Assessment of a passive wearable robot for reducing low back disorders during rebar work

Low back disorder continues to be prevalent amongst construction workers, especially the rebar workers who are often engaged in repetitive stooping postures. Wearable robots, exoskeletons, are recent ergonomic interventions currently explored in the construction industry that have potentials of reducing the risks of low back pain by augmenting users’ body parts and reducing demands on the back. This paper presents the assessment of a commercially available passive wearable robot, BackX, designed for reducing low back disorder amongst rebar workers. The study evaluated the exoskeleton in terms of task performance and physiological conditions. Outcome measures such as completion time were employed to evaluate the effect of the exoskeleton on task performance, while activations of Erector Spinae and Latissimus Dorsi muscles, and perceived discomfort across body parts were employed to assess the physiological effects of the exoskeleton. The results indicated mixed effects of the exoskeleton on muscle activations. Although the results revealed that the exoskeleton can reduce muscle activations across the Latissimus Dorsi, mixed effects were observed for the Erector Spinae especially during the forward bending tasks. The exoskeleton reduced completion time by 50% during the rebar tasks. There was also a 100% reduction in perceived discomfort on the back, but discomfort was tripled at the chest region when the exoskeleton was worn. This study reveals the potentials of the exoskeleton for reducing low back disorder and improving productivity amongst the rebar workers. However, the unintended consequences such as increased discomfort at the chest region and activations of the muscles highlight the need for improving existing exoskeleton designs for construction work.

Stressed Out: Predictors of Depression Among Jail Officers and Deputies

Prevalence and predictors of depression, a debilitating medical illness, are unknown among officers working in jails. We conducted a cross-sectional survey with jail officers at four facilities, utilizing age, ethnicity, gender, musculoskeletal back disorder, global physical health and mental health, and psychological well-being as predictor variables. Descriptive analyses detailed prevalence, and hierarchical regression models identified depression predictors. The prevalence of depression among jail officers was high and strongly influenced by job burnout over and above other health indicators. Mitigation of workplace stressors and identification of targeted interventions are needed to reduce risks for depression among jail officers.

Understanding Causal Pathways for Occupationally Related Low Back Disorders

Extended Abstract Low back pain has been a leading cause of disability worldwide for nearly two decades (Hartvigsen et al 2018). In a study of US health care spending between 1996 through 2013, low back and neck pain was the health care condition with the highest increase in spending (Dieleman et. al. 2016). Continued increases in health care costs due to low back pain are not sustainable. Therefore, we need to develop better low back disorder prevention plans or tools. In order to prevent occupational low back disorders several tools (ie. NIOSH lifting guide, 3DSSPP, Snook Tables, Lumbar Motion Monitor risk model, REBA, LiFFT) have been developed to quantify the biomechanical or physical exposure risk. There are a multitude of risk factors for low back disorders including psychological, psychosocial, and personal factors none of which are included in the available ergonomics tools (Ferguson and Marras, 1997). The goal of this panel is to promote discussion of the biopsychosocial risk factors that lead to low back disorders and disability. Health care providers suggest that patient advocacy should include preventing prolonged work loss (Nguyen and Randolph, 2007) yet one of the most common personal risk factors of low back pain is previous history of low back pain. The prevention tools above do not include any personal risk factors regarding an individual’s low back health status or any other personal risk factor. Should a new low back injury prevention tool include some personal risk factors for previous low back injury or some other personal risk factor? What about a smoking status risk factor or since sitting is the new smoking what about a sitting risk factor? What about psychosocial factors such as supervisor support or co-worker support? What new tools might we need? What stakeholders to do we need or want at the table in order to develop a tool that will actually be effective and who will the users be? The National Institute of Occupational Safety and Health funded several field studies in the 2000s to examine biomechanical exposure as risk factors of low back disorders. Several of the panelists had studies in the group. A consortium was formed to pool data where possible to increase statistical power to measure these more complex relationships. The common surveillance questionnaire measures of low back disorder included varying degrees of low back disorder severity. The surveillance measures in order from least severe to most severe were 1) any low back pain, 2) seeking medical care due to low back pain and 3) self-reported lost time due to low back pain in the past year. The panelists will be asked to address how the role of their specific topic may change as a function of the various surveillance measures. What does a new tool being developed really need to prevent (low back pain, seeking medical care, self-reported lost time, low back disability)? We will have each panel member discuss causality from several different multidimensional perspectives and will have an open debate/discussion. We will also allow time for audience perspectives Panelist Roles Dr. Jay Kapellusch will be discussing the role of psychophysics and the NIOSH lifting equation. Dr. Matthew S. Thiese will be examining the role of psychosocial risk factors. Dr. Kermit Davis will address interventions. Dr. Sean Gallagher will be probing specific physical injury mechanisms. Dr. William S. Marras will be presenting the multidimensional causal pathway for low back disorders.

Clinical investigation of back disorders in horses: A retrospective study (2002-2017)

Background and Aim: Back disorder is an ailment that often affects athletic and riding horses. Despite the rapidly growing equine athletic and equestrian activities, there is no documentation on the nature of equine back disorder (EBD) in Malaysian horses. The purpose of this study was to characterize EBD cases presented to University Veterinary Hospital, Universiti Putra Malaysia, between 2002 and 2017. Materials and Methods: The compilation of data was based on signalment, case history, duration of clinical signs, anatomical location of the pain, method of diagnosis, type of EBD, treatment, and outcome. The diagnosis of EBD was based on a history of poor performance, clinical examination findings, radiography, and, where applicable, necropsy. Results: A total of 181 diagnosed cases of EBDs were identified. The age of horses ranged from 5 to 22 years. The EBD cases were more prevalent in male than female horses and predominantly in geldings (60.77%). Thoroughbred, Arab, Polo pony, and Warmblood also recorded the most EBD cases among breeds. The discipline of horses tended to influence the development of EBDs, with patrolling horses recording the highest frequency. Most EBD cases were of the primary type (92.27%), with the main causes being soft-tissue lesions (57.48%), vertebral lesions (18.56%), tack-associated problems (16.77%), and neurological lesions (7.19%). The common treatments employed were administration of nonsteroidal anti-inflammatory agents, 1 to 3-month rest, warm and cold compression therapy, massage therapy, exercise adjustment, as well as correction of ill-saddle fit. Conclusion: Most EBDs in this study were associated with soft-tissue lesions. Among vertebral lesions, kissing spines were the most common cause of EBDs in horses in Malaysia.

Hard Physical Work Intensifies the Occupational Consequence of Physician-Diagnosed Back Disorder: Prospective Cohort Study with Register Follow-Up among 10,000 Workers

While musculoskeletal pain is common in the population, less is known about its labor market consequences in relation to physical activity at work. This study investigates whether hard physical work aggravates the consequences of back disorder. Using Cox regression analyses, we estimated the joint association of physical activity at work and physician-diagnosed back disorder in 2010 with the risk of register-based long-term sickness absence (LTSA) of at least 6 consecutive weeks during 2011-2012 among 9,544 employees from the general working population (Danish Work Environment Cohort Study). Control variables were age, gender, psychosocial work environment, smoking, leisure physical activity, BMI, depression, and mental health. At baseline, 19.4% experienced high low-back pain intensity (≥5, 0–9 scale) and 15.2% had diagnosed back disorder. While high pain intensity was a general predictor for LTSA, physician-diagnosed back disorder was a stronger predictor among those with hard physical work (HR 2.23; 95% CI 1.68–2.96) compared with light work (HR 1.40; 95% CI 1.09–1.80). Similarly, physician-diagnosed back disorder with simultaneous high pain intensity predicted LTSA to a greater extent among those with hard physical work. In conclusion, the occupational consequence of physician-diagnosed back disorder on LTSA is greater among employees with hard physical work.