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Ergonomics for Cleft Providers: A Systematic Review
Jose A Garcia1, Wassim Najjar, Dana Andari
1From the Global Smile Foundation, Norwood, MA.
Background:
Cleft care providers, particularly surgeons, are at high risk for work-related musculoskeletal disorders (MSDs) due to prolonged and repetitive procedures. Despite increasing recognition of ergonomics, comprehensive strategies to address this issue remain underexplored. This systematic review consolidates evidence on ergonomic challenges, practices, and interventions for cleft care surgeons to enhance their musculoskeletal well-being and optimize performance.
Methods:
A systematic search of PubMed, Embase, Google Scholar, and Cochrane databases was conducted for studies published between January 1, 2000, and July 20, 2023. Eligible studies focused on ergonomic challenges and interventions among cleft care surgeons. Screening, data extraction, and risk of bias assessment were performed in duplicate following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Nineteen studies met the inclusion criteria.
Results:
Work-related MSDs were prevalent, with rates ranging from 47.5% to 97%. The most commonly reported symptoms occurred in the neck, shoulders, and lower back. Risk factors included years in practice, poor posture, and lack of ergonomic training. Recommendations included adopting visualization tools (eg, videoscopes, prismatic glasses), ergonomic devices, robotic-assisted surgery, and posture feedback systems. Ergonomic training and curricula were highlighted as essential for early intervention and long-term prevention. Barriers such as accessibility, cost, and implementation feasibility in resource-limited settings were noted.
Conclusions:
MSDs are pervasive among cleft care providers, underscoring the urgent need for ergonomic interventions. Integrating ergonomic principles into practice, enhancing surgical training, and promoting tailored interventions for all cleft care disciplines are critical to improving provider health and career longevity. Implementing ergonomic strategies and integrating them into clinical practice can significantly improve provider well-being, reduce musculoskeletal disorders, and ensure career longevity across diverse clinical settings.
