Author(s)
Emily A. Montgomery, MS
Danielle A. Morrison, MD
Matthew T. Ryan, MD
Jacqueline M. Tamayo, Occupational Therapist
Francois O. Tuamokumo, PhD
Anthony M. Tolisano, MD
Charles A Riley, MD
Affiliation(s)
Uniformed Services University of the Health Sciences;
Abstract:
Introduction: Poor ergonomics during endoscopic sinus surgery (ESS) can lead to significant physical discomfort. The purpose of this study is to compare objective ergonomic posture and subjective pain scores among otolaryngology residents and medical students performing simulated ESS.
Methods: In a cross-sectional study, participants performed ESS on cadavers and were assigned a Rapid Upper Limb Assessment (RULA) score by an Occupational Therapist trained in ergonomics. Participants completed a survey addressing discomfort related to ESS. Participants were compared by level of training: senior residents (SRs) vs junior residents (JRs) vs medical students (MSs), gender, monitor gaze, and other factors.
Results: A total of 14 participants completed surveys (SRs: 4, JRs: 6, MSs: 4) with 10 participants meeting inclusion criteria for RULA analysis (SRs: 3, JRs: 3, MSs: 4). Total average RULA was 3.8 +/- 1.0. A total of 57% of survey respondents experienced pain attributed to ESS. No independent risk factors were found to be significantly associated with pain during ESS: level of training (p = 0.223), female gender (p = 0.408), non-horizontal gaze (p = 0.064), height (dichotomized) (p = 0.221), and footwear (p = 0.273). No independent risk factors were found to be significantly associated with RULA score: amount of training (p = 0.380), female gender (p = 0.999), non-horizontal gaze (p = 0.576), footwear (p = 0.999), and perceived pain (p = 0.999).
Conclusions: Our study did not demonstrate a significant association between RULA score and subjective pain between SRs, JRs, and MSs. Further study examining potential associations between objective ergonomic posture and subjective pain during ESS is needed.