Prevalence and risk factors of work-related musculoskeletal disorders among physical therapists in Ho Chi Minh City, Vietnam.

BACKGROUND: Understanding risk factors linked to work-related musculoskeletal disorders (WMSDs) is crucial for enhancing health promotion and ensuring workplace safety among healthcare professionals particularly physical therapists (PTs). However, in Vietnam, there has been lack of an investigation. Therefore, this study was to determine whether potential risk factors contributed to the occurrence of WMSDs among PTs in Ho Chi Minh City. METHOD: An online self-reported questionnaire for WMSDs comprising the Nordic Musculoskeletal Questionnaire (NMQ), Job-risk and Environmental factors, the Perceived Stress Scale (PSS-4) and the coping strategies, were distributed to PTs. They were enrolled if they had: age ≥ 22 years, graduated from PT program, a full-time job with ≥1 year of experience. Unadjusted and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were determined using Logistic regression. RESULTS: Our study found that within the past 12 months, the prevalence of WMSDs was 76.4% (n = 204/267): neck 58.4% and lower back 57.3%. PTs aged 22-29 years, < 4 years of education, and < 7 years of working experience were more likely to have WMSDs 2-3 times than those who did not. After adjusting for age, education, and work experience, PTs who engaged in manual techniques/exercises, lifting/transferring patients, and maintaining awkward postures were 5-7 times more likely to have WMSDs in the neck and lower back than those who did not. Environmental and psychological factors, such as number of treatment tables, size of electrotherapy rooms, using PTs modalities, and stress were significantly associated with WMSDs. More than 50% of PTs used modified positions and new treatment/techniques that did not aggravate their symptoms, as coping strategies. CONCLUSIONS: This study indicates potential risk factors associated with WMSDs, affecting the neck and lower back among PTs in Vietnam. These risk factors should be addressed to improve overall PTs health, retain skilled workers, and encourage them to continue working.

Factors associated with reduced risk of musculoskeletal disorders among office workers: a cross-sectional study 2017 to 2020.

BACKGROUND: Prolonged sitting at work should be avoided to reduce the risks of either noncommunicable diseases (NCDs) or musculoskeletal disorders (MSDs) among office workers. A short duration of breaks in sitting every hour can reduce cardiometabolic risk factors contributing to NCDs. However, the recommendation for a break from sitting at work to reduce the risks of MSDs has not been identified. Therefore, this study aimed to determine whether breaking by changing position at work, physical activity, physical fitness, stress and sleep were associated with MSDs among office workers. METHODS: A cross-sectional study was conducted from 2017 to 2020. Participants aged 20-59 years and using a computer at work ≥ 4 days/week were recruited. Data were collected using an online self-reporting questionnaire for computer users and 5 domains of physical fitness tests. Odds ratio (OR) with 95% confidence interval (CI) and multivariate logistic regression were used for statistical analysis. RESULTS: Prevalence of MSDs was 37.9% (n = 207/545) and the most area of complaint were the neck, shoulders and back. A nonsignificant association between physical fitness and MSDs among office workers was obtained. After adjusting for age, sex, body mass index, and comorbidity, moderate-to-vigorous intensity physical activity (MVPA) ≥ 150 min/week and sitting at work ≥ 4 h/day were MSDs risk factors (OR = 1.57, 95%CI = 1.04-2.37). Frequently changing positions from sitting to standing or walking at work every hour could reduce the risks of MSDs by more than 30%. The risks of MSDs increased among office workers who commuted by staff shuttle bus and personal car and had high to severe stress and slept < 6 h/day (1.6 to 2.4 times). CONCLUSION: Our findings indicated MVPA and prolonged sitting were MSD risk factors. We recommend office workers change position from sitting to standing or walking during work every hour and sleep ≥ 6 h/day to reduce risks of MSDs.

Immediate effects of muscle energy technique and stabilization exercise in patients with chronic low back pain with suspected facet joint origin: A pilot study.

BACKGROUND: Facet joint is a potential structure to be the source of chronic low back pain (LBP) affecting lumbar motion, pain, and disability. Other than the recommended treatment of lumbar stabilization exercise (LSE), several manual procedures including muscle energy technique (MET) are commonly used in physical therapy clinic. However, little evidences of the effects of MET have been reported. OBJECTIVE: This study aimed to compare the immediate effects of MET and LSE in patients with chronic LBP with suspected facet joint origin. METHODS: Twenty-one patients with low back pain were recruited and randomly assigned to receive treatment either MET or LSE. The outcomes were kinematic changes, pain intensity, and disability level. Lumbar active range of motion (ROM) of flexion, extension, left and right lateral flexion, and left and right rotation were evaluated using the three-dimension motion analysis system at baseline and immediately after treatment. Pain intensity was evaluated using visual analogue scale (VAS) at baseline, immediately after, and two days after treatment. Thai version of the modified Oswestry disability questionnaire (ODQ) was utilized at baseline and two days after treatment. The mixed model analysis of variance was used to analyze all outcomes. RESULTS: The results showed that all outcomes were not different between groups after treatments. Although there were statistically significant improvements after the treatments when collapsing the groups, the minimal clinically important change was found only for pain but not for lumbar movements and disabilities scores. CONCLUSION: The effect of MET and LSE alone in single session might not be intensive enough to improve movements and decrease disability in patients with chronic LBP with suspected facet joint origin.

Effects of Thai Dancing on Median Neurodynamic Response During 4-Hour Computer Use.

OBJECTIVE: To investigate the effects of Thai dancing on median neurodynamic response during 4-hour computer use. MATERIAL AND METHOD: Twenty-four healthy participants aged 20-30 years performed 5 minutes of Thai dancing including Prom See Na, Yoong Fon Hang, Sod Soy Mala, Lor Keaw and Cha Nee Rai Mai during a 10-minute break of 4-hour computer use. All participants were assessed for nerve tension by elbow range of motion ofupper limb neurodynamic test 1 (ULNT1) and components of quick test. The discomfort was measured by visual analogue discomfort scale (VADS). These measurements were assessed before and after computer work. The statistical analyses employed paired t-test for continuous outcome and Friedman's test. RESULTS: The median nerve tension (indicated by elbow range of motion) was significantly reduced at before and after work, when 5 minutes of Thai dancing was introduced during the break. While components of the quick test emphasized that Thai dance immediately helped reduce the median nerve tension. The VADS in eight body areas increased over the period of 4 hours, but decreased after performing Thai dancing (p<0.05). CONCLUSION: Thai dancing helped relieve median nerve tension and body discomfort. It may be recommended as an exercise during break for computer users who continuously work to prevent WMSDs.

Trunk Muscle Performance and Work-Related Musculoskeletal Disorders among Manual Lifting with Back Belt Wearing Workers.

OBJECTIVE: to determine the effects ofback belt use on trunk muscle performance and the association between those performance outcomes with Work-Related Musculoskeletal Disorders (WMSDs). MATERIAL AND METHOD: All manual lifting workers in one grocery distribution, warehouse center were interviewed about the history of illness, back injury, WMSDs, lifting manner and experience of back belt use. They were assessedfor trunk muscles performance including the flexion (F), the extension (E) and the right and left side bridge (RSB and LSB) endurance test and Exercise Level of Lumbar Stabilization test (ELLS). Pearson s correlation and Spearman's rank correlation statistics were used to determine the association. RESULTS: One hundred and seven males, aged 18 to 42 years participated in the study. Most participants had ELLS at levels 2 (31.1%) and 3 (30.2%). The mean F, E, RSB and LSB endurance times were 62.33, 88.62, 77.17 and 77.33 seconds, respectively. The greatest area of WMSDs was the lower back (53.33%). Significant correlations were found between the ELLS and RSB (r = 0.244, p = 0.012) and between the ELLS and LSB (r = 0.199, p = 0.041). Significant correlations were found between pain scale of backpain and ELLS (r = -0.299, p = 0.016). Significant correlations were found between the number of WMSD areas and trunkflexion endurance (r = -0.263, p = 0.007), right trunk endurance (r,= -0.195, p = 0.044), left trunk endurance (r = -0.325, p = 0.001) and endurance ratio of RSB/LSB (r(s) = 0.224, p = 0.022). Furthermore, most participants (84.1%) had imbalanced endurance of RSB/LSB. Duration andfrequency ofback belt use did not correlate with any trunk muscle performance. This may have been because few participants did not wear belts (10.1%) or wore belts sometimes (26.6%). CONCLUSION: Low correlation was found between back belt use and WMSDs. To prevent back injury, the lifting workers should be trained to balance their trunk muscles endurance, especially right and left trunk muscles and to stabilize their lower back while lifting.

Correlation between Pressure Pain Threshold and Soft Tissue Displacement in Muscle Pain Conditions.

OBJECTIVE: To determine the correlation between pressure pain threshold (PPT), displacement pain threshold (DI) and pain visual analog scale (VAS) in patients with delayed onset muscle soreness (DOMS) and myofascial pain syndrome (MPS). MATERIAL AND METHOD: PPT and DPT were measured in the same time by modified Algometer commander. This study used the algometer for measuring PPT (N/cm2), in three groups of subjects, including DOMS (n=10), MPS (n=10), and asymptomatic (n=10). The DPT represented the displacement of the algometer probe on the skin in millimeters, while measuring PPT The DOMS was induced in the non-dominant biceps brachii muscle. The subjects with active myofascial trigger point (MTrP) at the upper trapezius muscle were recruited into the MPS group. DOMS group rated pain by VAS during elbow movement, while the MPS group rated at resting. Spearman's rank coefficient of correlation was usedfor data analysis. RESULTS: The results showed correlation between PPT and DPT in the asymptomatic biceps brachii muscle (r = 0.77, p = 0.001) andDOMS group (r(s) = 0.65, p = 0.04). No correlation wasfound between MPS and the asymptomatic upper trapezius muscle. CONCLUSION: A correlation was found between PPTandDPT in biceps brachii muscles. Thisfinding suggested that to assess the DOMS, the PPT and DPT accurately are requiredfor identifying pain and tissue softness.

Immediate effects of breathing re-education on respiratory function and range of motion in chronic neck pain.

OBJECTIVE: Neck pain is associated with certain breathingpatterns and may lead to altered respiratory function. Moreover the altered breathing patterns may cause neck pain symptoms. This study has determined the effects of respiratory muscle reeducation on neck pain symptoms and respiratory function. MATERIAL AND METHOD: Subjects with chronic neck pain (n = 36) were re-educated with three breathing patterns for 30 min. The pain intensity at rest and at the end-of-range of each neck movement, the cervical range of motion (CROM) measured from photographic images and the chest expansion during full inhalation and exhalation recorded using videography were evaluated before and after breathing re-education. Upper trapezius, anterior scalene, and sternocleidomastoid activity were evaluated during normal and deep breathing using surface electromyography, and the respiratory function measured by a spirometer was also evaluated during the same period. RESULTS: The pain intensity and the muscle activity were significantly decreased after re-education. The CROM and chest expansion at lower rib cage were significantly increased after re-education. CONCLUSION: Breathing re-education can change breathing patterns and increase chest expansion. This change leads to an improvement in CROM Positive consequences may result from the improvement in diaphragm contraction or reduced activity of accessory muscles.

Trunk stabilizer muscle activity during manual lifting with and without back belt use in experienced workers.

OBJECTIVE: The present study evaluated the changes in trunk-stabilizer electromyography (EMG) activities during manual lifting with and without a back belt in experienced back belt users. MATERIAL AND METHOD: Eighteen participants from a warehouse and distribution center in Thailand, aged 22 to 44 years, were assessed for trunk stabilizer muscle EMG activity including the rectus abdominis (RA), external abdominal oblique (EO), transversus abdominis (TrA), internal abdominal oblique (IO), erector spinae (ES), and multifidus (MF). The EMG data were recorded during (1) rest and (2) the initial phase of manual lifting in a dynamic semi-squat posture. For both conditions, the data were compared with and without wearing a back belt. RESULTS: The results showed that wearing a back belt significantly decreased TrA/IO activity during rest (p<0.01) and significantly increased RA activity during the lifting period (p<0.05) as compared with the condition of no back belt. CONCLUSION: The present study does not recommend healthy workers wear a back belt as a protective device for lower back injury, particularly without any lifting activity. However the back belt can be applied during lifting as it can enhance RA activity, which may help improve abdominal pressure and is less likely cause weakness of the TrA.

Online self-report questionnaire on computer work-related exposure (OSCWE): validity and internal consistency.

OBJECTIVE: To develop an online, self-report questionnaire on computer work-related exposure (OSCWE) and to determine the internal consistency, face and content validity of the questionnaire. MATERIAL AND METHOD: The online, self-report questionnaire was developed to determine the risk factors related to musculoskeletal disorders in computer users. It comprised five domains: personal, work-related, work environment, physical health and psychosocial factors. The questionnaire's content was validated by an occupational medical doctor and three physical therapy lecturers involved in ergonomic teaching. Twenty-five lay people examined the feasibility of computer-administered and the user-friendly language. The item correlation in each domain was analyzed by the internal consistency (Cronbach's alpha; alpha). RESULTS: The content of the questionnaire was considered congruent with the testing purposes. Eight hundred and thirty-five computer users at the PTT Exploration and Production Public Company Limited registered to the online self-report questionnaire. The internal consistency of the five domains was: personal (alpha = 0.58), work-related (alpha = 0.348), work environment (alpha = 0.72), physical health (alpha = 0.68) and psychosocial factor (alpha = 0.93). CONCLUSION: The findings suggested that the OSCWE had acceptable internal consistency for work environment and psychosocial factors. The OSCWE is available to use in population-based survey research among computer office workers.

Effects of lymphatic drainage therapy on autonomic nervous system responses in healthy subjects: A single blind randomized controlled trial.

OBJECTIVES: This study aimed to determine effects of lymphatic drainage therapy (LDT) on autonomic nervous system (ANS) responses by comparing including Hoffmann reflex (H reflex), heart rate variability (HRV), salivary alpha-amylase (sAA) and muscle tone (via straight leg raise (SLR)) in healthy participants. METHODS: A single blind randomized controlled trial evaluating sixty-six healthy participants including 58 females and 8 males aged between 40 and 65 years. All participants were blinded and randomized to either experimental group (EXP: LDT) or control group (CT: rest). LDT was applied to participants 45 min in experimental group. The LDT is light movement applied by an experienced physical therapist, starting from neck, deep abdomen, and along to the leg. While for the control group, participants received 45 min supine on the treatment table. Tests for evaluating ANS such as Hoffmann reflex (H reflex), heart rate variability (HRV), salivary alpha-amylase (sAA) and straight leg raise (SLR) were assessed at pre and post intervention. RESULTS: The findings demonstrated that H reflex decreased significantly after applying LDT; within and between groups (p < 0.05). Whereas, it increased significantly in control group. First tension (R1) indicated by participants during SLR significantly improved within both groups. However, there were no significant differences of HRV and sAA in either LDT or control groups. CONCLUSION: This study demonstrated that LDT decreased autonomic activity via decreased spinal reflex excitability and tension in healthy participants.

Breathing retraining with chest wall mobilization improves respiratory reserve and decreases hyperactivity of accessory breathing muscles during respiratory excursions: A randomized controlled trial.

PURPOSE: The aim of this paper was to evaluate the effects of breathing retraining with chest wall mobilization on the onset of accessory breathing muscle recruitment and respiratory reserve in individuals with chronic neck pain. METHODS: Thirty-two participants with non-specific chronic neck pain were randomly assigned into intervention and control groups. The intervention group received 30 minutes of breathing retraining with chest wall mobilization and the control group was assigned to rest for 30 minutes. Electromyography (EMG) of upper trapezius (UT), scalene (SC), and sternocleidomastoid (SCM) muscles were recorded during respiratory excursions by cycling for 12 minutes. Measurement of maximum voluntary ventilation (MVV), chest expansion, and pain intensity were taken during normal breathing. The immediate effects within each group and between two groups were analyzed. RESULTS: Significant improvement in respiratory reserve was observed in the intervention group compared to control group through prolonged EMG onset of accessory breathing muscles. Moreover, increase of MVV, chest expansion and decrease in pain intensity were observed. CONCLUSIONS: This research suggests that breathing patterns and chest expansion should be considered within the physical assessment of breathing retraining, and that chest wall mobilization offers clinically important improvements in patients with chronic neck pain.

The Effects of Ramp Gradients and Pushing-Pulling Techniques on Lumbar Spinal Load in Healthy Workers.

BACKGROUND: Many tasks in industrial and health care setting are involved with pushing and pulling tasks up or down on a ramp. An efficient method of moving cart which reduces the risk of low back pain should be concerned. This study aimed to investigate the effects of handling types (HTs) and slope on lumbar spinal load during moving a cart on a ramp. We conducted a 2 × 2 × 4 factorial design with three main factors: 2 HTs, 2 handling directions of moving a cart and 4 degrees of ramp slope. METHODS: Thirty healthy male workers performed 14 tasks consist of moving a cart up and down on the ramp of 0°, 10°, 15°, and 20° degrees with pushing and pulling methods. Joint angles from a 3D motion capture system combined with subject height, body weight, and hand forces were used to calculate the spinal load by the 3DSSPP program. RESULTS: Our results showed significant effect of HT, handling directions and slope on compression and shear force of the lumbar spine (p < 0.001). When the ramp gradient increased, the L4/5 compression forces increased in both pushing and pulling (p < 0.001) Shear forces increased in pulling and decreased in pushing in all tasks. At high slopes, pulling generated more compression and shear forces than that of pushing (p < 0.01). CONCLUSION: Using the appropriate technique of moving a cart on the ramp can reduce the risk of high spinal load, and the pushing is therefore recommended for moving a cart up/down on ramp gradients.

Determining Sincerity of Effort Based on Grip Strength Test in Three Wrist Positions.

BACKGROUND: Several grip strength tests are commonly used for detecting sincerity of effort. However, there is still no widely accepted standardized sincerity of effort test. Therefore, this study aimed to examine whether grip strength test in three wrist positions could distinguish between maximal and submaximal efforts. METHODS: Twenty healthy individuals (10 men and 10 women) with a mean age of 26.7 ± 3.92 years participated in this study. All participants completed two test conditions (maximal and submaximal efforts) in three wrist positions (neutral, flexion, and extension) using both hands. Each participant exerted 100% effort in the maximal effort condition and 50% effort in the submaximal effort condition. The participants performed three repetitions of the grip strength test for each session. RESULTS: The results showed that there is a significant main effect of the type of effort (p < 0.001), wrist position (p < 0.001), and hand (p = 0.028). There were also significant types of effort and wrist position interactions (p < 0.001) and effort and hand interactions (p < 0.028). The results also showed that grip strength was highest at the wrist in neutral position in both the maximal and the submaximal effort condition. Grip strength values of the three wrist positions in the maximal effort condition were noticeably greater than those in the submaximal effort condition. CONCLUSION: The findings of this study suggest that grip strength test in three wrist positions can differentiate a maximal effort from a submaximal effort. Thus, this test could potentially be used to detect sincerity of effort in clinical setting.

Break in Sedentary Behavior Reduces the Risk of Noncommunicable Diseases and Cardiometabolic Risk Factors among Workers in a Petroleum Company.

Although prolonged sitting appears as a novel risk factor related to health outcomes for all ages, its association needs to be replicated in occupational conditions. This study explored the associations between sedentary behavior and four noncommunicable diseases (NCDs) as well as two cardiometabolic risk factors (CMRFs) among workers in a petroleum company, Thailand. All workers were invited to complete the online self-report questionnaire. Sedentary behavior was measured as the amount of time sitting at work, during recreation, and while commuting. Out of 3365 workers contacted, 1133 (34%) participated. Prevalence of NCDs and CMRFs was 36% and was positively associated with sedentary behavior. After adjusting for age, BMI, and exercise, the risk of NCDs and CMRFs for sedentary office work was 40% greater compared with more active field work. Those who took a break without sitting more than twice a day and commuted by walking or cycling had less risk of NCDs and CMRFs. The total duration of sedentary behavior was 10 h/day, and two-thirds of that total was workplace sitting. This was significantly associated with NCDs and CMRFs (p < 0.001). Day-and-night rotating shiftwork was negatively associated with NCDs and CMRFs (p < 0.001). Sedentary behavior should be considered a health risk among workers. Hence, to promote a healthy lifestyle and safe workplace, organizations should encourage standing activities during break and physically active commutes, and have workers avoid prolonged sitting.