Endoscopy 2025; 57(S 02): S140
DOI: 10.1055/s-0045-1805368
Abstracts | ESGE Days 2025
Oral presentation
Ergo, ergonomics! 04/04/2025, 16:45 – 17:45 Room 118+119

Use of wearable electromyographic sensors for real-time analysis of muscle activation in upper GI endoscopy procedures: a pilot study

Authors

  • F Schlicht

    1   Clinic for Internal Medicine I, Gastroenterology, University Hospital Ulm, Ulm, Germany
    2   Endoscopic Research Unit, Ulm, Germany

  • M Müller

    1   Clinic for Internal Medicine I, Gastroenterology, University Hospital Ulm, Ulm, Germany

  • V Bessone

    3   Research and Development, Ambu Innovation GmbH, Augsburg, Germany

  • T Seufferlein

    1   Clinic for Internal Medicine I, Gastroenterology, University Hospital Ulm, Ulm, Germany

  • B Walter

    2   Endoscopic Research Unit, Ulm, Germany
    1   Clinic for Internal Medicine I, Gastroenterology, University Hospital Ulm, Ulm, Germany
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Aims Musculoskeletal injuries are frequent among GI endoscopists [1] [2]. Main reason is chronic muscle overuse driven by procedural volume and years in practice. However, the musculoskeletal complaints of endoscopists indicate only the end state of a long-term misuse and the magnitude of the muscle activation (load) during GI endoscopic procedures is still limitedly explored. This due to the cumbersome electromyographic (EMG) sensors of the past. The recent development of wearable EMG systems enhance the potential of data collections in real work set-ups. We aim to evaluate the feasibility of real-time EMG measurement collected by wearable sensors to determine the muscle activity and overstrain within endoscopy procedures in a high-volume endoscopy center.

Methods One endoscopist (male) participated to the test performing four EGD procedures while wearing a shirt with embedded EMG sensors (ErgoShirt, Myontec Ltd., Kuopio, Finland; sampling rate 1.000 Hz) to detect the muscle contractions of trapezius, biceps, triceps, wrist flexors and extensors of both arms. Three procedures were performed with a reusable (GIF-HQ190, GIF-1500 Olympus) and one with a disposable gastroscope (aScope Gastro, Ambu A/S) and had a ASGE complexity level ranging between 2 and 3 [3]. Before starting the test, the maximal voluntary contraction was measured by performing two sets of minimum 5-second maximal contraction (MVC) for all the recorded muscles. At the end of each procedure, the rate of perceived exertion (RPE) was asked to the subject [4]. The muscle load (percentage of the normalization of the EMG signals on MVC) was calculated using Matlab (Mathworks, Natick, MA, USA), and divided in five thresholds: 0-3% muscle at-rest, 3-10% healthy load, 10-30% overload, 30-50% overload that should not exceed 10% of working day,>50% at-risk. The ratio of time spent in the different muscle activation levels was calculated for each procedure and muscle relatively to the total duration of the procedure.

Results The highest overload/risk muscle load was recorded for the forearm muscles. The right wrist extensors muscle resulted to be the most activated muscles being overloaded or at-risk more than half of the procedure time (58-84%). After the two procedures (ASGE level 3) performed with the reusable endoscope, RPE was reported as moderate/somewhat hard, while light exertion was reported after using the disposable endoscope during an equally complex procedure.

Conclusions The results of this study show, that real-time EMG measurement by means of wearable sensors as an indicator of muscle activity and overuse is feasible in endoscopy. The issue of chronic overuse in endoscopist´s work should be further elucidated by EMG measurement.



Publication History

Article published online:
27 March 2025

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