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. 2022 Apr 26;113(2):e2022012. doi: 10.23749/mdl.v113i2.12498

2. Workers’ evaluation

First examination 2nd examination 3rd examination
Personal history Evaluation of acute or chronic osteoarticular symptoms, surgeries, and diagnostic exams performed traumas, physical training and physical activity outside work.
Subjective exam Pain map (where, intensity, time, increasing factors, impact on quality of life, coping strategies) Pain map evolution Pain map evolution
Physical examination Subject in erect position, sitting-down and walking.
Spine active movements in all directions with recording of pain. Cervical spine observed also in sitting position
Evaluation of sensitivity, strength, reflexes and Lasegue, Slump, Spurling, Upper Limp Tension and repeated movements tests.
Multifidous and Transverse muscular test, activational test for deep cervical spine, stabilizers test.
Evaluation of other districts, if symptomatic, or as differential evaluation (shoulder tendinous test, pyriform evaluation, sacrumiliac test).
Photographic exam of the cranium-vertebral angle (Forward Head Posture).
- Re-evaluation and progression of the exercises. Re-evaluation of the cranium-vertebral angle (Forward Head Posture).
Changes in comparison to the first session.
Principal aspects emerged from the evaluation Head anteposition attitude Rectification of rachis curvatures
Difficult activation of lumbar rachis stabilizers muscles
Difficult diaphragmatic respiration
Neck, shoulders and periscapular muscles tension
Pain reported at neck, shoulders and lumbar rachis
Frequent tension or cervicogenic headaches
Scarce corporeal awareness
Scarce physical activity level
- Video display terminal posture feedback and possible questions.
Changes in comparison to the first section.
Proposed exercises and self-treatment based on the personal needs - Exercise setting Diaphragmatic respiration exercises, stretching and various districts involved mobility exercises (lumbar rachis extension, cervical rachis extension and retroposition, neurodynamic exercises), muscular activation exercises (multifidous, transversus abdominis, cervical rachis deep flexors, rotator cuff). Correct exercises execution check and possible progression, aimed at increasing articular range, muscular activation or the complexity of proposed exercises.
Education Postural variability during working hours, by vertebral column active movements, rising up from the work station at least once an hour. Information about physical activity benefits in cardiovascular, metabolic, tumoral, musculoskeletal pathologies prevention and in pain modulation. - Questions, doubts regarding the education received and final feedback.