Prevalence of work-related musculoskeletal symptoms among young orthopedics during the surgical practice: an intervention study

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Barbara Cacciatori
Raffaele Schiattarella
Francesca Larese Filon


ergonomics, prevention, physiotherapy


Background: Work-related muscle-skeletal symptoms (WRMS) represent a substantial social and economic impact on the way of work and have a high incidence in surgeons. In the literature, several studies address the impact of WRMS in surgeons performing gynecological, laparoscopic, and robotic surgery, but there are no studies in the field of orthopedic surgery. This pilot study aims to assess the effectiveness of a preventive program to reduce pain. Methods: All workers filled in a standardized questionnaire, and postoperative pain in the operating room was quantified using a numeric scale (NAS). The intervention group followed ergonomic principles in the operating room supervised by a physiotherapist and specific physical exercises before and after surgery. Data were analyzed using the statistical program STATA rel. 14.0. Results: Twenty-one surgeons were assigned to intervention groups and thirty-three to controls. At baseline, the two groups were homogeneous for anthropometric factors, and controls were older and with higher work seniority. Pain perception resulted in high in both groups in many body districts. At follow-up, after three months, the intervention group significantly reduced pain perception in all body districts for the lumbar back, knees, ankles and feet (p<0.05). In the control group, pain perception increased in all body districts investigated. Conclusions: We found a high prevalence of WRMS in young orthopedic surgeons, and we demonstrated the effectiveness of a preventive program through targeted ergonomic education and exercises for the most affected body districts.

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1. Yasobant S, Rajkumar P. Work-related Musculoskeletal Disorders Among Health Care Professionals: A Cross-Sectional Assessment of Risk Factors in a Tertiary Hospital, India, Indian J Occup Environ Med. 2014: 18,75-81. DOI: 10.4103/0019-5278.146896
2. Luger T, Maher CG, Rieger MA, et al. Work-break schedules for preventing musculoskeletal symptoms and disorders in healthy workers. Cochrane Database Syst Rev. 2019: 23:CD012886. DOI: 10.1002/14651858.CD012886.pub2
3. Relazione Annuale del Presidente, giugno 2018, Roma;, Accessed December 20, 2021.
4. Naidoo RN, Haq SA, Naidoo RN, et al. Occupational use syndromes. Best Pract Res Clin Rheumatol. 2008 :22, 677-91. DOI: 10.1016/j.berh.2008.04.001
5. Ribeiro T, Serranheira F, Loureiro H, et al. Work related musculoskeletal disorders in primary health care nurses. Appl Nurs Res. 2017:33,72-77. DOI: 10.1016/j.apnr.2016.09.003
6. Epstein S, Sparer EH, Tran BN, et al. Prevalence of Work-Related Musculoskeletal Disorders Among Surgeons and Interventionalists: A Systematic Review and Meta-analysis. JAMA Surg. 2018: 21,153-155. DOI: 10.1001/jamasurg.2017.4947
7. Gilbert CR, Thiboutot J, Mallow C, et al. Assessment of Ergonomic Strain and Positioning During Bron-choscopic Procedures: A Feasibility Study. J Bronchology Interv Pulmonol. 2020:27,58-67.
8. Epstein S, Tran BN, Capone AC, et al. Work-Related Musculoskeletal Disorders among Plastic Surgeons: A Systematic Review. J Reconstr Microsurg. 2018: 34,553-562. DOI: 10.1097/LBR.0000000000000615
9. Kim-Fine S, Woolley SM, Weaver AL, et al.Work-related musculoskeletal disorders among vaginal sur-geons. Int Urogynecol J. 2013:24,1191-200.
10. Catanzarite T, Tan-Kim J, Menefee SA, et al. Ergonomics in gynecologic surgery. Curr Opin Obstet Gynecol. 2018:30,432-440. DOI: 10.1007/s00192-012-1958-x
11. Howarth AL, Hallbeck S, Mahabir RC, et al. Work-Related Musculoskeletal Discomfort and Injury in Mi-crosurgeons. J Reconstr Microsurg. 2019:35,322-328. DOI: 10.1055/s-0038-1675177
12. Stomberg MW, Tronstad SE, Hedberg K, et al. Work-related musculoskeletal disorders when performing laparoscopic surgery. Surg Laparosc Endosc Percutan Tech. 2010: 20,49-53. DOI: 10.1097/SLE.0b013e3181cded54
13. Gadjradj PS, Ogenio K, Voigt I, et al. Ergonomics and Related Physical Symptoms Among Neurosurgeons. World Neurosurg. 2020: 134,e432-441. DOI: 10.1016/j.wneu.2019.10.093
14. Pandey SK, Sharma V, Pandey SK, et al. Robotics and ophthalmology: Are we there yet? Indian J Oph-thalmol. 2019: 67,988-994. DOI: 10.4103/ijo.IJO_1131_18
15. Vijendren A, Yung M, Sanchez J et al. "he ill surgeon: a review of common work-related health problems amongst UK surgeons. Langenbecks Arch Surg. 2014:399,967-79. DOI: 10.1007/s00423-014-1233-3
16. Hallbeck MS, Lowndes BR, Bingener J, et al. The impact of intraoperative microbreaks with exercises on surgeons: A multi-center cohort study." Appl Ergon. 2017: 60,334-341. DOI: 10.1016/j.apergo.2016.12.006
17. Giagio S, Volpe G, Pillastrini P, et al. A Preventive Program for Work-related Musculoskeletal Disorders Among Surgeons: Outcomes of a Randomized Controlled Clinical Trial. Ann Surg. 2019:270,969-975. DOI: 10.1097/SLA.0000000000003199
18. Gobba F, Ghersi R, Martinelli S, et al. Italian translation and validation of the Nordic IRSST standardized questionnaire for the analysis of musculoskeletal symptoms. Med Lav. 2008:99,424-43. PMID: 19086615
19. Ware JE Jr. Patient-based assessment: tools for monitoring and improving healthcare outcomes. Behav Health Tomorrow. 1996:5,88, 87. PMID: 10158047
20. Price DD, McGrath PA, Rafii A, et al. The validation of visual analogue scales as ratio scale measures for chronic and experimental pain. Pain. 1983:17,45-56. DOI: 10.1016/0304-3959(83)90126-4
21. Wauben LS, van Veelen MA, Gossot D, et al. Application of ergonomic guidelines during minimally inva-sive surgery: a questionnaire survey of 284 surgeons. Surg Endosc. 2006:20,1268-74. DOI: 10.1007/s00464-005-0647-y
22. Ware J Jr, Kosinski M, Keller SD. A 12-Item Short-Form Health Survey: construction of scales and pre-liminary tests of reliability and validity. Med Care. 1996:34,220-33. DOI: 10.1097/00005650-199603000-00003
23. Grant KMK, Vo T, Tiong LU. et al. The painful truth: work-related musculoskeletal disorders in Austral-ian surgeons. Occup Med (Lond). 2020: 12,60-63. DOI: 10.1093/occmed/kqz155
24. Szeto GP, Ho P, Ting AC, et al. Work-related musculoskeletal symptoms in surgeons., J Occup Rehabil. 2009: 19, 175-84. DOI: 10.1007/s10926-009-9176-1
25. Gadjradj PS, Ogenio K, Voigt I, et al. Ergonomics and Related Physical Symptoms Among Neurosurgeons. World Neurosurg. 2020:134,e432-e441. DOI: 10.1016/j.wneu.2019.10.093
26. Berquer R., W D Smith, S Davis. An Ergonomic Study of the Optimum Operating Table Height for Laparo-scopic Surgery. Surg Endosc. 2002: 16,416-21. DOI: 10.1007/s00464-001-8190-y