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A possible revival of population-representing digital human manikins in static work situations - exemplified through an evaluation of a prototype console for robotic surgery
Karolinska Inst, Inst Environm Med, Stockholm, Sweden.;Chalmers Univ Technol, Dept Ind & Mat Sci, Gothenburg, Sweden..
Karolinska Inst, Inst Environm Med, Stockholm, Sweden..
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden..
KTH, School of Engineering Sciences in Chemistry, Biotechnology and Health (CBH), Biomedical Engineering and Health Systems, Ergonomics. Karolinska Inst, Inst Environm Med, Stockholm, Sweden..ORCID iD: 0000-0001-5777-4232
2021 (English)In: Work: A journal of Prevention, Assessment and rehabilitation, ISSN 1051-9815, E-ISSN 1875-9270, Vol. 70, no 3, p. 833-851Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: In the 90s, digital human manikins (DHMs) were introduced in planning ofworkstations, by static or semi-static simulations. Modern DHMs can simulate dynamic work and offer a rapid way for a virtual pre-production ergonomic evaluation. Work-related musculoskeletal disorders may affect surgical performance and patient safety. A prototype of an open console, which is contrary to the conventional closed consoles and may be seen as a representative for a new generation, has been designed to reduce workload for robotic surgery surgeons. OBJECTIVE: The aim of this project was to test a new DHM tool with improved usability to evaluate the ergonomics of a console of a robotic surgical system in a pre-production stage. METHODS: The DHM tool IMMA was used together with a 3D model of the prototype console. Twelve manikins who represented females and males from two national populations were introduced. Manikin-console distances, after console adjustments per manikin, were compared with a US checklist and Swedish standard for VDU work. RESULTS: The DHM tool was useful for this case, but the distances of the checklist and the standard were needed to be obtained "manually". The automatic functions of the DHM worked smoothly but were not optimized for VDU work. The prototype fulfilled most, but not all, of the ergonomic criteria of the checklist and the standard. CONCLUSIONS: There is room for improvements of the adjustable ranges of the console prototype. DHMs may facilitate rapid pre-production evaluation of workstations for static work; if ergonomic assessment models for VDU work are built-in, there may be a revival of DHMs in static work situations.

Place, publisher, year, edition, pages
IOS Press , 2021. Vol. 70, no 3, p. 833-851
Keywords [en]
Robotic surgery, digital human manikin, simulation, ergonomic assessment, occupational ergonomics
National Category
Production Engineering, Human Work Science and Ergonomics
Identifiers
URN: urn:nbn:se:kth:diva-306570DOI: 10.3233/WOR-213604ISI: 000724731100017PubMedID: 34719466Scopus ID: 2-s2.0-85122647567OAI: oai:DiVA.org:kth-306570DiVA, id: diva2:1621734
Note

QC 20211220

Available from: 2021-12-20 Created: 2021-12-20 Last updated: 2023-05-11Bibliographically approved
In thesis
1. Ergonomics risk assessment methods for creating healthy work environments
Open this publication in new window or tab >>Ergonomics risk assessment methods for creating healthy work environments
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Risk assessments of ergonomic conditions in pre-production and in field are necessary to prevent work-related musculoskeletal disorders and to increase productivity and quality. Methods for such assessments include simulations, direct measurements and observations. In order to carry out correct ergonomic assessments, which is an important part in the work of creating healthy workplaces, it is vital that these methods are user-friendly, accurate and reliable. However, several methods are insufficiently tested with respect to these factors.

The aim of this thesis was to increase the knowledge of some relevant risk assessment methods for the prevention of musculoskeletal disorders. The methods include risk assessments in both planned and existing work environments.

A risk assessment approach for digital human modelling was developed. The approach included a reference database of epidemiological relationships between directly measured exposure and related musculoskeletal disorders. For illustration, a case in manual assembly was simulated; exposures were calculated and compared to the reference data to indicate the risk of work-related musculoskeletal disorders. The application and detailed assessment would be helpful to prioritise among different design solutions.

A 3D digital prototype of a laparoscopic robotic open console was ergonomically evaluated using the simulation tool Intelligently Moving MAnikins (IMMA); twelve manikins representing anthropometries of the Swedish and US populations were used. The work-ranges of the console and the manikins were calculated and compared. The ergonomics was evaluated using a US checklist and the Swedish standard for computer work. The assessment criteria, which are related to the adjustability of the screen, the armrests, and the pedals, were not fulfilled. The result showed that IMMA, with its built-in functions, provides the opportunity for risk assessment of planned static work tasks. With some improvements, tools like IMMA may increasingly be used efficiently for early assessments of planned products or work environments.

The inter- and intra-rater reliability and validity of six observation-based assessment methods, ART, HARM, SI, QEC, OCRA and SWEA, were studied through twelve ergonomists' and an expert group's repeated risk assessments of ten videotaped tasks. The results showed a low to moderate inter- and intra-rater reliability. Both the percent agreement and the reliability differed for the assessments of the methods' overall risk levels. Using a standardised task duration of 3.75 hours (rather than different durations for the different tasks) in the statistical calculations, the reliability of all methods decreased, except for OCRA. The decrease was most evident for HARM and ART, which was due to the fact that the duration of the task has a large impact in the methods' calculation of the total risk level. The validity was similar to the inter-rater reliability for each method.

This thesis emphasizes the importance of detailed quantification of exposure and reliable methods to draw accurate conclusions about the risk of musculoskeletal disorders, both in planned and existing work environments.

Today's technology, with small and wireless devices for direct measurements and methods for analysing physical exposure, provides opportunities to perform accurate and reliable ergonomic assessments. The possibility of using similar measurement strategies in digital human modelling, allows the discrimination of small differences in exposure which simplifies comparisons of different design solutions as well as between planned and existing work environment. Although the reliability of several observation-based methods was found to be low, observational methods are still important in the risk assessments of physical exposure, in order to include parts of the work environment that are not yet possible to measure. However, observational methods should preferably be used for screening and in combination with technical measurements.

Abstract [sv]

Riskbedömningar av ergonomiska förhållanden i förproduktion och i fält är nödvändiga för att förebygga arbetsrelaterade muskuloskeletala besvär och för att öka produktivitet och kvalitet. Metoder för sådana bedömningar inkluderar simuleringar, direkta mätningar och observationer. För att kunna genomföra korrekta ergonomiska bedömningar, vilket är en viktig del i arbetet med att skapa hälsosamma arbetsplatser, är det avgörande att dessa metoder är användarvänliga, noggranna och tillförlitliga. Flera metoder är dock otillräckligt testade när det gäller dessa faktorer. 

Syftet med den här avhandlingen var att öka kunskapen om några relevanta riskbedömningsmetoder för att förebygga muskuloskeletala besvär. Metoderna inkluderar riskbedömningar i både planerade och befintliga arbetsmiljöer. 

En riskbedömningsmetodik för digitala mänskliga modeller utvecklades. Metodiken inkluderade en referensdatabas över epidemiologiskt identifierade samband mellan direkt uppmätt exponering och relaterade muskuloskeletala besvär. Som illustration simulerades ett fall i manuell montering; exponeringar beräknades och jämfördes med referensdata för att påvisa risken för besvärsuppkomst. En sådan metodik kan komma att vara till hjälp för att prioritera bland olika designlösningar. 

Ergonomin vid arbete i en digital 3D-prototyp av en öppen robotisk konsol för laparoskopisk kirurgi studerades med hjälp av simuleringsverktyget Intelligently Moving MAnikins (IMMA); tolv digitala människomodeller (manikiner) med antropometriska mått från svensk och amerikansk befolkning användes. Arbetsområdena för konsolen och manikinerna beräknades och jämfördes. De ergonomiska kriterierna utvärderades med hjälp av en amerikansk checklista och den svenska standarden för datorarbete. Bedömningskriterierna, vilka är relaterade till justerbarheten av skärmen, armstödet och pedalerna, uppfylldes inte för samtliga manikiner. Resultatet visade att IMMA med sina inbyggda funktioner ger möjlighet till riskbedömning av planerat statiska arbete. Med några förbättringar kommer metoder som IMMA i allt högre grad kunna användas effektivt för tidiga bedömningar av planerade produkter och arbetsmiljöer. 

Inter- och intrabedömartillförlitligheten och validiteten hos sex observationsbaserade bedömningsmetoder, ART, HARM, SI, QEC, OCRA och SWEA, studerades genom tolv ergonomers, samt en expertgrupps, upprepade riskbedömningar av tio videoinspelade arbetsuppgifter. Resultaten visade en låg till måttlig inter- och intrabedömartillförlitlighet. Både procentuell överensstämmelsen och linjärt viktad kappa skilde sig åt med avseende på metodernas övergripande risknivåer. Med en standardiserad uppgiftslängd på 3,75 timmar (istället för olika tidslängder för de olika uppgifterna) i de statistiska beräkningarna, minskade tillförlitligheten hos alla metoder utom OCRA. Tillförlitligheten för HARM och ART minskade mest vilket berodde på att uppgiftens tidslängd har en stor inverkan i metodernas beräkning av den totala risknivån. Validiteten liknade interbedömartillförlitligheten för varje metod. 

Den här avhandlingen betonar att det är viktigt med detaljerad kvantifiering av exponering och tillförlitliga metoder för att dra korrekta slutsatser om risken för muskuloskeletala besvär, både i planerade och befintliga arbetsmiljöer.

Dagens teknik, med små och trådlösa enheter för direkta mätningar samt metoder för att analysera fysisk exponering, ger möjligheter att utföra noggranna och tillförlitliga bedömningar. Möjligheten att använda liknande mätstrategier för analys inom digital mänsklig modellering, medger identifiering av små skillnader i exponering, vilket förenklar jämförelser av olika designlösningar samt mellan planerade och befintliga arbetsmiljöer. Även om tillförlitligheten hos flera observationsbaserade metoder visade sig vara låg, är observationsmetoder fortfarande viktiga i riskbedömningarna av fysisk exponering, detta för att inkludera delar i arbetsmiljön som ännu inte är möjliga att mäta. Observationsmetoder ska dock helst användas för screening och gärna i kombination med tekniska mätningar.

Place, publisher, year, edition, pages
Stockholm: KTH Royal Institute of Technology, 2023. p. 101
Series
TRITA-CBH-FOU ; 2023:22
Keywords
Ergonomics, Risk assessment, Reliability, Validity, Systematic Observation, Direct measurement, Simulation, Digital Human Modelling, Workplace Design, Work-related Musculoskeletal Disorders, Biomechanical Exposure
National Category
Medical Modelling and Simulation
Research subject
Technology and Health
Identifiers
urn:nbn:se:kth:diva-326816 (URN)978-91-8040-590-4 (ISBN)
Public defence
2023-06-02, https://kth-se.zoom.us/j/62935040135, Emmy Rappnesalen (room T1), School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH, Hälsovägen 11C, Huddinge, 09:00 (English)
Opponent
Supervisors
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 1212-1202AFA Insurance, 180098, 180254Vinnova
Note

QC 20230511

Available from: 2023-05-11 Created: 2023-05-11 Last updated: 2025-02-09Bibliographically approved

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