Quantitative Assessment of Trunk Flexion in Nurses Using Wearable Inertial Sensor: A Pilot Study

  • Micaela Porta
  • Marcello Campagna
  • Giovanni Marco Mura
  • Massimiliano PauEmail author
Conference paper
Part of the Advances in Intelligent Systems and Computing book series (AISC, volume 1215)


Nurses are at increased risk to develop musculoskeletal disorders (in particular low back pain) due to prolonged exposure to awkward postures, but there is a lack of quantitative objective measurements useful to characterize such postures. In the present study, we employed a single wearable inertial measurement unit (IMU) placed in the low back to monitor trunk flexion of eleven professional nurses working at maternity and cardiology wards during two hours of a regular shift. Trunk movement was analyzed using an exposure variation analysis approach which classifies flexion in three classes (i.e. 30–60°, 60–90° and >90°). The results show that tested nurses spent 3.5% of the monitored time with their trunk flexed between 30 and 60° and 0.2% between 60 and 90°. The IMU-based approach appears suitable to perform long-term monitoring of trunk postures in workers at risk for musculoskeletal disorders, overcoming the limitation of the observational methods and questionnaires.


Trunk posture Inertial sensors Nurses Work related musculoskeletal disorders 


  1. 1.
    Magnago, T.S., Lisboa, M., Souza, I., Moreira, M.: Musculoskeletal disorders in nursing workers: evidences associated to work conditions. Rev. Bras. Enferm. 60(7), 191–196 (2007)Google Scholar
  2. 2.
    Solidaki, E., Chatzi, L., Bitsios, P., Markatzi, I., Plana, E., Castro, F., Palmer, K., Coggon, D., Kogevinas, M.: Work-related and psychological determinants of multisite musculoskeletal pain. Scand. J. Work Environ. Health 36(1), 54–56 (2010)CrossRefGoogle Scholar
  3. 3.
    Nourollahi, M., Afshari, D., Dianat, I.: Awkward trunk postures and their relationship with low back pain in hospital nurses. Work. 59(3), 317–323 (2018)CrossRefGoogle Scholar
  4. 4.
    Abdollahzade, F., Mohammadi, F., Dianat, I., Asghari, E., Asghari-Jafarabadi, M., Sokhanvar, Z.: Working posture and its predictors in hospital operating room nurses. Health Promot. Perspect. 6(1), 17–22 (2016)CrossRefGoogle Scholar
  5. 5.
    Bootsman, R., Markopoulos, P., Qi, Q., Wang, Q., Timmermans, A.A.: Wearable technology for posture monitoring at the workplace. Int. J. Hum Comput Stud. 132, 99–111 (2019)CrossRefGoogle Scholar
  6. 6.
    Burdof, A., van Riel, M.: Design of strategies to assess lumbar posture during work. Int. J. Ind. Ergon. 18, 239–249 (1996)CrossRefGoogle Scholar
  7. 7.
    David, G.C.: Ergonomic methods for assessing exposure to risk factors for work-related musculoskeletal disorders. Occup. Med. 55, 190–199 (2005)CrossRefGoogle Scholar
  8. 8.
    Bergman, J.H.M., McGregor, A.H.: Body-worn sensor design: what do patients and clinicians want? Ann. Biomed. Eng. 39(9), 2299–2312 (2011)CrossRefGoogle Scholar
  9. 9.
    Shall Jr., M.C., Fethke, N.B., Chen, H.: Evaluation of four sensor locations for physical activity assessment. Appl. Ergon. 53, 103–109 (2016)CrossRefGoogle Scholar
  10. 10.
    Douphrate, D.I., Fethke, N.B., Nonnenmann, M.W., Rosecrance, J.C., Reynolds, S.J.: Full shift arm inclinometry among dairy parlor workers: a feasibility study in a challenging work environment. Appl. Ergon. 43(3), 604–613 (2012)CrossRefGoogle Scholar
  11. 11.
    Asante, B.O., Bath, B., Trask, C.: Trunk posture assessment during work tasks at a Canadian recycling center. Int. J. Ind. Ergonom. 68, 297–303 (2018)CrossRefGoogle Scholar
  12. 12.
    Faber, G.S., Kingma, I., Bruijn, S.M., van Dieen, J.H.: Optimal inertial sensor location for ambulatory measurement of trunk inclination. J. Biomech. 42, 2406–2409 (2009)CrossRefGoogle Scholar
  13. 13.
    Mathiassen, S.E., Winkel, J.: Quantifying variation in physical load using exposure-vs-time data. Ergonomics 34(12), 1455–1468 (1991)CrossRefGoogle Scholar
  14. 14.
    Hildebrand, M., Van Hees, V.T., Hansen, B.H., Ekelund, U.: Age group comparability of raw accelerometer output from wrist- and hip-worn monitors. Med. Sci. Sports Exerc. 46(9), 1816–1824 (2014)CrossRefGoogle Scholar
  15. 15.
    Lee, Y.S., Huang, Y.C., Kao, Y.H.: Physical activities and correlates of clinical nurses in Taipei municipal hospitals. J Nurs Res. 13(4), 281–292 (2005)CrossRefGoogle Scholar
  16. 16.
    Hoogendoorn, W.E., Bongers, P.M., de Vet, H.C., Douwes, M., Koes, B.W., Miedema, M.C., Ariëns, G.A., Bouter, L.M.: Flexion and rotation of the trunk and lifting at work are risk factors for low back pain: results of a prospective cohort study. Spine 25(23), 3087–3092 (2000)CrossRefGoogle Scholar
  17. 17.
    Coenen, P., Kingma, I., Boot, C.R., Twisk, J.W., Bongers, P.M., van Dieën, J.H.: Cumulative low back load at work as a risk factor of low back pain: a prospective cohort study. J. Occup. Rehabil. 23(1), 11–18 (2013)CrossRefGoogle Scholar

Copyright information

© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Micaela Porta
    • 1
  • Marcello Campagna
    • 2
  • Giovanni Marco Mura
    • 1
  • Massimiliano Pau
    • 1
    Email author
  1. 1.Department of Mechanical, Chemical and Materials EngineeringUniversity of CagliariCagliariItaly
  2. 2.Department of Medical Sciences and Public HealthUniversity of CagliariCagliariItaly

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