The effectiveness of Sustained Natural Apophyseal Glide on Flexion Rotation Test, pain intensity, and functionality in subjects with Cervicogenic Headache: A Systematic Review of Randomized Trials.

OBJECTIVE: To determine the effect of sustained natural apophyseal glide (SNAG) on Flexion Rotation Test, pain intensity, and functionality in subjects with Cervicogenic Headache (CH). METHODS: The research was conducted on five computerized databases PubMed/Medline, Web of Science, PEDro, Lilacs, and Cochrane Library (CENTRAL), using the keywords combination: (sustained natural apophyseal glide OR SNAG OR joint mobilization OR Mulligan) AND (cervicogenic headache) according to PRISMA guidelines. The methodological quality of the included studies was analyzed using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Eight articles fulfilled the eligibility criteria and were included in the review. The selected studies had a methodological quality of 6.6/10 on the PEDro scale and included a total of 357 participants. The SNAG significantly improved pain, Flexion Rotation Test and reduced functional symptoms. CONCLUSION: The available evidence suggests that SNAG may be a relevant intervention for CH.

Predicting musculoskeletal symptoms in workers of a manufacturing company.

Background. Musculoskeletal symptoms are the leading factor responsible for sickness absence. Factors associated with the development of musculoskeletal symptoms must be identified and addressed. Objective. To investigate the 7-day prevalence of musculoskeletal symptoms by body regions, and assess the contribution of individual, lifestyle and occupational risk factors to the development of musculoskeletal disorders. Methods. The sample comprised 202 white-collar and blue-collar workers. Musculoskeletal symptoms were assessed with the Nordic questionnaire, and physical activity level and sitting time with the international physical activity questionnaire. Statistical analyses were conducted to assess the associations between individual, lifestyle and occupational category factors and musculoskeletal symptoms. Results. The 7-day prevalence of work-related musculoskeletal symptoms was 41.6% (n = 84). The highest prevalence of symptoms was reported in the lower back (18.8%), followed by the wrists/hands (17.3%), neck (15.8%), shoulder (15.3%) and ankles/feet (11.4%). A significant association was found between reporting musculoskeletal symptoms and work category. In addition, musculoskeletal symptoms were reported more often by older workers. Work category was a significant predictor of pain in the lower back and shoulder regions, and gender was a significant predictor for neck pain. Conclusions. Our results emphasize the need for worksite interventions to prevent musculoskeletal symptoms in this population.

The Effects of Workplace Physical Activity Programs on Musculoskeletal Pain: A Systematic Review and Meta-Analysis.

This article reviews the effectiveness of physical activity (PA) interventions at the workplace to reduce musculoskeletal pain among employees and assesses the effect size of these programs using meta-analysis. Four databases (i.e., PubMed, EBSCO, Web of Science, and Cochrane) were searched for research trials, which included comparison groups of employees that assessed PA programs, musculoskeletal pain, and health-related behaviors, published between January 1990 and March 2013. The meta-analysis estimates of standardized mean differences (Hedges' g) present significant evidence of less general pain (g = -.40 with a 95% confidence interval [CI] = [-0.78, -0.02]) and neck and shoulder pain (g = -.37 with a 95% CI = [-0.63, -0.12]) in intervention groups. The few studies of low back pain and arm, elbow, wrist, hand, or finger pain did not present sufficient statistically significant evidence. Consistent evidence demonstrates that workplace PA interventions significantly reduce general musculoskeletal pain and neck and shoulder pain. More studies are needed to determine the effectiveness of work-related PA interventions for arm, elbow, wrist, hand or finger, and low back pain.

The effect of a physical activity program on decreasing physical disability indicated by musculoskeletal pain and related symptoms among workers: a pilot study.

UNLABELLED: The aim of this study was to verify the effect of a physical activity (PA) program on musculoskeletal pain and related symptoms in different body regions among workers. METHODS: The intervention study lasted 6 months. The training sessions were given during work time. The intervention group (TOI) (n = 39) participated in 10-15 min of physical exercise training 3 times a week and focused on stretching exercises and general strength. The reference group (TOR) (n = 31) were asked to continue their daily activities. Musculoskeletal pain was assessed with the standardized Nordic questionnaires for analyzing musculoskeletal symptoms. Evaluations were performed at baseline and at the end of the intervention. RESULTS: After the intervention, the TOI obtained some significant results regarding a decrease in the intensity of pain in some of the body regions evaluated, such as elbow (p = .03) and dorsal region (p = .015). In comparing the TOR and TOI after the 6 months of the PA program, we can verify that in the elbow and in the thigh/hip regions, the pain intensity decreased significantly; additionally, there is some evidence to suggest statistically significant results in the neck region (p = .063). CONCLUSION: Our intervention seems to have reduced musculoskeletal pain and related symptoms in factory workers.

Vitamin D intake and cardiometabolic risk factors in adolescents.

BACKGROUND: A growing body of research suggests that vitamin D might play an important role in overall health. No data exist on vitamin D intake for the Azorean adolescent population. The purpose of this study was to assess vitamin D intake and investigate a possible association between vitamin D intake and cardiometabolic risk factors in Azorean adolescents. METHODS: A cross-sectional school-based study was conducted on 496 adolescents (288 girls) aged 15-18 years from the Azorean Islands, Portugal. Anthropometric measurements (waist circumference and height), blood pressure (systolic), and plasma biomarkers [fasting glucose, insulin, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TGs)] were measured to assess metabolic risk. Homeostasis model assessment (HOMA), TC-to-HDL-C ratio, and waist-to-height ratio were calculated. For each of these variables, a Z-score was computed by age and sex. A metabolic risk score was constructed by summing the Z-scores of all individual risk factors. High risk was considered when the individual had ≥1 standard deviation (SD) of this score. Vitamin D intake was assessed with a semiquantitative food frequency questionnaire. Participants were classified into quartiles of vitamin D intake. Logistic regression was used to determine odds ratios for high cardiometabolic risk scores after adjusting for total energy intake, pubertal stage, fat mass percentage, and cardiorespiratory fitness. RESULTS: Mean (SD) vitamin D intake was 5.8 (6.5) µg/day, and 9.1% of Azorean adolescents achieved the estimated average requirement of vitamin D (10 µg/day or 400 IU). Logistic regression showed that the odds ratio for a high cardiometabolic risk score was 3.35 [95% confidence interval (CI) 1.28-8.75] for adolescents in the lowest vitamin D intake quartile in comparison with those in the highest vitamin D intake quartile, even after adjustment for confounders. CONCLUSION: A lower level of vitamin D intake was associated with worse metabolic profile among Azorean adolescents.

Intake of milk, but not total dairy, yogurt, or cheese, is negatively associated with the clustering of cardiometabolic risk factors in adolescents.

Epidemiologic studies have reported an inverse association between dairy product consumption and cardiometabolic risk factors in adults, but this relation is relatively unexplored in adolescents. We hypothesized that a higher dairy product intake is associated with lower cardiometabolic risk factor clustering in adolescents. To test this hypothesis, a cross-sectional study was conducted with 494 adolescents aged 15 to 18 years from the Azorean Archipelago, Portugal. We measured fasting glucose, insulin, total cholesterol, high-density lipoprotein cholesterol, triglycerides, systolic blood pressure, body fat, and cardiorespiratory fitness. We also calculated homeostatic model assessment and total cholesterol/high-density lipoprotein cholesterol ratio. For each one of these variables, a z score was computed using age and sex. A cardiometabolic risk score (CMRS) was constructed by summing up the z scores of all individual risk factors. High risk was considered to exist when an individual had at least 1 SD from this score. Diet was evaluated using a food frequency questionnaire, and the intake of total dairy (included milk, yogurt, and cheese), milk, yogurt, and cheese was categorized as low (equal to or below the median of the total sample) or "appropriate" (above the median of the total sample).The association between dairy product intake and CMRS was evaluated using separate logistic regression, and the results were adjusted for confounders. Adolescents with high milk intake had lower CMRS, compared with those with low intake (10.6% vs 18.1%, P = .018). Adolescents with appropriate milk intake were less likely to have high CMRS than those with low milk intake (odds ratio, 0.531; 95% confidence interval, 0.302-0.931). No association was found between CMRS and total dairy, yogurt, and cheese intake. Only milk intake seems to be inversely related to CMRS in adolescents.