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1.
BMJ Open Sport Exerc Med ; 5(1): e000541, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31275606

RESUMO

Single leg squat (SLS) is a common tool used in clinical examination to set and evaluate rehabilitation goals, but also to assess lower extremity function in active people. Objectives: To conduct a review and meta-analysis on the inter-rater and intrarater reliability of the SLS, including the lateral step-down (LSD) and forward step-down (FSD) tests. Design: Review with meta-analysis. Data sources: CINAHL, Cochrane Library, Embase, Medline (OVID) and Web of Science was searched up until December 2018. Eligibility criteria: Studies were eligible for inclusion if they were methodological studies which assessed the inter-rater and/or intrarater reliability of the SLS, FSD and LSD through observation of movement quality. Results: Thirty-one studies were included. The reliability varied largely between studies (inter-rater: kappa/intraclass correlation coefficients (ICC) = 0.00-0.95; intrarater: kappa/ICC = 0.13-1.00), but most of the studies reached 'moderate' measures of agreement. The pooled results of ICC/kappa showed a 'moderate' agreement for inter-rater reliability, 0.58 (95% CI 0.50 to 0.65), and a 'substantial' agreement for intrarater reliability, 0.68 (95% CI 0.60 to 0.74). Subgroup analyses showed a higher pooled agreement for inter-rater reliability of ≤3-point rating scales while no difference was found for different numbers of segmental assessments. Conclusion: Our findings indicate that the SLS test including the FSD and LSD tests can be suitable for clinical use regardless of number of observed segments and particularly with a ≤3-point rating scale. Since most of the included studies were affected with some form of methodological bias, our findings must be interpreted with caution.PROSPERO registration numberCRD42018077822.

2.
Diagn Progn Res ; 3: 5, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31093575

RESUMO

Background: Many studies have been performed to identify important prognostic factors for outcomes after rehabilitation of patients with chronic pain, and there is a need to synthesize them through systematic review. In this process, it is important to assess the study quality and risk of bias. The "Quality In Prognosis Studies" (QUIPS) tool has been developed for this purpose and consists of several prompting items categorized into six domains, and each domain is judged on a three-grade scale (low, moderate or high risk of bias). The aim of the present study was to determine the interrater agreement of the risk of bias assessment in prognostic studies of patients with chronic pain using QUIPS and to elaborate on the use of this instrument. Methods: We performed a systematic review and a meta-analysis of prognostic factors for long-term outcomes after multidisciplinary rehabilitation in patients with chronic pain. Two researchers rated the risk of bias in 43 published papers in two rounds (15 and 28 papers, respectively). The interrater agreement and Cohen's quadratic weighted kappa coefficient (κ) and 95% confidence interval (95%CI) were calculated in all domains and separately for the first and second rounds. Results: The raters agreed in 61% of the domains (157 out of 258), with similar interrater agreement in the first (59%, 53/90) and second rounds (62%, 104/168). The overall weighted kappa coefficient (kappa for all domains and all papers) was weak: κ = 0.475 (95%CI = 0.358-0.601). A "minimal agreement" between the raters was found in the first round, κ = 0.323 (95%CI = 0.129-0.517), but increased to "weak agreement" in the second round, κ = 0.536 (95%CI = 0.390-0.682). Conclusion: Despite a relatively low interrater agreement, QUIPS proved to be a useful tool in assessing the risk of bias when performing a meta-analysis of prognostic studies in pain rehabilitation, since it demands of raters to discuss and investigate important aspects of study quality. Some items were particularly hard to differentiate in-between, and a learning phase was required to increase the interrater agreement. This paper highlights several aspects of the tool that should be kept in mind when rating the risk of bias in prognostic studies, and provides some suggestions on common pitfalls to avoid during this process. Trial registration: PROSPERO CRD42016025339; registered 05 February 2016.

3.
BMC Health Serv Res ; 19(1): 130, 2019 Feb 21.
Artigo em Inglês | MEDLINE | ID: mdl-30791905

RESUMO

BACKGROUND: Health risk assessment (HRAs) are commonly used by occupational health services (OHS) to aid workplaces in keeping their employees healthy, but for unknown reasons, many employees choose not to participate in the HRAs. The aim of the study was to explore whether demographic, lifestyle and health-related factors in employees are associated with non-participation in initial and repeated HRAs. METHODS: In an OHS-based health project, 2022 municipal employees were asked to participate in three repeated HRAs. Multiple logistic regression analyses were used so as to determine associations between non-participating and demographic, lifestyle and health-related factors (e.g. biomarkers). RESULTS: Among the employees who were asked to participate in the health project, more than half did not participate in any HRA and among those who did, more than one third did not participate in repeated HRAs. Young age, male sex and being employed in the Technical department or Health and Social Care department in comparison with being employed in the department for Childcare and Education were factors significantly associated with non-participation in the initial HRA. These factors, together with being on sick leave and having unhealthy dietary habits, were factors associated with non-participation in repeated HRAs. CONCLUSIONS: Among the non-participators in initial HRAs and in repeated HRAs younger men and those already related to ill-health were overrepresented. This implicates that health care providers to a higher extent should focus on "those most needed" and that employers should be more engaged in results of repeated HRA's. Future studies should focus on modifiable variables that could make the HRAs more attractive and inclusive.


Assuntos
Comportamentos Relacionados com a Saúde , Promoção da Saúde , Indicadores Básicos de Saúde , Serviços de Saúde do Trabalhador/estatística & dados numéricos , Medição de Risco/estatística & dados numéricos , Engajamento no Trabalho , Adulto , Idoso , Feminino , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
4.
BMC Musculoskelet Disord ; 19(1): 6, 2018 01 08.
Artigo em Inglês | MEDLINE | ID: mdl-29310637

RESUMO

BACKGROUND: Clinical examinations are subjective and often show a low validity and reliability. Objective and highly reliable quantitative assessments are available in laboratory settings using 3D motion analysis, but these systems are too expensive to use for simple clinical examinations. Qinematic™ is an interactive movement analyses system based on the Kinect camera and is an easy-to-use clinical measurement system for assessing posture, balance and side-bending. The aim of the study was to test the test-retest the reliability and construct validity of Qinematic™ in a healthy population, and to calculate the minimal clinical differences for the variables of interest. A further aim was to identify the discriminative validity of Qinematic™ in people with low-back pain (LBP). METHODS: We performed a test-retest reliability study (n = 37) with around 1 week between the occasions, a construct validity study (n = 30) in which Qinematic™ was tested against a 3D motion capture system, and a discriminative validity study, in which a group of people with LBP (n = 20) was compared to healthy controls (n = 17). We tested a large range of psychometric properties of 18 variables in three sections: posture (head and pelvic position, weight distribution), balance (sway area and velocity in single- and double-leg stance), and side-bending. RESULTS: The majority of the variables in the posture and balance sections, showed poor/fair reliability (ICC < 0.4) and poor/fair validity (Spearman <0.4), with significant differences between occasions, between Qinematic™ and the 3D-motion capture system. In the clinical study, Qinematic™ did not differ between people with LPB and healthy for these variables. For one variable, side-bending to the left, there was excellent reliability (ICC =0.898), excellent validity (r = 0.943), and Qinematic™ could differentiate between LPB and healthy individuals (p = 0.012). CONCLUSION: This paper shows that a novel software program (Qinematic™) based on the Kinect camera for measuring balance, posture and side-bending has poor psychometric properties, indicating that the variables on balance and posture should not be used for monitoring individual changes over time or in research. Future research on the dynamic tasks of Qinematic™ is warranted.


Assuntos
Movimento/fisiologia , Equilíbrio Postural/fisiologia , Postura/fisiologia , Software/normas , Adulto , Fenômenos Biomecânicos/fisiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes
5.
Syst Rev ; 6(1): 199, 2017 10 11.
Artigo em Inglês | MEDLINE | ID: mdl-29020989

RESUMO

BACKGROUND: Chronic musculoskeletal pain is a major public health problem. Early prediction for optimal treatment results has received growing attention, but there is presently a lack of evidence regarding what information such proactive management should be based on. This study protocol, therefore, presents our planned systematic review and meta-analysis on important predictive factors for health and work-related outcomes following multidisciplinary rehabilitation (MDR) in patients with chronic musculoskeletal pain. METHODS: We aim to perform a synthesis of the available evidence together with a meta-analysis of published peer-reviewed original research that includes predictive factors preceding MDR. Included are prospective studies of adults with benign, chronic (> 3 months) musculoskeletal pain diagnoses who have taken part in MDR. In the studies, associations between personal and rehabilitation-based factors and the outcomes of interest are reported. Outcome domains are pain, physical functioning including health-related quality of life, and work ability with follow-ups of 6 months or more. We will use a broad, explorative approach to any presented predictive factors (demographic, symptoms-related, physical, psychosocial, work-related, and MDR-related) and these will be analyzed through (a) narrative synthesis for each outcome domain and (b) if sufficient studies are available, a quantitative synthesis in which variance-weighted pooled proportions will be computed using a random effects model for each outcome domain. The strength of the evidence will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation. DISCUSSION: The strength of this systematic review is that it aims for a meta-analysis of prospective cohort or randomized controlled studies by performing an extensive search of multiple databases, using an explorative study approach to predictive factors, rather than building on single predictor impact on the outcome or on predefined hypotheses. In this way, an overview of factors central to MDR outcome can be made and will help strengthen the evidence base and inform a wide readership including health care practitioners and policymakers. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016025339.


Assuntos
Dor Crônica/psicologia , Dor Musculoesquelética/reabilitação , Prognóstico , Qualidade de Vida , Resultado do Tratamento , Assistência à Saúde/métodos , Humanos , Retorno ao Trabalho , Revisões Sistemáticas como Assunto
6.
Work ; 55(4): 849-859, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-28059808

RESUMO

BACKGROUND: Health risk appraisals (HRAs) in occupational health services (OHS) in Sweden are very commonly used for health promotion issues, but not much research has explored the extent and nature of individual feedback that is provided. OBJECTIVES: This study aimed to describe and explore HRAs in OHS regarding the content of the feedback in relation to the individual status and overall employee satisfaction. METHODS: Feedback (evaluation and advice) and employee satisfaction with HRA were studied in employees that participated in health risk appraisals with a specific feedback session (HRA-F) (n = 272) and employees that participated in a single session (HRA-S) (n = 104). Associations between feedback and individual status concerning life style were assessed with Cohen's kappa (k). RESULTS: The employees received mainly information and advice for improvement on health and lifestyle issues (89-100%), while advice for improvement of working conditions was less common (15-59%). The feedback provided on life style was not based on individual status (k < 0.4), except for smoking and risky alcohol consumption (k > 0.55). A great majority of employees reported good overall satisfaction with their HRAs. CONCLUSIONS: The evaluation and feedback given to employees after HRAs should be based more on HRA-results and advice could be focused more on work-related factors.


Assuntos
Retroalimentação , Serviços de Saúde do Trabalhador/métodos , Medição de Risco/normas , Adulto , Feminino , Promoção da Saúde/métodos , Humanos , Estilo de Vida , Masculino , Pessoa de Meia-Idade , Serviços de Saúde do Trabalhador/normas , Medição de Risco/métodos , Inquéritos e Questionários , Suécia
7.
Spine (Phila Pa 1976) ; 38(6): E350-8, 2013 Mar 15.
Artigo em Inglês | MEDLINE | ID: mdl-23492976

RESUMO

STUDY DESIGN: Meta-analysis of randomized, controlled trials. OBJECTIVE: To determine the short-term, intermediate, and long-term effectiveness of MCE, with regard to pain and disability, in patients with chronic and recurrent low-back pain. SUMMARY OF BACKGROUND DATA: Previous meta-analyses have shown no difference between the effects of MCE and general exercise in the treatment of low back pain. Several high quality studies on this topic have been published lately, warranting a new meta-analysis. METHODS: We searched electronic databases up to October 2011 for randomized controlled trials clearly distinguishing MCE from other treatments. We extracted pain and disability outcomes and converted them to a 0 to 100 scale. We used the RevMan5 (Nordic Cochrane Centre, Copenhagen, Denmark) software to perform pooled analyses to determine the weighted mean differences (WMDs) between MCE and 5 different control interventions. RESULTS: Sixteen studies were included. The pooled results favored MCE compared with general exercise with regard to disability during all time periods (improvement in WMDs ranged from -4.65 to -4.86), and with regard to pain in the short and intermediate term (WMDs were -7.80 and -6.06, respectively). Compared with spinal manual therapy, MCE was superior with regard to disability during all time periods (the WMDs ranged between -5.27 and -6.12), but not with regard to pain. Furthermore, MCE was superior to minimal intervention during all time periods with regard to both pain (the WMDs ranged between -10.18 and -13.32) and disability (the WMDs ranged between -5.62 and -9.00). CONCLUSION: In patients with chronic and recurrent low back pain, MCE seem to be superior to several other treatments. More studies are, however, needed to investigate what subgroups of patients experiencing LBP respond best to MCE.


Assuntos
Pessoas com Deficiência/reabilitação , Terapia por Exercício/métodos , Dor Lombar/reabilitação , Dor/reabilitação , Doença Crônica , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Resultado do Tratamento
8.
Disabil Rehabil ; 34(23): 2001-6, 2012.
Artigo em Inglês | MEDLINE | ID: mdl-22455469

RESUMO

PURPOSE: The Fox-walk test is a new method used to estimate aerobic capacity outside a clinical environment, which may be useful in the implementation of daily health-enhancing physical activity. The aim of our study was to investigate the reliability of the test in people with rheumatoid arthritis (RA). METHOD: Fifteen participants performed the Fox-walk test three times with weekly intervals. The intraclass correlation coefficient (ICC), the standard error of measurement (SEM) and the smallest detectable change (SDC) were used to estimate the reliability. General health perception, lower limb pain and fatigue were measured to determine their potential influence on the reliability. RESULTS: There were no systematic differences between the three test occasions (p = 0.190) and the reliability was almost perfect (ICC = 0.982). None of the covariates influenced the reliability. The SEM was 0.999 ml/kg/min or 3.4% and the SDC was 2.769 ml/kg/min or 9.4%. CONCLUSIONS: These findings demonstrate that the Fox-walk test is reliable in people with RA and enables differentiation between people with RA and monitoring progress. The validity of the test among people with RA is still to be determined. IMPLICATIONS FOR REHABILITATION: • The Fox-walk test is a new method to estimate aerobic capacity and could be performed walking or running. • The test is self administered without expensive equipment and is available in 150 public places in Sweden and several other European countries. • The Fox-walk test is a reliable test for use among people with rheumatoid arthritis monitoring the progress of their physical activity.


Assuntos
Artrite Reumatoide/fisiopatologia , Teste de Esforço/métodos , Tolerância ao Exercício , Caminhada , Adulto , Idoso , Avaliação da Deficiência , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Atividade Motora , Consumo de Oxigênio , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Inquéritos e Questionários
9.
Physiother Theory Pract ; 27(3): 213-22, 2011 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-20690880

RESUMO

The objective of this study was to determine the prevalence of and risk factors for work-related musculoskeletal disorders (WRMDs) in female physiotherapists with more than 15 years of job experience. A self-administered postal questionnaire was sent to 203 female physiotherapists with more than 15 years of job experience. Unconditional logistic regression was used to study the association between job exposures and the risk for WRMDs. The questionnaire was returned by 131 physiotherapists (64.5%). Of 99 subjects who answered specific questions about WRMDs, 52 (53.5%) were affected by WRMDs in at least one body part. Regions most affected were the hand/wrist (n=31; 58.5%) and the lower back (n=30; 56.5%). For hand/wrist pain, associations were found with: orthopedic manual therapy techniques (adjusted odds ratio [OR]=3.90; 95% confidence interval [CI]=1.2-13.1); working in awkward or cramped positions (OR=4.96; 95% CI=1.3-18.7); and high psychological job demands (OR=4.34; 95% CI=1.2-15.0). For lower back pain, associations were found with: working in awkward or cramped positions (adjusted OR=6.37; 95% CI=1.6-24.7); and kneeling or squatting (adjusted OR=4.76; 95% CI=1.4-15.9). More than half of the respondents reported WRMDs. General physical and psychosocial work-related exposures, as well as specific therapy tasks, were strongly associated with WRMDs. Larger, longitudinal studies are needed to determine the direction of causality.


Assuntos
Doenças Musculoesqueléticas/epidemiologia , Doenças Profissionais/epidemiologia , Saúde do Trabalhador , Fisioterapia , Idoso , Estudos Transversais , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Razão de Chances , Postura , Prevalência , Medição de Risco , Fatores de Risco , Estresse Psicológico/epidemiologia , Inquéritos e Questionários , Suécia , Fatores de Tempo
10.
Physiother Theory Pract ; 26(4): 281-7, 2010 May.
Artigo em Inglês | MEDLINE | ID: mdl-20397863

RESUMO

The primary aim was to determine the intra- and interexaminer reliability of measurements of isometric wrist extension force obtained with the Nicholas Manual Muscle Tester (NMMT) in a "break test." A secondary aim was to use NMMT measurements to describe the relation between electromyographic (EMG) activity and force produced in wrist extensors at different levels of contraction strain. Two examiners tested 51 healthy subjects (aged 19-46) in a test-retest approach with 6-7 days between the tests. Eleven subjects from this sample were also recruited for the study investigating the relation between EMG and force in the wrist extensor. Intraexaminer reliability was excellent for both examiners (ICC 0.944 and 0.902). The results also showed excellent interexaminer reliability (ICC 0.925) and relatively low CV% and S(diff). The EMG-force relation in wrist extensor muscles was strong (r = 0.985). The excellent test-retest stability indicates that measurements of isometric wrist extension force obtained with NMMT are appropriate for clinical evaluation as well as for further studies of wrist isometric extensor muscle strength. The tests indicated that the relation between force produced and levels of EMG activity in wrist extensor muscles is approximately linear.


Assuntos
Dinamômetro de Força Muscular , Amplitude de Movimento Articular , Articulação do Punho/fisiologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Adulto Jovem
11.
Clin Rehabil ; 21(7): 648-59, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17702707

RESUMO

OBJECTIVE: To determine whether symptoms and clinical signs can predict persistent neck/shoulder pain, future medical care-seeking and sickness absence. DESIGN: A population-based cohort was followed prospectively over a 5-6 year period. SETTING: Subjects from the district of Norrtälje (Sweden). SUBJECTS: Subjects with self-rated neck/shoulder pain were included (n = 1471). MAIN MEASURES: Cox regression analyses were used to test the predictive value of single and combinations of symptoms and clinical signs obtained with questionnaires and simple tests concerning persistent neck/shoulder pain, future medical care-seeking and sickness absence. RESULTS: Several symptoms and clinical signs were associated with the outcomes of interest: the relative risk (RR) for persistent neck/shoulder pain was 1.38 (95% confidence interval (CI) 1.14-1.52) for subjects with pain for over three months at baseline and concerning future medical care-seeking RR was 2.10 (95% CI 1.73-2.54) for subjects who had previously sought medical care. An episode of sickness absence during the year of enrolment increased the risk for future sickness absence (RR = 2.42, 95% CI 1.95-3.00). Having five or seven concurrent symptoms and clinical signs was common and more strongly associated with persistent pain (RR = 1.77, 95% CI 1.39 - 2.27) and future medical care-seeking (RR = 4.51, 95% CI 2.54-9.94), respectively, but not concerning sickness absence. CONCLUSION: By simply counting the number of concurrent symptoms and clinical signs, it is possible to predict persistent neck/shoulder pain and future medical care-seeking, but not sickness absence.


Assuntos
Inquéritos Epidemiológicos , Cervicalgia/complicações , Medição da Dor , Dor de Ombro/complicações , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Aceitação pelo Paciente de Cuidados de Saúde , Valor Preditivo dos Testes , Estudos Prospectivos , Licença Médica , Suécia
12.
Eur Spine J ; 16(12): 2083-91, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17721712

RESUMO

To determine associations between work-related exposures and the prognosis of self-reported neck/shoulder pain. This prospective cohort study was based on 803 working subjects who reported neck/shoulder pain at baseline. The proportion of subjects who 5-6 years later were symptom-free was calculated. Data concerning work-related biomechanical, psychosocial, and organizational exposures were collected at baseline. The Cox regression analyses were used to calculate the relative chances (RC) of being symptom-free at the end of the study for single exposures, and also for up to three simultaneous work-related exposures. Adjustments were made for sex and age. Only 36% of the subjects were symptom-free 5-6 years later. The relative chance for being symptom-free at the end of the study was 1.32 (95% CI = 0.99-1.74) for subjects who were exposed to sitting > or =75% of the working time and 1.53 (95% CI = 1.02-2.29) for subjects who were exposed to job strain, i.e., the combination of high demands and low decision latitude. The relative chance of being symptom-free at the end of the study was 0.61 (95% CI = 0.40-0.94) for subjects with at least two out of three simultaneous biomechanical exposures at work; manual handling, working with the hands above shoulder level, and working with vibrating tools. In a heterogeneous population with moderate nonspecific neck/shoulder pain, sedentary work enhanced the chance of being symptom-free 5-6 years later, whereas simultaneous exposures to at least two of manual handling, working with hands above shoulder level and working with vibrating tools were associated with a lower chance of being symptom-free at the end of the study. This could imply that subjects with neck/shoulder pain should avoid such simultaneous exposures.


Assuntos
Transtornos Traumáticos Cumulativos/epidemiologia , Cervicalgia/epidemiologia , Doenças Profissionais/epidemiologia , Exposição Ocupacional/estatística & dados numéricos , Dor de Ombro/epidemiologia , Adulto , Distribuição por Idade , Estudos de Casos e Controles , Estudos de Coortes , Transtornos Traumáticos Cumulativos/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/fisiopatologia , Doenças Profissionais/fisiopatologia , Ocupações/estatística & dados numéricos , Prognóstico , Estudos Prospectivos , Fatores de Risco , Distribuição por Sexo , Articulação do Ombro/lesões , Articulação do Ombro/fisiopatologia , Dor de Ombro/fisiopatologia , Suécia/epidemiologia , Trabalho/estatística & dados numéricos
13.
Work ; 28(4): 313-23, 2007.
Artigo em Inglês | MEDLINE | ID: mdl-17522452

RESUMO

The aim of this study was to examine the effect of two types of ergonomic intervention on pain and pain-related disability in the neck/shoulder and low back regions. A cohort of 492 subjects of various occupations with non-specific neck/shoulder or low back pain was followed over a five to six year period. The study subjects were classified into four intervention groups: no ergonomic intervention, educational worksite intervention, workplace intervention, and combined workplace and educational worksite intervention. The group with no ergonomic intervention was used as the reference group. The changes in pain intensity and pain-related disability from baseline to follow-up in each of the three groups with intervention were compared to the changes in the reference group. During the follow-up, 39% of the subjects had received ergonomic intervention. The average change in pain intensity and pain-related disability was smaller in the educational worksite intervention group than in the reference group. The average reduction of pain intensity and pain-related disability did not differ between the two other intervention groups and the reference group. Thus, for subjects still at work, ergonomic intervention seemed to be ineffective for reducing neck/shoulder and low back pain and pain-related disability.


Assuntos
Ergonomia/métodos , Dor Lombar/prevenção & controle , Cervicalgia/prevenção & controle , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento
14.
Eur Spine J ; 16(5): 631-8, 2007 May.
Artigo em Inglês | MEDLINE | ID: mdl-16741741

RESUMO

In Sweden, musculoskeletal disorders, in particular low back disorders (LBD) and neck-shoulder disorders (NSD) constitute by far the most common disorders, causing sick leave and early retirement. Studies that compare sickness absence in individuals with LBD and individuals with NSD are lacking. Moreover, it is likely that having concurrent complaints from the low back region and the neck-shoulder region could influence sickness absence. The purpose of the present study was to explore potential differences in sickness absence and in long-term sickness absence during a 5-year period, 1995-2001, among individuals with (1) solely LBD, (2) solely NSD, and (3) concurrent LBD and NSD. The present study was based on 817 subjects from the MUSIC-Norrtälje study, whom were working at baseline and whom at both baseline and follow-up reported LBD and/or NSD. Three groups were identified based on pain and pain-related disability at both baseline and follow-up: (1) solely LBD, (2) solely NSD, and (3) concurrent LBD and NSD. Subjects who did not give consistent answers at both the baseline and follow-up occasions were assigned a fourth group: (4) migrating LBD/NSD. Two outcomes were analysed: (1) prevalence of sickness absence, and (2) long-term sickness absence among those with sickness absence days. Logistic regression analysis was used to calculate odds ratios (OR) for sickness absence in the different disorder groups, taking into account confounding factors such as gender, age and other non-musculoskeletal-related disorders. In the group concurrent LBD and NSD, 59% had been sickness absent between baseline and follow up, compared to 42% in the group solely LBD, 41% in the group solely NSD, and 46% in the group migrating LBD/NSD. No difference in sickness absence was found between the group solely LBD compared to the group solely NSD [OR 0.65 (0.36-1.17)]. The adjusted OR for sickness absence in the group concurrent LBD and NSD compared to subjects with solely LBD or solely NSD was [OR 1.69 (1.14-2.51)]. The adjusted OR for having long-term sickness absence was 2.48 (95% CI = 1.32-4.66) for the group concurrent LBD and NSD. In the present study, having concurrent LBD and NSD were associated with a higher risk for sickness absence and also long-term sickness absence. This suggests that, when research on sickness absence and return to work after a period of LBD or NSD is performed, it is important to take into consideration any concurrent pain from the other spinal region. The study also implies that spinal co-morbidity is an important factor to be considered by clinicians and occupational health providers in planning treatment, or in prevention of these disorders.


Assuntos
Doenças Musculoesqueléticas/epidemiologia , Dor/epidemiologia , Licença Médica/estatística & dados numéricos , Comorbidade , Avaliação da Deficiência , Seguimentos , Humanos , Dor Lombar/epidemiologia , Análise Multivariada , Cervicalgia/epidemiologia , Dor de Ombro/epidemiologia , Suécia/epidemiologia
15.
J Occup Environ Med ; 46(2): 138-46, 2004 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-14767216

RESUMO

This study estimated the 5-year cumulative incidence of neck/shoulder pain and identified work-related risk factors leading subjects to seek care for this problem. Four to six years after the case-referent MUSIC-Norrtälje Study, a postal questionnaire was sent to the referents of this study, and 81% responded. At baseline, 516 men and 697 women were assessed as to their work-related exposures. The 4- to 6-year cumulative incidence for seeking care for neck/shoulder pain was 29% for women and 18% for men. For men, moderately increased risks were found for manual handling, night work/shift work, hindrances at work, and solitary work. For men, the risk increased with an increasing number of risk indicators. No work-related risk factors were found for women, highlighting the difficulty of identifying risk factors in a general population.


Assuntos
Cervicalgia/epidemiologia , Doenças Profissionais/epidemiologia , Dor de Ombro/epidemiologia , Adulto , Fenômenos Biomecânicos , Feminino , Serviços de Saúde/estatística & dados numéricos , Humanos , Masculino , Pessoa de Meia-Idade , Cervicalgia/prevenção & controle , Doenças Profissionais/prevenção & controle , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Dor de Ombro/prevenção & controle , Estresse Psicológico/epidemiologia , Suécia/epidemiologia
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