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Sample records for chronic compensated musculoskeletal

  1. Does self-management for return to work increase the effectiveness of vocational rehabilitation for chronic compensated musculoskeletal disorders? - Protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    McLeod Rebecca

    2010-06-01

    Full Text Available Abstract Background Musculoskeletal disorders are common and costly disorders to workers compensation and motor accident insurance systems and are a leading contributor to the burden of ill-health. In Australia, vocational rehabilitation is provided to workers to assist them to stay in, or return to work. Self-management training may be an innovative addition to improve health and employment outcomes from vocational rehabilitation. Methods/Design The research plan contains mixed methodology consisting of a single blind randomised controlled trial, an economic evaluation and qualitative research. Participants (n = 366 are volunteers with compensated musculoskeletal disorders of 3 months to 3 years in duration who were working at the time of the injury/onset of the chronic disorder. The trial tests the effectiveness of usual vocational rehabilitation plus the Chronic Disease Self-Management Program (CDSMP to which two additional and newly-developed modules have been added, against vocational rehabilitation alone (control The modules added to the CDSMP focus on how to navigate through compensation systems and manage the return to work process, and aim to be relevant to those in a vocational rehabilitation setting. The primary outcome of this study is readiness for return to work which will be evaluated using the Readiness for Return-to-Work scale. Secondary outcomes include return to work status, health efficacy (heiQ™ questionnaire and general health status (SF-12v2® Health Survey. Measures will be taken at baseline, immediately post-intervention and at 6- and 12- months post-intervention by an independent assessor. An economic evaluation will compare the costs and outcomes between the intervention and control groups in terms of cost-effectiveness and a partial cost-benefit or cost analysis. The impact of the intervention will also be evaluated qualitatively, in terms of its acceptability to stakeholders. Discussion This article describes the

  2. Common acute and chronic musculoskeletal injuries among female ...

    African Journals Online (AJOL)

    The hip/lower back was the most prevalent anatomical site of chronic musculoskeletal injury. (p<0.001). The intrinsic ..... Musculoskeletal disorders among nursing personnel in Korea. Int J ... Marieb E. Human Anatomy and Physiology. 7th ed.

  3. Various musculoskeletal manifestations of chronic renal insufficiency

    International Nuclear Information System (INIS)

    Lim, C.Y.; Ong, K.O.

    2013-01-01

    Musculoskeletal manifestations in chronic renal insufficiency are caused by complex bone metabolism alterations, now described under the umbrella term of chronic kidney disease mineral- and bone-related disorder (CKD-MBD), as well as iatrogenic processes related to renal replacement treatment. Radiological imaging remains the mainstay of disease assessment. This review aims to illustrate the radiological features of CKD-MBD, such as secondary hyperparathyroidism, osteomalacia, adynamic bone disease, soft-tissue calcifications; as well as features associated with renal replacement therapy, such as aluminium toxicity, secondary amyloidosis, destructive spondyloarthropathy, haemodialysis-related erosive arthropathy, tendon rupture, osteonecrosis, and infection

  4. Duloxetine in the management of chronic musculoskeletal pain

    OpenAIRE

    Smith, Howard; Smith,; Smith,

    2012-01-01

    Howard S Smith,1 Eric J Smith,2 Benjamin R Smith21Department of Anesthesiology, Albany Medical College, Albany, NY; 2The Pharmaceutical Research Institute, Albany College of Pharmacy and Health Sciences, Rensselaer, NY, USAAbstract: Chronic musculoskeletal pain is among the most frequent painful complaints that healthcare providers address. The bulk of these complaints are chronic low back pain and chronic osteoarthritis. Osteoarthritis is the most common form of arthritis in the United State...

  5. [Working women with chronic musculoskeletal pain: a case series].

    Science.gov (United States)

    Ordóñez-Hernández, Cecilia Andrea; Contreras-Estrada, Mónica Isabel; Soltero-Avelar, Ruben

    2015-10-01

    This study aimed to analyze the experience of working women suffering from chronic musculoskeletal pain, using a qualitative design with a phenomenological approach. The technique drew on in-depth interviews with five working women that presented to the orthopedics and neurosurgery departments of a hospital in Guadalajara, Mexico, with a complaint of musculoskeletal pain for more than six months. The study showed that the women felt rejection, segregation, discrimination, lack of support at the workplace, and feelings of frustration and powerlessness related to their health condition. The women also perceived as a barrier the lack of efficiency in disability proceedings and job reintegration or relocation. Financial and family responsibilities were their main reason for continuing to work despite their chronic musculoskeletal pain.

  6. Footwear Experiences of People With Chronic Musculoskeletal Diseases.

    Science.gov (United States)

    Hendry, Gordon J; Brenton-Rule, Angela; Barr, Georgina; Rome, Keith

    2015-08-01

    Foot pain and deformities are frequently reported by people with chronic musculoskeletal diseases, but only limited research has been conducted to explore the key issues concerning footwear difficulties in this population. The aim of this study is to explore, identify, and describe the main issues surrounding the footwear experiences of people with chronic musculoskeletal diseases. A qualitative manifest content analysis of open-ended survey responses concerning footwear experiences was conducted from a national footwear survey of people with chronic musculoskeletal diseases in New Zealand. Eighty-five respondents submitted usable responses. Specific statements in the text were identified as units of analysis prior to coding and organizing these units into emerging mutually exclusive categories. Content analysis was independently undertaken by 3 researchers, and the final categories and coding were achieved through consensus. Frequencies of assigned units of analysis were calculated in order to obtain a quantitative description for each category. Four categories encompassing a total of 9 subcategories related to the footwear experiences of respondents emerged from the qualitative data content analysis: difficulty finding appropriate footwear; dissatisfaction with therapeutic footwear provision and foot care access; high costs of footwear, foot care, and self-care; and satisfaction with therapeutic footwear and foot care. Key categories describing the important issues surrounding the footwear experiences of respondents with chronic musculoskeletal diseases were identified, which may provide important targets for improving footwear and foot care services and self-management strategies. © 2015, American College of Rheumatology.

  7. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain

    OpenAIRE

    Hauser, Ross A.; Lackner, Johanna B.; Steilen-Matias, Danielle; Harris, David K.

    2016-01-01

    Objective The aim of this study was to systematically review dextrose (D-glucose) prolotherapy efficacy in the treatment of chronic musculoskeletal pain. Data Sources Electronic databases PubMed, Healthline, OmniMedicalSearch, Medscape, and EMBASE were searched from 1990 to January 2016. Study Selection Prospectively designed studies that used dextrose as the sole active prolotherapy constituent were selected. Data Extraction Two independent reviewers rated studies for quality of evidence usi...

  8. The musculoskeletal radiologic findings associated with chronic renal insufficiency

    International Nuclear Information System (INIS)

    Ruiz, P.J.; Gomez, I.; Hernandez, L.; Relanzon, S.; Hurtado, M.

    1997-01-01

    The numerous musculoskeletal changes associated with chronic renal insufficiency (CRI) are detected with increasing frequency since hemodialysis and kidney transplantation have prolonged the survival of these patients. These signs have been divided into two large groups. The first includes secondary hyperparathyroidism (bone resorption, periostitis and brown tumors), osteoporosis, osteosclerosis, osteomalacia and vascular and soft tissue calcification, all of which are grouped under the term renal osteodystrophy. the second group is composed of miscellaneous disorders including aluminum poisoning, amyloid and crystal deposition, destructive spondyloarthropathy, tendon rupture, infection and avascular necrosis. These changes are less common and occur especially in patients under prolonged hemodialysis or kidney transplant recipients. The detection of musculoskeletal involvement in CRI patients has a considerable impact on their clinical management. The present article reviews the radiological signs of these changes, including representative images that will aid in their recognition. (Author) 33 refs

  9. Tanezumab in the treatment of chronic musculoskeletal conditions.

    Science.gov (United States)

    Jayabalan, Prakash; Schnitzer, Thomas J

    2017-02-01

    The management of pain associated with chronic musculoskeletal conditions represents a significant challenge for the clinician. There remains a need for novel medications that have a significant analgesic benefit and are also safe and well tolerated. Both pre-clinical and clinical data have provided evidence of the role of nerve growth factor (NGF) in a multitude of pain eliciting conditions. Therefore, the development of monoclonal antibodies to NGF for chronic painful musculoskeletal conditions has generated interest. Areas covered: This manuscript is a review that examines both the pharmacological properties and clinical studies of tanezumab, the most widely studied antibody to NGF, for management of osteoarthritis (OA) and low back pain. In addition, the safety and tolerability profile and development history of tanezumab are also discussed. Expert opinion: Most studies provide strong support for the ability of tanezumab to provide clinically meaningful pain relief in individuals with these conditions, with longer-term studies suggesting durability of effect. The adverse event profile appears favorable, assuming the risk mitigation strategies are effective at reducing the incidence of joint-related side effects. Further data are being collected to define the optimal dose and dosing strategy in both OA and chronic low back pain.

  10. Multi-faceted case management: reducing compensation costs of musculoskeletal work injuries in Australia.

    Science.gov (United States)

    Iles, Ross Anthony; Wyatt, M; Pransky, G

    2012-12-01

    This study aimed to determine whether a multi-faceted model of management of work related musculoskeletal disorders reduced compensation claim costs and days of compensation for injured workers. An intervention including early reporting, employee centred case management and removal of barriers to return to work was instituted in 16 selected companies with a combined remuneration over $337 million. Outcomes were evaluated by an administrative dataset from the Victorian WorkCover Authority database. A 'quasi experimental' pre-post design was employed with 492 matched companies without the intervention used as a control group and an average of 21 months of post-intervention follow-up. Primary outcomes were average number of days of compensation and average cost of claims. Secondary outcomes were total medical costs and weekly benefits paid. Information on 3,312 claims was analysed. In companies where the intervention was introduced the average cost of claims was reduced from $6,019 to $3,913 (estimated difference $2,329, 95 % CI $1,318-$3,340) and the number of days of compensation decreased from 33.5 to 14.1 (HR 0.77, 95 % CI 0.67-0.88). Medical costs and weekly benefits costs were also lower after the intervention (p costs were noted across industry types, injury location and most employer sizes. The model of claims management investigated was effective in reducing the number of days of compensation, total claim costs, total medical costs and the amount paid in weekly benefits. Further research should investigate whether the intervention improves non-financial outcomes in the return to work process.

  11. Association between chronic musculoskeletal pain and executive function in community-dwelling older adults.

    Science.gov (United States)

    Murata, S; Sawa, R; Nakatsu, N; Saito, T; Sugimoto, T; Nakamura, R; Misu, S; Ueda, Y; Ono, R

    2017-11-01

    We examined the association of chronic musculoskeletal pain with executive function in community-dwelling older adults. This cross-sectional study recruited 234 community-dwelling older adults in Japan (mean age: 72.7, women: 62.8%). Chronic musculoskeletal pain was defined as having moderate or more severe pain lasting ≥ 3 months. Executive function was assessed using the Digit Symbol Substitution Test (DSST), Trail Making Test (TMT) parts A and B, Letter Verbal Fluency Test (LVFT) and Category Verbal Fluency Test (CVFT). Prevalence of chronic musculoskeletal pain was 19% (n = 44). In the univariate analysis, the DSST and CVFT scores were significantly lower in the chronic musculoskeletal pain group than in the control group (DSST: chronic musculoskeletal pain group vs. control group, 40.2 vs. 45.4, respectively, p dwelling older adults. The association of chronic musculoskeletal pain with executive function requires further investigation. Our results suggest an association between moderate-severe chronic musculoskeletal pain and impairments of semantic fluency and processing speed in community-dwelling older adults. © 2017 European Pain Federation - EFIC®.

  12. Exploring the Associations between Sleep Problems and Chronic Musculoskeletal Pain in Adolescents: A Prospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Lee Harrison

    2014-01-01

    Full Text Available BACKGROUND: The prevalence of musculoskeletal chronic pain in adolescents is estimated to be approximately 4% to 40%. The development of musculoskeletal pain during teenage years could have a marked impact on physical, psychological and social well-being.

  13. ‘On their own’: social isolation, loneliness and chronic musculoskeletal pain in older adults

    OpenAIRE

    Smith, Toby

    2017-01-01

    Purpose: In this paper, the concepts of social isolation and loneliness will be explored in relation to people with chronic musculoskeletal pain. Through this, biological, psychological and social factors will be examined to consider how we can identified people at risk of social isolation and loneliness who have chronic musculoskeletal pain and secondly how health professionals may intervene to reduce their effects. Design/methodology/approach: Conceptual paper. Findings: Social isolation an...

  14. The use of CAM and conventional treatments among primary care consulters with chronic musculoskeletal pain

    OpenAIRE

    Lewis Martyn; Croft Peter; Artus Majid

    2007-01-01

    Abstract Background Chronic musculoskeletal pain is the single most cited reason for use of complementary and alternative medicine (CAM). Primary care is the most frequent conventional medical service used by patients with pain in the UK. We are unaware, however, of a direct evidence of the extent of CAM use by primary care patients, and how successful they perceive it to be. Methods Aims and objectives To determine CAM use among patients with chronic musculoskeletal pain who have consulted a...

  15. Homecare-based motor rehabilitation in musculoskeletal chronic graft versus host disease

    Directory of Open Access Journals (Sweden)

    A Tendas

    2011-01-01

    Full Text Available Chronic graft versus host disease (cGVHD is a frequent complication of allogeneic stem cell transplantation. Extensive musculoskeletal and skin involvement may induce severe functional impairment, disability and quality of life deterioration. Physical rehabilitation is recommended as ancillary therapy in these forms, but experiences are sparse. A 39-year-old man affected by musculoskeletal and skin chronic graft versus host disease (cGVHD was treated with a homecare-based motor rehabilitation program during palliation for disease progression. Significant functional improvement was obtained. Motor rehabilitation should be strongly considered for patients with musculoskeletal cGVHD, both in the palliative and in the curative phase of disease.

  16. Addressing Neuroplastic Changes in Distributed Areas of the Nervous System Associated With Chronic Musculoskeletal Disorders.

    Science.gov (United States)

    Pelletier, René; Higgins, Johanne; Bourbonnais, Daniel

    2015-11-01

    Present interventions utilized in musculoskeletal rehabilitation are guided, in large part, by a biomedical model where peripheral structural injury is believed to be the sole driver of the disorder. There are, however, neurophysiological changes across different areas of the peripheral and central nervous systems, including peripheral receptors, dorsal horn of the spinal cord, brain stem, sensorimotor cortical areas, and the mesolimbic and prefrontal areas associated with chronic musculoskeletal disorders, including chronic low back pain, osteoarthritis, and tendon injuries. These neurophysiological changes appear not only to be a consequence of peripheral structural injury but also to play a part in the pathophysiology of chronic musculoskeletal disorders. Neurophysiological changes are consistent with a biopsychosocial formulation reflecting the underlying mechanisms associated with sensory and motor findings, psychological traits, and perceptual changes associated with chronic musculoskeletal conditions. These changes, therefore, have important implications in the clinical manifestation, pathophysiology, and treatment of chronic musculoskeletal disorders. Musculoskeletal rehabilitation professionals have at their disposal tools to address these neuroplastic changes, including top-down cognitive-based interventions (eg, education, cognitive-behavioral therapy, mindfulness meditation, motor imagery) and bottom-up physical interventions (eg, motor learning, peripheral sensory stimulation, manual therapy) that induce neuroplastic changes across distributed areas of the nervous system and affect outcomes in patients with chronic musculoskeletal disorders. Furthermore, novel approaches such as the use of transcranial direct current stimulation and repetitive transcranial magnetic stimulation may be utilized to help renormalize neurological function. Comprehensive treatment addressing peripheral structural injury as well as neurophysiological changes occurring across

  17. Central Hyperexcitability in Chronic Musculoskeletal Pain: A Conceptual Breakthrough with Multiple Clinical Implications

    Directory of Open Access Journals (Sweden)

    Jan Lidbeck

    2002-01-01

    Full Text Available Recent investigations of dysfunctional pain processing in the central nervous system have contributed much knowledge about the development of chronic musculoskeletal pain. Many common chronic musculoskeletal pain syndromes - including regional myofascial pain syndromes, whiplash pain syndromes, refractory work-related neck-shoulder pain, certain types of chronic low back pain, fibromyalgia and others - may essentially be explained by abnormalities in central pain modulation. The growing awareness of dysfunctional central pain modulation may be a conceptual breakthrough leading to a better understanding of common chronic pain disorders. A new paradigm will have multiple clinical implications, including re-evaluation of clinical practice routines and rehabilitation methods, and will focus on controversial issues of medicolegal concern. The concept of dysfunctional central pain processing will also necessitate a mechanism-based classification of pain for the selection of individual treatment and rehabilitation programs for subgroups of patients with chronic musculoskeletal pain due to different pathophysiological mechanisms.

  18. Musculoskeletal Dysfunctions in Patients With Chronic Pelvic Pain

    DEFF Research Database (Denmark)

    Mieritz, Rune Mygind; Thorhauge, Kirsten; Forman, Axel

    2016-01-01

    stratified levels of self-reported pelvic pain, self-rated health, education, and work status based on musculoskeletal dysfunction status. METHODS: This study used a cross-sectional design to determine the prevalence of musculoskeletal dysfunctions in women with CPP who were referred to a tertiary care...... between the groups with respect to self-rated health, education, work status, and pain level. Pain location was significantly different after Bonferroni correction in 1 out of the 36 aspects. CONCLUSIONS: In this sample of CPP patients, 51% were categorized as having a musculoskeletal dysfunction. Overall...

  19. Staying at work with chronic nonspecific musculoskeletal pain : a qualitative study of workers' experiences

    NARCIS (Netherlands)

    de Vries, Haitze J.; Brouwer, Sandra; Groothoff, Johan W.; Geertzen, Jan H. B.; Reneman, Michiel F.

    2011-01-01

    Background: Many people with chronic nonspecific musculoskeletal pain (CMP) have decreased work ability. The majority, however, stays at work despite their pain. Knowledge about workers who stay at work despite chronic pain is limited, narrowing our views on work participation. The aim of this study

  20. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain

    Science.gov (United States)

    Hauser, Ross A.; Lackner, Johanna B.; Steilen-Matias, Danielle; Harris, David K.

    2016-01-01

    OBJECTIVE The aim of this study was to systematically review dextrose (d-glucose) prolotherapy efficacy in the treatment of chronic musculoskeletal pain. DATA SOURCES Electronic databases PubMed, Healthline, OmniMedicalSearch, Medscape, and EMBASE were searched from 1990 to January 2016. STUDY SELECTION Prospectively designed studies that used dextrose as the sole active prolotherapy constituent were selected. DATA EXTRACTION Two independent reviewers rated studies for quality of evidence using the Physiotherapy Evidence Database assessment scale for randomized controlled trials (RCTs) and the Downs and Black evaluation tool for non-RCTs, for level of evidence using a modified Sackett scale, and for clinically relevant pain score difference using minimal clinically important change criteria. Study population, methods, and results data were extracted and tabulated. DATA SYNTHESIS Fourteen RCTs, 1 case–control study, and 18 case series studies met the inclusion criteria and were evaluated. Pain conditions were clustered into tendinopathies, osteoarthritis (OA), spinal/pelvic, and myofascial pain. The RCTs were high-quality Level 1 evidence (Physiotherapy Evidence Database ≥8) and found dextrose injection superior to controls in Osgood–Schlatter disease, lateral epicondylitis of the elbow, traumatic rotator cuff injury, knee OA, finger OA, and myofascial pain; in biomechanical but not subjective measures in temporal mandibular joint; and comparable in a short-term RCT but superior in a long-term RCT in low back pain. Many observational studies were of high quality and reported consistent positive evidence in multiple studies of tendinopathies, knee OA, sacroiliac pain, and iliac crest pain that received RCT confirmation in separate studies. Eighteen studies combined patient self-rating (subjective) with psychometric, imaging, and/or biomechanical (objective) outcome measurement and found both positive subjective and objective outcomes in 16 studies and positive

  1. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain.

    Science.gov (United States)

    Hauser, Ross A; Lackner, Johanna B; Steilen-Matias, Danielle; Harris, David K

    2016-01-01

    The aim of this study was to systematically review dextrose (d-glucose) prolotherapy efficacy in the treatment of chronic musculoskeletal pain. Electronic databases PubMed, Healthline, OmniMedicalSearch, Medscape, and EMBASE were searched from 1990 to January 2016. Prospectively designed studies that used dextrose as the sole active prolotherapy constituent were selected. Two independent reviewers rated studies for quality of evidence using the Physiotherapy Evidence Database assessment scale for randomized controlled trials (RCTs) and the Downs and Black evaluation tool for non-RCTs, for level of evidence using a modified Sackett scale, and for clinically relevant pain score difference using minimal clinically important change criteria. Study population, methods, and results data were extracted and tabulated. Fourteen RCTs, 1 case-control study, and 18 case series studies met the inclusion criteria and were evaluated. Pain conditions were clustered into tendinopathies, osteoarthritis (OA), spinal/pelvic, and myofascial pain. The RCTs were high-quality Level 1 evidence (Physiotherapy Evidence Database ≥8) and found dextrose injection superior to controls in Osgood-Schlatter disease, lateral epicondylitis of the elbow, traumatic rotator cuff injury, knee OA, finger OA, and myofascial pain; in biomechanical but not subjective measures in temporal mandibular joint; and comparable in a short-term RCT but superior in a long-term RCT in low back pain. Many observational studies were of high quality and reported consistent positive evidence in multiple studies of tendinopathies, knee OA, sacroiliac pain, and iliac crest pain that received RCT confirmation in separate studies. Eighteen studies combined patient self-rating (subjective) with psychometric, imaging, and/or biomechanical (objective) outcome measurement and found both positive subjective and objective outcomes in 16 studies and positive objective but not subjective outcomes in two studies. All 15 studies

  2. A Systematic Review of Dextrose Prolotherapy for Chronic Musculoskeletal Pain

    Directory of Open Access Journals (Sweden)

    Ross A. Hauser

    2016-01-01

    Full Text Available Objective The aim of this study was to systematically review dextrose (D-glucose prolotherapy efficacy in the treatment of chronic musculoskeletal pain. Data Sources Electronic databases PubMed, Healthline, OmniMedicalSearch, Medscape, and EMBASE were searched from 1990 to January 2016. Study Selection Prospectively designed studies that used dextrose as the sole active prolotherapy constituent were selected. Data Extraction Two independent reviewers rated studies for quality of evidence using the Physiotherapy Evidence Database assessment scale for randomized controlled trials (RCTs and the Downs and Black evaluation tool for non-RCTs, for level of evidence using a modified Sackett scale, and for clinically relevant pain score difference using minimal clinically important change criteria. Study population, methods, and results data were extracted and tabulated. Data Synthesis Fourteen RCTs, 1 case–control study, and 18 case series studies met the inclusion criteria and were evaluated. Pain conditions were clustered into tendinopathies, osteoarthritis (OA, spinal/pelvic, and myofascial pain. The RCTs were high-quality Level 1 evidence (Physiotherapy Evidence Database ≥8 and found dextrose injection superior to controls in Osgood–Schlatter disease, lateral epicondylitis of the elbow, traumatic rotator cuff injury, knee OA, finger OA, and myofascial pain; in biomechanical but not subjective measures in temporal mandibular joint; and comparable in a short-term RCT but superior in a long-term RCT in low back pain. Many observational studies were of high quality and reported consistent positive evidence in multiple studies of tendinopathies, knee OA, sacroiliac pain, and iliac crest pain that received RCT confirmation in separate studies. Eighteen studies combined patient self-rating (subjective with psychometric, imaging, and/or biomechanical (objective outcome measurement and found both positive subjective and objective outcomes in 16 studies

  3. Common acute and chronic musculoskeletal injuries among female ...

    African Journals Online (AJOL)

    Objective. To document the prevalence and nature of musculoskeletal injuries among female adolescent hockey players over a 12-month period (1 November 2011 - 31 October 2012). Methods. Data were collected from 148 high school players who belonged to the KwaZulu-Natal Hockey League via voluntary, ...

  4. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain and stress among laboratory technicians

    DEFF Research Database (Denmark)

    Jay, Kenneth; Brandt, Mikkel; Hansen, Klaus

    2015-01-01

    BACKGROUND: Chronic musculoskeletal pain is prevalent among laboratory technicians and work-related stress may aggravate the problem. OBJECTIVES: This study investigated the effect of a multifaceted worksite intervention on pain and stress among laboratory technicians with chronic musculoskeletal......: neck, shoulder, lower and upper back, elbow, and hand at 10 week follow-up. The secondary outcome measure was stress assessed by Cohen´s perceived stress questionnaire. In addition, an explorative dose-response analysis was performed on the adherence to PCMT with pain and stress, respectively......, as outcome measures. RESULTS: A significant (P stress was observed (treatment by time P = 0.16). Exploratory analyses for each body...

  5. Chronic Musculoskeletal Disabilities following Snake Envenoming in Sri Lanka: A Population-Based Study.

    Directory of Open Access Journals (Sweden)

    Subashini Jayawardana

    2016-11-01

    Full Text Available Snakebite is a major public health problem in agricultural communities in the tropics leading to acute local and systemic impairments with resultant disabilities. Snakebite related long-term musculoskeletal disabilities have been a neglected area of research. We conducted a population-based, cross-sectional study in an agricultural community to describe the chronic musculoskeletal disabilities of snake envenoming.A sample representative of residents of a single district in a region of high incidence of snake envenoming was recruited to identify ever snakebite victims. They were evaluated for chronic musculoskeletal disabilities that had developed immediately or within four weeks after the snakebite and persisted over three months. In-depth interviews, validated musculoskeletal functional assessment criteria and specialists' examinations were utilised. Among the 816 victims, 26 (3.2%, 95% confidence interval: 2.2-4.6% had musculoskeletal disabilities, persisting on average for 13.4 years (SD = 14.4. The disabilities were mostly in lower limbs (61.5% and ranged from swelling (34.6%, muscle wasting (46.1%, reduced motion (61.5%, reduced muscle power (50%, impaired balance (26.9%, chronic non-healing ulcers (3.85%, abnormal gait (3.85%, fixed deformities (19.2% to amputations (15.4%. Based on disability patterns, six snakebite-related musculoskeletal syndromes were recognised. The offending snakes causing disabilities were cobra (30.8%, Russell's viper (26.9% and hump-nosed viper (7.7%. Cobra bites manifested muscle wasting (87.5%, reduced muscle power (87.5%, joint stiffness (62.5% and deformities (37.5% while viper bites manifested impaired balance (42.8%, pain (71.4% and swelling (71.4%.Snakebite envenoming is associated with considerable long-term musculoskeletal disabilities. Facilities for specialized care and rehabilitation need to be established in high risk areas.

  6. Insomnia, Sleep Duration, Depressive Symptoms, and the Onset of Chronic Multisite Musculoskeletal Pain.

    Science.gov (United States)

    Generaal, Ellen; Vogelzangs, Nicole; Penninx, Brenda W J H; Dekker, Joost

    2017-01-01

    The temporal relationships among sleep, depressive symptoms, and pain are unclear. This longitudinal study examines whether insomnia and sleep duration predict the onset of chronic multisite musculoskeletal pain over 6 years and whether this association is mediated by depressive symptoms. 1860 subjects of the Netherlands Study of Depression and Anxiety, free from chronic multisite musculoskeletal pain at baseline, were followed up for the onset of chronic multisite musculoskeletal pain over 6 years (Chronic Pain Grade Questionnaire). We determined baseline insomnia (Women's Health Initiative Insomnia Rating Scale ≥9) and sleep duration (short: ≤6 hr, normal: 7-9 hr, long: ≥10 hr). Depressive symptoms were assessed at baseline and as a change score over time (Inventory of Depressive Symptomatology). Insomnia (hazard ratio [HR] [95% confidence interval, 95%CI] = 1.60 [1.30-1.96], p insomnia and short sleep with chronic pain onset (∆B = 40% and 26%, respectively). Adding the change score of depressive symptoms further weakened the association for insomnia (∆B = 16%) but not for short sleep. All direct effects for sleep measures with chronic pain onset remained statistically significant (p insomnia and short sleep duration are risk factors for developing chronic pain. Depressive symptoms partially mediate the effect for insomnia and short sleep with developing chronic pain. © Sleep Research Society 2016. Published by Oxford University Press on behalf of the Sleep Research Society. All rights reserved. For permissions, please e-mail journals.permissions@oup.com.

  7. Effects of Chronic Musculoskeletal Pain on Fertility Potential in Lean and Overweight Male Patients

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    Fereshteh Dardmeh

    2017-01-01

    Full Text Available Both chronic pain and obesity are known to affect reproductive hormone profiles in male patients. However, the effect of these conditions, alone or in combination, on male fertility potential has received less attention. 20 chronic musculoskeletal pain patients and 20 healthy controls were divided into lean and overweight subgroups according to their BMI. Current level of chronic pain (visual analogue scale and pressure pain thresholds (PPTs in 16 predefined sites, classically described and tested as painful points on the lower body, were measured. Levels of reproductive hormone and lipid profiles were assessed by ELISA. Sperm concentration and motility parameters were analyzed using a computer-aided sperm analysis system. Sperm concentration, progressive motility, and percentage of hyperactivated sperm were generally lower in the chronic pain patients in both lean and overweight groups. The overweight control and the lean chronic pain groups demonstrated a significantly lower percentage of progressively motile sperm compared with the lean control group, suggesting that musculoskeletal chronic pain may have a negative influence on sperm quality in lean patients. However, due to the potential great negative influence of obesity on the sperm parameters, it is difficult to propose if musculoskeletal chronic pain also influenced sperm quality in overweight patients. Further research in chronic pain patients is required to test this hypothesis.

  8. Interrelationships between chronic tension-type headache, musculoskeletal pain, and vitamin D deficiency: Is osteomalacia responsible for both headache and musculoskeletal pain?

    Directory of Open Access Journals (Sweden)

    Sanjay Prakash

    2013-01-01

    Full Text Available Background: Headache, musculoskeletal symptoms, and vitamin D deficiency are common in the general population. However, the interrelations between these three have not been delineated in the literature. Materials and Methods: We retrospectively studied a consecutive series of patients who were diagnosed as having chronic tension-type headache (CTTH and were subjected to the estimation of serum vitamin D levels. The subjects were divided into two groups according to serum 25(OH D levels as normal (>20 ng/ml or vitamin D deficient (<20 ng/ml. Results: We identified 71 such patients. Fifty-two patients (73% had low serum 25(OH D (<20 ng/dl. Eighty-three percent patients reported musculoskeletal pain. Fifty-two percent patients fulfilled the American College of Rheumatology criteria for chronic widespread pain. About 50% patients fulfilled the criteria for biochemical osteomalacia. Low serum 25(OH D level (<20 ng/dl was significantly associated with headache, musculoskeletal pain, and osteomalacia. Discussion: These suggest that both chronic musculoskeletal pain and chronic headache may be related to vitamin D deficiency. Musculoskeletal pain associated with vitamin D deficiency is usually explained by osteomalacia of bones. Therefore, we speculate a possibility of osteomalacia of the skull for the generation of headache (osteomalacic cephalalgia?. It further suggests that both musculoskeletal pain and headaches may be the part of the same disease spectrum in a subset of patients with vitamin D deficiency (or osteomalacia, and vitamin D deficiency may be an important cause of secondary CTTH.

  9. Self-reported Work Ability and Work Performance in Workers with Chronic Nonspecific Musculoskeletal Pain

    NARCIS (Netherlands)

    de Vries, H.J.; Reneman, M.F.; Groothoff, J.W.; Geertzen, J.H.; Brouwer, S.

    Purpose To assess self-reported work ability and work performance of workers who stay at work despite chronic nonspecific musculoskeletal pain (CMP), and to explore which variables were associated with these outcomes. Methods In a cross-sectional study we assessed work ability (Work Ability Index,

  10. Factors promoting staying at work in people with chronic nonspecific musculoskeletal pain : a systematic review

    NARCIS (Netherlands)

    de Vries, H.J.; Reneman, M.F.; Groothoff, J.W.; Geertzen, J.H.B.; Brouwer, S.

    2012-01-01

    Purpose: To identify determinants for staying at work (SAW) in workers with chronic musculoskeletal pain (CMP). Method: A systematic review of factors that promote SAW in workers with CMP. We searched the databases of PubMed, EMBASE, PsycInfo, CINAHL and the Cochrane Library. We included studies

  11. Life satisfaction in patients with chronic musculoskeletal pain and its predictors

    NARCIS (Netherlands)

    Boonstra, Anne M.; Reneman, Michiel F.; Stewart, Roy E.; Post, Marcel W.; Preuper, Henrica R. Schiphorst

    Purpose To determine the life satisfaction of patients with chronic non-malignant musculoskeletal pain (CMP) compared to the general population (GP) and to identify predictors of life satisfaction. Methods Subjects were patients with CMP (n = 1,082) admitted to multidisciplinary rehabilitation and a

  12. Explaining sex differences in chronic musculoskeletal pain in a general population.

    NARCIS (Netherlands)

    Wijnhoven, Hanneke A H; Vet, Henrica C W de; Picavet, H Susan J

    2006-01-01

    Many studies report a female predominance in the prevalence of chronic musculoskeletal pain (CMP) but the mechanisms explaining these sex differences are poorly understood. Data from a random postal questionnaire survey in the Dutch general population were used to examine whether sex differences in

  13. The brain-derived neurotrophic factor pathway, life stress, and chronic multi-site musculoskeletal pain.

    Science.gov (United States)

    Generaal, Ellen; Milaneschi, Yuri; Jansen, Rick; Elzinga, Bernet M; Dekker, Joost; Penninx, Brenda W J H

    2016-01-01

    Brain-derived neurotrophic factor (BDNF) disturbances and life stress, both independently and in interaction, have been hypothesized to induce chronic pain. We examined whether (a) the BDNF pathway (val(66)met genotype, gene expression, and serum levels), (b) early and recent life stress, and (c) their interaction are associated with the presence and severity of chronic multi-site musculoskeletal pain. Cross-sectional data are from 1646 subjects of the Netherlands Study of Depression and Anxiety. The presence and severity of chronic multi-site musculoskeletal pain were determined using the Chronic Pain Grade (CPG) questionnaire. The BDNF val(66)met polymorphism, BDNF gene expression, and BDNF serum levels were measured. Early life stress before the age of 16 was assessed by calculating a childhood trauma index using the Childhood Trauma Interview. Recent life stress was assessed as the number of recent adverse life events using the List of Threatening Events Questionnaire. Compared to val(66)val, BDNF met carriers more often had chronic pain, whereas no differences were found for BDNF gene expression and serum levels. Higher levels of early and recent stress were both associated with the presence and severity of chronic pain (p stress in the associations with chronic pain presence and severity. This study suggests that the BDNF gene marks vulnerability for chronic pain. Although life stress did not alter the impact of BDNF on chronic pain, it seems an independent factor in the onset and persistence of chronic pain. © The Author(s) 2016.

  14. Does the economy affect functional restoration outcomes for patients with chronic disabling occupational musculoskeletal disorders?

    Science.gov (United States)

    Hartzell, Meredith M; Mayer, Tom G; Neblett, Randy; Marquardt, Dennis J; Gatchel, Robert J

    2015-06-01

    To determine how the economy affects psychosocial and socioeconomic treatment outcomes in a cohort of chronic disabling occupational musculoskeletal disorder (CDOMD) patients who completed a functional restoration program (FRP). A cohort of 969 CDOMD patients with active workers' compensation claims completed an FRP (a medically-supervised, quantitatively-directed exercise progression program, with multi-modal disability management). A good economy (GE) group (n = 532) was released to work during a low unemployment period (2005-2007), and a poor economy (PE) group (n = 437) was released during a higher unemployment period (2008-2010). Patients were evaluated upon admission for demographic and psychosocial variables, and were reassessed at discharge. Socioeconomic outcomes, including work return and work retention 1 year post-discharge, were collected. Some significant differences in psychosocial self-report data were found, but most of the effect sizes were small, so caution should be made when interpreting the data. Compared to the PE group, the GE group reported more depressive symptoms and disability at admission, but demonstrated a larger decrease in depressive symptoms and disability and increase in self-reported quality of life at discharge. The PE group had lower rates of work return and retention 1-year after discharge, even after controlling for other factors such as length of disability and admission work status. CDOMD patients who completed an FRP in a PE year were less likely to return to, or retain, work 1-year after discharge, demonstrating that a PE can be an additional barrier to post-discharge work outcomes. A difference in State unemployment rates of <3% (7 vs. 5%) had a disproportionate effect on patients' failure to return to (19 vs. 6%) or retain (28 vs. 15%) work.

  15. Workers' compensation claims for musculoskeletal disorders among wholesale and retail trade industry workers--Ohio, 2005-2009.

    Science.gov (United States)

    2013-06-07

    Work-related musculoskeletal disorders (WMSDs) resulting from ergonomic hazards are common in the United States. Recent data from the Bureau of Labor Statistics (BLS) indicate that in 2011, one third of occupational injuries and illnesses resulting in lost time from work were WMSDs. Based on data from the 2010 BLS Survey of Occupational Injuries and Illnesses, a higher rate of WMSDs resulting in lost time from work occurred in the Wholesale and Retail Trade (WRT) industry compared with most other industries. To assess trends and identify WRT subsectors and subgroups associated with high rates of WMSD workers' compensation claims, the Ohio Bureau of Workers' Compensation (OBWC) and CDC analyzed OBWC claims data for single-location WRT employers in Ohio for the period 2005-2009. From 2005 to 2009, the rate of WMSD claims declined from 86.3 to 52.8 per 10,000 employees. The three WRT industry subsectors with the highest rates of WMSD claims were Merchant Wholesalers, Nondurable Goods; Furniture and Home Furnishings Stores; and Merchant Wholesalers, Durable Goods. Within those three WRT subsectors, the highest rates of WMSD claims were noted in five subgroups: furniture stores and wholesalers of alcoholic beverages, groceries and related products, metal and minerals, and motor vehicle parts. Providing recommendations for WMSD prevention is particularly important for these WRT subgroups.

  16. Musculoskeletal pain in patients with chronic kidney disease

    Directory of Open Access Journals (Sweden)

    Francisco Caravaca

    2016-07-01

    Conclusions: CMP is highly prevalent in patients with advanced CKD and is associated with other common symptoms of chronic uraemia. As with the general population, elderly age, the female gender, obesity and some comorbid conditions are the best determinants of CMP. Increased inflammatory markers commonly observed in patients with CMP may have a relevant role in its pathogenesis.

  17. A cognitive-behavioral program for parents of children with chronic musculoskeletal pain; A feasibility study.

    Science.gov (United States)

    Wiertz, C; Goossens, M; Spek, E M; Verbunt, J A

    2017-10-01

    The purpose of the study is to evaluate the feasibility of a newly developed parent program for parents of children with non-specific chronic musculoskeletal pain. This program is part of the child's interdisciplinary outpatient pain rehabilitation treatment. The goal of the parent program is to change parent's thoughts/behaviour regarding pain with the ultimate intention to further improve their child's functioning. There were two main objectives in the study: First, to evaluate the feasibility of the parent program. Second, to evaluate changing in parental behavioral factors pre- and posttreatment. Participants were parents of adolescents, who underwent a interdisciplinary outpatient pain program for non-specific chronic musculoskeletal pain. Parents participated in a parent program as part of their child's treatment. Adolescents reported their level of disability, pain intensity, fear of pain and pain catastrophizing by filling out questionnaires. Parents reported catastrophic thinking about their child's pain, fear of pain and disabilities of their child. In addition, they evaluated the parent program. Sixty five parents (36 mothers and 29 fathers) of 44 adolescents filled in the baseline questionnaires. Result showed significant and clinically relevant improvements for both parents as well for adolescents. Parents were positive about the content of the parent program, they evaluated the program as supportive and informative. Adding a parent program to a interdisciplinary outpatient pain program for adolescent with chronic musculoskeletal pain, seems to be feasible in daily life of the parents and results in positive behavioural changes for both parents and adolescents. A parent program, designed to change cognition and behaviour of parents of children with chronic musculoskeletal pain is feasible. © 2017 European Pain Federation - EFIC®.

  18. Mechanisms Mediating Vibration-induced Chronic Musculoskeletal Pain Analyzed in the Rat

    OpenAIRE

    Dina, Olayinka A.; Joseph, Elizabeth K.; Levine, Jon D.; Green, Paul G.

    2009-01-01

    While occupational exposure to vibration is a common cause of acute and chronic musculoskeletal pain, eliminating exposure produces limited symptomatic improvement, and re-exposure precipitates rapid recurrence or exacerbation. To evaluate mechanisms underlying these pain syndromes, we have developed a model in the rat, in which exposure to vibration (60–80 Hz) induces, in skeletal muscle, both acute mechanical hyperalgesia as well as long-term changes characterized by enhanced hyperalgesia t...

  19. Self-reported Work Ability and Work Performance in Workers with Chronic Nonspecific Musculoskeletal Pain

    OpenAIRE

    de Vries, Haitze J.; Reneman, Michiel F.; Groothoff, Johan W.; Geertzen, Jan H. B.; Brouwer, Sandra

    2012-01-01

    Purpose To assess self-reported work ability and work performance of workers who stay at work despite chronic nonspecific musculoskeletal pain (CMP), and to explore which variables were associated with these outcomes. Methods In a cross-sectional study we assessed work ability (Work Ability Index, single item scale 0-10) and work performance (Health and Work Performance Questionnaire, scale 0-10) among 119 workers who continued work while having CMP. Scores of work ability and work performanc...

  20. Perceptions of adults with overweight/obesity and chronic musculoskeletal pain: An interpretative phenomenological analysis.

    Science.gov (United States)

    Cooper, Lesley; Ells, Louisa; Ryan, Cormac; Martin, Denis

    2018-03-01

    To gain insight into the lived experience of adults with overweight/obesity and chronic musculoskeletal pain. Knowledge gained will inform healthcare professionals about the complexity of the weight-pain relationship and enable more effective engagement with this population. Quantitative studies show links between weight and pain. Adults with overweight/obesity are more likely to experience comorbidity; however, qualitative research describing the complexities of the relationship is limited. A purposive sample of adults with overweight/obesity and chronic musculoskeletal pain participated in face-to-face interviews. Interviews were audio-recorded, transcribed verbatim and analysed using interpretive phenomenological analysis. Eighteen adults (16 female) aged 29-71, body mass index ≥25-46, participated in this study. Three superordinate themes emerged: "pain as a motivator and barrier to weight loss"; "fear of weight causing more damage"; and "activity is positive." Pain motivates some individuals to lose weight while simultaneously inhibiting weight loss efforts. Participants' perception that extra pressure caused by their weight further damaged joints contributed to fear and catastrophising. Fear is often exacerbated by healthcare professionals' descriptions of musculoskeletal damage, or participants' perception of healthcare professionals' attitude towards people with overweight/obesity. Conversely, individuals acknowledged the benefits of increased activity. Adults with overweight/obesity and chronic musculoskeletal pain in this study identified a bidirectional relationship between their weight and pain that challenged their weight loss efforts. Overweight/obesity contributed to fear and catastrophising, which resulted in avoidance of exercise that would have assisted their weight loss. Healthcare professionals need to understand the complex relationship between weight and pain, and their patients' understanding of that relationship. Healthcare professionals

  1. Insomnia in a chronic musculoskeletal pain with disability population is independent of pain and depression.

    Science.gov (United States)

    Asih, Sali; Neblett, Randy; Mayer, Tom G; Brede, Emily; Gatchel, Robert J

    2014-09-01

    Insomnia is frequently experienced by patients suffering from chronic musculoskeletal disorders but is often seen as simply a symptom of pain or depression and not as an independent disorder. Compared with those who experience only chronic pain, patients with both chronic pain and insomnia report higher pain intensity, more depressive symptoms, and greater distress. However, insomnia has not yet been systematically studied in a chronic musculoskeletal pain with disability population. This study assessed the prevalence and severity of patient-reported insomnia, as well as the relationship among insomnia, pain intensity, and depressive symptoms, in a chronic musculoskeletal pain with disability population. This was a retrospective study of prospectively captured data. A consecutive cohort of 326 chronic musculoskeletal pain with disability patients (85% with spinal injuries) entered a functional restoration treatment program. All patients signed a consent form to participate in this protocol. Insomnia was assessed with the Insomnia Severity Index, a validated patient-report measure of insomnia symptoms. Four patient groups were formed: no clinically significant insomnia (score, 0-7); subthreshold insomnia (score, 8-14); moderate clinical insomnia (score, 15-21); and severe clinical insomnia (score, 22-28). Three patterns of sleep disturbance were also evaluated: early, middle, and late insomnia. Additional validated psychosocial patient-reported data were collected, including the Pain Visual Analog Scale, the Beck Depression Inventory, the Oswestry Disability Index, and the Pain Disability Questionnaire. Patients completed a standard psychosocial assessment battery on admission to the functional restoration program. The program included a quantitatively directed exercise process in conjunction with a multimodal disability management approach. The four insomnia groups were compared on demographic and psychosocial variables. The shared variances among insomnia

  2. Costs by industry and diagnosis among musculoskeletal claims in a state workers compensation system: 1999-2004.

    Science.gov (United States)

    Dunning, Kari K; Davis, Kermit G; Cook, Chad; Kotowski, Susan E; Hamrick, Chris; Jewell, Gregory; Lockey, James

    2010-03-01

    Musculoskeletal disorders (MSDs) are a tremendous burden on industry in the United States. However, there is limited understanding of the unique issues relating to specific industry sectors, specifically the frequency and costs of different MSDs. Claim data from 1999 to 2004 from the Ohio Bureau of Workers' Compensation were analyzed as a function of industry sector (NAICS industry-sector categories) and anatomical region (ICD-9 codes). Almost 50% of the claims were lumbar spine (26.9%) or hand/wrist (21.7%). The majority of claims were from manufacturing (25.1%) and service (32.8%) industries. The industries with the highest average costs per claim were transportation, warehouse, and utilities and construction. Across industries, the highest costs per claim were consistently for the lumbar spine, shoulder, and cervical spine body regions. This study provides insight into the severity (i.e., medical and indemnity costs) of MSDs across multiple industries, providing data for prioritizing of resources for research and interventions. 2009 Wiley-Liss, Inc.

  3. Measurement Tools for Adherence to Non-Pharmacologic Self-Management Treatment for Chronic Musculoskeletal Conditions: A Systematic Review

    NARCIS (Netherlands)

    Hall, A.M.; Kamper, S.J.; Hernon, M.; Hughes, K.; Kelly, G.; Lonsdale, C.; Hurley, D.A.; Ostelo, R.W.J.G.

    2015-01-01

    Objectives To identify measures of adherence to nonpharmacologic self-management treatments for chronic musculoskeletal (MSK) populations; and to report on the measurement properties of identified measures. Data Sources Five databases were searched for all study types that included a chronic MSK

  4. Impact of Chronic Diseases and Multimorbidity on Health and Health Care Costs: The Additional Role of Musculoskeletal Disorders

    NARCIS (Netherlands)

    Zee-Neuen, A. van der; Putrik, P.; Ramiro, S.; Keszei, A.; Bie, R. de; Chorus, A.; Boonen, A.

    2016-01-01

    Objective: Chronic diseases are increasingly prevalent and often occur as multimorbidity. This study compares the impact of musculoskeletal disorders (MSKDs) on health and health care costs with other chronic diseases, and assesses the additional impact of MSKDs on these outcomes when occurring as

  5. Pain Adaptability in Individuals With Chronic Musculoskeletal Pain Is Not Associated With Conditioned Pain Modulation.

    Science.gov (United States)

    Wan, Dawn Wong Lit; Arendt-Nielsen, Lars; Wang, Kelun; Xue, Charlie Changli; Wang, Yanyi; Zheng, Zhen

    2018-03-27

    Healthy humans can be divided into the pain adaptive (PA) and the pain nonadaptive (PNA) groups; PA showed a greater decrease in pain rating to a cold pressor test (CPT) than PNA. This study examined if the dichotomy of pain adaptability existed in individuals with chronic musculoskeletal pain. CPTs at 2°C and 7°C were used to assess the status of pain adaptability in participants with either chronic nonspecific low back pain or knee osteoarthritis. The participants' potency of conditioned pain modulation (CPM) and local inhibition were measured. The strengths of pain adaptability at both CPTs were highly correlated. PA and PNA did not differ in their demographic characteristics, pain thresholds from thermal and pressure stimuli, or potency of local inhibition or CPM. PA reached their maximum pain faster than PNA (t 41 = -2.76, P adaptability exists in musculoskeletal pain patients. Consistent with the healthy human study, the strength of pain adaptability and potency of CPM are not related. Pain adaptability could be another form of endogenous pain inhibition of which clinical implication is yet to be understood. The dichotomy of pain adaptability was identified in healthy humans. The current study confirms that this dichotomy also exists in individuals with chronic musculoskeletal pain, and could be reliably assessed with CPTs at 2°C and 7°C. Similar to the healthy human study, pain adaptability is not associated with CPM, and may reflect the temporal aspect of pain inhibition. Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All rights reserved.

  6. Mechanisms mediating vibration-induced chronic musculoskeletal pain analyzed in the rat.

    Science.gov (United States)

    Dina, Olayinka A; Joseph, Elizabeth K; Levine, Jon D; Green, Paul G

    2010-04-01

    While occupational exposure to vibration is a common cause of acute and chronic musculoskeletal pain, eliminating exposure produces limited symptomatic improvement, and reexposure precipitates rapid recurrence or exacerbation. To evaluate mechanisms underlying these pain syndromes, we have developed a model in the rat, in which exposure to vibration (60-80Hz) induces, in skeletal muscle, both acute mechanical hyperalgesia as well as long-term changes characterized by enhanced hyperalgesia to a proinflammatory cytokine or reexposure to vibration. Exposure of a hind limb to vibration-produced mechanical hyperalgesia measured in the gastrocnemius muscle of the exposed hind limb, which persisted for approximately 2 weeks. When nociceptive thresholds had returned to baseline, exposure to a proinflammatory cytokine or reexposure to vibration produced markedly prolonged hyperalgesia. The chronic prolongation of vibration- and cytokine-hyperalgesia was prevented by spinal intrathecal injection of oligodeoxynucleotide (ODN) antisense to protein kinase Cepsilon, a second messenger in nociceptors implicated in the induction and maintenance of chronic pain. Vibration-induced hyperalgesia was inhibited by spinal intrathecal administration of ODN antisense to receptors for the type-1 tumor necrosis factor-alpha (TNFalpha) receptor. Finally, in TNFalpha-pretreated muscle, subsequent vibration-induced hyperalgesia was markedly prolonged. These studies establish a model of vibration-induced acute and chronic musculoskeletal pain, and identify the proinflammatory cytokine TNFalpha and the second messenger protein kinase Cepsilon as targets against which therapies might be directed to prevent and/or treat this common and very debilitating chronic pain syndrome. Copyright 2010 American Pain Society. All rights reserved.

  7. Familial Risk of Chronic Musculoskeletal Pain and the Importance of Physical Activity and Body Mass Index: Prospective Data from the HUNT Study, Norway.

    Science.gov (United States)

    Lier, Ragnhild; Mork, Paul Jarle; Holtermann, Andreas; Nilsen, Tom Ivar Lund

    2016-01-01

    The main objectives of the current study was i) to prospectively examine if chronic musculoskeletal pain in parents is associated with risk of chronic musculoskeletal pain in their adult offspring, and ii) to assess if these parent-offspring associations are modified by offspring body mass index and leisure time physical activity. We used data on 4,742 adult offspring linked with their parents who participated in the population-based HUNT Study in Norway in 1995-97 and in 2006-08. Family relations were established through the national Family Registry. A Poisson regression model was used to estimate relative risk (RR) with 95% confidence interval (CI). In total, 1,674 offspring (35.3%) developed chronic musculoskeletal pain during the follow-up period of approximately 11 years. Both maternal (RR: 1.26, 95% CI: 1.03, 1.55) and paternal chronic musculoskeletal pain (RR: 1.29, 95% CI: 1.06, 1.57) was associated with increased risk of offspring chronic musculoskeletal pain. Compared to offspring of parents without chronic musculoskeletal pain, the adverse effect of parental pain was somewhat stronger among offspring who reported a low (RR: 1.82, 95% CI: 1.32, 2.52) versus high (RR: 1.32, 95% CI: 0.95, 1.84) level of leisure time physical activity. Offspring of parents with chronic musculoskeletal pain and who were classified as obese had more than twofold increased risk (RR: 2.33, 95% CI: 1.68, 3.24) of chronic musculoskeletal pain compared to normal weight offspring of parents without pain. In conclusion, parental chronic musculoskeletal pain is positively associated with risk of chronic musculoskeletal pain in their adult offspring. Maintenance of normal body weight may reduce the risk of chronic musculoskeletal pain in offspring of pain-afflicted parents.

  8. Familial Risk of Chronic Musculoskeletal Pain and the Importance of Physical Activity and Body Mass Index: Prospective Data from the HUNT Study, Norway.

    Directory of Open Access Journals (Sweden)

    Ragnhild Lier

    Full Text Available The main objectives of the current study was i to prospectively examine if chronic musculoskeletal pain in parents is associated with risk of chronic musculoskeletal pain in their adult offspring, and ii to assess if these parent-offspring associations are modified by offspring body mass index and leisure time physical activity. We used data on 4,742 adult offspring linked with their parents who participated in the population-based HUNT Study in Norway in 1995-97 and in 2006-08. Family relations were established through the national Family Registry. A Poisson regression model was used to estimate relative risk (RR with 95% confidence interval (CI. In total, 1,674 offspring (35.3% developed chronic musculoskeletal pain during the follow-up period of approximately 11 years. Both maternal (RR: 1.26, 95% CI: 1.03, 1.55 and paternal chronic musculoskeletal pain (RR: 1.29, 95% CI: 1.06, 1.57 was associated with increased risk of offspring chronic musculoskeletal pain. Compared to offspring of parents without chronic musculoskeletal pain, the adverse effect of parental pain was somewhat stronger among offspring who reported a low (RR: 1.82, 95% CI: 1.32, 2.52 versus high (RR: 1.32, 95% CI: 0.95, 1.84 level of leisure time physical activity. Offspring of parents with chronic musculoskeletal pain and who were classified as obese had more than twofold increased risk (RR: 2.33, 95% CI: 1.68, 3.24 of chronic musculoskeletal pain compared to normal weight offspring of parents without pain. In conclusion, parental chronic musculoskeletal pain is positively associated with risk of chronic musculoskeletal pain in their adult offspring. Maintenance of normal body weight may reduce the risk of chronic musculoskeletal pain in offspring of pain-afflicted parents.

  9. The use of CAM and conventional treatments among primary care consulters with chronic musculoskeletal pain

    Directory of Open Access Journals (Sweden)

    Lewis Martyn

    2007-05-01

    Full Text Available Abstract Background Chronic musculoskeletal pain is the single most cited reason for use of complementary and alternative medicine (CAM. Primary care is the most frequent conventional medical service used by patients with pain in the UK. We are unaware, however, of a direct evidence of the extent of CAM use by primary care patients, and how successful they perceive it to be. Methods Aims and objectives To determine CAM use among patients with chronic musculoskeletal pain who have consulted about their pain in primary care. Study design Face-to-face interview-based survey. Setting Three general practices in North Staffordshire. Participants Respondents to a population pain survey who had reported having musculoskeletal pain in the survey and who had consulted about their pain in primary care in the previous 12 months as well as consenting to further research and agreeing to an interview. Information was gathered about their pain and the use of all treatments for pain, including CAM, in the previous year. Results 138 interviews were completed. 116 participants (84% had used at least one CAM treatment for pain in the previous year. 65% were current users of CAM. The ratio of over-the-counter CAM use to care from a CAM provider was 3:2. 111 participants (80% had used conventional treatment. 95 (69% were using a combination of CAM and conventional treatment. Glucosamine and fish oil were the most commonly used CAM treatments (38%, 35% respectively. Most CAM treatments were scored on average as being helpful, and users indicated that they intended to use again 87% of the CAM treatments they had already used. Conclusion We provide direct evidence that most primary care consulters with chronic musculoskeletal pain have used CAM in the previous year, usually in combination with conventional treatments. The high prevalence and wide range of users experiences of benefit and harm from CAM strengthen the argument for more research into this type of medicine

  10. The use of CAM and conventional treatments among primary care consulters with chronic musculoskeletal pain.

    Science.gov (United States)

    Artus, Majid; Croft, Peter; Lewis, Martyn

    2007-05-04

    Chronic musculoskeletal pain is the single most cited reason for use of complementary and alternative medicine (CAM). Primary care is the most frequent conventional medical service used by patients with pain in the UK. We are unaware, however, of a direct evidence of the extent of CAM use by primary care patients, and how successful they perceive it to be. To determine CAM use among patients with chronic musculoskeletal pain who have consulted about their pain in primary care. Face-to-face interview-based survey. Three general practices in North Staffordshire. Respondents to a population pain survey who had reported having musculoskeletal pain in the survey and who had consulted about their pain in primary care in the previous 12 months as well as consenting to further research and agreeing to an interview. Information was gathered about their pain and the use of all treatments for pain, including CAM, in the previous year. 138 interviews were completed. 116 participants (84%) had used at least one CAM treatment for pain in the previous year. 65% were current users of CAM. The ratio of over-the-counter CAM use to care from a CAM provider was 3:2. 111 participants (80%) had used conventional treatment. 95 (69%) were using a combination of CAM and conventional treatment. Glucosamine and fish oil were the most commonly used CAM treatments (38%, 35% respectively). Most CAM treatments were scored on average as being helpful, and users indicated that they intended to use again 87% of the CAM treatments they had already used. We provide direct evidence that most primary care consulters with chronic musculoskeletal pain have used CAM in the previous year, usually in combination with conventional treatments. The high prevalence and wide range of users experiences of benefit and harm from CAM strengthen the argument for more research into this type of medicine to quantify benefit and assess safety. The observation that most users of conventional medicine also used CAM

  11. Military Chronic Musculoskeletal Pain and Psychiatric Comorbidity: Is Better Pain Management the Answer?

    Directory of Open Access Journals (Sweden)

    Cindy A. McGeary

    2016-06-01

    Full Text Available Chronic musculoskeletal pain, such as low back pain, often appears in the presence of psychiatric comorbidities (e.g., depression, posttraumatic stress disorder (PTSD, especially among U.S. military service members serving in the post-9/11 combat era. Although there has been much speculation about how to best address pain/trauma psychiatric symptom comorbidities, there are little available data to guide practice. The present study sought to examine how pre-treatment depression and PTSD influence outcomes in a functional restoration pain management program using secondary analysis of data from the Department of Defense-funded Functional and Orthopedic Rehabilitation Treatment (FORT trial. Twenty-eight FORT completers were analyzed using a general linear model exploring how well depression and PTSD symptoms predict post-treatment pain (Visual Analog Scale (VAS pain rating, disability (Oswestry Disability Index; Million Visual Analog Scale, and functional capacity (Floor-to-Waist and Waist-to-Eye Level progressive isoinertial lifting evaluation scores in a sample of active duty military members with chronic musculoskeletal pain and comorbid depression or PTSD symptoms. Analysis revealed that pre-treatment depression and PTSD symptoms did not significantly predict rehabilitation outcomes from program completers. Implications of these findings for future research on trauma-related pain comorbidities are discussed.

  12. Generalised chronic musculoskeletal pain as a rational reaction to a life situation?

    Science.gov (United States)

    Steen, E; Haugli, L

    2000-11-01

    While the biomedical model is still the leading paradigm within modern medicine and health care, and people with generalised chronic musculoskeletal pain are frequent users of health care services, their diagnoses are rated as having the lowest prestige among health care personnel. An epistemological framework for understanding relations between body, emotions, mind and meaning is presented. An approach based on a phenomenological epistemology is discussed as a supplement to actions based on the biomedical model. Within the phenomenological frame of understanding, the body is viewed as a subject and carrier of meaning, and therefore chronic pain can be interpreted as a rational reaction to the totality of a person's life situation. Search for possible hidden individual meanings in painful muscles presupposes meeting health personnel who view the person within a holistic frame of reference.

  13. Small molecule therapeutics for inflammation-associated chronic musculoskeletal degenerative diseases: Past, present and future.

    Science.gov (United States)

    Chen, Yangwu; Huang, Jiayun; Tang, Chenqi; Chen, Xiao; Yin, Zi; Heng, Boon Chin; Chen, Weishan; Shen, Weiliang

    2017-10-01

    Inflammation-associated chronic musculoskeletal degenerative diseases (ICMDDs) like osteoarthritis and tendinopathy often results in morbidity and disability, with consequent heavy socio-economic burden. Current available therapies such as NSAIDs and glucocorticoid are palliative rather than disease-modifying. Insufficient systematic research data on disease molecular mechanism also makes it difficult to exploit valid therapeutic targets. Small molecules are designed to act on specific signaling pathways and/or mechanisms of cellular physiology and function, and have gradually shown potential for treating ICMDDs. In this review, we would examine and analyze recent developments in small molecule drugs for ICMDDs, suggest possible feasible improvements in treatment modalities, and discuss future research directions. Copyright © 2017. Published by Elsevier Inc.

  14. Problems, solutions, and strategies reported by users of TENS for chronic musculoskeletal pain: A qualitative exploration using patient interviews

    OpenAIRE

    Gladwell, P.; Badlan, K.; Cramp, F. A.; Palmer, S.

    2016-01-01

    BACKGROUND: Transcutaneous Electrical Nerve Stimulation (TENS) could offer a non-drug form of pain relief, but there is no consensus regarding its effectiveness for chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to inform the development of a pragmatic implementation design for a TENS evaluation.\\ud OBJECTIVES: To explore the experiences of s...

  15. Chronic widespread musculoskeletal pain, fatigue, depression and disordered sleep in chronic post-SARS syndrome; a case-controlled study.

    Science.gov (United States)

    Moldofsky, Harvey; Patcai, John

    2011-03-24

    The long term adverse effects of Severe Acute Respiratory Syndrome (SARS), a viral disease, are poorly understood. Sleep physiology, somatic and mood symptoms of 22 Toronto subjects, 21 of whom were healthcare workers, (19 females, 3 males, mean age 46.29 yrs.+/- 11.02) who remained unable to return to their former occupation (mean 19.8 months, range: 13 to 36 months following SARS) were compared to 7 healthy female subjects. Because of their clinical similarities to patients with fibromyalgia syndrome (FMS) these post-SARS subjects were similarly compared to 21 drug free female patients, (mean age 42.4 +/- 11.8 yrs.) who fulfilled criteria for fibromyalgia. Chronic post-SARS is characterized by persistent fatigue, diffuse myalgia, weakness, depression, and nonrestorative sleep with associated REM-related apneas/hypopneas, an elevated sleep EEG cyclical alternating pattern, and alpha EEG sleep anomaly. Post- SARS patients had symptoms of pre and post-sleep fatigue and post sleep sleepiness that were similar to the symptoms of patients with FMS, and similar to symptoms of patients with chronic fatigue syndrome. Both post-SARS and FMS groups had sleep instability as indicated by the high sleep EEG cyclical alternating pattern rate. The post-SARS group had a lower rating of the alpha EEG sleep anomaly as compared to the FMS patients. The post-SARS group also reported less pre-sleep and post-sleep musculoskeletal pain symptoms. The clinical and sleep features of chronic post-SARS form a syndrome of chronic fatigue, pain, weakness, depression and sleep disturbance, which overlaps with the clinical and sleep features of FMS and chronic fatigue syndrome.

  16. The optimal frequency of aquatic physiotherapy for individuals with chronic musculoskeletal pain: a randomised controlled trial.

    Science.gov (United States)

    Cuesta-Vargas, Antonio I; White, Melanie; González-Sánchez, Manuel; Kuisma, Raija

    2015-01-01

    To establish whether there was a difference in health-related quality of life (HRQoL) in people with chronic musculoskeletal disorders (PwCMSKD) after participating in a multimodal physiotherapy program (MPP) either two or three sessions a week. Total of 114 PwCMSKD participated in this prospective randomised controlled trial. An individualised MPP, consisting of exercises for mobility, motor-control, muscle strengthening, cardiovascular training, and health education, was implemented either twice a week (G2: n = 58) or three times a week) (G3: n = 56) for 1 year. HRQoL physical and mental health state (PHS/MHS), Roland Morris disability Questionnaire (RMQ), Neck-Disability-Index (NDI) and Western Ontario and McMaster Universities' Arthritis Index (WOMAC) were used to measure outcomes of MPP for people with chronic low back pain, chronic neck pain and osteoarthritis, respectively. Measures were taken at baseline, 8 weeks (8 w), 6 months (6 m), and 1 year (1 y) after starting the programme. No statistically significant differences were found between the two groups (G2 and G3), except in NDI at 8 w (-3.34, (CI 95%: -6.94/0.84, p = 0.025 (scale 0-50)). All variables showed improvement reaching the following values (from baseline to 1 y) G2: PHS: 57.72 (baseline: 41.17; (improvement: 16.55%), MHS: 74.51 (baseline: 47.46, 27.05%), HRQoL 0.90 (baseline: 0.72, 18%)), HRQoL-VAS 84.29 (baseline: 58.04, 26.25%), RMQ 4.15 (baseline: 7.85, 15.42%), NDI 3.96 (baseline: 21.87, 35.82%), WOMAC 7.17 (baseline: 25.51, 19.10%). G3: PHS: 58.64 (baseline: 39.75, 18.89%), MHS: 75.50 (baseline: 45.45, (30.05%), HRQoL 0.67 (baseline: 0.88, 21%), HRQoL-VAS 86.91 (baseline: 52.64, 34.27%), RMQ 4.83 (baseline: 8.93, 17.08%), NDI 4.91 (baseline: 23.82, 37.82%), WOMAC 6.35 (baseline: 15.30, 9.32%). No significant differences between the two groups were found in the outcomes of a MPP except in the NDI at 8 weeks, but both groups improved in all variables during the course of 1

  17. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain, stress and work ability among laboratory technicians

    DEFF Research Database (Denmark)

    Jay, Kenneth; Petersen, Mikkel Brandt; Sundstrup, Emil

    2014-01-01

    control and may result in extended periods of time spent in static positions.In populations characterized by intense chronic musculoskeletal pain and diagnosed conditions in conjunction with psycho-physiological symptoms such as stress-related pain and soreness and other disabling conditions...... biopsychosocial intervention strategy on musculoskeletal pain, stress and work disability in lab technicians with a history of musculoskeletal pain at a single worksite in Denmark. METHODS/DESIGN: In this single-blind two-armed parallel-group randomized controlled trial with allocation concealment, participants......BACKGROUND: Among laboratory technicians, the prevalence of neck and shoulder pain is widespread possibly due to typical daily work tasks such as pipetting, preparing vial samples for analysis, and data processing on a computer including mouse work - all tasks that require precision in motor...

  18. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain.

    Science.gov (United States)

    Louw, Adriaan; Diener, Ina; Butler, David S; Puentedura, Emilio J

    2011-12-01

    To evaluate the evidence for the effectiveness of neuroscience education (NE) for pain, disability, anxiety, and stress in chronic musculoskeletal (MSK) pain. Systematic searches were conducted on Biomed Central, BMJ.com, CINAHL, the Cochrane Library, NLM Central Gateway, OVID, ProQuest (Digital Dissertations), PsycInfo, PubMed/Medline, ScienceDirect, and Web of Science. Secondary searching (PEARLing) was undertaken, whereby reference lists of the selected articles were reviewed for additional references not identified in the primary search. All experimental studies including randomized controlled trials (RCTs), nonrandomized clinical trials, and case series evaluating the effect of NE on pain, disability, anxiety, and stress for chronic MSK pain were considered for inclusion. Additional limitations: studies published in English, published within the last 10 years, and patients older than 18 years. No limitations were set on specific outcome measures of pain, disability, anxiety, and stress. Data were extracted using the participants, interventions, comparison, and outcomes (PICO) approach. Methodological quality was assessed by 2 reviewers using the Critical Review Form-Quantitative Studies. This review includes 8 studies comprising 6 high-quality RCTs, 1 pseudo-RCT, and 1 comparative study involving 401 subjects. Most articles were of good quality, with no studies rated as poor or fair. Heterogeneity across the studies with respect to participants, interventions evaluated, and outcome measures used prevented meta-analyses. Narrative synthesis of results, based on effect size, established compelling evidence that NE may be effective in reducing pain ratings, increasing function, addressing catastrophization, and improving movement in chronic MSK pain. For chronic MSK pain disorders, there is compelling evidence that an educational strategy addressing neurophysiology and neurobiology of pain can have a positive effect on pain, disability, catastrophization, and

  19. The role of psychosocial stress in the development of chronic musculoskeletal pain disorders: protocol for a systematic review and meta-analysis.

    Science.gov (United States)

    Buscemi, Valentina; Chang, Wei-Ju; Liston, Matthew B; McAuley, James H; Schabrun, Siobhan

    2017-11-03

    Psychosocial factors play an important role in chronic musculoskeletal pain disorders. Although psychosocial stress is likely to contribute to the development of chronic musculoskeletal pain, investigations are limited to work-related stress or examination of specific conditions such as upper limb pain. The purpose of this review is to assess the evidence for an aetiological role of psychological stress in chronic musculoskeletal pain disorders. A systematic review and meta-analysis will be conducted. Electronic databases will be searched using predefined search terms to identify relevant studies. Data will be extracted by two independent reviewers, and disagreement will be resolved by a third reviewer. Only prospective longitudinal studies that assess psychosocial stress at baseline will be included. The population of interest will be inception cohorts or cohorts of people who have not yet developed chronic musculoskeletal pain disorders. The primary outcome measure will be the onset of chronic musculoskeletal pain. To our knowledge, this review will be the first to systematically explore the available evidence on the aetiological role of psychosocial stress for the development of chronic musculoskeletal pain disorders. This review has the capacity to inform clinical practice on the importance of an early identification and, consequently, treatment of individuals who present with acute musculoskeletal disorders accompanied by a high level of stress. PROSPERO CRD42017059949.

  20. Horticultural therapy for patients with chronic musculoskeletal pain: results of a pilot study.

    Science.gov (United States)

    Verra, M L; Verra, Martin L; Angst, Felix; Beck, Trudi; Lehmann, Susanne; Brioschi, Roberto; Schneiter, Renata; Aeschlimann, Andre

    2012-01-01

    Therapists can use horticultural therapy as an adjuvant therapy in a non threatening context, with the intent of bringing about positive effects in physical health, mental health, and social interaction. Very few experimental studies exist that test its clinical effectiveness. To determine whether the addition of horticultural therapy to a pain-management program improved physical function, mental health, and ability to cope with pain. The research team designed a prospective, nonrandomized, controlled cohort study, enrolling all patients consecutively referred to the Zurzach Interdisciplinary Pain Program (ZISP) who met the studys criteria. The team divided them into two cohorts based on when medical professionals referred them: before (control group) or after (intervention group) introduction of a horticultural therapy program. The setting was the rehabilitation clinic (RehaClinic) in Bad Zurzach, Switzerland. Seventy-nine patients with chronic musculoskeletal pain (fibromyalgia or chronic, nonspecific back pain) participated in the study. The research team compared a 4-week, inpatient, interdisciplinary pain-management program with horticultural therapy (intervention, n = 37) with a pain-management program without horticultural therapy (control, n = 42). The horticultural therapy program consisted of seven sessions of group therapy, each of 1-hour duration. The research team assessed the outcome using the Medical Outcome Study Short Form-36 (SF-36), the West Haven-Yale Multidimensional Pain Inventory (MPI), the Hospital Anxiety and Depression Scale (HADS), the Coping Strategies Questionnaire (CSQ ), and two functional performance tests. The team tested participants on entry to and discharge from the 4-week pain-management program. Between-group differences in sociodemographic and outcome variables were not significant on participants entry to the pain-management program. On discharge, the research team measured small to moderate outcome effects (effect size [ES

  1. [Effectiveness of education based on neuroscience in the treatment of musculoskeletal chronic pain].

    Science.gov (United States)

    Cuenda-Gago, J D; Espejo-Antunez, L

    2017-07-01

    Chronic pain is one of the most frequent health, economic and social problems. Given this, numerous approaches have been described, one of which is pain neuroscience education. To examine the effectiveness of pain neuroscience education in the treatment of musculoskeletal disorders with chronic pain and to explore the impact of specific aspects of the technique on its effectiveness. Relevant studies published between 2000 and 2015 were identified by searching PubMed, Scopus and Web of Science. Studies identified by electronic searches were screened against a set of pre-defined inclusion criteria. PEDro and SIGN scales were used to evaluate the methodological quality of the included studies. Ten studies were included in this systematic review. The main outcomes that were measured were pain, disability, neurophysiology pain test, attitudes and beliefs, fear-avoidance beliefs, self-care, kinesiophobia, quality of life and algometry. The results suggest that pain neuroscience education is effective in the short term and medium/long term for pain relief, either alone or combined with multimodal treatment. It was also effective in normalizing cognitions about pain, fear-avoidance beliefs, and self-care. Despite some evidence for a positive effect in the short and medium/long term, the heterogeneity in the technical aspects used does not allow the obtaining of conclusive results.

  2. Effect on health-related quality of life of a multimodal physiotherapy program in patients with chronic musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Cuesta-Vargas Antonio Ignacio

    2013-02-01

    Full Text Available Abstract Background Musculoskeletal disorders are major causes of morbidity in the world, and these conditions have a strong negative influence in terms of health-related quality of life. The purpose of this study was to evaluate the effect of an 8-week multimodal physical therapy program on general health state and health-related quality of life in patients with chronic musculoskeletal disorders. Methods There were 244 participants in this prospective cohort analysis with 8-week follow-up. The primary outcome was general health state (physical and mental components, determined with the Short Form-12 Health Survey (SF-12. The secondary outcome was health related quality of life, determined with the EuroQoL-5D and VAS. The intervention was evaluated by comparing pre- and post-outcome measurements. T-tests were performed for paired data. Results Differences were statistically significant for physical health state: +1.68 (p  Conclusions Eight weeks of a Multimodal Physical Therapy Program seemed to moderately enhance the general health state and HRQoL of patients with chronic musculoskeletal diseases. This kind of therapeutic exercise can be recommended to patients with chronic low back pain, chronic neck pain and osteoarthritis, at least in the short term.

  3. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain.

    Science.gov (United States)

    Boonstra, Anne M; Schiphorst Preuper, Henrica R; Reneman, Michiel F; Posthumus, Jitze B; Stewart, Roy E

    2008-06-01

    To determine the reliability and concurrent validity of a visual analogue scale (VAS) for disability as a single-item instrument measuring disability in chronic pain patients was the objective of the study. For the reliability study a test-retest design and for the validity study a cross-sectional design was used. A general rehabilitation centre and a university rehabilitation centre was the setting for the study. The study population consisted of patients over 18 years of age, suffering from chronic musculoskeletal pain; 52 patients in the reliability study, 344 patients in the validity study. Main outcome measures were as follows. Reliability study: Spearman's correlation coefficients (rho values) of the test and retest data of the VAS for disability; validity study: rho values of the VAS disability scores with the scores on four domains of the Short-Form Health Survey (SF-36) and VAS pain scores, and with Roland-Morris Disability Questionnaire scores in chronic low back pain patients. Results were as follows: in the reliability study rho values varied from 0.60 to 0.77; and in the validity study rho values of VAS disability scores with SF-36 domain scores varied from 0.16 to 0.51, with Roland-Morris Disability Questionnaire scores from 0.38 to 0.43 and with VAS pain scores from 0.76 to 0.84. The conclusion of the study was that the reliability of the VAS for disability is moderate to good. Because of a weak correlation with other disability instruments and a strong correlation with the VAS for pain, however, its validity is questionable.

  4. Development of a profile scoring system for assessing the psychosocial situation of patients with chronic musculoskeletal pain

    Science.gov (United States)

    Nikaido, Takuya; Fukuma, Shingo; Wakita, Takafumi; Sekiguchi, Miho; Yabuki, Shoji; Onishi, Yoshihiro; Fukuhara, Shunichi; Konno, Shin-ichi

    2017-01-01

    Chronic pain is a manifestation of interactions among physical, psychological, and social conditions, but the latter two, that is, the nonphysical correlates of chronic pain, are only rarely measured. This study aimed to develop a profile scoring system for assessing the psychosocial situation of patients with chronic musculoskeletal pain. An expert panel chose social and psychological domains considered to be relevant to patients with chronic pain and wrote questions asking about each of those domains. The questionnaire was completed by 252 patients with chronic musculoskeletal pain. Factor analysis was used to select questionnaire items for each domain. Associations and interactions of pain severity and each domain score with pain-related quality of life (PRQOL) were examined using linear regression models. Five domains were chosen: work, family, sleep, mental health, and PRQOL. Then, a total of 17 questions were created for the work, family, and sleep domains. Using the likelihood-ratio test, we found significant interactions with PRQOL in four pairs: severity–family, severity–mental, family–sleep, and work–mental. The association between pain severity and PRQOL was related to each patient’s social and psychological situation. These results suggest that interventions for patients with chronic pain may be personalized to account for each individual’s psychosocial situation. PMID:28814896

  5. Elevated [11C]-D-Deprenyl Uptake in Chronic Whiplash Associated Disorder Suggests Persistent Musculoskeletal Inflammation

    Science.gov (United States)

    Linnman, Clas; Appel, Lieuwe; Fredrikson, Mats; Gordh, Torsten; Söderlund, Anne; Långström, Bengt; Engler, Henry

    2011-01-01

    There are few diagnostic tools for chronic musculoskeletal pain as structural imaging methods seldom reveal pathological alterations. This is especially true for Whiplash Associated Disorder, for which physical signs of persistent injuries to the neck have yet to be established. Here, we sought to visualize inflammatory processes in the neck region by means Positron Emission Tomography using the tracer 11C-D-deprenyl, a potential marker for inflammation. Twenty-two patients with enduring pain after a rear impact car accident (Whiplash Associated Disorder grade II) and 14 healthy controls were investigated. Patients displayed significantly elevated tracer uptake in the neck, particularly in regions around the spineous process of the second cervical vertebra. This suggests that whiplash patients have signs of local persistent peripheral tissue inflammation, which may potentially serve as a diagnostic biomarker. The present investigation demonstrates that painful processes in the periphery can be objectively visualized and quantified with PET and that 11C-D-deprenyl is a promising tracer for these purposes. PMID:21541010

  6. Elevated [11C]-D-deprenyl uptake in chronic Whiplash Associated Disorder suggests persistent musculoskeletal inflammation.

    Directory of Open Access Journals (Sweden)

    Clas Linnman

    Full Text Available There are few diagnostic tools for chronic musculoskeletal pain as structural imaging methods seldom reveal pathological alterations. This is especially true for Whiplash Associated Disorder, for which physical signs of persistent injuries to the neck have yet to be established. Here, we sought to visualize inflammatory processes in the neck region by means Positron Emission Tomography using the tracer (11C-D-deprenyl, a potential marker for inflammation. Twenty-two patients with enduring pain after a rear impact car accident (Whiplash Associated Disorder grade II and 14 healthy controls were investigated. Patients displayed significantly elevated tracer uptake in the neck, particularly in regions around the spineous process of the second cervical vertebra. This suggests that whiplash patients have signs of local persistent peripheral tissue inflammation, which may potentially serve as a diagnostic biomarker. The present investigation demonstrates that painful processes in the periphery can be objectively visualized and quantified with PET and that (11C-D-deprenyl is a promising tracer for these purposes.

  7. Words that describe chronic musculoskeletal pain: implications for assessing pain quality across cultures.

    Science.gov (United States)

    Sharma, Saurab; Pathak, Anupa; Jensen, Mark P

    2016-01-01

    People from different cultures who speak different languages may experience pain differently. This possible variability has important implications for evaluating the validity of pain quality measures that are directly translated into different languages without cultural adaptations. The aim of this study was to evaluate the impact of language and culture on the validity of pain quality measures by comparing the words that individuals with chronic pain from Nepal use to describe their pain with those used by patients from the USA. A total of 101 individuals with chronic musculoskeletal pain in Nepal were asked to describe their pain. The rates of the different pain descriptor domains and phrases used by the Nepali sample were then compared to the published rates of descriptors used by patients from the USA. The content validity of commonly used measures for assessing pain quality was then evaluated. While there was some similarity between patients from Nepal and the USA in how they describe pain, there were also important differences, especially in how pain quality was described. For example, many patients from Nepal used metaphors to describe their pain. Also, the patients from Nepal often used a category of pain descriptor - which describes a physical state - not used by patients from the USA. Only the original McGill Pain Questionnaire was found to have content validity for assessing pain quality in patients from Nepal, although other existing pain quality measures could be adapted to be content valid by adding one or two additional descriptors, depending on the measure in question. The findings indicate that direct translations of measures that are developed using samples of patients from one country or culture are not necessarily content valid for use in other countries or cultures; some adaptations may be required in order for such measures to be most useful in new language and culture.

  8. A Serious Exergame for Patients Suffering from Chronic Musculoskeletal Back and Neck Pain: A Pilot Study.

    Science.gov (United States)

    Jansen-Kosterink, Stephanie M; Huis In 't Veld, Rianne M H A; Schönauer, Christian; Kaufmann, Hannes; Hermens, Hermie J; Vollenbroek-Hutten, Miriam M R

    2013-10-01

    Over recent years, the popularity of videogames has gone beyond youth and gamers and is slowly entering the field of professional healthcare. Exergames are an attractive alternative to physical therapy. The primary aim of this pilot study was to explore the user experience (usability, satisfaction, level of motivation, and game experience) of the patient with the "PlayMancer" exergame. The secondary aim was to explore the progression of the performed motor skills (walking velocity, overhead reach ability, and cervical range of motion) and the clinical changes (to physical condition, disability, and pain intensity) in a group of patients with chronic musculoskeletal pain using an exergame for 4 weeks. In the European PlayMancer project, an exergame for physical rehabilitation of chronic pain patients was developed. This exergame is controlled by relevant motions of the patient's body captured by a motion suit and several infrared cameras. In three different integrated minigames, the patient can train the following motor skills: Walking velocity, overhead reaching, and neck mobility. Ten patients participated in this study and completed the 4 weeks of gaming. Patients rated the usability of the exergames as good (score of 78.5 [standard deviation 9.7; range, 60.0-97.5]) on the System Usability Scale, and the game motivated all patients to perform their exercises. Patients enjoyed playing and were pleased with both the game environment and the game play. Overall, the patients made a progression in the examined motor skills during the minigames over the 4 weeks of gaming. The "PlayMancer" exergame is a potential tool for achieving physical rehabilitation because it motivates patients to perform their exercises and as a result increases their motor skills and physical condition.

  9. Staying at work with chronic nonspecific musculoskeletal pain: a qualitative study of workers' experiences

    Directory of Open Access Journals (Sweden)

    Geertzen Jan HB

    2011-06-01

    Full Text Available Abstract Background Many people with chronic nonspecific musculoskeletal pain (CMP have decreased work ability. The majority, however, stays at work despite their pain. Knowledge about workers who stay at work despite chronic pain is limited, narrowing our views on work participation. The aim of this study was to explore why people with CMP stay at work despite pain (motivators and how they manage to maintain working (success factors. Methods A semi-structured interview was conducted among 21 subjects who stay at work despite CMP. Participants were included through purposeful sampling. Interviews were audio-recorded, transcribed verbatim, and imported into computer software Atlas.ti. Data was analyzed by means of thematic analysis. The interviews consisted of open questions such as: "Why are you working with pain?" or "How do you manage working while having pain?" Results A total of 16 motivators and 52 success factors emerged in the interviews. Motivators were categorized into four themes: work as value, work as therapy, work as income generator, and work as responsibility. Success factors were categorized into five themes: personal characteristics, adjustment latitude, coping with pain, use of healthcare services, and pain beliefs. Conclusions Personal characteristics, well-developed self-management skills, and motivation to work may be considered to be important success factors and prerequisites for staying at work, resulting in behaviors promoting staying at work such as: raising adjustment latitude, changing pain-coping strategies, organizing modifications and conditions at work, finding access to healthcare services, and asking for support. Motivators and success factors for staying at work may be used for interventions in rehabilitation and occupational medicine, to prevent absenteeism, or to promote a sustainable return to work. This qualitative study has evoked new hypotheses about staying at work; quantitative studies on staying at

  10. Development of a profile scoring system for assessing the psychosocial situation of patients with chronic musculoskeletal pain

    Directory of Open Access Journals (Sweden)

    Nikaido T

    2017-08-01

    Full Text Available Takuya Nikaido,1 Shingo Fukuma,2,3 Takafumi Wakita,4 Miho Sekiguchi,1 Shoji Yabuki,1 Yoshihiro Onishi,5 Shunichi Fukuhara,2,3 Shin-ichi Konno1 On behalf of the profile scoring system for multilateral assessment of social factors in patients with chronic musculoskeletal pain study group 1Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine, Fukushima, 2Department of Healthcare Epidemiology, Kyoto University, Graduate School of Medicine and Public Health, Kyoto, 3Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE, Fukushima Medical University, Fukushima, 4Department of Sociology, Kansai University, Osaka, 5Institute for Health Outcomes and Process Evaluation Research (iHope International, Kyoto, Japan Abstract: Chronic pain is a manifestation of interactions among physical, psychological, and social conditions, but the latter two, that is, the nonphysical correlates of chronic pain, are only rarely measured. This study aimed to develop a profile scoring system for assessing the psychosocial situation of patients with chronic musculoskeletal pain. An expert panel chose social and psychological domains considered to be relevant to patients with chronic pain and wrote questions asking about each of those domains. The questionnaire was completed by 252 patients with chronic musculoskeletal pain. Factor analysis was used to select questionnaire items for each domain. Associations and interactions of pain severity and each domain score with pain-related quality of life (PRQOL were examined using linear regression models. Five domains were chosen: work, family, sleep, mental health, and PRQOL. Then, a total of 17 questions were created for the work, family, and sleep domains. Using the likelihood-ratio test, we found significant interactions with PRQOL in four pairs: severity–family, severity–mental, family–sleep, and work–mental. The association between pain severity and PRQOL was

  11. Towards an ICF Core Set for chronic musculoskeletal conditions: commonalities across ICF Core Sets for osteoarthritis, rheumatoid arthritis, osteoporosis, low back pain and chronic widespread pain.

    Science.gov (United States)

    Schwarzkopf, S R; Ewert, T; Dreinhöfer, K E; Cieza, A; Stucki, G

    2008-11-01

    The objective of the study was to identify commonalities among the International Classification of Functioning, Disability and Health (ICF) Core Sets of osteoarthritis (OA), osteoporosis (OP), low back pain (LBP), rheumatoid arthritis (RA) and chronic widespread pain (CWP). The aim is to identify relevant categories for the development of a tentative ICF Core Set for musculoskeletal and pain conditions. The ICF categories common to the five musculoskeletal and pain conditions in the Brief and Comprehensive ICF Core Sets were identified in three steps. In a first step, the commonalities across the Brief and Comprehensive ICF Core Sets for these conditions were examined. In a second and third step, we analysed the increase in commonalities when iteratively excluding one or two of the five conditions. In the first step, 29 common categories out of the total number of 120 categories were identified across the Comprehensive ICF Core Sets of all musculoskeletal and pain conditions, primarily in the component activities and participation. In the second and third step, we found that the exclusion of CWP across the Comprehensive ICF Core Sets increased the commonalities of the remaining four musculoskeletal conditions in a maximum of ten additional categories. The Brief ICF Core Sets of all musculoskeletal and pain conditions contain four common categories out of a total number of 62 categories. The iterative exclusion of a singular condition did not significantly increase the commonalities in the remaining. Based on our analysis, it seems possible to develop a tentative Comprehensive ICF Core Set across a number of musculoskeletal conditions including LBP, OA, OP and RA. However, the profile of functioning in people with CWP differs considerably and should not be further considered for a common ICF Core Set.

  12. "SYMBIOTIC" HEMOFILTRATION FOR CHRONIC RENAL F AILURE COMPENSATION

    Directory of Open Access Journals (Sweden)

    E. A. Yumatov

    2015-01-01

    Full Text Available AbstractWidely used nowadays hemodialysis and hemofiltration cannot replace completely the excretory function of human kidneys in the natural conditions of physiological regulation. The aim of our study is to develop and create a new method and apparatus for CRF patients «symbiotic» compensation, based on hemofiltration and healthy humans kidneys natural physiological functions, excluding mixing of partners blood.Method of «symbiotic» hemofiltration is based on mutual exchange of equivalent blood ultrafiltrate volumes between healthy person and CRF patient, needed to be cleansed from metabolites. During exchange procedure patient’s and a healthy person’s circulations are separated by hemofilters excluding blood mixing.During CRF patient’s blood cleansing from metabolic products separate hemofiltration of healthy donor and CRF patient in equal volumes is processed. Patient’s blood ultrafiltrate enters the bloodstream of a healthy person, as a healthy person ultrafiltrate in the same extent enters the bloodstream of CRF patient. At the same time remaining after filtration blood components of donor and patient are returned in their bloodstream respectively.Fundamentally important advantage of «symbiotic» hemofiltration is that CRF patient’s blood is cleansed from uremic metabolites due to healthy human kidneys natural physiological functions. «Symbiotic» hemofiltration is a highly effective physiological method of CRP patient’s blood purification from the uremic substances.

  13. What Are the Predictors of Altered Central Pain Modulation in Chronic Musculoskeletal Pain Populations? A Systematic Review.

    Science.gov (United States)

    Clark, Jacqui; Nijs, Jo; Yeowell, Gillian; Goodwin, Peter Charles

    2017-09-01

    Altered central pain modulation is the predominant pain mechanism in a proportion of chronic musculoskeletal pain disorders and is associated with poor outcomes. Although existing studies predict poor outcomes such as persistent pain and disability, to date there is little consensus on what factors specifically predict altered central pain modulation. To review the existing literature on the predictive factors specifically for altered central pain modulation in musculoskeletal pain populations. This is a systematic review in accordance with supplemented PRISMA guidelines. A systematic search was performed by 2 mutually blinded reviewers. Relevant articles were screened by title and abstract from Medline, Embase, PubMed, CINAHL, and Web of Science electronic databases. Alternative sources were also sought to locate missed potential articles. Eligibility included studies published in English, adults aged 18 to 65, musculoskeletal pain, baseline measurements taken at the pre-morbid or acute stage, > 3-month follow-up time after pain onset, and primary outcome measures specific to altered central pain modulation. Studies were excluded where there were concurrent diseases or they were non-predictive studies. Risk of bias was assessed using the quality in prognostic studies (QUIPS) tool. Study design, demographics, musculoskeletal region, inclusion/exclusion criteria, measurement timelines, predictor and primary outcome measures, and results were extracted. Data were synthesized qualitatively and strength of evidence was scored using the grading of recommendations, assessment, development, and evaluations (GRADE) scoring system. Nine eligible articles were located, in various musculoskeletal populations (whiplash, n = 2; widespread pain, n = 5; temporomandibular disorder, n = 2). Moderate evidence was found for 2 predictive factors of altered central pain modulation: 1) high sensory sensitivity (using genetic testing or quantitative sensory tests), and 2) psychological

  14. The musculoskeletal radiologic findings associated with chronic renal insufficiency; Manifestaciones radiologicas musculoesqueleticas de la insuficiencia renal cronica

    Energy Technology Data Exchange (ETDEWEB)

    Ruiz, P J; Gomez, I; Hernandez, L; Relanzon, S; Hurtado, M [Hospital General Universitario Gregorio Maranon, Madrid (Spain)

    1997-10-01

    The numerous musculoskeletal changes associated with chronic renal insufficiency (CRI) are detected with increasing frequency since hemodialysis and kidney transplantation have prolonged the survival of these patients. These signs have been divided into two large groups. The first includes secondary hyperparathyroidism (bone resorption, periostitis and brown tumors), osteoporosis, osteosclerosis, osteomalacia and vascular and soft tissue calcification, all of which are grouped under the term renal osteodystrophy. the second group is composed of miscellaneous disorders including aluminum poisoning, amyloid and crystal deposition, destructive spondyloarthropathy, tendon rupture, infection and avascular necrosis. These changes are less common and occur especially in patients under prolonged hemodialysis or kidney transplant recipients. The detection of musculoskeletal involvement in CRI patients has a considerable impact on their clinical management. The present article reviews the radiological signs of these changes, including representative images that will aid in their recognition. (Author) 33 refs.

  15. Predictors of seeking financial compensation following motor vehicle trauma: inception cohort with moderate to severe musculoskeletal injuries.

    Science.gov (United States)

    Murgatroyd, Darnel; Harris, Ian A; Chen, Jian Sheng; Adie, Sam; Mittal, Rajat; Cameron, Ian D

    2017-05-02

    Compensation related factors have been repeatedly associated with poor recovery following orthopaedic trauma. There is limited research into the factors associated with seeking financial compensation. Further understanding of these factors could facilitate injury recovery by purposeful compensation scheme design. The aim of this study was to investigate the predictors of seeking financial compensation, namely making a claim and seeking legal representation, following motor vehicle related orthopaedic trauma. The study was conducted in New South Wales (NSW), Australia, in motor vehicle crash and workers' compensation schemes. Participants were patients admitted with upper or lower extremity factures following a motor vehicle crash to two trauma hospitals. Data were collected at baseline within two weeks of injury. Participants were followed up at six months. Analysis involved: descriptive statistics for baseline characteristics; comparison of compensable and non-compensable participants with Analysis of Variance (ANOVA) and chi-squared tests; and logistic regression for predictor models. The cohort consisted of 452 participants with a mean age 40 years; 75% male; 74% working pre-injury; 30% in excellent pre-injury health; 56% sustained serious injuries with an Injury Severity Score (ISS) 9-15; 61% had a low-middle range household income; and 35% self-reported at fault in the crash. There was no significant difference in pre-injury/baseline health between compensable and non-compensable participants. Follow up data was available for 301 (67%) participants. The significant predictor of claiming compensation in the adjusted analysis was higher body mass index (BMI) (overweight Odds Ratio [OR] 3.05, 95% Confidence Interval [CI] 1.63-5.68; obese OR 1.63, 95% CI 0.83-3.20). Participants less likely to claim were: involved in a motorcycle crash (OR 0.47, 95% CI 0.28-0.82); socioeconomically less disadvantaged (OR 0.37, 95% CI 0.17-0.82) or least disadvantaged (OR 0.39, 95

  16. A behavioral medicine intervention for community-dwelling older adults with chronic musculoskeletal pain: protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Cederbom S

    2017-04-01

    Full Text Available Sara Cederbom,1 Eva Denison,2 Astrid Bergland1 1Department of Physiotherapy, Faculty of Health Sciences, Oslo and Akershus University College of Applied Sciences, Oslo, Norway; 2Department of Physiotherapy, School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden Background: Chronic musculoskeletal pain is a major health problem among older adults, particularly those who live alone and/or those who are dependent on formal care. Chronic pain is associated with mobility problems, falls, fear of falling, catastrophizing thoughts, and a lower quality of life. Research shows that physical therapy interventions based on behavioral medicine approaches are beneficial for middle-aged adults with chronic pain. However, there appears to be no previous randomized controlled trials (RCTs based on this theoretical framework that have examined the effect on older adults with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives. The aim of the planned study is to evaluate the effect of an individually tailored integrated physical therapy intervention based on a behavioral medicine approach compared with the effect of standard care.Methods/design: The planned study is an RCT that will include one intervention and one control group involving a total of 150 adults aged ≥75 years with chronic musculoskeletal pain who live alone at home and are dependent on formal care to manage their everyday lives. The intervention will involve a 12-week home-based individually tailored intervention that will be designed to enhance the participants’ ability to perform everyday activities by improving physical function and reducing pain-related disability and beliefs. The control group will be given standard care, including general advice about physical activity. The participants will be assessed at baseline and at 3 and 6 months after baseline. The primary outcome will be pain

  17. Self-reported work ability and work performance in workers with chronic nonspecific musculoskeletal pain.

    Science.gov (United States)

    de Vries, Haitze J; Reneman, Michiel F; Groothoff, Johan W; Geertzen, Jan H B; Brouwer, Sandra

    2013-03-01

    To assess self-reported work ability and work performance of workers who stay at work despite chronic nonspecific musculoskeletal pain (CMP), and to explore which variables were associated with these outcomes. In a cross-sectional study we assessed work ability (Work Ability Index, single item scale 0-10) and work performance (Health and Work Performance Questionnaire, scale 0-10) among 119 workers who continued work while having CMP. Scores of work ability and work performance were categorized into excellent (10), good (9), moderate (8) and poor (0-7). Hierarchical multiple regression and logistic regression analysis was used to analyze the relation of socio-demographic, pain-related, personal- and work-related variables with work ability and work performance. Mean work ability and work performance were 7.1 and 7.7 (poor to moderate). Hierarchical multiple regression analysis revealed that higher work ability scores were associated with lower age, better general health perception, and higher pain self-efficacy beliefs (R(2) = 42 %). Higher work performance was associated with lower age, higher pain self-efficacy beliefs, lower physical work demand category and part-time work (R(2) = 37 %). Logistic regression analysis revealed that work ability ≥8 was significantly explained by age (OR = 0.90), general health perception (OR = 1.04) and pain self-efficacy (OR = 1.15). Work performance ≥8 was explained by pain self-efficacy (OR = 1.11). Many workers with CMP who stay at work report poor to moderate work ability and work performance. Our findings suggest that a subgroup of workers with CMP can stay at work with high work ability and performance, especially when they have high beliefs of pain self-efficacy. Our results further show that not the pain itself, but personal and work-related factors relate to work ability and work performance.

  18. Mental health indicators and quality of life among individuals with musculoskeletal chronic pain: a nationwide study in Iceland.

    Science.gov (United States)

    Björnsdóttir, S V; Jónsson, S H; Valdimarsdóttir, U A

    2014-01-01

    Musculoskeletal chronic pain is a costly public health threat. The aim of our study was to investigate mental health indicators, including self-reported symptoms of depression, sleep disruption, stress, well-being, and quality of life (QoL), among men and women with musculoskeletal chronic pain in a general population. This was a cross-sectional study; a postal questionnaire was mailed to a stratified random sample of 9807 eligible Icelanders retrieved from a national registry, of whom 5906 responded (response rate = 60.2%). Chronic pain conditions included reports of current chronic back pain, chronic neck symptoms, and/or fibromyalgia. Gender-stratified associations of chronic pain conditions with mental health indicators were estimated with logistic regression analyses adjusting for age, income, body mass index (BMI), smoking, education, and residence. We observed higher odds of low satisfaction with life [adjusted odds ratio (OR(adj)) women 2.0, 95% confidence interval (CI) 1.5-2.6; OR(adj) men 2.3, 95% CI 1.7-3.1], higher levels of perceived stress (OR(adj) women 1.7, 95% CI 1.3-2.2; OR(adj) men = 1.5, 95% CI 1.1-2.1), depressive symptoms (OR(adj) women 2.4, 95% CI 1.9-3.0; OR(adj) men 2.8, 95% CI 2.1-3.7), and sleep disruption (OR(adj) women 2.8, 95% CI 2.2-3.5; OR(adj) men 2.2, 95% CI 1.5-3.1), and diminished QoL (OR(adj) women 1.6, 95% CI 1.2-2.1; OR(adj) men 1.5, 95% CI 1.0-2.1) among individuals with chronic pain compared with those without the condition. Our data indicate that individuals with musculoskeletal chronic pain have increased risk of poor mental health and diminished QoL. Further studies are needed on treatment and preventative measures of a decline in mental health among individuals with chronic pain.

  19. Biological Stress Systems, Adverse Life Events, and the Improvement of Chronic Multisite Musculoskeletal Pain Across a 6-Year Follow-Up.

    Science.gov (United States)

    Generaal, Ellen; Vogelzangs, Nicole; Macfarlane, Gary J; Geenen, Rinie; Smit, Johannes H; de Geus, Eco J C N; Dekker, Joost; Penninx, Brenda W J H

    2017-02-01

    Dysfunction of biological stress systems and adverse life events, independently and in interaction, have been hypothesized to predict chronic pain persistence. Conversely, these factors may hamper the improvement of chronic pain. Longitudinal evidence is currently lacking. We examined whether: 1) function of biological stress systems, 2) adverse life events, and 3) their combination predict the improvement of chronic multisite musculoskeletal pain. Subjects of the Netherlands Study of Depression and Anxiety (NESDA) with chronic multisite musculoskeletal pain at baseline (N = 665) were followed-up 2, 4, and 6 years later. The Chronic Pain Grade Questionnaire was used to determine improvement (not meeting the criteria) of chronic multisite musculoskeletal pain at follow-up. Baseline assessment of biological stress systems included function of hypothalamic-pituitary-adrenal axis (1-hour cortisol awakening response, evening level, and post dexamethasone level), the immune system (basal and lipopolysaccharide-stimulated inflammatory markers), the autonomic nervous system (heart rate, pre-ejection period, SD of the normal-to-normal interval, and respiratory sinus arrhythmia). The number of adverse life events were assessed at baseline and 2-year follow-up using the List of Threatening Events Questionnaire. We showed that hypothalamic-pituitary-adrenal axis, immune system, and autonomic nervous system functioning and adverse life events were not associated with the improvement of chronic multisite musculoskeletal pain, either as a main effect or in interaction. This longitudinal study could not confirm that biological stress system dysfunction and adverse life events affect the course of chronic multisite musculoskeletal pain. Biological stress systems and adverse life events are not associated with the improvement of chronic multisite musculoskeletal pain over 6 years of follow-up. Other determinants should thus be considered in future research to identify in which

  20. The association between diabetes mellitus, glucose, and chronic musculoskeletal complaints. Results from the Nord-Trøndelag Health Study

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    Zwart John-Anker

    2008-12-01

    Full Text Available Abstract Background The relationship between diabetes mellitus (DM and chronic musculoskeletal complaints (MSCs is unclear. The aim of this study was to investigate the association between DM, non-fasting glucose and chronic MSCs defined as pain and/or stiffness ≥ 3 months during the past year in the general adult population. Methods The results were based on cross-sectional data from 64,785 men and women (aged ≥ 20 years who participated in the Nord-Trøndelag Health Survey, which included 1,940 individuals with known DM. Associations were assessed using multiple logistic regression, estimating prevalence odds ratio (OR with 95% confidence intervals (CIs. Results High non-fasting glucose was associated with a lower prevalence of chronic MSCs compared to a low glucose level. DM was associated with higher prevalence of chronic MSCs, in particular chronic widespread MSCs. In the multivariate analysis, adjusting for glucose level, BMI, age, gender and physical activity, chronic widespread MSCs was 1.6 times more likely (OR = 1.6, 95% CI 1.2–2.2 among individuals Conclusion In this cross-sectional study a high non-fasting glucose was associated with lower prevalence of chronic MSCs. Among individuals with known DM chronic widespread MSCs were more likely.

  1. Effect of electroacupuncture on opioid consumption in patients with chronic musculoskeletal pain: protocol of a randomised controlled trial

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    Xue Charlie CL

    2012-09-01

    Full Text Available Abstract Background Chronic musculoskeletal pain is common and has been increasingly managed by opioid medications, of which the long-term efficacy is unknown. Furthermore, there is evidence that long-term use of opioids is associated with reduced pain control, declining physical function and quality of life, and could hinder the goals of integrated pain management. Electroacupuncture (EA has been shown to be effective in reducing postoperative opioid consumption. Limited evidence suggests that acupuncture could assist patients with chronic pain to reduce their requirements for opioids. The proposed research aims to assess if EA is an effective adjunct therapy to standard pain and medication management in reducing opioids use by patients with chronic musculoskeletal pain. Methods In this multicentre, randomised, sham-acupuncture controlled, three-arm clinical trial, 316 patients regularly taking opioids for pain control and meeting the defined selection criteria will be recruited from pain management centres and clinics of primary care providers in Victoria, Australia. After a four-week run-in period, the participants are randomly assigned to one of three treatment groups to receive EA, sham EA or no-EA with a ratio of 2:1:1. All participants receive routine pain medication management delivered and supervised by the trial medical doctors. Twelve sessions of semi-structured EA or sham EA treatment are delivered over 10 weeks. Upon completion of the acupuncture treatment period, there is a 12-week follow-up. In total, participants are involved in the trial for 26 weeks. Outcome measures of opioid and non-opioid medication consumption, pain scores and opioid-related adverse events are documented throughout the study. Quality of life, depression, function, and attitude to pain medications are also assessed. Discussion This randomised controlled trial will determine whether EA is of significant clinical value in assisting the management of

  2. Musculoskeletal infections: ultrasound appearances

    Energy Technology Data Exchange (ETDEWEB)

    Chau, C.L.F. [Department of Radiology, North District Hospital, NTEC, Fanling, NT, Hong Kong (China)]. E-mail: c8681@yahoo.com; Griffith, J.F. [Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, NTEC, Shatin, NT, Hong Kong (China)

    2005-02-01

    Musculoskeletal infections are commonly encountered in clinical practice. This review will discuss the ultrasound appearances of a variety of musculoskeletal infections such as cellulitis, infective tenosynovitis, pyomyositis, soft-tissue abscesses, septic arthritis, acute and chronic osteomyelitis, and post-operative infection. The peculiar sonographic features of less common musculoskeletal infections, such as necrotizing fasciitis, and rice body formation in atypical mycobacterial tenosynovitis, and bursitis will also be presented.

  3. Musculoskeletal infections: ultrasound appearances

    International Nuclear Information System (INIS)

    Chau, C.L.F.; Griffith, J.F.

    2005-01-01

    Musculoskeletal infections are commonly encountered in clinical practice. This review will discuss the ultrasound appearances of a variety of musculoskeletal infections such as cellulitis, infective tenosynovitis, pyomyositis, soft-tissue abscesses, septic arthritis, acute and chronic osteomyelitis, and post-operative infection. The peculiar sonographic features of less common musculoskeletal infections, such as necrotizing fasciitis, and rice body formation in atypical mycobacterial tenosynovitis, and bursitis will also be presented

  4. Optimism, Positive and Negative Affect, and Goal Adjustment Strategies: Their Relationship to Activity Patterns in Patients with Chronic Musculoskeletal Pain

    Directory of Open Access Journals (Sweden)

    Rosa Esteve

    2018-01-01

    Full Text Available Objective. Activity patterns are the product of pain and of the self-regulation of current goals in the context of pain. The aim of this study was to investigate the association between goal management strategies and activity patterns while taking into account the role of optimism/pessimism and positive/negative affect. Methods. Two hundred and thirty-seven patients with chronic musculoskeletal pain filled out questionnaires on optimism, positive and negative affect, pain intensity, and the activity patterns they employed in dealing with their pain. Questionnaires were also administered to assess their general goal management strategies: goal persistence, flexible goal adjustment, and disengagement and reengagement with goals. Results. Structural equation modelling showed that higher levels of optimism were related to persistence, flexible goal management, and commitment to new goals. These strategies were associated with higher positive affect, persistence in finishing tasks despite pain, and infrequent avoidance behaviour in the presence or anticipation of pain. Conclusions. The strategies used by the patients with chronic musculoskeletal pain to manage their life goals are related to their activity patterns.

  5. Optimism, Positive and Negative Affect, and Goal Adjustment Strategies: Their Relationship to Activity Patterns in Patients with Chronic Musculoskeletal Pain.

    Science.gov (United States)

    Esteve, Rosa; López-Martínez, Alicia E; Peters, Madelon L; Serrano-Ibáñez, Elena R; Ruiz-Párraga, Gema T; Ramírez-Maestre, Carmen

    2018-01-01

    Activity patterns are the product of pain and of the self-regulation of current goals in the context of pain. The aim of this study was to investigate the association between goal management strategies and activity patterns while taking into account the role of optimism/pessimism and positive/negative affect. Two hundred and thirty-seven patients with chronic musculoskeletal pain filled out questionnaires on optimism, positive and negative affect, pain intensity, and the activity patterns they employed in dealing with their pain. Questionnaires were also administered to assess their general goal management strategies: goal persistence, flexible goal adjustment, and disengagement and reengagement with goals. Structural equation modelling showed that higher levels of optimism were related to persistence, flexible goal management, and commitment to new goals. These strategies were associated with higher positive affect, persistence in finishing tasks despite pain, and infrequent avoidance behaviour in the presence or anticipation of pain. The strategies used by the patients with chronic musculoskeletal pain to manage their life goals are related to their activity patterns.

  6. The efficacy of the Peginterferon treatment in chronic hepatitis HDV and compensate liver cirrhosis.

    Science.gov (United States)

    Tugui, Letitia; Dumitru, M; Iacob, Speranta; Gheorghe, Liana; Preda, Carmen; Dinu, Ioana; Becheanu, G; Dumbrava, Mona; Nicolae, Ioana; Andrei, Adriana; Lupu, A; Diculescu, M

    2014-01-01

    To evaluate the efficiency of the treatment with Peginterferon alfa 2a 180 mcg/week, 48 weeks in patients with chronic hepatitis or compensated liver cirrhosis HDV and predictive factors of response to treatment. Prospective study that enrolled 50 patients with chronic hepatitis or compensated cirrhosis HDV between the 1st of January 2011 - 3st of December 2011. The diagnosis of chronic HDV infection was made based on the presence of detectable anti HDV IgG antibodies and HDV-RNA. Patients were evaluated at baseline by CBC, liver function tests, HBV profile, HDV RNA, and by liver biopsy/Fibrotest for evaluating fibrosis and necroinflammatory activity. At 24 weeks CBC (count blood cells), liver function tests, quantitative HBsAg and at 48 and 72 weeks biochemical tests, HDV RNA, HBV DNA, quantitative HBsAg, were performed. Adverse reactions to the treatment were recorded. SVR (sustained virologic response) was recorded in 12 patients (24%) and biochemical response in 28 patients (56%). SVR was correlated with low-grade fibrosis, age, the aminotransferase value and the value of HBsAg at the beginning of the treatment. In week 48 HDV RNA was undetectable in 20 patients (40%). The therapy was well tolerated, except two patients for whom the discontinuation of the treatment was decided for severe exacerbation of cytolysis, respectively hepatic decompensation. In a representative group of patients, the treatment with Peginterferon once again proves its efficacy in treating chronic HDV.

  7. Work-family conflicts and self-reported work ability: cross-sectional findings in women with chronic musculoskeletal disorders.

    Science.gov (United States)

    Bethge, Matthias; Borngräber, Yvonne

    2015-03-18

    Under conditions of gender-specific division of paid employment and unpaid childcare and housework, rising employment of women increases the likelihood that they will be faced with work-family conflicts. As recent research indicates, such conflicts might also contribute to musculoskeletal disorders. However, research in patient samples is needed to clarify how important these conflicts are for relevant health-related measures of functioning (e.g., work ability). We therefore examined, in a sample of women with chronic musculoskeletal disorders, the indirect and direct associations between the indicators of work-family conflicts and self-reported work ability as well as whether the direct effects remained significant after adjustment for covariates. A cross-sectional questionnaire-based study was conducted. Participants were recruited from five rehabilitation centers. Work-family conflicts were assessed by four scales referring to time- and strain-based work interference with family (WIF) and family interference with work (FIW). Self-reported work ability was measured by the Work Ability Index. A confirmatory factor analysis was performed to approve the anticipated four-factor structure of the work-family conflict measure. Direct and indirect associations between work-family conflict indicators and self-reported work ability were examined by path model analysis. Multivariate regression models were performed to calculate adjusted estimators of the direct effects of strain-based WIF and FIW on work ability. The study included 351 employed women. The confirmatory factor analysis provided support for the anticipated four-factor structure of the work-family conflict measure. The path model analysis identified direct effects of both strain-based scales on self-reported work ability. The time-based scales were indirectly associated with work ability via the strain-based scales. Adjusted regression analyses showed that a five-point increase in strain-based WIF or FIW was

  8. Musculoskeletal sporotrichosis

    Energy Technology Data Exchange (ETDEWEB)

    Chang, A.C.; Destouet, J.M.; Murphy, W.A.

    1984-06-01

    Sporotrichosis is a chronic, indolent, fungal infection that rarely involves the musculoskeletal system. The etiologic agent, Sporothrix schenckii, is ubiquitous in nature and has been isolated from soil, timber, decaying vegetation, and a variety of foliage. The organism gains entrance to the body through trauma to the skin or, in rare instances, by inhalation. The vast majority of infections in humans is characterized by nodular or ulcerated lesions of the cutaneous tissues and adjacent lymphatics. Osteoarticular involvement may occur either by contiguous spread from a cutaneous focus, through direct inoculation of tissue by the organism, or by hematogenous dissemination. The rarity of musculoskeletal sporotrichosis often causes a delay in diagnosis which leads to inappropriate therapy and permanent deformity in some patients. Three cases which show a spectrum of bone and joint involvement are presented.

  9. Musculoskeletal sporotrichosis

    International Nuclear Information System (INIS)

    Chang, A.C.; Destouet, J.M.; Murphy, W.A.

    1984-01-01

    Sporotrichosis is a chronic, indolent, fungal infection that rarely involves the musculoskeletal system. The etiologic agent, Sporothrix schenckii, is ubiquitous in nature and has been isolated from soil, timber, decaying vegetation, and a variety of foliage. The organism gains entrance to the body through trauma to the skin or, in rare instances, by inhalation. The vast majority of infections in humans is characterized by nodular or ulcerated lesions of the cutaneous tissues and adjacent lymphatics. Osteoarticular involvement may occur either by contiguous spread from a cutaneous focus, through direct inoculation of tissue by the organism, or by hematogenous dissemination. The rarity of musculoskeletal sporotrichosis often causes a delay in diagnosis which leads to inappropriate therapy and permanent deformity in some patients. Three cases which show a spectrum of bone and joint involvement are presented. (orig.)

  10. Compensating Hand Function in Chronic Stroke Patients Through the Robotic Sixth Finger.

    Science.gov (United States)

    Salvietti, Gionata; Hussain, Irfan; Cioncoloni, David; Taddei, Sabrina; Rossi, Simone; Prattichizzo, Domenico

    2017-02-01

    A novel solution to compensate hand grasping abilities is proposed for chronic stroke patients. The goal is to provide the patients with a wearable robotic extra-finger that can be worn on the paretic forearm by means of an elastic band. The proposed prototype, the Robotic Sixth Finger, is a modular articulated device that can adapt its structure to the grasped object shape. The extra-finger and the paretic hand act like the two parts of a gripper cooperatively holding an object. We evaluated the feasibility of the approach with four chronic stroke patients performing a qualitative test, the Frenchay Arm Test. In this proof of concept study, the use of the Robotic Sixth Finger has increased the total score of the patients by two points in a five points scale. The subjects were able to perform the two grasping tasks included in the test that were not possible without the robotic extra-finger. Adding a robotic opposing finger is a very promising approach that can significantly improve the functional compensation of the chronic stroke patient during everyday life activities.

  11. Direct and indirect benefits reported by users of transcutaneous electrical nerve stimulation for chronic musculoskeletal pain: Qualitative exploration using patient interviews

    OpenAIRE

    Gladwell, P. W.; Badlan, K.; Cramp, F. A.; Palmer, S.

    2015-01-01

    Background There is no consensus regarding the effectiveness of Transcutaneous Electrical Nerve Stimulation (TENS) for chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to guide selection of Patient Reported Outcome Measures appropriate for TENS evaluation.\\ud \\ud Objectives To explore the experiences of secondary care Pain Clinic patients who s...

  12. Validation of the French Version of the “Patterns of Activity Measure” in Patients with Chronic Musculoskeletal Pain

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    Charles Benaim

    2017-01-01

    Full Text Available Background. The “Patterns of Activity Measure” (POAM-P is a self-administered questionnaire that assesses “avoidance”, “pacing” and “overdoing” activity patterns in chronic pain patients. Objectives. To adapt the POAM-P to French (“POAM-P/F” and test its validity and reliability in Chronic Musculo-Skeletal Pain patients (CMSP. Methods. We followed the recommended procedure for translation of questionnaires. Five hundred and ninety five inpatients, admitted to a tertiary rehab center in the French-speaking part of Switzerland for chronic pain after orthopedic trauma, were included (sex ratio M/F = 4.36, mean age 43±12. Face, content and criterion validities, internal consistency and reliability were assessed. Data included: TAMPA Scale for Kinesiophobia (TSK, Chronic Pain Coping Inventory (CPCI, Pain Catastrophizing Scale (PCS, Brief Pain Inventory (BPI, Hospital Anxiety and Depression Scale (HADS. Results. Face and content validities were checked during the translation process. Correlations between POAM-P/F-avoidance and TSK, POAM-P/F-pacing and CPCI-pacing, POAM-P/F-overdoing and CPCI-task persistence were highly significant (r>0.3, p 0.8 and test-retest reliability (Intraclass Correlation Coefficients > 0.8. They correlated very differently with the other scales. Discussion and Conclusion. The three POAM-P/F subscales clearly assess different behaviors in CMSP. The POAM-P/F is a suitable questionnaire for classifying French speaking CMSP into avoiders, pacers or overdoers.

  13. Novel Three-Day, Community-Based, Nonpharmacological Group Intervention for Chronic Musculoskeletal Pain (COPERS: A Randomised Clinical Trial.

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    Stephanie J C Taylor

    2016-06-01

    Full Text Available Chronic musculoskeletal pain is the leading cause of disability worldwide. The effectiveness of pharmacological treatments for chronic pain is often limited, and there is growing concern about the adverse effects of these treatments, including opioid dependence. Nonpharmacological approaches to chronic pain may be an attractive alternative or adjunctive treatment. We describe the effectiveness of a novel, theoretically based group pain management support intervention for chronic musculoskeletal pain.We conducted a multi-centre, pragmatic, randomised, controlled effectiveness and cost-effectiveness (cost-utility trial across 27 general practices and community musculoskeletal services in the UK. We recruited 703 adults with musculoskeletal pain of at least 3 mo duration between August 1, 2011, and July 31, 2012, and randomised participants 1.33:1 to intervention (403 or control (300. Intervention participants were offered a participative group intervention (COPERS delivered over three alternate days with a follow-up session at 2 wk. The intervention introduced cognitive behavioural approaches and was designed to promote self-efficacy to manage chronic pain. Controls received usual care and a relaxation CD. The primary outcome was pain-related disability at 12 mo (Chronic Pain Grade [CPG] disability subscale; secondary outcomes included the CPG disability subscale at 6 mo and the following measured at 6 and 12 mo: anxiety and depression (Hospital Anxiety and Depression Scale [HADS], pain acceptance (Chronic Pain Acceptance Questionnaire, social integration (Health Education Impact Questionnaire social integration and support subscale, pain-related self-efficacy (Pain Self-Efficacy Questionnaire, pain intensity (CPG pain intensity subscale, the census global health question (2011 census for England and Wales, health utility (EQ-5D-3L, and health care resource use. Analyses followed the intention-to-treat principle, accounted for clustering by course

  14. Applying principles of self-management to facilitate workers to return to or remain at work with a chronic musculoskeletal condition.

    Science.gov (United States)

    Johnston, Venerina; Jull, Gwendolen; Sheppard, Dianne M; Ellis, Niki

    2013-08-01

    It is incumbent on health care professionals to support patients with chronic musculoskeletal conditions to manage the impact of the condition on their life. Work is a positive health behaviour for which self-management skills are essential. In this paper, self-management is defined and the role of clinicians in promoting self-management for return to work is outlined with examples and tips on how the clinician can incorporate self-management into practice. The clinician is ideally placed to assist individuals with chronic musculoskeletal conditions manage to remain at work or return to work. This can be achieved through such activities as the promotion of the core self-management skills of problem-solving, decision making, resource utilisation, developing a cooperative partnership between clinician and patient and making an action plan. Copyright © 2013 Elsevier Ltd. All rights reserved.

  15. Predictors of return-to-work in patients with chronic musculoskeletal pain: A randomized clinical trial

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    Randi Brendbekken

    2017-11-01

    Full Text Available Objective: To assess the predictive effect of a multidisciplinary intervention programme, pain, work-related factors and health, including anxiety/depression and beliefs, on return-to-work for patients sick-listed due to musculoskeletal pain. Design: A randomized clinical study. Methods: A total of 284 patients were randomized to either a multidisciplinary intervention programme (n = 141 or to a less resource-demanding brief intervention (n = 143. Work participation was estimated monthly from register data for 12 months. Return-to-work was defined as increased work participation in 3 consecutive months. Results: In the adjusted model, return-to-work by 3 months was associated with a multidisciplinary intervention programme (odds ratio (OR = 2.7, 95% confidence interval (95% CI = 1.1–6.9, the factor “belief that work was cause of the pain” (OR = 2.2, 95% CI = 1.1–4.3, anxiety and depression (OR = 0.5, 95% CI = 0.2–0.98, and by an interaction between the multidisciplinary intervention and perceived support at work (OR = 0.3, 95% CI = 0.1–0.9. At 12 months, only duration of sick leave was associated with return-to-work (OR = 0.6, 95% CI = 0.5–0.8. Conclusion: Multidisciplinary intervention may hasten return-to-work and benefit those who perceive low support at work, but at 12 months only duration of sick leave at baseline was associated with return-to-work.

  16. Reliability of the Life Satisfaction Questionnaire to assess patients with chronic musculoskeletal pain

    NARCIS (Netherlands)

    Boonstra, Anne M.; Reneman, Michiel F.; Posthumus, Jitze B.; Stewart, Roy E.; Schiphorst Preuper, Henrica R.

    The aim of this study was to determine the reliability of the Life Satisfaction Questionnaire, Dutch version (LSQ-DV), to assess chronic pain patients. The study was designed as test-retest. The setting was the general rehabilitation centre. There were 51 patients over 18 years of age, suffering

  17. Functional capacity and work ability in patients with chronic musculoskeletal pain

    NARCIS (Netherlands)

    van der Meer, Suzan

    2014-01-01

    Patients suffering from chronic low back pain (CLBP) and whiplash associated disorders (WAD) may experience many problems, including in work. Work ability is considered a balance between work demands and personal resources. Functional Capacity Evaluations (FCE) can be used to measure aspects of work

  18. Reliability and validity of the visual analogue scale for disability in patients with chronic musculoskeletal pain

    NARCIS (Netherlands)

    Boonstra, Anne M.; Schiphorst Preuper, Henrica R.; Reneman, Michiel F.; Posthumus, Jitze B.; Stewart, Roy E.

    To determine the reliability and concurrent validity of a visual analogue scale (VAS) for disability as a single-item instrument measuring disability in chronic pain patients was the objective of the study. For the reliability study a test-retest design and for the validity study a cross-sectional

  19. The effects of a novel psychological attribution and emotional awareness and expression therapy for chronic musculoskeletal pain: A preliminary, uncontrolled trial.

    Science.gov (United States)

    Burger, Amanda J; Lumley, Mark A; Carty, Jennifer N; Latsch, Deborah V; Thakur, Elyse R; Hyde-Nolan, Maren E; Hijazi, Alaa M; Schubiner, Howard

    2016-02-01

    Current psychological and behavioral therapies for chronic musculoskeletal pain only modestly reduce pain, disability, and distress. These limited effects may be due to the failure of current therapies: a) to help patients learn that their pain is influenced primarily by central nervous system psychological processes; and b) to enhance awareness and expression of emotions related to psychological trauma or conflict. We developed and conducted a preliminary, uncontrolled test of a novel psychological attribution and emotional awareness and expression therapy that involves an initial individual consultation followed by 4 group sessions. A series of 72 patients with chronic musculoskeletal pain had the intervention and were assessed at baseline, post-treatment, and 6-month follow-up. Participation and satisfaction were high and attrition was low. Intent-to-treat analyses found significant improvements in hypothesized change processes: psychological attributions for pain, emotional awareness, emotional approach coping, and alexithymia. Pain, interference, depression, and distress showed large effect size improvements at post-treatment, which were maintained or even enhanced at 6 months. Approximately two-thirds of the patients improved at least 30% in pain and other outcomes, and one-third of the patients improved 70%. Changes in attribution and emotional processes predicted outcomes. Higher baseline depressive symptoms predicted greater improvements, and outcomes were comparable for patients with widespread vs. localized pain. This novel intervention may lead to greater benefits than available psychological interventions for patients with chronic musculoskeletal pain, but needs controlled testing. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Chronic Osteoporotic Pain in Mice: Cutaneous and Deep Musculoskeletal Pain Are Partially Independent of Bone Resorption and Differentially Sensitive to Pharmacological Interventions

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    Miyako Suzuki

    2017-01-01

    Full Text Available Although the pathological changes in osteoporotic bones are well established, the characterization of the osteoporotic pain and its appropriate treatment are not fully elucidated. We investigated the behavioral signs of cutaneous and deep musculoskeletal pain and physical function; time-dependent changes in bone mineral density (BMD and the emergence of the behavioral phenotype; and the effects of pharmacological interventions having different mechanisms of action (chronic intraperitoneal administration of pamidronate [0.25 mg/kg, 5x/week for 5 weeks] versus acute treatment with intraperitoneal morphine [10 mg/kg] and pregabalin [100 mg/kg] in a mouse model of ovariectomized or sham-operated mice 6 months following surgery. We observed reduced BMD associated with weight gain, referred cutaneous hypersensitivity, and deep musculoskeletal pain that persisted for 6 months. Chronic bisphosphonate treatment, 6 months after ovariectomy, reversed bone loss and hypersensitivity to cold, but other behavioral indices of osteoporotic pain were unchanged. While the efficacy of acute morphine on cutaneous pain was weak, pregabalin was highly effective; deep musculoskeletal pain was intractable. In conclusion, the reversal of bone loss alone is insufficient to manage pain in chronic osteoporosis. Additional treatments, both pharmacological and nonpharmacological, should be implemented to improve quality of life for osteoporosis patients.

  1. Prescribing Generic Medication in Chronic Musculoskeletal Pain Patients: An Issue of Representations, Trust, and Experience in a Swiss Cohort.

    Directory of Open Access Journals (Sweden)

    Valérie Piguet

    Full Text Available Parallel to an ever stronger advocacy for the use of generics, various sources of information report concerns regarding substitution. The literature indicates that information regarding substitution is not univocal. The aim of this qualitative study was to explore patients' representations regarding generics in patients suffering from non-specific disabling chronic musculoskeletal pain, as these patients are confronted with the issue of the prescription and/or substitution of original formulations with generics.Qualitative methods were selected because the aim was to access the range of patients' representations and to consider their conceptions. Standardized face-to-face semi-structured interviews were used, and transcripts were submitted to content analysis.Patients' representations suggest that they might be confident in taking a generic medication: when he/she has an understanding of generics as resulting from a development process that has become part of the public domain; the generic medication is prescribed by the physician; each prescription is discussed, i.e., the patient is prescribed the generic version of a given medication and not a generic medication.Economic arguments are not sufficient to justify substitution, and may even raise issues calling upon cognitive dissonance. Even in non-life-threatening diseases, negative cues require attention and need be de-emphasized - in particular lower price as an indication of lower quality, and generic status as contradictory with advocating individualization of medication.

  2. Does Mindfulness Improve After Heart Coherence Training in Patients With Chronic Musculoskeletal Pain and Healthy Subjects? A Pilot Study.

    Science.gov (United States)

    Soer, Remko; de Jong, Annemieke B; Hofstra, Bert L; Preuper, Henrica R Schiphorst; Reneman, Michiel F

    2015-07-01

    Mindfulness and heart coherence training (HCT) training are applied increasingly in the treatment of patients with chronic musculoskeletal pain (CMP). Questionnaires have been developed to assess changes in mindfulness but no gold standard is available. Explore the relationship between changes in mindfulness scores and changes in heart coherence after 3 sessions of HCT in patients with CMP and in healthy subjects. Ten patients with CMP and 15 healthy subjects were trained in self-regulation with the use of HCT following a standardized stress relief program developed by the HeartMath Institute. A heart coherence-score (HC-score) was constructed with scores ranging from 0-100 with higher scores reflecting more heart rate variability (HRV) coherency. Change scores, Spearman correlation coefficients, and Wilcoxon Signed Rank test were calculated to test relationships and differences between HC-score, the Mindfulness Attention and Awareness Scale (MAAS) and Five Facet Mindfulness Questionnaire (FFMQ). A new questionnaire was constructed to explore on which mindfulness-related domains patients with CMP report changes after HCT. Increases were present on HC-score in healthy subjects (Ppilot study, mindfulness as assessed by the MAAS and FFMQ does not appear to improve after HCT. HRV coherency, MAAS, and FFMQ measure different constructs and are weakly related. It is of great importance to choose and develop valid measures that reflect patients' states of mindfulness. Content and face validity of measures of mindfulness may be considered in the light of performance-based measures.

  3. A synthesis of qualitative research exploring the barriers to staying in work with chronic musculoskeletal pain.

    Science.gov (United States)

    Toye, Francine; Seers, Kate; Allcock, Nick; Briggs, Michelle; Carr, Eloise; Barker, Karen

    2016-01-01

    Qualitative research can help to advance our understanding, management and prevention of work disability. Our aim was to integrate qualitative research findings in order to increase our understanding of barriers to stay in work with chronic pain. We searched five electronic bibliographic databases until September 2012, supplemented by citation tracking and hand-searching. We used meta-ethnography to synthesis our findings. Central to meta-ethnography is identifying “concepts” and developing a conceptual model. Concepts were compared and organised into categories. The following categories can have an impact on the decision to remain in work: struggling to affirm myself as a good worker; balancing life and work in the face of unpredictable symptoms; my work colleagues don't believe me; the system does not facilitate return to work; the battle for legitimacy. Our innovation is to present an internationally relevant model based on a conceptual synthesis. This model highlights the adversarial work experience of people with chronic. The papers span 15 years of qualitative research. A significant finding is that these themes continue to pervade the current work environment for those in pain, and this has clear implications for education, social care and policy. People with chronic pain face an adversarial struggle to maintain their credibility at work. Strategies to maintain personal credibility can have an adverse effect on working lives. Changes at a systems level are needed to facilitate continuance and return to work. Cultural changes in the way that we view people with pain would help to keep people in work.

  4. Short- and long-term changes in perceived work ability after interdisciplinary rehabilitation of chronic musculoskeletal disorders: prospective cohort study among 854 rehabilitants.

    Science.gov (United States)

    Saltychev, Mikhail; Laimi, Katri; Pentti, Jaana; Kivimäki, Mika; Vahtera, Jussi

    2014-06-01

    To investigate the changes in rehabilitants' perceived work ability after rehabilitation for chronic musculoskeletal disorders with respect to the baseline characteristics. Prospective cohort study based on register and repeated survey data. Public sector employees in ten towns and five hospital districts. A total of 854 employees who participated in the rehabilitation programme owing to common chronic musculoskeletal disorders between 1997 and 2009. Interdisciplinary, biopsychosocial, inpatient rehabilitation programme targeting people of working age with common chronic musculoskeletal disorders. The programme was executed in different rehabilitation centres across the country and funded by the Social Insurance Institution of Finland. Differences in perceived work ability level before and after rehabilitation. Data were derived from repeated surveys on average 2.1 years before rehabilitation, and 1.5 years (short-term follow-up) and 6.0 years (long-term follow-up) after rehabilitation. Before the rehabilitation, perceived work ability was 7.13 (SD 1.84) among the rehabilitants and 7.27 (SD 1.72) in the matched reference population. Among rehabilitants, this figure decreased by 0.82 (95% confidence interval -0.98 to -0.67) in the short-term and by 1.26 (95% confidence interval -1.45 to -1.07) in the long-term follow-up. Only slight differences in steepness of this deterioration were observed between subgroups, created based on the participants' baseline characteristics. Perceived work ability of participants, in an interdisciplinary biopsychosocial rehabilitation programme for common musculoskeletal disorders, deteriorated regardless of any studied pretreatment characteristics. The improvement of work ability may be an unrealistic goal for participants in this type of rehabilitation. © The Author(s) 2014.

  5. Physical inactivity is associated with chronic musculoskeletal complaints 11 years later: results from the Nord-Trøndelag Health Study

    Directory of Open Access Journals (Sweden)

    Zwart John-Anker

    2008-12-01

    Full Text Available Abstract Background Physical inactivity is associated with several diseases, but studies evaluating the association between chronic musculoskeletal complaints (MSCs and physical exercise have shown conflicting results. The aim of this large-scale prospective population-based study was to investigate the association between self-reported physical exercise at baseline and the prevalence of chronic musculoskeletal complaints (MSCs 11 years later. Methods The results are based upon two consecutive public health studies conducted within the county of Nord-Trøndelag, Norway (The HUNT studies. A total of 39,520 (83% out of 47,556 adults who participated in HUNT 1 and HUNT 2 responded to questions about physical exercise at baseline in 1984–86, and to questions about musculoskeletal complaints 11 years later (1995–97. Chronic MSCs was defined as MSCs ≥ 3 months during the past year, and chronic widespread MSCs such as pain ≥ 15 days during the last month from the axial region, above the waist, and below the waist. Associations were assessed using multiple logistic regression, estimating prevalence odds ratio (OR with 95% confidence intervals (CIs. All the final analyses were adjusted for age, gender, body mass index, smoking and education level. Results At follow-up 20,223 (51% reported chronic MSCs, and among these 2,318 (5.9% reported chronic widespread MSCs. Individuals who exercised at baseline were less likely to report chronic MSCs 11 years later (OR 0.91, 95% CI 0.85–0.97 than inactive persons. Among individuals who exercised more than three times per week, chronic widespread MSCs were 28% less common (OR 0.72, 95% CI 0.59–0.88 compared to inactive individuals. Conclusion In this large-scale population-based study, physical exercise was associated with lower prevalence of chronic MSCs, in particular chronic widespread MSCs. Future studies should try to clarify whether chronic MSCs are a cause or a consequence of inactivity.

  6. Pain adaptability in individuals with chronic musculoskeletal pain is not associated with conditioned pain modulation

    DEFF Research Database (Denmark)

    Wan, Dawn Wong Lit; Arendt-Nielsen, Lars; Wang, Kelun

    2018-01-01

    (MSK). CPTs at 2°C and 7°C were used to assess the status of pain adaptability in participants with either chronic non-specific low back pain or knee osteoarthritis. The participants' potency of conditioned pain modulation (CPM) and local inhibition were measured. The strengths of pain adaptability...... at both CPTs were highly correlated. PA and PNA did not differ in their demographics, pain thresholds from thermal and pressure stimuli, or potency of local inhibition or CPM. PA reached their maximum pain faster than PNA (t41=-2.76, p... days whereas PNA did not (F (6,246) = 3.01, p = 0.01). The dichotomy of pain adaptability exists in MSK patients. Consistent with the healthy human study, the strength of pain adaptability and potency of CPM are not related. Pain adaptability could be another form of endogenous pain inhibition which...

  7. Effect of individually tailored biopsychosocial workplace interventions on chronic musculoskeletal pain, stress and work ability among laboratory technicians: randomized controlled trial protocol.

    Science.gov (United States)

    Jay, Kenneth; Brandt, Mikkel; Sundstrup, Emil; Schraefel, Mc; Jakobsen, Markus D; Sjøgaard, Gisela; Andersen, Lars L

    2014-12-18

    Among laboratory technicians, the prevalence of neck and shoulder pain is widespread possibly due to typical daily work tasks such as pipetting, preparing vial samples for analysis, and data processing on a computer including mouse work - all tasks that require precision in motor control and may result in extended periods of time spent in static positions.In populations characterized by intense chronic musculoskeletal pain and diagnosed conditions in conjunction with psycho-physiological symptoms such as stress-related pain and soreness and other disabling conditions, multifactorial approaches applying a combination of individually tailored physical and cognitive strategies targeting the areas most needed, may be an effective solution to the physical and mental health challenges.The aim of this study is therefore to investigate the effect of an individually tailored biopsychosocial intervention strategy on musculoskeletal pain, stress and work disability in lab technicians with a history of musculoskeletal pain at a single worksite in Denmark. In this single-blind two-armed parallel-group randomized controlled trial with allocation concealment, participants receive either an individualized multifactorial intervention or "usual care" for 10 weeks at the worksite. 1) female laboratory technician (18-67 years of age) and 2) Pain intensity ≥ 3 (0-10 Visual Analogue Scale) lasting ≥3 months with a frequency of ≥ 3 days per week in one or more of the following regions: i) upper back i) low back iii) neck, iv) shoulder, v) elbow and/or vi) hand. 1) life-threatening disease and 2) pregnancy. Stress, as measured by Cohen´s perceived stress questionnaire is not an inclusion criteria, thus participants can participate regardless of their stress level.We will implement an individualized intervention addressing biopsychosocial elements of musculoskeletal pain with the following components; i) increasing physical capacity through strength- and motor control

  8. Cluster subgroups based on overall pressure pain sensitivity and psychosocial factors in chronic musculoskeletal pain: Differences in clinical outcomes.

    Science.gov (United States)

    Almeida, Suzana C; George, Steven Z; Leite, Raquel D V; Oliveira, Anamaria S; Chaves, Thais C

    2018-05-17

    We aimed to empirically derive psychosocial and pain sensitivity subgroups using cluster analysis within a sample of individuals with chronic musculoskeletal pain (CMP) and to investigate derived subgroups for differences in pain and disability outcomes. Eighty female participants with CMP answered psychosocial and disability scales and were assessed for pressure pain sensitivity. A cluster analysis was used to derive subgroups, and analysis of variance (ANOVA) was used to investigate differences between subgroups. Psychosocial factors (kinesiophobia, pain catastrophizing, anxiety, and depression) and overall pressure pain threshold (PPT) were entered into the cluster analysis. Three subgroups were empirically derived: cluster 1 (high pain sensitivity and high psychosocial distress; n = 12) characterized by low overall PPT and high psychosocial scores; cluster 2 (high pain sensitivity and intermediate psychosocial distress; n = 39) characterized by low overall PPT and intermediate psychosocial scores; and cluster 3 (low pain sensitivity and low psychosocial distress; n = 29) characterized by high overall PPT and low psychosocial scores compared to the other subgroups. Cluster 1 showed higher values for mean pain intensity (F (2,77)  = 10.58, p cluster 3, and cluster 1 showed higher values for disability (F (2,77)  = 3.81, p = 0.03) compared with both clusters 2 and 3. Only cluster 1 was distinct from cluster 3 according to both pain and disability outcomes. Pain catastrophizing, depression, and anxiety were the psychosocial variables that best differentiated the subgroups. Overall, these results call attention to the importance of considering pain sensitivity and psychosocial variables to obtain a more comprehensive characterization of CMP patients' subtypes.

  9. "I was a little surprised": Qualitative Insights from Patients Enrolled in a 12-Month Trial Comparing Opioids to Non-Opioid Medications for Chronic Musculoskeletal Pain.

    Science.gov (United States)

    Marianne S Matthias; Donaldson, Melvin T; Jensen, Agnes C; Krebs, Erin E

    2018-04-28

    Chronic musculoskeletal pain is a major public health problem. Although opioid prescribing for chronic pain has increased dramatically since the 1990s, this practice has come under scrutiny because of increases in opioid-related harms and lack of evidence for long-term effectiveness. The Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial was a pragmatic 12-month randomized trial comparing benefits and harms of opioid versus non-opioid medications for chronic musculoskeletal pain. The current qualitative study was designed to better understand trial results by exploring patients' experiences, including perceptions of medications, experiences with the intervention, and whether expectations were met. Thirty-four participants who were purposefully sampled based on treatment group and intervention response participated in semi-structured interviews. The constant comparison method guided analysis. Results revealed that participants often held strong beliefs about opioid medications, which sometimes changed during the trial as they gained experience with medications; participants described a wide variety of experiences with treatment effectiveness, regardless of study group or their response to the intervention; and participants highly valued the personalized pain care model used in SPACE. SPACE trial results indicated no advantage for opioid over non-opioid medications. Qualitative findings suggest that, for patients in both treatment groups, pre-existing expectations of medications and of anticipated improvement in pain shaped experiences with and responses to medications. In addition, the personalized pain care model was described as contributing to positive outcomes in both groups. Copyright © 2018. Published by Elsevier Inc.

  10. A Systematic Review and Meta-Analysis of Mindfulness-Based (Baduanjin) Exercise for Alleviating Musculoskeletal Pain and Improving Sleep Quality in People with Chronic Diseases.

    Science.gov (United States)

    Zou, Liye; Yeung, Albert; Quan, Xinfeng; Boyden, Sean David; Wang, Huiru

    2018-01-25

    we performed the first systematic review with meta-analyses of the existing studies that examined mindfulness-based Baduanjin exercise for its therapeutic effects for individuals with musculoskeletal pain or insomnia. Both English- (PubMed, Web of Science, Elsevier, and Google Scholar) and Chinese-language (CNKI and Wangfang) electronic databases were used to search relevant articles. We used a modified PEDro scale to evaluate risk of bias across studies selected. All eligible RCTS were considered for meta-analysis. The standardized mean difference was calculated for the pooled effects to determine the magnitude of the Baduanjin intervention effect. For the moderator analysis, we performed subgroup meta-analysis for categorical variables and meta-regression for continuous variables. The aggregated result has shown a significant benefit in favour of Baduanjin at alleviating musculoskeletal pain (SMD = -0.88, 95% CI -1.02 to -0.74, p Mindfulness-based Baduanjin exercise may be effective for alleviating musculoskeletal pain and improving overall sleep quality in people with chronic illness. Large, well-designed RCTs are needed to confirm these findings.

  11. A Systematic Review and Meta-Analysis of Mindfulness-Based (Baduanjin Exercise for Alleviating Musculoskeletal Pain and Improving Sleep Quality in People with Chronic Diseases

    Directory of Open Access Journals (Sweden)

    Liye Zou

    2018-01-01

    Full Text Available Objective: we performed the first systematic review with meta-analyses of the existing studies that examined mindfulness-based Baduanjin exercise for its therapeutic effects for individuals with musculoskeletal pain or insomnia. Methods: Both English- (PubMed, Web of Science, Elsevier, and Google Scholar and Chinese-language (CNKI and Wangfang electronic databases were used to search relevant articles. We used a modified PEDro scale to evaluate risk of bias across studies selected. All eligible RCTS were considered for meta-analysis. The standardized mean difference was calculated for the pooled effects to determine the magnitude of the Baduanjin intervention effect. For the moderator analysis, we performed subgroup meta-analysis for categorical variables and meta-regression for continuous variables. Results: The aggregated result has shown a significant benefit in favour of Baduanjin at alleviating musculoskeletal pain (SMD = −0.88, 95% CI −1.02 to −0.74, p < 0.001, I2 = 10.29% and improving overall sleep quality (SMD = −0.48, 95% CI −0.95 to −0.01, p = 004, I2 = 84.42%. Conclusions: Mindfulness-based Baduanjin exercise may be effective for alleviating musculoskeletal pain and improving overall sleep quality in people with chronic illness. Large, well-designed RCTs are needed to confirm these findings.

  12. Kinetic Compensations due to Chronic Ankle Instability during Landing and Jumping.

    Science.gov (United States)

    Kim, Hyunsoo; Son, S Jun; Seeley, Matthew K; Hopkins, J Ty

    2018-02-01

    Skeletal muscles absorb and transfer kinetic energy during landing and jumping, which are common requirements of various forms of physical activity. Chronic ankle instability (CAI) is associated with impaired neuromuscular control and dynamic stability of the lower extremity. Little is known regarding an intralimb, lower-extremity joint coordination of kinetics during landing and jumping for CAI patients. We investigated the effect of CAI on lower-extremity joint stiffness and kinetic and energetic patterns across the ground contact phase of landing and jumping. One hundred CAI patients and 100 matched able-bodied controls performed five trials of a landing and jumping task (a maximal vertical forward jump, landing on a force plate with the test leg only, and immediate lateral jump toward the contralateral side). Functional analyses of variance and independent t-tests were used to evaluate between-group differences for lower-extremity net internal joint moment, power, and stiffness throughout the entire ground contact phase of landing and jumping. Relative to the control group, the CAI group revealed (i) reduced plantarflexion and knee extension and increased hip extension moments; (ii) reduced ankle and knee eccentric and concentric power, and increased hip eccentric and concentric power, and (iii) reduced ankle and knee joint stiffness and increased hip joint stiffness during the task. CAI patients seemed to use a hip-dominant strategy by increasing the hip extension moment, stiffness, and eccentric and concentric power during landing and jumping. This apparent compensation may be due to decreased capabilities to produce sufficient joint moment, stiffness, and power at the ankle and knee. These differences might have injury risk and performance implications.

  13. A study of the psychometric properties of 12-item World Health Organization Disability Assessment Schedule 2.0 in a large population of people with chronic musculoskeletal pain.

    Science.gov (United States)

    Saltychev, Mikhail; Bärlund, Esa; Mattie, Ryan; McCormick, Zachary; Paltamaa, Jaana; Laimi, Katri

    2017-02-01

    To assess the validity of the Finnish translation of the 12-item World Health Organization Disability Assessment Schedule (WHODAS 2.0). Cross-sectional cohort survey study. Physical and Rehabilitation Medicine outpatient university clinic. The 501 consecutive patients with chronic musculoskeletal pain. Exploratory factor analysis and a graded response model using item response theory analysis were used to assess the constructs and discrimination ability of WHODAS 2.0. The exploratory factor analysis revealed two retained factors with eigenvalues 5.15 and 1.04. Discrimination ability of all items was high or perfect, varying from 1.2 to 2.5. The difficulty levels of seven out of 12 items were shifted towards the elevated disability level. As a result, the entire test characteristic curve showed a shift towards higher levels of disability, placing it at the point of disability level of +1 (where 0 indicates the average level of disability within the sample). The present data indicate that the Finnish translation of the 12-item WHODAS 2.0 is a valid instrument for measuring restrictions of activity and participation among patients with chronic musculoskeletal pain.

  14. Baggage handler seniority and musculoskeletal symptoms

    DEFF Research Database (Denmark)

    Bern, Stine Hvid; Brauer, Charlotte; Møller, Karina Lauenborg

    2013-01-01

    Heavy lifting is associated with musculoskeletal disorders but it is unclear whether it is related to acute reversible effects or to chronic effects from cumulated exposure. The aim of this study was to examine whether musculoskeletal symptoms in Danish airport baggage handlers were associated wi...... with their seniority as baggage handler, indicating chronic effects from cumulated workload....

  15. The association between rurality and return to work for workers' compensation claimants with work-related musculoskeletal injuries: An analysis of workers who failed to return to work within typical healing time frames.

    Science.gov (United States)

    Lavoie, Callum A; Voaklander, Don; Beach, Jeremy R; Gross, Douglas P

    2017-07-14

    The objectives of this study have been to: 1) describe and compare urban and rural injured worker populations in Alberta, Canada; 2) identify return-to-work outcomes in urban and rural populations; 3) examine the relationship between geographic location of residence and recovery from work-related musculoskeletal injury; and 4) investigate if this relationship is attenuated after controlling for other known risk factors. This study was a secondary analysis utilizing data of a population of musculoskeletal injury claimants who underwent clinical/RTW (return to work) assessment between December 2009 and January 2011 collected by the Workers' Compensation Board of Alberta. Descriptive statistics were computed for 32 variables and used for comparing urban and rural workers. The logistic regression analysis was performed to test the association between geographic location of residence and likelihood of return-to-work. Data on 7843 claimants was included, 70.1% of them being urban and 29.9% - rural. Rural claimants tended to have spent less time in formal education, have a blue-collar job, have no modified work available, have a diagnosed comorbidity, and not been enrolled in a specialized rehabilitation program. They were 1.43 (1.12-1.84) times the odds more likely than urban claimants to be continuing to receive full disability benefits 90 days after their RTW assessment, and 1.68 (1.06-2.67) times the odds as likely to report a recurrence of receiving disability benefits. Rural residence was associated with prolonged work disability, even after controlling for age, job type, education level, health utilization and other potential confounders. Further research is required to explore why injured workers in rural settings experience prolonged reception of disability benefits and have greater rates of recurrence of receiving disability benefits. Int J Occup Med Environ Health 2017;30(5):715-729. This work is available in Open Access model and licensed under a CC BY-NC 3

  16. Problems, Solutions, and Strategies Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews.

    Science.gov (United States)

    Gladwell, Peter William; Badlan, Kathryn; Cramp, Fiona; Palmer, Shea

    2016-07-01

    Transcutaneous electrical nerve stimulation (TENS) could offer a non-drug form of pain relief, but there is no consensus regarding its effectiveness for chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methods identified significant problems with low treatment fidelity. There is little information available to inform the development of a pragmatic implementation design for a TENS evaluation. The aim of this study was to explore the experiences of patients who were receiving secondary care in a pain clinic and who had expertise in using TENS to manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. Semistructured interviews were conducted with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Data analysis indicated that patients learned to address a range of problems in order to optimize TENS use. Patients may need to personalize the positioning of electrodes and the TENS settings and to readjust them over time. Patients learned to use TENS in a strategic manner, and the outcomes of each strategy varied. The findings indicated that a pragmatic TENS evaluation may need to incorporate a learning phase to allow patients to optimize this complex pattern of TENS usage, and evaluation may need to be sensitive to the outcomes of strategic use. These findings also have implications for clinical practice. © 2016 American Physical Therapy Association.

  17. Direct and Indirect Benefits Reported by Users of Transcutaneous Electrical Nerve Stimulation for Chronic Musculoskeletal Pain: Qualitative Exploration Using Patient Interviews.

    Science.gov (United States)

    Gladwell, Peter William; Badlan, Kathryn; Cramp, Fiona; Palmer, Shea

    2015-11-01

    There is no consensus regarding the effectiveness of transcutaneous electrical nerve stimulation (TENS) for management of chronic musculoskeletal pain or chronic low back pain. A recent review of previous trial methodology identified significant problems with low treatment fidelity. There is little information available to guide selection of patient-reported outcome measures appropriate for TENS evaluation. The purpose of this study was to explore the experiences of patients at a secondary care pain clinic who successfully used TENS to help manage chronic musculoskeletal pain. These key informants were selected because they had the potential to generate knowledge that could inform research design and clinical practice. A qualitative method using individual semistructured interviews with open questions was selected for its capacity to generate rich data. A mini focus group informed the development of a discussion guide for semistructured interviews with 9 patients (6 women, 3 men). Thematic analysis was used as the primary data analysis method, and this analysis was enhanced by a case-level analysis of the context and processes of TENS use of each individual. Data analysis indicated that distraction from pain and a reduction in the sensations associated with muscle tension or spasm should be considered as separate outcomes from pain relief. These direct benefits led to a wide range of indirect benefits dependent on patient decision making, including medication reduction, enhanced function, psychological benefits, and enhanced ability to rest. The findings indicate that evaluating TENS using a unidimensional pain scale is likely to overlook potential benefits. The complex pattern of TENS usage, as well as multiple direct and indirect outcomes, indicates that TENS could be considered as a complex intervention. © 2015 American Physical Therapy Association.

  18. Multi-chronic musculoskeletal pain is a useful clinical index to predict the risk of falls in older adults with normal motor function.

    Science.gov (United States)

    Asai, Tsuyoshi; Misu, Shogo; Sawa, Ryuichi; Doi, Takehiko; Yamada, Minoru

    2015-10-01

    The number of chronic musculoskeletal pain sites (nCMSP) is reportedly associated with risk of falls. Older participants in community-based research show a wide range of physical functions, but few studies have focused on the risk of falls in older adults with normal motor function (NMF). Clarification of the effects of pain on dual-tasking performance is also important, given the strong link between falls and dual-tasking. The objectives were to investigate the associations between: (1) nCMSP and falls; and (2) nCMSP and dual-task performance in older adults with NMF. A total of 112 older adults with NMF (44 men, 68 women; 73.4 ± 4.6 years) were classified as fallers (n = 22) or non-fallers (n = 90) according to their fall history. Musculoskeletal pain in the lower body was assessed using questions ascertaining pain in musculoskeletal sites (back, hip, knee, foot, or toe). Participants were assigned to three pain groups according to nCMSP. Basic physical performances and gait performances (normal gait, fast gait, or dual-task gait) were measured. The nCMSP represented a significant risk factor for falls according to logistic regression modeling after adjusting for the five chair stand test and fear of falls. The nCMSP was not associated with any gait variables. Potential fall risk may be increased by nCMSP, even in older adults with NMF. Pain-related reduction in attention resources may not represent a risk factor for falls among older adults with NMF. The nCMSP represents a potential risk factor for falls in older adults with NMF.

  19. [Helping reintegration of patients suffering from chronic musculoskeletal diseases with decreased working ability in the National Institute of Rheumatology and Physiotherapy, Budapest, Hungary].

    Science.gov (United States)

    Sallai, Julianna Rozália; Hunka, Aniella; Héjj, Gábor; Bálint, Géza; Poór, Gyula

    2017-04-01

    An important task of our institute is to support social reintegration: including occupational rehabilitation of patients suffering from chronic musculoskeletal diseases with decreased working ability. The aim of the authors was to provide informations of their daily practice, how they perform patient education, giving information for their patients about their disease, the rehabilitation possibilities, how they support the patients with decreased working ability to take part in their own rehabilitation. Patients taking part in in-patient rehabilitation received teaching and education about their disease and rehabilitation options in groups. Patients interested in part-time jobs were individually interviewed by a 30-120 minutes talk about their educational level and training, social conditions and about the available part time jobs. The part time jobs were available with the help of the Motivation Foundation of the National Association of the Societies of Motion Disabled, and the Alfa Rehabilitation Nonprofit Rt. The data of patients receiving in-patient rehabilitation betwen the 1st of January 2009 and 31st of December 2014 were analyzed. Out of the 230 patients seeking our help for part time job, our social service could organise jobs for 180 disabled persons, all town-inhabitants, but was unsuccesful in getting jobs for patients living in villages and separated farms. Part time jobs can be organized for musculoskeletal disabled living in cities and towns. For village-dwellers there are no suitable jobs and working places. It is necessary to organize rehabilitation working possibitities for musculoskeletal disabled patients living in villages. Orv Hetil. 2017; 158(17): 662-667.

  20. Clinical Policy Recommendations from the VHA State-of-the-Art Conference on Non-Pharmacological Approaches to Chronic Musculoskeletal Pain.

    Science.gov (United States)

    Kligler, Benjamin; Bair, Matthew J; Banerjea, Ranjana; DeBar, Lynn; Ezeji-Okoye, Stephen; Lisi, Anthony; Murphy, Jennifer L; Sandbrink, Friedhelm; Cherkin, Daniel C

    2018-05-01

    As a large national healthcare system, Veterans Health Administration (VHA) is ideally suited to build on its work to date and develop a safe, evidence-based, and comprehensive approach to the care of chronic musculoskeletal pain conditions that de-emphasizes opioid use and emphasizes non-pharmacological strategies. The VHA Office of Health Services Research and Development (HSR&D) held a state-of-the-art (SOTA) conference titled "Non-pharmacological Approaches to Chronic Musculoskeletal Pain Management" in November 2016. Goals of the conference were (1) to establish consensus on the current state of evidence regarding non-pharmacological approaches to chronic musculoskeletal pain to inform VHA policy in this area and (2) to begin to identify priorities for the future VHA research agenda. Workgroups were established and asked to reach consensus recommendations on clinical and research priorities for the following treatment strategies: psychological/behavioral therapies, exercise/movement therapies, manual therapies, and models for delivering multimodal pain care. Participants in the SOTA identified nine non-pharmacological therapies with sufficient evidence to be implemented across the VHA system as part of pain care. Participants further recommended that effective integration of these non-pharmacological approaches across the VHA and especially into VHA primary care, pain care, and mental health settings should be a priority, and that these treatments should be offered early in the course of pain treatment and delivered in a team-based, multimodal treatment setting concurrently with active self-care and self-management approaches. In addition, we recommend that VHA leadership and policy makers systematically address the barriers to implementation of these approaches by expanding opportunities for clinician and veteran education on the effectiveness of these strategies; supporting and funding further research to determine optimal dosage, duration, sequencing

  1. Renal compensation to chronic hypoxic hypercapnia: downregulation of pendrin and adaptation of the proximal tubule.

    NARCIS (Netherlands)

    Seigneux, S. de; Malte, H.; Dimke, H.; Frokiaer, J.; Nielsen, S.; Frische, S.

    2007-01-01

    The molecular basis for the renal compensation to respiratory acidosis and specifically the role of pendrin in this condition are unclear. Therefore, we studied the adaptation of the proximal tubule and the collecting duct to respiratory acidosis. Male Wistar-Hannover rats were exposed to either

  2. Preliminary results of training with gravity compensation of the arm in chronic stroke survivors

    NARCIS (Netherlands)

    van der Kooij, Herman; Prange, Grada Berendina; Prange, G.B.; Krabben, T.; Krabben, T.; Renzenbrink, G.H.; Boer, J.; Hermens, Hermanus J.; Jannink, M.J.A.

    2009-01-01

    After stroke, arm function can be limited by a reduction in the selectivity of movements, due to involuntary coupling of shoulder abduction and elbow flexion, limiting the ability to reach. Gravity compensation of the arm reduces the required active shoulder abduction torques, which results in a

  3. An explorative study into changes in reach performance after gravity compensation training in chronic stroke patients

    NARCIS (Netherlands)

    Prange, Grada Berendina; Krabben, T.; Renzenbrink, G.J.; de Boer, Jan; Hermens, Hermanus J.; Jannink, M.J.A.

    2009-01-01

    After stroke, arm function can be limited by a reduction in the selectivity of movements, due to involuntary coupling of shoulder abduction and elbow flexion, limiting the ability to reach. Gravity compensation reduces the required active shoulder abduction torques, which results in a larger range

  4. Cost-effectiveness of 40-hour versus 100-hour vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain: study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Beemster, Timo T.; van Velzen, Judith M.; van Bennekom, Coen A. M.; Frings-Dresen, Monique H. W.; Reneman, Michiel F.

    2015-01-01

    Although vocational rehabilitation is a widely advocated intervention for workers on sick leave due to subacute or chronic nonspecific musculoskeletal pain, the optimal dosage of effective and cost-effective vocational rehabilitation remains unknown. The objective of this paper is to describe the

  5. Cost-effectiveness of 40-hour versus 100-hour vocational rehabilitation on work participation for workers on sick leave due to subacute or chronic musculoskeletal pain : study protocol for a randomized controlled trial

    NARCIS (Netherlands)

    Beemster, Timo T.; van Velzen, Judith M.; van Bennekom, Coen A. M.; Frings-Dresen, Monique H. W.; Reneman, Michiel F.

    2015-01-01

    Background: Although vocational rehabilitation is a widely advocated intervention for workers on sick leave due to subacute or chronic nonspecific musculoskeletal pain, the optimal dosage of effective and cost-effective vocational rehabilitation remains unknown. The objective of this paper is to

  6. Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain: Variability and Influence of Sex and Catastrophizing

    NARCIS (Netherlands)

    Boonstra, A.M.; Stewart, R.; Koke, A.J.A.; Oosterwijk, R.F.A.; Swaan, J.L.; Schreurs, Karlein Maria Gertrudis; Schiphorst Preuper, H.R.

    2016-01-01

    Objectives: The 0–10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the

  7. Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain : Variability and Influence of Sex and Catastrophizing

    NARCIS (Netherlands)

    Boonstra, Anne M; Stewart, Roy E; Köke, Albère J A; Oosterwijk, René F A; Swaan, Jeannette L; Schreurs, Karlein M G; Schiphorst Preuper, Henrica R

    2016-01-01

    Objectives: The 0-10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the

  8. The effect of plasma exchange on entecavir-treated chronic hepatitis B patients with hepatic de-compensation and acute-on-chronic liver failure.

    Science.gov (United States)

    Yue-Meng, Wan; Yang, Li-Hong; Yang, Jin-Hui; Xu, Ying; Yang, Jing; Song, Gui-Bo

    2016-05-01

    Various studies showed that entecavir (ETV) failed to improve the short-term survival in chronic hepatitis B (CHB) patients with severe acute exacerbation (SAE) and hepatic de-compensation or acute-on-chronic liver failure (ACLF). One study concluded that plasma exchange (PE) significantly decreased the short-term mortality of CHB patients with ACLF who were treated with lamivudine (LAM). Our study was designed to examine the effect of PE on CHB patients with ACLF who were treated with ETV. From August 2010 to January 2015, 38 (PE group) and 120 (control group) consecutive CHB-naïve patients with hepatic de-compensation and ACLF treated with PE plus ETV and ETV, respectively, were recruited. The primary endpoint was liver-related mortality at week 12. Biochemical and virological responses were also studied. At baseline, the PE group had higher serum alanine aminotransferase (ALT) levels and model for end-stage liver disease (MELD) scores, and had lower albumin levels than the control group. The cumulative survival rate at week 4 and week 12 in the PE group and control group were, respectively, 37 and 18 %, and 29 and 14 % (p  0.05). Univariate analysis showed that the control group had a higher liver-related mortality (p = 0.038) at week 12 than the PE group. Multivariate analysis showed that hepatic encephalopathy, ascites, PE treatment, and MELD scores were independent factors for liver-related mortality at week 12. PE significantly improved the short-term survival of CHB patients with hepatic de-compensation and ACLF who were treated with ETV. Hepatic encephalopathy, ascites, PE treatment, and MELD scores were independent factors for liver-related mortality at week 12.

  9. Attenuation of Experimental Pain by Vibro-Tactile Stimulation in Patients with Chronic Local or Widespread Musculoskeletal Pain

    OpenAIRE

    Staud, Roland; Robinson, Michael E.; Goldman, Casey T.; Price, Donald D.

    2011-01-01

    Patients with chronic pain syndromes, like fibromyalgia (FM) complain of widespread pain and tenderness, as well as non-refreshing sleep, cognitive dysfunction, and negative mood. Several lines of evidence implicate abnormalities of central pain processing as contributors for chronic pain, including dysfunctional descending pain inhibition. One form of endogenous pain inhibition, diffuse noxious inhibitory controls (DNIC), has been found to be abnormal in some chronic pain patients and eviden...

  10. Musculoskeletal injuries

    International Nuclear Information System (INIS)

    Gigirey, V

    2012-01-01

    This presentation is about musculoskeletal injuries and the diagnosis of osseous tumors. The use of the radiology, bone scintigraphy, computed tomography and magnetic resonance contribute to detect the localization of the osseous lesions as well as the density (lytic, sclerotic, mixed) and the benign and malignant tumors.

  11. A Research Agenda for Advancing Non-pharmacological Management of Chronic Musculoskeletal Pain: Findings from a VHA State-of-the-art Conference.

    Science.gov (United States)

    Becker, William C; DeBar, Lynn L; Heapy, Alicia A; Higgins, Diana; Krein, Sarah L; Lisi, Anthony; Makris, Una E; Allen, Kelli D

    2018-05-01

    Chronic pain is widely prevalent among Veterans and can have serious negative consequences for functional status and quality of life among other domains. The Veterans Health Administration (VHA) convened a state-of-the-art (SOTA) conference to develop research priorities for advancing the science and clinical practice of non-pharmacological management of chronic musculoskeletal pain. In this perspective article, we present the methods and consensus recommendations for research priorities emanating from the SOTA. In the months leading up to the SOTA, a core group of researchers defined four areas of focus: psychological/behavioral therapies; exercise/movement therapies; manual therapies; and models for delivering multi-modal pain care and divided into workgroups. Each workgroup, in their respective areas of focus, identified seminal studies capturing the state of the evidence. Herein, we present consensus recommendations ranging from efficacy to effectiveness to implementation/dissemination research depending on the state of the evidence as assessed by participants, including commentary on common elements across workgroups and future areas of innovation in study design, measurement, and outcome ascertainment.

  12. Biological stress systems, adverse life events and the onset of chronic multisite musculoskeletal pain : a six-year cohort study

    NARCIS (Netherlands)

    Generaal, E.; Vogelzangs, N.; Macfarlane, G.J.; Geenen, R.; de Geus, E.; Smit, J.H.; Penninx, B.W.; Dekker, J.

    2015-01-01

    Background Dysregulated biological stress systems and adverse life events, both independently and in interaction, have been hypothesized to initiate chronic pain. Objectives We examine whether (i) function of biological stress systems, (ii) adverse life events, and (iii) their combination predict

  13. Device evaluation and coverage policy in workers' compensation: examples from Washington State.

    Science.gov (United States)

    Franklin, G M; Lifka, J; Milstein, J

    1998-09-25

    Workers' compensation health benefits are broader than general health benefits and include payment for medical and rehabilitation costs, associated indemnity (lost time) costs, and vocational rehabilitation (return-to-work) costs. In addition, cost liability is for the life of the claim (injury), rather than for each plan year. We examined device evaluation and coverage policy in workers' compensation over a 10-year period in Washington State. Most requests for device coverage in workers' compensation relate to the diagnosis, prognosis, or treatment of chronic musculoskeletal conditions. A number of specific problems have been recognized in making device coverage decisions within workers' compensation: (1) invasive devices with a high adverse event profile and history of poor outcomes could significantly increase both indemnity and medical costs; (2) many noninvasive devices, while having a low adverse event profile, have not proved effective for managing chronic musculoskeletal conditions relevant to injured workers; (3) some devices are marketed and billed as surrogate diagnostic tests for generally accepted, and more clearly proven, standard tests; (4) quality oversight of technology use among physicians may be inadequate; and (5) insurers' access to efficacy data adequate to make timely and appropriate coverage decisions in workers' compensation is often lacking. Emerging technology may substantially increase the costs of workers' compensation without significant evidence of health benefit for injured workers. To prevent ever-rising costs, we need to increase provider education and patient education and consent, involve the state medical society in coverage policy, and collect relevant outcomes data from healthcare providers.

  14. [Musculoskeletal medicine--strategies towards a "good musculoskeletal consultation"].

    Science.gov (United States)

    Vulfsons, Simon

    2011-03-01

    The burden of musculoskeletal disease and disability is huge. The direct costs of diagnosis and treatment are dwarfed by the indirect costs to society comprised of sick leave, early retirement, pension funds and disability allowances. Chronic musculoskeletal pain and dysfunction account for the most common cause for chronic pain and for up to 25% of all consultations to family practitioners in the developed world. It is therefore surprising to find that education and training in musculoskeletal medicine has been given short shrift by medical schools, specialist training programs for family practitioners and post graduate continuing medical education. This has been shown quite comprehensively by Mashov and Tabenkin in this edition of the journal. At the close of the Bone and Joint Decade 2000-2010, as declared by the WHO, it is timely to see what has been achieved in terms of the original goals for this decade. There has been a major effort for increasing awareness both in the health community and the general public towards managing chronic musculoskeletal pain. Much has been written, but far less performed in changing the priorities of medical schools and family practice programs towards teaching and training doctors to adequately recognize and treat patients suffering from chronic musculoskeletal problems. In Israel, it is estimated that the indirect costs through lost productivity amount to up to 1.15 billion shekels a year. Investing time and money in training programs for medical students and doctors, together with building an incentive program for primary care physicians to adequately treat this huge chronically disabled population is not only feasible, but can also make great inroads towards easing suffering while curtailing costs.

  15. Interdisciplinary approach to compensation of hypoglycemia in diabetic patients with chronic heart failure.

    Science.gov (United States)

    Anfinogenova, Yana; Grakova, Elena V; Shvedova, Maria; Kopieva, Kristina V; Teplyakov, Alexander T; Popov, Sergey V

    2018-05-01

    Diabetes mellitus is a chronic disease requiring lifelong control with hypoglycemic agents that must demonstrate excellent efficacy and safety profiles. In patients taking glucose-lowering drugs, hypoglycemia is a common cause of death associated with arrhythmias, increased thrombus formation, and specific effects of catecholamines due to sympathoadrenal activation. Focus is now shifting from merely glycemic control to multifactorial approach. In the context of individual drugs and classes, this article reviews interdisciplinary strategies evaluating metabolic effects of drugs for treatment of chronic heart failure (CHF) which can mask characteristic hypoglycemia symptoms. Hypoglycemia unawareness and cardiac autonomic neuropathy are discussed. Data suggesting that hypoglycemia modulates immune response are reviewed. The potential role of gut microbiota in improving health of patients with diabetes and CHF is emphasized. Reports stating that nondiabetic CHF patients can have life-threatening hypoglycemia associated with imbalance of thyroid hormones are discussed. Regular glycemic control based on HbA1c measurements and adequate pharmacotherapy remain the priorities in diabetes management. New antihyperglycemic drugs with safer profiles should be preferred in vulnerable CHF patients. Multidrug interactions must be considered. Emerging therapies with reduced hypoglycemia risk, telemedicine, sensor technologies, and genetic testing predicting hypoglycemia risk may help solving the challenges of hypoglycemia in CHF patients with diabetes. Interdisciplinary work may involve cardiologists, diabetologists/endocrinologists, immunologists, gastroenterologists, microbiologists, nutritionists, imaging specialists, geneticists, telemedicine experts, and other relevant specialists. This review emphasizes that systematic knowledge on pathophysiology of hypoglycemia in diabetic patients with CHF is largely lacking and the gaps in our understanding require further discoveries.

  16. Characteristics of chronic non-specific musculoskeletal pain in children and adolescents attending a rheumatology outpatients clinic: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Murray Kevin

    2011-01-01

    Full Text Available Abstract Background Chronic non-specific musculoskeletal pain (CNSMSP may develop in childhood and adolescence, leading to disability and reduced quality of life that continues into adulthood. The purpose of the study was to build a biopsychosocial profile of children and adolescents with CNSMSP. Methods CNSMSP subjects (n = 30, 18 females, age 7-18 were compared with age matched pain free controls across a number of biopsychosocial domains. Results In the psychosocial domain CNSMSP subjects had increased levels of anxiety and depression, and had more somatic pain complaints. In the lifestyle domain CNSMSP subjects had lower physical activity levels, but no difference in television or computer use compared to pain free subjects. Physically, CNSMSP subjects tended to sit with a more slumped spinal posture, had reduced back muscle endurance, increased presence of joint hypermobility and poorer gross motor skills. Conclusion These findings support the notion that CNSMSP is a multidimensional biopsychosocial disorder. Further research is needed to increase understanding of how the psychosocial, lifestyle and physical factors develop and interact in CNSMSP.

  17. The avoidance of activities due to fear of falling contributes to sedentary behavior among community-dwelling older adults with chronic musculoskeletal pain: a multisite observational study.

    Science.gov (United States)

    Stubbs, Brendon; Patchay, Sandhi; Soundy, Andy; Schofield, Pat

    2014-11-01

    Physical inactivity and sedentary behavior (SB) are leading causes of mortality. We investigated if older adults with chronic musculoskeletal pain (CMP) are more sedentary than a group of similar age and sex without CMP and possible contributory factors to this. In this multisite observational study, 285 community-dwelling older adults (response rate 71%) took part. One hundred forty-four had CMP (78.4 years, 65.9% female), and 141 formed the comparison group without CMP. Details regarding falls were collected, and all participants completed the brief pain inventory (BPI), modified version of the survey of activities and fear of falling in elderly scale (mSAFFE), and the International Physical Activity Questionnaire (IPAQ) to measure SB. Data were analyzed with hierarchical regression analysis. Older adults with CMP spent approximately 3 1/2 hours a day more being sedentary than the comparison group (11.5 hours vs 7.9, Psedentary than those of a similar sex and age without CMP. It appears that the avoidance of activities due to fear of falling is a significant contributory factor to SB in older adults with CMP. Wiley Periodicals, Inc.

  18. Assessing Psycho-social Barriers to Rehabilitation in Injured Workers with Chronic Musculoskeletal Pain: Development and Item Properties of the Yellow Flag Questionnaire (YFQ).

    Science.gov (United States)

    Salathé, Cornelia Rolli; Trippolini, Maurizio Alen; Terribilini, Livio Claudio; Oliveri, Michael; Elfering, Achim

    2018-06-01

    Purpose To develop a multidimensional scale to asses psychosocial beliefs-the Yellow Flag Questionnaire (YFQ)-aimed at guiding interventions for workers with chronic musculoskeletal (MSK) pain. Methods Phase 1 consisted of item selection based on literature search, item development and expert consensus rounds. In phase 2, items were reduced with calculating a quality-score per item, using structure equation modeling and confirmatory factor analysis on data from 666 workers. In phase 3, Cronbach's α, and Pearson correlations coefficients were computed to compare YFQ with disability, anxiety, depression and self-efficacy and the YFQ score based on data from 253 injured workers. Regressions of YFQ total score on disability, anxiety, depression and self-efficacy were calculated. Results After phase 1, the YFQ included 116 items and 15 domains. Further reductions of items in phase 2 by applying the item quality criteria reduced the total to 48 items. Phase factor analysis with structural equation modeling confirmed 32 items in seven domains: activity, work, emotions, harm & blame, diagnosis beliefs, co-morbidity and control. Cronbach α was 0.91 for the total score, between 0.49 and 0.81 for the 7 distinct scores of each domain, respectively. Correlations between YFQ total score ranged with disability, anxiety, depression and self-efficacy was .58, .66, .73, -.51, respectively. After controlling for age and gender the YFQ total score explained between R2 27% and R2 53% variance of disability, anxiety, depression and self-efficacy. Conclusions The YFQ, a multidimensional screening scale is recommended for use to assess psychosocial beliefs of workers with chronic MSK pain. Further evaluation of the measurement properties such as the test-retest reliability, responsiveness and prognostic validity is warranted.

  19. Increased Renal Clearance of Rocuronium Compensates for Chronic Loss of Bile Excretion, via upregulation of Oatp2.

    Science.gov (United States)

    Wang, Long; Zhou, Mai-Tao; Chen, Cai-Yang; Yin, Wen; Wen, Da-Xiang; Cheung, Chi-Wai; Yang, Li-Qun; Yu, Wei-Feng

    2017-01-13

    Requirement for rocuronium upon surgery changes only minimally in patients with end-stage liver diseases. Our study consisted of both human and rat studies to explore the reason. The reduction rate of rocuronium infusion required to maintain neuromuscular blockade during the anhepatic phase (relative to paleohepatic phase) was examined in 16 children with congenital biliary atresia receiving orthotopic liver transplantation. Pharmacodynamics and pharmacokinetics of rocuronium were studied based on BDL rats. The role of increased Oatp2 and decrease Oatp1 expressions in renal compensation were explored. The reduction of rocuronium requirements significantly decreased in obstructively jaundiced children (24 ± 9 vs. 39 ± 11%). TOF50 in BDL rats was increased by functional removal of the kidneys but not the liver, and the percentage of rocuronium excretion through urine increased (20.3 ± 6.9 vs. 8.6 ± 1.8%), while that decreased through bile in 28d-BDL compared with control group. However, this enhanced renal secretion for rocuronium was eliminated by Oatp2 knock-down, rather than Oatp1 overexpression (28-d BDL vs. Oatp1-ShRNA or Oatp2-ShRNA, 20.3 ± 6.9 vs. 17.0 ± 6.6 or 9.3 ± 3.2%). Upon chronic/sub-chronic loss of bile excretion, rocuronium clearance via the kidneys is enhanced, by Oatp2 up-regulation.

  20. Treinamento resistido progressivo nas doenças musculoesqueléticas crônicas Progressive resistance training in chronic musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Renata Trajano Jorge

    2009-12-01

    physical exercises in physical therapy, besides optimizing the results of the treatment. OBJECTIVE: To review studies that used progressive resistance training in chronic musculoskeletal diseases and to demonstrate the importance of including this type of training in the rehabilitation of those diseases. SOURCE OF THE DATA: Pubmed, Medline, and Lilacs databases were reviewed without restrictions of date and/or language. REVIEW: Due to the countless benefits attributed to this treatment modality, the importance of exercises in physical therapy has been well documented. Despite the proven efficacy, high-intensity exercises are not routinely prescribed, and this prescription is usually not standardized, which does not allow a consensus on the type of strengthening used, as well as load calculation and progression. Progressive resistance training implies the gradual increase in load during the training period. The number of repetitions that each individual can complete depends on the calculation of the maximal repetition. CONCLUSION: Based on the findings of this review, the use of progressive resistance training to complement traditional exercises used in rehabilitation of chronic musculoskeletal diseases is recommended in order to standardize treatment protocols, with adequate control of individual load, and to optimize training results. However, it should be emphasized that further studies are necessary for more reliable conclusions.

  1. Effects of chronic infusion of a GABAA receptor agonist or antagonist into the vestibular nuclear complex on vestibular compensation in the guinea pig.

    Science.gov (United States)

    Gliddon, Catherine M; Darlington, Cynthia L; Smith, Paul F

    2005-06-01

    The aim of this study was to determine the effects of chronic infusion of a GABA(A) receptor agonist/antagonist into the ipsilateral or contralateral vestibular nuclear complex (VNC) on vestibular compensation, the process of behavioral recovery that occurs after unilateral vestibular deafferentation (UVD). This was achieved by a mini-osmotic pump that infused, over 30 h, muscimol or gabazine into the ipsilateral or contralateral VNC. Spontaneous nystagmus (SN), yaw head tilt (YHT), and roll head tilt (RHT) were measured. Infusion of muscimol or gabazine into either the ipsilateral or the contralateral VNC had little effect on SN compensation. In contrast, infusion of muscimol (250, 500, and 750 ng) into the contralateral VNC and gabazine (31.25, 62.5, and 125 ng) into the ipsilateral VNC significantly affected YHT and RHT (p 0.05). Interestingly, the effects of muscimol and gabazine on YHT and RHT were consistent throughout the first 30 h post-UVD. Infusion of muscimol (62.5, 125, and 250 ng) into the ipsilateral VNC and gabazine (125, 375, and 750 ng) into the contralateral VNC had little effect on YHT and RHT or their rate of compensation. These results suggest that the ipsilateral gabazine and contralateral muscimol infusions are modifying the expression of the symptoms without altering the mechanism of compensation. Furthermore, the neurochemical mechanism responsible for vestibular compensation can cope with the both the GABA(A) receptor-mediated and the UVD-induced decrease in resting activity.

  2. Mobility Limitations and Fall-Related Factors Contribute to the Reduced Health-Related Quality of Life in Older Adults With Chronic Musculoskeletal Pain.

    Science.gov (United States)

    Stubbs, Brendon; Schofield, Pat; Patchay, Sandhi

    2016-01-01

    To investigate (1) the prevalence of chronic musculoskeletal pain (CMP) among a sample of community-dwelling older adults and (2) health-related quality of life (HRQOL) in people with CMP, particularly the association with mobility limitations and falls-related factors. Overall, 295 (response rate 73.5%) community-dwelling older adults were recruited across 10 sites. CMP was assessed using recognized criteria. In the sample of people with CMP, a hierarchical multiple regression analysis was conducted with HRQOL as the dependent variable and a number of independent variables were then inserted into the model. After controlling for demographic and medical variables, mobility (timed up and go (TUG), walking aid use, sedentary behavior) and fall-related factors (falls history, balance confidence, concerns about consequences of falling) were inserted into the model at the second step and changes in adjusted R(2) noted. Within our sample of older adults, 52% had CMP (154/295). Compared to the group without CMP of similar age (n = 141), those with CMP had reduced HRQOL and profound mobility limitations and more falls risk factors (P falls explanatory variables increased the variance explained within HRQOL from 14% to 36% (adjusted R(2) change 20%) in those with CMP. Sedentary behavior, pain interference, concerns about the consequences of falling, falls history, TUG scores, and balance confidence all remained significant predictors of HRQOL in the fully adjusted model in the CMP sample. Older adults with CMP have pronounced mobility limitations and increased falls risk factors, and these are associated with a marked reduction in HRQOL. Future prospective research is required to build on this cross-sectional study. © 2014 World Institute of Pain.

  3. A Systematic Review and Meta-Analysis of Mindfulness-Based (Baduanjin) Exercise for Alleviating Musculoskeletal Pain and Improving Sleep Quality in People with Chronic Diseases

    OpenAIRE

    Liye Zou; Albert Yeung; Xinfeng Quan; Sean David Boyden; Huiru Wang

    2018-01-01

    Objective: we performed the first systematic review with meta-analyses of the existing studies that examined mindfulness-based Baduanjin exercise for its therapeutic effects for individuals with musculoskeletal pain or insomnia. Methods: Both English- (PubMed, Web of Science, Elsevier, and Google Scholar) and Chinese-language (CNKI and Wangfang) electronic databases were used to search relevant articles. We used a modified PEDro scale to evaluate risk of bias across studies selected. All elig...

  4. A Randomized Trial of Musculoskeletal Pain Treatment in a Military Population

    National Research Council Canada - National Science Library

    Gatchel, Robert J

    2005-01-01

    .... This study investigates the effectiveness of an interdisciplinary functional restoration approach to the treatment of Active Duty military from all four branches suffering from chronic musculoskeletal pain (CMP...

  5. Work-related musculoskeletal disorders : prevention report

    NARCIS (Netherlands)

    Podniece, Z.; Heuvel, S. van den; Blatter, B.

    2008-01-01

    Work-related musculoskeletal disorders (MSDs) can interfere with activities at work and can lead to reduced productivity, sickness absence and chronic occupational disability. The aim of this report is to systematic evaluate the effectiveness of interventions at the workplace since 2002 and to

  6. Biological stress systems, adverse life events and the improvement of chronic multi-site musculoskeletal pain across a 6-year follow-up

    NARCIS (Netherlands)

    Generaal, E.; Vogelzangs, N.; Macfarlane, G.J.; Geenen, R.; Smit, J.H.; de Geus, E.J.C.N.; Dekker, J.; Penninx, B.W.J.H.

    Dysfunction of biological stress systems and adverse life events, independently and in interaction, have been hypothesized to predict chronic pain persistence. Conversely, these factors may hamper the improvement of chronic pain. Longitudinal evidence is currently lacking. We examined whether: 1)

  7. Biological Stress Systems, Adverse Life Events, and the Improvement of Chronic Multisite Musculoskeletal Pain Across a 6-Year Follow-Up

    NARCIS (Netherlands)

    Generaal, Ellen; Vogelzangs, Nicole; Macfarlane, Gary J; Geenen, Rinie; Smit, Johannes H; de Geus, Eco J C N; Dekker, Joost; Penninx, Brenda W J H

    Dysfunction of biological stress systems and adverse life events, independently and in interaction, have been hypothesized to predict chronic pain persistence. Conversely, these factors may hamper the improvement of chronic pain. Longitudinal evidence is currently lacking. We examined whether: 1)

  8. Cardiovascular and metabolic effects of 48-h glucagon-like peptide-1 infusion in compensated chronic patients with heart failure

    DEFF Research Database (Denmark)

    Halbirk, Mads; Nørrelund, Helene; Møller, Niels

    2010-01-01

    effects of 48-h GLP-1 infusions in patients with congestive HF. In a randomized, double-blind crossover design, 20 patients without diabetes and with HF with ischemic heart disease, EF of 30 +/- 2%, New York Heart Association II and III (n = 14 and 6) received 48-h GLP-1 (0.7 pmol.kg(-1).min(-1......)) and placebo infusion. At 0 and 48 h, LVEF, diastolic function, tissue Doppler regional myocardial function, exercise testing, noninvasive cardiac output, and brain natriuretic peptide (BNP) were measured. Blood pressure, heart rate, and metabolic parameters were recorded. Fifteen patients completed...... patients. GLP-1 infusion increased circulating insulin levels and reduced plasma glucose concentration but had no major cardiovascular effects in patients without diabetes but with compensated HF. The impact of minor increases in heart rate and diastolic blood pressure during GLP-1 infusion requires...

  9. Musculoskeletal pain in overweight and obese children

    Science.gov (United States)

    Smith, S M; Sumar, B; Dixon, K A

    2014-01-01

    This review seeks to provide a current overview of musculoskeletal pain in overweight and obese children. Databases searched were Academic Search Complete, CINAHL, Medline, Proquest Health and Medical Complete, Scopus, Google Scholar, SPORTDiscuss and Trove for studies published between 1 January 2000 and 30 December 2012. We used a broad definition of children within a 3- to 18-year age range. The search strategy included the following terms: obesity, morbid obesity, overweight, pain, musculoskeletal pain, child, adolescent, chronic pain, back pain, lower back pain, knee pain, hip pain, foot pain and pelvic pain. Two authors independently assessed each record, and any disagreement was resolved by the third author. Data were analysed using a narrative thematic approach owing to the heterogeneity of reported outcome measures. Ninety-seven records were initially identified using a variety of terms associated with children, obesity and musculoskeletal pain. Ten studies were included for thematic analysis when predetermined inclusion criteria were applied. Bone deformity and dysfunction, pain reporting and the impact of children being overweight or obese on physical activity, exercise and quality of life were the three themes identified from the literature. Chronic pain, obesity and a reduction in physical functioning and activity may contribute to a cycle of weight gain that affects a child's quality of life. Future studies are required to examine the sequela of overweight and obese children experiencing chronic musculoskeletal pain. PMID:24077005

  10. Biological stress systems, adverse life events and the onset of chronic multi-site musculoskeletal pain: a six-year cohort study

    NARCIS (Netherlands)

    Generaal, E.; Vogelzangs, N.; MacFarlane, G.J.; Geenen, R.|info:eu-repo/dai/nl/087017571; Smit, J.H.; de Geus, E.J.C.N.; Penninx, B.W.J.H.; Dekker, J.

    2016-01-01

    Objectives Dysregulated biological stress systems and adverse life events, independently and in interaction, have been hypothesised to initiate chronic pain. We examine whether (1) function of biological stress systems, (2) adverse life events, and (3) their combination predict the onset of chronic

  11. Complementary and alternative treatment of musculoskeletal pain.

    Science.gov (United States)

    Grazio, Simeon; Balen, Diana

    2011-12-01

    The use of complementary and alternative medicine (CAM) is high and increasing worldwide. Patients usually use CAM in addition to conventional medicine, mainly to treat pain. In a large number of cases, people use CAM for chronic musculoskeletal pain as in osteoarthritis, back pain, neck pain, or fibromyalgia. Herewith, a review is presented of CAM efficacy in treating musculoskeletal pain for which, however, no scientific research has so far provided evidence solid enough. In some rare cases where adequate pain control cannot be achieved, CAM might be considered in rational and individual approach based on the first general rule in medicine "not to harm" and on the utility theory of each intervention, i.e. according to the presumed mechanism of painful stimulus and with close monitoring of the patient's response. Further high quality studies are warranted to elucidate the efficacy and side effects of CAM methods. Therefore, conventional medicine remains the main mode of treatment for patients with musculoskeletal painful conditions.

  12. Reliable prediction of clinical outcome in patients with chronic HCV infection and compensated advanced hepatic fibrosis: a validated model using objective and readily available clinical parameters.

    Science.gov (United States)

    van der Meer, Adriaan J; Hansen, Bettina E; Fattovich, Giovanna; Feld, Jordan J; Wedemeyer, Heiner; Dufour, Jean-François; Lammert, Frank; Duarte-Rojo, Andres; Manns, Michael P; Ieluzzi, Donatella; Zeuzem, Stefan; Hofmann, W Peter; de Knegt, Robert J; Veldt, Bart J; Janssen, Harry L A

    2015-02-01

    Reliable tools to predict long-term outcome among patients with well compensated advanced liver disease due to chronic HCV infection are lacking. Risk scores for mortality and for cirrhosis-related complications were constructed with Cox regression analysis in a derivation cohort and evaluated in a validation cohort, both including patients with chronic HCV infection and advanced fibrosis. In the derivation cohort, 100/405 patients died during a median 8.1 (IQR 5.7-11.1) years of follow-up. Multivariate Cox analyses showed age (HR=1.06, 95% CI 1.04 to 1.09, pstatistic=0.78, 95% CI 0.72 to 0.83). In the validation cohort, 58/296 patients with cirrhosis died during a median of 6.6 (IQR 4.4-9.0) years. Among patients with estimated 5-year mortality risks 10%, the observed 5-year mortality rates in the derivation cohort and validation cohort were 0.9% (95% CI 0.0 to 2.7) and 2.6% (95% CI 0.0 to 6.1), 8.1% (95% CI 1.8 to 14.4) and 8.0% (95% CI 1.3 to 14.7), 21.8% (95% CI 13.2 to 30.4) and 20.9% (95% CI 13.6 to 28.1), respectively (C statistic in validation cohort = 0.76, 95% CI 0.69 to 0.83). The risk score for cirrhosis-related complications also incorporated HCV genotype (C statistic = 0.80, 95% CI 0.76 to 0.83 in the derivation cohort; and 0.74, 95% CI 0.68 to 0.79 in the validation cohort). Prognosis of patients with chronic HCV infection and compensated advanced liver disease can be accurately assessed with risk scores including readily available objective clinical parameters. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Creative compensation

    International Nuclear Information System (INIS)

    Coll, D.

    1994-01-01

    A discussion is presented of executive compensation in Canada's petroleum industry. Mandatory disclosure of executive compensation and benefits is regulated by the Ontario Securities Commission. Examination of the compensation packages of 80 oilpatch CEOs shows a clear difference in philosophy between large and small companies. Larger companies pay larger salaries, offer pension plans, and reward long-term loyalty. Within smaller companies, compensation tends to be linked with stock performance. Trends in compensation are to lower base salaries with more variables such as bonuses, cash incentives and gain-sharing programs. Increasing shareholder scrutiny is prompting more stringent guidelines on stock option plans. Some companies place performance conditions on stock vesting. Another option is to grant premium priced options to executives, to increase the gains required for the executive to post a profit. Other comapanies are granting stock options to their field personnel, or are granting stock to all employees. Directors are playing an increasing role in executive compensation. 4 tabs

  14. Neurocognitive performance and physical function do not change with physical-cognitive-mindfulness training in female laboratory technicians with chronic musculoskeletal pain

    DEFF Research Database (Denmark)

    Jay, Kenneth; Brandt, Mikkel; Schraefel, M. C.

    2016-01-01

    BACKGROUND: Cognitive and physical performance can be negatively affected by chronic pain. This study evaluates the effect of combined physical-, cognitive-, and mindfulness training (PCMT) on cognitive and physical performance. METHODS: From a large pharmaceutical company in Denmark we randomly...

  15. Musculoskeletal ultrasound in childhood

    Energy Technology Data Exchange (ETDEWEB)

    Maurer, Kathrin, E-mail: kathrin.maurer@i-med.ac.at

    2014-09-15

    Ultrasonography is one of the first line imaging modalities for the evaluation of musculoskeletal disorders in children. This article provides an overview of the most important pathologic entities in which ultrasonography significantly contributes to the diagnostic workup.

  16. Imaging features of musculoskeletal tuberculosis

    International Nuclear Information System (INIS)

    Vuyst, Dimitri De; Vanhoenacker, Filip; Bernaerts, Anja; Gielen, Jan; Schepper, Arthur M. de

    2003-01-01

    The purpose of this article is to review the imaging characteristics of musculoskeletal tuberculosis. Skeletal tuberculosis represents one-third of all cases of tuberculosis occurring in extrapulmonary sites. Hematogenous spread from a distant focus elsewhere in the body is the cornerstone in the understanding of imaging features of musculoskeletal tuberculosis. The most common presentations are tuberculous spondylitis, arthritis, osteomyelitis, and soft tissue involvement. The diagnostic value of the different imaging techniques, which include conventional radiography, CT, and MR imaging, are emphasized. Whereas conventional radiography is the mainstay in the diagnosis of tuberculous arthritis and osteomyelitis, MR imaging may detect associated bone marrow and soft tissue abnormalities. MR imaging is generally accepted as the imaging modality of choice for diagnosis, demonstration of the extent of the disease of tuberculous spondylitis, and soft tissue tuberculosis. Moreover, it may be very helpful in the differential diagnosis with pyogenic spondylodiscitis, as it may easily demonstrate anterior corner destruction, the relative preservation of the intervertebral disk, multilevel involvement with or without skip lesions, and a large soft tissue abscess, as these are all arguments in favor of a tuberculous spondylitis. On the other hand, CT is still superior in the demonstration of calcifications, which are found in chronic tuberculous abscesses. (orig.)

  17. Losses compensation; Compensation des pertes

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-07-01

    One mission of RTE (Electric Power Transportation), is to watch over the losses compensation resulting from the power transport on the electric power network. Since january 2001, RTE makes good the electric losses by the purchase of energy. To choose the marketers, a consultation has been realized by RTE. This document presents the rules concerning these losses compensation. (A.L.B.)

  18. Musculoskeletal ultrasonography in children

    International Nuclear Information System (INIS)

    Teo, E.-L.H.; Strouse, P.J.; Chhem, R.K.

    2002-01-01

    With the development of high-resolution ultrasound transducers, the role of ultrasonography (US) in evaluating the musculoskeletal system has increased. It is now possible to obtain detailed images of bones and soft-tissue structures that were previously unattainable. The advantages of US, when compared with other imaging modalities, are many. It is less expensive than magnetic resonance imaging (MRI) and computed tomography (CT). It does not expose the patient to ionizing radiation, so US examinations can be repeated without harm to the patient. Furthermore, US is performed in real-time, making it possible to assess the musculoskeletal system dynamically, in multiple planes and with contralateral comparison. In experienced hands, US is a quick, noninvasive and cost-effective way to assess the musculoskeletal system in children. It is used to evaluate soft-tissue masses, joint swelling, infections, lesions involving the chest and abdominal walls, bones, muscles and clubfoot deformity and to locate any foreign bodies. (author)

  19. Imaging of musculoskeletal tuberculosis

    International Nuclear Information System (INIS)

    Boussel, L.; Marchand, B.; Blineau, N.; Picaud, G.; Emn, M.; Coulon, A.; Pagnon, P.; Rode, A.; Pin-Leveugle, J.; Berthezene, Y.; Pariset, C.; Boibieux, A.; Hermier, M.

    2002-01-01

    Purpose and methods. To perform an illustrated and educational review of musculoskeletal tuberculosis. Results. As the incidence of musculoskeletal tuberculosis still increases, a review appears justified. The following four main presentations are detailed and illustrated, by emphasizing the value of both CT and MR imaging: a) spine tuberculosis (∼ 50 %/) commonly involves two adjacent vertebral bodies with usual large paravertebral abscesses. The following lesions are highly suggestive of tuberculosis: solitary vertebral involvement, solitary epidural abscess with or without erosive spondylitis; b) osteo-arthritis: peripherally located erosions at synovial insertions with gradual narrowing of the joint space are highly suggestive; c) osteomyelitis: unusual, may involve any bones; d) tenosynovitis and bursitis. Conclusion. Imaging studies are essential for diagnosis and to assess the extent of musculo-skeletal tuberculosis. (author)

  20. Creative compensation

    Energy Technology Data Exchange (ETDEWEB)

    Coll, D

    1994-09-19

    A discussion is presented of executive compensation in Canada's petroleum industry. Mandatory disclosure of executive compensation and benefits is regulated by the Ontario Securities Commission. Examination of the compensation packages of 80 oilpatch CEOs shows a clear difference in philosophy between large and small companies. Larger companies pay larger salaries, offer pension plans, and reward long-term loyalty. Within smaller companies, compensation tends to be linked with stock performance. Trends in compensation are to lower base salaries with more variables such as bonuses, cash incentives and gain-sharing programs. Increasing shareholder scrutiny is prompting more stringent guidelines on stock option plans. Some companies place performance conditions on stock vesting. Another option is to grant premium priced options to executives, to increase the gains required for the executive to post a profit. Other comapanies are granting stock options to their field personnel, or are granting stock to all employees. Directors are playing an increasing role in executive compensation. 4 tabs.

  1. Physical Performance Characteristics of Military Aircraft Maintenance Personnel Resistant to Work-Related Musculoskeletal Disorders of the Hand and Wrist

    National Research Council Canada - National Science Library

    Pekarek, Deanna S

    2006-01-01

    Work related musculoskeletal disorders (WMSD), the largest portion of reported and compensated work-related diseases, represent at least one-third of all reported occupational diseases in the United States, Nordic countries, and Japan...

  2. Using a profile of a modified Brief ICF Core Set for chronic widespread musculoskeletal pain with qualifiers for baseline assessment in interdisciplinary pain rehabilitation

    Directory of Open Access Journals (Sweden)

    Löfgren M

    2013-08-01

    Full Text Available Monika Löfgren,1,2 Jan Ekholm,2 Lisbet Broman,3 Philipe Njoo,1 Marie-Louise Schult1–3 1Department of Rehabilitation Medicine Stockholm, Danderyd University Hospital, Sweden; 2Karolinska Institutet, Division of Rehabilitation Medicine, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden; 3Karolinska Institutet, Department of Neurobiology, Care Sciences and Society, Stockholm, Sweden Aim: To describe the use of a “workable” visual profile of function and disability, based on a modified Brief International Classification of Functioning, Disability and Health (ICF Core Set for chronic widespread pain, for initial assessments in a clinical setting of interdisciplinary pain rehabilitation teams. Method: The Brief ICF Core Set was slightly adapted to meet the needs of an interdisciplinary rehabilitation medicine team working in a university outpatient clinic and admitting patients referred from primary care. The Core Set categories were made measurable by means of eg, assessment instruments and clinical investigations. The resulting profile was given a workable shape to facilitate rapid understanding of the initial assessment outcome. Results: Individual patients showed different profiles of problems and resources, which facilitated individual rehabilitation planning. At the level of the study group, the profiles for the Core Set component Body Functions showed that most patients had severe impairment in the sensation of pain and exercise tolerance categories of function, but most had resources in the motivation and memory categories of function. Likewise, for the component Activities, most patients had limitations in lifting and carrying objects and remunerative employment, but most had resources in intimate relationships and family relationships. At first, the use of the modified Brief ICF Core Set in the team conference was rather time consuming, but after a couple of months of experience, the team assessment took

  3. Neurocognitive performance and physical function do not change with physical-cognitive-mindfulness training in female laboratory technicians with chronic musculoskeletal pain

    DEFF Research Database (Denmark)

    Jay, Kenneth; Brandt, Mikkel; Schraefel, Mc

    2016-01-01

    in terms of shoulder external rotation strength and rate of force development in a custom-made dynamometer setup. RESULTS: No between-group differences (least square means [95% confidence interval]) from baseline to follow-up could be detected in any of the neurocognitive domains as measured by the central......BACKGROUND: Cognitive and physical performance can be negatively affected by chronic pain. This study evaluates the effect of combined physical-, cognitive-, and mindfulness training (PCMT) on cognitive and physical performance. METHODS: From a large pharmaceutical company in Denmark we randomly.......63 (-4.8 to 3.6), or rate of force development 14.8 (-12.6 to 42.2) of the shoulder external rotators. Finally, test-retest reliability of maximal voluntary contraction and rate of force development shoulder external rotation showed high reliability at 0 to 30 ms, 0 to 50 ms, 0 to 100 ms, and 0 to 200 ms...

  4. Musculoskeletal management of a patient with a history of chronic ankle sprains: identifying rupture of peroneal brevis and peroneal longus with diagnostic ultrasonography.

    Science.gov (United States)

    Bruin, Dick B; von Piekartz, Harry

    2014-09-01

    The purpose of this case report is to describe the use of mobilization and eccentric exercise training for a patient with ankle pain and a history of chronic ankle sprains and discuss the course of diagnostic decision making when the patient did not respond to care. A 48-year-old police officer who had sustained multiple ankle sprains throughout his life presented with pain and restriction in his ability to walk, run, and work. The Global Rating of Change Scale score was - 6, the Numeric Pain Rating Scale score was 7/10, and the Lower Extremity Functional Scale score was - 33. Palpation of the peroneus longus and brevis muscles and inversion with overpressure reproduced the chief concern (Numeric Pain Rating Scale 7/10). The patient was initially diagnosed with chronic peroneal tendinopathy. Treatment included lateral translation mobilization of the talocrural joint combined with eccentric exercise using an elastic band for the peroneal muscles. The patient reported improvement in pain and function during the course of intervention but not as rapidly as expected. Therefore, follow-up ultrasonographic imaging and radiography were performed. These studies revealed partial rupture of the peroneal brevis muscle and total rupture of the peroneal longus muscle. A patient with long-term concerns of the foot complex with a diagnosis of peroneal tendinopathy showed slight improvement with eccentric exercises combined with manual therapy of the talocrural joint. After a course of treatment but minimal response, a diagnosis of tendon rupture was confirmed with diagnostic ultrasonography. Clinicians should be aware that when injuries do not improve with care, tendon rupture should be considered.

  5. Surgeons' musculoskeletal pain in minimally invasive surgery

    DEFF Research Database (Denmark)

    Dalager, Tina; Søgaard, Karen; Bech (Katrine Tholstrup Pedersen), Katrine Tholstrup

    in surgeons performing MIS is high and derives mainly from static postures. Positioning of monitor, adjustment of table height and instrument design also contribute substantially. Robotic assisted laparoscopy seems less physically demanding for the surgeon compared with conventional laparoscopy. However, some...... put the patients at a higher risk of complications, and on the longer term there is an increasing risk for the surgeon to develop chronic musculoskeletal pain that will disable him/her to perform his/her job. Therefore, surgeons’ musculoskeletal health is of vital importance and must be considered...... alongside patient safety. The present literature study supports the need for a randomized controlled trial evaluating the effect of an individually designed training program for surgeons performing MIS....

  6. The impact of headache and chronic musculoskeletal complaints on the risk of insomnia: longitudinal data from the Nord-Trøndelag health study

    Science.gov (United States)

    2013-01-01

    Background A strong relationship between insomnia and painful disorders has been found, but it is still unclear whether chronic pain leads to insomnia. There is a need of large-scale prospective studies to evaluate if there is a causal relationship between painful disorders and insomnia. Methods All inhabitants aged ≥ 20 years in Nord-Trøndelag County of Norway were invited to participate in two surveys (n = 92,566 and 93,860, respectively). 27,185 subjects participated in both surveys, and 19,271 of these were insomnia-free at baseline (population at risk). Using logistic regression, we evaluated the influence of headache, CMSCs and coexisting headache and CMSCs on the subsequent risk of insomnia. Results Compared to subjects without headache and CMSCs, there was an increased risk of insomnia among those with headache, most pronounced among those with headache ≥ 7 days / month (OR = 2.2, 95% CI = 1.9 – 2.6). Similarly, an increased risk among those with CMSCs was found, most evident for those with widespread CMSCs (OR = 2.0, 95% CI = 1.8 – 2.2). Having coexistent CMSCs and headache (OR = 2.0, 95% CI = 1.8 – 2.2) predisposed more strongly to insomnia than having headache (OR = 1.5, 95% CI = 1.3 – 1.6) and CMSCs (OR = 1.6, 95% CI = 1.4 – 1.7) alone. Conclusion In this prospective study headache and CMSCs were risk factors for insomnia 11 years later. PMID:23566158

  7. Learning musculoskeletal imaging

    Energy Technology Data Exchange (ETDEWEB)

    Vilanova, Joan C. (eds.) [Girona Univ. (Spain). Clinica Girona; Ribes, Ramon

    2010-07-01

    This introduction to musculoskeletal imaging is a further volume in the Learning Imaging series. Written in a user-friendly format, it takes into account that musculoskeletal radiology is a subspecialty which has widely expanded its scope and imaging capabilities with the advent of ultrasound, MRI, multidetector CT, and PET. The book is divided into ten sections covering: infection and arthritis, tumors, tendons and muscles, bone marrow, spine, shoulder, elbow, hand and wrist, hip and pelvis, knee, and ankle and foot. Each chapter is presented with an introduction and ten case studies with illustrations and comments from anatomical, physiopathological and radiological standpoints along with bibliographic recommendations. Learning Imaging is a unique case-based series for those in professional education in general and for physicians in particular. (orig.)

  8. Learning musculoskeletal imaging

    International Nuclear Information System (INIS)

    Vilanova, Joan C.; Ribes, Ramon

    2010-01-01

    This introduction to musculoskeletal imaging is a further volume in the Learning Imaging series. Written in a user-friendly format, it takes into account that musculoskeletal radiology is a subspecialty which has widely expanded its scope and imaging capabilities with the advent of ultrasound, MRI, multidetector CT, and PET. The book is divided into ten sections covering: infection and arthritis, tumors, tendons and muscles, bone marrow, spine, shoulder, elbow, hand and wrist, hip and pelvis, knee, and ankle and foot. Each chapter is presented with an introduction and ten case studies with illustrations and comments from anatomical, physiopathological and radiological standpoints along with bibliographic recommendations. Learning Imaging is a unique case-based series for those in professional education in general and for physicians in particular. (orig.)

  9. Musculoskeletal pain in patients with myotonic dystrophy type 2.

    Science.gov (United States)

    George, Annette; Schneider-Gold, Christiane; Zier, Sandra; Reiners, Karlheinz; Sommer, Claudia

    2004-12-01

    Myotonic dystrophy type 2/proximal myotonic myopathy (DM2/PROMM) is an autosomal dominant multisystem disorder. Musculoskeletal pain is one of its frequent symptoms but also occurs in other chronic noninflammatory muscle disorders (OMD). To characterize the phenotype of DM2/PROMM-associated musculoskeletal pain and to test whether it shows features distinct from OMD. Outpatient clinic for patients with neuromuscular disorders, university hospital. Twenty-four patients with DM2/PROMM (12 women and 12 men; median age, 57 years) and 24 age- and sex-matched patients with OMD consecutively recruited during a 3-year period were examined for musculoskeletal pain. Standardized pain assessment; McGill Pain Questionnaire; depression score; and quantification of pain thresholds to blunt pressure on limb muscles with analgometer. Unlike patients with OMD who have musculoskeletal pain, patients with DM2/PROMM distinguished a wide spectrum of coexisting pain types. The major pain type in patients with DM2/PROMM was exercise-related, temperature-modulated, and palpation-induced, whereas, cramps were rare. In 8 of the patients with DM2/PROMM and in 3 of the patients with OMD, musculoskeletal pain was the most disabling symptom. Besides many similarities, DM2/PROMM-associated musculoskeletal pain shows features distinct from OMD.

  10. Development and validation of an index of musculoskeletal functional limitations

    Directory of Open Access Journals (Sweden)

    Katz Jeffrey N

    2009-06-01

    Full Text Available Abstract Background While musculoskeletal problems are leading sources of disability, there has been little research on measuring the number of functionally limiting musculoskeletal problems for use as predictor of outcome in studies of chronic disease. This paper reports on the development and preliminary validation of a self administered musculoskeletal functional limitations index. Methods We developed a summary musculoskeletal functional limitations index based upon a six-item self administered questionnaire in which subjects indicate whether they are limited a lot, a little or not at all because of problems in six anatomic regions (knees, hips, ankles and feet, back, neck, upper extremities. Responses are summed into an index score. The index was completed by a sample of total knee replacement recipients from four US states. Our analyses examined convergent validity at the item and at the index level as well as discriminant validity and the independence of the index from other correlates of quality of life. Results 782 subjects completed all items of the musculoskeletal functional limitations index and were included in the analyses. The mean age of the sample was 75 years and 64% were female. The index demonstrated anticipated associations with self-reported quality of life, activities of daily living, WOMAC functional status score, use of walking support, frequency of usual exercise, frequency of falls and dependence upon another person for assistance with chores. The index was strongly and independently associated with self-reported overall health. Conclusion The self-reported musculoskeletal functional limitations index appears to be a valid measure of musculoskeletal functional limitations, in the aspects of validity assessed in this study. It is useful for outcome studies following TKR and shows promise as a covariate in studies of chronic disease outcomes.

  11. Compensation of Disadvantages in University Examination Procedures

    Directory of Open Access Journals (Sweden)

    Ulrike Quapp

    2016-08-01

    Full Text Available Active social participation of disabled people is one of the major tasks of modern society. That also includes access to the academic community by higher education. Universities all over the world work hard to give handicapped students a chance to graduate. In this context, compensation of disadvantages in examination procedures is an important matter. But, also chronic illness may impair the student's examination performance. To ensure equal examination opportunities for all students, responsible university officials must be creative to find individual compensation solutions. The paper analyzes examination regulations at universities in different countries and offers solutions to compensate disabled and chronic ill students' disadvantages. It discusses the necessity of compensation for different types of disability and chronic illness. Finally, an overview of current German case law and solutions for compensation problems are provided.

  12. Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain: Variability and Influence of Sex and Catastrophizing.

    Science.gov (United States)

    Boonstra, Anne M; Stewart, Roy E; Köke, Albère J A; Oosterwijk, René F A; Swaan, Jeannette L; Schreurs, Karlein M G; Schiphorst Preuper, Henrica R

    2016-01-01

    Objectives: The 0-10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the variability of the optimal cut-off points, and to determine the influence of patients' catastrophizing and their sex on these cut-off points. Methods: 2854 patients were included. Pain was assessed by the NRS, functioning by the Pain Disability Index (PDI) and catastrophizing by the Pain Catastrophizing Scale (PCS). Cut-off point schemes were tested using ANOVAs with and without using the PSC scores or sex as co-variates and with the interaction between CP scheme and PCS score and sex, respectively. The variability of the optimal cut-off point schemes was quantified using bootstrapping procedure. Results and conclusion: The study showed that NRS scores ≤ 5 correspond to mild, scores of 6-7 to moderate and scores ≥8 to severe pain in terms of pain-related interference with functioning. Bootstrapping analysis identified this optimal NRS cut-off point scheme in 90% of the bootstrapping samples. The interpretation of the NRS is independent of sex, but seems to depend on catastrophizing. In patients with high catastrophizing tendency, the optimal cut-off point scheme equals that for the total study sample, but in patients with a low catastrophizing tendency, NRS scores ≤ 3 correspond to mild, scores of 4-6 to moderate and scores ≥7 to severe pain in terms of interference with functioning. In these optimal cut-off schemes, NRS scores of 4 and 5 correspond to moderate interference with functioning for patients with low catastrophizing tendency and to mild interference for patients with high catastrophizing tendency. Theoretically one would therefore expect that among the patients with NRS scores 4 and 5 there would be a higher average PDI score for those with low

  13. Engineering Musculoskeletal Tissue Interfaces

    Directory of Open Access Journals (Sweden)

    Ece Bayrak

    2018-04-01

    Full Text Available Tissue engineering aims to bring together biomaterials, cells, and signaling molecules within properly designed microenvironments in order to create viable treatment options for the lost or malfunctioning tissues. Design and production of scaffolds and cell-laden grafts that mimic the complex structural and functional features of tissues are among the most important elements of tissue engineering strategy. Although all tissues have their own complex structure, an even more complex case in terms of engineering a proper carrier material is encountered at the tissue interfaces, where two distinct tissues come together. The interfaces in the body can be examined in four categories; cartilage-bone and ligament-bone interfaces at the knee and the spine, tendon-bone interfaces at the shoulder and the feet, and muscle-tendon interface at the skeletal system. These interfaces are seen mainly at the soft-to-hard tissue transitions and they are especially susceptible to injury and tear due to the biomechanical inconsistency between these tissues where high strain fields are present. Therefore, engineering the musculoskeletal tissue interfaces remain a challenge. This review focuses on recent advancements in strategies for musculoskeletal interface engineering using different biomaterial-based platforms and surface modification techniques.

  14. Improving musculoskeletal health: global issues.

    Science.gov (United States)

    Mody, Girish M; Brooks, Peter M

    2012-04-01

    Musculoskeletal (MSK) disorders are among the leading reasons why patients consult a family or primary health practitioner, take time off work and become disabled. Many of the MSK disorders are more common in the elderly. Thus, as the proportion of the elderly increases all over the world, MSK disorders will make a greater contribution to the global burden of disease. Epidemiological studies have shown that the spectrum of MSK disorders in developing countries is similar to that seen in industrialised countries, but the burden of disease tends to be higher due to a delay in diagnosis or lack of access to adequate health-care facilities for effective treatment. Musculoskeletal pain is very common in the community while fibromyalgia is being recognised as part of a continuum of chronic widespread pain rather than a narrowly defined entity. This will allow research to improve our understanding of pain in a variety of diffuse pain syndromes. The availability of newer more effective therapies has resulted in efforts to initiate therapy at an earlier stage of diseases. The new criteria for rheumatoid arthritis, and the diagnosis of axial and peripheral involvement in spondyloarthritis, permit an earlier diagnosis without having to wait for radiological changes. One of the major health challenges is the global shortage of health workers, and based on current training of health workers and traditional models of care for service delivery, the global situation is unlikely to change in the near future. Thus, new models of care and strategies to train community health-care workers and primary health-care practitioners to detect and initiate the management of patients with MSK disorders at an earlier stage are required. There is also a need for prevention strategies with campaigns to educate and raise awareness among the entire population. Lifestyle interventions such as maintaining an ideal body weight to prevent obesity, regular exercises, avoidance of smoking and alcohol

  15. Prevention of the Musculoskeletal Complications of Hemophilia

    Directory of Open Access Journals (Sweden)

    E. C. Rodriguez-Merchan

    2012-01-01

    Full Text Available Hemophilia is an inherited disorder of clotting factor deficiencies resulting in musculoskeletal bleeding, including hemarthroses, leading to musculoskeletal complications. The articular problems of hemophiliac patients begin in infancy. These include: recurrent hemarthroses, chronic synovitis, flexion deformities, hypertrophy of the growth epiphyses, damage to the articular cartilage, and hemophilic arthropathy. The most commonly affected joints are the ankle, the knee, and the elbow. Hematologic prophylactic treatment from ages 2 to 18 years could avoid the development of hemophilic arthropathy if the concentration of the patient's deficient factor is prevented from falling below 1% of normal. Hemarthroses can be prevented by the administration of clotting factor concentrates (prophylaxis. However, high costs and the need for venous access devices in younger children continue to complicate recommendations for universal prophylaxis. Prevention of joint arthropathy needs to focus on prevention of hemarthroses through prophylaxis, identifying early joint disease through the optimal use of cost-effective imaging modalities and the validation of serological markers of joint arthropathy. Screening for effects on bone health and optimal management of pain to improve quality of life are, likewise, important issues. Major hemarthrosis and chronic hemophilic synovitis should be treated aggressively to prevent hemophilic arthropathy.

  16. Epidemiology of musculoskeletal injury in the California film and motion picture industry

    Science.gov (United States)

    Kusnezov, Nicholas A.; Yazdanshenas, Hamed; Garcia, Eddie

    2016-01-01

    Introduction Musculoskeletal injury exerts a significant burden on US industry. The purpose of this study was to investigate the frequency and characteristics of musculoskeletal injuries in the California (CA) film and motion picture (FMP) industry which may result in unforeseen morbidity and mortality. Methods We reviewed the workers’ compensation (WC) claims database of the Workers’ Compensation Insurance Rating Bureau of California (WCIRB) and employment statistics through the US Bureau of Labor Statistics (BLS). We analyzed the frequency, type, body part affected, and cause of musculoskeletal injuries. Results From 2003 to 2009, there were 3505 WC claims of which 94.4% were musculoskeletal. In the CA FMP industry, the most common injuries were strains (38.4%), sprains (12.2%), and fractures (11.7%). The most common sites of isolated injury were the knee (18.9%), lower back (15.0%), and ankle (8.6%). Isolated musculoskeletal spine injuries represented 19.3% of all injuries. The most common causes of injury were work-directed activity (36.0%) and falls (25.5%). Conclusion We present the first report on the unique profile of musculoskeletal injury claims in the FMP industry. This data provides direction for improvement of workplace safety. PMID:26812757

  17. Epidemiology of musculoskeletal injury in the California film and motion picture industry.

    Science.gov (United States)

    Kusnezov, Nicholas A; Yazdanshenas, Hamed; Garcia, Eddie; Shamie, Arya N

    2016-06-01

    Musculoskeletal injury exerts a significant burden on US industry. The purpose of this study was to investigate the frequency and characteristics of musculoskeletal injuries in the California (CA) film and motion picture (FMP) industry which may result in unforeseen morbidity and mortality. We reviewed the workers' compensation (WC) claims database of the Workers' Compensation Insurance Rating Bureau of California (WCIRB) and employment statistics through the US Bureau of Labor Statistics (BLS). We analyzed the frequency, type, body part affected, and cause of musculoskeletal injuries. From 2003 to 2009, there were 3505 WC claims of which 94.4% were musculoskeletal. In the CA FMP industry, the most common injuries were strains (38.4%), sprains (12.2%), and fractures (11.7%). The most common sites of isolated injury were the knee (18.9%), lower back (15.0%), and ankle (8.6%). Isolated musculoskeletal spine injuries represented 19.3% of all injuries. The most common causes of injury were work-directed activity (36.0%) and falls (25.5%). We present the first report on the unique profile of musculoskeletal injury claims in the FMP industry. This data provides direction for improvement of workplace safety.

  18. Computed tomography of the musculoskeletal system

    International Nuclear Information System (INIS)

    Scott, W.W.; Magid, D.; Fishman, E.K.

    1987-01-01

    This book contain 10 chapters. The chapter titles are: Soft Tissue Masses; Primary Bone Tumors; The Role of CT in the Therapeutic Management of Soft Tissue Sarcomas; Assessment of Musculoskeletal Inflammation; Assessment of Musculoskeletal Trauma; The Foot and Ankle; The Shoulder; Measurement of Bone Mineral for Early Detection of Osteoporosis; MRI of the Musculoskeletal System; and Advances in CT Imaging of Musculoskeletal Pathology

  19. Can high social capital at the workplace buffer against stress and musculoskeletal pain?

    DEFF Research Database (Denmark)

    Jay, Kenneth; Andersen, Lars L.

    2018-01-01

    Work-related musculoskeletal pain and stress are both highly prevalent in the working environment and relate well to the biopsychosocial model. While the onset of musculoskeletal pain is often dependent on the biological element of the biopsychosocial model, chronic pain is often influenced...... by psychological and social factors. Similarly, stress is also influenced by biological, psychological, and social factors. This study investigates the possibility of social capital being a buffer for stress and musculoskeletal pain in a group of female laboratory technicians.Female laboratory technicians (n = 500......) replied to questions about stress (Cohens Perceived Stress Scale-10), musculoskeletal pain (0-10 visual analog scale), and social capital at the workplace (bonding [in teams], bridging [between teams], and linking [between teams and leaders]). Outcome variables were stress and musculoskeletal pain...

  20. Musculoskeletal dysfunction in dental practice

    Directory of Open Access Journals (Sweden)

    Hakim A. Larbi and Dmitry Ye. Suyetenkov

    2012-06-01

    Full Text Available This article highlights the comparative statistics of musculoskeletal system deseases depending on a type of dental method. The practical recommendations on prevention of diseases of joints, ligaments and spine were done.

  1. The Belfast musculoskeletal ultrasound course.

    LENUS (Irish Health Repository)

    Taggart, Allister J

    2009-09-01

    To conduct a training course in musculoskeletal ultrasound (MSUS) for rheumatologists in Northern Ireland with the aim of equipping the participants with a basic knowledge of the theoretical and practical aspects of MSUS as they are applied to rheumatology.

  2. Musculoskeletal MRI: dedicated systems

    International Nuclear Information System (INIS)

    Masciocchi, C.; Barile, A.; Satragno, L.

    2000-01-01

    The ''dedicated'' MRI units have characteristics of high diagnostic accuracy and lower installation and management costs as compared with whole-body systems. The dedicated MRI units are easy to install. The low weight allows their installation also under unfavorable circumstances. In a dedicated system cost-effectiveness and ease of installation must be accompanied by the capability of providing high-quality images. In our experience, the high number of examinations performed, the most part of which provided with the surgical controls, allowed an accurate evaluation of the diagnostic potentialities of the dedicated magnet. We were not able to perform the examinations in only 3 % of cases due to the physical shape of the patient and the clinical condition of the patient which may hinder the correct positioning of the limb. The overlapping of the diagnostic accuracy of the E-scan and Artoscan units in the study of the lower limbs, compared with whole-body units and surgery, prompted us to exploit the potentialities of the E-Scan in the study of the shoulder. We had a good correlation between E-Scan, whole-body units, and surgical findings, which confirmed the high diagnostic accuracy of the dedicated system. In conclusion, in our experience carried out in the musculoskeletal system, the dedicated magnets showed promising results. Their diagnostic reliability and utility was comparable to that obtained from conventional units operating at higher magnetic fields. (orig.)

  3. Chronic pelvic pain.

    Science.gov (United States)

    Stein, Sharon L

    2013-12-01

    Chronic pelvic pain is pain lasting longer than 6 months and is estimated to occur in 15% of women. Causes of pelvic pain include disorders of gynecologic, urologic, gastroenterologic, and musculoskeletal systems. The multidisciplinary nature of chronic pelvic pain may complicate diagnosis and treatment. Treatments vary by cause but may include medicinal, neuroablative, and surgical treatments. Copyright © 2013 Elsevier Inc. All rights reserved.

  4. Factors that affect functional capacity in patients with musculoskeletal pain : a Delphi study among scientists, clinicians, and patients

    NARCIS (Netherlands)

    Jorna-Lakke, Sandra; Wittink, Harriët; Geertzen, Jan H; van der Schans, Cees; Reneman, Michiel F

    OBJECTIVE: To reach consensus on the most important biopsychosocial factors that influence functional capacity results in patients with chronic nonspecific musculoskeletal pain, arranged in the framework of the International Classification of Functioning, Disability and Health. DESIGN: Three-round,

  5. Compensative-rehabilitative responses of blood-forming tissue cells after chronic irradiation.; Kompensatorno-vosstanovitel`nye reaktsii kletok krovetvornoj tkani pri khronicheskom obluchenii.

    Energy Technology Data Exchange (ETDEWEB)

    Nosova, L I; Ryasenko, V I [Yinstitut Zoologyiyi, Natsyional` na Akademyiya Nauk Ukrayini, Kyiv (Ukraine); [Nauchno-Proizvodstvennoe Ob` ` edinenie Pripyat` , Chernobyl (Ukraine)

    1994-12-31

    The bone marrow eosinophils of minks and wild rats subjected to chronical irradiation are able of secreting a peroxidase system obtained by neutrophils. As a result heterophilic granulocytes appear in the peripheral blood. Intercellular transgranulation, emperiopolesis into megakaryocytes and eosinophils as peroxidase donors for neutrophils are regarded as cellular and subcellular adaptations in the mammalian bone marrow after irradiation.

  6. Extracorporeal shockwave therapy in musculoskeletal disorders.

    Science.gov (United States)

    Wang, Ching-Jen

    2012-03-20

    The sources of shockwave generation include electrohydraulic, electromagnetic and piezoelectric principles. Electrohydraulic shockwaves are high-energy acoustic waves generated under water explosion with high voltage electrode. Shockwave in urology (lithotripsy) is primarily used to disintegrate urolithiasis, whereas shockwave in orthopedics (orthotripsy) is not used to disintegrate tissues, rather to induce tissue repair and regeneration. The application of extracorporeal shockwave therapy (ESWT) in musculoskeletal disorders has been around for more than a decade and is primarily used in the treatment of sports related over-use tendinopathies such as proximal plantar fasciitis of the heel, lateral epicondylitis of the elbow, calcific or non-calcific tendonitis of the shoulder and patellar tendinopathy etc. The success rate ranged from 65% to 91%, and the complications were low and negligible. ESWT is also utilized in the treatment of non-union of long bone fracture, avascular necrosis of femoral head, chronic diabetic and non-diabetic ulcers and ischemic heart disease. The vast majority of the published papers showed positive and beneficial effects. FDA (USA) first approved ESWT for the treatment of proximal plantar fasciitis in 2000 and lateral epicondylitis in 2002. ESWT is a novel non-invasive therapeutic modality without surgery or surgical risks, and the clinical application of ESWT steadily increases over the years. This article reviews the current status of ESWT in musculoskeletal disorders.

  7. Extracorporeal shockwave therapy in musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Wang Ching-Jen

    2012-03-01

    Full Text Available Abstract The sources of shockwave generation include electrohydraulic, electromagnetic and piezoelectric principles. Electrohydraulic shockwaves are high-energy acoustic waves generated under water explosion with high voltage electrode. Shockwave in urology (lithotripsy is primarily used to disintegrate urolithiasis, whereas shockwave in orthopedics (orthotripsy is not used to disintegrate tissues, rather to induce tissue repair and regeneration. The application of extracorporeal shockwave therapy (ESWT in musculoskeletal disorders has been around for more than a decade and is primarily used in the treatment of sports related over-use tendinopathies such as proximal plantar fasciitis of the heel, lateral epicondylitis of the elbow, calcific or non-calcific tendonitis of the shoulder and patellar tendinopathy etc. The success rate ranged from 65% to 91%, and the complications were low and negligible. ESWT is also utilized in the treatment of non-union of long bone fracture, avascular necrosis of femoral head, chronic diabetic and non-diabetic ulcers and ischemic heart disease. The vast majority of the published papers showed positive and beneficial effects. FDA (USA first approved ESWT for the treatment of proximal plantar fasciitis in 2000 and lateral epicondylitis in 2002. ESWT is a novel non-invasive therapeutic modality without surgery or surgical risks, and the clinical application of ESWT steadily increases over the years. This article reviews the current status of ESWT in musculoskeletal disorders.

  8. Reactive power compensating system

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Timothy J. (Redondo Beach, CA); El-Sharkawi, Mohamed A. (Renton, WA); Venkata, Subrahmanyam S. (Seattle, WA)

    1987-01-01

    The reactive power of an induction machine is compensated by providing fixed capacitors on each phase line for the minimum compensation required, sensing the current on one line at the time its voltage crosses zero to determine the actual compensation required for each phase, and selecting switched capacitors on each line to provide the balance of the compensation required.

  9. Yellow flag scores in a compensable New Zealand cohort suffering acute low back pain

    Directory of Open Access Journals (Sweden)

    Karen Grimmer-Somers

    2008-12-01

    Full Text Available Karen Grimmer-Somers1, Mathew Prior1, Jim Robertson21Centre for Allied Health Evidence, University of South Australia, City East Campus, North Tce, Adelaide, South Australia, Australia; 2New Zealand Accident Compensation Corporation, Auckland, New ZealandBackground: Despite its high prevalence, most acute low back pain (ALBP is nonspecific, self-limiting with no definable pathology. Recurrence is prevalent, as is resultant chronicity. Psychosocial factors (yellow flags comprising depression and anxiety, negative pain beliefs, job dissatisfaction are associated with the development of chronic LBP.Methods: A national insurer (Accident Compensation Corporation, New Zealand [NZ], in conjunction with a NZ primary health organization, piloted a strategy for more effective management of patients with ALBP, by following the NZ ALBP Guideline. The guidelines recommend the use of a psychosocial screening instrument (Yellow Flags Screening Instrument, a derivative of Örebro Musculoskeletal Pain Questionnaire. This instrument was recommended for administration on the second visit to a general medical practitioner (GP. This paper tests whether published cut-points of yellow flag scores to predict LBP claims length and costs were valid in this cohort.Results: Data was available for 902 claimants appropriately enrolled into the pilot. 25% claimants consulted the GP once only, and thus were not requested to provide a yellow flag score. Yellow flag scores were provided by 48% claimants who consumed two or more GP services. Approximately 60% LBP presentations resolved within five GP visits. Yellow flag scores were significantly and positively associated with treatment costs and service use, although the association was nonlinear. Claimants with moderate yellow flag scores were similarly likely to incur lengthy claims as claimants with at-risk scores.Discussion: Capturing data on psychosocial factors for compensable patients with ALBP has merit in predicting

  10. Clinical presentation and manual therapy for lower quadrant musculoskeletal conditions.

    Science.gov (United States)

    Courtney, Carol A; Clark, Jeffrey D; Duncombe, Alison M; O'Hearn, Michael A

    2011-11-01

    Chronic lower quadrant injuries constitute a significant percentage of the musculoskeletal cases seen by clinicians. While impairments may vary, pain is often the factor that compels the patient to seek medical attention. Traumatic injury from sport is one cause of progressive chronic joint pain, particularly in the lower quarter. Recent studies have demonstrated the presence of peripheral and central sensitization mechanisms in different lower quadrant pain syndromes, such as lumbar spine related leg pain, osteoarthritis of the knee, and following acute injuries such as lateral ankle sprain and anterior cruciate ligament rupture. Proper management of lower quarter conditions should include assessment of balance and gait as increasing pain and chronicity may lead to altered gait patterns and falls. In addition, quantitative sensory testing may provide insight into pain mechanisms which affect management and prognosis of musculoskeletal conditions. Studies have demonstrated analgesic effects and modulation of spinal excitability with use of manual therapy techniques, with clinical outcomes of improved gait and functional ability. This paper will discuss the evidence which supports the use of manual therapy for lower quarter musculoskeletal dysfunction.

  11. Improved endothelial function and lipid profile compensate for impaired hemostatic and inflammatory status in iatrogenic chronic subclinical hyperthyroidism of thyroid cancer patients on L-t4 therapy.

    Science.gov (United States)

    Gazdag, A; Nagy, E V; Burman, K D; Paragh, G; Jenei, Z

    2010-06-01

    We aimed to compare the changes of endothelial function and haemostatic, inflammatory and metabolic parameters of short-term iatrogenic hypothyroidism to the characteristics of subclinical hyperthyroidism in patients with differentiated thyroid cancer. Twenty four women (mean age 42.4+/-8.1 years) had undergone total thyroidectomy and radioiodine ablation in treatment for differentiated thyroid cancer. We measured serum thyroglobulin, thyroid function, plasma levels of lipid parameters, homocystine, C-reactive protein, fibrinogen, von Willebrandt factor activity (vWF), nitric oxide, as well as flow-mediated vasodilatation (FMD) and nitroglycerin-mediated vasodilatation of the brachial artery during iatrogenic hypothyroidism (TSH 89.82+/-29.36 mU/L) and again in the same patients during subclinical hyperthyroidism secondary to exogenous levothyroxine administration (TSH 0.24+/-0.11 mU/L). In hypothyroidism, FMD was markedly lower than in subclinical hyperthyroidism (6.79+/-4.44 vs. 14.37+/-8.33%, phyperthyroidism was associated with improved endothelial function and lipid profile, while haemostatic and inflammatory parameters were impaired. The two opposite mechanisms may well compensate for each other at the level of the vessel wall. (c) J. A. Barth Verlag in Georg Thieme Verlag KG Stuttgart, New York.

  12. Musculoskeletal Findings in Behcet's Disease

    Directory of Open Access Journals (Sweden)

    Ali Bicer

    2012-01-01

    Full Text Available Behcet's disease is a multisystem disease characterized by recurrent oral and genital ulcers, relapsing uveitis, mucocutaneous, articular, gastrointestinal, neurologic, and vascular manifestations. Rheumatologic manifestations may also occur in Behcet's disease, and arthritis and arthralgia are the most common musculoskeletal findings followed by enthesopathy, avascular necrosis, myalgia, and myositis. Although the main pathology of Behcet's disease has been known to be the underlying vasculitis, the etiology and exact pathogenesis of the disease are still unclear. Musculoskeletal findings of Behcet's disease, the relationship between Behcet's disease and spondyloarthropathy disease complex, and the status of bone metabolism in patients with Behcet's disease were discussed in this paper.

  13. Prenatal sonographic diagnosis of focal musculoskeletal anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jung Kyu; Cho, Jeong Yeon; Lee, Young Ho; Kim, Ei Jeong; Chun, Yi Kyeong [Samsung Cheil Hospital, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2002-09-15

    Focal musculoskeletal anomalies are various and may be an isolated finding or may be found in conjunction with numerous associations, including genetic syndromes, Karyotype abnormals, central nervous system anomalies and other general musculoskeletal disorders. Early prenatal diagnosis of these focal musculoskeletal anomalies nor only affects prenatal care and postnatal outcome but also helps in approaching other numerous associated anomalies.

  14. Prenatal sonographic diagnosis of focal musculoskeletal anomalies

    International Nuclear Information System (INIS)

    Ryu, Jung Kyu; Cho, Jeong Yeon; Lee, Young Ho; Kim, Ei Jeong; Chun, Yi Kyeong

    2002-01-01

    Focal musculoskeletal anomalies are various and may be an isolated finding or may be found in conjunction with numerous associations, including genetic syndromes, Karyotype abnormals, central nervous system anomalies and other general musculoskeletal disorders. Early prenatal diagnosis of these focal musculoskeletal anomalies nor only affects prenatal care and postnatal outcome but also helps in approaching other numerous associated anomalies.

  15. Sleep fragmentation exacerbates mechanical hypersensitivity and alters subsequent sleep-wake behavior in a mouse model of musculoskeletal sensitization.

    Science.gov (United States)

    Sutton, Blair C; Opp, Mark R

    2014-03-01

    Sleep deprivation, or sleep disruption, enhances pain in human subjects. Chronic musculoskeletal pain is prevalent in our society, and constitutes a tremendous public health burden. Although preclinical models of neuropathic and inflammatory pain demonstrate effects on sleep, few studies focus on musculoskeletal pain. We reported elsewhere in this issue of SLEEP that musculoskeletal sensitization alters sleep of mice. In this study we hypothesize that sleep fragmentation during the development of musculoskeletal sensitization will exacerbate subsequent pain responses and alter sleep-wake behavior of mice. This is a preclinical study using C57BL/6J mice to determine the effect on behavioral outcomes of sleep fragmentation combined with musculoskeletal sensitization. Musculoskeletal sensitization, a model of chronic muscle pain, was induced using two unilateral injections of acidified saline (pH 4.0) into the gastrocnemius muscle, spaced 5 days apart. Musculoskeletal sensitization manifests as mechanical hypersensitivity determined by von Frey filament testing at the hindpaws. Sleep fragmentation took place during the consecutive 12-h light periods of the 5 days between intramuscular injections. Electroencephalogram (EEG) and body temperature were recorded from some mice at baseline and for 3 weeks after musculoskeletal sensitization. Mechanical hypersensitivity was determined at preinjection baseline and on days 1, 3, 7, 14, and 21 after sensitization. Two additional experiments were conducted to determine the independent effects of sleep fragmentation or musculoskeletal sensitization on mechanical hypersensitivity. Five days of sleep fragmentation alone did not induce mechanical hypersensitivity, whereas sleep fragmentation combined with musculoskeletal sensitization resulted in prolonged and exacerbated mechanical hypersensitivity. Sleep fragmentation combined with musculoskeletal sensitization had an effect on subsequent sleep of mice as demonstrated by increased

  16. Pain relief after musculoskeletal trauma

    NARCIS (Netherlands)

    Helmerhorst, G.T.T.

    2018-01-01

    This thesis showed that, in spite of seemingly similar nociception (pathophysiology), there are substantial cultural differences in experiencing and managing pain after surgery of musculoskeletal trauma. The United States and Canada are in the midst of a crisis of opioid use, misuse, overdose, and

  17. Musculoskeletal System Symptoms in Goiter

    Directory of Open Access Journals (Sweden)

    Sevim Akin

    2013-04-01

    Full Text Available Aim: The aim of this study was to investigate the prevalence of musculoskeletal manifestations in patients with thyroid dysfunction. Methods: One hundred and twenty-three patients (100 female, 23 male who visited the nuclear medicine department for thyroid gland scintigraphy were included in our study. According to thyroid hormone levels, patients were allocated into five categories: hyperthyroidism, subclinical hyperthyroidism, euthyroid, subclinical hypothyroidism, and hypothyroidism. Before neurological and musculoskeletal examinations, a standardized symptom questionnaire was completed including questions about sensory symptoms, muscle weakness, restricted joint mobility, musculoskeletal pain. Neurological examination, range of motion of joints, effusion or swelling of joints was assessed. Diagnosis of osteoarthritis was done by the clinical and radiological characteristics. The diagnosis of FMS was made according to criteria of American College of Rheumatology. According to the World Health Organization (WHO, a T-score ≤ -2.5 was classified as osteoporosis, whereas a T-score between -2.5 and -1.0 was classified as osteopenia. Thyroid status was determined by serum TSH levels. Results: Eighty-one percent of the patients were female (100 and 19% were male (23. Mean age of female patients was 49.99±15.27 years (range 20-87 and mean age of male patients was 61.8±12.33 years (range 34-88. When divided according to thyroid status, 21.1% (n=26 had hyperthyroidism, 21.1% (n=26 had subclinical hyperthyroidism, 49.6% (n=61 were euthyroid, 4.9% (n=6 had subclinical hypothyroidism and 3.3% (n=4 were hypothyroid. None of 59% of patients had any musculoskeletal diagnosis. Osteoporosis was the most common problem, affecting 23.7% of patients Conclusion: The presence of musculoskeletal symptoms in patients with goiter should be considered and investigated. [Cukurova Med J 2013; 38(2.000: 261-269

  18. Musculoskeletal pain in obese adolescents.

    Science.gov (United States)

    Jannini, Suely Nóbrega; Dória-Filho, Ulysses; Damiani, Durval; Silva, Clovis Artur Almeida

    2011-01-01

    To determine the prevalence of pain, musculoskeletal syndromes, orthopedic disorders and using computers and playing videogames among obese adolescents. This was a cross-sectional study that investigated 100 consecutive obese adolescents and 100 healthy-weight controls using a confidential, self-report questionnaire covering demographic data, sports participation, painful musculoskeletal system symptoms and using computers and playing videogames. The questionnaire's test-retest reliability was tested. Physical examination covered six musculoskeletal syndromes and seven orthopedic disorders. The kappa index for test-retest was 0.724. Pain and musculoskeletal syndromes were equally prevalent in both groups (44 vs. 56%, p = 0.09; 12 vs. 16%, p = 0.541; respectively). Notwithstanding, orthopedic disorders (98 vs. 76%, p = 0.0001), tight quadriceps (89 vs. 44%, p = 0.0001) and genu valgum (87 vs. 24%, p = 0.0001) were significantly more prevalent in obese adolescents than in controls. Median time spent using a computer the day before, on Saturdays and on Sundays were all lower among the obese subjects (30 vs. 60 minutes, p = 0.0001; 1 vs. 60 minutes, p = 0.001; and 0 vs. 30 minutes, p = 0.02; respectively). Obese adolescents were less likely to play handheld videogames (2 vs. 11%, p = 0.003) and there was no difference in the two groups' use of full-sized videogames (p > 0.05). Comparing obese adolescents with pain to those free from pain revealed that pain was more frequent among females (59 vs. 39%, p = 0.048) and was associated with greater median time spent playing on Sundays [0 (0-720) vs. 0 (0-240) minutes, p = 0.028]. Obesity can cause osteoarticular system damage at the start of adolescence, particularly to the lower limbs. Programs developed specifically for obese female adolescents with musculoskeletal pain are needed.

  19. Essays in Executive Compensation

    NARCIS (Netherlands)

    D. Zhang (Dan)

    2012-01-01

    textabstractThis dissertation focuses on how executive compensation is designed and its implications for corporate finance and government regulations. Chapter 2 analyzes several proposals to restrict CEO compensation and calibrates two models of executive compensation that describe how firms would

  20. Ergonomic Chair Explorative Intervention Study: Effect on Chronic ...

    African Journals Online (AJOL)

    Ergonomic Chair Explorative Intervention Study: Effect on Chronic Upper ... they are associated with a complex relationship between individual, work-related and ... in chronic upper quadrant musculoskeletal dysfunction and work productivity ...

  1. Complementary and Alternative Medicine Use by Normal Weight, Overweight, and Obese Patients with Arthritis or Other Musculoskeletal Diseases.

    Science.gov (United States)

    Mbizo, Justice; Okafor, Anthony; Sutton, Melanie A; Burkhart, Erica N; Stone, Leauna M

    2016-03-01

    The Centers for Disease Control and Prevention estimates that 50 million Americans have been diagnosed with arthritis and other musculoskeletal diseases. The purpose of the current study was to (1) estimate the prevalence of overall complementary and alternative medicine (CAM) use and (2) examine the role of body mass index (BMI) on CAM use among normal weight, overweight, and obese persons with chronic lower back pain, chronic neck pain, chronic/rheumatoid arthritis, or musculoskeletal diseases, while controlling for other covariates. Cross-sectional design using secondary data for 9724 adults from the 2007 National Health Interview Survey. Data were weighted and analyzed by using Stata 12 for Windows (Stata Corp., College Station, TX). Descriptive, bivariate, and multivariate logistic regression statistics were computed. The participants were randomly surveyed from U.S. households. CAM use was measured as reported use of any modality within the five National Center for Complementary and Integrative Health domains. CAM use was statistically significantly associated with female sex; race/ethnicity; having chronic neck pain, lower back pain, or chronic/rheumatoid arthritis; having limitations due to chronic disease; and geographic region (p CAM use included age 50-64 years, income categorized as "other/missing," and having musculoskeletal diseases. Stratification by body mass index suggested increased odds of CAM use among normal/underweight persons with chronic neck pain but decreased odds for those with chronic musculoskeletal diseases. For overweight patients, increased odds of CAM use were significant for chronic lower back pain, musculoskeletal diseases, and chronic/rheumatoid arthritis. Musculoskeletal diseases and arthritis represent important public health problems with economic implications for the well-being of individuals and society. Identifying CAM use trends by patient weight can be used to improve strategies to increase awareness and access to CAM

  2. In-111 WBC imaging in musculoskeletal sepsis

    International Nuclear Information System (INIS)

    Thompson, L.; Ouzounian, T.J.; Webber, M.M.; Amstutz, H.C.

    1984-01-01

    This study evaluated the accuracy and utility of the In-111 labeled WBC imaging in a series of patients who were suspected of having musculoskeletal sepsis. The labeling of the WBCs was patterned after a method previously described, in which the WBCs are labeled with In-111 oxine in plasma. The WBCs from 100 ml of blood are separated and incubated with In-111 oxine complex, and then 500 μCi. of the labeled cells were reinjected into the patient. Images of the areas in question were obtained at 24 hrs. In some instances, 48 hour images were also obtained. Images were interpreted using consistent criteria. Forty imaging procedures were done on 39 patients. These included 39 total joint protheses, and 17 other images to evaluate possible osteomyelitis, septic arthritis or deep abscesses. Of these studies, 15 were positive, and 42 negative. The findings were then correlated with operative culture and pathology in 21, aspiration cultures and gram stains in 14, and with clinical findings in the remaining 21. This correlation showed 41 true negatives, 12 true positives, 1 false negative, and 2 false positives. The sensitivity was 92.9% and the specificity was 95.2%l. The false negative occurred in a patient on chronic suppressive antibiotic therapy for an infected total hip replacement. The false positive images occurred in a patient with active rheumatoid arthritis and in a patient imaged one month post operative placement of the prosthesis. These images were very useful in several septic patients who had many possible sites of infection. The authors conclude that In-III imaging is an accurate and useful non-invasive method of evaluating musculoskeletal sepsis

  3. Identifying return-to-work trajectories using sequence analysis in a cohort of workers with work-related musculoskeletal disorders

    NARCIS (Netherlands)

    McLeod, Christopher B.; Reiff, Eline; Maas, Esther; Bultmann, Ute

    2018-01-01

    Objectives This study aimed to identify return-to-work (RTW) trajectories among workers with work-related musculoskeletal disorders (MSD) and examine the associations between different MSD and these RTW trajectories. Methods We used administrative workers' compensation data to identify accepted MSD

  4. Musculoskeletal manifestations of bacterial endocarditis

    Directory of Open Access Journals (Sweden)

    Érika Bevilaqua Rangel

    2000-09-01

    Full Text Available CONTEXT: The incidence of staphylococcal infection has been increasing during the last 20 years. OBJECTIVE: Report a case of staphylococcal endocarditis preceded by musculoskeletal manifestations, which is a rare form of clinical presentation. DESIGN: Case report. CASE REPORT: A 45-year-old-man, without addictions and without known previous cardiopathy, was diagnosed as having definitive acute bacterial endocarditis due to Staphylococcus aureus. Its etiology was community-acquired, arising from a non-apparent primary focus. In addition, the musculoskeletal symptoms preceded the infective endocarditis (IE by about 1 month, which occurred together with other symptoms, e.g. mycotic aneurysms and petechiae. Later, the patient showed perforation of the mitral valve and moderate mitral insufficiency with clinical control.

  5. Incidental findings in musculoskeletal radiology

    International Nuclear Information System (INIS)

    Wuennemann, F.; Rehnitz, C.; Weber, M.A.

    2017-01-01

    Increasing numbers of conventional X-rays, computed tomography and magnetic resonance imaging in the inpatient, outpatient and scientific routine leads to an increasing number of incidental findings. The correct interpretation of these incidental findings with respect to the relevance and the evaluation concerning further work-up is an important task of radiologists. Description of common incidental findings in musculoskeletal imaging and their clinical classification. A PubMed literature search was performed using the following terms: incidental findings, population-based imaging, musculoskeletal imaging, non-ossifying fibroma, enchondroma, osteodystrophia deformans, chondrosarcoma, fibrous dysplasia, simple bone cyst, unicameral bone cyst, solitary bone cyst, aneurysmal bone cyst, vertebral hemangioma, bone island, osteopoikilosis, Tarlov cyst and diffuse idiopathic skeletal hyperostosis (DISH). Incidental findings are observed in up to 40% of imaging procedures. In up to 6% these incidental findings involve the skeletal system. Common incidental findings are discussed and their clinical relevance is explained. (orig.) [de

  6. Radionuclide imaging of musculoskeletal infection

    International Nuclear Information System (INIS)

    Palestr, Christopher J.; North Shore Long Island Jewish Health System, Manhasset and New Hyde Park, NY; Love, Charito

    2007-01-01

    Radionuclide imaging studies are routinely used to evaluate patients suspected of having musculoskeletal infection. Three-phase bone imaging is readily available, relatively inexpensive, and very accurate in the setting of otherwise normal bone. Labeled leukocyte imaging should be used in cases of 'complicating osteomyelitis' such as prosthetic joint infection. This test also is useful in clinically unsuspected diabetic pedal osteomyelitis as well as in the neuropathic joint. It is often necessary, however, to perform complementary bone marrow imaging, to maximize the accuracy of labeled leukocyte imaging. In contrast to other regions in the skeleton, labeled leukocyte imaging is not useful for diagnosing spinal osteomyelitis. At the moment, gallium is the preferred radionuclide procedure for this condition and is a useful adjunct to magnetic resonance imaging. FDG-PET likely will play an important role in the evaluation of musculoskeletal infection, especially spinal osteomyelitis, and may replace gallium imaging for this purpose. (author)

  7. Radionuclide imaging of musculoskeletal infection

    Energy Technology Data Exchange (ETDEWEB)

    Palestr, Christopher J. [Albert Einstein College of Medicine, Bronx, NY (United States); North Shore Long Island Jewish Health System, Manhasset and New Hyde Park, NY (United States). Div. of Nuclear Medicine and Molecular Imaging; E-mail: palestro@lij.edu; Love, Charito [North Shore Long Island Jewish Health System, Manhasset and New Hyde Park, NY (United States). Div. of Nuclear Medicine and Molecular Imaging

    2007-09-15

    Radionuclide imaging studies are routinely used to evaluate patients suspected of having musculoskeletal infection. Three-phase bone imaging is readily available, relatively inexpensive, and very accurate in the setting of otherwise normal bone. Labeled leukocyte imaging should be used in cases of 'complicating osteomyelitis' such as prosthetic joint infection. This test also is useful in clinically unsuspected diabetic pedal osteomyelitis as well as in the neuropathic joint. It is often necessary, however, to perform complementary bone marrow imaging, to maximize the accuracy of labeled leukocyte imaging. In contrast to other regions in the skeleton, labeled leukocyte imaging is not useful for diagnosing spinal osteomyelitis. At the moment, gallium is the preferred radionuclide procedure for this condition and is a useful adjunct to magnetic resonance imaging. FDG-PET likely will play an important role in the evaluation of musculoskeletal infection, especially spinal osteomyelitis, and may replace gallium imaging for this purpose. (author)

  8. Musculoskeletal ultrasound in pediatric rheumatology

    Directory of Open Access Journals (Sweden)

    Özçakar Levent

    2011-09-01

    Full Text Available Abstract Although musculoskeletal ultrasound (MSUS has emerged as an indispensible tool among physicians involved in musculoskeletal medicine in the last two decades, only recently has it become more attractive to pediatric rheumatologists. Thereafter, the use of MSUS in pediatric rheumatology has started to increase. Yet, an ever-growing body of literature shows parity and even superiority of MSUS when compared to physical examination and other imaging modalities. MSUS is suitable for examination of children of all ages and it has certain advantages over other imaging modalities; as it is cheaper, mobile, instantly accessible bedside, easy to combine with clinical assessment (interactivity and non-invasive. It does not require sedation, which facilitates repetitive examinations. Assessment of multiple locations is possible during the same session. Agitation is rarely a problem and small children can be seated in their parents' lap or they can even play while being examined.

  9. Radiology of musculoskeletal stress injuries

    International Nuclear Information System (INIS)

    Keats, T.E.

    1989-01-01

    With the new emphasis on physical fitness, musculoskeletal stress injuries are being seen with greater frequency in children and adults, and in locations that are not widely associated with stress injury. Some of the injuries continue to be mistaken for signs of more serious illnesses, such as infection and neoplasm, and this may lead to unnecessary investigative effort. This book covers both the classic stress injuries and the new manifestations

  10. Imaging in percutaneous musculoskeletal interventions

    International Nuclear Information System (INIS)

    Gangi, Afshin; Guth, Stephane; Guermazi, Ali

    2009-01-01

    This is one of the first books to deal specifically with imaging in percutaneous musculoskeletal interventions. The use of different imaging modalities during these procedures is well described. In the first chapter, the basic procedures and different guidance techniques are presented and discussed. The ensuing chapters describe in exhaustive detail the abilities and uses of imaging in guiding procedures ranging from biopsy and joint injection to management of pain and tumors. These procedures are extensively documented in adults as well as in the pediatric population. The third part of the book describes the different indications for vascular interventions in musculoskeletal lesions. The final chapter focuses on ultrasound-guided interventions, as they are more common and tend to be fashionable. The book is well illustrated with carefully chosen and technically excellent images. Each of the 18 chapters is written by an expert of international repute, making this book the most current and complete treatment of the subject available. It should be of great interest to interventional radiologists and also musculoskeletal and general radiologists. (orig.)

  11. Musculoskeletal diseases in forestry workers

    Directory of Open Access Journals (Sweden)

    Vuković Slađana

    2004-01-01

    Full Text Available The most common hazards in the forestry that may induce disorders of the musculoskeletal system are vibrations, unfavorable microclimatic conditions, noise, over-time working hours, work load and long-term repeated movements. The objective of this study was to analyze the prevalence of musculoskeletal diseases and its difference among workers engaged in various jobs in the forestry. Two groups of workers were selected: woodcutters operating with chain-saw (N=33 and other loggers (N=32. Selected workers were of the similar age and had similar total length of employment as well as the length of service in the forestry. Both groups of workers employed in the forestry had the high prevalence of musculoskeletal diseases (woodcutters 69.7% and other loggers 62.5%, respectively. Degenerative diseases of spinal column were very frequent, in dependently of the type of activity in the forestry. Non-significantly higher risk of carpal tunnel syndrome was found in woodcutters with chain-saw compared to workers having other jobs in the forestry (OR=3.09; 95%CI=0.64-19.72. The lateral epicondylitis was found only in woodcutters operating with chain-saw with the prevalence of 18.2%.

  12. Musculoskeletal manifestations in type 2 diabetes mellitus

    OpenAIRE

    Deepti P. Deshmukh; Asmita G. Akarte

    2017-01-01

    Background: Musculoskeletal complications of diabetes have been generally ignored and poorly treated as compared to other complications. Hence we carried out this study to find the prevalence of musculoskeletal manifestations in type II diabetes mellitus and its correlation with age, BMI, duration of diabetes, and control of diabetes. Methods: 100 consecutive patients of type II diabetes were studied. Duration of diabetes, control of diabetes, and any musculoskeletal complaints were noted....

  13. Developing fair compensation structures

    International Nuclear Information System (INIS)

    Trousdale, W.J.

    1998-01-01

    The issue of finding an effective way to incorporate Aboriginal values into the process of developing fair compensation structures was discussed. This paper discusses pricing intangible values using dollars, but it was emphasized that 'values' are whatever are important to us. Therefore, in order to achieve fair compensation, creative alternatives that are value-focused should be pursued. In addition to the more straight-forward monetary compensation, compensation could also be about avoiding losses, mitigating adverse impacts, achieving better communication, and promoting cultural understanding. 25 refs., 2 tabs

  14. Imaging of systemic lupus erythematosus. Part II: Gastrointestinal, renal, and musculoskeletal manifestations

    International Nuclear Information System (INIS)

    Goh, Y.P.; Naidoo, P.; Ngian, G.-S.

    2013-01-01

    Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease that has a relapsing and remitting course. It has a wide range of presentations with various organ manifestations. In this review, we have compiled the radiological findings of gastrointestinal, renal, and musculoskeletal manifestations of SLE.

  15. Pain assessment strategies in patients with musculoskeletal conditions

    Directory of Open Access Journals (Sweden)

    M. Carotti

    2012-09-01

    Full Text Available Valid and reliable assessment of pain is fundamental for both clinical trials and effective pain management. The nature of pain makes objective measurement impossible. Chronic musculoskeletal pain assessment and its impact on physical, emotional and social functions require multidimensional qualitative tools and healthrelated quality of life instruments. The recommendations concerning outcome measurements for pain trials are useful for making routine assessments that should include an evaluation of pain, fatigue, disturbed sleep, physical functioning, emotional functioning, patient global ratings of satisfaction, and quality of life. Despite the growing availability of instruments and theoretical publications related to measuring the various aspects of chronic pain, there is still little agreement and no unified approach has been devised. There is, therefore, still a considerable need for the development of a core set of measurement tools and response criteria, as well as for the development and refinement of the related instruments, standardized assessor training, the cross-cultural adaptation of health status questionnaires, electronic data capture, and the introduction of valid, reliable and responsive standardized quantitative measurement procedures into routine clinical care. This article reviews a selection of the instruments used to assess chronic musculoskeletal pain, including validated newly developed and well-established screening instruments, and discusses their advantages and limitations.

  16. Motor control and the management of musculoskeletal dysfunction.

    Science.gov (United States)

    van Vliet, Paulette M; Heneghan, Nicola R

    2006-08-01

    This paper aims to develop understanding of three important motor control issues--feedforward mechanisms, cortical plasticity and task-specificity and assess the implications for musculoskeletal practice. A model of control for the reach-to-grasp movement illustrates how the central nervous system integrates sensorimotor processes to control complex movements. Feedforward mechanisms, an essential element of motor control, are altered in neurologically intact patients with chronic neck pain and low back pain. In healthy subjects, cortical mapping studies using transcranial magnetic stimulation have demonstrated that neural pathways adapt according to what and how much is practised. Neuroplasticity has also been demonstrated in a number of musculoskeletal conditions, where cortical maps are altered compared to normal. Behavioural and neurophysiological studies indicate that environmental and task constraints such as the goal of the task and an object's shape and size, are determinants of the motor schema for reaching and other movements. Consideration of motor control issues as well as signs and symptoms, may facilitate management of musculoskeletal conditions and improve outcome. Practice of entire everyday tasks at an early stage and systematic variation of the task is recommended. Training should be directed with the aim of re-educating feedforward mechanisms where necessary and the amount of practice should be sufficient to cause changes in cortical activity.

  17. Shared genetic factors underlie chronic pain syndromes

    NARCIS (Netherlands)

    Vehof, Jelle; Zavos, Helena M. S.; Lachance, Genevieve; Hammond, Christopher J.; Williams, Frances M. K.

    Chronic pain syndromes (CPS) are highly prevalent in the general population, and increasingly the evidence points to a common etiological pathway. Using a large cohort of twins (n = 8564) characterized for chronic widespread musculoskeletal pain (CWP), chronic pelvic pain (PP), migraine (MIG), dry

  18. Musculoskeletal Pain in Gynecologic Surgeons

    Science.gov (United States)

    Adams, Sonia R.; Hacker, Michele R.; McKinney, Jessica L.; Elkadry, Eman A.; Rosenblatt, Peter L.

    2013-01-01

    Objective To describe the prevalence of musculoskeletal pain and symptoms in gynecologic surgeons. Design Prospective cross-sectional survey study (Canadian Task Force classification II-2). Setting Virtual. All study participants were contacted and participated via electronic means. Participants Gynecologic surgeons. Interventions An anonymous, web-based survey was distributed to gynecologic surgeons via electronic newsletters and direct E-mail. Measurements and Main Results There were 495 respondents with complete data. When respondents were queried about their musculoskeletal symptoms in the past 12 months, they reported a high prevalence of lower back (75.6%) and neck (72.9%) pain and a slightly lower prevalence of shoulder (66.6%), upper back (61.6%), and wrist/hand (60.9%) pain. Many respondents believed that performing surgery caused or worsened the pain, ranging from 76.3% to 82.7% in these five anatomic regions. Women are at an approximately twofold risk of pain, with adjusted odds ratios (OR) of 1.88 (95% confidence interval [CI], 1.1–3.2; p 5 .02) in the lower back region, OR 2.6 (95% CI, 1.4–4.8; p 5 .002) in the upper back, and OR 2.9 (95% CI, 1.8–4.6; p 5 .001) in the wrist/hand region. Conclusion Musculoskeletal symptoms are highly prevalent among gynecologic surgeons. Female sex is associated with approximately twofold risk of reported pain in commonly assessed anatomic regions. Journal of Minimally Invasive Gynecology (2013) 20, 656-660 PMID:23796512

  19. Musculoskeletal pareidolia in medical education.

    Science.gov (United States)

    Foye, Patrick; Abdelshahed, Dena; Patel, Shounuck

    2014-07-01

    Medical educators use a variety of strategies to help medical students and resident doctors understand and remember complex topics. One teaching tool is matching up radiographic appearances with unrelated, common, non-medical images, in order to help students easily recognise clinical patterns. However, even among medical educators who use this approach, many are not aware of the neuropsychiatric phenomenon they are using, known as pareidolia. We will describe pareidolia (a form of patternicity) and give two examples of its use in the clinical teaching of musculoskeletal imaging abnormalities: the winking owl and the Scottie dog. © 2014 John Wiley & Sons Ltd.

  20. Cooperation, compensation and transition

    NARCIS (Netherlands)

    Ju, Y.

    2004-01-01

    Cooperation and compensation are two important and well-linked issues in economics. The central question in cooperation is how to share the joint gains among participating players. Compensation is a specific aspect of surplus sharing problems providing incentives for agents to sacrifice their own

  1. Options in Compensation

    DEFF Research Database (Denmark)

    Flor, Christian Riis; Frimor, Hans; Munk, Claus

    2014-01-01

    We derive the optimal compensation contract in a principal–agent setting in which outcome is used to provide incentives for both effort and risky investments. To motivate investment, optimal compensation entails rewards for high as well as low outcomes, and it is increasing at the mean outcome...

  2. Relationship between Comorbid Health Problems and Musculoskeletal Disorders Resulting in Musculoskeletal Complaints and Musculoskeletal Sickness Absence among Employees in Korea.

    Science.gov (United States)

    Baek, Ji Hye; Kim, Young Sun; Yi, Kwan Hyung

    2015-06-01

    To investigate the relationship between musculoskeletal disorders and comorbid health problems, including depression/anxiety disorder, insomnia/sleep disorder, fatigue, and injury by accident, and to determine whether certain physical and psychological factors reduce comorbid health problems. In total, 29,711 employees were selected from respondents of the Third Korean Working Conditions Survey and categorized into two groups: Musculoskeletal Complaints or Musculoskeletal Sickness Absence. Four self-reported health indicators (overall fatigue, depression/anxiety, insomnia/sleep disorder, and injury by accident) were selected as outcomes, based on their high prevalence in Korea. We used multiple logistic regression analysis to determine the relationship between comorbid health problems, musculoskeletal complaints, and sickness absence. The prevalence of musculoskeletal complaints and musculoskeletal sickness absence due to muscular pain was 32.26% and 0.59%, respectively. Compared to the reference group, depression/anxiety disorder and overall fatigue were 5.2-6.1 times more prevalent in the Musculoskeletal Complaints Group and insomnia/sleep disorder and injury by accident were 7.6-11.0 times more prevalent in the Sickness Absence Group. When adjusted for individual and work-related physical factors, prevalence of all four comorbid health problems were slightly decreased in both groups. Increases in overall fatigue and depression/anxiety disorder were observed in the Musculoskeletal Complaints Group, while increases in insomnia/sleep disorder and injury by accident were observed in the Sickness Absence Group. For management of musculoskeletal complaints and sickness absence in the workplace, differences in health problems between employees with musculoskeletal complaints and those with sickness absence as well as the physical and psychological risk factors should be considered.

  3. Work load and musculoskeletal complaints during pregnancy

    NARCIS (Netherlands)

    Paul, J. A.; van Dijk, F. J.; Frings-Dresen, M. H.

    1994-01-01

    Many pregnant women have musculoskeletal complaints, the onset and aggravation of which are thought to be associated with their activity or work postures. The purpose of this paper was to obtain more insight into the influence of pregnancy on the load of the musculoskeletal system at work to provide

  4. Epidemiology and clinical profile of common musculoskeletal ...

    African Journals Online (AJOL)

    Epidemiology and clinical profile of common musculoskeletal diseases in patients with diabetes mellitus at Tikur Anbessa Specialized Hospital in Addis Ababa, Ethiopia. ... or worsening of MSD. Keywords: musculoskeletal complications; diabetic foot; foot care; trigger finger; Dupuytren's contracture; stiff frozen shoulder ...

  5. Selection related to musculoskeletal complaints among employees

    NARCIS (Netherlands)

    de Zwart, B. C.; Broersen, J. P.; van der Beek, A. J.; Frings-Dresen, M. H.; van Dijk, F. J.

    1997-01-01

    To (a) describe differences in the outcome of cross sectional and longitudinal analysis on musculoskeletal complaints relative to age and work demands, and (b) to assess the entrance and drop out selection on musculoskeletal complaints among groups of employees relative to age and work demands. A

  6. The prevalence and factors associated with musculoskeletal ...

    African Journals Online (AJOL)

    Background: Sickle cell anaemia (SCA) is a condition characterized by a predominance of haemoglobin S (hbss) in the red blood cells. Musculoskeletal involvement is one of the commonest clinical manifestations of SCA. There is limited information on the prevalence, patterns and factors associated with Musculoskeletal ...

  7. Musculoskeletal injuries resulting from patient handling tasks among hospital workers.

    Science.gov (United States)

    Pompeii, Lisa A; Lipscomb, Hester J; Schoenfisch, Ashley L; Dement, John M

    2009-07-01

    The purpose of this study was to evaluate musculoskeletal injuries and disorders resulting from patient handling prior to the implementation of a "minimal manual lift" policy at a large tertiary care medical center. We sought to define the circumstances surrounding patient handling injuries and to identify potential preventive measures. Human resources data were used to define the cohort and their time at work. Workers' compensation records (1997-2003) were utilized to identify work-related musculoskeletal claims, while the workers' description of injury was used to identify those that resulted from patient handling. Adjusted rate ratios were generated using Poisson regression. One-third (n = 876) of all musculoskeletal injuries resulted from patient handling activities. Most (83%) of the injury burden was incurred by inpatient nurses, nurses' aides and radiology technicians, while injury rates were highest for nurses' aides (8.8/100 full-time equivalent, FTEs) and smaller workgroups including emergency medical technicians (10.3/100 FTEs), patient transporters (4.3/100 FTEs), operating room technicians (3.1/100 FTEs), and morgue technicians (2.2/100 FTEs). Forty percent of injuries due to lifting/transferring patients may have been prevented through the use of mechanical lift equipment, while 32% of injuries resulting from repositioning/turning patients, pulling patients up in bed, or catching falling patients may not have been prevented by the use of lift equipment. The use of mechanical lift equipment could significantly reduce the risk of some patient handling injuries but additional interventions need to be considered that address other patient handling tasks. Smaller high-risk workgroups should not be neglected in prevention efforts.

  8. Subgroups of musculoskeletal pain patients and their psychobiological patterns – The LOGIN study protocol

    Directory of Open Access Journals (Sweden)

    Gerhardt Andreas

    2012-08-01

    Full Text Available Abstract Background Pain conditions of the musculoskeletal system are very common and have tremendous socioeconomic impact. Despite its high prevalence, musculoskeletal pain remains poorly understood and predominantly non-specifically and insufficiently treated. The group of chronic musculoskeletal pain patients is supposed to be heterogeneous, due to a multitude of mechanisms involved in chronic pain. Psychological variables, psychophysiological processes, and neuroendocrine alterations are expected to be involved. Thus far, studies on musculoskeletal pain have predominantly focused on the general aspects of pain processing, thus neglecting the heterogeneity of patients with musculoskeletal pain. Consequently, there is a need for studies that comprise a multitude of mechanisms that are potentially involved in the chronicity and spread of pain. This need might foster research and facilitate a better pathophysiological understanding of the condition, thereby promoting the development of specific mechanism-based treatments for chronic pain. Therefore, the objectives of this study are as follows: 1 identify and describe subgroups of patients with musculoskeletal pain with regard to clinical manifestations (including mental co-morbidity and 2 investigate whether distinct sensory profiles or 3 distinct plasma levels of pain-related parameters due to different underlying mechanisms can be distinguished in various subgroups of pain patients. Methods/Design We will examine a population-based chronic pain sample (n = 100, a clinical tertiary care sample (n = 100 and pain-free patients with depression or post-traumatic stress disorder and pain-free healthy controls (each n = 30, respectively. The samples will be pain localisation matched by sex and age to the population-based sample. Patients will undergo physical examination and thorough assessments of mental co-morbidity (including psychological trauma, perceptual and central sensitisation

  9. Subgroups of musculoskeletal pain patients and their psychobiological patterns - the LOGIN study protocol.

    Science.gov (United States)

    Gerhardt, Andreas; Hartmann, Mechthild; Tesarz, Jonas; Janke, Susanne; Leisner, Sabine; Seidler, Günter; Eich, Wolfgang

    2012-08-03

    Pain conditions of the musculoskeletal system are very common and have tremendous socioeconomic impact. Despite its high prevalence, musculoskeletal pain remains poorly understood and predominantly non-specifically and insufficiently treated.The group of chronic musculoskeletal pain patients is supposed to be heterogeneous, due to a multitude of mechanisms involved in chronic pain. Psychological variables, psychophysiological processes, and neuroendocrine alterations are expected to be involved. Thus far, studies on musculoskeletal pain have predominantly focused on the general aspects of pain processing, thus neglecting the heterogeneity of patients with musculoskeletal pain. Consequently, there is a need for studies that comprise a multitude of mechanisms that are potentially involved in the chronicity and spread of pain. This need might foster research and facilitate a better pathophysiological understanding of the condition, thereby promoting the development of specific mechanism-based treatments for chronic pain. Therefore, the objectives of this study are as follows: 1) identify and describe subgroups of patients with musculoskeletal pain with regard to clinical manifestations (including mental co-morbidity) and 2) investigate whether distinct sensory profiles or 3) distinct plasma levels of pain-related parameters due to different underlying mechanisms can be distinguished in various subgroups of pain patients. We will examine a population-based chronic pain sample (n = 100), a clinical tertiary care sample (n = 100) and pain-free patients with depression or post-traumatic stress disorder and pain-free healthy controls (each n = 30, respectively). The samples will be pain localisation matched by sex and age to the population-based sample. Patients will undergo physical examination and thorough assessments of mental co-morbidity (including psychological trauma), perceptual and central sensitisation (quantitative sensory testing), descending

  10. Musculoskeletal trauma services in Uganda.

    Science.gov (United States)

    Naddumba, E K

    2008-10-01

    Approximately 2000 lives are lost in Uganda annually through road traffic accidents. In Kampala, they account for 39% of all injuries, primarily in males aged 16-44 years. They are a result of rapid motorization and urbanization in a country with a poor economy. Uganda's population is an estimated 28 million with a growth rate of 3.4% per year. Motorcycles and omnibuses, the main taxi vehicles, are the primary contributors to the accidents. Poor roads and drivers compound the situation. Twenty-three orthopaedic surgeons (one for every 1,300,000 people) provide specialist services that are available only at three regional hospitals and the National Referral Hospital in Kampala. The majority of musculoskeletal injuries are managed nonoperatively by 200 orthopaedic officers distributed at the district, regional and national referral hospitals. Because of the poor economy, 9% of the national budget is allocated to the health sector. Patients with musculoskeletal injuries in Uganda frequently fail to receive immediate care due to inadequate resources and most are treated by traditional bonesetters. Neglected injuries typically result in poor outcomes. Possible solutions include a public health approach for prevention of road traffic injuries, training of adequate human resources, and infrastructure development.

  11. Reactive power compensator

    Science.gov (United States)

    El-Sharkawi, Mohamed A.; Venkata, Subrahmanyam S.; Chen, Mingliang; Andexler, George; Huang, Tony

    1992-01-01

    A system and method for determining and providing reactive power compensation for an inductive load. A reactive power compensator (50,50') monitors the voltage and current flowing through each of three distribution lines (52a, 52b, 52c), which are supplying three-phase power to one or more inductive loads. Using signals indicative of the current on each of these lines when the voltage waveform on the line crosses zero, the reactive power compensator determines a reactive power compensator capacitance that must be connected to the lines to maintain a desired VAR level, power factor, or line voltage. Alternatively, an operator can manually select a specific capacitance for connection to each line, or the capacitance can be selected based on a time schedule. The reactive power compensator produces control signals, which are coupled through optical fibers (102/106) to a switch driver (110, 110') to select specific compensation capacitors (112) for connections to each line. The switch driver develops triggering signals that are supplied to a plurality of series-connected solid state switches (350), which control charge current in one direction in respect to ground for each compensation capacitor. During each cycle, current flows from ground to charge the capacitors as the voltage on the line begins to go negative from its positive peak value. The triggering signals are applied to gate the solid state switches into a conducting state when the potential on the lines and on the capacitors reaches a negative peak value, thereby minimizing both the potential difference and across the charge current through the switches when they begin to conduct. Any harmonic distortion on the potential and current carried by the lines is filtered out from the current and potential signals used by the reactive power compensator so that it does not affect the determination of the required reactive compensation.

  12. Reactive power compensator

    Energy Technology Data Exchange (ETDEWEB)

    El-Sharkawi, Mohamed A. (Renton, WA); Venkata, Subrahmanyam S. (Woodinville, WA); Chen, Mingliang (Kirkland, WA); Andexler, George (Everett, WA); Huang, Tony (Seattle, WA)

    1992-01-01

    A system and method for determining and providing reactive power compensation for an inductive load. A reactive power compensator (50,50') monitors the voltage and current flowing through each of three distribution lines (52a, 52b, 52c), which are supplying three-phase power to one or more inductive loads. Using signals indicative of the current on each of these lines when the voltage waveform on the line crosses zero, the reactive power compensator determines a reactive power compensator capacitance that must be connected to the lines to maintain a desired VAR level, power factor, or line voltage. Alternatively, an operator can manually select a specific capacitance for connection to each line, or the capacitance can be selected based on a time schedule. The reactive power compensator produces control signals, which are coupled through optical fibers (102/106) to a switch driver (110, 110') to select specific compensation capacitors (112) for connections to each line. The switch driver develops triggering signals that are supplied to a plurality of series-connected solid state switches (350), which control charge current in one direction in respect to ground for each compensation capacitor. During each cycle, current flows from ground to charge the capacitors as the voltage on the line begins to go negative from its positive peak value. The triggering signals are applied to gate the solid state switches into a conducting state when the potential on the lines and on the capacitors reaches a negative peak value, thereby minimizing both the potential difference and across the charge current through the switches when they begin to conduct. Any harmonic distortion on the potential and current carried by the lines is filtered out from the current and potential signals used by the reactive power compensator so that it does not affect the determination of the required reactive compensation.

  13. Climate change and compensation

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint; Flanagan, Tine Bech

    2013-01-01

    This paper presents a case for compensation of actual harm from climate change in the poorest countries. First, it is shown that climate change threatens to reverse the fight to eradicate poverty. Secondly, it is shown how the problems raised in the literature for compensation to some extent...... are based on misconceptions and do not apply to compensation of present actual harm. Finally, two arguments are presented to the effect that, in so far as developed countries accept a major commitment to mitigate climate change, they should also accept a commitment to address or compensate actual harm from...... climate change. The first argument appeals to the principle that if it is an injustice to cause risk of incurring harm in the future, then it is also an injustice to cause a similar harm now. The second argument appeals to the principle that if there is moral reason to reduce the risk of specific harms...

  14. Workers Compensation Claim Data -

    Data.gov (United States)

    Department of Transportation — This data set contains DOT employee workers compensation claim data for current and past DOT employees. Types of data include claim data consisting of PII data (SSN,...

  15. Work load and musculoskeletal complaints during pregnancy.

    Science.gov (United States)

    Paul, J A; van Dijk, F J; Frings-Dresen, M H

    1994-06-01

    Many pregnant women have musculoskeletal complaints, the onset and aggravation of which are thought to be associated with their activity or work postures. The purpose of this paper was to obtain more insight into the influence of pregnancy on the load of the musculoskeletal system at work to provide a better basis for preventing complaints. To this end, literature pertinent to a model called "work load of the musculoskeletal system" was reviewed. The model was developed to describe how work contributes to musculoskeletal complaints. It was found that pregnancy causes changes in a worker's characteristics. These changes can lead to changes in the work situation, activity pattern, and postural characteristics and possibly result in a change in work load. In addition, physical changes such as weight gain increase the work load in a given posture. The load-bearing capacity of the musculoskeletal system decreases due to pregnancy. The changes in load and the decrease in load-bearing capacity singly or simultaneously increase the risk of musculoskeletal complaints. The multifactorial cause of musculoskeletal complaints during pregnancy reveals various possibilities for prevention.

  16. Musculoskeletal manifestations of diabetes mellitus.

    Science.gov (United States)

    Merashli, M; Chowdhury, T A; Jawad, A S M

    2015-11-01

    The prevalence of Type 1 and Type 2 diabetes are increasing significantly worldwide. Whilst vascular complications of diabetes are well recognized, and account for principle mortality and morbidity from the condition, musculoskeletal manifestations of diabetes are common and whilst not life threatening, are an important cause of morbidity, pain and disability. Joints affected by diabetes include peripheral joints and the axial skeleton. Charcot neuroarthropathy is an important cause of deformity and amputation associated with peripheral neuropathy. A number of fibrosing conditions of the hands and shoulder are recognized, including carpal tunnel syndrome, adhesive capsulitis, tenosynovitis and limited joint mobility. People with diabetes are more prone to gout and osteoporosis. Management of these conditions requires early recognition and close liaison between diabetes and rheumatology specialists. © The Author 2015. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Musculoskeletal imaging insight 2015: Kenya

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, Kathryn J. [Stanford University School of Medicine, Department of Radiology, Stanford, CA (United States); Mutiso, Kavulani [Aga Khan University Hospital, Department of Radiology, Nairobi (Kenya); Sconfienza, Luca Maria [University of Milan, Department of Biomedical Sciences for Health, Milan (Italy); IRCCS Istituto Ortopedico Galeazzi, Unit of Radiology, Milan (Italy); Monu, Johnny [University of Rochester Medical Center, Rochester, NY (United States)

    2016-07-15

    Over the past 6 years the International Skeletal Society (ISS) outreach programs have become popular amongst the various radiology organizations in sub-Saharan Africa. So much so that that the ISS outreach is now routinely expected to participate in many of the international radiology conferences in that part of the world. The organizational planning for an outreach visit to Kenya took place over a 3-year period. Eventually a double-headed event; the seventh and eighth sub-Saharan outreach efforts were organized in Nairobi and in Mombasa, Kenya. The Nairobi outreach was an educational course on musculoskeletal imaging at the University of Nairobi and the Aga Khan University in Nairobi from 26 to 28 May 2015. The Mombasa outreach was organized in collaboration with the African Society of Radiology (ASR) at their annual meeting in Mombasa from 30 May to 2 June 2015. (orig.)

  18. Musculoskeletal imaging insight 2015: Kenya

    International Nuclear Information System (INIS)

    Stevens, Kathryn J.; Mutiso, Kavulani; Sconfienza, Luca Maria; Monu, Johnny

    2016-01-01

    Over the past 6 years the International Skeletal Society (ISS) outreach programs have become popular amongst the various radiology organizations in sub-Saharan Africa. So much so that that the ISS outreach is now routinely expected to participate in many of the international radiology conferences in that part of the world. The organizational planning for an outreach visit to Kenya took place over a 3-year period. Eventually a double-headed event; the seventh and eighth sub-Saharan outreach efforts were organized in Nairobi and in Mombasa, Kenya. The Nairobi outreach was an educational course on musculoskeletal imaging at the University of Nairobi and the Aga Khan University in Nairobi from 26 to 28 May 2015. The Mombasa outreach was organized in collaboration with the African Society of Radiology (ASR) at their annual meeting in Mombasa from 30 May to 2 June 2015. (orig.)

  19. Musculoskeletal pain in Dentistry students

    Directory of Open Access Journals (Sweden)

    Rosane Batista e Silva

    2010-06-01

    Full Text Available Objective: To investigate the frequency of musculoskeletal pain in dental students. Methods: A descriptive study of observational and cross-sectional approach in which was used an Ergonomics and Posture Questionnaire for Dentists adapted by the researchers, associated with the Cooler Quiz. The sample comprised 43 students who attended between the 6th, 8th and 10th academic periods. The data were submitted to descriptive analysis and expressed as percentages, means and standard deviations, also maximum and minimum. For the comparative analysis between the variables, we used the chi-square test, chi-square test with Yates correction or Fisher exact test, when necessary, considering the significance level of 5%. Results: Among the students surveyed 20 (46.51% were men and 23 (53.5% women with a mean age of 23.14 ± 10.24 years, maximum of 35 years and minimum of 19. It was found that 40 (93.02% reported pain in some part of the body, 23 (53.5% in the upper limbs, 20 (46.5% in the lower limbs and 37 (86% in axial skeleton, with no difference between genders (p = 0.59. Pain intensity was classified as mild 10 (25%, moderate 21(52.5% and severe 7 (17.5%. In the assessment we evidenced the direct correlation between the hours of trainning and the intensity of pain. Conclusions: The results of the survey showed that the students assessed developed high frequency of musculoskeletal pain and that pain was associated with hours of daily training held during graduation at the dental clinic.

  20. Musculoskeletal disorders in main battle tank personnel

    DEFF Research Database (Denmark)

    Nissen, Lars Ravnborg; Guldager, Bernadette; Gyntelberg, Finn

    2009-01-01

    PURPOSE: To compare the prevalence of musculoskeletal disorders of personnel in the main battle tank (MBT) units in the Danish army with those of personnel in other types of army units, and to investigate associations between job function in the tank, military rank, and musculoskeletal problems......, and ankle. RESULTS AND CONCLUSIONS: There were only 4 women in the MBT group; as a consequence, female personnel were excluded from the study. The participation rate was 58.0% (n = 184) in the MBT group and 56.3% (n = 333) in the reference group. The pattern of musculoskeletal disorders among personnel...

  1. Assessment of musculoskeletal disorders in a manufacturing company using QEC and LUBAmethods and comparison of results

    Directory of Open Access Journals (Sweden)

    B. Afsartala

    2010-04-01

    Full Text Available Background and aims   Musculoskeletal disorders (MSDs are the most important causes of workers disabilities, increasing compensations and reducing productivity in developed and developing countries. This study was aimed to determine prevalence of musculoskeletal disorders and assessment of them by using QEC and LUBA methods and comparison of results in a manufacturing company in Iran.     Methods   This descriptive-analytical study was performed on 115 operators in 15 working stations by using QEC and LUBA methods. The prevalence of MSDs was obtained by using Nordic Musculoskeletal Questionnaire (NMQ. The data were analyzed by Spearman correlation coefficients.     Results   According to findings of NMQ, 81.4 percent of operators at least in one of nine parts of musculoskeletal system have pain since 12 months ago. Assessment with QEC and LUBA  revealed that 71.3 and 24.35 percent of operators respectively are in action level four.     Conclusion   According to the analysis, correlation between findings of NMQ and action levels in QEC is higher than LUBA action levels. Whereas LUBA just assess working postures, this method is not a suitable tool for evaluation of working stations that require repetitive carrying of loads, static posture and long time to do.  

  2. An ergonomic intervention to reduce musculoskeletal discomfort among semiconductor assembly workers.

    Science.gov (United States)

    Aghilinejad, Mashallah; Azar, Neda Soleimanvandy; Ghasemi, Mohammad Sadegh; Dehghan, Naser; Mokamelkhah, Elahe Kabir

    2016-06-14

    Work-related musculoskeletal disorders (MSDs) and ergonomics-related injuries are the single largest category of workplace injuries and are responsible for almost 30% of all worker's compensation costs. Awkward working posture refers to positions of the body that deviate significantly from the neutral position while job tasks are being performed and it is the primary ergonomic risk factor for developing musculoskeletal discomfort. This study was conducted among assembly workers of a semiconductor in Tehran province with the objective of implementing an interventional ergonomic program to minimize musculoskeletal discomfort. This study that was conducted on 105 male assembly workers of a semiconductor industry based on a census method. The standardized Nordic Musculoskeletal Questionnaire (NMQ) was used to determine the prevalence of MSDs. Corlett and Bishop's body part discomfort scale (BPD) was applied to evaluate body discomfort before and after the intervention (using a magnifying loupes to improve visibility of the parts). The results of NMQ showed the highest rate of MSDs were in neck, shoulder, upper arm and lower back regions (more than 75%). After ergonomic intervention, significant decrements of discomfort was observed in neck, shoulder, upper arm, elbows, lower arm, lower back and whole body discomfort (p ergonomic interventions can decrease MSDs of at risk body regions in the long term.

  3. Relationship of musculoskeletal pain and well-being at work - Does pain matter?

    Science.gov (United States)

    Malmberg-Ceder, Kirsi; Haanpää, Maija; Korhonen, Päivi E; Kautiainen, Hannu; Soinila, Seppo

    2017-04-01

    Musculoskeletal pain is a common symptom and many people even with chronic pain continue to work. The aim of our study is to analyze how musculoskeletal pain affects work well-being by comparing work engagement in employees with or without pain, and how pain-related risk of disability is associated with work engagement. In a separate analysis, we also studied, how psychosocial factors are related to work engagement. This is a cross-sectional study of Finnish female employees of the city of Pori, Finland (PORi To Aid Against Threats (PORTAAT) study). Data was collected by trained study nurses and self-administrated questionnaires. Work well-being was measured by work engagement using Utrecht Work Engagement Scale (UWES-9) questionnaire and the burden of pain was measured by using the short version of Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ). Study population was divided into four groups: those without pain and the groups with low (I), medium (II) or high (III) ÖMPSQ score, reflecting increasing risk of long term disability due to musculoskeletal pain. The study nurse assessed psychosocial risk factors using defined core questions. We evaluated 702 female employees, 601 (86%) had suffered from musculoskeletal pain over the past 12 months, whereas 101 (14%) reported no pain at all. Pain was chronic (duration at least 3 months) in 465/601 (77%) subjects. Subjects with musculoskeletal pain were older, had higher BMI and were on sick leave more often than subjects without pain. Of the psychosocial risk factors, depression, type D personality, anxiety and hostility were significantly more common among subjects with musculoskeletal pain. Hypertension and the use of non-steroidal anti-inflammatory drugs were significantly more frequent in the musculoskeletal pain group. Quality of sleep and working capability were significantly better among persons without pain. Average weekly working hours were slightly higher among those with musculoskeletal pain. In

  4. Clinical applications of dynamic functional musculoskeletal ultrasound

    Directory of Open Access Journals (Sweden)

    Petscavage-Thomas J

    2014-02-01

    Full Text Available Jonelle Petscavage-Thomas Department of Radiology, Penn State Hershey Medical Center, Hershey, PA, USA Abstract: There is an increasing trend in medicine to utilize ultrasound for diagnosis of musculoskeletal pathology. Although magnetic resonance imaging provides excellent spatial resolution of musculoskeletal structures in multiple imaging planes and is generally the cross-sectional modality of choice, it does not provide dynamic functional assessment of muscles, tendons, and ligaments. Dynamic maneuvers with ultrasound provide functional data and have been shown to be accurate for diagnosis. Ultrasound is also less expensive, portable, and more readily available. This article will review the common snapping, impingement, and friction syndromes imaged with dynamic ultrasound. It will also discuss future areas of research, including musculoskeletal sonoelastography. Keywords: snapping, dynamic, ultrasound, functional, musculoskeletal

  5. Prevalence and factors contributing to musculoskeletal disorder ...

    African Journals Online (AJOL)

    Journal Home > Vol 9, No 5S (2017) > ... Method used in this study is standard Nordic questionnaire (SNQ) Malay version for 150 garage workers ... Keywords: vehicle maintenance; musculoskeletal disorder; ache, pain, discomfort; prevalence ...

  6. Algorithm of Functional Musculoskeletal Disorders Diagnostics

    OpenAIRE

    Alexandra P. Eroshenko

    2012-01-01

    The article scientifically justifies the algorithm of complex diagnostics of functional musculoskeletal disorders during resort treatment, aimed at the optimal application of modern methods of physical rehabilitation (correction programs formation), based on diagnostic methodologies findings

  7. Algorithm of Functional Musculoskeletal Disorders Diagnostics

    Directory of Open Access Journals (Sweden)

    Alexandra P. Eroshenko

    2012-04-01

    Full Text Available The article scientifically justifies the algorithm of complex diagnostics of functional musculoskeletal disorders during resort treatment, aimed at the optimal application of modern methods of physical rehabilitation (correction programs formation, based on diagnostic methodologies findings

  8. injury to presentation delays among musculoskeletal trauma ...

    African Journals Online (AJOL)

    Background: Injuries are a common cause of morbidity and mortality in the developing world with road traffic ... Methods: All musculoskeletal injury patients presenting to Mulago Hospital were prospectively .... who fell or were injured in sports.

  9. Common running musculoskeletal injuries among recreational half ...

    African Journals Online (AJOL)

    probing the prevalence and nature of running musculoskeletal injuries in the 12 months preceding ... or agony, and which prevented them from physical activity for ..... injuries to professional football players: Developing the UEFA model.

  10. Prevalence of Work Related Musculoskeletal Disorders Among ...

    African Journals Online (AJOL)

    Journal Home > Vol 4, No 4 (2014) > ... Background: Work related musculoskeletal disorders (MSDs) are one of the common occupational ... of the doctor, duration of practice, working hours per week, physical activity and working environment.

  11. Musculoskeletal Modelling and the Physiome Project

    NARCIS (Netherlands)

    Fernandez, Justin; Zhang, Ju; Shim, Vickie; Munro, Jacob T.; Sartori, Massimo; Besier, Thor; Lloyd, David G.; Nickerson, David P.; Hunter, Peter; Pivonka, Peter

    2018-01-01

    This chapter presents developments as part of the International Union of Physiological Sciences (IUPS) Physiome Project. Models are multiscale, multispatial and multiphysics, hence, suitable numerical tools and platforms have been developed to address these challenges for the musculoskeletal system.

  12. Assessment of Functional and Musculoskeletal Problems, and ...

    African Journals Online (AJOL)

    Jibril Mohammed

    services. The questionnaires were administered to 384 elderly consenting individuals (aged 60 years and above) ... musculoskeletal problems had good ADL performance capacity rating. ..... may be that many of them scored high on tasks that.

  13. Psychosocial stressors at work and musculoskeletal problems

    NARCIS (Netherlands)

    Houtman, I.L.D.; Bongers, P.M.; Smulders, P.G.W.; Kompier, M.A.J.

    1994-01-01

    Objectives - This paper examines the relationship between work stressors and the following health indicators: psychosomatic complaints, health behavior, and musculoskeletal problems. Methods - Secondary analyses were performed on data from the National Work and Living Condition Survey, which

  14. Chest pain in focal musculoskeletal disorders

    DEFF Research Database (Denmark)

    Stochkendahl, Mette Jensen; Christensen, Henrik Wulff

    2010-01-01

    overlapping conditions and syndromes of focal disorders, including Tietze syndrome, costochondritis, chest wall syndrome, muscle tenderness, slipping rib, cervical angina, and segmental dysfunction of the cervical and thoracic spine, have been reported to cause pain. For most of these syndromes, evidence......The musculoskeletal system is a recognized source of chest pain. However, despite the apparently benign origin, patients with musculoskeletal chest pain remain under-diagnosed, untreated, and potentially continuously disabled in terms of anxiety, depression, and activities of daily living. Several...... arises mainly from case stories and empiric knowledge. For segmental dysfunction, clinical features of musculoskeletal chest pain have been characterized in a few clinical trials. This article summarizes the most commonly encountered syndromes of focal musculoskeletal disorders in clinical practice....

  15. Visual prediction: psychophysics and neurophysiology of compensation for time delays.

    Science.gov (United States)

    Nijhawan, Romi

    2008-04-01

    A necessary consequence of the nature of neural transmission systems is that as change in the physical state of a time-varying event takes place, delays produce error between the instantaneous registered state and the external state. Another source of delay is the transmission of internal motor commands to muscles and the inertia of the musculoskeletal system. How does the central nervous system compensate for these pervasive delays? Although it has been argued that delay compensation occurs late in the motor planning stages, even the earliest visual processes, such as phototransduction, contribute significantly to delays. I argue that compensation is not an exclusive property of the motor system, but rather, is a pervasive feature of the central nervous system (CNS) organization. Although the motor planning system may contain a highly flexible compensation mechanism, accounting not just for delays but also variability in delays (e.g., those resulting from variations in luminance contrast, internal body temperature, muscle fatigue, etc.), visual mechanisms also contribute to compensation. Previous suggestions of this notion of "visual prediction" led to a lively debate producing re-examination of previous arguments, new analyses, and review of the experiments presented here. Understanding visual prediction will inform our theories of sensory processes and visual perception, and will impact our notion of visual awareness.

  16. CT of AIDS-related musculoskeletal infections

    International Nuclear Information System (INIS)

    Magid, D.; Fishman, E.K.

    1990-01-01

    This paper characterizes musculoskeletal inflammatory diseases in human immunodeficiency virus-positive patients and with acquired immunodeficiency syndrome (AIDS). CT, radiographic, and clinical data were reviewed in 10 patients, and patterns and features were compared with those in musculoskeletal infections occurring in non-AIDS patients. Infection was confirmed by means of biopsy or aspiration in eight cases and strongly suggested in the other two by blood cultures, cell counts, and other data

  17. Musculoskeletal disorders in shipyard industry: prevalence, health care use, and absenteeism

    Directory of Open Access Journals (Sweden)

    Konstantinou Eleni

    2006-11-01

    Full Text Available Abstract Background It is unclear whether the well-known risk factors for the occurrence of musculoskeletal disorders (MSD also play an important role in the determining consequences of MSD in terms of sickness absence and health care use. Methods A cross-sectional study was conducted among 853 shipyard employees. Data were collected by questionnaire on physical and psychosocial workload, need for recovery, perceived general health, occurrence of musculoskeletal complaints, and health care use during the past year. Retrospective data on absenteeism were also available from the company register. Results In total, 37%, 22%, and 15% of employees reported complaints of low back, shoulder/neck, and hand/wrist during the past 12 months, respectively. Among all employees with at least one MSD, 27% visited a physician at least once and 20% took at least one period of sick leave. Various individual and work-related factors were associated with the occurrence of MSD. Health care use and absenteeism were strongest influenced by chronicity of musculoskeletal complaints and comorbidity with other musculoskeletal complaints and, to a lesser extent, by work-related factors. Conclusion In programmes aimed at preventing the unfavourable consequences of MSD in terms of sickness absence and health care use it is important to identify the (individual factors that determine the development of chronicity of complaints. These factors may differ from the well-know risk factors for the occurrence of MSD that are targeted in primary prevention.

  18. Radionuclide imaging of musculoskeletal infection

    Directory of Open Access Journals (Sweden)

    Christopher J. Palestro

    2007-09-01

    Full Text Available Radionuclide imaging studies are routinely used to evaluate patients suspected of having musculoskeletal infection. Three-phase bone imaging is readily available, relatively inexpensive, and very accurate in the setting of otherwise normal bone. Labeled leukocyte imaging should be used in cases of "complicating osteomyelitis" such as prosthetic joint infection. This test also is useful in clinically unsuspected diabetic pedal osteomyelitis as well as in the neuropathic joint. It is often necessary, however, to perform complementary bone marrow imaging, to maximize the accuracy of labeled leukocyte imaging. In contrast to other regions in the skeleton, labeled leukocyte imaging is not useful for diagnosing spinal osteomyelitis. At the moment, gallium is the preferred radionuclide procedure for this condition and is a useful adjunct to magnetic resonance imaging. FDG-PET likely will play an important role in the evaluation of musculoskeletal infection, especially spinal osteomyelitis, and may replace gallium imaging for this purpose.Estudos através de imagens com o uso de radionuclídeos são rotineiramente usadas para avaliar pacientes suspeitos de terem infecção músculo-esquelética. A imagem óssea em tridimensional é facilmente avaliável, relativamente de baixo custo, e muito precisa na localização de alterações ósseas. Imagem com leucócito marcado poderia ser usada nos casos de "osteomielite com complicações" tais como infecção prostética articular. Esse teste também é útil na não suspeita clinica de osteomielite associada ao pé diabético tanto quanto nas junções neuropáticas. É sempre necessário, por outro lado, realizar imagem complementar da medula óssea para aumentar a precisão da imagem com leucócito marcado. Em contraste com outras regiões no esqueleto, imagem com leucócito marcado não é útil para diagnosticar osteomielite da coluna vertebral. Até agora, o gálio é o radionuclídeo preferido para

  19. Aeromagnetic Compensation for UAVs

    Science.gov (United States)

    Naprstek, T.; Lee, M. D.

    2017-12-01

    Aeromagnetic data is one of the most widely collected types of data in exploration geophysics. With the continuing prevalence of unmanned air vehicles (UAVs) in everyday life there is a strong push for aeromagnetic data collection using UAVs. However, apart from the many political and legal barriers to overcome in the development of UAVs as aeromagnetic data collection platforms, there are also significant scientific hurdles, primary of which is magnetic compensation. This is a well-established process in manned aircraft achieved through a combination of platform magnetic de-noising and compensation routines. However, not all of this protocol can be directly applied to UAVs due to fundamental differences in the platforms, most notably the decrease in scale causing magnetometers to be significantly closer to the avionics. As such, the methodology must be suitably adjusted. The National Research Council of Canada has collaborated with Aeromagnetic Solutions Incorporated to develop a standardized approach to de-noising and compensating UAVs, which is accomplished through a series of static and dynamic experiments. On the ground, small static tests are conducted on individual components to determine their magnetization. If they are highly magnetic, they are removed, demagnetized, or characterized such that they can be accounted for in the compensation. Dynamic tests can include measuring specific components as they are powered on and off to assess their potential effect on airborne data. The UAV is then flown, and a modified compensation routine is applied. These modifications include utilizing onboard autopilot current sensors as additional terms in the compensation algorithm. This process has been applied with success to fixed-wing and rotary-wing platforms, with both a standard manned-aircraft magnetometer, as well as a new atomic magnetometer, much smaller in scale.

  20. Mini Treadmill for Musculoskeletal Health

    Science.gov (United States)

    Humphreys, Bradley

    2015-01-01

    Because NASA's approach to space exploration calls for long-term extended missions, there is a pressing need to equip astronauts with effective exercise regimens that will maintain musculoskeletal and cardiovascular health. ZIN Technologies, Inc., has developed an innovative miniature treadmill for use in both zero-gravity and terrestrial environments. The treadmill offers excellent periodic impact exercise to stimulate cardiovascular activity and bone remodeling as well as resistive capability to encourage full-body muscle maintenance. A novel speed-control algorithm allows users to modulate treadmill speed by adjusting stride, and a new subject load device provides a more Earth-like gravity replacement load. This new and compact treadmill offers a unique approach to managing astronaut health while addressing the inherent and stringent challenges of space flight. The innovation also has the potential to offer numerous terrestrial applications, as a real-time daily load stimulus (DLS) measurement feature provides an effective mechanism to combat or manage osteoporosis, a major public health threat for 55 percent of Americans over the age of 50.

  1. Treatment of chikungunya musculoskeletal disorders: a systematic review.

    Science.gov (United States)

    Guaraldo, Lusiele; Wakimoto, Mayumi Duarte; Ferreira, Heloisa; Bressan, Clarisse; Calvet, Guilherme Amaral; Pinheiro, Geraldo Castelar; Siqueira, Andre Machado; Brasil, Patrícia

    2018-04-01

    Chikungunya virus is amongst the fastest expanding vector transmissible diseases in recent years and has been causing massive epidemics in Africa, Asia, Latin America and the Caribbean. Despite human infection by this virus being first described in the 1950s, there is a lack of adequate therapeutic evaluations to guide evidence-based recommendations. The current guidelines rely heavily in specialists' opinion and experience instead of using higher rated evidence. Areas covered: A systematic review of the literature was performed- not restricted to clinical trials - reporting the therapeutic response against this infection with the intent to gather the best evidence of the treatment options against musculoskeletal disorders following chikungunya fever. The 15 studies included in the analysis were categorized considering the initiation of treatment during the acute, subacute and chronic phase. Expert commentary: This review demonstrates the complexity of chikungunya fever and difficulty of therapeutic management. This review found no current evidence-based treatment recommendations for the musculoskeletal disorders following chikungunya fever. To provide an optimal treatment that prevents perpetuation or progression of chikungunya infection to a potentially destructive and permanent condition without causing more harm is an aim that must be pursued by researchers and health professionals working with this disease.

  2. Enthalpy–entropy compensation

    Indian Academy of Sciences (India)

    Enthalpy–entropy compensation is the name given to the correlation sometimes observed between the estimates of the enthalpy and entropy of a reaction obtained from temperature-dependence data. Although the mainly artefactual nature of this correlation has been known for many years, the subject enjoys periodical ...

  3. Motion compensated digital tomosynthesis

    NARCIS (Netherlands)

    van der Reijden, Anneke; van Herk, Marcel; Sonke, Jan-Jakob

    2013-01-01

    Digital tomosynthesis (DTS) is a limited angle image reconstruction method for cone beam projections that offers patient surveillance capabilities during VMAT based SBRT delivery. Motion compensation (MC) has the potential to mitigate motion artifacts caused by respiratory motion, such as blur. The

  4. Teacher Compensation and Organization.

    Science.gov (United States)

    Kelley, Carolyn

    1997-01-01

    Examines changes in the conceptualization of schooling over time from an organizational perspective. Explores how compensation systems might be better designed to match alternative organizational designs, considering scientific management, effective schools, content-driven schooling, and high standards/high involvement schools as organizational…

  5. (statcom) in synchronous compensator

    African Journals Online (AJOL)

    eobe

    with fast response and low cost for stabilizing electricity grid power and voltage. ... The conventional and modified Newton-Raphson-based power flow equations .... The control of the reactive power exchange between .... because of its faster rate of convergence and accuracy ..... compensator, North American Power System.

  6. Reactive Power Compensating System.

    Energy Technology Data Exchange (ETDEWEB)

    Williams, Timothy J.; El-Sharkawi, Mohamed A.; Venkata, Subrahmanyam S.

    1985-01-04

    The circuit was designed for the specific application of wind-driven induction generators. It has great potential for application in any situation where a varying reactive power load is present, such as with induction motors or generators, or for transmission network compensation.

  7. Headache and musculoskeletal complaints among subjects with self reported whiplash injury. The HUNT-2 study

    Directory of Open Access Journals (Sweden)

    Nygaard Oystein

    2011-06-01

    Full Text Available Abstract Background To evaluate the life-time prevalence of self reported whiplash injury and the relationship to chronic musculoskeletal complaints (MSCs and headache in a large unselected adult population. Methods Between 1995 and 1997, all inhabitants 20 years and older in Nord-Trondelag county in Norway were invited to a comprehensive health survey. Out of 92,936 eligible for participation, a total of 59,104 individuals (63.6% answered the question about whiplash injury (whiplash. Among these, 46,895 (79.3% responded to the questions of musculoskeletal complaints and headache. Results The total life-time prevalence of self reported whiplash injury was 2.9%, for women 2.7% and for men 3.0%. There was a significant association between self reported whiplash injury and headache (OR = 2.1; 95% CI 1.8-2.4, and chronic MSCs (OR = 3.3; 95% CI 2.8-3.8, evident for all ten anatomical sites investigated. The association was most pronounced for those with a combination of headache and chronic MSC for both men (OR = 4.8; 95% CI 3.6-6.2 and women (OR = 5.2; 95% CI 3.7-7.1. Conclusions Subjects with self reported whiplash injury had significantly more headache and musculoskeletal complaints than those without, and may in part be due to selective reporting. The causal mechanism remains unclear and cannot be addressed in the present study design.

  8. Center for Worker's Compensation Studies

    Data.gov (United States)

    Federal Laboratory Consortium — The mission of the NIOSH Center for Workers’ Compensation Studies (CWCS) is to use workers’ compensation data and systems to improve workplace safety and health....

  9. Addressing inadequate compensation | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2016-08-12

    Aug 12, 2016 ... The issue LSLAs raise a number of concerns regarding compensation, including ... at a meeting with traders in Lamu, Kenya, where a new port is planned. ... compensation and a fair share of benefits and risks in land deals.

  10. Structuring competitive physician compensation models.

    Science.gov (United States)

    Mobley, Kim; Turcotte, Claire

    2010-12-01

    When developing and reviewing their physician compensation programs, healthcare organizations should: Understand the market data. Test outcomes of incentive plans for fair market value. Check total compensation for fair market value and reasonableness.

  11. Aquatic exercise & balneotherapy in musculoskeletal conditions.

    Science.gov (United States)

    Verhagen, Arianne P; Cardoso, Jefferson R; Bierma-Zeinstra, Sita M A

    2012-06-01

    This is a best-evidence synthesis providing an evidence-based summary on the effectiveness of aquatic exercises and balneotherapy in the treatment of musculoskeletal conditions. The most prevalent musculoskeletal conditions addressed in this review include: low back pain, osteoarthritis, fibromyalgia and rheumatoid arthritis. Over 30 years of research demonstrates that exercises in general, and specifically aquatic exercises, are beneficial for reducing pain and disability in many musculoskeletal conditions demonstrating small to moderate effect sizes ranging between 0.19 and 0.32. Balneotherapy might be beneficial, but the evidence is yet insufficient to make a definitive statement about its use. High-quality trials are needed on balneotherapy and aquatic exercises research especially in specific patient categories that might benefit most. Copyright © 2012 Elsevier Ltd. All rights reserved.

  12. Musculoskeletal disorder survey for pond workers

    Science.gov (United States)

    Maryani, A.; Partiwi, S. G.; Dewi, H. N. F.

    2018-04-01

    Mucsuloskeletal disorder will affect worker performance and become serious injury when ignored, so that workers cannot work normally. Therefore, an effective strategy plan is needed to reduce the risk of musculoskeletal disorder. A pond worker is profession with high risk of physical complain. Four main activities are ponds preparation, seed distribution, pond maintenance, and harvesting. The methods employed in this current musculoskeletal disorder survey are questionnaire and interview. The result from 73 questionnaires shown that most of pond workers were working for 7 days a week. Prevalence physical complain are on neck, shoulders, upper back, lower back, and knees. The level of perceived complaint is moderate pain. However, most of them do not contact therapists or physicians. Therefore it is necessary to improve the working methods to be able to reduce physical complains due to musculoskeletal disorder.

  13. RELIABILITY OF LENTICULAR EXPANSION COMPENSATORS

    Directory of Open Access Journals (Sweden)

    Gabriel BURLACU,

    2011-11-01

    Full Text Available Axial lenticular compensators are made to take over the longitudinal heat expansion, shock , vibration and noise, made elastic connections for piping systems. In order to have a long life for installations it is necessary that all elements, including lenticular compensators, have a good reliability. This desire can be did by technology of manufactoring and assembly of compensators, the material for lenses and by maintenance.of compensator

  14. Physical Ergonomics and Musculoskeletal Disorders: What's hot? What's cool?

    NARCIS (Netherlands)

    Beek, A.J. van der; IJmker, S.

    2007-01-01

    This chapter discusses the physical ergonomics and musculoskeletal disorders and summarizes the Triennial International Ergonomics Association (IEA) World Congress 2006-IEA2006-highlights on physical ergonomics and work-related MusculoSkeletal Disorders (MSDs). Two general trends are observed.

  15. Compensation Consultants and CEO Pay

    NARCIS (Netherlands)

    Kabir, Mohammed Rezaul; Minhat, Marizah

    2014-01-01

    The study examines the practice of employing multiple compensation consultants. Examining data of a sample of UK companies over the period 2003–2006 we find that CEOs receive higher equity-based pay when firms employ more than one compensation consultant. An increase in the number of compensation

  16. MR imaging of appendicular musculoskeletal trauma

    International Nuclear Information System (INIS)

    Kathol, M.H.; Montgomery, W.J.; Yuh, W.T.C.; El-Khoury, G.Y.

    1987-01-01

    Thirty cases of musculoskeletal trauma to the extremities examined by MR imaging have been reviewed retrospectively. Examples of various injuries will be shown, including disruption of ligament and tendon, muscular tear and edema, hemorrhage (local or diffuse), vascular injury, bone marrow contusion, osteocartilaginous fracture, meniscal tear, and joint fluid. Many of these patients were collegiate athletes, and MR was valuable in establishing a rapid, accurate diagnosis influencing not only treatment but also return to competition. Negative examinations allowed resumption of competition with a high degree of confidence. The advantages and disadvantages of MR in musculo-skeletal trauma are discussed

  17. International spinal cord injury musculoskeletal basic data set

    DEFF Research Database (Denmark)

    Biering-Sørensen, Fin; Burns, A S; Curt, A

    2012-01-01

    To develop an International Spinal Cord Injury (SCI) Musculoskeletal Basic Data Set as part of the International SCI Data Sets to facilitate consistent collection and reporting of basic musculoskeletal findings in the SCI population.Setting:International.......To develop an International Spinal Cord Injury (SCI) Musculoskeletal Basic Data Set as part of the International SCI Data Sets to facilitate consistent collection and reporting of basic musculoskeletal findings in the SCI population.Setting:International....

  18. Compensability index for compensation radiotherapy after treatment interruptions

    International Nuclear Information System (INIS)

    Putora, Paul Martin; Schmuecking, Michael; Aebersold, Daniel; Plasswilm, Ludwig

    2012-01-01

    The goal of our work was to develop a simple method to evaluate a compensation treatment after unplanned treatment interruptions with respect to their tumour- and normal tissue effect. We developed a software tool in java programming language based on existing recommendations to compensate for treatment interruptions. In order to express and visualize the deviations from the originally planned tumour and normal tissue effects we defined the compensability index. The compensability index represents an evaluation of the suitability of compensatory radiotherapy in a single number based on the number of days used for compensation and the preference of preserving the originally planned tumour effect or not exceeding the originally planned normal tissue effect. An automated tool provides a method for quick evaluation of compensation treatments. The compensability index calculation may serve as a decision support system based on existing and established recommendations

  19. Compensability index for compensation radiotherapy after treatment interruptions

    Directory of Open Access Journals (Sweden)

    Putora Paul

    2012-12-01

    Full Text Available Abstract Background The goal of our work was to develop a simple method to evaluate a compensation treatment after unplanned treatment interruptions with respect to their tumour- and normal tissue effect. Methods We developed a software tool in java programming language based on existing recommendations to compensate for treatment interruptions. In order to express and visualize the deviations from the originally planned tumour and normal tissue effects we defined the compensability index. Results The compensability index represents an evaluation of the suitability of compensatory radiotherapy in a single number based on the number of days used for compensation and the preference of preserving the originally planned tumour effect or not exceeding the originally planned normal tissue effect. An automated tool provides a method for quick evaluation of compensation treatments. Conclusions The compensability index calculation may serve as a decision support system based on existing and established recommendations.

  20. Work related musculoskeletal disorders among farm workers: A case ...

    African Journals Online (AJOL)

    Work related musculoskeletal disorders among farm workers: A case study of an agricultural college in Zimbabwe. ... hazards, therefore a need for intervention to protect them from musculoskeletal complaints. Improvement in farm work practices through ergonomic training might help reduce musculoskeletal complaints.

  1. Characteristics of occupational musculoskeletal disorders of five sectors in service industry between 2004 and 2013.

    Science.gov (United States)

    Choi, Hyun-Woo; Kim, Young-Ki; Kang, Dong-Mug; Kim, Jong-Eun; Jang, Bo-Young

    2017-01-01

    ' Work related musculoskeletal disorders (WRMSDs)' have been mostly reported in the manufacturing industry but recently the occurrence of industrial injuries has been constantly increasing in the service industry. This research is going to analyze the data about workers' compensation for WRMSDs in five different service sectors and identify characteristics of occupations with the highest approved occupations. According to the data released from the Korea Worker's Compensation & Welfare Service, the overview of 12,730 cases of workers' compensation for WRMSDs in five service sectors from 2004 to 2013 is going to be analyzed and the source data is going to be classified by the Korean Standard Classification of Occupations to select the top five occupations that have the highest number of approval. After selecting each five occupations from the service sector that have work related musculoskeletal disorders, the result showed that the occupation with the highest number of approval in the health and social care sector were the early childhood educators, cooks in the school canteens in education services sector, garbage collectors in the sanitation and similar services sector, deliverymen in wholesale and retail, consumer goods repair and building cleaners in general management businesses such as those in building maintenance. The major event observed in the top five occupations was the overexertion and reaction as a cause of WRMSDs. The day when the WRMSDs mostly occurred was on Monday and the most likely time was 10 am. The median days away from work and lost working days are 29-90 days and 0-50 days respectively. The difference in each occupation was observed in year of service, age, and gender. 83.21% of the approved cases of workers' compensation for WRMSDs occurred in the top 25 occupations in all of the five service sectors, which meant that the approval of workers' compensation is concentrated in specific occupations. This research is going to suggest

  2. Laparoscopic Cholecystectomy for Gallbladder Calculosis in Fibromyalgia Patients: Impact on Musculoskeletal Pain, Somatic Hyperalgesia and Central Sensitization

    Science.gov (United States)

    Costantini, Raffaele; Affaitati, Giannapia; Massimini, Francesca; Tana, Claudio; Innocenti, Paolo; Giamberardino, Maria Adele

    2016-01-01

    Fibromyalgia, a chronic syndrome of diffuse musculoskeletal pain and somatic hyperalgesia from central sensitization, is very often comorbid with visceral pain conditions. In fibromyalgia patients with gallbladder calculosis, this study assessed the short and long-term impact of laparoscopic cholecystectomy on fibromyalgia pain symptoms. Fibromyalgia pain (VAS scale) and pain thresholds in tender points and control areas (skin, subcutis and muscle) were evaluated 1week before (basis) and 1week, 1,3,6 and 12months after laparoscopic cholecystectomy in fibromyalgia patients with symptomatic calculosis (n = 31) vs calculosis patients without fibromyalgia (n. 26) and at comparable time points in fibromyalgia patients not undergoing cholecystectomy, with symptomatic (n = 27) and asymptomatic (n = 28) calculosis, and no calculosis (n = 30). At basis, fibromyalgia+symptomatic calculosis patients presented a significant linear correlation between the number of previously experienced biliary colics and fibromyalgia pain (direct) and muscle thresholds (inverse)(pfibromyalgia pain significantly increased and all thresholds significantly decreased at 1week and 1month (1-way ANOVA, pFibromyalgia pain and thresholds returned to preoperative values at 3months, then pain significantly decreased and thresholds significantly increased at 6 and 12months (pfibromyalgia patients undergoing cholecystectomy thresholds did not change; in all other fibromyalgia groups not undergoing cholecystectomy fibromyalgia pain and thresholds remained stable, except in fibromyalgia+symptomatic calculosis at 12months when pain significantly increased and muscle thresholds significantly decreased (pfibromyalgia symptoms and that laparoscopic cholecystectomy produces only a transitory worsening of these symptoms, largely compensated by the long-term improvement/desensitization due to gallbladder removal. This study provides new insights into the role of visceral pain comorbidities and the effects of

  3. Sex differences in consequences of musculoskeletal pain

    NARCIS (Netherlands)

    Wijnhoven, H. A H; de Vet, Henrica C W; Picavet, H. Susan J

    STUDY DESIGN. Cross-sectional population-based study. OBJECTIVE. To study sex differences in consequences of musculoskeletal pain (MP): limited functioning, work leave or disability, and healthcare use. SUMMARY OF BACKGROUND DATA. MP is a major public health problem in developed countries due to

  4. Prevalence of musculoskeletal injuries among young squash ...

    African Journals Online (AJOL)

    The aim of the study was to investigate the prevalence of musculoskeletal injuries sustained by young squash players in Malaysia. This study was conducted retrospectively by using. Standardized Nordic Questionnaire (NSQ) during SUKMA 2016 at Kuching, Sarawak, Malaysia. The questionnaires were distributed to the ...

  5. Smoking expands expected lifetime with musculoskeletal disease

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Juel, Knud

    2003-01-01

    By indirect estimation of mortality from smoking and life table methods we estimated expected lifetime without musculoskeletal diseases among never smokers, ex-smokers, and smokers. We found that although life expectancy of a heavy smoker is 7 years shorter than that of a never smoker, heavy...

  6. Psychosocial risk factors for musculoskeletal disorders (MSDs)

    NARCIS (Netherlands)

    Heuvel, S. van den

    2014-01-01

    It has been known for some time that risk factors in the workplace can have a negative effect on health. Ramazzini was one of the first scientists to identify occupational health hazards. He wrote about diseases of the musculoskeletal system caused by sudden and irregular movements and the adoption

  7. Musculoskeletal disorder (MSD) among agricultural workers.

    Science.gov (United States)

    Basher, A; Nath, P; Siddique, Z S; Rahman, M H; Rubel, M A; Sayed, M S; Ahmad, S A; Mondol, G D; Bhuiyan, M R

    2015-01-01

    Farming is a large and main industry in Bangladesh. Large numbers of people are directly involved in farming and have very unique exposure compare to other sectors. Musculoskeletal problems among farmer population are not infrequent. This study was carried out among 200 farmers in one selected district. The study revealed that musculoskeletal problems were common among the farmers working in a traditional way. All the respondents were male. The age of all respondents lie between 20-60 years. Among them 22.5% farmers were illiterate, about 45.5% below Class V. About half (42%) of the respondents had reported pain in different parts of the body at least one or more times during working in land. And about two third (65.5%) of the farmers had history of joint pain and stiffness in last 12 month. Most of the farmers who suffered from musculoskeletal symptoms were 41-60 years. Specially who worked more then 20 years (82.6%) and average 6 hours per day (66.7%). The occurrence of musculoskeletal problems in various part of the body included Knee pain - 48.1%, Back pain (back ache) - 22.9%, Waist pain (low back ache) - 13.3%, Neck pain - 18.3% and shoulder pain - 10.7%. Length of work in year and daily average working hours were found significant association with musculoskeletal pain. It was found that musculoskeletal pain were more common among the farmers when they worked in squatting position (52%) and specially during weeding of plants (31%). Among them only 22% also engaged in other business. Most of the farmers complained dull aching pain (40.6%), only 2.3% noticed severe acute pain, but about 86% farmers' temporary stop their work for pain and 80% get relief after discontinue of work. About 75% respondents visited doctors for their pain which was statistically significant (p=0.001). It was found that the rates of musculoskeletal complaints are more among those individuals who worked relatively bad ergonomic condition, such as body position probably play an important

  8. Fukushima: liability and compensation

    International Nuclear Information System (INIS)

    Vasquez-Maignan, Ximena

    2012-01-01

    On 11 March 2011, Japan endured one of the worst natural disasters in its history when a massive earthquake struck the Pacific coast of the country and was followed by a tsunami which led to considerable loss of lives. It also led to a major accident at the Fukushima Daiichi nuclear power plant. Soon afterwards, the operator of the plant, Tokyo Electric Power Company (TEPCO), assumed responsibility and liability for the nuclear accident. On 28 April 2011, TEPCO established a dedicated contact line to provide consulting services for financial compensation related to the damage caused

  9. Efficiency of overhead ceiling lifts in reducing musculoskeletal injury among carers working in long-term care institutions.

    Science.gov (United States)

    Alamgir, Hasanat; Yu, Shicheng; Fast, Catherine; Hennessy, Stephanie; Kidd, Catherine; Yassi, Annalee

    2008-05-01

    A longitudinal study was conducted in three long-term care facilities to evaluate the effectiveness and cost benefit of overhead lifts in reducing the risk of musculoskeletal injury among healthcare workers. Analysis of injury trends spanning 6 years before intervention (1996-2001) and 4 years after intervention (2002-2005) found a significant and sustained decrease in workers' compensation claims per number of beds and in working days lost per bed. The payback period was estimated under various assumptions and varied from 6.3 to 6.2 years if only direct claim-cost savings were included, and from 2.06 to 3.20 years when indirect savings were added. The significant reductions in injury rates and compensation claims support intervention with overhead ceiling lifts. A more comprehensive evaluation of such programmes should incorporate in the analysis important variables such as staffing ratios, job stresses, injury reporting systems and compensation policies during the study period.

  10. Women's experiences of developing musculoskeletal diseases: employment challenges and policy recommendations.

    Science.gov (United States)

    Crooks, Valorie A

    2007-07-30

    To answer three specific questions: (i) How do women experience the workplace after the onset of a musculoskeletal disease; (ii) What employment policy and programme suggestions can they offer for ways to better support chronically ill women in their abilities to maintain workforce participation; and (iii) How are these women's employment policy and programme recommendations informed by their own lived experiences and desires? In-depth interviews were conducted with 18 women who had developed musculoskeletal diseases while involved in the labour market. Data were coded and analysed thematically. Participants identified three common workplace barriers experienced and three types of workplace accommodations commonly requested. They offered four specific employment policy and programme recommendations for ways to better support women who develop musculoskeletal diseases in maintaining labour market participation. It is found that their employment policy and programme recommendations are informed by their own experiences in the workplace and desires for being supported in maintaining involvement in paid labour. Creating employment programmes and policies that support chronically ill women in their attempts to remain involved in the workforce based on how much paid labour they are able to perform and where they are best able to work is of the utmost importance.

  11. Whiplash and the compensation hypothesis.

    Science.gov (United States)

    Spearing, Natalie M; Connelly, Luke B

    2011-12-01

    Review article. To explain why the evidence that compensation-related factors lead to worse health outcomes is not compelling, either in general, or in the specific case of whiplash. There is a common view that compensation-related factors lead to worse health outcomes ("the compensation hypothesis"), despite the presence of important, and unresolved sources of bias. The empirical evidence on this question has ramifications for the design of compensation schemes. Using studies on whiplash, this article outlines the methodological problems that impede attempts to confirm or refute the compensation hypothesis. Compensation studies are prone to measurement bias, reverse causation bias, and selection bias. Errors in measurement are largely due to the latent nature of whiplash injuries and health itself, a lack of clarity over the unit of measurement (specific factors, or "compensation"), and a lack of appreciation for the heterogeneous qualities of compensation-related factors and schemes. There has been a failure to acknowledge and empirically address reverse causation bias, or the likelihood that poor health influences the decision to pursue compensation: it is unclear if compensation is a cause or a consequence of poor health, or both. Finally, unresolved selection bias (and hence, confounding) is evident in longitudinal studies and natural experiments. In both cases, between-group differences have not been addressed convincingly. The nature of the relationship between compensation-related factors and health is unclear. Current approaches to testing the compensation hypothesis are prone to several important sources of bias, which compromise the validity of their results. Methods that explicitly test the hypothesis and establish whether or not a causal relationship exists between compensation factors and prolonged whiplash symptoms are needed in future studies.

  12. Under-reporting of work-related musculoskeletal disorders in the Veterans Administration.

    Science.gov (United States)

    Siddharthan, Kris; Hodgson, Michael; Rosenberg, Deborah; Haiduven, Donna; Nelson, Audrey

    2006-01-01

    Work-related musculoskeletal disorders following patient contact represent a major concern for health care workers. Unfortunately, research and prevention have been hampered by difficulties ascertaining true prevalence rates owing to under-reporting of these injuries. The purpose of this study is to determine the predictors for under-reporting work-related musculoskeletal injuries and their reasons. Multivariate analysis using data obtained in a survey of Veterans Administration employees in the USA was used to determine underreporting patterns among registered nurses, licensed practical nurses and nursing assistants. Focus groups among health care workers were conducted at one of the largest Veterans Administration hospitals to determine reasons for under-reporting. A significant number of workers reported work-related musculoskeletal pain, which was not reported as an injury but required rescheduling work such as changing shifts and taking sick leave to recuperate. The findings indicate that older health care workers and those with longer service were less likely to report as were those working in the evening and night shifts. Hispanic workers and personnel who had repetitive injuries were prone to under-reporting, as were workers in places that lack proper equipment to move and handle patients. Reasons for under-reporting include the time involved, peer pressure not to report and frustration with workers' compensation procedures. This study provides insights into under-reporting musculoskeletal injuries in a major US government organization. The research indicates that current reporting procedures appear to be overtly cumbersome in time and effort. More flexible work assignments are needed to cover staff shortfalls owing to injuries. Health education on the detrimental long-term effects of ergonomic injuries and the need for prompt attention to injuries should prove useful in improving rates of reporting.

  13. Psychosocial factors, musculoskeletal disorders and work-related fatigue amongst nurses in Brunei: structural equation model approach.

    Science.gov (United States)

    Abdul Rahman, Hanif; Abdul-Mumin, Khadizah; Naing, Lin

    2017-09-01

    Psychosocial factors, musculoskeletal disorders and work-related fatigue have adverse effects on individual nurses and place a substantial financial burden on health care. Evidence of an association has been reported in the literature, but no theoretical explanation has been published to date. To explore and develop a structural model to provide a theoretical explanation for this relationship. A cross-sectional study using data from 201 valid samples of emergency and critical care nurses across public hospitals in Brunei was performed via self-administered questionnaire. The structural equation model was assessed using partial least squares analysis. A valid and robust structural model was constructed. This revealed that 61.5% of the variance in chronic fatigue could be explained by psychosocial factors and musculoskeletal disorders pathways. Among the psychosocial factors, work-family conflict was identified as a key mediator for progression of musculoskeletal problems and subsequent fatigue through stress and burnout. This report provides a novel theoretical contribution to understanding the relationship between psychosocial factors, musculoskeletal disorders and work-related fatigue. These preliminary results may be useful for future studies on the development of work-related fatigue and musculoskeletal disorders, particularly the central role of work-family conflict. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. [Work-related musculoskeletal disorders and their association with occupational nursing].

    Science.gov (United States)

    Barboza, Michele Cristiene Nachtigall; Milbrath, Viviane Marten; Bielemann, Valquíria Machado; de Siqueira, Hedi Crecencia Heckler

    2008-12-01

    Work-related musculoskeletal diseases (MSD) are disorders in the musculoskeletal structures caused by chronic occupational processes. The objective of this study was to get to know scientific papers on MSD related to the nursing profession. A bibliographic research of the last ten years was conducted at Health Virtual Library using the main data bases. Twenty-one summaries were found. Among them, thirteen were selected because they specifically focused on the subject. Three main areas were identified: occupational health nurses in relation to MSDs--their importance in health prevention and promotion; Ergonomics as MSDs prevention method: performed as changes on work consider risk factors; Vulnerability of Nursing staff to MSDs--predisposing factors to disease caused by inappropriate working conditions. The conclusion was that an occupational and ergonomic health service is important to prevent MSDs, especially among the nursing staff.

  15. The value of musculoskeletal ultrasound in geriatric care and rehabilitation.

    Science.gov (United States)

    Can, Büşra; Kara, Murat; Kara, Özgür; Ülger, Zekeriya; Frontera, Walter R; Özçakar, Levent

    2017-12-01

    The WHO reports that one of the major chronic conditions affecting the elderly worldwide is musculoskeletal disorders that are associated with long-term pain and disability. Considering the healthcare needs of the elderly (i.e. comprehensive, accessible, efficient) and the advantages of ultrasound (US) use (patient-friendly, convenient, cost-effective, and does not require exposure to radiation or magnetic fields), there seems to be a 'gap' in the actual clinical practice. In this paper, we aimed to highlight the potential value of US imaging in the management of the elderly with a wide spectrum of musculoskeletal conditions (degenerative/rheumatic joint diseases, falls/trauma, nursing care, peripheral nerve problems, sarcopenia, and interventions). In this respect, electronic databases (ISI Web of Science, PubMed, Elsevier Science Direct) and reference lists of relevant articles/reviews were screened by two blinded investigators for each topic. The main medical subject heading terms selected to capture the most relevant papers on the topics in accordance with the literature were knee/hip/hand osteoarthritis, prevalence, rotator cuff injury, lateral epicondylitis, tendinopathy, rheumatoid arthritis, Sjogren's syndrome, polymyalgia rheumatica, crystal arthropathies, gout, pseudogout, carpal tunnel syndrome, fall, fractures, hematoma, pressure ulcer, ultrasonography, interventional, sarcopenia, body composition, rehabilitation, frail elderly, and aged. The search was limited to peer-reviewed full-text English journals starting from the earliest papers to May 2017. A study population (or part of the study population) of adults older than 65 years (if possible) was included. We especially underscore the use of US by clinicians as an extension of their physical examination or as a practical guide for an immediate intervention.

  16. Can high social capital at the workplace buffer against stress and musculoskeletal pain?

    Science.gov (United States)

    Jay, Kenneth; Andersen, Lars L.

    2018-01-01

    Abstract Work-related musculoskeletal pain and stress are both highly prevalent in the working environment and relate well to the biopsychosocial model. While the onset of musculoskeletal pain is often dependent on the biological element of the biopsychosocial model, chronic pain is often influenced by psychological and social factors. Similarly, stress is also influenced by biological, psychological, and social factors. This study investigates the possibility of social capital being a buffer for stress and musculoskeletal pain in a group of female laboratory technicians. Female laboratory technicians (n = 500) replied to questions about stress (Cohens Perceived Stress Scale-10), musculoskeletal pain (0–10 visual analog scale), and social capital at the workplace (bonding [in teams], bridging [between teams], and linking [between teams and leaders]). Outcome variables were stress and musculoskeletal pain and the predictor variable was social capital. General linear models tested the association of the 3 types of social capital (predictor variables) with stress and pain (mutually adjusted outcome variables). Analyses were controlled for age, lifestyle (body mass index, smoking), seniority, and working hours per week. For stress as outcome, moderate and high bonding social capital were different from low social capital with −2.04 (95% confidence interval [CI] −3.33 to −0.76) and −4.56 (95% CI −5.84 to −3.28) points on the Perceived Stress Scale of 0 to 42, respectively. Similarly, moderate and high bridging social capital were different from low social capital with −1.50 (95% CI −2.76 to −0.24) and −4.39 (95% CI −5.75 to −3.03), respectively. For linking, only high social was significantly different from low with −2.94 (95% CI −4.28 to −1.60). None of the 3 types of social capital was associated with musculoskeletal pain. Higher levels of social capital at the workplace appear to buffer against stress, but not against

  17. Playing-related musculoskeletal disorders in music students-associated musculoskeletal signs.

    Science.gov (United States)

    Steinmetz, A; Möller, H; Seidel, W; Rigotti, T

    2012-12-01

    Pain and overuse are common problems for musicians. Up to 80% of professional musicians suffer from playing-related musculoskeletal disorders (PRMD). The prevalence rate in music students is very high as well. Sufficient data on the underlying musculoskeletal dysfunctions however is scarce. Additionally, the self-assessment of health in musicians seems to differ compared to non-musicians, which might influence their attitudes concerning preventive strategies. Evaluation of frequency of PRMD in music students, investigation of signs and symptoms in music students compared to non-music controls, comparison of self-reported health and well-being between the two groups. Prospective, cross-sectional, case control, non-randomized. Other (University volunteers). Music students in comparison to a non-music control group. Musculoskeletal examination and questionnaire of 36 volunteers of a music university and 19 volunteer students of an university of education were analyzed. The total number of musculoskeletal dysfunctions and differences between the student groups were examined. The personal pain and health self-rating were compared between music and non-music students. Eighty one percent of musicians experienced PRMD. Musicians experienced 6.19 pain regions on average compared to 4.31 of non-musicians. Musicians experiencing PRMD reported significantly (PMusic students presented with nearly the double amount (8.39 versus 4.37) of musculoskeletal dysfunctions per person compared to the non-music control group. Nevertheless, musicians significantly (P<0.05) rated their health more positively than the controls. Musicians presented with more pain regions and a higher amount of musculoskeletal dysfunctions. Further studies evaluating the clinical relevance and their role in the development of PRMD are warranted. Screening of musicians for musculoskeletal dysfunction may identify those musicians at increased risk. Early treatment may prevent PRMD in musicians. Additional

  18. Temperature compensated photovoltaic array

    Science.gov (United States)

    Mosher, Dan Michael

    1997-11-18

    A temperature compensated photovoltaic module (20) comprised of a series of solar cells (22) having a thermally activated switch (24) connected in parallel with several of the cells (22). The photovoltaic module (20) is adapted to charge conventional batteries having a temperature coefficient (TC) differing from the temperature coefficient (TC) of the module (20). The calibration temperatures of the switches (24) are chosen whereby the colder the ambient temperature for the module (20), the more switches that are on and form a closed circuit to short the associated solar cells (22). By shorting some of the solar cells (22) as the ambient temperature decreases, the battery being charged by the module (20) is not excessively overcharged at lower temperatures. PV module (20) is an integrated solution that is reliable and inexpensive.

  19. Imaging of musculoskeletal soft tissue infections

    Energy Technology Data Exchange (ETDEWEB)

    Turecki, Marcin B.; Taljanovic, Mihra S.; Holden, Dean A.; Hunter, Tim B.; Rogers, Lee F. [University of Arizona HSC, Department of Radiology, Tucson, AZ (United States); Stubbs, Alana Y. [Southern Arizona VA Health Care System, Department of Radiology, Tucson, AZ (United States); Graham, Anna R. [University of Arizona HSC, Department of Pathology, Tucson, AZ (United States)

    2010-10-15

    Prompt and appropriate imaging work-up of the various musculoskeletal soft tissue infections aids early diagnosis and treatment and decreases the risk of complications resulting from misdiagnosis or delayed diagnosis. The signs and symptoms of musculoskeletal soft tissue infections can be nonspecific, making it clinically difficult to distinguish between disease processes and the extent of disease. Magnetic resonance imaging (MRI) is the imaging modality of choice in the evaluation of soft tissue infections. Computed tomography (CT), ultrasound, radiography and nuclear medicine studies are considered ancillary. This manuscript illustrates representative images of superficial and deep soft tissue infections such as infectious cellulitis, superficial and deep fasciitis, including the necrotizing fasciitis, pyomyositis/soft tissue abscess, septic bursitis and tenosynovitis on different imaging modalities, with emphasis on MRI. Typical histopathologic findings of soft tissue infections are also presented. The imaging approach described in the manuscript is based on relevant literature and authors' personal experience and everyday practice. (orig.)

  20. Imaging of musculoskeletal soft tissue infections

    International Nuclear Information System (INIS)

    Turecki, Marcin B.; Taljanovic, Mihra S.; Holden, Dean A.; Hunter, Tim B.; Rogers, Lee F.; Stubbs, Alana Y.; Graham, Anna R.

    2010-01-01

    Prompt and appropriate imaging work-up of the various musculoskeletal soft tissue infections aids early diagnosis and treatment and decreases the risk of complications resulting from misdiagnosis or delayed diagnosis. The signs and symptoms of musculoskeletal soft tissue infections can be nonspecific, making it clinically difficult to distinguish between disease processes and the extent of disease. Magnetic resonance imaging (MRI) is the imaging modality of choice in the evaluation of soft tissue infections. Computed tomography (CT), ultrasound, radiography and nuclear medicine studies are considered ancillary. This manuscript illustrates representative images of superficial and deep soft tissue infections such as infectious cellulitis, superficial and deep fasciitis, including the necrotizing fasciitis, pyomyositis/soft tissue abscess, septic bursitis and tenosynovitis on different imaging modalities, with emphasis on MRI. Typical histopathologic findings of soft tissue infections are also presented. The imaging approach described in the manuscript is based on relevant literature and authors' personal experience and everyday practice. (orig.)

  1. Musculoskeletal desmoid tumours: Diagnostic imaging appearances

    International Nuclear Information System (INIS)

    Liu, Daniel; Perera, Warren; Schlicht, Stephen; Choong, Peter; Slavin, John; Pianta, Marcus

    2015-01-01

    This study aimed to discuss the role medical imaging has on diagnosis of musculoskeletal desmoid tumours and to describe their radiological appearances on various imaging modalities. Imaging of histologically proven cases of desmoid tumours at St. Vincent's Hospital Melbourne were obtained via picture archiving communication system (PACS) and then assessed by two musculoskeletal radiologists. Suitable imagings were obtained from PACS. All imaging chosen was de-identified. Desmoid tumours can occur in many areas of the body. Imaging plays an important role in the diagnosis of these tumours and magnetic resonance imaging has been the gold standard for imaging and is the most accurate in terms of assessing tumour margins and involvement of surrounding structure.

  2. Musculoskeletal manifestations of the antiphospholipid syndrome.

    Science.gov (United States)

    Noureldine, M H A; Khamashta, M A; Merashli, M; Sabbouh, T; Hughes, G R V; Uthman, I

    2016-04-01

    The scope of clinical and laboratory manifestations of the antiphospholipid syndrome (APS) has increased dramatically since its discovery in 1983, where any organ system can be involved. Musculoskeletal complications are consistently reported in APS patients, not only causing morbidity and mortality, but also affecting their quality of life. We reviewed all English papers on APS involvement in the musculoskeletal system using Google Scholar and Pubmed; all reports are summarized in a table in this review. The spectrum of manifestations includes arthralgia/arthritis, avascular necrosis of bone, bone marrow necrosis, complex regional pain syndrome type-1, muscle infarction, non-traumatic fractures, and osteoporosis. Some of these manifestations were reported in good quality studies, some of which showed an association between aPL-positivity and the occurrence of these manifestations, while others were merely described in case reports. © The Author(s) 2016.

  3. Musculoskeletal pain in children and adolescents

    DEFF Research Database (Denmark)

    Kamper, Steve J; Henschke, Nicholas; Hestbaek, Lise

    2016-01-01

    Introduction Musculoskeletal (MSK) pain in children and adolescents is responsible for substantial personal impacts and societal costs, but it has not been intensively or systematically researched. This means our understanding of these conditions is limited, and healthcare professionals have litt...... to understand these conditions at a time close to their initial onset may offer a better chance of developing effective prevention and treatment strategies.......Introduction Musculoskeletal (MSK) pain in children and adolescents is responsible for substantial personal impacts and societal costs, but it has not been intensively or systematically researched. This means our understanding of these conditions is limited, and healthcare professionals have little...... empirical evidence to underpin their clinical practice. In this article we summarise the state of the evidence concerning MSK pain in children and adolescents, and offer suggestions for future research. Results Rates of self-reported MSK pain in adolescents are similar to those in adult populations...

  4. Musculoskeletal disorders associated with HIV infection and AIDS. Part I: Infectious musculoskeletal conditions

    International Nuclear Information System (INIS)

    Tehranzadeh, Jamshid; Ter-Oganesyan, Ramon R.; Steinbach, Lynne S.

    2004-01-01

    The musculoskeletal system can be affected by a variety of abnormalities in association with human immunodeficiency virus (HIV) infection. Although not as common as complications involving other organ systems, such as the pulmonary and the central nervous systems, HIV-associated musculoskeletal disorders are sometimes the initial presentation of the viral illness. Knowledge of the existence and the characteristic appearance of the conditions affecting bone, joint, and muscle in HIV-infected patients is valuable to radiologists for diagnosis and to clinicians for detection and appropriate treatment. We reviewed recent literature to provide a comprehensive assessment of the HIV-associated musculoskeletal disorders, and present radiologic examples from our own collection. This article is divided into two parts. In the first part we review the infectious musculoskeletal disorders associated with HIV illness and AIDS, including cellulitis, abscesses, pyomyositis, septic bursitis, septic arthritis, osteomyelitis, and bacillary angiomatosis. We also present a comprehensive spectrum of mycobacterial infections, consisting of tuberculous spondylitis and spondylodiskitis, arthritis, osteomyelitis, and tenosynovitis, as well as infections caused by atypical mycobacteria. Part II of this review will concentrate on non-infectious musculoskeletal conditions, including rheumatic disorders and neoplasms. (orig.)

  5. Musculoskeletal disorders associated with HIV infection and AIDS. Part I: Infectious musculoskeletal conditions

    Energy Technology Data Exchange (ETDEWEB)

    Tehranzadeh, Jamshid [Department of Radiological Sciences, University of California, Irvine, Irvine, California (United States); Department of Radiological Sciences, Rt. 140, 101 The City Drive ZC 5005, CA 92868-3298, Orange (United States); Ter-Oganesyan, Ramon R. [College of Medicine, University of California, Irvine, Irvine, California (United States); Steinbach, Lynne S. [Department of Radiological Sciences, University of California, San Francisco, San Francisco, California (United States)

    2004-05-01

    The musculoskeletal system can be affected by a variety of abnormalities in association with human immunodeficiency virus (HIV) infection. Although not as common as complications involving other organ systems, such as the pulmonary and the central nervous systems, HIV-associated musculoskeletal disorders are sometimes the initial presentation of the viral illness. Knowledge of the existence and the characteristic appearance of the conditions affecting bone, joint, and muscle in HIV-infected patients is valuable to radiologists for diagnosis and to clinicians for detection and appropriate treatment. We reviewed recent literature to provide a comprehensive assessment of the HIV-associated musculoskeletal disorders, and present radiologic examples from our own collection. This article is divided into two parts. In the first part we review the infectious musculoskeletal disorders associated with HIV illness and AIDS, including cellulitis, abscesses, pyomyositis, septic bursitis, septic arthritis, osteomyelitis, and bacillary angiomatosis. We also present a comprehensive spectrum of mycobacterial infections, consisting of tuberculous spondylitis and spondylodiskitis, arthritis, osteomyelitis, and tenosynovitis, as well as infections caused by atypical mycobacteria. Part II of this review will concentrate on non-infectious musculoskeletal conditions, including rheumatic disorders and neoplasms. (orig.)

  6. [Musculoskeletal disorders among university student computer users].

    Science.gov (United States)

    Lorusso, A; Bruno, S; L'Abbate, N

    2009-01-01

    Musculoskeletal disorders are a common problem among computer users. Many epidemiological studies have shown that ergonomic factors and aspects of work organization play an important role in the development of these disorders. We carried out a cross-sectional survey to estimate the prevalence of musculoskeletal symptoms among university students using personal computers and to investigate the features of occupational exposure and the prevalence of symptoms throughout the study course. Another objective was to assess the students' level of knowledge of computer ergonomics and the relevant health risks. A questionnaire was distributed to 183 students attending the lectures for second and fourth year courses of the Faculty of Architecture. Data concerning personal characteristics, ergonomic and organizational aspects of computer use, and the presence of musculoskeletal symptoms in the neck and upper limbs were collected. Exposure to risk factors such as daily duration of computer use, time spent at the computer without breaks, duration of mouse use and poor workstation ergonomics was significantly higher among students of the fourth year course. Neck pain was the most commonly reported symptom (69%), followed by hand/wrist (53%), shoulder (49%) and arm (8%) pain. The prevalence of symptoms in the neck and hand/wrist area was signifcantly higher in the students of the fourth year course. In our survey we found high prevalence of musculoskeletal symptoms among university students using computers for long time periods on a daily basis. Exposure to computer-related ergonomic and organizational risk factors, and the prevalence ofmusculoskeletal symptoms both seem to increase significantly throughout the study course. Furthermore, we found that the level of perception of computer-related health risks among the students was low. Our findings suggest the need for preventive intervention consisting of education in computer ergonomics.

  7. Musculoskeletal symptoms in pharmaceutical sales representatives.

    Science.gov (United States)

    Sang, Katherine; Gyi, Diane; Haslam, Cheryl

    2010-03-01

    Musculoskeletal disorders (MSDs) are a leading cause of work-related ill health. Existing literature indicates that pharmaceutical sales representatives (PSRs) report a high prevalence of MSDs, possibly exacerbated by the nature of work (prolonged driving and manual handling). In addition, they experience difficulty in accessing occupational health services. To assess the prevalence of musculoskeletal symptoms and associated risk factors among PSRs in order to assist their occupational health management through raising risk awareness. A self-completed questionnaire distributed to 205 PSRs within a UK pharmaceutical company was used to assess the prevalence of musculoskeletal symptoms, psychosocial factors, work tasks undertaken and company car use. To assist understanding of work tasks and organizational factors, semi-structured interviews were undertaken with a sample of 12 key personnel. The questionnaire response rate was 68%. PSRs reported high mileage and 100% reported working from the car in a typical day. Forty-seven per cent reported both manual handling for > or = 4 h/day and 'often' or 'sometimes' working from the car. Fifty-seven per cent reported low back symptoms in the last 12 months. Interview data revealed issues relating to car choice, storage in the boot and working from the car, which should be considered when developing priorities for preventive management of MSDs. Musculoskeletal symptoms appear to be a problem for PSRs, with risk factors reported as prolonged driving, sitting in the car, working from the car and manual handling. Interventions to facilitate their occupational health management should focus on raising awareness of the risks of prolonged driving and working from the car.

  8. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    OpenAIRE

    Susan Armijo-Olivo; David Magee

    2012-01-01

    ABSTRACT Objectives The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maxima...

  9. Musculoskeletal Injuries and Their Associated Risk Factors

    OpenAIRE

    M Jahangiri; H Rahimi Fard; A.R Choobineh; S Mahmood Khani

    2012-01-01

    Background and aims :Prevalence of musculoskeletal disorders (MSDs) is high among office workers. Long time seated posture, working with computer, repetitive movements and inappropriate environmental conditions may have causal effects in these disorders. High prevalence rate of MSDs makes ergonomics assessment and working conditions improvement necessary. Designing an assessment checklist and calculating ergonomics indices can be useful in this evaluation. This study was conducted with the ob...

  10. Prenatal sonographic diagnosis of focal musculoskeletal anomalies

    International Nuclear Information System (INIS)

    Ryu, Jung-Kyu; Cho, Jeong-Yeon; Choi, Jong-Sun

    2003-01-01

    Focal musculoskeletal anomalies vary, and can manifest as part of a syndrome or be accompanied by numerous other conditions such as genetic disorders, karyotype abnormalities, central nervous system anomalies and other skeletal anomalies, lsolated focal musculoskeletal anomaly does, however, also occur; its early prenatal diagnosis is important in deciding prenatal care, and also helps in counseling parents about the postnatal effects of numerous possible associated anomalies. We have encountered 50 cases involving focal musculoskeletal anomalies, including total limb dysplasia [radial ray abnormality (n=3), mesomelic dysplasia (n=1)]; anomalies of the hand [polydactyly (n=8), syndactyly (n=3), ectrodactyly (n=1), clinodactyly (n=6), clenched hand (n=5)]; anomalies of the foot [clubfoot (n=10), rockerbottom foot (n=5), sandal gap deformity (n=1), curly toe (n=2)]; amniotic band syndrome (n=3); and anomalies of the focal spine [block vertebra (n=1), hemivertebra (n=1)]. Among these 50 cases, five [polydactyly (n=1), syndactyly (n=2) and curly toe (n=2) were confirmed by postnatal physical evaluation, two (focal spine anomalies) were diagnosed after postnatal radiologic examination, and the remaining 43 were proven at autopsy. For each condition, we describe the prenatal sonographic findings, and include a brief review

  11. Prenatal sonographic diagnosis of focal musculoskeletal anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jung-Kyu; Cho, Jeong-Yeon; Choi, Jong-Sun [Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2003-12-15

    Focal musculoskeletal anomalies vary, and can manifest as part of a syndrome or be accompanied by numerous other conditions such as genetic disorders, karyotype abnormalities, central nervous system anomalies and other skeletal anomalies, lsolated focal musculoskeletal anomaly does, however, also occur; its early prenatal diagnosis is important in deciding prenatal care, and also helps in counseling parents about the postnatal effects of numerous possible associated anomalies. We have encountered 50 cases involving focal musculoskeletal anomalies, including total limb dysplasia [radial ray abnormality (n=3), mesomelic dysplasia (n=1)]; anomalies of the hand [polydactyly (n=8), syndactyly (n=3), ectrodactyly (n=1), clinodactyly (n=6), clenched hand (n=5)]; anomalies of the foot [clubfoot (n=10), rockerbottom foot (n=5), sandal gap deformity (n=1), curly toe (n=2)]; amniotic band syndrome (n=3); and anomalies of the focal spine [block vertebra (n=1), hemivertebra (n=1)]. Among these 50 cases, five [polydactyly (n=1), syndactyly (n=2) and curly toe (n=2) were confirmed by postnatal physical evaluation, two (focal spine anomalies) were diagnosed after postnatal radiologic examination, and the remaining 43 were proven at autopsy. For each condition, we describe the prenatal sonographic findings, and include a brief review.

  12. An entropy-assisted musculoskeletal shoulder model.

    Science.gov (United States)

    Xu, Xu; Lin, Jia-Hua; McGorry, Raymond W

    2017-04-01

    Optimization combined with a musculoskeletal shoulder model has been used to estimate mechanical loading of musculoskeletal elements around the shoulder. Traditionally, the objective function is to minimize the summation of the total activities of the muscles with forces, moments, and stability constraints. Such an objective function, however, tends to neglect the antagonist muscle co-contraction. In this study, an objective function including an entropy term is proposed to address muscle co-contractions. A musculoskeletal shoulder model is developed to apply the proposed objective function. To find the optimal weight for the entropy term, an experiment was conducted. In the experiment, participants generated various 3-D shoulder moments in six shoulder postures. The surface EMG of 8 shoulder muscles was measured and compared with the predicted muscle activities based on the proposed objective function using Bhattacharyya distance and concordance ratio under different weight of the entropy term. The results show that a small weight of the entropy term can improve the predictability of the model in terms of muscle activities. Such a result suggests that the concept of entropy could be helpful for further understanding the mechanism of muscle co-contractions as well as developing a shoulder biomechanical model with greater validity. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Magnetic resonance of the musculoskeletal system

    International Nuclear Information System (INIS)

    Berquist, T.H.

    1987-01-01

    This book provides a review of the principles and techniques of musculoskeletal MRI and its broad range of diagnostic applications. Opening chapters of the book summarize the principles of musculoskeletal MRI, explaining how these principles can be applied to provide optimal tissue contrast and characterization. Step-by-step guidelines are then offered on patient selection, positioning, and coil techniques, with full consideration of how coils, number of averages, matrix size, repetition time, and other factors affect image quality. Patient throughput and the most commonly used pulse sequences are also discussed. The book features coverage of the use of MRI in evaluation of specific diseases: bone and soft tissue tumors;infections;musculoskeletal trauma;spinal disorders;and miscellaneous conditions. The authors' comparisons of MRI with computed tomography, ultrasound, isotopes, and other techniques will assist the physician in determining which clinical problems are best evaluated by MRI. Where MRI is the optimal technique, the text outlines the examination procedure, indicates which sequences provide the most information, and describes the pathologic findings that can be observed in MRI scans

  14. Prevalence of Musculoskeletal Disorders Among Office Workers

    Directory of Open Access Journals (Sweden)

    Valipour Noroozi

    2015-01-01

    Full Text Available Background Musculoskeletal disorders are among common occupational diseases in the world, which have high prevalence not only among hard and hurtful jobs, but also in office works. Objectives The purpose of this study was to describe the prevalence of musculoskeletal disorders (MSDs among office workers of Ahvaz Jundishapur University of Medical Sciences. Patients and Methods This study carried out intermittently among 392 individuals of Ahvaz Jundishapur University of Medical Sciences office workers by Nordic questionnaire from October 2013 to December 2013. Study population included office workers of different departments as well as central organization and library. We use descriptive statistic, t test and chi-square test for data analysis. Results The mean and standard deviation of participants’ age was 35.4 ± 6.7 years and their work experience was 9.7 ± 6.65 years, respectively. Most signs (51% were in back region, which forced 18.9% of individuals to withdraw from daily activities. Statistical analysis also showed 36.7% neck disorders in office workers, which demonstrated significant association with age and work experience (P < 0.001. Conclusions Significant association of work experience and age with musculoskeletal disorders shows that individual’s education and knowledge improvements with regard to ergonomics risk factors and correction of work postures are very important and ought to follow management and technical practices in the organization.

  15. Musculoskeletal injuries among Malaysian badminton players.

    Science.gov (United States)

    Shariff, A H; George, J; Ramlan, A A

    2009-11-01

    The purpose of this study was to investigate the pattern of musculoskeletal injuries sustained by Malaysian badminton players. This is a retrospective case notes review of all badminton players who attended the National Sports Institute (NSI) Clinic, Kuala Lumpur, Malaysia, and were diagnosed with musculoskeletal injuries. In a two and a half year period, from January 2005 to June 2007, 469 musculoskeletal injuries were diagnosed among badminton players at the NSI Clinic. The mean age of the players who attended the clinic was 19.2 (range 13-52) years. Approximately 60 percent of the injuries occurred in players younger than 20 years of age. The majority of injuries (91.5 percent) were categorised as mild overuse injury and mostly involved the knee. The majority of the injuries sustained by badminton players in this study were due to overuse, primarily in the knee. The majority of the injuries were diagnosed in younger players and occurred during training/practice sessions. There was no difference in terms of incidence and types of injuries between the genders.

  16. Takeovers and (Excess) CEO Compensation

    NARCIS (Netherlands)

    Feito Ruiz, Isabel; Renneboog, Luc

    2017-01-01

    We study if a CEO’s equity-based compensation affects the expected value generation in takeovers. When the objectives of management and shareholders are more aligned, as proxied by the use of equity-based compensation, more value-maximizing acquisitions are expected. Whereas in widely-held firms the

  17. Takeovers and (excess) CEO compensation

    NARCIS (Netherlands)

    Feito Ruiz, Isabel; Renneboog, Luc

    We study if a CEO’s equity-based compensation affects the expected value generation in takeovers. When the objectives of management and shareholders are more aligned, as proxied by the use of equity-based compensation, more value-maximizing acquisitions are expected. Whereas in widely-held firms the

  18. Changing Conceptions of Employee Compensation

    Science.gov (United States)

    Dixon, Mark R.; Hayes, Linda J.

    2004-01-01

    This paper reviews and discusses many differing forms of incentive compensation systems that are being used in today's organizations. The review traces the roots of bonus compensation from individual piece-work plans through the adoption of organization-wide gain sharing plans to the growing recognition of open-book management. Reasons for the…

  19. Musculoskeletal disorders associated with HIV infection and AIDS. Part II: Non-infectious musculoskeletal conditions

    International Nuclear Information System (INIS)

    Tehranzadeh, Jamshid; Ter-Oganesyan, Ramon R.; Steinbach, Lynne S.

    2004-01-01

    This section of a two-part series on musculoskeletal disorders associated with HIV infection and AIDS reviews the non-infectious musculoskeletal conditions. In the first part, the infectious conditions were reviewed. The non-infectious conditions include polymyositis, drug-induced myopathy, myositis ossificans, adhesive capsulitis, avascular necrosis, bone marrow abnormalities, and hypertrophic osteoarthropathy. Inflammatory and reactive arthropathies are more prevalent in HIV-positive individuals, and a separate section is dedicated to these conditions, including Reiter's syndrome, psoriatic arthritis, HIV-associated arthritis, painful articular syndrome, and acute symmetric polyarthritis. Lastly, we include a discussion of HIV-related neoplastic processes that affect the musculoskeletal system, namely Kaposi's sarcoma and non-Hodgkin's lymphoma. (orig.)

  20. Musculoskeletal disorders associated with HIV infection and AIDS. Part II: Non-infectious musculoskeletal conditions

    Energy Technology Data Exchange (ETDEWEB)

    Tehranzadeh, Jamshid [Department of Radiological Sciences, University of California, Irvine, CA (United States); Department of Radiological Sciences, Orange, CA (United States); Ter-Oganesyan, Ramon R. [College of Medicine, University of California, Irvine, CA (United States); Steinbach, Lynne S. [Department of Radiological Sciences, University of California, San Francisco (United States)

    2004-06-01

    This section of a two-part series on musculoskeletal disorders associated with HIV infection and AIDS reviews the non-infectious musculoskeletal conditions. In the first part, the infectious conditions were reviewed. The non-infectious conditions include polymyositis, drug-induced myopathy, myositis ossificans, adhesive capsulitis, avascular necrosis, bone marrow abnormalities, and hypertrophic osteoarthropathy. Inflammatory and reactive arthropathies are more prevalent in HIV-positive individuals, and a separate section is dedicated to these conditions, including Reiter's syndrome, psoriatic arthritis, HIV-associated arthritis, painful articular syndrome, and acute symmetric polyarthritis. Lastly, we include a discussion of HIV-related neoplastic processes that affect the musculoskeletal system, namely Kaposi's sarcoma and non-Hodgkin's lymphoma. (orig.)

  1. Obesity, Metabolic Syndrome, and Musculoskeletal Disease: Common Inflammatory Pathways Suggest a Central Role for Loss of Muscle Integrity

    Directory of Open Access Journals (Sweden)

    Kelsey H. Collins

    2018-02-01

    Full Text Available Inflammation can arise in response to a variety of stimuli, including infectious agents, tissue injury, autoimmune diseases, and obesity. Some of these responses are acute and resolve, while others become chronic and exert a sustained impact on the host, systemically, or locally. Obesity is now recognized as a chronic low-grade, systemic inflammatory state that predisposes to other chronic conditions including metabolic syndrome (MetS. Although obesity has received considerable attention regarding its pathophysiological link to chronic cardiovascular conditions and type 2 diabetes, the musculoskeletal (MSK complications (i.e., muscle, bone, tendon, and joints that result from obesity-associated metabolic disturbances are less frequently interrogated. As musculoskeletal diseases can lead to the worsening of MetS, this underscores the imminent need to understand the cause and effect relations between the two, and the convergence between inflammatory pathways that contribute to MSK damage. Muscle mass is a key predictor of longevity in older adults, and obesity-induced sarcopenia is a significant risk factor for adverse health outcomes. Muscle is highly plastic, undergoes regular remodeling, and is responsible for the majority of total body glucose utilization, which when impaired leads to insulin resistance. Furthermore, impaired muscle integrity, defined as persistent muscle loss, intramuscular lipid accumulation, or connective tissue deposition, is a hallmark of metabolic dysfunction. In fact, many common inflammatory pathways have been implicated in the pathogenesis of the interrelated tissues of the musculoskeletal system (e.g., tendinopathy, osteoporosis, and osteoarthritis. Despite these similarities, these diseases are rarely evaluated in a comprehensive manner. The aim of this review is to summarize the common pathways that lead to musculoskeletal damage and disease that result from and contribute to MetS. We propose the overarching

  2. Obesity, Metabolic Syndrome, and Musculoskeletal Disease: Common Inflammatory Pathways Suggest a Central Role for Loss of Muscle Integrity.

    Science.gov (United States)

    Collins, Kelsey H; Herzog, Walter; MacDonald, Graham Z; Reimer, Raylene A; Rios, Jaqueline L; Smith, Ian C; Zernicke, Ronald F; Hart, David A

    2018-01-01

    Inflammation can arise in response to a variety of stimuli, including infectious agents, tissue injury, autoimmune diseases, and obesity. Some of these responses are acute and resolve, while others become chronic and exert a sustained impact on the host, systemically, or locally. Obesity is now recognized as a chronic low-grade, systemic inflammatory state that predisposes to other chronic conditions including metabolic syndrome (MetS). Although obesity has received considerable attention regarding its pathophysiological link to chronic cardiovascular conditions and type 2 diabetes, the musculoskeletal (MSK) complications (i.e., muscle, bone, tendon, and joints) that result from obesity-associated metabolic disturbances are less frequently interrogated. As musculoskeletal diseases can lead to the worsening of MetS, this underscores the imminent need to understand the cause and effect relations between the two, and the convergence between inflammatory pathways that contribute to MSK damage. Muscle mass is a key predictor of longevity in older adults, and obesity-induced sarcopenia is a significant risk factor for adverse health outcomes. Muscle is highly plastic, undergoes regular remodeling, and is responsible for the majority of total body glucose utilization, which when impaired leads to insulin resistance. Furthermore, impaired muscle integrity, defined as persistent muscle loss, intramuscular lipid accumulation, or connective tissue deposition, is a hallmark of metabolic dysfunction. In fact, many common inflammatory pathways have been implicated in the pathogenesis of the interrelated tissues of the musculoskeletal system (e.g., tendinopathy, osteoporosis, and osteoarthritis). Despite these similarities, these diseases are rarely evaluated in a comprehensive manner. The aim of this review is to summarize the common pathways that lead to musculoskeletal damage and disease that result from and contribute to MetS. We propose the overarching hypothesis that there

  3. Musculoskeletal applications of magnetic resonance imaging: Council on Scientific Affairs

    International Nuclear Information System (INIS)

    Harms, S.E.; Fisher, C.F.; Fulmer, J.M.

    1989-01-01

    Magnetic resonance imaging provides superior contrast, resolution, and multiplanar imaging capability, allowing excellent definition of soft-tissue and bone marrow abnormalities. For these reasons, magnetic resonance imaging has become a major diagnostic imaging method for the evaluation of many musculoskeletal disorders. The applications of magnetic resonance imaging for musculoskeletal diagnosis are summarized and examples of common clinical situations are given. General guidelines are suggested for the musculoskeletal applications of magnetic resonance imaging

  4. Prevalence and predictors of musculoskeletal pain among Danish fishermen

    DEFF Research Database (Denmark)

    Berg-Beckhoff, Gabriele; Østergaard, Helle; Jepsen, Jørgen Riis

    2016-01-01

    at sea, age, BMI and education were used as predictors for the overall musculoskeletal pain score (multiple linear regression) and for each single pain site (multinomial logistic regression). RESULTS: The prevalence of pain was high for all musculoskeletal locations. Overall, more than 80...... demanding and impacting their musculoskeletal pain. Potential explanation for this unexpected result like increased work pressure and reduced financial attractiveness in small scale commercial fishery needs to be confirmed in future research....

  5. Compensated pulsed alternator

    International Nuclear Information System (INIS)

    Weldon, W.F.; Driga, M.D.; Woodson, H.H.

    1980-01-01

    This invention relates to an electromechanical energy converter with inertial energy storage. The device, a single phase, two or multi-pole alternator with stationary field coils, and a rotating armature is provided. The rotor itself may be of laminated steel for slower pulses or for faster pulses should be nonmagnetic and electrically nonconductive in order to allow rapid penetration of the field as the armature coil rotates. The armature coil comprises a plurality of power generating conductors mounted on the rotor. The alternator may also include a stationary or counterrotating compensating coil to increase the output voltage thereof and to reduce the internal impedance of the alternator at the moment of peak output. As the machine voltage rises sinusoidally, an external trigger switch is adapted to be closed at the appropriate time to create the desired output current from said alternator to an external load circuit, and as the output current passes through zero a self-commutating effect is provided to allow the switch to disconnect the generator from the external circuit

  6. Stabilized thermally compensated mirror

    International Nuclear Information System (INIS)

    Dunn, C. III; Tobin, R.D.; Bergstreser, N.E.; Heinz, T.A.

    1975-01-01

    A thermally compensated mirror is described that is formed by a laminated structure. The structure is comprised of a front plate having a reflective front surface and having a plurality of grooves formed in the rear surface for conducting coolant fluid in heat exchanging relation with said reflective surface, a rear plate having coolant inlet and coolant outlet openings extending therethrough, a minimum temperature plate interposed between said front and rear plates and formed with a plurality of coolant distribution passageways coupled to receive coolant fluid from said coolant inlet and oriented to distribute said coolant fluid in a manner to establish a minimum temperature plane parallel to said reflective surface, a temperature stabilization plate interposed between said front plate and said minimum temperature plate and formed with a plurality of coolant distribution channels coupled to receive said coolant fluid after said coolant fluid has passed in heat exchanging relation with said reflective surface and oriented to distribute said coolant fluid in a manner to establish a uniform temperature plane parallel to said reflective surface, and means for circulating said coolant fluid through said structure in a predetermined path. (U.S.)

  7. [Vestibular compensation studies]. [Vestibular Compensation and Morphological Studies

    Science.gov (United States)

    Perachio, Adrian A. (Principal Investigator)

    1996-01-01

    The following topics are reported: neurophysiological studies on MVN neurons during vestibular compensation; effects of spinal cord lesions on VNC neurons during compensation; a closed-loop vestibular compensation model for horizontally canal-related MVN neurons; spatiotemporal convergence in VNC neurons; contributions of irregularly firing vestibular afferents to linear and angular VOR's; application to flight studies; metabolic measures in vestibular neurons; immediate early gene expression following vestibular stimulation; morphological studies on primary afferents, central vestibular pathways, vestibular efferent projection to the vestibular end organs, and three-dimensional morphometry and imaging.

  8. Design Approach of Biologically-Inspired Musculoskeletal Humanoids

    Directory of Open Access Journals (Sweden)

    Yuto Nakanishi

    2013-04-01

    Full Text Available In order to realize more natural and various motions like humans, humanlike musculoskeletal tendon-driven humanoids have been studied. Especially, it is very challenging to design musculoskeletal body structure which consists of complicated bones, redundant powerful and flexible muscles, and large number of distributed sensors. In addition, it is very challenging to reveal humanlike intelligence to manage these complicated musculoskeletal body structure. This paper sums up life-sized musculoskeletal humanoids Kenta, Kotaro, Kenzoh and Kenshiro which we have developed so far, and describes key technologies to develop and control these robots.

  9. An Interpreter's Interpretation: Sign Language Interpreters' View of Musculoskeletal Disorders

    National Research Council Canada - National Science Library

    Johnson, William L

    2003-01-01

    Sign language interpreters are at increased risk for musculoskeletal disorders. This study used content analysis to obtain detailed information about these disorders from the interpreters' point of view...

  10. Scaling of musculoskeletal models from static and dynamic trials

    DEFF Research Database (Denmark)

    Lund, Morten Enemark; Andersen, Michael Skipper; de Zee, Mark

    2015-01-01

    Subject-specific scaling of cadaver-based musculoskeletal models is important for accurate musculoskeletal analysis within multiple areas such as ergonomics, orthopaedics and occupational health. We present two procedures to scale ‘generic’ musculoskeletal models to match segment lengths and joint...... three scaling methods to an inverse dynamics-based musculoskeletal model and compared predicted knee joint contact forces to those measured with an instrumented prosthesis during gait. Additionally, a Monte Carlo study was used to investigate the sensitivity of the knee joint contact force to random...

  11. Chronic pelvic pain arising from dysfunctional stabilizing muscles of the hip joint and pelvis

    OpenAIRE

    Lee, Dae Wook; Lim, Chang Hun; Han, Jae Young; Kim, Woong Mo

    2016-01-01

    Chronic pelvic pain in women is a very annoying condition that is responsible for substantial suffering and medical expense. But dealing with this pain can be tough, because there are numerous possible causes for the pelvic pain such as urologic, gynecologic, gastrointestinal, neurologic, or musculoskeletal problems. Of these, musculoskeletal problem may be a primary cause of chronic pelvic pain in patients with a preceding trauma to the low back, pelvis, or lower extremities. Here, we report...

  12. Skew quad compensation at PEP

    International Nuclear Information System (INIS)

    Murray, J.J.

    1977-10-01

    Rotational and focal effects of solenoids used in PEP detectors will cause severe perturbations of machine beam optics and must be corrected. Ordinarily this would be accomplished by the addition of compensating solenoids and adjustment of insertion quadrupole strengths. It has been found that an arbitrary cross plane coupling representing the effects of solenoids and/or skew quads in any combination can be synthesized (or compensated) exactly using a quartet of skew quads combined with other erect transport elements in a wide variety of configurations. Specific skew quad compensating systems for PEP have been designed and are under study by PEP staff. So far no fundamental flaws have been discovered. In view of that, PEP management has tentatively authorized the use of such a system in the PEP-4, PEP-9 experiments and proposes to leave the question open ''without prejudice'' for other experiments. Use of skew quad compensation involves an imponderable risk, of course, simply because the method is new and untested. But in addition to providing the only known method for dealing with skew quad perturbations, skew quad compensation, as an alternate to compensating solenoids, promises to be much cheaper, to require much less power and to occupy much less space in the IR's. The purpose of this note is to inform potential users of the foregoing situation and to explain skew quad compensation more fully. 2 refs., 1 fig., 1 tab

  13. A primer for workers' compensation.

    Science.gov (United States)

    Bible, Jesse E; Spengler, Dan M; Mir, Hassan R

    2014-07-01

    A physician's role within a workers' compensation injury extends far beyond just evaluation and treatment with several socioeconomic and psychological factors at play compared with similar injuries occurring outside of the workplace. Although workers' compensation statutes vary among states, all have several basic features with the overall goal of returning the injured worker to maximal function in the shortest time period, with the least residual disability and shortest time away from work. To help physicians unfamiliar with the workers' compensation process accomplish these goals. Review. Educational review. The streamlined review addresses the topics of why is workers' compensation necessary; what does workers' compensation cover; progression after work injury; impairment and maximum medical improvement, including how to use the sixth edition of American Medical Association's (AMA) Guides to the evaluation of permanent impairment (Guides); completion of work injury claim after impairment rating; independent medical evaluation; and causation. In the "no-fault" workers' compensation system, physicians play a key role in progressing the claim along and, more importantly, getting the injured worker back to work as soon as safely possible. Physicians should remain familiar with the workers' compensation process, along with how to properly use the AMA Guides. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. The Pilates method in the rehabilitation of musculoskeletal disorders: a systematic review

    Directory of Open Access Journals (Sweden)

    Josiane Cristiane Cruz

    Full Text Available Abstract Introduction: Joseph Pilates created an authentic method of physical and mental conditioning, which he called Contrology and defined as the complete coordination of body, mind and spirit. Recent studies indicate that the Pilates Method is a useful tool in rehabilitation can improve overall health, sports performance and help in the prevention and attenuation of injuries and disorders of the musculoskeletal system. Musculoskeletal disorders are prevalent and costly conditions that develop gradually, presenting a chronic course and often remain untreated. Objective: This study aimed to identify the effects of the Pilates Method in the rehabilitation of musculoskeletal disorders through a systematic review. Methods: An active search was performed in the PubMed, PEDro, Scielo and Bireme databases. A total of 24 studies were pre-selected and their methodological quality was evaluated based on the PEDro scale. Of these, 14 fulfilled the selection criteria. Results: The studies analyzed indicate that Pilates can be effective both for the treatment of conditions such as scoliosis, back pain, ankylosing spondylitis and breast cancer, and for preventing injuries in adults, elderly people and athletes. Conclusion: The high methodological variability requires that these studies be viewed with caution. It indicates the need for the performance of new studies with high methodological quality and standardization of evaluation instruments.

  15. Shockwave treatment for musculoskeletal diseases and bone consolidation: qualitative analysis of the literature

    Directory of Open Access Journals (Sweden)

    Paulo Kertzman

    2015-02-01

    Full Text Available Shockwave treatment is an option within orthopedics. The exact mechanism through which shockwaves function for treating musculoskeletal diseases is unknown. The aim of this study was to make a qualitative analysis on the effectiveness of shockwave treatment among patients with musculoskeletal pathological conditions and pseudarthrosis. Searches were conducted in the Cochrane Library, Medline and Lilacs databases. Thirty-nine studies that reported using shockwave treatment for musculoskeletal diseases were found. Their results varied greatly, as did the types of protocol used. The studies that evaluated the effectiveness of shockwave treatment for lateral epicondylitis, shoulder tendinopathy, knee osteoarthrosis, femoral head osteonecrosis and trochanteric bursitis reported inconsistent results for most of their patients. Those that evaluated patients with calcifying tendinopathy, plantar fasciitis, Achilles tendinopathy, patellar tendinopathy and pseudarthrosis showed benefits. Shockwave treatment is a safe and non-invasive method for chronic cases in which conventional techniques have been unsatisfactory and should be used in association with other treatment methods for tendinopathy. Further quality studies are needed.

  16. Medication adherence in patients with rheumatoid arthritis: the effect of patient education, health literacy, and musculoskeletal ultrasound.

    Science.gov (United States)

    Joplin, Samantha; van der Zwan, Rick; Joshua, Fredrick; Wong, Peter K K

    2015-01-01

    Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease affecting educational levels and limited health literacy are contributory factors. Psychological models may assist in explaining medication nonadherence. Increasing patient knowledge of their disease seems sensible. Existing educational interventions appear ineffective at improving medication adherence, probably due to an overemphasis on provision of biomedical information. A novel approach to patient education using musculoskeletal ultrasound is proposed.

  17. Assessment of the structure of the Hospital Anxiety and Depression Scale in musculoskeletal patients

    Directory of Open Access Journals (Sweden)

    Bailey Catherine M

    2005-12-01

    Full Text Available Abstract Background Research suggests there is a high prevalence of anxiety and depression amongst patients with chronic musculoskeletal pain, which can influence the effectiveness of rehabilitation programs. It is therefore important for clinicians involved in musculoskeletal rehabilitation programs to consider screening patients for elevated levels of anxiety and depression and to provide appropriate counselling or treatment where necessary. The HADS has been used as a screening tool for assessment of anxiety and depression in a wide variety of clinical groups. Recent research however has questioned its suitability for use with some patient groups due to problems with dimensionality and the behaviour of individual items. The aim of this study is to assess the underlying structure and psychometric properties of the HADS among patients attending musculoskeletal rehabilitation. Methods Data was obtained from 296 patients attending an outpatient musculoskeletal pain clinic. The total sample was used to identify the proportion of patients with elevated levels of anxiety and depression. Half the sample (n = 142 was used for exploratory factor analysis (EFA, with the holdout sample (n = 154 used for confirmatory factor analysis (CFA to explore the underlying structure of the scale. Results A substantial proportion of patients were classified as probable cases on the HADS Anxiety subscale (38.2% and HADS Depression subscale (30.1%, with the sample recording higher mean HADS subscales scores than many other patient groups (breast cancer, end-stage renal disease, heart disease reported in the literature. EFA supported a two factor structure (representing anxiety and depression as proposed by the scale's authors, however item 7 (an anxiety item failed to load appropriately. Removing Item 7 resulted in a clear two factor solution in both EFA and CFA. Conclusion The high levels of anxiety and depression detected in this sample suggests that screening for

  18. Assessment of the structure of the Hospital Anxiety and Depression Scale in musculoskeletal patients

    Science.gov (United States)

    Pallant, Julie F; Bailey, Catherine M

    2005-01-01

    Background Research suggests there is a high prevalence of anxiety and depression amongst patients with chronic musculoskeletal pain, which can influence the effectiveness of rehabilitation programs. It is therefore important for clinicians involved in musculoskeletal rehabilitation programs to consider screening patients for elevated levels of anxiety and depression and to provide appropriate counselling or treatment where necessary. The HADS has been used as a screening tool for assessment of anxiety and depression in a wide variety of clinical groups. Recent research however has questioned its suitability for use with some patient groups due to problems with dimensionality and the behaviour of individual items. The aim of this study is to assess the underlying structure and psychometric properties of the HADS among patients attending musculoskeletal rehabilitation. Methods Data was obtained from 296 patients attending an outpatient musculoskeletal pain clinic. The total sample was used to identify the proportion of patients with elevated levels of anxiety and depression. Half the sample (n = 142) was used for exploratory factor analysis (EFA), with the holdout sample (n = 154) used for confirmatory factor analysis (CFA) to explore the underlying structure of the scale. Results A substantial proportion of patients were classified as probable cases on the HADS Anxiety subscale (38.2%) and HADS Depression subscale (30.1%), with the sample recording higher mean HADS subscales scores than many other patient groups (breast cancer, end-stage renal disease, heart disease) reported in the literature. EFA supported a two factor structure (representing anxiety and depression) as proposed by the scale's authors, however item 7 (an anxiety item) failed to load appropriately. Removing Item 7 resulted in a clear two factor solution in both EFA and CFA. Conclusion The high levels of anxiety and depression detected in this sample suggests that screening for psychological

  19. Altitude Compensating Nozzle

    Science.gov (United States)

    Ruf, Joseph H.; Jones, Daniel

    2015-01-01

    The dual-bell nozzle (fig. 1) is an altitude-compensating nozzle that has an inner contour consisting of two overlapped bells. At low altitudes, the dual-bell nozzle operates in mode 1, only utilizing the smaller, first bell of the nozzle. In mode 1, the nozzle flow separates from the wall at the inflection point between the two bell contours. As the vehicle reaches higher altitudes, the dual-bell nozzle flow transitions to mode 2, to flow full into the second, larger bell. This dual-mode operation allows near optimal expansion at two altitudes, enabling a higher mission average specific impulse (Isp) relative to that of a conventional, single-bell nozzle. Dual-bell nozzles have been studied analytically and subscale nozzle tests have been completed.1 This higher mission averaged Isp can provide up to a 5% increase2 in payload to orbit for existing launch vehicles. The next important step for the dual-bell nozzle is to confirm its potential in a relevant flight environment. Toward this end, NASA Marshall Space Flight Center (MSFC) and Armstrong Flight Research Center (AFRC) have been working to develop a subscale, hot-fire, dual-bell nozzle test article for flight testing on AFRC's F15-D flight test bed (figs. 2 and 3). Flight test data demonstrating a dual-bell ability to control the mode transition and result in a sufficient increase in a rocket's mission averaged Isp should help convince the launch service providers that the dual-bell nozzle would provide a return on the required investment to bring a dual-bell into flight operation. The Game Changing Department provided 0.2 FTE to ER42 for this effort in 2014.

  20. What Constitutes Fair Compensation for Unfair Dismissal

    African Journals Online (AJOL)

    user

    Generally the monetary compensation is perceived to be a solatium. 19 .... compensation for non-patrimonial loss in the context of an unfair labour practice. 41 .... awards of compensation where a person's dignity is impaired in the course of an.

  1. The Fear of Movement/Pain in Musculoskeletal Pain-A Review

    Directory of Open Access Journals (Sweden)

    Behnam Akhbari

    2012-07-01

    Full Text Available Objective: To investigate and review psychological influences of pain such as kinesiophobia and pain-related fear on patients with musculoskeletal pain and on rehabilitation outcomes. Materials & Methods: Fear is a universal and powerful emotion and, as a result, it can have a profound impact on human behavior. the fear-motivated behavior has the potential to adversely impact rehabilitation outcomes for patients with musculoskeletal pain. cross-sectional studies consistently documented a positive association between elevated pain-related fear and increased pain intensity and disability. in addition, several longitudinal studies indicated that elevated pain-related fear is a precursor to poor clinical outcomes. existence of catastrophizing in patients effect on the fear of movement/ (reinjury. this fear contributes to avoidance behaviors and subsequent disuse, depression, and disability. it has been established that kinesiophobia plays a negative role in the outcome of the rehabilitation of acute and chronic low back pain, chronic fatigue syndrome and fibromyalgia syndrome. Results: The recent studies suggest that physical therapists should consider the role of pain-related fear and avoidance behaviors in patients' function and they should assess these cognitive and behavioral factors. or (physical therapists should assess pain-related fear when rehabilitating certain individuals with musculoskeletal pain. currently, there is a lot of evidence for the assessment of pain-related fear in patients with musculoskeletal pain. self-report questionnaires are readily available for assessment and investigation of pain-related fear and several studies have found support for their validity and reliability. recent research indicated that besides fear-avoidance responses, endurance-related responses lead to chronic pain via physical overload. the existence of mental kinesiophobia has been established in patients with chronic stress complaints, and this

  2. Musculoskeletal injuries in break-dancers.

    Science.gov (United States)

    Cho, Chul Hyun; Song, Kwang Soon; Min, Byung Woo; Lee, Sung Moon; Chang, Hyuk Won; Eum, Dae Seup

    2009-11-01

    Since no epidemiologic studies have been reported about musculoskeletal injuries in break-dancers, there are no data on the rates and patterns of musculoskeletal injuries in this population that clinicians can use to find ways to decrease injury rate. We believe that the incidence of injuries in break-dancers is higher than assumed and that injury rates and patterns differ between professional and amateur dancers. Descriptive epidemiologic study. Of a total of 42 study subjects, 23 were professional dancers and 19 were amateur dancers. Injury frequency, site and type, along with the presence of supervised training, the use of protective devices and warm-up exercises done were recorded. Of the 42 study subjects, excluding two amateur dancers, 40 (95.2%) had had musculoskeletal injuries at more than one site. The mean number of sites per dancer was 4.60. The frequency of injury depended on the site and was as follows: wrist (69.0%), finger (61.9%), knee (61.9%), shoulder (52.4%), lumbar spine (50.0%), elbow (42.9%), cervical spine (38.1%), ankle (38.1%), foot (28.6%) and hip (16.7%). Sprain, strain and tendinitis were the most common injuries, accounting for the most cases. Of the 42 dancers, 13 (31%) had had fractures or dislocations. Eight (19.1%) learned break-dancing under supervised instruction, 17 (40.5%) used protective devices and 28 (66.7%) performed warm-up exercises before dancing. There were significant differences in age, dance career length, amount of dance training, mean number of injury sites and the presence of supervised training between professionals and amateurs (Pnature of the activities that result in both unusual and common injuries in break-dancers and educate them about safety. Careful screening, instruction and supervised training of break-dancers will help to prevent injuries.

  3. Assessment of musculoskeletal load in refuse collectors

    Directory of Open Access Journals (Sweden)

    Zbigniew W. Jóźwiak

    2013-08-01

    Full Text Available Background: The aim of this work was to assess the load on the musculoskeletal system and its effects in the collectors of solid refuse. The rationale behind this study was to formulate proposals how to reduce excessive musculoskeletal load in this group of workers. Material and Methods: The study group comprised 15 refuse collectors aged 25 to 50 years. Data about the workplace characteristics and subjective complaints of workers were collected by the free interview and questionnaire. During the survey the photorecording of the workpostures, the distance and velocity by GPS recorders, measurements of forces necessary to move containers, energy expenditure (lung ventilation method, workload estimation using the Firstbeat system and REBA method and stadiometry were done. Results: The distance walked daily by the collectors operating in terms of 2 to 3 in urban areas was about 15 km, and in rural areas about 18 km. The most frequent musculoskeletal complaints concerned the feet (60% subjects, knees, wrists and shoulders (over 40% subjects. After work-shift all examined workers had vertebral column shorter by 10 to 14 mm (11.4 mm mean. Conclusions: The results of our study show that the refuse collectors are subjected to a very high physical load because of the work organization and the way it is performed. To avoid adverse health effects and overload it is necessary to undertake ergonomic interventions, involving training of workers to improve the way of their job performance, active and passive leisure, technical control of the equipment and refuse containers, as well as the renegotiation of contracts with clients, especially those concerning non-standard containers. Med Pr 2013;64(4:507–519

  4. Reduction of metal artefacts in musculoskeletal imaging

    International Nuclear Information System (INIS)

    Sutter, Reto; Dietrich, Tobias

    2016-01-01

    Joint replacement and other orthopaedic implants are utilized in many patients with musculoskeletal disorders. While these operations commonly show a good clinical result, a substantial number of patients need to undergo postoperative imaging during follow-up. The presence of orthopaedic implants induces severe metal artefacts at MRI and CT. We review several basic methods and advanced techniques for reducing metal artefacts at MRI and CT in order to enable a diagnostic examination in patients with metal implants. With the use of these techniques, MRI and CT are important and reliable modalities to examine patients with joint replacement and orthopaedic implants.

  5. A disjointed effort: paediatric musculoskeletal examination.

    LENUS (Irish Health Repository)

    Gill, Irwin

    2012-07-01

    Musculoskeletal (MSK) symptoms are a frequent cause of emergency department attendance for children, and while most often indicative of benign or self-limiting disease, such symptoms can occasionally be the first presentation of serious illness such as leukaemia or juvenile idiopathic arthritis. MSK examination, however, is often not included as part of the routine paediatric examination. The authors aimed to evaluate how often and how thoroughly MSK examination was performed during admissions to the paediatric ward and to compare it with the examination of other symptoms in relation to the presenting complaint and eventual diagnosis.

  6. Biological variation in musculoskeletal injuries: current knowledge, future research and practical implications.

    Science.gov (United States)

    Collins, Malcolm; September, Alison V; Posthumus, Michael

    2015-12-01

    Evidence from familial and genetic association studies have reported that DNA sequence variants play an important role, together with non-genetic factors, in the aetiology of both exercise-associated and occupational-associated acute and chronic musculoskeletal soft tissue injuries. The associated variants, which have been identified to date, may contribute to the interindividual variation in the structure and, by implication, mechanical properties of the collagen fibril and surrounding matrix within musculoskeletal soft tissues, as well as their response to mechanical loading and other stimuli. Future work should focus on the establishment of multidisciplinary international consortia for the identification of biologically relevant variants involved in modulating injury risk. These consortia will improve the limitations of the published hypothesis-driven genetic association studies, since they will allow resources to be pooled in recruiting large well-characterised cohorts required for whole-genome screening. Finally, clinicians and coaches need to be aware that many direct-to-consumer companies are currently marketing genetic tests directly to athletes without it being requested by an appropriately qualified healthcare professional, and without interpretation alongside other clinical indicators or lifestyle factors. These specific genetic tests are premature and are not necessarily required to evaluate susceptibility to musculoskeletal soft tissue injury. Current practice should rather consider susceptibility through known risk factors such as a positive family history of a specific injury, a history of other tendon and/or ligament injuries and participation in activities associated with the specific musculoskeletal injuries. Potential susceptible athletes may then be individually managed to reduce their risk profile. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. Musculoskeletal training: are GP trainees exposed to the right case mix for independent practice?

    Science.gov (United States)

    Goff, Iain; Wise, Elspeth Mary; Coady, David; Walker, David

    2016-02-01

    Musculoskeletal conditions are common in general practice, but clinicians express poor self confidence in dealing with them. Training in general practice relies on clinical exposure to a range of presentations in order to gain competence. It has been suggested that trainees are exposed to a different case mix from qualified general practices (GPs), due to seeing more minor illness and less chronic disease and that this may be responsible in part for their subsequent lack of confidence. The aims of this study were to analyse the case mix of musculoskeletal conditions encountered by general practice trainees and to compare this to the overall population consulting behaviour. This is a prospective observational study. Thirteen general practices in North East England were recruited. Musculoskeletal disorders encountered by 13 GP trainees (7 junior and 6 senior) were prospectively recorded using a handheld diary. Disorders were classified according to working diagnosis or body region if diagnosis was unclear. Musculoskeletal (MSK) disorders comprised 17 % of consultations, and the distribution of diagnoses of these was in proportion to epidemiological studies of MSK disorders in the UK as they present in primary care. Back pain was the most frequent label with 141 (29 %) consultations with a further 43 (9 %) for neck pain. Inflammatory arthritis accounted for the same number 43 (9 %). Individual joint problems were 115 (24 %) with knee being most common. A specific diagnosis was more likely to be applied when symptoms were more distal and less likely when axial. Trainees are exposed to the same spectrum of MSK disorders as are present in the population as a whole. Case mix does not appear to be a significant factor in low confidence levels in dealing with MSK disorders.

  8. Compensative hypertrophy of the kidney

    International Nuclear Information System (INIS)

    Raynaud, C.

    1976-01-01

    Several measurement methods are available to practitioners to reveal a compensative hypertrophy. Mensuration of the kidney has the advantage of simplicity but is in fact an unreliable and inaccurate method. Separate clearances in their traditional form have never entered into routine use because of the disadvantages of ureteral catheterism. The use of radioactive tracers avoids this drawback, but clearances calculated in this way are only valid in the absence of obstructive urinary disorders. Solutions have been proposed, but the values obtained are no longer identical with the clearances. The Hg uptake test quantifies quite accurately the function of each kidney. From the results obtained a complete compensative hypertrophy developed on a healthy kidney and an incomplete compensative hypertrophy developed on the diseased kidney have been described. In each of these situations the degree to which compensative hypertrophy develops seems to be fixed at a given level peculiar to each patient [fr

  9. CEO Compensation and Disclosure Policy

    OpenAIRE

    Zhang, Weijia; Zhang, Kun

    2016-01-01

    This paper examines the relationship between CEO compensation and disclosure policy related to corporate governance information within S&P 500 index. Our sample consists of 456 companies for the period from 2005 to 2015. Most previous researchers mainly put their attention on various corporate governance characteristics such as board size, board independence, and executive ownership when analysing CEO compensation. Our paper extends the previous study by dividing corporate governance into...

  10. Prevalence of triathlon-related musculoskeletal pain among Kwa ...

    African Journals Online (AJOL)

    The subjects' training history and epidemiology of triathlon-related musculoskeletal pain were gathered employing the use of a self report musculoskeletal pain questionnaire, in addition to body mass, stature, Q-angles and navicular height measurements. Descriptive statistics which included the mode, mean, frequency, ...

  11. Video Analysis of Musculoskeletal Injuries in Nigerian and English ...

    African Journals Online (AJOL)

    Video Analysis of Musculoskeletal Injuries in Nigerian and English Professional Soccer Leagues: A Comparative Study. ... The knee and the ankle were the most common injured parts. Most injuries were caused by tackling ... Keywords: Soccer Players, Nigerian Premier League, English Premier League. Musculoskeletal ...

  12. Musculoskeletal colour/power Doppler in sports medicine

    DEFF Research Database (Denmark)

    Boesen, M I; Boesen, M; Langberg, Henning

    2010-01-01

    This review article discusses the aspects of sports medicine where musculoskeletal Doppler ultrasound has valuable contribution in diagnosis and/or treatment of some of the typical musculoskeletal sports injuries. Also, conditions where the Doppler ultrasound has no value are discussed. Some...

  13. Patterns of Musculoskeletal Diseases seen in Zambian Children

    African Journals Online (AJOL)

    Administrator

    Background: Musculoskeletal disorders are a common cause of long-term pain and physical disability affecting many people worldwide and have an enormous economic and social impact on the individual, society and national health systems. Although the burden of disease due to musculoskeletal disorders is said to be ...

  14. Musculoskeletal pain in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Molsted, S; Tribler, J; Snorgaard, O

    2012-01-01

    The aims were to investigate the prevalence of musculoskeletal pain in patients with type 2 diabetes and demonstrate possible associated factors.......The aims were to investigate the prevalence of musculoskeletal pain in patients with type 2 diabetes and demonstrate possible associated factors....

  15. Incidence of work-related musculoskeletal pain among dentists in ...

    African Journals Online (AJOL)

    Dentists commonly experience musculoskeletal pain during the course of their career. This study investigated the incidence and mechanism of work-related musculoskeletal pain among practising dentists in Kwa-Zulu Natal. A descriptive survey was conducted among 94 dentists, who voluntarily consented to participate in ...

  16. Does muscle strength predict future musculoskeletal disorders and sickness absence?

    DEFF Research Database (Denmark)

    Faber, A; Sell, L; Hansen, J V

    2012-01-01

    High muscle strength is considered relevant for preventing musculoskeletal disorders and long-term sickness absence. However, prospective studies on the association between muscle strength and future musculoskeletal disorders and long-term sickness absence are few and show contrasting results....

  17. Tailor's chair and musculoskeletal disorders in Nigeria | Akanbi ...

    African Journals Online (AJOL)

    It is concluded that seat devices which are not ergonomically designed, impose various work postures on operators which may partly be responsible for their musculoskeletal disorders. Hence, the redesign of sitting devices with ergonomic characteristics is recommended. Keywords: Musculoskeletal disorders, sewing ...

  18. Work related musculoskeletal pain among teachers in selected ...

    African Journals Online (AJOL)

    The impact of musculoskeletal pain specifically within the teaching profession has not been given sufficient attention in the literature especially in Nigeria. This study determined the prevalence of work related musculoskeletal pain among public secondary school teachers in Ife-Central Local Government Area (LGA), Osun ...

  19. Motion control of musculoskeletal systems with redundancy.

    Science.gov (United States)

    Park, Hyunjoo; Durand, Dominique M

    2008-12-01

    Motion control of musculoskeletal systems for functional electrical stimulation (FES) is a challenging problem due to the inherent complexity of the systems. These include being highly nonlinear, strongly coupled, time-varying, time-delayed, and redundant. The redundancy in particular makes it difficult to find an inverse model of the system for control purposes. We have developed a control system for multiple input multiple output (MIMO) redundant musculoskeletal systems with little prior information. The proposed method separates the steady-state properties from the dynamic properties. The dynamic control uses a steady-state inverse model and is implemented with both a PID controller for disturbance rejection and an artificial neural network (ANN) feedforward controller for fast trajectory tracking. A mechanism to control the sum of the muscle excitation levels is also included. To test the performance of the proposed control system, a two degree of freedom ankle-subtalar joint model with eight muscles was used. The simulation results show that separation of steady-state and dynamic control allow small output tracking errors for different reference trajectories such as pseudo-step, sinusoidal and filtered random signals. The proposed control method also demonstrated robustness against system parameter and controller parameter variations. A possible application of this control algorithm is FES control using multiple contact cuff electrodes where mathematical modeling is not feasible and the redundancy makes the control of dynamic movement difficult.

  20. Purinergic signalling in the musculoskeletal system.

    Science.gov (United States)

    Burnstock, Geoffrey; Arnett, Timothy R; Orriss, Isabel R

    2013-12-01

    It is now widely recognised that extracellular nucleotides, signalling via purinergic receptors, participate in numerous biological processes in most tissues. It has become evident that extracellular nucleotides have significant regulatory effects in the musculoskeletal system. In early development, ATP released from motor nerves along with acetylcholine acts as a cotransmitter in neuromuscular transmission; in mature animals, ATP functions as a neuromodulator. Purinergic receptors expressed by skeletal muscle and satellite cells play important pathophysiological roles in their development or repair. In many cell types, expression of purinergic receptors is often dependent on differentiation. For example, sequential expression of P2X5, P2Y1 and P2X2 receptors occurs during muscle regeneration in the mdx model of muscular dystrophy. In bone and cartilage cells, the functional effects of purinergic signalling appear to be largely negative. ATP stimulates the formation and activation of osteoclasts, the bone-destroying cells. Another role appears to be as a potent local inhibitor of mineralisation. In osteoblasts, the bone-forming cells, ATP acts via P2 receptors to limit bone mineralisation by inhibiting alkaline phosphatase expression and activity. Extracellular ATP additionally exerts significant effects on mineralisation via its hydrolysis product, pyrophosphate. Evidence now suggests that purinergic signalling is potentially important in several bone and joint disorders including osteoporosis, rheumatoid arthritis and cancers. Strategies for future musculoskeletal therapies might involve modulation of purinergic receptor function or of the ecto-nucleotidases responsible for ATP breakdown or ATP transport inhibitors.

  1. Vitamin D Related Musculoskeletal System Findings

    Directory of Open Access Journals (Sweden)

    Banu Sarıfakıoğlu

    2015-12-01

    Full Text Available Objective: The effect of vitamin D on bone metabolism has been well known for a long time. Recently, various hormonal and immunity related effects has have been obtained. Additionally, the deficiency of vitamin D is thought to be related with various pain syndromes. In this study, we aimed to investigate the main musculoskeletal symptoms of patients with vitamin D deficiency admitting to physical medicine and rehabilitation clinics. Materials and Methods: The data were retrospectively investigated in patients with myalgia, arthralgia, regional pain, widespread body pain (WBP and in whom vitamin D levels were measured. Patients over 50 years old and with known osteoporosis/osteomalacia diagnosis, endocrinological pathology, and inflammatory rheumatological disease were excluded. Results: The data of 571 patients were investigated and totally 214 of them were included in the study. There were 178 females (83.2%, 36 males (16.8%. The mean age of the patients was 39.19±9.58 years. Of the patients, 100 (46.7% were in severe deficiency, 68 (31.8% were in deficiency, 46 (21.5% were in insufficient group. The symptoms were regional pain in 65 (30.3%, WBP in 63 (29.4%, arthralgia in 49 (23%, and myalgia in 37 (17.3% patients. Conclusion: Vitamin D deficiency may be encountered as musculoskeletal problems. In the presence of persistent joint-muscle pain, regional pain and fibromiyalgia, vitamin D deficiency should be kept in mind.

  2. The Effect of a Stretching- Strengthening Exercise Program on Decreasing Pain Index on Workers with Musculoskeletal Complaints

    Directory of Open Access Journals (Sweden)

    AR Ashraf

    2007-01-01

    Full Text Available ABSTRACT: Introduction & Objective: Musculoskeletal disorders are the leading cause of disability among people during working years which impose high expenses on the society in different aspects. this study was conducted to assess the effect of a stretching- strengthening exercise program on decreasing pain index on workers with musculoskeletal complaints. Materials & Methods: This quasi-experimental study was done on cleaning unit workers in one of the factories producing hygiene instruments in Shiraz in 2006. All the fifty four employees were considered in our study. First, all workers were evaluated by the physiatrist under complete musculoskeletal examination and pain intensity was assessed by VAS and BPI indices. After 3 months, to confirm the chronicity of symptoms, the second examination was done and then exercise program was recommended for 3 months. The collected results were analyzed by SPSS software and non-parametric Wilcoxon test. Results: The primary mean of the VAS index was 5.00±2.27cm while after 3 months it was raised to 5.32±2.76 cm and reduced to 1.98±2.07 after doing exercise program, which is a significant decline (p< 0.001. Mean of different indices of BPI showed significant decrease after completing exercise program (p< 0.001. Conclusion: Doing an exercise program based on type of work, and availability of facilities in work environment is effective in decreasing musculoskeletal complaints as a primary cause of disability among workers.

  3. An Overview of Recent Patents on Musculoskeletal Interface Tissue Engineering

    Science.gov (United States)

    Rao, Rohit T.; Browe, Daniel P.; Lowe, Christopher J.; Freeman, Joseph W.

    2018-01-01

    Interface tissue engineering involves the development of engineered grafts that promote integration between multiple tissue types. Musculoskeletal tissue interfaces are critical to the safe and efficient transmission of mechanical forces between multiple musculoskeletal tissues e.g. between ligament and bone tissue. However, these interfaces often do not physiologically regenerate upon injury, resulting in impaired tissue function. Therefore, interface tissue engineering approaches are considered to be particularly relevant for the structural restoration of musculoskeletal tissues interfaces. In this article we provide an overview of the various strategies used for engineering musculoskeletal tissue interfaces with a specific focus on the recent important patents that have been issued for inventions that were specifically designed for engineering musculoskeletal interfaces as well as those that show promise to be adapted for this purpose. PMID:26577344

  4. Multisite musculoskeletal pain predicts medically certified disability retirement among Finns.

    Science.gov (United States)

    Haukka, E; Kaila-Kangas, L; Ojajärvi, A; Saastamoinen, P; Holtermann, A; Jørgensen, M B; Karppinen, J; Heliövaara, M; Leino-Arjas, P

    2015-09-01

    Musculoskeletal pain at several sites (multisite pain) is more common than single-site pain. Little is known on its effects on disability pension (DP) retirement. A nationally representative sample comprised 4071 Finns in the workforce aged 30 to 63. Data (questionnaire, interview, clinical examination) were gathered in 2000-2001 and linked with national DP registers for 2000-2011. Pain during the preceding month in 18 locations was combined into four sites (neck, upper limbs, low back, lower limbs). Hazard ratios (HR) of DP were estimated by Cox regression. The HR of any DP (n = 477) was 1.6 (95% confidence interval 1.2-2.1) for one, 2.5 (1.9-3.3) for two, 3.1 (2.3-4.3) for three and 5.6 (4.0-7.8) for four pain sites, when adjusted for age and gender. When additionally adjusted for clinically assessed chronic diseases, the HRs varied from 1.4 (1.0-1.8) to 3.5 (2.5-4.9), respectively. When further adjusted for physical and psychosocial workload, education, body mass index, smoking, exercise and sleep disorders, the HRs were 1.3 (0.9-1.7), 1.6 (1.2-2.2), 1.8 (1.3-2.5) and 2.5 (1.8-3.6). The number of pain sites was especially strong in predicting DPs due to musculoskeletal diseases (HRs in the full model; 3.1 to 4.3), but it also predicted DPs due to other somatic diseases (respective HRs 1.3 to 2.3); pain in all four sites was also predictive of DPs due to mental disorders (full model HR 2.2). The number of pain sites independently predicted DP retirement. Employees with multisite pain may need specific support to maintain their work ability. © 2014 The Authors. European Journal of Pain published by John Wiley & Sons Ltd on behalf of European Pain Federation - EFIC®.

  5. Importancia de los problemas reumáticos en la población de Cataluña: prevalencia y repercusión en la salud percibida, restricción de actividades y utilización de recursos sanitarios Importance of chronic musculoskeletal problems in the population of Catalonia (Spain: prevalence and effect on self-perceived health, activity restriction and use of health services

    Directory of Open Access Journals (Sweden)

    María Jesús Pueyo

    2012-02-01

    Full Text Available Objetivo: Conocer la importancia de las enfermedades reumáticas en la población adulta de Cataluña y su repercusión en la salud autopercibida, la restricción de actividades y el uso de servicios sanitarios. Métodos: Encuesta poblacional a 15.926 adultos. Muestreo estratificado polietápico. Variables recogidas: características sociodemográficas, problemas de salud, salud autopercibida, restricción de actividades y uso de recursos sanitarios. Los problemas musculoesqueléticos se clasificaron en cuatro categorías: artrosis-artritis o reumatismo, dorsalgia-lumbalgia crónica, cervicalgia crónica y osteoporosis. Resultados: El 77,4% declara problemas crónicos de salud. La dorsalgia-lumbalgia, la cervicalgia crónica y el grupo artrosis-artritis o reumatismo, por este orden, son los más frecuentemente declarados. Tras ajustar por la edad, el sexo femenino incrementa el riesgo de declarar artrosis-artritis o reumatismo, dorsalgia-lumbalgia crónica, cervicalgia crónica y osteoporosis (odds ratio [OR]=2,6, 1,5, 2,3 y 5,3, respectivamente. La prevalencia es más alta en los grupos de mayor edad con gradiente social. Tras ajustar por edad, sexo, clase social y obesidad, la percepción de la salud es peor en las personas afectadas (42,7% frente a 11%, que también declaran una mayor restricción de la actividad en el último año y en los últimos 15 días (OR=2,70 y 2,32, respectivamente, y un uso de los servicios sanitarios significativamente superior. Conclusiones: Los problemas reumáticos son los principales problemas de salud crónicos declarados por la población adulta. La prevalencia es mayor en las mujeres, aumenta con la edad y en las clases desfavorecidas. Hay una asociación significativa entre declarar problemas musculoesqueléticos y salud autopercibida mala o regular, y mayor restricción de actividades y uso de servicios sanitarios.Objective: To determine the importance of chronic musculoskeletal problems in the adult

  6. Biomarkers for Musculoskeletal Pain Conditions: Use of Brain Imaging and Machine Learning.

    Science.gov (United States)

    Boissoneault, Jeff; Sevel, Landrew; Letzen, Janelle; Robinson, Michael; Staud, Roland

    2017-01-01

    Chronic musculoskeletal pain condition often shows poor correlations between tissue abnormalities and clinical pain. Therefore, classification of pain conditions like chronic low back pain, osteoarthritis, and fibromyalgia depends mostly on self report and less on objective findings like X-ray or magnetic resonance imaging (MRI) changes. However, recent advances in structural and functional brain imaging have identified brain abnormalities in chronic pain conditions that can be used for illness classification. Because the analysis of complex and multivariate brain imaging data is challenging, machine learning techniques have been increasingly utilized for this purpose. The goal of machine learning is to train specific classifiers to best identify variables of interest on brain MRIs (i.e., biomarkers). This report describes classification techniques capable of separating MRI-based brain biomarkers of chronic pain patients from healthy controls with high accuracy (70-92%) using machine learning, as well as critical scientific, practical, and ethical considerations related to their potential clinical application. Although self-report remains the gold standard for pain assessment, machine learning may aid in the classification of chronic pain disorders like chronic back pain and fibromyalgia as well as provide mechanistic information regarding their neural correlates.

  7. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... abuse over many years. Repeated episodes of acute pancreatitis can lead to chronic pancreatitis. Genetics may be ...

  8. Effectiveness of a Mindfulness-Based Intervention in the Management of Musculoskeletal Pain in Nursing Workers.

    Science.gov (United States)

    Lopes, Shirlene Aparecida; Vannucchi, Bruna Pesce; Demarzo, Marcelo; Cunha, Ângelo Geraldo José; Nunes, Maria do Patrocínio Tenório

    2018-05-17

    Chronic pain is a prevalent disorder in nursing workers worldwide. Several studies have proposed measures to mitigate this critical scenario. Mindfulness-based interventions (MBI) have been found to have promising results in the treatment of this disorder. To quantify the effectiveness of an adapted mindfulness program (AMP) in the management of musculoskeletal pain (MSP) in nursing technicians of a Brazilian university hospital. This study was a clinical, prospective, open, repeated measures trial, with data collection between January and July 2015. Brazilian university hospital. Participants/Subjects: Sixty-four female nursing technicians with a mean age of 47.01 years (standard deviation = 9.50) with chronic pain symptoms. Sixty-four female nursing technicians with a mean age of 47.01 years (standard deviation = 9.50) and MSP participated in this prospective study. Before the intervention (T0), scores of anxiety, depression, mindfulness, musculoskeletal complaints, pain catastrophizing, self-compassion, and perception of quality of life were quantified. These scores were reevaluated after 8 weeks (T1) and 12 weeks (T2) of weekly AMP sessions (60 minutes each). The variables were evaluated by analysis of variance for repeated measures, followed by the Bonferroni test. AMP reduced the scores of musculoskeletal symptoms, anxiety, depression, and pain catastrophizing (p < .001). A significant increase was identified in self-compassion scores and perception of quality of life in the physical, psychological, and overall assessment (p ≤ .04). Positive effects of AMP occurred at T1 and remained unchanged at T2. AMP contributed to a reduction in painful symptoms and improved the quality of life of nursing workers, with a lasting effect until the 20th week of follow-up, indicating utility as an effective strategy for the management of MSP in the group studied. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights

  9. 29 CFR 525.6 - Compensable time.

    Science.gov (United States)

    2010-07-01

    ... 29 Labor 3 2010-07-01 2010-07-01 false Compensable time. 525.6 Section 525.6 Labor Regulations... WITH DISABILITIES UNDER SPECIAL CERTIFICATES § 525.6 Compensable time. Individuals employed subject to this part must be compensated for all hours worked. Compensable time includes not only those hours...

  10. 48 CFR 970.2270 - Unemployment compensation.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Unemployment compensation... Unemployment compensation. (a) Each state has its own unemployment compensation system to provide payments to... unemployment compensation benefits through a payroll tax on employers. Most DOE contractors are subject to the...

  11. Motion-compensated processing of image signals

    NARCIS (Netherlands)

    2010-01-01

    In a motion-compensated processing of images, input images are down-scaled (scl) to obtain down-scaled images, the down-scaled images are subjected to motion- compensated processing (ME UPC) to obtain motion-compensated images, the motion- compensated images are up-scaled (sc2) to obtain up-scaled

  12. Which Instruments Can Detect Submaximal Physical and Functional Capacity in Patients With Chronic Nonspecific Back Pain? A Systematic Review

    NARCIS (Netherlands)

    van der Meer, Suzan; Trippolini, Maurizio A.; van der Palen, Job; Verhoeven, Jan; Reneman, Michiel F.

    2013-01-01

    Study Design. Systematic review. Objective. To evaluate the validity of instruments that claim to detect submaximal capacity when maximal capacity is requested in patients with chronic nonspecific musculoskeletal pain. Summary of Background Data. Several instruments have been developed to measure

  13. Crime victims‘ right to compensation

    Directory of Open Access Journals (Sweden)

    Mrvić-Petrović Nataša

    2012-01-01

    Full Text Available This paper analyzes the most important documents of the United Nations, Council of Europe and the European Union relating to rights to damage compensation (restitution from offender and state compensation. The analysis shows that there is a gradual move from the concept of exercising the rights of victims in favor of a solidaristic model that takes less into account the rights of victims, and more the need to satisfy their legitimate interests. The economic crisis that is undermining the foundations of the welfare state could jeopardize the realization of this concept, especially in those European countries where the criminal justice system focuses solely on the offender, as is the case in Serbia. In such circumstances, regulation which protects the right to compensation, other rights and interests of victims, shall apply only to the extent that serves crime prevention. So it happens that in spite of a suitable normative framework and developments regarding the protection of victims of domestic violence and trafficking, the right to compensation and other rights of the victims do not actually get actualized in practice. In order to overcome this, a systemic reform to the criminal justice system should be undertaken with the aim to redirect the system towards the victim of the offense. Within these reforms a public fund for compensation of the victims of violence should be established and the process of mediation between the victim and the offender with the goal to make a settlement should be regulated, because these mechanisms do not exist in Serbia.

  14. Gradient-based optimization with B-splines on sparse grids for solving forward-dynamics simulations of three-dimensional, continuum-mechanical musculoskeletal system models.

    Science.gov (United States)

    Valentin, J; Sprenger, M; Pflüger, D; Röhrle, O

    2018-05-01

    Investigating the interplay between muscular activity and motion is the basis to improve our understanding of healthy or diseased musculoskeletal systems. To be able to analyze the musculoskeletal systems, computational models are used. Albeit some severe modeling assumptions, almost all existing musculoskeletal system simulations appeal to multibody simulation frameworks. Although continuum-mechanical musculoskeletal system models can compensate for some of these limitations, they are essentially not considered because of their computational complexity and cost. The proposed framework is the first activation-driven musculoskeletal system model, in which the exerted skeletal muscle forces are computed using 3-dimensional, continuum-mechanical skeletal muscle models and in which muscle activations are determined based on a constraint optimization problem. Numerical feasibility is achieved by computing sparse grid surrogates with hierarchical B-splines, and adaptive sparse grid refinement further reduces the computational effort. The choice of B-splines allows the use of all existing gradient-based optimization techniques without further numerical approximation. This paper demonstrates that the resulting surrogates have low relative errors (less than 0.76%) and can be used within forward simulations that are subject to constraint optimization. To demonstrate this, we set up several different test scenarios in which an upper limb model consisting of the elbow joint, the biceps and triceps brachii, and an external load is subjected to different optimization criteria. Even though this novel method has only been demonstrated for a 2-muscle system, it can easily be extended to musculoskeletal systems with 3 or more muscles. Copyright © 2018 John Wiley & Sons, Ltd.

  15. Ultrasound as a stimulus for musculoskeletal disorders

    Directory of Open Access Journals (Sweden)

    Ning Zhang

    2017-04-01

    Full Text Available Ultrasound is an inaudible form of acoustic sound wave at 20 kHz or above that is widely used in the medical field with applications including medical imaging and therapeutic stimulation. In therapeutic ultrasound, low-intensity pulsed ultrasound (LIPUS is the most widely used and studied form that generally uses acoustic waves at an intensity of 30 mW/cm2, with 200 ms pulses and 1.5 MHz. In orthopaedic applications, it is used as a biophysical stimulus for musculoskeletal tissue repair to enhance tissue regeneration. LIPUS has been shown to enhance fracture healing by shortening the time to heal and reestablishment of mechanical properties through enhancing different phases of the healing process, including the inflammatory phase, callus formation, and callus remodelling phase. Reports from in vitro studies reveal insights in the mechanism through which acoustic stimulations activate cell surface integrins that, in turn, activate various mechanical transduction pathways including FAK (focal adhesion kinase, ERK (extracellular signal-regulated kinase, PI3K, and Akt. It is then followed by the production of cyclooxygenase 2 and prostaglandin E2 to stimulate further downstream angiogenic, osteogenic, and chondrogenic cytokines, explaining the different enhancements observed in animal and clinical studies. Furthermore, LIPUS has also been shown to have remarkable effects on mesenchymal stem cells (MSCs in musculoskeletal injuries and tissue regeneration. The recruitment of MSCs to injury sites by LIPUS requires the SDF-1 (stromal cell derived factor-1/CXCR-4 signalling axis. MSCs would then differentiate differently, and this is regulated by the presence of different cytokines, which determines their fates. Other musculoskeletal applications including bone–tendon junction healing, and distraction osteogenesis are also explored, and the results are promising. However, the use of LIPUS is controversial in treating osteoporosis, with negative

  16. Evaluation of musculoskeletal pain management practices in rural nursing homes compared with evidence-based criteria.

    Science.gov (United States)

    Decker, Sheila A; Culp, Kennith R; Cacchione, Pamela Z

    2009-06-01

    Chronic pain, mainly associated with musculoskeletal diagnoses, is inadequately and often inappropriately treated in nursing home residents. The purpose of this descriptive study is to identify the musculoskeletal diagnoses associated with pain and to compare pain management of a sample of nursing home residents with the 1998 evidence-based guideline proposed by the American Geriatrics Society (AGS). The sample consists of 215 residents from 13 rural Iowa nursing home homes. The residents answered a series of face-to-face questions that addressed the presence/absence of pain and completed the Mini Mental State Examination (MMSE). Data on pain were abstracted from the Minimum Data Set (MDS). Analyses included descriptive statistics, cross tabulations, and one-way analysis of variance. Residents' responses to the face-to-face pain questions yielded higher rates of pain compared with the MDS pain data. Resident records showed that acetaminophen was the most frequently administered analgesic medication (30.9%). Propoxyphene, not an AGS-recommended opioid, was also prescribed for 23 residents (10.7%). Of the 70 residents (32.6%) expressing daily pain, 23 (32.9%) received no scheduled or pro re nata analgesics. There was no significant difference between MMSE scores and number of scheduled analgesics. Additionally, residents' self-reported use of topical agents was not documented in the charts. The findings suggest that the 1998 AGS evidence-based guideline for the management of chronic pain is inconsistently implemented.

  17. Clinical Evaluation of Iliopsoas Strain with Findings from Diagnostic Musculoskeletal Ultrasound in Agility Performance Canines – 73 Cases

    Directory of Open Access Journals (Sweden)

    Robert Cullen

    2017-06-01

    Full Text Available Objective: Iliopsoas injury and strain is a commonly diagnosed disease process, especially amongst working and sporting canines. There has been very little published literature regarding iliopsoas injuries and there is no information regarding the ultrasound evaluation of abnormal iliopsoas muscles. This manuscript is intended to describe the ultrasound findings in 73 canine agility athletes who had physical examination findings consistent with iliopsoas discomfort. The population was chosen given the high incidence of these animals for the development of iliopsoas injury; likely due to repetitive stress.Methods: Medical records of 73 agility performance canines that underwent musculoskeletal ultrasound evaluation of bilateral iliopsoas muscle groups were retrospectively reviewed. Data included signalment, previous radiographic findings, and ultrasound findings. A 3-tier grading scheme for acute strains was used while the practitioner also evaluated for evidence of chronic injury and bursitis.Results: The majority of pathologies were localised to the tendon of insertion, with the majority being low grade I-II strains (80.8%. Tendon fibre disruption (71.2% and indistinct hypoechoic lesions (91.8% were the most common of acute changes noted. Hyperechoic chronic changes were noted in 84.9 percent of cases. Acute and chronic changes were commonly seen together (62.8%.Conclusion: Diagnostic musculoskeletal ultrasound was used to identify lesions of the iliopsoas tendon consistent with acute and chronic injury, as well as identifying the region of pathology. The majority of agility performance dogs had low grade acute strains based on the tiered system, with mixed acute and chronic lesions being noted frequently.Application: Diagnostic musculoskeletal ultrasound provides a non-invasive diagnostic modality for patients suspected of having an iliopsoas strain.

  18. Musculoskeletal problems among string instrumentalists in South Africa

    Directory of Open Access Journals (Sweden)

    Adedayo T. Ajidahun

    2017-02-01

    Full Text Available Background: Musicians who play string instruments are affected more by musculoskeletal injuries when compared to other instrument playing groups. Musculoskeletal problems are commonly found in the upper extremities and trunk. Several risk factors such as gender, practice hours and instrument played are associated with the prevalence and distribution of musculoskeletal problems among string instrumentalists. Objectives: The aim of this study was to determine the prevalence, distribution, severity and risk factors for musculoskeletal problems among string instrumentalists. Method: A cross-sectional study design using both online and paper-based questionnaires were used to collect data from string instrumentalists playing in both amateur and professional orchestras in South Africa. Results: A total of 114 string instrumentalists participated in the study, of which 86 (77% reported problems in one or more anatomic regions while 39 (35% were currently experiencing musculoskeletal problems that affected their performance. The trunk and both shoulders were the most commonly affected body regions. The majority of the participants reported the severity of the complaints as mild to moderate with aching, soreness, tingling and fatigue being the most commonly used descriptors of the symptoms of playing-related musculoskeletal problems. Conclusion: The results of this study showed that the prevalence of musculoskeletal problems that affect performance is high among string instrumentalists in South Africa. An evaluation of associated risk factors with the aim of reducing injuries may be important in improving performance.

  19. MAJOR INJURIES MUSCULOSKELETALS IN YOUNG ATHLETES BASKETBALL

    Directory of Open Access Journals (Sweden)

    José Simão Rodrigues Filho

    2012-11-01

    Full Text Available The growth of participation of youth in sports is accompanied by an increase in the number of musculoskeletal injuries, especially in contact sports. Basketball gained prominence among contact sports not only for its plastic and beauty of their games, but because it is a sport that demands much of its practitioners, and in the case of young athletes, this requirement can endanger children and adolescents are not properly monitored for health professionals sports. In this study we can see that the ankle is the most affected, followed by knee and fingers and wrists. The mechanisms of injury most frequently reported were sprains, after the bruises and fractures. Highlight for disturbances dorsolumbar, pointed out by many authors. The prevention programs and pre-competition oriented properly treated as paramount by all the authors investigated, in order to reduce the number of injuries in young athletes.

  20. Musculoskeletal Risk Factors in the Young Athlete.

    Science.gov (United States)

    Moskwa, C A; Nicholas, J A; Goldberg, B

    1989-11-01

    In brief: Many children and adolescents participate in sports that put them at risk for musculoskeletal injuries. Underlying physical conditions, or risk factors, may predispose them to particular types of sports injuries. Research shows that these risk factors fall into five categories: body type, flexibility, muscle strength, inadequate rehabilitation of a previous injury, and skeletal malalignment and anomalies. Some findings show, for example, that youthful football players who are also heavy have an increased rate of injury, sprains and strains are less common in flexible athletes, and patellar pain or subluxation may be related to a variety of malalignment factors. The authors recommend using a systematic, integrated approach to risk assessment of the athlete, both for detecting risk factors and determining their potential for con tribu ting to a sports injury.

  1. Musculoskeletal manifestations in sickle cell anemia

    Directory of Open Access Journals (Sweden)

    Reddy Ravikanth

    2017-01-01

    Full Text Available Sickle cell anemia is an inherited hemoglobin disorder characterized by substitution of glutamic acid by valine at the sixth position of the beta globin chain. The sequence of events leads to pain crisis. Ischemia of the tissues resulting from decreased blood flow is believed to occur in pain crisis. Repeated or prolonged sickling causes red cell death in the form of hemolytic anemia. The majority of hospital admissions are due to painful crisis. These patients are at increased risk for both osteomyelitis and infarction of the long bones. Magnetic resonance imaging has been shown to be helpful in the diagnosis of early osteomyelitis and its differentiation from infarction in sickle cell disease patients with acute bone crisis. Others findings include dactylitis, medullary infarcts, diploic space widening, fish mouth vertebrae, and avascular necrosis. We present a case series on the various musculoskeletal manifestations of sickle cell disease.

  2. A telephonic intervention for promoting occupational re-integration in work-disabled individuals with musculoskeletal pain.

    Science.gov (United States)

    Sullivan, Michael J L; Simon, Gregory

    2012-06-01

    The purpose of the present research was to examine the feasibility of a telephonic occupational rehabilitation program. A sample of 23 individuals with chronic musculoskeletal pain was enrolled in the telephonic version of the Progressive Goal Attainment Program (PGAP-Tel). The PGAP-Tel is a risk-targeted intervention designed to reduce pain-related disability consequent to musculoskeletal injury. Treatment outcomes of PGAP-Tel were compared to a group of individuals with chronic musculoskeletal pain, who participated in the face-to-face format of the PGAP. Results showed that PGAP-Tel was acceptable to the majority of participants (76%) to whom it was offered. There were indications that engagement and adherence issues were more problematic in PGAP-Tel than in the face-to-face intervention. Both groups showed comparable reductions in pain, depression, fear of symptom exacerbation, and self-reported disability. Participants in the face-to-face intervention showed greater reduction in catastrophic thinking than participants in PGAP-Tel. Finally, 26% of participants in PGAP-Tel had resumed some form of employment at treatment termination compared to 56% of the participants in the face-to-face intervention. Given the low cost of the PGAP-Tel intervention and the accessibility advantages of a telephonic delivery, this type of intervention might be an important resource for targeting occupational disability in rural or remote communities when face-to-face services are not available.

  3. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    Science.gov (United States)

    Magee, David

    2012-01-01

    ABSTRACT Objectives The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance) to determine cervical musculoskeletal impairments. Results A strong relationship between neck disability and jaw disability was found (r = 0.82). Craniocervical posture was statistically different between patients with myogenous Temporomandibular Disorders (TMD) and healthy subjects. However, the difference was too small (3.3º) to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (P = 0.07). However, clinically important effect sizes (0.42 - 0.82) were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Conclusions Subjects with Temporomandibular Disorders presented with impairments of the cervical flexors and extensors muscles. These results could help guide clinicians in the assessment and prescription of more effective interventions for individuals with Temporomandibular Disorders. PMID:24422022

  4. Cervical Musculoskeletal Impairments and Temporomandibular Disorders

    Directory of Open Access Journals (Sweden)

    Susan Armijo-Olivo

    2012-09-01

    Full Text Available Objectives: The study of cervical muscles and their significance in the development and perpetuation of Temporomandibular Disorders has not been elucidated. Thus this project was designed to investigate the association between cervical musculoskeletal impairments and Temporomandibular Disorders. Material and Methods: A sample of 154 subjects participated in this study. All subjects underwent a series of physical tests and electromyographic assessment (i.e. head and neck posture, maximal cervical muscle strength, cervical flexor and extensor muscles endurance, and cervical flexor muscle performance to determine cervical musculoskeletal impairments. Results: A strong relationship between neck disability and jaw disability was found (r = 0.82. Craniocervical posture was statistically different between patients with myogenous Temporomandibular Disorders (TMD and healthy subjects. However, the difference was too small (3.3º to be considered clinically relevant. Maximal cervical flexor muscle strength was not statistically or clinically different between patients with TMD and healthy subjects. No statistically significant differences were found in electromyographic activity of the sternocleidomastoid or the anterior scalene muscles in patients with TMD when compared to healthy subjects while executing the craniocervical flexion test (P = 0.07. However, clinically important effect sizes (0.42 - 0.82 were found. Subjects with TMD presented with reduced cervical flexor as well as extensor muscle endurance while performing the flexor and extensor muscle endurance tests when compared to healthy individuals. Conclusions: Subjects with Temporomandibular Disorders presented with impairments of the cervical flexors and extensors muscles. These results could help guide clinicians in the assessment and prescription of more effective interventions for individuals with Temporomandibular Disorders.

  5. Musculoskeletal Injuries and Their Associated Risk Factors

    Directory of Open Access Journals (Sweden)

    M Jahangiri

    2012-01-01

    Full Text Available Background and aims :Prevalence of musculoskeletal disorders (MSDs is high among office workers. Long time seated posture, working with computer, repetitive movements and inappropriate environmental conditions may have causal effects in these disorders. High prevalence rate of MSDs makes ergonomics assessment and working conditions improvement necessary. Designing an assessment checklist and calculating ergonomics indices can be useful in this evaluation. This study was conducted with the objectives of determination of prevalence rate, ergonomics assessment of working conditions and determination of factors associated with MSDs among office workers. Methods:In this study 400 randomly selected office workers participated. Nordic musculoskeletal disorders questionnaire was applied to determine prevalence rate of MSDs. Working conditions were assessed by the designed ergonomics checklist and ergonomic risk factors were identified. Data were analyzed using statistical tests including t-test, Chi-square and test of proportion by SPSS software (Version 12.0. Results:The highest prevalence rates of MSDs were reported in lower back and neck regions (49% and 47%, respectively. Statistical analysis revealed that there were significant association between occurrence of MSDs and calculated ergonomics indices (P<0.05. The mean of ergonomics index among those suffered from MSDs were less than other healthy workers indicating inappropriate ergonomics conditions. Calculation of OR also revealed that ergonomics conditions was associated with MSDs occurrence among workers (P<0.05. Totally, 53.3% of the office workers studied had poor working conditions. Awkward working posture and inappropriate workstation design were recognized as the main risk factors in the office workplace.  Conclusion:Most ergonomics problems were originated from bad postures and inappropriate design of workstation. Any interventional program for working conditions improvement should

  6. Evaluation of musculoskeletal disorders in sewing machine operators of a shoe manufacturing factory in Iran.

    Science.gov (United States)

    Aghili, Mir Masih Moslemi; Asilian, Hasan; Poursafa, Parinaz

    2012-03-01

    A 15-year research conducted in USA showed that compensation expenses paid to workers for musculoskeletal disorders (MSDs) of back exceeded 128 million Dollars calculated on the basis of 0.97 Dollars per hour of work. In addition, according to the latest studies carried out in relation with disease burdens with risk factors in Iran, DALYs indices for low back pain, knee arthrosis and other musculoskeletal disorders have been reported to be 307772, 291305 and 872633 respectively, which have caused the work related diseases to occupy the second position in the country, after cardiovascular diseases. On the other hand, in accordance with occupational health indices of Iranian health ministry, 37% of all working population had had poor work postures with 15% of all working population had been working with inappropriate working tools in the year 2009. This was a case study comparing exposed workers with control group using Standard Nordic Questionnair in sewing machine operators of a shoe manufacturing factory in Iran. In this study, the mentioned questionnaires were filled out for the exposed group (25 sewing machine operators with average age of 43.5 years with work records of 16.8 years) and control group (15 employees from administrative department with average age of 39.8 years with work records of 13.4 years) which both were selected through simple random method. There were statistically significant differences in age between musculoskeletal disorders of right elbow (p = 0.033), thigh (p = 0.044), both knees (p = 0.019) and ankles (p = 0.039). There were also statistically significant association between gender and musculoskeletal disorders of right elbow (p = 0.028), thigh (p = 0.026) both knees (p = 0.011); right shoulder disorders (p = 0.018) and work records; disorders of both knees (p = 0.031) and number of cigarettes smoked. In general, prevalence of disorders of cervical area, shoulders with hands, vertebral column, back, knees, thigh with feet were higher

  7. Adaptive Motion Compensation in Radiotherapy

    CERN Document Server

    Murphy, Martin J

    2011-01-01

    External-beam radiotherapy has long been challenged by the simple fact that patients can (and do) move during the delivery of radiation. Recent advances in imaging and beam delivery technologies have made the solution--adapting delivery to natural movement--a practical reality. Adaptive Motion Compensation in Radiotherapy provides the first detailed treatment of online interventional techniques for motion compensation radiotherapy. This authoritative book discusses: Each of the contributing elements of a motion-adaptive system, including target detection and tracking, beam adaptation, and pati

  8. Network compensation for missing sensors

    Science.gov (United States)

    Ahumada, Albert J., Jr.; Mulligan, Jeffrey B.

    1991-01-01

    A network learning translation invariance algorithm to compute interpolation functions is presented. This algorithm with one fixed receptive field can construct a linear transformation compensating for gain changes, sensor position jitter, and sensor loss when there are enough remaining sensors to adequately sample the input images. However, when the images are undersampled and complete compensation is not possible, the algorithm need to be modified. For moderate sensor losses, the algorithm works if the transformation weight adjustment is restricted to the weights to output units affected by the loss.

  9. Possibilities of whole-body MRI for investigating musculoskeletal diseases

    International Nuclear Information System (INIS)

    Lenk, S.; Claussen, C.D.; Schlemmer, H.P.; Fischer, S.; Koetter, I.

    2004-01-01

    This contribution outlines possibilities and limitations of whole-body MRI for investigating musculoskeletal diseases. Benefits and drawbacks of the novel whole-body MRI technology are discussed and a possible whole-body MRI sequence protocol for musculoskeletal examinations is proposed. Muscle, joint and bone diseases are discussed in which the application of whole-body MRI may be of advantage. Particularly, polymyositis, muscledystrophy, rheumatoid arthritis, spondylitis ancylosans, multiple trauma, skeletal metastases, multiple myeloma and malignant lymphoma are mentioned. Whole-body MRI opens new advantages for the examination of multifocal musculoskeletal diseases. The clinical benefit of this method for particular diseases has to be evaluated in further studies, however. (orig.) [de

  10. Effects on musculoskeletal pain, work ability and sickness absence in a 1-year randomised controlled trial among cleaners

    DEFF Research Database (Denmark)

    Jørgensen, Marie B.; Faber, Anne; Hansen, Jørgen V.

    2011-01-01

    Only a few workplace initiatives among cleaners have been reported, even though they constitute a job group in great need of health promotion. The purpose of this trial was to evaluate the effect of either physical coordination training or cognitive behavioural training on musculoskeletal pain......, work ability and sickness absence among cleaners. A cluster-randomised controlled trial was conducted among 294 female cleaners allocated to either physical coordination training (PCT), cognitive behavioural training (CBTr) or a reference group (REF). Questionnaires about musculoskeletal pain and work...... intervention appeared effective for reducing chronic neck/shoulder pain among the female cleaners. It is recommended that future interventions among similar high-risk job groups focus on the implementation aspects of the interventions to maximise outcomes more distal from the intervention such as work ability...

  11. Can high social capital at the workplace buffer against stress and musculoskeletal pain?: Cross-sectional study.

    Science.gov (United States)

    Jay, Kenneth; Andersen, Lars L

    2018-03-01

    Work-related musculoskeletal pain and stress are both highly prevalent in the working environment and relate well to the biopsychosocial model. While the onset of musculoskeletal pain is often dependent on the biological element of the biopsychosocial model, chronic pain is often influenced by psychological and social factors. Similarly, stress is also influenced by biological, psychological, and social factors. This study investigates the possibility of social capital being a buffer for stress and musculoskeletal pain in a group of female laboratory technicians.Female laboratory technicians (n = 500) replied to questions about stress (Cohens Perceived Stress Scale-10), musculoskeletal pain (0-10 visual analog scale), and social capital at the workplace (bonding [in teams], bridging [between teams], and linking [between teams and leaders]). Outcome variables were stress and musculoskeletal pain and the predictor variable was social capital. General linear models tested the association of the 3 types of social capital (predictor variables) with stress and pain (mutually adjusted outcome variables). Analyses were controlled for age, lifestyle (body mass index, smoking), seniority, and working hours per week.For stress as outcome, moderate and high bonding social capital were different from low social capital with -2.04 (95% confidence interval [CI] -3.33 to -0.76) and -4.56 (95% CI -5.84 to -3.28) points on the Perceived Stress Scale of 0 to 42, respectively. Similarly, moderate and high bridging social capital were different from low social capital with -1.50 (95% CI -2.76 to -0.24) and -4.39 (95% CI -5.75 to -3.03), respectively. For linking, only high social was significantly different from low with -2.94 (95% CI -4.28 to -1.60). None of the 3 types of social capital was associated with musculoskeletal pain.Higher levels of social capital at the workplace appear to buffer against stress, but not against musculoskeletal pain. Intervention studies should

  12. Psychology of Pay and Compensation

    NARCIS (Netherlands)

    Thierry, Hk.; Smelser, N.J.; Baltes, P.B.

    2002-01-01

    In most industrialized countries the compensation, of managers and employees is structured along quite comparable patterns. One part consists of base pay, a second part of results-oriented pay, and a third part of secondary labor conditions. In many instances part four is composed of perquisites:

  13. Ongoing transients in carbonate compensation

    NARCIS (Netherlands)

    Boudreau, B.P.; Middelburg, J.J.; Hofmann, A.F.; Meysman, F.J.R.

    2010-01-01

    Uptake of anthropogenic CO2 is acidifying the oceans. Over the next 2000 years, this will modify the dissolution and preservation of sedimentary carbonate. By coupling new formulas for the positions of the calcite saturation horizon, zsat, the compensation depth, zcc, and the snowline, zsnow, to a

  14. Strategic Design of Teacher Compensation

    Science.gov (United States)

    Shields, Regis

    2012-01-01

    Spurred by the national focus on revitalizing the teacher evaluation and support/development process, as well as the current economic downturn, many school districts are reviewing how teachers are compensated. While a few courageous districts have completely upended current structures, most districts are undertaking changes that leave the most…

  15. Optimal compensation for neuron loss

    Science.gov (United States)

    Barrett, David GT; Denève, Sophie; Machens, Christian K

    2016-01-01

    The brain has an impressive ability to withstand neural damage. Diseases that kill neurons can go unnoticed for years, and incomplete brain lesions or silencing of neurons often fail to produce any behavioral effect. How does the brain compensate for such damage, and what are the limits of this compensation? We propose that neural circuits instantly compensate for neuron loss, thereby preserving their function as much as possible. We show that this compensation can explain changes in tuning curves induced by neuron silencing across a variety of systems, including the primary visual cortex. We find that compensatory mechanisms can be implemented through the dynamics of networks with a tight balance of excitation and inhibition, without requiring synaptic plasticity. The limits of this compensatory mechanism are reached when excitation and inhibition become unbalanced, thereby demarcating a recovery boundary, where signal representation fails and where diseases may become symptomatic. DOI: http://dx.doi.org/10.7554/eLife.12454.001 PMID:27935480

  16. Synchrony - Cyberknife Respiratory Compensation Technology

    International Nuclear Information System (INIS)

    Ozhasoglu, Cihat; Saw, Cheng B.; Chen Hungcheng; Burton, Steven; Komanduri, Krishna; Yue, Ning J.; Huq, Saiful M.; Heron, Dwight E.

    2008-01-01

    Studies of organs in the thorax and abdomen have shown that these organs can move as much as 40 mm due to respiratory motion. Without compensation for this motion during the course of external beam radiation therapy, the dose coverage to target may be compromised. On the other hand, if compensation of this motion is by expansion of the margin around the target, a significant volume of normal tissue may be unnecessarily irradiated. In hypofractionated regimens, the issue of respiratory compensation becomes an important factor and is critical in single-fraction extracranial radiosurgery applications. CyberKnife is an image-guided radiosurgery system that consists of a 6-MV LINAC mounted to a robotic arm coupled through a control loop to a digital diagnostic x-ray imaging system. The robotic arm can point the beam anywhere in space with 6 degrees of freedom, without being constrained to a conventional isocenter. The CyberKnife has been recently upgraded with a real-time respiratory tracking and compensation system called Synchrony. Using external markers in conjunction with diagnostic x-ray images, Synchrony helps guide the robotic arm to move the radiation beam in real time such that the beam always remains aligned with the target. With the aid of Synchrony, the tumor motion can be tracked in three-dimensional space, and the motion-induced dosimetric change to target can be minimized with a limited margin. The working principles, advantages, limitations, and our clinical experience with this new technology will be discussed

  17. Effect of physical exercise prelabyrinthectomy on locomotor balance compensation in the squirrel monkey

    Science.gov (United States)

    Igarashi, M.; Ohashi, K.; Yoshihara, T.; MacDonald, S.

    1989-01-01

    This study examines the effectiveness of physical exercise, during a prepathology state, on locomotor balance compensation after subsequent unilateral labyrinthectomy in squirrel monkeys. An experimental group underwent 3 hr. of daily running exercise on a treadmill for 3 mo. prior to the surgery, whereas a control group was not exercised. Postoperatively, the locomotor balance function of both groups was tested for 3 mo. There was no significant difference in gait deviation counts in the acute phase of compensation. However, in the chronic compensation maintenance phase, the number of gait deviation counts was fewer in the exercise group, which showed significantly better performance stability.

  18. Psychosocial Work Stressors, Work Fatigue, and Musculoskeletal Disorders: Comparison between Emergency and Critical Care Nurses in Brunei Public Hospitals.

    Science.gov (United States)

    Abdul Rahman, Hanif; Abdul-Mumin, Khadizah; Naing, Lin

    2017-03-01

    Little evidence estimated the exposure of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders for nurses working in South-East Asian region, and research on this subject is almost nonexistent in Brunei. The main aim of our study was to provide a comprehensive exploration and estimate exposure of the study variables amongst emergency (ER) and critical care (CC) nurses in Brunei. The study also aims to compare whether experiences of ER nurses differ from those of CC nurses. This cross-sectional study was implemented in the ER and CC departments across Brunei public hospitals from February to April 2016 by using Copenhagen Psychosocial Questionnaire II, Occupational Fatigue Exhaustion Recovery scale, and Cornell Musculoskeletal Discomfort Questionnaire. In total, 201 ER and CC nurses (82.0% response rate) participated in the study. Quantitative demands of CC nurses were significantly higher than ER nurses. Even so, ER nurses were 4.0 times more likely [95% confidence interval (2.21, 7.35)] to experience threats of violence, and 2.8 times more likely [95% confidence interval: (1.50, 5.29)] to experience chronic fatigue. The results revealed that nurses experienced high quantitative demands, work pace, stress, and burnout. High prevalence of chronic and persistent fatigue, threats of violence and bullying, and musculoskeletal pain at the neck, shoulder, upper and lower back, and foot region, was also reported. This study has provided good estimates for the exposure rate of psychosocial work stressors, work-related fatigue, and musculoskeletal disorders among nurses in Brunei. It provided important initial insight for nursing management and policymakers to make informed decisions on current and future planning to provide nurses with a conducive work environment. Copyright © 2017. Published by Elsevier B.V.

  19. Musculoskeletal disorders among first-year Ghanaian students in a ...

    African Journals Online (AJOL)

    Keywords: Musculoskeletal disorders, nursing students, functional impairment. ... female sex6,7,14,17, lack of regular exer- cise13,18 and psychosocial stress and mental pressure6,15 .... students in China and Malaysia respectively. There is.

  20. Everyday burden of musculoskeletal conditions among villagers in rural Botswana

    DEFF Research Database (Denmark)

    Hondras, Maria; Hartvigsen, Jan; Myburgh, Corrie

    2016-01-01

    with an interpreter. Audio recordings were transcribed verbatim, with Setswana contextually translated into English. The theoretical lens included Bury's biographical disruption, in which he distinguishes between "meaning as consequence" and "meaning as significance". RESULTS: Interviews revealed co-existing accounts...... for the consequences and significance of musculoskeletal burden related to 3 themes: (i) hard work for traditional lives; (ii) bearing the load of a rugged landscape; and, (iii) caring for others with disrupted lives. Physical labour with musculoskeletal symptoms had economic and subsistence consequences. The loss...... of independence and social identity to fulfil traditional roles held meaning as significance. Outmigration for wage labour and other shifts in family structure compounded everyday musculoskeletal burden. CONCLUSION: Uncovering burden is an important first step to address musculoskeletal care needs in developing...

  1. Prevalence of musculoskeletal pain and factors associated with ...

    African Journals Online (AJOL)

    EPHA USER33

    with kyphosis among pedestrian back-loading women in Bench-Maji zone. Methods: The study was ... prevalence of work related musculoskeletal disorder was 57.1%. ..... local government to empower women and search for other source of ...

  2. Musculoskeletal Adverse Events Associated with Adjuvant Aromatase Inhibitors

    Directory of Open Access Journals (Sweden)

    Qamar J. Khan

    2010-01-01

    Full Text Available Musculoskeletal symptoms including arthralgia and myalgia occur frequently in aging women, particularly during the transition to menopause, when plasma estrogens precipitously decline. In postmenopausal women (PMW with breast cancer, third-generation aromatase inhibitors (AIs as adjuvant hormonal therapy have proven to be more effective, and to have a more predictable side effect profile, than tamoxifen. However, AIs further reduce plasma estrogens in PMW, exacerbating musculoskeletal symptoms. Clinical trial data have shown significantly higher incidences of arthralgia and myalgia with AIs compared with women on tamoxifen or placebo. Symptoms may be severe enough to significantly affect quality of life; musculoskeletal symptoms are a frequent reason for discontinuing therapy. In many cases, symptoms can be effectively managed with oral analgesics or other strategies. Early recognition and effective management of musculoskeletal symptoms can help maximize treatment compliance, enabling patients to derive optimal benefit from therapy in terms of preventing recurrence.

  3. Diagnostic imaging of sport related musculoskeletal system injuries

    International Nuclear Information System (INIS)

    Fernandes, Artur da Rocha Correa; Schivartche, Vivian

    1998-01-01

    The authors review the literature about musculoskeletal injuries related to sports, emphasizing the main findings with different imaging methods. They also present the specific characteristics of each method. (author)

  4. Ultrasound imaging of sports-related musculoskeletal injuries

    International Nuclear Information System (INIS)

    Craig, J.G.; Holsbeek, M.T. van; Gauthier, T.P.; Cook, W.J.

    2006-01-01

    Sports-related injuries of the musculoskeletal system affect millions of individuals every year. Integrating high-frequency Tissue Harmonic Imaging ultrasound with MRI and CT gives the greatest opportunity for diagnosing specific injuries. (orig.)

  5. Chaining of the musculoskeletal disorders from various viewpoints in physiotherapy

    OpenAIRE

    Hák, Jaroslav

    2016-01-01

    Title of diploma thesis: Chaining of the musculoskeletal disorders from various viewpoints in physiotherapy Objective: The purpouse of this thesis is to research available literary sources describing the possible mechanisms of chaining of musculoskeletal disorders from various viewpoints in physiotherapy. Methods: This diploma thesis has descriptively-analytical character. It is structured in the form of literary research. Results: On the basis of the researched literary sources, the thesis s...

  6. Lumbar Spine Musculoskeletal Physiology and Biomechanics During Simulated Military Operations

    Science.gov (United States)

    2016-06-01

    AWARD NUMBER: W81XWH-13-2-0043 TITLE: Lumbar Spine Musculoskeletal Physiology and Biomechanics During Simulated Military Operations PRINCIPAL...31May2016 4. TITLE AND SUBTITLE Lumbar Spine Musculoskeletal Physiology and Biomechanics 5a. CONTRACT NUMBER During Simulated Military Operations 5b... Biomechanics , Cincinnati, 2015. § Website(s) or other Internet site(s) § Nothing to report § Technologies or techniques § Nothing to report

  7. CT/MRI of musculoskeletal complications of AIDS

    Energy Technology Data Exchange (ETDEWEB)

    Wyatt, S.H. [Russel H. Morgan Dept. of Radiology and Radiological Science, Baltimore, MD (United States); Fishman, E.K. [Russel H. Morgan Dept. of Radiology and Radiological Science, Baltimore, MD (United States)

    1995-10-01

    While uncommon, many musculoskeletal disorders may be seen in association with the acquired immune deficiency syndrome (AIDS). Infections such as osteomyelitis, bacterial myositis and septic arthritis, neoplasms such as non-Hodgkin lymphoma and Kaposi sarcoma, and myopathies and polymyositis have been reported in this patient population. Computed tomography and magnetic resonance imaging frequently detect unanticipated musculoskeletal disease in a patient with AIDS, and may further help to distinguish infections from neoplastic disorders. (orig.)

  8. Magnetic Resonance Imaging of Nonneoplastic Musculoskeletal Pathologies in the Pelvis.

    Science.gov (United States)

    Alapati, Sindhura; Wadhwa, Vibhor; Komarraju, Aparna; Guidry, Carey; Pandey, Tarun

    2017-06-01

    Musculoskeletal pathologies in the pelvis encompass a wide variety of lesions including femoroacetabular impingement, athletic pubalgia, ischiofemoral impingement, and apophyseal avulsion injuries. Magnetic resonance imaging is the noninvasive imaging modality of choice for the diagnosis and management of these lesions. In this article, the authors discuss the nonneoplastic musculoskeletal lesions in the pelvis, with illustrations and relevant case examples. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Assessing work-related musculoskeletal symptoms among otolaryngology residents.

    Science.gov (United States)

    Wong, Kevin; Grundfast, Kenneth M; Levi, Jessica R

    Previous studies have suggested that musculoskeletal symptoms are common among practicing otolaryngologists. Early training can be the ideal time to foster knowledge of ergonomics and develop safe work habits, however, little data exists regarding musculoskeletal symptoms in residents. The purpose of this study was to identify and characterize musculoskeletal symptoms in a preliminary sample of otolaryngology residents. A cross-sectional survey incorporating the Nordic Musculoskeletal Questionnaire was sent to 30 Otolaryngology-Head and Neck Surgery residencies to examine musculoskeletal symptoms among residents. A two-sample test of proportions was performed to compare symptoms between male and female residents. In total, 141 respondents (response rate=34.7%) completed the survey. Fifty-five percent of survey respondents were male and 45% were female. Musculoskeletal symptoms were most frequently reported in the neck (82.3%), followed by the lower back (56%), upper back (40.4%), and shoulders (40.4%). The most common symptoms were stiffness in the neck (71.6%), pain in the neck (61.7%), and pain in the lower back (48.2%). In total, 6.4% of residents missed work and 16.3% of residents stopped during an operation at some point due to their symptoms. Most residents (88.3%) believed their musculoskeletal symptoms were attributed to their surgical training. Female residents were significantly more likely to experience neck (p<0.0001) and wrist/hand (p=0.019) discomfort compared to male residents. Musculoskeletal symptoms were common among residents, approaching rates similar to those previously identified in practicing otolaryngologists. Increased emphasis on surgical ergonomics is warranted to improve workplace safety and prevent future injury. Copyright © 2017. Published by Elsevier Inc.

  10. A Mokken analysis of the literacy in musculoskeletal problems questionnaire.

    Science.gov (United States)

    Vaughan, Brett; Mulcahy, Jane; Coffey, Amy; Addinsall, Laura; Ryan, Stephanie; Fitzgerald, Kylie

    2017-12-21

    Limited health literacy is known to impact on medication adherence, hospital readmission and potentially poorer health outcomes. The literature on the health literacy of those with musculoskeletal conditions suggests greater functional limitations and increased pain levels. There are a number of measures of health literacy. One that specifically relates to musculoskeletal complaints is the Literacy in Musculoskeletal Problems (LiMP) questionnaire. The LiMP contains 9 multiple choice items that cover anatomy, musculoskeletal conditions and the diagnosis of musculoskeletal complaints. The aim of the study was to evaluate the dimensionality and internal structure of the LiMP in patients attending for osteopathy care at a student-led clinic, as a potential measure of musculoskeletal health literacy. Three hundred and sixty-one (n = 361) new patients attending the Victoria University Osteopathy Clinic completed the LiMP and a demographic and health information questionnaire prior to their initial consultation. Mokken scale analysis, a nonparametric item response theory approach, was used to evaluate the dimensionality and structure of the LiMP in this population, to ascertain whether the questionnaire was measuring a single latent construct - musculoskeletal health literacy. McDonald's omega and Cronbach's alpha were calculated as the reliability estimations. The relationship between the LiMP and a single item screen of health literacy was also undertaken. The 9 items on the LiMP did not form a Mokken scale and the reliability estimations were below an acceptable level (alpha and omega literacy (p literacy. Further research may also develop a health literacy measure that is specific to patients seeking manual therapy care for musculoskeletal complaints.

  11. Musculoskeletal manifestations and autoantibodies in children and adolescents with leprosy

    Directory of Open Access Journals (Sweden)

    Luciana Neder

    2014-09-01

    Full Text Available Objective: To evaluate musculoskeletal involvement and autoantibodies in pediatric leprosy patients. Methods: 50 leprosy patients and 47 healthy children and adolescents were assessed according to musculoskeletal manifestations (arthralgia, arthritis, and myalgia, musculoskeletal pain syndromes (juvenile fibromyalgia, benign joint hypermobility syndrome, myofascial syndrome, and tendinitis, and a panel of autoantibodies and cryoglobulins. Health assessment scores and treatment were performed in leprosy patients. Results: At least one musculoskeletal manifestation was observed in 14% of leprosy patients and in none of the controls. Five leprosy patients had asymmetric polyarthritis of small hands joints. Nerve function impairment was observed in 22% of leprosy patients, type 1 leprosy reaction in 18%, and silent neuropathy in 16%. None of the patients and controls presented musculoskeletal pain syndromes, and the frequencies of all antibodies and cyoglobulins were similar in both groups (p > 0.05. Further analysis of leprosy patients demonstrated that the frequencies of nerve function impairment, type 1 leprosy reaction, and silent neuropathy were significantly observed in patients with versus without musculoskeletal manifestations (p = 0.0036, p = 0.0001, and p = 0.309, respectively, as well as multibacillary subtypes in leprosy (86% vs. 42%, p = 0.045. The median of physicians' visual analog scale (VAS, patients' VAS, pain VAS, and Childhood Health Assessment Questionnaire (CHAQ were significantly higher in leprosy patients with musculoskeletal manifestations (p = 0.0001, p = 0.002, p = 0002, and p = 0.001, respectively. Conclusions: This was the first study to identify musculoskeletal manifestations associated with nerve dysfunction in pediatric leprosy patients. Hansen's disease should be included in the differential diagnosis of asymmetric arthritis, especially in endemic regions.

  12. Radionuclide Imaging of Musculoskeletal Injuries in Athletes with Negative Radiographs.

    Science.gov (United States)

    Nagle, C E; Freitas, J E

    1987-06-01

    In brief: Radionuclide bone scans can be useful in the diagnostic evaluation of musculoskeletal injuries in athletes. Bone scans can detect shinsplints, stress fractures, and muscle injuries before they are detectable on radiographs. Prognosis can be accurately assessed, allowing appropriate treatment to proceed without delay. The authors discuss the use of bone scans and identify musculoskeletal injuries that are associated with specific sports, such as stress fracture of the femur (soccer), tibia (running), scapula (gymnastics), and pars interarticularis (football or lacrosse).

  13. Correlation of physical factors with musculoskeletal pain among physiotherapists

    Directory of Open Access Journals (Sweden)

    Vidhi Rajen Kalyani

    2017-01-01

    Full Text Available Introduction: The etiology of musculoskeletal work related disorders remains largely unclear, pain being the predominant complaint. The prevalence of neck pain, shoulder pain, upper and lower back pain increases drastically during professional practice in Physiotherapy. This study evaluated the prevalence of musculoskeletal pain. Also, the study determined the role of modifiable risk factors for physiotherapists (physical activity, psychological status and quantity and quality of sleep for pain. Method: The study population includes 60 physiotherapists with atleast work experience of 1 year and work duration of 6 hours per day. Outcome measures used were Nordic Musculoskeletal Questionnaire as a screening tool, Orebro Musculoskeletal Pain Questionnaire, The Short Questionnaire to Assess Health-Enhancing Physical Activity (SQUASH, University of Cambridge sleep questionnaire and Internet Mental Health Quality of Life (IMHQOL scale. Results: Comparatively, pain was more concentrated at spinal regions than peripheral locations among physiotherapists. Surprisingly, many physiotherapists reported multiple sites of musculoskeletal pains. Conclusion: A weak correlation was established between physical activity and musculoskeletal pain among physiotherapists.

  14. Cultural differences in musculoskeletal symptoms and disability.

    Science.gov (United States)

    Madan, Ira; Reading, Isabel; Palmer, Keith T; Coggon, David

    2008-10-01

    To test the hypothesis that cultural factors such as health beliefs and expectations have an important influence on common musculoskeletal symptoms and associated disability, we compared prevalence rates in groups of workers carrying out similar physical activities in different cultural settings. We conducted a cross-sectional survey at factories and offices in Mumbai, India and in the UK. A questionnaire about symptoms, disability and risk factors was administered at interview to six occupational groups: three groups of office workers who regularly used computer keyboards (165 Indian, 67 UK of Indian subcontinental origin and 172 UK white), and three groups of workers carrying out repetitive manual tasks with the hands or arms (178 Indian, 73 UK of Indian subcontinental origin and 159 UK white). Modified Cox regression was used to calculate hazard ratios (HRs) for the prevalence of symptoms and disability by occupational group, adjusted for differences in sex, age, mental health and job satisfaction. Reported occupational activities were similar in the three groups of office workers (frequent use of keyboards) and in the three groups of manual workers (frequent movements of the wrist or fingers, bending of the elbow, work with the hands above shoulder height and work with the neck twisted). In comparison with the Indian manual workers, the prevalence of back, neck and arm pain was substantially higher in all of the other five occupational groups. The difference was greatest for arm pain lasting >30 days in the past year in UK white manual workers (HR 17.8, 95% CI 5.4-59.1) and UK manual workers of Indian subcontinental origin (HR 20.5, 95% CI 5.7-73.1). Office workers in India had lower rates of pain in the wrist and hand than office workers in the UK. Only 1% of the Indian manual workers and 16% of the Indian office workers had ever heard of 'RSI' or similar terms, as compared with 80% of the UK workers. Our findings support the hypothesized impact of cultural

  15. Epidemiological profile of workers with musculoskeletal disorders of a supermarket company

    Directory of Open Access Journals (Sweden)

    Marcia Benites da Silva

    Full Text Available AbstractIntroduction The epidemiological profile is considered a sensitive indicator of living conditions and the disease process. The musculoskeletal disorders are the most common causes of pain and can lead to disability or restriction of daily activities. These disorders take the name of RCT/OWRD when they are associated with work activities and may be associated with risk conditions at work.Objectives To describe the epidemiological profile of supermarket workers with musculoskeletal disorders under treatment at a physiotherapy clinic in the city of Porto Alegre, Brazil.Methods This was a cross-sectional, observational study which used retrospective data collected from 360 records of patients treated from January 2010 to December 2011 in a physiotherapy clinic that provides health services for a supermarket chain.Results There was a predominance of females (73.9%, aged 30–39 years (35.1%; 63.0% reported being single and 73.4% lived in Porto Alegre. The most commonly reported occupation was cashier (31.2%. The main reasons for referral to physiotherapy treatment were low back pain (21.4%, neck pain (19.7%, pain (16.1%, subacromial bursitis (13.9% and back pain (12.2%. Among the signs and symptoms 95.8% of the sample reported pain in chronic phase.Conclusion The prevalence of musculoskeletal pain was high in this group. The presence of pain can disable the worker for daily activities and physiotherapy becomes the therapeutic procedure of choice for their rehabilitation.

  16. Good work ability despite multisite musculoskeletal pain? A study among occupationally active Finns.

    Science.gov (United States)

    Pensola, Tiina; Haukka, Eija; Kaila-Kangas, Leena; Neupane, Subas; Leino-Arjas, Päivi

    2016-05-01

    Although multisite pain (MSP) often threatens work ability (WA), some of those with MSP retain good WA. Our aim was to identify factors associated with good WA among subjects with MSP. A nationally representative sample (the Health 2000-Study, response rate 87%) comprising 3884 occupationally active Finns aged 30-64 years. Data on WA, musculoskeletal pain, physical and psychosocial working conditions, chronic diseases, lifestyle and domestic situation were gathered by questionnaire, interview and clinical examination. Good current WA compared with the lifetime best was defined as ⩾9 on a 0-10 scale. Musculoskeletal pain in 18 body locations was combined into four sites, and thereafter pain in two or more sites was defined as MSP (N=1351). Poisson regression analysis was used to obtain prevalence rate ratios (PRR). Good WA was reported by 48% of the women and 37% of the men with MSP. In a multivariable model good WA was associated with younger age, female gender, physically non-strenuous work (PRR 1.3, 95% CI 1.1-1.5), low job strain (1.2, 1.0-1.4), high supervisor support (1.2, 1.0-1.4), and not having musculoskeletal diseases (1.3, 1.1-1.5), mental disorders (1.4, 1.1-1.9), daytime tiredness (1.4, 1.2-1.7) or economic troubles (1.5, 1.1-1.9). Age-stratified analyses revealed also associations with high coworker support (1.2, 1.0-1.4) and strenuous leisure-time physical exercise (1.2, 1.0-1.4) in those aged 30-44 and low alcohol consumption (1.8, 1.2-2.6) in the age-group 45-64. Several potentially modifiable factors related to health, work, and lifestyle were associated with good WA among occupationally active subjects with MSP. © 2015 the Nordic Societies of Public Health.

  17. 33 CFR 136.223 - Compensation allowable.

    Science.gov (United States)

    2010-07-01

    ...) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS... allowable under paragraph (a) of this section must be reduced by— (1) All compensation made available to the... under § 136.235. Government Revenues ...

  18. Nuclear damage compensation and energy reform

    International Nuclear Information System (INIS)

    Yokemoto, Masafumi

    2013-01-01

    Nuclear damage compensation and energy reform were closely related. Nuclear damage compensation cost should be part of generation cost of nuclear power. Extend of nuclear damage compensation was limited by compensation standard of Tokyo Electric Power Co. (TEPCO) following guidelines of Dispute Reconciliation Committee for Nuclear Damage Compensation. TEPCO had already paid compensation of about two trillion yen until now, which was only a part of total damage compensation cost. TEPCO had been provided more than 3.4 trillion yen by Nuclear Damage Liability Facilitation Cooperation, which would be put back by nuclear operators including TEPCO. TEPCO could obtain present raising funds and try to reconstruct business with restart of nuclear power, which might disturb energy reform. Present nuclear damage compensation scheme had better be reformed with learning more from Minamata disease case in Japan. (T. Tanaka)

  19. Estimating cranial musculoskeletal constraints in theropod dinosaurs.

    Science.gov (United States)

    Lautenschlager, Stephan

    2015-11-01

    Many inferences on the biology, behaviour and ecology of extinct vertebrates are based on the reconstruction of the musculature and rely considerably on its accuracy. Although the advent of digital reconstruction techniques has facilitated the creation and testing of musculoskeletal hypotheses in recent years, muscle strain capabilities have rarely been considered. Here, a digital modelling approach using the freely available visualization and animation software Blender is applied to estimate cranial muscle length changes and optimal and maximal possible gape in different theropod dinosaurs. Models of living archosaur taxa (Alligator mississippiensis, Buteo buteo) were used in an extant phylogenetically bracketed framework to validate the method. Results of this study demonstrate that Tyrannosaurus rex, Allosaurus fragilis and Erlikosaurus andrewsi show distinct differences in the recruitment of the jaw adductor musculature and resulting gape, confirming previous dietary and ecological assumptions. While the carnivorous taxa T. rex and Allo. fragilis were capable of a wide gape and sustained muscle force, the herbivorous therizinosaurian E. andrewsi was constrained to small gape angles.

  20. Dynamic MR imaging of the musculoskeletal system

    International Nuclear Information System (INIS)

    Shah, A.S.; Hylton, H.; Hentz, V.R.; Schattner, P.

    1991-01-01

    This paper reports on dynamic MR imaging which is an MR technique that allows imaging of the musculoskeletal system in motion. Current methods for observing the articulation of muscles and joints are limited to acquisition of stationary images at different spatial orientations. These images are then replayed from computer memory to simulate motion. Unlike stationary acquisition, dynamic MR imaging allows the volume of interest to be subjected to motion and dynamic stress, which is important for detecting stress-induced pathology. To demonstrate the utility of dynamic MR imaging, a system for imaging a moving wrist has been developed. The system consists of apparatus capable of providing simultaneous radialulnar deviation and flexion-extension, and hardware for system control and acquisition gating. The apparatus is mounted on the patient bed and is transferable to a variety of standard clinical MR imaging systems. Images were obtained during motion, and the ability of dynamic MR imaging to accurately image the moving wrist with very little motion artifact was demonstrated

  1. Diabetes Mellitus and the Musculoskeletal System

    International Nuclear Information System (INIS)

    Monu, Johnny V.J.

    2015-01-01

    Diabetes mellitus is a metabolic disease with systemic manifestations. Occurrence is increasing worldwide from 153m to 347m from 1980 to 2011. Traditionally there are two main types: Insulin dependent or juvenile diabetes and non-insulin dependent or Maturity onset or insulin resistant diabetes. Gestational diabetes the second type of diabetes is increasingly seen in young patients and it evolves into insulin dependence. Obesity is causally related to type II diabetes. Diabetes Mellitus affects appendicular and peripheral structures more commonly – ankle and feet. Diabetes in the MSK System effects manifested as congenital problems, Peripheral neuropathy, Peripheral vasculopathy Infections and Connective tissue changes. The disease target Structures like Cardio-vascular system, Central nervous system (brain, eyes) and peripheral nerves, Reticulo-endothelial system, Kidneys and Musculoskeletal system. Osteomyelitis fractures including fragmentation of bones and disorganization of joints – neuropathic changes. Diabetic Myopathy occurs predominantly in long-standing, poorly controlled type 1 diabetics often have other vascular or end organ complications. Etiology related to microvascular disease leads to muscle ischemia and infarction eventual muscle atrophy

  2. Musculoskeletal magnetic resonance imaging: importance of radiography

    International Nuclear Information System (INIS)

    Taljanovic, Mihra S.; Hunter, Tim B.; Fitzpatrick, Kimberly A.; Krupinski, Elizabeth A.; Pope, Thomas L.

    2003-01-01

    To determine the usefulness of radiography for interpretation of musculoskeletal (MSK) magnetic resonance imaging (MRI) studies. In a 1-year period, 1,030 MSK MRI studies were performed in 1,002 patients in our institution. For each study, the interpreting radiologist completed a questionnaire regarding the availability and utility of radiographs, radiological reports and clinical information for the interpretation of the MRI study. Radiographs were essential, very important or added information in 61-75% of all MSK MRI cases. Radiographs were judged as essential for reading of MRI studies more often for trauma, infection/inflammation and tumors than for degenerative and miscellaneous/normal diagnoses (χ 2 =60.95, df=16, P 2 =93.07, df=16, P<0.0001). The clinical and MRI diagnoses were the same or partially concordant significantly more often for tumors than for trauma, infection/inflammation and degenerative conditions, while in the miscellaneous/normal group they were different in 64% of cases. When the diagnoses were different, there were more instances in which radiographs were not available. Radiographs are an important, and sometimes essential, initial complementary study for reading of MSK MRI examinations. It is highly recommended that radiographs are available when MSK MRI studies are interpreted. (orig.)

  3. Imaging review of lipomatous musculoskeletal lesions

    Directory of Open Access Journals (Sweden)

    Burt Ashley M.

    2017-01-01

    Full Text Available Lipomatous lesions are common musculoskeletal lesions that can arise within the soft tissues, bone, neurovascular structures, and synovium. The majority of these lesions are benign, and many of the benign lesions can be diagnosed by radiologic evaluation. However, radiologic differences between benign and malignant lipomatous lesions may be subtle and pathologic correlation is often needed. The use of sonography, computed tomography (CT, and magnetic resonance imaging (MRI is useful not only in portraying fat within the lesion, but also for evaluating the presence and extent of soft tissue components. Lipomas make up most soft tissue lipomatous lesions, but careful evaluation must be performed to distinguish these lesions from a low-grade liposarcoma. In addition to the imaging appearance, the location of the lesion and the patient demographics can be utilized to help diagnose other soft tissue lipomatous lesions, such as elastofibroma dorsi, angiolipoma, lipoblastoma, and hibernoma. Osseous lipomatous lesions such as a parosteal lipoma and intraosseous lipoma occur less commonly as their soft tissue counterpart, but are also benign. Neurovascular and synovial lipomatous lesions are much rarer lesions but demonstrate more classic radiologic findings, particularly on MRI. A review of the clinical, radiologic, and pathologic characteristics of these lesions is presented.

  4. Hand dominance in upper extremity musculoskeletal disorders.

    Science.gov (United States)

    Shiri, Rahman; Varonen, Helena; Heliövaara, Markku; Viikari-Juntura, Eira

    2007-05-01

    To investigate the role of hand dominance in common upper extremity musculoskeletal disorders (UEMSD) in a population study. The target population consisted of a representative sample of people aged 30 years or older residing in Finland during 2000-2001. Of the 7977 eligible subjects, 6254 (78.4%) were included in the study. The prevalence of UEMSD was as follows: rotator cuff tendinitis 3.8%, bicipital tendinitis 0.5%, lateral epicondylitis 1.1%, medial epicondylitis 0.3%, carpal tunnel syndrome (CTS) 3.8%, and surgery due to CTS 1.3%. CTS was 2.5 times as prevalent in women as men, whereas the other UEMSD were as common in both sexes. Rotator cuff and bicipital tendinitis and medial epicondylitis were more prevalent in the dominant arm only in women, whereas lateral epicondylitis was more prevalent in the dominant elbow in both sexes. The higher prevalence of rotator cuff and bicipital tendinitis in the dominant side persisted beyond working age. The prevalence of CTS did not differ by hand dominance. Dominant hand had been operated more frequently for CTS in women. Our findings show that UEMSD are more prevalent in the dominant than nondominant arm mainly in women. For shoulder tendinitis, the difference persists throughout adult age. Physical load factors may have long-lasting effects on the shoulder and they may play a greater role in women than men.

  5. Musculoskeletal Imaging Findings of Hematologic Malignancies.

    Science.gov (United States)

    Navarro, Shannon M; Matcuk, George R; Patel, Dakshesh B; Skalski, Matthew; White, Eric A; Tomasian, Anderanik; Schein, Aaron J

    2017-01-01

    Hematologic malignancies comprise a set of prevalent yet clinically diverse diseases that can affect every organ system. Because blood components originate in bone marrow, it is no surprise that bone marrow is a common location for both primary and metastatic hematologic neoplasms. Findings of hematologic malignancy can be seen with most imaging modalities including radiography, computed tomography (CT), technetium 99m ( 99m Tc) methylene diphosphonate (MDP) bone scanning, fluorine 18 ( 18 F) fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT, and magnetic resonance (MR) imaging. Because of the diversity of imaging appearances and clinical behavior of this spectrum of disease, diagnosis can be challenging, and profound understanding of the underlying pathophysiologic changes and current treatment modalities can be daunting. The appearance of normal bone marrow at MR imaging and FDG PET/CT is also varied due to dynamic compositional changes with normal aging and in response to hematologic demand or treatment, which can lead to false-positive interpretation of imaging studies. In this article, the authors review the normal maturation and imaging appearance of bone marrow. Focusing on lymphoma, leukemia, and multiple myeloma, they present the spectrum of imaging findings of hematologic malignancy affecting the musculoskeletal system and the current imaging tools available to the radiologist. They discuss the imaging findings of posttreatment bone marrow and review commonly used staging systems and consensus recommendations for appropriate imaging for staging, management, and assessment of clinical remission. © RSNA, 2017.

  6. Musculoskeletal injuries in young ballet dancers.

    Science.gov (United States)

    Leanderson, Charlotte; Leanderson, Johan; Wykman, Anders; Strender, Lars-Erik; Johansson, Sven-Erik; Sundquist, Kristina

    2011-09-01

    The aim of this study was to examine the incidence of musculoskeletal injuries, site and type of injury, and the most common injury diagnoses in young ballet dancers at the Royal Swedish Ballet School, a public school in Stockholm. This retrospective study of 476 students (297 girls and 179 boys) aged 10-21 years was based on medical records for the period August 1988 to June 1995. Data on diagnosis, site of injury and type of injury were collected, and the injuries were classified as traumatic or due to overuse. In total, 438 injuries were recorded. The injury incidence rate was 0.8 per 1,000 dance hours in both female and male dancers and tended to increase with increasing age. Most injuries occurred as the result of overuse. Seventy-six per cent of all injuries occurred in the lower extremities. Ankle sprain was the most common traumatic diagnosis, while the most common overuse-related diagnosis was tendinosis pedis. A few gender differences were noted. The findings of this study suggest that there is a need to apply primary injury prevention in young ballet dancers. Future studies could aim to identify (1) injury risk factors and (2) injury prevention programmes that are effective at reducing injury rates in young dancers.

  7. Quantum electrodynamics with compensating current

    Energy Technology Data Exchange (ETDEWEB)

    Bechler, A [Warsaw Univ. (Poland). Instytut Fizyki Teoretycznej

    1974-01-01

    A formulation of quantum electrodynamics is proposed in which all the propagators and field operators are gauge invariant. It is based on an old idea of Heisenberg and Euler which consists in the introduction of the linear integrals of potentials as arguments of the exponential functions. This method is generalized by an introduction of the so-called ''compensating currents'', which ensure local, i.e. in every point of space-time, charge conservation. The linear integral method is a particular case of that proposed in this paper. As the starting point we use quantum electrodynamics with a non-zero, small photon mass (Proca theory). It is shown that, due to the presence of the compensating current, the theory is fully renormalizable in Hilbert space with positive definite scalar product. The problem of the definition of the current operator is also briefly discussed.

  8. Executive compensation: a calibration approach

    OpenAIRE

    Ivilina Popova; Joseph G. Haubrich

    1998-01-01

    We use a version of the Grossman and Hart principal-agent model with 10 actions and 10 states to produce quantitative predictions for executive compensation. Performance incentives derived from the model are compared with the performance incentives of 350 firms chosen from a survey by Michael Jensen and Kevin Murphy. The results suggest both that the model does a reasonable job of explaining the data and that actual incentives are close to the optimal incentives predicted by theory.

  9. Compensating Differentials for Sexual Harassment

    OpenAIRE

    Joni Hersch

    2011-01-01

    Workplace sexual harassment is illegal, but many workers report that they have been sexually harassed. Exposure to the risk of sexual harassment may decrease productivity, which would reduce wages. Alternatively, workers may receive a compensating differential for exposure to sexual harassment, which would increase wages. Data on claims of sexual harassment filed with the Equal Employment Opportunity Commission are used to calculate the first measures of sexual harassment risks by industry, a...

  10. Chronic diseases in elderly men

    DEFF Research Database (Denmark)

    Nielsen, Morten Frost Munk; Wraae, Kristian; Gudex, Claire

    2012-01-01

    OBJECTIVE: prevalence estimates for chronic diseases and associated risk factors are needed for priority setting and disease prevention strategies. The aim of this cross-sectional study was to estimate the self-reported and clinical prevalence of common chronic disorders in elderly men. STUDY......-reported data on risk factors and disease prevalence were compared with data from hospital medical records. RESULTS: physical inactivity, smoking and excessive alcohol intake were reported by 27, 22 and 17% of the study population, respectively. Except for diabetes, all the chronic diseases investigated......, including hypertension, musculoskeletal and respiratory diseases were underreported by study participants. Erectile dysfunction and hypogonadism were substantially underreported in the study population even though these diseases were found to affect 48 and 21% of the participants, respectively. CONCLUSIONS...

  11. 23 CFR 751.15 - Just compensation.

    Science.gov (United States)

    2010-04-01

    ... 23 Highways 1 2010-04-01 2010-04-01 false Just compensation. 751.15 Section 751.15 Highways... AND ACQUISITION § 751.15 Just compensation. (a) Just compensation shall be paid the owner for the... nonconforming junkyard as provided in § 751.11 must pertain at the time of the taking or removal in order to...

  12. Dynamic Phase Compensation of wind turbines

    DEFF Research Database (Denmark)

    Soerensen, P.; Skaarup, J.; Iov, Florin

    2004-01-01

    This paper describes a dynamic phase compensation unit for a wind turbine with directly connected induction generators. The compensation unit is based on thyristor switched capacitors, where conventional wind turbine compensations use mechanical contactors to switch the capacitors. The unit modules...

  13. 33 CFR 136.217 - Compensation allowable.

    Science.gov (United States)

    2010-07-01

    ...) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF SOURCE; AND ADVERTISEMENT Procedures for Particular Claims § 136.217 Compensation... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Compensation allowable. 136.217...

  14. 33 CFR 136.205 - Compensation allowable.

    Science.gov (United States)

    2010-07-01

    ...) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF SOURCE; AND ADVERTISEMENT Procedures for Particular Claims § 136.205 Compensation... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Compensation allowable. 136.205...

  15. 33 CFR 136.113 - Other compensation.

    Science.gov (United States)

    2010-07-01

    ...) MARINE POLLUTION FINANCIAL RESPONSIBILITY AND COMPENSATION OIL SPILL LIABILITY TRUST FUND; CLAIMS PROCEDURES; DESIGNATION OF SOURCE; AND ADVERTISEMENT General Procedure § 136.113 Other compensation. A... 33 Navigation and Navigable Waters 2 2010-07-01 2010-07-01 false Other compensation. 136.113...

  16. The battle over workers' compensation.

    Science.gov (United States)

    Ellenberger, J N

    2000-01-01

    Faced with lower profits and rapidly increasing premium costs in the 1980s, insurers and employer organizations cleverly parlayed the public perception of worker fraud and abuse in the workers' compensation system (that they helped to create) into massive legislative changes. Over the last decade, state legislators and governors, Republican and Democrat alike, have jumped on this bandwagon, one that workers and their allies have dubbed the workers' compensation "deform" movement. Alleging a "game plan" and a calculated campaign on the part of insurers and employers, the author looks at the major components of changes that were made, examines the elements of workers' compensation over which employers and insurers have gained control, and discusses Newt Gingrich's efforts to capitalize on employer and insurer fervor over the system. This campaign whistled through the country until it goaded the labor movement, injured workers, the trial bar, and others in Ohio in 1997 to organize themselves to stand up to employers by defeating the deform law through a ballot initiative. The article details that battle and suggests that similar voices can be achieved through a return to grassroots organizing and mobilization.

  17. Compensation Techniques in Accelerator Physics

    Energy Technology Data Exchange (ETDEWEB)

    Sayed, Hisham Kamal [Old Dominion Univ., Norfolk, VA (United States)

    2011-05-01

    Accelerator physics is one of the most diverse multidisciplinary fields of physics, wherein the dynamics of particle beams is studied. It takes more than the understanding of basic electromagnetic interactions to be able to predict the beam dynamics, and to be able to develop new techniques to produce, maintain, and deliver high quality beams for different applications. In this work, some basic theory regarding particle beam dynamics in accelerators will be presented. This basic theory, along with applying state of the art techniques in beam dynamics will be used in this dissertation to study and solve accelerator physics problems. Two problems involving compensation are studied in the context of the MEIC (Medium Energy Electron Ion Collider) project at Jefferson Laboratory. Several chromaticity (the energy dependence of the particle tune) compensation methods are evaluated numerically and deployed in a figure eight ring designed for the electrons in the collider. Furthermore, transverse coupling optics have been developed to compensate the coupling introduced by the spin rotators in the MEIC electron ring design.

  18. Psychosocial effects of workplace physical exercise among workers with chronic pain:Randomized controlled trial

    OpenAIRE

    Andersen, Lars L.; Persson, Roger; Jakobsen, Markus D.; Sundstrup, Emil

    2017-01-01

    Abstract While workplace physical exercise can help manage musculoskeletal disorders, less is known about psychosocial effects of such interventions. This aim of this study was to investigate the effect of workplace physical exercise on psychosocial factors among workers with chronic musculoskeletal pain. The trial design was a 2-armed parallel-group randomized controlled trial with allocation concealment. A total of 66 slaughterhouse workers (51 men and 15 women, mean age 45 years [standard ...

  19. 38 CFR 21.3023 - Nonduplication; pension, compensation, and dependency and indemnity compensation.

    Science.gov (United States)

    2010-07-01

    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false Nonduplication; pension, compensation, and dependency and indemnity compensation. 21.3023 Section 21.3023 Pensions, Bonuses, and... Nonduplication; pension, compensation, and dependency and indemnity compensation. (a) Child; age 18. A child who...

  20. Advancing Psychologically Informed Practice for Patients With Persistent Musculoskeletal Pain: Promise, Pitfalls, and Solutions.

    Science.gov (United States)

    Keefe, Francis J; Main, Chris J; George, Steven Z

    2018-05-01

    There has been growing interest in psychologically oriented pain management over the past 3 to 4 decades, including a 2011 description of psychologically informed practice (PIP) for low back pain. PIP requires a broader focus than traditional biomechanical and pathology-based approaches that have been traditionally used to manage musculoskeletal pain. A major focus of PIP is addressing the behavioral aspects of pain (ie, peoples' responses to pain) by identifying individual expectations, beliefs, and feelings as prognostic factors for clinical and occupational outcomes indicating progression to chronicity. Since 2011, the interest in PIP seems to be growing, as evidenced by its use in large trials, inclusion in scientific conferences, increasing evidence base, and expansion to other musculoskeletal pain conditions. Primary care physicians and physical therapists have delivered PIP as part of a stratified care approach involving screening and targeting of treatment for people at high risk for continued pain-associated disability. Furthermore, PIP is consistent with recent national priorities emphasizing nonpharmacological pain management options. In this perspective, PIP techniques that range in complexity are described, considerations for implementation in clinical practice are offered, and future directions that will advance the understanding of PIP are outlined.

  1. Rééducation Posturale Globale in musculoskeletal diseases: scientific evidence and clinical practice

    Directory of Open Access Journals (Sweden)

    D. Tosarelli

    2011-09-01

    Full Text Available Several studies on the treatment of musculoskeletal diseases with physiotherapy and clinical experiences on the basis of a method called Rééducation Posturale Globale (RPG, have highlighted the usefulness of this treatment. Although such treatment technique is commonly used in physical therapy practice, only few studies support its therapeutic effectiveness. Objective: To search the literature for evidence of RPG effectiveness, in order to identify the most appropriate therapeutic contexts for its use. Methods: A review of the literature through the following databases: PubMed, Embase, Cinahl, Pedro, and Medscape. The keywords used for the search in the databases are: Rééducation Posturale Globale, Souchard, Posture, and Manual Therapy. The following clinical studies were selected: randomized controlled studies, non-randomized controlled studies, observation studies, and case reports, in English, Spanish, Portuguese, and Italian. Results: Out of 18 studies found, 9 were analyzed: 2 randomized controlled studies, 2 non-randomized controlled studies, 3 non-controlled studies, and 2 case reports. Conclusions: The RPG method has been shown to be an effective treatment technique for musculoskeletal diseases, in particular for ankylosing spondylitis, acute and chronic low back pain, and lumbar discherniation. Although the scarcity of rigorous experimental trials on a large scale does not allow the drawing of undisputable conclusions, the results gathered up to now are an encouragement to carry on research in the field of conservative treatment.

  2. Assessment of a new undergraduate module in musculoskeletal medicine.

    Science.gov (United States)

    Queally, Joseph M; Cummins, Fionnan; Brennan, Stephen A; Shelly, Martin J; O'Byrne, John M

    2011-02-02

    Despite the high prevalence of musculoskeletal disorders seen by primary care physicians, numerous studies have demonstrated deficiencies in the adequacy of musculoskeletal education at multiple stages of medical education. The aim of this study was to assess a newly developed module in musculoskeletal medicine for use at European undergraduate level (i.e., the medical-school level). A two-week module in musculoskeletal medicine was designed to cover common musculoskeletal disorders that are typically seen in primary care. The module incorporated an integrated approach, including core lectures, bedside clinical examination, and demonstration of basic practical procedures. A previously validated examination in musculoskeletal medicine was used to assess the cognitive knowledge of ninety-two students on completion of the module. A historical control group (seventy-two students) from a prior course was used for comparison. The new module group (2009) performed significantly better than the historical (2006) control group in terms of score (62.3% versus 54.3%, respectively; p pass rate (38.4% versus 12.5%, respectively; p = 0.0002). In a subgroup analysis of the new module group, students who enrolled in the graduate entry program (an accelerated four-year curriculum consisting of students who have already completed an undergraduate university degree) were more likely to perform better in terms of average score (72.2% versus 57%, respectively; p pass rates (70.9% versus 21.4%, respectively; p paper represents an educational advance at undergraduate (i.e., medical-school) level as demonstrated by the improvement in scores in a validated examination. As pressure on medical curricula grows to accommodate advancing medical knowledge, it is important to continue to improve, assess, and consolidate the position of musculoskeletal medicine in contemporary medical education.

  3. Evaluation of Musculoskeletal Disorders in Household Appliances Manufacturing Company

    Directory of Open Access Journals (Sweden)

    Aioob Ghanbary

    2015-12-01

    Full Text Available Work-related musculoskeletal disorders are the most prevalent work-related disorders and injuries and being the main cause of disability. This study was conducted to assessment of the prevalence of musculoskeletal disorders in worker company household appliances production. Posture analysis was evaluated by OWAS method and prevalence of musculoskeletal disorders by Nordic questionnaire. With evaluating musculoskeletal disorders among company household appliances production can intervention action to reduce musculoskeletal disorders was carried out. This cross-sectional study was performed on 100 workers of the appliance manufacturing industry. These Individuals were included 15 persons from foam injection workshop, 17 persons from molding workshop, 17 operators of presses, 17 persons from packaging, 17 person from cutting unit and 17 operators of rivet. The Nordic questionnaire was completed by Individuals for the organs of arm, back, leg and wrist and Posture analysis was performed by OWAS method. The data were analyzed using Spss software version 18 and descriptive statistics and Anova test. Nordic questionnaire results revealed that highest disorders were observed in the arm (25%, back (22% and leg (21%. Also Anova test showed that was observed a significant correlation respectively between age and work experience with the prevalence of musculoskeletal disorders (p<0.02 (p<0.01. The results showed based on the level of risk OWAS for each job respectively, the highest level of risk associated with foam injection unit, packaging and cutting unit (risk level 4 and the lowest level of risk associated with molding workshop unit (risk level 2.The results of this study showed that household appliances Manufacturing workers due to the nature of their jobs are at risk of musculoskeletal disorders and Ergonomic interventions to do such as workstation redesign, reduced working hours, cycle of rest-work development.

  4. Evaluation of Musculoskeletal Disorders among computer Users in Isfahan

    Directory of Open Access Journals (Sweden)

    Ayoub Ghanbary

    2015-08-01

    Full Text Available Along with widespread use of computers, work-related musculoskeletal disorders (MSDs have become the most prevalent ergonomic problems in computer users. With evaluating musculoskeletal disorders among Computer Users can intervent a action to reduce musculoskeletal disorders carried out. The aim of the present study was to Assessment of Musculoskeletal Disorders among Computer Users in Isfahan University with Rapid Office Strain Assessment (ROSA method and Nordic questionnaire. This cross-sectional study was conducted on 96 computer users in Isfahan university. The data were analyzed using correlation and line regression by test spss 20. and descriptive statistics and Anova test. Data collection tool was Nordic questionnaire and Rapid Office Strain Assessment method checklist. The results of Nordic questionnaire showed that prevalence of musculoskeletal disorders in computer users were in the shoulder (62.1%, neck (54.9% and back (53.1% respectively more than in other parts of the body. Based on the level of risk of ROSA were 19 individuals in an area of low risk, 50 individual area of notification and 27 individual in the area hazard and need for ergonomics interventions. Musculoskeletal disorders prevalence were in women more than men. Also Anova test showed that there is a direct and significant correlation between age and work experience with a final score ROSA (p<0.001. The study result showed that the prevalence of MSDs among computer users of Isfahan universities is pretty high and must ergonomic interventions such as computer workstation redesign, users educate about ergonomic principles computer with work, reduced working hours in computers with work, and elbows should be kept close to the body with the angle between 90 and 120 degrees to reduce musculoskeletal disorders carried out.

  5. A long-term evaluation of the stage of change approach and compensable injury outcomes - a cluster-randomised trial.

    Science.gov (United States)

    Rothmore, Paul; Aylward, Paul; Gray, Jodi; Karnon, Jonathan

    2017-05-01

    This study investigated the long-term injury outcomes for workers in companies from a range of industries which had been randomly allocated to receive ergonomics interventions tailored according to the stage of change (SOC) approach or standard ergonomics advice. Differences in compensable injury outcomes between the groups were analysed using logistic regression models. Questionnaire results from face-to-face interviews to assess musculoskeletal pain and discomfort (MSPD), job satisfaction and other factors were also analysed. Although not significant at the 0.05 level, after adjusting for workgroup clustering, workers in receipt of tailored advice were 55% (OR = 0.45, 95% CI = 0.19-1.08) less likely to report a compensable injury than those in receipt of standard ergonomics advice. Workload, job satisfaction and MSPD were significantly correlated with injury outcomes. The observed outcomes support the potential value of the SOC approach, as well as highlighting the need to consider workload, job satisfaction and MSPD when planning injury prevention programmes. Practitioner Summary: This study investigated compensable injury outcomes for workers who had received ergonomics advice tailored according to the stage of change (SOC) approach compared with standard ergonomics advice. The results support the potential value of the SOC approach and highlight the need to consider workload, job satisfaction and musculoskeletal pain and discomfort when planning injury prevention interventions.

  6. Work Sectors with High Risk for Work-Related Musculoskeletal Disorders in Korean Men and Women

    Directory of Open Access Journals (Sweden)

    Jungsun Park

    2018-03-01

    Full Text Available Background: To identify work sectors with high risk for work-related musculoskeletal disorders (MSDs in Korean men and women. Methods: We analyzed nationwide data to identify ergonomic risk factors in Korean employees. In particular, we analyzed data on exposure to five ergonomic risk factors (painful/tiring postures, lifting/moving heavy materials, standing/walking, repetitive hand/arm movements, and hand/arm vibration according to employment sector, sex, and age, using the 2014 Fourth Korean Working Conditions Survey. We also used workers' compensation data on work-related MSDs in 2010, which is available by sex. Results: The different work sectors had different gender distributions. “Manufacturing” (27.7% and “construction” (11.3% were dominated by males, whereas “human health and social work activities” (12.4%, “hotel and restaurants” (11.7%, and “education” (10.4% were dominated by females. However, “wholesale and retail trade” and “public administration and defense” employed large numbers of males and females. Furthermore, the work sectors with a greater proportion of work-related MSDs and with multiple ergonomic risk factors were different for men and women. For men, “construction” and “manufacturing” had the highest risk for work-related MSDs; for women, “hotel and restaurants” had the highest risk for work-related MSDs. Conclusion: Ergonomic interventions for workers should consider gender and should focus on work sectors with high risk for MSDs, with multiple ergonomic risk factors, and with the largest number of workers. Keywords: ergonomic, risk factor, Korean workers, musculoskeletal disorder

  7. Musculoskeletal MRI findings of juvenile localized scleroderma

    Energy Technology Data Exchange (ETDEWEB)

    Eutsler, Eric P. [Nemours Children' s Health System/Alfred I. duPont Hospital for Children, Wilmington, DE (United States); Washington University School of Medicine, Mallinckrodt Institute of Radiology, St. Louis, MO (United States); Horton, Daniel B. [Nemours Children' s Health System/Alfred I. duPont Hospital for Children, Division of Rheumatology, Department of Pediatrics, Wilmington, DE (United States); Rutgers Robert Wood Johnson Medical School, Department of Pediatrics, New Brunswick, NJ (United States); Epelman, Monica [Nemours Children' s Health System/Nemours Children' s Hospital, Department of Medical Imaging, Orlando, FL (United States); Finkel, Terri [Nemours Children' s Health System/Nemours Children' s Hospital, Department of Pediatrics, Orlando, FL (United States); Averill, Lauren W. [Nemours Children' s Health System/Alfred I. duPont Hospital for Children, Wilmington, DE (United States)

    2017-04-15

    Juvenile localized scleroderma comprises a group of autoimmune conditions often characterized clinically by an area of skin hardening. In addition to superficial changes in the skin and subcutaneous tissues, juvenile localized scleroderma may involve the deep soft tissues, bones and joints, possibly resulting in functional impairment and pain in addition to cosmetic changes. There is literature documenting the spectrum of findings for deep involvement of localized scleroderma (fascia, muscles, tendons, bones and joints) in adults, but there is limited literature for the condition in children. We aimed to document the spectrum of musculoskeletal magnetic resonance imaging (MRI) findings of both superficial and deep juvenile localized scleroderma involvement in children and to evaluate the utility of various MRI sequences for detecting those findings. Two radiologists retrospectively evaluated 20 MRI studies of the extremities in 14 children with juvenile localized scleroderma. Each imaging sequence was also given a subjective score of 0 (not useful), 1 (somewhat useful) or 2 (most useful for detecting the findings). Deep tissue involvement was detected in 65% of the imaged extremities. Fascial thickening and enhancement were seen in 50% of imaged extremities. Axial T1, axial T1 fat-suppressed (FS) contrast-enhanced and axial fluid-sensitive sequences were rated most useful. Fascial thickening and enhancement were the most commonly encountered deep tissue findings in extremity MRIs of children with juvenile localized scleroderma. Because abnormalities of the skin, subcutaneous tissues and fascia tend to run longitudinally in an affected limb, axial T1, axial fluid-sensitive and axial T1-FS contrast-enhanced sequences should be included in the imaging protocol. (orig.)

  8. Prevalence of burnout among musculoskeletal radiologists

    Energy Technology Data Exchange (ETDEWEB)

    Chew, Felix S.; Porrino, Jack A.; Mulcahy, Hyojeong; Relyea-Chew, Annemarie [University of Washington, Department of Radiology, Seattle, WA (United States); Mulcahy, Michael J. [Central Washington University, Department of Sociology, Ellensburg, WA (United States)

    2017-04-15

    Burnout is a job-related psychological syndrome with three aspects: emotional exhaustion, depersonalization, and perceived lack of personal accomplishment. Burnout is associated with deleterious effects on both workers and their work. When burnout affects physicians, their well-being, longevity, and care of patients are at risk. Recent studies concerning physician burnout treat specialists such as radiologists as one group. We studied burnout in musculoskeletal (MSK) subspecialist radiologists. An institutional review board exemption was obtained. Society of Skeletal Radiology members received invitations to an anonymous survey that included questions from the Maslach Burnout Inventory trademark (MBI) measuring all three aspects of burnout. The response rate was 36.4% (433/1190). The prevalence of emotional exhaustion was 61.7% (255/413), of depersonalization 53.3% (219/411), and of perceived lack of personal accomplishment 39.6% (161/407). Only 19.5% (79/405) of MSK radiologists reported no burnout, while 80.5% (326/405) reported burnout along one or more dimensions. For all three dimensions, the prevalence was higher and the mean severity was worse for private practice compared with academic practice. The prevalence of burnout was affected more by practice setting than by gender. Burnout prevalence and severity also varied systematically with years since completion of training. Among MSK radiologists, we found a much higher prevalence and greater severity of burnout than has been previously reported for radiologists and other physicians. There were differences in prevalence and severity of burnout among practice settings, genders, and longevity cohorts. (orig.)

  9. Prevalence of burnout among musculoskeletal radiologists

    International Nuclear Information System (INIS)

    Chew, Felix S.; Porrino, Jack A.; Mulcahy, Hyojeong; Relyea-Chew, Annemarie; Mulcahy, Michael J.

    2017-01-01

    Burnout is a job-related psychological syndrome with three aspects: emotional exhaustion, depersonalization, and perceived lack of personal accomplishment. Burnout is associated with deleterious effects on both workers and their work. When burnout affects physicians, their well-being, longevity, and care of patients are at risk. Recent studies concerning physician burnout treat specialists such as radiologists as one group. We studied burnout in musculoskeletal (MSK) subspecialist radiologists. An institutional review board exemption was obtained. Society of Skeletal Radiology members received invitations to an anonymous survey that included questions from the Maslach Burnout Inventory trademark (MBI) measuring all three aspects of burnout. The response rate was 36.4% (433/1190). The prevalence of emotional exhaustion was 61.7% (255/413), of depersonalization 53.3% (219/411), and of perceived lack of personal accomplishment 39.6% (161/407). Only 19.5% (79/405) of MSK radiologists reported no burnout, while 80.5% (326/405) reported burnout along one or more dimensions. For all three dimensions, the prevalence was higher and the mean severity was worse for private practice compared with academic practice. The prevalence of burnout was affected more by practice setting than by gender. Burnout prevalence and severity also varied systematically with years since completion of training. Among MSK radiologists, we found a much higher prevalence and greater severity of burnout than has been previously reported for radiologists and other physicians. There were differences in prevalence and severity of burnout among practice settings, genders, and longevity cohorts. (orig.)

  10. Musculoskeletal MRI findings of juvenile localized scleroderma

    International Nuclear Information System (INIS)

    Eutsler, Eric P.; Horton, Daniel B.; Epelman, Monica; Finkel, Terri; Averill, Lauren W.

    2017-01-01

    Juvenile localized scleroderma comprises a group of autoimmune conditions often characterized clinically by an area of skin hardening. In addition to superficial changes in the skin and subcutaneous tissues, juvenile localized scleroderma may involve the deep soft tissues, bones and joints, possibly resulting in functional impairment and pain in addition to cosmetic changes. There is literature documenting the spectrum of findings for deep involvement of localized scleroderma (fascia, muscles, tendons, bones and joints) in adults, but there is limited literature for the condition in children. We aimed to document the spectrum of musculoskeletal magnetic resonance imaging (MRI) findings of both superficial and deep juvenile localized scleroderma involvement in children and to evaluate the utility of various MRI sequences for detecting those findings. Two radiologists retrospectively evaluated 20 MRI studies of the extremities in 14 children with juvenile localized scleroderma. Each imaging sequence was also given a subjective score of 0 (not useful), 1 (somewhat useful) or 2 (most useful for detecting the findings). Deep tissue involvement was detected in 65% of the imaged extremities. Fascial thickening and enhancement were seen in 50% of imaged extremities. Axial T1, axial T1 fat-suppressed (FS) contrast-enhanced and axial fluid-sensitive sequences were rated most useful. Fascial thickening and enhancement were the most commonly encountered deep tissue findings in extremity MRIs of children with juvenile localized scleroderma. Because abnormalities of the skin, subcutaneous tissues and fascia tend to run longitudinally in an affected limb, axial T1, axial fluid-sensitive and axial T1-FS contrast-enhanced sequences should be included in the imaging protocol. (orig.)

  11. Musculoskeletal MRI findings of juvenile localized scleroderma.

    Science.gov (United States)

    Eutsler, Eric P; Horton, Daniel B; Epelman, Monica; Finkel, Terri; Averill, Lauren W

    2017-04-01

    Juvenile localized scleroderma comprises a group of autoimmune conditions often characterized clinically by an area of skin hardening. In addition to superficial changes in the skin and subcutaneous tissues, juvenile localized scleroderma may involve the deep soft tissues, bones and joints, possibly resulting in functional impairment and pain in addition to cosmetic changes. There is literature documenting the spectrum of findings for deep involvement of localized scleroderma (fascia, muscles, tendons, bones and joints) in adults, but there is limited literature for the condition in children. We aimed to document the spectrum of musculoskeletal magnetic resonance imaging (MRI) findings of both superficial and deep juvenile localized scleroderma involvement in children and to evaluate the utility of various MRI sequences for detecting those findings. Two radiologists retrospectively evaluated 20 MRI studies of the extremities in 14 children with juvenile localized scleroderma. Each imaging sequence was also given a subjective score of 0 (not useful), 1 (somewhat useful) or 2 (most useful for detecting the findings). Deep tissue involvement was detected in 65% of the imaged extremities. Fascial thickening and enhancement were seen in 50% of imaged extremities. Axial T1, axial T1 fat-suppressed (FS) contrast-enhanced and axial fluid-sensitive sequences were rated most useful. Fascial thickening and enhancement were the most commonly encountered deep tissue findings in extremity MRIs of children with juvenile localized scleroderma. Because abnormalities of the skin, subcutaneous tissues and fascia tend to run longitudinally in an affected limb, axial T1, axial fluid-sensitive and axial T1-FS contrast-enhanced sequences should be included in the imaging protocol.

  12. Academic musculoskeletal radiology: influences for gender disparity.

    Science.gov (United States)

    Qamar, Sadia R; Khurshid, Kiran; Jalal, Sabeena; Bancroft, Laura; Munk, Peter L; Nicolaou, Savvas; Khosa, Faisal

    2018-03-01

    Research productivity is one of the few quintessential gauges that North American academic radiology departments implement to determine career progression. The rationale of this study is to quantify the relationship of gender, research productivity, and academic advancements in the musculoskeletal (MSK) radiology to account for emerging trends in workforce diversity. Radiology residency programs enlisted in the Fellowship and Residency Electronic Interactive Database (FREIDA), Canadian Resident Matching Service (CaRMS) and International Skeletal Society (ISS) were searched for academic faculty to generate the database for gender and academic profiles of MSK radiologists. Bibliometric data was collected using Elsevier's SCOPUS archives, and analyzed using Stata version 14.2. Among 274 MSK radiologists in North America, 190 (69.34%) were men and 84 (30.66%) were women, indicating a statistically significant difference (χ2 = 6.34; p value = 0.042). The available number of female assistant professors (n = 50) was more than half of the male assistant professors (n = 88), this ratio however, plummeted at higher academic ranks, with only one-fourth of women (n = 11) professors compared to men (n = 45). The male MSK radiologist had 1.31 times the odds of having a higher h-index, keeping all other variables constant. The trend of gender disparity exists in MSK radiology with significant underrepresentation of women in top tiers of academic hierarchy. Even with comparable h-indices, at the lower academic ranks, a lesser number of women are promoted relative to their male colleagues. Further studies are needed to investigate the degree of influence research productivity has, in determining academic advancement of MSK radiologists.

  13. Musculoskeletal Complications Among Children with Sickle Cell ...

    African Journals Online (AJOL)

    Diagnostic criteria of avascular necrosis of head of femur in this study involve painful limitation of hip motion with restriction of passive movements of the hip. This was then confirmed by antero‑posterior radiographs of the affected hip.[12]. Chronic osteomyelitis (COM), on the other hand was diagnosed as a relapsing and ...

  14. Automatic error compensation in dc amplifiers

    International Nuclear Information System (INIS)

    Longden, L.L.

    1976-01-01

    When operational amplifiers are exposed to high levels of neutron fluence or total ionizing dose, significant changes may be observed in input voltages and currents. These changes may produce large errors at the output of direct-coupled amplifier stages. Therefore, the need exists for automatic compensation techniques. However, previously introduced techniques compensate only for errors in the main amplifier and neglect the errors induced by the compensating circuitry. In this paper, the techniques introduced compensate not only for errors in the main operational amplifier, but also for errors induced by the compensation circuitry. Included in the paper is a theoretical analysis of each compensation technique, along with advantages and disadvantages of each. Important design criteria and information necessary for proper selection of semiconductor switches will also be included. Introduced in this paper will be compensation circuitry for both resistive and capacitive feedback networks

  15. Personality and Its Relationship with Prevalence of Musculoskeletal Disorders

    Directory of Open Access Journals (Sweden)

    Omran Ahmadi

    2016-12-01

    Full Text Available Background Individual factors are usually important as non-occupational parameters that participate in the prevalence of musculoskeletal disorders. Personality traits are one of the individual factors that affect physical illness, which are constant over time, thereby reflecting stable individual differences. Identifying the personality trait can be used to predict musculoskeletal disorders in workers and select individual with appropriate personality traits for different works. Objectives The purpose of the present study was to identify the personality traits used to determine the relationship between different personality traits and the prevalence of musculoskeletal disorders. Methods 136 people of 2 different companies in Tabriz (in 2015 were selected as the study population. The first group was selected from the petrochemical repair workers and the second from a dairy factory. The 50-item version of Goldberg’s big five personality scale was used to assess the personality traits. Nordic questionnaire was employed to evaluate the prevalence of musculoskeletal disorders. Chi-square test was incorporated for analyzing the data. Finally, logistic regression test was used to study the factors affecting upper and lower body pain. Results Results indicated that individual personality traits were associated with musculoskeletal disorder prevalence in some members of body: Extraversion with wrist (P-value = 0.013 and hip (P-value = 0.044, emotional stability with shoulder (P-value = 0.012, wrist (P-value = 0.043, back (P-value = 0.034, low back (P-value = 0.029 and ankle( P-value = 0.014, Conscientiousness with Hip ( P-value = 0.009, Agreeableness with shoulder (P-value = 0.004, back (P-value = 0.001, Hip ( P-value = 0.006 and ankle ( P-value = 0.019. Conclusions According to the results of this study, the personality traits can contribute to musculoskeletal disorders. Therefore, notice of personality traits can be used to predict individuals who

  16. CT Guided biopsies of musculoskeletal lesions, radiological and pathologic correlation

    International Nuclear Information System (INIS)

    Hadzihasanovic, B.; Milisic, L.; Zuban, J.; Mujic, E.; Jahic, E.; Gjikolli, B.; Hasanovic, B.; Lincender-Cvijetic, L.; Jaganjac, S.

    2006-01-01

    Full text: The aim of the study is to overview our experiences in taking the CT guided biopsies of musculoskeletal lesions during the period of sixteen months, analysis of validity of samples taken and correlation with pathological findings. CT guided biopsies of musculoskeletal lesions were performed in 32 patients during the period of sixteen months (from December 2004 until March 2006). Age range was from 13 to 78 years. Majorities of the biopsies were performed with coaxial cutting needle system (14 G and 16 G) with introducers size 13 and 15 G. Bone biopsies were performed with Yamsidi needles in purpose of taking the bone cylinder. Majorities of the biopsies were performed under local anaesthesia except a thirteen years old child to whom CT guided biopsy of corpus Th 6 was performed under general anaesthesia. Two samples of tissues were sent in formalin solutions to Pathology Institute for pathological verification. In one case of musculoskeletal lesions CT guided biopsies didn't yield a representative tissue sample. We had high level of congruence between radiological and pathological findings; precise presented in the article. CT guided biopsies of musculoskeletal lesions are method of choice for pathologic verification of musculoskeletal lesions proving incomparable less risk compared to 'open' biopsy which requires operating theatre and general anaesthesia. Coaxial needle systems has shown as suitable for yielding representative tissue samples (two samples for each patient), and samples are also appropriate for immunohistochemical analysis

  17. Association Between Smartphone Use and Musculoskeletal Discomfort in Adolescent Students.

    Science.gov (United States)

    Yang, Shang-Yu; Chen, Ming-De; Huang, Yueh-Chu; Lin, Chung-Ying; Chang, Jer-Hao

    2017-06-01

    Despite the substantial increase in the number of adolescent smartphone users, few studies have investigated the behavioural effects of smartphone use on adolescent students as it relates to musculoskeletal discomfort. The purpose of this study was to explore the association between smartphone use and musculoskeletal discomfort in students at a Taiwanese junior college. We hypothesised that the duration of smartphone use would be associated with increased instances of musculoskeletal discomfort in these students. This cross-sectional study employed a convenience sampling method to recruit students from a junior college in southern Taiwan. All the students (n = 315) were asked to answer questionnaires on smartphone use. A descriptive analysis, stepwise regression, and logistic regression were used to examine specific components of smartphone use and their relationship to musculoskeletal discomfort. Nearly half of the participants experienced neck and shoulder discomfort. The stepwise regression results indicated that the number of body parts with discomfort (F = 6.009, p smartphone functions. The logistic regression analysis showed that the students who talked on the phone >3 h/day had a higher risk of upper back discomfort than did those who talked on the phone smartphone use and musculoskeletal discomfort is related to the duration of smartphone ancillary function use. Moreover, hours spent talking on the phone was a predictor of upper back discomfort.

  18. Risks of musculoskeletal disorders among betel quid preparers in Taiwan.

    Science.gov (United States)

    Chang, Jer-Hao; Wu, Jyun-De; Chen, Chih-Yong; Sumd, Shih-Bin; Yin, Hsin-I; Hsu, Der-Jen

    2014-04-01

    Betel quid chewing is common in Taiwan. The work of betel quid preparers is characterized by long hours of static work, awkward working posture and highly repetitive hand/wrist motion. However, the musculoskeletal health of betel quid preparers receives very little attention. The Chinese version of the Standardized Nordic Musculoskeletal Questionnaire (NMQ) was administered, and electrogoniometers and electromyography were used in this cross-sectional study to characterize the hand/wrist motion of the subjects. Physical examinations on the thumbs and wrists of the subjects were conducted by means of Phalen's test and Finkelstein's test, respectively. Among the 225 participants, more than 95% attributed their musculoskeletal complaints to their work, and shoulder, neck, hand/wrist, and lower back discomfort were most frequently reported. More than 70% of the preparers did not seek medical treatment for their musculoskeletal problems. Based on the physical examination, 24% of the participants had suspected symptom of either carpal tunnel syndrome (CTS) or DeQuervain's tenosynovitis. The instrumental measurements indicated that betel quid preparation is characterized by extreme angle ranges and moderate repetition of wrist motion as well as low forceful exertion. This study concludes that betel quid preparers are a high risk group of developing musculoskeletal disorders (MSDs). Future studies by electrogoniometers and detailed physical examination on betel quid preparers are needed to determine the predisposing factors for CTS. Some intervention measures to prevent MSDs and to lessen psychological stress for this group of workers are strongly suggested. © 2014 Wiley Periodicals, Inc.

  19. Dermatological and musculoskeletal assessment of diabetic foot: A narrative review.

    Science.gov (United States)

    Arsanjani Shirazi, Azam; Nasiri, Morteza; Yazdanpanah, Leila

    2016-01-01

    Diabetic Foot Syndrome (DFS) is the most costly and devastating complication of diabetes mellitus (DM), which early effective assessment can reduce the severity of complications including ulceration and amputations. This study aimed to review dermatological and musculoskeletal assessment of diabetic foot. In this review article, we searched for articles published between March 1, 1980 and July 28, 2015 in PubMed, Science Direct, Embase, Web of Science, and Scopus, for both English and non-English language articles with the following keywords: "Diabetic foot syndrome", "Ulceration", "Amputation", "Foot assessment", "Skin disorders" and "Musculoskeletal deformities". In dermatological dimension, most studies focused on elucidated changes in skin temperature, color, hardiness and turgor as well as common skin disorders such as Diabetic Dermopathy (DD), Necrobiosis Lipoidica Diabeticorum (NLD) and Diabetic Bullae (DB), which are common in diabetic patients and have high potential for leading to limb-threatening problems such as ulceration and infection. In musculoskeletal dimension, most studies focused on range of motion and muscle strength, gait patterns and as well as foot deformities especially Charcot osteoarthropathy (COA), which is the most destructive musculoskeletal complication of diabetes. DFS as a common condition in DM patients lead to ulceration and lower limb amputation frequently unless a prompt and comprehensive assessment was taken. So that dermatological and musculoskeletal assessments are usually neglected in primary health care, these assessments should be done frequently to reduce the high risk of serious complications. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

  20. Musculoskeletal symptoms among female garment factory workers in Sri Lanka.

    Science.gov (United States)

    Lombardo, Sarah R; Vijitha de Silva, P; Lipscomb, Hester J; Ostbye, Truls

    2012-01-01

    To assess the prevalence of musculoskeletal symptoms and their association with sociodemographic risk factors among female garment factory workers in Sri Lanka. 1058 randomly selected female garment factory workers employed in the free trade zone of Kogalla, Sri Lanka were recruited to complete two interviewer-administered questionnaires assessing musculoskeletal symptoms and health behaviors. Musculoskeletal complaints among female garment workers in the FTZ of Kogalla are less common than expected. Sociocultural factors may have resulted in underreporting and similarly contribute to the low rates of healthcare utilization by these women. 164 (15.5%) of workers reported musculoskeletal symptoms occurring more than 3 times or lasting a week or more during the previous 12-month period. Back (57.3%) and knee (31.7%) were the most common sites of pain. Although most symptomatic women reported that their problems interfered with work and leisure activities, very few missed work as a result of their pain. Prevalence correlated positively with increased age and industry tenure of less than 12 months. Job type, body mass index, and education were not significant predictors of musculoskeletal symptoms.

  1. Physiotherapeutic intervention on chronic lumbar pain impact in the elderly

    OpenAIRE

    Jorge, Matheus Santos Gomes; Zanin, Caroline; Knob, Bruna; Wibelinger, Lia Mara

    2015-01-01

    ABSTRACT BACKGROUND AND OBJECTIVES: Geriatric population is considerably increasing. However, musculoskeletal disorders, especially chronic low back pain, which is one of the most common complaints during outpatient assistance, seem to grow together with this phenomenon and physiotherapy may be an alternative to treat such pathology. This study aimed at reviewing in the literature information about physiotherapeutic management for chronic low back pain in the elderly. CONTENTS: Twenty-six a...

  2. Chronic female pelvic pain

    Directory of Open Access Journals (Sweden)

    Gaurab Maitra

    2013-01-01

    Full Text Available Chronic pelvic pain (CPP is defined as nonmalignant pain perceived in the structures related to the pelvis that has been present for more than 6 months or a non acute pain mechanism of shorter duration. Pain in the pelvic region can arise from musculoskeletal, gynaecological, urologic, gastrointestinal and or neurologic conditions. Key gynaecological conditions that contribute to CPP include pelvic inflammatory disease (PID, endometriosis, adnexa pathologies (ovarian cysts, ovarian remnant syndrome, uterine pathologies (leiomyoma, adenomyosis and pelvic girdle pain associated with pregnancy. Several major and minor sexually transmitted diseases (STD can cause pelvic and vulvar pain. A common painful condition of the urinary system is Interstitial cystitis(IC. A second urologic condition that can lead to development of CPP is urethral syndrome. Irritable bowel syndrome (IBS is associated with dysmenorrhoea in 60% of cases. Other bowel conditions contributing to pelvic pain include diverticular disease,Crohn′s disease ulcerative colitis and chronic appendicitis. Musculoskeletal pathologies that can cause pelvic pain include sacroiliac joint (SIJ dysfunction, symphysis pubis and sacro-coccygeal joint dysfunction, coccyx injury or malposition and neuropathic structures in the lower thoracic, lumbar and sacral plexus. Prolonged pelvic girdle pain, lasting more than 6 months postpartum is estimated in 3% to 30% of women. Nerve irritation or entrapment as a cause of pelvic pain can be related to injury of the upper lumbar segments giving rise to irritation of the sensory nerves to the ventral trunk or from direct trauma from abdominal incisions or retractors used during abdominal surgical procedures. Afflictions of the iliohypogastric, ilioinguinal, genitofemoral, pudendal and obturator nerves are of greatest concern in patients with pelvic pain. Patient education about the disease and treatment involved is paramount. A knowledge of the differential

  3. Gadolinium-DTPA: value in MR imaging of extraspinal musculoskeletal infections

    International Nuclear Information System (INIS)

    Haddad, M.C.; Sharif, H.S.; Aabed, M.Y.; Al Shahed, M.S.; Sammak, B.M.; Clark, D.C.

    1993-01-01

    To determine if paramagnetic contrast agents can improve the detection, delineation, and characterization of extraspinal musculoskeletal infections (MSI) on magnetic resonance (MR) imaging, 42 patients with clinical suspicion of MSI underwent MR imaging before and after intravenous administration of gadolinium-DTPA. The lesions consisted of 27 proven infections and 15 noninfective conditions. Specificity and accuracy in identifying infective lesions averaged 80% and 84%, respectively, on precontrast studies and 80% and 89% on the enhanced examinations, with no statistically significant difference. Rim enhancement around abscess loculi was the only pathognomonic sign of infection seen in ten patients with chronic osteomyelitis and pyogenic or tuberculous infections. In 17 patients with acute osteomyelitis, brucellosis, or mycetoma, detection and delineation of the lesions were best on precontrast studies, while postcontrast examinations resulted in underestimation of the extent of abnormalities in all cases. We conclude that intravenous gadolinium-DTPA has limited usefulness in the MR evaluation of extraspinal MSI. (orig.)

  4. Gadolinium-DTPA: value in MR imaging of extraspinal musculoskeletal infections

    Energy Technology Data Exchange (ETDEWEB)

    Haddad, M.C. [Dept. of Radiology, Riyadh Armed Forces Hospital, Riyadh (Saudi Arabia); Sharif, H.S. [Dept. of Radiology, Riyadh Armed Forces Hospital, Riyadh (Saudi Arabia); Aabed, M.Y. [Dept. of Radiology, Riyadh Armed Forces Hospital, Riyadh (Saudi Arabia); Al Shahed, M.S. [Dept. of Radiology, Riyadh Armed Forces Hospital, Riyadh (Saudi Arabia); Sammak, B.M. [Dept. of Radiology, Riyadh Armed Forces Hospital, Riyadh (Saudi Arabia); Clark, D.C. [Dept. of Radiology, Riyadh Armed Forces Hospital, Riyadh (Saudi Arabia)

    1993-12-01

    To determine if paramagnetic contrast agents can improve the detection, delineation, and characterization of extraspinal musculoskeletal infections (MSI) on magnetic resonance (MR) imaging, 42 patients with clinical suspicion of MSI underwent MR imaging before and after intravenous administration of gadolinium-DTPA. The lesions consisted of 27 proven infections and 15 noninfective conditions. Specificity and accuracy in identifying infective lesions averaged 80% and 84%, respectively, on precontrast studies and 80% and 89% on the enhanced examinations, with no statistically significant difference. Rim enhancement around abscess loculi was the only pathognomonic sign of infection seen in ten patients with chronic osteomyelitis and pyogenic or tuberculous infections. In 17 patients with acute osteomyelitis, brucellosis, or mycetoma, detection and delineation of the lesions were best on precontrast studies, while postcontrast examinations resulted in underestimation of the extent of abnormalities in all cases. We conclude that intravenous gadolinium-DTPA has limited usefulness in the MR evaluation of extraspinal MSI. (orig.)

  5. Physician practicing preferences for conventional or homeopathic medicines in elderly subjects with musculoskeletal disorders in the EPI3-MSD cohort

    Directory of Open Access Journals (Sweden)

    Danno K

    2014-09-01

    Full Text Available Karine Danno,1 Clementine Joubert,1 Gerard Duru,2 Jean-Marie Vetel31Laboratoires Boiron, Messimy, France; 2Cyklad Group, Lyon, France; 3Centre Hospitalier du Mans, Le Mans, FranceBackground: Musculoskeletal pain is common in elderly persons. Analgesic use is high in the elderly and may involve unacceptable risk in individuals with chronic pain. Our aim was to compare the socio-demographic characteristics of elderly subjects with musculoskeletal disorders (MSD and to assess medication use and clinical evolution of musculoskeletal pain according to physician prescribing preference: homeopathy (Ho group, conventional medicine (CM group, or mixed prescription (MX group.Methods: The EPI3 study was a 1 year observational survey carried out among general practitioners in France between March 2007 and July 2008. This sub-analysis was carried out on elderly subjects aged ≥70 years from the original EPI3 cohort. Socio-demographic data were collected at inclusion using a self-administered patient questionnaire and medical data were recorded for each patient. Quality of life was measured using the Short Form-12 questionnaire. Patients completed a structured telephone interview on their functional status (evaluated with the QuickDash questionnaire, EIFEL scale or Lequesne index within 72 hours of inclusion. This telephone interview was repeated at 1, 3, and 12 months. Drug exposure was also assessed during these interviews.Results: 146 patients (mean age ± standard deviation: 75.8±4.8 years were analyzed (80.1% female, 74.7% MSD of the spine or lower limbs, 64.4% chronic MSD. Patients in the CM and MX groups were 3.7 times or 2.5 times more likely (odds ratio [OR] =3.71, 95% confidence interval [CI]: 1.12-12.30; OR =2.52, 95% CI: 1.05-6.05; respectively to have used non-steroidal anti-inflammatory drugs (NSAIDs than those in the Ho group. In contrast, analgesic use was comparable in the three groups (OR =1.06 [CM versus Ho], 95% CI: 0.09-12.11; OR =0

  6. DC-Compensated Current Transformer.

    Science.gov (United States)

    Ripka, Pavel; Draxler, Karel; Styblíková, Renata

    2016-01-20

    Instrument current transformers (CTs) measure AC currents. The DC component in the measured current can saturate the transformer and cause gross error. We use fluxgate detection and digital feedback compensation of the DC flux to suppress the overall error to 0.15%. This concept can be used not only for high-end CTs with a nanocrystalline core, but it also works for low-cost CTs with FeSi cores. The method described here allows simultaneous measurements of the DC current component.

  7. Novel Musculoskeletal Loading System for Small Exercise Devices

    Science.gov (United States)

    Downs, Meghan; Newby, Nate; Trinh, Tinh; Hanson, Andrea

    2016-01-01

    Long duration spaceflight places astronauts at increased risk for muscle strain and bone fracture upon return to a 1-g or partial gravity environment. Functionally limiting decrements in musculoskeletal health are likely during Mars proving-ground and Earth-independent missions given extended transit times and the vehicle limitations for exercise devices (low-mass, small volume, little to no power). This is particularly alarming for exploration missions because astronauts will be required to perform novel and physically demanding tasks (i.e. vehicle egress, exploration, and habitat building activities) on unfamiliar terrain. Accordingly, NASA's exploration roadmap identifies the need for development of small exercise equipment that can prevent musculoskeletal atrophy and has the ability to assess musculoskeletal health at multiple time points during long-duration missions.

  8. MUSCULOSKELETAL PAIN TRAINEES IN PHYSICAL THERAPY OF UESB

    Directory of Open Access Journals (Sweden)

    Marta Rodrigues Barreto Neta

    2015-01-01

    Full Text Available To determine musculoskeletal disorders presented in algic way of undergraduates supervised I and II of the physiotherapy course at the State University of Southwest Bahia, Jequié campus. The study of descriptive, transversal and quantitative character, with a sample of 35 trainees of the physiotherapy course at the State University of Southwest Bahia. Data were obtained through questionnaires demographic social, Nordic and Mc Gill. Of the participants 20% were male and 80% female, aged between 20-29 years (23 ± 2. The regions most affected by musculoskeletal disorders in the current period, 7 days and 12 months were the lower back (40%, shoulder (28,6%, neck and upper back (25.7%. Regarding the classification of pain, trainees described as tiring (60%; thin (40%; sharp and stabbing (34%. This study concluded that physiotherapy graduates have high musculoskeletal pain complaints, before entering the labor market.

  9. MUSCULOSKELETAL PAIN TRAINEES IN PHYSICAL THERAPY OF UESB

    Directory of Open Access Journals (Sweden)

    Marta Rodrigues Barreto Neta

    2015-05-01

    Full Text Available To determine musculoskeletal disorders presented in algic way of undergraduates supervised I and II of the physiotherapy course at the State University of Southwest Bahia, Jequié campus. The study of descriptive, transversal and quantitative character, with a sample of 35 trainees of the physiotherapy course at the State University of Southwest Bahia. Data were obtained through questionnaires demographic social, Nordic and Mc Gill. Of the participants 20% were male and 80% female, aged between 20-29 years (23 ± 2. The regions most affected by musculoskeletal disorders in the current period, 7 days and 12 months were the lower back (40%, shoulder (28,6%, neck and upper back (25.7%. Regarding the classification of pain, trainees described as tiring (60%; thin (40%; sharp and stabbing (34%. This study concluded that physiotherapy graduates have high musculoskeletal pain complaints, before entering the labor market.

  10. Current status of musculoskeletal application of shear wave elastography

    Energy Technology Data Exchange (ETDEWEB)

    Ryu, Jeong Ah [Dept. of Radiology, Hanyang University Guri Hospital, Hanyang University School of Medicine, Guri (Korea, Republic of); Jeong, Woo Kyoung [Dept. of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2017-07-15

    Ultrasonography (US) is a very powerful diagnostic modality for the musculoskeletal system due to the ability to perform real-time dynamic high-resolution examinations with the Doppler technique. In addition to acquiring morphologic data, we can now obtain biomechanical information by quantifying the elasticity of the musculoskeletal structures with US elastography. The earlier diagnosis of degeneration and the ability to perform follow-up evaluations of healing and the effects of treatment are possible. US elastography enables a transition from US-based inspection to US-based palpation in order to diagnose the characteristics of tissue. Shear wave elastography is considered the most suitable type of US elastography for the musculoskeletal system. It is widely used for tendons, ligaments, and muscles. It is important to understand practice guidelines in order to enhance reproducibility. Incorporating viscoelasticity and overcoming inconsistencies among manufacturers are future tasks for improving the capabilities of US elastography.

  11. Augmentation of musculoskeletal regeneration: role for pluripotent stem cells.

    Science.gov (United States)

    Jevons, Lauren A; Houghton, Franchesca D; Tare, Rahul S

    2018-03-20

    The rise in the incidence of musculoskeletal diseases is attributed to an increasing ageing population. The debilitating effects of musculoskeletal diseases, coupled with a lack of effective therapies, contribute to huge financial strains on healthcare systems. The focus of regenerative medicine has shifted to pluripotent stem cells (PSCs), namely, human embryonic stem cells and human-induced PSCs, due to the limited success of adult stem cell-based interventions. PSCs constitute a valuable cell source for musculoskeletal regeneration due to their capacity for unlimited self-renewal, ability to differentiate into all cell lineages of the three germ layers and perceived immunoprivileged characteristics. This review summarizes methods for chondrogenic, osteogenic, myogenic and adipogenic differentiation of PSCs and their potential for therapeutic applications.

  12. Current status of musculoskeletal application of shear wave elastography

    Directory of Open Access Journals (Sweden)

    JeongAh Ryu

    2017-07-01

    Full Text Available Ultrasonography (US is a very powerful diagnostic modality for the musculoskeletal system due to the ability to perform real-time dynamic high-resolution examinations with the Doppler technique. In addition to acquiring morphologic data, we can now obtain biomechanical information by quantifying the elasticity of the musculoskeletal structures with US elastography. The earlier diagnosis of degeneration and the ability to perform follow-up evaluations of healing and the effects of treatment are possible. US elastography enables a transition from US-based inspection to US-based palpation in order to diagnose the characteristics of tissue. Shear wave elastography is considered the most suitable type of US elastography for the musculoskeletal system. It is widely used for tendons, ligaments, and muscles. It is important to understand practice guidelines in order to enhance reproducibility. Incorporating viscoelasticity and overcoming inconsistencies among manufacturers are future tasks for improving the capabilities of US elastography.

  13. Current status of musculoskeletal application of shear wave elastography

    International Nuclear Information System (INIS)

    Ryu, Jeong Ah; Jeong, Woo Kyoung

    2017-01-01

    Ultrasonography (US) is a very powerful diagnostic modality for the musculoskeletal system due to the ability to perform real-time dynamic high-resolution examinations with the Doppler technique. In addition to acquiring morphologic data, we can now obtain biomechanical information by quantifying the elasticity of the musculoskeletal structures with US elastography. The earlier diagnosis of degeneration and the ability to perform follow-up evaluations of healing and the effects of treatment are possible. US elastography enables a transition from US-based inspection to US-based palpation in order to diagnose the characteristics of tissue. Shear wave elastography is considered the most suitable type of US elastography for the musculoskeletal system. It is widely used for tendons, ligaments, and muscles. It is important to understand practice guidelines in order to enhance reproducibility. Incorporating viscoelasticity and overcoming inconsistencies among manufacturers are future tasks for improving the capabilities of US elastography

  14. Quantitative techniques for musculoskeletal MRI at 7 Tesla.

    Science.gov (United States)

    Bangerter, Neal K; Taylor, Meredith D; Tarbox, Grayson J; Palmer, Antony J; Park, Daniel J

    2016-12-01

    Whole-body 7 Tesla MRI scanners have been approved solely for research since they appeared on the market over 10 years ago, but may soon be approved for selected clinical neurological and musculoskeletal applications in both the EU and the United States. There has been considerable research work on musculoskeletal applications at 7 Tesla over the past decade, including techniques for ultra-high resolution morphological imaging, 3D T2 and T2* mapping, ultra-short TE applications, diffusion tensor imaging of cartilage, and several techniques for assessing proteoglycan content in cartilage. Most of this work has been done in the knee or other extremities, due to technical difficulties associated with scanning areas such as the hip and torso at 7 Tesla. In this manuscript, we first provide some technical context for 7 Tesla imaging, including challenges and potential advantages. We then review the major quantitative MRI techniques being applied to musculoskeletal applications on 7 Tesla whole-body systems.

  15. Stress, Visual and Musculoskeletal Complaints in Open Plan Office Staff

    Directory of Open Access Journals (Sweden)

    Vangelova K.

    2014-06-01

    Full Text Available The aim of the study was to identify the main ergonomic and organizational risks contributing to stress, visual and musculoskeletal disorders in open plan office workers. A total of 73 subjects of mean age 28.3 ±4.7 years were studied. Measurements of salivary cortisol and self-ratings for strain, fatigue, stress symptoms, visual and musculoskeletal complaints were performed. The work places were organized well, but the studied staff reported high work load and time pressure. The data showed higher cortisol levels during the workday under time pressure. High incidence of visual and musculoskeletal complaints mainly in the region of the back and the neck were found, associated with flickering and blinks on the screen monitors and overtime. Optimizing workplace organization could help reduce stress and health complaints of office staff.

  16. Epidemiology of chronic pain in Denmark: an update

    DEFF Research Database (Denmark)

    Sjøgren, Per; Ekholm, Ola; Peuckmann, Vera

    2008-01-01

    -administrated questionnaire. The same questions were included in the survey in 2000 and, hence, it was possible to evaluate the trends in the past five years. In all, 20.2% of the adult Danish population has chronic pain. From year 2000-2005 the prevalence of chronic pain has remained stable. Generally, chronic pain......The most recent Danish health survey of 2005 is based on a region-stratified random sample of 10.916 individuals. Data were collected via personal interviews and self-administrated questionnaires. Respondents suffering from chronic pain were identified through the question 'Do you have chronic...... was associated with female gender and increasing age. Higher prevalence of chronic pain were associated with being divorced, separated or widowed, having less than 10 years of education and high BMI. Musculoskeletal diseases (66.8%) were the most common cause for chronic pain and most persons with chronic pain...

  17. Dissatisfaction with work as a risk factor of musculoskeletal complaints among foresters in Poland

    Directory of Open Access Journals (Sweden)

    Stanisław Lachowski

    2017-12-01

    Low level of job satisfaction is a risk factor for the occurrence of musculoskeletal disorders. Shaping of work conditions, which are the source of job satisfaction, should be considered as one of the main elements of prevention of musculoskeletal complaints.

  18. Central adaptation of pain perception in response to rehabilitation of musculoskeletal pain

    DEFF Research Database (Denmark)

    Andersen, Lars L; Andersen, Christoffer H; Sundstrup, Emil

    2012-01-01

    Understanding the mechanisms of long-standing musculoskeletal pain and adaptations in response to physical rehabilitation is important for developing optimal treatment strategies. The influence of central adaptations of pain perception in response to rehabilitation of musculoskeletal pain remains...

  19. Proceedings from the 7th Annual International Society for Musculoskeletal Imaging in Rheumatology (ISEMIR) conference

    DEFF Research Database (Denmark)

    Troum, Orrin M; Pimienta, Olga L; Schmidt, Wolfgang A

    2015-01-01

    The International Society for Musculoskeletal Imaging in Rheumatology (ISEMIR) was founded in 2005 with the goal of discussing matters related to imaging in rheumatology, particularly, validation, education, and use in clinical practice and research. Because the field of musculoskeletal (MSK...

  20. Physical recreational activity and musculoskeletal disorders in nurses

    Directory of Open Access Journals (Sweden)

    Władysław Mynarski

    2014-04-01

    Full Text Available Background: The role of physical activity (PA in the prevention and treatment of civilization diseases has been recognized by the medical society. Despite extensive knowledge and well-documented evidence of health aspects of PA, the identification and assessment of the PA level in various social and professional groups are still needed. The main goal of this research was to work out a preliminary assessment of possible relationship between recreational physical activity and reduced common musculoskeletal disorders in nurses. Material and Methods: The study included 93 nurses, aged 41.4±7.31, with body height of 164.4±7.04 and body weight of 64.5±10.8. The Nordic Musculoskeletal Questionnaire (NMQ was applied to assess pain and the International Physical Activity Questionnaire (IPAQ (long version to assess the level of physical activity. The intergroup differences, due to the occurrence of pain and physical activity levels, were determined using the Mann Whitney test and the Kruskal Wallis test. To evaluate the significance of individual factors potentially influencing the onset of musculoskeletal pains, the Chi2 test for independence was performed. Results: Over 70% of the examined nurses reported musculoskeletal complaints, mostly related with lower back pain. Taking up recreational activity, of at least moderate to vigorous physical activity (MVPA, reduces the risk of musculoskeletal disorders. Conclusion: It is most likely that recreational physical activity at appropriate parameters may prevent musculoskeletal disorders, especially in nurses with long work experience. However, this hypothesis needs to be verified by experimental studies with use of objective tools for the assessment of physical activity. Med Pr 2014;65(2:181–188

  1. Effect of musculoskeletal pain of care workers on job satisfaction.

    Science.gov (United States)

    Kim, DeokJu

    2018-01-01

    [Purpose] The purpose of this study was to examine the musculoskeletal pain of care workers and investigate its effect on their job satisfaction. [Subjects and Methods] Subjects were 87 care workers working at C elderly care service center in P region. The average age of men was 62.5 ± 3.4 years and that of women was 57.3 ± 2.7 years. The 'Guidelines for Risk Factor Survey on Tasks with Musculoskeletal Burden' of the KOSHA CODE (H-30-2003) of the Korea Occupational Safety and Health Agency (KOSHA) was used for measurement of musculoskeletal pain. This survey tool for job satisfaction consisted of 12 questions including the areas of wage satisfaction, professional satisfaction, job performance satisfaction, and relationship satisfaction. [Results] Study results showed that musculoskeletal pain varied depending on professional satisfaction, job performance satisfaction, and relationship satisfaction. The correlation between the areas of musculoskeletal pain and job satisfaction was examined and the following was revealed. Professional satisfaction was correlated with arm/elbow pain and lower back pain, job performance satisfaction with lower back pain, and relationship satisfaction with shoulder pain and lower back pain. [Conclusion] In this study, subjects were older and could have been easily exposed to diseases because of their age. To improve job efficiency among care workers, continuing education related to the job should take precedence. In addition, social support is required that can alleviate the heavy workload related to physical activity support, which is among the responsibilities of care workers. Moreover, application standards and coverage of industrial insurance for the treatment of musculoskeletal disorders of care workers should be extended further to relieve the burden of medical costs. A series of such measures will have a positive effect on improving the job satisfaction of care workers.

  2. Effects of muscular endurance training on musculoskeletal disorders in teachers

    Directory of Open Access Journals (Sweden)

    Elisângela Valevein Rodrigues

    Full Text Available AbstractIntroduction Physical exercise is indicated to reduce the incidence of musculoskeletal symptoms in teachers.Objective To evaluate the effects of muscular endurance training on muscle strength and musculoskeletal symptoms related to the lower limbs of public elementary school teachers.Materials and methods Thirty-one female teachers were divided into two groups: control (CG, n = 15 and muscular endurance training (TG, n = 16. The training consisted of two sets of 15 repetitions of exercises for quadriceps and hamstring muscle groups, twice a week, for 7 weeks, which were conducted with 50% of 10 repetition maximum(10RM (first to fourth week and 60% of 10 RM (fifth to seventh week. Musculoskeletal symptoms (Nordic Musculoskeletal Questionnaire, isometric peak torque (Load cell and muscle strength (10RM were assessed before and after intervention. ANOVA for repeated measures and Tukey post hoc were used to analyse strength and peak torque of quadriceps and hamstrings and Chi-square goodness-of-fit test were used to analyse the frequency of occurrence of osteomuscular symptoms.Results The highest incidence of symptoms was found in the lumbar region in both groups. Training caused increased muscle strength of the quadriceps and hamstrings, but there were no significant differences in either the peak torque in the quadriceps and hamstrings or in the reduction of musculoskeletal symptoms.Conclusion The exercise program performed in this study increased the dynamic strength in the TG in relation to the CG, but did not alter the incidence of symptoms in the lumbar region and lower limbs in neither of the groups. Thus, results suggest that the duration of intervention may not have been enough to increase peak torque and decrease musculoskeletal symptoms.

  3. Musculoskeletal system pathology in aids patients

    International Nuclear Information System (INIS)

    Zabala, R.; Oleaga, L.; Garcia Bolado, A.; Grande, D.; Gorrino, O.; Lecumberri, I.

    2003-01-01

    We studied 22 AIDS patients who presented musculoskeletal system pathology. The affected area underwent simple X-ray and MR. The MR study was performed using a 1 Tesla magnet. T1 and T2 weighted echo spin sequences, as well as sequences of short T1 inversion recovery (STIR). In nine cases, intravenous gadolinium was used at a dose of 0.2cc/kg. The study plane was selected depending on the location of the lesion and surface coils were used when appropriate. In those patients showing pathology which was removed from the appendicular skeleton, the principal magnet was used as both transmitter and receiver. In one case, an On-Tine Tomography (CT) was also carried out. The evaluated ata were: a) localization; b) bony erosion; c) soft-tissue mass; d) articular effusion; e) cartilaginous changes; f) and T2 signals, and g) gadolinium enhancement. A diagnosis was made on the basis of biopsy or clinical culture, and evolution. Spinal cord alterations were the most frequent, being found in 13 cases. Twelve were caused by spondylodiscitis, 10 by tuberculosis, one by staphylococcal infection and one by candidiasis. In all cases, there appeared disk damage, as well as bone marrow signal alterations in the affected area and disks soft-tissue. In the mine cases in which gadolinium was used, the disk, vertebral plates and cases in which gadolinium was used, the disk, vertebral plates and soft-tissue mass heterogeneously enhanced, demonstrating an abscess with ring enhancement, and a central necrotic area in one case. In one patient, a spinal cord alteration due to non-Hodgkin's lymphoma was observed. In six cases,there was observed and infectious arthritis two in coxofemoral joints, three in knees and one in a glenohumeral joint. Isolated germs were staphylococcal in three cases one being Mycobacterium tuberculosis, another being M. kansasii and the third identified as. Candida. In all cases, there was observed joint effusion, synovial thickening, joint cartilage damage and bony

  4. The efficacy of pain neuroscience education on musculoskeletal pain: A systematic review of the literature.

    Science.gov (United States)

    Louw, Adriaan; Zimney, Kory; Puentedura, Emilio J; Diener, Ina

    2016-07-01

    Systematic review of randomized control trials (RCTs) for the effectiveness of pain neuroscience education (PNE) on pain, function, disability, psychosocial factors, movement, and healthcare utilization in individuals with chronic musculoskeletal (MSK) pain. Systematic searches were conducted on 11 databases. Secondary searching (PEARLing) was undertaken, whereby reference lists of the selected articles were reviewed for additional references not identified in the primary search. All experimental RCTs evaluating the effect of PNE on chronic MSK pain were considered for inclusion. Additional Limitations: Studies published in English, published within the last 20 years, and patients older than 18 years. No limitations were set on specific outcome measures. Data were extracted using the participants, interventions, comparison, and outcomes (PICO) approach. Study quality of the 13 RCTs used in this review was assessed by 2 reviewers using the PEDro scale. Narrative summary of results is provided for each study in relation to outcomes measurements and effectiveness. Current evidence supports the use of PNE for chronic MSK disorders in reducing pain and improving patient knowledge of pain, improving function and lowering disability, reducing psychosocial factors, enhancing movement, and minimizing healthcare utilization.

  5. Acute and chronic lumbosacral pain: Topical problems

    Directory of Open Access Journals (Sweden)

    Ekaterina Vladimirovna Podchufarova

    2012-01-01

    Full Text Available The paper gives an account of approaches to treating patients with acute and chronic back pain in the context of evidence-based medicine and current clinical guidelines. In the vast majority, acute back pain is a benign self-limiting condition (nonspecific musculoskeletal pain and most patients need additional instrumental examinations. An active approach to treatment is considered to be optimal. It is expedient to apply a more differential approach involving the refinement of mechanisms for development of the pain syndrome and the elaboration of treatment strategy in relation to the leading pathophysiological mechanism when examining the patients with chronic back pain.

  6. The Study of Relationship between Anthropometric Indices and Physical Activities with Musculoskeletal Complaints in High School Female Students of Tabriz in 1388

    Directory of Open Access Journals (Sweden)

    Shabnam Salekzamani

    2015-07-01

    Full Text Available ​Background and Objectives : Adolescence is a proper time to make lifestyle changes to reduce the incidence of chronic diseases in the adulthood. This study aimed to describe the anthropometric indices and physical activities status and their relationship with musculoskeletal complaints in high school female students in Tabriz. Materials and Methods : Two hundred students were selected by cluster sampling method. Anthropometric indicators, physical activity level and musculoskeletal complaints were determined using standard protocols and questionnaires. Statistical analysis of data was performed according to age and body types. Results : The mean age and BMI of the subjects were 17.12 years and 22.16 kg/m2, respectively. About 20% of the students were overweight or obese. The body type of the students was endomorph-mesomorph. Only 8% of the students exercised in gyms and 31% spent more than three hours a day watching television and 70% did the housework. Body type and Body Mass Index did not differ significantly between age groups. Logistic regression models showed no relationship between musculoskeletal complaints, physical activities and body types. Conclusion : This study showed reduction in the physical activities of female students, but there was no significant relationship between musculoskeletal complaints, physical activities and body types.

  7. Vertical vibration analysis for elevator compensating sheave

    International Nuclear Information System (INIS)

    Watanabe, Seiji; Nakazawa, Daisuke; Fukui, Daiki; Okawa, Takeya

    2013-01-01

    Most elevators applied to tall buildings include compensating ropes to satisfy the balanced rope tension between the car and the counter weight. The compensating ropes receive tension by the compensating sheave, which is installed at the bottom space of the elevator shaft. The compensating sheave is only suspended by the compensating ropes, therefore, the sheave can move vertically while the car is traveling. This paper shows the elevator dynamic model to evaluate the vertical motion of the compensating sheave. Especially, behavior in emergency cases, such as brake activation and buffer strike, was investigated to evaluate the maximum upward motion of the sheave. The simulation results were validated by experiments and the most influenced factor for the sheave vertical motion was clarified

  8. How to avoid deferred-compensation troubles.

    Science.gov (United States)

    Freeman, Todd I

    2005-06-01

    Executive compensation packages have long included stock options and deferred compensation plans in order to compete for talent. Last year, Congress passed a law in response to the Enron debacle, in which executives were perceived to be protecting their deferred compensation at the expense of employees, creditors, and investors. The new law is designed to protect companies and their shareholders from being raided by the very executives that guided the company to financial ruin. Physicians who are part owners of medical practices need to know about the changes in the law regarding deferred compensation and how to avoid costly tax penalties. This article discusses how the changes affect medical practices as well as steps physician-owned clinics can take to avoid the risk of penalty, such as freezing deferred compensation and creating a new deferred compensation plan.

  9. Vertical vibration analysis for elevator compensating sheave

    Science.gov (United States)

    Watanabe, Seiji; Okawa, Takeya; Nakazawa, Daisuke; Fukui, Daiki

    2013-07-01

    Most elevators applied to tall buildings include compensating ropes to satisfy the balanced rope tension between the car and the counter weight. The compensating ropes receive tension by the compensating sheave, which is installed at the bottom space of the elevator shaft. The compensating sheave is only suspended by the compensating ropes, therefore, the sheave can move vertically while the car is traveling. This paper shows the elevator dynamic model to evaluate the vertical motion of the compensating sheave. Especially, behavior in emergency cases, such as brake activation and buffer strike, was investigated to evaluate the maximum upward motion of the sheave. The simulation results were validated by experiments and the most influenced factor for the sheave vertical motion was clarified.

  10. A pilot study to profile the lower limb musculoskeletal health in children with obesity.

    LENUS (Irish Health Repository)

    O'Malley, Grace

    2012-01-01

    : Evidence suggests a negative effect of obesity on musculoskeletal health in children. A pilot study was undertaken to investigate the presence of musculoskeletal impairments in children with obesity and to explore the relationships among body mass index, physical activity, and musculoskeletal measures.

  11. Enthalpy-entropy compensation in protein unfolding

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    Enthalpy-entropy compensation was found to be a universal law in protein unfolding based on over 3 000 experimental data. Water molecular reorganization accompanying the protein unfolding was suggested as the origin of the enthalpy-entropy compensation in protein unfolding. It is indicated that the enthalpy-entropy compensation constitutes the physical foundation that satisfies the biological need of the small free energy changes in protein unfolding, without the sacrifice of the bio-diversity of proteins. The enthalpy-entropy compensation theory proposed herein also provides valuable insights into the Privalov's puzzle of enthalpy and entropy convergence in protein unfolding.

  12. Spanish version of the screening Örebro musculoskeletal pain questionnaire: a cross-cultural adaptation and validation.

    Science.gov (United States)

    Cuesta-Vargas, Antonio Ignacio; González-Sánchez, Manuel

    2014-10-29

    Spanish is one of the five most spoken languages in the world. There is currently no published Spanish version of the Örebro Musculoskeletal Pain Questionnaire (OMPQ). The aim of the present study is to describe the process of translating the OMPQ into Spanish and to perform an analysis of reliability, internal structure, internal consistency and concurrent criterion-related validity. Translation and psychometric testing. Two independent translators translated the OMPQ into Spanish. From both translations a consensus version was achieved. A backward translation was made to verify and resolve any semantic or conceptual problems. A total of 104 patients (67 men/37 women) with a mean age of 53.48 (±11.63), suffering from chronic musculoskeletal disorders, twice completed a Spanish version of the OMPQ. Statistical analysis was performed to evaluate the reliability, the internal structure, internal consistency and concurrent criterion-related validity with reference to the gold standard questionnaire SF-12v2. All variables except "Coping" showed a rate above 0.85 on reliability. The internal structure calculation through exploratory factor analysis indicated that 75.2% of the variance can be explained with six components with an eigenvalue higher than 1 and 52.1% with only three components higher than 10% of variance explained. In the concurrent criterion-related validity, several significant correlations were seen close to 0.6, exceeding that value in the correlation between general health and total value of the OMPQ. The Spanish version of the screening questionnaire OMPQ can be used to identify Spanish patients with musculoskeletal pain at risk of developing a chronic disability.

  13. Multi-qubit compensation sequences

    International Nuclear Information System (INIS)

    Tomita, Y; Merrill, J T; Brown, K R

    2010-01-01

    The Hamiltonian control of n qubits requires precision control of both the strength and timing of interactions. Compensation pulses relax the precision requirements by reducing unknown but systematic errors. Using composite pulse techniques designed for single qubits, we show that systematic errors for n-qubit systems can be corrected to arbitrary accuracy given either two non-commuting control Hamiltonians with identical systematic errors or one error-free control Hamiltonian. We also examine composite pulses in the context of quantum computers controlled by two-qubit interactions. For quantum computers based on the XY interaction, single-qubit composite pulse sequences naturally correct systematic errors. For quantum computers based on the Heisenberg or exchange interaction, the composite pulse sequences reduce the logical single-qubit gate errors but increase the errors for logical two-qubit gates.

  14. Compensation for incoherent ground motion

    International Nuclear Information System (INIS)

    Shigeru, Takeda; Hiroshi, Matsumoto; Masakazu, Yoshioka; Yasunori, Takeuchi; Kikuo, Kudo; Tsuneya, Tsubokawa; Mitsuaki, Nozaki; Kiyotomo, Kawagoe

    1999-01-01

    The power spectrum density and coherence function for ground motions are studied for the construction of the next generation electron-positron linear collider. It should provide a center of mass energy between 500 GeV-1 TeV with luminosity as high as 10 33 to 10 34 cm -2 sec -1 . Since the linear collider has a relatively slow repetition rate, large number of particles and small sizes of the beam should be generated and preserved in the machine to obtain the required high luminosity. One of the most critical parameters is the extremely small vertical beam size at the interaction point, thus a proper alignment system for the focusing and accelerating elements of the machine is necessary to achieve the luminosity. We describe recent observed incoherent ground motions and an alignment system to compensate the distortion by the ground motions. (authors)

  15. Self compensating fire detection device

    International Nuclear Information System (INIS)

    Cholin, J. M.

    1985-01-01

    A device employing ionization principles for fire detection disclosing a configuration which allows compensation for adverse effects due to the flow of the gas through the device or due to the accumulation of dust and dirt therein. The detecting device includes two ionization chambers, each having a first member, such as a cylindrically shaped cup, having first and second conductive surface portions. Each chamber also incudes a second member, such as a circular, electrode disc having two conductive surface portions. There is disposed in each chamber a radioactive source for ionizing the gas in the volumes intervening between respective pairs of surfaces. The area dimensions of the respective pairs of surfaces, the interventing volumes and the distances there between, and the relative orientation of the respective pairs are calculated and placed such that the ionization currents flowing between pairs of conductive surfaces are substantially equal and orthogonal to each other

  16. Pain, power and patience - A narrative study of general practitioners' relations with chronic pain patients

    OpenAIRE

    Hemborg Kristiansson, Mia; Brorsson, Annika; Wachtler, Caroline; Troein, Margareta

    2011-01-01

    Abstract Background Chronic pain patients are common in general practice. In this study "chronic pain" is defined as diffuse musculoskeletal pain not due to inflammatory diseases or cancer. Effective patient-physician relations improve treatment results. The relationship between doctors and chronic pain patients is often dysfunctional. Consultation training for physicians and medical students can improve the professional ability to build effective relations, but this demands a thorough unders...

  17. Design and control of a pneumatic musculoskeletal biped robot.

    Science.gov (United States)

    Zang, Xizhe; Liu, Yixiang; Liu, Xinyu; Zhao, Jie

    2016-04-29

    Pneumatic artificial muscles are quite promising actuators for humanoid robots owing to their similar characteristics with human muscles. Moreover, biologically inspired musculoskeletal systems are particularly important for humanoid robots to perform versatile dynamic tasks. This study aims to develop a pneumatic musculoskeletal biped robot, and its controller, to realize human-like walking. According to the simplified musculoskeletal structure of human lower limbs, each leg of the biped robot is driven by nine muscles, including three pairs of monoarticular muscles which are arranged in the flexor-extensor form, as well as three biarticular muscles which span two joints. To lower cost, high-speed on/off solenoid valves rather than proportional valves are used to control the muscles. The joint trajectory tracking controller based on PID control method is designed to achieve the desired motion. Considering the complex characteristics of pneumatic artificial muscles, the control model is obtained through parameter identification experiments. Preliminary experimental results demonstrate that the biped robot is able to walk with this control strategy. The proposed musculoskeletal structure and control strategy are effective for the biped robot to achieve human-like walking.

  18. Musculoskeletal injuries: A cross-sectional study in Irrua, Nigeria ...

    African Journals Online (AJOL)

    Musculoskeletal injuries: A cross-sectional study in Irrua, Nigeria. ... Its economic impact on victims and family is tremendous. ... Road traffic collision was the leading cause of injury (121 patients; 80%), and 67.8% of these injuries were ...

  19. Musculoskeletal disorders among first-year Ghanaian students in a ...

    African Journals Online (AJOL)

    Musculoskeletal disorders among first-year Ghanaian students in a nursing college. Jubilant Kwame ... Abstract: Objective: To estimate the prevalence and extent of MSDs among a sample of freshmen in a nursing college in Ghana. Methods: A ... cise13,18 and psychosocial stress and mental pressure6,15 have been ...

  20. Prevalence of Musculoskeletal Pain in Construction Workers in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Ahmad Alghadir

    2015-01-01

    Full Text Available The objective of this study was to find out the prevalence, characteristics, and distribution of musculoskeletal pain among construction workers in Saudi Arabia. A questionnaire about musculoskeletal pain in different parts of the body was completed by 165 construction workers from the construction industries in Dammam and Riyadh cities. The descriptive data were analyzed using chi-square test. The level of statistical significance was set at P<0.05. Eighty (48.5% of the responding workers had pain in neck, shoulders, lower back, hand, knee, or ankle. The majority of respondents had low back pain (50% followed by knee pain (20%. The average intensity of pain at all sites during activity and rest was 6.65 and 3.59, respectively. Thirty-four (42.5% respondents had dull aching pain and 24 (30% had cramping pain. There was an association between years of experience, duration of break during work, and use of protective equipment with the prevalence of musculoskeletal pain in construction workers (P<0.05. Most of the workers complaining of pain got medical treatment (62.5% and only 25% received physical therapy. It can be concluded from this study that the prevalence of musculoskeletal pain among construction workers in Saudi Arabia is high.