A painful symphony: the presence of overuse syndrome in professional classical musicians / Una sinfonía dolorosa: la presencia del síndrome de uso excesivo en músicos clásicos profesionales

Musculoskeletal problems are common in instrumental musicians. Little is known about the factors that place musicians at risk, and the ways in which musicians can prevent these problems. Overuse syndrome is the most reported diagnosis among instrumental musicians suffering from playing related musculoskeletal injuries. The study group comprised 50 musicians employed in Symphony Orchestra of the Serbian National Theatre of Novi Sad. Out of the 50 musicians, 30 (60 %) are male and 20 (40 %) female. Higher frequencies of the presence of musculoskeletal symptoms were neck, region of trapezius, back, shoulder, wrist, hand and arm. A larger number of musicians (81.8 %) had perception of high demand of the profession. This investigation with professional classical musicians should show the music-medical interest.

Los problemas musculo-esqueléticos son comunes en los músicos instrumentales. Poco se sabe sobre los factores que ponen en riesgo a los músicos y las formas en que los ellos pueden prevenir estos problemas. El síndrome de uso excesivo es el diagnóstico más informado entre los músicos instrumentales que sufren lesiones musculo-esqueléticas relacionadas al uso de instrumentos musicales. El grupo de estudio estuvo compuesto por 50 músicos de la Orquesta Sinfónica del Teatro Nacional Serbio de Novi Sad. De los 50 músicos, 30 (60 %) eran hombres y 20 (40 %) mujeres. La frecuencia más alta de presencia de síntomas musculoesqueléticos se produjo en el cuello, músculo trapecio, espalda, hombro, muñeca, mano y brazo. Un mayor número de músicos (81,8 %) tuvo una percepción de alta demanda de la profesión. Esta investigación con músicos clásicos profesionales debería ser de interés médico-musical.

Work-Related Musculoskeletal Disorders among Spine Surgeons / 대한정형외과학회잡지

PURPOSE: To investigate the prevalence and risk factors of musculoskeletal disorder (MSD) among spine surgeons. MATERIALS AND METHODS: A modified version of discomfort survey was sent via e-mail to surgeons that belong to the Korean Society of Spine Surgery. The survey questionnaires were composed of demographics, factors relating to spine surgery, and MSD. We investigated the common sites of occurrence of MSD and its risk factors. RESULTS: The survey was sent to a total of 420 subjects; of which, 80 subjects (19.0%) responded. About 78.8% of the respondents had MSD for the past year. The common sites of occurrence included the neck (52.5%), back (46.3%), and shoulder (18.8%). The prevalence of pain in the elbow joint/forearm was higher in the group performing a higher frequency of spine surgeries (p=0.033). Moreover, the prevalence of pain in the wrist/hand (p=0.008) and in the back (p=0.042) was higher in those with greater frequency of major surgeries (>10 case/year) as compared with those with lower frequency of major surgeries. CONCLUSION: As shown, about 78.8% of spine surgeons experienced MSD for the past one year. Its prevalence was higher as compared with the general population. Thus, more attention should be paid to the prevention of MSD among spine surgeons.

A case of occupational overuse syndrome improved, according to M-Test, with acupuncture / 全日本鍼灸学会雑誌

[Purpose]We report a case concerning 5 months of left elbow and knee joint pain thought to be caused by repetitive use at work. Symptoms were improved successfully (checked by M-test) by a single acupuncture treatment. <BR>[Case]We used acupuncture to treat a 50-year-old woman who visited our Acupuncture and Moxibustion Centerwith complaints of increasing elbow and knee joint pain in the left side. Since 4 months ago, her job involved frequent stair-climbing while carrying an 18-liter can of cooking oil. The soft tissues seemed to be damaged and caused pain due to the repeated lifting of heavy cans at work. Acu-points were decided by M-Test to check limitations of movement, which identified damaged regions and provided feedback for optimal treatment. According to the specific operations of the patient's work, we identified limited movements of left-elbow joint flexion-extension, left-shoulder joint extension, and left hip joint inner rotation and external gyration. These were regarded as target motions for the treatment. Her Visual Analog Scale (VAS) scores before treatment were 90 mm in the left elbow and 80 mm in the left knee. Despite only a single round of acupuncture treatment, the respective values dropped to 18 mm and 15 mm.<BR>[Consideration and Conclusion]The limited movement identified by M-Test could expose the affected areas and help in treating the appropriate acu-points. Therefore, acupuncture using M-Test might improve painful motions of the body.

Post-Thalidomide Syndrome at 50 Years / The Japanese Journal of Rehabilitation Medicine

Thalidomide embryopathy resulted in babies born with deformities such as phocomelia after their mothers took only a few tablets of thalidomide drug during 36 to 56 days after their last menstrual periods. There are two thalidomide embryopathy groups depending upon whether their hypoplasia is in the limbs or the auditory organs. In the limb group, deformities range from amelia to hypoplasia of the thumb. In the auditory group, the severity can be determined by the degree of deafness. This group is often associated with aplasia of the abducens and facial nucleus. Fifty years after the thalidomide scandal, the drug is still in use. It helps treat leprosy, multiple myeloma, AIDS and cachexia. As of June 2012, there are two hundred and ninetyfive victims still living in Japan. Disabilities include inadequate pinch and grasp, besides short reach. In the last two decades, the condition of these patients has worsened with chronic intractable pain due to overuse of hypoplastic skeletal muscles. They are now suffering from snapping fingers, stenosing tenosynovitis (trigger finger) and carpal tunnel syndrome. As their concomitant deformities or impairments include dislocation of the shoulder, droopy shoulders, hip dislocation, cervical block vertebrae, thoracic kyphosis, scoliosis, occult spina bifida, and L 6 lumbarization, these have become secondary etiologies for chronic pain, resulting in a dependent ADL condition. For these patients, physical exercise or recreation activities have become a viscous circle of ever increasing pain, weakness and fatigue. Furthermore, the resulting inactivity and weight gain has made ADL even more problematic. They also suffer from internal organ anomalies. Thus, a variety of problems including weakness and chronic intractable pain, which may be called post-thalidomide syndrome, has created an additional barrier for the surviving thalidomide embryopathy patients in social participation, as their aging is progressing.

Orthopedic disease and sports medicine related to lower limbs

In this study, the cause, diagnosis, and treatment of common lower limb injuries during the sports activities were presented. Sports injuries of the lower limbs are the most common injuries in the sports medicine field due to the high level of use of the lower limbs during sports activities. The common causes of leg injuries in athletes are traumatic force over the critical limit of normal tissue, repetitive microtrauma, and overuse. Common hip and pelvis problems encountered by the authors include trochanteric bursitis, snapping hip syndrome, and labral tears. The anterior and posterior cruciate ligaments, medial and lateral collateral ligaments, and meniscus have been most frequently involved in sports injuries affecting the knees. Lateral ankle sprain represents one of common injuries in the athletic population. Common overuse injuries are tendinopathies, stress fractures, chronic exertional compartment syndrome, and shin splints. Athletic activity provides a variety of positive benefits to participants' health. To safely continue those activities, an injury prevention program focusing on injuries that may occur in specific sports activities is recommended for participants. Early diagnosis and proper treatment are also important in promoting prompt recovery and preventing secondary injuries.

Prevalence of cumulative trauma disorders of the upper extremity and identification of risk factors among non-medical personnel in the University of the Philippines - Philippine General Hospital

OBJECTIVES: This cross-sectional study aimed to determine the prevalence of cumulative trauma disorders (CTDs) of the upper extremity among non-medical personnel of the University of the Philippines - Philippine General Hospital (UP-PGH) and to identify risk factors that may have contributed to their development. METHODS: A total of 87 participants from five different administrative divisions of the UP-PGH were included in this study. Three assessment tools were administered, namely: 1) symptom survey form, 2) Rapid Upper Limb Assesment, and 3) ergonomic workstation evaluation checklist. RESULTS: The study showed that the prevalence of CTDs of the upper extremity was 47.1%. The highest prevalence of CTDs was noted in the Budget division (75%), which was composed mainly of budget officers and clerks. The most common CTD indentified was myofascial pain syndrome. Among the socio-demographic factors, only handedness was significantly related to the development of CTDs (p=0.022).CONCLUSION: This study did not show a significant relationship between the identified risk factors and the development of CTDs. Awareness of the existence of CTD cases as documented in this study, however should raise concern from the authorities to implement corrective measures to reduce or prevent CTDs and to improve the general health and thus, productivity of the non-medical personnel at the UP-PGH.

O uso da termografia infravermelha na avaliação do retorno ao trabalho em programa de reabilitação ampliado (PRA) / The use of infrared thermography in evaluating returns to work in an extended rehabilitation program (PRA)

Em certas ocasiões, mesmo com tratamento corretamente instituído em pacientes com lesões por esforços repetitivos/distúrbios osteomusculares relacionados ao trabalho (LER/DORT), depara-se com situações de difícil julgamento quanto ao retorno ao trabalho. Muitas vezes por uma queixa persistente de não melhora dos sintomas ou quando associado a outras comorbidades, como síndrome fibromiálgica. O objetivo deste estudo foi comparar os padrões térmicos encontrados com a avaliação pericial de retorno ao trabalho de pacientes acometidos por LER/DORT, por meio de avaliação clínica e termográfica duplo-cega. Foram avaliados 128 pacientes, acometidos por LER/DORT de uma empresa do setor da agroindústria-frigorífico, onde um grupo de 62 pacientes foi selecionado para perícia quanto ao retorno ao trabalho. Destes, 3,2% tiveram retorno imediato ao trabalho, 77,4% afastamento por 60 dias, 6,4%, afastamento por 6 meses e 12,9% aposentadoria por invalidez. As alterações térmicas tiveram direta correlação com a classificação de retorno às atividades realizadas pelos peritos, segundo critérios de número de lesões, natureza etiológica, diferencial térmico e índice termográfico para síndrome fibromiálgica. A termometria cutânea por termografia infravermelha demonstrou-se como método complementar útil e objetivo no apoio a avaliação pericial para definição de capacidade ou incapacidade para o trabalho.

Even with proper treatment of patients with repetitive strain injuries/work-related musculoskeletal disorders (RSI/WRULD), on certain occasions returning to work can be a difficult judgment call. There are frequent complaints of symptoms not improving or combined with co-morbid associations such as fibromyalgia syndrome. The purpose of this study was to compare the thermal patterns found by a clinical return-to-work evaluation of patients with RSI/WRULD in a double-blind clinical thermographic study. 128 patients were studied suffering from RSI/WRULD from a meat-packing plant from which 62 patients were selected for evaluation to return to work. Of these, 3.2% were cleared for immediate return to work, 77.4% were kept out for 60 days, 6.4% were kept out for 6 months, and 12.9% were retired on disability. Thermal alterations had a direct correlation with the experts? work classifications according to the number of injuries, etiology, thermal differential, and thermographic index for fibromyalgia syndrome. Cutaneous thermometry by infrared thermography has proven itself a useful and objective supplementary method to support clinical evaluations in defining one?s capacity to work.