Neck Risk Factors Research Articles

Social isolation as a risk factor for neck and low back pain: a cotwin design

Social isolation as a risk factor for neck and low back pain: a cotwin design

Dynamic alterations of amplitude of low-frequency fluctuations in patients with chronic neck pain.

The pathogenesis of neck pain in the brain, which is the fourth most common cause of disability, remains unclear. Furthermore, little is known about the characteristics of dynamic local functional brain activity in cervical pain. The present study aimed to investigate the changes of local brain activity caused by chronic neck pain and the factors leading to neck pain. Using the amplitude of low-frequency fluctuations (ALFF) method combined with sliding window approach, we compared local brain activity that was measured by the functional magnetic resonance imaging (fMRI) of 107 patients with chronic neck pain (CNP) with that of 57 healthy control participants. Five pathogenic factors were selected for correlation analysis. The group comparison results of dynamic amplitude of low-frequency fluctuation (dALFF) variability showed that patients with CNP exhibited decreased dALFF variability in the left inferior temporal gyrus, the middle temporal gyrus, the angular gyrus, the inferior parietal marginal angular gyrus, and the middle occipital gyrus. The abnormal dALFF variability of the left inferior temporal gyrus was negatively correlated with the average daily working hours of patients with neck pain. The findings indicated that the brain regions of patients with CNP responsible for audition, vision, memory, and emotion were subjected to temporal variability of abnormal regional brain activity. Moreover, the dALFF variability in the left inferior temporal gyrus might be a risk factor for neck pain.This study revealed the brain dysfunction of patients with CNP from the perspective of dynamic local brain activity, and highlighted the important role of dALFF variability in understanding the neural mechanism of CNP.

Effect of Core Stability Exercise in Patients with Neckpain

Background: Pain is the most common symptom of which the human kind complaints. Neck pain is thesecond common condition cause of time off work after low back pain. According to 18% of the responders,the cause of their symptoms was unknown. The most frequently reported causes were ascribed to workingconditions (29%), tension: stress (29%) and a poor posture (21%). Sitting at work for more than 95% of theworking time seems to be a risk factor for neck pain.Aims and Objectives: To study the effectiveness of conventional physical therapy in patients with neckpain and to study the additive effect of core stability exercises on conventional physical therapy in patientswith neck pain.Materials and Methods: Study included 30 (Thirty) patients with chronic case of non-specific neck painbetween age group of 18-40 years. They were divided into 2 groups: Group A (Conventional therapy +Core stability exercises group) included 15 patients and Group B (Conventional therapy group) included 15patients by random sampling. The patients were treated for a period of 1 month. Pain was assessed by VisualAnalogue Scale, neck function was measured by Neck Disability Index and deep neck flexor strength wasmeasured by craniocervical flexion test.Results: Results showed that there was significant difference in VAS (P< 0.0001), NDI (P=0.002) and deepneck flexor strength (p< 0.0001) between Group A and B.Conclusion: Core stability exercise along with conventional physiotherapy was found to be more effectivein patients with chronic non-specific neck pain. So, these interventions can be applied in clinical setup incombination with conventional treatment for the better and long term improvements.

Aortic Neck Severity in Endovascular Aneurysm Repair is Determined by Multiple Morphological Characteristics

Introduction: The anatomy of the aortic neck influences the outcome of endovascular abdominal aneurysm repair (EVAR) and is defined severe (SPN) when at least one of the following characteristics, length, diameter, angle, and thrombus/calcification hamper a proper proximal sealing.1Aim of this study was to evaluate the individual role ofeach one of these characteristics on early and late EVAR outcomes. Methods: Data were retrieved from a monocentric inhouse database prospectively maintained from January 2012 to July 2018. Anatomical aortic neck risk factors (NRF) considered were short length (< 15 mm), wide diameter (>28 mm), severeb-angle (>60°), severe mural thrombus/calcification (>50%), not cylindrical shape (tapered/reverse tapered), Chaikof aortic neck severity score = 3 (CSS)1and analyzed in terms of early [adjunctive intraoperative aortic cuff (IAC) and neck-related technical success (TS), including type Ia endoleak (ELIa), renal coverage, open-conversion]and late complications [ELIa, freedom from proximal neck-related re-interventions (FFR), survival]. Results: Five-hundreds-ninety-fourpatients (mean age, 75±7 years) underwent elective EVAR for abdominal aortic aneurysm (mean diameter, 57±11 mm). The anatomical proximal aortic neck features are reported in Table 1. Fourteen (2.4%) IAC needed to be deployed during EVAR. By univariate analysis, short neck (p=.005), severeb-angle (p=.03) and CSS (p=.05) were related to IAC, and severe angle was confirmed as independent risk factor at the multivariate analysis (p=.05, 95% CI .117-1.022).Seven (1.1%) ELIa and 1 (0.2%) renal coverage occurred. Overall neck-related TS was achieved in 586 (99%) patients. At the univariate analysis, severe b-angle (p=.003), tapered shape (p=.003) and CSS (p=.003) significantly affected the neck-related TS, with severe b-angle confirmed as the only independent predictor (p=.009, 95% CI 1.634-30.49). At a mean follow-up of 30 ± 22 months, survival was 94%, 85% and 67% at 1, 3 and 5 years, respectively. Thirteen (2.2%) ELIa occurred during follow-up. At the univariate analysis,short neck (p=.005), wide neck (p=.03), severe angle (p=.02), tapered (p=.001) / reversed tapered (p=.02) shape and CSS (p=.004) were risk factors for late ELIa, and short neck (p=.04, 95% CI .081-.958), tapered (p=.001, 95% CI .006 - .268) and reversed tapered shape (p=.034, 95% CI .068 - .900) were independent risk factors at multivariate analysis. Of 34 (5.7%) late reinterventions, 12 (2%) were related to the proximal neck and were associated with severe b-angle (p=.02).Overall FFR was 98%, 95% and 86% at 1, 3 and 5 years, respectively. Severe b-angle was significantly related to IAC (p=.02), neck-related TS (p=.02) and re-interventions(p=.03), only if associated with short neck, and with late ELIa (p< .001) and re-interventions(p< .001) only if associated with wide neck. Conclusion: Severe b-angle is one of the main predictors of early outcomes, due to the higher risk of IAC and neck related TS. However, if it is associated with a neck length >15 mm and diameter < 28 mm is less prone to short- and long-term complications. Differently, ELIa, are mainly influenced by the short and non-cylindrical neck. Our results suggest that the severity of the aortic neck is better defined by the association of several risk factors rather than CSS alone.Table 1Anatomical proximal aortic neck features Disclosure: Nothing to disclose

RECOMMENDED TACTICS FOR THE EVALUATION OF POTENTIALLY MALIGNANT DISORDERS IN THE ORAL CAVITY

Since oral cavity, head and neck are relatively well-visualized anatomical sites, the dentists have multifold possibilities for the evaluation of the oral mucosa, face skin, lips, and neck lymph nodes during their routine work. Dentists are the specialists who are able to detect malignant tumors and refer patients to the oncologists.&#x0D; The aim of the article is to compare the clinical recommendations of the Ministry of Healthcare of Ukraine and the recommendation made by the American Dental Association (ADA) in their updated clinical practice guidelines for the evaluation of potentially malignant disorders in the oral cavity.&#x0D; Basic principles of the oncological alertness in dentistry, and the route organization of clinical patient. The usage of the classification of precancerous diseases, proposed by Ye.V. Borovskyi, M.F. Danilevskyi, A.L. Mashquillain (1991) is the first step of the oncological alertness in dentistry. The role of dentist is adjuvant and helps to identify a suspicious oral lesion. A pattern of action in such situations is referring patients directly to an oncologist, who will conduct a biopsy, histological examination and treat the cancer. Consequently, the attention of Ukrainian dentists is focused on precancerous lesions, but less attention is paid actually to the cancer. Responsibility for dispanserisation (clinical follow up) is carried mainly by dentists-surgeons without participation of orthopedists, pediatric dentists, and orthodontists. Those involve whole series of redirections of the patient among dentists themselves, before referring to the really necessary specialist, and it represents a negative item in the organization.&#x0D; In contrast to the algorithm provided by the Ministry of Healthcare of Ukraine, doing an immediate biopsy in patients with a suspicious oral lesion – or referring a patient to a specialist who can do that – remains the only most important recommendation made by the American Dental Association (ADA) in their updated clinical practice guidelines for the evaluation of potentially malignant disorders in the oral cavity.&#x0D; Epidemiological data in Ukraine, unlike the USA, is not enough to understand the real situation and to plan the measures of oncological alertness.&#x0D; Risk factors for malignant lesions in the oral cavity. The role of HPV-related cancer of the oral cavity is underestimated in Ukraine. “Over the past 20 years HPV infection has surpassed tobacco and alcohol as a major risk factor [for head and neck cancer],” the ADA authors note, and they estimate that HPV infection causes approximately 75% of all OPSCCs identified today. &#x0D; Adjunctive test for precancerous and cancerous cases in the oral cavity (include autofluorescence, tissue reflectance, vital staining, and salivary adjuncts) is recognized by the Ukrainian and American experts, as “adjuncts”, none of which was felt to be accurate enough to identify target lesions in the primary care setting. These methods do not exceed the accuracy of the histological examination.&#x0D; Conclusions. Regardless the geography, dentists have a good opportunity to assess patients for oral cancer caused by traditional head and neck risk factors. Dentists of Ukraine have a good opportunity at the primary care setting to get reports about head and neck cancer prevention, and to inform their patients. The clinical route of a patient with suspected oral lesions is flexible and is connected with appropriate consulting centers, which facilitates the activity of a dentist, but creates additional redirections instead of referring to the specialist immediately. Ukrainian dentists should take signs of HPV-related cancer – cancer that occur at the back of the throat, at the base of the tongue, and on the tonsils – are difficult if not impossible to visualize. So dentists must be trained not only to look inside the mouth but also to assess patients for tonsillar asymmetry.

Risk factors for neck pain among forklift truck operators: a retrospective cohort study

BackgroundNo previous research has been performed into neck pain among forklift operators. This is a common complaint among these workers, who number around 150,000 in Sweden and six million in Europe. The aim of the study was to examine long-term exposure to unnatural neck positions among forklift operators as a risk factor for neck pain.MethodsA retrospective cohort study was conducted of all eligible employees at a high-level warehouse. Forklift operators and office workers answered an 18-page questionnaire comprising questions about joint pain, work tasks, work postures and year of start for all items. By using person years in the exposed and less-exposed groups before start of neck pain we were able to calculate Incident Rate ratios for various exposures.ResultsForty nine percent of the forklift operators reported having experienced neck pain compared to 30 % of office workers. Being a forklift operator was associated with an increased risk of neck pain (OR = 5.1, 95% CI 1.4–18.2). Holding the head in an unnatural position resulted in significantly increased risks for neck pain, irrespective of type of position. The risks for neck pain remained after taking other ergonomic exposures and psychosocial aspects into consideration.ConclusionsThis is the first published study showing that forklift operators have an increased risk of neck pain. The results are therefore of significance for improving work schedules, the adjustment of work tasks for these workers and the design of the vehicles.

Work–family conflict and neck and back pain in surgical nurses

Objective. Surgical nurses’ work is physically and mentally demanding, possibly leading to work–family conflict (WFC). The current study tests WFC to be a risk factor for neck and lower back pain (LBP). Job influence and social support are tested as resources that could buffer the detrimental impact of WFC. Methods. Forty-eight surgical nurses from two university hospitals in Germany and Switzerland were recruited. WFC was assessed with the Work–Family Conflict Scale. Job influence and social support were assessed with the Copenhagen Psychosocial Questionnaire, and back pain was assessed with the North American Spine Society Instrument. Results. Multiple linear regression analyses confirmed WFC as a significant predictor of cervical pain (β = 0.45, p < 0.001) and LBP (β = 0.33, p = 0.012). Job influence and social support did not turn out to be significant predictors and were not found to buffer the impact of WFC in moderator analyses. Conclusion. WFC is likely to affect neck and back pain in surgery nurses. Work–life interventions may have the potential to reduce WFC in surgery nurses.

The Impact of Use of Dual Monitor Screens on 3D Head–Neck Posture and Activity of Neck Muscles

OCCUPATIONAL APPLICATIONS Computers with dual monitor screens are being increasingly used at many workplaces. Altered screen layout and increased viewing space associated with dual monitor screens may affect head–neck working postures and the activity of neck muscles. However, this problem has not been investigated in the past, and standard guidelines based on empirical data are not available for setting up a computer workstation with dual monitor screens. The present study compared the effects of single versus dual monitor screens on 3D head–neck postures and the activity of neck muscles in computer users. The results of this study have demonstrated that working on a video display unit workstation with dual monitor screens involved more rotated, asymmetric head–neck postures and higher activation of the anterior neck muscles than a video display unit workstation with a single monitor screen. TECHNICAL ABSTRACT Background: Among workstation design factors, placement of the computer monitor screen is the most frequently identified risk factor for neck and shoulder pain among video display unit users. One of the recent changes in video display unit workstation design that may influence the position of computer monitor screens is the use of dual monitors. Some studies have shown that user performance and efficiency was positively affected by the use of dual monitor screens; however, the effect of use of dual monitor screens on the biomechanical behavior of the head-neck region is currently unknown. Purpose: This study was aimed at understanding the effect of single versus dual monitor screens on 3D head–neck postures and the activity of neck muscles. Method: Ten healthy participants performed three types of video display unit tasks: (1) reading for 10 minutes, (2) typing for 5 minutes, and (3) performing search and find tasks for 10 minutes using single and dual monitor screens. An inertial motion-capture system was used to measure 3D head–neck postures. Activity of sternocleidomastoid and cervical trapezius muscles was recorded bilaterally using surface electromyography. Results: Use of dual monitor screens significantly increased head–neck rotation by 9.0° compared to the single monitor screen. The range of motion of head–neck rotation increased significantly by 8.4° using dual monitor screens compared to the single monitor screen. Corresponding to the increase in the head–neck rotation, a contralateral increase in the activity of the right sternocleidomastoid muscle was observed with the dual monitor screen layout. Activity of cervical trapezius muscle was not affected by the type of monitor layout. Conclusions: Increased activation of anterior neck muscles caused by asymmetrical, more rotated head–neck postures while operating a video display unit workstation with dual monitor screens may increase the risk of neck musculoskeletal disorders, especially with prolonged computer use.

Is peak exposure to computer use a risk factor for neck and upper-extremity symptoms?

Epidemiologic studies on physical exposure during computer use have mainly focused on average exposure duration. In this study, we aimed to relate periods of high peak exposure during computer use with the occurrence of neck-shoulder (NS) and arm-wrist-hand (AWH) symptoms. A prospective cohort study among 1951 office workers was carried out for two years, with periodical questionnaires and continuous measurements of computer input use. To define peak exposure, a distinction was made between peak days and weeks. Peak days were defined as days with a long duration of computer (ie, ≥4 hours) or mouse use (ie, ≥2.5 hours) or days with high frequency of mouse (ie, ≥20 clicks per minute) or keyboard use (ie, ≥160 keystrokes per minute). Weeks containing ≥3 peak days were considered peak weeks. Independent variables were numbers of peak days and peak weeks during a 3-month measurement period; dependent variables were self-reported NS and AWH symptoms during the following 3-month measurement period. Valid data were available for 2116 measurements of 774 office workers. No relation was found between any of the peak exposure parameters and AWH symptoms or with peak exposure in duration and NS symptoms. Most parameters referring to high frequency-related peak exposure were associated with less NS symptoms, but the effect estimates were very small and the confidence intervals close to the null. In this study, we found no indication that high peaks in computer use were related to the occurrence of NS or AWH symptoms.

Are peaks in computer use a risk factor for neck and upper extremity symptoms?

ObjectivesEpidemiologic studies on physical exposure during computer use have mainly focused on average exposure duration. In the current study, we aimed to relate periods of high peak exposure during computer...

Femoral neck fracture following ipsilateral total knee replacement: an analysis of associations and risk factors

There have been case reports of ipsilateral femoral neck fracture after total knee replacement. This occurrence has been attributed to risk factors such as rheumatoid arthritis, osteoporosis, steroid use and poor mobility. The aim of this study was to see if total knee replacement is a risk factor for neck of femur fracture and to study the associated risk factors. Twenty two patients who had sustained subsequent ipsilateral femoral neck fracture were identified from 1,362 patients who had previously undergone a posterior cruciate ligament-substituting total knee replacement. Clinical chart review and radiological assessment were performed. The average age of the patients was 77(±7) years and the fracture occurred 35(±27) months following the total knee replacement. Positive associations were identified between ipsilateral neck of femur fracture and total knee replacement (P 0.5). We also observed an increased risk of supracondylar fracture of the ipsilateral femur in patients who had sustained a neck of femur fracture following total knee replacement (P < 0.001).

Do work technique and musculoskeletal symptoms differ between men and women performing the same type of work tasks?

Musculoskeletal disorders are more common among women than among men. When comparing the difference between men and women in the prevalence of musculoskeletal disorders, methodological problems arise as men and women seldom perform the same type of activities, neither at work nor at home.The main objective of this cross-sectional case study was to compare work technique and self-reported musculoskeletal symptoms between men and women performing the same type of work tasks within a metal industry. Other factors, such as leisure activities, were also taken into consideration. Three data collection methods were used; questionnaire, interviews and systematic observations. The results from the observations revealed that women worked more frequently and during longer times with their hands above shoulder height than men. Working with hands above shoulder height is considered a risk factor for neck and shoulder disorders according to previous studies. Workplace design factors were probably a reason for differences in working technique between men and women. A higher proportion of women than men reported shoulder symptoms. Women spent more time on household activities than men, which indicates a higher total workload in paid and unpaid work.

Mouse versus keyboard use: A comparison of shoulder muscle load

Use of the computer mouse as an input device at visual display units is increasing, yet few studies could be found that directly addressed related musculoskeletal problems. Tasks similar to mousing, such as keyboarding, have been shown to result in static muscle loading of the shoulder, therefore the potential may also exist for increased neck and upper limb disorder with mouse use. The major aim of this pilot study was to compare the dominant shoulder muscle load from upper trapezius and anterior deltoid, gross postures and discomfort during mousing and keyboarding. This was performed in an effort to investigate whether use of the computer mouse is likely to be a risk factor for neck and upper limb disorders and the extent of this risk compared to keyboarding. Eight subjects performed a 10 min computer task with both mouse and keyboard input. Electromyographs of anterior deltoid and upper trapezius muscles, observations of posture and ratings of discomfort were collected. Group differences suggested increased anterior deltoid loads with mouse use and decreased trapezius loads. Also evident was the considerable inter-individual variation in muscle loads. This may help explain the pattern of work-related neck and upper limb disorders. Relevance to industry Investigation of shoulder muscle loading during mousing may help identify risk factors contributing to the development of potentially associated neck and upper limb disorders. Costly negative effects of these disorders to industry can include workers compensation claims, decreased productivity and reduced user satisfaction and well being. Once possible risk factors such as shoulder load are identified, approaches to their minimisation in industry may then be addressed.