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(1) Background: Dance teachers (DT) are dependent on their functional body. Pain can hardly be avoided during the professional practice of dance. Pain can become so intense that it impairs, or even prevents, the professional practice. The aim of this study was to identify the determinants of pain intensity of the most severely affected body regions of DT in pain during the three-month period prior to the survey. (2) Methods: This cross-sectional study was conducted by an online survey. A total of 166 DT participated in the study; 143 of the DT were in pain during the three-month period and were included in the analysis. Using multiple linear regression, the determinants of pain intensity were identified from population parameters, occupational data, pain localisation, and temporal pain course. (3) Results: Regions of the lower extremity and head/trunk regions were most frequently indicated as the body regions with the most severe pain. The multiple regression model generated with the factors “functional impairment”, “biomechanical exposure”, and “pain at rest” explains a statistically significant, moderate proportion of the variance in pain intensity (R2 = 0.22, F (3, 106) = 10.04, p < 0.001). (4) Conclusions: Intensity of pain in DT seems to be related to the physical demands of professional practice.
Background: Dentists (Ds) and dental assistants (DAs) have a high lifetime prevalence of musculoskeletal disorders (MSDs). In this context, it is assumed that they have an increased intake of substances such as pain medication. Currently, there exist no data on the use of medication among Ds and DAs with MSDs in Germany. Methods: The online questionnaire (i.e., the Nordic Questionnaire) analysed the medical therapies used by 389 Ds (240 f/149 m) and 406 DAs (401 f/5 m) to treat their MSDs. Results: Ds (28.3–11.5%) and DAs (29.4–10.3%) with MSDs took medication depending on the affected body region. A trend between the Ds and DAs in the intake of drug therapy and the frequency was found for the neck region (Ds: 21.1%, DAs: 28.7%). A single medication was taken most frequently (Ds: 60.0–33.3%, DAs: 71.4–27.3%). The frequency of use varied greatly for both occupational groups depending on the region affected. Conclusion: Ds and DAs perceived the need for medical therapies because of their MSDs. Painkillers such as ibuprofen and systemic diclofenac were the medications most frequently taken by both occupational groups. The intake of pain killers, most notably for the neck, should prevent sick leave.
Background: dental professionals suffer frequently from musculoskeletal disorders (MSD). Dentists and dental assistants work closely with each other in a mutually dependent relationship. To date, MSD in dental assistants have only been marginally investigated and compared to their occurrence in dentists. Therefore, the aim of this study was to compare the prevalence of MSD between dentists and dental assistants by considering occupational factors, physical activity and gender. Methods: This was a cross-sectional observational study. A Germany-wide survey, using a modified version of the Nordic Questionnaire and work-related questions, was applied. In total, 2548 participants took part, of which 389 dentists (240 females and 149 males) and 322 dental assistants (320 females and 2 males) were included in the analysis. Data were collected between May 2018 and May 2019. Differences between the dentists and dental assistants were determined by using the Chi2 test for nominal and the Wilcoxon–Mann–Whitney U test for both ordinal and non-normally distributed metric data. Results: A greater number of dental assistants reported complaints than dentists in all queried body regions. Significant differences in the most affected body regions (neck, shoulders, wrist/hands, upper back, lower back and feet/ankles) were found for the lifetime prevalence, annual prevalence and weekly prevalence. Data from the occupational factors, physical activity and gender analyses revealed significant differences between dentists and dental assistants. Conclusions: Dental assistants appear to be particularly affected by MSD when compared to dentists. This circumstance can be explained only to a limited extent by differences in gender distribution and occupational habits between the occupations.
Traditional ergonomic risk assessment tools such as the Rapid Upper Limb Assessment (RULA) are often not sensitive enough to evaluate well-optimized work routines. An implementation of kinematic data captured by inertial sensors is applied to compare two work routines in dentistry. The surgical dental treatment was performed in two different conditions, which were recorded by means of inertial sensors (Xsens MVN Link). For this purpose, 15 (12 males/3 females) oral and maxillofacial surgeons took part in the study. Data were post processed with costume written MATLAB® routines, including a full implementation of RULA (slightly adjusted to dentistry). For an in-depth comparison, five newly introduced levels of complexity of the RULA analysis were applied, i.e., from lowest complexity to highest: (1) RULA score, (2) relative RULA score distribution, (3) RULA steps score, (4) relative RULA steps score occurrence, and (5) relative angle distribution. With increasing complexity, the number of variables times (the number of resolvable units per variable) increased. In our example, only significant differences between the treatment concepts were observed at levels that are more complex: the relative RULA step score occurrence and the relative angle distribution (level 4 + 5). With the presented approach, an objective and detailed ergonomic analysis is possible. The data-driven approach adds significant additional context to the RULA score evaluation. The presented method captures data, evaluates the full task cycle, and allows different levels of analysis. These points are a clear benefit to a standard, manual assessment of one main body position during a working task.
Hintergrund: Der eigene Körper ist das zentrale Arbeitsinstrument eines*einer Tanzpädagog*in (TP) innerhalb der Bewegungsvermittlung. Bisher fehlen Erkenntnisse über die subjektive Wahrnehmung der eigenen berufsassoziierten Gesundheit und Zufriedenheit sowie die Identifizierung gesundheitsbelastender Berufsmerkmale.
Methodik: Im Rahmen einer fragebogenbasierten Querschnittserhebung wurde eine Kohorte von TP in Deutschland zur eigenen Gesundheit und generellen Berufszufriedenheit und belastenden Aspekten im Zusammenhang mit ihrer Berufsausübung untersucht. Zusätzlich wurden allgemeine anthropometrische und soziodemographische Merkmale erfasst. Neben der Betrachtung der Gesamtkohorte wurde auf geschlechtsspezifische Unterschiede getestet. In die statistische Analyse wurden n = 232 TP (m: 51/w: 181) im Alter von 43,1 ± 11,0 Jahren eingeschlossen.
Ergebnisse: Der allgemeine Gesundheitszustand wurde von 85,3 % der Befragten mit „befriedigend“ (26,1 %) bis „sehr gut“ (14,7 %) beurteilt. 59,2 % der Tanzpädagog*innen schätzten ihre Gesundheit „gut“ (35,3 %) bis „sehr gut“ ein. Es herrschte eine hohe Zufriedenheit mit der eigenen Berufsausübung für 80 % der Teilnehmenden. Die TP fühlten sich überwiegend in der Lage (trifft „voll & ganz“ bzw. „eher zu“), mit den physischen (75,7 %) und psychischen Berufsanforderungen (70,3 %) umzugehen. Als belastende Berufsmerkmale in der Eigenwahrnehmung können neben Zukunftsängsten (51,5 %) vor allem arbeitsorganisatorische (fehlende Zeit für Familie und Freunde bei 28,4 %) und ökonomische Aspekte (Einkommensunsicherheit bei 61,0 % und fehlende Altersabsicherung bei 65,7 %) herausgestellt werden.
Diskussion: Die Berufsausübung als TP geht mit einer hohen generellen Zufriedenheit und einem positiven Empfinden des eigenen Gesundheitszustandes einher. Eine Bestätigung dieser positiven Ergebnisse durch Verletzungs- und Erkrankungsstatistiken steht noch aus. Darüber hinaus wäre eine Verbesserung arbeitsorganisatorischer und ökonomischer Aspekte wünschenswert.
The aim of this study was to investigate gender-specific influences of different symmetric and asymmetric occlusion conditions on postural control during standing and walking. The study involved 59 healthy adult volunteers (41 f/19 m) aged between 22 and 53 years (30.2 ± 6.3 years). Postural control measurements were carried out using a pressure plate by measuring plantar pressure distribution during standing and walking test conditions. Seven different occlusion conditions were tested. Prior to a MANOVA model analysis, the relationship between the two test conditions were checked using a factor analysis with a varying number of factors (between 2 and 10). The plantar pressure distributions during walking and standing are independent test conditions. The coefficient of variance across all variables between the conditions and genders was not significant: t(46) = 1.51 (p = 0.13). No statement can be made whether, or not, the influence of gender is greater than the influence of the conditions. Healthy male and female test subjects did not show any difference between seven occlusion conditions on the plantar pressure distribution while standing or walking. No differences between the genders were found for any of the investigated variables. In contrast to custom-made occlusion splints, simple cotton rolls appear not to influence the neuromuscular system in a systematic manner.
Background: The aim is to investigate to what extent the different oral protections compared to the habitual occlusion affect the upper body posture in statics and during taekwondo-specific movement.
Methods: 12 Taekwondoka (5 f/7 m) of German national team were measured by using a 3d back scanner and an ultrasonic distance measuring (upright stand, taekwondo attack and defense movement, two taekwondo specific combinations) in habitual occlusion, with a custom-made and ready-made mouth protection
Results: There are no significant changes in the upper body posture (p ≥ 0.05). Depending on the dynamic measurements, different significant reactions of the spinal position were found while wearing the custom made mouthguard or the ready-made mouthguard according to the conducted movement.
Conclusion: The measured changes in dynamic movements are not clinical relevant. Based on the positive responses from the participants, the custom-made mouth protection can be recommended combined with an individual analysis.
Standard reference values of the upper body posture in healthy middle-aged female adults in Germany
(2021)
In order to classify and analyze the parameters of upper body posture, a baseline in form of standard values is demanded. To this date, standard values have only been published for healthy young women. Data for female adults between 51 and 60 years are lacking. 101 symptom-free female volunteers aged 51–60 (55.16 ± 2.89) years. The mean height of the volunteers was 1.66 ± 0.62 m, with a mean body weight of 69.3 ± 11.88 kg and an average BMI of 25.02 ± 4.55 kg/m2. By means of video raster stereography, a 3D-scan of the upper back surface was measured in a habitual standing position. The confidence interval, tolerance range and ICCs were calculated for all parameters. The habitual standing position is almost symmetrical in the frontal plane the most prominent deviation being a slightly more ventral position of the left shoulder blade in comparison to the right. The upper body (spine position) is inclined ventrally with a minor tilt to the left. In the sagittal plane, the kyphosis angle of the thoracic spine is greater than the lordosis angle of the lumbar spine. The pelvis is virtually evenly balanced with deviations from an ideal position falling under the measurement error margin of 1 mm/1°. There were also BMI influenced postural variations in the sagittal plane and shoulder distance. The ICCs are calculated from three repeated measurements and all parameters can be classified as "almost perfect". Deflections from an ideally symmetric spinal alignment in women aged 51–60 years are small-scaled, with a minimal frontal-left inclination and accentuated sigmoidal shape of the spine. Postural parameters presented in this survey allow for comparisons with other studies as well as the evaluation of clinical diagnostics and applications.
Der Biomarker TRACP5b (tartratresistente saure Phosphatase 5b) : ein Marker des Knochenstoffwechsels
(2021)
Die vorliegende Übersicht zum Biomarker TRACP5b wird im Rahmen der Serie „Tumormarker“ des Zentralblatts für Arbeitsmedizin, Arbeitsschutz und Ergonomie publiziert, die sich mit dem immer häufigeren Gebrauch der Bestimmung von spezifischen Markern bei sog. Manager-Vorsorgen und Check-up-Untersuchungen beschäftigt. TRACP5b eignet sich grundsätzlich nicht für solche Vorsorgen, sondern ist ein Marker zur Therapie‑, Verlaufs- und Rezidivkontrolle von Osteoporose und der ossären Metastasen. Hier zeigt dieser eine hohe Sensitivität und Spezifität, wobei der Marker aber auf keinen Fall als Screeningparameter zur Frühdiagnostik eingesetzt werden soll.
Die vorliegende Übersicht zu den Knochenmarkern Knochen-Sialoprotein (BSP), carboxyterminales Typ-I-Kollagen-Telopeptid (CTX) und N‑aminoterminales Typ-I-Kollagen-Telopeptid (NTX) wird im Rahmen der Serie „Tumormarker“ des Zentralblatts für Arbeitsmedizin, Arbeitsschutz und Ergonomie publiziert, die sich mit dem immer häufigeren Gebrauch der Bestimmung von spezifischen Markern bei sog. Manager-Vorsorgen und Check-up-Untersuchungen beschäftigt. BSP, CTX und NTX eignen sich grundsätzlich nicht für solche Vorsorgen, sondern sind Marker zur Therapie‑, Verlaufs- und Rezidivkontrolle von Knochenmetastasen. Unabhängig davon ist über diese Marker vielfach publiziert worden, wobei sich zudem eine hohe Sensitivität und Spezifität zeigt. Die Marker eignen sich aber auf keinen Fall als Screening-Parameter zur Frühdiagnostik und sollten hier nicht eingesetzt werden.
Musculoskeletal disorders of the trunk and neck are common among cleaners. Vacuum cleaning is a demanding activity. The aim of this study was to present the movement profile of the trunk and neck during habitual vacuuming. The data were collected from 31 subjects (21f./10 m) using a 3D motion analysis system (Xsens). 10 cycles were analysed in vacuuming PVC and carpet floors with 8 vacuum cleaners. The joint angles and velocities were represented statistically descriptive. When vacuuming, the trunk is held in a forwardly inclined position by a flexion in the hip and rotated from this position. In the joint angles and velocities of the spine, the rotation proved to be dominant. A relatively large amount of movement took place in the cervical spine and also in the lumbar spine. The shown movement profile is rather a comfort area of vacuuming which may serve as a reference for ergonomics in vacuuming.
Das Übergangstraining : Maßnahme in der betrieblichen Wiedereingliederung im professionellen Tanz
(2021)
Neben der Vorbeugung von akuten und chronischen Schäden ist im professionellen Bühnentanz bei gesundheitlichen Problemen am Muskel-Skelett-System eine intensive – dem Berufssport vergleichbare – Rehabilitation unter Berücksichtigung tanzspezifischer Bewegungselemente von großer Bedeutung. In Kombination mit anderen, die Leistungsfähigkeit wiederherstellenden Maßnahmen ist das in diesem Beitrag erläuterte sog. Übergangstraining („transition dance class“) als Trainingsform im Rahmen der stufenweisen beruflichen Wiedereingliederung von zentraler Bedeutung, da es die Übergangsphase zwischen allgemeinen Maßnahmen einer Rehabilitation und dem Wiedererreichen der vollständigen Arbeitsfähigkeit im Tanzberuf darstellt.