辦公室工作者的作業姿勢與上交叉症候群之人因工程分析

Ergonomic analysis of working postures and upper crossed syndrome for office workers.

黃怡文(Yi-Wen Huang)

指導教授 ： 羅世忠

中山醫學大學/醫學科技學院/職能治療學系/碩士(2021年)

https://doi.org/10.6834/csmu202100154

摘要

背景：辦公室工作者需要長時間維持不適當姿勢，此姿勢外觀與牽涉肌肉張力以及骨骼排列異常的「上交叉症候群」。本研究目的為了解辦公室作業情境，是否使工作者達到上交叉症候群的姿勢，並分析不同情境對於上交叉症候群的嚴重程度。
方法：本研究納入24位辦公室工作者，填寫頸部失能問卷使用人體動作分析系統，擷取人體動作資料蒐集放鬆坐姿與6種辦公室模擬情境動作，包括在水平作業區建議操作範圍內、外進行操作；各方向書本讀打操作；筆電操作。後續電腦計算處理獲得顱頸角、頭前傾、圓肩和頸部屈曲角度資料，並衍伸獲得動作活動範圍、角速度和頸椎屈曲力矩。數據經皮爾森相關係數檢定失能程度是否與工作相關；並使用單因子重複量測變異數分析將各情境數據資料進行分析，顯著水準α訂為0.05。
結果：根據頸部失能問卷結果進行檢定，工作者年齡與自覺疼痛有中度正相關。模擬情境間比較下，顱頸角、圓肩及頸部屈曲角度顯示統計上的差異：進行辦公室作業中的姿勢較放鬆坐姿不理想、書本讀打情境較建議範圍內操作情境不理想。顱頸角、圓肩角度顯示統計上的差異：使用筆記型電腦操作時，比在建議範圍內操作桌上型電腦姿勢不理想。結果發現在所有情境中受試者的平均角度皆達到上交叉症候群標準。研究也發現當受試者於直視螢幕進行的模擬情境時，右側動作活動範圍大於左側；讀打情境時動作活動範圍高於一般文書處理情境。
結論：辦公室作業情境使工作者曝露於上交叉症候群的姿勢，而不同情境也有相異的影響程度，建議未來進行辦公室工作者上背肩頸疾病預防，應同時考量作業情境、環境設置、工作者本身脊椎排列姿勢因素。

關鍵字

辦公室作業 ； 人因工程 ； 上交叉症候群 ； 職業性肌肉骨骼不適

並列摘要

Background： Office workers often needs to maintain inappropriate posture for a long time. The posture is similar to “ Upper Crossed System (UCS)” which related to multiple muscle tone and abnormal skeletal alignment. The purpose of this study was to discover the relationship between office’s working scenarios and posture of UCS, and analyzed the severity in different scenarios.
Method：Twenty-four office workers used the Chinese version of the Neck Disability Index (NDI) for neck pain analysis. Motion capture cameras were used to obtain the kinematic data on the neck-shoulder region while the subjects were relaxing and completing six stimulated office work scenarios. Posture is measured by retrieving data from cranial vertebral angle (CVA), anterior head angle (FHA), anterior shoulder angle (FSA), and neck flexion angle. After completing the action collection, the data was analyzed to obtain range of motion (ROM), angular velocity, and joint moment. Pearson's correlation coefficient and one-way ANOVA with repeated measures were used to analyze the data.
Results：Moderate positive correlation between age and pain(r=0.4644) was founded on NDI questionnaire. In all scenarios, working posture were significantly worse than relaxed sitting (CVA, FSA, neck flexion angle; p<.05). The postures of reading and typing were worse than the situation of recommended operating range using the PC (CVA, FSA, neck flexion angle; p<.05). When using laptop, the postures were also worse than the situation of recommended operating range using the PC (CVA, FSA; p<.05).The average angle of the workers in all scenarios reached the standard angles of UCS. When the worker is looking directly at the screen during simulation tasks, the right side showed larger ROM than the left side. At the same time, we also found that when reading and typing simultaneously will show larger ROM than typing only.
Conclusion：The posture of the office workers increased the risk of having UCS, and different scenarios will affect its severity respectively. In order to prevent future shoulder-neck musculoskeletal disorders, we suggest company should design the office based on different working situations, environment settings and according to worker’s posture alignment.

並列關鍵字

office worker ； upper crossed syndrome ； ergonomic analysis ； MSDs

參考文獻

1. Arshadi, R., Ghasemi, G. A., Samadi, H. (2019). Effects of an 8-week selective corrective exercises program on electromyography activity of scapular and neck muscles in persons with upper crossed syndrome: Randomized controlled trial. Physical Therapy in Sport, 37, 113-119.

2. Bae, W. S., Lee, H. O., Shin, J. W., Lee, K. C. (2016). The effect of middle and lower trapezius strength exercises and levator scapulae and upper trapezius stretching exercises in upper crossed syndrome. The Journal of Physical Therapy Science, 28(5), 1636-1639. doi:10.1589/jpts.28.1636

3. Bayattork, M., Seidi, F., Minoonejad, H., Andersen, L. L., Page, P. (2020). The effectiveness of a comprehensive corrective exercises program and subsequent detraining on alignment, muscle activation, and movement pattern in men with upper crossed syndrome: protocol for a parallel-group randomized controlled trial. Trials, 21(1), 255. doi:10.1186/s13063-020-4159-9

4. Boocock, M. G., Collier, J. M., McNair, P. J., Simmonds, M., Larmer, P. J., Armstrong, B. (2009). A framework for the classification and diagnosis of work-related upper extremity conditions: systematic review. Paper presented at the Seminars in arthritis and rheumatism.

5. Cagnie, B., Danneels, L., Van Tiggelen, D., De Loose, V., Cambier, D. (2007). Individual and work related risk factors for neck pain among office workers: a cross sectional study. European Spine Journal, 16(5), 679-686.