Low Physical Demands Research Articles

Management of Rotator Cuff Injuries: Surgical Repair vs. Conservative Treatment

Rotator cuff injuries are a common cause of shoulder pain and dysfunction, resulting from acute trauma or degenerative changes. These injuries, including partial and full-thickness tears, can significantly impair daily activities and reduce quality of life. Treatment options range from conservative measures, such as physical therapy and NSAIDs, to surgical interventions like arthroscopic repair. The choice of treatment depends on factors such as tear size, patient age, and activity level. This review compares the effectiveness of conservative treatment and surgical repair for rotator cuff injuries, focusing on pain relief, functional recovery, and complication rates. Conservative treatment is typically the first-line approach for partial-thickness tears or patients with lower physical demands. Physical therapy and nonsteroidal anti-inflammatory drugs are common modalities that can improve symptoms, particularly for smaller tears. Corticosteroid injections are also used to provide short-term relief, although their long-term benefits are less clear. For larger or full-thickness tears, surgery is often necessary due to the risk of progressive degeneration and persistent symptoms. Arthroscopic repair is particularly beneficial for younger or more active patients, offering superior long-term outcomes in terms of strength and function. Studies indicate that while conservative treatment and surgery may offer similar short-term outcomes for smaller tears, surgery provides better long-term recovery for more extensive injuries. Ultimately, the decision between conservative and surgical treatment should be individualized, considering tear size, patient age, activity level, and overall health. Surgery is recommended for full-thickness tears or when conservative treatment fails to yield sufficient improvement, while conservative management remains effective for many smaller tears.

Effect of a smartphone self-management digital support system for low-back pain (selfBACK) among workers with high physical work demands - secondary analysis of a randomized controlled trial.

This study aimed to investigate whether physical work demands modify the effect of the selfBACK app, which is designed to support self-management of low-back pain. In a secondary analysis of the selfBACK trial with 346 employed participants, we stratified into low (N=165) and high physical work demands (N=181). Outcomes included the Roland-Morris Disability Questionnaire (0-24), a numeric rating scale for low-back pain intensity (0-10), the Pain Self-Efficacy Questionnaire (0-60), and work ability (0-10). Intervention effects were assessed at three- and nine-month follow-ups using a linear mixed model. At three months, high physical demand workers with selfBACK showed a significant reduction in pain intensity [-0.8, 95% confidence interval (CI) -1.3- -0.2] compared to usual care. By nine months, the high physical demands workers with selfBACK reported reduced pain-related disability (-1.4, 95% CI -2.7- -0.1), improved pain self-efficacy (3.5, 95% CI 0.9-6.0), and lower pain intensity (-1.0, 95% CI -1.6- -0.4) compared to usual care. Low physical demands workers with selfBACK also improved pain self-efficacy [2.8 (95% CI 0.3-5.3)] compared to usual care. The impact of selfBACK was more noticeable among workers with high physical demands compared to their low physical demand counterparts, but no statistically significant differences were found in any outcome. The selfBACK intervention had consistent effects across workers with high and low physical work demands, indicating that these demands did not modify its impact. Both groups experienced similar positive effects, highlighting the intervention's effectiveness across varying levels of physical work demands.

Identifying pain profiles in employees including work-related factors and pain perceptions: a cross-sectional study in Belgian companies

ObjectivesStudies usually investigate a limited number or a predefined combinations of risk factors for sickness absence in employees with pain. We examined frequently occurring combinations across a wide range of...

Prevalence of musculoskeletal pain and dysfunction in electrical utility workers: Practical considerations for prevention and rehabilitation in the workplace.

This study assessed the prevalence and associations of musculoskeletal pain and dysfunction in electrical utility workers, with the aim of applying the findings to better prevent and rehabilitate workplace musculoskeletal disorders. Employees completed an online survey recording their musculoskeletal symptoms across nine anatomical locations for the preceding 12 months. A total of 565 employees, working across eight different electrical utility organisational work units, completed the survey. The study was collaborative and conducted in Australia's largest, wholly government owned electricity company. The study originated from the participating organisation wanting to better understand their musculoskeletal disorder (MSD) risks. Employees who experienced high job stress were 4.06 times (95% confidence interval [CI] = 1.78-9.29) more likely to report musculoskeletal symptoms in the shoulder compared with employees with lower reported job stress. Employees that perceived their work to have high physical demands report lower back musculoskeletal symptoms at 2.64 times the rate of those perceiving their job to be of low physical demand (95% CI = 1.44-4.84). There were significant differences in the lower back musculoskeletal symptoms according to work unit membership. Understanding the prevalence of MSDs is critical to implementing practical prevention and rehabilitation strategies in the workplace. This anonymous survey highlighted that a large proportion of electrical utility workers reported that musculoskeletal symptoms had impacted their ability to perform their job, housework and/or hobbies in the preceding 12 months. Early access to rehabilitation services is essential. However, many workers report barriers to disclosing MSDs; therefore, workplace rehabilitation services may need to be broadened to account for these barriers.

Handwriting for Text Input and the Impact of XR Displays, Surface Alignments, and Sentence Complexities.

Text input is desirable across various eXtended Reality (XR) use cases and is particularly crucial for knowledge and office work. This article compares handwriting text input between Virtual Reality (VR) and Video See-Through Augmented Reality (VST AR), facilitated by physically aligned and mid-air surfaces when writing simple and complex sentences. In a $2\times 2\times 2$ experimental design, 72 participants performed two ten-minute handwriting sessions, each including ten simple and ten complex sentences representing text input in real-world scenarios. Our developed handwriting application supports different XR displays, surface alignments, and handwriting recognition based on digital ink. We evaluated usability, user experience, task load, text input performance, and handwriting style. Our results indicate high usability with a successful transfer of handwriting skills to the virtual domain. XR displays and surface alignments did not impact text input speed and error rate. However, sentence complexities did, with participants achieving higher input speeds and fewer errors for simple sentences (17.85 WPM, 0.51% MSD ER) than complex sentences (15.07 WPM, 1.74% MSD ER). Handwriting on physically aligned surfaces showed higher learnability and lower physical demand, making them more suitable for prolonged handwriting sessions. Handwriting on mid-air surfaces yielded higher novelty and stimulation ratings, which might diminish with more experience. Surface alignments and sentence complexities significantly affected handwriting style, leading to enlarged and more connected cursive writing in both mid-air and for simple sentences. The study also demonstrated the benefits of using XR controllers in a pen-like posture to mimic styluses and pressure-sensitive tips on physical surfaces for input detection. We additionally provide a phrase set of simple and complex sentences as a basis for future text input studies, which can be expanded and adapted.

Contrast-Enhanced Ultrasound-Assessed Supraspinatus Muscle Perfusion Indicates Better Tissue Vitality and Outcome After Supraspinatus Tendon Repair and Subacromial Decompression.

Supraspinatus tendon (SSP) tears are a frequent indication for shoulder surgery. Therapy options include physiotherapy, tendon repair and less invasive surgical options like subacromial decompression (SAD). The selection of the most appropriate treatment depends on the specific characteristics and needs of each patient subgroup. Typically, physically active patients are candidates for tendon repair, while a conservative approach is preferred for individuals with severe muscle degeneration or low physical demands. The goal of this study was to assess the impact of contrast-enhanced ultrasound (CEUS)-assessed SSP muscle perfusion on post-operative shoulder function and tendon healing in patients undergoing SSP repair or SAD, thereby enhancing personalized therapy for SSP tendon tears. Two cohorts of patients with SSP tendon tears were treated either by SAD or tendon repair. Pre-operative and 6-month post-operative SSP muscle perfusion was quantified using CEUS and investigated as a surrogate for tissue vitality. The magnetic resonance imaging-derived parameters fatty infiltration and tendon retraction and established shoulder function scores were assessed pre- and post-operatively. Thirty-five SSP repair patients were compared with 20 SAD patients. Pre-operative perfusion was comparable in the SAD and SSP repair cohorts when a re-tear occurred (wash-in perfusion index=103.8 ± 124.0 vs. 114.6 ± 155.0, p=0.83), while being significantly higher among patients with an intact repair (103.8 ± 124 vs. 325.4 ± 388.6, p=0.006). Below-median pre-operative muscle perfusion was associated with lower post-operative shoulder function (Constant score: 59 ± 28 vs. 78 ± 19, p=0.012). CEUS can visualize SSP muscle perfusion as a surrogate for tissue vitality and tendon healing, which is associated with better post-operative shoulder function.

Longitudinal profiles of occupational physical activity during late midlife and their association with functional limitations at old age: a multi-cohort study

ObjectiveThe aim was to examine longitudinal profiles of occupational physical activity (OPA) from midlife to retirement and to investigate how the different OPA-profiles are associated with mobility limitations (ML) and activities of daily living (ADL-disability) at old age.MethodsHarmonized data from two cohort studies from Finland and the United States, that have followed people from midlife until old age were used. Repeated measurements of self-reported OPA were collected during approximately 11- to 12-year period. Persons who had data on OPA from ≥ 2 time points during the period from mid-working life to retirement were included. Latent class growth analysis was used to identify OPA-profiles. Risk ratios (RRs) with 95% confidence intervals for the associations of the OPA-profiles and later life MLs and ADL-disability were estimated.ResultsThree OPA-profiles were identified in both cohorts: high-persistent, moderate-fluctuating, and low-persistent. For majority OPA remained stable: for workers reporting high or low levels of OPA at midlife, the physical demands of work likely persisted, whereas people reporting moderate level OPA had high fluctuation in their exposure level. Members of high-persistent and moderate-fluctuating OPA-profiles had increased risk of subsequent MLs at old age. The RRs for ADL-disability did not differ between the profiles.ConclusionsPerceived OPA remains rather stable for workers reporting high or low physical work demands during midlife, yet fluctuating profiles also exist. Workers exposed to high or moderate OPA have higher risk for MLs when they reach old age. Establishing safe and health-promoting levels of OPA during late working life might have positive long-term consequences on healthy ageing.

Musculoskeletal demands in microsurgery-an explorative study comparing the ergonomics of microscope and 3D exoscope.

To assess neurosurgeons' physical demands and investigate ergonomic aspects when using microsurgical visualization devices. Six neurosurgeons performed micro-surgical procedures on cadaveric specimens using the prototype of a digital 3D exoscope system (Aeos®, Aesculap, Tuttlingen, Germany) and a standard operating microscope (Pentero 900, Zeiss, Oberkochen, Germany) at two different patient positions (semisitting (SS), supine (SP)). The activities of the bilateral upper trapezius (UTM), anterior deltoid (ADM), and lumbar erector spinae (LEM) muscles were recorded using bipolar surface electromyography and neck flexion, arm abduction, and arm anteversion angles by gravimetrical posture sensors. Perceived discomfort frequency was assessed and subjects compared the two systems in terms of usability, posture, physical and mental demands, and working precision. Using the exoscope led to reduced ADM activity and increased UTM and LEM activity during SS position. The neck was extended when using the exoscope system with lower arm anteversion and abduction angles during the SS position. Subjects reported discomfort at the shoulder-neck area less frequently and lower physical demands when using the Aeos®. However, mental demands were slightly higher and two subjects reported lower working precision. The exoscope system has the potential to reduce the activity of the ADM by changing surgeons arm posture which may be accompanied by less discomfort in the shoulder-neck area. However, dependent on the applied patient position higher muscle activities could occur in the UTM and LEM.

A Quantitative Investigation of Mental Fatigue Elicited during Motor Imagery Practice: Selective Effects on Maximal Force Performance and Imagery Ability.

In the present study, we examined the development of mental fatigue during the kinesthetic motor imagery (MI) of isometric force contractions performed with the dominant upper limb. Participants (n = 24) underwent four blocks of 20 MI trials of isometric contractions at 20% of the maximal voluntary contraction threshold (20% MVCMI) and 20 MI trials of maximal isometric contractions (100% MVCMI). Mental fatigue was assessed after each block using a visual analogue scale (VAS). We assessed maximal isometric force before, during and after MI sessions. We also assessed MI ability from self-report ratings and skin conductance recordings. Results showed a logarithmic pattern of increase in mental fatigue over the course of MI, which was superior during 100% MVCMI. Unexpectedly, maximal force improved during 100% MVCMI between the 1st and 2nd evaluations but remained unchanged during 20% MVCMI. MI ease and vividness improved during 100% MVCMI, with a positive association between phasic skin conductance and VAS mental fatigue scores. Conversely, subjective measures revealed decreased MI ability during 20% MVCMI. Mental fatigue did not hamper the priming effects of MI on maximal force performance, nor MI's ability for tasks involving high physical demands. By contrast, mental fatigue impaired MI vividness and elicited boredom effects in the case of motor tasks with low physical demands.

Effectiveness of Planned Teaching Programme on Knowledge regarding Pulmonary Rehabilitation in Copd patients among Nursing Students in selected Nursing colleges

Background and Purpose of the study: Pulmonary rehabilitation for patients with COPD is well established and widely accepted as a means to alleviate symptoms and optimize functional status, increase participation, and reduce health care costs by stabilizing or reversing systemic manifestations of the disease. It is a form of rehabilitation dealing with respiratory disorders and limited participation in daily life. Pulmonary rehabilitation includes patient education, exercise training, psychosocial support and advice on nutrition. Pulmonary rehabilitation has been shown to improve exercise capacity, reduce breathlessness, improve health-related quality of life, and decrease healthcare utilization. Pulmonary rehabilitation should be offered to all patients who consider themselves functionally disabled by COPD4. Patients with chronic obstructive pulmonary disease (COPD) often decrease their physical activity because exercise can worsen dyspnea. The progressive deconditioning associated with inactivity initiates a vicious cycle, with dyspnea becoming problematic at ever lower physical demands. Pulmonary rehabilitation aims to break the cycle. Objectives: 1) To assess the level of knowledge regarding pulmonary rehabilitation in COPD patients among nursing students. 2) To find out the effectiveness of planned teaching programme regarding pulmonary rehabilitation in COPD patients among nursing students. 3) To find out the association between the pre-test knowledge regarding pulmonary rehabilitation in COPD patients with selected socio demographic variables. Approach: Evaluative approach was selected for the study. Design: Quasi-experimental (one group pretest and posttest) was selected for the study. Subjects: 50 nursing students. Sampling Technique: A purposive sampling technique was used to select the sample for study. Data Collection Tool: A structured questionnaire was used to collect data from the subjects. Data Analysis: The obtained data was analyzed using descriptive and inferential statistics and interpreted in terms of objectives and hypothesis of the study. The level of significance was set at 0.05 levels. Results: 88% of the nursing students obtained adequate level of information and 6% had a moderate level of knowledge. None of the staff nurses possessed inadequate level of knowledge Conclusion: In the pretest the subjects had an inadequate knowledge where as in the post test all the subjects had gained adequate knowledge. The study findings indicate that PPT was effective enhancing the knowledge of nursing students regarding pulmonary rehabilitation in COPD patients.

Changes in Community-Dwelling Elderly's Activity and Participation Affecting Depression during COVID-19 Pandemic: A Cross-Sectional Study.

We determined the changes in the activity or participation of the community-dwelling elderly in Japan during the COVID-19 pandemic and identified the activities leading to depression. This will allow us to evaluate rehabilitation interventions that can be used to minimize or eliminate the negative impact of COVID-19 on today's community-dwelling elderly. Herein, demographics, activity or participation (Activity Card Sort-Japan version: ACS-JPN), the number of social networks (Lubben Social Network Scale: LSNS), and depression (Geriatric Depression Scale: GDS) were examined in 74 community-dwelling elderly in Japan from August to October 2020. A statistical analysis was conducted to determine the effect of demographics on GDS, LSNS, and ACS-JPN, to compare the activity retention rates of the four domains using ACS-JPN, and to extract the activities that might affect depression using a generalized linear model. The results show that the retention of leisure activity with a high physical demand (H-leisure) and sociocultural activities was significantly lower than instrumental activities of daily living and leisure activity with a low physical demand (L-leisure). L-leisure and the number of social networks were possible risk factors for depression during the pandemic. This study highlighted the importance of maintaining the number of L-leisure and social networks at home to prevent depression in community-dwelling elderly when they could not perform outdoor activities and direct interpersonal interaction.

Intraoperative Ergonomic Assessment of Exoscopes versus Conventional DIEP Flap.

This study compared the ergonomics of surgeons during deep inferior epigastric perforator (DIEP) flap surgery using either baseline equipment (loupes, headlights, and an operating microscope) or an exoscope. Plastic surgeons may be at high risk of musculoskeletal problems. Recent studies indicate that adopting an exoscope may significantly improve surgeon postures and ergonomics. Postural exposures, using inertial measurement units at the neck, torso, and shoulders, were calculated in addition to the surgeons' subjective physical and cognitive workload. An ergonomic risk score on a scale of 1 (lowest) to 4 (highest) was calculated for each of the postures observed. Data from 23 bilateral DIEP flap surgeries (10 baseline and 13 exoscope) were collected. The neck and torso risk scores decreased significantly during abdominal flap harvest and chest dissection, while right shoulder risk scores increased during the abdominal flap harvest for exoscope DIEP flap procedures compared with. Exoscope anastomoses demonstrated higher neck, right shoulder, and left shoulder risk scores. The results from the survey for the "surgeon at abdomen" showed that the usage of exoscopes was associated with decreased performance and increased mental demand, temporal demand, and effort. However, the results from the "surgeon at chest" showed that the usage of exoscopes was associated with lower physical demand and fatigue, potentially due to differences in surgeon preference. Our study revealed some objective evidence for the ergonomic benefits of exoscope; however, this is dependent on the tasks the surgeon is performing. Additionally, personal preferences may be an important factor to be considered in the ergonomic evaluation of the exoscope.

Physical work demands and expected labor market affiliation (ELMA): Prospective cohort with register-follow-up among 46 169 employees.

This study aimed to estimate the impact of high physical work demands on expected labor market affiliation (ELMA) among men and women of different ages in the general working population. After participating in the Danish Work Environment and Health study (2012, 2014, and/or 2016), 46 169 employees were followed for two years in national registers. Using multi-state modeling, taking all day-to-day transition probabilities of labor market affiliation into account (work, unemployment, sickness absence, temporary out, and permanently out), and performing multilevel adjustment, we estimated the prospective association between physical work demands (ergonomic index including 7 factors) and ELMA. During 104 896 person-years of follow-up, we identified of 439 045 transitions. Using low physical work demands as reference, higher physical work demands were associated with fewer days of active work (2-35 days) during 730 days of follow-up, and more days of sickness absence (4-26 days) and unemployment (ranging 1-9 days) among men and women of aged 40-49 and 50-64 years. Among men and women aged 18-39 years, high physical work demands only had minor and inconsistent impact on ELMA. Analyzing multiple and highly detailed patterns of transition probabilities concerning labor market affiliation we showed that reducing physical work demands is likely to increase the active working time and prevent high societal cost of sickness absence and unemployment, especially among middle-aged and older workers.

Interaction between physical demands and job strain on musculoskeletal symptoms and work performance

This study investigated the interaction between physical demands and job strain on musculoskeletal symptoms in upper extremities (MSUE) and work performance. Two years of prospective data were analysed from 713 full-time workers from twelve manufacturing and healthcare facilities in Washington in the United States. Physical exposure was measured by the Strain Index and Threshold Limit Value for hand activity, giving rise to safe, action, and hazardous physical demand groups. Job strain was calculated as the ratio of psychological job demands to job control. Multilevel modelling analysis showed that job strain affected MSUE and limited work performance less in the high physical demand group than the safe group because the protective effect of job control was smaller in these groups. Findings may suggest that high physical demand jobs are structured such that workers have low job control or high physical demand groups experience job strain not adequately captured by psychosocial variables. Practitioner Summary: The effects of job strain and job control on musculoskeletal symptoms in upper extremities and work performance were smaller among workers with higher physical demands. This could imply that high physical demand jobs limit job control or psychosocial variables may not adequately capture job strain among high physical demand groups.

Pectoralis major and pectoralis minor transfer for irreparable subscapularis tendon tears.

Irreparable rotator cuff injuries in young patients with moderate to high levels of physical activity remain achallenging pathology for shoulder surgeons. Irreparable anterior rotator cuff injuries require treatment that seeks to restore the dynamic anterior forces of the glenohumeral joint. Among surgical treatment options, transfer of the pectoralis major and minor muscle, have shown good functional outcomes. This technique attempts to reproduce the vector of the subscapular muscle in cases with irreparable tear. Restoration of the dynamic external and internal couple forces to maintain the humeral head in the center of rotation. Pectoralis major transfer (PMa): Irreparable subscapularis tendon (SSC) tear in active patients without osteoarthritis. Pectoralis minor transfer (PMi): Irreparable superior SSC tear with concomitant irreparable supraspinatus tendon (SSP) tear in active patients with no osteoarthritis. Primary osteoarthritis Samilson gradeC, cuff tear arthropathy HamadaIII-V, infection, axillary nerve palsy, older patients with low physical demand, combination with irreparable SSP/infraspinatus tendon (ISP) tear for PMa or combination with irreparable ISP tear for PMi. General anesthesia and beach-chair position with the arm freely mobile in an arm holder. Deltopectoral approach. Exposure of the humeral head and confirmation of the irreparability of the subscapularis tendon. PMa: Detachment of the tendon to be transferred from the humeral insertion, blunt anatomic dissection medially. Exposure of the conjoined tendon and coracoid process. PMi: Detachment of the tendon with an osteotomy at the coracoid process. Passing the PMa or PMi tendon under the conjoined tendon. The PMa tendon is fixed in a2-row configuration, the PMi in asingle row with suture anchors to the lesser tuberosity. Shoulder abduction sling(30°) for 6weeks. Assisted range-of-motion (ROM) exercises with abduction/adduction 60-0-0°, internal/external rotation free-0-0° for 6weeks. Free active ROM exercises after 6weeks, muscle strengthening after 12weeks. The pectoralis major and minor transfer shows an improvement in strength and range of motion in young active patients and an improved Constant score (CS) in long-term follow-up examinations.

Hemiarthroplasty vs. tripolar total hip arthroplasty in the treatment of displaced femoral neck fractures in old-age patients

Background Displaced femoral neck fractures (DFNFs) are increasingly common in elderly patients. Hip arthroplasty, the recommended treatment of DFNF, consists of the total hip arthroplasty (THA) and hemiarthroplasty (HA). THA is superior to HA in younger patients. However, there are concerns whether the more substantial surgical trauma and higher dislocation rate would trade off the advantages of THA due to frailty and lower physical demands in the elderly over 75 years. Objective This study was designed to compare the clinical score, dislocation rate, and functional outcome between the dual mobility total hip replacement and the bipolar hemiarthroplasty (BHA) in the treatment of FNFs and which of them is more successful. Patients and methods A comparative randomized prospective study was conducted on 50 patients with DFNFs. All cases were operated upon in Helwan University Hospitals, divided them into two equal groups: the first group was treated by total hip replacement with a dual mobility cup (DMC) and the second group was treated by BHA. Full analysis of history detailed examination and primarily samples are taken during the period study from February 2020 to April 2021. Results There is a statistically significant improvement in modified Harris hip score (MHHS) in the last follow-up at 9 months later in favor to DMC group compared with BHA group (P<0.001). The postoperative MHHS in the last follow-up of DMC ranged from 68 to 92 with the mean of 85.96±5.47, whereas in BHA group, ranged from 60 to 89 with the mean of 78.04±8.40. Conclusion THA may be a preferred management option for active elderly patients over 75 years, which can provide superior hip function and life quality with acceptable risks. Strict management should be followed to prevent dislocation after a THA, especially within the first 6 months.

A Dynamic Wheelchair Armrest for Promoting Arm Exercise and Mobility After Stroke.

Arm movement recovery after stroke can improve with sufficient exercise. However, rehabilitation therapy sessions are typically not enough. To address the need for effective methods of increasing arm exercise outside therapy sessions we developed a novel armrest, called Boost. It easily attaches to a standard manual wheelchair just like a conventional armrest and enables users to exercise their arm in a linear forward-back motion. This paper provides a detailed design description of Boost, the biomechanical analysis method to evaluate the joint torques required to operate it, and the results of pilot testing with five stroke patients. Biomechanics results show the required shoulder flexion and elbow extension torques range from −25% to +36% of the torques required to propel a standard pushrim wheelchair, depending on the direction of applied force. In pilot testing, all five participants were able to exercise the arm with Boost in stationary mode (with lower physical demand). Three achieved overground ambulation (with higher physical demand) exceeding 2 m/s after 2–5 practice trials; two of these could not propel their wheelchair with the pushrim. This simple to use, dynamic armrest provides people with hemiparesis a way to access repetitive arm exercise outside of therapy sessions, independently right in their wheelchair. Significantly, Boost removes the requirements to reach, grip, and release the pushrim to propel a wheelchair, an action many individuals with stroke cannot complete.

Increasing prevalence of chronic non-cancer pain in Denmark from 2000 to 2017: A population-based survey.

This investigation comprised information from the Danish population to analyse the development of chronic non-cancer pain (CNCP) prevalence according to sex, age, physical job demand and educational level. Data derives from the Danish Health and Morbidity Surveys based on random samples of adults living in Denmark. The analysed samples were composed by 10,457 in 2000 (response rate: 62.7%), 5686 in 2005 (52.1%), 15,165 in 2010 (60.1%), 14,265 in 2013 (57.1%) and 14,022 in 2017 (56.1%). CNCP was defined as pain lasting 6months or more. Individuals with a self-reported history of cancer were excluded. Calibration weighting was applied to reduce the impact of potential non-response bias. The Relative and the Absolute Concentration Index were calculated to measure educational inequalities. CNCP prevalence has increased 8.3 percentage points during 2000-2017 (19.5%-27.8%) and is highest among women (22.1% to 30.8%). Higher CNCP prevalence among men aged 45-64years exceeded the men aged >65years in 2017 (31.9% and 29.8%, respectively). There was a continuous increase in CNCP prevalence in individuals with sedentary work or low physical demand at job from 2000 to 2017; among those with moderate or high physical demand at job the prevalence increased sharply from 2000 to 2010 after which the prevalence remained stable. Higher CNCP prevalence persisted among individuals with lower level of education regardless of gender and the inequalities remained stable over time. The Danish prevalence of chronic pain has increased in the last two decades and higher numbers are observed in some sociodemographic groups. This study provides an overview of the development of chronic non-cancer pain in a country and analyses the trends with socioeconomic inequalities. The continuous increasing prevalence may have huge social and economic implications. This study reveals an urgent need for measures to attenuate the increasing prevalence, which should be a priority for public health policy.

Assessment of Task Demand and Usability of a Virtual Reality-Based Rehabilitation Protocol for Combat Related Traumatic Brain Injury From the Perspective of Veterans Affairs Healthcare Providers: A Pilot Study

The risk of traumatic brain injury (TBI) is significantly higher among Veterans compared to non- Veterans. Access to treatment for TBI and post concussive symptoms is sometimes difficult, because of barriers related to distance, finances, and public safety (i.e., COVID-19 infection). Virtual reality rehabilitation (VRR) offers an opportunity to incorporate a virtual space into a rehabilitation environment. To our knowledge, VRR has not been used to assist Veterans with TBI and related health problems with Instrumental Activities of Daily Living (iADLs). The purpose of this study is to investigate the usability of a novel VRR ADL and iADL training protocols, developed by the Gaming Research Integration for Learning Laboratory (GRILL®) at the Air Force Research Laboratory, for cognitive rehabilitation for Veterans with a TBI. We deployed a prototype protocol among healthcare providers (n = 20) to obtain feedback on usability, task demand, and recommended adjustments. Our preliminary analysis shows that providers found the VRR protocol involved low physical demand and would likely recommend it to their patients. Although they had some concerns with vertigo-like symptoms from using a digital technology, they believed the protocol would improve iADL functioning and was a good addition to pre-existing rehabilitation protocols. These outcomes provide justification for more impactful studies investigating the effectiveness of this protocol among Veterans with TBI.

The physical activity paradox: a longitudinal study of the implications for burnout

PurposeThis study investigates the independent and interactive associations of physical job demands and three types of off-job physical activity (during transportation, household, and recreation) with burnout. We use a recently proposed new conceptualization and assessment of burnout including core and secondary burnout symptoms. We predicted that physical job demands would be positively and the three types of off-job physical activity would be negatively related to burnout. Further, we hypothesized that the negative relations between the three types of off-job physical activity and burnout would be stronger for employees with low (vs. high) physical job demands.MethodsTo test our hypotheses, we conducted a two-wave survey study among a heterogeneous sample of full-time workers (N = 355), using a longitudinal design with a half-year time lag. We tested cross-sectional, prospective and longitudinal relations.ResultsHierarchical regression analyses partly confirmed our predictions. Cross-sectionally and prospectively, it was shown that physical job demands were positively related to burnout symptoms. In addition, off-job physical activity was negatively related to primary and secondary burnout symptoms among employees with low physical job demands and positively related to burnout symptoms among employees with high physical job demands. However, these relationships disappeared when investigated longitudinally.ConclusionTogether, these findings suggest that not all off-job physical activities can prevent burnout, and that potential positive effects of physical activity during off-job time may depend on employees’ physical activity level at work.