المؤلفون: Zhang, MaryAnn, Selzer, Faith, Losina, Elena, Collins, Jamie E., Katz, Jeffrey N.

المصدر: ACR Open Rheumatology; Sep2021, Vol. 3 Issue 9, p583-592, 10p

مصطلحات موضوعية: MUSCULOSKELETAL system diseases, TOTAL knee replacement, POSTOPERATIVE care, RANDOMIZED controlled trials, DISEASE incidence, OSTEOARTHRITIS treatment

مستخلص: Objective: To examine impact of pre‐existing and incident problematic musculoskeletal (MSK) areas after total knee replacement (TKR) on postoperative 60‐month Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain/function scores. Methods: Using data from a randomized controlled trial of subjects undergoing TKR for osteoarthritis, we assessed problematic MSK areas in six body regions before TKR and 12, 24, 36, and 48 months after TKR. We defined the following two variables: 1) density count (number of problematic MSK areas occurring after TKR; range 0‐24) and 2) cumulative density count (problematic MSK areas both before and after TKR, categorized into four levels: no preoperative areas and density count of 0‐1 [reference group]; no preoperative areas and density count of 2 or more; one or more preoperative areas and density count of 0‐1; and one or more preoperative areas and density count of 2 or greater). We evaluated the associations between categorized 60‐month WOMAC and cumulative density count by ordinal logistic regression. Results: Among 230 subjects, 24% reported one or more preoperative problematic MSK area. After TKR, 75% reported a density count of 0 to 1; 25% reported a density count of 2 or more. Compared with the reference group, each cumulative density count category was associated with an increased odds of having a higher category of 60‐month WOMAC pain score, as follows: 2.97 (95% confidence interval [CI], 1.48‐5.98) for no preoperative problematic areas and density count of 2 or greater, 3.31 (95% CI, 1.64‐6.66) for one or more preoperative problematic areas and density count of 0 to 1, and 2.85 (95% CI, 0.97‐8.39) for one or more preoperative problematic areas and density count of 2 or greater. Similar associations were observed with 60‐month WOMAC function score. Conclusion: In TKR recipients, the presence of problematic musculoskeletal areas beyond the index knee—preoperatively and/or postoperatively—was associated with worse 60‐month WOMAC pain/function score. [ABSTRACT FROM AUTHOR]

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المؤلفون: Alves, Kristin, Penny, Norgrove, Kobusingye, Olive, Olupot, Robert, Katz, Jeffrey N., Sabatini, Coleen S.

المصدر: International Orthopaedics; Aug2018, Vol. 42 Issue 8, p1967-1973, 7p

مصطلحات موضوعية: MUSCULOSKELETAL system diseases, CHILDREN'S health, KNEE injury treatment, CLINICAL trials, QUADRICEPS muscle

مستخلص: Purpose: The purpose of this study is to estimate the burden of musculoskeletal disease among children treated in Kumi District, Uganda, to inform training, capacity-building efforts, and resource allocation.Methods: We conducted a retrospective cohort study by reviewing the musculoskeletal (MSK) clinic and community outreach logs for children (age < 18 years) seen at Kumi Hospital in Kumi, Uganda, between January 2013 and December 2015. For each patient, we recorded the age, sex, diagnosis, and treatment recommendation.Results: Of the 4852 children, the most common diagnoses were gluteal and quadriceps contractures (29.4% (95% CI 28.1-30.7%), 96% of which were gluteal fibrosis), post-injection paralysis (12.7% (95% CI 11.8-13.6%)), infection (10.5% (95% CI 9.7-11.4%)), trauma (6.9% (95% CI 6.2-7.6%)), cerebral palsy (6.9% (95% CI 6.2-7.7%)), and clubfoot (4.3% (95% CI 3.8-4.9%)). Gluteal fibrosis, musculoskeletal infections, and angular knee deformities create a large surgical burden with 88.1%, 59.1%, and 54.1% of patients seen with these diagnoses referred for surgery, respectively. Post-injection paralysis, clubfoot, and cerebral palsy were treated non-operatively in over 75% of cases.Conclusion: While population-based estimates of disease burden and resource utilization are needed, this data offers insight into burden of musculoskeletal disease for this region of Sub-Saharan Africa. We estimate that 50% of the surgical conditions could be prevented with policy changes and education regarding injection practices and early care for traumatic injuries, clubfeet, and infection. This study highlights a need to increase capacity to care for specific musculoskeletal conditions, including gluteal fibrosis, post-injection paralysis, infection, and trauma in the paediatric population of Uganda. [ABSTRACT FROM AUTHOR]

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المؤلفون: Jain, Nitin B., Higgins, Laurence D., Losina, Elena, Collins, Jamie, Blazar, Philip E., Katz, Jeffrey N.

المصدر: BMC Musculoskeletal Disorders; 2014, Vol. 15 Issue 1, p1-15, 15p, 3 Charts, 1 Graph

مصطلحات موضوعية: AMBULATORY surgery, MUSCULOSKELETAL system diseases, ROTATOR cuff surgery, ARTHROSCOPY, PERIARTHRITIS, BURSITIS, ARTICULAR cartilage

مستخلص: Background Musculoskeletal disorders of the upper extremity are common reasons for patients to seek care and undergo ambulatory. The objective of our study was to assess the overall and ageadjusted utilization rates of rotator cuff repair, shoulder arthroscopy performed for indications other than rotator cuff repair, carpal tunnel release, and wrist arthroscopy performed for indications other than carpal tunnel release in the United States. We also compared demographics, indications, and operating room time for these procedures. Methods We used the 2006 National Survey of Ambulatory Surgery to estimate the number of procedures of interest performed in the United States in 2006. We combined these data with population size estimates from the 2006 U.S. Census Bureau to calculate rates per 10,000 persons. Results An estimated 272,148 (95% confidence intervals (CI) = 218,994, 325,302) rotator cuff repairs, 257,541 (95% CI = 185,268, 329,814) shoulder arthroscopies excluding those for cuff repairs, 576,924 (95% CI = 459,239, 694,609) carpal tunnel releases, and 25,250 (95% CI = 17,304, 33,196) wrist arthroscopies excluding those for carpal tunnel release were performed. Overall, carpal tunnel release had the highest utilization rate (37.3 per 10,000 persons in persons of age 45–64 years; 38.7 per 10,000 persons in 65–74 year olds, and; 44.2 per 10,000 persons in the age-group 75 years and older). Among those undergoing rotator cuff repairs, those in the age-group 65–74 had the highest utilization (28.3 per 10,000 persons). The most common indications for non-cuff repair related shoulder arthroscopy were impingement syndrome, periarthritis, bursitis, and instability/SLAP tears. Non-carpal tunnel release related wrist arthroscopy was most commonly performed for ligament sprains and diagnostic arthroscopies for pain and articular cartilage disorders. Conclusions Our data shows substantial age and demographic differences in the utilization of these commonly performed upper extremity ambulatory procedures. While over one million upper extremity procedures of interest were performed, evidence-based clinical indications for these procedures remain poorly defined. [ABSTRACT FROM AUTHOR]

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المؤلفون: Katz, Jeffrey N.^1,2,3,4,5 jnkatz@partners.org, Lyons, Nancy⁶, Wolff, Lisa S.⁶, Silverman, Jodie⁶, Emrani, Parastu¹, Holt, Holly L.¹, Corbett, Kelly L.¹, Escalante, Agustin⁷, Losina, Elena^1,2,3,4,8

المصدر: BMC Musculoskeletal Disorders. 2011, Vol. 12 Issue 1, p78-85. 8p.

مصطلحات موضوعية: *MUSCULOSKELETAL system diseases, *BACKACHE, *HEALTH facilities, *HEALTH education, *DISEASE management

مستخلص: Background: Musculoskeletal disorders affect all racial and ethnic groups, including Hispanics. Because these disorders are not life-threatening, decision-making is generally preference-based. Little is known about whether Hispanics in the U.S. differ from non-Hispanic Whites with respect to key decision making preferences. Methods: We assembled six focus groups of Hispanic and non-Hispanic White patients with chronic back or knee pain at an urban medical center to discuss management of their conditions and the roles they preferred in medical decision-making. Hispanic groups were further stratified by socioeconomic status, using neighborhood characteristics as proxy measures. Discussions were led by a moderator, taped, transcribed and analyzed using a grounded theory approach. Results: The analysis revealed ethnic differences in several areas pertinent to medical decision-making. Specifically, Hispanic participants were more likely to permit their physician to take the predominant role in making health decisions. Also, Hispanics of lower socioeconomic status generally preferred to use non-internet sources of health information to make medical decisions and to rely on advice obtained by word of mouth. Hispanics emphasized the role of faith and religion in coping with musculoskeletal disability. The analysis also revealed broad areas of concordance across ethnic strata including the primary role that pain and achieving pain relief play in patients' experiences and decisions. Conclusions: These findings suggest differences between Hispanics and non-Hispanic Whites in preferred information sources and decision-making roles. These findings are hypothesis-generating. If confirmed in further research, they may inform the development of interventions to enhance preference-based decision-making among Hispanics. [ABSTRACT FROM AUTHOR]

المؤلفون: Menéndez, Cammie Chaumont, Amick III, Benjamin C., Chang, Che-Hsu (Joe), Dennerlein, Jack T., Harrist, Ronald B., Jenkins, Mark, Robertson, Michelle, Katz, Jeffrey N.

المصدر: Work; 2009, Vol. 34 Issue 4, p401-408, 8p, 2 Charts

مصطلحات موضوعية: MUSCULOSKELETAL system diseases, EPIDEMIOLOGY, HEALTH of college students, UNDERGRADUATES, PUBLIC health

مستخلص: Objective: The study examines temporal variations in upper-extremity musculoskeletal symptoms throughout the day, over a week and throughout the semester. Methods: 30 undergraduates were followed in a repeated measures study throughout a semester. Upper extremity musculoskeletal symptoms data were collected on handheld computers randomly throughout the day for seven days over three data collection periods. Multilevel statistical models evaluated associations between time-related predictors and symptoms. Results: In adjusted models, pain reported at baseline was associated with increased odds of experiencing both any symptoms (OR=15.64; 90% CI 7.22–33.88) and moderate or greater symptoms (OR=16.44; 90% CI 4.57–29.99). Any symptoms were less likely to be reported if responses occurred at 58–76 days (OR=0.66; 90% CI 0.49–0.86), 77–90 days (OR=0.29; 90% CI 0.20–0.42) and 91–117 days (OR=0.54; 90% CI 0.39–0.75) into the semester compared to 35–57 days. Similarly, responding after midnight was associated with greater odds of reporting moderate or greater symptoms (OR=21.33; 90% CI 6.49–65.97). There was no association observed for day of week and symptoms. Conclusion: This pilot work suggests upper extremity musculoskeletal symptoms exhibit temporal variations related to time of day and days into semester. Understanding the natural history of musculoskeletal symptoms and disorders is needed when designing epidemiologic research and/or intervention studies using symptom outcome measures. [ABSTRACT FROM AUTHOR]

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المؤلفون: Chang, Che-Hsu, Johnson, Peter W., Katz, Jeffrey N., Eisen, Ellen A., Dennerlein, Jack T., Joe Chang, Che-Hsu

المصدر: European Journal of Applied Physiology; Jan2009, Vol. 105 Issue 1, p93-101, 9p, 1 Diagram, 1 Chart, 5 Graphs

مصطلحات موضوعية: ISOMETRIC exercise, MUSCLE physiology, FINGERS, ELECTRIC stimulation, MUSCULOSKELETAL system diseases, TYPISTS, PSYCHOLOGY, PHYSIOLOGY, FINGER physiology, COMPARATIVE studies, ELECTROMYOGRAPHY, KINEMATICS, RESEARCH methodology, MEDICAL cooperation, MUSCLE contraction, RESEARCH, TECHNOLOGY, EVALUATION research, BODY movement

مستخلص: A repeated-measures laboratory experiment tested whether keystroke duration during touch-typing changes after a finger performs submaximal isometric flexion exercises. Fourteen right-handed touch-typists used right ring finger to perform three 15-min exercise conditions, two isometric exercises and a no-force condition, each on a separate day. Before and after each exercise condition, typing keystroke duration and isometric force elicited by electrical stimulation were measured for right ring finger. Keystroke duration of right ring finger decreased by 5% (6 ms, P < 0.05) immediately after the exercises but not after the no-force condition. Peak isometric finger force elicited by electrical stimulation decreased by 17-26% (P < 0.05) for the flexor digitorum superficialis and decreased by 4-8% for the extensor digitorum communis after the isometric exercises. After the finger was exposed to isometric exercises, changes in typing keystroke duration coincided with changes in the physiological state of the finger flexor and extensor muscles. [ABSTRACT FROM AUTHOR]

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المؤلفون: Wasan, Ajay D., Jamison, Robert N., Pham, Loc, Tipirneni, Naveen, Nedeljkovic, Srdjan S., Katz, Jeffrey N.

المصدر: BMC Musculoskeletal Disorders; 2009, Vol. 10, Special section p1-9, 9p, 1 Chart, 3 Graphs

مصطلحات موضوعية: PATHOLOGICAL psychology, COMORBIDITY, LUMBAR pain, NECK pain, CERVICAL vertebrae, MUSCULOSKELETAL system diseases

مستخلص: Background: Comorbid psychopathology is an important predictor of poor outcome for many types of treatments for back or neck pain. But it is unknown if this applies to the results of medial branch blocks (MBBs) for chronic low back or neck pain, which involves injecting the medial branch of the dorsal ramus nerves that innervate the facet joints. The objective of this study was to determine whether high levels of psychopathology are predictive of pain relief after MBB injections in the lumbar or cervical spine. Methods: This was a prospective cohort study. Consecutive patients in a pain medicine practice undergoing MBBs of the lumbar or cervical facets with corticosteroids were recruited to participate. Subjects were selected for a MBB based on operationalized selection criteria and the procedure was performed in a standardized manner. Subjects completed the Brief Pain Inventory (BPI) and the Hospital Anxiety and Depression Scale (HADS) just prior to the procedure and at one-month follow up. Scores on the HADS classified the subjects into three groups based on psychiatric symptoms, which formed the primary predictor variable: Low, Moderate, or High levels of psychopathology. The primary outcome measure was the percent improvement in average daily pain rating onemonth following an injection. Analysis of variance and chi-square were used to analyze the analgesia and functional rating differences between groups, and to perform a responder analysis. Results: Eighty six (86) subjects completed the study. The Low psychopathology group (n = 37) reported a mean of 23% improvement in pain at one-month while the High psychopathology group (n = 29) reported a mean worsening of -5.8% in pain (p < .001). Forty five percent (45%) of the Low group had at least 30% improvement in pain versus 10% in the High group (p < .001). Using an analysis of covariance, no baseline demographic, social, or medical variables were significant predictors of pain improvement, nor did they mitigate the effect of psychopathology on the outcome. Conclusion: Psychiatric comorbidity is associated with diminished pain relief after a MBB injection performed with steroid at one-month follow-up. These findings illustrate the importance of assessing comorbid psychopathology as part of a spine care evaluation. [ABSTRACT FROM AUTHOR]

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المؤلفون: Menéndez, Cammie Chaumont, Amick III, Benjamin C., Che-Hsu (Joe) Chang, Dennerlein, Jack T., Harrist, Ronald B., Jenkins, Mark, Robertson, Michelle, Katz, Jeffrey N.

المصدر: Journal of Occupational Rehabilitation; Jun2008, Vol. 18 Issue 2, p166-174, 9p, 2 Charts

مصطلحات موضوعية: COLLEGE students, MUSCULOSKELETAL system diseases, ARM diseases, COMPUTER users, SYMPTOMS

مستخلص: Introduction Over half of surveyed college students are experiencing pain they are attributing to computer use. The study objective was to evaluate the effect of computing patterns on upper extremity musculoskeletal symptoms. Methods Symptom experiences and computing/break patterns were reported several times daily over three weeks for 30 undergraduate students over a semester. Two-level logistic regression models described the daily association between each computing pattern and both any and moderate or greater symptom experienced, adjusting for covariates. Results The associations between most computing/break patterns and experiencing any symptoms were positive: total hours of computer use adjOR = 1.1 (90% CI 1.1–1.2), 1–2 breaks versus none adjOR = 1.3 (90% CI 0.9–1.9), 3–6 breaks versus none adjOR = 1.5 (90% CI 1.1–2.2), >15 min break versus none adjOR = 1.6 (90% CI 1.1–2.2), and number of stretch breaks adjOR = 1.3 (90% CI 1.1–1.5). However, breaks for less than 15 min were negatively associated with experiencing any symptoms: adjOR = 0.6 (90% CI 0.5–0.9). The associations between most computing/break patterns and experiencing moderate or greater symptoms were positive: total hours of computer use OR = 1.1 (90% CI 1.1–1.2), 1–2 breaks and 5–6 breaks versus none OR = 1.8 (90% CI 1.1–2.9), 7–8 breaks versus none OR = 2.0 (1.0–4.2), >15 min break versus none 1.8 (1.1–3.1), and number of stretch breaks OR = 1.3 (1.0–1.5). Conclusion Computing/break patterns were consistently associated with experiencing symptoms. Our findings suggest evaluating breaks with computing duration (computing patterns) is more informative than assessing computing duration alone and can be used to better design ergonomic training programs for student populations that incorporate break times. [ABSTRACT FROM AUTHOR]

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المؤلفون: Menéndez, Cammie Chaumont, Amick III, Benjamin C., Jenkins, Mark, Janowitz, Ira, Rempel, David M., Robertson, Michelle, Dennerlein, Jack T., Che-Hsu (Joe) Chang, Katz, Jeffrey N.

المصدر: Work; 2007, Vol. 28 Issue 4, p287-297, 11p, 9 Charts

مصطلحات موضوعية: COLLEGE students, COMPUTER users, MUSCULOSKELETAL system diseases, POSTURE, STUDENTS, EPIDEMIOLOGY

مستخلص: Purpose: To characterize undergraduate computer use using different data collection methods, emphasizing computing-related postures, use patterns and upper extremity musculoskeletal symptoms. Subjects and methods: In Spring, 2004, undergraduate students from a single dormitory at a private university agreed to complete a College Computing & Health Survey. For three separate data collection periods each lasting a week, we observed postures during computer once per period and continuously measured computer input device usage. During these three periods, students self-reported computer usage and symptoms 3–5 times daily. Results: Thirty students participated and all completed the study. Eighty-six percent reported ever experiencing symptoms after computer work. There were no time-related trends across data collection periods for posture, symptoms, and computing activities and patterns. Typed work and communicating (when compared with playing games) were usually the predominant computing activities throughout the semester. There was significantly greater self-reported computer use than that directly measured (p<0.05). Conclusion: This is the first study that utilized several methods of exposure assessment to describe computing postures, use patterns and upper extremity musculoskeletal symptoms among a college student cohort. Epidemiological studies need to explore time-related changes such as time of day, weekday, and days into the semester to further understand symptoms, posture, and computer use changes. [ABSTRACT FROM AUTHOR]

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المؤلفون: Gold, Judith E., Punnett, Laura, Katz, Jeffrey N.

المصدر: International Archives of Occupational & Environmental Health; Mar2006, Vol. 79 Issue 2, p128-134, 7p

مصطلحات موضوعية: INDUSTRIAL hygiene, AUTOMOBILE industry, MUSCULOSKELETAL system diseases, PAIN, ARM, OCCUPATIONAL diseases, MANUFACTURING industries, MUSCLES, TENDONS

مستخلص: Objectives: Reduced pressure pain thresholds (PPTs) have been reported in occupational groups with symptoms of upper extremity musculoskeletal disorders (UEMSDs). The purpose of this study was to determine whether automobile manufacturing workers ( n=460) with signs and symptoms of UEMSDs had reduced PPTs (greater sensitivity to pain through pressure applied to the skin) when compared with unaffected members of the cohort, which served as the reference group. The association of PPTs with symptom severity and localization of PE findings was investigated, as was the hypothesis that reduced thresholds would be found on the affected side in those with unilateral physical examination (PE) findings. Methods: PPTs were measured during the workday at 12 upper extremity sites. A PE for signs of UEMSDs and symptom questionnaire was administered. After comparison of potential covariates using t tests, linear regression multivariable models were constructed with the average of 12 sites (avgPPT) as the outcome. Results: Subjects with PE findings and/or symptoms had a statistically significant lower avgPPT than non-cases. AvgPPT was reduced in those with more widespread PE findings and in those with greater symptom severity (test for trend, P≤0.05). No difference between side-specific avgPPT was found in those with unilateral PE findings. Reduced PPTs were associated with female gender, increasing age, and grip strength below the gender-adjusted mean. After adjusting for the above confounders, avgPPT was associated with muscle/tendon PE findings and symptom severity in multivariable models. Conclusions: PPTs were associated with signs and symptoms of UEMSDs, after adjusting for gender, age and grip strength. The utility of this noninvasive testing modality should be assessed on the basis of prospective large cohort studies to determine if low PPTs are predictive of UEMSDs in asymptomatic individuals or of progression and spread of UEMSDs from localized to more diffuse disorders. [ABSTRACT FROM AUTHOR]

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