Epidemiological Patterns of Work-Related Musculoskeletal Disorders among Healthcare Workers in Five Reference Hospitals in the City of Douala, Cameroon

Introduction: Work-related musculoskeletal disorders (WRMSDs) are a public health problem and have forced many workers to quit their jobs prematurely. This study investigated the prevalence and risk factors of WRMSDs among Healthcare workers in five reference hospitals in the City of Douala-Cameroon. Methods: A cross-sectional study was conducted in 2022 among 561 healthcare workers working in five reference hospitals in the city of Douala, Cameroon. Participants were selected using a convenient sampling technique. Data were collected with structured questionnaires;data on the demographics and risk factors were collected using a well-designed questionnaire, while estimation of the prevalence of WRMSDs was done using the Modified Nordic questionnaire. Results: The overall prevalence rate of WRMSDs among healthcare workers in Douala hospitals was 83.4% (468/561). The prevalence per professional groups was as follows: 88.8% (71) for Medical Laboratory Scientists (MLS), 81.9% (289) for nurses, 21 (80.8%) for Physiotherapists (PTs) and 78.8% (41) for Medical Doctors (MDs). There was a significant difference (p = 0.001) in the prevalence of WRMSDs with respect to place of work where healthcare workers from HLD recorded the highest prevalence 89.9%, while Healthcare workers from NBDH were 2.91 times at risk (AOR = 2.91;95% CI: 1.32 - 6.41;p = 0.001) to develop WRMSDs than healthcare workers in the other hospitals. With respect to body region, the highest prevalence of WRMSDs was recorded on the lower back, 58.8% with the lowest at the elbows 11.2%. The age group 30 to 39 years was significantly associated with WRMSDs at level of the shoulder (p = 0.002), upper back (p = 0.019), elbows (p Conclusion: The overall prevalence rate of WRMSDs among healthcare workers in Douala hospitals was high. The prevalence of WRMSDs is highest among MLS and nurses and the most affected body parts are;lower back, neck and upper back. Working on the same posture, stressful job, and repetitive tasks were the major risk factors associated to WRMSDs among healthcare workers in Douala hospitals.

Prevalence and factors of work-related musculoskeletal disorders among hand surgeons

BACKGROUND The nature of tasks required by hand surgeons require both forceful and repetitive maneuvers,thus subjecting these surgeons to the risk of musculoskeletal(MSK)injuries during their years in practice.AIM To assess the prevalence,characteristics and impact of MSK disorders among hand surgeons.METHODS A modified version of the physical discomfort survey was sent to surgeons who were members of the American Society for Surgery of the Hand via e-mail.The collected data were analyzed using descriptive statistics,one-way analysis of variance,and Fisher’s exact test.P values of<0.05 were considered statistically significant.RESULTS Of the 578 respondents,60.4%reported that they had sustained a work-related MSK injury,of which the most common diagnoses were lateral elbow epicondylitis(18.7%),low back pain(17.1%)and carpal tunnel syndrome(15.6%).Among those that reported an injury,73.1%required treatment and 29.2%needed time off work as a direct result of their injury.The number of work-related injuries incurred by a surgeon increased significantly with increasing age(P<0.003),increasing years in practice(P<0.001)and higher case load(P<0.05).CONCLUSION To our knowledge this study is the first of its kind to assess MSK injuries sustained by Hand surgeons with a high incidence.These results should increase awareness on this aspect and fuel future studies directed at preventing these types of work-related injuries,thus minimizing the financial and psychological burden on these surgeons and the healthcare system.

High Prevalence of Musculoskeletal Disorders and Self-Medication among Street Vendors in Bangui, Central African Republic (CAR)

Introduction: Musculoskeletal disorders (MSDs) are a set of peri-articular conditions that result mainly in pain and functional discomfort. They represent a major occupational health problem in all areas of activity. The objective of this work was to determine the prevalence of MSDs among street vendors in the city of Bangui in the Central African Republic (CAR). Methods: A cross-sectional study was conducted from September 01 to October 31, 2021 in Bangui, the capital of CAR. The study population consisted of street vendors which were included at the entrance of 4 large markets of Bangui after giving informed consent. The sample size, calculated according to the Schwartz formula, was 384. Sociodemographic data (age, gender, level of education, marital status), professional data (the duration of sale in hours, the distance traveled per day);and health data (the health problems suffered by itinerant sellers and the means of dealing with them) were collected using a pre-established self-questionnaire. This collected data was processed using Microsoft Excel 2013 and Epi-Info version 7 software. Results: Among 384 street vendors included, women represented a quarter (24.9%). The average age was 27 years;the 25-34 age group was the most represented (50%). About two-thirds (64.8%) sold for at least 12 hours and traveled more than 10 km (69.3%) per day. The main health problems reported by street vendors were musculoskeletal disorders (95.8%). Their locations concerned the upper limbs shoulder 65.36% (251), elbow 24.22% (93). Non-ergonomic postures that stress the back and joints all day long, causing pain are risk factors for MSDs. These MSDs were treated by self-medication with non-steroidal anti-inflammatory drugs (22.0%), mainly sold on the street. Conclusion: MSDs dominated the health problems of street vendors. These problems raise the need for recognition and support for these workers to optimize their performance while preserving their health through awareness and good management of MSDs whose chronicity generates a disability.

Work-related musculoskeletal injuries among upper extremity surgeons:A web-based survey

BACKGROUND Work-related injuries have gained recent attention,especially in the orthopaedic literature.As upper extremity orthopaedic surgical tasks require repetitive and constant maneuvers,these surgeons can be at increased risk of acquiring workrelated musculoskeletal(MSK)disorders during their years in practice.AIM To assess the prevalence,characteristics and impact of MSK disorders among upper extremity orthopaedic surgeons.METHODS A modified version of the physical discomfort survey was sent to surgeons who were members of the American Shoulder and Elbow Surgeons and the Canadian shoulder and elbow society via e-mail.The collected data were analyzed using descriptive statistics,one-way analysis of variance,and Fisher's exact test.P values of<0.05 were considered statistically significant.RESULTS Of the 142 respondents,90.8% were males and the majority were younger than 55 years old(65.5%).A work-related MSK injury was reported by 89.4% of respondents,of which the most common diagnoses were low back pain(26.1%)and lateral elbow epicondylitis(18.3%).Among those that reported an injury,82.7%required treatment and 26% required time off work as a direct result of their injury.The need to undergo treatment due to the injury was associated with increased number of injuries(P<0.01).Moreover,surgeons were more likely to require time off work when they had been in practice for>21 years(P<0.05).CONCLUSION A high proportion of surgeons in our survey reported MSK injuries,with more than one quarter of surgeons reported requiring time off work due to an MSK injury.The high incidence of these disorders may place a financial and psychological burden on surgeons and affect their ability to provide patient care.Awareness of operative ergonomics,irrespective of surgical specialty may help to decrease or possibly prevent the occurrence of these disorders.

Survey of Prevalence and Risk Factors Associated with Upper Extremity Musculoskeletal Disorders by Repetitive Job Activities Methods in Baker of Iran

Aim: The first purpose is to survey the cumulative trauma disorder (CTD) prevalence in 4 zones of neck, shoulder, hand/wrist and back, and the second purpose is to survey the risk factors producing upper limb musculoskeletal disorders by using OCRA index method. In this analytic-descriptive and cross-sectional study, incorporation of four data collection methods was contained;observing and interviewing methods, using questionnaire and check list, were utilized. Randomly, 384 samples for CTD prevalence and 423 samples for OCRA index exposure survey were collected by cluster ratio sampling. In this study, findings indicated that CTD prevalence was high in studied bakery workers and most disorder and pain were reported in back, knees and hand/wrist. Through different tasks, most percentage of neck CTD (7.1%) and shoulder CTD (27.8%) was related to selling and baker tasks respectively, and most percentage of hand/wrist CTD (33/3%) and back CTD (38.1%) was related to bread baker task. There was a significant correlation between shoulder, hand/wrist and back CTD with bakery and task type, and effect of job background on CTD preva-lence was improved in the above four zones. The rather high prevalence of CTD in the young pop-ulation with average age of 30 years which have a few work experiences and the results of per-formed risk assessment can be taken account of serious warning, if it is not considered.

Influence of Metabolic Syndrome versus Musculoskeletal Disorders on Saudi Health-Related Quality of Life

Aim: This work aimed to study the influence of two chronic health conditions, metabolic syndrome (MetS) and musculoskeletal disorders (MSDs), on the health-related quality of life (HRQoL) of Saudis. Method: The Medical Outcomes Study Short Form-36 (SF-36) health status questionnaire was used to measure the HRQoL and compare the mean scores of the questionnaire subscales and physical and mental component summaries (PCS and MCS) of 33 patients with MetS, 18 patients with MSDs, and 30 apparently healthy (AH) subjects. Regression analysis was used to measure the prediction power of the study group, age and gender of the participants in estimating the HRQoL. Results: Results showed that the mean scores of the physical subscales, the PCS, the mental subscales and MCS were arranged in descending order from AH subjects, patients with MetS, to patients with MSDs. The mean scores difference among the 3 study groups were statistically significant with the only exception for the general mental health (GMH) subscale (P = 0.404). The study group and age accounted for 41.8% of the variability of PCS while the study group accounted for 19.6% of the variability in the MCS. The resulted equation to estimate the PCS score was as follows: PCS = 113.18 - 12.85 (Group: 0 for AH, 1 for MetS, and 2 for MSDs) - 0.67 age. On the other hand the resulted equation to estimate the MCS score was as follows: MCS = 76.203 - 10.426 (Group: 0 for AH, 1 for MetS, and 2 for MSDs). Conclusion: Patients with MetS and patients with MSDs had lower HRQoL than AH subjects. All the physical and mental dimensions of HRQoL are negatively influenced with MetS and with MSDs with the only exception for the GMH subscale. The physical and mental burden of MSDs is more dominant. The study group and age can be used to predict the PCS while the study group can be used to predict the MCS.

Hepatomusculoskeletal disorders:Coining a new term might improve the management of the musculoskeletal manifestations of chronic liver disease

Chronic liver disease can affect many body systems including the musculoskeletal system.The pathogenetic crosstalk between the liver and organs such as the brain and the kidneys has already been described with compound terms merging the organs affected by the pathology,such as the hepatorenal syndrome.Nevertheless,the musculoskeletal manifestations of chronic liver disease have not been coined with such a term to date.Because of this shortage,documenting the musculoskeletal implications of chronic liver disease in both research and clinical practice is challenging.To fill this gap,the authors propose the term hepatomusculoskeletal disorders,a compound term of Greek origin that encompasses all the body structures involved in the aforementioned pathologic crosstalk.

A Study on the Prevalence of Musculoskeletal Disorders among Ageing Workforce of Indian Construction Industry

Ageing work force is one of the leading causes behind the depletion in the growth rate of the labor force in construction industries.Construction industry is a paramount source of employment worldwide after agricul­tural industry explicitly in urban areas.Manual material handling in con­struction industries causes musculoskeletal disorders affecting both upper and lower extremities of the body.Studies on lower limb problems due to dynamic work like handling of heavy loads in construction industries are scanty.To analyze the level of exertion,ergonomics risk factors and the prevalence of work-related lower limb disorders among the young and elderly construction workforce.20 male construction workers in the age group of i)20 to 30 years(golden age group);ii)50 years and above were selected from a local construction site in Mumbai.Demographic data like age,height,weight,BMI,body fat,waist hip ratio and risk assessment by questionnaires study comprising QEC,NMQ,VAS,and LEFS were collected.Compared to the golden age group,the elderly subjects were found to feel more discomfort in their lower back,knee and calf regions of lower limb due to immoderate forces and motions tolerated by their lower limbs during their daily work.Muscle pliability and proper coor­dination diminishes with age and it is appearing to be the most probable reason behind the pain experienced in their lower limbs might be due to improper techniques and postures.For elderly workers,age related limita­tions become an additional factor to maintain their normal work-life.

The Application of NIOSH Lifting Equation to Prevent Musculoskeletal Disorder Risks

The objective of the study was to reduce musculoskeletal disorder risks by applying the NIOSH lifting equation variables include the horizontal location, the vertical location, the vertical travel distance, the asymmetric, the lifting frequency and the coupling classification. The 17 specific samples from 4W and ZECP division were selected by the weight of box 15.4 - 28.7 pounds. The standardized Nordic questionnaire for the analysis of musculoskeletal symptoms with pain scale from 0 (no pain) to 10 (worst pain) was used to self-report feeling. The ergonomics redesigns trained for the workers included: 1) brought the load closer to the worker by training;2) raised the height of objects placed to reduce the vertical distance between the origin and destination of the lift;and 3) moved the origin and destination of lift closer together to reduce the angel twist. The new procedures were trained to all participated workers. The result found that the lifting index was safer (<1.0). For successful outcome, be supposed to monitoring is careful the data about a problem of the worker health, give the carefulness in case of specially exceed environment more than the LI advises and should do training continuously.

A comprehensive musculoskeletal and peripheral nervous system assessment of war-related bilateral upper extremity amputees

Background: Upper limb amputations are one of the unpleasant war injuries that armed forces are exposed to frequently. The present study aimed to assess the musculoskeletal and peripheral nervous systems in Iraq-Iran war veterans with bilateral upper extremity amputation.Methods: The study consisted of taking a history and clinical examinations including demographic data, presence and location of pain, level of amputation, passive and active ranges of movement of the joints across the upper and lower extremities and spine, manual palpation, neurological examination, blood circulation pulses and issues related to a prosthetic limb. In this study, 103 Iranian bilateral upper extremity amputees(206 amputations) from the IranIraq war were evaluated, and a detailed questionnaire was also administered.Results: The most common level of amputation was the finger or wrist level(108, 52.4%). Based on clinical examination, we found high frequencies of limited active and passive joint range of movement across the scapula, shoulder, elbow, wrist and metacarpophalangeal, interphalangeal and thumb joints. Based on muscle strength testing, we found varying degrees of weakness across the upper limbs. Musculoskeletal disorders included epicondylitis(65, 31.6%), rotator cuff injury(24, 11.7%), bicipital tendonitis(69, 33.5%), shoulder drop(42, 20.4%) and muscle atrophy(19, 9.2%). Peripheral nerve disorders included carpal tunnel syndrome in 13(6.3%) and unilateral brachial plexus injury in 1(1%). Fifty-three(51.5%) were diagnosed with facet joint syndrome at the level of the cervical spine(the most frequent site). Using a prosthesis was reported by 65(63.1%), both left and right sides. The back was the most common site of pain(71.8%).Conclusion: The high prevalence of neuro-musculoskeletal disorders among bilateral upper extremity amputees indicates that they need regular rehabilitation care.

Frequency of Comorbid Musculoskeletal Problems in Patients with Parkinson’s Disease: What and When?

Background: Musculoskeletal problems, deteriorating posture and pain are common complaints/comorbidities in Parkinson’s disease (PD). The aim of this study was to investigate the frequency of comorbid musculoskeletal problems in PD, and their relationship with disease stage and severity. Methods: The study was approved by the local ethical committee of Duzce University numbered with 2018/52 on date 26.03.2018. Patients with PD (pwPD) underwent a detailed examination to investigate the possible comorbidity of musculoskeletal findings in the orthopedics and traumatology clinic. Socio-demographic features, disease characteristics, motor and non-motor scores were recorded. Results: Thirty-seven pwPD were enrolled in the study. Mean age was 68.75 ± 10.75 years. Comorbid musculoskeletal problems were rotator cuff syndrome (27%), knee osteoarthritis (24.3%), meniscus (13.5%), lumber disc herniation (10.8%), kyphosis (8.1%), myotendinous diseases (16.3%). Rotator-cuff disease and knee osteoarthritis were most common comorbidities, especially in the “mild” and “moderate” stages of pwPD. Conclusion: Since most of the pwPD, especially the ones that have musculoskeletal complaints prior to the diagnosis of PD, present to the orthopedics and traumatology clinics or physiotherapists, it is mandatory to enhance the awareness of the orthopedic surgeons, and physiotherapy specialist in order to keep PD in mind.

Is burnout a mediating factor between sharps injury and workrelated factors or musculoskeletal pain?

BACKGROUND Burnout,musculoskeletal pain,and sharps injuries(SIs)affect medical workers.AIM To establish a model between SIs,burnout,and the risk factors to assess the extent to which burnout affects SIs.METHODS This questionnaire was used for an observational and cross-sectional study,which was based on members at a hospital affiliated with a medical university in Taichung,Taiwan,in 2020.The valid responses constituted 68.5%(1734 of 2531).The items were drawn from the Nordic Musculoskeletal Questionnaire and Copenhagen burnout inventory and concerned work experience,occupational category,presence of chronic diseases,sleep duration,overtime work,and work schedule.Factor analysis,chi-square test,Fisher exact test,Multiple linear,logistic regression and Sobel test were conducted.The present analyses were performed using SAS Enterprise Guide 6.1 software(SAS Institute Inc.,Cary,NC,United States),and significance was set at P<0.05.RESULTS Personal and work-related burnout ranks, sex, work experience ranks, occupationalgroups, drinking in the past month, sleep duration per day, presence ofchronic diseases, overtime work ranks, and work schedule were associated withSIs. Frequent upper limb and lower limb pain (pain occurring every day or once aweek) determined to be related to SIs. High personal burnout (> Q3) and highwork-related burnout (> Q3) mediated the relationship between SIs and frequentlower limb pain. Similarly, frequent lower limb pain mediated the relationship ofSIs with high personal and high work-related burnout. High personal and highwork-related burnout mediated the relationships of SIs with overtime work andirregular shift work. The mediating model provides strong evidence of anassociation between mental health and SIs.CONCLUSIONBurnout was determined to contribute to SIs occurrence;specifically, it mediatedthe relationships of SIs with frequent musculoskeletal pain, overtime work, andirregular shift work.

Mulligan动态关节松动术对肌肉骨骼疾病治疗效果及机制的研究进展

研究综述了Mulligan动态关节松动术在治疗不同肌肉骨骼疾病中的效果,包括肩袖损伤、肱骨外上髁炎、腰痛、慢性踝关节不稳等,并探讨了该技术的干预机制。研究发现,Mulligan动态关节松动术治疗常见的肌肉骨骼系统疾病的即时效果显著,包括减轻疼痛、增加关节活动度、改善肢体功能,并且在改善关节活动度方面有明显优势,但其长期效果需要进一步研究。Mulligan动态关节松动术的潜在治疗机制为:1)在生物力学方面,可能通过特别定向的动态关节滑动纠正2个关节面微小的错误排列,继而加强薄弱处的肌肉力量并拉伸紧张的肌肉,恢复身体机能;2)在神经生理学方面,优化处理疼痛的大脑区域之间的功能连接;降低脊髓兴奋性和疼痛敏感性;降低TNF-α、IL-6炎症因子,并促进内啡肽和5-羟色胺等神经递质的释放。

基于sEMG的拉力作业肌肉疲劳与恢复研究

目的为了探究动态拉力作业肌肉疲劳与恢复的特征,避免肌肉疲劳累积,降低肌肉骨骼疾患(MSDs)风险。方法设计动态拉力作业疲劳与恢复试验,选取10名男性本科生。测量屈指肌和肱三头肌的表面肌电信号,通过统计学方法分析肌群指标MF和MPF的变化特征。结果经过静坐恢复方式干预,肌力恢复至88%MVC,屈指和肱三头肌肌电频域指标MF和MPF均呈上升趋势,主观疲劳感随休息时间延长呈下降趋势。结论肌电频域指标MF和MPF能够较好地作为评估动态拉力作业中肌肉疲劳状态恢复过程的客观指标。本研究的疲劳状态恢复特征研究内容可为现实拉力作业中的休息设计提供依据。

基于柔筋解结法综合防治慢性筋骨病损述要

筋结是筋受伤的表现,是慢性筋骨病损的开端。筋作为人体的重要组成部分,受伤以后其形态结构发生改变,引起“筋出槽”,形成筋结,致其功能受损,表现出慢性疼痛。但随着科学技术发展,施术者在诊疗过程中往往忽视或不够重视筋的作用,从而误诊、失治,导致病情迁延难愈,形成慢性筋骨病损。文章基于詹红生教授“筋主骨从、筋为骨用”的学术思想,强调“筋结”这一关键病因病机,阐述以“柔筋解结”为核心,“四‘以’相合、医患合作”为总则,重视体格检查,顺应四时规律,注重医患合作,结合中医整体辨证施治思维综合论治慢性筋骨病损的科学性、合理性及重要性。

胎儿生长受限的病因及对患儿远期健康的影响

胎儿生长受限(fetal growth restriction,FGR)是指胎儿在妊娠期内无法达到其预期的生长潜力,其是妊娠期常见且较复杂的并发症之一。FGR病因复杂多样,可能是由母体、胎儿或胎盘因素所引起。对于存在FGR的儿童和成年患者,长期的追踪研究揭示了其健康状况的不良后果。生长受限胎儿的出生体质量和身长明显落后于正常儿童,绝大部分患儿在生后早期即开始出现明显的生长追赶,但其存在更高的代谢问题风险。FGR常常伴随着一系列的远期并发症,如神经系统发育障碍和骨骼肌生长代谢异常等问题,甚至是在成年期时更易出现代谢综合征和心血管疾病,这对患儿的身体健康和生活质量产生了严重影响。综述FGR致病因素及对患儿远期健康的影响,以期为临床防治提供相关理论支持。

我国钢琴表演专业学生肌肉骨骼疾患现状及影响因素分析

针对钢琴表演专业学生肌肉骨骼疾患的影响因素展开量化研究。研究采用了新编制钢琴演奏肌肉骨骼不适量表,对我国十余所音乐院校的969名钢琴表演专业学生进行问卷调查。研究发现:新编制钢琴演奏肌肉骨骼不适量表信效度较好;学生的肌肉骨骼疾患问题较普遍,背部和腰、颈椎、肩部、手腕、小臂是较严重的五个区域;性别、年级、肘关节屈伸姿态、肩关节外展姿态、坐高姿态是钢琴演奏肌肉骨骼疾患的影响因素。学生应多关注在钢琴练习及演奏过程中自身的肌肉骨骼舒适度,及时调整弹奏的身体姿态,避免出现因不良姿态所导致的肌肉骨骼疾患。钢琴专业教师在教学过程中也应提醒和帮助学生以舒适、自然的状态进行钢琴演奏训练。

基于sEMG的渣土车驾驶员肌肉疲劳与恢复研究

目的 为了解渣土车驾驶员肌肉疲劳发展与疲劳恢复特征,避免疲劳累积,降低肌肉骨骼损伤风险.方法 设计并组织渣土车模拟驾驶实验.招募8 名被试参与实验,测量驾驶过程和恢复阶段驾驶员主观疲劳评分数据与颈部左右斜方肌、腰部左右竖脊肌、左右多裂肌共6 个肌群的肌肉活动信息,运用统计学分析方法分析肌肉疲劳随驾驶时间和恢复时间而变化的特征.结果 经过180 min模拟渣土车驾驶任务后,驾驶员达到非常疲劳状态,所测量6 个肌群肌肉疲劳,腰部CR-10 评分高于颈部;经过5 min静坐和30 min静坐且听音乐休息后,驾驶员恢复至较清醒状态,所测6 个肌群中,身体左侧相关肌群逐渐恢复,身体右侧相关肌群仍然处于疲劳状态.结论 渣土车驾驶过程肌肉疲劳明显,静坐恢复方式有利于疲劳恢复,但是身体右侧斜方肌、竖脊肌和多裂肌仍处于疲劳状态.

The Protocol of Ultrasonic Backscatter Measurements of Musculoskeletal Properties

This study aims to introduce the protocol for ultrasonic backscatter measurements of musculoskeletal properties based on a novel ultrasonic backscatter bone diagnostic(UBBD)instrument.Dual-energy X-ray absorptiometry(DXA)can be adopted to measure bone mineral density(BMD)in the hip,spine,legs and the whole body.The muscle and fat mass in the legs and the whole body can be also calculated by DXA body composition analysis.Based on the proposed protocol for backscatter measurements by UBBD,ultrasonic backscatter signals can be measured in vivo,deriving three backscatter parameters[apparent integral backscatter(AIB),backscatter signal peak amplitude(BSPA)and the corresponding arrival time(BSPT)].AIB may provide important diagnostic information about bone properties.BSPA and BSPT may be important indicators of muscle and fat properties.The standardized backscatter measurement protocol of the UBBD instrument may have the potential to evaluate musculoskeletal characteristics,providing help for promoting the application of the backscatter technique in the clinical diagnosis of musculoskeletal disorders(MSDs),such as osteoporosis and muscular atrophy.