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Mr. Chawanwong Srinak Faculty of Physical Therapy, Mahidol University

Web-based Web-based learning program learning program

for adjusting for adjusting computer computer

workstation: workstation: development and development and

validity testvalidity test

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Background and Background and RationaleRationale

In Thailand, 63% of office workers complain about musculoskeletal symptoms associated with work (Janwantanakul et al., 2008)

In Britain, the cost associated with work-related upper limb disorders is £1.25 billion per year

(Korhan O, Mackieh A. 2010)

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Ergonomics intervention Ergonomic training in computer

operators can improve postural MSDs. (Zeidi IM et at al 2011) Training method using self-modeling

webcam photos improve posture of computer users. (Maimon

MT et al. 2012)Limitation: costs, time, specific group

Background and Background and RationaleRationale

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Web-based learning (WBL) Web-based learning (WBL) Since 1960 (Nicholson P. 1960)Learning via internet or intranet (Nicholson P.

1960)Used in various fields: Mathametrics (González JA.

2010), Medical (Gerdprasert S.), Science (Sun KT. 2011)Same or more effective than traditional

instruction. WBL may be used as a tool for ergonomics

intervention.

Background and Background and RationaleRationale

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Background and Background and RationaleRationale

Rucker NP 2004Ergonomics web-based training VS traditional instruction.Both methods had a significant improve in knowledge and behavioral changes.Local intranet More virtual approach may be used

LOGOGeneral objective to develop and evaluate the web-based program to

reduce the risk of the computer related musculoskeletal disorders for Thai computer users.

Specific objectives 1. to compare RULA for the computer workstation adjusted

by using with and without the web-based program.

2. to compare REBA for the computer workstation adjusted by using with and without the web-based program.

3. to determine satisfaction of the program.

Purpose of the Purpose of the studystudy

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Independent variable - Web-based program for computer usersDependent variables - Rapid Upper Limb Assessment (RULA)

score - Rapid Entire Body Assessment (REBA)

score- Satisfaction questionnaire scores

Control variable- Duration of workstation adjustment- Duration of program use

Variables of the Variables of the studystudy

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A tool to decrease the risks of work related musculoskeletal

disorders for computer users. A simplified program that can be

used widespread. A teaching tool for ergonomists,

physical therapists, and other health care professionals.

Advantages of Advantages of the studythe study

LOGOMethods

Study designThis study was divided in 2

phases: 1) Web-based program

development.2) Application test for the

developed web-based program.

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- Computer users who had frequent computer use. - Without RSI or RSI was not greater than 2

(Browne et al. 1984) "Symptoms fail to disappear overnight and begin

to disturb sleep. Performance on repetitive tasks is

significantly reduced. Physical signs may be apparent. The

condition usually persists for months." - Never used to participate in ergonomics class or

training.

Criteria

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ProcedureScreeningInformed consentSetting the work station

MethodsMethods

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Complete the satisfaction questionnaire

Analyze photos by assessor

MethodsMethods

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Descriptive statisticsDescriptive statistics

- Demographic data & satisfaction- Demographic data & satisfactionRULA & REBARULA & REBA

- Friedman test- Friedman test

- Wilcoxon sign rank test- Wilcoxon sign rank testSPSS for Windows version 17SPSS for Windows version 17

Data analysisData analysis

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Results

Higher RULA score refer to more postural risk

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ResultsFriedman test Statistically significant difference in RULA score between groups with

2(3) = 21.289 and p = 0.000Post hoc analysis was performed by Wilcoxon sign-rank tests.

Median RULA score of period A 4.50 (3 to 6)

B 5.00 (4 to 6) C 3.00 (3 to 5) D 3.00 (3 to 5) There were significant differences between Period B and C (Z = -3.558, p = 0.000) Period B and D (Z= -3.791, p = 0.000)

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Results

Higher REBA score refer to more postural risk

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Results

Friedman test Statistically significant difference in REBA score between groups with 2(3) = 21.289 and p = 0.000Post hoc analysis was performed by Wilcoxon sign-rank tests.

Median REBA score of period A 5.00 (5 to 7)

B 6.00 (5 to 8) C 4.00 (3 to 6) D 4.00 (3 to 5) There were significance differences between

Period A and C (Z = -2.865, p = 0.004)

Period A and D (Z = -3.192, p = 0.001)

Period B and C (Z = -3.542, p = 0.000)

Period B and D (Z = -3.732, p = 0.000)

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Results

Satisfacti

on

Mean SD Interpret

ation

1.

Program

use

2.

Knowled

ge

3.

Advantag

e

4.28

4.48

4.62

0.71

0.63

0.56

high

high

very high

Total 4.38 0.68 high

X

Satisfaction in main categories

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DiscussionProgram development

5 steps using the guidline of Jones and Muthaya in 2009 (29).

(Jones & Muthaya 2009) Validate content by experts - Ensure its content to be validProgram development - Adobe Captivate 6Tested by 60 PT students - Evaluate its content and interface

of program Revise - Improve both content and interfaceValidate content by experts again - Final content validation

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DiscussionIntroduction - Basic knowledge: causes & symptoms of computer-related injuries. - Understand the mechanism of injuries, early detect the symptoms. - Realize & avoid inappropriate use of computer.Workstation adjustment - Step by step. - Can choose the similar devices. - Easy to use

Content of program

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Discussion

Recommendation - Behavior change and exercise for computer users. - Maybe prevent or treat themselves.Unexpected problems - Common set up mistake and how to manage limitations of devices setting.Discussion and knowledge sharing - Discussion between users on Facebook

Content of program

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DiscussionPrevious study of Rucker NP. 2004 - Instructer-taugh course & Developed web-based course - The content was similar to the current study but his program was available only via local network.

- Current study provided more selection of computer devices and the step of workstation adjustment was easy to follow.

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DiscussionApplication test of developed web-based program- Pre-post test design: suitable to evaluated the effectiveness of program-The 20-minute rest break: minimize the fatigue. base on the study of Szeto GPY. and Sham KSW. 2008-RULA: evaluate upper limb, Rueder R. 1996-REBA: evaluate whole body, Pillastrini P. et al 2007- Satisfaction: evaluate users attitude toward the program, Kaveevivitchai C. et al 2009

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- Using web-based program: RULA & REBA.

- Proper workstation adjustment: Improve more neutral

posture. - The results similar with Taieb-

Maimon M et al. and Pillastini P et al.

DiscussionRULA & REBA

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DiscussionThe postural change- Using web-based program: RULA & REBA.- Proper workstation adjustment: Improve more neutral posture. - Biomechanically described. In first session Changed posture instead of adjusting the workstation. Too low monitor - bend head forward Too far monitor - lean head & trunks forward reach hand Too low chair - elevate shoulders or bend elbow more than 90 degrees.

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DiscussionSatisfaction

- Likert scale: range 1-5 (very low, low, moderate, high, very high). - Satisfaction of this program: high to very high. - Easy to follow the program. - The knowledge was new & important to know. - The program was new, easy to access. - Similar to the study of Kaveevivitchai C et al. 2009

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Co-operation between a

professional software developer and researchers.No control group.Comparison with other

ergonomics training.Different populations: age, sex,

and education.

DiscussionLimitation and further study

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ConclusionThe developed web-based program - Valid tool. - Able to help reduce the risk of the computer related musculoskeletal disorders. - Better working posture as indicated by better RULA and REBA. - Available at http://www.pt.mahidol.ac.th/web_app/computerergo/ - First web-based ergonomics program in Thai language. - Appropriate for Thai users.