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PubMedDate not supplied

Manual materials handling: the cause of over-exertion injury and illness in industry.

It is reported from various sources that overexertion due to lifting, pushing, pulling, and carrying objects accounts for about 27 percent of all compensable industrial injury and illness in the United States. Resulting strain/sprain injuries account for over 50 percent of workmen's compensation clams in many industries. Almont two-thirds of these involve back pain, with reported compensation and medical payments totaling well over one billion dollars annually in the U.S. An estimated 300,000 plus workers will be affected each year, 5 to 10 percent of whom will have a permanent disability and often will be unemployable. This paper attempts to describe four basic approaches used to study this occupational health problem. In so doing, a concerted effort is made to identifiy the gaps in knowledge which need to be more fully researched. The approaches utilized to understand and control the hazards of manual materials handling are: 1) epidemiological studies of job and worker attributes to identify those that individually and in combination cause musculoskeletal incidents, 2) psychophysical studies to ascertain the volitional tolerance of workers to the stress mitigated by manual materials-handling activities, 3) biomechanical studies of the musculoskeletal system during common exertions required in manual materials-handling activities, and 4) physiological studies of the strain imposed on the cardiovascular system during repeated load-handling activities. The state of knowledge from each of these approaches is summarized briefly, and a case is made that much research is still needed to substantiate the necessary controls to lessen the economic burden and human suffering associated with manual materials-handling acts in industry.

Adolescent↗

PubMed1979

Cancer in persons with inherited blood coagulation disorders.

In order to assess the influence of an inherited blood coagulation disorder in individuals who developed cancer, a mail survey of physicians who care for individuals with a bleeding diathesis was evaluated. Sixty-one individuals in an estimated population of 10,500 with both disorders were identified. An apparent increase in the incidence of cancer in the genitourinary and musculoskeletal systems was noted. However, in the largest group ( hemophilia) the primary site of cancer was similar to an age and sex matched population. There did not appear to be a change in the onset of metastatic disease in these individuals, as compared to an individual with cancer who did not have an inherited blood coagulation disorder.

Adolescent↗

PubMed1996

Bovine asymmetric hind limb paresis, a presumptive in-utero plant poisoning.

A new locomotory disturbance of cattle is described. The condition has occurred sporadically since the mid-1980s. Affected herds had all grazed flood plain pastures in a restricted area of north-western New South Wales. Calves were either born with clinical signs or developed them by 4 months of age. The disease was characterised by a slowly progressive, irreversible, asymmetrical, paresis of the hind limbs. Affected cattle experienced persistent hyperextension of the hip and stifle joints. Macroscopic and microscopic examination of the nervous and musculoskeletal system failed to demonstrate abnormalities that would account for the clinical signs. The disorder shares many similarities with bovine spastic paresis. It is suggested that the pathogenesis of the disorder is nervous, and probably involves nigro-striatal, medulla oblongata, and spinal dysfunctional inputs. An in-utero plant poisoning was suspected but no specific plant association was determined.

Animals↗

PubMed2005

Multidetector row CT in pediatric musculoskeletal imaging.

The proliferation of multidetector row CT (MDRCT) has had a significant effect on imaging of the musculoskeletal system. An increasing number of such examinations is being performed in children. We reviewed our experience using such examinations in children during a period of 20 months. In this review, we discuss MDRCT techniques and issues regarding the radiation dose of these examinations. We present the effect of newer scanning techniques and their incorporation into our scanning protocols.

Child↗

PubMedDate not supplied

Exercise and older adults: changing behavior with the transtheoretical model.

The loss of muscle strength, decreased flexibility and range of motion, and decreased sense of balance that frequently accompany aging contribute to falls and functional decline. Even in advanced old age, one can improve strength, decrease the risk of falls, improve cardiorespiratory fitness, and improve ability to live independently. The Transtheoretical Model (TTM) of behavior change is an internationally recognized model that holds much promise for health behavior changes of all types. This article outlines the effects of exercise on age-related changes in the musculoskeletal system and describes the TTM as a model useful to help older adults change their exercise behavior. Research studies are documented that support the effectiveness of the TTM in changing behavior. Application of the model is described with specific examples illustrated in two case studies.

Accidental Falls↗

PubMed1985

Strain on the back in concrete reinforcement work.

To investigate the long term effect of heavy construction work on the back the occurrence of postures, lifting, carrying, and accidents in concrete reinforcement work and in maintenance house painting were measured. The 32 620 observations covering 272 work hours showed that reinforcement work necessitated stooped postures and heavy lifting more often than did painting. Reported minor back accidents were more than ten times as common in reinforcement work than in painting (1.3 compared with 0.11 accidents per man-year, p less than 0.001). Accidents of the musculoskeletal system, registered by the insurance companies, were also several times more common in reinforcement work (81 compared with 25 per 1000 man-years, p less than 0.001). The premature development of lumbar degeneration detected in the clinical study of the reinforcement workers was evidently due to the occupational strain on the back. The different types of hazardous back loads probably potentiate the effects of each other.

Accidents, Occupational↗

PubMed1994

Musculoskeletal MR imaging: turbo (fast) spin-echo versus conventional spin-echo and gradient-echo imaging at 0.5 tesla.

The value of T2-weighted fast spin-echo imaging of the musculoskeletal system was assessed in 22 patients with various neoplastic, inflammatory, and traumatic disorders. Images were acquired with high echo number (i.e., echo train length) fast spin-echo (FSE; TR 2000 ms, effective TE 100 ms, echo number 13, linear k-space ordering), conventional spin-echo (SE; TR 2000 ms, TE 100 ms) and gradient-echo (GRE) sequences (TR 600 ms, TE 34 ms, flip angle 25 degrees). Signal intensities, signal-to-noise ratios, contrast, contrast-to-noise ratios, lesion conspicuousness, detail perceptibility, and sensitivity towards image artifacts were compared. The high signal intensity of fat on FSE images resulted in a slightly inferior lesion-to-fat contrast on FSE images. However, on the basis of lesion conspicuity, FSE is able to replace time-consuming conventional T2-weighted SE imaging in musculoskeletal MRI. In contrast, GRE images frequently showed superior lesion conspicuity. One minor disadvantage of FSE in our study was the frequent deterioration of image quality by blurring, black band, and rippling artifacts. Some of these artifacts, however, can be prevented using short echo trains and/or short echo spacings.

Adolescent↗

PubMed2002

Drug-induced metabolic bone disorders.

A number of drugs, either physician prescribed or those taken without the knowledge of the physician, may have metabolic effects on, and result in abnormal changes in, the musculoskeletal system. These medications may involve the developing fetus, infant, child, or adult and may manifest as drug-induced embryopathies, osteoporosis, osteomalacia, or rickets, or a combination of these, or they may be associated with proliferative changes. Not uncommonly, the radiologist may be the first physician to identify the metabolic manifestations of these medications. The radiological changes associated with such drugs will be reviewed. Certain drugs may have teratogenic effects, nonteratogenic effects, or both. These effects, dependent solely on the timing of administration, will be discussed separately.

Abnormalities, Drug-Induced↗

PubMed1976

Mineral and nitrogen balance study observations: the second manned Skylab mission.

A metabolic study of the effects of space flight on various chemical elements, particularly those with special revelance to the musculoskeletal system, was carried out on the three astronauts of the SL-3 mission for 21 d preflight, during the 60 d flight phase, and for 17 d postflight. The study required of the cooperating crewmen quite constant dietary intake, continuous 24-hour urine collections and total fecal collections. Urinary calcium was significantly increased during flight in all three crewmen with man-to-man variation in pattern and amount; the degree of calcium loss was, in general, similar to that in the prior study of the 28-d Skylab flight (SL-2). The similarity to bedrest immobilization in the pattern of urinary calcium increases and of total calcium shifts suggested that calcium losses would continue for a very long time. Significant losses of nitrogen and phosphorus occurred that were associated with observed reduction in muscle tissue. Both mineral and muscle losses occurred despite vigorous exercise regimens during flight. It was concluded that these studies give warning that capable musculoskeletal function may be significantly impaired during prolonged space flights lasting 1.5 to 3 years unless protective measures are developed.

Adult↗

PubMed1988

Orthopaedic injuries in children associated with the use of off-road vehicles.

Two hundred and thirty-three children who had musculoskeletal injuries related to the use of off-road vehicles were admitted to acute-care hospitals in the two largest urban centers in Manitoba between April 1979 and August 1986. There were 190 boys and forty-three girls, and the ages ranged from two to seventeen years. Ninety-three accidents involved the use of a minibike or dirtbike; seventy-two, a snowmobile; fifty-nine, a three-wheeled all-terrain vehicle; and nine, a four-wheeled all-terrain vehicle. The injuries in 73 per cent of the children occurred in a rural setting. The use of alcohol or a drug was recorded for only three children. Loss of control of the vehicle led to the majority of injuries. There were 352 fractures of an extremity or the spine and fifty-one major soft-tissue injuries of the musculoskeletal system; 186 (53 per cent) of the fractures were displaced, 107 (46 per cent) of the patients had more than one fracture, and thirty-four (10 per cent) of the fractures were open. There were sixty growth-plate injuries. A total of 186 associated injuries were present in ninety-one patients. In a separate review of the records of the Chief Medical Examiner, it was noted that twenty-one fatal accidents that were related to the use of off-road vehicles occurred in the Province of Manitoba during the same period of time.

Accidents↗

PubMed2006

MDCT in the evaluation of skeletal trauma: principles, protocols, and clinical applications.

Multidetector computed tomography (MDCT) scanners have made volume imaging possible and are used extensively to study polytrauma patients, especially in the evaluation of the spine and peripheral skeleton. An MDCT scanner coupled with a modern workstation has become an essential diagnostic tool for any emergency department. Familiarity with the basic physical principles of MDCT such as projection data, section collimation, and beam collimation is important to achieve high-quality imaging while keeping unnecessary radiation to a minimum. After a polytrauma MDCT examination, images can be reconstructed to obtain different slice thickness, slice interval, fields of view, or reconstruction kernels. No additional scanning is needed for imaging the thoracolumbar spine or bony pelvis. High-quality multiplanar reformation (MPR) and three-dimensional (3-D) images can be created at the workstation using the volumetric data. However, MDCT is a high-dose examination, and care should be taken to use as low a dose as possible. In the musculoskeletal system, MDCT has long been used for evaluation of spinal and pelvic trauma; however, the frequency of its use in extremity trauma has been low. In the extremities, radiography seems to underestimate the extent and severity of injury, especially in complex areas such as the shoulder, elbow, wrist, knee, and ankle. MDCT in the extremities is helpful in fracture detection, evaluation, characterization, and treatment planning. The MPR images give excellent structural detail, and the 3-D images help in understanding the spatial relations, which is important for fracture classification and for preoperative planning. MDCT is also helpful in the follow-up of postoperative results, even in the presence of hardware. Tendon injuries can also be evaluated with MDCT.

Artificial Intelligence↗

PubMed2005

Ergonomics of abrasive blasting: a comparison of high pressure water and steel shot.

Abrasive blasting with silica sand has long been associated with silicosis. Alternatives to sand are being used increasingly. While NIOSH has done extensive investigations of the respiratory effects of the substitutes for sand, the ergonomic effects of the substitutes have not been examined. Too often, hazards are shifted, and technologies that might save workers' lungs could do so at the expense of their musculoskeletal systems. Hence, the objective of this study was to examine the ergonomic effects of alternatives to sand. Multiple methods, both qualitative and quantitative, were used to yield numerous kinds of data for the analysis of exposures to abrasive blasters. PATH, a method for quantifying ergonomic exposure in non-routine work, was combined with interviews with workers, biomechanical modeling and noise level readings to assess the ergonomics of two abrasive blasting operations: high-pressure water and steel shot. Advantages and disadvantages of each medium are discussed. High-pressure water was slightly less ergonomically stressful, environmentally cleaner, much quieter and less dusty that steel shot, and it was reported to be slower on those tasks where both media could be used.

Biomechanical Phenomena↗

PubMedDate not supplied

Mineral and nitrogen balance study: results of metabolic observations on Skylab II 28-day orbital mission.

Prediction that the various stresses of flight, particularly weightlessness, would bring about significant derangements in the metabolism of the musculoskeletal system has been based on various observations of long-term immobilized or inactive bed rest. The only attempt at controlled measurement of metabolic changes in space prior to Skylab, a study during the 14-day Gemini VII flight, revealed rather modest losses of important elements. The three astronauts of Skylab II consumed a planned day-by-day, quite constant, dietary intake of major metabolic elements in mixed foods and beverages and provided virtually complete collections of excreta for 31 days preflight, during the 28 days inflight, and for 17 days postflight. Analyses showed that, in varying degree among the crewmen, urinary calcium increased gradually during flight in a pattern similar to that observed in bed-rest studies: the mean plateau peak of urinary calcium excretion in the latter part of flight was double preflight levels. Fecal calcium excretion did not change significantly, but calcium balance, owing to the urinary calcium rise, became either negative or less positive than in preflight measurement. Increased excretion and negative balance of nitrogen and phosphorus indicated appreciable loss of muscle tissue in all three crewmen. Significant losses also occurred inflight in potassium, sodium, and magnesium. Based on the similarity in pattern and degree between these observations and those in bed rest of the losses in calcium, phosphorus, and nitrogen, musculoskeletal integrity would not be threatened in space flights of up to at least 3 months. However, if similar changes occur, indicative of continuing losses of these elements, in the planned Skylab flights for considerably more than 28 days, concern for capable musculoskeletal function should be serious for flights of very many months' duration, and greater research attention will need to be given to development of protective counter-measures.

Aerospace Medicine↗

PubMed2001

Potential health-related benefits of resistance training.

Public health guidelines primarily focus on the promotion of physical activity and steady-state aerobic exercise, which enhances cardiorespiratory fitness and has some impact on body composition. However, research demonstrates that resistance exercise training has profound effects on the musculoskeletal system, contributes to the maintenance of functional abilities, and prevents osteoporosis, sarcopenia, lower-back pain, and other disabilities. More recent seminal research demonstrates that resistance training may positively affect risk factors such as insulin resistance, resting metabolic rate, glucose metabolism, blood pressure, body fat, and gastrointestinal transit time, which are associated with diabetes, heart disease, and cancer. Research also indicates that virtually all the benefits of resistance training are likely to be obtained in two 15- to 20-min training sessions a week. Sensible resistance training involves precise controlled movements for each major muscle group and does not require the use of very heavy resistance. Along with brief prescriptive steady-state aerobic exercise, resistance training should be a central component of public health promotion programs.

Back Injuries↗

PubMed2002

Traumatic injuries: imaging of peripheral musculoskeletal injuries.

The current dominant role of conventional radiography must be reassessed at increasingly shorter intervals in view of the continuing emergence of new imaging modalities that are available to diagnose peripheral musculoskeletal injuries. In comparison with conventional radiography, digital radiographic techniques offer advantages for optimization of image quality and dose, such as a wider dynamic range and post-processing of images. Currently, digital luminescence radiography (storage phosphor radiography) is the most commonly used digital method for obtaining radiographs, using the established positioning projections and routines of the film-screen technique. A new process, radiography with flat-panel amorphous silicon detectors, is still under development. Computed tomography is a valuable tool for diagnosing injuries of the peripheral musculoskeletal system, especially when three-dimensional data sets are acquired; these allow reformating images in all planes desired (2D technique) or in a volumetric format (3D technique). Established indications for CT in the peripheral skeleton are hip fractures, wrist injuries and calcaneal fractures; however, CT may be used as a supplement to radiography in every region of the body. Sonography is beginning to play an increasingly important role in trauma. Muscle and tendon injuries are the most common indications, but worthwhile information can be gained of the shoulder, elbow, hip, and knee joints, supplementing conventional or digital radiography. Magnetic resonance imaging effectively visualizes traumatic changes of the skeleton and the peripheral soft tissues. It is the method of choice to detect occult fractures. It can be used to diagnose muscle and tendon injuries. Joint injuries, especially in the knee and the shoulder joint, are common indications for MRI in the posttraumatic setting.

Arm Injuries↗

PubMed1994

Hyperplasia of the thyroid gland and concurrent musculoskeletal deformities in western Canadian foals: reexamination of a previously described syndrome.

A syndrome of neonatal foals characterized by hyperplasia of the thyroid gland and concurrent musculoskeletal deformities (TH-MSD) has been described in western Canada and may be increasing in incidence. In an attempt to improve recognition and understanding of this syndrome, 2946 records of equine abortuses, stillborns, and dead neonatal foals were examined to determine the laboratory involved, the year and month of submission, the breed and sex of the fetus or foal, the type of perinatal loss, the length of gestation, and whether or not the submission had evidence of a lesion of the thyroid gland, the musculoskeletal system, or other abnormal clinical or postmortem findings. One hundred and fifty-four (5.2%) records indicated the presence of an abnormal thyroid gland. Of these, 79 (2.7%) had additional lesions consistent with the TH-MSD syndrome described in the 1980s, while 75 (2.5%) were without these additional lesions. Comparisons among these two groups and a third group of fetuses and foals without lesions of the thyroids glands are described. The results confirm that the TH-MSD syndrome is a specific and unique disease with no breed or sex predilection. It is argued that there may be an "exposure-related" cause, and based on a review of similar disease syndromes of the horse, it is suggested that an examination of the feed is indicated in outbreaks of the TH-MSD syndrome.

Abortion, Veterinary↗

PubMed2006

Muskuloskeletal MR imaging at 3.0 T: current status and future perspectives.

Magnetic resonance (MR) imaging has become an important diagnostic tool in evaluation of the musculoskeletal system. While most examinations are currently performed at magnetic field strengths of 1.5 T or lower, whole-body MR systems operating at 3.0 T have recently become available for clinical use. The higher field strengths promise various benefits, including increased signal-to-noise ratios, enhanced T2* contrast, increased chemical shift resolution, and most likely a better diagnostic performance in various applications. However, the changed T1, T2, and T2* relaxation times, the increased resonance-frequency differences caused by susceptibility and chemical-shift differences, and the increased absorption of radiofrequency (RF) energy by the tissues pose new challenges and/or offer new opportunities for imaging at 3.0 T compared to 1.5 T. Some of these issues have been successfully addressed only in the very recent past. This review discusses technical aspects of 3.0 T imaging as far as they have an impact on clinical routine. An overview of the current data is presented, with a focus on areas where 3.0 T promises equivalent or improved performance compared 1.5 T or lower field strengths.

Contrast Media↗

PubMed1995

New characters for the functional interpretation of primate scapulae and proximal humeri.

The study of muscle function in nonhuman primates through the technique of electromyography (EMG) has facilitated the identification of specific functional roles for muscles in particular behaviors. This has led to a more complete understanding of the biomechanics of certain regions of the musculoskeletal system, and should facilitate our ability to identify morphological features useful in the functional interpretation of fossil material. The current paper represents one such investigation of a new set of morphometric characters of the scapula and proximal humerus suggested by EMG analyses of shoulder muscle function. A set of new metric variables were examined on the scapulae and proximal humeri of 25 species of extant anthropoid primates, as well as on casts of scapulae and humeri of three fossil primate taxa. The variables are primarily related to the line of action and attachments of the rotator cuff muscles. The position of the scapular spine, the degree of lateral expansion of the subscapular fossa, the size and shape of the subscapularis insertion facet on the lesser tubercle, and the orientation of the infraspinatus insertion facet on the greater tubercle all appear to successfully sort the extant taxa into locomotor groups. Their appearance on the fossil specimens generally supports previous functional interpretations of each taxon's locomotor abilities based on a variety of other characters, suggesting that these traits are equally applicable to fossil material.

Animals↗