The effect of a structured personalized ergonomic intervention program for hospital nurses with reported musculoskeletal pain: An assigned randomized control trial.

BACKGROUND: Intervention programs for hospital nurses with musculoskeletal pain present a challenge for the health professions. OBJECTIVE: To examine the effect of a structured personalized ergonomic intervention program for hospital nurses with musculoskeletal pain. METHODS: In a randomised controlled trial, 31 nurses from one central hospital with musculoskeletal pain were observed at work. A multi-stage study that included the Nordic Musculoskeletal Questionnaire, Karasek's questionnaire, The Rapid Entire Body Assessment, and an intervention program was completed with 14 nurses, while the remaining 17 were assigned to a control group. The intervention program was carried out by one physiotherapist and included four meetings over three months. The control group received only instruction sheets. Data on body posture and frequency and intensity of pain were collected before and at three months after the termination of the intervention program. RESULTS: Compared with the control group, the intervention group showed an improvement in REBA scores and in posture that is considered risk factor for work-related musculoskeletal discomfort disorders [p < 0.001], but there were no significant differences in the number of body parts in pain or in the level of musculoskeletal pain. CONCLUSIONS: The intervention was shown to be effective in reducing risk factors for work-related musculoskeletal disorders over a short follow-up period. A long-term study is required to determine if this effect is preserved over a longer period and to determine whether the intervention can reduce musculoskeletal symptoms.

Perceived environmental restrictions for the participation of children with mild developmental disabilities.

AIM: In light of the International Classification of Functioning, and Health (ICF) model, to assess whether parents of children with mild developmental disabilities perceived various environmental factors as barriers to their child's participation, and whether these factors have a unique contribution to the total explained variance of participation, beyond personal factors. METHODS: Seventy-nine kindergarten children (mean age 5.20 ± 0.52 years old) with mild developmental disabilities and their parents participated in the study. Three questionnaires measuring the child's participation, performance skills and environmental factors were completed by the parents. RESULTS: Parents perceived environmental factors as slightly restricting to their child's participation. Associations were found between home and education factors and the dimensions of child participation - independence, enjoyment and parental satisfaction. Although parents perceived human environmental factors as more restricting than physical factors at home, regression analysis revealed that the latter was found to affect the child participation dimension of independence beyond the contribution of personal factors. INTERPRETATION: These findings are the first, to our knowledge, to support the contribution of environmental factors to the participation of young children with mild developmental disabilities. The results show that environmental factors have significant slight contribution to child's independence in participation beyond other predictors (i.e. personal factors). Therefore, it is recommended to include environmental restrictions measurement in the child evaluation process to facilitate effective intervention programs.

Personal and environmental pathways to participation in young children with and without mild motor disabilities.

OBJECTIVE: Participation in everyday activities has a positive influence upon health and well-being and is considered as an outcome measure. According to recent models child participation is the product of the dynamic interaction between health states and both individual and environmental factors. Children with mild developmental disabilities often present decreased participation in everyday activities. The purpose of this study was to explore the extent to which individual and environmental factors explain the participation of young children, with and without mild motor disabilities. METHODS: The study population included 58 kindergarten children together with their parents (29 children with mild motor disabilities who were referred to occupational therapy and 29 children without motor disabilities). Both groups of children were matched for: age; gender; age of parents; and socio-economic status (SES). We assessed participation using the Child Participation Questionnaire (intensity, diversity, independence, child enjoyment and parental satisfaction) and we assessed children's self-efficacy and motor abilities for individual factors. Parental self-efficacy and SES were collected by questionnaires. RESULTS: Participation diversity (number of activities) was predicted by child and mother self-efficacy and by SES. Child independence and enjoyment as well as parental satisfaction were predicted by child motor ability but mainly by maternal self-efficacy. Results suggest that the total explained variance is more than double when the environmental variables (parental self-efficacy and SES) are inserted to the participation model. CONCLUSIONS: Maternal self-efficacy and SES serve as facilitators to increased participation and well-being of children with mild motor disabilities.

Correlation between risk factors and musculoskeletal disorders among classical musicians.

BACKGROUND: Musculoskeletal disorders in humans may originate from biomechanical, environmental, psychosocial and personal risk factors encountered in the working environment. These disorders in musicians are designated as playing related musculoskeletal disorders (PRMD). AIMS: To investigate the correlation between biomechanical, environmental, psychosocial and personal risk factors and potential incidence of PRMD arising in professional classical musicians. METHODS: Fifty-nine orchestral classical musicians were observed: They also filled out questionnaires providing information regarding musculoskeletal symptoms, psychosocial factors and demography. RESULTS: Clinical observation using the Rapid Upper Limb Assessment (RULA) showed significantly higher scores in string musicians compared with woodwind and brass players (right RULA score F = 4.77, P < 0.05; left RULA score, F = 3.90, P < 0.05). A multivariate regression model showed statistical significance for five of the six dependent variables regarding prevalence of painful joints, severity of musculoskeletal symptoms and functional limitation. The regression analysis revealed that biomechanical risk factors, perceived physical environment risk factors, instrument weight and average playing hours per week, were the main predictors of PRMD. CONCLUSIONS: The biomechanical risk factors that predict PRMD are mainly associated with the upper limbs. A high association between PRMD and clinical observation emphasizes the need for further investigation of these risk factors and to study possible implementations in order to define 'prevention strategies' for musical routines and patterns, as used by classical musicians.

Can personal and environmental factors explain dimensions of child participation?

OBJECTIVE: One of the main goals of paediatric occupational therapists and other health professionals is to enhance child participation in age-related activities within their communities. According to theoretical models, the act of participation has numerous dimensions, affected by personal and environmental factors. However, there have been relatively few studies undertaken to validate this theory. The purpose of this study was to explore the extent to which personal and environmental factors explain each of five distinct dimensions of child participation, which are: diversity, intensity, independence, enjoyment and subsequent parental satisfaction. METHOD: A convenient sample of 70 kindergarten children without developmental disabilities together with their parents participated in the study. Data were collected using standardized assessments for personal factors and questionnaires for environmental factors. RESULTS: The findings confirmed our hypothesis and revealed that with typical children, motor and cognitive abilities affect participation diversity. Moreover, performance skills and self-perceptions of competence affect their independence levels, while environmental factors contribute to frequency of participation and parental satisfaction. However, these factors on their own do not fully explain the degree of enjoyment experienced by children. CONCLUSIONS: The findings highlight the importance of measuring the full range of participation dimensions, and provide empirical evidence about the nature of child participation. Further studies are warranted to validate this approach for children with developmental difficulties.

Efficiency of the home parental programme in visual-motor home activity among first-grade children.

BACKGROUND: The objectives of this study were to assess the efficacy of the home parental programme (HPP) in improving children's visual-motor skills, and to assess parent satisfaction with the programme. METHODS: Forty-five children and their parents participated in the study: 23 children and their parents in the study group (children receiving consultation in the classroom and whose parents participated in the HPP) and 22 children and their parents in the control group (children receiving consultation in the classroom only). All children were recruited based on their scores on the Visual Motor Integration test or upon teacher referral. The Developmental Test of Visual Perception-2 administered before and after intervention served as an outcome measure. HPP lasted approximately 12 weeks and included relevant visual-motor activities carried out at home by the parents with their children. RESULTS: The study failed to prove that HPP improved children's visual-motor skills beyond the other service delivery methods used in the present study. CONCLUSIONS: Parent satisfaction was significantly higher among those who participated in the HPP. Parents showed high compliance with the friendly programme despite their low socio-economic status.

The presence of musculoskeletal disorders among amateur bowlers.

BACKGROUND: With increasing numbers of adults taking part in amateur athletic activity during leisure hours there have been indications that amateur athletic activity may have negative effects on musculoskeletal disease. A literature review focusing on musculoskeletal injuries among bowlers provided only limited references. STUDY OBJECTIVES: Studying the characteristic of bowlers complaining of musculoskeletal disorders in general and of upper extremity cumulative trauma disorders specifically, and locating the factors that statistically predict musculoskeletal disorders among Israeli bowlers. METHODS: The research population includes 98 amateur bowlers who attended two bowling clubs (cluster sampling). Musculoskeletal disorders of the research population were assessed by subjective report using the Standardized Nordic Questionnaires. Further use was made of questionnaires concerning bio-demographic data, work assessment, and the characteristics of the bowling game. RESULTS: Sixty two percent of bowlers reported the presence of musculoskeletal symptoms in one or more of their body joints during the preceding year. Regression analysis with the number of painful joints in the upper extremities as a dependent variable revealed one main predictor: the number of leagues in which the bowler participated (beta = 0.22, p < 0.03). When the dependent variable was the number of painful joints in the entire body, the statistical predictor was the average achievement of the bowlers (beta = 0.40, p < 0.001). CONCLUSIONS: Research findings shed light on the unique musculoskeletal disorders of bowlers. Bowlers should be instructed with regard to what are the safe limits of their leisure activities.

Part I: the effect of long-term exposure to organic solvents on memory: a cross sectional study.

This study focuses on a wide range of different aspects of memory functions trying to ascertain a possible profile of memory changes, which take place following long-term exposure to organic solvents. The research design was cross-sectional. Study population included 31 industrial painters who were exposed at work to organic solvents and 31 unexposed workers. Workers after long-term exposure to organic solvents showed significant decline in memory as indicated in all three standard memory tests (i.e. Wechsler Memory Scale - Revised, Benton Revised Visual Retention Test, and Rey Auditory Verbal Learning Test). The results of Rey Auditory Verbal Learning Test showed a negative correlation with exposure index indicating that the more intensive and longer the time of exposure was, the more impaired is the verbal memory. It was also found that the affect of age on memory was stronger among workers after long-term exposure to organic solvents compared to the unexposed workers.

Reported level of pain of upper extremities related to multi-factorial workloads among office workers during and after work hours.

OBJECTIVES: This research compared the level of reported pain between women workers with high workload (main work involved typing) and women workers with low workload (various office work where typing was not the main task). The research examined the relationship between reported pain of upper extremities (UE) and the following variables: physical strain exerted during typing on a computer keyboard, extra-work strain on UE, bio-demographic variables, psychosocial variables, and ergonomic variables. STUDY DESIGN: Participants were 60 women who worked in offices, divided into two groups. The index group included women whose main work involved typing (high workload: M=6.16 h of typing per day), and the control group did various office work where typing was not the main task (low workload: M=3.23 h of typing per day). The level of pain, physical strain, and data concerning bio-demographic variables, psychosocial variables and ergonomic variables was assessed by a self-reported questionnaire. RESULTS: The results suggested that there was a significant difference between workers with high and low typing workloads. Workers with higher typing load reported higher levels of pain. There was a significant positive correlation between level of reports of pain and levels of physical overload at work, and extra-work strain on UE both among workers with high and low workloads. It was also found that levels of pain correlated significantly with bio-demographic variables (age and number of children) and psychosocial variables (managerial responsibilities) among low workload workers only. CONCLUSIONS: The research on pain of UE indicates that pain may be affected by a multi-factorial nature of a work-related environment which includes physical strain exerted during typing on a computer keyboard, extra-work strain on UE, bio-demographic variables and psychosocial variables.