title: The impact of the alexander technique on improving posture and surgical ergonomics during minimally invasive surgery: pilot study.
abstract: OBJECTIVE
  One of the main ergonomic challenges during surgical procedures is surgeon posture. There have been reports of a high number of work related injuries in laparoscopic surgeons. The Alexander technique is a process of psychophysical reeducation of the body to improve postural balance and coordination, permitting movement with minimal strain and maximum ease. We evaluated the efficacy of the Alexander technique in improving posture and surgical ergonomics during minimally invasive surgery.
  
  
  METHODS
  We performed a prospective cohort study in which subjects served as their own controls. Informed consent was obtained. Before Alexander technique instruction/intervention subjects underwent assessment of postural coordination and basic laparoscopic skills. All subjects were educated about the Alexander technique and underwent post-instruction/intervention assessment of posture and laparoscopic skills. Subjective and objective data obtained before and after instruction/intervention were tabulated and analyzed for statistical significance.
  
  
  RESULTS
  All 7 subjects completed the study. Subjects showed improved ergonomics and improved ability to complete FLS™ as well as subjective improvement in overall posture.
  
  
  CONCLUSIONS
  The Alexander technique training program resulted in a significant improvement in posture. Improved surgical ergonomics, endurance and posture decrease surgical fatigue and the incidence of repetitive stress injuries to laparoscopic surgeons. Further studies of the influence of the Alexander technique on surgical posture, minimally invasive surgery ergonomics and open surgical techniques are warranted to explore and validate the benefits for surgeons.
authors.affiliation: Division of Pediatric Urology, Cincinnati Children's Hospital, Xavier University, Cincinnati, Ohio 45229-3039, USA. pramod.reddy@cchmc.org
authors.forename: Pramod P
authors.initials: PP
authors.lastname: Reddy
authors.forename: Trisha P
authors.initials: TP
authors.lastname: Reddy
authors.forename: Jennifer
authors.initials: J
authors.lastname: Roig-Francoli
authors.forename: Lois
authors.initials: L
authors.lastname: Cone
authors.forename: Bezalel
authors.initials: B
authors.lastname: Sivan
authors.forename: W Robert
authors.initials: WR
authors.lastname: DeFoor
authors.forename: Krishnanath
authors.initials: K
authors.lastname: Gaitonde
authors.forename: Paul H
authors.initials: PH
authors.lastname: Noh
mesh_terms: D002983:Clinical Competence; D006804:Ergonomics / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D009873:Operating Rooms; D010865:Pilot Projects; D004856:Postural Balance / Q000502:physiology*; D011187:Posture; D011446:Prospective Studies; D013647:Task Performance and Analysis