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   Abstract
  Introduction
  Subjects and Methods
  Results
  Discussion
  Conclusions
   References

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ORIGINAL ARTICLE
Year : 2019  |  Volume : 23  |  Issue : 1  |  Page : 54-56
 

Prevalence of upper cross syndrome in laundry workers


Department of Cardiopulmonary Sciences, Faculty of Physiotherapy, KIMS, “Deemed to be University”, Karad, Maharashtra, India

Date of Web Publication15-Apr-2019

Correspondence Address:
Mr. Junaid Chandsaheb Mujawar
Intern, Faculty of Physiotherapy, KIMS “Deemed to be University”, Karad, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijoem.IJOEM_169_18

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  Abstract 


Context: Upper crossed syndrome is caused by weakness in one group of muscles and tightness in other group of muscles. Deep-neck flexor weakness and tight pectorals and sternocleidomastoid contribute to this syndrome. This syndrome mainly arises as a result of muscular imbalance that usually develops between weak and tonic muscles. Laundry workers tend to develop this syndrome due to the nature of their work. Aims: The aim of the study is to find the prevalence of upper crossed syndrome in laundry workers. Subjects and Methods: A prevalence study was conducted among laundry workers. Laundry workers were selected by random sampling method. They were assessed by performing various special tests for tightness and weakness of the muscles. Oswestry neck disability index questionnaire was then filled up by the population included. Results: Data from fifty laundry workers were obtained and analyzed. The symptoms of upper crossed syndrome were present (n = 14) in the population with mild neck disability (n = 4) and moderate neck disability (n = 11) and no disability (n = 35). Conclusions: These findings reported in the study provide a better understanding of impact and the extent of upper crossed syndrome. We found out that there is a significant prevalence of upper crossed syndrome in laundry workers. Neck pain presents as the main symptom, and these patients also present with forward head-and-neck posture.


Keywords: Laundry workers, neck disability, pectoral tightness, upper crossed syndrome


How to cite this article:
Mujawar JC, Sagar JH. Prevalence of upper cross syndrome in laundry workers. Indian J Occup Environ Med 2019;23:54-6

How to cite this URL:
Mujawar JC, Sagar JH. Prevalence of upper cross syndrome in laundry workers. Indian J Occup Environ Med [serial online] 2019 [cited 2019 Sep 16];23:54-6. Available from: http://www.ijoem.com/text.asp?2019/23/1/54/256224





  Introduction Top


Upper crossed syndrome is caused by weak lower and middle trapezius, tight upper trapezius and levator scapulae, weak deep-neck flexors, tight suboccipital muscles and sternocleidomastoid, weak serratus anterior, and tight pectoralis major and minor.[1]

The syndrome mainly arises as a result of muscular imbalance that usually develops between tonic and weak muscles.[2] There are two types of muscles present in our body – the postural muscles such as pectoralis major, upper trapezius, and sternocleidomastoid and other phasic muscles such as deep-neck flexors, and lower trapezius. Predominantly static or postural muscles have a tendency to tighten. In various movements, they are activated more than the muscles that are predominantly dynamic and phasic in function, which have a tendency to develop weakness.[3] Opposite group muscle imbalances in upper crossed syndrome give rise to postural disturbance.[4]

Individuals who present with upper crossed syndrome will show a forward head posture (FHP), hunching of the thoracic spine (rounded upper back), elevated and protracted shoulders, scapular winging, and decreased mobility of the thoracic spine.[5] Sometimes, manual material handling activities can cause musculoskeletal disorders,[6] for example, the workers who do their work in inappropriate position and repeating the same action throughout their workday.[7]

The simultaneous occurrence of FHP and rounded shoulder is nothing but upper crossed syndrome.[8] Musculoskeletal injuries often affect both neck and upper limbs and can occur when performing a given professional activity that is repetitive and involves still posture as well as handling considerable load.[9] FHP is caused by maintaining an abnormal or inappropriate posture for a long time.[10] Studies prove that causes of bad posture can be the occupation related; continuous working for long hours may result in postural defects and deviation.[11]

The activity of washing clothes is done in forward flexed posture for long periods of time and known to be heavy and imposes large amount of stress on the worker's body.[12]

Ironing is also the repetitive task both at the professional and at the domestic levels. This task is generally carried out in standing posture and therefore demands greater energy consumption.[13] This work is frequently required to make short brisk movements. This usually leads to dynamic overload of the upper limb muscles and to a static overload in the shoulders and column.[14]

Aim

The aim of the study is to find the prevalence of upper crossed syndrome in laundry workers.

Objectives

  • To find the number of laundry workers having upper crossed syndrome
  • To determine the prevalence and risk factors for the development of upper crossed syndrome among laundry workers


  • o i.e., Washermen and ironing workers

  • To provide an overview of the posture during work and its influence on musculoskeletal disorder.



  Subjects and Methods Top


Methodology

  • Study type: survey
  • Study design: analytical study
  • Place of study: Karad and nearby rural area
  • Sampling methods: simple random sampling
  • Sample size: 50 participants.


Inclusion criteria

  • Participants with constantly or frequently occurring neck–shoulder pain more than 1 month


  • Participants working for at least 3 years
  • Age between 25 and 50 years
  • The participant should be male


    • The participant should be laundry worker, i.e., washermen or ironing worker.


Exclusion criteria

  • Any malignancy related to soft tissue and joints
  • Congenital shoulder deformities
  • Recent fractures to related joints
  • Recent surgery.


Procedure

  • The participants were taken on the basis of inclusion and exclusion criteria
  • The participants were made aware about the study
  • The proper consent from the participants was taken
  • Each participant was taken into isolation to respect their privacy
  • The participants were asked to follow the instruction
  • Pectoralis major contracture test was performed to check the pectoral muscles tightness
  • After that, trapezius weakness test was performed. In this test weakness of middle and lower trapezius muscle was assessed.[15]
  • At last Oswestry neck disability index questioner was given to the participants and asked to fill it
  • After examining all the participants, the statistical analysis was done.


The outcomes were recorded.


  Results Top


Upper crossed syndrome is having 28% prevalence in laundry workers in Karad and nearby rural areas.

Working in abnormal posture for prolonged duration is the main risk factor.

Neck pain presents as the main symptom.

Pectoral muscles are tight, and lower and middle trapezius muscles are weak also forward head-and-neck posture is present.


  Discussion Top


This study was focused on the prevalence of upper crossed syndrome in laundry workers. The study was conducted in Karad and nearby rural areas.

Upper crossed syndrome is caused by muscular imbalance that usually develops between tonic and weak muscles. Individuals who present with upper crossed syndrome will show a forward head-and-neck posture. Study shows that many laundry workers are having postural alterations. Sometimes, manual material handling activities can cause musculoskeletal disorders.

The laundry workers do their work in inappropriate position and repeat the same action throughout their workday; hence, they are at the risk of developing upper crossed syndrome. The task of washing clothes is done in bent static posture for long periods of time and known to be heavy and imposes large amount of stress on the worker's body.

During the survey, participants were collected from Karad and nearby rural areas. A prior written consent was taken from laundry worker.

Fifty samples were taken, out of which 14 participants had upper crossed syndrome. Data collection was done using special tests and questionnaire.

Pectoral muscles tightness is the most common, and the first sign is showed in this study with 34%.

Lower trapezius muscle weakness is common and showed in this study with 34%.

Middle trapezius muscle weakness is also common and showed with 36%.

Thus, the prevalence of upper crossed syndrome in laundry workers is 28%.


  Conclusions Top


Upper crossed syndrome is having 28% prevalence in laundry workers in Karad and nearby rural areas.

Working in abnormal posture for prolonged duration is the main risk factor.

Pectoral muscle tightness and neck pain present as the main symptoms associated with upper crossed syndrome.

Lower and middle trapezius is weak, and also forward head-and-neck posture is present.

Limitations

There may be certain limitations in the study, which may be due to as follows:

  • Small sample size
  • Short duration of the study
  • Samples were taken only from Karad and nearby rural area.


Recommendations

  • A further study can be done with larger number of samples in relevance to other areas
  • Awareness of causes, complications, preventions, and treatment of upper crossed syndrome should be created in laundry workers
  • Awareness program and survey should be conducted in laundry workers
  • Advice should be given to laundry worker to take rest periods between work and importance of exercise should be explained and also explain the preventive aspect.


Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Muscolino J. Upper crossed syndrome. J Aust Tradit Med Soc 2015;21:80-5.  Back to cited text no. 1
    
2.
Yoo WG, Yi CH, Kim MH. Effects of a ball-backrest chair on the muscles associated with upper crossed syndrome when working at a VDT. Work 2007;29:239-44.  Back to cited text no. 2
    
3.
Weon JH, Oh JS, Cynn HS, Kim YW, Kwon OY, Yi CH, et al. Influence of forward head posture on scapular upward rotators during isometric shoulder flexion. J Bodyw Mov Ther 2010;14:367-74.  Back to cited text no. 3
    
4.
Evans O, Patterson K. Predictors of neck and shoulder pain in non-secretarial computer users. Int J Ind Ergon 2000;26:357-65.  Back to cited text no. 4
    
5.
Public Education Section Department of Business and Consumer Business Oregon OSHA. Introduction to the Ergonomics of Manual Material Handling. Diunduhdari: Diakses Tanggal Maret; 2012.  Back to cited text no. 5
    
6.
Etika M, Indah P, Rafsanjan F. Analisis Manual Material Handling Menggunakan Niosh Equation. Jurnal Ilmiah Teknik Industri Vol. 5. No. 2. 2006. Diunduhdari. Diakses Tanggal: 4 Maret 2014.  Back to cited text no. 6
    
7.
Janda V. Muscles and Motor Control in Cervicogenic Disorders. New York: Churchill Livingstone; 1994.  Back to cited text no. 7
    
8.
Buckle PW, Devereux JJ. The nature of work-related neck and upper limb musculoskeletal disorders. Appl Ergon 2002;33:207-17.  Back to cited text no. 8
    
9.
Neuman DA. Kinesiology of the Musculoskeletal System. 2nd ed. Singapore: Mosby; 2009.  Back to cited text no. 9
    
10.
Kumar B. Poor posture and its causes. Int J Phys Educ Sports Health 2016;3:177-8.  Back to cited text no. 10
    
11.
Kaushik V, Charpe NA. Effect of body posture on stress experienced by worker. Stud Home Comm Sci 2008;2:1-5.  Back to cited text no. 11
    
12.
Kroemer KH, Grandjean E. Manual Ergonomics - Adapting work to Man. São Paulo: Bookman; 2008.  Back to cited text no. 12
    
13.
Hviid-Andersen J, Kaergaard A, Frost P, Frolund-Thomsen J, Bonde J, Fallentin N, et al. Physical, psychosocial, and individual risk factors for neck/shoulder pain with pressure tenderness in the muscles among workers performing monotonous, repetitive work. Occup Health Ergon 2002;27:660-7.  Back to cited text no. 13
    
14.
Janda V. Muscles and motor control in low back pain: Assessment and management. In: Physical Therapy of the Low Back. New York: Churchill Livingstone; 1987. p. 253-78.  Back to cited text no. 14
    
15.
Magee D. Orthopaedic Physical Assessment. Saunders. 6th ed. 2016. p. 338,342-343.  Back to cited text no. 15
    




 

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