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Hussain M, Kong YK, Park SS, Shim HH, Park J. Exoskeleton Usability Questionnaire: a preliminary evaluation questionnaire for the lower limb industrial exoskeletons. ERGONOMICS 2024; 67:1198-1207. [PMID: 38111360 DOI: 10.1080/00140139.2023.2289856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 11/26/2023] [Indexed: 12/20/2023]
Abstract
Exoskeleton robots are a promising solution to reduce musculoskeletal disorders (MSDs) in different work environments, but a specific usability scale for evaluating them is lacking. This study aimed to develop and verify a preliminary Exoskeleton Usability Questionnaire (EUQ) for the lower limb exoskeletons by creating a draft survey questionnaire from existing questions in prior studies. An experiment was conducted with 20 participants who performed a specific task while wearing three lower limb robots and provided subjective feedback using the developed questionnaire. Data were analysed using exploratory and confirmatory factor analysis (CFA), resulting in a usability evaluation questionnaire for exoskeleton robots clustered into four main factors: mobility, adjustability, handling and safety. This study's findings are expected to be useful in evaluating the usability of the lower limb exoskeletons in both general production sites and agricultural work, which can aid in reducing the prevalence of lower limb MSDs.Practitioner Summary: This study developed a preliminary subjective usability evaluation questionnaire for exoskeleton robots. The questionnaire is clustered into four main factors: mobility, adjustability, handling and safety. These findings provide a valuable tool for assessing exoskeleton usability, potentially reducing musculoskeletal disorders (MSDs) in various work environments.
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Affiliation(s)
- Muhammad Hussain
- Department of Computer Science, University of York, York, UK
- Department of Industrial and Management Engineering, Incheon National University (INU), Incheon, Republic of Korea
| | - Yong-Ku Kong
- Department of Industrial Engineering, Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Sang-Soo Park
- Department of Industrial Engineering, Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Hyun-Ho Shim
- Department of Industrial Engineering, Sungkyunkwan University (SKKU), Suwon, Republic of Korea
| | - Jaehyun Park
- Department of Industrial and Management Engineering, Incheon National University (INU), Incheon, Republic of Korea
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Shah OA, Spence C, Kader D, Clement ND, Asopa V, Sochart DH. Patellar resurfacing and kneeling ability after total knee arthroplasty: a systematic review. ARTHROPLASTY 2023; 5:32. [PMID: 37268994 DOI: 10.1186/s42836-023-00184-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 03/31/2023] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Difficulty kneeling following total knee arthroplasty (TKA) remains highly prevalent, and has cultural, social, and occupational implications. With no clear evidence of superiority, whether or not to resurface the patella remains debatable. This systematic review examined whether resurfacing the patella (PR) or not (NPR) influences kneeling ability following TKA. METHODS This systematic review was conducted by following PRISMA guidelines. Three electronic databases were searched utilizing a search strategy developed with the aid of a department librarian. Study quality was assessed using MINROS criteria. Article screening, methodological quality assessment and data extraction were performed by two independent authors, and a third senior author was consulted if consensus was not reached. RESULTS A total of 459 records were identified, with eight studies included in the final analysis, and all deemed to be level III evidence. The average MINORS score was 16.5 for comparative studies and 10.5 for non-comparative studies. The total number of patients was 24,342, with a mean age of 67.6 years. Kneeling ability was predominantly measured as a patient-reported outcome measure (PROM), with two studies also including an objective assessment. Two studies demonstrated a statistically significant link between PR and kneeling, with one demonstrating improved kneeling ability with PR and the other reporting the opposite. Other potential factors associated with kneeling included gender, postoperative flexion, and body mass index (BMI). Re-operation rates were significantly higher in the NPR cohort whereas PR cohorts had higher Feller scores, patient-reported limp and patellar apprehension. CONCLUSION Despite its importance to patients, kneeling remains not only under-reported but also ill-defined in the literature, with no clear consensus regarding the optimum outcome assessment tool. Conflicting evidence remains as to whether PR influences kneeling ability, and to clarify the situation, large prospective randomized studies are required.
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Affiliation(s)
- Owais A Shah
- South West London Elective Orthopaedic Centre, Epsom, KT18 7EG, UK.
| | | | - Deiary Kader
- South West London Elective Orthopaedic Centre, Epsom, KT18 7EG, UK
| | - Nick D Clement
- South West London Elective Orthopaedic Centre, Epsom, KT18 7EG, UK
- Edinburgh Orthopaedics, Royal Infirmary of Edinburgh, Edinburgh, EH16 4SA, UK
| | - Vipin Asopa
- South West London Elective Orthopaedic Centre, Epsom, KT18 7EG, UK
| | - David H Sochart
- South West London Elective Orthopaedic Centre, Epsom, KT18 7EG, UK
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Tjosvoll SO, Seeberg TM, Fimland MS, Wiggen Ø, Jahren SE. Classification of kneeling and squatting in workers wearing protective equipment: development and validation of a rule-based model using wireless triaxial accelerometers. ERGONOMICS 2022; 65:1410-1420. [PMID: 35133239 DOI: 10.1080/00140139.2022.2039410] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 02/01/2022] [Indexed: 06/14/2023]
Abstract
Several professions in industries, such as petroleum, manufacturing, construction, mining, and forestry require prolonged work tasks in awkward postures, increasing workers' risks for musculoskeletal pain and injury. Therefore, we developed and validated a rule-based model for classifying unilateral and bilateral kneeling and squatting based on 15 individuals wearing personal protective equipment and using three wireless triaxial accelerometers. The model provided both high sensitivity and specificity for classifying kneeling (0.98; 0.98) and squatting (0.96; 0.91). Hence, this model has the potential to contribute to increased knowledge of physical work demands and exposure thresholds in working populations with strict occupational safety regulations. Practitioner summary: Our results indicate that this rule-based model can be applied in a human-factors perspective enabling high-quality quantitative information in the classification of occupational kneeling and squatting, known risk factors for musculoskeletal pain, and sick leave. This study is adapted for working populations wearing personal protective equipment and aimed for long-term measurements in the workplace.
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Affiliation(s)
- Svein O Tjosvoll
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
| | - Trine M Seeberg
- Smart Sensor Systems, SINTEF Digital, SINTEF AS, Oslo, Norway
| | - Marius S Fimland
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, NTNU Norwegian University of Science and Technology, Trondheim, Norway
- Unicare Helsefort Rehabilitation Centre, Rissa, Norway
| | | | - Silje E Jahren
- Smart Sensor Systems, SINTEF Digital, SINTEF AS, Oslo, Norway
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Laudanski AF, Buchman-Pearle JM, Acker SM. Quantifying high flexion postures in occupational childcare as they relate to the potential for increased risk of knee osteoarthritis. ERGONOMICS 2022; 65:253-264. [PMID: 34397308 DOI: 10.1080/00140139.2021.1969041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
High knee flexion postures, despite their association with increased incidences of osteoarthritis, are frequently adopted in occupational childcare. This study sought to define and quantify high flexion postures typically adopted in childcare to evaluate any increased likelihood of knee osteoarthritis development. Through video analysis of eighteen childcare workers caring for infant, toddler, and preschool-aged children, eight high knee flexion postures were identified and quantified by duration and frequency. An analysis of postural adoption by task was subsequently performed to determine which might pose the greatest risk for cumulative joint trauma. Childcare workers caring for children of all ages were found to adopt kneeling and seated postures for extended durations and at elevated frequencies, exceeding proposed thresholds for incidences of knee osteoarthritis development. Structured activities, playing, and feeding tasks demanded the greatest adoption of high flexion postures and should be evaluated to minimise the potential childcare-related risks of osteoarthritis. Practitioner summary: High knee flexion postures (kneeling, squatting, etc.) have been associated with increased incidences of knee injury yet are commonly adopted in childcare. Childcare workers' postures were examined through video analysis revealing that proposed adoption thresholds for knee health are commonly exceeded when caring for children of all ages. Abbreviations: OA: osteoarthritis; WSIB: workplace safety insurance board; CAD: Canadian Dollar; DK: dorsiflexed kneeling; PK: plantarflexed kneeling; SAK: single arm supported kneeling; DAK: double arm supported kneeling; FS: flatfoot squatting; HS: heels up squatting; FLRS: floor sitting; SS: side sitting or leaning; STLS: stool sitting; BR: bending and reaching.
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Affiliation(s)
- Annemarie F Laudanski
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Jessa M Buchman-Pearle
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
| | - Stacey M Acker
- Department of Kinesiology and Health Sciences, Faculty of Health, University of Waterloo, Ontario, Canada
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Bahns C, Bolm-Audorff U, Seidler A, Romero Starke K, Ochsmann E. Occupational risk factors for meniscal lesions: a systematic review and meta-analysis. BMC Musculoskelet Disord 2021; 22:1042. [PMID: 34911509 PMCID: PMC8672613 DOI: 10.1186/s12891-021-04900-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/08/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Meniscal lesions are common and are associated with the development of knee osteoarthritis. Knee-straining activities at work such as kneeling or squatting cause high biomechanical stresses on the knee joints that can lead to acute or chronic injuries. The objective of this systematic review is to update the evidence on the potential relationship between occupational risk factors and meniscal lesions. METHODS We searched the Medline, Embase and Web of Science databases until August 2021 to identify epidemiological observational studies on the association between occupational risk factors and meniscal lesions. Study selection, data extraction and risk of bias assessment were performed independently by two reviewers. Effect measures were extracted from individual studies and pooled with random effects meta-analysis. Heterogeneity analyses were conducted. We used GRADE (Grades of Recommendations, Assessment, Development and Evaluation) to assess the overall quality of evidence. RESULTS The database search resulted in 11,006 references, and 46 additional studies were identified through hand search. Twenty-two studies (represented in 25 publications) met the predefined eligibility criteria and nine records were included in the meta-analysis. There was only one study with an overall low risk of bias. Significant associations between occupational risk factors and the development of meniscal lesions were found for kneeling (effect size (ES) 2.15, 95% CI 1.67-2.76), squatting (ES 2.01, 95% CI 1.34-3.03), climbing stairs (ES 2.28, 95% CI 1.58-3.30), lifting and carrying weights ≥ 10 kg (ES 1.63, 95% CI 1.35-1.96), lifting and carrying weights ≥ 25 kg (ES 1.56, 95% CI 1.08-2.24), playing football on a professional level (ES 5.22, 95% CI 3.24-8.41), working as a hard coal miner (ES 5.23, 95% CI 2.16-12.69) and floor layers (ES 1.99, 95% CI 1.43-2.78). The overall quality of evidence according GRADE was moderate to low. CONCLUSION We found consistent evidence of an increased risk of meniscal lesions by occupational knee-straining exposures. Our findings are important for the development of preventive strategies to reduce work-related knee disorders and work absence. TRIAL REGISTRATION PROSPERO (registration no. CRD42020196279 ).
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Affiliation(s)
- Carolin Bahns
- Luebeck Institute of Occupational Health (LIOH), University of Luebeck, Luebeck, Germany. .,Department of Therapy Science I, Brandenburg Technical University Cottbus - Senftenberg, Senftenberg, Germany.
| | - Ulrich Bolm-Audorff
- Division of Occupational Health, Department of Occupational Safety, Regional Government of South Hesse, Wiesbaden, Germany.,Associate Professor of Occupational Medicine, University Medical Center Giessen, Justus-Liebig-University, Giessen, Germany
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Karla Romero Starke
- Institute and Policlinic of Occupational and Social Medicine (IPAS), Faculty of Medicine Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Institute of Sociology, Faculty of Behavioral and Social Sciences, Chemnitz University of Technology, Chemnitz, Germany
| | - Elke Ochsmann
- Luebeck Institute of Occupational Health (LIOH), University of Luebeck, Luebeck, Germany
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Seidel DH, Heinrich K, Hermanns-Truxius I, Ellegast RP, Barrero LH, Rieger MA, Steinhilber B, Weber B. Assessment of work-related hand and elbow workloads using measurement-based TLV for HAL. APPLIED ERGONOMICS 2021; 92:103310. [PMID: 33352500 DOI: 10.1016/j.apergo.2020.103310] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 06/12/2023]
Abstract
Direct-measurement-based methods for assessing workloads of the hand or elbow in the field are rare. Aim of the study was to develop such a method based on the Threshold Limit Value for Hand Activity Level (TLV for HAL). Hence, HAL was quantified using kinematic data (mean power frequencies, angular velocities and micro-pauses) and combined with electromyographic data (root-mean-square values) in order to generate a measurement-based TLV for HAL (mTLV for HAL). The multi-sensor system CUELA including inertial sensors, potentiometers and a 4-channel surface electromyography module was used. For wrist and elbow regions, associations between mTLV for HAL and disorders/complaints (quantified by odds ratios (OR [95%-confidence interval])) were tested exploratively within a cross-sectional field study with 500 participants. Higher workloads were frequently significantly associated with arthrosis of distal joints (9.23 [3.29-25.87]), wrist complaints (2.89 [1.63-5.11]) or elbow complaints (1.99 [1.08-3.67]). The new method could extend previous application possibilities.
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Affiliation(s)
- David H Seidel
- Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Alte Heerstrasse 111, Sankt Augustin, 53757, DE, Germany; University Hospital Tuebingen, Institute of Occupational and Social Medicine and Health Services Research (IASV), Wilhelmstrasse 27, Tuebingen, 72074, DE, Germany.
| | - Kai Heinrich
- Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Alte Heerstrasse 111, Sankt Augustin, 53757, DE, Germany
| | - Ingo Hermanns-Truxius
- Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Alte Heerstrasse 111, Sankt Augustin, 53757, DE, Germany
| | - Rolf P Ellegast
- Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Alte Heerstrasse 111, Sankt Augustin, 53757, DE, Germany
| | - Lope H Barrero
- Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Alte Heerstrasse 111, Sankt Augustin, 53757, DE, Germany; School of Engineering, Department of Industrial Engineering, Pontificia Universidad Javeriana, Carrera 7 No. 40 - 62, Bogotá DC, 110231, CO, Colombia
| | - Monika A Rieger
- University Hospital Tuebingen, Institute of Occupational and Social Medicine and Health Services Research (IASV), Wilhelmstrasse 27, Tuebingen, 72074, DE, Germany
| | - Benjamin Steinhilber
- University Hospital Tuebingen, Institute of Occupational and Social Medicine and Health Services Research (IASV), Wilhelmstrasse 27, Tuebingen, 72074, DE, Germany
| | - Britta Weber
- Institute for Occupational Safety and Health of the German Social Accident Insurance (IFA), Alte Heerstrasse 111, Sankt Augustin, 53757, DE, Germany
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Wang X, Perry TA, Arden N, Chen L, Parsons CM, Cooper C, Gates L, Hunter DJ. Occupational Risk in Knee Osteoarthritis: A Systematic Review and Meta-Analysis of Observational Studies. Arthritis Care Res (Hoboken) 2020; 72:1213-1223. [PMID: 32638548 DOI: 10.1002/acr.24333] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 05/19/2020] [Indexed: 12/26/2022]
Abstract
OBJECTIVE To assess the association between occupational exposures and knee osteoarthritis (OA). METHODS We systematically searched for observational studies that examined the relationship between occupational exposures and knee OA and total knee replacement. Four databases were searched up to October 1, 2019. Two reviewers independently assessed study quality using the Newcastle-Ottawa Scale and evidence quality using the Grading of Recommendations Assessment, Development and Evaluation approach. Subgroup meta-analyses were conducted for important study characteristics and each type of occupational exposure. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were estimated for the meta-analysis using random-effects models. RESULTS Eighty eligible studies were identified including 25 case-control (n = 20,505 total participants), 36 cross-sectional (n = 139,463 total participants), and 19 cohort studies (n = 16,824,492 total participants). A synthesis of 71 studies suggested increased odds of knee OA (OR 1.52 [95% CI 1.37-1.69]) by combining different physically demanding jobs and occupational activities as compared to sedentary occupations and/or low-exposure groups. Odds of knee OA were greater in males and in industry-based studies and studies assessing lifetime occupational exposures. There were 9 specific job titles that were associated with knee OA, including farmer, builder, metal worker, and floor layer. Occupational lifting, kneeling, climbing, squatting, and standing were all associated with higher odds of knee OA as compared to the odds of knee OA in sedentary workers. CONCLUSION Strenuous, physically demanding occupations and occupational activities were associated with increased odds of knee OA as supported by moderate-quality evidence. Specifically, agricultural and construction sectors, which typically involve heavy lifting, frequent climbing, prolonged kneeling, squatting, and standing, carried increased odds of knee OA.
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Affiliation(s)
- Xia Wang
- Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Thomas A Perry
- Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia, and University of Oxford, Oxford, UK
| | - Nigel Arden
- University of Oxford, Oxford, UK, and Southampton General Hospital, University of Southampton, Southampton, UK
| | - Lingxiao Chen
- Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - Camille M Parsons
- Southampton General Hospital, University of Southampton, Southampton, UK
| | - Cyrus Cooper
- Southampton General Hospital, National Institute for Health Research Biomedical Research Centre, University of Southampton, and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Lucy Gates
- University of Oxford, Oxford, UK, and University of Southampton, Southampton, UK
| | - David J Hunter
- Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
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A Comparative Study on Loadings of the Lower Extremity during Deep Squat in Asian and Caucasian Individuals via OpenSim Musculoskeletal Modelling. BIOMED RESEARCH INTERNATIONAL 2020. [DOI: 10.1155/2020/7531719] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Populations of different ethnicities may present different movement capacities and muscular function adaptations. The purpose of this study was to investigate the differences of motion and loading in the lower extremity during dynamic deep squats between Asian and Caucasian individuals using OpenSim modelling technique with a customized squat-specific musculoskeletal model. Twenty-four participants joined the test performing the step-squat test, with right foot stepping side, squatting, and returning. The one-dimensional statistical parametric mapping package was used for statistical analysis. The main findings of the current study were as follows: (1) significant lower squat depth was observed in the Asian individuals, (2) the greater knee range of motion and contact forces were found in the Asian individuals, and (3) the greater ankle contact forces in the Caucasian individuals were notable while performing the deep squat compared to the Asian group. Knowledge found in the current study may provide implication for exercise practitioners and physiotherapists while designing schemes for the prevention of loading accumulation in the lower extremity.
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Pillai MV, Van Engelhoven L, Kazerooni H. Evaluation of a Lower Leg Support Exoskeleton on Floor and Below Hip Height Panel Work. HUMAN FACTORS 2020; 62:489-500. [PMID: 32150477 DOI: 10.1177/0018720820907752] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The aim of this study is to determine the effectiveness of using a leg support exoskeleton (legX) in different modes on simulated work tasks which emulate real-world job tasks. BACKGROUND Prolonged kneeling and squatting tasks increase the risk of work-related musculoskeletal disorders at the knee in industrial occupations. METHODS We evaluated legX capable of spring assistance throughout one's range of motion and/or locking support at a fixed angular position. Participants performed a dynamic panel task, alternating between hip and knee height, and a sustained floor level task with and without the exoskeleton. The exoskeleton was evaluated in spring mode, locking mode, and spring + locking mode for the panel task and only in locking mode for the floor task. The participants' (N = 15) muscle activity was recorded for the right lumbar erector spinae, thoracic erector spinae, tibialis anterior, rectus femoris, semitendinosus, and lateral gastrocnemius. RESULTS Significant reduction of the rectus femoris activity was observed with the exoskeleton (median reduction: 22%-56% and peak reduction: 12%-48% for the panel task and median reduction: 57% and peak reduction:34% during the floor task). CONCLUSION legX significantly reduces rectus femoris activity during squatted static (floor) and dynamic (panel) work and may reduce pain and discomfort associated with squatting and potentially reduce the risk of developing knee disorders. Dynamic tasks benefit from both locking modes and spring assistance, the greatest benefit occurring with a combination of the two. APPLICATION These results show that the legX can be beneficial to activities such as electrical panel work, grinding, sanding of larger surfaces, and concrete laying.
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Hendriksen PF, Korshøj M, Skotte J, Holtermann A. Detection of kneeling and squatting during work using wireless triaxial accelerometers. ERGONOMICS 2020; 63:607-617. [PMID: 32100646 DOI: 10.1080/00140139.2020.1734668] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 02/11/2020] [Indexed: 06/10/2023]
Abstract
Occupational kneeling and squatting are well-documented risk factors for knee disorders. A method using 3 wireless accelerometers to detect and discriminate kneeling and squatting during work were developed based on data from a semi-standardised laboratory protocol. The method was tested for validity under free-living working conditions. The developed method showed high sensitivity (88-99%) and specificity (98-99%) for detection of kneeling and squatting during the semi-standardised laboratory conditions. During free-living working conditions, kneeling showed very high sensitivity (94%) and specificity (99%), while squatting results were non-conclusive due to limited duration of squatting during the free-living working conditions. This method shows great promise for long-term technical measurement of kneeling and squatting during normal working conditions using wireless accelerometers. The method opens up possibilities for using technical measurements to provide valid exposure assessments and intervention evaluations of kneeling and squatting, as well as increased feasibility for technical measurements in large cohort studies. Practitioner summary: Quantification of kneeling and squatting during work is important for prevention, but limited by either imprecise or costly methods. This study developed and validated an inexpensive wireless accelerometer-based measurement method that can be used by practitioners and researchers for long-term measurements of kneeling and squatting during free-living working conditions.
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Affiliation(s)
| | - Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Jørgen Skotte
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Abstract
Kneeling ability is consistently the poorest patient-rated outcome after total knee replacement (TKR), with 60-80% of patients reporting difficulty kneeling or an inability to kneel.Difficulty kneeling impacts on many activities and areas of life, including activities of daily living, self-care, leisure and social activities, religious activities, employment and getting up after a fall. Given the wide range of activities that involve kneeling, and the expectation that this will be improved with surgery, problems kneeling after TKR are a source of dissatisfaction and disappointment for many patients.Research has found that there is no association between range of motion and self-reported kneeling ability. More research is needed to understand if and how surgical factors contribute to difficulty kneeling after TKR.Discrepancies between patients' self-reported ability to kneel and observed ability suggests that patients can kneel but elect not to. Reasons for this are multifactorial, including knee pain/discomfort, numbness, fear of harming the prosthesis, co-morbidities and recommendations from health professionals. There is currently no evidence that there is any clinical reason why patients should not kneel on their replaced knee, and reasons for not kneeling could be addressed through education and rehabilitation.There has been little research to evaluate the provision of healthcare services and interventions for patients who find kneeling problematic after TKR. Increased clinical awareness of this poor outcome and research to inform the provision of services is needed to improve patient care and allow patients to return to this important activity. Cite this article: EFORT Open Rev 2019;4:460-467. DOI: 10.1302/2058-5241.4.180085.
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Affiliation(s)
- Vikki Wylde
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK.,National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK
| | - Neil Artz
- Department of Allied Health Professions, University of the West of England, Bristol, UK
| | - Nick Howells
- North Bristol NHS Trust, Southmead Hospital, Bristol, UK
| | - Ashley W Blom
- Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, UK.,National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, UK.,North Bristol NHS Trust, Southmead Hospital, Bristol, UK
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12
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Salleh NFM, Sukadarin EH, Khamis NK, Ramli R. Pattern of muscle contraction in different postures among Malaysia pineapple plantation workers. ACTA ACUST UNITED AC 2019. [DOI: 10.1088/1757-899x/469/1/012088] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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13
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Ahmad I, Kim JY. Assessment of Whole Body and Local Muscle Fatigue Using Electromyography and a Perceived Exertion Scale for Squat Lifting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15040784. [PMID: 29670002 PMCID: PMC5923826 DOI: 10.3390/ijerph15040784] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Revised: 04/13/2018] [Accepted: 04/16/2018] [Indexed: 11/30/2022]
Abstract
This research study aims at addressing the paradigm of whole body fatigue and local muscle fatigue detection for squat lifting. For this purpose, a comparison was made between perceived exertion with the heart rate and normalized mean power frequency (NMPF) of eight major muscles. The sample consisted of 25 healthy males (age: 30 ± 2.2 years). Borg’s CR-10 scale was used for perceived exertion for two segments of the body (lower and upper) and the whole body. The lower extremity of the body was observed to be dominant compared to the upper and whole body in perceived response. First mode of principal component analysis (PCA) was obtained through the covariance matrix for the eight muscles for 25 subjects for NMPF of eight muscles. The diagonal entries in the covariance matrix were observed for each muscle. The muscle with the highest absolute magnitude was observed across all the 25 subjects. The medial deltoid and the rectus femoris muscles were observed to have the highest frequency for each PCA across 25 subjects. The rectus femoris, having the highest counts in all subjects, validated that the lower extremity dominates the sense of whole body fatigue during squat lifting. The findings revealed that it is significant to take into account the relation between perceived and measured effort that can help prevent musculoskeletal disorders in repetitive occupational tasks.
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Affiliation(s)
- Imran Ahmad
- Department of Industrial Management Engineering, Hanyang University, Ansan 15588, Korea.
| | - Jung-Yong Kim
- Department of Industrial Management Engineering, Hanyang University, Ansan 15588, Korea.
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Fischer HJ, Vergara XP, Yost M, Silva M, Lombardi DA, Kheifets L. Developing a job-exposure matrix with exposure uncertainty from expert elicitation and data modeling. JOURNAL OF EXPOSURE SCIENCE & ENVIRONMENTAL EPIDEMIOLOGY 2017; 27:7-15. [PMID: 25967069 DOI: 10.1038/jes.2015.37] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 04/12/2015] [Indexed: 06/04/2023]
Abstract
Job exposure matrices (JEMs) are tools used to classify exposures for job titles based on general job tasks in the absence of individual level data. However, exposure uncertainty due to variations in worker practices, job conditions, and the quality of data has never been quantified systematically in a JEM. We describe a methodology for creating a JEM which defines occupational exposures on a continuous scale and utilizes elicitation methods to quantify exposure uncertainty by assigning exposures probability distributions with parameters determined through expert involvement. Experts use their knowledge to develop mathematical models using related exposure surrogate data in the absence of available occupational level data and to adjust model output against other similar occupations. Formal expert elicitation methods provided a consistent, efficient process to incorporate expert judgment into a large, consensus-based JEM. A population-based electric shock JEM was created using these methods, allowing for transparent estimates of exposure.
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Affiliation(s)
- Heidi J Fischer
- Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | | | - Michael Yost
- Department of Env. and Occ. Health Sciences, University of Washington, Seattle, Washington, USA
| | | | - David A Lombardi
- Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts, USA
| | - Leeka Kheifets
- Department of Epidemiology, University of California School of Public Health, Los Angeles, California, USA
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Ohlendorf D, Schwarzer M, Rey J, Hermanns I, Nienhaus A, Ellegast R, Ditchen D, Mache S, Groneberg DA. Medical work assessment in German hospitals: a study protocol of a movement sequence analysis (MAGRO-MSA). J Occup Med Toxicol 2015; 10:1. [PMID: 25606049 PMCID: PMC4298873 DOI: 10.1186/s12995-014-0040-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2014] [Accepted: 11/07/2014] [Indexed: 02/07/2023] Open
Abstract
Background Medical doctors are essential for the German public and occupational health system. They ensure the productivity of German society by enabling people to regain and recover their health. That is why the physicians’ health and hence their productivity require special attention. Musculoskeletal disorders have a high prevalence in this work area. As a consequence, movement sequences, range of motions, and body postures of physicians in the course of the working day are in focus of this research project. Methods For this investigation 21 male or female junior physicians of various conservative medical disciplines will be covered. Data will be collected over one working day (approx. 9 hours). The CUELA system attached to the test person’s body detects body posture and/or movements. This biomechanical measurement system ensures a locomotor and posture analysis that includes movement sequences, movement intensity, and range of motions to qualify the work tasks. For data analysis intra- and inter-professional comparisons are chosen. Conclusions Working movement sequence analysis of physicians by means of the CUELA system is exclusive and novel in its focus. Up to now, knowledge of the working tasks of medical doctors has only been acquired by real-time observation approaches to work activity. In addition to this method of analysis, the CUELA system is able to record quantified biomechanical data about musculoskeletal loads of ordinary working tasks. Workloads and activities of physicians can be improved by ergonomic work design to reduce musculoskeletal disorders by utilizing the data collected. The healthcare system in Germany will thus be optimized by improving medical doctors’ health. Consequently, MAGRO-MSA will also be used for other healthcare professions such as nurses and physicians assistants.
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Affiliation(s)
- Daniela Ohlendorf
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9a, Frankfurt/Main, 60596 Germany
| | - Mario Schwarzer
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9a, Frankfurt/Main, 60596 Germany
| | - Julia Rey
- Institute of Biostatistics and Mathematical Modeling, Goethe-University, Frankfurt/Main, Germany
| | - Ingo Hermanns
- Institute for Occupational Health and Safety (IFA) of the German Social Accident Insurance (DGUV), Sankt Augustin, Germany
| | - Albert Nienhaus
- Principles of Prevention and Rehabilitation Department (GPR), Institute for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW), Hamburg, Germany
| | - Rolf Ellegast
- Institute for Occupational Health and Safety (IFA) of the German Social Accident Insurance (DGUV), Sankt Augustin, Germany
| | - Dirk Ditchen
- Institute for Occupational Health and Safety (IFA) of the German Social Accident Insurance (DGUV), Sankt Augustin, Germany
| | - Stefanie Mache
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9a, Frankfurt/Main, 60596 Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt/Main, Theodor-Stern-Kai 7, Building 9a, Frankfurt/Main, 60596 Germany
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