Factors influencing musculoskeletal pain among physical therapists

El dolor múscul-esquelètic és comú entre els professionals de la salut, inclosos els fisioterapeutes, a causa de la naturalesa física del seu treball. Estudis previs han explorat els factors que influïxen en el dolor múscul-esquelètic, però degut a que la naturalesa del dolor és complexa, encara hi ha moltes preguntes sobre quins factors influïxen en el dolor entre els fisioterapeutes. Millorar la comprensió del dolor múscul-esquelètic i els factors relacionats amb el treball entre els fisioterapeutes pot ser rellevant per a mantindre una vida laboral saludable. A més, comprendre com el dolor local i en llocs múltiples pot influir en la capacitat laboral dels fisioterapeutes i altres factors modificables, com ara l'activitat física i els nivells d'entrenament de força durant el temps lliure, també podria ajudar a reduir les altes taxes de prevalença de dolor múscul-esquelètic en esta professió. Per tant, els objectius d'este estudi van ser: i) investigar l'associació entre els factors relacionats amb el treball i el dolor en esquena, coll i extremitats superiors entre els fisioterapeutes; ii) analitzar l'associació entre activitat física moderada i vigorosa i dolor en fisioterapeutes; iii) investigar la prevalença del dolor local i en múltiples llocs entre els fisioterapeutes, l'associació entre la intensitat del dolor i els nivells de capacitat de treball, així com la seua associació amb el nombre de llocs de dolor; i iv) analitzar l'associació entre freqüència i intensitat de l'entrenament de força i dolor en esquena, coll- muscle i braç-mà entre els fisioterapeutes. Per mitjà d'un qüestionari online, es van extraure i van analitzar dades de 1006 fisioterapeutes. Els resultats d'aquestos anàlisis van mostrar que diferents factors laborals, com la falta d'experiència professional, el treball en clíniques privades i l'alta càrrega de treball, es van associar a major dolor múscul-esquelètic. Respecte als factors associats a menors nivells de dolor, es va trobar que realitzar >75 minuts d'activitat física vigorosa per setmana estava associat amb menors nivells de dolor de coll i muscle, i realitzar entrenament de força d'alta intensitat (>80% de Repetició Màxima [RM]) durant el temps lliure es va associar fortament amb menor dolor múscul-esquelètic en braç, mà, coll, muscle i esquena. A més, es va trobar una relació dosi-resposta entre el nombre de llocs de dolor i una menor capacitat de treball, especialment quan el dolor es localitza en més d'un lloc simultàniament. En conclusió, aquestos resultats suggerixen que, encara que diversos factors relacionats amb el treball poden augmentar les probabilitats de tindre dolor múscul-esquelètic, altres variables com la quantitat d'activitat física i l'entrenament de força durant el temps lliure podrien contribuir a reduir el dolor múscul-esquelètic entre aquestos professionals. Els resultats de la present investigació podrien contribuir a millorar les condicions de treball d'aquesta professió i proporcionar recomanacions per a promoure una vida laboral saludable, obrint així una via per a futures investigacions

Is device-measured vigorous physical activity associated with health-related outcomes in children and adolescents? A systematic review and meta-analysis

Objective This study sought to analyze the prospective association between vigorous-intensity physical activity (VPA) and health-related outcomes in children and adolescents. Methods Studies reporting associations between device-measured VPA and health-related factors in children and adolescents aged 3–18 years were identified through database searches (MEDLINE, EMBASE, and SPORTDiscus). Correlation coefficients were pooled if outcomes were reported by at least 3 studies, using DerSimonian-Laird random effects models. Results Data from 23 studies including 13,674 participants were pooled using random effects models. Significant associations were found between VPA at baseline and overall adiposity (r = −0.09, 95% confidence interval (95%CI): –0.15 to –0.03; p = 0.002; I2 = 89.8%), cardiometabolic risk score (r = –0.13, 95%CI: –0.24 to –0.02, p = 0.020; I2 = 69.6%), cardiorespiratory fitness (r = 0.25, 95%CI: 0.15−0.35; p < 0.001; I2 = 57.2%), and total body bone mineral density (r = 0.16, 95%CI: 0.06 to 0.25; p = 0.001; I2 = 0%). Conclusion VPA seems to be negatively related to adiposity and cardiometabolic risk score and positively related to cardiorespiratory fitness and total body bone mineral density among children and adolescents at follow-up. Therefore, our findings support the need to strengthen physical activity recommendations regarding VPA due to its health benefits in children and adolescents

Prevalence and predisposing factors for recurrence after hallux valgus surgery: a systematic review and meta-analysis

Recurrence is a frequent and undesirable outcome after hallux valgus (HV) surgery. However, the prevalence of HV recurrence and the pre- and postoperatory factors associated with it have not been adequately studied. This study aimed to quantify the prevalence rate of HV recurrence and to analyze its predisposing factors. MEDLINE and EMBASE databases were systematically searched for observational studies including individuals undergoing HV surgical correction. The random-effects restricted maximum likelihood model was used to estimate the pooled effect size (correlation coefficient (r)). Twenty-three studies were included, yielding a total of 2914 individuals. Pooled prevalence of HV recurrence was 24.86% (95% confidence interval (CI), 19.15 to 30.57, I2 = 91.92%, p = 0.00). Preoperative HV angle (HVA) (r = 0.29; 95% CI, 0.14 to 0.43) and preoperative intermetatarsal angle (IMA) (r = 0.13; 95% CI, 0.00 to 0.27) showed a moderate positive relationship with recurrence. Postoperative HVA (r = 0.57; 95% CI, 0.21 to 0.94) and sesamoid position (r = 0.46; 95% CI, 0.31 to 0.60) showed strong relationships with recurrence. In conclusion, preoperative HVA, IMA, and postoperative HVA and sesamoid position are significant risk factors for HV recurrence, and the association of these factors with recurrence is affected by age

Dose-response Association Between Multi-Site Musculoskeletal Pain and Work Ability in Physical Therapists: A Cross-Sectional Study

Purpose Multi-site musculoskeletal pain (MP) is common among health care professionals and is considered a threat to work ability and thereby a long and healthy working life. However, literature is scarce regarding these associations among physical therapists (PTs). This study aims to quantify the prevalence of local and multi-site MP among PTs, to investigate the associations between pain intensity and number of pain sites, respectively, with the level of work ability. Methods We conducted a survey among 1006 PTs about pain the previous month in different body areas and work ability. Work ability was measured using the Work Ability Index (WAI) including its seven categories. The odds of having lower level of work ability as a function of pain intensity (0–10) and multi-site pain were determined using binary logistic regression controlled for relevant confounders. Results The neck (36.3%) and the low back (32.3%) were the most commonly affected body areas. Furthermore, a dose–response relationship was observed between the number of pain sites and lower work ability (trend test, p  5 in one to two body regions (OR 2.14, 95% CI 1.27–3.60). This association was stronger when participants reported pain in three to four sites (OR 4.02, 95% CI 2.36–6.82) and even stronger when pain was experienced in five or more sites (OR 6.13, 95% CI 3.31–11.38). Conclusions Multi-site MP is strongly associated—in a dose–response fashion—with lower levels of work ability among PTs.Sin financiación3.015 JCR (2020) Q2, 86/203 Public, Environmental & Occupational Health0.797 SJR (2020) Q2, 167/560 Public Health, Environmental and Occupational HealthNo data IDR 2020UE

Effect of a brief progressive Resistance training program in hospital porters on pain,work ability, and physical function

Background: Hospital porters are possibly exposed to the greatest mechanical loads within the hospital environment. However, the evidence about preventive strategies in this population is scarce. Objective: To investigate the effect of a workplace-based progressive resistance-training program on musculoskeletal pain among hospital porters. Method: A total of 37 hospital porters (27 women, 10 men) participated. Participants allocated to the intervention group performed five brief resistance training sessions/week, for 9 weeks during working hours at the hospital. Intensity was progressively increased. Participants allocated to the control group maintained their usual physical activity. The primary outcome was pain assessed with the patient global impression of pain change scale. Secondary outcome measures were average pain intensity, work ability, use of analgesics, and physical function. Additionally, perceived general changes were evaluated at follow-up: wellness, satisfaction at work, desire to exercise, motivation to eat healthy, energy to be with family and friends, and socialization with colleagues. Results: For the primary outcome, the intervention group showed lower general pain (p < 0.0001) and greater wellbeing (p < 0.0001), work satisfaction (p ¼ 0.0048), desire for practicing exercise (p ¼ 0.0007), and energy (p ¼ 0.0474) compared with the control group. Significant between-group interactions were found for work impairment due to diseases (d ¼ -1.2), hips/thighs pain (d ¼ 0.7), ankles/feet pain (d ¼ 0.4), the Biering- Sorensen test (d ¼ -0.6) and the push-ups test (d ¼ -2.3) favoring the intervention group. All between-group differences were clinically important. Conclusion: A progressive resistance training program performed at the workplace is feasible and effective in reducing musculoskeletal pain and improving work ability and physical function among hospital porters

Cardiorespiratory fitness measured with cardiopulmonary exercise testing and mortality in patients with cardiovascular disease: a systematic review and meta-analysis

Background Cardiorespiratory fitness (CRF) is inversely associated with mortality in apparently healthy subjects and in some clinical populations, but evidence for the association between CRF and all-cause and/or cardiovascular disease (CVD) mortality in patients with established CVD is lacking. This study aimed to quantify this association. Methods We searched for prospective cohort studies that measured CRF with cardiopulmonary exercise testing in patients with CVD and that examined all-cause and CVD mortality with at least 6 months of follow-up. Pooled hazard ratios (HRs) were calculated using random-effect inverse-variance analyses. Results Data were obtained from 21 studies and included 159,352 patients diagnosed with CVD (38.1% female). Pooled HRs for all-cause and CVD mortality comparing the highest vs. lowest category of CRF were 0.42 (95% confidence interval (95%CI): 0.28–0.61) and 0.27 (95%CI: 0.16–0.48), respectively. Pooled HRs per 1 metabolic equivalent (1-MET) increment were significant for all-cause mortality (HR = 0.81; 95%CI: 0.74–0.88) but not for CVD mortality (HR = 0.75; 95%CI: 0.48–1.18). Coronary artery disease patients with high CRF had a lower risk of all-cause mortality (HR = 0.32; 95%CI: 0.26–0.41) than did their unfit counterparts. Each 1-MET increase was associated with lower all-cause mortality risk among coronary artery disease patients (HR = 0.83; 95%CI: 0.76–0.91) but not lower among those with heart failure (HR = 0.69; 95%CI: 0.36–1.32). Conclusion A better CRF was associated with lower risk of all-cause mortality and CVD. This study supports the use of CRF as a powerful predictor of mortality in this population

Professional experience, work setting, work posture and workload influence the risk for musculoskeletal pain among physical therapists: a cross-sectional study

Purpose Physical therapists (PTs) have a high risk of developing musculoskeletal pain (MP) due to the physically demanding nature of their work tasks. Experience or the specialty area, have been associated with MP, however, previous studies are few and small. The aim of this study was to investigate the association between work-related factors and MP among PTs. Methods In this cross-sectional study, we collected information about MP and work-related factors of 1006 PTs using an online questionnaire. Associations between various work-related factors and MP were modelled using logistic regression controlled for various confounders. Results Neck (57%) and low back pain (49%) were most common. Work-related factors associated with higher risk for having moderate-to-high MP (≥ 3 on a scale of 0-10) were 'treating more patients at the same time' [OR 2.14 (95% CI 1.53-2.99)], 'working ≥45 h per week' [OR 1.73 (95% CI 1.05-2.84)], and 'work in a seated position' [OR 2.04 (95% CI 1.16-3.57)] for the low back. 'More years of experience' showed a negative association for elbow pain [OR 0.41 (95% CI 0.21-0.78)] and low back pain [OR 0.48 (95% CI 0.29-0.79)] compared with their less experienced counterparts. Conclusions The lack of professional experience, working in private clinics, working in a seated position and high workload are associated with the higher risk for MP among PTs. These results add further insight about the relevance of such factors, which might be considered for developing effective interventions to prevent work-related MP and better working conditions among PTs

Cross Sectional Area of the Supraspinatus Muscle and Acromio-humeral Distance in Overhead Athletes With and Without Shoulder Pain: A Cross-sectional Study

Context: The supraspinatus muscle has an important role in the stabilization of the glenohumeral joint. Identifying abnormalities concerning its size and the subacromial space in the presence of pain may be relevant to provide more specific treatments focused on the etiology of pain. Objective: To determinate whether painful shoulder causes changes in the supraspinatus cross-sectional area (CSA) and the acromio-humeral distance (AHD) between overhead athletes. Design: Cross-sectional study. Setting: University campus and local sports clubs' Physical Therapist room. Participants: 81 male overhead athletes were divided into 2 groups according to the presence of shoulder pain and clinical symptoms. Main Outcome Measures: Ultrasonography measurements of the supraspinatus CSA and the AHD in 2 groups of overhead athletes with and without pain. Results: In the pain group, the CSA was significantly smaller compared with the no pain group. No differences between groups were found in the AHD measurement. Conclusions: Shoulder pain in overhead athletes was associated with a reduction in their supraspinatus muscle CSA, but not in the AHD. These findings suggest that muscle atrophy exists in the presence of pain. However, in active overhead athletes, the AHD is not clearly reduced in overhead athletes with shoulder pain. Further studies are needed to understand this condition.Sin financiación1.811 JCR (2017) Q2, 28/65 Rehabilitation0.769 SJR (2017) Q1, 29/125 RehabilitationNo data IDR 2017UE

Muscular fitness and work ability among Physical therapists

The Work Ability Index (WAI) is a validated and widely used tool in occupational research. However, normative values for physical therapists (PTs) by age and sex are lacking. Although the nature of PTs' work is physically demanding, it is unknown whether muscular fitness is associated with their WAI. This study sought to provide reference WAI data for Spanish PTs and to evaluate the association between PTs' muscular fitness and WAI. Data on WAI of 1005 PTs were collected using a questionnaire. A subgroup (n = 68) performed a battery of physical tests including grip strength, push-ups and back-extension endurance. Associations between muscular fitness and WAI were evaluated using logistic regression controlling for various confounders. PTs aged 50 years or older had lower WAI scores than their younger counterparts. PTs with high back-extension endurance scored 3.5 (95% CI) higher in the WAI than those with low endurance. No associations were found between grip strength or number of push-ups and WAI. Our findings seem to highlight the importance of muscular fitness in PTs, especially the back-extension endurance

Cross Sectional Area of the Supraspinatus Muscle and Acromio-humeral Distance in Overhead Athletes with and Without Shoulder Pain: A Cross-sectional Study

Context: The supraspinatus muscle has an important role in the stabilization of the glenohumeral joint. Identifying abnormalities concerning its size and the subacromial space in the presence of pain may be relevant to provide more specific treatments focused on the etiology of pain. Objective: to determinate whether painful shoulder causes changes in the supraspinatus cross-sectional area (CSA) and the acromio-humeral distance (AHD) between overhead athletes. Design: Cross-sectional study. Setting: University campus and local sports clubs' Physical Therapist room. Participants: Eighty-one male overhead athletes were divided into two groups, according to the presence of shoulder pain and clinical symptoms. Main Outcome Measures: Ultrasonography measurements of the supraspinatus CSA and the AHD in two groups of overhead athletes with and without pain. Results: In the pain group, the CSA was significantly smaller compared with the no pain group. No differences between groups were found in the AHD measurement. Conclusions: Shoulder pain in overhead athletes was associated with a reduction in their supraspinatus muscle CSA, but not in the AHD. These findings suggest that muscle atrophy exists in the presence of pain. However, in active overhead athletes, the AHD is not clearly reduced in overhead athletes with shoulder pain. Further studies are needed to understand this condition