The aim of the present controlled study was to evaluate the effect of a general fitness program, performed by an occupational health service, using pre-post assessment for a number of different outcome measures. A total of 160 employees working in the central home care service district of Umeå, Sweden were asked to participate in a program of a 1-year long exercise program. Of the 160 selected, 54 subjects declined to participate and nine subjects were rejected after a medical check up. The remaining 97 subjects participated in a schedule consisting of pre-post medical and physiotherapy examinations, questionnaires concerning sociodemography, musculoskeletal and general health complaints and work environment, physiological tests of cardiovascular fitness, and of strength and endurance of shoulder flexors and knee extensors, and registration of sick leave. The subjects were randomly assigned to an exercise (treatment) or control group. The exercise group trained twice a week for 1 year using a mixed program including exercises for coordination, strength/endurance, and fitness. The test schedule was repeated for both groups after 1 year. The exercise intervention was associated with positive changes in prevalence and intensity of musculoskeletal and psychosomatic complaints, better physiotherapy status (less muscle tightness, better neck mobility, and less tender points), increased shoulder strength and increased coordination in thigh muscles. However, the exercise group reported worse situations post-exercise concerning aspects of their physical and psychosocial work-environment (i.e., concerning ergonomy, influence, appreciation and communication with work manager), which might have been due to stress associated with the exercise situation.
We measured the proximal-distal and anterior-posterior displacement of the femoral head in 200 femoral neck fractures. The numerical data were compared with the Garden classification. The average displacement of the Stages I and II fractures were almost equal. Moreover, the displacement of the Stage III fractures did not differ from the displacement of the Stage IV fractures. The Garden Stages I and II fractures displayed a more posterior position of the femoral head than did the normal hips. The femoral heads of Stages III and IV were situated more posterodistally than those of the Stages I and II fractures. Classification of femoral neck fractures into two groups without (Stages I and II) and with (Stages III and IV) proximal displacement is probably sufficient for clinical use.
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