There is increasing attention to medical problems of musicians. Many studies find a high prevalence of work-related musculoskeletal disorders in musicians, ranging from 73.4% to 87.7%, and string players have the highest prevalence of musculoskeletal problems. This paper examines the various positions and movements of the upper extremities in string players: 1) basic postures for holding instruments, 2) movements of left upper extremity: fingering, forearm posture, high position and vibrato, 3) movements of right upper extremity: bowing, bow angles, pizzicato and other bowing techniques. These isotonic and isometric movements can lead to musculoskeletal problems in musicians. We reviewed orthopedic disorders that are specific to string players: overuse syndrome, muscle-tendon syndrome, focal dystonia, hypermobility syndrome, and compressive neuropathy. Symptoms, interrelationships with musical performances, diagnosis and treatment of these problems were then discussed.
Cumulative Trauma Disorders/*etiology ; Humans ; Musculoskeletal Diseases/*etiology ; *Music ; Neuromuscular Diseases ; Occupational Diseases/*etiology

Anxiety ; etiology ; Cardiovascular Diseases ; etiology ; Comorbidity ; Depression ; etiology ; Humans ; Inflammation ; complications ; Metabolic Syndrome ; etiology ; Musculoskeletal Diseases ; etiology ; Osteoporosis ; etiology ; Pulmonary Disease, Chronic Obstructive ; complications ; Pulmonary Embolism ; etiology ; Smoking ; adverse effects

OBJECTIVETo analyze the prevalence and risk factors of multiple musculoskeletal disorders (MSDs) in auto workers and the associations between MSDs at different sites.

METHODSA cross-sectional survey was conducted in 3998 workers, who were selected from a Chinese auto corporation by cluster random sampling, using the revised Nordic MSDs standard questionnaire; 3800 completed questionnaires were returned. Multinomial logistic regression analysis was performed to assess the risk factors for multiple MSDs. The logbinomial model was used to calculate the prevalence ratios (PRs) of MSDs at different sites and evaluate the associations between MSDs at different sites.

RESULTSOf the 3800 subjects, 2452 (64.5%) had MSDs at two or more sites, and 469 (12.3%) had MSDs at one site. The PRs varied from 1.5 to 6.7, with significant differences among different sites (P < 0.01). Relatively close associations were found between the MSDs at neck and shoulders, back and shoulders/waist, elbows and wrists/hands, waist and neck, wrists/hands and waist, hip and waist, knees and waist, and ankles/feet and elbows. The multinomial logistic regression analysis indicated that the highest risk factor for MSDs was poor posture, including often working in an uncomfortable posture, neck bending forward, and neck twisting (ORs = 3.39, 1.93, and 1.38), followed by labor organization, in which break between tasks could decrease the risk of MSDs at three or more sites to 31%, staff shortage, which could increase the risk of MSDs by 75%, and pushing and pulling heavy objects (> 20 kg) (OR = 1.76).

CONCLUSIONMost auto workers with MSDs have multiple sites affected, and there are high associations between the MSDs at different sites. The major risk factors for multiple MSDs in auto workers include poor posture, labor organization, and heavy physical labor.

Adult ; Automobiles ; Cross-Sectional Studies ; Female ; Humans ; Logistic Models ; Male ; Middle Aged ; Musculoskeletal Diseases ; epidemiology ; etiology ; Occupational Diseases ; epidemiology ; etiology ; Risk Factors ; Surveys and Questionnaires

OBJECTIVETo investigate the interactive effect of job task and psychosocial factors on the outcomes of musculoskeletal disorders.

METHODS653 workers from different type of manufacturing industries and administration office recruited in a cross-sectional epidemiological survey. The Quick Exposure Check (QEC) was applied to assess the ergonomic load of job task, Job Content Questionnaire (JCQ) for identifying psychological characteristics, and Nordic Standardized Questionnaire for investigating outcomes of WMSDs.

RESULTSThe prevalence of WMSD in shoulder, upper back, lower back and hand/wrist were significantly different under a variety of combined job task and psychosocial characteristics (P < 0.05 or P < 0.01). The more physical and psychological loads, the higher prevalence of WMSDs were revealed. By using multivariate analyses, a potential interactive effect was found in terms of the WMSDs symptoms in hand/wrist, shoulder, upper back and lower back after adjusted by work year, age, and gender.

CONCLUSIONSHigher physical load and greater psychosocial risk are more frequent self-reported symptoms of WMSDs than those of lower exposures. Ergonomic intervention strategies aimed at reducing the incidence of WMSDs should not only be focused on control of physical work factors but also psychosocial risks of relevance.

Adolescent ; Adult ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Diseases ; etiology ; psychology ; Occupational Diseases ; etiology ; psychology ; Stress, Psychological ; Surveys and Questionnaires ; Task Performance and Analysis ; Young Adult

OBJECTIVETo investigate the morbidity and influence factors of work-related musculoskeletal disorders (WMSD) in oil drillers.

METHODSThe modified Nordic Standardized Questionnaire for WMSD was used to perform the epidemiological investigation in 860 oil drillers.

RESULTSThe predominant sites of WMSD in the oil drillers were waist (50.6%), neck (29.8%) and shoulder (23.4%), respectively. There were significant differences of the WMSD morbidities in all body sites except for wrist and hip among groups with different working years (P < 0.05 of P < 0.01). The WMSD morbidities in the neck, shoulder, back and waist of oil drillers working for more than 40h a week were significantly higher than those of oil drillers working for less than 40 ha week (P < 0.05). The results of logistic regression analysis revealed that some occupational factors, i.e. keeping stoop and stand for long time, repeating trunk bend, keeping awkward lift posture and lifting the heave objects, were the risk factors for WMSD at waist (P < 0.05), also some management factors, i.e. overtime work and inadequate rest, were the risk factors for WMSD at waist (P < 0.05).

CONCLUSIONThe WMSD appears to be a serious ergonomic problem in oil drillers, it is necessary to correct working posture, reduce working load, improve organizational management, and encourage a workplace health program with regular work and rest.

Adult ; Ergonomics ; Humans ; Male ; Middle Aged ; Morbidity ; Musculoskeletal Diseases ; etiology ; Occupational Diseases ; etiology ; Occupational Health ; Petroleum ; Risk Factors ; Workload ; Workplace ; Young Adult

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) are dramatically increased in the world due to the advancement of technology and competitiveness of markets. There were limited studies carried out regarding WMSDs among bank workers in Africa particularly in Ethiopia. Therefore, the aim of this study was to assess the magnitude of work-related musculoskeletal disorders and associated factors among bank workers in Addis Ababa, Ethiopia. METHODS: Institution-based cross-sectional study design was employed in the study. Multi-stage sampling techniques were used to select 838 bank workers from 62 banks in Addis Ababa. Self-administered standard Nordic questionnaires were used as well. Multivariable binary logistic regression analyses were employed to identify factors associated with WMSDs. Moreover adjusted odds ratio (AOR), 95% confidence interval (CI) and p value < 0.05 was used to show the strength of association between explanatory variables and dependent variable. RESULTS: Out of 838 total numbers of participants, 755 bank workers returned their questionnaires responding with a rate of 90%. Of these, 77.6% (N = 586) suffered WMSDs with a 95% CI [75-81%]. Based on the final multivariate logistic regression analysis being female [AOR = 2.98, 95% CI 1.91-4.65], sitting back in a twisted position [AOR = 3.59, 95% CI 2.13-6.08], sitting back bent [AOR = 4.06, 95% CI 2.48-6.66], work on fixed position [AOR = 1.78, 95% CI 1.17-2.71], no work time break [AOR = 3.33, 95% CI 1.44-7.71], type of chairs [AOR = 2.62, 95% CI 1.19-5.75] and job stress [AOR = 2.33, 95% CI 1.19-4.54] were factors significantly associated with WMSDs. CONCLUSION From the study's findings, the magnitude of work-related musculoskeletal disorders among bank workers was high. Being female, awkward posture, no work time break, fixed position, type of chairs, and job stress are the factors significantly associated with WMSDs. So bank workers should use proper types of chairs, practice proper work posture, increase healthy working conditions, and create awareness programs on how to maintain beneficial health conditions which may lead to increased leisure time.
Adult ; Aged ; Banking, Personal ; Cities ; Cross-Sectional Studies ; Ethiopia ; epidemiology ; Female ; Humans ; Male ; Middle Aged ; Musculoskeletal Diseases ; epidemiology ; etiology ; Occupational Diseases ; epidemiology ; etiology ; Risk Factors ; Young Adult

OBJECTIVES: This study was conducted to measure the decline in the health-related quality of life (HRQoL) associated with some diseases in South Korean adults. METHODS: The EQ-5D health states in the 2005 National Health and Nutrition Examination Survey (NHNES) and the Korean EQ-5D valuation set were used to obtain the EQ-5D indexes of the study subjects. Each disease group was defined when the subjects reported to the NHNES that they were diagnosed with the corresponding disease during the previous 1 year by physicians. Since the distributions of the EQ-5D indexes in each subgroup were negatively skewed, median regression analysis was used to estimate the effects of specific diseases on the HRQoL. Median regression analysis produced estimates that approximated the median of the EQ-5D indexes and there are more robust for analyzing data with many outliers. RESULTS: A total of 16,692 subjects (6,667 patients and 10,025 people without any disease) were included in the analysis. As a result of the median regression analysis, stroke had the strongest impact on the HRQoL for both males and females, followed by osteoporosis, osteoarthritis, rheumatic arthritis, and herniation of an intervertebral disc. While asthma had a significant impact on the HRQoL only in men, cataract, temporo-mandibular dysfunction, and peptic ulcer significantly affected the HRQoL only in women. CONCLUSIONS: Stroke and musculoskeletal diseases were associated with the largest losses of the HRQoL in Korean adults.
Adult ; Female ; Health Status ; Humans ; Korea ; Male ; Middle Aged ; Musculoskeletal Diseases/etiology ; *Quality of Life ; Questionnaires ; Regression Analysis ; Sex Factors ; Sickness Impact Profile ; Stroke/etiology

OBJECTIVETo investigate lifting-related musculoskeletal disorders in metal processing, to analyze the risk factors, and to study the validity and feasibility of using NIOSH lifting equation in China.

METHODSThe questionnaires of semi-structured interview, the Ovako Working Posture Analysing System (OWAS) postural analysis and variables of the NIOSH equation were applied to the study. The study population consisted of 69 workers mainly involved in manual materials handling (MMH), categorized as Job A; and 51 machinery workers, served as controls, that were less MMH task involved, as Job B.

RESULTSThe prevalence of low back pain (LBP), which was defined at least one episode lasting for more than 24 hours in the past 12 months, were 63.8% and 37.3% for Job A and Job B, respectively. However, the prevalence of LBP lasting for more than a week due to lifting were 26.09% and 5.88% for Job A and B, respectively. The proportion of awkward back postures were found higher in Job A than that of Job B (66% vs 63%, P < 0.05). The NIOSH Lifting Index (LI) was estimated to be 2.4 for Job A, and 0 < LI < 1 for Job B. The analysis of multiple regressions revealed that the repetitiveness of lifting and length of service had greatly attributed to the occurrence of LBP. The "composite load" (object weight x activity repetitiveness) had a significant adverse effect on lower back meaning that the objective weight remains an ingredient part of the risk.

CONCLUSIONThe occurrence of LBP is not only related to the force load, but the repetitiveness of lifting and awkward postures. The method of OWAS observation and US-NIOSH equation are important tools in assessing characteristics and risk factors of LBP for MMH tasks. Further study aimed at developing an integral scheme for the assessment system is needed.

Adult ; Back Injuries ; epidemiology ; etiology ; China ; epidemiology ; Female ; Humans ; Male ; Metallurgy ; Middle Aged ; Musculoskeletal Diseases ; epidemiology ; etiology ; Occupational Diseases ; epidemiology ; etiology ; Prevalence ; Risk Factors ; Surveys and Questionnaires ; Time Factors ; Weight Lifting ; injuries

BACKGROUND: The risk of various complications after Achilles tendon lengthening is mainly related to the length of surgical exposure and the lengthening method. A comprehensive technique to minimize the complications is required. METHODS: The treatment of Achilles tendon tightness in 57 patients (95 ankles) were performed by using a short transverse incision on a skin crease of the heel and by Z-lengthening of the tendon. In the severe cases, two or three transverse incisions were required for greater lengthening of the tendon, and a serial cast or Ilizarov apparatus was applied for the gradual correction. The results of these 95 ankles were compared to those of 18 ankles, which underwent percutaneous sliding lengthening, and to the 19 ankles, which received Z-lengthening with a medial longitudinal incision. RESULTS: The functional and cosmetic satisfaction was achieved among those who underwent the tendon lengthening with the new technique. The mean American Orthopaedic Foot & Ankle Society (AOFAS) score improved from 56.1 to 81.8. The second operations to correct recurrence were performed in the two cerebral palsy patients. CONCLUSIONS: The new technique has a low rate of complications such as scarring, adhesion, total transection, excessive lengthening, and recurrence of shortening. The excellent cosmesis and the short operation time are the additional advantages.
Achilles Tendon/*surgery ; Adolescent ; Adult ; Child ; Child, Preschool ; Female ; Humans ; Male ; Musculoskeletal Diseases/complications ; Tendinopathy/etiology/*surgery ; Tenotomy/*methods ; Young Adult

Antegrade transmalleolar drilling method is one of the options for the treatment of osteochondral lesion of talus (OLT). We present five patients who underwent tibial drilling for treatment of OLT and later developed distal tibial cystic formation induced by cartilage opening or heat necrosis during drilling. Antegrade transmalleolar drilling can be a possible option for the treatment of OLT if the lesion is not easily reachable; however, other viable treatment should be considered due to its possibility of distal tibial pathologic change.
Adult ; Ankle Joint/surgery ; Cartilage, Articular/*surgery ; Female ; Humans ; *Iatrogenic Disease ; Male ; *Musculoskeletal Diseases/etiology/surgery ; *Orthopedic Procedures/adverse effects/methods ; Talus/*surgery ; *Tibia/injuries/surgery ; Young Adult