Prevalence Of Musculoskeletal Disorder Health And Social Care Essay

Musculoskeletal disorders, also called repetitive motion disorder, are injuries of the muscles, tendons, ligaments, joints, cartilage, nerves, and spinal discs. It could lead to occupation injury because of repetitive movement, forceful exertion, poor posture, and other factors. Back pain is one of musculoskeletal disorders most commonly experienced radiographers or x-ray technicians. This is attributed to poor posture and wrong movements that radiographers used to do during their long working hours (1)

One common wrong movement practiced by radiographers is carrying cassettes on the hip, which puts load on one side of body and imparts torsional strain on the spinal muscles. Other wrong movements include; lifting patient by one radiographer with arms and legs in straight position, and bending from their waist with straight legs to retrieve an object from the floor (1-3). To avoid back pain among the radiographers, there must be safety rules and principles to follow during working hours.

Literature Review:

Several studies aimed to investigate the relationship between musculoskeletal disorders and occupational therapy among radiographers. All showed similar result indicating that the most common pain among radiographers was low back pain (4-9).

Back pain among radiographers:

An initial study of back pain was done by D. Wright and P. Witt (1993) to indicate any incidence of back pain, obtain demographic data, and discover preferences for performing radiography tasks. Randomly, 226 radiographers were chosen but only 18 male and 92 female radiographers accept to actively participate. Most of them worked in general diagnostic areas and were divided into two group. The first group consisted of participants with back pain from both genders. The male mean age was 40.08, mean height 68.3 inches, average of weight 181 pounds, and average of back pain intensity 2.4 on 10 point scales. The female mean age36.79, mean height 64.5 inches, average of weight 146 pounds and average of back pain intensity 3.5 on 10 point scales. Both males and females with back pain reported 6.85 of work related stress. The second group was without back pain. The male mean age was 43, mean height 69.8 inches, and average of weight 171 pounds. The female mean age37.56, mean height 64.8 inches, and average of weight 142 pounds. Their mean age was 43 for males and 37.56 for females.

Instrument of the study was through the use of a survey with eight written pages and demographic information related to age, height, weight, area of specialization, work related stress, intensity and anatomical distribution of back pain. It was distributed to the volunteer to collect descriptive frequency data on back pain and their methods to perform 10 tasks. Some of these tasks were: moving over head tube, carrying multiple cassettes and transferring horizontal patient. It was found that there was no significant age, height, weight related links for back pain. It was also found that the methods to perform the tasks was not related to back pain. The study suggested that repeated poor posture, back strain, and faulty body mechanics may lead to back pain. However due to small sample size and self selected survey the study had limitations (4).

Risk factors and musculoskeletal complaints in X-ray technologists:

Another study was done by E. Bos, et al (2007) to determine prevalence rates of musculoskeletal complaints of neck, shoulder and low back and perceived exposure to risk factors. Non-specialized nurses, Intensive Care Unit (ICU) nurses, operation room nurses, and x-ray technologists (n= 3169), worked in 8 different hospitals, were included in the study.

A Dutch Musculoskeletal Questionnaire, which is a standardized questionnaire, partly derived from the Nordic Musculoskeletal Questionnaire, was given to the subjects to collect personal information and demographic information such as height, weight, function, having managerial task, working hours, and work in past and lifestyle. Moreover, musculoskeletal complaints, musculoskeletal workload, health, task, and psychosocial working conditions items were included. The final results clearly showed that x-ray technologists and nurses reported low back complaints (5).

Musculoskeletal complaints among x-ray technologists:

A cross-sectional study was done by A. Lorusso, S. Bruno, and N. L’abbate (2007) included two hundred and fourteen x-ray technologists working in 13 different hospital in Italy. The volunteers were given a self administered questionnaire to collect information on individual characteristics and compliance of musculoskeletal pain. They were asked if they had lifted patients, transferred lead apron wearing, and handled cassettes. A Standardized Nordic Questionnaire was used in order to evaluate musculoskeletal complaints in neck, shoulder, low back, hand/wrist, and legs during the past 12 months.

The mean age was 48.5 years for men and 42.8 years for women. Fifty six of them were smokers, and 119 had a regular exercise program. The result reported low back pain as

the most commonly symptom followed by shoulder and neck pain (6).

Musculoskeletal complaints among x-ray technology students:

Lorusso, L, et al (2010) aimed in their study to estimate the prevalence of musculoskeletal complaints among a group of x-ray technology students. The subjects consisted of 60 male students and 49 female students (n=109). Their mean age was 21.1

years and of their body mass index (BMI) was twenty three.

The students were given a questionnaire that had been used in a musculoskeletal survey among X-ray technologists. It collected information on individual characteristics such as

gender, age, height/weight, smoking status, and leisure time physical activities. Information about physical exposure during training and complaint about the presence of musculoskeletal pain were also collected. The participants were also asked if they had lifted patients, transferred or positioned portable equipment handling, lead apron wearing and cassettes. A Standardized Nordic Questionnaire was used to evaluate musculoskeletal complaints in specific body regions such as neck, shoulder, low back, hand and wrist and legs. The result showed that low back pain (LBP) was the most reported symptoms followed by neck and shoulder pain (7).

Musculoskeletal disorders among radiographers in Kuwait:

Sheikha Al-Kindari, el al (2008) investigated musculoskeletal disorder among radiographers in Kuwait. Data were collected by questionnaire from 147 radiographers who were working in different governmental hospitals. The questionnaire included 6 different parts, including demographic data, education and the current job, physical risk factor related with the regular work, psychological risk factor related with the regular work, general health status, and exist of any musculoskeletal problem in body. Musculoskeletal disorder on neck and lower back regions was the highest percentage because of standing for a long time, moving different equipments, lifting, caring, pushing and pulling loads (8).

Work-related musculoskeletal disorders among radiographers:

Finally, Kao, et al (2009) checked the relationship between musculoskeletal disorder and work related risk factor in radiography department. The subjects were 107 from radiography department. The majority worked at the department less than 5 years and were divided in different sections such as Magnetic Resonance Imaging (MRI), Computed Tomography (CT), X-ray, Ultrasound (US), and other. A questionnaire, which contained questions on work characteristics, work description, posture during long period, and body pain, was completed by the subjects. A modified body map also was used to indicate areas of experienced pain. It was categorized to upper back pain, upper limb pain, lower back pain, and lower limb pain. The participants were asked if their pain was related to their work, and were included to the study if there had answered with partially or fully related. Ninety seven subjects continued in the study while 7 refused and 3 pregnant women were excluded. The result of this study was a high percentage on low back pain and upper limb pain. The association between low back pain and working in CT was also significant because of heavy workload such as heavy lifting, twisting, and bending. The study limitations included small subject size, self reporting for measurement of outcomes limited, and estimations were some of limitations of this study (9).

Biomechanical principles

According to previous studies (3-4), musculoskeletal complaints among radiographers is caused by wrong movements such as repeated back strain, poor posture, and faulty body mechanics. To avoid the musculoskeletal pain, biomechanical principles must be

followed. These principles include:

Keeping a load “cassettes and tube” close to center of gravity (COG)

Carrying the cassette vertically against chest rather than carrying it on

the hip to avoid the load on one side of the body and imparts torsional strain on the spinal muscles.

Lowering the tube to waist height before moving it horizontally to

avoid back strain.

Using legs muscles rather than paraspinal muscles

Pushing mobile unit rather than pulling it.

Transferring horizontal patient with assistance from 2 people

with apart feet and straight legs.

Bending knee, slightly bending back forward to pick up objects

form floor.

Avoiding twisting the back while loading paraspinal muscles when

moving Bucky tray, moving supplies, moving equipment through

doorways, working with wheelchair patients, and placing a cassette

behind a bed redden patient.

Using both hand to move the Bucky tray.

Conclusion

Musculoskeletal disorders are injuries of the muscles, tendons, ligaments, joints,

cartilage, nerves, and spinal discs. Back pain is the most common musculoskeletal

disorder among radiographers due to poor posture and wrong movements such as

carrying cassettes on hip, lifting patient by one radiographer, and bending from their

waist to retrieve an object from the floor. Several studies were done aimed to determine

the prevalence of musculoskeletal complaints among the x-ray technologists. The results

confirmed that 72% and 77% prevalence of low back pain respectively among male and

female radiographers, respectively (10-11). Biomechanical principles such as keeping a load

close to center of gravity, using legs muscles, avoiding twisting back, and using both

hand to move the Bucky tray, are recommended in order to avoid musculoskeletal pain in

radiographers.