Ergonomic risk assessment during massage among physiotherapists: Introduction of generic postures notion.

Background: Musculoskeletal disorders are prevalent among physiotherapists. They perform many repetitive tasks in awkward postures that require a high muscle load. This issue was often addressed through subjective analysis (questionnaire) but rarely using postural evaluation combined with an ergonomic assessment.

Objective: The aim of this article was to decompose draining lymphatic massage performed by physiotherapists in generic postures (GP) to quickly assess the musculoskeletal disorder risk.

Methods: Based on numeric video recorded in frontal and sagittal planes, 3360 postures were defined from 20-minutes lymphatic drainage massage performed by 7 physiotherapists over a period of 6 months. A hierarchical cluster analysis was applied to define the GP.

Results: Seven GP were identified, which were described by their average joint angles, variability and relative frequency. GP6, GP4 and GP2 had the highest frequencies (17.6%, 16.9% and 16.8% respectively). Trunk and neck were essentially flexed (neck: 17.0±10.0° for GP1; trunk: 20.4±8.7° for GP4). Shoulder flexion and abduction ranged from 15° (GP7) to 60° (GP4). Mean and variability of RULA score completed the analysis. The highest scores were computed for GP2 and GP3 (respectively 5.5±1.3 and 5.8±1.2, p < 0.05). GP4 had the lowest (4.0±1.1, p < 0.05). The results suggest that massages have to be monitored. Attention should be paid to the postures used to prevent the occurrence of MSDs.

Conclusion: The massages could be described as a combination of generic posture for a rapid ergonomic assessment.