Relato de caso de lombalgia inflamatória com extenso comprometimento anatômico-funcional: a importância de uma adequada abordagem da dor lombar na Atenção Primária à Saúde / Case report of inflammatory low back pain with extensive anatomical-functional impairment: The importance of an adequate approach to low back pain in Primary Care / Presentación de un caso de lumbalgia inflamatoria con afectación anatómico-funcional extensa: La importancia de un abordaje adecuado de la lumbalgia en Atención Primaria de Salud

Introdução: A lombalgia é uma condição prevalente e que apresenta importante impacto na capacidade funcional e na qualidade de vida, sendo a sua correta abordagem na Atenção Primária à Saúde fundamental para a identificação e o estabelecimento de um diagnóstico etiológico precoce de possíveis patologias que possam estar relacionadas a desfechos mórbidos e a graves limitações funcionais. Apresentação do caso: Paciente de 56 anos, sexo masculino, hipertenso, foi encaminhado para serviço especializado de reumatologia com histórico de lombalgia havia mais de 20 anos. Ao exame físico foi constatada presença de deformidades da coluna vertebral e extensa limitação de movimentos. Exames radiográficos mostravam esclerose de articulações sacroilíacas, osteopenia difusa e coluna vertebral em aspecto de "bambu". Conclusões: Constata-se a importância de que na abordagem das lombalgias na atenção primária se busque o reconhecimento de possíveis etiologias graves e potencialmente incapacitantes que possam estar subjacentes à queixa de dor lombar. Com esse objetivo, é fundamental o reconhecimento das chamadas red flags relacionadas às lombalgias, além de sua caracterização como mecânica ou inflamatória. Perante a atuação da atenção primária no oferecimento de um cuidado pautado na integralidade e na prevenção de agravos, reafirma-se a importância de uma avaliação clínica pormenorizada das lombalgias nesse nível de atenção à saúde.

Introduction: Low back pain is a prevalent condition that has an important impact on functional capacity and quality of life, and its correct approach in Primary Care is fundamental to the identification and establishment of an early etiological diagnosis of possible pathologies that may be related to outcomes morbid conditions and serious functional limitations. Case presentation: 56-year-old male patient, hypertensive, referred to a specialized rheumatology service with a history of low back pain for over 20 years. Physical examination revealed the presence of spinal deformities and extensive movement limitations. Radiographic examinations showing sclerosis of the sacro-iliac joints, diffuse osteopenia and a "bamboo" appearance of the spine. Conclusions: It is important that in the approach of low back pain in Primary Care, we seek to recognize possible serious and potentially disabling etiologies that may underlie the complaint of low back pain. For that, it is essential to recognize the so-called "red flags" related to low back pain, in addition to its characterization as mechanical or inflammatory. Given the role of Primary Care in offering care based on integrality and in the prevention of injuries, the importance of a detailed clinical assessment of low back pain at this level of health care is reaffirmed.

Introducción: La lumbalgia es una patología prevalente que tiene un impacto importante en la capacidad funcional y la calidad de vida, y su correcto abordaje en Atención Primaria de Salud es fundamental para la identificación y establecimiento de un diagnóstico etiológico precoz de posibles patologías que puedan estar relacionadas con los resultados, condiciones morbosas y limitaciones funcionales graves. Presentación del caso: Paciente masculino de 56 años, hipertenso, remitido a servicio especializado de reumatología con antecedentes de dolor lumbar de más de 20 años. El examen físico reveló la presencia de deformidades de la columna y amplias limitaciones de movimiento. Los exámenes radiológicos muestran esclerosis de las articulaciones sacroilíacas, osteopenia difusa y una apariencia de "bambú" de la columna. Conclusiones: Es importante que al abordar la lumbalgia en Atención Primaria de Salud busquemos reconocer las posibles etiologías graves y potencialmente incapacitantes que pueden subyacer a la queja de lumbalgia. Con este objetivo, es fundamental reconocer las llamadas "banderas rojas" relacionadas con la lumbalgia, además de su caracterización como mecánica o inflamatoria. Dado el papel de Atención Primaria de Salud a la hora de ofrecer una atención basada en la integralidad y prevención de enfermedades, se reafirma la importancia de una evaluación clínica detallada de la lumbalgia en este nivel de atención sanitaria.

Detection of musculoskeletal inflammatory lesions in patients with chronic chikungunya infection using 3T whole-body magnetic resonance imaging

ABSTRACT Background: Musculoskeletal inflammatory lesions in chronic Chikungunya virus (CHIKV) infection have not been thoroughly assessed using whole-body magnetic resonance imaging (WBMRI). This study aimed to determine the prevalence of these lesions in such patients. Methods: From September 2018 to February 2019, patients with positive Chikungunya-specific serology (Immunoglobulin M/Immunoglobulin G anti-CHIKV), with a history of polyarthralgia for > 6 months prior to MRI with no pre-existing rheumatic disorders, underwent 3T WBMRI and localized MRI. The evaluation focused on musculoskeletal inflammatory lesions correlated with chronic CHIKV infection. Pain levels were assessed using a visual analogue scale on the same day as WBMRI. Results: The study included 86 patients of whom 26 met the inclusion criteria. All patients reported pain and most (92.3%) categorized it as moderate or severe. The most common finding across joints was effusion, particularly in the tibiotalar joint (57.7%) and bursitis, with the retrocalcaneal bursa most affected (48.0%). Tenosynovitis was prevalent in the flexor compartment of the hands (44.2%), while Kager fat pad and soleus edema were also observed. Bone marrow edema-like signals were frequently seen in the sacroiliac joints (19.2%). Most WBMRI findings were classified as mild. Conclusions: This study represents the first utilization of 3T WBMRI to assess musculoskeletal inflammatory disorders in chronic CHIKV infection. The aim was to identify the most affected joints and prevalent lesions, providing valuable insights for future research and clinical management of this condition regarding understanding disease pathophysiology, developing targeted treatment strategies, and using advanced imaging techniques in the assessment of musculoskeletal manifestations.

Trastornos musculoesqueléticos y prácticas ergonómicas en universitarios peruanos durante la pandemia de la COVID-19

Introducción: El aislamiento social impuesto por la pandemia de la COVID-19 ha obligado a adaptarse a la educación a distancia. Objetivo: Determinar la prevalencia de trastornos musculoesqueléticos y su asociación con las prácticas ergonómicas durante el uso de la computadora en estudiantes de una universidad peruana. Métodos: Se realizó un estudio transversal en octubre de 2020. La muestra se compuso por 738 estudiantes, a quienes se les aplicaron el cuestionario nórdico estandarizado, para detectar síntomas de trastornos musculoesqueléticos, y otro desarrollado por los autores, para evaluar las prácticas ergonómicas. Resultados: La prevalencia de trastornos musculoesqueléticos fue de 97,4 %. Las regiones más afectadas resultaron el cuello (85,5 %), la región lumbar (73 %) y la dorsal (70,2 %). Los estudiantes con antecedentes de algún traumatismo (PRa: 1,03; IC 95 %: 1,01-1,04) que, durante el uso de la computadora, adoptaron las posturas decúbito prono (RPa: 1,02; IC 95 %: 1,01-1,04) y sentados con la cabeza inclinada (RPa: 1,03; IC 95 %: 1,00-1,07) tuvieron mayor prevalencia de un trastorno musculoesquelético. Conclusiones: Existe una alta prevalencia de trastornos musculoesqueléticos en los universitarios. Sobresalen el sexo femenino y quienes adoptan malas posturas durante el uso de la computadora; por tanto, se deben brindar medidas ergonómicas preventivas y de intervención en esta población.

Introduction: The social isolation imposed by the COVID-19 pandemic has made it necessary to adapt to distance education. Objective: To determine the prevalence of musculoskeletal disorders and their association with ergonomic practices during computer use in students from a Peruvian university. Methods: A cross-sectional study was carried out in October 2020. The sample consisted of 738 students, they had the standardized Nordic questionnaire to detect symptoms of musculoskeletal disorders; and another, developed by the authors, to evaluate ergonomic practices. Results: The prevalence of musculoskeletal disorders was 97.4%. The most affected regions were the neck (85.5%), the lumbar region (73%) and the dorsal region (70.2%). Students with history of trauma (PRa: 1.03; 95% CI: 1.01-1.04) who, while using the computer, adopted the prone position (RPa: 1.02; 95% CI : 1.01-1.04) and sitting with head tilted (RPa: 1.03; 95% CI: 1.00-1.07) had higher prevalence of a musculoskeletal disorder. Conclusions: There is high prevalence of musculoskeletal disorders in university students. The female sex and those who adopt incorrect postures while using the computer stand out; therefore, preventive and intervention ergonomic measures should be provided in this population.

Kinesiología Musculoesquelética Pediátrica en Chile, ¿Qué piensan los profesionales? / Pediatric musculoskeletal physical therapy in Chile; what do professionals think?

Introducción. La kinesiología musculoesquelética pediátrica es una especialidad reconocida en el mundo pero que en Chile está muy poco desarrollada. Objetivo. El objetivo de este estudio fue recolectar la opinión de profesionales acerca de la kinesiología musculoesquelética pediátrica en Chile, para exponer la creciente necesidad que existe de fomentar esta área en el país. Esto para impulsar su desarrollo y buscar alcanzar los estándares europeos y norte americanos, donde ésta se reconoce como una especialidad. Métodos. Se utilizó una encuesta online de 10 preguntas creada por la autora para recopilar la opinión de traumatólogos/as, kinesiólogos/as y estudiantes de último año de kinesiología acerca de la kinesiología musculoesquelética pediátrica en Chile. Los resultados se presentan como frecuencia absoluta y porcentaje de respuesta para cada pregunta. Resultados. de las 232 respuestas, 82.92% fueron de kinesiólogos/as y 8.19% fueron de traumatólogos/as. De acuerdo con estos profesionales, la kinesiología es un complemento esencial a la traumatología (98.71%), y la kinesiología pediátrica es diferente a la de los/as adultos/as (92.67%). Esta última requiere de habilidades técnicas (89.22%) y relacionales (96.98%) específicas. También se piensa que es un área poco desarrollada en Chile (90.09%), la cual debería desarrollarse (89.66%). Conclusiones. los traumatólogos/as y kinesiólogos/as de Chile están de acuerdo en que la kinesiología musculoesquelética pediátrica es un área de práctica que está poco desarrollada y que debería desarrollarse en Chile. Este estudio muestra un vacío que existe en la kinesiología chilena, el cual debería llenarse con futuras investigaciones científicas y cambios en los programas educacionales.

Background. Pediatric musculoskeletal physiotherapy is a recognized specialty in the world but it is underdeveloped in Chile. Objective. The aim of this study was to collect professionals' opinion about pediatric musculoskeletal physiotherapy in Chile to expose the growing need to promote this area of practice in the country. This to encourage its development for the good of our children and adolescents, and to seek to achieve European and north American standards, where this area of practice is recognized as specialty. Methods. An online self-created survey was used to collect orthopedic medical doctors and physiotherapists' opinions on pediatric musculoskeletal physiotherapy in Chile trough 10 Likert scale questions. Results are presented as absolute frequency and percentage for each question. Results. 232 responses were included in the analysis, where 82.92% of the responders were physiotherapists and 8.19% were orthopedic medical doctors. According to these professionals, physiotherapy is an essential complement to orthopedics (98.71%), and pediatric physiotherapy is different from adult physiotherapy (92.67%), so it needs technical (89.22%) and relational (96.98%) specific skills. They also think that it is an underdeveloped area of expertise in Chile (90.09%) that should be developed (89.66%). Conclusions. Chilean orthopedic medical doctors and physiotherapists agreed that pediatric musculoskeletal physiotherapy is an underdeveloped area of practice that should be developed in the country. This study shows an existing void in Chilean physiotherapy that should be filled in with future research and changes in educational programs.

Riesgo ergonómico y trastornos musculoesqueléticos en trabajadores de industria alimentaria en el Callao en el 2021

Objetivo: El presente trabajo tuvo como objetivo determinar la relación entre el riesgo ergonómico y los trastornos musculoesqueléticos (TME) en los trabajadores de una industria alimentaria en el Callao, 2021. Materiales y métodos: Estudio con un enfoque cuantitativo, alcance correlacional, diseño transversal, no experimental. La muestra estuvo conformada por 184 trabajadores. Las variables principales se midieron con el método de Evaluación Rápida del Cuerpo Completo (REBA, por sus siglas en inglés) y los TME, con el Cuestionario Nórdico de Kuorinka. Se realizó el análisis bivariado para las variables principales y secundarias usando la prueba de chi al cuadrado, la correlación de Pearson y la prueba t de Student. Se consideró un nivel de significancia menor o igual a 0,05. Resultados: El 43,48 % tuvo un riesgo ergonómico bajo y el 79,89 % presentó TME que se desarrollaron, con mayor molestia, en la espalda, con un 27,03 %, y en la mano (muñeca derecha), con un 26,35 %. Además, se determinó que la relación entre el factor del riesgo ergonómico y los TME fue significativa (p = 0,001), con una fuerza de correlación positiva de 0,301. Asimismo, los TME se relacionaron con sexo (p = 0,015), estado civil (p = 0,011), tipo de contrato (p = 0,001) y puesto de trabajo (p = 0,000). Conclusiones: Se encontró relación entre el riesgo ergonómico y los TME en los trabajadores de una industria alimentaria en el Callao, 2021. Asimismo, la mayoría de los trabajadores presentaron TME, con mayor molestia en la espalda. Las variables del presente estudio deben tenerse en cuenta al explorar estrategias de intervención efectivas y concretas para evitar los TME. Se recomienda concientizar a los trabajadores y los empleadores sobre las medidas ergonómicas y personales apropiadas que son necesarias para mejorar la seguridad y el bienestar de los trabajadores.

Objective: To determine the relationship between ergonomic risk and musculoskeletal disorders (MSDs) among food industry workers in Callao, 2021. Materials and methods: A quantitative, correlational, cross-sectional, non-experimental study. The sample consisted of 184 workers. The main variables were measured with the Rapid Entire Body Assessment (REBA) and the MSDs with Kuorinka's Standardized Nordic questionnaires. A bivariate analysis of the primary and secondary variables was performed using the chi-square test, Pearson correlation coefficient and Student's t-test. A significance level less than or equal to 0.05 was considered. Results: Out of all workers, 43.48 % had a low ergonomic risk and 79.89 % developed MSDs, with greater discomfort in the back, with 27.03 %, and the hand (right wrist), with 26.35 %. In addition, the relationship between the ergonomic risk factor and MSDs was significant (p = 0.001), with a positive correlation of 0.301. Likewise, MSDs were related to sex (p = 0.015), marital status (p = 0.011), type of contract (p = 0.001) and job position (p = 0.000). Conclusions: A relationship was found between ergonomic risk and MSDs among food industry workers in Callao, 2021. Moreover, most workers developed MSDs, with greater discomfort in the back. The variables of the present study should be taken into account when exploring effective and concrete intervention strategies to prevent MSDs. It is recommended to raise awareness of workers and employers about the appropriate ergonomic and personal measures necessary to improve the safety and well-being of workers.

Anos de vida perdidos ajustados pela incapacidade decorrentes de distúrbios musculoesqueléticos em profissionais de enfermagem oncológica / Disability adjusted life years due to musculoskeletal disorders in oncology nursing professionals / Años de vida perdidos ajustados por discapacidad por trastornos musculoesqueléticos en profesionales de enfermería oncologica

Objetivos: Estimar Anos de Vida Perdidos Ajustados pela Incapacidade - DALY decorrentes de distúrbios musculoesqueléticos em profissionais de enfermagem nas unidades hospitalares de uma instituição oncológica. Métodos: Estudo ecológico, utilizando banco de dados institucionais. Valores absolutos de DALY foram transformados em taxas por 100 mil habitantes, e calculadas por categoria profissional, sexo e faixa etária. Resultados: Estimou-se 3,78 DALY (2.136/100 mil) entre todos os profissionais de enfermagem; entre Técnicos de enfermagem 2,62 DALY (2186//100 mil); e entre Enfermeiros 1,15 DALY (2024/100mil). Maior DALY ocorreu entre técnicos de enfermagem, sexo feminino, faixa etária de 50 a 59 anos, cujo valor é 0,98 (3.161/100mil). As Dorsopatias geraram mais DALY (1,97 DALY), destacando-se as lombalgias e cervicalgias. Dos diagnósticos encontrados, 54% referiam-se a Doenças Osteomusculares Relacionadas ao Trabalho, e apresentaram 2,62 DALY (69% do total de DALY). Conclusão: Houve uma grande quantidade de DALY decorrente de doenças musculoesqueléticas entre os profissionais de enfermagem da instituição.

Objectives: To estimate Disability-Adjusted Life Years Lost - DALY due to musculoskeletal disorders in nursing professionals in the hospital units of an oncology institution. Methods: Ecological study, using institutional database. Absolute DALY values were transformed into rates per 100,000 inhabitants and calculated by professional category, sex and age group. Results: It was estimated 3.78 DALY (2,136/100 thousand) among all nursing professionals, among Nursing Technicians 2.62 DALY (2186//100 thousand) and among Nurses 1.15 DALY (2024/100 thousand). Higher DALYs occurred among female nursing technicians, aged 50 to 59 years with 0.98 DALY (3,161/100,000). Dorsopathies generated more DALY (1.97 DALY), especially low back pain and neck pain. Of the diagnoses found, 54% referred to Work-Related Musculoskeletal Diseases, and presented 2.62 DALYs (69% of the total DALY). Conclusion: There was a large amount of DALY due tomusculoskeletal disorders among nursing professionals at the institution.

Objetivos: Estimar los Años de Vida Ajustados en función de la Discapacidad (AVAD) derivada de los trastornos musculoesqueléticos entre los profesionales de enfermería en centros de una institución de oncología. Métodos: Estudio ecológico, basado en datos institucionales.Los valores absolutos de AVAD encontrados se transformaron en tasas por 100.000 habitantes, y se calcularon según categoría profesional, sexo y grupo de edad. Resultados:Se estimaron 3,78 AVAD (2.136/100.000) entre los profesionales de enfermería; 2,62 AVAD (2186/100.000) entre los técnicos de enfermería; y 1,15 AVAD (2.024/100.000) entre los enfermeros. El mayor AVAD ocurrió entre los técnicos de enfermería, del sexo femenino, de entre 50 y 59 años de edad, con el valor de 0,98 (3.161/100.000). Las dorsopatías generaron más AVAD (1,97 AVAD), especialmente lumbalgia y cervicalgia. El 54% de losdiagnósticos se refieren a Enfermedades Musculoesqueléticas Relacionadas con el Trabajo, con 2,62 AVAD (69% del total de AVAD). Conclusión: Existe una alta carga de enfermedad musculoesquelética entre los profesionales de enfermería de la institución en estudio.

Contracepção em situações especiais / Contraception in special situations

A decisão de escolha do método contraceptivo em situações clínicas especiais é desafiadora tanto para médicos quanto para pacientes. Em parte, isso se deve às contraindicações reais que alguns contraceptivos apresentam. Porém, há uma estreita relação com a falta de conhecimento e medo de muitos profissionais em prescrever métodos que, na realidade, são seguros. A má escolha do método contraceptivo para pacientes portadoras de condições específicas pode levar a diversos desfechos ruins, como piora da condição de base, ocorrência de eventos adversos indesejáveis e preveníveis e ocorrência de gravidez de alto risco indesejada. Dessa forma, foi realizada uma revisão na literatura com o objetivo de auxiliar profissionais médicos na decisão contraceptiva de pacientes portadoras de doenças reumatológicas e musculoesqueléticas, epilepsia, esclerose múltipla, transtornos alimentares, anemia falciforme e obesidade, e que já foram submetidas a cirurgia bariátrica.(AU)

The decision to choose the contraceptive method in special clinical situations is challenging for both physicians and patients. In part, this is due to the real contraindications that some contraceptives present. However, there is a close relationship with the lack of knowledge and fear of many professionals in prescribing methods that are actually safe. The poor choice of contraceptive method in patients with specific conditions can lead to several bad outcomes, such as worsening of the baseline condition, occurrence of undesirable and preventable adverse events and occurrence of an unwanted high-risk pregnancy. Thus, a literature review was carried out in order to assist medical professionals in the contraceptive decision of patients with rheumatological and musculoskeletal diseases, epilepsy, multiple sclerosis, eating disorders, sickle cell anemia, obesity and who have already undergone bariatric surgery.(AU)

Safe radiological spinal intervention: A multicenter snapshot survey of musculoskeletal radiologists in the UK and India

Objectives: Research, knowledge, and technological advances have promoted minimally invasive image-guided diagnostic and therapeutic intervention. Such interventions are increasingly performed for musculoskeletal diseases by radiologists within outpatient settings. The objective of this study was to ascertain levels of safe practice among musculoskeletal radiologists in the United Kingdom and the Indian public health-care system, as defined by access to spinal surgeons and anesthetists during radiological spinal procedures. Material and Methods: An online cross-sectional survey of eight questions (multiple choice and free text) was circulated among musculoskeletal radiologists in the UK and India, to evaluate: (i) Image-guided practice among musculoskeletal radiologists. (ii) Types of interventions undertaken. (iii) Practice setting. (iv) Availability of supportive, backup access to spinal surgery services. Results: A total of 53 replies were received of which 43 (81.1%) were from musculoskeletal radiologists who perform spinal interventional procedures. Spinal biopsies and injections were the most common procedures performed by the 43 eligible radiologists (79.1% and 74.4%, respectively), with vertebroplasty and sacroplasty performed by only 16.3% and 11.6%, respectively. Less than half (46.5%) of musculoskeletal radiologists performing interventional procedures did so within a hospital setting with both a spinal surgeon and an anesthetist on site, 20.9% had an anesthetist on site but no spinal surgeon and 16.3% had neither on-site. Conclusion: Minimally invasive image-guided diagnostic and therapeutic intervention is a niche sub-specialty practiced by a few musculoskeletal radiologists. Enhanced resource allocation, skills training, and multidisciplinary service provision will ultimately minimize existing deficiencies, improving patient-related clinical outcomes, and quality of care.

Qualidade de Vida no Trabalho (QVT) e sintomas osteomusculares em Agentes Comunitários de Saúde / Quality of Work Life (QWL) and the musculoskeletal symptoms in Community Health Workers

INTRODUÇÃO: O Agente Comunitário em Saúde, em seu ambiente de trabalho, lida com vários desafios, tais como: as inúmeras tarefas, a exigência de produtividade, a falta de recursos, os conflitos interpessoais e as condições salariais inadequadas, implicando assim em sobrecarga física e mental, aspectos que podem repercutir na qualidade de vida e no aparecimento de distúrbios osteomusculares. OBJETIVO: Avaliar a Qualidade de Vida no Trabalho (QVT) e a presença dos sintomas osteomusculares dos Agente Comunitário de Saúde (ACS). MÉTODOS: Trata-se de um estudo transversal, com amostragem por conveniência, cujos participantes foram os ACS atuantes nas Unidades de Saúde da Família do Segundo Distrito Sanitário de Saúde em Maceió - Alagoas. Coletou-se os dados por meio dos seguintes instrumentos: questionário sociodemográficos; questionário de avaliação da qualidade de vida no trabalho (QWLQ-bref); e o questionário de sintomas osteomusculares (QNSO). RESULTADOS: Participaram 38 ACS, sendo a maioria do sexo feminino (86,8%). Obtiveram um escore médio de QVT de 59,84, o que representa uma posição de satisfação. Já na análise por domínios, o pessoal, psicológico e físico também se encontram na faixa de satisfação, exceto o domínio profissional com escore de 53,44, classificado como neutro. Em relação aos sintomas osteomusculares, o pescoço (55,3%) e a coluna lombar (47,4%) foram as regiões mais acometidas nos últimos 12 meses. CONCLUSÃO: Os resultados deste estudo, sinalizam a necessidade de adoção de melhorias nas condições de trabalho, tanto no sentido de repensar as questões que repercutem na QVT quanto no manejo dos problemas musculoesqueléticos.

INTRODUCTION: The Community Health Agent, in their work environment, deals with several challenges, such as the numerous tasks, the demand for productivity, the lack of resources, interpersonal conflicts and inadequate salary conditions, thus implying physical and mental overload; aspects that can affect the quality of life and the onset of musculoskeletal disorders. OBJECTIVE: Evaluate the Quality of Life at Work (QWL) and the presence of musculoskeletal symptoms in Community Health Agents (CHA). METHODS: This is a cross-sectional study, with convenience sampling, in which the participants were the CHA servers working in the Family Health Units of the Second Health Health District in Maceió - Alagoas. Data were collected using the following instruments: a sociodemographic questionnaire; a quality of work life assessment questionnaire (QWLQ-bref); and the musculoskeletal symptoms questionnaire (QNSO). RESULTS: Thirty-eight CHAs participated, most of them female (86.8%). It was obtained an average QWL score of 59.84, which represents a satisfactory position. In the analysis by domains, the personal, psychological and physical are also in the range of satisfaction, except for the professional domain with a score of 53.44, classified as neutral. Regarding musculoskeletal symptoms, the neck (55.3%) and lumbar spine (47.4%) were the most affected regions in the last 12 months. CONCLUSIONS: The results of this study indicate the need to adopt improvements in working conditions, both in the sense of rethinking the issues that affect QWL, as well as in the management of musculoskeletal problems.

Musculoskeletal pitfalls in 68Ga-PSMA PET/CT / Pitfalls do sistema musculoesquelético na PET/CT com 68Ga-PSMA

Abstract Prostate-specific membrane antigen (PSMA) is a transmembrane protein expressed in normal prostate cells and overexpressed in prostate cancer. Consequently, it is an important tool in the evaluation of prostate cancer, including the staging of high-risk patients and the assessment of biochemical recurrence. Despite the "specific" designation, benign musculoskeletal conditions, such as fractures, osteodegenerative changes, and fibrous dysplasia, can also show PSMA uptake, which can lead to misinterpretation of the imaging findings. Therefore, radiologists must be aware of these potential pitfalls, understand their causes, and fully analyze their morphologic features on unfused computed tomography (CT) and magnetic resonance imaging scans to correctly interpret the examination. In this pictorial essay, we review the basic characteristics of the 68Ga-PSMA positron-emission tomography/CT (PET/CT) radiotracer, discuss potential causes of false-positive findings on 68Ga-PSMA PET/CT in the musculoskeletal system, and illustrate the corresponding imaging findings.

Resumo O antígeno de membrana próstata específico (PSMA) é uma proteína transmembrana que apresenta expressão em células prostáticas normais e superexpressão em neoplasia da próstata. Dessa forma, é uma importante ferramenta na avaliação da neoplasia prostática, de utilidade no estadiamento de pacientes de alto risco e na análise de recorrência bioquímica. Apesar do termo "específico", condições musculoesqueléticas benignas podem demonstrar captação de PSMA, como fraturas, alterações osteodegenerativas e displasia fibrosa, podendo levar a uma avaliação equivocada dos achados de imagem. Assim, o radiologista deve conhecer esses potenciais pitfalls, compreender suas causas e analisar as características morfológicas nas imagens não fundidas de TC e RM para interpretar corretamente o exame. Neste ensaio iconográfico, revisaremos as características básicas do radiofármaco 68Ga-PSMA PET/CT, discutiremos possíveis causas de resultados falso-positivos na 68Ga-PSMA PET/CT no sistema musculoesquelético e ilustraremos os achados de imagem correspondentes.

Indicadores de acesso nos serviços de reabilitação física das desordens musculoesqueléticas em Belo Horizonte (MG) / Indicadores de acceso en servicios de rehabilitación física para trastornos musculoesqueléticas en Belo Horizonte (MG) / Access indicators in physical rehabilitation services for musculoskeletal disorders in Belo Horizonte (MG)

RESUMO A crescente demanda por atendimento nos serviços de reabilitação física do Sistema Único de Saúde (SUS) excede a oferta, o que resulta em longas filas de espera. Neste estudo, realizou-se uma pesquisa quantitativa de cunho exploratório que teve por objetivo a apresentação de indicadores para facilitar o acesso aos serviços de reabilitação física no que tange às desordens musculoesqueléticas. Os dados foram colhidos dos prontuários de usuários residentes nas regiões noroeste e oeste de Belo Horizonte (MG), com mais de 18 anos de idade, submetidos a acolhimento no Centro Especializado em Reabilitação IV no ano de 2019. Obtiveram-se os seguintes indicadores: absenteísmo no momento da avaliação; tempo médio para início do tratamento de acordo com a prioridade; tempo médio de tratamento; e média de usuários atendidos ao mês. A análise deste estudo foi pautada em 362 prontuários. O tempo médio para início de tratamento foi de aproximadamente 69 dias e o período médio de tratamento, de 94 dias. O serviço absorveu cerca de 30 novos usuários ao mês e apresentou índice de absenteísmo de 16,8%. Acredita-se que os indicadores apresentados possivelmente favorecerão a gestão e o controle das filas de espera dos serviços de reabilitação do SUS.

RESUMEN La creciente demanda de atención en los servicios de rehabilitación física del Sistema Único de Salud (SUS) supera la oferta, lo que se traduce en largas colas de espera. Este estudio es una investigación cuantitativa exploratoria, que tuvo como objetivo presentar indicadores para facilitar el acceso a los servicios de rehabilitación física con respecto a los trastornos musculoesqueléticos. Se recolectaron datos de las historias clínicas de los usuarios residentes en las regiones noroeste y oeste de Belo Horizonte (en Mina Gerais, Brasil), mayores de 18 años de edad y que ingresaron al Centro Especializado en Rehabilitación IV en 2019. Se obtuvieron los siguientes indicadores: Absentismo al momento de la evaluación; tiempo medio para iniciar el tratamiento según la prioridad; tiempo medio de tratamiento y número medio de usuarios atendidos por mes. El análisis de este estudio se basó en 362 historias clínicas. El tiempo medio para iniciar el tratamiento fue de aproximadamente 69 días y el período medio de tratamiento, 94 días. El servicio recibió cas 30 nuevos usuarios al mes y presentó una tasa de absentismo del 16,8%. Los indicadores presentados pueden favorecer la gestión y control de las listas de espera de los servicios de rehabilitación del SUS.

ABSTRACT The growing demand for care in the physical rehabilitation services of the Unified Health System (SUS) exceeds the supply, resulting in long waiting lines. This study is an exploratory quantitative research, which aims to present indicators to ease the access to physical rehabilitation services related to musculoskeletal disorders. Data were collected from the medical records of users residing in the northwest and west regions of Belo Horizonte (MG), who were over 18 years old and underwent treatment at the Specialized Rehabilitation Center IV (CER-IV) in 2019. The following indicators were obtained: absenteeism at the time of assessment; average time to start treatment according to priority; mean treatment time; and average number of users served per month. The analysis was based on 362 medical records. The mean time to start treatment was approximately 69 days and the mean treatment period was 94 days. The service absorbed around 30 new users per month and presented an absenteeism rate of 16.8%. It is believed that the indicators presented will possibly favor the management and control of the SUS rehabilitation services waiting lines.

Comparison between pain intensity, functionality, central sensitization, and self-efficacy in individuals with unilateral or bilateral knee osteoarthritis: a cross-sectional study

SUMMARY OBJECTIVE: This study aimed to compare pain intensity, stiffness, functionality, central sensitization, and self-efficacy, between individuals with bilateral knee osteoarthritis and unilateral knee osteoarthritis. METHODS: We included sedentary participants with knee osteoarthritis. The diagnosis was defined by a specialist, in which there was a complaint of pain and/or altered function in the lower limbs (duration ≥3 months); morning stiffness; pain intensity ≥3; Kellgren-Lawrence 2-3° associated with X-ray; persistence of symptoms >3 months. We used the following tools: Western Ontario and McMaster Universities Arthritis Index, Numerical Pain Scale, Central Sensitization Inventory, and Pain Self-Efficacy Questionnaire. Intergroup comparisons were performed using the t-test. RESULTS: The sample consisted of 118 adult individuals, divided into two groups: bilateral knee osteoarthritis (n=59) and unilateral knee osteoarthritis (n=59). We observed a significant difference (p<0.05) and a large effect size (d≥0.8), in the comparisons between: stature, body mass index, physical function, central sensitization, and self-efficacy. CONCLUSION: Individuals with bilateral knee osteoarthritis have higher levels of central sensitization, impaired functionality, and a lower level of self-efficacy.

Avaliação postural: avaliação quantitativa da postura estática de crianças de seis a dez anos de idade / Postural assessment: quantitative evaluation of static posture in children from six to ten years old

A avaliação da postura corporal estática de crianças permite identificar e prevenir desordens musculoesqueléticas no estágio inicial. Objetivo: Avaliar a postura estática de alunos de uma escola pública, comparando a postura entre as faixas etárias e entre os sexos. Métodos: A amostra foi composta por 130 escolares (62 do sexo masculino e 68 do sexo feminino), os quais tinham entre 6 e 10 anos de idade. Cada escolar foi fotografado nas vistas anterior, posterior e lateral direita, e o registro fotográfico foi analisado por meio do Software de Avaliação Postural (SAPo). Resultados: Somente foi encontrada diferença entre os sexos no ângulo do tornozelo, além de interação entre sexo e faixa etária. Em relação à idade, o alinhamento horizontal dos acrômios e o alinhamento horizontal da cabeça foram diferentes entre 6-7 e 9 anos. O alinhamento horizontal da cabeça, o alinhamento horizontal das espinhas ilíacas ântero-superior (EIAS) e o alinhamento sagital do membro inferior também apresentaram interação significativa entre sexo e idade. Conclusão: Em média, a maioria dos resultados demonstra que há um alinhamento vertical e uma simetria horizontal nos ângulos analisados, com exceção do alinhamento sagital do membro inferior, do ângulo do tornozelo e do alinhamento sagital do corpo que não demostraram um alinhamento próximo do ideal. Logo, os escolares avaliados apresentam uma boa saúde musculoesquelética.

Static postural evaluation of children allows for identifying and preventing musculoskeletal disorders in the early stages. Objective:To evaluate the static posture of students at a public school, comparing age groups and sex. Methods:The sample consisted of 130 schoolchildren (62 males and 68 females) who were 6-10 years old. Each student was photographed at the anterior, posterior, and right lateral views, and the photographic records were analyzed with the Software Postural Assessment (SAPo). Results:The ankle angle was different between sexes, presenting interaction between sex and age group. Regarding age groups, the horizontal alignment of acromion processes and horizontal alignment of the head were different between 6-7 and 9 years. The horizontal alignment of the head, the horizontal alignment of the anterior superior iliac spines, and the sagittal alignment of the lower limb also showed a significant interaction between sex and age group. Conclusion:On average, most results show a vertical alignment and a horizontal symmetry in the analyzed angles. However, the sagittal alignment of the lower limb, ankle angle, and sagittal alignment of the body did not maintain satisfactory alignment. The participants of our study presented good musculoskeletal health.

Study on ergonomic intervention to relieve work-related musculoskeletal disorders among assembly workers in a railway vehicle manufacturing enterprise / 环境与职业医学

Background Work-related musculoskeletal diseases (WMSDs) occur in a variety of occupational populations. Because of their various discomfort and serious disease burden, they have become an important issue worthy of attention in the field of occupational health. The prevention and control of WMSDs is one of the public health problems to be solved. Objective To evaluate the intervention effect on WMSDs among assembly workers in a railway vehicle manufacturing enterprise, so as to provide scientific basis for the prevention and control of WMSDs. Methods A total of 250 assembly workers in a railway vehicle manufacturing enterprise were selected using convenience sampling from August to December 2017. The Chinese Musculoskeletal Questionnaire was used for epidemiological investigation, and the Ergonomic Checkpoints was used for ergonomic inspection and worker interview. According to the above survey results, a six-month intervention plan including stepladder improvement and ergonomics training were implemented in the assembly workshop from September 2018 to February 2019. The intervention effects including the awareness of WMSDs, the exposure level of ergonomic load, and the occurrence of WMSDs symptoms were evaluated with relevant cross-sectional survey results before and after the intervention. The scores of WMSDs symptom intensity, symptom duration, and symptom frequency from low to high were 0-10, 1-4, and 1-5, respectively. Results After the intervention, the awareness rates of assembly workers on WMSDs types, affected body sites, influencing factors, preventive measures, and symptoms all increased from 52.3%, 51.9%, 25.5%, 19.1%, and 51.5% to 68.5%, 61.3%, 48.1%, 40.9%, and 61.3%, respectively (P<0.05). After the intervention, the proportion of assembly workers who "often" bend their head backwards frequently decreased from 34.6% to 21.8%, the proportion who "often" keep their trunk backward for a long time decreased from 26.6% to 15.0%, and the proportion who "never" raise their arms frequently increased from 3.4% to 9.0% (P<0.05). After the intervention, the scores of WMSDs symptom intensity in neck, shoulders, upper back, low back, elbows, hands/wrists, hips/thighs, knees, and ankles/feet all decreased, and the medians were mostly decreased from 6 to 3 (P<0.05); the scores of WMSDs symptom duration only decreased in neck (P<0.05) and there was no significant difference in the other body sites before and after the intervention; the median scores of WMSDs symptom frequency in low back, hands/wrists, and hips/thighs decreased from 3 to 2 (P<0.05). Conclusion The six-month intervention of stepladder improvement and ergonomics training among assembly workers in a railway vehicle manufacturing enterprise can improve workers' awareness of WMSDs, and reduce the exposure frequency of awkward postures and the intensity, duration, and frequency of WMSDs symptoms.

Doenças osteomusculares são a principal causa de absenteísmo-doença entre trabalhadores da indústria de petróleo no Brasil: resultados de um estudo de coorte / Musculoskeletal diseases are the main cause of sick leave among oil industry workers in Brazil: results of a cohort study

Resumo Objetivo: descrever indicadores de absenteísmo-doença entre trabalhadores de indústria de petróleo. Métodos: estudo de coorte retrospectiva, realizado de 2012 a 2016, com dados secundários de prontuários médicos e de bases de dados da empresa. Foram calculados indicadores de absenteísmo por morbidade, características sociodemográficas e ocupacionais. Resultados: participaram 2.028 trabalhadores, do sexo masculino (87,6%), com idade maior ou igual a 50 anos (46,9%), nível médio de escolaridade (49,2%) e que trabalhavam em atividade não-operacional (65,1%). A incidência acumulada de afastamento do trabalho foi de 71,5% e a taxa de incidência de 25,8/100 pessoas-ano. Maiores taxas foram observadas entre mulheres (31,6), trabalhadores com 50 ou mais anos (29,9), 30 ou mais anos de serviço (31,9), menor escolaridade (29,2), em atividade operacional (27,9) e horário regular (26,1). Doenças osteomusculares (n=2001), respiratórias (n=1016) e digestivas (n=967) foram responsáveis pelo maior número de licenças. Os maiores números de dias de ausência ao trabalho foram por doenças osteomusculares (n=11640), lesões por causas externas (n=6267) e transtornos mentais (n=5042). Dor lombar foi o diagnóstico com maior número de dias de absenteísmo (n=3632). Conclusão: mulheres, trabalhadores com mais tempo de serviço e de menor escolaridade devem ser alvo de programas de saúde que visem o controle das morbidades identificadas.

Abstract Objective: to describe the incidence of sickness absence among workers of an oil industry in Brazil. Methods: retrospective cohort study conducted with 2,028 workers. Study data were obtained from workers' medical records from 2012 to 2016. Indicators of absenteeism were calculated by sociodemographic characteristics, occupational characteristics, and morbidity. Results: of the participants, 87.6% were men, 49.2% with high school educational level, 46.9% aged 50 years or older, 65.1% worked in non-operational activities. The cumulative incidence of sick leave was 71.5% and its incidence rate, 25.8 per 100 person-years. We found the highest incidence rates amongst women (31.6), workers aged 50 years or older (29.9), lower educational attainment (29.2), work experience spanned 30 years or more (31.9), working in operational activities (27.9), and regular work schedule (26.1). Musculoskeletal (n=2,001), respiratory (n=1,016), and digestive diseases (n=967) were responsible for the largest number of sick leaves. The highest number of absence days was due to musculoskeletal diseases (n=11,640), followed by injuries (n=6,267) and mental disorders (n=5,042). Low back pain diagnostic was responsible for the greatest number of absence days (n=3,632). Conclusions: health programs aimed at controlling the identified morbidities should target women, those with longer work experiences, and those with lower educational attainment.

Síntomas osteomusculares en galponeros de granjas avícolas asociados a condiciones del trabajo / Osteomuscular symptoms in poultry farm workers associated with working conditions

INTRODUCCIÓN. Según datos de la Organización Mundial de Salud los trastornos musculoesqueléticos son la principal causa de discapacidad en el mundo; retrasar su diagnóstico provocaría una discapacidad prevenible. OBJETIVO. Determinar la prevalencia de síntomas osteomusculares en galponeros de granjas avícolas asociados a condiciones del trabajo. MATERIALES Y MÉTODOS. Estudio descriptivo transversal. Muestra aleatoria estratificada de 223 trabajadores, divididos en 106 galponeros y 117 personal administrativo de granjas avícolas de la provincia de Manabí. Criterios de inclusión: trabajadores mayores de 18 años de edad con al menos un año en la misma actividad. Para el análisis de datos, se utilizó Epi Info versión 7. RESULTADOS. La prevalencia de síntomas osteomusculares en los últimos 12 meses fue mayor en los galponeros en: hombro 81,69% y columna lumbar 56,96%. Mediante un análisis a través de regresión logística se determinó que los galponeros que trabajan por más de 10 años y que realizan movimientos repetitivos en menos de un minuto, tienen mayor riesgo de presentar dolor en el hombro (IC del 95% 1,26 ­ 4,98) e (IC del 95% 1,65 ­ 5,29). CONCLUSIÓN. Se registró la prevalencia de síntomas osteomusculares en galponeros de granjas avícolas asociados a condiciones del trabajo. RECOMENDACIÓN. Es necesario contar con sistemas de vigilancia a fin de proponer estrategias públicas en la industria avícola del Ecuador

INTRODUCTION. According to data from the World Health Organization musculoskeletal disorders are the leading cause of disability in the world; delaying their diagnosis would result in preventable disability. OBJECTIVE. To determine the prevalence of musculoskeletal symptoms in poultry farm workers associated with working conditions. MATERIALS AND METHODS. Cross-sectional descriptive study. Stratified random sample of 223 workers, divided into 106 poultry sheds workers and 117 administrative personnel of poultry farms in the province of Manabí. Inclusion criteria: Workers over 18 years of age with at least 1 year in the same activity. Fort he data analysis, Epi Info version 7 was used. RESULTS. The prevalence of musculoskeletal symptoms in the last 12 months was higher in sheds workers in: shoulder 81,69% and lumbar spine 56,96%. Using logistic regression analysis, it was determined that the sheds workers who have been working for more than 10 years and who perform repetitive movements in less than one minute have a greater risk of presenting shoulder pain (95% CI 1,26 ­ 4,98) and (95% CI 1,65 ­ 5,29). CONCLUSION. The prevalence of osteomuscular symptoms in poultry farm workers associated with working conditions was recorded. RECOMMENDATION. It is necessary to have surveillance systems in order to propose public strategies in the Ecuadorian poultry industry

Lumbar Decompression Versus Spinal Fusion ina Private Outpatient Setting: A Retrospective Study with Three Years of Follow-up / Descompressão lombar versus fusão espinhal em ambiente ambulatorial privado: Um estudo retrospectivo com três anos de acompanhamento

Abstract Objective To compare pain, function, quality of life and adverse events of lumbar decompression and spinal fusion in patients with degenerative spinal pathologies who participated in a second opinion program for spinal surgeries with a 36-month followup. Methods The data for this retrospective cohort were withdrawn from a private healthcare system between June 2011 and January 2014. The study sample consisted of 71 patients with a lumbar spine surgical referral. The outcomes for the comparisons between lumbar decompression and spinal fusion were quality of life (evaluated through the EuroQoL 5D), pain (measured by the Numerical Rating Scale) and function (assessed through the Roland Morris Disability Questionnaire) measured at baseline, and at 12 and 36 months after the surgical procedures. The definitions of recovery were established by the minimal clinically important difference (MCID). The baseline differences between the groups were analyzed by non-paired t-test, and the differences in instrument scores between time points, by generalized mixed models. The results were presented as mean values adjusted by the models and 95% confidence intervals. Results Concerning the surgical techniques, 22 patients were submitted to spinal fusion and 49 patients, to lumbar decompression. As for the comparisons of the findings before and after the surgical interventions, the MCID was achieved in all outcomes regarding quality of life, pain and function at both time points when compared to baseline scores Moreover, concerning the complication rates, only lumbar decompression presented a surgical rate of 4% (n = 3) for recurrence of lumbar disc hernia. Conclusion Patients with degenerative spinal pathologies present improvements in long-term outcomes of pain, function and quality of life which are clinically significant, no matter the surgical intervention.

Resumo Objetivo Comparar a dor, a função, a qualidade de vida e os eventos adversos da descompressão lombar e da fusão espinhal em pacientes com patologias degenerativas da coluna vertebral que participaram de um programa de segunda opinião para cirurgias de coluna com acompanhamento de 36 meses. Métodos Os dados desta coorte retrospectiva foram obtidos de um sistema de saúde privado entre junho de 2011 e janeiro de 2014. A amostra do estudo foi composta por 71 pacientes encaminhados para cirurgia de coluna lombar. Os desfechos para comparações entre a descompressão lombar e a fusão espinhal foram qualidade de vida (avaliada pelo questionário EuroQoL 5D), dor (medida pela Escala Numérica de Classificação de Dor) e função (avaliada pelo Questionário de Incapacidade de Roland Morris) no início do estudo e aos 12 e 36 meses de acompanhamento pós-cirúrgico. As definições de recuperação foram estabelecidas pela diferença mínima clinicamente importante (DMCI). As diferenças basais entre os grupos foram analisadas por teste t não pareado, e as diferenças nas pontuações dos instrumentos entre os momentos, por modelos mistos generalizados. Os resultados foram apresentados como valores médios ajustados pelos modelos e intervalos de confiança de 95%. Resultados No total, 22 pacientes foram submetidos à artrodese, e 49 pacientes, à descompressão lombar. Quanto às comparações de achados antes e depois das intervenções cirúrgicas, a DMCI foi alcançada em todos os desfechos de qualidade de vida, dor e função nos dois pontos de acompanhamento em relação aos escores basais Em relação às complicações, apenas a descompressão lombar apresentou 4% (n = 3) de taxa cirúrgica de recidiva da hérnia de disco lombar. Conclusão Pacientes com patologias espinhais degenerativas apresentam melhoras nos desfechos de dor, função e qualidade de vida em longo prazo que são clinicamente significativas e independentes da intervenção cirúrgica.

Evaluación del riesgo ergonómico por posturas forzadas en fisioterapeutas / Evaluation of ergonomic risk due to forced postures in physiotherapists

INTRODUCCIÓN. Los trastornos músculo esqueléticos son problemas de salud en el trabajo y causa de ausentismo laboral a nivel mundial, por lo que la valoración de los factores de riesgo laboral es necesaria para lograr prevención. OBJETIVO. Evaluar el nivel de riesgo ergonómico por posturas forzadas en los fisioterapeutas. MATERIALES Y MÉTODOS. Estudio descriptivo transversal. Población de 35 y muestra de 31 fisioterapeutas del Área de Medicina Física y Rehabilitación del Hospital de Especialidades Carlos Andrade Marín, agosto de 2020. Se aplicó el cuestionario nór-dico para conocer la percepción de la sintomatología osteomuscular; una lista de verificación rápida de condiciones de riesgo (ISO TR 12295); y, para medir el nivel de riesgo de posturas forzadas se aplicó los métodos OWAS REBA. RESULTADOS. El 96,77% (30; 31) tuvo sintomatología osteomuscular en los últimos 12 meses. Las zonas corporales con mayor afectación fueron: cuello 77,42% (24; 31), espalda alta 64,52% (20; 31), y espalda baja 58,06% (18; 31). REBA mujer: puntaje de 11; nivel de acción 4, riesgo muy alto; y, hombre: nivel de acción 3, riesgo alto. OWAS mujer: nivel 3; y, hombre: nivel 2. CONCLUSIÓN. Se evaluó el nivel de riesgo ergonómico por posturas forzadas en los fisioterapeutas. Existieron factores predisponentes para el desarrollo de trastornos músculo esqueléticos que han repercutido en el normal desarrollo de sus actividades. Las metodologías REBA y OCRA, evidenciaron que las actividades laborales presentaron un nivel de riesgo alto a muy alto, por lo que es necesaria la actuación en el mejoramiento del puesto de trabajo.

INTRODUCTION. Musculoskeletal disorders are occupational health problems and a cause of absenteeism worldwide, so occupational risk assessment is necessary to achieve prevention. OBJECTIVE. To evaluate the level of ergonomic risk due to forced postures in physical therapists. MATERIALS AND METHODS. Cross-sectional descriptive study. Population of 35 and sample of 31 physical therapists of the Phy-sical Medicine and Rehabilitation Area of the Carlos Andrade Marín Specialties Hos-pital, august 2020. The nordic questionnaire was applied to know the perception of musculoskeletal symptomatology; a quick checklist of risk conditions (ISO TR 12295); and, to measure the level of risk of forced postures the OWAS REBA methods were applied. RESULTS. The 96,77% (30; 31) had musculoskeletal symptomatology in the last 12 months. The most affected body areas were: neck 77,42% (24; 31), upper back 64,52% (20; 31), and lower back 58,06% (18; 31). REBA female: score of 11; performance level 4, very high risk; and, male: performance level 3, high risk. OWAS woman: level 3; and, man: level 2. CONCLUSION. The level of ergonomic risk due to forced postures of physiotherapists was evaluated. There were predisposing factors for the development of musculoskeletal disorders that have impacted on the normal development of their activities. The REBA and OCRA methodologies showed that the work activities presented a high to very high level of risk, which is why it is necessary to revise the activities assigned to this job position.

Enfermedades musculoesqueléticas y su asociación con el sobrepeso y obesidad en adultos mayores, un estudio transversal / Musculoskeletal diseases and their association with overweight and obesity in older adults, a cross-sectional study

Objetivo: determinar la prevalencia y la asociación de enfermedades musculoesqueléticas con el sobrepeso y obesidad, y las diferencias respecto a edad y sexo. Métodos: el presente estudio es de tipo transversal, descriptivo y analítico, el universo está compuesto por pacientes adultos mayores a 60 años con diagnóstico de enfermedades musculoesqueléticas que acuden a consulta en el periodo de enero a diciembre, del año 2019, en el centro de salud "Villa Oruro", en Tiquipaya, Cochabamba, Bolivia, con un muestreo no probabilístico por conveniencia, la muestra del estudio fue 353 pacientes. Resultados: se evaluó a 353 pacientes mayores a 60 años, 156 hombres y 197 mujeres, con una edad promedio de 71,51 ± 8,45 con índice de masa corporal promedio de 26,68 ± 1,77. Se realizó el análisis estadístico de asociación de variables categóricas, en base a rangos del índice de masa corporal (sobrepeso y obesidad) con las enfermedades musculoesqueléticas. Conclusiones: dentro de la evaluación del sobrepeso y obesidad, y su relación con patologías musculoesqueléticas, la gonartrosis es la más relacionada con la presencia de sobrepeso y obesidad, por lo que se recomienda establecer métodos de educación en la población con hábitos alimenticios y estilos de vida saludables para disminuir la prevalencia de enfermedades musculoesqueléticas asociadas a sobrepeso y obesidad.

Objectives: the aim of this study is to determine the prevalence and association of musculoskeletal diseases with overweight and obesity, and the differences with respect to age and sex. Methods: this type of study is cross-sectional, descriptive and analytical, the universe is composed of adult patients over 60 years of age with a diagnosis of musculoskeletal diseases who come for consultation in the period from January to December, year 2019, of the health center "Villa Oruro", Tiquipaya, Cochabamba, Bolivia, with a non-probabilistic sampling by convenience, the study sample was 353 patients. Results: we evaluated 353 patients over 60 years of age, 156 men and 197 women, with an average age of 71.51 ± 8.45 with an average body mass index of 26.68 ±1.77. Statistical analysis of association of categorical variables, based on body mass index ranges (overweight and obesity) with musculoskeletal diseases, was performed. Conclusions: within the evaluation of overweight and obesity, and their relationship with musculoskeletal pathologies, gonarthrosis is the most related to the presence of overweight and obesity, it is recommended and establish education in the population with healthy eating habits and lifestyles to reduce the prevalence of musculoskeletal diseases associated with overweight and obesity.