ERG - Ergonomic Assessment OWAS

Measurement and Ergonomic
Implications of Work Posture

Body Discomfort vs Pain
• Relationship of
Discomfort and Pain
• Bates et al
investigated the
relationship
between the
discomfort and pain
intensities.
Body Discomfort vs Pain
• Pain and Discomfort Ratings
Description of Discomfort
• To adequately describe discomfort four aspects need to be covered:
• Intensity
• Quality
• Location
• Temporal Pattern
• For example, sitting on a hard chair for several hours may result in
discomfort which could be described as a numb, cold feeling in the areas
extending approximately 15 cm out from each ischial tuberosity which is of
low to moderate intensity and which began after about 15 minutes of
sitting and increased to the end of the first hour then remained at a
constant level until arising from the chair, when the discomfort subsided to
minimal intensity after 5 minutes.
Aspects of Discomfort
• Intensity
• Measurement of the intensity of discomfort has usually been attempted by asking the worker
to rate the intensity on a scale commonly termed a subjective scale.
• Subjective scales can be grouped into: verbal rating scales; visual analog scales; numeric
rating scales; and graphic rating scales.
• Discomfort intensity in inferred from changes in behavior (using a behavior rating scale), or
changes in correlated biomechanical and physiological entities.
• Behavior Rating Scales
• Branton (1969) suggested sitting for a purpose and that discomfort can be
seen as an interference which, when it reaches a sufficient intensity, results in
changes to a sitting posture. Thus, an increased number of postural changes
would be considered to indicate an increase in discomfort intensity.
• Shackel et al. (1969) considered the use of time-sampling of posture changes
and duration as an objective measure of discomfort.
• Corlett and Bishop (1976) recorded machine use and machine idle times for
two weeks before and after ergonomic intervention.
• Verbal Rating Scales
• There are two type of verbal rating scales:
• Single noun is used to describe the construct (in this case :discomfort)
• Multiple adjectives are used to indicate changes in intensity, and another in which different
nouns are used.
• Analysis of these data is by frequency distributions and rank order non-
parametric statistics.
• Visual Analog Scales
• Consist of a line, usually 100 mm in length, with a label at each end (often
termed “anchors”).
• Robust parametric statistics, such as analysis of variance, are often used for
analysis.
• Numeric Rating Scales
• Similar to visual analog scales except they have a discrete
number of categories and can be either visual or verbal.
• Common examples use 0 to 10 in one-unit intervals to give an
11-unit scale or 0 to 10 in one-unit intervals to give a 101 unit
scale.
• Data recorded are less parametric than visual analog scale
ratings so nonparametric statistical analysis should be used
1-4 aspect of discomfort
5-6 examples of subjective scale
7-12 qualities of discomfort
13 -15 Subjective Assessment
16-18 objective assessment
19 – 20 Types of Verbal Rating Scale
• Graphic Rating Scales
• Mixture of analog scale and either a numeric or verbal rating scale.
• The scale consists of a vertical or horizontal line with anchors (as for visual
analog scale) with the addition of either numbers or adjectives along the line.
• Non-parametric tests should be used.
• Quality
• The quality of discomfort can probably only be assessed by allowing different nouns to be
used by the worker.
• Different qualities of discomfort may include:
• tingling,
• burning,
• searing,
• numbness,
• coldness,
• stiffness,
• heat,
• cramping,
• prickling,
• stabbing, and
• gnawing.
• Location
• Commonly collected either through the
use of a body map or by a specific
reference to a body part.
• Temporal Pattern
• Often measured by collecting information
about discomfort at different times.
• Branton (1969) suggested that because
post-experience discomfort reporting lies
on kinesthetic memory, discomfort
information should be collected while the
worker is experiencing the discomfort.
Fundamentals of Discomfort Measurement
• Important Fundamentals of Discomfort Measurement
• Discomfort measurement is likely to be useful in the assessment of
information about physical matches and mismatches
• Consistent use of the sole noun “discomfort” will assist the validity of
assessment
• Discomfort is a subjective experience and can therefore only be measured by
worker report
• Intensity, location and temporal pattern are important attributes of
discomfort
• A Visual Analog Discomfort Scale is probably the most widely applicable
discomfort intensity scale.
Methods for Assessing Musculoskeletal
Problems
• Subjective Assessments
• Body Part Discomfort Scale
• Cornell Musculoskeletal Discomfort Questionnaire
• Nordic Questionnaires
• Objective Assessments
• OWAS
• RULA
• REBA
Subjective Assessment (Body Part
Discomfort Scale)
• Corlett and Bishop (1976)
presented a technique of body
part discomfort survey tool
that evaluates the respondent’s
direct experience of discomfort
at different body parts.
• Discomfort levels are made on
a scale usually on a 5 or 7 point
scale
• This demonstrated that the
amount of discomfort is
linearly related to the amount
and duration of a particular
Subjective Assessment (Body Part
Discomfort Scale)
Procedures in mapping body discomfort:
• Use the body map divided into segments and the
person is asked to rate the amount of comfort on
a seven (or five) point scale, where zero (0)
corresponds to no discomfort and 7 to extreme
discomfort.
• To investigate the effect of hours of work, at
intervals during the whole working day, people
are asked to point the site(s) of current
discomfort on the body map and rate the
intensity.
• These scores are plotted against time of day for
each body site, dividing the scale during analysis
Subjective Assessment (NMQ)
Nordic Musculoskeletal Questionnaire (NMQ)
• Consists of structured, forced binary or
multiple-choice questions used to indicate
general and specific information regarding pain
in various regions of the body (Kourinka, 1987).
It can be used in self-assessment and
interviews.
• The main purpose of the questionnaire is the
screening of musculoskeletal disorders in the
context of ergonomics.
• The localization of symptoms may reveal their
causes in terms of loading analyzed in reference
to the daily activities, job tasks, and work
Subjective Assessment (NMQ)
• Standardized Nordic Questionnaire
Subjective Assessment (CMDQ)
• Cornell Musculoskeletal Discomfort
Questionnaire
• Cornell MS Discomfort Questionnaire (CMDQ) is
a well-designed data collection tool which was
developed by Professor Alan Hedge and
ergonomics graduate students at Cornell
University. CMDQ Addresses 7-day frequency,
severity and working ability interference effects
of MS discomfort across 20 body parts.
• Copies of CMDQ for male/female standing and
sedentary workers are available in Cornell
University Ergonomics Web.
• CMDQ Diagrams available:
• Standing Male
• CMDQ Diagrams available:
• Standing Female
• Sedentary Male and Female
• Sedentary Male and Female
• Right Hand
• Left Hand
• Scoring Guidelines - Cornell Musculoskeletal and Hand
Discomfort Questionnaires
• These questionnaires are for research screening purposes
and not for diagnostic purposes. Scores can be analyzed in
4 ways:
• by simply counting the number of symptoms per person
• by summing the rating values for each person
• by weighting the rating scores to more easily identify the most
serious problems as follows:
Never = 0
1-2 times/week = 1.5
3-4 times/week = 3.5
Every day = 5
Several times every day = 10
• by multiplying the above Frequency score (0,1.5 , 3.5, 5, 10) by
the Discomfort score (1,2,3) by the Interference score (1,2,3)
CMDQ Validity and Reliability
• The survey is derived from previous postural
discomfort surveys and has high face validity.
The survey is a screening tool and not a
diagnostic instrument. If you are using it in a
research study in any other way you should
undertake your own test-retest reliability study.
Given the nature of musculoskeletal discomfort
(i.e. mostly intermittently experienced)
differences in responses can be expected over
longer test-retest intervals. The diagnostic
validity of this survey can be tested in any study
be comparing survey responses with clinical
reports.
Objective Assessment
Ovako Working Posture Analysis
System (OWAS)
•Created in the mid – 1970s by Ovako
Oy, a private steel company in Finland
•Developed as joint effort between
Ovako Oy and the Finnish Institute for
Occupational Health
•Basic concepts have been
incorporated into other posture
analysis (e.g., RULA, REBA, etc.)
• Purpose:
• Identifying and assessing stressful work postures
• Determining how urgently corrective measures are
required to the job by classification into four categories
of action
• Body regions assessed:
• Trunk, Arms , Lower Body, Neck
• Description
• Video recording of the job
• Observation of the videotape at regular intervals of the
assessed body regions
• Determine percentage of time in each pre-defined
category
• Classification into four action categories
• Results compared to benchmark
Objective Assessment (OWAS)
Trunk Posture
1. Straight / upright (“neutral”)
2. Bent forward (“pure” flexion)
3. Straight and twisted (“pure” axial twisting)
4. Bent and twisted (combination of flexion, lateral
bending, and/or twisting)
• Trunk Posture Action Levels
Arm Posture
1. Both arms below shoulder height (“neutral”)
2. One arm above shoulder height – defined as
elbow above the shoulder height
3. Both arms above shoulder height
• Arm Posture Action Levels
• Lower Body Posture
1. Sitting
2. Standing -- weight on 2 legs, knees straight
3. Standing -- weight on 1 leg, knees straight
4. Standing -- weight on 2 legs, knees bent
5. Standing -- weight on 1 leg, knee bent
6. Kneeling -- 1 or 2 knees touching the ground
7. Walking or moving
• Lower Body Posture
• Lower Body Action Levels
• Load Handled
1. Load < 10 kg
2. 10 < Load < 20 kg
3. Load > 20 kg
• OWAS Example
• In a 25 – observation study, the following truck
posture categories were observed:
• Neutral : 13 (52%)
• Bent : 9 (36%)
• Twisted : 1 (4%)
• Bent and Twisted : 2 (8%)
• OWAS Example Results

• Look up action level for each category:
• Neutral : 52% (Acceptable)

• Bent : 36% (Slightly
harmful)
• Twisted : 4% (Acceptable)
• Bent and Twisted : 8% (Slightly harmful)
• For the trunk, this job would be rated “Slightly
Harmful”
• Action category for each individual OWAS classified
posture combination.
• The OWAS Action Categories Prevention
• OWAS Advantages
• Relatively easy to learn and use. Results can be compared against
benchmarks to establish intervention priority.
• Scores at each body part can be used for “before” and “after”
comparisons to evaluate intervention effectiveness
• Scores at each body part can be used in epidemiological studies
• Relatively easy to customize system to specific user needs.
• OWAS Weaknesses
• Posture categories are rather broad for the trunk and
shoulders
• No information on duration of postures
• Method does not separate left and right arms
• Method gives no information for the elbow or wrist
Rapid Entire Body
Assessment (REBA)
Subjective Assessment
Rapid Entire Body Assessment (REBA)
The Rapid Entire Body Assessment (REBA) method was developed by Dr. Sue Hignett and Dr. Lynn
McAtamney , ergonomists from University of Nottingham in England (Dr. McAtamney is now at
Telstra, Australia) .
REBA is a postural targeting method for estimating the risks of work-related entire body disorders. A
REBA assessment gives a quick and systematic assessment of the complete body postural risks to a
worker. The analysis can be conducted before and after an intervention to demonstrate that the
intervention has worked to lower the risk of injury.
This ergonomic assessment uses a systematic process to evaluate whole body postural MSD and
risks associated with job tasks. A single page worksheet is used to evaluate required or selected
body posture, forceful exertions, type of movement or action, repetition, and coupling.
• Using the REBA worksheet, the evaluator will assign a score for each of the following body
regions:
• Wrists, forearms
• Elbows, shoulders
• Neck, trunk
• Back, legs and knees
Subjective Assessment (REBA)
• REBA can be used when an ergonomic workplace assessment
identifies that further postural analysis is required and:
• The whole body is being used.
• Posture is static, dynamic, rapidly changing, or unstable.
• Animate or inanimate loads are being handled either frequently or
infrequently.
• Modifications to the workplace, equipment, training, or risk-taking behavior
of the worker are being monitored pre/post changes.
Using Rapid Entire Body Assessment
Getting Ready
The evaluator should prepare for the assessment by
1. interviewing the worker being evaluated to gain an understanding of the job
tasks and demands and ;
2. observing the worker’s movements and postures during several work cycles.
3. Selection of the postures to be evaluated should be based on
a. the most difficult postures and work tasks (based on worker interview and initial
observation),
b. the posture sustained for the longest period of time, or
c. the posture where the highest force loads occur.
The REBA can be conducted quickly, so multiple positions and tasks within the
work cycle can usually be evaluated without a significant time/effort cost. When
using REBA, only the right or left side is assessed at a time. After interviewing
and observing the worker, the evaluator can determine if only one arm should
be evaluated, or if an assessment is needed for both sides.
Determine Body Position Selections
The REBA assessment requires that you determine postural
angles of six different body positions. In most cases, you will be
able to determine the body position angle in the field as you
observe the task. However, we find that it’s very helpful to take
pictures or video of the task being performed from several
angles if possible. You can then display the pictures on your
computer monitor and use a goniometer (as pictured on left) or
an overlaid transparent protractor image (as pictured on right)
to measure the body segment angles. These methods are both
very quick and easy and will give you the assurance that you’ve
obtained the correct body position angles for the assessment.
https://ergo-plus.com/wp-content/uploads/rapid-entire-body-assessment-reba-1.png?x45295
Parts of the REBA Worksheet
The REBA worksheet is

divided into two body
segment sections on the
labeled A and B.
• Section A (left side) covers

the neck, trunk, and leg.
• Section B (right side) covers
the arm and wrist.
Score Group A (Trunk, Neck

and Legs) postures first, then
score
Group B (Upper Arms, Lower

Arms, and Wrists) postures
for left and right.
For each region, there is a

posture scoring scale and
additional adjustments which
need to be considered and
accounted for in the score.

labeled A and B.

the arm and wrist.

score

for left and right.


labeled A and B.

the arm and wrist.

score

for left and right.


labeled A and B.

the arm and wrist.

score

for left and right.

EXAMPLE
Consider the position of
this worker:
Step 1 : Locate the neck position and neck adjustment
The neck position score will be between 1-3. The score is based on the degree of neck flexion or extension,
along with any adjustment for neck twisting or side bending (lateral flexion). Neck flexion is movement of
the chin towards the chest from a neutral neck position. Neck extension is moving the chin away from the
chest (backwards) from a neutral neck position.
In this example, neck flexion is less than 20 degrees. There is no twisting or side bending required, so no
selection is made under neck adjustments.
1
Step 1 : Locate the neck position and neck adjustment
The neck position score will be between 1-3. The score is based on the degree of neck flexion or extension,
along with any adjustment for neck twisting or side bending (lateral flexion). Neck flexion is movement of
the chin towards the chest from a neutral neck position. Neck extension is moving the chin away from the
chest (backwards) from a neutral neck position.
In this example, neck flexion is less than 20 degrees. There is no twisting or side bending required, so no
selection is made under neck adjustments.
1
REBA Step-by Step Guide
• Step 4: Using values from steps 1-3, locate the score for this step in
table A.
• Step 5: Add the force score to this box. In this case, the weight of the
component part inserted by the worker is 11.5 lbs. Therefore, the
score for this step is +1.
• Step 6: Add the values in step 4 and 5 to obtain score A. Find row for
Score A in Table C and circle value.
• Step 4 - 6:
• Steps 7-9: Right Arm and Wrist Analysis
• Step 10: Using values from steps 7-9, locate the posture score for this
step in table B.
• Step 11: Add the coupling score. In this case, the coupling is
considered fair (+1).
• Step 12: First, add the values in step 10 and 11 to obtain score B.
Next, find column in Table C and match with Score A in row from step
6 to obtain Table C Score.
• Step 13: The Activity Score is +1 due to job requiring small range
actions (more than 4x per minute). The Final REBA Score = Table C
Score + Activity Score
• Steps 10-
13: Calculate the
score for Group
B as outlined
below.
Evaluation of REBA Score
• After the data for each region is collected and scored, tables on the
form are then used to compile the risk factor variables, generating a
single score that represents the level of MSD risk:
Evaluation of REBA Score
• A follow-up analysis using the REBA worksheet was performed. Using
the new work method, the final REBA score was reduced from 9 to 4
Subjective Assessment (RULA)
• Rapid Upper Limb Assessment (RULA) by (McAtamney
and Corlett, 1993) provides an easily calculated rating
of musculoskeletal loads in tasks where people have a
risk of neck and upper-limb loading.
• RULA is used to assess the posture, force, and
movement associated with sedentary tasks. The four
main applications of RULA are to:
1. Measure musculoskeletal risk, usually as part of a broader
ergonomic investigation
2. Compare the musculoskeletal loading of current and
modified workstation designs
3. Evaluate outcomes such as productivity or suitability of
equipment
4. Educate workers musculoskeletal risk created by different
working postures
RULA Assessment Worksheet
RULA Level of MSD Risk
Using RULA Assessment Tool
• The evaluator should prepare for the assessment by interviewing the
worker being evaluated to gain an understanding of the job tasks and
demands, and observing the worker’s movements and postures
during several work cycles.
• Selection of the postures to be evaluated should be based on:
1. the most difficult postures and work tasks (based on worker interview and
initial observation),
2. the posture sustained for the longest period of time,
3. the posture where the highest force loads occur.
• The RULA can be conducted quickly, so multiple positions and tasks
within the work cycle can usually be evaluated without a significant
time and effort.
• When using RULA, only the right or left side is assessed at a time.
• After interviewing and observing the worker, the evaluator can
determine if only one arm should be evaluated or if an assessment is
needed for both sides.
• Step 1 – 4 : Right Arm & Wrist Analysis
• Step 5 : using values from step 1 – 4, locate the score for this step in
Table A.
• Step 6 : Add the muscle use score to this box. In this example, the
posture is not sustained for more than 10 minutes, and not repeated
4x per minute. Therefore the score is zero (0).
• Step 7 : In this example, the load is greater than 4.4 lbs. and repeated.
Therefore, the score is +2.
• Step 8 : Add the values in steps 5 -7 to obtain the Wrist / Arm Score.
• Step 5 – 8: Calculate the score for group A
• Steps 9 – 11: Neck, Trunk and leg Analysis
• Steps 12 - 15: Calculate the
total score for Group B as
outlined below:
• Step 12: Using values from steps 9-11, locate the score for this step in
table B.
• Step 13: Add the muscle use score to this box. In this example, the
posture is not sustained for more than 10 minutes, and not repeated
4x per minute. Therefore, the score is 0.
• Step 14: In this example, the load is greater than 4.4 lbs. and
repeated. Therefore, the score is +2.
• Step 15: Add the values in steps 12-14 to obtain the Neck, Trunk, &
Leg Group B Score.
• Determine Final RULA Score: Use Table C to determine the final RULA
score as shown below.
• Final RULA Score = 7
In this example, the final RULA score of 7 indicates high risk and calls
for engineering and/or work method changes to reduce or eliminate
MSD risk as outlined in the chart.

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Measurement and Ergonomic

Implications of Work Posture

• OWAS Example Results

• Neutral : 52% (Acceptable)

The REBA worksheet is

• Section A (left side) covers

Score Group A (Trunk, Neck

Group B (Upper Arms, Lower

For each region, there is a

The REBA worksheet is

• Section A (left side) covers

Score Group A (Trunk, Neck

Group B (Upper Arms, Lower

For each region, there is a

The REBA worksheet is

• Section A (left side) covers

Score Group A (Trunk, Neck

Group B (Upper Arms, Lower

For each region, there is a

The REBA worksheet is

• Section A (left side) covers

Score Group A (Trunk, Neck

Group B (Upper Arms, Lower

For each region, there is a

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