Factors Associated With Musculoskeletal Pain Among Hair Transplant Surgeons: Analyses of Survey Data and Review of the Literature.

BACKGROUND: The prevalence of work-related musculoskeletal disorders (WRMD) is increasing among all surgical specialties. OBJECTIVE: Results of a cross-sectional survey of hair transplant surgeons were analyzed, with the aims to (1) determine the prevalence of WRMD, (2) assess risk factors associated with musculoskeletal (MSK) symptoms, and (3) identify mitigation measures. MATERIALS AND METHODS: A survey pertaining to demographics, MSK-related symptoms and its impacts, and pain mitigation measures taken, if any, were distributed to 834 hair transplant surgeons. Risk factors associated with pain severity were assessed using linear regression. RESULTS: Overall, 78.5% (73 of 93) respondents had experienced pain when performing surgery. Musculoskeletal symptoms were most severe in the neck, followed by upper/lower back, and extremities. Number of grafts performed per session of follicular unit extraction positively correlated with pain severity; female surgeons and surgeons aged >71 years were at higher risk. A majority expressed concern that WRMD may limit their career and agreed to a need for improved workplace education. Strength training and ergonomic improvements of surgical procedure were not commonly adopted. CONCLUSION: In sum, WRMD can be debilitating in health care professionals. Workplace ergonomic adjustments and physical exercise programs may be warranted to better mitigate MSK symptoms.

Arch Height Index, Arch Rigidity Index, and Arch Stiffness Values in a Symptomatic Population.

BACKGROUND: Studies of arch height index (AHI), arch rigidity index (ARI), and arch stiffness have primarily focused on healthy populations. Normative values of the aforementioned measurements in a pathologic sample may be useful in identifying relationships between arch structure and pathology. METHODS: AHI was obtained bilaterally at 10% and 90% weightbearing conditions using the AHI measurement system. ARI and arch stiffness were calculated using AHI measurements. Dependent t tests compared right and left, dominant and nondominant, and injured and noninjured limbs. Dominant feet were compared between sexes using independent t tests. Relationships between arch stiffness and subcategories were examined using the coefficient of determination (R2). One-way analyses of variance determined differences between arch structure and number of pathologies or body mass index (BMI). RESULTS: A total of 110 participants reported one (n = 55), two (n = 38), or three or more (n = 17) pathologies. Plantar fasciitis (n = 31) and hallux valgus (n = 28) were the most common. AHI, ARI, and arch stiffness did not differ between limbs or sexes for any comparisons. Between subgroups of BMI and number of pathologies, BMI influenced AHI (10% weightbearing) and arch stiffness (P < .05). Arch stiffness showed a weak relationship to AHI, where a higher AHI was associated with a stiffer arch (R2 = 0.06). CONCLUSIONS: Normative arch structure values were established in a pathologic sample with a large incidence of plantar fasciitis and hallux valgus. Understanding relationships between arch structure and pathology is helpful for clinicians and researchers.