BACKGROUND: There have been some concerns related to manual handling of large items in industry. Manual handling operations of large sheet metal may expose workers to risks related to efficiency as well as occupational safety and health. Large sheet metals are difficult to move and burdensome to lift/transfer, and handling the sharp sheet edges may result in contact stress and/or cut injuries on the workers. METHODS: Through observation, interview, and immersive simulation activities, a few problems related to current handling of sheet metals were identified. A sheet metal trolley-lifter was then designed and fabricated to address these issues. A pilot study on the use of the developed trolley-lifter for handling sheet metals was conducted to compare between the new and traditional handling methods. RESULTS: The pilot study of the trolley-lifter showed promising results in terms of improving the cycle time, manpower utilization, and working postures compared with the traditional handling method. CONCLUSION: The trolley-lifter offers an alternative solution to automation and a mechanized assistive device by providing a simple mechanism to assist the handling of sheet metals effectively and safely.
Automation ; Human Engineering ; Metals ; Methods ; Occupational Health ; Pilot Projects ; Posture ; Self-Help Devices

BACKGROUND/AIMS: Endoscopic assistive devices have been developed to reduce the complexity and improve the safety of surgeries involving the use of endoscopes. We developed an assistive robotic arm for endoscopic submucosal dissection (ESD) and evaluated its efficiency and safety in this in vitro pilot study. METHODS: ESD was performed using an auxiliary transluminal endoscopic robot. An in vitro test bed replicating the intra-abdominal environment and pig stomachs were used for the experiment. Participants were divided into skilled operators and unskilled operators. Each group performed ESD 10 times by using both conventional and robot-assisted methods. The perforation incidence, operation time, and resected mucous membrane size were measured. RESULTS: For the conventional method, significant differences were noted between skilled and unskilled operators regarding operation time (11.3 minutes vs 26.7 minutes) and perforation incidence (0/10 vs 6/10). Unskilled operators showed a large decrease in the perforation incidence with the robot-assisted method (conventional method vs robot-assisted method, 6/10 vs 1/10). However, the operation time did not differ between the conventional and robot-assisted methods. On the other hand, skilled operators did not show differences in the operation time and perforation incidence between the conventional and robot-assisted methods. Among both skilled and unskilled operators, the operation time decreased with the robot-assisted method as the experiment proceeded. CONCLUSIONS: The surgical safety of unskilled operators greatly improved with robotic assistance. Thus, our assistive robotic arm was beneficial for ESD. Our findings suggest that endoscopic assistive robots have positive effects on surgical safety.
Arm ; Endoscopes ; Endoscopy ; Hand ; In Vitro Techniques ; Incidence ; Methods ; Mucous Membrane ; Pilot Projects ; Self-Help Devices ; Stomach ; Surgery, Computer-Assisted

OBJECTIVES: The purpose of this study was to assess the ergonomic risk factors in beekeeping, and to evaluate the effectiveness of assistive device hive lift. METHODS: This study included 30 subjects of beekeeper in Pocheon, Korea. We assessed the ergonomic risk of main task in beekeeping with NLE, OWAS and evaluate the effectiveness of hive lift. We also surveyed prevalence of musculoskeletal symptoms among the subjects based on the Korea Working Condition Survey. RESULTS: Moving to different floral origin, internal inspection of beehives, feeding syrup is the most burdensome to musculoskeletal system (NLE LI value=2~3. OWAS action category=4). The prevalence of musculoskeletal symptoms (lower and upper extremities) among the subjects was over 80 %. The introduction of assistive devices in the three hazardous tasks has dramatically reduced the risk by removing manual lifting hives (OWAS action category<1). CONCLUSIONS: Beekeeping is a heavy workload on the musculoskeletal system because it has a lot of manual lifting task. As a result of applying the hive lift, the burden could be reduced.
Beekeeping ; Korea ; Lifting ; Musculoskeletal System ; Prevalence ; Risk Assessment ; Risk Factors ; Self-Help Devices ; Urticaria

PURPOSE: The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls.METHODS: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls.RESULTS: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ≥81, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs.CONCLUSION: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.
Accidental Falls ; Comorbidity ; Gait Disorders, Neurologic ; Hospitalization ; Humans ; Incidence ; Inpatients ; Joints ; Nursing ; Organization and Administration ; Patient Care ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Self-Help Devices ; Survival Analysis ; Survival Rate ; Tertiary Care Centers

BACKGROUND: The aim of this study was to investigate the current state of the assistive devices and appliances provision system for cerebral palsy patients registered with brain disability. METHODS: From 2003 to 2013, we analyzed the records of cerebral palsy patients who had assistive devices and appliances provisioned at least once in their lives based on National Health Information Database. Patients with cerebral palsy were divided into three groups: infants and toddlers, school age and adolescence, and adults. RESULTS: Data on short leg plastic orthoses, ankle joint orthoses, and wheelchair were mainly analyzed. The types of ankle joint orthoses divided into three categories: limited, 90° limited, and Klenzac. Limited ankle joint orthoses was most frequently supported of the three in all age groups. Powered wheelchair and scooter were most supported to adult patients. When the re-supply duration was evaluated, the duration was suitable to the duration on guideline of regulation of re-supplement according to the related laws in adult patients but not in infants/toddlers and school age/adolescence as the actual re-supplement duration was much shorter than the reference value. CONCLUSION: This study confirmed the pattern of assistive devices and appliances supply differed depending on the age of cerebral palsy patients.
Adolescent ; Adult ; Ankle Joint ; Brain ; Cerebral Palsy ; Foot Orthoses ; Humans ; Infant ; Jurisprudence ; Korea ; Leg ; Orthotic Devices ; Plastics ; Reference Values ; Self-Help Devices ; Wheelchairs

PURPOSE: An axillary crutch is the most commonly used assistive device in foot and ankle patients who require nonweightbearing. On the other hand, its use frequently induces axillary or wrist pain and critical neurovascular injuries have been reported in several studies. This study compared the clinical outcomes of patients using the knee walker and axillary crutch. MATERIALS AND METHODS: A retrospective analysis was performed comparing the utility of a knee walker and axillary crutch as a nonweightbearing ambulatory aid for 62 foot and ankle patients treated between November 2016 and March 2018. A comparative study of the two orthosis could be performed because all the patients temporarily used an axillary crutch before or after the use of a knee walker. A demographic study and comparative analysis based on the visual analogue scale (VAS) satisfaction score (0~100), complications, and fall down history were evaluated. Furthermore, under the assumption of having retreatment, their preference of orthosis between the knee walker and axillary crutch was investigated. RESULTS: The mean age of the patients was 36.5 and the mean duration of ambulation with a knee walker and axillary crutch were 5.2 and 2.4 weeks. The VAS satisfaction score of the knee walker and crutch was 88.8 and 27.5, respectively (p < 0.05). The most frequent complications of the knee walker and crutch were ipsilateral knee pain (6 cases) and axillary or wrist pain (56 cases), respectively. No case of falling down occurred during knee walker ambulation, but there were two cases of crutch ambulation. Fifty-eight patients (93.5%) preferred the knee walker and four patients (6.5%) preferred a crutch. CONCLUSION: Compared to the axillary crutch, the knee walker afforded lower complication and higher satisfaction. Most patients preferred the knee walker to a crutch. Therefore, the knee walker is an efficient and safe orthosis for foot and ankle patients who require nonweightbearing.
Accidental Falls ; Ankle* ; Foot* ; Hand ; Humans ; Knee* ; Orthotic Devices ; Retreatment ; Retrospective Studies ; Self-Help Devices ; Walkers* ; Walking ; Wrist

The manual handling of people (MHP) is known to be associated with high incidence of musculoskeletal disorders for aged care staff. Environment-related MHP interventions, such as appropriate seated heights to aid sit-to-stand transfers, can reduce staff injury while improving the patient's mobility. Promoting patient mobility within the manual handling interaction is an endorsed MHP risk control intervention strategy. This article provides a narrative review of the types of MHP environmental controls that can improve mobility, as well as the extent to which these environmental controls are considered in MHP risk management and assessment tools. Although a range of possible environmental interventions exist, current tools only consider these in a limited manner. Development of an assessment tool that more comprehensively covers environmental strategies in MHP risk management could help reduce staff injury and improve resident mobility through auditing existing practices and guiding the design of new and refurbished aged care facilities.
Activities of Daily Living ; Humans ; Incidence ; Risk Management ; Self-Help Devices

STUDY DESIGN: Retrospective, case series. PURPOSE: The purpose of this study is to determine morbidity, complications, and patient reported outcomes from minimally invasive sacroiliac joint (SIJ) fusion. OVERVIEW OF LITERATURE: Lumbar back pain emanating from the SIJ can be surgically treated via a percutaneous approach in the appropriately selected patient with minimal morbidity and acceptable functional outcomes. METHODS: Patients diagnosed by >2 physical examination maneuvers and subjective relief from a computed tomography–guided lidocaine-bupivacaine-steroid injection underwent SIJ fusion after failing conservative management with a combination of oral anti-inflammatory medications, physical therapy, and pelvic belt stabilization. Perioperative data collected include estimated blood loss (EBL) and operative time. Oswestry disability index, 12-item short form health survey (SF-12), visual analogue score, and functional status were analyzed. All complications were noted. RESULTS: The study cohort of 45 cases (69% female) achieved postoperative survey follow-up at 9.9 and 32.3 months. SF-12 physical component summary statistically improved while all other scores were equivalent. Mean EBL and operative time were 22 mL and 36 minutes, respectively. Initial survey showed that 64% of patients discontinued narcotics (29/45), 71% do not use an assistive device (32/45), and 15.6% do not work due to pain (7/45). 73% of patients stated they would have the surgery again (33/45). For the second survey, 65% of patients discontinued narcotics (26/40), 70% did not use an assistive device (28/40), and 17.5% did not work due to pain (7/40). A history of thoracolumbar instrumentation (16/45) did not significantly affect outcomes. Three complications described by screw malposition with neurologic deficit (6.7%) were treated with screw repositioning (1 case) and removal of a single superior implant (2 cases) with time to revision of 2.2 months. All three ultimately had resolution of radicular pain. CONCLUSIONS: Percutaneous SIJ fusion offers minimal morbidity and acceptable functional outcomes. While women and those with a prior history of lumbar instrumentation may be at increased risk of having SIJ dysfunction requiring surgical intervention, it was not found to affect postoperative functional outcomes when compared to the non-instrumented group.
Back Pain ; Cohort Studies ; Female ; Follow-Up Studies ; Health Surveys ; Humans ; Narcotics ; Neurologic Manifestations ; Operative Time ; Physical Examination ; Retrospective Studies ; Sacroiliac Joint* ; Self-Help Devices

OBJECTIVES: The purpose of this study was to identify the association between satisfaction with assistive technology devices and psychosocial impact among some mentally or physically disabled children. METHODS: The study subjects were 120 disabled children and their primary caregivers who were using rental assistive technology devices in Gwangju and Jeollanam-Do. Data were collected by structured questionnaire composed of general characteristics of subjects, characteristics related with using assistive devices. Quebec User Evaluation of Satisfaction with assistive Technology 2.0 (QUEST 2.0) and Psychosocial Impact of Assistive Device Scale (PIADS). The statistical analysis were performed by descriptive statistics, t-test, ANOVA and Pearson's correlational analysis. RESULTS: The total mean score for QUEST 2.0 was 4.08±0.66 (satisfaction with devices, 4.01±0.70; satisfaction with the assistive devices service, 4.14±0.90) and the mean of PIADS was 1.00±0.75 (ability, 0.99±0.78; adaptability, 1.04±0.86; self-respect, 0.99±0.74). The scores of PIADS was statistically significant difference according to usage time of assistive devices. The PIADS was significantly positive correlated with QUEST 2.0 CONCLUSIONS: The mentally or physically disabled children reported that the higher level of satisfaction and the more positive impact of psychosocial aspect with assistive technology devices. It would be necessary to perform further studies for addressing the effects of assistive technology devices.
Caregivers ; Child* ; Disabled Children ; Disabled Persons* ; Gwangju ; Humans ; Jeollanam-do ; Quebec ; Self-Help Devices*

PURPOSE: This research was conducted to reveal Japanese mothers' changing perceptions towards their technology-dependent children in the home care setting. METHODS: Fourteen Japanese mothers participated in semi-structured interviews, which were analyzed using a grounded theory approach. RESULTS: "Degree of preoccupation with the child" emerged as the category representing the mothers' perceptions towards their child. Three categories emerged that represented the progression of maternal perceptions over time: "accepting the child's conditions", "mastering the management of care in various conditions", and "considering social participation for the child". CONCLUSIONS: First, mothers gradually accepted the conditions of their child after his/her disease and disability were known. Second, others managed technology-required care and concurrently considered the social participation of their child through daily care at home. Third, the level of preoccupation with the child was affected by the mothers' management of care and their attitude towards the social participation of their child in home care. In this study, as is widely alleged in historical recognition of Japan, mothers provided daily care almost without help from other family members. Additionally, they thought it natural and good for their children. Above all, especially in Japan, professional support for mothers are necessary so that they can take breaks from care.
Adaptation, Psychological ; Adolescent ; Adult ; *Attitude to Health ; Biomedical Technology ; Caregivers ; Child ; Child Advocacy ; Disabled Children/*psychology ; Female ; Home Care Services ; Humans ; Japan ; Male ; Middle Aged ; Mother-Child Relations ; Mothers/*psychology ; Perception ; Personal Autonomy ; Self-Help Devices ; Young Adult