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Table of Contents
ORIGINAL ARTICLE
Year : 2022  |  Volume : 71  |  Issue : 2  |  Page : 114-118

Analysis of Workstation Posture in Diversified Professionals as a Tool to Enhance Better Understanding of Health Outcomes to Avoid Occupational Health Hazards


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Date of Submission09-Apr-2020
Date of Decision08-Sep-2021
Date of Acceptance18-Apr-2022
Date of Web Publication30-Jun-2022

Correspondence Address:
Jinu Merlin Koshy
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JASI.JASI_60_20

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  Abstract 


Introduction: Wrong postures change the body mechanics, causing pressure on joint surfaces, strain to ligaments, and skeletal muscle disadvantage. Simple faulty posture is one of the main reasons for musculoskeletal pain, especially back pain and neck pain. Based on the understanding that aberrations in posture can cause pain and injury, training and education for posture correction through training have been used as treatment approaches. The intent of the present study was to analyze posture and the severity of postural abnormalities using plumb line and to identify if these abnormalities are associated with pain among professionals. Material and Methods: The posture of 120 participants from four occupational groups was analyzed using a plumb line in relation to anatomical landmark and categorized into four types. Data were recorded as the frequency of the posture types. To test the equality of means among more than two groups, the Kruskal–Wallis test was used. Posture frequency was then compared with musculoskeletal symptoms. Results: The major finding in this study is that a considerable proportion of the study sample displayed some degree of postural anomaly. Kyphosis was found to be highest among IT professionals (76.7%) compared to the other professional groups. Kypholordotic posture was more among the nurses. The frequency of pain increased in participants with more severe postural issues. It is hypothesized that the means of different groups compared are the same against the alternative that at least one group's mean is different from others. The difference observed difference was statistically significant (P < 0.001). Discussion and Conclusion: Postural abnormalities are a significant risk factor for musculoskeletal disorders. The ergonomics of the working environment have a direct impact on the well-being of professionals. Hence, the organizations employing them, and the professionals themselves need to be sensitized regarding the importance of correct working posture.

Keywords: Kypholordosis, kyphosis, musculoskeletal symptoms, plumb line, posture


How to cite this article:
Johnson W M, Koshy JM, Rajasundram A. Analysis of Workstation Posture in Diversified Professionals as a Tool to Enhance Better Understanding of Health Outcomes to Avoid Occupational Health Hazards. J Anat Soc India 2022;71:114-8

How to cite this URL:
Johnson W M, Koshy JM, Rajasundram A. Analysis of Workstation Posture in Diversified Professionals as a Tool to Enhance Better Understanding of Health Outcomes to Avoid Occupational Health Hazards. J Anat Soc India [serial online] 2022 [cited 2022 Aug 17];71:114-8. Available from: https://www.jasi.org.in/text.asp?2022/71/2/114/349502




  Introduction Top


The word posture comes from the Latin verb “ponere,” which means “to put or place.”[1] Posture refers to the position of the human body and its orientation in space. Posture is defined as a state of skeletal and muscular balance and alignment that protects the supporting structures of the body from progressive deformity and injury.[2] In an ideal posture, the weight of the body is evenly distributed through the body so all joints are in their neutral zone and there will be minimal wear and tear on the structures. This will help maintain the natural balance and correct the length of the muscles. There is no restriction on the movement patterns and all vital organs are properly placed, and therefore can function efficiently. The line of gravity passes through a point on a level with and immediately in front of the second sacral vertebra (the center of gravity).[3]

Wrong postures change the body mechanics, causing pressure on joint surfaces, strain to ligaments, and skeletal muscle disadvantage. Soft tissue shortening associated with this may cause back pain. Another added problem is chronic pain, and that can worsen mood and decrease motivation. Stiffness and pain in the spine and ribs may hinder ventilation, and poor posture with low body weight may result in poor body image and diminished self-confidence. We wonder why it is so important to maintain correct posture. The answer is simple faulty posture is one of the main reasons for musculoskeletal pain, especially back pain and neck pain. Based on the understanding that aberrations in posture can cause pain and injury, training and education for posture correction through training have been used as treatment approaches.[4],[5],[6],[7],[8],[9],[10],[11]

While there are many studies that have documented a high incidence of postural anomalies in a given population, the methods of measurement were not defined accurately.[9],[10],[11],[12],[13],[14]

The resting position and the lumbar spine are having a strong correlation. Kendall et al.[6] explained the optimal posture using the plumb line assessment.

The spine has three natural curvatures, which can become exaggerated in one direction or the other.[6],[7],[8],[9],[10],[11],[12],[13],[14],[15],[16] Four posture types are commonly seen in [Figure 1]; A is the optimal or neutral posture and exaggerated postures are B, C, and D.
Figure 1: Comparison of common posture types. a)Optimal, b)Kypholordotic c)Swayback d) Flat back

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Optimal posture

This posture has a vertical line passing through the midline of the knee, lumbar vertebrae, shoulder joint, cervical vertebrae, and earlobe.

Kypholordotic posture

An increased thoracic and lordotic curvature can be observed in this posture. The head is held slightly forward, often becoming the most anterior segment of the body. The pelvis tends to tilt anteriorly with an increase in lumbar lordosis (inward curve).

Swayback posture

In this posture, the pelvis becomes the most anterior segment of the body, and there is an increase in the inward curve. The knee joints tend to get hyperextended. Abdominal obesity worsens this posture.

Flat-back posture

A posterior tilt is observed in the pelvis with very little normal inward curvature of the lumbar spine. The knee joints are hyperextended. Sometimes the head is tilted slightly forward. The thoracic spine may be flexed forward a bit.

This study was designed to assess the severity of postural abnormalities among professionals and to determine whether these abnormalities are associated with pain.

Aim and objective

The aim of the present study was to analyze posture and the severity of postural abnormalities using a plumb line and to identify if these abnormalities are associated with pain among professionals.


  Material and Methods Top


The study was designed to assess the posture using plumb line. The screenings were conducted in four occupational groups: the banking sector (Group 1), computer professionals (Group 2), dentists (Group 3), and nurses (Group 4). Thirty people from each group participated in the study.

The proposal was submitted to the institutional ethics committee and due clearance was obtained from the same.

Inclusion criteria:

Inclusion criteria was not based on presence or absence of pain. The participants were asked about the presence or absence of pain and noted it. They were also assessed using Nordic Questionnaire too.

  • Bank employees, IT professionals, nurses, and dentists with a minimum of 3 years of work experience and a maximum of 25 years
  • Age ranging from 25 to 55 years
  • Both sexes.


Exclusion criteria:

  • Individuals with any acute ailments or systemic diseases
  • Pregnant women
  • Those who were not willing.


Informed written consent was obtained from each of the participants.

Armamentarium:

  • Weighing scale
  • Freemans measuring tape
  • Tailor's tape
  • Plumb line.


The participants who fulfill the inclusion criteria were included based on their willingness and not based on the presence or absence of musculoskeletal pain they were having. Anthropometric measurements were recorded. Participants were positioned with their lateral malleolus 6 cm behind the plumb line. Participants were asked to take 10 steps leading with their right leg and then to stop and remain in the resulting postural position was noted then.

The plumb line position was noted in relation to anatomical landmark and posture was determined. The participant was viewed from 3 aspects:

  1. Anterior–posterior (A–P): The plumb line runs through the center of the forehead, middle of the sternum, navel, and midpoint between feet
  2. Posterior–anterior (P–A): The plumb line runs through the occipital protuberance, spinous processes C7, T12, L5, coccyx, and between the feet
  3. Lateral: The plumb line runs through the acromion, midpoint of the iliac crest, greater trochanter, and in front of the ankle.


Data were entered into Microsoft Excel spreadsheets after thorough screening and analysis were carried out using IBM SPSS Software Version 16: IBM, Technology company American multinational technology corporation headquartered in (Armonk, NewYork, USA). Descriptive statistics such as mean with standard deviation and proportions were reported. Posture was categorized into the four types and data were recorded as the frequency of the posture types. To test the equality of means among more than two groups, Kruskal–Wallis test was being used. Posture frequency was then compared with musculoskeletal symptoms.


  Results Top


Data collected from the 120 participants in the study group (53 males and 67 females) were analyzed. There were 30 participants in each group. The general characteristics of the study participants are given in [Table 1].
Table 1: Physical characteristics of participants (mean±standard deviation)

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Posture was categorized as one of the four standard types and frequency was recorded for both males and females among the four professional groups. [Table 2] represents the posture frequency of the four professional groups. Combinations of posture types were also seen. The nurses who were having swayback posture with anterior pelvic shift were having thoracic kyphosis which is extended to the upper part of the lumbar spine. The three dentists, four nurses, and one IT employee who were having kyphotic postures were exhibiting kypholordosis also.
Table 2: Association between the plumb line scores and the occupation groups

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To test the equality of means among more than two groups, Kruskal–Wallis test was used. It is hypothesized that the means of different groups compared are the same against the alternative that at least one group's mean is different from others.

The observed difference was found to be statistically significant (P < 0.001). In [Figure 2] Incidence of postural abnormalities in the Plumb line analysis of the four professional groups can be viewed.
Figure 2: Incidence of postural abnormalities in plumb line analysis

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Participants having optimal posture and deviated posture are given in [Table 3]. All the participants who were having Kyphotic or Kypholordotic posture experienced pain in their back or neck. The pain among the participants was directly proportional with the age of the. One participant who was having optimal posture experienced pain in the neck.
Table 3: Participants having optimal posture and deviated posture

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  Discussion Top


The major finding in this study is that a substantial proportion of the study population exhibited some degree of postural abnormality. Kyphosis was found to be highest among IT Professionals (76.7%) compared to other professional groups. Kypholordotic posture was more among the nurses.

The incidence of pain increased in the participants with severe postural abnormalities in the present study which is contrary to the study which reported no relationship was found between the severity of postural abnormality and the severity and frequency of pain.[15],[16],[17] The severity of postural anomalies would be greater in an older population as compared to a younger population.[18] Habits of “falling into gravity” are proposed to aggravate with advancing age.

Swayback posture was found to be the predominant among the participants and the flat-back posture had the least occurrence in previous studies whereas the present study findings show that kypholordotic and kyphotic posture is more common in the study participants.[16] This may be due to the difference in the age group in both studies, In the present study, the mean age of the study participants was 35 years and that of the previous one was adolescent participants. The participants in the present study were professionals and deviation from the standard working posture and extended working hours were also a reason for the musculoskeletal symptoms. Females were having less postural deviation compared to males, but the incidence of pain was more among females. Physiological factors contribute to the higher prevalence of musculoskeletal disorders (MSDs) in women. One of them is the presence of more type one fibers in the trapezius muscle in women than in men, and others include sexual dimorphism of the spine and the high incidence of dysmenorrhea, which sometimes is confounded with mechanical low back pain. Multitasking also accredited to the higher MSDs among women.[19]

The most common risk factor for work-related musculoskeletal disorders (WMSDs) is bad posture which is a deviation from the ideal posture. Awkward, restrictive, uneven, repetitive, and prolonged postures; overstressing movements, and force can overload the tissues and exceed their threshold of tolerable stress, causing injury due to overexertion or imbalance.[20] A person working in an or awkward posture will have to use more force to accomplish the same amount of work compared to using a neutral posture, which in turn affects muscle loading and compressive forces on the intervertebral disc.[21]

In poor, or faulty posture there is a flawed relationship among various skeletal structures of the body, and this may produce strain on the body's supporting framework.[21] With faulty posture, the body is balanced less efficiently over its base of support. The plumb line analysis revealed that kyphosis was found to be highest among IT professionals (76.7%), compared to the other occupation groups. The observed difference was found to be statistically significant (P < 0.001).

An in-depth assessment of posture among IT employees was made due to their prolonged duration of work (mean working hours 8.6 h per day). An increased prevalence of abnormal positioning of the employees was observed which could potentially increase the risk of WMSD. The most common risk factor is sloppy posture which is a deviance from the ideal working posture of arms at the side of the torso, elbows bent, with the wrists straight and it typically includes reaching behind, twisting, working overhead, kneeling, forward or backward bending, and squatting. Awkward, restrictive, uneven, repetitive, and prolonged postures; overstressing movements and force can overload the tissues and exceed their threshold of tolerable stress, causing injury due to overexertion, or imbalance.[20],[22]


  Conclusion Top


Postural abnormalities are a significant risk factor for MSD. Although all individuals are vulnerable in this regard, certain specific occupation groups are at increased risk of developing these postural problems, owing to the nature of their job and working environment. Our study was carried out to compare the prevalence of postural problems and MSD among select four occupations, namely dentists, nurses, IT professionals, and bank employees. In conformity with the research objectives, the following conclusions are derived: nearly three-fourths of the professionals we studied had mentioned having some health problems. The ergonomics of the working environment of the professionals have a direct impact on their level of well-being. Hence, the organizations employing them, as well as the professionals themselves need to be sensitized regarding the importance of correct working posture.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

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22.
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    Figures

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    Tables

  [Table 1], [Table 2], [Table 3]



 

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