Work-related Upper Limb Disorders Research Articles

Workplace-based rehabilitation with garment workers: A multiple case study.

Garment workers are at risk of developing work-related upper limb disorders (WRULD) due to the highly repetitive nature of their work. Workplace-based rehabilitation (WBR) facilitates improvement in work performance by providing intervention at the worker's place of work. This study aims to determine the documented outcomes of workplace-based occupational therapy rehabilitation of garment workers with upper limb conditions. A multiple case study design was used through a retrospective record review. All garment workers with upper limb conditions who were treated at a student occupational therapy practice in Cape Town, South Africa, with pre- and post-intervention outcome assessment, were included in the study (n = 7). Data were extracted from occupational therapy and medical files. 70% of the cases (n = 5) improved after WBR while 30% of cases showed no improvement or deterioration. Participants received 3- 5 individual WBR sessions of approximately 30 minutes each, over a period of 4 to 6 weeks. Interventions included workstation adaptations, job rotation, psychoeducation, work task modification, assistive technology and exercise programmes. Outcome measures most commonly used were the RULA, DASH, Boston Carpal Tunnel Questionnaire and pain intensity using the VAS. Workplace-based occupational therapy can be effective at improving upper limb function, pain and ergonomic risk amongst garment workers with upper limb conditions.

Prevalence of and prevention for work-related upper limb disorders among physical therapists: a systematic review

BackgroundPhysical therapists (PTs) are at increased risk for development of work-related upper limb disorders (WRULDs) due to the physically intensive, constant hands-on nature of the profession. The objectives of this systematic review were to examine the literature on WRULDs among PTs, specifically the (1) 1-year prevalence, (2) workplace risk factors, (3) consequences, and (4) coping strategies utilized to mitigate WRULDs.MethodsA comprehensive search of the literature was performed using PubMed, CINHAL, EMBASE, and Google Scholar. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for conducting this systematic review. Studies that reported the 1-year prevalence of WRULDs among PTs, workplace risk factors for WRULDs, consequences of WRULDs, and coping strategies utilized by PTs were included.ResultsTwelve studies met the inclusion criteria. The 1-year WRULDs prevalence rates varied widely, with thumb disorders having the highest prevalence (7.6-52.5%), followed by wrist and hand disorders (5-66.2%), shoulder disorders (3.2-45.2%), and elbow disorders (4-16%). Reported risk factors included treating a high volume of patients and frequent performance of manual therapy techniques. Consequences included interference with PTs’ personal and professional activities while coping strategies involved alterations to the work environment, techniques used, and workload.ConclusionsWRULDs remain a persistent threat to the PT workforce, likely due to the hands-on, physically intensive nature of professional activities. An essential strategy to reduce WRULDs is to improve clinicians’ awareness of WRULDs, workplace risk factors, and subsequent consequences of WRULDs. Effective coping strategies are critical to preserve, protect, and prolong PTs’ use of the upper limbs.

Association between cardiovascular risk factors and work-related upper limb disorders

Association between cardiovascular risk factors and work-related upper limb disorders

‘radical gleaning’: Doing Prac Crip

This article develops what I call ‘prac crip’ as an innovative methodology to perform on the page the scholarly realities of working, living and writing with the disability of repetitive strain injury. Prac crip is a prac crit of crips that complicates liberatory crip criticism. It shows how repetitive strain injury changes an approach to practical criticism, but also, by association with ‘crit’, how practices of practical criticism with repetitive strain injury shift some key uses of the ‘crip’. Critical of this mode of cripping as well as cripical, prac crip demonstrates the emancipatory limits of practising crip criticism for those crips the work also hurts in the act.Peter Larkin’s fascination with gleaning runs parallel to the rise of lean. To glean and its derivatives have a ‘distinctive presence’ in his lexis from Pastoral Advert (1988) to Seven Leaf Sermons (2018), a thirty-year period during which lean management has become increasingly global. The article traces through Larkin the eco-politically crucial relationships between the common right of gathering after harvest known as gleaning, historically, a practice for disabled people; the gesture of leaning; and the genealogy of global lean management technologies in the packing of lean meat. The essay explores how disability is an integral part of how its readings are produced, as well as addressing the predicament that work-related upper limb disorders, which are driven by lean managed environments, continue to be driven by writing against lean managed environments.

Developments in work-related upper limb disorders (WRULD) amongst Dutch university students from 2004 to 2014.

Former studies on work-related upper limb disorders (WRULD) within university education report substantial prevalence rates. In this study, developments in WRULD amongst students in the period 2004-2014 were investigated. Our findings can be a benchmark for future studies, in particular when there are major societal changes as in the case of the COVID-19 pandemic. Differences in time (academic year), how long students have been studying (year of studying), relations with computer time and societal changes were points of interest. 2254 students (average age 20.0 years) responded to a questionnaire on WRULD. Students experiencing complaints were further questioned about the severity of complaints and associated body locations. The average percentage of students experiencing complaints was 57%. The highest prevalence rates and severity scores were found in the first and last recorded academic years. The neck, shoulder, back and wrist were most often indicated. The prevalence of complaints raised from the 1st (49%) to the 4th (75%) year of studying. Two seriousness measures showed highest scores in the 5th/6th/7th year of studying. Relations were found between both the prevalence and seriousness of complaints with reported computer time. After an initial decreasing trend from the academic year 2006/2007 to 2010/2011 there was an increase in WRULD amongst students from 2010/2011 to 2013/2014. Limiting financial and study time factors may have played a role. Structural attention for WRULD prevention and risk factors seems to be effective in reducing prevalence and severity of WRULD. This seems to be even more necessary due to recent COVID-related changes in the students' lives.

Prevalence of work related upper limb disorders and the associated psychosocial factors among midwives

BackgroundWork related upper limb disorders (WRULDs) are a major occupational health concern. The health field, with its various occupational categories, is a conducive environment for the emergence of these conditions. Midwives are particularly at risk for WRULDs. ObjectiveTo determine the prevalence of WRULDs among midwives exersing at a Tunisian academic maternity and identify its associated factors. MethodsThis is a cross-sectional descriptive study conducted among midwives working at the maternity Departement of the Farhat Hached Teaching Hospital in the central region of Tunisia, during the period from March to May 2016. This study was based on a self-administered questionnaire including socio-professional characteristics, the “Nordic” questionnaire for the assessment of WRULDs in the last 12 months and the last 7 days, and the job content questionnaire for the evaluation of the psychosocial environment at work. ResultsA total of 54 midwives participated to our study with a response rate of 84.3%. The mean age was 46.1 + 8.7 years. In the last week before the study, the median number of deliveries performed by midwives per day was 3. Job strain was noted in 33.3% of cases. During the last 12 months, the prevalence of WRULDs was 90.7%. The complaints were located at the neck in 72.7% of cases. For the last seven days, this prevalence was 53.7%. Obesity and upper limb trauma history were significantly associated with WRULDs over the last 7 days. No social-occupational risk factors were associated with WRULDs in midwives in the last 12 months. ConclusionOur study found a high prevalence of WRULDs in midwives, emphasizing the need of adequate prevention in order to reduce the importance of this occupational disease and its harmful consequences.

Work-related upper limb disorder and cervical stenosis

Background: This is an account of a patient working in an ophthalmology clinic in a tertiary care hospital, Riyadh, who initially presented with work-related musculoskeletal disorder of the upper limb. The primary complaint was pain in the right shoulder and arm for the past 6 months. She was diagnosed with tenosynovitis of the upper limb on the first presentation, but later investigations revealed cervical stenosis. Case Presentation: A 42-year-old Indian female nurse, working in ophthalmology outpatient clinic at a university hospital in Riyadh, Saudi Arabia, presented with the complaints of pain in the right shoulder and arm for the past 6 months. She was transferred to another area with less work load and reduced exposure to occupational work manual exertion and sustained awkward exposure. The symptoms improved after 6 months of her transfer to the current unit. Conclusion: Although the initial symptoms were in favor of work-related upper limb musculoskeletal disorder, the nature of symptoms led to extensive workup, magnetic resonance imaging, diagnosis of cervical stenosis, and referral to orthopedics and neurology for further management.

Work-related upper limb disorders and risk assessment among automobile manufacturing workers: A retrospective cohort analysis.

To estimate the three-year cumulative risk of work-related upper limb disorders (WRULDs) in a cohort of automotive industry workers and to provide a first test of the ability of the European Assembly Worksheet (EAWS) methodology to predict WRULDs. 292 workers were investigated by reviewing workers' medical records during the period from 2012-2015 to determine their exposure to biomechanical overload according to EAWS risk scores (0-25, low risk, Green zone; 26-50, medium risk, Yellow zone; >50, High risk; Red zone). The risks were 0.83%, 5.71%, and 11.88% for the Control (unexposed), Green and Yellow Groups, respectively. Only the comparison between the Yellow/Control Groups was significant (p = 0.0014). In total, we observed 17 cases of musculoskeletal disorders (MSDs) (14 symptomatic and 3 cases detected by physical examination). The EAWS is a useful tool for the preliminary risk assessments of biomechanical overload among automotive industry workers. The finding of mainly non-specific disorders highly suggests that health surveillance should aim to identify not only full-blown diseases but also symptomatic cases.

Rapid upper limb assessment (RULA) in ergonomic assessment: A comprehensive review

INTRODUCTION: RULA (rapid upper limb assessment) is a survey method developed for use in ergonomics investigations of workplaces where work-related upper limb disorders are reported. There are various researches available regarding the use of RULA in assessing work-related musculoskeletal disorders (WRMSDs). But till date, there is no compiled review available regarding the comprehensive research on the uses of RULA in various ergonomic assessment. OBJECTIVE: To compile the availability of article related to the uses of RULA in assessing WRMSDs among workers from various fields. MATERIALS AND METHODS: The articles related to RULA in ergonomic assessment were searched using the reputed academic databases, including PubMed, Medline, CINAHL, PsycINFO, and EBSCO from inception to July 22, 2019 using the five keywords, “ergonomics,” “musculoskeletal,” “workplace,” and “rapid upper limb assessment.” These keywords were combined using the Boolean operators “AND,” “OR,” and “NOT.” RESULTS: A total of 263 articles (n=263) were identified. After the removal of 161 duplicate articles, 102 articles were screened for the analysis. Among then, 21 articles were excluded and 81 full-text articles were assessed for eligibility. Again 68 articles were excluded due to not meeting the inclusion criteria and finally 13 articles were included in the qualitative comprehensive analysis. CONCLUSION: The wider application of RULA has been confirmed from this comprehensive review.

Rapid upper limb assessment (RULA): validity and reliability evidences in identifying workplace ergonomics among bank employee’s using computers

BACKGROUND: Musculoskeletal disorders (MSDs) represent one of the leading causes of occupational injury and disability. Awkward body posture while typing is associated with MSDs among the computer users. RULA (rapid upper limb assessment) is a subjective observation method of posture analysis for use in ergonomics investigations of workplaces where work-related upper limb disorders are reported. To date, no data available on reliability and validity of RULA among the bank employee’s using computers. OBJECTIVE: To examine the validity and reliability of RULA among the bank employees’ using computers. MATERIALS AND METHODS: A sample of bank employee were recruited by simple random sampling technique to take part in this validity and reliability study. All anthropometric measurement was taken before the beginning of the study including age, height and weight. The concurrent validity of RULA was established with the criterion referenced, Rapid Entire Body Assessment (REBA). Principal investigator recorded both the scores of RULA and REBA to estimate the concurrent validity. Intra-rater reliability of RULA was established by the principal investigator across two trials on the same group of participants in the same environmental condition and same timings with a gap of 2 days. Inter–rater reliability of RULA was established by the principal investigator and another researcher on the same group of participants with in the same environmental conditions and same with a gap of 2 minutes. RESULT: Total 301 Participants were recruited in this study, in which 170 participants were males, and other 131 were females. Concurrent validity of RULA with the criterion measure REBA is found to be good as measured by spearman’s rank correlation test, ?=0.91 (p<0.001). Intra-and inter-rater reliability of RULA is found to excellent with ICC=0.92 (0.90-0.94) and 0.91 (0.89-0.93) respectively. CONCLUSION: Validity and reliability of RULA have been established among the bank employees’ using computers. There exists good validity and excellent reliability among them.

Exercise therapy and work-related musculoskeletal disorders in sedentary workers.

Work-related upper limb disorders (WRULDs) are a syndrome of symptoms affecting the upper quadrant of the body and are a significant cause of pain, disability and sickness absence among workers. Exercise therapy is considered to be a clinical and cost-effective strategy in WRULD management. To evaluate the effectiveness of exercise therapy for WRULDs in sedentary workers. This review follows an a priori protocol to maintain internal validity describing essential procedures to be followed (e.g. a comprehensive search strategy, duel extraction and critical appraisal). The methodological quality of the studies were assessed using Cochrane Risk of Bias Tool for all randomized controlled trials and the Assessing the Methodological Quality of Systematic Reviews (AMSTAR) tool for systematic reviews. A total of 11 articles were selected for inclusion. There was moderate evidence to suggest exercise is effective in reducing the symptoms of pain and improved function in WRULDs in sedentary workers when compared to a control group. The results were comparable to recent systematic reviews, which have found evidence to support the use of exercise therapy, in mixed populations of workers. There is a need for further research to highlight the most effective form of exercise, optimal dosage and delivery method.

Can Teaching Ultrasound Ergonomics to Ultrasound Practitioners Reduce White Knuckles and Transducer Grip Force?

Ergonomic training is necessary to help reduce work-related upper limb disorders (WRULD) in sonographers. This study provided an ergonomic training session for sonographers, to determine whether a teaching intervention changed the grip force used to hold a transducer. Thirteen practitioners participated and were placed into two groups (intervention group n = 7). Participants were asked to scan the same simulated transabdominal early pregnancy case. An ergometer was used, which enabled all participants to hear the effect of holding the transducer tightly. Their matched grip force was measured before and after the intervention using a dynamometer. The intervention group reviewed videos and photographs taken during the scan to see if this affected the matched grip force further. Study findings showed that the short ergonomic training session with the use of an ergometer significantly reduced the matched grip force applied to a transducer ( P < .05) for all participants. The video/photo review did not result in any further significant changes.

EFFECT OF STRETCHING EXERCISES ON TRAPEZIUS WORKLOAD USING MVIC AS AN INDICATOR

The substantial increase in using the desktop in offices is directly associated with Work Related Upper Limb Disorders (WRULDs) where an average workload on trapezius of 4hours/-day in females, is the main cause. Ergonomically inappropriate work station may increase the static muscle load at bilateral shoulder and wrist joint where keyboard is mostly responsible.Intermittent rest periods and varying positions are found significant during constant sedentary work. The aim of this study was to determine the effect of active stretching on the upper fibers of trapezius using desktop computer measured by MVIC.

Risk assessment of manual handling operations at work with the key indicator method (KIM-MHO) \u2014 determination of criterion validity regarding the prevalence of musculoskeletal symptoms and clinical conditions within a cross-sectional study

BackgroundManual handling operations (MHO) are known to be risk factors for work-related upper limb disorders (WRULDs), e.g. symptoms and conditions such as carpal tunnel syndrome. To estimate the risk of WRULDs, a Key Indicator Method (KIM) for the risk assessment of MHO was developed. The method was validated in regard to different criteria, including face validity, criterion validity, reliability and further aspects concerning utility. This paper describes the KIM-MHO and criterion validity of this method with reference to prevalence of musculoskeletal disorders (MSDs).MethodsA cross-sectional sample of 643 employees exposed to MHO was compared to a reference group of 804 unexposed subjects predominantly working at visual display terminals. The Nordic Questionnaire and a standardized clinical examination were used to obtain the 7-day and 12-months prevalence of symptoms and clinical conditions of the musculoskeletal system. Job specific exposure levels to MHO were assessed by ergonomists using the KIM-MHO. The resulting risk scores were categorized into risk categories 1 - low risk (reference group), 2 - increased risk, 3 - highly increased risk, and 4 - high risk. Log-linear Poisson regression models were applied to obtain adjusted prevalence ratios (PR) with 95%-confidence intervals.ResultsThe 7-day prevalence of symptoms for subjects in risk category 3 compared to risk category 1 was significant for the regions shoulder [women (w): PR 1.8 (1.2–2.7), men (m): PR 2.3 (1.2–4.4)], elbow [w: PR 3.3 (1.5–7.2), m: PR 2.4 (0.8–7.3)], and hand/wrist [w: PR 3.0 (1.7–5.3), m: PR 5.5 (2.7–11.3)]. The 7-day prevalence of symptoms for risk category 4 was also significant for the regions shoulder [w: PR 1.9 (1.3–2.8), m: PR 1.9 (1.3–2.7)], elbow [w: PR 4.5 (2.3–8.7), m: PR 3.3 (2.1–5.4)], and hand/wrist [w: PR 4.2 (2.6–6.9), m: PR 5.5 (3.5–8.5)]. The 12-months prevalence in these joint regions show comparable increases in the risk categories 3 and 4.ConclusionsThe KIM-MHO is valid in regard to criterion validity. The hypothesis could be confirmed, that high risk scores were associated with an increased prevalence of symptoms and clinical conditions especially in the shoulder, elbow and hand/wrist regions among employees exposed to MHO.

The Impact of Physical and Ergonomic Hazards on Poultry Abattoir Processing Workers: A Review.

The poultry abattoir industry continues to grow and contribute significantly to the gross domestic product in many countries. The industry expects working shifts of eight to eleven hours, during which workers are exposed to occupational hazards which include physical hazards ranging from noise, vibration, exposure to cold and ergonomic stress from manual, repetitive tasks that require force. A PubMed, Medline and Science Direct online database search, using specific keywords was conducted and the results confirmed that physical and ergonomic hazards impact on abattoir processing workers health, with harm not only to workers’ health but also as an economic burden due to the loss of their livelihoods and the need for treatment and compensation in the industry. This review endeavours to highlight the contribution poultry processing plays in the development of physical agents and ergonomic stress related occupational diseases in poultry abattoir processing workers. The impact includes noise-induced hearing loss, increased blood pressure, menstrual and work related upper limb disorders. These are summarised as a quick reference guide for poultry abattoir owners, abattoir workers, poultry associations, occupational hygienists and medical practitioners to assist in the safer management of occupational health in poultry abattoirs.

New Product Ideas to Support Macro Breaks in Computer Work

A healthy work-to-rest ratio during computer work can be an important part of successful preventive workrelated upper limb disorders (WRULD) intervention. Existing break software applications designed to realise such a work-to-rest ratio often possess product features that limit their functionality. Most applications focus on physical relaxation by implementing (micro) breaks into computer work time. Through the emphasis on break time, these applications give the impression that there is no productivity, possibly strengthened by the applications themselves that often visualise the remainder of the break as a slowly decreasing time bar. Moreover, application features such as blocking input devices may counteract cognitive relaxation of computer workers. As imposed physical breaks can be cognitively stressful, especially when deadlines loom, combining physical and cognitive relaxation is a challenge. Actually, research shows that, instead of micro breaks, macro breaks need more attention. It is worthwhile to think of new products for both forms of relaxation within this time span. An idea for a possible product innovation is tested with a small sample and is presented here: a new software application that shows customisable video content during macro breaks.

An assessment of hand volumetric and temperature changes during office related repetitive activities

Hand usage and movement is routinely performed by all individuals daily irrespective of age. These movements can vary and can be repetitive in nature. Exposure of the hard and soft tissues of the hand to prolonged repetitive activities could contribute to the development of work related upper limb disorders (WRULD). Within the work setting, work related upper limb disorders (WRULDs) rank high in the United Kingdom (UK), second only to back complaints. This paper reports the amount of tendon travel and swelling that occurs in the hand during repetitive office activities associated with WRULDs. Nine healthy adults (five males; four females) participated in the study. A 30-minute laboratory-based simulated office activity that consisted of data entry, mouse clicking and dragging, and mouse scrolling tasks was performed. Participants wore a custom-made cost effective flexible electrogoniometric glove (FEG) as two experimental conditions were tested; namely, FEG - only, and FEG using a Splint (FEG - Splint). The FEG - only condition produced a higher overall tendon travel compared to the FEG - Splint condition. Both hands presented no statistically significant differences in hand temperature (p > 0.05) and hand volume increments (p > 0.05) with respect to the FEG - only and FEG - Splint office activity experiments. All participants that showed a decrease in hand volumetric measurement produced final temperature measurements lower than initial temperature measurements taken at the commencement of the experiment. Based on participants' perception, the mouse scrolling task was deemed as most strenuous. The findings can help to advise patients on biomechanical 'risks' associated with repetitive activities.

Ergonomic risk factors and their association with musculoskeletal disorders among Indian dentist: a preliminary study using Rapid Upper Limb Assessment.

Ergonomics is the scientific study of people and their work. The manufacturers typically do not design to accommodate the dimensions of the individual user. Work-related musculoskeletal disorders (MSDs) have emerged as major health problem among workers in both industrialized and industrially developing countries. Rapid Upper Limb Assessment (RULA) was developed to investigate the exposure of the individual workers to risk factors associated with work-related upper limb disorders. The assessment of the posture using RULA, which is quick reliable tool to determine the posture, has not been done in the Indian dentist population, indicating the need for the same. A total of 104 subjects were included from New Delhi/NCR. The procedure was explained, and the questionnaire was distributed and assessment was done using RULA. The MSDs can be recorded using the standard Nordic questionnaire. The data were collected from 104 subjects out of the 192 evaluated and was statistically analyzed using SPSS software. The study sample included 70 male and 34 female dentists. The posture of the subjects and the MSDs are not associated with a significant difference as according to Pearson's Chi-square test (0.231). RULA can be used as a screening tool for postural risks following a short training session regardless of the assessor's experience in postural risk assessments.

Comparative ergonomic evaluation of the hand-pieces of three instrument series for root planning

Introduction: Musculoskeletal disorders (MSD) are the most frequent cause of disability in the working population, exceeding accidental trauma in frequency. The risk of developing work-related upper limb disorders (WURLDs) is high among dental hygienists and the most frequently affected are elderly subjects and women. Since such disorders can have a negative effect on the working life and on the quality of life, it is of vital importance to put in place preventive measures. Aim: To make a comparative analysis of the hand-pieces of three different manual instruments used for root planning. Materials and Methods: To evaluate the physical characteristics (section, diameter, external surface, weight) of the hand-pieces of three series of instruments for root planning, twenty-nine dental hygienists students were videoed while working clinically. They were also interviewed using a specific questionnaire to determine subjective preferences in terms of perceived efficacy, safety, comfort and general acceptability of the hand-piece used. Results: Lightness, full-cylindrical section with larger-diameter ends, and coating with anti-slip silicone are the most appreciated characteristics of a hand-piece. Conclusions: Ergonomic analyses of manual instruments are not frequent in the dental field, and the literature reports no guidelines to guide selection of the type of hand-piece of manual instruments. The data gathered may help manufacturers in designing new manual instruments, and guiding professionals in their selection.

Work-Related Upper Limb Disorders: How can We Improve Prevention and Management?

Work-related upper limb disorders remain a challenge to the clinician because an estimated 75% are regarded as diagnostically unclassifiable. Evidence-based prevention and treatment of these frequent and disabling disorders have therefore been limited and largely unsuccessful. It is essential to identify the involved tissues and structures as well as the responsible pathologies. To do so would require improved diagnostic approaches.