry mouth and temporomandibular joint (TMJ) disorders were identified as orofacial problems of career musicians. Options available for prevention and palliative treatment as well as instrument selection are suggested to overcome these problems. CONCLUSIONS: Career musicians express reluctance to attend dentists who are not sensitive to their specific needs. General practitioner dentists who understand how the instruments impact on the orofacial structures and are aware of potential problems faced by musicians are able to offer preventive advice and supportive treatment to these patients, especially those in the early stages of their career.

Cumulative Trauma Disorders↗
PubMed2006

Preventing upper limb work-related musculoskeletal disorders (UL-WMSDS): new approaches in job (re)design and current trends in standardization.

In industrialized countries, upper limb work-related musculoskeletal disorders (UL-WMSDs) are the most common form of occupational diseases. They are generating a growing population of workers with reduced working capacity. The link between these pathologies and different aspects of work organization has been convincingly proven. Recent experiences in Europe supporting the combination of traditional work design methods used in manufacturing companies with ergonomics methods are reported briefly, with special focus on the use of the occupational repetitive action (OCRA) method for risk assessment and management of manual repetitive tasks. The combined approach strives to achieve the goal of maintaining a satisfactory level of productivity while respecting ergonomics criteria and, definitely, workers' health. New ergonomics standards provide for interaction between job and machinery designers and ergonomists in the design of work processes and workplaces. These standards generally refer only to the healthy adult working population and do not always provide criteria for protecting particular working populations, such as that represented by workers affected by UL-WMSDs. The results of preliminary studies concerning productive re-employment of workers with UL-WMSDs allow the introduction of some criteria for implementing current ergonomics standards in this connection. One aim of this paper is to summarize experiences of close cooperation between ergonomists, machinery designers and job designers to guarantee productivity and the prevention of musculoskeletal disorders. A second aim is to examine current ergonomics standards in the field of manual physical work (designed for healthy workers) and to suggest preliminary criteria for their implementation taking into account the capabilities and needs of specific sub-groups of the working population.

Cumulative Trauma Disorders↗
PubMed2001

Biceps tendinitis and subluxation.

Since the 17th century, the long head of the biceps tendon as a source of shoulder pain and its functional significance has been a source of debate. Although the term tendinitis is commonly used, overuse tendon injuries infrequently demonstrate inflammatory cells; instead, degenerative changes resulting from the failure of self-repair usually are found. Bicipital tendinitis or bicipital tenosynovitis is most often secondary to impingement beneath the coracoacromical arch. Primary bicipital tendinitis and tendinitis secondary to instability are possible, however. Through a careful history, physical examination, and appropriate imaging studies, the clinician can establish the diagnosis of disorders of the biceps tendon Arthroscopic evaluation greatly improves the diagnosis and treatment of biceps tendon and related shoulder pathology. Although the exact functional role of the biceps tendon remains incompletely defined, a growing body of evidence supports its role as a stabilizer of the glenohumeral joint. This stabilizing function should be incorporated into the treatment of biceps tendon disorders. Routine tenodesis has been replaced by a more individualized approach, taking into consideration physiologic age, activity level, expectations, and exact shoulder pathology present. New repair techniques are under development, and preservation of the biceps-labral complex is now preferred when possible.

Cumulative Trauma Disorders↗
PubMed1999

Do repetitive tasks give rise to musculoskeletal disorders?

Repetitive tasks can undoubtedly cause discomfort and pain, but whether they cause or worsen the pathology causing the pain is most uncertain. Research in this area is difficult as the 'work-related upper limb disorders' do not occur exclusively in workers and because there is no simple, reliable and reproducible test for most 'work-related upper limb disorders'. Furthermore many studies are difficult to interpret as they detect disease by the presence of symptoms: one would expect manual workers to complain of more symptoms than sedentary workers and symptom aggravation does not tell one anything about the causation of the underlying pathology.

Arm↗
PubMedDate not supplied

[Repetitive movement of the upper limbs: results of exposure evaluation and clinical investigation in cash register operators in supermarkets].

In order to evaluate the prevalence of joint and periarticular disorders of the upper limbs attributable to repetitive movements (WMSDs), 100 female supermarket cashiers were examined. Their average age was 29.5 years (SD = 6.3), and their average length of service was 3.9 years (SD = 1.9). Only 26% of the women were anamnestically negative for WMSDs, while 74% had one or more disorders due to repetitive trauma of the upper limbs, although a definite diagnosis could be made in only 33 cases. The majority of the disorders affected the right side and the localisation was primarily in the shoulder and wrist. The risk factor analysis on the one hand confirmed that high-frequency repetitive movements of the wrist and hand, associated with inadequate recovery times, do play a role in determining the onset of upper limb and carpal tunnel syndrome. On the other hand, the study also revealed a definite need to review the way the work is organised, so that each shift at the cash register includes suitable functional recovery periods.

Adult↗