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BackgroundStandard laparoscopy (SL) is responsible for musculoskeletal disorders in surgeons because of poor ergonomic positions, which could be reduced by robot-assisted laparoscopy (RAL) owing to the surgeons’ seated position. One of the aims of the ROBOGYN-1004 study (NCT01247779) was to evaluate surgeons’ workloads during real-time procedures of gynecological oncological surgery.MethodsPatients with gynecological cancer eligible for minimally invasive surgery were recruited from 13 French centers between December 2010 and December 2015. Physical workload was evaluated using the Borg scale every hour over the surgery duration and the perception of workload evaluated using NASA-TLX at the end of surgery.ResultsA total of 369 patients were recruited, of whom 176 underwent RAL and 193 underwent SL (per-protocol analysis). Posture during SL was significantly more challenging for all body parts except the back. There was an increase in discomfort over time (up to 4 h) for the hands and arms, neck, and legs in SL compared with RAL. Perceived physical activity and abilities were rated higher in SL than in RAL (p < 0.01), whereas perceived personal performance was higher in SL (p < 0.01). Perceived physical effort during surgery was lower in RAL than in SL.ConclusionsRAL improves the perception of physical workload. Compared with SL, the perceived effort is lower in RAL regardless of the complexity of the surgery.

This study introduces a novel wearable Inertial Measurement Unit (IMU)-based system for an objective and comprehensive assessment of Work-Related Musculoskeletal Disorders (WMSDs), thus enhancing workplace safety. The system integrates wearable technology with a user-friendly interface, providing magnetometer-free orientation estimation, joint angle measurements, and WMSDs risk evaluation. Tested in a cable manufacturing facility, the system was evaluated with ten female employees. The evaluation involved work cycle identification, inter-subject comparisons, and benchmarking against standard WMSD risk assessments like RULA, REBA, Strain Index, and Rodgers Muscle Fatigue Analysis. The evaluation demonstrated uniform joint patterns across participants (ICC=0.72±0.23) and revealed a higher occurrence of postures warranting further investigation, which is not easily detected by traditional methods such as RULA. The experimental results showed that the proposed system’s risk assessments closely aligned with the established methods and enabled detailed and targeted risk assessments, pinpointing specific bodily areas for immediate ergonomic interventions. This approach not only enhances the detection of ergonomic risks but also supports the development of personalized intervention strategies, addressing common workplace issues such as tendinitis, low back pain, and carpal tunnel syndrome. The outcomes highlight the system’s sensitivity and specificity in identifying ergonomic hazards. Future efforts should focus on broader validation and exploring the relative influence of various WMSDs risk factors to refine risk assessment and intervention strategies for improved applicability in occupational health.

Background Neck pain is a significant public health issue, especially among office workers, with a prevalence ranging from 42 to 68%. This study aimed to evaluate the cost-utility and cost-benefit of a multi-component intervention targeting neck pain in the general population of office workers in Switzerland. The 12-week multi-component intervention consisted of neck exercises, health promotion information workshops, and workplace ergonomics sessions. Methods The study was designed as a stepped-wedge cluster randomized controlled trial and assessed using an employer’s perspective. The main analysis focused on the immediate post-intervention period. Long-term effects were examined in a subsample at the 4, 8, and 12-month follow-ups. The intervention effects on costs and quality-adjusted life years (QALYs) were estimated using generalized linear mixed-effects models, controlling for confounding factors. Incremental cost-effectiveness ratios (ICERs) and cost-effectiveness acceptability curves were presented, along with calculations of the break-even point and the return on investment. Various sensitivity analyses were performed. Results A total of 120 office workers participated in the trial, with 100 completing the intervention period and 94 completing the entire study. The main analysis included 392 observations. The intervention had a significant positive effect on QALYs and a nonsignificant effect on costs. The ICER was estimated at -25,325 per QALY gain, and the probability of the intervention being cost saving was estimated at 88%. The break-even point was reached one week after the end of the intervention. Conclusion The multi-component intervention is likely to reduce company costs and simultaneously improve the quality of life of employees. However, the implementation of such interventions critically depends on evidence of their cost-effectiveness. As there is still a large research gap in this area, future studies are needed. Trial registration ClinicalTrials.gov, NCT04169646 . Registered 15 November 2019-Retrospectively registered. Trial protocol Aegerter AM, Deforth M, Johnston V, Ernst MJ, Volken T, Luomajoki H, et al. On-site multi-component intervention to improve productivity and reduce the economic and personal burden of neck pain in Swiss office-workers (NEXpro): protocol for a cluster-randomized controlled trial. BMC Musculoskelet Disord. 2020;21(1):391.  https://doi.org/10.1186/s12891-020-03388-x .

Endoscopic endonasal skull base surgery is a promising alternative to transcranial approaches. However, standard instruments lack articulation, and thus, could benefit from robotic technologies. The aim of this study was to develop an ergonomic handle for a handheld robotic instrument intended to enhance this procedure. Two different prototypes were developed based on ergonomic guidelines within the literature. The first is a forearm-mounted handle that maps the surgeon’s wrist degrees-of-freedom to that of the robotic end-effector; the second is a joystick-and-trigger handle with a rotating body that places the joystick to the position most comfortable for the surgeon. These handles were incorporated into a custom-designed surgical virtual simulator and were assessed for their performance and ergonomics when compared with a standard neurosurgical grasper. The virtual task was performed by nine novices with all three devices as part of a randomised crossover user-study. Their performance and ergonomics were evaluated both subjectively by themselves and objectively by a validated observational checklist. Both handles outperformed the standard instrument with the rotating joystick-body handle offering the most substantial improvement in terms of balance between performance and ergonomics. Thus, it is deemed the more suitable device to drive instrumentation for endoscopic endonasal skull base surgery.

Construction work frequently involves heavy physical work, and a reduction of the physical workload should have high priority. Technological development has made it possible to obtain field measurements with surface electromyography (sEMG), kinematics measured with inertial measurement units (IMUs), and video recordings. However, no studies have used these methods simultaneously to detect situations with excessive physical workload (events) during a working day. Thus, knowledge about these specific events may combat work-related risk factors. Participatory ergonomics (PE) has shown promising results, but whether it can be used as a tool to reduce the physical workload during construction work remains unknown. This cluster randomized controlled trial investigated whether a PE intervention with technical measurements consisting of IMUs, sEMG, heart rate monitoring, and video recordings of physical workload could reduce the number of events with excessive physical workload during a working day. Furthermore, other outcomes were obtained from questionnaires. A total of 80 male full-time construction workers (aged 19 to 67 years) were randomized at the cluster level (gang) to a PE intervention consisting of 3 workshops (7 gangs and 32 workers) or to a control group (8 gangs and 48 workers). The physical workload was recorded by technical measurements, that is, IMUs, sEMG, heart rate monitoring, and video recordings during a full working day at baseline and 3 and 6 months' follow-up. On the basis of the technical measurements, a custom-made computer program detected the situations (events) where the construction workers were exposed to excessive physical workload and used in the intervention. Differences in the number of events from baseline to follow-up between intervention and control were evaluated using linear mixed models (intention-to-treat), with individual nested in cluster as a random factor. Furthermore, questionnaires were filled out on test days. The results of the primary outcome showed no change in the number of events with excessive physical workload. However, compared with the control group, the other outcomes showed decreased general fatigue after a typical working day (P=.001) and increased influence on own work (P=.04). This PE intervention with technical measurements did not reduce the number of events with excessive physical workload during construction work. However, the intervention led to decreased general fatigue and increased influence on own work. ClinicalTrials.gov NCT02498197; https://clinicaltrials.gov/ct2/show/NCT02498197 (Archived by WebCite at http://www.webcitation.org/74SZ3DIWS).

Background Musculoskeletal disorders (MSDs) are known as one of the main problems affecting the health of industrial workers and can lead to lost working days, functional disability of workers and wasting the financial resources of an organization. Therefore, the present study aimed to evaluating the effect of ergonomic interventions on reducing MSDs and improving working posture in the in a foundry industry workers. Methods A field multicomponent cross-interventional study was conducted on workers working in a foundry industry. In this study, 117 male workers were divided into 4 groups, including a control group, a group with specialized ergonomics training, a group with workstation intervention, and a group simultaneously undergoing training and workstation intervention. All 4 groups were evaluated during a period of baseline, 6 and 12-months follow- up. The Cornell Musculoskeletal Discomfort Questionnaire (CMDQ) and direct observations of working postures by using the Quick Exposure Check (QEC) method were used. Results The results showed that the implemented interventions in the shoulder/arm, back and stress level were effective and the difference in the final score was significant among different groups ( P -value > 0.05). In addition, the interventions led to a significant decrease in the QEC scores and musculoskeletal symptom scores in the neck, shoulder, lower back, knee, and lower leg regions among different groups ( P -value > 0.05). Conclusion The results showed that workstation modification and training and workstation intervention simultaneously had a greater effect on MSDs and improving working posture compared to training alone.

Healthcare professionals (namely, occupational therapists) face ergonomic risk factors that may lead to work-related musculoskeletal disorders (WRMSD). Ergonomic assessments are crucial to mitigate this occupational issue. Wearable devices are a potential solution for such assessments, providing continuous measurement of biomechanical and physiological parameters. Ergo4workers (E4W) is a mobile application designed to integrate data from independent wearable sensors—motion capture system, surface electromyography, force platform, and smartwatch—to provide an overview of the posture and workload of occupational therapists. It can help identify poor work practices and raise awareness about ergonomic risk factors. This paper describes the development of E4W by following a User-Centred Design (UCD) approach. The initial stage focused on specifying the context of use in collaboration with six occupational therapists. Then the app was implemented using WordPress. Three iterations of the UCD cycle were performed. The usability test of prototype 1 was carried out in a laboratory environment, while the others were tested in a real healthcare work environment. The Cognitive Walkthrough was applied in the usability tests of prototypes 1 and 2. The System Usability Scale evaluated prototype 3. Results evidenced positive feedback, reflecting an easy-to-use and intuitive smartphone app that does not interfere with daily work activities.

Purpose Neck pain is common among office workers and leads to work productivity loss. This study aimed to investigate the effect of a multi-component intervention on neck pain-related work productivity loss among Swiss office workers. Methods Office workers, aged 18–65 years, and without serious neck-related health problems were recruited from two organisations for our stepped-wedge cluster randomized controlled trial. The 12-week multi-component intervention included neck exercises, health-promotion information, and workplace ergonomics. The primary outcome of neck pain-related work productivity loss was measured using the Work Productivity and Activity Impairment Questionnaire and expressed as percentages of working time. In addition, we reported the weekly monetary value of neck pain-related work productivity loss. Data was analysed on an intention-to-treat basis using a generalized linear mixed-effects model. Results Data from 120 participants were analysed with 517 observations. At baseline, the mean age was 43.7 years (SD 9.8 years), 71.7% of participants were female (N = 86), about 80% (N = 95) reported mild to moderate neck pain, and neck pain-related work productivity loss was 12% of working time (absenteeism: 1.2%, presenteeism: 10.8%). We found an effect of our multi-component intervention on neck pain-related work productivity loss, with a marginal predicted mean reduction of 2.8 percentage points (b = −0.27; 95% CI: −0.54 to −0.001, p = 0.049). Weekly saved costs were Swiss Francs 27.40 per participant. Conclusions: Our study provides evidence for the effectiveness of a multi-component intervention to reduce neck pain-related work productivity loss with implications for employers, employees, and policy makers.Trial Registration ClinicalTrials.gov, NCT04169646. Registered 15 November 2019—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04169646.

Background Surgeons are in high demand due to the ageing population’s increased need for surgery. However, the high prevalence of musculoskeletal pain (MSP) threatens their career longevity. While improving intraoperative ergonomics is crucial, physical exercise training is also widely used in managing MSP. The objective is to investigate the added effectiveness of intelligent physical exercise training (IPET) when combined with intraoperative ergonomic recommendations (ERGO), compared to ERGO alone, in reducing MSP among abdominal and pelvic surgeons. Methods This pragmatic, multicenter, 20-week, superiority, open-label randomized controlled trial (RCT) is conducted in two phases. Phase 1 is a 3-month ergonomic educational period (ERGO) delivered to all participants. Phase 2 is the RCT, where participants are randomized 1:1 to ERGO (control) or ERGO + IPET (intervention). ERGO provides recommendations for operating room (OR) ergonomics, including posture and microbreaks, displayed in and around ORs. IPET prescribes 50 min of individualized weekly exercise, tailored to MSP, job profile (sedentary, walking/standing, or heavy work), physical capacity, and health risk indicators, and is delivered via a mobile application. Eligible surgeons specialize in gynecology, urology, and colorectal surgery and perform ≥ 4 h/week of abdominal or pelvic surgery (robot-assisted, laparoscopic, or open, excluding vaginal surgery), and complete the Phase 1 questionnaire. Surgeons advised against exercise by their GP are excluded. Participants are recruited from regional and academic hospitals in Denmark and North America. Enrollment begins with completion of the ERGO survey and consent in the baseline questionnaire. Recruitment started 13 December 2023, with a target sample size of 83. The primary effect of interest is the between-group difference in MSP intensity (0–10 numeric rating scale) at 20 weeks in the body part reported as most painful at baseline, analyzed using a linear mixed model with baseline MSP as covariate. Harms include increases in MSP or injury, though these will not be systematically collected. Participants and research staff are not blinded. Outcome interpretation will be blinded to group allocation. Discussion This trial addresses a gap in strategies to mitigate MSP among surgeons by combining ergonomics recommendations with app-delivered IPET. Findings may inform strategies to improve surgeon well-being and reduce future workforce shortages. Trial registration Clinicaltrials.gov, NCT06112106. Registered on October 4, 2023.

Purpose This study aimed to evaluate the combined effects of a 12-week ergonomic training and exercise program on musculoskeletal pain and ergonomic risks among supermarket cashiers. Methods This study cohort comprised 77 cashiers, aged between 18 and 45, who were experiencing musculoskeletal pain. Of these, 60 participants completed the study after random assignment to either the intervention group, which received ergonomic training and exercise, or the control group, which received only ergonomic training. The study lasted 12 weeks, with assessments conducted at baseline (week 0) and 12 weeks post-intervention. The outcomes included the Visual Analogue Scale, the Extended Nordic Musculoskeletal Questionnaire (NMQ-E), and the Rapid Upper Limb Assessment. The clinical trial registration number is NCT06407440. Results Musculoskeletal pain in the upper back, lower back, and hips/thighs decreased significantly after the intervention, while there were no significant changes in the control group, except for a reduction in upper back pain. A significant improvement in activity limitations was observed in the intervention group, particularly in the upper back and lower back. Consultations with health professionals for upper and lower back pain (NMQ-E) decreased significantly in the intervention group. Symptoms in the past 7 days showed a significant decrease in the intervention group, especially for the upper back, lower back, and hips/thighs, with no significant change in the control group. Conclusion The integrated approach of ergonomic training and exercise programs has the potential to alleviate musculoskeletal discomfort among supermarket cashiers. These interventions may prove an effective strategy for enhancing the well-being of workers in physically demanding retail environments.