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Applied Ergonomics Jul 2024This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and...
This review is an update of a previous systematic review and assesses the evidence for the association of work-related physical and psychosocial risk factors and specific disorders of the shoulders. Medline, Embase, Web of Science Core Collection, Cochrane Central and PsycINFO were searched and study eligibility and risk of bias assessment was performed by two independent reviewers. A total of 14 new articles were added with the majority focusing on rotator cuff syndrome (RCS) with seven studies. Nine articles reported psychosocial exposures in addition to physical exposures. The strongest evidence was found for the association between elevation, repetition, force and vibration and the occurrence of SIS and tendinosis/tendonitis. Evidence also suggests that psychosocial exposures are associated with the occurrence of RCS and tendinosis/tendonitis. Other findings were inconsistent which prevents drawing strong conclusions.
Topics: Humans; Occupational Diseases; Occupational Exposure; Risk Factors; Rotator Cuff Injuries; Vibration; Tendinopathy; Shoulder Pain
PubMed: 38579494
DOI: 10.1016/j.apergo.2024.104277 -
PeerJ 2024Understanding differential strength capability between sexes is critical in ergonomics and task design. Variations in study designs and outcome measures generates...
BACKGROUND
Understanding differential strength capability between sexes is critical in ergonomics and task design. Variations in study designs and outcome measures generates challenges in establishing workplace guidelines for strength requirements to minimize upper extremity risk for workers. The purpose of this systematic review was to collate and summarize sex differences in strength at the shoulder across movement directions and contraction types.
METHODS
A total of 3,294 articles were screened from four databases (Embase, Medline, SCOPUS, and Web of Science). Eligibility criteria included observational studies, direct measurement of muscular joint, and healthy adult participants (18-65 years old). Strength outcome measures were normalized to percentages of male outputs to allow comparisons across articles.
RESULTS
A total of 63 studies were included within the final review. Majority of articles observed increased strength in males; the gap between male-female strength was greater in flexion and internal/external rotation, with females generating ~30% of male strength; scaption strength ratios were most consistent of the movement groups, with females generating 55-62% of male strength.
CONCLUSION
Sex strength differences should be considered as an important factor for workplace task design as women are more at risk for occupational-related injuries than men in equivalent strength requirements. Differences in strength were not synonymous across motions; females demonstrated increased disparity relative to male strength in horizontal flexion/extension, forward flexion and internal/external rotation. Some movements had an extremely limited pool of available studies for examination which identified critical research gaps within the literature. Collating and quantifying strength differences is critical for effective workstation design with a range of users to mitigate potential overexertion risk and musculoskeletal injury.
Topics: Adult; Humans; Female; Male; Adolescent; Young Adult; Middle Aged; Aged; Shoulder; Sex Characteristics; Upper Extremity; Movement; Range of Motion, Articular
PubMed: 38525275
DOI: 10.7717/peerj.16968 -
The Knee Jun 2024In order to assess the published validity of focal resurfacing of the knee, a systematic review and meta-analysis were conducted to (i) evaluate revision rates and... (Meta-Analysis)
Meta-Analysis
PURPOSE
In order to assess the published validity of focal resurfacing of the knee, a systematic review and meta-analysis were conducted to (i) evaluate revision rates and implant survival of focal resurfacing of the knee; (ii) explore surgical complications; and (iii) evaluate patient reported clinical outcome measures.
METHODS
PubMED, Cochrane Library and Medline databases were searched by 2 independent reviewers in February 2022 for prospective and retrospective cohort studies evaluating any of the following implant types: HemiCAP®, UniCAP®, Episealer® or BioBoly®. Data on incidence of revision, complications and various patient reported outcome measures, such as Knee Society Score (KSS) or Knee Injury and Osteoarthritis Outcome Score (KOOS) was sourced.
RESULTS
A total of 24 published studies were identified with a total of 1465 enrolled patients. A revision rate of 12.97% over a 5.9 year weighted mean follow-up period was observed across all implant types. However, in one series a Kaplan-Meir survival as high as 92.6% at a 10-year follow-up period was noted. A statistically significant improvement was documented across multiple subjective clinical outcomes scores, for example a mean 4.56 point improvement of the VAS (0-10) pain score. The Kellgren-Lawrence score was used to evaluate the radiological progression of osteoarthritis and showed a small significant reduction in all anatomical locations, hence not supporting the hypothesis that focal femoral implants can lead to the progression of osteoarthritis in the affected compartment. There was a low reported incidence of post-operative complications such as aseptic loosening or deep wound infection.
CONCLUSIONS
Focal femoral resurfacing appears to be a viable treatment option for focal symptomatic chondral lesions in patients beyond biological reconstruction, with low revision rates and high patient satisfaction especially at short and medium length follow-up.
Topics: Humans; Arthroplasty, Replacement, Knee; Reoperation; Osteoarthritis, Knee; Knee Prosthesis; Knee Joint; Patient Reported Outcome Measures; Prosthesis Failure
PubMed: 38521014
DOI: 10.1016/j.knee.2024.02.013 -
Frontiers in Public Health 2024A large number of studies have found that the musculoskeletal injury of modern and contemporary dancers has a high incidence. Previous publications have indicated that... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A large number of studies have found that the musculoskeletal injury of modern and contemporary dancers has a high incidence. Previous publications have indicated that there are many potential factors that are related to dancing injury; however, they have not been proven, and even some data are conflicting in different research.
RESULTS
The search yielded 18 prospective studies reporting on professional and pre-professional modern or contemporary dancers from companies and schools. The prevalence of modern and contemporary dancers was 0.82 (: 0.74~0.90). The injury proportion of trauma, overuse, ankle and foot, lower extremity, joint and ligaments, muscle and tendons, and time-loss were 0.40, 0.26, 0.49, 0.34, 0.33, and 0.29 in the total number of injuries. There was no evidence of a significant difference in sex, age, and education program. The factors of BMI and injury history achieved statistical significance, and the -values were less than 0.01.
CONCLUSION
Based on the results of this article, BMI and injury history may be risk factors for injury in contemporary and modern dancers. Modern and contemporary dancers have a high prevalence of musculoskeletal injuries. Lower extremity injuries are the most common in the whole body, with injuries to the foot and ankle being more frequent. The mechanism of injury is mostly overuse injury, and the injured tissues are mostly muscle tendons and joint ligaments.
Topics: Humans; Prospective Studies; Prevalence; Musculoskeletal Diseases; Lower Extremity; Dancing; Risk Factors
PubMed: 38481844
DOI: 10.3389/fpubh.2024.1325536 -
Computers in Biology and Medicine Apr 2024Physiotherapy is a critical area of healthcare that involves the assessment and treatment of physical disabilities and injuries. The use of Artificial Intelligence (AI)...
Physiotherapy is a critical area of healthcare that involves the assessment and treatment of physical disabilities and injuries. The use of Artificial Intelligence (AI) in physiotherapy has gained significant attention due to its potential to enhance the accuracy and effectiveness of clinical decision-making and treatment outcomes. Nevertheless, it is still a rather innovative field of application of these techniques and there is a need to find what aspects are highly developed and what possible job niches can be exploited. This systematic review aims to evaluate the current state of research on the use of a particular AI called deep learning models in physiotherapy and identify the key trends, challenges, and opportunities in this field. The findings of this review, conducted following the PRISMA guidelines, provide valuable insights for researchers and clinicians. The most relevant databases included were PubMed, Web of Science, Scopus, Astrophysics Data System, and Central Citation Export. Inclusion and exclusion criteria were established to determine which items would be considered for further review. These criteria were used to screen the items during the first and second peer review processes. A set of quality criteria was developed to select the papers obtained after the second screening. Finally, of the 214 initial papers, 23 studies were selected. From our analysis of the selected articles, we can draw the following conclusions: Concerning deep learning models, innovation is primarily seen in the adoption of hybrid models, with convolutional models being extensively utilized. In terms of data, it's unsurprising that body signals and images are predominantly used. However, texts and structured data present promising avenues for groundbreaking work in the field. Additionally, medical tests that involve the collection of 3D images, Functional Movement Screening, or thermographies emerge as novel areas to explore applications within the scope of physiotherapy.
Topics: Artificial Intelligence; Clinical Decision-Making; Databases, Factual; Deep Learning; Medicine; Humans
PubMed: 38461697
DOI: 10.1016/j.compbiomed.2024.108082 -
Brazilian Journal of Physical Therapy 2024Lateral elbow tendinopathy is a common musculoskeletal disorder. Effectiveness of non-invasive therapies for this health condition are unclear. (Meta-Analysis)
Meta-Analysis Review
Effectiveness of non-invasive therapies on pain, maximum grip strength, disability, and quality of life for lateral elbow tendinopathy: A systematic review and meta-analysis.
BACKGROUND
Lateral elbow tendinopathy is a common musculoskeletal disorder. Effectiveness of non-invasive therapies for this health condition are unclear.
OBJECTIVE
To investigate the effectiveness of non-invasive therapies on pain, maximum grip strength, disability, and quality of life for lateral elbow tendinopathy.
METHODS
Searches were conducted on MEDLINE, Embase, CINAHL, AMED, PEDro, Cochrane Library, SPORTDiscus and PsycINFO without language or date restrictions up to May 3rd, 2023. Randomized trials investigating the effectiveness of any non-invasive therapy compared with control or other invasive interventions were included. Two independent reviewers screened eligible trials, extracted data, and assessed the risk of bias of included trials and certainty of the evidence.
RESULTS
Twenty-two different therapies investigated in 47 randomized trials were included in the quantitative analysis. Moderate certainty evidence showed that betamethasone valerate medicated plaster may reduce disability (mean difference -6.7; 95% CI -11.4, -2.0) in the short-term when compared with placebo. Low certainty evidence showed that acupuncture may reduce disability (MD -9.1; 95% CI -11.7, -6.4) in the short-term when compared with sham. Moderate to very low certainty of evidence also showed small to no effect of non-invasive therapies on pain intensity, maximum grip strength, and disability outcomes in the short-term compared to control or invasive interventions. Most therapies had only very low certainty of evidence to support their use.
CONCLUSIONS
Decision-making processes for lateral elbow tendinopathy should be carefully evaluated, taking into consideration that most investigated interventions have very low certainty of evidence. There is an urgent call for larger high-quality trials.
Topics: Humans; Quality of Life; Hand Strength; Tendinopathy; Pain
PubMed: 38402668
DOI: 10.1016/j.bjpt.2024.100596 -
Molecular Pain 2024Nociception related salivary biomolecules can be useful patients who are not able to self-report pain. We present the existing evidence on this topic using the... (Review)
Review
Nociception related salivary biomolecules can be useful patients who are not able to self-report pain. We present the existing evidence on this topic using the PRISMA-ScR guidelines and a more focused analysis of cortisol change after cold pain induction using the direction of effect analysis combined with risk of bias analysis using ROBINS-I. Five data bases were searched systematically for articles on adults with acute pain secondary to disease, injury, or experimentally induced pain. Forty three articles met the inclusion criteria for the general review and 11 of these were included in the cortisol-cold pain analysis. Salivary melatonin, kallikreins, pro-inflammatory cytokines, soluable TNF-α receptor II, secretory IgA, testosterone, salivary α-amylase (sAA) and, most commonly, cortisol have been studied in relation to acute pain. There is greatest information about cortisol and sAA which both rise after cold pain when compared with other modalities. Where participants have been subjected to both pain and stress, stress is consistently a more reliable predictor of salivary biomarker change than pain. There remain considerable challenges in identifying biomarkers that can be used in clinical practice to guide the measurement of nociception and treatment of pain. Standardization of methodology and researchers' greater awareness of the factors that affect salivary biomolecule concentrations are needed to improve our understanding of this field towards creating a clinically relevant body of evidence.
Topics: Adult; Humans; Hydrocortisone; Acute Pain; Saliva; Nociception; Salivary alpha-Amylases; Biomarkers; Stress, Psychological
PubMed: 38385158
DOI: 10.1177/17448069241237121 -
Heliyon Feb 2024Workplace injuries are a serious issue for the health and social care industry, with the sector accounting for 20 % of all serious claims reported. The aim of this...
Workplace injuries are a serious issue for the health and social care industry, with the sector accounting for 20 % of all serious claims reported. The aim of this systematic review was to determine whether patient handling training interventions that included instruction on patient transfer techniques are effective in preventing musculoskeletal injuries in healthcare workers. : Electronic databases MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO) and Health and Safety Science Abstracts (ProQuest) were searched for controlled trials from January 1996-August 2022. Risk of bias was evaluated using the PEDro scale and overall certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluation for each meta-analysis. A total of nine studies (3903 participants) were included. There is moderate certainty evidence that could not conclude whether patient handling training affects the 12-month incidence of lower back pain (OR = 0.83, 95 % CI [0.59, 1.16]). There is low certainty evidence that patient handing training does not prevent lower back pain in health professionals without pre-existing pain (MD = -0.06, 95 % CI [-0.63, 0.52]) but may reduce lower back pain in those with pre-existing pain (MD = -2.92, 95 % CI [-5.44, -0.41]). The results also suggest that there may be a positive effect of training incorporating risk assessment on musculoskeletal injury rates; however the evidence is of very low certainty. There is low certainty evidence from a single study that training may have a short-term effect on sickness absences.) There is a lack of evidence to support patient handling training when delivered to all healthcare staff. Training in its current form may be an ineffective strategy for reducing musculoskeletal injuries and pain. High quality disinvestment studies or trials incorporating risk assessment strategies are warranted. This review suggests health service managers question the effectiveness of current patient handling training practices and consider evaluating current practices before allocating resources to meet employee risk reduction obligations.
PubMed: 38371982
DOI: 10.1016/j.heliyon.2024.e24937 -
Scientific Reports Feb 2024The objective of this review was to evaluate the effect of exercise on pain intensity, function, and quality of life in individuals with gluteal tendinopathy. Searches... (Meta-Analysis)
Meta-Analysis
The objective of this review was to evaluate the effect of exercise on pain intensity, function, and quality of life in individuals with gluteal tendinopathy. Searches were carried out in PUBMED, EMBASE, CINAHL, Cochrane Library, and PEDro databases. Randomized or quasi-randomized controlled trials were included. Five studies met the eligibility criteria, comparing exercise-based interventions with minimal interventions and/or corticosteroid injections. Three studies, involving 383 participants, were included in the quantitative analysis. Meta-analyses showed that exercise is superior to minimal intervention for function in short-term [mean difference (MD) = 10.24; 95% confidence interval (95%CI) = 5.98, 14.50) and long-term (MD = 6.54; 95%CI = 1.88, 11.21]). However, no difference was observed for quality of life in the short [standardized mean difference (SMD) = 0.33; 95%CI = -0.29, 0.94] and long-term (SMD = 0.11; 95%CI = -0.16, 0.37). The effect of exercise was no different from that of corticosteroid injections for pain intensity in the short (MD = 1.25; 95%CI = -3.56, 6.05) and long-term (MD = -1.37; 95%CI = -3.72, 0.98]). In conclusion, exercise is superior to minimal interventions for function in the short- and long-term in individuals with gluteal tendinopathy. Exercise and corticosteroid injections had similar effects on pain intensity, however, exercise showed a higher treatment success rate when compared to corticosteroid injections in this population. The GRADE analysis revealed that the certainty of the evidence ranges from low to very low, therefore, large high-quality randomized controlled trials are recommended.PROSPERO registration number: CRD42021242853.
Topics: Humans; Quality of Life; Musculoskeletal Diseases; Exercise; Exercise Therapy; Adrenal Cortex Hormones
PubMed: 38336959
DOI: 10.1038/s41598-024-53283-x -
Systematic Reviews Feb 2024Work-related musculoskeletal disorders (WMSDs), also referred to as work-related musculoskeletal injuries (MSKIs), cause surgeons pain and discomfort. Implementing...
BACKGROUND
Work-related musculoskeletal disorders (WMSDs), also referred to as work-related musculoskeletal injuries (MSKIs), cause surgeons pain and discomfort. Implementing ergonomics in the operating room has helped reduce such symptoms. However, there are still many issues that surgeons face when dealing with medical instruments, especially among female surgeons or surgeons with smaller hands.
METHODS
The Cochrane methodology for performing a systematic review was utilized to search five databases for pertinent literature based on the study question "Do female surgeons or surgeons with smaller hand size, who use surgical instruments have an increased risk of musculoskeletal disorders and discomfort compared to male or larger handed surgeons?". The literature search strategy was designed around the three conceptual domains of surgeons/surgery, smaller hand size, and instrumentation. We searched PubMed, Embase.com, CINAHL Plus with Full Text (EBSCOhost), Scopus, and Web of Science Core Collection. This exploration identified 2165 research publications, and after specific inclusion and exclusion criteria, 19 studies were included in the systematic review. Risk of bias analysis was conducted to assess the quality of the included studies. After conducting a heterogeneity test, a meta-analysis was not performed due to high heterogeneity.
RESULTS
Using certain surgical instruments presents challenges in the form of MSKIs for female and smaller-handed surgeons. Studies showed that 77% of females and 73% of surgeons who wear < 6.5 glove size report musculoskeletal issues ranging from difficulty of use to pain. Difficulties using surgical instruments and reported injuries have a greater impact on surgical trainees which might deter interest in surgical fields for future proceduralists. Recommendations for improved ergonomic tool design are suggested by some of the included studies to help tackle the MSKIs that surgeons face when performing operations.
CONCLUSIONS
The number of female surgeons has increased substantially in the last decade. Hence, there exists an urgent need to address the major challenges they encounter by focusing on this specific aspect of workplace safety and health to mitigate injury. Doing so will yield a productive environment while simultaneously protecting the health and safety of both surgeons and patients.
SYSTEMATIC REVIEW REGISTRATION
The study protocol was registered on PROSPERO (ID: CRD42022283378).
Topics: Humans; Male; Female; Occupational Diseases; Equipment Design; Musculoskeletal Diseases; Surgeons; Pain
PubMed: 38326919
DOI: 10.1186/s13643-024-02462-y