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Objective: The aim of this study was to evaluate the prevalence of upper-body-quadrant pain among ultrasonographers and to evaluate the association between individual ergonomics, musculoskeletal disorders, and occurrence of neck pain. Method: A hundred and ten ( N = 110) Belgian and Dutch male and female hospital ultrasonographers were consecutively enrolled in the study. Data on work-related ergonomic and musculoskeletal disorders were collected with an electronic inquiry, including questions regarding ergonomics (position of the screen, high-low table, and ergonomic chair), symptoms (neck pain, upper-limb pain), and work-related factors (consecutive working hours a day, average working hours a week). Results: Subjects with the screen on their left had significantly more neck pain (odds ratio [OR] = 3.6, p = .0286). Depending on the workspace, high-low tables increased the chance of developing neck pain (OR = 12.9, p = .0246). A screen at eye level caused less neck pain (OR = .22, p = .0610). Employees with a fixed working space were less susceptible to arm pain (OR = 0.13, p = .0058). The prevalence of arm pain was significantly higher for the vascular department compared to radiology, urology, and gynecology departments (OR = 9.2, p = .0278). Conclusions: Regarding prevention of upper-limb pain in ultrasonograph, more attention should be paid to the work environment and more specialty to the ultrasound workstation layout. Primary ergonomic prevention could provide a painless work situation for the ultrasonographer. Application: Further research on the ergonomic conditions of ultrasonography is necessary to develop ergonomic solutions in the work environment that will help to alleviate neck and arm pain.

Background: the performances of modern fighter aircrafts imposed musculoskeletal constraints on the cervical spine of fighter pilots. We propose a neck pain survey on French fighter crew members in order to determine its prevalence and its potential contributing factors. Methods: an anonymous questionnaire was distributed in the military aeromedical centers and in the fighter squadrons from May to July 2016. Every fighter aircraft members (pilots and navigators) from the French Air Force (FAF) and Navy were invited to complete the survey. Results: 311 fighter aircraft members, mean age 36±7 years, completed the survey. 82,3% of respondents were pilots. 60.4% of fighter aircraft members reported having experienced neck pain, 63% of the FAF pilots vs 40.5% of the navy pilots. 71.7% of the fighter aircraft personnel suffering neck pain had experienced it in flight. The major factors triggering neck pain in flight were G-load exposure (59.6%), air combat maneuvers (53.7%), rotation (39.3%), checking six (32.4%) and wearing night vision goggles (31.9%). The history of neck trauma was identified as neck pain provider (p<0,01), as well as being a navigator. No relation was found between neck pain and age or total flight hours of the crew members or aircraft's type. Conclusion: we suggest recommendations particularly on practice of cervical muscle strengthening exercises. A longitudinal survey of fighter aircraft members throughout their careers must be suggested in order to evaluate the trigger's factors of neck pain. ; Objet : les avions de chasse modernes imposent des contraintes musculo-squelettiques ciblées sur le rachis cervical du personnel navigant (PN). Nous proposons une étude épidémiologique des cervicalgies chez les PN chasse afin d'en déterminer la prévalence ainsi que des facteurs favorisants potentiels. Méthodes : un questionnaire anonyme a été soumis à tous les PN chasse (pilotes et navigateurs officiers système d'arme) de l'armée de l'air (AA) et de la marine en visite au sein des centres d'expertise médicale du personnel navigant (CEMPN) ainsi que dans les escadrons de chasse entre mai et juillet 2016. Résultats : 311 PN chasse, d'âge moyen 36±7 ans, ont répondu à l'enquête. 82,3% des PN interrogés étaient des pilotes. 60,4% des PN déclaraient avoir présenté des douleurs cervicales, 63% des pilotes de l'AA contre 40,5% des pilotes de l'aéronavale. Parmi les PN souffrant de cervicalgies, 71,7% les avaient ressentis en vol. Les facteurs majeurs déclenchants des cervicalgies en vol étaient le facteur de charge (59,6%), le combat aérien (53,7%), la position en rotation (39,3%), la position « check-6 » (32,4%) et le port des jumelles de vision nocturne (31,9%). L'antécédent de traumatisme cervical constituait un facteur de risque de cervicalgies (p<0,01), de même que la fonction de navigateur. L'âge, le nombre d'heures de vols ou le type d'avion n'étaient pas significativement liés à des cervicalgies. Discussion : nous suggérons des recommandations portant notamment sur la sensibilisation au renfort musculaire du rachis. Une étude longitudinale des PN chasse sur toute leur carrière pourrait être proposée afin de mieux évaluer les facteurs de survenue des cervicalgies.

Background: the performances of modern fighter aircrafts imposed musculoskeletal constraints on the cervical spine of fighter pilots. We propose a neck pain survey on French fighter crew members in order to determine its prevalence and its potential contributing factors. Methods: an anonymous questionnaire was distributed in the military aeromedical centers and in the fighter squadrons from May to July 2016. Every fighter aircraft members (pilots and navigators) from the French Air Force (FAF) and Navy were invited to complete the survey. Results: 311 fighter aircraft members, mean age 36±7 years, completed the survey. 82,3% of respondents were pilots. 60.4% of fighter aircraft members reported having experienced neck pain, 63% of the FAF pilots vs 40.5% of the navy pilots. 71.7% of the fighter aircraft personnel suffering neck pain had experienced it in flight. The major factors triggering neck pain in flight were G-load exposure (59.6%), air combat maneuvers (53.7%), rotation (39.3%), checking six (32.4%) and wearing night vision goggles (31.9%). The history of neck trauma was identified as neck pain provider (p<0,01), as well as being a navigator. No relation was found between neck pain and age or total flight hours of the crew members or aircraft's type. Conclusion: we suggest recommendations particularly on practice of cervical muscle strengthening exercises. A longitudinal survey of fighter aircraft members throughout their careers must be suggested in order to evaluate the trigger's factors of neck pain. ; Objet : les avions de chasse modernes imposent des contraintes musculo-squelettiques ciblées sur le rachis cervical du personnel navigant (PN). Nous proposons une étude épidémiologique des cervicalgies chez les PN chasse afin d'en déterminer la prévalence ainsi que des facteurs favorisants potentiels. Méthodes : un questionnaire anonyme a été soumis à tous les PN chasse (pilotes et navigateurs officiers système d'arme) de l'armée de l'air (AA) et de la marine en visite au sein des centres d'expertise médicale du personnel navigant (CEMPN) ainsi que dans les escadrons de chasse entre mai et juillet 2016. Résultats : 311 PN chasse, d'âge moyen 36±7 ans, ont répondu à l'enquête. 82,3% des PN interrogés étaient des pilotes. 60,4% des PN déclaraient avoir présenté des douleurs cervicales, 63% des pilotes de l'AA contre 40,5% des pilotes de l'aéronavale. Parmi les PN souffrant de cervicalgies, 71,7% les avaient ressentis en vol. Les facteurs majeurs déclenchants des cervicalgies en vol étaient le facteur de charge (59,6%), le combat aérien (53,7%), la position en rotation (39,3%), la position « check-6 » (32,4%) et le port des jumelles de vision nocturne (31,9%). L'antécédent de traumatisme cervical constituait un facteur de risque de cervicalgies (p<0,01), de même que la fonction de navigateur. L'âge, le nombre d'heures de vols ou le type d'avion n'étaient pas significativement liés à des cervicalgies. Discussion : nous suggérons des recommandations portant notamment sur la sensibilisation au renfort musculaire du rachis. Une étude longitudinale des PN chasse sur toute leur carrière pourrait être proposée afin de mieux évaluer les facteurs de survenue des cervicalgies.

AbstractExperimental studies have suggested biological factors as a possible explanation for gender disparities in perception of pain. Recently, heritability of liability to neck pain (NP) has been found to be statistically significantly larger in women compared to men. However, no studies have been conducted to determine whether the sex differences in heritability of NP are due to sex-specific genetic factors. Data on lifetime prevalence of NP from a populationbased cross-sectional survey of 33,794 Danish twins were collected and age-stratified univariate biometrical modeling using sex-limitation models was performed based on 10,605 dizygotic (DZ) twins of opposite sex to estimate the qualitative sex differences. In a full sex-limitation model the genetic component in females were higher than in males, but the genetic and the shared environmental correlations were equal to what is normally assumed between same-sex DZ twins. A 'no-sex-effects' model showed the overall best model fit which confirms absence of sex-related gene interaction. The age-stratified sex-limitation models showed similar results. Thus, there is no evidence for a sex-specific genetic influence in the liability of heritability of NP.

Objective- To determine the prevalence and predictors of neck and shoulder pain in female office workers in Tromsø. Methods- A cross-sectional study was performed using population- based data from the Tromsø 6 study which was carried out between 2007 and 2008. The population under study were 619 female office workers. Information regarding individual factors, lifestyle factors and work factors were extracted. Associations between independent variables and neck and shoulder pain were investigated using logistic regression and were reported as odds ratios (OR) with 95% confidence interval. Results- The prevalence of neck pain and shoulder pain among female office workers was 21.8% and 21.6%, respectively. Three main risk factors were significantly associated with neck pain: (1) Current smoking (OR: 2.098; CI: 1.171-3.757) and former smoking (OR: 1.942; CI: 1.142-3.301), (2) employment in local government or county authorities (OR: 2.288; CI: 1.305-4.011), as well as (3) unfairly treated at work (OR: 2.169; CI:1.060-4.440). The risk factor significantly associated with shoulder pain was employment in local government or county authorities (OR:1.842; CI:1.049-3.235). Full time work was significantly, but inversely, associated with both neck pain (OR: 0.415; CI: 0.265-0.649) and shoulder pain (OR: 0.380; CI: 0.243-0.595) in our study. Conclusion- Neck pain in the studied female office workers of Tromsø was significantly associated with smoking, employment in local government/ county authorities and unfair treatment at work. Employment in local government or county authorities was a significant risk factor for pain in the shoulder region. Full-time work did not present as a risk factor for neck or shoulder pain, rather opposite.

Neck pain is a medical problem in modern military aviation. While neck exercises are recommended, clinical trials of neck motor function have been less investigated. The aims of the work presented in this thesis were to estimate potential flight-related and individual factors involved in helicopter pilots neck pain, to explore neck motor function in fighter pilots and helicopter pilots with different progression of neck pain and to evaluate the effect of an early neck/shoulder exercise intervention for neck pain in helicopter pilots. The subjects were volunteers recruited consecutively as the pilots reported to the Swedish Armed Forces Aeromedical Center for regular medical examinations (papers I and II) and from two operational air force helicopter bases in Sweden (papers III and IV). A survey estimated the prevalence of, and potential flight-related and individual risk indicators for, neck pain in helicopter pilots (paper I, N = 127). Experimental measures of neck motor function included neck extensor and flexor muscle strength, and electromyography (EMG) frequency parameters in extensors and sternocleidomastoid (SCM) muscles with the subject seated during sustained contraction against stipulated loads representing 50% of maximal strength (paper II, N = 60). EMG frequency parameters were also obtained for SCM in supine position against the weight of the head. Further, EMG activity in SCM during staged active craniocervical flexion when supine, as well as neck range of motion when seated, were assessed. Fear-avoidance beliefs about physical activity were rated (paper III, N = 72). A controlled trial evaluated a six-week, supervised, neck/shoulder exercise intervention. Intervention members and untreated controls were followed regarding the number of neck pain cases (defined as reported neck pain during the previous three months), SCM activity and rated fear-avoidance beliefs (paper IV, N = 68). The results showed the three-month prevalence of neck pain to be 57%. Previous neck pain and shoulder pain were associated risk factors, while use of helmet-mounted night-vision goggles indicated a risk. About half the neck pain cases reported that their pain occasionally interfered with flying duty and leisure, while only 25% had ever been on sick-leave related to neck pain. Experimental findings showed that fighter pilots with frequent pain had lower neck extensor strength than their pain-free controls, while no such differences were found for helicopter pilots. In seated position, EMG frequency shifts were less in SCM for helicopter pilots with frequent pain, while no significant effect emerged for helicopter pilots in supine. Helicopter pilots with acute ongoing pain as well as subacute pain had higher SCM activity during active craniocervical flexion than pain-free controls did, while the acute group, solely, had less range of motion and rated higher fear-avoidance beliefs than controls. A logistic regression entering EMG variables, range of motion and fear-avoidance suggested that SCM activity was the strongest predictor of neck pain. In the clinical trial, SCM activity at the highest contraction level of active craniocervical flexion was reduced in intervention members post-intervention while no betweengroup effect emerged for fear-avoidance beliefs. At a 12-month follow-up, the results indicated a reduction in number of neck pain cases among subjects allocated to the intervention. In conclusion, neck pain is common in air force helicopter pilots, and preventive action aiming to reduce the risk of a first neck pain episode seems important. In air force pilots, screenings of neck extensor strength and surface neck flexor activity appeared to be relevant measures of neck motor function for clinical understanding of pilots neck pain, but should be understood in the context of pilots specific exposure. A supervised neck/shoulder exercise intervention improved neck motor function to some extent and had a positive early preventive effect over a 12-month period in reducing the occurrence of neck pain in air force pilots.

In doing sewing work, a tailor will arrange the work-place and the table into the most comfortable position which is sometimes a bit low and will cause the back to bend slightly and automatically the shoulders will be lifted to feel comfortable in sewing activities. A sedentary and monotonous position will burden the neck, shoulders, arms so that fatigue / discomfort / pain in the neck and upper-back area often occurs. Neck pain is pain is felt at the top of the spine. This is a sign that the joints, muscles or other parts of the neck are injured, strained or not functioning as they should. Neck pain is also a common problem. Two out of three people will experience it in their lifetime. To determine the difference between Mc Kenzie Exercise and Neck Stabilization Exercise Interventions on reducing neck pain in tailors at Bangko Lereng Market who came to Suparno's Independent Physiotherapy Practice. This research design uses a quasi-experimental method with a pre-test and post-test two group design using a purposive sampling technique. The population in this study were 25 employees and the samples were taken from 20 employees, who tailor garments at the Lereng market with neck pain. there is an impact of Mc Kenzie Exercise on reducing neck pain. There is an impact of Neck Stabilization Exercise on reducing neck pain there is no difference between Mc Kenzie Exercise intervention and the provision of Neck Stabilization Exercise in reducing neck pain. there is an effect of giving Mc Kenzie Exercise and Neck Stabilization Exercise interventions in reducing neck pain, but there is no difference in the intervention between those two. It is hoped that the sample can perform the movements that have been taught by the researcher independently in order to reduce neck pain

[Lebois] ; Kopft. ; Volltext // Exemplar mit der Signatur: Regensburg, Staatliche Bibliothek -- 999/Hist.pol.3200(3

Medications used to manage chronic pain have documented side effects including drug dependency, drug interaction, and adverse systemic reactions. This case study used Interpretative Phenomenological Analysis to understand how one individual experienced chronic neck pain including pharmaceutical and non-pharmaceutical interventions. Convenience sampling identified Ms. P, an individual with a 10-year history of chronic pain. The research questions were: "How does one individual with chronic neck pain describe their experience living with neck pain?" and "How does one individual with chronic neck pain manage their pain?" Three super-ordinate themes emerged: pain pervades everything, finding relief, and recovery. Findings suggest that living with chronic pain is framed by both the experience of severe pain and the search for a cure. Fear, panic, and despair accompany ongoing pain. Initially, the participant's physician prescribed medications including narcotics, which are described as a slippery slope. In desperation, the participant sought alternative treatments.

Introduction: Considering the recurring nature of neck pain, and that it is a big societal as well as individual burden, it is of great importance to increase the knowledge about what factors that affect the risk and prognosis of neck pain. Objectives: The objective of this thesis was to study factors of potential importance for the risk and prognosis of neck pain, including whiplash-associated disorders (WAD). The specific objectives for study I were to assess the sex specific role of disposable income for onset and prognosis of neck pain in the general population, and if economic stress influences such potential associations. In study II the objectives were to investigate if work related physical activity and physical activity during leisure time are of importance for the risk and prognosis of neck pain. The objective of study III was to investigate if pre-treatment expectations of recovery is a prognostic factor for recovery from neck pain at seven weeks follow-up in patients seeking manual therapy treatment. And in study IV the objective was to determine if prevalent self-reported cardiovascular disorders (CVD) are associated with poor self-rated recovery in persons with WAD. Material and methods: Study I and II were based on the Stockholm Public Health Cohort (n=23 794) with information on exposures and potential confounders collected at baseline in 2002-2003. The outcome Long Duration troublesome Neck Pain (LDNP) was measured at follow-up in 2007. Those answering "yes" to the question: "During the last five-year period, have you had neck pain for at least three consecutive months that bothered you considerably?" were classified as cases. Study III was based on the Stockholm Manual INtervention Trial (n=1057), a randomized controlled trial where patients with neck pain were studied as one cohort for the objectives of this thesis. The outcome was "recovery" measured by a modified version of the Global Perceived Recovery Question at seven weeks follow-up. Study IV was based on the Saskatchewan Government Insurance cohort including individuals who made a traffic- injury claim or received health care after a traffic injury, between 1997 and 1999. Included in study IV were 6011 participants reporting WAD. The outcome "recovery" was measured at six weeks, three months, six months, nine months, and twelve months post injury by the Global Perceived Recovery Question. Results and conclusions: Having a low income yielded a higher odds of getting LDNP in both a cohort without neck pain at baseline (assessing risk) and a cohort with occasional neck pain at baseline (assessing prognosis), and among both sexes. Combining low income with perceived economic stress in the analyses indicates that income and economic stress interact in their association with LDNP. Higher levels of leisure physical activity than sedentary are protective of developing LDNP in a population free from neck pain at baseline. The prognosis for neck pain was not affected by leisure physical activity according to the results and physical activity within the work tasks was neither associated with risk nor prognosis of neck pain. The results from study III show that expectations of recovery is a prognostic factor for recovery from neck pain in a population seeking and receiving treatment. In study IV the results showed no associations between CVD and recovery from WAD among men and likely there is no association among women either as only weak associations were detected, and they are possibly subject to bias from residual confounding.

Back pain and neck pain are very common and among the most frequent causes of sick-leave and disability pension, thereby greatly affecting the individual and the community. This stresses the need for prognostic research regarding these conditions. Aim: The main aim of the present work was to study prognostic factors, including manual therapy, for back and neck pain. The specific aims were, to investigate the influence of regular leisure physical activity and the body mass index (BMI) on the recovery from persistent low back pain (Study I), to study the influence of healthy lifestyle behaviour on the prognosis of occasional low back pain (Study II), to explore the long-term effects (up to one year) of naprapathic manual therapy for patients with non-specific back and/or neck pain (Study III), and to develop a prediction model for the recovery from whiplash-associated disorders (WAD) in patients who consulted physiotherapy (Study IV). Methods: Studies I and II were based on the Stockholm Public Health Cohort, and comprised data from four questionnaire-based public-health surveys conducted between 2002 and 2010. Study I included 1836 individuals reporting persistent low back pain at baseline in 2002 and answering the follow-up in 2007, while Study II involved 8994 individuals with occasional low back pain at baseline in 2006 responding to the 2010 survey. Information on exposures and potential confounders was collected at baseline. The exposures were, regular leisure physical activity and BMI (Study I), and "healthy lifestyle behaviour", a combination of four lifestyle factors (smoking habits, alcohol consumption, leisure physical activity and consumption of fruit and vegetables) (Study II). Both Studies I and II assessed men and women separately. Study III was based on a Swedish randomized controlled trial of 409 patients with non-specific back and/or neck pain. It compared naprapathic manual therapy with evidence based support on staying active and on pain coping strategies. Questionnaires at 26 and 52 weeks provided the follow-up data. Study IV included 680 patients with WAD consulting physiotherapy, using data retrieved from the Saskatchewan Government Insurance study, Canada (1997-1999). A prediction model for recovery from WAD was developed and internally validated by assessing twenty-five possible prognostic factors, using survival analyses. Results and Conclusions: Regular leisure physical activity improved recovery from persistent low back pain among women. No such association was found among men, or between BMI and recovery regardless of sex (Study I). Healthy lifestyle behaviour decreased the risk of long duration troublesome low back pain among women with occasional low back pain. No clear association was found among men (Study II). Compared to evidence-based care, naprapathic manual therapy implied greater long-term improvement in pain and disability for patients with non-specific back and/or neck pain (Study III). The prediction model developed includes seven clinically important prognostic factors, and has acceptable predictive ability (Study IV). The conclusions in this thesis are, that lifestyle factors are of importance for the prognosis of low back pain among women, that combined manual therapy, such as naprapathy, has a long-term effect on non-specific back and/or neck pain, and that the present prediction model for recovery from WAD has acceptable predictive ability but has to be further validated to be used in clinical practice.

Non-radicular neck pain arising from local musculoskeletal structures, known as mechanical neck pain or somatic dysfunction, is highly prevalent in the fighter jet aviator population. The management of this problem includes both therapeutic and aeromedical decisions. In addition to non-steroidal anti-inflammatory medications, waiver guides recommend therapeutic exercise and manipulative therapy as treatments for somatic spine pain in aviators, and such treatments are employed in many military locations. However, there are currently no published studies that describe the use of manipulative therapy for fighter jet aviators. We report the case of an F/A-18 instructor pilot who experienced long-term relief of uncomplicated mechanical neck pain following interdisciplinary management that included manipulation and a home exercise program. Diagnostic considerations, conservative treatment options, and aeromedical concerns are discussed.

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