Musculoskeletal Health Outcomes Research Articles

Use of a factor analysis to assess biomechanical factors of American Sign Language in native and non-native signers

Prior studies suggest that native (born to at least one deaf or signing parent) and non-native signers have different musculoskeletal health outcomes from signing, but the individual and combined biomechanical factors driving these differences are not fully understood. Such group differences in signing may be explained by the five biomechanical factors of American Sign Language that have been previously identified: ballistic signing, hand and wrist deviations, work envelope, muscle tension, and “micro” rests. Prior work used motion capture and surface electromyography to collect joint kinematics and muscle activations, respectively, from ten native and thirteen non-native signers as they signed for 7.5 min. Each factor was individually compared between groups. A factor analysis was used to determine the relative contributions of each biomechanical factor between signing groups. No significant differences were found between groups for ballistic signing, hand and wrist deviations, work envelope volume, excursions from recommended work envelope, muscle tension, or “micro” rests. Factor analysis revealed that “micro” rests had the strongest contribution for both groups, while hand and wrist deviations had the weakest contribution. Muscle tension and work envelope had stronger contributions for native compared to non-native signers, while ballistic signing had a stronger contribution for non-native compared to native signers. Using a factor analysis enabled discernment of relative contributions of biomechanical variables across native and non-native signers that could not be detected through isolated analysis of individual measures. Differences in the contributions of these factors may help explain the differences in signing across native and non-native signers.

Multi-stakeholder perspectives regarding preferred modalities for mental health intervention delivered in the orthopedic clinic: a qualitative analysis

BackgroundAlthough depressive and anxious symptoms negatively impact musculoskeletal health and orthopedic outcomes, a gap remains in identifying modalities through which mental health intervention can realistically be delivered during orthopedic care. The purpose of this study was to understand orthopedic stakeholders’ perceptions regarding the feasibility, acceptability, and usability of digital, printed, and in-person intervention modalities to address mental health as part of orthopedic care.MethodsThis single-center, qualitative study was conducted within a tertiary care orthopedic department. Semi-structured interviews were conducted between January and May 2022. Two stakeholder groups were interviewed using a purposive sampling approach until thematic saturation was reached. The first group included adult orthopedic patients who presented for management of ≥ 3 months of neck or back pain. The second group included early, mid, and late career orthopedic clinicians and support staff members. Stakeholders’ interview responses were analyzed using deductive and inductive coding approaches followed by thematic analysis. Patients also performed usability testing of one digital and one printed mental health intervention.ResultsPatients included 30 adults out of 85 approached (mean (SD) age 59 [14] years, 21 (70%) women, 12 (40%) non-White). Clinical team stakeholders included 22 orthopedic clinicians and support staff members out of 25 approached (11 (50%) women, 6 (27%) non-White). Clinical team members perceived a digital mental health intervention to be feasible and scalable to implement, and many patients appreciated that the digital modality offered privacy, immediate access to resources, and the ability to engage during non-business hours. However, stakeholders also expressed that a printed mental health resource is still necessary to meet the needs of patients who prefer and/or can only engage with tangible, rather than digital, mental health resources. Many clinical team members expressed skepticism regarding the current feasibility of scalably incorporating in-person support from a mental health specialist into orthopedic care.ConclusionsAlthough digital intervention offers implementation-related advantages over printed and in-person mental health interventions, a subset of often underserved patients will not currently be reached using exclusively digital intervention. Future research should work to identify combinations of effective mental health interventions that provide equitable access for orthopedic patients.Trial registrationNot applicable.

Sex and Gender Differences in Pediatric Knee Injuries.

The participation of females in sports has increased significantly since the passage of Title IX. Sports participation may place young athletes at risk for knee injuries, including patellofemoral pain syndrome (PFPS), osteochondritis dissecans (OCD), and anterior cruciate ligament (ACL) rupture. Differences in anatomy, hormone production, and neuromuscular patterns between female and male athletes can contribute to disparities in knee injury rates with female athletes more vulnerable to PFPS and ACL injury. Biological differences between sexes alone cannot fully explain worldwide differences in musculoskeletal health outcomes. Social, cultural and societal attitudes toward gender and the participation of girls and women in sports may result in a lack of accessible training for both injury prevention and performance optimization; one must recognize the effects of gender disparities on injury risk. More nuanced approaches to assess the complex interplay among biological, physiologic, and social influences are needed to inform best practices for intervention and sports injury prevention.

Investigating the Efficacy of an 18-Week Postpartum Rehabilitation and Physical Development Intervention on Occupational Physical Performance and Musculoskeletal Health in UK Servicewomen: Protocol for an Independent Group Study Design.

BackgroundPostpartum women are at an increased risk of pelvic floor dysfunction, musculoskeletal injury, and poor psychological health and have reduced physical fitness compared to before pregnancy. There is no formal, evidence-based rehabilitation and physical development program for returning UK servicewomen to work following childbirth.ObjectiveThis study aims to examine the efficacy of a rehabilitation and physical development intervention for returning postpartum UK servicewomen to occupational fitness.MethodsEligible servicewomen will be assigned to a training or control group in a nonrandomized controlled trial 6 weeks after childbirth. Group allocation will be based on the location of standard pregnancy and postpartum care. The control group will receive standard care, with no prescribed intervention. The training group will start an 18-week core and pelvic health rehabilitation program 6 weeks post partum and a 12-week resistance and high-intensity interval training program 12 weeks post partum. All participants will attend 4 testing sessions at 6, 12, 18, and 24 weeks post partum for the assessment of occupational physical performance, pelvic health, psychological well-being, quality of life, and musculoskeletal health outcomes. Occupational physical performance tests will include vertical jump, mid-thigh pull, seated medicine ball throw, and a timed 2-km run. Pelvic health tests will include the Pelvic Organ Prolapse Quantification system, the PERFECT (power, endurance, repetitions, fast, every contraction timed) scheme for pelvic floor strength, musculoskeletal physiotherapy assessment, the Pelvic Floor Distress Inventory–20 questionnaire, and the International Consultation on Incontinence Questionnaire–Vaginal Symptoms. Psychological well-being and quality of life tests will include the World Health Organization Quality of Life questionnaire and the Edinburgh Postnatal Depression Scale. Musculoskeletal health outcomes will include body composition; whole-body areal bone mineral density; tibial volumetric bone mineral density, geometry, and microarchitecture; patella tendon properties; muscle architecture; muscle protein and collagen turnover; and muscle mass and muscle breakdown. Data will be analyzed using linear mixed-effects models, with participants included as random effects, and group and time as fixed effects to assess within- and between-group differences over time.ResultsThis study received ethical approval in April 2019 and recruitment started in July 2019. The study was paused in March 2020 owing to the COVID-19 pandemic. Recruitment restarted in May 2021. The results are expected in September 2022.ConclusionsThis study will inform the best practice for the safe and optimal return of postpartum servicewomen to physically and mentally demanding jobs.Trial RegistrationClinicalTrials.gov NCT04332757; https://clinicaltrials.gov/ct2/show/NCT04332757International Registered Report Identifier (IRRID)DERR1-10.2196/32315

Associations among Musculoskeletal Fitness Assessments and Health Outcomes: The Lisbon Study for the Development and Evaluation of Musculoskeletal Fitness Standards in Youth

ABSTRACT This study summarized protocols in the Lisbon Study for the Development and Evaluation of Musculoskeletal Fitness Standards in Youth and assessed associations between fitness assessments and health outcomes. The sample was 529 children and adolescents (10 to 18 yr). The fitness assessments included handgrip, vertical jump, long jump, plank, and lower body power. The health outcomes were total body and hip bone mineral content, hip bone mineral density, and total body lean tissue mass. Correlation analyses examined associations unadjusted and adjusted for size and maturity. After adjustment, in females, vertical jump, long jump, and lower body power were associated with all health outcomes (r = 0.22 to 0.55, p < .05). In males, all fitness assessments were associated with all health outcomes (r = 0.17 to 0.64, p < .05). Musculoskeletal fitness assessments including non-invasive and easy-to-measure field assessments are associated with important muscle and bone health outcomes in youth.

Understanding the role of smoking and chronic excess alcohol consumption on reduced caloric intake and the development of sarcopenia.

This narrative review provides mechanistic insight into the biological link between smoking and/or chronic excess alcohol consumption, and increased risk of developing sarcopenia. Although the combination of excessive alcohol consumption and smoking is often associated with ectopic adipose deposition, this review is focused on the context of a reduced caloric intake (leading to energy deficit) that also may ensue due to either lifestyle habit. Smoking is a primary cause of periodontitis and chronic obstructive pulmonary disease that both induce swallowing difficulties, inhibit taste and mastication, and are associated with increased risk of muscle atrophy and mitochondrial dysfunction. Smoking may contribute to physical inactivity, energy deficit via reduced caloric intake, and increased systemic inflammation, all of which are factors known to suppress muscle protein synthesis rates. Moreover, chronic excess alcohol consumption may result in gut microbiota dysbiosis and autophagy-induced hyperammonemia, initiating the up-regulation of muscle protein breakdown and down-regulation of muscle protein synthesis via activation of myostatin, AMPK and REDD1, and deactivation of IGF-1. Future research is warranted to explore the link between oral healthcare management and personalised nutrition counselling in light of potential detrimental consequences of chronic smoking on musculoskeletal health outcomes in older adults. Experimental studies should investigate the impact of smoking and chronic excess alcohol consumption on the gut-brain axis, and explore biomarkers of smoking-induced oral disease progression. The implementation of behavioural change interventions and health policies regarding smoking and alcohol intake habits may mitigate the clinical and financial burden of sarcopenia on the healthcare system.

Investigating musculoskeletal health and wellbeing; a cohort study protocol

BackgroundIn an ageing population, pain, frailty and disability frequently coexist across a wide range of musculoskeletal diagnoses, but their associations remain incompletely understood. The Investigating Musculoskeletal Health and Wellbeing (IMH&W) study aims to measure and characterise the development and progression of pain, frailty and disability, and to identify discrete subgroups and their associations. The survey will form a longitudinal context for nested research, permitting targeted recruitment of participants for qualitative, observational and interventional studies; helping to understand recruitment bias in clinical studies; and providing a source cohort for cohort randomised controlled trials.MethodsIMH&W will comprise a prospective cohort of 10,000 adults recruited through primary and secondary care, and through non-clinical settings. Data collection will be at baseline, and then through annual follow-ups for 4 years. Questionnaires will address demographic characteristics, pain severity (0–10 Numerical Rating Scale), pain distribution (reported on a body Manikin), pain quality (McGill Pain Questionnaire), central aspects of pain (CAP-Knee), frailty and disability (based on Fried criteria and the FRAIL questionnaire), and fracture risk. Baseline characteristics, progression and associations of frailty, pain and disability will be determined. Discrete subgroups and trajectories will be sought by latent class analysis. Recruitment bias will be explored by comparing participants in nested studies with the eligible IMH&W population.DiscussionIMH&W will elucidate associations and progression of pain, frailty and disability. It will enable identification of people at risk of poor musculoskeletal health and wellbeing outcomes who might be suitable for specific interventions, and facilitate generalisation and comparison of research outcomes between target populations. The study will benefit from a large sample size and will recruit from diverse regions across the UK. Purposive recruitment will enrich the cohort with people with MSK problems with high representation of elderly and unwell people.Trial registrationClinicaltrials.gov NCT03696134. Date of Registration: 04 October 2018.

Life satisfaction and musculoskeletal complaints in a population seeking osteopathy care: consecutive sample of 611 patients

BackgroundLife satisfaction is a component of the subjective well-being construct. Research consistently suggests that life satisfaction is associated with enhanced social benefits and improved health outcomes. However, its relationship to musculoskeletal health outcomes is underexplored. This study evaluates the life satisfaction of a patient population presenting with musculoskeletal complaints, and the relationship of life satisfaction with other health demographics and behaviours.MethodThe study used a consecutive sampling design. Patients attending the Victoria University Osteopathy Clinic (Melbourne, Australia) were invited to complete the PROMIS® General Life Satisfaction scale (GLSS) along with questions related to health demographics and behaviours.ResultsThe GLSS T-score was not significantly different for gender, being born outside of Australia, speaking English at home, or complaint chronicity.ConclusionsLife satisfaction did not appear to be related to a range of health and demographic variables in the current musculoskeletal pain cohort. The PROMIS® General Life Satisfaction scale could prove useful to explore the relationship between life satisfaction and treatment outcomes for musculoskeletal complaints.

Biomechanical factors during common agricultural activities: Results of on-farm exposure assessments using direct measurement methods

Agricultural work is associated with increased risk of adverse musculoskeletal health outcomes. The purpose of this study was to quantify exposure to biomechanical factors among a sample (n = 55) of farmers in the Midwest region of the U.S. while they performed a variety of routine agricultural activities, and to compare exposure levels between these activities. Surface electromyography was used to estimate activity levels of the erector spinae, upper trapezius, forearm flexor, and forearm extensor muscle groups. Simultaneously, inertial sensors were used to measure kinematics of the trunk, upper arm, and wrist. In general, lower muscle activity levels, less extreme postures, and slower movement speeds were observed during activities that involved primarily the use of agricultural machinery in comparison to manual activities, suggesting a potential advantage of mechanization relative to musculoskeletal health. Median wrist movement speeds exceeding recently proposed exposure thresholds were also observed during many manual activities, such as milking animals and repairing equipment. Upper arm postures and movement speeds did not appear to confer excessive risk for shoulder-related outcomes (on the whole), but interpretation of the results is limited by a sampling approach that may not have captured the full extent of exposure variation. Not surprisingly, substantial variation in exposure levels were observed within each agricultural activity, which is related to substantial variation in the equipment, tools, and work practices used by participants. Ultimately, the results of this study contribute to an emerging literature in which the physical demands of routine agricultural work have been described on the basis of sensor-based measurements rather than more common self-report or observation-based approaches.

Social Determinants of Health: If You Aren't Measuring Them, You Aren't Seeing the Big Picture.

Clinicians often assume that interventions directly influence the recovery of patients with musculoskeletal impairments. In reality, other factors may influence recovery more than the direct treatment provided. The most powerful factor may be upstream effects such as economic stability, education, health and health care, neighborhood and built environment, and social and community context-commonly termed the social determinant of health (SDH). Although a single empirical pathway linking the collective impacts of the SDH to musculoskeletal health outcomes has not been established, our view is that they exert tremendous effects on physical therapy outcomes in practice and research. In this Viewpoint, the authors discuss the SDH and argue that recognizing the impact of SDHs on health behavior is vital to seeing the whole picture related to musculoskeletal recovery. J Orthop Sports Phys Ther 2019;49(12):872-874. doi:10.2519/jospt.2019.0613.

Dietary Inflammatory Index and Non-Communicable Disease Risk: A Narrative Review

There are over 1,000,000 publications on diet and health and over 480,000 references on inflammation in the National Library of Medicine database. In addition, there have now been over 30,000 peer-reviewed articles published on the relationship between diet, inflammation, and health outcomes. Based on this voluminous literature, it is now recognized that low-grade, chronic systemic inflammation is associated with most non-communicable diseases (NCDs), including diabetes, obesity, cardiovascular disease, cancers, respiratory and musculoskeletal disorders, as well as impaired neurodevelopment and adverse mental health outcomes. Dietary components modulate inflammatory status. In recent years, the Dietary Inflammatory Index (DII®), a literature-derived dietary index, was developed to characterize the inflammatory potential of habitual diet. Subsequently, a large and rapidly growing body of research investigating associations between dietary inflammatory potential, determined by the DII, and risk of a wide range of NCDs has emerged. In this narrative review, we examine the current state of the science regarding relationships between the DII and cancer, cardiometabolic, respiratory and musculoskeletal diseases, neurodevelopment, and adverse mental health outcomes. We synthesize the findings from recent studies, discuss potential underlying mechanisms, and look to the future regarding novel applications of the adult and children’s DII (C-DII) scores and new avenues of investigation in this field of nutritional research.

Vitamin D Supplementation in Military Personnel: A Systematic Review of Randomized Controlled Trials.

Vitamin D supplementation is important in military research because of its role in musculoskeletal health. This systematic review examined the effects of vitamin D supplementation on serum 25-hydroxyvitamin D (25(OH)D) concentrations and musculoskeletal health outcomes in military personnel. A comprehensive search was conducted using MEDLINE, EMBASE, CINAHL, SportDiscus, and the Cochrane Library databases and the reference lists of existing review articles and relevant studies. Reviewers independently screened titles, abstracts, and full texts of the articles using predefined criteria. Systematic review of randomized controlled trials (RCTs) using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Level 3. Three reviewers independently extracted data and assessed the methodological quality. Mean differences with 95% CI in serum 25(OH)D concentrations between the vitamin D and placebo arms were calculated. Four RCTs were included in the qualitative analyses. The 25(OH)D concentrations were improved with 2000 IU/d supplementation (mean difference, 3.90 ng/mL; 95% CI, 0.22-7.58). A trial on female Navy recruits showed a significant decrease in stress fractures (risk ratio, 0.77; 95% CI, 0.62-0.95), particularly tibial fractures, from daily supplementation of 800 IU vitamin D and 2000 mg calcium. There was a positive trend in 25(OH)D concentrations from higher doses of supplementary vitamin D in military submariners and a possible benefit to bone health when vitamin D was combined with calcium.

The effectiveness of workplace health promotion interventions on physical and mental health outcomes - a systematic review of reviews.

Objective This systematic review aimed to provide an overview of the effectiveness of health promotion interventions at the workplace on physical and mental health outcomes related to chronic diseases. Methods A search for reviews published between 2009 and 2018 was performed in electronic databases. References of the included reviews were checked for additional reviews. Workplace health promotion interventions were included if they studied metabolic risk factors as important predictors of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVD) or if they studied mental or musculoskeletal health outcomes. Review quality was assessed using the AMSTAR checklist. Results Of the 23 reviews included, 9 were of high quality. For weight-related outcomes, there was strong evidence for favorable effects of workplace interventions, especially for interventions targeting physical activity and/or diet. For the remaining metabolic risk factors, there was no evidence for a positive effect of workplace health promotion interventions due to the absence of high quality reviews and mixed conclusions between the reviews. There was also strong evidence for a positive, small effect on the prevention of mental health disorders of workplace psychological interventions, especially those that use e- health and cognitive behavioral therapy techniques. Furthermore, strong evidence was found for the prevention of musculoskeletal disorders through workplace interventions, especially resistance exercise training. Conclusions This review found evidence for the effectiveness of workplace interventions on the prevention of weight-related outcomes as well as mental health and musculoskeletal disorders. Future research is however needed on the factors that contribute to the successful implementation of an intervention.

Impact of California's safe patient handling legislation on musculoskeletal injury prevention among nurses.

This study evaluated the impact of California's safe patient handling (SPH) legislation on musculoskeletal injury prevention among hospital nurses. Two serial cross-sectional surveys were conducted using postal and online questionnaires in statewide random samples of California registered nurses in 2013 and 2016. Analysis included hospital nurses who performed patient handling (n = 254 and n = 281, respectively). In 2016, there were significant improvements in nurses' knowledge of a SPH policy in their hospital (87%), receipt of annual SPH training (73%), and availability of lift equipment (80%); 33% perceived their hospital's SPH programs as excellent or very good. Significant prevalence reduction was observed for work-related musculoskeletal symptoms (61% vs 52%; Adjusted Prevalence Ratio = 0.78, 95% CI 0.66-0.91). Our findings indicate the significant role of SPH legislation with positive impacts on SPH policies and programs at the hospital level and on musculoskeletal health outcomes at the worker level.

The impact of vitamin D supplementation on musculoskeletal health outcomes in children, adolescents, and young adults living with HIV: A systematic review.

ObjectiveHIV-positive children, adolescents, and young adults are at increased risk poor musculoskeletal outcomes. Increased incidence of vitamin D deficiency in youth living with HIV may further adversely affect musculoskeletal health. We investigated the impact of vitamin D supplementation on a range of musculoskeletal outcomes among individuals aged 0–25 years living with HIV.MethodsA systematic review was conducted using databases: PubMed/Medline, CINAHL, Web of Knowledge, and EMBASE. Interventional randomised control trials, quasi-experimental trials, and previous systematic reviews/meta-analyses were included. Outcomes included: BMD, BMC, fracture incidence, muscle strength, linear growth (height-for-age Z-score [HAZ]), and biochemical/endocrine biomarkers including bone turnover markers.ResultsOf 497 records, 20 studies met inclusion criteria. Thirteen studies were conducted in North America, one in Asia, two in Europe, and four in Sub-Saharan Africa. High-dose vitamin D supplementation regimens (1,000–7,000 IU/day) were successful in achieving serum 25-hydroxyvitamin-D (25OHD) concentrations above study-defined thresholds. No improvements were observed in BMD, BMC, or in muscle power, force and strength; however, improvements in neuromuscular motor skills were demonstrated. HAZ was unaffected by low-dose (200–400 IU/day) supplementation. A single study found positive effects on HAZ with high-dose supplementation (7,000 vs 4,000IU/day).ConclusionsMeasured bone outcomes were unaffected by high-dose vitamin D supplementation, even when target 25OHD measurements were achieved. This may be due to: insufficient sample size, follow-up, intermittent dosing, non-standardised definitions of vitamin D deficiency, or heterogeneity of enrolment criteria pertaining to baseline vitamin D concentration. High-dose vitamin D may improve HAZ and neuromuscular motor skills. Adequately powered trials are needed in settings where HIV burden is greatest.PROSPERO Number: CRD42016042938.

Whole-Body Vibration and Trunk Posture During Operation of Agricultural Machinery.

Exposure to whole-body vibration (WBV) is common among agricultural workers and is associated with musculoskeletal health outcomes such as low back pain. Little is known, however, about the characteristics of exposure experienced during actual production practices. We measured WBV levels during agricultural machinery use among a sample of farmers (n = 55) performing routine agricultural activities and explored machinery attributes that may explain WBV summary measures. We also measured trunk posture to provide additional information about physical exposures during machinery operation. Measurements were made on-farm and during actual work conditions of a sample of agricultural machines (n = 112), including tractors, combines, heavy utility vehicles, and all-terrain vehicles (ATVs). Results indicated the presence of high levels of vibration (median frequency-weighted root-mean-square acceleration of approximately 0.8 m s-2) with time signatures that include high-amplitude mechanical shocks (median crest factor of nearly 23). Compared to other machinery types, combines exhibited the lowest WBV levels and among the most favorable trunk postures. Substantial variability was observed in both the WBV and trunk posture summary measures, suggesting for future studies that alternative sampling strategies are needed to fully capture temporal patterns of machinery use.

Effects of core strength training combined with Tai Chi Chuan for the musculoskeletal system and cardiopulmonary function in older adults: A study protocol for a randomized controlled trial.

Background:According to the national census, China has gradually become an aging society; moreover, aging has become an irreversible worldwide trend in the twenty-first century. Aging can lead to decreased physical function, mobility, cardiopulmonary function and quality of life (QOL). The feasibility and benefits of core strength training (CST) and Tai Chi Chuan (TCC) in older adults (including improving cardiovascular, musculoskeletal, and mental health outcomes) have been confirmed in previous studies. To date, these exercise programmes have not been systematically compared, and the potential benefits of their combined use have not been tested. The primary objective of this study protocol is to evaluate the effects of CST compared to those of TCC on the function of the musculoskeletal system and the cardiopulmonary system in older adults.The second objective is to test the effectiveness of combined physical training that incorporates CST and TCC.Methods:A randomized, single-blind, parallel-controlled trial will be conducted. Three hundred eighty-four participants who meet the eligibility criteria will be randomly allocated into a control group, a CST group, a TCC group, and a combined group in a 1:1:1:1 ratio. Participants in the CST group and the TCC group will respectively receive CST and TCC training at a frequency of 1 hour per day, 5 days per week, totally 12 weeks. Participants in the combined group will receive 30 minutes CST and 30 minutes TCC training per day, 5 days per week, totally 12 weeks. No specific exercises will be required of the participants in the control group. Both musculoskeletal and cardiopulmonary function outcomes, including bone density detection, balance and coordination ability, walking ability, pain visual analogue scale (VAS) score, fall risk assessment, activities of daily living, pulmonary function tests, color sonography and electrocardiogram, will be evaluated by blinded operators at baseline, 13 weeks and 25 weeks (follow-up period).Discussion:The results of this study protocol are expected to clarify the synergistic effect of CST and TCC training on musculoskeletal and cardiopulmonary function in older adults. Furthermore, these findings will confirm whether combined or exclusive CST and TCC training, is more effective at improving functional outcomes in the elderly.Trial registration:Chinese Clinical Trial Registry: ChiCTR-IOR-17010769. Registration date: March 3, 2017.

A Randomized Controlled Trial of a Truck Seat Intervention: Part 2-Associations Between Whole-Body Vibration Exposures and Health Outcomes.

This randomized controlled trial study was conducted to determine whether two different seating interventions would reduce exposure to whole-body vibration (WBV) and improve associated health outcomes. Forty professional truck drivers were randomly assigned to two groups: (i) a control group of 20 drivers who received a new, industry-standard air-suspension seat, and (ii) an intervention group of 20 drivers who received an active-suspension seat. This study collected regional body pain (10-point scale), low back disability [Oswestry Disability Index (ODI)], physical and mental health [the Short Form 12-item Health Survey (SF-12)], and work limitations [Work Limitation Questionnaire (WLQ)] before and 3, 6, and 12 months after the seating intervention. WBV exposures were also collected during the same time periods. Due to dropouts at the 12-month time period, only data up to 6 months post-intervention were included in the analyses. The post-intervention A(8) WBV exposures were lower in both groups with a more substantial WBV exposure reduction (~50%) in the intervention group compared to the control group (~26%). There was little to no change in the impulsive exposures [VDV(8) and Sed(8)] post-intervention and no differences between the two groups. The self-reported musculoskeletal health outcomes showed that intervention group experienced a greater reduction in the low back pain (LBP) and other musculoskeletal outcomes than the control group. The LBP reduction in the intervention group was clinically meaningful (>25%); however, none of the changes in pain reached statistical significance (P's > 0.22). The SF-12 health scores demonstrated that the intervention group's physical health improved after the intervention (P's < 0.06) while the control group experience little to no improvement (P's > 0.11). The WLQ scores showed that the intervention group generally experienced reduced (improved) work limitation over time whereas the control group showed inconsistent changes in work limitation scores. These study findings indicate that reducing truck drivers' exposure to WBV through seating intervention can lead to improvements in LBP and other health outcomes.

Musculoskeletal health of Indigenous Australians.

Research on non-communicable diseases (NCD) in Indigenous Australians has mostly focused on diabetes mellitus and chronic kidney or cardiovascular disease. Osteoporosis, characterised by low bone mass and structural deterioration of bone tissue, and sarcopenia, the age-related loss of muscle mass and strength, often co-exist with these common NCDs-the combination of which will disproportionately increase bone fragility and fracture risk and negatively influence cortical and trabecular bone. Furthermore, the social gradient of NCDs, including osteoporosis and fracture, is well-documented, meaning that specific population groups are likely to be at greater risk of poorer health outcomes: Indigenous Australians are one such group. This review summarises the findings reported in the literature regarding the muscle and bone health of Indigenous Australians. There are limited data regarding the musculoskeletal health of Indigenous Australians; however, areal bone mineral density (aBMD) measured by dual-energy X-ray absorptiometry (DXA) is reported to be greater at the hip compared to non-Indigenous Australians. Falls are the leading cause of injury-related hospitalisations in older Australians, particularly Indigenous Australians, with a great proportion suffering from fall-related fractures. Despite sparse data, it appears that Indigenous men and women have a substantially higher risk of hip fracture at a much younger age compared to non-Indigenous Australians. Data on more detailed musculoskeletal health outcomes are required in Indigenous Australians to better understand fracture risk and to formulate evidence-based strategies for fracture prevention and to minimise the risk of falls.

The Effect of Tobacco Smoking on Musculoskeletal Health: A Systematic Review.

This systematic review explored associations between smoking and health outcomes involving the musculoskeletal system. AMSTAR criteria were followed. A comprehensive search of PubMed, Web of Science, and Science Direct returned 243 articles meeting inclusion criteria. A majority of studies found smoking has negative effects on the musculoskeletal system. In research on bones, smoking was associated with lower BMD, increased fracture risk, periodontitis, alveolar bone loss, and dental implant failure. In research on joints, smoking was associated with increased joint disease activity, poor functional outcomes, and poor therapeutic response. There was also evidence of adverse effects on muscles, tendons, cartilage, and ligaments. There were few studies on the musculoskeletal health outcomes of secondhand smoke, smoking cessation, or other modes of smoking, such as waterpipes or electronic cigarettes. This review found evidence that suggests tobacco smoking has negative effects on the health outcomes of the musculoskeletal system. There is a need for further research to understand mechanisms of action for the effects of smoking on the musculoskeletal system and to increase awareness of healthcare providers and community members of the adverse effects of smoking on the musculoskeletal system.