Low Back Disorders Research Articles

Work-related musculoskeletal disorders in anesthesiologists: A cross-sectional study on prevalence and risk factors

Aim: To investigate the prevalence of self-reported work-related musculoskeletal disorders (WRMDs) of anesthesiologists, to evaluate potential risk factors, including personal and workload characteristics and working ergonomics.Material and Methods: A cross-sectional international survey including personal and workload characteristics of anesthesiologists was conducted. The Standardized Nordic Musculoskeletal Questionnaire was used to identify working ergonomics and the quality of ergonomic conditions of the operating room. The prevalence of WRMDs was calculated, and predictors of these symptoms were evaluated using binary logistic regression.Results: 98.4% of respondents reported a WRMD in the previous 12 months, mainly low back disorders (70.7%). Cardiothoracic anesthesiologists were more likely to report 12-month knee problems (66%). Overall, pediatric anesthesiologists were more likely to report 12-month WRMDs in most of their body sites. Women were more likely to develop WRMDs in the upper back (OR=2.465; 95% CI:1.061-5.729) as compared with men. Long-duration bending was the most significant ergonomic hazard for all 3 body regions of musculoskeletal symptoms, with an OR of 4.210 (95% CI:1.081-16.391) for the neck, 4.619 (1.274-16.744) for the upper back, and 4.750 (1.045-21.590) for the low back. Suboptimal quality of ergonomic conditions in the operating room was significantly associated with increased WRMDs risk of the neck (OR=0.346; 95% CI:0.147- 0.812) and shoulder (OR=0.405; 95% CI:0.167- 0.982) regions. Conclusion: Anesthesiologists are at high risk for WRMDs. There is a need to improve ergonomic conditions of operative rooms according to demands of anesthesiologists and to educate them on proper posture for a longer and pain-free career.Keywords: Anesthesiologist; ergonomics; work-related musculoskeletal disorders; posture; survey.

Physiotherapy management of lumbar disc herniation with radiculopathy: A narrative review

Introduction: Lumbar disc herniation with radiculopathy (LDHR) has been one of the most difficult conditions to manage among low back disorders. Individuals with chronic or recurring lumbar radiculopathy experience difficulties returning to work due to poor lower limb neuromuscular control. Given the consequences of LDHR, there is the need for effective treatment approaches that will be helpful in the amelioration of the problem. Objectives: In this study the most recent physical therapy literature in the management of patients with LDHR was evaluated. Methods: A literature review was conducted from inception to January 2019 in the PubMed, PEDro, and OTseeker databases. Results: Fifteen studies relating to the physiotherapy managements of LDHR were identified and discussed. Out of these studies, 1 study was a cohort study and 14 studies were randomized controlled trials. 5 studies examined the effects of physical therapy modalities, 6 studes examined the effects of physical therapy/exercises and 4 studies examined the effects of spinal manipulation (SM) in the management of LDHR. Conclusion: The findings of this study concluded that extension-oriented treatment approach, SM and lumbar stabilization exercise in combination with low power laser therapy are better than any physiotherapy intervention in the management of LDHR.

Athletic training for prevention of low back disorders

Athletic training for prevention of low back disorders

Monitoring and Evaluation of Whole-Body Vibration Exposure of Equipment Operators and Assessment of Associated Health Risk in an Indian Underground Pb-Zn Mine

Exposure to whole-body vibration (1-80 Hz) manifest in higher incidences of low back pain and other musculoskeletal disorders among the workforce in mining industry. The aim of the study was to determine the vibration intensity of twelve mining equipments which are regularly deployed in an underground mine and to evaluate the long term health risk of their operators as per ISO 2631-1:1997 guidelines. It was observed that the low profile dump trucks (LPDT) and load haul dumpers (LHD) had x axis (front-back) as dominant axis of vibration. The operators of LPDTs and LHDs had moderate health risk considering frequency weighted root mean square (r.m.s.) acceleration values of vibration (0.46 – 1.01 m/s2) and corresponding daily exposure of about 6 hours in a shift. Operators of three equipments i.e. water sprinkler, utility vehicle and backfill material carrier had high health risk with z (vertical) as dominant axis of vibration. RMS acceleration values were comparatively high (1.30- 1.96 m/s2) even though their duration of exposure was less (2.5-5.0 hours). Motor grader operator had minimal health risk from vibration exposure while rest two operators of explosive and personnel carrier had moderate health risk. Additional assessment of health risk was carried out using total vibration dose values wherever applicable. High health risks were attributed to fast and harsh driving, poor seat condition and absence of independent seat suspension. Besides technical and operational modifications, training programs should be organised to improve the awareness of this hazard among miners in India.

Effects of triple-treatment trunk stretching on physical fitness and curvature of the spine

BackgroundResearch on the effectiveness of treatment for low back disorders has been made, however yet no established method has been found. Therefore, we devised a triple-treatment trunk stretching program comprising the following three trunk stretching exercises: stretching using an unstable flex chair; stretching using a stretching bench; and stretching using a stretch pad. Our three-treatment trunk stretching program is based on the principles of static muscular stabilization of the spine and uses well-known physiological strength-training principles. In this study, we investigated the effects of triple-treatment trunk stretching on physical fitness levels and curvature of the spine measured by X-ray photographs. MethodsThirteen healthy male subjects (mean age, 26.3 ± 4.0 years; height, 173.5 ± 4.9 cm; weight, 64.9 ± 5.7 kg; BMI 21.6 ± 1.7) were enrolled in this study. In consideration of safety and simplicity, we applied the physical fitness test introduced by the Ministry of Education, Culture, Sports, Science and Technology of Japan for 65- to 79-year-olds. ResultsTriple-treatment trunk stretching led to significant improvements in sit-and-reach flexibility, 10-m obstacle course walking time, standing forward flexion, thoracolumbar extension and horizontal flexion. Significant improvements were also observed in the neutral angle of the curvature of the lower thoracic spine and the neutral angle of the curvature of the lower lumbar spine. ConclusionsSignificant improvements were evident in the neutral angles of both the curvature of the lower thoracic spine and the curvature of the lower lumbar spine after triple-treatment trunk stretching. This suggests that triple-treatment trunk stretching can help improve the curvature of the spine and physical fitness.

Inter-Rater Reliability of Pain Provocation Tests for Painful Lumbar Facet Joints. A Pilot Study.

With a life-time prevalence of 39%, low back pain (LBP) is one of the most common musculoskeletal disorders. Correct diagnosis of underlying causes is commonly seen as a prerequisite for successful therapy of LBP. Currently, there is no useful, non-invasive clinical test to diagnose painful lumbar zygapophyseal joints. Clinical tests with high diagnostic accuracy are therefore desirable. Inter-rater reliability is commonly seen as a prerequisite of test validity. The objective of this pilot study was thus to evaluate inter-rater reliability of new clinical pain provocation tests for diagnosing painful lumbar zygapophyseal joints. If a clinically significant level of inter-rater reliability were to be determined, this study could constitute a first step towards establishing the clinical utility of this new set of tests in the structural diagnosis of low back disorders. Patients participating in this study were recruited in a specialist hospital throughout June 2015 until September 2016. Both female and male patients with current LBP, with or without buttock or lower extremity symptoms were screened for inclusion. Patients had preferably to be 50 years or older in order to be included in this study. The upper age limit was set at 90 years. They also had to be fluent in German to be able to follow verbal instructions. Exclusion criteria comprised the presence of red flags, surgical spinal fusion at any level of the lumbar spine, discectomy within the past 12 months, radiculopathy and/or radicular pain, interventional treatments for the IVD, SIJs or ZAJs within the past three months, psychiatric disorders, current litigation issues concerning back pain, and central nervous system diseases. Three certified manual therapy instructors tested patients independently. Fleiss' kappa values and percent agreements were calculated. Subjects included a sample of 48 patients (15 males and 33 females) with a mean age of 66.48 years (range 33 - 90) presenting at a specialist hospital with low back pain. The new pain provocation tests for lumbar zygapophyseal joints showed moderate reliability (Fleiss' κ = 0.46) and an overall percent agreement of 68.8%. Separate tests for the zygapophyseal joints of L5-S1 showed fair reliability (Fleiss' κ = 0.37) and an overall percent agreement of 64.6%. Unidimensional tests that were used in the study to exclude the intervertebral disc as a nociceptive generator showed fair reliability as well (average κ of 0.28 and 0.39, respectively). Neither drop outs nor adverse events occurred. The new pain provocation tests for lumbar zygapophyseal joints showed clinically significant levels of inter-rater reliability. Validation of these tests against fluoroscopy-guided medial branch blocks is warranted.

Ageing well with chronic musculoskeletal pain: protocol for a systematic review of non-pharmacological interventions aimed at reducing pain in an ageing population

Background: Chronic musculoskeletal pain in the elderly is highly prevalent, with osteoarthritis, low back pain, neck pain and other musculoskeletal disorders as the leading contributors to pain chronicity and disability. Previous reviews identifying effective components of non-pharmacological interventions for treating chronic pain have either few studies or the included studies examine outcome over a limited time span. This systematic review will investigate the effectiveness and components of interventions associated with management of chronic musculoskeletal pain in older adults (≥65 years).Methods/Design: This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidance. Randomised controlled trials of non-pharmacological interventions aimed at reducing pain in older adults with chronic musculoskeletal pain will be included. Articles will be identified through a comprehensive search of the following databases: Ovid MEDLINE, Embase, CINAHL, AMED, Scopus, Web of Science and PEDro. Two review authors will independently screen articles retrieved from the search for eligibility, and extract relevant data on methodological issues. A narrative synthesis will be completed if there are insufficient data for a meta-analysis. The narrative synthesis will summarise the current state of knowledge, interventions, study designs and robustness of evidence.Discussion: Findings of the study will inform support programs and interventions to assist people aging with pain, carers and other supporters and practitioners.Systematic review registration: PROSPERO 2017:CRD42017074173.

Individuals with sacroiliac joint dysfunction display asymmetrical gait and a depressed synergy between muscles providing sacroiliac joint force closure when walking

Walking is often compromised in individuals with low back and hip disorders, such as sacroiliac joint dysfunction (SIJD). The disorder involves reduced coactivation of the gluteus maximus and contralateral latissimus dorsi, which together provide joint stability during walking. The purpose of our study was to compare the kinematics and contributions of selected muscles to identified synergies during walking between healthy individuals and those with SIJD. Six women with unilateral SIJD and six age-matched healthy controls walked on a force-measuring treadmill at 1 m/s while we recorded kinematics and the activity of 16 muscles with surface EMG. Non-negative matrix factorization was used to identify patterns of EMG activity (muscle synergies). Individuals with SIJD exhibited less hip extension and lower peak vertical ground reaction forces on the affected side than the unaffected side. In contrast to controls, the SIJD group also displayed a depressed muscle synergy between gluteus maximus on the affected side and the contralateral latissimus dorsi. The results indicate that individuals with SIJD exhibited both reduced activation of gluteus maximus during a loading synergy present in walking and greater asymmetry between legs when walking compared with age-matched controls.

Trunk posture assessment during work tasks at a Canadian recycling center

Musculoskeletal disorders are common among waste workers but preventative effort is lagging behind. This exploratory study assessed trunk posture during waste sorting tasks via statistical and experimental means. Posture exposure exceeded levels previously shown and related to elevated risk of Low Back Disorders (LBD). Results show predisposition of waste workers to LBDs.

선원들의 요통발생 실태 및 위험요인에 관한연구

The purpose of this research is to provide basic date on the causes and factors related with the workload on boars for seafarer’s Low Back Pain. the results of study are as follows;BR 1. The incidence of occupational Low Back Pain for the recent 12 months has been recorded as 56.2% of the subject. 2. The higher occupational satisfaction has the lower incidence of Low Back Pain(p〈0.01). and the person who takes a rest(p〈0.05) and physical exercise regularly(p〈0.01) has lower experience of the incidence 3. The incidence of Low Back Pain by characteristics of vessel was turn out as 59.3% of the fishing vessel, 55.3% merchantship and 52.9% of the vessel of special purpose. The incidence of each department of a ship has recorded as 54.3% of deck dept. 59.2% of engine dept. but there was little relationship between those. and the longer period of work and on-board service has the hither incidence of the higher incidence(p〈0.01). 4. The fitness of the working table (p〈0.01) and chair(p〈0.01) has affected the incidence of Low Back Pain significantly 5. The higher incidence of Low Back Pain has been experienced in case of working in back posture, and lifting up or carrying a heavy load(p〈0.01) 6. The major cause of Low Back Pain was turned out as excessive workload(26.5%) and stress (18.5%) ; the stress(24.1%) and excessive overwork(22.4%) for Deck dept. and excessive workload(32.3%) and bad position(21.7%) for Engine dept(p〈0.01). This study shows that low back pain disorders are seafare’s important health problem. The factors in which the prevalence rate of low back pain decrease are to provide information on health and safety and stress, work condition , and workload etc.

Associations between Variants in BDNF/BDNFOS Gene and Lumbar Disc Herniation Risk among Han Chinese People

Lumbar disc herniation (LDH) is a low back pain disorder and associated with several single nucleotide polymorphisms (SNPs). However, the role of brain-derived neurotrophic factor (BDNF) and BDNFOS gene in LDH susceptibility remains unknown. To examine whether the variants contribute to LDH, 7 SNPs were genotyped in 380 patients and 692 healthy controls among Han Chinese population. Multiple genetic models, stratification by age/gender and haploview analysis was used by calculating odds ratio (OR) and 95% confidence intervals (CIs). Rs11030064 in BDNFOS gene was associated with modified susceptibility for LDH at age ≤50 years but three loci (rs6265, rs11030104 and rs10767664) of BDNF gene increased LDH risk at age >50 years. Further, rs11030096 polymorphism in BDNFOS gene was associated with LDH the increased susceptibility of LDH in females. Haplotype analysis shown that haplotype “GCC” in the block (rs988712, rs7481311, and rs11030064) increased LDH risk (OR = 1.49, 95% CI = 1.06–2.10, p = 0.022) at age ≤50 years. However, there was no significant association between BDNF/BDNFOS gene and LDH risk in the overall before stratified analysis. For the first time, our results provide evidence on polymorphism of BDNF / BDNFOS gene associated with LDH risk in Chinese Han population.

The effectiveness of interventions designed to increase the uptake of clinical practice guidelines and best practices among musculoskeletal professionals: a systematic review

BackgroundThe objective of this systematic review was to summarize and evaluate evidence about the effectiveness of knowledge translation (KT) interventions to improve the uptake and application of clinical practice guidelines and best practices for a wide range of musculoskeletal (MSK) disorders and health care professionals.MethodsA search for relevant randomized controlled trials (RCTs) published in English was conducted in MEDLINE (Ovid interface), EMBASE, CINAHL, and CENTRAL (Cochrane library). Two independent reviewers selected studies, assessed risk of bias, and extracted data. All MSK disorders were included except MSK injuries, fractures, trauma, or inflammatory disorders.ResultsA total of 7904 citations yielded 11 eligible RCTs. The targeted MSK disorders included: low back pain (n = 5), neck pain (n = 2), whiplash (1), spinal disorders (n = 1), and osteoarthritis of the hip and knee (n = 2). Studies primarily involved physiotherapists, chiropractors, and a mix of physiotherapists, chiropractors and osteopaths. Results were reported using effect sizes (Cohen’s d). Interactive educational meetings were the most commonly used KT strategy. For professional outcomes, 3 studies using single-component interventions had a small effect (d ranges from 0.14 to 0.28) and 7 studies used multifaceted interventions (3 were effective (d ranges from 0.824 to 2.27). For patient outcomes, 4 studies were ineffective (d ranges from 0.06 to 0.31). The majority of the included RCTs had moderate-to-high risk of bias. About half of the studies used theory-based interventions, but the elements of the interventions and theoretical frameworks were often poorly described. Furthermore, there were no comparable outcome measures to evaluate the impact of the interventions on a similar scale.ConclusionsThe findings suggested that multifaceted educational KT interventions appear to be effective for improving professional outcomes, although effects were inconsistent. The KT strategies were generally not effective on patient outcomes. In general, studies were of low quality, interventions were poorly described, and only half had theoretical underpinning. Researchers are encouraged to use validated professional and patient outcomes.

Development of a Multivariate Prognostic Model for Pain and Activity Limitation in People With Low Back Disorders Receiving Physiotherapy

ObjectiveTo identify predictors for back pain, leg pain, and activity limitation in patients with early persistent low back disorders (LBDs). DesignProspective inception cohort study. SettingPrimary care private physiotherapy clinics in Melbourne, Australia. ParticipantsIndividuals (N=300) aged 18-65 years with low back and/or referred leg pain of ≥6 weeks and ≤6 months duration. InterventionsNot applicable. Main Outcome MeasuresNumeric rating scales for back pain and leg pain as well as the Oswestry Disability Scale. ResultsPrognostic factors included sociodemographics, treatment related factors, subjective/physical examination, subgrouping factors, and standardized questionnaires. Univariate analysis followed by generalized estimating equations were used to develop a multivariate prognostic model for back pain, leg pain, and activity limitation. Fifty-eight prognostic factors progressed to the multivariate stage where 15 showed significant (P<.05) associations with at least 1 of the 3 outcomes. There were 5 indicators of positive outcome (2 types of LBD subgroups, paresthesia below waist, walking as an easing factor, and low transversus abdominis tone) and 10 indicators of negative outcome (both parents born overseas, deep leg symptoms, longer sick leave duration, high multifidus tone, clinically determined inflammation, higher back and leg pain severity, lower lifting capacity, lower work capacity, and higher pain drawing percentage coverage). The preliminary model identifying predictors of LBDs explained up to 37% of the variance in outcome. ConclusionsThis study evaluated a comprehensive range of prognostic factors reflective of both the biomedical and psychosocial domains of LBDs. The preliminary multivariate model requires further validation before being considered for clinical use.

Prevalence and Risk Factors of Work-Related Musculoskeletal Disorders among Nurses in Erbil Teaching Hospitals

Background and objective: The term musculoskeletal disorders includes a gamut of inflammatory and degenerative conditions that affect the muscles, tendons, ligaments, joints, peripheral nerves, and supporting blood vessels with consequent ache, pain or discomfort. The risk of musculoskeletal disorders is high among various healthcare professionals. This study investigated the prevalence of work-related musculoskeletal disorders and risk factors among nurses in Erbil teaching hospitals. Methods: This cross-sectional study was conducted in Erbil city teaching hospitals in the Kurdistan Region of Iraq. A total number of 256 nurses were selected as study samples through the use of non-probability convenience sampling method. The data were collected by a standardized questionnaire through the use of the interview (face to face) technique. Results: The previous 12-month prevalence of work-related musculoskeletal disorders among nurses was 67%. Lower back disorder was the most prevalent disorder compared to other body regions at 75% followed by 52% reported in one or both knees, and the lowest percentages (9%) reported in the upper back region. Conclusion: Work-related musculoskeletal disorders are high among nurses. There was an association between the prevalence of musculoskeletal disorders, genders, and training program on preventing work-related musculoskeletal disorders. It is recommended that training programmes on prevent work-related musculoskeletal disorders be implemented for all nurses.

Personalized method for self-management of trunk postural ergonomic hazards in construction rebar ironwork

Construction rebar workers face postural ergonomic hazards that can lead to work-related Lower Back Disorders (LBDs), primarily due to their prolonged awkward working postures required by the job. In a previous study, Wearable Inertial Measurement Units (WIMUs)-based Personal Protective Equipment (PPE) was developed to alert workers when their trunk inclination holding time exceeded acceptable thresholds as defined in ISO standard 11226:2000. However, subsequent field testing identified PPE was ineffective for some workers because the adopted ISO thresholds were not personalized and did not consider differences in individual’s response to postural ergonomic hazards. To address this problem, this paper introduces a worker-centric method to assist in the self-management of work-related ergonomic hazards, based on data-driven personalized healthcare intervention. Firstly, personalized information is gathered by providing each rebar ironworker a WIMU-based personalized mobile health (mHealth) system to capture their trunk inclination angle and holding time data. Then, the captured individual trunk inclination holding times are analyzed by a Gaussian-like probability density function, where abnormal holding time thresholds can be generated and updated in response to incoming trunk inclination records of an individual during work time. These abnormal holding time thresholds are then adapted to be used as personalized trunk inclination holding time recommendations for an individual worker to self-manage their working postures, based on their own trunk inclination records. The proposed worker-centric method to assist in the self-management of ergonomic postural hazards leading to LBDs was field tested on a construction site over a three-month duration. The results of the paired t-tests indicate that posture scores evaluated by the Ovako Working Posture Analysis System (OWAS) significantly decrease when the personalized recommendation is applied, while increase again when the personalized recommendation is removed. Based on data-driven personalized healthcare intervention, the results demonstrate the significant potential of the proposed worker-centric self-management method for rebar workers in preventing and controlling postural ergonomic hazards during construction rebar ironwork.

Effectiveness of extrinsic feedback for management of non-specific low back pain: a systematic review protocol

IntroductionLow back pain is the greatest cause of years lived with disability worldwide and is linked with high societal and economic burden. Neuromuscular control impairments are a common clinical presentation...

Identification of potential biomechanical risk factors for low back disorders during repetitive rebar lifting

PurposeWork-related low back disorders (LBDs) are prevalent among rebar workers although their causes remain uncertain. The purpose of this study is to examine the self-reported discomfort and spinal biomechanics (muscle activity and spinal kinematics) experienced by rebar workers.Design/methodology/approachIn all, 20 healthy male participants performed simulated repetitive rebar lifting tasks with three different lifting weights, using either a stoop (n = 10) or a squat (n = 10) lifting posture, until subjective fatigue was reached. During these tasks, trunk muscle activity and spinal kinematics were recorded using surface electromyography and motion sensors, respectively.FindingsA mixed-model, repeated measures analysis of variance revealed that an increase in lifting weight significantly increased lower back muscle activity at L3 level but decreased fatigue and time to fatigue (endurance time) (p < 0.05). Lifting postures had no significant effect on spinal biomechanics (p < 0.05). Test results revealed that lifting different weights causes disproportional loading upon muscles, which shortens the time to reach working endurance and increases the risk of developing LBDs among rebar workers.Research limitations/implicationsFuture research is required to: broaden the research scope to include other trades; investigate the effects of using assistive lifting devices to reduce manual handling risks posed; and develop automated human condition-based solutions to monitor trunk muscle activity and spinal kinematics.Originality/valueThis study fulfils an identified need to study laboratory-based simulated task conducted to investigate the risk of developing LBDs among rebar workers primarily caused by repetitive rebar lifting.

Using relative phase analyses and vector coding to quantify Pelvis-Thorax coordination during lifting—A methodological investigation

Low-back disorder risk can be modulated by pelvis-thorax coordination when lifting. To objectively discriminate between coordination patterns during lifting, the analytical methods used require evaluation. The primary study objective was to determine if continuous relative phase (CRP) and vector coding (VC) analyses can discriminate between lifting techniques that differ based on biomechanical risk criteria. The secondary objective was to determine if normalization/transformation of input segmental angular position and velocity data is required to discriminate between lifting techniques. Sixteen volunteers performed a sagittal lifting task using freestyle (FRE), flexed spine (FLX), and neutral spine (NTL) techniques. CRP and VC analyses were implemented to quantify pelvis-thorax coordination patterns based on time-normalized, phase-normalized, and Hilbert-transformed segmental angular kinematic data. Mean relative phase angles along with thorax-only and in-phase coupling patterns were significantly different between FRE-NTL and FLX-NTL techniques (p < 0.01), but not FRE-FLX (p > 0.44). This finding was consistent across all relative phase normalization/transformation methods. Therefore, CRP and VC analyses successfully discriminated between different lifting techniques, regardless of the relative phase normalization/transformation method used.

Risk factors associated with chronic low back pain: an analysis of Turkey health survey data

Background: Turkey, a developing country has low back disorders as the most common symptom among adults with 33% prevalence in 2014. The patient’s self reports are important to determine the condition as chronic low back pain (CLBP) is a symptom rather than the disease. However, there is a scarcity of knowledge about self-reported CLBP among adults from developing countries. Methods: A community-based cross-sectional population survey study conducted by face-to-face interviews. To identify socio-demographic factors, health, behavior, and comorbidities associated with (CLBP). 6729 adults (≥15 years) with self-reported CLBP and 12400 non-CLBP adults who participated 2014 Turkey Health Survey (THS) were included. Data on smoking, alcohol consumption, physical activity, healthy eating behavior, muscle strengthening activities, and kinesitherapist and psychotherapist visits were collected. Socio-demographic characteristics, comorbidities, and health of CLBP and non-CLBP adults were compared using logistic regression analysis. Results: Age, gender, marital status, occupational status and health insurance were associated with a higher likelihood to report CLBP (p&lt;0.001). The likelihood of diabetes and hypertension was higher in patients with CLBP (p&lt;0.001). Visiting a psychotherapist, smoking and healthy eating were associated with a higher likelihood of CLBP (p&lt;0.001) whereas, alcohol consumption, physical activity, muscle strengthening activities and visiting kinesiotherapist were associated with a lower likelihood of CLBP (p&lt;0.001). Conclusions: Reduced smoking and alcohol consumption, healthy eating, increased physical activity, kinesitherapy and psychotherapy can be employed to manage CLBP.

EVALUATION OF AGRICULTURAL TRACTOR SEAT COMFORT WITH A NEW PROTOCOL BASED ON PRESSURE DISTRIBUTION ASSESSMENT.

Professional drivers have been found to be at a high risk of developing low back pain due to prolonged sitting and vehicle vibration. In a previous survey carried out on 1,155 tractor drivers, tractor vibration and/or incorrect posture while driving were found to cause low back disorders in more than 80% of the interviewed drivers. In this context, the present research introduces a new evaluation protocol to assess the ergonomic characteristics of agricultural tractor seats through the use of pressure sensors, taking into account both static and dynamic conditions. The degree of comfort was defined by analyzing the pressure distribution exerted by a sample of 12 drivers sitting on two seats in five different operating conditions. The pressure distribution values thus obtained were compared with the corresponding pressures recorded with the 12 drivers sitting on a reference seat (rigid seat, backrest, and suspension) designed for the purpose. From the comparison, it was possible to define a comfort index (CI) that allowed an objective assessment of the two seats. Statistical analysis showed that the CIs of the two seats were significantly different in all five operating conditions. Moreover, the two seats showed different CIs as a function of the operating condition. Although less comfortable, one seat showed almost constant CI values in all five operating conditions. Conversely, the other seat showed a progressively decreasing CI from the static condition to the uneven ground condition.