Related Musculoskeletal Injuries Research Articles

Prevalence, characteristics and clinical impact of work-related musculoskeletal pain in echocardiography

BackgroundWork-related musculoskeletal pain (WRMSP) is increasingly recognised in cardiac ultrasound practice. WRMSP can impact workforce health, productivity and sustainability. We sought to investigate the prevalence, characteristics and clinical impact of WRMSP.MethodsProspective electronic survey of 157 echocardiographers in 10 institutions. Data acquired on demographics, experience, working environment/pattern, WRMSP location, severity and pattern, the impact on professional, personal life and career.Results129/157 (82%) echocardiographers completed the survey, of whom 109 (85%) reported WRMSP and 55 (43%) reported work taking longer due to WRMSP. 40/129 (31%) required time off work. 78/109 (60%) reported sleep disturbance with 26/78 (33%) of moderate or severe severity. 56/129 (45%) required medical evaluation of their WRMSP and 25/129 (19%) received a formal diagnosis of musculoskeletal injury. Those with 11+ years of experience were significantly more likely to receive a formal diagnosis of WRMSP (p = 0.002) and require medication (p = 0.006) compared to those with 10 years or less experience.ConclusionWRMSP is very common amongst echocardiographers, with a fifth having a related musculoskeletal injury. WRMSP has considerable on impact on personal, social and work-related activities. Strategies to reduce the burden of WRMSP are urgently required to ensure sustainability of the workforce and patient access to imaging.

Pre-neuromusculoskeletal injury Risk factor Evaluation and Post-neuromusculoskeletal injury Assessment for Return-to-duty/activity Enhancement (PREPARE) in military service members: a prospective, observational study protocol

BackgroundNon-battle related musculoskeletal injuries (MSKI) are one of the primary medical issues diminishing Service member medical readiness. The MSKI problem is challenging because it is difficult to assess all of the factors that increase MSKI risk and influence post-MSKI outcomes. Currently, there are no high-throughput, clinically-feasible, and comprehensive assessments to generate patient-centric data for informing pre- and post-MSKI risk assessment and mitigation strategies. The objective of the “Pre-neuromusculoskeletal injury Risk factor Evaluation and Post-neuromusculoskeletal injury Assessment for Return-to-duty/activity Enhancement (PREPARE)” study is to develop a comprehensive suite of clinical assessments to identify the patient-specific factors contributing to MSKI risks and undesired post-MSKI outcomes.MethodsThis is a phased approach, multi-center prospective, observational study (ClinicalTrials.gov number: NCT05111925) to identify physical and psychosocial factors contributing to greater MSKI risk and undesired post-MSKI outcomes, and to identify and validate a minimal set of assessments to personalize risk mitigation and rehabilitation strategies. In Phase I, one cohort (n = 560) will identify the physical and psychosocial factors contributing to greater MSKI risks (single assessment), while a second cohort (n = 780) will identify the post-MSKI physical and psychosocial factors contributing to undesired post-MSKI outcomes (serial assessments at enrollment, 4 weeks post-enrollment, 12 weeks post-enrollment). All participants will complete comprehensive movement assessments captured via a semi-automated markerless motion capture system and instrumented walkway, joint range of motion assessments, psychosocial measures, and self-reported physical fitness performance and MSKI history. We will follow participants for 6 months. We will identify the minimum set of clinical assessments that provide requisite data to personalize MSKI risk mitigation and rehabilitation strategies, and in Phase II validate our optimized assessments in new cohorts.DiscussionThe results of this investigation will provide clinically relevant data to efficiently inform MSKI risk mitigation and rehabilitation programs, thereby helping to advance medical care and retain Service members on active duty status.Trial Registration: PREPARE was prospectively registered on ClinicalTrials.gov (NCT05111925) on 5 NOV 2021, prior to study commencement.

The efficacy of a lifting strap as an ergonomic intervention for EMS providers: Does it make it easier to raise a supine patient to an upright sitting posture?

Patient handling related musculoskeletal injuries are prevalent among Emergency Medical Service (EMS) providers. The first step in many patient handling situations is where a supine patient on the floor is brought to a sitting position. This study investigated whether a strap, placed under the patient's torso and long enough that EMS providers can perform the patient raising task in a standing posture, reduced muscular effort. Fifteen participants raised a simulated patient, with the help of an assistant, using the strap method and a traditional method (grasping the shoulders) in an open area, a restricted space, and in a bathtub. Torso postures improved in all location conditions when using the strap. The muscle activation data showed mixed results. While EMG responses from the latissimus dorsi muscles were reduced, EMG activity of the erector spinae muscles increased when the strap was used. Perceived effort assessments supported the use of the strap.

Which is more dangerous, earthquake, or the panic?Evaluation of the 24 January 2020 Elazig/Türkiye earthquake related musculoskeletal injuries.

The aim of this study is to evaluate the musculoskeletal injuries related with 24 January 2020 Elazig/Türkiye earthquake and their treatment protocols. Data of patients applied to İnönü University Medical Faculty Hospital, Elazığ Training and Research Hospital and Malatya Training and Research Hospital emergency departments within 48 h after the earthquake, were evaluated retrospectively. Age, gender, soft tissue injuries and sites, fracture sites and types, fracture etiology, and treatment methods were evaluated. 247 patients were evaluated. 118 were women and 139 were men. There were 24 (9.7%) pediatric patients. Mean age was 37.3 (1-92) years. Waist majority of injuries were simple soft-tissue injuries. There were 103 fractures in 86 patients. Thirty-eight patients' fractures were treated surgically. Every major disaster warrants retrospective studies so we can learn how to improve all levels of Emergency Medical Services. Great proportion of Elazıg earthquake victims had only simple soft tissue injuries such as sprain, laceration, or contusion. Many patients were injured due to reasons indirectly related to the destruction brought by the earthquake. Panic caused by the earth-quake caused more injury than the destruction it brought.

Impact Of Fifa 11+ Program On Acl Injury Rates In Collegian Female Rugby Players

This is a preliminary study on the impact of a FIFA 11+ training program for collegiate female rugby players at a local college. The FIFA 11+ was developed to prevent lower extremity injuries among soccer athletes. Retrospective analysis of injured Rugby athletes suggested the non-contact (NC) ACL injuries were similar to soccer related NC ACL injures. Given the success the FIFA 11+ program on injury reduction, it was suggested as an intervention. PURPOSE: The purpose is to investigate the effects of the FIFA 11+ program on reducing NC ACL injuries in collegiate female athletes. METHODS: Historical injury data was obtained. FIFA 11+ training program was implemented at the start of the season and continued as part of the pre-practice/game warm up. Injury data was logged throughout the rugby season of approximately 25 weeks between September and May. A comparison was made between 2016 season’s injuries to the 2017 and 2018 years. RESULTS: In the 2016 season prior to intervention, 9 athletes were injured/unable to participate because of rugby related musculoskeletal injuries with 3 NC ACL injuries. In the two seasons that the FIFA 11+ program was implemented, 2017 and 2018, NC ACL injuries were reduced to 0. In the 2017 season, 9 athletes were injured specifically, 3 concussions, 1 (Contact) ACL injury, and 5 other injuries. In 2018, ACL injuries were reduced to 0, while concussions (5) and fractures (3), and other injuries limited participation.Twice a week, 2-hour practice sessions and games were included to estimate a team NC ACL injury rate per activity hour ratio. In 2016 the ratio was 3/3000 hrs. There were no NC ACL injuries in both 2017 (0/3472 hrs) and 2018 (0/3900 hrs) together equal 0/7372 hrs. If the injury rate from 2016 were maintained, NC ACL injures would be predicted to be >7. CONCLUSIONS: This preliminary study suggests the FIFA 11+ may have broader application to other field sports and that specific training programs may reduce the incident of ACL injuries in Rugby athletes.

Epidemiology and associated factors for CrossFit-related musculoskeletal injuries: a cross-sectional study.

CrossFit® is usually composed of high intensity workout routines and is executed quickly, repetitively and with limited rest time. Previous studies have identified a high prevalence of injuries in CrossFit®. This study aimed to determine the prevalence of CrossFit-related musculoskeletal injuries and to identify potential associated factors. A cross-sectional study was conducted with 413 CrossFitters. Participants completed a questionnaire containing personal data, training characteristics and injury history in the last 12 months. Data were analyzed by descriptive statistics and logistic regression models. The prevalence of CrossFit-related musculoskeletal injuries was 24.0%; and the injury rate was of 0.80 injuries per 1,000 hours of exposure. The regions of the body most affected were the lumbar spine (33.3%), shoulders (31.3%) and knees (14.1%). The majority of CrossFitters participated in competitions (74.6%), had more than 12 months of experience in CrossFit® (62.7%), and trained up to 90 minutes a day (82.3%) for more than 4 days a week (76.8%). The variables that showed a significant association with CrossFit®-related musculoskeletal injuries were weekly training frequency (OR=2.25; 95% CI: 1.13-4.48) and regular physiotherapeutic care (OR=1.85; 95% CI: 1.11-3.07). The prevalence of musculoskeletal injury was 24.0%, and the most affected regions of the body were the lumbar spine, shoulders and knees. Training more than four days a week and do not receive regular physiotherapeutic care were associated with CrossFit-related musculoskeletal injuries.

Effectiveness of an Educational Intervention on Body Mechanics and its Importance Among Staff Nurses at Nekemte Referral Hospital, Wollega Oromia Region, Ethiopia

Practicing body mechanic technique is a very important aspect to protect the nurses from occupational related musculoskeletal injuries while performing the strenuous activities such as lifting, moving and transferring the patient. Objectives: The aim of the study is to assess the effectiveness of structured teaching program on knowledge regarding body mechanics and its importance among staff nurses at Nekemte Referral Hospital, Wollega, Oromia region, Ethiopia. Methodology: An institutional based one-group pre-test and post-test pre-experimental design was adopted; the samples were chosen by purposive sampling techniques, which consist of 80 staff nurses from Nekemte Referral Hospital at Wollega, Oromia Region, Ethiopia. A structured knowledge questionnaire was given to assess the knowledge on body mechanics and its importance, which followed by an intervention giving a structured teaching program on body mechanics and followed by administering the same questionnaire to assess the post test. Results: The overall mean post-test knowledge score regarding body mechanics and its importance (13.91 ± 2.30) was significantly higher than the overall mean pre-test knowledge score (10.27 ± 2.17), and the obtained t-value was 10.26 which was higher than the table value. There was no significant association found between the pre-test knowledge score with the demographic variables of staff nurses.

Work Related Musculoskeletal Injuries in Sonographers and Providers: The Grand Challenge

1 Assistant Professor, Director of Pain Medicine and Functional Rehabiliation Eglin Air Force Base, Intrepid Spirit Center, Assistant Professor, Department of Physical Medicine and Rehabilitation, Department of Family Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD

Functional Movement Screen Items Predict Dynamic Balance Under Military Torso Load.

Musculoskeletal injuries threaten military readiness and impose a significant financial burden. The functional movement screen (FMS), a 7-item, preparticipation screening tool, may aid in identifying compensatory movement patterns that can hinder physical performance and lead to injuries in active-duty military personnel. The primary aim of our study was to determine if items scores from the traditional FMS or a modified FMS (mFMS) obtained under loaded conditions can predict dynamic balance scores while wearing a military load. Thirty physically active adults (19 males and 11 females) who qualified for Army basic training completed unloaded and loaded FMS testing. Loaded balance was assessed using the Y balance test and the Biodex balance system. The mFMS and both loaded balance assessment protocols included a military load consisting of a standard issue rucksack (M.O.L.L.E.), kevlar helmet, and weighted vest (mass=24.2kg). mFMS item scores were significantly lower than FMS scores for six of the seven movement items. Both FMS and mFMS composite scores were correlated with Y balance scores (FMS: r=0.53, P=0.003; mFMS: r=0.37, P=0.043). Participants with higher composite scores (≥15) outperformed those with lower composite scores (≤14) for the FMS (P=0.006, d=1.16) and mFMS (P=0.031, d=0.75). Lasso penalized regression analyses revealed that (1) higher unloaded in-line lunge subscores predicted better Y balance scores, (2) loaded trunk stability push-up scores of three predicted worse balance on the Biodex, and (3) unloaded and loaded shoulder mobility scores of 3 predicted better performance on the Biodex balance system. The in-line lunge subscore from the FMS was the strongest predictor of torso-loaded balance, and the FMS may be more appropriate than a torso-loaded FMS battery when predicting torso-loaded balance among adults with body composition and fitness profiles similar to those of entering military recruits. These findings provide evidence supporting the use of the conventional FMS to identify active-duty personnel who exhibit greater balance deficits and may develop related musculoskeletal injuries while performing operational tasks that require the transport of heavy loads over long distances.

TCT-199 The Newton System: An Innovative Weight Supporting Device for the Prevention of Lead Apron–Related Musculoskeletal Injuries

Interventional cardiologists’ use of lead aprons for radiation protection has led to numerous musculoskeletal problems. Efficient prevention methods are lacking. It has been shown that thermal imaging could be used to ascertain muscular fatigue when wearing lead aprons. Aim: The purpose was to

A Pheochromocytoma in an Elite Collegiate Athlete

HISTORY: A 22-Year-old rugby union player presented to the Sports Medicine clinic complaining of a sore throat and skin rash over his back and upper arms for the past week. Further symptoms included rhinorrhoea and dry cough for the previous week, feeling “hot” (especially at night) and constant fatigue. The occurrence of these symptoms coincided with a regional measles outbreak. The clinical symptomatology persisted at subsequent visits over a period of 12 months and ranged from diarrhoea, skin rash, dry cough, headaches, anxiety, night sweats, rapid heart rate and exercise intolerance. Despite follow-up visits when he was asymptomatic, constant weight loss occurred over the period since he first presented. Except for weight loss and a single blood pressure reading of 135/90mmHg previously his medical history was uncompromized. He had a history of various sport related musculoskeletal injuries and there was no family history of note. PHYSICAL EXAMINATION: At initial physical examination athlete was afebrile, HR 100 b/min with a blood pressure reading of 110/60mmHg. Palpable tender occipital lymph nodes were present. Except for the non-purulent pharyngitis and maculopapular rash over the back and upper arms, the remainder of systemic physical examination was normal. Although normal or low BP measurements were recorded occasionally, he remained tachycardic and BP mildly elevated (135/90 mmHg) with the skin rash located over the trunk at most visits. DIFFERENTIAL DIAGNOSIS: Viral infection (measles, rubella, coxaci, EBV), Viral infection unspecified, Hyperthyroidism, Pulmonary tuberculosis, Vasomotor response to immune activation, Essential Hypertension, Pheochromocytoma. TEST AND RESULTS: FBC’s-normal, ESR-normal, CRP-normal, Rubella/Measles IGM (-), s-Urea (7.7mmol/L), s-Creatinine (108μmol/L), S-ALKP (136μmol/L), s-GGT (140μmol/L), S-ALT (101μmol/L), Coxaci-B AB (+), EBV (+), U-VMA-24hrs (50112 nmol/L), MIBG Scan negative (left) indicated a left adrenal gland mass, CT Abd (Triphasic)-well defined mass left adrenal gland FINAL WORKING DIAGNOSIS: Benign pheochromocytoma-left adrenal gland TREATMENT AND OUTCOMES: Laparoscopic adrenalectomy (left), Uncomplicated post operative recovery,Full return to sport

Prevalence, severity and characteristics of work-related musculoskeletal disorders amongst obstetrics and gynaecology professionals

Background: Backache is a common cause of morbidity among doctors and 50% of the obstetricians and gynaecologists suffering from this attribute it to working posture. Occupational injuries are poorly analyzed amongst these professionals. Work related injuries have adverse effect on health and work performance due to discomfort caused by pain. Awareness of ergonomics, correct posture and strategical assessment of risk factors is needed for the prevention of work related musculoskeletal injuries amongst obstetricians and gynaecologists.Methods: A survey based study was performed. Informed consent was taken for participation. The questionnaire included 16 questions categorised into: demographics; injury data; impact of injury; and general mental health. Hard copy of the questionnaire and online forms of the questionnaire were used to complete the data collection.Results: The response rate for the survey was 85% of the doctors who reported to have experienced pain in the last year. The most common site was back, which was followed by the neck and knees. 71.4% of doctors reported injuries attributed to work.Conclusions: The result demonstrates the prevalence of work related musculoskeletal injuries and their effects. These injuries are highly underreported. Ergonomics and work related injury prevention in this profession is a suggestion for solution as more data is needed regarding the analysis and risk factor assessment.

A pilot study to precisely quantify forces applied by sonographers while scanning: A step toward reducing ergonomic injury.

There is a significantly high rate of work-related musculsokeletal injuries in sonography professionals. To date, assessment of risk factors for work- related injuries in sonographers has been based primarily on surveys, subjective reports, and observational methods. There is a need to develop quantitative techniques to better understand risk factors and develop preventive interventions. We pilot tested a high-resolution force-measuring probe capable of precisely measuring forces applied through the transducer by sonographers and used this novel direct measurement technique to evaluate forces during abdominal imaging. Twelve sonographers with varied experience, ranging from 1-33 years, performed routine abdominal scans on 10 healthy volunteers who had varied body mass indices (BMI). Imaging was conducted using the force-measuring probe, which provided real-time measurement of forces, and angles. Data were compared by sonographer years of experience and subject BMI. In total, 47 abdominal examinations were performed as part of this study, and all images met standards for clinical diagnostic quality. The mean contact force applied across all exams was 8.2±4.3 Newtons (N) (range: 1.2-36.5 N). For subjects in the high BMI group (BMI>25, n = 4) the mean force was 10.5 N (range: 8.9-13.2 N) compared to 7.9 N (range: 5.9-10.9 N) for subjects with normal BMI (BMI = 18.5-25, n = 6). Similarly, the mean maximum force applied for subjects with high BMI (25.3 N) was significantly higher than force applied for subjects with normal BMI (17.4 N). No significant difference was noted in the amount of force applied by sonographers with more than 5 years of experience (n = 6) at 8.2 N (Range: 5.1-10.0 N) compared to less experienced sonographers (n = 6), whose forces averaged 8.1 N (Range: 5.8-10.0 N). It is feasible to directly measure forces applied by sonographers using a high-resolution force measurement system. Forces applied during abdominal imaging vary widely, are significantly higher when scanning subjects with high BMI, and are not related to sonographer years of experience. This force measurement system has the potential to provide an additional quantitative data point to explore the impact of applied forces on sonographer related musculoskeletal injury, particularly in conjunction with various body positions, exam types and force durations.

Work related musculoskeletal injuries sustained by Australian osteopaths: qualitative analysis of effects on practitioner health, clinical practice, and patient care

BackgroundThere is limited literature that explores the experiences of osteopaths injured while engaging in clinical practice. Evidence from other similar health professions has described the numerous effects of work-related musculoskeletal injuries (WRMI). Work-related musculoskeletal injury refers to trauma to joints, ligaments, muscles and tendons resulting from injury sustained while undertaking work duties. This research aimed to gain a contextualised understanding of the experiences of osteopaths who have sustained a work-related musculoskeletal injury while performing clinical practice.MethodThis research used a descriptive qualitative design. Participants were recruited as part of a larger cross-sectional study. Thirteen Australian osteopaths who had sustained a work-related musculoskeletal injury consented to participate in semi-structured interviews during May and June 2016. Thematic analysis was used to elicit important themes from the interview transcripts that had been recorded and transcribed verbatim. The qualitative accounts provided by the participants were coded for the impacts of their injuries on work, home life and leisure activities.ResultsThe participants provided detailed, contextual information about their injuries, including the contributing factors and the experience of living with a WRMI. The findings indicate that injured osteopaths often continue working because of financial commitments and their dedication to patient care. The participants offered insights into the challenges they faced due to the injury and the management strategies they used to deal with the impact on their work and personal life. The injuries were mostly unreported, the burden being carried by the participants and their families.ConclusionThis is the first research that explores the experiences of osteopaths who have sustained a WRMI. We anticipate that this research will encourage a broad and constructive discussion within the profession of the issues associated with WRMIs, including risk minimisation and injury prevention. Further research is warranted to understand the relationship between osteopaths training in ergonomics and injury prevention. This would lead to the development of guidelines and educational curricula addressing safe work for osteopaths.

Skeleton-free RULA ergonomic assessment using Kinect sensors

Ergonomic analysis methods and postural assessments assist in preventing work related musculoskeletal injuries. The primary outcome of this is to provide safer workplace environments and reduce the total number of work related injury occurrences. The dedicated marker- or sensor-based 3D motion capt ure solutions impose a series of portability and cost challenges when applied to work place environments. The Kinect motion recording system, which was introduced in the Xbox game console, provides a marker-less, portable and low-cost motion capture solution. This technology is capable of recording 3D coordinates of a moving body parts with an accuracy comparable to the state of the art systems. This paper investigates the utilisation of Kinect sensors for real time rapid upper limb assessment (RULA) to aid in ergonomic analysis for assembly operations in industrial environments. Unlike earlier similar attempts, the work presented in this paper does not rely on tracking body parts and extracting a kinematically sound skeleton. In this paper, identifying a RULA score is formulated as a semantic segmentation problem. A random decision forest (RDF) classifier is used to give each pixel a different RULA score based on postures captured with a Kinect camera. Results demonstrate a converging accuracy of 93% for the proposed method.

Current status and prevention of physical training related musculoskeletal injuries among Korea Military Academy cadets

Current status and prevention of physical training related musculoskeletal injuries among Korea Military Academy cadets

Incidence of musculoskeletal sport injuries in a sample of male and female recreational paddle-tennis players.

Nowadays paddle-tennis is practiced by the Spanish population, not only in a professional or semi-professional way, but also as a recreational sport. As occurs in tennis, the repetition of specific actions and gestures in paddle-tennis could be a factor associated with one or more types of musculoskeletal injuries in this population. The aim of this research was to describe the incidence and location of musculoskeletal injuries in a sample of Spanish recreational paddle-tennis and to explore a possible causality injury model, focusing on gender contribution. The sample was composed of 113 active paddle-tennis players, of whom 47.78% were men. The participants were asked about the injuries they had suffered during their paddle participation. Other variables such as age, physical position in the game and level of ability were taken into account. 85.4% of the players reported any sport paddle injury. The elbow and the lower back have been shown as the most common regions of injury, followed by knee and shoulder injuries. Female group reported a higher injury incidence due to playing paddle-tennis (OR=0.169; P=0.008). Significant differences also existed between the genders for calf injury location (OR=0.208; P=0.020). A global injury model explaining 22.5% of the variance has been observed. Gender seems to explain 7.4% of the variance. Being a medium-aged weighty right-handed woman seems to be the profile more likely to report paddle-tennis related musculoskeletal injuries. A lack of literature regarding paddle-tennis related injuries has been observed. It could be said that our results contribute substantially in this field.

Effects of Compliant Flooring Systems and Resident Weight on Hand Forces When Pushing Floor-Based Lifts and Wheelchairs among Long-Term Care Staff

Preliminary clinical findings suggest that compliant flooring may reduce the incidence and severity of fall- related injuries in long-term care (Knoefel et al., 2013) and acute-care settings (Drahota et al., 2013). However, there is concern that manoeuvring wheeled equipment on compliant flooring could expose care staff to potentially harmful pushing forces (Drahota et al., 2013; Wynn et al., 2011). We measured the external resultant hand forces (initial and sustained) required for female direct care staff to push two floor - based lifts (conventional manual and motor-driven) (n=14) or a wheelchair (n=14), loaded with passengers of average (67 kg) and ninetieth percentile (90 kg) resident weights, over four flooring systems: concrete + vinyl, compliant (1” SmartCells) + vinyl, concrete + carpet, and compliant + carpet. We observed an interaction between lift type and floor system for initial (p < 0.001) and sustained (p < 0.001) forces. Independent of resident weight, mean forces were lower for the motor-driven lift than the conventional lift on all flooring conditions (by 34.8 – 74.4 N for initial forces and by 14.1 – 64.5 N for sustained forces). With the vinyl overlay, initial forces were higher on compliant than concrete subflooring when using the conventional lift (mean difference = 44.7 N, 47.7% increase, p < 0.001) and motor-driven lift (29.8 N, 45.8% increase, p < 0.001). Similarly, with the vinyl overlay, sustained resultant forces were higher on compliant subflooring than concrete subflooring when using the conventional lift (39.0 N, 88.2% increase, p < 0.001) and motor-driven lift (9.7 N, 29.0% increase, p < 0.001). With the carpet overlay, the differences between compliant and concrete subfloors were less pronounced than with the vinyl overlay for the conventional lift (Finitial: 23.0 N higher, 14.9% increase, p < 0.001; Fsustained: 15.6 N higher, 18.7% increase, p < 0.001) and absent when using the motor-driven lift (Finitial: p = 0.975; Fsustained: p = 0.999). We also observed an interaction between resident weight and lift type for initial (p = 0.004) and sustained forces (p < 0.001). Independent of flooring system, Finitial was 18.6 N higher (13.5% increase, p < 0.001) and Fsustained was 11.7 N higher (14.3% increase, p < 0.001) for the ninetieth percentile weight than the average weight for the conventional lift. In contrast, there were no differences in Finitial (p = 0.200) and Fsustained (p = 0.100) between the average and ninetieth percentile weight conditions for the motor-driven lift. Similar trends were observed when participants pushed the wheelchair. In summary, this study found that compliant subflooring increased the external hand forces required for female direct care staff to push floor -based lifts and wheelchairs compared to concrete subflooring, and these increases in force were greater when pushing over vinyl than carpet overlay. This study also demonstrated that a motor-driven lift substantially reduced push forces compared to a conventional manual lift. Thus, motor-driven lifts may help to prevent work- related musculoskeletal injuries in long-term care facilities, especially in facilities with compliant flooring.

Evaluation of work Posture by RULA and REBA: A Case Study

The common occupational problem of the workers is musculoskeletal disorders in India. Currently the work is being carried out manually in most of the small scale industries therefore the issues of work related musculoskeletal disorders and injury in different body sites are of top priority. Postural analysis tool using Rapid upper limb assessment (RULA) and Rapid entire body assessment (REBA) were applied for assessment which indicates that the workers are working above the secure limit. This ergonomic study sheds light on posture analysis of the workers in small scale industry. The study was conducted on 15 workers engaged in small scale industry situated at MIDC Wardha (Maharashtra, India). Video tape on different activities of the workers was prepared and then images were cropped from it for the analysis. This study presents assessment of work posture of workers engaged in different activities of small scale industry. Evaluation of posture was carried out using RULA and REBA. Assessment is carried out using worksheet. The RULA method determined that the majority of the workers were under high risk levels and required immediate change. The REBA method determined that some of the workers were under lower levels and majority at high risk levels. Hence it was concluded that; there is a lack of ergonomics awareness and understanding in small scale industries. Evaluation using postural analysis by RULA and REBA indicates that the workers are working above the secure limit. The major percentage of the workers having awkward postures. Thus the workers are under moderate to high risk of Musculoskeletal disorders.

Contemplating change: a focus on manual handling in higher education

Manual handling activities in healthcare are a major risk factor for work related musculoskeletal injury and both graduate and undergraduate physiotherapists are at risk of injury. Current approaches to manual handling training lack evidence to support their efficacy in reducing musculoskeletal injury. Despite this, these approaches remain commonly used as occupational health and safety interventions both in industry and higher education. Issues associated with the education of undergraduate physiotherapy students on the topic of manual handling are the focus of this discussion paper. The authors propose that integration of behaviour change theory (based on the Trans-Theoretical Model of Change) with the development of knowledge and skills within the curriculum is worthy of consideration.