Assessing work-related musculoskeletal symptoms among otolaryngology residents

Wong, Kevin; Grundfast, Kenneth M.; Levi, Jessica R.

doi:10.1016/j.amjoto.2017.01.013

Cited by 37 publications

(57 citation statements)

References 23 publications

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“…Supporting this finding is a recent study, which found that the majority of the responders (63%) initially experienced MSK symptoms in their training years . Otolaryngology residents in the United States spend an average of 80 hours a week in the hospital, with 26 of those hours in the operating room . Although ergonomic injuries usually accrue over time, our study suggests it does not take long to develop MSK pain.…”

Section: Discussionsupporting

confidence: 82%

“…First, this study had a small sample size and was from a single institution, which may limit its generalizability. However, we had an excellent response rate of 68.6%, which compares very favorably to the literature . Additionally, assessment of the REBA score can be subjective, as most postural positions are scored based on both an angular and a time factor.…”

Section: Discussionsupporting

confidence: 68%

“…1 Otolaryngology residents in the United States spend an average of 80 hours a week in the hospital, with 26 of those hours in the operating room. 20 Although ergonomic injuries usually accrue over time, our study suggests it does not take long to develop MSK pain. A recent study in otolaryngology residents demonstrated that 76.6% of residents experience some form of MSK pain or discomfort, with 6.4% missing days from residency and 16.3% needing to stop operating during surgery due to the symptoms.…”

Section: Discussionmentioning

confidence: 63%

“…In our cohort, the standing position was significantly associated with cervical pain ( P = .034). Several other surveys of otolaryngology surgeons reported on neck pain as being most common MSK strain area during the surgery . Secondly, standing for extended periods of time (>30 minutes) almost always elevated the REBA risk score into the high‐risk category.…”

Section: Discussionmentioning

confidence: 93%

“…Several other surveys of otolaryngology surgeons reported on neck pain as being most common MSK strain area during the surgery. 1,[8][9][10]19,20 Secondly, standing for extended periods of time (>30 minutes) almost always elevated the REBA risk score into the high-risk category. Thus, our study has identified a potential target for intervention to mitigate ergonomic risk.…”

Section: Discussionmentioning

confidence: 99%

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Ergonomic hazards in otolaryngology

et al. 2018

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Objectives/Hypothesis To evaluate the presence of postural‐related strain and musculoskeletal discomfort, along with the level of ergonomics training and the availability of ergonomic equipment among otolaryngology surgeons. Study Design Intraoperative observations and survey study. Methods Using the Rapid Entire Body Assessment score system to identify ergonomic hazards, we conducted intraoperative observations assessing operating room personnel during different otolaryngological subspecialty procedures. Based on these findings, otolaryngology surgeons at a single academic institution in the United States were sent a survey that evaluated ergonomic practice, environmental infrastructure, and prior ergonomic training or education. Results A response rate of 69% was obtained from 70 surgeons, with 72.9% of responding surgeons suffering from some level of back pain, with cervical spine pain being the most common. Interestingly, residents were equally affected when compared to more senior surgeons both in subjective survey reports and from observational risk analysis. Furthermore, 43.8% of surgeons reported suffering from the highest level of pain when standing, whereas only 12.5% experienced pain when sitting. Importantly, 10% stated that pain impacted their work. Only 24% of surgeons had any prior ergonomic training or education. Conclusions Our data suggest that pain and disability induced by poor ergonomics are widespread among the otolaryngology community and confirm that surgeons rarely receive ergonomic training in the surgical context. Additionally, intraoperative observational findings identified that the majority of observed surgeons display poor posture, particularly a poor cervical angle and use of ergonomic setups, both of which increase ergonomic risk hazard. These data provide guidance for future interventional studies. Level of Evidence NA Laryngoscope, 129:370–376, 2019

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Section: Discussionsupporting

confidence: 82%

Section: Discussionsupporting

confidence: 68%

Section: Discussionmentioning

confidence: 63%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Ergonomic hazards in otolaryngology

et al. 2018

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Association of Vibrotactile Biofeedback With Reduced Ergonomic Risk for Surgeons During Tonsillectomy

Kelly

Althubaiti

Katapadi

et al. 2023

JAMA Otolaryngol Head Neck Surg

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ImportanceWork-related musculoskeletal disorders are common among otolaryngologists and can be associated with decreased productivity, missed workdays, and reduced quality of life. Ergonomic risk for surgeons is elevated during common otolaryngology procedures; current ergonomic interventions lack the ability to provide real-time feedback. The ability to quantify and mitigate ergonomic risk during surgery may reduce work-related musculoskeletal disorders.ObjectiveTo quantify the association of vibrotactile biofeedback with intraoperative ergonomic risk to surgeons during tonsillectomy.Design, Setting, and ParticipantsThis cross-sectional study was conducted between June 2021 and October 2021 at a freestanding tertiary care children’s hospital and included 11 attending pediatric otolaryngologists. Data analysis was conducted from August to October 2021.InterventionsReal-time quantification of ergonomic risk during tonsillectomy and the use of a vibrotactile biofeedback posture monitor.Main Outcomes and MeasuresAssociation of vibrotactile biofeedback with objective measures of ergonomic risk. Assessment tools included the Rapid Upper Limb Assessment, craniovertebral angle, and time spent in an at-risk posture.ResultsEleven surgeons (mean [SD] age 42 [7] years; 2 women [18%]) performed 126 procedures with continuous posture monitoring in the presence (80 [63%]) and absence (46 [37%]) of vibrotactile biofeedback. No complications or delays associated with the device were reported. Intraoperative vibrotactile biofeedback was associated with improved Rapid Upper Limit Assessment neck, trunk, and leg scores by 0.15 (95% CI, 0.05-0.25), improved craniovertebral angle by 1.9 (95% CI, 0.32-3.40), and decreased overall time spent in an at-risk posture by 30% (95% CI, 22%-39%).Conclusions and RelevanceThe results of this cross-sectional study suggest that use of a vibrotactile biofeedback device to quantify and mitigate ergonomic risk for surgeons is feasible and safe while performing surgery. Vibrotactile biofeedback was associated with reduced ergonomic risk during tonsillectomy and may have a role in improving surgical ergonomics and preventing work-related musculoskeletal disorders.

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Estimation of surgeons’ ergonomic dynamics with a structured light system during endoscopic surgery

Lobo

Anuarbe

López‐Higuera

et al. 2019

Int Forum Allergy Rhinol

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Background:The purpose of this study was to use motion capture to collect body posture information during simulated endoscopic sinus surgery interventions performed by both specialists and residents in standing and si ing positions and to analyze that information with the validated Rapid Upper Limb Assessment (RULA) tool, which allows calculation of a risk index of musculoskeletal overload. Methods:Bilateral endoscopic sinus surgery was performed in 5 cadaver heads by 2 residents, and 4 practicing rhinologists. Musculoskeletal symptoms were evaluated before and a er the dissection. Full-body postural data were collected with the help of Kinect and a .NET WPF (Windows Presentation Foundation) so ware application to record images of the surgical procedures, and then analyzed with the RULA tool to calculate a risk score indicative of the exposure of the individual surgeon to ergonomic risk factors associated with upper extremity musculoskeletal disorders.Results: All subjects reported physical discomfort after nasal endoscopic procedures. An overall similar RULA score was obtained by the residents and the practicing rhinologists. The RULA score was slightly lower for the sitting position than for the standing position, mostly due to a lower score in group B (neck, trunk, and leg); however, the RULA score for group A (arm and wrist analysis) was higher, denoting a higher risk for the upper back and arms.Conclusion: Significant musculoskeletal symptoms were reported a er an endoscopic operation by both the resident and the practicing otolaryngologists. All surgeons obtained a high RULA score, meaning that urgent changes are required in the task. C 2019 ARS-AAOA, LLC. How to Cite this Article:Lobo D, Anuarbe P, López-Higuera JM, Viera J, Castillo N, Megía R. Estimation of surgeons' ergonomic dynamics with a structured light system during endoscopic surgery. Int Forum Allergy Rhinol. 2019;9:857-864.

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Assessing work-related musculoskeletal symptoms among otolaryngology residents

Cited by 37 publications

References 23 publications

Ergonomic hazards in otolaryngology

Ergonomic hazards in otolaryngology

Association of Vibrotactile Biofeedback With Reduced Ergonomic Risk for Surgeons During Tonsillectomy

Estimation of surgeons’ ergonomic dynamics with a structured light system during endoscopic surgery

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