Ergonomic Analysis of Dental Work in Different Oral Quadrants: A Motion Capture Preliminary Study among Endodontists.

BACKGROUND: Dentists, including endodontists, frequently experience musculoskeletal disorders due to unfavourable working postures. Several measures are known to reduce the ergonomic risk; however, there are still gaps in the research, particularly in relation to dental work in the different oral regions (Quadrants 1-4). METHODS: In this study (of a pilot character), a total of 15 dentists (8 male and 7 female) specialising in endodontics were measured while performing root canal treatments on a phantom head. These measurements took place in a laboratory setting using an inertial motion capture system. A slightly modified Rapid Upper Limb Assessment (RULA) coding system was employed for the analysis of kinematic data. The significance level was set at p = 0.05. RESULTS: The ergonomic risk for the entire body was higher in the fourth quadrant than in the first quadrant for 80% of the endodontists and higher than in the second quadrant for 87%. For 87% of the endodontists, the ergonomic risk for the right side of the body was significantly higher in the fourth quadrant compared to the first and second quadrant. The right arm was stressed more in the lower jaw than in the upper jaw, and the neck also showed a greater ergonomic risk in the fourth quadrant compared to the first quadrant. CONCLUSION: In summary, both the total RULA score and scores for the right- and lefthand sides of the body ranged between 5 and 6 out of a possible 7 points. Considering this considerable burden, heightened attention, especially to the fourth quadrant with a significantly higher ergonomic risk compared to Quadrants 1 and 2, may be warranted.

Differences in upper body posture between patients with lumbar spine syndrome and healthy individuals under the consideration of sex, age and BMI.

BACKGROUND: Work-related forced postures, such as prolonged standing work, can lead to complaints in the lower back. Current research suggests that there is increased evidence of associations between patients with low back pain (LBP) and reduced lordosis in the lumbar spine and generally less spinal tilt in the sagittal plane. The aim of this study is to extend the influence of LBP to other parameters of upper body posture in standing, taking into account the rotational and frontal planes. METHODS: The study included a no-LBP group (418 males, 412 females, aged 21-65 years) and an LBP group (138 subjects: 80 females, 58 males, aged 18-86 years) with medically diagnosed lumbar spine syndrome (LSS). The "ABW BodyMapper" back scanner from ABW GmbH in Germany was used for posture assessment using video raster stereography. Statistical analyses employed two-sample t-tests or Wilcoxon-Mann-Whitney-U tests to assess the relationship between the LBP/no-LBP groups and back posture parameters. Linear and logarithmic regressions were used with independent variables including group, sex, height, weight and body mass index (BMI). Significance level: α = 0.05 (95% confidence). RESULTS: The regression analysis showed that sagittal parameters of the spine (sagittal trunk decline, thoracic and lumbar bending angle, kyphosis and lordosis angles) depend primarily on sex, age, BMI, height and/or weight but not on group membership (LBP/no-LBP). In the shoulder region, a significant dependency between group membership and scapular rotation was found. In the pelvic region, there were only significant dependencies in the transverse plane, particularly between pelvic torsion and BMI, weight, height and between pelvic rotation and group membership, age and sex. CONCLUSION: No difference between the patients and healthy controls were found. In addition, sex appears to be the main influencing factor for upper body posture. Other influencing factors such as BMI, height or weight also seem to have a significant influence on upper body posture more frequently than group affiliation.

Healthy working in inclusive companies - a study protocol of the GAIN project.

BACKGROUND: The research project GAIN (working healthy in inclusion companies) deals with the topics of health and work in inclusive companies. Due to a great need for research on (occupational) health (e.g. physical and mental health status) and workplace design in companies employing people with disabilities, this project pursues the primary goal of generating information for the development and implementation of health-preserving measures within the framework of occupational health and safety, and risk assessment, for employees with and without impairments in inclusive companies. METHODS: Within the framework of the project, the employees of three inclusive companies will be examined with the help of an interdisciplinary and triangulative approach. Using quantitative and qualitative methods, specific physical workloads and hazards will be investigated by means of baseline screening methods and measurement techniques, specifically among employees with physical disabilities and impairments. In the statistical analysis, descriptive methods will be used to record the current state, while inferential statistical methods will be used to evaluate health maintenance measures. Inferential statistics for continuous data with confidence intervals based on the statistical parametric mapping (SPM) method will also be performed. The significance level will be set at 5%. Qualitative methods will be used to analyse structures and working conditions within the companies, with particular attention to the specific construction of the relationship between work, health and disability. CONCLUSIONS: The structures in inclusion companies must be specifically designed to support and promote the understanding of work and health in relation to the idea of one's own body, its positioning in space and its performance. These characteristics are to be identified in the course of the project and bundled into best-practice recommendations. Furthermore, it is the aim of the research project to derive recommendations for action at its conclusion and to present further advice for the promotion of health in inclusive companies.

Testing the Level of Agreement between Two Methodological Approaches of the Rapid Upper Limb Assessment (RULA) for Occupational Health Practice-An Exemplary Application in the Field of Dentistry.

BACKGROUND: The Rapid Upper Limb Assessment (RULA) is used for the risk assessment of workplace-related activities. Thus far, the paper and pen method (RULA-PP) has been predominantly used for this purpose. In the present study, this method was compared with an RULA evaluation based on kinematic data using inertial measurement units (RULA-IMU). The aim of this study was, on the one hand, to work out the differences between these two measurement methods and, on the other, to make recommendations for the future use of the respective method on the basis of the available findings. METHODS: For this purpose, 130 (dentists + dental assistants, paired as teams) subjects from the dental profession were photographed in an initial situation of dental treatment and simultaneously recorded with the IMU system (Xsens). In order to compare both methods statistically, the median value of the difference of both methods, the weighted Cohen's Kappa, and the agreement chart (mosaic plot) were applied. RESULTS: In Arm and Wrist Analysis-area A-here were differences in risk scores; here, the median difference was 1, and the agreement in the weighted Cohen's kappa test also remained between 0.07 and 0.16 (no agreement to poor agreement). In area B-Neck, Trunk, and Leg Analysis-the median difference was 0, with at least one poor agreement in the Cohen's Kappa test of 0.23-0.39. The final score has a median of 0 and a Cohen's Kappa value of 0.21-0.28. In the mosaic plot, it can be seen that RULA-IMU had a higher discriminatory power overall and more often reached a value of 7 than RULA-PP. CONCLUSION: The results indicate a systematic difference between the methods. Thus, in the RULA risk assessment, RULA-IMU is mostly one assessment point above RULA-PP. Therefore, future study results of RULA by RULA-IMU can be compared with literature results obtained by RULA-PP to further improve the risk assessment of musculoskeletal diseases.

Upper body posture in Latin American dancers: a quantitative cross-sectional study comparing different postures.

BACKGROUND: In Latin American dance sport (LD), the shoulder girdle and the torso area are particularly stressed due to the dance style specific requirements. The aim of the study was to define differences in various dance specific upper body postures in Latin American dancers and to show gender-specific differences. METHODS: Three dimensional back scans were performed in n = 49 dancers (28 f/21 m). Five typical trunk positions in Latin American dance (habitual standing and 4 dance specific positions, P1-P5) were compared with each other. Statistical differences were calculated using the Man-Whitney U test, Friedmann test, Conover-Iman test and a Bonferroni-Holm correction. RESULTS: Significant gender differences were found in P2, P3 and P4 (p ≤ 0.01-0.001). In P5, the frontal trunk decline, the axis deviation, the standard deviation of the rotation, the kyphosis angle and the shoulder as well as the pelvic rotation were also significantly different. The comparison of the postures showed significant differences between postures 1-5 (p ≤ 0.01-0.001) in the males, (scapular height, right and left scapular angles and pelvic torsion). Similar results were observed for the female dancers, with only the parameters of frontal trunk decline with the lordosis angle as well as the right and left scapular angles being non-significant. CONCLUSIONS: This study is an approach to better understand the involved muscular structures in LD. Performing LD changes the static parameters of the upper body statics. Further projects are needed to analyse the field of dance even more thoroughly.

Musculoskeletal complaints, postural patterns and psychosocial workplace predictors in police officers from an organizational unit of a German federal state police force - a study protocol.

BACKGROUND: Police officers are exposed to a particularly high risk of musculoskeletal disorders (MSDs) and psychosocial stress due to their working conditions. Therefore, the aim of this project will be to assess the occupational physical and mental health of police officers from an organizational unit of the police force of a German federal state. METHODS: The aim is to analyze at least 200 active police officers of a state police force in Germany between the age of 18 and 65 years. In a mixed-methods design, a video raster stereography-based measurement of the upper body posture and a modified version of the Nordic Questionnaire (NQ) will be used for investigating their physical health, while the Copenhagen Psychosocial Questionnaire (COPSOQ) and the Operational Police Stress Questionnaire (PSQ-Op) will be used to analyze their mental health. In addition, job-specific psychosocial factors at the workplace will be assessed (using self-designed questions that were previously evaluated in an expert interview). DISCUSSION: To date, there is a lack of current questionnaire-based data on the prevalence of MSDs in police officers, or of MSDs associated with injuries or psychosocial workplace factors. Thus, in this study, these MSDs will be correlated with quantitative upper body posture data. If these results prove an increased physical and/or psychosocial stress, then the existing workplace health promotion measures should be analyzed and modified if necessary.

Ergonomic Risk Assessment of Oral and Maxillofacial Surgeons - RULA Applied to Objective Kinematic Data.

BACKGROUND: The prevalence of musculoskeletal disorders is high in oral and maxillofacial surgeons (OS) due to their static and contorted working positions. Hence, the aim of this study was to conduct posture analyses in this specific group of dental professionals using the Rapid Upper Limb Assessment (RULA). METHODS: In total, 15 (12 m/3 f) OS participated in this study. An inertial motion capture system (Xsens) was used to collect kinematic data during a simulated workflow. Computer-based routines calculated the RULA score for the extracted joint angles at each defined time point. Then, an analysis of the time-dependent RULA scores by body regions was conducted. Key variables were the relative occurrence of specific RULA scores during the complete workflow, individual subtasks, and for treatment of each of the four different dental quadrants. The subtasks and dental quadrants were compared using the Friedman test. RESULTS: The total median RULA score represented a high risk for OS during their work (7), including the temporal component (OS spent 77.54% of their working time with a RULA score of 7). The wrists and hands, elbows, lower arms, and the neck were exposed to postures with the highest risk for musculoskeletal strain. DISCUSSION: For OS, both the right and the left assisting hand were heavily strained while working on the first dental quadrant caused the most unfavorable postures for OS.

Improvement of cervical spine mobility and stance stability by wearing a custom-made mandibular splint in male recreational athletes.

OBJECTIVES: The range of motion (ROM) of the cervical spine and postural stability are important for an economical and motorically adequate adaptation of the body to any situation. Therefore, this study aims to analyze whether these two components of postural and movement control can be influenced by means of a splint in a centric position compared to habitual occlusion. METHODS: 38 recreational male athletes volunteered. Cervical spine ROM was recorded using an ultrasound system and the a pressure measuring plate for postural stability (length of center of pressure (CoP) movement, area of CoP). The two dental occlusion conditions employed were the habitual occlusion and wearing a splint in an idealized, condylar position close to the centric position. Level of significance was set at ρ ≤ 0.05. RESULTS: The cervical spine mobility increased significantly by wearing the splint regarding rotation to the left (+3.9%) and right (+2.7%) and lateral flexion to the left (+4.4%) and right (+6.7%). Wearing the splint reduced the area of sway deflections by about 31.5% in the bipedal stance and by about 2.4% (left) and 28.2% (right) in the unipedal stance. The CoP trace was reduced in the sagittal plane by approximately 8.2% in the right single-leg stance. CONCLUSIONS: The major findings seem to demonstrate that wearing a splint that keeps the jaw close to the centric relation may increase the cervical ROM and may improve balance stability in male recreational athletes. Changing the jaw relation in athletes can possibly aid the release of performance potentials by improving coordination skills.

Effects of Resistance Training as a Behavioural Preventive Measure on Musculoskeletal Complaints, Maximum Strength and Ergonomic Risk in Dentists and Dental Assistants.

INTRODUCTION: For dental professionals, musculoskeletal disorders (MSD) are common health hazards and resistance training programmes have been promising approaches in the quest for a reduction in the pain intensity of these professionals. Therefore, the aim of the current study was to investigate the effect of a trunk-oriented 10-week resistance training programme. METHOD: In total, the study was conducted with 17 dentists and dental assistants (3 m/14 f) over a course of 10 weeks, with workouts being performed 2 times a week using a 60 min intervention programme consisting of 11 resistance training exercises. The outcome values that were collected were the pain intensity (visual analogue scale (VAS) combined with a modified version of the Nordic Questionnaire), the MVIC and the rapid upper limb assessment (RULA) score (based on data from inertial motion units) during a standardised dental treatment protocol. RESULTS: A significant reduction in pain intensity was found for each queried body region: the neck, upper back, lower back and the right and left shoulders. The maximum voluntary isometric contraction (MVIC) improved significantly in all outcome measures: flexion, extension, right and left lateral flexion and right and left rotation. CONCLUSIONS: A 10-week resistance training programme for dentists and dental assistants had significant effects on pain intensity reduction and the MVIC of the musculature of the trunk and is, therefore, suitable as a behavioural preventive measure against MSD in dental professionals.

The burden of conveyor belt work in the canteen kitchen: A question of working height?

BACKGROUND: Working in forced postures and standing continuously can be classified as straining the musculoskeletal system. OBJECTIVE: Since such postures are frequently used in hospital canteen kitchens, we used kinematic analysis to determine the working postures of canteen kitchen staff. METHODS: In this study, the daily work routine of 18 (11 w/7 m) workers of a hospital canteen kitchen (Frankfurt Main/Germany) aged 21-62 years (46±13 years) was examined by means of kinematic analysis (CULEA system; IFA; Sankt Augustin/Germany) and a detailed computerized analysis of the activities performed on-site. Angle values of the head and trunk were evaluated in accordance with ergonomic standards and presented using percentile values (P05-P95). The OWAS method was also employed to capture the proportions of standing, walking and sitting work. RESULTS: The kinematic posture analysis showed for all activities on the conveyor belt a tendency towards a dorsally inclined body position: trunk inclination (-7.5° to 0), thoracic spine inclination or a bending forward (-11.3° to 0°) and curvature of the back within the thoracic spine (-15.2° to 0°). In addition, >90% of the "activities on the belt" (46% of the daily working routine) were carried out standing. CONCLUSION: The activities on the conveyor belt were characterized by a tendency towards hyperextension of the trunk, possibly due to a too high working environment. Furthermore, an increased burden on body structures while standing can be concluded. From a primary prevention perspective, this increased standing load should be reduced by behavioral and relational prevention measures.

Home office versus ergonomic workstation - is the ergonomic risk increased when working at the dining table? An inertial motion capture based pilot study.

BACKGROUND: In order to reduce the risk of infection with Sars-Cov-2, work practices have been shifted to the home office in many industries. The first surveys concerning this shift indicate an increase in musculoskeletal complaints of many employees. The aim of this study was to compare the ergonomic risk in the upper extremities and trunk of working in a home office with that of working in an ergonomically optimized workplace. METHODS: For this purpose, 20 subjects (13w/7m) aged 18-31 years each performed a 20-minute workplace simulation (10 min writing a text, 10 min editing a questionnaire) in the following set up: on a dining table with dining chair and laptop (home office) and on an ergonomically adjusted workstation (ergonomically optimized workplace). The subjects were investigated using a combined application of a motion capture kinematic analysis and the rapid upper limb assessment (RULA) in order to identify differences in the ergonomic risk. RESULTS: Significantly reduced risk values for both shoulders (left: p < 0.001; right: p = 0.02) were found for the ergonomically optimized workstations. In contrast, the left wrist (p = 0.025) showed a significantly reduced ergonomic risk value for the home office workstation. CONCLUSION: This study is the first study to compare the ergonomic risk between an ergonomically optimized workplace and a home office workstation. The results indicate minor differences in the upper extremities in favor of the ergonomically optimized workstation. Since work-related musculoskeletal complaints of the upper extremities are common among office workers, the use of an ergonomically optimized workstation for home use is recommended based on the results.

A RULA-Based Comparison of the Ergonomic Risk of Typical Working Procedures for Dentists and Dental Assistants of General Dentistry, Endodontology, Oral and Maxillofacial Surgery, and Orthodontics.

BACKGROUND: In general, the prevalence of work-related musculoskeletal disorders (WMSD) in dentistry is high, and dental assistants (DA) are even more affected than dentists (D). Furthermore, differentiations between the fields of dental specialization (e.g., general dentistry, endodontology, oral and maxillofacial surgery, or orthodontics) are rare. Therefore, this study aims to investigate the ergonomic risk of the aforementioned four fields of dental specialization for D and DA on the one hand, and to compare the ergonomic risk of D and DA within each individual field of dental specialization. METHODS: In total, 60 dentists (33 male/27 female) and 60 dental assistants (11 male/49 female) volunteered in this study. The sample was composed of 15 dentists and 15 dental assistants from each of the dental field, in order to represent the fields of dental specialization. In a laboratory setting, all tasks were recorded using an inertial motion capture system. The kinematic data were applied to an automated version of the Rapid Upper Limb Assessment (RULA). RESULTS: The results revealed significantly reduced ergonomic risks in endodontology and orthodontics compared to oral and maxillofacial surgery and general dentistry in DAs, while orthodontics showed a significantly reduced ergonomic risk compared to general dentistry in Ds. Further differences between the fields of dental specialization were found in the right wrist, right lower arm, and left lower arm in DAs and in the neck, right wrist, right lower arm, and left wrist in Ds. The differences between Ds and DAs within a specialist discipline were rather small. DISCUSSION: Independent of whether one works as a D or DA, the percentage of time spent working in higher risk scores is reduced in endodontologists, and especially in orthodontics, compared to general dentists or oral and maxillofacial surgeons. In order to counteract the development of WMSD, early intervention should be made. Consequently, ergonomic training or strength training is recommended.

Ergonomic Comparison of Four Dental Workplace Concepts Using Inertial Motion Capture for Dentists and Dental Assistants.

When the inventory is arranged in a dental practice, a distinction can be made between four different dental workplace concepts (DWCs). Since the prevalence of musculoskeletal diseases in dental professionals is very high, preventive solution need to be investigated. As the conventionally used DWCs have, to date, never been studied in terms of their ergonomics, this study aims to investigate the ergonomic risk when working at the four different DWCs. In total, 75 dentists (37 m/38 f) and 75 dental assistants (16 m/59 f) volunteered to take part in this study. Standardized cooperative working procedures were carried out in a laboratory setting and kinematic data were recorded using an inertial motion capture system. The data were applied to an automated version of the Rapid Upper Limb Assessment (RULA). Comparisons between the DWCs and between the dentists and dental assistants were calculated. In all four DWCs, both dentists and dental assistants spent 95-97% of their working time in the worst possible RULA score. In the trunk, DWCs 1 and 2 were slightly favorable for both dentists and dental assistants, while for the neck, DWC 4 showed a lower risk score for dentists. The ergonomic risk was extremely high in all four DWCs, while only slight advantages for distinct body parts were found. The working posture seemed to be determined by the task itself rather than by the different inventory arrangements.

Ergonomic Risk Assessment of Dental Students-RULA Applied to Objective Kinematic Data.

Musculoskeletal disorder (MSD) is already prevalent in dental students despite their young age and the short duration of dental practice. The current findings state that the causes of MSD are related to posture during dental work. This study aims to investigate the ergonomic risk of dental students. In order to analyze the ergonomic risk of dental students, 3D motion analyses were performed with inertial sensors during the performance of standardized dental activities. For this purpose, 15 dental students and 15 dental assistant trainees (all right-handed) were measured in a team. Data were analyzed using the Rapid Upper Limb Assessment (RULA), which was modified to evaluate objective data. Ergonomic risk was found for the following body parts in descending order: left wrist, right wrist, neck, trunk, left lower arm, right lower arm, right upper arm, left upper arm. All relevant body parts, taken together, exhibited a posture with the highest RULA score that could be achieved (median Final Overall = 7), with body parts in the very highest RULA score of 7 for almost 80% of the treatment time. Dental students work with poor posture over a long period of time, exposing them to high ergonomic risk. Therefore, it seems necessary that more attention should be paid to theoretical and practical ergonomics in dental school.

Combining Ergonomic Risk Assessment (RULA) with Inertial Motion Capture Technology in Dentistry-Using the Benefits from Two Worlds.

Traditional ergonomic risk assessment tools such as the Rapid Upper Limb Assessment (RULA) are often not sensitive enough to evaluate well-optimized work routines. An implementation of kinematic data captured by inertial sensors is applied to compare two work routines in dentistry. The surgical dental treatment was performed in two different conditions, which were recorded by means of inertial sensors (Xsens MVN Link). For this purpose, 15 (12 males/3 females) oral and maxillofacial surgeons took part in the study. Data were post processed with costume written MATLAB® routines, including a full implementation of RULA (slightly adjusted to dentistry). For an in-depth comparison, five newly introduced levels of complexity of the RULA analysis were applied, i.e., from lowest complexity to highest: (1) RULA score, (2) relative RULA score distribution, (3) RULA steps score, (4) relative RULA steps score occurrence, and (5) relative angle distribution. With increasing complexity, the number of variables times (the number of resolvable units per variable) increased. In our example, only significant differences between the treatment concepts were observed at levels that are more complex: the relative RULA step score occurrence and the relative angle distribution (level 4 + 5). With the presented approach, an objective and detailed ergonomic analysis is possible. The data-driven approach adds significant additional context to the RULA score evaluation. The presented method captures data, evaluates the full task cycle, and allows different levels of analysis. These points are a clear benefit to a standard, manual assessment of one main body position during a working task.

Comparison of Joint Kinematics in Transition Running and Isolated Running in Elite Triathletes in Overground Conditions.

Triathletes often experience incoordination at the start of a transition run (TR); this is possibly reflected by altered joint kinematics. In this study, the first 20 steps of a run after a warm-up run (WR) and TR (following a 90 min cycling session) of 16 elite, male, long-distance triathletes (31.3 ± 5.4 years old) were compared. Measurements were executed on the competition course of the Ironman Frankfurt in Germany. Pacing and slipstream were provided by a cyclist in front of the runner. Kinematic data of the trunk and leg joints, step length, and step rate were obtained using the MVN Link inertial motion capture system by Xsens. Statistical parametric mapping was used to compare the active leg (AL) and passive leg (PL) phases of the WR and TR. In the TR, more spinal extension (~0.5-1°; p = 0.001) and rotation (~0.2-0.5°; p = 0.001-0.004), increases in hip flexion (~3°; ~65% AL-~55% PL; p = 0.001-0.004), internal hip rotation (~2.5°; AL + ~0-30% PL; p = 0.001-0.024), more knee adduction (~1°; ~80-95% AL; p = 0.001), and complex altered knee flexion patterns (~2-4°; AL + PL; p = 0.001-0.01) occurred. Complex kinematic differences between a WR and a TR were detected. This contributes to a better understanding of the incoordination in transition running.

Oral Health: Global Research Performance under Changing Regional Health Burdens.

Objectives: Inadequate oral hygiene still leads to many serious diseases all over the world. Therefore, this study aimed to analyze scientific research in the field of oral health in order to be able to comprehend their relevant subject areas, research connections, or developments. Methods: This study aimed to assess the global publication output on oral hygiene to create a world map that provides background information on key players, trends, and incentives of research. For this purpose, established bibliometric parameters were combined with state-of-the-art visualization techniques. Results: This study shows the actual key players of research on oral hygiene in high-income economies with only marginal participation from lower economies. This still corresponds to the current burden situations, but they are more and more shifting to the disadvantage of the low-income countries. There is a clear North-South and West-East gradient, with the USA and the Western European nations being the most publishing nations on oral hygiene. As an emerging country, Brazil plays a role in the research. Conclusions: The scientific power players were concentrated in high-income countries. However, the changing epidemiological situation requires a different scientific approach to oral hygiene. This requires an expansion of the international network to meet the demands of future global oral health burdens, which are mainly related to oral hygiene.

Office work and stretch training (OST) study: effects on the prevalence of musculoskeletal diseases and gender differences: a non-randomised control study.

OBJECTIVES: For the prevention of musculoskeletal diseases (MSDs), stretch training can be a measure of the workplace health promotion (WHP) for office workers. This can lead to an increase in mobility and, ultimately, reduce or prevent MSD. The aim of the study was to examine a standardised and individualised stretch training on a device, specifically 'five Business', for the prevalence of MSD. DESIGN: This study is a non-randomised control study. SETTING: WHP programme with clerical employees of a German car manufacturer. PARTICIPANTS: 252 (110 women; 142 men) subjects (median age of 44 ([Formula: see text] 21 years) finished the study successfully. Inclusion criteria included a full-time employment in the office workplace and subjective health. INTERVENTION: The intervention group completed 22-24 training units of 10 min each on the 'five-Business' device two times a week for 12 weeks. PRIMARY AND SECONDARY OUTCOME MEASURES: Data were collected in the form of a pre-post study Nordic Questionnaire. RESULTS: After the intervention, significantly fewer subjects reported pain in the area of the neck (-17.79), shoulder (-11.28%), upper back (-14.7%), lower back (-12.78%) and feet (-8.51%). The gender analysis revealed that women are, in general, more often affected by musculoskeletal complaints than men, especially in the neck (+29.5%) and feet (+15.03%). Both sexes had significant reductions of MSD in the most commonly affected regions. Thus, 27.12% less women reported having neck pain, while 13.14% less men reported having low back pain. CONCLUSIONS: The results suggest that a stretching programme performed for 3 months can reduce musculoskeletal complaints in the most commonly affected areas in office workers. Both men and women benefited from the stretch training to a similar extent, suggesting that this would be a promising measure for therapy and prevention as part of WHP.

Intra- and inter-rater reliability of joint range of motion tests using tape measure, digital inclinometer and inertial motion capturing.

BACKGROUND: In clinical practice range of motion (RoM) is usually assessed with low-cost devices such as a tape measure (TM) or a digital inclinometer (DI). However, the intra- and inter-rater reliability of typical RoM tests differ, which impairs the evaluation of therapy progress. More objective and reliable kinematic data can be obtained with the inertial motion capture system (IMC) by Xsens. The aim of this study was to obtain the intra- and inter-rater reliability of the TM, DI and IMC methods in five RoM tests: modified Thomas test (DI), shoulder test modified after Janda (DI), retroflexion of the trunk modified after Janda (DI), lateral inclination (TM) and fingertip-to-floor test (TM). METHODS: Two raters executed the RoM tests (TM or DI) in a randomized order on 22 healthy individuals while, simultaneously, the IMC data (Xsens MVN) was collected. After 15 warm-up repetitions, each rater recorded five measurements. FINDINGS: Intra-rater reliabilities were (almost) perfect for tests in all three devices (ICCs 0.886-0.996). Inter-rater reliability was substantial to (almost) perfect in the DI (ICCs 0.71-0.87) and the IMC methods (ICCs 0.61-0.993) and (almost) perfect in the TM methods (ICCs 0.923-0.961). The measurement error (ME) for the tests measured in degree (°) was 0.9-3.3° for the DI methods and 0.5-1.2° for the IMC approaches. In the tests measured in centimeters the ME was 0.5-1.3cm for the TM methods and 0.6-2.7cm for the IMC methods. Pearson correlations between the results of the DI or the TM respectively with the IMC results were significant in all tests except for the shoulder test on the right body side (r = 0.41-0.81). INTERPRETATION: Measurement repetitions of either one or multiple trained raters can be considered reliable in all three devices.