Advertisement

(Re-)Defining ergonomics in hand therapy: Applications for the management of upper extremity osteoarthritis

      Highlights

      • Ergonomics includes support for physical, cognitive, and organizational factors
      • Hand therapy ergonomic approaches can be applied at micro, meso, and macro levels
      • There is a dearth of evidence for use of ergonomics in upper extremity osteoarthritis
      • Contextualized and lifestyle approaches best support carryover in daily life
      • Promoting self-efficacy is a vital component for long-term effects of ergonomics

      Abstract

      Study Design

      Invited literature review

      Background

      Arthritis is the leading cause of disability in adults, and research shows that people living with arthritis experience work instability, loss of independence, financial difficulties, and overall decreased quality of life. Current nonpharmacological treatments can be beneficial for short term relief; however, the evidence on these long-term treatments is limited. Ergonomic modifications have been used in the workplace to address musculoskeletal conditions to ensure proper fit of one's environment, and research shows that these modifications can decrease pain and injury and increase work productivity. A broader perspective on ergonomic approaches may be important to supporting individuals with arthritis within hand therapy.

      Purpose of the Study

      This review proposes an expanded perspective on ergonomic approaches within hand therapy and explores published literature to identify potential benefits of applying ergonomic approaches for individuals with upper extremity arthritis.

      Methods

      A systematic search and screening process was conducted to identify articles that implemented an ergonomic approach for the support of individuals with upper extremity osteoarthritis or rheumatoid arthritis.

      Results

      A total of 34 articles described interventions that employed ergonomics including task-based or general ergonomics (n = 17), contextualized supports (n = 8), or holistic, lifestyle approaches (n = 9). Only one study focused solely on individuals with osteoarthritis, whereas interventions for individuals with rheumatoid arthritis showed positive outcomes across these categories. Situational learning, building of patient self-efficacy, and development of new habits and routines are vital for carryover and implementation to support performance in daily life.

      Conclusion

      There is an opportunity for hand therapists to extend the scope of interventions provided as part of an ergonomic approach to supporting patients. Specifically, therapists can consider use of emerging technologies and telehealth that promote contextualization and follow-up for long-term outcomes.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Journal of Hand Therapy
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Baldwin D
        • Johnstone B
        • Ge B
        • Hewett J
        • Smith M
        • Sharp G
        Randomized prospective study of a work place ergonomic intervention for individuals with rheumatoid arthritis and osteoarthritis.
        Arthritis Care Res. 2012; 64: 1527-1535
        • Dziedzic K
        • Nicholls E
        • Hill S
        • et al.
        Self-management approaches for osteoarthritis in the hand: a 2× 2 factorial randomised trial.
        Ann Rheum Dis. 2015; 74: 108-118
        • Barbour KE
        • Helmick CG
        • Boring M
        • Brady TJ
        Vital signs: prevalence of doctor-diagnosed arthritis and arthritis-attributable activity limitation—United States, 2013–2015.
        MMWR Morb Mortal Wkly Rep. 2017; 66: 246
        • Masiero S
        • Boniolo A
        • Wassermann L
        • Machiedo H
        • Volante D
        • Punzi L
        Effects of an educational–behavioral joint protection program on people with moderate to severe rheumatoid arthritis: a randomized controlled trial.
        Clin Rheumatol. 2007; 26: 2043-2050
        • Hammond A
        • Lincoln N
        • Sutcliffe L
        A crossover trial evaluating an educational–behavioural joint protection programme for people with rheumatoid arthritis.
        Patient Educ Counsel. 1999; 37: 19-32
        • Bobos P
        • Nazari G
        • Szekeres M
        • Lalone EA
        • Ferreira L
        • MacDermid JC
        The effectiveness of joint-protection programs on pain, hand function, and grip strength levels in patients with hand arthritis: a systematic review and meta-analysis.
        J Hand Ther. 2019; 32: 194-211
        • Lacaille D
        • White MA
        • Rogers PA
        • Backman CL
        • Gignac MA
        • Esdaile JM
        A proof-of-concept study of the “employment and arthritis: making it work” program.
        Arthritis Care Res. 2008; 59: 1647-1655
        • Van Vilsteren M
        • Boot C
        • Twisk J
        • et al.
        One year effects of a workplace integrated care intervention for workers with rheumatoid arthritis: results of a randomized controlled trial.
        J Occup Rehab. 2017; 27: 128-136
        • Ye L
        • Kalichman L
        • Spittle A
        • Dobson F
        • Bennell K
        Effects of rehabilitative interventions on pain, function and physical impairments in people with hand osteoarthritis: a systematic review.
        Arthritis Res Ther. 2011; 13: 1-13
        • Niedermann K
        • Buchi S
        • Ciurea A
        • et al.
        Six and 12 months' effects of individual joint protection education in people with rheumatoid arthritis: a randomized controlled trial.
        Scandinavian J Occup Ther. 2012; 19: 360-369
        • Hammond A
        Joint protection: enabling change in musculoskeletal conditions.
        International Handbook of Occupational Therapy Interventions. Springer, New York2015: 607-618
        • Singleton WT
        A first introduction to ergonomics Chapter 1: The industrial use of ergonomics.
        Appl Ergon. 1969; 1: 26-32
        • Browne RC
        • Darcus HD
        • Roberts CG
        • et al.
        Ergonomics Research Society.
        Br Med J. 1950; 1: 1009
        • Hollnagel E
        Cognitive ergonomics: it's all in the mind.
        Ergonomics. 1997; 40: 1170-1182
        • Hendrick HW
        Ergonomics in organizational design and management.
        Ergonomics. 1991; 34: 743-756
        • Reason J
        Managing the Risks of Organizational Accidents. Routledge, London1997 (doi:10.4324/9781315543543, 2016. [Accessed 5 July 2022])
        • Karwowski W
        The discipline of human factors and ergonomics.
        Handbook Human Factors Ergon. 2012; 4: 3-37
        • Shackel B
        Whitfield D Chapter 2: General framework and workstation analysis.
        Appl Ergon. 1969; 1: 33-41
        • Hendrick HW
        • Kleiner BM
        Macroergonomics: Theory, Methods, and Applications. CRC Press, Boca Raton2002
        • Panjaitan N
        • Ali AYB
        Clasification of ergonomics levels for research.
        (Paper presented at:)in: IOP Conference Series: Materials Science and Engineering. 2019
        • Panjaitan N
        • Hasnida A-S
        • Ali AY
        Mesoergonomics, the missing part of the macroergonomics and microergonomics approach.
        J Eng Design Technol. 2021;
        • Barnett RL
        On the safety hierarchy and hierarchy of controls.
        Am J Mech Eng. 2020; 8: 61-68
      1. National Institute for Occupational Safety and Health. Hierarchy of controls. Available at: https://www.cdc.gov/niosh/topics/hierarchy/default.html. Accessed April 11, 2022.

        • de Castro AB
        “Hierarchy of Controls”: providing a framework for addressing workplace hazards.
        AJN Am J Nurs. 2003; 103: 104
        • Chari R
        • Chang CC
        • Sauter SL
        • et al.
        Expanding the paradigm of occupational safety and health: a new framework for worker well-being.
        J Occup Environ Med. 2018; 60: 589-593
        • Tamers SL
        • Chosewood LC
        • Childress A
        • Hudson H
        • Nigam J
        • Chang C-C
        Total Worker Health® 2014–2018: the novel approach to worker safety, health, and well-being evolves.
        Intl J Environ Res Public Health. 2019; 16: 321
        • Gilmore DJ
        • Millard D
        Integrating micro- and macro-ergonomics.
        Proc Human Factors Ergon Soc Annual Meeting. 1998; 42: 964-968
        • Arksey H
        • O'Malley L
        Scoping studies: towards a methodological framework.
        Intl J Soc Res Methodol. 2005; 8: 19-32
        • Moher D
        • Liberati A
        • Tetzlaff J
        • Altman DG
        Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement.
        Ann Intern Med. 2009; 151 (W264): 264-269
        • Stamm TA
        • Machold KP
        • Smolen JS
        • et al.
        Joint protection and home hand exercises improve hand function in patients with hand osteoarthritis: a randomized controlled trial.
        Arthritis Care Res. 2002; 47: 44-49
        • Hammond A
        • Jeffreson P
        • Jones N
        • Gallagher J
        • Jones T
        Clinical applicability of an educational-behavioural joint protection programme for people with rheumatoid arthritis.
        British J Occup Ther. 2002; 65: 405-412
        • Amaral D
        • Duarte A
        • Barros S
        • et al.
        Assistive devices: an effective strategy in non-pharmacological treatment for hand osteoarthritis—randomized clinical trial.
        Rheumatol Intl. 2018; 38: 343-351
        • Backman CL
        • Village J
        • Lacaille D
        The ergonomic assessment tool for arthritis: development and pilot testing.
        Arthritis Care Res. 2008; 59: 1495-1503
        • Carruthers EC
        • Rogers P
        • Backman CL
        • et al.
        Employment and arthritis: making it work” a randomized controlled trial evaluating an online program to help people with inflammatory arthritis maintain employment (study protocol).
        BMC Med Inf Decis Making. 2014; 14: 1-7
        • Hammond A
        • O'Brien R
        • Woodbridge S
        • et al.
        Job retention vocational rehabilitation for employed people with inflammatory arthritis (WORK-IA): a feasibility randomized controlled trial.
        BMC Musculoskeletal Disord. 2017; 18: 1-15
        • Macedo AM
        • Oakley SP
        • Panayi GS
        • Kirkham BW
        Functional and work outcomes improve in patients with rheumatoid arthritis who receive targeted, comprehensive occupational therapy.
        Arthritis Care Res. 2009; 61: 1522-1530
        • Furst GP
        • Gerber LH
        • Smith CC
        • Fisher S
        • Shulman B
        A program for improving energy conservation behaviors in adults with rheumatoid arthritis.
        Am J Occup Ther. 1987; 41: 102-111
        • Hammond A
        • Freeman K
        One-year outcomes of a randomized controlled trial of an educational–behavioural joint protection programme for people with rheumatoid arthritis.
        Rheumatology. 2001; 40: 1044-1051
        • Hammond A
        • Freeman K
        The long-term outcomes from a randomized controlled trial of an educational–behavioural joint protection programme for people with rheumatoid arthritis.
        Clin Rehab. 2004; 18: 520-528
        • Niedermann K
        • de Bie RA
        • Kubli R
        • et al.
        Effectiveness of individual resource-oriented joint protection education in people with rheumatoid arthritis. A randomized controlled trial.
        Patient Educ Counsel. 2011; 82: 42-48
        • Shao J-H
        • Yu K-H
        • Chen S-H
        Effectiveness of a self-management program for joint protection and physical activity in patients with rheumatoid arthritis: a randomized controlled trial.
        Intl J Nurs Studies. 2021; 116103752