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    women with disabilities-chronic musculoskeletal conditions

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    jenny c.
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    women with disabilities-chronic musculoskeletal conditions Empty synthesis- women with chronic musculoskeletal conditions

    Post  jenny c. Thu 02 Jul 2009, 10:37 pm

    Good evening everybody and sorry for the late response and synthesis of our previous discussion.

    I would like to thank everyone for making this discussion possible and successful and with all the responses given regarding the how and why musculoskeletal disorders affect women and what should be done to address this are as follows.

    Looking into the graph given by the CDC, Osteoarthritis is the most common musculoskeletal disorder for both men and women, but is greatly seen to affect women than men in both developed and industrialized countries. Although OA affects people of all ages, it is a condition whose incidence rises greatly with age. It can affect both genders, but it is twice as a common in women over 65 years of age than it is in their male counterparts. (R. C. Lawrence, C. G. Helmick, F. C. Arnett, et al. 1998). There is also a dramatic increase of these cases in developed countries than in those industrialized countries. Changes in lifestyle factors, such as increased obesity and lack of physical activity with the urbanization and motorization of the developing world further increase the burden.
    Moreover, musculoskeletal conditions greatly affect women, physiologically and psychologically. Hormonal variations and changes related to women's reproductive functions is one of the reasons pointed out to result in this case. Depletion of Estrogen and progesterone is known to have an effect in calcium absorption and utilization. The musculoskeletal problems, aches, and pains that tend to plague women after menopause could be also related to a drop in levels of collagen in ligaments and other soft tissues, according to indications in the study conducted by Rich (2006).
    Poverty, another identified cause on the increased incidence, made housewives to spend more time during household chores, domestic and provision of needs.

    Work-related factors including jobs involve physical labor especially lifting, pushing, or pulling heavy objects, or twisting during lifting also jobs requiring prolonged sitting and standing are considered in the formation of chronic musculoskeletal conditions most especially back pain.
    As these factors are being identified by most literatures cited in our discussion, these have posted women in general to a lot of physical and psychological consequences.

    Experience of these symptoms can result in poor levels of physical activity and increase in the risk of other diseases including heart disease, diabetes and obesity. In the psychological aspect, assumption of sick role may cause stress, depression, anger and anxiety. Women may experience difficulty in coping with pain and disability, which in turn can lead to feelings of helplessness, lack of self-control and changes in self-esteem and body image. They often experience social isolation which can later on affect their activities, employment and personal relationships. This may be compounded by lack of understanding and empathy among co-workers, employers and others. Economically, women may shoulder the burden for the costs of care, support and the purchase of aids and equipment. And since those who are affected by this condition may have a problem with the employment opportunities, financial independence may also be restricted. As these debilitating conditions are painful for the individual, this also lead to the inability to work and to enjoy life fully, and are a cost to societies and countries (WHO, 2003).

    In the remarkable increase of chronic musculoskeletal conditions among women, Multidisciplinary treatment approach would be beneficial for women as well as Cognitive-behavioral approaches. Recent research indicates that behavioral interventions are generally superior to medical treatment controls in improving the overall condition of the woman. Exercise, a known intervention in most chronic musculoskeletal conditions, is the key to the management of certain arthritis and musculoskeletal conditions. Evidence and current research suggests that exercise and muscle-strengthening can have an impact on function by reducing pain and stiffness, improving muscle strength and endurance, maintaining cardiac fitness, supporting weight reduction, and contributing to an improved sense of well-being. Moreover, accessible employment or appropriate social security support, training and education, self management training, information and advice on positive lifestyle options and self management strategies should be strengthened; aids and adaptations and fully accessible buildings, transport, housing, leisure facilities and pursuits are also recommended.

    Though women are regarded as the “primary care giver of the family”, I agree that women also need to be loved not only by their family but of the society as well.

    Thank you again for sharing with us your ideas. God bless everyone!
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    mfnierra
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    Post  mfnierra Wed 01 Jul 2009, 3:55 am

    Jenny, aren't you going to give a synthesis on this discussion? Wink
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    megsenga_crown princess o


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    Post  megsenga_crown princess o Sat 27 Jun 2009, 3:19 am

    A mailed self-report survey gathered data from 737 Australian Public Service employees (73% women). The majority of respondents were clerical workers (73%). Eighty one per cent reported some upper body symptoms; of these, 20% reported severe and continuous upper body pain. Upper body musculoskeletal symptoms were more prevalent and more severe among women. The gender difference in symptom severity was explained by risk factors at work (repetitive work, poor ergonomic equipment), and at home (having less opportunity to relax and exercise outside of work). Parenthood exacerbated this gender difference, with mothers reporting the least time to relax or exercise. There was no suggestion that women were more vulnerable than men to pain, nor was there evidence of systematic confounding between perceptions of work conditions and reported health status.

    Changes in the nature of work mean that more and more employees, especially women, use computers for significant parts of their workday. The sex-segregation of women into sedentary, repetitive and routine work, and the persisting gender imbalance in domestic work are interlinking factors that explain gender differences in musculoskeletal disorders.


    Osteoarthritis of the knee is a major cause of impaired mobility, particularly among women. As the incidence and prevalence of osteoarthritis rise with increasing age, extended life expectancy will result in greater numbers of people with the condition. The burden will be the greatest in developing countries, where life expectancy is increasing and access to arthroplasty and joint replacement is not readily available.

    Complex interactions exist between the female sex hormones and rheumatoid arthritis.

    Back pain has a marked effect on the patient and on society because of its frequency and economic consequences.

    Pain often is persistent during the episode, and many patients do not have complete resolution of their symptoms but have "flares" against a background of chronic pain. Pain is often worse with prolonged walking, standing, and sitting, which restricts mobility, as well as when travelling any distance in a vehicle. Pain may affect sleep. Episodes and fear of recurrence may affect strenuous activities and leisure pursuits. Most patients return to work within one week and 90% return within two months, but the longer a person is on sick leave the less likely he or she is to return to work. After six months off work, less than 50% of people will return to work, and after two years absence, there is little chance of the person returning, which greatly impacts on society.

    Lyndall Strazdins and Gabriele Bammer Women, work and musculoskeletal health available at: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6VBF-49BS7HD-S&_user=10&_rdoc=1&_fmt=&_orig=search&_sort=d&_docanchor=&view=c&_searchStrId=940800824&_rerunOrigin=scholar.google&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=57b08d5e16b2af81ce6353ed982ee8a3


    Burden of major musculoskeletal conditions available at: http://www.scielosp.org/scielo.php?pid=S0042-96862003000900007&script=sci_arttext
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    megsenga_crown princess o


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    Post  megsenga_crown princess o Sat 27 Jun 2009, 2:54 am

    Musculoskeletal conditions have a major impact on women and the society due to their frequency, chronicity, and resultant disability.

    Work disability

    Musculoskeletal complaints are a major cause of absence because of sickness in developed countries (60, 61); they are second only to respiratory disorders as a cause of short-term sickness absence (less than two weeks) (62). Musculoskeletal complaints are the most common medical causes of long-term absence, accounting for more than half of all sickness absences lasting longer than two weeks in Norway (63). Statistics on sickness absence in Norway show that of people who took sick leave for longer than four days because of musculoskeletal and connective tissue disorders, 33% had low back pain and 20% neck and shoulder disorders, but only 3% had rheumatoid arthritis.

    Musculoskeletal complaints also are common reasons for people claiming disability pensions, along with mental disorders and cardiovascular disorders. In Sweden, up to 60% of people on early retirement or long-term sick leave claimed musculoskeletal problem as the reason (64). In Norway, low back disorders were the most common reason for people claiming disability pensions (65).

    Utilization of health care services

    Musculoskeletal complaints are the second most common reason for consulting a doctor and constitute, in most countries, up to 10–20% of primary care consultations (66). In the Ontario Health Survey, musculoskeletal complaints were the reason for almost 20% of all health care utilization (7). They were the most expensive disease category in the Swedish cost of illness study, representing 22.6% of the total cost of illness; the greatest costs were indirect costs related to morbidity and disability (67). The total direct cost for use of health services that results from musculoskeletal conditions was 0.7% of the gross national product in the Netherlands, 1.0% in Canada, and 1.2% in the USA (68, 69). The indirect costs of musculoskeletal conditions (loss of productivity and wages) were much greater than the direct costs, corresponding to 2.4% and 1.3% of the gross national products of Canada and the USA, respectively.



    Future trends

    The impact of musculoskeletal disorders on individuals and society is expected to increase dramatically. Many of these conditions are more prevalent or have a greater impact in older patients, and the predicted ageing of the worlds population, predominantly in less-developed countries, will markedly increase the number of people affected by these conditions. In addition, changes in lifestyle factors, such as increased obesity and lack of physical activity with the urbanization and motorization of the developing world, will further increase the burden.

    This is an excerpt from an article I read which you can access from this site:
    http://www.scielosp.org/scielo.php?pid=S0042-96862003000900007&script=sci_arttext
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    megsenga_crown princess o


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    Post  megsenga_crown princess o Fri 26 Jun 2009, 10:50 pm

    I can see that Osteoarthritis afflicts more women than men and it ranks the highest in the disability causing musculoskeletal conditions among women and men as well.

    While in the article posted by mrs. nierras linking muscoloskeletal conditions among elderly women with hormonal change, I have also read an article that links lifestyle of women with the incidence of osteoarthritis. Researchers of the study say that wearing stilletos and platforms may increses the risk of developing knee osteoarthrtis.

    This is an exerpt from the article I have read:


    PM&R physician D. Casey Kerrigan, MD, wanted to see if high heels played any part in the higher incidence of knee osteoarthritis in women. Kerrigan is an associate professor at Harvard Medical School, and director, Center for Rehabilitation Science, Spaulding Rehabilitation Hospital. She found that women who wear 2 ½ inch heels strain the joints, muscles, and tendons in their knees. That increased pressure on the knees is believed to lead to osteoarthritis, a painful joint disease that destroys the cartilage surrounding the knee. PM&R physicians treat osteoarthritis and say that by the time some patients feel its effects, a lot of damage has already been done.

    Think you're saving yourself future pain by wearing "chunky" high heels instead of stilettos? Think again. Kerrigan and her research team recently went back into the lab to see if the width of the heel makes any difference. They found that wide-heeled women's dress shoes caused the same, if not greater, pressures on the knees as narrow-heeled shoes.

    And because these shoes are more comfortable than stilettos, women tend to wear them longer, exposing their knees to even more strain.


    Reference:
    http://www.aapmr.org/condtreat/pain/highheels.htm
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    mfnierra
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    Post  mfnierra Fri 26 Jun 2009, 7:44 pm

    More observations:

    3. Jonnah, in your review of researches on interventions to control MSD, you made mention of a proposed model that aimed to decrease the "stress load." However, I was confused with the consequences which included among others an increase in blood pressure and perception of pain. How can such consequences decrease "stress load"?

    4. Rai, I agree with your endorsement of a multidisciplinary approach in addressing musculoskeletal conditions and their consequences. Indeed, the use of cognitive-behavioral approaches may go a long way towards improving the overall quality of life of the afflicted women in society.
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    Post  mfnierra Fri 26 Jun 2009, 7:35 pm

    Some observations:

    1. Thea, there seems to be incongruence in your statement about the suffering of postmenopusal women due to musculoskeletal conditions remaining a "mystery" when in your first two sentences in item # 3 you pointed out the role of hormonal fluctuations and the research of Rich (2006)relating to a drop of levels of collagen in ligaments and other soft tissues as probable culprits.

    2. Tina, your said you agree with Thea that OA increases with age because it is "REVERSIBLE"? I did not find that in her discussion. However, I was struck by the statement about work stress and job satisfaction playing a fundamental role in the development of MSD. Perhaps that is worth looking into.
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    railibo-
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    Post  railibo- Fri 26 Jun 2009, 2:53 pm

    1. Looking into the statistics provided by Disease Control Priorities Project, what conclusion could you derive? (Kindly provide empirical studies to support your claim).

    Musculoskeletal conditions are a major burden on individuals, health systems, and social care systems, with indirect costs being predominant.

    • Osteoarthritis, which is characterized by loss of joint cartilage that leads to pain and loss of function primarily in the knees and hips, is the leading cause of chronic musculoskeletal conditions among women in developing countries. It affects 9.6% of men and 18% of women aged >60 years. The increases in life expectancy and ageing populations are expected to make osteoarthritis the fourth leading cause of disability by the year 2020.

    • Rheumatoid arthritis is an inflammatory condition that usually affects multiple joints. It affects 0.3–1.0% of the general population and is more prevalent among women and in developed countries. Persistent inflammation leads to joint destruction, but the disease can be controlled with drugs. The incidence may be on the decline, but the increase in the number of older people in some regions makes it difficult to estimate future prevalence (Woolf and Pfledger, 2009).

    2. How do chronic musculoskeletal conditions affect women’s health?

    • Musculoskeletal conditions have a major impact on society due to their frequency, chronicity, and resultant disability. It is a reality that women who have chronic musculoskeletal conditions are being limited in the performance of certain tasks that they would normally do if it weren’t for their condition.

    • Chronic pain is usually one of the symptoms experienced by a person with chronic musculoskeletal condition. It has been associated with deficits in quality of life and psychological adjustment, disability, reduced income potential, high levels of health care utilization and high costs to private industry. Recent reviews report that the prevalence of most pain conditions is higher among women than men.

    • Normal hormonal variations and changes related to women's reproductive functions can be sex-specific sources of pain, as can pathologic processes associated with these.

    • Psychologically, women may differ in their cognitive and emotional processing of pain and also behave differently when in pain. Psychological distress is common in both men and women who experience chronic pain. Estimates of depression prevalence among patients with chronic pain range from 31% to 100%, and pain complaints in depressed individuals range from 34% to 66%. This is particularly important for women, as they suffer from clinical depression at twice the rate of men.

    • Socially, women differ from men in their societal, family and occupational roles, and these may also be potential sources of sex differences in pain. Age and socio-economic variables have been associated with chronic pain. For certain pain syndromes, such as joint pain, chronic widespread pain and fibromyalgia, prevalence rates increase with age. It is not surprising to note then that chronic pain is also associated with multiple comorbid conditions. Also, some studies have consistently found an association between chronic pain and lower educational levels and socio-economic status.

    • The functional interference of pain is also high, and a whole range of activities are often severely curtailed. Daily chores become difficult, ability to work diminishes, and there is a lower rate of full-time employment. Social support can also diminish as friends and family lose patience with a problem that is usually invisible and endless. Individuals with chronic pain can also suffer rejection from health care providers frustrated with their failed attempts to heal and with the dependence on pain medications that their patients commonly show. Chronic pain also exacts a high cost from society at large and the health care system in particular. It is associated with a loss of productivity, high utilization of health services and substantial health care expenditures.

    3. What are the factors that could affect the experience of these women having chronic musculoskeletal conditions?

    • Hormonal variations and changes related to women's reproductive functions

    • Economic factors.

    • Psychologic factors or how they respond to stressors

    • Work related factors: Signs and symptoms of chronic musculoskeletal conditions are particularly difficult to accommodate to the demands of the workplace. The prevalence of work disability in this disease is high and much job loss occurs in the first year , often before the patient is referred to hospital or started on treatments.

    • Social support specifically marital. (Hamberg, 1997) and familial support

    • Gender- gender gaps in some health outcomes might narrow as women’s participation in the labor force comes nearer to men’s. On the other, women and men may have vastly different experiences of paid employment and its effects on family life, especially once they become parents (Blane, Berney, & Montgomery, 2001) as cited by Strazdins and Bammer.

    • Health risk factors- Greater prevalence or severity of symptoms may be due to the higher demands and constraints that women face, or because women are more affected by, or vulnerable to,the health impact of particular demands and constraints (McDonough & Walters, 2001)as cited by Strazdins and Bammer.

    4. What could have been done to help women in addressing the psychological impact of chronic musculoskeletal conditions?

    • A Multidisciplinary treatment approach woulb be beneficial for women with chronic muscculo skeletal conditions. In addition to medical and physical therapy, cognitive-behavioural approaches is also an important component in treatment that should be considered. Recent research indicates that behavioural interventions are generally superior to medical treatment controls in improving the overall condition of the woman.

    REFERENCES:

    Meana, M., Cho, R. and DesMeules, M. (2004) Chronic Pain: The Extra Burden on Canadian Women licensee BioMed Central Ltd retrieved June 25, 2009 from http://www.biomedcentral.com/1472-6874/4/S1/S17

    Hamberg, K (1997) “The impact of marital relationship on the rehabilitation process in a group of women with long-term musculoskeletal disorders” Scandinavian Journal of Public Health retrieved June 26, 2009 from http://sjp.sagepub.com/cgi/content/abstract/25/1/17

    Strazdins, L.and Bammer, G “Women, work and Musculoskeletal Health” Social Science and Medicine retrieved June 26, 2009 from http://www.elsevier/locate/socscimed

    Woolf, A. D. and Bruce Pfleger, B. (2009) “Burden of Major Musculoskeletal Conditions” Bulletin of World Health Organization retrieved June 25, 2009 from http://www.scielosp.org/scielo.php?pid=S0042-96862003000900007&script=sci_arttext&tlng=en
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    Post  jonnah Fri 26 Jun 2009, 2:22 pm

    In view of the Psychological impact of musculoskeletal disorders, I noticed that there is a little acknowledgment that WOMEN also needs to be taken cared of. Women are oftentimes viewed as someone to take care of the family. Having backaches, muscle and joint pains are instances when women demands for care and concern. Remember that most of MSD occurs along aging. In the study "Ambulatory Physicians care for musculoskeletal disorders in canada" by Power, et al, it was concluded that "as the population ages, there would be an escalating demand for care." If I am to be that woman in pain, I would like to be unloaded of my tasks and be given considerations like somebody else to prepare the meals, look over the children and grand children, and oversee home management. These ways sound so simple but it does decrease the "stress load". In a "Review of research on interventions to control musculoskeletal disorders', author Smith proposed a model which aimed to decrease this "stress load" which has biomechanical, physiological and psychological consequences such as forces on the joints, increase blood pressure and increase perception of pain.
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    ma. cristina arroyo


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    Post  ma. cristina arroyo Fri 26 Jun 2009, 12:20 pm

    Factors Affecting Musculoskeletal Conditions

    Effect of Age
    Review of musculoskeletal disorders and workplace factors suggests, loss of tissue strength with age may increase the probability or severity of soft tissue damage from a given insult.

    Effect of Work Stress

    Frequently experiencing work stress was associated with increased risk of disability. Also, those not satisfied with their job were at elevated risk among both males and females with knee conditions. These findings support the hypothesis that work stress and job satisfaction may play a fundamental role in the development of musculoskeletal conditions and their resulting physical disability.

    Effect of recurrent hospitalization

    Recurrent hospitalization, a surrogate measure of injury severity in some cases and of healing in others, was associated with increased risk for males with knee conditions or other conditions, but not back or overuse conditions.

    Effect of education

    A lower level of education was found to be an independent predictor of disability discharge among women for knee and overuse conditions, it was not found to be predictive among males for any diagnostic group. Many studies have identified education level as one of the strongest predictors of disability resulting from musculoskeletal conditions such as low back pain, lower extremity fracture, and rheumatoid arthritis

    Effect of smoking

    Smoking is a significant predictor of disability among males for knee injuries but not back injuries. There is a significant literature that relates smoking to the incidence of back conditions. A recent review suggests that cigarette smoking may be associated with the progression of musculoskeletal conditions to disability (Lincoln, 2002).

    Women particularly is affected by various factors in facing musculoskeletal conditions. Her ersonal and behavioral risk factors, such as age, her gender which accompanies hormones production, weight, and lifestyle factors such as smoking. Psychological aspect is also included.
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    ma. cristina arroyo


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    Post  ma. cristina arroyo Fri 26 Jun 2009, 12:05 pm

    Impact of musculoskeletal Conditions

    Mostly, we just the same answers. The major impact of musculoskeletal conditions will be on physical and psychological aspects. On the physical aspect pain, Disability, Physical limitation, alteration on ADL's are present. As for the psychologcal one, social isolation, increase anxiety on the patient herself and family. It may also hamper personal and social relationships.

    Musculoskeletal conditions are prevalent and their impact is pervasive. They are the most common cause of severe long term pain and physical disability, and they affect hundreds of millions of people around the world. They significantly affect the psychosocial status of affected people as well as their families and careers. The burden of musculoskeletal disorders can be measured in terms of the problems associated with them, that is the pain or impaired functioning (disability) related to the musculoskeletal system, or in relation to the cause, such as joint disease or trauma (Woolf, 2003).
    Among older people rheumatoid arthritis, osteoarthritis and osteoporosis are associated with a loss of independence and a need for more support in the community or admission to residential care. Pain is the most prominent symptom in most people with arthritis, and is the most important determinant of disability in patients with osteoarthritis. The prevalence of physical disability is higher in women than men. It rises with age; around 60% of women aged over 75 living in the community report some physical limitations.
    As a result, musculoskeletal conditions are giving rise to enormous health-care expenditures and loss of work. There will be a marked increase in requirements for health care and community support in the coming years. These debilitating conditions are painful for the individual, lead to the inability to work and to enjoy life fully, and are a cost to societies and countries (WHO, 2003).
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    Post  ara_portillo Fri 26 Jun 2009, 11:55 am

    PORTILLO, Maria Santa R.
    MCN – EXEC 4


    1. Looking into the statistics provided by Disease Control Priorities Project, what conclusion could you derive?

    The statistics show that women are the ones affected by all musculoskeletal conditions like osteo arthritis, rheumatoid arthritis and other diseases than men. Also, high burden of women suffering from such diseases are from developing countries.
    In the US, Arthritis, is the most common chronic condition reported by American women (23 million in 1990). About 16 million Americans suffer from osteoarthritis, which affect 2 times as many women as it does men, while rheumatoid arthritis afflicts 2.1 million Americans, occurring in 3 times as many women as men. An estimated 4 to 6 million women over age 50 suffer from osteoporosis, while an additional 13 to 17 million have osteopenia (less severe bone loss).In all its forms, arthritis is the third leading cause of bed disability (NIH, 2008).

    Also, arthritis and musculoskeletal conditions are large contributors to illness, pain and disability in Australia, according to a report from the Australian Institute of Health and Welfare (AIHW) released late October 2005.

    Figures on such disorders from developing countries are not abundant. However, a number of studies in countries such as Indonesia, Thailand, Vietnam, Pakistan and Lebanon have shown that MSD are quite prevalent with the proportion of the population affected ranging from 14 to 42%. Studies carried out in Lebanon showed a higher prevalence among women than men of all ages for several types of MSD, such as arthritis and back pain(Habib, 2005).

    2. How do chronic musculoskeletal conditions affect women’s health?
    The impact of musculoskeletal conditions is pervasive. They are the most common cause of severe long-term pain and physical disability, and they affect hundreds of millions of people around the world (WHO, 2003). They significantly affect the psychosocial status of affected people as well as their families and caregivers. The burden of musculoskeletal disorders can be measured in terms of the problems associated with them, that is the pain or impaired functioning (disability) related to the musculoskeletal system, or in relation to the cause, such as joint disease or trauma. The burden should also be considered in terms of who is at risk.

    Pain together with the physical disability are the most commonly reported symptoms (Kazis et al, 1983; van Baar et al, 1998). In surveys carried out in Canada, the USA, and Western Europe, the prevalence of physical disabilities caused by a musculoskeletal condition repeatedly has been estimated at 4–5% of the adult population. The prevalence is higher among women and increases markedly with age. Pain itself prevents women from accomplishing their duties properly. Also, it has a great effect on posing limitation with regards to their activities whether at work or at home. On the other hand, physical disability affects social functioning and psychological health (body image).

    3. What are the factors that could affect the experience of these women having chronic musculoskeletal conditions?
    The following are factors that affects women suffering from Musculoskeletal Disorders (From Habib et al, 2005):
    • Personal and behavioral risk factors, including increased age, female sex, increased weight, and lifestyle factors, such as tobacco smoking and physical activity, in addition to psychological factors affect the musculoskeletal system (Palmer, Syddall, Cooper, & Coggon, 2003; Peltonen, Lindroos, & Torgerson, 2003; Cassou, Derriennic, Monfort, Norton, & Touranchet, 2002; Tsuritani, Honda, Noborisaka, Ishida, Ishizaki, & Yamada, 2002; Malchaire, Roquelaure, Cock, Piette, Vergracht, & Chiron, 2001; Kaergaard & Anderson, 2000; Barnekow-Bergkvist, Hedberg, Janlert, & Jansson, 1998). Recent research reported a positive association between MSD and depression in women (Dionne & Chénard, 2004, Réthelyi, Berghammer, Ittzés, Szumska, Purebl, & Csoboth, 2004).
    • The epidemiology of women’s occupational health has so far focused primarily on hazardous physical and psychosocial exposures in the workplace. Nurses, industrial workers, sewing machines operators, and cleaners have been extensively studied (Alexopoulos, Burdorf, & Kalokerinou, 2003, Björkstén, Boquist, Talbäck, & Edling, 2001; Kaergaard & Anderson, 2000; Messing, 1998). Women’s domestic labor remains largely unexplored in the literature on women’s health.

    References:

    Agenda for Research on Women’s Health for the 21st Century, New Frontiers in Women’s Health

    The burden of musculoskeletal diseases at the start of the new millennium. Report of a WHO scientific group. Geneva: World Health Organization, 2003. Technical Report Series, No. 919.

    Habib, R., Hamdan, M., Nuwayhid, I., Odaymat, F., 2005. MusculoSkeletal disorders among fulltime homemakers in poor communities. Women Health. 2005; 42(2): 1–14. Electronic Version available at http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1821091#R40

    Kazis LE, Meenan RF, Anderson JJ., 1983. Pain in the rheumatic diseases. Investigation of a key health status component. Arthritis and Rheumatism;26:1017-22. Cited in Bulletin of World Health Organization. 2003. Vol. 81. No. 9 Available at http://www.scielosp.org/scielo.php?pid=S0042-96862003000900007&script=sci_arttext
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    ma. cristina arroyo


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    Post  ma. cristina arroyo Fri 26 Jun 2009, 11:49 am

    i agree with ms. perez, osteoarthritis indeed increases with age because it's reversible. Specifically for women, the incidence is highest among aged 64-74 years old. Men are affected more often than women among those aged <45 years, whereas women are affected more frequently among those aged >55 years (Woolf, 2003).
    There is indeed higher incidence of musculoskeletal diseases in the developing countries that industrialized countries. In the developing world, successful treatment of communicable diseases, combined with a rapid increase in road traffic accidents, will lead to an increase in the burden of musculoskeletal conditions. In industrialized countries, the increasing numbers of elderly people is a key factor in this rise (WHO, 2003).
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    Post  Maria Al Fri 26 Jun 2009, 8:51 am

    Perez, Maria Althea Sabrina L.
    Executive-4

    1. Looking into the statistics provided by Disease Control Priorities Project, what conclusion could you derive? (Kindly provide empirical studies to support your claim).

    It was seen on the graph that there is an increase occurrence of Osteoarthritis is greater in women compared to men and in comparison to the economic status, it have higher cases on developing countries rather than industrialized countries. The prevalence of musculoskeletal disorders generally increases with age, with the majority of persons aged seventy-five and over having some form of musculoskeletal disorder, especially arthritis. Approximately 55 percent of adults are affected by musculoskeletal signs or symptoms, including limitation of motion or pain in a joint or extremity. Osteoarthritis is the most common form of arthritis and, depending on how it is defined, affects 10 to 20 percent of all adults and a much larger percentage of the elderly (Felson, 2000). Carpal tunnel syndrome also increases in older women, seeing its greatest occurrence in women over the age of 55 (Rich, 2006). Approximately 70% of adhesive capsulitis cases occur in women, with the incidence increasing in those over age 40. The hormonal fluctuations that women experience at menopause may be responsible for a reduction in their physical strength and other musculoskeletal changes. It was affirmed by the Center for Prevention and Health Services Research in The Netherlands (2006), that the present study shows that women have higher prevalence rates of musculoskeletal pain in most anatomic pain sites, no matter the duration of musculoskeletal pain.

    2. How do chronic musculoskeletal conditions affect women’s health?

    Osteoarthritis significantly impacts psychosocial and physical function and is a leading cause of disability in later life. Pain, the most prominent symptom in most people with osteoarthritis, is the most important determinant of disability. For women who are involve in an active lifestyle, such as working or doing household chores, any discomforts felt by the client will have an effect when performing the roles expected of her (Fillingim, 2009). Any chronic musculoskeletal disorders do not only affect performance of roles by women but also their body images as well. Certain disorders such as carpal tunnel syndrome, fibromyalgia, osteoporosis and adhesive capsulitis can cause body image alteration (Schmerz, 2003).

    3. What are the factors that could affect the experience of these women having chronic musculoskeletal conditions?

    The hormonal fluctuations that women experience at menopause may be responsible for a reduction in their physical strength and other musculoskeletal changes. The musculoskeletal problems, aches, and pains that tend to plague women after menopause could be related to a drop in levels of collagen in ligaments and other soft tissues, according to indications in the study conducted by Rich (2006). The hormonal fluctuations that women experience at menopause may be responsible for a reduction in their physical strength and other musculoskeletal changes. Persons at high risk of low back pain include those between age twenty and forty, and whose jobs involve physical labor especially lifting, pushing, or pulling heavy objects, or twisting during lifting also jobs requiring prolonged sitting and standing. Truck drivers are the occupational group who experience the most back pain. Another risk factor for low back pain is cigarette smoking, and poor physical fitness may also contribute to its occurrence. The high rate of back pain in particular occupations has suggested that altering work tasks may be a successful way to prevent episodes of back pain. Indeed, industry training programs have achieved success in lessening the rate of low back pain in some occupations.


    4. What could have been done to help women in addressing the psychological impact of chronic musculoskeletal conditions?

    Why so many women suffer from musculoskeletal problems following menopause remains a mystery. Perhaps it's due to some factor that hasn't been studied much yet. For example, a study published in the journal Cell in April reported that high levels of follicle-stimulating hormone, which is elevated approaching menopause, caused bone loss. The study was conducted on mice, but it highlights the fact that there remains much we may not know about how menopause, hormonal changes, and aging affect the musculoskeletal health of women. For now, exercise appears to be the clear prescription for women prior to menopause and following it, particularly upper body strengthening activities. Getting the word out to practitioners and women is the key, as is figuring out how to motivate more women to engage in strength training exercises.

    References:

    Felson, D. T. (2000). "Epidemiology of the Rheumatic Diseases." In Arthritis & Allied Conditions, ed. W. Koopman. Philadephia, PA: Lippincott, Williams & Collens.

    Fillingim RB, et al. (2009). Sex, gender, and pain: a review of recent clinical and experimental findings. Clinical Pain. May; 10(5):447-85.

    Andersson GBJ: Epidemiologic features of chronic low back pain. Lancet 1999, 354:581-5.

    Burdorf A, Sorock G: Positive and negative evidence for risk factors of work-related back disorders. Scand J Work Environ Health 1997, 23:243-56.
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    Angel Ve
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    Post  Angel Ve Fri 26 Jun 2009, 2:08 am

    MA. ANGELICA H. VERAIN 0404286
    EXEC 4- MSN MCN PROF. NIERRAS

    ANSWER #1

    Prevalence of Muskuloskeletal Condition in terms of Gender


    The table shows that there is greater number of women compare to men who acquire osteoarthritis, Rheumatoid Arthritis and all musculoskeletal conditions except for the other musculoskeletal conditions was not elaborated.

    Osteoarthritis (OA) is the most prevalent musculoskeletal condition in the United States affecting more than 21 million people. (Lawrence RC, Helmick CG, Arnett FC, et al. 1998)The prevalence of OA is growing, most likely due to an increase in the average age of our population and better recognition and diagnosis of the disease. Although OA affects people of all ages, it is a condition whose incidence rises greatly with age. It can affect both genders, but it is twice as a common in women over 65 years of age than it is in their male counterparts. (Lawrence RC, Helmick CG, Arnett FC, et al. 1998)

    Rheumatoid Arthritis (RA) is the second most common musculoskeletal condition. Three-quarters of the people afflicted with RA are women, and peak onset is between the ages of 20 and 45 years. (American College of Rheumatology).Rheumatoid arthritis is a disease that fluctuates in severity leaving the patient unable to predict when flares will occur.

    FM affects 2% of the American population and it is 7 times more common in women than men, especially women of childbearing age. (American College Of Rheumatology)


    Prevalence of Musculoskeletal Condition in terms of Countries


    As shown in the table, people from developing countries have more cases of musculoskeletal conditions (osteoarthritis, rheumatoid arthritis and all the musculoskeletal conditions. The disaggregation by developing and developed regions, however, shows that while musculoskeletal conditions account for around 3.4 percent of the total burden of disease in the developed world, they account for 1.7 percent in the developing world. The data also show that, of the set of musculoskeletal conditions, OA accounts for the largest burden, approximately 52 percent of the total in developing regions and 61 percent in developed regions.

    2. How do chronic musculoskeletal conditions affect women’s health?

    Musculoskeletal conditions do not only affect the health of a woman but also her well-being,and quality of life. The symptom of musculoskeletal conditions may include pain, loss of joint movement and mobility, joint deformity and fatigue. Experience of these symptoms can result in poor levels of physical activity and increase in the risk of other diseases including heart disease, diabetes and obesity. In the psychological aspect, assumption of sick role may cause stress, depression, anger and anxiety. Women may experience difficulty in coping with pain and disability, which in turn can lead to feelings of helplessness, lack of self-control and changes in self-esteem and body image.

    Women with musculoskeletal conditions may also experience social isolation which can later on affect their activities, employment and personal relationships. This may be compounded by lack of understanding and empathy among co-workers, employers and others. In the economic state, women may shoulder the burden for the costs of care, support and the purchase of aids and equipment. And since those who are affected by this condition may have a problem with the employment opportunities, financial independence may be restricted.

    3. What are the factors that could affect the experience of these women having chronic musculoskeletal condition

    Women who experience musculoskeletal condition or injury can affect a her ability to remain independent in daily life or to work. Although women with this condition can function independently, their health related quality of life may be influenced in physical, emotional and social terms. In this connection the possibilities range from complete incapacity for work to adaptation to the regular environment. The impact of the experience of musculoskeletal conditions relate to the site of fracture, pain chronicity and impairment of function. Work loss, disability pension

    4. What could have been done to help women in addressing the psychological impact of chronic musculoskeletal conditions?

    Quality of life improvements can be gained by people with musculoskeletal disorders through lifestyle changes including safe exercise and other physical activities. In some cases, exercise is the key to the management of certain arthritis and musculoskeletal conditions. Evidence and current research suggests that exercise and muscle-strengthening can have an impact on function by reducing pain and stiffness, improving muscle strength and endurance, maintaining cardiac fitness, supporting weight reduction, and contributing to an improved sense of well-being. The Welsh Backs Campaign is an initiative that reinforces these healthy lifestyle messages, particularly those of exercise and mobility. The campaign Status – Consultation Document 12 May 2006 addresses the impact that back pain has on individuals, the economy and the wider society.

    Although no cure exists for arthritis and chronic musculoskeletal conditions,much can be done to improve quality of life and maximise independence of people living with these conditions. Timely and appropriate access to the following can all play an important part in enabling people to take more control over their lives:

    • Flexible and responsive services that are multi disciplinary and seamless
    • Self management training, information and advice on positive lifestyle
    options and self management strategies
    • Aids and adaptations
    • Accessible employment or appropriate social security support, training and education
    • Fully accessible buildings, transport, housing, leisure facilities and pursuits. It is important that service developments and support systems for people with arthritis and chronic musculoskeletal conditions allow for these issues to be back pain.

    References

    WHO Scientific Group. The burden of Musculoskeletal conditions at the Start of the New Millenium. Available at:

    Bjorksten M., Talback M. 2000. A follow-up study of Psychosocial Factors and musculoskeletal problems aming unskilled female workers with monotonous work. Available at:

    Strazdins L., Bammer G. 2003. Women, work and Musculoskeletal Health. Elsevier science Ltd. From

    Lincoln A., Smith G., Amoroso P., Bell N. 2002.The natural history and risk factors of musculoskeletal conditions resulting in disability among US Army Personnel. Available at:

    McCool W., Smith T., Aberg C., 2004. Pain in Women’s Health: Developmental Aspects of Pain. Elsevier science

    WHO.2003. Burden of Major Musculoskeletal conditions. Available at:
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    Jonnahmo
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    Post  Jonnahmo Thu 25 Jun 2009, 5:03 pm

    In the study conducted for the British Society of Rheumatology in 2006, Dieppe identified three links to musculoskeletal disorders. Those are:Age, poverty, pain and behaviour. Alongside he discussed roles of sex, ethnicity and rural living. In the graph presented, More women are afflicted with musculoskeletal disorder and occurrence is higher in developing countries. Let's take into consideration some of the factors identified by the researcher and relate it with physiologic changes in women.
    As women age, she is also depleted of hormones Estrogen and Progesterone. These hormones play a vital role in preparing the reproductive system, the same as it affects bone formation.Although not completely understood, physicians and researchers agreed that lack of estrogen decreases calcium absorption and utilization which is needed to maintain bone integrity.
    The relationship between poverty women and musculoskeletal disorder can be rooted on the fact that women belonging to the lower socioeconomic group had more pregnancies and childbirth. Most of them are housewives who spent more time in domestic care, house hold chores and provision of basic needs. This was, at least, the findings of the study
    "Musculoskeletal disorders among full-time homemakers in poor communities.
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    jenny c.
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    Post  jenny c. Thu 25 Jun 2009, 2:31 pm

    Good afternoon everyone, one of the three topics that we are to discuss today is chronic musculoskeletal conditions affects both gender and women in general. I hope I could answer some of your queries (my internet connection sometimes is the problem). As we go along the literatures, the following questions will guide us to further explore the given topic:

    1. Looking into the statistics provided by Disease Control Priorities Project, what conclusion could you derive? (Kindly provide empirical studies to support your claim).
    Note: The chart is uploaded in our yahoo groups.

    http://groups.yahoo.com/group/exec_msnbatch4/files/MCN%20Cluster/Women%27s%20Health/

    Title: estimated burden of musculoskeletal conditions

    2. How do chronic musculoskeletal conditions affect women’s health?
    3. What are the factors that could affect the experience of these women having chronic musculoskeletal conditions?
    4. What could have been done to help women in addressing the psychological impact of chronic musculoskeletal conditions?



    At the end of the discussion and when all your responses are submitted, I’ll be giving a synthesis of what had transpired during the discussion.

    God bless, everyone!



    Facts:
    • Globally, the number of people suffering from musculoskeletal conditions increased by 25 percent over the past decade. Musculoskeletal conditions are currently the most common cause of chronic disability. Although the evidence needed to determine the most cost-effective interventions is scant, affordable measures to prevent and treat musculoskeletal conditions are available.


    • Osteoarthritis is characterized by focal areas of loss of articular cartilage within synovial joints, which are associated with hypertrophy of bone (osteophytes and subchondral bone sclerosis) and thickening of the capsule. Estimates from Australia indicate that the incidence of osteoarthritis is higher among women than men among all age groups. For women, the highest incidence is among those aged 65–74 years, reaching approximately 13.5 per 1000 population per year; for men, the highest incidence occurs among those aged ≥75 years with approximately 9 per 1000 population per year.

    • Osteoporosis is characterized by a low bone mass and a microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. The general prevalence of osteoporosis rises from 5% among women aged 50 years to 50% at 85 years of age; among men, the comparable figures are 2.4% and 20%.

    • Low back pain is known as a localized below the line of the twelfth rib and above the inferior gluteal folds, with or without leg pain; and it can be classified as “specific” (suspected pathological cause) or “non-specific” (about 90% of cases).

    • The burden of musculoskeletal disorders can be measured in terms of the problems associated with them, that is the pain or impaired functioning (disability) related to the musculoskeletal system, or in relation to the cause, such as joint disease or trauma.

    • Factors associated with work disability commonly are the nature of the job (the level of physical activity required and the degree of autonomy, particularly over the place of work), the age at onset of the disease, marital status, level of formal education, duration of the disease and the level of disability.

    • Psychosocial changes are one of the significant adverse impacts of rheumatoid arthritis. The loss of positive body image is a serious problem for many. Meenan et al. (1981) found that 63% had experienced at least one major change in their life (marital status, employment) as a result of their disease. Of those surveyed, 83% of people between the ages of 21 and 65 had to make significant changes in their leisure activities.

    • Although musculoskeletal conditions are the most common cause of chronic disability worldwide, few data are available on approaches to addressing these conditions. Thus, it is difficult to estimate the most cost-effective interventions for developing countries.


    thanks!

    -jenny

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