Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 103
Filtrar
Más filtros

Banco de datos
Tipo del documento
Intervalo de año de publicación
1.
J Head Trauma Rehabil ; 38(1): E79-E87, 2023.
Artículo en Inglés | MEDLINE | ID: mdl-35617655

RESUMEN

OBJECTIVE: The Buffalo Concussion Treadmill Test (BCTT) was developed to identify potential physiological system impairment (PSI) underlying persistent symptoms post-mild traumatic brain injury (mTBI). This study evaluates PSI in individuals 4 weeks to 6 months post-mTBI using the BCTT "failure" criteria, and additional exploratory measures of test duration and heart rate (HR) response. SETTING: Tertiary hospital and university. PARTICIPANTS: Participants included 73 individuals 4 weeks to 6 months post-mTBI and a comparison group of 39 healthy controls (HCs). The mTBI group was further subgrouped at screening into those considering themselves asymptomatic (Asymp mTBI) ( n = 35) or symptomatic (Symp mTBI) ( n = 36). DESIGN: Observational cohort study. MAIN MEASURES: BCTT; failure rate (%), test duration (minutes), HR responses. RESULTS: : Thirty percent of the mTBI group (including 50% of the Symp and 9% of the Asymp subgroups) failed the BCTT. BCTT duration and associated overall HR change was significantly lower in the mTBI group and Symp subgroup compared with HCs. Compared with HCs maximal HR percentage was higher for the first 4 minutes of the test in the mTBI group, and for the first 2 minutes of the test for the Symp subgroup. CONCLUSIONS: Individuals post-mTBI demonstrated PSI impairment subacutely. In some individuals this was despite an initially reported absence of symptoms. The study also showed some preliminary evidence that BCTT duration and HR responses may be additionally informative post-mTBI.


Asunto(s)
Conmoción Encefálica , Humanos , Conmoción Encefálica/diagnóstico , Estudios de Cohortes , Prueba de Esfuerzo
2.
Occup Environ Med ; 2022 Sep 26.
Artículo en Inglés | MEDLINE | ID: mdl-36163159

RESUMEN

OBJECTIVES: To determine the impact of a 12-week ergonomic/exercise programme compared with an ergonomic/health education programme on the development of neck pain in office workers over 12 months. METHODS: This cluster-randomised trial prospectively recruited office workers from public and private organisations. Only non-neck pain cases at baseline were included (n=484). All participants received an ergonomic workstation review then randomly allocated to receive a neck/shoulder progressive exercise programme (20 min, 3 ×/week; intervention group) or health education sessions (60 min, 1 ×/week; active control) for 12 weeks. Generalised estimating equations evaluated group differences in the point prevalence of neck pain cases (defined as those with a neck pain score of ≥3 on a 0 (no pain) to 9 (worst pain) scale) over time (3, 6, 9 and 12 months) with cumulative incidence of neck pain cases evaluated descriptively. RESULTS: While no significant group × time interaction was evident, the 12-month point prevalence of neck pain cases in the intervention group (10%) was half that of the active control group (20%) (adjusted OR 0.46, 95% CI 0.21 to 1.01, p=0.05). Lower cumulative incidence of neck pain cases was observed in the intervention (17%) compared with active control group (30%) over the 12 months. CONCLUSIONS: A combined ergonomics and exercise intervention may have more benefits in preventing neck pain cases in office workers than an ergonomic and health education intervention. Group differences were modest and should be interpreted with caution when considering strategies for primary prevention of neck pain in the office worker population. TRIAL REGISTRATION: ACTRN12612001154897.

3.
Arch Phys Med Rehabil ; 103(5): 921-928, 2022 05.
Artículo en Inglés | MEDLINE | ID: mdl-34861233

RESUMEN

OBJECTIVE: To identify whether adults 4 weeks to 6 months post mild traumatic brain injury (mTBI) have sensorimotor impairments compared with controls without mTBI. A secondary aim was to determine if impairments were evident irrespective of participant perceived absence of symptoms. DESIGN: Observational cohort study. SETTING: Tertiary university and hospital. PARTICIPANTS: Participants included 113 individuals (N=113) aged 18-60 years, consisting of 39 controls with no prior concussion history and 74 individuals 4 weeks to 6 months post mTBI, of which 35 considered themselves asymptomatic (ASYMP) and 37 symptomatic (SYMP). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Assessments of oculomotor, vestibulo-ocular reflex (VOR) control, balance, single- and dual-task tandem walk, and vestibular positional testing. RESULTS: Poorer balance and tandem walk performance as well as a higher frequency of positive oculomotor, VOR, and vestibular positional tests were evident in the mTBI group compared with controls. In particular ≥2 positive oculomotor findings were evident in 53.7% of the participants with mTBI compared with 10.8 % of controls. The mTBI group who considered themselves recovered (ASYMP) demonstrated significantly increased dual-task tandem walk time, and a higher proportion 53% had ≥2 positive oculomotor tests compared with controls. CONCLUSIONS: Persistent sensorimotor impairments, particularly evidenced by disturbed oculomotor function and deficits in dual-task tandem walking were identified among adults 4 weeks to 6 months post mTBI. These disturbances were evident regardless of whether ongoing symptoms were reported. The findings support recommendations for routine clinical assessment of sensorimotor function post mTBI with implications for injury prevention.


Asunto(s)
Conmoción Encefálica , Adulto , Estudios de Cohortes , Movimientos Oculares , Humanos , Estudios Longitudinales , Caminata
4.
BMC Musculoskelet Disord ; 22(1): 68, 2021 Jan 12.
Artículo en Inglés | MEDLINE | ID: mdl-33435941

RESUMEN

BACKGROUND: Neck pain is prevalent among office workers. This study evaluated the impact of an ergonomic and exercise training (EET) intervention and an ergonomic and health promotion (EHP) intervention on neck pain intensity among the All Workers and a subgroup of Neck Pain cases at baseline. METHODS: A 12-month cluster-randomized trial was conducted in 14 public and private organisations. Office workers aged ≥18 years working ≥30 h per week (n = 740) received an individualised workstation ergonomic intervention, followed by 1:1 allocation to the EET group (neck-specific exercise training), or the EHP group (health promotion) for 12 weeks. Neck pain intensity (scale: 0-9) was recorded at baseline, 12 weeks, and 12 months. Participants with data at these three time points were included for analysis (n = 367). Intervention group differences were analysed using generalized estimating equation models on an intention-to-treat basis and adjusted for potential confounders. Subgroup analysis was performed on neck cases reporting pain ≥3 at baseline (n = 96). RESULTS: The EET group demonstrated significantly greater reductions in neck pain intensity at 12 weeks compared to the EHP group for All Workers (EET: ß = - 0.53 points 95% CI: - 0.84- - 0.22 [36%] and EHP: ß = - 0.17 points 95% CI: - 0.47-0.13 [10.5%], p-value = 0.02) and the Neck Cases (EET: ß = - 2.32 points 95% CI: - 3.09- - 1.56 [53%] and EHP: ß = - 1.75 points 95% CI: - 2.35- - 1.16 [36%], p = 0.04). Reductions in pain intensity were not maintained at 12 months with no between-group differences observed in All Workers (EET: ß = - 0.18, 95% CI: - 0.53-0.16 and EHP: ß = - 0.14 points 95% CI: - 0.49-0.21, p = 0.53) or Neck Cases, although in both groups an overall reduction was found (EET: ß = - 1.61 points 95% CI: - 2.36- - 0.89 and EHP: ß = - 1.9 points 95% CI: - 2.59- - 1.20, p = 0.26). CONCLUSION: EET was more effective than EHP in reducing neck pain intensity in All Workers and Neck Cases immediately following the intervention period (12 weeks) but not at 12 months, with changes at 12 weeks reaching clinically meaningful thresholds for the Neck Cases. Findings suggest the need for continuation of exercise to maintain benefits in the longer term. CLINICAL TRIAL REGISTRATION: hACTRN12612001154897 Date of Registration: 31/10/2012.


Asunto(s)
Dolor de Cuello , Lugar de Trabajo , Adolescente , Adulto , Ergonomía , Terapia por Ejercicio , Promoción de la Salud , Humanos , Dolor de Cuello/diagnóstico , Dolor de Cuello/epidemiología , Dolor de Cuello/prevención & control
5.
Hum Factors ; 63(4): 663-683, 2021 06.
Artículo en Inglés | MEDLINE | ID: mdl-32119582

RESUMEN

OBJECTIVE: To identify risk factors for the development of interfering neck pain in office workers including an examination of the interaction effects between potential risk factors. BACKGROUND: The 1-year incidence of neck pain in office workers is reported as the highest of all occupations. Identifying risk factors for the development of neck pain in office workers is therefore a priority to direct prevention strategies. METHODS: Participants included 214 office workers without neck pain from two cultures. A battery of measures evaluating potential individual and workplace risk factors were administered at baseline, and the incidence of interfering neck pain assessed monthly for 12 months. Survival analysis was used to identify relationships between risk factors and the development of interfering neck pain. RESULTS: One-year incidence was 1.93 (95% CI [1.41, 2.64]) per 100 person months. Factors increasing the risk of developing interfering neck pain were older age, female gender, increased sitting hours, higher job strain, and stress. A neutral thorax sitting posture, greater cervical range of motion and muscle endurance, and higher physical activity were associated with a decreased risk of neck pain. The effects of some risk factors on the development of neck pain were moderated by the workers' coping resources. CONCLUSION: Multiple risk factors and interactions may explain the development of neck pain in office workers. Therefore, plans for preventing the development of interfering neck pain in office workers should consider multiple individual and work-related factors with some factors being potentially more modifiable than others.


Asunto(s)
Dolor de Cuello , Enfermedades Profesionales , Femenino , Humanos , Dolor de Cuello/epidemiología , Enfermedades Profesionales/prevención & control , Ocupaciones , Rango del Movimiento Articular/fisiología , Factores de Riesgo
6.
BMC Public Health ; 20(1): 180, 2020 Feb 04.
Artículo en Inglés | MEDLINE | ID: mdl-32019559

RESUMEN

BACKGROUND: This study uses the RE-AIM framework to provide a process evaluation of a workplace-based cluster randomised trial comparing an ergonomic plus exercise intervention to an ergonomic plus health promotion intervention; and to highlight variations across organisations; and consider the implications of the findings for intervention translation. METHOD: This study applied the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) methodology to examine the interventions' implementation and to explore the extent to which differences between participating organisations contributed to the variations in findings. Qualitative and quantitative data collected from individual participants, research team observations and organisations were interrogated to report on the five RE-AIM domains. RESULTS: Overall reach was 22.7% but varied across organisations (range 9 to 83%). Participants were generally representative of the recruitment pool though more females (n = 452 or 59%) were recruited than were in the pool (49%). Effectiveness measures (health-related productivity loss and neck pain) varied across all organisations, with no clear pattern emerging to indicate the source of the variation. Organisation-level adoption (66%) and staffing level adoption (91%) were high. The interventions were implemented with minimal protocol variations and high staffing consistency, but organisations varied in their provision of resources (e.g. training space, seniority of liaisons). Mean adherence of participants to the EET intervention was 56% during the intervention period, but varied from 41 to 71% across organisations. At 12 months, 15% of participants reported regular EET adherence. Overall mean (SD) adherence to EHP was 56% (29%) across organisations during the intervention period (range 28 to 77%), with 62% of participants reporting regular adherence at 12 months. No organisations continued the interventions after the follow-up period. CONCLUSION: Although the study protocol was implemented with high consistency and fidelity, variations in four domains (reach, effectiveness, adoption and implementation) arose between the 14 participating organisations. These variations may be the source of mixed effectiveness across organisations. Factors known to increase the success of workplace interventions, such as strong management support, a visible commitment to employee wellbeing and participant engagement in intervention design should be considered and adequately measured for future interventions. TRIAL REGISTRATION: ACTRN12612001154897; 29 October 2012.


Asunto(s)
Ejercicio Físico , Promoción de la Salud/métodos , Salud Laboral , Evaluación de Procesos, Atención de Salud , Adulto , Eficiencia , Ergonomía , Femenino , Humanos , Masculino , Dolor de Cuello/prevención & control , Evaluación de Programas y Proyectos de Salud
7.
BMC Musculoskelet Disord ; 21(1): 807, 2020 Dec 03.
Artículo en Inglés | MEDLINE | ID: mdl-33272228

RESUMEN

BACKGROUND: Non-surgical multidisciplinary management is often the first pathway of care for patients with chronic low back pain (LBP). This study explores if patient characteristics recorded at the initial service examination have an association with a poor response to this pathway of care in an advanced practice physiotherapist-led tertiary service. METHODS: Two hundred and forty nine patients undergoing non-surgical multidisciplinary management for their LBP across 8 tertiary public hospitals in Queensland, Australia participated in this prospective longitudinal study. Generalised linear models (logistic family) examined the relationship between patient characteristics and a poor response at 6 months follow-up using a Global Rating of Change measure. RESULTS: Overall 79 of the 178 (44%) patients completing the Global Rating of Change measure (28.5% loss to follow-up) reported a poor outcome. Patient characteristics retained in the final model associated with a poor response included lower Formal Education Level (ie did not complete school) (Odds Ratio (OR (95% confidence interval)) (2.67 (1.17-6.09), p = 0.02) and higher self-reported back disability (measured with the Oswestry Disability Index) (OR 1.33 (1.01-1.77) per 10/100 point score increase, p = 0.046). CONCLUSIONS: A low level of formal education and high level of self-reported back disability may be associated with a poor response to non-surgical multidisciplinary management of LBP in tertiary care. Patients with these characteristics may need greater assistance with regard to their comprehension of health information, and judicious monitoring of their response to facilitate timely alternative care if no benefits are attained.


Asunto(s)
Dolor de la Región Lumbar , Fisioterapeutas , Australia/epidemiología , Evaluación de la Discapacidad , Humanos , Estudios Longitudinales , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/epidemiología , Dolor de la Región Lumbar/terapia , Dimensión del Dolor , Estudios Prospectivos
8.
J Manipulative Physiol Ther ; 43(4): 284-293, 2020 05.
Artículo en Inglés | MEDLINE | ID: mdl-32951686

RESUMEN

OBJECTIVES: Speckle tracking analysis (STA) of ultrasound (US) images quantifies the longitudinal deformation of a region of muscle tissue to provide a mechanical measure of muscle activity. As the validity and reliability of this method has not yet been adequately assessed, the aim of this study was to determine the validity and reliability of STA in the dorsal neck muscles during isometric neck extension contractions. METHODS: Twenty volunteers performed 3 repetitions of isometric neck extension in a dynamometer at 10%, 20%, 40%, 60%, and 80% of maximal voluntary torque while US and surface electromyography (EMG) data were recorded. Speckle tracking analysis was then used to calculate measurements of muscle deformation. The relationship among torque, muscle deformation (separate for each muscle and summed), and EMG was evaluated using linear regressions and Spearman's correlation coefficients. The reliability of EMG and muscle deformation was determined using intraclass correlation coefficients (ICCs). RESULTS: Muscle deformation in 4 of the 5 muscles when examined separately and collectively was significantly related to torque (P < .05); however, the relationship was weak (r2 = 0.03-0.18). In contrast, a strong linear relationship was observed between torque and EMG (P < .001, r2 = 0.83). Poor to moderate reliability of muscle deformation measures (ICC: 0.02-0.69) was found compared with EMG, which was highly reliable (ICC: 0.67-0.90). CONCLUSION: These results suggest that the validity of US STA measurements for isometric contractions of the dorsal neck muscles is questionable. Further investigation into this method is required before it can be used as a tool to measure muscle activity.


Asunto(s)
Electromiografía/métodos , Contracción Isométrica/fisiología , Fuerza Muscular/fisiología , Músculo Esquelético/fisiología , Rango del Movimiento Articular/fisiología , Torque , Adulto , Femenino , Humanos , Masculino , Músculos del Cuello , Músculos Pectorales/fisiología , Esfuerzo Físico/fisiología , Reproducibilidad de los Resultados , Ultrasonografía
9.
Hum Factors ; 61(7): 1141-1161, 2019 11.
Artículo en Inglés | MEDLINE | ID: mdl-30730777

RESUMEN

OBJECTIVE: In this study, the reliability of measures of upper body postural behavior (head, thorax, neck, and arm) during sustained office work was evaluated. BACKGROUND: Although there has been a substantial body of research examining the technical aspects of posture measurement in office workers using motion sensors, there is a paucity of literature examining whether posture-related behaviors are actually consistent among office workers in the field on different days and times. METHOD: Thirty one office workers performed their usual work for three, 1-hr sessions (two morning sessions and one afternoon session) while wearing wireless motion sensors. Reliability coefficients of the derived measures of postural behavior were calculated. RESULTS: Most (30/31) of the postural behavior measures demonstrated modest to excellent reliability (ICC 2.1: 0.48-0.84). Reliability appeared to be mildly affected by factors such as the time of day recordings were taken and variations in desk setups. CONCLUSION: The findings suggest these measures may be a reliable method for evaluating postural behavior in the office work environment in future studies. APPLICATION: Postural measurement using a technical motion sensor described an acceptable reliability to be used for risk assessment in the workplace. Consideration of assessment time and desk setting would increase the accuracy of postural measurement.


Asunto(s)
Ergonomía , Sedestación , Dispositivos Electrónicos Vestibles , Adulto , Ergonomía/instrumentación , Ergonomía/métodos , Ergonomía/normas , Femenino , Humanos , Masculino , Persona de Mediana Edad , Salud Laboral , Reproducibilidad de los Resultados , Lugar de Trabajo , Adulto Joven
10.
J Appl Biomech ; 35(3): 209-215, 2019 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-30860406

RESUMEN

Isometric strength and endurance performance of cervical flexor and extensor muscles were compared in women with (n = 30) and without (n = 30) idiopathic neck pain at the craniocervical and cervicothoracic axes. Strength and endurance time (time to task failure in seconds) at 50% maximal voluntary contraction were recorded in 4 directions (craniocervical flexion/extension and cervicothoracic flexion/extension) and 6 strength and endurance ratios were calculated. Participants in both groups were matched for body mass index. The idiopathic neck pain group demonstrated significantly less strength for the cervicothoracic flexors and extensors (1.58-4.7 N·m [12.4%-17.9%] less, P < .04) and significantly less endurance time for the cervicothoracic and craniocervical flexors (10.77-10.9 s [23.3%-27.5%] less, P < .03). The cervicothoracic extension to craniocervical flexion strength ratio was also lower in the idiopathic neck pain group (P = .01); however, no other strength or endurance ratio was significantly different between groups. This exploratory study suggests assessing specific performance parameters accounting for regional muscular differences in the upper and lower neck is potentially informative to understanding impairments in neck pain conditions, particularly as impairments may not be uniform across muscle groups.


Asunto(s)
Fuerza Muscular/fisiología , Músculos del Cuello/fisiopatología , Dolor de Cuello/fisiopatología , Resistencia Física/fisiología , Adulto , Evaluación de la Discapacidad , Femenino , Humanos , Dinamómetro de Fuerza Muscular , Torque
11.
BMC Musculoskelet Disord ; 19(1): 348, 2018 Sep 27.
Artículo en Inglés | MEDLINE | ID: mdl-30261861

RESUMEN

BACKGROUND: To explore patient characteristics predictive of a poor response to multidisciplinary non-surgical rehabilitation of three common orthopaedic conditions within a tertiary care service. METHODS: A retrospective audit of medical records of patients who had undergone multidisciplinary non-surgical management of their knee osteoarthritis (KOA, n = 190), shoulder impingement syndrome (SIS, n = 199), or low back pain (LBP, n = 242) within a multisite tertiary care service was undertaken. Standardised clinical measures recorded by the service at the initial consultation were examined using a base binary logistic regression model to determine their relationship with a poor response to management (ie. not achieving a minimal clinically important improvement in the condition disability measure pre-post management). RESULTS: Factors predictive of a poor response following non-surgical management included;; higher levels of anxiety (OR 1.11, P < 0.02) and lower functional score (OR 0.76, P < 0.04) for KOA, higher number of comorbidities (OR 1.16, P < 0.03) for SIS, and coexisting cervical or thorax pain (OR 2.1, P = 0.04) and lower pain self-efficacy (OR 0.98, P = 0.02) for LBP. CONCLUSIONS: General health issues may present a barrier to achieving favourable outcomes in response to multidisciplinary non-surgical rehabilitation for the management of common orthopaedic conditions in a tertiary care setting. Clinicians may need to consider these broader patient issues when designing management strategies for patients with these conditions.


Asunto(s)
Ansiedad/epidemiología , Dolor de la Región Lumbar/rehabilitación , Osteoartritis de la Rodilla/rehabilitación , Síndrome de Abducción Dolorosa del Hombro/rehabilitación , Atención Terciaria de Salud/métodos , Adulto , Anciano , Ansiedad/psicología , Evaluación de la Discapacidad , Femenino , Humanos , Dolor de la Región Lumbar/psicología , Masculino , Persona de Mediana Edad , Osteoartritis de la Rodilla/psicología , Dimensión del Dolor , Planificación de Atención al Paciente , Grupo de Atención al Paciente , Estudios Retrospectivos , Autoeficacia , Síndrome de Abducción Dolorosa del Hombro/psicología , Resultado del Tratamiento
12.
Aust Health Rev ; 42(3): 334-339, 2018 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28501050

RESUMEN

Objective The aim of the present study was to determine the rates of re-referral to specialist out-patient clinics for patients previously managed and discharged from an advanced practice physiotherapy-led service in three metropolitan hospitals. Methods A retrospective audit was undertaken of 462 patient cases with non-urgent musculoskeletal conditions discharged between 1 April 2014 and 30 March 2015 from three metropolitan hospitals. These patients had been discharged from the physiotherapy-led service without requiring specialist medical review. Rates and patterns of re-referral to specialist orthopaedic, neurosurgical, chronic pain, or rheumatology services within 12 months of discharge were investigated. Results Forty-six of the 462 patients (10.0%) who were managed by the physiotherapy-led service were re-referred to specialist medical orthopaedic, neurosurgical, chronic pain or rheumatology departments within 12 months of discharge. Only 22 of these patients (4.8%) were re-referred for the same condition as managed previously and discharged. Conclusions Ninety-five per cent of patients with non-urgent musculoskeletal conditions managed by an advanced practice physiotherapy-led service at three metropolitan hospitals did not re-present to access public specialist medical services for the same condition within 12 months of discharge. This is the first time that re-presentation rates have been reported for patients managed in advanced practice physiotherapy services and the findings support the effectiveness of these models of care in managing demand for speciality out-patient services. What is known about the topic? Advanced practice physiotherapy-led services have been implemented to address the needs of patients referred with non-urgent musculoskeletal conditions to hospital specialist out-patient services. Although this model is widely used in Australia, there has been very little information about whether patients managed in these services subsequently re-present for further specialist medical care. What does this paper add? This paper identifies that the majority (95%) of patients managed by an advanced practice physiotherapy-led service did not re-present for further medical care for the same condition within 12 months of discharge. What are the implications for practitioners? This paper supports the use of advanced practice physiotherapy-led services in the management of overburdened neurosurgical and orthopaedic specialist out-patient waiting lists.


Asunto(s)
Enfermedades Musculoesqueléticas/terapia , Fisioterapeutas , Derivación y Consulta/estadística & datos numéricos , Especialización/estadística & datos numéricos , Adulto , Anciano , Instituciones de Atención Ambulatoria , Auditoría Clínica , Femenino , Hospitales Urbanos , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Musculoesqueléticas/epidemiología , Alta del Paciente , Fisioterapeutas/estadística & datos numéricos , Queensland/epidemiología , Estudios Retrospectivos
13.
Int Arch Occup Environ Health ; 90(5): 373-410, 2017 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-28224291

RESUMEN

INTRODUCTION: Identifying risk factors associated with the development of work-related neck pain in office workers is necessary to facilitate the development of prevention strategies that aim to minimise this prevalent and costly health problem. The aim of this systematic review is to identify individual worker (e.g., lifestyle activity, muscular strength, and posture) and workplace (e.g., ergonomics and work environment) physical factors associated with the development of non-specific neck pain in office workers. METHODS: Studies from 1980 to 2016 were identified by an electronic search of Pubmed, CINAHL, EMBASE, Psychlnfo and Proquest databases. Two authors independently screened search results, extracted data, and assessed risk of bias using the epidemiological appraisal instrument (EAI). A random effect model was used to estimate the risk of physical factors for neck pain. RESULTS: Twenty papers described the findings of ten prospective cohort studies and two randomized controlled trials. Low satisfaction with the workplace environment (pooled RR 1.28; CI 1.07-1.55), keyboard position close to the body [pooled RR 1.46; (CI 1.07-1.99)], low work task variation [RR 1.27; CI (1.08-1.50)] and self-perceived medium/high muscular tension (pooled RR 2.75/1.82; CI 1.60 /1.14-4.72/2.90) were found to be risk factors for the development of neck pain. CONCLUSIONS: This review found evidence for a few number of physical risk factors for the development of neck pain, however, there was also either limited or conflicting factors. Recommendations for future studies evaluating risk factors are reported and how these may contribute to the prevention of neck pain in office workers.


Asunto(s)
Dolor de Cuello/etiología , Enfermedades Profesionales/etiología , Lugar de Trabajo/psicología , Ergonomía , Humanos , Satisfacción en el Trabajo , Dolor de Cuello/prevención & control , Enfermedades Profesionales/prevención & control , Ocupaciones , Postura , Ensayos Clínicos Controlados Aleatorios como Asunto , Factores de Riesgo
14.
Clin Rehabil ; 31(5): 625-638, 2017 May.
Artículo en Inglés | MEDLINE | ID: mdl-27141087

RESUMEN

OBJECTIVE: To evaluate the effectiveness of treatment delivered via real-time telerehabilitation for the management of musculoskeletal conditions, and to determine if real-time telerehabilitation is comparable to conventional methods of delivery within this population. DATA SOURCES: Six databases (Medline, Embase, Cochrane CENTRAL, PEDro, psycINFO, CINAHL) were searched from inception to November 2015 for literature which reported on the outcomes of real-time telerehabilitation for musculoskeletal conditions. REVIEW METHODS: Two reviewers screened 5913 abstracts where 13 studies ( n = 1520) met the eligibility criteria. Methodological quality was assessed using the Downs & Black 'Checklist for Measuring Quality' tool. Results were pooled for meta-analysis based upon primary outcome measures and reported as standardised mean differences and 95% confidence intervals (CI). RESULTS: Aggregate results suggest that telerehabilitation is effective in the improvement of physical function (SMD 1.63, 95%CI 0.92-2.33, I2=93%), whilst being slightly more favourable (SMD 0.44, 95%CI 0.19-0.69, I2=58%) than the control cohort following intervention. Sub-group analyses reveals that telerehabilitation in addition to usual care is more favourable (SMD 0.64, 95%CI 0.43-0.85, I2=10%) than usual care alone, whilst treatment delivered solely via telerehabilitation is equivalent to face-to-face intervention (SMD MD 0.14, 95% CI -0.10-0.37, I2 = 0%) for the improvement of physical function. The improvement of pain was also seen to be comparable between cohorts (SMD 0.66, 95%CI -0.27-1.60, I2=96%) following intervention. CONCLUSIONS: Real-time telerehabilitation appears to be effective and comparable to conventional methods of healthcare delivery for the improvement of physical function and pain in a variety of musculoskeletal conditions.


Asunto(s)
Enfermedades Musculoesqueléticas/rehabilitación , Telerrehabilitación/normas , Humanos , Telerrehabilitación/métodos
15.
Eur Arch Otorhinolaryngol ; 274(12): 4183-4193, 2017 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-28940024

RESUMEN

Patients with head and neck cancer can report reduced health-related quality of life several years after treatment. The aim of this study was to identify risk factors for reduced quality of life in patients up to 5 years following neck dissection. This cross-sectional study was conducted at two hospitals in Brisbane, Australia. Patients completed two measures of quality of life: the Neck Dissection Impairment Index (NDII), a region- and disease-specific tool, and the Assessment of Quality of Life-4 Domains, a general tool. Generalised linear modelling was used to determine which demographic and clinical variables were associated with quality of life. The cohort included n = 129 patients (71% male, median age 61, median 3 years since surgery). Positive nodal disease was associated with better quality of life on the NDII [e.g. N2 vs N0 coeff (95% CI) = 22.84 (7.33, 38.37)]. Worse quality of life was associated with adjuvant treatment [e.g. Independent Living domain model: surgery with chemoradiation vs surgery only coeff (95% CI) = -0.11 (-0.22, -0.01)]. Positive nodal disease was associated with better quality of life, which may be a reflection of response shift. Multimodality treatment leads to worse quality of life compared with surgery only.


Asunto(s)
Neoplasias de Cabeza y Cuello/cirugía , Disección del Cuello , Calidad de Vida , Adulto , Anciano , Australia , Terapia Combinada , Estudios Transversales , Femenino , Neoplasias de Cabeza y Cuello/patología , Neoplasias de Cabeza y Cuello/psicología , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
16.
J Appl Biomech ; 33(5): 379-383, 2017 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-28530477

RESUMEN

Acromion marker cluster (AMC) methods have been shown to accurately track scapula motion during humeral elevation below 90°, however, their accuracy has not been assessed in shoulder girdle motion such as clavicle protraction, retraction, elevation, and depression independent of humeral movement. The aim of this study was to examine the reliability and validity of the AMC method to record scapula orientation at end range clavicle protraction, retraction, elevation, and depression. The right scapulae of 22 female and 20 male asymptomatic volunteers were assessed with an AMC and scapula locator (SL) method during end range clavicle protraction, retraction, elevation, and depression (without humeral elevation) using an 8-camera 3D movement registration system. Measurements recorded from the AMC and SL measures showed fair to excellent agreement (ICC 0.4-0.92). While the AMC method overestimated and underestimated scapular motion in some planes compared to the SL, root mean square error between methods were low for scapular internal/external rotation (2.3-3.7°), upward/downward rotation (4.5-6.6°), and anterior/posterior tilt (3.2-5.1°), across all conditions. The AMC method was shown to be a reliable and valid measurement of scapula orientation at end range clavicle movements independent of humeral movement.


Asunto(s)
Acromion/fisiología , Clavícula/fisiología , Rango del Movimiento Articular/fisiología , Escápula/fisiología , Adulto , Puntos Anatómicos de Referencia , Fenómenos Biomecánicos , Femenino , Humanos , Masculino , Reproducibilidad de los Resultados
17.
J Appl Biomech ; 33(2): 166-170, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27834549

RESUMEN

This study examined isometric strength (maximal voluntary contraction [MVC]) and endurance of cervical flexor and extensor muscles in healthy individuals at the craniocervical (CC) and cervicothoracic (CT) axes. MVC and endurance measures (time to task failure in seconds [s]) at 50% MVC were recorded in 4 directions (CC flexion, CC extension, CT flexion, and CT extension) in 20 males and 20 females, and 6 strength and endurance ratios were calculated. The findings showed that the cervical extensor muscles are not only much stronger than the flexors (1.3-2 times greater MVC), but also have greater capacity for endurance (2-2.4 times greater). While males produced significantly greater MVC recordings than females (P < .003), strength ratios (P > .06) and endurance measures (P > .11) were similar. Endurance ratios were also similar except the CT extension to CC flexion ratio, which was significantly larger in females compared with males (P = .03). These findings demonstrate that substantial but normal variation exists in strength and endurance parameters between cervical flexor and extensor muscles. This is informative to clinicians when evaluating the performance of these neck muscles or when deciding on exercise parameters (eg, load, duration) when training their performance.


Asunto(s)
Músculos de la Espalda/fisiología , Contracción Muscular/fisiología , Fuerza Muscular/fisiología , Músculos del Cuello/fisiología , Resistencia Física/fisiología , Adulto , Vértebras Cervicales/fisiología , Femenino , Humanos , Valores de Referencia , Reproducibilidad de los Resultados , Sensibilidad y Especificidad , Vértebras Torácicas/fisiología
18.
J Man Manip Ther ; 25(4): 208-214, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28912633

RESUMEN

OBJECTIVES: Arthritis resulting from recurrent intra-articular bleeding in individuals with hemophilia can be severely debilitating due to joint pain and stiffness with subsequent loss of mobility and function. Very limited studies have investigated the potential benefits of joint mobilization for this condition. This case series is a preliminary investigation of safety, as well as immediate and short-term clinical benefits, associated with gentle knee and ankle joint mobilization in people with hemophilic arthropathy. METHODS: A single intervention of joint mobilization was applied to the affected knees and/or ankles of 16 individuals with severe or moderate hemophilia within a public hospital setting. Adverse events, as well as immediate (pain-free passive joint range, Timed Up and Go Test with maximum pain numerical rating scale) and short-term (Lower Extremity Functional Scale) effects of the intervention were evaluated with a repeated measures ANOVA. RESULTS: There were no adverse events. An immediate significant increase was observed in pain-free passive ankle joint range of motion (p < 0.05) following the joint mobilization intervention. DISCUSSION: The findings of this case series suggest that gentle joint mobilization techniques may be safely considered as part of a multimodal management approach for hemophilic arthropathy.

19.
Muscle Nerve ; 52(5): 772-9, 2015 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25702919

RESUMEN

INTRODUCTION: In this preliminary study we determined whether MRI markers of cervical muscle degeneration [elevated muscle fatty infiltration (MFI), cross-sectional area (CSA), and reduced relative muscle CSA (rmCSA)] could be modified with exercise in patients with chronic whiplash. METHODS: Five women with chronic whiplash undertook 10 weeks of neck exercise. MRI measures of the cervical multifidus (posterior) and longus capitus/colli (anterior) muscles, neck muscle strength, and self-reported neck disability were recorded at baseline and at completion of the exercise program. RESULTS: Overall significant increases in CSA and rmCSA were observed for both muscles, but significant reductions in MFI were only evident in the cervical multifidus muscle. These changes coincided with increased muscle strength and reduced neck disability. CONCLUSIONS: MRI markers of muscle morphology in individuals with chronic whiplash appear to be modifiable with exercise.


Asunto(s)
Ejercicio Físico/fisiología , Músculos del Cuello/anatomía & histología , Músculos del Cuello/fisiología , Entrenamiento de Fuerza/métodos , Lesiones por Latigazo Cervical/diagnóstico , Lesiones por Latigazo Cervical/terapia , Adulto , Vértebras Cervicales , Enfermedad Crónica , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Fuerza Muscular/fisiología , Proyectos Piloto , Adulto Joven
20.
J Manipulative Physiol Ther ; 38(7): 465-476.e4, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26387858

RESUMEN

OBJECTIVE: The purpose of this study was to compare the effects of 3 different exercise approaches on neck muscle endurance (NME), kinesiophobia, exercise compliance, and patient satisfaction in patients with chronic whiplash. METHODS: This prospective randomized clinical trial included 216 individuals with chronic whiplash. Participants were randomized to 1 of 3 exercise interventions: neck-specific exercise (NSE), NSE combined with a behavioral approach (NSEB), or prescribed physical activity (PPA). Measures of ventral and dorsal NME (endurance time in seconds), perceived pain after NME testing, kinesiophobia, exercise compliance, and patient satisfaction were recorded at baseline and at the 3- and 6-month follow-ups. RESULTS: Compared with individuals in the prescribed physical activity group, participants in the NSE and NSEB groups exhibited greater gains in dorsal NME (P = .003), greater reductions in pain after NME testing (P = .03), and more satisfaction with treatment (P < .001). Kinesiophobia and exercise compliance did not significantly differ between groups (P > .07). CONCLUSION: Among patients with chronic whiplash, a neck-specific exercise intervention (with or without a behavioral approach) appears to improve NME. Participants were more satisfied with intervention including neck-specific exercises than with the prescription of general exercise.


Asunto(s)
Analgésicos/uso terapéutico , Terapia por Ejercicio/métodos , Quinesiología Aplicada/métodos , Cooperación del Paciente/estadística & datos numéricos , Lesiones por Latigazo Cervical/diagnóstico , Lesiones por Latigazo Cervical/rehabilitación , Adulto , Factores de Edad , Análisis de Varianza , Terapia Conductista/métodos , Enfermedad Crónica , Femenino , Estudios de Seguimiento , Humanos , Puntaje de Gravedad del Traumatismo , Modelos Lineales , Masculino , Persona de Mediana Edad , Actividad Motora/fisiología , Músculos del Cuello/lesiones , Músculos del Cuello/fisiopatología , Dimensión del Dolor , Resistencia Física/fisiología , Estudios Prospectivos , Medición de Riesgo , Factores Sexuales , Resultado del Tratamiento , Adulto Joven
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA