Musculoskeletal Injury Prevention

Anterior cruciate ligament (ACL) injuries have been shown to place a severe burden on the injured athlete and the Australian health care system. Significant research has been dedicated to injury prevention training programs with limited success in reducing ACL injury rates among heterogeneous athletic populations. A contributing factor to unsuccessful injury prevention programs are low athlete attendance, compliance and/or engagement to the training protocol (Donnelly et al, 2012a). Though lower limb injury rates are high among elite level athletes, injury prevention programs are generally considered to be low priority as coaches have a misguided perception that there is an inverse relationship between prophylactic training and athletic performance (ie. speed/agility, aerobic power, and strength). Recent literature has identified the dynamic strength and control of the hip and trunk during dynamic sporting tasks is of paramount importance for reducing an athlete’s peak knee loading and injury risk in sport (Dempsey et al, 2009; Donnelly et al, 2012b; Weir et al, 2014). The purpose of this study was to show that a biomechanically focused ACL injury prevention training protocol is effective in reducing ACL injury rates, while simultaneously having no negative effect on athletic performance.

Ergonomics Risk Factors (ERFs) at computer works are commonly related to Musculoskeletal Disorders (MSDs) such as repetitive movements, doing work in awkward postures and static postures while prolonged seating at works. The main objective of this study was to investigate the ergonomic risk factors associated with MSDs among employees in computer workstation. In this study, the data were obtained by structured interview using self-reported questionnaire and direct observation. The results show that there is significant association between neck and stress score with musculoskeletal symptoms and among office workers. As a conclusion, by assessing ERFs at workplace, the effectiveness of workplace interventions can be evaluated without waiting for changes in the prevalence of MSDs.

In the context of resistance training the so-called "sticking point"  is commonly understood as the position in a lift in which a disproportionately large increase in the difficulty to continue the lift is experienced.  If the lift is taken to the point of momentary muscular failure, the sticking point is usually where the failure occurs.  Hence the sticking point is associated with an increased chance of exercise form deterioration or breakdown.  Understanding the mechanisms that lead to the occurrence of sticking points, as well as different training strategies which can be used to overcome them is important to strength practitioners (trainees and coaches alike), and instrumental for the avoidance of injury and continued progress.  In this paper we survey and consolidate the body of existing research on the topic: we discuss different definitions of the sticking point adopted in the literature and propose a more precise definition, describe different muscular and biomechanical aspects which give rise to sticking points, and review the effectiveness of different training modalities used to address them.

Hip hop dance has rapidly become a popular international
art form. There is limited information on injury patterns in
this population. The purpose of this study was to determine
injury incidence and patterns among three groups of hip hop
dancers. Three hundred and twelve intermediate, advanced,
and expert hip hop dancers were recruited at battles, dance
conferences, clubs, and on dance related web sites within the
United States and internationally. A Web-based survey was
conducted over a 6-month period. Inclusion criteria included
intermediate and advanced level dancers over the age of 13.
Dancers were divided into three main categories: Breakers,
Popper/Lockers, and New Schoolers. Separate analysis of
variances were used to compare injury pattern differences
between groups. Two hundred and thirty-two dancers reported
a total of 738 injuries. Five hundred and six of these
(sustained by 205 dancers) were time-loss (TL) injuries.
Annual injury incidence was 237% (162% involving TL).
Lower extremity injuries were 52% and upper extremity
injuries 32% of total injuries. Breakers had a higher injury
incidence compared with Popper/Lockers, and New Schoolers.
Hip hop dancers report injury rates that are higher than
other dance forms but similar to gymnastics. These dancers
should be educated concerning injury prevention, biomechanics,
and use of protective equipment.

Background: Work related musculoskeletal disorders affect millions of people around the world and are the most common cause
of severe long-term pain and physical disability. Sugarcane workers are involved in heavy lifting, bending, cutting and twisting
activities. Our study objective was to find out the prevalence and identify most commonly affected body regions among sugar
cane worker.
Procedure: The Ethical clearance was obtained for the study from Institutional Ethical Committee of PDVVPF, COPT,
Ahmednagar. Written informed consent was obtained from all the subject fitting in inclusion criteria. Initially the demographic
data i.e Name, Age, Gender, Height, Weight & BMI was assessed and standardized Nordic questionnaire was filled up by every
participant.
Result: The descriptive statistical analysis of data (N=100, Workers, Males-57 & Females-43).The most commonly affected
body regions are low back pain(50%) & knee pain(29%).
Conclusion: The result shows that prevalence of MSDs is high in sugarcane workers. The highest prevalence of MSDs for the
last twelve months is on the low back & knee

BACKGROUND: Bottling workers maintain awkward postures while performing machine paced repetitive motions in many of their job tasks and therefore are predisposed to work related musculoskeletal discomfort (WMSD). There is a paucity of literature on prevalence and impact of musculoskeletal discomfort among this occupational group. OBJECTIVE: This study was conducted among Eastern Nigerian beverage factory workers to investigate prevalence of WMSD as a first step towards risk factors investigation and ergonomic future intervention. METHOD: A total of 301 workers (8 workstations) completed a modified Nordic Musculoskeletal Questionnaire in this cross sectional survey. RESULTS: Twelve month prevalence of WMSD was 91.4% and 65.1% had been prevented from doing activity at home or workplace by WMSD in the past 12 months. Shoulder, neck and upper back in that order were the most common complaints. Prevalence of WMSD in body regions were associated with age but not with gender except for neck, upper back, shoulder, and ankle/foot complaints. CONCLUSION: WMSDs are very high among beverage bottling workers. Investigation into the prevailing risk factors especially the work posture and work organization/work psychosocial factors for possible risk exposure in these workers is essential for ergonomic intervention towards work injury prevention.

The detection of double edges in x-ray images of lumbar vertebrae is of prime importance in the assessment of vertebral injury or collapse that may be caused by osteoporosis and other spine pathology. In addition, if the above double-edge detection process is conducted within an automatic framework, it would not only facilitate inexpensive and fast means of obtaining objective morphometric measurements on the spine, but also remove the human subjectivity involved in the morphometric analysis. This paper proposes a novel force-formulation scheme, termed as Pressurized Open Directional Gradient Vector Flow snakes, to discriminate and detect the superior and inferior double edges present in the radiographic images of the lumbar vertebrae. As part of the validation process, this algorithm is applied to a set of 100 lumbar images and the detection results are quantified using analyst-generated ground truth. The promising nature of the detection results bears testimony to the efficacy of the proposed approach

The purpose of this study was to investigate the prevalence of body part symptoms and sources of injury/discomfort among workers in a car tyre service centre. Questionnaire survey and interview session were used to identify the level of body discomfort areas and sources of injury or discomfort. From questionnaire survey findings, 12 of respondents have body discomfort in the neck (66.7%%), shoulder (83.3%), elbow/forearm (75%), hand/wrist (91.7%), knee (58.3%), lower leg (75%), ankle/foot (33%) and lower back (30%). The main sources of injury/discomfort in the workplace were poor body posture (75%), bending the back (75%), highly repetitive motions (75%), lifting heavy objects (83.3%), the long-term standing (66.7%), long-term squatting (58.3%), bending the neck (66.7%) and high hand force (58.3%). About 50% reported that poor workplace design also contributed to injury while 41.7% mentioned the use of hand tools. To address modifying the ergonomic hazards, engineering controls and administrative controls can be used. The study will be useful to ergonomists, researchers, consultants, workshop managers, maintenance workers and others concerned with identifying body part symptoms and sources of injury/discomfort at the workplace.

Patellofemoral pain (PFP) accounts for 25% of all knee pain presentations in active individuals to outpatient physical therapy clinics.  Historically, the etiology of PFP has been attributed to altered patellofemoral joint mechanics and stresses. However, recent research has suggested insufficient strength of the proximal hip musculature may contribute to PFP.  Many studies exploring the effectiveness of hip strengthening include confounding interventions such as hip strengthening combined with quadriceps strengthening. Therefore, there is a lack of literature exploring the effectiveness of hip strengthening as an isolated intervention in the treatment of PFP. A structured review was conducted to answer the following clinical question: “What is the effect of hip strengthening on pain and function in the rehabilitation of patients under 45 years of age with patellofemoral pain?”
Based on results of 11 studies, there is moderate evidence to suggest that hip strengthening is effective in (1) decreasing general pain and pain during activity and (2) improving generalized lower extremity function during activities such as squatting, walking, and stair negotiation, functional strength and health status in people with PFP. The population that best applies to this review includes active and sedentary men and women 22-35 years old with chronic PFP. Additionally, this review indicates that hip strengthening alone or in combination with quadriceps strengthening or trunk stability training is more effective at improving pain and function compared to quadriceps strengthening alone.

Musculoskeletal disorders are often found in various types of work, including surgeons. Standing working position is immobile and rigid when performing surgical operations. The equipment used is less ergonomic which is the main parameter. The surgeon profession belongs to the category of the high-risk profession and has the potential to experience musculoskeletal disorders. Surgeons who suffer musculoskeletal disorders sense disease start from mild-to-severe due to the muscles receiving static loads frequently in the long-term. The emergence of musculoskeletal disorders can be caused by working environment conditions and standing position while working, causing injury to joints, vertebral discs, nerves, cartilage, tendons, and muscles. This paper describes in extensive the potential for reducing musculoskeletal problems with the use of a chairless chair for surgeons in carrying out operations. Musculoskeletal problems in surgery and the use of chairless chairs have been further expl...

Background: Lack of the neuromuscular control during locomotion in the knee joint leads to an increased risk of anterior cruciate ligament (ACL) injury in children. Hence, we aimed to explore the effects of a repetitive, model-oriented, and self-organized approach on lower limb kinematics during gait in children. Methods: In randomized controlled trial, 36 children with 4 ± 0.79 years of age from the children gym were randomly (a lottery method) allocated into three groups, including (1) the model-oriented (n = 10), (2) Differential Learning (n = 11), and (3) control (n = 10) groups. Kinematic data of hip, knee, and ankle joints in the sagittal plane were recorded by a GoPro camera at the moments of heel-ground contact and toe-off the ground before and after a 6-week intervention (two sessions per week). Results: The results indicate a 35% post-intervention increase of ankle dorsiflexion (95% CI: − 5.63 _ − 0.96) in the moment of heel-ground contact in the model-oriented group; however, knee flexion (95% CI: − 1.05 _ 8.34) and hip flexion (95% CI: 3.01 _ 11.78) were respectively decreased by 20% and 20%. After the intervention, moreover, ankle plantar flexion (95% CI: − 9.18 _ − 2.81) and hip extension (95% CI: − 12.87 _ − 3.72) have respectively increased by 37% and 37%, while knee flexion (95% CI: 3.49 _ 11.30) showed a %16 decrease in the moment of toe off the ground. As for the Differential Learning group, ankle dorsiflexion (95% CI: − 5.19 _ − 1.52) increased by 33%, and knee (95% CI: 0.60 _ 5.76) and hip flexion (95% CI: 2.15 _ 7.85) respectively decreased by 17% and 17% at the moment of the heelground contact following the intervention. At toe lifting off the ground, the plantar flexion (95% CI: − 7.77 _ − 2.77) increased by 35%, knee flexion (95% CI: 2.17 _ 7.27) decreased to 14%, and hip extension (95% CI: − 9.98 _ − 4.20) increased by %35 following the intervention for the Differential Learning group subjects. Based on the results obtained from the one-way ANOVA, there was a significant difference between these groups and the control group in all kinematic gait variables (p ≤ 0.05). However, no statistically significant differences were found between the two experimental groups. Conclusions: The results implied that the model-oriented repetitive and the self-organized Differential Learning approach were both appropriate to alter the kinematic gait pattern in the 3-5-year-old children. Previous research has almost exclusively recommended a model-oriented approach to change kinematic patterns and preventing noncontact motor injuries. However, the present study showed that the Differential Learning approach can help children to achieve the same goal by continuously changing environments and stimulating challenges.

Musculoskeletal disorders are injuries of the muscles, nerves, tendons, ligaments, joints, cartilage, or spinal discs and are often classified as soft tissue injuries. They are the result of chronic or gradual development and are not caused by acute incidents such as slips, trips, or falls. The significance of this phenomenon prompted us to carry out a broader study of pathologies attributable to repetitive movements in the upper limbs within the citrus growing industry. Calabria, a very important region for citrus fruit growing in Italy, was chosen as the study area. The study analyzed the risks of repetitive movements for 180 workers on 35 different farms using the OCRA (Occupational Repetitive Actions) checklist method. By analyzing the scores obtained in the different work phases, it was possible to determine the tasks that incur more risk in the citrus fruit industry. The OCRA checklist considers all the repetitive tasks involved in a complex job and estimates the level of exposure to each worker. In support of the specific aims of the present study, it is possible to identify a series of working conditions for which the level of risk may be reasonably estimated and for which it is possible to adopt a checklist system. The results of this study suggest that there must be a significant increase in the use of effective ergonomic interventions in the workplace in order to attain reductions in the number of local musculoskeletal complaints.

Cite this article as: Abaraogu UO, Ugwa WO. Selected anthropometrics, spinal posture, and trunk muscle endurance as correlated factor of static balance among adolescent and young adult males. Turk J Phys Med Rehab 2016;1(62):9-15. ABSTRACT Objectives: This study aims to investigate the possible relationship of selected anthropometric variables, spinal posture, and trunk muscle endurance with static balance among adolescent and young adult males. Patients and methods: Between April 2014 and June 2014, a total of 153 males (mean age 20 years; range 13 to 25 years) were included in this study. The anthropometric measures of height, weight, body mass index, waist circumference, waist-hip ratio, waist-height ratio, trunk-cephalic height, conicity index, fat mass index, and fat-free mass index were recorded. Thoracic and lumbar curvatures were assessed with flexicurve and the angles calculated in degrees using the formula, 4 actan (2h/L). Trunk flexor and extensor endurance levels were measured with flexor endurance test and Sorenson's test, respectively. Static balance was assessed using the single-limb stance test. Results: Among all anthropometric variables measured, a significant correlation was only found between the fat-free mass index and trunk extensor endurance (r=0.175, p=0.033). The trunk flexor and extensor endurance were each significantly correlated with static balance (r=0.359, p=0.000 and r=0.276, p=0.001, respectively). A negative correlation was equally found between thoracic kyphotic angle and trunk flexors endurance (r=-0.233, p=0.004). Conclusion: Our study results suggest a significant relationship between static balance and each of trunk flexor and extensor endurance, between thoracic kyphotic angle and trunk flexor endurance, and between fat-free mass index and trunk extensor endurance. Ergen ve genç erişkin erkeklerde static dengenin ilişkili faktörleri olarak bazı antropometrik özellikler, spinal postür ve gövde kas dayanıklılığı ÖZ Amaç: Bu çalışmada ergen ve genç erişkin erkeklerde bazı antropometrik değişkenler, spinal postür ve gövde kas dayanıklılığının statik denge ile olan muhtemel ilişkisi araştırıldı. Hastalar ve yöntemler: Nisan 2014-Haziran 2014 tarihleri arasında, çalışmaya toplam 153 erkek (ort. yaş 20 yıl; dağılım 13-25 yıl) alındı. Boy, kilo, vücut kütle indeksi, bel çevresi, bel-kalça oranı, bel-boy oranı, gövde-sefalik boy, koni indeksi, yağ kütle indeksi ve yağsız kütle indeksinin antropometrik ölçümleri kaydedildi. Esnek eğri ve 4 aktan (2 s./L) formülü ile derecesi hesaplanan açılar ile torasik ve lomber kürvatürler değerlendirildi. Gövde fleksör ve ekstansör dayanıklılık düzeyleri, sırasıyla fleksör dayanıklılık testi ve Sorenson testi ile hesaplandı. Statik denge, tek ekstremite duruş testi kullanılarak değerlendirildi. Bulgular: Ölçülen tüm antropometrik değişkenler arasında, yalnızca yağsız kütle indeksi ve gövde ekstansör dayanıklılığı arasında anlamlı bir ilişki bulundu (r=0.175, p=0.033). Gövde fleksör ve ekstansör dayanıklılığı, tek başına statik denge ile anlamlı düzeyde ilişkili idi (sırasıyla r=0.359, p=0.000 ve r=0.276, p=0.001). Torasik kifoz açısı ve gövde fleksör dayanıklılığı arasında eş değer negatif bir ilişki saptandı (r=-0.233, p=0.004). Sonuç: Çalışma bulgularımız, statik denge ve gövde fleksör ve ekstansör dayanıklılığı, torasik kifoz açısı ve gövde fleksör dayanıklılığı ve yağsız kütle indeksi ve gövde ekstansör dayanıklılığı arasında anlamlı bir ilişki olduğunu göstermektedir. Anahtar sözcükler: Antropometri; erkek; spinal postür; statik denge; gövde kas dayanıklılığı.

The occurrence of so-called "sticking points" in a lift is pervasive in weight training practice. Biomechanically complex exercises often exhibit multimodal variation of effective force exerted against the load as a function of the elevation and velocity of the load. This results in a variety of possible loci for the occurrence of sticking points and makes the problem of designing the optimal training strategy to overcome them challenging. In this paper a case founded on theoretical grounds is made against a purely empirical method. It is argued that the nature of the problem considered and the wide range of variables involved limit the generality of conclusions which can be drawn from experimental studies alone. Instead an alternative is described, whereby a recently proposed mathematical model of neuromuscular adaptation is employed in a series of computer simulations. These are used to examine quantitatively the effects of differently targeted partial range of motion (ROM) training approaches. Counter-intuitively and in contrast to common training practices, the key novel insight inferred from the obtained results is that in some cases the most effective approach for improving performance in an exercise with a sticking point at a particular point in the ROM is to improve force production capability at a different and possibly remote position in the lift. In the context of the employed model, this result is explained by changes in the neuromuscular and biomechanical environment for force production.

Background: Tai Chi is Chinese martial art strengthening the performance of individuals. Objectives: The purpose of present study is to determine the effect of a Tai Chi exercise period on static and dynamic balance of young girls. Methods: For the purpose of this research, 32 young girls were voluntarily selected and randomly divided into two groups: Tai Chi training group (21 subjects; mean ± SD; age 22.05±2.4 weight 53.67±6.3 kg, height 1.60±0.5 m) and control group (11 subjects; mean ± SD; age 23.37±0.9 weight 53.64±7.8 kg, height 1.62±0.4 m) players. Static and dynamic balance were measured using Biodex Balance System SD three days before and after a 12-session training period with similar conditions in terms of time and place (75 minutes each session). Results: Mixed repeated measure test showed a significant difference between pre and post-tests in open eye single-foot, closed eye single-foot, open eye two-foot, and closed eye two-foot stances (p=0.001). However, no significa...

Musculosceletal Disorder (MSD) is a current phenomenon that occur in the student as the effect of sitting in a long duration while lecturing. Most of student activities spend by sitting in the classroom as consequent long duration of time studying that have to be Attended.Supporting cheerfulness in the studying is important to match the concept of desk and chair the which is suitable with anthropometry or criteria, such as desk and chair the which are ergonomic. This research Aimed to identify the risk factors that correlated with Musculoskeletal complaints in 5th grade student at Pioneer School. Design used in this research is correlative roomates amount of of participants is 100 and statistical analyzes was perfomed with the chi-square test.Musculoskeletal complaints were uncorrelated with sitting posture (α> 0.05, p = 0.202) of Pioneer School pupils. Result of ergonomic analysis about a desk and chair design based on the pupil's anthropometry were desk and chair did not me...

Current multimodal approaches for the management of non-specific patellofemoral pain are not optimal, however, targeted intervention for subgroups could improve patient outcomes. This study explores whether subgrouping of non-specific patellofemoral pain patients, using a series of low cost simple clinical tests, is possible. The exclusivity and clinical importance of potential subgroups was assessed by applying à priori test thresholds (1 SD) from seven clinical tests in a sample of adult patients with non-specific patellofemoral pain. Hierarchical clustering and latent profile analysis, were used to gain additional insights into subgroups using data from the same clinical tests. 130 participants were recruited, 127 had complete data: 84 (66%) female, mean age 26 years (SD 5.7) and mean body mass index 25.4 (SD 5.83), median (IQR) time between onset of pain and assessment was 24 (7-60) months. Potential subgroups defined by the à priori test thresholds were not mutually exclusive a...

My co-authors and I respond to the authors' claim that there is no evidence for spinal manipulation for non-chronic low back pain. In this letter to the editor, we found the author's literature review search stopped in 2009 which omitted several high-quality systematic reviews that found that spinal manipulation was beneficial for low back pain. We also critiqued the author's recommendation of opioids which currently goes against the best practice guidelines and the preponderance of the literature.