Search Results (28)

Background: COVID-19 presented many challenges for our health system, one being a suspected change in the epidemiology of severe hand trauma modalities. These complex injuries are traditionally treated at specialized hand trauma centers, but COVID-19 has in many ways disturbed these established pathways and presented new challenges. Methods: We retrospectively analyzed finger amputation injuries treated at the University Hospital of St. Poelten between 2018 and 2022 to examine differences in the management of micro amputation injuries before and during the COVID-19 pandemic. Further challenges in the treatment of hand trauma patients were analyzed and solutions were developed. Results: Overall, the number of occupational finger amputation injuries in Lower Austria declined during the COVID-19 pandemic. Contrarily, more private accidents were treated in the same period, suggesting a lockdown specific change in injury characteristics. Throughout the entire examined period, a total of 130 injured fingers, including 29 thumbs, were treated. In 67 cases, a reconstruction attempt was feasible and successful in 59 cases. Specific challenges were fewer active hand trauma centers, subsequent long transport times, specific COVID-19 prevention measures, and limited postoperative rehabilitation resources. Conclusions: Despite many challenges overall affecting the time to revascularization, good results were achieved by small but meaningful modifications. These included well-established principles such as back table preparation and strengthening novel concepts such as tele-medicine for patient selection. Overall, the reconstruction of severe hand injuries is often challenging, especially during a world-wide health crisis, but with adequate solutions, good results can be readily achieved. Full article

Background/Objectives: Many patients evaluated by shoulder specialists suffer from intractable pain, neuropathy, and weakness. The pectoralis minor (PM) remains the only scapula muscle to receive lower trunk (C8-T1) input. We propose a novel syndrome: the Human Disharmony Loop. This model portrays how this unique PM innervation causes scapular dyskinesia, which deranges the anatomy of the upper limb girdle and produces a refractory symptom complex of pain, neuropathy, and weakness. We hypothesize that certain patients with historically intractable symptoms of the upper limb girdle may benefit from PM tenotomy. Methods: Ten patients of diverse etiologies presented with a similar constellation of complaints. The patients included a female athlete, a female with macromastia, a male bodybuilder, and patients with post-radiation breast cancer, post-operative shoulder arthroplasty, interscalene block injury, cervical spine disease, persistent impingement after rotator cuff repair, direct traction injury, and occupational disorder. All patients exhibited coracoid tenderness, scapula protraction with internal rotation and anterior tilt, and pain involving the neck, shoulder, and upper back. The patients demonstrated varying degrees of arm neuropathy, subacromial impingement, and occipital headaches. The patients failed all prior treatments by multiple subspecialists, including surgery. Each patient underwent isolated open PM tenotomy. Results: In all ten patients, PM tenotomy substantially reduced shoulder, upper back, and neck pain, cleared concomitant neuropathy, restored full motion, and eradicated occipital headaches. The response to surgery was rapid, dramatic, and durable. Conclusions: The unique asymmetric neurologic innervation to the sole ventral stabilizer of the scapula, the pectoralis minor, predisposes the human shoulder to neurologic and musculoskeletal imbalance. This produces the Human Disharmony Loop: a clinical syndrome spanning from the neck to the fingertips, with chronic pain, neuropathy, and weakness. These challenging patients may benefit dramatically from isolated PM tenotomy. Full article

Background: Occupational low back pain (LBP) is a pervasive health issue that significantly impacts productivity and contributes to work-related musculoskeletal disorders (WMSDs). Inadequate lifting postures are a primary, modifiable risk factor associated with LBP, making early detection of unsafe practices crucial to mitigating occupational injuries. Our study aims to address these limitations by developing a markerless, smartphone-based camera system integrated with a deep learning model capable of accurately classifying lifting postures. Material and Method: We recruited 50 healthy adults who participated in lifting tasks using correct and incorrect postures to build a robust dataset. Participants lifted boxes of varying sizes and weights while their movements were recorded from multiple angles and heights to ensure comprehensive data capture. We used the OpenPose algorithm to detect and extract key body points to calculate relevant biomechanical features. These extracted features served as inputs to a bidirectional long short-term memory (LSTM) model, which classified lifting postures into correct and incorrect categories. Results: Our model demonstrated high classification accuracy across all datasets, with accuracy rates of 96.9% for Tr, 95.6% for the testing set, and 94.4% for training. We observed that environmental factors, such as camera angle and height, slightly influenced the model’s accuracy, particularly in scenarios where the subject’s posture partially occluded key body points. Nonetheless, these variations were minor, confirming the robustness of our system across different conditions. Conclusions: This study demonstrates the feasibility and effectiveness of a smartphone camera and AI-based system for lifting posture classification. The system’s high accuracy, low setup cost, and ease of deployment make it a promising tool for enhancing workplace ergonomics. This approach highlights the potential of artificial intelligence to improve occupational safety and underscores the relevance of affordable, scalable solutions in the pursuit of healthier workplaces. Full article

This study aimed to quantify the postures and muscle activity while parks and gardens workers operated ride-on mowers during a typical shift. Eight participants operated ride-on mowers in the same park but on different terrains (flat and undulating). Body postures and muscle activity were collected wirelessly and unobtrusively. Participants adopted a forward-flexed seated posture with the predominant movement being head rotation. Oscillatory movements (20–40° from neutral) of the thorax in all three planes of movement were noted in all participants. Low levels (<30% MVIC) of muscle activity were recorded in all muscles tested. These levels were elicited for most (>90%) of the recording time. Higher (>50% MVIC) activation levels were interspersed through the data, but these were not sustained. There was no difference in posture or muscle activity between the flat and undulating terrain. The forward-flexed posture combined with vibration can increase the risk of discomfort and injury in the low back while ride-on mowing. The low levels of muscle activity suggest participants did not actively brace for the occupational situation and task. The large inter-participant difference in posture attests to subjective variation to accommodate muscular stress, and this may not be optimal for injury mitigation. Full article

Background: Caregivers experience high rates of occupational injuries, especially during wheelchair transfers, which often result in back pain and musculoskeletal disorders due to the physical demands of lifting and repositioning. While mechanical floor lifts, the current standard, reduce back strain, they are time-consuming and require handling techniques that subject caregivers to prolonged and repeated non-neutral trunk postures, increasing the risk of long-term back injuries. Aims: The aim was to assess the time efficiency and ergonomics of the powered personal transfer system (PPTS), a robotic transfer device designed for bed-to/from-wheelchair transfers. Methods: We evaluated transfers with the PPTS and mechanical lift with eight able-bodied participants who assisted with transfers between a bed and a wheelchair. Inertial measurement units (IMUs) were placed on participants to track their motion and assess trunk joint angles during transfers. Results: The PPTS significantly reduced the transfer time (144.31 s vs. 525.82 s, p < 0.001) and required significantly less range of motion for trunk flexion (p < 0.001), lateral bending (p = 0.008), and axial rotation (p = 0.001), all of which have been associated with back injuries. Additionally, the PPTS significantly reduced the time caregivers spent in non-neutral trunk postures, potentially lowering injury risks. Conclusions: These findings suggest that the PPTS improves transfer efficiency and caregiver safety, offering a promising alternative to the current standard of care for wheelchair-to/from-bed transfers. Full article

In coastal stow net fishing, the heavy weight of a typical anchor (750–1000 kg) can increase the risk of capsizing the boat and crew member injury during hoisting operations. Thus, to prevent these accidents, a reduction in the anchor weight is required. One strategy to achieve this is to reduce the resistance force of the fishing gear used, which would allow lighter anchors to be employed. This requires the accurate estimation of the resistance force for various gear designs. Therefore, the resistance force and shape during the operation of two representative types of coastal stow nets currently employed in the Korean coastal stow net fishing industry were investigated using simulations and modeling experiments. The modeled fishing gear was divided into four sections according to the mesh size. Based on the results, the twine thickness was reduced in order to target areas of the gear where the greatest resistance was observed, while the front part of the gear was redesigned to prevent the front of the net from being pushed back into a suboptimal shape. The proposed low-resistance fishing gear has the potential to improve occupational safety in the coastal stow net fishing industry. Full article

In self-driving vehicles, passengers can set their seats in an unconventional seating position, such as rear-facing. Sitting in such an orientation can increase the risk of whiplash in the head-and-neck system in a frontal impact, as frontal crashes usually have higher severities compared with rear-end crashes. This paper shows that a forward-facing front seat optimised for rear-impact protection needs to be redesigned to be used as a rear-facing seat. In the second and main part of this paper, a restraint system for rear-facing car seats is developed, and frontal impact simulations with 64 km/h of delta-V are used to evaluate its performance. The designed seating system comprises two rigid torso plates, a fixed recliner and an energy absorber under the seat pan. Without using the developed restraint system, the 50th percentile male human model is exposed to neck shear forces exceeding 600 N. With the developed restraint system, neck shear forces are less than 350 N in frontal impacts with 64 km/h of delta-V. Apart from whiplash, the risk of head, chest, lower extremity and lower back injuries are also evaluated. The results confirm that the developed restraint system successfully protects the occupant since all assessment criteria values are lower than the injury assessment reference values. Full article

The Baker cyst (BC), also known as the popliteal cyst or parameniscal cyst, is a fluid-filled sac that normally develops in the back of the knee, between the semimembranosus and medial head of the gastrocnemius. We aimed to evaluate the effectiveness of physiotherapy (10 days of treatment) that associates intermittent vacuum therapy (IVT) on the lower limbs in the treatment of the BC, respectively, in its size reduction. Sixty-five patients with knee osteoarthritis using Kellgren–Lawrence criteria and the presence of BC (ultrasonography evaluation), were divided into the Control and Vacuum groups. We collected the following features: sex, age, level of education, occupation, environment, body mass index, Knee Injury and Osteoarthritis Outcome Score, Western Ontario, and McMaster Universities Osteoarthritis Index, the Functional Independence Measurement, the Fall Risk Score, and the Visual Analog Scale were recorded at baseline and after 10 days. Both groups are similar in terms of demographic features. Regarding the clinical functional parameters, the results elicit a statistically significant change in all parameters between admission and discharge, including the echo volume at BC. Physical medicine and rehabilitation increase the autonomy of patients with BC. Clinical-functional improvement begins in the first 10 days of complex rehabilitation treatment; it is statistically significant and is not different between the two groups, which brings an additional argument for the effectiveness of conservative therapy in the treatment of BC. Although IVT has not demonstrated its superiority over classical balneo-physical therapy, additional research, and long-term monitoring are needed to provide additional arguments regarding this aspect. Full article

Caregivers that assist with wheelchair transfers are susceptible to back pain and occupational injuries. The study describes a prototype of the powered personal transfer system (PPTS) consisting of a novel powered hospital bed and a customized Medicare Group 2 electric powered wheelchair (EPW) working together to provide a no-lift solution for transfers. The study follows a participatory action design and engineering (PADE) process and describes the design, kinematics, and control system of the PPTS and end-users’ perception to provide qualitative guidance and feedback about the PPTS. Thirty-six participants (wheelchair users (n = 18) and caregivers (n = 18)) included in the focus groups reported an overall positive impression of the system. Caregivers reported that the PPTS would reduce the risk of injuries and make transfers easier. Feedback revealed limitations and unmet needs of mobility device users, including a lack of power seat functions in the Group-2 wheelchair, a need for no-caregiver assistance/capability for independent transfers, and a need for a more ergonomic touchscreen. These limitations may be mitigated with design modifications in future prototypes. The PPTS is a promising robotic transfer system that may aid in the higher independence of powered wheelchair users and provide a safer solution for transfers. Full article

Occupational hazards, such as psychosocial stressors, physical injuries from human–animal interactions, and physically demanding work tasks, are common in the veterinary profession, and musculoskeletal discomfort and pain (MDP) may already be present in veterinary undergraduates. This preliminary study investigates the effects of very short, active interventions, called microbreaks, in 36 veterinary students. At the start, participants had a high prevalence of MDP, especially in the neck and lower back. Within a 12-week observational period, 6 weeks of active intervention comprised teaching microbreaks (nine strengthening, stretching, and relaxation exercises; 30–90 s each) and a weekly veterinary-specific ergonomics education and discussion. After the intervention, participants reported fewer painful body regions and an increase in their self-efficacy in potentially painful, risky, or dangerous human–animal interactions. After the 12-week observational period, participants had increased self-efficacy in the maintenance of physical health and self-protection but decreased self-efficacy in healing injuries after veterinary human–animal interactions. Participants felt to have increased and decreased control over dangerous situations with dogs and horses, respectively, although self-efficacy in handling horses increased. Participants integrated microbreaks well into their undergraduate activities and rated the topic relevant to their (later) profession. This should encourage the inclusion of similar programs in undergraduate curricula. Full article

The use of dental handpieces and ultrasonic instruments expose dental professionals to high-frequency vibration, precise gripping, high pinch force, and repetitive bending movements of wrist during restorative procedures involving cutting dental material, periodontal scaling, and root planning. There is clear evidence of an association between the dentistry profession and work-related musculoskeletal disorders in the neck, upper back and upper extremities; however, the influence of high-frequency vibration on hand and fingers from dental handpieces is not well known. The objectives of the current paper are to present the results of a survey on hand-arm vibration syndrome (HAVS) among members of a professional dental society and to present a literature review on dental handpieces and ultrasonic scalers exposure assessment and occurrence of hand-arm vibration syndrome among dental professionals. There seems to be limited awareness of the occupational risk associated with hand-arm vibration from handpieces and ultrasonic devices. This study highlights the occurrence of vascular and neurological disorders of HAVS among dental professionals, as well as wrist/hand pain, osteoarthritis, diminished hand grip, and carpal tunnel syndrome. The assessment of high-frequency vibration and ultra-vibration from these vibrating tools and vibration-related injuries deserve special attention for future preventive measures. Full article

The mitigation of the risks of passenger injuries when a vehicle is involved in a collision with a street pole shielded with a layer of tire-derived material (TDM) was assessed. This can effectively absorb a fraction of the total energy from a speeding vehicle. Since such tests are expensive to conduct experimentally, the study relies on using the Abaqus/Explicit FEA solver to accurately calculate the non-linear nature of this scenario. Two categories of this scenario were evaluated to understand the effect a shielded street pole has on the vehicle—and the total absorbed energies during frontal and corner collisions, which are typically the most common categories of such accidents to happen. Results show that at lower speeds, these reinforcements are least effective in absorbing some of the kinetic energy applied by the vehicle, with about 5% of the energy absorbed by the reinforcement. At higher speeds, however, the results show that the TDM reinforcement absorbs about 28% of kinetic energy, which can reduce injury of the vehicle occupants, as well as decrease the damage on poles. Results for this simulation also show that there is a critical thickness of TDM that can absorb these kinetic energies, after which further thicknesses results in energies being applied back to the vehicle, therefore negating any purpose to further increase TDM thicknesses. Full article

The COVID-19 pandemic continuously highlights the need for occupational health and safety among healthcare professionals. Physical and mental health safety resulting from needle prick injuries, stress, infections, and chemical hazards are priority work-related musculoskeletal disorders for nurses, including those working in the intellectual disability unit. The intellectual disability unit provides basic nursing care to patients with known mental disabilities, such as learning, problem-solving, and judgment problems, which demand diverse physical activities. Nevertheless, the safety of nurses within the unit receives little attention. Thus, we adopted a quantitative cross-sectional epidemiological survey design to determine the prevalence of work-related musculoskeletal disorders amongst nurses working in the intellectual disability unit at the selected hospital in Limpopo Province, South Africa. A self-administered questionnaire collected data from 69 randomly selected nurses from the intellectual disability unit. Data were extracted, coded, and captured in MS Excel format (2016) and imported into the IBM Statistical Package for the Social Sciences (SPSS), software version 25.0, for analysis. The study reported a low (38%) prevalence of musculoskeletal disorders in the intellectual disability unit, with significant effects on nursing care and staffing. The effects of these WMSDs included missing work, interference with the daily routine, disturbance with sleeping patterns after work, and absenteeism from work. Since intellectually disabled patients depend entirely on nurses for the basic activities of daily living, this paper recommends the incorporation of physiotherapy among nurses in the intellectual disability unit to treat the incidence of lower back pain while mitigating nurses missing work or absenteeism. Full article

Low back disorders (LBDs) are a leading occupational health issue. Wearable sensors, such as inertial measurement units (IMUs) and/or pressure insoles, could automate and enhance the ergonomic assessment of LBD risks during material handling. However, much remains unknown about which sensor signals to use and how accurately sensors can estimate injury risk. The objective of this study was to address two open questions: (1) How accurately can we estimate LBD risk when combining trunk motion and under-the-foot force data (simulating a trunk IMU and pressure insoles used together)? (2) How much greater is this risk assessment accuracy than using only trunk motion (simulating a trunk IMU alone)? We developed a data-driven simulation using randomized lifting tasks, machine learning algorithms, and a validated ergonomic assessment tool. We found that trunk motion-based estimates of LBD risk were not strongly correlated (r range: 0.20–0.56) with ground truth LBD risk, but adding under-the-foot force data yielded strongly correlated LBD risk estimates (r range: 0.93–0.98). These results raise questions about the adequacy of a single IMU for LBD risk assessment during material handling but suggest that combining an IMU on the trunk and pressure insoles with trained algorithms may be able to accurately assess risks. Full article

A new ergonomic-risk-assessment tool was developed that combines musculoskeletal-model-based loading estimates with insights from fatigue failure theory to evaluate full-body musculoskeletal loading during dynamic tasks. Musculoskeletal-modeling output parameters, i.e., joint contact forces and muscle forces, were combined with tissue-specific injury thresholds that account for loading frequency to determine the injury risk for muscles, lower back, and hip cartilage. The potential of this new risk-assessment tool is demonstrated for defining ergonomic interventions in terms of lifting characteristics, back and shoulder exoskeleton assistance, box transferring, stoop lifting, and an overhead wiring task, respectively. The MATE identifies the risk of WMSDs in different anatomical regions during occupational tasks and allows for the evaluation of the impact of interventions that modify specific lifting characteristics, i.e., load weight versus task repetition. Furthermore, and in clear contrast to currently available ergonomic assessment scores, the effects of the exoskeleton assistance level on the risk of WMSDs of full-body musculoskeletal loading (in particular, the muscles, lower back, and hips) can be evaluated and shows small reductions in musculoskeletal loading but not in injury risk. Therefore, the MATE is a risk-assessment tool based on a full-body, musculoskeletal-modeling approach combined with insights from the fatigue failure theory that shows the proof of concept of a shoulder and back exoskeleton. Furthermore, it accounts for subject-specific characteristics (age and BMI), further enhancing individualized ergonomic-risk assessment. Full article