Wiroj Jiamjarasrangsi

Associations between Prevalence of Self-reported Musculoskeletal Symptoms of the Spine and Biopsychosocial Factors among Office Workers

Associations between Prevalence of Self‐reported Musculoskeletal Symptoms of the Spine and Biopsychosocial Factors among Office Workers: Prawit Janwantanakul, et al. Department of Physical Therapy, Faculty of Allied Health Sciences, Chulalongkorn University, Thailand

Comparison of waist circumference, body mass index, percent body fat and other measure of adiposity in identifying cardiovascular disease risks among Thai adults

SUMMARY OBJECTIVE To compare the abilities of body mass index (BMI), percent body fat (%BF), waist circumference (WC), waist-hip ratio (WHR) and waist-height ratio (WHtR) to identify cardiovascular disease risk factors. METHODS This cross-sectional study is comprised of 1391 Thai participants (451 men and 940 women) receiving annual health check-ups. Spearmans rank correlation was used to determine the association of the five anthropometric indices with metabolic parameters including fasting plasma glucose, triglyceride, high-density lipoprotein and blood pressure. The prevalence of cardiovascular disease risk factors was determined according to tertile of each anthropometric measure. Receiver operating characteristic (ROC) curves were plotted to compare anthropometric measure as predictors of the prevalence of cardiovascular risk factors. RESULTS Metabolic parameters were more strongly associated with %BF and WHR and least correlated with BMI in men. Among women, BMI was most strongly correlated with metabolic parameters. In both genders, the prevalence of cardiovascular disease risk factors increased across successive tertiles for each anthropometric measure. Review of ROC curves indicated that %BF and WHR performed slightly better than other measures in identifying differences in CVD risk factors among men. BMI performed at least as well or better than other measures of adiposity among women. CONCLUSIONS These findings confirm high correlations between anthropometric measures and metabolic parameters. BMI, WC and other measures were not materially different in identifying cardiovascular disease risk factors. Although small differences were observed, the magnitudes of those differences are not likely to be of public health or clinical significance.

Development of a risk score for low back pain in office workers - a cross-sectional study

BackgroundLow back pain (LBP) is common among office workers and is the most common cause of work-related disability in people under 45 years of age. The aetiology of LBP is widely accepted to be multi-factorial. Prognostic research into office workers at risk of developing LBP has received limited attention. The aims of this study were to develop a risk score to identify office workers likely to have LBP and to evaluate its predictive power.Methods397 office workers filled out a self-administered questionnaire and underwent physical examination. The questionnaire gathered data on individual, work-related physical and psychosocial data as well as the presence of low back pain in the previous 4 weeks. The physical examination included measurement of body weight, height, waist circumference, hamstrings length, spinal scoliosis, spinal curve, Backache Index and lumbar stability. Logistic regression was used to select significant factors associated with LBP to build a risk score. The coefficients from the logistic regression model were transformed into the components of a risk score.ResultsThe model included six items: previous history of working as an office worker, years of work experience, continuous standing for >2 hrs/d, frequency of forward bending during work day, chair having lumbar support and Backache Index outcome. The risk score for LBP in office workers (The Back pain Risk score for Office Workers: The BROW) was built with a risk score ranging from 0 to 9. A cut-off score of ≥4 had a sensitivity of 80% and a specificity of 58%. The positive predictive value and negative predictive values were 70% each.ConclusionsThe BROW is easy and quick to administer. It appears to have reasonable sensitivity, specificity, positive predictive value and negative predictive values for the cut-off point of ≥4. The BROW is a promising tool for use to identify office workers in need of early interventions. Further prospective study is needed to validate the predictive performance of the BROW.

Increased alanine aminotransferase level and future risk of type 2 diabetes and impaired fasting glucose among the employees in a university hospital in Thailand

AIM The purpose of this study was to determine the association between baseline alanine aminotransferase (ALT) levels, and future risk of impaired fasting glucose and type 2 diabetes among the employees of a university hospital in Bangkok, Thailand. METHODS Totally, 2370 and 1619 workers without diabetes and impaired fasting glucose (IFG) at baseline, respectively, who were 35 years or older were followed during 2001-2005. Diagnosis of IFG and type 2 diabetes was based on the fasting plasma glucose levels of 100-125 and greater or equal to 126 mg/dl, respectively. RESULTS Higher baseline ALT levels were associated with future diabetes risk in an obvious dose-response manner (the OR [95% CI] for the groups with baseline ALT of 17-22, 23-38, and greater than 38 mg/dl comparing to the group with baseline ALT of 1-16 mg/dl were 4.75 [1.25-18.10], 6.14 [1.54-24.45], and 7.19 [1.32-39.16], respectively). Magnitude of association were even higher among those with existing IFG at baseline. The association patterns were consistent for both genders. Concerning the IFG risk, while those who developed IFG had significantly higher baseline ALT levels than those who remained normal at the end of follow-up period, further analyses did not show that baseline ALT was significantly associated with future IFG risk. CONCLUSION Present study provided supporting evidence from a cohort of Asian subjects about the ALT and future type 2 diabetes risk.

Prevalence of and factors associated with musculoskeletal symptoms in the spine attributed to computer use in undergraduate students.

OBJECTIVE This study aimed to investigate the 3-month prevalence of musculoskeletal symptoms at the spine attributed to computer use and to identify biopsychosocial factors associated with the prevalence in undergraduate students. PARTICIPANTS Undergraduate students who studied at a public university in Thailand. METHODS A cross-sectional survey was conducted with a self-administered questionnaire delivered to 3,545 students. RESULTS A total of 2,511 students (73.7%) returned the questionnaires. Cervical symptoms (22.3%) were the most frequently reported, followed by thoracic (11%) and lumbar symptoms (10.7%). Females, daily computer use greater than three hours and too-high keyboards position were significantly associated with a high prevalence of cervical symptoms. A significant association was found between higher undergraduate year of the study and too-high keyboards position and a high prevalence of thoracic symptoms. Higher undergraduate year of the study and daily computer use greater than three hours were significantly related to a high prevalence of lumbar symptoms. Better-than-normal mental health status was associated with a low prevalence of lumbar symptoms. CONCLUSION Spinal symptoms are common among undergraduate students. Various factors were identified to be associated with high prevalence of spinal symptoms. Further research investigating the causal relation between these factors and musculoskeletal symptoms should be conducted.

Risk factors for the onset and persistence of neck pain in undergraduate students: 1-year prospective cohort study

BackgroundAlthough neck pain is common in young adulthood, studies on predictive factors for its onset and persistence are scarce. It is therefore important to identify possible risk factors among young adults so as to prevent the development of neck pain later in life.MethodsA prospective study was carried out in healthy undergraduate students. At baseline, a self-administered questionnaire and standardized physical examination were used to collect data on biopsychosocial factors. At 3, 6, 9, and 12 months thereafter, follow-up data were collected on the incidence of neck pain. Those who reported neck pain on ≥ 2 consecutive follow-ups were categorized as having persistent neck pain. Two regression models were built to analyze risk factors for the onset and persistence of neck pain.ResultsAmong the recruited sample of 684 students, 46% reported the onset of neck pain between baseline and 1-year follow-up, of whom 33% reported persistent neck pain. The onset of neck pain was associated with computer screen position not being level with the eyes and mouse position being self-rated as suitable. Factors that predicted persistence of neck pain were position of the keyboard being too high, use of computer for entertainment < 70% of total computer usage time, and students being in the second year of their studies.ConclusionNeck pain is quite common among undergraduate students. This study found very few proposed risk factors that predicted onset and persistence of neck pain. The future health of undergraduate students deserves consideration. However, there is still much uncertainty about factors leading to neck pain and more research is needed on this topic.

The relationship between upper extremity musculoskeletal symptoms attributed to work and risk factors in office workers

PurposeOffice workers are exposed to various individual, work-related and psychosocial factors during work that have been associated with the development of musculoskeletal symptoms. There is an increasing in evidence that suggests that musculoskeletal symptoms in the upper extremity are very common among office workers. The aim of this study was to examine the effects of individual, work-related physical and psychosocial factors on the prevalence of shoulder, elbow and wrist/hand symptoms attributed to work in office workers.MethodsA self-administered questionnaire was delivered to 2,000 office workers in 54 workplaces in Bangkok, registered at the Social Security Office of Thailand.ResultsA total of 1,428 subjects (71%) returned the questionnaire, of whom 1,185 were eligible for the study. Alcohol consumption, frequency of working in an uncomfortable posture and relationships with colleagues were each significantly related to the prevalence of experiencing shoulder symptoms. No significant association between the investigated factors and the prevalence of experiencing elbow symptoms was found. Frequency of working in the position that hands were above the shoulder level and self-rated perception of air circulation in the office were significantly associated with the prevalence of experiencing wrist/hand symptoms.ConclusionsVarious individual, work-related and psychosocial factors were identified to be associated with high prevalence of musculoskeletal symptoms attributed to work in the shoulder and wrist/hand among office workers. Further research investigating the causal relation between these factors and musculoskeletal symptoms should be conducted.

Prevalence of insulin resistance and its relationship with cardiovascular disease risk factors among Thai adults over 35 years old

AIMS To estimate the prevalence of insulin resistance (HOMA-IR) and to study its relationship with selected cardiovascular disease risk factors among Thai adults. METHODS This cross-sectional study was comprised of 227 men and 990 women undergoing routine health check-up. The prevalence of insulin resistance was estimated using diagnostic criteria previously employed in Asian and other populations. Spearmans rank correlation coefficients were used to evaluate associations of HOMA-IR with selected cardiovascular disease risk factors. Multivariable logistic regression procedures were used to evaluate associations of hypertriglyceridemia, low HDL-Cholesterolemia, and hypertension with varying HOMA-IR values. RESULTS Approximately 25.1% of men (HOMA-IR>or=1.56) and 21.5% of women (HOMA-IR>or=1.64) were classified as having insulin resistance. HOMA-IR values were statistically significantly and positively associated with body mass index, body fat percentage, waist circumference, and serum triglycerides. The values were inversely correlated with HDL-Cholesterol. When compared with those whose HOMA-IR values were within the lowest quartile (<0.45), men with HOMA-IR values in the highest quartile (>or=1.58) had higher risks of hypertriglyceridemia (adjusted OR=2.83), low HDL-Cholesterolemia (adjusted OR=2.79), and hypertension (adjusted OR=2.76). Similar associations were observed among women. CONCLUSION Insulin resistance, as determined using HOMA-IR, was positively associated with selected cardiovascular disease risk factors among Thai adults.

Effects of an exercise programme on preventing neck pain among office workers: a 12-month cluster-randomised controlled trial.

Objectives This study aimed to evaluate the effects of an exercise programme focusing on muscle stretching and endurance training on the 12-month incidence of neck pain in office workers. Methods A 12-month prospective cluster-randomised controlled trial was conducted in healthy office workers with lower-than-normal neck flexion movement or neck flexor endurance. Participants were recruited from 12 large-scale enterprises. A total of 567 healthy office workers were randomly assigned at the cluster level into either intervention (n=285) or control (n=282) groups. Participants in the intervention group received an exercise programme that included daily stretching exercise and twice-a-week muscle endurance training. Those in the control group received no intervention. The primary outcome measure was the 12-month incidence of neck pain, and the secondary outcome measures were pain intensity, disability level, and quality of life and health status. Analyses were performed using the Cox proportional hazard models. Results Over the 12-month follow-up, 12.1% of participants in the intervention group and 26.7% in the control group developed incident neck pain. Hazard rate ratios showed a protective effect of the exercise programme for neck pain (HR=0.45, 95% CI 0.28 to 0.71) after adjusting for biopsychosocial factors. There was no significant difference in pain intensity, disability and quality of life and health status between those who reported incident neck pain in the intervention and control groups. Conclusions The exercise programme reduced incident neck pain and increased neck flexion movement for office workers with lower-than-normal neck flexion movement.

Biopsychosocial Factors Are Associated with High Prevalence of Self-reported Musculoskeletal Symptoms in the Lower Extremities Among Office Workers

BACKGROUND AND AIMS Little attention has been given to musculoskeletal symptoms in the lower extremities among office workers. The aim of this study was to investigate the relationships between the self-reported prevalence of musculoskeletal symptoms in the hip, knee and ankle/foot and individual, work-related physical and psychosocial factors. METHODS A cross-sectional survey was conducted in which 2000 office workers from 54 workplaces in Bangkok registered at the Social Security Office of Thailand received a self-administered questionnaire. Of those, 1428 (71%) returned the questionnaire. After screening for exclusion criteria, 1185 office workers were eligible for the study. The prevalence of self-reported musculoskeletal symptoms in the hip, knee and ankle/foot was associated with certain individual, work-related physical and psychosocial factors. RESULTS Mental demands and work repetitiveness were each significantly associated with the prevalence of experiencing hip symptoms. Suffering from a chronic disease, the average number of working hours/day, sleep quality and self-rated perception of air circulation in the office were significantly related to the prevalence of experiencing knee symptoms. Significant associations were found between the prevalence of experiencing ankle/foot symptoms and sleep quality, self-rated perception of the ergonomics of the desk and size of office space and frequency of feeling frustrated during the previous 4 weeks. CONCLUSIONS Results of this study indicated that several biopsychosocial factors were associated with a high prevalence of self-reported musculoskeletal symptoms in the lower extremities among office workers. Further prospective studies are required to substantiate the observed associations.