Date Presented Accepted for AOTA INSPIRE 2021 but unable to be presented due to online event limitations.
Although multiple robust ergonomics tools are available to assess postural risk, these tools are often too general and do not consider nuances of specific jobs. This study examined the concurrent validity of a postural assessment tool tailored to dental professionals. Findings provide support for use of this tool to assess risk and identify areas for intervention by OT practitioners.
Primary Author and Speaker: Samantha Randolph
Additional Authors and Speakers: Jody Liu
Contributing Authors: Shawn C. Roll, Jacquelyn Dylla
PURPOSE: Musculoskeletal disorders (MSD) are common sources of pain and discomfort in dental professionals. In fact, more than 60% of dental health care providers experience MSDs, leading many to reduce clinical hours or exit the profession entirely (Akesson et al., 1999; Moodley et al., 2018). Poor posture is one significant risk factor, and there is a need for ergonomic assessments that are tailored to the dental environment and can be used to identify and correct risky postures during clinical practice (Humann & Rowe, 2015). The Movement Strategies and Alignment Tool (MSAT) was developed to help dental hygienists identify and correct poor posture as part of an ergonomic training program. The tool examines twelve items: base of support; lumbar spine; hips/pelvis; trunk lateral flexion and rotation; head/neck forward flexion, lateral flexion, and rotation; shoulder elevation, sagittal flexion, abduction, and protraction. Because this tool has not been formally validated, the purpose of this study was to examine concurrent validity of the MSAT with a widely-used general ergonomic assessment tool.
DESIGN: In this validation study, participants were dental hygiene students in their second year of training who had each received fundamental ergonomic education in their academic programs.
METHOD: Students were video recorded using cameras places at three angles (front, side, overhead) during multiple sessions while conducting scaling activities with patients. Ten segments were extracted from each of video, and each segment was analyzed using the MSAT and the Rapid Upper Limb Assessment (RULA). Raters received training in each assessment to ensure competency in using the tools. Descriptive statistics were calculated for each tool, overall and across all sub-components. Concurrent validity between the MSAT and RULA for individual items that assessed the same joints was examined using the Spearman’s Rank-Order Correlation. Pearson product moment correlation coefficients (r) were used to examine total and grouped scores.
RESULTS: A total of 55 videos were obtained from 20 dental hygiene students whose ages ranged from 19-31. Across the 550 video segments analyzed, the mean total RULA score was 5.0 (SD, 1.2), indicating moderate risk for injury. The mean total MSAT score (out of a possible 12 points) was 9.7 (SD, 1.3). Low to moderate correlations were found between individual items on the MSAT and RULA (r = .07 to .52, p < .01). Moderate correlations were found between MSAT and RULA items that were grouped by joint (r = .42 to .63, p < .01), as well as between the total scores (r = .536, p < .01).
CONCLUSION: Moderate correlations between the assessment tools indicate preliminary validation that the overall MSAT tool has potential for identifying individuals who have poor posture. A tailored approach to postural assessment specific to dental hygiene practice was the primary reason that individual items had lower correlation to the generic RULA items.
IMPACT STATEMENT: The MSAT is user-friendly, accessible, and tailored for assessing risk in dental professionals by accounting for specific positions and equipment used in dental clinics. This preliminary validation supports use of the tool to identify and correct concerning postures while working practice to reduce risk of developing MSDs.
References
Akesson, I., Johnsson, B., Rylander, L., Moritz, U., & Skerfving, S. (1999). Musculoskeletal disorders among female dental personnel - clinical examination and a 5-year follow-up study of symptoms. International Archives of Occupational and Environmental Health, 72(6), 395-403. https://doi.org/10.1007/s004200050391
Humann, P., & Rowe, D. (2015). Relationship of Musculoskeletal Disorder Pain to Patterns of Clinical Care in California Dental Hygienists. Journal of Dental Hygiene, 89(5), 305–312.
Moodley, R., Naidoo, S., & Wyk, J. (2018). The prevalence of occupational health-related problems in dentistry: A review of the literature. Journal of Occupational Health, 60(2), 111-125. https://doi.org/10.1539/joh.17-0188-ra
