Pamela Hess, OTD, OTR, PMH-C, NCPT, is Clinical Assistant Professor, Department of Occupational Therapy, University of Florida, Gainesville. At the time of this research, Hess was Clinical Assistant Professor and Academic Fieldwork Coordinator, School of Health and Human Science, Indiana University-Indianapolis;
Dimitrios Athanasiadis, MD, is PGY4, Department of Surgery, Indiana University, Indianapolis.
Am J Occup Ther. 2024 Sep 1;78(5). doi: 10.5014/ajot.2024.050395.
Work-related musculoskeletal disorders (WMSDs) among surgeons are markedly increasing. Several proposed interventions to reduce WMSDs among surgeons have been studied, but few follow an occupational therapy-oriented approach addressing biomechanical, psychophysical, and psychosocial risk factors.
To design, implement, and assess the potential of the Comprehensive Operating Room Ergonomics (CORE) program for surgeons, a holistic evidence-based ergonomics and wellness intervention grounded in occupational therapy principles.
Mixed-methods pilot study with the quantitative strand embedded in the qualitative strand.
University-affiliated hospital.
Six laparoscopic surgeons.
CORE program outcomes were assessed using qualitative and quantitative data to indicate changes in posture, physical discomfort, sense of wellness, and operating room (OR) ergonomic performance. The Rapid Upper Limb Assessment (RULA) was used to quantify surgeons' WMSD risk level before and after intervention.
There were 12 baseline observations (two for each participant), and two or three post-CORE implementation observations. A statistically significant difference, F(1, 6) = 8.57, p = .03, was found between pre- and post-occupational therapy intervention RULA scores. Thematic analysis of surgeon feedback, which was overwhelmingly positive, identified five themes: postural alignment, areas of commonly reported physical pain or discomfort, setup of the OR environment, surgical ergonomics training, and ergonomics in everyday life.
The CORE program effectively decreased ergonomic risk factors to optimize surgeons' occupational performance in the OR. This study demonstrates a potential solution to how occupational therapists can holistically support surgeons and health care providers who are at risk for WMSDs. Plain-Language Summary: By 2025, a surgeon shortage is expected, partly because of the increase in surgeons' work-related musculoskeletal disorders, which affect their health and job continuity. This pilot study shows that the Comprehensive Operating Room Ergonomics program effectively addresses these problems. The study also serves as a framework for occupational therapy professionals to work with health care providers on ergonomics, benefiting population health. Results suggest that this approach could enhance surgeons' work conditions, supporting the American Occupational Therapy Association's Vision 2025 to improve health and quality of life.
外科医生的与工作相关的肌肉骨骼疾病（WMSD）显著增加。已经研究了几种减少外科医生 WMSD 的拟议干预措施，但很少有研究采用以职业治疗为导向的方法来解决生物力学、心理物理学和社会心理风险因素。
设计、实施并评估全面手术室人体工程学（CORE）计划对外科医生的潜力，这是一种基于职业治疗原则的整体循证人体工程学和健康干预措施。
具有定性研究嵌入定量研究的混合方法试点研究。
大学附属医院。
六名腹腔镜外科医生。
使用定性和定量数据评估 CORE 计划的结果，以表明姿势、身体不适、健康感和手术室（OR）人体工程学性能的变化。使用快速上肢评估（RULA）来量化干预前后外科医生的 WMSD 风险水平。
有 12 个基线观察（每个参与者两个）和 2 到 3 个 CORE 实施后观察。在职业治疗干预前后的 RULA 评分之间发现了统计学上显著的差异，F（1，6）= 8.57，p =.03。外科医生反馈的主题分析，绝大多数是积极的，确定了五个主题：姿势对齐、常见身体疼痛或不适区域、手术室环境设置、手术人体工程学培训和日常生活中的人体工程学。
CORE 计划有效地减少了人体工程学风险因素，以优化外科医生在 OR 中的职业表现。这项研究展示了职业治疗师如何全面支持有 WMSD 风险的外科医生和医疗保健提供者的潜在解决方案。
到 2025 年，预计会出现外科医生短缺，部分原因是外科医生的工作相关肌肉骨骼疾病增加，这影响了他们的健康和工作连续性。这项试点研究表明，全面手术室人体工程学计划有效地解决了这些问题。该研究还为职业治疗专业人员与医疗保健提供者合作开展人体工程学提供了框架，有利于改善人口健康。结果表明，这种方法可以改善外科医生的工作条件，支持美国职业治疗协会 2025 年愿景，以改善健康和生活质量。
