Safety and Health at Work

Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency (산업안전보건연구원)
권호 표지
DOI QR코드

DOI QR Code

Assessments of Physical Workload in Sonography Tasks Using Inclinometry, Goniometry, and Electromyography

  • Simonsen, Jenny Gremark (Division of Occupational and Environmental Medicine, Lund University) ;
  • Dahlqvist, Camilla (Division of Occupational and Environmental Medicine, Lund University) ;
  • Enquist, Henrik (Division of Occupational and Environmental Medicine, Lund University) ;
  • Nordander, Catarina (Division of Occupational and Environmental Medicine, Lund University) ;
  • Axmon, Anna (Division of Occupational and Environmental Medicine, Lund University) ;
  • Arvidsson, Inger (Division of Occupational and Environmental Medicine, Lund University)
  • Received : 2017.03.15
  • Accepted : 2017.08.26
  • Published : 2018.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Background: Echocardiography involves strenuous postures of the upper limbs. This study explored the physical workload in the neck and upper limbs in sonographers performing echocardiography, and the extent to which the workload differs from than in other work tasks (other sonographic examinations, and nonsonographic tasks). Methods: The physical load was assessed by inclinometry, goniometry, and electromyography methods in 33 female sonographers during authentic work using three different echocardiography techniques and other work tasks. Results: Echocardiography was characterized by low velocities of the head, arms, and wrists, and a low proportion of muscular resting time in the forearms, in the transducer limb, and the computer limb. The transducer limb was more elevated in one of the techniques, but this technique also involved a higher proportion of muscular resting time of the trapezius muscle. We also found a high proportion of awkward wrist postures in the transducer wrist in all three techniques; in one due to prolonged flexion, and in the others due to prolonged extension. Other work tasks were less static, and were performed with higher upper arm and wrist velocities. Conclusion: None of the three echocardiography techniques was optimal concerning physical workload. Thus, to achieve more variation in physical load we recommend that the equipment be arranged so that the sonographer can alternate between two different techniques during the workday. We also propose alternation between echocardiography and nonsonographic tasks, in order to introduce variation in the physical workload. Clinical expertise should be used to achieve further improvements.

Keywords

References

  1. Baker JP, Coffin CT. The importance of an ergonomic workstation to practicing sonographers. J Ultrasound Med 2013;32:1363-75. https://doi.org/10.7863/ultra.32.8.1363
  2. Russo A, Murphy C, Lessoway V, Berkowitz J. The prevalence of musculoskeletal symptoms among British Columbia sonographers. Appl Ergon 2002;33:385-93. https://doi.org/10.1016/S0003-6870(02)00038-8
  3. Brown G, Baker J. Work-related musculoskeletal disorders in sonographers. J Diagn Med Sonogr 2004;20:85-93. https://doi.org/10.1177/8756479304263022
  4. Schoenfeld A, Goverman J, Weiss DM, Meizner I. Transducer user syndrome: an occupational hazard of the ultrasonographer. Eur J Ultrasound 1999;10:41-5. https://doi.org/10.1016/S0929-8266(99)00031-2
  5. Wihlidal LM, Kumar S. An injury profile of practicing diagnostic medical sonographers in Alberta. Int J Ind Ergon 1997;19:205-16. https://doi.org/10.1016/S0169-8141(95)00107-7
  6. Pike I, Russo A, Berkowitz J, Baker Joan P, Lessoway Vickie A. The prevalence of musculoskeletal disorders among diagnostic medical sonographers. J Diagn Med Sonogr 1997;13:219-27. https://doi.org/10.1177/875647939701300501
  7. Kim T, Roh H. Analysis of risk factors for work-related musculoskeletal disorders in radiological technologists. J Phys Ther Sci 2014;26:1423-8. https://doi.org/10.1589/jpts.26.1423
  8. Hagberg M. ABC of work related disorders. Neck and arm disorders. BMJ 1996;313:419-22. https://doi.org/10.1136/bmj.313.7054.419
  9. Gibbs V, Young P. A study of the experiences of participants following attendance at a workshop on methods to prevent or reduce work-related musculoskeletal disorders amongst sonographers. Radiography 2011;17:223-9. https://doi.org/10.1016/j.radi.2011.02.003
  10. Sommerich CM, Lavender SA, Evans K, Sanders E, Joines S, Lamar S, Radin Umar RZ, Yen WT, Li J, Nagavarapu S, Dickerson JA. Collaborating with cardiac sonographers to develop work-related musculoskeletal disorder interventions. Ergonomics 2016;59:1193-204. https://doi.org/10.1080/00140139.2015.1116613
  11. Simonsen JG, Gard G. Swedish Sonographers' perceptions of ergonomic problems at work and their suggestions for improvement. BMC Musculoskelet Disord 17 2016;391:1-10. https://doi.org/10.1186/s12891-016-1245-y
  12. Tornqvist EW, Hagberg M, Hagman M, Risberg EH, Toomingas A. The influence of working conditions and individual factors on the incidence of neck and upper limb symptoms among professional computer users. Int Arch Occup Environ Health 2009;82:689-702. https://doi.org/10.1007/s00420-009-0396-7
  13. Gremark Simonsen J, Axmon A, Nordander C, Arvidsson I. Neck and upper extremity pain in sonographers - associations with occupational factors. Appl Ergon 2017;58:245-53. https://doi.org/10.1016/j.apergo.2016.06.019
  14. Hansson GA, Balogh I, Bystrom JU, Ohlsson K, Nordander C, Asterland P, Sjolander S, Rylander L, Winkel J, Skerfving S., Malmo Shoulder-Neck Study Group. Questionnaire versus direct technical measurements in assessing postures and movements of the head, upper back, arms and hands. Scand J Work Environ Health 2001;27:30-40. https://doi.org/10.5271/sjweh.584
  15. Paschoarelli LC, de Oliveira AB, Cote Gil Coury HJ. Assessment of the ergonomic design of diagnostic ultrasound transducers through wrist movements and subjective evaluation. Int J Ind Ergon 2008;38:999-1006. https://doi.org/10.1016/j.ergon.2008.01.013
  16. Village J, Trask C. Ergonomic analysis of postural and muscular loads to diagnostic sonographers. Int J Ind Ergon 2007;37:781-9. https://doi.org/10.1016/j.ergon.2007.06.005
  17. Stenberg B, Elliott ST. Can live bi-plane sonography reduce work-related musculoskeletal disorders of the wrist? J Clin Ultrasound 2013;41:140-4. https://doi.org/10.1002/jcu.22003
  18. Murphey SL, Milkowski A. Surface EMG evaluation of sonographer scanning postures. J Diagn Med Sonogr 2006;22:298-307. https://doi.org/10.1177/8756479306292683
  19. Arvidsson I, Gremark Simonsen J, Dahlqvist C, Axmon A, Karlson B, Bjork J, Nordander C. Cross-sectional associations between occupational factors and musculoskeletal pain in women teachers, nurses and sonographers. BMC Musculoskelet Disord 17 2016;35:1-15. https://doi.org/10.1186/s12891-016-0883-4
  20. Lyon RA, Alto P, Henderson WR, Mesaros R, Vaughn RM. Ultrasound transducer probe having case handle grip surfaces. US 5897503 A; 1999.
  21. Hansson G-A, Asterland P, Holmer N, Skerfving S. Validity and reliability of triaxial accelerometers for inclinometry in posture analysis. Med Biol Eng Comput 2001;39:405-13. https://doi.org/10.1007/BF02345361
  22. Hansson G-A, Arvidsson I, Ohlsson K, Nordander C, Mathiassen SE, Skerfving S, Balogh I. Precision of measurements of physical workload during standardised manual handling. Part II: inclinometry of head, upper back, neck and upper arms. J Electromyogr Kinesiol 2006;16:125-36. https://doi.org/10.1016/j.jelekin.2005.06.009
  23. Balogh I, Ohlsson K, Nordander C, Skerfving S, Hansson GA. Precision of measurements of physical workload during standardized manual handling part III: goniometry of the wrists. J Electromyogr Kinesiol 2009;19:1005-12. https://doi.org/10.1016/j.jelekin.2008.07.003
  24. Greene WB, Heckman JD, editors. The clinical measurement of joint motion. Rosemont, IL: American Academy of Orthopaedic Surgeons; 1994.
  25. Nordander C, Balogh I, Mathiassen SE, Ohlsson K, Unge J, Skerfving S, Hansson G-A. Precision of measurements of physical workload during standardised manual handling. Part I: surface electromyography of m. trapezius, m. infraspinatus and the forearm extensors. J Electromyogr Kinesiol 2004;14:443-54. https://doi.org/10.1016/j.jelekin.2003.12.003
  26. Hansson G-A, Balogh I, Ohlsson K, Granqvist L, Nordander C, Arvidsson I, Akesson I, Unge J, Rittner R, Stromberg U, Skerfving S. Physical workload in various types of work; part II: neck, shoulder and upper arm. Int J Ind Erg 2010;40:267-81. https://doi.org/10.1016/j.ergon.2009.11.002
  27. Hansson G-A, Balogh I, Ohlsson K, Granqvist L, Nordander C, Arvidsson I, Akesson I, Unge J, Rittner R, Stromberg U, Skerfving S. Physical workload in various types of work; part I: wrist and forearm. Int J Ind Ergon 2009;39:221-33. https://doi.org/10.1016/j.ergon.2008.04.003
  28. Hansson G-A, Balogh I, Ohlsson K, Rylander L, Skerfving S. Goniometer measurements and computer analysis of wrist angles and movements applied to occupational repetitive work. J Electromyogr Kinesiol 1996;6:23-35. https://doi.org/10.1016/1050-6411(95)00017-8
  29. Palmer AK, Werner FW, Murphy D, Glisson R. Functional wrist motion: a biomechanical study. J Hand Surg Am 1985;10:39-46. https://doi.org/10.1016/S0363-5023(85)80246-X
  30. O'Driscoll JM, Bahia SS, Gravina A, Di Fino S, Thompson MM, Karthikesalingam A, Holt PJE, Sharma R. Transthoracic echocardiography provides important long-term prognostic information in selected patients undergoing endovascular abdominal aortic repair. Circ Cardiovasc Imaging 2016;9:e003557.
  31. Nordander C, Ohlsson K, Akesson I, Arvidsson I, Balogh I, Hansson G-A, Stromberg U, Rittner R, Skerfving S. Exposure-response relationships in workrelated musculoskeletal disorders in elbows and hands - a synthesis of group-level data on exposure and response obtained using uniform methods of data collection. Appl Ergon 2013;44:241-53. https://doi.org/10.1016/j.apergo.2012.07.009
  32. Claes F, Berger J, Stassijns G. Arm and neck pain in ultrasonographers. Hum Factors 2015;57:238-45. https://doi.org/10.1177/0018720814547872
  33. Rolander B, Karsznia A, Jonker D, Oberg T, Bellner AL. Perceived contra observed physical work load in Swedish dentists. Work 2005;25:253-62.
  34. Arvidsson I, Axmon A, Skerfving S. Follow-up study of musculoskeletal disorders 20 months after the introduction of a mouse-based computer system. Scand J Work Environ Health 2008;34:374-80. https://doi.org/10.5271/sjweh.1277
  35. Harris-Adamson C, Eisen EA, Kapellusch J, Garg A, Hegmann KT, Thiese MS, Dale AM, Evanoff B, Burt S, Bao S, Silverstein B, Merlino L, Gerr F, Rempel D. Biomechanical risk factors for carpal tunnel syndrome: a pooled study of 2474 workers. Occup Environ Med 2015;72:33-41. https://doi.org/10.1136/oemed-2014-102378
  36. Mathiassen SE. Diversity and variation in biomechanical exposure: what is it, and why would we like to know? Appl Ergon 2006;37:419-27. https://doi.org/10.1016/j.apergo.2006.04.006

Cited by

  1. Self-recordings of upper arm elevation during cleaning – comparison between analyses using a simplified reference posture and a standard reference posture vol.19, pp.None, 2018, https://doi.org/10.1186/s12891-018-2328-8