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Effect of chair types on work-related musculoskeletal discomfort during vaginal surgery.
Am J Obstet Gynecol. 2016 Nov; 215(5):648.e1-648.e9.AJ

Abstract

BACKGROUND

Evidence supports that surgeons are at high risk for work-related musculoskeletal disorders.

OBJECTIVE

The objective of the study was to compare the effect of different chairs on work-related musculoskeletal discomfort for surgeons during vaginal operations.

STUDY DESIGN

This crossover study randomly assigned 4 surgeons to 4 chair types using a 4 × 4 Latin square model: a conventional round stool, a round stool with a backrest, a saddle chair with a backrest, and a Capisco chair. Subjective assessments of surgeon discomfort were performed with a validated body discomfort survey, and workload was assessed with the surgical task load index. The objective postural load was quantified with inertial measurement units of the modified rapid upper limb assessment limits. Subjective and objective assessments of chair comfort were performed with an 11 point scale and seat interface pressure-mapped distributions, respectively. The primary outcome was the difference in body discomfort scores between pre- and postsurgery measurements. Secondary outcomes were the differences in chair comfort scores, postural load, and seating interface pressure-mapped distribution. For each outcome, comparisons among the chair types were based on fitting a linear mixed model that handled the surgeon as a random effect and the chair type as a fixed effect.

RESULTS

Data were collected for 48 vaginal procedures performed for pelvic organ prolapse. Mean (SD) duration of surgery was 122.3 (25.1) minutes. Surgeons reported body discomfort during 31 procedures (67.4%). Subjective increase in discomfort from the preoperative state was noted most commonly in the lower back (n = 14, 30.4%), followed by right shoulder (n = 12, 26.1%), upper back (n = 8, 17.4%), hips and buttocks (n = 7, 15.2%), left shoulder (n = 6, 13.0%), right or left thigh (n = 6, 13.0%), and neck (n = 6, 13.0%). Pre- and postsurgery body discomfort scores did not differ with respect to chair type. Chair discomfort scores for the round stool and the saddle chair were significantly higher than the round stool with backrest and the Capisco chair (P < .001). Although the average modified rapid upper limb assessment postural scores showed moderate to high musculoskeletal risk of neck and shoulder discomfort across the 4 surgeons; chair type did not affect postural scores. The saddle chair had significantly reduced dispersion of seated pressure vs the round stool with backrest (P ≤ .001), depicted by the number of cells with pressure values >5 mm Hg. An increased dispersion of pressure across the chair surface was associated with increased comfort (Spearman correlation, 0.40, P = .006).

CONCLUSION

Musculoskeletal strain and associated discomfort for surgeons are very high during vaginal operations. Chair type can affect comfort, and chairs with more uniform distribution and fewer pressure points are more comfortable. However, the chair type used in surgery did not influence the musculoskeletal postural load findings.

Authors+Show Affiliations

Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN. Electronic address: singh.ruchira@mayo.edu.Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN.Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN.Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN.Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN.Department of Safety, Mayo Clinic, Rochester, MN.Division of Health Care Policy and Research, Mayo Clinic, Rochester, MN.Division of Gynecologic Surgery, Mayo Clinic, Rochester, MN.

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

27319363

Citation

Singh, Ruchira, et al. "Effect of Chair Types On Work-related Musculoskeletal Discomfort During Vaginal Surgery." American Journal of Obstetrics and Gynecology, vol. 215, no. 5, 2016, pp. 648.e1-648.e9.
Singh R, Carranza Leon DA, Morrow MM, et al. Effect of chair types on work-related musculoskeletal discomfort during vaginal surgery. Am J Obstet Gynecol. 2016;215(5):648.e1-648.e9.
Singh, R., Carranza Leon, D. A., Morrow, M. M., Vos-Draper, T. L., Mc Gree, M. E., Weaver, A. L., Woolley, S. M., Hallbeck, S., & Gebhart, J. B. (2016). Effect of chair types on work-related musculoskeletal discomfort during vaginal surgery. American Journal of Obstetrics and Gynecology, 215(5), e1-e9. https://doi.org/10.1016/j.ajog.2016.06.016
Singh R, et al. Effect of Chair Types On Work-related Musculoskeletal Discomfort During Vaginal Surgery. Am J Obstet Gynecol. 2016;215(5):648.e1-648.e9. PubMed PMID: 27319363.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of chair types on work-related musculoskeletal discomfort during vaginal surgery. AU - Singh,Ruchira, AU - Carranza Leon,Daniel A, AU - Morrow,Melissa M, AU - Vos-Draper,Tamara L, AU - Mc Gree,Michaela E, AU - Weaver,Amy L, AU - Woolley,Sandra M, AU - Hallbeck,Susan, AU - Gebhart,John B, Y1 - 2016/06/16/ PY - 2016/01/28/received PY - 2016/05/27/revised PY - 2016/06/07/accepted PY - 2016/10/30/pubmed PY - 2017/6/1/medline PY - 2016/6/21/entrez KW - chairs KW - ergonomics KW - musculoskeletal discomfort KW - vaginal surgery SP - 648.e1 EP - 648.e9 JF - American journal of obstetrics and gynecology JO - Am J Obstet Gynecol VL - 215 IS - 5 N2 - BACKGROUND: Evidence supports that surgeons are at high risk for work-related musculoskeletal disorders. OBJECTIVE: The objective of the study was to compare the effect of different chairs on work-related musculoskeletal discomfort for surgeons during vaginal operations. STUDY DESIGN: This crossover study randomly assigned 4 surgeons to 4 chair types using a 4 × 4 Latin square model: a conventional round stool, a round stool with a backrest, a saddle chair with a backrest, and a Capisco chair. Subjective assessments of surgeon discomfort were performed with a validated body discomfort survey, and workload was assessed with the surgical task load index. The objective postural load was quantified with inertial measurement units of the modified rapid upper limb assessment limits. Subjective and objective assessments of chair comfort were performed with an 11 point scale and seat interface pressure-mapped distributions, respectively. The primary outcome was the difference in body discomfort scores between pre- and postsurgery measurements. Secondary outcomes were the differences in chair comfort scores, postural load, and seating interface pressure-mapped distribution. For each outcome, comparisons among the chair types were based on fitting a linear mixed model that handled the surgeon as a random effect and the chair type as a fixed effect. RESULTS: Data were collected for 48 vaginal procedures performed for pelvic organ prolapse. Mean (SD) duration of surgery was 122.3 (25.1) minutes. Surgeons reported body discomfort during 31 procedures (67.4%). Subjective increase in discomfort from the preoperative state was noted most commonly in the lower back (n = 14, 30.4%), followed by right shoulder (n = 12, 26.1%), upper back (n = 8, 17.4%), hips and buttocks (n = 7, 15.2%), left shoulder (n = 6, 13.0%), right or left thigh (n = 6, 13.0%), and neck (n = 6, 13.0%). Pre- and postsurgery body discomfort scores did not differ with respect to chair type. Chair discomfort scores for the round stool and the saddle chair were significantly higher than the round stool with backrest and the Capisco chair (P < .001). Although the average modified rapid upper limb assessment postural scores showed moderate to high musculoskeletal risk of neck and shoulder discomfort across the 4 surgeons; chair type did not affect postural scores. The saddle chair had significantly reduced dispersion of seated pressure vs the round stool with backrest (P ≤ .001), depicted by the number of cells with pressure values >5 mm Hg. An increased dispersion of pressure across the chair surface was associated with increased comfort (Spearman correlation, 0.40, P = .006). CONCLUSION: Musculoskeletal strain and associated discomfort for surgeons are very high during vaginal operations. Chair type can affect comfort, and chairs with more uniform distribution and fewer pressure points are more comfortable. However, the chair type used in surgery did not influence the musculoskeletal postural load findings. SN - 1097-6868 UR - https://www.unboundmedicine.com/medline/citation/27319363/Effect_of_chair_types_on_work_related_musculoskeletal_discomfort_during_vaginal_surgery_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9378(16)30346-5 DB - PRIME DP - Unbound Medicine ER -