RESUMO
BACKGROUND: Tibialis posterior tendinopathy (TPT) is characterised by pain around the medial foot/ankle and difficulties weightbearing. OBJECTIVE: Compare individuals who have TPT with asymptomatic controls across the International Classification of Functioning, Disability and Health (ICF) domains of body structure and function, activity, participation and personal factors. METHODS: Twenty-two individuals meeting the selection criteria for TPT (86% female, mean ± SD age:43 ± 13 years; body mass index [BMI]:28 ± 7 kg/m2) were compared to 27 controls (93% female, age:44 ± 16 years, BMI:23 ± 5 kg/m2). Standardised differences (and 95% confidence intervals [CIs]) between groups were estimated for outcomes under each ICF domain using Cliff's delta to allow for comparison of the magnitude of deficits across outcomes (>0.47 considered large). RESULTS: Impairments in body structure and function in individuals with TPT were accompanied by activity limitations including difficulties due to foot problems (-1.0 (-1.0, -1.0)) and with independent living (-0.8 (-1.0, -0.3)) and greater time to complete stair descent/ascent (-0.6 (-0.8, -0.3)). Considering participation, overall foot-related function (-1.0 (-1.0, -1.0)), ability to participate in activities (-0.7 (-0.08, -0.3)), social restrictions (-0.8 (-1.0, -0.4)) and quality of life (-0.7 (-0.9, -0.5)) were poorer in individuals with TPT. CONCLUSION: Individuals with TPT have large impairments in body structure and function, activity limitations and participation restrictions, particularly relating to independent living, mental health and pain. Personal factors appear to contribute to a lesser extent to the TPT presentation. Treatment plans should consider activity and participation limitations in addition to body structure and function.
Assuntos
Classificação Internacional de Funcionalidade, Incapacidade e Saúde , Tendinopatia , Humanos , Feminino , Adulto , Pessoa de Meia-Idade , Masculino , Atividades Cotidianas , Estudos Transversais , Avaliação da Deficiência , Qualidade de Vida , DorRESUMO
BACKGROUND: In some occupational groups, prolonged standing is associated with adverse symptoms. While the introduction of sit-stand workstations in office workers is increasingly common, the profile of symptom development is not known. OBJECTIVES: To identify and describe the location, intensity, quality, and timing of symptoms experienced by office workers while standing at a sit-stand workstation. METHODS: This cross-sectional observational study was performed in an university campus laboratory simulated as an office with a sit-stand workstation. Sixty-three office workers without low back pain or prior exposure to a sit-stand workstation participated. For primary outcome measures, participants recorded any symptoms of pain, stiffness, and/or fatigue on a body chart every 15 min during a 2-hour standing task. Participants rated symptom intensity on an 11-point numerical rating scale (NRS). RESULTS: Fifty-three participants (84%) experienced symptoms during the 2-hour standing task, with 30 participants (48%) reporting at least one symptom within 30 min of standing. A greater number of participants reported symptoms rated ≥2 on the NRS in the lumbar spine, lower extremity, and feet/ankle than the upper quadrant (odds ratios from 3.84 to 6.86). Mean maximal symptom intensity for the lumbar spine was greater than that for the upper quadrant and feet/ankles (incidence rate ratios: 1.46 to 1.79). CONCLUSION: Symptoms of pain, stiffness, and fatigue, especially those affecting the lumbar spine, lower extremity and feet/ankles are common in office workers who stand at a workstation. Study findings suggest that physical therapists should advise workers using sit-stand workstations to monitor symptoms and consider changing position within 30 min.
Assuntos
Comportamento Sedentário , Local de Trabalho , Estudos Transversais , Fadiga , Humanos , Dor , PosturaRESUMO
OBJECTIVE: To examine the acute effects of isometric exercise of different intensities on pain perception in individuals with chronic lateral epicondylalgia. MATERIALS AND METHODS: Participants performed 3 experimental tasks completed in a randomized order on separate days: control (no exercise) and isometric wrist extension (10×15 s) at load 20% below (infrathreshold), and 20% above (suprathreshold) an individual's pain threshold. Self-reported pain intensity (11-point numeric rating scales), pressure pain threshold, and pain-free grip were assessed by a blinded examiner before, immediately after, and 30 minutes after task performance. Relation analysis between pain ratings and clinical variables, including pain and disability and kinesiophobia was performed. RESULTS: Twenty-four individuals with unilateral lateral epicondylalgia of median 3-month duration participated. Pain intensity during contraction was significantly higher during suprathreshold exercise than infrathreshold exercise (mean difference in numeric rating scale 1.0; 95% confidence interval, 0.4-1.5; P=0.002). Pain intensity during suprathreshold exercise was significantly correlated with pain and disability (R=0.435, P=0.034) and kinesiophobia (R=0.556, P=0.005). Pain intensity was significantly higher immediately after performance of suprathreshold exercise, compared with infrathreshold exercise (P=0.01) and control (P<0.001) conditions, whereas infrathreshold exercise and control conditions were comparable. Thirty minutes later, pain levels remained significantly higher for suprathreshold exercise compared with infrathreshold exercise (P=0.043). Pressure pain threshold and pain-free grip showed no significant effects of time, condition, or time×condition (P>0.05). DISCUSSION: Individuals with lateral epicondylalgia demonstrated increased pain intensity after an acute bout of isometric exercise performed at an intensity above, but not below, their individual pain threshold. Further investigation is needed to determine whether measurement of an individual's exercise induced pain threshold may be important in reducing symptom flares associated with exercise.