Low back pain among physical therapists is a common musculoskeletal disorder that first occurs early in their career or as a student. This observational prospective study assessed the ability of hip and lumbopelvic neuromuscular control, endurance and hip range of motion tests to predict the development of transient low back pain development during a standing task. Seventy-two physical therapy students without low back pain completed nine performance tests and a 2-hour standing test on two separate days. Participants were classified as transient pain developers (PD) if they reported a ≥ 10mm increase in low back pain on a visual analog scale. Transient back pain was reported by 37.5% of students during the standing test. A cluster of three positive tests, self-rated active hip abduction (somewhat difficult or more), bilateral total hip internal rotation greater than 81 degrees, and non-dominant limb single-leg squat (moderate deviations), demonstrated an increased probability (94.9%) of identifying PDs. Negative findings on the same three tests decreased the probability to 10.7%. Overall, the classification accuracy for the three-test model was 72.2%. The sensitivity for the model was 63% and the specificity was 77.8%.
A 3-test cluster of poor hip and lumbopelvic neuromuscular control and increased hip internal rotation range of motion is an effective screening tool for identifying physical therapy students who are most likely and least likely to develop transient LBP during 2 hours of standing.

Bilateral lower extremity inflammatory lymphedema (BLEIL) is a novel condition characterized by confluent erythema and painful edema prominent to the dorsum of the feet and ankles bilaterally following prolonged standing and marching, occurring most often in military recruits. Prolonged standing during the initial week of basic training is thought to cause venous congestion and subsequent inflammatory vasculitis. This condition may be misdiagnosed as bilateral cellulitis, prompting the initiation of unnecessary antibiotic therapy. Increased education and recognition of this new clinical entity would lead to the initiation of appropriate therapy and earlier symptom resolution and, thus, an earlier return to military training. Herein, we describe a small case series of Marine Corps recruit members undergoing their first week of basic training (i.e., \"processing week\") who developed bilateral lower extremity edema, erythema, and pain localized to the dorsum of the feet and the medial and lateral aspects of the ankles consistent with the diagnosis of BLEIL but were initially diagnosed with bilateral lower extremity cellulitis and received intravenous antimicrobial therapy. With prompt initiation of venous decongestive therapy with leg elevation, both patients had rapid symptom resolution and returned to basic training without any future episodes of symptoms. These cases add to the paucity of data on this clinical entity, illustrate the symptoms and demographics of BLEIL, and describe the importance of recognition and initiation of appropriate therapy.

UNASSIGNED: The typical American worker spends about two-thirds of their work day standing. Prolonged standing has been found to be associated with acute and chronic adverse health outcomes. There is considerable variability among existing methods of analysis for prolonged-standing data, and therefore difficulty interpreting and comparing results across studies.
UNASSIGNED: The purpose of this study is to develop a bodyweight transfer analysis method that incorporates factors of both time and amplitude of loading. This method was then applied to actual prolonged-standing data, to understand how the results of this method are impacted by time spent standing, and how the results relate to previously-reported methods of analysis for weight shifting data.
UNASSIGNED: Seven subjects (six male, one female) stood with each foot on one of two force plates for 6 h with a 5-min seated rest break between hours. Our new method identified two different types of events: fidgets and weight shifts. Center-of-pressure data were analyzed with the proposed method and three existing methods of analysis.
UNASSIGNED: Subjects utilized different quantities of fidgets and weight shifts over the course of the trials. Existing methods of analysis identified a wide range in number of events, with some methods consistently identifying more events than others. These existing methods significantly differed from the proposed method. Fidgets, weight shifts, and fidgets + weight shifts, as identified using the proposed method, had significant interactions with time, while only one of the existing methods showed a significant time interaction.
UNASSIGNED: The conclusions drawn from analysis of prolonged standing center-of-pressure data can differ significantly depending on the method of analysis used. The method proposed here accounts for the different sources of discomfort and the tissue characteristics of these sources. Future work should explore the relationships between physiologic parameters and fidgets and weight shifts, so that appropriate clinical interventions can be identified.

BACKGROUND: Adherence to sit-stand workstation usage has been shown to decrease post-intervention, with the reported reasons related to fatigue, cumbersome workstation adjustments, and focus.
OBJECTIVE: To characterize the mechanical work and total energy required to perform transitions from a traditional office chair and a dynamic chair designed specifically for sit-stand workstations. The whole-body, thigh, and shank centre-of-mass (CoM) were evaluated.
METHODS: Fifteen participants (8 male; 7 female) performed three intermittent sit-to-stand and stand-to-sit transitions from the traditional and dynamic chairs. Kinematic data of the trunk, pelvis, and lower extremities were collected using an optoelectronic motion capture system and triaxial accelerometers. The change in total energy and work between the sitting and standing postures were evaluated for each CoM point. Lumbar spine range-of-motion was further assessed between chair conditions.
RESULTS: Chair designs facilitated opposite work and energy responses for a given transition. Transitions performed from the dynamic chair reduced the work and total energy of the whole-body CoM, by ±8.5J and ±214.6J (p < 0.001), respectively. The work and energy of the thigh CoM differed within transitions (p < 0.001), but the positive and negative components were similar between chairs (work =±0.18J, energy =±0.55J). The dynamic chair increased the total energy (±38.3J, p < 0.001) but not the work of the shank CoM (±1.1J, p≥0.347).
CONCLUSIONS: The required mechanical work and energy of sit-to-stand and stand-to-sit transitions was modified by chair design. These outcomes have the potential to address identified reasons for the disuse of sit-stand workstations.

Background Varicose veins (VV) are abnormally swollen, tortuous, and prominent veins caused by insufficient venous valves leading to venous congestion and elevated venous pressure. Prolonged standing at work has been proposed to be an important risk factor for varicose veins. Teachers are prone to have varicose veins due to prolonged standing. The aim of this study was to assess the risk of varicose veins among teachers in Al-Asha, Saudi Arabia. Method This was a cross-sectional study conducted among teachers of primary, secondary, and high schools in Al-Ahsa, of both genders, between April 2022 and June 2022. The participants were interviewed and examined for the presence of signs and symptoms of the disease. Finally, the collected data were analyzed using Statistical Package for Social Sciences (SPSS Inc., Chicago, IL, version 26.0 for Windows) software. Result Out of 399 participating teachers with a mean age of 43.2 ± 12.9 years, 216 (54.1%) were males and the remainder were female. The commonest symptom was pain in the legs, which was exacerbated by work (43.1%). Most of the participants were working for more than 16 years (43.6%) and standing for less than six hours per day (72.7%). The most pointed sign was spider legs-shaped veins (23.8%). However, the least collective sign was paleness in the ulcer area after healing (1.8%). A total of 140 teachers had a family history of varicose veins, 74 of them (18.5%) were diagnosed with varicose veins previously. We summarize our result as female teachers who have a family history of VV have more risk to develop the disease. Conclusion The prevalence of varicose veins was high among teachers in Al-Ahsa, Saudi Arabia. According to our study, teachers have a significant chance of developing the condition since their working style contributes to its progression. Further actions need to be made in order to increase awareness and prevent its complications.

UNASSIGNED: Proprioception deficit has been suggested as a possible mechanism contributing for the impaired postural control in low back pain (LBP) patients. Whether proprioception deficit is a result of or a cause of LBP has not been investigated.
UNASSIGNED: The purpose of this study was to compare proprioceptive postural control strategies between prolonged standing induced low back pain developers (PDs) and non-pain developers (NPDs).
UNASSIGNED: Thirty-two healthy subjects performed 1-h prolonged standing and their ratings of perceived LBP have been recorded. Eight quiet standing trials for 60 s performed immediately before and after the prolonged standing. Postural control was challenged by muscle vibration and different postural conditions during quiet standing. Data were recorded using a force platform.
UNASSIGNED: Forty percentage of participants is classified as PD. Before the prolonged standing, relative proprioceptive weighting was greater in the PD compared to NPD group (P = .029). Main effect of postural condition (F1,24 = 5.21, P = .032) and interaction of time by group (F1,24 = 8.08, P = .009) were significant for COP displacement in anteroposterior direction. Interaction of postural condition by group (F1,26 = 7.82, P = .010) and time by group (F1,26 = 9.71, P = .004) were significant for COP displacement in mediolateral direction. Main effect of postural condition (F1,26 = 6.31, P = .018) and interaction of postural condition by group (F1,26 = 7.07, P = .013) were significant for mean velocity in mediolateral direction.
UNASSIGNED: The PD group has altered proprioceptive postural control strategies before and after prolonged standing. Proprioception deficit should not be considered to be solely an adaptive response and may be causal for LBP development.

Musculoskeletal disorders can be significantly disabling, particularly those related to work, when the underlying mechanisms and clinical variables are not well known and understood. Nurses usually remain in standing positions or walk for long periods, thus increasing the risk for the development of musculoskeletal disorders, particularly on the foot, such as plantar fasciitis or edema. This type of disorders is a major cause of sickness, absence from work, and also dropout ratios among nursing students, which contributes to the shortage of nursing professionals. This review will address foot disorders that arise from prolonged standing in nursing professionals and describe the main clinical parameters characterizing them, with exclusions for other health professions or disorders with other identified causes. English, French, Portuguese, and Spanish published studies from 1970 to the current year will be considered. The review will follow the JBI methodology, mainly though the PCC mnemonic, and the reporting guidelines for Scoping Reviews. The search will include main databases and relevant scientific repositories. Two independent reviewers will analyze the titles, abstracts, and full texts. A tool developed by the research team will aid in the data collection.

BACKGROUND: Joint Hypermobility Syndrome (JHS) is a rare Heritable Disorder of Connective tissue characterised by generalised joint laxity and chronic widespread pain. Joint Hypermobility Syndrome has a large impact on patients\' day to day activities, and many complain of symptoms when standing for prolonged periods. This study investigates whether people with JHS exhibit the same behaviours to deal with the effects of prolonged standing as people with equal hypermobility and no pain, and people with normal flexibility and no pain.
METHODS: Twenty three people with JHS, 22 people with Generalised Joint Hypermobility (GJH), and 22 people with normal flexibility (NF) were asked to stand for a maximum of 15 min across two force-plates. Fidgets were counted and quantified using a cumulative sum algorithm and sway parameters of the quiet standing periods between fidgets were calculated.
RESULTS: Average standing time for participants with JHS was 7.35 min and none stood for the full 15 min. All participants with GJH and NF completed 15 min of standing. There were no differences in fidgeting behaviour between any groups. There was a difference in anteroposterior sway (p = .029) during the quiet standing periods.
CONCLUSIONS: There is no evidence to suggest people with JHS exhibit different fidgeting behaviour. Increased anteroposterior-sway may suggest a muscle weakness and strengthening muscles around the ankle may reduce postural sway and potentially improve the ability to stand for prolonged periods.

Complaints of musculoskeletal pain are common among employees who stand for prolonged periods. This study sought to determine if an anti-fatigue mat (AFM) could uniquely affect low back pain (LBP), low back posture, and foot-floor interface responses in individuals prone to developing LBP (termed pain developers (PDs)) during prolonged standing experiments compared to those who do not develop LBP under the same exposures (termed non pain developers (NPDs)). Sixteen volunteers (8 PDs and 8 NPDs) were recruited based on their pain-development tendencies, which were established in previous standing experiments. They visited the laboratory on two separate days for 60 min of light manual work while standing on either a rigid floor or AFM. All participants were asymptomatic at the beginning of each experimental session. The amount of LBP experienced during the standing exposure, measured via a visual analogue scale, was reduced (p = 0.03) in the PD group when on the AFM (3.6 ± 6 mm) compared to the rigid floor (6.8 ± 7 mm). LBP levels remained low and unchanged (p = 0.5) between the AFM (2.4 ± 5 mm) and rigid floor (1.6 ± 2 mm) conditions for the NPD group. Neither postural nor foot-floor interface measures correlated with this unique reduction of LBP for the PD group when standing on the AFM. The AFM did, however, increase centre of pressure excursion (NPD 55% increase; PD 35% increase) and tended to increase the number of body weight shifts (NPD 116% increase; PD 54% increase) in both the PD and NPD groups. These findings suggest that AFMs may selectively benefit individuals prone to developing standing-induced back pain by facilitating subtle movements at the foot-floor interface.

BACKGROUND: Many occupations require workers to stand for prolonged periods, which can cause discomfort, pain and even injures. Some supermarkets in life provide a foot pad for checkout staff to let them stand on it at work, thereby reducing standing fatigue caused by standing for a long time. The inclined platform is the same as the foot pad mentioned above. That is, the staff stepped on it and relieved standing fatigue to a certain extent.
OBJECTIVE: The study aims to analyze how the standing angle affects fatigue among prolonged standing workers and tries to find an inclined platform with a specific angle to reduce standing fatigue.
METHODS: This experiment studied fatigue of the inclined platforms with different angles on prolonged standing workers, eight participants were selected to participate in the test. The plantar pressures and sEMG (Surface Electromyography) were used to collect the physiological information change of prolonged standing participants in the lower limb and waist. The visual analogue scale was used as a subjective method to measure the psychological fatigue.
CONCLUSIONS: The study highlights the relationship between standing angle and lower limb fatigue. The inclination of the standing platform has different effects on the participants under different time conditions. When participants stand on inclined platforms at 0°, 5° and 10°, the iEMG (Integrated Electromyography) values of the gastrointestinal muscle were not significantly different until the third sampling point (40 minutes). After that self-regulation of lower limb muscles is better when standing on an inclined platform between 5° and 10°, it has a certain effect on alleviating lower limb fatigue. This knowledge is crucial for the design of the inclined working platforms fitting the needs of prolonged standing workers.