Displaying publications 1 - 20 of 93 in total

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  1. Labao HC, Faller EM, Bacayo MFD
    Ann Glob Health, 2018 08 31;84(3):474-480.
    PMID: 30835403 DOI: 10.29024/aogh.2331
    BACKGROUND AND PURPOSE: Musculoskeletal disorders (MSDs) are alarmingly high among migrant workers in Malaysia. MSDs are the most prevalent occupational-related conditions in most parts of the world affecting function, productivity and overall health-related quality of life. Therefore, this study aims to determine the profile of Filipino migrant workers in Malaysia and their various musculoskeletal complaints.

    METHOD: This study utilized a quantitative, nonexperimental, cross-sectional research design. A total of 60 subjects were randomly selected after passing the study's sampling criteria. The Nordic Musculoskeletal Questionnaire (NMQ) was to used to determine common MSDs affecting the various regions in the body. The Demographic Pofile Sheet was provided to gather a subject's demographic characteristics.

    RESULTS: Filipino migrant workers mostly complain of pain in the low back area (60%) and shoulder pain (60%), followed by pain in the upper back (48.3%) and neck pain (45%) in the last 12 months. Household workers accounting for 73.3% of the subjects commonly complain of pain in the hips/thighs (78.9%), while workers in the service industry commonly complain of knee pain (39.1%).

    CONCLUSIONS: Results imply that Filipino migrant workers have a higher prevalence of shoulder and lower back pain in the last 12 months. Household workers are more susceptible to hip/thigh pain. Interventions focusing on ergonomics policy implementation, education on posture and lifting techniques and physical function is recommended. Further studies should consider the psychological and psychosocial aspects of migrant employment, which are known risk factors for MSDs.

    Matched MeSH terms: Musculoskeletal Diseases
  2. Isa Halim, Rohana Abdullah, Ahmad Rasdan Ismail
    MyJurnal
    Work-related Musculoskeletal Disorders (WMSDs) are common occupational injuries among workers in the construction industry. Epidemiological studies indicated that WMSDs include neck pain, lower back pain, knee pain, leg fatigue as well as ankle and feet discomfort. The objectives of this study are to identify the WMSDs experienced by the workers during construction works and discuss the causes of those WMSDs. Subjective approach associated with modified Nordic Musculoskeletal Questionnaire (NMQ) was applied to identify the symptoms of WMSDs. A case study was conducted in several construction sites situated at the southern region of Peninsular Malaysia. During the study, 37 construction workers with different age and scope of works were interviewed to determine the WMSDs that they have experienced. Based on distributed questionnaire, almost all workers experienced pain in the region of lower back, upper back and biceps. These pains were contributed by manipulation of heavy load and high force exertion. Based on discussed causations, control measures via engineering controls method and administrative controls method were proposed to alleviate the risk of WMSDs among construction workers.
    Matched MeSH terms: Musculoskeletal Diseases
  3. Adlina, S., Narimah, A.H.H., Mazlin, M.M., Nuraliza, A.S., Hakimi, Z.A., Soe, S.A., et al.
    MyJurnal
    This study was conducted to determine the patterns of disease and treatment at two disaster sites. Studies prior to this have shown that all natural disasters are unique in that each affected region of the world have different social, economic and health backgrounds. However, similarities exist among the health effects of different disasters which if recognized can ensure that health and emergency medical relief and limited resources are well managed. This study found that although Aceh and Balakot were two totally different areas with reference to locality and climate it was noticed that the patterns of disease two months post disaster are similar the commonest being respiratory conditions followed by musculoskeletal conditions and gastrointestinal conditions. For the treatment patterns it was observed that the two areas prescribed almost similar, types of medicine mainly for gastrointestinal and respiratory systems. However in Aceh, there were more skin treatment and in Balakot there was more usage of musculoskeletal drugs.
    Matched MeSH terms: Musculoskeletal Diseases
  4. Al Maini M, Al Weshahi Y, Foster HE, Chehade MJ, Gabriel SE, Saleh JA, et al.
    Clin Rheumatol, 2020 Mar;39(3):627-642.
    PMID: 31127461 DOI: 10.1007/s10067-019-04544-y
    Rheumatic and musculoskeletal diseases (RMDs) encompass a spectrum of degenerative, inflammatory conditions predominantly affecting the joints. They are a leading cause of disability worldwide and an enormous socioeconomic burden. However, worldwide deficiencies in adult and paediatric RMD knowledge among medical school graduates and primary care physicians (PCPs) persist. In October 2017, the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD), an international think tank of RMD and related experts, met to discuss key challenges and opportunities in undergraduate RMD education. Topics included needs analysis, curriculum content, interprofessional education, teaching and learning methods, implementation, assessment and course evaluation and professional formation/career development, which formed a framework for this white paper. We highlight a need for all medical graduates to attain a basic level of RMD knowledge and competency to enable them to confidently diagnose, treat/manage or refer patients. The importance of attracting more medical students to a career in rheumatology, and the indisputable value of integrated, multidisciplinary and multiprofessional care are also discussed. We conclude that RMD teaching for the future will need to address what is being taught, but also where, why and to whom, to ensure that healthcare providers deliver the best patient care possible in their local setting.
    Matched MeSH terms: Musculoskeletal Diseases/diagnosis; Musculoskeletal Diseases/epidemiology; Musculoskeletal Diseases/therapy
  5. Harith HH, Mohd MF, Nai Sowat S
    Appl Ergon, 2021 Sep;95:103455.
    PMID: 33991852 DOI: 10.1016/j.apergo.2021.103455
    Manual harvesting is still prevalent in the agricultural industry. Accordingly, it is one of the largest contributors toward work-related musculoskeletal disorder. The cutting task in oil palm harvesting uses a long pole and involves repetitive and forceful motion of the upper limbs. Exoskeleton technology is increasingly explored to assist manual tasks performance in manufacturing and heavy industries, mainly for reducing discomfort and injuries, and improving productivity. This paper reports an initial investigation on the feasibility of using an upper limb exoskeleton to assist oil palm harvesting tasks. Previous studies highlighted that exoskeletons for agricultural activities should be adaptable to changing field tasks, tools and equipment. The immediate difference in the activity of three muscles were analyzed for a range of harvesting-simulated tasks. Lower activities were observed for tasks involving overhead work when using the prototype. Nevertheless, users' feedback highlighted that its design should be optimized for better acceptance.
    Matched MeSH terms: Musculoskeletal Diseases*
  6. Lim, Jac Fang, Richard Avoi, Noraziah Bakri, Leonard Masudal, Iskandar Nonche, Adrian Joseph, et al.
    MyJurnal
    The low back is usually associated with the lumbar spine which supports the entire weight of the upper body and significantly, is vital to the body mobility. Injury to the surrounding soft tissues can cause mild to debilitating symptoms due to muscle strain and ligament sprain. The causes of injury to the lower back are probably due to sudden twisting movement, poor posture position at work and manual handling of heavy objects or with twisting or bending movements while lifting. An Ergonomic Risk Assessment was carried out on a dental laboratory worker who complained of unresolved low back ache after a year on treatment and follow up at the outpatient department of a health clinic. From the various investigative methods used, it was found that the worker in question was placed in a situation that will over time encourage her to develop musculoskeletal disease. Our recommendations for change include immediate awareness and training in ergonomic principles of work and to report all cases so that appropriate action can be taken, reassess the workstation and environment of work, job enrichment, and creating a conducive environment for work. Once the changes have been implemented, a review will be necessary in three months time.
    Matched MeSH terms: Musculoskeletal Diseases
  7. Ahmad Rasdan Ismail, Mohd Afiq Zainal Rosli, Isa Halim, Baba Md. Deros, Mohd Nizam Ab Rahman, Md. Mustafizur Rahman
    MyJurnal
    The main purpose of this study was to establish the comfort zone for bus drivers in a seated position. In addition, this study is to investigate the seated pressure distribution among Malaysian bus drivers. The study consists of 10 bus drivers randomly selected to be a part of this study. The FSA pressure mat was utilized in order to investigate the force distribution of buttock to the seat pan of the drivers’ seat. This device is placed on the driver seat and backrest. Later, the subject would sit on for several minute. The finding reveals that most of the bus drivers feel discomfort by having low back pain and musculoskeletal disorder. The seat pressure distribution of Malaysian busses indicated that the seat not able to absorb high pressure generated from buttock that later may cause the discomfort and restricted the performance of drivers.
    Matched MeSH terms: Musculoskeletal Diseases
  8. Anita, A.R., Yazdani, A., Hayati, K.S., Adon, M.Y.
    MyJurnal
    Automotive industry in Malaysia is one of the booming industries which encompass the design, development and manufacturing of motor vehicles. However, it has its own setback as the interaction between complex tools, machines, and instruments, coupled with humans as workers pose several health hazards. A cross-sectional study was conducted to determine the prevalence of musculoskeletal disorders (MSD) and the association with awkward posture among automotive assembly line workers. A simple random sampling method was adopted and data were collected based on Standardized Nordic Questionnaire (SNQ) and Rapid Upper Limb Assessment (RULA) method for analysing awkward posture. With a response rate of 83%, a total of 232 assembly line workers with at least one year job tenure participated in this study. The findings revealed that 78.4% of workers reported MSD while the highest percentage of complaints concerned the lower back (50.9%). Three factors were found to be significantly associated with MSD: age (χ2=5.61, p=0.018), job tenure (χ2= 8.26, p=0.004) and awkward posture (χ2= 65.37, p < 0.001). Logistic regression analysis indicated that significant risk factors for MSD symptoms were workers aged ≥ 25 years old (OR= 2.25, 95%CI 1.14-4.46) and those workers with equal and more than three years job tenure (OR= 2.44, 95%CI 1.04-5.63). In addition, workers in the very high and high RULA action level who were 69 times (OR = 69.38, 95%CI 14.51- 331.73) and 12 times (OR = 12.42, 95%CI 5.21-29.58), respectively, also had higher odds of complaints of MSD. The high prevalence of MSD shows that MSD symptoms is a significant problem among automotive assembly line workers while age, job tenure and awkward posture based on RULA action level are the significant factors for MSD. In particular, this study proves that the prevalence of MSD increases as the RULA action level and job tenure increases. Thus, this problem could be reduced by decreasing RULA action level through appropriate ergonomic workstation design and ergonomic training for workers.
    Matched MeSH terms: Musculoskeletal Diseases
  9. Mohd Din FH, Rampal S, Muslan MA, Hoe VC
    Occup Environ Med, 2016 07;73(7):429-34.
    PMID: 27013525 DOI: 10.1136/oemed-2015-103140
    OBJECTIVES: Pain catastrophising is defined as exaggerated negative thoughts, which can occur during an actual or anticipated painful experience, such as musculoskeletal injuries (MSI) or disorders (MSD). The aims of this study are to examine the association between pain catastrophising and MSI and MSD in Malaysian Army male recruits, and evaluate the effects of past injury.

    METHODS: A cohort of 611 male Malaysian Army recruits were recruited and followed up at 3 and 6 months. Pain catastrophising, MSD, sociodemographic and work factors were measured using a self-administered questionnaire, and MSI incidence was retrieved from the medical records. Multivariable fixed effects regression was used to model the cumulative incidence of MSD and MSI.

    RESULTS: Approximately 12% of the recruits were diagnosed with incident MSI and 80% reported incident MSD. Higher pain catastrophising at baseline was associated with higher 6 month MSD risk (adjusted OR (aOR) 1.6 per 1 SD increase of Pain Catastrophising Scale (PCS) scores; 95% CI 1.2 to 2.0), and longitudinally associated with MSD incidence (aOR 1.2, 95% CI 1.1 to 1.4). Pain catastrophising was not associated with MSI incidence (aOR 1.0, 95% CI 0.8 to 1.3). The association between pain catastrophising and self-reported MSD was stronger among recruits with self-reported past injury (p for interaction <0.001).

    CONCLUSIONS: Pain catastrophising was able to predict symptomatic MSD, and not physician-diagnosed MSI, and these findings are directly related to individual health beliefs. Pain catastrophising has a greater influence on how military recruits perceived their musculoskeletal conditions during training, and efforts to reduce pain catastrophising may be beneficial.

    Matched MeSH terms: Musculoskeletal Diseases/epidemiology; Musculoskeletal Diseases/psychology*
  10. Kim DK, Jeong J, Shin SD, Song KJ, Hong KJ, Ro YS, et al.
    PLoS One, 2021;16(10):e0258811.
    PMID: 34695147 DOI: 10.1371/journal.pone.0258811
    Hemorrhage, a main cause of mortality in patients with trauma, affects vital signs such as blood pressure and heart rate. Shock index (SI), calculated as heart rate divided by systolic blood pressure, is widely used to estimate the shock status of patients with hemorrhage. The difference in SI between the emergency department and prehospital field can indirectly reflect urgency after trauma. We aimed to determine the association between delta SI (DSI) and in-hospital mortality in patients with torso or extremity trauma. Patients with DSI >0.1 are expected to be associated with high mortality. This retrospective, observational study used data from the Pan-Asian Trauma Outcomes Study. Patients aged 18-85 years with abdomen, chest, upper extremity, lower extremity, or external injury location were included. Patients from China, Indonesia, Japan, Philippines, Thailand, and Vietnam; those who were transferred from another facility; those who were transferred without the use of emergency medical service; those with prehospital cardiac arrest; those with unknown exposure and outcomes were excluded. The exposure and primary outcome were DSI and in-hospital mortality, respectively. The secondary and tertiary outcome was intensive care unit (ICU) admission and massive transfusion, respectively. Multivariate logistic regression analysis was performed to test the association between DSI and outcome. In total, 21,534 patients were enrolled according to the inclusion and exclusion criteria. There were 3,033 patients with DSI >0.1. The in-hospital mortality rate in the DSI >0.1 and ≤0.1 groups was 2.0% and 0.8%, respectively. In multivariate logistic regression analysis, the DSI ≤0.1 group was considered the reference group. The unadjusted and adjusted odds ratios of in-hospital mortality in the DSI >0.1 group were 2.54 (95% confidence interval [CI] 1.88-3.42) and 2.82 (95% CI 2.08-3.84), respectively. The urgency of traumatic hemorrhage can be determined using DSI, which can help hospital staff to provide proper trauma management, such as early trauma surgery or embolization.
    Matched MeSH terms: Musculoskeletal Diseases/complications*
  11. Wong SK, Chin KY, Ima-Nirwana S
    Phytomedicine, 2020 Jul 15;73:152892.
    PMID: 30902523 DOI: 10.1016/j.phymed.2019.152892
    BACKGROUND: Musculoskeletal disorders are a group of disorders that affect the joints, bones, and muscles, causing long-term disability. Berberine, an isoquinoline alkaloid, has been previously established to exhibit beneficial properties in preventing various diseases, including musculoskeletal disorders.

    PURPOSE: This review article aims to recapitulate the therapeutic potential of berberine and its mechanism of action in treating musculoskeletal disorders.

    METHODS: A wide range of literature illustrating the effects of berberine in ameliorating musculoskeletal disorders was retrieved from online electronic databases (PubMed and Medline) and reviewed.

    RESULTS: Berberine may potentially retard the progression of osteoporosis, osteoarthritis and rheumatoid arthritis. Limited studies reported the effects of berberine in suppressing the proliferation of osteosarcoma cells. These beneficial properties of berberine are mediated in part through its ability to target multiple signaling pathways, including PKA, p38 MAPK, Wnt/β-catenin, AMPK, RANK/RANKL/OPG, PI3K/Akt, NFAT, NF-κB, Hedgehog, and oxidative stress signaling. In addition, berberine exhibited anti-apoptotic, anti-inflammatory, and immunosuppressive properties.

    CONCLUSION: The current evidence indicates that berberine may be effective in preventing musculoskeletal disorders. However, findings from in vitro and in vivo investigations await further validation from human clinical trial.

    Matched MeSH terms: Musculoskeletal Diseases/drug therapy*; Musculoskeletal Diseases/metabolism; Musculoskeletal Diseases/prevention & control
  12. Negrini S, Arienti C, Pollet J, Engkasan JP, Gimigliano F, Grubisic F, et al.
    Eur J Phys Rehabil Med, 2018 Jun;54(3):463-465.
    PMID: 29901359 DOI: 10.23736/S1973-9087.18.05317-0
    Since his launch Cochrane Rehabilitation has started working to be a bridge between Cochrane and rehabilitation. After a fist period of work organization, the field has started producing actions through its committees: communication, education, methodology, publication and reviews. All the results of this first year of activity are listed in this report.
    Matched MeSH terms: Musculoskeletal Diseases/rehabilitation*
  13. Rebi, M.A.M., Zein, R.M., Aziz, R.A., Tamilselvan, H.K., Azis, N.A., Mali, M.N., et al.
    MyJurnal
    This study is carried out to establish the prevalence of Work-related Musculoskeletal Disorders (MSD) among
    the Malaysian workforce population in order to propose some measures to benefit the people at large. Secondary data
    from three studies among drivers, clerical workers using visual display terminals (VDT) and fabrication workers were
    used to report the prevalence of MSDs and the associated risk factors. The study identified high prevalence of MSDs in
    multiple body regions. The MSD occurrence was also significantly associated with psychosocial factors. There is need
    for organisations to consider such factors in work design, which will reduce the high prevalence and high financial
    implications associated with MSDs among workers.
    Matched MeSH terms: Musculoskeletal Diseases
  14. Lim WL, Liau LL, Ng MH, Chowdhury SR, Law JX
    Tissue Eng Regen Med, 2019 Dec;16(6):549-571.
    PMID: 31824819 DOI: 10.1007/s13770-019-00196-w
    BACKGROUND: Tendon and ligament injuries accounted for 30% of all musculoskeletal consultations with 4 million new incidences worldwide each year and thus imposed a significant burden to the society and the economy. Damaged tendon and ligament can severely affect the normal body movement and might lead to many complications if not treated promptly and adequately. Current conventional treatment through surgical repair and tissue graft are ineffective with a high rate of recurrence.

    METHODS: In this review, we first discussed the anatomy, physiology and pathophysiology of tendon and ligament injuries and its current treatment. Secondly, we explored the current role of tendon and ligament tissue engineering, describing its recent advances. After that, we also described stem cell and cell secreted product approaches in tendon and ligament injuries. Lastly, we examined the role of the bioreactor and mechanical loading in in vitro maturation of engineered tendon and ligament.

    RESULTS: Tissue engineering offers various alternative ways of treatment from biological tissue constructs to stem cell therapy and cell secreted products. Bioreactor with mechanical stimulation is instrumental in preparing mature engineered tendon and ligament substitutes in vitro.

    CONCLUSIONS: Tissue engineering showed great promise in replacing the damaged tendon and ligament. However, more study is needed to develop ideal engineered tendon and ligament.

    Matched MeSH terms: Musculoskeletal Diseases/pathology; Musculoskeletal Diseases/therapy
  15. Mugilan Muralitharan, Syed Ahmad Helmi, Kamarulafizam Ismail, Azanizawati Ma'aram
    MyJurnal
    Aesthetic value of the automotive car seat has been one of the selling points of each car besides
    providing functions such as being safe, supportive as well provides comfort to the occupants. Other
    criteria considered besides the aesthetic element are cushion foam and self-adjustment factor.
    Ergonomics is not a new issue because most of the existing seat design today have already practiced it.
    Existing car seat manufacturers have considered anthropometry data. The average upon 95th percentile of
    human measurement had been deliberated. However, issues such as time spent driving and seat design
    issue have arisen upon the search of comfort and rising of musculoskeletal disease such as back pain. As a
    solution, this study would propose an automotive car seat design of ergonomic evolution, which would
    create comfort by manipulating the seat cushion foams. The proposed seat cushion foam would be use to
    replace the existing polymers with beanbag foam. This is inspire by the nature of beanbag, fitting up and
    providing comfort to the occupants of various body sizes and shapes. Malaysian anthropometry
    measurements are required for design of car seat, which later compared with the existing seats of
    commercial vehicle. The literature review showed the pressure mapping technique of respondent seating
    on the existing car seat. The most sensitive compartments where discomfort are experienced studied and
    placed with sachets filed with beanbag beads. This experiment conducted many times over a few
    respondents by using the pressure mat to find out, if there are any changes in terms of comfort. This
    design of new car seat with a manipulation cushion foam replaced with beanbag foam could be a niche to
    eliminate discomfort to all range body sizes and shapes.
    Matched MeSH terms: Musculoskeletal Diseases
  16. Lim KK, Chan M, Navarra S, Haq SA, Lau CS
    Best Pract Res Clin Rheumatol, 2016 06;30(3):398-419.
    PMID: 27886939 DOI: 10.1016/j.berh.2016.08.007
    This chapter discusses the challenges faced in the development and implementation of musculoskeletal (MSK) Models of Care (MoCs) in middle-income and low-income countries in Asia and outlines the components of an effective MoC for MSK conditions. Case studies of four such countries (The Philippines, Malaysia, Bangladesh and Myanmar) are presented, and their unique implementation issues are discussed. The success experienced in one high-income country (Singapore) is also described as a comparison. The Community Oriented Program for Control of Rheumatic Diseases (COPCORD) project and the role of Asia Pacific League of Associations for Rheumatology (APLAR), a professional body supporting MoC initiatives in this region, are also discussed. The experience and lessons learned from these case studies can provide useful information to guide the implementation of future MSK MoC initiatives in other middle-income and low-income countries.
    Matched MeSH terms: Musculoskeletal Diseases/therapy*
  17. Ling CF, Radin Umar RZ, Ahmad N
    Int J Occup Saf Ergon, 2020 Dec 29.
    PMID: 33096963 DOI: 10.1080/10803548.2020.1840116
    Objective. Limited models are available to predict work-relatedness of musculoskeletal disorders (MSDs) among semiconductor back-end workers. This study aims to develop a model to predict the MSDs development among back-end workers. Method. Potential MSD risk factors were extracted from 277 work compensation investigation reports conducted between 2011-2019. Binary logistic regression approach was used to determine significant predictors. Results. Significant predictors (p 
    Matched MeSH terms: Musculoskeletal Diseases
  18. Halim I, Omar AR
    Int J Occup Saf Ergon, 2012;18(1):85-96.
    PMID: 22429532
    Many occupations in industry such as metal stamping workers, electronics parts assembly operators, automotive industry welders, and lathe operators require working in a standing posture for a long time. Prolonged standing can contribute to discomfort and muscle fatigue particularly in the back and legs. This study developed the prolonged standing strain index (PSSI) to quantify the risk levels caused by standing jobs, and proposed recommendations to minimize the risk levels. Risk factors associated with standing jobs, such as working posture, muscles activity, standing duration, holding time, whole-body vibration, and indoor air quality, were the basis for developing the PSSI. All risk factors were assigned multipliers, and the PSSI was the product of those multipliers. Recommendations for improvement are based on the PSSI; however, extensive studies are required to validate their effectiveness. multipliers, and the PSSI was the product of those multipliers. Recommendations for improvement are based on the PSSI; however, extensive studies are required to validate their effectiveness.
    Matched MeSH terms: Musculoskeletal Diseases/etiology*; Musculoskeletal Diseases/physiopathology*
  19. Thulasi, M., Rosnah Md Yusuff, Norzima bt Zulkifli, Perimal, Enoch Kumar
    MyJurnal
    Upper extremity musculoskeletal disorder (MSD) has become a common problem among office workers in Malaysia. Studies have shown that an appropriate work-rest schedule can reduce fatigue and MSDs among office workers. In Malaysia, there has been an increase in the occurrence of MSDs, especially in work that require intensive computer use. Operators who used computers continuously for more than 4 hours a day have shown to develop CTDs. Studies on the effect of break time on the performance of office workers in Malaysia are still lacking. As such this study was aimed to evaluate effect of work rest schedule on the discomfort, performance and muscular load levels of computer users in Malaysia. The effect of break time starting with no break, one minute and 30 seconds break interval were carried out on the 15 subjects. EMG was measured for each task given. Performance which was calculated by multiplying speed and accuracy (WPM) showed 30 seconds break was 13.5% higher than 1 minute break and 20.14% higher than schedule with no break. EMG analyses showed 30 seconds have lowest mean AEMG which was 0.035 for flexor carpi ulnaris and 0.0331 for radialis muscles. It also recorded least discomfort scale for upper extremity muscles compared to the other two schedules. This study showed that more frequent microbreaks can improve performance of office workers and reduce MSD problem from occurring.
    Matched MeSH terms: Musculoskeletal Diseases
  20. Khan SA, Chew KY
    PMID: 23547959 DOI: 10.1186/1471-2474-14-118
    Work-related musculoskeletal disorders are one of the main occupational health hazards affecting dental practitioners. This study was conducted to assess the prevalence of Work-related Musculoskeletal Disorder (WMSD) amongst dental students. Possible correlations with the working environment and ergonomics taught in Malaysian dental schools were also sought.
    Matched MeSH terms: Musculoskeletal Diseases/epidemiology*; Musculoskeletal Diseases/physiopathology; Musculoskeletal Diseases/prevention & control*
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