Reference Values for Cervical Muscle Strength in Healthy Women Using a Hand-Held Dynamometer and the Association with Age and Anthropometric Variables.

Knowledge of reference values for cervical muscle strength is a key tool for clinicians to use as a clinical reference measure and to establish goals during rehabilitation. The objective was to establish reference values for the maximal strength of cervical muscles in healthy women using a handheld dynamometer and verify the association of cervical muscle strength with age and anthropometric measurements. A hundred women were classified into four groups (n = 25) according to age: 18-29 years, 30-39 years, 40-49 years, and 50-60 years. Maximal muscle strength of the cervical spine was measured using a Lafayette® handheld dynamometer for flexion, extension, and bilateral lateral flexion. No differences in cervical muscle strength were observed among the groups (p > 0.05). However, the 18-29-year-old group took less time to reach the peak of force for flexion than the 50-60-year-old group. Moderate correlations were observed between cervical flexor strength and weight, body mass index, and neck circumference, and between cervical extensor strength and weight and body mass index (r = 0.43-0.55; p < 0.05). Reference values for cervical muscle strength in healthy women were established using a handheld dynamometer, and the association between muscle strength and anthropometric data was moderate.

Neck Strength Evaluated With Fixed and Portable Dynamometers in Asymptomatic Individuals: Correlation, Concurrent Validity, and Agreement.

OBJECTIVE: The purpose of this study was to assess the correlation, concurrent validity, and agreement between the isometric cervical force measurements obtained with fixed and portable dynamometers in asymptomatic individuals. METHODS: Fifty asymptomatic individuals performed 3 maximal isometric contractions for flexion, extension, and lateral flexion of the cervical spine using fixed and portable dynamometers. The correlation and concurrent validity for the measurements of the portable and fixed dynamometers were analyzed using Spearman's correlation coefficient and the intraclass correlation coefficient (ICC), respectively. The agreement between the force values of the portable and fixed dynamometers was measured using the Bland-Altman method. RESULTS: Isometric cervical force measurements obtained with the fixed dynamometer and portable dynamometer showed a moderately to highly significant correlation for flexion (rs = 0.74), extension (rs = 0.82), right lateral flexion (rs = 0.74), and left lateral flexion (rs = 0.68). The concurrent validity was moderate to good for all measurements (ICC2,3 = 0.67-0.80). The fixed and portable dynamometers did not agree, with a significant mean difference between the methods of 2.8 kgf (95% confidence interval [CI], 2.1-3.4 kgf) for cervical flexion, 5.3 kgf (95% CI, 4.2-6.4 kgf) for extension, and 9.1 kgf (95% CI, 0.4-2.1 kgf) for left lateral flexion. The limits of agreement were broad for all movements, with errors that varied between 61% and 77% of the mean force obtained with the fixed dynamometer. CONCLUSION: The neck strength measurements obtained with the fixed and portable dynamometers demonstrated high to moderate correlation and had moderate to good comparability for asymptomatic participants. However, they did not agree in that the 2 methods did not provide equivalent measurements, and, therefore, based on these findings, the same equipment should always be used when reassessing an individual.

Ergonomic evaluation of computer workers.

Introduction: Information technologies have become indispensable in the office environment with a considerable increase in the use of computers. Musculoskeletal complaints in computer workers have a multifactorial etiology; therefore, an ergonomic investigation should be based on both self-reporting of symptoms and quantifiable observational methods. Objectives: This study aimed to evaluate ergonomic and biomechanical characteristics of computer workers to identify the presence of symptoms and to assess the existence of a correlation between experts' observational assessment and workers' self-perception. Methods: Participants were approached by an observer responsible for screening of symptoms and demographic characteristics. Volunteers were then evaluated simultaneously by two blinded observers. Results: Seventy-one computer workers participated, and no significant differences were observed for duration of work on a computer between participants with and without pain. Interobserver reliability was good (0.93, 95%CI 0.88-0.96). No correlation was found between Maastricht Upper Extremity Questionnaire and Rapid Office Strain Assessment scores (p = 0.054/r = 0.230). There was no difference between participants with and without pain in the Rapid Office Strain Assessment (p = 0.931). In the Maastricht Upper Extremity Questionnaire assessment, there were differences in job demand (p = 0.004), complaints (p = 0.034), and total score (p = 0.044), with higher scores for asymptomatic participants. Conclusions: The results suggest that asymptomatic individuals are subject to higher job demands probably because they have not previously experienced significant pain. However, they have other complaints, such as stiffness, disability, weakness, edema, and paresthesia. Symptomatic individuals, in turn, have greater trouble in aspects such as reduced amount of time spent on work and performance of work requiring extra effort.

Introdução: As tecnologias da informação tornaram-se indispensáveis no ambiente de escritório, resultando no aumento considerável do uso do computador. As queixas musculoesqueléticas em trabalhadores usuários de computador possuem etiologia multifatorial; assim, no campo da ergonomia, a investigação deve ser baseada em relato de sintomas e por métodos observacionais quantificáveis. Objetivos: Avaliar aspectos ergonômicos e biomecânicos de trabalhadores de escritório usuários de computador, identificar a presença de sintomas e verificar a existência de correlação entre a avaliação observacional e a percepção dos colaboradores. Métodos: Os participantes foram abordados por um avaliador responsável pela triagem, que incluiu sintomas e características demográficas. Em seguida, o voluntário foi avaliado simultaneamente por dois avaliadores cegados entre si e para as características dos participantes. Resultados: Participaram 71 trabalhadores, não sendo observadas diferenças significativas para tempo de trabalho entre os indivíduos com e sem dor. A confiabilidade interavaliador foi considerada forte (0,93; IC95% 0,88-0,96). Não foi encontrada correlação entre o Maastricht Upper Extremity Questionnaire e o Rapid Office Strain Assessment (p = 0,054/r = 0,230). Não foi observada diferença entre os indivíduos com e sem dor no Rapid Office Strain Assessment (p = 0,931). Já na análise do Maastricht Upper Extremity Questionnaire, houve diferença nos domínios demanda (p = 0,004), queixas (p = 0,034) e total (p = 0,044), com maior pontuação para os assintomáticos. Conclusões: Os resultados sugerem que os indivíduos assintomáticos se submetem a uma maior demanda de trabalho, provavelmente devido à ausência de experiências prévias significativas de dor. Entretanto, apresentam outras queixas, com ênfase em rigidez, incapacidade, fraqueza, edema e parestesia. Já os sintomáticos apresentam maior dificuldade em questões como tempo dedicado ao trabalho e execução do tempo de trabalho, necessitando realizar esforços extras.

Avaliação das queixas cervicobraquiais e do desalinhamento estático da escápula em usuários de computador / Assessment of arm, neck and shoulder complaints and scapular static malposition among computer users

Introdução: Queixas musculoesqueléticas nas regiões dos membros superiores, do complexo do ombro e da cervical não atribuídas a trauma agudo ou a desordens sistêmicas (complaints of arms, neck and shoulders ­ CANS) são caracterizadas por sintomas como dor, dormência e parestesia e podem atingir níveis severos e debilitantes, comprometendo o desempenho de atividades de vida diária e ocupacionais. Nos últimos anos, o uso de computador no trabalho intensificou-se, gerando considerável aumento das ocorrências das CANS entre os usuários. Objetivo: O objetivo foi descrever os fatores de risco biomecânicos e psicossociais, o desequilíbrio estático escapular e o impacto funcional nas atividades ocupacionais e de vida diária decorrente de sinais e sintomas dos membros superiores em trabalhadores usuários de computador. Métodos: Foram analisados os fatores de risco ergonômicos e psicossociais pelo Maastricht Upper Extremity Questionnaire (MUEQ-Br), o desequilíbrio postural estático da escápula por meio do Scapular Malposition, Inferior Medial Border Prominence, Coracoid Pain and Malposition, and Dyskinesis of Scapular Movement (SICK-Scapula) e o comprometimento funcional das atividades ocupacionais e de vida diária pelo Disabilities of the Arm, Shoulder and Hand (DASH) de 109 trabalhadores usuários de computador do setor privado. Resultados: Foi encontrada pontuação média significativamente maior para postura e controle de trabalho nos indivíduos sintomáticos. Posicionamento escapular não se mostrou diferente entre as amostras com e sem dor, entretanto foi diferente para impacto funcional. Conclusões: A adoção de posturas inadequadas no trabalho e o mau gerenciamento das condições de controle de trabalho parecem contribuir para o desenvolvimento das CANS em trabalhadores de escritório que utilizam computador. O desalinhamento estático da escápula não necessariamente está presente em indivíduos com CANS; o inverso é verdadeiro. Ademais, os indivíduos com CANS apresentaram maior impacto funcional

Background: Musculoskeletal complaints of the arm, neck and/or shoulder not attributed to acute trauma or any systemic disorder (CANS) are characterized by symptoms such as pain, numbness and paresthesia which may reach severe and disabling levels and thus significantly interfere with the performance of work and daily living activities. Computer use at work considerably increased in recent years, being attended with a substantial elevation of the prevalence of CANS among individuals who use computers at work. Objective: To investigate biomechanical and psychosocial risk factors, scapular static imbalance and functional impact on work and daily living activities of upper limb complaints among workers who use computers. Methods: We analyzed ergonomic and psychosocial risk factors by means of MUEQ-Br, scapular static malposition with the SICK-scapula protocol, and functional impairment in work and daily living activities with DASH. The sample comprised 109 employees of a private institution who use computers at work. Results: The average scores on body posture and control over tasks were significantly higher among the symptomatic participants. Scapular malposition did not differ between the symptomatic and asymptomatic participants, but functional impairment did. Conclusion: Awkward posture at work and poor control over tasks seem to contribute to the occurrence of CANS among office workers who use computers. Scapular malposition is not systematically present among individuals with CANS, but the opposite is true. Individuals with CANS exhibited functional impairments.

Assessment of arm, neck and shoulder complaints and scapular static malposition among computer users.

BACKGROUND: Musculoskeletal complaints of the arm, neck and/or shoulder not attributed to acute trauma or any systemic disorder (CANS) are characterized by symptoms such as pain, numbness and paresthesia which may reach severe and disabling levels and thus significantly interfere with the performance of work and daily living activities. Computer use at work considerably increased in recent years, being attended with a substantial elevation of the prevalence of CANS among individuals who use computers at work. OBJECTIVE: To investigate biomechanical and psychosocial risk factors, scapular static imbalance and functional impact on work and daily living activities of upper limb complaints among workers who use computers. METHODS: We analyzed ergonomic and psychosocial risk factors by means of MUEQ-Br, scapular static malposition with the SICK-scapula protocol, and functional impairment in work and daily living activities with DASH. The sample comprised 109 employees of a private institution who use computers at work. RESULTS: The average scores on body posture and control over tasks were significantly higher among the symptomatic participants. Scapular malposition did not differ between the symptomatic and asymptomatic participants, but functional impairment did. CONCLUSION: Awkward posture at work and poor control over tasks seem to contribute to the occurrence of CANS among office workers who use computers. Scapular malposition is not systematically present among individuals with CANS, but the opposite is true. Individuals with CANS exhibited functional impairments.

INTRODUÇÃO: Queixas musculoesqueléticas nas regiões dos membros superiores, do complexo do ombro e da cervical não atribuídas a trauma agudo ou a desordens sistêmicas (complaints of arms, neck and shoulders - CANS) são caracterizadas por sintomas como dor, dormência e parestesia e podem atingir níveis severos e debilitantes, comprometendo o desempenho de atividades de vida diária e ocupacionais. Nos últimos anos, o uso de computador no trabalho intensificou-se, gerando considerável aumento das ocorrências das CANS entre os usuários. OBJETIVO: O objetivo foi descrever os fatores de risco biomecânicos e psicossociais, o desequilíbrio estático escapular e o impacto funcional nas atividades ocupacionais e de vida diária decorrente de sinais e sintomas dos membros superiores em trabalhadores usuários de computador. MÉTODOS: Foram analisados os fatores de risco ergonômicos e psicossociais pelo Maastricht Upper Extremity Questionnaire (MUEQ-Br), o desequilíbrio postural estático da escápula por meio do Scapular Malposition, Inferior Medial Border Prominence, Coracoid Pain and Malposition, and Dyskinesis of Scapular Movement (SICK-Scapula) e o comprometimento funcional das atividades ocupacionais e de vida diária pelo Disabilities of the Arm, Shoulder and Hand (DASH) de 109 trabalhadores usuários de computador do setor privado. RESULTADOS: Foi encontrada pontuação média significativamente maior para postura e controle de trabalho nos indivíduos sintomáticos. Posicionamento escapular não se mostrou diferente entre as amostras com e sem dor, entretanto foi diferente para impacto funcional. CONCLUSÕES: A adoção de posturas inadequadas no trabalho e o mau gerenciamento das condições de controle de trabalho parecem contribuir para o desenvolvimento das CANS em trabalhadores de escritório que utilizam computador. O desalinhamento estático da escápula não necessariamente está presente em indivíduos com CANS; o inverso é verdadeiro. Ademais, os indivíduos com CANS apresentaram maior impacto funcional.