Investigation of the relationship between measurement of scapular asymmetry and working posture in dentists

Abstract

Dentists are at risk due to adverse conditions they are exposed to, such as improper working posture, repetitive movements, long-term static positions, excessive effort with frequent use of small muscles, tight grip of materials, using vibrating instruments, and holding their arms high for long periods of time (1). Does the scapular asymmetry distance increase as the working posture of dentists worsens? In the study, 122 volunteers (52 males, 70 females, age: 25.94±3.40 years) from dentists who have been active in the clinic for at least 6 months were included. The Lateral Scapular Slide Test was used to measure scapular asymmetry. Measurement was performed in 4 positions: in a neutral position of the glenohumeral joint with arms at both sides in a free-standing position, shoulders at 45° abduction and 90° abduction (2), and the arms were in 90° abduction holding 2.3 kg (5 lb) for those with a body weight of 68.1 kg and above, and 1.4 kg (3 lb) for those with a body weight of less than 68.1 kg. The distance between the inferior end of the scapula and the spinous process of the nearest thoracic vertebra was measured in all four positions. Working posture was evaluated during the study by observation with the REBA whole-body assessment method. The risk levels of the scoring results were made according to the REBA method; 1 point was classified as “negligible, 2-3 points as “low”, 4-7 points as “moderate”, 8-10 as “high” and 11-15 as “very high” (3,4). According to the REBA score risk classification, 36.1% of the participants were included between 4-7 “medium risk”, 56.6% 8-10 “high risk”, and 7.4% 11-15 “very high risk” group. The mean REBA score was found to be 6.48±0.73 in the intermediate-risk group, 8.72±0.73 in the high-risk group, and 11.00±0.00 in the very high-risk group. A positive correlation was found between the REBA score and dominant side lateral scapular slide test with neutral, 45°, 90° and weights (r=0.325, p<0.001; r=0.268, p=0.003; r=0.267, p=0.003; r=0.265, p=0.003). In the results, it was seen that the working posture of the dentists was risky and there was no participant in the risk-free group. The scapular asymmetry distance increased as the risk in the working posture of the dentists increased. In a previous study, interns and 1-year dentists were compared for the lateral scapular slide test, and, scapular asymmetry distance was found to be higher in 1-year dentists. (5). It has been observed that the exposure may increase as the exposure to the working posture increases. Risky postures may be related to scapular asymmetry those may further develop dysfunctions.