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Okuyucu K1, Hignett S1, Gyi D1, Doshani A2
1Loughborough University, Loughborough, United Kingdom, 2University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
Background: Epidemiological studies have shown that musculoskeletal disorders (MSDs) are commonly experienced by health professionals with high rates of sickness absence. This results in both considerable financial cost to organisations and a negative impact on quality of life and productivity at work. Excessive and awkward positions at work have been widely associated with the high prevalence of MSD. These predisposing factors have been extensively explored for nurses, but there is relatively little data about midwives.
Purpose: To analyse the most frequent and extreme working postures with regard to physical exposure on the musculoskeletal system and risk of MSD.
Methods: Midwives with an active clinical role at a UK hospital were recruited using a snowball sampling strategy over a 5-day period in October 2017. The Rapid Entire Body Assessment (REBA) was used to assess the posture and exposure to work-related risk factors. The most common delivery and post-delivery tasks (suturing and assisting breast feeding) were simulated by the participants with a model (a woman acting as a mother) in a delivery suite room. Multi-directional video data were recorded by three cameras from different angles. The most extreme postures adopted by participants during the tasks were extracted from the video data with event sampling. A REBA score was assigned with the measured range of motions in trunk, neck, legs, upper arms, lower arms and wrists. In addition, twisting or side flexion of the trunk and neck; weight bearing on the legs; abduction, rotation, shoulder elevation, support or gravity assistance of the upper arms; and deviation or twisting of the wrist were scored. Then, the scores were combined to generate a final REBA score indicating the degree of MSD risk (action category).
Results: Twenty-two midwives aged between 25 and 58 years (mean=34.7, SD=8.4) were recruited. The participants' mean experience in midwifery was 6.4 years (SD=6.02) with a range of 1-21 years. A total of 141 positions were identified from the video recordings.
All the postures was analysed as having a very high- medium REBA risk levels with action categories indicating that change is definitely necessary. Of these, immediate action is required for the delivery positions where the midwife is working at floor level e.g. mother standing or kneeling on the floor. Trunk, neck and upper arm were the most affected body parts. The REBA scores varied for the same task performed by different midwives, which reflects individual capabilities, experience and unique interactions with each mother.
Conclusion(s): Changes are necessary (with some urgency) to reduce work-related MSD for specific midwifery tasks in delivery and post-delivery. The variation in REBA results for the same task may indicate that midwives' characteristics, training levels and ability using the equipment will change the risk level for MSD.
Implications: The findings of this research will inform the design of evidence based risk management strategies for MSD. This research will also help to improve educational and training programmes.
Keywords: work-related musculoskeletal disorders, postural evaluation, midwives
Funding acknowledgements: Nothing to declare
Purpose: To analyse the most frequent and extreme working postures with regard to physical exposure on the musculoskeletal system and risk of MSD.
Methods: Midwives with an active clinical role at a UK hospital were recruited using a snowball sampling strategy over a 5-day period in October 2017. The Rapid Entire Body Assessment (REBA) was used to assess the posture and exposure to work-related risk factors. The most common delivery and post-delivery tasks (suturing and assisting breast feeding) were simulated by the participants with a model (a woman acting as a mother) in a delivery suite room. Multi-directional video data were recorded by three cameras from different angles. The most extreme postures adopted by participants during the tasks were extracted from the video data with event sampling. A REBA score was assigned with the measured range of motions in trunk, neck, legs, upper arms, lower arms and wrists. In addition, twisting or side flexion of the trunk and neck; weight bearing on the legs; abduction, rotation, shoulder elevation, support or gravity assistance of the upper arms; and deviation or twisting of the wrist were scored. Then, the scores were combined to generate a final REBA score indicating the degree of MSD risk (action category).
Results: Twenty-two midwives aged between 25 and 58 years (mean=34.7, SD=8.4) were recruited. The participants' mean experience in midwifery was 6.4 years (SD=6.02) with a range of 1-21 years. A total of 141 positions were identified from the video recordings.
All the postures was analysed as having a very high- medium REBA risk levels with action categories indicating that change is definitely necessary. Of these, immediate action is required for the delivery positions where the midwife is working at floor level e.g. mother standing or kneeling on the floor. Trunk, neck and upper arm were the most affected body parts. The REBA scores varied for the same task performed by different midwives, which reflects individual capabilities, experience and unique interactions with each mother.
Conclusion(s): Changes are necessary (with some urgency) to reduce work-related MSD for specific midwifery tasks in delivery and post-delivery. The variation in REBA results for the same task may indicate that midwives' characteristics, training levels and ability using the equipment will change the risk level for MSD.
Implications: The findings of this research will inform the design of evidence based risk management strategies for MSD. This research will also help to improve educational and training programmes.
Keywords: work-related musculoskeletal disorders, postural evaluation, midwives
Funding acknowledgements: Nothing to declare
Topic: Occupational health & ergonomics; Musculoskeletal; Human movement analysis
Ethics approval required: Yes
Institution: Loughborough University and National Health Services
Ethics committee: University of Hospitals of Leicester R&I and Health Research Authority
Ethics number: 1
All authors, affiliations and abstracts have been published as submitted.
