Registros de movimentos do pescoço: estado da arte, validação e aplicação e avaliação durante o trabalho de técnicos de enfermagem

Abstract

Neck pain has been highly prevalent among workers. In occupational settings physical risk factors, especially posture, are considered fundamental in neck pain development. However, neck posture and movements have not been properly evaluated at workplace due to the use of not reliable measurement methods. Furthermore, most of the studies that evaluate posture during occupational activities have focused on the wrist and hand assessment. Thus, in order to contribute with information about neck movements recording in occupational settings, three related studies were developed. The aim of the first study was to investigate the applications and limitations of the systems for direct measurement of neck movement in the workplace. The results of this study showed that in most of the articles the three axes of neck movement were not simultaneously recorded. Deficiencies in available equipment explain this flaw, demonstrating that sensors and systems need to be improved so that a true understanding of real occupational exposure can be achieved. Further studies are also needed to assess neck movement in those who perform heavy‐duty work, such as nurses and electricians, since no report about such jobs was identified. Based on these results, an option to record three‐dimensional neck movements in occupational settings is the use of flexible electrogoniometers. But neither electrogoniometers, nor inclinometers (direct measurement most commonly used) were compared with a system considered more accurate and precise. Then, the objective of the second study was to assess concurrent validity between flexible electrogoniometers (EGM), inclinometers (INC) and a three‐dimensional analysis system based on video recording (IMG) in simultaneous and synchronized data collection. EGM presented high differences when compared with INC and IMG. Moreover, the EGM sensors physically restricted the full neck flexion‐extension range of motion. Inclinometers, which cannot record rotation movement, presented good concurrent validity in relation to IMG, except for flexion‐extension movement. Due to non‐optimal conditions during flexion‐extension movement, IMG underestimated these movements. The results of the studies described above designed the third study that aimed to quantify the head, upper back and upper arm postures of practical nurses while performing their occupational activities and to verify if there are differences between the postures of professionals with and without symptoms. The results showed that most of the activities of practical nurses involve considerable postural risk for the head, upper back and upper arms. The postural risk varied among tasks: there was more exposure for the neck region when separating medication and keeping medical records. In general, workers with symptoms in the neck and upper arm region presented greater amplitude of movement and a higher fraction of time spent in awkward postures than asymptomatic workers, but with no significant difference between these two groups.