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Gidumal S, Saade M, Schwam ZG, Govindan A, Mavrommatis M, Wong K, Perez ER, Wanna GB, Cosetti MK. Use of Soft Cervical Collar Improves Surgeon Ergonomics During Simulated Otologic Surgery. Otol Neurotol 2024; 45:266-272. [PMID: 38238911 DOI: 10.1097/mao.0000000000004097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
OBJECTIVE To determine whether surgeon use of a soft cervical collar during endoscopic and microscopic otologic surgery is feasible and impacts surgeon ergonomics as measured by inertial sensors. STUDY DESIGN Prospective crossover trial. SETTING US-based otolaryngology training program. PATIENTS Otolaryngology residents and fellows. INTERVENTIONS Therapeutic-use of a soft cervical collar during simulated otologic surgery. MAIN OUTCOME MEASURES Time spent in high-risk angles of neck and back flexion and extension; average angle of neck flexion, extension, rotation, and lateral bending; validated assessment of neck pain; average daily phone use. RESULTS Fifteen subjects met criteria for inclusion. Ten of 15 (67%) were male. Seven of 15 (47%) were postgraduate year 1-2. Seven of 15 (47%) reported a history of neck pain. None reported prior spinal steroid injections or surgery. Across all subjects, use of the soft cervical collar significantly reduced time spent in high-risk angles of neck flexion/extension during both endoscopic (56% vs. 35%, p < 0.05) and microscopic (60% vs. 32%, p < 0.05) otologic surgery. There was no effect on back flexion or extension. There was no difference in time spent in high-risk neck or back angles between endoscopic and microscopic surgery. Average angles of neck or back flexion, extension, lateral bending, and rotation were not significantly different for subgroups with more operative experience, increased phone use, perception of good posture, or history of neck pain. CONCLUSIONS Use of a soft cervical collar during simulated otologic surgery significantly reduced time spent in high-risk neck positions. These data support feasibility of soft collar use during otologic surgery and hold promise for reduction in the high rates of neck pain reported by neurotologists. PROFESSIONAL PRACTICE GAP AND EDUCATIONAL NEED Improving surgeon ergonomics for otologic surgery. LEARNING OBJECTIVE To identify a therapeutic intervention to mitigate neck pain in surgeons caused by assumption of high-risk cervical neck flexion and extension. DESIRED RESULT To demonstrate that use of a readily available soft cervical collar reduces risk of neck pain in otologic surgeons. LEVEL OF EVIDENCE II. INDICATE IRB OR IACUC Exempt.
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Affiliation(s)
- Sunder Gidumal
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
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Li YY, Gan J. Effect of wearable chair on gait, balance, and discomfort of new users during level walking with anterior loads. JOURNAL OF SAFETY RESEARCH 2023; 87:27-37. [PMID: 38081701 DOI: 10.1016/j.jsr.2023.08.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 05/22/2023] [Accepted: 08/25/2023] [Indexed: 12/18/2023]
Abstract
INTRODUCTION Walking with anterior loads is common in industrial scenarios, but as exoskeletons are increasingly used in work environments to alleviate musculoskeletal disorders (MSDs), this new "human-robot" system composed of the human body and exoskeleton may be associated with new risks and harm that warrant further investigation. Therefore, this study will discuss the effect of a wearable chair on the gait, balance, and discomfort of new users with different weights of anterior loads during level walking. METHOD Twenty-two healthy subjects (sex balanced) participated in the experiment. Each exposure comprised one of two exoskeleton states (with/without) and four load conditions: No carried load, carrying an empty box (0.3 kg), 5%Body Weight (BW), and 10%BW. The order of exoskeleton states and load conditions was randomly assigned. Using an eight-camera motion capture system to record the entire movement. And the subjective discomfort and perceived balance after each exposure were recorded on an 11-point numeric rating scale, respectively. Using SPSS 26.0 software (IBM Inc., Chicago) to conduct statistical analyses. RESULTS Level walking with a wearable chair in different load conditions significantly affected gait parameters (like cadence) and gait balance. The perceived balance decreased with the exoskeleton, consistent with objective results. For subjective discomfort, wearing the exoskeleton significantly impacted global discomfort. Also, it increased the local discomfort of the shoulders, waist, thighs, shanks, and feet/ankles. CONCLUSIONS For new users, the risk of losing balance or falling may be increased when wearing an exoskeleton for non-target task behaviors (level walking/anterior load), and caution is recommended when the anterior load exceeds 5% BW. PRACTICAL APPLICATION The proposed strategy for assessing human gait, balance, and discomfort in wearable chairs may be applied during the iterative design of the product. These controls will help develop training programs and implementation guidelines for this exoskeleton type.
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Affiliation(s)
- Ying-Yi Li
- School of Mechanical Engineering, Sichuan University, Chengdu, China.
| | - Jing Gan
- School of Mechanical Engineering, Sichuan University, Chengdu, China.
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Ünver S, Makal Orğan E. The effect of anti-fatigue floor mat on pain and fatigue levels of surgical team members: A crossover study. APPLIED ERGONOMICS 2023; 110:104017. [PMID: 36933417 DOI: 10.1016/j.apergo.2023.104017] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/09/2023] [Accepted: 03/13/2023] [Indexed: 06/18/2023]
Abstract
As ergonomics is important to maintain comfort, this study aimed to examine the effect of anti-fatigue floor mats on pain and fatigue levels of surgical team members. Thirty-eight members participated in this crossover-designed study with no-mat and with-mat conditions, separated by a one-week washout period. They stood on the 15 mm thick rubber anti-fatigue floor mat and on the standard antistatic polyvinyl chloride flooring surface during the surgical procedures. Subjective ratings of pain and fatigue levels were measured pre and after-surgery for each experimental condition using the Visual Analogue Scale and Fatigue-Visual Analogue Scale scales. The after-surgery pain and fatigue levels for the with-mat condition were significantly lower than the no mat condition (p < .05). Consequently, anti-fatigue floor mats are effective in decreasing pain and fatigue levels of surgical team members during surgical procedures. Using anti-fatigue mats may be a practical and easy way to prevent discomfort that is often experienced by surgical teams.
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Affiliation(s)
- Seher Ünver
- Trakya University, Faculty of Health Sciences, Department of Surgical Nursing, Edirne, Turkey.
| | - Esra Makal Orğan
- Trakya University, Faculty of Health Sciences, Department of Surgical Nursing, Edirne, Turkey.
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Gold BS, Oh SJ, Varelas EA, Arrighi-Allisan AE, Kominsky ES, Perez ER, Cosetti MK. Does “Just in Time” teaching of ergonomic principles improve posture of trainees during otologic microscopic surgery? Am J Otolaryngol 2023; 44:103682. [DOI: 10.1016/j.amjoto.2022.103682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
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Karimi Z, Mazloumi A, Sharifnezhad A, Jafari AH, Kazemi Z, Keihani A, Mohebbi I. Nonlinear analysis of postural changes related to the movement interventions during prolonged standing task. ERGONOMICS 2022:1-15. [PMID: 36039393 DOI: 10.1080/00140139.2022.2119284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 08/21/2022] [Indexed: 06/15/2023]
Abstract
This study assessed the effects of movement-based interventions on the complexity of postural changes during prolonged standing. Twenty participants, equally distributed in gender and standing work experience (SWE), completed three simulated prolonged standing sessions: without movement (control), leg exercise and footrest. The amount and complexity of variability in the centre of pressure (COP) and lumbar curvature angle were quantified using linear and nonlinear tools. Lower leg swelling and back/leg discomfort were also monitored. Participants in the SWE group showed significantly greater postural complexity during the standing. Regular leg exercise resulted in significantly higher postural complexity and lower leg discomfort and swelling. The footrest led to significant changes in amount of COP variability. Both interventions significantly reduced back discomfort. Overall, the nonlinear analysis of postural changes provided different findings compared to linear ones, considering the standing time, interventions and standing job experience. Nonlinear results were consistent with leg discomfort and swelling. Practitioner summary: The effect of movement-based interventions on dynamics of postural alterations over prolonged standing were characterised using nonlinear techniques. The effect of standing work experience was also considered. Previous experience of standing jobs and leg movements increase the complexity of postural behaviour over standing period.
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Affiliation(s)
- Zanyar Karimi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Department of Occupational Health, School of Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Adel Mazloumi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Sharifnezhad
- Department of Sport Biomechanics and Technology, Sport Sciences Research Institute, Tehran, Iran
| | - Amir Homayoun Jafari
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Kazemi
- Department of Industrial Engineering, Clemson University, Clemson, SC, USA
| | - Ahmadreza Keihani
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Mohebbi
- Social Determinants of Health Research Center, Urmia University of Medical Sciences, Urmia, Iran
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Leung KL, Segal RM, Bernstein JD, Orosco RK, Reid CM. Surgical ergonomics: Assessment of surgeon posture and impact of training device during otolaryngology procedures. Laryngoscope Investig Otolaryngol 2022; 7:1351-1359. [PMID: 36258864 PMCID: PMC9575056 DOI: 10.1002/lio2.901] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 08/09/2022] [Accepted: 08/10/2022] [Indexed: 11/15/2022] Open
Abstract
Objective To identify factors associated with cervical‐thoracic spine posture in otolaryngology surgeries and evaluate the efficacy of a commercially available posture‐training device in enhancing surgeon ergonomics. Methods Over 3 months, neck and spine posture from individuals performing otolaryngology surgeries was recorded using UpRight Go 2™. Average baseline posture was first recorded and biofeedback was later introduced to attempt to correct posture. The proportion of time spent in upright/neutral cervical‐thoracic spine posture was correlated with surgeon and procedure characteristics and compared to proportion of upright posture time after biofeedback intervention. Results The proportion of upright operating time was significantly different between procedure subtypes and surgical approaches with best performance in rhinology procedures and worst performance in head and neck surgeries (90% vs. 62%; both p < .001). Female gender, shorter stature, and use of sitting stools were associated with greater proportion of surgery spent upright (all p < .05). Loupes use was associated with less time in upright posture (p < .001). With biofeedback intervention, 8 of 10 subjects demonstrated an average of 5% improvement in operating upright, with most improvement found when performing laryngology procedures (7%) and least improvement in head and neck procedures (2%). Conclusions While surgeon posture varies across otolaryngology surgeries, sitting and minimizing the use of loupes may help promote a more ergonomic operating environment and improve surgeon posture. Although the efficacy of biofeedback intervention from a commercially available posture‐training device differs among otolaryngologists, exploration of alternative interventions and incorporation of an ergonomics curriculum is warranted to address postural issues experienced by many surgeons. Level of Evidence 3.
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Affiliation(s)
- Karen L. Leung
- School of Medicine UC San Diego San Diego California USA
| | | | - Jeffrey D. Bernstein
- Department of Otolaryngology ‐ Head & Neck Surgery, Department of Surgery UC San Diego Health San Diego California USA
| | - Ryan K. Orosco
- Department of Otolaryngology ‐ Head & Neck Surgery, Department of Surgery UC San Diego Health San Diego California USA
| | - Chris M. Reid
- Division of Plastic Surgery, Department of Surgery UC San Diego Health San Diego California USA
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The Effect of Standing Mats on Biomechanical Characteristics of Lower Limbs and Perceived Exertion for Healthy Individuals during Prolonged Standing. Appl Bionics Biomech 2022; 2022:8132402. [PMID: 35942253 PMCID: PMC9356849 DOI: 10.1155/2022/8132402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Revised: 03/30/2022] [Accepted: 07/13/2022] [Indexed: 11/18/2022] Open
Abstract
Objective To identify the effect of standing mats on biomechanical characteristics of lower limbs and perceived exertion for healthy adult individuals during a prolonged standing task. Methods 32 healthy college students were recruited in the randomized and cross-over designed trial according to the effect size and statistical power. After collecting the anthropometric data, each participant was asked to finish 2 sessions of 4-hour prolonged standing tasks on standing mats (MS) and hard ground (GS) in a random order and with a 72-hour interval rest. The plantar pressure distribution, foot morphology, and scores of the BESS (balance error scoring system) would be recorded pre- and posteach task. The Borg Rating of Perceived Exertion (RPE) would be collected during the whole task. Paired-samples t test was adopted to analyse the before and after difference within group and independent-samples t test was adopted to analyse the difference between groups separately. Results (1) A prolonged standing task on both MS and GS have a negative effect on RPE and balance performance. (2) The negative effect on RPE and balance performance induced by MS is significantly smaller than that induced by GS. (3) Compared to GS, prolonged standing on MS has a lower peak plantar pressure and an implicit decrease in navicular drop and AHI (arch index). Conclusion Standing mat tends to alleviate the fatigue induced by prolonged standing in lower limbs, optimize the distribution of plantar pressure, and maintain the stability.
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Lin MIB, Yen YT, Chang CH. Use of an inflatable mat to reduce body discomfort development when performing computer work at a standing desk. ERGONOMICS 2022; 65:1015-1034. [PMID: 34797209 DOI: 10.1080/00140139.2021.2009042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 10/26/2021] [Indexed: 06/13/2023]
Abstract
This study aimed to determine the effects of inflatable mat design on body discomfort, task performance, and musculoskeletal exposures during standing computer work. Twenty-seven healthy adults completed three 2-hour standing trials on different mediums (concrete floor, foam mat, and inflatable mat) on different days in an experimental laboratory. Both mats were associated with reduced discomfort in all lower-body regions and increased typing performance compared to the concrete floor. Perceived discomfort in lower extremities (except thighs) was further alleviated while standing on the inflatable mat than on the foam mat. Use of the inflatable mat led to increased lower-body muscle activity, a flexed lower back, and a wide range of sagittal knee movements. As standing time increased, body discomfort increased, typing accuracy decreased, and there were increased variations in muscle activity and postural movements in the lower body. The inflatable mat shows potential to improve the ergonomic experience during prolonged standing. Practitioner summary: Incorporating standing postures in office-based workplaces can reduce sitting time and may mitigate the health hazards associated with sedentary behaviour. With adequate weight-shifting movements, using an inflatable mat for standing could be an effective way to lessen discomfort and accumulated musculoskeletal strain due to constrained standing, without jeopardising task productivity. Abbreviations: APDF: amplitude probability distribution function. AVR: average rectified value. CI: confidence interval. CMRR: common mode rejection ratio. COP: center of pressure. CV: coefficient of variation. EA: electrical activity. EMG: electromyography. FL: fibularis longus. GM: gluteus medius. LBP: lower back pain. LES: lumbar erector spinae. MVC: maximum voluntary contraction. PD: pain developer. rANOVA: repeated-measures analysis of variance. SOL: soleus. VAS: visual analog scale. WPM: words per minute.
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Affiliation(s)
- Ming-I Brandon Lin
- Department of Industrial and Information Management, National Cheng-Kung University, Tainan, Taiwan
- Institute of Information Management, National Cheng-Kung University, Tainan, Taiwan
| | - Yi-Ting Yen
- Department of Industrial and Information Management, National Cheng-Kung University, Tainan, Taiwan
| | - Chun Han Chang
- Department of Industrial and Information Management, National Cheng-Kung University, Tainan, Taiwan
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Winberg TB, Glinka MN, Gallagher KM, Weaver TB, Laing AC, Callaghan JP. Anti-fatigue mats can reduce low back discomfort in transient pain developers. APPLIED ERGONOMICS 2022; 100:103661. [PMID: 34837750 DOI: 10.1016/j.apergo.2021.103661] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/27/2021] [Accepted: 11/21/2021] [Indexed: 06/13/2023]
Abstract
Complaints of musculoskeletal pain are common among employees who stand for prolonged periods. This study sought to determine if an anti-fatigue mat (AFM) could uniquely affect low back pain (LBP), low back posture, and foot-floor interface responses in individuals prone to developing LBP (termed pain developers (PDs)) during prolonged standing experiments compared to those who do not develop LBP under the same exposures (termed non pain developers (NPDs)). Sixteen volunteers (8 PDs and 8 NPDs) were recruited based on their pain-development tendencies, which were established in previous standing experiments. They visited the laboratory on two separate days for 60 min of light manual work while standing on either a rigid floor or AFM. All participants were asymptomatic at the beginning of each experimental session. The amount of LBP experienced during the standing exposure, measured via a visual analogue scale, was reduced (p = 0.03) in the PD group when on the AFM (3.6 ± 6 mm) compared to the rigid floor (6.8 ± 7 mm). LBP levels remained low and unchanged (p = 0.5) between the AFM (2.4 ± 5 mm) and rigid floor (1.6 ± 2 mm) conditions for the NPD group. Neither postural nor foot-floor interface measures correlated with this unique reduction of LBP for the PD group when standing on the AFM. The AFM did, however, increase centre of pressure excursion (NPD 55% increase; PD 35% increase) and tended to increase the number of body weight shifts (NPD 116% increase; PD 54% increase) in both the PD and NPD groups. These findings suggest that AFMs may selectively benefit individuals prone to developing standing-induced back pain by facilitating subtle movements at the foot-floor interface.
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Affiliation(s)
- Taylor B Winberg
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Michal N Glinka
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Kaitlin M Gallagher
- Exercise Science Research Center, University of Arkansas, Fayetteville, AR, 72701, USA
| | - Tyler B Weaver
- LISKE Accident & Injury Experts, Fonthill, Ontario, Canada
| | - Andrew C Laing
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - Jack P Callaghan
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada.
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Tu Y, Zhu A, Song J, Zhang X, Cao G. Design and Experimental Evaluation of a Lower-Limb Exoskeleton for Assisting Workers With Motorized Tuning of Squat Heights. IEEE Trans Neural Syst Rehabil Eng 2022; 30:184-193. [PMID: 35030082 DOI: 10.1109/tnsre.2022.3143361] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
This paper presents the E-LEG, a novel semi-passive lower-limb exoskeleton for worker squatting assistance, with motorized tuning of the assistive squatting height. Compared with other passive industrial exoskeletons for the lower-limbs, the E-LEG presents novel design features namely inertial sensor for measuring the tilt angle of thigh and the novel electromagnetic switch for adjusting squat height. These features could enhance the effectiveness of the system. In addition to the introduction to exoskeleton design, this paper also reports the systematic experimental evaluation of human subjects. With the assistance of different conditions, the variability of muscular activity was evaluated in long-term static squatting task. The set of metrics to evaluate the effect of the device included leg muscle activity, plantar pressure fluctuation, plantar pressure center fluctuation and gait angles. Results show that the exoskeleton can reduce the muscular activity of the user during squatting, and it will have little affect the normal gait of the user during walking. In this study, we found that the E-LEG exoskeleton has potential effectiveness in reducing the muscular strain on long-term continuous squatting activities.
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Arrighi-Allisan AE, Garvey KL, Wong A, Filip P, Shah J, Spock T, Del Signore A, Cosetti MK, Govindaraj S, Iloreta AM. Ergonomic Analysis of Functional Endoscopic Sinus Surgery Using Novel Inertial Sensors. Laryngoscope 2021; 132:1153-1159. [PMID: 34355793 DOI: 10.1002/lary.29796] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 07/07/2021] [Accepted: 07/17/2021] [Indexed: 01/22/2023]
Abstract
OBJECTIVES/HYPOTHESIS Suboptimal ergonomics during endoscopic sinus surgery can lead to considerable physical discomfort and fatigue for the surgeon. The purpose of this pilot study is to objectively evaluate the ergonomic positions of trainee and attending surgeons while performing functional endoscopic sinus surgery (FESS). STUDY DESIGN Pilot prospective trial. METHODS Six surgeons (two attendings and four trainees) performed FESS while wearing 11 inertial measurement units (IMUs) affixed to either side of each major joint. Screen placement was standardized to be 1 m directly in front of the surgeon and on the patient's left, 0-15° declined from the surgeons' eyes. Bed height was standardized such that the workspace was 0 to 10 cm below the elbows. IMU data were analyzed to calculate joint angles. Ideal joint angles (i.e., <10° for neck and trunk) were determined by the validated Rapid Entire Body Assessment tool. Subjects subsequently completed a modified National Aeronautics and Space Administration Task Load Index to assess cognitive and physical burden and pain. Student's t-test was employed to detect differences between groups. RESULTS Trainees adopted positions involving significantly greater neck flexion (9.90° vs. -6.48°, P = .03) and reported significantly higher frustration levels (3.04 vs. 1.33, P = .02) while operating than attendings. For both cohorts, increased operative time was significantly correlated with greater back flexion (r = 0.90, P = .02; r = 0.55, P = .04, respectively). CONCLUSIONS Our data suggest that trainees operate with higher risk neck postures than do attendings. These data indicate high-risk operative postures may be borne of inexperience and present an opportunity for postural interventions at an early stage of training. LEVEL OF EVIDENCE N/A Laryngoscope, 2021.
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Affiliation(s)
- Annie E Arrighi-Allisan
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Katherine L Garvey
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Anni Wong
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Peter Filip
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Janki Shah
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Todd Spock
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Anthony Del Signore
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Maura K Cosetti
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Satish Govindaraj
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
| | - Alfred Marc Iloreta
- Department of Otolaryngology, Icahn School of Medicine at Mount Sinai, New York, New York, U.S.A
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Saad H. A Study of Some Important Issues for a Muslim in the Month of Ramadan. JOURNAL OF RELIGION AND HEALTH 2021; 60:903-921. [PMID: 33387190 DOI: 10.1007/s10943-020-01125-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/27/2020] [Indexed: 06/12/2023]
Abstract
The month of Ramadan is associated with many worships that might exhaust the weak body. The most important worships in Ramadan are fasting and prayer. Some prayers require the length of sitting and standing, in addition to prayer movements. Many Muslims are spending a long time in the mosque; sitting on the ground for reading or standing for prayer. The questionnaire is focused on those who spend a long time in the mosque. Seven attributes were considered for the understanding of what affects the worshiper's health, especially those who with chronic diseases. We found that there is a strong relationship between age and chronic diseases that may increase with the age. Also, the elderly cannot continue to pray for more than half an hour, and this is if balanced standing and sitting on a chair when is needed to prevent the disorder of the body and the emergence of symptoms of chronic disease.
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Affiliation(s)
- Hamza Saad
- System Sciences and Industrial Engineering Department, The State University of New York at Binghamton, Binghamton, NY, USA.
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Yan Z, Han B, Du Z, Huang T, Bai O, Peng A. Development and testing of a wearable passive lower-limb support exoskeleton to support industrial workers. Biocybern Biomed Eng 2021. [DOI: 10.1016/j.bbe.2020.12.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Wall R, Garcia G, Läubli T, Seibt R, Rieger MA, Martin B, Steinhilber B. Physiological changes during prolonged standing and walking considering age, gender and standing work experience. ERGONOMICS 2020; 63:579-592. [PMID: 32009579 DOI: 10.1080/00140139.2020.1725145] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 01/14/2020] [Indexed: 06/10/2023]
Abstract
Occupational standing is associated with musculoskeletal and venous disorders. The aim was to investigate whether lower leg oedema and muscle fatigue development differ between standing and walking and whether age, gender and standing work habituation are factors to consider. Sixty participants (15 young females, 15 young males, 15 older males, and 15 young males habituated to standing work) were included and required to stand/walk for 4.5 hours in three periods with two seated breaks. Waterplethysmography/bioelectrical impedance, muscle twitch force and surface electromyography were used to assess lower leg swelling (LLS) and muscle fatigue as well as gastrocnemius muscle activity, respectively. While standing led to LLS and muscle fatigue, walking did not. Low-level medial gastrocnemius activity was not continuous during standing. No significant influence of age, gender and standing habituation was observed. Walking can be an effective prevention measure to counteract the detrimental effects of quasi-static standing.Practitioner summary: Prolonged standing leads to lower leg oedema and muscle fatigue while walking does not. The primary cause of fatigue may be in other muscles than the medial gastrocnemius. Walking may be an effective prevention measure for health risks of occupational standing when included intermittently.Abbreviation: BI: bioelectrical impedance; LLS: lower leg swelling; SEMG: surface electromyography; MTF: muscle twitch force; WP: waterplethysmography; Bsl: Baseline; L: Lunch; E: Evening; MTM: method times measurement; EA: electrical activity; IQR: interquartile range; p: percentile; M: mean; SE: standard error; Adj: adjusted.
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Affiliation(s)
- Rudolf Wall
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital, Tuebingen, Germany
| | - Gabriela Garcia
- Department of Health Sciences and Technology, Sensory-Motor Systems Lab, ETH Zürich, Zurich, Switzerland
- Industrial Engineering Department, Universidad San Francisco de Quito, Quito, Ecuador
| | - Thomas Läubli
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital, Tuebingen, Germany
- Department of Health Sciences and Technology, Sensory-Motor Systems Lab, ETH Zürich, Zurich, Switzerland
| | - Robert Seibt
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital, Tuebingen, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital, Tuebingen, Germany
| | - Bernard Martin
- Industrial and Operations Engineering Center for Ergonomics, University of Michigan, Ann Arbor, MI, USA
| | - Benjamin Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital, Tuebingen, Germany
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15
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Luger T, Seibt R, Cobb TJ, Rieger MA, Steinhilber B. Influence of a passive lower-limb exoskeleton during simulated industrial work tasks on physical load, upper body posture, postural control and discomfort. APPLIED ERGONOMICS 2019; 80:152-160. [PMID: 31280799 DOI: 10.1016/j.apergo.2019.05.018] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 05/15/2019] [Accepted: 05/26/2019] [Indexed: 06/09/2023]
Abstract
This study investigated the effect of wearing a passive lower-limb exoskeleton on physical load, kinematics, postural control, and discomfort. 45 healthy males participated and were exposed to three 21-min simulations, including screwing, cable-mounting, and clip-fitting. Each exposure comprised one of three exoskeleton statuses (standing, high and low sitting on exoskeleton) and three working distances (optimal, far, very far). The order of exoskeleton status and working distance were randomized across subjects. A force platform was used to calculate the mean center of pressure (COP) and absolute (SSABS) and relative static postural stability (SSREL) as measures of postural control as well as the weight transferred to the exoskeleton supports as indicator of physical load. Neck and back angles were recorded together with electrical activity of four bilateral muscles (trapezius, erector, vastus, gastrocnemius). Discomfort was recorded before and after each exposure on an 11-point numeric rating scale. Physical load decreased due to the exoskeleton carrying up to 64% of the subject's body mass. The COP remained within the base of support with the lowest values of static postural stability for high sitting (27%). During sitting, vastus activity increased (∼95-135%) while gastrocnemius activity decreased (∼25%) compared to standing. Trapezius and erector activity levels showed only minor differences between exposures. Larger working distances resulted in a more anterior COP and increased erector activity. Standing without exoskeleton was related to less discomfort (0.5) than sitting on the exoskeleton (∼1.3). Working postures and distances changed SSREL and activity levels of the vastus, gastrocnemius, and erector, but not SSABS. However, postural stability did not approach a critical state in our simulations without external perturbations. Therefore, investigating exoskeletons in the field will provide useful information about their effectiveness and usability in dynamic working situations where external forces could occur.
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Affiliation(s)
- Tessy Luger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany.
| | - Robert Seibt
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
| | - Timothy J Cobb
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
| | - Monika A Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
| | - Benjamin Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Wilhelmstraße 27, 72074, Tübingen, Germany
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16
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Rekant JS, Wiltman SA, Chambers AJ. A Novel Method of Analysis for Prolonged-Standing Data: Accounting for Joint and Muscle Discomfort. IISE Trans Occup Ergon Hum Factors 2019; 7:142-152. [PMID: 36865785 PMCID: PMC9976808 DOI: 10.1080/24725838.2019.1640810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background The typical American worker spends about two-thirds of their work day standing. Prolonged standing has been found to be associated with acute and chronic adverse health outcomes. There is considerable variability among existing methods of analysis for prolonged-standing data, and therefore difficulty interpreting and comparing results across studies. Purpose The purpose of this study is to develop a bodyweight transfer analysis method that incorporates factors of both time and amplitude of loading. This method was then applied to actual prolonged-standing data, to understand how the results of this method are impacted by time spent standing, and how the results relate to previously-reported methods of analysis for weight shifting data. Methods Seven subjects (six male, one female) stood with each foot on one of two force plates for 6 h with a 5-min seated rest break between hours. Our new method identified two different types of events: fidgets and weight shifts. Center-of-pressure data were analyzed with the proposed method and three existing methods of analysis. Results Subjects utilized different quantities of fidgets and weight shifts over the course of the trials. Existing methods of analysis identified a wide range in number of events, with some methods consistently identifying more events than others. These existing methods significantly differed from the proposed method. Fidgets, weight shifts, and fidgets + weight shifts, as identified using the proposed method, had significant interactions with time, while only one of the existing methods showed a significant time interaction. Conclusions The conclusions drawn from analysis of prolonged standing center-of-pressure data can differ significantly depending on the method of analysis used. The method proposed here accounts for the different sources of discomfort and the tissue characteristics of these sources. Future work should explore the relationships between physiologic parameters and fidgets and weight shifts, so that appropriate clinical interventions can be identified.
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Affiliation(s)
- Julie S Rekant
- Department of Bioengineering, University of Pittsburgh, 4420 Bayard Street, Pittsburgh, PA, USA
| | - Stephanie A Wiltman
- Department of Bioengineering, University of Pittsburgh, 4420 Bayard Street, Pittsburgh, PA, USA
| | - April J Chambers
- Department of Bioengineering, University of Pittsburgh, 4420 Bayard Street, Pittsburgh, PA, USA
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17
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Garcia MG, Läubli T, Martin BJ. Muscular and Vascular Issues Induced by Prolonged Standing With Different Work-Rest Cycles With Active or Passive Breaks. HUMAN FACTORS 2018; 60:806-821. [PMID: 29648891 DOI: 10.1177/0018720818769261] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the long-lasting motor, behavioral, physiological, and perceptual effects of prolonged standing work in three work-rest cycle conditions including passive or active rest breaks. BACKGROUND Muscle fatigue has been evidenced after prolonged standing work through physiological and neuromotor measures. It has been postulated that muscle fatigue induced by prolonged work could be attenuated by appropriate scheduling of work and rest periods. However, investigations in this domain remain limited. METHOD Thirty participants simulated standing work for 5 hr with work-rest cycles of short, medium, or long standing periods including passive or active breaks. Lower-leg muscle twitch force (MTF), muscle oxygenation, lower-leg volume, postural stability, force control, and discomfort perception were quantified on 2 days. RESULTS Prolonged standing induced significant changes in all measures immediately after 5 hr of work, indicating a detrimental effect in long-lasting muscle fatigue, performance, discomfort, and vascular aspects. Differences in the measures were not significant between work cycles and/or break type. CONCLUSION Similar physiological and motor alterations were induced by prolonged standing. The absence of difference in the effects induced by the tested work-rest cycles suggests that simply altering the work-rest cycle may not be sufficient to counteract the effects of mainly static standing work. Finally, standing for 3 hr or more shows clear detrimental effects. APPLICATION Prolonged standing is likely to contribute to musculoskeletal and vascular symptoms. A limitation to less than 3 hr of mostly static standing in occupational activities could avoid alterations leading to these symptoms.
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Son JI, Yi CH, Kwon OY, Cynn HS, Lim OB, Baek YJ, Jung YJ. Effects of footrest heights on muscle fatigue, kinematics, and kinetics during prolonged standing work. J Back Musculoskelet Rehabil 2018; 31:389-396. [PMID: 28946538 DOI: 10.3233/bmr-170798] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Among the tools for relieving lower back pain, footrests are commonly recommended. Few studies have investigated the effects of footrest and the proper application of footrest height. OBJECTIVE The purpose of this study was to compare the effects of the normalized footrest height on muscle fatigue, kinematics, kinetics, and pain intensity. METHODS In total, 13 males who had a history of non-specific lower back pain during prolonged standing were recruited. The experimental conditions were 2-hour prolonged standing with no footrest and with footrests of 5%, 10%, and 15% of body height. Muscle fatigue was investigated through measurements of the median frequency ratio and the muscle activity ratio (post/pre) in lumbar erector spinae. The lumbo-pelvic angles, and the external moment in the lumbar region were investigated. A visual analog scale was used to investigate the intensity of the pain. RESULTS The footrests at 10% and 15% of the body height caused a lower change in the median frequency ratio and the muscle activity ratio than the other conditions. The footrest at 10% of the body height placed the lowest external moment on the lumbar region among all the conditions. The pain intensity was significantly lower in with footrest conditions than with no footrest condition. CONCLUSIONS The results suggests that a footrest height of 10% of the body height can be recommended as a normalized height for prolonged standing work in subjects with a history of non-specific lower back pain during prolonged standing.
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Affiliation(s)
- Jae-Ik Son
- Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Korea
| | - Chung-Hwi Yi
- Department of Physical Therapy, College of Health Science, Yonsei University, Wonju, Korea
| | - Oh-Yun Kwon
- Department of Physical Therapy, College of Health Science, Yonsei University, Wonju, Korea
| | - Heon-Seock Cynn
- Department of Physical Therapy, College of Health Science, Yonsei University, Wonju, Korea
| | - One-Bin Lim
- Department of Physical Therapy, Rehabilitation Hospital, National Rehabilitation Center, Seoul, Korea
| | - Yun-Jeong Baek
- Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Korea
| | - Ye-Ji Jung
- Department of Physical Therapy, The Graduate School, Yonsei University, Wonju, Korea
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19
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Speed G, Harris K, Keegel T. The effect of cushioning materials on musculoskeletal discomfort and fatigue during prolonged standing at work: A systematic review. APPLIED ERGONOMICS 2018; 70:300-314. [PMID: 29866322 DOI: 10.1016/j.apergo.2018.02.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 02/18/2018] [Accepted: 02/20/2018] [Indexed: 06/08/2023]
Abstract
This systematic review updates the current state of evidence on the effectiveness of softer flooring and cushioned shoe insoles on reducing musculoskeletal discomfort amongst workers who are required to stand for prolonged periods to work and the impact of factors such as age and gender on the outcomes. A systematic search identified 10 unique studies that met the eligibility criteria. The heterogeneity of study designs impacted on the strength of evidence. A moderate level of evidence was found in support of using cushioned materials in reducing discomfort/fatigue among standing workers. A limited level of evidence exists in favour of using insoles over anti-fatigue mats. Insufficient information exists for the impact of gender or age. Larger, good quality prospective intervention trials based in real workplaces that consider the impact of psychosocial and organisational factors on musculoskeletal discomfort whilst standing at work are required to inform industry recommendations.
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Affiliation(s)
- Gosia Speed
- Centre for Ergonomics and Human Factors, School of Psychology and Public Health, Latrobe University, Australia
| | | | - Tessa Keegel
- Centre for Ergonomics and Human Factors, School of Psychology and Public Health, Latrobe University, Australia; Monash Centre for Occupational and Environmental Health, School of Public Health and Preventative Medicine, Australia.
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20
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Karimi Z, Azghani MR, Allahyari T. Lower leg swelling and muscle co-contraction during prolonged standing: an unstable footwear evaluation. FOOTWEAR SCIENCE 2017. [DOI: 10.1080/19424280.2017.1342702] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Zanyar Karimi
- Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Reza Azghani
- Department of Biomechanics, Faculty of Mechanical Engineering, Sahand University of Technology, Tabriz, Iran
| | - Teimour Allahyari
- Department of Occupational Health, School of Health, Urmia University of Medical Sciences, Urmia, Iran
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21
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Pazan S, Danoff J. Techniques for Comparison of Shoe Inserts During Stance. IISE Trans Occup Ergon Hum Factors 2017. [DOI: 10.1080/24725838.2017.1335660] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Jerome Danoff
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, 950 New Hampshire Avenue, NW, Washington, DC 20052, USA
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22
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Garcia MG, Wall R, Steinhilber B, Läubli T, Martin BJ. Long-Lasting Changes in Muscle Twitch Force During Simulated Work While Standing or Walking. HUMAN FACTORS 2016; 58:1117-1127. [PMID: 27613826 DOI: 10.1177/0018720816669444] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2015] [Accepted: 08/10/2016] [Indexed: 05/23/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the long-lasting effects of prolonged standing work on a hard floor or floor mat and slow-pace walking on muscle twitch force (MTF) elicited by electrical stimulation. BACKGROUND Prolonged standing work may alter lower-leg muscle function, which can be quantified by changes in the MTF amplitude and duration related to muscle fatigue. Ergonomic interventions have been proposed to mitigate fatigue and discomfort; however, their influences remain controversial. METHOD Ten men and eight women simulated standing work in 320-min experiments with three conditions: standing on a hard floor or an antifatigue mat and walking on a treadmill, each including three seated rest breaks. MTF in the gastrocnemius-soleus muscles was evaluated through changes in signal amplitude and duration. RESULTS The significant decrease of MTF amplitude and an increase of duration after standing work on a hard floor and on a mat persisted beyond 1 hr postwork. During walking, significant MTF metrics changes appeared 30 min postwork. MTF amplitude decrease was not significant after the first 110 min in any of the conditions; however, MTF duration was significantly higher than baseline in the standing conditions. CONCLUSION Similar long-lasting weakening of MTF was induced by standing on a hard floor and on an antifatigue mat. However, walking partially attenuated this phenomenon. APPLICATION Mostly static standing is likely to contribute to alterations of MTF in lower-leg muscles and potentially to musculoskeletal disorders regardless of the flooring characteristics. Occupational activities including slow-pace walking may reduce such deterioration in muscle function.
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Affiliation(s)
| | - Rudolf Wall
- ETH Zürich, Zurich, Switzerland
- University of Tübingen, Tubingen, Germany
- ETH Zürich, Zurich, Switzerland
- University of Michigan, Ann Arbor
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