Screening, diagnosis, treatment and outcomes of developmental dysplasia of the hip in Brazilian population: a scoping review protocol.

INTRODUCTION: Developmental dysplasia of the hip (DDH) includes a spectrum of clinical and imaging findings at birth or early infancy. The circumstances in which this condition is detected and managed may be heterogeneous in Brazil owing to its large territory and regional socio-economic differences. Mapping DDH perspectives in a country is fundamental for designing guidelines and strategies for public policy. This scoping review aims to map the available literature related to screening, diagnosis, treatment and outcomes of DDH in the Brazilian population to provide an overview of this condition and to describe regional variations in presentation and management across the country. METHODS AND ANALYSIS: This study will follow the methods outlined in the Joanna Briggs Institute Reviewers manual for conducting a scoping review. Relevant publications will be first searched in PubMed/MEDLINE, Scientific Electronic Library Online, Web of Science, Scopus, "Biblioteca virtual em saúde" and "Biblioteca Digital Brasileira de Teses e Dissertações" using search terms developed from a brief preliminary search of those databases. There were no language or date range limitations for study inclusion. Databases will be searched from their inception until February 2024. Titles and abstracts will be analysed by two or more independent reviewers to assess them against the inclusion criteria for the review. The search results and study inclusion process will be reported in full in the final version of the scoping review and presented in a Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) flowchart. The resulting data will be recorded and organised to present the key information contained in all examined articles. ETHICS AND DISSEMINATION: This review will include existing available studies and does not require a specific ethical review or approval. The final study will be submitted for presentation at conferences that focus on Brazilian healthcare and publication in peer-reviewed journals. This scoping review protocol was registered in the Open Science Framework. DOI registration (https://doi.org/10.17605/OSF.IO/V3AYH).

Can electroencephalography (EEG) identify the different dimensions of pain in fibromyalgia? A pilot study.

BACKGROUND: Electroencephalography (EEG) is a promising tool for identifying the physiological biomarkers of fibromyalgia (FM). Evidence suggests differences in power band and density between individuals with FM and healthy controls. EEG changes appear to be associated with pain intensity; however, their relationship with the quality of pain has not been examined. We aimed to investigate whether abnormal EEG in the frontal and central points of the 10-20 EEG system in individuals with FM is associated with pain's sensory-discriminative and affective-motivational dimensions. The association between EEG and the two dimensions of emotional disorders (depression and anxiety) was also investigated. METHODS: In this cross-sectional pilot study, pain experience (pain rating index [PRI]) and two dimensions of emotional disorders (depression and anxiety) were assessed using the McGill Pain Questionnaire (PRI-sensory and PRI-affective) and Hospital Anxiety and Depression Scale (HADS), respectively. In quantitative EEG analysis, the relative spectral power of each frequency band (delta, theta, alpha, and beta) was identified in the frontal and central points during rest. RESULTS: A negative correlation was found between the relative spectral power for the delta bands in the frontal (r= -0.656; p = 0.028) and central points (r= -0.624; p = 0.040) and the PRI-affective scores. A positive correlation was found between the alpha bands in the frontal (r = 0.642; p = 0.033) and central points (r = 0.642; p = 0.033) and the PRI-affective scores. A negative correlation between the delta bands in the central points and the anxiety subscale of the HADS (r = -0.648; p = 0.031) was detected. CONCLUSION: The affective-motivational dimension of pain and mood disorders may be related to abnormal patterns of electrical activity in patients with FM. TRIAL REGISTRATION: Retrospectively registered on ClinicalTrials.gov (NCT05962658).

Programa de gimnasia laboral para los moldeadores manuales metalúrgicos

Los trastornos músculo-esqueléticos relacionados con el trabajo constituyen motivo de preocupación para la comunidad científica, avalado por su efecto negativo en la vida de los trabajadores y la productividad de las empresas. En el proceso de fundición de metales, los moldeadores manuales con pisón neumático exteriorizan manifestaciones de estas afecciones. Ello indujo a realizar una investigación que tuvo como objetivo elaborar un programa de Gimnasia Laboral para contribuir a la atención de los trastornos músculo-esqueléticos en los moldeadores manuales metalúrgicos. Para recopilar, analizar y procesar los datos se emplearon métodos teóricos, empíricos y matemático-estadísticos, entre ellos el histórico-lógico, analítico-sintético, inductivo-deductivo, sistémico-estructural-funcional, la observación participante, encuesta, entrevista, revisión documental, el experimento, criterio de usuarios y la estadística descriptiva e inferencial. La población objeto de estudio estuvo conformada por 19 moldeadores manuales metalúrgicos, seleccionados de forma intencional. El diagnóstico y la sistematización teórica alcanzada posibilitaron elaborar un programa de Gimnasia Laboral, en correspondencia con los requerimientos del proceso de moldeo, cuya efectividad fue constatada.

As lesões músculo-esqueléticas relacionadas com o trabalho são motivo de preocupação para a comunidade científica, sustentadas pelos seus efeitos negativos na vida dos trabalhadores e na produtividade das empresas. No processo de fundição do metal, os moldadores manuais com compactador pneumático externalizam as manifestações dessas condições. Isso originou uma pesquisa que teve como objetivo desenvolver um programa de Ginástica Laboral para contribuir no cuidado de lesões osteomusculares em moldadores manuais metalúrgicos. Para coletar, analisar e tratar os dados foram utilizados métodos teóricos, empíricos e matemático-estatísticos, incluindo histórico-lógico, analítico-sintético, indutivo-dedutivo, sistêmico-estrutural-funcional, observação participante, levantamento, entrevista, revisão documental, o experimento, critérios de usuário e estatísticas descritivas e inferenciais. A população em estudo foi composta por 19 modeladores manuais metalúrgicos, selecionados intencionalmente. O diagnóstico e a sistematização teórica conseguidos permitiram desenvolver um programa de Ginástica Laboral, em correspondência com as exigências do processo de moldagem, cuja eficácia foi verificada.

Work-related musculoskeletal disorders are a cause of concern for the scientific community, supported by their negative effect on the lives of workers and the productivity of companies. In the metal casting process, manual molders with pneumatic tamper externalize manifestations of these conditions. This led to carrying out a research that aimed to develop a Labor Gymnastics program to contribute to the care of musculoskeletal disorders in metallurgical manual shapers. To collect, analyze and process the data, theoretical, empirical and mathematical-statistical methods were used, including historical-logical, analytical-synthetic, inductive-deductive, systemic-structural-functional, participant observation, survey, interview, documentary review, the experiment, user criteria and descriptive and inferential statistics. The population under study was made up of 19 metallurgical manual shapers, intentionally selected. The diagnosis and theoretical systematization achieved made it possible to develop a Labor Gymnastics program, in correspondence with the requirements of the molding process, whose effectiveness was verified.

Musculoskeletal disorders and quality of life for Chilean teachers during the COVID-19 pandemic at the academic year-end.

Introduction: Schoolteachers have reported multiple demands contributing to poor perceptions regarding their quality of life and high rates of musculoskeletal disorders. However, there are few studies about the association between musculoskeletal disorders and quality of life from the end of the academic period during the COVID-19 pandemic. Objective: Evaluate musculoskeletal disorders rates and their association with quality of life perceptions among teachers from the last academic period during the COVID-19 pandemic. Participants and methods: A total sample of 161 Chilean schoolteachers was included in a cross-sectional study musculoskeletal disorders prevalence was evaluated using the Standardized Nordic Questionnaire, and quality of life was evaluated through the Short-Form 12 Health Survey Instrument. A logistic regression was applied to evaluate the association between musculoskeletal disorders and quality of life perceptions adjusted by gender, age, and contract type. Results: 98% of teachers have suffered from some type of musculoskeletal disorders during the last 12 months, and 64% have had six or more painful regions. Women showed a higher musculoskeletal disorders rate than men. The group of teachers with the most musculoskeletal disorders (≥p50) saw significantly greater risk of low scores on the physical (OR: 2.16; p < 0.05) and mental components (OR: 4.86; p < 0.01) of quality of life, regardless of gender, age, and contract type. Conclusion: High musculoskeletal disorders rates suggest that preventive and informative actions must be taken regarding these disorders in order to protect teachers' mental and physical health, considering the effects of the school year and the COVID-19 health crisis.

Use of cupping therapy in musculoskeletal disorders: A cross-sectional study on the profile, training, and practice of Brazilian physical therapists.

INTRODUCTION: Cupping therapy is a widely used technique in Brazilian physical therapy for the treatment of musculoskeletal disorders. However, there is limited scientific evidence to support its effectiveness. OBJECTIVE: To investigate the profile, training, clinical practice, and scientific updates of Brazilian Physical Therapists who use cupping therapy as a therapeutic resource for musculoskeletal disorders. METHODS: A cross-sectional study was conducted through an online questionnaire, including 646 Physical Therapists who use cupping therapy in their practice. All data were analysed descriptively. RESULTS: Cupping therapy is a technique that has been widely adopted in clinical practice by Physical Therapists, particularly among young, female professionals who have recently graduated from private universities. The primary reason for interest in this technique among these Physical Therapists is the high demand from patients. Additionally, it is often used in conjunction with other manual therapeutic techniques. They identified easy access, low cost, and ease of use as the key factors that make cupping therapy an attractive option. However, a lack of high-quality scientific evidence, as described in the literature, was identified as a major barrier to its use. CONCLUSION: The Physical Therapists included in this study use cupping therapy in their clinical practice, relying heavily on their own experience and the preferences of their patients, rather than utilizing the third pillar of evidence-based practice, which is to rely on the best available evidence. This study suggests that these Physical Therapists are currently implementing a technique without current scientific recommendations for its use in the treatment of musculoskeletal disorders.

Anterior Knee Pain Scale (AKPS): structural and criterion validity in Brazilian population with patellofemoral pain.

PURPOSE: To identify the best internal structure of the Brazilian version of the Anterior Knee Pain Scale (AKPS), comparing different instrument structures (structural validity) and correlating the scores of the versions (criterion validity). METHODS: We included Brazilian volunteers, aged ≥ 18 years, with patellofemoral pain (PFP) for at least 3 months. We used the confirmatory factor analysis and considered the following fit indices: chi-square/degrees of freedom (DF), comparative fit index (CFI), Tucker-Lewis index (TLI), root mean square error of approximation (RMSEA). We considered the structure with the lowest values of the Akaike information criterion (AIC), sample size adjusted Bayesian information criterion (SABIC), and assessed criterion validity using Pearson correlation coefficient (r) to correlate the long and short versions. RESULTS: The study included 101 participants, mostly women (65.3%), young adults (~ 31 years old), overweight (BMI > 25 kg/m2), incomplete higher education (37.6%), and physically active (64.4%). The original 1-domain, 13-item structure showed adequate fit indices (chi-square/GL < 3.00, TLI and CFI > 0.90, and RMSEA < 0, 08). However, items 11 and 12 had a factorial load of less than 0.23. Therefore, we excluded items 11 and 12 and found adequate fit indices (chi-square/GL < 3.00, TLI and CFI > 0.90, and RMSEA < 0, 08) and lower AIC and SABIC values. We observed a correlation coefficient above the acceptable cutoff of 0.70 (r = 0.966, p-value < 0.001) between the versions. CONCLUSION: The 11-item AKPS (without items 11 and 12) is the version with the most adequate internal structure and correlates satisfactorily with the long version of the instrument.

Trends in the disease burden of musculoskeletal disorders in Mexico from 1990-2019.

OBJECTIVE: This study aimed to describe the disease burden and trends of musculoskeletal (MSK) disorders in Mexico from 1990 to 2019. METHOD: A cross-sectional study using systematic analysis from the Global Burden of Disease Study 2019 (GBD study 2019) was performed to analyze data on MSK disorders and estimate crude and age-standardized rates per 100,000 population concerning disease prevalence, incidence, mortality, disability-adjusted life-years (DALY), and years lived with disability (YLD). The average annual percentage change (AAPC) was calculated using the joinpoint regression. RESULTS: In 2019, there were 4.8 million (95% UI 4.3, 5.4) new cases and 3,312 (95% UI 2201, 4,790) deaths attributable to MSK disorders. In 2019, MSK disorders ranked first, increasing from 1990 (second rank) for the YLD in Mexico. Subnational variations were identified, with the state of Oaxaca having the highest age-standardized incidence rate (ASIR) per 100,000 population in 2019. Joinpoint analysis revealed a significant increase in prevalence in Mexico from 1990 to 2019 (AAPC: 0.14%; 95%CI 0.09-0.19), incidence (AAPC: 0.05%; 95%CI 0.03-0.07), DALY (AAPC: 0.13%; 95%CI 0.04-0.22), and YLD (AAPC: 0.13%; 95%CI 0.02-0.24). Among the risk factors, occupational ergonomic factors and high body mass index (BMI) had the largest influence on MSK disorders. CONCLUSIONS: In Mexico, we observed an increase the national burden of MSK disorders from 1990 to 2019. Specific determinants, such as occupational ergonomic factors and high BMI, contribute to the MSK disorder burden. The burden of MSK disorders requires an improved and prompt assessment to plan valuable diagnostic and management approaches. Key Points • In Mexico, the burden of musculoskeletal (MSK) disorders increased from 1990 to 2019. • Specific risk factors, such as occupational ergonomic factors and high body mass index, contribute to the MSK disorder burden.

Sex differences in the impact of musculoskeletal disorders on health-related quality of life: a population-based study, Campinas, SP - ISACamp 2014/15 / Diferenças entre os sexos no impacto das doenças musculoesqueléticas na qualidade de vida relacionada à saúde: estudo de base populacional, Campinas, SP - ISACamp 2014/15

Abstract This article aims to estimate the prevalence of musculoskeletal disorders (MD) on the adult population of Campinas, São Paulo, Brazil, verifying associated demographic and socioeconomic factors, and to analyze their impact on Health-Related Quality of Life (HRQoL) according to sex. A population-based study was conducted with 2,166 individuals using data from the ISACamp 2014/15. The Medical Outcomes Study SF-36-Item Short Form Health Survey (SF-36) was used to measure HRQoL according to MD. Prevalence ratios (PR) were estimated by Poisson regression. Musculoskeletal disorders had a prevalence of 8.5% (6.7% tendonitis and 2.7% work-related musculoskeletal disorders - WMSD). Results showed a higher prevalence of musculoskeletal disorders in women, active or on leave due to illness, and in individuals with higher education levels. Moreover, reduced HRQoL scores were observed in 6 of the 8 domains, due to MD. The mental component and physical component showed greater impairment respectively among women and men after self-reported WMSD. These findings point to substantial damage from musculoskeletal disorders on the population's HRQoL. WMSD affect the HRQoL of men and women distinctly.

Resumo O objetivo deste artigo é estimar a prevalência de doenças musculoesqueléticas (DM) na população adulta de Campinas/SP, Brasil, verificar fatores demográficos e socioeconômicos associados e analisar o seu impacto na qualidade de vida relacionada à saúde (QVRS) segundo sexo. Este é um estudo de base populacional utilizando dados do ISACamp 2014/15, com 2.166 indivíduos. Para a medida de QVRS, foram calculados os escores médios do Short Form Health Survey 36 (SF-36) segundo as DM e utilizada a regressão de Poisson para estimar as razões de prevalência (RP). A prevalência de DM foi de 8,5% (6,7% de tendinite e 2,7% de doenças osteomusculares relacionadas ao trabalho - DORT). Os resultados deste estudo mostraram maior prevalência de DM em mulheres, na população adulta ativa ou afastada por doença e em indivíduos com maior escolaridade. Além disso, observou-se redução nos escores de QVRS, devido às DM, em quase todos os domínios do instrumento. O maior comprometimento foi observado no componente mental entre as mulheres, e no componente físico, entre os homens, após autorrelato de DORT. Os achados mostram o impacto substancial das DM na QVRS da população. As DORT afetam distintamente a QVRS de homens e mulheres.

Manifestaciones de trastornos musculoesqueléticos en moldeadores manuales metalúrgicos

Introducción: Los trastornos musculoesqueléticos en el contexto laboral metalúrgico repercuten negativamente desde la perspectiva personal, económica y social de los trabajadores. Objetivo: Identificar las manifestaciones de trastornos musculoesqueléticos en los moldeadores manuales metalúrgicos del área de fundición de la empresa Holmeca de la provincia Holguín, Cuba, en el período comprendido enero-marzo de 2021. Método: Se realizó un estudio observacional, no experimental de corte transversal en 19 moldeadores manuales metalúrgicos, en el que se incluyeron variables sociodemográficas, ubicación de zonas dolorosas, intensidad del dolor, tiempo de aparición y duración del trastorno. Se emplearon métodos teóricos, empíricos. Fue utilizado el Cuestionario Nórdico estandarizado de Kuorinka y la Escala Visual Analógica. El procesamiento de la información se llevó a cabo mediante la estadística descriptiva. Resultados: Se identificaron las zonas dolorosas y la prevalencia más alta de dolor musculoesqueléticos en: muñeca/mano (94,74 %), hombro (89,47 %), dorsal/lumbar (89,47 %) y codo/antebrazo (84,21 %). La intensidad del dolor fue determinada como intenso en el 36,84 % y moderado en el 42,11 % de los trabajadores; mientras que en el 21,05 % fue leve. El tiempo de padecimiento delos trastornos fue de 3-38 años,que aparecieron luego de 5 a 7 años de haber comenzado las labores en el área de estudio. Conclusiones: La prevalencia de manifestaciones de trastornos musculoesqueléticos en los moldeadores manuales metalúrgicos del área de fundición de la empresa Holmeca de Holguín es elevada. Se identifican en mano/muñeca, hombro, lumbar y codo/antebrazo, como las zonas anatómicas más afectadas en este grupo poblacional.

Introduction: Musculoskeletal disorders in the metallurgical work context have a negative impact from the personal, economic and social perspective of workers. Objective: To identify the manifestations of musculoskeletal disorders in metallurgical manual molders in the foundry area of the Holmeca company in the province of Holguín, Cuba, in the period from January to March 2021. Method: An observational, non-experimental study was carried out. cross-sectional study in 19 metallurgical manual shapers, which included sociodemographic variables, location of painful areas, pain intensity, time of onset and duration of the disorder. Theoretical and empirical methods were used. The standardized Kuorinka Nordic Questionnaire and the Visual Analog Scale were used. The information processing was carried out using descriptive statistics. Results: The painful areas and the highest prevalence of musculoskeletal pain were identified in: wrist/hand (94.74%), shoulder (89.47%), dorsal/lumbar (89.47%) and elbow/forearm (84.21%). The intensity of the pain was determined as intense in 36.84% and moderate in 42.11% of the workers; while in 21.05% it was mild. The duration of the disorders was 3-38 years, which appeared after 5 to 7 years after beginning work in the study area. Conclusions: The prevalence of manifestations of musculoskeletal disorders in metallurgical manual molders in the foundry area of the Holmeca company in Holguín is high. They are identified in the hand/wrist, shoulder, lumbar and elbow/forearm, as the anatomical areas most affected in this population group.

Introdução: As lesões osteomusculares no contexto do trabalho metalúrgico têm um impacto negativo na perspectiva pessoal, económica e social dos trabalhadores. Objetivo: Identificar as manifestações de distúrbios osteomusculares em moldadores manuais metalúrgicos da área de fundição da empresa Holmeca, na província de Holguín, Cuba, no período de janeiro a março de 2021. Método: Foi realizado um estudo observacional, não experimental. estudo transversal em 19 modeladores manuais metalúrgicos, que incluiu variáveis sociodemográficas, localização das áreas dolorosas, intensidade da dor, tempo de início e duração do distúrbio. Foram utilizados métodos teóricos e empíricos. Foram utilizados o Questionário Nórdico Kuorinka padronizado e a Escala Visual Analógica. O processamento das informações foi realizado por meio de estatística descritiva. Resultados: As áreas dolorosas e as maiores prevalências de dores musculoesqueléticas foram identificadas em: punho/mão (94,74%), ombro (89,47%), dorsal/lombar (89,47%) e cotovelo/antebraço (84,21%). A intensidade da dor foi determinada como intensa em 36,84% e moderada em 42,11% dos trabalhadores; enquanto em 21,05% foi leve. A duração dos distúrbios foi de 3 a 38 anos, surgindo após 5 a 7 anos após o início do trabalho na área de estudo. Conclusões: É elevada a prevalência de manifestações de distúrbios musculoesqueléticos em moldadores manuais metalúrgicos na área de fundição da empresa Holmeca em Holguín. São identificadas na mão/punho, ombro, lombar e cotovelo/antebraço, como as áreas anatômicas mais acometidas neste grupo populacional.

Perception of RSI/WMSD risks involved in teleworking among employees at a public university / Percepção dos riscos de LER/DORT no teletrabalho de servidores de uma universidade pública

Abstract Introduction Although teleworking emerged decades before the COVID-19 pandemic, the spread of the virus in 2020 resulted in faster and more widespread implementation of this work format. However, the lack of a dedicated workspace may pose ergonomic risks and increase the incidence of musculoskeletal disorders. Objective Understand the risks of repetitive strain injury (RSI) and work-related musculoskeletal disorders (WMSDs) in teleworking from the perspective of employees at a public university. Methods A list of employees at a public university who were full or part-time teleworkers was obtained from the campus Personnel Department and used to select subjects for individual scripted interviews. The interviews were recorded and transcribed for thematic content analysis. Results Eight employees took part in the interviews, most of whom were women, aged between 33 and 64 years and from different professional categories. The interviewees reported ergonomic deficiencies, musculoskeletal symptoms, using individual preventive strategies, and the advantages of teleworking, among others. Conclusion There are still ergonomic-related risks of RSI/WRMDs, and despite changes made during the COVID-19 pandemic, it remains important to comply with preventive needs and improve knowledge management among workers.

Resumo Introdução O teletrabalho surgiu décadas antes da pandemia. Em 2020, porém, com a propagação do vírus da COVID-19, esse modo de trabalho foi implementado de forma rápida e mais ampla. A falta de um ambiente dedicado ao teletrabalho, contudo, pode promover riscos ergonômicos e consequentemente uma maior ocorrência de distúrbios osteomusculares. Objetivo Compreender os riscos de lesões por esforços repetitivos (LER) e distúrbios osteomusculares relacionadas ao trabalho (DORT) no teletrabalho a partir da percepção de servidores de uma universidade pública. Métodos Obteu-se uma listagem de servidores da Divisão de Gestão com Pessoas de um campus de uma universidade pública que estavam em teletrabalho (parcial ou total) e selecionaram-se sujeitos para a realização de entrevistas individuais, com base em roteiro elaborado. As entrevistas foram gravadas e transcritas para análise temática de conteúdo. Resultados Participaram das entrevistas oito servidores, a maioria do sexo feminino, com idade entre 33 e 64 anos e de diversas categoriais profissionais. Nas entrevistas, surgiram inadequações ergonômicas, sintomas osteomusculares, utilização de estratégias individuais de prevenção, vantagens do teletrabalho, entre outros. Conclusão Ainda existem aspectos ergonômicos de risco para LER/DORT e, apesar das adaptações feitas ao longo da pandemia de COVID-19, ainda há necessidade de atender às necessidades de prevenção e melhorar a gestão de conhecimento para os trabalhadores.

Intervenções no trabalho para prevenção de distúrbios musculoesqueléticos: revisão sistemática de ensaios randomizados / Workplace interventions to prevent musculoskeletal disorders: a systematic review of randomized trials

Resumo Objetivo: investigar os efeitos de intervenções no ambiente laboral para prevenção de distúrbios musculoesqueléticos. Métodos: revisão sistemática que incluiu ensaios randomizados, individuados ou comunitários, que investigaram efeitos de intervenções no trabalho para prevenir distúrbios musculoesqueléticos, relatados em artigos publicados entre 2015 e 2020 e indexados nas bases de dados: Lilacs, Medline/Pubmed, PEDro e Web of Science. Os estudos foram categorizados conforme a modalidade de intervenção e avaliados quanto à qualidade metodológica. Resultados: dos 58 estudos selecionados, 15 atenderam satisfatoriamente aos critérios de qualidade, abordando diferentes modalidades de exercícios físicos e/ou abordagem cognitivo-comportamental, aplicadas de forma única ou combinada; nenhum estudo abordou intervenções organizacionais. Apesar da heterogeneidade de intervenções e desfechos, exercícios físicos realizados nos locais de trabalho resultaram em diminuição da dor musculoesquelética, do uso de analgésicos e do afastamento do trabalho por distúrbios musculoesqueléticos, no entanto, combinados às intervenções comportamentais não mostraram os resultados esperados. Os resultados com a Ergonomia Participativa ratificaram o papel fundamental dos trabalhadores na realização de intervenções em seus ambientes de trabalho. Conclusão: apesar de benefícios observados, salienta-se que os estudos revisados não produziram evidências consolidadas acerca das intervenções mais eficazes para prevenir distúrbios musculoesqueléticos entre trabalhadores.

Abstract Objective: to investigate the effects of workplace interventions aiming to prevent musculoskeletal disorders. Methods: systematic review that included randomized, individual or community trials, which investigated the effects of workplace interventions aiming to prevent musculoskeletal disorders, reported in articles published between 2015 and 2020 and indexed in the following databases: Lilacs, Medline/Pubmed, PEDro, and Web of Science. Studies were categorized according to the type of intervention and evaluated in terms of methodological quality. Results: of all 58 studies selected, 15 satisfactorily met the quality criteria, addressing different types of physical exercise and/or cognitive-behavioral approaches, applied alone or in combination. No study addressed organizational interventions. Despite the heterogeneity of interventions and outcomes, physical exercises performed in the workplace led to reduction in musculoskeletal pain, use of analgesics, and absence from work due to musculoskeletal disorders; however, combined with behavioral interventions, they did not show the expected results. The results with participatory ergonomics confirmed the critical role of workers in performing interventions in the workplace. Conclusion: despite the benefits observed, the studies reviewed did not produce consolidated evidence about the most effective interventions to prevent musculoskeletal disorders among workers.

Análisis de la discapacidad por trastornos musculoesqueléticos en México de 1990 a 2021 / Analysis of musculoskeletal disorders-associated disability in Mexico from 1990 to 2021

Resumen Antecedentes: Los trastornos musculoesqueléticos (TME) afectan a 1710 millones de personas en todo el mundo y es la principal causa de discapacidad. Objetivo: Analizar los años vividos con discapacidad (AVD) por TME en México entre 1990 y 2021. Material y métodos: Con las estimaciones del estudio de la Carga Global de la Enfermedad 2021 se analizaron los AVD por TME y sus seis categorías: osteoartritis, artritis reumatoide, gota, dolor cervical, lumbalgia y otros TME. Se evaluaron patrones y tendencias del número, tasa cruda y tasa estandarizada por edad de los AVD a nivel nacional, estatal, por grupos de edad y sexo. Resultados: Los TME constituyeron la principal causa de AVD en México entre 1990 y 2021, con un incremento de 57.3 %; pasaron de 1458.4 a 2293.7 por 100 000 habitantes. La lumbalgia (840.6 AVD) destacó con la mayor tasa en 2021 y la osteoartritis, con el mayor incremento. Los TME se incrementaron con la edad y, con excepción de la gota, afectaron más a las mujeres. Conclusiones: De 1990 a 2021, los TME constituyeron la principal causa de AVD en México, con mayor impacto en adultos y mujeres. Los TME se evidencian desde edades tempranas, de ahí la necesidad de intervenciones continuas para preservar la calidad de vida.

Abstract Background: Musculoskeletal disorders (MSD) affect 1.71 billion people worldwide and are the leading cause of disability. Objective: To analyze the years lived with disability (YLD) attributed to MSD in Mexico between 1990 and 2021. Material and methods: With estimates from the Global Burden of Disease 2021 study, the YLDs due to MSD and their six categories were analyzed, including osteoarthritis, rheumatoid arthritis, gout, neck pain, low back pain, as well as other MSDs. Patterns and trends in the number, crude rate, and YLD age-standardized rate were evaluated at the national and state levels, as well as by age group and gender. Results: MSDs were the main cause of YLDs in Mexico between 1990 and 2021, with an increase of 57.3%, going from 1,458.4 to 2,293.7 per 100,000 population. Low back pain (840.6 YLD) showed the highest rate in 2021, while osteoarthritis had the largest increase. MSDs increased with age and, and except for gout, affected women more often. Conclusions: From 1990 to 2021, MSDs were the main cause of YLDs in Mexico, with a higher impact on adults and women. MSDs can appear early in life, hence the need for continuous interventions in order to preserve quality of life.

Inequalities in employment and gender differences in the prevalence of work-related musculoskeletal disorders cases: a nationwide survey from Brazil, 2019.

OBJECTIVES: The present study aimed to investigate the prevalence of work-related musculoskeletal disorders (WRMDs) and to determine whether differences regarding the employment status (standard and non-standard), according to gender, increased the probability of WRMDs. STUDY DESIGN: Cross-sectional study. METHODS: Data from the 2019 National Health Survey (NHS) in Brazil were used. In total, 50,066 participants, both women and men, aged 18-65 years were included. Data were analysed for self-reported WRMDs. The binary logistic regression model, adjusting for possible covariables, was used to evaluate the association between working in the labour market and the occurrence of WRMDs. For covariates in the multivariate analysis, a P-value of <0.20 was considered in the univariate analysis. The variables with a P-value of <0.05 remained in the model. The odds ratio (OR), together with their confidence intervals at 95% (95% CI), were estimates both in the univariate and multivariate models. RESULTS: The prevalence of WRMDs was higher in women (4.2%) than men (1.9%). The likelihood of WRMDs was associated with the employment status only among men and proved to be lower for non-standard employment than standard employment (OR = 0.61; 95% CI = 0.43-0.87). Only among women, an increase in the likelihood of WRMDs associated with exposure to occupational noise was observed (OR = 1.77; 95% CI = 1.31-2.38) and a less favourable self-reported health (OR = 1.66; 95% CI = 1.08-2.54). Results showed higher change of WRMD for men and women associated with rheumatoid arthritis (men: OR = 3.94; 95% CI = 2.10-7.38; women: OR = 2.39; 95% CI = 1.68-3.39), depression (men: OR = 2.62; 95% CI = 1.54-4.45; women: OR = 2.39; 95% CI = 1.68-3.39) and occupational accidents (men: OR = 4.36; 95% CI = 2.34-8.14; women: OR = 2.20; 95% CI = 1.19-4.07). CONCLUSIONS: It is possible that the "double presence" that involves both the productive and reproductive spheres explains the higher prevalence of WRMDs among women Indicators that are sensitive to the effects of gender norms are necessary to understand the context of inequalities in the prevalence of WRMDs. The results of this study should be considered when developing strategies in the workplace and public health policies to reduce the prevalence of WRMDs.

Surgical fatigue syndrome and EDiS3 intervention, should every surgeon need to know how to mitigate muscle skeletal discomfort?

Background: Surgical fatigue syndrome (SFS) is a frequent, but underestimated, entity that occurs during laparoscopic surgeries. It could impair surgical outcomes, patient safety, and surgeon health. Furthermore, current surgical education lacks effective interventions to avoid it. Discomfort represents the most common manifestation and includes musculoskeletal fatigue, numbness, or frank pain. The most common affected sites are the back neck, dominant hand shoulder, and high or low back. We propose an integral intervention (surgeon posture, instruments/devices design & use and discomfort improvement) that prevents or mitigates SFS. Methods: An experimental study was conducted on 57 general surgery residents and general surgeons. Participants in the experimental and control group executed standardized laparoscopic knots in a simulator and knowledge, body discomfort, and posture/ergonomic risk was evaluated before and after intervention application. Results: A statistically significant decrease in discomfort intensity was found in the experimental group. Also, discomfort presentation by the anatomic site diminishes and surgical performance improves. Conclusions: Intervention prevents or mitigates discomfort associated with muscle-skeletal component of SFS. ACGME competency: Practice Based-Learning and Improvement.

The Diagnostic Capacity of Physical Examinations in Diagnosing Musculoskeletal Disorders of the Lower Limbs in Children with Down Syndrome.

Background and Objectives: although musculoskeletal alterations are common in patients with Down syndrome (DS), studies investigating this association are scarce, and proposals for diagnostic standardization are limited. We aimed to evaluate the prevalence of musculoskeletal disorders in the lower limbs in a sample of children and adolescents with DS and to investigate the diagnostic capacity of orthopedic clinical examinations performed by orthopedists and pediatricians to diagnose these alterations. Materials and Methods: Twenty-two patients aged between three and ten years with DS were included. Patients and guardians answered a simple questionnaire regarding orthopedic complaints and underwent a systematic orthopedic physical examination, performed twice: once by an orthopedist and again by a pediatrician. Patients underwent a series of radiographs to diagnose anisomelia, hip dysplasia, epiphysiolysis, flatfoot valgus, mechanical axis varus, and mechanical axis valgus. The radiological diagnosis was considered the gold standard, and the diagnostic capacity of the physical examination performed by each physician was determined. Results: The median age was 6.50 years. Only four patients (18.2%) presented with orthopedic complaints. All patients were diagnosed with at least one musculoskeletal disorder. The only musculoskeletal disorder with a good diagnostic capacity was flatfoot valgus. Limited sensitivity values were found for hip dysplasia, mechanical axis varus, and mechanical axis valgus. The agreement between the orthopedic physical examinations performed by the two examiners was weak, poor, or indeterminate for most of the analyzed items. Conclusions: There was a high prevalence of orthopedic alterations in children with DS who did not present with musculoskeletal complaints. The diagnostic capacity of the physical examination was limited. Therefore, all children with DS should undergo a radiological evaluation of the musculoskeletal system and subsequent specialized orthopedic evaluation. Level of Evidence: Level II (Diagnostic Studies).

Utilizing Motion Capture Systems for Instrumenting the OCRA Index: A Study on Risk Classification for Upper Limb Work-Related Activities.

In the search to enhance ergonomic risk assessments for upper limb work-related activities, this study introduced and validated the efficiency of an inertial motion capture system, paired with a specialized platform that digitalized the OCRA index. Conducted in a semi-controlled environment, the proposed methodology was compared to traditional risk classification techniques using both inertial and optical motion capture systems. The inertial method encompassed 18 units in a Bluetooth Low Energy tree topology network for activity recording, subsequently analyzed for risk using the platform. Principal outcomes emphasized the optical system's preeminence, aligning closely with the conventional technique. The optical system's superiority was further evident in its alignment with the traditional method. Meanwhile, the inertial system followed closely, with an error margin of just ±0.098 compared to the optical system. Risk classification was consistent across all systems. The inertial system demonstrated strong performance metrics, achieving F1-scores of 0.97 and 1 for "risk" and "no risk" classifications, respectively. Its distinct advantage of portability was reinforced by participants' feedback on its user-friendliness. The results highlight the inertial system's potential, mirroring the precision of both traditional and optical methods and achieving a 65% reduction in risk assessment time. This advancement mitigates the need for intricate video setups, emphasizing its potential in ergonomic assessments.

Potential and Limitations of Induced Pluripotent Stem Cells-Derived Mesenchymal Stem Cells in Musculoskeletal Disorders Treatment.

The burden of musculoskeletal disorders (MSK) is increasing worldwide. It affects millions of people worldwide, decreases their quality of life, and can cause mortality. The treatment of such conditions is challenging and often requires surgery. Thus, it is necessary to discuss new strategies. The therapeutic potential of mesenchymal stem cells (MSC) in several diseases has been investigated with relative success. However, this potential is hindered by their limited stemness and expansion ability in vitro and their high donor variability. MSC derived from induced pluripotent stem cells (iPSC) have emerged as an alternative treatment for MSK diseases. These cells present distinct features, such as a juvenile phenotype, in addition to higher stemness, proliferation, and differentiation potential than those of MSC. Here, we review the opportunities, challenges, and applications of iPSC as relevant clinical therapeutic cell sources for MSK disorders. We discuss iPSC sources from which to derive iMSC and the advantages and disadvantages of iMSC over MSC as a therapeutic approach. We further summarize the main preclinical and clinical studies exploring the therapeutic potential of iMSC in MSK disorders.

Exoskeletons: Contribution to Occupational Health and Safety.

This review aims to characterize the current landscape of exoskeletons designed to promote medical care and occupational safety in industrial settings. Extensive exploration of scientific databases spanning industries, health, and medicine informs the classification of exoskeletons according to their distinctive attributes and specific footholds on the human physique. Within the scope of this review, a comprehensive analysis is presented, contextualizing the integration of exoskeletons based on different work activities. The reviewers extracted the most relevant articles published between 2008 and 2023 from IEEE, Proquest, PubMed, Science Direct, Scopus, Web of Science, and other databases. In this review, the PRISMA-ScR checklist was used, and a Cohen's kappa coefficient of 0.642 was applied, implying moderate agreement among the reviewers; 75 primary studies were extracted from a total of 344. The future of exoskeletons in contributing to occupational health and safety will depend on continued collaboration between researchers, designers, healthcare professionals, and industries. With the continued development of technologies and an increasing understanding of how these devices interact with the human body, exoskeletons will likely remain valuable for improving working conditions and safety in various work environments.

Prevalence of musculoskeletal disorders in the lower limbs among artisanal fisherwomen / shellfish gatherers of Brazil / Prevalência de distúrbios musculoesqueléticos nos membros inferiores de pescadoras artesanais/marisqueiras do Brasil

Introduction: Small-scale fishing is responsible for at least 40% of the fish consumed in the world. In Brazil, the worker in this sector is the artisanal fisherman, who accounts for one in every 200 Brazilians. Artisanal fishing is part of the informal economy; therefore, the pathologies that affect these fishermen are invisible in the country's official statistics. Musculoskeletal disorders represent a major socioeconomic and public health problem, but their prevalence is little known among non-formal workers. Objective: to estimate the prevalence of musculoskeletal disorders (MSDs) in the lower limbs and to verify the associated factors among artisanal fishermen/ fisherwomen from Saubara, Bahia, Brazil. Methodology: a cross-sectional study, using the Nordic Musculoskeletal Questionnaire (NMQ), the Brazilian version of the Job Content Questionnaire (JCQ) and a questionnaire about physical demands, were used to collect information in a random sample of artisanal fishermen/shellfish gatherers, in 2013. Results: the prevalence of MSDs in lower limbs in the sample was 65.5% (n=137). The prevalence of MSDs in the thigh/knee segment, leg and ankle/foot were 48.7% (n=92), 47.7% (n=95) and 38.1% (n=72), respectively. There was also a high frequency of obesity, poor education, low wages, early age at onset of labor, and excessive workload. Factors such as age, smoking, physical demands, working time, absence of breaks and having had a previous job were associated with MSDs in the lower limbs. Conclusion: the high prevalence of MSDs in lower limbs in female artisanal fishermen indicates the need to develop strategies for prevention, diagnosis and reporting of these diseases.

Introdução: a pesca em pequena escala é responsável por pelo menos 40% do pescado consumido no mundo e, no Brasil, o trabalhador desse setor é o pescador artesanal, que contabiliza um a cada 200 brasileiros. Por se tratar de uma atividade da economia informal, as patologias que afetam esses pescadores são praticamente invisíveis nas estatísticas oficiais do país. Nesse contexto, os distúrbios musculoesqueléticos representam um grande problema socioeconômico e de saúde pública, mas sua prevalência é pouco conhecida entre trabalhadores não formais. Objetivo: estimar a prevalência de distúrbios musculoesqueléticos nos membros inferiores e fatores associados, em pescadores artesanais/marisqueiras de Saubara, Bahia, Brasil. Metodologia: trata-se de um estudo transversal, utilizando o Nordic Musculoskeletal Questionnaire, a versão brasileira do Job Content Questionnaire e um questionário sobre demandas físicas, para a coleta de informações em uma amostra aleatória de pescadores artesanais/marisqueiras, ocorrida em 2013. Resultados: a prevalência de distúrbios musculoesqueléticos em membros inferiores na amostra foi de 65,5% (n=137); a prevalência no segmento coxa/joelho, perna e tornozelo/pé foi de 48,7% (n=92), 47,7% (n=95) e 38,1% (n=72), respectivamente. Observaram-se também alta frequência de obesidade, baixa escolaridade, baixos salários, idade precoce para o início do trabalho e carga horária excessiva. Fatores como idade, tabagismo, demandas físicas, tempo de trabalho, ausência de pausas e trabalho anterior, estavam associados aos referidos distúrbios. Conclusão: A alta prevalência de distúrbios musculoesqueléticos dos membros inferiores em pescadoras artesanais indica a necessidade de desenvolver estratégias de prevenção, diagnóstico e notificação dessas doenças

Work-related musculoskeletal disorders in vulnerable populations: what are the most common body parts affected?

BACKGROUND: Studies investigating vulnerable populations have shown that work-related musculoskeletal disorders have a negative impact on quality of life. However, no study has examined the body regions commonly affected by work-related musculoskeletal disorders in vulnerable populations. OBJECTIVE: To describe the body regions commonly affected by work-related musculoskeletal disorders in vulnerable populations. METHODS: Cross-sectional study. We used the ABEP questionnaire, the World Health Organization Quality of Life, the Nordic Musculoskeletal Disorders Questionnaire, the Perceived Stress Scale, and a self-report questionnaire to determine morning-evening in human circadian rhythms (chronotype assessment). To reduce the possibility of information bias, we provided prior training in the use of the instruments and created an electronic database that was filled out in duplicate (in cases of disagreement, a third researcher was consulted). We tested the normality of the data using the Shapiro-Wilk test. RESULTS: The sample consisted of 132 participants, but there was a sample loss of 41.6% (final sample n = 77). We observed the predominance of those who worked from 6 to 8 h/day, rest of 1 h during the working day, from 1 to 10 years of service and only 1 employment relationship. Regarding the quality of life, we observed a worse result in the domain related to the environment, as well as a stress level of 15.43 (± 7.52) with a maximum of 30. Finally, we observed the presence of pain self-reported by the artisanal fishermen in several regions of the body, lumbar being the most mentioned. CONCLUSION: The neck, shoulders, arms, elbows, forearms, wrists, back, lumbar spine, and lower limbs are the most common parts of the body affected by work-related musculoskeletal disorders in artisanal fishermen.