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基于证据的术中微休息活动以减少手术室中的肌肉骨骼损伤

Evidence-based intraoperative microbreak activities for reducing musculoskeletal injuries in the operating room.

作者信息

Coleman Wood Krista A, Lowndes Bethany R, Buus Ryan J, Hallbeck M Susan

机构信息

Motion Analysis Laboratory, Mayo Clinic, Rochester, MN, USA.

Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.

出版信息

Work. 2018;60(4):649-659. doi: 10.3233/WOR-182772.

Abstract

BACKGROUND

Neuromusculoskeletal pain and fatigue have been self-reported by over 70% surgeons who perform minimally invasive surgery (MIS). These problems can become impairments impacting surgical performance, patient outcomes, and career longevity. Human factors engineering has identified microbreaks coupled with activities as a viable strategy to counteract known physical, cognitive, and environmental stressors as well as mitigate neuromusculoskeletal (NMS) problems for workers in office and manufacturing domains.

OBJECTIVE

Develop a novel set of intraoperative surgical microbreaks activities tailored for MIS surgeons to mitigate surgery-induced neuromusculoskeletal fatigue and pain.

METHODS

Using NSM problems identified by practitioners and literature, a clinician determined causes and solutions and ranked them based on literature and clinical expertise. Solutions were incorporated into synchronized activities that addressed overarching goals and multiple tissues.

RESULTS

The resulting activities, translating contemporary science in clinical physical medicine and rehabilitation practice and tissue biomechanics, specifically address the overarching goals of: 1) posture correction; 2) normalization of tissue tension and soft tissue mobility/gliding; and 3) relaxation/stress reduction.

CONCLUSION

Surgeons can perform the activities in approximately one minute inside the sterile field. Movements encompassing multiple requirements and engaging multiple body segments are combined to provide an efficient and effective intervention to the target tissues.

摘要

背景

超过70%的进行微创手术(MIS)的外科医生自我报告存在神经肌肉骨骼疼痛和疲劳。这些问题可能会成为影响手术操作、患者预后和职业寿命的损伤。人因工程学已确定微休息与活动相结合是一种可行的策略,可应对已知的身体、认知和环境压力源,并减轻办公室和制造领域工作人员的神经肌肉骨骼(NMS)问题。

目的

为MIS外科医生开发一套全新的术中手术微休息活动,以减轻手术引起的神经肌肉骨骼疲劳和疼痛。

方法

利用从业者和文献中确定的NMS问题,一名临床医生确定了原因和解决方案,并根据文献和临床专业知识对其进行了排序。解决方案被纳入同步活动中,这些活动解决了总体目标和多个组织的问题。

结果

由此产生的活动将临床物理医学和康复实践以及组织生物力学方面的当代科学进行了转化,具体解决了以下总体目标:1)姿势矫正;2)组织张力和软组织活动度/滑动的正常化;3)放松/减轻压力。

结论

外科医生可以在无菌区域内大约一分钟内完成这些活动。包含多种要求并涉及多个身体部位的动作相结合,为目标组织提供了一种高效且有效的干预措施。

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