Muscle-Cooling Intervention to Reduce Fatigue and Fatigue-Induced Tremor in Novice and Experienced Surgeons: A Preliminary Investigation

Jensen, Lauren; Dancisak, Michael; Korndorffer, James R.

doi:10.1055/s-0036-1594246

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…Chan, Duffield, and Watsford (2016) found that wearing compression garments during a 4-hr simulated manual work task and for 24 hr thereafter did not significantly reduce perceived fatigue compared with the effect of not wearing the garments. Similar results were found by Jensen, Dancisak, and Korndorffer (2016), where the use of a cooling garment did not improve the time to functional fatigue compared with the results of a thermal-neutral condition.…”

Section: Grading the Level Of Evidence For Each Interventionsupporting

confidence: 82%

Interventions to Mitigate Fatigue Induced by Physical Work: A Systematic Review of Research Quality and Levels of Evidence for Intervention Efficacy

Megahed

Cavuoto

2019

Hum Factors

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Objective:We present a literature review on workplace physical fatigue interventions, focusing on evaluating the methodological quality and strength of evidence.Background:Physical fatigue is a recognized workplace problem, with negative effects on performance and health-related complaints. Although many studies have focused on the mechanisms and consequences of fatigue, few have considered the effectiveness of interventions to mitigate fatigue.Method:A systematic review of the workplace safety literature for controlled trials of physical fatigue interventions was conducted. Data on intervention type, subject characteristics, targeted tasks and body locations, outcome measures, and study design were extracted. The methodological quality for each study was evaluated using the PEDro scale, and the level of evidence was based on quality, amount, and consistency.Results:Forty-five controlled trials were reviewed, examining 18 interventions. We categorized those interventions into individual-focused ( N = 28 studies, nine interventions), workplace-focused ( N = 12 studies, five interventions), and multiple interventions ( N = 5 studies, four interventions). We identified moderate evidence for interventions related to assistive devices and task variation. There was moderate evidence supporting no fatigue attenuation for the garment change category of interventions. The interventions in the remaining categories had limited to minimal evidence of efficacy. The heterogeneity of the included trials precludes the determination of effect size.Conclusion:This review showed a lack of high levels of evidence for the effectiveness of most physical fatigue interventions.Application:Due to a lack of high levels of evidence for any category of reviewed physical fatigue interventions, further high-quality studies are needed to establish the efficacy of others.

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Section: Grading the Level Of Evidence For Each Interventionsupporting

confidence: 82%

Interventions to Mitigate Fatigue Induced by Physical Work: A Systematic Review of Research Quality and Levels of Evidence for Intervention Efficacy

Megahed

Cavuoto

2019

Hum Factors

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“…Comparatively, there were only 16 studies identified from other surgical specialities within medicine; approximately 81% of these studies reported an improvement in surgical metric performance when a tremor eliminating strategy was employed (See Online Resource 1) [10,17,[27][28][29][30][31][32][33][34][35][36][37][38][39][40]. The literature evaluating the impact of tremor elimination on procedural outcomes was far scarcer, with only seven studies identified (Table 3).…”

Section: Resultsmentioning

confidence: 99%

“…The onset of physical fatigue over the course of a day can result in the increase in amplitude of a surgeon’s physiological tremor. One study demonstrated that muscle-cooling was effective in reducing the amplitude of fatigue-induced tremors [ 27 ]. The trial demonstrated a statistically significant reduction in tremor amplitude of experienced surgeons when wearing a muscle cooling suit (5 °C).…”

Section: Discussionmentioning

confidence: 99%

Overcoming the impact of physiologic tremors in ophthalmology

Singh

Jie

Sun

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Purpose Ophthalmic surgery involves the manipulation of micron-level sized structures such as the internal limiting membrane where tactile sensation is practically absent. All humans have physiologic tremors that are of low amplitude and not discernible to the naked eye; they do not adversely affect the majority of the population’s daily functioning. However, during microsurgery, such tremors can be problematic. In this review, we focus on the impact of physiological tremors on ophthalmic microsurgery and offer a comparative discussion on the impact of such tremors on other surgical specialties. Methods A single investigator used the MEDLINE database (via PubMed) to search for and identify articles for inclusion in this systematic review. Ten key factors were identified as potentially having an impact on tremor amplitude: beta-blockers, muscle fatigue, robotic systems, handheld tools/micromanipulators, armrests/wrist supports, caffeine, diet, sleep deprivation, consuming alcohol, and workouts (exercise). These key terms were then searched using the advanced Boolean search tool and operators (i.e., AND, OR) available on PubMed: (*keyword*) AND (surgeon tremor OR microsurgery tremor OR hand steadiness OR simulator score). Results Ten studies attempted to quantify the baseline severity of operator physiologic tremor. Approximately 89% of studies accessing the impact of tremors on performance in regards to surgical metrics reported an improvement in performance compared to 57% of studies concluding that tremor elimination was of benefit when considering procedural outcomes. Conclusions Robotic technology, new instruments, exoskeletons, technique modifications, and lifestyle factors have all demonstrated the potential to assist in overcoming tremors in ophthalmology.

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“…The different position of hand during harvesting may result in fatigue and exhaustion. The long procedure with flexed wrist position results in mental exhaustion and physical hand tremors . These may result in increased transection of hair with increase in the total operating time.…”

Section: Discussionmentioning

confidence: 99%

Effect of surgeon's workload on rate of transection during follicular unit excision/extraction (FUE)

Malik¹,

Mohmand²

2019

J of Cosmetic Dermatology

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Objectives To compare the transection rate at the start and at the end of the FUE procedure. Materials and methods The study was conducted in a private setup in patients undergoing first session of FUE surgery over 2000 grafts. Six areas of 1 cm2 were marked, two in midline and two on either side. All the procedures were undertaken by the single surgeon to avoid any bias. At the start of the surgery, the extraction of hair was performed in areas A1, A2, and A3. All the excised hair and transected hair were counted. The surgery was then completed but the remaining three areas (B1, B2, and B3) were left intact. Later, FUE was done in these areas. The excised hair and transected hair were counted. All the data were analyzed statistically by paired t test. Results A total of 25 patients were included in the study. The mean age of the patients was 35.2 years. The transection rate was 5.3/cm2 in mid‐zone, 4.4/cm2 on right side, and 5.7/cm2 on left side at the start and 27.7/cm2 in mid‐zone, 25.6/cm2 on right side, and 24.2/cm2 on left side at the end. The transection rate increased from 5.03 to 6.0/cm2 for FUS <2500 but increased from 4.83 to 6.6/cm2 with FUs over 2500 and increased from 5.5 to 6.67/cm2 when FUs were over 3000. Conclusion The surgeon's workload increases the hair transection during FUE.

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Muscle-Cooling Intervention to Reduce Fatigue and Fatigue-Induced Tremor in Novice and Experienced Surgeons: A Preliminary Investigation

Cited by 5 publications

References 17 publications

Interventions to Mitigate Fatigue Induced by Physical Work: A Systematic Review of Research Quality and Levels of Evidence for Intervention Efficacy

Interventions to Mitigate Fatigue Induced by Physical Work: A Systematic Review of Research Quality and Levels of Evidence for Intervention Efficacy

Overcoming the impact of physiologic tremors in ophthalmology

Effect of surgeon's workload on rate of transection during follicular unit excision/extraction (FUE)

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