Muscle Activity Comparisons In Dental Hygiene Students When Using Different Fulcrums While Scaling

The high incidence rate of cumulative trauma disorders in dental hygienists attests to the musculoskeletal problems experienced by dental hygienists. Research is ongoing to investigate ergonomic practices that will minimize muscle trauma when providing scaling and root debridement. The purpose of this study was to determine differences in the activity of four forearm muscles, (extensor carpi radialis longus, flexor carpi ulnaris, biceps brachii and pronator teres) when using five different finger fulcrums while scaling in dental hygiene students. A convenience sample of 29 consenting senior dental hygiene students participated in the study. Using a 4 x 5 counterbalanced research design, participants used a Gracey 11/12 curet to scale artificial calculus from each permanent first molar tooth on a typodont. While scaling, each participant had sEMG sensors attached to each muscle under investigation to measure muscle activity via electromyography. Participants scaled using one of 5 finger fulcrums (opposite arch, standard intra-oral, basic extra-oral, cross arch and finger on finger) on 5 different typodonts resulting in a total of 20 sEMG readings per participant. The highest amount of muscle activity was observed in the pronator teres (X=28.73) and the least in the biceps brachii (X=13.39). Data analysis with two-way ANOVA revealed a statistically significant difference only in the activity of the biceps brachii muscle when a change in fulcrum occurred. (p=0.0002). Using an average of all four muscles ANOVA revealed no statistically significant differences when comparing scaling with different fulcrums and the amount of muscle activity generated (p=0.0776) In this clinical study that measured the activity of four forearm muscles when scaling, only the biceps brachii was affected by a change in fulcrumming technique. Results suggest that similar muscle activity is produced when scaling regardless of the muscles measured and the type of fulcrum used. More research is needed to clarify the role of fulcrums and individual muscle activity in the ergonomic practice of dental hygiene. [ABSTRACT FROM AUTHOR

Dental Hygienists\u27 Perspectives on Four Periodontal Instrument Handle Designs

Problem: Developing new instrument designs to address the ergonomics of instrumentation and to decrease repetitive strain injuries in the dental hygienist is an ongoing area of development. Changing the weight and diameter of instrument handles has been suggested to reduce risk for trauma in the practitioner but minimal research has been conducted to determine design preferences of practicing dental hygienists. Objective: The purpose of this study was to assess dental hygienists opinions on the weight, diameter, balance and maneuverability of four different instrument handles. Methodology: After IRB approval, a convenience sample of 27 practicing dental hygienists from Virginia participated in the study. Four typodonts were set up for each participant with a different instrument randomly assigned for use on each. Subjects scaled first molars coated with artificial calculus using a Columbia 13/14 curet with four commercially available handle designs that varied in weight and diameter: A) 16 grams and 12.7 mm diameter; B) 23 grams and 11.1 mm diameter; C) 21 grams and 7.9 mm diameter and D) 18 grams, and 6.35 mm diameter. Following scaling participants used a 6 item survey to rate their comfort level on a 5-point scale ranging from 1 (very comfortable) to 5 (uncomfortable) with regard to balance, weight, diameter, maneuverability and overall preference. A Friedman test determined significant differences between participants\u27 perceptions. A Wilcoxan signed rank test followed if differences were found. Results: Handle designs had significant effects on dental hygienists\u27 instrument preferences while performing simulated scaling. Results revealed significant differences for participants\u27 preferences concerning diameter (x2(3)=50.584, p=0.000), weight (x2(3)=24.650, p=0.000), balance (x2(3)=69.504, p=0.000) and maneuverability (x2(3)=67.728, p=0.000). When comparing comfort based on diameter grip, results reveal instrument D was least comfortable compared to A, B and C (p=0.000, p=0.000, p=0.000). Instrument A was most comfortable in weight when compared to all other instruments (p=0.008, p=0.000, p=0.000). In regards to balance significant differences were found between instrument A when compared to both C and D (p=0.000, p=0.000), with instrument A having the highest mean score (x=4.7). Finally, instrument A was rated most comfortable for maneuverability (p=0.003, p=0.000, p=0.000). Sixty-three percent of participants preferred instrument A, 26% instrument B, 11% instrument C and none preferred D. Conclusion: When performing simulated scaling, results indicate most participants preferred using a lighter weight, larger diameter instrument handle. Diameter affected preference more than weight. The smallest diameter handle was always ranked the lowest with regards to balance, weight, diameter and maneuverability although it was not the heaviest

Effects of 5 Different Finger Rest Positions on Arm Muscle Activity During Scaling by Dental Hygiene Students

Purpose. This study was conducted to determine the effects of 5 different finger rest positions: opposite arch, standard intraoral, basic extraoral, cross arch, and finger on finger on the muscle activity of 4 forearm muscles (extensor carpi radialis longus, flexor carpi ulnaris, biceps brachii, and pronator teres) during a simulated periodontal scaling experience. Methods. A convenience sample of 32 consenting senior dental hygiene students who met inclusion criteria participated. Using a 4 x 5 counter-balanced research design, each participant used a Gracey 11/12 curet to scale one cc of artificial calculus from first permanent molar typodont teeth (#3,14,19,30). Five different typodonts were set up for each participant with fulcrums randomly assigned for use on each typodont. While scaling, the participant’s muscle activity was measured by surface electromyography. Two-way analysis of variance with repeated measures was used to determine if significant differences existed in the amount of muscle activity generated with each fulcrum. Results. Results revealed no statistically significant interaction effect between area of the mouth scaled, muscle activity, and fulcrum used. Similar muscle activity was produced throughout the mouth regardless of the fulcrum used. The upper right quadrant produced the most muscle activity (p= 0.0101) and the lower left quadrant produced the least (p=\u3c .0001). When comparing the overall muscle activity generated with each fulcrum, only the cross arch fulcrum when compared to the opposite fulcrum produced statistically significant results (p=0.0110). Conclusions. Based on the results, similar muscle activity is produced when using any of the 5 fulcrums in each quadrant of the mouth. Clinicians appear to experience minimal ergonomic advantage in terms of fulcrums used and area of the mouth scaled during a simulated scaling experience

Effects of Instrument Handle Design on Dental Hygienists\u27 Forearm Muscle Activity During Scaling

Purpose: The purpose of this study was to determine the effects of 4 different commercially available instrument handle designs (A. 16 grams and 12.7 mm diameter, B. 23 grams and 11.1 mm diameter, C. 21 grams and 7.9 mm diameter and D. 18 grams and 6.35 mm diameter) on the muscle activity of four forearm muscles during a simulated scaling experience. Methods: A convenience sample of 27 (n=27) dental hygienists used a Columbia 13/14 curet with four different instrument handles to scale artificial calculus from typodont teeth. Each participant\u27s muscle activity was measured using surface electromyography (sEMG). Results: Similar muscle activity was generated when scaling with instruments at 16, 18, and 21 grams with varying diameter handles. Instrument B generated significantly more muscle activity when compared to each of the other instrument handle designs (p=0.001, p=0.002, p=0.039). The lower left quadrant displayed significantly less muscle activity during scaling than the upper and lower right quadrants (p=0.026, p=0.000), although no significant interaction effect was found with instruments within quadrants. Most participants (62.96%) preferred instrument A, which was rated more comfortable based on weight when compared to the other instruments tested. Conclusions: Instrument handle design has an effect on forearm muscle activity when scaling in a simulated environment. The heaviest instrument with a relatively large diameter (B 11.1 mm and 23 g) generated significantly more overall mean muscle activity compared to the other three instruments. Similar amounts of muscle activity were produced by instruments weighing between 16 and 21 g. Participants\u27 instrument preferences were more affected by handle diameter than weight. Results support the need for further research to determine the impact of these findings on muscle load related to risk of musculoskeletal disorders in a real-world setting

Special Publication No. 1, Checklist Of The Internal And External Parasites of Deer, Odocoileus Hemionus And O. Virginianus, In The United States And Canada

United States Department of Agriculture, Bureau of Animal Industr

Nurses\u27 Alumnae Association Bulletin - Volume 6 Number 9

Remember the Relief Fund Welcome! Miss Childs Financial Report Calendar of Coming Events Lest You Forget! Attention Review of the Alumnae Association Meetings Institutional Staff Nurses\u27 Section Report of Staff Activities - 1947-1948 Private Duty Section The White Haven Division Barton Memorial Division Remember the Relief Fund Student Nurses\u27 Activities Jefferson Scores Again The Clara Melville Scholarship Fund Interesting Activities of the Nurses\u27 Home Committee of the Women\u27s Board Exclusive for Nurses Changes in the Maternity Division Gray Lady Musical Therapy Service Memorial Service Honoring Mrs. Bessie Dobson Altemus The Blood Donor Center The Hospital Pharmacy Medical College News Remember the Relief Fund Administrative Staff and Faculty of the School of Nursing Streptomycin Changes in the Staff at Jefferson Hospital Care of the Thoracic Surgical Patient Miscellaneous Items Marriages New Arrivals Deaths The Bulletin Committee Attention, Alumnae New Addresse

Nurses\u27 Alumnae Association Bulletin - Volume 6 Number 10

Financial Report Calendar of Events Attention, Class of 1945! Miss Shafer Retires Review of the Alumnae Association Meetings Institutional Staff Nurses\u27 Section Report of Staff Activites - 1948-1949 The Staff Stockings! Stockings! Stockings! Pop-Up Toaster It\u27s Not Too Soon Any White Elephants? Private Duty Section The Jefferson Hospital Private Duty Nurses\u27 Register Report for Barton Memorial Hospital Progress of the Orthopedic Department Just Under the Date Line Pediatrics at Jefferson Controlled Respiration in Anesthesia Anesthesia Progress Physical Advances at Jefferson During the Past Year The White Haven Division The Clara Melville Scholarship Fund The Relief Fund The Busy Year for the Nurses\u27 Home Committee of the Women\u27s Board The Gray Ladies Memories Lost Miscellaneous Items Medical College News Marriages Births Deaths Condolences Prizes District No. 1 Dues Help! Help! Help! Jap Prison School Spurs Nurse to Win University Degree Twenty Ways to Kill an Organization The Bulletin Committee Attention, Alumnae New Addresse

Health Professions Students\u27 Attitudes Toward Teamwork Before and After an Interprofessional Education Co-Curricular Experience

Background: Effective interprofessional collaboration may positively impact clinical outcomes, patient satisfaction, and cost effectiveness. However, educational silos and discipline-specific socialization have reinforced each health profession’s independent values, attitudes, and problem-solving approaches. Methods and Findings: Students’ (N = 376) attitudes about teamwork were measured with the Interprofessional Attitudes Scale, Teamwork, Roles, and Responsibilities subscale using a pretest-posttest design. Experiential learning strategies and a case study approach were used to introduce students to the roles and responsibilities of the students’ disciplines. There was a positive mean difference in pretest-posttest measures (p \u3c .001) with a moderate effect size (r = .27). Conclusions: Providing opportunities for pre-licensure health sciences students to understand the roles and responsibilities of other disciplines through IPE co-curricular learning can enhance positive attitudes toward teamwork

Supplement 18, Part 6, Parasite-Subject Catalogue: Subject Headings And Treatment

United States Department of Agriculture, Bureau of Animal Industry, Animal Parasitology Institute, Agriculture Research Servic

Reference Group Data for the Functional Gait Assessment

Background and Purpose: The Functional Gait Assessment (FGA) is a clinical tool for evaluating performance in walking. The purpose of this study was to determine age-referenced norms for performance on the FGA in community-living older adults. Subjects: Subjects were 200 adults, ages 40 to 89 years, living independently. Methods: Each subject completed the FGA one time and was scored simultaneously by 2 testers. Results: The intraclass correlation coefficient for interrater reliability was .93. Mean scores for the FGA ranged from 29/30 for adults in their 40s to 21/30 for adults in their 80s. Discussion and Conclusion: Patient performance on the FGA can be compared with age-referenced norms for expected performance. Further research is needed to determine the FGA\u27s usefulness in tracking clinical changes or predicting falls. The FGA is a reliable test for people without disease, and it is able to detect decreases in gait performance among typical older adults