Anna Brzęk

Professional experience and ergonomic aspects of midwives’ work

ObjectivesThe most frequent manner of attending childbirth imposes on midwives assuming poor body position affecting the musculoskeletal system. Long professional experience does not mitigate the negative effects. The adopted movement habit, as well as the type, number and frequency of actions influence the body posture. The aim of the study was to identify ergonomic threats of basic occupational midwives activities and how particular spinal segments arrangements while attending childbirth using the same technique in senior midwives differ from those of junior ones. It was also checked whether pain influences the working position assumed by midwives.Materials and MethodsExaminations were conducted in 95 midwives aged 21–50 (X = 29.25±9.34): 51 graduates of BSc midwifery who worked 680 h in delivery rooms during obligatory practical classes and apprenticeship and 44 senior midwives with professional experience of 7–27 years (X = 14.84±5.98). The study was threefold. The spinal alignment while performing work activities associated with attending childbirth was assessed using the OWAS system and the SonoSens Monitor, the center of gravity projection on basal plane — using the AccuGait AMTI stabilometric platform. The measurements were taken during a simulation of attending childbirth (on examination model). A survey was conducted aimed at identifying spinal pain.ResultsMidwives’ working postures require unnatural body alignments. Postural instability in the working position and no maximal usage of basal plane were observed. The work overload may afflict the musculoskeletal system, which was confirmed by different pain discomforts in 67.3% of the examinees.ConclusionsSpinal alignment while attending childbirth is individually differentiated and in every case non-ergonomic. Identifying explicitly spinal overloads is difficult, but the most prevalent ones affect lumbar and cervical regions altogether. Spinal pain is frequently noted, both in junior and senior midwives, and is characteristic for midwives working in maximal movement ranges.

Body posture and syndromes of back pain.

BACKGROUND The effects of faulty postures include disturbances of the symmetric distribution of compressive and tensile forces acting on both sides of the body axis and the emergence of harmful shear forces. The torques of antigravity muscles also change unfavourably. This may lead to the development of a repetitive strain syndrome, stenosis of intervertebral foramina, compression of nerve roots and back pain. The development of back pain syndromes is significantly affected by the performance of various work-related tasks in non-ergonomic positions. The aim of the study was to investigate the association between back pain syndromes and the quality of body posture, especially in the context of work ergonomics. MATERIAL AND METHODS The study enrolled 125 persons: 39 adults with a childhood history of scoliosis, 39 midwives, and 47 physiotherapists. Body posture was assessed in all participants. In midwives and physiotherapists, body position during the performance of work-related tasks was also evaluated. The frequency and severity of pain was assessed with the Jackson-Moskowitz measure. RESULTS The study revealed that over 80% of the participants suffered from spinal pain. In most cases, the pain was intermittent and was felt in the lumbar spine. The occurrence of pain among midwives and physiotherapists was not directly dependent on the predominant type of abnormal spinal position assumed during the performance of occupational tasks or the quality of body posture. The complaint was also reported by ca. 85% of persons with a history of scoliosis. CONCLUSIONS An incorrect body posture (especially scoliosis) and performance of work-related tasks in non-ergonomic positions increase the probability of back pain.

Some possibilities of correction and compensation in body posture regulation among children and adolescents with low degree scoliosis.

BACKGROUND Postural alignments, secondary curves of spine and tendency to unequal body weight distribution are the compensatory mechanisms in scoliosis, eventually leading to disturbances in the regulation of body posture. The pathological pattern of incorrect posture, evokes a vicious circle of causes and effects, which probably includes alterations in body weight distribution to both feet. OBJECTIVE To examine the role of equal weight loading of both feet in posture regulation among children and adolescents with low-degree scoliosis. METHODS A total of 115 participants, aged 7-19 years, were divided into three groups: low degree scoliosis (10-26⁰ Cobb; n = 56), scoliotic posture (5-9⁰; n = 29), and without lateral spine curvature (n = 30). Three measurements of body arrangement and the weight distribution on feet were simultaneously taken using the photogrammetry and the podographic platform: in a free standing position, while attempt to correct body arrangement and with equal loading of both feet. RESULTS Unequal weight distribution was observed in free standing position in patients with scoliosis. Attempts to correct body arrangement worsened existing disproportion, especially in the left-side curvatures. Equal feet loading lead to the body disarrangement, even among non - scoliotic subjects. CONCLUSIONS In subjects with low degree scoliosis the compensatory changes in the spatial arrangement of the body are usually accompanied by asymmetric distribution of foot pressure and the active attempt to correct the curvature enhances this asymmetry. Attempts to maintain symmetrical distribution of body weight result in significant deterioration of the posturometric parameters even in non-scoliotic subjects.

How does the activity level of the parents influence their children’s activity? The contemporary life in a world ruled by electronic devices

Introduction Apart from many positive changes associated with technical civilization, there are also – from the health point of view – some threats. The reduction in the level of physical activity is one of them. The aim of the study was to investigate whether there are any relationships between children’s physical activity and behaviors, and to assess the impact of the adults’ activity on their children’s habits. Material and methods The study involved a group of 340 children aged 7–12 years (mean age: 9.81 ±1.7) and their parents. In order to evaluate children’s physical activity and the amount of time that they spend with electronic devices, an original questionnaire and the IPAQ questionnaire were used. Results Children usually use electronic devices between 2 and 7 days per week (mean: 4.74 ±0.86), regardless of sex (p > 0.09) and spend between 5 and 1620 min per week (mean: 459.46 ±308.1) with their mobile phone, tablet, PCs and TVs. 67.92% of boys and 69.61% of girls lead an active lifestyle. The children’s activity level depends on their parents’ level of activity (p < 0.000001). Parents of semi-active children lead a lifestyle with a moderate level of physical activity. Conclusions The level of physical activity in younger children depends on the children’s relationship with their parents and their level of activity. Children spend a lot of free time with their electronic devices. It is necessary to develop and implement activities intended to raise awareness of children and their families about the effects of hypokinesis.

Efficiency of lung ventilation for people performing wind instruments

BACKGROUND Wind instruments musicians are particularly prone to excessive respiratory efforts. Prolonged wind instruments performing may lead to changes in respiratory tracts and thus to respiratory muscles overload. It may result in decreasing lung tissue pliability and, as a consequence, in emphysema. Aim of the research has been to describe basic spirometric parameters for wind players and causes of potential changes. MATERIAL AND METHODS Slow and forced spirometry with the use of Micro Lab Viasys (Micro Medical, Great Britain) was conducted on 31 wind musicians (group A). A survey concerning playing time and frequency, weight of instruments, and education on diaphragmatic breathing was conducted. The control group included 34 healthy persons at similar age (group B). The results were statistically described using Excel and Statistica programmes. RESULTS The respiratory parameters were within the range of physiological norms and forced expiratory volume in 1 s to forced vital capacity (FEV1/FVC) exceeded in both groups the values of 100%. Forced vital capacity and expiratory vital capacity (EVC) values were significantly lower in the group of musicians than in the control group (p < 0.001). In 45% the group A used diaphragmatic breathing, in 31% of examinees mixed respiratory tract was observed. The significant discrepancy of individual parameters was obtained regarding age and the length of time when performing wind instrument. CONCLUSIONS Spirometric parameters relative to standards may prove a good respiratory capacity. Peak expiratory flow (PEF) and FEV1 may indicate that a proper technique of respiration during performance was acquired. The length of time when performing wind instrument may influence parameters of dynamic spirometry. Med Pr 2016;67(4):427-433.

Assessment of back proprioceptive sensibility in girls with double curve idiopathic scoliosis

Materials and method 58 girls, aged 10-16 years (mean 13.6 ±1.4) with double curve idiopathic scoliosis were examined. Control group consisting of 40 healthy girls. 12 points were selected at the patient’s back at the scapulae, thorax and waist areas, and a paper sheet with schematic representation of the back was given to each patient. The researcher touched the patient’s back while the patient herself, pointed out the areas where the researcher touched the back. Examination was performed twice: immediately before and after a 5-day FITS therapy.

Muscle shortening in structural versus non-structural spine deformities

Background Restriction of muscle flexibility is observed in lower limbs of both healthy adolescents and those diagnosed with spine deformity. Children sedentary lifestyle is suspected to be the reason. The resulting inhibition of antagonistic muscle group and disturbance of synergistic/stabilizing groups can potentially involve global muscular balance. The aim of the study was to assess lower limb muscle shortening in children with spine disorders