Back health in health education: reflections on musculoskeletal fitness

BackgroundTai Chi (TC) has proven to be effective at improving musculoskeletal fitness by increasing upper and lower body strength, low back flexibility and overall physical health. The objectives of this study were to examine changes in musculoskeletal health-related fitness and self-reported physical health after a 16 week TC program in a low income multiple ethnicity mid to older adult population.MethodsTwo hundred and nine ethnically diverse mid to older community dwelling Canadian adults residing in low income neighbourhoods were enrolled in a 16 week Yang style TC program. Body Mass Index and select musculoskeletal fitness measures including upper and lower body strength, low back flexibility and self-reported physical health measured by SF 36 were collected pre and post the TC program. Determinants of health such as age, sex, marital status, education, income, ethnicity of origin, multi-morbidity conditions, weekly physical activity, previous TC experience as well as program adherence were examined as possible musculoskeletal health-related fitness change predictors.ResultsUsing paired sample t-tests significant improvements were found in both upper and lower body strength, low back flexibility, and the SF 36 physical health scores (p < 0.05). Based on multiple linear regression analyses, no common health determinants explained a significant portion of the variation in percent changes of the musculoskeletal fitness and SF 36 measures.ConclusionsThese results reveal that TC has the potential of having a beneficial influence on musculoskeletal health-related fitness and self-reported physical health in a mid to older low socioeconomic, ethnically diverse sample.

BackgroundWork disability due to musculoskeletal and mental health disorders constitutes one of the greatest social and labor market challenges. There is a need to investigate the long-term impact of interventions provided to employees.ObjectiveTo investigate if a brief work-oriented intervention targeting musculoskeletal and mental health disorders affected the risk of work disability.MethodsA prospective study using national register data was designed. The intervention group consisted of all patients (n = 6348) who in the years 2008-2017 participated in a brief intervention at an outpatient clinic in the secondary health care service. The comparison group (n = 25,354) consisted of employees sick-listed for musculoskeletal or mental health disorders in the same years as the intervention group. Cox proportional hazard regression was used to model the effect of the intervention on the risk of future disability pension. Overall and subgroup analyses for gender and diagnoses were conducted for various categories of full-time equivalent number of days lost to work.ResultsGenerally, there was a pattern of increased risk of disability among patients in the intervention group if they participated in the intervention in an early phase of sick leave. This pattern was found in the overall analysis, for males, females, and patients with musculoskeletal disorders. Except for patients with only musculoskeletal disorders, there was a pattern of reduced risk of disability with sick leave of between three and six months.ConclusionsOverall, the intervention did not reduce the risk of disability. However, the results do indicate that intervention timing may be of significance.

Workplace computer use has increased dramatically in recent years and has been linked to musculoskeletal disorders, a leading cause of work disability and productivity losses in industrialized nations. Tai Chi is a simple, convenient workplace intervention that may promote musculoskeletal health without special equipment or showering, yet no study has investigated Tai Chi as a workplace physical exercise for health promotion. To examine the effects of a workplace Tai Chi (TC) intervention on musculoskeletal fitness and psychological well-being among female university employees who are computer users. The exercise program consisted of two 50 minute TC classes per week for 12 consecutive weeks during the months of May-August 2007. Fifty-two participants were enrolled in a class conducted on campus by a professional TC practitioner during the lunch hour. Socio-demographic characteristics, including information on age, marital status, ethnicity, job category and perceived overall health were collected from all participants. Fitness testing conducted by qualified personnel was assessed pre- and post-program. The tests included resting heart rate, resting blood pressure, anthropometric measures, musculoskeletal fitness and back fitness. Psychological well-being was assessed by the Perceived Stress Scale pre- and post-program. There were significant positive results in several areas including resting heart rate, waist circumference and hand grip strength. Results showed that the TC program was effective in improving musculoskeletal fitness and psychological well-being. Significant improvements in physiological and psychological measures were observed, even at the large class sizes tested here, suggesting that TC has considerable potential as an economic, effective and convenient workplace intervention.

ObjectiveTo identify potentially effective complementary approaches for musculoskeletal (MSK)–mental health (MH) comorbidity, by synthesising evidence on effectiveness, cost-effectiveness and safety from systematic reviews (SRs).DesignScoping review of SRs.MethodsWe searched literature databases,...

Pregnancy and low back pain: physical therapy can reduce back and pelvic pain during and after pregnancy.

Over the past century, global health priorities were largely focused on communicable diseases. With the world's population growth, increased average age and decreased death rates, people are now living longer and becoming increasingly susceptible to the non-communicable diseases, including musculoskeletal (MSK) disorders. The recent Global Burden of Disease (GBD) Study estimated the burden disability in 187 countries and 21 regions of the world for the years 1990, 2010 and 2013 of all MSK disorders - osteoarthritis (OA), rheumatoid arthritis (RA), gout, low back pain (LBP), neck pain (NP) and all other musculoskeletal disorders. Throughout the world, the prevalence and burden from MSK conditions were exceptionally high. All MSK disorders combined caused 21.3% of the total years lived with disability (YLDs) globally - second to mental and behavioural problems (23.2%). When taking into account both death and disability, all MSK disorders combined accounted for 6.7% of the total global disability-adjusted life years (DALYs), which was the fourth greatest burden on the health of the world's population (third in the developed countries). Out of the 291 conditions studied, LBP ranked first (highest) for the disability (YLDs), and sixth for the overall burden (DALYs). For NP, the condition ranked fourth highest for YLDs, and 21st for DALYs. ‘Other MSK disorders’ ranked sixth highest for YLDs and 23rd for DALYs. Osteoarthritis, RA and gout were also significant contributors to the global disability burden. In addition to this burden of disability as estimated by these summary measures of health, there is the impact on the individual's quality of life and economic independence as well as the costs to society due to health and social care and due to work loss. Despite this enormous and growing burden there is a lack of priority and of policies focusing on musculoskeletal health. This needs to change if we are to meet the demands of an ageing population that needs to be able to remain economically independent.

The need for novel strategies to analyze the dynamic pattern of worker’s health over time and the consequences for sustained employability

Tai Chi Chuan (Tai Chi) is a Chinese traditional mind-body exercise and recently, it becomes popular worldwide. During the practice of Tai Chi, deep diaphragmatic breathing is integrated into body motions to achieve a harmonious balance between body and mind and to facilitate the flow of internal energy (Qi). Participants can choose to perform a complete set of Tai Chi or selected movements according to their needs. Previous research substantiates that Tai Chi has significant benefits to health promotion, and regularly practicing Tai Chi improves aerobic capacity, muscular strength, balance, health-related quality of life, and psychological well-being. Recent studies also prove that Tai Chi is safe and effective for patients with neurological diseases (e.g., stroke, Parkinson's disease, traumatic brain injury, multiple sclerosis, cognitive dysfunction), rheumatological disease (e.g., rheumatoid arthritis, ankylosing spondylitis, and fibromyalgia), orthopedic diseases (e.g., osteoarthritis, osteoporosis, low-back pain, and musculoskeletal disorder), cardiovascular diseases (e.g., acute myocardial infarction, coronary artery bypass grafting surgery, and heart failure), chronic obstructive pulmonary diseases, and breast cancers. Tai Chi is an aerobic exercise with mild-to-moderate intensity and is appropriate for implementation in the community. This paper reviews the existing literature on Tai Chi and introduces its health-promotion effect and the potential clinical applications.

Objectives. This study aimed to analyze the effects of musculoskeletal disorders (MSDs) on the work performance, musculoskeletal fitness and quality of life of female office workers employed at a university. Methods. MSDs were evaluated in different body regions with the Cornell musculoskeletal discomfort questionnaire (CMDQ), job performance with the work role functioning questionnaire (WRFQ), musculoskeletal fitness with the musculoskeletal fitness battery (MFB) and quality of life with the short form-12 quality of life questionnaire (SF-12). Results. There was a significant weak correlation between job performance and lower back pain (LBP) (r = −0.21, p = 0.01). There were significant weak to moderate negative correlations between quality of life and CMDQ pain scores for each body part except the back, lower back and hip. There was a significant difference between those who always went to work and those who missed work for 10 days or more only in terms of LBP and hip pain scores (p = 0.008, p = 0.002). Conclusion. Musculoskeletal pain negatively impacts employees’ quality of life and work performance. Neck and extremity pain reduce office workers’ quality of life, while LBP and hip pain can affect work performance and lead to absenteeism.

BackgroundWorkplace injury is an international costly burden. Health care workers are an essential component to managing musculoskeletal disorders, however in doing this, they may increase their own susceptibility. While there is substantial evidence about work-related musculoskeletal disorders across the health workforce, understanding risk factors in specific occupational groups, such as podiatry, is limited.The primary aim of this study was to determine the prevalence and intensity of work related low back pain in podiatrists.MethodsThis was an international cross-sectional survey targeting podiatrists in Australia, New Zealand and the United Kingdom. The survey had two components; general demographic variables and variables relating to general musculoskeletal pain in general or podiatry work-related musculoskeletal pain. Multivariable regression analyses were used to identify factors associated with musculoskeletal stiffness and pain and low back pain intensity. Thematic analysis was used to group comments podiatrists made about their musculoskeletal health.ResultsThere were 948 survey responses (5% of Australian, New Zealand and United Kingdom registered podiatrists). There were 719 (76%) podiatrists reporting musculoskeletal pain as a result of their work practices throughout their career. The majority of injuries reported were in the first five years of practice (n = 320, 45%). The body area reported as being the location of the most significant injury was the low back (203 of 705 responses, 29%). Being female (p < 0.001) and working in private practice (p = 0.003) was associated with musculoskeletal pain or stiffness in the past 12 months. There were no variables associated with pain or stiffness in the past four weeks. Being female was the only variable associated with higher pain (p = 0.018). There were four main themes to workplace musculoskeletal pain: 1. Organisational and procedural responses to injury, 2. Giving up work, taking time off, reducing hours, 3. Maintaining good musculoskeletal health and 4. Environmental change.ConclusionsThe postures that podiatrists hold while treating patients appear to impact on musculoskeletal pain and stiffness. Recently graduated and female podiatrists are at higher risk of injury. There is a need for the profession to consider how they move and take care of their own musculoskeletal health.

Work-related musculoskeletal and mental health disorders: Are workplace policies and practices based on contemporary evidence?

Obesity is a prevalent global health challenge with a significant yet unclear impact on musculoskeletal health, particularly among females. This systematic review aimed to unravel the association between obesity and musculoskeletal health, as well as functional mobility in women. A comprehensive literature search was conducted across PubMed, Scopus, Web of Science, and the Cochrane Library for articles published between January 2001 and December 2023. Studies were selected based on their examination of the relationship between overweight or obesity and musculoskeletal health (including bones, joints, and soft tissues) and/or functional mobility in adult females (age ≥19) within the general population. Studies focusing on selective populations, or involving subjects with other health conditions or work-related musculoskeletal issues, were excluded. The data collected revealed a direct impact of obesity on musculoskeletal health, gait, and functional mobility, especially among women. Markedly, there was a strong association between obesity and musculoskeletal pain, particularly lower back pain. Obesity significantly alters gait biomechanics, leading to increased plantar pressure, altered kinematic patterns, and higher energy expenditure during walking. Higher BMI was found to significantly impact mobility-related limitations. Data also revealed that obesity, especially with BMI levels above 35 kg/m², adversely affects weight-bearing tasks such as walking, stair climbing, and chair rise ability. The findings of this systematic review emphasize the need for targeted interventions to address obesity-related mobility challenges, gait alterations and musculoskeletal pain to allow independence and enhanced functional outcomes in the daily activities of individuals with obesity. Exploring gender differences in obesity towards better understanding of the effect of obesity on the musculoskeletal health and functional mobility of women is critical for devising female-specific mitigation measures and optimizing management and treatment modalities, including pharmacotherapy.

Background: Low back pain (LBP) is one of the most prevalent musculoskeletal disorders in adults worldwide. Alterations in postural and lumbopelvic control and functionality appear to be determining factors in its resolution. Methods: A cross-sectional study was performed. Patients with LBP were enrolled. Lumbar pain; postural control (PC), total area of the center of pressure (TACOP), and the velocity of the center of pressure (VCOP); lumbopelvic control (LPC); and functionality were evaluated. Statistical tests were implemented to determine differences between sex and age and correlation models among the variables. Results: Thirty adult patients with LBP were analyzed. A strong relationship was found between pain and functionality [r = 0.64; p < 0.001]. A moderate relationship was found between pain and TACOP [r = 0.395; p = 0.031]. A moderate relationship was observed between TACOP and functionality [0.413; p = 0.023] and between LPC and TACOP [r = 0.416; p = 0.001]. Conclusions: This study demonstrates the significant impact of LBP on postural control, lumbopelvic control, and functionality. These results highlight the importance of addressing postural and lumbopelvic control in LBP treatment. No significant differences based on gender and age were found, but all clinical variables differed significantly between the LBP and control groups, underscoring the unique impairments associated with LBP.

Introduction: Tai Chi is a moderate mindful physical activity with long historical practice. There are new and novel types and forms of Tai Chi with promising results. The aim of this narrative review was to assess the quantity of the presence of Tai Chi in clinical guidelines that recommended or mentioned Tai Chi globally. Materials and Methods: Three medical databases were searched from inception to November 1, 2021, the retrieved search results were screened by two authors according to inclusion and exclusion criteria. Literature in English language, which is a clinical guideline, and Tai Chi was mentioned or recommended in the text of the guideline were included. Results: A total of 1539 articles were retrieved after searching medical databases. Retrieved articles were screened by two authors for possible inclusion in this review. Finally, 50 clinical guidelines that mentioned Tai Chi were included. Tai Chi was recommended 38 times of the 50 included clinical guidelines that mentioned Tai Chi (76%). Tai Chi was mentioned mostly in clinical guidelines for pain management (n = 5), osteoarthritis (n = 5), and cancer (n = 5). Furthermore, Tai Chi was recommended in all included clinical guidelines for (pain management, low back pain, stroke, and Parkinson's disease). Conclusions: Tai Chi was recommended mostly in the management of pain and musculoskeletal diseases. Updating health promotion and chronic diseases management programs to include the new forms and types of mindful exercises according to the best scientific evidence is suggested. This review recommended performing future research and critical analysis assessing the quality of evidence of included clinical guidelines.

Introduction: To investigate and compare the prevalence of some postural and musculoskeletal disorders in women with and without Urinary Incontinence (UI). Urinary Incontinence (UI) is one of the most important social and health problems in women. Limited studies have shown that UI prevalence is around 35%-55% in Iran. Nevertheless, to the best of our knowledge, there is no exact and reliable data reported in the literature on the prevalence of musculoskeletal, postural, or other related disorders in UI patients in Iran. Methods and Materials: The current study was conducted based on the data obtained from 166 incontinent and 90 continent women attending Vali-e-Asr University Hospital between 2010 and 2012. After collecting participants’ demographic information, postural status was assessed. In addition, we measured values for pelvic inclination and lumbar lordosis angles. Finally, vaginal tone and pelvic floor muscle strength and endurance were evaluated. Kolmogorov-Smirnov (K-S) goodness-of-fit, Independent t, X 2 , and Pearson correlation tests were used for the purposes of data analysis. Results: The prevalence of low back pain, chronic pelvic pain, and pelvic asymmetry were significantly higher in incontinent women compared with that in continent women (p<0.05). It was found that lumbar lordosis was significantly different between the two groups ( P =0.021); however, no significant difference was observed regarding pelvic inclination ( P =0.20). Conclusion: The present study confirms the hypothesis that incontinent women have higher prevalence of low back and pelvic pain and pelvic asymmetry. It is recommented that further epidemiologic and comprehensive etiologic investigations be conducted on these findings. Keywords: Urinary Incontinence, Posture, Musculoskeletal Disorders, Women