Background and Aims
The prevalence and burden of ergonomic-related musculoskeletal injury are well established
in the literature, but data are scarce on techniques that can be used to avoid injury.
This pilot study aimed to develop a new method of endoscopist wellness assessment.
The technique presented here is an intervention by a physical therapist assessing
ergonomic position and posturing during endoscopy to create an individualized wellness
plan.
Methods
Volunteer endoscopists were identified in a single ambulatory surgical center. Demographics,
previous injury, current pain, and posture were evaluated. A comprehensive assessment
was developed by the physical therapist while observing endoscopists performing at
least 2 colonoscopies and while working at their computer workspace. The detailed
personalized wellness program included recommendations for individualized exercises,
static and dynamic posture re-education during and between procedures, optimization
of procedure suite setup, pain education, and an opportunity for follow-up 1-on-1
sessions with the physical therapist. Endoscopists were later interviewed regarding
their perception of and compliance with the wellness plan. Specific outcomes evaluated
included changes in musculoskeletal pain, acceptance, and incorporation of wellness
recommendations and procedure suite alterations into clinical practice.
Results
As we developed this new method of endoscopic wellness assessment, 8 endoscopists
representing a wide range of ages and clinical experience were assessed. Twenty-two
pain sites were identified among 5 subjects, with back and neck pain the most common
pain sites. A variety of ergonomic inefficiencies and suboptimal movement patterns
was observed, resulting in highly variant wellness plans. By the end of the study,
63% of pain sites were reduced in intensity or resolved, whereas 32% of pain sites
were unchanged and 4% increased in intensity. Seven of 8 participants found the pictures
depicting their posture that supported their movement analysis helpful, and 3 participants
requested reassessment by the physical therapist. All participants reported static
and dynamic postural education and procedure suite setup recommendations to be impactful
to their ergonomic performance.
Conclusions
Ergonomic assessment and instruction by a physical therapist was well received and
resulted in improvement of musculoskeletal complaints among a cohort of endoscopists
reporting baseline pain associated with performing endoscopy. In addition, this intervention
provided ergonomic education that can be carried forward throughout their professional
endoscopic career. We believe that ongoing individualized assessment and optimization
of ergonomics is necessary because generalized wellness programs or even modifications
to endoscopic equipment would not target all the unique ergonomic challenges faced
by each physician. Ergonomic programs using the new method presented here could potentially
contribute to career longevity, decrease burnout, reduce lost days of work, and, most
importantly, reduce pain and fatigue among practitioners.
Graphical abstract
Graphical Abstract
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Article info
Publication history
Published online: February 06, 2021
Accepted:
January 30,
2021
Received:
October 5,
2020
Footnotes
DISCLOSURE: All authors disclosed no financial relationships.
If you would like to chat with an author of this article, you may contact Dr Teitelman at [email protected]
Identification
Copyright
© 2021 by the American Society for Gastrointestinal Endoscopy
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- Endoscopist injury: shifting our focus to interventionsGastrointestinal EndoscopyVol. 94Issue 2
- PreviewEndoscopists undergo rigorous training to become proficient in diagnostic and therapeutic endoscopy so they may provide high-quality GI care. Unfortunately, performing endoscopy can be hazardous to the endoscopist’s health.1 In some cases, work-related musculoskeletal discomfort and disorders can constrain or end an endoscopist’s practice.2
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