Frequency and risk factors of musculoskeletal disorders in high risk occupation workers in Urban, Karachi.

OBJECTIVE: To determine the frequency and risk factors of musculoskeletal disorders in high-risk occupation workers in an urban setting. METHODS: The analytical cross-sectional study was conducted in Karachi from July to December 2020, and comprised office workers, operation theatre technicians and coolies. The presence of musculoskeletal disorders was assessed using the Nordic Musculoskeletal Questionnaire to determine factors associated with moderate to severe condition. Data was analysed using SPSS 20. RESULTS: Of the 300 male subjects, 100(33.3%) each were office workers, operation theatre technicians and coolies. The overall mean age was 33.25±6.8 years (range: 18-50 years). The overall prevalence of musculoskeletal disorders was 179(59.7%). Besides, 117(65.4%) patients with musculoskeletal disorders had intermediate stage of the disease. The lower back and neck were the most common site of trouble involved in preceding 12 months 111(43.6%) each. CONCLUSIONS: Prevalence of musculoskeletal disorders was found to be a common problem affecting high-risk occupational workers.

Work-Related Musculoskeletal Disorders and Mental Health among Nursing Personnel in the Context of COVID-19 Pandemic in West Bengal, India

Introduction: COVID-19 outbreak created enormous turmoil all over the world. The health sectors were overburdened with critically ill COVID-19 patients. The load on the health sector burdened and fatigued the health care workers especially the nursing personnel as they were in direct contact with the symptomatic patients predominantly. In each wave, the patients' number surged and overwhelmed the health sectors. In this study, the prevalence of work-related musculoskeletal disorders (WMSDs) discomfort and mental exhaustion among the nursing personnel were assessed. Methods: The duration of the study was from the end of September 2021 to March 2022. The factors that sourced the discomfort symptoms amidst and the interludes of the later waves of COVID-19 and their interrelations were also assessed here. The Modified Nordic Questionnaire and the COVID Stress Scales (CSS) were used in this study. Results: 73.9% of subjects (N=88) reported the presence of WMSDs symptoms in at least one body region in the last one-year time period with the most prevalent discomfort in the lower back region (42%), followed by discomforts in the ankles, neck, and knee. The mean value of the total score of CSS was 33.74(±19.90) with high mean values in compulsive checking, danger, and contamination subscales. This study showed significant positive correlations between the presence of WMSD symptoms with BMI (rs=0.266, p= 0.012) and CSS total scores (rs=0.216, p=0.043). Conclusion: Large percentages of reports on musculoskeletal discomforts with reports on mental enervation related to COVID-19 indicated weariness of the nursing personnel. The physical exhaustion due to overloading work and the interplay between mental stress and WMSDs revealed pivotal issues of concern. © 2023 The Author(s).

Effectiveness of eHealth therapeutic education interventions in the management of fibromyalgia: protocol for a systematic review and meta-analysis.

INTRODUCTION: Non-pharmacological approaches have shown promising results in improving symptoms and quality of life of patients with fibromyalgia. However, these approaches may not be easily accessible or feasible for everyone. eHealth interventions may offer a more convenient and cost-effective approach to reach a wider range of patients with fibromyalgia and improve their outcomes. As eHealth tools become more prevalent in clinical practice, it is crucial to understand their effectiveness, limitations and how they can be integrated into standard care to optimise clinical outcomes. This systematic review aims to evaluate the effectiveness of eHealth therapeutic education interventions in managing fibromyalgia. METHODS AND ANALYSIS: Randomised controlled trials including eHealth therapeutic education interventions for individuals ≥18 years old with fibromyalgia, published in English or Spanish, will be retrieved by searching the databases PubMed, CINAHL Plus, EMBASE, Scopus, ISI Web of Science, PsycINFO and the Cochrane Central Register of Controlled Trials. Covidence software will be used for the selection of studies and data extraction. The risk of bias and the certainty of evidence will be assessed using the Cochrane Risk of Bias Assessment tool. We plan to perform a meta-analysis contingent on the number of studies retrieved and the interstudy heterogeneity, which will be explored with I2 statistics. ETHICS AND DISSEMINATION: This protocol and the subsequent systematic review will not collect individual-level data and do not require approval by an ethical committee. We intend to disseminate the study results via peer-reviewed scientific journals and relevant (inter)national conferences. PROSPERO REGISTRATION NUMBER: CRD42022343373.

Evaluation of Musculoskeletal Disorders and the Effect of Ergonomic Conditions in Karadeniz Technical University Students Receiving Distance Education Due to COVID-19

Objective: The aim of the study was to evaluate the effects of musculoskeletal disorders (MSDs) and ergonomic conditions in Karadeniz Technical University students who received distance education due to coronavirus disease-2019 (COVID-19). Methods: The population of this descriptive study consisted of 33,219 students at Karadeniz Technical University. Three hundred two university students selected using the convenience sampling method were included in the study by completing the questionnaire completely. Participation in the research was based on volunteering. The questionnaire consisted of sociodemographic and personal characteristics, online education and work environment characteristics, Cornell Musculoskeletal Disorders Questionnaire and International Physical Activity Questionnaire Short Form. Results: The mean of participants' Total Cornell Score was 76.6 +/- 97.3 (0-624). The chairs used by 205 (67.9%) of the participants during the lesson did not have wheels and 360 degrees rotation feature. Total Cornell Score of the participants without head-neck and lumbar support was statistically significantly higher than those with head-neck and lumbar support (p values were 0.009 and 0.006, respectively). The Total Cornell Score was statistically significantly higher in the participants who could not put their feet on the ground completely while sitting on the chair compared to the participants who could keep their feet on the ground completely (p=0.018). The Total Cornell Score was statistically significantly lower in those who had adequate lighting in the room used during the lesson than those who did not have (p=0.028). Conclusion: This study showed the importance of providing ergonomically appropriate conditions in the working environment in order to prevent musculoskeletal disorders.

Face shield use and its relation to musculoskeletal disorders among health practitioners

Introduction: The COVID-19 pandemic highlighted the importance of the use of personal protective equipment (PPE) such as a face shield, face mask, and protective eyewear by Health Care Workers (HCWs). Research has documented that usage of PPEs could lead to musculoskeletal disorder (MSDs), headache, impingement of neck etc. Objective(s): To identify the perceptions of face-shield use and its relation to MSDs among Health Practitioners (HPs). Material(s) and Method(s): An online cross-sectional survey was conducted among 145 Health Practitioners (HPs) in Chennai during April and September 2021 to identify their perceptions about wearing a face shield and MSDs using a validated self-administered questionnaire. We analysed the data using Pearson's chi-squared test on SPSS. Result(s): Among 145 HPs, 52.4% reported to have experienced MSDs. 44.7% of the HPs reported MSDs due to continuous wearing of the face shield. This was found to have a significant association. It was found that 95% of the HPs reported discomfort and poor visual clarity. The MSD risk was 3.4 times higher among those HPs using PPEs (95% CI: 1.03-11.28;p=0.035). 72% of them perceived that movement restriction due to PPE had caused MSD. Those who perceived thus, were 2.5 times more likely to experience MSD (95%CI: 1.27-5.07;P=0.007). Although, the duration of PPE use was not associated with MSD, 9% of the HPs who work for more than 6 hrs reported higher MSD. A significant association was found between having previous history of work-related MSDs and prevalence of MSDs among the HPs (OR: 9.5;95% CI: 2.71-33.53;p=0.000). Conclusion(s): Majority of the participants perceived discomfort, lack of visual clarity, movement restriction as factors that were found to be significantly associated with MSD among HPs. Recommendation: Hence adaptation and proactive intervention are required to safeguard HPs against the detrimental effects of face shields.

Physical and cognitive impairments in people suffering from long COVID: protocol for a longitudinal population-based cohort study.

INTRODUCTION: Approximately 33% of people who contracted COVID-19 still experience symptoms 12 weeks after infection onset. This persistence of symptoms is now considered a syndrome itself called 'long COVID'. Evidence regarding long COVID and its cognitive and physical impacts is growing, but the literature is currently lacking objectively measured data to guide towards adapted healthcare trajectories. The objectives are to describe the physical and cognitive impairments experienced by individuals living with long COVID using self-reported and clinical objective measures, and to compare the evolution over time of the physical and cognitive state between adults living with long COVID (at least one physical or cognitive COVID-19 symptom for more than 12 weeks following infection; long COVID group), people who developed COVID-19 but did not experience persistent symptoms (short COVID group) and people who did not develop COVID-19 (control group). METHODS AND ANALYSIS: In this longitudinal cohort study, 120 participants will be recruited in each group. Variables will be collected through three evaluation sessions over 6 months (baseline, 3 months, 6 months). Variables include self-administered questionnaires on health-related quality of life, comorbidity, sleep, pain, anxiety, depressive symptoms, fatigue and cognitive function, as well as objective measures of cognitive (attention, memory, executive functioning) and physical (grip strength, balance, gait speed, gait endurance, VO2, frailty) functions. Activity, heart rate and sleep will be monitored with a fitness tracker watch for 7 days following evaluation sessions. Maximum-likelihood analyses of variance (ANOVAs) will be used to compare data at baseline between groups. Repeated measures ANOVAs will be used to compare the longitudinal performance variations across groups of the self-reported and clinical variables. ETHICS AND DISSEMINATION: Ethics committees of the CIUSSS de la Capitale-Nationale and CIUSSS de l'Est-de-l'Île-de-Montréal approved the project. Results will be disseminated through clinical and community platforms as well as through peer-reviewed manuscripts and international conferences. TRIAL REGISTRATION NUMBER: NCT05216536.

Emerging role of mesenchymal stem/stromal cells (MSCs) and MSCs-derived exosomes in bone- and joint-associated musculoskeletal disorders: a new frontier.

Exosomes are membranous vesicles with a 30 to 150 nm diameter secreted by mesenchymal stem/stromal cells (MSCs) and other cells, such as immune cells and cancer cells. Exosomes convey proteins, bioactive lipids, and genetic components to recipient cells, such as microRNAs (miRNAs). Consequently, they have been implicated in regulating intercellular communication mediators under physiological and pathological circumstances. Exosomes therapy as a cell-free approach bypasses many concerns regarding the therapeutic application of stem/stromal cells, including undesirable proliferation, heterogeneity, and immunogenic effects. Indeed, exosomes have become a promising strategy to treat human diseases, particularly bone- and joint-associated musculoskeletal disorders, because of their characteristics, such as potentiated stability in circulation, biocompatibility, low immunogenicity, and toxicity. In this light, a diversity of studies have indicated that inhibiting inflammation, inducing angiogenesis, provoking osteoblast and chondrocyte proliferation and migration, and negative regulation of matrix-degrading enzymes result in bone and cartilage recovery upon administration of MSCs-derived exosomes. Notwithstanding, insufficient quantity of isolated exosomes, lack of reliable potency test, and exosomes heterogeneity hurdle their application in clinics. Herein, we will deliver an outline respecting the advantages of MSCs-derived exosomes-based therapy in common bone- and joint-associated musculoskeletal disorders. Moreover, we will have a glimpse the underlying mechanism behind the MSCs-elicited therapeutic merits in these conditions.

Prevalence of Work-Related Musculoskeletal Disorders and Its Effects amongst Nurses in the Selected Intellectual Disability Unit of the Limpopo Province.

The COVID-19 pandemic continuously highlights the need for occupational health and safety among healthcare professionals. Physical and mental health safety resulting from needle prick injuries, stress, infections, and chemical hazards are priority work-related musculoskeletal disorders for nurses, including those working in the intellectual disability unit. The intellectual disability unit provides basic nursing care to patients with known mental disabilities, such as learning, problem-solving, and judgment problems, which demand diverse physical activities. Nevertheless, the safety of nurses within the unit receives little attention. Thus, we adopted a quantitative cross-sectional epidemiological survey design to determine the prevalence of work-related musculoskeletal disorders amongst nurses working in the intellectual disability unit at the selected hospital in Limpopo Province, South Africa. A self-administered questionnaire collected data from 69 randomly selected nurses from the intellectual disability unit. Data were extracted, coded, and captured in MS Excel format (2016) and imported into the IBM Statistical Package for the Social Sciences (SPSS), software version 25.0, for analysis. The study reported a low (38%) prevalence of musculoskeletal disorders in the intellectual disability unit, with significant effects on nursing care and staffing. The effects of these WMSDs included missing work, interference with the daily routine, disturbance with sleeping patterns after work, and absenteeism from work. Since intellectually disabled patients depend entirely on nurses for the basic activities of daily living, this paper recommends the incorporation of physiotherapy among nurses in the intellectual disability unit to treat the incidence of lower back pain while mitigating nurses missing work or absenteeism.

Changes to consultations and diagnosis of osteoarthritis in primary care during the COVID-19 pandemic.

OBJECTIVE: General practitioners (GP) are often the first medical professionals to treat musculoskeletal complaints. Yet the impact of COVID-19 on primary care utilisation for musculoskeletal complaints is largely unknown. This study quantifies the impact of the pandemic on primary care utilisation for musculoskeletal complaints and specifically osteoarthritis (OA) in the Netherlands. DESIGN: We extracted data on GP consultations in 2015-2020 from 118,756 patients over 45 years of age and estimated reductions in consultations in 2020 as compared to 5-year average. Outcomes were GP consultations for: any musculoskeletal complaints, knee and hip OA, knee and hip complaints, and newly diagnosed knee and hip OA/complaints. RESULTS: The relative reductions in consultations ranged from 46.7% (95% confidence intervals (CI): 43.9-49.3%) (all musculoskeletal consultations) to 61.6% (95% CI: 44.7-73.3%) (hip complaints) at the peak of the first wave, and from 9.3% (95% CI: 5.7-12.7%) (all musculoskeletal consultations) to 26.6% (95% CI: 11.5-39.1%) (knee OA) at the peak of the second wave. The reductions for new diagnoses were 87.0% (95% CI: 71.5-94.1%) for knee OA/complaints, and 70.5% (95% CI: 37.7-86.0%) for hip OA/complaints at the peak of the first wave, and not statistically significant at the peak of the second wave. CONCLUSION: We observed 47% reduction in GP consultations for musculoskeletal disorders during the first wave and 9% during the second wave. For hip and knee OA/complaints, the reductions were over 50% during the first, and 10% during the second wave. This disruption may lead to accumulation of patients with severe OA symptoms and more requests for arthroplasty surgery.

[The influence of working/learning remotely on the prevalence of musculoskeletal complaints in a group of university staff and students]. / Wplyw pracy/nauki zdalnej na wystepowanie dolegliwosci miesniowo-szkieletowych w grupie pracowników i studentów uczelni wyzszych.

BACKGROUND: The COVID-19 pandemic has led to a fundamental change in the lifestyle and the ways of learning and working patterns which in turn might lead to health consequences including musculoskeletal disorders. The aim of this study was to evaluate the conditions of e-learning and remote working and the impact of the learning/working modality on the occurrence of musculoskeletal symptoms among university students and workers in Poland. MATERIAL AND METHODS: This study covered 914 students and 451 employees who filled in an anonymous online questionnaire. The questions covered 2 periods: before the COVID-19 pandemic and during the period from October 2020 to June 2021 and were aimed at obtaining information about lifestyle (including physical activity, perceived stress and sleep pattern), ergonomic of computer workstations, the incidence and severity of musculoskeletal symptoms and headaches. RESULTS: During the outbreak, the severity of musculoskeletal complaints increased significantly in the teaching staff group (3.2±2.5 vs. 4.1±3.0 VAS pts), in the administrative staff group (3.1±2.5 vs. 4.0±3.1 VAS pts), and in the student group (2.8±2.4 vs. 3.5±2.8 VAS pts). The average level of burden and risk of musculoskeletal complaints was revealed by the assessment using the ROSA method, in all 3 study groups. CONCLUSIONS: In light of current results, it is very important to educate people on the rational use of new technology devices, including the appropriate design of computer workstations, planning breaks and time for recovery and physical activity. Med Pr. 2023;74(1):63-78.

Effect of physical activity intervention on the musculoskeletal health of university student computer users during homestay.

Objectives. The coronavirus outbreak delivered the condition of dying from infection and forced people (especially university student computer users) to perform all working and non-working activities during homestay. In this situation, device usage for a longer duration is mainly responsible for work-related health issues. This study aims to discover the effect of a physical activity intervention (PAI) on computer users' musculoskeletal health during homestay. Methods. The investigation was performed on 40 university student computer users. To measure body discomfort before and after using the PAI, the body part discomfort scale of Corlett and Bishop was applied. Results. After implementing the PAI, the musculoskeletal disorder (MSD) decrement in major body regions was reported as wrist/forearm (from 8.17 ± 1.45 to 4.57 ± 1.10), lower back (from 8.01 ± 1.42 to 4.40 ± 1.14), elbow (from 7.57 ± 1.71 to 3.49 ± 1.13) and neck (from 7.40 ± 1.71 to 4.02 ± 0.81). Conclusions. PAI significantly decreased the discomfort among users in various body regions. This research suggested that PAIs may reduce the risk of MSDs in the long term for different body regions.

Remote working during the COVID-19 pandemic: Computer-related musculoskeletal symptoms in university staff.

BACKGROUND: The COVID-19 pandemic resulted in mandatory remote working for workers in many sectors, including education. OBJECTIVE: This study aimed to investigate the physical characteristics of workspaces, computer use, and prevalence, associated factors, and reported impact of computer-related musculoskeletal symptoms (MSS) among university staff during the COVID-19 pandemic. METHODS: A cross-sectional study of staff in a university in Ireland was conducted in March 2021. An anonymous online survey of computer use, work practices and 3-month prevalence and the reported impact of computer-related MSS (modified Nordic Musculoskeletal Questionnaire) was conducted. Data analysis involved descriptive statistics and factors associated with MSS were ascertained using chi-squared analysis. RESULTS: The analysis included 1045 responses. The majority (63%) worked solely from home, used a laptop more frequently than a desktop computer, and worked a greater number of hours. Almost half (48%) did not have a dedicated home workspace. More respondents reported their university workspace (72%) was more comfortable than their home workspace (51.2% ; p <  0.0001). Prevalence of computer-related MSS was 83% : neck (62%), shoulder (57%), lower back (47%). Laptop-related MSS was reported more frequently (82%) than desktop-related MSS (65% ; p <  0.05). Computer-related MSS was associated with workspace, equipment at home, laptop use, female gender, and righthandedness (p <  0.05). A reduction in non-work-related activities (35%), work activities (18%) and seeking medical attention (24%) was reported. CONCLUSION: The prevalence of computer-related MSS was high and associated with remote working. Further studies that aim to mitigate the risks of computer-related MSS in those working remotely or in hybrid models are required.

A Research on Home Workers' Work-Related Musculoskeletal Disorders in Pandemic Period

Working life has been transformed and its dynamics experienced a new break with the Covid-19 outbreak which made working home model as a new normal. Coronavirus caused significant changes in all aspects of life, which an important one was compelling people staying and working home. Hence, increasing sedentary lifestyle and spending more time on internet and television affected musculoskeletal health negatively. The aim of this study is to investigate the impact of working home arrangements on work related musculoskeletal disorders (WMSD) during Covid-19 pandemic. Research was conducted with a group of 424 participants who experienced working home style in pandemic period in Turkey. A questionnaire containing demographic questionnaire and Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) was sent to participants. The findings of this study showed that the working home arrangements during pandemic period worsened the musculoskeletal health of the participants. It is predicted that this deterioration will continue to increase with the continuation of working from home. Consequently, in order to decrease this negative situation, organizations and individuals should take the necessary precautions, regulations and training.

Risk factors of musculoskeletal disorders in loading and unloading tasks of couriers.

BACKGROUND: The use of home delivery services has expanded due to coronavirus disease - 2019, and couriers' high level of work intensity has become a severe social issue in various nations. OBJECTIVE: This study investigates the risk factors of musculoskeletal disorders (MSDs) caused by frequent loading and unloading actions, known to be the most demanding tasks for couriers. METHODS: A self-report survey and post-hoc interview were employed to collect personal information, task frequency, and the incidence of MSDs. Frequent actions during loading and unloading packages were identified, and the Rapid Entry Body Assessment (REBA) and National Institute for Occupational Safety and Health (NIOSH) lifting equations were assessed. RESULTS: Approximately 29.5% of the 44 subjects suffered from MSDs, and identify the types of actions that frequently occur during loading and unloading packages. According to the REBA survey, 60% of the responses for both loading and unloading are distributed within the risk range of 8-13 points, suggesting a high risk (mean REBA score: 8.8 (loading), 8.5 (unloading)). In every case, NIOSH determined that the lifting index (LI) was harmful (mean LI: 1.62). Thereby, the bending or twisting posture of the hands and neck, long horizontal distance between the packages and the body, and high lifting frequency were identified as major problems. CONCLUSION: The study identified a very high level of musculoskeletal risk for couriers, and the detailed working methods and body parts vulnerable to MSDs.

Effects of COVID-19 home confinement on musculoskeletal health and physical performance in a cross-sectional study: results of the COVID-19 era online survey.

Introduction: the global pandemic of COVID-19 is the unique health crisis, the populations were exposed to situations of unprecedented confinement, this represents a major public health challenge, with a high risk of developing musculoskeletal disorders. The objective of the present work is to identify the potential effects of sedentary behavior on musculoskeletal health and physical performance. Methods: after two months of confinement a survey was uploaded and shared on Google's online survey platform. Two research laboratories, University Moulay Ismail, University Ibn Tofail, promoted the survey which was developed on the basis of two questionnaires: the French version of the Nordic questionnaire musculoskeletal disorders and the French version of the Global Physical Activity Questionnaire (GPAQ). Results: out of 384 respondents, 209 (54.4%) were females 124 (32.3%) were between 30-49 years old (6.8%) and 123 (32%) had an underweight and overweight levels, respectively. One hundred and thirty-nine 139 (36.2%) reported sitting more than eight hours. The results of our survey show that many of our respondents had developed some sort of musculoskeletal pain during the confinement. One hundred and sixty two (42.2%) reported to have pain in the lower back region, 108 (28.1%) of participants reported to have pain in the neck region, 93 (28.2%) in the shoulder region, 97 (25.3) - in the upper back region and more women than men reported musculoskeletal pain in more than five regions. The results of our survey also show that 322 (83,9%) of the participants, after two months of confinement, were unable to do high intensity exercises for at least 10 min per day in their usual daytime activity, the prevalence of musculoskeletal pain differed across categories of body mass index (BMI) between males and females, (p<0.05). Conclusion: the results of this study show the existence of musculoskeletal disorders and deterioration in physical performance and strongly recommend the urgent implementation of prevention and remediation interventions.

Troubles musculo-squelettiques, pratique instrumentale et ressentis des musiciens d'orchestre professionnels en confinement dû à la COVID-19

Résumé Introduction: Les musiciens d’orchestre professionnels souffrent fréquemment de troubles musculo-squelettiques liés à leurs conditions de travail. Au printemps 2020, le confinement et l’arrêt des activités professionnelles liés à la pandémie de la COVID-19 pouvait présenter une opportunité de récupération mais également augmenter leur incertitude professionnelle et être source d’émotions négatives. Objectif: Le premier objectif est d’évaluer l’évolution des troubles musculo-squelettiques des musiciens professionnels liée à l’arrêt des activités professionnelles provoqué par la COVID-19. Le second est d’examiner l’impact de l’incertitude professionnelle générée par la pandémie et le confinement sur la pratique instrumentale, en fonction des émotions qu’elle a provoquées. Méthode: Un questionnaire sur la pratique instrumentale et les troubles musculo-squelettiques a été renseigné par 439 musiciens d’orchestres français en 2019 (période d’activité professionnelle). Pendant le confinement (avril 2020), un second questionnaire portant sur ces variables ainsi que sur l’incertitude professionnelle, les émotions, l’épuisement émotionnel et le vécu du confinement a été renseigné par 172 musiciens. Résultats: La pratique instrumentale et la prévalence des troubles musculo-squelettiques ont chuté entre les périodes d’activité et de confinement. L’incertitude professionnelle pendant le confinement corrélait aux émotions négatives. L’épuisement émotionnel médiatisait les relations entre l’incertitude et l’effort perçu à pratiquer son instrument, d’une part, et le plaisir ressenti, d’autre part. Conclusion: Pour les musiciens d’orchestre confinés, l’incertitude était associée aux émotions négatives. Jouer de son instrument demandait plus d’effort et n’était pas un facteur de bien-être, soulignant les difficultés pour une reprise de l’activité professionnelle dans des conditions qui limiteraient le risque de blessures. Introduction: Professional orchestra musicians frequently suffer from musculoskeletal disorders related to their working conditions. In the spring of 2020, the lockdown and the interruption of their professional activities because of the COVID-19 pandemic could have presented an opportunity for them to recuperate but could also have increased their professional uncertainty and been a source of negative emotions. Objective: The first objective is to evaluate the evolution of musicians’ musculoskeletal disorders in relation to the interruption of their professional activities due to COVID-19. The second is to examine the impact of professional uncertainty caused by the pandemic on their instrument practice as a function of the emotions it generated. Method: A questionnaire concerning instrument practice and musculoskeletal disorders was completed by 439 French orchestra musicians in 2019 (period of professional activity). During lockdown (April 2020), a second questionnaire measuring these variables as well as professional uncertainty, emotions, emotional exhaustion, and the lockdown experience was completed by 172 musicians. Results: Instrument practice and musculoskeletal disorders decreased between the periods of activity and lockdown. Professional uncertainty during lockdown correlated with negative emotions. Emotional exhaustion mediated the relations between uncertainty and the effort perceived when practicing one’s instrument on the one hand and the pleasure experienced during practice on the other. Conclusion: For orchestra musicians in lockdown, uncertainty was related to negative emotions. Playing their instrument required more effort and was not associated with well-being, emphasizing the difficulties regarding the resumption of their professional activity in conditions which would limit the risk of injury.

Efficiency & Outcomes of Direct Access to Physical Therapy for Musculoskeletal Disorders vs Physician-First Access in the US Panel Session: Panel Session

Musculoskeletal disorders effect one in every two Americans costing $213 billion a year. They are also the #1 cause of disability worldwide. With advancements in medicine and technology, the cost and disability rates of musculoskeletal disorders (MSDs) continues to escalate. Speakers will discuss innovative ways to reduce the musculoskeletal epidemic through proven results and published research on the cost effectiveness of physical therapy (PT) and virtual care from employer, employee and overall impact on the healthcare market. Discussion topics Outcomes of specialty trained PTs in MDT vs traditional community care? What is PT Direct Access and what the APTA’s stance is on both DA and telePT? What does published research tell us about the cost effectiveness of PT Direct Access? Misdiagnosis and training vs MDs? What’s the primary dilemma of the traditional model of care for MSDS? How has teleheath impacted traditional care for MSDS? What are the strengths and weaknesses of telerehab? What are the main obstacles and misperceptions to Direct Access? Since COVID 19, what are the obstacles to telerehab? What are the outcomes for WorkComp, Self-Pay and Group Health?

Healthcare professionals' perceptions and experiences of physiotherapy for people with mental illness: a protocol for a systematic review and meta-ethnography.

INTRODUCTION: There is a high global prevalence of patients presenting with physical and mental health comorbidities. Physiotherapeutic interventions, such as exercise, can have positive benefits for physical and mental health. However, poor accessibility and negative experiences of healthcare services for those with mental illness (MI) have been consistently observed within literature with recent research identifying poor experiences of physiotherapeutic interactions and processes such as referrals and discharges. One way to help improve physiotherapy services for this population is to understand the personal experiences and perceptions of healthcare professionals (HCPs) toward physiotherapy for patients with MI. Qualitative-based evidence syntheses are suited to bring this data together with the aim of improving physiotherapy services for patients with MI. This review will systematically search and synthesise existing evidence around HCP experiences and perceptions of physiotherapy for people with MI. METHODS AND ANALYSIS: A systematic search and seven-phase meta-ethnography will be undertaken. A comprehensive search of electronic databases (CINAHL plus, MEDLINE, Pubmed, Embase and Psycinfo) and search engines as well as grey literature (unpublished primary research such as theses) will be completed. Searches are planned to take place in July 2022. Eligibility criteria include: (a) qualitative data, (b) perceptions identified from HCP, including physiotherapists, assistants and HCP referring into physiotherapy, about physiotherapy for patients with MI and (c) are primary studies. ETHICS AND DISSEMINATION: This work is exempt from requiring ethical approval due to review methodology with data accessed from published works. This systematic review is expected to provide insight into experiences and perceptions of HCP around benefits and barriers to accessing physiotherapy for patients with mental health illness. Findings will be used to inform further research and co-develop recommendations to overcome barriers and optimise facilitators to care for this population. Findings will be disseminated via peer-reviewed journal, conference presentations and to key stakeholder groups. PROSPERO REGISTRATION NUMBER: CRD42021293035.

Effects of combining electrical stimulation of the calf and thigh muscles in patients with osteoarthritis of the knee: protocol for a double-blind, randomised, sham-controlled trial.

INTRODUCTION: Knee osteoarthritis (KOA) is a leading cause of disability and is characterised by degenerative changes causing pain and loss of function. Neuromuscular electrical stimulation (NMES) has been shown to influence muscle size and strength in healthy subjects. A novel self-administered NMES device has been developed to help manage the symptoms of KOA. This study aims to investigate the effects of combining NMES of the calf and quadriceps on individuals with KOA. METHODS AND ANALYSIS: 193 individuals with KOA will be recruited to a single-centre, double-blind, randomised, sham-controlled trial at the Respiratory Biomedical Research Centre, Leicester, UK. Participants will be randomised (1:1) to follow an 8-week home-based intervention using a NMES device or sham device. The NMES device consists of footplate electrodes and two quadriceps electrodes. Footplate stimulation will be completed daily for 30 min and quadriceps stimulation for 20 min, five times a week (compliance is recorded in a self-reported participant diary). The primary outcome is the Western Ontario and McMaster Universities Arthritis Index pain domain, taken at 8 weeks follow-up. Secondary outcomes will explore quadriceps muscle strength, swelling, health-related quality of life, exercise capacity, anxiety and depression, sleep, physical activity and self-reported compliance. A powered subgroup analysis for compliance to the active device will be complete for the primary outcome. Participant focus groups will be completed following recruitment of half of the participants and after all participants have been recruited. ETHICS AND DISSEMINATION: Ethical approval has been obtained from the North-West Preston ethics committee (17/NW/0081). Participants are required to provide informed consent following review of the participant information sheet and discussion regarding study procedures with a member of the research team. The study results will be disseminated to the appropriate stakeholders through presentations, conferences and peer-reviewed journals. Results will be presented to participants following study completion at the Biomedical Research Centre-Respiratory, Glenfield Hospital, Leicester. TRIAL REGISTRATION NUMBER: ISRCTN registry, ISRCTN12112819 (date registered 1 May 2019). IRAS registry 219 693. University Hospitals of Leicester registry 91 017. Protocol Version 8.

SHORT-TERM IMPACTS OF MOBILE TOUCH-SCREEN DEVICE USE ON MUSCULOSKELETAL DISORDERS DURING COVID-19 PANDEMIC: RISK ASSESSMENT MODELLING AND VERIFICATION

The intensive and repetitive use of touch-screens may pose significant problems, such as ergonomic pain or musculoskeletal disorders. This research aims to study the effect of using mobile touch-screen devices on the human musculoskeletal system during the COVID-19 pandemic lockdown and to develop a model for classifying the effects of musculoskeletal stress (pain and discomfort) on the performance of educational activities. The Cornell musculoskeletal discomfort questionnaire was given to 544 participants (71% males and 29% females). An Association Rule Mining approach was applied to illustrate the correlation, and multiple machine-learning models – used to predict the impact of pain and discomfort on different body regions – were applied to determine risk levels that might interfere with the ability to perform daily activities. Most musculoskeletal disorders were reported in the neck region and lower back (64.33% and 55.33% respectively), followed by upper back (44.30%) and the right shoulder (38%). Analysis of association rules showed high positive correlation between the lower back and the neck (support = 43%, confidence = 77%). Additionally, it was found that the radial basis function network has the highest accuracy in prediction (84%). The results of the radial basis function model showed that interference in educational activities can be predicted by using pain indicators in body parts resulting from touch-screen device usage. © 2022, South African Institute of Industrial Engineering. All rights reserved.