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姿势负荷与肌肉骨骼疾病的发展

Postural load and the development of musculo-skeletal illness.

作者信息

Aarås A

机构信息

Standard Telefon og Kabelfabrik A/S, Oslo, Norway.

出版信息

Scand J Rehabil Med Suppl. 1987;18:5-35.

PMID:3484083
Abstract

Early in the 1970s, high rates of sick-leave due to musculo-skeletal complaints were frequently recorded among workers at Standard Telefon and Kabelfabrik's (STK's) factory in Norway. Workstations were redesigned according to ergonomics principles that allowed workers a wider choice of working postures and following their introduction in 1975, there was a marked reduction in sickness absence. Postural load was studied in groups of female workers in well defined assembly tasks. Trapezius load was recorded by electromyography (EMG). Simultaneously, postural angles of the upper arm in the shoulder joint and flexion/extension of head/neck and back were measured by using pendulum potentiometers. A quantitative relationship was found for the group between its median value of static trapezius load and the development of musculo-skeletal sick-leave, as a function of length of employment. Further support for a relationship between musculo-skeletal injury and trapezius load was found for the same subjects who suffered less musculo-skeletal sick-leave, consistent with the reduced trapezius load when working at the redesigned work stands. The relationship between postural load and musculo-skeletal injury was studied in comparable groups of the female workers with respect to age, working hours per day and time of employment. Psychosocial problems, spare time activities and living habits of workers did not show any significant difference across the groups. Postural load, both in terms of the magnitude of the flexion angle of the upper arm in the shoulder joint and the distribution of the work load between flexors and extensors, appeared to influence the incidence of load-related musculo-skeletal illness in the upper part of the body. The incidence of musculo-skeletal sick-leave in a group of workers with a median static trapezius load of about 1 to 2% MVC (Maximum Voluntary Contraction) for most of the work day, was approximately the same as for a group of comparable female workers without continuous work load. This suggests that a static trapezius load level of about 1% MVC is acceptable for the major part of the work day if adequate breaks in the load pattern are allowed when needed. At the same time, a median arm flexion of 15 degrees and a median arm abduction less than 10 degrees indicate the amplitude of these angles for 50% of the recording time. No details about the work-pause pattern was obtained, therefore these limits are only a rough indication of an acceptable arm position.

摘要

20世纪70年代初,挪威标准电话电缆厂(STK)的工人中,因肌肉骨骼问题导致的病假率居高不下。根据人体工程学原理重新设计了工作站,使工人有了更广泛的工作姿势选择。1975年引入这些设计后,病假缺勤率显著下降。对从事明确装配任务的女工群体进行了姿势负荷研究。通过肌电图(EMG)记录斜方肌负荷。同时,使用摆式电位计测量肩关节中上臂的姿势角度以及头/颈和背部的屈伸情况。研究发现,对于该群体,静态斜方肌负荷的中值与肌肉骨骼病假的发展之间存在定量关系,该关系是就业时长的函数。对于肌肉骨骼病假较少的同一批受试者,也发现了肌肉骨骼损伤与斜方肌负荷之间的关系,这与在重新设计的工作台上工作时斜方肌负荷降低一致。针对年龄、每日工作时长和就业时间相当的女工群体,研究了姿势负荷与肌肉骨骼损伤之间的关系。各群体中工人的社会心理问题、业余活动和生活习惯均无显著差异。姿势负荷,无论是肩关节中上臂屈曲角度的大小,还是屈肌和伸肌之间的工作负荷分布,似乎都影响身体上部与负荷相关的肌肉骨骼疾病的发病率。对于大多数工作日静态斜方肌负荷中值约为1%至2%最大自主收缩(MVC)的一组工人,其肌肉骨骼病假发生率与一组无持续工作负荷的可比女工大致相同。这表明,如果在需要时允许在负荷模式中有足够的休息时间,那么在工作日的大部分时间里,静态斜方肌负荷水平约为1%MVC是可以接受的。同时,15度的中位手臂屈曲和小于10度的中位手臂外展表明这些角度在记录时间的50%时的幅度。由于未获得关于工作暂停模式的详细信息,因此这些限制只是对可接受手臂位置的粗略指示。

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