Effects of a workplace exercise program on physical capacity and lower back symptoms in hospital nursing assistants: a randomized controlled trial.

PURPOSE: Considering the relevance of muscle strength for sustaining good musculoskeletal health among workers who perform physically demanding work, the aim of this study was to evaluate the effectiveness of a therapeutic exercise program on muscle strength and low back symptoms among hospital nursing assistants. METHODS: One hundred and twenty-nine nursing assistants filled out a questionnaire on personal, occupational information and health status, which allowed the identification of workers able to exercise. Ninety participants were randomly allocated to an intervention and a reference group. The therapeutic exercise program (TEP) lasted 12 weeks and included warm-up, strengthening and stretching exercises. Muscle strength of trunk flexors and trunk extensors, hamstring flexibility, and low back symptoms were evaluated before and after the intervention period by two blinded assessors. The comparison between groups was carried out using Mann-Whitney and χ2 tests at a significance level of 0.05. RESULTS: The average participation in the exercise program was 17.5 sessions. Results showed increased trunk flexors muscle strength (p = 0.002; effect size: 0.77), improved pressure pain threshold for dorsal longissimus (p = 0.001; effect size > 0.8), and reduced low back symptoms (p = 0.002; OR = 6.25). No differences between groups were identified for back extensor muscle strength or flexibility. CONCLUSION: The exercise program applied is a feasible intervention which resulted clinically relevant results for nursing assistants' musculoskeletal health expressed through trunk flexors muscle strength improvement and low back symptoms control among nursing assistants. This RCT brings contribution to the Occupational Health field as the exercise program applied resulted in clinically relevant results for nursing assistants' musculoskeletal health. This study brings contribution especially for low-income and middle-income countries where low back pain and disability can be considered more severe as adequate resources to address the problem are scarce. Thus, we must highlight the importance of low-cost preventive strategies, like exercise programs carried out in hospital settings to avoid the progress of disability among active nursing personnel.

An Instrumented Workstation to Evaluate Weight-Bearing Distribution in the Sitting Posture.

BACKGROUND: Sitting posture may be related to risk factors, including inadequate weight-bearing support, particularly when maintained for long periods. Considering that body weight is loaded in a closed support system composed of the seat, backrest, floor and working surface, the aims of the present study were to describe the development of an ergonomic sitting workstation to continuously record weight-bearing at the seat, chair, backrest, work surface, and floor and to test its measurement properties: reproducibility, criterion-related validity, and sensitivity. METHODS: Rigid bodies (1 to 30 kg) and participant weights were recorded to evaluate the workstation measurement properties. RESULTS: Rigid body tests showed variation values less than 0.050 kg on reproducibility test and errors below 5% of measured value on criterion validity tests. Participant tests showed no statistically significant differences between repeated measures (p ≥ 0.40), errors were less than 2% of participant weights and sensitivity presented statistically significant changes (p = 0.007). CONCLUSION: The sitting workstation proposed showed to be reliable, valid and sensitive for use in future ergonomic studies to evaluate the sitting posture.

Prevalence of musculoskeletal symptoms in hospital nurse technicians and licensed practical nurses: associations with demographic factors

Objective : This cross-sectional study aimed at analyzing: 1. the main musculoskeletal symptoms (MSS) presented by hospital nursing workers and; 2. personal, occupational, and health factors related to MSS among them. Method : Two questionnaires were filled in by 245 nurse technicians (NTs) and licensed practical nurses (LPNs) (response rate 95%) associated with direct patient care sectors from a hospital. These questionnaires were: the standardized version of the Nordic Musculoskeletal Questionnaire (NMQ) and one including questions on 15 demographic independent variables potentially related to outcomes from the NMQ. Univariate analyses and binary logistic regression analyses were performed to identify which variables would explain the occurrence of MSS in different body regions. Results: The low back (57%), shoulder (52%), and neck (48%) were identified as the most affected regions. The logistic regression analysis showed that low back symptoms in the last 12 months were significantly associated with LPN activities (OR=2.36; CI=1.24-4.5) and previous sick leave due to MSS (OR=5.97; CI=1.2-29.1). Smoking was significantly associated with symptoms in the low back (OR=2.77; CI=1.13-6.8) and thoracic spine (OR=2.37; CI=1.04-5.40). Physical exercise showed a protective effect on the cervical spine (OR=0.42; CI=0.23-0.77). Previous sick leave was significantly associated with pain in the knees (OR=4.24; CI=1.33-13.5) and in the upper limbs (OR=5.36; CI=1.07-26.7). Conclusions: The nursing workers who were evaluated presented a high prevalence of MSS. Previous history of sick leave was strongly associated with the presence of symptoms in various body regions. These results indicate the need for preventive programs in the hospital environment in order to control more severe MSS in nursing professionals. .

Prevalence of musculoskeletal symptoms in hospital nurse technicians and licensed practical nurses: associations with demographic factors.

OBJECTIVE: This cross-sectional study aimed at analyzing: 1. the main musculoskeletal symptoms (MSS) presented by hospital nursing workers and; 2. personal, occupational, and health factors related to MSS among them. METHOD: Two questionnaires were filled in by 245 nurse technicians (NTs) and licensed practical nurses (LPNs) (response rate 95%) associated with direct patient care sectors from a hospital. These questionnaires were: the standardized version of the Nordic Musculoskeletal Questionnaire (NMQ) and one including questions on 15 demographic independent variables potentially related to outcomes from the NMQ. Univariate analyses and binary logistic regression analyses were performed to identify which variables would explain the occurrence of MSS in different body regions. RESULTS: The low back (57%), shoulder (52%), and neck (48%) were identified as the most affected regions. The logistic regression analysis showed that low back symptoms in the last 12 months were significantly associated with LPN activities (OR=2.36; CI=1.24-4.5) and previous sick leave due to MSS (OR=5.97; CI=1.2-29.1). Smoking was significantly associated with symptoms in the low back (OR=2.77; CI=1.13-6.8) and thoracic spine (OR=2.37; CI=1.04-5.40). Physical exercise showed a protective effect on the cervical spine (OR=0.42; CI=0.23-0.77). Previous sick leave was significantly associated with pain in the knees (OR=4.24; CI=1.33-13.5) and in the upper limbs (OR=5.36; CI=1.07-26.7). CONCLUSIONS: The nursing workers who were evaluated presented a high prevalence of MSS. Previous history of sick leave was strongly associated with the presence of symptoms in various body regions. These results indicate the need for preventive programs in the hospital environment in order to control more severe MSS in nursing professionals.

30° inclination in handles of plastic boxes can reduce postural and muscular workload during handling.

BACKGROUND: The handling of materials, which occurs in the industrial sector, is associated with lesions on the lumbar spine and in the upper limbs. Inserting handles in industrial boxes is a way to reduce work-related risks. Although the position and angle of the handles are significant factors in comfort and safety during handling, these factors have rarely been studied objectively. OBJECTIVE: To compare the handling of a commercial box and prototypes with handles and to evaluate the effects on upper limb posture, muscle electrical activity, and perceived acceptability using different grips while handling materials from different heights. METHOD: Thirty-seven healthy volunteers evaluated the handles of prototypes that allowed for changes in position (top and bottom) and angle (0°, 15°, and 30°). Wrist, elbow, and shoulder movements were evaluated using electrogoniometry and inclinometry. The muscle electrical activity in the wrist extensors, biceps brachii, and the upper portion of the trapezius was measured using a portable electromyographer. The recorded data on muscle movements and electrical activity were synchronized. Subjective evaluations of acceptability were evaluated using a visual analog scale. RESULTS AND CONCLUSIONS: The prototypes with handles at a 30° angle produced the highest acceptability ratings, more neutral wrist positions, lower levels of electromyographic activity for the upper trapezius, and lower elevation angles for the arms. The different measurement methods were complementary in evaluating the upper limbs during handling.

30o inclination in handles of plastic boxes can reduce postural and muscular workload during handling

BACKGROUND: The handling of materials, which occurs in the industrial sector, is associated with lesions on the lumbar spine and in the upper limbs. Inserting handles in industrial boxes is a way to reduce work-related risks. Although the position and angle of the handles are significant factors in comfort and safety during handling, these factors have rarely been studied objectively. OBJECTIVE: To compare the handling of a commercial box and prototypes with handles and to evaluate the effects on upper limb posture, muscle electrical activity, and perceived acceptability using different grips while handling materials from different heights. METHOD: Thirty-seven healthy volunteers evaluated the handles of prototypes that allowed for changes in position (top and bottom) and angle (0°, 15°, and 30°). Wrist, elbow, and shoulder movements were evaluated using electrogoniometry and inclinometry. The muscle electrical activity in the wrist extensors, biceps brachii, and the upper portion of the trapezius was measured using a portable electromyographer. The recorded data on muscle movements and electrical activity were synchronized. Subjective evaluations of acceptability were evaluated using a visual analog scale. RESULTS AND CONCLUSIONS: The prototypes with handles at a 30° angle produced the highest acceptability ratings, more neutral wrist positions, lower levels of electromyographic activity for the upper trapezius, and lower elevation angles for the arms. The different measurement methods were complementary in evaluating the upper limbs during handling. .

Wrist electrogoniometry: are current mathematical correction procedures effective in reducing crosstalk in functional assessment?

BACKGROUND: The recording of human movement is an essential requirement for biomechanical, clinical, and occupational analysis, allowing assessment of postural variation, occupational risks, and preventive programs in physical therapy and rehabilitation. The flexible electrogoniometer (EGM), considered a reliable and accurate device, is used for dynamic recordings of different joints. Despite these advantages, the EGM is susceptible to measurement errors, known as crosstalk. There are two known types of crosstalk: crosstalk due to sensor rotation and inherent crosstalk. Correction procedures have been proposed to correct these errors; however no study has used both procedures in clinical measures for wrist movements with the aim to optimize the correction. OBJECTIVE: To evaluate the effects of mathematical correction procedures on: 1) crosstalk due to forearm rotation, 2) inherent sensor crosstalk; and 3) the combination of these two procedures. METHOD: 43 healthy subjects had their maximum range of motion of wrist flexion/extension and ulnar/radials deviation recorded by EGM. The results were analyzed descriptively, and procedures were compared by differences. RESULTS: There was no significant difference in measurements before and after the application of correction procedures (P<0.05). Furthermore, the differences between the correction procedures were less than 5° in most cases, having little impact on the measurements. CONCLUSIONS: Considering the time-consuming data analysis, the specific technical knowledge involved, and the inefficient results, the correction procedures are not recommended for wrist recordings by EGM.

Wrist electrogoniometry: are current mathematical correction procedures effective in reducing crosstalk in functional assessment? / Eletrogoniometria de punho: procedimentos matemáticos usuais de correção são eficazes para reduzir crosstalk em avaliação funcional?

BACKGROUND: The recording of human movement is an essential requirement for biomechanical, clinical, and occupational analysis, allowing assessment of postural variation, occupational risks, and preventive programs in physical therapy and rehabilitation. The flexible electrogoniometer (EGM), considered a reliable and accurate device, is used for dynamic recordings of different joints. Despite these advantages, the EGM is susceptible to measurement errors, known as crosstalk. There are two known types of crosstalk: crosstalk due to sensor rotation and inherent crosstalk. Correction procedures have been proposed to correct these errors; however no study has used both procedures in clinical measures for wrist movements with the aim to optimize the correction. OBJECTIVE: To evaluate the effects of mathematical correction procedures on: 1) crosstalk due to forearm rotation, 2) inherent sensor crosstalk; and 3) the combination of these two procedures. METHOD: 43 healthy subjects had their maximum range of motion of wrist flexion/extension and ulnar/radials deviation recorded by EGM. The results were analyzed descriptively, and procedures were compared by differences. RESULTS: There was no significant difference in measurements before and after the application of correction procedures (P<0.05). Furthermore, the differences between the correction procedures were less than 5° in most cases, having little impact on the measurements. CONCLUSIONS: Considering the time-consuming data analysis, the specific technical knowledge involved, and the inefficient results, the correction procedures are not recommended for wrist recordings by EGM.

CONTEXTUALIZAÇÃO: O registro do movimento humano é requisito fundamental para análises biomecânicas, clínicas e ocupacionais, permitindo avaliar variações posturais, riscos e aprimoramento de programas preventivos e de reabilitação em Fisioterapia. O eletrogoniômetro flexível (EGM), considerado um equipamento confiável e acurado, é utilizado para o registro dinâmico de diferentes articulações. Apesar das vantagens, o EGM é suscetível de erros de medida, denominados crosstalk. Atualmente, são conhecidos dois tipos de crosstalk, o crosstalk devido à rotação do sensor e o crosstalk inerente. Procedimentos de correção foram propostos para a correção desses erros, no entanto nenhum estudo utilizou ambos os procedimentos em medidas clínicas dos movimentos do punho, visando otimizar a correção. OBJETIVO: Avaliar o efeito de procedimentos matemáticos atualmente empregados para correção do: 1) crosstalk devido à rotação do antebraço; 2) crosstalk inerente aos sensores e 3) combinação desses dois procedimentos. MÉTODO: Quarenta e três indivíduos saudáveis tiveram as amplitudes máximas dos movimentos de flexão/extensão e desvios ulnar/radial do punho registrados pelos EGM. Os resultados foram analisados de forma descritiva, e os procedimentos foram comparados por diferenças. RESULTADOS: Não houve alteração significativa nas medidas após a aplicação dos procedimentos de correção (P<0,05). Além disso, as diferenças entre os procedimentos de correção foram inferiores a 5° para a maioria dos casos, indicando pouco impacto sobre as medidas. CONCLUSÕES: Considerando o tempo de processamento, o conhecimento técnico específico exigido e os ineficazes resultados obtidos, desaconselha-se a aplicação desses procedimentos na correção de registros eletrogoniométricos do punho.

Are cutout handles used when available in real occupational settings? Description of grips and upper extremities movements during industrial box handling.

In order to achieve better postures and decrease musculoskeletal risks adequate design of hand/box couplings for manual materials handling (MMH) are still needed. No studies evaluating upper limb movement thorough direct measurements during box handling in workplace were identified in the literature. In this study we describe the types of grip and movements adopted by ten workers when handling redesigned boxes with cutout handles between different heights on industrial pallets. The new handles were used by 90% of the workers through different types of grip. Electrogoniometric measurements showed relatively safe forearm and wrist movements, although elbow inadequate range of movement was recorded. Despite the good acceptance of the cutout by workers, the new design requires extra internal space in the boxes reducing applications for this alternative of box.

Brazilian version of an assessment tool for the evaluation of work organizational aspects (AOT) by the NIOSH WMSD Research Consortium: translation and application in industrial sectors.

Work organization affects the production of a company as well as the health of employees. It is a challenge to create sustainable production systems with the least harm to the health. An observational assessment tool was developed by the NIOSH--WMSD Research Consortium and adapted by the SHARP study. The objectives were to translate this assessment tool into Brazilian Portuguese (as the Avaliação de Aspectos Organizacionais do Trabalho--AOT) and to evaluate its applicability in an industrial setting. The AOT final translated version was obtained after a consensus by the research team. Difficulties arose in applying the translated version due to technical terms with no direct equivalents in Portuguese, nonexcluding or similar alternatives, and questions that gave room for various interpretations, besides the great complexity of the tasks performed in the sectors. Despite that, the results suggest that AOT was sensitive for discriminating differences between sectors. Nevertheless, for better application of this tool in complex industrial environments, it is necessary: training and consensus among evaluators, familiarity with organizational aspects of the occupational settings evaluated. Also for assuring the internal validity of the analysis, might be necessary, the creation of subdivisions in the sectors evaluated if the tasks vary significantly intra-sector. The present report can help to understand the difficulties inherent to the evaluation of organizational aspects on a collective level and also the possible implications related to the translation of this assessment into other languages.

How do low/high height and weight variation affect upper limb movements during manual material handling of industrial boxes? / Como a variação de altura e massa da carga afetam os movimentos do membro superior durante o manuseio de caixas industriais?

OBJECTIVES: To evaluate the effect of surface height and load weight on upper limb movements and electromyographic (EMG) recordings during manual handling performed by both experienced and inexperienced lifter subjects. METHODS: Sixteen experienced and sixteen inexperienced lifters handled a box (both 7 and 15 kg) from an intermediate height (waist level) to either a high or low surface. Electromyography and video images were recorded during the tasks. The 10th, 50th and 90th percentiles were calculated for the deltoid and biceps muscles, shoulder flexion, shoulder abduction, and elbow flexion movements. Groups, right/left sides, weights and heights were compared. There were no differences between either groups or sides. RESULTS: Weight and height variations affected EMG and posture, although weight had more impact on EMG. Shoulder abduction and flexion movements higher than 60º occurred, particularly for the higher surface. Shoulder flexion was also higher when the box was moved to the low height. This study provides new evidence as shoulder postures during boxes handling on low surfaces had not previously been evaluated. CONCLUSIONS: The high demand of upper limb in manual material handling tasks is clear, particularly for the shoulder. This knowledge can be used by physical therapists to plan better rehabilitation programs for manual material handling-related disorders, particularly focusing on return to work.

OBJETIVOS: Avaliar o efeito da altura de superfície e massa da carga nos movimentos e na atividade eletromiográfica (EMG) dos membros superiores durante o manuseio de carga realizado por sujeitos experientes e inexperientes. MÉTODOS: Dezesseis sujeitos experientes e 16 inexperientes manusearam uma caixa (7 e 15 kg) de uma superfície com altura intermediária para uma superfície alta e/ou baixa. Durante as tarefas, foram registradas imagens de vídeo e EMG. Os dados foram processados para obtenção dos percentis 10, 50 e 90 referentes à EMG dos músculos deltoide e bíceps e aos movimentos de flexão e abdução do ombro e flexão do cotovelo. Foram comparados os grupos, lados (direito/esquerdo), massas e altura de manuseio. RESULTADOS: Não foram encontradas diferenças significantes entre os grupos ou lados. As variações de massa e altura de manuseio afetaram a EMG e postura, embora a massa da caixa tenha tido mais impacto sobre a EMG. Os movimentos de abdução e flexão do ombro ocorreram acima de 60º, particularmente no manuseio para a superfície alta. A amplitude de flexão de ombro também foi alta quando a caixa foi movida para a superfície baixa. Esse resultado consiste em uma nova evidência, já que posturas do ombro durante o manuseio de carga em superfícies baixas não tinham sido investigadas. CONCLUSÕES: A alta demanda do membro superior em tarefas de manuseio de carga é clara, particularmente do ombro. Esse conhecimento pode ser usado por fisioterapeutas para um melhor planejamento da reabilitação de lesões relacionadas ao manuseio de cargas, visando o retorno ao trabalho.

How do low/high height and weight variation affect upper limb movements during manual material handling of industrial boxes?

OBJECTIVES: To evaluate the effect of surface height and load weight on upper limb movements and electromyographic (EMG) recordings during manual handling performed by both experienced and inexperienced lifter subjects. METHODS: Sixteen experienced and sixteen inexperienced lifters handled a box (both 7 and 15 kg) from an intermediate height (waist level) to either a high or low surface. Electromyography and video images were recorded during the tasks. The 10th, 50th and 90th percentiles were calculated for the deltoid and biceps muscles, shoulder flexion, shoulder abduction, and elbow flexion movements. Groups, right/left sides, weights and heights were compared. There were no differences between either groups or sides. RESULTS: Weight and height variations affected EMG and posture, although weight had more impact on EMG. Shoulder abduction and flexion movements higher than 60º occurred, particularly for the higher surface. Shoulder flexion was also higher when the box was moved to the low height. This study provides new evidence as shoulder postures during boxes handling on low surfaces had not previously been evaluated. CONCLUSIONS: The high demand of upper limb in manual material handling tasks is clear, particularly for the shoulder. This knowledge can be used by physical therapists to plan better rehabilitation programs for manual material handling-related disorders, particularly focusing on return to work.

Evaluation of workload among industrial workers with the Need for Recovery Scale.

BACKGROUND: Work conditions can overload a worker's capabilities and result in health complaints. The early identification of hazardous work conditions allows the definition of priorities for more efficient ergonomic interventions. OBJECTIVES: To assess the need for recovery among industrial workers under different work conditions using the Need for Recovery Scale (NFR), and to verify the association between the scores and personal factors, occupational factors and daily activities. METHODS: 191 workers (mean age of 34.5±8.3 years) from a manufactory industry participated in this study. Workers answered both a questionnaire regarding demographic and occupational factors, and daily activities as well as the NFR. Ergonomic assessment of workplace sectors was carried out based on the Ergonomic Workplace Analysis. The Pearson chi-square test (significance level 5%) was used to verify the association between NFR scores and the variables of interest. RESULTS: The only association was between work sector and NFR score. According to the ergonomic assessment, the work sector with the highest need for recovery also presented the worst environmental and organizational conditions. CONCLUSIONS: The Need for Recovery Scale proved to be a helpful tool for differentiating work sectors presenting different workload demands and contributed to the definition of intervention priorities for preserving worker health.

Evaluation of workload among industrial workers with the Need for Recovery Scale / Sobrecarga em trabalhadores da indústria avaliada por meio da escala de necessidade de descanso

BACKGROUND: Work conditions can overload a worker's capabilities and result in health complaints. The early identification of hazardous work conditions allows the definition of priorities for more efficient ergonomic interventions. OBJECTIVES: To assess the need for recovery among industrial workers under different work conditions using the Need for Recovery Scale (NFR), and to verify the association between the scores and personal factors, occupational factors and daily activities. METHODS: 191 workers (mean age of 34.5±8.3 years) from a manufactory industry participated in this study. Workers answered both a questionnaire regarding demographic and occupational factors, and daily activities as well as the NFR. Ergonomic assessment of workplace sectors was carried out based on the Ergonomic Workplace Analysis. The Pearson chi-square test (significance level 5 percent) was used to verify the association between NFR scores and the variables of interest. Results: The only association was between work sector and NFR score. According to the ergonomic assessment, the work sector with the highest need for recovery also presented the worst environmental and organizational conditions. Conclusions: The Need for Recovery Scale proved to be a helpful tool for differentiating work sectors presenting different workload demands and contributed to the definition of intervention priorities for preserving worker health.

CONTEXTUALIZAÇÃO:As condições de trabalho podem gerar demandas excessivas e comprometer a saúde dos trabalhadores. A identificação precoce de condições críticas de trabalho permite determinar prioridades para intervenções preventivas e aumentar as chances de maior eficácia dessas medidas. OBJETIVOS: Avaliar a necessidade de descanso para trabalhadores industriais submetidos a diferentes condições de trabalho utilizando a Escala de Necessidade de Descanso (ENEDE) e verificar a associação de seus resultados com fatores pessoais, ocupacionais e de hábitos cotidianos desses trabalhadores. MÉTODOS:Participaram do estudo 191 trabalhadores (média de idade de 34,5±8,3 anos) de uma indústria de transformação de madeira. Os trabalhadores responderam a um questionário sobre dados demográficos, ocupacionais e de aspectos de vida cotidiana e à ENEDE. Realizou-se avaliação ergonômica dos setores de trabalho com base no protocolo Ergonomic Workplace Analysis. O teste qui-quadrado de Pearson a 5 por cento de significância foi utilizado para verificar associação entre a pontuação obtida pela ENEDE e os fatores avaliados. RESULTADOS:Os resultados mostraram que houve associação apenas entre o setor de trabalho e as pontuações da ENEDE. Segundo a avaliação ergonômica, o setor que apresentou maior necessidade de descanso também apresentou piores condições de trabalho quanto a aspectos ambientais e organizacionais. Conclusões: A escala para avaliação da necessidade de descanso mostrou-se um instrumento útil para diferenciar setores de trabalho com diferentes níveis de exigências e contribuir para a definição de prioridades de intervenção para a preservação da saúde de trabalhadores industriais.

Efetividade do exercício físico em ambiente ocupacional para controle da dor cervical, lombar e do ombro: uma revisão sistemática / Evaluation of the effectiveness of workplace exercise in controlling neck, shoulder and low back pain: a systematic review

CONTEXTUALIZAÇÃO: As disfunções musculoesqueléticas representam um problema de saúde mundial. Dentre o conjunto de medidas para controle dessas alterações está a prática de exercício físico em ambiente ocupacional que pode ser realizada no próprio setor de trabalho ou em ambientes à parte, mas dentro da empresa. Entretanto, há controvérsias quanto à efetividade e à forma de aplicação desse tipo de intervenção. OBJETIVOS: Avaliar a efetividade e fornecer evidências a respeito da prática de exercício físico no ambiente ocupacional para o controle da dor musculoesquelética. MÉTODOS: As seguintes bases bibliográficas foram consultadas: PubMed, MEDLINE, Embase, Cochrane, PEDro e Web of Science. Dois revisores independentes selecionaram os estudos pertinentes, e as eventuais discordâncias foram solucionadas por consenso. Foram incluídos no estudo os ensaios clínicos randomizados controlados que realizaram intervenção no local de trabalho envolvendo exercício e avaliaram a dor musculoesquelética. A escala PEDro, que tem pontuação de 0-10, foi utilizada para avaliação da qualidade dos estudos incluídos nesta revisão. RESULTADOS E CONCLUSÕES: A busca eletrônica resultou em um total de 8680 referências publicadas em inglês. Ao final do processo de seleção, 18 estudos foram incluídos. Forte evidência foi encontrada para a efetividade do exercício físico no controle de dor cervical em trabalhadores que realizavam atividades em escritórios ou setores administrativos, descritos como sedentários enquanto evidência moderada foi encontrada para a região lombar daqueles que realizavam atividades envolvendo manuseio de pacientes ou materiais na indústria, desde que os treinamentos fossem aplicados por períodos superiores a dez semanas, incluíssem exercícios realizados com algum tipo de resistência e fossem supervisionados. Nenhum estudo avaliando trabalhadores sedentários relatou resultados positivos para o controle da dor musculoesquelética em ombros. ...

BACKGROUND: Musculoskeletal disorders have been recognized as a worldwide health problem. One of the measures for controlling these disorders is workplace exercise, either at the workstation or in a separate environment within the company. However, there is controversy regarding the effectiveness and means of applying these interventions. OBJECTIVES: To assess and provide evidence of the effectiveness of workplace exercise in controlling musculoskeletal pain. METHODS: The following databases were searched: PubMed, MEDLINE, Embase, Cochrane, PEDro and Web of Science. Two independent reviewers selected the elegible studies. Possible disagreements were solved by consensus. All randomized controlled clinical trials that evaluated exercise interventions in the workplace musculoskeletal pain relief were included. The PEDro scale (range=0-10 points) was used to rate the quality of the studies included in this review. Results and CONCLUSIONS: The electronic search yielded a total of 8680 references published in English. At the end of the selection process, 18 studies were included. Strong evidence was found to support the effectiveness of physical exercise in controlling neck pain among workers who performed sedentary tasks in offices or administrative environments, while moderate evidence was found for low back pain relief among healthcare and industrial workers who performed heavy physical tasks. These positive results were reported when the training periods were longer than 10 weeks, the exercises were performed against some type of resistance and the sessions were supervised. None of the studies evaluating sedentary workers reported positive results for controlling musculoskeletal shoulder pain. Further randomized controlled trials are needed to comparatively evaluate, among other aspects, the effects of light and heavy training for shoulder pain relief.

Low back problems and possible improvements in nursing jobs.

AIM: This paper reports a study that aimed to evaluate the workload, to identify problems leading to the higher incidence rate of work-related low back injury among nurses in the orthopaedic and intensive care unit departments of the hospital, and to gather information about improvements that the nurses would like in the workplace. BACKGROUND: The literature shows that low back injuries are common among nurses, and intervention programmes are needed to address this problem. METHOD: The hospital injury records were examined in a retrospective study. In addition, a validated questionnaire was administered between January and May 2005 to 47 nurses (23 orthopaedic and 24 intensive care nurses). The questionnaire contained questions on workload, history of back injuries, problems, possible solutions and psychophysical measures of exertion. FINDINGS: The life-time incidence and point prevalence of low back pain were 65% and 30%, respectively, in orthopaedic nurses, and 58% and 25%, respectively, in the intensive care nurses. The mean weight handled was reported to be 47 +/- 30 kg by the orthopaedic nurses and 26 +/- 10 kg by the intensive care nurses. The low back scored highest for body-part discomfort - 4.6 and 4.0, respectively, on a 10-point scale. The rate of perceived job exertion was 6.7 +/- 1.8 (very strong), and 5.8 +/- 1.9 (strong) on Borg's 10-point scale. The total effort required by the job, rated on Visual Analogue Scales, was 67 +/- 14% and 68 +/- 15% of the maximum, respectively. The Borg scores and the total effort according to the Visual Analogue Scale, and the Borg scores and force effort on the Visual Analogue Scale were moderately correlated (r = 0.53, P < 0.01 for both comparisons). CONCLUSION: The methodology proposed here is practical for job evaluation and to design a participatory ergonomic intervention aiming at reducing low back injuries in nursing jobs. There are workload differences between nursing jobs. Lifting devices, biomechanical training, bigger rooms, adequate set-up and additional staff are suggested improvements.