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"Back Injuries prevention "
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Effectiveness of participatory training for prevention of musculoskeletal disorders: a randomized controlled trial
Purpose
Health and safety training program has been applied to prevent work-related musculoskeletal disorders (MSDs) in workplace. We evaluated the effectiveness of participatory training and didactic training programs on MSD prevention among frontline workers in Shenzhen, China.
Methods
The authors randomly assigned 918 workers from intervention factories to receive participatory training (intervention group), and 907 workers from intervention factories and 1,654 workers from control factories to receive didactic training (control_1 group, control_2 group, respectively) from June 1, 2008 to November 30, 2009. Participants were asked to report experience of ache, pain or discomfort in 10 body parts at baseline and 1 year after training. Data were analyzed to compare the MSD prevalence 1 year before and 1 year after training in different groups from 2009 to 2010.
Results
The follow-up rate was 61 % (2,120/3,479) at 1 year after training. In the year after training, there were no statistically significant changes in the proportion of workers who reported MSD in any body part. MSD prevalence rates in the intervention group reduced from 16.8 to 9.9 % for lower extremities (χ
2
= 13.102,
p
< 0.001) and from 12.9 to 8.3 % (χ
2
= 9.433,
p
= 0.002) for wrist and finger at 1 year after training. However, the rates did not change significantly for upper back, lower back, neck, shoulder and elbow in the intervention group and for all 10 body parts in two control groups.
Conclusions
Overall, the training programs did not seem to prevent the occurrence of MSD among frontline workers. However, participatory training might be effective to reduce MSD in the lower extremities and wrist and finger.
Journal Article
Modifying bowling kinematics in cricket pace bowlers with exercise-based injury prevention: A cluster-randomised controlled trial
Undesirable bowling kinematics can increase the risk of low back injury. This study investigated if an exercise-based injury prevention program (IPP) could modify bowling kinematics in community-level adolescent pace bowlers.
Cluster-randomised controlled trial.
Pace bowlers from eight cricket organisations were cluster-randomised into an intervention or control group. At baseline and follow-up sessions biomechanical bowling data were collected. Between sessions, the intervention group completed an eight-week IPP while the control continued their normal cricket activity. Treatment effects (95% CI) were estimated with linear mixed models.
There were significant treatment effects favouring the intervention group for shoulder counter-rotation (−3.8°; −7.2° to −0.3°) and lateral trunk flexion relative to the pelvis (−2.2°; −4.0° to −0.5°). Shoulder counter-rotation also increased in the control group by 2.2° (Cohen’s d=0.22). There were no effects of the intervention on: lateral trunk flexion at front foot contact (FFC) (1.2°; −2.5° to 4.8°), lateral trunk flexion at ball release (BR) (−0.5°; −3.0° to 2.0°), pelvis rotation at FFC (0.9°; −4.0° to 2.2°), pelvis rotation at BR (−1.1°; −5.7° to 3.6°), front hip angle at FFC (1.6°; −3.6° to 6.7°), front hip angle at BR (−1.6°; −5.0° to 1.9°), front knee angle at FFC (−1.1°; −4.5° to 2.3°), front knee angle at BR (1.7°; −5.6° to 9.1°), or ball velocity (1.1kmh−1; −7.5kmh−1 to 9.7kmh−1).
The IPP maintained shoulder counter-rotation and lateral trunk flexion relative to the pelvis in the intervention group and this could attenuate injury risk. No treatment effects were observed for lower-limb kinematics.
Journal Article
Recreational Soccer Can Improve the Reflex Response to Sudden Trunk Loading Among Untrained Women
Pedersen, MT, Randers, MB, Skotte, JH, and Krustrup, P. Recreational soccer can improve the reflex response to sudden trunk loading among untrained women. J Strength Cond Res 23(9)2621-2626, 2009-A slower reflex response to sudden trunk loading (SL) has been shown to increase future risk of low back injuries in healthy subjects, and specific readiness training can improve the response to SL among healthy subjects. The purpose of the study was to investigate the effect of recreational soccer training on the reaction to SL among untrained healthy women. Thirty-six healthy, untrained, Danish women (age 19-45 years) were randomly assigned to a soccer group (SO, n = 19) and a running group (RU, n = 17). In addition, an untrained control group (CON, n = 10) was recruited. Training was performed for 1 hour twice a week (mean heart rate of 165 b·min in SO and 164 b·min in RU) for 16 weeks. Test of reactions to sudden unexpected trunk loading was performed before and after the training period. Furthermore, time-motion analysis of the soccer training was performed for 9 subjects. Group assignment was blinded to the test personnel. Physical education students organized the training. During 1 hour of soccer training, the total number of sudden moves including sudden loading of the upper body (e.g. turns, stops, throw-ins, headers, and shoulder tackles) was 192 (63). In SO, time elapsed until stopping of the forward movement of the trunk (stopping time) decreased (p < 0.05) by 15% and distance moved after unexpected SL decreased (p < 0.05) by 24% compared with no changes in RU and CON. In conclusion, football training includes a high number of sudden loadings of the upper body and can improve the reflex response to SL. The faster reflex response indicates that soccer training can reduce the risk of low back injuries.
Journal Article
Injuries and illnesses among competitive Norwegian rhythmic gymnasts during preseason: a prospective cohort study of prevalence, incidence and risk factors
ObjectivesRhythmic gymnastics is an Olympic sport that demands high training volume from early age. We investigated the extent of, and risk factors for, injuries among competitive Norwegian rhythmic gymnasts.MethodsOne hundred and seven of 133 (80.5%) female rhythmic gymnasts (mean age: 14.5 years (SD 1.6), mean body mass index: 18.9 (SD 2.2)) participated. All gymnasts completed a baseline questionnaire and the ‘Triad-Specific Self-Report Questionnaire’. Injuries, illnesses and training hours were recorded prospectively for 15 weeks during preseason using the ‘Oslo Sports Trauma Research Center Questionnaire on Health Problems’ (OSTRC-H2).ResultsResponse rate to OSTRC-H2 was 97%. Mean overuse and acute injury prevalence were 37% (95% CI: 36% to 39%) and 5% (95% CI: 4% to 6%), respectively. Incidence was 4.2 overuse injuries (95% CI: 3.6 to 4.9) and 1.0 acute injuries (95% CI: 0.5 to 1.6) per gymnast per year. Overuse injuries in knees, lower back and hip/groin represented the greatest burdens. Previous injury increased the odds of injury (OR 30.38, (95% CI: 5.04 to 183.25)), while increased age (OR 0.61 per year, (95% CI: 0.39 to 0.97)) and presence of menarche (OR: 0.20, (95% CI: 0.06 to 0.71)) reduced the odds of all injuries and substantial injuries, respectively.ConclusionsOveruse injuries were common among Norwegian rhythmic gymnasts. Younger gymnasts had higher all-injury risk. Gymnasts who were not menstruating had higher substantial injury risk. Injury prevention interventions should start at an early age and focus on preventing knee, lower back and hip/groin injuries.
Journal Article
The Effect of Individual Job Coaching and Use of Health Threat in a Job-Specific Occupational Health Education Program on Prevention of Work-Related Musculoskeletal Back Injury
Objective: To examine the effect of individual job coaching and use of health threat in a job-specific occupational health education program in preventing work-related musculoskeletal back injuries during manual materials handling in construction laborers. Methods: Two hundred five laborers were recruited by 3-stage cluster sampling process a randomly assigned to receive different education programs on manual materials handling. Control group was given a conventional program, whereas experimental group received a job-specific program. Results: A statistically significant group difference was found in the knowledge and practical skills on manual materials handling after training (P < 0.0001). Furthermore, the results from 1-year cumulative incidence revealed a significantly lesser number of first-time reports of work-relat musculoskeletal back injuries in the experimental group. Conclusions: These results indicate that job-specific education is an effective preven tive strategy for work-related musculoskeletal back injury.
Journal Article
PREVENTING BACK INJURIES IN HOSPITAL SETTINGS: THE EFFECTS OF VIDEO MODELING ON SAFE PATIENT LIFTING BY NURSES
This study evaluated video scoring and feedback about scoring as a safety intervention among 6 nursing staff. The dependent variable was safety behavior on one‐person transfers. Following baseline, 5 nursing staff participated in an information phase. A video scoring phase was then introduced for all 6. A feedback phase was added for 2 participants. All participants experienced treatment withdrawal. Information resulted in improvements for all 5 participants who received it. Further improvements were observed during video scoring for the 5 participants who improved following information. No improvements were observed for the participant who received only video scoring. Safety feedback further improved safety for the 2 participants who received it. However, participants' behavior returned to video scoring levels during withdrawal.
Journal Article
Safe patient handling and movement : a guide for nurses and other health care providers
Presenting various practices in safe patient handling and movement, this book shows health care professionals the best ways to improve care for patients and reduce the risk of staff suffering unneccessary injuries.
eBook
Analysis of squat and stoop dynamic liftings: muscle forces and internal spinal loads
Despite the well-recognized role of lifting in back injuries, the relative biomechanical merits of squat versus stoop lifting remain controversial. In vivo kinematics measurements and model studies are combined to estimate trunk muscle forces and internal spinal loads under dynamic squat and stoop lifts with and without load in hands. Measurements were performed on healthy subjects to collect segmental rotations during lifts needed as input data in subsequent model studies. The model accounted for nonlinear properties of the ligamentous spine, wrapping of thoracic extensor muscles to take curved paths in flexion and trunk dynamic characteristics (inertia and damping) while subject to measured kinematics and gravity/external loads. A dynamic kinematics-driven approach was employed accounting for the spinal synergy by simultaneous consideration of passive structures and muscle forces under given posture and loads. Results satisfied kinematics and dynamic equilibrium conditions at all levels and directions. Net moments, muscle forces at different levels, passive (muscle or ligamentous) forces and internal compression/shear forces were larger in stoop lifts than in squat ones. These were due to significantly larger thorax, lumbar and pelvis rotations in stoop lifts. For the relatively slow lifting tasks performed in this study with the lowering and lifting phases each lasting approximately 2 s, the effect of inertia and damping was not, in general, important. Moreover, posterior shift in the position of the external load in stoop lift reaching the same lever arm with respect to the S1 as that in squat lift did not influence the conclusion of this study on the merits of squat lifts over stoop ones. Results, for the tasks considered, advocate squat lifting over stoop lifting as the technique of choice in reducing net moments, muscle forces and internal spinal loads (i.e., moment, compression and shear force).
Journal Article
Artificial neural networks to predict 3D spinal posture in reaching and lifting activities; Applications in biomechanical models
Spinal posture is a crucial input in biomechanical models and an essential factor in ergonomics investigations to evaluate risk of low back injury. In vivo measurement of spinal posture through the common motion capture techniques is limited to equipped laboratories and thus impractical for workplace applications. Posture prediction models are therefore considered indispensable tools. This study aims to investigate the capability of artificial neural networks (ANNs) in predicting the three-dimensional posture of the spine (S1, T12 and T1 orientations) in various activities. Two ANNs were trained and tested using measurements from spinal postures of 40 male subjects by an inertial tracking device in various static reaching and lifting (of 5kg) activities. Inputs of each ANN were position of the hand load and body height, while outputs were rotations of the three foregoing segments relative to their initial orientation in the neutral upright posture. Effect of posture prediction errors on the estimated spinal loads in symmetric reaching activities was also investigated using a biomechanical model. Results indicated that both trained ANNs could generate outputs (three-dimensional orientations of the segments) from novel sets of inputs that were not included in the training processes (root-mean-squared-error (RMSE)<11° and coefficient-of-determination (R2)>0.95). A graphic user interface was designed and made available to facilitate use of the ANNs. The difference between the mean of each measured angle in a reaching task and the corresponding angle in a lifting task remained smaller than 8°. Spinal loads estimated by the biomechanical model based on the predicted postures were on average different by < 12% from those estimated based on the exact measured postures (RMSE=173 and 35N for the L5-S1 compression and shear loads, respectively).
Journal Article