Compliance compromises an interventional study on iron supplementation in female combatants.

INTRODUCTION: Low iron levels are related to overuse injuries, poor physical performance and cognitive impairments in female recruits. The aim of this study was to evaluate iron supplement compliance in female combatants during basic training, and its effect on haemoglobin (Hgb), ferritin and injuries. METHODS: 329 female recruits to light infantry units filled induction questionnaires regarding smoking status, previous overuse injuries and iron deficiency. Blood was drawn for Hgb and ferritin. Subjects with ferritin levels below 20 ng/mL were considered iron depleted and were prescribed a ferrous fumarate supplement. After 4 months of basic training, the subjects completed a follow-up questionnaire regarding overuse injuries, reasons for failure to complete basic training and compliance with iron supplementation. Blood tests were repeated. RESULTS: Mean ferritin levels declined during training (from 18.1±18.2 to 15.3±9.6, p=0.01). Compliance with iron supplementation was observed in 26 (26.3%) of the subjects. In compliant subjects, Hgb levels remained constant and ferritin levels increased by 2.9±5.4 (p=0.07). The main reasons for reported non-compliance were forgetfulness, 26 (35.6%), and gastrointestinal side effects, 17 (23.3%). Injuries during training were not found to be associated with iron status. Smokers had a significantly higher rate of reported injuries prior to training (p<0.01). CONCLUSIONS: Ferritin levels decline during training. Compliance with iron supplementation is low. Iron supplementation has a significant effect on ferritin levels, even in the non-compliance group. Injuries were not related to iron status in this group. Further research is needed in order to clarify the most appropriate iron supplementation method.

Manual Therapy Facilitates Homeostatic Adaptation to Bone Microstructural Declines Induced by a Rat Model of Repetitive Forceful Task.

The effectiveness of manual therapy in reducing the catabolic effects of performing repetitive intensive force tasks on bones has not been reported. We examined if manual therapy could reduce radial bone microstructural declines in adult female Sprague-Dawley rats performing a 12-week high-repetition and high-force task, with or without simultaneous manual therapy to forelimbs. Additional rats were provided 6 weeks of rest after task cessation, with or without manual therapy. The control rats were untreated or received manual therapy for 12 weeks. The untreated TASK rats showed increased catabolic indices in the radius (decreased trabecular bone volume and numbers, increased osteoclasts in these trabeculae, and mid-diaphyseal cortical bone thinning) and increased serum CTX-1, TNF-α, and muscle macrophages. In contrast, the TASK rats receiving manual therapy showed increased radial bone anabolism (increased trabecular bone volume and osteoblast numbers, decreased osteoclast numbers, and increased mid-diaphyseal total area and periosteal perimeter) and increased serum TNF-α and muscle macrophages. Rest, with or without manual therapy, improved the trabecular thickness and mid-diaphyseal cortical bone attributes but not the mineral density. Thus, preventive manual therapy reduced the net radial bone catabolism by increasing osteogenesis, while rest, with or without manual therapy, was less effective.

Injury rates in martial arts athletes and predictive risk factors for lower limb injuries.

BACKGROUND: Previous studies attempted to identify possible risk factors for acute and overuse injuries in several sports disciplines such as running, gymnastics or team sports. Given the lack of scientific works focused on risk factors for lower limb injuries in martial arts, the present study was aimed to investigate foot anatomy, anthropometric measures, and other background information as possible risk factors of injury in barefoot athletes practicing judo, karate, kung fu, Thai boxing, or aikido. In addition, the injury rates were evaluated in relation with the different martial art styles. METHODS: One group of 130 martial artists was retrospectively evaluated. Data of three morphological variables of the foot were collected: navicular height (NH), navicular drop (ND), and the rear foot (RF). In addition, each participant filled an interview questionnaire providing the following information: age, sex, body weight, height, Body Mass Index, hours of training per week, the kind of injury occurred to the lower limbs in the preceding year. RESULTS: Of 130 subjects, 70 (53.8%) did not sustain injuries, 35 (27.0%) suffered an acute injury and the remaining 25 (19.2%) reported an overuse injury. No significant differences were observed in the injury rates in relation to style and kind of martial art. Age, training volume and BMI were found as significant predictors of injury, while NH, ND, and RF were not able to predict acute or overuse injury at lower limbs. CONCLUSIONS: The injury rates were similar in karate, judo, kung fu, aikido, and Thai boxing. The foot morphology variables were not related with the presence or absence of acute and overuse injuries. Conversely, older and heavier martial artists, performing more hours of barefoot training, are at higher risk of acute and overuse injury. Athletic trainers should strongly take into account the present information in order to develop more accurate and specific injury prevention programs for martial artists.

The effect of topical thiocolchicoside in preventing and reducing the increase of muscle tone, stiffness, and soreness: A real-life study on top-level road cyclists during stage competition.

In professional road cyclists, the majority of overuse injuries affect the lower limbs and are mostly represented by contractures or muscle shortening, characterized by an increase of tone and stiffness and a variation of elasticity. Treatment and prevention of these specific conditions may include physical, supplementary, and pharmacologic support. The aim of this real-life study was to determine: first, the alterations of tone, stiffness, elasticity, and soreness of rectus femoris (RF) and biceps femoris (BF) in top class cyclists engaged in 3 multistage races, and second, whether any variable in the management of the athletes may affect the prevention and/or reduction of such alterations.Twenty-three professional cyclists competing in 3 international, cycling stage races were assessed. Athletes could receive, upon the approval of the medical staff, physical, dietary, and/or pharmacological management which could include treatments with topical over-the-counter myorelaxants to prevent and/or reduce muscle contractures. MyotonPro was used to daily measure tone, stiffness, and elasticity in RF and BF in relaxed and contracted state after every stage. In parallel, BF and RF soreness was also assessed with a Likert scale.All athletes received the same general massage management; none of them received dietary supplements; some of the athletes were treated with a topical myorelaxant thiocolchicoside (TCC 0.25%) foam 3 times daily. TCC was identified as the only variable able to affect these muscle parameters in the cyclists. Tone, stiffness (regardless of the state), and soreness significantly increased over time either in BF or RF in all athletes. In the group of athletes that used TCC (n = 11; TCC+) the increase in tone, stiffness, and soreness was significantly lower than in the group not receiving TCC (n = 12; No-TCC). Elasticity varied coherently with tone and stiffness.A very intense and protracted sport activity increases muscular tone, stiffness, and soreness over time. Topical TCC foam significantly attenuates these alterations and might represent an efficient strategy both to prevent and manage contractures and their consequences in professional cyclists as well in athletes from other disciplines involving similar workloads.

Prevention and treatment of exercise related leg pain in young soldiers; a review of the literature and current practice in the Dutch Armed Forces.

Overuse injuries of the leg are a common problem for young soldiers. This article reviews the literature concerning the prevention and treatment of exercise related leg pain in military settings and presents the latest developments in proposed mechanisms and treatments. Current practice and treatment protocols from the Dutch Armed Forces are reviewed, with an emphasis on the most prevalent conditions of medial tibial stress syndrome and chronic exertional compartment syndrome. The conclusion is that exercise related leg pain in the military is an occupational problem that deserves further study.

Mindfulness e dor nos distúrbios osteomusculares: uma experiência com auxiliares e técnicos de enfermagem / Mindfulness and pain in musculoskeletal disorders: an experience with nursing assistants and technicians

Introdução: Fatores que levam a queixas musculoesqueléticas entre profissionais de enfermagem tem sido objeto de várias pesquisas científicas, apontando a necessidade de estratégias no ambiente de trabalho, que promovam saúde para minimizar este cenário emergente. Os programas baseadas em mindfulness - atenção plena - tem demonstrado resultados promissores em aspectos clínicos e não clínicos da saúde, inclusive no manejo da dor crônica. Objetivo: Avaliar a eficácia de um Programa Adaptado de Mindfulness (PAM) como estratégia complementar no manejo da dor crônica originada por distúrbios osteomusculares, em auxiliares e técnicos de enfermagem de um hospital universitário público brasileiro, bem como a implementação do programa por meio de uma gestão colaborativa e a inserção das práticas na rotina dos participantes. Método: Realizou-se um ensaio aberto, prospectivo, com análises quantitativa e qualitativa no ambiente de trabalho com 64 trabalhadoras mulheres, entre 25 e 68 anos, Média= 47, DP= 9,50. Todas as participantes apresentaram queixas musculoesqueléticas por mais de seis meses, participaram de ao menos cinco dos oito encontros presenciais, com uma hora de duração para cada sessão e se comprometeram a realizar tarefa diária de 20 minutos de prática individual. Um questionário sócio-demográfico foi aplicado no momento da inclusão do estudo. Para as medidas quantitativas do estudo foram aplicadas escalas de autorrelato que avaliam os níveis dos sintomas das queixas musculoesqueléticas (QNSO), ansiedade (IDATE -T), depressão (BDI), pensamentos catastróficos sobre a dor (EPCD), autocompaixão (SELFCS), atenção e consciência plenas (MAAS) e percepção da qualidade de vida (WHOQOL-Bref). Todas as variáveis foram avaliadas pelos testes ANOVA de medidas repetidas e Bonferroni com pré-follow up (T0), pós- intervenção - oito semanas (T1) e após três meses do término do programa - doze semanas de follow up (T2). Para a avaliação qualitativa foram produzidas notas descritivas e reflexivas a partir da observação participante nos setores estudados, bem como a análise temático-categorial de relatos (T1) e entrevistas semi-estruturadas (T2). Resultados: O PAM contribuiu na redução significativa (p<=0,05) dos sintomas osteomusculares, níveis de ansiedade, depressão e pensamentos catastróficos sobre a dor; aumento significativo nos níveis de autocompaixão e na percepção da qualidade de vida total, global e nos domínios físico e psicológico em (T0-T1). Não houve resultados estatisticamente significativos (p > 0,05) nos níveis de atenção e consciência plenas - MAAS e nos domínios relações sociais e meio ambiente - WHOQOL-Bref. As análises qualitativas dos relatos (T1) e entrevistas (T2) apontaram benefícios na dor e na qualidade de vida e um repensar sobre a necessidade do cuidar de si com estratégias, dentro da realidade subjetiva, para a inserção das práticas no cotidiano sugerindo a continuidade do PAM como ação factível e eficaz para a categoria estudada. Conclusão: Os resultados sugerem que o PAM contribuiu para a redução dos sintomas físicos e emocionais da dor e melhora da qualidade de vida do público estudado. Os escores desde a pós-intervenção (T1) se mantiveram, ao menos por 20 semanas (T2), indicando a eficácia do PAM como estratégia complementar para o manejo da dor e melhora da qualidade vida dos auxiliares e técnicos de enfermagem em ambiente hospitalar.(AU)

Introduction: Factors that lead to musculoskeletal complaints among nursing professionals have been the subject of several scientific researches, pointing out the need for strategies in the work environment to promote health and minimize this emerging scenario. Mindfulness-based programs have shown promising results in clinical and non-clinical aspects of health, including management of chronic pain. Objective: To evaluate the effectiveness of a Mindfulness Adapted Program (MAP) as a complementary strategy in the management of chronic pain caused by musculoskeletal disorders in nursing assistants and technicians of a Brazilian public university hospital, as well as the implementation of the program through a collaborative management and the insertion of the practices in the routine of the participants. Method: An open, prospective, quantitative and qualitative analysis was performed in the work environment with 64 women workers, age between 25-68 years, Mean= 47, SD= 9.50. A socio-demographic questionnaire was applied at the time of the inclusion of the study. All participants presented musculoskeletal complaints for more than six months, participated in at least five of the eight face-to-face meetings, with an hour of duration for each session and committed to perform daily task of 20 minutes of individual practice. For the quantitative measures of the study, self-report scales were used to evaluate the levels of symptoms of musculoskeletal complaints (NMQ), anxiety (STAI), depression (BDI), catastrophic thoughts on pain (PCS), self-compassion (SELFCS), attention and awareness (MAAS) and perception of quality of life (WHOQOL-Bref). All variables were evaluated by repeated measures ANOVA and Bonferroni with pre-follow up (T0), post-intervention - eight weeks (T1) and three months after the end of the program - twelve weeks of follow up (T2). For the qualitative evaluation, descriptive and reflexive notes were produced based on participant observation in the studied sectors, as well as the thematic-categorical analysis of reports (T1) and semi-structured interviews (T2). Results: MAP contributed to the significant reduction (p <= 0.05) of musculoskeletal symptoms, anxiety levels, depression and catastrophic thoughts about pain; significant increase in the levels of self-compassion and in the perception of total, global quality of life and in the physical and psychological domains in (T0-T1). There were no statistically significant results (p > 0.05) at full attention and consciousness levels - MAAS and in the social relations and environment domains - WHOQOL-Bref. The qualitative analyzes of the reports (T1) and interviews (T2) showed benefits in pain and quality of life and a rethinking about the need to take care of oneself with strategies, within the subjective reality, for the insertion of daily practices suggesting continuity of MAP as an action feasible and effective for the category studied. Conclusion: The results suggest that MAP contributed to the reduction of physical and emotional symptoms of pain and improvement of the quality of life of the studied public. The post-intervention (T1) scores were maintained for at least 20 weeks (T2), indicating the efficacy of MAP as a complementary strategy for pain management and improvement of the quality of life of nursing assistants and technicians in a hospital setting.(AU)

National Strength and Conditioning Association Position Statement on Long-Term Athletic Development.

There has recently been a growing interest in long-term athletic development for youth. Because of their unique physical, psychological, and social differences, children and adolescents should engage in appropriately prescribed exercise programs that promote physical development to prevent injury and enhance fitness behaviors that can be retained later in life. Irrespective of whether a child is involved in organized sport or engages in recreational physical activity, there remains a need to adopt a structured, logical, and evidence-based approach to the long-term development of athleticism. This is of particular importance considering the alarmingly high number of youth who fail to meet global physical activity recommendations and consequently present with negative health profiles. However, appropriate exercise prescription is also crucial for those young athletes who are physically underprepared and at risk of overuse injury because of high volumes of competition and an absence of preparatory conditioning. Whether the child accumulates insufficient or excessive amounts of exercise, or falls somewhere between these opposing ends of the spectrum, it is generally accepted that the young bodies of modern day youth are often ill-prepared to tolerate the rigors of sports or physical activity. All youth should engage in regular physical activity and thus should be viewed as "athletes" and afforded the opportunity to enhance athleticism in an individualized, holistic, and child-centered manner. Because of emerging interest in long-term athletic development, an authorship team was tasked on behalf of the National Strength and Conditioning Association (NSCA) to critically synthesize existing literature and current practices within the field and to compose a relevant position statement. This document was subsequently reviewed and formally ratified by the NSCA Board of Directors. A list of 10 pillars of successful long-term athletic development are presented, which summarize the key recommendations detailed within the position statement. With these pillars in place, it is believed that the NSCA can (a) help foster a more unified and holistic approach to long-term athletic development, (b) promote the benefits of a lifetime of healthy physical activity, and

Reflexoterapia podal para alívio da dor lombar aguda relacionada ao trabalho da equipe de enfermagem: ensaio clínico randomizado / Foot Refletotherapy for relief of acute lower back pain related to work of nursing staff: randomized clinical trial

Os Distúrbios Osteomusculares Relacionados ao Trabalho (DORT) são definidos por condições vinculadas a fatores estressores e repetitivos no trabalho que debilitam a estrutura musculoesquelética corpórea. Dentre as profissões da área da saúde, a equipe de enfermagem é a mais afetada pelo distúrbio, uma vez que a própria função exige força, movimentos repetitivos acompanhados de posturas inadequadas para execução de procedimentos nas atividades realizadas. Assim, esse estudo direcionou atenção para a dor aguda, localizada na região lombar, uma vez que é a área mais comprometida por DORT que acomete os profissionais na equipe de enfermagem e propôs uma intervenção para alívio desta dor com a reflexoterapia podal. Para tanto, o objetivo do estudo foi analisar o resultado da aplicação da reflexoterapia podal no alívio da dor lombar aguda, ocasionada por DORT na equipe de enfermagem atuante em ambiente hospitalar. A pesquisa caracterizou-se como um ensaio clínico piloto, randomizado, controlado, duplo cego, desenvolvido pela Universidade Federal de Santa Catarina (UFSC) e aplicado no Hospital Universitário Polydoro Ernani de São Thiago (HU-UFSC), no período de maio a julho de 2016. A pesquisa teve aprovação em abril pelo Comitê de Pesquisa com Seres Humanos (CEPSH-UFSC) sob o registro protocolar CAAE: 54909616.0.0000.0121. Obteve-se publicação no Registro Brasileiro de Ensaios Clínicos (ReBEC) sob registro RBR-5ndq22. Participaram efetivamente da pesquisa 36 profissionais da equipe de enfermagem atuantes, alocados randomicamente em grupos controle e experimental, da qual foram submetidos ao protocolo de reflexoterapia para dor lombar em duas sessões com intervalo de 72 horas. Os instrumentos da pesquisa para coleta de dados foram a escala visual e analógica de intensidade na avaliação da dor (EVA) e o Questionário para lombalgia. Para análise dos dados foram aplicados o teste de Shapiro Wilk, para normalidade da amostra, teste do Qui-quadrado ou Exato de Fisher para calcular associação das variáveis categóricas, o teste de Wilcoxon para distribuição não paramétrica e teste t para dados paramétricos e na avaliação das associações entre variáveis contínuas aplicou-se o Coeficiente de Correlação de Pearson ou Spearman. Adotou-se o nível de significância de p<0,05 para um intervalo de confiança (IC) de 95%. Os resultados apresentaram significância estatística para aplicação da reflexoterapia podal no alívio da intensidade da dor, finalizado com pesquisa p=0,000 para os dados obtidos no instrumento EVA. Nos resultados do questionário para lombalgia, houve significância positiva para redução da dor lombar aguda com aplicação da reflexoterapia (p=0,000). A reflexoterapia é uma técnica milenar de manipulação em pontos específicos dos pés mãos e orelhas (pontos reflexos), cuja resposta ao estímulo é o bem estar, promoção da saúde, tratamento de distúrbios fisiológicos e ou emocionais, alívio da sintomatologia do estresse, e principalmente alívio da dor. Conclui-se que a prática é eficaz na redução da intensidade da dor lombar aguda nos profissionais da Enfermagem participantes deste estudo. (AU)

The Work-Related Musculoskeletal Disorders (WMSDs) are defined by conditions linked to stressor and repetitive factors at work which weaken the body's musculoskeletal structure. Among the health professions, the nursing staff is the most affected by the disorder, since the activity itself requires strength, repetitive movements and generally unsuitable postures for the execution of procedures and activities carried out. Thus, this study directed attention to acute pain, located in the lower back region, since it is the most affected area by WMSDs among professionals in the nursing staff and proposed an intervention for relief from this pain with foot reflexology. Therefore, the objective of the study was to analyze the result of the application of foot reflexology for relieving acute low back pain, caused by WMSDs of the nursing staff working in the hospital environment. The research was characterized as a pilot clinical trial, randomized, controlled and double-blind, developed by the Federal University of Santa Catarina (UFSC) and applied at the University Hospital Polydoro de São Thiago Ernani (HU-UFSC), from May to July of 2016. The research was approved in April by the Research Committee on Human Beings (CEPSH-UFSC) under the registration protocol CAAE: 54909616.0.0000.0121. It was published in the Brazilian Registry of Clinical Trials (ReBEC) under registry RBR5ndq22. Thirty-six (36) active nursing staff professionals participated effectively of the research, randomly allocated into control and experimental groups, and subjected to reflexotherapy protocol for low back pain in two sessions with an interval of 72 hours. The research instruments for data collection were the visual analog scale of intensity in the assessment of pain (VAS) and the Questionnaire for low back pain. For data analysis, were applied the Shapiro-Wilk test for normality of the sample, Chi-square test or Fisher's exact test to calculate the combination of categorical variables, the Wilcoxon test for nonparametric distribution and t test for parametric data; for evaluating the associations between continuous variables, we applied the correlation coefficient of Pearson or Spearman. The p significance level < 0.05 for a confidence interval (CI) of 95% was adopted. The results were statistically significant for the application of foot reflexology in diminishing the intensity of pain, finished with research p = 0.000 for the data obtained in the VAS instrument. In the results of the questionnaire for low back pain, there was a positive significance for the reduction of acute low back pain with the application of reflexotherapy (p = 0.000). Reflexotherapy is an ancient technique of manipulation on specific points of the feet, hands and ears (reflex points). The response to the stimulus is well-being, health promotion, treatment of physiological and or emotional disorders, relieving stress symptoms, and mainly pain relief. It follows that practice was effective in reducing the intensity of acute low back pain of nursing professionals participating in this study. (AU)

Attenuation of indirect markers of eccentric exercise-induced muscle damage by curcumin.

PURPOSE: Polyphenolic curcumin is known to have potent anti-inflammatory effects; thus the present study investigated the hypothesis that curcumin ingestion would attenuate muscle damage after eccentric exercise. METHODS: Fourteen untrained young men (24 ± 1 years) performed 50 maximal isokinetic (120°/s) eccentric contractions of the elbow flexors of one arm on an isokinetic dynamometer and the same exercise with the other arm 4 weeks later. They took 150 mg of curcumin (theracurmin) or placebo (starch) orally before and 12 h after each eccentric exercise bout in a randomised, crossover design. Maximal voluntary contraction (MVC) torque of the elbow flexors, range of motion of the elbow joint, upper-arm circumference, muscle soreness, serum creatine kinase (CK) activity, and plasma interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) concentration were measured before, immediately after, and 24, 48, 72 and 96 h after each eccentric exercise. Changes in these variables over time were compared between curcumin and placebo conditions by two-way repeated measures ANOVA. RESULTS: MVC torque decreased smaller and recovered faster (e.g., 4 days post-exercise: -31 ± 13 % vs. -15 ± 15 %), and peak serum CK activity was smaller (peak: 7684 ± 8959 IU/L vs. 3398 ± 3562 IU/L) for curcumin than placebo condition (P < 0.05). However, no significant differences between conditions were evident for other variables, and no significant changes in IL-6 and TNF-α were evident after exercise. CONCLUSION: It is concluded that theracurmin ingestion attenuates some aspects of muscle damage such as MVC loss and CK activity increase.

Intervention program in college instrumental musicians, with kinematics analysis of cello and flute playing: a combined program of yogic breathing and muscle strengthening-flexibility exercises.

College musicians encounter health risks not dissimilar to those of professional musicians. Fifteen collegiate instrumental musicians participated in the intervention program of yogic-breathing and muscle-strengthening and flexibility exercises for 8 weeks. Pre- and post-intervention data from the Health-Pain-Injury Inventory (HPI) and the Physical & Musical-Performance Efficacy Assessment Survey (PME) were analyzed for the effects of the program on the musicians' physical and musical-performance efficacy. HPI results showed that the majority of our sample had healthy lifestyles and minimal pain and injuries but irregular eating and exercise habits. The pre-intervention PME data showed a high level of musical efficacy (i.e., awareness of music technique, tone, and flow) but a low-level of physical efficacy (i.e., awareness of posture, tension, and movement flexibility). Post-intervention data showed that the program improved physical efficacy by increased awareness of posture and tension. In 2 volunteer musicians, kinematics motion analysis was conducted for exploratory purposes. Our cellist played the scale using a larger range of motion (ROM) in right shoulder flexion and abduction and slightly increased rotation while keeping decreased right elbow ROM after the intervention program. The flutist shifted the body weight from one foot to the other more in the second playing post-intervention. These changes can be attributed to the increased physical efficacy that allowed freedom to express musicality. Findings from these case scenarios provide empirically based hypotheses for further study. We share our experience so that others may use our model and instruments to develop studies with larger samples.

Ergonomic basket design to reduce cumulative trauma disorders in tea leaf plucking operation.

Work related musculoskeletal disorders are seen as an indicating parameter of occupational stress among the women workers engaged in tea leaf plucking operation. The hand plucking (no mechanized plucking is practiced in Assam) being a highly repetitive task requires forceful exertions to reach to the distant periphery of the tea bushes and mechanical compression (pressing against hard surfaces). Specifically it aggravates with awkward positions adopted. The current research addresses to minimize the risk factors associated with CTDs and to ascertain the role of ergonomic design development in improving the situation. Women workforce engaged in tea industry in Assam suffer from back, shoulder, arm and finger pains. Workers perform the activity for 440 minutes in the entire shift with one hour lunch break in between in the garden itself. An ergonomic investigation aiming at studying the strain index of plucking operation in tea industry was conducted. While performing the operation workers were found to assume unnatural posture which is static as well as highly dynamic with a load (tea leaf collecting basket up to weight of 30 kg when filled with plucked leaves) at back. With gradual increment of load and pain though the load is released intermittently the strain level found to remain at a high level. The total QEC scores found for plucking activity was 110 out of 138. To improve the situation and to reduce the work related upper limb disorder (WRULD) an ergonomically designed basket was conceived and trial results showed improvements. The newly designed plucking basket fits the back curvature of the workers well, which keeps the basket in place unlike the existing round basket. The new basket is light in weight having more leaf capacity. Significant reduction in energy expenditure and MSDs suffered was observed while using improved basket over existing basket.

A qualitative study on overuse injuries: the beliefs of athletes and coaches.

OBJECTIVES: Preventive approaches for overuse injuries in sports will be more successful when synchronised with athletes' and coaches' beliefs. We interviewed athletes and coaches in order to better characterize their beliefs about the definition of an overuse injury, as well as the intrinsic and extrinsic risk factors that underlie overuse injuries. DESIGN: Qualitative study using in-depth interviews in athletes and coaches of different sports. METHODS: Athletes who had experienced overuse injuries and coaches who trained athletes who had sustained overuse injuries from sports clubs were invited to participate through interview. We explored each participant's individual definition of an overuse injury and the beliefs concerning the intrinsic and extrinsic risk factors concerning overuse injuries were explored. RESULTS: After nine athletes and nine coaches, sample size saturation was confirmed. Athletes and coaches integrate somatic as well as psychological and sociological factors into the definition of and risk factors for overuse injuries. Intrinsic factors for an overuse injury were related to physical factors, technique, psychological factors and heredity. The extrinsic factors were related to situational, social and training factors, as well as the individual coach. CONCLUSIONS: Athletes and coaches have a holistic view on the definition of overuse injuries, and the intrinsic and extrinsic risk factors for overuse injuries. If preventive approaches for overuse injuries are developed and implemented, they should incorporate physical factors, as well as incorporate psychological and social factors. Based on the input of coaches and athletes, the latter are important risk factors for overuse injuries.

The effect of chair massage on muscular discomfort in cardiac sonographers: a pilot study.

BACKGROUND: Cardiac sonographers frequently have work-related muscular discomfort. We aimed to assess the feasibility of having sonographers receive massages during working hours in an area adjacent to an echocardiography laboratory and to assess relief of discomfort with use of the massages with or without stretching exercises. METHODS: A group of 45 full-time sonographers was randomly assigned to receive weekly 30-minute massage sessions, massages plus stretching exercises to be performed twice a day, or no intervention. Outcome measures were scores of the QuickDASH instrument and its associated work module at baseline and at 10 weeks of intervention. Data were analyzed with standard descriptive statistics and the separation test for early-phase comparative trials. RESULTS: Forty-four participants completed the study: 15 in the control group, 14 in the massage group, and 15 in the massage plus stretches group. Some improvement was seen in work-related discomfort by the QuickDASH scores and work module scores in the 2 intervention groups. The separation test showed separation in favor of the 2 interventions. CONCLUSION: On the basis of the results of this pilot study, larger trials are warranted to evaluate the effect of massages with or without stretching on work-related discomfort in cardiac sonographers. TRIAL REGISTRATION: NCT00975026 ClinicalTrials.gov.

Advanced biofeedback from surface electromyography signals using fuzzy system.

The aims of this study were to develop a fuzzy inference-based biofeedback system and investigate its effects when inducing active (shoulder elevation) and passive (relax) pauses on the trapezius muscle electromyographic (EMG) activity during computer work. Surface EMG signals were recorded from clavicular, descending (bilateral) and ascending parts of the trapezius muscles during computer work. The fuzzy system readjusted itself based on the history of previous inputs. The effect of feedback was assessed in terms of muscle activation regularity and amplitude. Active pause resulted in non-uniform muscle activity changes in the trapezius muscle depicted by increase and decrease of permuted sample entropy in ascending and clavicular parts of trapezius, respectively (P < 0.05) compared with no pause. Concomitantly, the normalized root mean square of EMG increased approximately 5% in descending part of trapezius bilaterally (P < 0.01). These findings confirm that advanced feedback can change the pattern of muscle activation.

A ginástica terapêutica e preventiva chinesa Lian Gong/Qi Gong como um dos instrumentos na prevenção e reabilitação da LER/DORT / Lian Gong/Qi Gong Chinese therapeutic and preventive exercise as an instrument for Cumulative Trauma Disorder prevention and rehabilitation

Este ensaio traz elementos da medicina ocidental, da medicina tradicional chinesa e da sociologia do trabalho para reflexão sobre o Qi Gong exercícios terapêuticos, um dos pilares da Medicina Tradicional Chinesa (MTC) como importante meio de prevenção da LER/DORT e recuperação da saúde. Considerando a natureza interdisciplinar e diversos níveis de prevenção,aborda aspectos sociológicos sobre as condições de trabalho frequentemente relacionadas com este tipo de adoecimento e categorias de trabalhadores mais acometidos. Focaliza aspectos médicos sobre a LER/DORT e as Síndromes de Bloqueio na MTC, estabelecendo canais de articulação e contribuição entre esses campos de conhecimento sobre a saúde humana. Ressalta o Qi Gong como importante prática terapêutica e preventiva na MTC e sua adequação à LER/DORT. No âmbito do Qi Gong, focaliza o Lian Gong Shi Ba Fa Lian Gong em 18 Terapias, já amplamente experimentado na China e divulgado, inclusive no Brasil, para tratar e prevenir síndromes de dor em região cervical, ombros, membros superiores, membros inferiores e região lombar. À guisa de conclusão, são apresentadas algumas reflexões sobre a propriedade e a importância do Qi Gong na reabilitação e na prevenção da LER/DORT.

This paper evaluates Qi Gong therapeutic exercises, one of the pillars ofthe Traditional Chinese Medicine (TCM) as an important tool of preventing Cumulative Trauma Disorders (CTD) and healing, using allopathic medicine,TCM, and sociology of work elements. Considering its interdisciplinary nature and various levels of CTD prevention, this study examines the sociological aspects of work conditions that are usually associated with CTD and with groups that most frequently report symptoms. It focuses on CTD medical aspects and on TCM Blocking Syndromes, opening channels of communication and contribution between these s of knowledge. It emphasizes that Qi Gong is an important therapeutic and preventive practice within TCM, and that is suitable for treating CTD. Within Qi Gong, it emphasizes Lian Gong Shi Ba Fa Lian Gong in 18 therapies, which has been broadly experienced in China, and also publicized in Brazil, for treatment and prevention of pain syndromes in the upper and lowerlimbs, as well as in the cervical and lumbar regions. It finalizes by presenting considerations on the suitability and importance of Qi Gong for rehabilitation and prevention of CTD.

Performing arts medicine - instrumentalist musicians: part III - case histories.

In parts I and II of this article series, the basic principles of examining musicians in a healthcare setting were reviewed [Dommerholt, J. Performing arts medicine - instrumentalist musicians: part I: general considerations. J. Bodyw. Mov. Ther., in press-a; Dommerholt, J. Performing arts medicine - instrumentalist musicians: part II: the examination. J. Bodyw. Mov. Ther., in press-b]. Part III describes three case reports of musicians with hand pain, interfering with their ability to play their instruments. The musicians consulted with a performing arts physiotherapist. Neither musician had a correct medical diagnosis if at all, when they first contacted the physiotherapist. Each musician required an individualized approach not only to establish the correct diagnosis, but also to develop a specific treatment program. The treatment programs included ergonomic interventions, manual therapy, trigger point therapy, and patient education. All musicians returned to playing their instruments without any residual pain or dysfunction.

Work-related musculoskeletal disorders among Brazilian dental students.

The aim of this analytical cross-sectional study was to evaluate the presence of work-related musculoskeletal disorders (WMSD) among dental students in two Brazilian dental schools. The sample included 227 randomized subjects from fifth to ninth semesters who were developing clinical activities. Each student signed an informed consent form. A self-reporting questionnaire was used to obtain data on the practice of physical exercise, the presence of pain during or soon after treating patients, and the adoption of preventive measures related to clinical activities. Results were analyzed using the Statistical Package for Social Sciences 13.0. The chi(2) test was used to identify associations between variables. The presence of pain during or after clinical work was reported by 173 participants (76.2 percent). Statistically significant differences were found between gender and the occurrence of pain. Pain was present during clinical activities (p=0.006) and imposed limitations on the work routine (p=0.011). Among those who practiced physical exercise, eighty-eight (74.6 percent) reported pain. The high percentage of pain reported by dental students suggests the value of reviewing work conditions in dental practices in order to minimize the exposure of all workers to WMSD.

High levels of glucosamine-chondroitin sulfate can alter the cyclic preload and acute overload responses of chondral explants.

A recent study by our laboratory showed that 14 days of low intensity, intermittent cyclic preloading of chondral explants elevated the concentration of proteoglycans (PGs) to cause a mechanical stiffening of the explants prior to an acute overload and limit the extent of tissue damage. Longer term loading to 21 days resulted in tissue degradation prior to the acute traumatic event and excessive damage from an acute overload. Previous studies by others showed that bathing chondral explants in a supplement of glucosamine-chondroitin sulfate (glcN-CS) upregulated the synthesis of tissue PGs, particularly in stressed tissue, and the supplement served as an anti-inflammatory agent. Our current hypothesis was that the supplementation of culture media with a high concentration of glcN-CS would upregulate the production of tissue PG and limit or mitigate long-term degradation of chondral explants under cyclic preloading and limit tissue damage in an acute overload. We showed that, in the presence of supplement, cyclic preloading significantly increased tissue PG content and matrix modulus by about 65 and 300%, respectively, at 21 days, resulting in a reduction of matrix damage and cell death following an acute overload. These data show a biological action of high concentrations of this supplement and its effect on the mechanical properties in this in vitro model.