Effect of tool design on hand pain in dental practiioners

描述(申请人提供)：这是一项随机对照试验，旨在评估一种新的牙科工具手柄设计对120名进行牙科洁治的牙科卫生员和牙医的手和手臂症状和功能的影响。牙医和牙科保健师患上肢肌肉骨骼疾病的风险增加，如腕管综合征和肌腱炎。在这些职业中，这些疾病比其他任何原因导致更多的残疾退休。与这些疾病相关的主要风险因素是高咬合力和与牙周工作相关的笨拙的手腕姿势，如牙垢。一项实验室研究的初步数据表明，在模拟伸缩任务中，改变牙科工具的直径和重量可以对夹紧力和前臂肌肉负荷产生重大影响。这是一项为期3个月的实践者工作场所的干预研究。参与者将随机接受新的工具设计(大直径和轻量化)或传统工具设计。他们将在3个月的时间内使用该工具进行所有牙周工作。在每个周末，他们将被要求对他们的手和手臂疼痛、疲劳和感觉异常、手功能、止痛药使用情况以及当周攀爬的小时数进行评分。在调整潜在的协变量(例如，年龄、性别、职业、每周工作时数、工作时间、非工作手部活动等)的同时，将比较不同组之间手部症状强度的变化。在干预结束时，从每组随机选择的20名受试者将在人体模型上执行标准化的缩放任务，以测量捏合力。这项研究可能会确定一种工具手柄设计，以防止牙医和牙科卫生员中的(初级或次级)肌肉骨骼疼痛和残疾。叙事牙医和牙齿卫生师经历了肌肉骨骼疾病的高发病率，如腕管综合征和肌腱炎，主要是由于牙齿刮除所需的高咬合力。有证据表明，较轻和较大直径的工具可以显著降低夹紧力。这项随机对照研究将确定，与继续使用传统工具的人相比，使用这种工具的牙医或牙齿卫生员报告的手和手臂疼痛是否更少。

DESCRIPTION (provided by applicant): This is a randomized controlled trial to evaluate the effects of a new dental tool handle design on hand and arm symptoms and function among 120 dental hygienists and dentists who perform dental scaling. Dentists and dental hygienists are at increased risk for the development of upper extremity musculoskeletal disorders such as carpal tunnel syndrome and tendonitis. These disorders are responsible for more disability retirement in these professions than any other cause. The primary risk factors associated with these disorders are the high pinch force and awkward wrist postures associated with periodontal work, such as dental scaling. Preliminary data from a laboratory study suggests that modifying the diameter and weight of the dental tool can have a significant impact on the pinch force and forearm muscle load during a simulated scaling task. This is a 3 month intervention study in the practitioner's workplace. Participants will be randomized to receive a new tool design (large diameter and lightweight) or a conventional tool design. They will use the tool for all of their periodontal work for a 3 month duration. At the end of every week they will be asked to rate their hand and arm pain, fatigue and paresthesias, hand function, pain medication usage, and the number of hours of scaling for that week. Change in hand symptom intensity over the 3 month period will be compared between groups while adjusting for potential covariates (e.g., age, gender, occupation, scaling hours per week, work hours, non-work hand activity, etc.). At the end of the intervention, a randomly selected subset of 20 subjects from each group will perform a standardized scaling task on a mannequin to measure pinch force. The study may identify a tool handle design that prevents (primary or secondary) musculoskeletal pain and disability among dentists and dental hygienists. NARRATIVE Dentists and dental hygienists experience elevated rates of musculoskeletal disorders, such as carpal tunnel syndrome and tendonitis, primarily due to the high pinch force required for dental scaling. There is evidence that a lighter and larger diameter tool can significantly reduce the pinch force. This randomized controlled study will deterimine if dentists or dental hygienists who use such a tool report less hand and arm pain compared to those who continue to use the conventional tool design.