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The rotator cuff, comprising the subscapularis, supraspina-tus, infraspinatus, and teres minor muscles, plays a crucial role in stabilizing the glenohumeral joint by securing the head of the humerus within the glenoid cavity of the scapula. The tendinous insertions of these muscles generate tension within the capsule, enhancing joint stability during muscular activity. The rotator cuff is susceptible to damage from disease, injury, or trauma, which can result in tears or ruptures of one or more tendons. The evaluation of the infraspinatus muscle and tendon is vital for diagnosing and managing various shoulder pathologies. Accurate imaging to determine the specific muscle involvement and injury severity significantly impacts treatment decisions. Diagnostic musculoskeletal ultrasound (MSK-US) has emerged as a valuable tool for assessing the infraspinatus muscle and tendon, offering real-time, dynamic assessment capabilities essential for precise diagnosis and effective rehabilitation planning. This article reviews the utility and advantages of MSK-US in evaluating the infraspinatus muscle and tendon, emphasizing technique specifics, diagnostic accuracy, and comparative efficacy against other imaging modalities. It details a systematic approach to the ultrasound examination technique for the infraspinatus, including patient positioning and identification of common pathologies such as tears, tendinopathy, and calcifications. With recent advancements in transducer strength, image resolution, and operator training, ultrasound serves as an excellent alternative imaging modality for diagnosing rotator cuff tears. This article aims to equip rehabilitation professionals with a comprehensive understanding of MSK-US as a diagnostic tool for the infraspinatus, promoting more precise diagnosis, treatment planning and improved patient outcomes. [ABSTRACT FROM AUTHOR]

Objective: To examine the effect of concurrent physical and cognitive demands as well as age on indicators of muscle fatigue at the wrist. Background: There are few studies examining risk indicators for musculoskeletal disorders associated with work-related physical and cognitive demands that often occur simultaneously in the workplace. Methods: Twenty-four gender-balanced older and 24 gender-balanced younger (mean age 60 and 23 years) participants performed four 30 min dual tasks. Tasks differed by the muscular load level during force tracking: 5% and 10% of maximum voluntary contraction force (MVC) and concurrent cognitive demands on the working memory: easy and difficult. Muscle fatigue was assessed by MVC decline and changes in surface electromyography (increased root mean square: RMS, decreased median frequency: MF) at the extensor digitorum (ED) and extensor carpi ulnaris (EU). Results: A decline in MVC was found in all participants when tracking was performed at 10% MVC (mean ± SD: 137.9 ± 49.2 – 123.0 ± 45.3 N). Irrespective of age, muscular, or cognitive load, RMS increased (ED 12.3 ± 6.5 – 14.1 ± 7.0% MVE, EU 15.4 ± 7.6 – 16.9 ± 8.6% MVE) and MF decreased (ED 85.4 ± 13.6 – 83.2 ± 12.8 Hz, EU 107.2 ± 17.1 – 104.3 ± 16.7 Hz) in both muscles. However, changes in MF of EU tended to be more pronounced in the older group at higher cognitive and lower muscular load, without reaching statistical significance. Conclusion: Maximum voluntary contraction indicated no interaction between muscle fatigue, cognitive load, or age. However, the tendencies toward altered muscle activity due to an increase in cognitive load and older age suggest muscular adaptations while maintaining tracking performance during the onset of fatigue signs in the sEMG signal. Application: If the tendencies in muscle activity are confirmed by further studies, ergonomic assessments in industrial workplaces should consider cognitive load and age when describing the risk of musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

Background: Globally, Musculoskeletal disorders (MSDs) are the biggest contributor (17%) to years lived with disability. For offering diagnosis and appropriate health interventions options along with follow-up care, it is pertinent to have a thorough awareness of its associated risk factors. Objectives: The study aims to assess the prevalence and association between MSDs and risk factors among the Indian older adults above 45 years. Methodology: Prevalence of MSDs among 28,436 participants was estimated using nationally representative survey on older Indian adults. Spatial distribution maps were created to display the magnitude of MSD prevalence at Indian sub-national level. Association between presence of MSDs and associated risk factors (such as occupation, employment duration, physical activity, BMI, diabetes, hypertension, tobacco usage, and alcohol consumption) was explored through Multivariate logistic regression. P-value <0.05 was considered as statistically significant. Results: MSD was prevalent in over half of participants (53.5 (52.9–54.1)%), with more among females and in those aged >60 years (60.4 (59.3–61.4)%). Overall, joint pain (41.9 (41.3–41.4)%) was more common than back pain (32.6 (32.0–33.1)%). Prevalence was highest in Manipur (81.1 (77.9–83.9)%) and lowest in West Bengal (33.1 (30.7–35.5)%). MSD presence was positively associated with certain occupational groups, pre-obesity (BMI 25–29.9 Kg/m2), currently hypertensive, vigorous physical activity among overall population. Tobacco usage was positively associated, while alcohol consumption was linked to a lower occurrence of MSDs for 45–60 years age group. Conclusions: Customised policy interventions can be developed for specific age category of older Indian adults and musculoskeletal health can be improved by addressing modifiable risk factors such as physical inactivity, tobacco usage, avoiding workplace risks in occupations requiring manual labour as revealed by this study. [ABSTRACT FROM AUTHOR]

Background: Intensive care units (ICUs) are one of the high-risk working areas in terms of musculoskeletal disability and ergonomic risks including the environment and posture factors. Correct posture technique is often ignored by nurses working in these units. This study was conducted to determine the effect of posture regulation training on work-related musculoskeletal disorders, fatigue level and job performance in nurses working in ICUs. Methods: This quasi-experimental study with one-group pretest-posttest design included 64 intensive care nurses. The nurses received posture regulation training in three different sessions. The post-test was administered four months after the posture regulation training. Results: The nurses reported to frequently have aches, pains and discomfort in the neck, upper back and lumbar regions. After the posture regulation training, their level of pain, ache and discomfort in the neck, right and left shoulder, upper back, lower back and right/left foot areas decreased significantly (p < 0.05). The posture regulation training reduced the levels of behavior/severity and affect, which are sub-dimensions of fatigue, and increased the level of contribution to work, which is a sub-dimension of job performance (p < 0.05). Conclusion: The posture regulation training decreased the level of symptoms in the neck, shoulder, upper back, lower back and foot regions of intensive care nurses and partially improved their fatigue level and job performance. Therefore, posture regulation training should be added to in-service training programs and permanent measures should be taken for ergonomic risks in ICUs. [ABSTRACT FROM AUTHOR]

Chronic low back pain (LBP) is a common musculoskeletal disorder and is often accompanied by functional leg length inequality (FLLI). However, little was known about the effects of gluteal muscle control training in patients with LBP and FLLI. This study was designed to investigate the effects of gluteal control training in patients with LBP and FLLI. This is a double-blinded, randomized controlled study design. Forty-eight LBP patients with FLLI were randomized to the gluteal control training (GT) (47.58 ± 9.42 years) or the regular training (RT) (47.38 ± 11.31 years) group and received allocated training for six weeks. The outcome measures were pelvic inclination (PI), ilium anterior tilt difference (IATD), FLLI, visual analogue scale (VAS), patient specific-functional scale (PSFS), Oswestry disability index (ODI), hip control ability, global rating of change scale (GRoC), and lower extremity strength and flexibility. The intervention effects were compared using two-way repeated measures analysis of variance and chi-square tests with α = 0.05. The results indicated that the GT group showed greater improvement (P < 0.01) in PI (1.03 ± 0.38∘ vs. 1.57 ± 0.51∘), IATD (0.68 ± 0.66∘ vs. 2.31 ± 0.66∘), FLLI (0.3 ± 0.22 vs. 0.59 ± 0.13 cm), VAS (1.41 ± 1.32 vs. 3.38 ± 1.51), hip control ability (2.20 ± 0.45 vs. 0.89 ± 0.74), GRoC at 3rd and 6th week as compared to the RT group. Hip strength and flexibility also improved more in the GT group (P < 0.05). In conclusion, gluteal control training was more effective in improving low back pain and dysfunctions, and should be integrated in the management plan in patients with LBP and FLLI. [ABSTRACT FROM AUTHOR]

Introduction: Individuals with participation and activity limitations face important healthcare challenges. Objectives: We investigated healthcare utilization and characteristics of Canadians living with participation and activity limitations between 2001 and 2010. Methods: We pooled data from 5 cycles of the Canadian Community Health Survey (2001-2010 CCHS). The multistage stratified cluster-sampling method used covered approximately 98% of Canadians, aged 12 years and older residing in private dwellings. We described sociodemographic, behavioral, and health-related characteristics of participants with participation and activity limitations and reported their annual utilization (prevalence; 95% CI) of 7 healthcare providers. Multivariable modified Poisson regression identified individual characteristics associated with healthcare utilization and examined the trends over time. Results: Annually, 8.1 million Canadians aged 12 years and older (29.8%) reported participation and activity limitations. Most common health conditions were back problems (37%) and arthritis (34%). Predominant healthcare providers were medical doctors (88.8%; 95% CI = 88.6-89.0), nurses (16.3%; 95% CI = 16.1-16.6), physiotherapists (15.0%; 95% CI = 14.7-15.2), and chiropractors (14.4%; 95% CI = 14.2-14.7). Overall, males, older adults, immigrants, those with lower education, lower income, recent employment, and better general health were less likely to consult providers. Over time, utilization of most non-medical providers increased. Conclusion: Participation and activity limitations are prevalent in Canada, and most consulted medical doctors. Disadvantaged groups reported lower utilization of most providers, emphasizing access challenges and the need for equitable and integrated healthcare policies. Improving access to rehabilitation services and their inclusion within universal healthcare coverage should be a priority. [ABSTRACT FROM AUTHOR]

Introduction: The job of sonographers exposes them to numerous ergonomic risk factors, making the sonography profession one of the high-risk job groups vulnerable to musculoskeletal disorders (MSDs). The present systematic review and meta-analysis specifically examined the prevalence of MSDs among sonographers. Materials and methods: The present review study was carried out in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. The protocol of the study was registered in the international prospective register of systematic review (PROSPERO) with the code CRD42024507972. Searches were conducted in databases including PubMed, Scopus, Web of Science, Science Direct, SID, ISC, and Google Scholar, without imposing a time limit until February 7th, 2024. The random-effects model was employed for meta-analysis, and the I2 index was used to assess heterogeneity among studies. Finally, data analysis was performed using STATA (version 14). Results: Based on the search in different databases, a total of 4367 articles were identified. Finally, after screening, selecting, and quality evaluation of the studies, 30 studies were considered for meta-analysis in which 13,916 sonographers were examined. According to the results of the meta-analysis, the overall prevalence of MSDs among sonographers was reported as 75.80% (95% CI: 65.37–86.23, I2 = 99.7%, P < 0.001). Additionally, the prevalence rates of these disorders in the neck (63.73%), shoulder (60.13%), upper back (53.69%), lower back (49.84%), wrist (44.41%), elbow (27.46), hip (24.93%), knee (19.59), and ankle (16.92%) were determined. Conclusion: Given the relatively high prevalence of MSDs among sonographers and the importance of reducing specific risk factors associated with their duties, it is recommended to consider solutions such as carrying out ergonomic assessments and interventions, as well as providing training programs and appropriate corrective exercises to mitigate MSDs among sonographers. [ABSTRACT FROM AUTHOR]

Background: The rise in risk factors like obesity, hypertension, and diabetes mellitus has partly led to the increase in the number of patients affected by chronic kidney disease, affecting an estimated 843 million people, which is nearly 10% of the general population worldwide in 2017. Patients with CKD have an increased risk of functional difficulties and disability. This study aimed to assess the level of functional status and disability and its associated factors among patients with chronic kidney attending Saint Paul Hospital, Millennium Medical College, Addis Ababa, Ethiopia. Methods: An institution-based cross-sectional study was conducted with 302 enrolled study participants through systematic random sampling techniques. Face-to-face interviews and chart reviews were used to collect data using a semi-structured questionnaire adapted from works of literature. The Health Assessment Questionnaire Disability Index (HAQ-DI) was used to assess the functional status and disability of the participants. Data was entered into EPI info version 7 and exported to SPSS version 23 for analysis. Bivariate logistic regression analysis was employed with a p-value less than 0.25. Finally, those variables with a p-value less than 0.05 in multivariate analysis were taken as statistically significant. Results: A total of 219 (72.5%) CKD patients had moderate to severe functional limitation and disability (HAQ-Di > 0.5-3). Age > 50 years [AOR = 1.65; 95% CI (1.23, 3.15)], being at stage 2 and 3 CKD [AOR = 4.05; 95% CI (1.82, 9.21), being at stage 4 and 5 CKD [AOR = 2.47; 95% CI (1.87, 4.72)], and having MSK manifestations [AOR = 2.97; 95% CI (1.61, 5.55)] were significantly associated with functional status and disability. Conclusion: The findings of this study suggest that CKD-associated functional disabilities are common. The advanced stage of CKD, higher age, and presence of musculoskeletal manifestations appear to be important variables predicting self-reported functional status. Healthcare professionals treating CKD shall be vigilant about the CKD-associated disability, the modifiable predictors, and interventions to limit the CKD-related disability. [ABSTRACT FROM AUTHOR]

Background : Several surgical options for degenerative lumbar spinal stenosis (LSS) are available, but current guidelines do not recommend which one should be prioritized. Although previous network meta-analyses (NMAs) have been performed on this topic, they have major methodological problems and could not provide the convincing evidence and clinical practical information required. Methods: Randomized controlled trials (RCTs) comparing at least two surgical interventions were included by searching AMED, CINAHL, EMBASE, the Cochrane Library, and MEDLINE (inception to August 2023). A frequentist random-effects NMA was performed for physical function and adverse events due to any reason. For physical function, three follow-up time points were included: short-term (< 6 months post-intervention), mid-term (≥ 6 months but < 12 months), and long-term (≥ 12 months). Laminectomy was the reference comparison intervention. Results: A total of 43 RCTs involving 5017 participants were included in the systematic review and 28 RCTs encompassing 14 types of surgical interventions were included in the NMA. For improving physical function (scale 0–100), endoscopic-assisted laminotomy (mean difference: − 8.61, 95% confidence interval: − 10.52 to − 6.69; moderate-quality evidence), laminectomy combined with Coflex (− 8.41, − 13.21 to − 3.61; moderate quality evidence), and X-stop (− 6.65, − 8.60 to − 4.71; low-quality evidence) had small effects at short-term follow-up; no statistical difference was observed at mid-term follow-up (very low- to low-quality evidence); at long-term follow-up, endoscopic-assisted laminotomy (− 7.02, − 12.95 to − 1.08; very low-quality evidence) and X-stop (− 10.04, − 18.16 to − 1.93; very low-quality evidence) had a small and moderate effect, respectively. Compared with laminectomy, endoscopic-assisted laminotomy was associated with fewer adverse events due to any reason (odds ratio: 0.27, 0.09 to 0.86; low-quality evidence). Conclusions: For adults with degenerative LSS, endoscopic-assisted laminotomy may be the safest and most effective intervention in improving physical function. However, the available data were insufficient to indicate whether the effect was sustainable after 6 months. Trial registration: PROSPERO (CRD42018094180). [ABSTRACT FROM AUTHOR]

This study aims at improving the lower-limb muscle segmentation accuracy of deep learning approaches based on Magnetic Resonance Imaging (MRI) scans, crucial for the diagnostic and therapeutic processes in musculoskeletal diseases. In general, segmentation methods such as U-Net deep learning neural networks can achieve good Dice Similarity Coefficient (DSC) values, e.g. around 0.83 to 0.91 on various cohorts. Some generic post-processing strategies have been studied to incorporate connectivity constraints into the resulting masks for the purpose of further improving the segmentation accuracy. In this paper, a novel mean shape (MS) based post-processing method is proposed, utilizing Statistical Shape Modelling (SSM) to fine-tune the segmentation output, taking into consideration the muscle anatomical shape. The methodology was compared to existing post-processing techniques and a commercial semi-automatic tool on MRI scans from two cohorts of post-menopausal women (10 Training, 8 Testing, voxel size 1.0x1.0x1.0 mm3). The MS based method obtained a mean DSC of 0.83 across the different analysed muscles and the best performance for the Hausdorff Distance (HD, 20.6 mm) and the Average Symmetric Surface Distance (ASSD, 2.1 mm). These findings highlight the feasibility and potential of using anatomical mean shape in post-processing of human lower-limb muscle segmentation task and indicate that the proposed method can be popularized to other biological organ segmentation mission. [ABSTRACT FROM AUTHOR]

Purpose: To observe the effect of the forearm rotation function reconstruction with an external fixator in treating congenital radioulnar synostosis. Methods: From July 2017 to July 2023, 6 patients (9 sides) with congenital radioulnar synostosis who underwent reconstruction of the forearm rotation with the external fixator were retrospectively analyzed. The extent of flexion and rotation, the Modified An and Morrey functional rating index, and the grade according to the classification system proposed by Failla et al. were compared before and after the operation. Results: All patients were followed up for an average of 12.00 (8.00, 38.50) months. The average range of rotation, the Modified An and Morrey functional rating index increased from 0°, 64.56 ± 1.33 points to 85.00° ± 25.86°, 83.71 ± 5.50 points, respectively. The differences were statistically significant (t = 9.86, P < 0.01, t = 11.20, P < 0.01). There was no significant difference in forearm flexion before and after the operation (Z = 1.34, P = 0.18). According to the Failla classification system, 2 forearms were classified as poor preoperatively, 6 as fair and 1 as good. 2 forearms were assessed as excellent, 6 as good and 1 as fair during the last follow-up. Conclusion: Reconstruction of the forearm rotation function with an external fixator is safe and effective for treating congenital radioulnar synostosis. This technique can restore the partial rotational function of the forearm. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal disorders such as cervicogenic headaches present with suboccipital muscle hypertonicity and trigger points. One manual therapy intervention commonly used to target the suboccipital muscles is the suboccipital release technique, previously related to positive systemic effects. Therefore, this study aimed to determine the immediate and short-term effects of the Suboccipital Release Technique (SRT) on brainwave activity in a subgroup of healthy individuals. Methods: Data were collected from 37 subjects (20 females and 17 males, with a mean age of 24.5). While supine, the subjects underwent a head hold followed by suboccipital release. A total of four 15 s electroencephalogram (EEG) measurements were taken and a Global Rating of Change Scale was used to assess self-perception. Results: There was a statistically significant difference (p < 0.005) in various band waves under the following electrodes: AF3, F7, F3, FC5, T7, P7, O1, O2, P8, T8, and FC6. An 8-point range in the Global Rating of Change Scores with a mean score of 1.649 (SD = 1.719 and SE = 0.283) supported the hypothesis of a self-perceived benefit from the intervention. Conclusions: The results of this study indicate that the suboccipital release technique significantly affects brain wave activity throughout different brain regions. This change is likely not the result of any placebo effect and correlates highly with the subject's self-perception of a change following the intervention. These findings support the clinical use of the suboccipital release technique when a centralized effect is desired. [ABSTRACT FROM AUTHOR]

The intricate interplay between cellular senescence and alterations in the gut microbiome emerges as a pivotal axis in the aging process, increasingly recognized for its contribution to systemic inflammation, physiological decline, and predisposition to age‐associated diseases. Cellular senescence, characterized by a cessation of cell division in response to various stressors, induces morphological and functional changes within tissues. The complexity and heterogeneity of senescent cells, alongside the secretion of senescence‐associated secretory phenotype, exacerbate the aging process through pro‐inflammatory pathways and influence the microenvironment and immune system. Concurrently, aging‐associated changes in gut microbiome diversity and composition contribute to dysbiosis, further exacerbating systemic inflammation and undermining the integrity of various bodily functions. This review encapsulates the burgeoning research on the reciprocal relationship between cellular senescence and gut dysbiosis, highlighting their collective impact on age‐related musculoskeletal diseases, including osteoporosis, sarcopenia, and osteoarthritis. It also explores the potential of modulating the gut microbiome and targeting cellular senescence as innovative strategies for healthy aging and mitigating the progression of aging‐related conditions. By exploring targeted interventions, including the development of senotherapeutic drugs and probiotic therapies, this review aims to shed light on novel therapeutic avenues. These strategies leverage the connection between cellular senescence and gut microbiome alterations to advance aging research and development of interventions aimed at extending health span and improving the quality of life in the older population. [ABSTRACT FROM AUTHOR]

This paper focuses on improving the ergonomics of industrial workers. It addresses the critical implications of poor ergonomics, which can lead to musculoskeletal disorders over time. A novel methodology for a path-planning algorithm designed for human–robot collaboration was introduced to tackle this challenge. The algorithm's essential contribution lies in determining the most ergonomic path for a robot to guide a human's hand during task execution, facilitating a transition toward an optimized body configuration. The algorithm effectively charts the ergonomic path by adopting a Cartesian path-planning approach and employing the cell decomposition method. The methodology was implemented on a dataset of ten individuals, representing a diverse group of male and female subjects aged between 20 and 35, with one participant being left-handed. The algorithm was applied to three different activities: "stacking an item," "taking an object from a shelf," and "assembling an object by sitting over a table." The results demonstrated a significant improvement in the REBA score (as a measure of ergonomics condition) of the individuals after applying the algorithm. This outcome reinforces the efficacy of the methodology in enhancing the ergonomics of industrial workers. Furthermore, the study compared the performance of A* with three heuristic functions against Dijkstra's algorithm, aiming to identify the most effective approach for achieving optimal ergonomic paths in human–robot collaboration. The findings revealed that A* with a specific heuristic function surpassed Dijkstra's algorithm, underscoring its superiority in this context. The findings highlight the potential for optimizing human–robot collaboration and offer practical implications for designing more efficient industrial work environments. [ABSTRACT FROM AUTHOR]

Background: Pain attributed to musculoskeletal disorders are a significant hinderance to work ability and economic growth, especially in developing countries. Quality of life and lived experience of workers with musculoskeletal disorders have not been explored enough to determine whether person-centred care is provided. There is a wealth of evidence for using the biomedical approach in the management of workers with musculoskeletal disorders, which has proved ineffective in reducing absenteeism and symptoms experienced by workers. The purpose of this study was to explore the lived experience of workers seeking care for musculoskeletal disorders and how their pain attitudes and beliefs influenced their experience. Methods: A qualitative approach with thematic analysis was used. Purposive sampling was used to recruit six participants for semi-structured interviews. All participants were either experiencing pain attributed to a musculoskeletal disorder or had received care for a musculoskeletal disorder. Results: Pain attitudes and beliefs of workers with a musculoskeletal disorder and healthcare professionals greatly influenced the care and recovery process of musculoskeletal disorders. There is a primary biomedical lens informing care of workers with musculoskeletal disorders received. Workers expect healthcare professionals to explore their concerns further, but the focus of care for most participants was their presenting complaint. There is also a need for the autonomy of workers to be preserved, and communication between healthcare professionals and workers with musculoskeletal disorders needs to improve. Conclusions: Many stakeholders are involved in the recovery process from musculoskeletal disorders. There is a need for a biopsychosocial informed practice to improve return-to-work (RTW) in workers with musculoskeletal disorders. Change is needed at all healthcare system levels to reduce the negative experiences of workers and maladaptive pain beliefs that is associated with persisting symptoms and extended absenteeism. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to investigate the effects of a head/neck supporting exoskeleton (HNSE) on the electromyographic fatigue threshold (EMGFT) of the neck and shoulder muscles during a simulated overhead work task. Background: Overhead work is a well-known risk factor for neck and shoulder musculoskeletal disorders due to the excessive strain imposed on the muscles and joints in these regions. Method: Fourteen healthy males performed a repetitive overhead nut fastening/unfastening task to exhaustion while wearing and not wearing the HNSE at two neck extension angles (40% and 80% of neck maximum range of motion). Electromyographic signals were continuously recorded from the right and left sternocleidomastoid (SCMR, SCML), splenius capitis (SCR, SCL), upper trapezius (UTR, UTL), and anterior deltoid (ADR, ADL) muscles. The normalized electromyographic amplitude (nEMG) data was time normalized, and a bisegmental linear regression was applied to determine the muscle fatigue break point. Results: The results showed a significant increase in fatigue threshold time in the SCMR (p <.001), SCML (p =.002), and UTR (p =.037) muscles when the HNSE was used. However, the EMGFT times for the right and left deltoid and left trapezius muscles showed a nonsignificant reduction due to the head/neck support exoskeleton use. In addition, the neck extension angle did not reveal a significant effect on muscles' EMGFT time. Conclusion: Overall, the findings confirmed a significant delay in fatigue onset in sternocleidomastoid muscles, as measured by the electromyographic fatigue threshold. This finding suggests that the HNSE can be an effective ergonomic intervention for reducing the risk of musculoskeletal disorders in overhead workers. However, further studies are needed to investigate the effect of the HNSE at other neck extension angles and more realistic tasks to ensure the generalizability of our results. Application: The present findings emphasize the application of the fatigue onset time to evaluate the effectiveness of ergonomic interventions, including exoskeletons, which can subsequently be utilized to alleviate postural demands and reduce the risk of musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

Introduction: Gym instructors within the fitness industry play a pivotal role in guiding individuals towards achieving a range of health and fitness goals. In addition to muscular and skeletal health, gym instructors are instrumental in boosting the immune system. Even though they help in maintaining the body gym trainers have a limited knowledge of mechanism of injury, neglecting and repetitive movements of the joint leads to worsening of injury and increase in the pain. Musculoskeletal pain can stem from various sources, including uncommon or repetitive activities that strain muscles, tendons, and ligaments. Additionally, it may result from sudden, jerky movements, falls, fractures, or underlying musculoskeletal conditions. The result of repetitive activities that strain the muscles, tendons and sprain the ligaments. Insufficient recovery time, rapid pace work, repetitive motion patterns, heavy weight lifting, forceful manual exertions, mechanical pressure concentrations or whole body vibrations can lead to development of other musculoskeletal disorders. The impact of a musculoskeletal condition on an individual's quality of life is substantial, extending beyond mere physical discomfort. Such conditions not only affect personal well-being but also impose a considerable financial strain, manifested through compensation payments and lost wages. Instances of sick leave, absenteeism, and even job abandonment contribute to diminished job efficiency, further exacerbating the socioeconomic repercussions of these disorders. Methodology: A total of 147 participants were selected on the basis of inclusion and exclusion criteria. A consent form was filled by them and the study and questionnaire was explained to them. Self-made Questionnaire was explained to each gym instructors according to language understood by that person as well as google forms were also made available for their convenience. Each gym instructor completed a self administered questionnaire which included information regarding complaints of current shoulder pain. The total data was collected and was statistically analyzed. Conclusion: The Prevalence of shoulder pain in gym instructors is high (78%). The presence of shoulder pain causes a gym instructors to avoid certain activities due to pain which causes a hindrance in their work related activities. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal issues at work have an influence on daily life, productivity, and quality of life. Musculoskeletal issues that go untreated can result in severe damage and function loss, which can limit participation, cause financial loss, and add to the rising burden of illness in the world. Objective: The purpose of this study was to find the effect of occupational therapy rehabilitation program in occupational therapy students with work related musculoskeletal disorder. Study Design: Quasi-experimental, pilot study design was chosen for the research Methods: The study employed a quasi-experimental study design. Thirty occupational therapy students aged 20-25 years were recruited through convenience sampling after a prevalence check where 30 students reported 54 musculoskeletal problems. A total number of participants (n= 30) received occupational therapy rehabilitation program. Standardised Nordic musculoskeletal questionnaire (SNMQ) and Numeric pain rating scale (NPRS) were administered to Pain and work related musculoskeletal disorder for all the participants. Result: It revealed that there was a statistically significant difference in pre-test and post-test with numeric pain rating scale (t=10.625, p=0.000). There was a significant difference in percentage in 7 days component of SNMQ. There was no statistical difference with post-test of score of 12 months component of SNMQ. Conclusion: Occupational therapy rehabilitation program is effective for reducing Musculoskeletal disorder or discomfort in occupational therapy students. [ABSTRACT FROM AUTHOR]

Musculoskeletal disorders occur frequently in industrial settings, and police officers in particular are at high risk of developing musculoskeletal disorders due to the nature of their work, but research on this is lacking. Therefore, the purpose of this study was to examine the prevalence and risk factors of musculoskeletal disorders according to the job functions of police officers. A survey was conducted, targeting active-duty police officers, and data were collected from 4268 respondents who answered all items on the questionnaire. As a control group, we used the general population dataset from the 2020 National Health and Nutrition Examination Survey conducted in Korea. The survey included general information such as gender, age, working hours, and type of work. It also investigated medical utilization, including the frequency of medical visits and hospitalizations. The assessment of musculoskeletal disorders was analyzed using pain NRS, VAS, SPADI, and ODI. The working characteristics of police officers were found to be more irregular in terms of working hours and involved a higher intensity of work activities compared with the general population. However, there was a lack of precise diagnoses and continuous treatment for these disorders. These results imply that police officers' occupational characteristics are related to musculoskeletal disorders. Considering the direct relationship between police officers' health and public safety, systematic evaluation and management of their musculoskeletal disorders are needed. [ABSTRACT FROM AUTHOR]

Background/Objectives: Digital health applications (DHAs) promise to improve disease self-management, but adherence remains suboptimal. We aimed to explore self-monitoring practices of rheumatic and musculoskeletal diseases (RMD) patients. A web-survey was conducted over 7 months including RMD patients to study their self-monitoring practices and the potential of DHAs. Methods: Health, sociodemographic, and technology adherence indicators were retrieved for comparison. Regression analyses and unsupervised profiling were performed to investigate multiple patient profiles. Results: From 228 responses gathered, most reported willingness to use DHAs to monitor their condition (78% agreement), although the majority rarely/never tracked symptoms (64%), often due to stable condition or no perceived value (62%). Of those tracking regularly, 52% used non-digital means. Participants with regular self-monitoring practices were more open to use a self-monitoring app (OR = 0.8 [0.6, 0.9]; p = 0.008) and be embedded in multidisciplinary care (OR = 1.4 [1.1, 1.6]; p < 0.001), but showed worse health status (g = 0.4; p = 0.006). Cluster analyses revealed three distinct groups of reasons for not tracking regularly ( χ 2 = 174.4; p < 0.001), two characterised by perceived low disease activity. Conclusions: Effective use of DHAs remains limited and non-digital means prevail in symptom monitoring. Findings suggest that better patient engagement strategies and passive monitoring should be adopted in early development stages of DHAs for better long-term disease self-care. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to assess the potential value of patient-reported outcomes (PROs) of depression, fibromyalgia symptoms, and pain in predicting non-inflammatory vs. inflammatory diagnoses in rheumatology patients. Methods: This retrospective, single-center study evaluated electronic health record (EHR) data from adults who were seen for their first rheumatology consultation and subsequently received a diagnosis of an inflammatory (e.g., rheumatoid arthritis or spondyloarthritis) or non-inflammatory (e.g., osteoarthritis or fibromyalgia) condition. The PROs evaluated included depressive symptoms (Patient Health Questionnaire-2 [PHQ-2]), fibromyalgia symptom severity (FM SS), and pain. Results: A total of 3669 patients were evaluated, including patients with (n = 984; 26.82%) and without (n = 2685; 73.18%) inflammatory rheumatologic disease, of whom 141 (3.8%) had fibromyalgia. The non-inflammatory subgroup reported higher FM SS scores, and the inflammatory subgroup had higher pain and inflammatory markers. Bivariate models based on PHQ-2 and FM SS had a very low specificity (0.3%) for predicting non-inflammatory conditions, resulting in the misclassification of >99% of inflammatory cases. Adding pain, inflammatory markers, and other relevant EHR variables increased specificity but still resulted in a high level of misclassification. Conclusions: The PROs evaluated in this study are not suitable for predicting non-inflammatory vs. inflammatory rheumatologic disease, even when combined with other EHR variables. [ABSTRACT FROM AUTHOR]

A 65-year-old man with a history of seronegative rheumatoid arthritis presented with pain and swelling in his knees and wrists. Despite previous treatments, his symptoms did not improve. Laboratory tests showed low potassium levels, high ESR, and high CRP. X-rays revealed osteoarthritic changes. The differential diagnosis includes various forms of arthritis, such as seronegative rheumatoid arthritis, peripheral spondyloarthritis, osteoarthritis, infectious arthritis, crystalline arthritis, and paraneoplastic arthritis. Further evaluation is needed to determine the correct diagnosis. In this case, the patient was diagnosed with chronic calcium pyrophosphate crystal inflammatory arthritis due to hypomagnesemia caused by proton pump inhibitor use. Checking for hypomagnesemia in patients with CPPD disease is important, and PPI use should be considered as a potential cause. [Extracted from the article]

Background: Family factors, sleep, and physical activity have previously been associated with risk of sick leave and disability benefits due to musculoskeletal disorders. However, how these factors act during adolescence and young adulthood is unclear. The aim of this study was to (i) examine if chronic pain, disability benefits and education in parents influence the risk of long-term sick leave due to musculoskeletal disorders in young adulthood, and (ii) to explore if offspring sleep problems and physical activity modify these effects. Methods: A population-based prospective study of 18,552 adolescents and young adults (≤ 30 years) in the Norwegian HUNT Study. Survey data was linked to national registry data on sick leave, disability benefits, family relations and educational attainment. We used Cox regression to estimate hazard ratio (HR) with 95% confidence interval (CI) for long-term (≥ 31 days) sick leave due to a musculoskeletal disorder in offspring associated with parental factors and the joint effect of parental factors and offspring lifestyle factors. Results: Parental chronic pain (HR 1.36, 95% CI 1.27–1.45), disability benefits (HR 1.41, 95% CI 1.33–1.48) and low educational attainment (HR 1.78, 95% CI 1.67–1.90) increased the risk of long-term sick leave due to musculoskeletal disorders among offspring. There was no strong evidence that sleep and physical activity modified these effects. Conclusion: Chronic pain, disability benefit and low education in parents increased the risk of long-term sick leave due to musculoskeletal disorders among offspring, but these effects were not modified by offspring sleep problems or physical activity level. The findings suggest that efforts beyond individual lifestyle factors might be important as preventive measures. [ABSTRACT FROM AUTHOR]

Background: Denosumab is authorized to treat several diseases, including cancer and bone disorders. Nevertheless, its use in clinical practice has been affected by safety concerns. The work retrospectively investigated adverse events (AEs) of denosumab to better understand toxicities. Methods: The FAERS data base data from Q1 of 2010 to Q3 of 2023 was chosen. The definition of Medical Dictionary for Regulatory Activities (MedDRA) was dependent on preferred terms (PTs) and system organ class (SOCs). Following the removal of duplicate reports, a disproportionality analysis was conducted to identify safety signals through the calculation of reporting odds ratios (ROR). Results: During the reporting period, 130611 denosumab-related cases were identified; 670 pTs with a substantial disproportionality were retained. The connective and musculoskeletal tissue disorders, poisoning, injury, and procedural complications, as well as medical and surgical procedures, were among the important SOCs that satisfied the criteria. Reports at PT levels including off-label use, death, osteonecrosis of the jaw, arthralgia, and pain in extremities were determined. Severe consequences in terms of life-threatening injuries and death accounted for 841 and 19704 cases, respectively of the reported cases. Conclusion: These findings underscore the critical importance of pharmacovigilance and are consistent with established clinical observations. Notably, osteonecrosis of the jaw, arthralgia, pain in extremities, back pain, myalgia, and bone pain were identified as the most prevalent risk signals associated with denosumab. [ABSTRACT FROM AUTHOR]

Background: Acute lumbar sprain (ALS) is common musculoskeletal disorder characterized by severe low back pain and activity limitation, which significantly impacts the patient's work and life. Immediate relief of pain and restoration of mobility in a short period of time are the main needs of patients when they visit the clinic. This study aims to evaluate the immediate efficacy of this combined treatment for ALS within 10 minutes. Methods: This is a single-center, prospective, randomized clinical trial. 128 eligible patients with ALS will be randomly allocated in a 1:1 ratio to either the auricular acupuncture (AA) group or the sham auricular acupuncture (SAA) group. All patients will receive a single 10-minute treatment. The primary outcome will be the change in pain intensity after 10 minutes of treatment. The secondary outcomes include changes in pain intensity at other time points (2, 5 minutes), changes in lumbar range of motion (ROM) at different time points, blinded assessment, treatment effect expectancy scale evaluation, and treatment satisfaction scale evaluation. All participants will be included in the analysis according to the intention-to-treat principle. Discussion: This is the first randomized controlled trial to assess the immediate efficacy of AA combined with active exercise for ALS. The findings of this study are expected to provide a simple and rapid treatment for ALS in clinical. Trial registration: Chinese Clinical Trial Registry ChiCTR2400083740. Registered 30 April 2024. [ABSTRACT FROM AUTHOR]

Introduction and Objectives: La Clínica Latina is a free clinic that strives to meet the healthcare needs of the Spanish-speaking population of Franklin County, Ohio, including metropolitan Columbus. As a student-run free clinic, care is provided each week by volunteer medical students and resident physicians under the administrative leadership of the medical student board and clinical supervision of licensed physicians. Patients served by the clinic have a multitude of chronic health conditions, which are managed by clinic volunteers through the delivery of over 1500 appointments per year. In order to better serve the rapidly growing patient population, this study describes the delivery and results of an assessment aimed at understanding the needs that are being met sufficiently at the clinic and what pitfalls still exist in the clinic's provision of care. Methods: By delivering a survey inquiring about the experiences of patients at La Clínica Latina, clinic workflow can be optimized for the provision of patient-centered care. Results: Insights collected from a convenience sample of 30 patients demonstrate mobile phone use as the primary mode of communication with clinic volunteers, previously under-appreciated musculoskeletal health concerns, longer than desired wait times after check-in, and variable experiences of health literacy by patient gender. Conclusion: By addressing each of these insights in updates to clinic workflow, La Clínica Latina may prove to become an even more useful resource to the region's growing Hispanic population. [ABSTRACT FROM AUTHOR]

Background: Temporomandibular disorders (TMD) may be associated with degenerative disease of temporomandibular joint (TMJ), such as condyle erosion and subchondral cysts. Occlusal splint and cranio-mandibular manual therapy, or combined therapy, is recommended as a conservative treatment to alleviate pain-related signs and symptoms in TMD. This study aimed to assess osseous condylar changes and skeletal changes following occlusal splint and cranio-mandibular manual therapy in TMD using cone beam computed tomography (CBCT). Methods: A retrospective cohort study included 24 patients diagnosed with TMD. Combined therapy was performed until pain-related signs and symptoms disappeared. CBCT scans were performed before and after therapy. Osseous structure of condyles and their subsequent modifications were analyzed on CBCT images: flattening, erosion, and subchondral cyst. Sella-Nasion-A point (SNA), Sella-Nasion-B point (SNB), A point-Nasion-B point (ANB), Sella-Articulare-Gonion (Condylar angle), and anterior and posterior facial height (AFH, PFH) were measured on CBCT-generated lateral cephalograms. A paired t-test, Wilcoxon rank-sum test, McNemar test, and Stuart–Maxwell test were used for the statistical analyses. Results: The treatment period with combined therapy was 7.42 ± 3.27 months, and 21 out of 33 TMJ presenting degenerative disease (63.6%) had significant complete remodeling (p < 0.05). Following therapy, SNB significantly decreased from 75.61 ±3.47° to 74.82 ± 3.41° (p = 0.02), ANB significantly increased from 4.05° (3.35–4.9°) to 4.8° (3.3–6.12°) (p < 0.001), AFH significantly increased from 112.85 mm (109.28–118.72) to 115.3 mm (112.58–118.88) (p < 0.001), PFH/AFH significantly decreased from 64.17 (61.39–66.1) to 63 (59.68–64.51) (p = 0.012), and condylar angle significantly increased from 140.84 ± 8.18° to 144.42 ± 8.87° (p = 0.007). Conclusion: Combined therapy promoted significant condylar remodeling in TMJ degenerative disease, along with skeletal changes (mandibular retrusion and increase in facial height). Therapeutic strategies should consider condylar remodeling in TMD. Skeletal and dental parameters should be evaluated prior to occlusal splint therapy. [ABSTRACT FROM AUTHOR]

A series of conditions can mimic musculoskeletal infections on imaging, complicating their diagnosis and affecting the treatment. Depending on the anatomical location, different conditions can manifest with clinical and imaging findings that mimic infections. Herein we present a wide spectrum of the musculoskeletal disorders of the axial skeleton, long bones, peripheral joints, and soft tissue that may manifest as infectious processes, and we focus on the potential mimics of osteomyelitis, septic arthritis, and infectious spondylodiscitis that are common in clinical practice. We present the typical imaging characteristics of each musculoskeletal infection, followed by mimicking conditions. [ABSTRACT FROM AUTHOR]

Background and Aims: Low back pain is a prevalent condition affecting 60–85% of individuals during their lifetime. Despite various proposed mechanisms, the etiology of low back pain remains unclear. This study aims to evaluate the effectiveness of combining ultrasound-guided infiltrations with early rehabilitation in reducing pain and improving functional limitations in patients with chronic nonspecific low back pain. Methods: A retrospective observational study was conducted, reviewing data from January to April 2024 involving 40 patients with chronic nonspecific low back pain. Each patient received two cycles of ultrasound-guided lidocaine and corticosteroid infiltrations at the level of the posterior lower iliac spine, followed by 10 rehabilitation sessions. Patients were assessed at baseline (T0), after the first treatment cycle (T1), and after the second cycle (T2) using the Oswestry Disability Index, Quebec Back Pain Disability Scale, Roland Disability Questionnaire, and Numeric Rating Scale. Results: Significant improvements were observed across all assessment scales. The ODI scores decreased from 33.5 at baseline to 3.5 after treatment (p < 0.001). Similar reductions were noted in the QBPDS (from 61.5 to 10.3), RDQ (from 18 to 3.4), and NRS (from 7.4 to 1.3). The combination of ultrasound-guided infiltrations and early rehabilitation resulted in a significant reduction in pain and disability, with the most notable improvements occurring after the second treatment cycle. Conclusions: The integration of ultrasound-guided infiltrations with early rehabilitation is highly effective in managing chronic nonspecific low back pain, significantly reducing both pain and functional limitations. [ABSTRACT FROM AUTHOR]

Ultrasound imaging is a vital imaging tool in musculoskeletal medicine, with the number of publications on ultrasound-guided surgery increasing in recent years, especially in minimally invasive procedures of sports, foot and ankle, and hand surgery. However, ultrasound imaging has drawbacks, such as operator dependency and image obscurity. Artificial intelligence (AI) and deep learning (DL), a subset of AI, can address these issues. AI/DL can enhance screening practices for hip dysplasia and osteochondritis dissecans (OCD) of the humeral capitellum, improve diagnostic accuracy for carpal tunnel syndrome (CTS), and provide physicians with better prognostic prediction tools for patients with knee osteoarthritis. Building on these advancements, DL methods, including segmentation, detection, and localization of target tissues and medical instruments, also have the potential to allow physicians and surgeons to perform ultrasound-guided procedures more accurately and efficiently. This review summarizes recent advances in ultrasound-guided procedures for musculoskeletal diseases and provides a comprehensive overview of the utilization of AI/DL in ultrasound for musculoskeletal medicine, particularly focusing on ultrasound-guided surgery. [ABSTRACT FROM AUTHOR]

Depression and multiple musculoskeletal disorders are overrepresented in women compared with men. Given that depression is a modifiable risk factor and improvement of depressive symptoms increases positive outcomes following orthopedic intervention, efforts to improve clinical recognition of depressive symptoms and increased action toward ameliorating depressive symptoms among orthopedic patients are positioned to reduce complications and positively affect patient-reported outcomes. Although psychosocial factors play a role in the manifestation and remittance of depression, it is also well appreciated that primary biochemical changes are capable of causing and perpetuating depression. Unique insight for novel treatments of depression may be facilitated by query of the bidirectional relationship between musculoskeletal health and depression. This Review aims to synthesize the diverse literature on sex, depression, and orthopedics and emphasize the potential for common underlying biological substrates. Given the overrepresentation of depression and musculoskeletal disorders among women, increased emphasis on the biological drivers of the co-occurrence of these disorders is positioned to improve women’s health. [ABSTRACT FROM AUTHOR]

Background: Most of the worldwide population is overweight and suffers from the resulting musculoskeletal comorbidities such as knee osteoarthritis or back pain. Practice guidelines recommend weight loss interventions for individuals suffering from these conditions. This systematic review investigated whether including a weight loss intervention in the musculoskeletal therapy of these individuals was cost-effective compared to administering the musculoskeletal therapy alone. Methods: This study followed the PRISMA guidelines to systematically and independently search six databases and select full health economic evaluations published up to May 2024 from health care or societal perspectives according to predefined eligibility criteria. Cost data were standardised to 2023 Belgium Euros. The methodological quality was assessed using two health economic-specific checklists. Results: The searches produced 5′305 references, of which 8 studies were selected for a total of 1′726 participants. The interventions consisted of different exercise plans and nutritional targets. Six values were in the north-eastern; leading to increased quality-adjusted life year (QALY) and higher costs; and two in the south-eastern quadrant of the cost-utility plane; leading to increased QALYs and lower costs. Two studies observed no differences in QALYs. Incremental cost utility ratios (ICUR) ranged from €13′580.10 to €34′412.40 per additional QALY from a healthcare perspective. From a societal perspective, the ICUR was €30′274.84. The included studies fulfilled 86 percent of the criteria in trial-based economic evaluations and 57 percent in model-based economic evaluations. The most common limitations of the studies were related to appropriate cost measures' specifications, research questions, time horizon choices, and sensitivity analyses. Conclusions: This systematic review showed weak but consistent evidence of cost-effectiveness for adding a weight loss intervention to musculoskeletal therapy for individuals with overweight, from either perspective. Further economic evaluations should evaluate the long-term cost-effectiveness of the intervention. Trial registration: International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY (2022,110,122). [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal changes occur during pregnancy; one-half of pregnant women experienced low back pain and/or pelvic pain during pregnancy. Prescription opioid use for Medicaid enrolled pregnant women has increased dramatically due to severe low back pain/pelvic pain. Objectives: This study aimed to explore the prevalence of low back pain/pelvic pain and related risk factors among a broader population. Design: This is a retrospective cohort study. Methods: This study utilized de-identified Medicaid claims data provided by the South Carolina Revenue and Fiscal Affairs Office, including individuals who gave birth between 2016 and 2021 during pregnancy. Low back pain/pelvic pain and a group of musculoskeletal risk factors were identified with International Classification of Diseases v10. Comparisons were made for the prevalence of low back pain and pelvic pain between those with pregnancy-related musculoskeletal risk and those without. Results: Among 167,396 pregnancies, 65.6% were affected by musculoskeletal risk factors. The overall prevalence of low back pain was 15.6%, and of pregnancy-related pelvic pain was 25.2%. The overall prevalence for either low back pain or pelvic pain was 33.3% (increased from 29.5% in 2016 to 35.3% in 2021), with 24.6% being pregnancy-induced. Pregnancies with musculoskeletal risk factors were more likely to be diagnosed with low back pain (20.7% versus 5.7%, p < 0.001) or pelvic pain (35.3% versus 6.0%, p < 0.001) than those without. Conclusion: This study found a very high prevalence of musculoskeletal risk and a high prevalence of low back pain or pelvic pain, with an increasing trend, among South Carolina pregnancies enrolled in Medicaid during the period 2016–2021. Most of the diagnosed low back pain or pelvic pain were pregnancy induced. Musculoskeletal risk factors were associated with low back pain or pelvic pain. [ABSTRACT FROM AUTHOR]

Musculoskeletal disorders (MSDs) present a major occupational health challenge, especially among office workers. Objective: To evaluate the effectiveness of a workplace intervention program for managing MSDs and measure its impact on presenteeism/absenteeism and health status. Methods: This semi-experimental study was conducted between May 2019 and October 2022 in Greece and involved 247 office workers randomly assigned to early and late intervention groups. The intervention included a seminar on ergonomics and proper workstation practices with a demonstration of exercises. Data were collected by the SF-36, the Standardised Nordic, and the Work Productivity and Activity Impairment Questionnaires. Results: In the early intervention group (n = 143), presenteeism significantly decreased (p = 0.045), from a mean value of 0.11 to 0.07, but not absenteeism. Significant improvements were observed in physical (p = 0.007) and mental health (p = 0.012). Reductions in pain were recorded for the neck (p = 0.032), shoulders (p = 0.015), wrists (p = 0.014), upper back, lower back, hips, and knees (p = 0.044 for each). In the late intervention group (n=104), there were no significant changes in absenteeism or presenteeism. Mental health improved significantly (p = 0.008), and reductions in pain were noted for the neck (p = 0.001), wrist (p = 0.0005), and upper back (p = 0.001). Conclusions: This workplace intervention program proved effective both in reducing pain in various body areas and reducing presenteeism, and improved physical and mental health were observed in the intervention groups while absenteeism remained unchanged. [ABSTRACT FROM AUTHOR]

Background: The accurate segmentation of spine muscles plays a crucial role in analyzing musculoskeletal disorders and designing effective rehabilitation strategies. Various imaging techniques such as MRI have been utilized to acquire muscle images, but the segmentation process remains complex and challenging due to the inherent complexity and variability of muscle structures. In this systematic review, we investigate and evaluate methods for automatic segmentation of spinal muscles. Methods: Data for this study were obtained from PubMed/MEDLINE databases, employing a search methodology that includes the terms 'Segmentation spine muscle' within the title, abstract, and keywords to ensure a comprehensive and systematic compilation of relevant studies. Systematic reviews were not included in the study. Results: Out of 369 related studies, we focused on 12 specific studies. All studies focused on segmentation of spine muscle use MRI, in this systematic review subjects such as healthy volunteers, back pain patients, ASD patient were included. MRI imaging was performed on devices from several manufacturers, including Siemens, GE. The study included automatic segmentation using AI, segmentation using PDFF, and segmentation using ROI. Conclusion: Despite advancements in spine muscle segmentation techniques, challenges still exist. The accuracy and precision of segmentation algorithms need to be improved to accurately delineate the different muscle structures in the spine. Robustness to variations in image quality, artifacts, and patient-specific characteristics is crucial for reliable segmentation results. Additionally, the availability of annotated datasets for training and validation purposes is essential for the development and evaluation of new segmentation algorithms. Future research should focus on addressing these challenges and developing more robust and accurate spine muscle segmentation techniques to enhance clinical assessment and treatment planning for musculoskeletal disorders. [ABSTRACT FROM AUTHOR]

Musculoskeletal ultrasound has become a practical and accessible diagnostic tool for musculoskeletal diseases. It is used to examine joints, tendons, vessels, and nerves due to its wide availability in rheumatology practice. Ultrasound has also been applied for years in other areas such as muscular injuries in sports activities and rheumatic diseases with inflammation such as myositis. The knowledge among rheumatologists about muscle ultrasound is increasingly growing taking into account it is not the main target of their ultrasound activity but mainly based on the evaluation of joint, synovitis, tenosynovitis, vasculitis in giant cell arteritis, and parotid gland evaluation in Sjögren's syndrome. Thus, the present review describes anatomical and ultrasound findings including all muscles of the thigh (anterior, posterior, medial aspects) and leg (anterior, lateral, posterior superficial, deep posterior compartments) of lower limb structures to ease a comprehensive clinical and sonographic evaluation. [ABSTRACT FROM AUTHOR]

Background: Electroencephalography (EEG) is a promising tool for identifying the physiological biomarkers of fibromyalgia (FM). Evidence suggests differences in power band and density between individuals with FM and healthy controls. EEG changes appear to be associated with pain intensity; however, their relationship with the quality of pain has not been examined. We aimed to investigate whether abnormal EEG in the frontal and central points of the 10–20 EEG system in individuals with FM is associated with pain's sensory-discriminative and affective-motivational dimensions. The association between EEG and the two dimensions of emotional disorders (depression and anxiety) was also investigated. Methods: In this cross-sectional pilot study, pain experience (pain rating index [PRI]) and two dimensions of emotional disorders (depression and anxiety) were assessed using the McGill Pain Questionnaire (PRI-sensory and PRI-affective) and Hospital Anxiety and Depression Scale (HADS), respectively. In quantitative EEG analysis, the relative spectral power of each frequency band (delta, theta, alpha, and beta) was identified in the frontal and central points during rest. Results: A negative correlation was found between the relative spectral power for the delta bands in the frontal (r= -0.656; p = 0.028) and central points (r= -0.624; p = 0.040) and the PRI-affective scores. A positive correlation was found between the alpha bands in the frontal (r = 0.642; p = 0.033) and central points (r = 0.642; p = 0.033) and the PRI-affective scores. A negative correlation between the delta bands in the central points and the anxiety subscale of the HADS (r = -0.648; p = 0.031) was detected. Conclusion: The affective-motivational dimension of pain and mood disorders may be related to abnormal patterns of electrical activity in patients with FM. Trial registration: Retrospectively registered on ClinicalTrials.gov (NCT05962658). [ABSTRACT FROM AUTHOR]

Musculoskeletal Disorders (MSDs) stand as a prominent cause of injuries in modern agriculture. Scientific research has highlighted a causal link between MSDs and awkward working postures. Several methods for the evaluation of working postures, and related risks, have been developed such as the Rapid Upper Limb Assessment (RULA). Nevertheless, these methods are generally applied with manual measurements on pictures or videos. As a consequence, their applicability could be scarce, and their effectiveness could be limited. The use of wearable sensors to collect kinetic data could facilitate the use of these methods for risk assessment. Nevertheless, the existing system may not be usable in the agricultural and vine sectors because of its cost, robustness and versatility to the various anthropometric characteristics of workers. The aim of this study was to develop a technology capable of collecting accurate data about uncomfortable postures and repetitive movements typical of vine workers. Specific objectives of the project were the development of a low-cost, robust, and wearable device, which could measure data about wrist angles and workers' hand positions during possible viticultural operations. Furthermore, the project was meant to test its use to evaluate incongruous postures and repetitive movements of workers' hand positions during pruning operations in vineyard. The developed sensor had 3-axis accelerometers and a gyroscope, and it could monitor the positions of the hand–wrist–forearm musculoskeletal system when moving. When such a sensor was applied to the study of a real case, such as the pruning of a vines, it permitted the evaluation of a simulated sequence of pruning and the quantification of the levels of risk induced by this type of agricultural activity. [ABSTRACT FROM AUTHOR]

• Understanding the costs and benefits of exoskeleton is a major facilitator. • Incompatibility of exoskeletons with other devices can be a major barrier. • Exoskeletons require adjustments to suit the construction industry. • Training and communication plans are essential in exoskeleton implementation. Introduction: Active back-support exoskeletons are gaining more awareness as a solution to the prevalence of work-related musculoskeletal disorders in the construction industry. This study aims to understand the factors that influence the adoption of active back-support exoskeletons in the construction industry. Method: A literature review was conducted to gather relevant adoption factors related to exoskeleton implementation. Building on the TOE (Technology, Organization, and Environment) framework, two rounds of the survey via the Delphi technique were administered with 13 qualified industry professionals to determine the most important adoption factors using the relative importance index. Through semi-structured interviews, the professionals expressed their perspectives on the impact of active back-support exoskeletons on the construction industry. Results: Important factors included 18 facilitators and 21 barriers. The impact of the exoskeletons in the construction industry was categorized into expected benefits, barriers, solutions, adjustment to technology, implementation, and applicable tasks. Conclusions: This study identified the factors to be considered in the adoption and implementation of active back-support exoskeletons in the construction industry from the perspective of stakeholders. The study also elucidates the impact of active exoskeletons on construction organizations and the broader environment. Practical Applications : This study provides useful guidance to construction companies interested in adopting active back-support exoskeletons. Our results will also help manufacturers of active back-support exoskeletons to understand the functional requirements and adjustments required for utilization in the construction industry. Lastly, the study expands the application of the TOE framework to the adoption of active back-support exoskeletons in the construction industry. [ABSTRACT FROM AUTHOR]

Nowadays, the world is struggling with the problems of an aging society. With the increasing share of older people in the population, degenerative joint diseases are a growing problem. The result of progressive degenerative changes in joints is primarily the deterioration of the patients' quality of life and their gradual exclusion from activity and social life. The ability to effectively, non-invasively and quickly detect cases of chondromalacia of the knee joints is a challenge for modern medicine. The possibility of early detection of progressive degenerative changes allows for the appropriate selection of treatment protocols and significantly increases the chances of inhibiting the development of degenerative diseases of the musculoskeletal system. The article presents a non-invasive method for detecting degenerative changes in the knee joints based on recurrence analysis and classification using neural networks. The result of the analyses was a classification accuracy of 91.07% in the case of multilayer perceptron (MPL) neural networks and 80.36% for radial basis function (RBF) networks. [ABSTRACT FROM AUTHOR]

Logistics activities involve significant risk factors for the development of work-related musculoskeletal disorders (WMSD), particularly low back pain. Exoskeletons have emerged as potential solutions to mitigate these risks. This study assesses the short-term effects of dual passive back-support exoskeletons (Auxivo and Htrius) on WMSD risk factors in logistics operations. Two workstations were evaluated using self-report ratings, postural assessment, and surface electromyography (EMG). The results indicate that both exoskeletons provided relief and support during tasks, with Htrius showing a slight advantage. Exoskeletons reduced perceived exertion, especially during trunk flexion tasks, and improved posture, particularly in tasks involving manual lifting loads at lower height levels. While variations in muscular activity were observed, the Htrius exoskeleton showed a trend of reducing lumbar muscle activity. Overall, Htrius demonstrated promise in improving workers' comfort, safety, and efficiency, potentially reducing WMSD risk and muscular fatigue. However, individual preferences and workplace-specific characteristics should be considered when selecting exoskeleton models. Future research should explore the effects on different loads, genders, and EMG of different muscles to further enhance the understanding and application of exoskeletons in occupational contexts. [ABSTRACT FROM AUTHOR]

The aging of the world population is closely associated with an increased prevalence of musculoskeletal disorders, such as osteoporosis, sarcopenia, and osteoarthritis, due to common genetic, endocrine, and mechanical risk factors. These conditions are characterized by degeneration of bone, muscle, and cartilage tissue, resulting in an increased risk of fractures and reduced mobility. Importantly, a crucial role in the pathophysiology of these diseases has been proposed for cellular senescence, a state of irreversible cell cycle arrest induced by factors such as DNA damage, telomere shortening, and mitochondrial dysfunction. In addition, senescent cells secrete pro-inflammatory molecules, called senescence-associated secretory phenotype (SASP), which can alter tissue homeostasis and promote disease progression. Undoubtedly, targeting senescent cells and their secretory profiles could promote the development of integrated strategies, including regular exercise and a balanced diet or the use of senolytics and senomorphs, to improve the quality of life of the aging population. Therefore, our review aimed to highlight the role of cellular senescence in age-related musculoskeletal diseases, summarizing the main underlying mechanisms and potential anti-senescence strategies for the treatment of osteoporosis, sarcopenia, and osteoarthritis. [ABSTRACT FROM AUTHOR]

Work-related musculoskeletal disorders affect a large number of people, diminishing inter alia, their workplace efficiency. For this reason, rehabilitation procedures and equipment are called for, designed to expedite the swift reintegration of patients into daily activity. Within this context, this paper proposes a novel constructive solution of a device that ensures rehabilitation through the transverse passive mobilization of the neck joint. This paper introduces a torsion motor actuated by two pneumatic muscles that ensure sufficient adaptability of the device to, for example, conduct patient exercise within the boundaries of pain supportability. Based on the research results, recommendations are offered for the optimum operation of the rehabilitation equipment. [ABSTRACT FROM AUTHOR]

This study aims to enhance the effectiveness of the preparation process and the performance of wheelchair users in international billiard competitions through modified equipment. The research methods include analysis and synthesis of the scientific and methodological literature, sociological research methods (questionnaires), expert assessment methods, pedagogical research methods (observation, testing, experimentation), and methods of mathematical statistics. The results of our study are significant: Implementing our developed training program for billiards players with musculoskeletal disorders, utilizing the modified equipment (special mechanical bridge and straps for cue fixation during shots) we created in a pedagogical experiment, demonstrated a probable improvement of 36% in the technical and tactical preparedness of the athletes compared to previous years. This led to a 33% increase in players from the Ukrainian team's competition performance at the national and European Pool Championships (wheelchair division). In conclusion, implementing our developed training program, accompanied by specialized auxiliary equipment, demonstrated promising results in a pedagogical experiment. These findings underscore the potential of the modified equipment and tailored training programs to optimize sports training for individuals with musculoskeletal impairments in adaptive billiards, contributing to the continued humanization of the sport and offering an effective preparation process for the athletes. [ABSTRACT FROM AUTHOR]

Unpredictable emergency department (ED) admissions challenge healthcare systems, causing resource allocation inefficiencies. This study analyses associations between air pollutants, meteorological factors, and 2,655,861 cause‐specific ED admissions from 2014 to 2018 across 12 categories. Generalized additive models were used to assess non‐linear associations for each exposure, yielding Incidence Rate Ratios (IRR), while the population attributable fraction (PAF) calculated each exposure's contribution to cause‐specific ED admissions. IRRs revealed increased risks of ED admissions for respiratory infections (IRR: 1.06, 95% CI: 1.01–1.11) and infectious and parasitic diseases (IRR: 1.09, 95% CI: 1.03–1.15) during increased rainfall (13.21–16.97 mm). Wind speeds >12.73 km/hr corresponded to increased risks of ED admissions for respiratory infections (IRR: 1.12, 95% CI: 1.03–1.21) and oral diseases (IRR: 1.58, 95% CI: 1.31–1.91). Higher concentrations of air pollutants were associated with elevated risks of cardiovascular disease (IRR: 1.16, 95% CI: 1.05–1.27 for PM10) and respiratory infection‐related ED admissions (IRR: 2.78, 95% CI: 1.69–4.56 for CO). Wind speeds >12.5 km/hr were predicted to contribute toward 10% of respiratory infection ED admissions, while mean temperatures >28°C corresponded to increases in the PAF up to 5% for genitourinary disorders and digestive diseases. PM10 concentrations >60 μg/m3 were highly attributable toward cardiovascular disease (PAF: 10%), digestive disease (PAF: 15%) and musculoskeletal disease (PAF: 10%) ED admissions. CO concentrations >0.6 ppm were highly attributable to respiratory infections (PAF: 20%) and diabetes mellitus (PAF: 20%) ED admissions. This study underscores protective effects of meteorological variables and deleterious impacts of air pollutant exposures across the ED admission categories considered. Plain Language Summary: The unpredictability and variability of emergency department (ED) admissions load pose significant challenges for healthcare systems, as it can lead to a strain in resources. Understanding risk factors leading to higher ED admission loads provide an opportunity to anticipate surges, identify potential trends, and allocate resources in a pre‐emptive manner, thereby enhancing the responsiveness and preparedness of healthcare systems. Our analyses revealed that: (a) high total daily rainfall was negatively associated with ED admissions (b) mean temperature, while positively associated with ED admissions, typically had delayed effects on ED admissions (c) increased wind speed contributed disproportionately to increased ED admissions due to respiratory infections (d) increased ambient air pollutant concentrations, while positively associated with ED admissions due to most categories, had the greatest impact on the categories belonging to cardiorespiratory system disorders. Key Points: High total daily rainfall was negatively associated with emergency department (ED) admissions, while mean temperature was positively associated with ED admissionsIncreased wind speed contributed disproportionately to increased ED admissions due to respiratory infectionsIncreased ambient air pollutant concentrations had the greatest impact on the categories belonging to the cardiorespiratory system disorders [ABSTRACT FROM AUTHOR]

Prolonged static sitting at the workplace is considered one of the main risks for the development of musculoskeletal disorders (MSDs) and adverse health effects. Factors such as poor posture and extended sitting are perceived to be a reason for conditions such as lumbar discomfort and lower back pain (LBP), even though the scientific explanation of this relationship is still unclear and raises disputes in the scientific community. The current study focused on evaluating the relationship between LBP and prolonged sitting in poor posture using photogrammetric images, postural angle calculation, machine learning models, and questionnaire-based self-reports regarding the occurrence of LBP and similar symptoms among the participants. Machine learning models trained with this data are employed to recognize poor body postures. Two scenarios have been elaborated for modeling purposes: scenario 1, based on natural body posture tagged as correct and incorrect, and scenario 2, based on incorrect body postures, corrected additionally by the rehabilitator. The achieved accuracies of respectively 75.3% and 85% for both scenarios reveal the potential for future research in enhancing awareness and actively managing posture-related issues that elevate the likelihood of developing lower back pain symptoms. [ABSTRACT FROM AUTHOR]

Economic evaluations are used to compare the costs and consequences of healthcare interventions, including those for musculoskeletal (MSK) disorders, which are very common and a major source of morbidity and absence from work. Reimbursement decisions for interventions for MSK disorders by decision-makers rely on the findings of economic evaluations, the design and results of which depend largely on the perspective adopted. Despite methodological advancements in economic evaluations, there are no clear guidelines on the perspective to adopt. This paper explores the adoption of a societal perspective in economic evaluations of MSK disorders. Within health economics evaluations, the most commonly used perspectives include the payer perspective, the healthcare perspective, and the societal perspective. To facilitate optimal resource allocation decisions in order to reduce the significant economic burden of MSK disorders and improve the health outcomes of individuals with these disorders, all costs and benefits associated with interventions for them should be included. Thus, the societal perspective is arguably a preferable option to the others for economic evaluations of interventions for MSK disorders. [ABSTRACT FROM AUTHOR]

Aim: The present research aimed to provide a systematic analysis of the work ability (WA) of nurses assessed through the Work Ability Index (WAI) with a focus on factors influencing WA in the studied population. Design: A systematic literature review. Methods: In January 2024, a literature search was performed using Medline / PubMed and ScienceDirect databases, in order to identify studies focused on assessment of WA with the WAI among nurses. Databases were searched using ‘work ability index’ and ‘nurse’ as key terms. Articles were selected according to PRISMA guidelines. Results: Three hundred twenty-two studies were identified in the initial search (230 studies indexed by Medline / PubMed and 92 by ScienceDirect). After applying inclusion and exclusion criteria, a total of 16 studies were included in the systematic review. The results revealed common factors that affect WA among nurses. These factors are grouped as follows: age, gender, marital status, education, years of work, shift work, and diagnosed diseases. Conclusion: Assessing the WA of nurses with the WAI provides a comprehensive and structured approach to understanding their capacity to meet the demands of their profession while considering various dimensions of health and work-related factors. [ABSTRACT FROM AUTHOR]

Background: Lateral and medial elbow tendinopathies are common soft tissue disorders affecting 1–3% of the general population, causing significant pain and functional impairment in the elbow and upper limb. While often associated with overuse and repetitive strain, their exact etiology, including potential associations with prior injuries in adjacent joints, remains unclear. This preliminary study aims to explore the distribution of lateral and medial elbow tendinopathies and investigate the occurrence of previous lesions in adjacent joints among diagnosed individuals, providing foundational insights for future research. Methods: A multicenter cross-sectional observational study was conducted involving 90 subjects diagnosed with lateral and/or medial elbow tendinopathy. The data collection occurred during the initial consultations, including demographic information, clinical assessments, and history of prior injuries in adjacent joints. Results: Among the sample, 44.4% reported prior injuries to adjacent joints in the affected upper limb, with 45.6% of these injuries identified as musculotendinous in nature. The analysis also showed that the type of elbow tendinopathy was significantly associated with sex (p = 0.01) and occupational origin (p = 0.022). Conclusions: While a notable percentage of the subjects reported prior musculoskeletal injuries in the same limb, the study's geographic limitations and reliance on self-reported data introduce potential recall bias. These preliminary findings suggest a possible relationship between prior adjacent joint injuries and elbow tendinopathy. Further research with larger sample sizes and more rigorous study design is needed to confirm these observations and explore the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Background: Dental instrumentation with hand-held devices is associated with discomfort, fatigue and musculoskeletal diseases or repetitive stress injuries. The goal of this in vivo study was to determine the effect of an ergonomic handle sheath on muscle work, comfort and fatigue associated with (a) piezoelectric scaling by hygienists with and without musculoskeletal disorders (MSDs), and (b) dental cavity preparation by healthy dentists using a dental micromotor. Materials and Methods: Two groups of ten hygienists each tested the piezoelectric scaler. Hygienists in Group 1 had no MSDs, while those in Group 2 had been diagnosed with MSDs. Additionally, ten dentists with no MSDs used a dental micromotor to prepare four standardized cavities. Time-based work in four muscles, comfort and fatigue were recorded in the presence and absence of an add-on soft, insulating handle sheath. Data were analyzed using a repeated measures analysis of variance model with Tukey's post-hoc test. Results: Comfort, fatigue and muscle work were significantly better for both devices when the sheath was used. While hygienists with MSDs used more muscle work to complete the set scaling task, and the sheath-related reduction in work was somewhat greater, these MSD-related differences did not quite reach significance. Conclusions: The results of this pilot study show that the ergonomic performance of an ultrasonic scaler and a dental micromotor may be improved by the use of an ergonomic handle sheath. [ABSTRACT FROM AUTHOR]