A method for the risk assessment of biomechanical overload in hospital physiotherapists.

BACKGROUND: In physiotherapists, biomechanical overload risk assessment (RA) is particularly complex due to the tasks' variability. The present study aims to propose a new methodology, named Whole Body RA Biomechanical Overload (WB-RAMBO), to assess the risk in the activities performed by physiotherapists. METHODS: Each type of intervention was broken down into elementary operations. The risk factors (force, repetitiveness, and incongruous postures) were recorded and evaluated for each of these. For each task, the risk level was obtained by integrating the results of multiple ergonomic methods among those proposed by the international literature. To verify and validate the obtained results, we reviewed the medical records of health surveillance carried out on physiotherapists. RESULTS: From the ergonomic point of view, RA shows a situation of acceptability. The observed slight dysergonomies are diluted in the work shift and allow an optimal functional recovery of the musculoskeletal system. CONCLUSIONS: This method proposes a RA for each operation performed. A work plan subjected to such a peculiar RA can be redesigned and adapted to the company's and the hypersusceptible worker's organizational needs.

A Twenty-Year Retrospective Analysis of Risk Assessment of Biomechanical Overload of the Upper Limbs in Multiple Occupational Settings: Comparison of Different Ergonomic Methods.

BACKGROUND: Several methods with which to assess the risk of biomechanical overload of the upper limb are described in the literature. METHODS: We retrospectively analysed the results of the risk assessment of the biomechanical overload of the upper limb in multiple settings by comparing the application of the Washington State Standard, the threshold limit values (TLV) proposed by the American Conference of Governmental Industrial Hygienists (ACGIH), based on hand-activity levels (HAL) and normalised peak force (PF), the Occupational Repetitive Actions (OCRA) checklist, the Rapid Upper-Limb Assessment (RULA), and the Strain Index and Outil de Repérage et d'Evaluation des Gestes of INRS (Institut National de Recherche et de Sécurité). RESULTS: Overall, 771 workstations were analysed for a total of 2509 risk assessments. The absence of risk demonstrated for the Washington CZCL, used as the screening method, was in good agreement with the other methods, with the sole exception of the OCRA CL, which showed at-risk conditions in a higher percentage of workstations. Differences in the assessment of the frequency of actions were observed among the methods, while their assessments of strength appeared to be more uniform. However, the greatest discrepancies were observed in the assessment of posture. CONCLUSIONS: The use of multiple assessment methods ensures a more adequate analysis of biomechanical risk, allowing researchers to investigate the factors and segments in which different methods show different specificities.