Promoting running as the best treatment for lower back pain in physiotherapy practice: a best practice implementation project.

OBJECTIVES: This project aimed to promote running as the best treatment for lower back pain (LBP) in an outpatient setting. INTRODUCTION: LBP is one of the most prevalent conditions worldwide. Sixty-two percent of all Germans experience episodes of non-specific back pain at least once a year, with one-fifth developing chronic conditions. Intervertebral disc (IVD) degeneration is a natural process, contributing to periods of acute LBP. However, the scientific literature and guidelines partially overlook the significance of water management in IVD. This implementation project sought to address this gap by educating patients about this process. Running and/or walking were chosen as general approaches for treatment rather than specific disease-related approaches. METHODS: This implementation project was conducted in an outpatient physiotherapy clinic in Brandenburg, Germany, utilizing the JBI Evidence Implementation Framework. An evidence-informed clinical audit and feedback strategy was used to measure compliance with ten audit criteria. Five physiotherapists and 20 patients took part in the audits. RESULTS: At baseline, only 20% of participating physiotherapists screened for yellow flags regarding psychological issues. However, after project implementation, this criterion scored 100% compliance. Some patients performed exercises independently, but confusion persisted regarding the choice of beneficial exercises. Patients continued running, but those who took a break due to pain expressed uncertainty about resuming. CONCLUSIONS: The project highlighted the effectiveness of collaborative efforts between patients and therapists to address the issue. The project team's conviction in action and solution strategies serves as the foundation for this collaboration. This implementation strategy provided "running" patients with the confidence to either resume or reintegrate running after an extended break. SPANISH ABSTRACT: http://links.lww.com/IJEBH/A222.

Psychosocial ergonomics of the workplace of medical staff during the COVID-19 pandemic in three risk's dimensions: working hours, violence and the use of psychoactive drugs-a prospective pilot study.

Introduction: Workplace ergonomics should also be considered in the context of psychosocial factors affecting the worker, which have a real impact on occupational risk. The present study examined psychosocial risk factors in medical personnel in three domains: working hours, violence and substance abuse. Methods: The purpose of the present study is to assess the current state of psychosocial ergonomics of medical personnels by measuring occupational risks in the domains of: working hours, violence and psychoactive substance abuse. The survey is consisted of two parts: socio-demographic information of participants and participants' assements of psychosocial risk factors. Results: In more than half of the respondents (52%), increased risk was identified in the domain of working hours. Nearly half of the respondents (49.6%) have an identified high risk in the domain of violence, and more than half of the respondents (52%) are at high risk in the domain of psychoactive substance abuse. Discussion: Our findings show that the present psychosocial ergonomics of the Polish health system must be improved. The COVID-19 pandemic has been a compelling test to assess the current state. Our findings highlighted the fact that HCWs often worked overtime and that many cases of workplace violence and substance abuse were reported.

Assessment of selected psychosocial risk factors: stress, job burnout, and bullying in the case of medical staff as part of workplace ergonomics during the COVID-19 pandemic-A prospective pilot study.

Background: The purpose of the pilot study conducted by the authors was to assess occupational risk in selected areas of psychosocial risk factors among health professions in a pilot study. Medical staff working in the healthcare sector experience stress, job burnout and bullying on a daily basis. Monitoring occupational risks in the above areas provides an opportunity to take appropriate preventive measures. Methods: The prospective online survey included 143 health care workers from various professional groups. Eighteen participants did not complete the survey, and the results of 125 participants were eventually included in the analysis. The study used health and safety questionnaires in the healthcare sector, which are not widely used as screening tools in Poland. Results: The following statistical methods were performed in the study: the Mann-Whitney test, Kruskal-Wallis test, Dunn's test. In addition, multivariate analysis was performed. The results obtained in the study indicate that the questionnaires used in the study can be widely used by employers or occupational medicine as screening tools. Conclusions: Our findings show that level of education attainment in healthcare is correlated with higher chance of experiencing stress and burnout. Among the surveyed professions, nurses reported a higher amount of stress and burnout. Paramedics reported the highest chance of being bullied at work. This can be explained by their nature of work which requires directly interacting with patients and their families. In addition, it should be noted that the tools used can be successfully applied in workplaces as elements of workplace ergonomics assessment in the context of cognitive ergonomics.

Protocol for a Randomized Crossover Trial to Evaluate the Effect of Soft Brace and Rigid Orthosis on Performance and Readiness to Return to Sport Six Months Post-ACL-Reconstruction.

A randomized crossover trial was designed to investigate the influence of muscle activation and strength on functional stability/control of the knee joint, to determine whether bilateral imbalances still occur six months after successful anterior cruciate ligament reconstruction (ACLR), and to analyze whether the use of orthotic devices changes the activity onset of these muscles. Furthermore, conclusions on the feedforward and feedback mechanisms are highlighted. Therefore, twenty-eight patients will take part in a modified Back in Action (BIA) test battery at an average of six months after a primary unilateral ACLR, which used an autologous ipsilateral semitendinosus tendon graft. This includes double-leg and single-leg stability tests, double-leg and single-leg countermovement jumps, double-leg and single-leg drop jumps, a speedy jump test, and a quick feet test. During the tests, gluteus medius and semitendinosus muscle activity are analyzed using surface electromyography (sEMG). Motion analysis is conducted using Microsoft Azure DK and 3D force plates. The tests are performed while wearing knee rigid orthosis, soft brace, and with no aid, in random order. Additionally, the range of hip and knee motion and hip abductor muscle strength under isometric conditions are measured. Furthermore, patient-rated outcomes will be assessed.

A Randomized, Double-Blind Placebo Control Study on the Effect of a Blood Flow Restriction by an Inflatable Cuff Worn around the Arm on the Wrist Joint Position Sense in Healthy Recreational Athletes.

The number of blood flow restriction (BFR) training practitioners is rapidly increasing, so understanding the safety issues associated with limb occlusion is strongly needed. The present study determined the effect of BFR by an inflatable cuff worn around the arm on the wrist joint position sense (JPS) in healthy recreational athletes. In the prospective randomized, double-blind placebo control study, sixty healthy right-handed recreational athletes aged x = 22.93 ± 1.26 years were assigned to groups of equal size and gender rates: BFR, placebo, and control. The active wrist JPS was assessed in two separate sessions using an isokinetic dynamometer. The first assessment was performed with no cuffs. In the second session, a cuff with a standardized pressure was worn on the examined limb in the BFR group. In the placebo group, the cuff was uninflated. A between-session comparison in each group of collected angular errors expressed in degrees was carried out. The angular error in the BFR group was larger during the second measurement than the first one (p = 0.011-0.336). On the contrary, in the placebo (p = 0.241-0.948) and control (p = 0.093-0.904) groups, the error value in the second session was comparable or smaller. It was determined that BFR by an inflatable cuff around the arm impairs the wrist position sense. Hence, BFR training should be performed with caution.

Wrist motion assessment using Microsoft Azure Kinect DK: A reliability study in healthy individuals.

BACKGROUND: Motion analysis systems have been widely used in orthopedics and rehabilitation for diagnostics, patient monitoring and outcome evaluation purposes. Since Microsoft Azure Kinect Developer Kit (DK) had been released, only a few studies were published concerning its usage. However, it has not been used for wrist motion assessments, even though the use of standardized examinations with known reliability, validity and responsiveness remains a constant challenge. OBJECTIVES: This study aimed to examine the reliability of hand and forearm range of motion (ROM) measurements recorded using new software utilizing the Microsoft Azure Kinect DK. MATERIAL AND METHODS: Twenty-eight healthy males and 28 healthy females participated in measurements of active ROM for wrist extension, wrist flexion, radial deviation, ulnar deviation, and forearm supination and pronation on 3 separate occasions. Sessions 1 and 2 were carried out on the same day with a 90-minute rest period between each session, while the 3rd session was conducted a week later. Data were recorded simultaneously in both limbs using a custom-made software developed by a software development company (Oleksy Medical & Sports Sciences, Lancut, Poland) for the purposes of the present study using Microsoft Azure Kinect DK. The assessment of intra-day and inter-day reliability was based on intraclass correlation coefficient (ICC) calculations and interpreted based on commonly used guidelines. RESULTS: In the group of males, the lowest ICC was 0.846 for intra-day comparisons and 0.816 for inter-day analyses. In the female group, the lowest ICC for intra-day comparisons was 0.826 and exceeded 0.833 for inter-day comparisons. CONCLUSIONS: The developed software using Microsoft Azure Kinect DK demonstrated high reliability in measuring wrist and forearm active ROM. These promising results support the use of Microsoft Azure Kinect DK in a clinical capacity as a potential hand assessment and rehabilitation tool.

Symmetry Function: The Differences between Active and Non-Active Above-the-Knee Amputees.

The number of patients with unilateral above-knee amputation (AKA) due to non-vascular causes has remained stable over the years, at 0.92 per 1000 people per year. Post-AKA individuals are at risk of experiencing a higher incidence of chronic pain. Post rehabilitation, it is estimated that between 16−62% of patients with musculoskeletal disabilities fail to meet the minimum criteria for physical activity in comparison to a healthy population. The current study included 14 participants (11 men and 3 women) with a mean age of 46.1 ± 14.2 years, body height of 1.76 ± 0.09 m, and weight of 79.6 ± 18.3 kg, who were all post-unilateral above-the-knee amputees. Patients in the study were divided into two groups: active (AC) and non-active (NAC). This study was conducted in a certified Laboratory of Biomechanical Analysis using the BTS Smart-E system (BTS Bioengineering). In order to investigate the symmetry function (SF) of gait, the only measurements included were the time series assessment of gait variables defining pelvic and lower limb joint motion and ground reaction forces (GRF). Both groups had an asymmetrical gait pattern with a different magnitude and relative position in the gait cycle, which was revealed by SF. The differences in terms of median, minimum, and maximum were statistically significant (p < 0.05), with SF ranging from −25 to 24% for the AC group and from 43 to 77% (59% on average) for the NAC group. The AC's pattern was more symmetrical compared to the NAC's pattern, especially in the case of pelvic and hip joint motion.

Reliability and Validity of the Athletic Shoulder (ASH) Test Performed Using Portable Isometric-Based Strength Training Device.

The Athletic Shoulder (ASH) test was introduced as a tool for quantifying the ability to produce and transfer force across the shoulder girdle. Whether using the portable isometric-based strength training device Active5™ is a reliable alternative to a gold standard force plate for ASH testing purposes remains unknown; therefore, the present study determined the reliability and validity of Active5™ usage in the ASH test compared to force plates. Fifty-one healthy participants performed the ASH test using Active5™ and K-Force plates in three separate sessions. The maximal force was measured bilaterally in a prone position at three shoulder abduction angles, precisely at 180°, 135°, and 90°. The first rater carried out the first and third sessions, spaced at a one-week interval. A second rater performed the second session. The reliability was assessed using the intraclass correlation coefficient (ICC). The linear Pearson's correlation coefficient (r) calculation was used to determine the relationship between ASH test results using the two devices. The ICC = 0.77-0.99 result indicated good to excellent reliability for Active5™ usage. A high to a very high correlation between the two devices at 180° and 90° was noted (r = 0.75-0.95). This data supports the isometric-based strength training device Active5™ as a reliable and valid tool for ASH test performance.

Rationing of Nursing Care and Professional Burnout Among Nurses Working in Cardiovascular Settings.

Introduction: Nursing needs close interpersonal contact with the patient and emotional involvement, therefore can contribute to professional burnout and rationing of nursing care. Aim: Assessing the relationship between the rationing of nursing care and professional burnout in nursing staff. Materials and Methods: The study included a group of 219 nurses working in cardiovascular facilities. This was a cross-sectional study designed to investigate the relationship between factors of the care rationing and professional burnout. The survey data was collected with standardised and research instruments such as the revised Basel Extent of Rationing of Nursing Care questionnaire (BERNCA-R) and the Maslach Burnout Inventory (MBI). Results: The total mean BERNCA-R score was 1.38 (SD = 0.62), while the total MBI score amounted to 38.14 (SD = 22.93). The specific components of professional burnout yielded the values: emotional exhaustion (M = 44.8), job dissatisfaction (M = 40.66), and depersonalisation (M = 28.95). Multiple linear regression showed that independent predictors of BERNCA-R score were emotional exhaustion, depersonalisation, job dissatisfaction, and multi-jobs activity (p < 0.001). Conclusion: The level of rationing of nursing care in cardiovascular facilities increases along with emotional exhaustion, depersonalisation and job dissatisfaction, and multi-jobs activity.

Association of physical fitness with quality of life in community-dwelling older adults aged 80 and over in Poland: a cross-sectional study.

BACKGROUND: Aging is a progressive and irreversible process that negatively affects the quality of life (QOL). Older adults face difficulties related to worsening health, lowering the level of physical and mental efficiency. We aimed to analyze the associations between physical fitness and QOL in Polish older adults considering sex differences. METHODS: This cross-sectional study was performed from March to August 2015. The sample consisted of 100 community-dwelling adults (67 women, 33 men) with a mean age of 82.94 ± 2.67 years. The World Health Organization QOL, Short Form questionnaire (WHOQOL-BREF), and the Fullerton Functional Fitness Test (FFFT) were used. Biometric data, social and environmental situation, nutritional and lifestyle behaviors have been also collected using a questionnaire designed by the authors. RESULTS: The results obtained in individual domains of WHOWOL-BREF indicate a good level of QOL in all the examined domains. Statistically significant sex differences were obtained in physical (p = 0.01), psychological (p = 0.04) and environmental (p = 0.02) domains in WHOQOL-BREF. It was noted that men perform better in terms of the upper (arm curl, p < 0.001) and lower body strength (chair stand, p = 0.01), aerobic endurance (two-minute step test, p < 0.001), agility and dynamic balance (up and go test, p < 0.001) in FFFT. CONCLUSIONS: Community-dwelling older adults aged 80-93 years in Poland present a good level of QOL, and the higher score was obtained in men. Also, men presented better physical fitness, showed a higher level of independence in daily activities, and assessed better their own QOL than women.

Symmetry function in gait pattern analysis in patients after unilateral transfemoral amputation using a mechanical or microprocessor prosthetic knee.

BACKGROUND: Above-knee amputations (AKAs) contribute to gait asymmetry. The level of asymmetry is affected by the type of knee prosthetic module. There is limited evidence suggesting that more technically advanced solutions (microprocessor modules; MicPK) are superior to less advanced ones (mechanical modules; MechPK). The study aimed to evaluate the variable range of hip and pelvic joint movements during gait and look for differentiating areas with an increased level of asymmetry of the gait cycle in individuals who underwent an AKA and are equipped with MicPK or MechPK. METHODS: Twenty-eight individuals participated in the study; 14 were assigned to a study group of individuals who underwent a unilateral AKA, and the other 14 were healthy participants as a control group. The movement task was recorded using the optoelectronic SMART-E system following the standard Davis protocol (the Newington model). A new method of quantifying gait symmetry using the symmetry function (SF) is proposed. SF is an integral measure of absolute differences in time-standardized signals between sides throughout the whole cycle of motion variability. RESULTS: In the frontal plane, there were significant differences between groups in the asymmetry of the range of movement in the hip joint of the intact limb. In the middle of the support phase, the intact limb was more adducted in individuals with MicPK and less abducted in people with MechPK (differences in mean 180%, p < 0.000; max 63%, p < 0.000; min 65%, p < 0.000). In the sagittal plane, the range of asymmetry of the flexion and thigh extension of the intact limb was similar to and only slightly different from the physiological gait. In the transverse plane, higher asymmetry values were noted for individuals with MicPK. In the final stage of the swing phase, the thigh was more rotated both externally and internally. The size of the asymmetry, when compared to gait of healthy individuals, reached 50% (differences in mean 115%, p < 0.232; max 62% p < 0.26; min 50, p < 0.154). CONCLUSIONS: In the study group, the assessed ranges of pelvic and thigh movement in the hip joint differed only in the frontal plane. Individuals who underwent a unilateral above-knee amputation may gain less from using MicPK than anticipated.

Factors affecting work ability index among polish nurses working in hospitals - A prospective observational survey.

AIMS: To assess the ability to work of Polish nurses by age groups. BACKGROUND: The ability to work is widely discussed in the literature in the context of nurses' productivity; thus, it is necessary to identify the ability to work when facing an increasing demand for services. METHODS: The observational study involved 349 professionally active nurses aged 46.9 ± 9.7 years, with a length of service of 23.5 ± 9.6 years. The Work Ability Index (WAI) was used to assess the nurses' ability to work. RESULTS: The ability to work decreases with age (rs  = -0.324, p < .000) and with seniority (rs  = -0.257; p < .000). Nurses with higher education presented higher Work Ability Index scores. Also, the age (B = -0.25, p < .001), work seniority (B = -0.19, p < .001) and education (masters' degree: B = 1.41, p = .012; ref. secondary) affect work ability. CONCLUSIONS: The ageing process and seniority of nurses negatively affect their ability to work. A lack of programmes to maintain physical condition for nurses can result in a shortage of staff. IMPLICATIONS FOR NURSING MANAGEMENT: Programmes can be developed to create or improve healthy working environments to increase productivity.

Analysis of Selected Body Composition Parameters and Ergonomic Safety among Professionally Active Nurses in Poland: A Preliminary Prospective Monocentric and Observational Study.

Nurses consist of an occupational group that is particularly exposed to harmful work-related factors such as prolonged working hours, severe stress, fatigue, and excessive strain on the musculoskeletal system. According to nurses, the limitation of the application of ergonomic principles of work may contribute to the occurrence of numerous dangerous behaviors, improper eating habits, or deficiency of systematic physical activity. The most common consequences are nutritional disorders and musculoskeletal system dysfunctions. This prospective observational study was aimed at evaluating selected parameters of the body composition of professionally active nurses and at determining work-related risks during nursing activities. The study group consisted of 37 active nurses (38.38 ± 11.33 years). The research tool was a device for bioelectrical impedance analysis (BIA). A questionnaire designed by the authors was also implemented, which covered ergonomic principles, musculoskeletal injuries, and nutritional habits. In the present study, it was shown that all average values of the tested nurses' body composition parameters were within the normal range. The majority of respondents (97.3%) reached a high level of body water. A statistically significant correlation was found between the knowledge of the workplace ergonomic principles and body mass index. In conclusion, musculoskeletal pain and lack of implementation of ergonomic behaviors are a significant problem among nurses, which may be the cause of overweight or obesity in this occupational group.

Evaluation of the occurrence of work-related musculoskeletal pain among anesthesiology, intensive care, and surgical nurses: An observational and descriptive study.

Clinical nurses can encounter musculoskeletal pain episodes stemming from regular exposure to workplace risk factors that contribute to overloads. This study aimed to evaluate the occurrence and location of work-related musculoskeletal pain among Polish nurses. An observational and descriptive survey study was conducted among 136 nurses working in the anesthesiology, intensive care, and surgery units. An extended version of the Nordic Musculoskeletal Questionnaire was used to investigate musculoskeletal pain. Only 8% of the participating nurses experienced no musculoskeletal pain, while 85% suffered from pain in more than one location. The lower back (67%), upper back (59%), and neck (66%) were the most common pain locations. In summary, nurses experienced multiple musculoskeletal pain episodes, occurring most frequently in the spinal region (lower and upper back and neck). It is crucial to determine the real causes of musculoskeletal pain and to take appropriate preventive measures to improve workplace ergonomics.

Assessment of pressure pain threshold at the cervical and lumbar spine region in the group of professionally active nurses: A cross-sectional study.

OBJECTIVES: The problem of spinal pain among nurses and lack of compliance with workplace ergonomy is increasing. The study aimed to assess the pressure pain threshold (PPT) at the cervical and lumbar spine in nursing staff. METHODS: The sample of this prospective and observational study consisted of 30 female nurses with a mean age of 38.6 ± 11.1 years. The standardized Oswestry (ODI) and the Neck Disability Index (NDI) were used, as well as the Authors' Designed Questionnaire (ADQ) was used to assess compliance with ergonomic principles. The PPT analysis using a computerized pressure algometer (CPA) was performed to examine the level of PPT. RESULTS: A mild disability was found in 56% of nurses (NDI and ODI). A value of <4 kg/cm2 (CPA), indicating musculoskeletal overload was observed in 57% of subjects. Also, 60% of nurses work with a lying patient; 73.4% grabs the patient's armpits while transferring in bed; 16.7% never adjusts the height of the bed, and only 13.4% choose specialist footwear for work. There is a correlation between PPT values for trapezius and erector spinae muscles on the same side of the body in nurses with mild and moderate disability (P < .05). CONCLUSIONS: Pain complaints are associated with lower PPT of trapezius and erector spinae muscles and asymmetry of muscle tension. Also, it was noted that the lack of implementation of ergonomic principles by nursing staff affects their degree of disability.

Muscle torque production and kinematic properties in post-stroke patients: a pilot cross-sectional study.

PURPOSE: Stroke-related hemiplegia is an important factor influencing parameters of gait. So far, limited papers have assessed temporo- spatial capabilities and their correlations with gait parameters in the early post-stroke stage. This pilot study evaluated the temporospatial parameters of gait and assessed the maximal isometric and isokinetic torque production of the plantar flexor and dorsiflexor muscles. METHODS: 15 patients with lower limb spasticity and 15 healthy controls were included. Stroke severity was assessed using the Modified Ashworth Scale and the Barthel Index. Gait cadence, gait speed, and gait cycle were assessed using inertial sensors during a Timed Up and Go test. Maximal isometric and isokinetic torque production of the ankle plantar flexor and dorsiflexor muscles were assessed using an isokinetic dynamometer device. RESULTS: Post-stroke patients had statistically significantly lower gait cadence than healthy participants (17%, p < 0.05). Statistically significantly lower values of vertical acceleration were also noted during a sit-to-stand movement task (42%, p < 0.05). Plantar flexion torque of the affected limb was significantly different during isometric (63%, p ≤ 0.01) and isokinetic work for 30o/s (49%, p = 0.04), 60o/s (58%, p = 0.01) and 20 °/s (53%, p = 0.01). Dorsiflexor muscles' torque production was significantly different in isometric activity (38%, p = 0.04). A statistically significant positive correlation occurred between the absolute peak torque of the dorsiflexor muscles in both static and speed phases of gait (Rs = 0.65, p = 0.04). CONCLUSIONS: Despite the low intensity of spasticity and early phase after stroke, differences in the muscle torque production and temporo-spatial parameters, as well as the correlations between them, were noticeable.

Evaluation of Postural Stability and Transverse Abdominal Muscle Activity in Overweight Post-Stroke Patients: A Prospective, Observational Study.

PURPOSE: Post-stroke hemiparesis has a significant impact on postural stability. The transversus abdominis (TrA) muscle contributes to the stability of the spine. The aim was to assess both the postural stability and the activity of the TrA muscle in overweight post-stroke patients. METHODS: A group of 56 participants (61.12 ± 11.5 years) was divided into the study group (n=28 post-stroke patients, 63.7 ± 10.9 years) and control group (n= 23 healthy participants (58.5 ± 12.2 years). The Berg Balance Scale (BBS) and the Timed Up and Go Test (TUG) were used to evaluate postural stability and risk of falls. The Pressure Bio-Feedback Stabilizer (PBFS) device was used to assess functional stability. RESULTS: Stroke had a significantly negative effect on the BBS (p < 0.001) and TUG (p = 0.001). The older age negatively affected the BBS (p = 0.001), TUG (p = 0.017), and the TrA muscle activity (p = 0.017). Higher values of body mass index (BMI) negatively affected the BBS (p = 0.028), however there were no changes of TUG results (p = 0.141), and the TrA muscle activity (p = 0.808). Also, BBS and TUG results were not associated with TrA muscle activity (p = 0.541 and p = 0.411, respectively). The results of the BBS, TUG, and PBFS did not differ according to gender (p < 0.05). Time from stroke negatively affected the TUG (p = 0.001), but had no effect on the TrA muscle activity (p < 0.05). The side of hemiparesis did not affect the postural stability (p < 0.05). CONCLUSION: The consequences of a stroke have an essential negative effect on postural stability. Factors such as age, gender, time from stroke, and the side of the hemiparesis have not negatively affected postural stability in overweight post-stroke patients.

Baropodometric evaluation of foot load distribution during gait in the group of professionally active nurses.

OBJECTIVES: Nurses are extremely exposed to musculoskeletal overloads. Prolonged standing postural balance distributions, functional deficits and pain may affect the symmetry of the load on the feet. The study aimed to assess the distribution of foot load during gait among nurses. METHODS: The sample of this prospective and observational study consisted of 37 female nurses with mean age of 39 years. The Nordic Musculoskeletal Questionnaire (NMQ) was used to evaluate musculoskeletal disturbances and baropodometric gait analysis (BGA) was performed to register distribution of foot load during gait. RESULTS: We showed that 68% of nurses declare that they know the principles of workplace ergonomics, but only 14% comply with them. NMQ results indicate that as many as 73% of the respondents feel ailments in the "lower back" area. An asymmetry was observed in the load of IV-V of the metatarsal head between the left and right foot (P = .000) and in the load of the left and right lateral part of the heel (P = .028) in the BGA test. Correlations between ailments occurring in the neck area and loading of the lateral arch of the right foot (P = .032) were found. Moreover, the load in this area correlated positively with the occurrence of "lower back" pain (P = .045). CONCLUSIONS: Nurses have asymmetric distribution of foot load during gait, which results in a discrepancy between the loads on the three main support points of the foot and which may affect nurses' work productivity.