Ameer Alhusuny1,2, Margaret Cook3, Akram Khalil4,5, Andrew Hill6,7,8, Venerina Johnston5,9. 1. School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Australia. a.alhusuny@uq.edu.au. 2. St Lucia Clinical Unit, The University of Queensland, Level 4, Building 69, St Lucia, QLD, 4068, Australia. a.alhusuny@uq.edu.au. 3. School of Earth and Environmental Sciences, Faculty of Science, The University of Queensland, Brisbane, Australia. 4. School of Clinical Medicine, Faculty of Medicine, The University of Queensland, Brisbane, Australia. 5. Obstetrics and Gynecology Department, Metro North Hospital and Health Service, Royal Brisbane and Women's Hospital, Brisbane, Australia. 6. Clinical Skills Development Service, Metro North Hospital and Health Service, Brisbane, Australia. 7. Minerals Industry Safety and Health Centre, Sustainable Minerals Institute, The University of Queensland, Brisbane, Australia. 8. School of Psychology, The University of Queensland, Brisbane, Australia. 9. School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia.
Abstract
BACKGROUND: Minimally Invasive Surgery (MIS) has an impact on surgeons' musculoskeletal and visual systems. However, the relationship between visual symptoms and musculoskeletal problems is not well understood. AIM OF THE STUDY: This study used surface electromyography (sEMG) to examine changes in fatigue of the neck/shoulder muscles among surgeons with visual impairments when performing simulated surgical tasks in 2D and 3D viewing modes. DESIGN: Cross-sectional laboratory study. METHODS: Changes in median frequency (MDF, an indicator of muscle fatigue) were examined in 17 experienced gynaecologists. Four simulated surgical laparoscopy tasks were performed in 2D and 3D viewing modes. The MDF of three neck/shoulder muscles (cervical erector spinae, [CES], upper trapezii [UT], and anterior deltoids [AD]) were examined bilaterally. Visual parameters (accommodation, convergence, and stereoacuity) were measured prior to commencement. RESULTS: There was a downward shift of MDF from simple to more complex tasks for the right and left CES and AD muscles but not the UT, which was consistent for surgeons with mild accommodation/convergence impairment and/or good stereoacuity. There were significant differences in the level of muscle fatigue of the neck/shoulder muscles according to the severity of visual impairment, muscle side, task and surgical performance level. CONCLUSIONS: The results show a relationship between the degree of visual impairments and muscle fatigue of the neck/shoulder muscles among MIS surgeons. These findings have important implications in understanding the concurrence of musculoskeletal problems and visual symptoms.
BACKGROUND: Minimally Invasive Surgery (MIS) has an impact on surgeons' musculoskeletal and visual systems. However, the relationship between visual symptoms and musculoskeletal problems is not well understood. AIM OF THE STUDY: This study used surface electromyography (sEMG) to examine changes in fatigue of the neck/shoulder muscles among surgeons with visual impairments when performing simulated surgical tasks in 2D and 3D viewing modes. DESIGN: Cross-sectional laboratory study. METHODS: Changes in median frequency (MDF, an indicator of muscle fatigue) were examined in 17 experienced gynaecologists. Four simulated surgical laparoscopy tasks were performed in 2D and 3D viewing modes. The MDF of three neck/shoulder muscles (cervical erector spinae, [CES], upper trapezii [UT], and anterior deltoids [AD]) were examined bilaterally. Visual parameters (accommodation, convergence, and stereoacuity) were measured prior to commencement. RESULTS: There was a downward shift of MDF from simple to more complex tasks for the right and left CES and AD muscles but not the UT, which was consistent for surgeons with mild accommodation/convergence impairment and/or good stereoacuity. There were significant differences in the level of muscle fatigue of the neck/shoulder muscles according to the severity of visual impairment, muscle side, task and surgical performance level. CONCLUSIONS: The results show a relationship between the degree of visual impairments and muscle fatigue of the neck/shoulder muscles among MIS surgeons. These findings have important implications in understanding the concurrence of musculoskeletal problems and visual symptoms.