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Brukner Havelková P, Dulíková V, Bejdová Š, Vacková J, Velemínský P, Bárta M. Ancient Egyptian scribes and specific skeletal occupational risk markers (Abusir, Old Kingdom). Sci Rep 2024; 14:13317. [PMID: 38937484 PMCID: PMC11211405 DOI: 10.1038/s41598-024-63549-z] [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: 12/01/2023] [Accepted: 05/30/2024] [Indexed: 06/29/2024] Open
Abstract
Men with writing proficiency enjoyed a privileged position in ancient Egyptian society in the third millennium BC. Research focusing on these officials of elevated social status ("scribes") usually concentrates on their titles, scribal statues, iconography, etc., but the individuals themselves, and their skeletal remains, have been neglected. The aim of this study is to reveal whether repetitive tasks and maintained postures related to scribal activity can manifest in skeletal changes and identify possible occupational risk factors. A total of 1767 items including entheseal changes, non-metric traits, and degenerative changes were recorded from the human remains of 69 adult males of well-defined social status categories from the necropolis at Abusir (2700-2180 BC). Statistically significant differences between the scribes and the reference group attested a higher incidence of changes in scribes and manifested themselves especially in the occurrence of osteoarthritis of the joints. Our research reveals that remaining in a cross-legged sitting or kneeling position for extended periods, and the repetitive tasks related to writing and the adjusting of the rush pens during scribal activity, caused the extreme overloading of the jaw, neck and shoulder regions.
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Affiliation(s)
- Petra Brukner Havelková
- Department of Anthropology, National Museum in Prague, Cirkusová 1740, 193 00, Prague 9, Czech Republic.
- Czech Institute of Egyptology, Faculty of Arts, Charles University, 110 00, Prague, Czech Republic.
| | - Veronika Dulíková
- Czech Institute of Egyptology, Faculty of Arts, Charles University, 110 00, Prague, Czech Republic
| | - Šárka Bejdová
- Department of Anthropology and Human Genetics, Faculty of Science, Charles University, 128 00, Prague, Czech Republic
| | - Jana Vacková
- Czech Institute of Egyptology, Faculty of Arts, Charles University, 110 00, Prague, Czech Republic
- Department of Applied Mathematics, Faculty of Information Technology, Czech Technical University in Prague, 160 00, Prague, Czech Republic
| | - Petr Velemínský
- Department of Anthropology, National Museum in Prague, Cirkusová 1740, 193 00, Prague 9, Czech Republic
| | - Miroslav Bárta
- Czech Institute of Egyptology, Faculty of Arts, Charles University, 110 00, Prague, Czech Republic
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2
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Gerhardsson L. A follow-up study of vibration-induced injuries in workers exposed to transient and high frequency vibrations. J Occup Med Toxicol 2024; 19:27. [PMID: 38907277 PMCID: PMC11191195 DOI: 10.1186/s12995-024-00425-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2024] [Accepted: 06/12/2024] [Indexed: 06/23/2024] Open
Abstract
BACKGROUND In a previous study from 2018, 38 wheel loader assembly workers were examined, showing high exposures to transient and high-frequency vibrations. After the investigation, preventive measures were immediately implemented to reduce the vibration exposure. In 2022, a follow-up study was carried out to examine the effect of these measures. METHODS The follow-up study included 35 (27 men and 8 women) of the original 38 workers. They were divided into two groups, 24 workers with ongoing vibration exposure and 11 workers, not vibration exposed since 2018. All participants completed a questionnaire and underwent a thorough examination, including several neurophysiological tests and a comprehensive assessment of musculoskeletal symptoms. The questionnaire responses and on-site vibration level measurements formed the basis for the individual vibration exposure assessment. RESULTS In 2018, clear differences were noted between the two groups regarding vibration perception thresholds (VPT), needle test, 2-PD (2-point discrimination), and monofilament test with deviating results in the unexposed group. The difference between the two groups was significantly smaller at the follow-up examination in 2022, where differences remained for VPT and monofilament tests, with deviating test results in the unexposed group. When comparing variable values between 2018 and 2022 within the exposed and unexposed groups, respectively, the unexposed group showed mostly unchanged values, while a deterioration was observed for VPT, needle test and temperature sensitivity test among the exposed workers during follow-up. The prevalence of VWF (Vibration white fingers) was around 30-40% and neuropathy around 75% among exposed workers during follow-up compared to about 60% and 85% respectively, in the unexposed group. CONCLUSION The overall categorization of white fingers and neuropathy, according to the Stockholm Workshop Scale, remained largely unchanged in both study groups from 2018 to 2022. The introduction of cost-effective and relatively simple preventive measures may have contributed to this result. Throughout the follow-up period, the number of exposed workers who developed musculoskeletal disorders and newly reported cases of vibration injuries at the factory decreased. Without this preventive program, increased vascular and nerve symptoms would most likely have occurred during follow-up due to continued vibration exposure.
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Affiliation(s)
- Lars Gerhardsson
- Department of Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Medicinaregatan 16 A, Box 414, Gothenburg, SE-405 30, Sweden.
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Chander DS, Tomezzoli A, Cavatorta MP, Gréau M, Marie S, Pontonnier C. Biomechanical requirements of meat cutting tasks: A pilot study quantifying tasks sustainability and assistance required at the wrist. APPLIED ERGONOMICS 2024; 116:104186. [PMID: 38052153 DOI: 10.1016/j.apergo.2023.104186] [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: 07/10/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 12/07/2023]
Abstract
The meat processing industry is particularly affected by distal upper limb musculoskeletal disorders. This pilot study aims at proposing a methodology able to quantify biomechanical requirements of meat cutting tasks at butchers' dominant wrist and, when necessary, at estimating the assistance needed to reach sustainability. Six professional butchers repeatedly cut pieces of pork. Joint angles were recorded using a motion capture system, cutting forces using an instrumented knife. Sustainability was computed by the maximal acceptable effort method. Assistance requirements were computed for isolated stressful exertions and for overall work cycle sustainability. Five butchers exceeded the sustainability threshold for wrist flexion. Ulnar or radial deviation torques were excessive for 2 and 3 of them, respectively. Extension torques were sustainable. The peak assistive torque for isolated exertions was at most 1.1Nm, 1.6Nm and 1.1Nm, and the percentage of assistance for overall sustainability was at most 60%, 56% and 56% for wrist flexion, ulnar and radial deviation, respectively.
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Atkins J, Chang D, Lee H. Design of a wearable shoulder exoskeleton robot with dual-purpose gravity compensation and a compliant misalignment compensation mechanism. WEARABLE TECHNOLOGIES 2024; 5:e4. [PMID: 38486861 PMCID: PMC10936389 DOI: 10.1017/wtc.2024.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/06/2023] [Accepted: 01/09/2024] [Indexed: 03/17/2024]
Abstract
This paper presents the design and validation of a wearable shoulder exoskeleton robot intended to serve as a platform for assistive controllers that can mitigate the risk of musculoskeletal disorders seen in workers. The design features a four-bar mechanism that moves the exoskeleton's center of mass from the upper shoulders to the user's torso, dual-purpose gravity compensation mechanism located inside the four-bar's linkages that supports the full gravitational loading from the exoskeleton with partial user's arm weight compensation, and a novel 6 degree-of-freedom (DoF) compliant misalignment compensation mechanism located between the end effector and the user's arm to allow shoulder translation while maintaining control of the arm's direction. Simulations show the four-bar design lowers the center of mass by cm and the kinematic chain can follow the motion of common upper arm trajectories. Experimental tests show the gravity compensation mechanism compensates gravitational loading within Nm over the range of shoulder motion and the misalignment compensation mechanism has the desired 6 DoF stiffness characteristics and range of motion to adjust for shoulder center translation. Finally, a workspace admittance controller was implemented and evaluated showing the system is capable of accurately reproducing simulated impedance behavior with transparent low-impedance human operation.
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Affiliation(s)
- John Atkins
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA
| | - Dongjune Chang
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA
| | - Hyunglae Lee
- School for Engineering of Matter, Transport and Energy, Arizona State University, Tempe, AZ, USA
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Goislard de Monsabert B, Caumes M, Berton E, Vigouroux L. Influence of Force-Length Relationship and Task-Specific Constraints on Finger Force-Generating Capacities. Ann Biomed Eng 2023; 51:2453-2464. [PMID: 37326945 DOI: 10.1007/s10439-023-03276-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 06/03/2023] [Indexed: 06/17/2023]
Abstract
Grip strength loss in extended and flexed wrist postures has been explained by reduced force-generating capacities of extrinsic finger flexor resulting from non-optimal length, owing to the force-length relationship. Recent works suggested that other muscles, especially wrist extensors, participate in this grip strength loss. The objective of this study was to clarify the role of the force-length relationship in finger force production. 18 participants performed maximal isometric finger force production during pinch grip (Pinch) and four-finger pressing (Press) tasks in four different wrist postures (extended, flexed, neutral, spontaneous). The maximum finger force (MFF), finger and wrist joint angles, as well as activation of four muscles were determined using dynamometry, motion capture, and electromyography. The force and length of the four muscles were estimated from joint angles and muscle activation using a musculoskeletal model. MFF decreased for flexed wrist during Pinch but remained stable across wrist postures during Press. The results suggested that the loss of pinch grip force in deviated wrist posture is partially related to force-length relationship of finger extensors. In opposition, MFF during Press was not influenced by the modulation of muscle capacities but was probably first limited by mechanical and neural factors related to finger interdependence.
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Affiliation(s)
| | | | - Eric Berton
- Aix-Marseille University, CNRS, ISM, Marseille, France
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Goislard de Monsabert B, Herbaut A, Cartier T, Vigouroux L. Electromyography-informed musculoskeletal modeling provides new insight into hand tendon forces during tennis forehand. Scand J Med Sci Sports 2023; 33:1958-1975. [PMID: 37340897 DOI: 10.1111/sms.14434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/12/2023] [Accepted: 06/09/2023] [Indexed: 06/22/2023]
Abstract
Lateral epicondylitis, also known as tennis elbow, is a major health issue among tennis players. This musculo-skeletal disorder affects hand extensor tendons, results in substantial pain and impairments for sporting and everyday activities and requires several weeks of recovery. Unfortunately, prevention remains limited by the lack of data regarding biomechanical risk factors, especially because in vivo evaluation of hand tendon forces remains challenging. Electromyography-informed musculo-skeletal modeling is a noninvasive approach to provide physiological estimation of tendon forces based on motion capture and electromyography but was never applied to study hand tendon loading during tennis playing. The objective of this study was to develop such electromyography-informed musculo-skeletal model to provide new insight into hand tendon loading in tennis players. The model was tested with three-dimensional kinematics and electromyography data of two players performing forehand drives at two-shot speeds and with three rackets. Muscle forces increased with shot speed but were moderately affected by racket properties. Wrist prime extensors withstood the highest forces, but their relative implication compared to flexors depended on the player-specific grip force and racket motion strategy. When normalizing wrist extensor forces by shot speed and grip strength, up to threefold differences were observed between players, suggesting that gesture technique, for example, grip position or joint motion coordination, could play a role in the overloading of wrist extensor tendons. This study provided a new methodology for in situ analysis of hand biomechanical loadings during tennis gesture and shed a new light on lateral epicondylitis risk factors.
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Affiliation(s)
| | - Alexis Herbaut
- Human Factors & Ergonomics Department, Decathlon SportsLab Research and Development, Lille, France
| | - Théo Cartier
- Aix-Marseille University, CNRS, ISM, Marseille, France
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7
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Aqueveque P, Peña G, Gutiérrez M, Gómez B, Germany E, Retamal G, Ortega-Bastidas P. Utilizing Motion Capture Systems for Instrumenting the OCRA Index: A Study on Risk Classification for Upper Limb Work-Related Activities. SENSORS (BASEL, SWITZERLAND) 2023; 23:7623. [PMID: 37688078 PMCID: PMC10490628 DOI: 10.3390/s23177623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 08/17/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023]
Abstract
In the search to enhance ergonomic risk assessments for upper limb work-related activities, this study introduced and validated the efficiency of an inertial motion capture system, paired with a specialized platform that digitalized the OCRA index. Conducted in a semi-controlled environment, the proposed methodology was compared to traditional risk classification techniques using both inertial and optical motion capture systems. The inertial method encompassed 18 units in a Bluetooth Low Energy tree topology network for activity recording, subsequently analyzed for risk using the platform. Principal outcomes emphasized the optical system's preeminence, aligning closely with the conventional technique. The optical system's superiority was further evident in its alignment with the traditional method. Meanwhile, the inertial system followed closely, with an error margin of just ±0.098 compared to the optical system. Risk classification was consistent across all systems. The inertial system demonstrated strong performance metrics, achieving F1-scores of 0.97 and 1 for "risk" and "no risk" classifications, respectively. Its distinct advantage of portability was reinforced by participants' feedback on its user-friendliness. The results highlight the inertial system's potential, mirroring the precision of both traditional and optical methods and achieving a 65% reduction in risk assessment time. This advancement mitigates the need for intricate video setups, emphasizing its potential in ergonomic assessments.
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Affiliation(s)
- Pablo Aqueveque
- Departamento de Ingeniería Eléctrica, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile; (G.P.); (E.G.); (G.R.)
| | - Guisella Peña
- Departamento de Ingeniería Eléctrica, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile; (G.P.); (E.G.); (G.R.)
| | - Manuel Gutiérrez
- Departamento de Ergonomía, Facultad de Ciencias Biológicas, Universidad de Concepción, Concepción 4070386, Chile;
| | - Britam Gómez
- Ingeniería Biomédica, Facultad de Ingeniería, Universidad de Santiago de Chile, Santiago 8320000, Chile;
| | - Enrique Germany
- Departamento de Ingeniería Eléctrica, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile; (G.P.); (E.G.); (G.R.)
| | - Gustavo Retamal
- Departamento de Ingeniería Eléctrica, Facultad de Ingeniería, Universidad de Concepción, Concepción 4070386, Chile; (G.P.); (E.G.); (G.R.)
| | - Paulina Ortega-Bastidas
- Departamento de Kinesiología, Facultad de Medicina, Universidad de Concepción, Concepción 4030000, Chile;
- Programa de Doctorado en Ciencias de la Salud, Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28943 Madrid, Spain
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Dahlgren G, Liv P, Öhberg F, Slunga Järvholm L, Forsman M, Rehn B. Correlations between Ratings and Technical Measurements in Hand-Intensive Work. Bioengineering (Basel) 2023; 10:867. [PMID: 37508893 PMCID: PMC10376394 DOI: 10.3390/bioengineering10070867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 07/11/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
An accurate rating of hand activity and force is essential in risk assessment and for the effective prevention of work-related musculoskeletal disorders. However, it is unclear whether the subjective ratings of workers and observers correlate to corresponding objective technical measures of exposure. Fifty-nine workers were video recorded while performing a hand-intensive work task at their workplace. Self-ratings of hand activity level (HAL) and force (Borg CR10) using the Hand Activity Threshold Limit Value® were assessed. Four ergonomist observers, in two pairs, also rated the hand activity and force level for each worker from video recordings. Wrist angular velocity was measured using inertial movement units. Muscle activity in the forearm muscles flexor carpi radialis (FCR) and extensor carpi radialis (ECR) was measured with electromyography root mean square values (RMS) and normalized to maximal voluntary electrical activation (MVE). Kendall's tau-b correlations were statistically significant between self-rated hand activity and wrist angular velocity at the 10th, 50th, and 90th percentiles (0.26, 0.31, and 0.23) and for the ratings of observers (0.32, 0.41, and 0.34). Significant correlations for force measures were found only for observer-ratings in five of eight measures (FCR 50th percentile 0.29, time > 10%MVE 0.43, time > 30%MVE 0.44, time < 5% -0.47) and ECR (time > 30%MVE 0.26). The higher magnitude of correlation for observer-ratings suggests that they may be preferred to the self-ratings of workers. When possible, objective technical measures of wrist angular velocity and muscle activity should be preferred to subjective ratings when assessing risks of work-related musculoskeletal disorders.
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Affiliation(s)
- Gunilla Dahlgren
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Per Liv
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Fredrik Öhberg
- Radiation Physics, Department of Radiation Sciences, Umeå University, S-901 87 Umeå, Sweden
| | - Lisbeth Slunga Järvholm
- Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, S-901 87 Umeå, Sweden
| | - Mikael Forsman
- IMM Institute of Environmental Medicine, Karolinska Institutet, S-171 77 Stockholm, Sweden
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, S-141 57 Huddinge, Sweden
| | - Börje Rehn
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, S-901 87 Umeå, Sweden
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Bouzgarrou L, Kheder A, Ben Afia L, Ormrane A, Hermassi F. Biomechanical Risk Factors of the Upper Limbs' Musculoskeletal Disorders among Carpet Weavers in Tunisia: Semi-Quantitative Ergonomic Assessment. Indian J Occup Environ Med 2023; 27:148-154. [PMID: 37600651 PMCID: PMC10434804 DOI: 10.4103/ijoem.ijoem_109_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 11/21/2022] [Accepted: 11/26/2022] [Indexed: 08/22/2023] Open
Abstract
Background Musculoskeletal disorders are one of the most common occupational health problems and one of the leading causes of temporary disability. This study aimed to assess the biomechanical constraints of upper limb musculoskeletal disorders associated with Tunisian weavers' tasks. Methodology An ergonomic approach was adopted with a representative sample of Tunisian weavers. First, the activity was observed mainly for identifying tasks and sub-tasks. Then, the biomechanical constraints were assessed based on the Borg scale and the software analyses and encoding of the 2,000 images extracted from the activity video recordings. These analyses were done with the ERGOROM software. Results Four main tasks were identified (warping of the loom, weaving itself, beating up, and finishing). As for the subtasks, the six most important were thread coiling, shedding and picking, beating up the weft, knotting, cutting, and shearing. Semi-quantitative analysis revealed that weavers spent most of their working time in the constrained neck and upper limb postures. Shoulders were in flexion/abduction during 68.6% of the activity and pinch grip was spread over 83.3% of the working time. Furthermore, elbows and wrists were highly concerned by elevated gestural variability scores. The estimated deployed strength was "medium" to "strong" in 50% to nearly 80% of cases. Conclusion According to the results, in carpet weavers, exposure to biomechanical constraints at risk of musculoskeletal disorders was high for the various joints and parts of the upper limbs. It is, therefore, necessary to carry out interventional studies for the development of ergonomic hand tools and workstations adapted to the traditional weaver activity.
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Affiliation(s)
- Lamia Bouzgarrou
- Department of Occupational Medicine and Ergonomics, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Asma Kheder
- Department of Occupational Medicine and Ergonomics, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Latifa Ben Afia
- Department of Occupational Medicine and Ergonomics, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Amira Ormrane
- Department of Occupational Medicine and Ergonomics, Faculty of Medicine, University of Monastir, Monastir, Tunisia
| | - Faten Hermassi
- Department of Occupational Medicine and Ergonomics, Faculty of Medicine, University of Monastir, Monastir, Tunisia
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Tilley PM, Mulla DM, Keir PJ. Effects of sex and age on work-related upper extremity musculoskeletal disorders in Ontario, Canada. Work 2023:WOR220175. [PMID: 36710702 DOI: 10.3233/wor-220175] [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: 01/25/2023] Open
Abstract
BACKGROUND Effective targeting of workplace upper extremity musculoskeletal disorder (MSD) prevention strategies requires the identification of demographic groups most at risk. Workers' compensation data provides an effective means of surveillance of MSDs at the population level. OBJECTIVE The primary purpose of this study was to identify the effects of age and sex on rates of tendon injuries of the wrist and hand, carpal tunnel syndrome (CTS), epicondylitis, and soft tissue shoulder injuries in Ontario, Canada between 2000-2019 using workers' compensation data from the Association of Workers Compensation Boards of Canada (AWCBC). METHODS Age and sex specific rates of lost-time injury claims from the four identified injury categories as well as "non-specific" upper extremity MSDs which did not fit into the four categories were calculated by standardizing injury claim totals with "at-risk" population estimates from the Canada Labour Force Survey. A multiple regression analysis was used to analyze the effects of age and sex on rates of specific injury claims. RESULTS Statistically significant age and sex effects were identified for rates of claims from tendon injuries of the wrist and hand, CTS, and shoulder injuries, while only age effects were significant for epicondylitis. Between 2000-2019, rates of claims from the four injury categories studied and the magnitude of the age and sex effects declined substantially over time. CONCLUSION Detailed surveillance of workplace ergonomic hazards in Ontario workplaces is needed to determine what is causing rates of upper extremity claims to decline.
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Affiliation(s)
- Paul M Tilley
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Daanish M Mulla
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
| | - Peter J Keir
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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Yang F, Di N, Guo WW, Ding WB, Jia N, Zhang H, Li D, Wang D, Wang R, Zhang D, Liu Y, Shen B, Wang ZX, Yin Y. The prevalence and risk factors of work related musculoskeletal disorders among electronics manufacturing workers: a cross-sectional analytical study in China. BMC Public Health 2023; 23:10. [PMID: 36597111 PMCID: PMC9809125 DOI: 10.1186/s12889-022-14952-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES To describe the prevalence of self-reported musculoskeletal disorders among workers in the electronics manufacturing industry and to investigate the relations between work-related musculoskeletal disorders (WMSDs) and work-related variables. METHODS An interview-based questionnaire survey was carried out in thirty electronics manufacturing factories in China in 2018. The prevalence of WMSDs was estimated using the modified Nordic Musculoskeletal Questionnaire (NMQ). A multivariate logistic regression model was applied to evaluate the effects of risk factors on WMSDs on multiple body parts. RESULTS The 12-month prevalence of WMSDs among participants was 40.6%, and the common body sites affected were the neck (26.8%), shoulder (22.8%), upper back (14.9%), and lower back (14.8%). The results of logistic regression showed that female adults, > 5 job tenure and work-related factors (including awkward posture, lifting or carrying weights, excessive repetition, prolonged sitting, monotonous work and working under conditions of cold or temperature variations) led to a higher risk of WMSDs on most body parts. Upper back, wrist/hand and elbow pain levels were significantly higher for workers with vibration. However, more frequently, physical exercise was a protective factor against WMSDs on most body parts except the upper back, leg and knee. CONCLUSIONS The study indicates a high prevalence of musculoskeletal pain among the electronics manufacturing industry in China. Different personal and work factors are related to the occurrence of WMSD on different body parts. Preventive measures should be implemented based on the characteristics of WMSD in the electronic manufacturing industry. Furthermore, the training and intervention guidance of ergonomic hazards in the workplace need to be strengthened by understanding the impact of bad posture, avoiding long-term sitting posture and increasing physical activities.
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Affiliation(s)
- Feng Yang
- grid.430328.eDepartment of Occupational Health and Poisoning Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Niu Di
- grid.430328.eDepartment of Occupational Health and Poisoning Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Wei-wei Guo
- grid.430328.eDepartment of Occupational Health and Poisoning Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Wen-bin Ding
- grid.430328.eDepartment of Occupational Health and Poisoning Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
| | - Ning Jia
- grid.508383.50000 0004 7588 9350Department of Occupational Protection and Ergonomics, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
| | - Hengdong Zhang
- grid.410734.50000 0004 1761 5845Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu China
| | - Dongxia Li
- Guizhou Province Occupational Disease Prevention and Control Hospital, Guiyang, Guizhou China
| | - Dayu Wang
- Tianjin Occupational Disease Prevention and Control Hospital, Tianjin, China
| | - Rugang Wang
- grid.418263.a0000 0004 1798 5707Beijing Center for Disease Control and Prevention, Beijing, China
| | - Danying Zhang
- Guangdong Province Hospital for Occupational Disease Prevention and Treatment, Guangzhou, Guangdong China
| | - Yongquan Liu
- Institute of Occupational Medicine of Jiangxi, Nanchang, Jiangxi China
| | - Bo Shen
- Fuzhou Center for Disease Control and Prevention, Fuzhou, Fujian China
| | - Zhong-xu Wang
- grid.508383.50000 0004 7588 9350Department of Occupational Protection and Ergonomics, National Institute of Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, 100050 China
| | - Yan Yin
- grid.430328.eDepartment of Occupational Health and Poisoning Control, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, 200336 China
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12
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Mojaeva E, McAlonan M, Scott A. The effect of rigid tape on wrist postures during tree planting. ERGONOMICS 2022:1-12. [PMID: 36274582 DOI: 10.1080/00140139.2022.2139417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/17/2022] [Indexed: 06/16/2023]
Abstract
Taping has been suggested to reduce the incidence of tendinopathy in tree planters. However, the ability of taping to reduce wrist postures during planting has not yet been formally evaluated. The primary aim was to test the effect of rigid taping on wrist postures during tree planting tasks. Eleven tree planters planted up to 50 trees in three conditions: no-tape (NT), tape-on-the-dorsum-of-the-hand (T1) and tape-on-the-thumb (T2) in a randomised cross-over, within-participant, repeat-measures design. Electrogoniometers (EG) recorded continuous wrist postures. Digital video recordings were used to segment EG traces of each planting cycle (one planted tree) into 4 kinematically distinct Phases. The tree and shovel wrist were analysed separately. Tree-wrist peak ulnar deviation and frequency of shovel-wrist awkward frontal plane postures were significantly reduced in the T2 condition. Taping may be effective at reducing non-neutral postures and should be researched further to determine its effectiveness in reducing tree planting injuries.Practitioner summary: The effect of rigid taping on wrist postures during tree planting has not yet been formally evaluated. A randomised cross-over, within-participant, repeat measures design was used to evaluate the effect of rigid taping on wrist postures during planting. Thumb rigid taping appeared to reduce wrist range of motion during planting. KEY POINTSTaping of the thumb reduced peak ulnar deviation of the tree wrist and frequency of awkward frontal plane postures of the shovel wrist.While taping of the dorsum of the hand appeared to be more restrictive, it did not significantly reduce wrist movement; this is likely because only its effect on sagittal plane posture was assessed which had a higher variance.Upon application, tape appeared to restrict voluntary movement patterns, decreased voluntary grip force exertion and physically restrain wrist movement.Overall, rigid tape was found to be an acceptable intervention for the tree planting occupation, with financial costs and perceived effort identified as the primary barriers to acceptability.
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Affiliation(s)
- Elizaveta Mojaeva
- Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Mike McAlonan
- Total Physiotherapy, Houston, British Columbia, Canada
| | - Alex Scott
- Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
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13
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Graben PR, Schall MC, Gallagher S, Sesek R, Acosta-Sojo Y. Reliability Analysis of Observation-Based Exposure Assessment Tools for the Upper Extremities: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191710595. [PMID: 36078310 PMCID: PMC9518117 DOI: 10.3390/ijerph191710595] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 08/22/2022] [Accepted: 08/23/2022] [Indexed: 05/13/2023]
Abstract
(1) Background: The objectives of this systematic review were to (i) summarize the results of studies evaluating the reliability of observational ergonomics exposure assessment tools addressing exposure to physical risk factors associated with upper extremity musculoskeletal disorders (MSDs), and (ii) identify best practices for assessing the reliability of new observational exposure assessment tools. (2) Methods: A broad search was conducted in March 2020 of four academic databases: PubMed, Science Direct, Ergonomic Abstracts, and Web of Science. Articles were systematically excluded by removing redundant articles, examining titles and abstracts, assessing relevance to physical ergonomics and the upper extremities, and article type. (3) Results: Eleven articles were included in the review. The results indicated no singular best practice; instead, there were multiple methodological approaches researchers chose to use. Some of the significant variations in methodologies include the selection of reliability coefficients, rater and participant selection, and direct vs. digital observation. (4) Conclusion: The findings serve as a resource summarizing the reliability of existing observational risk assessment tools and identify common methods for assessing the reliability of new observational risk assessment tools. Limitations of this review include the number of databases searched, the removal of truncation symbols, and the selection of keywords used for the initial search.
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Affiliation(s)
| | - Mark C. Schall
- Correspondence: (P.R.G.); (M.C.S.J.); Tel.: +1-(708)-539-8957 (M.C.S.J.)
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14
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Moro-López-Menchero P, Cigarán-Méndez MI, Florencio LL, Güeita-Rodríguez J, Fernández-de-Las-Peñas C, Palacios-Ceña D. Facing symptoms and limitations: a qualitative study of women with carpal tunnel syndrome. Scand J Occup Ther 2022:1-11. [PMID: 35995148 DOI: 10.1080/11038128.2022.2112970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
BACKGROUND Carpal tunnel syndrome (CTS) is a neuropathic pain condition characterised by pain, paresthesia, loss of strength and disability. OBJECTIVE To explore the experiences of women with CTS regarding the management of symptoms and limitations. METHODS A qualitative phenomenological study was conducted. Women with a clinical and electromyographic diagnosis of CTS recruited from the Neurology Department of a Public Hospital were included. Purposeful sampling was performed. Data were collected using in-depth interviews and researchers' field notes. Analysis proposed by Giorgi was used. RESULTS A total of 18 women with CTS were included. Two themes emerged: a) Living with CTS symptoms and limitations: describing the symptoms experienced, triggers of their symptoms and how they define CTS. Also, describing the difficulties that they experience on a daily basis, at home when handling tools, communicating, driving, and at work; and b) developing daily strategies for managing limitations: developing potential daily strategies to overcome daily limitations and/or compensate for them, and seeking professional help. CONCLUSIONS AND SIGNIFICANCE Current results provide insight on how symptoms and daily limitations are experienced by a group of women with CTS. These findings could help occupational therapists to understand the day-to-day difficulties and the reasons for developing certain strategies.
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Affiliation(s)
- Paloma Moro-López-Menchero
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine and Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Madrid, Spain
| | | | - Lidiane L Florencio
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine and Research Group of Manual Therapy, Dry Needling and Therapeutic Exercise of Universidad Rey Juan Carlos (GITM-URJC), Universidad Rey Juan Carlos, Madrid, Spain
| | - Javier Güeita-Rodríguez
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine and Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Madrid, Spain
| | - César Fernández-de-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine and Research Group of Manual Therapy, Dry Needling and Therapeutic Exercise of Universidad Rey Juan Carlos (GITM-URJC), Universidad Rey Juan Carlos, Madrid, Spain
| | - Domingo Palacios-Ceña
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine and Research Group of Humanities and Qualitative Research in Health Science of Universidad Rey Juan Carlos (Hum&QRinHS), Universidad Rey Juan Carlos, Madrid, Spain
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15
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Evaluation of a New Simplified Inertial Sensor Method against Electrogoniometer for Measuring Wrist Motion in Occupational Studies. SENSORS 2022; 22:s22041690. [PMID: 35214592 PMCID: PMC8874503 DOI: 10.3390/s22041690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/26/2022]
Abstract
Wrist velocity is an important risk factor for work-related musculoskeletal disorders in the elbow/hand, which is also difficult to assess by observation or self-reports. This study aimed to evaluate a new convenient and low-cost inertial measurement unit (IMU)-based method using gyroscope signals against an electrogoniometer for measuring wrist flexion velocity. Twelve participants performed standard wrist movements and simulated work tasks while equipped with both systems. Two computational algorithms for the IMU-based system, i.e., IMUnorm and IMUflex, were used. For wrist flexion/extension, the mean absolute errors (MAEs) of median wrist flexion velocity compared to the goniometer were <10.1°/s for IMUnorm and <4.1°/s for IMUflex. During wrist deviation and pronation/supination, all methods showed errors, where the IMUnorm method had the largest overestimations. For simulated work tasks, the IMUflex method had small bias and better accuracy than the IMUnorm method compared to the goniometer, with the MAEs of median wrist flexion velocity <5.8°/s. The results suggest that the IMU-based method can be considered as a convenient method to assess wrist motion for occupational studies or ergonomic evaluations for the design of workstations and tools by both researchers and practitioners, and the IMUflex method is preferred. Future studies need to examine algorithms to further improve the accuracy of the IMU-based method in tasks of larger variations, as well as easy calibration procedures.
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16
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Chimera NJ, Holmes MWR, Gabriel DA. Anthropometrics and electromyography as predictors for maximal voluntary isometric wrist torque: Considerations for ergonomists. APPLIED ERGONOMICS 2021; 97:103496. [PMID: 34171571 DOI: 10.1016/j.apergo.2021.103496] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 05/26/2021] [Accepted: 06/04/2021] [Indexed: 06/13/2023]
Abstract
The purpose of this study was to evaluate anthropometry and forearm muscle activity as predictors of maximal isometric wrist torque. Thirteen anthropometric measures, forearm electromyography from flexor carpi radialis (FCR) and extensor carpi radialis (ECR), and maximal isometric wrist flexion/extension torque were obtained from 25 male participants. Pearson correlation coefficients assessed relationships between peak isometric torque and: (1) anthropometrics, (2) FCR and ECR activation, (3) FCR/ECR antagonist/agonist coactivation ratios. Based on significant correlations, linear regression equations were developed (SPSS v.25; p < 0.05). Hand thickness, forearm circumference and ECR activation or hand thickness, elbow circumference, FCR activation and body weight were most highly correlated with extension or flexion torque, respectively. Hand thickness, forearm circumference, and ECR activation (R2 = 54.5%; p = 0.001) and hand thickness, elbow circumference, FCR activation (R2 = 68.3%; p < 0.001) explained similar variance in torque regressions as did the addition of body weight to extension (R2 = 58.0%; p = 0.001) and flexion (R2 = 69.9%; p < 0.001) torque regression equations, respectively. Circumference measurements, a pseudo for muscle size, and activation amplitude influenced wrist force output more than limb length or coactivation.
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Affiliation(s)
- Nicole J Chimera
- Department of Kinesiology, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, Canada.
| | - Michael W R Holmes
- Department of Kinesiology, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, Canada
| | - David A Gabriel
- Department of Kinesiology, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, Canada
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17
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Aavang Petersen J, Brauer C, Thygesen LC, Flachs EM, Lund CB, Thomsen JF. Repetitive and forceful movements of the hand as predictors of treatment for pain in the distal upper extremities. Occup Environ Med 2021; 79:55-62. [PMID: 34417338 PMCID: PMC8685618 DOI: 10.1136/oemed-2021-107543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/02/2021] [Indexed: 12/02/2022]
Abstract
Objective To investigate repetitive movements and the use of hand force as causes of treatment for distal upper extremities musculoskeletal disorders Methods A cohort of 202 747 workers in a pension health scheme from 2005 to 2017 in one of 17 jobs (eg, office work, carpentry, cleaning) was formed. Representative electro-goniometric measurements of wrist angular velocity as a measure for repetition and expert-rated use of hand force were used in a job exposure matrix (JEM). Job titles were retrieved from the Danish registers. Outcome was first treatment in the distal upper extremities. In a Poisson regression model, incidence rate ratios (IRRs) of treatment were adjusted for age, calendar-year, diagnosis of rheumatoid arthritis and arm fractures. In further analyses, wrist velocity or hand force was added. Results In men, wrist velocity had an IRR of 1.48 (95% CI 1.15 to 1.91) when the highest exposure level was compared with the lowest but with no clear exposure-response pattern. The effect became insignificant when adjusted for hand force. Hand force had an IRR of 2.65 (95% CI 2.13 to 3.29) for the highest versus the lowest exposure with an exposure-response pattern, which remained after adjustment for wrist velocity. Among women, no increased risk was found for hand force, while wrist velocity showed a significantly protective association with treatment. Conclusions In men, occupational exposure to hand force more than doubled the risk of seeking treatment. The results for exposure to repetition were less clear. In women, we could not find any indications of an increased risk neither for force nor for repetition.
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Affiliation(s)
| | - Charlotte Brauer
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Lau Caspar Thygesen
- National institute of Public Health, University of Southern Denmark, Odense, Denmark
| | | | - Christina Bach Lund
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
| | - Jane Frølund Thomsen
- Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Copenhagen, Denmark
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18
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Bakker R, Kalra M, Tomescu SS, Bahensky R, Chandrashekar N. The effects of pistol grip power tools on median nerve pressure and tendon strains. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:1904-1910. [PMID: 34212825 DOI: 10.1080/10803548.2021.1950992] [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: 10/20/2022]
Abstract
Objectives. Tendonitis and carpal tunnel syndrome are common cumulative trauma disorders that can occur with repetitive usage of pistol grip power tools. The role of reaction torque resulting in a forceful rotary displacement of the tool handle, as well as the role of applied grip force, is not clear in the development of these disorders. This study aimed to quantify the flexor tendon strains and median nerve pressure during a typical power tool operation securing a threaded fastener. Methods. Six fresh-frozen cadaver arms were made to grip a replica pistol grip power tool using static weights to apply muscle forces. A 5-Nm torque was applied to the replica power tool. The median nerve pressure and strains in the flexor digitorum profundus and superficialis tendons were measured using a catheter and strain gauges, at three wrist flexion angles. Results. The peak tendon strains were between 1.5 and 2% and were predominantly due to the grip force more than the transmitted torque. Median nerve pressure significantly increased with the wrist flexed versus extended. Conclusion. The results indicate that the contribution of the grip force to the tendon strain and median nerve pressure was greater than the contribution from the reaction torque.
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Affiliation(s)
- Ryan Bakker
- Mechanical and Mechatronics Engineering, University of Waterloo, Canada
| | - Mayank Kalra
- Mechanical and Mechatronics Engineering, University of Waterloo, Canada
| | | | - Robert Bahensky
- Mechanical and Mechatronics Engineering, University of Waterloo, Canada
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19
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Ehmke S, Farias Zuniga A, Keir PJ. Effect of Force, Posture, and Repetitive Wrist Motion on Intraneural Blood Flow in the Median Nerve. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2021; 40:939-950. [PMID: 32896908 DOI: 10.1002/jum.15467] [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: 02/24/2020] [Revised: 06/21/2020] [Accepted: 06/28/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVES Pinching, deviated wrist postures, and repetitive motion are risk factors for carpal tunnel syndrome. Hypervascularization of the median nerve and increased intraneural blood flow proximal to the carpal tunnel result in finger force and deviated wrist postures. The purpose of this study was to determine the effects of pinching with and without force, wrist posture, and repetitive wrist motion on intraneural blood flow in the median nerve. METHODS Eleven healthy and 11 carpal tunnel syndrome-symptomatic individuals completed 3 sections of this study: 15 pinch posture force trials, 3 repetitive wrist motion trials, and 3 static wrist posture trials. Intraneural blood flow (centimeters per second) was measured with pulsed wave Doppler ultrasound during each trial. Transverse B-mode images obtained from static trials were used to calculate the median nerve cross-sectional area and circumference. RESULTS An analysis of variance statistical analysis revealed significant main effects of pinch posture force (F4,80 = 21.397; P < .001) and wrist posture (F2,40 = 14.545; P < .001). Intraneural blood flow velocities were significantly greater when 6 N of force was applied by the thumb, finger, or pinch compared to no applied force in the same postures. Intraneural blood flow velocities were higher at 30° wrist flexion (mean ± SD, 2.24 ± 0.42 cm/s) than neutral (2.06 ± 0.45 cm/s) and 30° wrist extension (1.97 ± 0.46 cm/s). No changes were found in response to repetitive wrist motion. CONCLUSIONS Flexed wrists as well as applied finger and thumb forces increase median nerve blood flow at the entry to the carpal tunnel, which may negatively affect the median nerve.
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Affiliation(s)
- Samantha Ehmke
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Amanda Farias Zuniga
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
| | - Peter J Keir
- Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, Ontario, Canada
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20
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Feng B, Chen K, Zhu X, Ip WY, Andersen LL, Page P, Wang Y. Prevalence and risk factors of self-reported wrist and hand symptoms and clinically confirmed carpal tunnel syndrome among office workers in China: a cross-sectional study. BMC Public Health 2021; 21:57. [PMID: 33407293 PMCID: PMC7789363 DOI: 10.1186/s12889-020-10137-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 12/27/2020] [Indexed: 11/10/2022] Open
Abstract
Background Carpal tunnel syndrome (CTS) is a common cause of pain, numbness and tingling in the wrist and hand region and is associated with repetitive wrist and hand use in office workers. However, scarce knowledge exists about the epidemiology of clinically confirmed CTS among Chinese office workers. This study aimed to investigate the prevalence of wrist/hand symptoms and CTS in office workers in China and to identify associated risk factors. Methods A cross-sectional survey was carried out in a metropolitan city in China involving 969 respondents (aged 17–49 years) from 30 workplaces. A questionnaire was distributed to each participant to collect their demographic, work-related physical and psychosocial factors, and wrist and hand symptoms. The wrist and hand pain/numbness symptoms were marked on a body chart and the nature and intensity of symptoms, nocturnal symptoms, as well as aggravating activities were also recorded. Clinically confirmed CTS cases were screened based on the history, Phalen’s test, Tinel Sign and skin sensation testing among symptomatic respondents. Logistic regression was employed to estimate the odds ratio (OR) and 95% confidence interval (95% CI) for the occurrence of self-reported wrist and hand symptoms and clinically confirmed CTS. Results The clinically confirmed CTS prevalence was 9.6%. The prevalence of wrist and hand symptoms were 22 and 15%, respectively. Frequently working in pain was associated with higher odds of CTS. Multivariate modelling adjusted for age and gender showed that prolonged computer use time and working without breaks were associated with presence of wrist/hand symptoms (adjusted ORs: 1.11 (95% CI 1.02–1.22) and 1.88 (95% CI 1.12–3.14)). Educational level was inversely associated with CTS and smoking was associated with wrist/hand complaints (adjusted OR: 2.20 (95% CI 1.19–4.07)). Conclusions The prevalence of work-related clinically confirmed CTS symptoms among young office workers in China is high. Frequently working in pain is closely associated with clinically confirmed CTS. Intense computer use and no breaks at work are associated with wrist and hand symptoms.
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Affiliation(s)
- Beibei Feng
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, China.,Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, SAR, China
| | - Kedi Chen
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, China
| | - Xiaoxia Zhu
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, China
| | - Wing-Yuk Ip
- Department of Orthopaedics & Traumatology, The University of Hong Kong, Hong Kong, SAR, China.
| | - Lars L Andersen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Phil Page
- Doctor of Physical Therapy Program, Franciscan Missionaries of Our Lady University, Baton Rouge, Louisiana, USA
| | - Yuling Wang
- Department of Rehabilitation Medicine, The Sixth Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510655, China.
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21
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Glenday JD, Steinhilber B, Jung F, Haeufle DFB. Development of a musculoskeletal model of the wrist to predict frictional work dissipated due to tendon gliding resistance in the carpal tunnel. Comput Methods Biomech Biomed Engin 2020; 24:973-984. [PMID: 33356567 DOI: 10.1080/10255842.2020.1862094] [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: 10/22/2022]
Abstract
Carpal tunnel syndrome is an entrapment neuropathy that has been associated with the aggravation of tendon gliding resistance due to forceful, high velocity, awkwardly angled, and repetitive wrist motions. Cadaveric and epidemiological studies have shown that combinations of these risk factors have a more than additive effect. The aim of the current study was to develop a musculoskeletal model of the wrist that could evaluate these risk factors by simulating frictional work dissipated due to the gliding resistance of the third flexor digitorum superficialis tendon. Three flexion angle zones, three extension angle zones, five levels of task repetitiveness, and five levels of task effort were derived from ergonomic standards. Of the simulations performed by systematically combining these parameters, the extreme wrist flexion zone, at peak task repetitiveness and effort, dissipated the most frictional work. This zone dissipated approximately double the amount of frictional work compared to its equivalent zone in extension. For all motions, a multiplicative effect of the combination of task repetitiveness and effort on frictional work was identified by the musculoskeletal model, corroborating previous epidemiological and experimental studies. Overall, these results suggest that the ergonomic standards for wrist flexion-extension may need to be adjusted to reflect equivalent biomechanical impact and that workplace tasks should be designed to minimise exposure to combinations of highly repetitive and highly forceful work, especially when the wrist is highly flexed.
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Affiliation(s)
- J D Glenday
- Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany
| | - B Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, Eberhard-Karls University, Tübingen, Germany
| | - F Jung
- Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany.,Institute of Occupational and Social Medicine and Health Services Research, Eberhard-Karls University, Tübingen, Germany
| | - D F B Haeufle
- Multi-level Modeling in Motor Control and Rehabilitation Robotics, Hertie Institute for Clinical Brain Research, Eberhard-Karls University, Tübingen, Germany
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22
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Nambiema A, Bodin J, Fouquet N, Bertrais S, Stock S, Aublet-Cuvelier A, Descatha A, Evanoff B, Roquelaure Y. Upper-extremity musculoskeletal disorders: how many cases can be prevented? Estimates from the COSALI cohort. Scand J Work Environ Health 2020; 46:618-629. [PMID: 32638027 PMCID: PMC7737791 DOI: 10.5271/sjweh.3911] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Objective: This study aimed to estimate the proportion and number of incident upper-extremity musculoskeletal disorders (UEMSD) cases attributable to occupational risk factors in a working population. Methods: Between 2002−2005, occupational physicians randomly selected 3710 workers, aged 20–59, from the Pays de la Loire (PdL) region. All participants underwent a standardized clinical examination. Between 2007−2010, 1611 workers were re-examined. This study included 1246 workers who were free of six main clinically diagnosed UEMSD at baseline but were diagnosed with at least one of these UEMSD at follow-up [59% of men, mean age: 38 (standard deviation 8.6) years]. Relative risks and population-attributable fractions (PAF) were calculated using Cox multivariable models with equal follow-up time and robust variance. The total number of incident UEMSD in the PdL region was estimated after adjustment of the sample weights using 2007 census data. The estimated number of potentially avoidable UEMSD was calculated by multiplying PAF by the total number of incident UEMSD in PdL. Results: At follow-up, 139 new cases of UEMSD (11% of the study sample) were diagnosed. This represented an estimated 129 320 incident cases in the PdL in 2007. Following adjustment for personal factors, 26 381 (20.4% of all incident UEMSD) were attributable to high physical exertion, 16 682 (12.9%) to low social support, and 8535 (6.6%) to working with arms above shoulder level. Conclusions: A large number and important proportion of incident UEMSD may be preventable by reducing work exposures to physical exertion and working with arms above shoulder level as well as improving social support from co-workers/supervisors.
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Affiliation(s)
- Aboubakari Nambiema
- Irset - Inserm UMR 1085 - Equipe Ester, Faculté de santé - Département Médecine, 28 Rue Roger Amsler, 49100 Angers, France. , orcid.org/0000-0002-4258-3764
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23
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Babatunde FO, MacDermid J, Grewal R, Macedo L, Szekeres M. Development and Usability Testing of a Web-Based and Therapist-Assisted Coping Skills Program for Managing Psychosocial Problems in Individuals With Hand and Upper Limb Injuries: Mixed Methods Study. JMIR Hum Factors 2020; 7:e17088. [PMID: 32374265 PMCID: PMC7240444 DOI: 10.2196/17088] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 02/05/2020] [Accepted: 02/21/2020] [Indexed: 01/16/2023] Open
Abstract
Background Ineffective coping has been linked to prolonged pain, distress, anxiety, and depression after a hand and upper limb injury. Evidence shows that interventions based on cognitive behavioral therapy (CBT) may be effective in improving treatment outcomes, but traditional psychological interventions are resource intensive and unrealistic in busy hand therapy practices. Developing web-based, evidence-based psychological interventions specifically for hand therapy may be feasible in clinical practice and at home with reduced training and travel costs. Hand Therapy Online Coping Skills (HOCOS) is a program developed to supplement traditional hand therapy with therapist-assisted coping skills training based on principles from CBT and the Technology Acceptance Model. Objective This study aimed to describe the development and assess the usability of HOCOS to support hand therapists in the management of psychosocial problems. Methods The ADDIE model (Analysis, Design, Development, Implementation, and Evaluation) of system design was applied to create HOCOS. The usability testing of HOCOS involved a 2-stage process. In the first step, heuristic testing with information and communications technology (ICT) experts was completed using two sets of heuristics: Monkman heuristics and the Health Literacy Online (HLO) checklist. The second step involved user testing with hand therapists performing a series of online and face-to-face activities, completing 12 tasks on the website using the think-aloud protocol, completing the system usability scale (SUS) questionnaire, and a semistructured feedback interview in 2 iterative cycles. Descriptive statistics and content analyses were used to organize the data. Results In total, 4 ICT experts and 12 therapists completed usability testing. The heuristic evaluation revealed 15 of 35 violations on the HLO checklist and 5 of 11 violations on the Monkman heuristics. Initially, hand therapists found 5 tasks to be difficult but were able to complete all 12 tasks after the second cycle of testing. The cognitive interview findings were organized into 6 themes: task performance, navigation, design esthetics, content, functionality and features, and desire for future use. Usability issues identified were addressed in two iterative cycles. There was good agreement on all items of the SUS. Overall, therapists found that HOCOS was a detailed and helpful learning resource for therapists and patients. Conclusions We describe the development and usability testing of HOCOS; a new web-based psychosocial intervention for individuals with a hand and upper limb injuries. HOCOS targets psychosocial problems linked to prolonged pain and disability by increasing access to therapist-guided coping skills training. We actively involved target users in the development and usability evaluation of the website. The final website was modified to meet the needs and preferences of the participants.
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Affiliation(s)
- Folarin Omoniyi Babatunde
- School of Rehabilitation Science, Institute of Applied Health Science, McMaster University, Hamilton, ON, Canada
| | - Joy MacDermid
- School of Rehabilitation Science, Institute of Applied Health Science, McMaster University, Hamilton, ON, Canada.,Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care London, Western University, London, ON, Canada.,Department of Physical Therapy, Western University, London, ON, Canada
| | - Ruby Grewal
- Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care London, Western University, London, ON, Canada.,Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
| | - Luciana Macedo
- School of Rehabilitation Science, Institute of Applied Health Science, McMaster University, Hamilton, ON, Canada
| | - Mike Szekeres
- Roth McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care London, Western University, London, ON, Canada
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24
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Nambiema A, Bertrais S, Bodin J, Fouquet N, Aublet-Cuvelier A, Evanoff B, Descatha A, Roquelaure Y. Proportion of upper extremity musculoskeletal disorders attributable to personal and occupational factors: results from the French Pays de la Loire study. BMC Public Health 2020; 20:456. [PMID: 32252693 PMCID: PMC7137334 DOI: 10.1186/s12889-020-08548-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 03/18/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Upper extremity musculoskeletal disorders (UEMSD) are one of the most common and costly occupational health problems. We aimed to assess the population-attributable fraction (PAF) of personal and occupational risk factors associated with incident UEMSD in a working population. METHODS From 2002 to 2005, a random sample of 3710 workers from the Pays de la Loire region in France, aged 20-59 were included by occupational physicians (OPs). Between 2007 and 2010, 1611 workers were re-examined by their OPs. Subjects free from UEMSD at baseline were included in this study (1275 workers, mean age: 38.2 years). Cox regression models with equal follow-up time and robust variance estimates were used to estimate age-adjusted and multivariable-adjusted relative risks (RRs) and their 95% confidence intervals (CIs). Based on multivariable models, PAF associated with each factor included in the models was estimated. RESULTS During the follow-up period, 143 (11%) cases of UEMSD were diagnosed. PAFs for factors associated with the incident UEMSD risk were 30% (7 to 51) for high physical exertion (RPE Borg scale ≥12), 12% (- 0.2 to 24) for low social support, 7% (- 3 to 17) for working with arms above shoulder level (≥2 h/day), 20% (12 to 28) for age group ≥45, 13% (3 to 22) for the age group 35-44, and 12% (0.3 to 24) for female gender. CONCLUSIONS Our study suggests that an important fraction of UEMSD can be attributed to occupational exposures after the contributions of personal and other work-related factors are considered. In terms of public health, our findings are in agreement with the ergonomic literature postulating that a high proportion of UEMSD are preventable through modifying workplace risk factors. Such information is useful to help public health practitioners and policy makers implement programs of prevention of UEMSD in the working population.
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Affiliation(s)
- Aboubakari Nambiema
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France
| | - Sandrine Bertrais
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France
| | - Julie Bodin
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France
| | - Natacha Fouquet
- Santé publique France, the French national public health agency, Direction of Occupational Health, EpiprevTMS team associated to the University of Angers, F-49000 Angers, France
| | - Agnès Aublet-Cuvelier
- INRS, Département Homme au travail, 1 rue du Morvan CS60027, 54519 Vandoeuvre, France
| | - Bradley Evanoff
- Division of General Medical Sciences, Washington University School of Medicine, St. Louis, St. Louis, MO 13 63310 USA
| | - Alexis Descatha
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France
- Inserm, UMS 011, unité cohortes épidémiologiques en population, Villejuif, France
| | - Yves Roquelaure
- Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) - UMR_S 1085, F-49000 Angers, France
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25
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A Pilot Study of Five Types of Maximum Hand Strength among Manufacturing Industry Workers in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16234742. [PMID: 31783550 PMCID: PMC6926616 DOI: 10.3390/ijerph16234742] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 11/24/2019] [Accepted: 11/25/2019] [Indexed: 12/22/2022]
Abstract
Background: The purpose of this study is to collect five types of maximum hand strength among workers in the manufacturing industry in Taiwan. Methods: This study is a cross sectional study with a stratified and convenient sample of workers on the production line in manufacturing industries in Central Taiwan. In total, we recruited 198 healthy subjects to participate in this study. Five types of hand strength were measured in both hands three times with 3 min rests between trials. Results: The strength of females for these five types of hand exertions were 52.0% to 67.6% of the strength of males (p < 0.001). For both genders, there was a main effect for the types of hand strength for the right hand (p < 0.001) and the left hand (p < 0.001). In general, the hand strength in U.S. and EU countries was 1.2 to 1.7 times greater than the strength among the three types of hand exertions in this study. Conclusion: These results can be used to evaluate the musculoskeletal burdens on the upper extremities in the manufacturing industry and could also be used for tool and job design and job modifications.
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