Patient Positioning During In-Office Otologic Procedures Impacts Physician Ergonomics

Govil, Nandini; DeMayo, William M.; Hirsch, Barry E.; McCall, Andrew A.

doi:10.1097/mao.0000000000001961

Cited by 15 publications

(32 citation statements)

References 16 publications

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“…(2017 and 2018) looked to measure Rapid Upper Limb Assessment scores by observing joint positions of clinicians while performing cerumen removal using a wall-mounted microscope. 35,36 The authors showed a reduction of 2.0 points ( p < 0.05) on the Rapid Upper Limb Assessment scoring system in their first study when mock patients were supine versus sitting, and one year later demonstrated a similar reduction of 2.5 points ( p < 0.05) in another study involving 24 genuine patients.…”

Section: Resultsmentioning

confidence: 91%

“…For instance, Govil et al (2018) used an observer in the room at the time of procedure whereas Smith et al (2015) measure data from static photography taken at the end of each simulated test session. 36,37 The resulting Rapid Upper Limb Assessment score may be affected by the angle and aspect of the relevant photograph, which limits the generalisability of Rapid Upper Limb Assessment scores measured in different ways across studies.…”

Section: Discussionmentioning

confidence: 99%

“…Govil et al (2017 and 2018) looked to measure Rapid Upper Limb Assessment scores by observing joint positions of clinicians while performing cerumen removal using a wall-mounted microscope. 35,36 The authors showed a reduction of 2.0 points ( p < 0.05) on the Rapid Upper Limb Assessment scoring system in their first study when mock patients were supine versus sitting, and one year later demonstrated a similar reduction of 2.5 points ( p < 0.05) in another study involving 24 genuine patients. 37 Doctors allocated to the ergonomically favourable position demonstrated reduced Rapid Upper Limb Assessment scores ( p < 0.05), fewer microbreaks ( p < 0.05), fewer task repetitions ( p < 0.05), less self-reported pain ( p < 0.05) and better usability ( p < 0.05).…”

Section: Patient Positioningmentioning

confidence: 92%

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A systematic review of interventions to prevent work-related musculoskeletal disorders in ENT surgeons

et al. 2021

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Objective Work-related musculoskeletal disorders in ENT surgeons are common and detrimental, yet few are aware of preventative measures. We evaluate the evidence for interventions to prevent work-related musculoskeletal disorders in ENT surgeons. Method A systematic search of databases up to 8 June 2021 was performed using Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines and predetermined inclusion criteria. Results Seven prospective cohort studies and 2 case series were identified (51 participants). Interventions included novel equipment (n = 3), patient positioning (n = 2), clinician positioning (n = 3) and operative technique (n = 1). Five studies reported Rapid Upper Limb Assessment scores as outcome measures of strain. Strain decreased when adopting a favourable operating posture, using a supportive chair and keeping patients supine for clinic procedures. Conclusion A small number of low-quality studies were identified. Modifiable risk factors exist, and ergonomic education may help prevent work-related musculoskeletal disorders. Further studies with longer term follow up are required.

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Section: Resultsmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Patient Positioningmentioning

confidence: 92%

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A systematic review of interventions to prevent work-related musculoskeletal disorders in ENT surgeons

et al. 2021

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“…[191] 2019 Iran Assessment using RULA of workers performing a task in a traditional way and with a newly designed instrument. [192] 2018 USA Application of RULA on otolaryngologists. [193] 2018 Ireland Use of RULA and other tools on ICU nurses.…”

Section: Human Health and Social Work Activitiesmentioning

confidence: 99%

“…• Otolaryngology Goyil et al [192,199] analysed the postures adopted by the otolaryngologists when the patient was placed in position (sitting or lying on their back). The RULA method was used.…”

Section: • Radiologymentioning

confidence: 99%

Musculoskeletal Risks: RULA Bibliometric Review

Gómez-Galán

Callejón-Ferre

Pérez-Alonso

et al. 2020

IJERPH

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The objective of this study was to reveal RULA method applications in terms of the knowledge, country, year and journal categories. The search was performed using the “Web of Science Core Collection”. The period from 1993 to April 2019 was selected. Eight hundred nine results were obtained, of which 226 were used. The largest number of publications was determined to be in the fields of industry and health and social assistance, which coincides with the OWAS and Standardized Nordic Questionnaire methods. By country, the USA stands out for its greater number of research studies and categories that are encompassed. By date, 2016 was the year when more studies were carried out, again coinciding with the Standardized Nordic Questionnaire. By journal, “Work—A Journal of Prevention Assessment and Rehabilitation” is highlighted, as it is for the REBA method as well. It was concluded that RULA can be applied to workers in different fields, usually in combination with other methods, while technological advancement provides benefits for its application.

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Ergonomics in Otolaryngology: A Systematic Review and Meta‐analysis

et al. 2022

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Objectives To determine the proportion of otolaryngologists with work‐related musculoskeletal discomfort (WRMD) and to review objective ergonomic data that contribute to WRMD. Study Design Systematic review and meta‐analysis. Methods A comprehensive search of the literature identified 1121 articles for initial review of which 19 (3563 participants) met criteria for qualitative discussion and eight (2192 participants) met criteria for meta‐analysis. Random effects meta‐analyses were used to estimate the proportion of otolaryngologists reporting WRMD. Results The overall proportion (95% confidence intervals [CI]) of general otolaryngologists reporting WRMD was 0.79 (0.66, 0.88) for any symptoms; 0.54 (0.40, 0.67) for neck symptoms; 0.33 (0.20, 0.49) for shoulder symptoms; and 0.49 (0.40, 0.59) for back symptoms. Surgeons performing primarily subspecialty cases had a lower estimated overall prevalence of WRMD versus those performing general ENT cases, however the odds ratio (OR) was not statistically significant (OR [95% confidence interval] 0.53 [0.22, 1.25]). 23%–84% of otolaryngologists underwent medical treatment for WRMD. 5%–23% took time off work and 1%–6% stopped operating completely as a result of WRMD. 23%–62.5% of otolaryngologists believed WRMD negatively impacted their quality of life. Objective measures of ergonomic posture indicate moderate to severe risk of injury during the routine clinic and surgical procedures with none found to be low risk. Conclusions Ergonomic stressors among otolaryngologists contribute to a high rate of WRMD across all subspecialties with notable impact on productivity, longevity, and quality of life. Laryngoscope, 133:467–475, 2023

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Patient Positioning During In-Office Otologic Procedures Impacts Physician Ergonomics

Cited by 15 publications

References 16 publications

A systematic review of interventions to prevent work-related musculoskeletal disorders in ENT surgeons

A systematic review of interventions to prevent work-related musculoskeletal disorders in ENT surgeons

Musculoskeletal Risks: RULA Bibliometric Review

Ergonomics in Otolaryngology: A Systematic Review and Meta‐analysis

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