Burden of shoulder and/neck pain among school teachers in Ethiopia.
ABSTRACT: BACKGROUND:Shoulder and neck pain are reported as the most common occupational-related health problem and cause of morbidity, absenteeism from work among school teachers worldwide. School teachers represent an occupational group, who are exposed and appears to have prevalent shoulder and/or neck pain due to their daily work tasks and the nature of work. There is a scant epidemiological study regarding shoulder and neck pain among school teachers in Ethiopia. Therefore, this study was set out to assess the prevalence and associated factors of shoulder and/or neck pain among school teachers of Gondar town in North West Ethiopia. METHOD:An institutional based cross-sectional study was conducted from December 2016 to January 2017, a structured questionnaire adapted from the Nordic musculoskeletal questionnaire was distributed to 848 primary and secondary school teachers in Gondar town, Northwest Ethiopia. To assess the burden of shoulder and/neck pain, data were collected using a self-administered questionnaire and physical measures like height and weight were also measured during data collection. Independent variables which had significant association were identified using logistic regression model. RESULT:A total of 754 teachers participated, with a mean age of 42?±?9.73?years (88.9% response rate). Previous 12?months self-reported prevalence of shoulder and/ neck pain among school teachers was 57.3% with 95%CI (53.4-61.0%). Regular physical exercise (OR?=?0.18, 95% CI: 0.08-0.42), teaching experience (OR?=?2.85, 95% CI: 1.09-7.42), static head down posture (OR?=?2.26, 95% CI: 1.55-3.33), elevated arm over shoulder (OR?=?2.71, 95% CI: 1.86-3.95), prolonged sitting (OR?=?1.50,95% CI: 1.02-2.23) and hypertension (OR?=?2.18, 95% CI: 1.24-3.82) were factors found to be significantly associated with shoulder and/neck pain. CONCLUSION AND RECOMMENDATION:More than half of the study participants self-reported to have suffered shoulder and neck pain in the previous 12?months. Teaching experience, static head down posture, elevated arm over shoulder, and hypertension are likely to be significantly associated with shoulder and/ neck pain among school teachers in Ethiopia. Engaging in regular physical exercise has a protective effect against the shoulder and/or neck pain. Therefore, school authorities are recommended to provide facilities to enhance physical activity among school teachers and also provide adjustable board and classroom materials.
Project description:<h4>Objective</h4>To assess the association between effort-reward imbalance (ERI) and health indicators among Bolivian school teachers.<h4>Design</h4>School-based cross-sectional study.<h4>Setting</h4>Sixty randomly selected schools from rural (33) and urban (27) schools in Chuquisaca, Bolivia.<h4>Participants</h4>A total of 1062 school teachers were invited to participate, of which 597 answered the questionnaire (response 56.2%).<h4>Exposure measure</h4>Psychosocial factors at work were explored through the short version of the Effort-Reward Questionnaire.<h4>Primary and secondary outcome measures</h4>Health outcomes included self-rated overall health, mental distress (12-item General Health Questionnaire ?5) and the 7-day prevalence of low back pain (LBP) as well as neck or shoulder pain (Nordic Questionnaire). Crude and adjusted ORs and their 95% CIs for each health outcome were calculated using logistic regression models.<h4>Results</h4>The median value for the effort-reward ratio was 0.91 (range: 0.3-2.3) with higher values for teachers from rural versus urban schools. Overall, about 43% of the teachers reported their overall health as fair or poor; 45% suffered mental distress, 17% reported LBP and 29% neck or shoulder pain. Prevalences were higher for teachers employed at rural schools compared with those at urban schools. After adjusting for potential confounders and school location, ERI was statistically significantly associated with fair/poor self-rated health (adjusted OR 1.7, 95% CI 1.0 to 2.9); mental distress (1.9; 95% CI 1.2 to 3.1) and LBP (2.3; 95% CI 1.3 to 4.1).<h4>Conclusion</h4>Our results indicate the urgent need to improve psychosocial working conditions among Bolivian school teachers, in order to promote their health and well-being.
Project description:Background:This study investigated the relationship between verbal aggression against school teachers and upper extremity (neck, shoulder, upper limb, and/or upper back) musculoskeletal pain. Methods:This was a cross-sectional study of 525 elementary school teachers from Jaboatão dos Guararapes, Northeast Brazil. Results:The prevalence of upper extremity musculoskeletal pain among teachers who reported verbal aggression in the past six months (67.7%) was higher than that among those who did not report verbal aggression (51.7%): (prevalence ratio = 1.21; 95% confidence interval = 1.04-1.40). The prevalence of upper extremity musculoskeletal pain was associated with verbal aggression, sex, and common mental disorders, controlled by skin color, age, monthly income, teachers' education, years working as a teacher, workload, and obesity. Furthermore, the measure of the association between verbal aggression and upper extremity musculoskeletal pain was modified by sex and common mental disorders, considered altogether. Teachers who suffered verbal aggression, of the feminine sex, and also having common mental disorders reported high prevalence (85.4%) of upper extremity musculoskeletal pain. Conclusion:The association between verbal violence in the school and complaints of upper extremity musculoskeletal pain was strong and modified by teachers' sex and common mental disorders.
Project description:AIMS: To investigate the longitudinal relation between physical capacity (isokinetic lifting strength, static endurance of the back, neck, and shoulder muscles, and mobility of the spine) and low back, neck, and shoulder pain. METHODS: In this prospective cohort study, 1789 Dutch workers participated. At baseline, isokinetic lifting strength, static endurance of the back, neck, and shoulder muscles, and mobility of the spine were measured in the pain free workers, as well as potential confounders, including physical workload. Low back, neck, and shoulder pain were self-reported annually at baseline and three times during follow up. RESULTS: After adjustment for confounders, Poisson generalised estimation equations showed an increased risk of low back pain among workers in the lowest sex specific tertile of performance in the static back endurance tests compared to workers in the reference category (RR = 1.42; 95% CI 1.19 to 1.71), but this was not found for isokinetic trunk lifting strength or mobility of the spine. An increased risk of neck pain was shown for workers with low performance in tests of isokinetic neck/shoulder lifting strength (RR = 1.31; 95% CI 1.03 to 1.67) and static neck endurance (RR = 1.22; 95% CI 1.00 to 1.49). Among workers in the lowest tertiles of isokinetic neck/shoulder lifting strength or endurance of the shoulder muscles, no increased risk of shoulder pain was found. CONCLUSIONS: The findings of this study suggest that low back or neck endurance were independent predictors of low back or neck pain, respectively, and that low lifting neck/shoulder strength was an independent predictor of neck pain. No association was found between lifting trunk strength, or mobility of the spine and the risk of low back pain, nor between lifting neck/shoulder strength or endurance of the shoulder muscles and the risk of shoulder pain.
Project description:Although leisure-time physical activity is important for health, adherence to regular exercise is challenging for many adults. The workplace may provide an optimal setting to reach a large proportion of the adult population needing regular physical exercise. This study evaluates the effect of implementing strength training at the workplace on non-specific neck and shoulder pain among industrial workers.Cluster-randomized controlled trial involving 537 adults from occupations with high prevalence of neck and shoulder pain (industrial production units). Participants were randomized to 20 weeks of high-intensity strength training for the neck and shoulders three times a week (n = 282) or a control group receiving advice to stay physically active (n = 255). The strength training program followed principles of progressive overload and periodization. The primary outcome was changes in self-reported neck and shoulder pain intensity (scale 0-9).85% of the participants followed the strength training program on a weekly basis. In the training group compared with the control group, neck pain intensity decreased significantly (-0.6, 95% CI -1.0 to -0.1) and shoulder pain intensity tended to decrease (-0.2, 95% CI -0.5 to 0.1, P = 0.07). For pain-cases at baseline (pain intensity > = 3) the odds ratio - in the training group compared with the control group--for being a non-case at follow-up (pain intensity < 3) was 2.0 (95% CI 1.0 to 4.2) for the neck and 3.9 (95% CI 1.7 to 9.4) for the shoulders.High-intensity strength training relying on principles of progressive overload can be successfully implemented at industrial workplaces, and results in significant reductions of neck and shoulder pain.NCT01071980.
Project description:Refractive error is an important cause of correctable visual impairment in the worldwide with a global distribution of 1.75% to 20.7% among schoolchildren. Teacher's knowledge about refractive error play an important role in encouraging students to seek treatment that helps in reducing the burden of visual impairment.To determine knowledge, attitude and associated factors among primary school teachers regarding refractive error in school children in Gondar city.Institution based cross-sectional study was conducted on 565 primary school teachers in Gondar city using pretested and structured self-administered questionnaire. For processing and analysis, SPSS version 20 was used and variables which had a P value of <0.05 in the multivariable analysis were considered as statistically significant.A total of 565 study subjects were participated in this study with a mean age of 42.05 ± 12.01 years. Of these study participants 55.9% (95% CI: 51.9, 59.8) had good knowledge and 57.2% (95% CI: 52.9, 61.4) had favorable attitude towards refractive error. History of spectacle use [AOR = 2.13 (95% CI: 1.32, 3.43)], history of eye examination [AOR = 1.67 (95% CI: 1.19, 2.34)], training on eye health [AOR = 1.94 (95% CI; 1.09, 3.43)] and 11-20 years of experience [AOR = 2.53 (95% CI: 1.18, 5.43)] were positively associated with knowledge. Whereas being male [AOR = 2.03 (95% CI: 1.37, 3.01)], older age [AOR = 3.05 (95% CI: 1.07, 8.72)], 31-40 years of experience [AOR = 0.23 (95% CI: 0.07, 0.72)], private school type [AOR = 1.76 (95% CI: 1.06, 2.93)] and 5th -8th teaching category [AOR = 1.54 (95% CI: 1.05, 2.24)] were associated with attitude.Knowledge and attitude of study subjects were low which needs training of teachers about the refractive error.
Project description:BACKGROUND:Pelvic girdle pain (PGP) is a commonly reported maternal morbidity that negatively impacts the well-being of women during pregnancy and extends long term into the post-partum period. The burden of maternal morbidity; including pregnancy-related PGP; has been overlooked in Ethiopia to date. This study aimed to determine the prevalence and identify factors associated with pelvic girdle pain during pregnancy in North West Ethiopia. METHODS:A hospital-based cross-sectional study was conducted among pregnant women visiting the antenatal care clinic in Obstetrics 'outpatient department at the University of Gondar comprehensive specialized hospital in Gondar. Data were collected by interview method using structured questionnaires, patient medical record reviews, and physical measurements. Univariate and multivariable logistic regression model analyses were used to identify factors associated with PGP. RESULTS:A total of 424 participants with gestational ages ranging from 6 to 39?weeks participated in this study. The age of the study participants ranged from 18 to 44?years with a mean age of (27?±?4.6?years). The overall cumulative prevalence of pelvic girdle pain among pregnant women was 103 (24.3%),95% CI (20.3, 28.8). The major associated factors with pelvic girdle pain were previous history of pelvic girdle pain (AOR 16.08; 95% CI, 8.47-30.51), previous history of back pain (AOR 1.66; 95% CI, 1.5-4.24) and having children (AOR 1.42; 95% CI, 1.29-3.76). CONCLUSION:One-quarter of pregnant Ethiopian women reported pelvic girdle pain. PGP must be considered as major pregnancy-related morbidity, and progress in the intervention of PGP is vital to enhance the quality of life in this population.
Project description:Noninvasive physical management is often prescribed for headache and neck pain. Systematic reviews, however, indicate that the evidence of its efficacy is limited. Our aim was to evaluate the effectiveness of a workplace educational and physical program in reducing headache and neck/shoulder pain.Cluster-randomized controlled trial. All municipal workers of the City of Turin, Italy, were invited to participate. Those who agreed were randomly assigned, according to their departments, to the intervention group (IG) or to the control group and were given diaries for the daily recording of pain episodes for 1 month (baseline). Subsequently, only the IG (119 departments, 923 workers) began the physical and educational program, whereas the control group (117 departments, 990 workers) did not receive any intervention. All participants were again given diaries for the daily recording of pain episodes after 6 months of intervention. The primary outcome was the change in the frequency of headache (expressed as the proportion of subjects with a ?50% reduction of frequency; responder rate); among the secondary outcomes there were the absolute reduction of the number of days per month with headache and neck/shoulder pain. Differences between the two groups were evaluated using mixed-effect regression models. The IG showed a higher responder rate [risk ratio, 95% confidence interval (CI)] for headache (1.58; 1.28 to 1.92) and for neck/shoulder pain (1.53; 1.27 to 1.82), and a larger reduction of the days per month (95% CI) with headache (-1.72; -2.40 to -1.04) and with neck/shoulder pain (-2.51; -3.56 to -1.47).The program effectively reduced headache and neck/shoulder pain in a large working community and appears to be easily transferable to primary-care settings. Further trials are needed to investigate the program effectiveness in a clinical setting, for highly selected patients suffering from specific headache types.ClinicalTrials.gov NCT00551980.
Project description:OBJECTIVE:We conducted a cross-sectional study to assess perceived work-related stress and associated factors among public secondary school teachers in Gondar city, northwest Ethiopia. A self-completed questionnaire was used for data collection. Data was entered into Epi-info version 7.1 and analyzed by SPSS version 20 software. The associations between dependent and independent variables were assessed using a multivariate binary logistic regression analysis based on the adjusted odds ratio (AOR) with 95% confidence intervals (CI) and p values?<?0.05. RESULTS:The response rate was 96.4%. The overall prevalence of perceived work-related stress was 58.2%. Teaching experience <?5 years (AOR 2.03, 95% CI (1.10, 3.73), education level BSC/BED (AOR 1.66, 95% CI (1.07, 3.17), high job demand (AOR 1.61, 95% CI (1.29, 3.74), and poor relationships (AOR 1.88, 95% CI (1.07, 3.31) were significantly associated with work-related stress. In conclusion, the findings showed a high proportion of stress among participants. Therefore, we suggested a need to take action to balance job demand and teaching experience, offering the opportunity to upgrade their educational level and establish good relationships to ease the burden of stress factors related to work.
Project description:OBJECTIVE:To evaluate the effectiveness of exercise, ergonomic modification, and a combination of training exercise and ergonomic modification on the scores of pain in office workers with neck, shoulders, and lower back pain. METHODS:Participants (N=142) in this randomized controlled trial were office workers aged 20-50 years old with neck, shoulders, and lower back pain. They were randomly assigned to either the ergonomic modification group, the exercise group, the combined exercise and ergonomic modification group, or the control group (no-treatment). The exercise training group performed a series of stretching exercises, while the ergonomic group received some modification in the working place. Outcome measures were assessed by the Cornell Musculoskeletal Disorders Questionnaire at baseline, after 2, 4, and 6 months of intervention. RESULTS:There was significant differences in pain scores for neck (MD -10.55; 95%CI -14.36 to -6.74), right shoulder (MD -12.17; 95%CI -16.87 to -7.47), left shoulder (MD -11.1; 95%CI -15.1 to -7.09) and lower back (MD -7.8; 95%CI -11.08 to -4.53) between the exercise and control groups. Also, significant differences were seen in pain scores for neck (MD -9.99; 95%CI -13.63 to -6.36), right shoulder (MD -11.12; 95%CI -15.59 to -6.65), left shoulder (MD -10.67; 95%CI -14.49 to -6.85) and lower back (MD -6.87; 95%CI -10 to -3.74) between the combined exercise and ergonomic modification and control groups. The significant improvement from month 4 to 6, was only seen in exercise group (p<0.05). CONCLUSION:To have a long term effective on MSDs, physical therapists and occupational therapists should use stretching exercises in their treatment programs rather than solely rely on ergonomic modification. CLINICAL TRIAL ID:NCT02874950 - https://www.clinicaltrials.gov/ct2/show/NCT02874950.
Project description:BACKGROUND:Accessory nerve shoulder dysfunction is common after neck dissection in oral cancer survivors. This study aimed to investigate the short-term effects of scapular muscle strengthening exercises with motor-control techniques on neck dissection-related shoulder dysfunction in oral cancer survivors before the initiation of radiotherapy. METHODS:Thirty-eight participants were randomly allocated into the motor-control and regular-exercise groups. Each group received conventional physical therapy and specific scapular muscle strengthening exercises for 1 month immediately after neck dissection. Motor control techniques were integrated with scapular strengthening exercises for the motor-control group. Shoulder pain, active range of motion (AROM) of shoulder abduction, and scapular muscle activities including upper trapezius (UT), middle trapezius (MT), lower trapezius (LT), and serratus anterior (SA) when performing maximal voluntary isometric contraction (MVIC) and scapular muscle exercises were evaluated at baseline and after 1 month of training. RESULTS:Both groups reduced shoulder pain and increased muscle activity of maximum voluntary isometric contraction (MVIC) of each muscle after the intervention. Increased AROM of shoulder abduction was only observed in the motor-control group (95% CI 3.80 to 20.51, p = 0.004). Relative to baseline evaluation, muscle activities of UT decreased in the motor-control group when performing shoulder shrug with 1-kg weight (95% CI -33.06 to -1.29, p = 0.034). Moreover, the SA activity decreased in the motor-control group (95% CI -29.73 to -27.68, p<0.001) but increased in the regular-exercise group (95% CI 28.16 to 30.05, p<0.001) when performing shoulder horizontal adduction and flexion. CONCLUSION:Early strengthening exercise with motor control techniques has greater benefits for improving AROM of shoulder abduction, muscle economy, and reducing compensatory scapular muscle activities in patients with neck dissection-related shoulder dysfunction before the initiation of radiotherapy.