Reduction of Work-Related Musculoskeletal Disorders in Plastic Surgeons by Introduction of a Posture Training Device.
Journal
Annals of plastic surgery
ISSN: 1536-3708
Titre abrégé: Ann Plast Surg
Pays: United States
ID NLM: 7805336
Informations de publication
Date de publication:
01 05 2022
01 05 2022
Historique:
medline:
25
9
2023
pubmed:
1
5
2022
entrez:
23
9
2023
Statut:
ppublish
Résumé
Plastic surgeons have an increased risk for the development of musculoskeletal disorders because of frequent poor ergonomics of the operating room. This study characterizes selected plastic surgery procedures, with an attempt to identify high-risk procedures and procedural components as well as the impact of biofeedback on surgical ergonomics. A commercially available posture training device was used to initially record neck and spine positioning and later to send biofeedback to prompt surgeons to correct posture. Device data were correlated with in-person observations to characterize factors associated with more time spent in the slouched/nonneutral cervical and thoracic spine posture. The proportion of time spent in the upright position during surgery was significantly different among male and female participants, level of training, participant height, in the sitting versus nonsitting positioning (P < 0.001), with loupes use, and if there was more than an 8-inch height difference between 2 participants (mean, 0.70 ± 0.285). Using the device intervention, all participants spent a larger proportion of operating time upright. Half of these improvements in posture were statistically significant. While in feedback mode, participants experienced shorter and more frequent periods of slouching/nonneutral posture. When comparing the same participant performing the same procedure with and without device biofeedback, 72.2% of participants spent more time in the upright/neutral posture during the surgery when the device was sending feedback. Biofeedback devices used in the operating room can lead to improved surgical posture, which may translate to reduction of workplace injuries, and overall physician health. This study found that a commercially available posture training device and sitting stools in the operating room could significantly improve physician cervical and thoracic spine posture.
Sections du résumé
BACKGROUND
Plastic surgeons have an increased risk for the development of musculoskeletal disorders because of frequent poor ergonomics of the operating room. This study characterizes selected plastic surgery procedures, with an attempt to identify high-risk procedures and procedural components as well as the impact of biofeedback on surgical ergonomics.
METHODS
A commercially available posture training device was used to initially record neck and spine positioning and later to send biofeedback to prompt surgeons to correct posture. Device data were correlated with in-person observations to characterize factors associated with more time spent in the slouched/nonneutral cervical and thoracic spine posture.
RESULTS
The proportion of time spent in the upright position during surgery was significantly different among male and female participants, level of training, participant height, in the sitting versus nonsitting positioning (P < 0.001), with loupes use, and if there was more than an 8-inch height difference between 2 participants (mean, 0.70 ± 0.285). Using the device intervention, all participants spent a larger proportion of operating time upright. Half of these improvements in posture were statistically significant. While in feedback mode, participants experienced shorter and more frequent periods of slouching/nonneutral posture. When comparing the same participant performing the same procedure with and without device biofeedback, 72.2% of participants spent more time in the upright/neutral posture during the surgery when the device was sending feedback.
CONCLUSIONS
Biofeedback devices used in the operating room can lead to improved surgical posture, which may translate to reduction of workplace injuries, and overall physician health. This study found that a commercially available posture training device and sitting stools in the operating room could significantly improve physician cervical and thoracic spine posture.
Identifiants
pubmed: 37740471
doi: 10.1097/SAP.0000000000003136
pii: 00000637-202205004-00014
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
S379-S384Informations de copyright
Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflicts of interest and sources of funding: No authors have any relevant conflict of interest to disclose.
Références
Epstein S, Sparer EH, Tran BN, et al. Prevalence of work-related musculoskeletal disorders among surgeons and interventionalists: a systematic review and meta-analysis. JAMA Surg. 2018;153:e174947.
Auerbach JD, Weidner ZD, Milby AH, et al. Musculoskeletal disorders among spine surgeons: results of a survey of the scoliosis research society membership. Spine (Phila Pa 1976). 2011;36:E1715–E1721.
Sivak-Callcott JA, Diaz SR, Ducatman AM, et al. A survey study of occupational pain and injury in ophthalmic plastic surgeons. Ophthal Plast Reconstr Surg. 2011;27:28–32.
Vijendren A, Yung M, Sanchez J. The ill surgeon: a review of common work-related health problems amongst UK surgeons. Langenbecks Arch Surg. 2014;399:967–979.
Soueid A, Oudit D, Thiagarajah S, et al. The pain of surgery: pain experienced by surgeons while operating. Int J Surg. 2010;8:118–120.
Kokosis G, Dellon LA, Lidsky ME, et al. Prevalence of musculoskeletal symptoms and ergonomics among plastic surgery residents: results of a national survey and analysis of contributing factors. Ann Plast Surg. 2020;85:310–315. Available at: https://journals.lww.com/annalsplasticsurgery/Fulltext/2020/09000/Prevalence_of_Musculoskeletal_Symptoms_and.22.aspx. Accessed December 21, 2020.
Fisher SM, Teven CM, Song DH. Ergonomics in the operating room: the cervicospinal health of today's surgeons. Plast Reconstr Surg. 2018;142:1380–1387.
Khansa I, Khansa L, Westvik TS, et al. Work-related musculoskeletal injuries in plastic surgeons in the United States, Canada, and Norway. Plast Reconstr Surg. 2018;141:165e–175e.
Winters JN, Sommer NZ, Romanelli MR, et al. Stretching and strength training to improve postural ergonomics and endurance in the operating room. Plast Reconstr Surg Glob Open. 2020;8:e2810. https://journals.lww.com/prsgo/Fulltext/2020/05000/Stretching_and_Strength_Training_to_Improve.29.aspx.
Sergesketter AR, Lubkin DT, Shammas RL, et al. The impact of ergonomics on recruitment to surgical fields: a multi-institutional survey study. J Surg Res. 2019;236:238–246.
Cochran A, Melby S, Neumayer LA. An internet-based survey of factors influencing medical student selection of a general surgery career. Am J Surg. 2005;189:742–746.
Howarth AL, Hallbeck MS, Lemaine V, et al. Work-related musculoskeletal discomfort and injury in craniofacial and maxillofacial surgeons. J Craniofac Surg. 2019;30:1982. https://journals.lww.com/jcraniofacialsurgery/Fulltext/2019/10000/Work_Related_Musculoskeletal_Discomfort_and_Injury.15.aspx.
Nimbarte AD, Zreiqat M, Chapman M, Sivak-Callcott JA. Physical risk factors for neck pain among oculoplastic surgeons. Presented at: 62nd IIE Annual Conference and Expo, May 19–23, 2012; Orlando, FL.
Hansraj KK. Assessment of stresses in the cervical spine caused by posture and position of the head. Surg Technol Int. 2014;25:277–279. Available at: http://www.ncbi.nlm.nih.gov/pubmed/25393825. Accessed December 21, 2020.
Lakhiani C, Fisher SM, Janhofer DE, et al. Ergonomics in microsurgery. J Surg Oncol. 2018;118:840–844.
Kant IJ, de Jong LC, van Rijssen-Moll M, et al. A survey of static and dynamic work postures of operating room staff. Int Arch Occup Environ Health. 1992;63:423–428.
Yu D, Green C, Kasten SJ, et al. Effect of alternative video displays on postures, perceived effort, and performance during microsurgery skill tasks. Appl Ergon. 2016;53:281–289.
Hallbeck MS, Lowndes BR, Bingener J, et al. The impact of intraoperative microbreaks with exercises on surgeons: a multi-center cohort study. Appl Ergon. 2017;60:334–341.
Dorion D, Darveau S. Do micropauses prevent surgeon's fatigue and loss of accuracy associated with prolonged surgery? An experimental prospective study. Ann Surg. 2013;257:256–259.
Quinn D, Moohan J. The trainees' pain with laparoscopic surgery: what do trainees really know about theatre set-up and how this impacts their health. Gynecol Surg. 2015;12:71–76.
Abareshi F, Yarahmadi R, Solhi M, et al. Educational intervention for reducing work-related musculoskeletal disorders and promoting productivity. Int J Occup Saf Ergon. 2015;21:480–485.
McCambridge J, Witton J, Elbourne DR. Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects. J Clin Epidemiol. 2014;67:267–277.