Back Injury Research Articles

Epidemiology of musculoskeletal injury in professional and amateur golfers: a systematic review and meta-analysis

ObjectiveTo determine the prevalence and incidence of musculoskeletal injury in amateur and professional golfers, and to identify common injury sites and factors associated with increased injury frequency.DesignSystematic epidemiological review and...

Transhumeral prosthesis use affects upper body kinematics and kinetics

BackgroundTranshumeral (TH) limb loss leads to loss of body mass and reduced shoulder range of motion. Despite most owning a prosthesis, prosthesis abandonment is common. The consequence of TH limb loss and prosthesis use and disuse during gait may be compensation in the upper body, contributing to back pain or injury. Understanding the impact of not wearing a TH prosthesis on upper body asymmetries and spatial-temporal aspects of gait will inform how TH prosthesis use and disuse affects the body. Research questionDoes TH limb loss alter upper body asymmetries and spatial-temporal parameters during gait when wearing and not wearing a prosthesis compared to able-bodied controls? MethodsEight male TH limb loss participants and eight male control participants completed three gait trials at self-selected speeds. The TH limb loss group performed trials with and without their prosthesis. Arm swing, trunk angular displacement, trunk-pelvis moment, and spatial-temporal aspects were compared using non-parametric statistical analyses. ResultsBoth TH walking conditions showed greater arm swing in the intact limb compared to the residual (p≤0.001), resulting in increased asymmetry compared to the control group (p≤0.001). Without the prosthesis, there was less trunk flexion and lateral flexion compared to the control group (p≤0.001). Maximum moments between the trunk and pelvis were higher in the TH group than the control group (p≤0.05). Spatial-temporal parameters of gait did not differ between the control group and either TH limb loss condition. SignificanceProsthesis use affects upper body kinematics and kinetics, but does not significantly impact spatial-temporal aspects of gait, suggesting these are compensatory actions. Wearing a prosthesis helps achieve more normative upper body kinematics and kinetics than not wearing a prosthesis, which may help limit back pain. These findings emphasize the importance of encouraging at least passive use of prostheses for individuals with TH limb loss.

Simulation analysis of low back forces in Snatch and Clean & Jerk movements via digital human modelling.

Weightlifting is an Olympic sport for dynamic strength and power, and requires the execution of different lifting techniques It is important to analyze the forces subjected to the lower back during weightlifting movements to prevent injuries. Digital Human Modeling (DHM) is a powerful tool that can be used to analyze and optimize the performance of humans while doing their work or activities. The purpose of this study is to present a simulation analysis of the lower back forces during the execution of two weightlifting techniques: Snatch (SN) and Clean & Jerk (CJ), with different loads and for both genders. Digital Human modelling through JACK simulation package was used analyze the forces exerted on the lumbosacral area (L5-S1) of the lower back in order to determine the risk for low back injuries. The level of compression and shear forces recommended by the literature have been set as thresholds. The simulaitons were performed in male and female models, with loads from 20-100kg. The results show that any weight higher than 60 kg in both movements poses risk for the weightlifters in terms of compression and shear forces. It has been observed that weightlifters can lift greater loads in the CJ technique compared to the SN technique. Furthermore, females are able to lift higher loads with lower risk of injuries. Weightlifting is a high-risk activity due to the high levels of shear and compression forces that the body is exposed to during the lifting techniques. Digital Human Modeling holds significant value due to their ability to facilitate the exploration of diverse conditions within a safe environment, devoid of any potential harm to human subjects.

Identifying factors associated with physical therapy use versus non-use among injured workers with back pain in Washington State.

There is little information about predictors of physical therapy (PT) use among injured workers with back pain. The primary objective of this study is to investigate the associations between PT use and baseline factors not routinely captured in workers' compensation (WC) data. We conducted a secondary analysis using the Washington State Workers' Compensation Disability Risk Identification Study Cohort, which combines self-reported surveys with claims data from the Washington State Department of Labor and Industries State Fund. Workers with an accepted or provisional WC claim for back injury between June 2002 and April 2004 were eligible. Baseline factors for PT use were selected from six domains (socio-demographic, pain and function, psychosocial, clinical, health behaviors, and employment-related). The outcome was a binary measure for PT use within 1 year of injury. Bivariate and multivariable logistic regression models were conducted to evaluate the associations between PT use and baseline factors. Among the 1370 eligible study participants, we identified 673 (49%) who received at least one PT service. Baseline factors from five of the six domains (all but health behaviors) were associated with PT use, including gender, income, pain and function measures, injury severity rating, catastrophizing, recovery expectations, fear avoidance, mental health score, body mass index, first provider seen for injury, previous injury, and several work-related factors. We identify baseline factors that are associated with PT use, which may be useful in addressing disparities in access to care for injured workers with back pain in a WC system.

Lateral Pelvis and Lumbar Motion in Seated and Standing Office Work and Their Association With Transient Low Back Pain.

To assess frontal plane motion of the pelvis and lumbar spine during 2 h of seated and standing office work and evaluate associations with transient low back pain. Although bending and twisting motions are cited as risk factors for low back injuries in occupational tasks, few studies have assessed frontal plane motion during sedentary exposures. Twenty-one participants completed 2 h of seated and standing office work while pelvic obliquity, lumbar lateral bending angles, and ratings of perceived low back pain were recorded. Mean absolute angles were compared across 15-min blocks, amplitude probability distribution functions were calculated, and associations between lateral postures and low back pain were evaluated. Mean pelvic obliquity (sit = 4.0 ± 2.8°, stand = 3.5 ± 1.7°) and lumbar lateral bending (sit = 4.5 ± 2.5°, stand = 4.1 ± 1.6°) were consistently asymmetrical. Pelvic obliquity range of motion was 4.7° larger in standing (13.6 ± 7.5°) than sitting (8.9 ± 8.7°). In sitting, 52% (pelvis) and 71% (lumbar) of participants, and in standing, 71% (pelvis and lumbar) of participants, were considered asymmetric for >90% of the protocol. Lateral postures displayed weak to low correlations with peak low back pain (R ≤ 0.388). The majority of participants displayed lateral asymmetries for the pelvis and lumbar spine within 5° of their upright standing posture. In short-term sedentary exposures, associations between lateral postures and pain indicated that as the range in lateral postures increases there may be an increased possibility of pain.

Secular trends in gabapentinoid dispensing by compensated workers with low back pain: a retrospective cohort study

ObjectivesThe increase in gabapentinoid prescribing is paralleling the increase in serious harms. To describe the low back pain workers compensation population whose management included a gabapentinoid between 2010 and 2017,...

Can the combination of deep tissue massage and stretching influence the recovery process of lower back pain injuries?

Lower Back Pain (LBP) presents as discomfort in the lumbar region, leading to movement limitations. Addressing LBP requires specialized treatment to alleviate pain. The aim of this study was to demonstrate the effectiveness of combining deep tissue massage and stretching in healing low back pain injuries. This study adopted a pre-experimental design, employing a one-group pretest and posttest approach. The initial assessments (pretests) gauged LBP severity using VAS, Modified Schober Test, Fingertip to Floor, and ODI. Subsequently, a combination therapy of deep tissue massage and stretching is administered three times weekly over three weeks. Final assessments (posttest) are conducted. Participants, recruited from the LKP Rumah Sehat Mandiri clinic over the past five months, consisted of 20 individuals aged 20-60 years, sampled purposively. The study revealed significant improvements in pain, flexion, extension, right flexion, left flexion, and functional indicators following the combination therapy, with a significance value of 0.000, indicating a profound effect (p < 0.05). Notably, left flexion demonstrated a significance value of 0.001, further affirming the treatment's efficacy. The findings support the effectiveness of combining deep tissue massage and stretching in reducing LBP severity and promoting healing. Thus, this combined approach holds promise for managing LBP injuries effectively.

Effectiveness of structured teaching programme on knowledge of preventive measures of low back pain among first year B.Sc. Nursing students in selected nursing college at Bangalore

Lower back pain is universally common issue. It can be experienced at any age, and most people experience at least once in their life. Low back pain (LBP) describes pain between the lower edge of the ribs and the buttock. The first episode usually occurs between early years of age. Nurses are vulnerable and ignored so they must supposed to be knowledgeable about the risk factors and preventive measures and effectively apply it into practice to prevent them from sustaining back injuries. Pain often gets better with rest, physical therapy and medication. Reduce your risk of low back pain by keeping at a healthy weight and staying active. Hence different treatments are available for it but knowledge and primary prevention is essential as core for any. This study done on a total of 50 second year B.Sc nursing students were selected in a college The study reveals that the structured teaching programme could increase the knowledge level of student nurse and it should be an on-going process. The findings of the present study have implications for Nursing practice like clinical instructor should expertise in assisting the student nurses to improve the knowledge about preventive measures of low back pain Key words: Effectiveness, Structured teaching programme, Knowledge of preventive measures of low back pain, low back pain, LBP.

A new framework for exploration of transportation maintenance-related prevalent work injuries, hazardous activities, and effectiveness of ergonomic solutions in the United States

The transportation industry involves various ergonomic injuries caused by activities exceeding workers’ capabilities. Although the construction industry has been thoroughly studied regarding work-­related injuries, hazardous activities, and effective ergonomic solutions, there is a lack of such research in the transportation sector. However, injuries, risky activities, and effectiveness of solutions may be different in transportation activities due to different work duration, intensity, and frequency. Thus, this research intends to explore the common work-related injuries, hazardous transportation activities, and the effectiveness of ergonomic solutions for transportation maintenance workers. This thorough examination incorporated historical injury records, online surveys, in-person site observations, and field experiments. Specifically, a preliminary list was first created based on transportation workers’ historical injury data, including common injured worker positions, injury types, activities causing most injures, and potential risk factors. An online survey was then designed to identify work-related injuries and activities. Following observations, field experiments involved 29 transportation maintenance workers. Back injuries emerged as the most prevalent when engaging in lifting and pushing/pulling tasks. Using a back exoskeleton can eliminate physical fatigue risks when lifting weights of 50 pounds or more. In addition, lifting lighter loads (31.5 pounds) can significantly reduce the risk of injuries.

Injury Occurrence and Localization in Tennis: Perspectives on Prevention and Physiotherapy

Injuries happens in sports involving human movement, with the heightened demands of the sport often correlating with increased injury risk. Tennis, in particular, presents notable challenges as the repetitive motions involved can lead to muscle imbalances and varying levels of strain across different parts of the body. In this narrative literature review, we included 66 studies with the aim of providing a comprehensive overview of tennis-related injuries and offering insights into physiotherapy interventions for prevention and recovery. The first part of our review is on the most prevalent tennis injuries and their anatomical localization. It is noteworthy that injuries predominantly occur during matches rather than in training sessions. These injuries span a wide range, encompassing both acute and chronic conditions, affecting various parts of the body. Notably, muscle-tendon injuries are common, with frequent occurrences in areas such as the thigh, ankle, knee, and shoulder. Furthermore, it is observed that men suffer from back injuries compared to women. In the subsequent section, we delve into specific body regions and their associated injuries in greater detail. Our analysis leads to the recommendation that tennis players should engage with physiotherapists early in their sports careers for injury recovery and mainly for prevention measures. Collaboration with physiotherapists can significantly mitigate the risk of injuries and enhance overall performance and longevity in the sport.

Implementing an accelerometer-based pelvis segment for low back kinetic analyses during dynamic movement tasks

An accelerometer-based pelvis has been employed to study segment and joint kinematics during scenarios involving close human-object interface and/or line-of-sight obstructions. However, its accuracy for examining low back kinetic outcomes is unknown. This study compared reaction moments and contact forces of the L5S1 joint calculated with an accelerometer-based and optically tracked pelvis segment. An approach to correct the global pelvis position as a function of thigh angle was developed. One participant performed four dynamic tasks: forward bend, squat, sit-to-stand-to-sit, and forward lunge. A standard bottom-up inverse dynamics approach was used and the root mean square error (RMSE) and coefficient of determination (R2) were calculated to examine kinetic differences between the optical and accelerometer approaches. The RMSE observed for L5S1 reaction flexion-extension moments ranged from 1.32 Nm to 2.20 Nm (R2 ≥ 0.98). The RMSE for net shear and compression reaction forces ranged from 2.13 to 10.45 N and 0.63 – 4.96 N, respectively. Similarly, the RMSE for L5S1 joint contact shear and compression ranged from 13.45 N to 19.51 N (R2 ≥ 0.85) and 31.18 N – 55.97 N (R2 ≥ 0.97), respectively. In conclusion, the accelerometer-based pelvis together with the approach to correct the global pelvis position is a feasible approach for computing low back kinetics with a single equivalent muscle model. The observed error in joint contact forces represents less than 5 % of the NIOSH recommended action limits and is unlikely to alter the interpretation of low back injury risk.

Lightweight active back exosuit reduces muscular effort during an hour-long order picking task

Occupational back exoskeletons and exosuits aim to reduce low back injuries in the workplace. For these technologies to be adopted, it is important that they provide biomechanical benefits to the wearer and do not disrupt job performance. To address this challenge, here we developed a lightweight, soft, active back exosuit that can autonomously control virtual impedance to apply differing assistance during lowering and lifting. In usability tests, participants rated the exosuit as easy to learn and use and reported feeling confident while wearing it. In an experiment involving an hour-long order picking task we demonstrated that the exosuit reduced peak and median muscle activations in the back by 18% and 20%, respectively. Despite the complexity of the movements required, such as walking, bending, and navigating around obstacles while lifting boxes from under a rack, our controller demonstrated impressive robustness with only 14 mistriggers out of 9600 lifts (0.1%). The results of this research suggest that active exosuit technology has the potential to be a highly usable solution to aid warehouse workers in real-world settings.

Does Overhead Squat Performance Affect the Swing Kinematics and Lumbar Spine Loads during the Golf Downswing?

The performance of the overhead squat may affect the golf swing mechanics associated with golf-related low back pain. This study investigates the difference in lumbar kinematics and joint loads during the golf downswing between golfers with different overhead squat abilities. Based on the performance of the overhead squat test, 21 golfers aged 18 to 30 years were divided into the highest-scoring group (HS, N = 10, 1.61 ± 0.05 cm, and 68.06 ± 13.67 kg) and lowest-scoring group (LS, N = 11, 1.68 ± 0.10 cm, and 75.00 ± 14.37 kg). For data collection, a motion analysis system, two force plates, and TrackMan were used. OpenSim 4.3 software was used to simulate the joint loads for each lumbar joint. An independent t-test was used for statistical analysis. Compared to golfers demonstrating limitations in the overhead squat test, golfers with better performance in the overhead squat test demonstrated significantly greater angular extension displacement on the sagittal plane, smaller lumbar extension angular velocity, and smaller L4-S1 joint shear force. Consequently, the overhead squat test is a useful index to reflect lumbar kinematics and joint loading patterns during the downswing and provides a good training guide reference for reducing the risk of a golf-related lower back injury.

Nationwide Etoricoxib Injection Clinical Experience (NICE): Real-World Evidence in Indian Patients.

Introduction Pain is a major health issue globally. Etoricoxib, a highly selective COX-2 inhibitor, given orally, has been found to be efficacious and safe in the management of acute and chronic pain. Oral etoricoxib has been extensively studied; however, there is a lack of research exploring the use of etoricoxib via alternative routes, specifically intramuscular (IM) injection. This study aimed to evaluate the effectiveness and safety of an innovative and novel formulation of IM etoricoxib injection 90 mg/mL in the management of patients with acute pain in India. Method This was a real-world, multicenter, retrospective, observational study to investigate the effectiveness and safety of IM etoricoxib injection in the management of patients with acute pain in India (outpatient setting). The clinical data of 383 patients from 42 centers across India were collected from November 2022 to April 2023. Following approval from the site investigator, comprehensive patient-level information encompassing demographic and clinical variables as well as comorbidities was collected and entered into a case report form. Approval from the Independent Ethics Committee (IEC) and Institutional Review Board (IRB) was sought. The safety and effectiveness at 30 minutes and 60 minutes of IM etoricoxib injection were then analyzed. Results Among the studied patients, etoricoxib was used for the management of knee arthritis, fracture, post-traumatic pain, postoperative cases, acute back pain, back injury, torn ligament, and muscle strain and sprain. Of 383 patients, 98.17% had moderate-to-severe pain at baseline on the visual analogue scale (VAS) (0 being no pain and 10 being severe unbearable pain). The percentage of patients with severe pain reduced to only 6.78% and 4.17% at 30 minutes and 60 minutes, respectively. The improvement in the VAS score was statistically significant from baseline to 30 minutes and 60 minutes, and at 60 minutes compared to 30 minutes (p < 0.0001). More than half the patients (56.91%) had no pain at the site of the injection. Most of the doctors (70.23%) opined that the IM etoricoxib injection was better than their currently used NSAID injections for pain relief. Only 12.79% of patients required rescue analgesia post-IM etoricoxib injection. IM etoricoxib injection was well tolerated as 98.69% of the patients did not experience or report any adverse events post-IM injection. Conclusion This real-world, multicenter, retrospective, observational study across India demonstrated that the innovative and novel formulation of etoricoxib (90 mg/mL IM injection) was effective and well-tolerated in the management of acute pain. Overall, this study provides valuable insights into the real-world effectiveness and safety of IM etoricoxib injections, suggesting it could be a promising therapy for the management of acute pain for optimal patient benefit.

Core stability exercise for the impact of weightlifting and deadlifting on herniated nucleus pulposus (HNP): a systematic review

Background: Herniated nucleus pulposus or disc herniation is a serious medical condition, the common cause of sciatic pain, and the most common indication for spine surgery. People doing athletic sports, especially weightlifting and deadlifting, may face significant acute and overuse spinal injuries that can cause HNP. Core stability exercise (CSE) improves athletes' sports performance and can prevent injury. This systematic review aims to determine the impact of core stability exercises on weightlifting and deadlifting on herniated nucleus pulposus. Method: According to PRISMA recommendations, a systematic review using an online database was carried out. The inclusion criteria set includes studies regarding the impact of core stability exercise on deadlifting and weightlifting to prevent HNP, using adult samples&gt;18 years old and providing the type of CSE exercise. In contrast, the exclusion criteria were studied not available in full text and not available in Bahasa or English. Study quality assessments were done using a checklist for the Joanna Briggs Institute. Result: Ten studies are included in this systematic review, consisting of six randomized controlled trials, two review articles, one case-control study, and one prospective cohort study. The CSE effectively improves the endurance, strength, mobility, and dynamic balance of core muscles, especially spinal muscles, which can prevent back injury, especially for weightlifters and dead lifters. Core stability exercises should be incorporated into athletes' training programs to improve sports performance and reduce the risk of back injury, especially HNP. Conclusion: The CSE effectively improves the endurance, strength, mobility, and dynamic balance of core muscle, especially spinal muscle, which can prevent back injury in athletes, especially weightlifters and dead lifters.

The highs and lows of lifting loads: SPM analysis of multi-segmental spine angles in healthy adults during manual handling with increased load

Introduction: Manual handling personnel and those performing manual handling tasks in non-traditional manual handling industries continue to suffer debilitating and costly workplace injuries. Smart assistive devices are one solution to reducing musculoskeletal back injuries. Devices that provide targeted assistance need to be able to predict when and where to provide augmentation via predictive algorithms trained on functional datasets. The aim of this study was to describe how an increase in load impacts spine kinematics during a ground-to-platform manual handling task. Methods: Twenty-nine participants performed ground-to-platform lifts for six standardised loading conditions (50%, 60%, 70%, 80%, 90%, and 100% of maximum lift capacity). Six thoracic and lumbar spine segments were measured using inertial measurement units that were processed using an attitude-heading-reference filter and normalised to the duration of the lift. The lift was divided into four phases weight-acceptance, standing, lift-to-height and place-on-platform. Statistical significance of sagittal angles from the six spine segments were identified through statistical parametric mapping one-way analysis of variance with repeated measures and post hoc paired t-tests.Results: Two regions of interest were identified during a period of peak flexion and a period of peak extension. There was a significant increase in spine range of motion and peak extension angle for all spine segments when the load conditions were increased (p &amp;lt; 0.001). There was a decrease in spine angles (more flexion) during the weight acceptance to standing phase at the upper thoracic to upper lumbar spine segments for some condition comparisons. A significant increase in spine angles (more extension) during the place-on-platform phase was seen in all spine segments when comparing heavy loads (&amp;gt;80% maximum lift capacity, inclusive) to light loads (&amp;lt;80% maximum lift capacity) (p &amp;lt; 0.001).Discussion: The 50%–70% maximum lift capacity conditions being significantly different from heavier load conditions is representative that the kinematics of a lift do change consistently when a participant’s load is increased. The understanding of how changes in loading are reflected in spine angles could inform the design of targeted assistance devices that can predict where and when in a task assistance may be needed, possibly reducing instances of back injuries in manual handling personnel.

Swimming Anatomy and Lower Back Injuries in Competitive Swimmers: A Narrative Review.

Competitive swimmers are at high risk of overuse musculoskeletal injuries due to their high training volumes. Spine injuries are the second most common musculoskeletal injury in swimmers and are often a result of the combination of improper technique, high loads on the spine in strokes that require hyperextension, and repetitive overuse leading to fatigue of the supporting trunk muscles. The purpose of this review is to summarize the current evidence regarding swimming biomechanics, stroke techniques, and common injuries in the lumbar spine to promote a discussion on the prevention and rehabilitation of lower back injuries in competitive swimmers. From a PUBMED/MEDLINE search, 16 articles were identified for inclusion using the search terms "swimming," "low back" or "lumbar," and "injury" or "injuries." Narrative review. Levels 4 and 5. The trunk muscles are integral to swimming stroke biomechanics. In freestyle and backstroke, the body roll generated by the paraspinal and abdominal muscles is integral to efficient stroke mechanics by allowing synergistic movements of the upper and lower extremities. In butterfly and breaststroke, the undulating wave like motion of the dolphin kick requires dynamic engagement of the core to generate repetitive flexion and extension of the spine and is a common mechanism for hyperextension injuries. The most common lower back injuries in swimming were determined to be lumbar strain, spondylolysis and spondylolisthesis, facet joint pain, and disc disease. Most overuse swimming injuries can be treated conservatively with physical therapy and training adjustments. Managing swimmers with low back pain requires a basic knowledge of swimming technique and a focus on prevention-based care. Since most swimming injuries are secondary to overuse, it is important for providers to understand the mechanisms underlying the swimming injury, including an understanding of the biomechanics involved in swimming and the role of spine involvement in the 4 strokes that assist in stabilization and force generation in the water. Knowledge of the biomechanics involved in swimming and the significant demands placed on the spinal musculoskeletal system will aid the clinician in the diagnosis and management of injuries and assist in the development of a proper rehabilitation program aimed at correction of any abnormal swimming mechanics, treatment of pain, and future injury prevention. B. Recommendation based on limited quality or inconsistent patient-oriented evidence.

The Impact of Wrong Body Mechanics and Musculoskeletal Disorder among Nursing Staff of Hafr Albatin Hospital on the Quality of Patient Care

Background: Back pain is an international economic and social issue within healthcare. It is the main reason stated for sickness and absence and is a significant occupational health problem that has an influence in all areas of health care provision. Ergonomic and musculoskeletal problems are regarded as the leading occupational issue affecting the global healthcare workforce. Healthcare workers constantly rank amongst the main occupations with permanent back injuries which occur mainly from the handling of patients. Back pain studies in healthcare workers have shown a correlation between the symptoms of back pain and being in a poor posture Aim: This study aimed to assess the Wrong Body Mechanics and Musculoskeletal Disorder among Nursing Staff and relationship between back pain with nursing activities and the use of body mechanics among nurses working in hospitals. Design: a cross-sectional research design was utilized. Setting: Study was carried out in Harf Al-Batin Saudi Arabia Hospitals. Subjects: A convenience sample of nurses (158) was recruited from above mentioned setting. Tools: Tool I: Demographic questionnaire and lifestyles patterns, Tool II: Back pain scale, body mechanics observation and Common nursing care activities questionnaire. Results: This study showed that 72.3 % of the studied nurses had back pain in intensive care , acute kidney unit and operation room, 100% of them had daily work hours 8and 9 and 66.7% was listed in marital status , 87.5% had barriers to perform body mechanics pain intensity in female gender and have significant result of the studied nurses in age ranged 36-40.Conclusion: The current study revealed that was a statistically positive correlation between barriers to perform body mechanics, degree of back pain, and nursing activities of the studied nurses. Recommendations: The study recommended a program for nurses to enhance the safe nursing practice of body mechanics and develop strategies to prevent back pain.

The “Weekday Effect”: A Decrease in Occupational Accidents from Monday to Friday—An Extension of the “Monday Effect”

Objective. Study the variation in the number of accidents across days of the workweek, from Monday to Friday. Data and Method. All occupational accidents of full-time workers in Spain from 2011 to 2018 are analyzed. A total amount of 2,873,872 accidents are representative and not heavily affected by underreporting bias. Chi-squared test (χ2) and z-value determine statistically significant differences in accident percentages from Monday to Friday, controlling personal (sex, age, nationality, and seniority), company (activity, size, and region), temporal (hour of the day and working hour) variables, and consequences (severity, injury type, and injured body part). Results. “Weekday effect” with a decrease in accidents of 29.4% from Monday to Friday, a decrease of 14.3% from Monday to Tuesday (“Monday effect”), 3.9% from Tuesday to Wednesday, 7.9% from Wednesday to Thursday, and 7% from Thursday to Friday. The “weekday effect” and the “Monday effect” occur across industries, for all company sizes, for all types of workers (both genders, different ages and seniority), for different types of injury, and across the day and the shift. “Monday effect” increases with age and seniority, for men, in small companies (10 to 49 workers), in the morning, at the beginning of the work shift hours, and for back injuries. “Weekday effect” decreases with age and increases with seniority, for men, in companies between 20 and 249 workers, in the morning and at the beginning of the work shift hours, and for back injuries.

Association of Case Duration with Late vs. Early Physical Therapy Initiation in Treatment of Work-Related Musculoskeletal Injuries: A Retrospective Analysis

Background:Occupational medicine providers treat patients who are injured while working. Conservative management with over-the-counter anti-inflammatory medicines, physical modalities (ice/heat), and activity restrictions are first-line treatment strategies. Physical therapy (PT) is often added to assist with patients’ return to baseline through symptom reduction and restoration of function. PT efficacy on outcomes and healthcare costs has been described in other patient populations but less described in injured worker populations. This study focused on associations between PT timing and case duration for treating musculoskeletal injuries in a regional injured workerpopulation.&#x0D; Methods:A retrospective chart review of 795 patients receiving care at Parkview Occupational Health (POH) for musculoskeletal injuries from 2017-2023 was conducted to determine if early PT was associated with case duration. Patients employed in Indiana and referred to PT within Parkview were included in the study. Age, BMI, and case duration were compared between early vs. late PT groups using two-sampled t-test. Race, sex, smoking status, and injury type were compared using chi-squared tests.&#x0D; Results:The mean case duration (73.41 days) when PT was initiated early (≤ 30 days after date of injury, DOI) was significantly shorter compared to the mean case duration (104.21 days) when PT was initiated late (p&lt;0.0001). Case duration was even shorter (67.61 days) when early PT was defined as ≤14 days after injury (p=0.001). There was no significant difference in case duration (mean difference=9.5 days) between patients initiating PT within 14 days and within 15-30 days (p=0.15). Injury type (back vs. other musculoskeletal injuries) was significantly associated with PT timing (p=0.002).&#x0D; Conclusion/Implications:Future analysis should compare case duration, days of restricted work, advanced imaging utilization, and specialist referral rate between patients with early and late PT initiation. This comparison will aid in development of best practice guidance for treatment of work-related musculoskeletal injuries at POH.