Time dependency assessment of muscular fatigue index and hand tremor under operating conditions

Abstract

The aim of this paper is to determine if operating has an effect on a surgeon's muscular fatigue and hand tremor. Electromyography and tremor measurements were taken throughout a day of operating from the brachioradialis (BR) and mid deltoid (MD) muscles of six head and neck surgery consultants and two Ear, Nose, and Throat (ENT) registrars. The percent change in Mean Frequency (MF) of their EMG signal and tremor amplitudes was compared to twenty normal controls performing desk work. It was found that operating led to an increase in the fatigue level and hand tremor in all subjects, compared to very little increase from within the controls study. It was also determined that the BR is used more than the MD muscle and hence fatigues at a faster rate. Surgeons should be aware that their muscular fatigue levels and consequently their hand tremor will increase as an operation progresses, therefore, if possible, more complex parts of the operation should be performed as early as possible.

Does Elastic Resistance Affect Finger Pinch Discrimination?

“…It has been argued that during prolonged operating, muscular fatigue can develop and result in a decrement in a surgeon's fine motor control (Masters, Poolton, Abernethy, & Patil, 2008;Slack, Coulson, Ma, Webster, & Proops, 2008;Slack & Ma, 2007). Future studies are needed to determine whether muscular fatigue may affect finger pinch movement discrimination ability and how instrument elastic resistance may affect the rate of fatigue.…”

Detection of involuntary human hand motions using Empirical Mode Decomposition and Hilbert-Huang Transform

“…[3] Though the results based on Levinson-Durbin algorithm (LD algorithm) show faster convergence than LMS (Least Mean Square) and RLS (Recursive Least Squares) algorithms, however, it does not detect amplitude and frequency range of a tremor at a given specific time. In addition, no effort to date specifically addresses tremors in different frequency bands, though it has been shown that different kinds of tremor have different characteristics [4], [5].…”

Differential analysis of muscle fatigue induced elbow and wrist tremor in controlled laparoscopic manoeuvring

“…It requires a higher level of precision and accuracy of the surgeons' hand movements, where FIT is the primary hindrance. Hand tremor studies have been reported earlier by several groups on manipulation of hand‐held microsurgical devices . However, a thorough analysis of fatigue induced hand tremor in laparoscopic tool manipulation has not been reported so far.…”

“…However, a thorough analysis of fatigue induced hand tremor in laparoscopic tool manipulation has not been reported so far. Even though several studies have shown that long‐term training increases the accuracy of the LTM, effect of FIT in such cases were not addressed . Since laparoscopic surgeries are comparatively longer in time with respect to open surgeries, generation of muscle fatigue is also very common in these cases which affect the accuracy of the surgical procedure causing tremor .…”

“…Even though several studies have shown that long‐term training increases the accuracy of the LTM, effect of FIT in such cases were not addressed . Since laparoscopic surgeries are comparatively longer in time with respect to open surgeries, generation of muscle fatigue is also very common in these cases which affect the accuracy of the surgical procedure causing tremor . Hence, the aim of this study is to perform a characteristic differential analysis of muscle fatigue induced tremor on elbow and wrist joint in Laparoscopic manoeuvring.…”