Assessing Post-Driving Discomfort and Its Influence on Gait Patterns

Professional drivers need constant attention during long driving periods and sometimes perform tasks outside the truck. Driving discomfort may justify inattention, but it does not explain post-driving accidents outside the vehicle. This study aims to study the discomfort developed during driving by analysing modified preferred postures, pressure applied at the interface with the seat, and changes in pre- and post-driving gait patterns. Each of the forty-four volunteers drove for two hours in a driving simulator. Based on the walking speed changes between the two gait cycles, three homogeneous study groups were identified. Two groups performed faster speeds, while one reduced it in the post-steering gait. While driving, the pressure at the interface and the area covered over the seat increased throughout the sample. Preferred driving postures differed between groups. No statistical differences were found between the groups in the angles between the segments (flexed and extended). Long-time driving develops local or whole-body discomfort, increasing interface pressure over time. While driving, drivers try to compensate by modifying their posture. After long steering periods, a change in gait patterns can be observed. These behaviours may result from the difficulties imposed on blood circulation by increasing pressure at this interface.

Investigating the Prevalence of Musculoskeletal Disorders and Degree of Body Discomfort in the Office Staff of the School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd

Introduction: Musculoskeletal disorders are one of the most important occupational health issues. In recent years, the rapid growth of technology and the use of computers have affected almost all office workstations. These disorders are also very common among office staff. Therefore, the present study aimed to investigate the prevalence of musculoskeletal disorders and the degree of body discomfort in the staff of the School of Public Health, Shahid Sadoughi University of Medical Sciences Yazd. Methods: This descriptive cross-sectional study was conducted on 130 office staff of Yazd School of Public Health in 2021. The inclusion criterion consisted of having at least one year of work experience and the exclusion criteria included the presence of musculoskeletal complications in different organs of the body and no history of incidents, accidents, and inherited diseases. To collect data, the Nordic questionnaire was used along with a body map (to better understand the position of the limbs) and a visual analog scale (VAS) (to show the severity of discomfort in different parts of the body). The data were analyzed using SPSS software version 22 using frequency, mean, standard deviation, and AONVA tests. Results: 108 people (83.7%) of the study population felt pain and discomfort in at least one of the 9 areas of the body during the last 12 months. The most musculoskeletal disorders was related to the low back (67.4%), neck (63.6%), and back (55%). Also, the low back waist, neck, and shoulder areas had the highest mean discomfort, respectively, and the thigh and elbow areas had the lowest mean discomfort. In the report of pain by body map, a significant relationship was observed between the variable of work experience and shoulder, thigh, and low back organs (p <0.05). A significant relationship was observed between low back pain, musculoskeletal disorders in the hands and wrists and body mass index (p <0.05). Conclusion: Due to the high prevalence of musculoskeletal disorders and the high degree of discomfort, especially in the low back and neck, it is recommended to perform educational programs, corrective exercises, and appropriate interventions.

Car seat impact on driver’s sitting behavior and perceived discomfort during prolonged real driving on varied road types

Prolonged driving under real conditions can entail discomfort linked to driving posture, seat design features, and road properties like whole-body vibrations (WBV). This study evaluated the effect of three different seats (S1 = soft; S2 = firm; S3 = soft with suspension system) on driver’s sitting behavior and perceived discomfort on different road types in real driving conditions. Twenty-one participants drove the same 195 km itinerary alternating highway, city, country, and mountain segments. Throughout the driving sessions, Contact Pressure (CP), Contact Surface (CS), Seat Pressure Distribution Percentage (SPD%) and Repositioning Movements (RM) were recorded via two pressure mats installed on seat cushion and backrest. Moreover every 20 minutes, participants rated their whole-body and local discomfort. While the same increase in whole-body discomfort with driving time was observed for all three seats, S3 limited local perceived discomfort, especially in buttocks, thighs, neck, and upper back. The pressure profiles of the three seats were similar for CP, CS and RM on the backrest but differed on the seat cushion. The soft seats (S1 & S3) showed better pressure distribution, with lower SPD% than the firm seat (S2). All three showed highest CP and CS under the thighs. Road type also affected both CP and CS of all three seats, with significant differences appearing between early city, highway and country segments. In the light of these results, automotive manufacturers could enhance seat design for reduced driver discomfort by combining a soft seat cushion to reduce pressure peaks, a firm backrest to support the trunk, and a suspension system to minimize vibrations.

Diffuse Pain and Abnormal Brain MRI Findings

A 46-year-old woman with a remote history of classical migraine had development of pain behind her left eye followed by holocephalic headache. She subsequently began to have episodic headaches. Her sleep became disrupted. Irritability, cognitive symptoms, and fatigue then developed. Her headaches occurred daily, along with whole-body discomfort. She underwent polysomnography and was diagnosed with obstructive sleep apnea syndrome. Her sleep quality improved with continuous positive airway pressure therapy, but her daily headaches, cognitive symptoms, and limb pain persisted. She was diagnosed with “seronegative Lyme disease.” Fourteen days of doxycycline therapy was not accompanied by improvement in symptoms. After extensive laboratory evaluations and consultations, the patient was diagnosed with fibromyalgia. Short trials of low doses of amitriptyline, nortriptyline, gabapentin, and pregabalin were undertaken, but these were poorly tolerated and discontinued in each instance. The patient was concerned that she may have multiple sclerosis, and she underwent magnetic resonance imaging of the brain. The radiology report documented multiple, small areas of T2-signal change, and demyelinating disease was included in the radiologic differential diagnosis. The patient then sought a second opinion. Evaluations at Mayo Clinic supported evidence of diffuse myofascial limb and back pain and tenderness. Brain magnetic resonance images were reviewed. Extensive work-up for alternative differential diagnostic considerations for her pain was unremarkable. The patient was diagnosed with fibromyalgia with features of central sensitization, with brain magnetic resonance imaging demonstrating nonspecific radiologic abnormalities. A detailed discussion about fibromyalgia and central sensitization was undertaken with the patient. The concepts rehabilitative approaches were reviewed. Slowly progressive, incremental, physical reconditioning, and cognitive behavioral retraining were recommended. She was advised to complete a fibromyalgia and chronic fatigue treatment program, focusing on cognitive and behavioral approaches, stress management, sleep hygiene, balanced lifestyle, moderation, energy conservation, and graded exercise. No new medications were recommended given her previous poor tolerance. The patient’s atypical symptoms, normal examination findings, and brain magnetic resonance imaging appearance assisted in excluding a diagnosis of demyelinating disease. The radiologic findings, termed white matter leukoaraiotic change, are commonly encountered in healthy persons as they age, particularly in patients with migraine or those with microvascular risk factors.

Age-Related Vestibular Dysfunction with Motion Sensitive Vertigo and Risk of Fall in Adults

Background: This ageing is physiological process associated with vestibular dysfunction. The incidence of vestibular problems increases with age and can lead to drops, dropping risk, lack of confidence, pain and depression. Vestibular disorder is commonly characterized by vertigo or body discomfort (look and aggravation of postural stability) (a sense of spinning movement). In older adults with a fall history, peripheral vestibular disorders are among the most frequently known and widespread vestibular dysfunctions. Aim: To associate vestibular dysfunction and motion sensitive vertigo and risk of fall in adults. Methodology: Cross sectional study with convenient non- random sampling. For tests has been applied for screening vestibular dysfunction. If a participant shows 2 tests positive have vestibular dysfunction. SPSS 21 is used for data analysis. Results: Highly significant results between association of age with motion sensitive and age with fall efficacy scale P value is less than 5. Results are also significant between MSQ and FES-1. Conclusion: After conducting this research it has been concluded. That age-related vestibular dysfunction significantly associated with motion sensitive vertigo and risk of fall. As with the age people are more concerned about fall Keywords: vestibular dysfunction, vertigo, risk of fall in adults

FAKTOR RISIKO PAJANAN ERGONOMI DAN GANGGUAN MUSKULOSKELETAL PADA DOKTER GIGI DI KOTA CIMAHI JAWA BARAT

Posisi kerja yang tidak ergonomis dapat menyebabkan gangguan muskuloskeletal. Dalam melakukan pekerjaannya, dokter gigi mengalami pajanan ergonomi cukup besar karena bekerja dalam posisi janggal, melakukan pekerjaan repetitif, menggunakan tenaga yang besar, dan menggunakan peralatan yang tidak ergonomis. Evaluasi pajanan ergonomi menggunakan kuesioner Baseline Risk Identification of Ergonomic Factor (BRIEF) memberikan gambaran risiko pajanan ergonomi yang diberikan oleh metode kerja, posisi kerja dan durasi kerja. Kuesioner Body Discomfort Map (BDM) merupakan alat bantu subjektif untuk menjelaskan bagian tubuh yang merasakan gangguan muskuloskeletal. Penelitian dilakukan dengan metode potong lintang bertujuan untuk mencari hubungan antara risiko pajanan ergonomi yang dialami oleh dokter gigi dengan bagian tubuh yang mengalami keluhan. Sebanyak 39 dokter gigi yang sudah mempunyai pengalaman praktik 1 tahun diambil secara simple random sampling di wilayah kota Cimahi . Hasil penelitian menunjukkan hubungan antara faktor risiko pajanan ergonomi dengan gangguan muskuloskeletal pada daerah tangan dan pergelangan tangan kanan (p=0,018) dan pada daerah leher (p=0,026). Hasil tersebut sesuai dengan pajanan ergonomi yang diterima oleh dokter gigi seperti gerakan repetitif, posisi kerja yang janggal, gerakan yang membutuhkan kekuatan, desain kerja yang kurang baik, dan frekuensi vibrasi yang tinggi, Pekerjaan dokter gigi sangat sering menggunakan tangan dan pergelangan tangan kanan untuk melakukan perawatan atau tindakan dengan posisi yang tidak fisiologis. Daerah leher adalah daerah yang mengikuti posisi tubuh saat melakukan gerakan menyamping untuk memeriksa pasien. Kesimpulan pajanan ergonomi mempunyai hubungan dengan keluhan gangguan muskuloskeletal yang dialami oleh dokter gigi pada bagian tangan dan pergelangan tangan kanan serta daerah leher.

Alleviating gender dysphoria: A qualitative study of perspectives of trans and gender diverse people

Objectives This study sought to explore perspectives of trans and gender diverse (TGD) people of ways to alleviate gender dysphoria in service provision and to develop a framework for application in health and other areas that can be used by researchers and service providers to design study protocols, assess organisations and enhance everyday practice in ways that are sensitive to TGD people’s experiences. Methods Data from a national Australian survey on TGD people conducted in 2018–2019 (n = 340) were used to develop a framework for alleviating dysphoria. Participants were asked an open-ended question on ways that body discomfort could be minimised in clinical encounters. Inductive thematic analysis was used to develop themes true to participant sentiment, which formed the basis for the development of a framework. Results The sample was overall young, with 60.6% aged 18–24, and a strong representation of gender diverse people (42.6%). The most important theme for participants was the context of the experience, which included the subthemes of the interpersonal qualities of service providers, language and pronouns, and practical aspects. Aspects of systems were also important, with education and awareness being particularly emphasised, followed by inclusive environments. Access to gender affirming medical and surgical procedures was rarely mentioned (2.6%). A minority of participants indicated that there was nothing that could be done to alleviate their gender dysphoria (4.4%). Conclusions The study proposes a framework that can help facilitate assessment of a service’s current practices, inform a practitioner’s daily practice and be used by researchers to appropriately design studies. The most important areas to address centre on the context of the immediate experience, which may be influenced through systems-level characteristics.

Subjective Preferences and Discomfort Ratings of Backrest and Seat Pan Adjustments at Various Speeds

Power seats (i.e., electrically adjustable seats that can be designed to move in several ways) have become increasingly common in airplanes, vehicles, and offices. Many studies have investigated the effects of seat attitude parameters, for example, the inclined angles of a backrest, on discomfort during the adjustment process. However, few studies have considered discomfort under different speeds during the adjustment process. In this study, we investigated discomfort with three speeds (i.e., “fast”, “median”, and “slow” corresponding to three durations of 15, 20, and 25 s, respectively) and two adjustments of a power seat, i.e., incline angle adjustment of the backrest and fore-and-aft position adjustment of the seat pan. We also investigated the effects of different physiological parameters on subjects’ discomfort. Twenty-four subjects (12 males and 12 females) completed a questionnaire to indicate their adjustment condition preferences, to rate their overall discomfort during the adjustment processes on a category-ratio scale, and to rate their local body discomfort. The majority of subjects preferred the fast speed adjustment condition and the trend was that a lower backrest adjustment speed increased discomfort during the process. The dominant local discomfort was in the upper and lower back regions during the backrest adjustment, whereas there was no obvious dominant local discomfort during the seat pan adjustment. The physiological parameters also had significant correlations with discomfort in some adjustment movements, for example, the discomfort was negatively correlated with height during the backrest adjustment.