شیوع اختلالات عضلانی- اسکلتی و ارزیابی وضعیت حین آندوسکوپی و کلونوسکوپی در پزشکان فوق تخصص بیماری‌های گوارش و کبد شهر اصفهان

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، گروه طب فیزیکی و توان‌بخشی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 پزشک عمومی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

 مقاله پژوهشیمقدمه:پزشکان فوق تخصص بیماری‌های گوارش و کبد، به دلیل کار در موقعیت‌های گوناگون در درمانگاه و بیمارستان، در صورت عدم وضعیت‌گیری صحیح، می‌توانند مستعد مشکلات عضلانی- اسکلتی مختلف باشند. مطالعه‌ی حاضر، با هدف بررسی ارتباط وضعیت قرارگیری این افراد با بروز مشکلات عضلانی- اسکلتی انجام شد.روش‌ها: سه روش بررسی وضعیت شامل گزارش فردی، روش عینی (مشاهده‌ای) و اندازه‌گیری مستقیم وجود دارد. بر اساس مطالعات، روش عینی از نظر روایی و پایایی، روش بهتری است. در این مطالعه، با استفاده از ابزارهای Rapid upper limb assessment (RULA) و Ovako working posture assessment system (OWAS)، حرکات پزشکان حین انجام آندوسکوپی و کلونوسکوپی با مشاهده‌ی مستقیم مورد آنالیز قرار گرفت. همچنین، پرسش‌نامه‌ی Nordic به منظور بررسی مشکلات عضلانی- اسکلتی، توسط آن‌ها تکمیل گردید.یافته‌ها: سطح خطر وضعیت بر اساس OWAS، در 2/22 درصد موارد، 1 و در 8/77 درصد موارد، 2 به دست آمد. سطح خطر وضعیت بر اساس RULA، در 9/38 درصد موارد 4، در 9/38 درصد موارد 5 و در 2/22 درصد موارد 6 بود. میزان مشکلات عضلانی- اسکلتی بر اساس Nordic با سطح خطر بر اساس RULA رابطه‌ی مستقیم داشت، اما با سطح خطر بر اساس OWAS رابطه‌ی معنی‌داری نداشت. سطح خطر بر اساس RULA، با تعداد عمل در روز رابطه‌ی مستقیم داشت. همچنین، میزان مشکلات عضلانی- اسکلتی بر اساس Nordic با تعداد عمل در روز و شاخص توده‌ی بدنی (Body mass index یا BMI) رابطه‌ی مستقیم داشت. سطح خطر بر اساس RULA، با میزان مشکلات عضلانی- اسکلتی در گردن، بالای کمر و زانو رابطه‌ی مستقیم داشت.نتیجه‌گیری: مشکلات عضلانی- اسکلتی در میان پزشکان فوق تخصص بیماری‌های گوارش و کبد شهر اصفهان از شیوع بالایی برخوردار بود. خطر بروز این مشکلات نیز در حد زیادی ارزیابی شد. شاخص توده‌ی بدنی و تعداد بالای عمل در روز، باعث افزایش سطح خطر وضعیت و مشکلات عضلانی- اسکلتی به صورت هم‌زمان می‌شود. از این رو، کاهش تعداد عمل و یا افزایش زمان استراحت میان نوبت‌ها، انجام آندوسکوپی و کلونوسکوپی به صورت منقطع، افزایش دقت در وضعیت‌گیری صحیح و استفاده از تکنیک تله‌روبوتیک به جای روش دستی در پزشکان فوق تخصص بیماری‌های گوارش و کبد که دارای بار کاری بیشتری هستند، مؤثر خواهد بود.

کلیدواژه‌ها


عنوان مقاله [English]

Prevalence of Musculoskeletal Disorders and Postural Assessment during Endoscopy and Colonoscopy among Gastroenterologists in Isfahan City, Iran

نویسندگان [English]

  • Babak Vahdatpour 1
  • Mostafa Sayed-Mirramazani 2
1 Associate Professor, Department of Physical Medicine and Rehabilitation, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 General Practitioner, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Gastroenterologists may be susceptible to various musculoskeletal disorders in the absence of proper position, because of working in various positions in offices and hospitals. This study aimed to assess the relationship between the posture and musculoskeletal disorders among gastroenterologists in Isfahan city, Iran.Methods: Three methods of posture evaluating are self-report, observational method and direct measurement. Based on studies, the validity and reliability of the observational method is more than others. In this study, gastroenterologists' postures during endoscopy and colonoscopy were analyzed using two observational methods of Rapid Upper Limb Assessment (RULA) and Ovako Working Posture Assessment System (OWAS). They also completed Nordic questionnaire for assessment of musculoskeletal disorders.Findings: Based on OWAS, the posture risk was 1 in 22.2% and 2 in 77.8% of gastroenterologists; while based on RULA, this risk was 4 in 38.9%, 5 in 38.9% and 6 in 22.2% of them. Musculoskeletal disorders had a direct relationship with the level of risk based on RULA, but had no significant association with the level of risk based on OWAS. The level of risk based on RULA had a direct relationship with the number of procedures per day. In addition, the rate of musculoskeletal disorders had a direct relationship with the number of procedures per day and body mass index (BMI). The level of risk based on RULA had a direct relationship with incidence of musculoskeletal disorders in the neck, upper back and knees.Conclusion: Musculoskeletal disorders are highly prevalent among gastroenterologists in Isfahan city. Postural analysis results showed that the risk of incidence of these disorders is to a large extent, too. High body mass index was one of the factors contributing to the occurrence of musculoskeletal disorders. Since about half of the target group were overweight, losing weight can help to reduce the incidence of musculoskeletal disorders. In addition, the high number of procedures per day increases the risk of posture and musculoskeletal problems simultaneously. So, reducing the number of procedures or increasing the rest time between appointments, discontinuous endoscopy and colonoscopy, increasing precision and accurate positioning and using Tele-Robotic techniques instead of manually ones, would be effective for gastroenterologists that have more workload.

کلیدواژه‌ها [English]

  • Posture
  • Gastroenterologist
  • Musculoskeletal disorders
  • Rapid upper limb assessment (RULA)
  • Ovako working posture assessment system (OWAS)
  • Nordic questionnaire
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