Incidence of tennis elbow and association of hand grip strength among college students

Background: Lateral epicondylitis is an overuse injury involving the origin of common extensor tendon at elbow joint. Among the college students there is more complaint on wrist and elbow. Objective was to find out the incidence of tennis elbow & grip strength among the students during the entire academic year.Methods: Three hundred and seventy subjects fulfilled the inclusion criteria with age respondents between seventeen to twenty four years. This study is done in those students who have local tenderness on palpation over the lateral epicondyle (grade 2). NPRS was used for measuring the pain intensity. Mill’s test and Cozen’s test was performed to confirm the tennis elbow. The subject is asked to squeeze the dynamometer three times with left and right hand respectively. There was one minute resting period between each squeeze were taken into account.Results: The incidence of confirmed tennis elbow was 4.05% & 2.70% in right and left respectively. Among those participants Mill’s test was positive in 16.2% on right and left side and Cozen’s test was positive in 8.1% on right side and 5.4% on left side. The mean rank of left and right grip strength for the students who are confirmed as tennis elbow were 52.75 Kg and 50.67 Kg and for not-confirmed were 36.56 Kg and 36.41 Kg respectively.Conclusions: The study concluded that 6.7% incidence rate of tennis elbow was observed in college students during the entire academic year. And also concluded there is no much significance correlation between grip strength and tennis elbow incidence rate

Development of an assessment method for work-related musculoskeletal loads in the elbow region based on a systematic literature review and measurement-based occupational-scientific analyses

Titel: Entwicklung eines Bewertungsverfahrens für arbeitsbedingte muskuloskelettale Belastungen in der Region des Ellenbogens auf Basis einer systematischen Literaturrecherche und messtechnischer arbeitswissenschaftlicher Analysen Arbeitsbedingte Muskel-Skelett-Erkrankungen und Beschwerden am Ellenbogen treten jährlich und vergleichsweise häufig bei Arbeitnehmenden auf. In der Folge kann es bei Beschäftigten z. B. zu Arbeitsausfällen und bei Firmen zu Bruttowertschöpfungsverlusten oder anderen hohen Kosten kommen. Um Arbeitnehmende vor Überlastungen zu schützen, sind evidenzbasierte, transparente und objektive Gefährdungsbeurteilungen von physischen Belastungen z. B. im Ellenbogenbereich sehr wichtig. Ziel dieser Arbeit war daher die Entwicklung eines objektiven, evidenz- und messdatenbasierten Bewertungsverfahrens für den Ellenbogenbereich, basierend auf den Erkenntnissen einer systematischen Literaturrecherche und arbeitswissenschaftlichen Untersuchungen im Feld. Darüber hinaus wird dieses neue Verfahren exemplarisch in Ergänzung zu anderen Methoden der betrieblichen Praxis vorgestellt. Um in Zukunft objektive Beurteilungen zu etablieren, war es notwendig, drei Forschungsthemen zu untersuchen. Erstens, wurde zuerst eine systematische Übersicht über quantitative Informationen benötigt, da bisherige systematische Übersichtsarbeiten meist qualitative oder semiquantitative Risikofaktoren im Ellenbogen beschrieben haben. In Anlehnung an die PRISMA-Richtlinie wurden die Datenbanken MEDLINE, EMBASE und Cochrane Work von 2007 bis 2017 durchsucht. Von insgesamt 524 Artikeln wurden 10 relevante Artikel identifiziert. Diese wurden hinsichtlich der methodischen Qualität und der Art der Erfassung von Expositionen und Outcomes bewertet. Die Untersuchung der Studien identifizierte 5 Hauptexpositionskategorien (Kraft, Repetition, Haltung/Bewegung, Vibration, kombinierte Expositionen) und 16 Unterkategorien. Die Evidenz der Unterkategorien wurde mit Hilfe der GRADE-Methode geschätzt und reichte von sehr niedrig bis hoch. Insgesamt wurden 133 quantitative Risikofaktorspezifikationen identifiziert, die mit lateraler/medialer Epikondylitis, ulnarer Neuropathie, Radial Tunnel Syndrom oder Pronator teres Syndrom assoziiert wurden. Zweitens wurde in weiteren Untersuchungen die Kombination aus Kraft und Repetition als wichtigste Unterkategorie für Expositionen identifiziert. Außerdem wurden Handgelenksflexion/-extension und Unterarm Supination/Pronation als die wichtigsten Freiheitsgrade ermittelt. Weiterhin wurden drei kinematische Parameter (Mittenfrequenz, Winkelgeschwindigkeit, kinematische Mikropausen) und ein kinetischer Parameter (Elektromyographie) als wichtige Grundlage für die Entwicklung eines Bewertungsverfahrens herausgearbeitet. Diese kinematischen Parameter wurden unter Berücksichtigung der verbal verankerten Latko-Skala in einem Repetitionsscore verrechnet und mit normalisierten Kraftspitzen zusammengeführt. Dabei wurde das mTLV for HAL-Verfahren entwickelt. Dieses kann die kombinierten Belastungen aus Kraft und Repetition im Bereich des Handgelenks und Ellenbogens abschätzen. In einer Pilotstudie konnte gezeigt werden, dass der Repetitionsscore nicht von der konventionellen HAL-Bewertung zu unterscheiden ist. Darüber hinaus ergaben Zusammenhangsanalysen auf Basis von GEE-Modellen, dass der mTLV for HAL mit Karpaltunnelsyndrom, Arthrose der distalen Gelenke, lateraler Epikondylitis und Beschwerden in den Hand- und Ellenbogengelenken/ -regionen teilweise signifikant assoziiert werden kann. Die Validierung und Analyse von 500 Datensätzen zu einzelnen Probanden zeigte, dass der mTLV for HAL sehr gut in der Praxis eingesetzt werden kann. Darüber hinaus ist diese Methode eine sehr gute Arbeitszyklus-unabhängige Ergänzung zu bisherigen beobachtungs- und videobasierten TLV for HAL-Bewertungsansätzen. Drittens ist es für Fachkräfte für Arbeitssicherheit oder Arbeitsschutzbeauftrage manchmal schwierig, die geeignete Sensorik in Verbindung mit der geeigneten Beurteilungsmethode für die jeweilige Gefährdungsbeurteilungssituation auszuwählen. Daher wurde insbesondere eine Kategorisierung von messdatenbasierten Bewertungsmethoden für den Bereich der oberen Extremitäten benötigt. Zu diesem Zweck wurde eine international anerkannte 3-stufige Kategorisierung auf diesen Bereich übertragen. Damit konnten sowohl Sensortechnologien als auch messdatenbasierte Methoden den Fachkräften für Arbeitssicherheit oder Arbeitsschutzbeauftragen vorgestellt werden. Der mTLV for HAL-Bewertungsansatz wurde ebenfalls klassifiziert und anderen ausgewählten Methoden dabei gegenübergestellt. Die vorliegende Arbeit soll Fachleute aus der Wissenschaft, Medizin und des Arbeitsschutzes dazu anregen, evidenzbasierte quantitative Informationen zu verarbeiten und Expositionen zu messen. Auch die Anwendung von messtechnischen Beurteilungsmethoden wird empfohlen, insbesondere für den Bereich des Ellenbogens. Damit bietet diese Arbeit eine gute Grundlage für Maßnahmen der Primär-, Sekundär- und Tertiärprävention.Work-related musculoskeletal disorders and elbow complaints occur annually and relatively frequently among employees. Consequently, employees may be absent from work and companies may suffer from loss of gross value added or have other high costs. To protect employees from overload, evidence-based, transparent, and objective risk assessments of physical workload, e.g., in the elbow region, are very important. The aim of this work was therefore to develop an objective, evidence- and measurement-based assessment approach for the elbow region, based on the findings of a systematic literature review and occupational scientific investigations in the field. Furthermore, this new approach is presented as an example in addition to other methods to usage in the working environment. To establish objective assessments in the future, it was necessary to investigate three research topics. First, a systematic review of quantitative information was required because previous systematic reviews have mostly described qualitative or semiquantitative risk factors in the elbow. Following the PRISMA guideline, the MEDLINE, EMBASE, and Cochrane Work databases were screened from 2007 to 2017. From a total of 524 articles, 10 relevant articles were identified. These were assessed for methodological quality and the way exposures and outcomes were recorded. The review of studies identified 5 main exposure categories (Force, Repetition, Posture/movement, Vibration, Combined exposures) and 16 subcategories. Evidence of subcategories were estimated using the GRADE method and ranged from very low to high. A total of 133 quantitative risk factor specifications were identified that were associated with lateral/medial epicondylitis, radial tunnel syndrome, pronator teres syndrome or ulnar neuropathy. Second, further research identified the combination of force and repetition as the most important subcategory related to elbow exposures. In addition, wrist flexion/extension and forearm supination/pronation were identified as the most important degrees of freedom. Furthermore, three kinematic parameters (mean power frequency, angular velocity, kinematic micro-pauses) and one kinetic parameter (electromyography) were extracted as an important basis for the development of an assessment approach. These kinematic parameters were computed into the repetition score, considering the verbally anchored Latko-scale, and were merged with normalized peak force. In this process, the mTLV for HAL method was developed. It can estimate combined loads (force and repetition) in the wrist and elbow region. A pilot study demonstrated that the repetition score was indistinguishable from conventional HAL assessment. In addition, association analyses based on GEE models revealed that the mTLV for HAL can partially be significantly associated with carpal tunnel syndrome, arthrosis of the distal joints, lateral epicondylitis, and complaints in the hand and elbow joints/regions. The validation and analysis of 500 data sets of individual subjects showed that the mTLV for HAL can be used very well in practice. Furthermore, this method is a very good duty cycle independent supplement to previous observational- and video-based TLV for HAL assessment approaches. Third, it is sometimes difficult for occupational safety specialists or occupational safety and health officers to select the appropriate sensor technology in combination with the appropriate assessment method for the respective risk assessment situation. Therefore, a categorization of measurement-based assessment methods for the upper extremity region was particularly required. For this purpose, an internationally accepted 3-level categorization was applied to this area. This allowed both – sensor technologies and measurement-based methods – to be presented to occupational safety specialists or occupational safety and health officers. The mTLV for HAL assessment approach was also classified and contrasted with other selected methods. This work is intended to encourage scientific, medical, and occupational safety and health professionals to process evidence-based quantitative information and measure exposures. The use of measurement-based assessment methods is also recommended, especially for the elbow region. Thus, this work provides a good basis for primary, secondary, and tertiary prevention measures

Work Related Musculoskeletal Pain and It’s Management

This is an ongoing project, your comments are welcome! [email protected] chapter reviews current best evidence in the identification and management of work related factors causing musculoskeletal pain and discomfort

Using the Strain Index and TLV for HAL to Predict Incidence of Aggregate Distal Upper Extremity Disorders in a Prospective Cohort

Work-related distal upper extremity (DUE) musculoskeletal disorders (MSDs) are very prevalent and costly in the United States. It is important to recognize working conditions that lead to these disorders, in order to lessen the impact that they have on workers and their employers. Identifying jobs that are likely to cause DUE MSDs is difficult because there are many factors that are believed to contribute to DUE MSD development. The current study aims to determine if the Strain Index (SI) and the ACGIH TLV for HAL (two DUE job physical exposure assessment methods) predict increased risk of workers developing aggregate DUE MSDs. For this study, aggregate disorders include: (i) carpal tunnel syndrome, (ii) lateral epicondylitis, (iii) medial epicondylitis, (iv) tendonitis of wrist flexors and extensors, (v) de Quervain\u27s disease, and (vi) trigger finger. Subjects for this study were drawn from a recently completed large-scale prospective cohort study consisting of 1,205 volunteer workers from 21manufacturing companies located in IL, UT, and WI. Of the 1,205 workers, only those workers who had no previous history of an aggregate disorder at study onset will be considered. Workers were followed monthly to determine if new DUE MSD symptoms developed. Specific case definitions are used to identify when a worker develops one or more aggregate DUE MSD. Physical exposures from workers\u27 jobs were individually measured and videos were recorded at baseline. Jobs were investigated quarterly to determine physical exposure changes and re-analyzed as necessary. Time to first aggregate DUE MSD was modeled using proportional hazards regression to determine if there is a relationship between SI and TLV for HAL scores and increased risk of developing DUE MSDs while controlling for relevant covariates (age, gender, BMI). Univariate analyses, showed a strong relationship between age (HR = 1.03, p = 0.001) and gender (HR = 2.38, p = 0.002) and the development of aggregate DUE MSDs. There was suggestive evidence that the SI, with a cut point of 6.1 (p = 0.13), predicts increased risk of first lifetime aggregate DUE MSD. No significance was noted for the TLV for HAL. Efforts per minute showed a slightly significant association using a spline placed at 37.3 (p = 0.03). Multivariate analyses found suggestive evidence for an association between efforts per minute when analyzing using a spline placed at 37.3 efforts per minute (p = 0.08). No effect was found with the SI or TLV for HAL. Age and gender appear to be significantly associated with the development of first lifetime DUE MSD. The SI appears to be a more reliable method to use to determine jobs that place workers at increased risk of developing first lifetime aggregate DUE MSD, when comparing it to the TLV for HAL

An exploration of the social factors that may have contributed in the UK to perceptions of work-relevant upper limb disorders in keyboard users

The outputs that form the basis of this PhD submission include a web site that summarises a unique collection of over 200 Court Judgments in personal injury claims for work-related upper limb disorders heard in the UK, together with a number of more conventional publications. Individually, these outputs all address upper limb disorders associated with work although they each had slightly different objectives and the audiences for which they were produced significantly influenced the type of publication in which they appeared. Together, they help illustrate when, how and, to some extent, why upper limb disorders associated with keyboard use became the issue it did in the UK in the late 1980s and 1990s. While many might now regard keyboard or computer use as an innocuous task, in the late 1980s and 1990s upper limb disorders associated with keyboard use, particularly computer use, became the subject of litigation, legislation, industrial disputes and widespread publicity. The outputs on which this submission is based, together, suggest that following the importation of the concept of repetitive strain injuries (RSI) from Australia in the later 1980s, the activities of trades unions and journalists in the UK promoted work-relevant upper limb symptoms and disorders associated with keyboard use as work-induced injuries. Subsequently, a small number of successful, union-backed, personal injury claims, which involved contentious medical evidence and perhaps an element of iatrogenesis, were widely promoted as proof that computer use causes injury. Around the same time, the government chose to implement flawed Regulations relating to the design and use of computer workstations, which failed to distinguish between that which might give rise to discomfort, fatigue and frustration and that which might give rise to injury. The existence of these Regulations, which among other things require regular, individual risk assessments of computer users, unlike any other type of work, could be interpreted as further 'proof' that computer use causes injury. The approach to the prevention and management of musculoskeletal disorders advocated in current HSE guidance, including the risk assessment strategy, remain capable of generating distorted perceptions of the risks arising from keyboard and computer use

Work-related upper limb disorder:- An investigative study

The primary aim of occupational health staff within a manufacturing company is to ensure the health and well being of the employees are safeguarded. The aim may be difficult to achieve as it goes directly against the ethos of business, i.e. making money. It is the researcher's experience that company owners, especially Far Eastern owners, are disinclined to introduce health and safety measures that cost money. The study is conducted in an electronic company (Company X) in the northeast of England, owned by foreign nationals. Retrospective examination of accident, sickness and absenteeism records reveal that work-related upper limb disorder (WRULD) is apparent and upper limb discomfort is a significant problem in Соmpany X. Research shows that the principle of job rotation tends to reduce fatigue and the incidence of WRULD, consequently sickness and absenteeism and labour turnover will also be reduced. In Company X physiological stress to the limb is highly relevant to the production line workers, based on case studies of employees with work-related upper limb disorder. This led to conducting a study of two sites building different electrical equipment. 80 employees participated in the study which involved monitoring the employees on six paced production lines in the Personal Computer Monitor factory PCM which included seven teams and employees in five teams on four production lines in the Microwave Oven Factory. A semi paced line, the Bent Tool Machine BTM in MWO were also involved in the job rotation experiment. Discomfort scale measurements were administered to all that took part and an extra objective measurement of grip strength was provided by the employees in the BTM to provide information on fatigue. A comparison between grip strength and discomfort was analysed for any con-elation. The main data collection took place between September and December 2000.There is some evidence that the differences in discomfort is caused by job rotation as where job rotation was taking place the employees in the study had lower levels of discomfort than those on non- rotational duties. In the CDT prep job PCM where job rotation was taking place a comparison between job rotation and the non-rotation group with regard to discomfort in body parts differed (Fisher's exact test, p=0.05).The job action analysis that was designed specifically for the production line environment allowed comparisons of upper limb score for different jobs. It would appear that regular job analysis should be introduced as a matter of practice in Company X in the future. The study demonstrated the importance of prevention and innovation ergonomics and there was evidence to suggest that the occupational health department should adopt an active role in the future for the benefit of the employees and the financial survival of the Company

Short Term Treatment Effectiveness And Long Term Prognosis In Patients With Lateral Epicondylosis/Tennis Elbow

This thesis investigated the short term and long term outcomes of patients who underwent treatment for lateral epicondylosis (LE). The first manuscript compared the immediate effects of counterforce brace versus kinesiotaping on pain free grip during a repetitive upper extremity reaching task in thirty patients (n=30) with LE. The study found kinesiotape to be superior over bracing as it not only improved immediate pain free grip strength by 17.5% but also maintained this during activity as compared to brace which had a smaller improvement of 9.3%. The second manuscript determined the extent of work disability/limitations experienced by patients (n=32) following lateral arthroscopic release and how it is influenced by demographic, occupational and worker’s compensation status. Patients in this cohort reported substantial work limitations when compared to other chronic conditions. Force and repetition of work tasks were identified as the most significant predictors of work disability

What Treatment and Prevention Options are the Most Effective for Elbow, Knee, and Plantar Tendinopathies?

Objective: Tendinopathies of the upper and lower extremity are one of the most common injuries in athletes and non-athletes in the United States. This literature review aimed to determine the most effective preventions and treatments for patients with tendinopathies. Methods: A literature search was conducted primarily through Google Scholar and PubMed, for articles related to effective preventions and treatments for tendinopathies. Discussion: Based on the literature review, there were multiple effective treatments and preventative measures for tendinopathies in the upper and lower extremity. The most effective preventative measures consisted of risk factors, dynamic warmups, and prevention programs. Treatments were broken down into three categories: elbow, patella, and plantar tendinopathies. The diamond tape job and counterforce brace improved symptoms in patients with elbow tendinopathies, and improved function throughout the body. Corticosteroids improved symptoms short term in the UE and LE, while PRP improved symptoms and promoted long term tissue healing. Physical therapy (eccentric exercises) appeared to show abundant benefit on tendinopathies regardless of the location. Conclusion: For tendinopathies that fail conservative treatments, preventative measures can help avert tendinopathies. Corticosteroids, PRP, and physical therapy can be used for treatment. Specific prevention programs can inhibit elbow tendinopathies and improve function throughout the whole body, while a reduction in risk factors could prevent elbow, patella, and plantar tendinopathies. Regarding the elbow and plantar fascia, the best long-term results were PRP or physical therapy (eccentric exercises). For the knee, eccentric exercises were the most effective treatment, while PRP had mixed results. Despite an increase in research on these topics, more RCT’s are needed in upper/lower tendinopathies, and standard protocols for PRP

A study of the viscosities and densities of some binary and ternary regular liquid mixtures at different temperature levels.

The viscosities and densities of ten binary subsystems of the quinary system: heptane, octane, cyclohexane, toluene, and ethylbenzene were measured and reported over the entire composition range at 293.15, 298.15, 308.15, and 313.15 K. In addition, the viscosities and densities of the binary and ternary subsystems of the quinary system: hexane, octane, cyclohexane, toluene, and ethylbenzene were measured and reported at 293.15 and 298.15 K. The experimental data obtained during the course of the study were employed to test the predictive capabilities of five viscosity models available in the literature; viz., the generalized McAllister model, the pseudo-binary McAllister model, The group contribution GC-UNIMOD model, the generalized corresponding state principle model (GCSP), and the Allan and Teja correlation. These models were selected since they are widely used in the literature. The results of testing indicated that the generalized McAllister model predicted the experimental data much better than the other models.Dept. of Environmental Engineering. Paper copy at Leddy Library: Theses & Major Papers - Basement, West Bldg. / Call Number: Thesis2005 .A44. Source: Masters Abstracts International, Volume: 45-01, page: 0379. Thesis (M.A.Sc.)--University of Windsor (Canada), 2006