The Effectiveness of Ergonomic Intervention in Work-related Postures and Upper Crossed Syndrome of Metal Industry Workers

Main Article Content

Seyed Mohammad Hosseini https://orcid.org/0000-0002-7414-1530
Mohammad Armin Lahoori https://orcid.org/0009-0009-5022-9958
Zeinab Rasouli Kahaki https://orcid.org/0000-0001-5861-9103

Keywords

Awkward posture, Ergonomics, REBA, RULA, Upper crossed syndrome

Abstract


Introduction: Upper Crossed Syndrome (UCS) is a musculoskeletal disorder that mainly occurs due to awkwardposture in a static position. Considering the impact of musculoskeletal disorders on individual and social life, and the limited studies carried out in metal industries, this study evaluated the effect of ergonomic interventions using engineering controls on work-related postures and skeletal abnormalities caused by UCS in one of the metal industries. Methods: In this interventional study, 132 welders, press, and warehouse workers who had symptoms related to UCS were included. There were 78 participants in the experimental group (43 welders and 35 press operators) and 54 warehouse workers in the control group. Sitting and standing workstations were evaluated using the RULA and REBA methods, respectively. Then, with the technical committee's decision, the necessary ergonomics interventions were carried out. After three months of applying the interventions, the postures were re-evaluated. The paired t-test method was used for intra-group evaluation, and the independent t-test was used to compare the experimental and control groups using SPSS. Result: This study showed that ergonomic interventions can significantly reduce the risk score of musculoskeletal disorders in different body segments in sitting and standing workstations. Examining the UCS of the experimental group with sitting activities after the intervention, the average angle of the forward head, round shoulder, and kyphosis was reduced by 3.89, 4.05, and 3.73 degrees, and with standing activities by 3.27, 2.70, and 3.10 degrees, respectively. Conclusion: The results of the study revealed that modifying the workstation has a significant role in reducing the UCS.


Abstract 542 | PDF Downloads 338

References

1. Demissie B, Bayih ET, Demmelash AA. A systematic review of work-related musculoskeletal disorders and risk factors among computer users. Heliyon. 2024;15;10(3). Doi: 10.1016/j.heliyon.2024.e25075
2. Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ. 2003; 81(9):646-56. PMCID: PMC2572542
3. Cieza A, Causey K, Kamenov K, Hanson SW, Chatterji S, Vos T. Global estimates of the need for rehabilitation based on the Global Burden of Disease study 2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet. 2020.19;396(10267):2006-17. Doi: https://doi.org/10.1016/S0140-6736(20)32340-0
4. Driscoll T, Jacklyn G, Orchard J, et al. The global burden of occupationally related low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):975-81. Doi: 10.1136/annrheumdis-2013-204631
5. Najafi F, Darbandi M, Neya SK, et al. Epidemiology of musculoskeletal disorders among Iranian adults: results from a non-communicable disease cohort study. BMC Musculoskelet Disord. 2023;24(1):315. Doi: https://doi.org/10.1186/s12891-023-06435-5
6. Saberipour B, Ghanbari S, Zarea K, Gheibizadeh M, Zahedian M. Investigating prevalence of musculoskeletal disorders among Iranian nurses: A systematic review and meta-analysis. CEGH. 2019. 1;7(3):513-8. https://doi.org/10.1016/j.cegh.2018.06.007
7. Parno A, Sayehmiri K, Parno M, et al. The prevalence of occupational musculoskeletal disorders in Iran: A meta-analysis study. Work. 2017;58(2):203-14. Doi:10.3233/WOR-172619
8. Aghilinejad M, Choobineh A, Sadeghi Z, Nouri M, Ahmadi AB. Prevalence of musculoskeletal disorders among Iranian steel workers. Iran Red Crescent Med. 2012;14(4):198. PMCID: PMC3385797
9. Jacquier-Bret J, Gorce P. Prevalence of Body Area Work-Related Musculoskeletal Disorders among Healthcare Professionals: A Systematic Review. Int Environ Res Public Health. 2023;20(1):841. Doi: https://doi.org/10.3390/ijerph20010841
10. Joseph L, Vasanthan L, Standen M, et al. Causal relationship between the risk factors and work-related musculoskeletal disorders among professional drivers: a systematic review. Hum factors. 2023;65(1):62-85. Doi: 10.1177/00187208211006500
11. Yaghoubitajani Z, Gheitasi M, Bayattork M, Andersen LL. Online supervised versus workplace corrective exercises for upper crossed syndrome: a protocol for a randomized controlled trial. Trials. 2021;22(1):1-12. Doi: https://doi.org/10.1186/s13063-021-05875-5
12. Khosravi Z, Mohammad Ali Nasab Firouzjah E, Firouzjah MH. Comparison of balance and proprioception of the shoulder joint in girls with and without upper cross syndrome. BMC Musculoskeletal Disorders. 2024;25(1):618. Doi: https://doi.org/10.1186/s12891-024-07552-5
13. Chaudhuri S, Chawla JK, Phadke V. Physiotherapeutic Interventions for Upper Cross Syndrome: A Systematic Review and Meta-Analysis. Cureus. 2023;15(9):e45471. Doi: 10.7759/cureus.45471
14. Morris CE, Bonnefin D, Darville C. The Torsional Upper Crossed Syndrome: A multi-planar update to Janda's model, with a case series introduction of the mid-pectoral fascial lesion as an associated etiological factor. J Bodyw Mov Ther. 2015;19(4):681-9. Doi: http://dx.doi.org/10.1016/j.jbmt.2015.08.008
15. Sepehri S, Sheikhhoseini R, Piri H, Sayyadi P. The effect of various therapeutic exercises on forward head posture, rounded shoulder, and hyperkyphosis among people with upper crossed syndrome: a systematic review and meta-analysis. BMC musculoskelet Dis. 2024;25(1):105. Doi: https://doi.org/10.1186/s12891-024-07224-4
16. Roshani S, Mahdavinejad R, Ghanizadehesar N. The effect of a NASM-based training protocol on upper cross syndrome in paraplegia spinalcord injury patients. J Ilam Univ Med Sci. 2018;25(6):73-85. Doi: 10.29252/sjimu.25.6.73
17. Altundaş Hatman E, Öngel FS, Yavuz ME, Gülenç N. Work-related diseases and risk factors associated with work-related musculoskeletal disorders among unionized metal industry workers: a cross-sectional study. Int J Occup Saf Ergo. 2023:1-11. Doi: 10.1080/10803548.2023.2284538
18. Akter S, Maruf MZU, Chowdhury SK. Prevalence of musculoskeletal symptoms and associated factors: a cross-sectional study of metal workers in Bangladesh. Work. 2015;50(3):363-70. Doi: 10.3233/WOR-151992
19. Wilson JR. Fundamentals of ergonomics in theory and practice. Appl Ergon. 2000;31(6):557-67. Doi: 10.1016/s0003-6870(00)00034-x
20. Elpeze G, Usgu G, editors. The Effect of a Comprehensive Corrective Exercise Program on Kyphosis Angle and Balance in Kyphotic Adolescents. Healthcare. 2022;10 (12):1–15. Doi: 10.3390/healthcare10122478
21. Thigpen CA, Padua DA, Michener LA, et al. Head and shoulder posture affect scapular mechanics and muscle activity in overhead tasks. JEK. 2010;20(4):701-9. Doi: 10.1016/j.jelekin.2009.12.003
22. Hignett S, McAtamney L. Rapid entire body assessment (REBA). Appl Ergon. 2000;31(2):201-5. Doi: 10.1016/s0003-6870(99)00039-3
23. McAtamney L, Corlett EN. RULA: a survey method for the investigation of work-related upper limb disorders. Appl Ergon. 1993;24(2):91-9. Doi: 10.1016/0003-6870(93)90080-s
24. De Oliveira TS, Candotti CT, La Torre M, et al. Validity and reproducibility of the measurements obtained using the flexicurve instrument to evaluate the angles of thoracic and lumbar curvatures of the spine in the sagittal plane. Rehabil Res Pract. 2012;2012(1):186156. Doi: 10.1155/2012/186156. Epub 2012 Apr 24
25. Greendale G, Nili N, Huang M-H, Seeger L, Karlamangla A. The reliability and validity of three non-radiological measures of thoracic kyphosis and their relations to the standing radiological Cobb angle. Osteoporosis international. 2011;22:1897-905. doi: 10.1007/s00198-010-1422-z. Epub 2010 Oct 12
26. Mogharrabi-Manzari M, Ghasemi G, Negahban H. The effect of eight-week shoulder girdle, pelvic girdle and combined corrective exercises on maximal voluntary ventilation in female students with upper crossed syndrome: a randomized clinical trial. J Rehabil Sci Res. 2021;8(2):51-6. Doi: https://doi.org/10.30476/jrsr.2021.89863.1136
27. Raupp EG, Candotti CT, Marchetti BV, Vieira A, Medeiros FS, Loss JF. The validity and reproducibility of the Flexicurve in the evaluation of cervical spine lordosis. JMPT. 2017;40(7):501-10. Doi:10.1016/j.jmpt.2017.06.010
28. Karwowski W, Taiar R, Rodrick D, Sherehiy B, Fox RR. Human factors and ergonomics standards. Handbook of human factors and ergonomics. 2021:1305-50. Wiley. Doi: https://doi.org/10.1002/9781119636113.ch50
29. Fulder T, Pizmoht P, Polajnar A, Leber M. Ergonomically designed workstation based on simulation of worker’s movements. Int J Simul Model. 2005;4(1):27-34. Doi:10.2507/IJSIMM04(1)3.038
30. Kee D. Systematic comparison of OWAS, RULA, and REBA based on a literature review. Int J Environ Res Public Health. 2022;19(1):595. Doi: https://doi.org/10.3390/ijerph19010595
31. Swinton PA, Cooper K, Hancock E. Workplace interventions to improve sitting posture: A systematic review. Prev Med.. 2017;101:204-12. Doi: https://doi.org/10.1016/j.ypmed.2017.06.023
32. Susihono W, Adiatmika IPG. The effects of ergonomic intervention on the musculoskeletal complaints and fatigue experienced by workers in the traditional metal casting industry. Heliyon. 2021;7(2):e06171. Doi: https://doi.org/10.1016/j.heliyon.2021.e06171
33. Choobineh A, Shakerian M, Faraji M, et al. A multilayered ergonomic intervention program on reducing musculoskeletal disorders in an industrial complex: A dynamic participatory approach. Int J Ind Ergon. 2021;86:103221. Doi: https://doi.org/10.1016/j.ergon.2021.103221
34. Seidi F, Bayattork M, Minoonejad H, Andersen LL. Comprehensive corrective exercise program improves alignment, muscle activation and movement pattern of men with upper crossed syndrome: randomized controlled trial. Sci Rep. 2020;10(1):20688. Doi: https://doi.org/10.1038/s41598-020-77571-4
35. Shahrjerdi S, Mondalizadeh Z. The effects of an 8-week selective corrective exercises program on the worker's productivity with the upper crossed syndrome–a randomized controlled trial. J Bodyw Mov Ther. 2024;38:299-305. Doi: https://doi.org/10.1016/j.jbmt.2023.09.007
36. Karimian R, Rahnama N, Ghasemi G, Lenjannejadian S. Photogrammetric analysis of upper cross syndrome among teachers and the effects of national academy of sports medicine exercises with ergonomic intervention on the syndrome. J Res Health Sci. 2019;19(3):e00450. PMCID: PMC7183553