Article

A comparison of the effects of floor mats and shoe in-soles on standing fatigue

October 2002
Applied Ergonomics 33(5):477-84

Source
PubMed

Authors:

In assembly line positions and other occupations, employees experience pain and discomfort associated with long periods of standing. Modifying flooring is a common intervention method used to alleviate problems associated with constrained standing. This study investigated the effects of four different standing conditions upon assembly workers' perception of general fatigue and discomfort associated with various body parts following 1 week of 8-h days of exposure to each condition. The four standing conditions were (1) on hard floor, (2) on a floor mat, (3) wearing shoe in-soles, and (4) wearing shoe in-soles while standing on a floor mat. Questions were asked regarding general fatigue and discomfort. In general, the mat, in-soles and combined conditions were more comfortable than standing on hard floor. Moderately strong correlations were found for the variables of height, age and job tenure. Shorter individuals experienced greater discomfort in the upper leg and low back when standing on a mat and when wearing in-soles. The older workers and those with more job seniority reported greater discomfort associated with body joints when standing on the hard floor and when standing on the floor mat. No significant differences in fatigue or discomfort were found when comparing the overall effects of using the floor mat to wearing the shoe in-soles or the combined condition.

Does plantar pressure in short-term standing differ between modular insoles selected based upon preference or matched to self-reported foot shape?

Article

Jun 2024

Gait Characteristics and Fatigue Profiles When Standing on Surfaces with Different Hardness: Gait Analysis and Machine Learning Algorithms

Article

Full-text available

Oct 2021

Simple Summary The purpose of this study was to explore if an anti-fatigue soft mat could improve the gait performance after standing for long periods and to examine if a machine-learning algorithm could evaluate fatigue state objectively. Compared with standing directly on the hard ground, using an anti-fatigue mat could reduce the negative effect of standing for a long time (4 h). The machine-learning algorithm demonstrated moderate accuracy in measuring fatigue. The accuracy of gait parameters used to consider a non-fatigued state following the use of an anti-fatigue mat was higher than that of the fatigue state. The results may indicate that it is beneficial to use anti-fatigue mats when standing for long periods, and it is feasible to use gait parameters and machine-learning algorithms to detect fatigue. Abstract Background: Longtime standing may cause fatigue and discomfort in the lower extremities, leading to an increased risk of falls and related musculoskeletal diseases. Therefore, preventive interventions and fatigue detection are crucial. This study aims to explore whether anti-fatigue mats can improve gait parameters following long periods of standing and try to use machine learning algorithms to identify the fatigue states of standing workers objectively. Methods: Eighteen healthy young subjects were recruited to stand on anti-fatigue mats and hard ground to work 4 h, including 10 min rest. The portable gait analyzer collected walking speed, stride length, gait frequency, single support time/double support time, swing work, and leg fall intensity. A Paired sample t-test was used to compare the difference of gait parameters without standing intervention and standing on two different hardness planes for 4 h. An independent sample t-test was used to analyze the difference between males and females. The K-nearest neighbor (KNN) classification algorithm was performed, the subject’s gait characteristics were divided into non-fatigued and fatigue groups. The gait parameters selection and the error rate of fatigue detection were analyzed. Results: When gender differences were not considered, the intensity of leg falling after standing on the hard ground for 4 h was significantly lower than prior to the intervention (p < 0.05). When considering the gender, the stride length and leg falling strength of female subjects standing on the ground for 4 h were significantly lower than those before the intervention (p < 0.05), and the leg falling strength after standing on the mat for 4 h was significantly lower than that recorded before the standing intervention (p < 0.05). The leg falling strength of male subjects standing on the ground for 4 h was significantly lower than before the intervention (p < 0.05). After standing on the ground for 4 h, female subjects’ walking speed and stride length were significantly lower than those of male subjects (p < 0.05). In addition, the accuracy of testing gait parameters to predict fatigue was medium (75%). After standing on the mat was divided into fatigue, the correct rate was 38.9%, and when it was divided into the non-intervention state, the correct rate was 44.4%. Conclusion: The results show that the discomfort and fatigue caused by standing for 4 h could lead to the gait parameters variation, especially in females. The use of anti-fatigue mats may improve the negative influence caused by standing for a long period. The results of the KNN classification algorithm showed that gait parameters could be identified after fatigue, and the use of an anti-fatigue mat could improve the negative effect of standing for a long time. The accuracy of the prediction results in this study was moderate. For future studies, researchers need to optimize the algorithm and include more factors to improve the prediction accuracy.

The Effect of Foot Orthosis on the Vertical Component of the Ground Reaction Force While Walking: A Review Study

Article

Full-text available

Apr 2021
J REHABIL

Objective Everyone is required to walk and stand for long time in daily activities, especially in the workplace. As a result, the Ground Reaction Force (GRF) on the components and joints is so great that they sometimes reach several times the weight of the body. These forces can have devastating effects on the feet and ankles. Various studies have suggested different methods and factors for reducing the GRF while walking. The purpose of this study was to identify the different causes of factors and methods affecting the GRF according to the current study. Materials & Methods This review study was conducted by searching the databases of ProQuest, PabMed, Web of Science, and MBS from 1995 to 2019. The keywords included 'Ground Reaction Force', foot orthosis', 'walking', 'long term standing impact force'. After reviewing the abstract and title of each study by the authors, the criteria for selecting the article were considered. At the control level of each article, based on the main design of the search, from 1 to 5 were scored as randomized control trial, prospective controlled trial (Cohort), case-control, pre/post, observational clinical consensus, respectively. The quality of the articles was evaluated and scored using the Down and Black tool. Results Out of 82 articles, 21 articles were selected for analysis based on the criteria. Reporting scores, external validity, and internal validity varied between 4-8, 3-1, 5-2, 6-3, 7-4, respectively. From the studies performed on the molding insoles and the change in the loading rate of the maximum vertical GRF, there is a contradiction in proving it. Investigating the effect of foot orthoses in terms of material may lead to a further reduction in plantar. Conclusion Determining the effect of different components on GRF in the sole of the foot will help us better understand the factors involved in quality of life. The four domains of gender, post, material, and molding had different effects. Due to the lack of articles related to the study of the effect of gender and the creation of posts in the insole on the GRF can not be decisive.

Interventions to Mitigate Fatigue Induced by Physical Work: A Systematic Review of Research Quality and Levels of Evidence for Intervention Efficacy

Article

Oct 2019

Objective We present a literature review on workplace physical fatigue interventions, focusing on evaluating the methodological quality and strength of evidence. Background Physical fatigue is a recognized workplace problem, with negative effects on performance and health-related complaints. Although many studies have focused on the mechanisms and consequences of fatigue, few have considered the effectiveness of interventions to mitigate fatigue. Method A systematic review of the workplace safety literature for controlled trials of physical fatigue interventions was conducted. Data on intervention type, subject characteristics, targeted tasks and body locations, outcome measures, and study design were extracted. The methodological quality for each study was evaluated using the PEDro scale, and the level of evidence was based on quality, amount, and consistency. Results Forty-five controlled trials were reviewed, examining 18 interventions. We categorized those interventions into individual-focused ( N = 28 studies, nine interventions), workplace-focused ( N = 12 studies, five interventions), and multiple interventions ( N = 5 studies, four interventions). We identified moderate evidence for interventions related to assistive devices and task variation. There was moderate evidence supporting no fatigue attenuation for the garment change category of interventions. The interventions in the remaining categories had limited to minimal evidence of efficacy. The heterogeneity of the included trials precludes the determination of effect size. Conclusion This review showed a lack of high levels of evidence for the effectiveness of most physical fatigue interventions. Application Due to a lack of high levels of evidence for any category of reviewed physical fatigue interventions, further high-quality studies are needed to establish the efficacy of others.

Enhancing Ergonomics in Pediatric Endoscopy Training and Practice

Article

Apr 2023

Catharine Walsh

Pediatric endoscopists are at risk of work-related injuries from overuse and repetitive motions during endoscopy. Recently, there has been increasing appreciation for the importance of ergonomics education and training to help build long-term habits that prevent injury. This article reviews the epidemiology of endoscopy-related injuries in pediatric practice, describes methods for controlling exposures in the workplace, discusses key ergonomic principles that can be used to mitigate injury risk, and outlines tips for integrating education on endoscopy ergonomics during training.

Ergonomics in Interventional Radiology: Awareness Is Mandatory

Article

Full-text available

May 2021
MED LITH

Ergonomics in interventional radiology has not been thoroughly evaluated. Like any operators, interventional radiologists are exposed to the risk of work-related musculoskeletal disorders. The use of lead shielding to radiation exposure and the lack of ergonomic principles developed so far contribute to these disorders, which may potentially affect their livelihoods, quality of life, and productivity. The objectives of this review were to describe the different situations encountered in interventional radiology and to compile the strategies both available to date and in development to improve ergonomics.

Calf massager: Intervention for body muscle discomfort during prolonged standing

Article

Jul 2019

Many occupations require workers to stand for long periods of time without proper interventions, which causes discomfort in the back and lower limbs. Therefore, this study aims to assess the effectiveness in alleviating body muscle discomfort during prolonged standing through the use of a calf massager. This study was conducted among male workers at a manufacturer with production line workers and the list was obtained from the HR Department and simple random sampling was done by number categorization. A total of 100 respondents (50 respondents for both the control and the experimental groups) participated in this study. The experiment took place in a room with a similar setup for the production line. Each respondent was requested to perform the simulated task for 2 hr. For the experimental group, the calf massager was turned on every 15 min. At every 15‐min interval after turning on the calf massager, respondents from both groups were required to evaluate their discomfort level on a Borg's scale CR‐10 questionnaire. The results showed that the level of body discomfort among respondents in the experimental group reduced (20–30%) compared with that of the control group. Multivariate analysis results revealed that the discomfort rating for the lower back, knees, thighs, calves, and feet was significantly lower (p < .05) among the experimental group compared with the control group. For lower body parts, the lower back region was statistically significant (p < .05) at the 90th, 105th, and 120th min; the thigh region was statistically significant (p < .05) at the 120th min; the knee region was statistically significant (p < .05) at the 105th and 120th min; the calf region was statistically significant (p < .05) at all minute intervals except the 15th and 45th min, while the feet region, was statistically significant at the 105th and 120th min. Therefore, this study indicates that calf massage treatment is capable of reducing body muscle discomfort during prolonged standing and highlights the significance of calf massage.

Einfluss schichtbedingter Anstrengung und Ermüdung auf RULA-Score und Fußbelastung: Eine Feldstudie unter Verwendung inertialer und resistiver Sensorik

Conference Paper

Mar 2025

Kurzfassung: Physische Anstrengung und Ermüdung am Arbeitsplatz sind wesentliche Faktoren für arbeitsbedingte Muskel-Skelett-Erkrankungen (MSE). Während experimentelle Studien bereits Ermüdungsindikatoren im Schichtkontext aufzeigten, fehlen Feldstudien in realen industriellen Szenarien. Diese Studie untersuchte den Einfluss körperlicher Belastung auf ergonomische Risikowerte und den plantaren Fußdruck in einer realen Umgebung. 24 Teilnehmer (17 Männer, 7 Frauen) nahmen teil. Die Arbeits-belastung wurde mit inertialen Messeinheiten (IMUs, n = 24) und plantarer Innenschuh-Druckmessung (n = 18) in zwei 12-minütigen Bewegungsaufzeichnungen zu Schichtbeginn und nach drei Stunden ohne Unterbrechung erfasst. Mittels Borg CR-10 und visueller Analogskala wurden physische Anstrengung und Ermüdung operationalisiert. Die Sensordaten wurden mit MATLAB und SPSS ausgewertet. Trotz erhöhter wahrgenommener Anstrengung und Ermüdung zeigten die RULA-Werte keine signifikanten Unterschiede im Pre-Post-Vergleich, was auf eine begrenzte Sensitivität des RULA für Müdigkeit hinweisen könnte. Beim plantaren Druck ergaben sich keine signifikanten Zeitunterschiede, jedoch signifikante Unterschiede zwischen den Seiten, die auf einseitige Arbeitsanforderungen oder Seitenpräferenz zurückzuführen sind.

Impact of Anti‐Fatigue Floor Mat on Surgical Staff Comfort Levels in Head and Neck Surgery Cases

Article

Full-text available

Jan 2025

Objective Musculoskeletal symptoms are common among surgical staff and can have long‐term implications on health and wellbeing. The purpose of this study is to evaluate the impact of anti‐fatigue floor mat on the comfort level of surgical teams during head and neck surgeries lasting ≥ 3 h. Methods Over 4 months, we prospectively randomized 34 major (≥ 3 h) head and neck procedures to the use or not of an anti‐fatigue floor mat. Anonymous questionnaires measured the comfort levels in different subjects including the surgeons, assistant surgeons, and surgical scrub technicians (n = 57). Subjects completed questionnaires before, immediately after, and one day after surgery. Variables collected included demographics, overall discomfort level, overall energy level, discomfort level in different body parts, number of breaks taken during the case, time since last physical exercise, and frequency of physical exercise. The analysis of variance (ANOVA) technique was used for data analysis. Results The group that used anti‐fatigue floor mats reported lower increases in discomfort from pre‐op to immediately post‐op and 24 h post‐op compared to the group that did not (p = 0.009 and p < 0.001). Participants who used the mats reported significant lower levels of pain in the ankles and feet, knees, and shoulders immediately post‐op compared to participants who did not. Participants who used the mats reported lower increases in discomfort in their back, hips, knees, neck, and shoulders from pre‐op to post‐op. Conclusions Using anti‐fatigue floor mats during surgery is an effective and low‐cost intervention to decrease the musculoskeletal symptoms experienced by the surgical team. Level of Evidence 2.

0.35-mm Lead Equivalent Aprons Provide Similar Protection to Interventionalists Compared to 0.5-mm Lead Equivalent Aprons During Fluoroscopically Guided Interventions

Article

Full-text available

Oct 2024

Musculoskeletal Injuries in the Endoscopy Practitioner Risk Factors, Ergonomic Challenges and Prevention—Narrative Review and Perspectives

Article

Full-text available

Sep 2023

GI endoscopy forms an important part in the daily practice of a gastroenterologist. Musculoskeletal injuries related to GI endoscopy are on the rise. Observational studies and surveys depict the importance of a proper ergonomic environment when performing GI endoscopy. Our aim is to describe the pathophysiology, risk factors and possible preventive measures to reduce the risk of musculoskeletal injuries during gastrointestinal (GI) endoscopy. We review the most relevant studies that outline the gravity of the problem. A detailed analysis of proposed ergonomic recommendations is performed, outlining crucial steps in injury prevention. Proper ergonomic education is a key step in preventing occupational injury. Robotics and other mechanical solutions offer a variety of approaches to tackling the ergonomic challenge. Implementing proper ergonomic education and mechanical solutions lowers the possibility of occupational injury. The strategies and appliances presented are beneficial to all GI endoscopy practitioners.

Prevention of Musculoskeletal Injuries in Gastrointestinal Endoscopy – Structured Review and Perspectives

Preprint

Full-text available

Jul 2023

Tadej Durič

GI endoscopy forms an important part in a daily practice of a gastroenterologist. Musculoskeletal injuries related to GI endoscopy are on the rise. Observational studies and surveys depict the importance of proper ergonomical environment when performing GI endoscopy. Our aim is to outline preventive measures in gastrointestinal (GI) endoscopy in reducing possibility for occupational injury. We review most relevant studies that outline the gravity of the problem. A detailed analysis of proposed ergonomical recommendations is performed, outlining crucial steps in injury prevention. Proper ergonomical education is a key-step in preventing occupational injury. Robotics and other mechanical solutions offer a variety of approaches tackling the ergonomical challenge. Implementing proper ergonomical education and mechanical solutions lowers the possibility if occupational injury. Strategies and appliances presented are beneficial to all GI endoscopy practitioners.

The Effect of Anti-Fatigue Mat and Stretching on Musculoskeletal Disorders (MSDs) Complaints of Sewing Operator PT. X

Article

Full-text available

Jul 2022

The Effect of Standing Mats on Biomechanical Characteristics of Lower Limbs and Perceived Exertion for Healthy Individuals during Prolonged Standing

Article

Full-text available

Jul 2022

Objective: To identify the effect of standing mats on biomechanical characteristics of lower limbs and perceived exertion for healthy adult individuals during a prolonged standing task. Methods: 32 healthy college students were recruited in the randomized and cross-over designed trial according to the effect size and statistical power. After collecting the anthropometric data, each participant was asked to finish 2 sessions of 4-hour prolonged standing tasks on standing mats (MS) and hard ground (GS) in a random order and with a 72-hour interval rest. The plantar pressure distribution, foot morphology, and scores of the BESS (balance error scoring system) would be recorded pre- and posteach task. The Borg Rating of Perceived Exertion (RPE) would be collected during the whole task. Paired-samples t test was adopted to analyse the before and after difference within group and independent-samples t test was adopted to analyse the difference between groups separately. Results: (1) A prolonged standing task on both MS and GS have a negative effect on RPE and balance performance. (2) The negative effect on RPE and balance performance induced by MS is significantly smaller than that induced by GS. (3) Compared to GS, prolonged standing on MS has a lower peak plantar pressure and an implicit decrease in navicular drop and AHI (arch index). Conclusion: Standing mat tends to alleviate the fatigue induced by prolonged standing in lower limbs, optimize the distribution of plantar pressure, and maintain the stability.

A decision support system for designing win–win interventions impacting occupational safety and operational performance in ageing workforce contexts

Article

Mar 2022
SAFETY SCI

Many companies are facing issues related to the increasing average age of their workforce, which impacts both operational and occupational safety and health (OSH) performance. In recent years, the ageing workforce (AW) has been investigated from various perspectives by researchers, showing how companies can use different approaches to address this phenomenon, either in their OSH interventions or operational strategies. However, no studies have investigated the interrelations between these approaches. In this study, we first conducted an extensive literature review that enabled the identification of (i) the aspects of operational and OSH performance affected by the AW, (ii) the suitable types of interventions in an AW context, and (iii) the interrelations between the three. Based on this, we then present a conceptual decision support system (DSS) to assist decision makers in analysing operational and OSH performance at their workplace and defining the proper interventions for an AW context. Specifically, by considering the interrelations between the interventions and both operational and OSH performance, the conceptual DSS facilitates a win–win approach, where both operational and OSH performances are improved simultaneously by choosing the proper intervention(s). An illustrative application case is then developed to show the application of the DSS before drawing conclusions about its major strengths and limitations, and further research avenues.

Comparison of Physiological Effects Induced by Two Compression Stockings and Regular Socks During Prolonged Standing Work

Article

Full-text available

Jun 2021

Objective The goal of this study was to evaluate and compare lower-leg muscle fatigue, edema, and discomfort induced by the prolonged standing of security guards wearing regular socks and those wearing 15–20 or 20–30 mmHg compression stockings as intervention. Background Compression stockings are somewhat used by individuals standing all day at work. However, quantitative evidence showing their potential benefits for lower-leg health issues in healthy individuals during real working conditions is lacking. Method Forty male security employees participated in the study. All were randomly assigned to the control or one of the two intervention groups (I 15–20 or I 20–30 ). Lower-leg muscle twitch force, volume, and discomfort ratings were measured before and after their regular 12-hr standing work shift. Results Significant evidence of lower-leg long-lasting muscle fatigue, edema, and discomfort was observed after standing work for guards wearing regular socks. However, no significant changes were found for guards wearing either compression stockings. Conclusion In healthy individuals, compression stockings seem to attenuate efficiently the tested outcomes in the lower leg resulting from prolonged standing. Application Occupational activities requiring prolonged standing may benefit from 15–20 or 20–30 mmHg compression stockings. As similar benefits were observed for both levels of compression, the lower level may be sufficient.

Negative Impacts of Prolonged Standing at Work on Musculoskeletal Symptoms and Physical Fatigue: The Fifth Korean Working Conditions Survey

Article

Full-text available

Jun 2021

Purpose: We aimed to investigate variations in the risk of low back pain (LBP), lower extremity muscle pain, and whole body fatigue according to differences in prolonged standing work hours in relation to risk factor exposure and rest frequency. Materials and methods: From the fifth Korean Working Conditions Survey data collected in 2017, data for 32970 full-time workers who worked for more than 1 year at their present job were analyzed. We classified the workers according to exposure to fatigue or painful postures, carrying heavy objects, performance of repetitive movements that burden the musculoskeletal system, and how often they took a break. Relationships between time spent in a standing posture at work and risks of LBP, lower extremity muscle pain, and whole body fatigue were analyzed by multivariate logistic regression. Results: Of the full-time workers in the survey, 48.7% worked in a standing position for more than half of their total working hours. A higher odds ratio (OR) value for lower extremity muscle pain was observed in female not exposed to carrying heavy objects [OR: 3.551, 95% confidence interval (CI): 3.038-4.150] and not exposed to performing repetitive movements (OR: 3.555, 95% CI: 2.761-4.557). Conclusion: Changes in work methodologies are needed to lower the number of hours spent in a prolonged standing posture at work, including being able to rest when workers want to do so, to reduce pain and fatigue.

Ergonomics in the Unit: Modeling the Environment Around the Endoscopist

Article

Dec 2020

Strain and injury related to endoscopy are frequently reported. Recent studies have shown that female gender may be independently associated with musculoskeletal injury (MSI). Incorporation of ergonomic principles into endoscopic practice helps to prevent MSI caused by sustained high force exertion, awkward postures and repetitive motion. The strategies that can be implemented in the endoscopy unit to minimize injury risk and create a safe environment include: ergonomic endoscope instrument redesign, integrating adjustable elements into the endoscopy suite, providing supportive equipment, and implementing an ergonomic checklist and time out into the work flow. Additionally, an ergonomic approach to endoscopy while pregnant can help address new musculoskeletal challenges. This article reviews ergonomic issues arising in endoscopy with a focus on women in the field.

Footfall Deflection of Antifatigue Flooring During Simulated Human Stance

Article

Nov 2020
Ergon Des

This study quantified the effect of compression load and duration on the deflection of five separate anti-fatigue flooring surfaces. Following standardized measurement of A Shore hardness, each sample underwent simulated single-leg stance indentation procedures that differed by compression load (45.3 kg, 90.7 kg, 136.1 kg) and duration (initial = 2.5s, intermediate = 6.25s, final = 12.5s). Vertical deflection was compared across conditions, and the relationship between A Shore hardness and deflection was characterized. When compressed with 45.3 kg, deflection was not influenced by duration, but at 136 kg, deflection differed between durations by up to 15%. The relationship between A Shore hardness and deflection was characterized by a third order polynomial function (R2 > 0.991).

Investigating the effect of custom‐made insoles and exercises on lower limb and back discomfort in assembly‐line workers in a rubber tire factory: A randomized controlled trial

Article

Aug 2019

Many occupations require standing for prolonged periods, which can be a major contributor to musculoskeletal problems and cause disturbances in different parts of the body, especially the lower back and lower extremities. The aim of this study was to investigate the effect of custom‐made insoles and exercise training on the lower limb and lower back discomfort in workers on a production line at a rubber tire factory. One hundred male workers (mean age 35.96 years, work experience of 10.62 years, standing time 6.58 hr) participated in this randomized controlled trial. The men were randomly assigned to one of four groups: (a) custom‐made insole plus lower limb exercises, (b) insoles only, (c) lower limb exercises only, and (d) no intervention. Discomfort level was recorded with a visual analog scale and a body map. The data were analyzed with analysis of covariance. The results showed a significant difference in discomfort levels between groups in the lower back (p = .001), thigh (p = .001), and knee (p = .001) areas. The combined insole and exercise group had less discomfort in the lower back, thigh, and knee. In the group that used the insole only without exercises, the discomfort level in the lower back area was reduced. The results indicate that the simultaneous use of insoles and exercises might be an effective intervention to reduce discomfort in the lower limbs and lower back in workers who remain standing for prolonged periods.

Effect of military footwear on balance and stability: A pilot study

Article

Apr 2019

ABSTRACT: : To perform daily activity under both static and dynamic conditions maintenance of balance and stability plays an important role to prevent slip and falls. Maintenance of balance is essential in an occupational workplace and industrial setting during performing tasks. The effect of footwear on balance is poorly understood in military setting. Proper military footwear helps improve balance and postural stability, minimizing the risk injuries. This study was aimed to observe the influence of military footwear on balance and postural sway during quiet standing. Twenty one (n=21) physically fit Indian infantry soldiers volunteered for the study. Two types of footwear, namely footwear 1 & 2 (without & with proper foot bed respectively) were investigated for suitability or fitness during standing. Participants stood on force platform for 40 seconds in each condition. Bioware was used to collect and process the data. Results suggest that in footwear 2, sway area is more concentrated than footwear 1 and a shifting of the center of pressure (COP) to midline was also observed in footwear 2. All the parameters were decreased in Footwear 2 compared to footwear 1. The use of footwear with proper foot bed for absorbing impact force (footwear 2) improves balance and stability during quiet standing.

Influence of footwear on individual performance during prolonged standing

Article

Dec 2019

A. S. Shaikh

Standing is a normal posture during working in industries, some jobs even make it mandatory to stand while working. Standing is natural and itself doesn’t pose a specific health risk. But standing for a very long duration has an immense share in many health complications. The aim of this study is to determine which type of footwear is healthier to wear while standing for long periods. Five physically fit participants ( ) were chosen from lthe ive industrial environment. All the five participants participated in this study without disturbing their usual work as ma achine operator. Photo-plethysmography (PPG) was used to collect continuous heart rate information from each participant. Each participant was observed for six hours each day for two consecutive days, wearing different footwear each day. The information collected was used to calculate total energy expenditure during the experimentation period.

Ageing workforce management in manufacturing systems: state of the art and future research agenda

Article

Full-text available

Apr 2019

The workforce ageing phenomenon is recently affecting most of the Organisation for Economic Co-operation and Development (OECD) member countries, due to a general ageing of their populations and a higher average retirement age of the workforce. In this paper, the topic of ageing workforce management is addressed from a production research standpoint, with the aim of understanding how older workers can be supported and involved in a manufacturing system. First, the current state of the art related to the ageing workforce in production systems is presented. This is structured according to four main topics: (1) analysis and evaluation of ageing workers’ functional capacities, (2) consideration of ageing workers’ capacities in industrial system modelling and management, (3) analysis and exploitation of ageing workers’ expertise, (4) acknowledgement, analysis, design and integration of supporting technologies. Next, the discussion on the impact of the ageing workforce on manufacturing systems’ performances leads to the comparison of some technological advances that are related to the Industry 4.0 paradigms. Finally, a future research agenda on this topic is proposed, based on the same topics classification proposed for the literature analysis. Five different research areas are derived, suggesting future directions for appropriate research concerning the employ of older workers in production environments.

Ergonomics in Rhinologic Surgery

Article

May 2025
Operat Tech Otolaryngol Head Neck Surg

REHABILITATION STRATEGIES AND FOOTWEAR RECOMMENDATIONS FOR NURSES IN STANDING ENVIRONMENTS: A NARRATIVE REVIEW

Article

Jun 2024

Introduction: Prolonged standing can lead to tendon and ligament damage, particularly in the feet and ankles, if preventive measures are not taken. Ill-fitting shoes are associated with increased foot pain and disorders, especially among nurses. This narrative review aims to comprehensively synthesize existing literature on footwear recommendations for nurses in prolonged standing positions, emphasizing healthcare strategies and rehabilitation benefits. It seeks to provide a comprehensive overview while identifying gaps for future research. Methodology: A narrative literature review was conducted using databases such as MEDLINE, CINAHL, Web of Science, and ScienceDirect. Studies were included if they described footwear characteristics and therapeutic indications for workers in prolonged standing contexts, following the PRISMA guideline. Results: Twenty-three studies published between 1998 and 2021 were reviewed, revealing recommendations to reduce gastrocnemius fatigue levels with viscoelastic insoles and arch support. Personalized footwear with cushioning is recommended to decrease peak pressure and alleviate issues like calluses and blisters. Soft shoes help reduce edema formation, while optimizing shoe climate is crucial. The combination of antifatigue mats and sports shoes enhances comfort. Discussion: Current research primarily focuses on insole impact, leaving areas like psychological comfort and footwear design acceptance largely unexplored. Future research should investigate the influence of standing environments and footwear, considering variations in foot health among worker cohorts. Conclusion: Few studies address nurses' footwear needs. Future research should provide detailed information on footwear characteristics and their podiatric benefits for nurses.

A Randomized Controlled Trial to Compare the Effectiveness of Smart Dynamic Fabric Actuator with Exercises in Chronic Musculoskeletal Leg Pain Associated with Prolonged Standing in a Hospital Setting

Article

Dec 2024
Indian J Occup Environ Med

Background There are adverse effects on the health outcomes of workers whose occupation involves prolonged standing, such as lower back pain, leg pain, cardiovascular diseases, fatigue, discomfort, and pregnancy-related health outcomes. The effectiveness of massage therapy as an intervention for managing leg pain associated with prolonged standing needs to be addressed. Aims This study aimed to evaluate the smart dynamic fabric actuator’s effectiveness in treating chronic musculoskeletal leg pain in persons with occupations involving prolonged standing. Setting Tertiary care hospital. Design Randomized controlled trial. Methods Thirty participants with chronic leg pain satisfying the inclusion and exclusion criteria participated in the study. The intervention group used the device for 15 minutes for each leg once a day and stretching exercises twice a day for six weeks. The control group performed stretching exercises twice a day for six weeks. The outcome was assessed at baseline, three weeks, and six weeks with a Numeric Rating Scale for pain and fatigue, short form-McGill Pain Questionnaire for pain, and SF-36 for quality of life. Statistical Analysis The groups were compared using the two-sample t -test with equal variances, the two-sample Wilcoxon rank-sum test, and the Chi ² exact test as appropriate. Results Thirty medical (nursing officers and doctors) and nonmedical professionals (security guards and sales assistants) with a mean age of 32.9 ± 5.6 years (intervention group) and 36.2 ± 5.1 years (control group) participated in the study. At six weeks, a significant improvement in pain (4.80 ± 1.14 to 1.66 ± 1.04 vs 4.66 ± 0.89 to 2.6 ± 0.91, P = 0.014), quality of life (58.77 ± 9.06 to 71.76 ± 8.43 vs 51.39 ± 8.26 to 63.87 ± 7.61, P = 0.012), and reduced fatigue (5 to 2 vs 5 to 3, P = 0.003) was observed in the intervention group when compared with the control group. No adverse events were observed. Conclusion A smart dynamic fabric actuator can be used as an adjunct to exercises for reducing leg pain and fatigue associated with prolonged standing.

Overcoming Barriers: Sex Disparity in Surgeon Ergonomics

Article

Mar 2024
J AM COLL SURGEONS

Background Musculoskeletal discomfort is widely experienced by surgeons across multiple surgical specialties. Developing technologies and new minimally invasive techniques add further complexity and ergonomic stressors. These stressors differentially affect male and female surgeons, but little is known about the role these gender disparities play in surgical ergonomic stress. We reviewed existing literature to better understand how ergonomic stress varies between male and female surgeons. Study design A literature search was performed via Pubmed including but not limited to the topics: ergonomics, surgeons, female surgeons, women surgeons, pregnancy, operating room. A review of available quantitative data was performed. Results Female surgeons endure more pronounced ergonomic discomfort than their male counterparts, with added ergonomic stress associated with pregnancy. Conclusions A four-fold method is proposed to overcome ergonomic barriers: 1) improved education on prevention and treatment of ergonomic injury for active surgeons and for trainees; 2) increased departmental and institutional support for ergonomic solutions for surgeons; 3) partnerships with industry to study innovative ergonomic solutions; and 4) additional research on the nature of surgical ergonomic challenges and the differential effects of surgical ergonomics on female surgeons.

Impact of Fatigue on Ergonomic Risk Scores and Foot Kinetics: A Field Study Employing Inertial and In-Shoe Plantar Pressure Measurement Devices

Article

Full-text available

Feb 2024
SENSORS-BASEL

(1) Background: Occupational fatigue is a primary factor leading to work-related musculoskeletal disorders (WRMSDs). Kinematic and kinetic experimental studies have been able to identify indicators of WRMSD, but research addressing real-world workplace scenarios is lacking. Hence, the authors of this study aimed to assess the influence of physical strain on the Borg CR-10 body map, ergonomic risk scores, and foot pressure in a real-world setting. (2) Methods: Twenty-four participants (seventeen men and seven women) were included in this field study. Inertial measurement units (IMUs) (n = 24) and in-shoe plantar pressure measurements (n = 18) captured the workload of production and office workers at the beginning of their work shift and three hours later, working without any break. In addition to the two 12 min motion capture processes, a Borg CR-10 body map and fatigue visual analog scale (VAS) were applied twice. Kinematic and kinetic data were processed using MATLAB and SPSS software, resulting in scores representing the relative distribution of the Rapid Upper Limb Assessment (RULA) and Computer-Assisted Recording and Long-Term Analysis of Musculoskeletal Load (CUELA), and in-shoe plantar pressure. (3) Results: Significant differences were observed between the two measurement times of physical exertion and fatigue, but not for ergonomic risk scores. Contrary to the hypothesis of the authors, there were no significant differences between the in-shoe plantar pressures. Significant differences were observed between the dominant and non-dominant sides for all kinetic variables. (4) Conclusions: The posture scores of RULA and CUELA and in-shoe plantar pressure side differences were a valuable basis for adapting one-sided requirements in the work process of the workers. Traditional observational methods must be adapted more sensitively to detect kinematic deviations at work. The results of this field study enhance our knowledge about the use and benefits of sensors for ergonomic risk assessments and interventions.

Effects of a range of 6 prefabricated orthotic insole designs on plantar pressure in a healthy population: A randomized, open-label crossover investigation

Article

Sep 2023
PROSTHET ORTHOT INT

Background: Prefabricated orthotic insoles are widely commercially available for self-selection to treat foot and lower-body musculoskeletal pain, without requiring advice from health care professionals. Although they are generally designed to mimic traditional design features of custom-made orthotics used in clinical practice, the effects of prefabricated insoles on plantar pressure distribution are poorly understood. Objective: This investigation aimed to evaluate and directly compare the effects of a range of 6 different commercially available prefabricated orthotic insole designs on plantar pressure in healthy individuals. Methods: This was a single-center, randomized, open-label, crossover investigation. In-shoe dynamic pressure (F-scan) was investigated in 24 healthy subjects with normal foot posture, wearing standard shoes alone and in combination with 6 different orthotic insoles, consecutively, measured on a single day. The biomechanical impact of each insole was determined by the statistical significance of changes from baseline measurements (standard shoe alone). Results: Insoles with heel cups and medial arch geometries consistently increased contact area at medial arch and whole-foot regions and reduced both plantar peak pressure (PP) and pressure time integral at medial arch and heel regions. Conclusions: This investigation has aided in further understanding the mode of action of prefabricated insoles in a healthy population. The insoles in this study redistributed plantar pressure at key regions of the foot, based on design features common to prefabricated insoles. Prefabricated orthotic insoles represent an easily accessible means of reducing lower-body musculoskeletal stress for those who spend prolonged periods of time on their feet.

ASGE Guideline on the Role of Ergonomics for Prevention of Endoscopy-related Injury (ERI): Methodology and Review of Evidence

Article

May 2023
GASTROINTEST ENDOSC

The effect of anti-fatigue floor mat on pain and fatigue levels of surgical team members: A crossover study

Article

Mar 2023

As ergonomics is important to maintain comfort, this study aimed to examine the effect of anti-fatigue floor mats on pain and fatigue levels of surgical team members. Thirty-eight members participated in this crossover-designed study with no-mat and with-mat conditions, separated by a one-week washout period. They stood on the 15 mm thick rubber anti-fatigue floor mat and on the standard antistatic polyvinyl chloride flooring surface during the surgical procedures. Subjective ratings of pain and fatigue levels were measured pre and after-surgery for each experimental condition using the Visual Analogue Scale and Fatigue-Visual Analogue Scale scales. The after-surgery pain and fatigue levels for the with-mat condition were significantly lower than the no mat condition (p < .05). Consequently, anti-fatigue floor mats are effective in decreasing pain and fatigue levels of surgical team members during surgical procedures. Using anti-fatigue mats may be a practical and easy way to prevent discomfort that is often experienced by surgical teams.

The effects of biomechanical risk factors on musculoskeletal disorders among baggers in the supermarket industry

Article

Full-text available

Dec 2022
Work

Background: Baggers play a significant role in the customer service of supermarket stores. Objective: The purpose of this study was to determine the effects of biomechanical risk factors on musculoskeletal disorders (MSD) experienced by baggers in the supermarket industry. Methods: Forty baggers employed among five supermarket stores in the National Capital Region in the Philippines participated in the study. To examine the biomechanical risk factors of the baggers, this study used an observational approach as well as standard ergonomic tools like REBA and NIOSH. In addition, musculoskeletal discomfort was subjectively rated using the standardized Cornell Musculoskeletal Disorder Questionnaire at the end of the work shift. Furthermore, correlation and stepwise regression analysis were utilized to determine the association between biomechanical risk factors and MSD. Results: Approximately 76% of study participants reported work-related MSD. The highest prevalence was in the foot area, followed by upper back, shoulder, lower leg, lower back, neck, and upper arm. Pearson correlation analysis had found a significant association between MSD and biomechanical risk factors. The highest correlation was observed between MSD and postural risk index (R2 = 0.863, p < 0.001), followed by weight lifted (R2 = 0.836, p < 0.001), task duration (R2 = 0.816, p < 0.001), task frequency (R2 = 0.756, p < 0.001), and lifting index (R2 = 0.661, p < 0.001). Furthermore, stepwise regression analysis revealed that the postural risk index (REBA) had the highest coefficient value (β=16.99), indicating the strongest positive effect to MSD. Conclusion: This present study revealed that grocery baggers are frequently exposed to risk factors such as awkward posture, lifting heavy loads, extended task durations, and prolonged postures during repetitive tasks increased their risk of developing MSDs. Hence, preventive measures are suggested to minimize the risk of MSD, such as the implementation of intervention through ergonomic solutions like awareness and training on safe lifting practices, adjustment of workstations to fit the stature of workers, introducing rest breaks in between work shifts, use of floor mats, and use of compression stockings in conjunction with safety shoes.

Effects of Wearing the Rangers Type Combat Boots on the Soldier's Foot/ Effets du port de la chaussure militaire type Rangers sur le pied du soldat

Thesis

Sep 2022

INTRODUCTION : In the military environment, the function of the foot is constrained by the daily wearing of combat boots, a veritable orthopedic brace. A significant segment of the military population reports shoe-related foot disorders and pain, but there is little research evaluating the effects of military footwear on the development of these disorders, both internationally and in the Algerian context. The main objective of this work was to evaluate the effects of regular wearing of Rangers type military footwear on the soldier's foot, by studying the incidence of musculoskeletal and skin disorders affecting the ankle-foot complex during a 12-month follow-up period, and by comparing foot health status before and after wearing military footwear. SUBJECTS AND METHODS : This is a prospective study of the longitudinal type on a population of young male adults following their training in a military school in the south-east of Algeria. These new recruits were observed for a period of twelve months with regular wearing of Rangers type military footwear. This follow-up period extends from T0 to T12 knowing that T0 corresponds to the date of incorporation, and T12 corresponds to twelve months after the start of military training. During this period, we recorded all the cases consulting for a problem of the foot or the ankle, on a register created especially for this purpose. Foot status was analyzed at T0 and at T12 using three evaluation methods : clinical, podoscopic and functional. The footprint taken by the electronic podoscope was analyzed by calculating the Chippaux Smirak Index (CSI) and measuring the Alpha angle (α) of hallux valgus and the Beta angle (ß) of quintus varus of the two feet. To assess the functional impact, we opted for the use of the scale "Lower Extremity Functional Scale" in its Arabic version (LEFS-Ar). Furthermore, a comparative analysis before after wearing the shoe was carried out for the different parameters studied. RESULTS : 426 soldiers are participating in this study, of which 384 have completed all stages of the protocol. In this young adult population (mean age = 19.5 ± 0.89 years), the cumulative incidence of all foot and ankle disorders was estimated at 80.5%. The incidence of musculoskeletal disorders is higher than that of dermatological disorders (64.6% versus 38.5%). The main risk factors retained are footwear mismatch, obesity, lower limb misalignments, lower limb previous injuries, and anatomical shape of the foot. Abstract The comparison of foot statue before and after wearing combat boots (T0/T12) showed a significant upward trend in the prevalence of the majority of foot disorders. This difference concerns the musculoskeletal disorders such as hallux valgus, quintus varus, claw toes and overlapping toes, and the dermatological disorders such as corns, calluses, blisters, wounds, and onychodystrophies. Comparative analysis of the T0/T12 footprint indicates a significant increase in the CSI (p < 0.001), the Alpha angle (α) of hallux valgus on the left foot (p < 0.005), and the Beta angle (ß) quintus varus on both feet (p < 0.001). Regarding the evolution of the functional state from T0 to T12, we observe a very significant regression (p < 0.005) in the LEFS-Ar score. DISCUSSION & CONCLUSION: These results confirm that podiatric disorders remain fairly common among military personnel. Its frequency seems to worsen with the wearing of Rangers type military footwear. These epidemiological data, obtained in a completely original way, can help in the planning of future prevention interventions. Keywords: Military footwear, foot deformities, musculoskeletal disorders, footprint, Chippaux Smirak Index, Lower Extremity Functional Scale, Algeria

A Comfort Analysis of AR Glasses on Physical Load During Long-Term Wearing

Article

Nov 2022

The present study investigated the effect of the physical load of augmented reality (AR) glasses on subjective assessments for an extended duration of a video viewing task. Ninety-six subjects were recruited for this test and were divided by spectacle use, sex, age, and body mass index (BMI). Four glasses frame weights were assessed. To investigate their effectiveness, a novel prototype adopting three design interventions, (1) adjustable frame width, (2) ergonomic temples, and (3) fixed centre of gravity, was designed with regard to subjective discomfort ratings (nose, ear, and overall). Subjective discomfort in all regions was significantly increased with increasing physical load on the nose. In addition, non-spectacle users, women, older users, and participants in the middle BMI category reported higher discomfort than other groups. This finding could have important implications for the ergonomic design of AR glasses and could help to identify design considerations relevant to the emerging wearable display industry. Practitioner summary: This research aims to explore the influence of the physical load of augmented reality (AR) glasses. It found that discomfort was increased with added nose load. Non-spectacle users, women, older users, and participants in the middle BMI category were more sensitive to discomfort. The results have important implications for glasses-type wearables’ design.

بررسی‬ ‫ت‬ ‫أ‬ ‫ثیر‬ ‫بر‬ ‫ارگونومیک‬ ‫کفپوش‬ ‫در‬ ‫پایی‬ ‫کف‬ ‫فشار‬ ‫توزیع‬ ‫مدت‬ ‫طوالنی‬ ‫ایستادن

Article

Full-text available

Jan 2021

Zahra Rahimi Khalifeh Kandi

Knee Pain Reduction Using a Shock-Absorbing Sole

Article

Mar 2022

Background: The biomechanics of the foot and leg are responsible for shock absorption during human gait. Lack of shock absorption is known to be a key component of knee pain. This study compares a new model of shoe sole with a built-in modification intended to absorb shock with a traditional sole shoe to examine whether shoe design modifications can help alleviate knee pain. Methods: A double-blind randomized controlled study was performed. Fifty-two adults with overuse symptoms of knee pain, either unilateral or bilateral, were enrolled and randomly assigned to use the intervention sole or the traditional sole shoes. For 5 weeks, participants wore either the shoe with the intervention sole or the shoe with the traditional sole, rating their knee pain on a 10-point visual analog scale at study onset, midway, and study completion. Results: After 5 weeks, participants using the intervention sole shoe reported an average reduction in knee pain of 85%, significantly better than participants using the traditional sole shoe ( P < .001), whose average pain scores increased. Positive effects on back and foot pain were also observed in those with the intervention sole shoe compared with the traditional sole shoe. Conclusions: The intervention shock-absorbing sole represents an approach to midsole and outsole construction that can potentially increase shock absorption and decrease knee pain during prolonged standing and walking.

Ergonomic Evaluation of Working Conditions in Orthotists and Prosthetists by Rapid Entire Body Assessment (REBA)

Article

Full-text available

Dec 2021

Background and Objectives: This study aimed to determine the prevalence rate of musculoskeletal disorders and evaluate the body position in routine tasks among orthotists and prosthetists. Methods: Forty orthotists and prosthetists were included. The scores of the Nordic Musculoskeletal Questionnaire and the Rapid Entire Body Assessment were used to determine the prevalence rate of musculoskeletal disorders and analyze the work position of orthotists and prosthetists, respectively. An examiner evaluated 10 working postures that were dominantly used every day, in each orthotist and prosthetist. Results: Among the orthotists, 55.6% of men and 47% of women suffered from pain in the trunk, neck, and lower limbs. Nearly similar results were seen in the upper limbs (74.1% men and 45.5% women). Such high prevalence rates were not seen in prosthetists. The analysis of the Rapid Entire Body Assessment scores based on the working task and gender of the orthotist and prosthetist showed that more than 60% of the workers achieved a score of 4 to 7 approximately in half of the tasks. It shows the medium risk of musculoskeletal disorders, thus, corrective action is necessary. Conclusion: Based on the findings, musculoskeletal disorders are highly prevalent among orthotists and prosthetists, especially in the orthotist workers. To reduce these disorders, it is recommended to add ergonomic topics and training courses for working with devices to increase the knowledge of specialists and apply and select practical tools based on the principles of ergonomics.

Anti-fatigue mats can reduce low back discomfort in transient pain developers

Article

Apr 2022
APPL ERGON

Complaints of musculoskeletal pain are common among employees who stand for prolonged periods. This study sought to determine if an anti-fatigue mat (AFM) could uniquely affect low back pain (LBP), low back posture, and foot-floor interface responses in individuals prone to developing LBP (termed pain developers (PDs)) during prolonged standing experiments compared to those who do not develop LBP under the same exposures (termed non pain developers (NPDs)). Sixteen volunteers (8 PDs and 8 NPDs) were recruited based on their pain-development tendencies, which were established in previous standing experiments. They visited the laboratory on two separate days for 60 min of light manual work while standing on either a rigid floor or AFM. All participants were asymptomatic at the beginning of each experimental session. The amount of LBP experienced during the standing exposure, measured via a visual analogue scale, was reduced (p = 0.03) in the PD group when on the AFM (3.6 ± 6 mm) compared to the rigid floor (6.8 ± 7 mm). LBP levels remained low and unchanged (p = 0.5) between the AFM (2.4 ± 5 mm) and rigid floor (1.6 ± 2 mm) conditions for the NPD group. Neither postural nor foot-floor interface measures correlated with this unique reduction of LBP for the PD group when standing on the AFM. The AFM did, however, increase centre of pressure excursion (NPD 55% increase; PD 35% increase) and tended to increase the number of body weight shifts (NPD 116% increase; PD 54% increase) in both the PD and NPD groups. These findings suggest that AFMs may selectively benefit individuals prone to developing standing-induced back pain by facilitating subtle movements at the foot-floor interface.

Investigation of the effect of ergonomic flooring on the distribution of foot pressure in long standing

Article

Nov 2021

Mohamad Sadegh Ghasemi

Quality improvement study into the effectiveness of the semi-custom, prefabricated shoe insert program (Quadrastep System) at reducing complaints of discomfort in an industrial setting.:

Article

Sep 2021

A common source of reduced productivity and lost work time in the industrial setting is musculoskeletal discomfort in the feet, knees, hips, and low back. Even when working identical job posts, these symptoms can vary widely between employees, and could potentially be caused by intrinsic foot biomechanics coupled with long-term standing activities. Therefore, to prevent injury and reduce daily discomfort, onesize-fits-all approaches such as anti-fatigue mats or off-the-shelf shoe insoles may be less effective than treating each employee’s specific biomechanical traits. The Quadrastep System is a prefabricated, semi-custom shoe insert system that bridges the gap between more expensive, fully customized orthotics and off-the-shelf options. We studied the effectiveness of the system in a large manufacturing plant by assessing and providing Quadrastep inserts to 28 volunteers. After 2 months of daily wear, 94% of these volunteers said they received some benefit from the inserts, while 52% reported full resolution of daily symptoms.

Muscle Fatigue Analysis During Welding Tasks Using sEMG and Recurrence Quantification Analysis

Article

Full-text available

Jan 2021

The main goal of this study was to detect muscle fatigue and to identify muscles vulnerable to musculoskeletal disorders by evaluating muscle activation of subjects during welding tasks. In this study, six subjects performed two different welding tasks for a total of three hours. Surface electromyography (sEMG) was used to record the muscle activation of sixteen different muscles. Recurrence Quantification Analysis (RQA) was then used to analyze the EMG data. In addition, a subjective fatigue assessment was conducted to draw comparisons with the RQA results. According to the RQA results, twelve of the tested muscles experienced fatigue by showing significant difference in RQA values (p-value < 0.05) between the first and last 10 minutes of the experiment. Moreover, time-to-fatigue results obtained from RQA and subjective analysis were closely correlated for seven muscle groups. This study showed that RQA can be used in ergonomic studies for evaluating muscle activation during construction tasks. Full Text: https://www.igi-global.com/pdf.aspx?tid=287609&ptid=254314&ctid=4&oa=true&isxn=9781799862345

Investigation of the effect of ergonomic flooring on the distribution of foot pressure in long standing

Article

Full-text available

Sep 2021

Introduction: Many occupations require prolonged standing during exercise, which is one of the most important causes of musculoskeletal disorders, causing pain and discomfort in the back, lower limbs, and especially the soles of the feet, resulting in improper distribution of pressure in the soles of the feet. Epidemiological studies also show a strong association between prolonged standing and pressure on the lower back and lower limbs. One of the ergonomic solutions to reduce the problems caused by long-standing activities is to correct the surface under the fee. Therefore, this study investigates the effect of ergonomic flooring and conventional flooring on the distribution of foot pressure in healthy individuals; based on that, the effect of using ergonomic flooring in comparison with conventional flooring, more appropriate distribution, and reduction of pressure in the sole can be determined. Materials and Methods: This descriptive-analytical study was performed on 16 students with a mean age of 27.87±7.31 and a body mass index of 24.15±4.31. According to previous comparative studies and data analysis obtained from pilot samples, by considering the 95% confidence interval, the samples were determined by the convenience sampling method. Each participant was measured at eight anatomical points for one hour at two different surfaces of ergonomic and ordinary floor. Foot pressure distribution using a pedar-x device while the volunteers were barefoot. Data were analyzed by paired t-test and Wilcoxon using SPSS software. Results: This study showed that the ergonomic flooring significantly reduced the mean pressure on the plantar pressure (p≤0.001). Also, there is a significant difference in the mean pressure of left and right legs in different anatomical points when using ordinary surfaces and flooring (p≤0.001). Conclusion: There is a difference between the distribution of plantar pressure in ergonomic flooring and conventional flooring. Ergonomic flooring has better distribution than the ground and reduces the pressure on the sole during static activities.

Enhancing occupational safety in the X-ray laboratory

Article

Aug 2021
Coron Artery Dis

Despite more than 80% of interventional operators reporting one or more orthopedic injuries attributed to the X-ray laboratory, there has been limited adoption of various strategies and equipment to minimize these injuries. A comprehensive review of these methods to reduce musculoskeletal strain is lacking in the current literature, and is essential in order to ensure a long, healthy, and productive interventional career.

Ergonomics of Endoscopy

Article

Jul 2021
Gastrointest Endosc Clin

Optimal endoscopic operations incorporate ergonomic principles into the endoscopy environment benefiting endoscopists, endoscopy unit personnel, and patients. A high prevalence of occupational musculoskeletal injuries is well established among endoscopists and gastroenterology nurses. Ergonomics can be integrated into all facets of the endoscopy unit including scheduling, endoscopy unit design, training programs, and investment in technology. Preprocedure, intraprocedure, and postprocedure areas should aim to deliver patient safety, privacy, and comfort, while also supporting endoscopists and staff with adjustable rooms and effective work flows. Team-wide educational initiatives can improve ergonomic awareness. These strategies help mitigate risks for musculoskeletal injuries and can lead to increased productivity. The COVID-19 area brings novel challenges to endoscopy.

Ergonomics in IR

Article

Dec 2020
J VASC INTERV RADIOL

Ergonomic research in the field of interventional radiology remains limited. Existing literature suggests that operators are at increased risk for work-related musculoskeletal disorders related to the use of lead garments and incomplete knowledge of ergonomic principles. Data from existing surgical literature suggest that musculoskeletal disorders may contribute to physician burnout and female operators are at a higher risk of developing musculoskeletal disorders. This review article aims to summarize the existing ergonomic challenges faced by interventional radiologists, reiterate existing solutions to these challenges, and highlight the need for further ergonomic research in multiple areas, including burnout and gender.

Footrest intervention: Association between prolonged standing and perceived exertion in the body parts among industrial workers using Borg's scale questionnaire

Article

Mar 2020
INT J IND ERGONOM

Health Considerations for the HQHVSN Surgeon

Chapter

Dec 2019

Sara White

High‐quality high‐volume spay–neuter (HQHVSN) and shelter surgery can be rewarding, but at times it can also be physically, emotionally, and mentally challenging. Health and wellbeing are important not only for surgeons’ quality of life, but also for their longevity in the field of HQHVSN, and the quality of patient care that they can provide. This chapter discusses general safety, physical ergonomics, and mental health, stress, and wellbeing, and provides information on how to minimize associated risks for surgeons and staff. There are numerous hazards associated with animal care and surgical workplaces, and excellent resources are available that describe these hazards and provide precautionary measures to minimize their harm. These hazards may be chemical (waste anesthetic gases, disinfectants), biologic (zoonoses, allergies), or physical (patient handling concerns, equipment malfunction, sharps injuries). Because of the ready availability of these resources, discussion of general safety in the chapter is limited to waste anesthetic gas exposure and animal handling safety.

Design and Preliminary Experimentation of Passive Weight-Support Exoskeleton *

Conference Paper

Aug 2018

Part I: How to Ergonomically Design a Modern Endoscopic Suite

Article

Jul 2019
Tech Gastrointest Endosc

The endoscopy suite is the central hub of activity where most gastroenterologists spend a majority of their time in clinical practice. With the evolution of more complex diagnostic and therapeutic procedures, an ergonomically designed and dedicated gastrointestinal endoscopic unit is not only desirable but a necessity. Such a unit will ensure optimal workflow efficiency and throughput, as well as both patient and physician safety. It is important to plan meticulously upfront by seeking input from all stakeholders including engineers, physicians, nurses, technicians and architects. This will ensure a highly desirable work environment including procedural areas and the scope cleaning/sterilization section while optimizing patient and instrument flow. The procedure room should be ergonomically designed to allow for adjustability and optimize utilization of space for endoscopists, technicians, nurses, anesthesiologists, and trainees as well as the equipment required to perform the endoscopic procedures. This article provides practical tips on how to plan and develop an endoscopy suite, taking into consideration ergonomic and regulatory aspects, and is based on real life experience with designing a modern gastroenterology procedural suite.

Failure of an Engineered System: The Gastrointestinal Endoscope

Article

Apr 2019
Tech Gastrointest Endosc

Advances in endoscopic technology continue to expand the field of gastrointestinal endoscopy. However, there have been no parallel advances in general endoscope design, and gastroenterologists are at risk for musculoskeletal repetitive strain injury due to the repetition, high forces and prolonged, awkward postures required to perform endoscopy. The current endoscope design lacks a consideration of human factors, and due to the high risk of injury, represents a failure of an engineered system. This review will focus on a risk assessment and management strategy for the gastrointestinal endoscope. Risk assessment is the identification of potential flaws in the system. Risk management describes the steps taken to mitigate these flaws. Three different approaches to risk assessment and management, proactive, reactive, and interactive risk assessment and management, will be reviewed as they apply to the performance of gastrointestinal endoscopy.

THE EFFECTS OF FLOOR TYPES ON STANDING TOLERANCE IN INDUSTRY

Article

Full-text available

Influence of Flooring on Standing Fatigue

Article

Full-text available

Sep 1995

This study investigated effects of flooring on perceived tiredness, fatigue, and discomfort for workers required to stand while performing their jobs. Eight flooring conditions of varying thickness and stiffness (including one shoe insert) were evaluated by workers who answered a questionnaire. Questions were asked regarding whole-body tiredness. leg fatigue. and discomfort. Flooring had a significant effect on workers' perception. In general softer materials caused less perceived tiredness; however, one extremely soft floor resulted in higher ratings of tiredness. Similar results were found for material thickness. The shoe insert condition showed low tiredness ratings as compared with most floors, including one made of the same material. The discomfort ratings indicated that harder flooring materials caused greater discomfort. Discomfort of the lower extremities tended to decrease as distance from the floor increased. Low back discomfort was found for hard flooring surfaces.

Influence of Artificial Shock Absorbers on Human Gait

Article

Full-text available

Nov 1981

The effect of artificial shock absorbers on the human gait and the technique for its quantitative evaluation have been studied. The results obtained have shown that viscoelastic inserts reduced the amplitude of the incoming shock waves bearing upon the musculoskeletal system as a result of the heel strike, by 42 percent (mean value). Conservative treatment, using such inserts for patients with different clinical symptoms of degenerative joint diseases, has shown excellent results. Seventy-eight percent of the clinical symptoms disappeared, while satisfactory improvement was reported in 17 percent of the subjects.

Biomechanical risk factors for occupational related low back disorders

Article

Full-text available

Mar 1995

A continuing challenge for ergonomists has been to determine quantitatively the types of trunk motion and how much trunk motion contributes to the risk of occupationally-related low back disorder (LBD). It has been difficult to include this motion information in workplace assessments since the speed at which trunk motion becomes dangerous has not been determined. An in vivo study was performed to assess the contribution of three-dimensional dynamic trunk motions to the risk of LBD during occupational lifting in industry. Over 400 industrial lifting jobs were studied in 48 varied industries. The medical records in these industries were examined so that specific jobs historically categorized as either low, medium, or high risk for occupationally-related LBD could be identified. A tri-axial electrogoniometer was worn by workers and documented the three-dimensional angular position, velocity, and acceleration characteristics of the lumbar spine while workers worked at these low, medium, or high risk jobs. Workplace and individual characteristics were also documented for each of the repetitive lifting tasks. A multiple logistic regression model indicated that a combination of five trunk motion and workplace factors predicted well both medium risk and high risk occupational-related LBD. These factors included lifting frequency, load moment, trunk lateral velocity, trunk twisting velocity, and trunk sagittal angle. Increases in the magnitude of these factors significantly increased the risk of LBD. The analyses have enabled us to determine the LBD risk associated with combined changes in the magnitudes of the five factors. The results indicate that by suitably varying these five factors observed during the lift collectively, the odds of high risk group membership may decrease by over ten times. These results were related to the biomechanical, ergonomic, and epidemiologic literature. The five trunk motion and workplace factors could be used as quantitative, objective measures to redesign the workplace so that the risk of occupationally-related LBD is minimized.

Occupational risk factors associated with soft tissue disorders of the shoulder: A review of recent investigations in the literature

Article

Full-text available

Jul 1993

Cumulative trauma illness currently accounts for over half of all occupational illness in the United States. From 1987 to 1989 there was a 100% increase in the reported number of cases of cumulative trauma illness (Bureau of Labor Statistics 1990). Shoulder region pain ranks second only to low back and neck pain in clinical frequency, and the occurrence of occupational shoulder illness is on the rise. This paper summarizes findings of a subset of recent epidemiologic, laboratory, and field studies conducted in order to identify occupational risk factors for cumulative trauma disorders (CTDs) of the shoulder region. These studies have identified the following risk factors as being associated with particular shoulder pain syndromes: awkward or static postures, heavy work, direct load bearing, repetitive arm movements, working with hands above shoulder height, and lack of rest. The paper begins with a discussion of several shoulder disorders, includes problems in studying cumulative trauma, presents results of recent studies, and concludes with suggested ergonomic controls that could help to reduce the incidence of shoulder disorders, by eliminating or reducing exposure to the associated risk factors.

The Influence of Anti-Fatigue Mats on Back and Leg Fatigue

Article

Oct 1993

Prolonged standing is common in many industrial workplaces. It is also quite common for workers to complain of discomfort in the back and legs as a result of prolonged standing. Mats are often provided for the worker to relieve this fatigue. However, there is no quantitative evidence that these mats relieve leg and back fatigue. Five subjects were asked to stand on a concrete surface and two mat surfaces for prolonged periods of time. Spectral electromyo-graphic (EMG) analyses indicated that mats reduce localized muscle fatigue in the erector spinae muscle only. Furthermore, this fatigue reduction occurred only with the more com-pressible of the two mats tested. These results imply mat localized muscular fatigue in the leg may not be relieved with “anti-fatigue” mats and some of these mats only benefit the back.

An Evaluation of Floor Surfaces

Article

Oct 1989
Proc Hum Factors Ergon Soc Annu Meet

Three floor surfaces (concrete, a San-EZE-7/8″ thick resilient rubber mat, and a Traction Mat-3/8″ rubber mat with raised knob design) were evaluated based on foot dimensions, lower leg and foot temperature and body comfort. Nine college students (2 females) stood for one hour on each of the floor types performing two types of visual inspection: inspecting pennies for a particular year, and inspecting pennies for several years at a time. There was a significant difference in body comfort between floor surfaces. Both mats were better than concrete (although not always statistically significantly so). The Traction mat was better for upper, mid and lower back comfort; the San-EZE mat was better for lower leg, ankle, hindfoot and forefoot. The temperature of the calf and instep was significantly higher for both mats than for concrete.

Low back muscle reactions to constrained standing in relation to shock absorbing properties of floor and shoes

Article

Jan 1993

Musculo-skeletal disorders (and discomfort) and associated work factors

Article

Jan 1986

Floor Mats

Article

Oct 1990
Proc Hum Factors Ergon Soc Annu Meet

During standing work, some surfaces are better than others. This study is a continuation of our previous study (Rys and Konz, 1989a). In Experiment 1 we evaluated responses of standing on concrete, on a “Footsaver” mat, a San-Eze II mat and an Optimat mat. The 20 subjects stood for 1.5 h on each of the four mats. The criteria were: foot length, width, circumference, forefoot thickness, skin instep and calf temperature. The comfort criteria were a modification of Corlett and Bishop's scale. Based on those criteria all three mats were significantly more comfortable than concrete. Comfort seems to be inversely related to mat compressibility. In Experiment 2 we investigated the relationship of abdominal endurance and lumbar flexibility to fatigue and discomfort during a simple standing task. Twelve male subjects were tested for physical characteristics. Height, limb length discrepancies, abdominal strength, and flexibility were the best predictors of comfort during 2 h standing work. Higher foot and leg temperature and lower heart rate corresponded to higher productivity.

Standing Work: Carpet vs. Concrete

Article

Oct 1988
Proc Hum Factors Ergon Soc Annu Meet

A significant part of the workforce works with the feet and legs in a relatively static standing position. In an experiment, 20 college students (mean age = 23) stood wearing 2 pairs of socks but no shoes at a table for 240 minutes (120 minutes on carpet on one day and 120 minutes on concrete on another day). Ten subjects stood in the morning and 10 in the afternoon. Foot volume and instep vertical and horizontal circumference and calf circumference did not differ significantly between morning and afternoon or between carpet and concrete. Heart rate did not differ between morning and afternoon but the 95.2 for carpet was significantly lower than the 100.1 for concrete. Perceived comfort ratings were higher for carpet than concrete. Body areas in which comfort decreased the most while on concrete were: lower leg, upper leg, ankle, whole foot, the neck and the shoulder. When the individual factors were combined into a single factor using factor analysis, the 77.7 score (0–100 scale) for carpet was significantly better than the 71.9 for concrete.

Subjective, physiological and biomechanical responses to prolonged manual work performed standing on hard and soft surfaces

Article

Dec 1997
Eur J Appl Physiol Occup Physiol

The aim of this laboratory study was to examine the subjective, physiological and biomechanical responses to prolonged light repetitive manual work during standing on soft (polyurethane standard mat) and hard (aluminum casting) surfaces. The subjects stood on the hard (10 subjects) and on the soft surfaces (11 subjects) for 2 h. Intensity of unpleasantness, shank circumference, electromyograph (EMG) activities from the right soleus and tibialis anterior muscles, mean amplitude and total angular displacement around the left and right ankle in the saggital plane, centre of pressure (CoP) displacement in the frontal and saggital planes, calf surface temperature, and pain intensity in experimentally induced muscle pain were recorded. Maximal voluntary contraction and fatigue tests were performed before and after the 2 h experiment. Standing on a soft surface caused a lower intensity of unpleasantness. During standing on a hard surface compared to a soft one the results showed an enhanced swelling of the shank, an increased EMG activity (right soleus muscle) of the lower leg, a greater amplitude and total angular displacement, and a larger CoP displacement in the frontal plane. Indications of more pronounced muscle fatigue while standing on the hard surface were also noticed. After 105 min, experimental muscle pain was elicited by injecting hypertonic saline. The intensity of the induced pain was lower when standing on the soft surface. Amplitude, angular distance and CoP displacement showed a tendency to be greater after injection of the hypertonic saline. It was found that the experimentally induced pain influenced postural activity, underlining central interactions between proprioceptors and nociceptors. The results highlighted a higher feeling of comfort when standing on the soft surface. In addition, postural activity was lower when standing on the soft surface, but the activity was sufficient to prevent swelling of the lower legs.

Arbeitsbedingungen und gesundheitliches Befinden aus der Sicht der Erwerbst�tigen

Article

Mar 1993

Josef Buchberger

In the present study details about disruptive factors in working conditions, elements injurious to health or general well-being, personal attitudes to work etc. have been obtained by means of a representative survey of about 2000 employed persons in Switzerland. The most frequent disruptive factors in working conditions (>30%) are noise and too little time for family and friends. A relatively large number of employed persons (20-25%) complain about unsatisfactory ventilation, air pollution due to dust, smoke etc., draughts, uncomfortable temperature, dry air, lifting and carrying heavy weights, uncomfortable body positions at work, unsuitable working hours, as well as pressure on time, too much concentration required, pressure of responsibility, insufficient recognition and lack of information about the planning and results of work being done. In the field of health complaints, back problems and nervous tension are at the top of the list (39%), followed by fatigue, sleeping problems, neck or leg problems, burning eyes, and stomach and intestinal problems (25-34%). The analysis shows that interrelationships exist - sometimes in the sense of a vicious circle-between complaints about disruptive factors in work conditions, professional groups, health problems and attitudes to professional live. The results provide a comprehensive survey of the incidence of problems in the fields of worker protection.

The effects of mats on back and leg fatigue

Article

Feb 1994
APPL ERGON

Prolonged standing is common in many industrial workplaces. It is also quite common for workers to complain of discomfort in the back and legs as a result of prolonged standing. Mats are often provided for the worker to relieve this fatigue. However, there is no quantitative evidence that these mats relieve leg and back fatigue. Five subjects were asked to stand on a concrete surface and two mat surfaces for prolonged periods of time. Spectral electromyographic analyses indicated that mats reduced localized muscle fatigue in the erector spinae muscle only. Furthermore, this fatigue reduction occurred only with the more compressible of the two mats tested. These results imply that localized muscular fatigue in the leg may not be relieved with ‘anti-fatigue’ mats, and some of these mats only benefit the back.

Constrained standing: Evaluating the foot/floor interface

Article

Feb 1991

A methodological study was conducted to provide a multivariate evaluation of the foot/floor interface in constrained standing. Measures of body movement (from force platform and video recording), leg muscle EMGs, reported exertion/discomfort and task performance were taken during a two-hour task. Factor Analysis showed four major factors named Body Movement, Muscle Contraction, Perceived Fatigue and Task Errors. Most measures showed strong effects of time on task (Period Effect), indicating cumulative fatigue. Hard-soled shoes where marginally worse than soft soled shoes on a number of measures. Mat thickness had little effect. To test the methodology a commercial mat was evaluated in a separate experiment. Strong period effects were again obtained, but again the mat had little effect on any measures. Implications for a measurement methodology are discussed

The Prevalence of musculo-sketal symptoms in supermarket workers

Article

May 1989

G. Anthony Ryan

The Victorian Branch of the Shop Distributive and Allied Employees Association became concerned in 1985 by the large number of cases of musculo-skeletal symptoms being reported by members working in food and grocery supermarkets. With the support of the Victorian Occupational Health and Safety Commission a survey was carried out which was aimed at determining the prevalence of such symptoms, and identifying associated factors. A questionnaire designed to establish the presence of musculo-skeletal symptoms was administered to all employees of seven supermarkets ranging in size from 15 to 171 employees, with a response rate of 73%. The staff of supermarkets were predominantly young, female and transient. One-third reported regular symptoms in some part of their body. Prevalence rates were calculated for body area and department. The checkout department had the highest rates for almost all body areas. The lower back, lower limbs and feet were the body areas with the highest rates. Postures and activities of a sample of job categories in each department were sampled at 10 s intervals for periods of 30 min for a total of 1000 observations for each department. A positive and significant correlation was found between proportion of time spent standing and symptoms in the lower limb and foot, especially in the checkout department where 90% of the time was spent standing in one place. It was concluded that there was an excess of symptoms appearing in checkout operators, and therefore, the operating methods of the checkout department warrant revision.

Shoe Insoles in the Workplace

Article

Mar 1988

Ninety-six women participated in a crossover study to evaluate the effectiveness of viscoelastic polyurethane insoles in reducing back, leg, and foot pain among adults who spend the majority of each work day standing. Twenty-five of the subjects reported that the insoles made their shoes too tight to be comfortable. The remainder, however, found the insoles very comfortable (P less than .002, Wilcoxon, signed-rank test) and reported significant reductions in back pain (P less than .02), foot pain (P less than .03), and leg pain (P less than .007). When these subjects were asked whether they would prefer to wear their shoes alone or with insoles, the preference for insoles was overwhelming (P less than .007, back; P less than .03, leg; and P less than .009, foot pain). It is concluded that viscoelastic insoles can effectively improve comfort and reduce back, leg, and foot pain in individuals who must stand throughout the day.

Low back pain: Conservative treatment with artificial shock absorbers

Article

Apr 1985
ARCH PHYS MED REHAB

A new method of conservative treatment for low back pain (LBP) was studied by follow-up investigation of 382 patients during the last five years. The attempt to reduce repetitive impulsive intervertebral impact in the troublesome S1-L5-4 area by significant improvement of the foot's attenuational capacity through artificial viscoelastic shock absorbing was prompted by the authors' work on decreased capability of LBP spines to attenuate axially propagated walking stresses. Viscoelastic shoe inserts were used in addition to light flexible shoes as artificial shock absorbing devices. Maximal amplitudes of bone oscillation during walking were reduced by about 40% by the viscoelastic inserts. Rapid and surprisingly significant improvement of pain syndrome and patient mobility occurred in about 80% of the patients. The accelerographic patterns recorded on a sacrum of patient with LBP were unusual for a healthy subject; they usually disappeared after treatment in LBP cases. Results suggested that poor walking impact attenuation was a true cause for prolonging intervertebral structures overstrain and consequent degeneration. It seemed logical that as spine damage could be explained primarily by prolonged impulsive overstrain, treatment must include viscoelastic inserts which increase foot shock absorbing capacity and help cushion the spine.

Hypotheses of peripheral and central mechanisms underlying oc- cupational muscle pain and injury

Article

Feb 1988
Eur J Appl Physiol Occup Physiol

Richard H. T. Edwards

In an overview of the problem of occupational muscle pain the evidence indicates that injury is more common the greater the load and the worse the posture in which the work is performed. The commonest are backstrains or ligament or joint damage due to overuse. Fatigue is associated with alterations in energy metabolites in muscle while pain is often due to microscopical damage to the cellular architecture. The progress of pathological changes in muscle following occupational injury may be similar to those seen in primary fibromyalgia (fibrositis) because of a final common pathway involving calcium-induced secondary damage. Occupational muscle pain frequently occurs in the muscles supporting the upper limb girdle and head in workers engaged in repetitively performing skilled manipulations or activities requiring high or sustained mental concentration. It is suggested that both occupational myalgia of this kind may be due to an imbalance in the use of muscles for postural activity (holding or supporting fine movements) compared to phasic use in dynamic work. While there are undoubtedly muscular indications of damage these may be secondary to alterations in (unconscious) central motor control mechanisms.

Evaluation of foot swelling and lower-limb temperatures in relation to leg activity during long-term seated office work

Article

Mar 1986

Seven healthy females were studied during three experimental days, each comprising 8 hours of seated office work at different well-defined levels of leg activity. The mean foot swelling was 4·8% in the case of no leg activity (‘inactive sitting’), 2·3% when the legs were moved freely (‘ semi-active sitting’) and 0·8% at the highest activity level (‘active sitting’). The activity of the soleus muscle was evaluated by EMG and discussed in relation to the function of the musculovenous pump. The decrease in skin temperature (Tsk) of the foot and lower leg was completed after half the working day, and on average it was 4·6°C/2·8°C (foot) and 3·3°C/l·6°C (lower leg) during ‘inactive sitting’/‘active sitting’. The mean temperature in the flexor hallucis longus muscle (Tm) decreased by 3·7°C during the 8 hours of ‘inactive sitting’, but was almost constant during ‘active sitting’. The discomfort of the lower leg and foot was significantly correlated to foot swelling and Tm, but not to Tsk. The mean heart rate was highest during ‘inactive sitting’.The results indicate that it is possible to reduce physiological and discomfort problems in the lower legs and feet during prolonged sedentary work by introducing modest leg activity as a natural part of the seated work.

Effect of viscoelastic insoles on pain

Article

Sep 1987

The purpose of this study was to assess the effect of viscoelastic shoe inserts on pain in nursing students. Students (N = 100) were randomly assigned to control and viscoelastic groups. The viscoelastic group used viscoelastic insoles in their work shoes for five weeks. A pain questionnaire was used to measure location and intensity of post-work pain. The questionnaire was administered as a pre-test and after five weeks. Post-test comparisons between groups indicated significant differences which were not present at pre-test. The viscoelastic group reported a significant peripheral shift in pain location from back to lower extremity; the viscoelastic group also showed significant changes in duration of post-work pain and frequency of pain during the workday. The clinical efficacy of viscoelastic shoe inserts for modifying weight bearing-induced back pain is supported. Further clinical research into the therapeutic and prophylactic value of shock-attenuating shoe inserts for healthy as well as patient populations is advocated.

Assessment of some shock absorbing insoles

Article

May 1986

Due to the increase in prescription of insoles to relieve symptoms due to skeletal shocks at heel strike a pilot study was initiated to look at some materials used for this purpose. Five materials were examined (Plastazote, Spenco, Sorbothane, Poron (PPT) and Viscolas) by two methods. The first method used an accelerometer mounted between the teeth of one of the authors (PR) to record skeletal shock. The second method used a force plate to record the shock produced by dropping a ball-bearing onto the insoles from a standard height. The results showed that Plastazote is poor at absorbing shock with Spenco and Sorbothane being quite good. The best insole materials tested were Poron (PPT) and Viscolas with the latter being marginally superior. No account was taken of degradation of the materials in use except that Plastazote worn for 72 hours was also used in the study, this producing the worst results.

Risk of back trouble in individual occupations in Denmark

Article

Feb 1985

Fin Biering-Sørensen

National accident statistics showed overstraining to be the major cause for back injuries, and that trauma, in particular falls, included nearly all other accidents affecting the back and spine. Hospital-work, home nursing and patient treatment together constituted not less than 42% of all the notified back injuries caused by overstraining. It was found that the frequency of low back complaints is high among plumbers, slaughterhouse workers, forklift truck-drivers as well as hospital porters, nurses and assistant nurses. Housewives had as much low back trouble as women in work generally.

Enhanced Venous Pump Activity as a Result of Standing on a Varied Terrain Floor Surface

Article

Jun 1970
J Occup Med

Compression testing of foamed plastics and rubbers for use as orthotic shoe insoles

Article

May 1982

Thirty-one materials have been tested in compression in order to generate the stress (force per unit of cross-sectional area) versus strain (deformation) behaviour, for the purpose of assessing the suitability of various foamed plastics and rubbers as shoe insole materials. It was found that the materials could be classified into three distinct categories (very stiff, moderately deformable and very deformable) according to the shape of the characteristic stress versus strain curve. The moderately deformable group has been selected as the most promising for clinical application.

Influences on the ??-muscle spindle system from muscle afferents stimulated by increased intramuscular concentrations of bradykinin and 5-HT

Article

Jul 1995
NEUROSCI RES

There is evidence that static muscular contractions induce a release of bradykinin (BK) in the working muscle, and that increased concentration of BK and 5-HT in a muscle increases the discharge rate of a subpopulation of group III and group IV muscular afferents. It is also known that activity in group III and IV muscle afferents may activate gamma-motoneurones to both homonymous and heteronymous muscles. The aim of the present study was to investigate whether increased concentration of BK and 5-HT in one muscle may influence the activity in primary and secondary muscle spindle afferents (MSAs) from the chemically affected muscle and from surrounding muscles, via fusimotor reflexes. The experiments were made on six cats anaesthetised with alpha-chloralose. The triceps surae (GS) and the posterior biceps and semitendinosus (PBSt) muscles were subjected to sinusoidal stretches. Simultaneous recordings of 2-11 MSAs from these muscles were made and the mean rate of firing and the modulation for each MSA were determined. Responses of 47 MSAs (26 PBSt and 21 GS) were recorded. The responsiveness of the MSAs to injections of BK (9-100 mg/ml, 0.5-1.0 ml) and 5-HT (25-150 mg/ml, 0.5-1.0 ml) was 89% and 83%, respectively, for injections into the arterial supply of the ipsilateral GS muscle, and 84% and 40% respectively for injections to the contralateral GS muscle. Of 10 secondarŁy MSAs, only one was unresponsive to BK injections, while several MSAs responded to both ipsilateral and contralateral BK injections.(ABSTRACT TRUNCATED AT 250 WORDS)

Influences on the ??-muscle-spindle system from muscle afferents stimulated by increased intramuscular concentrations of arachidonic acid

Article

Dec 1994
BRAIN RES

There is evidence that static muscular contractions induce a release of arachidonic acid (AA) in the working muscle and that increased concentration of AA in a muscle increases the discharge rate of a subpopulation of groups III and IV muscular afferents. It is also known that activity in groups III and IV muscle afferents may activate gamma-motoneurones to both homo- and heteronymous muscles. The aim of the present study was to investigate if increased concentration of AA in one muscle may influence the activity in primary and secondary muscle spindle afferents (MSAs) from the chemically affected muscle and from surrounding muscles, via fusimotor reflexes. The experiments were made on five cats anaesthetized with alpha-chloralose. The triceps surae (GS) and the posterior biceps and semitendinosus (PBSt) muscles were subjected to sinusoidal stretches. Simultaneous recordings of 2-12 MSAs from these muscles were made and the mean rate of firing and the modulation for each MSA were determined. Responses of 36 MSAs (17 PBSt and 19 GS) were recorded. The responsiveness of the MSAs to injections of AA (0.3-1.0 mg; 0.3-1 ml) was 86% (n = 36) for injections into the arterial supply of the ipsilateral GS muscle and 45% (n = 20) for injections to the contralateral GS muscle. Out of 14 secondary MSAs, only one was unresponsive to ipsilateral AA injections while two of eight were unresponsive to contralateral AA injection. The majority of responses were compatible with predominantly static or mixed dynamic and static fusimotor activation. None of the effects were compatible with inhibition of fusimotor activity. The duration of the effects were usually 2-4 min. However, on some occasions the elevations in MSA activity persisted for up to 1 h. Local anaesthesia of the nerve to the injected muscle always abolished the effects of the injections and control injections of the solution in which the AA was dissolved were ineffective in changing the MSA responses. I.v. injections occasionally induced effects on the MSAs, but such effects were significantly different from those caused by close arterial muscle injections. Thus, increased concentration of AA may excite primary and secondary MSAs from homo- as well as heteronymous muscles, including contralateral muscles, most probably via fusimotor reflexes evoked by activity in chemosensitive muscle afferents.

Shoe concerns and foot problems of wearers of safety footwear

Article

Jun 1993

In Australia workers in many industries are required to wear safety footwear (footwear incorporating a steel toe cap). An investigation of the problems reported by 321 workers (70 per cent male) employed in a broad range of work activities and required to wear safety footwear was conducted in 1990 and 1991. Respondents were interviewed by a professionally trained podiatrist using a structured questionnaire followed by a foot examination. An extremely high percentage (91 per cent) of subjects reported one or more foot problems (which were verified by the podiatrist), and most considered that the safety footwear either caused the problem or adversely affected an existing foot condition. The main shoe concerns reported were excessive heat (65 per cent of all respondents), inflexible soles (52 per cent), weight (48 per cent) and pressure from steel toe cap (47 per cent). Certain gender differences were identified. General recommendations are made.

Standing

Article

May 1994

The paper summarizes 12 papers by the authors over the last six years on various aspects of standing. This paper is divided into four sections. The anthropometry section discusses foot dimensions (including volume and footprints) and discusses leg-length discrepancy. The criteria section discusses the usefulness, for standing, of various physiological criteria and of body comfort votes. The floor surfaces section discusses concrete, rubber mats and carpet. The posture section discusses standing postures.

The effect of surgical floor mats in prolonged standing: an EMG study of the lumbar paraspinal and anterior tibialis muscles

Article

Jun 1993
J Biomed Eng

The purpose of this study was to determine whether or not surgical floor mats affect low back and leg muscle activity during prolonged standing. The EMG activity was measured continuously using surface electrodes on the paraspinal muscles of the low back and on the anterior tibialis muscles; the subjects were normal and stood on two different surfaces. Six male subjects were each instructed to stand for two hours on a specially designed surgical floor mat and then, on a separate day, to stand for two hours on a linoleum-covered concrete surface. Six other subjects carried out the same procedure, but stood on the linoleum first. There was no difference in EMG activity obtained from the anterior tibialis muscles and paraspinal muscles of the low back when the subjects stood on the surgical mat, as compared with the linoleum-covered concrete.

Influence on the gamma-muscle spindle system from muscle afferents stimulated by KCL and lactic acid

Article

Feb 1993
NEUROSCI RES

It is known that accumulation of contraction metabolites in muscles stimulates group III and IV afferents and induces excitation of gamma-efferents to the homonymous muscle. The aim of the present study was to investigate whether increased concentrations of lactic acid and KCl in one muscle may influence the activity in primary and secondary muscle spindle afferents (MSAs) from the chemically affected muscle and from surrounding muscles. The experiments were made on 7 cats anesthetized with alpha-chloralose. Recordings were made simultaneously from 2-8 single MSAs from the triceps surae (GS) and the posterior biceps and semitendinosus muscles (PBSt). The mean rate of firing and the depth of modulation of MSA responses to sinusoidal stretching of the receptor-bearing muscles were determined. Responses of 27 primary MSAs (11 from PBSt and 16 from GS) were recorded. On 24 of these clear-cut alterations in sinusoidal response were evoked by injection of 1 ml of KCl (50-600 mM) or 1 ml of lactic acid (20-200 mM) into the artery supply of the GS muscle. Also, all secondary MSAs recorded (4 from PBSt and 1 from GS) showed sizable effects to increased intramuscular concentrations of KCl and/or lactic acid. On both primary and secondary MSAs, from GS as well as from PBSt muscles, nearly all effects observed were compatible with activation of static fusimotor neurons. Effects on MSAs were completely abolished when the ipsilateral L7-L6 ventral roots were cut and when the GS nerve was anesthetized. Intravenous injections of KCl and lactic acid, as well as arterial injections of 0.9% NaCl, were ineffective in changing the MSA responses.(ABSTRACT TRUNCATED AT 250 WORDS)

Significance of mat and shoe softness during prolonged work in upright position: Based on measurements of low back muscle EMG, foot volume changes, discomfort and ground force reactions

Article

Feb 1998
APPL ERGON

The aim of the investigation was to study the significance of mat and shoe softness during prolonged work in an upright position based on some physiological, biomechanical and comfort measurements related to the lower extremities and the low back. Eight healthy female volunteers performed 2 h of simulated standing and 2 h of standing/walking work tasks in the laboratory using four combinations of soft shoes, clogs, soft mat and concrete. Thus, each subject performed a total of eight 2 h work tests. The following parameters were measured pre-experimentally and one or more times during 2 h: total foot volume, vascular volume and interstitial volume of the left foot, EMG from the lumbar paraspinals, movement of centre of gravity (only during standing), biomechanical heel impact (only during standing/walking), perceived discomfort in lumbar back, legs and feet, whole body oxygen uptake, arterial blood pressure and heart rate. Using soft shoes rather than clogs during standing/walking work implies approximately a halving of the foot oedema formation and the heel impact. The effects due to the introduction of the soft mat are negligible. The local circulatory responses in the feet and the EMG-signs of paravertebral muscle fatigue are larger during standing compared to standing/walking work. The two investigated work types in this study differ regarding exposures as well as responses. Thus, it is recommended to shift between these postures and seated work during the working hours to improve job exposures.

Standing on concrete vs. floor mats

Jan 1990
991-998

S Konz
V Bandla
M Rys
J Sambasivan

Konz, S., Bandla, V., Rys, M., Sambasivan, J., 1990. Standing on concrete vs. floor mats. In: Das, B. (Ed.), Advances in Industrial Ergonomics and Safety II. Taylor & Francis, London, pp. 991–998.

8801 Consolidated Drive

Inc Viscolas

Significance of mat and shoe softness during prolonged work in upright position

Jan 1998
217

Hansen

The effect of surgical floor mats in prolonged standing

Jan 1993
247

Cook

Standing on concrete vs. floor mats

Jan 1990
991

Konz

Occupational risk factors associated with soft tissue disorders of the shoulder

Jan 1993
697

Sommerich

Constrained standing

Jan 1991
175

Zhang

A comparison of the effects of floor mats and shoe in-soles on standing fatigue

Abstract

No full-text available

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