Research in Progress: Review of Tractor Seating Issues Related to Ergonomics of Difference C.S. Wilhite, University of New Mexico-School of Medicine W.E. Field, Purdue University Funded Research-Southwest Center for Agricultural Health, Injury Prevention, and Education, NIOSH-2U540H007541, CFDA # 93. 262 No other financial disclosures Introduction • Agricultural machinery technology is rapidly evolving. • Design of seating, seat materials, and management of seated pressure largely unchanged. • Current seating may not conform to the needs of people who vary by size, weight, posture, gender, or health status (ergonomics of difference). • People with ergonomics of difference may have to incorporate after-market accommodations to fit themselves to the seating conditions. • No research on risks/benefits of changing the dynamics of the seating system. Example: AgrAbility • Farmers with spinal cord injuries (SCI) – Access machinery with fabricated manlifts and operate machinery with hand controls – Paralysis create changes in sensation, motor function, circulation, and tissue health that can pre-dispose the person to skin tears, lacerations, and pressure-related ulcers – Most farmers with SCI select additional cushioning materials (WC cushions, egg-crate foam, sheepskins, etc.) Research • • Purpose: – Test feasibility of mapping seated pressure on an average original equipment foam contour tractor seat, with and without intervention wheelchair cushions Subjects: – Convenience sampling – Inclusion: Person with SCI, no current unstable decubitus ulcer – 5 Male, 3 Female (age ranges 2560 years) – The University of New MexicoHealth Sciences Center Institutional Review Board (#13129) approved the research. Research • Methods – Mixed methods, singlesubjects with repeated measures • Instruments – FSA Pressure Mapping System by Vista Medical – Simulation Platform – Braden Scale pressure ulcer risk questionnaire – Likert Scale Seat Ratings – Postural photographs Results-Clinical Image Examples Contour Foam Tractor Seat-Settle Contour Foam Tractor SeatCompleted Perturbations Results-Clinical Image Examples High Profile ROHO Air Cushionsettle High Profile ROHO Air CushionCompleted Perturbations Results Summary • Seven out of eight subjects demonstrated better distribution of pressure, minimal migration, and better immersion with the high profile air cushion. • One subject appeared to have acceptable outcomes on both seating conditions. • Further data transformation is underway. Limitations • • • • • Laboratory vs. field conditions Small sample size Only one tractor seat, five conditions Only seated pressures measured Experience of investigator; not blinded to results Discussion • 1. Are there practical limitations on how much front-end design can accommodate the variances involved in ergonomics of difference (e.g. weight, gender, size, postural asymmetries, and disability)? • 2. What new materials, structures, contours, and dimensions can be incorporated into front-end design to widen the variance for ergonomics of difference? • 3. What should be the role of aftermarket and custom design solutions that “fit” into existing front-end design? What research needs to be performed to ensure aftermarket solutions are effective in resolving seating issues, without creating other problems? • 3. What body of knowledge and standardization of process needs to be developed for recommending aftermarket accommodations for people with ergonomics of difference? • 4. Who needs to perform the work (i.e. designers, engineers, ergonomists, researchers, occupational health nurses, and others)? Will the work be performed in isolation or best performed through multi-disciplinary teams? References • Armstrong, R., Hall, B. J., Doyle, J., and Waters, E. (2011). Cochrane update: ‘Scoping the scope’ of a Cochrane review. Journal of Public Health, 33(1), 147-150. doi: 10.1093/pubmed/dr015 • Balasubramanian, K., Burks, T. F., Lehtola, C. J., & Lee, W.S. (2006). Shock and vibration data acquisition system for off-road vehicle operator health and safety assessment. Journal of Agricultural Safety and Health, 12(4), 293−313. • Bergstrom, N., Braden, B. J., Laguzza, A., & Holman, V. (1987). The Braden Scale for predicting pressure sore risk. Nursing Research, 36(4), 205-210. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/3299278 • Des Jarlais, D. C., Lyles, C., Crepaz, N. (2004). Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: The TREND statement. American Journal of Public Health, 94, 361-366. • • • • • • Donati, P. (2002). Survey of technical preventative measures to reduce whole body vibration effects when designing mobile machinery. Journal of Sound and Vibration, 253(1), 169-183. doi:10.1006/jsvi.2001.4254 Eslami, V., Saadat, S., Habibi-Arejan, Vaccaro, A. R., Ghodsi, S. M., & RahimiMovaghar, V. (2012). Factors associated with the development of pressure ulcers After spinal cord injury. Spinal Cord, 50, 899–903. doi.org/10.1038/sc.2012.75 Gefen, A. (2007). The biomechanics of sitting-acquired pressure ulcers in patients with spinal cord injury or lesions. International Wound Journal, 4(3), 222-231. Hostens, I., Papaioannou, G., Spaepen, A., & Ramon, H. (2001). Buttock and back pressure distribution tests on seats of mobile agricultural machinery. Applied Ergonomics, 32, 347-355. Retrieved from Elsevier at http://www.elsevier.com/locate/apergo • Hunter, I. A., & Sakar, R. (2011). Managing pressure sores. Surgery, 29(2), 518-522. • Kroemer, K. H. E. (2006). Extra-ordinary ergonomics: How to accommodate small and big persons, the disabled and elderly, expectant mothers, and children. New York, NY: Taylor & Francis. • Linder-Ganz, E., Shabshin, N., Itzchak, Y., Yizhar, Z., Siev-Ner, I., & Gefen, A. (2008). Strains and stresses in sub-dermal tissues of the buttocks are greater in paraplegics than in healthy during sitting. Journal of Biomechanics, 41, 567–580. doi.org/10.1016/j.jbiomech.2007.10.011 • Minkel, J. L. (2000). Seating and mobility considerations for people with spinal cord injury. Physical Therapy, 80(7), 701-709. Retrieved from http://ptjournal.apta.org • National Pressure Ulcer Advisory Panel (2009). International guideline: Prevention of pressure ulcers quick reference guide. Retrieved from http://www.npuap.org • Portnoy, L. G., & Watkins, M. P. (2000). Foundations of clinical research: Applications to practice (2nd ed.). Upper Saddleback, NJ: Prentice-Hall. • Vista Medical. (2022). User manual for Boditrack and FSA Systems (1st ed.). Winnipeg: Vista Medical, LTD. • Wilkinson, T. L. & Field, W.E . (1987). Modified agricultural equipment: Agricultural manlifts for farmers and ranchers with physical handicaps. West Lafayette, IN: Breaking New Ground. • Yoder, A., Stoller, N., & Field, W.E. (2000). Plowshares #8: New concepts in lift attachments for tractors and combines. West Lafayette, IN: Breaking New Ground. Thank you! Use this QR Code to access the complete paper for this presentation