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      Effectiveness of Educational Physical Activity Intervention for Preventive of Musculoskeletal Disorders in Bus Drivers

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          Abstract

          Background:

          Driving is a challenging job. Drivers always face the high risk of musculoskeletal disorders (MSDs). Educational interventions could be effective in preventing and controlling these disorders. The present study aims to assess the effectiveness of an educational physical activity intervention in preventing MSDs among bus drivers in Isfahan, Iran.

          Methods:

          This quasi-experimental study was conducted on 60 urban bus drivers, who were selected using multistage sampling. They were evaluated at two time points, namely before and three months after the intervention. The intervention was conducted in three 90-minute sessions. The HBM-based educational content was delivered through lectures, PowerPoint presentations, videos, practical demonstrations of corrective exercises, and educational pamphlets. Data were analysed using the SPSS program, version 20, the paired t-test, and the independent t-test.

          Results:

          Before the intervention, there was no significant difference between the two groups with respect to the mean scores of the HBM constructs. However, later on, the mean scores of perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy, and behaviour increased significantly in the intervention group, compared with those in the control group. ( P < 0.001).

          Conclusions:

          The results showed that the physical activity as an HBM-based educational intervention had a positive effect on the prevention of MSDs in urban bus drivers.

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          Most cited references30

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          Systematic review: strategies for using exercise therapy to improve outcomes in chronic low back pain.

          Exercise therapy encompasses a heterogeneous group of interventions. There continues to be uncertainty about the most effective exercise approach in chronic low back pain. To identify particular exercise intervention characteristics that decrease pain and improve function in adults with nonspecific chronic low back pain. MEDLINE, EMBASE, PsychInfo, CINAHL, and Cochrane Library databases to October 2004 and citation searches and bibliographic reviews of previous systematic reviews. Randomized, controlled trials evaluating exercise therapy in populations with chronic (>12 weeks duration) low back pain. Two reviewers independently extracted data on exercise intervention characteristics: program design (individually designed or standard program), delivery type (independent home exercises, group, or individual supervision), dose or intensity (hours of intervention time), and inclusion of additional conservative interventions. 43 trials of 72 exercise treatment and 31 comparison groups were included. Bayesian multivariable random-effects meta-regression found improved pain scores for individually designed programs (5.4 points [95% credible interval (CrI), 1.3 to 9.5 points]), supervised home exercise (6.1 points [CrI, -0.2 to 12.4 points]), group (4.8 points [CrI, 0.2 to 9.4 points]), and individually supervised programs (5.9 points [CrI, 2.1 to 9.8 points]) compared with home exercises only. High-dose exercise programs fared better than low-dose exercise programs (1.8 points [CrI, -2.1 to 5.5 points]). Interventions that included additional conservative care were better (5.1 points [CrI, 1.8 to 8.4 points]). A model including these most effective intervention characteristics would be expected to demonstrate important improvement in pain (18.1 points [CrI, 11.1 to 25.0 points] compared with no treatment and 13.0 points [CrI, 6.0 to 19.9 points] compared with other conservative treatment) and small improvement in function (5.5 points [CrI, 0.5 to 10.5 points] compared with no treatment and 2.7 points [CrI, -1.7 to 7.1 points] compared with other conservative treatment). Stretching and strengthening demonstrated the largest improvement over comparisons. Limitations of the literature, including low-quality studies with heterogeneous outcome measures and inconsistent and poor reporting; publication bias. Exercise therapy that consists of individually designed programs, including stretching or strengthening, and is delivered with supervision may improve pain and function in chronic nonspecific low back pain. Strategies should be used to encourage adherence. Future studies should test this multivariable model and further assess specific patient-level characteristics and exercise types.
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            Work-related musculoskeletal disorders in urban bus drivers of Hong Kong.

            Work-related musculoskeletal disorders (WMSD) affect workers in many occupations including drivers of large vehicles. Urban bus drivers have been found to have high prevalence rates of back problems in overseas studies. Hong Kong is a densely populated city and has a large number of double-deck buses that constitute a major means of public transportation. The present study aimed at investigating the prevalence and characteristics of WMSD in male and female bus drivers who operate double-deck buses in Hong Kong. Altogether 481 bus drivers (404 males, 77 females) participated in the study that consisted of a questionnaire survey as well as physical assessment. The questionnaire included questions on work, musculoskeletal complaints and perceived occupational risk factors associated with each discomfort. Physical assessment consisted of measurement of lumbar spine mobility, hand grip strength, sit-and-reach test, and observation of standing and sitting postures. The results showed generally the male drivers had longer years of work experience but their daily workloads were similar to the females. On the average drivers worked 9-10 h per day, with 5 days on and 1 day off. Neck, back, shoulder and knee/thigh areas had the highest 12-month prevalence rates ranging from 35% to 60%, and about 90% of the discomfort was related to bus-driving. Occupational factors of prolonged sitting and anthropometric mismatch were perceived to be most related to musculoskeletal discomfort. On physical examination, grip strength was significantly related to neck and shoulder discomfort. The present results showed high prevalence rates of WMSD among bus drivers in Hong Kong which warrants further investigation.
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              The Association between risk factors and low back pain among commercial vehicle drivers in peninsular Malaysia: a preliminary result.

              To determine the risk factors associated with complain of low back pain. A cross sectional study was done from June 2004 until August 2005. Seven hundred and sixty commercial vehicle drivers from 11 bus companies in central, northern and eastern regions in Malaysia participated in this study. Modified Nordic questionnaire was used to determine the prevalence of low back pain; Maestro human vibration meter was used to measure the personal R.M.S values of lateral, anterior-posterior and vertical axes. Modified Owas was used to assess the awkward posture of the driver torso namely, bending forward movement, leaning, sitting straight and twisting. Profile of Mood States (POMS) was used to evaluate the mood states of bus drivers with complain of low back pain. A high prevalence of low back pain (60.4%) among Malaysian commercial vehicle drivers was found. Logistic regression analysis controlling for age, income, education level and non occupational activities revealed that the following factors were related to low back pain: Tension-anxiety [1.080, 95% CI 1.041-1.121], depression dejection [1.047, 95% CI 1.023-1.072], anger-hostility [1.053, 95% CI 1.027-1.081], fatigue [1.132, 95% CI 1.089-1.177] and confusion [1.114, 95% CI 1.061-1.169] of POMS, length of employment [1.001, 95% CI 1.0-1.003], steering wheel adjustment [1.521, 95% CI 1.101-2.101], perception of exposing to vibration [1.943, 95% CI 1.389-2.719]. In conclusion, combinations of risks lead to high increase of low back pain complain among Malaysian bus drivers.
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                Author and article information

                Journal
                Int J Prev Med
                Int J Prev Med
                IJPVM
                International Journal of Preventive Medicine
                Wolters Kluwer - Medknow (India )
                2008-7802
                2008-8213
                2019
                12 August 2019
                : 10
                : 132
                Affiliations
                [1 ] Department of Environmental Manangment, Najafabad Branch, Islamic Azad University, Najafabad, Iran
                [2 ] Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
                Author notes
                Address for correspondence: Dr. Asiyeh Pirzadeh, Department of Health Education and Promotion, School of Health, Isfahan University of Medical Sciences, Isfahan, IR Iran. E-mail: as_pirzadeh@ 123456hlth.mui.ac.ir
                Article
                IJPVM-10-132
                10.4103/ijpvm.IJPVM_339_18
                6710914
                4c628690-c1fc-46b6-a30f-289b5973279a
                Copyright: © 2019 International Journal of Preventive Medicine

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 29 July 2018
                : 16 March 2019
                Categories
                Original Article

                Health & Social care
                exercise,health education,musculoskeletal diseases
                Health & Social care
                exercise, health education, musculoskeletal diseases

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