Neck Solutions Blog

Ergonomic practices within patient care units are associated with musculoskeletal pain and limitations

From: Am J Ind Med. 2011 Nov 23

With the high prevalence of musculoskeletal disorders for patient care unit workers, prevention efforts through ergonomic practices within units may be related to symptoms associated with typical work-related musculoskeletal disorders.

The authors completed a cross-sectional survey of patient care workers (n = 1,572) in two large academic hospitals in order to evaluate relationships between self-reported musculoskeletal pain, work interference due to this pain, and limitations during activities of daily living (functional limitations) and with ergonomic practices and other organizational policy and practices metrics within the unit. Bivariate and multiple logistic regression analyses tested the significance of these associations.

Prevalence of self-reported musculoskeletal symptoms in the past 3 months was 74% with 53% reporting pain in the low back. 32.8% reported that this pain interfered with their work duties and 17.7% reported functional limitations in the prior week. Decreased ergonomic practices were significantly associated with reporting pain in four body areas (low back, neck/shoulder, arms, and lower extremity) in the previous 3 months, interference with work caused by this pain, symptom severity, and limitations in completing activities of daily living in the past week. Except for low back pain and work interference, these associations remained significant when psychosocial covariates such as psychological demands were included in multiple logistic regressions.

Ergonomic practices appear to be associated with many of the musculoskeletal symptoms denoting their importance for prevention efforts in acute health care settings.

A systematic review of musculoskeletal disorders among school teachers.

From: BMC Musculoskelet Disord. 2011 Nov 17;12(1):260. [Epub ahead of print]

Musculoskeletal disorders represent one of the most common and important occupational health problems in working populations, being responsible for a substantial impact on quality of life and incurring a major economic burden in compensation costs and lost wages. musculoskeletal disorders decrease productivity at work due to sick leave, absenteeism and early retirement, and are also costly in terms of treatment and individual suffering. Moreover, musculoskeletal disorders represent a common health-related reason for discontinuing work and for seeking health care. In many occupations, musculoskeletal disorders include a wide range of inflammatory and degenerative conditions affecting the muscles, ligaments, tendons, nerves, bones and joints; and can occur from a single or cumulative trauma.

The work tasks of school teachers often involves significant use of a ‘head down’ posture, such as frequent reading, marking of assignments, and writing on a blackboard. Nursery school teachers, however, also perform a wide variety of tasks combining basic health childcare and teaching duties, and those that require sustained mechanical load and constant trunk flexion. Nursery school teachers have been found to have elevated prevalence of neck, shoulder, arm and low back disorders, and lower-extremity musculoskeletal disorders due to activities which require sustained periods of kneeling, stooping, squatting or bending.

School teachers in general, have been demonstrated relative to other occupational groups, to report a high prevalence of musculoskeletal disorders, with prevalence rates of between 40% and 95%. During the course of their work, teachers may be subjected to conditions that cause physical health problems. The work of a teacher does not only involve teaching students, but also preparing lessons, assessing students’ work and being involved in the extracurricular activities such as sports. Teachers also participate in different school committees. These may cause teachers to suffer adverse mental and physical health issues due to the variety of job functions. Despite this, the impact of musculoskeletal disorders specifically within the teaching profession has not been given sufficient attention in the literature. Furthermore, comparatively little research has investigated the prevalence of musculoskeletal disorders in the teaching profession.

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Muscle onset can be improved by therapeutic exercise: A systematic review.

From: Phys Ther Sport. 2011 Nov;12(4):199-209

The objective of this study was to determine whether therapeutic exercise can improve the timing of muscle onset following musculoskeletal pathology, and examine what exercise prescription parameters are being used to achieve these effects in people with a musculoskeletal pathology by measuring muscle onset timing by electromyography.

Sixteen investigations were identified containing 19 therapeutic exercise groups. Three exercise modes were identified including: isolated muscle training, instability training, and general strength training. Isolated muscle training is consistently shown to have a positive effect on the muscle onset timing of transversus abdominus in people with low back pain. There is some evidence from cohort studies that instability training may change muscle onset timing in people with functional ankle instability, however controlled trials suggest that no effect is present. General strength training shows no effect on muscle onset timing in people with low back or neck pain, although one cohort study suggests that a positive effect on gluteus maximus may be present in people with low back pain.

Therapeutic exercise training is likely to improve muscle onset timing. Additionally, isolated muscle training appears to be the best exercise mode to use to achieve these effects.

Does Radiating Spinal Pain Determine Future Work Disability? A Retrospective Cohort Study of 22,952 Danish Twins

From: Spine (Phila Pa 1976). 2011 Oct 21. [Epub ahead of print]

This was a population-based, retrospective cohort study to determine if radiating spinal pain from the low back, mid back, and neck is associated with future use of health-related benefits and their duration as compared to those with non-radiating spinal pain. Studies on the socioeconomic consequences of radiating pain have primarily focused on the low back and to a lesser extent on the neck and mid back. Additionally, few studies report on the incidence of health-related benefit use after any radiating spinal pain.

A cohort of 22,952 subjects was formed from the 2002 survey of the Danish Twin Registry. The survey contained information on spinal pain and important confounding factors. Work disability over an 8-year period was determined through data linkage with the Danish DREAM register of government transfer payments. The authors determined the incidence rate ratio for receipt of sickness benefit and the mean duration of the first and total sickness benefit periods by radiating and non-radiating spinal pain. Relative risks for the occurrence and number of sickness benefit episodes were calculated by radiating spinal pain status.

The incidence of sickness benefit was greater for those with radiating spinal pain than those with non-radiating spinal pain. However, the duration of time off work, conditional on one day or more off work, was the same between those with and without radiating spinal pain. Radiating spinal pain is an important risk factor for future sickness benefit. Radiating spinal pain was not associated with the duration of sickness benefit. These findings were independent of the effects of pain duration at baseline. The results highlight the need for interventions to prevent the onset of work disability, especially for those with radiating pain.