Saddle seat reduces musculoskeletal discomfort in microsurgery surgeons

Background. Microsurgery is a surgical procedure requiring a high degree of precision and is commonly facilitated through the use of an intraoperative microscope. When operating the microscope system, the long-term posture leads to musculoskeletal disorders in surgeons, and seats are commonly employed to diminish these problems. The present study was conducted to evaluate musculoskeletal discomfort during work with a saddle seat in comparison with conventional seats for microscopic work. Methods. Two types of seats, a saddle and a conventional one, were evaluated for 73 microsurgical surgeons in terms of musculoskeletal discomfort. Corlett and Bishop's body part discomfort scale was used to assess musculoskeletal discomfort before and after working with the seats. Results. The highest amount of discomfort that microsurgical surgeons acquire in the workplace was focused on their neck, shoulders, arms and back. During work with a saddle seat, a significant reduction was found for discomfort values in the neck, shoulder, arm, back, elbow and forearm, as well as the whole body (p?<?0.05). Conclusion. This study showed that the use of saddle seats provides a more appropriate physical posture at work, and can decrease musculoskeletal discomfort in different parts of the body of microsurgical surgeons.     

Posture and belt fit in reclined passenger seats

Abstract

Objective: Highly reclined postures may be common among passengers in future automated vehicles. A laboratory study was conducted to address the need for posture and belt fit in these seating configurations.

Methods: In a laboratory vehicle mockup, the postures of 24 men and women with a wide range of body size were measured in a typical front vehicle seat at seat back angles of 23°, 33°, 43°, and 53°. Data were gathered with and without a sitter-adjusted headrest. Posture was characterized by the locations of skeletal joint centers estimated from digitized surface landmarks.

Results: Regression analysis demonstrated that the pelvis rotated rearward and lumbar spine flexion decreased with increasing recline. The lap portion of the 3-point belt was more rearward relative to the pelvis in more-reclined postures, and the torso portion crossed the clavicle closer to the midline of the body. Regression equations were developed to predict posture and belt fit variables as a function of passenger characteristics, seat back angle, and the use of the headrest.

Conclusions: Spine posture changes as the torso reclines in an automotive seat, and belt fit is altered by the change in posture. The results can be used to accurately position crash test dummies and computation human models and to guide the design of belt restraints.     

Infrared thermography reveals effect of working posture on skin temperature in office workers

Introduction. Musculoskeletal symptoms related to using traditional computer workstations are common. Quantitative methods for measuring muscle stress and strain are needed to improve ergonomics of workstations. We hypothesize that infrared thermography (IRT) is suited for this purpose. Methods. This hypothesis was evaluated by estimating muscle activity in upright and traditional working postures with IRT and surface electromyography (sEMG). IRT and sEMG measurements were conducted in 14 female participants with both working postures. First, measurements with the traditional posture were performed. Later, participants had 1?month to adjust to the upright working posture before repeating the measurements. IRT images were acquired before and after a full working day, with sEMG recordings being conducted throughout the measurement days. Participants evaluated their neck pain severity using neck disability index (NDI) questionnaires before the first and after the second measurement day. Results. Spatial variation in upper back temperature was higher (p?=?0.008) when working in traditional posture and the upright working posture reduced (p?p?=?0.003) after working in the upright posture. Conclusion. IRT was found suitable for evaluating muscle activity and upright working posture to reduce the NDI and muscle activity in the upper back.     

Effects of work surface and task difficulty on neck–shoulder posture and trapezius activity during a simulated mouse task

Objectives. The purpose of this study is to evaluate the influence of the work surface and task difficulty on the head, upper back and upper arm postures and activity of the descending trapezius during a simulated mouse task. Methods. Healthy female university students (N?=?15) were evaluated. The work surface was positioned at elbow height (EH) and above elbow height (AEH) and the task difficulty was set at low (LD) and high (HD) levels. The postures were recorded by inclinometers. Trapezius activity was normalized by the maximum voluntary isometric contraction (MVIC). Results. Significantly higher head flexion was found at EH compared to the AEH condition, with an average difference of 2°–5° at the same difficulty level. The HD task significantly increased head (3°–6°) and upper back flexion (6°–7°) at the same table height. For upper arm elevation and trapezius activation, the AEH condition presented higher upper arm elevation (about 6°–8°) and trapezius activity (0.8–1.4% of MVIC), regardless of the difficulty level of the task. Conclusions. Head posture was influenced by the table height and task difficulty; the upper back posture by high difficulty; and upper arm posture and trapezius activity were only influenced by table height.     

Anthropometric evaluation of cockpit designs

The objective of this research is to evaluate all the critical reaches in a cockpit and determine the visual sufficiency of a cockpit to accommodate 90% of potential pilots. While mismatches of measurements with cockpit dimensions are revealed, proposals are made to improve cockpit ergonomics. Regression models were generated to predict and assure adequate exterior vision. Mean, lower and upper control limits of all measurements were found acceptable except eye level. There are very strong positive relationships between stature and eye level (R²?=?0.972, p?R²?=?0.994, p?SD smaller than the eye level mean or seating adjustment limits in height may be changed. In general, cockpit design is acceptable in terms of fit/reach accommodation for pilots, except eye level and visual variables that could be solved by better seat adjustments.     

Impact of posture and upper-limb muscle activity on grip strength

Purpose. The current research was carried out to determine grip strength (GS) with change in posture and upper-limb muscle activity of manual workers and investigate the impacts of these changes. Methods. For the current research, 120 male and 80 female participants were selected and GS was assessed using a digital hand grip dynamometer in various conditions. Results. The outcomes showed that male participants had higher GS as compared to female participants. Maximum GS was found in a standing posture with the fixed forward shoulder at 45°, elbow at 90° and a neutral position of the wrist and forearm for all participants. Conclusions. Higher values of GS were attained in standing postures which may result in attainment of higher performance levels by the workers. The outcomes justify the importance of correct postures during manual work in industries employing traditional methods.     

Postural and Muscular Responses While Viewing Different Heights of Screen

This study aimed to examine the effects of visual display terminal (VDT) viewing angle on human postural angle and muscular activity. The participants’ neck, thoracic bending, and trunk inclination angles; and the activity of sternocleidomastoid, trapezius, splenius capitis, and erector spinae at 5 viewing angles (+40°, +20°,0°, –20°, and –40°) of a VDT screen were collected for 1 min. This study showed that neck and thoracic bending angles increased with viewing angle, while viewing angle did not significantly affect trunk inclination angle. In addition, the activity of trapezius and erector spinae increased when viewing a higher or lower VDT screen height compared with viewing a horizontal VDT screen height; however, the activity of splenius capitis decreased with viewing angle.     

Relationship between musculoskeletal disorders and anthropometric indices among bus drivers in Zahedan city

Introduction. Most work-related musculoskeletal disorders (MSDs) are associated with improper postures and poorly designed workstations. This study is an attempt to examine the prevalence and severity of MSDs as well as anthropometric dimensions among city bus drivers. Methodology. This cross-sectional study was carried out on 60 male bus drivers. A body discomfort chart was used to evaluate MSDs. Spearman correlation was employed to examine the relationship between body size and the severity of discomfort. Results. Data analysis showed that discomfort reported in the lower back (33.3%), upper back (18.3%) and knee (15%) was severe and there was a direct and significant correlation between the body mass index and the severity of discomfort in the shoulder, arm and hip (p?p?Conclusion. The results of the study can be used to address ergonomic risk factors and reduce their associated disorders. The findings of the study can be used in training programs to educate drivers how to decrease the risk associated with work-related MSDs by adopting appropriate behavior strategies.     

Ergonomic design and evaluation of a diagnostic ultrasound transducer holder

Background. Work-related musculoskeletal disorders (WMSDs) are injuries and disorders that affect the body’s movement and musculoskeletal system. Awkward postures represent one of the major ergonomic risk factors that cause WMSDs among sonographers while working with an ultrasound transducer. This study aimed to design and evaluate a new holder for the ultrasound transducer. Materials and methods. In the first phase a new holder was designed for the transducer, considering design principles. Evaluation of the new holder was then carried out by electrogoniometry and a locally perceived discomfort (LPD) scale. Results. The application of design principles to the new holder resulted in an improvement of wrist posture and comfort. Wrist angles in extension, flexion, radial deviation and ulnar deviation were lower with utilization of the new holder. The severity of discomfort based on the LPD method in the two modes of work with and without the new holder was reported with values of 1.3 and 1.8, respectively (p?<?0.05). Conclusion. Overall, this study indicated that applying ergonomics design principles was effective in minimizing wrist deviation and increasing comfort while working with the new holder.     

Presence of scapular dysfunction in dominant shoulder of professional guitar players

Background. Playing guitar can cause adoption of asymmetric postures and affect the shoulder's stability. Objective. To assess the presence of scapular dysfunction in professional guitar players. Method. A lateral scapular slide test was performed at the level of the spine of the scapula and at the inferior angle of the scapula in 20 professional guitar players (age: 18–40 years) and was compared with 20 age-matched non-players at angles of 0°, 45° and 90° of shoulder abduction with both limbs loaded with 0.5-kg weights. Analysis was done by unpaired t test. Results. Scapular dysfunction in guitar players was seen in the form of asymmetric scapula at rest in 25% and dyskinetic scapula in 20% of players. 100% of non-players had normal scapular positioning. Comparison at the level of the spine of the scapula showed no significant difference (p?>?0.05), but the inferior angle showed a significant difference at 0° (1.37?cm), 45° (1.93?cm) and 90° (2.15?cm) which was more in the player's category (p?Conclusion. There exists a marked dysfunction of scapular stabilizers in professional guitar players at the level of the inferior angle of the scapula.     

Postural assessment in pen-and-paper-based observational methods and their associated health effects: a review

Introduction. This review describes standardized ergonomics assessment based on pen-and-paper observational methods for assessing ergonomics risk factors. Objective. The three main objectives are to analyze published pen-and-paper observational methods, to extract and understand the risk levels of each method and to identify their associated health effects. Methodology. The authors searched scientific databases and the Internet for materials from 1970 to 2013 using the following keywords: ergo, posture, method, observational, postural angle, health effects, pain and diseases. Postural assessments of upper arms, lower arms, wrists, neck, back and legs in six pen-and-paper-based observational methods are highlighted, extracted in groups and linked with associated adverse health effects. Results. The literature reviewed showed strengths and limitations of published pen-and-paper-based observational methods in determining the work activities, risk levels and related postural angles to adverse health effects. This provided a better understanding of unsafe work postures and how to improve these postures. Conclusion. Many pen-and-paper-based observational methods have been developed. However, there are still many limitations of these methods. There is, therefore, a need to develop a new pen-and-paper-based observational method for assessing postural problems.     

Workstation design in carpet hand-weaving operation: guidelines for prevention of musculoskeletal disorders.

Carpet weavers suffer from musculoskeletal problems mainly attributed to poor working postures. Their posture is mostly constrained by the design of workstations. This study was conducted to investigate the effects of 2 design parameters (weaving height and seat type) on postural variables and subjective experience, and to develop guidelines for workstation adjustments. At an experimental workstation, 30 professional weavers worked in 9 different conditions. Working posture and weavers' perceptions were measured. It was shown that head, neck and shoulder postures were influenced by weaving height. Both design parameters influenced trunk and elbows postures. The determinant factor for weavers' perception on the neck, shoulders and elbows was found to be weaving height, and on the back and knees it was seat type. Based on the results, the following guidelines were developed: (a) weaving height should be adjusted to 20 cm above elbow height; (b) a 10 degrees forward-sloping high seat is to be used at weaving workstations.     

Effect of posture on forces and moments measured in a Hybrid III ATD lower leg

Objective: Anthropomorphic test devices (ATDs) are used to assess real injury risk to occupants of vehicles during injurious events. In the lower leg, values from load cells are compared to injury criteria developed in cadaveric studies. These criteria are typically developed with the leg in a neutral posture, whereas the ATD may assume a wide range of postures during safety evaluation tests. The degree to which the initial posture of an ATD has an effect on the measured forces and moments in the lower leg is unknown.

Methods: A Hybrid III ATD lower leg was impacted in a range of postures under conditions representing a crash test, and peak axial force and adjusted tibia index injury measures were evaluated. Ankle posture was varied in 5° increments using a custom-made footplate, and dorsi/plantarflexion (20° DF to 20° PF) and in/eversion (20° IV to 5° EV) were evaluated. Tibia angle was also varied (representing knee flexion/extension) by ±10° from neutral.

Results: Peak axial force was not affected by ankle flexion or tibia angulation. Adjusted tibia index was lowest for plantarflexion, as well as for tibia angles representative of knee extension. Both peak axial force and adjusted tibia index were lowest for postures of great inversion and were highest in neutral or near-neutral postures.

Conclusions: The range of postures tested herein spanned published injury criteria and thus would have made the difference between pass and fail in a safety evaluation. In/eversion had the largest influence on injury metrics, likely due to the change in axial stiffness and altered impact durations in these postures. Results suggest increased injury risk at neutral or near-neutral postures, whereas previous cadaveric studies have suggested that in/eversion does not influence injury risk. It is unclear whether the ATD appropriately represents the natural lower leg for impacts in out-of-position testing. Great care must be taken when initially positioning ATDs for safety evaluations, because small perturbations in posture were shown herein to have large effects on the measured injury risk using this tool.     

Variation in posture quality across musical instruments and its impact during performances

Objective. Bad posture increases the risk that a musician may suffer from musculoskeletal disorders. This study compared posture quality required by different instruments or families of instruments. Methods. Using an ad-hoc postural observation instrument embracing 11 postural variables, four experts evaluated the postures of 100 students attending a Spanish higher conservatory of music. Results. The agreement of the experts’ evaluations was statistically confirmed by a Cohen's κ value between 0.855 and 1.000 and a Kendall value between 0.709 and 1.000 (p?χ² tests revealed significant association between instrument families and seated posture with respect to pelvic attitude, dorsal curvature and head alignment in both sagittal and frontal planes. This analysis also showed an association between instrument families and standing posture with respect to the frontal plane of the axis of gravity, pelvic attitude, head alignment in the frontal plane, the sagittal plane of the shoulders and overall posture. Conclusions. While certain postural defects appear to be common to all families of instruments, others are more characteristic of some families than others. The instrument associated with the best posture quality was the bagpipe, followed by percussion and strings.     

Small female rib cage fracture in frontal sled tests

Objectives: The 2 objectives of this study are to (1) examine the rib and sternal fractures sustained by small stature elderly females in simulated frontal crashes and (2) determine how the findings are characterized by prior knowledge and field data.

Methods: A test series was conducted to evaluate the response of 5 elderly (average age 76 years) female postmortem human subjects (PMHS), similar in mass and size to a 5th percentile female, in 30 km/h frontal sled tests. The subjects were restrained on a rigid planar seat by bilateral rigid knee bolsters, pelvic blocks, and a custom force-limited 3-point shoulder and lap belt. Posttest subject injury assessment included identifying rib cage fractures by means of a radiologist read of a posttest computed tomography (CT) and an autopsy. The data from a motion capture camera system were processed to provide chest deflection, defined as the movement of the sternum relative to the spine at the level of T8.

?A complementary field data investigation involved querying the NASS-CDS database over the years 1997–2012. The targeted cases involved belted front seat small female passenger vehicle occupants over 40 years old who were injured in 25 to 35 km/h delta-V frontal crashes (11 to 1 o'clock).

Results: Peak upper shoulder belt tension averaged 1,970 N (SD = 140 N) in the sled tests. For all subjects, the peak x-axis deflection was recorded at the sternum with an average of ?44.5 mm or 25% of chest depth. The thoracic injury severity based on the number and distribution of rib fractures yielded 4 subjects coded as Abbreviated Injury Scale (AIS) 3 (serious) and one as AIS 5 (critical). The NASS-CDS field data investigation of small females identified 205 occupants who met the search criteria. Rib fractures were reported for 2.7% of the female occupants.

Conclusions: The small elderly test subjects sustained a higher number of rib cage fractures than expected in what was intended to be a minimally injurious frontal crash test condition. Neither field studies nor prior laboratory frontal sled tests conducted with 50th percentile male PMHS predicted the injury severity observed. Although this was a limited study, the results justify further exploration of the risk of rib cage injury for small elderly female occupants.     

A pre/post evaluation of fatigue,stress and vigilance amongst commercially licensed truck drivers performing a prolonged driving task

Purpose. The main purpose of this research study was to evaluate changes in fatigue, stress and vigilance amongst commercially licensed truck drivers involved in a prolonged driving task. The secondary purpose was to determine whether a new ergonomic seat could help reduce both physical and cognitive fatigue during a prolonged driving task. Two different truck seats were evaluated: an industrial standard seat and a new truck seat prototype. Methods. Twenty male truck drivers were recruited to attend two testing sessions, on two separate days, with each session randomized for seat design. During each session, participants performed two 10-min simulated driving tasks. Between simulated sessions, participants drove a long-haul truck for 90 min. Fatigue and stress were quantified using a series of questionnaires whereas vigilance was measured using a standardized computer test. Results. Seat interactions had a significant effect on fatigue patterns. Conclusion. The new ergonomic seat design holds potential in improving road safety and vehicle accidents due to fatigue-related accidents.     

Taxi driver seat belt wearing in Nanjing, China

Objective

To determine and validate patterns of seat belt use and attitudes of taxi drivers on wearing a seat belt following national and provincial seat belt legislation in 2004-2005. Design: Roadside daylight seat belt observation and interview survey methods were used, as well as observations from inside taxis during routine trips and a taxi driver focus group. The setting was Nanjing, Jiangsu Province, PR China in April of 2006 and 2007.

Main outcome measures

Prevalence of seat belt use and attitudes to wearing a seat belt were determined, as were vehicle and driver characteristics, and comparisons with other motor-vehicle driver's seat belt use and attitudes.

Results

Taxi drivers interviewed were predominantly male and aged 30-39 years. They spent more hours per week in their vehicles and had more driving experience than other drivers. Over half (56.2%) of taxi drivers interviewed reported that they always wore seat belts, while observation of taxi drivers showed lower wearing rates (i.e., roadside observation was 43.8%, and observation from inside taxis was 36.2%). Belt tampering was a practice of 12-15% of taxi drivers. “Fine avoidance, safety, high speed and long trips” were given as important reasons for wearing and “feeling trapped and uncomfortable” for not wearing. Seat belt reminder signs in taxis were common (82.6% of taxis), but did not appear to impact on driver seat belt use.

Conclusion

The four research methods found taxi drivers to have consistently low “correct wearing” rates.

Impact on industry

As in several other countries, taxi drivers are particularly resistant to seat belt use. Innovative strategies, including occupational health and safety approaches, may be required to achieve increased levels of seat belt use.     

Reality and risk of contact-type head injuries related to bicycle-mounted child seats

Objective

The authors have treated numerous children who have been injured by falling from bicycle-mounted child seats. Despite the greatly increased use of such seats, the understanding of their risk and the importance of helmet use remains alarmingly poor. The objective of this study was to confirm the risk of bicycle-mounted child seats and to evaluate the efficacy of helmets, seat belts, and back seat height in terms of preventing or mitigating contact-type head impacts that occur in falls from bicycle-mounted child seats.

Materials and methods

Biometrical dummy tests were performed to examine contact-type head injuries in falls from stationary bicycles. A bicycle with an anthropometric test dummy placed in a bicycle-mounted child seat was tipped over. Each test was repeated three times and three-dimensional acceleration was measured using accelerometer. Head Injury Criteria (HIC) were calculated and the respective influences of a helmet, a seat belt, and increased height of the back of the seat on such impacts were evaluated.

Results

Only helmets unequivocally lowered maximal acceleration and/or HIC values with statistical significance. The seat belt lowered HIC values as long as it was used with the high-back seat. Only when the dummy wore a helmet sitting in a high-back seat did the HIC show less than the threshold of 570 for three-year-old children. The HIC showed the lowest score of 161.5 when the dummy wore both a helmet and a seat belt sitting in a high-back seat.

Conclusions

Riders in bicycle-mounted child seats definitely have higher risks of contact-type head injuries. In transporting a child on a bicycle-mounted child seat, parents must use both a child-bicycle helmet and a high-back child seat at least; a seat belt is highly recommended as long as it is used with the other safety devices.

Impact on Industry

The bicycle-mounted child seat should have a high enough back and an appropriate seat belt to protect the head of the child from a contact-type injury.     

Influence of Seat Properties on Occupant Dynamics in Severe Rear Crashes

Seat performance in retaining an occupant, transferring energy, and controlling neck responses is often questioned after severe rear crashes when fatal or disabling injury occur. It is argued that a stiffer seat would have improved occupant kinematics. However, there are many factors in occupant interactions with the seat. This study evaluates four different seat types in 26 and 32 mph (42 and 51 km/h), rear crash delta Vs. Two seats were yielding with k = 20 kN/m occupant load per displacement. One represented a 1970s yielding seat with j = 3.4°/kN frame rotation per occupant load, and 3 kN maximum load (660 Nm moment), and the other a high retention seat phased into production since 1997 with j = 1.4°/kN, and 10 kN maximum load (2200 Nm). Two seats were stiff with k = 40 kN/m. One represented a 1990s foreign benchmark with j = 1.8°/kN and a 7.7 kN maximum load (1700 Nm), and the other an all belts to seat (ABTS) with j = 1.0°/kN and 20 kN maximum load (4400 Nm). The crash was a constant acceleration of 11.8 g, or 14.5 g for 100 ms. Occupant interactions with the seat were modeled using a torso mass, flexible neck and head mass. By analysis of the equations of motion, the initial change in seatback angle (Δθ) is proportional to jk(y ? x), the product jk and the differential motion between the vehicle (seat cushion) and occupant. The transition from 1970s–80s yielding seats to stronger seats of the 1990s involved an increase in k stiffness; however, the jk property did not change as frame structures became stronger. The yielding seats of the 1970s had jk = 68°/m, while the stiff foreign benchmark seat had jk = 72°/m. The foreign benchmark rotated about the same as the 1970s seat up to 50 ms in the severe rear crashes. While it was substantially stronger, it produced higher loads on the occupant, and the higher loads increased seatback rotations and neck responses. The ABTS seat had the lowest rotations but also caused high neck responses because of the greater loads on the torso. Neck displacement (d) is initially proportional to (k/m_T) ∫∫ y, seat stiffness times the second integral of vehicle displacement divided by torso mass. As seat stiffness increases, head-torso acceleration, velocity, and neck displacement increase. This study shows that the jk seat property determines the initial seatback rotation in rear crashes. If a stronger seat has a higher stiffness, it rotates at higher loads on the occupant, reducing the overall benefit of the stronger frame, while increasing neck responses related to whiplash or neck extension prior to subsequent impacts. The aim of seat designs should be to reduce jk, provide pocketing of the pelvis, and give head-neck support for the best protection in severe rear crashes. For low-speed crashes, a low k is important to reduce early neck responses related to whiplash.     

An ergonomics study on wrist posture when using laparoscopic tools in four techniques in minimally invasive surgery

Purpose. With reference to four minimally invasive surgery (MIS) cholecystectomies, the aims were (a) to recognize the factors influencing dominant wrist postures manifested by the surgeon; (b) to detect risk factors involved in maintaining deviated wrist postures; (c) to compare the wrist postures of surgeons while using laparoscopic tools. Methods. Video films were recorded during live surgeries. The films were synchronized with wrist joint angles obtained from wireless electrogoniometers placed on the surgeon's hand. The analysis was conducted for five laparoscopic tools used during all surgical techniques. Results. The most common wrist posture was extension. In the case of one laparoscopic tool, the mean values defining extended wrist posture were distinct in all four surgical techniques. For one type of surgical technique, considered the most beneficial for patients, more extreme postures were noticed regarding all laparoscopic tools. We recognized a new factor, apart from the tool's handle design, that influences extreme and deviated wrist postures. It involves three areas of task specification including the type of action, type of motion patterns and motion dynamism. Conclusions. The outcomes proved that the surgical technique which is best for the patient imposes the greatest strain on the surgeon's wrist.?