# Kinematic Assessment of the Physician’s Body Position and Musculoskeletal Loads During Breast and Abdominal Ultrasound Examinations

## TL;DR

This study examines the physical strain on physicians during breast and abdominal ultrasound exams, finding that these procedures can lead to musculoskeletal issues.

## Contribution

The study introduces a kinematic assessment of ergonomic strain during ultrasound exams, identifying specific areas with high musculoskeletal load.

## Key findings

- Examinations of the left breast and left kidney showed the most demanding postures.
- RULA and REBA scores indicated medium to high musculoskeletal loading during the procedures.
- Ergonomic modifications are needed to reduce strain and prevent occupational injuries.

## Abstract

Background: Ultrasound is a non-invasive imaging technique that provides real-time evaluation of anatomical structures. While versatile in examining various organs, it can be physically demanding for physicians due to the need for challenging positions, causing musculoskeletal pain and potentially work-related diseases over time. The study aimed to assess the ergonomics of abdominal and breast ultrasound, identify the most challenging anatomical area, determine which part of the examination causes the greatest strain, and evaluate the overall ergonomic impact of the entire procedure. Methods: This single-center study involved 4 radiologists and focused on breast and abdominal ultrasonography. Kinematic data were recorded using the Noraxon Ultium Motion inertial system to track body movements during the ultrasound procedures. Five critical segments were identified while examining the liver, right kidney, left kidney, right breast, and left breast. Ergonomic assessment was performed using the Rapid Upper Limb Assessment (RULA) and Rapid Entire Body Assessment (REBA) methods, evaluating postural risks and physical strain during each segment and the whole procedure. Results: Both RULA and REBA assessments yielded median total scores of 6.0–7.0 and 6.0–7.5, respectively, reflecting consistently medium to high musculoskeletal loading. Examinations of the left breast and left kidney were associated with the most demanding postures. These elevated scores demonstrate that abdominal and breast ultrasonography imposes substantial ergonomic strain, potentially increasing the risk of work-related musculoskeletal disorders. Conclusions: The high ergonomic risk scores indicate an urgent need to modify scanning techniques and workstation design to reduce musculoskeletal strain in sonographers. Implementing ergonomic improvements is essential to prevent occupational injuries and promote long-term health.