Prevalence of musculoskeletal symptoms in hospital nurse technicians and licensed practical nurses: associations with demographic factors

Objective : This cross-sectional study aimed at analyzing: 1. the main musculoskeletal symptoms (MSS) presented by hospital nursing workers and; 2. personal, occupational, and health factors related to MSS among them. Method : Two questionnaires were filled in by 245 nurse technicians (NTs) and licensed practical nurses (LPNs) (response rate 95%) associated with direct patient care sectors from a hospital. These questionnaires were: the standardized version of the Nordic Musculoskeletal Questionnaire (NMQ) and one including questions on 15 demographic independent variables potentially related to outcomes from the NMQ. Univariate analyses and binary logistic regression analyses were performed to identify which variables would explain the occurrence of MSS in different body regions. Results: The low back (57%), shoulder (52%), and neck (48%) were identified as the most affected regions. The logistic regression analysis showed that low back symptoms in the last 12 months were significantly associated with LPN activities (OR=2.36; CI=1.24-4.5) and previous sick leave due to MSS (OR=5.97; CI=1.2-29.1). Smoking was significantly associated with symptoms in the low back (OR=2.77; CI=1.13-6.8) and thoracic spine (OR=2.37; CI=1.04-5.40). Physical exercise showed a protective effect on the cervical spine (OR=0.42; CI=0.23-0.77). Previous sick leave was significantly associated with pain in the knees (OR=4.24; CI=1.33-13.5) and in the upper limbs (OR=5.36; CI=1.07-26.7). Conclusions: The nursing workers who were evaluated presented a high prevalence of MSS. Previous history of sick leave was strongly associated with the presence of symptoms in various body regions. These results indicate the need for preventive programs in the hospital environment in order to control more severe MSS in nursing professionals. .

30o inclination in handles of plastic boxes can reduce postural and muscular workload during handling

BACKGROUND: The handling of materials, which occurs in the industrial sector, is associated with lesions on the lumbar spine and in the upper limbs. Inserting handles in industrial boxes is a way to reduce work-related risks. Although the position and angle of the handles are significant factors in comfort and safety during handling, these factors have rarely been studied objectively. OBJECTIVE: To compare the handling of a commercial box and prototypes with handles and to evaluate the effects on upper limb posture, muscle electrical activity, and perceived acceptability using different grips while handling materials from different heights. METHOD: Thirty-seven healthy volunteers evaluated the handles of prototypes that allowed for changes in position (top and bottom) and angle (0°, 15°, and 30°). Wrist, elbow, and shoulder movements were evaluated using electrogoniometry and inclinometry. The muscle electrical activity in the wrist extensors, biceps brachii, and the upper portion of the trapezius was measured using a portable electromyographer. The recorded data on muscle movements and electrical activity were synchronized. Subjective evaluations of acceptability were evaluated using a visual analog scale. RESULTS AND CONCLUSIONS: The prototypes with handles at a 30° angle produced the highest acceptability ratings, more neutral wrist positions, lower levels of electromyographic activity for the upper trapezius, and lower elevation angles for the arms. The different measurement methods were complementary in evaluating the upper limbs during handling. .

Wrist electrogoniometry: are current mathematical correction procedures effective in reducing crosstalk in functional assessment? / Eletrogoniometria de punho: procedimentos matemáticos usuais de correção são eficazes para reduzir crosstalk em avaliação funcional?

BACKGROUND: The recording of human movement is an essential requirement for biomechanical, clinical, and occupational analysis, allowing assessment of postural variation, occupational risks, and preventive programs in physical therapy and rehabilitation. The flexible electrogoniometer (EGM), considered a reliable and accurate device, is used for dynamic recordings of different joints. Despite these advantages, the EGM is susceptible to measurement errors, known as crosstalk. There are two known types of crosstalk: crosstalk due to sensor rotation and inherent crosstalk. Correction procedures have been proposed to correct these errors; however no study has used both procedures in clinical measures for wrist movements with the aim to optimize the correction. OBJECTIVE: To evaluate the effects of mathematical correction procedures on: 1) crosstalk due to forearm rotation, 2) inherent sensor crosstalk; and 3) the combination of these two procedures. METHOD: 43 healthy subjects had their maximum range of motion of wrist flexion/extension and ulnar/radials deviation recorded by EGM. The results were analyzed descriptively, and procedures were compared by differences. RESULTS: There was no significant difference in measurements before and after the application of correction procedures (P<0.05). Furthermore, the differences between the correction procedures were less than 5° in most cases, having little impact on the measurements. CONCLUSIONS: Considering the time-consuming data analysis, the specific technical knowledge involved, and the inefficient results, the correction procedures are not recommended for wrist recordings by EGM.

CONTEXTUALIZAÇÃO: O registro do movimento humano é requisito fundamental para análises biomecânicas, clínicas e ocupacionais, permitindo avaliar variações posturais, riscos e aprimoramento de programas preventivos e de reabilitação em Fisioterapia. O eletrogoniômetro flexível (EGM), considerado um equipamento confiável e acurado, é utilizado para o registro dinâmico de diferentes articulações. Apesar das vantagens, o EGM é suscetível de erros de medida, denominados crosstalk. Atualmente, são conhecidos dois tipos de crosstalk, o crosstalk devido à rotação do sensor e o crosstalk inerente. Procedimentos de correção foram propostos para a correção desses erros, no entanto nenhum estudo utilizou ambos os procedimentos em medidas clínicas dos movimentos do punho, visando otimizar a correção. OBJETIVO: Avaliar o efeito de procedimentos matemáticos atualmente empregados para correção do: 1) crosstalk devido à rotação do antebraço; 2) crosstalk inerente aos sensores e 3) combinação desses dois procedimentos. MÉTODO: Quarenta e três indivíduos saudáveis tiveram as amplitudes máximas dos movimentos de flexão/extensão e desvios ulnar/radial do punho registrados pelos EGM. Os resultados foram analisados de forma descritiva, e os procedimentos foram comparados por diferenças. RESULTADOS: Não houve alteração significativa nas medidas após a aplicação dos procedimentos de correção (P<0,05). Além disso, as diferenças entre os procedimentos de correção foram inferiores a 5° para a maioria dos casos, indicando pouco impacto sobre as medidas. CONCLUSÕES: Considerando o tempo de processamento, o conhecimento técnico específico exigido e os ineficazes resultados obtidos, desaconselha-se a aplicação desses procedimentos na correção de registros eletrogoniométricos do punho.

How do low/high height and weight variation affect upper limb movements during manual material handling of industrial boxes? / Como a variação de altura e massa da carga afetam os movimentos do membro superior durante o manuseio de caixas industriais?

OBJECTIVES: To evaluate the effect of surface height and load weight on upper limb movements and electromyographic (EMG) recordings during manual handling performed by both experienced and inexperienced lifter subjects. METHODS: Sixteen experienced and sixteen inexperienced lifters handled a box (both 7 and 15 kg) from an intermediate height (waist level) to either a high or low surface. Electromyography and video images were recorded during the tasks. The 10th, 50th and 90th percentiles were calculated for the deltoid and biceps muscles, shoulder flexion, shoulder abduction, and elbow flexion movements. Groups, right/left sides, weights and heights were compared. There were no differences between either groups or sides. RESULTS: Weight and height variations affected EMG and posture, although weight had more impact on EMG. Shoulder abduction and flexion movements higher than 60º occurred, particularly for the higher surface. Shoulder flexion was also higher when the box was moved to the low height. This study provides new evidence as shoulder postures during boxes handling on low surfaces had not previously been evaluated. CONCLUSIONS: The high demand of upper limb in manual material handling tasks is clear, particularly for the shoulder. This knowledge can be used by physical therapists to plan better rehabilitation programs for manual material handling-related disorders, particularly focusing on return to work.

OBJETIVOS: Avaliar o efeito da altura de superfície e massa da carga nos movimentos e na atividade eletromiográfica (EMG) dos membros superiores durante o manuseio de carga realizado por sujeitos experientes e inexperientes. MÉTODOS: Dezesseis sujeitos experientes e 16 inexperientes manusearam uma caixa (7 e 15 kg) de uma superfície com altura intermediária para uma superfície alta e/ou baixa. Durante as tarefas, foram registradas imagens de vídeo e EMG. Os dados foram processados para obtenção dos percentis 10, 50 e 90 referentes à EMG dos músculos deltoide e bíceps e aos movimentos de flexão e abdução do ombro e flexão do cotovelo. Foram comparados os grupos, lados (direito/esquerdo), massas e altura de manuseio. RESULTADOS: Não foram encontradas diferenças significantes entre os grupos ou lados. As variações de massa e altura de manuseio afetaram a EMG e postura, embora a massa da caixa tenha tido mais impacto sobre a EMG. Os movimentos de abdução e flexão do ombro ocorreram acima de 60º, particularmente no manuseio para a superfície alta. A amplitude de flexão de ombro também foi alta quando a caixa foi movida para a superfície baixa. Esse resultado consiste em uma nova evidência, já que posturas do ombro durante o manuseio de carga em superfícies baixas não tinham sido investigadas. CONCLUSÕES: A alta demanda do membro superior em tarefas de manuseio de carga é clara, particularmente do ombro. Esse conhecimento pode ser usado por fisioterapeutas para um melhor planejamento da reabilitação de lesões relacionadas ao manuseio de cargas, visando o retorno ao trabalho.