Deborah Alperovitch-Najenson

Lumbar facet orientation in spondylolysis: a skeletal study.

Study Design. Orientation of the lumbar articular facets at the L1–L5 level was measured and analyzed. Objective. To characterize the relationship between lumbar facet orientation and isthmic spondylolysis. Summary of Background Data. Whereas many studies have explored the relationship between facet orientation in the transverse plane and various spinal pathologies, there is insufficient data regarding this relationship and isthmic spondylolysis. Methods. A 3-dimensional digitizer was used to measure the transverse orientation of the lumbar facet joints at the L1–L5 level in 115 male individuals with bilateral isthmic spondylolysis (at L5) and 120 age and sex-matched normal control subjects from the Hamann-Todd Human Osteological Collection (Cleveland Museum of Natural History, Cleveland, OH). Statistical analysis included paired t tests and analysis of variance. Results. In both isthmic spondylolysis and control groups, considerable shifts were noticed from sagittally oriented articular facets at L1 to frontally oriented facets at L5. The change in orientation was significantly greater (up to 13° at L4) in the isthmic spondylolysis group (right inferior facets). Three of the 4 articular facets of L5 (right and left inferior and right superior) were significantly more frontally oriented in isthmic spondylolysis compared to the control group. A greater tendency of asymmetry in facet orientation was noticed in the isthmic spondylolysis group. Conclusion. Individuals with more frontally oriented facets in the lower lumbar vertebrae incorporated with facet tropism are at a greater risk for developing isthmic spondylolysis at L5.

Handgrip Strength as a Diagnostic Tool in Work-Related Upper Extremity Musculoskeletal Disorders in Women

The aim of this study was to determine if handgrip strength might be used as a diagnostic tool in musculoskeletal disorders of the upper extremities in women working in an industrial environment. The setting was an electronic factory with four groups of women (n = 101) in a factory assembling electronic components. Handgrip strength was measured using a Jamar® hydraulic hand dynamometer. The study investigated grip strength in managers-engineers, cable wiring, circuit board assembly, integrated circuits women at 90? elbow flexion and 180? elbow extension. Women seeking or receiving medical care for musculoskeletal disorders of the upper extremities or neck showed significant declines (p < 0.01) in handgrip strength and these also related to the type of work and the level of perceived physical exertion. Women in the managerial-engineering group showed fewer musculoskeletal disorders of the upper extremity compared with the other groups and also had significantly stronger handgrip. Our findings encourage us to recommend hand dynamometer testing as a useful diagnostic tool to determine loss of handgrip strength.

Physical Therapists Versus Nurses in a Rehabilitation Hospital: Comparing Prevalence of Work-Related Musculoskeletal Complaints and Working Conditions

ABSTRACT The objective of this study was to investigate the prevalence and work avoidance of work-related musculoskeletal complaints and to compare patient handling tasks and psychosocial factors of physical therapists (PTs) and nurses in a rehabilitation hospital. Cross-sectional observational study was carried out using questionnaires relating to basic demographics, prevalence of musculoskeletal morbidity, workload, and job satisfaction. Comparing 26 PTs and 54 nurses, all females, lower back pain was significantly more prevalent in PTs, even after adjusting for the confounding demographic factors; PTs performed full and partial manual patient transfer, as well as trunk bending and walking assistance more frequently than the nurses and were significantly more satisfied. Unique physical load could be the main factor for the high prevalence of lower back pain in PTs. They should urgently initiate a “no-lift policy” in treatment.

Work-related musculoskeletal disorders among physical therapists: A comprehensive narrative review.

Healthcare workers, especially those with direct patient contact are amongst professions with the highest rate of workrelated musculoskeletal disorders (WMSDs), physical therapists (PTs) being one of them. Our objective was to review current knowledge relating to the prevalence, risk factors and prevention of WMSDs among PTs. Pubmed, Google Scholar and PEDro databases were searched for terms relating to WMSDs in PTs from inception to 2015. The prevalence of WMSDs among PTs was high, with lifetime prevalence reported as 55-91%, and 12-month prevalence ranges 40-91.3%, and the lower back as the most frequently affected, with estimates of a lifetime prevalence ranging 26-79.6%, and a 12-month prevalence ranging 22-73.1%, followed most often by the neck, upper back and shoulders. The major risk factors for workrelated low back pain (LBP) were: lifting, transferring, repetitive movements, awkward and static postures, physical load, treating a large number of patients in a single day and working while injured. Low back pain seems to be age- and genderrelated with a higher prevalence in females, younger PTs and PTs working in rehabilitation settings. Physical therapists, as a consequence of work-related LBP, may seek treatment, modify their daily living and leisure (lifestyle) activities, use aids and equipment or change their specialty area either within the profession or by leaving it. Skills and knowledge as to correct body mechanics do not prevent work-related injuries. Mechanical aids used for a patient transfer should be adopted by PTs and new strategies should be developed to reduce their WMSDs without compromising the quality of treatment. Int J Occup Med Environ Health 2016;29(5):735-747.

Effect of kinesio tape application on hemiplegic shoulder pain and motor ability: a pilot study.

The aim of our single-group pre–post design pilot study was to evaluate the short-term effect of kinesio taping (KT) application on pain and motor ability of hemiplegic shoulder pain (HSP) patients. Eleven poststroke patients with HSP hospitalized in the Department of Neurology C, Loewenstein Rehabilitation Hospital, Raanana, Israel, received a KT application in addition to their usual rehabilitation protocol. KT, consisting of one to three strips according to a predefined algorithm, was applied to the painful shoulder region. A 10 cm Visual Analog Scale of shoulder pain at rest and at arm movement, active and passive pain-free abduction range of motion, Box & Blocks, and Fugl-Meyer upper extremity motor assessment were performed before treatment and 24 h after wearing the KT. After applying the KT, there was no significant change in any variables. Short-term KT application, used in our study, produced no change in shoulder pain, range of motion, or ability of upper limb in HSP patients. Additional studies should evaluate the effect of long-term application and different types of KT applications on HSP.

Rehabilitation versus Nursing Home Nurses' Low Back and Neck‐Shoulder Complaints

Purpose: To compare the prevalence of those complaints in nurses working in rehabilitation departments and nursing homes, and to evaluate factors associated with them. Design: A cross‐sectional study in rehabilitation and in nursing home departments. Methods: Data were obtained from questionnaires relating to basic demographics, prevalence of musculoskeletal complaints, potentially harmful positions and actions and job satisfaction. Findings: Multivariate analyses demonstrated higher work‐related musculoskeletal complaints for nurses in rehabilitation than nursing home nurses (p = .012 for low back pain; p < .001 for neck‐shoulder pain). Trunk bending, static posture, repetitive tasks, and recognition of superiors were associated with low back pain. Freedom to choose work techniques and degree of diversity at work were associated with neck‐shoulder pain. Conclusions: Differences between the nurse groups as to work tasks might be a reason for differences in musculoskeletal complaints. Further comparisons between nurses working in different fields might reveal more accurate potential risk factors for work‐related musculoskeletal complaints. Clinical Relevance: Instruction for static/awkward posture avoidance, by using mechanical aids and designing a friendlier environment, should be part of a nursing staff injury prevention strategy.

Prevention of Nurses’ Work-Related Musculoskeletal Disorders Resulting From Repositioning Patients in Bed Comprehensive Narrative Review

Repositioning patients in bed to promote comfort and prevent impairments caused by continuously lying in a prone position is a task frequently performed by nurses and nursing assistants. Repositioning is a high-risk activity, frequently causing occupational injuries. These occupational injuries are attributed to excessive physical demands on nurses due to patients’ weight and awkward nurse postures. During repositioning, risk of injury can be lowered by reducing friction between the patient and the bed. Hence, certain friction-reducing devices have been developed to reduce the manual force required to move patients. Nevertheless, further research is needed to evaluate the potential effectiveness of these devices. Therefore, the aim of this review was to present current research about the risk factors, prevention strategies, and assistive devices that could reduce work-related musculoskeletal disorders caused by repositioning patients in bed.

The impact of patient's weight on post-stroke rehabilitation.

Abstract Purpose To evaluate the influence of patient’s weight on rehabilitation outcomes in first-event stroke patients. Design Retrospective, observational comparative study. 102 first-time stroke male and female patients admitted to the 52-bed neurology rehabilitation department in a rehabilitation hospital were included in the study. Body mass index (BMI), Functional Independence Measure (FIM) on admission and at discharge, as well as the delta-FIM (FIM on admission – FIM at discharge) were evaluated. The Kruskal–Wallis test was used to compare the FIM and the NIHSS scores between BMI groups (normal, overweight, moderate and severe obesity). Results A statistically significant negative correlation (rho = −0.20, p = 0.049) was found between FIM change and BMI, that remained significant after adjustments for age, sex and hospitalisation days. No difference was found between groups in FIM or NIHSS change between BMI groups. Conclusions In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients’ BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. Further investigations are needed to identify the functional parameters affected by the patients’ BMI. Implications for Rehabilitation In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients’ BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. New rehabilitation strategies should be designed to improve the functional outcomes of rehabilitation of obese patients.

Osteophytes in the cervical vertebral bodies (C3-C7) - Demographical perspectives: Demographical aspects of cervical osteophytes

Vertebral osteophytes are an age‐dependent manifestation of degenerative changes in the spine. We aimed to determine the prevalence and severity of cervical osteophytosis in a large study population. To do so, we developed a grading system for osteophytosis, enabling the assessment of their presence and severity in the cervical spine, and applied it to the analysis of dried cervical vertebral bodies (C3–C7) from 273 individuals. Statistical analyses were carried out per motion segment, while testing for the effect of age, sex, and ethnicity. The highest prevalence of osteophytes was found in motion segment C5/C6 (48.2%), followed by C4/C5 (44.1%), and last C6/C7 and C3/C4 (40.5%). Severe osteophytes are most commonly seen in motion segment C5/C6. In all motion segments, the inferior discal surface of the upper vertebra manifests more osteophytes than the superior discal surface of the lower one. Osteophytes prevalence is sex‐dependent only in the upper cervical vertebrae (C3–C4), and age‐ and ethnicity‐dependent for all vertebrae. Anat Rec, 302:226–231, 2019.