Ergonomic learning curves on gynecological laparoendoscopic single-site (LESS) surgery.

BACKGROUND: Few previous studies have introduced general techniques to overcome the "chopstick effect" in laparoendoscopic single-site surgery (LESS). We aim to investigate and highlight the key ergonomic methodologies for gynaecologic LESS based on the surgeon's hands-on performance. METHODS: The first author surgeon A reviewed and analyzed the LESS procedures performed by herself and how she taught surgeon B from January 2021 to April 2022. The procedures were classified based on technical difficulty and learning periods, and the hands-on technical skills of LESS module were evaluated. RESULTS: Surgeon A conducted 580 LESS procedures, which were divided into the novice (n = 48) and intermediate (n = 33) periods, and the remaining cases were included in the routine period. We formed a special ergonomic LESS operating methodology: Maintain good LESS laparoscopic spatial sensation, keep hand-eye coordination, well cooperation between the main surgeon and the assistant; Experienced multiport laparoscopy surgery (MPS) skills, improve basic LESS technique: grasp, lift, transfer, place, blunt separating, coagulation and cutting. Coordination location, orientation, movements, and flexion or extension of shoulders, arms, elbow, wrist and finger joints; Maintain strength, tension and ambidexterity postures with joint and muscular efforts to control instruments. Surgeon B learned the above experiences by performing 39 LESS procedures under the guidance of surgeon A. CONCLUSION: This educational research sheds light on the common challenges faced in LESS and presents the importance of ergonomic hands-on performance skills in improving surgical outcomes, which could serve as a guide for future training and education in LESS.

Compensation Method for Missing and Misidentified Skeletons in Nursing Care Action Assessment by Improving Spatial Temporal Graph Convolutional Networks.

With the increasing aging population, nursing care providers have been facing a substantial risk of work-related musculoskeletal disorders (WMSDs). Visual-based pose estimation methods, like OpenPose, are commonly used for ergonomic posture risk assessment. However, these methods face difficulty when identifying overlapping and interactive nursing tasks, resulting in missing and misidentified skeletons. To address this, we propose a skeleton compensation method using improved spatial temporal graph convolutional networks (ST-GCN), which integrates kinematic chain and action features to assess skeleton integrity and compensate for it. The results verified the effectiveness of our approach in optimizing skeletal loss and misidentification in nursing care tasks, leading to improved accuracy in calculating both skeleton joint angles and REBA scores. Moreover, comparative analysis against other skeleton compensation methods demonstrated the superior performance of our approach, achieving an 87.34% REBA accuracy score. Collectively, our method might hold promising potential for optimizing the skeleton loss and misidentification in nursing care tasks.

Perception and Knowledge of Dental Ergonomics among Romanian Dental Students.

Musculoskeletal disorders (MSDs) are among leading factors for early retirement of dental practitioners while the application of ergonomic principles is often overlooked during dental education. The article aims to assess the need for dental ergonomics modules as an integrated part of the dental school curriculum and to quantify the significance and role of ergonomics in reducing musculoskeletal stress generated while undergoing dental training. The study design consisted of a three-part original close-ended multiple-choice questionnaire carried out among 75 sixth year students from "Victor Babes" University of Medicine and Pharmacy, Timisoara, Romania. Questions focused on the basic knowledge of theoretical ergonomics, the ISO 11226 standard and means of improvement in undergraduate ergonomics training. Most students had an average level of knowledge regarding dental ergonomic principles. Data analysis showed that 62.16% agree that the information received in the second-year dental ergonomics course was helpful in regard to time organization. A high percentage (86%) also understood the correct positioning of the patient while performing dental procedures. Although implementation of ergonomic principles in the early dental training years has a high influence in the prevention of MSDs, students do not fully understand the impact this subject has on their future careers.

Visual vs vibrotactile feedback for posture assessment during upper-limb robot-aided rehabilitation.

Repetitive and intensive exercises during robot-aided rehabilitation may expose patients to inappropriate and unsafe postures. The introduction of a sensory feedback can help the subject to perform the rehabilitation task with an ergonomic posture. In this work, the introduction of visual and vibrotactile feedback in a robotic platform for upper limb rehabilitation has been proposed to ensure ergonomic posture during rehabilitation. The two feedback modalities have been used to provide information about incorrect neck and trunk posture. Ten healthy subjects have been involved in this study. Each of them performed 3D reaching movements with the aid of the robotic platform in three different conditions, i.e. without feedback, with visual feedback and with vibrotactile feedback, and a comparative analysis has been carried out to evaluate feedback effectiveness, acceptance and performance. Experimental results show that in case of no feedback the subjects reach and maintain configurations that can lead to incorrect neck and trunk configurations and therefore, if repeated, to musculoskeletal disorders. Conversely, with visual or vibrotactile feedback, the subjects tend to correct inappropriate posture with both trunk and head during task performing.

Comparing the Effectiveness of Three Ergonomic Risk Assessment Methods-RULA, LUBA, and NERPA-to Predict the Upper Extremity Musculoskeletal Disorders.

BACKGROUND: Musculoskeletal disorders are a major problem in all jobs. Several methods are available for assessing the exposure to risk factors associated with musculoskeletal disorders. This study is aimed at comparing three different ergonomic risk assessment methods-rapid upper limb assessment (RULA), loading on the upper body assessment (LUBA), and new ergonomic posture assessment (NERPA) method-to predict upper extremity musculoskeletal disorders. MATERIALS AND METHODS: The study was conducted on 210 workers from three different industries including pharmaceutical, automotive, and assembly in the Isfahan province. A Nordic questionnaire was used for determining the levels of musculoskeletal disorders. Then, selected postures were evaluated with RULA, LUBA, and NERPA methods. Finally, data were analyzed with Kolmogorov-Smirnov test to check the normality distribution of data, Spearman's correlation test to investigate the correlation between the assessed levels with musculoskeletal disorders, and Wilcoxon test to identify significant differences between the values with SPSS version 16. RESULTS: Wilcoxon test revealed a significant difference between the values related to NERPA and RULA (P < 0.001), whereas no significant relation between LUBA and RULA was shown by this test (P = 0.914). The correlation coefficients of the musculoskeletal disorders' level with RULA level, NERPA level, and LUBA level were 0.74, 0.73, and 0.69, respectively. CONCLUSION: Low-risk levels in NERPA, medium-risk levels in LUBA, and high-risk levels in RULA are evaluated better. The results showed that RULA was the best method for assessing musculoskeletal disorders among the three methods.