Pinch force and forearm-muscle load during routine colonoscopy: a pilot study.
OBJECTIVE
Overuse injuries of the hand, wrist, forearm, and shoulder are common among endoscopists and may be from repetitive pinching and gripping forces or awkward posturing. In this pilot study, we evaluated distal upper-extremity musculoskeletal load during colonoscopy (1) to confirm the feasibility of performing ergonomic measurements in endoscopists and (2) to identify tasks that may contribute to overuse injuries.


METHODS
Three experienced gastroenterologists were evaluated during 3 colonoscopies each.


METHODS
Veterans Affairs Medical Center, San Francisco, California.


METHODS
Right-thumb pinch force using a thumb-force sensor and bilateral forearm-muscle activity using electromyography.


RESULTS
The mean duration of the 9 colonoscopies was 19.5 minutes. The highest mean (SD) right-thumb peak pinch forces occurred during left (10.4 [4.1] N) and right (10.1 [4.5] N) colon insertion, which exceeded the injury threshold of 10 N. Mean peak forearm-muscle activity was also greatest during left and right colon insertion. Activity of the left abductor pollicis longus, left extensor carpi radialis, and right extensor carpi radialis exceeded the American Conference of Industrial Hygienists (ACGIH) hand activity level (HAL) action limit. The left extensor carpi radialis was at the ACGIH HAL threshold limit.


CONCLUSIONS
The small sample size, no force measurement for the left thumb, and all the gastroenterologists were men.


CONCLUSIONS
The pinch forces and forearm-muscle loads applied during routine colonoscopy may pose a risk for overuse injuries at the elbow and wrist.
Shergill
Amandeep K
AK
San Francisco Veterans Affairs Medical Center, San Francisco, California 94121, USA. amandeep.shergill@ucsf.edu
Asundi
Krishna R
KR
Barr
Alan
A
Shah
Janak N
JN
Ryan
James C
JC
McQuaid
Kenneth R
KR
Rempel
David
D
D000328:Adult; D000488:Allied Health Personnel; D000704:Analysis of Variance; D001696:Biomechanical Phenomena; D003113:Colonoscopy / Q000379:methods*; D004576:Electromyography; D005260:Female; D005542:Forearm / Q000502:physiology; D005762:Gastroenterology; D006801:Humans; D008297:Male; D008875:Middle Aged; D053580:Muscle Strength / Q000502:physiology*; D009140:Musculoskeletal Diseases / Q000517:prevention & control; D009784:Occupational Diseases / Q000517:prevention & control; D016272:Occupational Health; D010865:Pilot Projects; D052581:Pinch Strength; D011336:Probability; D013314:Stress, Mechanical; D013933:Thumb / Q000502:physiology