The effectiveness of video-based exercise training program for people with intellectual disability: a multicenter study.

Objective: To examine the effectiveness of a specially designed video-based exercise program in promoting physical and balance performance in people with intellectual disability. Methods: This study was a multicenter controlled trial. Participants with intellectual disability were divided into exercise group and control group by cluster sampling. The participants in the exercise group received 1 h exercise training sessions twice a week for 8 weeks, and the controls continued their usual care without exercise training. The exercises were specially designed to match the physical ability level of the participants classified as high and low, and a third group called "special" was designed for those wheelchair-bound persons with limited mobility. Elements of light-tempo music and animation were introduced in the videos to motivate the participants. Recording the exercises in video format makes it easier for the class instructors and participants to perform the exercises together, and ensure consistency across different exercise groups conducted in different centers. Each participant underwent the pre- and post-intervention assessment including 30-s chair stand repetitions, five-time chair stand duration, 4-m comfortable walk time, standing static balance level, 6-min walk test, and short physical performance battery score. These variables were compared within each group at pre- and post-intervention stages, and they were also compared between the two groups. Results: A total of 180 participants were enrolled in 16 subcenters, including 160 participants in the exercise group and 20 participants in the control group. After 8 weeks of exercise training, there were significant improvements in their physical performance including 30-s chair stand repetitions and five-time chair stand duration, 4-m comfortable walk time and also 6-min walk test, within the exercise group (all P < 0.05). Approximately 39% of the participants in the exercise group also showed significant improvement in standing static balance level. No significant differences were found when compared with the control group participants who did not have any regular exercise participation. Conclusion: A specially designed video-based exercise program has demonstrated some positive effects on physical and balance performance after 8 weeks of training among adults with intellectual disability.

Towards a global partnership model in interprofessional education for cross-sector problem-solving.

OBJECTIVES: A partnership model in interprofessional education (IPE) is important in promoting a sense of global citizenship while preparing students for cross-sector problem-solving. However, the literature remains scant in providing useful guidance for the development of an IPE programme co-implemented by external partners. In this pioneering study, we describe the processes of forging global partnerships in co-implementing IPE and evaluate the programme in light of the preliminary data available. METHODS: This study is generally quantitative. We collected data from a total of 747 health and social care students from four higher education institutions. We utilized a descriptive narrative format and a quantitative design to present our experiences of running IPE with external partners and performed independent t-tests and analysis of variance to examine pretest and posttest mean differences in students' data. RESULTS: We identified factors in establishing a cross-institutional IPE programme. These factors include complementarity of expertise, mutual benefits, internet connectivity, interactivity of design, and time difference. We found significant pretest-posttest differences in students' readiness for interprofessional learning (teamwork and collaboration, positive professional identity, roles, and responsibilities). We also found a significant decrease in students' social interaction anxiety after the IPE simulation. CONCLUSIONS: The narrative of our experiences described in this manuscript could be considered by higher education institutions seeking to forge meaningful external partnerships in their effort to establish interprofessional global health education.

Students' interaction anxiety and social phobia in interprofessional education in Hong Kong: mapping a new research direction.

BACKGROUND: Interprofessional education (IPE) has been promoted as a breakthrough in healthcare because of the impact when professionals work as a team. However, despite its inception dating back to the 1960s, its science has taken a long time to advance. There is a need to theorize IPE to cultivate creative insights for a nuanced understanding of IPE. This study aims to propose a research agenda on social interaction by understanding the measurement scales used and guiding researchers to contribute to the discussion of social processes in IPE. METHOD: This quantitative research was undertaken in a cross-institutional IPE involving 925 healthcare students (Medicine, Nursing, Social Work, Chinese Medicine, Pharmacy, Speech Language Pathology, Clinical Psychology, Food and Nutritional Science and Physiotherapy) from two institutions in Hong Kong. Participants completed the Social Interaction Anxiety Scale (SIAS-6) and Social Phobia Scale (SPS-6). We applied a construct validation approach: within-network and between-network validation. We performed confirmatory factors analysis, t-test, analysis of variance and regression analysis. RESULTS: CFA results indicated that current data fit the a priori model providing support to within-network validity [RMSEA=.08, NFI=.959, CFI=.965, IFI=.965, TLI=.955]. The criteria for acceptable fit were met. The scales were invariant between genders, across year levels and disciplines. Results indicated that social interaction anxiety and social phobia negatively predicted behavioural engagement (F = 25.093, p<.001, R2=.065) and positively predicted behavioural disaffection (F = 22.169, p<.001, R2=.057) to IPE, suggesting between-network validity. CONCLUSIONS: Our data provided support for the validity of the scales when used among healthcare students in Hong Kong. SIAS-6 and SPS-6 have sound psychometric properties based on students' data in Hong Kong. We identified quantitative, qualitative and mixed methods research designs to guide researchers in getting involved in the discussion of students' social interactions in IPE.Key MessagesThe Social Anxiety Scale (SIAS-6) and Social Phobia Scale (SPS-6) scales have sound psychometric properties based on the large-scale healthcare students' data in IPE in Hong Kong.Social interaction anxiety and social phobia negatively predicted students' behavioural engagement with IPE and positively predicted behavioural disaffection. The scales are invariant in terms of gender, year level and discipline.Quantitative, qualitative and mixed methods studies are proposed to aid researchers to contribute in healthcare education literature using the SIAS-6 and SPS-6.

Association between time spent on smartphones and digital eye strain: A 1-year prospective observational study among Hong Kong children and adolescents.

Prolonged electronic screen use can cause digital eye strain. It can be difficult to rectify due to increasing smartphone reliance, potentially leading to serious public health problems. To investigate the association between time spent on smartphones and digital eye strain (DES) among Hong Kong Chinese school-aged children. Of a total of 1,508 students (748 males, 49.6%) from 8 to 14 years old (mean age = 10.91 years, SD = 2.01) who provided valid data on DES, the 1,298 (86%) who completed the DES questionnaire at 1-year follow-up were included in the analysis. DES was measured using a 10-item scale, and the sum of the 10 dichotomised scores was used as the DES total score. The most commonly reported symptoms were eye fatigue (n = 804, 53.3%), blurred vision (changing from reading to distance viewing) (n = 586, 38.9%), and irritated or burning eyes (n = 516, 34.2%). The DES total scores at baseline and 1-year follow-up were 2.91 (SD = 2.90) and 3.20 (SD = 3.19), respectively. Linear regression controlling for demographic and socio-economic confounders showed that participants with baseline smartphone usage of 241 + min/d had a significantly higher baseline total DES score than those with baseline smartphone usage of 0-60 min/d (2.44 vs 3.21, P < 0.001), and participants with baseline smartphone usage of 181-240 min/d had a significantly higher 1-year follow-up total DES score than those with baseline smartphone usage of 0-60 min/d (2.80 vs 3.50, P = 0.003).

The Concerns and Experiences of Patients With Lumbar Spinal Stenosis Regarding Prehabilitation and Recovery After Spine Surgery: A Qualitative Study.

Objectives: To improve our understanding of patients' perspectives regarding: (1) the decision-making and prehabilitation before lumbar spinal stenosis (LSS) surgery and (2) their postoperative experiences. Design: Qualitative research with semi-structured interviews. Setting: General community. Participants: Individuals who received (N=10) and who did not receive (N=15) prehabilitation before LSS surgery were recruited at the 6-month postoperative follow-up (8 females; average age: 67.7±6.7 years) by purposive sampling. Additionally, 1 participant invited her daughter to accompany her in an interview. Interventions: Not applicable. Main Outcome Measures: Concerns and experiences of patients with LSS regarding prehabilitation and recovery after spine surgery. Results: Thematic analysis was conducted to identify 4 themes inductively: (1) sources of information about LSS surgery; (2) factors affecting the surgical decision-making; (3) attitudes toward prehabilitation; and (4) postoperative recovery. All participants desired to have more preoperative education to inform their surgical decision-making. There were mixed opinions regarding the perceived benefits of prehabilitation because some individuals hesitated to participate in prehabilitation because of their symptoms, or the cost or time of traveling. Many participants expected some or even complete relief of LSS-related symptoms after surgery. However, not all participants experienced the expected postoperative improvements. Some participants only experienced temporary symptomatic relief, while others experienced new postoperative symptoms. Patients generally found that postoperative exercises taught by physiotherapists were useful although their compliance decreased over time. Conclusions: Our study highlights the need for better preoperative LSS education. Because face-to-face prehabilitation or postoperative rehabilitation may not be feasible for all patients, future studies should explore whether online-based prehabilitation or postoperative rehabilitation may benefit certain patient subgroups.

Using cervical movement velocity to assist the prediction of pain and functional recovery for people with chronic mechanical neck pain.

BACKGROUND: Impaired cervical kinematics particularly the movement velocity had been consistently found in people with neck pain. The recovery and potential of cervical movement velocity in assisting the prediction of recovery in individuals with chronic neck pain remained unknown. This study investigated the application of cervical movement velocity to predict the outcomes of pain intensity and functional disability for a cohort of participants with chronic mechanical pain after completion of a 12-week intervention program. METHODS: Cervical movement velocity when performing neck motions in the anatomical planes, pain intensity and functional disability score were assessed before and after the physiotherapy program. Correlations between kinematic and clinical outcomes, and validity of applying the peak velocity values of the cervical spine measured at baseline for prediction of recovery of pain and function after the physiotherapy program were examined (n = 68). FINDINGS: Significant improvements were found in the peak values of cervical velocity in all movement planes, pain intensity and functional disability score at post-program reassessment (p < 0.001). Significant negative correlations between peak values of cervical movement velocity and pain intensity (for specific directions, r = -0.163 to -0.191), and functional disability were found (for all directions, r = -0.158 to -0.282). Area under the Receiver Operating Characteristics curve was >0.6 for cervical extension, flexion and right rotation velocity for predicting functional recovery post-program. INTERPRETATION: These findings suggest that cervical velocity of selected planes measured at baseline may inform the prediction of recovery of functional disability but not pain intensity in people with chronic mechanical neck pain.

Bedtime smart device usage and accelerometer-measured sleep outcomes in children and adolescents.

PURPOSE: We analyzed the association between bedtime smart device usage habits and accelerometer-measured sleep outcomes (total sleeping time, sleep efficiency, and wake after sleep onset) in Hong Kong children and adolescents aged 8-14. METHODS: A total of 467 students in Hong Kong participated in this study from 2016 to 2017. They self-reported their bedtime smart device usage habits. The primary caregiver of each participant was also invited to complete a self-administered questionnaire about the family's social-economic status and bedtime smart device usage habits. An ActiGraph GT3X accelerometer was used to assess participants' 7-day sleep outcomes. RESULTS: The mean age of the participants was 10.3 (SD 1.9), and 54% were girls. Among the participants, 27% (n = 139) used a smart device before sleep, and 33% (n = 170) kept the smart device on before sleep. In total, 27% (n = 128) placed the smart device within reach before sleep, 23% (n = 107) would wake up when notifications were received, and 25% (n = 117) immediately checked the device after being awakened by a notification. Multiple regression controlling for age, sex, socio-economic status, and other confounders showed that those who woke up after receiving a notification had a statistically longer sleeping time (19.7 min, 95% CI: 0.3, 39.1, p = 0.046), lower sleep efficiency (- 0.71%, 95% CI - 1.40, - 0.02, p = 0.04), and a longer wake after sleep onset (2.6 min, 95% CI: 0.1, 5.1, p = 0.045) than those who did not. Nonetheless, all primary caregivers' bedtime smart device habits were insignificantly associated with all sleep outcomes of their children. CONCLUSION: Those who woke up after receiving smart device notifications had lower sleep efficiency and longer wake after sleep onset than those who did not, and they compensated for their sleep loss by lengthening their total sleep time.

Recovery of the lumbopelvic movement and muscle recruitment patterns using motor control exercise program in people with chronic nonspecific low back pain: A prospective study.

This study aims to investigate the dysfunction and recovery of the lumbopelvic movement and motor control of people with chronic nonspecific low back pain after a structured rehabilitation which emphasizes on re-education and training of movement and motor control. The lumbopelvic movement and motor control pattern of 30 adults (15 with chronic low back pain, 15 healthy controls) were assessed using 3D motion and electromyographic analysis during the repeated forward bending test, in additional to the clinical outcome measures. Regional kinematics and muscle recruitment pattern of the symptomatic group was analysed before and after the 6-week rehabilitation, and compared to healthy controls. Significant improvement in back pain, functional capacity and self-efficacy of the symptomatic group was found after the rehabilitation. Patients with chronic nonspecific low back pain were capable to recover to a comparable level of the healthy controls in terms of their lumbopelvic movement and motor control pattern upon completion of a 6-week rehabilitation program, despite their dysfunction displayed at baseline. Phase specific motor control reorganization in which more profound and positive changes shown during the flexion phase. Our findings indicate that the recovery of the movement and motor control pattern in patients with chronic low back pain achieved to a comparable level of the healthy able-bodies. The improvement of both the physical outcome measures suggest that specific rehabilitation program which emphasizes on optimizing motor control during movements would help promoting the functional recovery of this specific low back pain subgroup.

Development of the Prevent for Work questionnaire (P4Wq) for assessment of musculoskeletal risk in the workplace: part 1-literature review and domains selection.

OBJECTIVE: This study aims to define appropriate domains and items for the development of a self-administered questionnaire to assess the risk of developing work-related musculoskeletal disorder (WMSD) and the risk of its progression to chronicity. DESIGN: Literature review and survey study. SETTING AND PARTICIPANTS: A literature review and a two-round interview with 15 experts in musculoskeletal pain were performed to identify the available domains for WMSD assessment. INTERVENTIONS AND OUTCOME: To ensure quality, only validated questionnaires were included for the Delphi process. A three-round Delphi method, with three round steps, was used to select the most pertinent and relevant domains and items. RESULTS: Nine questionnaires were identified through the expert discussion and literature review, comprising 38 candidate domains and 504 items. In the first round of the Delphi group, 17 domains reached more than 70% agreement and were selected. In the second round, 10 domains were rejected, while 11 were selected to complete the pool of domains. In the third and final round, 89 items belonging to 28 domains were defined as significant to develop a WMSDs risk assessment questionnaire. CONCLUSIONS: No specific risk assessment questionnaires for WMSDs were identified from the literature. WMSD risk of presence and chronicity can be defined by an assessment tool based on the biopsychosocial model and the fear-avoidance components of chronic pain. The present study provides the formulation and operationalisation of the constructs in domains and items needed for developing and validating the questionnaire.

Association between Time Spent on Smart Devices and Change in Refractive Error: A 1-Year Prospective Observational Study among Hong Kong Children and Adolescents.

This study examined the association between smart device usage and the 1-year change in refractive error among a representative sample of Hong Kong children and adolescents aged 8-14 years. A total of 1597 participants (49.9% male, mean age 10.9, SD 2.0) who completed both baseline (2017-2018) and 1-year follow-up (2018-2019) eye examinations were included in the present study. The non-cycloplegic auto-refractive error was measured and the average spherical equivalent refraction (SER) was analyzed. The participants also self-reported their smart device usage at baseline. Multivariate regression adjusted for age, sex, baseline SER, parents' short-sightedness, BMI, time spent on moderate-to-vigorous physical activity (MVPA), and caregiver-reported socio-economic status showed that, compared with the reference group (<2 h per day on both smartphone and tablet usages), those who spent ≥2 h per day using a smartphone and <2 h per day using a tablet had a significantly negative shift in refractive error (1-year change in SER -0.25 vs. -0.09 D, p = 0.01) for the right eye, while the level of significance was marginal (1-year change -0.28 vs. -0.15 D, p = 0.055) for the left eye. To conclude, our data suggested spending at most 2 h per day on both smartphones and tablets.

A field study on spinal postures and postural variations during smartphone use among university students.

This field study compared the real-time spinal movements and postural variations during smartphone-use versus non-use in university students. Ten males and eight females (mean age of 21.5 ± 2.6 years) participated, with similar daily phone use time between the two sexes. Five inertial motion sensors were attached to the cervical, thoracic and lumbar spinal regions, and kinematics was recorded for 3 h while participants went about their usual academic activities within the university campus. Significantly greater degrees of cervical and upper thoracic flexion were adopted during phone use versus non-use time (p < 0.01). There were also significantly greater frequency of postural variations (zero crossing per min) in all spinal regions in the sagittal plane (all p < 0.05), and in some of the movements in transverse and frontal planes comparing phone use vs non-use. The postural variables also showed some significant correlations with self-reported pre-existing neck and upper back pain scores.

The biomechanical evaluation of patient transfer tasks by female nursing students: With and without a transfer belt.

This study was to examine the kinematics, muscle activities, and perceived physical exertion in different regions of the spine during patient transfers by nursing students between a bed and a wheelchair, with or without a transfer belt in a laboratory setting. Results showed that with the effect of the belt, the % maximum voluntary contraction of the lumbar erector spinae was reduced significantly by nearly 10%. Muscle activity was significantly increased in thoracic erector and multifidus spinae during wheelchair-to-bed transfer, compared to bed-to-wheelchair transfers. There was no significant effect of belt or task on the spinal angular displacement in different spinal regions. Using the transfer belt was associated with a significantly decreased score for perceived exertion. In conclusion, this study supports the use of a transfer belt contributing to lower muscle activity and lower perceived physical exertion in the low back.

A Study on Trunk Muscle Activation of 2 Deep Water Running Styles (High-Knee and Cross-Country Style) and Land Walking.

CONTEXT: Deep water running (DWR) is an aquatic aerobic exercise which involves running in water without the feet touching the bottom of the pool, and it may involve different activation of trunk muscles compared with running or walking on land. This form of exercise is gradually being adopted as a form of therapeutic exercise for people with low back pain. It is proposed that different types of running or walking in water may be a more comfortable form of training for the trunk and abdominal muscles compared with exercising on dry land. OBJECTIVES: This study aimed to examine the trunk muscle activation in DWR in 2 different styles-high knee style and cross-country style, and these were compared with walking on land. PARTICIPANTS: Eleven healthy individuals (2 females and 9 males, mean age = 24 [4.6]) were recruited for this study. OUTCOME MEASURES: Surface electromyography was used to examine the activities of the right transversus abdominis, rectus abdominis, lumbar multifidus, and lumbar erector spinae muscles in 5 conditions: static standing on land and in water, running in deep water with high knee and cross-country styles, and finally walking on a treadmill. RESULTS: The percentage of maximal voluntary contraction of the transversus abdominis was significantly higher for both running styles in DWR, compared with that of static standing in water. Comparing directly the 2 styles, muscle activity was higher with a high knee action compared to without. The activation of transversus abdominis during high-knee DWR was comparable with that during treadmill walking and this may have clinical implications. CONCLUSION: The results of this study confirmed that running in deep water with a high knee action activated trunk muscles differently compared with standing or walking on land.

Effects of Ergomotor Intervention on Improving Occupational Health in Workers with Work-Related Neck-Shoulder Pain.

(1) Background: Work-related neck and shoulder pain (WRNSP) are common problems, and past occupational research has focused on ergonomic interventions such as adjusting workstations while physiotherapists have traditionally focused on teaching exercises to improve posture and movement control in the clinical setting. The current study aimed to integrate these two approaches and evaluate the immediate and long-term effects of such interventions on occupational exposure outcomes. (2) Methods: A total of 101 patients diagnosed with WRNSP were randomized into 2 groups: Control (CO) group (n = 50) and ergomotor (EM) group (n = 51). Participants in the control group had 12 weeks of usual care (conventional physiotherapy) while participants in the EM group received an integrated program with tailor-made motor control training and ergonomic advice for 12 weeks. (3) Results: Both groups achieved significant improvement in pain and functional outcomes at post-intervention. The EM group also reported significantly improved scores in terms of perceived exertion in the job-related physical demands (JRPD) and the short form workstyle questionnaires compared to the control group. (4) Conclusions: The results suggest that ergomotor intervention may be more effective in producing favorable occupational health outcomes compared to conventional physiotherapy.

Psychometric Properties and Demographic Correlates of the Smartphone Addiction Scale-Short Version Among Chinese Children and Adolescents in Hong Kong.

Nearly all children and teens in Hong Kong own a smartphone. There is currently no validated instrument that measures whether they use their phone too much. This study tested the psychometric properties of a translated Chinese version of the Smartphone Addiction Scale-Short Version (SAS-SV) and examined the demographic correlates of smartphone addiction among Hong Kong children and adolescents. A total of 1,901 primary school children and secondary school pupils were recruited from 15 Hong Kong schools. Furthermore, 1,797 primary caregivers were asked to complete a self-administered questionnaire on their socioeconomic status and educational attainment. The study used exploratory factor analysis (EFA) to identify the factor structure of SAS-SV for half the participants (n = 951), while confirmatory factor analysis (CFA) was used to assess the goodness-of-fit of EFA models for the remaining half (n = 951). Spearman correlations were used to assess the convergent validity of the SAS-SV, taking account of time spent by subjects on phones per day, the Smart Device Addiction Screening Tool (SDAST), the Pittsburgh Sleep Quality Index (PSQI), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Center for Epidemiological Studies Depression Scale for Children (CES-DC). EFA generated a three-factor model (with factors labeled "dependency," the incidence of a "problem," and "time spent"). CFA confirmed this model yielded an acceptable goodness-of-fit (Comparative Fit Index = 0.96, Tucker Lewis Index = 0.95, and root-mean-square error of approximation = 0.06). SAS-SV was positively correlated with SDAST (ρ = 0.59), PSQI (ρ = 0.29), and CES-D (ρ = 0.35), and negatively correlated with MSPSS (ρ = -0.10). A linear regression model showed that female adolescents, those with highly educated caregivers and those who spent more time using smartphones on their holidays, had on average higher SAS-SV scores, meaning they showed greater vulnerability to becoming addicted. The study found that SAS-SV is a valid scale for estimating excessive smartphone use among Hong Kong children and adolescents.

Comparing the effectiveness of integrating ergonomics and motor control to conventional treatment for pain and functional recovery of work-related neck-shoulder pain: A randomized trial.

BACKGROUND: Work-related neck and shoulder pain (WRNSP) is highly prevalent among patients who seek physiotherapy treatment. Clinicians may tend to focus on teaching home exercises and provide general advice about workplace improvement. The present study investigates the short- and long-term impact of an intervention approach that emphasizes on integrating the motor control re-education with ergonomic advice. METHODS: Participants diagnosed with WRNSP (n = 101) were randomly assigned into two groups in this randomized controlled trial. The Ergo-motor Group (EM, n = 51) received an integrated intervention with ergonomic advice/modifications and motor control training individualized for each participant based on their specific work demands. Control Group (CO, n = 50) received treatment for pain relief and general exercises of their necks at a designated physiotherapy clinic. Neck pain intensity and functional outcome measures were assessed before, immediately and 1-year after the 12-week intervention programmes. Global Rating of Change Score was used to evaluate the perceived recovery at 1-year follow-up. RESULTS: Both groups reported significant reductions in pain and functional disability scores at post-intervention (EM, n = 44; CO, n = 42) and 1-year follow-up (EM, n = 40; CO, n = 38); however, no significant between-group differences were found (p > 0.05). Significantly higher rating in global recovery score was reported in EM group at 1-year follow-up (p < 0.05). CONCLUSIONS: Intervention integrating ergonomic advice/modification with motor control exercise was found to be equally effective as pain relief and general exercise for pain and functional recovery. However, at 1-year follow-up, such integrated approach resulted in significantly better global recovery perceived by people with WRNSP. SIGNIFICANCE: Integrating ergonomic intervention and motor control training achieved similar reduction in pain and functional outcomes compared to conventional physiotherapy at post-intervention and at 1-year follow-up, for patients with moderate level of work-related neck-shoulder pain and mild degree of functional disability. The Ergo-motor Group reported significantly better perceived overall recovery at 1-year follow-up.

Association of electromyographic activation patterns with pain and functional disability in people with chronic neck pain.

PURPOSE: This study examined the activation patterns of the cervical and thoracic muscles in people with and without chronic neck pain during functional activities and their associations with pain intensity and functional disability. METHODS: Thirty-four adults with chronic neck pain and 34 asymptomatic adults were recruited. They were requested to perform active cervical movements and an upper limb lifting task. Electromyographic activation patterns (EMG) of bilateral upper trapezius, cervical erector spinae, sternocleidomastoid, and thoracic erector spinae were recorded during these tasks. Correlation and multiple regression analysis were used to examine the associations between EMG variables and severity of pain and functional disability. RESULTS: When performing the cervical movements, the neck pain group displayed lower EMG activity levels, especially in the cervical and thoracic extensors. In addition, significantly prolonged activation was observed in seven of the ten muscles during the upper limb lifting task. The changes in EMG amplitude and activation duration were found to be significantly correlated with severity of pain (R2 = 0.716) and functional disability (R2 = 0.623). CONCLUSIONS: Significant differences in the activation patterns of multiple cervical and thoracic muscles were found in individuals with neck pain compared with those without neck pain. These were significantly associated with their degree of pain and functional limitation. The findings of this study highlight the importance of assessing and optimising the neuromuscular activation of these muscles in the rehabilitation of those suffering from chronic neck pain.

Psychometric Evaluation of the Workstyle Short Form among Nursing Assistants with Work-Related Musculoskeletal Symptoms.

The Workstyle Short Form (24 items) (WSF-24) has been tested for its psychometric properties on work-related upper-extremity musculoskeletal symptoms (WRUEMSs) among office workers. However, the impact of workstyle should not only be limited to WRUEMSs and the sedentary workforce. The purpose of this study was to test the psychometric properties of the modified 24-item Chinese WSF (C-WSF-24) to identify work-related musculoskeletal symptoms (WRMSs) in various body parts among nursing assistants (NAs) working in nursing homes. Four hundred and thirty-nine NAs participated in the study. The results of the factor analysis were that a four-factor solution (working through pain, social reactivity at work, demands at work and breaks) accounted for 56.45% of the total variance. Furthermore, validation against known groups showed that the total score and subscale scores of the C-WSF-24 had the ability to discriminate between NAs with and without WRMSs in various body parts (such as low back and lower extremities). Additionally, C-WSF-24 had a statistically significant association with the contributing factors to WRMSs. This is the first study to examine the psychometric properties of the C-WSF-24 in the non-sedentary workforce, with a focus on various body parts of WRMSs. The results demonstrated that C-WSF-24 is reliable and valid for assessing WRMSs in various body parts among NAs.

Prevalence of and Factors Associated with Work-Related Musculoskeletal Symptoms in Nursing Assistants Working in Nursing Homes.

The prevalence of work-related musculoskeletal symptoms (WRMSs) in different body parts for nursing assistants (NAs) working in nursing homes is currently unknown. The aim of this study was to determine the extent of WRMSs in nursing assistants and the factors associated with them. Four hundred and forty NAs from 52 nursing homes, recruited by convenience sampling, participated in this cross-sectional study in 2014-2015. A valid and reliable study questionnaire was used to collect data. The results of our study found that 88.4% of NAs reported at least one body part with WRMSs. These NAs reported more symptoms in the shoulders than lower back. Adverse workstyle (OR = 1.04, 95% CI = 1.01-1.08) was the only factor associated with WRMSs after adjustment for potential confounders using multivariable logistic regression. This adverse workstyle could be developed because of physical and psychological work demands. Efforts should be directed at integrating "workstyle intervention" into lifestyle physical activity training to this group of healthcare workers.