To investigate the general characteristics of video display terminal (VDT) workers with lower extremity pain, to identify the risk factors of work-related lower extremity pain, and to examine the relationship between work stress and health-related quality of life.
A questionnaire about the general characteristics of the survey group and the musculoskeletal symptom was used. A questionnaire about job stress used the Korean Occupational Stress Scale and medical outcome study 36-item Short Form Health Survey (SF-36) to assess health-related quality of life.
There were 1,711 subjects in the lower extremity group and 2,208 subjects in the control group. Age, sex, hobbies, and feeling of loading affected lower extremity pain as determined in a crossover analysis of all variables with and without lower extremity pain. There were no statistically significant difference between the two groups in terms of job stress and SF-36 values of the pain and control groups.
Job stress in VDT workers was higher than average, and the quality of life decreased as the stress increased. Factors such as younger age, women, hobbies other than exercise, and feeling of loading influenced lower extremity pain of workers. Further long-term follow-up and supplementary studies are needed to identify risk factors for future lower extremity pain, taking into account ergonomic factors such as worker's posture.
Citations
Bisphosphonates are potent inhibitors of bone resorption and considered as a gold standard and are generally recommended as first-line therapy in patients with osteoporosis. Though bisphosphonates are shown to significantly reduce the risk of vertebral, non-vertebral and hip fractures, recent reports suggest a possible correlation between long-term bisphosphonate therapy and the occurrence of insufficiency fractures owing to prolonged bone turnover suppression. We report a patient with non-traumatic stress fractures of bilateral femoral shafts related to long-term bisphosphonate therapy indicating the need for a critical evaluation of patients with long-term bisphosphonate therapy.
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Method: Rectus femoris muscles of rats were divided into 4 groups according to conditioned ischemic stresses as followings: sham-operated control group; 2 hour ischemia group by clamping the proximal femoral vessel; ischemia- reperfusion group by 30 minutes of reperfusion following 2 hours of ischemia; ischemia-reperfusion-electrical nerve stimulation group in which current was applied at the femoral nerve during 30 min of reperfusion period to induce repetitive muscle contraction. Either genistein-5% dimethyl sulfoxide (DMSO) or DMSO was injected 2 hours before ischemic induction. NF-κB activities were analysed by electrophoretic mobility shift assay.
Results: NF-κB activities pretreated with DMSO were significantly increased in ischemia, ischemia-reperfusion and ischemia-reperfusion-electrical nerve stimulation group compared with those of control group and in ischemia- reperfusion-electrical nerve stimulation group compared with those of ischemia group. Muscle edema was increased in ischemia- reperfusion-electrical nerve stimulation group. But, NF-κB activities and muscle edema pretreated with genistein were attenuated in ischemia-reperfusion-electrical nerve stimulation group compared with those pretreated with DMSO alone.
Conclusion: NF-κB activities reflect the severity of ischemic stresses. Pretreatment with genistein can attenuate NF-κB activities and muscle edema in ischemic stress of rat skeletal muscle. (J Korean Acad Rehab Med 2003; 27: 990-996)
Objective: To investigate sympathetic vasomotor response of the hands to cold and warm stress on the foot with Digital Infrared Thermal Imaging (DITI) in normal healthy subjects.
Method: Fifteen healthy subjects were participated in this study. The DITI was taken during immersing right foot in cold and warm water bath. The thermal images of the dorsal hands were captured at the starting point and then every 5-minute up to 30 minutes. The ratio of temperature between the ending point (30T) and the starting point (0T) was calculated.
Results: In cold stress test, the mean 30T/0T ratio were 92.8⁑2.4% and 92.2⁑2.7% in the right and left hands, respectively. There were no statistically significant side to
side differences. The temperature of the each hand was significantly lowered at every 5 minutes interval (p＜0.05). In warm stress test, the mean 30T/0T ratio were 104.5⁑1.8% and 104.4⁑2.0% in the right and left hands, respectively. The temperature of each hand was significantly increased at the first 5 minutes (p＜0.05), and tended to increase until 10 minutes. After then, the temperature was not significantly changed until 30 miniutes.
Conclusion: We could identify the normal sympathetic vasomotor response to the cold and warm stress with DITI. It might be served as an useful baseline data for the identification of sympathetic dysfunction. (J Korean Acad Rehab Med 2002; 26: 223-227)
Objective: To investigate the influence of psychologic factors and stress on chronic pain syndrome and predictive factors of chronic pain.
Method: The subjects were 23 patients with chronic pain. The age was ranged from 25 to 66 years with an average of 45. We measured pain with initial visual analogue scale (VAS), one-week total VAS, and tenderness threshold by pressure algometer. We evaluated the degree of depression, anxiety and disability with chronic pain and the impact of stress of major versus minor daily events. Association between degree of pain and psychologic factors was studied by regression and stress of major versus minor daily events by correlation analysis. Predictive factors for chronic pain were determined by multiple regression analysis. Association of daily fluctuation of pain severity and stress from minor life events was also studied.
Results: One-week total VAS was associated with initial VAS (r=0.601, p＜0.05). Initial VAS had association with depression and anxiety. Predictive factors for one-week total VAS were initial VAS, static anxiety, and pain disability (r=0.624, p＜0.05).
Conclusion: Depression, anxiety, pain disability from chronic pain, and stress were major influencing factors in patients with chronic pain.
Objective: To evaluate cardiopulmonary function and maximal exercise capacity in patients with ankylosing spondylitis using exercise stress test, the possible causes of reduced maximal exercise capacity and the correlation between dynamic pulmonary function and static pulmonary funtion
Method: Twenty patients with ankylosing spondylitis were evaluated with incremental exercise stress test, static pulmonary function test and the mobility of thoracic cage and spine.
Results: 1) Nineteen patients (95%) showed reduced maximal exercise capacities. 2) Deconditioning was the most frequent cause of reduced maximal exercise capacities (13 patients, 68%). 3) There was no significant correlation between exercise stress test and static pulmonary function test, and between exercise stress test and the mobility of the spine and thoracic cage.
Conclusion: Maximal exercise capacities were reduced in patients with ankylosing spondylitis, and the most frequent cause of them was deconditioning. To improve exercise capacity, conditioning exercise should be emphasized in patients with ankylosing spondylitis.
Objective: To investigate the relationship between activities of daily living (ADL) dependence and psychological parameters in the adult hemiplegic stroke patients.
Methods: The subjects were total 122 stroke patients who underwent rehabilitation therapy. Patients were surveyed with questionnaires for anxiety, stress, and depression. Cognitive functions were assessed by mini-mental status examination and their ADL functions were evaluated by modified Barthel index. The correlation between ADL function and psychological parameters was statistically analyzed by Pearson's correlation test.
Results: Results were as follows: The average stress score of stroke patients was 76.7 which was relatively high. Fourty-seven percent of stroke patients suffered from depression, and it was more frequent in the left hemiplegics. As the result of the Pearson's correlation test, ADL function is closely correlated with intrapersonal stress level, but not with the level of anxiety or depression. The cognitive function has correlation with intrapersonal stress level, but not with depression.
Conclusion: Understanding of the relationship between psychological status and ADL function in the stroke patients will be helpful to the physician for conducting efficient rehabilitation of these patients.
Objective: To know the clinical features of overuse injury in performing musicians and to evaluate related factors that may affect the overuse injury and playing related pain.
Methods: Eighty professional musicians and music college students were examined during 1 year. All were examined by a history taking, physical examination, radiologic exam and if needed electromyography. Nonparametric Sperman's correlation were used for the statistic analysis and 5 interval grading system, visual analog scale for pain, and stress, criteria of joint hypermobility were used for various measurements.
Results: Fifty four men were studied in 3 music colleges and a professional orchestra. Frequency of symptom was 46.3%. The string players were most frequently affected (65%), whereas the wind instrument players were least frequently affected (11.5%). The most commonly affected site was the hand and wrist (54.2%) followed by the spine. Patients were divided by the severity into 5 groups and among them the grade 1 was most common (29.6%). No significant correlation was seen between the practice hours per week but a significant correlation was noted between the stress and playing related pain. Joint hypermobility plays an important role in music playing which is dependent on the kind of instruments.
Conclusion: Incidence of the overuse injury in musicians is high in Korea and the prevention and early treatment are essential for the good outcome of overuse syndrome.
Purpose: To estimate the stress level and to evaluate the psychiatric symptoms in mothers of cerebral palsy (CP) children according to the clinical type and severity.
Methods: Sixty two mothers of CP children and 51 mothers of normal children (control) completed the Daily stress inventory, Schedule of recent life experience, Questionnaire on resources and stress-Friedrich and Symptom checklist-90-revision. The data were statistically analyzed.
Results: 1) Rather than the mothers of atonic CP, there were no significant differences in the stress level of every day life and events between mothers of CP children and control. 2) Mothers of CP children showed a higher level of stress related to children, and it was Mothers of statistically significant (p＜0.05) quadriplegics and/or severe CP children showed the highest stress level. 3) Mothers of quadriplegic and diplegic types with a moderate disability showed the significantly (p＜0.05) high scores in the categories of psychiatric symptoms of somatization, obsessive-compulsiveness, depression, anxiety, hostility, phobia and psychoticism, which may need therapeutic intervention.
Conclusion: It seems to be very important to determine the level of stress and psychiatric symptoms in mothers of CP children for the comprehensive rehabilitation of CP children.
Motor point block with phenol solution has the advantage of technical ease, bedside performance, and repetition as necessary in reducing spasticity. To our knowledge, however, complicating stress fracture that occur during the course of treatment after motor point block has not been described. We report the occurance of stress fracture of the head of right talus after motor point block with phenol solution. A 17-year-old boy had a gait disturbance due to excessive plantar flexion and inversion of right ankle by spasticity. Percutaneous motor point block to right tibialis posterior and right gastrocnemius was done with 7% aqueous phenol solution. Just after the block, he began to bear his weight on right heel and physical therapy including gait training was started. He complained of right ankle pain a week after resumption of weight-bearing while walking. Bone scan and magnetic resonance imaging of right ankle revealed stress fracture of talus of right foot. This case illustrated that physiatrists involved in the management of such patients should be aware that secondary stress fractures can occur.
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