Work-related musculoskeletal disorders in oral health professionals: an umbrella review protocol.

OBJECTIVE: The objective of this review is to synthesize the evidence on the prevalence, incidence, risk factors, and preventive and management interventions for work-related musculoskeletal disorders (MSD) in oral health professionals. INTRODUCTION: Oral health professionals face a considerable risk of developing work-related MSD due to the nature of their work. These disorders can lead to loss of employment, reduced job quality, increased occupational injuries, and early retirement. They can also lead to significant financial burdens for employers and society. INCLUSION CRITERIA: This umbrella review will include systematic reviews and meta-analyses that have oral health professionals as a population group and address at least one of the following topics: the prevalence or incidence, risk factors, and the efficiency or effectiveness of interventions for the prevention or management of work-related MSD. METHODS: A systematic search will be conducted across CINAHL Complete (EBSCOhost), Dentistry and Oral Sciences Source (EBSCOhost), MEDLINE (EBSCOhost), Cochrane Library (Ovid), Scopus, PsycINFO (Ovid), AMED Allied and Complementary Medicine (Ovid), Epistemonikos, Ergonomics Abstracts Online (EBSCOhost), and Google Scholar (first 200 articles). The search will be limited to articles published in English, with no restrictions on geographical location. Two independent reviewers will screen the titles and abstracts against the inclusion criteria. The reviews will be assessed using the JBI critical appraisal instrument for systematic reviews and research syntheses, and data will be extracted from each review using a modified version of the JBI data extraction tool. A narrative summary and tables will be used to describe the review characteristics and findings. Results will be presented in a table using visual indicators (traffic light system) to represent beneficial, neutral, and negative effects with each risk factor and intervention. The GRADE approach will be used to rate the overall quality and strength of the evidence. REVIEW REGISTRATION: PROSPERO CRD42023388779.

Prevalence and risk factors of work-related musculoskeletal disorders among physical therapists in Ho Chi Minh City, Vietnam.

BACKGROUND: Understanding risk factors linked to work-related musculoskeletal disorders (WMSDs) is crucial for enhancing health promotion and ensuring workplace safety among healthcare professionals particularly physical therapists (PTs). However, in Vietnam, there has been lack of an investigation. Therefore, this study was to determine whether potential risk factors contributed to the occurrence of WMSDs among PTs in Ho Chi Minh City. METHOD: An online self-reported questionnaire for WMSDs comprising the Nordic Musculoskeletal Questionnaire (NMQ), Job-risk and Environmental factors, the Perceived Stress Scale (PSS-4) and the coping strategies, were distributed to PTs. They were enrolled if they had: age ≥ 22 years, graduated from PT program, a full-time job with ≥1 year of experience. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were determined using Logistic regression. RESULTS: Our study found that within the past 12 months, the prevalence of WMSDs was 76.4% (n = 204/267): neck 58.4% and lower back 57.3%. PTs aged 22-29 years, < 4 years of education, and < 7 years of working experience were more likely to have WMSDs 2-3 times than those who did not. After adjusting for age, education, and work experience, PTs who engaged in manual techniques/exercises, lifting/transferring patients, and maintaining awkward postures were 5-7 times more likely to have WMSDs in the neck and lower back than those who did not. Environmental and psychological factors, such as number of treatment tables, size of electrotherapy rooms, using PTs modalities, and stress were significantly associated with WMSDs. More than 50% of PTs used modified positions and new treatment/techniques that did not aggravate their symptoms, as coping strategies. CONCLUSIONS: This study indicates potential risk factors associated with WMSDs, affecting the neck and lower back among PTs in Vietnam. These risk factors should be addressed to improve overall PTs health, retain skilled workers, and encourage them to continue working.

Minimal clinical datasets for spine-related musculoskeletal disorders in primary and outpatient care settings: a scoping review.

OBJECTIVES: Effective measurement and monitoring of health status in patients with spine-related musculoskeletal (MSK) disorders are essential for providing appropriate care and improving outcomes. Minimal clinical datasets are standardized sets of key data elements and patient-centered outcomes that can be measured and recorded during routine clinical care. Our scoping review aimed to identify and map current evidence on minimal clinical datasets for measuring and monitoring health status in patients with spine-related MSK disorders in primary and outpatient healthcare settings. STUDY DESIGN AND SETTING: We followed the JBI (formerly Joanna Briggs Institute) methodology for scoping reviews. MEDLINE, CINAHL, Cochrane Library, Index to Chiropractic Literature, MANTIS, ProQuest Dissertations and Theses Global, and medRxiv preprint repository were searched from database inception to August 1, 2021. Two reviewers independently screened titles and abstracts, full-text articles, and charted the evidence. Findings were synthesized and summarized descriptively. RESULTS: After screening 5,583 citations and 301 full-text articles, 104 studies about 32 individual minimal clinical datasets were included. Most minimal clinical datasets were developed for patient populations with spine-involving inflammatory arthritis, nonspecific or degenerative spinal pain, and MSK disorders in general. The minimal clinical datasets varied substantially in terms of the author-reported time-to-complete (1-48 minutes) and the number of items (5-100 items). Fifty percent of the datasets involved healthcare professionals in their development process, and only 28% involved patients. Health domain items were most frequently linked to the components of activities and participation (43.9%) and body functions (28.6%), according to the International Classification of Functioning, Disability, and Health. There is no standardized definition of minimal clinical datasets to measure and monitor health status of patients with spine-related MSK disorders in routine clinical practice. Common core elements identified were practicality, feasibility in a busy routine practice, time efficiency, and the capability to be used across different healthcare settings. CONCLUSION: Due to the absence of a standard definition for minimal clinical datasets for patients with spine-related MSK disorders, there is a lack of consistency in the selection of key data elements and patient-centered outcomes that should be included. More research on the implementation and feasibility of minimal clinical datasets in routine care settings is warranted and needed. It is essential to involve all relevant partners in the development process of minimal clinical datasets to ensure successful implementation and adoption in routine primary care.

A systematic model to identify and reduce work-related musculoskeletal disorders in firefighters, and improve their function.

INTRODUCTION: Firefighting is a high-risk job with a high prevalence of work-related musculoskeletal disorders (WMSDs). The aim of his study was to determine the prevalence of WMSDs, estimate the likelihood of subsequent disorders, and investigate the effect of NASM-based training protocol on firefighters function. METHOD: First, prevalence and region of WMSDs in all 524 male Isfahan firefighters were determined by Medical-history-questionnaire. Then, functional movement screen (FMS) separated firefighters to the 2-dimension FMS score (FMSCS≤14 or FMSCS>14) to show at risk firefighters. Finally, 40 Participants with both FMSCS≤14 and common WMSDs randomly assigned to either an intervention (IG) (n = 20) or control (CG) (n = 20) group. The IG received NASM-based training, while the CG engaged in daily activities. Outcomes included movement efficiency during landing error scoring system-real time, Y balance, single-leg squat, and deep squat, which were assessed in pretest and posttest. RESULTS: The prevalence of disorders was 52.1%, which lower limb, back, upper limb, and neck were the highest prevalence respectively. Only lower limb and back disorders could identify individuals at disorder risk with a likelihood of 89% and 71%, sequentially. Also, movement performance significantly improved in all functional tests in IG relative to CG. CONCLUSIONS: Considering high disorder rate in firefighters, the value of our study lies in alleging a systematic model periodically to reduce WMSDs and risk of subsequent disorders. Not only our model determined the prevalence of WMSDs, but it also identified those who are at risk. In addition, our model represents exercise therapy as a solution.

Symptom burden, fatigue, sleep quality and perceived social support in hemodialysis patients with musculoskeletal discomfort: a single center experience from Egypt.

BACKGROUND AND AIMS: Musculoskeletal disorders (MSDs) are commonly encountered in hemodialysis (HD) patients. However, the causes linked to these disorders are still partially defined. The aim of this study was to determine the frequency of MSDs and their relationship to a variety of clinico-social characteristics such as sleep quality, mood disorders, fatigue, and social support, in addition to the patients' clinical and therapeutic profile. METHOD: The study included 94 patients on maintenance HD. Clinical and Sociodemographic data was gathered. To investigate the prevalence and trends of MSDs, the Nordic Musculoskeletal Questionnaire (NMQ-E) was employed. Patients completed the modified Edmonton Symptom Assessment System, Pittsburgh Sleep Quality Index (PSQI), multidimensional Fatigue Inventory (MFI-20), and Perceived Social Support from Family Scales. Univariate and multivariate regression analysis were used to assess the determinants of MSDs. RESULTS: The patients' mean age was 49.73 and 59.6% were males. Seventy-two percent of patients were afflicted by MSDs. Knee pain (48.9%), low back pain (43.6%), shoulder pain (41.6%), hip/thigh pain (35.1%), and neck pains (35.1%) were the most reported MSD domains. Pain (p = 0.001), fatigue (p = 0.01), depression (p = 0.015), and anxiety (p = 0.003) scores were substantially higher in patients with MSDs. Furthermore, patients with MSDs engaged in less physical activity (p = 0.02) and perceived less social support (p = 0.029). Patients with MSDs had lower subjective sleep quality, daytime dysfunction domains, and global PSQI scores (p = 0.02, 0.031, 0.036, respectively). Female gender (p = 0.013), fatigue (p = 0.012), depression (p = 0.014), anxiety (p = 0.004), lower activity (p = 0.029), and PSQI score (0.027), use of erythropoiesis-stimulating agents (ESAs), antihypertensive drugs, calcium and Iron supplementation were all significantly associated with MSDs. At the multivariable regression model, administration of ESAs (p = 0.017) and pain score (p = 0.040) were the only independent variables associated with the outcome. CONCLUSION: MSDs are quite common among HD patients. Female gender, pain, fatigue, depression, anxiety, reduced activity, poor sleep quality, and use of ESAs are all significantly associated with MSDs in HD patients. Patients with MSD perceived less social support compared to the other group. Patients treated with antihypertensive drugs, calcium and iron supplements were more likely to suffer MSDs.

The impact of COVID-19 related lockdown restrictions on musculoskeletal health: a systematic review.

There is limited empirical evidence on whether Coronavirus disease 2019 (COVID-19) related lockdown restrictions precipitate or perpetuate musculoskeletal (MSK) disorders. This study was aimed to synthesis literature that assessed the impact of COVID-19 related lockdown restrictions on MSK health. A literature search was conducted using MEDLINE, CINAHL, PsycINFO, Allied and Complementary Medicine Database (AMED), Web of Science, and Scopus databases. Studies meeting the following criteria were included in the review: the condition being considered was MSK health, the intervention was COVID-19 related lockdown restrictions, cross sectional studies, cohort studies, case controlled, prospective studies and retrospective studies. Data were extracted by 2 independent researchers. Risk of bias was assessed by the Newcastle-Ottawa quality assessment scale. Evidence from included studies was summarised using narrative synthesis. Fourteen studies comprising 22,471 participants of the general population from Turkey (n = 5), Italy (n = 1), Poland (n = 1), Australia (n = 2), Jordan (n = 1), Bangladesh (n = 1), Estonia (n = 1), the Netherlands (n = 1) and Saudi Arabia (n = 1) have met the inclusion criteria. The sample size of populations studied ranged from 91 to 1054. The included studies used questionnaire, visual analogic scale, or growth mixture modelling. Except for one study, all the included studies reported increased prevalence and incidence of MSK disorders due to COVID-19 related lockdown restrictions. The findings suggest that COVID-19 related lockdown restriction led to increased MSK disorders. Home-based strategies such as physical activity programmes and ergonomic workspace could potentially guide public health authorities to avoid MSK health problem.

Social Determinants of Health Documentation Among Individuals With Rheumatic and Musculoskeletal Conditions in an Integrated Care Management Program.

OBJECTIVE: Social determinants of health (SDoH), such as poverty, are associated with increased burden and severity of rheumatic and musculoskeletal diseases. This study was undertaken to study the prevalence and documentation of SDoH-related needs in electronic health records (EHRs) of individuals with these conditions. METHODS: We randomly selected individuals with ≥1 International Classification of Diseases, Ninth/Tenth Revision (ICD-9/10) code for a rheumatic/musculoskeletal condition enrolled in a multihospital integrated care management program that coordinates care for medically and/or psychosocially complex individuals. We assessed SDoH documentation using terms for financial needs, food insecurity, housing instability, transportation, and medication access according to EHR note review and ICD-10 SDoH billing codes (Z codes). We used multivariable logistic regression to examine associations between demographic factors (age, gender, race, ethnicity, insurance) and ≥1 (versus 0) SDoH need as the odds ratio (OR) with 95% confidence interval (95% CI). RESULTS: Among 558 individuals with rheumatic/musculoskeletal conditions, 249 (45%) had ≥1 SDoH need documented in EHR notes by social workers, care coordinators, nurses, and physicians. A total of 171 individuals (31%) had financial insecurity, 105 (19%) had transportation needs, 94 (17%) had food insecurity; 5% had ≥1 related Z code. In the multivariable model, the odds of having ≥1 SDoH need was 2.45 times higher (95% CI 1.17-5.11) for Black versus White individuals and significantly higher for Medicaid or Medicare beneficiaries versus commercially insured individuals. CONCLUSION: Nearly half of this sample of complex care management patients with rheumatic/musculoskeletal conditions had SDoH documented within EHR notes; financial insecurity was the most prevalent. Only 5% of patients had representative billing codes suggesting that systematic strategies to extract SDoH from notes are needed.

Effect of Covid-19 lockdown/ compulsory work from home (WFH) situation on musculoskeletal disorders in India.

OBJECTIVE: To estimate self-reported musculoskeletal disorders among Indian population in work from home COVID-19 lockdown and its association on various socio-demographic and occupational factors among them. METHODS: The present cross-sectional study was conducted on working Indian professionals, through an online self-reported survey during the COVID-19 work from the home situation. Details about the perceived musculoskeletal discomforts, weight gain or loss, physical activity profile, number of working hours, total sedentary time, and satisfaction perceived with working from home were recorded from the participant responses and thereafter analyzed. RESULTS: A total of 281 responses were analyzed. 47.6% of respondents reported musculoskeletal disorders before lockdown, whereas 53.6% reported them during the lockdown period. 10% of respondents reported declination in physical activity. Finding of the chi-square for association and Spearman's rho correlation analysis suggested that gender, pre-existing musculoskeletal discomforts, current sedentary time, and long working hours are significantly associated with musculoskeletal discomforts during work from home COVID-19 lockdown. CONCLUSION: This study concluded the increment in the self-reported musculoskeletal disorders among working Indian professionals during work from home COVID-19 lockdown. The study also found the significant association between MSD and gender, working hours, sedentary time and pre-existing musculoskeletal discomforts.

Ergonomic risk assessment during massage among physiotherapists: Introduction of generic postures notion.

BACKGROUND: Musculoskeletal disorders are prevalent among physiotherapists. They perform many repetitive tasks in awkward postures that require a high muscle load. This issue was often addressed through subjective analysis (questionnaire) but rarely using postural evaluation combined with an ergonomic assessment. OBJECTIVE: The aim of this article was to decompose draining lymphatic massage performed by physiotherapists in generic postures (GP) to quickly assess the musculoskeletal disorder risk. METHODS: Based on numeric video recorded in frontal and sagittal planes, 3360 postures were defined from 20-minutes lymphatic drainage massage performed by 7 physiotherapists over a period of 6 months. A hierarchical cluster analysis was applied to define the GP. RESULTS: Seven GP were identified, which were described by their average joint angles, variability and relative frequency. GP6, GP4 and GP2 had the highest frequencies (17.6%, 16.9% and 16.8% respectively). Trunk and neck were essentially flexed (neck: 17.0±10.0° for GP1; trunk: 20.4±8.7° for GP4). Shoulder flexion and abduction ranged from 15° (GP7) to 60° (GP4). Mean and variability of RULA score completed the analysis. The highest scores were computed for GP2 and GP3 (respectively 5.5±1.3 and 5.8±1.2, p < 0.05). GP4 had the lowest (4.0±1.1, p < 0.05). The results suggest that massages have to be monitored. Attention should be paid to the postures used to prevent the occurrence of MSDs. CONCLUSION: The massages could be described as a combination of generic posture for a rapid ergonomic assessment.

Evaluation of work ability index and its association with job stress and musculoskeletal disorders among midwives during the Covid-19 pandemic.

BACKGROUND: Musculoskeletal disorders (MSDs) and work-related stress are among the factors that can negatively affect work ability. Given the importance of midwives' health, this study aims to evaluate the work ability of midwives and to investigate its association with the prevalence of MSDs and work-related stress in midwifery. METHODS: Ninety-one midwives participated in this study. Three questionnaires, including Nordic musculoskeletal questionnaire (NMQ) plus body map, Persian version of work ability index (WAI) questionnaire, and Health and Safety Executive (HSE) job stress questionnaire, were used to collect data. Finally, the association of MSDs, work-related stress, and individual characteristics with WAI among midwives was investigated. RESULTS: The highest rates of pain and discomfort were reported in the lower back and neck. The mean job stress was 116.08 with the highest scores on demand, role, and control subscales. The work ability among midwives was at an acceptable level of 39.07 on average. Inter-variable association analysis showed that the work ability was significantly associated with pain in the past 12 months and the number of coexisting MSDs. Job stress was not associated with work ability. CONCLUSIONS: Midwives' WAI was at an acceptable level despite high prevalence of MSDs in midwives, the confirmation of the possible correlation between MSDs and work ability, as well as the high job stress in midwifery. Since the present study was conducted during the Covid-19 pandemic, the high stress in midwives may be partly due to the pandemic and may not be permanent. However, this level of stress may reduce the midwives' work ability over a long time.

Prevalence of work-related musculoskeletal symptoms among tea garden workers in Bangladesh: a cross-sectional study.

OBJECTIVES: Occupational health is still in the developmental stage in Bangladesh. There is a lack of focus on agricultural workers. Statistics on musculoskeletal symptoms (MSS) of any occupational group can assist in developing intervention and ergonomics-based prevention. This study aimed to assess work-related MSS among tea garden workers. SETTING: This cross-sectional study was done in one tea garden in Moulvibazar district which has the highest number of gardens in Bangladesh. DESIGN AND PARTICIPANTS: 346 tea garden workers were interviewed using the Nordic Musculoskeletal Questionnaire Extended Version 2. Workers 18-60 years of age and of both sexes were interviewed individually. OUTCOME MEASURES: Prevalence of MSS among the tea garden workers, MSS in different body regions and MSS related informations. Sociodemographic and work-related factor associated with MSS. RESULTS: Among the tea garden workers, 276 were female and 70 were male. The study showed 80.9% had symptoms in the past 12 months while 80.1% and 76.6% had in the past 4 weeks and on the day of the interview, respectively. Symptoms were most commonly reported at the shoulder (78.2%) followed by upper back (56.1%) and lower back (32.5%). Workers engaged with plucking operation were found to be significantly associated with symptoms compared with non-pluckers (p<0.05). Female workers were more likely to display symptoms in the neck (p<0.05) than male workers. Increased work hours were significantly associated with symptoms in the lower back (p<0.05). Overtime was responsible for symptoms in the elbow and hip/buttock (p<0.05). Statistics from relevant studies in India, Malaysia and Thailand were compared with the results of this study. CONCLUSIONS: The prevalence of MSS among tea garden workers was found to be very high, and ergonomic interventions like reduction of weight load, job rotation and small breaks can reduce these symptoms.

Work-related musculoskeletal complaints in massage practitioners.

BACKGROUND: Work-related musculoskeletal complaints (WMSCs) are induced or aggravated by work activities and/or work conditions. OBJECTIVE: The aim was to evaluate the impact of work as a massage practitioner, with a special emphasis on WMSCs. METHODS: Massage practitioners were invited to participate in the study through an advert in the rehabilitation medical clinics. The participants completed a self-administered questionnaire, collecting general data and questions about WMSCs. RESULTS: Thirty-seven subjects (88.09%) reported pain in at least one body part in the last 4 weeks. The most common WMSCs was pain in the neck region (69.04%), followed by pain in the shoulder region (54.76%), upper back (52.38%), lower back (40.48%), wrist-hand (33.33%) and elbow (21.43%). The massage practitioners aged between 21 and 30 years old reported significantly more frequently WMSCs localized in neck, shoulders, wrist-hand, upper back and lower back. CONCLUSIONS: This study shows that WMSCs are widely reported among massage practitioners. The most common complaints were reported in the neck and shoulder regions, especially in younger massage practitioners.

Chiropractic website claims related to non-musculoskeletal conditions: a cross-sectional study.

BACKGROUND: Chiropractors frequently use spinal manipulation therapy as a treatment modality in the management of musculoskeletal (MSK) conditions such as spinal pain and sometimes in the treatment of non-MSK disorders. The latter is not supported by evidence. This study aimed to investigate the extent of non-MSK website claims from French chiropractors to assess if websites were aligned with current recommendations on evidence-based practice. METHODS: This was a cross-sectional study of a representative sample of French chiropractors. Information on non-MSK conditions was collected from chiropractic professional websites by two independent observers in June 2020. For each non-MSK condition, it was noted whether a clarifying explanation justifying the mentioning of the condition was available. In addition, data on professional association affiliation status, country of education, years since graduation, and special clinical focus (e.g., seniors, children) were collected. RESULTS: A total of 287 randomly selected websites were included in the study corresponding to 22% of all chiropractors registered in France. One or more of 42 different non-MSK conditions were identified on 231 websites, of which 5 (2.2%) provided a clarifying explanation. 226 (79%) websites mentioned a non-MSK condition without a clarifying explanation. The non-MSK conditions most often mentioned were sleep problems, constipation/digestive problems, unease/discontent in children and menstrual cramps/pains. A larger proportion of the websites advertising treatment for non-MSK disorders was found among those claiming a special clinical focus on infants/children, seniors, pregnant women or athletes compared to those that did not. Also, a larger proportion of chiropractors who were affiliated with a professional association were advertising treatment for non-MSK disorders compared to those who were not affiliated. CONCLUSIONS: Eight out of ten chiropractic websites mentioned one or more non-MSK diagnoses or symptoms. It is unclear if this reflects inaccurate communication or if treatments for non-MSK conditions are provided by the chiropractors.

Orthopaedic Disorders in Cerebral Palsy in International Cooperation Projects: A Descriptive Cross-Sectional Study.

BACKGROUND: In international cooperation projects that are carried out in less developed and developing countries, a large number of children with disabilities present cerebral palsy (CP). Orthopaedic disorders are frequent complications associated with this disorder. Their prevention and early intervention are essential to achieve an appropriate therapeutic approach for children with PC and to improve their quality of life. OBJECTIVE: To describe the treatment approach that is currently used in international cooperation projects for the rehabilitation management of the orthopaedic disorders in children with cerebral palsy. METHODS: This is an observational, descriptive, cross-sectional study, carried out by means of an online questionnaire to professionals in the field of Physiotherapy and Rehabilitation working in international cooperation projects. The inclusion criteria were professionals working in the rehabilitation field in development aid, humanitarian action or emergency projects that provided rehabilitation services, working with children with cerebral palsy from 0 to 18 years old. RESULTS: Ninety-eight questionnaires were analysed. The average age of the participants was 33.2 years, they were mainly working in development cooperation projects (83.33%) that were implemented in rehabilitation centres and through community-based rehabilitation services (60%). The projects were located in countries all over the world but mainly on the Asian continent (71.4%). Physiotherapists and orthopaedic technicians (72.22%) were the main professionals working in these projects, followed by occupational therapists and social workers (55.56%). The results indicated that the orthopaedic disorders were very frequent in the sample (66.67%), with hip subluxation (50%), scoliosis (77.78%), kyphosis (61.1%), clubfoot (88.7%) and varus foot (61.11%) standing out. The most commonly used treatment approaches were positioning (88.89%) and the Bobath concept (83.33%). The technical aids that were used by the professionals were ankle foot orthosis (AFO) (94.44%), bracing (66.67%), standing frames (83.33%), moulded seats (100%), corner seats (93.75%) and adapted seats (92.85%). CONCLUSIONS: In international cooperation projects, the rehabilitation treatment of children with cerebral palsy is based on a holistic approach. This is reflected in the interventions that are carried out to treat their orthopaedic disorders and in locally produced devices, awareness raising and community education. However, the professionals surveyed considered that the aids or orthoses used are insufficient in the treatment and prevention of orthopaedic disorders in cerebral palsy.

Quantification of muscles activations and joints range of motions during oil palm fresh fruit bunch harvesting and loose fruit collection.

Although global demand for palm oil has been increasing, most activities in the oil palm plantations still rely heavily on manual labour, which includes fresh fruit bunch (FFB) harvesting and loose fruit (LF) collection. As a result, harvesters and/or collectors face ergonomic risks resulting in musculoskeletal disorder (MSD) due to awkward, extreme and repetitive posture during their daily work routines. Traditionally, indirect approaches were adopted to assess these risks using a survey or manual visual observations. In this study, a direct measurement approach was performed using Inertial Measurement Units, and surface Electromyography sensors. The instruments were attached to different body parts of the plantation workers to quantify their muscle activities and assess the ergonomics risks during FFB harvesting and LF collection. The results revealed that the workers generally displayed poor and discomfort posture in both activities. Biceps, multifidus and longissimus muscles were found to be heavily used during FFB harvesting. Longissimus, iliocostalis, and multifidus muscles were the most used muscles during LF collection. These findings can be beneficial in the design of various assistive tools which could improve workers' posture, reduce the risk of injury and MSD, and potentially improve their overall productivity and quality of life.

Fuzzy Logic Modeling of Factors Affecting Musculoskeletal Disorders in a Steel Factory in Iran: A Cross-Sectional Study.

OBJECTIVES: The aim of this study was to model associated factors affecting musculoskeletal disorders (MSDs), using fuzzy logic in a steel factory in Iran. METHODS: A cross-sectional study was conducted on steel industry workers. A 6-part questionnaire was used, consisting of demographic characteristics, occupational stress, work-family conflict, general health, occupational postures, and Nordic Musculoskeletal Questionnaire. Pearson correlation was used for statistical analysis. RESULTS: The prevalence of MSDs for 270 participants in the studied factory was 94.8%. Job stress, work-family conflict, general health, and work posture had a statistically significant relationship with MSDs (P < .05). The fuzzy model demonstrated 23.8% predictability for the actual data of the study. The defuzzification data had significant correlation with real data of MSDs. CONCLUSIONS: The results of this study provided a new perspective about associated factors affecting MSDs and demonstrate that fuzzy logic can be used as a possible tool for evaluating MSDs.

Musculoskeletal Disorders among Italian Dentists and Dental Hygienists.

Dental professionals often perform physically and mentally demanding therapeutical procedures. They work maintaining muscular imbalance and asymmetrical positions for a long time. The aim of the study was to describe the prevalence and the factors associated to work-related musculoskeletal disorders (WMSD) among Italian dental professionals and the most affected body regions. A cross-sectional observational study was conducted between March 2019 and February 2020. The Nordic Musculoskeletal questionnaire (NMQ) was implemented with questions related to working habits (dental occupation, working hours per week and per days, years of work) and lifestyle (practiced physical activity, including frequency and duration, mobilization activities, and knowledge of ergonomic guidelines) was used. The-chi square test was carried out to detect any statistically significant difference (p < 0.05). Logistic regression was carried out to detect the most significant factors associated to WMSD occurrence. A total of 284 questionnaires have been used for the analysis. A high proportion of dental professionals (84.6%) were affected by WMSD in the last 12 months. A higher prevalence was found in females (87%) when compared to males (80%). The prevalence of WMSD was correlated to the working hours/day and hour/week, with a higher risk for operators working >5 h/day and >30 h/week. In addition, a high prevalence was found in operators working for 2-5 years after graduation. Most of the surveyed dental professionals practiced physical activity (70.1%) but only a few had satisfactorily knowledge of ergonomic guidelines (12.7%). Interestingly, participants who practiced yoga or stretching as physical activities demonstrated lower WMSD (77%) when compared to other physical activities (84%). We can highlight that generic physical activities have no functional effect on WMSD for dental professionals. The most affected body areas were neck (59.9%), shoulders (43.3%), lumbar region (52.1%), dorsal region (37.7%) and wrists (30.6%). Considering the magnitude of the problem, there is an urgent need to implement the education in ergonomics among dental professionals, that may be achieved by teaching biomechanics, posturology and integrative functional therapies (such as yoga) during the university education and by promoting holistic health of dental operators.

Prevalence of Musculoskeletal Injuries in a Security Force Assistance Brigade Before, During, and After Deployment.

INTRODUCTION: The Security Force Assistance Brigades (SFABs) are specialized units designed to strengthen allied and partnered nations through advising, supporting, liaising, and assessing in support of U.S. national security interests and combatant commanders' war fighting objectives. As the 1st SFAB was the pioneer unit, descriptive analysis of the musculoskeletal injures and body regions occurring before, during, and after deployment was previously unavailable, limiting the ability of embedded holistic health and fitness teams to proactively address the unit's musculoskeletal needs and medical readiness. MATERIALS AND METHODS: Physical therapists collected and retrospectively analyzed data from 4597 encounters over 19 months: 4 months before, 9 months during, and 4 months after deployment using descriptive statistics. RESULTS: Physical therapy encounters averaged 124 per month during pre-deployment preparation, 363 per month during deployment, and 206 per month post-deployment. The most common musculoskeletal injuries identified during pre-deployment were to the lumbar spine (31.8%), knee (18.1%), and shoulder (9.1%). The most common areas of injury during deployment were to the lumbar spine (28.4%), thoracic spine (18.3%), and shoulder (14.0%). The most common post-deployment injuries consulted were to the lumbar spine (21.3), shoulder (19.6%), and knee (17.8%). CONCLUSION: Musculoskeletal injuries are a concern that may limit medical readiness in the SFABs in the time of before, during, and after deployment. Low back pain is the primary musculoskeletal injury of the 1st SFAB throughout the entire deployment cycle. Based on these findings, recommendations include embedding injury prevention programs to address low back pain to improve medical readiness. More research is required to assess the effectiveness of these programs in reducing incidents of musculoskeletal injuries before, during, and after deployment cycles.

Syndemics & syndemogenesis in COVID-19 and rheumatic and musculoskeletal diseases: old challenges, new era.

People with rheumatic and musculoskeletal diseases (RMDs) are facing several challenges during the COVID-19 pandemic, such as poor access to regular health services and drug shortages, particularly in developing countries. COVID-19 represents a syndemic, synergistic condition that interacts with and exacerbates pre-existing diseases such as RMDs, other co-morbidities and social conditions. The emerging evidence on both biological and non-biological factors implicated in worse outcomes in people with RMDs affected by the COVID-19 pandemic, whether infected by the virus or not, calls for the need to use more novel and holistic frameworks for studying disease. In this context, the use of a syndemic framework becomes particularly relevant. We appeal for a focus on the identification of barriers and facilitators to optimal care of RMDs in the context of the COVID-19 pandemic, in order to tackle both the pandemic itself and the health inequities inherent to it.

Work-related musculoskeletal disorders in physical therapists attributable to manual therapy.

Background: Use of manual therapy (MT) is a risk factor for the development of work-related musculoskeletal disorders (WRMDs) in physical therapists (PTs) although the current evidence is limited on this topic.Objectives: The purpose of this study was to understand the type, association, and prevalence of WRMDs among practitioners of MT, explore relationships between MT and WRMD, and determine impacts of WRMDs on PTs.Design: Cross-sectional survey design.Methods: A web-based survey was distributed through the Academy of Orthopaedic Physical Therapy of the American Physical Therapy Association. The survey gathered information on the respondents' professional profiles, any WRMDs sustained, and how those injuries affected their professional and personal lives.Results: Overall, 38.5% of PT respondents using MT reported having sustained an MT attributable WRMD. Female respondents reported a greater rate of MT attributable injuries. Although exposure risk is cumulative, novice practitioners are also injured.Limitations: Generalizability of these results may be limited because of the sample size and specific population responding.Conclusion: Over one-third of PT survey respondents reported WRMDs attributable to MT. The results indicated WRMDs may begin early in one's career and tend to accumulate over years of practice. MT educational programming at all levels warrants emphasis on practitioner safety.