Dabholkar Twinkle, Dabholkar Yogesh G, Yardi Sujata, Sethi Jyotika
School of Physiotherapy, D.Y. Patil University, Navi Mumbai, India.
Department of ENT, School of Medicine, D.Y. Patil University, Navi Mumbai, India.
Indian J Otolaryngol Head Neck Surg. 2020 Sep;72(3):342-349. doi: 10.1007/s12070-020-01840-x. Epub 2020 Apr 7.
There are increased reports of high prevalence of work related musculoskeletal symptoms in surgeons performing otolaryngology procedures. However, real time ergonomic risk assessment in the OR is difficult due to issues related to sterility, cooperation and acceptance from surgeons. Although such analyses can provide valid risk estimate and guide corrective actions, they are scarce. Hence, this study was undertaken to assess the postural ergonomic risk on RULA in otolaryngologists while performing Functional Endoscopic Sinus Surgery in OR, in real time. A cross sectional, observational multi-centric study was conducted in tertiary referral hospitals. Spinal, shoulder and elbow movements of 10 surgeons performing FESS were measured intraoperatively using orientation sensor-based, motion-analysis system (Noraxon myomotion). Postural ergonomic risk on RULA was computed using the motion analysis data. RULA is a method of quantifying the physical postural risk of the trunk and upper limb based on the postures adopted by an individual during work. 10 surgeons (9 males and 1 female) with the mean (± SD) age of 38 ± 7.5 years participated in the study. The motion analysis data results indicate that the surgeons often adopt awkward spinal and upper extremity postures during the surgery. All the surgeons scored higher than the acceptable RULA score (1 or 2) with the mean RULA scores being in the range of 6-7. The physical ergonomic risk in surgeons performing FESS is high (> 6 on RULA). There is a need for urgent ergonomic attention to the working environment of FESS surgeon.
越来越多的报告指出，进行耳鼻喉科手术的外科医生中与工作相关的肌肉骨骼症状患病率较高。然而，由于无菌、合作以及外科医生接受度等问题，在手术室进行实时人体工程学风险评估很困难。尽管此类分析能够提供有效的风险估计并指导纠正措施，但却很少见。因此，本研究旨在实时评估耳鼻喉科医生在手术室进行功能性鼻内镜鼻窦手术时，基于快速上肢评估法（RULA）的姿势人体工程学风险。在三级转诊医院开展了一项横断面观察性多中心研究。使用基于方向传感器的运动分析系统（Noraxon myomotion）在术中测量了10名进行功能性鼻内镜鼻窦手术的外科医生的脊柱、肩部和肘部运动。利用运动分析数据计算基于RULA的姿势人体工程学风险。RULA是一种根据个体在工作期间所采取的姿势来量化躯干和上肢身体姿势风险的方法。10名外科医生（9名男性和1名女性）参与了该研究，平均（±标准差）年龄为38±7.5岁。运动分析数据结果表明，外科医生在手术过程中经常采用笨拙的脊柱和上肢姿势。所有外科医生的得分均高于可接受的RULA评分（1或2），平均RULA评分为6 - 7。进行功能性鼻内镜鼻窦手术的外科医生的身体人体工程学风险很高（RULA评分>6）。迫切需要对功能性鼻内镜鼻窦手术外科医生的工作环境给予人体工程学方面的关注。
