Risk factors, clinical features and outcome of treatment of work related musculoskeletal disorders in on-site clinics among IT companies in India.

Workrelated musculoskeletal disorders among the IT professional is a common area of concern worldwide. This study was taken up to analyze the prevalence of risk factors, clinical features and outcome of treatment in onsite clinics in vaious information technology companies in India. Result revealed poor office ergonomics (54%), lack of keyboard tray (25%), lack of mouse tray (35%), lack of foot rest (60%), improper monitor height (80%) were the major self reported risk factors. Major identified MSD were Myofascial Pain Syndrome (49.20%), Thoracic outlet syndrome (25.02%), Fibromyalgia syndrome (8.5%). Majorly affected body regions were neck (64.9%), shoulder (42.1%), lower back (56.5%) and thigh (34.2%). The results were comparable with the literature. Feedback of the participants also revealed most of the participants were well satisfied with SHARAN's protocol.

Development of a score for assessing severity, predicting interventions and prognosis of musculoskeletal disorders.

Musculoskeletal disorders (MSD's) are a constellation of disorders. There is no single tool available which guides the clinicians to predict the severity, intervention and recovery period of the patients who is suffering from different musculoskeletal disorder. In this paper authors tried to categorize the severity of the musculoskeletal discomfort and the prognosis of the recovery period. The questionnaire was formulated using different epidemiological risk factor of the development of MSD and the effect of MSD on physical and psychosocial factors. The questionnaire contains 13 questions which include seven direct (rating was 0, 2, 4, 6, 8 and 10) and six indirect (rating was 0, 1, 2, 3, 4 and 5) questions. Results revealed a significant correlation with the prognosis of recovery and the actual recovery period (r= 0.80). It also showed a significant correlation between the total severity score and the actual recovery (r=0.82) period. Depending on the prognosis of the recovery the severity score was segregated in four categories as mild, moderate, severe and complicated. Due to small sample size the prognosis of recovery for higher severity score could not be plotted.

Correlation of ergonomic risk factors with RULA in IT professionals from India.

Work-related musculoskeletal disorders (WMSD) are common in computer professionals worldwide. Studies have shown that there is an association between the working posture and the development of musculoskeletal disorders. The IT professionals are exposed to different awkward posture while working. Therefore, it is expected that workers may develop different kinds of musculoskeletal discomfort/pain. This study aimed at to find out the relationship between the musculoskeletal discomfort and the postural score. RULA was used for postural analysis. Results of the postural analysis revealed that 30% of the participant's posture need to "modify soon" and 15% need to modify "immediately". 78% of the participants were using computer for more than 8 hours in a day. The major workstation risk factors were reported as improper keyboard height and mouse tray height (32%), improper monitor height (27%) and improper chair height (12%). Results also revealed a significant association between the regional body pain and the RULA score. Musculoskeletal pain was significantly associated with workstation keyboard/mouse surface (r=0.55) and duration of computer use (r=0.64). Intervention programme was recommended for the participant to modify the workstation and the working posture.

Back pack injuries in Indian school children: risk factors and clinical presentations.

The use of backpack increased substantially among the school children. Studies have shown that carrying a backpack cause to develop different symptoms of musculoskeletal disorders among the carrier of the backpack. In India there are fewer studies available in literature which explains the musculoskeletal discomfort among the school children. This study aimed at to find out the prevalence of different musculoskeletal problems among the school children. In a retrospective study data were collected for twenty two students. The main diagnostic criteria were pressure mark (redness or swelling) over neck and shoulder corresponding to the straps of the backpack, stooping posture while carrying the back pack, pain or stiffness in the neck, upper back and shoulders predominantly while carrying the back pack and absence of these symptoms during school holidays. Results revealed that pain in the upper back (40%), neck (27%) and shoulder (20%) were most prevalent body regions followed by forearm and wrist pain (7%) and low back (6%). Results further revealed that all the students participated in this study have a pressure mark over shoulder. 54.55% of the children were diagnosed with myofascial pain and rest with thoracic outlet syndrome.

Risk factors and clinical features of text message injuries.

Use of mobile phone and sending text message is a very common in today's life. While sending a text message the users need to use their thumb and other palm muscles extensively. The thumb most of the time adducted on the key pad of the mobile and use high force to type the letters. Studies in literature showed that text messaging has an adverse effect on musculoskeletal system of hand. But the extensive study on the type of disorders set in among the users who extensively use mobile phone for texting. This study aims at to evaluate risk factor and clinical feature of the MSD due to hand held devices. Twenty seven subjects participated in this study. Predefined protocols were used to evaluate type of MSD occurred among the subjects. The study revealed that development of tendinitis in extensor pollicis longus, myofascial pain syndrome (70.37%) of adductor pollicis, 1st interossei and extensor digitorum communis . Other associated problems diagnosed were thoracic outlet syndrome (51.85%), fibromyalgia syndrome (25.93%), hypothyroidism (7.41%), wrist tendinitis (14.81%) and De Quervain's syndrome (7.41%). It has been observed that the pathology were tendinitis of extensor pollicis longus, myofascial pain syndrome of thenar muscles and 1st interossei, extensor digitorum communis.

Injury prevention in physiotherapists--a scientific review.

This review targeted all research previously conducted on the topic of musculoskeletal disorders and injury among physiotherapists, with a particular focus on studies that had examined individual, physical and psychosocial risk factors and provided suggestions or recommendations to prevent such injuries. Scientific literature published in English languages was searched using electronic way. A total of 17 appropriate studies were located and examined, most of which had focused on the prevalence of musculoskeletal disorders/pan or any other injury. From the review, it was shown that major risk factors among the physiotherapist were manual therapy, repetitive movement, awkward and static posture, physical load, lifting and transferring, treating large number of patients treating in a single day, working while injured, years of experience. The preventive measures that described in these literatures were awareness of reporting of injury, use of less manual therapy, proper exercise, formulation of new devices, intervention at the level of workplace, work schedule allocation, proper training, ongoing risk assessment and control.

Musculoskeletal disorders in caregivers of children with cerebral palsy following a multilevel surgery.

The patients of cerebral palsy need assistance for their self activities which expose the caregivers to different risk factors of musculoskeletal disorders. But there is a scarcity of studies revealing the prevalence and the risk factors present among the caregivers of the cerebral palsy children. This lead to formulate a study to identify prevalence and risk factors among the caregivers of cerebral palsy children. Result revealed that most of the caregivers among both the groups were female (63.4% and 69.3%). The common age group of the children who underwent multilevel surgery was at the age group of 6 - 10 years. It has been observed that among the study group 56.5% were totally cooperative children. The Caregiver Strain Index value showed there is no significant difference among both the groups. Regional body pain of shoulder, elbow, upper back, lower back and ankle revealed a higher prevalence among the study group. Clinical diagnosis revealed prevalence of MPS, FMS and TOS among the study group were 27.6%, 24.5% and 23.0% respectively. Study further revealed that cooperativeness of the child was significantly associated with lower back pain, MPS, FMS and TOS among the study group.

Effect of ergonomic and workstyle risk factors on work related musculoskeletal disorders among IT professionals in India.

'Workstyle' can be described as a mechanism by which ergonomic and psychosocial risk factors interact to affect the development, exacerbation and/or maintenance of upper limb pain and functional limitations. Workstyle is associated with the increase in the work demand. In today's life use of computer in the workplace is very common and it causes to increase the work demand among the workers who are working with computer. As work demand increase, according to the characteristic of workstyle, risk of the development of musculoskeletal disorders also increased. This study aimed at to findout the association between ergonomics risk factors, workstyle and WRMSD. Two hundred IT professionals participated in this study. Result revealed that most prevalenet body regions were lower back (20%), Upper back (16%) and shoulder (14%). Study result says that there is a positive association between workstyle score with musculoskeletal pain (r=0.85). Also it revealed that posture and regional pain is associated (r=0.62), per day use of computer and musculoskeletal pain (r=0.46), micro breaks and pain (r=0.87) and productivity and the pain (r=0.95). This study further validates these observations and extends support for the assessment of working postures and workstyle behaviors during the design of WMSD treatment.

Virtual reality based therapy for post operative rehabilitation of children with cerebral palsy.

Virtual reality is the use of interactive replication created with computer hardware and software to impart users with opportunities to engage in environments that appear to feel similar to real world objects and events. The commonest rehabilitation program of cerebral palsy children involves stretching, strengthening, mobilization and various other activities, whereas the use of virtual reality based training (VRBT) for rehabilitation of cerebral palsy is not common. To understand the effect of VRBT a study was formulated. Twenty nine subjects participated (study group--14 and control group--15). Outcome measures were MACS, PBS, level of participation, motivation, cooperation and satisfaction of the child. Results revealed that balance and manual ability were significantly improved in both the groups (Balance: study: t-2.28, p<0.05; control: t-3.5, p<0.01; Manual ability: study: t-5.58, p<0.001; control: t-7.06, p<0.001). PBS had significantly greater improvement in the study group (t-t-2.02, p<0.05). Level of participation, motivation, cooperation and satisfaction of the child were also reported to be significantly higher among the study group as compared with control group. To the author's best knowledge, this is the first study on using the VR-based therapy for the postoperative rehabilitation of children with CP which need further elaboration with larger sample size.

The effect of cetylated fatty esters and physical therapy on myofascial pain syndrome of the neck.

Participants with Myofascial Pain Syndrome (MPS) of the neck were randomly assigned into 2 groups of the double-blinded study: topical cetylated fatty ester complex (CFEC) cream application plus physical therapy (CF-PT; n=37), and placebo cream application plus physical therapy (PL-PT; n=35). There were 3 visits during 4 weeks of treatment. Physical Therapy (PT), given twice/week, included Ischaemic Compression, Deep Pressure Trigger Point Massage and Myofascial Releases. Topical cream [CFEC cream (5.6%) and 1.5% menthol] or placebo cream [1.5% menthol, in a cream base] was applied twice/day. CF-PT provided the fastest and most effective study treatment modality. The addition of CFEC cream to PT resulted in statistically significant improvements, compared to PL-PT, for reduction of pain, neck disability and life quality indicators. Our results indicate that cetylated derivatives of fatty acids can effectively reduce pain and symptoms associated with neck MPS, when combined with physical therapy.