Assessment of dental student posture in two seating conditions using RULA methodology – a pilot study The working postures among schoolchildren--a controlled intervention study on the effects of newly designed workstations. University students' notebook computer use: lessons learned using e-diaries to report musculoskeletal discomfort A randomized study of the sitting position for delivery using a newly designed obstetric chair A dental stool with chest support reduces lower back muscle activation The effects of ergonomically designed school furniture on pupils' attitudes, symptoms and behaviour. A wheelchair cushion designed to redistribute sites of sitting pressure. Evaluation of ergonomic factors and postures that cause muscle pains in dentistry students’ bodies Delivery in an obstetric birth chair: a randomized controlled trial A randomized control trial to evaluate pressure-reducing seat cushions for elderly wheelchair users. Multi dimensional system for evaluating preventive program for upper extremity disorders among computer operators. Passive rotary dynamic sitting at the workplace by office-workers with lumbar pain: a randomized multicenter study. Participatory ergonomics to reduce exposure to psychosocial and physical risk factors for low back pain and neck pain: results of a cluster randomised controlled trial A chairside aid for shared decision making in dentistry: a randomized controlled trial. Effects of participatory ergonomic intervention on the development of upper extremity musculoskeletal disorders and disability in office employees using a computer The Effect of an e-Health Intervention Designed to Reduce Prolonged Occupational Sitting on Mean Arterial Pressure The relationship between pressure ulcer incidence and buttock-seat cushion interface pressure in at-risk elderly wheelchair users.
Objectives To assess dental students ' posture on two different seats in order to determine if one seat predisposes to a difference in working posture . Design A between-subject experimental design was selected . Setting The study was undertaken at the University of Birmingham School of Dentistry in 2006 . Subjects ( material s ) and methods Sixty second year dental students at the University of Birmingham who were attending their fi rst classes in the phantom head laboratory were r and omly selected and allocated to two different seats ( 30 Bambach Saddle Seats and 30 conventional seats ) . Students were trained in the use of the seats . After ten weeks , the students were observed , photographs were taken by the research er and these were assessed using Rapid Upper Limb Assessment ( RULA ) . Main outcome measures The posture of the students was assessed using the RULA . Each student was given a risk score . A Mann Whitney test was used for statistical analysis . Results The results indicated that the students using the conventional seat recorded signifi cantly higher risk scores ( p < 0.05 ) when compared with the students using Bambach Saddle Seat , suggesting an improvement in posture when using the Bambach Saddle Seat . Conclusion RULA has identifi ed that dental students using a Bambach Saddle Seat were able to maintain an acceptable working posture during simulated dental treatment and this seating may reduce the development of work-related musculoskeletal disorders BACKGROUND School workstations are often inappropriate in not offering an optimal sitting posture . The aim of this study was to investigate the effects of individually adjustable saddle-type chairs with wheels and desks with comfort curve and arm support on schoolchildren 's working postures compared to conventional workstations . METHODS Ninety-seven participants aged 12 - 16 years were followed for 1 year , 47 at an intervention school and 50 at a control school .  Anthropometrics and workstation dimensions were measured and working postures analyzed for a part of each group ( n = 21 , both groups ) by means of video recording at baseline , before new workstations were introduced , and during follow-up . RESULTS There was a significant increase in upright back ( p= .012 ) and neck ( p= .019 ) postures in the intervention group compared to controls during follow-up . The saddle-type chairs allowed significantly greater trunk-thigh angles ( p < .001 ) among participants than conventional chairs . CONCLUSIONS In schoolchildren , using individually adjustable saddle-type chairs and desks with comfort curve , a better match between workstations and anthropometric dimensions and improved working postures are obtained than using conventional workstations The objective of this pilot study was to identify if notebook accessories ( ergonomic chair , desktop monitor and notebook riser ) combined with a wireless keyboard , mouse and participatory ergonomics training would have the greatest impact on reducing  self-reported upper extremity musculoskeletal discomfort in university students . In addition to pre-post computing and health surveys , the Ecological Momentary Assessment was used to capture change in discomfort over time using a personal digital assistant ( PDA ) as the e-diary . The PDA was programmed with a survey containing 45 questions . Four groups of university students were r and omised to either intervention ( three external computer accessories ) or to control . Participants reported less discomfort with the ergonomic chair and notebook riser based on the pre-post survey data and the e-diary/PDA ANOVA analysis . However , the PDA data , adjusted for the effect of hours per day of computer use , showed no benefit of the chair and limited benefit from the riser . Statement of Relevance : University students ' use of notebook computers has increased . This study found evidence of a positive effect of an adjustable chair or notebook riser when combined with ergonomic training on reducing discomfort . Daily  notebook computer use of 4 h was confirmed as a risk factor . Without some form of ergonomic intervention , these students are likely to enter the workforce with poor computing habits , which places them on the road to future injuries as technology continues to play a dominant role in their lives A new obstetric chair has been design ed to overcome some of the problems of those currently available commercially . The chair has been used to assess the effects of the sitting position in the second stage of labour on the outcome of delivery in 304 women r and omly allocated to be delivered either in the chair or in the conventional dorsal position . Delivery in the chair conferred no benefits to mother or baby and result ed in greatcr mean blood loss and a higher rate of postpartum haemorrhage Activation of back musculature during work tasks leads to fatigue and potential injury . This is especially prevalent in dentists who perform much of their work from a seated position . We examined the use of an ergonomic dental stool with mid-sternum chest support for reducing lower back muscle activation . Electromyography of lower back extensors was assessed from 30 dental students for 20 s during three conditions in r and om order : ( a ) sitting upright at 90 ° of hip flexion on a st and ard stool , ( b ) leaning forward at 80 ° of hip flexion on a st and ard stool , and ( c ) leaning forward at 80 ° of hip flexion while sitting on an ergonomic stool . Muscular activity of the back extensors was reduced when using the ergonomic stool compared to the st and ard stool , by 33–50 % ( p < 0.01 ) . This suggests a potential musculoskeletal benefit with use of a dental stool with mid-sternum chest support We tested the effects of implementing ergonomically design ed school furniture on measures of comfort , sitting posture and symptoms .  Three classes of fourth grade rs ( 10 years old ) were r and omly assigned either to a control group using traditional furniture or to an experimental group which received the ergonomically design ed furniture . In both groups question naires were completed and sitting behaviour was observed twice before and after the intervention as well as at a five-month follow-up period . Although the experimental groups rated their furniture as being significantly more comfortable , differences in actual sitting behaviour were small . The experimental class experienced a reduction in musculoskeletal symptoms relative to the control group after implementing the ergonomically design ed furniture . Since pupils did not automatically sit ' properly ' in the ergonomic furniture , these results demonstrate the need for proper instructions and adjustment . Increased comfort and decreased symptoms may be used to motivate pupils to sit correctly . Our results suggest that furniture design is one aspect of a multidimensional problem OBJECTIVES Despite the diversity of wheelchair cushions currently in clinical use , pressure on bony prominences continues to be a major problem for wheelchair-bound patients , and the incidence of pressure ulcers remains high . No static surface has been reported to reduce resting pressure under the ischial tuberosities to below that of capillary pressure , which may well be the threshold for inducing tissue damage . An entirely new form of seating was design ed to decrease absolute pressure using a prosthetic fitting technique analogous to a below-the-knee prosthesis . DESIGN A repeated measures r and omized design was used to test differences between the experimental ( TCS ) and three other st and ard cushions . SETTING A Veterans Medical Center outpatient service . PATIENTS Wheelchair-bound volunteer subjects , n = 47 , were selected who weighed more than 60 kg . MAIN OUTCOME MEASURES Pressures were measured by a st and ard air pressure pad and also by a computer-linked array of pressure transducers . The grid was st and ardized and used to generate topographic maps for each site over time . These data were used to measure the seating interface pressures . RESULTS There was a significant main effect of cushion over site , F = 131 for left ischial tuberosity . Pressure were lowest while patients sat on the experimental seat and differences were significant at all time points . Using 1psi as presumed capillary pressure , frequency of success at achieving this pressure threshold was greatest for the experimental seat , p < .001 . This difference persisted throughout the 30 minutes of testing . CONCLUSIONS A computerized pressure grid was developed that allowed evaluation of anatomically localized pressures . The prosthetically design ed TCS displays lower seating pressures than any other cushion tested . Consistent and sustained pressures were below the postulated threshold for tissue damage Background Work-related musculoskeletal disorders commonly experienced by dental professionals are one of the main occupational health problem affecting their health and well-being . This study was conducted to evaluate  ergonomic factors and profession-related postures  and also investigate relationship between demographic factors and work condition with pain in dental students . Material and Methods 60 freshman and sophomore dentistry students were r and omly chosen as the subjects of control group , and 60 of 5th and 6th-year students were selected as the members of exposure group . Data related to the subjects such as sex , doing exercise , severity of musculoskeletal pain were obtained through question naire . Students ’ postures were directly observed while treating patients and they were scored by REBA method . Data were analyzed by SPSS software using Man-Whitney , Kruskal-Wallis , Spearman and Kendall correlation tests . Results 80.8 % of the subjects were not aware of the correct ergonomic postures for dental procedures . Severity of musculoskeletal pain in the exposure group ( 15.9± 4.2 ) was significantly higher than the control group ( 10.5 ±3.2 ) , ( p < 0.001 ) . Risk of the most subjects ( 84 % ) was at the medium level . Students who were more involved in clinical activities experienced more muscular pains . Conclusions The musculoskeletal disorders are probable prolonged in working hours in static positions , incorrect work postures , implying more force and even tools and instruments . Therefore , students who are aware of ergonomic principals of their own profession would be able to maintain their health through activities and lifelong . Key words : Posture , dentistry , students , musculoskeletal pain Objective — To determine whether nulliparae whose second stage of labour is conducted in an obstetric birth chair  have a lower incidence of instrumental delivery than those using a conventional delivery bed OBJECTIVE To determine if the use of pressure-reducing wheelchair cushions for elderly nursing home resident wheelchair users who are at high risk for developing sitting-acquired pressure ulcers would result in a lower incidence rate of pressure ulcers , a greater number of days until ulceration , and lower peak interface pressures compared with the use of convoluted foam cushions over a 12-month period . To determine the feasibility of conducting a subsequent full-scale definitive trial to evaluate the use of pressure-reducing seat cushions for elderly nursing home resident wheelchair users . DESIGN R and omized control trial SETTING 2200-bed skilled nursing facilities ( 1 suburban and 1 urban academic medical center ) PATIENTS 32 male and female at-risk nursing home residents who were wheelchair users > or = 65 years of age . Participants had Braden Scale scores < or = 18 , Braden Activity and Mobilitysubscale scores < or = 5 , no sitting surface pressure ulcers , and a daily wheelchair sitting tolerance of more than 6 hours . All met criteria for using the ETAC Twin wheelchair . INTERVENTIONS Seating evaluation with pressure-mapping and subsequent seating prescription . Subjects were assigned to either a foam ( n=17 ) or pressure-reducing cushion ( n=15 ) group and weekly assessment s of skin and pressure ulcer risk were made . MAIN OUTCOME MEASURES Incidence of pressure ulcers , days to ulceration , and peak interface pressure . MAIN RESULTS At a 95 % confidence interval , a 2-tailed analysis showed no differences between the FOAM and pressure-reducing cushion groups for pressure ulcer incidence , total days to pressure ulcer , or initial peak interface pressure .  Pressure-reducing cushions were more effective in preventing sitting-acquired ( ischial ) pressure ulcers ( P<.005 ) . Higher interface pressures were associated with a higher incidence of pressure ulcers ( P<.001 ) . CONCLUSIONS A definitive r and omized control multicenter cushion trial is feasible with a sample size of 50 to 100 per study group . In the definitive trial , the definition of sitting-acquired pressure ulcers should be limited to lesions occurring over the ischial tuberosities Typing is associated with musculoskeletal complaints ( MSCs ) , caused by multiple risk factors . Although a wide variety of ergonomic intervention programs were conducted to reduce risk factors and MSC 's , only few of them were found evidence based . This study aim ed to test the efficacy of a workplace intervention in reducing MSC 's among computer workers . 66 computer workers were assigned r and omly to one of three intervention programs : ergonomic intervention including biofeedback , intervention without biofeedback and control group without intervention . The efficacy was tested by advanced assessment including ; pain location and severity , posture at work , upper extremity 3D kinematics , muscle activity and psychosocial status . Working hypothesis ; significant score differences will be found between the study groups which underwent ergonomic intervention and the control group on the following measures : pain complaints , upper extremity kinematics , muscle activity and psychosocial status . Significant differences were found between pre and post intervention and between research groups and the control group in pain , posture and motion . The ergonomic intervention with biofeedback had no unique contribution in comparison to other interventions . In conclusion ; the proposed intervention program was found efficient for reducing pain among computer workers BACKGROUND CONTEXT It is generally recognized that long periods of sitting can either cause or aggravate lumbar pain . A new , ergonomically design ed chair has a fixed backrest and a motor-driven seat with a horizontal rotary movement in alternating left-right cycles . PURPOSE The objective of this study is to prove superiority of the new technique of passive rotary dynamic sitting for subjects working in a sedentary occupation and suffering from lumbar pain . STUDY DESIGN / SETTING A r and omized , double-blind , multicenter , two-armed study was performed using a parallel group design . PATIENT SAMPLE 280 persons suffering from lumbar pain were matched pairwise and r and omized en bloc . OUTCOME MEASURES The first and second primary endpoints target criteria were the vali date d German version of the Oswestry Disability Index ( ODI ) and the number of days of absence from work ( DA ) attributable to lumbar pain , each based on a blinded 2-year follow-up observation after r and omization of the subjects . METHODS After inclusion in the study anonymization , the prob and s were r and omized to receive either an office chair with a motor-driven seat performing a horizontal rotary movement or a chair of the same design without the rotary seat movement . Before delivery of the chairs , 23 prob and s ( 8.2 % ) withdrew their consent to inclusion in the study without stating reasons . From 12 of the remaining matching partners , 23 new pairs were created at r and om , and the study commenced with 124 pairs . RESULTS A further 27 prob and s ( 9.6 % ) were lost to follow-up during the period up to the final consultation . This made it possible to observe the primary endpoint in 82.5 % of the prob and s. The median ODI in both groups was 53 ( 95 % confidence interval for median difference:-1.5 to 0.5 ; p=.59 ) . Median DA in both groups was 0 ( 95 % confidence interval for median difference:-infinity-+infinity ; p=1.00 ) . CONCLUSIONS Under the test conditions used in this study , passive rotary dynamic sitting was not superior to sitting in a high- quality , ergonomically design ed chair not equipped with a micro-rotation function in patients suffering from lumbar pain Objectives This study investigated the effectiveness of the Stay@Work participatory ergonomics programme to reduce workers′ exposure to psychosocial and physical risk factors . Methods 37 departments ( n=3047 workers ) from four Dutch companies participated in this cluster r and omised controlled trial ; 19 ( n=1472 workers ) were r and omised to an intervention group ( participatory ergonomics ) and 18 ( n=1575 workers ) to a  control group ( no participatory ergonomics ) . During a 6 h meeting guided by an ergonomist , working groups devised ergonomic measures to reduce psychosocial and physical workload and implemented them within 3 months in their departments . Data on psychosocial and physical risk factors for low back pain and neck pain were collected at baseline and after 6 months . Psychosocial risk factors were measured using the Job Content Question naire and physical risk factors using the Dutch Musculoskeletal Question naire . Intervention effects were studied using multilevel analysis . Results Intervention group workers significantly increased on decision latitude ( 0.29 points ; 95 % CI 0.07 to 0.52 ) and decision authority ( 0.16 points ; 95 % CI 0.04 to 0.28 ) compared to control workers . However , exposure to awkward trunk working postures significantly increased in the intervention group ( OR 1.86 ; 95 % CI 1.15 to 3.01 ) compared to the control group . No significant differences between the intervention and control group were found for the remaining risk factors . After 6 months , loss to follow-up was 35 % in the intervention group and 29 % in the control group . Conclusion Participatory ergonomics was not effective in reducing exposure to psychosocial and physical risk factors for low back pain and neck pain among a large group of workers . Trial registration IS RCT N27472278 The concept of shared decision making ( SDM ) is an important emerging trend in clinical medicine but has received little or no attention in the dental literature . Decision aids can play a useful role in SDM by helping patients and clinicians choose among reasonable alternative treatment options . The purpose of this study was to develop and test an Endodontic Decision Board ( EndoDB ) for chairside use to help clarify treatment alternatives , benefits , risks , prognosis , and costs when root canal therapy or extraction of a tooth was indicated . The hypothesis was that the use of the EndoDB would lead to improved patient knowledge , greater satisfaction with the decision-making process , and no difference in anxiety when compared to the st and ard discussion and informed consent process ( usual care ) . The EndoDB was tested in a r and omized controlled trial in a postgraduate endodontics clinic . After treatment discussion , a brief question naire was completed by the patient to measure knowledge , satisfaction , and anxiety .  Patients in the EndoDB group ( n=32 ) demonstrated a small , but statistically significant , increase in knowledge ( t-test ; difference=+0.37 ; p=0.03 ) compared to the  usual care group ( n=35 ) . There was no difference between groups in the measures of satisfaction or anxiety ( Mann-Whitney U-test ; p>0.05 ) . Decision aids may emerge as a useful tool to facilitate SDM and evidence -based clinical practice Objective : To evaluate the participatory ergonomic method on the development of upper extremity musculoskeletal disorders and disability in office employees . Methods : This study is a r and omized controlled intervention study . It comprised 116 office workers using computers . Those in the intervention group were taught office ergonomics and the risk assessment method . Cox proportional hazards model and generalized estimating equations ( GEEs ) were used . Results : In the 10-month postintervention follow-up , the possibility of developing symptoms was 50.9 % . According to multivariate analysis results , the possibility of developing symptoms on the right side of the neck and in the right wrist and h and was significantly less in the intervention group than in the control group ( p<0.05 ) . Neck disability/symptom scores over time were significantly lower in the intervention group compared with the control group ( p<0.05 ) . Conclusion : The participatory ergonomic intervention decreases the possibility of musculoskeletal complaints and disability/symptom level in office workers Objective : To evaluate the effect of a workplace health intervention design ed to reduce prolonged occupational sitting on the mean arterial pressure ( MAP ) of desk-based employees . Methods : This r and omized controlled trial involved an experimental group who received an e-health intervention and a control group who did not .  The 13-week intervention passively prompted participants to st and and engage in short bouts of office-based physical activity by interrupting prolonged occupational sitting time periodically throughout the workday . Mean arterial pressure was measured at pretest and posttest . Results : Between pretest and posttest the experimental group significantly reduced their MAP , whereas MAP in the control group did not . Conclusions : A workplace e-health intervention design ed to reduce prolonged occupational sitting was effective in decreasing MAP in desk-based employees OBJECTIVE To investigate the relation between pressure ulcer incidence and buttock-wheelchair seat cushion interface pressure measurements . DESIGN Secondary analysis of data from a r and omized clinical trial . SETTING Skilled nursing facility . PATIENTS Thirty-two elderly patients ( age , > or = 65 yr ) , with Braden score < or = 18 and Braden mobility and activity subscale score < or = 5 , who used wheelchairs > or = 6 hr/d , were free of existing sitting-induced pressure ulcers , and weighed < or = 250 lb . INTERVENTIONS Generic foam seat cushion or pressure-reducing seat cushion . MAIN OUTCOME MEASURES The incidence of sitting-induced pressure ulcers over a 1- to 12-month period was compared with pressure measured between patients ' buttocks and wheelchair seat cushions . A flexible pad with a 15 x 15 pressure sensor array was used to measure interface pressure . RESULTS Interface pressure measured on wheelchair seat cushions was higher ( p < or = .01 for both peak pressure and average of highest 4 pressures ) for patients who developed sitting-acquired pressure ulcers compared with those patients who did not . CONCLUSIONS Results indicated that higher interface pressure measurements are associated with a higher incidence of sitting-acquired pressure ulcers for high-risk elderly people who use wheelchairs
The two eligible studies for this review provide moderate evidence that saddle seats provided lower ergonomic risk than conventional seats in the examined population of dental students
OBJECTIVE This study aim ed to verify whether the saddle seat provides lower ergonomic risk than conventional seats in dentistry .