The use of mobile touch screen devices (MTSDs) has increased rapidly over the last decade, and there are concerns that their use may have negative musculoskeletal consequences; yet evidence on the ...association of MTSD use with musculoskeletal symptoms and exposures is currently dispersed. The aim of this study was to systematically review available literature on musculoskeletal symptoms and exposures associated with MTSD use. The synthesised information may facilitate wise use of MTSDs and may identify areas in need of further research.
EMBASE, Medline, Scopus, PsycINFO and Proquest electronic databases were searched for articles published up to June 2016, using keywords describing MTSD, musculoskeletal symptoms (e.g. pain, discomfort) and musculoskeletal exposures (e.g. posture, muscle activity). Two reviewers independently screened the articles, extracted relevant data and assessed methodological quality of included studies. Due to heterogeneity in the studies, a meta-analysis was not possible and a structured narrative synthesis of the findings was undertaken.
A total of 9,908 articles were screened for eligibility with 45 articles finally included for review. Included articles were of cross-sectional, case-control or experimental laboratory study designs. No longitudinal studies were identified. Findings were presented and discussed in terms of the amount, features, tasks and positions of MTSD use and its association with musculoskeletal symptoms and musculoskeletal exposures.
There is limited evidence that MTSD use, and various aspects of its use (i.e. amount of usage, features, tasks and positions) are associated with musculoskeletal symptoms and exposures. This is due to mainly low quality experimental and case-control laboratory studies, with few cross-sectional and no longitudinal studies. Further research is warranted in order to develop guidelines for wise use of MTSDs.
To identify common recommendations for high-quality care for the most common musculoskeletal (MSK) pain sites encountered by clinicians in emergency and primary care (spinal (lumbar, thoracic and ...cervical), hip/knee (including osteoarthritis OA and shoulder) from contemporary, high-quality clinical practice guidelines (CPGs).
Systematic review, critical appraisal and narrative synthesis of MSK pain CPG recommendations.
Included MSK pain CPGs were written in English, rated as high quality, published from 2011, focused on adults and described development processes. Excluded CPGs were for: traumatic MSK pain, single modalities (eg, surgery), traditional healing/medicine, specific disease processes (eg, inflammatory arthropathies) or those that required payment.
Four scientific databases (MEDLINE, Embase, CINAHL and Physiotherapy Evidence Database) and four guideline repositories.
6232 records were identified, 44 CPGs were appraised and 11 were rated as high quality (low back pain: 4, OA: 4, neck: 2 and shoulder: 1). We identified 11 recommendations for MSK pain care: ensure care is patient centred, screen for red flag conditions, assess psychosocial factors, use imaging selectively, undertake a physical examination, monitor patient progress, provide education/information, address physical activity/exercise, use manual therapy only as an adjunct to other treatments, offer high-quality non-surgical care prior to surgery and try to keep patients at work.
These 11 recommendations guide healthcare consumers, clinicians, researchers and policy makers to manage MSK pain. This should improve the quality of care of MSK pain.
Government initiatives have tried to ensure uniform computer access for young people; however a divide related to socioeconomic status (SES) may still exist in the nature of information technology ...(IT) use. This study aimed to investigate this relationship in 1,351 Western Australian children between 6 and 17 years of age. All participants had computer access at school and 98.9% at home. Neighbourhood SES was related to computer use, IT activities, playing musical instruments, and participating in vigorous physical activity. Participants from higher SES neighbourhoods were more exposed to school computers, reading, playing musical instruments, and vigorous physical activity. Participants from lower SES neighbourhoods were more exposed to TV, electronic games, mobile phones, and non-academic computer activities at home. These patterns may impact future economic, academic, and health outcomes. Better insight into neighbourhood SES influences will assist in understanding and managing the impact of computer use on young people's health and development.
Recent evidence suggests the existence of a physical activity paradox, with beneficial health outcomes associated with leisure time physical activity, but detrimental health outcomes for those ...engaging in high level occupational physical activity. This is the first quantitative systematic review of evidence regarding the association between occupational physical activity and all-cause mortality.
Systematic review with meta-analysis.
A literature search was performed in electronic databases PubMed, Embase, CINAHL, PsycINFO and Cochrane.
We screened for peer reviewed articles from prospective studies assessing the association of occupational physical activity with all-cause mortality. A meta-analysis assessed the association of high (compared with low) level occupational physical activity with all-cause mortality, estimating pooled hazard ratios (HR) (with 95% CI).
2490 unique articles were screened and 33 (from 26 studies) were included. Data from 17 studies (with 193 696 participants) were used in a meta-analysis, showing that men with high level occupational physical activity had an 18% increased risk of early mortality compared with those engaging in low level occupational physical activity (HR 1.18, 95% CI 1.05 to 1.34). No such association was observed among women, for whom instead a tendency for an inverse association was found (HR 0.90, 95% CI 0.80 to 1.01).
The results of this review indicate detrimental health consequences associated with high level occupational physical activity in men, even when adjusting for relevant factors (such as leisure time physical activity). These findings suggest that research and physical activity guidelines may differentiate between occupational and leisure time physical activity.
Office workers are exposed to high levels of sedentary time. In addition to cardio-vascular and metabolic health risks, this sedentary time may have musculoskeletal and/or cognitive impacts on office ...workers. Participants (n = 20) undertook two hours of laboratory-based sitting computer work to investigate changes in discomfort and cognitive function (sustained attention and problem solving), along with muscle fatigue, movement and mental state. Over time, discomfort increased in all body areas (total body IRR 95% confidence interval: 1.43 1.33⁻1.53) reaching clinically meaningful levels in the low back and hip/thigh/buttock areas. Creative problem solving errors increased (β = 0.25 0.03⁻1.47) while sustained attention did not change. There was no change in erector spinae, trapezius, rectus femoris, biceps femoris and external oblique median frequency or amplitude; low back angle changed towards less lordosis, pelvis movement increased, and mental state deteriorated. There were no substantial correlations between discomfort and cognitive function. The observed changes suggest prolonged sitting may have consequences for musculoskeletal discomfort and cognitive function and breaks to interrupt prolonged sitting are recommended.
Objectives In spite of preventive efforts, organizations and employees face several challenges related to working life and occupational health, such as a substantial prevalence of musculoskeletal ...disorders, social inequality in health and physical capacity, multi-morbidity, an obesity epidemic and an aging workforce. We argue that a new approach to occupational ergonomics and health is required, going beyond prevention of harm caused by work. We propose the "Goldilocks Principle" for how productive work can be designed to promote health and physical capacity. Methods Physical (in)activity profoundly influences health and physical capacity, with effects depending on the extent and temporal structure of the (in)activity. Like the porridge, chair and bed that needed to be "just right" for Goldilocks in the The Three Bears fairytale, physical activity during productive work needs to be "just right" for promoting rather than deteriorating health and capacity. In many jobs, physical activity is, however, either too much/high/frequent or too little/low/infrequent to give positive biomechanical and cardiometabolic stimuli. Results This paper presents the rationale, concept, development, application and prospects of the Goldilocks Principle for how productive work can be designed to promote health and physical capacity. Conclusions We envision a great potential to promote health and physical capacity by designing productive work according to the Goldilocks Principle, thus leading to benefits with respect to the current challenges related to working life and occupational health for society, organizations and employees.
Shifting workforce proportions to sedentary occupations and technology developments in traditionally physically demanding occupations have resulted in low physical workloads for many workers. ...Insufficient physical stress is known to have detrimental short- and long-term effects on health and physical capacity. It is argued herein that many modern workers are at risk of insufficient physical workload. Further, it is argued that the traditional physical ergonomics paradigm of reducing risk by reducing physical loads ('less is better') is not appropriate for many modern occupations. It is proposed that a new paradigm is required, where 'more can be better'. The potential for work to be seen as an arena for improving physical health and capability is discussed and the types of changes to work that may be required are outlined. The paper also discusses challenges and responsibilities presented by this new paradigm for ergonomists, employers, health and safety authorities and the community. The majority of workers in affluent communities now face the significant threat to health of insufficient physical workload. Ergonomics can design work to a prescription that can not only reduce injury risk but enhance health and capacity. However, this will require a change in paradigm.
Occupational sedentary behaviour is an important contributor to overall sedentary risk. There is limited evidence for effective workplace interventions to reduce occupational sedentary time and ...increase light activity during work hours. The purpose of the study was to determine if participatory workplace interventions could reduce total sedentary time, sustained sedentary time (bouts >30 minutes), increase the frequency of breaks in sedentary time and promote light intensity activity and moderate/vigorous activity (MVPA) during work hours.
A randomised controlled trial (ANZCTR NUMBER: ACTN12612000743864) was conducted using clerical, call centre and data processing workers (n = 62, aged 25-59 years) in 3 large government organisations in Perth, Australia. Three groups developed interventions with a participatory approach: 'Active office' (n = 19), 'Active Workstation' and promotion of incidental office activity; 'Traditional physical activity' (n = 14), pedometer challenge to increase activity between productive work time and 'Office ergonomics' (n = 29), computer workstation design and breaking up computer tasks. Accelerometer (ActiGraph GT3X, 7 days) determined sedentary time, sustained sedentary time, breaks in sedentary time, light intensity activity and MVPA on work days and during work hours were measured before and following a 12 week intervention period.
For all participants there was a significant reduction in sedentary time on work days (-1.6%, p = 0.006) and during work hours (-1.7%, p = 0.014) and a significant increase in number of breaks/sedentary hour on work days (0.64, p = 0.005) and during work hours (0.72, p = 0.015); there was a concurrent significant increase in light activity during work hours (1.5%, p = 0.012) and MVPA on work days (0.6%, p = 0.012).
This study explored novel ways to modify work practices to reduce occupational sedentary behaviour. Participatory workplace interventions can reduce sedentary time, increase the frequency of breaks and improve light activity and MVPA of office workers by using a variety of interventions.
Australian New Zealand Clinical Trials Registry ACTN12612000743864.
Prevalence of low back pain (LBP) rises rapidly during adolescence, reaching adult levels by the age of 18. It has been suggested that adolescent LBP is benign with minimal impact, despite limited ...evidence.
The aim of this study was to investigate the impact of LBP and the influence of chronicity, gender and presence of other spinal pain comorbidities at age 17. Subjects (n=1283) were categorised according to experiencing current and chronic LBP, gender and presence of other areas of spinal pain. LBP impact was ascertained via questions regarding seeking professional assistance, using medication, missing school/work, limited normal or recreational physical activity and health related quality of life (HRQOL).
12.3% of participants reported current but not chronic LBP, while 19.9% reported current chronic LBP. LBP was more commonly reported by females than males. Other spinal pain comorbidities were common in the LBP groups. Impact was greater in subjects with chronic LBP, in females and in those with other spinal pain comorbidities.
LBP, and particularly chronic LBP, has a significant negative impact at 17 years. It is commonly associated with care seeking, medication use, school absenteeism, and reduced HRQOL. These findings support that adolescent LBP is an important public health issue that requires attention.
A prospective study of the sagittal standing posture of 766 adolescents.
To determine whether posture subgroups based on photographic assessment are similar to those used clinically and to previous, ...radiographically determined subgroups of sagittal standing posture, and whether identified subgroups are associated with measures of spinal pain.
Relatively little research has been performed toward a classification of subjects according to sagittal spinal alignment. Clinical descriptions of different standing posture classifications have been reported, and recently confirmed in a radiographic study. There is limited epidemiological data available to support the belief that specific standing postures are associated with back pain, despite plausible mechanisms. As posture assessment using radiographic methods are limited in large population studies, successful characterization of posture using 2-dimensional photographic images will enable epidemiological research of the association between posture types and spinal pain. METHODS.: Three angular measures of thoraco-lumbo-pelvic alignment were calculated from lateral standing photographs of subjects with retro-reflective markers placed on bony landmarks. Subgroups of sagittal thoracolumbar posture were determined by cluster analysis of these 3 angular measures. Back pain experience was assessed by questionnaire. The associations between posture subgroups and spinal pain variables were evaluated using logistic regression.
Postural subtypes identified by cluster analysis closely corresponded to those subtypes identified previously by analysis of radiographic spinal images in adults and to those described clinically. Significant associations between posture subgroups and weight, height, body mass index, and gender were identified. Those adolescents classified as having non-neutral postures when compared with those classified as having a neutral posture demonstrated higher odds for all measures of back pain, with 7 of 15 analyses being statistically significant.
Meaningful classifications exist for adolescent sagittal thoraco-lumbo-pelvic alignment, and these can be determined successfully from sagittal photographs. More neutral thoraco-lumbo-pelvic postures are associated with less back pain.
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