Hands on Workshop on Ergonomics in Delhi and Bhopal - November Save your dates!

Academy of Ergonomics and Neuromusculoskeletal Rehabilitation is organizing a two days hands on workshop on "Basic Office Ergonomics and Ergonomic Workplace Analysis" in Bhopal & Delhi.

First time in Central India; Second time in North India

Hurry up and get the benefit of Early Bird Registration.
Give a boost to your earning now.
Bhopal : 15th & 16th November '14 9:00 am to 5:00 pm
Hotel Royal Vilas, Near Board Office Bhopal Madhya Pradesh
Early Bird Registration till 15th Oct '14 - Rs. 3500
Later - Rs. 4000

Delhi : 29th & 30th November '14 9:00 am to 5:00 pmHotel LaSuite, East Patel Nagar Rajindra Place, Pusa Road, New Delhi
Early Bird Registration till 30th Oct '14 - Rs. 3500
Later - Rs. 4000

For Registration -

Mode of Payment: - Deposit Cash/Transfer through Net Banking/Cash

State Bank of India
Account No. 33561972315
Name : Ajay Kumar Upadhyay
Branch Name : Danish Kunj Bhopal
Branch Code : 10171
IFSC : SBIN0010171

Once payment is deposited please text your full name (as you need on your certificate), city, transaction details & e-mail id. You'll receive an invoice from our side for confirmation of payment and registration. Retain the invoice as you will need to be shown on the day of workshop.

Check out the brochure attached for Modules with subtopics within and other details.

Workshop fees includes Certificate with transcript of 16 Credit hours, CD with workshop total material (& recent research papers) and Catering for daytime.
Objective of the Workshop - This training will teach you how to perform an ergonomics analysis applicable in the industry, healthcare, and office workplace. It will help you to identify potential hazards that contribute to the development of musculoskeletal disorders. You’ll learn the element and application of an Ergonomics Jobsite Analysis forms and other basic ergonomic assessment tools. Using best practices, the instructor will guide you the implementation of cost-effective, high-impact solutions for prevention of workplace injury. You will be able to crack practical solutions for risk reduction and increasing employee productivity. Workshop will be more hands on emphasizing on practical aspects.

Who Should Attend - Physiotherapists, Occupational Therapists, Physiotherapy Students, Interns, Certified Safety Professionals, Ergonomists, Industrial Hygienists

For further queries contact Dr. Ajay Upadhyay +91 95841 88003

Best Regards
Ajay Upadhyay 
Course Coordinator
+91 95841 88003
ergo4otpt@gmail.com
Gayatri Ajay Upadhyay
Course Instructor

Ergonomics and Neuromusculoskeletal Rehabilitation

    

Online Ergonomics Course

Dear Sir/Madam,

Physiotherapy Day 2014 is coming!

Make it a day of opportunity by getting enrolled for Ergonomics course for just Rs. 1000/- on 8th Sept. '14.

It a matter of pride to share with you that most of our delegates have started running their own Ergonomics services after completion of the course.

Online Course with e Certification for Office Ergonomics and Ergonomics Workplace Evaluation Course Details – 15 Topics Covered in this course

Registration Helplines +91 95841 88003

Note - You’re not just taking the certificate but getting keys to earn in lakhs too! 

Look what few of our online course delegates had their say for the course!

For Registration -

Mode of Payment: - Deposit Cash / Transfer through Net Banking
To get bank details mail us on ergo4otpt@gmail.com

Once payment is deposited you need to mail -

1.       Transaction reference number

2.       Name as you want on the certificate

Course Learning Outcomes

This training will teach you how to perform an ergonomic analysis applicable in the industry, healthcare, and office workplace. It will help you to identify potential hazards that contribute to the development of musculoskeletal disorders. You’ll learn the element and application of an Ergonomics Jobsite Analysis forms and other basic ergonomic assessment tools. Using best practices, the course will guide you the implementation of cost-effective, high-impact solutions for prevention of workplace injury. You will be able to crack practical solutions for risk reduction and increasing employee productivity.

A GATEWAY TO ERGONOMICS
“Basic Office Ergonomics and Ergonomic Workplace Evaluation Course Details”

Topics Covered in this course -

1.      Overview of Ergonomics
2.      Overview of WRMSDS
3.      Application of Ergonomics
4.      Identifying the risk factors
5.      Subjective Ergonomic Workplace Analysis (EWA)
6.      Objective Ergonomic Workplace Analysis
7.      Self-Assessment Tools
8.      Ergonomic Analytic Eyes
9.      RULA & REBA
10.   Selecting the right Chair
11.   Setting up an Ergo Friendly workstation
12.   Preventive measures for WRMSDs
13.   Generating a written report for industries/companies
14.   Marketing ergonomics services and calculating Return on investment (ROI)
15.   Importance of Ergonomics Training

There is no exam, Certificate will be issued once you complete the course successfully.

Best Regards
Ajay Upadhyay 
Course Coordinator
+91 95841 88003 ergo4otpt@gmail.com
Gayatri Ajay Upadhyay
Course Instructor
Online Basic Office Ergonomics and Ergonomic Workplace Analysis Course

    

A man with completely paralysed from the lower trunk in robotic suit kicks off World Cup

Juliano Pinto, a 29-year-old with complete paralysis of the lower trunk performed the symbolic kick-off at the Corinthians Arena in Sao Paulo. Using his robotic suit, Mr Pinto kicked the official ball a short distance along a mat laid down by the touchline. His robotic exoskeleton was created by a Brazilian neuroscientist Dr. Miguel Nicolelis who led the team of 150 researchers on a project named "The Walk Again" which aimed to make people with paralysis abandon the wheelchair and literally walk again. The World Cup demonstration is "just the beginning" of a future for people suffering from paralysis.

It's for the first time that an exoskeleton has been controlled by brain activity and offered feedback to the patients. And also having a demonstration in a stadium is something very much outside routine in robotics. It's never been done before.

The exoskeleton uses a cap placed on the patient's head to pick up brain signals and relay them to a computer in the exoskeleton's backpack. This then decodes the signals which in return translates into commands for the robot to start moving and sends them to the legs. The robotic suit is powered by hydraulics, and a battery in the backpack allows for approximately two hours of use. Dr Cheng who led the development of a form of artificial skin for the exoskeleton. This skin consists of flexible printed circuit boards, each containing pressure, temperature and speed sensors. It is applied on the soles of the feet and allows the patient to receive tactile stimulation when walking with the exoskeleton. When the robotic suit starts to move and touches the ground, signals are transmitted to an electronic vibration device on the patient's arm, which stimulates their skin. After lots of practice, the brain starts associating the movements of the legs with the vibration in the arm. In theory, the patient should start to develop the sensation that they have legs and that they are walking.
The suit has been named Bra-Santos Dumont, which combines the three-letter designation for Brazil and Alberto Santos-Dumont, the aviation pioneer who was born in the country's southern state of Minas Gerais.

Looking at the screengrab of the kick, it’s unlikely that the Bra-Santos Dumont exoskeleton will instantly give you Cristiano Ronaldo skills, but it should certainly give some hope to soccer players who have lost the use of their legs.
 Paraplegic Performs World Cup’s Ceremonial First Kick in Mind-Controlled Robotic Suit

Measure 'Sixth Vital Sign' Using App "GaitTrack"

Bruce Schatz, lead researcher on the project GaitTrack app says it is different from other fitness apps, since it uses eight motion parameters to gather, record, and analyze critical information about a person’s gait — the overall pattern of a person’s physical movements while walking.

Schatz classifies gait as the “sixth vital sign" adding to the important vital health measurements as temperature, blood pressure, heart rate, respiratory rate, and blood oxygen level. Gait analysis can provide important information about a patient’s cardiopulmonary, muscular, and neurological health.
Routinely - actually rarely we use "6 min walk test" for checking the cardiovascular status of the client which is not ideal for detecting a new or already existing worsening condition. GaitTrack, developed by University of Illinois converts any cellphone into a sophisticated medical monitor for your heart and lungs.

The GaitTrack app runs constantly in the background of a user’s smartphone and periodically measures, records, and analyze key data related to gait. The app collects data in six minute increments tracking the user’s walking gait and analyzing it. It would then alert the patient or the patient’s doctor if the data ever indicated a dangerous change. It can be an important tool for those with congestive heart failure, chronic obstructive pulmonary disease (COPD), and asthma.

The GaitTrack app takes advantage of accelerometers and if coupled with a pulse oximeter, the app can record the gait along with the person’s heart rate and blood oxygenation for a more complete picture of health. The app have been tested in a research on 30 patients with chronic obstructive pulmonary disease (COPD) and found that the app is more accurate, and surely cheaper, than medical accelerometers already used in medicine. They discovered that the GaitTrack app was able to quite accurately predict a person’s FEV1 test (Forced Expiratory Volume in 1 Second).
The app will be publicly available sometime later this year.

Special Implication for PTs -
When we talk about therapy to improve gait, PTs know all the troubles to get effective results. Especially if we are dealing with Cardiopulmonary patients we have to be very precautious. This app will be a boon for PTs as it not only gives the parameters important for gait but also checks for the vitals related to heart as well as lungs which can help us to set the goals.

GaitTrack Smartphone App, a Medical Device for Automatic Gait Assessment

iHealth Align - The world’s smallest, most portable mobile glucometer

On June 12, 2014, Health Lab Inc. announced the launch of the iHealth Align, the world's smallest, FDA-approved mobile blood glucose monitor.

Simply plug in the iHealth Align into a smart phone and use it with the companion iHealth Gluco-Smart app in order to take a reading. Align has to be fully inserted into the audio port. iHealth Align comes with two CR1620 batteries. The battery needs to be installed before use.

The free iHealth Gluco-Smart app automatically keeps a history of your data and gives you the option to share your information with your doctor or caregiver. The devices work with both Apple and Android devices.

By displaying readings directly on the phone screen, iHealth was able to shrink the device size to just slightly larger than the circumference of a quarter. The compact size and mobile sync capability make iHealth Align a small and powerful new tool for diabetes management.

iHealth Align is the next generation of mobile solutions to diabetes management.

The budget friendly device is priced just $16.95 which comes with a lancing device and four colorful protective cases. Consumers can pre-order the iHealth Align beginning today at iHealthlabs.com. 

iHealth test strips are now available at the new low price of $12.50 per vial of 50 strips and can be found at iHealthlabs.com and Walgreens.com. The companion iHealth Gluco-Smart App is available for free from the Apple App Store for iPhone from Google Play for Android devices.

iHealth Align, World’s Smallest FDA Cleared Glucometer, Now Available in U.S. 

Special Implications for PTs
Physiotherapy plays a huge role in Diabetes management. Keeping track of the Blood Glucose level helps us decide our goals for patients. The exercise prescription is made on the basis of Blood Glucose level when it comes to Diabetic patients in order to prevent exercise induced hypoglycemia. If Glucometer like the one designed by iHealth is handy, testing levels become easier and safer too.

Health Kit app by Apple iOS 8 - Revolution in Health?

The Apple Worldwide Developers Conference (WWDC) 2014 event on June 2-6 in San Francisco certainly did not disappoint with the official announcement with news of HealthKit.

The new Health app gives you an easy-to-read dashboard of your health and fitness data. HealthKit which allows all the incredible health and fitness apps to work together might be the beginning of a health revolution.

Heart rate, calories burned, blood sugar, cholesterol; a complete health and fitness apps are great at collecting all that data.

The new Health app puts that data in one place, accessible with a tap, giving you a clear and current overview of your health. You can also create an emergency card with important health information — for example, your blood type or allergies — that’s available right from your Lock screen.

With HealthKit, developers can make their apps even more useful by allowing them to access your health data, too. And you choose what you want shared. For example, you can allow the data from your blood pressure app to be automatically shared with your doctor. Or allow your nutrition app to tell your fitness apps how many calories you consume each day. When your health and fitness apps work together, they become more powerful. And you might, too.

This time, it looks like population at large will be the main beneficiary.

Health tracking built in with your new smartphone: a new revolution?

Special Implications for PTs -

Documentation is very important when it comes to healthcare. This Health app will save time when we are dealing with patients especially in critical care. History is the most important part of documentation and when we ask patients about it, there may be times when important piece of information can get skipped. This app will fill in the gap of memory as well as will be time saving.

You wouldn't miss a murmur with Thinklabs One Digital Stethoscope

Thinklabs Medical devised a high end electronic stethoscope "Thinklabs One" with Advanced Audio Features.

It has changed the icon of medical practice where we tried to hear the human body using a hollow tube.



This new reinvented digital stethoscope is the smallest and the most powerful stethoscope in the world which fits in your palm and amplifies 100 times the vital sounds using audio headphones.
The device can be connected to tablets and smartphones to visually display the waveform of the audio using a matching app, which can also record and zoom for further clarification.

Thinklabs provides a library of pre-recorded heart sounds with the iMurmur app that can be used to learn and maybe even compare against one’s own patients. The standard package comes with a set of in-ear headphones. For the stylish physician there’s also the Beats Package that comes with Dr. Dre’s Executive headphones that feature noise canceling technology.

Its beyond "Bell" and "Diaphragm" to multiple filter choices where the frequencies can be set for low, midrange or higher frequencies. You wouldn't miss any of the sounds be it S3, valves and murmurs, and lung sounds. It will also filter out ambient noise frequencies. The Rechargeable Lithium Ion Battery requires only one or two charges a week with a typical workload, designed for 100 - 125 patient exams per charge. Battery indicator mode indicates the battery capacity.

It has open up a world of possibilities for Telemedicine, Education, Research and Electronic Medical Records (EMR).

Special Implications for PTs -
Being a health profession it is very important to keep track of vitals of patients. Thinklabs One Digital Stethoscope will be of gr8 help to PTs for practicing not only in the emergency care but in regular practice too. It will also help in academics and research.

Time to put your old stethoscope aside and switch to Thinklabs One 

Permanent Joint implants - Yes its without an expiry date!

Artificial joints presently come with a limited lifespan.  With wear and tear of these implants after few years from transplant many hip and knee joints have to be replaced. The situations become more complex when we talk about wear and tear of intervertebral disc implants, which cannot easily be replaced after their "expiry date". This restricts the patient's freedom of movement considerably.
Dr. Kerstin Thorwarth and team at Nanoscale Materials Science at Empa technology have devised a coating made of DLC ("diamond-like carbon") on mobile intervertebral disc implants so that they show no wear and will now last for a lifetime.

Normally a standard procedure of artificial joint replacements can be repeated up to three times with most implants.  As bone material is lost each time an implant is explanted, the new joint has to replace more bone and is therefore larger. In the case of intervertebral discs, this is virtually impossible. They are too close to spinal nerves and tissue structures that could be damaged by another operation. Currently available product implants carry the risk of triggering allergies or rejection reactions due to material abrasion.

These abrasions are actually caused by the corrosion behaviour of the bonding agent between the DLC layer and the metal body. This layer was made of silicon which corroded over the years, causing it to flake, which led to increased abrasion and, as a result, bone loss.

Empa researcher finally found and tantalum to be used as the bonding agent.  This coating was tested in a so-called total disc replacement - a mobile disc implant. They simulated 100 million cycles, i.e. about 100 years of movement in a specially designed joint simulator.  The small intervertebral disc implant held out, remaining fully operational with no abrasion or corrosion. The new bonding agent will be used in combination with DLC coatings for other joints too in near future.

Specific Implications for PTs -

Physiotherapist plays a major role in rehabilitation post joint transplant, where we see patients dealing with a new joint. Some patients recover within weeks, some take months to years.
If the same process of joint transplant is repeated after five to ten years, the patient may find it difficult to rehabilitate fully as aging leave its mark on body. The healing capacity as well as functioning reduces with age, hence this permanent joints will help patients to recover once from the agony of transplant. Knowledge about provision of such implants is essential for the benefit of the patients.

Joint implants without an expiry date from Empa technology

New Coating May Finally Help Make Artificial Joints Last a Lifetime.

Mirrors are miraculous

"Twice a day, ten minutes per session, for five weeks and the phantom pain will go away" - Stephen Sumner's recipe for mirror therapy.

That was Vilayanur S. Ramachandran who invented mirror box to help alleviate phantom limb pain, in which patients feel they still have a limb after having it amputated. Albeit research and researchers have their ongoing debate, there are people who feel benefited to alleviate the phantom pain with help of mirror therapy.

This story is of Stephen Sumner who lost his left leg that had been amputated six inches above the knee and his phantom pain. Stephen used the mirror for two weeks, then stopped because the pain had not returned. About a year and a half later, he felt the pain again, and this time he stayed the course for the full five weeks. He hasn’t had phantom pain for over four years. “It’s gone now,” he says. “It’s gone because I treated myself with a mirror.”

This man have done many magnificent jobs past the event and now he is on a mission to alleviate pain of people suffering from Phantom pain using mirrors. He meets people with amputation, learns about their story and shares his too. With people who have phantom pain he gives a mirror, teaches them the use of it and thereby alleviates their pain. He is "Mirror Man"; a mirror therapist who first targetted Cambodia, place where landmines and unexploded ordnance killed around 20,000 people and injured 44,000 more between 1979 and 2011.

Stephen thoughts about phantom pain is that “It’s not in the head, it’s in the limb.” He have travelled around Asia with mirrors on the back of his bicycle to help amputees who were suffering from phantom pain but now he is exhausted. He says "Mirrors are supereffective".

Stephen offers a simplified explanation of the brain reorganisation theory. Pointing to his head, he says, “You have a commander here that controls the body. The commander has a map of the whole body. When the map doesn’t match the body, the commander panics and you feel pain. This mirror is to trick the commander into thinking the leg still exists, so he stops panicking and the pain goes away.”

He is dedicated towards helping people to overcome from phantom pain using mirrors, read his full story by clicking the link below.

Specific Implications for Physiotherapists -
Mirror therapy is a part of Graded Motor Imagery which consist of three steps.
1st. Left Right Discrimination
2nd. Explicit Motor Imagery
3rd. Mirror Therapy
In order to get effective results we need to know the technique properly. Only use of mirror wouldn't give effective results.
See these videos from David Butler

Mirror Box Therapy with David Butler

GaitTrack Smartphone App, a Medical Device for Automatic Gait Assessment 

Its Is Not Just Big Tobacco Anymore

Hence WHO's Global NCD (Non Communicable diseases) Action Plan accepts the road to 25 × 25.
The UN high-level meeting on NCDs in September 2011 accepted the recommendation of Pearce and colleagues to include the 25×25 strategy to tackle the global epidemic of NCD. Margaret Chan, Director General of WHO stated that “It is not just Big Tobacco anymore. Public health must also contend with Big Food, Big Soda, and Big Alcohol. All of these industries fear regulation, and protect themselves by using the same tactics”.

The increasing burden of NCDs poses an enormous threat to populations and health systems across the globe. The 25×25 strategy seeks to reduce preventable mortality. The WHO Global NCD Action Plan 2013—2020 includes many disorders, the four disorders specified in the 25 ×25 strategy (cardiovascular disease, diabetes, cancer, and chronic respiratory disease) account for 87% of all deaths from NCDs. This plan lists nine voluntary national targets i.e. diabetes, obesity, reduced alcohol consumption, increased physical activity, reduced dietary salt, reduced smoking, improved blood pressure control, and enhanced treatment of those at risk are the major NCDs. The plan will acknowledge social, economic as well as political determinants of disease. However, making changes into the policy is less clear.

“The 25×25 strategy needs to be implemented in existing health systems in low-income and middle-income countries (LMICs), particularly in primary care. This approach would address NCDs in broader social, economic, and health-care contexts, adaptable to local circumstances.”

Special Implications for PTs
In the past decade energy expenditure has decreased markedly because of changes in the livelihood, including urban design, safety concerns, the rise of the car, and the near demise of public transport.
The dire need is environmental change so that physical exercise becomes part of daily life again, rather than being a lifestyle choice. If exercise were a pill, it would be one of the most cost-effective drugs ever invented. People can get lot of benefit from being more physically active.
Of all the health professionals dealing with NCDs, PTs have a big role in prevention as well as management of NCDs.
Thumb rule is increasing Physical Activity in order to meet up the 25×25 strategy success.

The road to 25×25: how can the five-target strategy reach its goal?

25×25 strategy for the burden of non-communicable diseases 

Weak Grip Strength Does not Predict Upper Extremity Musculoskeletal Symptoms or Injuries Among New Workers

Purpose Grip strength is often tested during post-offer pre-placement screening for workers in hand-intensive jobs.

The authors' purpose of this study was to evaluate the association between grip strength and upper extremity symptoms, work disability, and upper extremity musculoskeletal disorders (UE MSDs) in a group of workers newly employed in both high and low hand intensive work.

1,107 recently-hired workers completed physical examinations including grip strength measurements. Repeated surveys obtained over 3 years described the presence of upper extremity symptoms, report of physician-diagnosed musculoskeletal disorders (MSDs), and job titles. Baseline measured grip values were used in analytic models as continuous and categorized values to predict upper extremity symptoms, work disability, or UE MSD diagnosis.

Results Twenty-six percent of males and 20 % of females had low baseline hand strength compared to normative data. Multivariate logistic regression analyses showed no consistent associations between grip strength and three health outcomes (UE symptoms, work disability, and MSDs) in this young cohort (mean age 30 years). Past MSD and work type were significant predictors of these outcomes.

Conclusions Physical hand strength testing was not useful for identifying workers at risk for developing UE MSDs, and may be an inappropriate measure for post-offer job screens.

Dale AM, Addison L, Lester J, Kaskutas V, Evanoff B. Weak Grip Strength Does not Predict Upper Extremity Musculoskeletal Symptoms or Injuries Among New Workers. J Occup Rehabil 2014 06;24(2):325-31. 

Somatic dysfunction and fascia’s gliding potential

Somatic dysfunction is defined as “impaired or altered function of related components of the somatic (body framework) system: skeletal, arthrodial, and myofascial structures, and related vascular, lymphatic, and neural elements.” (Ward, 2003).

The osteopathic model of somatic dysfunction, that attempts to make sense of such a finding, has been summarized by the acronym STAR (Dowling, 1998).

This includes:
“S” =  sensitivity (abnormal tenderness)
“T” =  tissue texture change such as altered tone, laxity etc.
“A” =  asymmetry (malalignment)
“R” =  range of motion and pliability reduction (e.g. contracture)

The STAR designation offers no diagnosis - only an observation that all may not be well in the tissues being evaluated, demanding further investigation as to causal, aggravating and maintaining features  whether local, global or distant.

Sliding, gliding functions as part of the “R” feature of somatic function and dysfunction!

Chaitow L. Somatic dysfunction and fascia's gliding-potential. J Bodywork Movement Ther 2014 01;18(1):1-3.

Effect of therapeutic infra-red in patients with non-specific low back pain

The authors objective with this study was to investigate the effect of superficial heat by infra-red (IR) in patients with chronic non-specific low back pain (NSLBP).

Ten patients with NSLBP (5 men and 5 women) and disease duration of 21.7 11.50 months participated in this pilot study. Patients had a mean age of 36.40 10.11 years (range Z 25e55). Patients were treated with infra-red (IR) for 10 sessions, each for 15 min, 3 days per week, for a period of 4 weeks.

Outcome measures were the Numerical Rating Scale (NRS), the Functional Rating Index (FRI), the Modified eModified Schober Test (MMST), and the Biering-Sorensen test to assess pain severity, disability, lumbar flexion and extension range of motion (ROM), and back extensor endurance, respectively.

Data were collected at: baseline - study entry (T0); end of 5th treatment session after 2 weeks (T1); and end of the treatment after 4 weeks (T2). The results of the ANOVA demonstrated a statistically significant main effect of IR on all outcomes of pain, function, lumbar flexion-extension ROM, and back extensor endurance.

The treatment effect sizes ranged from large to small. IR was effective in improving pain, function, lumbar ROM, and back extensor endurance in a sample of patients with NSLBP. Treatment effect sizes ranged from large to small indicating clinically relevant improvements primarily in pain and function for patients with NSLBP.

Ansari NN, Naghdi S, Naseri N, Entezary E, Irani S, Jalaie S, et al. Effect of therapeutic infra-red in patients with non-specific low back pain: a pilot study. J Bodywork Movement Ther 2014 01;18(1):75-81. 

Including a range of outcome targets offers a broader view of fibromyalgia treatment outcome: results from a retrospective review of multidisciplinary treatment.

Fibromyalgia is associated with substantial functional disability. Current drug and non-drug treatments result in statistically significant but numerically small improvements in typical numeric measures of pain severity and fibromyalgia impact.

The authors aim with this study was to evaluate additional measures of pain severity and functional outcome that might be affected by fibromyalgia treatment. This retrospective review evaluated outcomes from 274 adults with fibromyalgia who participated in a six-week, multidisciplinary treatment programme.

Pain and function were evaluated on the first and final treatment visit. Pain was evaluated using an 11-point numerical scale to determine clinically meaningful pain reduction (decrease ≥ 2 points) and from a pain drawing. Function was evaluated by measuring active range of motion (ROM), walking distance and speed, upper extremity exercise repetitions, and self-reports of daily activities.
Numerical rating scores for pain decreased by 10-13% (p < 0.01) and Fibromyalgia Impact Questionnaire (FIQ) scores decreased by 20% (p < 0.001). More substantial improvements were noted when using alternative measures. Clinically meaningful pain relief was achieved by 37% of patients, and the body area affected by pain decreased by 31%. ROM showed significant improvements in straight leg raise and cervical motion, without improvements in lumbar ROM. Daily walking distance increased fourfold and arm exercise repetitions doubled. Despite modest albeit statistically significant improvements in standard measures of pain severity and the FIQ, more substantial pain improvement was noted when utilizing alternative measures of pain and functional improvement.

Alternative symptom assessment measures might be important outcome measures to include in drug and non-drug studies to better understand fibromyalgia treatment effectiveness.

Marcus DA, Bernstein CD, Haq A, Breuer P. Including a range of outcome targets offers a broader view of fibromyalgia treatment outcome: results from a retrospective review of multidisciplinary treatment. Musculoskeletal care 2014 06;12(2):74-81. 

The Impact of Persistent Pain on Working Memory and Learning

The authors by this study reviewed the evidence that persistent pain has the capacity to interrupt and consume working memory resources.

It was argued that individuals with persistent pain essentially operate within a compromised neurocognitive paradigm of limited working memory resources that impairs task performance.

Using cognitive load theory as a theoretical framework, the study investigated if multimedia materials could be used to support individuals with persistent pain. A 2×2 design was used where the first factor was the pain status of the participant (absence vs. presence for more than 6 months), and the second was instructional strategy (written + illustrations vs. written). Fifty-eight full-time teachers from two schools in New South Wales (Australia) were randomly assigned to an instructional strategy to learn about lightning formation.

Participants that identified as experiencing pain for 6 or more months demonstrated clinically low levels of pain, but nevertheless performed significantly worse than pain-free participants on retention and transfer tests. For both pain and pain-free participants, there was a significant benefit in learning from multimedia instruction compared to a written text only strategy.

Smith A, Ayres P. The Impact of Persistent Pain on Working Memory and Learning. Educational Psychology Review 2014 06;26(2):245-264. 

Short- and long-term changes in perceived work ability after interdisciplinary rehabilitation of chronic musculoskeletal disorders.

The authors objective with this study was to  investigate the changes in rehabilitants' perceived work ability after rehabilitation for chronic musculoskeletal disorders with respect to the baseline characteristics.

The study design followed it prospective cohort study based on register and repeated survey data.  Public sector employees in ten towns and five hospital districts were taken in the study.  A total of 854 employees who participated in the rehabilitation programme owing to common chronic musculoskeletal disorders between 1997 and 2009.

Interdisciplinary, biopsychosocial, inpatient rehabilitation programme targeting people of working age with common chronic musculoskeletal disorders. The programme was executed in different rehabilitation centres across the country and funded by the Social Insurance Institution of Finland.

Differences in perceived work ability level before and after rehabilitation was taken. Data were derived from repeated surveys on average 2.1 years before rehabilitation, and 1.5 years (short-term follow-up) and 6.0 years (long-term follow-up) after rehabilitation.

RESULTS: Before the rehabilitation, perceived work ability was 7.13 (SD 1.84) among the rehabilitants and 7.27 (SD 1.72) in the matched reference population. Among rehabilitants, this figure decreased by 0.82 (95% confidence interval -0.98 to -0.67) in the short-term and by 1.26 (95% confidence interval -1.45 to -1.07) in the long-term follow-up. Only slight differences in steepness of this deterioration were observed between subgroups, created based on the participants' baseline characteristics.

Perceived work ability of participants, in an interdisciplinary biopsychosocial rehabilitation programme for common musculoskeletal disorders, deteriorated regardless of any studied pretreatment characteristics. The improvement of work ability may be an unrealistic goal for participants in this type of rehabilitation.

Saltychev M, Laimi K, Pentti J, Kivimäki M, Vahtera J. Short- and long-term changes in perceived work ability after interdisciplinary rehabilitation of chronic musculoskeletal disorders: prospective cohort study among 854 rehabilitants. Clin Rehabil 2014 06;28(6):592-603. 

Impact of the fibromyalgia in the chronic fatigue syndrome

Different studies have showed association of the chronic fatigue syndrome (CFS) with other pathologies, including fibromyalgia (FM).

The author's objective with this study was to analyze whether there are differences in the clinic and in the assessment of fatigue in CFS patients associated or not with FM. A cross-sectional, single-site observational study was undertaken on a consecutive cases of a register of CFS patients at CFS Unit in Vall d'Hebron Hospital, Barcelona, from January 2008 until March 2011. The variables analyzed were FM comorbidity, sleep and fatigue characteristics and cognitive, neurological and autonomic symptoms. Questionnaires of fatigue impact scale, fatigue strength and impact on quality of life SF-36 were evaluated. We included 980 CFS patients (mean age: 48±9 years; 91% women).

Fibromyalgia was present in 528 patients (54%). The level of fatigue (P=.001) and pain (P<.001) was higher in FM patients. Patients with CFS and FM had more prevalence of sleep-related phenomena. The percentage of patients and the degree of severity of cognitive symptoms, neurological and autonomic dysfunction was higher in FM patients (P<.001). FM patients scored higher on the fatigue impact scale (P<.001) and showed worse results in the quality of life questionnaire (P<.001). FM co-morbidity worse clinical parameters, fatigue and the perception of quality of life in CFS patients.

Faro M, Sáez-Francàs N, Castro-Marrero J, Aliste L, Collado A, Alegre J. Impact of the fibromyalgia in the chronic fatigue syndrome]. Medicina clínica 2014 Jun 16;142(12):519-525. 

The effects of an 8-week, physiotherapy-led, structured group intervention during the early survivorship phase.

Health and Medicine; Findings from University of Dublin Trinity College Broaden Understanding of Physical Therapy and Rehabilitation Med

According to news reporting out of Dublin, Ireland, by NewsRx editors, research stated, "Strong evidence exists for rehabilitation programmes following a cancer diagnosis, although little is known about their cost. The effects of an 8-week, physiotherapy-led, structured group intervention during the early survivorship phase were evaluated."

Our news journalists obtained a quote from the research from the University of Dublin Trinity College, "Significant changes in quality of life and fatigue, and promising changes in fitness were found. The overall cost for this programme was is an element of 196 per participant, including the salaries of the clinicians, overheads and equipment costs."

According to the news editors, the research concluded: "The modest costs associated with this programme may support more routine 'cancer rehabilitation', although more robust analyses are required."

Health and Medicine; Findings from University of Dublin Trinity College Broaden Understanding of Physical Therapy and Rehabilitation Medicine. Obesity, Fitness & Wellness Week 2014 Jun 14:1390.

Therapies for ataxias.

Ataxia can originate from many genetic defects, but also from nongenetic causes. To be able to provide treatment, the first step is to establish the right diagnosis. Once the cause of the ataxia is defined, some specific treatments may be available.

Ataxia is a movement disorder resulting from the incoordination of movements and inadequate postural control, presented in balance and walking disturbances. It has three subcategories, which are sensory, cerebellar and vestibular ataxia. Some researchers regard frontal ataxia as the 4th category. Mixed ataxia involves symptoms of at least two basic types of ataxia together. Different clinical symptoms, interference of different neurological structures and different diseases play role in the formation of each ataxia type. Since ataxia is resistant to medical treatments, physical treatment applications are of major importance. Physical therapy applications involve proprioceptive training, balance exercises, stabilization techniques regarding the extremity ataxia and vestibular exercises for accomplishing functional improvement and restoration of the ataxic patient. Compensatory applications employ supportive devices.

For example, the nongenetic ataxias that arise from vitamin deficiencies can improve following treatment. In most cases, however, therapies do not cure the disease and are purely symptomatic.

Physiotherapy and occupational therapy are effective in all type of ataxias and often remain the most efficient treatment option for these patients to maximize their quality of life.

Martineau L, Noreau A, Dupré N. Therapies for ataxias. Current treatment options in neurology 2014 07;16(7):300. 

"Better for others than for me": A belief that should shape our efforts to promote participation in falls prevention strategies.

Falls are a common occurrence amongst older adults yet participation in prevention strategies is often poor. Although older adults may perceive a strategy works in general, they may not participate because they feel it will not benefit them personally.

The authors aimed to describe how frequently and why older adults identify falls prevention strategies as being "better for others than for me". A cross-sectional survey with n=394 community-dwelling older adults in Victoria, Australia was undertaken. Participants were provided with detailed descriptions of four evidence-based falls prevention strategies and for each were asked whether they felt that the strategy would be effective in preventing falls for people like them, and then whether they felt that the strategy would be effective for preventing falls for them personally. Follow-up questions asked why they thought the strategy would be more effective for people like them than for them personally where this was the case.

The authors found the "better for others than for me" perception was present for between 25% and 34% of the strategies investigated. Participants commonly said they felt this way because they did not think they were at risk of falls, and because they were doing other activities they thought would provide equivalent benefit.

Strategies to promote participation in evidence-based falls prevention strategies may need to convince older adults that they are at risk of falls and that what activities they are already doing may not provide adequate protection against falls in order to have greater effect.

Haines TP, Day L, Hill KD, Clemson L, Finch C. "Better for others than for me": A belief that should shape our efforts to promote participation in falls prevention strategies. Arch Gerontol Geriatr 2014;59(1):136-144. 

Influence of pressure-relief insoles developed for loaded gait (backpackers and obese people) on plantar pressure distribution and ground reaction forces.

Backpackers and obese subjects were benefited by using pressure relief insoles. One of the insoles better distributed the plantar pressures during the loaded gait. The vertical ground reaction force was decreased when one of the insoles was used. Different materials in the insoles influenced the plantar pressures and forces. Gait biomechanics is different among normal-weight, backpackers and obese subjects.

The authors aims with this study were to test the effects of two pressure relief insoles developed for backpackers and obese people on the ground reaction forces (GRF) and plantar pressure peaks during gait; and to compare the GRF and plantar pressures among normal-weight, backpackers, and obese participants.

Based on GRF, plantar pressures, and finite element analysis two insoles were manufactured: flat cork-based insole with (i) corkgel in the rearfoot and forefoot (SLS1) and with (ii) poron foam in the great toe and lateral forefoot (SLS2). Gait data were recorded from 21 normal-weight/backpackers and 10 obese participants. The SLS1 did not influence the GRF, but it relieved the pressure peaks for both backpackers and obese participants. In SLS2 the load acceptance GRF peak was lower; however, it did not reduce the plantar pressure peaks. The GRF and plantar pressure gait pattern were different among the normal-weight, backpackers and obese participants.

Peduzzi dC, Abreu S, Pinto V, Santos R, Machado L, Vaz M, et al. Influence of pressure-relief insoles developed for loaded gait (backpackers and obese people) on plantar pressure distribution and ground reaction forces. Appl Ergon 2014 07;45(4):1028-1034. 

Comparison of subjective comfort ratings between anatomically shaped and cylindrical handles

Most authors have provided diameter recommendations for cylindrical handle design in order to increase performance, avoid discomfort, and reduce the risk of cumulative trauma disorders. None of the studies has investigated the importance of determining the correct handle shape on the subjective comfort ratings, which could further improve the handles' ergonomics. Therefore, new methods based on a virtual hand model in its optimal power grasp posture have been developed in order to obtain customized handles with best fits for targeted subjects.

Cylindrical and anatomically shaped handles were evaluated covering ten subjects by means of an extensive subjective comfort questionnaire. The results suggest large impact of the handle shape on the perceived subjective comfort ratings. Anatomically shaped handles were rated as being considerably more comfortable than cylindrical handles for almost all the subjective comfort predictors. They showed that handle shapes based on optimal power grasp postures can improve subjective comfort ratings, thus maximizing performance. Future research should consider real conditions, since the comfort ratings can vary based on the specific task and by the tool selected for the task.

Harih G, Dolsak B. Comparison of subjective comfort ratings between anatomically shaped and cylindrical handles. Appl Ergon 2014 07;45(4):943. 

Task-specific performance effects with different numeric keypad layouts

Two commonly used keypad arrangements are the telephone and calculator layouts. The author's purpose with this study was to determine if entering different types of numeric information was quicker and more accurate with the telephone or the calculator layout on a computer keyboard numeric keypad. Fifty-seven participants saw a 10-digit numeric stimulus to type with a computer number keypad as quickly and as accurately as possible. Stimuli were presented in either a numerical [1,234,567,890] or phone [(123) 456-7890] format.

The results indicated that participants' memory of the layout for the arrangement of keys on a telephone was significantly better than the layout of a calculator. In addition, the results showed that participants were more accurate when entering stimuli using the calculator keypad layout. Critically, participants' response times showed an interaction of stimulus format and keypad layout: participants were specifically slowed when entering numeric stimuli using a telephone keypad layout. Responses made using the middle row of keys were faster and more accurate than responses using the top and bottom row of keys. Implications for keypad design and cell phone usage are also discussed in this paper.

Armand, J. T., Redick, T. S., & Poulsen, J. R. (2014). Task-specific performance effects with different numeric keypad layouts. Applied Ergonomics, 45(4), 917. 

Learning three sets of alarms for the same medical functions: A perspective on the difficulty of learning alarms specified in an international standard.

Three sets of eight alarms supporting eight functions specified in an international medical equipment standard (IEC 60601-1-8) were tested for learnability using non-anaesthetist participants.
One set consisted of the tonal alarms specified in the standard. A second set consisted of a set of abstract alarms randomly selected from a database of abstract alarm sounds held by the authors. A third set of alarms was designed as indirect metaphors of the functions.

The authors in this study presented the participants with the alarms and then asked to identify them across ten blocks of eight trials.

The results indicated a significant difference in learnability across the three sets of alarms. The indirect metaphors were learned significantly better than both other sets of alarms, and the randomly selected abstract alarms were learned significantly better than the alarms specified in the standard. The results suggest therefore that there are more readily learnable possible designs than those proposed in the standard. The use of auditory icons in particular should be given serious consideration as potential alarms for this application.


Edworthy, J., Page, R., Hibbard, A., Kyle, S., Ratnage, P., & Claydon, S. (2014). Learning three sets of alarms for the same medical functions: A perspective on the difficulty of learning alarms specified in an international standard. Applied Ergonomics, 45(5), 1291-1296. 

An investigation of training strategies to improve alarm reactions.

Researchers have suggested that operator training may improve operator reactions; however, researchers have not documented this for alarm reactions.
The authors goal for this research was to train participants to react to alarms using sensor activity patterns.

In Experiment 1, 80 undergraduates monitored a simulated security screen while completing a primary word search task. They received spatial, temporal, single sensor, or no training to respond to alarms of differing reliability levels.

Analyses revealed more appropriate and quicker reactions when participants were trained and when the alarms were reliable.

In Experiment 2, 56 participants practiced time estimation by simple repetition, performance feedback, or performance feedback and temporal subdivision. They then reacted to alarms based on elapsed time between sensor activity and alarm onset.

Surprisingly, results indicated that participants did not benefit differentially from temporal interval training, focusing instead on advertised system reliability. Researchers should replicate these findings with realistic tasks and real-world complex task operators.


Bliss, J. P., & Chancey, E. T. (2014). An investigation of training strategies to improve alarm reactions. Applied Ergonomics, 45(5), 1278-1284. 

The effects of different types of cognitive tasks in conjunction with circadian regulation on heart rate variability and performance parameters.

Every day, humans are exposed to a variety of tasks in the workplace, at home or even in activities of daily living. These tasks all require, to some extent, cognitive processing and activity. In order to perform a task, information from the environment must be perceived, interpreted and an appropriate response elicited (Wickens et al., 1998). The information processing places a certain amount of strain or demand on the resources available to process it (Wickens, 1985; Wickens et al., 1998). Therefore, the extent of this strain needs to be measurable to ensure that cognitive overload and performance impairment does not occur.

This authors aimed with this study to determine to which extent heart rate variability (HRV) is sensitive to changes in different forms of cognitive workload. The second objective was to determine the effects of cognitive tasks on HRV during different times of the day, in conjunction with the variability of performance parameters.

Five tasks were utilized, each at two levels of difficulty in order to ascertain specific cognitive resources. These tasks included a reading task, a decision-making task, a memory task and two forms of modified Fitts tasks. Only one of the modified Fitts tasks, which isolated motor organisation and the spelling error parameter for the difficult reading task showed a time of day effect with respect to performance. With respect to HRV, time domain analysis (rMSSD) and the low frequency (LF) band of a frequency domain analysis showed an overall significant effect of difficulty over all five tasks. The LF band, the high frequency (HF) band, rMSSD and heart rate frequency were sensitive to changes in cognitive workload for the memory task. The LF band was also sensitive to changes in cognitive workload for the modified Fitts task, which isolated motor organisation. The LF-HF ratio was the only HRV parameter that was influenced by the time of day during cognitive task performance.

In conclusion, in some instances, HRV was sensitive to changes in cognitive workload for specific HRV parameters and tasks, with selected HRV variables also being affected by time of day. However, no straightforward assignment of workload to HRV parameters and vice versa can be made yet.

Huysamen, K. C., Göbel, M., & Davy, J. (2013). The effects of different types of cognitive tasks in conjunction with circadian regulation on heart rate variability and performance parameters. Ergonomics SA, 25(1), 52-67. 

Comparisons of Muscular Activity in Males and Females While Walking in Restricted Postures

Increasing numbers of females are entering industrial workplaces. In the mining industry in South Africa, for example, this is partly the result of employment equity laws, which have ruled that by 2009 at least 10% of the workforce must be female (Department of Minerals and Energy, 2004). Differences in factors such as anthropometry and strength are evident between males and females. Males are generally taller and heavier than females, and possess a higher percentage of muscle mass and a lower percentage of body fat compared to females (McArdle et al, 2001). Furthermore, males are seen to possess significantly greater absolute strength than females, while females maintain approximately 50% of the upper body strength of males and 70% of the lower body strength of males (McArdle et al, 2001). Gender is also a factor that influences movement patterns during walking and running, and intrinsic characteristics, including skeletal alignment, muscle strength and anthropometric differences, are likely to contribute to this (Chiu and Wang, 2007). As a result, it is expected that responses to manual tasks are likely to differ between males and females.

The purpose of the authors to do this study was to examine differences in muscular activation between males and females while walking in restricted postures. Restricted postures are evident in various industries, including mining, construction and agriculture. These postures are associated with musculoskeletal disorders and lower back pain. Studies generally focus on a male workforce; however, more females are entering industrial workplaces.

Twelve male and 12 female subjects between the ages of 18 and 25 years participated in the study. Subjects walked on a treadmill at a speed of 3.5 km/h for four minutes under conditions of upright walking, and stooped walking under restrictions at 85% and 70% of stature. Electromyographic activity was measured on seven muscles (trapezius, latissimus dorsi, erector Spinae, rectus femoris, biceps femoris, medial gastrocnemius and tibialus anterior). Ratings of Perceived Exertion (RPE) and Body Discomfort were also obtained. The extent of vertical restriction significantly altered levels of muscle activation. Female subjects had significantly lower levels of activation of the medial gastrocnemius than males. Local RPE was greatest under the lowest restriction, and body discomfort of the neck, lower back and hamstrings was evident during restricted walking. Work place design and interventions should consider these consequences.

Hodgskiss, J., & Zschernack, S. (2013). Comparisons of muscular activity in males and females while walking in restricted postures. Ergonomics SA, 25(1), 39-51. 

A study of ergonomic factors leading to computer vision syndrome among computer users

The invention of computers has transformed and modernized both the work place and the home environment (Blehm et al., 2005). It has been estimated that the number of computer users globally was 670 million in 2007, and rising to 1 billion in 2010 (Izquierdo et al., 2007). With the rate at which the google computing system has grown, the total number of computer users is currently likely to be much higher than 1 billion. According to the National Institute of Occupational Health and Safety (NIOHS), USA, any individual who works with a computer for more than three hours per day is likely to experience symptoms of CVS (Jaschinki-Kruza, 1991; Atenio, 1996). CVS is defined as a complex of eye and vision problems which are experienced during computer use or a task related to the use of a computer (Wimalasundera, 2006; Yan et al, 2008). The symptoms of CVS can be divided broadly into two categories; eye and vision-related symptoms (e.g. dry eyes, watery eyes, irritated and burning eyes, eye strain, eye fatigue, headache, blurred vision and double vision) and posture-related symptoms (e.g. neck, shoulder and back pain) (Verma, 2001, Blehm et al., 2005; Sheedy, 2000; Yan et al., 2008). Other reported symptoms include light and glare discomfort, after-image distortion and colour distortion (Verma, 2001; Sen and Richardson, 2007).

The authors aim of this study was to investigate the ergonomic factors that might lead to computer vision syndrome (CVS) among non-presbyopic computer users in a University staff population. A complete eye examination was performed on each participant before he or she was interviewed using a structured questionnaire probing into demographic status and factors that could lead to CVS.
Eighty seven participants were included in the study. An observation and measurement of the participant's computer workstation was then made in order to identify the risk factors leading to CVS. Data were analysed with descriptive statistics. 72% of participants reported taking breaks after 2 hours while 28% reported taking breaks after every hour of computer use. Eye strain and visual fatigue (89%), headaches (81%), neck and back pains (77%) were the most severe and frequently reported symptoms among the participants. In general, the computer workstations were not economically designed and users were not aware that they were not adhering to ergonomie requirements for computer use.

This suggests the need for awareness campaigns on ergonomic factors that can prevent computer vision syndrome among computer users and early intervention programs for computer users that experience computer vision syndrome.

Mashige, K. P., Rampersad, N., & Oduntan, O. A. (2013). A study of ergonomic factors leading to computer vision syndrome among computer users. Ergonomics SA, 25(1), 3-12.

The effects of posture and cognitive information processing from different sensory modalities on perceived musculoskeletal discomfort and work performance

It appears evident within the literature that many individuals are subjected to a double burden of both physical and mental demands at work (Garson, 2009; Szeto, 2009). Physical work exposures often include having to maintain awkward, static postures for sustained periods of time, which ultimately result in the onset of local muscle fatigue and accompanied symptoms of discomfort (Armstrong et al., 1993). It is suggested that symptoms of discomfort trigger the motivation to recover vital resources, depleted during work, through down-regulation or complete rest (Brandäo and Graeff, 2006).

Various authors, however, have reported that the distraction, offered by concurrent cognitive engagement causes perceptions of discomfort to be over-ridden (or attenuated) (Bushnell et al., 1985; Miron et al., 1989; Hodes et al., 1996; Bushnell et al, 1999; Bantick et al, 2002; Tracey et al., 2002; Seminowicz et al., 2004; Van Damme et al., 2008). Hence, individuals who have jobs that require high levels of concentration are more likely to suffer from long-term musculoskeletal injuries, on account of being unable to receive biofeedback regarding the appropriate timing of rest and recovery (Garson, 2009). In contrast, it has also been reported that intense symptoms of discomfort/pain disrupt cognitive processing, resulting in lowered work performance (Eccleston et al, 1999).
The authors aimed with this research was to investigate the influence of time, awkward posture, and cognitive processing (utilizing different senses; visual and auditory) on measured physical (heart rate (HR), heart rate variability (HRV), electromyography (EMG)), perceptual (body discomfort (BD)) and performance (% error and reading speed) responses.

Results indicated that, apart from the percentage of error incurred, the influence of modality had no significant effect on any of the measured responses, irrespective of time and posture assumed. Exposure to an awkward posture, designed to induce muscular discomfort, had a significant impact on measured HRV during the visual condition. The addition of a stooped posture caused a significant improvement in auditory performance, during the first two minutes. Apart from this unexpected finding, which can be explained by the order of permutation, induced muscular discomfort caused no significant decrements in performance. Performance and HRV remained relatively unaffected by the influence of time. However, perceptions of body discomfort (BD) increased significantly from minute two to four.

Hopley, B., & Mattison, M. (2013). The effects of posture and cognitive information processing from different sensory modalities on perceived musculoskeletal discomfort and work performance. Ergonomics SA, 25(2), 12-21. 

A Study of Musculoskeletal Discomforts and Associated Risks among Indian Percussion (Tabla) Players

Musculoskeletal disorders at work are often the prime topic of discussion and research (Yeung et al, 1999). They are widespread in many countries, incurring substantial cost and affecting quality of life. The major contributory risk factors are non-optimal body posture, forceful and repetitive movements, whole body vibration and psychological stress. The risk factors are prevalent in almost all occupations (Punnett and Wegman, 2004). Unlike other professionals, the work of instrumentalist involves playing musical instruments hence work-related musculoskeletal disorders are called playing-related musculoskeletal disorders (PRMDs), which are often disabling (Zaza et al 1998; Bragg 2006). The prevalence of PRMDs in musicians has been found to range from 32% to 87% (Zaza et al, 1998; Storm, 2006).

The Tabla is the most popular percussion instrument used in Indian classical music. Ragothman (2004) reported that Tabla players also suffer from PRMDs. Tabla playing involves repetitive striking movements, force, contact stress and constrained posture for longer period of time which may be the predisposing factors for PRMDs. A study from The University of Pittsburg reported that Indian Tabla players suffer from musculoskeletal discomforts. Among harmonium, sarod and Tabla, Tabla players suffered from the greatest discomfort (http://www.umc.pitt.edu/india3/studv.htmr).

The authors conducted the study to find the most affected areas of discomfort and to identify the major risk factors contributing to playing related musculoskeletal discomforts among Indian Tabla players. Eighty-four professional Tabla players voluntarily participated in the study. The Nordic musculoskeletal questionnaire (NMQ) was administered to identify the susceptible/affected anatomical areas. A questionnaire consisting of eight items on a 10 point likert scale based was administered to identify the risk factors contributing to PRMDs. Results of the NMQ showed that the most commonly affected areas were the lower back (74.15%), right shoulder (67.06%) and neck (67.06%). The internal consistency of the questionnaire was determined by Cronbach's alpha which was found to be acceptable. From the factor analysis results, two factors emerged. Factor one was identified as posture related risk factors while factor two was identified as occupation related risk factors. The risk factors identified in the study were similar when compared to other instrumentalists.


Mishra, W., De, A., Gangopadhyay, S., & Chandra, A. M. (2013). A study of musculoskeletal discomforts and associated risks among indian percussion (tabla) players. Ergonomics SA, 25(2), 2-11.