Prevalence of Musculoskeletal Disorders and Postural Assessment during Endoscopy and Colonoscopy among Gastroenterologists in Isfahan City, Iran

Abstract

Background: Gastroenterologists may be susceptible to various musculoskeletal disorders (MSDs) in the absence of correct posture because of working in various positions in offices and hospitals. The aim of this study was to assess the relationship between posture and MSDs among gastroenterologists in Isfahan city, Iran. Methods: Three methods of posture evaluation are self-report, observational method, and direct measurement. Based on previous studies, the validity and reliability of the observational method is higher than others. In this study, gastroenterologists' postures during endoscopy and colonoscopy were analyzed using the two observational methods of Rapid Upper Limb Assessment (RULA) and Ovako Working Posture Assessment System (OWAS). They also completed the Nordic Musculoskeletal Questionnaire (NMQ). Results: Based on OWAS, the posture risk was 1 in 22.2% and 2 in 77.8% of gastroenterologists, while based on RULA, this risk was 4 in 38.9%, 5 in 38.9%, and 6 in 22.2% of the subjects. The incidence of MSDs had a direct relationship with the level of risk based on RULA, but had no significant association with the level of risk based on OWAS. The level of risk based on RULA had a direct relationship with the number of procedures per day. In addition, the prevalence of MSDs had a direct relationship with the number of procedures per day and body mass index (BMI). The level of risk based on RULA had a direct relationship with incidence of MSDs in the neck, upper back, and knees. Conclusion: musculoskeletal disorders are highly prevalent among gastroenterologists in Isfahan. Postural analysis results showed that the risk of incidence of these disorders is very high. High BMI was one of the factors contributing to the occurrence of MSDs. Since about half of the target group subjects were overweight, losing weight can help to reduce the incidence of MSDs. In addition, the high number of procedures per day increases the risk of posture and musculoskeletal problems simultaneously. Thus, reducing the number of procedures or increasing the rest time between appointments, performing endoscopy and colonoscopy as uncontinuous procedures, increasing precision and accuracy of positioning, and using tele-robotic techniques instead of manual ones could be effective in gastroenterologists who have a high workload.