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Biomedical subjects

Donald S Bloswick

Publications and source records attributed to Donald S Bloswick.

9 recordsLinked to original sources

Effects of prolonged wrist flexion on transmission of sensory information in carpal tunnel syndrome.

UNLABELLED: Carpal tunnel syndrome presents a constellation of symptoms which include discomfort (eg, pain, paraesthesia) and diminished sense of touch. This exploratory study simultaneously measured changes in tactile threshold and discomfort ratings during prolonged wrist flexion in symptomatic patients from a rehabilitation clinic and from a control population. Prolonged (15 min) wrist flexion significantly increased tactile threshold and discomfort ratings above baseline levels in both symptomatic and control populations. Sixty-two percent of the symptomatic sample was found to have abnormal conduction latency. Tactile threshold in symptomatic subjects with normal conduction latency (n = 13) did not differ significantly from control subjects (n = 36) at baseline but showed significant elevation during wrist flexion. In contrast, subjects with abnormal conduction latency (n = 21) exhibited significant elevation relative to control subjects at baseline and throughout wrist flexion as well as a slower recovery after flexion. Conduction latency correlated with baseline (r = .52, P < .0001) and 15-min (r = .67, P < .0001) tactile threshold for the entire subject population, as well as 15-min threshold (r = .53, P = .013) for the subpopulation with abnormal conduction latency. At 2.5 min after flexion, correlation was significant for whole (r = .64, P < .0001) and abnormal conduction latency (r = .58, P = .0063) samples. Regression slope of tactile threshold versus conduction latency was significantly greater than zero and did not differ significantly from linearity. The study demonstrates that increases in mechanosensory threshold and discomfort ratings during prolonged wrist flexion are more profound (and recovery less rapid) in patients with electrophysiologic evidence of injury. PERSPECTIVE: This study demonstrates a provocative procedure that enhances the symptoms of carpal tunnel syndrome. This measure may help clinicians discriminate median nerve compression from other types of peripheral nerve injury and help researchers investigate the impact of mechanical stress, tissue compression, and vascular stasis on compression-related neuropathy.

Adolescent↗

Job level risk assessment using task level strain index scores: a pilot study.

This paper explores 2 methods of modifying the Strain Index (SI) to assess the ergonomic risk of multi-task jobs. Twenty-eight automotive jobs (15 cases and 13 controls) were studied. The first method is based on the maximum task SI score, and the second method is modeled on the NIOSH Composite Lifting Index (CLI) algorithm, named cumulative assessment of risk to the distal upper extremity (CARD). Significant odds ratios of 11 (CI 1.7-69) and 24 (CI 2.4-240) were obtained using the modified maximum task and CARD, respectively. This indicates that modification of the SI may be useful in determining the risk of distal upper extremity injury associated with a multi-task job.

Humans↗

Job level risk assessment using task level ACGIH hand activity level TLV scores: a pilot study.

Existing upper extremity musculoskeletal disorder analytical tools are primarily intended for single or mono-task jobs. However, many jobs contain more than 1 task and some include job rotation. This case/control study investigates methods of modifying an existing tool, the American Conference of Governmental Industrial Hygienists (ACGIH) Hand Activity Level (HAL) Threshold Limit Value (TLV), to assess the upper extremity risk of multi-task jobs. Various methods of combining the task differences and ratios into a job level assessment were explored. Two methods returned significant odds ratios, (p < .05) of 18.0 (95% CI 1.8-172) and 12.0 (95% CI 1.2-120). These results indicate that a modified ACGIH HAL TLV may provide insight into the work-related risk of multi-task jobs. Further research is needed to optimize this process.

Hand↗

High-risk head and neck movements at high G and interventions to reduce associated neck injury.

BACKGROUND: Neck injuries are a significant concern for aviators of high performance aircraft. A recent comprehensive technical report on cervical spinal injury associated with exposure to sustained acceleration, from NATO's Research and Technology Organization, recommended delineating the neck muscles used by aviators in this flying environment and developing improved neck muscle strengthening programs in an attempt to reduce such injuries. METHODS: A review of current literature was conducted in the fields of biomechanics, ergonomics, orthopedics, neurology, neurosurgery, rehabilitative medicine, and aerospace medicine. An objective description is provided of the muscles involved in specific head and neck movements, and those movements that are associated with a greater risk of injury during high-G sorties. The intensity and duration of force exposures common to high performance aircraft sorties, the effects of seat-back angle on these exposures, and the types and mechanisms of neck injury reported in this environment are also described. RESULTS: Primary, secondary, and tertiary preventive interventions are introduced with the goal of providing unit-level flight surgeons an approach to reducing neck injury and promoting prompt, safe return to flying of aviators with identified neck injury. A central component of these interventions is a "specific" and "intensive" neck muscle training regimen, as described in the medical literature. CONCLUSION: Increased axial compressive force and unique biomechanics combine to make neck injury likely in high performance aviators. The application of some proposed intervention strategies may reduce the occurrence of these injuries.

Acceleration↗

Evaluation and quantification of manual materials handling risk factors.

This study investigated the ability of the Revised NIOSH Lifting Equation (RNLE) to measure the risk of low back injury as verified by employee health outcomes. In addition, several basic risk factors and combinations of risk factors presumed related to low back disorders were explored. The RNLE was modified to allow analysis of one-handed and two-handed, asymmetric lifts. Predictive performance was not changed. Simplifying the RNLE by removing several variables did not significantly reduce the RNLE's predictive performance. These modifications to the RNLE show promise for increasing both the usability and utility of the RNLE.

Confidence Intervals↗

An analysis of VDT monitor placement and daily hours of use for female bifocal users.

A population of 72 bifocal wearers was studied to determine the relationship between VDT (video display terminal) placement for those who reported musculoskeletal pain and those who did not. The mean hours worked was 50.4 minutes (p=0.003) greater for those who reported head/neck pain versus those who did not and 48.6 minutes (p=0.004) greater for those who reported shoulder/arm pain that those who did not. There was no statistically significant difference between the means of monitor height, distance, or angle for those who reported pain symptoms versus those who did not. This study indicates that, self reported pain symptoms are correlated with hours of VDT work and that there appears to be a threshold at approximately five hours for pain symptoms among bifocal wearers. No such correlation can be made for monitor placement

Adult↗

An exploratory study of nurse bag use by home visiting nurses.

Although the bag of the home care nurse is functional and historical, there is limited information in the literature about its use and nurses' preferences. This study analyzes how the bag is used, and examines comfort issues and preferences nurses have for this valuable tool. Implications for design and features are gained from this research as well as specific features to seek when choosing this important ergonomic tool.

Community Health Nursing↗

An ergonomic comparison between mechanical and manual patient transfer techniques.

Multiple studies have concluded that manual patient transfer and repositioning techniques are a significant cause of low back injuries. The objective of this study was to compare the low back stresses resulting from the use of two different mechanical patient transfer assist devices with the use of traditional manual transfer techniques. The mechanical transfer systems used were the Barton Patient Transfer System and a Sling-Suspension Lift similar to a "Hoyer Lift". The back compressive forces derived using the Michigan 3D Static Strength Model (Version 4.0) and electromyography (EMG) of the muscles of the low back were compared. This study found that the mechanical assist devices placed less stress on the low back and were more desirable to use than the traditional manual techniques. The Barton System was found to be, in general, less hazardous and more preferred than the Sling Suspension Lift.

Adult↗