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Chen, Yong. "Comparative Effectiveness of Alendronate and Risedronate on the Risk of Non-Vertebral Fractures in Older Women: An Instrumental Variables Approach: A Dissertation." eScholarship@UMMS, 2011. https://escholarship.umassmed.edu/gsbs_diss/582.
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Osteoporosis is a significant public health problem in the U.S. It not only affects the physical well-being of the older women but also creates a substantial financial burden for the health care system. The mainstay of osteoporosis medications is bisphosphonate treatment of which alendronate and risedronate are the most commonly prescribed in clinical practice. However, there have been no head-to-head randomized controlled trials (RCTs) evaluating the effects of these two bisphosphonates on fracture outcomes.
In the absence of RCTs, observational studies are necessary to provide alternative evidence on the comparative effectiveness between alendronate and risedronate on fracture outcomes. However, existing observational studies have provided inconclusive results partially due to residual confounding from unobserved variables such as patients’ health status or behavior. IV analysis may be one method to address unmeasured confounding bias in observational studies. While it has not been applied in bisphosphonate research, it has been used in research on a variety of other prescription medications.
In this dissertation, we applied the IV approach with an IV, date of generic alendronate availability, to evaluate the comparative effectiveness between alendronate and risedronate using observational data. This dissertation improved current research in several ways. First, we extended the IV approach to research on bisphosphonates. Second, compared with the current observational studies on bisphosphonates, this dissertation may more accurately estimate the relative effects between alendronate and risedronate because IV analysis is not subject to unmeasured confounding bias. Third, the study results extended the current evidence of the comparative effectiveness between the two most commonly prescribed bisphosphonates. Finally, we proposed and provided empirical evidence of a new IV that might be used for future prescription drug research.
The finding of this dissertation can be summarized from three aspects. First, we found that the evidence supported the validity of the date of generic availability as an IV in the study of bisphosphonates. Second, applying IV approach to study the comparative effectiveness of alendronate and risedronate, we found that alendronate and risedronate were comparable to reduce the risk of 12-month non-vertebral fractures in older women. Since generic alendronate is availability on the market while generic risedronate is not, promoting the use of alendronate may help reduce the healthcare cost and not sacrifice the clinical effectiveness. Finally, by comparing the proposed IV with a popular IV-physician preference, we found that both the calendar time IV based on the date of generic availability and the physician preference appeared to be valid. It might be practically easier to use the calendar time IV than the physician preference IV.
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Megale, Rodrigo Zunzarren. "Musculoskeletal pain and ageing." Thesis, The University of Sydney, 2017. http://hdl.handle.net/2123/19884.
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Musculoskeletal pain is a complex phenomenon involving biomechanics, inflammation and central pain processing pathways. The ageing process and ageing-related conditions can affect the course of musculoskeletal pain; conversely, the presence of pain can affect the ageing process, contributing to increased risks of adverse health outcomes. Despite the importance of managing pain in older adults, questions remain in terms of the best approach as the use of analgesics in this population is associated with increased risks of adverse events. This thesis contributes to the current knowledge of how age-related conditions such as multimorbidity and frailty interact with musculoskeletal pain and its management. The specific aims are: a) to determine whether frailty status is a risk factor for development of chronic or intrusive musculoskeletal pain; b) to determine whether pain increases the risk of developing the frailty phenotype; c) to describe the current management of vertebral compression fractures, a common and painful musculoskeletal condition typically seen in older adults; and d) to review and appraise the literature on the efficacy and safety of opioid analgesics for older adults with musculoskeletal pain.«br /» To address the first and the second aims, longitudinal data from the Concord Health and Ageing in Men Project (CHAMP), a prospective population based cohort study, were used.«strong» «/strong»A total of 1705 men aged 70 years or older, living in an urban area of New South Wales, Australia, were included in the CHAMP baseline study. Data on the presence of chronic pain (daily pain for at least 3 months), intrusive pain (pain causing moderate to severe interference with activities) and the criteria for the Cardiovascular Health Study frailty phenotype were collected in three waves, from January 2005 to October 2013. After adjusting for potential confounders, no association between frailty and future chronic or intrusive pain was observed. However, non-frail (robust and pre-frail) men who reported chronic pain were 1.60 (95% confidence interval (CI): 1.02 to 2.51, p=0.039) times more likely to develop frailty at follow-up, compared to those with no pain. For those reporting intrusive pain, the odds of developing future frailty were 1.64 (95%CI: 0.97-2.78, p=0.063). In summary, the presence of chronic pain increased the risk of developing the physical frailty phenotype in community-dwelling older men.«br /» To address the third aim, data from the Bettering the Evaluation And Care of Health (BEACH) program collected between April 2005 and March 2015 were used. Each year, a random national sample of approximately 1,000 GPs each recorded information on 100 consecutive patient encounters. All encounters at which vertebral compression fracture was managed were selected. Vertebral compression fractures were managed in 211 (0.022%; 95% CI: 0.018–0.025) of the 977,300 BEACH encounters recorded April 2005– March 2015. At encounters with patients aged 50 years or over, prescription of opioids analgesics (47.1 per 100 vertebral fractures; 95% CI: 38.4–55.7) was the most common management action. Prescriptions of paracetamol (8.2 per 100 vertebral fractures; 95% CI: 4-12.4) or non-steroidal anti-inflammatory drugs (4.1 per 100 vertebral fractures; 95% CI: 1.1-7.1) were less frequent. Non-pharmacological treatment was provided at a rate of 22.4 per 100 vertebral fractures (95% CI: 14.6-30.1). In summary, prescription of oral opioid analgesics remains the commonest general practice approach for vertebral compression fractures management, despite the lack of evidence to support this approach.«br /» The fourth aim concerns the efficacy and safety of using opioid analgesics in older adults with musculoskeletal pain. A systematic review with meta-analysis was performed including 23 randomized controlled trials with mean population age of 60 years or older that compared the efficacy and safety of opioid analgesics with placebo for musculoskeletal pain conditions. Opioid analgesics had a small effect on decreasing pain intensity (Standardised mean difference (SMD): -0.27; 95% CI: -0.33 to -0.20) and improving function (SMD: -0.27, 95%CI: -0.36 to -0.18), which was not associated with daily dose or treatment duration. The risk of adverse events was three times higher (OR: 2.94; 95% CI: 2.33 to 3.72) and treatment discontinuation four times higher (OR: 4.04; 95% CI: 3.10 to 5.25) in opioid treated patients. The systematic review concluded that, in older adults suffering from musculoskeletal pain, using opioid analgesics had only a small effect on pain and function at the cost of a higher risk of adverse events and treatment discontinuation. Therefore, for this specific population, the opioid-related risks may outweigh the benefits.«br /» From the results presented in the chapters of this thesis, important conclusions can be drawn: a) chronic musculoskeletal pain increases the risk of developing frailty in older adults and therefore, pain management should be part of a potential strategy to prevent frailty; b) despite being commonly prescribed for musculoskeletal pain in older adults, opioid analgesics alone are not likely to result in significant relief of chronic pain in these patients; c) instead of recommending opioid analgesics for persistent pain in older patients, guidelines should recommend comprehensive pain assessment, multimodal strategies and multidisciplinary approaches.
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Neville, Charlotte Eleanor. "Diet, lifestyle and musculoskeletal health." Thesis, Queen's University Belfast, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.534615.
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Payne, Nancy. "Musculoskeletal fitness, assessment and health implications." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk2/ftp01/MQ39219.pdf.
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Woods, Valerie. "Work inequalities and musculoskeletal ill health." Thesis, University of Surrey, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.435101.
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Logsdon, Susannah M. "The Incidence of Stress Fractures Among All Female Division I Athletes at Virginia Polytechnic Institute and State University." Thesis, Virginia Tech, 1999. http://hdl.handle.net/10919/42175.
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Stress fractures are common overuse injuries that have plagued athletes for many years. Often referred to as fatigue fractures, they are formed when the skeletal muscles fatigue and can no longer absorb the shock of repetitive pounding activities such as running. Stress fractures are most common in the weight-bearing bones of the lower extremities and are usually preceded by sudden increases or changes in training routines. Because they are most common in athletes who are least fit, it has been hypothesized that freshmen athletes who are not prepared for the increased physical demands of college athletics have the greatest risk for developing stress fractures compared to other academic classes. As of yet however, there have been very few studies that have examined the interaction of different variables such as academic class, on the formation of stress fractures. Therefore, the purpose of this study was to look at the incidence, frequency and pattern of stress fractures among the female athletes at Virginia Polytechnic Institute and State University. A retrospective analysis of 28 injury cases over four years revealed that 67% of the injuries occurred in freshmen athletes. The majority of these were in the lower leg and occurred in mid-season rather than pre-season. There were no relationships found between the variables sport, class, site and season and thus it was concluded that the incidence of injury was not affected by the interaction of these variables. However, the variables themselves did influence the formation of stress fractures. Ultimately, this study provided insight on what factors should be carefully examined in order to prevent future stress fracture injuries in collegiate athletes.Master of Science
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Prenzler, Elizabeth A. "Musculoskeletal adaptation to dance." Thesis, Queensland University of Technology, 1998. https://eprints.qut.edu.au/36748/1/36748_Prenzler_1998.pdf.
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Training can facilitate adaptive changes in the human body in response to activity, and these changes are evident in dancers. Unique manoeuvres inherent in the training programmes and performance of dancers have a significant influence on adaptive responses of the musculo-skeletal system. These set manoeuvres must be executed to be visually correct and often involve extreme ranges of movement, along with highly repetitive moves and frequent jumping. As dancers often begin training at an early age, physiological changes may take place as their bodies adapt to the positions and loads experienced. Additional factors that may influence adaptation are nutritional deficiencies, menstrual abnormalities, floor surfaces, inadequate footwear and hours of practice. The process of adaptation affects both the skeletal and muscular systems of the body and both positive and negative consequences are evident. Negative effects may be expressed by high injury rates, pertaining mainly to the lower limb and often chronic in nature. A significant factor in the cause of injury relates to the inability to effectively match training levels and intensities with positive adaptation. Bone mineral density (BMD) is one measure that can be taken to examine the adaptive response of bone. Following training, BMD has been found to increase at specific sites in response to loading at those sites. However, if the loads or frequency of loads are too great, failure may occur which may ultimateiy lead to stress fractures. Muscular adaptation to training may be evident by increases in muscular strength and the presence of muscle imbalance, although a precise definition of what constitutes an imbalance is unclear. Studies claim that symmetry in terms of strength should exist between muscles on opposite sides of the body, or that a specific ratio is found between the agonisUantagonist muscle groups of the same extremity. A discrepancy of more than 10% from expected values has been classified as an imbalance, potentially causing injury, and muscle imbalances have frequently been linked with dancing injuries. While many studies have investigated imbalance and injury, the relationship between them is still unclear and few studies have targeted specific muscle groups in the area of dance. It is necessary to prospectively examine this relationship and to more closely monitor training intensities and subsequent changes in the musculo-skeletal system. The purpose of this study was to investigate prospectively the relationship between factors commonly associated with injuries and the injury profiles of female dancers. The specific aims were to determine the anthropometry, skeletal status, muscular strength and flexibility characteristics of this group of dancers; to investigate the nature of the training program with respect to duration, intensity and frequency components; and to investigate the relationship between these factors and injury throughout a season of dancing.
Twenty female dance students from the Queensland University of Technology dance program and five female dance students from the Brisbane Dance Centre participated in the study. Over a 10-month period, five measures were taken at the beginning of the university semester. Muscie strength was measured using a Kin-Com isokinetic dynamometer including hip flexors/extensors, hip abductors/adductors, hip external/internal rotators, knee fiexors/extensors, ankle invertors/evertors and ankie plantar/dorsiflexors. These measures were also used to determine muscle strength ratio's. Passive ranges of movement of the above actions were measured using a Leighton flexometer. The Lunar densitometer was used to measure bone mineral density of the proximal femur and lumbar spine. Anthropometric measures were used to establish body composition and a submaximal fitness test was carried out at each of the test periods. Continual monitoring of activity levels and injuries occurred throughout the 10 month period. Training intensity was established by analysis of dance classes, activity diaries and force plate measurements.
The training hours of dancers were not significantly different between injured and non-injured dancers. It was noted however, that there was a discrepancy between the number of hours recorded and the actual number of active hours completed in the dancers training history, due to the nature of the dance classes. No skeletal injuries were recorded, therefore a comparison with BMD measures could not be made, however the values from the dancers from this study were higher than previous dance studies. Muscular characteristics in terms of strength and flexibility did show evidence of adaptation at certain joints compared to normal values, however they were different again to professional dancers. While a number of characteristics showed significant differences between injured and non-injured groups, these were viewed with caution due to the exploratory nature of the study. They did reveal however, that further investigation, particularly around the ankle joint and hip joint is warranted.
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Cruz, Eduardo José Brazete Carvalho. "Clinical reasoning in musculoskeletal physiotherapy in Portugal." Thesis, University of Brighton, 2010. https://research.brighton.ac.uk/en/studentTheses/5d5210fe-b5d1-4bc6-be38-aa29f91a1178.
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Clinical reasoning refers to the process in which practitioners, interacting with their patients, structure meaning, goals, and health management strategies based on clinical data, patient/client choices, and professional judgment and knowledge (Higgs & Jones, 2000, p. 11). Recent literature in physiotherapy and other allied health professions describes clinical reasoning as moving between cognitive and decision-making processes required to optimally diagnose and manage impairment and physical disabilities (hypothetic-deductive), and those required to understand and engage with patients' experience of disabilities and impairments (narrative reasoning). Clinical reasoning has been described as a universal process, common to all clinicians, in particular in the musculoskeletal area. However, clinical reasoning models emerged from research developed in specific and well-developed health care and professional cultures, such as Australia and United States, but there has been little discussion of their relevance and applicability to other cultural groups. Since research literature concerning physiotherapy in Portugal is almost non-existent, the aims of this study were twofold. The first aim was to explore clinical reasoning processes in a sample of Portuguese expert physiotherapists and secondly, to identify the current perspective of clinical reasoning held by educators and students, and how it is promoted in the undergraduate curriculum. The focus of the study was musculoskeletal physiotherapy. The research was influenced by the interpretative/constructivist paradigm of inquiry. The study consisted of three parts. In part one, the clinical reasoning approach of a sample of Portuguese expert therapists in musculoskeletal physiotherapy was investigated. The study focused on Portuguese clinicians' interaction with their patients in order to define and manage clinical problems. Data was collected through non-participant observation, semi-structured interviews, memos and field notes, and analysed thematically to identify and compare the practice and reasoning approach used. In part two, the generic aspects of undergraduate physiotherapy curricula in Portugal were analysed to provide a first insight of how educational programmes are organized and delivered in Portugal. Then, current musculoskeletal physiotherapy curricula in Portuguese entry-level physiotherapy programs were analysed by a questionnaire survey and documentary analysis. The specific aim was to capture the educational process and actions underlying current educational practice across undergraduate courses. In part three (Study 3 and 4), a sample of musculoskeletal lecturers and a sample of near graduate students were selected against criteria relating to the diversity of institutions that offer undergraduate physiotherapy courses (private versus public institutions) and length of time as a Physiotherapy education provider. Each course was examined from lecturer and student perspectives (through individual interviews and focus groups) to see what kind of clinical reasoning approach were most emphasised in relation to physiotherapy intervention in musculoskeletal conditions. Data were transcribed and subjected to thematic analysis. Findings showed some similar characteristics in the reasoning process of this group of Portuguese expert physiotherapists in the study when compared with other studies in the musculoskeletal physiotherapy field. However, findings also highlighted that Portuguese physiotherapists were more likely to use and value an instrumental approach to clinical practice. There was little evidence of patients sharing their perspectives about their problems or participating in clinical decisions made. An instrumental approach to reasoning and practice was also dominant in current Portuguese musculoskeletal programs as well in educators' and students' perspectives. The focus was on diagnostic and procedural strategies of reasoning with little emphasis on promoting student competences to involve patients in the decision making process. In this sense, the practice and reasoning of this sample could be seen as more instrumental than communicative. Perspectives on clinical reasoning differ between cultures and contexts of practice and this has implications for the quality of health care education and service delivery. This research has identified the current model of clinical reasoning in Portuguese Physiotherapy practice. The findings have significant implications for clinical practice in musculoskeletal physiotherapy, curriculum development, and wider education and health service policy.
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Sexton, Mary. "Patient-centredness : a conceptual framework for musculoskeletal physiotherapy." Thesis, University of Brighton, 2011. https://research.brighton.ac.uk/en/studentTheses/7b5f1fd2-cfdd-47ba-b05f-f5d4d12d96e1.
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Introduction The centrality of the patient to health care has been increasingly recognised both politically and professionally. Patient-centred care has become synonymous with high-quality care and a number of studies have reinforced patient's desire for, and the positive impact of the approach. Although the concept emerged over 30 years ago, it is still not clear what it is, upon what theories it is based, or how to measure it. Whilst the concept has been explored within medicine, nursing and other allied health professions, within physiotherapy there has only been minimal discussion. The aim of this research was to explore the meaning of patient-centred care in relation to low back pain, from the perspective of musculoskeletal physiotherapists. Methods Purposive sampling was initially used to select participants. Subsequently theoretical sampling was adopted whereby analysis of the data informed the sample selection. Nine musculoskeletal physiotherapists agreed to participate in the study. They ranged in experience from five to 25 years. Individual semi- structured interviews were adopted as the method of data collection. The interviews were audio taped and then transcribed verbatim. Analysis broadly followed the Grounded Theory approach outlined by Strauss and Corbin (1990). It consisted of a process of open, axial and selective coding. Constant comparative analysis resulted in the identification with a core category and three inter-related sub-categories and the development of a substantive theory of patient-centred care.
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Debiparshad, Kevin. "Musculoskeletal phenotype of Egr-1 deficient mice." Thesis, McGill University, 2010. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=86749.
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Early growth response protein-1 (EGR-1) is a transcription factor induced by stress or injury, mitogens, and differentiation factors. It has been shown to be regulated by various cytokines, growth factors and by ischemic/hypoxic stress as well as shear stress and mechanical injury. These regulators have been linked to both the development as well the degeneration of the musculoskeletal system, namely articlar cartilage, intervertebral discs (IVDs) and bone. Furthermore, Egr-1 has been shown to regulate the expression of collagens and enzymes affecting the extracellular matrix. Polymorphisms of DNA binding sites for EGR-1 have shown to be associated with both disc degeneration and osteoporosis. The aim of this study was to determine the affects of EGR-1 deficiency on articular cartilage, IVD and bone phenotype.Wild-type (+/+) C57Bl/6 or Egr-1-deficient (−/−) mice were sacrificed at the same age interval (8- to 9-months). Standard histological preparation and staining with Safranin-O/Fast Green were done. Also immuncohistochemistry was performed using anti-bodies to type X collagen, cleavage products of both type II collagen and aggrecan. Imaging of mice was with plain radiographs, bone mineral density measurements and microCT analysis.
Results revealed that these mice have differences including abnormal bone structure and density, structural and possibly compositional differences in articular cartilage and structural and biochemical changes in IVDs. This points to the importance of Egr-1 in the maintenance of normal bone, IVD and articular cartilage and makes it a possible target for initiating pathological conditions of these tissues.
La protéine de croissance EGR-1 (Early Growth Response protein-1, en anglais) est un facteur de transcription qui est induit par la tension ou la blessure, les facteurs mitogènes, et les facteurs de différenciation. EGR-1 est ainsi régulé par divers cytokines, facteurs de croissance, par les conditions ischémique, ainsi que la tension et les blessures mécaniques. Ces régulateurs ont été reliés au développement ainsi que la dégradation du système squeletto-musculaire, particulièrement le cartilage articulaire, les disques intervertébraux (DIV) et l'os. De plus, il a été démontré que EGR-1 peut réguler l'expression des collagènes et d'enzymes contribuant à la matrice extracellulaire. Le polymorphisme de séquences d'ADN pour les des sites d'attachements d'EGR-1 a démontré être associé avec la dégradation de disques intervertébraux et l'ostéoporose. L'objectif de cette étude était de déterminer l'effet d'une expression réduite d'EGR-1 sur les phénotypes du cartilage articulaire, les DIV, et l'os.
Les souris C57Bl/6 de phénotype sauvage (+/+) ou ceux avec une expression réduite d'EGR-1 (−/−) ont été sacrifiées au même intervalle d'âge (8 à 9 mois). La préparation histologique standard et la coloration avec Safranin-O/Fast Green a été fait. Aussi l'immunohistochimie a été exécuté avec des anticorps pour le collagène de type X, et les produits de clivage du collagène de type II ainsi que les aggrécanes. L'imagerie de souris a été faite avec les radiographies simples, les mesures de densité minéraux de l'os, et avec l'analyse de micro-tomodensitomètre.
Les résultats ont révélé que ces souris ont des différences incluant la structure et densité d'os anormaux, les différences structurelles et possiblement compositionnelles dans le cartilage articulaire, et les changements structurels et biochimiques dans les DIV. Ceci indique à l'importance d'EGR-1 dans l'entretien d'os normal, des DIV et le cartilage articulaire, et le rend une cible possible pour initier les conditions pathologiques de ces tissus.
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Wilkin, Linda Diane. "Rehabilitative influence of therapeutic ultrasound treatment on cellular markers of skeletal muscle regeneration following blunt contusion injury /." The Ohio State University, 2002. http://rave.ohiolink.edu/etdc/view?acc_num=osu1486463321624146.
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Knox, Terrance N. "Manual handling workload and musculoskeletal discomfort among warehouse personnel." ScholarWorks, 2010. https://scholarworks.waldenu.edu/dissertations/811.
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Work-related musculoskeletal disorders (WRMSD), specifically physical and muscular discomfort in the upper arm, lower arm, thigh, lower leg, wrist, shoulders, back, or neck, are among the most frequently reported workplace injuries in the United States. The dearth of knowledge about the types of workloads that may contribute to the development of WRMSD was the impetus of this research. The study aimed to identify antecedents of WRMSD among warehouse workers in order to reduce WRMSDs and increase productivity as expressed in a systems perspective on industrial health. The research questions examined the prevalence of specific WRMSDs, the relationship of high-risk tasks of warehouse personnel with WRMSD incidence, and the relationship of job category and workload with WRMSD incidence. The sample included 82 warehouse workers, stockroom clerks, and forklift drivers. MANOVA was used as the data analysis technique. The results showed that WRMSD was the most prevalent in the upper back, lower back, knees, and lower legs. Various high-risk tasks were linked to WRMSD incidence including repeatedly bending to lift objects was associated with discomfort in the lower back, shoulders, and lower legs. Furthermore, the use of pallets led to reduced discomfort and work interference in the hips and buttocks, upper arms, and knees. Proper lifting form may reduce WRMSD in the shoulders, forearms, lower back, and wrists in particular. The social change implications of this study stem from the notion that increasing the employers' WRMSD prevention awareness will lead to an increase in safety attentiveness and decrease workers' injuries.
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Düring, Alma, and Evelina Eklund. "Musculoskeletal Impairments at Piña Palmera, Mexico : Musculoskeletal Impairments at Piña Palmera, Mexico." Thesis, Hälsohögskolan, Jönköping University, HHJ, Avd. för rehabilitering, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-49634.
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Aim: The aim of this thesis was to map specific musculoskeletal impairments experienced by adults with physical disabilities at the Piña Palmera rehabilitation center in Mexico and to categorize them according to the ICF. Method: This cross-sectional study was conducted through observations and a survey based on predefined questions. The questions covered the individuals’ level of independence, pain, earlier treatment and biggest obstacle in daily life. The participants were observed when they received physical therapy or in their daily work at the center. The results from the survey and observations were later coded according to ICF. The participants were categorized and divided into groups depending on severity of their impairment: mild, moderate and severe. Results: This study includes 17 participants, nine women and eight men. The age of the participants ranged from 22 to 87 years (median: 44). The result shows an overview of the most common impairments that individuals’ who are visiting the center are affected by. The result also shows all the codes for each individual on the ICF-components. Conclusion: The group with severe loss of function had higher level of problem on the investigated components of ICF. Assistive device that should be prioritized is AFO.Syfte: Syftet med denna studie är att kartlägga de specifika muskuloskelettära funktionsnedsättningarna hos vuxna människor med fysiska funktionshinder på Piña Palmera rehabiliteringscenter i Mexico samt att kategorisera dessa enligt International Classification of Functioning, Disability and Health. Metod: Denna tvärsnittsstudie genomfördes genom observationer och ett förberett frågeformulär. Frågeformuläret innehöll frågor som rörde individens självständighetsförmåga, smärta, tidigare behandlingar samt deltagarens självupplevda största hinder i vardagen. Deltagarna observerades under besök hos fysioterapeuten eller i deras vardagliga arbete på centret. Resultatet från intervjun och undersökningarna kodades enligt ICF och deltagarna delades in i grupper beroende på grad av funktionsnedsättning, mild, medel eller svår. Resultat: Denna studie inkluderar 17 deltagare, nio kvinnor och åtta män. Deltagarnas ålder är mellan 22 och 87 år (median: 44 år). Resultatet ger en överblick på de vanligaste funktionshindren hos individer som besöker centret. Resultatet visar också kodningen för varje individ för fyra olika komponenter inom ICF. Slutsats: Gruppen med svår funktionsnedsättning hade högre problemgrad på alla ICF-komponenter, vilket var väntat. De assisterande hjälpmedlen som bör prioriteras för centret är AFO.
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Shamoto, Yoshiko. "Piano-related Musculoskeletal Disorders: Posture and Pain." Thesis, University of North Texas, 2013. https://digital.library.unt.edu/ark:/67531/metadc271895/.
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A healthy posture protects the body-supporting functions and prevents injuries by maintaining balance. Literature in performing arts medicine suggests that posture is an important component to prevent piano-playing related injuries. However, no known research studies have quantified, characterized, and compared pianists' sitting postures. The purpose of this study was to explore the relationship between playing postures and perceived pain among pianists. This study applied innovative approach using qualitative and quantitative methods, combined with three-dimensional motion captured technology. To examine risk factors related pianists' postures, three-dimensional motion-capture cameras recorded approximate 40 pianists' postures in various situations; data recordings were combined with a statistical method to investigate pain-posture correlations. Results reveal that the degrees of head-neck or body tilt angles are the tendency of risk factors for piano-playing related pain. Results from this study may have multiple practical implications among which are: (1) a risk factor pain, injury index, or indicator (2) a performance habits profile and (3) practice guide to prevention of piano-playing related musculoskeletal disorders.
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Jackson, Felisa. "Prevalence of Musculoskeletal Disorders in Third- and Fourth-Year Dental Students at the University of Health Science Center College of Dentistry." Digital Commons @ East Tennessee State University, 2021. https://dc.etsu.edu/etd/3925.
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The effects of pain suffered from musculoskeletal disorders by dental professionals may lead to reduced work hours, loss of production, and early retirement. Although third- and fourth-year dental students are provided lectures about musculoskeletal disorders, proper positioning and ergonomics, they are at an increased risk of developing MSD. This study was conducted to evaluate the prevalence on musculoskeletal disorders in third- and fourth-year dental students and to determine if third-year dental students experience more MSD pain than fourth-year dental students at the University of Tennessee Health Science Center College of Dentistry. A total of 50 third- and fourth- year dental students responded to the online questionnaire, 21 third-year dental students and 29 fourth-year dental students. Both third- and fourth-year dental students report experiencing MSD pain over the last twelve months. There was no statistically significant difference between MSD pain felt between third- or fourth-year dental students.
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Misra, Devyani. "Warfarin use and risk of osteoporotic fractures." Thesis, Boston University, 2012. https://hdl.handle.net/2144/21219.
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Thesis (M.S.M.) PLEASE NOTE: Boston University Libraries did not receive an Authorization To Manage form for this thesis or dissertation. It is therefore not openly accessible, though it may be available by request. If you are the author or principal advisor of this work and would like to request open access for it, please contact us at open-help@bu.edu. Thank you.OBJECTIVE: Prior studies examining the association of warfarin use and osteoporotic fractures have found conflicting results and have had methodological problems, such as confounding by indication and confounding by duration of warfarin use. Thus, we studied the association of warfarin use with fractures at the hip, spine and wrist, among older men and women with atrial fibrillation recruited from the general population, using rigorous statistical tools to overcome challenges faced by prior studies. METHODS: We included men and women ≥65 years with incident atrial fibrillation, without history of fracture, followed between 2000-2010 from The Health Improvement Network (THIN). Long-term warfarin use was defined in two ways: 1) warfarin use ≥ 1year; 2) warfarin use ≥3 years. Non-use was defined as no use of warfarin over the follow-up period. Propensity scores (PS) for warfarin use were calculated using logistic regression with long-term use of warfarin as the dependent variable and age, sex, body mass index (BMI), history of multiple falls, deep venous thrombosis, pulmonary embolism, heart failure, neuropsychiatric impairment, hyperthyroidism, estrogen use, beta blockers, corticosteroids, bisphosphonates, smoking and alcoholism as independent variables. Each warfarin user was then matched by PS to a non-user by the “greedy matching” method. Incidence rates were calculated for warfarin users and non-users. The association between long-term warfarin use and risk of hip, spine and wrist fractures was evaluated using Cox-proportional hazards models. RESULTS: Incidence rates of hip fracture were 5.21 and 6.20 per 1000 person-years among subjects with warfarin use >1 (n=20,346) and >3 (n=11,238) years, respectively. The hazard ratios of hip fracture for warfarin use >1 and >3 years were 1.08 (95% CI 0.87, 1.35) and 1.13 (95% CI: 0.84, 1.5), respectively. Similar findings were observed between warfarin use and risk of spine or wrist fracture. CONCLUSIONS: Long-term use of warfarin among older adults with atrial fibrillation is not associated with increased risk of osteoporotic fractures and thus, does not necessitate additional surveillance or prophylaxis.
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TUNCEL-KARA, E. SETENAY. "HEALTH AND SAFETY INTERVENTION FOR PREVENTION OF MUSCULOSKELETAL AND STRESS DISORDERS." University of Cincinnati / OhioLINK, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1178314152.
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Menzel, Nancy Nivison. "Manual Handling Workload and Musculoskeletal Discomfort in Nursing Personnel." [Tampa, Fla. : s.n.], 2001. http://purl.fcla.edu/fcla/etd/SFE0000020.
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Kanji, Nishma. "Gender differences in health care utilization by the elderly with musculoskeletal disorders." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0006/MQ45629.pdf.
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Koehoorn, Mieke. "Work organization factors and musculoskeletal symptoms and claims among health care workers." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0020/NQ46367.pdf.
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Cohen, Daniel Dylan. "Assessment of muscular fitness in relation to cardio-metabolic and musculoskeletal health." Thesis, London Metropolitan University, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.595302.
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Muscular fitness testing has been implemented in athletic settings and as part of youth fitness assessment in schools for many years, with the results compared to norms or used to monitor performance changes over time, Over recent decades however substantial ev idence has accumulated showing the value of muscular fitness testing for previously unrecognised purposes, In the area of health , muscular fitness and in particular muscular strength has emerged as an independent marker of metabolic risk iI?- youth, and as a risk factor for cardia-metabolic disease and mortality in adults. sitting alongside cardia-respiratory fitness (CRF) as a marker of current and future health. In the area of athletic performance, assessment of strength and strength imbalances has become part of injury risk screening needs analysis, underpinning the prescription of ("prehab',) exercises designe,d to reduce the risk of musculo-skeletal injuries during sports training or competition. The work I present here addresses these areas of strength related research focusing particularly on the use of two measures: the handgrip dynamometer in health related research and the isokinetic dynamometer in injury risk screening. Handgrip (HG) is a tool which we have shown can be employed in large-scale assessment of strength in school settings. I argue that HG has value not only as part of cross-sectional and longitudinal health surveillance but also as a means to engage children who do not excel in the widespread multi-stage fitness test that dominates "fitness" assessment. I highlight that in communities in developing countries, the associations between low strength and poor health may be compounded by low birth-weight. This warrants evaluation of interactions between strength, CRF, body composition and cardia-metabolic health and the potential benefit of interventions. With regard to isokinetic testing I show tbat the existing approach to hamstring injury risk screening emphasising peak strength may be enhanced by taking into consideration associations between fatigue and hamstring eccentric strength across the range motion. My work on strength assessment has already had media, educational and scientific "impact" and contributes to the existing knowledge in these two lines of research. I hope to have shown in this synthesis that it is also the basis for significant further developments.
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Wiitavaara, Birgitta. "Balancing intrusive illness : the experiences of people with musculoskeletal problems." Doctoral thesis, Umeå : Univ, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-1150.
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Allread, W. Gary. "An investigation of the relationship between personality and risk factors for Musculoskeletal Disorders /." The Ohio State University, 2000. http://rave.ohiolink.edu/etdc/view?acc_num=osu148819366523348.
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Vinnars, Bertil. "Scaphoid fractures : Studies on diagnosis and treatment." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Univ.-bibl. [distributör], 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8845.
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Mesa, Castrillon Carlos Ivan. "Prevalence and management of musculoskeletal pain in rural communities." Thesis, The University of Sydney, 2022. https://hdl.handle.net/2123/29629.
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The general aim of this thesis was to investigate the prevalence and management of chronic musculoskeletal conditions, such as low back pain and knee pain, in rural and remote communities. This thesis included one systematic review with a meta-analysis of observational studies, reported in Chapter Two, that compared the prevalence of physical activity, physical inactivity, and sedentary behaviour in a population of rural and urban Australian adults. Twenty-eight studies reporting data on a total of 515,532 people were included and found that the prevalence of physical inactivity was higher in rural populations (prevalence difference 4%; 95% confidence interval [CI] = 0.4% to 8%), but the prevalence of physical activity was similar in both rural and urban populations (prevalence difference 1%; 95% CI = -3% to 5%). The implications of the study call to action to reduce the urban-rural inequality of different factors that are associated with physical inactivity, such as the promotion of current guidelines focused on leisure physical activity, and adequate infrastructure for the safe practice of sports and exercise.
The systematic review reported in Chapter Three includes a meta-analysis of observational studies reporting on the worldwide prevalence of musculoskeletal conditions, such as back, knee, hip, and shoulder pain in rural compared to urban populations. The review included 42 studies from 24 countries with a total sample of 489,439 people, and the results indicated that hip (mean odds ratio [OR]=1.62; 95% CI=1.23 to 2.15), shoulder (OR=1.42; 95% CI=1.06 to 1.90), and overall musculoskeletal pain ([OR]=1.26, 95% [CI]= 1.08 to 1.47; n=302,911) were more prevalent in rural compared to urban populations. Similarly, although not statistically significant, back (OR=1.18, 95% CI=0.97 to 1.43; n=225,950), and knee pain (OR=1.13; 95% CI=0.83 to 1.52), but not neck pain (OR= 0.89; 95% CI=0.60 to 1.32), were more prevalent in rural compared to urban populations. Interestingly, the meta-analysis showed that adults in rural areas were less likely to seek treatment for musculoskeletal conditions than their urban counterparts (OR= 0.76; 95% CI=0.55 to 1.03).
Lastly, a randomised controlled trial that included 156 participants was conducted and reported in Chapters Four and Five of this thesis. The trial aimed to assess the effectiveness of a physiotherapist delivered real-time eHealth intervention including a physical activity plan and a personalised resistance training program, compared with usual care on physical function in adults with chronic non-specific low back pain or knee osteoarthritis in rural Australia. The primary outcome of physical function was assessed with the Patient-Specific Functional Scale, which ranges from 0 to 30, with higher values indicating better levels of function. The secondary outcome of disability was assessed using the Roland-Morris Disability Questionnaire in participants with low back pain, which ranges from 0 to 24 with lower scores indicating lower disability, or with the Western Ontario and McMaster Osteoarthritis Index in participants with knee osteoarthritis, which ranges from 0 to 68 (function section) with lower scores indicating lower disability. Health-related quality of life was measured using the Assessment of Quality of Life 8D instrument, which ranges from 0 to 100, with higher scores indicating better quality of life.
The findings reported in Chapter Five showed that the eHealth intervention provided greater clinically significant benefits in physical function at three months (mean between-group difference 3.63; 95% CI= 1.31 to 5.94), and at six months (mean between-group difference: 3.59; 95%CI= 1.14 to 6.05) compared to usual care. Disability (mean between-group difference 7.26; 95%CI= 2.14 to 12.38), and quality of life (mean between-group difference 4.51; 95%CI= 0.01 to 9.01) were statistically significantly higher in the eHealth intervention group at the three-month follow-up. No other between-group differences were found for the remaining outcomes or follow-ups. Results of this study showed that an eHealth intervention is effective to improve physical function, and can potentially complement and enhance face-to-face consultations, for people suffering from musculoskeletal pain in rural communities. These findings are important to inform rural and primary healthcare policy and clinical practice in Australia.
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La, Rochelle Natalie R. "Work-Related Musculoskeletal Disorders Among Dentists and Orthodontists." VCU Scholars Compass, 2017. http://scholarscompass.vcu.edu/etd/4765.
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WORK-RELATED MUSCULOSKELETAL DISORDERS AMONG DENTISTS AND ORTHODONTISTS
A thesis submitted in partial fulfillment of the requirements for the degree of
Master of Science in Dentistry at Virginia Commonwealth University.
by
Natalie R. La Rochelle
Thesis Director: Dr. Eser Tüfekçi, D.D.S., M.S., Ph.D., M.S.H.A.
Professor, Department of Orthodontics
Virginia Commonwealth University
Richmond, Virginia
May 2017
The practice of dentistry is physically demanding due to static and dynamic postures sustained daily throughout careers. Previous literature suggests that work-related musculoskeletal disorders (WMSD) are not solely the result of work habits, but also due to the individual, his or her physical makeup, genetics, and personal lifestyle. A 33-question survey was distributed to 1000 general dentists and 2300 orthodontists. The overall prevalence of work-related musculoskeletal disorders was greater among dentists and most often reported as self-limiting. Dentists were three times more likely than orthodontists to report WMSD; females were twice as likely to report WMSD than males; those who sought alternative medical remedies were two times more likely to have WMSD; and practitioners 6-10 years in practice were least likely to report WMSD. Dentists reported sitting in static positions longer than orthodontists; and those with WMSD indicated exercising, stretching, and seeking alternative health remedies more than dentists without WMSD.
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Borgström, Fredrik. "Health economics of osteoporosis /." Stockholm, 2006. http://diss.kib.ki.se/2006/91-7140-781-2/.
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Paananen, M. (Markus). "Multi-site musculoskeletal pain in adolescence: occurrence, determinants, and consequences." Doctoral thesis, Oulun yliopisto, 2011. http://urn.fi/urn:isbn:9789514296413.
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Abstract Recent studies in adults have shown that musculoskeletal (MS) pains are often experienced at several body sites. The number of pain sites has been shown to be proportional to poor health outcomes, such as functional ability and health-related quality of life (HRQoL). This study investigated the occurrence and persistence of MS pain in multiple locations, determinants of multiple-site pain, and the impact of multiple-site pain on HRQoL and health care use among adolescents aged 16 to 19. The data were based on three inquiries that were administered to the adolescents of the Northern Finland Birth Cohort 1986. MS pain was common and often occurred at multiple sites. Moreover, the majority of adolescents with multiple-site pain at 16 reported multiple-site pain also at 18. Multiple-site MS pains were strongly associated with psychosocial complaints, but also with high physical activity level, long sitting time, short sleeping time, smoking, and overweight. Emotional problems, behavioral problems, and high sitting time among males, and emotional problems, high physical activity level, short sleeping time, and smoking among females were predictive factors for the persistence of multiple-site pain. The likelihood of reduced HRQoL increased according to the number of MS pain sites. A trend toward an increase in health care use with the number of pain sites was also observed. Reporting pain in multiple sites in adolescence may have both peripheral (tissue origin) and central (pain experience) causes. As multiple-site pain in adolescence may predict subsequent MS morbidity, the adolescents who are at highest risk and also at the highest need of health promotion should be identified in further studiesTiivistelmä Aikuisväestössä tehtyjen tutkimusten perusteella tuki- ja liikuntaelimistön kivut esiintyvät tavallisesti usealla kehon alueella samanaikaisesti. Monikipuisuudella näyttää olevan epäedullisia vaikutuksia useisiin terveyteen liittyviin ilmiöihin kuten toiminta- ja työkykyyn sekä elämänlaatuun. Tässä tutkimuksessa tarkasteltiin monipaikkaisen tuki- ja liikuntaelinkivun esiintyvyyttä, pysyvyyttä ja riskitekijöitä sekä sen vaikutusta terveyteen liittyvään elämänlaatuun ja terveyspalvelujen käyttöön 16–19 –vuotiailla nuorilla. Tutkimuksen aineisto perustui kolmeen kyselyyn, jotka lähetettiin Pohjois-Suomen syntymäkohortti 1986:n nuorille. Tuki- ja liikuntaelinkipu oli yleistä ja esiintyi tavallisimmin usealla kehon alueella. Suurin osa nuorista, jotka raportoivat monen paikan kipua 16-vuotiaana, raportoivat sitä myös 18-vuotiaana. Monen kehon alueen tuki- ja liikuntaelinkipu yhdistyi voimakkaasti psykososiaalisiin tekijöihin, mutta myös korkeaan liikunta-aktiivisuuteen, runsaaseen istumiseen, vähäiseen uneen, tupakointiin ja ylipainoon. Käyttäytymisen- ja tunne-elämän häiriöt sekä runsas istuminen pojilla, ja tunne-elämän häiriöt, korkea liikunnallinen aktiivisuus, vähäinen uni sekä tupakointi tytöillä ennustivat monen kehon alueen kivun pysyvyyttä. Todennäköisyys heikentyneeseen terveyteen liittyvään elämänlaatuun lisääntyi suhteessa kipualueiden määrään. Myös terveyspalvelujen käytön ja kipualueiden lukumäärän välillä havaittiin yhteys. Monen paikan tuki- ja liikuntaelinkipua selittänevät sekä kudostasoiset että keskushermostolliset syyt. Koska laaja-alainen kipuoireilu nuoruudessa voi ennustaa myöhempiä tuki- ja liikuntaelinongelmia, riskiryhmiä ja samalla eniten terveyden edistämistä tarvitsevia nuoria tulisi pyrkiä jatkossa tarkemmin tunnistamaan
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Alberga, Angela. "Body composition, cardiorespiratory and musculoskeletal fitness in obese adolescents aged 14 to 18 years old." Thesis, University of Ottawa (Canada), 2008. http://hdl.handle.net/10393/27617.
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Background. The short and long term consequences of childhood obesity are widespread, highlighting the necessity of designing effective interventions targeting the specific needs of obese adolescents. Obese children typically score lower on standardized fitness tests compared to their leaner peers. However, few studies have looked at the relationship between musculoskeletal fitness and obesity in adolescents. Sex differences in fitness and adiposity are important considerations that also warrant further investigation.
Objectives. (1) To compare the musculoskeletal fitness of obese adolescents in the Healthy Eating Aerobic and Resistance Training in Youth (HEARTY) trial to the norms of the Canadian population in the same age group. A secondary objective was to determine the sex differences in musculoskeletal fitness in the HEARTY study. (2) To determine the sex differences in abdominal adiposity and cardiorespiratory fitness in male and female participants in the HEARTY study. The secondary purpose was to examine the relationship between cardiorespiratory fitness and fatness in male and female obese adolescents.
Methods. (1) 134 female and 45 male participants were included in the analysis. Musculoskeletal fitness was assessed by the Canadian Physical Activity Fitness and Lifestyle Approach guidelines to assess muscular strength, endurance and power. Measures of grip strength, push-ups, curl-ups, sit and reach and vertical jump in the HEARTY study were compared to the Canadian Musculoskeletal norms in their age group. (2) 94 female and 30 male participants were included in the analysis. VO2peak was assessed using a maximal treadmill protocol until exhaustion and abdominal adiposity was quantified by one-single cross-sectional image at L4-L5 by Magnetic Resonance Imaging.
Results. (1) Obese adolescents ranked lower on most musculoskeletal fitness tests compared to their non-obese peers. However, obese females had greater grip strength compared to their non-obese female counterparts. Males in the HEARTY study had a higher grip strength and vertical jump whereas females had higher push-up, and sit and reach scores than males in the HEARTY study. (2) HEARTY males had a greater BMI, visceral adipose tissue and higher VO2peak compared to females. There was no difference in abdominal subcutaneous adipose tissue between sexes.
Conclusions. (1) Male and female obese adolescents have lower musculoskeletal fitness compared to their non-obese peers. Obese males also had a lower overall musculoskeletal fitness ranking compared to obese females in the HEARTY study. (2) Obese male adolescents have greater visceral fat and higher cardiorespiratory fitness than obese females. However, it appears that the negative relationship between cardiorespiratory fitness and fatness is similar between male and female obese adolescents.
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Westman, Anders. "Musculoskeletal pain in primary health care : a biopsychosocial perspective for assessment and treatment." Doctoral thesis, Örebro : Örebro universitet, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-10084.
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Nilsson, Annika. "Musculoskeletal Pain among Health Care Staff : Riskfactors for Pain, Disability and Sick leave." Doctoral thesis, Uppsala University, Department of Public Health and Caring Sciences, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-8370.
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The present thesis is based on four empirical studies concerning risk factors related to musculoskeletal pain (MSP), disability, and sick leave among three non-clinical samples of health care staff. Initially, in Study I, cognitive, behavioural and environmental factors related to MSP of nurses' aides were explored. An experimental design including baseline, intervention and follow-ups among 29 nurses' aides working in a home for the elderly was used to evaluate effects of a workplace intervention based on cognitive behaviour (CB)- and conventional, symptom reduction principles. In Study II, a cross-sectional and correlational design was applied. A self-administered questionnaire was used to describe and investigate the relationship between risk factors and development of persistent pain, sick leave and long sick leave among 914 municipal health care staff. In Study III and IV, a longitudinal design was used among 200 registered nurses (RN) working in a county hospital to describe and predict pain, disability and sick leave. Data collection involved two self-administered questionnaires covering: 1) work and personal factors, pain, disability and sick leave at baseline and 2) valued life dimensions at baseline. The results showed that MSP was common among the staff. Study I showed positive effects among nurses' aides receiving the CB principles related to MSP compared with nurses' aides receiving the conventional principles. In Study II, pain severity and expectations to be working in 6 months were associated with persistent MSP and sick leave, respectively. In Study III, pain, disability and sick leave at baseline were the strongest predictors of pain, disability and sick leave at the three-year follow-up. In Study IV, the findings support the notion that individual values in different life domains are possible predictors of pain and disability.
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Greene, David, and res cand@acu edu au. "Exercise Type, Musculoskeletal Health and Injury Risk Factors in Adolescent Middle-Distance Runners." Australian Catholic University. School of Exercise Science, 2005. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp80.25092005.
Full textAbstract:
Adolescent growth provides a unique opportunity for the growing body to adapt to external stimuli. A positive association between site-specific mechanical loading and increases in regional bone mineral content (BMC) during adolescence is established. Mechanical loads associated with middle-distance running expose the skeleton to a combination of compressive ground reaction forces and muscular contraction. Previous studies concerning musculoskeletal health in active adolescents are largely limited to planar, two-dimensional measures of bone mineral status, using Dual X-ray Absorptiometry (DXA). Intrinsic bone material properties are accurately measured using DXA. However, the interaction between bone material and structural properties that reflects the mechanical integrity of bone require a combination of imaging modalities. Magnetic Resonance Imaging (MRI) provides a three-dimensional geometric and biomechanical assessment of bone. When MRI is integrated with DXA technology, an effective non-invasive method of assessing in vivo bone strength is achieved. The impact of high training volumes on musculoskeletal development of male and female adolescent athletes engaged in repetitive, high magnitude mechanical loading has not been investigated. Specifically, differences in total body and regional bone mineral, bone and muscle geometry, bone biomechanical indices and bone strength at differentially-loaded skeletal sites have not been compared between adolescent middle-distance runners and age- and gender-matched non-athletic controls. Objectives: (i) to investigate the effects of intense sports participation involving mechanical loading patterns on bone mineral, bone and muscle geometry, biomechanical indices and estimated regional bone strength between elite adolescent male and female middle-distance runners and age- and gender-matched controls (ii) to examine factors predictive of total body BMC, distal tibial bone geometry, distal tibial bone strength, and Hip Strength Analysis (HSA)- derived indicators of bone strength at the femoral neck. Methods: Four groups of 20 adolescents were comprised of male (mean (SD) age 16.8 ± 0.6 yr, physical activity 14.1 ± 5.7 hr.wk-1) and female (age 16 ± 1.7 yr, physical activity 8.9 ± 2.1 hr.wk-1) middle-distance runners, and male (16.4 ± 0.7 yr, physical activity 2.2 ± 0.7 hr.wk-1) and female (age 16 ± 1.8 yr, physical activity 2.0 ± 0.07 hr.wk-1) controls. Total body and regional BMC were calculated using DXA. Distal tibial bone and muscle cross-sectional areas (CSA) were assessed using MRI. To calculate distal tibial bone strength index (BSI), a region of interest representing 10% of the mid distal tibia was analysed for DXA-derived bone mineral and was combined with bone geometry and biomechanical properties from MRI assessments. Calculations for femoral neck strength were acquired from DXA-derived HSA software. Results: No differences were found between male athletes and controls for unadjusted BMC at total body or regional sites. After covarying for fat mass (kg), male athletes displayed greater BMC at the lumbar spine (p = 0.001), dominant proximal femur (p = 0.001) and dominant leg (p = 0.03) than male controls. No differences were found in distal tibial bone geometry, bone strength at the distal tibia or HSA-derived indicators of bone strength at the femoral neck between male athletes and controls. Lean tissue mass and fat mass were the strongest predictors of total body BMC (R2 = 0.71), total muscle CSA explained 43.5% of variance in BSI at the distal tibia, and femur length and neck of femur CSA explained 33.4% of variance at the femoral neck. In females, athletes displayed greater unadjusted BMC at the proximal femur (+3.9 ±1.4 g, p = 0.01), dominant femoral neck (+0.5 ± 0.12 g, p = 0.01) and dominant tibia (+4.1 ± 2.1 g, p = 0.05) than female controls. After covarying for fat mass (kg), female athletes displayed greater (p = 0.001) total body, dominant proximal femur and dominant leg BMC than female controls. Female athletes also showed greater distal tibial cortical CSA (+30.9 ± 9.5 mm2, p = 0.003), total muscle (+240.2 ± 86.4 mm2, p = 0.03) and extensor muscle (+46.9 ±19.5 mm2, p = 0.02) CSA, smaller medullary cavity (-32.3 ± 14.7 mm2, p = 0.03) CSA and greater BSI at the distal tibia (+28037 ± 8214.7 g/cm3.mm4, p = 0.002) than female controls. Lean tissue mass and fat mass were the strongest predictors of total body BMC (R2 = 65), hours of physical weekly activity and total muscle CSA explained 58.3% of the variance of distal tibial BSI, and neck of femur CSA accounted for 64.6% of the variance in a marker of femoral neck HSA. Conclusion: High training loads are associated with positive musculoskeletal outcomes in adolescent middle-distance runners compared to non-athletic controls. Exposure to similar high training loads may advantage female adolescent athletes, more than male adolescent athletes compared with less active peers in bone strength at the distal tibia.
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Greene, David. "Exercise type, musculoskeletal health and injury risk factors in adolescent middle-distance runners." Thesis, Australian Catholic University, 2005. https://acuresearchbank.acu.edu.au/download/20c126266dc3e703ede019fdb5ca4fa7a4da311765824692f2ab323fca88bfc9/7737634/02whole.pdf.
Full textAbstract:
Adolescent growth provides a unique opportunity for the growing body to adapt to external stimuli. A positive association between site-specific mechanical loading and increases in regional bone mineral content (BMC) during adolescence is established. Mechanical loads associated with middle-distance running expose the skeleton to a combination of compressive ground reaction forces and muscular contraction. Previous studies concerning musculoskeletal health in active adolescents are largely limited to planar, two-dimensional measures of bone mineral status, using Dual X-ray Absorptiometry (DXA). Intrinsic bone material properties are accurately measured using DXA. However, the interaction between bone material and structural properties that reflects the mechanical integrity of bone require a combination of imaging modalities. Magnetic Resonance Imaging (MRI) provides a three-dimensional geometric and biomechanical assessment of bone. When MRI is integrated with DXA technology, an effective non-invasive method of assessing in vivo bone strength is achieved. The impact of high training volumes on musculoskeletal development of male and female adolescent athletes engaged in repetitive, high magnitude mechanical loading has not been investigated. Specifically, differences in total body and regional bone mineral, bone and muscle geometry, bone biomechanical indices and bone strength at differentially-loaded skeletal sites have not been compared between adolescent middle-distance runners and age- and gender-matched non-athletic controls.;Objectives: (i) to investigate the effects of intense sports participation involving mechanical loading patterns on bone mineral, bone and muscle geometry, biomechanical indices and estimated regional bone strength between elite adolescent male and female middle-distance runners and age- and gender-matched controls (ii) to examine factors predictive of total body BMC, distal tibial bone geometry, distal tibial bone strength, and Hip Strength Analysis (HSA)- derived indicators of bone strength at the femoral neck. Methods: Four groups of 20 adolescents were comprised of male (mean (SD) age 16.8 REPLACE2 0.6 yr, physical activity 14.1 REPLACE2 5.7 hr.wk-1) and female (age 16 REPLACE2 1.7 yr, physical activity 8.9 REPLACE2 2.1 hr.wk-1) middle-distance runners, and male (16.4 REPLACE2 0.7 yr, physical activity 2.2 REPLACE2 0.7 hr.wk-1) and female (age 16 REPLACE2 1.8 yr, physical activity 2.0 REPLACE2 0.07 hr.wk-1) controls. Total body and regional BMC were calculated using DXA. Distal tibial bone and muscle cross-sectional areas (CSA) were assessed using MRI. To calculate distal tibial bone strength index (BSI), a region of interest representing 10% of the mid distal tibia was analysed for DXA-derived bone mineral and was combined with bone geometry and biomechanical properties from MRI assessments. Calculations for femoral neck strength were acquired from DXA-derived HSA software. Results: No differences were found between male athletes and controls for unadjusted BMC at total body or regional sites. After covarying for fat mass (kg), male athletes displayed greater BMC at the lumbar spine (p = 0.001), dominant proximal femur (p = 0.001) and dominant leg (p = 0.03) than male controls. No differences were found in distal tibial bone geometry, bone strength at the distal tibia or HSA-derived indicators of bone strength at the femoral neck between male athletes and controls.;Lean tissue mass and fat mass were the strongest predictors of total body BMC (R2 = 0.71), total muscle CSA explained 43.5% of variance in BSI at the distal tibia, and femur length and neck of femur CSA explained 33.4% of variance at the femoral neck. In females, athletes displayed greater unadjusted BMC at the proximal femur (+3.9 REPLACE21.4 g, p = 0.01), dominant femoral neck (+0.5 REPLACE2 0.12 g, p = 0.01) and dominant tibia (+4.1 REPLACE2 2.1 g, p = 0.05) than female controls. After covarying for fat mass (kg), female athletes displayed greater (p = 0.001) total body, dominant proximal femur and dominant leg BMC than female controls. Female athletes also showed greater distal tibial cortical CSA (+30.9 REPLACE2 9.5 mm2, p = 0.003), total muscle (+240.2 REPLACE2 86.4 mm2, p = 0.03) and extensor muscle (+46.9 REPLACE219.5 mm2, p = 0.02) CSA, smaller medullary cavity (-32.3 REPLACE2 14.7 mm2, p = 0.03) CSA and greater BSI at the distal tibia (+28037 REPLACE2 8214.7 g/cm3.mm4, p = 0.002) than female controls. Lean tissue mass and fat mass were the strongest predictors of total body BMC (R2 = 65), hours of physical weekly activity and total muscle CSA explained 58.3% of the variance of distal tibial BSI, and neck of femur CSA accounted for 64.6% of the variance in a marker of femoral neck HSA. Conclusion: High training loads are associated with positive musculoskeletal outcomes in adolescent middle-distance runners compared to non-athletic controls. Exposure to similar high training loads may advantage female adolescent athletes, more than male adolescent athletes compared with less active peers in bone strength at the distal tibia.
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Hallberg, Inger. "Health-Related Quality of Life in Postmenopausal Women with Osteoporotic Fractures." Doctoral thesis, Linköpings universitet, Omvårdnad, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-51524.
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Background: The global burden of osteoporosis includes considerable numbers of fractures, morbidity, mortality and expenses, due mainly to vertebral, hip and forearm fractures. Underdiagnosis and undertreatment are common. Several studies have shown decreased health-related quality of life (HRQOL) after osteoporotic fracture, but there is a lack of data from long-term follow-up studies, particularly regarding vertebral fractures, which are often overlooked despite patients reporting symptoms. Aim: The overall aim of this thesis was to evaluate the usefulness of a recent low-energy fracture as index event in a case-finding strategy for osteoporosis and to describe and analyse long-term HRQOL in postmenopausal women with osteoporotic fracture. The specific aims were to describe bone mineral density and risk factors in women 55-75 years of age with a recent low-energy fracture (I), estimate the impact of osteoporotic fractures on HRQOL in women three months and two years after a forearm, proximal humerus, vertebral or hip fracture (II), investigate the changes and long-term impact of vertebral or hip fracture on HRQOL in women prospectively between two and seven years after the inclusion fracture (III), and describe how HRQOL and daily life had been affected in women with vertebral fracture several years after diagnosis (IV). Design and methods: Data were collected from southern Sweden between 1998 and 2008. A total of 303 women were included in Study I, and this group served as the basis for Studies II (n=303), III (n=67), and IV (n=10). A cross-sectional observational, case-control design (I), and a prospective longitudinal observational design (II-III) were used. In Study IV a qualitative inductive approach with interviews was used and data were analysed using a qualitative conventional content analysis. Results: The type of recent fracture and number of previous fractures are important information for finding the most osteoporotic women in terms of severity (I). Hip and vertebral fractures in particular have a significantly larger impact on HRQOL evaluated using the SF-36 than do humerus and forearm fractures, both during the three months after fracture and two years later, compared between the different fracture groups and the reference population (II). Women who had a vertebral fracture as inclusion fracture had remaining pronounced reduction of HRQOL at seven years. At the mean age of 75.5 years (±4.6 SD), the prevalence of vertebral fracture suggests more negative long-term impact on HRQOL, more severe osteoporosis and a poorer prognosis than a hip fracture does, and this effect may have been underestimated in the past (III). Study IV demonstrates that the women’s HRQOL and daily life have been strongly affected by the long-term impact of the vertebral fracture several years after diagnosis. The women strive to maintain their independence by trying to manage different types of symptoms and consequences in different ways. Conclusions and implications: Type and number of fractures should be taken into account in the case-finding strategy for osteoporosis in postmenopausal women between 55 and 75 years of age. The long-term reduction of HRQOL in postmenopausal women (age span 55-75 yr) with vertebral fracture emerged clearly, compared to women with other types of osteoporotic fractures and references in this thesis. The results ought to be taken into consideration when developing guidelines for more effective fracture prevention and treatment, including non-pharmacological intervention for women with osteoporotic fractures, with highest priority placed on vertebral fractures and multiple fractures, to increase or maintain HRQOL.
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Bruno, Alexander G. "Investigation of spine loading to understand vertebral fractures." Thesis, Massachusetts Institute of Technology, 2015. http://hdl.handle.net/1721.1/98727.
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Thesis: Ph. D., Harvard-MIT Program in Health Sciences and Technology, 2015.Cataloged from PDF version of thesis.
Includes bibliographical references.
Vertebral fractures are the most common complication of osteoporosis and are associated with significant pain, height loss, disfigurement, respiratory impairment, depression, and decreased life span. Despite the high personal and societal costs of vertebral fractures, little is known regarding their biomechanical etiology. In particular, whereas much is known about the determinants of vertebral strength, little is known about the in vivo loading of the spine that may contribute to vertebral fracture. Prior efforts to understand the possible contribution of spine mechanics to vertebral fractures have been limited by the inability to accurately assess in vivo spinal loading, especially in the thoracic region. Thus, the overall goal of this work was to improve the understanding of vertebral fractures through detailed analysis of spinal loading. We first developed and validated a novel musculoskeletal model capable of predicting forces in the thoracolumbar spine during daily activities. Model-derived predictions of vertebral compressive loading and trunk muscle activity were highly correlated with previously collected in vivo measurements of pressure, vertebral compression from telemeterized implants, and trunk muscle myoelectric activity from electromyography. To gain insights into how individual variation in trunk anatomy influences vertebral loading, we developed a robust set of methods for rapid, automated generation of subject-specific musculoskeletal models of the thoracolumbar spine using computed tomography based measurements of spine curvature and trunk muscle morphology. Using these subject-specific models, we found that normal variations in spine curvature and muscle morphology in the adult population have a large effect on vertebral loading predictions. Specifically, we found that increasing thoracic kyphosis and reducing lumbar lordosis, changes that commonly occur with age, were both associated with higher spinal loads. Lastly, we used our musculoskeletal model to describe how vertebral loading and the factor-of-risk (load-to-strength ratio) vary along the spine for a large number of activities. For a majority of activities, the highest loads and factor-of- risk were in the thoracolumbar region, which is the spine region with the highest incidence of vertebral fracture. Further, we identified a unique biomechanical mechanism responsible for the high loads in this region.
by Alexander G. Bruno.
Ph. D.
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Reed, Suzanne Rene. "Epidemiology of joint injuries in thoroughbred racehorses in training." Thesis, Royal Veterinary College (University of London), 2011. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.559071.
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O'Gorman, Patricia M. "Economic evaluation of arthroplasty choice for femoral neck fractures." Thesis, Queensland University of Technology, 2016. https://eprints.qut.edu.au/98419/1/Patricia_O%27Gorman_Thesis.pdf.
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This thesis examined the cost-effectiveness of different types of arthroplasty and fixation methods used to treat femoral neck fractures in the Australian health system. Using a decision analytic model, the study measured the costs and health outcomes associated with different treatment options to determine which prostheses led to cost-effective care.
Cemented fixation of prostheses was found to be more cost-effective than uncemented fixation. The cost-effectiveness of different arthroplasties varied with age and whether QALYs or revision surgeries were the health outcome assessed.
The results support recommendations that cemented prostheses be used for femoral neck fractures. Further research into defining population groups, collecting preference based values of health states and costs would be beneficial to inform further research into this area.
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Carey, Shannon De Ann. "Development of an Evidence-Based Protocol for the Management of Acute Vertebral Fragility Fractures." ScholarWorks, 2017. https://scholarworks.waldenu.edu/dissertations/4049.
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Vertebral fragility fractures are common, affecting approximately 50% of all postmenopausal women and 33% of men over the age of 50, and are the most common type of fracture seen in osteoporosis. The management of vertebral fragility fractures in the acute care setting is lacking in standardization, in the use of evidence-based practice, and in addressing the underlying cause of osteoporosis. The purpose of this project was to develop an evidence-based protocol to standardize the care of the vertebral fragility fracture in the acute care setting. This protocol included patient education, fall risk assessment, screening for osteoporosis, and follow up with an osteoporosis clinic for comprehensive management once discharged. This project used the Donabedian model to provide a conceptual framework for evaluating the structure, process, and outcomes related to the practice problem. This quantitative study involved 10 participants that were selected using purposive sampling and used process control charting to show compliance with elements of the guideline, and descriptive data to depict process change. Guideline compliance was measured over an 8-week period and indicated successful implementation of fall risk assessment with a 100% compliance rate and osteoporosis screening with an 80% compliance rate. Compliance with fracture education and securement of follow up were difficult to ascertain in the 8-week period and non-compliance evident. In conclusion, two elements of the guideline showed to be an unstable process and further work is necessary to improve. Positive social change may result from empowering nurses by education and giving them autonomy to use evidence-based practice to decrease the risk for secondary vertebral fragility fractures.
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Jeffries, Jared A. "Speeding Diagnosis and Saving Money Using Point of Care Ultrasound Rather Than MRI for Work-related MSK Injuries." Scholar Commons, 2019. https://scholarcommons.usf.edu/etd/7816.
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This descriptive retrospective cohort study utilized a large workers comp insurer database. All MRI's performed on peripheral joints during calendar year 2017 that were (a) 2 weeks after the initial clinic visit, or (b) greater than 6 weeks after injury, but (c) not more than 3 months after the date of injury were evaluated in this study. Individual diagnoses rendered on MRI reports for these cases were categorized as to whether ultrasound alone or ultrasound + xray could adequately provide the same diagnoses. Results showed that, ultrasound + xray would be able to provide all of the same diagnoses compared to MRI in 54% of cases vs 33% of cases using ultrasound alone, highlighting the utility of using ultrasound and xray together. The proportion of cases where ultrasound + xray could reasonably be substituted for MRI increases to 70% overall when less severe diagnoses, considered not likely to change management, were excluded from analysis. If point of care ultrasound was performed for all 1482 cases with subsequent MRIs pursued in only 30% of cases, a cost savings between $456,186 and $331,698 would be realized, translating to $308 to $224 per patient. Additionally, if ultrasound + xray was performed at the point of care during the first clinic visit for an injury, the definitive diagnoses could be reached on average 33.3 days earlier. In total, these results suggest a significant proportion of musculoskeletal workers comp injuries could be accurately and completely evaluated at the point of care using ultrasound and xray together. This could yield greater provider and patient confidence in the diagnosis and treatment plan as well as more expeditious accurate diagnoses leading to reductions in both direct and indirect costs.
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Eliasson, Kristina. "Occupational health services in the prevention of musculoskeletal disorders : Processes, tools and organizational aspects." Licentiate thesis, KTH, Ergonomi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-200392.
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Work-related musculoskeletal disorders are associated with high costs and it is essential to prevent them. Occupational Health Services(OHS) provide expert services regarding work environment, health and rehabilitation of work related disorders. Risk assessments of the work environment can be an initial step for preventive measures, and ergonomists can be assigned by clients to assess exposures in the work environment. For such assignments different tools can be used. The aim of this thesis was to explore prerequisites, processes and practices of OHS consultants in Sweden within the domain of primary prevention of work-related musculoskeletal disorders. This was explored through the work of ergonomists in their role of assessing ergonomics risks. The research methodology was both quantitative and qualitative. Data collection includes a web questionnaire, semi-structured interviews and inter- and intra-observer reliability tests. The results shows that ergonomics risk assessments were most commonly initiated reactively and a systematic work methodology for the risk assessment process was often lacking. Swedish ergonomists used only a few standardized tools for risk assessment. The Ergonomics provision from the Swedish Work Environment Authority, AFS-98, was widely used, but other observation-based tools were used far less often. Ergonomics risks were often assessed solely by means of observation, based on ergonomists’ knowledge and experience. The results also pointed to that that the reliability was not acceptable when risk assessment was performed without any standardized tool. Furthermore, the results point to that support from the OHS organizations is an important prerequisite for ergonomists to work with primary prevention. Further, opportunities for specialization within a specific industry sector seem to facilitate ergonomic interventions. It is also important to have close relationships with clients and to make them aware about ergonomists competence. Conclusively, this thesis identifies a numbers of areas in which OHS must develop to improve primary preventive services regarding work environment.QC 20170127
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Colbrunn, Robb William. "A Robotic Neuro-Musculoskeletal Simulator for Spine Research." Cleveland State University / OhioLINK, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=csu1367977446.
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Greatorex, Ian F. "Proximal femoral fractures : a case study in the evaluation of health care." Thesis, University of Edinburgh, 1988. http://hdl.handle.net/1842/23953.
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Wagner, Erika Brown. "Musculoskeletal adaptation to Partial Weight Suspension : studies of Lunar and Mars loading." Thesis, Massachusetts Institute of Technology, 2007. http://hdl.handle.net/1721.1/42203.
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Thesis (Ph. D.)--Harvard-MIT Division of Health Sciences and Technology, 2007.Includes bibliographical references.
As human spaceflight extends in both duration and scope, it is critical to better understand the physiologic effects of this novel environment. In the weight bearing structures of the body, bone loss and muscle atrophy far in excess of age-related declines are hallmarks of microgravity adaptation. However, while the physiological effects of such disuse unloading are well-described, the effects of partial weight bearing, such as expected on the moon (16% of Earth's gravity) and Mars (38% of Earth's gravity), have yet to be quantified. In these environments, the risks of musculoskeletal atrophy and accompanying orthopedic injury are uncertain, and a means of further investigation is needed. To address this need, we developed a novel model of Partial Weight Suspension (PWS) that supports investigation of the physiologic effects of chronically reduced quadrupedal loading in mice. Validation of the PWS system was conducted using a gait analysis treadmill and high-precision force platform. These studies showed that peak ground reaction forces were significantly reduced under conditions of partial weightbeari:ng, and changes in gait dynamics were consistent with previous studies of human locomotion. Using the PWS system, we conducted the first known studies of chronic musculoskeletal adaptation to Mars and lunar levels of weight bearing. Adult female BALB/cByJ mice underwent 21 days of partial weight bearing or control treatment. Relative to controls, suspended animals showed significant bone and muscle loss. In particular, bone formation rate was decreased, leading to deterioration of both cortical and trabecular bone structure in mice exposed to weight bearingtbearing. Although material properties of the bone were largely unaffected, structural and geometric changes resulted in lower bone strength.
weight bearinged weight bearing at Mars and lunar levels led to similar losses of muscle and bone relative to controls. Comparison with previous literature suggests that adaptation to partial weight-bearing associated with both Mars and lunar loading provided some protection relative to the deconditioning seen in full unloading. Although additional studies are needed, the data also indicated that the musculoskeletal deterioration was not linearly related to the degree of unloading. Altogether, this model provides a validated, controlled system for investigaweight bearingof partial weightbearing and countermeasures on musculoskeletal deconditioning. Our initial findings have practical applications for bioastronautics, suggesting that physiological investigations on the surface of the moon may not be fully predictive for future Mars exploration.
by Erika Brown Wagner.
Ph.D.
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Meyers, Alysha Rose. "Prevention strategies for musculoskeletal disorders among high-risk occupational groups." Diss., University of Iowa, 2010. https://ir.uiowa.edu/etd/2946.
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The objective of the three studies in this dissertation was to improve methods to prevent musculoskeletal disorders among workers in high-risk occupations. The first two studies, Strain Index (SI) Studies I & II, addressed this problem by better characterizing the performance of a commonly used observational method of estimating potentially hazardous biomechanical exposures, the SI. The SI combines measures of several biomechanical risk factors into a single value (SI score). Strain Index scores are usually categorized into four ordinal SI "risk categories." In Strain Index Study I, multivariate survival analysis models were compared to evaluate the predictive validity of the original SI risk category cut-points to a new set of empirically derived cut-point values among 276 manufacturing workers. The results from this prospective study indicated that the empirically derived cut-points were a better predictor of incident hand-arm symptoms than the original cut-points, especially among women. In Strain Index Study II, Aim 1, exposures to forceful exertions, repetition and non-neutral wrist posture estimated with SI methods were compared to analogous exposures estimated with alternate methods. Statistically significant associations between separate methods designed to assess specific risk factors were observed only for those measuring non-neutral wrist posture. In Aim 2, a multivariate survival analysis model examining associations between incident hand-arm symptoms and biomechanical exposures estimated with the SI was compared to a model examining associations between incident hand-arm symptoms and biomechanical exposures estimated with separate estimates of biomechanical risk factors. Results favored the SI risk category metric to characterize biomechanical exposures compared to separate measures of exposure. he third study, light-weight block (LWB) Intervention Study, was a repeated measures laboratory study of 25 bricklayers performed to estimate the effect of block weight (LWB vs. standard-weight block (SWB)) and course height on low back disorder (LBD) risk factor exposure. Mixed-effect models showed that LWB was associated with reduced exposure for percent time spent in sagittal flexion >30°, lifting rate, LBD risk probability score, and non-dominant upper trapezius muscle activity. Bricklaying at ankle or chest heights was generally associated with higher exposure to risk factors than bricklaying at knuckle height.
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Muller, Sabine. "A simple ergonomic intervention for neck and upper back musculoskeletal pain in computer users." Thesis, Stellenbosch : Stellenbosch University, 2015. http://hdl.handle.net/10019.1/96938.
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Thesis (MScPhysio)--Stellenbosch University, 2015ENGLISH ABSTRACT: Background: The use of computers at school, university, work and for social media is growing and whilst neck pain is common in the general population, computer users have an even higher prevalence. Incorrect workstation ergonomics have been identified as a risk factor for the development of neck pain in computer workers. Aims: To assess the effect of adjusting chair and monitor height of a female office worker’s computer workstation on work related neck and upper back pain intensity, comfort of her sitting posture and disability. Methods: An N=1 study was conducted using the A-B-C design consisting of a computer workstation adjustment involving chair and monitor height of a female office worker. The effect of the intervention was evaluated using the Visual Analogue Scale (VAS) to measure neck and upper back pain intensity and comfort of sitting position, and the Neck Disability Index to measure disability. The effect of the intervention was assessed over the three phases, consisting of four weeks each. During these phases, the participant could continue with her usual computer work. The results were compiled and tabulated. Results: A reduction in neck and upper back pain intensity as well as an increase in sitting comfort position were found. However these improvements were not statistically or clinically significant. The effect size for pain intensity was 0.76 and for sitting comfort 0.21. The participant reported no disability as measured by the Neck Disability Index, at the start and at the end at the end of the study. Conclusion: The vertical adjustment of this female office worker’s chair and monitor height according to her anthropometrics improved neck and upper back pain intensity and comfort of sitting position. This ergonomic workstation intervention could form part of a practical management option for computer users with neck and upper back pain. Further research is recommended to establish whether these findings are generalizable to the wider community of computer users.
AFRIKAANSE OPSOMMING: Probleemstelling: Die gebruik van rekenaars by skole, universiteite, werksplekke en vir sosiale doeleindes neem toe. Nek pyn kom dikwels in die algemene bevolking voor, maar dit is meer prevalent in rekenaargebruikers. ‘n Werkstasie wat nie ergonomies korrek opgestel is nie, is geidentifiseer as ‘n risikofaktor vir die ontwikkeling van nekpyn in rekenaar werkers. Doelwitte: Om te bepaal of aanpassings in die stoel- en beeldskerm hoogte van ‘n vroulike kantoor werker se rekenaar werkstasie, ‘n effek het op werksverwante nek en boonste rug pyn, sitgemak en funksionele vermoë. Methode: Die N=1 studie met ‘n A-B-C ontwerp is onderneem en het bestaan uit n rekenaar werkstasie aanpassing waarby die hoogte van die stoel en beeldskerm van ‘n vroulike relenaargebruiker aangepas is. Die effek van die intervensie is ge-evalueer deur middle van die visueel analoogskaal (VAS) om pyn en sitgemak te bepaal; en die Nek Ongeskiktheids Indeks (NOI) om gestremtheid te bepaal. Die effek van die intervensie is oor drie fases, wat elk bestaan het uit vier weke, evalueer. Gedurende die fases, kon die deelnemer met haar gewone rekenaarwerk voortgaan. Die resultate is saamgestel en getabuleer. Resultate: Daar was ‘n vemindering in die intensiteit van nekpyn, boonste rug pyn en die sitgemak van die individu het ook verbeter. Hierdie verbeteringe was egter nie statisties of klinies betekenisvol nie. Die effek grootte vir pyn intensiteit was 0.76 en vir sitgemak was 0.21. Die deelnemer het geen gestremdheid gerapporteer, soos gemeet met die NOI met aanvangs van die studie of teen die einde van die studie nie. Gevolgtrekking: Die vertikale hoogte-aanpassing van die stoel en beeldskerm van hierdie vroulike rekenaar werker volgens haar antropometrie het bygedra tot ‘n verbetering in nek en boonste rug pyn, asook sitgemak. Hierdie ergonomiese werkstasie intervensie kan deel vorm van die praktiese hantering van nek en boonste rug pyn in rekenaargebruikers. Verdere navorsing wod aanbeveel om te bepaal of hierdie bevindinge veralgemeenbaar is na die wyer gemeenskap van rekenaarverbruikers.
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Griffin, Haley Michelle GRIFFIN. "Work-related Musculoskeletal Disorders in Radiation Therapists:An Exploration of Self-Reported Symptoms." The Ohio State University, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=osu1525719881238227.
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Liu, Ming-chi, and 廖明志. "Musculoskeletal injuries resulting from manual handling in health caresettings: a review of effectiveness forprevention programs." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2010. http://hub.hku.hk/bib/B45173229.
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Petersen, Elisabeth. "Physical activity, sence of coherence and functional health status in individuals with cronic musculoskeletal pain." Thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for sosialt arbeid og helsevitenskap, 2011. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-13074.
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This thesis is a part of the project ― "Målrettede rehabiliteringstiltak", offering a multidisciplinary rehabilitation program, based on a salutogenic understanding of health, coping and illness. This thesis consists of two papers. The first paper provides an overview of physical activity, sense of coherence (SOC) and functional health status in individuals with chronic musculoskeletal pain. The paper builds upon health promotion through a biopsychosocial and salutogenic approach. Paper two is an empirical investigation who exploring the relationship among physical activity and sense of coherence in functional health status in individuals with chronic musculoskeletal pain. Hopefully, this thesis can provide new knowledge within factors that can help individuals with chronicDenne masteren er en del av prosjektet "Målrettede rehabiliteringstiltak", som tilbyr et tverrfaglig rehabiliteringsprogram, basert på den salutogene forståelse av helse, mestring og sykdom. Masteren består av to artikler. Den første artikkelen gir en oversikt over fysisk aktivitet, ―opplevelsen av sammenheng‖ (OAS) og den funksjonelle helsetilstand hos personer med kronisk smerter i muskel- og skjelett systemet. Den bygger på helsefremming gjennom en biopsykososial og salutogen tilnærming. Andre artikkel er en empirisk undersøkelse som utforsker sammenhenger blant fysisk aktivitet og OAS i funksjonell helsestatus hos personer med kroniske kronisk smerter i muskel- og skjelett systemet. Forhåpentligvis kan denne oppgaven gi ny kunnskap innen faktorer som kan hjelpe personer med kroniske smerter i muskel- og skjelett systemet for å få mer forståelse for egen situasjon.
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Josephson, Malin. "Work factors and musculoskeletal disorders : an epidemiological approach focusing on female nursing personnel /." Solna : National Institute for Working Life (Arbetslivsinstitutet), 1998. http://diss.kib.ki.se/1999/91-7045-506-6/.
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Koperna, Lisa. "Sport-Related Concussion and Lower Extremity Musculoskeletal Injuries in High School Athletes." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/4740.
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Sport-related injuries (SRI) can be foreseen and averted when mechanisms and risk factors are completely understood. An appreciation of the relationship between sport-related concussion (SRC) and lower extremity musculoskeletal injuries (LEMI) is emerging amid professional and collegiate athletes. However, findings of such a relationship in adults may not be generalizable to younger populations, and the literature has not addressed this relationship in adolescents. The purpose of this cross-sectional quantitative study was to examine the relationship between SRC and LEMI in high school athletes. The dynamic model of etiology in sport injury provided the study's conceptual framework. A de-identified secondary dataset of high school athletic injuries was obtained from the Athletic Training Practice Based Rehab Network and analyzed with descriptive and inferential statistics. Concussions, knee sprains, and ankle sprains represented about 12%, 17%, and 70%, respectively, of the 1,613 cases in the dataset. Chi-square tests revealed that SRCs, and the number of SRCs, were associated with knee sprains [(p < .001), Cramer's V = .148] and ankle sprains [(p < .001), Cramer's V = .545]. This study may promote positive social change by prompting further retrospective and prospective studies to clarify whether a relationship exists between SRC and LEMI in high school athletes, and if so, whether this relationship is causal in nature. New knowledge may be used to guide practices and policies to reduce sports injuries in high school athletes, which may lead to fewer SRIs among adolescents, fewer school absences, more physical activity, and better health and well-being throughout the lifespan, thereby promoting a more active, productive, and healthy society.