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首页> 外文期刊>Surgical Endoscopy >Development of a more robust tool for postural stability analysis of laparoscopic surgeons.
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Development of a more robust tool for postural stability analysis of laparoscopic surgeons.

机译：开发了用于腹腔镜外科医生姿势稳定性分析的更强大的工具。

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BACKGROUND: Physical difficulties experienced by surgeons performing minimally invasive surgery (MIS) are being given extensive attention by ergonomic researchers. Postural stability, not commonly addressed, is our prime focus. Center of pressure (COP) alone is used in the few existing postural stability studies. Using COP, we previously correlated postural stability to instrument type, task difficulty, and skill level. This study, including center of mass (COM), sway area analysis, and what we uniquely term postural stability demand (PSD), extends our investigation. METHODS: Six surgeons from different experience levels were recruited to complete three fundamentals of laparoscopy (FLS(TM)) tasks. Standing on two force plates, participants performed each task as a motion capture system recorded body movements. An ellipse was created for sway area analysis of COP, the point where the ground reaction force was located, and COM, the point at which body mass was concentrated. PSD was defined as the mean distance between the COP and COM locations in the anterior-posterior (A-P) or medial-lateral (M-L) directions. Postural parameters and performance time were correlated. RESULTS: COM and COP sway areas positively correlated with pegboard transfer performance time (r = 0.928, p < 0.05; r = 0.864, p < 0.05) and also with circle-cutting performance time (r = 0.858, p < 0.05; r = 0.779, p = 0.06). However, COM and COP sway areas negatively correlated with endo-loop placement performance time (r = -0.925, p < 0.05; r = -0.935, p < 0.05). These results indicate unique postural controls based on skill level. During all tasks, PSD in the A-P direction strongly correlated with performance time (r = 0.829, p < 0.05; r = 0.913, p < 0.05; r = 0.880, p < 0.05), indicating that less-skilled participants experienced increased postural demands. CONCLUSIONS: This study demonstrated that variance in postural adjustments, as evidenced by sway area analysis, correlate to skill level and individual task. Strong correlation betweenPSD and performance time shows potential as a predictor of skill levels. Combining COM, COP, and PSD data produces a more robust analytic tool for identifying postural adjustments that can be correlated with skill level.
机译：背景：人体工程学研究人员给予了外科医生进行微创手术（MIS）所遇到的身体困难。姿势稳定性不是我们通常要解决的问题，这是我们的主要重点。现有的少数姿势稳定性研究仅使用压力中心（COP）。使用COP，我们以前将姿势稳定性与仪器类型，任务难度和技能水平相关联。这项研究包括质心（COM），摇摆区域分析以及我们唯一称呼的姿势稳定性需求（PSD），扩展了我们的研究范围。方法：招募了六名来自不同经验水平的外科医生，以完成腹腔镜检查（FLS（TM））任务的三个基础知识。参与者站在两个测力板上，执行每项任务，动作捕捉系统记录了人体的动作。创建了一个椭圆，用于分析地面反作用力COP和COM的摆动区域，COM是人体集中的位置。 PSD定义为COP和COM位置在前后（A-P）或内侧-外侧（M-L）方向上的平均距离。姿势参数和执行时间相关。结果：COM和COP摇摆面积与钉板转移执行时间（r = 0.928，p <0.05; r = 0.864，p <0.05）和切圆表演时间（r = 0.858，p <0.05; r = 0.779，p = 0.06）。但是，COM和COP摇摆面积与内环放置执行时间呈负相关（r = -0.925，p <0.05; r = -0.935，p <0.05）。这些结果表明基于技能水平的独特姿势控制。在所有任务中，AP方向上的PSD与执行时间密切相关（r = 0.829，p <0.05; r = 0.913，p <0.05; r = 0.880，p <0.05），表明技能较低的参与者的姿势需求增加。结论：这项研究表明，姿势变化的差异，如摇摆面积分析所证明，与技能水平和个人任务相关。 PSD和执行时间之间的强相关性显示了作为技能水平预测指标的潜力。将COM，COP和PSD数据结合起来，可以得到一种更强大的分析工具，用于识别可以与技能水平相关的姿势调整。

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