(33/1401) Muscle force and range of motion as predictors of function in older adults.
BACKGROUND AND PURPOSE: Musculoskeletal impairments and functional limitations are linked to disability in older adults. The purposes of this study were to identify the extremity musculoskeletal impairments that best predict functional limitations in older adults and to assess the validity of measurements obtained for the Physical Performance Test (PPT) as a predictor of disability. SUBJECTS AND METHODS: Eighty-one older adults residing in independent and dependent care facilities were tested for extremity muscle force, range of motion, and function. Data were analyzed using multiple regression analysis to identify extremity impairments that predicted function scores and logistic regression analysis to determine whether PPT scores predicted subjects' living situation as dependent versus independent. RESULTS: Subject age, lower-extremity muscle force, and lower-extremity range of motion explained 77% of the variance in function as measured by the PPT. Results differed when analysis was done by subject living situation, with a higher percentage of the variance in function scores explained by musculoskeletal measures for the dependent living group as compared with the independent living group. CONCLUSION AND DISCUSSION: Extremity musculoskeletal impairments have a strong relationship to function, especially in older adults living in dependent care settings. The results of this study can be used to design interventions to address the musculoskeletal disorders most related to function in the older population. (+info)
(34/1401) Finnish farmers' self-reported morbidity, work ability, and functional capacity.
The aim of the study was to evaluate Finnish farmers' self-reported morbidity, especially musculoskeletal disease and disabilities, work ability, physical fitness, and functional capacity. A further goal was to identify the group of farmers that most need a means to promote their work ability. The data were collected with a computer-assisted telephone interview. The study population comprised of 577 full-time farmers (296 men and 281 women). The results have been expressed as odds ratios with 95% confidence intervals determined in a logistic regression analysis. The farmers with the greatest need for activities that support and promote work ability are those over 34 years of age, female farmers, farmers with fewer than 10 years of education, farmers from farms with fewer than 20 hectares of cultivated land, farmers who milk cows regularly, and depressed farmers. (+info)
(35/1401) New avenues in research on musculoskeletal disorders.
Recent reviews on musculoskeletal disorders have clearly pointed out the need for more good-quality original research. Both symptom-based and objective outcome assessment methods should be improved. A variety of methods exists to assess exposure for short-term outcomes, whereas exposure assessment strategies for outcomes with long induction times should be developed. The change in exposure patterns--less force demands, more static, visual, cognitive, psychological and social load--will continue during the next millennium, and a likely result is a change in the disease panorama. The pathomechanisms of the effects of low-level static contractions and adverse psychosocial conditions need clarification. Genetic epidemiology is an emerging field of research, and it will be particularly interesting to study the interaction between genetically determined susceptibility and occupational risk factors. Because degeneration of the spine starts in adolescence, the importance of studying the etiology of degenerative disorders among young populations is emphasized. (+info)
(36/1401) Musculoskeletal disorders of the neck and shoulders in female sewing machine operators: prevalence, incidence, and prognosis.
OBJECTIVES: To assess the occurrence and persistence of two restrictively defined neck-shoulder disorders among sewing machine operators. To assess factors associated with the development of neck-shoulder disorder and prognostic factors for remaining a case, when disorders were already present. METHODS: In an initial group of 243 sewing machine operators, 178 were followed up for 2 years. At baseline and at 1 and 2 years follow up the participants underwent a clinical examination of the neck and arms and filled in a questionnaire about current musculoskeletal complaints. Clinical criteria for two main neck-shoulder disorders were defined: rotator cuff tendinitis and myofascial pain syndrome. A baseline control group consisted of 357 women with varied non-repetitive work. RESULTS: At baseline the overall prevalence of myofascial pain syndrome and rotator cuff tendinitis was 15.2% and 5.8% among sewing machine operators compared with 9.0% and 2.2%, respectively, among controls. The presence of the disorders was strongly associated with a self perception of poor general health. Although myofascial pain syndrome showed a U shaped association with years as a sewing machine operator, rotator cuff tendinitis was absent among the newest recruits and present among 15% of the women with more than 20 years as a sewing machine operator. Besides years as a sewing machine operator, the risk of having a neck-shoulder disorder at baseline was significantly associated with high stress (prevalence ratio (PR)=2.54; 95% confidence interval (95% CI) 1.28 to 5.05) when adjusted for age, body mass index, smoking, living alone with children, job strain, and social support from colleagues and supervisors. Only one of 13 participants with rotator cuff tendinitis at baseline recovered during follow up. Myofascial pain syndrome showed a much more fluctuating tendency. Low social support (RR 3.72; 95% CI 1.22 to 11.30) and smoking (RR 3.93; 95% CI 1.33 to 11.58) were associated with the development of neck-shoulder disorders, which was also associated with neck-shoulder pain score and living alone with children. CONCLUSION: Rotator cuff tendinitis showed a higher degree of persistence than myofascial pain syndrome. Both disorders highly influenced the perception of general health. Women who lived alone with children, were smokers, or experienced low support from colleagues and supervisors had a higher risk of contracting a neck-shoulder disorder. (+info)
(37/1401) Submaximal exercise testing: clinical application and interpretation.
Compared with maximal exercise testing, submaximal exercise testing appears to have greater applicability to physical therapists in their role as clinical exercise specialists. This review contrasts maximal and submaximal exercise testing. Two major categories of submaximal tests (ie, predictive and performance tests) and their relative merits are described. Predictive tests are submaximal tests that are used to predict maximal aerobic capacity. Performance tests involve measuring the responses to standardized physical activities that are typically encountered in everyday life. To maximize the validity and reliability of data obtained from submaximal tests, physical therapists are cautioned to apply the tests selectively based on their indications; to adhere to methods, including the requisite number of practice sessions; and to use measurements such as heart rate, blood pressure, exertion, and pain to evaluate test performance and to safely monitor patients. (+info)
(38/1401) Effects of screening for disorders among the elderly: an intervention study in general practice.
BACKGROUND: Preventive assessment of prevalent disorders may be considered as an instrument to maintain independence in the elderly. However, the outcomes of studies on these types of screening differ considerably regarding their effects. OBJECTIVES: The aim of the present study was to assess the effects of GPs' screening of the elderly on four highly prevalent disorders with possibilities for treatment: hearing and visual disorders, urinary incontinence and mobility disorders. METHODS: In an intervention study in 12 general practices, 1121 subjects aged 75 years and over were screened. Randomization was done by practice into an intervention group (576) and a control group (545). In the intervention group, all elderly patients were screened for the four disorders during the first year of the study. When the GP and patient agreed on intervention, usual care was provided by the GP. The patients in the control group were not screened in the first year. In the second year, all patients in both groups were screened for the four disorders. RESULTS: For none of the four disorders was a measurable effect of the screening at the population level found. In the first year, 1013 new disorders were found involving 479 of 576 people. The GPs considered information to be new in 293 cases. In 245 cases (out of 293), the GP discussed the new information with the patient. Of the 89 cases in which the patient agreed with an intervention, improvement was reported in 17 cases. CONCLUSIONS: Implementing a standardized screening programme for four highly prevalent disorders for elderly people is not recommended. Preventive assessment of the elderly should be applied in ways other than by screening. Preventive care should pay attention to the individual needs of the elderly, should be started before the age of 75 years and should be offered in a flexible way. (+info)
(39/1401) Antibiotic bead production.
We are reporting a practical technique for the production of antibiotic beads for use in combating musculoskeletal infections. The technique utilizes bead molds with tobramycin powder mixed with polymethylmethacrylate on twisted wire strands to produce strands of 25 beads of various sizes. These beads are gas sterilized and available for use "off the shelf" in a manner that is much more efficient than traditional production by hand on the back table in the operating room. Our technique was also utilized at a second institution to demonstrate its efficacy at another site. (+info)
(40/1401) Sickness absence and early retirement on health grounds in the construction industry in Ireland.
OBJECTIVE: To establish a detailed pattern of the nature and extent of illnesses and injuries among construction workers in Ireland which cause temporary absence from work, and to identify diseases and disabilities which lead to premature retirement from the industry on health grounds. METHODS: The population base for the study consisted of construction workers who were members of the Construction Federation operatives pension and sick pay scheme. Records of sickness absence since 1981, stored on computer disks, and records of early retirement on health grounds since 1972, stored on microfiche film, were examined. Pertinent data were extracted and transferred to a database; after cleaning and the exclusion of unvalidated data, records of 28 792 absences and 3098 records of early retirement were available for analysis. Data were analysed with Access 97 and Epi Info. RESULTS: Over the period of the study the mean annual absences were 7.8/100 workers. Three quarters of absences were among younger workers; however, the rate of absence increased with age, as did the mean duration of absence. Injury was the most frequent reason for absence, followed by infectious disease, then musculoskeletal disorders. The mean annual rate of early retirement on health grounds was 5.3/1000 workers. The median age at retirement was 58 years. Cardiovascular disease and musculoskeletal disorders each accounted for nearly one third of the conditions leading to permanent disability on the grounds of which early retirement was granted. During the period of the study, over 677 000 working days were lost due to sickness absence, and over 24 000 potential years of working lives were lost due to early retirement on health grounds. CONCLUSIONS: The study has shown patterns of sickness absence and early retirement on health grounds in the Irish construction industry which will contribute to the further development of health promotion strategies for construction workers. (+info)