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Kang SH, Lynch L, Wolf E, Mirka GA. Quantifying the effectiveness of a passive trunk-support exosuit at reducing erector spinae muscle fatigue during a quasi-static posture maintenance task. ERGONOMICS 2024; 67:1257-1266. [PMID: 38108329 DOI: 10.1080/00140139.2023.2295214] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
The objective of this study was to explore the effectiveness of a passive back-support exosuit at reducing low back muscle fatigue during an 18-minute trunk posture maintenance task. On two separate days sixteen participants performed an 18-minute trunk posture profile that reflected trunk flexion postures observed during a challenging vascular surgery procedure. On one day they performed the procedure with the support of the exosuit, on the other day without. Test contractions were performed every three minutes to capture the time-dependent electromyographic activity of the bilateral erector spinae muscles. Time domain (amplitude) and frequency domain (median frequency) measures of erector spinae muscle fatigue were assessed. Results revealed that the exosuit significantly reduced the measures of erector spinae muscle fatigue in terms of both amplitude (6.1%) and median frequency (5.3%), demonstrating a fatigue reduction benefit of the exosuit in a realistic surgical posture maintenance task.
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Affiliation(s)
- Sang Hyeon Kang
- The Physical Ergonomics and Biomechanics Laboratory, Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA
| | - Laura Lynch
- The Physical Ergonomics and Biomechanics Laboratory, Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA
| | - Emma Wolf
- The Physical Ergonomics and Biomechanics Laboratory, Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA
| | - Gary A Mirka
- The Physical Ergonomics and Biomechanics Laboratory, Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA
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Chen N, Hu Y, Liang M, Qin X, Liu J. Firefighters' muscle activity change during firefighting training program. Work 2024:WOR230614. [PMID: 38995753 DOI: 10.3233/wor-230614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Research on muscle activity to reduce injuries during firefighting training has getting increasing attention. OBJECTIVE The purpose of this study was to assess the activity changes in nine muscles of firefighters during the seven firefighting training programs, and to analyze the influence of different firefighting training programs on muscle activity. METHODS Ten healthy male firefighters were recruited to measure the field surface electromyographic activities (including the percentage of Maximum Voluntary Contraction electromyography (% MVC) and the integrated electromyography value (iEMG)) during all the firefighting training programs. RESULTS The results showed that the electromyographic activity of gastrocnemius (GA) was stronger in climbing the hooked ladder and climbing the six-meter long ladder training programs. Arms, shoulders, and lower limb muscles were more activated, myoelectric activities were more intense, and fatigue in these areas was more likely to occur during climbing five-story building with loads. Compared with other muscles, erector spine (ES) had a higher degree of activation during different postures of water shooting. The Borg scale scores of shoulders, trunk, thighs and calves were also higher. CONCLUSION After completing all training programs, GA, tibialis anterior (TA), trapezius (TR), and ES were strongly activated, and all muscles had obvious force. The % MVC and iEMG analyses correspond well with the Borg Scale score. The results can provide certain reference for reducing the musculoskeletal injury of firefighters, carrying out scientific training and formulating effective injury prevention measures for them.
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Affiliation(s)
- Na Chen
- School of Mechanics and Safety Engineering, Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Yitong Hu
- School of Mechanics and Safety Engineering, Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Man Liang
- School of Mechanics and Safety Engineering, Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Xiangnan Qin
- School of Water Conservancy and Transportation, Zhengzhou University, Zhengzhou, Henan Province, P.R. China
| | - Jun Liu
- National Earthquake Response Support Service, Beijing, P.R. China
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Maeda T, Hayashi H, Ando M, Kobayashi D, Nishigami R, Asahara T, Goto S, Lee C, Yamashita K, Higashino K, Konishi T, Murakami S, Maki M. Performance of elastic x-ray shield made by embedding Bi 2 O 3 particles in porous polyurethane. Med Phys 2024; 51:1061-1073. [PMID: 38103261 DOI: 10.1002/mp.16889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/22/2023] [Accepted: 11/29/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Many healthcare institutions have guidelines concerning the usage of protective procedures, and various x-ray shields have been used to reduce unwanted radiation exposure to medical staff and patients when using x-rays. Most x-ray shields are in the form of sheets and lack elasticity, which limits their effectiveness in shielding areas with movement, such as the thyroid. To overcome this limitation, we have developed an innovative elastic x-ray shield. PURPOSE The purpose of this study is to explain the methodology for developing and evaluating a novel elastic x-ray shield with sufficient x-ray shielding ability. Furthermore, valuable knowledge and evaluation indices are derived to assess our shield's performance. METHODS Our x-ray shield was developed through a process of embedding Bi2 O3 particles into porous polyurethane. Porous polyurethane with a thickness of 10 mm was dipped into a solution of water, metal particles, and chemical agents. Then, it was air-dried to fix the metal particles in the porous polyurethane. Thirteen investigational x-ray shields were fabricated, in which Bi2 O3 particles at various mass thicknesses (ranging from 585 to 2493 g/m2 ) were embedded. To determine the performance of the shielding material, three criteria were evaluated: (1) Dose Reduction Factor (D R F $DRF$ ), measured using inverse broad beam geometry; (2) uniformity, evaluated from the standard deviation (S D $SD$ ) of the x-ray image obtained using a clinical x-ray imaging detector; and (3) elasticity, evaluated by a compression test. RESULTS The elastic shield with small pores, containing 1200 g/m2 of the metal element (Bi), exhibited a well-balanced performance. TheD R F $DRF$ was approximately 80% for 70 kV diagnostic x-rays. This shield's elasticity was -0.62 N/mm, a loss of only 30% when compared to porous polyurethane without metal. Although the non-uniformity of the x-ray shield leads to poor shielding ability, it was found that the decrease in the shielding ability can be limited to a maximum of 6% when the shield is manufactured so that theS D $SD$ of the x-ray image of the shield is less than 10%. CONCLUSIONS It was verified that an elastic x-ray shield that offers an appropriate reduction in radiation exposure can be produced by embedding Bi2 O3 particles into porous polyurethane. Our findings can lead to the development of novel x-ray shielding products that can reduce the physical and mental stress on users.
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Affiliation(s)
- Tatsuya Maeda
- Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Hiroaki Hayashi
- College of Medical, Pharmaceutical and Health Sciences, Kanazawa, Ishikawa, Japan
| | - Miku Ando
- Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Daiki Kobayashi
- Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Rina Nishigami
- Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Takashi Asahara
- Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
- Okayama University Hospital, Kitaku, Okayama, Japan
| | - Sota Goto
- Faculty of Health Sciences, Kobe Tokiwa University, Kobe, Hyogo, Japan
| | - Cheonghae Lee
- Graduate School of Medical Sciences, Kanazawa University, Kanazawa, Ishikawa, Japan
| | - Kazuta Yamashita
- Department of Orthopedics, School of Medicine, Tokushima University, Tokushima, Tokushima, Japan
| | - Kosaku Higashino
- Department of Orthopedics and Rehabilitation, Shikoku Medical Center for Children and Adults, Zentsuji, Kagawa, Japan
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Norasi H, Wang T, Tetteh E, Smith T, Davila VJ, Erben Y, DeMartino RR, Hallbeck MS, Mendes BC. Intraoperative workload in elective open vascular and endovascular surgery: A study of procedural drivers. APPLIED ERGONOMICS 2023; 111:104049. [PMID: 37210778 DOI: 10.1016/j.apergo.2023.104049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Revised: 05/11/2023] [Accepted: 05/15/2023] [Indexed: 05/23/2023]
Abstract
This study investigated vascular surgeon workload and its association with specific procedural drivers over different procedure types. Thirteen attending vascular surgeons (two females) were emailed a survey over a 3-month period. Data from 253 surgical procedures (118 open, 85 endovascular, 18 hybrid, and 32 venous) revealed high physical and cognitive workload among vascular surgeons. Based on the statistically significant findings and similar non-significant trends in the data (significance level of 0.01), open and hybrid vascular procedures showed higher levels of physical and cognitive workload compared to venous cases, while endovascular procedures were relatively more moderate. Additionally, the workload subscales for five subcategories of open procedures (e.g., arteriovenous access) as well as three subcategories of endovascular procedures (e.g., aortic) were compared. The granularity of the intraoperative workload drivers across various vascular procedure types and adjunct equipment could be the key to create targeted ergonomic interventions to reduce workload during vascular surgeries.
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Affiliation(s)
- Hamid Norasi
- Mayo Clinic, Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, 205 3rd Avenue SW, Rochester, MN, 55905, USA; Mayo Clinic, Division of Health Care Delivery Research, 200 1st St. SW, Rochester, MN, 55905, USA.
| | - Tianke Wang
- Mayo Clinic, Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, 205 3rd Avenue SW, Rochester, MN, 55905, USA.
| | - Emmanuel Tetteh
- Mayo Clinic, Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, 205 3rd Avenue SW, Rochester, MN, 55905, USA; Mayo Clinic, Division of Health Care Delivery Research, 200 1st St. SW, Rochester, MN, 55905, USA.
| | - Tianqi Smith
- Mayo Clinic, Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, 205 3rd Avenue SW, Rochester, MN, 55905, USA.
| | - Victor J Davila
- Mayo Clinic, Division of Vascular Surgery, Department of Surgery, 5777 E. Mayo Blvd., Phoenix, AZ, 85054, USA.
| | - Young Erben
- Mayo Clinic, Division of Vascular Surgery, Department of Surgery, 4500 San Pablo Road, Jacksonville, FL, 32224, USA.
| | - Randall R DeMartino
- Mayo Clinic, Division of Vascular Surgery, Department of Surgery, 200 1st St. SW, Rochester, MN, 55905, USA.
| | - M Susan Hallbeck
- Mayo Clinic, Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, 205 3rd Avenue SW, Rochester, MN, 55905, USA; Mayo Clinic, Division of Health Care Delivery Research, 200 1st St. SW, Rochester, MN, 55905, USA.
| | - Bernardo C Mendes
- Mayo Clinic, Division of Vascular Surgery, Department of Surgery, 200 1st St. SW, Rochester, MN, 55905, USA.
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Tetteh E, Hallbeck MS, Mirka GA. Effects of passive exoskeleton support on EMG measures of the neck, shoulder and trunk muscles while holding simulated surgical postures and performing a simulated surgical procedure. APPLIED ERGONOMICS 2022; 100:103646. [PMID: 34847371 DOI: 10.1016/j.apergo.2021.103646] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 06/13/2023]
Abstract
Exoskeletons have shown significant impact at reducing the biomechanical demand on muscles during repetitive lifting and overhead tasks in non-healthcare industries. However, the benefits of exoskeletons are yet to be realized in the operating room, particularly as work-related musculoskeletal disorders continue to be a concern for surgeons. This study quantified the effect of using neck, arm, and trunk exoskeletons on muscle activity while assuming typical postures held in the operating room. Fourteen participants were recruited to participate in this study. In this two-part experiment participants were asked to 1) hold a series of neck flexion, arm abduction and trunk flexion postures seen in surgical procedures, and 2) perform a simulated surgical task requiring five different trunk flexion posture levels. Participants were required to complete these tasks with and without passive exoskeleton(s). This study showed that even for postures held short time periods, exoskeletons are beneficial at reducing the demand on muscles; however, the reduction in muscle demand depends on body segment and postural angle, as intended with these passive exoskeletons. Furthermore, for the simulated surgical task with awkward trunk flexion postures (10-65°), the trunk exoskeletons showed a significant reduction in the rate of rise in back muscle sEMG (+1.365%MVC/min vs. +0.769%MVC/min for non-dominant lumbar extensor muscles, p = 0.0108; +1.377%MVC/min vs. +0.770%MVC/min for the dominant lumbar extensor muscles, p = 0.0196) over 25 min, consequently resulting in improved trunk subjective discomfort scores (7.34 vs. 4.30, p < 0.05), with no impact on the neck and shoulder biomechanical demand. The results from this study indicate that exoskeletons may be a potential intervention to reduce biomechanical loading during surgery.
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Affiliation(s)
- Emmanuel Tetteh
- Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA.
| | - M Susan Hallbeck
- Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA; Division of Health Care Delivery Research, Mayo Clinic, Rochester, MN, USA
| | - Gary A Mirka
- Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
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Ergonomics in Interventional Radiology: Awareness Is Mandatory. MEDICINA (KAUNAS, LITHUANIA) 2021; 57:medicina57050500. [PMID: 34069174 PMCID: PMC8157181 DOI: 10.3390/medicina57050500] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 05/07/2021] [Accepted: 05/12/2021] [Indexed: 12/17/2022]
Abstract
Ergonomics in interventional radiology has not been thoroughly evaluated. Like any operators, interventional radiologists are exposed to the risk of work-related musculoskeletal disorders. The use of lead shielding to radiation exposure and the lack of ergonomic principles developed so far contribute to these disorders, which may potentially affect their livelihoods, quality of life, and productivity. The objectives of this review were to describe the different situations encountered in interventional radiology and to compile the strategies both available to date and in development to improve ergonomics.
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Norasi H, Tetteh E, Money SR, Davila VJ, Meltzer AJ, Morrow MM, Fortune E, Mendes BC, Hallbeck MS. Intraoperative posture and workload assessment in vascular surgery. APPLIED ERGONOMICS 2021; 92:103344. [PMID: 33359926 DOI: 10.1016/j.apergo.2020.103344] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 10/31/2020] [Accepted: 12/11/2020] [Indexed: 06/12/2023]
Abstract
Quantifying the workload and postural demand on vascular surgeons provides valuable information on the physical and cognitive factors that predispose vascular surgeons to musculoskeletal pain and disorders. The aim of this study was to quantify the postural demand, workload, and discomfort experienced by vascular surgeons and to identify procedural factors that influence surgical workload. Both objective (wearable posture sensors) and subjective (surveys) assessment tools were used to evaluate intraoperative workload during 47 vascular surgery procedures. Results demonstrate unfavorable neck and low back postures as well as high pain scores for those body segments. Additionally, workload from subjective surveys increased significantly as a function of operative duration, and mental workload was high across all procedure types. Neck postural risk exposure and physical demand were among the variables that increased with surgical duration, procedure type, and loupes used by the surgeons. Correlations among postural angles and pain scores showed consistency between the objective assessment and the subjective surveys for neck and trunk. The authors believe that the results of this study highlight the need for developing mitigating measures such as ergonomic interventions for vascular surgery.
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Affiliation(s)
- Hamid Norasi
- Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | - Emmanuel Tetteh
- Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA
| | | | | | | | - Melissa M Morrow
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Emma Fortune
- Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | | | - M Susan Hallbeck
- Department of Industrial and Manufacturing Systems Engineering, Iowa State University, Ames, IA, USA; Robert D. and Patricia E. Kern Center for the Science of Healthcare Delivery, Mayo Clinic, Rochester, MN, USA; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA; Department of Surgery, Mayo Clinic, Rochester, MN, USA.
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UÇAR M, AKKOÇ A, TOPCUOĞLU M, ÖZTÜRK SA, DEMİR M. İyonlaştırıcı Radyasyona Maruz Kalan Sağlık Çalışanlarında Radyasyon Maruziyeti ve Farkındalığının Değerlendirilmesi. ACTA MEDICA ALANYA 2020. [DOI: 10.30565/medalanya.804454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Monaco MGL, Carta A, Tamhid T, Porru S. Anti-X Apron Wearing and Musculoskeletal Problems Among Healthcare Workers: A Systematic Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17165877. [PMID: 32823627 PMCID: PMC7459898 DOI: 10.3390/ijerph17165877] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Revised: 07/30/2020] [Accepted: 08/10/2020] [Indexed: 11/16/2022]
Abstract
Interventional radiology activities and other medical practices using ionising radiation have become increasingly prevalent. In this context, the use of anti-X aprons, in association with awkward postures and non-ergonomic working conditions, might cause the onset of musculoskeletal disorders (MSDs). This research aims to evaluate the evidence about the correlation between wearing anti-X aprons and work-related MSDs. A systematic scoping review of articles published between 1990 and 2020 was conducted by searching the PubMed, Scopus, Embase, and Web of Science databases. Twelve cross-sectional studies, conducted among interventional physicians, nurses, and technicians, were finally included. Five studies primarily investigated the association between use of anti-X aprons and MSDs, showing that a higher prevalence of disorders was not always associated with the use of protective aprons. No studies investigated the impact of anti-X aprons on fitness for work assessment, particularly in subjects with MSDs. There is no complete agreement about the correlation between anti-X apron-wearing and the occurrence of MSDs, although the possible discomfort of workers using anti-X aprons appears more evident. Further studies are needed to objectify the role of these protective devices in the genesis of MSDs and to offer specific ergonomic solutions for healthcare workers.
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Affiliation(s)
- Maria Grazia Lourdes Monaco
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (A.C.); (S.P.)
- Correspondence: ; Tel.: +39-045-812-3946
| | - Angela Carta
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (A.C.); (S.P.)
- Department of Diagnostics and Public Health, Section of Occupational Health, University of Verona, 37134 Verona, Italy
| | - Tishad Tamhid
- Postgraduate School of Occupational Medicine, University of Verona, 37134 Verona, Italy;
| | - Stefano Porru
- Occupational Medicine Unit, University Hospital of Verona, 37134 Verona, Italy; (A.C.); (S.P.)
- Department of Diagnostics and Public Health, Section of Occupational Health, University of Verona, 37134 Verona, Italy
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