Дисертації з теми "Musculoskeletal condition"
Оформте джерело за APA, MLA, Chicago, Harvard та іншими стилями
Ознайомтеся з топ-50 дисертацій для дослідження на тему "Musculoskeletal condition".
Біля кожної праці в переліку літератури доступна кнопка «Додати до бібліографії». Скористайтеся нею – і ми автоматично оформимо бібліографічне посилання на обрану працю в потрібному вам стилі цитування: APA, MLA, «Гарвард», «Чикаго», «Ванкувер» тощо.
Також ви можете завантажити повний текст наукової публікації у форматі «.pdf» та прочитати онлайн анотацію до роботи, якщо відповідні параметри наявні в метаданих.
Переглядайте дисертації для різних дисциплін та оформлюйте правильно вашу бібліографію.
Piedrahita, Hugo. "Working in cold conditions indoors : effects on musculoskeletal symptoms and upper limb movements /." Luleå : Luleå tekniska universitet, 2008. http://epubl.ltu.se/1402-1544/2008/16/.
Повний текст джерелаWelsh, Claire Elizabeth. "Heritability analyses of musculoskeletal conditions and exercise-induced pulmonary haemorrhage in thoroughbred racehorses." Thesis, University of Glasgow, 2014. http://theses.gla.ac.uk/4862/.
Повний текст джерелаThomson, Colin E. "Interventions for the management musculoskeletal conditions of the foot : towards an evidence based approach." Thesis, University of York, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.428414.
Повний текст джерелаDawson, Lesley J. "Recommending core outcome measures for adults with musculoskeletal knee conditions : a consensus development conference." Thesis, Glasgow Caledonian University, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.601667.
Повний текст джерелаNdlovu, Mehluli. "Modelling factors associated with long-term prescription patterns of analgesia for musculoskeletal conditions in primary care." Thesis, Keele University, 2014. http://eprints.keele.ac.uk/2254/.
Повний текст джерелаDARAISEH, NANCY M. "A COMPREHENSIVE ASSESSMENT OF UNSAFE WORKING CONDITIONS, MUSCULOSKELETAL SYMPTOMS, AND SUBJECTIVE HEALTH COMPLAINTS AMONG NURSING PERSONNEL." University of Cincinnati / OhioLINK, 2004. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1085423245.
Повний текст джерелаSabariego, Carla. "Assessment and determinants of health care utilization among patients with musculoskeletal conditions undergoing outpatient rehabilitation in Germany." Diss., lmu, 2011. http://nbn-resolving.de/urn:nbn:de:bvb:19-126382.
Повний текст джерелаMetcalfe, Caroline Jane. "An investigation of patients' expectations of outpatient physiotherapy for peripheral musculoskeletal conditions and their effect on treatment outcome." Thesis, University of Hull, 2003. http://hydra.hull.ac.uk/resources/hull:8473.
Повний текст джерелаHills, Rosemary Eleanor. "Patient satisfaction with outpatient physiotherapy : an examination of needs and expectations of patients with acute and chronic musculoskeletal conditions." Thesis, King's College London (University of London), 2003. https://kclpure.kcl.ac.uk/portal/en/theses/patient-satisfaction-with-outpatient-physiotherapy--an-examination-of-needs-and-expectations-of-patients-with-acute-and-chronic-musculoskeletal-conditions(c9f0dd3b-12a0-4947-834b-4a3ad235b675).html.
Повний текст джерелаLumpkins, Logan, and Craig Wassinger. "Effects of Lower Extremity Aerobic Exercise and Conditioned Pain Modulation on Evoked Shoulder Pain." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/honors/434.
Повний текст джерелаPinzke, Stefan. "Towards the good work : methods for studying working postures to prevent musculoskeletal disorders with farming as refererence work /." Alnarp : Swedish Univ. of Agricultural Sciences (Sveriges lantbruksuniv.), 1999. http://epsilon.slu.se/avh/1999/91-576-5471-9.pdf.
Повний текст джерелаFjell, Ylva. "Working conditions and musculoskeletal pain in public sector employees : a study of female dominated workplaces in health care and educational services /." Stockholm : Karolinska institutet, 2007. http://diss.kib.ki.se/2007/978-91-7357-256-9/.
Повний текст джерелаRolander, Bo. "Work conditions, musculoskeletal disorders and productivity of dentists in public dental care in Sweden : Are dentists working smarter instead of harder?" Doctoral thesis, Linköpings universitet, Arbetslivsinriktad rehabilitering, 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-65428.
Повний текст джерелаLarsman, Pernilla. "On the relation between psychosocial work environment and musculoskeletal symptoms : a structural equation modeling approach /." Stockholm : Arbetslivsinstitutet, förlagstjänst, 2006. http://ebib.arbetslivsinstitutet.se/ah/2006/ah2006_02.pdf.
Повний текст джерелаPartlow, Adam. "A knowledge based engineering system for the prescription and manufacture of custom contoured seating for clients with severe musculoskeletal and postural conditions." Thesis, University of South Wales, 2014. https://pure.southwales.ac.uk/en/studentthesis/a-knowledge-based-engineering-system-for-the-prescription-and-manufacture-of-custom-contoured-seating-for-clients-with-severe-musculoskeletal-and-postural-conditions(d6dbc8e7-3874-4f1a-a824-1583b0250f52).html.
Повний текст джерелаde, Alwis Pahansen. "On Evaluation of Working Conditions aboard High-Performance Marine Craft." Licentiate thesis, KTH, Marina system, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-223903.
Повний текст джерелаHögprestandafartyg (HPMC) utgör komplexa tekniska system där sjösäkerheten i den stokastiska vågmiljön är en utmaning. Besättningen ombord utgör många gånger den begränsande faktorn för systemets prestanda vilket betonar betydelsen av att integrera olika aspekter av människan som systemkomponent (Human factors integration, HFI), vid så väl projektering, konstruktion som under driftsfasen. Riskerna vid arbete till sjöss är inte fullt ut kartlagda. Vad som står klart är dock att exponering för vibrationer och upprepade stötar ökar risken för att hälsan såväl som arbetets kvalité påverkas menligt. Om riskerna med exponeringen var kända skulle besättning i sitt handhavande kunna agera så att riskerna hålls på acceptabla nivåer och att arbetsgivaren uppfyller kraven i arbetsmiljö- och säkerhetslagstiftning. Dessutom, om riskrelationen mellan exponering och följder för hälsan och arbetsförmågan kan kvantifieras så öppnas en reell möjlighet att integrera human factors i både konstruktions- och driftsfasen. För närvarande är dock kunskapen begränsad om vilka negativa effekter på hälsa och arbetsförmågan som förekommer hos besättningar till HSMC, vilka faktorer som leder till dessa effekter och hur relationen mellan dessa ser ut. Avhandlingen presenterar ett holistiskt angreppsätt för att integrera human factors, i termer av hälsa och arbetsförmåga, vid konstruktion och drift av högprestandafartyg. Ett forskningsprogram har utformats för att klargöra konstruktions- och driftskrav för HPMC avseende HFI. En metod för att övervaka och i realtid karaktärisera stöt- och vibrationsförhållandena ombord introduceras för att möjliggöra bedömning av risken för akuta skador till följd av enstaka kraftiga genomslag, risken för nedsatt arbetsförmåga under pågående verksamhet samt risken för negativa hälsoeffekter till följd av ackumulerad stöt- och vibrationsexponering. Behovet av epidemiologiska studier för att klargöra exponeringens relation till hälsa och arbetsprestation blir i det här sammanhanget tydligt. Därför har nätbaserade enkätverktyg utvecklas, valideras och pilottestas för tvärsnitts- och longitudinella studier av besättningars hälsa och arbetsprestation. Exponeringen mäts med accelerometrar och studeras i relation till besättningarnas hälso- och prestandastatus samt den upplevelse av exponeringen som de rapporterar via enkäterna. Metoden för realtidsåterkoppling av exponeringsnivån kan informera besättningen om hälsorisker och prestationsnedsättning. Enkätverktygen kan användas för datainsamling till epidemiologiska studier i populationer, som t.ex. besättningar till högprestanda fartyg, för att undersöka arbetssituationens inverkan på hälsa och arbetsprestation, riskfaktorer samt relationen dem emellan. Inledande studier påvisar trender mellan kvantitativa mått på exponering och besättningars hälsostatus såväl som mellan uppmätt och upplevd exponering. Det fortsatta arbetet siktar mot att identifiera och kvantifiera relationerna mellan exponeringen och dess påverkan på hälsa och prestation. Därmed kan man bättre utnyttja befintlig standard, stödja den pågående utvecklingen av befintlig standard och bidra till att sätta relevanta gränser i regelverk och lagstiftning som styr konstruktion och handhavande av högprestandafartyg.
QC 20180305
Dahlberg, Raymond. "Health and working conditions among low-educated women /." Stockholm : Arbetslivsinstitutet, 2005. http://diss.kib.ki.se/2005/91-7045-758-1/.
Повний текст джерелаBarnes, Roline Yvette. "An investigation into the nature and prevalence of musculoskeletal conditions among women attending a community clinic, and the effectiveness of an intervention programme for these patients." Doctoral thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/23424.
Повний текст джерелаTängerstad, Louise, and Maria Källskog. "Finns det arbetsmiljöfaktorer på Arbetsförmedlingen Kundtjänst som förklarar korttidssjukfrånvaron? - En studie med MTO-perspektiv." Thesis, KTH, Ergonomi, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-153739.
Повний текст джерелаKällskog, Maria, and Louise Tängerstad. "Finns det arbetsmiljöfaktorer på Arbetsförmedlingen Kundtjänst som förklarar korttidssjukfrånvaron -en Studie med MTO-perspektiv." Thesis, KTH, Ergonomi, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-154039.
Повний текст джерелаKjellsson, Sara. "Sick of Work? : Questions of Class, Gender and Self-Rated Health." Doctoral thesis, Stockholms universitet, Sociologiska institutionen, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-148744.
Повний текст джерелаAt the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 2: Manuscript. Paper 3: Manuscript.
Mandelli, Marcia Cristina Castanhari. "Condições de trabalho e morbidade referida para distúrbios osteomusculares em catadores de materiais recicláveis." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/5/5137/tde-25082017-095724/.
Повний текст джерелаINTRODUCTION: Urbanization has been accompanied by a growing increase in the volume and diversity of solid waste produced. The practice of reusing these wastes has been carried out since the beginning of the XX century, initially by the figure of the \"bottle dealer\", up to 2003 when we had the recognition of the profession of \"recyclable materials collector\" in the Brazilian Classification of Occupations. The environmental problem caused by the production and disposal of waste led to the establishment of the National Solid Waste Policy, and among its guidelines there is an stimulus to the participation of the waste collector in the recycling chain. Despite the improvements in the working conditions of the waste collector, exposures to biomechanical loads, such as physical stresses, vicious positions and repetitive movements persist. In addition, the organization of the production process and the way in which the collectors perform their tasks are situations that predispose to risks and damages to health. OBJECTIVE: To identify the occurrence of musculoskeletal pain / discomfort related to the work of recyclable materials collector working in sorting cooperatives in the Metropolitan Region of São Paulo. METHOD: A cross-sectional study with a sample of 250 collectors distributed in four cooperatives, with an interview conducted by a standardized data collection instrument. RESULTS: Among the recyclable materials collector, the majority were women (62%), with age between 41-59 years (53%), of black / brown race (66.4%) and low education (77% with less than 8 years of schooling). Musculoskeletal pain / discomfort was reported by 163 (65%) of the recyclable materials collector, among them, the location in the spine was the most frequent (50%), followed by upper limbs (45%) and lower limbs (31%). The results found in the multivariate analysis showed that pain/discomfort was associated with the means of production of the cooperative (p < 0.000), having had another occupation (p=0.007) and having had a work accident previously (p = 0.043). CONCLUSIONS: The working conditions observed are extremely precarious and constitute an important risk factor for musculoskeletal disorders. Waste pickers are exposed to the same work position for long periods, inadequate postures, monotony, physical effort, repetitiveness and handling of sharp materials. The conditions under which they perform their tasks are likely factors to musculoskeletal problems
Dybeck, Axel, and Julia Persson. "Användning av transkutan elektrisk nervstimulering i smärtstillande syfte vid muskuloskeletala tillstånd : En litteraturstudie." Thesis, Högskolan i Halmstad, Akademin för hälsa och välfärd, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:hh:diva-43782.
Повний текст джерелаBackground: In painful musculoskeletal conditions, the patient is dependent on the nurse's nursing measures and support for pain relief. Transcutaneous electrical nerve stimulation (TENS) is a non-pharmacological pain relief method that can be advantageously combined with analgesic drugs for both acute and long-term pain conditions. To optimize the pain relief in everyday life in the event of long-term pain, the patient can be trained in using TENS in their self-care. Aim: The aim was to describe the effect of transcutaneous electrical nerve stimulation as part of the pain treatment for people with musculoskeletal pain conditions. Method: A General literature study with inductive approach, where two qualitative articles and seven quantitative articles were examined. Results: The results revealed two themes: TENS effect in acute pain and TENS effect in long lasting pain. The results showed that treatment with TENS could provide adequate pain relief and was a safe method with few negative consequences for the patient. Itwas also found that the treatment resulted in a reduction in the intake of analgesic pharmaceuticals for the patients. Patients treated with TENS also showed a higher degree of physical function and mental well-being. Conclusion: For the nurse's nursing of patients with musculoskeletal conditions, TENS appears to be an effective and safe nursing measure with more benefits than just a pain-relieving effect. Knowledge and training for the nurse of this treatment method can provide the nurse with additional tools for multimodal care of both acute and long lasting pain. The nurse's knowledge of TENS also provides opportunities for patient education and can strengthen the patient group's opportunities for self-care in case of pain.
Matzelle, Melissa M. "Inflammation Inhibits Osteoblast-Mediated Bone Formation in Rheumatoid Arthritis and Regulates the Wnt and BMP Signaling Pathways: A Dissertation." eScholarship@UMMS, 2012. https://escholarship.umassmed.edu/gsbs_diss/596.
Повний текст джерелаCoupaud, Marine. "Mondialisation, conditions de travail et santé." Thesis, Bordeaux, 2016. http://www.theses.fr/2016BORD0139/document.
Повний текст джерелаThis thesis aims at exploring to what extent globalization, through its diversecomponents, impacts the health of European workers. In a first part, we expose the socio-economicconsequences of this multi-faceted phenomenon. In a second part, we show that internationalcompetition, one of the essential components of globalization, is a risk factor for non-skilledworkers. Nevertheless, individual and organizational factors are the most likely to explain mentaland physical disorders prevalence in the population as a whole. Globalization also implies newpractices linked to firms’ internationalization strategy, another component of globalization. Weunderline that workers must acquire the skills to stay attractive in a constantly changing worldand they do not find much support in their companies. In a third part, we show that globalizationenhances the surge of the service sector in industrialized countries. In addition, the leanmanagement is implemented in those sectors and competitive pressure increases. These changesimpact the way the work is performed. Within this context, the health of workers deterioratesbecause they are exposed to changing risk factors, among them: intense of work related tointerpersonal relationships. Finally, we find that the Corporate Social Responsibility comes as ananswer to improve workers’ health and as a consequence, firms’ social and financial performance
Himalowa, Simon. "The effect of occupational-related low back pain on functional activities among male manual workers in a construction company in Cape Town, South Africa." Thesis, University of the Western Cape, 2010. http://etd.uwc.ac.za/index.php?module=etd&action=viewtitle&id=gen8Srv25Nme4_9770_1361367868.
Повний текст джерелаConstruction manual workers are at a high risk of suffering from occupational related low back pain because of high-risk activities involved and the nomadic nature of the workforce. Low back pain and its associated disability continue to plague the construction industry. The prevalence of occupational related low back pain among manual workers in construction companies is believed to be due to high exposure to awkward postures for long hours, heavy manual work and exposure to whole-body vibration in the work environment. As a result of these risky exposures, low back pain has consistently been the leading cause of both occupational disability and absenteeism in the construction industry. The purpose of this study was to determine the effect of occupationalrelated low back pain on the functional activities of the manual workers in a construction company in Cape Town. The prevalence and the predisposing factors of low back pain among construction manual workers were established as well as the effect of occupational-related low back pain on the functional activities of the manual workers was also determined. A crosssectional descriptive study using quantitative method was utilized. A convenient sampling method was employed and all the 212 available participants at two construction settings were recruited for the study. The population was categorised into four main occupational groups
 
masons, handymen, labourers and foremen. Data was collected using a structured questionnaire as a closed ended interview guide. The questionnaire comprised of four parts. Part one was used to determine the demographic data while parts two, three and four utilised three standardizedclose-ended validated questionnaires. These are
the Nordic Musculoskeletal Disorder Questionnaire, the Profile Fitness Mapping questionnaire and the Pain and Disability Questionnaire. Data was captured and analyzed using the statistical package for social sciences (SPSS) version 17.0 spreadsheet for statistical analysis. The study was conducted under the adherence of the ethical considerations. Descriptive and inferential statistical analyses describe the association between the investigated independent variables with the occurrence of occupational related low back pain in the study. Results are presented using tables, charts and graphs. The results revealed a 25% prevalence of low back pain while the one month and one week prevalence rates were 69% and 54% respectively. Masons recorded the highest low back pain prevalence rate (58%). Initial onset of low back pain was mainly attributed to bending (48%) and load lifting (28%). The chi-square test at p<
0.05 was done. The results revealed a lack of association between low back pain and the socio-demographic characteristics. Participants confirmed suffering physical, emotional, financial and functional problems with 41.5% reporting sickness absence and a mean of 4 days being lost during the past year. Further chi-square test for proportion revealed an association between low back pain and participants âability to
lift (p=0.006), bend back forwards (p=0.001) and ability to bend back backwards (p=0.014). To prevent impairment, activity limitation and participation restriction among construction manual workers, a number of factors must be addressed at epidemiological level as highlighted in the recommendations of this study.
Briggs, Virginia G. "Injection Treatment for Lower Back Pain in Older Adults with Lumbar Spinal Stenosis: A Dissertation." eScholarship@UMMS, 2009. https://escholarship.umassmed.edu/gsbs_diss/439.
Повний текст джерелаPélissier, Carole. "Conditions de travail et état de santé physique et psychique du personnel non médical des établissements d'hébergements pour personnes âgées dépendantes (EHPAD)." Thesis, Lyon 1, 2015. http://www.theses.fr/2015LYO10265.
Повний текст джерелаBackground: Non-medical staff in nursing homes for the elderly are exposed to high levels of physical and psychological stress related to managing increasingly dependent residents with multiple pathologies. Our research approach is based on Green and Kreuter's public health model. This is intended to describe the physical and mental health (epidemiological diagnosis) and to explore working conditions as experienced by nursing home staff (behavioral and environmental diagnosis). Methods: A cross-sectional descriptive survey was conducted by 78 occupational physicians on 2,649 employees (706 housekeepers, 1,565 nursing assistants and 378 nurses) in 105 nursing homes for the elderly in the Rhône-Alpes Region of France. Employee data were collected on several validated questionnaires. All statistical analyses were performed on SAS software, version 9.3. Results: Respondents related elevated hardship and desired more continuous training in palliative care. They were highly exposed to psychosocial stress (strong effort, low reward, effort/reward imbalance, overcommitment). Neck and upper limb musculoskeletal complaints and signs of psychological distress were significantly associated with exposure to psychosocial stress. Conclusions: The next phase of the research plan should consist in establishing an educational diagnosis by assessing the organizational factors associated with psychosocial stress in nursing home staff
Melzer, Adriana Cristina de Souza. "Trabalho e dor osteomuscular : um estudo em industrias ceramicas do municipio de Pedreira, SP." [s.n.], 2008. http://repositorio.unicamp.br/jspui/handle/REPOSIP/308418.
Повний текст джерелаTese (doutorado) - Universidade Estadual de Campinas, Faculdade de Ciencias Medicas
Made available in DSpace on 2018-08-11T21:10:35Z (GMT). No. of bitstreams: 1 Melzer_AdrianaCristinadeSouza_D.pdf: 4010646 bytes, checksum: f789104f16ca57bf824ef9a5515ddd51 (MD5) Previous issue date: 2008
Resumo: Introdução: Este estudo foi realizado no município de Pedreira, SP, cuja principal atividade industrial é a produção cerâmica. Grande número de trabalhadores destas indústrias tem se afastado do trabalho em conseqüência de Distúrbios Osteomusculares Relacionados ao Trabalho (DORT). Objetivos: Os principais objetivos foram descrever aspectos relacionados às condições e organização do trabalho nas indústrias cerâmicas, determinar a prevalência de dor osteomuscular em trabalhadores em atividade e identificar as associações entre dor e variáveis organizacionais, biomecânicas, psicossociais e individuais. Métodos: O estudo desenvolveu-se em duas fases complementares. Entre os anos de 2003 e 2005 foi realizado um estudo exploratório composto por duas partes: a descrição das atividades de produção de uma indústria cerâmica do município, por meio de uma abordagem ergonômica e a descrição da trajetória de trabalho e adoecimento de trabalhadores portadores de DORT, por meio de entrevistas. Entre os anos de 2006 e 2007, foi realizado um estudo sistemático de desenho transversal-descritivo. Nove indústrias cerâmicas participaram desta fase. As atividades de trabalho de 18 indivíduos, dois de cada empresa, foram descritas e analisadas através do método de observação direta. Todos os trabalhadores das empresas participantes responderam a um questionário sobre trabalho e saúde (n=235). Um outro questionário complementar para avaliação de sintomas psicológicos comuns foi aplicado a 57 indivíduos. Resultados: No geral, as condições de trabalho nas indústrias cerâmicas eram ruins. O ambiente físico era insalubre, expondo os trabalhadores a variados riscos à saúde, incluindo-se os provenientes da poeira de sílica, das altas temperaturas e ruído, da pouca ventilação, de problemas nos pisos e da ausência de proteção nas máquinas. A organização do trabalho estava baseada na divisão e no parcelamento das tarefas e no controle sobre o ritmo a fim de atingir as metas de produção. Homens e mulheres não executavam os mesmos tipos de atividades, revelando-se uma clara divisão sexual do trabalho. Aos trabalhadores da produção cabia a execução de atividades repetitivas, em ritmo elevado e com a utilização de posturas estáticas e inadequadas. A prevalência de dor nos últimos 12 meses foi de 38,5%. As principais localizações foram membros inferiores, coluna lombar e pescoço. Foi identificada uma associação positiva entre dor osteomuscular e sexo feminino. Entre as variáveis biomecânicas e psicossociais, repetitividade de movimentos, utilização de ferramentas de trabalho, ausência de participação nas decisões, preocupação com a produção, problemas de relacionamento com supervisores, insatisfação no trabalho e desejo de mudar de função foram associadas à dor. Conclusões: A dor osteomuscular é uma das expressões do elevado custo humano e social derivado das condições e da organização do trabalho nas indústrias cerâmicas. O ambiente e os equipamentos de trabalho precários, a divisão do trabalho, o parcelamento e a repetitividade das atividades, a mecanização seletiva e o ritmo acelerado são determinantes do desencadear da dor. A maior prevalência de dor entre as mulheres relaciona-se aos diferentes setores e atividades de trabalho em que estão concentradas, submetendo-as a um trabalho mais repetitivo e estático, em ritmo mais acelerado, com pouca autonomia para grandes decisões e sujeitas a menores salários. As pessoas estão trabalhando com dor. A procura por serviço médico é adiada até quando a incapacidade para o trabalho se instala, pela impossibilidade de manter a produção. O uso de medicamentos acaba sendo a única alternativa encontrada pelos trabalhadores para continuarem no trabalho. Palavras-chave: distúrbios osteomusculares relacionados ao trabalho; condições de trabalho; fatores de risco; indústria cerâmica; aparelho locomotor
Abstract: Background: This study was developed in the municipality of Pedreira, SP, Brazil, where the main industrial activity is the ceramic production. A large number of workers from these industry have left their jobs because of Work Related Musculoskeletal Disorders (WRMD). Objectives: To describe work conditions and organization pertaining to the ceramic industry, to determine the prevalence of pain among active workers and to identify the associations between symptoms and organizational, biomechanical, psychosocial and individual variables. Methods: The study was developed in two complementary stages. In the years 2003 and 2005 an exploratory study was carried out, divided in two steps: the description of the production activities developed in one ceramic manufacturer in Pedreira, by means of an ergonomic approach, and a description of the job and illness progression of workers with WRMD, using interviews. In the years 2006 and 2007, a systematic, descriptive and cross-sectional study was carried out. Nine ceramic manufacturers participated in this stage. The activities of 18 individuals, two in each company, were described and analyzed through the direct observation method. All workers answered a questionnaire about work and health (n=235). An additional questionnaire for the assessment of minor psychological disorders was applied to 57 subjects. Results: In general, the work conditions in the ceramic industry were found to be poor. The physical environment was unhealthy, as workers are exposed to several health risks, including those originated from silica dust, high temperatures and noise, low ventilation, inadequate flooring conditions and absence of safety gear. The work organization is based in the division of tasks and pace control in order to achieve the production demands. Men and women do not perform activities with the same characteristics, indicating a clear work division according to gender. Production workers are assigned repetitive activities, executed in a fast pace, using static and awkward postures. A 38.5% prevalence of musculoskeletal pain over the past 12 months was found, mostly localized in the lower limbs, back and neck. A relationship was identified between musculoskeletal pain and the female gender. Among the biomechanical and psychosocial variables, repetitiveness, tool using, lack of control over decisions, worries regarding work demands, relationship issues with supervisors, work dissatisfaction and wish to move on to another function, were associated with pain. Conclusions: Musculoskeletal pain is one of the outcomes of elevated social and human requirements resulting from work conditions and organization in the ceramic industry. The work environment and use of outdated equipment, the work division, repetitiveness of the activities, selective mechanization and fast pace are components in the development of pain. The higher prevalence of pain among women is related to their allocation in different sectors and activities, submitting them to a more repetitive and static work, executed in more accelerated pace, with less autonomy and low salaries. People are working with pain. Seeking medical service is delayed until the worker's capacity has compromised their ability to maintain the work schedules. Medication ends up as the only alternative found by workers to carry on with their duties
Doutorado
Epidemiologia
Doutor em Saude Coletiva
Moura, Neto Alvaro Braga de. "Nível de atividade física em trabalhadores do transporte coletivo urbano da cidade de Pelotas/RS." Universidade Federal de Pelotas, 2012. http://repositorio.ufpel.edu.br/handle/ri/1765.
Повний текст джерелаPhysical inactivity (IF) appears associated with a number of chronic diseases, affecting people in all age groups and different social groups. When we focus on the working class, lack of information regarding the specificity of their work difficult to recognize risk factors for certain diseases or health hazards, especially when the outcome it is the level of IF in the fields of leisure and work. The recognition of the level of physical inactivity, particularly those working in urban public transport, is of great value in order to provide information to help governing bodies to create public policy measures that include improvements in both the workplace and health this population. Objective: To determine the level of IF and associated factors among drivers and conductors of public transport of the city of Pelotas / RS. Methodology: Cross-sectional study of character in the census the urban area of Pelotas. All drivers and collectors working in the transportation of the city of Pelotas / RS for study. Data collection will be made through pre-tested questionnaires and coded, with questions on socioeconomic, demographic, labor conditions and health (musculoskeletal problems, level of IF and minor psychiatric disorders). The instrument used to determine the level of IF is the long version of the International Physical Activity Questionnaire (IPAQ), leisure and travel sections in the application interview on the previous week, including questions regarding the frequency and duration of performing activities moderate physical, vigorous and walking. Minor psychiatric problems or minor mental illnesses will be identified by the SRQ-Self-Report Questionnaire, an instrument consisting of 20 questions (SRQ-20) that can be answered through self-report or interview. The identification of musculoskeletal problems is through the reference of pain or discomfort located in different physical locations, as recommended by Kuorinka et al. (1987).
A inatividade física (IF) apresenta-se associada a uma série de doenças crônicas, atingindo pessoas em todas faixas etárias e de diferentes grupos sociais. Quando focamos a classe trabalhadora, escassez de informações referentes à specificidade de seu trabalho dificultam o reconhecimento de fatores de risco para determinadas doenças ou agravos a saúde, principalmente quando o desfecho trata-se do nível de IF nos domínios de lazer e trabalho. O reconhecimento do nível de inatividade física, em especial daqueles que trabalham no transporte coletivo urbano, é de grande valia no sentido de fornecer informações que auxiliem órgãos gestores de políticas públicas a criarem medidas que contemplem melhorias, tanto no ambiente de trabalho como para a saúde dessa população. Objetivo: Determinar o nível de IF e fatores associados em motoristas e cobradores do transporte coletivo urbano da cidade de Pelotas/RS. Metodologia: Estudo transversal de caráter censitário na zona urbana da cidade de Pelotas-RS. Todos os motoristas e cobradores que trabalham no transporte coletivo urbano da cidade de Pelotas/RS participarão do estudo. A coleta de dados será realizada através de questionários pré-testados e codificados, contendo questões sobre variáveis socioeconômicas, demográficas, condições de trabalho e saúde (problemas musculoesqueléticos, nível de IF e transtornos psiquiátricos menores). O instrumento utilizado para determinar o nível de IF será a versão longa do Questionário Internacional de Atividade Física (IPAQ), nas seções lazer e deslocamento com a aplicação de entrevista referente à semana anterior, contendo perguntas em relação à frequência e duração da realização de atividades físicas moderadas, vigorosas e da caminhada. Os problemas psiquiátricos menores ou doenças psíquicas menores serão identificados por meio do SRQ- Self-Report Questionnaire, instrumento constituído de 20 perguntas (SRQ-20) que podem ser respondidas através de autopreenchimento ou de entrevista. A identificação dos problemas musculoesqueléticos será através da referência de dor ou mal-estar localizado nas diversas localizações corporais, conforme recomendação de Kuorinka et al. (1987).
Encarnação, José Manuel Passeira. "Sintomas músculo-esqueléticos, compatibilidade homem-trabalho e qualidade de vida no trabalho em empresa industrial." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Ciências Empresariais, 2015. http://hdl.handle.net/10400.26/10660.
Повний текст джерелаO trabalho desenvolvido, realizado numa empresa multinacional do setor industrial, teve como objetivos principais: Avaliar a incidência de queixas músculo-esqueléticas relacionadas com o trabalho; Avaliar a compatibilidade homem-trabalho na empresa em estudo; Avaliar a qualidade de vida no trabalho na organização em estudo. Para o efeito, foi aplicado um inquérito por questionário a uma amostra de 49 trabalhadores afetos à área operacional da empresa em estudo. O questionário aplicado encontra-se dividido em 4 instrumentos: 1.ª parte: Caraterização sociodemográfica; 2.ª parte: Inventário da Qualidade de Vida no Trabalho (IQVT); 3.ª parte: Compatibilidade do Trabalho (CT) e 4.ª parte: Questionário Nórdico Músculo-Esquelético (QNME). Pretendeu-se, com a aplicação destes instrumentos, avaliar a importância e a frequência da qualidade de vida no trabalho na empresa, avaliar a compatibilidade homem-trabalho e ainda aferir a presença de sintomas músculo-esqueléticos. Além disso, foram efetuadas diversas correlações entre as variáveis dos diferentes instrumentos aplicados (IQVT, CT e QNME) e entre estas e as variáveis sociodemográficas, no sentido de se perceber de que forma as mesmas influenciam a QVT e a CT. Os resultados obtidos permitem verificar que relativamente à QVT, a média global da escala de “Importância” (4,44-grau de importante) é superior à da “Frequência” (3,56-grau de frequente) em todas as dimensões. No que se refere à CT, os resultados obtidos com a aplicação do instrumento demonstram que o grau de exigência do trabalho é de nível moderado (3,00) para os trabalhadores. Quanto aos resultados alcançados com a aplicação do QNME, é possível verificar que, cerca de 80% da amostra em estudo apresenta queixas relacionadas com as LMERT. Quanto às possíveis correlações entre os instrumentos aplicados e variáveis sociodemográficas, não se verificou qualquer correlação. Através dos resultados alcançados, foi ainda possível elencar algumas recomendações de melhoria, com o intuito de apoiar a organização na implementação de medidas que visem a melhoria das condições de trabalho e de saúde dos trabalhadores.
Abstract: The work, carried out in a multinational company in the industrial sector, had as main objectives, to evaluate the presence of musculoskeletal symptoms at work, the worker-job compatibility and the working life quality. To achieve these objectives, a questionnaire was used on a sample of 49 employees affects to the operational area of the company. The questionnaire is divided into four sections: Part 1: Socio-demographic characterization; Part 2: Quality of Life at Work Inventory (QLWI); 3rd part: Labor Compatibility (LC) and 4th part: Nordic Musculoskeletal (NM). It was intended, with the application of this questionnaire, to evaluate the importance and frequency of worker’s QLW, assess the Worker-Labor Compatibility and still measure the presence of musculoskeletal symptoms. In addition, different correlations have been made between the different sections used (QLWI, WLC and NM) and between sociodemographic variables, in order to understand how they influence QLW and LC of the workers. The results, show that in relation to QLW, the global average of the range of "Importance" (4,44-importance level) is superior to the "Frequency" one (3,56-frequecy level), in all dimensions. Regarding the LC, the results with the application of the section, demonstrate that the degree of labor requirement is moderate (3,00) for the workers. As for the results achieved with the application of QNME it can see that about 80% of the sample under study have complaints related to MSDs. As for possible correlations between sections applied and sociodemographic variables, there was no correlation. Through the results achieved, it was also possible to list some recommendations for improvement, in order to support the organization in implementing measures to improve working conditions and workers health.
Jalkebo, Charlotte. "Placement of Controls in Construction Equipment Using Operators´Sitting Postures : Process and Recommendations." Thesis, Linköpings universitet, Maskinkonstruktion, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-108980.
Повний текст джерелаDaerga, Laila. "Att leva i två världar : hälsoaspekter bland renskötande samer." Doctoral thesis, Umeå universitet, Epidemiologi och global hälsa, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-138405.
Повний текст джерелаMitra, Ganguli Tora. "Modulation of Voltage-Gated N-Type Calcium Channels by G Protein-Coupled Receptors Involves Lipids and Proteins: A Dissertation." eScholarship@UMMS, 2008. https://escholarship.umassmed.edu/gsbs_diss/389.
Повний текст джерелаIsosaki, Mitsue. "Intervenção nas situações de trabalho em um serviço de nutrição hospitalar de São Paulo e repercussões nos sintomas osteomusculares." Universidade de São Paulo, 2008. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-13012009-115732/.
Повний текст джерелаINTRODUCTION: Hospital food service workers have high level of physical, cognitive and mental demands that are associated with musculoskeletal disorders. The objective of this study was to introduce improvements in the working conditions in a hospital food service and to evaluate the workers perceptions and its effects on musculoskeletal symptoms. METHOD: this study was performed in a public cardiac hospital in São Paulo, Brazil, after its approval by the Ethics Committee. The data were collected by questionnaires and ergonomic analysis of the work. The questionnaire included: socio-demographic, workhistory, work conditions, musculoskeletal symptoms and job satisfaction. A hundred and fifteen questionnaries were applied from 130 workers. The work ergonomic analysis was carried out in accordance with Guérin et al (2001), by means of interviews, observations of kitchen working conditions and biomechanical analyses. Based on the results, interventions have been undertaken by means of a participatory ergonomic approach over one year. After this, another ergonomic analysis was carried out and 89 workers (77%) answered a new questionnaire that also included questions about their perception of the improvements. Data analysis was done by statistical tests to verify symptom prevalences before and after the interventions with a 5% level of significance. SPSS 13.0 and Excel 2003 software was used. RESULTS: The workers were women in the 25-34 age-group, had secondary education, were married, had children and occupied the position of nutrition attendants. They were in this hospital for from 5 to 10 years and on a 40 hour working week schedule. Most of problems observed were reduced space, inadequate equipment and work materials, absenteeism, insufficient number of workers, great volume of work with mental demands, high prevalence of musculoskeletal symptoms mainly in lower members and shoulders. After the improvements in working conditions, the symptoms of musculoskeletal disorders reduced and the workers perceived the following changes in the work process: better lighting and control of air conditioning, acquisition of low capacity mixer, repair of equipment, use of disposable utensils instead of glass plates, acquisition of more chairs, introduction of breaks during working hours, work related gymnastics, workshops for leadership training. In this period the number of hospital beds was increased with a corresponding intensification of the work load and a decline on job satisfaction. The hospital was in a financial crisis with consequences in terms of the hiring of personnel and the acquisition of equipment and materials. CONCLUSION: Interventions brought improvements mainly as regards the work environment and equipment and in the reduction of musculoskeletal symptoms in the lower members, shoulders, neck/cervical region, forearm and lumbar region, though this reduction has not been statistically significant.
Silva, Luciane Goulart da. "Condições de trabalho e saúde de professores pré-escolares da cidade de Pelotas." Universidade Federal de Pelotas, 2011. http://repositorio.ufpel.edu.br/handle/ri/1852.
Повний текст джерелаthe workers in education, nowadays, face problems like the increase of the students matriculated, lack of equipments and essential material or lack of maintenance of the ones that exist, lack of infrastructure and material resources, and others. The knowledge of the work conditions and their reflection in the teacher´s health, especially at those who work with childhood education, is very important to give information that helps public politician s managers to create measures that comprehend improvements, to both work environment and population involved health. Objectives: To investigate the work and health conditions of preschool teachers from the public schools in Pelotas, RS. Methodology: Descriptive study. All the preschool teachers of the city and the state will be part of this study. The collect of the data will be performed using a pretested and codified questioner, comprehend socioeconomic, demographic, work conditions and health (musculoskeletal problems, the level of physical activity, the voice problems correlated and the minor psychological disorders) variables. The instrument used to determinate the level of physical activity will be the long version of the International Physical Activity Questionnaire (IPAQ), performing an interview regarding the previous week, including questions about the frequency and duration of the realization of moderated and intense physical activity and walking. The minor psychological problems or the minor psychiatric disease will be identified by the SRQ Self-Report Questionnaire, instrument comprising 20 questions (SRQ-20) that can be answered by self-report or interview. The identification of the musculoskeletal problems will be by the report of the presence of pain or uneasiness located at the body, according to Kuorinka et al. (1987). Problems related to the voice will be investigated by the Brazilian versions of the V-RQOL (Hogikyan & Sethuraman, 1999), which received the name Qualidade de Vida em Voz QVV (Behlau et al. 2009)
Os trabalhadores em educação, atualmente, encontram problemas como aumentos de alunos matriculados, ausência de equipamentos e materiais essenciais ou falta de manutenção dos existentes, insuficiência de infra-estrutura e de recursos materiais, entre outros. O conhecimento das condições de trabalho e suas repercussões na saúde dos professores, em especial dos que trabalham na educação infantil, é de grande valia no sentido de fornecer informações que auxiliem órgãos gestores de políticas públicas a criarem medidas que contemplem melhorias, tanto no ambiente de trabalho como para a saúde dessa população. Objetivo: investigar as condições de trabalho e saúde de professores pré-escolares da cidade de Pelotas/RS. Metodologia: Estudo descritivo no qual participarão todos os professores pré-escolares que atuam em escolas municipais e estaduais da zona urbana da cidade de Pelotas/RS. A coleta de dados será realizada através de questionário pré-testado e codificado contendo questões sobre variáveis socioeconômicas, demográficas, condições de trabalho e saúde (problemas musculoesqueléticos, nível de atividade física, problemas relacionados à voz e transtornos psiquiátricos menores). O instrumento utilizado para determinar o nível de atividade física será a versão do Questionário Internacional de Atividade Física (IPAQ) na forma longa, com a aplicação de entrevista referente à semana anterior, contendo perguntas em relação à freqüência e duração da realização de atividades físicas moderadas, vigorosas e da caminhada. Os problemas psiquiátricos menores ou doenças psíquicas menores serão identificados por meio do SRQ- Self-Report Questionnaire, instrumento constituído de 20 perguntas (SRQ-20) que podem ser respondidas através de autopreenchimento ou de entrevista. A identificação dos problemas musculoesqueléticos será através da referência de dor ou mal-estar localizado nas diversas localizações corporais, conforme recomendação de Kuorinka et al (1987). Problemas relacionados à voz serão mensuradas pelo Protocolo de Qualidade de Vida e Voz (QVV) (Behlau et al. 2009), versão brasileira do Voice- Related Quality of Life (V-RQOL) (Hogikyan & Sethuraman, 1999)
Torá, Rocamora Isabel 1979. "Historia natural y factores determinantes de la duración de las incapacidades temporales por contingencia común en trabajadores afiliados a la Seguridad Social." Doctoral thesis, Universitat Pompeu Fabra, 2013. http://hdl.handle.net/10803/283472.
Повний текст джерелаThis thesis is based on the study of the determinants of the duration of sickness absence (SA). We examined the geographic variability of the SA duration between comarcas of Catalonia for SA in general and for two common groups of disorders, musculoskeletal disorders (MSDs) and mental health disorders. Cohort data of SA episodes ceded by the Institut Català d’Avaluacions Mèdiques i Sanitàries (ICAMS) of the Generalitat of Catalunya were used. All first SA episodes ending in 2007 and 2010 were analyzed studying individual factors (sex, age, diagnosis, entity managing the sick leave, employment status, and economic activity branch) and contextual factors related to health resources (number of basic health areas) and socioeconomic indicators (market share and unemployment rate) that could explain the observed variability. Multilevel proportional hazard regression models with episodes nested in comarcas were used. This thesis also proposes using a conditional frailty model based on a Poisson approach for analyzing SA duration (or other event of interest) in the presence of repeated events in the same individual, and demonstrates the usefulness of such a model to analyze large datasets. SA episodes ending in 2007, caused by mental health disorders and neoplasms were used, from which the conditional frailty model (CFM) and a novel approach based on a conditional frailty Poisson model (CFPM) were compared empirically.
Wood, Sarah. "Efficacy of Myofascial Decompression for Musculoskeletal Conditions." Thesis, 2021. https://vuir.vu.edu.au/42510/.
Повний текст джерелаBergsten, Eva L. "Working conditions and musculoskeletal disorders in flight baggage handling." Doctoral thesis, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-316468.
Повний текст джерелаStanhope, Jessica Louise. "The preventable burden of musculoskeletal conditions in Australian musicians." Thesis, 2019. http://hdl.handle.net/2440/123109.
Повний текст джерелаThesis (Ph.D.) -- University of Adelaide, School of Public Health, 2019
Маслов, Євген Вадимович. "Динаміка якості життя пацієнтів з коксартрозом під впливом фізичної терапії". Магістерська робота, 2020. https://dspace.znu.edu.ua/jspui/handle/12345/4562.
Повний текст джерелаUA : Дипломна робота: 59сторінок, 4 таблиці, 8 рисунків, 51 літературне джерело. Об’єкт дослідження – якість життя та функціональні порушення опорно-рухової системи у хворих з коксартрозом. Мета дослідження –оцінка ефективності застосування засобів фізичної терапії у реабілітації для покращення якості життя після ортопедичної корекції тазостегнового суглобу хворих з коксартрозом. Методи дослідження – аналіз та узагальнення літературних джерел за обраною темою, оцінка больового синдрому за комбінованою шкалою болі, лінійні вимірювання довжини, об’єму рухів у суглобах, опитувальники для визначення критерію якості життя хворого, методи математичної статистики. Представлені в даному обстеженні експериментальні матеріали дали змогу підтвердити ефективність запропонованої методики комплексної реабілітації хворих з коксартрозом, які перенесли хірургічну корекцію тазостегнового суглобу та дали змогу у подальшому проводити більш ефективну реабілітацію хворих за допомогою цього методу. Фізична терапіяв комплексній реабілітації надає змогу якомога швидшого і ефективного відновлення функцій опорно-рухової системи у порівнянні з традиційними методами реабілітації, що має велике практичне значення. Використання такого реабілітаційного підходу підвищує ефективність проведеного оперативного втручання, а самеендопротезування тазостегнового суглобу, покращує якість життя таких хворих і дає можливість запропонувати цей метод корекції, що має велике соціально-економічне значення.
EN : Thesis: 59 pages, 4 tables, 8 figures, 51 references. The object of research is the quality of life and functional disorders of the musculoskeletal system in patients with coxarthrosis. The aim of the study was to evaluate the effectiveness of physical therapy in rehabilitation to improve the quality of life after orthopedic correction of the hip joint in patients with coxarthrosis. Research methods – analysis and generalization of literature sources on the selected topic, assessment of pain on a combined pain scale, linear measurements of length, range of motion in the joints, questionnaires to determine the quality of life of the patient, methods of mathematical statistics. The experimental materials presented in this survey allowed to confirm the effectiveness of the proposed method of complex rehabilitation of patients with coxarthrosis who underwent surgical correction of the hip joint and allowed to further more effective rehabilitation of patients with this method. Physical therapy in complex rehabilitation allows the fastest and most effective recovery of musculoskeletal functions in comparison with traditional methods of rehabilitation, which is of great practical importance. The use of such a rehabilitation approach increases the effectiveness of surgery, namely hip arthroplasty, improves the quality of life of such patients and makes it possible to offer this method of correction, which is of great socio-economic importance.
Batista, Paula Alexandra Gouveia. "Musculoskeletal pain among Workers in Portugal - the European Workimg Conditions Survey." Master's thesis, 2016. https://hdl.handle.net/10216/87554.
Повний текст джерелаBatista, Paula Alexandra Gouveia. "Musculoskeletal pain among Workers in Portugal - the European Workimg Conditions Survey." Dissertação, 2016. https://hdl.handle.net/10216/87554.
Повний текст джерелаBatista, Paula Alexandra Gouveia. "Musculoskeletal pain among Workers in Portugal - the European Workimg Conditions Survey." Dissertação, 2002. https://repositorio-aberto.up.pt/handle/10216/87554.
Повний текст джерелаO'Brien, Kate Maree. "Telephone-based management for patients with osteoarthritis and other musculoskeletal conditions." Thesis, 2019. http://hdl.handle.net/1959.13/1405176.
Повний текст джерелаMusculoskeletal conditions, including osteoarthritis of the knee or hip and spinal pain, are leading causes of global disability. Despite this, evidence suggests that the vast majority of patients with osteoarthritis and spinal pain do not receive care that is consistent with evidence-based clinical practice guidelines, including encouragement to engage in physical activity and support to lose weight. Two key barriers to the provision of guideline-recommended care are concerned with the accessibility of such care, and scalability of existing clinical models of care. Telephone-based models of care are a promising option to support patients with musculoskeletal conditions. While a number of trials investigating the use of telephone-based interventions for osteoarthritis and spinal pain have been published there remains uncertainty about the effectiveness and cost-effectiveness of telephone interventions for patients in this population group. In Chapter Two, a systematic review was conducted to assess the effectiveness of telephone-based interventions to support patients with osteoarthritis and spinal pain on pain intensity and disability. Seven electronic databases were searched for randomised controlled trials (RCTs) and non-randomised controlled trials that aimed to test the effectiveness of telephone-based interventions for patients with osteoarthritis and spinal pain. Twenty-three studies with a total of 4,994 participants were included. All included studies examined interventions focused on supporting self-management and providing education in addition to a range of intervention targets, for example, physical activity. The review found moderate-quality evidence that telephone-based interventions reduce pain intensity (n = 5 trials, n = 1,357 participants, standardised mean difference (SMD) -0.27, 95%CI:-0.53 -0.01, Tau2 = 0.06, I2 = 74%) and disability (n = 7 trials, n = 1,537 participants, SMD -0.21, 95%CI: -0.40 to -0.02, Tau2 = 0.03, I2 = 56%) compared to usual care. There was moderate-quality evidence that telephone plus face-to-face interventions are no more effective than face-to-face interventions alone. The results highlight the potential for telephone-based services to support osteoarthritis and spinal pain patients to access better quality care. All clinical practice guidelines for osteoarthritis recommend weight loss as a core treatment for patients with knee osteoarthritis. Despite these recommendations, few overweight patients with knee osteoarthritis receive care to support weight loss. There is evidence to support telephone-based approaches in achieving modest weight loss among overweight participants in the general population. Similarly, telephone-based interventions have been found to be effective in addressing behavioural determinants of weight, diet and physical activity in the general population. However, there are no previous studies primarily focused on the provision of weight loss care via telephone for patients with knee osteoarthritis. Chapters Three and Four presents an a priori protocol and statistical analysis plan for a high-quality pragmatic RCT testing the effectiveness of referring patients with knee osteoarthritis, who are overweight or obese, to an existing non-condition specific telephone-based weight loss intervention. Eligible patients (n=120) were randomly allocated to receive the weight loss intervention or usual care. Chapter Five presents the results of the trial and showed that there were no differences between groups for knee pain intensity over 6 months (area under the curve, mean difference 5.4, 95%CI: -13.7 to 24.5, p=0.58; equivalent to a 0.2 point difference on the pain intensity numerical rating scale 95%CI: -0.53 to 0.94) or weight change (the hypothesised mechanism to reduce pain intensity) at 6 months (self-reported weight; mean difference -0.4, 95%CI: -2.6 to 1.8, p=0.74). These results suggest that among patients with knee osteoarthritis who are overweight, telephone-based weight loss support, provided using an existing weight loss intervention might not adequately support patients with knee osteoarthritis to reduce knee pain intensity or weight. Given the scarce resources in healthcare, policy-makers are increasingly requiring evidence of economic value for healthcare interventions to make informed decisions about how to allocate resources. Therefore, undertaking economic evaluations of knee osteoarthritis management approaches is important. Chapter Six presents an economic evaluation of the RCT presented in Chapters Three, Four and Five. Quality-adjusted life years (QALYs) was the utility measure of effect and pain intensity, disability, weight, and BMI were the clinical measures of effect. Costs included intervention costs, healthcare utilisation costs (healthcare services and medication use) and absenteeism costs due to knee pain, collected using a patient self-reported inventory. The primary cost-effectiveness analysis was performed from the societal perspective, which accounted for a range of cost categories (intervention costs, healthcare utilisation costs and absenteeism costs due to knee pain). Mean cost differences between groups (intervention minus control) were $493 (95%CI: -3513 to 5363) for healthcare costs, $-32 (95%CI: -73 to 13) for medication costs, and $125 (95%CI: -151 to 486) for absenteeism costs. The total mean difference in societal costs was $1197 (95%CI: - 2887 to 6106). For QALYs and all clinical measures of effect, the probability of the intervention being cost-effective compared with usual care was less than 0.36 at all willingness-to-pay values. These findings suggest from a societal perspective referral to an existing non-condition specific telephone-based weight loss service was not a cost-effective relative to usual care for quality-adjusted life years (QALYs). Whilst the studies included in this thesis have advanced the evidence-base regarding the effectiveness of telephone-based interventions for the delivery of recommended care for patients with osteoarthritis and spinal pain, there remain a number of aspects that require further investigation. Specifically, although the systematic review found that telephone-based interventions should be considered for the management of osteoarthritis and spinal pain, the referral of patients with knee osteoarthritis patients who were overweight or obese to an existing telephone weight loss service was neither effective nor cost-effective despite offering a scalable, accessible option for the delivery of weight loss care. Given the high prevalence of osteoarthritis, and that excess weight is a key driver for the onset and progression of this condition; a dedicated line of research to understand how to best deliver weight loss support at scale is warranted. This research should focus on how to best integrate and optimise scalable, effective weight loss interventions into clinical practice; such that clinicians can embed this care into routine practice and improve outcomes for patients with osteoarthritis.
Gattie, Eric. "Dry needling provided by physical therapists for the management of musculoskeletal pain conditions." Thesis, 2021. http://hdl.handle.net/1959.13/1429178.
Повний текст джерелаBackground: Dry needling is utilized by a growing number of physical therapists to treat musculoskeletal conditions. However, current evidence for its effectiveness is mixed and lacking long-term outcomes. Little is known about physical therapy practice patterns and safety performing dry needling. Purpose: To investigate (1) the effectiveness of dry needling as applied by physical therapists (Systematic review), (2) physical therapy clinical practice patterns related to dry needling (Survey), and (3) the long-term effectiveness of dry needling in patients with neck pain when applied using a typical physical therapy clinical approach (Randomized clinical trial). Methods: A systematic review with meta-analysis determined the effectiveness of dry needling applied by physical therapists for patients with musculoskeletal pain. A survey of physical therapists assessed dry needling practice patterns and adverse events. A sham-controlled randomized clinical trial with 1-year follow-up investigated the effectiveness of dry needling when added to a multi-modal treatment program of manual therapy and exercise for improving pain and disability in patients with mechanical neck pain. Results: The review of 13 studies (8 meta-analyses) found low to moderate quality evidence for dry needling in the short-term when compared to control/sham/other treatment, but few other long-term effects were reported. Fifty-five percent of 865 physical therapists surveyed performed dry needling, with practices consistent with expert advice. Minor adverse events were common. Major adverse events were rare, but more common than anticipated (407 occurrences reported by 413 respondents), 8 requiring emergency medical attention. The randomized clinical trial found no group-by-time interactions at 4-weeks, 6-months or 1-year for any outcomes (p>0.5), indicating the addition of dry needling to an evidence-based treatment had no added benefit. However, both groups demonstrated significant improvement in all outcomes (p<0.5) that was maintained to the 1-year follow up. Conclusions: The review found low to moderate quality evidence that dry needling is more effective compared to sham, no treatment, and physical therapy treatments in the short/medium-term, but not in the long-term. Physical therapists commonly apply dry needling, consistent with expert opinion, with frequent minor and several major adverse events reported. Adding dry needling to evidence-based care for patients with mechanical neck pain does not improve outcomes. These findings suggest dry needling may benefit some patients with musculoskeletal pain, but does not provide additional benefits beyond current evidence-based care in patients with neck pain. Potential risks of major adverse events suggest caution when applying dry needling and a need for more standardized training.
Jenkins, Heather Theresa. "Work-related thumb disorders in South African physiotherapists treating musculoskeletal conditions using manual therapy techniques." Thesis, 2014.
Знайти повний текст джерелаWilliams, Amanda Jayne. "The relationship between musculoskeletal conditions and chronic disease, and the management of lifestyle risk factors." Thesis, 2019. http://hdl.handle.net/1959.13/1397865.
Повний текст джерелаMusculoskeletal conditions, such as spinal pain and osteoarthritis (OA) have a high global burden. Although evidence suggests that musculoskeletal conditions are linked with both chronic diseases and lifestyle risk factors, there are significant evidence gaps in our understanding of these relationships. This thesis attempts to explore the relationship between musculoskeletal conditions and chronic diseases and assess the management of lifestyle risk factors in patients with common musculoskeletal conditions including chronic low back pain and knee OA. Chronic diseases and musculoskeletal conditions have a significant global burden and frequently co-occur. Emerging evidence suggests musculoskeletal conditions may contribute to the development of chronic disease and several mechanisms have been proposed to explain these links. However, the available studies have not been systematically synthesised, and longitudinal relationships have not been assessed. In Chapter Two, a systematic review was performed to investigate whether the most common musculoskeletal conditions contribute to the development of non-communicable chronic diseases. Electronic databases were searched for cohort studies reporting adjusted estimates of the association between musculoskeletal conditions (neck or back pain or osteoarthritis of the knee or hip) and subsequent development of chronic disease (cardiovascular disease, cancer, diabetes, chronic respiratory disease or obesity). Thirteen eligible cohort studies following 3,086,612 people were identified. In the primary meta-analysis of adjusted estimates, osteoarthritis was the exposure in eight studies and back pain in two studies and cardiovascular disease was the outcome in eight studies, cancer in one study, and diabetes in one study. Pooled adjusted estimates from these ten studies showed that people with a musculoskeletal condition, have a 17% increase in the risk of developing a chronic disease, compared to people without a musculoskeletal condition (hazard ratio 1.17, 95%CI 1.13 to 1.22; I2 52%, total n=2,686,113). The meta-analysis found musculoskeletal conditions may increase the risk of chronic disease. The results highlight that musculoskeletal conditions could be important in the prevention of chronic disease. There is evidence to suggest that the persistence of low back pain is linked to lifestyle risk factors, such as overweight and obesity. Although there is widespread suggestion that managing lifestyle risks such as weight, should be part of management for patients with low back pain, there is currently no evidence about the effectiveness of lifestyle management to guide clinical practice. Chapter Three presents a study protocol (Part A) and statistical analysis plan (Part B) for the first high quality randomised controlled trial (RCT) testing whether targeting lifestyle risk factors could improve outcomes for patients with chronic low back pain. Eligible patients (n=160) were randomly allocated, using a central concealed random allocation process, to receive advice and education and referral to a 6-month telephone-based healthy lifestyle coaching service, or usual care. Chapter Four presents the results of the trial and showed that there were no differences between groups for pain intensity over six months (area under the curve, mean difference 6.5, 95%CI -8.0 to 21.0; p=0.38) or any secondary outcome. The lifestyle intervention did not reduce self-reported weight, the hypothesised mechanism to influence important patient outcomes such as pain and disability. The results suggest that clinical education and advice coupled with referral to generic, non-disease specific telephone-based healthy lifestyle coaching may not adequately support patients with chronic low back pain. Standard analyses of RCTs estimate whether an intervention is effective or not. However, these analyses cannot provide explanations for how an intervention works, or why it does not work. Causal mediation analysis of RCTs can be used to determine if intervention effects worked through the hypothesised targets or if they are explained by other mechanisms. When there are no intervention effects, causal mediation analysis can help to determine if changing the targets is likely to lead to the outcome of interest. Chapter Five and Six presents an a priori protocol and results of a causal mediation analysis, respectively, of aggregated data from two RCTs; one which included 160 patients with chronic low back pain (the RCT presented in Chapters Three and Four), and another which included 120 patients with knee OA. In both trials the intervention consisted of brief advice and referral to a 6-month telephone-based healthy lifestyle coaching service. In the back pain trial participants were also offered a single physiotherapy consultation. The hypothesised primary mediator was self-reported weight and alternative mediators were diet, physical activity and pain beliefs. Outcomes were pain, disability and quality of life (QoL). Data were analysed using causal mediation analysis with sensitivity analyses for sequential ignorability. The intervention had no effect on pain intensity, disability or physical QoL. The intervention significantly improved mental QoL however, the intervention effect was not channeled via the selected mediators. The intervention did not reduce weight, or the alternative mediators (diet, physical activity, pain beliefs), and these mediators were not associated with the outcomes (with one exception; poor diet was associated with lower mental QoL). Although clinical guidelines advocate focusing on lifestyle risk factors and erroneous pain beliefs in patients with chronic low back pain or knee OA, there is uncertainty about whether they are causes of pain, disability, and poor QoL. These findings suggest that addressing lifestyle risk factors and erroneous pain beliefs may not be appropriate targets to improve pain, disability and quality of life in these patients. Decision makers often have limited funds and are required to choose between health care interventions. Economic analysis of RCTs provide decision makers with information to help guide allocation of scarce resources. Chapter Six presents an economic evaluation of a healthy lifestyle intervention for patients with chronic low back pain, compared with usual care (the RCT presented in Chapters Three and Four). The primary outcome was quality-adjusted life years (QALYs). Secondary outcomes were pain intensity, disability, weight, and body mass index. Costs included intervention costs, healthcare utilisation costs and work absenteeism costs. The primary analysis was conducted from the societal perspective and included all of these cost categories. Mean total costs were lower in the intervention group than the control group (-$614, 95%CI -3133 to 255). For all outcomes, the intervention was on average less expensive and more effective than usual care and the probability of the intervention being cost-effective compared to usual care was relatively high (i.e. 0.81) at a willingness-to-pay of $0/unit of effect. For QALYs, this probability increased to 0.90 at a willingness-to-pay of $17,000/QALY and reached a maximum of 0.96 at $67,000/QALY. However, the probability of cost-effectiveness was not as favourable among sensitivity analyses. These findings suggest that the healthy lifestyle intervention seems to be cost-effective from the societal perspective. However, variability in the sensitivity analyses indicate caution is needed when interpreting these findings. Overall, the studies included in this thesis have advanced the evidence-base regarding the relationship between musculoskeletal conditions and chronic disease, and the management of lifestyle risk factors. A systematic review of the literature suggests that musculoskeletal conditions should be considered in the prevention of chronic disease. However, a better understanding of the relationships between musculoskeletal conditions and chronic diseases is required to support inclusion of musculoskeletal conditions in the current chronic disease prevention agenda. To improve understanding about causal relationships, use of contemporary analytical methods in the assessment of longitudinal data is needed. Other aspects of this thesis explore management of lifestyle risk factors in patients with musculoskeletal conditions. Using existing population health services might be a scalable and cost-effective model to support clinicians to provide lifestyle-focused care for patients with musculoskeletal conditions. However, in their generic form, they do appear to produce clinically meaningful benefit to patients. Given the high prevalence of musculoskeletal conditions, a dedicated line of research would be warranted to support adaptation of available services for patients with musculoskeletal conditions and concomitant health risks. To maximise knowledge gained from the investment in research, clinical trialists should routinely plan and use supplementary analyses, such as causal mediation analyses and economic evaluations, in addition to standard analyses of treatment effectiveness. These methods of analysis extend knowledge from RCTs to guide intervention refinement and can inform decisions about resource allocation for clinical or policy decision-makers.
Ribeiro, Hermínia. "Adaptação cultural, validade e fiabilidade da versão portuguesa do Musculoskeletal Health Questionnaire (MSK-HQ)." Master's thesis, 2022. http://hdl.handle.net/10400.26/39546.
Повний текст джерелаIntroduction: Musculoskeletal conditions (MSC) have high prevalence in world's population being one major cause of years lived with disability. In this way, having an effective assessment and response by the health services is essential. Recent evidence has suggested that it is appropriate and relevant to consider a set of common domains in the management and evaluation of health outcomes in the various MSCs. The Musculoskeletal Health Questionnaire (MSK-HQ) is an instrument that assesses all those domains. The aim of this study was to culturally adapt the MSK-HQ to European Portuguese, and to analyze its validity and reliability in individuals with MSC. Methodology: This study was conducted in two phases. The first phase consisted of the translation and cultural adaptation of the MSK-HQ and followed current international guidelines. The second phase consisted in an observational, longitudinal and multicenter study, integrating a sample of individuals with MSC in the context of physiotherapy care. In the initial assessment, all participants filled in the Portuguese version of the MSK-HQ, the Numerical Pain Scale (NPS), and the Portuguese version of the European Quality of Life Survey (EQ-5D-3L). Participants with low back, neck, knee and shoulder pain filled in instruments specific to the body region, as they belonged to specific predefined subgroups. After 4 to 7 days, participants filled the MSK-HQ and the Portuguese version of the Patient Global Impression of Change (PGIC). Data collected in the initial assessment were used to study the internal consistency and construct validity. Data from the patients clinically stable after 4 to 7 days were used for analysis of the test-retest reliability and measurement error. Results: MSK-HQ was successfully translated and adapted to European Portuguese. Phase 2 of the study had a sample of 191 participants. MSK-HQ showed high internal consistency (α de Cronbach=0,885), and an excellent test-retest reliability (ICC(2,1)=0,908). Moderate correlations were also observed between the MSK-HQ and the EQ-5D-3L (rs=0,671), and between the MSK-HQ and all body-region specific instruments. The standard error was 2,82 and the minimum detectable difference was 7,81. Conclusion: MSK-HQ revealed adequate internal consistency and test-retest reliability. Most of the hypothesis predefined for the validity of the construct were confirmed. These results point to the use MSK-HQ in a clinical and research context in individuals with MSC.
Balasukumaran, Tharani. "The implication of backward walking in the rehabilitation of neuro-musculoskeletal conditions: systematic reviews and a biomechanical movement analysis." Thesis, 2018. https://hdl.handle.net/10539/25223.
Повний текст джерелаThe neuro-musculoskeletal gait impairments have an enormous and growing impact in the world. Estimation shows that one in four people suffer from gait impairments as a major limitation. It reduces the quality of life with poor balance, muscle fatigue, joint stiffness and deformity. To treat neuromuscular gait impairments proper rehabilitation training is crucial. Walking is one of the functional training used by therapist for rehabilitation. Though, walking refers a forward walking (FW) in our daily life backward walking (BW) was reported for an effective functional exercise in rehabilitation. The underlying biomechanical characteristics such kinetic and kinematic parameters of both FW and BW were studied to understand and predict the clinical benefits. Biomechanical characteristics of FW were studied extensively with respect to speed, inclination, and surface. Whereas, limited reports on BW were found with level and uphill walking with comfortable/fixed speed on both ground and treadmill. It is important to study biomechanical characteristics with respect to speed and inclination to understand neural control strategies and musculoskeletal activities during BW. This helps to evaluate their clinical worthiness before implementing on patients. The comparison of FW with BW as a systematic review is an optimum way to reveal their clinical benefits and unique changes in locomotion task. As there is no systematic review is available in the literature, the present thesis designed with two systematic reviews and an experimental study. In brief the methodologies followed in this thesis were as follow: The two systematic reviews identified existing literature based on a structured search strategy applied to various databases. The outcomes were statistically analysed by RevMan software. For experimental study, 3Dkinematic movements were tracked by reflective markers using Qualisys cameras. Force plate integrated treadmill was used to measure GRF and muscle activities were recorded by wireless EMG. These Qualisys camera, treadmill and EMG were synchronised with QTM software. The collected data were analysed and processed through Visual3D software. The processed data were used to simulate an anthropometric model via OpenSim software. This software was used to calculate the kinematic and kinetic parameters. The first systematic review in Chapter-3 explores the clinical effectiveness of BW as a functional training for neuro-musculoskeletal gait impairment condition. This review dealt with six types of comparison with BW as an experimental group. The systematic search strategy finalises the eight trials with three conditions such as knee osteoarthritis (OA), stroke, and diabetic peripheral neuropathy. The primary outcome measures were the pain, functional disability, muscle strength, gait parameters, balance and plantar pressure. The results show BW with CPT was significantly effective in reducing knee OA pain (total SMD: -0.87), lowering functional difficulties (total SMD: -1.39) and improving muscle strength (SMD: 1.51). In conclusion BW with CPT is an effective and clinically worthwhile training for rehabilitation of knee OA. The second systematic review in Chapter-4 deals with biomechanical characteristics BW through comparison of FW for healthy participants to understand neuromuscular contributions. Twenty trials were found through systematic search strategy for kinematic and kinetic outcomes. The results show that BW significantly different from FW with lower hip flexion, knee flexion, tibiofemoral joint reaction force, ankle joint power, hip joint power, GRF and temporal gait parameters. The muscles GM, BF, RF, and LGAS are more active in BW than FW. Hence, the modified neural control strategies were required to produce BW from FW. The absence of visual cues in BW improves the neuromuscular control, proprioception and protective reflexes. Among the trials, BW in water found to be safer and yields better results than ground and treadmill. The experimental study in Chapter-5 analysed biomechanical characteristics of FW and BW with controlled speed and inclination. Ten healthy participant were chosen for FW and BW in three inclinations (-5%, 0% and +5%) and speeds (0.28 m/s, 0.69 m/s and 1.11 m/s). The study concludes that, walking speed is directly related to energy requirements. Increasing the speed requires higher magnitudes of the joint moment, joint power and muscle activity irrespective of inclination and direction. In FW and BW, uphill and downhill task produces opposite joint moment with a variety of flexor and extensor muscles contributions. These indicate that the motor control task requires different control strategies for inclined walking. The anatomical constraint and visual cues give additional features in biomechanical parameters of BW. Hence, a simple time reversal is not sufficient to distinguish between BW and FW. Interestingly, the similarities were observed between FW uphill and BW downhill or FW downhill and BW uphill in hip/knee joint moment and muscle activities. Such as during FW uphill and BW downhill an extension moment was present at the hip joint and a flexion moment at the knee joint. Here, the biarticular muscles BF was active in both types of walking. But we cannot conclude both types of walking were controlled by the same neural network as power patterns were distinctly different. The distributions of total power flow among joints were found to be related to the posture associated with the inclination in both FW and BW. Ankle contribution is more in both FW uphill and BW downhill (leaned trunk) whereas hip contributes for FW downhill and BW uphill (erected trunk). In level walking ankle dominates in both FW and BW irrespective of speeds. The ankle joint had main propulsion at all inclination and speed during FW and BW except FW uphill.
XL2018