Effects of intensive microscopic work on neck and back strain and the benefits of a prototype ergonomic chair

Abstract

Learning Objectives: Introduction: Musculoskeletal pain is a common occupational hazard experienced by surgeons. Within the ENT community, Otologists have been noted to experience the most neck and back pain, possibly related to prolonged microscopicwork. Aims: 1. To investigate the effects of sustained microscopic work on the neck and back and its correlation to surgical experience 2. To assess the benefits of a prototype ergonomic chair during prolonged microscopic work Methods: A crossover study was performed on 10 male ENT clinicians using a standard operating chair and a prototype ergonomic support chair. We used a subjective measure of time to fatigue and pain for the neck and back as well as objective readings from a surface electromyogram (sEMG). Results: Surgeon experience (years) was correlated with the time (sec) to fatigue at the neck (R = 0.91, p < 0.001) and back (R = 0.76, p = 0.01) as well as time to pain at the neck (R = 0.74, p = 0.01) and back (R = 0.78, p < 0.01) when the standard chair was used. Group mean time to onset of neck fatigue was 348s, neck pain was 846s, back fatigue was around 502s and back pain was 821s. The prototype ergonomic support chair significantly delayed the sensation of neck fatigue (+672 ± 520s, p < 0.01) and neck pain (+427 ± 467s, p = 0.017) and also eliminated thedifference seen amongst the varying seniority of clinicians. These findings were corroborated by the sEMG readings. Conclusions: ENT surgeons who perform prolonged microscopic work are at risk of musculoskeletal pain, which correlates with surgical experience suggesting an element of postural adaptation. Our prototype ergonomic support system can help delay the sensations of postural strain.