Computer work and musculoskeletal disorders of the neck and upper extremity: A systematic review

<p>Abstract</p> <p>Background</p> <p>This review examines the evidence for an association between computer work and neck and upper extremity disorders (except carpal tunnel syndrome).</p> <p>Methods</p> <p>A systematic critical review of studies of computer work and musculoskeletal disorders verified by a physical examination was performed.</p> <p>Results</p> <p>A total of 22 studies (26 articles) fulfilled the inclusion criteria. Results show limited evidence for a causal relationship between computer work per se, computer mouse and keyboard time related to a diagnosis of wrist tendonitis, and for an association between computer mouse time and forearm disorders. Limited evidence was also found for a causal relationship between computer work per se and computer mouse time related to tension neck syndrome, but the evidence for keyboard time was insufficient. Insufficient evidence was found for an association between other musculoskeletal diagnoses of the neck and upper extremities, including shoulder tendonitis and epicondylitis, and any aspect of computer work.</p> <p>Conclusions</p> <p>There is limited epidemiological evidence for an association between aspects of computer work and some of the clinical diagnoses studied. None of the evidence was considered as moderate or strong and there is a need for more and better documentation.</p

The cost-effectiveness of the RSI QuickScan intervention programme for computer workers: Results of an economic evaluation alongside a randomised controlled trial

<p>Abstract</p> <p>Background</p> <p>The costs of arm, shoulder and neck symptoms are high. In order to decrease these costs employers implement interventions aimed at reducing these symptoms. One frequently used intervention is the RSI QuickScan intervention programme. It establishes a risk profile of the target population and subsequently advises interventions following a decision tree based on that risk profile. The purpose of this study was to perform an economic evaluation, from both the societal and companies' perspective, of the RSI QuickScan intervention programme for computer workers. In this study, effectiveness was defined at three levels: exposure to risk factors, prevalence of arm, shoulder and neck symptoms, and days of sick leave.</p> <p>Methods</p> <p>The economic evaluation was conducted alongside a randomised controlled trial (RCT). Participating computer workers from 7 companies (N = 638) were assigned to either the intervention group (N = 320) or the usual care group (N = 318) by means of cluster randomisation (N = 50). The intervention consisted of a tailor-made programme, based on a previously established risk profile. At baseline, 6 and 12 month follow-up, the participants completed the RSI QuickScan questionnaire. Analyses to estimate the effect of the intervention were done according to the intention-to-treat principle. To compare costs between groups, confidence intervals for cost differences were computed by bias-corrected and accelerated bootstrapping.</p> <p>Results</p> <p>The mean intervention costs, paid by the employer, were 59 euro per participant in the intervention and 28 euro in the usual care group. Mean total health care and non-health care costs per participant were 108 euro in both groups. As to the cost-effectiveness, improvement in received information on healthy computer use as well as in their work posture and movement was observed at higher costs. With regard to the other risk factors, symptoms and sick leave, only small and non-significant effects were found.</p> <p>Conclusions</p> <p>In this study, the RSI QuickScan intervention programme did not prove to be cost-effective from the both the societal and companies' perspective and, therefore, this study does not provide a financial reason for implementing this intervention. However, with a relatively small investment, the programme did increase the number of workers who received information on healthy computer use and improved their work posture and movement.</p> <p>Trial registration</p> <p>Trial registration number: NTR1117</p

A novel wearable system for the online assessment of risk for biomechanical load in repetitive efforts

Work-related Musculo Skeletal Disorders (WMSD) are considered the third main reason for disability and early retirement in the U.S. and are widespread in many occupations, involving both heavy and light biomechanical loads. In Italy, only taking into account the years 2009-2010, it is estimated an exponential increasing in the number of WMSD reports. In particular a 159.7% increment has been reported compared to the 2006 statistics. In this context, it is clear how important correctly diagnosing this kind of pathology is becoming. Traditional methods for WMDS assessment are based on observational techniques, in which experts manually segment, label and evaluate movements with the help of pro-forma sheets. Since these methods are currently based on visual inspection and subjective judgment, they could benefit from objective measurements in terms of both reliability and repeatability. Moreover an automatic tool for ergonomics assessment would vastly reduce the time that an expert needs to carry out the same assessment manually. In this context a novel wearable wireless system capable of assessing the muscular efforts and postures of the human upper limb for WMSDs diagnosis is proposed. The system, being non-obstructive, can be used to monitor workers in ecologic environment while they are carrying on their everyday tasks. A real-time assessment is obtained according to two of the most common indexes for the analysis of risk factors on workplaces: the Rapid Upper Limb Assessment (RULA) and the Strain Index (SI). The system exploits inertial measurement units (IMUs) to reconstruct the upper limb posture, modeled as a 7 degrees of freedom (DoF) kinematic chain. As far as muscular efforts are concerned, surface EMG sensors are used to assess forearm flexor muscles strain. As an example of the proposed system application the results of a first data collection campaign regarding super-market cashiers during everyday real-life operations is reported.Relevance to industry: The presented system has a high potential impact on industry as a timely intervention on the WMSD factors may reduce pathologies and reduce the recovery of expert workers. (C) 2015 Elsevier B.V. All rights reserved

Avaliação da função do ombro em técnicos de trânsito pelo protocolo de Constant-Murley Assessment of shoulder function in traffic technicians by the Constant-Murley protocol

O estudo visou verificar a associação entre capacidade funcional e atividade ocupacional em trabalhadores técnicos de trânsito expostos a movimentos repetitivos, associados ou não a esforço físico; e verificar a presença de queixas e sintomas de traumas cumulativos na região do ombro. Participaram do estudo 102 técnicos de trânsito, divididos em dois grupos: G1 expostos a movimentos repetitivos e esforço físico; G2 expostos só a movimentos repetitivos. Todos foram avaliados pelo método de Constant-Murley, que avalia intensidade de dor nas atividades de vida diária, mobilidade e força muscular dos ombros. Os dados foram tratados estatisticamente e o nível de signficância fixado em p<0,05. Queixas de dor nos ombros foram referidas por 66% dos trabalhadores no G1 e 28,8% no G2; com relação à intensidade da dor, o G1 referiu dor mais intensa no ombro direito (11,80±4,60) que o G2 (13,56±3,33; p=0,030). Foi encontrada uma tendência para o ombro esquerdo no G1 de dor mais intensa do que no G2 (p=0,054). Trabalhadores de ambos os grupos não apresentaram prejuízo da função em relação ao parâmetro normal. Não se verificou pois associação entre a capacidade funcional dos ombros e a atividade ocupacional em qualquer dos grupos, o que pode ser devido ao viés conhecido como efeito do trabalhador sadio. A queixa de dor no ombro do G1 foi associada ao movimento repetitivo e ao esforço físico presentes nas tarefas de trabalho desse grupo.<br>The purpose of the study was to assess whether there is a relation between shoulder functional capacity and occupational activity among traffic workers exposed to repetitive movements and/or to overexertion; and to inquire on shoulder complaints and symptoms of cumulative trauma disorders. A hundred and two traffic workers were divided into two groups - G1 exposed to overuse and overexertion, G2 exposed only to overuse - and submitted to the Constant-Murley functional shoulder protocol, which assesses four items: pain, pain in activities of daily living, range of motion, and muscle strength. Data were statistically analysed and significance level set at p<0.05. Shoulder pain was reported by 66% of G1 subjects and by 28.8% of G2's; G1 presented higher pain intensity complaints on the right shoulder (11.80±4.60) than G2 (13.56±3.33; p=0.030); and a trend was found to more intense pain on the left shoulder in G1 than in G2 (p=0.054). Workers of both groups did not present functional decrease as compared to normality parameters. There was hence no association between functional shoulder capacity and occupational activity in neither group, which may be due to the bias known as healthy worker effect. G1 shoulder pain complaints were linked to repetitive movements associated to physical effort inherent to G1 worker tasks