Abstract：
OBJECTIVE: This study aimed to explore the association between arm elevation and neck/shoulder pain, and trunk forwarding bending and low back pain among home care workers.
METHODS: Home care workers (N = 116) from 11 home care units in Trondheim, Norway, filled in pain assessment and working hours questionnaire, and wore 3 accelerometers for up to 7 consecutive days. Work time was partitioned into upright awkward posture, nonawkward posture, and nonupright time, i.e. sitting. Within a compositional approach framework, posture time compositions were expressed in terms of log-ratio coordinates for statistical analysis and modeling. Poisson generalized linear mixed models were used to analyze the relationship between arm elevation in upright postures and neck/shoulder pain, and between trunk forward bending in upright postures and low back pain, respectively. Isotemporal substitution analysis was used to investigate the association of pain assessment with the reallocation of time spent in the different postures.
RESULTS: Time spent in awkward postures was modest, especially for the more extreme angles (60° and 90°). Adjusting for age, gender, and body mass index, our study suggested that the compositions of time spent by home care workers in awkward postures were significantly associated with pain assessment (P < 0.01). Isotemporal substitution analysis showed that reallocating 5 min from upright posture with arms elevated below to above 60° and 90° was associated with a 6.8% and 19.9% increase in the neck/shoulder pain score, respectively. Reallocating 5 min from a forward bending posture while upright below to above 30°, 60°, and 90° was associated with 1.8%, 3.5%, and 4.0% increase in low back pain, respectively.
CONCLUSIONS: Although the exposure to awkward postures was modest, our results showed an association between increased time spent in awkward postures and an increase in neck/shoulder pain and low back pain in home care workers. As musculoskeletal pain is the leading cause of sickness absence, these findings suggest that home care units could benefit from re-organizing work to avoid excessive arm elevation and trunk forward bending in workers.
METHODS: Home care workers (N = 116) from 11 home care units in Trondheim, Norway, filled in pain assessment and working hours questionnaire, and wore 3 accelerometers for up to 7 consecutive days. Work time was partitioned into upright awkward posture, nonawkward posture, and nonupright time, i.e. sitting. Within a compositional approach framework, posture time compositions were expressed in terms of log-ratio coordinates for statistical analysis and modeling. Poisson generalized linear mixed models were used to analyze the relationship between arm elevation in upright postures and neck/shoulder pain, and between trunk forward bending in upright postures and low back pain, respectively. Isotemporal substitution analysis was used to investigate the association of pain assessment with the reallocation of time spent in the different postures.
RESULTS: Time spent in awkward postures was modest, especially for the more extreme angles (60° and 90°). Adjusting for age, gender, and body mass index, our study suggested that the compositions of time spent by home care workers in awkward postures were significantly associated with pain assessment (P < 0.01). Isotemporal substitution analysis showed that reallocating 5 min from upright posture with arms elevated below to above 60° and 90° was associated with a 6.8% and 19.9% increase in the neck/shoulder pain score, respectively. Reallocating 5 min from a forward bending posture while upright below to above 30°, 60°, and 90° was associated with 1.8%, 3.5%, and 4.0% increase in low back pain, respectively.
CONCLUSIONS: Although the exposure to awkward postures was modest, our results showed an association between increased time spent in awkward postures and an increase in neck/shoulder pain and low back pain in home care workers. As musculoskeletal pain is the leading cause of sickness absence, these findings suggest that home care units could benefit from re-organizing work to avoid excessive arm elevation and trunk forward bending in workers.
摘要：
目的：本研究旨在探讨手臂抬高与颈/肩痛之间的关系。以及家庭护理人员的躯干向前弯曲和腰痛。
方法：来自特隆赫姆11个家庭护理单位的家庭护理工作者（N=116），挪威,填写疼痛评估和工作时间问卷，并连续7天佩戴3个加速度计。工作时间被划分成直立的尴尬姿势，不尴尬的姿势，和非直立的时间，即坐着。在组成方法框架内，姿势时间组成以对数比坐标表示,用于统计分析和建模.采用泊松广义线性混合模型分析直立体位上臂抬高与颈肩痛的关系,在直立姿势的躯干向前弯曲和腰痛之间，分别。使用等时替代分析来研究疼痛评估与在不同姿势中花费的时间的重新分配之间的关联。
结果：在尴尬姿势中花费的时间很少，特别是对于更极端的角度（60°和90°）。调整年龄，性别,和身体质量指数,我们的研究表明，家庭护理人员在尴尬姿势中花费的时间组成与疼痛评估显着相关（P<0.01）。等时替代分析表明，从直立姿势重新分配5分钟，手臂升高到60°和90°以上，颈/肩痛评分增加6.8％和19.9％，分别。从直立下方到30°以上的前弯姿势重新分配5min,60°,90°与1.8%相关，3.5%,下腰痛增加4.0%，分别。
结论：尽管暴露于尴尬的姿势是适度的，我们的结果显示,在家庭护理工作者中,在尴尬姿势中花费的时间增加与颈部/肩部疼痛和腰背痛的增加之间存在关联.由于肌肉骨骼疼痛是疾病缺席的主要原因，这些发现表明，家庭护理单位可以从重新组织工作中受益，以避免工人手臂过度抬高和躯干向前弯曲。
方法：来自特隆赫姆11个家庭护理单位的家庭护理工作者（N=116），挪威,填写疼痛评估和工作时间问卷，并连续7天佩戴3个加速度计。工作时间被划分成直立的尴尬姿势，不尴尬的姿势，和非直立的时间，即坐着。在组成方法框架内，姿势时间组成以对数比坐标表示,用于统计分析和建模.采用泊松广义线性混合模型分析直立体位上臂抬高与颈肩痛的关系,在直立姿势的躯干向前弯曲和腰痛之间，分别。使用等时替代分析来研究疼痛评估与在不同姿势中花费的时间的重新分配之间的关联。
结果：在尴尬姿势中花费的时间很少，特别是对于更极端的角度（60°和90°）。调整年龄，性别,和身体质量指数,我们的研究表明，家庭护理人员在尴尬姿势中花费的时间组成与疼痛评估显着相关（P<0.01）。等时替代分析表明，从直立姿势重新分配5分钟，手臂升高到60°和90°以上，颈/肩痛评分增加6.8％和19.9％，分别。从直立下方到30°以上的前弯姿势重新分配5min,60°,90°与1.8%相关，3.5%,下腰痛增加4.0%，分别。
结论：尽管暴露于尴尬的姿势是适度的，我们的结果显示,在家庭护理工作者中,在尴尬姿势中花费的时间增加与颈部/肩部疼痛和腰背痛的增加之间存在关联.由于肌肉骨骼疼痛是疾病缺席的主要原因，这些发现表明，家庭护理单位可以从重新组织工作中受益，以避免工人手臂过度抬高和躯干向前弯曲。
