Department of Physical and Rehabilitation Medicine, University of Padova, Padova, Italy.
Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy.
Ann Surg. 2019 Dec;270(6):969-975. doi: 10.1097/SLA.0000000000003199.
To evaluate the effectiveness of a program to reduce work-related musculoskeletal disorders (WRMSD) among surgeons.
Surgeons are at high risk of WRMSD due to many physical and psychosocial factors.
This study is a multicenter randomized clinical trial (UMIN000028557) conducted from January to August 2015. Following cluster randomization by surgical division, surgeons were allocated to 2 groups. The NPP group (No Preventive Program) underwent no intervention, while the PP group (Preventive Program) followed ergonomic principles in the operating room and specific physical exercises supervised by a physical therapist. A multiple logistic regression was performed to identify baseline WRMSD risk factors. WRMSD assessment was based on 1 ad hoc and 3 validated questionnaires: Nordic Musculoskeletal Questionnaire (NMQ), Numerical Rating Scale (NRS), and Short Form 36 Health Survey (SF-36). Follow-up was planned after 3 and 6 months.
One hundred forty-one surgeons matched the inclusion criteria and were randomized in the PP (n = 65) and NPP (n = 76) groups. At the initial analysis, physical activity was the only modifiable independent risk factor for WRMSD (OR, 2.44; P = 0.05). The PP group showed a significant improvement in the item "General Health" (GH) regarding quality of life at 3 (NPP: 70.5 ± 15.2 vs PP: 75.9 ± 14.1; P = 0.04) and 6 months (70.6 ± 13.4 vs 75.3 ± 13.0; P = 0.04). The PP group had a significant reduction of low back pain (66.2% vs 50.0%; P = 0.04) and analgesic consumption (30.9% vs 15.5%; P = 0.03) after 6 months.
This study demonstrated the effectiveness of a global program based on the application of ergonomics in the operating room and specific physical exercises.
评估一项减少外科医生职业性肌肉骨骼疾病(WRMSD)的计划的有效性。
由于许多生理和心理社会因素,外科医生发生 WRMSD 的风险很高。
这是一项多中心随机临床试验(UMIN000028557),于 2015 年 1 月至 8 月进行。在按外科科室进行聚类随机分组后,外科医生被分配到 2 组。NPP 组(无预防计划)未进行任何干预,而 PP 组(预防计划)遵循手术室的人体工程学原则和由物理治疗师监督的特定体育锻炼。采用多变量逻辑回归识别基线 WRMSD 风险因素。WRMSD 评估基于 1 个专门和 3 个经过验证的问卷:北欧肌肉骨骼问卷(NMQ)、数字评分量表(NRS)和 36 项健康调查简表(SF-36)。计划在 3 个月和 6 个月后进行随访。
符合纳入标准的 141 名外科医生被随机分配到 PP 组(n = 65)和 NPP 组(n = 76)。在初步分析中,体力活动是 WRMSD 的唯一可改变的独立风险因素(OR,2.44;P = 0.05)。PP 组在生活质量的“一般健康”(GH)项目方面在 3 个月(NPP:70.5±15.2 与 PP:75.9±14.1;P = 0.04)和 6 个月(70.6±13.4 与 PP:75.3±13.0;P = 0.04)时均有显著改善。PP 组在 6 个月时的腰痛(66.2%与 50.0%;P = 0.04)和镇痛药使用率(30.9%与 15.5%;P = 0.03)均有显著降低。
本研究表明,基于在手术室应用人体工程学和特定体育锻炼的整体计划是有效的。