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PURPOSE: A hands-on-wall (HOW) position for low-dose stereoradiography of adolescent idiopathic scoliosis (AIS) patients would allow for skeletal maturity assessment of the hand and wrist. Our aims were twofold: confirm the reliability and validity of skeletal maturity assessment using the HOW radiographs and compare the spinal and pelvic 3D parameters to those of standard hands-on-cheeks (HOC) stereoradiographs. METHODS: Seventy AIS patients underwent two successive stereoradiographs and a standard hand and wrist radiograph on the same day. Patients were randomly assigned to begin with HOW and follow with HOC, or vice versa. Raters assessed digital skeletal age (DSA), Sanders Simplified Skeletal Maturity (SSMS) and Thumb Ossification Composite Index (TOCI). 3D reconstructions of the spine and pelvis bones were performed for each stereoradiograph to measure nine clinically relevant spinal and pelvic 3D parameters. RESULTS: Inter-rater and intra-rater reliabilities were excellent for DSA, SSMS and TOCI with both standard radiographs and HOW (ICC > 0.95). Strong correlation was found between ratings of both imaging types (ICC > 0.95). In the 3D reconstructions, kyphosis and sacral slope were slightly decreased in the HOW position, but within the clinical margin of error. All other parameters did not differ significantly between positions (p < 0.05). CONCLUSION: The results suggest that HOW stereoradiographs allow clinicians to assess skeletal maturity of the hand and wrist with adequate reliability and validity. We recommend that scoliosis clinics adopt the HOW position to assess skeletal maturity because there is no significant clinical impact on the spinal and pelvic evaluation, and on radiation exposure, cost or time.

RESUMEN

Background and Objectives: Acute and chronic injuries are frequent in volleyball. Biomechanics of sport-specific tasks can influence the risk of injury, which is also related to specific court positions. We investigated posture at raster-stereography, balance, and dynamic tasks using inertial motion units to find differences between roles, which can be predictive of a higher risk of injury. Materials and Methods: We cross-sectionally evaluated amateur volleyball athletes. Participants were divided into roles as outside hitters, setters, middle blockers, and opposite hitters. We excluded the "libero" position from our analysis. Results: Sixteen players were included in the analysis. A statistically significant difference was found in left lower limb stiffness among the outside hitter and setter groups. Conclusions: Differences in stiffness might be related to the different training and the different abilities among the two groups. Raster-stereography is extending its indications and should be implemented for non-invasive postural analysis. The use of inertial motion units provides objective measurements of variables that could go unrecognized within a clinical evaluation; its use should be considered in injury preventive programs.

Asunto(s)

Voleibol , Humanos , Atletas

RESUMEN

AIMS: To investigate the cross-sectional association between deep and superficial diabetic neuropathy, postural impairment assessed by wearable inertial sensors, and the risk of fall among patients with diabetic foot. METHODS: Diabetic patients attending a University Podiatric Clinic were evaluated for the presence of deep and superficial peripheral neuropathy in sensory tests. Postural impairment was assessed using a wearable inertial sensor, and the evaluation of balance/gait and risk of fall was determined by the Tinetti Scale and Downton Index, respectively. Glycemic control was measured by glycated haemoglobin concentration and fasting glycaemia. The postural parameters measured were the anteroposterior and medio-lateral sway of the center of mass (CoM) and the sway area (area traveled by the CoM per second). The results were analyzed through a logistic regression model to assess those posture variables mostly significantly associated with neuropathy and risk of fall scales. RESULTS: A total of 85 patients were evaluated. Spearman's rank correlation coefficients showed a strong and significant relationship (p < 0.05) between deep diabetic neuropathy assessed by Semmes-Weinstein monofilament, diapason and biothensiometer and postural alterations, whereas no significant correlations between superficial (painful sensitivity) neuropathy and the postural parameters. The sway path of the displacement along the anterior-posterior axis recorded during tests performed with eyes open and feet close together were significantly (p < 0.05) correlated with a poor glycemic (glycated haemoglobin concentration) control and each other with all diabetic neuropathy tests, fall risk scales, muscular weakness, ankle joint limitation and history of ulcers. CONCLUSIONS: The results support the existence of a strong association between alterations of the deep somato-sensitive pathway (although depending on the tool used to measure peripheral neuropathy), glycemic control and balance impairments assessed using a wearable sensors. Wearable-based postural analysis might be part of the clinical assessment that enables the detection of balance impairments and the risk of fall in diabetic patients with diabetic peripheral neuropathy.

Asunto(s)

Diabetes Mellitus , Pie Diabético , Neuropatías Diabéticas , Dispositivos Electrónicos Vestibles , Humanos , Neuropatías Diabéticas/complicaciones , Neuropatías Diabéticas/diagnóstico , Pie Diabético/complicaciones , Pie Diabético/diagnóstico , Estudios Transversales , Hemoglobina Glucada , Equilibrio Postural , Medición de Riesgo

RESUMEN

BACKGROUND: Musculoskeletal risks (MSRs) are a major concern among construction warehouse workers due to the lifting, carrying and lowering of heavy loads. OBJECTIVE: The objective of this study was to reduce MSRs among warehouse workers in the construction industry using virtual modelling and analysis of activities. METHODS: A preliminary study was carried out using the Standard Nordic Questionnaire. Biomechanical analysis, Ovako Working posture Assessment System (OWAS) and Rapid Upper Limb Assessment (RULA) were used to analyse the material handling activities. Virtual modelling was used develop the manikins with autoclaved aerated concrete (AAC) blocks at different carriage modes and stacking heights for the analysis. RESULTS: The preliminary study results revealed a higher prevalence of risk at their lower back (73.24%) among the construction warehouse workers. Biomechanical analysis showed a higher risk at L4-L5 joint of lumbar spine during overhead and bending postures for stacking the blocks. Posture analysis results of OWAS indicated a lower risk in overhead carriage mode. Detailed analysis with RULA confirms this result. Mean compressive force values at stacking heights were showed a significant difference (p < 0.05) in 8, 13, 18 and 21 kg AAC blocks. However, stacking height with a range of 120-140 cm was found as safer to the workers by considering all block sizes. CONCLUSION: An ergonomic intervention based on safer stacking heights was developed to reduce MSRs to an acceptable range. It improves productivity of handling the AAC blocks by reducing the cycle time. The intervention can be adapted for handling of similar materials in the construction industry.

Asunto(s)

Industria de la Construcción , Enfermedades Musculoesqueléticas , Sistema Musculoesquelético , Enfermedades Profesionales , Humanos , Ergonomía/métodos , Postura , Extremidad Superior , Enfermedades Musculoesqueléticas/etiología , Enfermedades Musculoesqueléticas/prevención & control , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Profesionales/epidemiología

RESUMEN

The prevalence of musculoskeletal disorders is very high amongmidwives resulting in sickness absenteeism, functional limitation and staff shortages. There are several contributory risk factors having impact on the development of MSDs. This study aimed to (1) explore midwives' experiences and views about work-related MSDs and contributing risk factors, and (2) analyse working postures for musculoskeletal injury risks. A mixed method approach was used with interviews/focus group (n = 15/7) and observations (n = 22) of specific tasks (during birth and after birth) using the posture analysis observational method (Rapid Entire Body Assessment, REBA). The participants were midwives who had an active role in the United Kingdom (UK) National Health Services (NHS). It was found that MSDs were often attributed to the physical (working in awkward positions), organisational (longer shift hours, fewer staff, increased work load), psychosocial (defensive practice, higher demand) challenges of midwifery. All postures had very high to medium REBA risk levels with action categories indicating that action or further assessment is definitely necessary to reduce MSDs. This research provides a holistic approach by analysing risk factors and interactions in the work context to inform the development of risk management strategies. Midwifery working conditions have a big impact on developing musculoskeletal symptoms. Management of such symptoms will improve staff wellbeing, mother and baby safety, individuals' life trajectories and staff shortages.

Asunto(s)

Partería , Enfermedades Musculoesqueléticas , Femenino , Grupos Focales , Humanos , Enfermedades Musculoesqueléticas/etiología , Embarazo , Encuestas y Cuestionarios , Reino Unido

RESUMEN

BACKGROUND: The prevalence of musculoskeletal disorders is high among teachers. Poor posture when writing on whiteboards is considered among the important causes of these disorders. OBJECTIVE: The present study aimed to evaluate an electromechanical rolling whiteboard for educational environments as an ergonomic intervention. METHODS: Thirty university lecturers volunteered to take part in the study. Participants performed a 5-minute writing task on a regular board and on the newly modified whiteboard in random order. The comfort and effectiveness of the boards and the perceived physical effort and posture of the participants were evaluated and compared by applying the verbal rating scale, Borg's rating of physical exertion scale, and rapid entire body assessment, respectively. RESULTS: A total of 83.2% of participants reported the new whiteboard to be comfortable or more comfortable to use than the regular whiteboard, and 76.6% of them found the new whiteboard to be higher or much higher in effectiveness and usefulness in comparison with the regular whiteboard. The comfort and posture ratings revealed that exertion was significantly less and posture improved while writing on the new board as compared to its counterpart (p < 0.0001). CONCLUSION: The new whiteboard increased user comfort, reduced physical effort, and improved posture, hopefully leading to a decreased number of work-related musculoskeletal disorders.

Asunto(s)

Ergonomía , Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Maestros , Humanos , Enfermedades Musculoesqueléticas/prevención & control , Enfermedades Profesionales/prevención & control , Esfuerzo Físico , Postura , Prevalencia

RESUMEN

This study applied the posturography framework on five static standing tasks from the Berg Balance Scale (BBS). Thirteen participants were recruited and the trajectory data of the center of pressure (CoP) were collected. To analyze the postural performance, two approaches were taken: the scores from the BBS and statistical analysis. For the statistical analysis, Spearman's method was applied to determine the correlation of CoP parameters. The results revealed the correlations between CoP parameters in the anterior-posterior (AP) and medial-lateral (ML) directions, and on the statokinesgram (SK) plane for all tasks. To obtain the in-depth detail between normal weight and overweight groups, the differences in the postural control mechanism were defined by correlations of CoP parameters. The Mann-Whitney U test was conducted to define the difference in postural control in terms of difference in weight gain and standing task factors, while Cohen's d was used to investigate the influence of the difference in standing tasks and weight gain on postural control. The results showed that the correlations of CoP parameters could distinguish the balance impairment in the overweight condition from the normal postural control. Otherwise, the scores of BBS, the Mann-Whitney U test and Cohen's d did not separate this slightly compensatory movement during equilibrium. Therefore, the correlations of CoP parameters could provide more information to analyze the balance function in each individual, especially in terms of slight compensation.

Asunto(s)

Equilibrio Postural , Adulto , Humanos , Movimiento , Sobrepeso

RESUMEN

STUDY DESIGN: Observational study. PURPOSE: The purpose of this study is to analyze the surgeon's neck postures while performing lumbar spinal surgeries. OVERVIEW OF LITERATURE: Lumbar spinal surgeries are on rising trend, and with increase in number of procedures, the average time spent by a spine surgeon performing surgical procedures is also increasing. The effect of operating posture on the surgeon's neck is largely unknown. From the studies conducted on usage of smartphones, abnormal neck postures, especially the forward head posture (FHP), were found to adversely affect the cervical spine of individuals. The present study analyzes the neck position of spine surgeons during lumbar spine surgeries. METHODOLOGY: Sixty video recordings (25 open transforaminal lumbar interbody fusions [TLIFs] and 35 lumbar decompression [LD] procedures - 15 with headlight and 20 with operating microscope) of surgeries performed by three spine surgeons of different heights were analyzed. Running videos of the surgeries were recorded concentrating on the surgeons with reflective markers taped to their surface landmarks corresponding to C7 spinous process, tragus of the ear, and outer canthus of the eye. Video recordings were standardized by a fixed video recorder in the same operating theater. Snapshots from the video were obtained whenever the surgeon changes the position. Head flexion angle (HFA), neck flexion angle (NFA), and cervical angle (CA) were measured and analyzed. RESULTS: During TLIF, HFA and NFA were significantly higher during the phases of decompression and fusion (P < 0.05). The average CA of all surgeons was lower, thereby adversely affecting the cervical spine (20.15° ± 5.05°). During LD, CA showed significant difference between usage of microscope and headlight (P < 0.001). CONCLUSION: Surgeon's FHP is frequently caused by a compromise between the need to perform surgery with hands, without elevating the arms, and simultaneous control of gaze at surgical field. The usage of microscope was found to reduce the stress on neck while performing surgery.

RESUMEN

Wearables are devices worn on the human body and are able to measure various health parameters, such as physical activity, energy expenditure and gait. With the advancement of technology, the general population are now spending more hours craning our necks and slouching over smartphones, tablets and computers, et cetera. Bodily posture is representative of physical and mental health. Poor posture can lead to spinal complications and the same can be said vice versa. As the standard of living increases, there is an increase in consumerism and the expectation to maintain such a lifestyle even in the aging population. Therefore, many are able to afford small luxuries in life, such as a piece of technology that could potentially improve their health in the long run. Wearable technology is a promising alternative to laboratory systems for movement and posture analysis. This article reviews commercial wearable devices with a focus on postural analysis. The clinical applicability of posture wearables, particularly in preventing, monitoring and treating spinal and musculoskeletal conditions, along with other purposes in healthcare, will be discussed.

Asunto(s)

Postura/fisiología , Dispositivos Electrónicos Vestibles , Animales , Ejercicio Físico/fisiología , Humanos , Movimiento/fisiología

RESUMEN

One-stage bilateral total hip arthroplasty (THA) implies similar complication rate and hospitalization time to unilateral THA, but no studies have evaluated the functional and postural recovery in these patients. The aim of this study was to assess short-term functional and postural recovery in patients after one-stage bilateral or unilateral THA. Forty patients undergoing bilateral (n = 20) or unilateral (n = 20) THA were assessed by Timed Up and Go (TUG), Numeric Rating Scale (NRS), Tampa Scale of Kinesiophobia (TSK) and Body Weight Distribution Symmetry Index (BWDSI) during stand-to-sit (STS). Centre of Pressure (CoP) parameters and BWDSI during standing with eyes open (EO) and closed (EC) were also assessed. Data were collected one day before surgery, at three and seven days. No between-group differences were found for TUG, NRS and TSK at any time-point, showing similar mobility, pain and fear of movement in both groups. BWDSI during STS (P = 0.001) and standing (OE P = 0.007; CE P = 0.012) revealed differences over time in favor of patients with bilateral THA, who showed better symmetry in weight distribution. Shorter CoP path length was observed during standing in patients with unilateral THA (OE P = 0.023; CE P = 0.018), who mainly used their non-affected limb to maintain balance.

Asunto(s)

Artroplastia de Reemplazo de Cadera , Movimiento , Osteoartritis/rehabilitación , Postura , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Osteoartritis/cirugía , Rango del Movimiento Articular

RESUMEN

BACKGROUND: Muscular co-contraction is a strategy commonly used by elders with the aim to increase stability. However, co-contraction leads to stiffness which in turns reduces stability. Some literature seems to suggest an opposite approach and to point out relaxation as a way to improve stability. Teaching relaxation is therefore becoming the aim of many studies letting unclear whether tension or relaxation are the most effective muscular strategy to improve stability. Relaxation is a misleading concept in our society. It is often confused with rest, while it should be addressed during stressing tasks, where it should aim to reduce energetic costs and increase stability. The inability to relax can be related to sub-optimal neuro-motor control, which can lead to increased stresses. RESEARCH QUESTION: The objective of the study is to investigate the effect of voluntary muscle contraction and relaxation over the stability of human standing posture, answering two specific research questions: (1) Does the muscular tension have an impact on stability of standing posture? (2) Could this impact be estimated by using a minimally invasive procedure? METHODS: By using a force plate, we analysed the displacement of the center of pressure of 30 volunteers during state of tension and relaxation in comparison with a control state, and with open and closed eyes. RESULTS: We found that tension significantly reduced the stability of subjects (15 out of 16 parameters, p < 0.003). SIGNIFICANCE: Our results show that daily situations of stress can lead to decreased stability. Such a loss might actually increase the risk of chronic joint overload or fall. Finally, breathing has direct effect over the management of pain and stress, and the results reported here point out the need to explicitly explore the troubling fact that a large portion of population might not be able to properly breath.

Asunto(s)

Contracción Muscular/fisiología , Tono Muscular/fisiología , Equilibrio Postural/fisiología , Posición de Pie , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Mecánica Respiratoria/fisiología , Adulto Joven

RESUMEN

Currently, the word 'comfort' is often used in relation to the marketing of products such as chairs, cars interiors, clothing, hand tools and even airplane tickets. In this field of research, the aim of this study is to investigate the influence of spinal posture on postural (dis)comfort perception; the test case is the analysis of the interaction between humans and vending machines for purchasing food or beverages. A statistical sample of 20 healthy students (subjects) performed the required tests, with each participant asked to take a product from three different vending machines (snacks, drinks and coffee). The subjects' postures were acquired non-invasively using cameras; software and instruments for virtual prototyping were used for posture analysis and interaction modelling, both questionnaires (subjective) and comfort-analysis software (objective) were used to rate the perceived (dis)comfort. The results obtained from simulations and questionnaires were compared, and a method to weigh the effect of the perceived spinal discomfort on overall postural (dis)comfort was proposed. These results reveal a good correlation between subjective perception and objective evaluation obtained through simulations, confirming the validity of the proposed method.

Asunto(s)

Dolor de Espalda/psicología , Comercio/instrumentación , Diseño de Equipo/psicología , Sistemas Hombre-Máquina , Postura , Bebidas , Comportamiento del Consumidor , Femenino , Voluntarios Sanos , Humanos , Masculino , Bocadillos , Columna Vertebral , Estudiantes/psicología , Adulto Joven

RESUMEN

In this paper, we study the postural behaviour of two categories of people: Post-CVA subjects suffering from cerebrovascular accident syndromes and healthy individuals under several levels of anterior-posterior and medial-lateral sinusoidal disturbances (0.1-0.5 Hz). These perturbations were produced from an omnidirectional platform called Isiskate. Afterwards, we have quantified seventy postural parameters, they were combined of linear stabilometric parameters and non-linear time dependent stochastic parameters using stabilogram diffusion analysis and some spectral attributes using power spectral density. The aim of our analysis is to reduce data dimensionality using principal component analysis (PCA). Furthermore, we proposed a new PCA-related criterion named: criterion of contribution in order to evaluate the contribution of every variable in the resulted system structure, and thus to eliminate the redundant postural characteristics. Afterwards, we highlighted some interesting distinctive parameters. The selected parameters were used thereafter in comparison between the studied groups. Finally, we created a classification model using support vector machines to distinguish stroke patients. Our proposed techniques help in understanding the human postural dynamics and facilitate the diagnosis of pathologies related to equilibrium which can be used to improve the rehabilitation services.

Asunto(s)

Postura , Análisis de Componente Principal , Accidente Cerebrovascular/patología , Accidente Cerebrovascular/fisiopatología , Adulto , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Máquina de Vectores de Soporte , Adulto Joven

RESUMEN

BACKGROUND: Depletion of groundwater has increased the depth of bore wells drilled to meet water requirements. Water from these bore wells are accessed by operating submersible pumps with multi-stages. The number of stages of submersible pump directly depends upon the depth of bore well. Health-related risk such as Musculoskeletal Disorders (MSDs) arises during the manual assembly of these pumps in an awkward posture. OBJECTIVE: The objective of this paper is to eliminate or reduce risk in the manual assembly of submersible pumps using virtual postural analysis. Secondary objective is to redesign the existing workstation incorporating ergonomic interventions. METHODS: It reports a case study in which postural analysis is carried out with the help of Rapid Upper Limb Assessment (RULA) method. RESULTS: It is observed that inserting the stage casing weighing around 1.5 Kg through top end of the shaft is the awkward working posture involving a flexion of the arm about 152°. RULA score (7) indicate a high level of risk exists in the workstation, calling for investigate and change the working posture immediately. In order to reduce this risk, a redesigned workstation has been proposed. CONCLUSION: This study results help in minimizing the awkward postures, thereby reducing the health-related risk. This will also increase the efficiency of the worker and his productivity.

Asunto(s)

Ergonomía/normas , Industria Manufacturera , Examen Físico/métodos , Postura/fisiología , Extremidad Superior/fisiología , Adulto , Ergonomía/métodos , Femenino , Humanos , Masculino , Industria Manufacturera/normas , Enfermedades Musculoesqueléticas/etiología , Enfermedades Profesionales/etiología , Examen Físico/normas , Factores de Riesgo , Encuestas y Cuestionarios , Pozos de Agua , Recursos Humanos

RESUMEN

BACKGROUND: Age-related hyperkyphosis causes deleterious effects on health, physical function, and quality of life. Recently, health care providers recognized it as a major health concern. OBJECTIVE: To identify the effect of corrective exercise strategy on hyperkyphosis and compare it with that of conventional exercise. METHODS: Subjects were randomly categorized into two groups. Each group comprised 30 subjects. Group A received the corrective exercise strategy, and group B received conventional exercises for 8 weeks of the study duration (15 repetitions of each exercise for three sessions/day for a total duration of 45 min and 4 days/week. Pre- and post-interventional hyperkyphosis were analyzed according to posture number using the Posture Pro 8 postural analysis software. In addition, pectoralis minor flexibility was assessed using the ruler scale method in centimeters. RESULTS: Both groups showed highly significant postural alteration and changes in pectoralis minor muscle length (p< 0.001)CONCLUSIONS:The corrective exercise strategy seems to promote scapular stability and produce a more upright posture of the upper thoracic spine.

Asunto(s)

Terapia por Ejercicio/métodos , Cifosis/rehabilitación , Adulto , Femenino , Humanos , Cifosis/fisiopatología , Masculino , Persona de Mediana Edad , Músculos Pectorales/anatomía & histología , Postura/fisiología , Método Simple Ciego

RESUMEN

STUDY OBJECTIVE: To investigate work-related musculoskeletal disorders (WRMSD) in gynaecological minimal access surgery (MAS), including bariatric (plus size) patients DESIGN: Mixed methods (Canadian Task Force classification III). SETTING: Teaching hospital in the United Kingdom. MEASUREMENTS: Survey, observations (anthropometry, postural analysis), and interviews. RESULTS: Work-related musculoskeletal disorders (WRMSDs) were present in 63% of the survey respondents (n = 67). The pilot study (n = 11) identified contributory factors, including workplace layout, equipment design, and preference of port use (relative to patient size). Statistically significant differences for WRMSD-related posture risks were found within groups (average-size mannequin and plus-size mannequin) but not between patient size groups, suggesting that port preference may be driven by surgeon preference (and experience) rather than by patient size. CONCLUSION: Some of the challenges identified in this project need new engineering solutions to allow flexibility to support surgeon choice of operating approach (open, laparoscopic or robotic) with a workplace that supports adaptation to the task, the surgeon, and the patient.

Asunto(s)

Procedimientos Quirúrgicos Ginecológicos , Ginecología , Procedimientos Quirúrgicos Mínimamente Invasivos , Enfermedades Musculoesqueléticas/etiología , Enfermedades Profesionales/etiología , Postura , Cirujanos , Adulto , Conducta de Elección , Femenino , Procedimientos Quirúrgicos Ginecológicos/efectos adversos , Procedimientos Quirúrgicos Ginecológicos/métodos , Procedimientos Quirúrgicos Ginecológicos/psicología , Procedimientos Quirúrgicos Ginecológicos/estadística & datos numéricos , Ginecología/métodos , Ginecología/estadística & datos numéricos , Humanos , Laparoscopía/métodos , Laparotomía/efectos adversos , Laparotomía/métodos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Mínimamente Invasivos/efectos adversos , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Procedimientos Quirúrgicos Mínimamente Invasivos/psicología , Procedimientos Quirúrgicos Mínimamente Invasivos/estadística & datos numéricos , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Profesionales/epidemiología , Proyectos Piloto , Procedimientos Quirúrgicos Robotizados/efectos adversos , Procedimientos Quirúrgicos Robotizados/métodos , Cirujanos/estadística & datos numéricos , Encuestas y Cuestionarios , Reino Unido/epidemiología , Recursos Humanos

RESUMEN

The ErgoKiTa study aimed to determine the musculoskeletal strain of preschool teachers and to identify and evaluate suitable prevention measures to reduce this strain. A comprehensive work analysis using objective and subjective methods was performed to determine the present work situation in preschools in Germany, and the results were used to derive suitable intervention measures. The musculoskeletal strain was determined by means of a comprehensive analysis of postures, forces and movements using the CUELA system and calculated as cumulative shift workloads. The intervention measures were evaluated in a pre- and post-intervention assessment for 12 participants. Significant alterations in the duration of postures were determined, specifically for the daily duration of knee-straining postures as well as the degree of trunk flexion between 60° and 90°, which were reduced from 8.4 to 3.1% and from 3.7 to 2.4%, respectively, following the intervention. Practitioner Summary: Research has shown that preschool teachers are at risk of developing musculoskeletal disorders. The effects of a situation-orientated and behaviour-orientated intervention approach were assessed with regard to awkward working postures. Significant alterations in the duration of postures following the intervention were found, specifically for knee-straining postures.

Asunto(s)

Enfermedades Musculoesqueléticas/prevención & control , Enfermedades Profesionales/prevención & control , Postura , Enseñanza , Adulto , Fenómenos Biomecánicos , Preescolar , Ergonomía , Humanos , Rodilla/fisiología , Persona de Mediana Edad , Salud Laboral , Instituciones Académicas , Factores de Tiempo , Torso/fisiología , Adulto Joven

RESUMEN

BACKGROUND: During pregnancy, the body undergoes many hormonal and anatomical changes causing several medical problems as the musculoskeletal system problems. OBJECTIVE: To investigate the plantar pressure distribution during pregnancy. SUBJECTS: Twenty two pregnant and non-pregnant females were selected from the King Abdulaziz University in Jeddah. METHODS: All females were evaluated by inspection regarding their deformities of the spine, pelvis, lower extremities and feet. Pain was assessed by the Visual Analog Scale (VAS), and the weight and height were recorded using a calibrated weighing scale. Finally, the plantar pressure distribution was examined by a Global Postural Analysis device (GPA). RESULTS: The results revealed significant asymmetry of weight bearing in the study group (pregnant) compared to the control group (non-pregnant) (p< 0.05). In addition, there was a significant increase in pain intensity in the study group (p= 0.02). On the other hand, the results showed a non-significant difference between study and control groups regarding the three points of pressure (calcaneus, 1st metatarasal and 5th metatarsal) (p> 0.05). Moreover, there was a significant direct relationship between the month of pregnancy and increased weight bearing on the 5th metatarsal in the study group (p= 0.04). CONCLUSION: There is an effect of pregnancy on plantar pressure distribution as well as weight symmetry which should be considered when designing an antenatal program.

Asunto(s)

Pie/fisiología , Embarazo/fisiología , Adulto , Femenino , Humanos , Masculino , Dolor/etiología , Dimensión del Dolor , Presión , Soporte de Peso , Adulto Joven

RESUMEN

PURPOSE: A prospective, cross-sectional study to determine the impact of arm position on the 3D spine and pelvic parameters and postural balance in adolescent idiopathic scoliosis. METHODS: A total number of 37 adolescent idiopathic scoliosis patients were enrolled prospectively. Three arm positions, (1) 45° shoulder flexion with knuckles on clavicles, (2) 90° shoulder and elbow flexion with forearms and palms on the front wall, and (3) arms hanging on either side, were instructed to the cohort. Bi-planar low dose X-ray images of the spine and pelvis were registered in a stereoradiography system in the first and second arm positions. A pressure mat recorded the position of the center of pressure in each arm position. Spinal and pelvic parameters were measured for the cohort. Statistical analysis was performed to determine the agreement between the spinal and pelvic parameters and standing balance in different arm positions. RESULTS: Thoracic kyphosis, sacral slope, sagittal vertical axis, T1 tilt, and spinal height were significantly different between the knuckles on clavicle and forearms on the wall positions p < 0.05. Significant differences were observed in the pressure distribution under the feet between the wall and freestanding positions. Bland-Altman plots determined disagreements between the first and second arm positions in clinical measurements and postural assessment of adolescent idiopathic scoliosis. CONCLUSION: The knuckles on clavicles position replicates the functional standing balance in AIS. Significant differences between the spinal and pelvic parameters suggest that the wall and clavicle arm positions should not be used interchangeably in AIS postural assessment. LEVEL OF EVIDENCE: Diagnostic level II.

Asunto(s)

Pelvis/diagnóstico por imagen , Equilibrio Postural/fisiología , Escoliosis/diagnóstico por imagen , Columna Vertebral/diagnóstico por imagen , Adolescente , Niño , Estudios Transversales , Femenino , Humanos , Imagenología Tridimensional , Masculino , Posicionamiento del Paciente , Pelvis/fisiopatología , Estudios Prospectivos , Columna Vertebral/fisiopatología

RESUMEN

Increasing evidence is being found for the association of health risk factors with work-related physical inactivity. An increasing number of people are being exposed to this form of inactivity, and as a result, various interventions aimed at increasing physical activity during working hours are being developed. This study aims to investigate the differences in postural, muscular and physical activities resulting from two dynamic workstations, namely an elliptical trainer and a treadmill workstation, compared with a conventional sitting and standing workstation. Twelve participants completed five standardised office tasks in a laboratory setting at all workstations. No significant effect was found regarding changes in posture and the muscular activity was only significantly higher for the trapezius muscle (50th percentile: 8.1 %MVC) at the dynamic workstations. For the dynamic workstations, physical activity ranged from 4.0 to 14.9 × 10(-2) g, heart rate from 14.3 to 27.5 %HRR and energy expenditure from 1.8 to 3.1 METs. Practitioner Summary: Work-related physical inactivity is associated with health risk factors. In this study, physiological and postural effects of dynamic workstations were assessed in comparison to conventional workstations. No significant effects were found regarding changes in posture and muscular activity. Physical activity, heart rate and energy expenditure increased for the dynamic workstations.

Asunto(s)

Computadores , Ergonomía , Ejercicio Físico , Postura , Lugar de Trabajo , Adulto , Electromiografía , Femenino , Humanos , Masculino , Persona de Mediana Edad , Músculo Esquelético