Prevalence and factors associated with lateral epicondylitis among hospital healthcare workers.

Background: Hospital healthcare workers have been reported to have a high prevalence of musculoskeletal disorders, but their association with lateral epicondylitis (LE) is unknown. This study aimed to clarify the prevalence of LE and its associated factors among hospital healthcare workers. Methods: The present study included all staff members of a secondary emergency hospital who provided their consent to participate. Participants with a history of elbow joint trauma were excluded from this study. The diagnostic criteria for definite LE were: (1) pain in the elbow joint within 2 weeks of the study; (2) pain in the lateral epicondyle region on resisted extension of the wrist with the elbow extended; and (3) tenderness in the lateral epicondyle. The diagnosis of LE was defined by meeting all criteria. Age, height, weight, sex, dominant hand, occupation, years of employment, smoking history, drinking history, personal computer usage history, and smartphone usage history were investigated using a questionnaire. A physical examination, in addition to evaluation of pain in the lateral epicondyle, grip strength and wrist extension strength were measured. A statistical analysis was used to assess the prevalence of LE and its associated factors. All investigations, including the diagnosis of LE, were performed by a single orthopedic specialist. Results: We evaluated 544 individuals, corresponding to approximately 80% of all staff members. The median age was 39 years (interquartile range, 30-48). The study population included 154 males and 390 females. The occupations of the participants were as follows: nurses (n = 265), doctors (n = 47), clerks (n = 93), therapists (n = 27), certified care workers (n = 23), medical technologists (n = 22), pharmacists (n = 19), and others (n = 48). LE was diagnosed in 30 limbs/30 individuals with a prevalence of approximately 5.5%. There was no difference in the prevalence of LE among occupations (P = .85). A logistic regression analysis revealed that age (odds ratio, 1.05; 95% confidence interval 1.01-1.1; P = .01) and smoking history (odds ratio, 2.94; 95% confidence interval 1.01-8.56; P = .04) were independently associated with LE. Conclusion: This study was conducted to evaluate the prevalence of LE among hospital healthcare workers. The prevalence of LE was 5.5%, and LE was independently associated with age and smoking history.

Changes in vaccine coverage and incidence of acute gastroenteritis and severe rotavirus gastroenteritis in children <5 years in Shibata City, Niigata Prefecture, Japan.

Rotavirus (RV) vaccines were first introduced in 2011 and adopted for universal vaccination in 2020 in Japan. However, the effectiveness of RV vaccines after being adopted for universal vaccination in 2020 has not been reported. Because of the easy accessibility of clinics in Japan, many children are not usually hospitalized for RV gastroenteritis (RVGE). Therefore, in order to evaluate the impact of the RV vaccine since 2008, we investigated the incidence of hospitalization for RVGE as well as the frequency of children aged < 5 years who received medical treatment for severe RVGE at clinics in Shibata City, Japan. The RV vaccine coverage rate was 94.0% (1,046/1,113) in Shibata City after universal vaccination in 2020; this was a significant increase from previous rates. The incidence per 1000 person - years for RVGE hospitalization and severe RVGE at clinics were significantly higher among children aged < 3 years than in previous time periods. The incidence in children with all acute gastroenteritis (AGE) decreased significantly after universal vaccination during the COVID-19 pandemic. The proportion of severe RVGE among all AGE cases also decreased significantly after universal vaccination among children aged < 3 years (0.0%) and those aged 3-4 years (0.6%). There were significant differences in the distribution of RV genotypes isolated from the feces of children with RVGE between different eras divided by RV vaccination rates, especially G1P[8], which was the major genotype before it recently almost disappeared. Further studies are warranted to assess the impact of the COVID-19 pandemic.

Pooled Minimal Clinically Important Differences of the Mini-Balance Evaluation Systems Test in Patients With Early Subacute Stroke: A Multicenter Prospective Observational Study.

OBJECTIVE: Balance problems are common in patients with stroke, and the Mini-Balance Evaluation Systems Test (Mini-BESTest) is a reliable and valid assessment tool for measuring balance function. Determining the minimal clinically important difference (MCID) is crucial for assessing treatment effectiveness. This study aimed to determine the MCID of the Mini-BESTest in patients with early subacute stroke. METHODS: In this prospective multicenter study, 53 patients with early subacute stroke undergoing rehabilitation in inpatient units were included. The mean age of the patients was 72.6 (SD = 12.2) years. The Mini-BESTest, which consists of 14 items assessing various aspects of balance function, including anticipatory postural adjustments, postural responses, sensory orientation, and dynamic gait, was used as the assessment tool. The global rating of change (GRC) scales completed by the participants and physical therapists were used as external anchors to calculate the MCID. The GRC scale measured subjective improvement in balance function, ranging from -3 (very significantly worse) to +3 (very significantly better), with a GRC score of ≥+2 considered as meaningful improvement. Four methods were used to calculate the MCID: mean of participants with GRC of 2, receiver operating characteristic-based method, predictive modeling method, and adjustment of the predictive modeling method based on the rate of improvement. From the MCID values obtained using these methods, a single pooled MCID value was calculated. RESULTS: The MCID values for the Mini-BESTest obtained through the 4 methods ranged from 3.2 to 4.5 points when using the physical therapist's GRC score as the anchor but could not be calculated using the participant's GRC score. The pooled MCID value for the Mini-BESTest was 3.8 (95% CI = 2.9-5.0). CONCLUSIONS: The Mini-BESTest MCID obtained in this study is valuable for identifying improvements in balance function among patients with early subacute stroke. IMPACT: Determination of the MCID is valuable for evaluating treatment effectiveness. The study findings provide clinicians with practical values that can assist in interpreting Mini-BESTest results and assessing treatment effectiveness.

Changes in physical activity level during hospitalization in patients with stroke and those with fracture: a prospective longitudinal study.

[Purpose] To examine changes in physical activity levels between admission and discharge in patients hospitalized after stroke and fracture. [Participants and Methods] Patients with stroke (n=36) or fracture (n=41) wore an accelerometer during the daytime for three days after admission and before discharge. Physical activity was divided into sedentary behavior (SB), light-intensity (LIPA), and moderate-to-vigorous (MVPA), and then compared between hospital admission and discharge using the Wilcoxon signed-rank test. The characteristics of patients with or without changes in SB during hospitalization were compared using the Mann-Whitney U test. [Results] The median LIPA time in patients after stroke and fracture increased from 107.5 and 106.7 minutes on admission to 122.0 and 127.3 minutes at discharge, and the median MVPA time increased from 2.7 and 0.7 minutes on admission to 4.2 and 2.7 minutes at discharge, respectively. In particular, LIPA in non-therapy time increased for patients both after stroke and fracture. No differences in characteristics were observed between with or without changes in SB regardless of differences in diagnoses. [Conclusion] These findings indicate that while physical activity levels increased during hospitalization, they remained below World Health Organization recommendations for MVPA, and patient characteristics alone may not account for increased activity levels.