Future directions of psychophysical studies.
(25/1401)
Psychophysics is a very old branch of psychology that is concerned with the relationship between physical stimuli that occur in the "outside world", and the sensations they produce in the body's "inside world". According to modern psychophysical theory, the strength of a sensation is directly related to the intensity of its physical stimulus by means of a power function. The history and development of psychophysics is briefly reviewed, and the application of psychophysics to manual handling tasks and repetitive hand and wrist motion is described. The advantages and disadvantages of psychophysics are discussed. The following 4 directions for future research are suggested: further validation of the data, expansion into other areas of concern (eg, other body parts, jobs, and postures), broadening of the subject base by including symptomatic subjects, and greater inclusion of psychophysical measures (eg, pain, fatigue, and discomfort) in studies of musculoskeletal disorders. (+info)
Exposure assessment strategies for work-related risk factors for musculoskeletal disorders.
(26/1401)
The design of assessment strategies depends on the risk factors of interest, features of the measurement device, feasibility considerations, and variation at the workplace. The selection of variables should permit specific etiologic inferences. Several researchers have combined different methods into a broad array of exposure measures. Other authors have converted inputs from disparate methods into a common exposure metric, varying from subjective ratings to quantitative measures such as compression forces in the lumbar back. The parameterization of an exposure variable should address the 3 principal exposure dimensions intensity, frequency, and duration. Standardized expressions of variation patterns of exposure have been suggested. An alternative approach is the modeling of exposure variability that allows for exposure assessment at the individual level. A related topic is the critical time window of risk factors for musculoskeletal disorders. This window not only requires detailed information of exposure events over time, but also appropriate characterization of episodic musculoskeletal problems. (+info)
Musculoskeletal diseases--a continuing challenge for epidemiologic research.
(27/1401)
In this paper some quality issues of epidemiologic studies on work-related musculoskeletal diseases are discussed. The advantages and disadvantages of different types of epidemiologic studies are described, among them the rarely applied case-crossover design. Problems in the ascertainment of disease, as well as the assessment of exposure to physical load, are also brought up. The importance of understanding the pathomechanisms of the diseases under study is stressed. (+info)
Pitfalls and delay in the diagnosis of Pancoast tumour presenting in orthopaedic units.
(28/1401)
Pancoast tumours present a difficult and peculiar problem. Their clinical manifestations may be extrapulmonary. The underlying lesion may be missed in patients presenting with predominantly orthopaedic symptoms. We present four consecutive cases, which were referred to our clinic and the diagnosis was made with mean delay of 18.5 months from the beginning of symptoms. (+info)
Evaluation of the acutely limping child.
(29/1401)
A limp may be defined as any asymmetric deviation from a normal gait pattern. The differential diagnosis of a limp includes trauma, infection, neoplasia and inflammatory, congenital, neuromuscular or developmental disorders. Initially, a broad differential diagnosis should be considered to avoid overlooking less common conditions such as diskitis or psoas abscess. In any patient with a complaint of knee or thigh pain, an underlying hip condition should be considered. The patient's age can further narrow the differential diagnosis, because certain disease entities are age-specific. Vigilance is warranted in conditions requiring emergent treatment such as septic hip. The challenge to the family physician is to identify the cause of the limp and determine if further observation or immediate diagnostic work-up is indicated. (+info)
Carpal tunnel syndrome: a nested case-control study of risk factors in women.
(30/1401)
Risk factors for the development of carpal tunnel syndrome in women were studied by means of a nested case-control analysis of a prospective cohort study of the health effects of oral contraception in British women. A total of 1,264 women who had a diagnosis of carpal tunnel syndrome reported by their general practitioner between 1968 and 1993 were compared with 1,264 age-matched control women who did not have this diagnosis. The syndrome was associated in older women with some hormonal factors, notably past use of oral contraception (adjusted odds ratio in women aged 40 years and over = 1.38, 95 percent confidence interval: 1.08, 1.76) and more generally with obesity (adjusted odds ratio = 1.68, 95 percent confidence interval: 1.29, 2.18). However, the strongest link was with a previous history of another musculoskeletal complaint for which consultation had been sought (adjusted odds ratio = 1.98, 95 percent confidence interval: 1.61, 2.42). Previous findings of a higher risk in women with diabetes and myxoedema were confirmed, but these contribute only a small proportion of all cases in women. There was no link with psychologic problems or nonmusculoskeletal pain complaints. The previously described increased incidence of carpal tunnel syndrome in women may be partly due to hormonal factors, but is also related to an underlying propensity to musculoskeletal problems and their higher overall frequency in women. (+info)
A prospective study of primary care patients with musculoskeletal pain: the identification of predictive factors for chronicity.
(31/1401)
Primary care faces the challenge of reducing the proportion of patients continuing with musculoskeletal pain beyond the acute phase. This study assessed patients presenting in general practice with a four- to 12-week history of pain and re-assessed them 12 weeks later. Patients whose pain was described as 'none' or 'slight' were allocated to the 'acute group', and those whose pain continued to be 'moderate' or 'severe' were allocated to the 'chronic group'. Comparative analysis of the two groups' responses at initial assessment identified pain intensity, active coping score, and previous pain episode to be factors independently predictive of chronicity. (+info)
Work-related musculoskeletal disorders in physical therapists: prevalence, severity, risks, and responses.
(32/1401)
BACKGROUND AND PURPOSE: Physical therapists are at risk for work-related musculoskeletal disorders (WMSDs). Little is known of how therapists respond or of what actions they take to prevent injury. The purpose of this study was to investigate the prevalence and severity of WMSDs in physical therapists, contributing risk factors, and their responses to injury. SUBJECTS: As part of a larger study, a systematic sample of 1 in 4 therapists on a state register (n=824) was surveyed. METHODS: An 8-page questionnaire was mailed to each subject. Questions investigated musculoskeletal symptoms, specialty areas, tasks and job-related risk factors, injury prevention strategies, and responses to injury. RESULTS: Lifetime prevalence of WMSDs was 91%, and 1 in 6 physical therapists moved within or left the profession as a result of WMSDs. Younger therapists reported a higher prevalence of WMSDs in most body areas. Use of mobilization and manipulation techniques was related to increased prevalence of thumb symptoms. Risk factors pertaining to workload were related to a higher prevalence of neck and upper-limb symptoms, and postural risk factors were related to a higher prevalence of spinal symptoms. CONCLUSION AND DISCUSSION: Strategies used to reduce work-related injury in industry may also apply to physical therapists. Increased risk of thumb symptoms associated with mobilization techniques suggests that further research is needed to establish recommendations for practice. The issues for therapists who move within or leave the profession are unknown, and further research is needed to better understand their needs and experiences. (+info)