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Vahedi Z, Kazemi Z, Sharifnezhad A, Mazloumi A. Perceived Discomfort, Neck Kinematics, and Muscular Activity During Smartphone Usage: A Comparative Study. HUMAN FACTORS 2024; 66:437-450. [PMID: 35477293 DOI: 10.1177/00187208221087760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE The present study aims to evaluate the effects of posture, task, and handgrip style on discomfort, neck kinematics, and concomitant muscular activity when using a smartphone (SP). BACKGROUND Along with the popularity of smartphones, musculoskeletal disorders have become prevalent among smartphone users. However, comprehensive aspects of discomfort, kinematics, and electromyographic responses across various conditions remain to be investigated. METHOD Twenty-four young smartphone users performed typing, video watching, and reading tasks while holding the smartphone both with one hand and with two hands while either sitting or standing. Neck kinematics and muscular activities were simultaneously recorded. RESULTS Working with SPs led to higher discomfort in the neck (p = 0.01), lower back (p = 0.01), and shoulder (p = 0.04) while sitting as compared to standing. Sitting was associated with greater neck flexion and more minor lateral bending for all tasks and grip styles (p < 0.05). Electromyographic analysis indicated significant differences between sitting and standing, with alterations being dependent on the test condition. Moreover, neck kinematics and muscular activities significantly differed based on the task nature, handgrip, and interactions. CONCLUSION This study highlights the risk of using smartphones in increased neck angle flexion and muscular activities fatigue. Thus, posture and handgrip should be considered while using SPs. As each test condition affects a specific dependent variable, a holistic approach is required to evaluate the responses of SP users' musculoskeletal systems. APPLICATION Results can be applied to develop guidelines for musculoskeletal disorders/discomfort prevention among SP users, especially with the rise of smartphone use during the COVID-19 pandemic.
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Affiliation(s)
- Zahra Vahedi
- Department of Industrial and Systems Engineering, University at Buffalo, Buffalo, NY, USA
| | - Zeinab Kazemi
- Department of Industrial Engineering, Clemson University, Clemson, USA
| | - Ali Sharifnezhad
- Centre of Sports Biomechanics, Sport Sciences Research Institute, Tehran, Iran
| | - Adel Mazloumi
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran, Department of Occupational Health Engineering, School of Public Health, Tehran University of Medical Sciences
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Kia K, Kincl L, Chan A, Kim JH. A fishermen-developed intervention reduced musculoskeletal load associated with commercial Dungeness crab harvesting. APPLIED ERGONOMICS 2023; 110:104016. [PMID: 36989738 DOI: 10.1016/j.apergo.2023.104016] [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: 09/06/2022] [Revised: 03/09/2023] [Accepted: 03/12/2023] [Indexed: 06/19/2023]
Abstract
This study characterized physical risk factors associated with injuries during a Dungeness crab harvesting task and evaluated the efficacy of a fishermen-developed ergonomic control (banger bar) in mitigating physical risk factors, including biomechanical loads in the low back, shoulders, and upper extremities, and postural instability. In a repeated-measures laboratory study, 25 healthy male participants performed manual crab harvesting tasks in five conditions: without any banger bar (control) and with 4 bars of differing heights or designs. The results showed that the ergonomic control reduced trunk and shoulder angles, L5/S1, and shoulder moments; muscle activities in low back, shoulders, and upper extremities; perceived exertion ratings; and postural sway measures. Moreover, these measures were lowest when the bar height was at 60 cm, indicating that the banger bar can reduce the risk of musculoskeletal injuries and postural instability, and that bar height is an important factor affecting these injury risk measures.
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Affiliation(s)
- Kiana Kia
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Laurel Kincl
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Allen Chan
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Jeong Ho Kim
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
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Christensen SWM, Palsson TS, Krebs HJ, Graven-Nielsen T, Hirata RP. Prolonged slumped sitting causes neck pain and increased axioscapular muscle activity during a computer task in healthy participants - A randomized crossover study. APPLIED ERGONOMICS 2023; 110:104020. [PMID: 36958253 DOI: 10.1016/j.apergo.2023.104020] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 06/18/2023]
Abstract
INTRODUCTION Sitting posture may contribute to spinal pain. Effects of postures on pain, sensitivity and muscle activity during computer tasks were investigated. METHODS Twenty-five healthy participants, seated at a workstation without backrest, completed four, 15-min typing tasks: A)Upright with forearm-support; B)Upright without forearm-support; C)Slumped with forearm-support; D)Slumped without forearm-support. Participants rated pain every minute on a numerical rating scale (NRS). RMS-EMG was recorded from upper/lower trapezius (UT, LT), serratus anterior and anterior/middle deltoid. At baseline and after tasks, pressure pain thresholds (PPTs) were recorded bilaterally over the head, UT, and leg. RESULTS All tasks caused clinically relevant increased NRS (≥2/10) compared to baseline (P < 0.001). NRS was higher in Task-D (P < 0.003) and lower in Task-B (P < 0.005) than others. PPTs did not change from baseline. Task-D caused higher UT and LT RMS-EMG (P < 0.02) than other tasks. CONCLUSION A 15-min task caused pain irrespective of posture with some causing larger changes than others.
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Affiliation(s)
- Steffan Wittrup McPhee Christensen
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark; Department of Physiotherapy, University College of Northern Denmark (UCN), Aalborg, Denmark.
| | - Thorvaldur Skuli Palsson
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark; Department of Physiotherapy and Occupational Therapy, Aalborg University Hospital, Denmark
| | - Hans Jørgen Krebs
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark
| | - Thomas Graven-Nielsen
- Center for Neuroplasticity and Pain (CNAP), Department of Health Science and Technology, Aalborg University, Denmark
| | - Rogerio Pessoto Hirata
- Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Denmark; Sport Sciences - Performance and Technology, Department of Health Science and Technology Aalborg University, Denmark
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Kong YK, Park SS, Shim JW, Choi KH, Shim HH, Kia K, Kim JH. A passive upper-limb exoskeleton reduced muscular loading during augmented reality interactions. APPLIED ERGONOMICS 2023; 109:103982. [PMID: 36739780 DOI: 10.1016/j.apergo.2023.103982] [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: 09/24/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
The aim of this study was to evaluate a passive upper-limb exoskeleton as an ergonomic control to reduce the musculoskeletal load in the shoulders associated with augmented reality (AR) interactions. In a repeated-measures laboratory study, each of the 20 participants performed a series of AR tasks with and without a commercially-available upper-limb exoskeleton. During the AR tasks, muscle activity (anterior, middle, posterior deltoid, and upper trapezius), shoulder joint postures/moment, and self-reported discomfort were collected. The results showed that the exoskeleton significantly reduced muscle activity in the upper trapezius and deltoid muscle groups and self-reported discomfort. However, the shoulder postures and task performance measures were not affected by the exoskeleton during the AR interactions. Given the significant decrease in muscle activity and discomfort without compromising task performance, a passive exoskeleton can be an effective ergonomic control measure to reduce the risks of developing musculoskeletal discomfort or injuries in the shoulder regions.
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Affiliation(s)
- Yong-Ku Kong
- Department of Industrial Engineering, Sungkyunkwan University, Corvallis, OR, USA
| | - Sang-Soo Park
- Department of Industrial Engineering, Sungkyunkwan University, Corvallis, OR, USA
| | - Jin-Woo Shim
- Department of Industrial Engineering, Sungkyunkwan University, Corvallis, OR, USA
| | - Kyeong-Hee Choi
- Department of Industrial Engineering, Sungkyunkwan University, Corvallis, OR, USA
| | - Hyun-Ho Shim
- Department of Industrial Engineering, Sungkyunkwan University, Corvallis, OR, USA
| | - Kiana Kia
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Jeong Ho Kim
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
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Santiago RJ, Baptista JS, Magalhães A, Costa JT. Impact of a 10-min typing task in the development of trapezius myalgia: a preliminary observational study. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2023; 29:115-120. [PMID: 34989660 DOI: 10.1080/10803548.2022.2026064] [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: 10/19/2022]
Abstract
Objectives. Computer use, as in typing, might contribute to trapezius myalgia (TM) development by increasing upper trapezius (UT) muscle fatigue. The purpose of this study is to investigate whether 10 min of performing a typing task by a population at risk would show significant changes in surface electromyography (sEMG) and pressure pain threshold (PPT) measurements. Supported and unsupported forearms postures are compared. Methods. Sixteen asymptomatic volunteers with minimum daily use of a computer of 5 h were randomized into two groups: fully supported forearms (n = 8) and unsupported forearms (n = 8). The protocol consisted of 10 min of a typing task, and the workstation was set according to the usual participant profile. sEMG and PPT readings were collected from both UT muscles. Results. PPT and sEMG readings were not significantly different among the two groups. Supported forearms had less reduction of PPT and a smaller increase in electrical activity. Conclusions. Ten minutes of typing seems insufficient to observe any significant changes that could lead to TM development.
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Affiliation(s)
- Rui José Santiago
- Faculty of Engineering, University of Porto, Portugal.,Porto Biomechanics Laboratory (Labiomep), University of Porto, Portugal
| | | | - André Magalhães
- School of Health Sciences, University Fernando Pessoa, Portugal
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Rungkitlertsakul S, Bhuanantanondh P, Buchholz B. The effect of tablet tilt angles and time on posture, muscle activity, and discomfort at the neck and shoulder in healthy young adults. PLoS One 2023; 18:e0283521. [PMID: 36952497 PMCID: PMC10035825 DOI: 10.1371/journal.pone.0283521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/09/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Although young adults regularly perform tablet writing, biomechanics during the tablet writing with different tilt angles has not been studied. The objective of this study was to compare posture, muscle activity, and discomfort at the neck and shoulder between tablet writing with 0° (horizontal) and 30° tablet tilt angles over 40 minutes in healthy young adults. METHODS Twenty participants wrote continuously for 40 minutes on a tablet with both tilt angles in a randomized order. Between conditions, there was a 5-minute activity break. Differences in neck and shoulder posture, muscle activity, and discomfort between both tablet tilt angles and changes in the outcomes every 10 minutes over 40 minutes were investigated. RESULTS With the tilted tablet, there were lower neck flexion (Z = -4.637, P<0.001), lower shoulder extension (Z = -3.734, P<0.001), and lower neck Visual Analogue Scale (VAS) (left; Z = -4.699, P<0.001 and right; Z = -3.874, P<0.001) as compared to the no tilt condition. However, the right upper trapezius muscle activity was higher in the tilted condition as compared to the no tilt one. Over 40 minutes, the neck VAS (left; χ2(4) = 30.235, P<0.001 and right; χ2(4) = 32.560, P<0.001) and heart rate variability (χ2(4) = 12.906, P = 0.012) showed notable increases after 20 minutes compared to baseline. CONCLUSION In conclusion, adjusting the tablet tilt to 30° and limiting time spent to 20 minutes are recommended for young adults during the tablet writing to prevent neck problems.
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Affiliation(s)
| | | | - Bryan Buchholz
- Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, Massachusetts, United States of America
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Wagenblast F, Seibt R, Läubli T, Rieger MA, Steinhilber B. The Influence of Neuroticism on the Muscle Response in the Trapezius and Frontalis Muscles to Anticipatory Stress. J PSYCHOPHYSIOL 2021. [DOI: 10.1027/0269-8803/a000289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Objective quantification of mental stress in the workplace would be beneficial for designing work tasks to avoid the negative consequences of mental stress. Methods such as surface electromyography have proven to be sensitive to mental demands. However, there is little knowledge about the muscle response and moderating factors during anticipatory stress paradigms. This study examined whether the personality dimension neuroticism moderates the muscle response to the expectation of an unpredictable electrical shock. Forty-seven subjects underwent three expectation phases, in which they could expect a pleasant audio signal (NoShock) or an electric shock in two conditions (anticipation of the first: Shock1, and second electric shock: Shock2) at an unpredictable moment. The frontalis muscle activity and the upper and upper/middle parts of the trapezius muscle were recorded using surface electromyography. Neuroticism was surveyed using the Big Five Inventory to assign the subjects to a group with lower or higher neuroticism. Shock1 only induced higher trapezius muscle activity in the higher neuroticism group, which vanished during Shock2, while the frontalis muscle showed no significant effects. The results suggest that neuroticism should be considered a moderating factor in assessing anticipatory stress using surface electromyography at the trapezius muscle.
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Affiliation(s)
- Florestan Wagenblast
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Germany
| | - Robert Seibt
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Germany
| | - Thomas Läubli
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Germany
| | - Monika A. Rieger
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Germany
| | - Benjamin Steinhilber
- Institute of Occupational and Social Medicine and Health Services Research, University Hospital Tübingen, University of Tübingen, Germany
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Tapanya W, Puntumetakul R, Neubert MS, Hunsawong T, Boucaut R. Ergonomic arm support prototype device for smartphone users reduces neck and shoulder musculoskeletal loading and fatigue. APPLIED ERGONOMICS 2021; 95:103458. [PMID: 33991854 DOI: 10.1016/j.apergo.2021.103458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 04/15/2021] [Accepted: 04/29/2021] [Indexed: 06/12/2023]
Abstract
Smartphone use is a risk factor for both neck and shoulder musculoskeletal disorders. The objective of this study was to evaluate an ergonomic arm support prototype device, which may help improve posture while using a smartphone, by determining its effect on muscle activity, muscle fatigue, and neck and shoulder discomfort. Twenty-four healthy young adult smartphone users performed 20 min of smartphone game playing under two different conditions, smartphone use with support prototype device (i.e. intervention condition) and without (i.e. control condition), while neck and shoulder posture were controlled at 0° neck flexion and 30° shoulder flexion. Activity and fatigue of four muscles were measured using surface electromyography (sEMG), these were: anterior deltoid (AD), cervical erector spinae (CES), upper trapezius (UT) and lower trapezius (LT). The intervention condition showed significantly decreased activity of all muscles. Fatigue of all muscles, except LT, significantly increased over time compared to the start point in the control condition. There was no significant difference in muscle fatigue between each time point in the intervention condition. In conclusion, the ergonomic arm support prototype device can be used as ergonomic intervention to reduce neck and shoulder muscle loading and fatigue.
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Affiliation(s)
- Weerasak Tapanya
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand; School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Rungthip Puntumetakul
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand; School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.
| | - Manida Swangnetr Neubert
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand; Program of Production Technology, Faculty of Technology, Khon Kaen University, Khon Kaen, Thailand
| | - Torkamol Hunsawong
- Research Center in Back, Neck, Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand; School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
| | - Rose Boucaut
- University of South Australia: Allied Health and Human Performance, iCAHE (International Centre for Allied Health Evidence), Adelaide, Australia
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Lee S, DE Barros FC, DE Castro CSM, DE Oliveira Sato T. Effect of an ergonomic intervention involving workstation adjustments on musculoskeletal pain in office workers-a randomized controlled clinical trial. INDUSTRIAL HEALTH 2021; 59:78-85. [PMID: 33250456 PMCID: PMC8010160 DOI: 10.2486/indhealth.2020-0188] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/24/2020] [Indexed: 06/07/2023]
Abstract
Office workers remain in a awkward position for long periods, which can lead to musculoskeletal symptoms. Ergonomic guidelines are recommended to avoid such problems. Evidence of the long-term effectiveness of ergonomic interventions is scarce. The aim of this randomised controlled trial was to compare pain intensity among office workers who received an ergonomic intervention and a control group before as well as 12, 24, and 36 wk after the intervention. Workers were randomly allocated to a control group (CG) and experimental group (EG). The EG received an ergonomic workstation intervention. Furniture measurements were related to individual anthropometric measurements to identify mismatches. The outcome was pain intensity, which was determined using a numerical pain scale and the Nordic Musculoskeletal Questionnaire. A linear mixed model was created with pain intensity as the dependent variable. Group and time were the independent variables. No significant interactions were found between group and time. Significant differences between groups were found for the pain intensity in the neck, shoulder, upper back, and wrist/hand (p<0.05), with lower intensity in the EG. The intervention reduced pain intensity in the neck, shoulder, upper back, and wrist/hand. However, no reduction in pain intensity was found for the lower back or elbow.
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Affiliation(s)
- Stefany Lee
- Department of Physical Therapy, Federal University of São Carlos, Brazil
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Eggleston ST. Mouse with your arm™: Facilitating forearm support using the chair armrest to prevent and mitigate musculoskeletal disorders. Work 2020; 65:483-495. [PMID: 32083609 DOI: 10.3233/wor-203103] [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: 11/15/2022] Open
Abstract
BACKGROUND Musculoskeletal disorders (MSDs) can be prevented by avoiding trauma caused by poor posture, compression, force, and repetition. Neutral postures are recommended to avoid MSDs. OBJECTIVE This study introduces Mouse With Your Arm™ (MWYA) methodology which promotes sitting back in a chair, using the chair's armrest for forearm support at relaxed elbow height, matching surface and armrest height, and keeping the mouse on the surface edge. This position allows optimal task chair use, facilitates movement and neutral postures, avoids compression and contact stress, and is effective in mitigating MSDs. METHOD MWYA was applied and measured in the field for more 23 years providing over 3,500 individualized assessments to integrate a participant's unique characteristics, reported health concerns, tasks, tools, and environment to achieve and sustain whole-body neutral and comfortable working postures. RESULTS Previous research has consistently recommended use of forearm support by a desk, apparatus, or wrist rest, and resulted in non-neutral, static postures and measured health consequences. By using armrests for support, MWYA avoids the potential of MSDs as can be caused by these previously endorsed postures. CONCLUSION By applying the five MWYA principles, computer users comprehend neutral posture and put forth the effort essential to creating healthy human computer relationships.
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Affiliation(s)
- Sara Taylor Eggleston
- Founder of Structured Health Resources, Inc. and Mouse With Your Arm Methodology, Ann Arbor, MI, USA. Tel.: +1 734-224-2425; E-mail:
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Mohammadipour F, Pourranjbar M, Naderi S, Rafie F. Work-related Musculoskeletal Disorders in Iranian Office Workers: Prevalence and Risk Factors. J Med Life 2019; 11:328-333. [PMID: 30894890 PMCID: PMC6418332 DOI: 10.25122/jml-2018-0054] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objective: This study aimed to identify the prevalence of musculoskeletal disorders (MSDs) and ergonomic risks for Kerman University of Medical Sciences’ office workers. Methods: The study sample comprised all office workers in the University and the sample included 129 women and 121 men. Data on MSDs were derived from the Nordic Musculoskeletal Questionnaire, while ergonomic data were collected through two direct observations via the rapid upper limb assessment (RULA) and the rapid office strain assessment (ROSA) method. Results: The results showed that the highest prevalence rates of MSDs were in the lower back (72.4%) and neck (55.2). Results of the postural assessment revealed that 68.8% of the participants’ require “further investigation in order to modify their posture” and 27.6% need to “modify their posture soon.” From the workstation analysis, the majority of the office workers were at a medium (55.2%) and high-risk level (27.6%). Results also revealed a significant association between some of MSDs in the lower back and neck with the RULA and ROSA score. Conclusions: Based on the results, for the prevention of MSDs, there should be ergonomics workshops for workers to be aware of ergonomics factors in the office. The ergonomics training must also be used in offices; the design of workstations should be improved.
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Affiliation(s)
- Fariborz Mohammadipour
- Department of Biomechanics, Faculty of Physical Education and Sport Sciences, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Mohammad Pourranjbar
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Sasan Naderi
- Department of Biomechanics, Faculty of Physical Education and Sport Sciences, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Forouzan Rafie
- Neuroscience Research Center, Kerman University of Medical Sciences, Kerman, Iran
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