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 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Seventy-nine medical secretaries with neck and shoulder pain were included in a study aimed at an in-depth description of the ergonomical work environment and the participant's symptom profile, as well as analysing relationships between ergonomical factors and symptoms. Data were collected by daily ratings, questionnaires, and direct observation. The symptom profile showed low mean daily ratings of perceived fatigue and pain, a low medicine consumption, and few stress symptoms. A mean number of 2.1 undesirable work postures was observed. The correlations between perceived fatigue, pain, and well-being with number of shifts from sitting to standing and time spent typing, were generally small. This study suggests that risk factors for neck and shoulder pain are individual and multifactorial.
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PMID:Neck and shoulder disorders in medical secretaries. Part II. Ergonomical work environment and symptom profile. 196 56

Tendomyopathies (TM) comprise two subgroups. Both are caused by the irritation of nociceptors (IN). Type I results from IN within muscles and tendons with the consequence of local pain, whereas type II refers to TM occurring at a site distant from IN anywhere in the body. Such TM-type II are understood to serve for the protection of the organism from further IN and depend on the regulatoric role of the central nervous system ("reflectoric TM"). Reflectoric shoulder pain emerging from arthritis in carpal joints (Hiemeyer et al.: Z. Rheumatol. 48, 1989, 139-143) is quoted as an example of such "regulatoric pain". Abnormal spinal posture (ASP) is believed to cause IN at various sites of the sceletomotoric system with the consequence of localized or generalized fibromyalgic syndromes (FS) of the type II subgroup. Now clinical signs of TM such as pain during motion, compression or stretching as well as muscular stiffness and fatigue are characteristic for so called primary FS; in addition, the majority of such patients exhibits ASP, especially increased thoracospinal kyphosis (Hiemeyer et al.: Akt. Rheumatol. 14, 1989, 193-201). For these reasons we arrive at the conclusion that ASP is a disposing factor for the development of FS. Therefore FS should not be called primary unless spinal posture has not been examined thoroughly. As a result of this concept we consider control of spinal posture by physiotherapy as an essential part in the causal treatment of FS.
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PMID:[Pathogenesis of tendon-/muscle pain with special reference to posture--a concept related contribution to the understanding of generalized tendomyopathy]. 269 90

Workers engaged in compulsory education and training of severely handicapped children have a high prevalence of neck pain, shoulder pain, low back pain and general fatigue. These complaints are mainly due to heavy physical burden placed on these workers in caring for a large number of handicapped children who are unable to satisfy by themselves daily needs such as excretion, putting on and off their clothes, and eating. To prevent these physical disturbances, it was found effective to reduce the number of assigned handicapped children, to introduce physical exercise especially designed for low back pain prevention, and to provide individual guidance to workers through health examination. Though these measures are expensive, they are considered necessary in preventing disturbances and in executing the government's program of providing compulsory education and training to all handicapped children in the country.
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PMID:[Health problems among workers engaged in the education of handicapped children. Status of daily care and trends in physical complaints]. 294 Mar 92

Shoulder pain correlated to manual labour is an increasing problem. The etiology is multifactorial and often unclear. High local muscle load and muscle ischemia in the supraspinatus muscle is present in elevated arm positions, as shown in several electromyographic studies. The purpose of this study was to evaluate intramuscular pressure (IMP) as a way to describe local muscle load in the supraspinatus muscle. Measurements were made in 15 arm positions, and with hand loads of 0, 1, or 2 kg weight, in 12 shoulders. The IMP was recorded with microcapillary infusion technique. The method was found to be suitable in recording IMP at rest and during exercise. High intramuscular pressures, i.e., above 50 mm Hg (6.7 kPa), were seen in moderate humeral abduction. The IMP increased further in abduction up to 90 degrees, where mean IMP was 122 mm Hg (16.2 kPa). Added hand load increased intramuscular pressure in all positions except in shoulder flexion of 135 degrees. The study thus demonstrated that intramuscular pressure offers important information about the load on the supraspinatus muscle in different positions of the arm. The results indicate that fatigue and shoulder pain related to elevated arm positions may be caused by muscle ischemia induced by the high intramuscular pressure present in these positions.
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PMID:Intramuscular pressure in the supraspinatus muscle. 334 29

The need to investigate shoulder injury in swimmers other than the young and elite is evident, as all ages and levels are represented in the 100 million Americans who classify themselves as swimmers. To investigate the differences between young, highly competitive collegiate swimmers and older, less elite swimmers, a survey questionnaire was distributed to 100 collegiate and 100 master's swim teams. Questions regarding swimming routines, performance standards, and several possible predisposing factors associated with "swimmer's shoulder," as implicated in the literature, were investigated. As expected, the results revealed that the collegiate group swam the higher yardage, with considerably faster times in both the 50- and the 1,000-yd freestyle, and more than double the number of workouts per week. However, the collegiate and master's group reported similar percentages, 47 and 48%, respectively, experiencing shoulder pain lasting 3 weeks or more, despite the lesser distances and intensities associated with the latter group. Chi-square analysis revealed no association between shoulder pain and perceived level of flexibility, hand paddle usage, or breathing side for either group. However, over 50% of the swimmers with shoulder pain in both groups perceived that increased intensities and/or distance provoked shoulder pain, indicating that fatigue may be the issue to avoid and on which to focus. Strengthening the muscles of the shoulder, specifically those shown to have a propensity to fatigue, provides a strong defense against injury, as fatigue of the shoulder muscles may be the initial antecedent to swimmer's shoulder. These results give the swimmer, coach, and medical practitioner feedback to consider for a swimmer of any age or level.
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PMID:Comparison of shoulder injury in collegiate- and master's-level swimmers. 761 80

Microcirculation in the upper portion of the right and left trapezius muscles was measured percutaneously by laser-doppler flowmetry (LDF) during two 10-min-long series of alternating 1-min periods of static contraction and rest determined electromyographically (EMG). Twenty-five patients with pain persisting after a soft-tissue injury of the neck were studied. Pain assessments by using visual analogue scales and drawings showed 13 patients with predominantly unilateral and 12 with bilateral neck-shoulder pain, in some cases with arm pain and numbness. Mean age was 41 (23-58) and 39 (22-54) years and a female/male ratio 8:5 and 10:2, respectively. Stepwise increased contraction was induced by keeping straight arms at 30 degrees, 60 degrees, 90 degrees and 135 degrees of elevation, and repeated with a 1 kg (women) or 2 kg (men) hand loads. Signal processing was done on-line by using a 386SX computer. LDF and EMG values were normalized. Spectral shift of EMG mean power frequency (MPF) for fatigue was analyzed. Muscle blood flow on the "normal" side in the unilateral pain group showed an ordinary increase at increased angle of arm elevation, shoulder torque and EMG amplitude. On the painful side, during increased muscle tension and fatigue, the ability to increase blood flow appeared to be impaired, and there was no consistent increase in either side of the bilateral pain group. EMG amplitude showed a significant positive correlation to the angle of arm elevation and shoulder torque. The rms-EMG (root mean squared EMG) increase was lower in the painful side at high force contraction (non-normalized data).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Chronic pain after soft-tissue injury of the cervical spine: trapezius muscle blood flow and electromyography at static loads and fatigue. 809 May 14

Functional changes were assessed in a group of 279 individuals with long-term spinal cord injuries. All had sustained their initial injuries 20 to 47 years ago and all had received initial and postinjury follow-up care at one of two British spinal cord injury treatment centers. Twenty-two percent reported that the need for physical assistance from others had increased over the years. Most (45%) needed additional help with transfers; others needed more assistance with dressing, mobility, and toileting. When compared to those whose need for help had not increased, significant differences were found by age: as a group, and when separated by level and severity of injury, those needing more help were older, and those with cervical injuries needed help at younger ages than their counterparts with lower level injuries. Those needing more help also had significantly more reports of shoulder pain, fatigue and weakness, weight gain, and postural changes. They used more attendant care, and perceived their quality of life to be lower than those whose level of function had not changed over time.
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PMID:Long-term spinal cord injury: functional changes over time. 821 52

In the overhand or throwing athlete, the shoulder is extremely vulnerable to injury due to the repetitive, high-energy forces. When these stresses are applied at a rate that exceeds that of tissue repair, progressive damage to the shoulder's stabilizing structures can occur. With continued throwing, the static restraints become progressively attenuated, allowing anterior glenohumeral subluxation. Initially, the dynamic stabilizers can compensate for this mild instability with increased muscle activity. Prolonged activity, however, may lead to fatigue. Over time, these compensatory mechanisms can become overloaded. The humeral head then may subluxate anteriorly, where it contacts with the coracoacromial arch, ultimately leading to subacromial impingement. Posterosuperior glenoid impingement may also occur as anterior humeral translation allows the undersurface of the tendinous portions of the supraspinatus and infraspinatus to impinge along the posterosuperior border of the glenoid rim. Fortunately, conservative management is effective in most chronic overuse injuries and includes an initial period of relative rest (avoidance of throwing), oral nonsteroidal antiinflammatory medication, a physical therapy program structured to provide local modalities to reduce inflammation, and a strengthening program for the rotator cuff and scapular rotators. For those athletes with continued symptoms, surgical intervention may become necessary. The appropriate surgical treatment depends on the diagnosis. In the young throwing athlete with shoulder pain, it is essential to recognize that instability or occult subluxation, rather than impingement, is the primary underlying pathology. The anterior capsulolabral reconstruction addresses the problem of instability by correcting the capsular redundancy or labral damage or both. When performed in the manner described, muscle attachments and proprioceptive muscle fibers are not disturbed and full shoulder range of motion can quickly be achieved. This most recent surgical technique and postoperative rehabilitation program has resulted in a significant improvement in the ability to correct instability in those athletes who have failed a prolonged course of conservative care. Prevention of these injuries may be attained, it is hoped, through continued research into the basic biomechanics and the pathoanatomy associated with overhand sports.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:The diagnosis and treatment of anterior instability in the throwing athlete. 850 90

The study examined the relationship between pain development in the shoulder, neck, and facial regions and the EMG activity of underlying muscles, during prolonged exposure to a mental stressor. The subjective perception of tension and fatigue was recorded. Thirty-six subjects were exposed to a two-choice reaction-time test for 1 hour. Electromyographic (EMG) recordings were performed bilaterally over the frontalis, temporalis, splenius, and trapezius muscles. Pain and perceived tension were scored on a visual analog scale, and fatigue on a Borg scale. Pain development was most pronounced in the shoulder and neck region. There was a weak tendency of those reporting pain in the shoulder region to generate higher EMG activity in the trapezius relative to those with no shoulder pain at the end of the test. No such relationship was observed for the other muscles. Perceived tension during the test was weakly related to pain and strongly related to fatigue at the end of the test, but not to EMG level. It is concluded that the mean level of the EMG response is of little consequence for pain development during stressful conditions. It is argued that other physiological responses such as prolonged activity in low-threshold motor units, whereby the surface EMG response can serve as a marker, can be important for shoulder pain originating in the trapezius muscle.
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PMID:Mental stress of long duration: EMG activity, perceived tension, fatigue, and pain development in pain-free subjects. 932 33

The relationship between different degrees of institutionalization in the care of the elderly (service house, home care, and a combination of both) and work-load, as well as staff feelings regarding psychosocial variables and health complaints, was investigated. Seventy-one staff members similar in background factors answered questionnaires semi-annually during a period of 3 years. The results revealed consistent and stable differences between the different settings. The staff in service houses had the highest documented and subjective work-load and were doubly at risk for neck pain, fatigue and nervousness, and with a five-fold risk of shoulder pain, in comparison with the staff in home care, with the mixed group in an intermediary position. The results indicate that work involving mixed tasks might lower the strain of dealing with highly dependent clients in a highly institutionalized environment. Generalizations are limited, because of small sample sizes and descriptive design, but the results were consistent and persisted over a 3-year period.
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PMID:Attitude to work and health problems among home care workers in settings with different degrees of institutionalization. 942 53


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