Effects of combined wrist deviation and forearm rotation on discomfort score.

The aim of the study was to examine the pattern of the change in discomfort for combined wrist deviation and forearm rotation as joint angles increased away from neutral in a repetitive task. There were five levels of wrist deviation (neutral, 35% and 55% of the range of motion (ROM) in radial and ulnar deviation) and five levels of forearm rotation (neutral, 30% and 60% of the ROM in pronation and supination). Twenty-five participants performed a repetitive flexion task with a force of 10 N +/- 1 N at a frequency of 15 exertions per min, with replication after 1 week for six of the participants. A visual analogue scale was used for recording the discomfort scores. Repeated measures analysis of covariance with the Greenhouse-Geisser correction, where necessary, was used on transformed values of the discomfort scores. Grip test endurance time at 50% of maximum voluntary contraction was included as a covariate. Wrist deviation (p = 0.007) and forearm rotation (p = 0.001) were found to have significant effects. Interactions of the main factors were not significant and nor was the covariate. Quadratic regression equations were derived and were used to generate iso-discomfort contours, which show a useful area of low discomfort around the central neutral zone of wrist postures, but with steep increases in discomfort at the extreme combinations of wrist ulnar/radial deviation with forearm pronation/supination. Discomfort equations and contours, showing wrist and forearm postures, which are either acceptable or potentially injurious, are useful for the design of industrial tools, machine controls and workspaces. Reference to these can help to reduce the risk of musculoskeletal injury associated with the tasks or tools by avoiding poor postures with unacceptable deviations from neutral posture.