By: Noor Emellia Jamaludin Pegawai Pemulihan Perubatan Hospital Sultan Abdul Halim

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Straight your body Listen to this video Follow as instructed

Pain or stiffness in your back, arms, or legs
◦ at the end of your work day or ◦ after performing the same task at work for prolonged periods of time?

Workstation, equipment, and/or work practices are the cause. It is important to recognize the work hazards that can lead to musculoskeletal injury, determine what improvements or changes should be made, and take action to improve your workspace.

Craskey CR. (1999):
◦ Ergonomics can improve work quality, increase productivity, raise morale, reduce absenteeism, and reduce workers compensation ◦ CTSs represent 65% of all injuries reported in clinical laboratory. ◦ Safety is everyone's job.

Seema VK. et. al., (2010):
◦ The laboratory workers are at increased risk of developing CTS, particularly technicians. ◦ If proper preventive measures are not initiated, they may progress and lead to late stages which can be quite debilitating.

Make the work fit the person, not the person fit the work. Goals;
◦ Finding ways to make strenuous, often repetitive work, less likely to prevent muscle and joint injuries -- and still get the job done. ◦ To prevent disorders of the soft-tissues such as muscles, tendons, nerves, blood vessels, & joints.

Common Musculoskeletal Disorders
◦ Stenosing tenosynovitis of the finger (trigger finger). ◦ De Quervain's disease. (thumb –gripping) ◦ Raynaud's phenomenon (white finger or vibration syndrome). ◦ Thoracic outlet syndrome (pain in neck, arm, hand) ◦ Carpal Tunnel Syndrome (enflamed/ compressed medial nerve) ◦ Back Strain/Sprain

Awkward Postures

Repetition Repetition

Awkward postures

Force Force

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Each risk factor is significant. However, discomfort or injury is more likely to develop when two or more of these factors are combined & the risk exposure is sustained over time.

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Prolonged use of a keyboard or mouse Prolonged sitting at a microscope Pipetting Screwing and unscrewing vial caps Standing at a laboratory instrument for a prolonged period of time Lack of rest - intensive hours at the workstation with few breaks Sustained awkward position

Use “Neutral Posture” at the Computer & Other Equipment

Neutral posture:

◦ Back supported by the chair back
◦ Ears, Shoulders, Elbows, Hips vertically aligned ◦ Elbows, hips, knees bent at near-right angles (90o – 105o) ◦ Feet flat on the floor or footrest

The basic neutral position most lab personnel should utilize a majority of the time they spend seated at the computer or other equipment.

Forward tilt posture:

◦ Raise the chair height a few inches and tilt the front downward slightly (8o 10o)
◦ Opens hip angle allowing legs to support some weight. ◦ Good position for lab work at a microscope or in a safety hood; ◦ Not recommended if you have knee or foot problems. May be used occasionally throughout the day by most people; but is not recommended for long periods at a time.

Reclining posture: ◦ Lean back 10o - 20o into the chair's backrest and put your feet out in front of you. ◦ Opens hip and knee angles to help relax back muscles and promotes blood circulation. Leaning back too far can result in an awkward neck posture. May be used occasionally throughout the day by most people; but not recommended for long periods at a time.

Standing posture:

◦ Provides biggest change in posture
◦ Good alternative to prolonged sitting ◦ Can be fatiguing, have chair available ◦ Prop one foot up on a low footrest to help occasionally shift your weight.

May be used occasionally throughout the day by most people; but not recommended for long periods at a time.

Neutral

Neutral

Use Neutral Hand Position whenever possible
working with equipment and tools.

Neutral

Awkward

Awkward Neutral

Neutral Awkward

Awkward

Neutral

When uses input devices;

o Proximity – Items close enough to use while your elbows are aligned between shoulders and hips. No reaching from the shoulder.
o Angle – Wrists & forearms parallel to the floor. No forearm or wrist angle.

o Padding - No resting on hard edges. Gel wrist rests are helpful.

Repetitive motions are those that are repeated every few seconds for extended periods of time. Repetitive activities are most often a concern when combined with awkward positions, high forces, or significant amounts of time spent at the activity without adequate recovery time.

Static Loading

Pinching

Manual Material handling

Gripping

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Eliminate awkward positions Use mechanical advantage Reduce weight of tool or object Redesign tool/user interface Use sharp, well-maintained tools Alternate Positions/Tasks Avoid resting your wrists against a desk edge Look at Material Handling Alternatives

Bend your Knees Get Close to the Load - Not your Back!

Use Large Leg Muscles to Rise Until Standing

Neck & shoulder Back, side and legs Relaxing eyes Stretch to prevent CTS

Shoulder Shrug: The purpose of the shoulder shrug is to relieve early symptoms of tightness or tension in the shoulder and neck area.

Head Glide: The head glide helps to stretch your chest, neck and shoulder muscles

Neck Relaxer: This exercise helps to relax the neck.

Shoulder Roll: This exercise will help relax the shoulder muscles.

Back / side stretch

Middle / upper back stretch

Back Curl (will also stretch your legs)

Ankle flex & stretch

Leg lift

Technique 1: Palming
◦ Rub your hands together until they feel warm (about 15 to 20 seconds). Then place your cupped hands over your closed eyes, being careful not to touch your eyes with the palms of your hands. The fingers of each hand should overlap and rest gently on the center of your forehead. ◦ Sit quietly for one to two minutes with your hands over your eyes. The more relaxed you become, the blacker the darkness you will see with your eyes closed.

Technique 2: Near-far focus
◦ ◦ ◦ ◦ ◦ ◦ Hold your thumb six inches from your nose. Focus on your thumb. Take one deep breath and exhale slowly. Then focus on an object about 10 feet away. Take another deep breath and slowly exhale. Repeat back and forth 15 times

Extend and stretch both wrists and fingers acutely as if they are in a handstand position. Hold for a count of 5.

Straighten both wrists and relax fingers.

Make a tight fist with both hands.

Then bend both wrists down while keeping the fist. Hold for a count of 5.

Straighten both wrists and relax fingers, for a count of 5.

The exercise should be repeated 10 times. Then let your arms hang loosely at the side and shake them for a few seconds

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Know the warning signs of back pain caused by poor ergonomics and posture. Get up and move. Keep the body in alignment while sitting in an office chair and while standing. Use exercise to help prevent injury and promote good posture. Wear supportive footwear when standing

For more information and intervention, please visit our department: Occupational Therapy Department, HSAH

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