Digital Human Modeling in Ergonomics Assessment of Patient Lifting by Paramedics

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This thesis to the authors knowledge is the first to attempt the use of Digital Human Modeling in the field of Healthcare (Paramedics). A design of experiment methodology was conducted for three plus a validation experiment. Results signify the importance of defining team roles based on anthropometry and its use in the manufacture of cost effective equipment..

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Digital Human Modeling in Ergonomics Assessment of Patient Lifting by Paramedics

  1. 1. Excellence Through Innovative Research Digital Human Modeling for Ergonomics Assessment of Patient Lifting by Paramedics Akiev Samson Graduate Research Associate Department of Systems Science and Industrial Engineering Binghamton University (State University of New York) Binghamton, NY 13902 Feb 27th, 2009 www.wise.binghamton.edu
  2. 2. Agenda • Ergonomics • Work-Related Musculoskeletal Disorders (WMSDs) • Patient Handling • Paramedic Profession, Statistics • Conventional Ergonomics vs Digital Human Modeling (DHM) • Research Objectives and Outline • Uniqueness and Significance • Experiments • Validation, Anthropometric Effect, Adjustment, Postural Effect • Results • Recommendations • Conclusions and Future Work 2 Binghamton University | February 2009 www.wise.binghamton.edu
  3. 3. Ergonomics Ergonomics 3 Binghamton University | February 2009 www.wise.binghamton.edu
  4. 4. Work-Related Musculoskeletal Disorders (WMSDs) Repetitive Motion WMSDs Injuries Repetitive Strain Injuries Cumulative Trauma Disorders Occupational Cervicobrachial Disorders  Construction Overuse Syndrome  Manufacturing  Mining Regional  Office Work Musculoskeletal Disorders Soft Tissue Orders 4 Binghamton University | February 2009 www.wise.binghamton.edu
  5. 5. Cost of WMSDs Construction: 50,000 Claims $1,000,000,000 Manufacturing: 45,000 Claims $500,000,000 Administrative: 20,000 Claims $200,000,000 “Increase in Ergonomic Educational: 8,000 Claims Injuries, Worker $75,000,000 Compensation Claim..” Healthcare Healthcare: Washington 36, 000 Claims Domain State $340,000,000 “Just for Washington Highest Risk State” $1 in $3 for 2 Million Rate of Spent on WRMSDs Lost 1 in 5 Injuries WRSMDs Workdays Reported Twice the WRMSDs Working Population Center for Occupational and Environmental Medicine, 2003. 5 Safety and Health Assessment and Research for Prevention (SHARP), 2005 Binghamton University | February 2009 www.wise.binghamton.edu
  6. 6. Motivation Du, 2005 6 Binghamton University | February 2009 www.wise.binghamton.edu
  7. 7. Patient Handling in Healthcare “Paramedics do not have the option of Time” 7 Binghamton University | February 2009 www.wise.binghamton.edu
  8. 8. Paramedic Profession “Less emphasis on “More than half have “Many devices Ambulance patient lifting some form of WMSD” and many injuries” Crashes training” Occupational Fatalities Shootings Fire Breakout Patient Lifting Repetitive Back Injuries Bending Awkward Bending Hazardous Material Excessive Sickness Work “Complex and challenging” “Lack of Treating the documentation of “Many EMTs were Diseased data” volunteers” 8 Binghamton University | February 2009 www.wise.binghamton.edu
  9. 9. Paramedics: Statistics Okada et al. (2005) 9 Binghamton University | February 2009 www.wise.binghamton.edu
  10. 10. Conventional Ergonomics vs DHM “Lumbar Motion “Electromyography” Monitor” Reach Zone TSB Simulation Analysis • Postural • Muscle • Stress BORG’s Angles Activity Perception LMM Vision Analysis EMG Scale Collision Detection • 3DSSPP • Electrodes • Survey Digital Humans DHM Never Lower Back Technology Animation Say ‘No’ !! Analysis Static Strength Fatigue Analysis Prediction Metabolic Energy Expenditure 10 Binghamton University | February 2009 www.wise.binghamton.edu
  11. 11. Research Objectives • To demonstrate the effectiveness of DHM software for ergonomics assessment of paramedic patient handling • To study the influence of anthropometry of paramedics on lower back stress • To study the influence of postural variables on lower back stress during patient lifting 11 Binghamton University | February 2009 www.wise.binghamton.edu
  12. 12. Research Outline Quantifying Lower Back Defining Team Roles through Stress: Validation Anthropometry “Challenging Environment” Adjustment of Stretcher and Postural Variables Gurney DHM Software 12 Binghamton University | February 2009 www.wise.binghamton.edu
  13. 13. Uniqueness and Significance “Innovative “Implementation of a Technology to Study Cost Effective Solution Healthcare to Study Healthcare Ergonomics” Ergonomics that will Benefit Healthcare Professionals in the long term” 13 Binghamton University | February 2009 www.wise.binghamton.edu
  14. 14. Research Methodology 14 Binghamton University | February 2009 www.wise.binghamton.edu
  15. 15. Excellence Through Innovative Research Validation of DHM Software as a Tool to Study Patient Lifting www.wise.binghamton.edu
  16. 16. Validation Replication of Images from Previous Research 10 Male Paramedics Variable Anthropometry 48 Kilogram Patient Difference in Back Stress between Teams Average Postural Angles Lavender et al. (2000a, 2000b) 16 Binghamton University | February 2009 www.wise.binghamton.edu
  17. 17. Results: Validation Stretcher Side Stretcher- Side Follower Follower Paramedic Paramedic Stretcher- Side Follower Follower Paramedic Bedside Patient Leader Gurney Side Patient Patient Paramedic: Paramedic Patient Patient Leader Patient Leader Kneeling Leader Bed-side Paramedic: Standing Backboard Patient Stairchair Stairs Stairs Stretcher Stairchair Backboard Stretcher Bed Stairs Stretcher Gurney Bed 17 Binghamton University | February 2009 www.wise.binghamton.edu
  18. 18. Results: Validation (Contd.) 48 Kg Patient “Paramedics will experience > 3400 N at least once during a complete transfer task” 18 Binghamton University | February 2009 www.wise.binghamton.edu
  19. 19. Excellence Through Innovative Research Effect of Anthropometry www.wise.binghamton.edu
  20. 20. Methodology for Simulating Postures Get Anthropometries Identify Grip Points Identify Dimensions which are (can be) Fixed Height of Bed Height of Height Stretcher Distance between Grips of (Stretcher, Backboard & A Gurney Stairchair) 20 Binghamton University | February 2009 www.wise.binghamton.edu
  21. 21. Methodology for Simulating Postures (Contd.) A Position Body with Respect to Grip Points Identify Dimensions (angles) which can be Varied Wrist Angles Validate Postures Trunk Flexion Shoulder Distance between Abduction Hands (Gripping a Bed Sheet) Paramedic Height Analyze Patient Weightth 5th 50th 95th 5th 95th 50 Repeat for Other Digital Humans 21 Binghamton University | February 2009 www.wise.binghamton.edu
  22. 22. Results: Effect of Anthropometry – Paramedic Height “ 22 Binghamton University | February 2009 www.wise.binghamton.edu
  23. 23. Excellence Through Innovative Research Influence of Stretcher and Gurney Height Adjustment on Lower Back Stress for Paramedics with Different Heights www.wise.binghamton.edu
  24. 24. Methodology for Simulating Tasks 5th 50th 95th 5th 50th 95th Paramedic Height 5th 50th 95th Paramedic Weight Patient Weight Stretcher and Gurney Height 53 72.5 92 cm cm cm 24 Binghamton University | February 2009 www.wise.binghamton.edu
  25. 25. Results: Stretcher Side Paramedic 4900 N 3750 N 2870 N 3200 N 25 Binghamton University | February 2009 www.wise.binghamton.edu
  26. 26. Main Effects: Stretcher Side Paramedic 4200 N 3000 N 26 Binghamton University | February 2009 www.wise.binghamton.edu
  27. 27. Contour Plot: Stretcher Side Paramedic 27 Binghamton University | February 2009 www.wise.binghamton.edu
  28. 28. Results: Gurney Side Paramedic 7600 N 6500 N 6050 N 5900 N 5750 N 5550 N 28 Binghamton University | February 2009 www.wise.binghamton.edu
  29. 29. Contour Plot: Gurney Side Paramedic 29 Binghamton University | February 2009 www.wise.binghamton.edu
  30. 30. Stretcher vs Gurney Side 30 Binghamton University | February 2009 www.wise.binghamton.edu
  31. 31. Excellence Through Innovative Research Postural Variables www.wise.binghamton.edu
  32. 32. Different Postural Variables 32 Binghamton University | February 2009 www.wise.binghamton.edu
  33. 33. Results: Trunk Flexion vs Shoulder Rotation 33 Binghamton University | February 2009 www.wise.binghamton.edu
  34. 34. Results: Trunk Flexion vs Shoulder Separation 34 Binghamton University | February 2009 www.wise.binghamton.edu
  35. 35. Results: Trunk Flexion vs Shoulder Elevation 35 Binghamton University | February 2009 www.wise.binghamton.edu
  36. 36. Results: Trunk Flexion vs Elbow Angle 36 Binghamton University | February 2009 www.wise.binghamton.edu
  37. 37. Summary of Results • Team Role • Leader in a safer role compared to follower • Gurney Side role strenuous • Standing safer than kneeling • Anthropometry of Paramedic • Shorter paramedics encounter lower back stress • Could influence lower back stress of team member • Height Adjustment is Crucial • Degree of adjustment more for stretcher side than gurney side • Postural Variables • Stress trends at 0 , 10 , 20 and 30 , 40 and 50 37 Binghamton University | February 2009 www.wise.binghamton.edu
  38. 38. Proposed Solutions • Ideal: Shorter Paramedics • Not the Most Effective: Shortage of Paramedics Recruitment • Less Strength: Less Strenuous Task • Equal Strength: Alternate between Tasks Pre-planning • Handles as Close as Possible to Patient Body • Use of DHM to Evaluate Equipment Equipment “Effort from Upper Management to Invest in Patient Lifting Equipment” 38 Binghamton University | February 2009 www.wise.binghamton.edu
  39. 39. Limitations 39 Binghamton University | February 2009 www.wise.binghamton.edu
  40. 40. Conclusions and Future Work Stryker, 2007 40 Binghamton University | February 2009 www.wise.binghamton.edu
  41. 41. 41 Binghamton University | February 2009 www.wise.binghamton.edu

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