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Web-based learning program for adjusting computer workstation: development and validity test
Mr. Chawanwong Srinak Faculty of Physical Therapy, Mahidol University
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Background and Rationale
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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Background and Rationale
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
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Background and Rationale
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.
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Background and Rationale
Rucker NP 2004 Ergonomics 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
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Purpose of the study General 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 3. to determine satisfaction of the program.
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Variables of the study Independent variable
- Web-based program for computer users Dependent 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
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Advantages of the study
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.
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Methods Study design This study was divided in 2 phases:
1) Web-based program development. 2) Application test for the developed web-based program.
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Criteria - 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.
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Methods Procedure Screening Informed consent Setting the work station
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Methods Complete the satisfaction questionnaire
Analyze photos by assessor
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Data analysis Descriptive statistics - Demographic data & satisfaction
RULA & REBA - Friedman test - Wilcoxon sign rank test SPSS for Windows version 17
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Results Higher RULA score refer to more postural risk
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Results Friedman test Statistically significant difference in RULA score between groups with 2(3) = and p = 0.000 Post hoc analysis was performed by Wilcoxon sign-rank tests. Median RULA score of period A (3 to 6) B (4 to 6) C (3 to 5) D (3 to 5) There were significant differences between Period B and C (Z = , p = 0.000) Period B and D (Z= , 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) = and p = 0.000 Post hoc analysis was performed by Wilcoxon sign-rank tests. Median REBA score of period A (5 to 7) B (5 to 8) C (3 to 6) D (3 to 5) There were significance differences between Period A and C (Z = , p = 0.004) Period A and D (Z = , p = 0.001) Period B and C (Z = , p = 0.000) Period B and D (Z = , p = 0.000)
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Results Satisfaction in main categories Satisfaction Mean SD
Interpretation 1. Program use 2. Knowledge 3. Advantage 4.28 4.48 4.62 0.71 0.63 0.56 high very high Total 4.38 0.68
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Discussion Program development (Jones & Muthaya 2009)
5 steps using the guidline of Jones and Muthaya in 2009 (29). Discussion Program development (Jones & Muthaya 2009) Validate content by experts - Ensure its content to be valid Program development - Adobe Captivate 6 Tested by 60 PT students - Evaluate its content and interface of program Revise - Improve both content and interface Validate content by experts again - Final content validation
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Discussion Content of program Introduction
- 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
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Discussion Content of program 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
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Discussion Previous 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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Discussion Application 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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Discussion RULA & REBA - 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.
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Discussion The 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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Discussion Satisfaction
- 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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Discussion Limitation and further study
Co-operation between a professional software developer and researchers. No control group. Comparison with other ergonomics training. Different populations: age, sex, and education.
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Conclusion The 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 - First web-based ergonomics program in Thai language. - Appropriate for Thai users.
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