Primerjava učinkov stoječega in sedečega načina dela na mehansko obremenitev hrbtenice : diplomsko delo

Gumilar, Tim (author), Kacin, Alan (mentor), Backović Juričan, Andrea (co-mentor)

Uvod: Bolečina v spodnjem delu hrbta je najpogostejša mišično-skeletna motnja v državah razvitega sveta. Večjo prevalenco nastanka težav v tem predelu imajo zaposleni, ki večino časa preživijo v prisilni stoječi ali sedeči telesni drži, ki povzroča mehanske obremenitve na pasivne in aktivne strukture. Ob sedečem delu so mišice, ki delujejo kot stabilizatorji, manj aktivne v primerjavi s stoječim delom, kar ima za posledico večjo obremenitev pasivnih struktur. Pri stoječem delu so obremenitve večje na spodnje okončine, prav tako se lahko pojavi prekomerna ledvena lordoza, ki povzroča povečane obremenite fasetnih sklepov. Namen: Pregledati novejšo literaturo, primerjati učinke pretežno stoječega ali sedečega načina dela na obremenitve hrbtenice ter izpeljati priporočila za oblikovanje delovnega mesta, ki bi zaposlenim povzročalo najmanj obremenitev na hrbtenične strukture. Metode dela: Literaturo smo iskali v sledečih podatkovnih zbirkah: PubMed, Science direct, PEDro ter tiskano literaturo v knjižnici Zdravstvene fakultete in Fakultete za šport Ljubljana. Za pregled literature smo uporabili naslednje vključitvene kriterije: dostopnost do celotnega besedila, angleški ali slovenski jezik, objava znanstvenega članka v obdobju med 2006 in 2019, znanstveni članki v revijah povezani s sedečo ali stoječo telesno držo pri delu in njen vpliv na mehansko obremenitev hrbtenice. Rezultati: Iz iskalnega nabora 517 zadetkov je bilo v končno analizo pregleda literature vključenih 5 randomiziranih kontroliranih poskusov tujih avtorjev. Vsaka od raziskav je preučevala vplive na obremenitev hrbtenice pri sedečem ali stoječem položaju. Razprava in zaključek: Tako prekomerna fleksija ledvene hrbtenice med sedenjem kot prekomerna ekstenzija med stojo vplivata na degeneracijo hrbteničnih struktur. Prihaja do postopnega utrujanja aktivnih struktur - mišic, ki pa zaradi zmanjšane aktivnosti pripomorejo k obremenjevanju pasivnih struktur - ligamentov, medvretenčne ploščice in živčnih korenin. Namesto preprečevanja dela sede in spodbujanja samo stoječega položaja, bi zaposleni morali imeti svobodo izbire delovnega položaja in enostavno prilagoditev le-tega. Na podlagi pregledane literature menimo, da bi zraven ergonomske prilagoditve delovnega mesta, bilo potrebno več poudarka namenit ohranjanju optimalne drže, ki jo zaposleni vzdržujejo bodisi med sedenjem ali stojo.

• Language: Slovenian
• Keywords: obremenitev hrbtenice, sedeč ali stoječ način dela, telesna drža, delovno okolje
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2019
• PID: 20.500.12556/RUL-112859
• COBISS.SI-ID: 5731691
• Publication date in RUL: 16.11.2019

Secondary language

• Language: English
• Title: Comparison of sitting and standing posture on mechanical spine load : diploma work

Abstract

Introduction: Lower back pain is the most common musculoskeletal disorder in developed countries. A higher prevalence of developing lower back problems is experienced by employees who spend most of their time in forced standing or sitting posture which causes mechanical stress on passive and active structures. When working in a sitting posture, the muscles that act as stabilizers are less active compared to when working in a standing posture, resulting in a greater stress on passive structures. When working in a standing posture, the stress is greater on the lower extremities, in addition, excessive lumbar lordosis may occur, causing increased stress on the facet joints. Purpose: To review recent literature, to compare the effects of a predominantly standing or sedentary mode of work on spine loads, and to develop recommendations for creating a workplace that would cause the least load on spinal structures of employees. Methods: We searched the literature in the following databases: PubMed, Science direct, PEDro, and printed literature in the libraries of the Faculty of Health Sciences and Faculty of Sport Ljubljana. The following inclusion criteria were used to review the literature: full text accessibility, English or Slovenian language, publication of a scientific article between 2006 and 2019, scientific journal articles discussing sitting or standing posture at work and its effect on the mechanical load of the spine. Results: From a search set of 517 hits, 5 randomized controlled trials by foreign authors were included in the final analysis of the literature review. Each of the studies examined the effects on spine load when sitting or standing. Discussion and conclusion: Both excessive flexion of the lumbar spine while sitting and excessive extension while standing affect the degeneration of spinal structures. There is a gradual fatigue of the active structures – muscles which due to reduced activity contribute to the stress on passive structures – ligaments, intervertebral discs and nerve roots. Instead of preventing sedentary work and promoting only standing posture, employees should have the freedom to choose a work posture and easily adjust it. Based on the literature reviewed, we believe that besides the ergonomic adjustment of the workplace more emphasis should be placed on maintaining the optimal posture that employees have either while sitting or standing.

• Keywords: spine load, sitting or standing work position, body posture, workplaces