Evaluación del riesgo ergonómico por posturas forzadas en fisioterapeutas / Evaluation of ergonomic risk due to forced postures in physiotherapists

INTRODUCCIÓN. Los trastornos músculo esqueléticos son problemas de salud en el trabajo y causa de ausentismo laboral a nivel mundial, por lo que la valoración de los factores de riesgo laboral es necesaria para lograr prevención. OBJETIVO. Evaluar el nivel de riesgo ergonómico por posturas forzadas en los fisioterapeutas. MATERIALES Y MÉTODOS. Estudio descriptivo transversal. Población de 35 y muestra de 31 fisioterapeutas del Área de Medicina Física y Rehabilitación del Hospital de Especialidades Carlos Andrade Marín, agosto de 2020. Se aplicó el cuestionario nór-dico para conocer la percepción de la sintomatología osteomuscular; una lista de verificación rápida de condiciones de riesgo (ISO TR 12295); y, para medir el nivel de riesgo de posturas forzadas se aplicó los métodos OWAS REBA. RESULTADOS. El 96,77% (30; 31) tuvo sintomatología osteomuscular en los últimos 12 meses. Las zonas corporales con mayor afectación fueron: cuello 77,42% (24; 31), espalda alta 64,52% (20; 31), y espalda baja 58,06% (18; 31). REBA mujer: puntaje de 11; nivel de acción 4, riesgo muy alto; y, hombre: nivel de acción 3, riesgo alto. OWAS mujer: nivel 3; y, hombre: nivel 2. CONCLUSIÓN. Se evaluó el nivel de riesgo ergonómico por posturas forzadas en los fisioterapeutas. Existieron factores predisponentes para el desarrollo de trastornos músculo esqueléticos que han repercutido en el normal desarrollo de sus actividades. Las metodologías REBA y OCRA, evidenciaron que las actividades laborales presentaron un nivel de riesgo alto a muy alto, por lo que es necesaria la actuación en el mejoramiento del puesto de trabajo.

INTRODUCTION. Musculoskeletal disorders are occupational health problems and a cause of absenteeism worldwide, so occupational risk assessment is necessary to achieve prevention. OBJECTIVE. To evaluate the level of ergonomic risk due to forced postures in physical therapists. MATERIALS AND METHODS. Cross-sectional descriptive study. Population of 35 and sample of 31 physical therapists of the Phy-sical Medicine and Rehabilitation Area of the Carlos Andrade Marín Specialties Hos-pital, august 2020. The nordic questionnaire was applied to know the perception of musculoskeletal symptomatology; a quick checklist of risk conditions (ISO TR 12295); and, to measure the level of risk of forced postures the OWAS REBA methods were applied. RESULTS. The 96,77% (30; 31) had musculoskeletal symptomatology in the last 12 months. The most affected body areas were: neck 77,42% (24; 31), upper back 64,52% (20; 31), and lower back 58,06% (18; 31). REBA female: score of 11; performance level 4, very high risk; and, male: performance level 3, high risk. OWAS woman: level 3; and, man: level 2. CONCLUSION. The level of ergonomic risk due to forced postures of physiotherapists was evaluated. There were predisposing factors for the development of musculoskeletal disorders that have impacted on the normal development of their activities. The REBA and OCRA methodologies showed that the work activities presented a high to very high level of risk, which is why it is necessary to revise the activities assigned to this job position.

Evaluación ergonómica en personal de emergencia, neurología y traumatología en un hospital de tercer nivel / Ergonomic evaluation in emergency personnel, neurology and traumatology in a third level hospital

INTRODUCCIÓN. El riesgo ergonómico es el más prevalente dentro de las lesiones ocupacionales y posibilidad de generar discapacidad1-3.. Sobre todo en unidades médicas de servicio hospitalario, en donde la manipulación de pacientes es obligatoria en el lecho o entre otros departamentos; porque tiene sus propias connotaciones, pero diferente exposición: exceso de levantamiento de pesos y posturas no ergonómicas, con tecnología de apoyo y el talento humano no siempre suficientes4-6. . OBJETIVO. Se evaluó el riesgo ergonómico en enfermeras/os y auxiliares, para recomendar medidas preventivas y correctivas en los Servicios de Emergencia, Neurología y Traumatología. MATERIALES Y MÉTODOS. Estudio observacional, descriptivo, la población fue de 411 trabajadores de salud y una muestra de 164. Datos recolecta dos a través del cuestionario nórdico: índice Movilización Asistencial de Pacientes Hospitalizados, y el método Ovako Working Posture Analysing System. Se analizó la base de datos en: Microsoft Excel, EpiInfo 2008 y SPSS Ver 10.0. RESULTADOS. El 31,0% (50;164), las molestias corporales evaluadas fueron del Área de Traumatología. Con mayor prevalencia las molestias de hombros 30,0% (15;50), muñecas 20,0% (10;50), columna lumbar 20,0% (10;50), columna dorsal 24,0% (12;50), rodillas y caderas 6,0% (3;50). CONCLUSIÓN. El riesgo ergonómico se encuentra directamente relacionado con la manipulación manual de pacientes.

INTRODUCTION. Ergonomic risk is the most prevalent in occupational injuries and the possibility of generating disability1-3. Especially in medical units of hospital service, where the manipulation of patients is obligatory in the bed or among other departments; because it has its own connotations, but different exposure: excess weight lifting and non-ergonomic postures, with support technology and human talent not always sufficient4-6.. OBJECTIVE. Ergonomic risk was evaluated in nurses and auxiliaries, to recommend preventive and corrective measures in the Emergency, Neurology and Traumatology Services. MATERIALS AND METHODS. An observational, descriptive study, the population was 411 health workers and a sample of 164. Data collected through the Nordic questionnaire: index Mobilization of Hospitalized Patients, and the Ovako Working Posture Analyzing System method. The database was analyzed in: Microsoft Excel, EpiInfo 2008 and SPSS Ver 10.0. RESULTS. 31,0% (50;164), the bodily discomforts evaluated were from the Traumatology Area. Most prevalent shoulder discomfort 30,0% (15;50), dolls 20,0% (10;50), lumbar spine 20,0% (10;50), dorsal spine 24,0% (12;50), 6,0% knees and hips (3;50). CONCLUSION. Ergonomic risk is directly related to the manual handling of patients.

Prevalencia de anticuerpos post-vacunales anti-antígeno de superficie del Virus de Hepatitis B / Prevalence of post-vaccine antibodies against surface antigen of Hepatitis B Virus

INTRODUCCIÓN. Los riesgos biológicos deben ser tratados de una manera especial; como tomar en cuenta la cantidad de Anticuerpos Anti Hbs de Hepatitis B de acuerdo al número de vacunas administradas y al puesto de trabajo. OBJETIVO. Determinar la prevalencia de anticuerpos post-vacunales anti-antígeno de superficie del virus de la Hepatitis B, en los trabajadores de salud, de acuerdo al número de dosis recibidas MATERIALES Y MÉTODOS. Estudio observacional retrospectivo de la prevalencia de anticuerpos post-vacunales anti-antígeno de superficie del virus de la Hepatitis B, en el personal de salud de acuerdo al número de vacunas, en el Hospital de Especialidades Carlos Andrade Marín, en el período comprendido entre marzo y octubre de 2017, analizado en el Sistema Informático AS 400. RESULTADOS. Predominó el sexo femenino. La edad fue 31,88% , (90:414) (30 y 40 años de edad), como área mayoritaria fue el Servicio de Cirugía con el 42,51% del total que generaron más anticuerpos a 100UI/ml y se consideraron seroprotegidos. En los trabajadores a los que no se les suministro la dosificación estándar se generaron niveles menores a los que si culminaron esta dosificación, CONCLUSION. Se determinó la prevalencia de los niveles séricos de anticuerpos anti antígeno de superficie, se estableció de acuerdo al número de dosis, la vacunación fue la principal fuente de generación de anticuerpos anti antígeno de superficie o anti ­ Hbs.

INTRODUCTION. Biological risks must be treated in a special way; how to take into account the amount of Antibodies Anti Hbs Hepatitis B according to the number of vaccines administered and the workplace. OBJECTIVE. To determine the prevalence of postvaccine anti-antigen antibodies to Hepatitis B virus surface, in health workers, according to the number of doses received. MATERIALS AND METHODS. Retrospective study of the prevalence of post-vacunal antibodies against antigen. of surface of the Hepatitis B virus, in the health personnel according to the number of vaccines, in the Hospital of Specialties Carlos Andrade Marín, in the period between March and October of 2017, analyzed in the Computer System AS 400. RESULTS. Female sex predominated. The age was 31,88% (32; 414), (30 and 40 years of age), as the majority area was the Surgery Service with 42,51% (43; 414) of the total that generated more antibodies at 100UI / ml and were considered seroprotected. In workers who were not given the standard dosage levels were generated lower than those that culminated this dosage, CONCLUSION. The prevalence of serum levels of antibodies against surface antigen was determined, was established according to the number of doses, vaccination was the main source of generation of antibodies against surface antigen or anti - Hbs

Postural control and sensory perception in patients with Parkinson's disease.

CONCLUSIONS: This study suggests that patients with Parkinson's disease (PD), even in the early stages, have decreased body limits of stability (LOS) and changes in the visual input impair their postural control. OBJECTIVE: To assess the LOS and the postural responses after changes in visual input in a group of PD patients in stage 1 of the Hoehn and Yahr classification. SUBJECTS AND METHODS: Twenty PD patients in stage 1 and a group of 24 normal subjects as control were assessed in two tests: (1) the LOS and (2) measurement of the body center of pressure area (COP) 10 s before and after sudden change in visual flow velocity. We also investigated labeling of the COP trajectory in these two periods. The stimulation paradigm was a horizontal optokinetic stimulation (60 degrees /s and suddenly stopped) using a virtual reality system. RESULTS: LOS showed significant decrease in PD patients as compared with the control group (p<0.001, Kruskal-Wallis and Wilcoxon ranked test). The COP values increased significantly (p<0.001, Wilcoxon signed rank test) after sudden changes in the visual flow velocity in relation to the control group. After the visual stop the PD patient showed a spatial 'roaming' approaching the limits of stability and therefore impairing the postural control.

Postural strategies in normal subjects and in patients with instability due to central nervous system diseases after sudden changes in the visual flow.

CONCLUSION: The results suggest that after a sudden change in the visual input, postural adaptation is impaired in patients with instability and central nervous system disorders (CNSD). OBJECTIVE: The aim of this study was the assessment of postural adaptation, as a transient phenomenon, when sudden changes in visual perception occur in normal subjects and in patients with instability due to different CNSD. SUBJECTS AND METHODS: Horizontal optokinetic stimulation (40 s and suddenly stopped) was performed in 16 patients with CNSD, and also in 22 normal subjects. Measurements were made of the body center of pressure area (COP) and the body sway velocity (SV) during 10 s before and after the stop and labeling the COP trajectory. RESULTS: Values of COP and SV (Wilcoxon signed rank test, p=0.979 and 0.496, respectively) in normal subjects did not show any significant change before and after the stop. In 15 of the 16 assessed patients with instability associated with CNSD an increase of the COP and SV values (Wilcoxon signed test, p=0.001 and 0.004, respectively) was observed in the 10 s after the visual stop. COP labeling showed 'roaming' of the COP spatial evolution approaching the limits of stability.