Calidad de vida, nivel de actividad física y pruebas funcionales en personas adultas y mayores laboralmente activas / Quality of life, level of physical activity and functional tests in actively working adults and older people

BACKGROUND: The population of actively working older people is growing rapidly. The relationship between quality of life, levels of physical activity and functionality in this population is not entirely clear. AIM: To determine the association between quality of life, levels of physical activity and functional tests in actively working adults and older people. MATERIAL AND METHODS: Cross sectional assessment of 138 adults aged 40 to 50 years (53% women) and 119 older people aged 60 to 75 years (53% women) who were actively working in two public services. Quality of life was measured with the SF-36 questionnaire and usual physical activity was assessed with the International Physical Activity Questionnaire (IPAQ-short). Handgrip strength, the timed up and go (TUG) and chair stand test (CST) were used as functional tests. RESULTS: Compared to older people, adults had better physical functional tests (P < 0.01). Older people had better scores in the mental health component (MHC) of quality of life (p < 0.05). In adults, the physical health component of quality of life (CSF) had a positive association with physical activity (Spearman Rho (rs)= 0.270; p = 0.01), grip strength (rs = 0.330; p < 0.01) and the TUG (rs = −0.229; p < 0.01). In older patients, CSM and CST were positively correlated (rs = 0.201; P = 0.029). In both groups, a correlation was observed between CSM, grip strength (adults rs = 0.283; p < 0.01; older people rs = 0.211; P = 0.02) and with TUG (adults rs = −0.197; P = 0.021; older people rs = - 0.212; p = 0.02). CONCLUSIONS: There is a positive correlation between quality of life and level of physical activity in working adults, which is not observed in older people. Adequate performance in physical functional tests is positively correlated with better quality of life (CSF and CSM) in adults and only with the mental health component in older people.

[Quality of life, level of physical activity and functional tests in actively working adults and older people]. / Calidad de vida, nivel de actividad física y pruebas funcionales en personas adultas y mayores laboralmente activas.

BACKGROUND: The population of actively working older people is growing rapidly. The relationship between quality of life, levels of physical activity and functionality in this population is not entirely clear. AIM: To determine the association between quality of life, levels of physical activity and functional tests in actively working adults and older people. MATERIAL AND METHODS: Cross sectional assessment of 138 adults aged 40 to 50 years (53% women) and 119 older people aged 60 to 75 years (53% women) who were actively working in two public services. Quality of life was measured with the SF-36 questionnaire and usual physical activity was assessed with the International Physical Activity Questionnaire (IPAQ-short). Handgrip strength, the timed up and go (TUG) and chair stand test (CST) were used as functional tests. RESULTS: Compared to older people, adults had better physical functional tests (P < 0.01). Older people had better scores in the mental health component (MHC) of quality of life (p < 0.05). In adults, the physical health component of quality of life (CSF) had a positive association with physical activity (Spearman Rho (rs)= 0.270; p = 0.01), grip strength (rs = 0.330; p < 0.01) and the TUG (rs = -0.229; p < 0.01). In older patients, CSM and CST were positively correlated (rs = 0.201; P = 0.029). In both groups, a correlation was observed between CSM, grip strength (adults rs = 0.283; p < 0.01; older people rs = 0.211; P = 0.02) and with TUG (adults rs = -0.197; P = 0.021; older people rs = - 0.212; p = 0.02). CONCLUSIONS: There is a positive correlation between quality of life and level of physical activity in working adults, which is not observed in older people. Adequate performance in physical functional tests is positively correlated with better quality of life (CSF and CSM) in adults and only with the mental health component in older people.

Transcutaneous Vagal Stimulation in Knee Osteoarthritis (TRAVKO): Protocol of a Superiority, Outcome Assessor- and Participant-Blind, Randomised Controlled Trial.

Current treatments for knee osteoarthritis (KOA) are partially effective. It is, therefore, necessary to find new strategies that can complement the existing ones. In this scenario, transcutaneous vagal stimulation (TVS) neurophysiological effects could be a helpful solution. However, there is no evidence of the efficacy of TVS in KOA. This trial aims to assess the efficacy of TVS in decreasing pain in participants aged 55 years or older with KOA. A randomised controlled, two-arm, double-blind (participants and outcome assessors) and clinical superiority trial will be conducted for 70 patients with KOA. All the participants will carry out an exercise program. It consists of 12 sessions over four weeks. In addition, they will be randomly assigned to (1) active TVS plus physical exercise or (2) sham TVS plus physical exercise. The application of active TVS consists of electronic stimulation of the auricular concha using a portable device. Sham TVS condition consists of the stimulation of the earlobe that does not cause neurophysiological effects. The primary outcome is the reduction in pain intensity. Additionally, functional capacity, physical performance, pain-related interference, pain-related distress, quality of life in older adults and global change will be measured. Assessments will be conducted at the beginning of the study (baseline), at the end of the intervention and after 1 and 3 months of follow-up. This trial will generate evidence regarding the efficacy of TVS in pain perception in individuals with KOA. This information will serve as an input in the clinical decision-making on the use or non-use of TVS in individuals with KOA. Thus, if the efficacy of TVS is confirmed, a new therapeutic tool may be included in the rehabilitation of individuals with KOA.

The association of musculoskeletal complaints and individual and work-related factors with work ability in Chilean white-collar and blue-collar workers.

Objective. The maintenance of good work ability has proven to have a positive effect on health, quality of work and productivity. There is little evidence regarding the association between musculoskeletal complaints, individual and work-related factors, and work ability in blue-collar and white-collar workers. Methods. A cross-sectional study of hospital and university workers (n = 360) was performed to determine the association between musculoskeletal complaints, individual and work-related factors, and work ability; two multiple linear regression models were created. Results. In white-collar workers, musculoskeletal complaints of the dorsal/lumbar region (ß = -0.259) and the wrist/hand segment (ß = -0.151) were significantly associated with reduced work ability. A higher body mass index (ß = -0.227) was also negatively associated with the dependent variable. In blue-collar workers, musculoskeletal complaints of the dorsal/lumbar region (ß = -0.317) and the elbow/forearm segment (ß = -0.171) were significantly associated with lower work ability. Increased age (ß = -0.204) was associated with reduced work ability in this group. No significant correlations were found between work-related factors and work ability. Conclusions. Musculoskeletal complaints and individual factors, but not work-related factors, are associated with work ability in Chilean blue-collar and white-collar workers. Nevertheless, the variables that explain the change in work ability are different between these groups.

Influence of age on functional capacity and work ability in Chilean workers: a cross-sectional study.

OBJECTIVE: To determine if there are differences in functional capacity and work ability between older and younger active workers in public institutions, and to relate functional capacity to work ability. METHODS: This cross-sectional study evaluated 360 subjects from two public institutions, a university and a high-complexity regional hospital. The participants were divided into 3 age ranges 40-49, 50-59 and ≥ 60 years. The following evaluations were applied: a multidimensional assessment questionnaire, work ability and functional capacity using physical tests (strength, flexibility and balance). RESULTS: There are no significant differences in work ability among the different age groups (P > 0.05). Significant differences were found according to age group in 30-s chair-stand test (30-s CST), 1 repetition maximum (1RM) extending the knee 90° (1RM-leg extension) and 1RM of handgrip strength (1RM-handgrip), upper body flexibility, lower body flexibility, static balance or dynamic balance (P < 0.05). Only the variables 30-s CST (rs = 0.13, P = 0.018), lower body flexibility (rs = 0.13, P = 0.012) and static balance (rs = 0.13, P = 0.012) were related to work ability. CONCLUSIONS: There are differences in functional capacity as the workers' ages increase. By contrast, work ability does not present any differences when comparing older and younger adults. Some physical tests of the lower extremities presented a small correlation with work ability.

Psychometric Properties of the Spanish Version of the Work Ability Index in Working Individuals.

It is increasingly important to have validated instruments to assess the ability to work. Thus, the aim of this study was to evaluate the psychometric properties of the Spanish version of the Work Ability Index (WAI) in working individuals. A cross-sectional study was conducted on 360 workers (men and women) in a high-complexity public hospital and in a public university. The participants were between 40 and 75 years, with a contract of at least 11 h weekly. The ability to work was assessed using the WAI and the perception of health through the Short Form 36 Health Survey version 2 (SF-36 v2). The concurrent validity was analyzed, correlating the WAI with the SF-36 v2. An exploratory factor analysis was performed to test construct validity. In addition, the internal consistency of the WAI was analyzed using the standardized Cronbach's alpha coefficient. The WAI showed a positive and statistically significant correlation (p < 0.001) with the SF-36 v2. The exploratory factor analysis showed three factors interpreted as, "Mental Resources", "Diseases and Health-Related Restrictions", and "Self-perception of Work Ability". The reliability of the factors was acceptable, except for the second factor, which was poor. The WAI demonstrated acceptable psychometric properties, such as internal consistency, concurrent and construct validity, constituting a reliable instrument to measure work ability for the population of active working individuals in the service sector.

Percepción del beneficio del ejercicio para la prevención de trastornos musculoesqueléticos: una perspectiva del trabajador / Workers' perception of benefit of the exercise for the prevention of musculoskeletal disorders

Resumen: Distintas modalidades de prevención para disminuir la incidencia de Trastornos musculoesqueléticos (TME) han sido propuestas, sin embar go, no existe evidencia nacional sobre la valoración que hacen los trabajadores sobre las acciones implementadas por las empresas. El propósito de este estudio fue evaluar la percepción de los trabajadores sobre el beneficio del ejercicio en el puesto de trabajo (EPT) para prevenir TME. Método: Bajo el contexto de un estudio de evaluación de efectividad del ejercicio en la prevención de TME en trabajadores manu factureros, se le aplicó una encuesta de percepción a la totalidad de los trabajadores (n = 109). Resultados: Un 92.3% de los trabajadores con sidera importante realizar EPT y el 82.8% lo asocia a una conducta saludable, destaca un alto nivel de satisfacción en la práctica grupal de los ejercicios (96%) y estar de acuerdo con implementarla como estra tegia de prevención permanente. Conclusión: Los trabajadores otorgan gran importancia a la aplicación de EPT, independiente de su modali dad, los cuales tienden a relacionarse con la percepción positiva respec to a los efectos beneficiosos para su salud. La aplicación de esta moda lidad de ejercicios tiene una alta aceptabilidad por los trabajadores, facilitando su implementación y logro de objetivos.

Abstract: Different forms of prevention to reduce the incidence of musculoskel etal disorders (MSDs) have been proposed, however, there is no national evidence on the assessment made by workers on the actions implemented by companies. The purpose of this study was to assess workers' perception of the benefit of exercise in the workplace to prevent MSDs. Method: In the context of an evaluation study of exercise effectiveness in the prevention of MSDs in manufacturing workers, a perception survey was applied to all workers (n = 109). Results: 92.3% of the workers considered it important to exercise in the workplace and 82.8% associated it with a healthy behavior, they reported a high level of satisfaction in the group practice of the exer cises (96%) and agree to implement it as a permanent prevention strategy. Conclusion: The workers give high importance to the appli cation of exercise in the workplace, regardless of their modality, which tend to relate to positive perception and beneficial effects for their health.. The application of this type of exercise has a high acceptabil ity by workers, facilitating its implementation and achievement of objectives.

Discapacidad laboral por dolor lumbar: estudio caso control en Santiago de Chile / Work disability for lower back pain: case control study in Santiago

ANTECEDENTES. La discapacidad laboral por dolor lumbar causa ausencia laboral y gastos económicos. Se ha responsabilizado su presencia a condiciones del entorno laboral y a la manipulación manual de cargas (MMC). Se evaluó la asociación entre niveles de exposición laboral a MMC y presencia de discapacidad en trabajadores protegidos por ley laboral en Santiago de Chile. MATERIAL Y MÉTODO. Estudio Caso Control. Exposición y covariables de interés fueron medidas en puesto de trabajo. Los análisis incluyeron Modelos de Regresión Logística Múltiple. RESULTADOS. La exposición a MMC moderada muestra OR: 1,62 (IC95%:0,61-4,33), la exposición a MMC alta y muy alta muestra OR de 2,75 (IC95%:1,08-6,95). DISCUSIÓN. Existe una importante magnitud y gradiente de asociación entre MMC y discapacidad. Variables psicosociales, organizacionales e individuales también explican el fenómeno. Se sugiere rediseñar las estrategias nacionales para prevenir riesgos laborales relacionados con discapacidad por dolor lumbar.

BACKGROUND: Work disability due to low back pain causes lost productivity and economic expense. It has been blamed on the working environment and the manual handling of loads (MHL). The link between levels of work exposure to MHL and the disability of workers protected by labor law was evaluated in Santiago, Chile. MATERIALS AND METHODS: Case-control study. Exposure and study co-variables were measured in the workplace. The analyses included multiple logistic regression models. RESULT AND DISCUSSION: Exposure to moderate MHL shows an OR: 1.62 (95% CI: 0.61-4.33), high and very high exposure to MHL shows an OR of 2.75 (95% CI: 1.08-6.95), controlled by psychosocial, organizational and individual aspects. There is a significant magnitude and gradient of association between MHL and disability. Psychosocial, organizational and individual variables also explain the phenomenon. It is suggested that national strategies be redesigned to prevent the occupational risks related to disability due to low back pain.

Factores de riesgo ergonómico y su relación con dolor musculoesquelético de columna vertebral: basado en la primera encuesta nacional de condiciones de empleo, equidad, trabajo, salud y calidad de vida de los trabajadores y trabajadoras en Chile (ENETS) 2009-2010 / Ergonomic risk factors and their relationship to spinal musculoskeletal pain: based on the first national survey of conditions of employment equity, labour, health and quality of life of the workers in Chile (ENETS) 2009-2010

El dolor de columna constituye un importante problema de salud en la población trabajadora, atribuido a factores individuales y condiciones laborales. Este estudio buscó determinar la influencia de la exposición a factores de riesgo ergonómico durante la jornada laboral sobre la presencia de dolor musculoesquelético en la columna vertebral. Los datos de este estudio se originaron a partir de los resultados que obtuvo la ENETS dirigida a la población laboral chilena. Se pudo concluir que los factores de riesgo ergonómicos que más explican el riesgo de padecer dolor de columna fueron "movimiento repetitivo" (OR: 1.34; CI: 1.08-1.65) seguido de "vibración corporal" (OR: 1.28; CI: 1.04-1.58). En relación al resultado del estudio, es recomendable revisar las políticas públicas en relación a la seguridad y salud laboral así como la legislación vigente relacionada con los problemas musculoesquelético. Estas deben orientarse a la acomodación ergonómica del puesto de trabajo con el propósito de reducir el impacto generado por la exposición reiterada a factores tales como, el manejo de cargas, posturas forzadas y movimientos corporales repetitivos y el efecto acumulativo por trabajos anteriores (AU)

Spinal pain is a major health problem in the working population, attributed to individual factors and conditions factors. This study sought to determine the influence of exposure to ergonomic risk factors during working hours on the presence of musculoskeletal pain in the spine. The data in this study originated from the results obtained ENETS aimed at Chilean workforce. We concluded that ergonomic risk factors that best explain the risk of spinal pain were "repetitive motion" (OR 1.34, CI: 1.08-1.65) followed by "body vibration" (OR: 1.28, CI: 1.04-1.58). Regarding the outcome of the study, you should review the policies in relation to occupational health and safety and current legislation related to musculoskeletal problems. These should focus on the accommodation ergonomic workstation in order to reduce the impact caused by repeated exposure to factors such as load handling, awkward postures and repetitive body movements and the cumulative effect from previous work (AU)

Asociación entre puesto de trabajo computacional y síntomas musculoesqueléticos en usuarios frecuentes / Association between computational jobs and musculoskeletal symptoms in office workers

Introducción: Está comprobado que el uso frecuente de computadores en trabajos administrativos muestra un aumento de problemas musculoesqueléticos en las personas que los utilizan. Este estudio pretende determinar asociaciones entre puestos de trabajo computacional y presencia de síntomas musculoesqueléticos, con especial énfasis en elementos físicos que componen el diseño. Materiales y Métodos: Estudio transversal realizado sobre una muestra poblacional de 153 sujetos administrativos y usuarios frecuentes de computadores. Se administró cuestionario de síntomas musculoesqueléticos y una evaluación ergonómica de los puestos de trabajo. Posteriormente, se realizó análisis univariado y multivariados. Resultados y Discusión: La proporción de puestos de trabajo con diseño ergonómico inadecuado de la superficie de trabajo fue 62,7%, teclado 53,6%, y portadocumentos 90,8%. La asociación más importante entre los síntomas por región corporal con diseño ergonómico inadecuado fue hombro izquierdo/teclado (valor p: 0,04). Se concluye que la población estudiada tiene alta prevalencia de síntomas musculoesqueléticos y que el diseño no ergonómico del teclado, escritorio y silla podrían estar relacionados con síntomas en extremidades superiores, región dorsal y lumbar, respectivamente. Se sugiere estudiar el uso dado a los puestos de trabajo por parte de los usuarios, ya que podría estar influyendo en los resultados (AU)

Introduction: This found that frequent use of computers in administrative work shows an increase of musculoskeletal problems in people who use them. This study evaluated associations between computational jobs and presence of musculoskeletal symptoms, with special emphasis on physical elements that make up the design. Materials and Methods: Cross-sectional study on a population sample of 153 subjects administrative and frequent users of computers. Questionnaire was administered musculoskeletal symptoms and ergonomic assessment of jobs. Subsequently, we performed univariate and multivariate analysis. Results and Discussion: The proportion of jobs with inadequate ergonomic work surface was 62.7%, 53.6% keyboard, 90.8% and briefcases. The most important association between symptoms by body region was inappropriate ergonomically designed left shoulder / keyboard (p value: 0.04). We conclude that the study population has a high prevalence of musculoskeletal symptoms and ergonomic design is not the keyboard, desk and chair might be related to symptoms in upper extremities, thoracic and lumbar region respectively. It is suggested to study the use made of the jobs by the users as it could be influencing the results (AU)

Vigilancia epidemiológica de los desórdenes músculo-esqueléticos(DME) relacionados con el trabajo: ¿una oportunidad para la investigación epidemiológica? / Epidemiological surveillance of work related musculoskeletal disorders (MSD): ¿an opportunity for epidemiological research?

Un problema relevante de salud pública lo constituyen los Desórdenes Músculo-Esqueléticos, DME, de origen laboral. Su difícil abordaje y definición como entidad patológica ha hecho dificultosa su vigilancia epidemiológica y, más aun, estudiarlos de manera científica. La vigilancia epidemiológica de los DME implica la identificación y caracterización de una variedad de trabajos con exposición a factores estresores, incluyendo agentes físicos, riesgos ergonómicos y de organización del trabajo. La información de los DME se obtiene a través de registros con fines económicos y médicos, además se utilizan los autorreportes de síntomas, lista de chequeo en el puesto de trabajo y exámenes clínicos. No existe una prueba de oro para la detección de los DME, y la comunidad científica no ha logrado una definición exenta de sesgos, por lo que es difícil cuantificarlos y analizarlos a partir de un sistema de vigilancia. La epidemiología puede ayudar a evidenciar las verdaderas relaciones entre los DME y los factores de riesgo de exposición en el lugar de trabajo, que pueden no ser simples, sino más bien relaciones de concurrencia e interacción, por lo cual es importante entender los efectos de estos perfiles de exposición. Potenciar sistemas de vigilancia en el ámbito ocupacional, que obtengan datos completos y de manera rigurosa, nos ayudará inicialmente a direccionar nuestras acciones en salud y, consecuentemente, a propiciar investigación epidemiológica. La vigilancia epidemiológica ocupacional resulta una oportunidad para las investigaciones epidemiológicas de los DME, pero requiere de grandes esfuerzos y consensos de los investigadores y de las instituciones involucradas para que la calidad y la suficiencia de los datos permitan avanzar en el conocimiento científico.

Work-related musculoskeletal disorders represent a significant public health problem. The difficulty in addressing and defining them as a pathological entity has made its epidemiological surveillance difficult and even more difficult to study them scientifically. Epidemiological surveillance of MSDs involves the identification and characterization of a variety of jobs exposed to stressor factors, includingphysical agents, ergonomic risks and work organization. MSDs information is obtained through records with economic and medical purposes. Symptoms self-report, check lists at the work place and clinical exams are also used. There is no a gold test for the detection of the MSDsand the scientific community has not achieved a bias-free definition, soit is difficult to quantify and analyze them from a surveillance system. Epidemiology can help reveal the true relationship between the MSDs and the exposure risk factors at the workplace, which may not be simple, but rather concurrency and interaction relations, for which reason it is important to understand the effects of these exposure profiles. Strengthening surveillance systems in the work environment, which obtain complete data and in a rigorous manner, will help us to initially direct our actions in health and, consequently, to facilitate epidemiological research. Occupational epidemiological surveillance is an opportunity for epidemiological investigations of MSDs, but it requires great efforts and consensus of investigators and of involved institutions so that the quality and sufficiency of data will allow scientific knowledge advancing.