Professional experience, work setting, work posture and workload influence the risk for musculoskeletal pain among physical therapists: a cross-sectional study.

PURPOSE: Physical therapists (PTs) have a high risk of developing musculoskeletal pain (MP) due to the physically demanding nature of their work tasks. Experience or the specialty area, have been associated with MP, however, previous studies are few and small. The aim of this study was to investigate the association between work-related factors and MP among PTs. METHODS: In this cross-sectional study, we collected information about MP and work-related factors of 1006 PTs using an online questionnaire. Associations between various work-related factors and MP were modelled using logistic regression controlled for various confounders. RESULTS: Neck (57%) and low back pain (49%) were most common. Work-related factors associated with higher risk for having moderate-to-high MP (≥ 3 on a scale of 0-10) were "treating more patients at the same time" [OR 2.14 (95% CI 1.53-2.99)], "working ≥45 h per week" [OR 1.73 (95% CI 1.05-2.84)], and "work in a seated position" [OR 2.04 (95% CI 1.16-3.57)] for the low back. "More years of experience" showed a negative association for elbow pain [OR 0.41 (95% CI 0.21-0.78)] and low back pain [OR 0.48 (95% CI 0.29-0.79)] compared with their less experienced counterparts. CONCLUSIONS: The lack of professional experience, working in private clinics, working in a seated position and high workload are associated with the higher risk for MP among PTs. These results add further insight about the relevance of such factors, which might be considered for developing effective interventions to prevent work-related MP and better working conditions among PTs.

Preoperative high-intensity strength training improves postural control after TKA: randomized-controlled trial.

PURPOSE: This study investigates the effectiveness of preoperative high-intensity strength training (with a special emphasis on lower limb muscle strength and secondarily on balance training) on postural control after TKA. METHODS: Forty-four subjects (7 men, 37 women, and mean age 66.7 ± 3.9 years) scheduled for unilateral TKA for osteoarthritis (OA) participated in this randomized-controlled trial. Each patient performed two postural control tests: Romberg test with eyes open and closed. These tests were assessed at 8 weeks before surgery (T1), after 8 weeks of training (T2), 1 month after TKA (T3), and finally 3 months after TKA (T4). The intervention group completed an 8-week training program 3 days per week prior to surgery, while the control group received no intervention. RESULTS: The Center of Pressure area (COP) was lower (i.e., better score) for the intervention group at T2, T3, and T4. The anteroposterior range of COP with eyes open was lower in the intervention group at T2, T3, and T4 and with eyes closed at T2. The medial-lateral standard deviation of COP with eyes open was lower in the intervention group at T2 and T4 and with eyes closed at T2 and T3. The anteroposterior standard deviation of COP with eyes open did not change, while that with eyes closed the intervention group showed lower score at T2. CONCLUSION: Preoperative high-intensity strength training is effective for improving postural control before and early after TKA. Recommendations should include preoperative strength training, and not only balance training, to speed-up recovery of postural control after TKA. LEVEL OF EVIDENCE: 1.

Muscle Activity During Unilateral vs. Bilateral Battle Rope Exercises.

High training intensity is important for efficient strength gains. Although battle rope training is metabolically demanding, no studies have quantified intensity of muscle activity during this type of training. This study analyzes muscle activity during unilateral alternating waves vs. bilateral waves of battle rope training. Twenty-one volunteers participated in a repeated-measures study on 2 different occasions. Surface electromyographic signals were recorded from the anterior deltoid (AD), external oblique (OBLIQ), lumbar erector spinae (LUMB), and gluteus medius (GM) during bilateral waves and unilateral waves and were normalized to the maximum voluntary isometric contraction (MVIC). Results showed that muscle activity ranged from 51%MVIC to 73%MVIC for AD, OBLIQ, and LUMB, whereas GM muscle activity was only 14-18%MVIC. OBLIQ activation was significantly greater (20%MVIC; p = 0.02) with the unilateral waves compared with the bilateral waves, whereas LUMB signal was significantly higher (16%MVIC; p = 0.001) with the bilateral waves compared with the unilateral waves. In conclusion, both wave movements can be used to provide moderate to high levels of muscle activity in the AD, OBLIQ, and LUMB. Fitness practitioners aiming for higher OBLIQ activity should perform unilateral waves, whereas the bilateral variation of the movement can be used for higher LUMB activity.

The shoulder medial rotation test: an intertester and intratester reliability study in overhead athletes with chronic shoulder pain.

OBJECTIVE: The purpose of this study was to examine intertester and intratester reliability of the shoulder medial rotation test (MRT) and reliability differences depending on examiner expertise. METHODS: Seventeen athletes with chronic shoulder pain participated in the study. Four independent observers with different experience levels simultaneously rated MRT performance as "correct" or "incorrect," after a standardized assessment protocol, the same day (for intertester reliability) and in a 7-day interval (for intratester reliability). RESULTS: The intrarater reliability was admissible for 2 experts and one novice, with κ values ranging between 0.32 to 0.76 and poor for one novice (κ <0). Interrater agreement for all 4 assessors demonstrated slight agreement (κ = 0.06; 95% confidence interval: 0.06-0.47), increasing to fair agreement (κ = 0.33; 95% confidence interval: 0.21-0.69) when comparing the MRT findings between the 2 experienced assessors. Practice with the MRT in novices only marginally improved their level of agreement. CONCLUSIONS: Reliability of the MRT for detecting movement control of the shoulder girdle was fair at best for experienced examiners and poor overall. Dexterity and repetitive performance of the test is necessary for correct interpretation of the MRT.