Ergonomic Awareness And Work-Related Musculoskeletal Disorders Among Healthcare Students: A PRISMA-Oriented Systematic Narrative Review Of Prevalence Patterns, Associated Factors, And Preventive Strategies

Abstract

Background: Work-related musculoskeletal disorders (WRMSDs) are now identified as a serious issue during the training of health care workers before they start their professional careers. Healthcare students are prone to prolonged sitting and standing, repeated clinical and laboratory activities, unusual working positions, digital-device usage and patient related activities. These exposures can lead to early musculoskeletal symptoms and can create potentially unsafe working practices which persist in working life.

Objective: To collate current primary evidence regarding prevalence patterns, affected anatomical sites, awareness of ergonomic issues and ergonomic factors and prevention strategies for WRMSD among healthcare students.

Methods: A systematic narrative review was performed which was guided by the PRISMA 2020 orientation and focused on student-centered primary records in the field of healthcare or health science. Reviews, protocols, editorials, commentaries, conference abstracts, professional-only and mixed-population studies (without student-relevant data) were not considered as primary evidence. There was no date restriction applied at the final eligibility stage in that there were several earlier studies identified that were closely related to the date. Due to the differences in studies by discipline, measurement instrument, recall period, anatomical definition and intervention design, findings were synthesized in a narrative way and not pooled.

Results: 29 peer-reviewed, full-text original journal articles related to students' perspectives were included in the qualitative synthesis. The studies of dental students were the largest, and there was also some evidence from studies by medical, nursing, physiotherapy, rehabilitation, and laboratory science and allied health students. Multiple complaints involved the neck, lower back, upper back, shoulders and wrist/hand areas. The associated factors included sustained or awkward posture, long sitting or standing periods, repetitive movements, screen time, academic or clinical workload, lack of training on practical ergonomics, poorly fitted workstations, restricted breaks, physical inactivity or more active years of clinical practice. In general, the level of ergonomic knowledge was higher than the level of ergonomic behavior.

Discussion: WRMSDs are identified as a concern among students in healthcare and seem to be preventable. The evidence is for the provision of early, practical and discipline-specific ergonomic training, instead of relying on theoretical instruction. Further longitudinal and intervention studies, especially in nursing, medical, pharmacy, radiography and laboratory science and allied-health programs are required.