TY - JOUR
T1 - Characterization of right wrist posture during simulated colonoscopy
T2 - An application of kinematic analysis to the study of endoscopic maneuvers
AU - Mohankumar, Deepika
AU - Garner, Hunter
AU - Ruff, Kevin
AU - Ramirez, Francisco C.
AU - Fleischer, David
AU - Wu, Qing
AU - Santello, Marco
N1 - Funding Information:
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication. This work has been partially supported by an ASU-Mayo Innovation Technology Seed grant (M.S., D.F.).
Copyright:
Copyright 2014 Elsevier B.V., All rights reserved.
PY - 2014/3
Y1 - 2014/3
N2 - Background Endoscopic maneuvers are associated with a high incidence of musculoskeletal injuries. Objective To quantify wrist motion patterns during simulated endoscopic procedures to identify potential causes of endoscopy-related overuse injury. Design Twelve endoscopists with different levels of experience were tested on 2 simulated endoscopic procedures that differed in their level of difficulty. Setting Right wrist movement patterns were recorded during simulated colonoscopies by using a magnetic motion-tracking device. Analysis focused on 3 wrist degrees of freedom: abduction/adduction, flexion/extension, and pronation/supination. Interventions Subjects were tested on 2 GI lower endoscopies (colonoscopies) on a simulator. Main Outcome Measurements Time spent within ranges of the entire wrist range of motion for 3 wrist degrees of freedom. Results Endoscopists spent up to 30% of the duration of the procedures at the extremes of the wrist joint range of motion. Endoscopic experience did not affect the time spent at the extremes of the wrist joint of motion. The time spent within each range of motion differed depending on the wrist degrees of freedom and difficulty of procedure. Limitations This study examined only 1 upper limb joint in a limited number of subjects and did not measure interaction forces with endoscopic tools. Conclusions We identified wrist movement patterns that can potentially contribute to the occurrence of musculoskeletal injury in endoscopists. This study lays the foundation for future work on establishing links between upper limb movement patterns and the occurrence of overuse injury caused by repetitive performance of endoscopic procedures.
AB - Background Endoscopic maneuvers are associated with a high incidence of musculoskeletal injuries. Objective To quantify wrist motion patterns during simulated endoscopic procedures to identify potential causes of endoscopy-related overuse injury. Design Twelve endoscopists with different levels of experience were tested on 2 simulated endoscopic procedures that differed in their level of difficulty. Setting Right wrist movement patterns were recorded during simulated colonoscopies by using a magnetic motion-tracking device. Analysis focused on 3 wrist degrees of freedom: abduction/adduction, flexion/extension, and pronation/supination. Interventions Subjects were tested on 2 GI lower endoscopies (colonoscopies) on a simulator. Main Outcome Measurements Time spent within ranges of the entire wrist range of motion for 3 wrist degrees of freedom. Results Endoscopists spent up to 30% of the duration of the procedures at the extremes of the wrist joint range of motion. Endoscopic experience did not affect the time spent at the extremes of the wrist joint of motion. The time spent within each range of motion differed depending on the wrist degrees of freedom and difficulty of procedure. Limitations This study examined only 1 upper limb joint in a limited number of subjects and did not measure interaction forces with endoscopic tools. Conclusions We identified wrist movement patterns that can potentially contribute to the occurrence of musculoskeletal injury in endoscopists. This study lays the foundation for future work on establishing links between upper limb movement patterns and the occurrence of overuse injury caused by repetitive performance of endoscopic procedures.
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U2 - 10.1016/j.gie.2013.11.023
DO - 10.1016/j.gie.2013.11.023
M3 - Article
C2 - 24439784
AN - SCOPUS:84893839656
SN - 0016-5107
VL - 79
SP - 480
EP - 489
JO - Gastrointestinal endoscopy
JF - Gastrointestinal endoscopy
IS - 3
ER -