Cristiane Shinohara Moriguchi

Reliability of intra- and inter-rater palpation discrepancy and estimation of its effects on joint angle measurements

This study presents data on the intra- and inter-rater reliability of palpation on normal and overweight subjects and shows the influence of palpation discrepancy on angular variability for a collected data set, using computer simulation. Thirty healthy males were recruited. Two physiotherapists identified 12 anatomical landmarks that enabled measurement of eight joint angles. Palpation discrepancy was determined by photographic recordings under ultraviolet light. Angular discrepancies were determined from photos of the subjects orthostatic posture. A computer simulation was developed to predict expected angular variation according to observed palpation discrepancy. The results showed that the inter-rater reliability was lower than the intra-rater reliability for both palpation and angle measurements. Palpation of the greater trochanter (GT), anterior superior iliac spine (ASIS), seventh cervical vertebra (C7) and femoral epicondyle (FE) showed larger discrepancies. The overweight group presented a significant difference in palpation discrepancy for ASIS (P<0.03). Angular variations were associated with palpation discrepancies for trunk flexion (TF), hip flexion (HF) and pelvic inclination (PI). Therefore, measurements should be performed by a single rater, rather than by different raters, if reliable angular measurements are intended. Specific anatomical landmarks require careful identification. Simulation was useful for providing estimates of variations due to palpation discrepancy.

Cultural adaptation and psychometric properties of Brazilian Need for Recovery Scale.

OBJETIVO: Traduzir a escala Need for Recovery Scale para a lingua portuguesa visando a adaptacao cultural e apresentando a estabilidade, consistencia interna e validade convergente da versao brasileira em trabalhadores da industria. METODOS: A traducao da escala seguiu normas para adaptacoes culturais de questionarios, que envolveu as etapas de traducao, sintese, retro-traducao, revisao por especialistas e pre-teste. A versao final da escala em portugues, denominada Escala de Necessidade de Descanso foi avaliada pelos testes de estabilidade (n=52) e de consistencia interna (n=192) e quanto a validade convergente em avaliacoes simultâneas com outros instrumentos: Escala de Borg (n=59), Questionario de Fadiga de Chalder (n=57) e escalas do Short Form-36 (n=56). RESULTADOS: A estabilidade e consistencia interna da escala atingiram o criterio de medida confiavel (ICC=0,80 e α de Cronbach=0,87, respectivamente). A validade convergente entre a versao brasileira da escala e os outros instrumentos tambem apresentaram bons resultados: Escala de Borg (r=0,64); Questionario de Fadiga de Chalder (r=0,67); escalas do Short Form-36: vitalidade (r=-0,84), capacidade funcional (r=-0,54) e aspectos fisicos (r=-0,47). CONCLUSOES: A versao brasileira da escala Need for Recovery Scale apresentou boa confiabilidade para avaliacao de sintomas de fadiga relacionada ao trabalho. Alem disto, apresentou correlacoes satisfatorias e significativas com outros instrumentos aceitos pela literatura, o que valida a escala para utilizacao em trabalhadores de perfil semelhante ao estudado.OBJECTIVE To translate the Need for Recovery Scale (NFR) into Brazilian Portuguese and culturally adapt it and assess the stability, internal consistency and convergent validity of the Brazilian scale among industrial workers. METHODS The translation process followed the guidelines for cultural adaptation of questionnaires including the steps of translation, synthesis, back translation, expert committee review, and pre-testing. The Brazilian Portuguese NFR, final version (Br-NFR) was assessed for stability (n=52) and internal consistency (n=192) and for convergent validity through simultaneous assessment with other instruments: the Borg Scale (n=59); the Chalder Fatigue Questionnaire (n=57) and 3 subscales of the SF-36 (n=56). RESULTS Stability and internal consistency met the criterion for a reliable measure (ICC=0.80 and Cronbachs alpha =0.87, respectively). The convergent validity between Br-NFR and other instruments also showed good results: Borg Scale (r= 0.64); Chalder Questionnaire (r= 0.67); SF-36 subscales: vitality (r= -0.84), physical functioning (r= -0.54), and role-physical (r= -0.47). CONCLUSIONS The Br-NFR proved to be a reliable instrument to evaluate work-related fatigue symptoms in industrial workers. Furthermore, it showed significant and good correlations with well-established instruments such as the Borg Scale, the Chalder Questionnaire and SF-36 vitality subscale, supporting the validity of the Br-NFR.

Occupational posture exposure among construction electricians.

The aim of this study is to record, objectively describe and compare working postures of Brazilian and Norwegian construction electricians. Postures of the upper arms, head, and neck during work and breaks were quantified by means of inclinometry for a representative sample of 12 Brazilian and 12 Norwegian electricians in the construction industry during a full work-shift. Despite that differences were found between specific work-related factors, Brazilian and Norwegian workers revealed a high and very similar level and pattern of postures for all evaluated body regions, suggesting that results could be extrapolated to other electricians. Upper arm elevation was high and similar for both groups and head flexion and extension was pronounced compared to other occupations. Thus, extreme postures were identified for construction electricians in both countries, with similar exposure pattern also for defined tasks (planning, support and wiredraw), suggesting that this job is risky regardless organizational differences.

Evaluation of workload among industrial workers with the Need for Recovery Scale.

BACKGROUND Work conditions can overload a workers capabilities and result in health complaints. The early identification of hazardous work conditions allows the definition of priorities for more efficient ergonomic interventions. OBJECTIVES To assess the need for recovery among industrial workers under different work conditions using the Need for Recovery Scale (NFR), and to verify the association between the scores and personal factors, occupational factors and daily activities. METHODS 191 workers (mean age of 34.5±8.3 years) from a manufactory industry participated in this study. Workers answered both a questionnaire regarding demographic and occupational factors, and daily activities as well as the NFR. Ergonomic assessment of workplace sectors was carried out based on the Ergonomic Workplace Analysis. The Pearson chi-square test (significance level 5%) was used to verify the association between NFR scores and the variables of interest. RESULTS The only association was between work sector and NFR score. According to the ergonomic assessment, the work sector with the highest need for recovery also presented the worst environmental and organizational conditions. CONCLUSIONS The Need for Recovery Scale proved to be a helpful tool for differentiating work sectors presenting different workload demands and contributed to the definition of intervention priorities for preserving worker health.

Ankle movements during normal gait evaluated by flexible electrogoniometer

Objective: To evaluate ankle movements of healthy individuals walking on a treadmill, by means of a flexible electrogoniometer. Method: Dorsiflexion and plantar flexion and eversion/inversion movements were recorded for 90 seconds at a velocity of 5.0 km/h. Ten healthy young men of mean age 21.4 ± 2.99 years and mean height 1.62 ± 0.22 meters took part in this study. The data were analyzed descriptively (mean, standard deviation, maximum and minimum). In the sagittal plane, the gait cycle was analyzed at three times, taking the movement peaks: foot flat (FF), midstance (M) and toe off (TO). The inversion and eversion angles corresponding to these phases were identified, as well as movement peaks during gait cycles. Inter and intra-subject coefficients of variability (CV) were calculated. Results: The mean values for the sagittal plane, for the left and right ankles were, respectively: 7o and 4o at FF, 2o and 7o at M, and 24o and 19o at TO. For the frontal plane, the results were inversion of 5o and 3o FF, 4o and 5o at M, and 15o and 16o at TO. The peak values were inversion of 17o and 18o and eversion of 1o. The maximum intrasubject CV was 0.39, and the maximum inter-subject CV was 0.44. Conclusion: The results obtained from the electrogoniometer were relatively similar to data reported in the literature for the sagittal plane, but not for the frontal plane. The discrepancies between studies measuring ankle movements suggest the need for standardization of the recording procedures.

A comparison between flexible electrogoniometers, inclinometers and three-dimensional video analysis system for recording neck movement

This study compared neck range of movement recording using three different methods goniometers (EGM), inclinometers (INC) and a three-dimensional video analysis system (IMG) in simultaneous and synchronized data collection. Twelve females performed neck flexion-extension, lateral flexion, rotation and circumduction. The differences between EGM, INC, and IMG were calculated sample by sample. For flexion-extension movement, IMG underestimated the amplitude by 13%; moreover, EGM showed a crosstalk of about 20% for lateral flexion and rotation axes. In lateral flexion movement, all systems showed similar amplitude and the inter-system differences were moderate (4-7%). For rotation movement, EGM showed a high crosstalk (13%) for flexion-extension axis. During the circumduction movement, IMG underestimated the amplitude of flexion-extension movements by about 11%, and the inter-system differences were high (about 17%) except for INC-IMG regarding lateral flexion (7%) and EGM-INC regarding flexion-extension (10%). For application in workplace, INC presents good results compared to IMG and EGM though INC cannot record rotation. EGM should be improved in order to reduce its crosstalk errors and allow recording of the full neck range of movement. Due to non-optimal positioning of the cameras for recording flexion-extension, IMG underestimated the amplitude of these movements.

Are posture data from simulated tasks representative of field conditions? Case study for overhead electric utility workers

Many ergonomics studies are conducted in laboratory-simulated work environments to assess risks for the development of musculoskeletal disorders under more controlled conditions. However, the simulated conditions could be of questionable validity with respect to reproduction of field conditions involving risk factors. The objective of this study was to verify whether the postures recorded for neck extension/flexion and upper arm elevation of overhead electric utility workers in a simulated environment were similar to those recorded in a field environment. Of the three frequently performed tasks analysed, two presented similar exposure in both conditions. However, differences were identified for a more complex task (relay replacement). These results suggest that simulated tasks may be more representative for more standardised tasks. This may indicate that researchers investigating risks should avoid simplifying complex tasks when reproducing field posture exposure in laboratories, since omitting extra subtasks may lead to an inaccurate reproduction of field exposure. Practitioner Summary: Studies comparing results from field and simulated environments are necessary to evaluate to what degree postural exposure reproduced in laboratory is representative of the exposure occurring in real work situations. This is particularly relevant for tasks involving training in simulated environment due to safety constraints.

Can a self-administered questionnaire identify workers with chronic or recurring low back pain?

To verify if the Nordic Musculoskeletal Questionnaire (NMQ), Visual Analogue Scale (VAS), Roland-Morris Disability Questionnaire (RDQ) and physical examination of the lumbar spine can identify workers with chronic or recurring low back pain, using health history for reference. Fifty office workers of both sexes, aged between 19 and 55 yr, were evaluated using a standardized physical examination and the NMQ, VAS and RDQ. Discriminant analysis was performed to determine the discriminant properties of these instruments. A higher success rate (94%) was observed in the model including only the NMQ and in the model including the NMQ and the physical examination. The lowest success rate (82%) was observed in the model including the NMQ, RDQ and VAS. The NMQ was able to detect subjects with chronic or recurring low back pain with 100% sensitivity and 88% specificity. The NMQ appears to be the best instrument for identifying subjects with chronic or recurring low back pain. Thus, this self-reported questionnaire is suitable for screening workers for chronic or recurring low back pain in occupational settings.

Need for recovery assessment among nursing professionals and call center operators

The present study descriptively compares the need for recovery (NFR) among 128 nursing professionals (nurses) and 223 call center operators according cutoff points in the literature (45 and 50) and by means of statistical tests, and verifies the association between NFR scores and the presence of musculoskeletal symptoms. NFR was evaluated with the Need for Recovery Scale and musculoskeletal symptoms were evaluated with the Nordic Musculoskeletal Questionnaire. At a 45 point cutoff, 22% of the call-center workers and 33% of the nurses were classified as fatigued; at a 50 point cutoff, 13% of the call center operators and 27% of the nurses were classified as fatigued. The nurses had higher fatigue levels than the call center workers (p=0.015). Significant correlations were found between NFR scores and musculoskeletal symptoms reported during the previous 12 months (r=0.299, p<0.001) and 7 days (r=0.314, p<0.001). Regarding cutoff points and statistical tests, the NFR scale identified higher fatigue levels among the nurses and was demonstrated to be a useful tool for evaluating worker well-being.

Biomechanical analysis of loading/unloading a ladder on a truck

Loading/unloading a ladder on vehicles are frequent tasks and involve overhead handling that may expose workers to risk factors of shoulder musculoskeletal disorders. The objective of the present study was to evaluate posture, forces required and perceived exertion when loading and unloading the ladder on a utility truck. Thirteen male overhead line workers from an electric utility in Brazil participated in this study. Shoulder elevation angle was measured using inclinometers. The required force to load/unload the ladder was measured by dynamometer. Subjective assessment of the perceived exertion was recorded to compare the exertion reported during the test conditions to the field conditions. The task of loading/unloading the ladder presented risks of shoulder musculoskeletal disorders (MSDs) to workers because it requires high levels of force (approximately 60% of the maximal force) combined with overhead posture of the shoulders (more than 100° from the neutral posture). Age and height presented to interfere in biomechanical risks presented in load/unload task. There was no significant difference between the subjective exertion during the test conditions and handling the ladder in the field. Ergonomic intervention is recommended to reduce these risks for shoulder MSDs.