1. Epidemiology of Locomotor Disorders Dr. Abdelmageed Osman Associate Prof. Community Medicine

2. Main Locomotor Disorders Rheumatoid arthritis (RA) Osteoarthritis of the knee, Low Backache (LBP or LBA) 11/30/20122Epidemiology of Locomotor Disorders

3. Introduction Rheumatoid arthritis (RA) is a systemic auto- immune disease. The arthritis usually begins in the small joints of the hands and the feet, spreading later to the larger joints 11/30/20123Epidemiology of Locomotor Disorders

4. The Problem of RA The incidence and prevalence of RA rises with increasing age until 70, then declines. Around twice as many women as men are affected. The prevalence of classical RA is <1 % but it is a serious cause of disability. The prevalence of RA is generally lower in tropical countries 11/30/20124Epidemiology of Locomotor Disorders

5. Disabilities due RA Disability rate is of 25% within the first three years for RA patients 40% over the first five years of having RA. After 10 years with RA, > 40 % of patients are no longer able to work. 11/30/20125Epidemiology of Locomotor Disorders

6. Osteoarthritis

7. Introduction to Osteoarthritis The most common is the knee osteoarthritis Knee osteoarthritis is a degenerative disease It is the most prevalent form of arthritis It is the major cause of disability in people aged 65 and older. 11/30/20127Epidemiology of Locomotor Disorders

8. 11/30/20128Epidemiology of Locomotor Disorders The main signs are pain, stiffness, decreasing range of motion and muscle weakness and atrophy

9. Risk Factors Age: > 65 Gender (more common among women) Genetic Factors (major ) Bone Density Nutritional Factors: (↓ intake of vitamins C & D) Obesity (as a local process and systemically) Joint immobilization Excessive exercise Joint injuries Occupational Factors 11/30/20129Epidemiology of Locomotor Disorders

10. Epidemiology of fractures related to osteoporosis

11. Introduction Almost all fractures are osteoporotic The risk of fracture increases as bone density decreases The most common osteoporosis fracture is the hip fracture. Hip fracture risk rises dramatically from the decade of the 70 th and thereafter 11/30/201211Epidemiology of Locomotor Disorders

12. Age > 65 Women have a higher risk of fractures than men. A history of prior fractures Patients presenting with hip fractures are several times more likely to have had 1 or more vertebral fractures 11/30/201212Epidemiology of Locomotor Disorders

13. Prevention of Hip Fractures Prevention should begin in childhood with healthy life style awareness (health education) Attitude modification Environmental modification 11/30/201213Epidemiology of Locomotor Disorders

14. Epidemiology of Low Backache Pain LBP

15. Low back pain (lumbago) is a common musculoskeletal disorder affecting 80% of people at some point in their lives it is the most common cause of job-related (occupational) disability, It is a leading contributor to missed work, and the second most common neurological ailment (only headache is more common). 11/30/2012Epidemiology of Locomotor Disorders15

16. The majority of lower back pain stems from benign musculoskeletal problems It is commonly due to muscle or soft tissues sprain or strain, particularly in instances where pain arose suddenly during physical loading of the back, with the pain lateral to the spine 11/30/2012Epidemiology of Locomotor Disorders16

17. 60 – 90% of adults experience LBP at some point in their life.  incidence age 35- 55 years 7% become chronic M/ F equally affected With surgery, no earlier return to work – symptomatic and functional outcome is better Herniation of a disc is one of the complications of LBP 11/30/2012Epidemiology of Locomotor Disorders17

18. Herniated Discs - only about 10% considered for surgery after 6 weeks 11/30/2012Epidemiology of Locomotor Disorders18

19. Prevention Ergonomics: Adjustment of Man & Machine) Awareness Exercise Cessation of smoking Weight control 11/30/2012Epidemiology of Locomotor Disorders19

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21. Thank You The seminar: – Accidents: Talal Ahmed Noor Alaa Abdelmageed – Artificial limbs: Ibrahim Husein Abdalla Mahmoud Islamia – Demonstration of artificial limbs (Artificial Limbs Department – contact Yasir Abuzaid) 11/30/2012Epidemiology of Locomotor Disorders21

22. Thank u 11/30/2012Epidemiology of Locomotor Disorders22