작업 관련 근골격계 질환의 위험성 저감을 위한 작업 자세 및 동작의 인간공학 연구

학위논문(박사) -- 서울대학교대학원 : 공과대학 산업공학과, 2022.2. 박우진.육체적 부하가 큰 자세 및 동작으로 작업을 수행하는 것은 작업자의 근골격계 질환의 위험성을 증가시킨다. 작업자의 근골격계에 가해지는 육체적 부하의 양상은 수행하는 작업의 종류에 따라 달라진다. 장시간 앉은 자세로 작업을 수행하는 경우, 작업자의 근육, 인대와 같은 연조직에 과도한 부하가 발생하여 목, 허리 등 다양한 신체 부위에서 근골격계 질환의 위험성이 증가할 수 있다. 따라서, 착좌 시 발생할 수 있는 근골격계 질환의 위험성을 저감하기 위해서는 작업자의 착좌 자세를 실시간으로 모니터링하고, 이에 대한 피드백을 제공하는 것이 필요하다. 들기 작업과 같은 동적인 움직임이 포함된 작업을 수행하는 경우, 작업자의 체중이 신체적 부하에 영향을 미칠 수 있다. 전세계적인 비만의 유행으로 인해 많은 작업자들이 체중 증가를 겪고 있고, 들기 작업과 같은 동적인 작업에서 비만은 신체적 부하에 악영향을 미칠 수 있다. 따라서, 비만과 작업 관련 근골격계 질환의 위험성은 잠재적인 연관성을 가지고 있고, 비만이 들기 작업에 미치는 생체역학적 영향을 논의할 필요성이 있다. 작업장에서의 근골격계 질환의 위험성을 저감하기 위해 다양한 연구들이 수행되어 왔지만, 작업 시스템의 인간공학적 설계 측면에서 추가적인 연구가 필요하다. 장시간 의자에 앉아 정적인 작업을 수행하는 작업자의 근골격계 질환을 저감하기 위한 유망한 방법 중 하나로, 작업자의 자세를 실시간으로 모니터링하고 분류하는 시스템을 개발하는 것이 제안되고 있다. 이러한 시스템은 작업자가 근골격계 질환의 위험성이 낮은 자세를 작업 시간 동안 유지하도록 돕는 데 활용될 수 있을 것이다. 기존의 대부분의 자세 모니터링 시스템에서는 분류할 자세를 정의하는 과정에서 인간공학적 문헌이 거의 고려되지 않았고, 사용자가 실제로 활용하기에는 여러 한계점들이 존재하였다. 들기 작업의 경우, 체질량 지수(BMI) 40 이상의 초고도 비만 작업자의 동작 패턴을 논의한 연구는 거의 찾아볼 수 없었다. 또한, 다양한 들기 작업 조건 하에서 전신 관절들의 움직임을 생체역학적 측면에서 분석한 연구는 부족한 실정이다. 따라서, 본 연구에서의 연구 목적은 1) 다양한 센서 조합을 활용한 실시간 착좌 자세를 분류하는 시스템을 개발하고, 2) 들기 작업 시 초고도 비만이 개별 관절의 움직임과 들기 동작 패턴에 미치는 영향을 이해하여, 다양한 종류의 작업에서 발생할 수 있는 근골격계 질환의 위험성을 저감하는 것이다. 연구 목적을 달성하기 위해 다음의 두 가지 연구를 수행하였다. 첫번째 연구에서는 실시간으로 착좌 자세를 분류하는 스마트 의자 시스템을 개발하였다. 스마트 의자 시스템은 각각 여섯 개의 거리 센서와 압력 센서를 조합하여 구성되었다. 착좌 관련한 근골격계 질환에 대해 문헌 조사를 수행하였고, 이를 바탕으로 결정된 자세들에 대해 서른 여섯 명의 데이터를 수집하였다. 스마트 의자 시스템에서 자세를 분류하기 위해 kNN 알고리즘을 활용하였고, 성능을 검증하기 위해 단일 종류의 센서로 구성된 기준 모델들과 비교를 수행하였다. 분류 성능을 비교한 결과, 센서를 조합한 스마트 의자 시스템이 가장 우수한 결과를 보였다. 두번째 연구에서는 들기 작업을 수행할 때 초고도 비만이 개별 관절의 움직임과 동작 패턴에 미치는 영향을 분석하기 위해 모션 캡쳐 실험을 수행하였다. 들기 실험에는 근골격계 질환 이력이 없는 서른 다섯 명이 참여하였다. 수집된 데이터를 바탕으로 주요 관절(발목, 무릎, 엉덩이, 허리, 어깨, 팔꿈치) 별 운동역학적 변수들과, 들기 동작의 패턴을 표현하는 동작 지수들을 계산하였다. 들기 작업 조건과 비만 수준에 따라, 대부분의 변수에서 통계적으로 유의한 차이를 보였다. 전체적으로 비만인은 정상체중인에 비해 다리 보다 허리를 사용하여 들기 작업을 수행하였고, 동작 수행 시 상대적으로 적은 관절 각도 변화와 느린 움직임을 보였다. 들기 작업에서 박스의 이동에 개별 관절이 기여하는 비율도 정상체중인과 비만인은 다른 패턴을 보였다. 본 연구의 결과를 활용하여 다양한 종류의 신체적 부하에 노출된 작업자들의 근골격계 질환의 위험성을 저감할 수 있고, 궁극적으로 업무의 생산성과 개인의 건강을 제고할 수 있을 것이다. 첫번째 연구에서 개발된 스마트 의자 시스템은 기존 자세 분류 시스템의 단점들을 완화하였다. 개발된 시스템은 저렴한 소수의 센서만을 활용하여 근골격계 측면에서 중요한 자세들을 높은 정확도로 분류하였다. 이러한 자세 분류 시스템은 작업자에게 실시간으로 자세 피드백을 제공하여, 근골격계 질환의 위험성이 낮은 자세를 유지하는 데 활용될 수 있을 것이다. 두번째 연구의 결과는 동적인 작업 시 초고도 비만으로 인한 잠재적인 근골격계 질환의 위험성을 이해하는 데 활용될 수 있다. 초고도 비만인과 정상체중인 간 관절의 움직임과 동작의 차이를 이해하여, 비만을 고려한 인간공학적 작업장 설계와 동작 가이드라인을 제공할 수 있을 것이다.Working in stressful postures and movements increases the risk of work-related musculoskeletal disorders (WMSDs). The physical stress on a worker’s musculoskeletal system depends on the type of work task. In the case of sedentary work, stressful sitting postures for prolonged durations could increase the load on soft connective tissues such as muscles and ligaments, resulting in the incidence of WMSDs. Therefore, to reduce the WMSDs, it is necessary to monitor a worker’s sitting posture and additionally provide ergonomic interventions. When the worker performs a task that involves dynamic movements, such as manual lifting, the worker’s own body mass affects the physical stress on the musculoskeletal system. In the global prevalence of obesity in the workforce, an increase in the body weight of the workers could adversely affect the musculoskeletal system during the manual lifting task. Therefore, obesity could be associated with the development of WMSDs, and the impacts of obesity on workers’ movement during manual lifting need to be examined. Despite previous research efforts to prevent WMSDs, there still exist research gaps concerning ergonomics design of work systems. For sedentary workers, a promising solution to reduce the occurrence of WMSDs is the development of a system capable of monitoring and classifying a seated worker's posture in real-time, which could be utilized to provide feedback to the worker to maintain a posture with a low-risk of WMSDs. However, the previous studies in relation to such a posture monitoring system lacked a review of the ergonomics literature to define posture categories for classification, and had some limitations in widespread use and user acceptance. In addition, only a few studies related to obesity impacts on manual lifting focused on severely obese population with a body mass index (BMI) of 40 or higher, and, analyzed lifting motions in terms of multi-joint movement organization or at the level of movement technique. Therefore, the purpose of this study was to: 1) develop a sensor-embedded posture classification system that is capable of classifying an instantaneous sitting posture as one of the posture categories discussed in the ergonomics literature while not suffering from the limitations of the previous system, and, 2) identify the impacts of severe obesity on joint kinematics and movement technique during manual lifting under various task conditions. To accomplish the research objectives, two major studies were conducted. In the study on the posture classification system, a novel smart chair system was developed to monitor and classify a worker’s sitting postures in real-time. The smart chair system was a mixed sensor system utilizing six pressure sensors and six infrared reflective distance sensors in combination. For a total of thirty-six participants, data collection was conducted on posture categories determined based on an analysis of the ergonomics literature on sitting postures and sitting-related musculoskeletal problems. The mixed sensor system utilized a kNN algorithm for posture classification, and, was evaluated in posture classification performance in comparison with two benchmark systems that utilized only a single type of sensors. The mixed sensor system yielded significantly superior classification performance than the two benchmark systems. In the study on the manual lifting task, optical motion capture was conducted to examine differences in joint kinematics and movement technique between severely obese and non-obese groups. A total of thirty-five subjects without a history of WMSDs participated in the experiment. The severely obese and non-obese groups show significant differences in most joint kinematics of the ankle, knee, hip, spine, shoulder, and elbow. There were also significant differences between the groups in the movement technique index, which represents a motion in terms of the relative contribution of an individual joint degree of freedom to the box trajectory in a manual lifting task. Overall, the severely obese group adopted the back lifting technique (stoop) rather than the leg lifting technique (squat), and showed less joint range of excursions and slow movements compared to the non-obese group. The findings mentioned above could be utilized to reduce the risk of WMSDs among workers performing various types of tasks, and, thus, improve work productivity and personal health. The mixed sensor system developed in this study was free from the limitations of the previous posture monitoring systems, and, is low-cost utilizing only a small number of sensors; yet, it accomplishes accurate classification of postures relevant to the ergonomic analyses of seated work tasks. The mixed sensor system could be utilized for various applications including the development of a real-time posture feedback system for preventing sitting-related musculoskeletal disorders. The findings provided in the manual lifting study would be useful in understanding the potential risk of WMSDs for severely obese workers. Differences in joint kinematics and movement techniques between severely obese and non-obese groups provide practical implications concerning the ergonomic design of work tasks and workspace layout.Chapter 1. Introduction 1 1.1 Research Background 1 1.2 Research Objectives 5 1.3 Dissertation Outline 6 Chapter 2. Literature Review 8 2.1 Work-related Musculoskeletal Disorders Among Sedentary Workers 8 2.1.1 Relationship Between Sitting Postures and Musculoskeletal Disorders 8 2.1.2 Systems for Monitoring and Classifying a Seated Worker's Postures 10 2.2 Impacts of Obesity on Manual Works 22 2.2.1 Impacts of Obesity on Work Capacity 22 2.2.2 Impacts of Obesity on Joint Kinematics and Biomechanical Demands 24 Chapter 3. Developing and Evaluating a Mixed Sensor Smart Chair System for Real-time Posture Classification: Combining Pressure and Distance Sensors 27 3.1 Introduction 27 3.2 Materials and Methods 33 3.2.1 Predefined posture categories for the mixed sensor system 33 3.2.2 Physical construction of the mixed sensor system 36 3.2.3 Posture Classifier Design for the Mixed Sensor System 38 3.2.4 Data Collection for Training and Testing the Posture Classifier of the Mixed Sensor System 41 3.2.5 Comparative Evaluation of Posture Classification Performance 43 3.3 Results 46 3.3.1 Model Parameters and Features 46 3.3.2 Posture Classification Performance 47 3.4 Discussion 50 Chapter 4. Severe Obesity Impacts on Joint Kinematics and Movement Technique During Manual Load Lifting 57 4.1 Introduction 57 4.2 Methods 61 4.2.1 Participants 61 4.2.2 Experimental Task 61 4.2.3 Experimental Procedure 64 4.2.4 Data Processing 65 4.2.5 Experimental Variables 67 4.2.6 Statistical Analysis 71 4.3 Results 72 4.3.1 Kinematic Variables 72 4.3.2 Movement Technique Indexes 83 4.4 Discussion 92 Chapter 5. Conclusion 102 5.1 Summary 102 5.2 Implications 105 5.3 Limitations and Future Directions 106 Bibliography 108 국문초록 133박

Occupational Exoskeletons: Understanding the Impact on Workers and Suggesting Guidelines for Practitioners and Future Research Needs

This paper examines occupational exoskeletons and their effects on workers. The study includes a thorough evaluation of the current literature on occupational exoskeletons, with an emphasis on the impact of these devices on workers’ health and the safety, performance and users’ subjective perceptions. The aim of the study was to gain knowledge of how exoskeletons affect the workers and to identify practical suggestions for practitioners. The findings of the study suggest that exoskeletons can have both positive and negative effects on workers. Some users claimed enhanced comfort and decreased fatigue, whilst others reported discomfort and suffering. The study highlights the importance of considering the individual needs and preferences of workers when selecting and implementing exoskeletons in the workplace, with a focus on health, safety, performance and user acceptance. Based on the findings, the paper presents suggestions for employers and practitioners to ensure the effective and safe use of exoskeletons in occupational settings. These recommendations cover areas such as the assessment of workplace requirements, the selection and fit of exoskeletons, the optimization of design and ergonomics and the evaluation of performance. The paper concludes by highlighting the need for further research in this area, particularly in the areas of long-term use

Effects of chronic low back pain on local dynamic stability and intersegment coordination during repetitive lifting

Background: Despite advancing developments in modern medicine and growing knowledge pertaining to spinal disorders, chronic low back pain (CLBP) remains the leading cause of disability worldwide. This is partly due to varying movement dysfunctions observed in people with CLBP. Although previous research has shown that people with CLBP exhibit altered motor control strategies, the literature is characterized by inconsistent findings. Thus, improved empirical assessment methods, such as intersegment coordination and local dynamic stability, have the potential to improve measurement of and detection of neuromuscular deficiencies exhibited in people with CLBP. While intersegment coordination and local dynamic stability measures have been used extensively in healthy people, there is a scarcity of research that has applied these measures to assess people with CLBP. Therefore, this thesis primarily aimed to compare movement and stability between CLBP and healthy people using intersegment coordination and local dynamic stability assessment. Methods: Twelve participants with CLBP and 12 healthy participants performed one set of repetitive deadlifts for 35 repetitions with a dowel rod and one set with a barbell loaded with 15% of their bodyweight for 35 repetitions. Inertial Measurement Units (IMU) were used to measure trunk and lower limb kinematic parameters. Local dynamic stability and intersegment coordination were then calculated from the kinematic data and compared between the groups using a 2-factor repeated measures ANOVA. Results: Significantly greater local dynamic stability of the hip and knee was observed in the CLBP group compared to the healthy control group. The CLBP group also reported increased low back pain immediately after completion of the loaded and un-loaded lifting trials. No differences in intersegment coordination or coordination variability were observed between two groups. There were no differences observed in local dynamic stability and intersegment coordination when lifting with a load compared to lifting with no-load for both groups. Conclusion: Our findings suggest that the significantly greater local dynamic stability of the hip and knee exhibited by the CLBP group may be mediated by pain avoidance. Local dynamic stability assesses both spatial and temporal characteristics of a lifting cycle, thus potentially providing greater insight into the differences in motor control of people with CLBP than intersegment coordination analysis. This thesis has shown that local dynamic stability is a measure which has potential clinical utility for monitoring changes in stability over time

Aerospace medicine and biology: A continuing bibliography with indexes (supplement 309)

This bibliography lists 136 reports, articles and other documents introduced into the NASA scientific and technical information system in February, 1988