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At least 451 records · Page 25Linked to original sources
PubMed2004

Static load repetition is a risk factor in the development of lumbar cumulative musculoskeletal disorder.

STUDY DESIGN: In vivo feline model subjected to variable number of repetitions of a short static lumbar flexion followed by an equally long rest period. OBJECTIVES: The purpose of this study was to determine the influence of the number of repetitions as a risk factor in promoting a cumulative low back disorder in the feline model. SUMMARY OF BACKGROUND DATA: Epidemiologic data point out that the increased number of repetitions of static lumbar loading is a major risk factor in the development of cumulative low back disorder. Biomechanical and physiologic confirmation of the epidemiology is lacking. Recent work demonstrated that repetitive static loading results in accumulation of creep in the lumbar viscoelastic tissues, resulting in a neuromuscular disorder consisting of spasms during loading and hyperexcitability of lumbar muscles during following rest. It was also shown that the load magnitude is a major risk factor. It is hypothesized that increased number of repetitions of static load periods result in increased severity of the resulting neuromuscular disorder. METHODS: Static lumbar flexion of 10 minutes duration followed by 10 minutes rest was repeated three times in one experimental group, six times in the second, and nine times in the third group. In all groups, the creep developing in the lumbar viscoelastic tissues as well as the reflexive EMG from the multifidus were monitored during the flexion/rest periods and throughout a 7-hour recovery period after the repetitions. RESULTS: Creep developed and accumulated during each of the flexion/rest periods in the three experimental protocols, with larger residual creep at the end of the nine repetitions. A residual creep was still present at the end of the 7 hours of recovery allowed in each of the three groups. During the flexion/rest sessions, EMG spasms were present, and the presence of an initial hyperexcitability was detected during the 7 hours of recovery in all the preparations. The presence of a delayed hyperexcitability was revealed only in the group subjected to nine flexion/rest periods, while it was not observed in the groups subjected to three and six flexion/rest repetitions. The statistical analysis (post hoc Fisher test) performed on the normalized integrated EMG and displacement data during the recovery phase showed a significant difference between the nine repetitions group and the other two groups (P < 0.0001). The two-way ANOVA analysis revealed a significant effect of time (P < 0.005) and number of repetitions (P < 0.0001) on all considered parameters. CONCLUSIONS: It was concluded that a cumulative neuromuscular disorder develops because of repetition of static lumbar flexion, and the severity of the disorder provoked is magnified by the number of repetitions. Despite the highly favorable 1:1 work-to-rest ratio and the 7-hour post loading rest period, a full recovery of creep was not obtained in this study.

Animals↗
PubMed1996

Prevalence of musculoskeletal disorders at the wrist as a function of angles, forces, repetitiveness and movement velocities.

OBJECTIVES: The purpose of this investigation was to study the relationship between the prevalence of musculoskeletal disorders at the wrists and the characteristics of the work conditions in terms of angles, forces, repetitiveness, and movement velocities. METHODS: Nine workplaces were selected and the prevalence of wrist disorders was determined by means of a questionnaire for both arms separately, along with characteristics of the 335 subjects (age, weight, height, seniority). A work analysis was performed on subjects selected at random from each workplace by recording, for both wrists during a representative number of work cycles, the angles both in radial and ulnar deviations and in flexion-extension and the surface electromyogram on the hand flexors of the forearm. Repetitiveness (defined as the number of transitions per minute) and movement velocities (in deviation and flexion-extension) were derived from the recordings of the angles. RESULTS: All the derived variables were highly correlated, greater angles and greater forces being associated with greater velocities and higher repetitiveness. A multivariate linear regression model for the prediction of the prevalence of musculoskeletal disorders of the wrist was constructed (R = 0.904). Height, weight, seniority, angles in radial-ulnar deviation, and forces were significant and independent predictors of the prevalence. CONCLUSIONS: The prevalence of wrist disorders is significantly linked to wrist angles in deviation and to forces exerted. Due to their high correlation with force, the repetitiveness indices and velocities, as defined, do not appear to play an additional role. Further research is needed to find alternative ways of characterizing repetitiveness.

Adult↗
PubMed1990

[Specific character of movement disorders in children studying string instruments].

Orthopaedic examinations were carried out in 242 children studying string instruments. Various indispositions and deformations of the motor organs were found in 31 children. It has been demonstrated that they were mainly the result of technical errors in holding of the instrument, which caused overloading of the upper extremities and the spine.

Arm↗
PubMed2006

The role of imaging of work-related upper extremity disorders.

Work-related upper extremity disorders can pose a diagnostic and management challenge because the nontraumatic disorders that are often believed to be caused by repetitive work activities can and do occur without any apparent provoking activity and can be caused or associated with many systemic medical conditions. One mainstay in the assessment of hand and arm disorders remains imaging. Imaging capabilities have made incredible advances with the advent of MRI, CT, ultrasound, bone scan, and numerous technologies that enable clinicians to view fine details of anatomy and pathology. This article reviews the potential imaging choices and clinical indications for work-related injuries of the elbow, hand, and wrist.

Arm Injuries↗
PubMedDate not supplied

Repetitive strain injury in computer keyboard users: pathomechanics and treatment principles in individual and group intervention.

Computer users experience high rates of injury and disability, broadly termed repetitive strain injury (RSI). With more than 60 million Americans using computers in offices and homes, the potential magnitude of the RSI problem indicates a need for increased attention to prevention and treatment. The purpose of this article is to: 1) present a conceptual model of RSI as a kinetic-chain, multifactorial disorder; 2) outline the salient features of the clinical evaluation of the RSI patient; 3) describe the role of postural deviation in the pathogenesis of RSI; 4) present the principles of individual manual therapy; and 5) discuss the rationale, admission criteria, educational principles, and outcome of a multidisciplinary group intervention.

Biomechanical Phenomena↗
PubMedDate not supplied

[Repetitive movements of the upper extremities: the results of assessing exposure to biomechanical overload and of a clinical study in a group of workers employed in the production of plywood and veneer panels].

In a group of 27 female workers employed on the manual "moulding" of plywood panels exposure to factors of biomechanical overload for the upper limbs was assessed and an anamnestic and clinical examination was made in order to clarify the occurrence of a series of WMSDs type diseases and disorders. Data are reported on the risk factors, frequency of action (range: right limb-->14.5 divided by 22.0 actions/min,-->5.5 divided by 11.0 actions/min), use of strength (right limb-->Borg 3.7-4.9; left limb-->Borg 3.0-3.8), incongruous postures and movements, complementary factors, and on the lack of recovery pauses (4 hours in an 8-hour shift). The OCRA indices were: single press: right limb-->146-208; left limb-->61-85; multi press: right limb-->4.8-7.1; left limb-->1.1-2.3. The EPM method showed that the factors producing greatest overloading were excessive use of strength, incongruous postures and movements (specially of wrist, hand and elbow) and of complementary factors like constant compression of the palm of the right hand, tearing movements and the use of gloves. Clinical examination according to EPM showed that tendon disorders (69% of which 34% were carpal tunnel syndrome) were the most frequent disorders followed by epicondylosis (23%); disorders of the shoulder were less frequent (8%). In view of the clear significance of the statistical data of these disorders which were proved to be caused by current work organization (Fisher test was highly significant for 65% and significant for 75% of the disorders), further diagnostic and therapeutic investigations for each single female worker are necessary along with specific interventions to improve working conditions. Among the possible prevention measures the need is stressed for improvements on tools, on job organization, and for an adequate information and training program for all workers.

Adolescent↗
PubMed2001

Back disorders (low back pain, cervicobrachial and lumbosacral radicular syndromes) and some related risk factors.

UNLABELLED: The AIM of this study was to estimate the prevalence rates of low back pain (LBP), cervicobrachial and lumbosacral radicular syndromes (CBR and LSRS) in workers from a fertilizer plant and also to analyze the impact of several important work-related and non-occupational risk factors. SUBJECTS of this comprehensive cross-sectional study were 898 workers and employees from the four main departments of the plant. The following complex of methods was applied: neurologic history, complete neurologic status and statistical method. RESULTS: Age is the first risk factor, discussed by authors. The data showed highly significant differences in the prevalence of CBS-16.2% in the risk group vs. 10.0% in the referent group (OR 1.73, 95% CI 1.14-2.63); LBP-25.8% vs. 17.0% (OR 1.70, 95% CI 1.21-2.38) and LSRS-16.0% vs. 5.8% (OR 3.09, 95% CI 1.89-5.08). Gender is the second risk factor strongly related to LBP, CBS and LSRS. The prevalence of radicular syndromes is higher for women that for men: OR for CBS is 3.27 and 1.93 for LSRS. There is an interesting trend in the case of combined impact of age and gender among men and women of 40 or under and over 40--the risk, estimated by OR, is higher. In men over 40, overweight, obesity and heaviness of smoking, estimated by duration of smoking and daily cigarette consumption (more than 20 years and more than 20 cigarettes per day), increase the risk of developing back disorders (BD). At this stage of the research, there is no proof of the impact of hypercholesterolemia, non-occupational or work-related strain on the development of BD. The authors' CONCLUSION is that these results may support programs for health promotion and health prevention.

Adult↗
PubMed2002

Ankle impingement syndromes.

The term "ankle impingement" encompasses a broad range of conditions that are typically post-traumatic and often chronic. Various forms of mechanical impingement can result from synovial proliferation, bone spur formation, or ligamentous scarring and hypertrophy. Since symptoms and physical findings can mimic a variety of disorders, accurate diagnosis may remain elusive, and proper effective therapy may be delayed. The objective of this article is to define and elucidate the etiology of the various forms of ankle impingement, clarify the range of associated osseous and soft-tissue pathology, and describe the imaging features and therapeutic options.

Ankle Injuries↗
PubMedDate not supplied

[Physiopathology of repetitive movements and vibrations of the hand-arm system].

This paper is a review of some recent findings in physiopathology of work related upper limb disorders and hand-arm-vibration-syndrome (HAVS). In a first section the data relative to work related upper limb musculoskeletal disorders are collected in three groups referring respectively to the muscle, to the tendon and to the peripheral nerve. Furthermore the physiopathological data are analyzed with respect to the Strain Index proposed by Moore and Garg. In a second section the physiopathological mechanisms of HAVS are summarized.

Arm↗
PubMed1996

Compressive neuropathies and tendinopathies in the athletic elbow and wrist.

Overuse syndromes of the upper extremity in the athletic population are a common and often difficult problem for physician and patient alike. Optimal function of the upper extremity is tied intimately to success in many sporting activities. Correct diagnosis and proper care require a thorough knowledge of the pertinent anatomy, pathophysiology, and pathomechanics involved in each disorder. Conservative care with rest, activity modification, and medication is adequate for most athletic injuries. Surgical intervention may be indicated for continuing pain, decreased performance, or to prevent chronic changes. Surgery must be followed by thoughtfully prepared training and rehabilitation programs to optimize the chances of a successful outcome.

Athletic Injuries↗
PubMed2003

Median nerve trauma in a rat model of work-related musculoskeletal disorder.

Anatomical and physiological changes were evaluated in the median nerves of rats trained to perform repetitive reaching. Motor degradation was evident after 4 weeks. ED1-immunoreactive macrophages were seen in the transcarpal region of the median nerve of both forelimbs by 5-6 weeks. Fibrosis, characterized by increased immunoexpression of collagen type I by 8 weeks and connective tissue growth factor by 12 weeks, was evident. The conduction velocity (NCV) within the carpal tunnel showed a modest but significant decline after 9-12 weeks. The lowest NCV values were found in animals that refused to participate in the task for the full time available. Thus, both anatomical and physiological signs of progressive tissue damage were present in this model. These results, together with other recent findings indicate that work-related carpal tunnel syndrome develops through mechanisms that include injury, inflammation, fibrosis and subsequent nerve compression.

Animals↗
PubMed1994

Musculoskeletal disorders in operators of visual display terminals.

Musculoskeletal disorders of the hands and arms are common among operators of visual display units. They are usually associated with poorly designed workplaces and with psychological factors. With a view to preventive action a multidisciplinary approach is needed in order to arrive at improved methods for identifying and evaluating health problems related to the use of visual display units.

Computer Terminals↗
PubMedDate not supplied

Ergonomic considerations and job design in upper extremity disorders.

This chapter has outlined some of the outcomes of poor job design, identified and defined risk factors associated with poor job design, and presented a brief overview of a layman's approach to job analysis. With this information, persons interested in fixing jobs that have ergonomically poor designs can begin to develop a working understanding of the problem, what caused it, and considerations regarding its solution.

Arm Injuries↗
PubMed1998

Risk factors for upper limb disorders. Implications for prevention and treatment.

Epidemiologic studies have revealed several associations between physical work load factors and some common upper limb disorders. In the treatment of a case of work related upper limb disorder, modifications of work that are feasible to be implemented in the field should be done as a first priority. Some case studies suggest notable effects of ergonomic measures on the occurrence of upper limb disorders. Economic analyses of individual workplace have indicated that the investments usually have a short payback period. In work related carpal tunnel syndrome, the physical demands of the job, especially the force demands of gripping, should be considered before deciding on surgery, because gripping force may return slowly after surgery, and may be compromised by the surgical procedure itself.

Arm Injuries↗
PubMed2005

Hard work never hurt anyone--or did it? A review of occupational associations with soft tissue musculoskeletal disorders of the neck and upper limb.

Pain in the neck and upper limb is common and contributes greatly to absence due to sickness. Evidence is accumulating that factors such as prolonged abnormal posture and repetition contribute to these conditions. Psychosocial factors may also play a part and the relative importance of these is not yet known. Primary and secondary prevention trials are needed.

Carpal Tunnel Syndrome↗
PubMedDate not supplied

[Diseases caused by repetitive trauma of the upper limbs: epidemiology, diagnosis, prevention. Epidemiological aspects].

The association between occupational risk factors and musculo-skeletal disorders due to biomechanical overload (WMSDs) has been focused on numerous research projects, ranging from those simple observing the different pathological findings reported among workers performing particular tasks, down to the latest studies actually quantifying the exposure of workers to basic risk factors, as force, awkward posture, repetition and to modifying factors as duration, intensity, temporal profile and cold temperatures. The critical review of the epidemiological studies, taking into account their quality, showed a clear relationship between basic and modifying risk factors and upper limb pathologies. In particular, force exertion has been shown strongly related to neck, elbow and hand-wrist pathologies; repetition showed some convincing evidence of causal relationship to neck, shoulder and hand-wrist pathologies. Insufficient evidence of work relatedness has been shown between both repetition and awkward posture and elbow pathologies.

Animals↗
PubMed1995

Screening of vibration-induced disorders in the building industry using digital tactilometry. Results of a field study.

As occupational physicians in the building industry, we observed among these workers a high frequency of vibration exposure, during different tasks. We intended to study vibration exposure effects on vibration perception thresholds measured by digital tactilometry in this population of construction workers. A cross-sectional field study was made, 405 subjects were examined; each of them answered a questionnaire, underwent a medical examination and performed a test measuring his vibration perception thresholds, 150 subjects constituted the reference group. A close relationship between age and thresholds among the non-exposed group was observed. A threshold normalization of age of study the 204 exposed subjects was applied. Two exposure indices allowing time dependency vibration exposure analysis were defined the present daily exposure and cumulated exposure. In the examined population, thresholds rise with the present daily exposure in hours per day for 125 Hertz, while no significant influence of cumulated exposure is apparent. It was also pointed out that subjects exposed more than one and a half hour per day have higher thresholds than reference subjects, even if they do not have any clinical neurological complaints. This results seems to indicate the infraclinical feature of the test. These results suggest that screening of hand-arm vibration exposed population should be developed using this method. As occupational physicians in the construction industry, practising in Paris and surrounding areas, the authors studied the relationship between neurological disorders measured by vibrotactile perception thresholds, and hand-arm vibration exposure, among workers. They present the results of a field study they led within their institute, in collaboration with the tested workers' firms, and with the financial participation of the French Ministry of Labour.

Adult↗
PubMedDate not supplied

Differential diagnosis in patients with disorders of the patellofemoral joint.

Anterior knee complaints are difficult diagnostic problems. It cannot be overstated that the most important information available is to be found in the patient's history. Onset, quality, and quantity of symptoms must be assessed. This information is then synthesized to determine the specific functional disabilities resulting from the patient's anterior knee disorder. Once a history is obtained, a consistent, methodical physical examination can be performed to narrow the differential diagnosis. Radiographic evaluation is used to further hone the differential or to confirm the most likely diagnosis. Ultimately, a specific working diagnosis is selected and treatment is tailored to changing the underlying structural or biomechanical abnormalities that led to the patient's complaints.

Cumulative Trauma Disorders↗