Correlations between body postures and musculoskeletal pain in guitar players

Background The guitar-playing community is the largest group at risk of developing playing related musculoskeletal disorders. A thorough investigation of the relationships between the various risk factors and players’ report on musculoskeletal pain using objective and accurate means of assessment has yet to be reported. Purpose (a) to explore the correlations between demographic characteristics, anthropometric measurements, playing habits, and personal habits of guitar player and their complaints of musculoskeletal pain, (b) explore the correlations between the upper body kinematics of guitar players during playing the guitar and their complaints of musculoskeletal pain, and (c) compare the upper body kinematics of guitar players during playing the guitar while sitting versus standing. Methods Twenty-five guitar players (27.5±4.6 years old) filled out questionnaires regarding their guitar-playing habits, and the Standardized Nordic Questionnaires for the analysis of musculoskeletal symptoms. Kinematics of their torso and upper limbs were tracked while they played a tune twice, once while sitting and once while standing. Results We found moderate correlations between the number of painful joints in the last year and factors, such as physical comfort while playing, years of playing, and position during playing. During standing, lower back pain severity correlated with the rotation range of the torso, while during sitting, it moderately correlated with the average radial-ulnar deviation of the right wrist. During sitting, we found higher anterior and right tilt of the torso, combined with greater abduction of the right shoulder, higher flexion in the left shoulder and higher radial deviation in the left wrist. Conclusion Our results point to several risk factors, related both to playing habits but also to playing posture, which should be considered by the guitar players in order to prevent playing-related musculoskeletal disorders.

Somatic and Abdominal Acupuncture for Pain Treatment in Adolescent Complex Regional Pain Syndrome (CRPS) of the Upper Limb: A Case Report

Complex regional pain syndrome (CRPS) is still poorly understood. It is a pain disorder in which pain is disproportionate to the initial stimulus. There is no specific therapy for CRPS, but it can be managed by a combination of treatments. We report a 13-year-old girl with CRPS of the upper limb treated with somatic and abdominal acupuncture. She described a severe, pulsating pain in the left wrist and hand, with hypersensitivity, allodynia, a marked reduction in strength, and swelling and sweating at the level of the fingers. Pain began three months previously, after a trauma to the left wrist. The diagnostic tests performed were negative. At the first visit we recommended oral tramadol. During the first two sessions we used somatic acupuncture. At the third session, the girl reported suffering intolerable pain in the affected limb during the previous sessions, so we decided to use abdominal acupuncture. After 8 sessions of abdominal acupuncture the pain completely disappeared. Acupuncture could be a potential alternative when conservative therapy with physical and medical treatment fails, but more often parents and adolescents prefer this therapy since other comorbidities are often present in pediatric populations and abdominal acupuncture could be a valuable alternative aid.

Designing of Facility Layout Ecobrick Material Using Ergonomic Intervention Reduce Muscoloskeletal Disorder

Kamulyan waste bank is a place to collect the waste from the household around Lowanu Village, Brontokusuman, Mergangsan, Yogyakarta. This waste is distributed to garbage collectors and sorted. Plastic waste that cannot be recycled is used as material for making ecobricks. Ecobricks are materials made from used plastic bottles filled with plastic sachets, plastic bags, and similar materials that are compressed. In making ecobricks, workers perform activities in a sitting position on the floor with both legs folded in and a slightly bent posture. This work attitude causes muscle complaints in the upper and lower neck, upper arm, right elbow, left wrist, and left hand. The purpose of the study was to improve work attitudes to reduce muscle complaints in body parts by designing ergonomic work facilities. This research was conducted with ergonomics intervention on the design of ecobrick plastic compaction work facilities with the Nordic Body Map-VAS Modified Questionnaire. The muscle complaints of the workers' body parts were determined using the Nordic Body Map questionnaire. The results of the study provide a design for compaction of ecobrick plastic materials with dimensions of table length 134.44 cm, table width 66.39 cm, table height 71.63 cm, length of seat mat 41.41 cm, width of seat mat 43.49 cm, height seat 44.51 cm, backrest height 55.5 cm, and backrest width 45.88 cm. Based on the NBM-VAS questionnaire, it shows that the initial condition of pain or pain in the upper neck and lower neck with a moderate pain value is aimed at a scale of 6.5 cm and 7.3 cm to mild pain with a scale of 4.2 cm and 4.3 cm. . Moderate pain in the left wrist and left hand with a scale of 6.1 cm, respectively, to no pain on a scale of 3.1 cm and 3 cm.

Surgical Treatment of Wrist Joint Dysfunction in Rheumatoid Arthritis: A Report of Two Cases

In rheumatoid arthritis (RA), it is important to actively treat wrist dysfunction to improve patient outcomes. Herein, we report two cases of wrist dysfunction in RA patients who required partial wrist fusion soon after drug initiation. [Case 1] A 38-year-old woman was referred to our hospital because of left wrist joint pain. At the time of examination, swelling and tenderness of the left wrist joint were observed. After 6 months of medication, no improvement in symptoms was noted; therefore, partial wrist fusion was performed. [Case 2] A 38-year-old woman was referred to our hospital because of right wrist joint pain. A plain X-ray image showed fusion of the carpal bones. Due to previous failure of drug treatment, the patient opted for arthrodesis. The postoperative course was good in both cases, and the pain improved. In these cases of monoarthritic RA, synovitis and bone destruction were observed, but blood tests showed no features of active disease, and drug treatment was ineffective. In such cases, early surgical treatment should be considered, rather than continuing conservative treatment, to ensure the best outcomes.

P091 Osteoid osteoma of the trapezoid bone: a diagnostic pitfall of a wrist chronic monoarthritis

Background Osteoid osteoma is a benign bone tumor representing ∼10% of all benign bone tumors. Although osteoid osteoma of the long bones is usual, the location in the carpus, especially, in the trapezoid bone is rare [1,2]. The Objective is toreport a case of osteoid osteoma of the trapezoid bone with extension to the adjacent second metacarpal bone that was missed diagnosis at initial presentation. Methods We describe the clinical, radiological features and outcomes after surgical resection. Results A 24-year-old right-handed female, presented with a three-year history of pain at the left wrist, particularly, in the radial-side. She didn’t report any trauma to the wrist. The pain increased over time. She couldn’t use her hand in daily activities and could hardly sleep because of increasing pain at night. Before being referred to our department, she consulted a surgeon. She was treated with oral anti-inflammatory drugs, steroids, several intraarticular steroid injections without relieving pain. The Magnetic resonance imaging (MRI) showed bone marrow oedema in the trapezium and the trapezoid bone, synovial effusion, and tenosynovitis of the flexors of the thumb. A synovectomy was performed and the histopathology revealed non-specific chronic inflammation. One year later in our department, examination showed wrist swelling, tenderness and pain on palpation. The erythrocyte sedimentation rate was 12 mm/h and the mean C-reactive protein was 2 mg/l. Autoantibodies testing were negative. Initial radiography was read as normal. Initially, Naproxen (550 mg/day) and Morphine (60 mg/day) were prescribed with partially relieving pain. Scintigraphy showed increased uptake of 99mTc in the radial-side of the left wrist. Then, a bone tumor was suspected. The Computed tomography (CT) images revealed a well-demarcated sclerotic nidus surrounded by a halo of radiolucent osteoid tissue, consistent with an osteoid osteoma of the trapezoid bone and the adjacent second metacarpal bone. Surgical resection of the osteoid osteoma was performed. Histopathological examination confirmed the diagnosis. The patient reported complete pain relief since her surgery. She had no recurrence to date. Conclusion Osteoid osteoma should be in the differential diagnosis list of chronic wrist pain/arthritis. In this case, careful attention is necessary for patients unresponsive to treatment with long-lasting symptoms. If radiographs are inconclusive, CT or MRI should be considered to better visualize the nidus of osteoid osteoma in the small bones of the hand.

Morphofunctional characteristics of single combats athletes as factors of success

Background and Study Aim. The aim of the article is a comparative analysis of the morphofunctional characteristics of athletes of various types of martial arts as factors of success. Material and Methods. The study participated students involved in martial arts (n = 29; age - 17.53 ± 0.15 years). The first group (group 1 - wrestlers) included judo, sambo, wrestling athletes (n = 12, age - 18.58 ± 0.38 years). The second group (group 2 - athletes of percussion martial arts) included athletes of karate, taekwondo (GTF), taekwondo (WTF), (n = 17; age - 18.12 ± 0.26 years). Determined 46 morphofunctional indicators: length and body weight; chest circumference in a pause, on inhalation and exhalation; length and circumference of the segments of the upper and lower extremities; wrist dynamometry. A goniometric study of the range of motion in the joints of the upper extremities was carried out. The dynamic grip strength was determined by the maximum frequency of hand squeezing in 10 seconds. To characterize the data, the median was determined - the first (25%) and third (75%) quartiles. Differences between groups were assessed using nonparametric criteria of Wilkinson-Mann-Whitney (U) and Rosenbaum (Q). Results. Athletes in group 1 had a greater interquartile range compared to athletes in group 1 in the following indicators: body weight; chest circumference in a pause, on inhalation and exhalation; hand dynamometry of the right and left hands; maximum frequency of the hand grip in the impulse mode with the left hand; shoulder width; circumference of the shoulder, forearm, thigh and lower leg. Athletes of percussion martial arts were characterized by large values of the shin length. The amplitude of abduction and adduction in the right wrist joint, the amplitude of abduction in the left wrist joint was greater in the wrestlers. Athletes of percussion martial arts had a large amount of extension of the left wrist joint, flexion of the right elbow joint, extension and abduction of the right shoulder joint. Conclusions. Analysis of morphofunctional indicators of athletes of various types of martial arts confirmed the specific effect of the sport on the body of athletes. The features that are the factors of success are highlighted. For wrestlers, these include hand strength in various modes. It allows to implement quickly and efficiently grip. This is the basis for a successful wrestling technique. Sufficient development of the muscles of the limbs ensures the execution of throws in wrestling. The lengthened calf size contributes to a more effective kick in martial arts. Goniometric features of movements reflect the possibility of high-quality gripping, striking or blocking. The used morphofunctional indicators can be applied to predict the success of athletes in various types of martial arts.

Congenital Constriction Band Syndrome: Clinical Study of Three Cases in Togo

Introduction: Congenital constriction band syndrome (CCBS) or amniotic band syndrome is a complex set of congenital malformations, mainly affecting the limbs, but also the craniofacial and thoraco-abdominal region. The Patients: The purpose of this work is to describe the clinical and diagnostic aspects of CCBS in Togo in relation to 03 clinical cases. The Primary Diagnoses, Interventions, and Outcomes: The first case is characterized by an asymmetric bilateral superficial constriction groove of the lower limbs, pseudosyndactylias and synostosis of the tibia and fibula on X-ray. The second has a deep strangulation in the left arm with an amputation of the fingers associated with hypochromic skin lesions, poorly hemmed polylobal ear and skin growths. The latter characterized by persistent bridle, strangulation and ischemia downstream of that of the left wrist with postnatal amputation of the left hand. Conclusion: The strengthening of antenatal diagnosis, the introduction of genetic counselling and the establishment of a national malformations register should make it possible to improve the management of cases of amniotic flange disease.

Ergonomic Risk Assessment of Dental Students—RULA Applied to Objective Kinematic Data

Musculoskeletal disorder (MSD) is already prevalent in dental students despite their young age and the short duration of dental practice. The current findings state that the causes of MSD are related to posture during dental work. This study aims to investigate the ergonomic risk of dental students. In order to analyze the ergonomic risk of dental students, 3D motion analyses were performed with inertial sensors during the performance of standardized dental activities. For this purpose, 15 dental students and 15 dental assistant trainees (all right-handed) were measured in a team. Data were analyzed using the Rapid Upper Limb Assessment (RULA), which was modified to evaluate objective data. Ergonomic risk was found for the following body parts in descending order: left wrist, right wrist, neck, trunk, left lower arm, right lower arm, right upper arm, left upper arm. All relevant body parts, taken together, exhibited a posture with the highest RULA score that could be achieved (median Final Overall = 7), with body parts in the very highest RULA score of 7 for almost 80% of the treatment time. Dental students work with poor posture over a long period of time, exposing them to high ergonomic risk. Therefore, it seems necessary that more attention should be paid to theoretical and practical ergonomics in dental school.

157 Non-Surgical Management of an Acute Isolated Volar Dislocation of the Distal Radio-Ulnar Joint

Isolated distal radio-ulnar joint dislocations are rare and commonly missed on radiographs. A young male presented with severe pain and deformity of the left wrist, following a collision whilst playing rugby. This was easily diagnosed using plain radiographs, and the initial attempted reduction methods in the Emergency Department failed. The patient was subsequently anaesthetised in theatre, yet reduction by an accepted method of palmar to dorsal pressure over the interosseous membrane with simultaneous distraction of the wrist failed. A further attempt to manipulate the dislocated ulnar head was successful, with the same force applied whilst the wrist was maximally flexed and pronated – thereby avoiding an open reduction. The patient was asymptomatic at final follow-up, over one year later. This technique has not previously been described in the literature and may be used in similar injuries in the future.

[A rare case of sepsis from Citrobacter koseri in adults]

We describe the case of a 53-year-old man, recently diagnosed with decompensated type II diabetes mellitus, admitted to our Department for fever, asthenia, and detection of multiple lung abscesses and pulmonary embolism at chest tomography.His clinical history revealed just a recent orthopedic surgery of osteosynthesis on the left wrist with normal clinical and instrumental post-surgical evolution. Empirical antibiotic therapy with piperacillin/tazobactam and clindamycin was initiated. During hospital stay, swelling and functional impotence in the right knee occurred. They were investigated by arthrocentesis and magnetic resonance, and diagnosed as septic arthritis.Blood culture performed at admission tested positive for Citrobacter koseri on several samples where meropenem was added according to antibiogram. On the other hand, the cultures of bronchoaspirate, pulmonary fine needle aspiration, and arthrocentesis were negative.Antibiotic therapy was administered up to two weeks after discharge and radiological and physical features progressively improved.