Ergonomic Risk Assessment of Oral and Maxillofacial Surgeons - RULA Applied to Objective Kinematic Data.

BACKGROUND: The prevalence of musculoskeletal disorders is high in oral and maxillofacial surgeons (OS) due to their static and contorted working positions. Hence, the aim of this study was to conduct posture analyses in this specific group of dental professionals using the Rapid Upper Limb Assessment (RULA). METHODS: In total, 15 (12 m/3 f) OS participated in this study. An inertial motion capture system (Xsens) was used to collect kinematic data during a simulated workflow. Computer-based routines calculated the RULA score for the extracted joint angles at each defined time point. Then, an analysis of the time-dependent RULA scores by body regions was conducted. Key variables were the relative occurrence of specific RULA scores during the complete workflow, individual subtasks, and for treatment of each of the four different dental quadrants. The subtasks and dental quadrants were compared using the Friedman test. RESULTS: The total median RULA score represented a high risk for OS during their work (7), including the temporal component (OS spent 77.54% of their working time with a RULA score of 7). The wrists and hands, elbows, lower arms, and the neck were exposed to postures with the highest risk for musculoskeletal strain. DISCUSSION: For OS, both the right and the left assisting hand were heavily strained while working on the first dental quadrant caused the most unfavorable postures for OS.

[Germany-Wide Survey on Networking and Cooperation Between Rehabilitation and Self-Help (VERS 2.0): An Overview of Opinions, Contacts and Cooperation of Rehabilitation Institutions in View of Self-Help]. / Deutschlandweite Befragung zur Vernetzung und Kooperation von Rehabilitation und Selbsthilfe (VERS 2.0): Ein Überblick über Meinungen, Kontakte und Kooperationen von Rehabilitationseinrichtungen in Bezug auf Selbsthilfe.

PURPOSE: The study aims to present opinions and knowledge of rehabilitation facilities in Germany about self-help (SH) and to identify initial structures and contacts in the networking of rehabilitation and SH. METHODS: The study is a quantitative observational study. The data were collected cross-sectionally by means of an online survey. Rehabilitation facilities in Germany were included. The convenience sample was collected using different approaches. The questionnaire is based on the survey on "Cooperation and networking of rehabilitation facilities and self-help groups/self-help organisations" (VERS) conducted by the University of Freiburg in 2002. RESULTS: 101 rehabilitation facilities across all 16 German federal states took part in the survey. The survey revealed a positive attitude towards SH and a high proportion of rehabilitation facilities that regularly inform about SH (76.2%) and maintain contacts with self-help associations/self-help clearing houses (74.3%). Information deficits regarding the specific experiences of self-help associations, the working and organisational forms of SH as well as the support opportunities of SH became apparent. CONCLUSION: To strengthen the networking of rehabilitation and SH, information gaps should be closed and transparency and structural conditions for cooperation should be created. The stronger integration of knowledge about SH in educational structures in the health sector, which is desired by the institutions, can be purposeful in the future.

Development of a Multidimensional Pain Questionnaire in Professional Dance (MPQDA): a pilot study.

BACKGROUND: Pain is part of the everyday life of professional dancers. It can indicate health risks and impair the ability to work. Suitable screening tools can be used to identify pain and its risk potential. A comprehensive, multidimensional, differentiated assessment tool for pain in professional dance does not currently exist. METHODS: An initial questionnaire was developed in German and English and was assessed in a qualitative pretest. In a field study with a cross-sectional design including n = 72 dancers from Germany (n = 36 responses each in the English and German language versions), the questionnaire was optimized by item analysis, its psychometric properties (dimensionality, construct validity, reliability) were examined and the ability of the pain dimensions to classify the subjective ability to work in training was analyzed (ROC analysis). RESULTS: The developed Multidimensional Pain Questionnaire in Professional Dance (MPQDA) was reduced and optimized in its psychometric properties. Following questions were reduced in their items or answer categories: pain localizations (from 20 to 15 regions), accompanying symptoms (from 6 to 3 items), sensory and affective pain quality (from 20 to 10 items), pain frequency (from 4 to 3 answer categories), and the motives of working with pain (from 14 to 12 items). Regarding the subjective ability to work in training, the variables of the ability to work in rehearsals and in performances, as well as the accompanying symptoms of tension and mobility restrictions, showed a relatively good classification ability (Area under the Curve (AUC) ≥ 0.7 in the 95% confidence interval) and significant, moderate to strong correlations (Somers' D > 0.25, p < 0.05). The classification ability of the other pain dimensions was largely absent or poor. CONCLUSION: The MPQDA differentiates various pain dimensions in professional dancers and is available in a compatible manner in German and English. The clinical relevance needs to be explored further in the future.

Determinants of Pain Intensity in Physical Education Teachers Focusing on Dance Teachers: A Cross-Sectional Study.

(1) Background: Dance teachers (DT) are dependent on their functional body. Pain can hardly be avoided during the professional practice of dance. Pain can become so intense that it impairs, or even prevents, the professional practice. The aim of this study was to identify the determinants of pain intensity of the most severely affected body regions of DT in pain during the three-month period prior to the survey. (2) Methods: This cross-sectional study was conducted by an online survey. A total of 166 DT participated in the study; 143 of the DT were in pain during the three-month period and were included in the analysis. Using multiple linear regression, the determinants of pain intensity were identified from population parameters, occupational data, pain localisation, and temporal pain course. (3) Results: Regions of the lower extremity and head/trunk regions were most frequently indicated as the body regions with the most severe pain. The multiple regression model generated with the factors "functional impairment", "biomechanical exposure", and "pain at rest" explains a statistically significant, moderate proportion of the variance in pain intensity (R2 = 0.22, F (3, 106) = 10.04, p < 0.001). (4) Conclusions: Intensity of pain in DT seems to be related to the physical demands of professional practice.

Determinants of pain occurrence in dance teachers.

OBJECTIVES: Dance teachers are strongly dependent on their functional body in their professional practice. As yet, it has largely been unclear whether the musculoskeletal system is endangered by a dance teaching activity. Pain can be a warning signal for a health hazard. The aims of the study were (a) to determine the pain prevalence, location and assessment of dance teachers and (b) to identify determinants of pain occurrence over a 3-month period prior to the survey. METHODS: The quantitative, retrospective cohort study was conducted with n=166 dance teachers by an anonymous online survey. The data on the study sample, professional practice and pain prevalence, location and assessment were presented descriptively. A binary logistic regression was used to identify determinants of pain occurrence in the last 3 months from the sample parameters and the data of professional practice. RESULTS: In the 3-month period n=143 (86.1%) of dance teachers had been in pain, often localized in the lower back and lower extremities. In the binary logistic regression model, the Body mass index (BMI) (odds ratio (OR)=1.15, 95% CI: 0.93-1.42, p=0.18), age (OR=1.03, 95% CI: 0.99-1.08, p=0.11) and the presence of disease (OR=2.81, 95% CI: 0.78-10.15, p=0.12) were identified as determinants of pain occurrence (LR-Chi2=7.8, p<0.05, pseudo R2=0.06, n=160). CONCLUSIONS: Pain occurs in dance teachers under multifactorial conditions. Pain occurrence seems to be favored by context factors, such as the BMI, age and the presence of diseases. However, none of these factors could be identified as a significant, clear risk factor for the occurrence of pain in this sample. Education and preventive measures, that consider pain as a warning signal, should take effect early in the dance career.

Office work and stretch training (OST) study: effects on the prevalence of musculoskeletal diseases and gender differences: a non-randomised control study.

OBJECTIVES: For the prevention of musculoskeletal diseases (MSDs), stretch training can be a measure of the workplace health promotion (WHP) for office workers. This can lead to an increase in mobility and, ultimately, reduce or prevent MSD. The aim of the study was to examine a standardised and individualised stretch training on a device, specifically 'five Business', for the prevalence of MSD. DESIGN: This study is a non-randomised control study. SETTING: WHP programme with clerical employees of a German car manufacturer. PARTICIPANTS: 252 (110 women; 142 men) subjects (median age of 44 ([Formula: see text] 21 years) finished the study successfully. Inclusion criteria included a full-time employment in the office workplace and subjective health. INTERVENTION: The intervention group completed 22-24 training units of 10 min each on the 'five-Business' device two times a week for 12 weeks. PRIMARY AND SECONDARY OUTCOME MEASURES: Data were collected in the form of a pre-post study Nordic Questionnaire. RESULTS: After the intervention, significantly fewer subjects reported pain in the area of the neck (-17.79), shoulder (-11.28%), upper back (-14.7%), lower back (-12.78%) and feet (-8.51%). The gender analysis revealed that women are, in general, more often affected by musculoskeletal complaints than men, especially in the neck (+29.5%) and feet (+15.03%). Both sexes had significant reductions of MSD in the most commonly affected regions. Thus, 27.12% less women reported having neck pain, while 13.14% less men reported having low back pain. CONCLUSIONS: The results suggest that a stretching programme performed for 3 months can reduce musculoskeletal complaints in the most commonly affected areas in office workers. Both men and women benefited from the stretch training to a similar extent, suggesting that this would be a promising measure for therapy and prevention as part of WHP.

Ergonomic Comparison of Four Dental Workplace Concepts Using Inertial Motion Capture for Dentists and Dental Assistants.

When the inventory is arranged in a dental practice, a distinction can be made between four different dental workplace concepts (DWCs). Since the prevalence of musculoskeletal diseases in dental professionals is very high, preventive solution need to be investigated. As the conventionally used DWCs have, to date, never been studied in terms of their ergonomics, this study aims to investigate the ergonomic risk when working at the four different DWCs. In total, 75 dentists (37 m/38 f) and 75 dental assistants (16 m/59 f) volunteered to take part in this study. Standardized cooperative working procedures were carried out in a laboratory setting and kinematic data were recorded using an inertial motion capture system. The data were applied to an automated version of the Rapid Upper Limb Assessment (RULA). Comparisons between the DWCs and between the dentists and dental assistants were calculated. In all four DWCs, both dentists and dental assistants spent 95-97% of their working time in the worst possible RULA score. In the trunk, DWCs 1 and 2 were slightly favorable for both dentists and dental assistants, while for the neck, DWC 4 showed a lower risk score for dentists. The ergonomic risk was extremely high in all four DWCs, while only slight advantages for distinct body parts were found. The working posture seemed to be determined by the task itself rather than by the different inventory arrangements.

Musculoskeletal Pain in Latin American Formation Dance: Localization, Assessment, and Related Behavior.

Competitive Latin formation dance, a form of dancesport, places extreme physical demands on dancers that can cause pain. Due to the sex-specific requirements of dancesport, sex-specific differences in pain are probable. The aim of this study was to analyze pain with regard to prevalence, localization, perception, assessment, and related behavior in male and female Latin formation dancers. The quantitative cross-sectional observational study was carried out with 41 female and 31 male dancers of a national premier league by use of an anonymous online survey, with 3- and 12-month pain intervals being recorded. Of all participating subjects, 33 females and 26 males confirmed having been in pain during the most recent 3 months and provided detailed information on the pain factors being studied. In order to operationalize pain characteristics, existing pain assessment measures were adapted for dancers. For the most painful body regions, accompanying symptoms, pain intensity, pain perception, and pain evaluation were surveyed. The pain behavior section included questions about trusted persons and dancing despite pain, as well as pain management strategies. As to pain localization, several parts of the lower extremity (hip joint, groin, ankle joint, forefoot, and toes) were significantly more affected in females than in males (p < 0.05). Sensory and affective pain perception ranged from "hardly" to "moderate," with female dancers being more severely affected. Almost 80% of each sex continued dancing despite pain. Intrinsic motives and solidarity with the dance team were most often given as reasons for this behavior. Primarily, sex-specific physical requirements seemed to be most relevant in the occurrence of pain; in addition, pain assessment characteristics and personal behavior were related to attitudes regarding pain and injury. Therefore, in addition to sex, motivational and socio-cultural factors should be considered in future studies of this subject.

The Movement Profile of Habitual Vacuuming as a Cyclic Movement-A Pilot Study.

BACKGROUND: Vacuum cleaning, which is associated with musculoskeletal complaints, is frequently carried out in private households and by professional cleaners. The aim of this pilot study was to quantify the movements during habitual vacuuming and to characterize the movement profile with regard to its variability. METHODS: The data were collected from 31 subjects (21 f/10 m) using a 3D motion analysis system (XSens). Eight vacuum cleaners were used to vacuum polyvinyl chloride (PVC) and carpet floors. In 15 joints of the right upper extremity, the trunk and the lower extremities, Principal Component Analysis was used to determine the predominantly varying joints during vacuuming. RESULTS: The movements of the trunk and the lower extremities were relatively constant and, therefore, had less influence. The shoulder, elbow and wrist joints were identified as joints that can be decisive for the movement profile and that can be influenced. These joints were represented in the course of the vacuuming cycle by the mean movement with its standard deviation. CONCLUSION: In summary, the generalization of a movement profile is possible for the trunk and the lower extremities due to the relative homogeneity. In future it will be necessary to identify factors influencing variability in order to draw conclusions about movement ergonomics.

Prevalence of self-reported musculoskeletal disorders of the hand and associated conducted therapy approaches among dentists and dental assistants in Germany.

BACKGROUND: Dental professionals are subjected to higher risks for musculoskeletal disorders (MSDs) than other professional groups, especially the hand region. This study aims to investigate the prevalence of hand complaints among dentists (Ds) and dental assistants (DAs) and examines applied therapies. METHODS: For this purpose, an online questionnaire analysed 389 Ds (240female/149male) and 406 DAs (401female/5male) working in Germany. The self-reported data of the two occupational groups were compared with regard to the topics examined. The questionnaire was based on the Nordic Questionnaire (self-reported lifetime, 12-month and 7-day MSDs prevalence of the hand, the conducted therapy and its success), additional occupational and sociodemographic questions as well as questions about specific medical conditions. RESULTS: 30.8% of Ds affirmed MSDs in the hand at any time in their lives, 20.3% in the last twelve months and 9.5% in the last seven days. Among DAs, 42.6% reported a prevalence of MSDs in the hand at any time in their lives, 31.8% in the last 12 months and 15.3% in the last seven days. 37.5% of the Ds and 28.3% of the DAs stated that they had certain treatments. For both, Ds and DAs, physiotherapy was the most frequently chosen form of therapy. 89.7% of Ds and 63.3% of DAs who received therapy reported an improvement of MSDs. CONCLUSION: Although the prevalence of MSDs on the hand is higher among DAs than among Ds, the use of therapeutic options and the success of therapy is lower for DAs compared to Ds.

Prevalence of Musculoskeletal Disorders among Dentists and Dental Students in Germany.

BACKGROUND: Dentists are at a higher risk of suffering from musculoskeletal disorders (MSD) than the general population. However, the latest study investigating MSD in the dental profession in Germany was published about 20 years ago. Therefore, the aim of this study was to reveal the current prevalence of MSD in dentists and dental students in Germany. METHODS: The final study size contained 450 (287 f/163 m) subjects of different areas of specialization. The age of the participants ranged from 23 to 75 years. The questionnaire consisted of a modified version of the Nordic Questionnaire, work-related questions from the latest questionnaire of German dentists, typical medical conditions and self-developed questions. RESULTS: The overall prevalence showed that dentists suffered frequently from MSD (seven days: 65.6%, twelve months: 92%, lifetime: 95.8%). The most affected body regions included the neck (42.7%-70.9%-78.4%), shoulders (29.8%-55.6%-66.2%) and lower back (22.9%-45.8%-58.7%). Overall, female participants stated that they suffered from pain significantly more frequently, especially in the neck, shoulders and upper back. CONCLUSION: The prevalence of MSD among dentists, especially in the neck, shoulder and back area, was significantly higher than in the general population. In addition, women suffered more frequently from MSD than men in almost all body regions.

Prevalence of Muscular Skeletal Disorders among Qualified Dental Assistants.

The occupation of dental assistants (DAs) involves many health risks of the musculoskeletal system due to static and prolonged work, which can lead to musculoskeletal disorders (MSDs). The aim of the study was to investigate the prevalence of MSDs in DAs in Germany. METHODS: For this purpose, an online questionnaire analyzed 406 (401 female participants and 5 male participants, 401w/5m) DAs. It was based on the Nordic Questionnaire (lifetime, 12-month, and seven-day MSDs' prevalence separated into neck, shoulder, elbow, wrist, upper back, lower back, hip, knee, and ankle), and occupational and sociodemographic questions as well as questions about specific medical conditions. RESULTS: 98.5% of the participants reported complaints of at least one body region in their lives, 97.5% reported at least one complaint in the last 12 months and 86.9% affirmed at least one complaint in the last seven days. For lifetime, 12-month and seven-day prevalence, the neck was the region that was most affected followed by the shoulder, the upper back and the lower back. CONCLUSION: The prevalence of MSDs among German (female) DAs was very high. The most affected area is the neck, followed by the shoulder, the lower back, and the upper back. It, therefore, seems necessary to devote more attention to ergonomics at the working practice of DAs as well in education and in dental work.