Risk Of Musculoskeletal Disorders Research Articles

Simulation of passive exotendon assistive device for agricultural harvesting task

This study proposes and investigates the feasibility of the passive assistive device to assist agricultural harvesting task and reduce the Musculoskeletal Disorder (MSD) risk of harvesters using computational musculoskeletal modelling and simulations. Several passive assistive devices comprised of elastic exotendon, which acts in parallel with different back muscles (rectus abdominis, longissimus, and iliocostalis), were designed and modelled. These passive assistive devices were integrated individually into the musculoskeletal model to provide passive support for the harvesting task. The muscle activation, muscle force, and joint moment were computed with biomechanical simulations for unassisted and assisted motions. The simulation results demonstrated that passive assistive devices reduced muscle activation, muscle force, and joint moment, particularly when the devices were attached to the iliocostalis and rectus abdominis. It was also discovered that assisting the longissimus muscle can alleviate the workload by distributing a portion of it to the rectus abdominis. The findings in this study support the feasibility of adopting passive assistive devices to reduce the MSD risk of the harvesters during agricultural harvesting. These findings can provide valuable insights to the engineers and designers of physical assistive devices on which muscle(s) to assist during agricultural harvesting.

Development of a Platform to Assess the Risk of Musculoskeletal Disorders in Manual Load Handling Activities - Preliminary Results.

Risk identification on workstations is a crucial step to prevent the occurrence of musculoskeletal disorders (MSD) in workers. The available methods and tools used by ergonomists to assess and estimate the risk related to manual handling of loads under repetitive work cycles are usually biased by the inter-evaluator error that can lead to a subjective determination of work-related risks due to the application of, mainly, observational methods. This paper shows the preliminary results of a platform to assess the risk of musculoskeletal disorders during manual load-handling tasks using an instrumented system and using the National Institute for Occupational Safety & Health (NIOSH) method. Eight healthy subjects were measured during lifting activities using an optical-based and inertial-based motion capture systems. The developed software implements a semi-automated instrumented version of the NIOSH method, helping the evaluator with automated calculations of body segment locations, displacements and joint angles making it possible to obtain a objective risk classification. Also, we achieved a reduction of 85% in the time for the estimation of the necessary factors for the digital evaluation methodology, making the proposed platform a promising and attractive alternative for its application in real environments for risk assessments.Occupational health relevance- This work proposes an assistance tool for the detection of musculoskeletal disorders in activities related to manual handling of loads, essential to initiate modification strategies in the workplace, reduce the occurrence of occupational diseases and reduce the time of risk classification.

Correlations between Ratings and Technical Measurements in Hand-Intensive Work.

An accurate rating of hand activity and force is essential in risk assessment and for the effective prevention of work-related musculoskeletal disorders. However, it is unclear whether the subjective ratings of workers and observers correlate to corresponding objective technical measures of exposure. Fifty-nine workers were video recorded while performing a hand-intensive work task at their workplace. Self-ratings of hand activity level (HAL) and force (Borg CR10) using the Hand Activity Threshold Limit Value® were assessed. Four ergonomist observers, in two pairs, also rated the hand activity and force level for each worker from video recordings. Wrist angular velocity was measured using inertial movement units. Muscle activity in the forearm muscles flexor carpi radialis (FCR) and extensor carpi radialis (ECR) was measured with electromyography root mean square values (RMS) and normalized to maximal voluntary electrical activation (MVE). Kendall's tau-b correlations were statistically significant between self-rated hand activity and wrist angular velocity at the 10th, 50th, and 90th percentiles (0.26, 0.31, and 0.23) and for the ratings of observers (0.32, 0.41, and 0.34). Significant correlations for force measures were found only for observer-ratings in five of eight measures (FCR 50th percentile 0.29, time > 10%MVE 0.43, time > 30%MVE 0.44, time < 5% -0.47) and ECR (time > 30%MVE 0.26). The higher magnitude of correlation for observer-ratings suggests that they may be preferred to the self-ratings of workers. When possible, objective technical measures of wrist angular velocity and muscle activity should be preferred to subjective ratings when assessing risks of work-related musculoskeletal disorders.

Ergonomic risk assessment during massage among physiotherapists: Introduction of generic postures notion.

Musculoskeletal disorders are prevalent among physiotherapists. They perform many repetitive tasks in awkward postures that require a high muscle load. This issue was often addressed through subjective analysis (questionnaire) but rarely using postural evaluation combined with an ergonomic assessment. The aim of this article was to decompose draining lymphatic massage performed by physiotherapists in generic postures (GP) to quickly assess the musculoskeletal disorder risk. Based on numeric video recorded in frontal and sagittal planes, 3360 postures were defined from 20-minutes lymphatic drainage massage performed by 7 physiotherapists over a period of 6 months. A hierarchical cluster analysis was applied to define the GP. Seven GP were identified, which were described by their average joint angles, variability and relative frequency. GP6, GP4 and GP2 had the highest frequencies (17.6%, 16.9% and 16.8% respectively). Trunk and neck were essentially flexed (neck: 17.0±10.0° for GP1; trunk: 20.4±8.7° for GP4). Shoulder flexion and abduction ranged from 15° (GP7) to 60° (GP4). Mean and variability of RULA score completed the analysis. The highest scores were computed for GP2 and GP3 (respectively 5.5±1.3 and 5.8±1.2, p < 0.05). GP4 had the lowest (4.0±1.1, p < 0.05). The results suggest that massages have to be monitored. Attention should be paid to the postures used to prevent the occurrence of MSDs. The massages could be described as a combination of generic posture for a rapid ergonomic assessment.

Factors Associated with Work-related Musculoskeletal Disorders Risk among Bamboo Craftsman in Mojorejo Village, Ponorogo Indonesia

Introduction: Work-related Musculoskeletal disorders (WMSDs) becomes the one of most-occupational problem and highly related to the individual and work factors. Eighty percent (80%) workers in the woven bamboo industry in Mojorejo Village dominated by middle aged workers (&gt;40 years) that most of their producing activities are manually handled, without using machine or modern technology. Incompatibility work station, long working hours and repeated movement aggravated the WMSDs risk. This study aims to describe the WMSDs risk and determine its factors based on individual characteristics. Methods: There are 58 workers as respondents in this cross-sectional study. Data were collected and analyzed using quantitative method. Posture Exposure (PE) were measured using the QEC instrument. While the WMSDs risk were measured using PLIBEL. Individual factors (PE, Age, Working Period) related to WMSDs were analyzed using Multinomial Logistic Regression (95% CI). The Chi-square test were also used to compare PE rates among WMSDs risk levels. Results: Most respondents (48.3%) with 51-70% PE rate have a high level of WMSDs risk. While 27 % respondents with PE rate &gt;70% have a very high level. The neck is the region most exposed to the WMSDs (score 15.5/very high level risk). PE rate is the only factor that significantly related to WMSDs risk (sig. = 0.043; Rsquare = 0.529; r =0.703). While the age and working period has no significant correlation (Sig = 0.859 and 0.851 respectively). Conclusion: Based on the result, immediate improvement required to be implemented. It is suggested to redesigned work stations adjusted to the workers posture and position.

Combined Application of a Novel Robotic System and Exoscope for Microsurgical Anastomoses: Preclinical Performance

Abstract Background The concept of robotic microsurgery is becoming increasingly known as several robotic systems tailored to the specific needs of microsurgery are being introduced. Training with these devices is essential to draw conclusions about their potential clinical utility. This study describes the training and learning curve of experienced microsurgeons and complete novices using such a robotic surgical system in combination with an exoscope. Methods Four experienced microsurgeons and three complete novices performed a total of 62 manual and robot-assisted anastomoses. The time for anastomosis completion and surgeon's satisfaction with the anastomosis and with the robotic system were recorded. The anastomoses' quality was assessed using the Structured Assessment of Microsurgery Skills (SAMS) and the Anastomosis Lapse Index (ALI). The Rapid Entire Body Assessment (REBA) was used for ergonomics evaluation. Results All expert microsurgeons and novices improved their performance during training. The average anastomosis time decreased significantly, while satisfaction with the anastomosis and robotic system increased significantly over time. Multiple SAMS score parameters increased significantly throughout robotic but not manual training and the ALI score demonstrated more errors in the manual group. The REBA score displayed a significantly lower risk for musculoskeletal disorders in the robotic group. Conclusion Currently, the first clinical applications of robotic surgical systems specifically designed for microsurgery are being reported. The introduction of such systems into clinical practice can be expected to have a steep learning curve, as demonstrated in our study. Meanwhile, robotic systems for microsurgical procedures may hold great potential for improvement of surgical quality and ergonomics.

The Effect of Prolonged Sitting on Thoracic Spine Mobility among College Students

Background and aims: Sitting over a prolonged period not only creates physiological health problem and cardiovascular diseases, but also increases the risk of musculoskeletal disorders. The goal of this study is to determine whether there is a link between thoracic spine mobility and prolonged sitting, and the objectives are, to assess whether there is a connection between the length of time spent sitting and the mobility of the thoracic spine and examine the effect of extended sitting on the mobility of the thoracic spine. Methodology: The inclusion and exclusion criteria were checked on patients who were willing to participate in the study, they will provide an overview of the study before measuring thoracic mobility using methods such as the sitting rotation test (bar in front), in order to limit movement in participants lower extremities during thoracic rotation, a small ball was placed between their knees and a PVC bar with a tape marker at the halfway also used, which helps to fix the upper extremity. Using revised Oswestry to measure thoracic disability levels, the values were evaluated. Results: The statistical analysis showed that those who spend more time in sitting had limited thoracic rotation range of motion. Also, the questionnaire of thoracic pain showed pain and high disability index who spend more time in sitting and travelling. Conclusion: In people who spend more than 7 to 8 hours sitting, the study’s findings showed that their thoracic spine mobility was decreased. According to the questionnaire, people who spend a lot of time sitting and travelling during the course of a day as well as those who experience discomfort or restriction when performing ADLs had a high disability index for thoracic spine pain.

Ergonomics of Ophthalmic Surgery: Evaluating the Effect of a Posture Trainer on Trainee Intraoperative Back Posture.

Purpose Ophthalmic surgeons are at an increased risk for musculoskeletal disorders resulting from ophthalmology-specific routines and equipment, which have become widely associated with poor posture. The purpose of this study was to observe the effect that a commercially available posture trainer, Upright Go, can have on the improvement of posture of ophthalmic surgeons. Methods Eight ophthalmologists-in-training were studied over a period of 4 weeks during their surgical rotations between September 2020 and June 2021. Participants underwent an "observation" period, followed by a 2-week "training" period, then a final "testing" period. The percentage of time users spent upright intraoperatively pre- and posttraining was evaluated. Pre- and poststudy surveys were also administered to help measure participant satisfaction and self-reported changes in posture. Results All eight participants demonstrated an increase in the percentage of time spent upright after the training period. Across all participants, the total average percentage spent upright in the observation period was 59.8%, while in the testing period was 87.1%, resulting in an average improvement of 27.3% of time spent in an upright position after the completion of the training period ( p < 0.0001). The range of improvement of time spent upright was 16.0 to 46.5%. Conclusion This cohort study utilized the Upright Go device to help determine the effect that its training could have on the improvement of posture in ophthalmic surgeons. The results indicated a significant increase in the average proportion of time spent with upright posture compared after the training period.

Effect of Musculoskeletal Disorders on ADLs of Patients with Diabetes

Background: An increased prevalence of musculoskeletal disease is recognised in diabetes and is a common source of disability. It is known to predominantly affect the upper limbs especially the hand and shoulder. The relationship with other complications of diabetes and glycaemic control is uncertain. Physical disability is a useful measure of the overall effect of diabetes on health. Disability can be defined in several ways, including difficulties with activities of daily living (ADL), difficulties with instrumental activities of daily living (IADL), and mobility limitations. Therefore, in this study, the effect of musculoskeletal disorder on patients with diabetes was investigated. Objective: To evaluate the effect of musculoskeletal disorders on ADLs of patients with diabetes. Method: After getting the ethical approval from the institutional ethical committee, subjects were screened based on the inclusion and exclusion criteria. Subjects willing to participate in the study were enrolled and a written informed consent was obtained from all the participants. Demographics of the patients were noted in the data collection sheet. ADLs, IADLs and Nordic scale were taken on patients. Result: Mostly involved joint is shoulder joint and knee joint and due to this patient face difficulty in their ADLs like overhead activities (dressing and bathing) and toileting. Conclusion: The risk of musculoskeletal disorders is more in diabetic patients due to poor glycemic control and according to the involved joint they face difficulty in their activities of daily living.

Evaluating the Risk of Injury for Aircraft Attendants using Virtual Reality and Advanced Motion Tracking System Integrated with Ergonomics Analysis

Aircraft attendants are at a high risk of occupational injuries and illnesses, leading to substantial compensation costs and staff shortages in the aviation industry. To address this issue, this study introduces an innovative virtual reality technique and advanced motion tracking system integrated with ergonomics tools to effectively evaluate the risk of musculoskeletal disorders (MSDs) among aircraft attendants during their routine tasks. The study involved twenty-two participants who performed two common tasks: opening/closing the passenger door,and lifting luggage from the floor and placing it into the overhead compartment. The inappropriate postures were identified, which resulted in excessive strain on the participants’ lower back. By analyzing the impact of biomechanical variables, such as object weight, body height, and trunk motion, on the lower back, the study provides valuable insights that can inform the development of safety training programs and real-time monitoring approaches for injury prevention. Additionally, this innovative technology can be applied to other occupational fields.

Comparative study of the saddle chair with two other conventional types of chair on the risk of musculoskeletal disorders and perceived comfort in dentists

Introduction: dentists often have to adopt awkward, asymmetric, static postures and tilt their heads forward while working. If this situation continues for a long time every day, it leads to excessive pressure on the involved muscles and joints and causes symptoms such as pain and discomfort, especially in the neck, shoulders, back, and waist. Considering the importance of prevention, and early treatment of musculoskeletal disorders among dentists, this research investigates the effect of three types of chairs used in dentistry on the risk of musculoskeletal disorders and the comfort perceived by dentists using each chair.&#x0D; Materials and Methods: This is a descriptive cross-sectional study conveyed in Tehran, the capital city of Iran. The present study includes a survey of a group of 70 male dentists. In this study, three types of chairs were compared. To evaluate body comfort, Corlette, and Bishop’s local discomfort questionnaire was used. The RULA method was used to determine the risk of upper limb musculoskeletal disorders and to assess each dentist's body condition.&#x0D; Results: The highest level of comfort was reported in the saddle model chair (the difference in the average intensity of discomfort before and after the work shift in the whole body = 12.39), the third type chair (13.04), and the second type chair (18/76). The dentists' posture evaluation results showed that the final score of RULA in three types of chairs varies from a minimum of 3 to a maximum of 7.&#x0D; Conclusion: According to the results of the study, the average intensity of discomfort in the whole body after using the saddle chair compared to the state before using it has significantly decreased compared to the other two types of chairs, which implies the positive effect of using the saddle chair in reducing musculoskeletal discomfort. The results of posture evaluation indicate that the use of the saddle chair, compared to the other two chairs, improves the working conditions and facilitates the work.

Musculoskeletal Disorders Mapping among Workers of Community Health Center

Background: The second most common work-related disease has been identified as musculoskeletal disorders (MSDs). That affect muscles, tendons, ligaments, joints, peripheral nerves, and supporting structures are inflammatory and degenerative conditions. This study identified the job activity of community health centers with the risk of MSDs.&#x0D; Methods: The Nordic musculoskeletal questionnaire (NMQ) was identified as a non-professional way of determining MSDs risk with modifications from statistical investigation models. The study was conducted with fifty-seven respondents of workers at a community health center (CHC).&#x0D; Results: The majority of respondents were female (82%) and showed obesity categories I and II. The correlation between age and work experience is 0.9. A prevalence of MSDs at the hand and wrist of 49% was found.&#x0D; Conclusion: Workers at CHC experienced the mild category of MSDs in the hand and wrist regions. Age and work experience are risk factors for MSDs in CHCs.

Automated Classification of the Phases Relevant to Work-Related Musculoskeletal Injury Risks in Residential Roof Shingle Installation Operations Using Machine Learning

Awkward kneeling in sloped shingle installation operations exposes roofers to knee musculoskeletal disorder (MSD) risks. To address the varying levels of risk associated with different phases of shingle installation, this research investigated utilizing machine learning to automatically classify seven distinct phases in a typical shingle installation task. The classification process relied on analyzing knee kinematics data and roof slope information. Nine participants were recruited and performed simulated shingle installation tasks while kneeling on a sloped wooden platform. The knee kinematics data were collected using an optical motion capture system. Three supervised machine learning classification methods (i.e., k-nearest neighbors (KNNs), decision tree (DT), and random forest (RF)) were selected for evaluation. The KNN classifier provided the best performance for overall accuracy. The results substantiated the feasibility of applying machine learning in classifying shingle installation phases from workers’ knee joint rotation and roof slope angles, which may help facilitate method and tool development for automated knee MSD risk surveillance and assessment among roofers.

Field measurement of hand forces of palm oil harvesters and evaluating the risk of work-related musculoskeletal disorders (WMSDs) through biomechanical analysis

Hand force data is critical in evaluating work-related musculoskeletal disorders (WMSDs). Nevertheless, earlier studies on oil palm workers relied on estimated or laboratory measurements, which may not accurately reflect the actual hand forces. This study is the first report on the field measurement of hand forces for palm oil harvesters using a chisel and sickle to harvest low and tall palm trees, respectively. The dynamic hand forces and ground reaction forces were measured using instrumented harvesting tools and force plates, while wearable motion (IMU) and electromyography (EMG) sensors were incorporated for quantifying postural angles and muscle activations, respectively. Additionally, the spinal loadings, continuous Rapid Entire Body Assessment (REBA) scores, and subjective pain scores were determined to evaluate the risk of WMSDs. A total of 10 harvesters were recruited to perform the palm pruning tasks using a chisel and sickle. Resultantly, the sickle and chisel recorded a maximum cutting force of 1601.23 ± 424.26 N and 420.80 ± 96.00 N, respectively. All pruning tasks were found to be highly risky to harvesters, with a peak REBA score of 12. Likewise, all investigated muscles were activated for over 40% MVC, thus inducing moderate pain in the muscles. The peak L5-S1 compression forces for all tasks exceeded the safety threshold (>3400 N), but the values were not significantly different. The shear force of the L5-S1 was extreme in pruning with a sickle (1446.10 ± 411.00 N) compared to using a chisel. In conclusion, palm harvesters were at a high risk of developing WMSDs following poor postures, high physical exertion and muscle activity, and excessive spinal loads.

Development of a real‐time work‐related postural risk assessment system of farm workers using a sensor‐based artificial intelligence approach

AbstractIn recent years, the promotion of farm mechanization has been directed toward reducing the human discomfort and fatigue associated with various agricultural work‐related activities. During these activities, many factors (like force, awkward posture, vibration, repetition, etc.) play a significant role in causing musculoskeletal disorders. Second, ergonomic risk assessment of physical work is conventionally conducted through observation and direct/indirect physiological measurements. However, these methods are time‐consuming and require human subjects to perform the motion to obtain detailed body movement data. In the present study, a semiautomatic rapid entire body assessment (REBA) evaluation tool is developed for real‐time assessment of agricultural work‐related musculoskeletal disorders risk of farm workers using Kinect V2 sensor‐based artificial intelligence approach. It allows the investigator speedy detect of awkward postures leading to critical conditions and to reduce subjective bias. It is useful to analyze online as well as offline posture analysis, it detects the critical areas of the body posture, which may lead to the musculoskeletal disorders of agricultural workers, and suggest aptly to correct the posture. The Kinect V2 REBA assessment score was found with a factual significant match with the reference expert evaluation as reflected by the Landis and Koch scale k = 0.673 (p &lt; 0.001), 95% confidence interval (CI) for the left side, and k = 0.644 (p &lt; 0.001), 95% CI for the right side of the body respectively.

Evaluation of Musculoskeletal Disorders and Ergonomic Risk Factors Among Office Workers of Kashan University of Medical Sciences in Iran

Background: Ergonomic risk factors are among the critical risk factors for musculoskeletal disorders (MSDs) in office workers. Objectives: This study investigated the MSD prevalence and the ergonomic risk factors of staff workstations at Kashan University of Medical Sciences (KAUMS), Kashan, Iran. Methods: This cross-sectional study was conducted in 2021. The samples were the office workers of KAUMS who had more than one year of work experience and worked with computers for at least 3 hours a day on average. The samples were selected using the stratified sampling method, and finally, 132 employees participated in the study. The data were collected using the Cornell Musculoskeletal Discomfort Questionnaire and the rapid office strain assessment (ROSA) checklist. The data were analyzed using Wilcoxon, Mann-Whitney U, Kruskal-Wallis, Spearman’s correlation, and non-parametric regression tests by SPSS software (version 26). Results: The mean age of the participants was 40.16 ± 7.79 years, and 62.9% of the subjects were female. Female subjects complained significantly more about MSDs than male subjects (P &lt; 0.05). The most widely recognized MSDs were neck, lower back, and upper back pain. Disorders in the right-sided upper limb were essentially more frequent than in the left (P &lt; 0.05). All chairs, 62.1% of the monitors-telephones, and 90.9% of the mouses-keyboards in workstations were in a warning or dangerous condition. The scores of MSDs in the vertebral column, shoulder girdle, forearm, lower back, and lower limbs were fundamentally related to the ROSA score in the monitor section. Conclusions: The most widely recognized MSDs among office workers were neck, lower back, and upper back pain, respectively. Female employees had more MSDs. All workstations (100%) were in an unsafe position, and the MSDs of the vertebral column, shoulder girdle, forearm, lower back, and lower organ were related to the position of the monitors. Accordingly, corrective interventions, particularly the adjustment of monitor placement in office workstations, are fundamental.

Analysis of Working Postures in Rubber Manufacturing Industry by using OWAS and RULA Methods

The basic conditions of working in a healthy and safe workplace are to design the job in accordance with the anthropometric measurements, body strength and personal characteristics of the person, to ensure that the materials, machinery and equipment used in the working process are suitable for the employee's capacity, and to provide an environment that will produce positive psycho-social results. Correct analysis methods should be used and evaluated in order to meet this basic requirement. Identifying the negative effects of working postures, taking corrective measures and improving them is a critical step of an efficient working environment. Working postures that are not properly analyzed cause strain on workers and even discomfort. It provides important contributions in the field of analyzing and improving working postures with scientific methods, controlling work performance and reducing musculoskeletal disorders (MSDs). OWAS (Ovako Working Posture Analyzing System) and RULA (Rapid Upper Limb Assessment) are successfully applied in various fields in the analysis of working postures. In this study, it was aimed to determine the MSDs risk levels of the workers working in the rubber industry by OWAS and RULA methods and measures were proposed for these risks. While OWAS analysis was obtained by using expert opinions in the study, CATIAV5R20 program was used for RULA analysis. The study includes the examination of 5 different postures in total. In the OWAS and RULA results of the study, it was seen that the most risky postures are attach the rubber hose to the cores and to place the rubber hoses attached to the cores in the autoclave. The results of the analysis showed that the RULA method is more suitable and reliable than the OWAS method for the analysis of the tasks in the vulcanization process workstations.

Psychosocial hazards play a key role in differentiating MSD risk levels of workers in high-risk occupations

ObjectivesWorkplace management practices targeting risk of musculoskeletal disorders (MSDs) fail to reflect evidence that risk is affected by psychosocial as well as physical hazards. To promote improved practices in occupations where MSD risk is highest, better information is needed on how psychosocial hazards, combined with physical hazards, affect risk of workers in these occupations. MethodsSurvey ratings of physical and psychosocial hazards by 2329 Australian workers in occupations with high MSD risk were subjected to Principal Components Analysis. Latent Profile Analysis of hazard factor scores identified different combinations of hazards to which latent subgroups of workers were typically exposed. Survey ratings of frequency and severity of musculoskeletal discomfort or pain (MSP) generated a pre-validated MSP score and its relationship with subgroup membership was analysed. Demographic variables associated with group membership were investigated using regression modelling and descriptive statistics. ResultsAnalyses identified three physical and seven psychosocial hazard factors and three participant subgroups with differing hazard profiles. Profile group differences were greater for psychosocial than physical hazards, and MSP scores out of 60 ranged from 6.7 for the low hazard profile (29% of participants) to 17.5 for the high hazard profile (21%). Differences between occupations in hazard profiles were not large. ConclusionsBoth physical and psychosocial hazards affect MSD risk of workers in high-risk occupations. In workplaces such as this large Australian sample where risk management has focused on physical hazards, actions targeting psychosocial hazards may now be the most effective way to reduce risk further.

Cardiovascular Disease Risk Factors Predict the Development and Numbers of Common Musculoskeletal Disorders in a Prospective Cohort.

The aim of the study is to assess risk of common musculoskeletal disorders (MSDs) based on cardiovascular disease (CVD) risk scores. Data from a 9-year prospective cohort of 1224 workers in three states were analyzed. Baseline data included questionnaires, structured interviews, physical examinations, anthropometric measurements, nerve conduction studies, and individualized measurement of job physical factors. Monthly follow-ups were conducted. Framingham risk scores were calculated. A priori case definitions were constructed for carpal tunnel syndrome, lateral epicondylopathy, medial epicondylopathy, and rotator cuff tendinopathy. Adjusted RRs for one or more MSDs increased to 3.90 (95% confidence interval, 2.20-6.90) among those with 10-year cardiovascular disease risk scores greater than 15% and 17.4 (95% confidence interval, 3.85-78.62) among those with more than 4 disorders. Cardiovascular disease factors are strongly associated with the subsequent development of common MSDs. Risks among those with multiple MSDs are considerably stronger.

A single group trial (before - after) on impact of physiotherapeutic intervention package on relief from low back pain of pregnant women.

More than half of the women have low back pain (LBP) at some point during pregnancy; the intensity of back pain increases as the pregnancy progresses. Such changes increase their risk for musculoskeletal disorders and fall injuries. Our study's objective was to estimate the prevalence of LBP in antenatal and postnatal cases of pregnancy in PGIMER, Chandigarh and to ascertain impact of a training intervention on incidence and severity of LBP in the study subjects. A single group trial (before and after) on impact of physiotherapeutic intervention package on relief from LBP in pregnant women in between 20 and 35 years of age group were selected. The study duration was one year. The numeric pain rating scale was taken for measuring pain intensity at different levels. Where 0 indicates no pain, 1-3 indicates mild pain (which may be nagging, annoying, and interfering little with activities of daily livings (ADLs)), 4-6 indicates moderate pain (interferes significant with ADLs), and 7-10 indicates severe pain (Disabling, unable to perform ADLs). As per available time, it was decided to include at least 30 subjects in the study. Initially 45 patients were enrolled. Of those, 30 patients were suffering from backache, that is, 67% of the total and 33% did not have any backache. There were no backaches reported in the first trimester, five cases were in the second trimester, and 18 cases were in the third trimester. Of 30 patients, 11 were less than 25 years of age and remaining 19 patients were in the age group of 26-35 years.