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Feige S, Holzgreve F, Fraeulin L, Maurer-Grubinger C, Betz W, Erbe C, Nienhaus A, Groneberg DA, Ohlendorf D. Ergonomic Analysis of Dental Work in Different Oral Quadrants: A Motion Capture Preliminary Study among Endodontists. Bioengineering (Basel) 2024; 11:400. [PMID: 38671821 PMCID: PMC11048138 DOI: 10.3390/bioengineering11040400] [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: 02/18/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Dentists, including endodontists, frequently experience musculoskeletal disorders due to unfavourable working postures. Several measures are known to reduce the ergonomic risk; however, there are still gaps in the research, particularly in relation to dental work in the different oral regions (Quadrants 1-4). METHODS In this study (of a pilot character), a total of 15 dentists (8 male and 7 female) specialising in endodontics were measured while performing root canal treatments on a phantom head. These measurements took place in a laboratory setting using an inertial motion capture system. A slightly modified Rapid Upper Limb Assessment (RULA) coding system was employed for the analysis of kinematic data. The significance level was set at p = 0.05. RESULTS The ergonomic risk for the entire body was higher in the fourth quadrant than in the first quadrant for 80% of the endodontists and higher than in the second quadrant for 87%. For 87% of the endodontists, the ergonomic risk for the right side of the body was significantly higher in the fourth quadrant compared to the first and second quadrant. The right arm was stressed more in the lower jaw than in the upper jaw, and the neck also showed a greater ergonomic risk in the fourth quadrant compared to the first quadrant. CONCLUSION In summary, both the total RULA score and scores for the right- and lefthand sides of the body ranged between 5 and 6 out of a possible 7 points. Considering this considerable burden, heightened attention, especially to the fourth quadrant with a significantly higher ergonomic risk compared to Quadrants 1 and 2, may be warranted.
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Affiliation(s)
- Sophie Feige
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Fabian Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Laura Fraeulin
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Christian Maurer-Grubinger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Werner Betz
- Institute of Dentistry, Department of Dental Radiology, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Christina Erbe
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University, Augustusplatz 2, 55131 Mainz, Germany
| | - Albert Nienhaus
- Principles of Prevention and Rehabilitation Department (GPR), Institute for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany
| | - David A. Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
| | - Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University Frankfurt, Theodor-Stern-Kai 7, 60590 Frankfurt am Main, Germany
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Weitbrecht M, Holzgreve F, Fraeulin L, Haenel J, Betz W, Erbe C, Maurer-Grubinger C, Wanke EM, Brueggmann D, Nienhaus A, Groneberg DA, Ohlendorf D. Ergonomic Risk Assessment of Oral and Maxillofacial Surgeons - RULA Applied to Objective Kinematic Data. HUMAN FACTORS 2023; 65:1655-1673. [PMID: 35238681 DOI: 10.1177/00187208211053073] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND The prevalence of musculoskeletal disorders is high in oral and maxillofacial surgeons (OS) due to their static and contorted working positions. Hence, the aim of this study was to conduct posture analyses in this specific group of dental professionals using the Rapid Upper Limb Assessment (RULA). METHODS In total, 15 (12 m/3 f) OS participated in this study. An inertial motion capture system (Xsens) was used to collect kinematic data during a simulated workflow. Computer-based routines calculated the RULA score for the extracted joint angles at each defined time point. Then, an analysis of the time-dependent RULA scores by body regions was conducted. Key variables were the relative occurrence of specific RULA scores during the complete workflow, individual subtasks, and for treatment of each of the four different dental quadrants. The subtasks and dental quadrants were compared using the Friedman test. RESULTS The total median RULA score represented a high risk for OS during their work (7), including the temporal component (OS spent 77.54% of their working time with a RULA score of 7). The wrists and hands, elbows, lower arms, and the neck were exposed to postures with the highest risk for musculoskeletal strain. DISCUSSION For OS, both the right and the left assisting hand were heavily strained while working on the first dental quadrant caused the most unfavorable postures for OS.
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Affiliation(s)
- Moritz Weitbrecht
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Fabian Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Laura Fraeulin
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Jasmin Haenel
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Werner Betz
- Institute of Dentistry, Department of Dental Radiology, Goethe-University, Frankfurt am Main, Germany
| | - Christina Erbe
- Department of Orthodontics, Medical Center of the Johannes Gutenberg-University, Mainz, Germany
| | - Christian Maurer-Grubinger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Eileen M Wanke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Doerthe Brueggmann
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Albert Nienhaus
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), Institute for Health Services Research in Dermatology and Nursing (IVDP), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
| | - Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, Frankfurt am Main, Germany
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Serna Arnau S, Asensio-Cuesta S, Porcar Seder R. Musculoskeletal disorders risk assessment methods: a scoping review from a sex perspective. ERGONOMICS 2023; 66:1892-1908. [PMID: 36636799 DOI: 10.1080/00140139.2023.2168767] [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: 05/04/2022] [Accepted: 01/08/2023] [Indexed: 06/17/2023]
Abstract
The evidence points to differences in the impact of musculoskeletal disorders (MSD) in males and females due to different exposure to risk factors and inherent characteristics. To identify risks associated with MSDs, ergonomic assessment is carried out by applying various methods. The aim of this scoping review was to determine to what extent ergonomic assessment methods consider sex-related factors and if they were found to do so, to determine the extent of this consideration. A total of 31 papers on 32 ergonomic assessment methods were analysed in the review. Of these 32 methods, only 6 considered sex as an assessment parameter or when interpreting the results. The results revealed that the limited consideration given to the sex factor in ergonomic methods, together with the different impacts of MSDs and their consequences according to a person's sex, supports the importance of including sex factors in ergonomic assessment methods. Practitioner summary: This scoping review determined to what extent ergonomic assessment methods consider sex-related factors and if they do so, to establish the extent of such consideration. Of the 32 methods analysed, only 6 considered a person's sex. The results revealed that only a limited consideration is given to the sex factor in ergonomic methods.
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Affiliation(s)
- Sonia Serna Arnau
- Instituto de Biomecánica de Valencia (IBV), Universitat Politècnica de València, Valencia, Spain
| | - Sabina Asensio-Cuesta
- Instituto de Tecnologías de la Información y Comunicaciones (ITACA), Valencia, Spain
| | - Rosa Porcar Seder
- Instituto de Biomecánica de Valencia (IBV), Universitat Politècnica de València, Valencia, Spain
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Zadeh SM, MacDermid J, Johnson J, Birmingham TB, Shafiee E. Applications of wearable sensors in upper extremity MSK conditions: a scoping review. J Neuroeng Rehabil 2023; 20:158. [PMID: 37980497 PMCID: PMC10656914 DOI: 10.1186/s12984-023-01274-w] [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: 02/18/2023] [Accepted: 10/30/2023] [Indexed: 11/20/2023] Open
Abstract
PURPOSE This scoping review uniquely aims to map the current state of the literature on the applications of wearable sensors in people with or at risk of developing upper extremity musculoskeletal (UE-MSK) conditions, considering that MSK conditions or disorders have the highest rate of prevalence among other types of conditions or disorders that contribute to the need for rehabilitation services. MATERIALS AND METHODS The preferred reporting items for systematic reviews and meta-analysis (PRISMA) extension for scoping reviews guideline was followed in this scoping review. Two independent authors conducted a systematic search of four databases, including PubMed, Embase, Scopus, and IEEEXplore. We included studies that have applied wearable sensors on people with or at risk of developing UE-MSK condition published after 2010. We extracted study designs, aims, number of participants, sensor placement locations, sensor types, and number, and outcome(s) of interest from the included studies. The overall findings of our scoping review are presented in tables and diagrams to map an overview of the existing applications. RESULTS The final review encompassed 80 studies categorized into clinical population (31 studies), workers' population (31 studies), and general wearable design/performance studies (18 studies). Most were observational, with 2 RCTs in workers' studies. Clinical studies focused on UE-MSK conditions like rotator cuff tear and arthritis. Workers' studies involved industrial workers, surgeons, farmers, and at-risk healthy individuals. Wearable sensors were utilized for objective motion assessment, home-based rehabilitation monitoring, daily activity recording, physical risk characterization, and ergonomic assessments. IMU sensors were prevalent in designs (84%), with a minority including sEMG sensors (16%). Assessment applications dominated (80%), while treatment-focused studies constituted 20%. Home-based applicability was noted in 21% of the studies. CONCLUSION Wearable sensor technologies have been increasingly applied to the health care field. These applications include clinical assessments, home-based treatments of MSK disorders, and monitoring of workers' population in non-standardized areas such as work environments. Assessment-focused studies predominate over treatment studies. Additionally, wearable sensor designs predominantly use IMU sensors, with a subset of studies incorporating sEMG and other sensor types in wearable platforms to capture muscle activity and inertial data for the assessment or rehabilitation of MSK conditions.
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Affiliation(s)
- Sohrob Milani Zadeh
- Biomedical Engineering, Physical Therapy, Western University, London, ON, Canada.
| | - Joy MacDermid
- Physical Therapy and Surgery, Western University, London, ON, Canada
- Clinical Research Lab, Hand and Upper Limb Center, St. Joseph's Health Center, London, ON, Canada
- Rehabilitation Science McMaster University, Hamilton, ON, Canada
| | - James Johnson
- Roth-McFarlane Hand and Upper Limb Centre, St. Joseph's Health Care, London, ON, Canada
| | - Trevor B Birmingham
- Biomedical Engineering, Physical Therapy, Western University, London, ON, Canada
| | - Erfan Shafiee
- School of Rehabilitation Therapy, Queen's University, Kingston, ON, Canada
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Nowara R, Holzgreve F, Golbach R, Wanke EM, Maurer-Grubinger C, Erbe C, Brueggmann D, Nienhaus A, Groneberg DA, Ohlendorf D. Testing the Level of Agreement between Two Methodological Approaches of the Rapid Upper Limb Assessment (RULA) for Occupational Health Practice-An Exemplary Application in the Field of Dentistry. Bioengineering (Basel) 2023; 10:bioengineering10040477. [PMID: 37106664 PMCID: PMC10136304 DOI: 10.3390/bioengineering10040477] [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: 03/13/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 04/29/2023] Open
Abstract
BACKGROUND The Rapid Upper Limb Assessment (RULA) is used for the risk assessment of workplace-related activities. Thus far, the paper and pen method (RULA-PP) has been predominantly used for this purpose. In the present study, this method was compared with an RULA evaluation based on kinematic data using inertial measurement units (RULA-IMU). The aim of this study was, on the one hand, to work out the differences between these two measurement methods and, on the other, to make recommendations for the future use of the respective method on the basis of the available findings. METHODS For this purpose, 130 (dentists + dental assistants, paired as teams) subjects from the dental profession were photographed in an initial situation of dental treatment and simultaneously recorded with the IMU system (Xsens). In order to compare both methods statistically, the median value of the difference of both methods, the weighted Cohen's Kappa, and the agreement chart (mosaic plot) were applied. RESULTS In Arm and Wrist Analysis-area A-here were differences in risk scores; here, the median difference was 1, and the agreement in the weighted Cohen's kappa test also remained between 0.07 and 0.16 (no agreement to poor agreement). In area B-Neck, Trunk, and Leg Analysis-the median difference was 0, with at least one poor agreement in the Cohen's Kappa test of 0.23-0.39. The final score has a median of 0 and a Cohen's Kappa value of 0.21-0.28. In the mosaic plot, it can be seen that RULA-IMU had a higher discriminatory power overall and more often reached a value of 7 than RULA-PP. CONCLUSION The results indicate a systematic difference between the methods. Thus, in the RULA risk assessment, RULA-IMU is mostly one assessment point above RULA-PP. Therefore, future study results of RULA by RULA-IMU can be compared with literature results obtained by RULA-PP to further improve the risk assessment of musculoskeletal diseases.
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Affiliation(s)
- Ramona Nowara
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Fabian Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Rejane Golbach
- Institute of Biostatistics and Mathematical Modelling, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany
| | - Eileen M Wanke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Christian Maurer-Grubinger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Christina Erbe
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany
| | - Doerthe Brueggmann
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Albert Nienhaus
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany
- Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (Berufsgenossenschaft für Gesundheitsdienst und Wohlfahrtspflege-BGW), 22089 Hamburg, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany
| | - Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany
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6
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Holzgreve F, Fraeulin L, Maurer-Grubinger C, Betz W, Erbe C, Weis T, Janssen K, Schulte L, de Boer A, Nienhaus A, Groneberg DA, Ohlendorf D. Effects of Resistance Training as a Behavioural Preventive Measure on Musculoskeletal Complaints, Maximum Strength and Ergonomic Risk in Dentists and Dental Assistants. SENSORS (BASEL, SWITZERLAND) 2022; 22:8069. [PMID: 36298418 PMCID: PMC9609802 DOI: 10.3390/s22208069] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 06/16/2023]
Abstract
INTRODUCTION For dental professionals, musculoskeletal disorders (MSD) are common health hazards and resistance training programmes have been promising approaches in the quest for a reduction in the pain intensity of these professionals. Therefore, the aim of the current study was to investigate the effect of a trunk-oriented 10-week resistance training programme. METHOD In total, the study was conducted with 17 dentists and dental assistants (3 m/14 f) over a course of 10 weeks, with workouts being performed 2 times a week using a 60 min intervention programme consisting of 11 resistance training exercises. The outcome values that were collected were the pain intensity (visual analogue scale (VAS) combined with a modified version of the Nordic Questionnaire), the MVIC and the rapid upper limb assessment (RULA) score (based on data from inertial motion units) during a standardised dental treatment protocol. RESULTS A significant reduction in pain intensity was found for each queried body region: the neck, upper back, lower back and the right and left shoulders. The maximum voluntary isometric contraction (MVIC) improved significantly in all outcome measures: flexion, extension, right and left lateral flexion and right and left rotation. CONCLUSIONS A 10-week resistance training programme for dentists and dental assistants had significant effects on pain intensity reduction and the MVIC of the musculature of the trunk and is, therefore, suitable as a behavioural preventive measure against MSD in dental professionals.
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Affiliation(s)
- Fabian Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Laura Fraeulin
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Christian Maurer-Grubinger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Werner Betz
- Institute of Dentistry, Department of Dental Radiology, Goethe University, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Christina Erbe
- Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University Mainz, Augustusplatz 2, 55131 Mainz, Germany
| | - Tim Weis
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Keno Janssen
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Lisa Schulte
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Amaya de Boer
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Albert Nienhaus
- Principles of Prevention and Rehabilitation Department (GPR), Institute for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 22089 Hamburg, Germany
| | - David A. Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
| | - Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Building 9a, Theodor-Stern-Kai 7, 60596 Frankfurt am Main, Germany
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Holzgreve F, Fraeulin L, Betz W, Erbe C, Wanke EM, Brüggmann D, Nienhaus A, Groneberg DA, Maurer-Grubinger C, Ohlendorf D. A RULA-Based Comparison of the Ergonomic Risk of Typical Working Procedures for Dentists and Dental Assistants of General Dentistry, Endodontology, Oral and Maxillofacial Surgery, and Orthodontics. SENSORS (BASEL, SWITZERLAND) 2022; 22:805. [PMID: 35161550 PMCID: PMC8839213 DOI: 10.3390/s22030805] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/11/2022] [Accepted: 01/14/2022] [Indexed: 05/06/2023]
Abstract
BACKGROUND In general, the prevalence of work-related musculoskeletal disorders (WMSD) in dentistry is high, and dental assistants (DA) are even more affected than dentists (D). Furthermore, differentiations between the fields of dental specialization (e.g., general dentistry, endodontology, oral and maxillofacial surgery, or orthodontics) are rare. Therefore, this study aims to investigate the ergonomic risk of the aforementioned four fields of dental specialization for D and DA on the one hand, and to compare the ergonomic risk of D and DA within each individual field of dental specialization. METHODS In total, 60 dentists (33 male/27 female) and 60 dental assistants (11 male/49 female) volunteered in this study. The sample was composed of 15 dentists and 15 dental assistants from each of the dental field, in order to represent the fields of dental specialization. In a laboratory setting, all tasks were recorded using an inertial motion capture system. The kinematic data were applied to an automated version of the Rapid Upper Limb Assessment (RULA). RESULTS The results revealed significantly reduced ergonomic risks in endodontology and orthodontics compared to oral and maxillofacial surgery and general dentistry in DAs, while orthodontics showed a significantly reduced ergonomic risk compared to general dentistry in Ds. Further differences between the fields of dental specialization were found in the right wrist, right lower arm, and left lower arm in DAs and in the neck, right wrist, right lower arm, and left wrist in Ds. The differences between Ds and DAs within a specialist discipline were rather small. DISCUSSION Independent of whether one works as a D or DA, the percentage of time spent working in higher risk scores is reduced in endodontologists, and especially in orthodontics, compared to general dentists or oral and maxillofacial surgeons. In order to counteract the development of WMSD, early intervention should be made. Consequently, ergonomic training or strength training is recommended.
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Affiliation(s)
- Fabian Holzgreve
- Social Medicine and Environmental Medicine, Institute of Occupational Medicine, Goethe-University, 60590 Frankfurt, Germany; (L.F.); (E.M.W.); (D.B.); (D.A.G.); (C.M.-G.); (D.O.)
| | - Laura Fraeulin
- Social Medicine and Environmental Medicine, Institute of Occupational Medicine, Goethe-University, 60590 Frankfurt, Germany; (L.F.); (E.M.W.); (D.B.); (D.A.G.); (C.M.-G.); (D.O.)
| | - Werner Betz
- Department of Dental Radiology, Institute of Dentistry, Goethe-University, 60590 Frankfurt, Germany;
| | - Christina Erbe
- Medical Center of the Johannes Gutenberg, Department of Orthodontics, University Mainz, 55131 Mainz, Germany;
| | - Eileen M. Wanke
- Social Medicine and Environmental Medicine, Institute of Occupational Medicine, Goethe-University, 60590 Frankfurt, Germany; (L.F.); (E.M.W.); (D.B.); (D.A.G.); (C.M.-G.); (D.O.)
| | - Dörthe Brüggmann
- Social Medicine and Environmental Medicine, Institute of Occupational Medicine, Goethe-University, 60590 Frankfurt, Germany; (L.F.); (E.M.W.); (D.B.); (D.A.G.); (C.M.-G.); (D.O.)
| | - Albert Nienhaus
- Principles of Prevention and Rehabilitation Department (GPR), Institute for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 20095 Hamburg, Germany;
| | - David A. Groneberg
- Social Medicine and Environmental Medicine, Institute of Occupational Medicine, Goethe-University, 60590 Frankfurt, Germany; (L.F.); (E.M.W.); (D.B.); (D.A.G.); (C.M.-G.); (D.O.)
| | - Christian Maurer-Grubinger
- Social Medicine and Environmental Medicine, Institute of Occupational Medicine, Goethe-University, 60590 Frankfurt, Germany; (L.F.); (E.M.W.); (D.B.); (D.A.G.); (C.M.-G.); (D.O.)
| | - Daniela Ohlendorf
- Social Medicine and Environmental Medicine, Institute of Occupational Medicine, Goethe-University, 60590 Frankfurt, Germany; (L.F.); (E.M.W.); (D.B.); (D.A.G.); (C.M.-G.); (D.O.)
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8
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Blume KS, Holzgreve F, Fraeulin L, Erbe C, Betz W, Wanke EM, Brueggmann D, Nienhaus A, Maurer-Grubinger C, Groneberg DA, Ohlendorf D. Ergonomic Risk Assessment of Dental Students-RULA Applied to Objective Kinematic Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910550. [PMID: 34639850 PMCID: PMC8508251 DOI: 10.3390/ijerph181910550] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 01/27/2023]
Abstract
Musculoskeletal disorder (MSD) is already prevalent in dental students despite their young age and the short duration of dental practice. The current findings state that the causes of MSD are related to posture during dental work. This study aims to investigate the ergonomic risk of dental students. In order to analyze the ergonomic risk of dental students, 3D motion analyses were performed with inertial sensors during the performance of standardized dental activities. For this purpose, 15 dental students and 15 dental assistant trainees (all right-handed) were measured in a team. Data were analyzed using the Rapid Upper Limb Assessment (RULA), which was modified to evaluate objective data. Ergonomic risk was found for the following body parts in descending order: left wrist, right wrist, neck, trunk, left lower arm, right lower arm, right upper arm, left upper arm. All relevant body parts, taken together, exhibited a posture with the highest RULA score that could be achieved (median Final Overall = 7), with body parts in the very highest RULA score of 7 for almost 80% of the treatment time. Dental students work with poor posture over a long period of time, exposing them to high ergonomic risk. Therefore, it seems necessary that more attention should be paid to theoretical and practical ergonomics in dental school.
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Affiliation(s)
- Kim Sarah Blume
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60596 Frankfurt am Main, Germany; (K.S.B.); (F.H.); (L.F.); (E.M.W.); (D.B.); (C.M.-G.); (D.A.G.)
| | - Fabian Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60596 Frankfurt am Main, Germany; (K.S.B.); (F.H.); (L.F.); (E.M.W.); (D.B.); (C.M.-G.); (D.A.G.)
| | - Laura Fraeulin
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60596 Frankfurt am Main, Germany; (K.S.B.); (F.H.); (L.F.); (E.M.W.); (D.B.); (C.M.-G.); (D.A.G.)
| | - Christina Erbe
- Department of Orthodontics, School of Dentistry, University Medical Centre of the Johannes Gutenberg University, 55131 Mainz, Germany;
| | - Werner Betz
- Institute of Dentistry, Goethe-University, 60596 Frankfurt am Main, Germany;
| | - Eileen M. Wanke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60596 Frankfurt am Main, Germany; (K.S.B.); (F.H.); (L.F.); (E.M.W.); (D.B.); (C.M.-G.); (D.A.G.)
| | - Doerthe Brueggmann
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60596 Frankfurt am Main, Germany; (K.S.B.); (F.H.); (L.F.); (E.M.W.); (D.B.); (C.M.-G.); (D.A.G.)
| | - Albert Nienhaus
- Principles of Prevention and Rehabilitation Department (GPR), Institute for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 20251 Hamburg, Germany;
| | - Christian Maurer-Grubinger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60596 Frankfurt am Main, Germany; (K.S.B.); (F.H.); (L.F.); (E.M.W.); (D.B.); (C.M.-G.); (D.A.G.)
| | - David A. Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60596 Frankfurt am Main, Germany; (K.S.B.); (F.H.); (L.F.); (E.M.W.); (D.B.); (C.M.-G.); (D.A.G.)
| | - Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, 60596 Frankfurt am Main, Germany; (K.S.B.); (F.H.); (L.F.); (E.M.W.); (D.B.); (C.M.-G.); (D.A.G.)
- Correspondence: ; Tel.: +49-69-63015622
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Ergonomic Comparison of Four Dental Workplace Concepts Using Inertial Motion Capture for Dentists and Dental Assistants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910453. [PMID: 34639753 PMCID: PMC8507819 DOI: 10.3390/ijerph181910453] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 11/17/2022]
Abstract
When the inventory is arranged in a dental practice, a distinction can be made between four different dental workplace concepts (DWCs). Since the prevalence of musculoskeletal diseases in dental professionals is very high, preventive solution need to be investigated. As the conventionally used DWCs have, to date, never been studied in terms of their ergonomics, this study aims to investigate the ergonomic risk when working at the four different DWCs. In total, 75 dentists (37 m/38 f) and 75 dental assistants (16 m/59 f) volunteered to take part in this study. Standardized cooperative working procedures were carried out in a laboratory setting and kinematic data were recorded using an inertial motion capture system. The data were applied to an automated version of the Rapid Upper Limb Assessment (RULA). Comparisons between the DWCs and between the dentists and dental assistants were calculated. In all four DWCs, both dentists and dental assistants spent 95–97% of their working time in the worst possible RULA score. In the trunk, DWCs 1 and 2 were slightly favorable for both dentists and dental assistants, while for the neck, DWC 4 showed a lower risk score for dentists. The ergonomic risk was extremely high in all four DWCs, while only slight advantages for distinct body parts were found. The working posture seemed to be determined by the task itself rather than by the different inventory arrangements.
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Rickert C, Fels U, Gosheger G, Kalisch T, Liem D, Klingebiel S, Schneider KN, Schorn D. Prevalence of Musculoskeletal Diseases of the Upper Extremity Among Dental Professionals in Germany. Risk Manag Healthc Policy 2021; 14:3755-3766. [PMID: 34539191 PMCID: PMC8443801 DOI: 10.2147/rmhp.s316795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 08/10/2021] [Indexed: 11/23/2022] Open
Abstract
Objective Although many findings on occupational musculoskeletal complaints are available from American and European dentists, the corresponding data from Germany are still scarce. Therefore, the aim of this study was to provide additional information on the prevalence of and risk factors for musculoskeletal disorders of the upper extremity, particularly the shoulder in this specific population. Methods A written survey was carried out among 600 dentists in the state of North Rhine-Westphalia, Germany. Questionnaire items included physical and psychosocial workload, general health, and the occurrence of musculoskeletal symptoms during the previous 12 months that led to sick leave and medical care according to a modified version of the Nordic Musculoskeletal Questionnaire (NMQ). Regression analysis was used to evaluate relevant risk factors for severe musculoskeletal disorders. Results A total of 229 dentists were participated in the study (response rate 38%). Overall, 92.6% of the participants had already suffered from musculoskeletal symptoms in at least one body region. Symptoms were mostly reported in the neck (65.1%) and in the shoulder (58.1%). Limitations in daily activities were experienced by 15.9% due to neck pain and by 15.4% due to shoulder pain. Medical care was sought by 23.7% because of neck pain and by 21.1% due to shoulder pain. Risk factors for symptoms in the upper extremity regions were gender (female), increased physical load, and numerous comorbidities. Conclusion There is a high prevalence of musculoskeletal disorders among dentists. Suitable interventions are therefore needed to prevent musculoskeletal diseases and pain among dental professionals, with particular attention to female dentists.
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Affiliation(s)
- Carolin Rickert
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | - Ulrike Fels
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | - Georg Gosheger
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | - Tobias Kalisch
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | | | - Sebastian Klingebiel
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
| | | | - Dominik Schorn
- Department of General Orthopedics and Tumor Orthopedics, Münster University Hospital, Münster, Germany
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Maurer-Grubinger C, Holzgreve F, Fraeulin L, Betz W, Erbe C, Brueggmann D, Wanke EM, Nienhaus A, Groneberg DA, Ohlendorf D. Combining Ergonomic Risk Assessment (RULA) with Inertial Motion Capture Technology in Dentistry-Using the Benefits from Two Worlds. SENSORS 2021; 21:s21124077. [PMID: 34199273 PMCID: PMC8231853 DOI: 10.3390/s21124077] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/07/2021] [Accepted: 06/10/2021] [Indexed: 12/12/2022]
Abstract
Traditional ergonomic risk assessment tools such as the Rapid Upper Limb Assessment (RULA) are often not sensitive enough to evaluate well-optimized work routines. An implementation of kinematic data captured by inertial sensors is applied to compare two work routines in dentistry. The surgical dental treatment was performed in two different conditions, which were recorded by means of inertial sensors (Xsens MVN Link). For this purpose, 15 (12 males/3 females) oral and maxillofacial surgeons took part in the study. Data were post processed with costume written MATLAB® routines, including a full implementation of RULA (slightly adjusted to dentistry). For an in-depth comparison, five newly introduced levels of complexity of the RULA analysis were applied, i.e., from lowest complexity to highest: (1) RULA score, (2) relative RULA score distribution, (3) RULA steps score, (4) relative RULA steps score occurrence, and (5) relative angle distribution. With increasing complexity, the number of variables times (the number of resolvable units per variable) increased. In our example, only significant differences between the treatment concepts were observed at levels that are more complex: the relative RULA step score occurrence and the relative angle distribution (level 4 + 5). With the presented approach, an objective and detailed ergonomic analysis is possible. The data-driven approach adds significant additional context to the RULA score evaluation. The presented method captures data, evaluates the full task cycle, and allows different levels of analysis. These points are a clear benefit to a standard, manual assessment of one main body position during a working task.
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Affiliation(s)
- Christian Maurer-Grubinger
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, 60323 Frankfurt am Main, Germany; (C.M.-G.); (L.F.); (D.B.); (E.M.W.); (D.A.G.); (D.O.)
| | - Fabian Holzgreve
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, 60323 Frankfurt am Main, Germany; (C.M.-G.); (L.F.); (D.B.); (E.M.W.); (D.A.G.); (D.O.)
- Correspondence:
| | - Laura Fraeulin
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, 60323 Frankfurt am Main, Germany; (C.M.-G.); (L.F.); (D.B.); (E.M.W.); (D.A.G.); (D.O.)
| | - Werner Betz
- Institute of Dentistry, Department of Dental Radiology, Goethe-University, 60323 Frankfurt am Main, Germany;
| | - Christina Erbe
- Department of Orthodontics, Medical Center of the Johannes Gutenberg-University Mainz, 55128 Mainz, Germany;
| | - Doerthe Brueggmann
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, 60323 Frankfurt am Main, Germany; (C.M.-G.); (L.F.); (D.B.); (E.M.W.); (D.A.G.); (D.O.)
| | - Eileen M. Wanke
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, 60323 Frankfurt am Main, Germany; (C.M.-G.); (L.F.); (D.B.); (E.M.W.); (D.A.G.); (D.O.)
| | - Albert Nienhaus
- Principles of Prevention and Rehabilitation Department (GPR), Institute for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), 20246 Hamburg, Germany;
| | - David A. Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, 60323 Frankfurt am Main, Germany; (C.M.-G.); (L.F.); (D.B.); (E.M.W.); (D.A.G.); (D.O.)
| | - Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University, 60323 Frankfurt am Main, Germany; (C.M.-G.); (L.F.); (D.B.); (E.M.W.); (D.A.G.); (D.O.)
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Ramírez-Sepúlveda KA, Gómez-Arias MY, Agudelo-Suárez AA, Ramírez-Ossa DM. Musculoskeletal disorders and related factors in the Colombian orthodontists' practice. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2021; 28:672-681. [PMID: 33256537 DOI: 10.1080/10803548.2020.1857975] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Objective. This study aimed to characterize the symptoms of musculoskeletal disorders (MSDs) and their related factors in a group of orthodontists in the city of Medellín (Colombia). Methods. A cross-sectional study was conducted in a sample of 100 orthodontists. A survey provided sociodemographic and work-related information. MSDs were recorded through the Nordic questionnaire. Descriptive and bivariate analyses were carried out by determining the prevalence of MSD symptoms by anatomical zone and selected variables. Results. Prevalence of MSDs was 81% for males and 88% for females. Anatomical regions were the neck (males 44%, females 59%), shoulders (males 44%, females 48%), lower back-lumbar zone (males 63%, females 51%), elbow-forearm (males 15%, females 15%) and wrist-hand (males 32%, females 51%). The frequency of symptoms was higher in males >41 years old, with more than a work contract or females who worked >40 h per week, and in orthodontists (males-females) who reported higher work-related dissatisfaction levels. Conclusions. A high prevalence of MSDs was found among orthodontists, with differences in the frequency of symptoms related to sociodemographic and work-related factors. Preventive strategies related to health and work safety would be advisable considering the particular needs of this dentist group.
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