Effect of a posture correction-based intervention on musculoskeletal symptoms and fatigue among control room operators

Evaluating the categorisation of interventions in individual working practice aimed at preventing work-related musculoskeletal disorders: An international experts consultation

In a previous scoping review, eight categories of interventions in individual work practice were defined. The aim of the present study is to evaluate the relevance and completeness of these eight categories and to increase the clarity of the nomenclature and definitions of each category. An international expert consultation has been carried out for this purpose. Thirty-eight experts from 13 countries participated. Data collection was conducted using a survey design comprising structured questions. Consensus was reached if 75% of the experts answered 'Strongly agree' or 'Agree' on a 5-point Likert scale. For the topic 'Relevance', there was consensus for six of the eight categories (range 78%-86%), the exceptions were the categories: 'Exercising' (72%) and 'Professional manners' (64%). With regard to the topic 'Nomenclature', consensus was reached for six categories and for the topic 'Definition' this was five categories. The present definitions have been improved based on the expert recommendations. With respect to the topic 'Completeness': although a limited number of suggestions were given, this did not lead to one or more categories being added to the existing eight categories. The final 'Nomenclature' for the categories is: 'Variation', 'Professional behaviour', 'Motoric skills', 'Vocational working techniques', 'Physical workplace', 'Physical training', 'Assistive devices and tools' and 'Task content and task organisation'. This expert consultation has provided a solid basis for endorsing the categorisation of interventions in IWP and is an important step in building a framework to develop and evaluate interventions in IWP.

Inertial Motion Capture-Driven Digital Human for Ergonomic Validation: A Case Study of Core Drilling

In the evolving realm of ergonomics, there is a growing demand for enhanced comfortability, visibility, and accessibility in the operation of engineering machinery. This study introduces an innovative approach to assess the ergonomics of a driller's cabin by utilizing a digital human. Through the utilization of inertial motion capture sensors, the method enables the operation of a virtual driller animated by real human movements, thereby producing more precise and realistic human-machine interaction data. Additionally, this study develops a simplified model for the human upper limbs, facilitating the calculation of joint forces and torques. An ergonomic analysis platform, encompassing a virtual driller's cabin and a digital human model, is constructed using Unity 3D. This platform enables the quantitative evaluation of comfortability, visibility, and accessibility. Its versatility extends beyond the current scope, offering substantial support for product development and enhancement.

Evaluation of the effect of corrective exercise intervention on musculoskeletal disorders, fatigue and working memory of office workers

Objectives: The present study aimed to investigate the effect of corrective exercise intervention (corrective exercise reminding and training software) on musculoskeletal disorders (MSDs), fatigue, posture and working memory among office workers. Methods: A total of 66 office workers participated in the present study. Data collection was carried out using questionnaires (including the Nordic musculoskeletal questionnaire, multidimensional fatigue inventory and Borg rating scale), direct observations of work postures using rapid upper limb assessment (RULA) and rapid office strain assessment, and the n-back test. Results: There was a significant difference between the two groups (intervention and control) in terms of the severity of musculoskeletal discomfort after the intervention. There was a significant decrease in the mean score of trunk posture and the total RULA score in the intervention group after the intervention. The severity of perceived discomfort in all areas except the knee declined during the intervention. There was also a significant difference in physical and mental fatigue scores before and after the intervention. There was a significant difference in the accuracy score of office workers after the intervention compared to before the intervention. Conclusions: Overall, the results confirm the effectiveness of this low-cost, simple and easy-to-use ergonomic intervention.

The immediate efficacy of the spinomed orthosis and biofeedback posture orthosis on balance and gait in older people with thoracic hyperkyphosis

BACKGROUND

Increased kyphosis is a common condition among older people that may, directly or indirectly, be a risk factor for poor balance and gait. Spinomed and Biofeedback Posture Trainer (BPT) orthoses is an effective treatment approach for hyperkyphosis. This study aimed to compare the immediate effects of the Spinomed and BPT orthoses on balance and gait in the older population.

METHODS

A total of 52 volunteer older people with hyperkyphosis (kyphosis angle>40°) participated in this study and were randomly allocated into two groups, to either the Spinomed orthosis (n = 26, mean age = 65.50 ± 5.50) or the BPT (n = 26, mean age = 65.38 ± 5.69) orthosis. All participants were asked to wear the orthoses for 1.5 h to get used to them. Balance parameters, which are Postural Stability Test (PST), Limits of Stability (LOS), and Clinical Test of Sensory Integration for Balance (m-CTSIB) were assessed using the Biodex Balance System, while walking parameters were assessed using the G-Walk with and without orthosis.

RESULTS

The Spinomed had a positive effect on balance parameters (p < 0.05) except for the closed eyes firm surface and the opened eyes foam surface conditions of the m-CTSIB (p > 0.05). BPT had a significant impact on the PST score, LOS, and the closed eyes firm surface condition of the m-CTSIB (p < 0.001). Spinomed had a significant effect on cadence, speed, gait cycle duration, elaborated steps, and symmetry index of pelvic angles (p < 0.05), while the BPT had a significant effect only on step length and rotation symmetry index. No significant difference was detected between the two types of orthoses in the balance and gait parameters (p > 0.05).

CONCLUSIONS

Spinomed and BPT were both effective in improving balance performance, with similar improvements demonstrated by both orthoses. Additionally, Spinomed may provide significant improvements in cadence, speed, gait cycle duration, elaborated steps, and all symmetry indexes of pelvic angles in the short term.

A Rapid Review on the Effectiveness and Use of Wearable Biofeedback Motion Capture Systems in Ergonomics to Mitigate Adverse Postures and Movements of the Upper Body

Work-related diseases and disorders remain a significant global health concern, necessitating multifaceted measures for mitigation. One potential measure is work technique training utilizing augmented feedback through wearable motion capture systems. However, there exists a research gap regarding its current effectiveness in both real work environments and controlled settings, as well as its ability to reduce postural exposure and retention effects over short, medium, and long durations. A rapid review was conducted, utilizing two databases and three previous literature reviews to identify relevant studies published within the last twenty years, including recent literature up to the end of 2023. Sixteen studies met the inclusion criteria, of which 14 were of high or moderate quality. These studies were summarized descriptively, and the strength of evidence was assessed. Among the included studies, six were rated as high quality, while eight were considered moderate quality. Notably, the reporting of participation rates, blinding of assessors, and a-priori power calculations were infrequently performed. Four studies were conducted in real work environments, while ten were conducted in controlled settings. Vibration feedback was the most common feedback type utilized (n = 9), followed by auditory (n = 7) and visual feedback (n = 1). All studies employed corrective feedback initiated by the system. In controlled environments, evidence regarding the effectiveness of augmented feedback from wearable motion capture systems to reduce postural exposure ranged from strong evidence to no evidence, depending on the time elapsed after feedback administration. Conversely, for studies conducted in real work environments, the evidence ranged from very limited evidence to no evidence. Future reach needs are identified and discussed.

Designing an adjustable ergonomic laptop desk and its evaluating by RULA and NERPA methods

BACKGROUND

Using a computer may lead to pain in wrists, neck, and back. In addition, adopting various body postures like sitting cross-legged, semi-fowler's position, and putting the laptop on the leg may lead to the development of persistent and irreversible discomfort.

OBJECTIVE

The purpose of this research is to design and build an adjustable ergonomic laptop desk based on the anthropometric characteristics of students in the age range of 20 to 30 years and to evaluate its efficiency using RULA and NERPA methods.

METHODS

This cross-sectional study conducted on 108 students, in which an adjustable and portable ergonomic desk designed and built based on 10 anthropometric dimensions of students and the length and width of 10 different laptop models. Two assessment methods, RULA and NERPA, were used. Wilcoxon statistic test and SPSS version 26 software used for data analysis.

RESULTS

The dimensions of the desk were calculated in three positions, and the desk was made with the ability to adjust height, width and tilt, each with two degrees of freedom. The statistical analysis comparing score of RULA and NERPA in two situations without using a desk and using an ergonomic laptop desk had a significant difference (P-value <  0.001). Comparison of RULA and NERPA scores showed that NERPA evaluated the low ergonomic risk level better than RULA method.

CONCLUSIONS

Due to the ability to adjust the designed desk, the changes in RULA and NERPA score in all three modes, it indicates the effectiveness of the table in improving the body posture of users when using a laptop.

A video processing and machine learning based method for evaluating safety-critical operator engagement in a motorway control room

In safety-critical automatic systems, safety can be compromised if operators lack engagement. Effective detection of undesirable engagement states can inform the design of interventions for enhancing engagement. However, the existing engagement measurement methods suffer from several limitations which damage their effectiveness in the work environment. A novel engagement evaluation methodology, which adopts Artificial Intelligence (AI) technologies, has been proposed. It was developed using motorway control room operators as subjects. Openpose and Open Source Computer Vision Library (OpenCV) were used to estimate the body postures of operators, then a Support Vector Machine (SVM) was utilised to build the engagement evaluation model based on discrete states of operator engagement. The average accuracy of the evaluation results reached 0.89 and the weighted average precision, recall, and F1-score were all above 0.84. This study emphasises the importance of specific data labelling when measuring typical engagement states, forming the basis for potential control room improvements.Practitioner summary: This study demonstrates an automatic, real-time, objective, and relatively unobtrusive method for measuring dynamic operator engagement states. Computer vision technologies were used to estimate body posture, then machine learning (ML) was utilised to build the engagement evaluation model. The overall evaluation shows the effectiveness of this framework.Abbreviations: AI: Artificial Intelligence; OpenCV: Open Source Computer Vision Library; SVM: Support Vector Machine; UWES: Utrecht Work Engagement Scale; ISA Engagement Scale: Intellectual, Social, Affective Engagement Scale; DSSQ: Dundee Stress State Questionnaire; SSSQ: Short Stress State Questionnaire; EEG: electroencephalography; ECG: Electrocardiography; VMOE: Video-based Measurement for Operator Engagement; CMU: Carnegie Mellon University; CNN: Convolutional Neural Network; 2D: two dimensional; ML: Machine learning.

Effect of different postures and loads on joint motion and muscle activity in older adults during overhead retrieval

Introduction: Pain is a common health problem among older adults worldwide. Older adults tend to suffer from arm, lumbar, and back pain when using hanging cabinets. Methods: This study used surface electromyography to record muscle activity and a motion capture system to record joint motion to research effects of different loads and retrieval postures on muscle activity and joint range of motion when older adults retrieve objects from a high place, to provide optimised feedback for the design of hanging cabinet furniture. Results: We found that: 1) The activity of BB (Biceps brachii) on the side of the body interacting with the cabinet door was greater than that of UT (Upper trapezius) and BR (Brachial radius) when retrieving objects from a high place, the activity of UT on the side of the body interacting with a heavy object was greater than that of BB and BR. 2) The activity of UT decreases when the shoulder joint angle is greater than 90°, but the activity of BB increases as the angle increases. In contrast, increasing the object's mass causes the maximum load on the shoulder joint. 3) Among the different postures for overhead retrieval, alternating between the right and left hand is preferable for the overhead retrieval task. 4) Age had the most significant effect on overhead retrieval, followed by height (of person), and load changes were significantly different only at the experiment's left elbow joint and the L.BR. 5) Older adults took longer and exerted more effort to complete the task than younger adults, and static exercise in older adults may be more demanding on muscle activity in old age than powered exercise. Conclusion: These results help to optimise the design of hanging cabinet furniture. Regarding the height of hanging cabinets, 180 cm or less is required for regular retrieval movements if the human height is less than 150 cm. Concerning the depth of the hanging cabinets, different heights chose different comfort distances, which translated into the depth of the hanging cabinets; the greater the height, the greater the depth of the hanging cabinets to use.

An ergonomic focus evaluation of work-related musculoskeletal disorders amongst operators in the UAE network control centres

Work-related musculoskeletal disorders (WMSDs) have rapidly increased during the last decade, but only a few descriptive surveys have been conducted in the United Arab Emirates (UAE). This study investigated the prevalence of WMSDs and analysed their ergonomic risks amongst operators in the network control rooms across two government organisations, X and Y, in the UAE. Essential data were collected by the Nordic Musculoskeletal Questionnaire (NMQ) and the Maastricht Upper Extremity Questionnaire (MUEQ) from online surveys and direct observations based on the Rapid Office Strain Assessment (ROSA) and the Rapid Upper Limb Assessment (RULA) form and ergonomic measurements for the working environments, respectively. Fifty-three and eighteen operators participated from Organisations X and Y. This study found a high presence of WMSDs in both organisations over the past 12 months. In Organisation X, individual, work-related physical and psychosocial risk factors of high BMI, educational level, morning work shift, high job duration, lack of exercise habit, awkward body posture, high job demand, low job control, and low work social support were associated with WMSDs in different body areas (p < 0.05). In Organisation Y, older age, high BMI, high job duration, lack of exercise habits, unergonomic workstations, awkward body posture, low break time, high job demand, and stress level were associated with WMSDs in different body areas (p < 0.05). The control room operators' most affected body areas were the back, eyes, and neck. Several efficient ergonomic intervention ideas were explored to lessen the detrimental effects of WMSDs and preclude the development of WMSDs amongst the control centre operators.

Biomechanical Assessments of the Upper Limb for Determining Fatigue, Strain and Effort from the Laboratory to the Industrial Working Place: A Systematic Review

Recent human-centered developments in the industrial field (Industry 5.0) lead companies and stakeholders to ensure the wellbeing of their workers with assessments of upper limb performance in the workplace, with the aim of reducing work-related diseases and improving awareness of the physical status of workers, by assessing motor performance, fatigue, strain and effort. Such approaches are usually developed in laboratories and only at times they are translated to on-field applications; few studies summarized common practices for the assessments. Therefore, our aim is to review the current state-of-the-art approaches used for the assessment of fatigue, strain and effort in working scenarios and to analyze in detail the differences between studies that take place in the laboratory and in the workplace, in order to give insights on future trends and directions. A systematic review of the studies aimed at evaluating the motor performance, fatigue, strain and effort of the upper limb targeting working scenarios is presented. A total of 1375 articles were found in scientific databases and 288 were analyzed. About half of the scientific articles are focused on laboratory pilot studies investigating effort and fatigue in laboratories, while the other half are set in working places. Our results showed that assessing upper limb biomechanics is quite common in the field, but it is mostly performed with instrumental assessments in laboratory studies, while questionnaires and scales are preferred in working places. Future directions may be oriented towards multi-domain approaches able to exploit the potential of combined analyses, exploitation of instrumental approaches in workplace, targeting a wider range of people and implementing more structured trials to translate pilot studies to real practice.

A multicomponent quasi-experimental ergonomic interventional study: long-term parallel four-groups interventions

BACKGROUND

Musculoskeletal disorders (MSDs) are known as one of the main problems affecting the health of industrial workers and can lead to lost working days, functional disability of workers and wasting the financial resources of an organization. Therefore, the present study aimed to evaluating the effect of ergonomic interventions on reducing MSDs and improving working posture in the in a foundry industry workers.

METHODS

A field multicomponent cross-interventional study was conducted on workers working in a foundry industry. In this study, 117 male workers were divided into 4 groups, including a control group, a group with specialized ergonomics training, a group with workstation intervention, and a group simultaneously undergoing training and workstation intervention. All 4 groups were evaluated during a period of baseline, 6 and 12-months follow- up. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) and direct observations of working postures by using the Quick Exposure Check (QEC) method were used.

RESULTS

The results showed that the implemented interventions in the shoulder/arm, back and stress level were effective and the difference in the final score was significant among different groups (P-value > 0.05). In addition, the interventions led to a significant decrease in the QEC scores and musculoskeletal symptom scores in the neck, shoulder, lower back, knee, and lower leg regions among different groups (P-value > 0.05).

CONCLUSION

The results showed that workstation modification and training and workstation intervention simultaneously had a greater effect on MSDs and improving working posture compared to training alone.

A first step towards a framework for interventions for individual working practice to prevent work-related musculoskeletal disorders: a scoping review

BACKGROUND

Work-related musculoskeletal disorders (WMSDs) are a key topic in occupational health. In the primary prevention of these disorders, interventions to minimize exposure to work-related physical risk factors are widely advocated. Besides interventions aimed at the work organisation and the workplace, interventions are also aimed at the behaviour of workers, the so-called individual working practice (IWP). At the moment, no conceptual framework for interventions for IWP exists. This study is a first step towards such a framework.

METHODS

A scoping review was carried out starting with a systematic search in Ovid Medline, Ovid Embase, Ovid APA PsycInfo, and Web of Science. Intervention studies aimed at reducing exposure to physical ergonomic risk factors involving the worker were included. The content of these interventions for IWP was extracted and coded in order to arrive at distinguishing and overarching categories of these interventions for IWP.

RESULTS

More than 12.000 papers were found and 110 intervention studies were included, describing 810 topics for IWP. Eventually eight overarching categories of interventions for IWP were distinguished: (1) Workplace adjustment, (2) Variation, (3) Exercising, (4) Use of aids, (5) Professional skills, (6) Professional manners, (7) Task content & task organisation and (8) Motoric skills.

CONCLUSION

Eight categories of interventions for IWP are described in the literature. These categories are a starting point for developing and evaluating effective interventions performed by workers to prevent WMSDs. In order to reach consensus on these categories, an international expert consultation is a necessary next step.

Effectiveness and usability of real-time vibrotactile feedback training to reduce postural exposure in real manual sorting work

Vibrotactile feedback training may be used as a complementary strategy to reduce time in demanding postures in manual handling. This study evaluated the short- and medium-term effects of concurrent posture-correction vibrotactile feedback training on trunk inclination exposure in real manual sorting work. Fifteen warehouse workers completed the training and the follow-up sessions. Trunk inclination angles were recorded using the ambulatory Smart Workwear System. Questionnaires were used for assessing system usability, perceived physical exertion, and work ability. The results showed reduced time in trunk inclination >30°, >45°, and >60°, and reductions in the 90th, 95th, and 99th percentile trunk inclination angles, when receiving feedback and immediately after feedback withdrawal. No significant reduction was retained after one and three weeks. The wearer's comfort was scored high, and the feedback did not increase the perceived cognitive demands. No significant effects attributed to changed trunk inclination exposure were observed for perceived physical exertion or work ability. The training program has the potential of contributing to reduced trunk inclination exposure in the short term. Future studies are needed to evaluate if improvements in the feedback training can transfer the short-term results to retained median- and long-term effects.Practitioner summary: A two-day training program with concurrent posture-correction vibrotactile feedback can contribute to reduced exposure of trunk inclination in real manual sorting work in the short term. More research is needed on how to design the feedback training programs in order to be effective in the long term.

Investigation of the multi-component ergonomics intervention effects on improving musculoskeletal outcomes and speech communication: A case study in open-plan offices

BACKGROUND

Office workers are at high risk of developing musculoskeletal symptoms (MSS) due to improper workstations. Open-plan bank office employees must communicate with bank clerks properly and perform financial activity precisely, but noise is a factor that disrupts their communication. Therefore, MSS and annoying noise are two of the main problems in open-plan offices.

OBJECTIVE

This study evaluated the effects of a multi-component intervention involving individual (employee ergonomics training) and physical (improvements in workstation design and work environment) ergonomic factors on musculoskeletal outcomes and speech communication in open-plan environments.

METHODS

A preliminary survey was carried out to investigate the overall ergonomics problems, the tasks and time analysis, workstations setup, the prevalence of MSS (Nordic Musculoskeletal Questionnaire), physical discomfort (Visual Analogue Scale [VAS]), and posture (assessed by Rapid Upper Limb Assessment [RULA] method), environmental status (measurement of noise), and speech intelligibility (assessed by Speech Interference Level [SIL] method based on ISO 9921). The multi-component interventions were performed afterward based on the data collected. A baseline assessment and a 9-month follow-up assessment were conducted.

RESULTS

The results showed a significant decrease in the prevalence of musculoskeletal complaints (shoulders, elbows, and low back), physical discomfort, and awkward working postures after the intervention. A considerable improvement was also found in speech intelligibility post-intervention. The post-intervention questionnaire survey also indicated that employees generally favored the redesigned workstations.

CONCLUSION

The results support the effectiveness of implementing multi-component interventions in open-plan bank offices to improve musculoskeletal complaints and speech communication.

Feedback for the prevention and rehabilitation of work-related musculoskeletal disorders: A systematic review

BACKGROUND

Work-related musculoskeletal disorders (WRMSDs) remain a challenge despite research aimed at improving their prevention and treatment. Extrinsic feedback has been suggested for the prevention and rehabilitation of WRMSDs to improve sensorimotor control, and ultimately to reduce pain and disability. However, there are few systematic reviews on the effectiveness of extrinsic feedback for WRMSDs.

OBJECTIVE

To perform a systematic review investigating the effect of extrinsic feedback for the prevention and rehabilitation of WRMSDs.

METHODS

Five databases (CINAHL, Embase, Ergonomics Abstract, PsycInfo, PubMed) were searched. Studies of various designs assessing the effects of extrinsic feedback during work tasks on three outcomes (function, symptoms, sensorimotor control) in the context of prevention and rehabilitation of WRMSDs were included.

RESULTS

Forty-nine studies were included, for a total sample of 3387 participants (including 925 injured) who performed work-related tasks in the workplace (27 studies) or in controlled environments (22 studies). The use of extrinsic feedback was shown to be effective in controlled environments for short-term prevention of functional limitations and sensorimotor alterations (very limited to moderate evidence) and for improving, in injured participants, function, symptoms and sensorimotor control (moderate evidence). In the workplace, it was shown to be effective for short-term prevention of functional limitations (limited evidence). There was conflicting evidence regarding its effect for WRMSD rehabilitation in the workplace.

CONCLUSION

Extrinsic feedback is an interesting complementary tool for the prevention and rehabilitation of WRMSDs in controlled environments. More evidence is needed regarding its effect for the prevention and rehabilitation of WRMSDs in the workplace.

Home office versus ergonomic workstation - is the ergonomic risk increased when working at the dining table? An inertial motion capture based pilot study

Background

In order to reduce the risk of infection with Sars-Cov-2, work practices have been shifted to the home office in many industries. The first surveys concerning this shift indicate an increase in musculoskeletal complaints of many employees. The aim of this study was to compare the ergonomic risk in the upper extremities and trunk of working in a home office with that of working in an ergonomically optimized workplace.

Methods

For this purpose, 20 subjects (13w/7m) aged 18–31 years each performed a 20-minute workplace simulation (10 min writing a text, 10 min editing a questionnaire) in the following set up: on a dining table with dining chair and laptop (home office) and on an ergonomically adjusted workstation (ergonomically optimized workplace). The subjects were investigated using a combined application of a motion capture kinematic analysis and the rapid upper limb assessment (RULA) in order to identify differences in the ergonomic risk.

Results

Significantly reduced risk values for both shoulders (left: p < 0.001; right: p = 0.02) were found for the ergonomically optimized workstations. In contrast, the left wrist (p = 0.025) showed a significantly reduced ergonomic risk value for the home office workstation.

Conclusion

This study is the first study to compare the ergonomic risk between an ergonomically optimized workplace and a home office workstation. The results indicate minor differences in the upper extremities in favor of the ergonomically optimized workstation. Since work-related musculoskeletal complaints of the upper extremities are common among office workers, the use of an ergonomically optimized workstation for home use is recommended based on the results.

Improvements in musculoskeletal symptoms, mental workload and mental fatigue: Effects of a multicomponent ergonomic intervention among call center workers

BACKGROUND: Call center workers are highly susceptible to work-related musculoskeletal disorders (WRMSDs) as well as mental stress. Nonetheless, there has been a surprising paucity in the body of the research regarding interventions among call center workers. OBJECTIVE: The purpose of this paper is to investigate the effectiveness of a multicomponent ergonomic intervention program on mental workload, mental fatigue and WRMSDs of call center employees. METHOD: A non-randomized interventional study with a single group pretest-posttest design was conducted among 84 call center workers of a private telecommunication company in the city of Tehran, Iran. At the baseline, data regarding WRMSDs prevalence, mental workload and mental fatigue were collected by means of standard Nordic, NASA-TLX and SOFI questionnaires, respectively. Then, subjects participated in a multifaceted intervention program including comprehensive office ergonomic training, work layout improvement, supervised on-site face to face visits, and provision of quality break time encompassing regular exercise program. Follow-up assessment was carried out after 6 months. RESULTS: After the intervention, prevalence of WMSDs in the neck (10%, P = 0.022), lower back (8.4%, P = 0.04), and knees (9.5%, P = 0.02) decreased significantly, while improvements in other body areas remained insignificant. Results also showed a significant decrease in overall score of mental demand (P = 0.000) as well as three of its subscales including performance (P = 0.02), effort (P = 0.001), and frustration (P = 0.025). Additionally, positive effect of the intervention was also observable on overall mental fatigue of call center workers (P = 0.016). As for its subscales, Lack of energy was reported to decrease meaningfully (P = 0.007) while lack of motivation did not change significantly (P = 0.240). CONCLUSION: Although the primary focus of many ergonomic interventions has remained to measure physical outcomes of the work place, our findings show that multicomponent interventions are indeed capable of boosting cognitive aspects of the work as well. The future studies should consider investigating such outcomes.

Detecting Low Back Physiotherapy Exercises and Postures with Inertial Sensors and Machine Learning (Preprint)

Background

Objective

Methods

Results

Conclusions

The impact of ergonomic-educational interventions on reduction of musculoskeletal symptoms among employees of oil and gas installations in Iran

BACKGROUND: Musculoskeletal disorders can cause increased absenteeism, costs, and injuries. OBJECTIVE: The present study was aimed to investigate the impact of ergonomic-educational interventions on the reduction of musculoskeletal symptoms among employees of oil and gas installations. METHODS: This interventional study was conducted on 1243 male workers of oil and gas installations in the south of Iran. The Nordic questionnaire and quick exposure check (QEC) method were used to evaluate the risk of developing musculoskeletal disorders in the participants. Then, the educational interventions via training sessions, designed educational booklets and leaflets, and prepared educational film were performed. Data were collected at the times of two months before and six months after the interventions. RESULTS: The prevalence of musculoskeletal symptoms, at least in one of the body areas, was equal to 71.28%. The results showed that the prevalence of these symptoms significantly decreased in all body areas after the educational interventions (P <0.028). The highest reduction rate occurred in the regions of wrists and hands (52.77%), knees (47.17%), and waist (47.13%), respectively. Moreover, the results indicated that the mean value of the total score of quick exposure check (QEC) had a meaningful decrease from 0.92 to 0.54 after the educational interventions (P <0.0001). CONCLUSION: The planned educational interventions efficiently reduced the prevalence of musculoskeletal symptoms and the ergonomic risk levels estimated by QEC in the research population.

The use of electromyography and kinematic measurements of the lumbar spine during ergonomic intervention among workers of the production line of a foundry

Purpose

Workers who perform repetitive movements are exposed to many risk factors leading to the occurrence of lumbar back pain. The aim of the research was to answer the question whether the ergonomic instruction conducted by a physiotherapist would change the tested range of motion of the segments of lumbar spine and the symmetry of the work of the torso and upper limbs muscles during work performed by foundry employees.

Methods

The study included 12 foundry production line workers with musculoskeletal pain. The workstation was built in the laboratory that perfectly simulates work on the production line. The workers performed two activities from their daily work, i.e. transferring and moving a casting. They were then given ergonomic instruction by a physiotherapist and performed the assigned tasks again. During the activities, the electromyographic signal from five muscles was recorded in terms of symmetry of their work. The maximum angular ranges of the motor segments of the lumbar spine were measured using gyroscopes.

Results

After the ergonomic instruction, the contralateral imbalance of muscle activity decreased statistically significantly during the first phase (p = 0.0004), second phase (p = 0.0002) and the third phase (p = 0.0069) of transferring the casting. While moving the casting , only erector spinae showed statistically significantly (p = 0.0131) more symmetrical work after the ergonomic instruction. During the transfer of the casting, statistically significantly lower values of the ranges of motion between the segments were obtained after carrying out the ergonomic instruction for the left (p = 0.0231) and right (p = 0.0032) lateral flexion. The ranges of movement between the segments differed statistically significantly for the flexion (p = 0.0117), extension (p = 0.0469) and left (p = 0.0031) and right lateral flexion movements (p = 0.0012).

Conclusion

Conducting ergonomic instruction consisting in teaching the correct performance of a movement task reduced the contralateral imbalance of muscle activity and changes the ranges of movement of L1-S1 segments. The task of optimizing the load on the musculoskeletal system, including the lumbar spine, should be carried out by means of appropriate ergonomic instruction and multi-pronged measures, including analysis of the health of employees, their working environment and physical activity outside the workplace. Electromyography and measurements of the range of movement of the lumbar spine appear to be good tools for the evaluation of workplace ergonomics.

Effectiveness of posture-correction interventions for mechanical neck pain and posture among people with forward head posture: protocol for a systematic review

INTRODUCTION

Forward head posture (FHP) is the most common postural deviation of the upper back. It is believed to be one of the predisposing factors for the development of mechanical neck pain (MNP). We propose doing a systematic review to find the effectiveness of interventions targeted on FHP with MNP and assess implementation fidelity associated with these interventions.

METHODS AND ANALYSIS

Medline (PubMed), Web of Science (Social Science Citation Index), EMBASE, Scopus, PEDro and CINAHL databases will be searched for studies published in English from their inception. Forward and backward citations of the included studies will be investigated for identifying additional records. We will include randomised controlled trials and non/quasi-experimental studies with two groups assessing the effectiveness of interventions targeted on FHP with MNP. Observational studies, non-randomised studies with single group and reviews will be excluded. We will consider the following outcome measures: postural variables of FHP, neck pain, performance-based functional disability scores of the neck, quality of life, basic activities of daily living and work-related outcomes. The unique citations will be screened by titles/abstracts and full texts, independently. The Cochrane Risk of Bias 2 tool will be used to critically appraise the included studies. The risk of bias and data abstraction of included studies will be undertaken independently. A qualitative synthesis will be conducted and, if sufficient studies with comparable outcome measures are available, we will statistically pool the result.

ETHICS AND DISSEMINATION

We will undertake a systematic review of primary studies, and will not directly recruit participants hence, ethical clearance is not applicable. We will aim to present the findings of the completed systematic review at an international conference and subsequently submit the manuscript in a peer-reviewed journal for publication.

PROSPERO REGISTRATION NUMBER

CRD42021250310.

Assessing the effectiveness of an ergonomics intervention program with a participatory approach: ergonomics settlement in an Iranian steel industry

PURPOSE

Work-related musculoskeletal disorders (WMSDs) are common occupational problems affecting the health and productivity of workers worldwide. Ergonomic intervention programs (EIPs) can play an effective role in preventing these disorders in the workplace. Assessing the effectiveness of an EIP is a challenge faced by both industries and researchers. This study was aimed at assessing the effectiveness of an EIP on human resources productivity (HRP), musculoskeletal disorders (MSDs), general health and occupational fatigue in a steel industry.

METHODS

This study was conducted in a steel industry in Isfahan, Iran, between 2018 and 2021. To assess the effectiveness of the EIP with a participatory approach, training and redesign of workstations, the criteria of HRP, MSDs, general health and occupational fatigue were investigated before and after the intervention, using HRP Questionnaire, Nordic musculoskeletal questionnaire (NMQ), 28-item General Health Questionnaire (28-GHQ), Swedish Occupational Fatigue Inventory (SOFI-20) and Occupational Fatigue/Exhaustion Recovery (OFER-15) Questionnaire, as data collection tools, respectively.

RESULTS

The implementation of EIP in the studied industry significantly led to an increase in HRP (p < 0.05). The prevalence of MSDs decreased significantly in most regions of the body after the interventions (p < 0.001). In addition, the program significantly improved general health (p < 0.001) and reduced occupational fatigue among employees (p < 0.001).

CONCLUSIONS

The implementation of EIP was significantly effective in working conditions improvement. Therefore, implementing EIP with participatory approach, workforce training, as well as redesigning of workstations are recommended in industries.

Investigation of office workers' sitting behaviors in an ergonomically adjusted workstation

Objectives. Common ergonomic office workstations are designed for a few optimum postures. Nonetheless, sitting is a dynamic activity and the ideal sitting posture is rarely maintained in practice. Therefore, the present study aimed to investigate the sitting behavior of office workers in an actual working environment using ergonomically adjusted workstations to examine whether they promote maintaining appropriate sitting postures. Methods. Sitting behaviors (frequency of postures and position changes in different body parts) were explored among 26 office workers during a 60-min sitting duration, using the posture recording and classification method developed by Graf et al. The rapid upper limb assessment (RULA) method was also used to assess postural load. Then, the results of the RULA method were compared with the results from investigating the sitting behavior of office workers. Results. Common ergonomic workstations were effective in eliminating some awkward postures. However, some important risk factors such as holding postures with an inappropriate lumbar spine curve (86% of the observations) and maintaining a posture for a long time (for 7-12 min) were observed in the participants' sitting behaviors, while they were neglected in the RULA method. Conclusions. The common ergonomic workstations could not guarantee the users' appropriate sitting behaviors.

The Relationship of Grip and Pinch Strength to Musculoskeletal Disorders in Female Carpet Weavers in Southeastern Iran, 2019

Background:

The repetitive and prolonged exertion of grip and pinch strength are current among carpet weaver tasks. The three objectives of this study were (1) to investigate the relationship between symptoms of musculoskeletal disorders and grip and pinch strength of carpet weavers in carpet weaving workshops in Kerman province, (2) to compare the grip and pinch strength of carpet weavers with normal values, and (3) to identify the relationship between hand postures of carpet weavers during work and force exertion.

Methods:

In this cross-sectional study, grip strength and key, tip and palmar pinch strengths of 101 female carpet weavers aged 20 to 71 years were measured in Kerman province, in 2018. Nordic Musculoskeletal Questionnaire (Extended version) was also used to evaluate musculoskeletal disorders.

Results:

Bivariate and multivariate linear regression analyses showed that participants who suffered from musculoskeletal disorders had lower grip and pinch strength than others and this decrease was statistically significant in upper back, wrists/hands, and knees. Moreover, there was a significant difference between grip and three types of pinch strength of carpet weavers and normal values. Furthermore, for both hands, the grip strength in the position recommended by American Society of Hand Therapists was significantly greater than that in the normal position carpet weavers usually adopt.

Conclusion:

Based on the results, the high prevalence of musculoskeletal disorders has led to a significant decrease in the grip and pinch strength of carpet weavers. Therefore, it is necessary to undertake ergonomic interventions in designing the carpet weaving workstation.

Interventions to Mitigate Fatigue Induced by Physical Work: A Systematic Review of Research Quality and Levels of Evidence for Intervention Efficacy

OBJECTIVE

We present a literature review on workplace physical fatigue interventions, focusing on evaluating the methodological quality and strength of evidence.

BACKGROUND

Physical fatigue is a recognized workplace problem, with negative effects on performance and health-related complaints. Although many studies have focused on the mechanisms and consequences of fatigue, few have considered the effectiveness of interventions to mitigate fatigue.

METHOD

A systematic review of the workplace safety literature for controlled trials of physical fatigue interventions was conducted. Data on intervention type, subject characteristics, targeted tasks and body locations, outcome measures, and study design were extracted. The methodological quality for each study was evaluated using the PEDro scale, and the level of evidence was based on quality, amount, and consistency.

RESULTS

Forty-five controlled trials were reviewed, examining 18 interventions. We categorized those interventions into individual-focused (N = 28 studies, nine interventions), workplace-focused (N = 12 studies, five interventions), and multiple interventions (N = 5 studies, four interventions). We identified moderate evidence for interventions related to assistive devices and task variation. There was moderate evidence supporting no fatigue attenuation for the garment change category of interventions. The interventions in the remaining categories had limited to minimal evidence of efficacy. The heterogeneity of the included trials precludes the determination of effect size.

CONCLUSION

This review showed a lack of high levels of evidence for the effectiveness of most physical fatigue interventions.

APPLICATION

Due to a lack of high levels of evidence for any category of reviewed physical fatigue interventions, further high-quality studies are needed to establish the efficacy of others.

Reducing postural load in order picking through a smart workwear system using real-time vibrotactile feedback

Vibrotactile feedback training may be one possible method for interventions that target at learning better work techniques and improving postures in manual handling. This study aimed to evaluate the short term effect of real-time vibrotactile feedback on postural exposure using a smart workwear system for work postures intervention in simulated industrial order picking. Fifteen workers at an industrial manufacturing plant performed order-picking tasks, in which the vibrotactile feedback was used for postural training at work. The system recorded the trunk and upper arm postures. Questionnaires and semi-structured interviews were conducted about the users' experience of the system. The results showed reduced time in trunk inclination ≥20°, ≥30° and ≥45° and dominant upper arm elevation ≥30° and ≥45° when the workers received feedback, and for trunk inclination ≥20°, ≥30° and ≥45° and dominant upper arm elevation ≥30°, after feedback withdrawal. The workers perceived the system as useable, comfortable, and supportive for learning. The system has the potential of contributing to improved postures in order picking through an automated short-term training program.

A Wearable Sensor System for Physical Ergonomics Interventions Using Haptic Feedback

Work-related musculoskeletal disorders are a major concern globally affecting societies, companies, and individuals. To address this, a new sensor-based system is presented: the Smart Workwear System, aimed at facilitating preventive measures by supporting risk assessments, work design, and work technique training. The system has a module-based platform that enables flexibility of sensor-type utilization, depending on the specific application. A module of the Smart Workwear System that utilizes haptic feedback for work technique training is further presented and evaluated in simulated mail sorting on sixteen novice participants for its potential to reduce adverse arm movements and postures in repetitive manual handling. Upper-arm postures were recorded, using an inertial measurement unit (IMU), perceived pain/discomfort with the Borg CR10-scale, and user experience with a semi-structured interview. This study shows that the use of haptic feedback for work technique training has the potential to significantly reduce the time in adverse upper-arm postures after short periods of training. The haptic feedback was experienced positive and usable by the participants and was effective in supporting learning of how to improve postures and movements. It is concluded that this type of sensorized system, using haptic feedback training, is promising for the future, especially when organizations are introducing newly employed staff, when teaching ergonomics to employees in physically demanding jobs, and when performing ergonomics interventions.

A multicomponent ergonomic intervention involving individual and organisational changes for improving musculoskeletal outcomes and exposure risks among dairy workers

A field intervention study was implemented to evaluate the effects of individual (physical exercise programme and worker ergonomics training) and organisational changes (optimising work-rest schedule and revised task procedure) on musculoskeletal outcomes and their exposure risks among milking workers in a dairy plant. A questionnaire survey (including the Cornell Musculoskeletal Discomfort Questionnaire [CMDQ]) and direct observations of working postures by using the Quick Exposure Check (QEC) method were used at baseline and 12-month follow-up. Shoulder, lower back and neck discomfort were found to be the most common problems. The results showed significant improvements in the frequency (neck, shoulder, lower back, forearm and knee symptoms), severity (shoulder, lower back and knee symptoms) and interference with work (particularly due to lower back symptoms) as well as in the exposure risks to musculoskeletal problems (using the QEC method) after the intervention. The findings support the effectiveness of implemented multiple component intervention for improving musculoskeletal health and exposure risks in the studied occupational group.

An Evaluation of Posture Recognition Based on Intelligent Rapid Entire Body Assessment System for Determining Musculoskeletal Disorders

Determining the potential risks of musculoskeletal disorders through working postures in a workplace is expensive and time-consuming. A novel intelligent rapid entire body assessment (REBA) system based on convolutional pose machines (CPM), entitled the Quick Capture system, was applied to determine the risk levels. The aim of the study was to validate the feasibility and reliability of the CPM-based REBA system through a simulation experiment. The reliability was calculated from the differences of motion angles between the CPM-based REBA and a motion capture system. Results show the data collected by the Quick Capture system were consistent with those of the motion capture system; the average of root mean squared error (RMSE) was 4.77 and the average of Spearman’s rho (ρ) correlation coefficient in the different 12 postures was 0.915. For feasibility evaluation, the linear weighted Cohen’s kappa between the REBA score obtained by the Quick Capture system and those from the three experts were used. The result shows good agreement, with an average proportion agreement index (P₀) of 0.952 and kappa of 0.738. The Quick Capture system does not only accurately analyze working posture, but also accurately determines risk level of musculoskeletal disorders. This study suggested that the Quick Capture system could be applied for a rapid and real-time on-site assessment.

Lower back pain at workplace: prevalence and risk factors

Objective — analysis of lower back pain (LBP) prevalence and risk factors for its development in employees with different conditions at their workplace, depending on their age, length of service, occupational factors, and physical activity. Material and Methods — As a result of a simultaneous cross-sectional study, 3300 employees with different conditions at their workplace were examined. To study the relationships between LBP prevalence and risk factors, we used the results of employees’ survey and physical examination, along with the data on their physical activity and working conditions. Results — The workplace posture was the most common production-related risk factor for developing LBP. The second most common risk factor was the weight of the load being lifted and carried, followed by general vibration at a workplace. The least significant factor was a bending motion. According to our data, LBP prevalence in all observation groups was increasing with both age and length of employment. Over 50% of those working in hazardous conditions at the age of 50 yo and higher had LBP. Low physical activity at a workplace led to a statistically significant increase in the chances of LBP emergence. Conclusion — In employees without exposure to harmful risk factors in the form of physical exertion and general vibration, the prevalence of LBP was significantly lower than in workers in harmful working conditions. The combined effect of static and dynamic physical activities at a workplace had a more pronounced negative impact on workers’ health. Low physical activity was a significant risk factor for LBP development.

Musculoskeletal Risks: RULA Bibliometric Review

The objective of this study was to reveal RULA method applications in terms of the knowledge, country, year and journal categories. The search was performed using the "Web of Science Core Collection". The period from 1993 to April 2019 was selected. Eight hundred nine results were obtained, of which 226 were used. The largest number of publications was determined to be in the fields of industry and health and social assistance, which coincides with the OWAS and Standardized Nordic Questionnaire methods. By country, the USA stands out for its greater number of research studies and categories that are encompassed. By date, 2016 was the year when more studies were carried out, again coinciding with the Standardized Nordic Questionnaire. By journal, "Work-A Journal of Prevention Assessment and Rehabilitation" is highlighted, as it is for the REBA method as well. It was concluded that RULA can be applied to workers in different fields, usually in combination with other methods, while technological advancement provides benefits for its application.

Association of musculoskeletal disorders and workload with work schedule and job satisfaction among emergency nurses

BACKGROUND

The emergency department is a highly demanding work environment, considered by high workload and stress. The impact of work-related factors on musculoskeletal disorders (MSDs) in emergency nurses (ENs) are not yet well understood. We investigated the association of MSDs and workload with work schedule (permanent day and night work) and job satisfaction in ENs.

METHOD

Data were collected through a questionnaire including individual and work-related factors, workload (National Aeronautics and Space Administration-Task Load Index [NASA-TLX]) and MSDs (Standardized Nordic Questionnaire) from 380 ENs in five hospitals.

RESULTS

The findings revealed that work schedule and job satisfaction levels were significantly associated with the MSDs in different body regions. Work schedule was significantly related to physical demand, performance, frustration, and overall workload, whereas it was not to the mental and temporal demands and effort. Job satisfaction level was negatively associated with mental demand and frustration. A high prevalence of musculoskeletal problems, particularly in knees, upper back, lower back, neck and shoulders were found.

CONCLUSION

MSDs are highly prevalent among ENs involved in night work and with low job satisfaction levels. The results are discussed in terms of their implications for emergency hospital nurses. The findings can help to better understand the working conditions and emphasize the need for ergonomic interventions in order to reduce MSDs and workload. Also, the study findings highlight the importance of mental aspects of workload in this occupational group.