[Diagnostic guidlines for occupational epicondylitis]. / Przewlekle zapalenie nadklykci kosci ramiennej wywolane sposobem wykonywania pracy--wytyczne diagnostyczno-orzecznicze.

Making final decisions on the occupational etiology of musculoskeletal diseases is often difficult and problematic at every stage of the diagnostic procedure. Taking into account the need to facilitate decision-making about the causal relationship between the diagnosed disease entity and the working conditions guidelines for the recognition of work-related musculoskeletal diseases have been developed. This paper presents the guidelines for the diagnosis of occupational etiology of humeral epicondylitis, one of the most common occupational disease of the musculoskeletal system in Poland. The developed guidelines have been based on the literature data concerning occupational risk factors of humeral epicondylitis, workload classification, including repetitive movements, awkward postures, and force. Some criteria applied in ergonomic evaluation methods were also included. The presented diagnostic guidelines define approximate benchmarks for stating (after excluding non-occupational etiology) that the identified humeral epicondylitis, is related to the way of working. Crucial work factors that should be analyzed include an operating time of movements overloading tendons connecting to the epicondyle, repetition and force used to perform occupational activities. The developed guidelines are aimed to facilitate occupational physicians diagnostic and certification procedures in case of humeral epicondylitis and determination whether there is a likelihood of its occupational etiology.

Influence of various laser therapy methods on knee joint pain and function in patients with knee osteoarthritis.

BACKGROUND: The aim of the study was to estimate the influence of various laser therapy methods on knee joint pain and function in patients with knee osteoarthritis. MATERIAL AND METHODS: 125 patients were randomly assigned to 4 groups: • group I received one-wave laser irradiation (wave length 810 nm, dose 8 J/point) • group II received two-wave MLS laser irradiation (power 1100 mW, frequency 2000 Hz, dose 12.4 J/point) • group III received a similar regimen of two-wave MLS laser irradiation, but at a dose of 6.6 J per point • group IV was a placebo group where laser therapy procedures were simulated without actual irradiation. The effectiveness of the therapy was evaluated by means of Lequesne's scale, a modified Laitinen questionnaire and a visual analogue scale (VAS). Statistical analysis utilised non-parametric Wilcoxon's and Mann-Whitney's tests. Calculations were carried out with MedCalc v. 11.6.1.0. RESULTS: Statistically significant improvements in knee joint function and pain relief were seen in all groups (I, II and III). When groups I, II and III were compared, the largest improvement was found in group II (MLS laser, dose 12.4 J/point). The degrees of improvement in groups I and III were similar. CONCLUSIONS: One-wave laser irradiation at a dose of 8 J per point and two-wave laser irradiation with doses of 12.4 J and 6.6 J per point significantly improved knee joint function and relieved knee pain in patients with osteoarthritis.