Download MBBS (Bachelor of Medicine, Bachelor of Surgery) 1st Year, 2nd Year, 3rd Year and Final year Physical Medicine and Rehabilitation 9 Cumulative Trauma Disorder And Ideal Ergonomics PPT-Powerpoint Presentations and lecture notes
Cumulative Trauma
Disorder &
Ideal Ergonomics
Department of PMR
Synonyms
Cumulative trauma disorder
Repetitive motion syndrome
Repetitive strain injury
Work related disorder
Myofascial pain
Overview
? Introduction
? Definition
? Patho-mechanics
? Stages
? Clinical feature
? Clinical Evaluation
? Treatment
? Ergonomics
Introduction
A. Cumulative: developed gradually over periods of weeks,
months, or even years.
cumulative concept: each repetition of an activity
produces some trauma or wear and tear on the tissues and
joints of the body.
B. Trauma: bodily injury from mechanical stresses.
C. Disorders: physical ailments or abnormal conditions.
Definition
CTD are work-related musculoskeletal injuries that affect
the musculoskeletal, peripheral nervous, and neurovascular
systems that are caused or aggravated by occupational
exposure to ergonomic hazards.
Common CTDs
? Neck tension syndrome
? Pronator teres syndrome
? Rotator cuff syndrome
? Radial tunnel syndrome
? Epicondylitis
? Carpal tunnel syndrome
? Tendonitis
? Guyon tunnel syndrome
? Tenosynovitis
? Ganglion
? Trigger finger
Mechanisms of injury
1) Sustained or constrained Posture
2) Repetition
3) Forcefull exertions
4) vibration
5) combinations
Patho-physiology
Continuous
Tissue
contraction of
Physiological
ischemia and
muscles from long-
Impaired
strain (muscle
delayed
term static load
circulation
fatigue &
dissipation of
with insufficient
pain)
metabolites
breaks
Stages
Stage 1
Stage 2
Stage 3
Mild discomfort
Pain is present
Pain is present
while working
while working
all the time.
Work is
affected.
Disappears when
Continues when
not working
not working. May
be taking pain
May not be able
medication.
to complete
Does not affect
simple daily
work or daily
tasks.
living tasks.
Begins to affect
work and daily
living tasks.
Not reversible,
Completely
can improve
reversible.
(but not a full
Completely
recovery).
reversible.
Signs and symptoms
? Pain
? Tenderness
? Swelling
? Unreasonable fatigue
? Disturbed sleep
? Tingling & Numbness
? Difficulty performing tasks or moving specific parts of the
body
Clinical Evaluation
q Identifying the specific injury
q Determine the degree to which the disorder is work related
`Each disorder has different cause, treatment & prognosis'
History
? Elicit the onset, location, duration, frequency, intensity
of the symptoms
? Whether symptoms started before or after employment
? If symptoms exacerbated by the job
? Previous injuries or fracture to that area
? If any medical condition known to be associated with
symptoms
Physical examination
? Inspection for sign of inflammation, ganglia cysts or
deformity
? Palpation - warmth
? Passive, active & resisted ROM
? Special tests e.g. Phalen's test, Finkelstein's test
Medical conditions associated with CTD
I.
Amyloidosis
II. Arthropathies & connective tissue disorders e.g. RA, SLE,
gout, OA and SpA
III. Cancer
IV. Diabetes mellitus
V. Hypothyroidism
VI. Obesity
VII. Pregnancy
LABORATORY TESTING
? CBC
? ESR and CRP
? Serum RF, Antinuclear antigen (ANA), HLA-B27
? Diabetic screening
? S. TSH
? S. calcium, phosphorus, uric acid, alkaline and acid
phosphatase for metabolic, endocrine and neo-plastic
conditions
? Serum protein electrophoresis
Treatment
Rehabilitation programme
q Application of Heat and Cold
q NSAIDs
q Exercises
q Splints
q Surgical intervention if conservative trail fails.
Ergonomics
"The science of studying people at work and then designing
tasks, jobs, information, tools, equipment, facilities and the
working environment so people can be safe and healthy,
effective, productive and comfortable"*
`Fitting the job to the worker'
*Ergonomic Design Guidelines, Auburn Engineering, Inc., 1998.
Posture is the most important aspect when looking at
workstation design.
Chairs
q Height
q Back support
q Seat tilt
q Depth
q Width
q Armrests
Height
? Highest point of the seat,
just below your kneecap.
Feet should rest firmly on the
floor when seated
Back support & Seat tilt
? Lumbar pad should supports the
natural curve of your lower back
(lumbar curve).
Upper body should slightly tilt to
reclined.
*110? is usually recommended.
Seat tilt of 5? is usually recommended.
Seat Depth & Width
? The seat pan should support the
back without the front of the seat
pressing against the back of your
knees.
? Wide enough not apply pressure
to your thighs.
? Narrow enough to reach the
armrests.
Armrests
Armrest should be adjusted to elbow
height.
v Too high will shrug the shoulders
v Too low will depressed the
shoulders - Affect the posture of
the back and neck.
Input devices
Position - Upper arms should be relaxed
and by your side, your elbows bent at a
right angle (90 degrees) and your wrists
straight.
Keyboard ? should promote neutral wrist
and hand posture.
? Negatively tilted keyboard
Mouse ?
? same level as the keyboard
? easy to reach
? switch the side by changing hands
Monitor
? Distance
? As far away as possible (60-90
cm)
? Increase the size of the font
? Height and location
? Top of the monitor just below
eye level
? Tilt 15 degrees
Computer & Desk Stretches
? Approximately four
minutes
? Do these stretches
every hour
Good Posture
Thank you
This post was last modified on 08 April 2022