Comparison of Spinal Sagittal Curvatures, Functional Status and Quality of Life of Medical Secretaries with or without Upper or Low Back Pain

Öz

Background: Upper and/or low back pain are common in medical secretaries. The aim of this study is to compare the curvature and mobility of the spine; disability and quality of life (QoL) of medical secretaries with or without upper or low back pain.
Materials and Methods: One hundred eleven medical secretaries working in the same hospital were included in the study. Medical secretaries were divided into two groups such as “with and without back pain”; and two other groups “with and without low back pain”. The curvature and mobility of the spine in the sagittal plane was measured using a non-invasive instrument called "Spinal Mouse™". The measurements were repeated while standing and in a sitting position.The Visual Analogue Scale (VAS) was used to assess pain; the Oswestry Disability Scale (ODS) was used to assess functionality; and the Nottingham Health Profile (NHP) was used to assess QoL.
Results: The mean age of the medical secretaries (75 female/36 male) included in the study was 30.73±5.74 years. Mean VAS score of 51 secretaries with back pain was 5.47±2.67; mean VAS score of 63 secretaries with low back pain was 5.52±2.66. The thoracic kyphosis angles of the secretaries with back pain measured while sitting and standing were higher than that of the secretaries without back pain (p˂0.032, p˂0.001). There was no difference between the two groups in terms of thoracic vertebra mobility measured while sitting and standing. There was a difference between the two groups between NHP-total, NHP-energy, NHP-pain, NHP-emotional reactions and NHP-physical mobility subgroups (p˂0.001, p=0.001, p˂0.001, p=0.001, p=0.001). The lumbar lordosis angle of the secretaries with low back pain measured in standing position was lower than those without low back pain (p ˂0.001). There was no difference between the lumbar lordosis angle measured in the sitting position between the two groups in terms of lumbar vertebra mobility measured in the sitting position and while standing. There was a difference between ODS, the subgroups of NHP-total, NHP-energy, NHP-pain and NHP-physical mobility between the two groups (p˂0.001, p=0.025, p=0.042, p=0.039, p=0.019).
Conclusions: Although there was no difference in spinal mobility measured by using Spinal Mouse™; it was observed that in the secretaries with back pain, there was an increase in the kyphosis of thoracic spine and there was a decrease in the lordosis of lumbar spine in those with low back pain. The presence of upper and low back pain negatively affects functionality and QoL.

Sırt veya Bel Ağrısı Olan ve Olmayan Tıbbi Sekreterlerin Omurga Sagittal Eğrilikleri, Fonksiyonel Durum ve Yaşam Kalitesi Düzeylerinin Karşılaştırılması

Öz

Amaç: Tıbbi sekreterlerde sırt ve/veya bel ağrısı sık görülmektedir. Bu çalışmanın amacı, sırt veya bel ağrısı olan sekreterler ile olmayan sekreterlerin omurga eğriliği, omurga hareketliliği, disabilite ve yaşam kalitesi düzeylerini karşılaştırmaktır.
Materyal ve Metod: Çalışmaya aynı hastanede çalışan 111 tıbbi sekreter dahil edildi. Tıbbi sekreterler sırt ağrısı olan ve olmayan olarak iki gruba; bel ağrısı olan ve olmayan olarak diğer iki gruba ayrıldılar. Omurganın sagittal düzlemdeki şekli ve hareketliliği “Spinal Mouse™” isimli non-invaziv bir alet kullanılarak ölçüldü. Ölçümler ayakta dururken ve oturma pozisyonunda ayrı ayrı tekrarlandı. Ağrı şiddeti Vizüel Analog Skala (VAS) ile; fonksiyonel durum Oswestry Disabilite Ölçeği (ODÖ) ile; yaşam kalitesi ise Notthigham Sağlık Profili (NSP) kullanılarak değerlendirildi.
Bulgular: Çalışmaya dahil edilen tıbbi sekreterlerin (75 kadın/36 erkek) yaş ortalaması 30.73±5.74 yıl idi. Sırt ağrısı olan 51 sekreterin VAS ortalaması 5.47±2.67; bel ağrısı olan 63 sekreterin VAS ortalaması 5.52±2.66 idi. Sırt ağrısı olan sekreterlerin oturur pozisyonda ve ayakta iken ölçülen torakal kifoz açısı, sırt ağrısı olmayan sekreterlere göre daha yüksekti (p˂0.032, p˂0.001). Her iki grup arasında oturur pozisyonda ve ayakta iken ölçülen torakal vertebra hareketliliği açısından anlamlı fark yoktu. İki grup arasında NSP-total, NSP-enerji, NSP-ağrı, NSP-duygusal reaksiyonlar ve NSP-fiziksel hareketlilik alt grupları arasında anlamlı fark vardı (p˂0.001, p=0.001, p˂0.001, p=0.001, p=0.001). Bel ağrısı olan sekreterlerin ayakta duruşta ölçülen lomber lordoz açısı, bel ağrısı olmayanlara göre daha düşüktü (p˂0.001). Her iki grup arasında oturur pozisyonda iken ölçülen lomber lordoz açısı ile oturur pozisyonda ve ayakta iken ölçülen lomber vertebra hareketliliği açısından anlamlı fark yoktu. İki grup arasında ODÖ, NSP-total, NSP-enerji, NSP-ağrı ve NSP-fiziksel hareketlilik alt grupları arasında anlamlı fark vardı (p˂0.001, p=0.025, p=0.042, p=0.039, p=0.019).
Sonuç: Spinal Mouse™ kullanılarak yapılan ölçümlerde omurga hareketliliğinde fark olmamasına rağmen; sırt ağrısı olan sekretelerde torakal omurgada kifoz artışı, bel ağrısı olanlarda da lomber omurgada lordoz azalması olduğu görülmüştür. Sırt ve bel ağrısının varlığı fonksiyonel durumu ve yaşam kalitesini olumsuz etkilemektedir.  

Anahtar Kelimeler

• Bilgisayar çalışanı,postür bozukluğu,ağrı,Spinal Mouse™,hayat kalitesi

Kaynakça

1. 1. Akbal A, Eroğlu P, Hınç Y, Engin T. Occupational Exposures and Musculoskeletal System Findings. Mesleki Maruz ve Kas İsklet Sist Bulguları. 2012;15:73–6.
2. 2. Melhorn J, Gardner P. How We Prevent Prevention of Musculoskeletal Disorders in the Workplace. Clin Orthop Relat Res. 2004;419:285–96.
3. 3. Marcus M, Gerr F, Monteilh C, Ortiz DJ, Gentry E, Cohen S, et al. A prospective study of computer users: II. Postural risk factors for musculoskeletal symptoms and disorders. Am J Ind Med. 2002;41(4):236–49.
4. 4. Fagarasanu M, Kumar S. Musculoskeletal symptoms in support staff in a large telecommunication company. Work. 2006;27(2):137–42.
5. 5. Waldemar K, Marras WS. The occupational ergonomics handbook. CRC Press; 1998.
6. 6. McKeown C. Office Ergonomics: Practical Applications. 1st ed. CRC Press; 2007.
7. 7. Yuk Szeto GP, Straker LM, O’Sullivan PB. Neck-shoulder muscle activity in general and task-specific resting postures of symptomatic computer users with chronic neck pain. Man Ther [Internet]. 2009;14(3):338–45. Available from: http://dx.doi.org/10.1016/j.math.2008.05.001
8. 8. Janwantanakul P, Pensri P, Jiamjarasrangsi W, Sinsongsook T. Associations between prevalence of self-reported musculoskeletal symptoms of the Spine and biopsychosocial factors among office workers. J Occup Health. 2009;51(2):114–22.

9. 9. Mannion AF, Knecht K, Balaban G, Dvorak J, Grob D. A new skin-surface device for measuring the curvature and global and segmental ranges of motion of the spine: Reliability of measurements and comparison with data reviewed from the literature. Eur Spine J. 2004;13:122–36.
10. 10. Myles PS, Troedel S, Boquest M, Reeves M. The Pain Visual Analog Scale: Linear or Nonlinear? Anesthesiology. 1999;89:1517–20.
11. 11. Yakut E, Düger T, Öksüz Ç, Yörükan S, Üreten K, Turan D, et al. Validation of the Turkish Version of the Oswestry Disability Index for Patients with Low Back Pain. Spine (Phila Pa 1976). 2004;29(5):581–5.
12. 12. Fairbank JC, Pynsent PB. The oswestry disability index. Spine (Phila Pa 1976). 2000;25(22):2940–53.
13. 13. Küçükdeveci AA, McKenna SP, Kutlay S, Gürsel Y, Whalley D, Arasıl T. The development and psychometric assessment of the Turkish version of the Nottingham Health Profile. Int J Rehabil Res. 2000;23:31–8.
14. 14. Hunt SM, McEwen J, McKenna SP. Measuring health status: a new tool for clinicians and epidemiologists. J R Coll Gen Pract. 1985;35(273):185–8.
15. 15. Kellis E, Adamou G, Tzilios G, Emmanouilidou M. Reliability of Spinal Range of Motion in Healthy Boys Using a Skin-Surface Device. J Manipulative Physiol Ther. 2008;31(8):570–6.
16. 16. Nachemson AL. Disc pressure measurements. Spine (Phila Pa 1976). 1981;6(1):93–7.
17. 17. McGill SM, Hughson RL, Parks K. Lumbar erector spinae oxygenation during prolonged contractions: Implications for prolonged work. Ergonomics. 2000;43(4):486–93.
18. 18. Briggs AM, Bragge P, Smith AJ, Govil D, Straker LM. Prevalence and associated factors for thoracic spine pain in the adult working population: A literature review. J Occup Health. 2009;51(3):177–92.
19. 19. Fouquet N, Bodin J, Descatha A, Petit A, Ramond A, Ha C, et al. Prevalence of thoracic spine pain in a surveillance network. Occup Med (Chic Ill). 2015;65:122–5.
20. 20. O’Sullivan PB, Mitchell T, Bulich P, Waller R, Holte J. The relationship between posture and back muscle endurance in industrial workers with flexion-related low back pain. Man Ther. 2006;11(4):264–71.
21. 21. Feldman DE, Shrier I, Rossignol M, Abenhaim L. Risk factors for the development of neck and upper limb pain in adolescents. Spine (Phila Pa 1976). 2002;27(5):523–8.
22. 22. Roussouly P, Nnadi C. Sagittal plane deformity: An overview of interpretation and management. Eur Spine J. 2010;19(11):1824–36.
23. 23. Sullivan PBO, Grahamslaw KM, Ther MM, Kendell M, Lapenskie SC, Moller NE, et al. The Effect of Different Standing and Sitting Postures on Trunk Muscle Activity in a Pain- Free Population The Effect of Different Standing and Sitting Postures on Trunk Muscle Activity in a Pain-Free Population. Spine (Phila Pa 1976). 2017;27(11):1238–44.
24. 24. Hertling D. The thoracic spine. In: Hertling D, Kessler RM, editors. Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. 1996. p. 570–621.
25. 25. Falla D. Neuromuscular control of the cervical spine in neck pain disorders. Med Sci. 2008;14–6.
26. 26. Janwantanakul P, Pensri P, Jiamjarasrangsri V, Sinsongsook T. Prevalence of self-reported musculoskeletal symptoms among office workers. Occup Med (Chic Ill). 2008;58:436–8.
27. 27. Kibler W Ben, Press J, Sciascia A. The Role of Core Stability in Athletic Function. 2006;36(3):189–98.
28. 28. Tüzün C, Yorulmaz I, Cindas A, Vatan S. Low back pain and posture1999; 18(4): 308-312. 21. Clin Rheumatol. 1999;18(4):308–12.
29. 29. Granata KP, Slota GP, Wilson SE. Influence of fatigue in neuromuscular control of spinal stability. Hum Factors. 2004;46:81–91.
30. 30. Terzi R, Altin F. Hastane çalişanlarinda bel aǧrisi sikliǧi, bel aǧrisinin kronik yorgunluk sendromu ve mesleki faktörler ile ilişkisi. Agri. 2015;27(3):149–54.
31. 31. Karahan A, Kav S, Abbasoglu A, Dogan N. Low back pain: Prevalence and associated risk factors among hospital staff. J Adv Nurs. 2009;65(3):516–24.
32. 32. Ouédraogo DD, Ouédraogo LT, Kinda M, Tiéno H, Zoungrana EI, Drabo JY. Prevalence and factors associated with low back pain among hospital staff in Ouagadougou (Burkina Faso). Med Trop. 2010;70(3):277–80.
33. 33. Schneider S, Randoll D, Buchner M. Why do women have back pain more than men? A representative prevalence study in the Federal Republic of Germany. Clin J Pain. 2006;22(8):738–47.
34. 34. Panagiotis Spyropoulos, George Papathanasiou, George Georgoudis, Efstathios Chronopoulos, Harilaos Koutis, Fotini Koumoutsou. Prevalence of Low Back Pain in Greek Public Office Workers. Pain Physician. 2007;10:651–60.
35. 35. Cımbız A, Uzgören N, Aras Ö, Öztürk S, Elem E, Aksoy CC. Kas iskelet sisteminde aǧrıya ait risk faktörlerinin lojistik regresyon analizi ile belirlenmesi: Pilot çalışma. Fiz Rehabil. 2007;18(1):20–7.
36. 36. Calik B, Atalay O, Baskan E, Gokce B. Analyzing Musculoskeletal System Discomfort, Work Interference and Risk Factors of Office Workers with Computer Users. J Marmara Univ Inst Heal Sci. 2013;3(4):1.
37. 37. Martini L, Hoffmann F. Comorbidity of chronic back pain and depression in Germany: Results from the GEDA study, 2009 and 2010. Z Evid Fortbild Qual Gesundhwes [Internet]. 2018;137–138:62–8. Available from: https://doi.org/10.1016/j.zefq.2018.10.003
38. 38. Keeley P, Creed F, Tomenson B, Todd C, Borglin G, Dickens C. Psychosocial predictors of health-related quality of life and health service utilisation in people with chronic low back pain. Pain. 2008;135(1–2):142–50.
39. 39. Yılmaz A, Altuǧ F, Coşkun E. Pain, disability status and psychological factors in patients with chronic low back pain. Turkiye Klin J Med Sci. 2012;32(5):1278–83.
40. 40. O’Donoghue GM, Fox N, Heneghan C, Hurley DA. Objective and subjective assessment of sleep in chronic low back pain patients compared with healthy age and gender matched controls: A pilot study. BMC Musculoskelet Disord. 2009;10(1):1–9.