RAJIV GANDHI UNIVERSITY OF HEALTH SCIENCES
BANGALORE, KARNATAKA
PERFORMA FOR RESGISTRATION OF SUBJECT FOR DISSERTATION
1 / NAME OF CANIDATE / AARABHI.S2 / NAME OF INSTITUTION / FLORENCE COLLEGE OF PHYSIOTHERAPY
3 / COURSE OF STUDY
AND SUBJECT / MASTERS OF PHYSIOTHERAPY
(PHYSIOTHERAPY IN MUSCULOSKELETAL DISORDERS AND SPORTS PHYSIOTHERAPY)
4 / DATE OF ADMISSION / 28.5.10
5 / TITLE OF TOPIC / “EFFECTIVENESS OF WORK STATION ANALYSIS & ERGONOMIC CORRECTION FOR REDUCING WORK RELATED MUSCULOSKELETAL DISORDERS ”
6. BRIEF RESUME OF THE INTENDED WORK
6.1 NEED OF THE STUDY
Over the past few decades, computer-based technology has become indispensable in most offices. Along with the proliferation of the technology, concern about healthy, safe, and comfortable use of computers has emerged.
Work-related musculoskeletal disorders (WRMSDs) are impairments of the bodily structures, such as muscles, joints, tendons, ligaments, nerves or the localized blood circulation system, which are caused or aggravated primarily by the performance of work and by the effects of the immediate environment in which work is carried out1.
The Bureau of Labor Statistics released a report in March 2003 stating that in 2001, there were 65,162 days of employees away from work resulting from repetitive motion. The Occupational Safety and Health Administration (OSHA) revealed that 1.8 million workers are affected by musculoskeletal disorders (MSD) each year. Ergonomic injuries cost an average of 15 billion to 20 billion annually for workers compensation and 30 billion to 40 billion in other expenses such as medical2.
Most WRMSDs are cumulative disorders, resulting from repeated exposure to high- or low-intensity loads over a long period of time. The symptoms may vary from discomfort and pain to decreased body function and invalidity. Although it is not clear to what extent WRMSDs are caused by work, their impact on working life is huge. WRMSDs can interfere with activities at work, and can cause a reduction in productivity, an increase in sickness absence, and chronic occupational disability. Musculoskeletal disorders are often confused with ergonomics1.
Ergonomics is the scientific study of people at work3.
The International Ergonomics Association defines ergonomics as follows: Ergonomics (or human factors) is the scientific discipline concerned with the understanding of interactions among humans and other elements of a system, and the profession that applies theory, principles, data and methods to design in order to optimize human well-being and overall system performance3.
Ergonomics is employed to fulfill the two goals of health and productivity. . The goal of ergonomics is to reduce stress and eliminate injuries and disorders associated with the overuse of muscles, bad posture, and repeated tasks. This is accomplished by designing tasks, work spaces, controls, displays, tools, lighting, and equipment to fit the employee´s physical capabilities and limitations Proper ergonomic design is necessary to preventrepetitive strain injuries which can develop over time and can lead to long-term disability3.
In the last decade, hundreds of thousands of otherwise healthy computer users have developed a painful, debilitating and sometimes disabling condition known as Repetitive Strain Injury (RSI), or Musculoskeletal disorders (MSDs) or Work- related musculoskeletal disorders (WRMSDs).
Musculoskeletal disorders (MSDs) are the most common work-related health problem affecting millions of workers. Work- related musculoskeletal disorders (WRMSDs) has attracted considerable attention because of its importance in assessing ergonomics risk factor involved in industrial workplaces.
In India the data regarding the importance of Ergonomics, Workstation Evaluation and their applications for prevention of WRMSDs in not known. So the study is proposed to find the Effect of Ergonomics & Work station analysis for reducing WRMSDs.
6.2 REVIEW OF LITERATURE
· K. Mekhora, et al: Studied “The long-term effects of ergonomic intervention on neck and shoulder discomfort among computer users. 80 Thai volunteers with symptoms of tension neck syndrome were identified through administration of a questionnaire to 470 computer users. Two pre-tests were conducted to determine subjects’ level of discomfort before the planned intervention commenced. Half of the subjects’ work stations were immediately adjusted according to ergonomic recommendations for individual anthropometry. The other half received the intervention 3 months later. Discomfort evaluations (head, neck, shoulders, arms, and back) were conducted eight times within 6 months for both groups. The same patterns of decrease in the levels of discomfort of all body parts were present in both groups. It was concluded that ergonomic intervention can help reduce the discomfort level of subjects with tension neck syndrome4.
· Michelle Robertson, Benjamin C. Amick III, et al: Conducted a study to examine the effects of office ergonomics training coupled with a highly adjustable chair on office workers’ knowledge and musculoskeletal risks. Office workers were assigned to one of three study groups: a group receiving the training and adjustable chair, a training-only group and a control group. The office ergonomics training program was created using an instructional systems design model. A pre/post-training knowledge test was administered to all those who attended the training. Body postures and workstation set-ups were observed before and after the intervention. Perceived control over the physical work environment was higher for both intervention groups as compared to workers in the control group. A significant increase in overall ergonomic knowledge was observed for the intervention groups. Both intervention groups exhibited higher level behavioral translation and had lower musculoskeletal risk than the control group5.
· D M Rempel N Krause R Goldberg, et al: A randomized controlled intervention trial evaluated the effects of a wide forearm support surface and a trackball on upper body pain severity and incident musculoskeletal disorders among 182 call centre operators at a large healthcare company. Participants were randomized to receive (1) ergonomics training only, (2) training plus a trackball, (3) training plus a forearm support, or (4) training plus a trackball and forearm support. Post-intervention, 63 participants were diagnosed with one or more incident musculoskeletal disorders. Hazard rate ratios showed a protective effect of the arm board for neck/shoulder disorders after adjusting for baseline pain levels and demographic and psychosocial factors. The arm board also significantly reduced neck/shoulder pain and right upper extremity pain in comparison to the control group6
· Bernacki, Edward J. MD, MPH; Guidera: The program resulted in an initial increase in the number and cost for the treatment of UEWMSDs. Subsequently, there was a significant decrease in the number of UEWMSDs reported and virtual elimination of the need to use surgical procedures to correct these conditions. This article suggests that a coordinated program of medical care, ergonomic assessment, and intervention can be efficacious in the primary, secondary, and tertiary prevention of UEWMSD 7.
· S I Jmker, Huysmans, et al: A systematic review of the literature on “Should office workers spend fewer hours at their computer” showed moderate evidence for an association between the duration of mouse use and the incidence of hand–arm symptoms. In addition, the neck–shoulder region seemed less susceptible to exposure to computer use than the hand–arm region. Both findings are supported by a patho-physiological mechanism based on the overuse of muscles during computer use. The low number of high-quality studies prevents drawing a firm conclusion 8.
· Wahlström J. , Sweden: The review summarizes the knowledge regarding ergonomics and musculoskeletal disorders and the association with computer work. The model emphasizes the associations between work organization, psychosocial factors and mental stress with physical demands and physical load. Further interventions should be carried out with management support and active involvement of the individual workers 9.
· Buckle P. UK: A study on Ergonomics and musculoskeletal disorders. Assessing the exposure of workers to known risk factors is essential and appropriate methods are reviewed. Similarly, a consideration of psychosocial factors thought to contribute indirectly to the problem has also been explored. Contemporary ergonomics stresses the importance of a participatory approach to prevention and solution finding, and evidence in support of this is presented. The final review considers the application of ergonomics knowledge to understanding musculoskeletal disorders amongst those using computer technologies10.
· Glenn Goodman, James Landis, Christina George, et al; Evaluation on Effectiveness of computer ergonomics interventions for an engineering company- a program was implemented by occupational therapist & physical therapist utilize the preventive measures with education about ergonomics, individualized evaluations of computer workstation, and recommendations for ergonomics & environmental changes. The program was deemed successful by 59 % of all therapist recommendation & 74% of ergonomic recommendation being implemented by the company. Conclusion: Successful implementation of ergonomics programs depend upon effective communication and education of the consumers, and the support, cooperation and collaboration of management and employees11.
· Vern Putz-Anderson,Bruce P. Bernard, Susan E. Burt et al: Conducted a review in assessing the work-relatedness of MSDs. The review involves examination of relevant epidemiologic information to assess the strength of the available evidence that, under certain conditions of exposure, specific risk factors could increase the risk of MSDs or increase the likelihood of impairment or disability from MSDs. The Observation suggests that psychosocial factors represent generalize risk factors for work related MSDs12.
· Orhan Korhan & Adham Mackieh: Determine the effect of musculoskeletal discomfort factors that contribute to WRMSDs resulting from intensive use of computer s in work places,, In this study a questionnaire was given to 84 intensive computer users working for the university sector in North Cyprus. The findings from this study shows that the gender, psychosocial factors like working with computers, office ergonomics qualities such as availability of foot support& availability of sufficient lightening were significant factors of the formation of work related WRMSDs. Additionally, it was shown that physical exposures are associated with increased risk of upper extremity disorders. The research also provides an evidence that the symptoms of musculoskeletal discomfort, and the frequency of these symptoms were also significant in the development of WRMSDs13
.
6.3 OBJECTIVE OF THE STUDY:
· To find the awareness of ergonomics among IT people using work station evaluation.
· To find the effect of Workstation analysis in reducing WRMSDs
6.4 HYPOTHESIS:
NULL HYPOTHESIS
Work Station Analysis & Ergonomic Correction is not effective in reducing WRMSDs in IT Companies
ALTERNATIVE HYPOTHESIS
Work Station Analysis & Ergonomic Correction is effective in reducing WRMSDs in IT Companies
7. MATERIALS & METHODS:
7.1 SOURCE OF DATA
· Employees of IT Companies in Mysore.
7.2 METHODS OF COLLECTION OF DATA
7.2.1 SAMPLE AND SAMPLING METHOD
· 50 Indian IT professionals are selected randomly as the subject for study.
7.2.2 RESEARCH DESIGN
· Survey method.
· Pre & Post Experimental design
7.2.3 POPULATION
50 subjects, both genders who fulfill the inclusion criteria are selected.
7.2.4 SELECTION CRITERIA
INCLUSION CRITERIA
· Sex – both Genders
· Age – between 22 to 45 years
· Person should be an IT professional having experience of 4 yrs
· Usage of computer for minimum 6hours per day
EXCLUSION CRITERIA
· Age – below 21 and above 45 years
· Non IT professionals
7.2.5 MATERIALS AND TOOLS USED MEASUREMENT TOOLS
· Predesigned Office Ergonomics Work -Station Evaluation Form(OSHA14)
· Visual Analog Scale
7.3 METHODOLOGY:
· 7.3.1 ETHICAL CLEARANCE
Ethical clearance will be obtained from the institution.
· 50 Subjects who fulfill the inclusion criteria were selected randomly; Photo images of work station of subjects are taken without their knowledge to assess the work station. Followed by pre designed office ergonomics work -station evaluation form is given to subjects; Intensity of pain is assessed through VAS prior to intervention.
On the basis of pre designed office ergonomics work -station evaluation form & Photo image, ergonomic work station will be given to the subjects and to implement daily, taking into consideration of the following criteria:
1. Head and neck to be upright, in-line with the torso (not bent down/back)
2. Head, neck, and trunk to face forward (not twisted)
3. Trunk to be perpendicular to floor (may lean back into backrest but not forward).
4. Shoulders and upper arms to be in-line with the torso, generally about perpendicular to the floor and relaxed (not elevated or stretched forward).
5. Upper arms and elbows to be close to the body (not extended outward)
6. Forearms, wrists, and hands to be straight and in-line (forearm at about 90 degrees to the upper arm).
7. Wrists and hands to be straight (not bent up/down or sideways toward the little finger)
8. Thighs to be parallel to the floor and the lower legs to be perpendicular to floor (thighs may be slightly elevated above knees).
9. Feet rest flat on the floor, supported by a stable footrest.
10. Backrest provides support for your lower back (lumbar area).
11. Seat front does not press against the back of your knees and lower legs (seat pan not too long).
12. Seat front does not press against the back of your knees and lower legs (seat pan not too long).
13. Keyboard/input device platform(s) is stable and large enough to hold a keyboard and an input device.
14. . Input device (mouse or trackball) is located right next to your keyboard so it can be operated without reaching.
15. . Input device is easy to activate and the shape/size fits your hand (not too big/small).
16. . Wrists and hands do not rest on sharp or hard edges.
17. Top of the screen is at or below eye level so you can read it without bending your head or neck down/back.
18. Monitor distance allows you to read the screen without leaning your head, neck or trunk forward/backward.
19. Monitor position is directly in front of you so you don't have to twist your head or neck.
20. Glare (for example, from windows, lights) is not reflected on your screen.
21. Thighs have sufficient clearance space between the top of the thighs and computer table/keyboard platform (thighs are not trapped).
22. Legs and feet have sufficient clearance space under the work surface a format on proper ergonomic setup will be given to subject.
After 45 days pre & post assessment data will be taken by using VAS & office ergonomics evaluation. Data will be analyzed by statistical method.
8. LIST OF REFERENCES
1. Occupational Safety & Health Administration (OSHA); United States ; Department of Labor:2005