Thesis Presentation.pptx group14l5 ki hua

Here's a comprehensive overview of sciatica:

Definition: Sciatica is a symptom of a problem with the sciatic nerve, which runs from the lower back down to the legs. It's characterized by pain, numbness, tingling, or weakness in the lower back, hips, or legs.

Causes:

- Herniated disc
- Degenerative disc disease
- Spondylolisthesis
- Spinal stenosis
- Piriformis syndrome
- Sacroiliac joint dysfunction
- Trauma or injury

Signs and Symptoms:

- Pain in the lower back, buttocks, or legs
- Numbness or tingling in the legs or feet
- Weakness in the legs or feet
- Difficulty walking or standing
- Pain when sitting or climbing stairs
- Limited range of motion in the hips or legs

Risk Factors:

- Age (30-50 years)
- Gender (male or female)
- Occupation (e.g., heavy lifting, bending)
- Obesity
- Smoking
- Sedentary lifestyle
- Family history

Physiotherapy Treatment:

- Pain management (e.g., heat, cold, electrical modalities)
- Stretching and strengthening exercises for the lower back, glutes, and legs
- Manual therapy (e.g., massage, joint mobilization)
- Postural correction and body mechanics education
- Core stabilization and strengthening exercises
- Progressive loading and strengthening of the affected leg
- Education on proper lifting, bending, and movement techniques

Note: Physiotherapy treatment aims to address the underlying cause of sciatica, improve pain and function, and prevent future recurrences. A comprehensive physiotherapy program will be individualized based on the specific needs and goals of the patient.
Here's a comprehensive overview of sciatica:

Definition: Sciatica is a symptom of a problem with the sciatic nerve, which runs from the lower back down to the legs. It's characterized by pain, numbness, tingling, or weakness in the lower back, hips, or legs.

Causes:

- Herniated disc
- Degenerative disc disease
- Spondylolisthesis
- Spinal stenosis
- Piriformis syndrome
- Sacroiliac joint dysfunction
- Trauma or injury

Signs and Symptoms:

- Pain in the lower back, buttocks, or legs
- Numbness or tingling in the legs or feet
- Weakness in the legs or feet
- Difficulty walking or standing
- Pain when sitting or climbing stairs
- Limited range of motion in the hips or legs

Risk Factors:

- Age (30-50 years)
- Gender (male or female)
- Occupation (e.g., heavy lifting, bending)
- Obesity
- Smoking
- Sedentary lifestyle
- Family history

Physiotherapy Treatment:

- Pain management (e.g., heat, cold, electrical modalities)
- Stretching and strengthening exercises for the lower back, glutes, and legs
- Manual therapy (e.g., massage, joint mobilization)
- Postural correction and body mechanics education
- Core stabilization and strengthening exercises
- Progressive loading and strengthening of the affected leg
- Education on proper lifting, bending, and movement techniques

Note: Physiotherapy treatment aims to address the underlying cause of sciatica, improve pain and function, and prevent future recurrences. A comprehensive physiothe

1. “Prevalence of Gastrocnemius and Soleus Trigger Points in Chefs due to prolonged standing and awkward posture”

2. Team Members: Ghazanfar Ali DPT-FA19-088 Muddsar Rasool DPT-FA19-122 Nida Sardar      DPT-FA19-159 Supervise By: Dr Amina Mehak Hasnat

3. Abstract Chefs frequently experience trigger points in the soleus and gastrocnemius muscles due to extended standing and demanding workloads. Despite its prevalence, this issue has received little attention. This research aims to determine the frequency of trigger points in these muscles among chefs and explore their association with prolonged standing and awkward posture. BACKGROUND This research used Travel & Simon’s Diagnostic Criteria (1999) to identify calf muscle trigger points (TrPs) in chefs who stand for prolonged periods. Assessments included physical exams and self-reported symptoms, with posture evaluated using the REEDCO tool. Statistical analyses determined the prevalence of TrPs linked to prolonged standing and awkward posture. MATERIALS AND METHDOLOGY This research was conducted to determine prevalence of calf muscles trigger points in chefs due to prolonged standing and awkward posture. AIMS AND OBJECTIVES KEY WORDS Gastrocnemius, soleus, trigger points, prolonged standing, awkward posture,chefs.

4. Trigger points (TrPs) are tender muscle areas linked to myofascial pain syndrome, causing stiffness, tenderness, and referred pain due to overuse, poor posture, and muscle strain. Common in shoulders, neck, and calves, they lead to muscle dysfunction, weakness, and limited motion. TrPs, associated with chronic musculoskeletal problems, develop from overuse, trauma, and microtrauma, affecting muscles crucial for maintaining posture (2) (12) The gastrocnemius-soleus (G-S) complex is crucial for foot stability and mobility. Issues such as equinus contracture can disrupt foot mechanics, leading to discomfort and altered foot function. The two-joint gastrocnemius muscle, which is superficial, often has trigger points along its medial or lateral edges, causing referred pain that travels from the calf to the instep of the foot. (4) (7) Chefs and restaurant workers are prone to work-related musculoskeletal disorders (WMSDs) because of the physical demands of food preparation, including prolonged standing, walking, repetitive motions, and forceful actions. The REEDCO posture score (RPS), a simple and cost-effective tool developed in 1974, is widely used to evaluate posture in both coronal and sagittal views. (1) (10) Introduction

5. RATIONALE This study examines the frequency of trigger points (TrPs) in the soleus and gastrocnemius muscles of chefs, who often stand for long periods and maintain awkward postures. It aims to address the occupational health issues chefs face, such as prolonged standing and repetitive movements, and their limited understanding of calf muscle TrPs. By filling this knowledge gap, the research seeks to enhance chefs' musculoskeletal health, potentially influencing occupational safety regulations and promoting healthier work environments in the culinary industry

6. OBJECTIVES  To see the prevalence of trigger points in chefs. To see the association between trigger points and prolonged standing. To see the association between trigger points and awkward posture.

7. RESEARCH QUESTION  WHAT IS THE PREVALANCE OF TRIGGER POINTS IN CHEFS ? WHAT IS THE ASSOCIATION BETWEEN TRIGGER POINTS, PROLONGED STANDING AND AWKWARD POSTURE?

8. SIGNIFICANCE Examining the prevalence of gastrocnemius and soleus trigger points in chefs due to prolonged standing is crucial for occupational health awareness and culinary professionals' well-being. Despite the inherent prolonged standing in this profession, there's a significant research gap concerning calf muscle TrPs. This study addresses this gap, providing insights for targeted interventions, enhanced ergonomic practices, and preventative strategies. The outcomes could influence occupational health policies, guide tailored interventions, and contribute to a healthier work environment. Ultimately, these findings aim to improve chefs' occupational health and job satisfaction, enriching the broader discourse on professionals' well-being in the culinary industry.

9. LITRETURE REVIEW In 2016, Zuil-Escobar and team investigated latent trigger points (LTrPs) in lower limb muscles, including the gastrocnemius and soleus, in 206 asymptomatic individuals. Using Simons, Travel, and Simons' diagnostic criteria, they found that 77.7% of participants had at least one LTrP, with an average of 7.5 LTrPs per individual. Gastrocnemius LTrPs were the most prevalent, ranging from 19.9% to 37.4%. The study underscores the high prevalence of LTrPs in asymptomatic individuals and suggests the need to consider LTrPs in musculoskeletal pain evaluation. Further research is recommended to understand their impact on musculoskeletal disorders.(2) In 2021, Xue Er S and colleagues studied the prevalence of musculoskeletal diseases (MSDs) and work-related risk factors among 104 pastry cooks in Malacca, Malaysia. Using convenience sampling and the Dutch Musculoskeletal Questionnaire (DMQ), they found a high 12-month MSD prevalence of 92.3%, with ankles (76.9%), upper back, and shoulders being most affected. Significant associations were found between MSDs and work-related factors like prolonged uncomfortable postures, extended static postures, force exertion on tools, and frequent bending and twisting of the trunk and neck. The study underscores the need for ergonomic interventions to reduce MSD risks among pastry chefs. (12)

10. LITRETURE REVIEW A study conducted in 2023 by Iqbal MU and colleagues in Islamabad and Rawalpindi examined the prevalence of musculoskeletal issues among chefs. Convenient sampling was used to select 307 participants, predominantly male, with a mean age of 32.87 years. The study found that prolonged hours and physical demands of the job led to frequent complaints of lower back, knee, shoulder, upper back, ankle, and foot pain. The Nordic Musculoskeletal Questionnaire (NMQ), Fatigue Assessment Scale (FAS), and Numeric Pain Rating Scale (NPRS) were employed to gather data. Overall, the research highlights the pressing need for ergonomic interventions and health initiatives to alleviate the risk of musculoskeletal injuries among chefs in Pakistani restaurants. (17)

11. MATERIAL AND METHODS Study Design: Cross Sectional study Study Setting: Pak Vero Wall Dera , Shinwari dera by Sitara, Baba Tikkah, Forks N Knives, AAT Food Insider, Marhaba Mahal, Silver Spoon. Study Population: Chefs Sample Size: 89 male chefs calculated by raosoft Study Duration: The duration of study was 04 months after approval of synopsis. Sampling Technique: Non probability purposive sampling was used in selection of study sample after screening with inclusion and exclusion criteria

12. MATERIAL AND METHODS Inclusion Criteria: Age 20 to 45years Only male subjects At least 5hours of work per day Participants of Faisalabad Exclusion Criteria: Recent surgical intervention of lower limb ACL/PCL repair Recent Trauma/injury of knee joint Any muscular deformity Popliteal fossa injury

13. MATERIAL AND METHODS Consent FORM: Assigned information consent had obtained from participants before recruitment into study. Data Collection Tools: Trigger points will be assessed by diagnostic criteria established by Simons and Travel and Posture was assessed by REEDCO posture assessment tool. Data collection procedure: It is a cross sectional study, data was collected after gaining information from ethical committee of The University of Faisalabad.

14. MATERIAL AND METHODS Data analysis: SPSS version 22 Ethical consideration: Data collection letter has been contained from university. A consent letter has been obtained from participants that there data will be confidential and only used for research purpose.

15. The frequency distribution shows that the majority of participants fall within the 31-35 age range, representing 37.1% of the sample, followed by the 25-30 and 36-40 age ranges, each comprising 22.5%, and the smallest age group being 41-45 years at 18.0%. The working hour distribution indicates that 65.2% of participants work between 9 to 12 hours per day, while 34.8% work between 5 to 8 hours. The analysis of MTP screening results reveals that 59.6% of participants tested positive for myofascial trigger points (MTP) according to the Travell and Simon criteria, with 41.6% having trigger points in the gastrocnemius muscle and 18.0% in the soleus muscle. The REEDCO Posture Assessment Total Scores show that 30.3% exhibited good posture, 22.5% had fair posture, and 6.7% had poor posture, with 40.4% not providing a response. The chi-square tests indicate a strong association between MTP screening results and both working hours (χ² = 70.032, p < .001) and posture assessment scores (χ² = 89.000, p < .001), highlighting the impact of prolonged working hours and posture on musculoskeletal health among chefs. RESULTS

16. DISCUSSION The purpose of this research was to evaluate the prevalence of gastrocnemius and soleus trigger points in chefs due to prolonged standing and awkward posture. The study aimed to shed light on the musculoskeletal challenges faced by chefs, who often endure long hours of standing and repetitive movements, which can lead to the development of myofascial trigger points. Our findings revealed that the presence of myofascial trigger points in the gastrocnemius and soleus muscles is notably high, with 59.6% of the chefs screened testing positive for these painful points. This significant prevalence underscores the occupational health risks associated with the culinary profession. In a 2016 study, 77.7% of 206 participants had at least one latent trigger point (LTrP) in lower limb muscles, averaging 7.5 LTrPs per individual, with gastrocnemius LTrPs being the most prevalent at 19.9% to 37.4%. Comparatively, our chef study found a 59.6% prevalence of myofascial trigger points (MTPs) in gastrocnemius and soleus muscles, both identifying gastrocnemius as commonly affected. These findings highlight widespread trigger point occurrence, providing insights into musculoskeletal health across populations.(34) In a 2023 study on kitchen workers, 90.6% experienced work-related musculoskeletal disorders (WRMSDs) within the past year, with knees (46.9%) and ankles (46.1%) being the most affected sites. These findings highlight the widespread impact of MSDs, particularly in the lower limbs. The interconnectedness of lower limb musculature underscores the importance of holistic understanding of musculoskeletal health. Our chef study on myofascial trigger points (MTPs) aligns with these findings, focusing on prolonged standing and awkward posture.(35)

17. CONCLUSION This study reveals a concerning prevalence of myofascial trigger points (MTPs) among chefs, with 59.6% experiencing these muscular issues. Moreover, our findings indicate significant associations between the presence of MTPs, working hours, and REEDCO Posture Assessment Total Score. Chefs working longer hours and those with poorer posture are particularly vulnerable to developing MTPs. LIMITATIONS The limitations of our research are that we faced limitations due to challenges in obtaining permission from restaurant managers, restricting data collection in many establishments. Additionally, the use of pressure pain threshold (PPT) algometers for myofascial trigger point assessment was hindered by their high cost and limited availability in retail stores. These specialized devices are crucial for accurately measuring pain sensitivity but pose practical constraints for researchers. As a result, our study may not fully represent the diversity of chefs in the culinary industry, and our ability to conduct comprehensive assessments was restricted. RECOMMENDATIONS Select the population from the different areas and cities. Further studies can be done on larger scale and can focuss on physical therapy services to chefs to manage their triggers points and other MSK disorders. Design and implement proper ergonomics among chefs. Further studies can be done on other kitchen and restaurant staff.

18. REFERENCES Abdelsalam A, Wassif GO, Eldin WS, Abdel-Hamid MA, Damaty SI. Frequency and risk factors of musculoskeletal disorders among kitchen workers. Journal of the Egyptian Public Health Association. 2023;98(1):3. Zuil-Escobar JC, Martínez-Cepa CB, Martín-Urrialde JA, Gómez-Conesa AJP. The prevalence of latent trigger points in lower limb muscles in asymptomatic subjects. 2016;8(11):1055-64. Bron C, Dommerholt JD. Etiology of Myofascial Trigger Points. Current Pain and Headache Reports. 2012;16(5):439-44. Chen W-M, Park J, Park S-B, Shim VP-W, Lee TJJob. Role of gastrocnemius–soleus muscle in forefoot force transmission at heel rise—A 3D finite element analysis. 2012;45(10):1783-9. Qasheesh MA, Kumar MB, Ganesan BBM, Sarah KNJIJoP, Print- OT, Electronic–. The Effectiveness of Trigger Point Release in Myofascial Pain of Calf Muscle. 2021;15(4):62-7. Loram ID, Maganaris CN, Lakie M. The passive, human calf muscles in relation to standing: the non-linear decrease from short range to long range stiffness. The Journal of physiology. 2007;584(Pt 2):661-75. Vijayakumar M, Jaideep A, Khankal R, Gazbare P, Abraham BJIJHSR. Effectiveness of compressive myofascial release vs instrument assisted soft tissue mobilization in subjects with active trigger points of the calf muscle limiting ankle dorsiflexion. 2019;9(4):98-106. Karelia BJ, Rathod D, Kumar AJIJoHS, Research. Assessment of Posture Related Musculoskeletal Risk Levels in Restaurant Chefs using Rapid Entire Body Assessment (REBA). 2021;11(5):333-9. Tan D, Balaraman TJWwic. Working posture and musculoskeletal pain among restaurant chef. 2020;14(02):2254. Nazar Z, Shakeel S, Naseer A, Razzaq RJPJoHS. Prevalence of Musculoskeletal Pain among Chefs Working in Restaurants of Sialkot: Prevalence of Musculoskeletal Pain. 2023:134-9. Di Giulio I, Maganaris CN, Baltzopoulos V, Loram IDJTJop. The proprioceptive and agonist roles of gastrocnemius, soleus and tibialis anterior muscles in maintaining human upright posture. 2009;587(10):2399-416. Money SJJop, pharmacotherapy pc. Pathophysiology of trigger points in myofascial pain syndrome. 2017;31(2):158-9. Shakya NR, Shrestha SJJoKMC. Prevalence of work related musculoskeletal disorders among canteen staff of Kathmandu University. 2018;17(4):162-7. Rozenfeld E, Strinkovsky A, Finestone AS, Kalichman L. Reliability of Trigger Point Evaluation in the Lower Leg Muscles. Pain Medicine. 2021;22(10):2283-9. Zuil-Escobar JC, Martínez-Cepa CB, Martín-Urrialde JA, Gómez-Conesa AJAoPM, Rehabilitation. Prevalence of myofascial trigger points and diagnostic criteria of different muscles in function of the medial longitudinal arch. 2015;96(6):1123-30. Jo H, Lim OB, Ahn YS, Chang SJ, Koh SB. Negative Impacts of Prolonged Standing at Work on Musculoskeletal Symptoms and Physical Fatigue: The Fifth Korean Working Conditions Survey. Yonsei medical journal. 2021;62(6):510-9. Iqbal MU, Ahmad N, Khan ZSU, Awan M, Zafar I, Safdar G, et al. Prevalence of musculoskeletal disorders among chefs working in restaurants of twins cities of Pakistan. Work (Reading, Mass). 2023;74(4):1507-13.

19. REFERENCES 18. Martínez-Jiménez EM, Jiménez-Fernández R, Corral-Liria I, Rodríguez-Sanz D, Calvo-Lobo C, López-López D, et al. Effects of Myofascial Induction Therapy on Ankle Range of Motion and Pressure Pain Threshold in Trigger Points of the Gastrocnemius-A Clinical Trial. Biomedicines. 2023;11(9). 19. ÖZtÜRk Ö, FeyzİOĞLu Ö, GÜVen F, ÇEvİK Saldiran T. Myotonometric Evaluation of Latent Myofascial Trigger Points and Taut Band in Elite Athletes. Journal of Basic and Clinical Health Sciences. 2022;6(2):408-14. 20. Konieczny M, Skorupska E, Domaszewski P, Pakosz P, Skulska M, Herrero P. Relationship between latent trigger points, lower limb asymmetry and muscle fatigue in elite short-track athletes. BMC Sports Science, Medicine and Rehabilitation. 2023;15(1):109. 21. Xue Er S, Muniandy Y, Krishnan Vasanthi R. Prevalence Of Musculoskeletal Disorders And Associated Work-Related Risk Factors Among Pastry Chefs In Malacca, Malaysia. 2021;3:20-30. 22. Rozenfeld E, Strinkovsky A, Finestone AS, Kalichman L. Reliability of Trigger Point Evaluation in the Lower Leg Muscles. Pain medicine (Malden, Mass). 2021;22(10):2283-9. 23. Kamat S, Mohamed S, Ali A. ANALYSIS AWKWARD POSTURE AT FOOD PRODUCTION ACTIVITY USING RULA ASSESSMENT. Journal of Applied and Fundamental Sciences. 2018;10:619-32. 24. Shah Z, Amjad A, Ashraf M, Mushtaq F, Sheikh IA. Prevalence of musculoskeletal problems and awkward posture in a Pakistani garments manufacturing industry. 2016;1:75-9. 25. Choudhary YQ, Idress MQJJRCoRS. Frequency of Musculoskeletal Pain Among Chefs Working in Restaurants of Lahore: JRCRS. 2020; 8 (2): 69-73. 2020;8(2):69-73. 26. Lenhart RL, Francis CA, Lenz AL, Thelen DGJJob. Empirical evaluation of gastrocnemius and soleus function during walking. 2014;47(12):2969-74. 27. Huynh T. Health risks of being a chef and its effects on chefs and the restaurant business. 2015. 28. Gerber LH, Sikdar S, Armstrong K, Diao G, Heimur J, Kopecky J, et al. A systematic comparison between subjects with no pain and pain associated with active myofascial trigger points. 2013;5(11):931-8. 29. Gerwin RD, Shannon S, Hong C-Z, Hubbard D, Gevirtz RJP. Interrater reliability in myofascial trigger point examination. 1997;69(1-2):65-73. 30. Vain A, Kums T, Ereline J, Pääsuke M, Gapeyeva HJPotEAoS. Gastrocnemius muscle tone, elasticity, and stiffness in association with postural control characteristics in young men. 2015;64(4):525-34. 31. Subramaniam S, Murugesan SJIJoOS, Ergonomics. Investigation of work-related musculoskeletal disorders among male kitchen workers in South India. 2015;21(4):524-31. 32. Beheshti MH, Tajpuor A, Jari A, Samadi S, Borhani Jebeli M, Rahmanzadeh HJAoOH. Evaluation of ergonomic risk factors for musculoskeletal disorders among kitchen workers. 2018;2(2):128-35. 33. KAMAT SR, NORDIN EA, HUSAIN K, ALI SASJHF, Journal E. Investigation of musculoskeletal disorders among workers in food services (CAFETERIA). 2017;2(3):27-33. 34. Zuil-Escobar JC, Martínez-Cepa CB, Martín-Urrialde JA, Gómez-Conesa A. The Prevalence of Latent Trigger Points in Lower Limb Muscles in Asymptomatic Subjects. PM & R : the journal of injury, function, and rehabilitation. 2016;8(11):1055-64. 35. Abdelsalam A, Wassif GO, Eldin WS, Abdel-Hamid MA, Damaty SI. Frequency and risk factors of musculoskeletal disorders among kitchen workers. The Journal of the Egyptian Public Health Association. 2023;98(1):3.

20. ANNEXURES I

21. ANNEXURES II

22. ANNEXURES III

23. DATA COLLECTION FORM

24. DATA COLLECTION CERTIFICATE

25. DATA COMPLETION CERTIFICATE

26. Thank you