Max Wunderlich

Analyse der Wirbelsäulenbelastung bei Operationstätigkeiten in der HNO-Heilkunde

BACKGROUND Back pain is a common cause of sick leave in industrialized countries. Performing surgery is often associated with considerable cervical spine disorders. However, only a few studies have examined to what extent working posture or individual surgical techniques can be seen as stress indicators. MATERIAL AND METHODS Posture and movement of the spine and trunk were assessed by means of a newly developed analysis system (3-D-SMG). The individual-case study was carried out during six sinus operations using varying techniques (microscope, endoscope or headlamp only). RESULTS Spine and trunk deviation from neutral position (upright standing) was strongest in the sagittal plane. Awkward distortions were primarily observed in the cervical and lumbar spine. The analysis of work characteristics revealed static postures in 65-90% of sinus operations. Isometric positions were mainly related to microscopic surgery. CONCLUSIONS The data from this explorative individual-case study indicate that prevalence and magnitude of forced isometric and awkward postures are strongly associated with work-related spinal stress in sinus surgery. The new measurement device enables not only the recommendation of individual preventive strategies but also the objective evaluation of ergonomics.

Validation of a short-term memory test for the recognition of people and faces

Memorising and processing faces is a short-term memory dependent task of utmost importance in the security domain, in which constant and high performance is a must. Especially in access or passport control-related tasks, the timely identification of performance decrements is essential, margins of error are narrow and inadequate performance may have grave consequences. However, conventional short-term memory tests frequently use abstract settings with little relevance to working situations. They may thus be unable to capture task-specific decrements. The aim of the study was to devise and validate a new test, better reflecting job specifics and employing appropriate stimuli. After 1.5 s (short) or 4.5 s (long) presentation, a set of seven portraits of faces had to be memorised for comparison with two control stimuli. Stimulus appearance followed 2 s (first item) and 8 s (second item) after set presentation. Twenty eight subjects (12 male, 16 female) were tested at seven different times of day, 3 h apart. Recognition rates were above 60% even for the least favourable condition. Recognition was significantly better in the ‘long’ condition (+10%) and for the first item (+18%). Recognition time showed significant differences (10%) between items. Minor effects of learning were found for response latencies only. Based on occupationally relevant metrics, the test displayed internal and external validity, consistency and suitability for further use in test/retest scenarios. In public security, especially where access to restricted areas is monitored, margins of error are narrow and operator performance must remain high and level. Appropriate schedules for personnel, based on valid test results, are required. However, task-specific data and performance tests, permitting the description of task specific decrements, are not available. Commonly used tests may be unsuitable due to undue abstraction and insufficient reference to real-world conditions. Thus, tests are required that account for task-specific conditions and neurophysiological characteristics.

Utilization and implementation of sports medical screening examinations: survey of more than 10 000 long-distance runners.

INTRODUCTION Preventive medical checkups may help to lower the health risks incurred by participation in sporting activity. However, there are no epidemiologically relevant data on either utilization or implementation of such checkups. METHODS An internet questionnaire (www.dshs-koeln.de/pace) and personal interviews of long-distance runners were used to obtain information on the acceptance and realization of medical checkups. RESULTS Only 50% of 10 025 runners had undergone preventive medical screening. Beginners and returnees to long-distance running are significantly less likely to have themselves checked than performance-oriented athletes (42.0% vs. 59.9%; p < 0.01). Moreover, the survey revealed deficiencies in many sports medical tests; for example, over 15% of runners screened stated that their checkup had not included physical examination. Resting ECG was performed in only 67.4% of cases. DISCUSSION The findings underline the need for qualified pre-emptive sports medical screening. If current public health campaigns are successful, higher numbers of overweight, untrained persons of all age groups will have to be examined and advised.

Analysis of spinal stress during surgery in otolaryngology

BACKGROUND Back pain is a common cause of sick leave in industrialized countries. Performing surgery is often associated with considerable cervical spine disorders. However, only a few studies have examined to what extent working posture or individual surgical techniques can be seen as stress indicators. MATERIAL AND METHODS Posture and movement of the spine and trunk were assessed by means of a newly developed analysis system (3-D-SMG). The individual-case study was carried out during six sinus operations using varying techniques (microscope, endoscope or headlamp only). RESULTS Spine and trunk deviation from neutral position (upright standing) was strongest in the sagittal plane. Awkward distortions were primarily observed in the cervical and lumbar spine. The analysis of work characteristics revealed static postures in 65-90% of sinus operations. Isometric positions were mainly related to microscopic surgery. CONCLUSIONS The data from this explorative individual-case study indicate that prevalence and magnitude of forced isometric and awkward postures are strongly associated with work-related spinal stress in sinus surgery. The new measurement device enables not only the recommendation of individual preventive strategies but also the objective evaluation of ergonomics.

Analyse von Wirbelsäulenbelastungen in ärztlichen Berufsfeldern

ZusammenfassungHintergrundIn ärztlichen Berufsgruppen sind Rückenschmerzen weit verbreitet. Als mögliche Ursache wird überwiegend die häufig ungünstige Körperhaltung bei den Tätigkeiten angegeben. Trotz der starken Verbreitung liegen zu diesen Tätigkeiten bislang kaum messtechnische Daten zur Haltungs- und Bewegungscharakteristik der Wirbelsäule vor. Zielsetzung war es daher, exemplarisch die Daten der Arbeitshaltung einer sitzenden und stehenden ärztlichen Tätigkeit zu analysieren.MethodenDie Datenerhebung erfolgte mithilfe eines neu entwickelten dreidimensionalen Analyseverfahrens (3D-SMG) während nichtchirurgischen-parodontologischen Behandlungen bzw. HNO-Operationen.ErgebnisseBeide Tätigkeiten wurden vorwiegend in asymmetrischer Haltung ausgeübt. Die Analyse der Wirbelsäulendynamik ergab für 70–80% der Tätigkeitsdauer statische Arbeitshaltungen. Dynamische Abschnitte waren nur von kurzer Dauer und geringer Amplitude. Insgesamt waren die HNO-Operationen durch eine stärkere Asymmetrie, Oberkörpervorneigung und Haltungsvariabilität gekennzeichnet.SchlussfolgerungenZur Kompensation der Belastungsfaktoren sollten neben einzelnen ergonomischen Maßnahmen, insbesondere kurze, auflockernde Bewegungsphasen in den Tagesablauf integriert werden, um die belastungsassoziierte Schmerzursache zu reduzieren.AbstractBackgroundBack pain is a common health problem in medical occupations. Work-related awkward postures have often been cited as potential risk factors. Despite the high prevalence of back pain valid measurements of posture and kinematics of the spine in field studies are still missing. Therefore the aim of the present study was to analyse work-related postures of sitting and standing medical occupations with a new mobile measurement system.MethodsData were collected by the recently developed three-dimensional measurement system (3D-SMG). Nonsurgical periodontal treatment modalities and ENT surgeries were recorded by an individual case study.ResultsBoth occupations were performed in a mainly asymmetrical position of the spine. Moreover, the analysis of the spine kinematics revealed static postures in 70–80% of the work duration. Movements were rare and of small amplitude. Asymmetric postures, forward trunk inclination and posture variability were increased during ENT surgery.ConclusionsTo compensate for physiological load factors the implementation of ergonomic measures is insufficient. The present data indicate that loosening movements should be integrated into the daily work routine in order to reduce the strain-dependent pain genesis.

Analyse der Wirbelsäulenbelastung bei Operationstätigkeiten in der HNO-Heilkunde@@@Analysis of spinal stress during surgery in otolaryngology

BACKGROUND Back pain is a common cause of sick leave in industrialized countries. Performing surgery is often associated with considerable cervical spine disorders. However, only a few studies have examined to what extent working posture or individual surgical techniques can be seen as stress indicators. MATERIAL AND METHODS Posture and movement of the spine and trunk were assessed by means of a newly developed analysis system (3-D-SMG). The individual-case study was carried out during six sinus operations using varying techniques (microscope, endoscope or headlamp only). RESULTS Spine and trunk deviation from neutral position (upright standing) was strongest in the sagittal plane. Awkward distortions were primarily observed in the cervical and lumbar spine. The analysis of work characteristics revealed static postures in 65-90% of sinus operations. Isometric positions were mainly related to microscopic surgery. CONCLUSIONS The data from this explorative individual-case study indicate that prevalence and magnitude of forced isometric and awkward postures are strongly associated with work-related spinal stress in sinus surgery. The new measurement device enables not only the recommendation of individual preventive strategies but also the objective evaluation of ergonomics.