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Results for “Cumulative Trauma Disorders”

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At least 235 records · Page 13Linked to original sources

PubMed2000

Finger motion, wrist motion and tendon travel as a function of keyboard angles.

OBJECTIVE: This study assessed the impact of keyboard angles (in terms of Pitch, Roll and Yaw) on tendon travel and wrist and finger joint kinematics for the flexor digitorum profundus and flexor digitorum superficialis.DESIGN. A repeated measures, laboratory study was conducted. Independent variables were three Pitch angles, three Roll angles, three Yaw angles, and three keyboard separation distances. Dependent variables were tendon travel, wrist deviation, wrist and finger joint kinematics, and Borg comfort rating. BACKGROUND: The increased usage of computers and the risk of cumulative trauma disorders have led to the development of alternate keyboards. This study is a biomechanical assessment of several keyboard designs.METHODS. Lightweight wrist and finger goniometers were used to measure motion of the wrist in three planes, and for three finger joints. Fifteen experienced typists (eight women, seven men) typed a standard text on 30 keyboard conditions. Regression equations were used to calculate tendon travel from joint positions. RESULTS: Tendon travel is sensitive to changes in Pitch, Roll and Yaw angles with approximately 13% difference between the minimal and maximal tendon travel. A flat keyboard produced more tendon travel than keyboards with greater Pitch and Roll angles.CONCLUSIONS. There is a trade-off between wrist and finger positions; as the wrist extends more, the finger joints flex more to compensate. Keyboards imposed different trade-offs between the wrist and finger positions, affecting the overall tendon travel. Relevance Alternate keyboard designs can significantly affect tendon travel and may address reduced repetitiveness in typing by reducing the amount of tendon travel.

Adult↗

PubMed1987

Tool design for prevention of hand and wrist injuries.

Incorrect hand tool designs can cause a variety of cumulative trauma disorders. Design elements of size, shape, texture, purpose, ease of operation, shock absorption, and weight must be properly applied in the design process to fulfill the physical safety needs of consumers and working people and to prevent the appearance of pathologic changes in the tissues of the hand and wrist.

Accidents, Occupational↗

PubMed2000

Tendon tissue sampling.

Mechanical load is regarded as the most important etiologic factor in cumulative trauma disorders affecting human tendons. At present there is limited knowledge concerning adaptation and the influence of training on human tendon tissue and the time process of developing a chronic tendon disorder. Tendon tissue samples and data concerning tendon pathology and repair have been derived from biopsies removed during surgery for rupture or pain conditions and from autopsy material. The ultrasound-guided percutaneous core biopsy technique provides the possibility to obtain tendon tissue from human Achilles and patellar tendon with limited discomfort for the individual. The specimens can be used for diagnostic purposes or for research and have the potential to highlight novel knowledge in, for example, the early stages of painful human tendon disorders. The fact that the procedure is invasive is a limitation. Autopsy material has limitations regarding poor information on case history, post mortem alterations and legal regulations on the use of tissue for medical purposes. The inflammatory process quickly affects ruptured tendons. The subcutaneous tendons that sustain a rupture are commonly characterized by degenerative alterations. Many tendon ruptures are treated with surgery, facilitating easy access to biopsy material. In summary, tendon tissue sampling in humans has obvious limitations. The recently described use of the core biopsy technique in human tendon research and diagnosis gives potential for new knowledge concerning human tendon adaptation, repair and disease.

Achilles Tendon↗

PubMed2002

An evaluation of the cumulative concussive effect of soccer heading in the youth population.

Soccer is the most popular team sport in the world, with 120 million individuals participating and 16 million of these individuals being based in the United States. In addition, soccer has become the fastest growing team sport in the United States over the past 10 years. Head impact injuries have been cited as comprising 15% of all injuries related to soccer. Previous studies have identified the technique of heading as being a significant factor in head impact injuries. In fact, 85% of various subgroups of participants, 19 years of age and older, have had a diminution in cognitive function abilities on a permanent basis. It was the purpose of this study to evaluate the effect of repetitive head impacts due to heading in 57 youth soccer players with a mean age of 11.5 years. The data were collected over three seasons during the first year, which correlated to approximately 60 games and/or practices. One team of 18 boys was followed for an additional year. The data collected included a cognitive function test, as well as documentation of concussive symptoms. These cognitive evaluations, conducted at both periods of time, revealed that statistically significant differences were not evident when compared to standardized norms with the exception of verbal learning. There was an inverse relationship between the number of ball impacts and verbal learning. Of note, however, is that 49% of the year-one study group did complain of headaches after heading the ball.

Adolescent↗

PubMed1994

A quantitative evaluation of gloves used with non-powered hand tools in routine maintenance tasks.

Non-powered hand tools are a major means of carrying out routine maintenance and repair activities. The use of gloves in such situations is essential in order to protect the hands from potential injuries. Together, the gloves and hand tools accomplish the task by transmitting the muscle force on to the workpiece. Several studies have reported that the capability of hands to exert force/torque is severely influenced by the use of gloves. The use of gloves could also lead to a cumulative trauma disorder, rapid onset of muscular fatigue, etc. Most previous studies have focused on determining the influence of gloves on grip strength or push/pull forces one would exert while using devices such as knives. The purpose of this study was to determine the influence of a variety of commercially available gloves on the force/torque exertion capability of workers with wrenches and screwdrivers that are commonly used in performing routine maintenance and repairs. Nineteen males participated in the study and, using seven different hand tools and nine varieties of commercial gloves, exerted peak volitional torques on a simulated workpiece. The peak torque and electromyogram of flexor and extensor muscles were recorded. The results indicated that muscle activity did not differ significantly between the glove and no-glove conditions and the peak torque exertion capability of individuals generally increased with gloves. The magnitude of torque exerted on the workpiece was different for different gloves. The results also contradict some of the previously reported findings.

Adult↗

PubMed1998

Predictive models of carpal tunnel syndrome causation among VDT operators.

Carpal tunnel syndrome (CTS), a cumulative trauma disorder of the hand and wrist, is one of the most common disabling injuries experienced by video-display terminal (VDT) operators. The purpose of this study was to develop a theoretically based operational quantitative predictive model of the risk of work-related CTS among VDT operators. A total of 100 female VDT operators, who performed a variety of office functions, were studied at a major midwestern university. Data were collected on job exposure, anthropometry and posture factors using questionnaires, direct observation and video-recording. Discriminant analysis and logistic regression were performed to develop the operational models. The results of the study indicated the following: (1) percentage of workday working with a VDT was the most significant factor and accounted for 60% of the variance explaining the causation of musculoskeletal discomforts associated with CTS; (2) discriminant function with six variables (i.e. work duration, trunk incline, wrist extension, wrist ulnar deviation, overall anthropometric measure, weighted anthropometric measure) correctly classified 73% of the CTS group and 72% of the non-CTS group; (3) using the logistic regression model, the probabilities associated with changes in the predictive variables as affecting CTS risk are presented such that increasing the daily work duration from 1 h to 4 h increases the probability of CTS risk from 0.45 to 0.92. The results of the study suggest that the main causation of CTS is job design, the secondary (and lesser cause) is posture associated with the workplace design and the least contributing factor to CTS causation is the individual's anthropometric make-up.

Analysis of Variance↗

PubMedDate not supplied

Range of motion of the wrist: implications for designing computer input devices for the elderly.

PURPOSE: The purpose of this study was to report normative values of the amplitude of joint wrist motions and grip strength for older age groups. METHOD: Volunteers. (N = 147) were divided into four age groups, 60-69, 70-79, 80-89 and 90+ years, with a total of 62 men and 85 women. Maximum range motion values were obtained for wrist flexion, extension and ulnar deviation. In addition, grip strength measures were obtained for each participant. RESULTS: In general, the strength and ROM values for the oldest participants in this study were lower than those of the younger age group (age 60 to 69) and significantly lower than those published for subjects between 25 and 54 years of age. Furthermore, across all age groups males were significantly stronger than females. However, females tended to have greater ROM than males, particularly for wrist extension and ulnar deviations. Joint ROM and grip strength declined significantly with age for both males and females. Comparisons with published data for younger subjects (age 25-35) indicate that a 60-69 year old male, will on average experience a decline in wrist flexion, extension and ulnar deviation of 12%, 41%, and 22% respectively. By age 90, an individual may be expected to have ROM values that are only approximately 60% of an average 30 year old individual. CONCLUSION: The results suggest that the ageing population (particularly men) may face greater difficulty using an input device such as a mouse that relies on motions of the wrist. In addition, the reduced ROM of the wrist may put the elderly at greater risk of developing cumulative trauma disorders. The implications of these findings for the design of input devices are discussed.

Adult↗

PubMed1996

Dental Workers, Musculoskeletal CumulativeTrauma, and Carpal Tunnel Syndrome: Who is at Risk? A Pilot Study.

A pilot study was conducted at a dental clinic to identify (a) the prevalence of musculoskeletal cumulative trauma disorders (MCTD), (b) associated symptoms (with special attention paid to carpal tunnel syndrome [CTS]), and (c) practitioners at risk. Videotapes, two questionnaires, a medical record review, and interviews were used. Forty-five dental workers participated and were classified into three categories: (a) dentists, (b) dental assistants and special assistants (DA/SA), and (c) dental hygienists and dental assistant-expanded function (DH/DAEF). Categorical data were analyzed using the chi- square statistic and risk ratios. The Fisher exact probability test was used for categorical data with a small cell. One or more symptoms associated with CTS were noted by 75.6% of the dental workers, 11% reported diagnosed CTS, and 53% reported back and shoulder pain. Both psychosocial factors and job demands appear to be associated with MCTD. All three categories of dental workers reported MCTD symptoms, and the DH/DAEF group was found to be at greatest risk for developing upper extremity symptoms, CTS, and back pain.

dental hygiene↗

PubMed1985

Assessment of hand vibration exposure on an assembly line.

This paper describes a study undertaken to evaluate and control vibration exposure associated with pneumatic screwdrivers used in an electrical appliance assembly plant. The study was motivated by management's concern about reports of cumulative trauma disorders in the upper extremities of workers who used pneumatic screwdrivers. Vibration exposure from power hand tools on an assembly line is difficult to predict due to highly variable conditions and techniques used between operators. Vibration exposure was measured using observation samples of tool vibration obtained on the assembly line for individual assembly tasks. Typical tool one-third octave band acceleration spectra estimated from laboratory measurements were used in conjunction with the measured exposure times to compare workers' risk of exposure to the hazards associated with operating vibrating hand tools. Characteristic vibration produced by the tools during phases of operation were separated and analyzed individually to identify and control the source.

Hand↗

PubMed2001

Application of demand-control theory to sign language interpreting: implications for stress and interpreter training.

The translation work of sign language interpreters involves much more than language. The characteristics and goings-on in the physical environment, the dynamics and interactions between the people who are present, and even the "inner noise" of the interpreter contribute to the accuracy, or lack thereof, of the resulting translation. The competent interpreter must understand and respond appropriately to the language and nonlanguage aspects of each interpreting assignment. We use the framework of demand-control theory (Karasek, 1979) to examine the complex occupation of sign language interpreting. Demand-control theory is a job analysis method useful in studies of occupational stress and reduction of stress-related illness, injury, and burnout. We describe sources of demand in the interpreting profession, including demands that arise from factors other than those associated with languages (linguistic demands). These include environmental, interpersonal, and intrapersonal demands. Karasek's concept of control, or decision latitude, is also explored in relation to the interpreting profession. We discuss the prevalence of cumulative trauma disorders (CTD), turnover, and burnout in the interpreting profession in light of demand-control theory and data from interpreter surveys, including a new survey study described herein. We conclude that nonlinguistic demand factors in particular and perceived restrictions in decision latitude likely contribute to stress, CTD, burnout, and the resulting shortage of sign language interpreters. We make suggestions for improvements in interpreter education and professional development, including the institution of an advanced, supervised professional training period, modeled after internships common in other high demand professional occupations.

Journal Article↗

PubMed2002

Health physics technician injury reduction.

As part of a safety summit sponsored by Fluor Hanford Occupational Health and Safety, it was noted that Health Physics Technicians (HPTs) have one of the highest injury rates at Hanford. A multi-disciplined team made up of HPTs, health physics professionals, health physics management, indostrial hygienists, and medical personnel was established to determine causes and corrective actions. Committee activities included reviewing and characterizing occupational injuries and illnesses, assessing areas affecting the health of HPTs, soliciting field input, performing field evaluations of tasks, and making recommendations for improvements to senior management. Five areas showed a need for immediate improvement: manmachine interface (human factors and ergonomics), work environment, procedures, people, and communications. A key area of risk identified is the lack of ergonomic design considerations of the survey instruments currently used. There are several cases of cumulative trauma disorder requiring surgery. These cases are directly related to use of health physics instrumentation and/or survey techniques. The committee has made ergonomics and instrument redesign/modification its key initiative for 2001. The committee is encouraging vendor support and is seeking feedback from other health physics organizations regarding their experience and any recommendations they would like to make. Some success has already been achieved through an ergonomics-training program aimed at all HPTs and their supervisors. In addition, there have been several changes made to the way surveys are conducted, survey frequencies have been reduced, and the way modifications have been made to existing instrumentation. This is a long-term initiative with broad support within the Hanford HPT community. This document reports the progress made thus far on the initiative.

Health Physics↗

PubMed1997

Computer keyboard force and upper extremity symptoms.

This case-control study assessed whether office workers who report more severe levels of musculoskeletal symptoms of the upper extremities demonstrate higher levels of keyforce in comparison to controls with less severe symptoms. Office workers reporting working on computer keyboards for four hours per day were classified as cases or controls based upon a median split on a Composite Symptom Severity score (cases = 23, controls = 25). Keyboard force and keying rate were measured during a 15-minute keyboarding task. Measures of task-related discomfort, muscular fatigue, pain, upper extremity symptoms, psychological distress and force were collected at baseline, post-keyboard task, and recovery. Ratings of perceived effort and task credibility were also obtained. Measures of work demands, perceived job stress, and upper extremity strength and flexibility were also collected. The results indicated group equivalence on reported work demands and upper extremity strength. Cases were more likely to receive a medical diagnosis of upper extremity cumulative trauma disorder, awaken from sleep due to symptoms, report higher levels of pain during work, experience greater impact of pain on function, and report higher workload pressure and lower support. Cases generated significantly higher keyboarding forces than controls, although both groups produced forces well above that required to operate the keyboard (4-5 times activation force). Cases reported higher levels of upper extremity symptoms and discomfort than controls, and these measures were highest after the keyboarding task for both groups. No significant correlation between keyforce and key rate was observed in either group. Results suggest that generation of excessive force while working on a computer keyboard may contribute to the severity of upper extremity symptoms. Clinically, the findings suggest that evaluating how an individual worker performs keyboarding tasks, or his or her workstyle, may be helpful in the management of these symptoms and disorders.

Adult↗

PubMed1998

Surveillance of occupational diseases in the United States. A survey of activities and determinants of success.

Managers of state-based occupational disease surveillance programs were interviewed for information on their program's characteristics and factors that contributed to their success. There were 68 programs in 52 jurisdictions (50 states, the District of Columbia and New York City). Reportable conditions ranged from a specific disease to "all occupational diseases". Of these programs, 56% met at least one of their objectives. Conditions associated with successful programs usually had short latency periods, were easily diagnosed, and were related to a workplace hazard. They included agricultural injuries, burns, respiratory diseases, cumulative trauma disorders, and poisonings due to lead, pesticides, or carbon monoxide. Successful programs had larger budgets and more staff than did unsuccessful programs, and also took actions after notification of a condition.

Chi-Square Distribution↗

PubMed1994

Nerve Entrapment Syndromes in the Wrist.

The patient with compression neuropathies of the median and ulnar nerves at the wrist commonly presents with pain, paresthesias, and weakness in the hand and digits. Diagnosis of these conditions is becoming more widespread with the increased attention given to "cumulative trauma disorders" during the past decade. Successful management requires a thorough understanding of the pathophysiology of compression neuropathy and how it relates to the various diagnostic tests available today. The authors review the epidemiology, etiology, and evaluation of compression neuropathy and discuss common clinical presentations, treatment recommendations, and controversies surrounding carpal and ulnar tunnel syndromes.

Journal Article↗

PubMed1999

Evaluation of the impingement of the pronator muscle in occupational carpal tunnel syndrome by electromyographic and ultrasonographic techniques.

Normal flexion of the fingers involves an involuntary contraction of the pronator and lumbrical muscle. In individuals whose profession involves constant flexing of the fingers those muscles become hypertrophied, impinging on the carpal tunnel. The narrowing of the carpal tunnel yields well to ultrasonography. The objective of this investigation was to find an ultrasonographic index of occupational carpal tunnel syndrome. Thus "Index M" denotes the variation obtained in the "M Space" before and after flexion-extension of the fingers. The study included 45 subjects performing tasks which involved the risk of cumulative trauma disorders. The subjects were tested using the electromyography and ultrasonography. The method was based on relation between the decrease in conduction of the median nerve measured by electromyography and the ultrasonographically measured variation of "M Space" in terms of sensitivity and specificity. The sensitivity of ultrasonography was 85%, as it confirmed the pathologic findings determined by electromyography ("M Index" positive) in twenty-two out of 26 hands, but the specificity was not statistically significant. Ultrasonography seems to have found very important application as a screening technique in occupational medicine. It is non-invasive, sensitive, easily repeated, and costs little.

Adult↗

PubMed2001

Disability issues with carpal tunnel syndrome. A case discussion.

This article reviews nerve entrapments and cumulative trauma disorders of the upper limbs including a problematic carpal tunnel syndrome (CTS) patient case, idiopathic arm pain, and ulnar neuropathy. Major points of the discourse focus on the problems of treatment, especially as they relate to impairment and disability management.

Adult↗

PubMed2000

Effectiveness of an educational intervention to increase knowledge and reduce use of risky behaviors associated with cumulative trauma in office workers.

OBJECTIVE: This pilot project assessed the effectiveness of an intervention to increase knowledge and reduce risky behaviors related to cumulative trauma disorders (CTD) in office workers. STUDY DESIGN: All 124 employees from the administrative offices of a health maintenance organization were invited to participate. Subjects were followed across time using an identification number. Data were collected via questionnaire in June 1994 (pretest1) (N=84), August 1994 (pretest II) (N= 63) and September 1995 (posttest) (N=40). The yearlong intervention focused on functional activities to prevent CTD. RESULTS: of chi-square analyses for the 40 subjects who completed all surveys indicated this intervention significantly increased overall knowledge of CTD (p =.002). Significant changes in self-reported hand/wrist (p =.016) and neck/shoulder (p =.003) posture were also found. CONCLUSIONS: This study is a first step in identifying effective educational interventions to increase knowledge and reduce risk factors related to CTD in office workers.

Journal Article↗

PubMed1999

An on-site ergonomic program: A model for industry.

Work related conditions caused by overexertion or repeated trauma affect millions of American workers. These conditions can result in time off from work, decreased productivity, and high financial costs, not to mention impairment of the worker. According to the Occupational Safety and Health Act (OSHAct) of 1970 [26], employers are required to provide hazard free workplaces for their employees. Fortunately resources exist to help employers set up on-site ergonomic programs to reduce the hazards that contribute to cumulative trauma disorders (CTDs) or other injuries. Companies that have implemented comprehensive ergonomic programs have reported benefits, most significantly, decreased injuries, and cost savings. A model is described for industry on starting and managing a successful on-site ergonomic program.

Journal Article↗