Appraised psychological workload, musculoskeletal symptoms, and the mediating effect of fatigue: a structural equation modeling approach

The aim of the present study was to test two structural models of the relationship between appraised psychological workload and musculoskeletal symptoms from the neck, shoulder, and upper and lower back with different aspects of perceived fatigue as mediating variables. In this cross-sectional study a questionnaire survey was conducted among employees at three Swedish assembly plants (n= 305). The proposed models were tested for one general fatigue dimension--lack of energy--and four specific fatigue dimensions--physical discomfort, physical exertion, lack of motivation, and sleepiness--using structural equation modeling. The results indicate that the role of perceived fatigue in the relationship between appraised workload and musculoskeletal symptoms is different for different aspects of fatigue. The general fatigue dimension, lack of energy, does not mediate the relationship. As regards the specific fatigue dimensions, the relationship is partially mediated by physical discomfort and lack of motivation but not by physical exertion or sleepiness. Appraised psychological workload has a unique effect on musculoskeletal symptoms not mediated by fatigue.     

Effects of back loading on the biomechanics of sit-to-stand motion in healthy children

The goal of the present study was to determine the thus far unstudied effects of back loading on the kinematics and kinetics of sit-to-stand (STS) motion in healthy children. Fifteen children (8 boys, 7 girls, mean age 9.6 years, SD 1.2 years) were tested with no back load and with a back load of 10% and 20% of body weight, respectively. A motion analysis system was used with six infrared cameras and two force plates. Total STS duration did not change; however, differential effects were shown for the durations of its phases. Back loading increased ankle dorsiflexion yielding a greater maximal dorsiflexion angle. Effects on the knee angle were limited except for a significant decrease in final knee flexion. Initial and maximal hip flexion increased but final hip angle did not change. Initial backward pelvic tilt decreased and a shift to forward pelvic tilt occurred at an earlier stage of STS motion. Back loading affected trunk motion: maximal and final forward shoulder tilt increased. Maximal ankle and knee moments and powers increased; however, hip joint kinetics was not affected significantly. Therefore, while maintaining the general pattern of STS motion, participants showed selectively significant adjustments to back loading during its different phases. The main kinematic adjustments were increased trunk flexion and greater ankle dorsiflexion, while the major kinetic adjustment was increased knee extension moment. Increased back loading yielded more pronounced effects, primarily in the ankle. In sum, back loading substantially affected the biomechanics of STS motion even for the lower load level studied. This finding may be of clinical relevance for musculoskeletal disorders, but this needs to be examined.     

Cross-Sectional Survey on Burnout and Musculoskeletal Disorders in Greek and Cypriot Occupational Therapists

Abstract

Background: Occupational therapy is a physically, psychologically and cognitively demanding job. This study aims to explore the epidemiology of musculoskeletal injuries, mental issues, and burnout in occupational therapy practitioners in Greece and Cyprus.

Method: A survey was conducted, including the Patient Health Questionnaire (PHQ-9), the Oldenburg Burnout Inventory, and the Nordic Musculoskeletal Questionnaire.

Results: Out of 247 respondents, 70% reported severe lower back pain, 9.7% of Greek occupational therapists were in the moderate and high PHQ-9 scale, while disengagement and exhaustion were found 2.026 (±0.54) and 2.592 (±0.533) respectively.

Conclusion: High rates of burnout, correlated with psychological and musculoskeletal disorders were identified in both countries. Work-related stress and musculoskeletal disorders may be more evident in countries hit by recession.     

Physician-diagnosed medical disorders in relation to PTSD symptoms in older male military veterans.

The association between physician-diagnosed medical disorders and combat-related posttraumatic stress disorder (PTSD) symptoms was examined in 605 male combat veterans of World War II and the Korean conflict. Physician exams were performed at periodic intervals beginning in the 1960s. PTSD symptoms were assessed in 1990. Cox regression was used to examine the onset of each of 12 disorder categories as a function of PTSD symptoms, controlling for age, smoking, alcohol use, and body weight at study entry. Even with control for these factors, PTSD symptoms were associated with increased onset of arterial, lower gastrointestinal, dermatologic, and musculoskeletal disorders. There was only weak evidence that PTSD mediated the effects of combat exposure on morbidity. Possible mediators of the relationship between combat exposure, PTSD, and physical morbidity are discussed.     

Etude des Facteurs psychosociaux,du burnout,de la Vigueur et des troubles musculosquelettiques chez les soignants hospitaliers

Psychosocial factors, the burnout and the musculoskeletal disorders coexist in health professionals at the hospital. From 176 answers to a questionnary built from Karasek (1990) and Siegrist (1996) theories of psychosocial factors, Shirom (2004) of burnout and vigor and finally Kuorinka (1987) of musculoskeletal disorders, we measure and put in link these different aspects, then we propose a predictive model for burnout and pains.     

RPE responses during arm and leg exercises: effect of variations in spontaneously chosen crank rate

The aim of this study was two-fold. First, the rating of perceived exertion (RPE) was compared between two different upper and lower body exercises. Subjects (n = 12) performed with spontaneously chosen crank or pedal rates: (i) incremental maximum power tests (Test 1), with an initial work rate of 50% of maximal power followed by increases of 10% at each 120-sec. work stage and (ii) tests (Test 2) with exercise bouts set at 20, 40, 60, and 80% of maximal power separated by passive recovery periods. Second, the effects of variations in spontaneously chosen crank rate on RPE was analysed using the second test performed only with upper body. Subjects performed Test 2 three times with crank rates spontaneously chosen by the subjects, set at plus or minus 20% of spontaneously chosen crank rate. During both Tests 1 and 2 for upper or lower body, RPE increased linearly (p<.01) with power output. No significant difference was noticed between upper and lower body tests; however, RPE was significantly different (p<.05) between Test 1 results for upper and lower body at 70, 80, 90, and 100% of maximal power. The greater RPE at high power output could be linked to the important effect of fatigue during upper body exercise. Among the three crank-rate conditions, no significant difference in RPE was noticed. The choice of crank rate does not seem to influence the perception of exertion in upper body cycling exercise.     

Santé et travail : le cas des facteurs de risque des troubles musculo-squelettiques du membre supérieur

The study proposes us to define and to treat the social questions that the musculoskeletal disorders suppose. Indeed, an optimal prevention is articulated around the two poles of musculoskeletal disorders factors of risk, which are the biomechanics and psychosocial factors of risk. The aim of this article is also to create a collective reaction for mobilise every one which are concerned by this subject. The musculoskeletal disorders are one of the first causes of compensation working disease. The factors of risk in their occurred are mainly the repetitivite gesture, the implementation of the muscular force, the extreme articular amplitudes and also, but in a less proportion, the psychological stress felt by a person during his working time. All these elements will be developing in this study.     

儿童支气管异物32例误诊分析

支气管异物系儿科常见病,误诊原因很多,如病史陈述不详细、辅助检查的干扰等,更重要的一个原因就是异物的不典型位置。传统观念中,右下肺异物高发,实际上,受气流及异物体积的影响,轻而小的塑料可被回吸进入左上肺,而较大的异物受自身重力影响多进入右下肺。异物进入体内,引起的·临床表现多种多样,咳嗽、咯血、喘息甚至呼吸困难等,诸类症状在呼吸系统疾病中较为常见,因此这些症状的鉴别就显得尤为重要。在治疗方面,突破传统的支气管镜技术,提倡可以首先采取保守治疗,给予拍背、体位引流等手段,部分患儿可自行咳出异物,这样就避免了手术的风险,在保守治疗无效的情况下可转入外科通过纤维支气管镜取出。     

Autonomic Activity, Pain, and Perceived Health in Patients on Sick Leave Due to Stress-Related Illnesses

OBJECTIVE: The aim of the present study was to compare autonomic activity, pressure-pain thresholds, and subjective assessments of health and behavior between patients with stress-related illnesses and healthy control subjects. METHODS: Twenty sick-listed patients with stress-related illnesses and 20 age- and gender-matched healthy subjects performed tests of autonomic regulation and algometric tests, and completed questionnaires about physical and mental health and behavioral patterns. RESULTS: Patients exhibited higher autonomic reactivity to cognitive and physical laboratory tasks (p < 0.05), and had lower pressure-pain thresholds in the shoulders and lower back than healthy control subjects (p < 0.05). Furthermore, the patients rated considerably poorer health and health behavior than the control subjects (p < 0.05). CONCLUSIONS: The results indicate an engagement of the autonomic nervous system in stress-related illnesses. Furthermore, they show that patients with stress-related illnesses experience symptoms of musculoskeletal pain, and it is therefore recommended that assessments of musculoskeletal pain be incorporated in the clinical examinations and the rehabilitation of patients with stress-related illnesses.     

Functional Status, Receipt of Help, and Perceived Health

We model the effects of disability, functional limitation, and receipt of help on perceived health. This analysis specifies a model with two dimensions of disability and three dimensions of functional limitation, including upper body disability, lower body disability, basic activities of daily living (ADLs), household ADLs, and advanced ADLs. The latent variables of receiving help are modeled for each of the ADLs as intervening between limitations and perceived health. The results show that instrumental social support in the form of receiving help for ADLs has no substantive independent effect on perceived health. In addition, receiving instrumental social support shows a pattern of task-specific responses to individual measures of need. Implications for both caregiver and care recipient are discussed.     

Body image distortions in healthy adults

Distortions of body image have often been investigated in clinical disorders. Much of this literature implicitly assumes healthy adults maintain an accurate body image. We recently developed a novel, implicit, and quantitative measure of body image — the Body Image Task (BIT). Here, we report a large-scale analysis of performance on this task by healthy adults. In both an in-person and an online version of the BIT, participants were presented with an image of a head as an anchoring stimulus on a computer screen, and told to imagine that the head was part of a mirror image of themselves in a standing position. They were then instructed to judge where, relative to the head, each of several parts of their body would be located. The relative positions of each landmark can be used to construct an implicit perceptual map of bodily structure. We could thus measure the internally-stored body image, although we cannot exclude contributions from other representations. Our results show several distortions of body image. First, we found a large and systematic over-estimation of width relative to height. These distortions were similar for both males and females, and did not closely track the idiosyncrasies of individual participant's own bodies. Comparisons of individual body parts showed that participants overestimated the width of their shoulders and the length of their upper arms, relative to their height, while underestimating the lengths of their lower arms and legs. Principal components analysis showed a clear spatial structure to the distortions, suggesting spatial organisation and segmentation of the body image into upper and lower limb components that are bilaterally integrated. These results provide new insight into the body image of healthy adults, and have implications for the study and rehabilitation of clinical populations.     

Tactile perception of nonpainful unpleasantness in relation to perceived roughness: effects of inter-element spacing and speed of relative motion of rigid 2-D raised-dot patterns at two body loci

Rigid surfaces consisting of spatially jittered 2-D raised-dot patterns with different inter-element spacings were moved back and forth across the skin at three different speeds (10-fold range). Within each psychophysical experiment, participants numerically estimated the perceived magnitude of either unpleasantness (nonpainful) or roughness of 2-D raised-dot surfaces applied to two stationary body sites (experiment 1: fingers; experiment 2: forearm). The psychophysical functions for the two types of perceptual judgment were highly similar at both body loci; more specifically, the perceived magnitude of unpleasantness and roughness both increased monotonically as a power function of increasing inter-element spacing, with the rate of growth declining at the upper end of the continuum. These results suggest that inter-element spacing is a critical determinant of the perceived magnitude of unpleasantness (nonpainful), as well as of roughness. Each perceptual judgment also increased as a function of increasing relative speed at both body loci. However, the magnitude of this effect was significantly greater for perceived unpleasantness than for perceived roughness; conversely, the speed effect was significantly greater on the forearm than on the fingers. Several possible explanations for these findings are considered.     

身体动作趋势对道德词空间-效价一致性效应的影响

在经典的空间—效价一致性范式的基础上,控制向上或向下看的动作趋向及幅度大小,探讨身体动作趋势对空间—效价一致性效应的影响。实验一分别在屏幕上方视野或下方视野进行词汇道德效价的判断。结果表明,在屏幕的上方视野和屏幕的下方视野不道德词汇都出现了空间—效价一致性效应,而道德词汇只在下方视野出现了一致性效应。实验二将注视点居于屏幕中央,改变词汇上下位置之间垂直距离的大小。发现在小间距条件下出现了显著的一致性效应,但是在大间距条件下一致性效应消失。综合两个实验表明,道德词的空间—效价一致性效应同时受到概念隐喻和极性相关的影响,当空间极性不明显时,概念隐喻的影响较大,而空间位置极性较明显时,空间位置极性会掩盖概念隐喻的作用。     

Troubles musculosquelettiques,pratique instrumentale et ressentis des musiciens d’orchestre professionnels en confinement dû à la COVID-19

IntroductionProfessional orchestra musicians frequently suffer from musculoskeletal disorders related to their working conditions. In the spring of 2020, the lockdown and the interruption of their professional activities because of the COVID-19 pandemic could have presented an opportunity for them to recuperate but could also have increased their professional uncertainty and been a source of negative emotions.ObjectiveThe first objective is to evaluate the evolution of musicians’ musculoskeletal disorders in relation to the interruption of their professional activities due to COVID-19. The second is to examine the impact of professional uncertainty caused by the pandemic on their instrument practice as a function of the emotions it generated.MethodA questionnaire concerning instrument practice and musculoskeletal disorders was completed by 439 French orchestra musicians in 2019 (period of professional activity). During lockdown (April 2020), a second questionnaire measuring these variables as well as professional uncertainty, emotions, emotional exhaustion, and the lockdown experience was completed by 172 musicians.ResultsInstrument practice and musculoskeletal disorders decreased between the periods of activity and lockdown. Professional uncertainty during lockdown correlated with negative emotions. Emotional exhaustion mediated the relations between uncertainty and the effort perceived when practicing one's instrument on the one hand and the pleasure experienced during practice on the other.ConclusionFor orchestra musicians in lockdown, uncertainty was related to negative emotions. Playing their instrument required more effort and was not associated with well-being, emphasizing the difficulties regarding the resumption of their professional activity in conditions which would limit the risk of injury.     

Autonomic activity, pain, and perceived health in patients on sick leave due to stress-related illnesses

Objective: The aim of the present study was to compare autonomic activity, pressure-pain thresholds, and subjective assessments of health and behavior between patients with stress-related illnesses and healthy control subjects.Methods: Twenty sick-listed patients with stress-related illnesses and 20 age- and gender-matched healthy subjects performed tests of autonomic regulation and algometric tests, and completed questionnaires about physical and mental health and behavioral patterns.Results: Patients exhibited higher autonomic reactivity to cognitive and physical laboratory tasks (p<0.05), and had lower pressure-pain thresholds in the shoulders and lower back than healthy control subjects (p<0.05). Furthermore, the patients rated considerably poorer health and health behavior than the control subjects (p<0.05).Conclusions: The results indicate an engagement of the autonomic nervous system in stress-related illnesses. Furthermore, they show that patients with stress-related illnesses experience symptoms of musculoskeletal pain, and it is therefore recommended that assessments of musculoskeletal pain be incorporated in the clinical examinations and the rehabilitation of patients with stress-related illnesses.     

Spirituality of Chronic Orofacial Pain Patients: Case–Control Study

The objective of this study was to investigate spirituality and blood parameters associated with stress in patients with facial musculoskeletal pain. Twenty-four women with chronic facial musculoskeletal pain (CFMP) and 24 healthy women were evaluated with a protocol for orofacial characteristics, research diagnostic criteria for temporomandibular disorders and the Spiritual Perspective Scale. Blood samples were collected to analyze blood count, cortisol, ACTH, C3, C4, thyroid hormones, total immunoglobulin, C-reactive protein and rheumatoid factor. The study group was more spiritualized than control group. Individuals with a high score of spirituality had less myofascial pain, less bruxism and fewer complaints. They also had lower levels of ACTH and IgE. Spirituality was higher in the study group and can be considered an important tool for coping with CFMP.     

Explicative models of musculoskeletal disorders (MSD): From biomechanical and psychosocial factors to clinical analysis of ergonomics

Following the apparition of new working schemes and work organization in companies, a so-called “reactive productivism” was set up at the worker level. This is characterized by an increased workload, flexibility efforts and productivity requirements, which show noticeable impacts on the worker’s health in their own professional environment. Among these consequences are musculoskeletal disorders (MSD) which have become the most current form of professional disease in France. Such troubles and disorders, in relation to working conditions, are complex mechanisms, often expressed by chronic pain and associated with functional troubles and even disability. The majority of researchers are currently in agreement in affirming the multidimensional aspect of these disorders in biomechanical and psychological terms. The purpose of this paper is to list and review the main risk factors leading to such consequences. These epidemiological and psychological factors will be related to francophone clinical and ergonomic concepts and positions. This perspective is oriented more towards the “meaning of activity” with a clinical and a psychodynamic approach. In our conclusion, we present a predictive model on musculoskeletal pain in relation to maneuver margins, workload and work recognition.     

The influence of proximal motor strategies on pianists' upper-limb movement variability

Repetitive movements are considered a risk factor for developing practice-related musculoskeletal disorders. Intra-participant kinematic variability might help musicians reduce the risk of injury during repetitive tasks. No research has studied the effects of proximal motion (i.e., trunk and shoulder movement) on upper-limb movement variability in pianists. The first objective was to determine the effect of proximal movement strategies and performance tempo on both intra-participant joint angle variability of upper-limb joints and endpoint variability. The second objective was to compare joint angle variability between pianist's upper-limb joints. As secondary objectives, we assessed the relationship between intra-participant joint angle variability and task range of motion (ROM) and documented inter-participant joint angle variability. The upper body kinematics of 9 expert pianists were recorded using an optoelectronic system. Participants continuously performed two right-hand chords (lateral leap motions) while changing movements based on trunk motion (with and without) and shoulder motion (counter-clockwise, back-and-forth, and clockwise) at two tempi (slow and fast). Trunk and shoulder movement strategies collectively influenced variability at the shoulder, elbow and, to a lesser extent, the wrist. Slow tempi led to greater variability at wrist and elbow flexion/extension compared to fast tempi. Endpoint variability was influenced only along the anteroposterior axis. When the trunk was static, the shoulder had the lowest joint angle variability. When trunk motion was used, elbow and shoulder variability increased, and became comparable to wrist variability. ROM was correlated with intra-participant joint angle variability, suggesting that increased task ROM might result in increased movement variability during practice. Inter-participant variability was approximately six times greater than intra-participant variability. Pianists should consider incorporating trunk motion and a variety of shoulder movements as performance strategies while performing leap motions at the piano, as they might reduce exposure to risks of injury.     

Development of upper visual field bias for faces in infants

The spatial location of the face and body seen in daily life influences human perception and recognition. This contextual effect of spatial locations suggests that daily experience affects how humans visually process the face and body. However, it remains unclear whether this effect is caused by experience, or innate neural pathways. To address this issue, we examined the development of visual field asymmetry for face processing, in which faces in the upper visual field were processed preferentially compared to the lower visual field. We found that a developmental change occurred between 6 and 7 months. Older infants aged 7–8 months showed bias toward faces in the upper visual field, similar to adults, but younger infants of 5–6 months showed no such visual field bias. Furthermore, older infants preferentially memorized faces in the upper visual field, rather than in the lower visual field. These results suggest that visual field asymmetry is acquired through development, and might be caused by the learning of spatial location in daily experience.