Practice Guidelines for Prevention of Musculoskeletal Disorders in Obstetric Sonography

Abstract

quipment installation and ergonomic work environments in obstetric sonography are seldom addressed. However, it is very important for sonographers of all experience levels to know the different musculoskeletal disorders that can occur in regular practice. These disorders have been clinically recognized since the late 1990s. 1 They denote a set of conditions responsible for pain and discomfort, affecting primarily the upper limbs and the cervical and lumbar spine.Many studies on the subject, mainly conducted in Englishspeaking countries, show that more than 80% of experienced sonographers of all specialties describe pain when performing examinations. 2 The average time between the start of regular sonography practice and the onset of pain is 5 years. Given the reality of this problem, it seems essential to continue research to better understand the causes of these disorders and improve prevention. After a literature review and our own work analysis, we propose and illustrate rules of good practice to limit harmful postures. REVIEW ARTICLEErgonomics and prevention of musculoskeletal disorders in obstetric sonography is a subject seldom discussed. However, 80% of sonographers describe pain when performing these examinations. The consequences of these disorders can range from impaired quality of life to the complete cessation of professional activity. Some diseases may even require surgical treatments such as carpal tunnel syndrome and shoulder rotator cuff injuries. After joint disorders mainly affecting the upper limbs and neck, deterioration of visual acuity is the second most commonly reported condition. A literature review can identify risk factors, particularly arm abduction greater than 30°, repeated isometric maneuvers without compensatory rest, the level of force applied to the probe, abdominal scanning approaches, examination times longer than 25 minutes, and more than 100 sonographic examinations per month. The ergonomics of the operator's workstation and posture are essential to prevent these disorders. Machine, probe, chair, and examination bed designs are already subject to industrial consensus, but sonographers are responsible for configuring their ideal workstations to preserve their professional and physical potential. Therefore, this article proposes rules of good practice and illustrates recommended positions and those to avoid.

Prevalence and Risk factors for Work Related Musculoskeletal Disorders among Sonographer of Sindh Province Pakistan

“…However, few questionnaires were not duly completely filled and finally 63.04% questionnaires were available for data analysis. It is estimated that prevalence of musculoskeletal disorders among general population is 13%-22%, in contrast to the high prevalence of WRMDs among sonologists, ranging from 63% to 91% 14 . In the present study we found prevalence of WRMDs among sonologists high as 75.17%.…”

The Prevalence of and Risk Factors Associated with Musculoskeletal Disorders among Sonographers in Central China: A Cross-Sectional Study

“…Height-adjustable chairs showed significant effect on the posture of bending neck backward (nonadjustable VS. adjustable, OR 1.9, 95% CI 1.07–3.50). Height-adjustable tilt tables (for special scan procedures), movable tables, and height-adjustable chairs are highly recommended by sonographer/sonologist associations and ergonomic researchers [ 39 , 62 – 63 ] to ensure an upright posture and optimize the position with the patient when necessary. In this study, only 9.9% reported having height-adjustable tables, and 40.5% reported the chairs they used were non-adjustable.…”

Radiologic and Sonography Professionals’ Ergonomics

“…Ergonomic techniques and postures were described only for abdominal sonographic scans and transvaginal sonographic scans. 25 For abdominal scans, it was recommended that sonographers (a) keep their neck straight by positioning their head directly in front of the monitor, (b) do not pass the probe cable around the back of the neck, (c) use a chair with adjustable height, (d) keep the lower back firmly supported on the chair's backrest, (e) keep the trunk straight in line with the axis of the screen, (f) position the patient as close as possible to the operator, (g) place the scanning arm on top of the patient, (h) hold the transducer with a palmar grip, (i) keep the wrist in a neutral position, and (j) keep the hips, knees, and ankles at a 90 degree angle.…”