Neck Disorders Research Articles

The impact of work-related risk factors on the development of neck and upper limb pain among low wage hotel housekeepers in Gondar town, Northwest Ethiopia: institution-based cross-sectional study

BackgroundMusculoskeletal disorders are a major source of disability accounting for considerable economic loss globally. Studies showed that housekeepers suffer from exposure to many high-risk factors for neck and upper limb musculoskeletal disorders. In Ethiopia, little is known and the information is limited in scope about the magnitude of the problem among hotel housekeepers. Therefore, this study aimed to determine the magnitude of the neck and upper limb musculoskeletal disorders and identify the associated risk factors among hotel housekeepers.MethodsInstitution-based cross-sectional study design was employed from March 1 to May 20, 2017. Systematic random sampling was used to select 422 study participants among the Gondar town hotels, Ethiopia. The standardized Nordic questionnaire for the analysis of musculoskeletal symptoms was used to measure the neck and upper limb musculoskeletal disorders. Bivariate and multivariable binary logistic regression analyses were performed using SPSS version 20. The significance level was obtained at 95% CI and p value ≤ 0.05.ResultsThe overall magnitude of a self-reported neck and upper limb musculoskeletal disorders among hotel housekeepers in the last 12 months was 62.8% (95% CI 58.3, 67.8). The main body areas of concern were neck pain (50.7%), shoulder pain (54%), elbow/forearm (47.2%), and hand/wrist (45.5%). Age, rest break taken, repetitive movement, reaching/overstretching, organization concern for health and safety, and job satisfaction were the risk factors significantly associated with neck and upper limb musculoskeletal disorders.ConclusionsA higher proportion of hotel housekeepers were found to be affected by neck and upper limb musculoskeletal disorders in Gondar town. Repetitive movement and reaching/overstretching were strongly associated risk factors with neck and upper limb musculoskeletal disorders. Therefore, ergonomic, organizational and personal measures, which focus on minimizing repetitive movement and awkward working position and facilitating rest break with exercise, are important to tackle neck and upper limb musculoskeletal disorders among hotel housekeepers.

Musculoskeletal neck disorders in thyroid cancer patients after thyroidectomy.

Thyroid cancer (TC) is the most common type of cancer in the endocrine system, and thyroidectomy is the preferred treatment. Complications associated are still common and 80% of patients complain of posterior neck pain. The aim of this study was to analyse the long-term musculoskeletal disorders in TC patients who had undergone thyroidectomy. An observational case-control study was carried out. Twenty-eight patients who had undergone thyroidectomy and 28 healthy control patients were included. Outcomes were collected 6months after surgery and included: musculoskeletal neck disorders (neck range of movement, trigger points) and functional variables (pain intensity and disability). Significant differences were found between groups in flexion (p=0.002) and extension (p=0.005), with lower values in the thyroidectomy group. The number of trigger points was higher in the thyroidectomy group in both scalenes (p<0.001), both sternocleidomastoids (p<0.001), both upper trapezius (p=0.005 and p=0.008), right levator scapulae (p=0.002) and both suboccipitalis (p=0.002). Pain intensity (p<0.001) and the Neck Outcome Scale subscales (p<0.05) also presented significant differences. Thyroidectomy patients, 6months after surgery, show a significant decrease in neck range of movement and an increase in the number of trigger points. They also show greater pain intensity and more disability.

Work-related neck and upper limb disorders \u2013 quantitative exposure\u2013response relationships adjusted for personal characteristics and psychosocial conditions

BackgroundWe have previously reported quantitative exposure-response relationships between physical exposures recorded by technical methods, and complaints and diagnoses in the neck/shoulders, and the elbows/hands, based on group data. In the present study the number of workers was doubled, and information on individual factors, and psychosocial working conditions was used. Relationships between various kinds of exposure and response have been analysed in this larger and more detailed sample.MethodsThe prevalence of complaints (Nordic Questionnaire) and diagnoses (clinical examination) were recorded in a number of occupational groups within which the participants had similar work tasks, 34 groups of female employees (N = 4733 women) and 17 groups of male employees (N = 1107 men). Age and other individual characteristics were recorded, as well as psychosocial work environment factors (job-content questionnaire) for most participants. Postures and velocities (inclinometry) of the head (N = 505) and right upper arm (N = 510), right wrist postures and velocities (electrogoniometry; N = 685), and muscular activity (electromyography; EMG) in the right trapezius muscle (N = 647) and forearm extensors (N = 396) were recorded in representative sub-groups. Exposure-response relationships between physical exposure and musculoskeletal disorders, adjusted for individual factors with Poisson regression were then calculated. The effect of introducing psychosocial conditions into the models was also assessed.ResultsAssociations were found between head velocity, trapezius activity, upper arm velocity, forearm extensor activity and wrist posture and velocity, and most neck/shoulder and elbow/hand complaints and diagnoses. Adjustment for age, other individual characteristics and psychosocial work conditions had only a limited effect on these associations. For example, the attributable fraction for tension neck syndrome among female workers with the highest quintile of trapezius activity was 58%, for carpal tunnel syndrome versus wrist velocity it was 92% in men in the highest exposure quintile.ConclusionsBased on the findings, we propose threshold limit values for upper arm and wrist velocity.

Predictors of work-related musculoskeletal disorders of neck and shoulders among nurses

Work-related musculoskeletal disorders (WRMSD) in the neck or shoulders are common occupational health problems among nursing professionals. This study aimed to identify potential predictors of WRMSD in neck and shoulders, namely workplace condition, emotional distress and work engagement, among Malaysian nurses in public hospitals. A cross-sectional study was conducted among female nurses working in public hospitals around Klang Valley, Malaysia. Predictors of WRMSD in the neck and shoulders were identified using multivariate logistic regression analysis. A total of 550 out of 660 nurses returned the questionnaire (83.3% response rate). However, the analysis was based on 376 nurses who reverted with completely answered questionnaires. 73.1% of nurses suffered from WRMSD in at least one site in the past 12 months. Of these, 48.9%, 36.9% and 55.6% reported symptoms in the neck alone, shoulders alone and any of these regions respectively. When all significant predictors (p<0.10) were simultaneously included in the final model, the odds of WRMSD in neck or shoulders were higher among nurses perceiving high physical demand (AOR: 1.18, 95% CI 1.02-1.30) and high psychological job demand (AOR: 1.08, 95%CI 1.01-1.15). Anxious and stressful nursing personnel possess 22.6% and 11.6% greater odds of WRMSD in neck or shoulders in comparison to nurses without the symptoms. Married nurses were also at higher odds (AOR: 2.12, 95% CI 1.27-3.55), whereas being engaged to work, significantly reduced the risk of WRMSD in any of the areas. This study indicated that the neck or shoulders WRMSD are prevalent among nurses. Psychological job demand, physical demand, anxiety and stress were the significant predictors of WRMSD in the studied anatomical areas.

The Prevalence of Skeletotopy Variation of the Atlas and Vertebral Arteries Among Lithuanians and Its Significance for Physical Medicine Procedures and Rehabilitation

Research background. Vertebral artery relation with atlas anatomical variations can lead to sensomotor disorders of head and neck, and vertebrobasilar insuffciency. Kimmerle’s anomaly, a bony ring around vertebral artery, is also known as a risk factor for physical medicine procedures. To the best of our knowledge, this is the frst study of Ponticulus posticus prevalence in Lithuania. Aim. The research aim was to investigate the prevalence of skeletotopy variations of the posterior arch and vertebral artery among Lithuanian orthodontic patients of various ages and both genders. Research methods. We randomly selected 870 digital lateral cephalograms of Lithuanian orthodontic patients of various ages and both genders. 706 images with good visualization of VA bony socket shadow on the superior surface of the atlas posterior arch were chosen for the investigation. According to the degree of depth of the bony socket we categorized them into three variations: sulcus, groove and bony ring. If contours around VA of bony arch were equal or greater than 180°, we included those cases into the group of bony groove. Research results. We estimated predominance of sulcus (67.6%) of bony socket variations. A bony groove of various depths was found in 24.0% and a bony ring was found in 7.5% of the subjects studied. Vertebral artery groove was found to be more prevalent in females than in males and bony ring was more common in males than in females, but there was no signifcant difference (p &gt; 0.05). Statistically signifcant predominace of bony ring in the age group of 17–20 years (13.2%) was observed and it was higher than in the age group of 8–16 years (5.1%) (p &lt; 0.05). Conclusions. 1. Variations of bony socket including sulcus, groove, and bony ring (Kimmerle’s anomaly) develop in adolescence when ossifcation is most active. 2. The bony ring and semi open groove, which limit mobility of distal part of the vertebral artery, can be a risk factor of physical medicine procedures, especially in the elderly, whose artery walls are less elastic.Keywords: Ponticulus posticus, Kimmerle’s anomaly, atlas, vertebral artery, manual therapy of neck.

THE USE OF PATIENT REPORTED OUTCOME MEASURES BY PHYSICAL THERAPISTS IN THE PEDIATRIC SPORTS POPULATION

Purpose: Patient reported outcome measures (PROs) allow physical therapists (PTs) the ability to objectively understand a patients’ perception of their symptoms, functional status, and health related quality of life. Although professional organizations have issued recommendations for PRO use, many of these measures were developed and validated within the adult population which may limit their application to pediatric orthopedics. It is currently unknown which measures are being used within this population, and thus the purpose of this study is to evaluate the current use of PROs among pediatric sports PT and determine how PRO information is used in clinical care. Methods: An online survey, developed in REDCap™, was administered via email to members of the Sports Section Youth Athlete Special Interest Group (YASIG) and the Pediatric Research in Sports Medicine Society (PRiSM), over the course of 8 weeks. The survey was developed and pilot tested by 4 physical therapists and 3 orthopedic surgeons and consisted of 24 possible questions, taking 3-5 minutes to complete. Descriptive statistics and frequency tallies were utilized to analyze the data. Results: There was a total of 70 respondents (response rate YASIG 17%; response rate PRiSM 90%) who completed the questionnaire in its entirety. There was a wide range of clinical experience with 31% reporting 0-5 years, 23%, 6-10 years, 16%, 11-15 years, and 30% &gt;16 years. The majority (54%) reported working in a hospital based outpatient setting or private practice (24%). Ninety four percent (n=66) of respondents reported using PROs, with 100% (n=66) of these subjects issuing them at the initial visit, 94% (n=62) at discharge, and 91% (n=60) monthly. The Neck Disability Index (76%, n=50), Oswestry (76%, n=50), and QuickDASH (68%, n=45) were most frequently used for neck, back and shoulder disorders, respectively. The Lower Extremity Functional Scale (LEFS) was the most widely utilized measure for multiple body regions including 74% (n=49) for either hip or knee dysfunction, and 26% (n=16) for ankle. In general, knee disorders demonstrated the highest degree of variability in scale selection with 52% (n=34) using the IKDC, 35% (n=23) using the Pedi-IKDC and 20% (n=13) (using the KOOS). The information obtained from PROs was used to demonstrate effectiveness of treatment (80%, n=53), inform clinical decisions (77%, n=51), satisfy insurance requirements (59%, n=39), used for goal writing (60%, n=40), and research (36%, n=24). Only 6% (n=4) of PTs indicated that PROs did not impact clinical reasoning within their plan of care. When asked how the information from PROs is used within clinical practice, it was noted that 71% (n=47) of PTs would ‘revise physical therapy goals’ if scores were either higher or lower than expected and 38% (n=25) would ‘refer patient back to the physician’ if PRO results showed lack of progress or regression. In addition, 20% (n=13) of PTs noted they utilize the results from PROs to help inform discharge decision making. When asked regarding barriers to using PROs, PTs reported inadequate time (42%, n=28), difficultly remembering to administer (38%, n=25) and uncertainty regarding which PRO to use (21%, n=14) as the main impediments in using PROs. Conclusions: Our results indicate that the majority of pediatric sports PTs are using PROs to establish efficacy of treatment, inform clinical decision making and set goals. Inadequate time and indecision with regards to which scale to use, were identified as barriers to use. Knee disorders demonstrated the largest variability in scale use. Interestingly, the LEFS was reported at high frequencies for the hip, knee and ankle joints despite the availability of other joint specific measures available. The Oswestry and NDI are also used by 76% of respondents despite neither tool being validated in pediatrics. This finding may be due to the absence of any pediatric specific alternative measures. Clinical Relevance: The Center for Medicare and Medicaid implemented value based purchasing program per the mandate of the Affordable Care Act. The Act established a performance based approach to payment with a goal of ensuring better clinical outcomes and improved patient experience. As a result, there is an increased emphasis on using PROs to demonstrate efficacy and functional improvement. It is reassuring that many PTs are using PROs and using the obtained data to drive clinical care. However, the high variability in scale choice makes comparative outcomes research difficult. In addition, the majority of the PROs used are not validated within the pediatric population and thus may not be appropriate tools for assessing these patients perception of care delivered or even represent their functional/athletic limitations. Given the high prevalence of use and importance to clinical practice, the need for psychometric testing and/or scale development specifically for pediatric sports population is imperative.

Comparison of immediate effects of sling-based manual therapy on specific spine levels in subjects with neck pain and forward head posture: a randomized clinical trial

Purpose: Forward head posture is identified as the flexion of the lower cervical spine along with the extension of the upper cervical spine, with an overall increase in the cervical curve. This study aimed to compare the immediate effect of upper-cervical level and cervicothoracic junction level manual therapy on head posture, cervical range of motion and muscle activity of the subjects with forward head posture.Methods: A total 22 subjects with chronic neck pain (numeric pain rating scale >3, forward head posture: cranio-vertebral angle <51°) participated in the study and were randomly allocated into the upper-cervical (n = 11) and cervicothoracic junction (n = 11) groups. Cranio-vertebral angle, cervical range of motion, and electromyography amplitude during performance of the craniocervical flexion test were measured before and immediately after the intervention.Results/findings: There were no significant main effects for the group by time outcome score of craniovertebral angle and electromyography amplitude. However, in the range of motion of the cervical area, the cervicothoracic junction group showed a significant increase in extension and right rotation than the upper-cervical group (p < 0.05). Moreover, in both groups, the electromyography amplitude of the sternocleidomastoid muscle was significantly reduced after intervention. The electromyography amplitude of the anterior scalene muscle in only the cervicothoracic junction group was significantly reduced after intervention (p < 0.05).Conclusion: Cervicothoracic junction manual therapy improved cervical alignment, cervical mobility (extension, rotation), and muscle recruitment ability in subjects with forward head posture. These observations may partially explain the efficacy of this manual therapy in rehabilitation of individuals with mechanical neck disorder (with forward head posture).Implications for rehabilitationForward head posture is identified as the flexion of the lower cervical spine along with the extension of the upper cervical spine, with an overall increase in the cervical curve.Cervicothoracic area manual therapy in subjects with neck pain and forward head posture better improved the muscle recruitment ability than upper cervical area manual therapy during motor tasks.

Female Office Workers With Moderate Neck Pain Have Increased Anterior Positioning of the Cervical Spine and Stiffness of Upper Trapezius Myofascial Tissue in Sitting Posture.

Work-related neck disorders are among the most common dysfunctions in office workers. Understanding cervical myofascial mechanical characteristics that differentiate symptomatic from asymptomatic office workers is crucial for the understanding of musculoskeletal dysfunctions in workers with neck pain. To assess the effect of moderate work-related neck disorders on head posture and stiffness and perceived pain threshold of the upper trapezius (UT) and sternocleidomastoid (SCM) muscles. Cross-sectional study. Work environment. Sixteen office workers with diagnosed moderate work-related neck disorders and 16 asymptomatic office workers matched for sex, age, body mass index, and the nature and duration of their work. Not applicable. The primary outcome measure consisted of measurements of head posture using craniovertebral angle and myotonometric muscle stiffness (Newtons per meter) of the UT and SCM muscles. The secondary output variable was the perceived pain threshold algometry of the studied muscles. Compared with controls, subjects with work-related neck pain had a significantly smaller craniovertebral angle (by 8.3%; Cohen d = 0.88, P = .02) and greater stiffness of the UT myofascial tissue (by 11.3%; Cohen d = 1.05, P = .006). No significant differences in perceived pain threshold of the myofascial tissue of the UT or SCM muscles were found between groups. In this study female office workers with neck pain had increased anterior positioning of the head and stiffness of the UT muscle in the sitting posture, which was not associated with changes in the pressure pain threshold of this muscle. III.

Determining the Prevalence of Musculoskeletal Disorders in Tailors in Kermanshah, Iran Using the Nordic Questionnaire (2018)

Background: Given that evaluating and diagnosing musculoskeletal disorders (MSDs) is an important step towards preventing labor disorders, The present study was conducted to determine the degree of MSDs in tailors in the city of Kermanshah, Iran. Methods: The present descriptive, analytical and cross-sectional study was conducted in winter 2018 on 150 randomly-selected tailors in the city of Kermanshah. The status of neck, waist, shoulder, wrist, ankle, hip, knee and elbow was evaluated using the Nordic questionnaire. The data collected were analyzed in SPSS using Spearman’s correlation coefficient. Results: The mean age of the tailors was 41.9 ± 13.1 years. A total of 59.33 % of the tailors were male, and the men and women were significantly different in terms of MSDs (P < 0.05). A weekly study reported neck, shoulder, waist, wrists, elbows, thighs, knees and ankles disorders to involve 49.7%, 41.6%, 55%, 40%, 11.4%, 25%, 43.6% and 42.66% of the tailors, respectively. The most prevalent injuries recorded in an annual examination were respectively associated with the waist (65.33%), neck (64.66%) and shoulder (56%). In the previous year, 52% of the samples had suffered from pain and discomfort in at least one of the eight areas cited. Conclusions: The results of the present study found marital status, working hours and exercise to be the most significant variables affecting MSDs in the tailors. MSDs were found to be highly prevalent in especially the upper extremity of the sewing profession population. Optimizing the working condition of tailors is therefore crucial.

CSM 2019 American Academy of Sports Physical Therapy Poster Presentations (Abstracts SPO1–SPO132)

CSM 2019 American Academy of Sports Physical Therapy Poster Presentations (Abstracts SPO1–SPO132)

Vestibular-Balance Rehabilitation in Patients with Whiplash-Associated Disorders

Whiplash associated syndrome is one of the neck disorders that is accompanied by several chronic symptoms. Balancing problems arising from common disorders and dizziness are considered as manifestations that are time-consuming to evaluate and treat. The present study aims to investigate the effect of vestibular-balance rehabilitation using a test that can be used for differential diagnosis of these lesions by comparing dizziness handicap inventory (DHI) and Smooth Pursuit Neck Torsion (SPNT) scores. This was an analytical cross-sectional study with a two-stage design. Forty patients with whiplash-associated disorders were randomly divided into control and intervention groups. SPNT test and DHI evaluation were performed for both groups. For twenty people selected randomly in the intervention group, vestibular-balance rehabilitation was performed during 12 sessions. Finally, the SPNT and DHI tests were performed again to examine and compare the results. The results of this study showed that there was a statistically significant difference between the scores of smooth pursuit neck torsion gain in the SPNT test, the total score of DHI, the functional components of this questionnaire between the control and intervention groups after the implementation of the rehabilitation, and the differences in the physical, functional, and emotional components of the questionnaires of the control and intervention groups after rehabilitation exercises. Vestibular-balance rehabilitation exercises can be an effective treatment for dizziness and improving the quality of life of a person suffering from whiplash-associated disorder, followed by the reduction in dizziness caused by disability.

Neck muscle responses of driver and front seat passenger during frontal-oblique collisions.

BackgroundLow-velocity motor vehicle crashes often lead to severe and chronic neck disorders also referred to as whiplash-associated disorders (WAD). The etiology of WAD is still not fully understood. Many studies using a real or simulated collision scenario have focused on rear-end collisions, whereas the kinematics and muscular responses during frontal-oblique collisions have hardly been investigated. In particular for rear-end collisions, drivers were shown to have a higher WAD risk than front seat passengers. Yet, independently from the impact direction, neither the muscular nor the kinematic responses of drivers and front seat passengers have been compared to date, although some findings indicate that the neck muscles have the potential to alter the head and neck kinematics, and that the level of neck muscle activity during impact may be relevant for the emergence of WAD.ObjectiveIn this study, we quantitatively examined the subjects’ neck muscle activity during low-velocity left-frontal-oblique impacts to gain further insights into the neuromuscular mechanism underlying whiplash-like perturbations that may lead to WAD.MethodsIn a within-subject study design, we varied several impact parameters to investigate their effect on neck muscle response amplitude and delay. Fifty-two subjects experienced at least ten collisions while controlling for the following parameters: change in velocity Δv (3 / 6 km/h), seating position (driver / front seat passenger), and deliberate pre-tension of the musculature (tense / relaxed) to account for a potential difference between an expected and an unexpected crash. Ten of the 52 subjects additionally ran the same experimental conditions as above, but without wearing a safety belt.FindingsThere were significant main effects of Δv and muscle pre-tension on the reflex amplitude but not of seating position. As for the reflex delay, there was a significant main effect of muscle pre-tension, but neither of Δv nor of seating position. Moreover, neither the safety belt nor its asymmetrical orientation had an influence on the reflexive responses of the occupants.ConclusionIn summary, we did not find any significant differences in the reflex amplitude and delay of the neck musculature between drivers and front seat passengers. We therefore concluded that an increased risk of the driver sustaining WAD in frontal-oblique collisions, if it exists, cannot be due to differences in the reflexive responses.

Factors associated with neck disorders among university student smartphone users.

In our digital society, the use of smartphones has increased rapidly. Parallel with the growing use of smartphones, musculoskeletal problems associated with intensive smartphone use have also increased. Neck flexion is the most commonly adopted posture by smartphone users while looking at the visual display terminals of smartphones for extended periods; this posture may lead to neck disorders. The purpose of the current study was to investigate musculoskeletal disorders (MSDs) in smartphone users in Thailand in order to confirm high prevalence of neck pain. The study also aimed to determine all possible factors associated with neck disorders among smartphone users. A cross-sectional survey study was conducted with 779 undergraduate smartphone users. A self-administered questionnaire was used to collect self-report measures of smartphone use and musculoskeletal disorders. Descriptive statistics were used to analyze participant characteristics and the prevalence of musculoskeletal disorders. Logistic regression analysis was used to identify associated factors. The most painful body region after the use of smartphones over a 12-month period was found to be the neck (32.50%). Factors associated with neck disorders were a flexed neck posture (Odds Ratio (OR): = 2.44, 95% Confidence Interval (CI) = 1.21-4.90) and smoking (OR 8.99, 95% CI 1.88-42.87). The results suggest that to address neck disorders in smartphone users preventive initiatives should focus on reducing flexed neck postures and smoking.

The use of skeletal muscle relaxants in musculoskeletal injuries: what is the evidence?

Skeletal muscle relaxants (SMRs) consist of a heterogeneous group of medications with a side effect profile of concern. The aim of this paper was to review the evidence of use of SMRs in the treatment of sports injuries. A literature search between 2005 – 2018 (Ovid MEDLINE, SPORTDiscus and SCOPUS) were conducted. In addition, citations within articles were searched, and the most commonly prescribed SMRs in South Africa were also used to explore the literature for additional publications. Relevant studies that met the inclusion criteria were selected. Clinical recommendations for general practitioners are given based on the Strength of Recommendation Taxonomy (SORT) level of evidence. Combination drugs rather than single agents are mostly used, however the effectiveness of SMR agents, single and in combination, as well as its significance as opposed to analgesics and non-steroidal anti-inflammatory drugs, still has to be evaluated. Evidence suggest SMRs to be probably effective for use in non-specific lower back pain (acute and chronic lower back muscle strains, ligament sprains, soft tissue contusions), as well as for whiplash associated disorder, mechanical neck disorders, piriformis syndrome, lateral epicondylosis, and plantar fasciitis. It does not appear if there is a role for SMRs as part of combination management for acute cervical strains, post-exercise muscle soreness or myofacial pain syndrome. However, substantial evidence to confirm the use of SMRs in the treatment of sports injuries have not been adequately investigated and is currently largely based on case reports and general reviews.

Temperature Modifications during Storage to Overcome Weak Neck Disorder in Banana (cv. Rasthali) using α- Amino Isobutyric Acid

Climacteric fruits respond well to the environmental temperature, because the respiration rate and ethylene production would vary according to the temperature. Banana fruit possess very short postharvest life, prone to injuries and postharvest disorders like weak neck because of the climacteric and perishable nature of the fruit. Hence an attempt was made with α- Amino isobutyric acid (AIB) to study the weak neck disorder of the banana under cold storage condition to increase the postharvest life. AIB is an ethylene biosynthesis inhibitor which inhibits the ethylene synthesis by inhibiting ACC oxidase enzyme. Banana fruits were treated with different AIB concentrations (50, 100, 150, 200 ppm along with control) and spraying methods (Dipping and Spraying). AIB @ 150 ppm dipped for 5 minutes showed decreased finger dislodge from the hands (50-70 per cent at 11th day after treatment) compared to control fruits (100 per cent at 9th day after treatment). On comparing AIB with ethylene inhibitor (1-MCP) and chemicals (Hexanal and calcium chloride) under cold and ambient storage condition, AIB showed better result with reduced finger drop. At 11th day of cold storage AIB treated fruits exhibited minimum finger drop of 50 per cent followed by 1-MCP vaporization with finger drop percentage of 60 and control fruits reported the maximum number of finger drop (90 per cent). Under ambient condition at 7th day itself the AIB treated fruits showed 60 per cent finger drop. Hence from the present study, the external temperature would alter the storage life of the fruits which may be an important factor and noted for further improvement of postharvest life of fruits by storing under required temperatures and minimizing the postharvest losses. .

The prevalence of myofascial trigger points in neck and shoulder-related disorders: a systematic review of the literature

BackgroundNeck and shoulder disorders may be linked to the presence of myofascial trigger points (MTrPs). These disorders can significantly impact a person’s activities of daily living and ability to work. MTrPs can be involved with pain sensitization, contributing to acute or chronic neck and shoulder musculoskeletal disorders. The aim of this review was to synthesise evidence on the prevalence of active and latent MTrPs in subjects with neck and shoulder disorders.MethodsWe conducted an electronic search in five databases. Five independent reviewers selected observational studies assessing the prevalence of MTrPs (active or latent) in participants with neck or shoulder disorders. Two reviewers assessed risk of bias using a modified Downs and Black checklist. Subject characteristics and prevalence of active and latent MTrPs in relevant muscles was extracted from included studies.ResultsSeven articles studying different conditions met the inclusion criteria. The prevalence of MTrPs was compared and analysed. All studies had low methodologic quality due to small sample sizes, lack of control groups and blinding. Findings revealed that active and latent MTrPs were prevalent throughout all disorders, however, latent MTrPs did not consistently have a higher prevalence compared to healthy controls.ConclusionsWe found limited evidence supporting the high prevalence of active and latent MTrPs in patients with neck or shoulder disorders. Point prevalence estimates of MTrPs were based on a small number of studies with very low sample sizes and with design limitations that increased risk of bias within included studies. Future studies, with low risk of bias and large sample sizes may impact on current evidence.

Effect of neck posture on cervicothoracic loads in overhead crane operators

Awkward neck postures are commonly documented to be associated with an increased risk of neck disorders. This study intended to continuously monitor and evaluate neck postures and to estimate the cervicothoracic loads among overhead crane operators during work time. Neck postures were measured among 40 randomly selected operators by an inclinometer during 2 h of work time. To determine the tasks and adapt the posture recordings to each of their corresponding tasks, direct observation was conducted concurrently. The median neck flexion and lateral bend angles were 28.23° and 11.30°, respectively. The mean compression and shear loads on the neck ranged from 75.22 to 113.14 N and from 9.50 to 41.11 N, respectively. The results indicated substantial levels of exposure to awkward and extreme neck postures among the operators. The nature of the operators’ work and the visual requirements of some tasks will increase the mechanical loads on the neck.

Are measures of pain sensitivity associated with pain and disability at 12-month follow up in chronic neck pain?

Pain sensitivity and psychosocial issues are prognostic of poor outcome in acute neck disorders. However, knowledge of associations between pain sensitivity and ongoing pain and disability in chronic neck pain are lacking. We aimed to investigate associations of pain sensitivity with pain and disability at the 12-month follow-up in people with chronic neck pain. The predictor variables were: clinical and quantitative sensory testing (cold, pressure); neural tissue sensitivity; neuropathic symptoms; comorbidities; sleep; psychological distress; pain catastrophizing; pain intensity (for the model explaining disability at 12months only); and disability (for the model explaining pain at 12months only). Data were analysed using uni- and multivariate regression models to assess associations with pain and disability at the 12-month follow-up (n=64 at baseline, n=51 at follow-up). Univariable associations between all predictor variables and pain and disability were evident (r>0.3; p<0.05), except for cold and pressure pain thresholds and cold sensitivity. For disability at the 12-month follow-up, 24.0% of the variance was explained by psychological distress and comorbidities. For pain at 12months, 39.8% of the variance was explained primarily by baseline disability. Neither clinical nor quantitative measures of pain sensitivity were meaningfully associated with long-term patient-reported outcomes in people with chronic neck pain, limiting their clinical application in evaluating prognosis.

The Ipswich Microbreak Technique to alleviate neck and shoulder discomfort during microscopic procedures

Neck and shoulder disorders are a considerable health problem amongst frequent microscope users. We aimed to investigate the neck and shoulder discomfort experienced during prolonged microscopic activity and to assess the benefits of minibreaks. A prospective crossover study was performed on 17 healthy volunteers sitting still while looking down a bench with and without the Ipswich Microbreak Technique (IMT). We used a subjective measure of time to fatigue and pain in the neck and shoulder regions as well as objective readings from a surface electromyogram (sEMG). The IMT delayed the sensation of pain in the neck and shoulder region while reducing the overall sEMG muscle activation. In conclusion, IMT is a useful strategy in reducing and delaying the pain in neck and shoulder from prolonged working under the microscope. This technique can be incorporated in other activities that involve a sustained stationary position.

Full shift assessment of back and head postures in overhead crane operators with and without symptoms.

Objectives: Prolonged sitting with a flexed back and neck is recognized as being associated with an increased risk of neck and back pain disorders among overhead crane operators. The aim of this study was to compare back and head postures over a full shift of work between operators who experience back and neck pain, and healthy operators. Methods: In a first phase, the prevalence of musculoskeletal symptoms was assessed using the Nordic questionnaire among 120 crane operators. Based on first phase results, 17 operators with back/neck disorders were matched with 15 healthy operators based on age and selected to participate in the second phase of the study. Postures and movements were continuously measured over an 8 h shift using inclinometers.Results: The highest 12-month prevalence of musculoskeletal disorders was found in the lower back, neck and knees. Case and control groups differed significantly in back and head flexion angles at the 50th percentiles APDF (p < 0.05). There was also a significant difference in the time spent working in an extreme posture of the back and head between groups (p < 0.05). Conclusions: This is the first study to document work postures assumed during a full work shift and to compare postures between symptomatic and healthy overhead crane operators. Physical exposure in case group operators was characterized by more awkward and extreme postures in the back and head. The results of this study demonstrate that effective prevention strategies directed towards musculoskeletal disorders are required that address awkward work postures for overhead crane operators.