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Effects of key stiffness on force and the development of fatigue while typing.

An experiment was conducted to investigate the effect of key stiffness on the development of fatigue, keyboard reaction forces, and muscle electromyography (EMG) responses. Six subjects typed continuously for 2 hours on each of two keyboards (0.28 N or 0.83 N resistance keys, presented in random order). Keyboard reaction force and root mean square finger flexor and extensor EMG were recorded for 2 minutes at 250 Hz for every 10 minutes subjects typed. After typing for 2 hours subjects were given a 2-hour rest break and then typed on the remaining keyboard for an additional 2 hours Fifty-four percent more peak force, 34% more peak finger flexor EMG, and 2% more peak finger extensor EMG were exerted while using the 0.83 N keyboard. Peak and 90th percentile values showed similar trends and were well correlated for force and finger flexor and extensor EMG. Subjects typed much harder than necessary (4.1 to 7.0 times harder on the 0.28 N keyboard and 2.2 to 3.5 times harder on the 0.83 N keyboard) to activate the keys. Fatigue was observed on the 0.83 N keyboard during 2 hours of continuous typing, but the trends were mild. It appears that the ratio of typing force to flexor EMG may not be a sensitive enough indicator of fatigue for low-force high repetition work.

Adult↗

Comparison of repetitive movements between ballet dancers and martial artists: risk assessment of muscle overuse injuries and prevention strategies.

Studies show that 64%-80% of professional dancers need to stop performing for extended periods due to Overuse Syndrome (OS). Although ballet and Tae-Kwon-Do seem to have similarities in muscle lengthening, the Tae-Kwon-Do injury rate is significantly lower. Identifying differences between both skills should provide insights for OS prevention. Therefore, the aims of this study are to quantitatively determine the diversities in intensity between both skills, to identify muscles at risk, and to draw possible prevention strategies from the comparison. The methods used were 3D motion capture and biomechanical modeling. Six ballet dancers and five Tae-Kwon-Do artists participated in the study. The results show that intensity during Tae-Kwvon-Do is higher than that during ballet, particularly for small muscles. As inteinsity cannot be responsible for higher injuries, strength training for small muscles and shorter exercise duration in Tae-Kwon-Do may account for the reversed rate; consequently, this is a promising procedure for ballet training. Clearly, further studies are needed to validate this conclusion.

Adolescent↗

Physical exercise and health education for neck and shoulder complaints among sedentary workers.

OBJECTIVE: To assess the effectiveness of 3 different health promotion exercise programs for work-related shoulder and neck pain. DESIGN: Comparative study design. SUBJECTS: A total of 178 employees were recruited and grouped. METHODS: Those in the "Self-exercise group" (n = 56) were given a lecture about the exercise program and then performed the program by themselves during their office break. "Team-exercise group I" (n = 69) performed the program once under the supervision of a physiotherapist after the lecture. "Team-exercise group II" (n = 14) performed the program twice; once under a physiotherapist's supervision. A modified Nordic questionnaire, pain threshold and cervical range of motion were used to evaluate the effect of intervention. There were 39 subjects in the reference group. RESULTS: When daily change of pain threshold (post-work-pre-work) was treated as an improvement index, the odds ratios for the self-exercise group, team-exercise group I and team-exercise group II were 1.39, 4.63 (p < 0.05) and 7.06 (p < 0.05), respectively, compared with the reference group. A dose-response effect of intervention intensity was demonstrated. CONCLUSION: An intensive team-exercise program is beneficial in reducing neck and shoulder symptoms in sedentary workers.

Adult↗

Comparison of neuromuscular injuries to the surgeon during hand-assisted and standard laparoscopic urologic surgery.

BACKGROUND AND PURPOSE: Hand-assisted procedures have assumed a greater role in the practice of many laparoscopists. We surveyed major laparoscopy program directors to compare the incidence and location of neuromuscular injury to the surgeon during hand-assisted laparoscopic (HAL) and standard laparoscopic (SL) surgery. MATERIALS AND METHODS: A questionnaire on neuromuscular injuries was e-mailed to 42 laparoscopic program directors. Respondents were instructed to report only injuries or pain associated with laparoscopic surgery when they were the primary responsible surgeon and not during open or endoscopic procedures. RESULTS: Surveys were returned from 23 attending laparoscopic surgeons and 2 laparoscopic fellows. Surgeons reported an average of 3.9 HAL and 6.3 SL cases per month as the primary surgeon. The HAL was completed with the GelPort, LapDisk, Omniport, or a combination of devices 55%, 22%, 5%, and 14%, respectively, of the time. Comparing HAL with SL, there was significantly more hand/wrist, forearm, and shoulder pain/injuries associated with HAL (P < 0.004). There was significantly more neck pain associated with SL than HAL (P < 0.003), but no significant difference in lower-back pain (P = 0.40). Comparing the two most commonly used hand-assist devices (GelPort and LapDisk), the LapDisk demonstrated significantly more hand/wrist pain or injury (P = 0.001). CONCLUSION: Hand-assisted laparoscopy is associated with more frequent neuromuscular strain to the upper extremity than SL, but SL surgeons experience more neck pain or injury. Surgeon discomfort is also dependent on the type of hand-assist device. The long-term consequences of physical strain on the laparoscopic surgeon are unknown currently, but measures to minimize neuromuscular strain should be considered.

Adult↗

Can we rely on retrospective pain assessments?

The objective of this paper was to study whether subjects in a workplace setting are able to assess the intensity of musculoskeletal pain retrospectively for a period of 3 months. The intensity of average pain and maximum pain in eight anatomic regions was assessed on a numeric rating scale. The results of 12 consecutive weekly pain recordings were compared with a final retrospective assessment of pain intensity covering the same 3-month period (119 subjects). The degree of agreement was good or excellent. The subjects were able to distinguish between the worst complaints and average complaints, and the subjective perception of aggravations or improvements corresponded to the direction of a change in score. Current complaint status slightly influenced the memory of pain. The reproducibility of the questionnaire was also assessed and showed kappa coefficients between 0.44 and 0.91 (36 subjects). The results suggest that subjects are able to accurately recall and rate the severity of pain or discomfort for a period of 3 months. These findings are of practical importance in epidemiologic studies, because they imply that retrospective reports on pain intensity are sufficiently reliable.

Adult↗

A cross-sectional study of health complaints among 79 data entry operators using video display terminals.

This paper reports on the findings of a cross-sectional study of 79 data entry clerks employed by an Ontario-based organization in five separate offices. The study was conducted to identify factors associated with physical complaints experienced by these office workers. A large percentage of the data entry clerks reported chronic physical complaints (eyestrain, musculo-skeletal pains, headache) as well as emotional or mental stress which they felt were associated with their occupation. Poorly designed overhead lighting systems in all offices contributed to both eyestrain and headache. Duration of employment as a data entry operator within the organization was not associated with stress or physical health complaints. The presence of an adjustable workstation did not in itself guarantee any protection from these conditions. Highly significant associations between occupational stress levels and some physical complaints were observed. The presence of these associations indicated that the management of both physical and stress complaints within these office environments should be tackled simultaneously.

Computer Terminals↗

Does RSI exist?

Explore the source record for details and available documents.

Cumulative Trauma Disorders↗

Does RSI exist?

Explore the source record for details and available documents.

Cumulative Trauma Disorders↗

What do doctors mean by tenosynovitis and repetitive strain injury?

Confusion exists in both the scientific and the lay press on the meaning of the terms tenosynovitis and repetitive strain injury. The courts are increasingly being asked to make judgements on individual cases but this gives little in the way of guidance to doctors producing reports for the Department of Social Security or solicitors. The aim of this study was to document what such doctors mean by these terms, what diagnostic criteria they use, and to make any necessary recommendations. The diagnostic criteria for DSS industrial conditions A8 (tenosynovitis) and A4 (professional cramp) varied greatly and what the experts understood by the term 'repetitive strain injury (RSI)' was so variable that the term is meaningless. Half of the doctors who responded felt that there was no genuine organic condition corresponding to their assessment of what the term means. As half of the doctors providing reports believe that 'repetitive strain injury' is not a genuine disease entity and the other half do, court cases will continue. The dilemma appears to be that completely different meanings are ascribed to the same term. Therefore, the term 'repetitive strain injury' should no longer be used.

Cumulative Trauma Disorders↗

Use of keyboards and symptoms in the neck and arm: evidence from a national survey.

The objective of this study was to examine the relationship between upper limb symptoms and keyboard use in a population survey. A questionnaire was mailed to 21,201 subjects aged 16-64 years, selected at random from the registers of 34 British general practices. Information was collected on occupation and on regular use of keyboards (for >4 h in an average working day), pain in the upper limbs and neck, numbness or tingling in the upper limbs, headaches, and feelings of tiredness or stress. Associations were explored by logistic regression, with the resultant odds ratios converted into prevalence ratios (PRs). Among 12,262 respondents, 4899 held non-manual occupations. These included 1871 regular users of keyboards (e.g. computer operators, data processors, clerks, administrators, secretaries and typists). Pain in the neck or upper limbs and sensory symptoms were common in the non-manual workers overall (with 1 week period prevalences of 30 and 15%, respectively), and were associated with older age, smoking, headaches and tiredness or stress. After adjustment for these factors, regular keyboard use was significantly associated with pain in the past week in the shoulders (PRs 1.2-1.4) and the wrists or hands (PR 1.4), but not with elbow pain or sensory symptoms over the same period, or with neck or upper limb pain that prevented normal activities in the past year. Disabling symptoms were somewhat less prevalent among symptomatic keyboard users than among other symptomatic workers. We conclude that use of keyboards was associated with discomfort at the shoulder and wrist or hand, but risk estimates were lower than generally reported in workplace surveys. Previous estimates of risk in the occupational setting may have been biased by shared expectations, concerns, or other aspects of illness behaviour.

Adolescent↗

Lateral epicondylitis in a hospital phlebotomist--an ergonomic solution.

This report outlines a case of lateral epicondylitis in a hospital phlebotomist thought to be due to the forceful gripping, and repetitive twisting, involved in breaking the seals on green vacutainer needles. An ergonomic solution in the form of a device to aid breaking of the vacutainer seals is presented. The importance of seeking ergonomic solutions with manufacturers is highlighted.

Blood Specimen Collection↗

Hypothenar hammer syndrome: a discrete syndrome to be distinguished from hand-arm vibration syndrome.

BACKGROUND: Hypothenar hammer syndrome (HHS) is a cause of vascular insufficiency to the hand and may be manifest as Raynaud's phenomenon. The cause is trauma to the vulnerable portion of the ulnar artery as it passes over the hamate bone, which may result in thrombosis, irregularity or aneurysm formation. AIM: This review was undertaken in order to clarify the features of HHS that may differentiate it from hand-arm vibration syndrome. METHODS: A tiered review of world literature was undertaken using Medline and EMBase as the primary search engines. Fifty-two relevant articles were critically reviewed. CONCLUSION: Colour and temperature changes occur more diffusely in HHS than in classical Raynaud's phenomenon and the absence of the triphasic colour change may alert clinicians to the diagnosis, which may be confirmed by Allen's test. Doppler or arteriographic studies are required for confirmation. It is important to recognize the possibility of HHS in the occupational setting as a potentially curable cause of Raynaud's phenomenon, distinct from hand-arm vibration syndrome. The possibility exists of HHS occurring as a result of repeated hypothenar trauma from vibrating tools, in which case the nature and magnitude of the individual episode of trauma may be more important than the weighted acceleration level of vibration exposure.

Arm Injuries↗