{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T08:00:57Z","timestamp":1777622457852,"version":"3.51.4"},"reference-count":52,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T00:00:00Z","timestamp":1685145600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100010801","name":"the Galician Government and the Ferrol Industrial Campus","doi-asserted-by":"publisher","award":["2022\/CP\/048"],"award-info":[{"award-number":["2022\/CP\/048"]}],"id":[{"id":"10.13039\/501100010801","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sensors"],"abstract":"<jats:p>People whose jobs involve repetitive motions of the wrist and forearm can suffer from lateral epicondylitis, which is a significant burden on both the individual and the employer due to treatment costs, reduced productivity, and work absenteeism. This paper describes an ergonomic intervention to reduce lateral epicondylitis in the workstation of a textile logistics center. The intervention includes workplace-based exercise programs, evaluation of risk factors, and movement correction. An injury- and subject-specific score was calculated from the motion captured with wearable inertial sensors at the workplace to evaluate the risk factors of 93 workers. Then, a new working movement was adapted to the workplace, which limited the observed risk factors and took into account the subject-specific physical abilities. The movement was taught to the workers during personalized sessions. The risk factors of 27 workers were evaluated again after the intervention to validate the effectiveness of the movement correction. In addition, active warm-up and stretching programs were introduced as part of the workday to promote muscle endurance and improve resistance to repetitive stress. The present strategy offered good results at low cost, without any physical modification of the workplace and without any detriment to productivity.<\/jats:p>","DOI":"10.3390\/s23115116","type":"journal-article","created":{"date-parts":[[2023,5,27]],"date-time":"2023-05-27T16:18:43Z","timestamp":1685204323000},"page":"5116","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Use of Wearable Inertial Sensors and Workplace-Based Exercises to Reduce Lateral Epicondylitis in the Workstation of a Textile Logistics Center"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2415-4007","authenticated-orcid":false,"given":"Florian","family":"Michaud","sequence":"first","affiliation":[{"name":"Laboratory of Mechanical Engineering, Campus Industrial de Ferrol, Universidade da Coru\u00f1a, 15403 Ferrol, Spain"}]},{"given":"Roberto","family":"Pazos","sequence":"additional","affiliation":[{"name":"The Well-Being Lab S.L., 15005 A Coru\u00f1a, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3537-9597","authenticated-orcid":false,"given":"Urbano","family":"Lugr\u00eds","sequence":"additional","affiliation":[{"name":"Laboratory of Mechanical Engineering, Campus Industrial de Ferrol, Universidade da Coru\u00f1a, 15403 Ferrol, Spain"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8604-6816","authenticated-orcid":false,"given":"Javier","family":"Cuadrado","sequence":"additional","affiliation":[{"name":"Laboratory of Mechanical Engineering, Campus Industrial de Ferrol, Universidade da Coru\u00f1a, 15403 Ferrol, Spain"}]}],"member":"1968","published-online":{"date-parts":[[2023,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1148\/rg.301095078","article-title":"Epicondylitis: Pathogenesis, Imaging, and Treatment","volume":"30","author":"Walz","year":"2010","journal-title":"Radiographics"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.recote.2015.11.007","article-title":"Four surgical tips in the treatment of epicondylitis","volume":"60","year":"2016","journal-title":"Rev. Espa\u00f1ola Cirug\u00eda Ortop\u00e9dica Y Traumatol. (Engl. Ed.)"},{"key":"ref_3","first-page":"6","article-title":"Factors Associated With Lateral Epicondylitis of the Elbow","volume":"9","author":"Gwark","year":"2021","journal-title":"Orthop. J. Sports Med."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"241","DOI":"10.53350\/pjmhs2023171241","article-title":"Work-Related Risk Factors for Lateral Epicondylitis in Chef in Lahore","volume":"17","author":"Amjad","year":"2023","journal-title":"Pak. J. Med. Health Sci."},{"key":"ref_5","first-page":"400","article-title":"Work-related risk factors for lateral epicondylitis and other cause of elbow pain in the working population","volume":"56","author":"Msc","year":"2012","journal-title":"Am. J. Ind. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5271\/sjweh.637","article-title":"Criteria document for evaluating the work-relatedness of upper-extremity musculoskeletal disorders","volume":"27","author":"Sluiter","year":"2001","journal-title":"Scand. J. Work. Environ. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/j.jht.2021.05.005","article-title":"Lateral epicondylosis: A literature review to link pathology and tendon function to tissue-level treatment and ergonomic interventions","volume":"34","author":"Bynum","year":"2021","journal-title":"J. Hand Ther."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Cho, Y., Yeo, J., Lee, Y.-S., Kim, E.J., Nam, D., Park, Y.-C., Ha, I.-H., and Lee, Y.J. (2022). Healthcare Utilization for Lateral Epicondylitis: A 9-Year Analysis of the 2010\u20132018 Health Insurance Review and Assessment Service National Patient Sample Data. Healthcare, 10.","DOI":"10.3390\/healthcare10040636"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1177\/1941738116650389","article-title":"Health Care Utilization and Direct Medical Costs of Tennis Elbow: A Population-Based Study","volume":"8","author":"Sanders","year":"2016","journal-title":"Sports Health A Multidiscip. Approach"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"81","DOI":"10.3233\/WOR-2010-1059","article-title":"Ergonomic and behavioral interventions as the primary treatment for work-related lateral epicondylitis","volume":"37","author":"Cormack","year":"2010","journal-title":"Work"},{"key":"ref_11","first-page":"CD008570","article-title":"Ergonomic interventions for preventing work-related musculoskeletal disorders of the upper limb and neck among office workers","volume":"2018","author":"Hoe","year":"2018","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"van de Wijdeven, B., Visser, B., Daams, J., and Kuijer, P.P. (2023). A first step towards a framework for interventions for individual working practice to prevent work-related musculoskeletal disorders: A scoping review. BMC Musculoskelet. Disord., 24.","DOI":"10.1186\/s12891-023-06155-w"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"163","DOI":"10.2486\/indhealth.2015-0055","article-title":"Evaluation of ergonomic physical risk factors in a truck manufacturing plant: Case study in SCANIA Production Angers","volume":"54","author":"Zare","year":"2016","journal-title":"Ind. Health"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"247","DOI":"10.3233\/WOR-213474","article-title":"A systematic review of biomechanical risk factors for the development of work-related musculoskeletal disorders in surgeons of the head and neck","volume":"69","author":"Maxner","year":"2021","journal-title":"Work"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1186\/1471-2474-14-213","article-title":"Physical activities at work and risk of musculoskeletal pain and its consequences: Protocol for a study with objective field measures among blue-collar workers","volume":"14","author":"Villumsen","year":"2013","journal-title":"BMC Musculoskelet. Disord."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.ergon.2009.11.002","article-title":"Physical workload in various types of work: Part II. Neck, shoulder and upper arm","volume":"40","author":"Hansson","year":"2010","journal-title":"Int. J. Ind. Ergon."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"103075","DOI":"10.1016\/j.apergo.2020.103075","article-title":"Shoulder pain among male industrial workers: Validation of a conceptual model in two independent French working populations","volume":"85","author":"Bodin","year":"2020","journal-title":"Appl. Ergon."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1097\/j.pain.0000000000001766","article-title":"Personal, biomechanical, psychosocial, and organizational risk factors for carpal tunnel syndrome: A structural equation modeling approach","volume":"161","author":"Roquelaure","year":"2019","journal-title":"Pain"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Stock, S., Nicolakakis, N., Messing, K., Turcot, A., and Raiq, H. (2013). Quelle est la relation entre les troubles musculo-squelettiques (TMS) li\u00e9s au travail et les facteurs psychosociaux?. Perspect. Interdiscip. Sur Trav. St.","DOI":"10.4000\/pistes.3407"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Zare, M., Bodin, J., Sagot, J.-C., and Roquelaure, Y. (2020). Quantification of Exposure to Risk Postures in Truck Assembly Operators: Neck, Back, Arms and Wrists. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17176062"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Donisi, L., Cesarelli, G., Pisani, N., Ponsiglione, A.M., Ricciardi, C., and Capodaglio, E. (2022). Wearable Sensors and Artificial Intelligence for Physical Ergonomics: A Systematic Review of Literature. Diagnostics, 12.","DOI":"10.3390\/diagnostics12123048"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Rybnik\u00e1r, F., Ka\u010derov\u00e1, I., Ho\u0159ej\u0161\u00ed, P., and \u0160imon, M. (2022). Ergonomics Evaluation Using Motion Capture Technology\u2014Literature Review. Appl. Sci., 13.","DOI":"10.3390\/app13010162"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Michaud, F., Soto, M.P., Lugr\u00eds, U., and Cuadrado, J. (2021). Lower Back Injury Prevention and Sensitization of Hip Hinge with Neutral Spine Using Wearable Sensors during Lifting Exercises. Sensors, 21.","DOI":"10.3390\/s21165487"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1007\/978-3-030-69547-7_25","article-title":"Evaluation of Two Upper-Limb Exoskeletons for Ceiling Welding in the Naval Industry","volume":"Volume 27","author":"Mouzo","year":"2021","journal-title":"Biosystems and Biorobotics"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Michaud, F., Lugr\u00eds, U., and Cuadrado, J. (2022). Determination of the 3D Human Spine Posture from Wearable Inertial Sensors and a Multibody Model of the Spine. Sensors, 22.","DOI":"10.3390\/s22134796"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Huang, C., Kim, W., Zhang, Y., and Xiong, S. (2020). Development and Validation of a Wearable Inertial Sensors-Based Automated System for Assessing Work-Related Musculoskeletal Disorders in the Workspace. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17176050"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Ye, S., Feng, S., Huang, L., and Bian, S. (2020). Recent Progress in Wearable Biosensors: From Healthcare Monitoring to Sports Analytics. Biosensors, 10.","DOI":"10.3390\/bios10120205"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Santos, S., Folgado, D., Rodrigues, J., Mollaei, N., Fuj\u00e3o, C., and Gamboa, H. (2020, January 24\u201326). Explaining the Ergonomic Assessment of Human Movement in Industrial Contexts. Proceedings of the 13th International Joint Conference on Biomedical Engineering Systems and Technologies (BIOSTEC 2020)-BIOSIGNALS, Valletta, Malta.","DOI":"10.5220\/0008953800790088"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"6093","DOI":"10.1007\/s12652-020-01926-y","article-title":"Analyzing the kinematic and kinetic contributions of the human upper body\u2019s joints for ergonomics assessment","volume":"11","author":"Menychtas","year":"2020","journal-title":"J. Ambient. Intell. Humaniz. Comput."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2633","DOI":"10.3390\/ijerph16152633","article-title":"Workplace-Based Exercise Intervention Improves Work Ability in Office Workers: A Cluster Randomised Controlled Trial","volume":"16","author":"Zheng","year":"2019","journal-title":"Int. J. Environ. Res. Public Health"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5271\/sjweh.1304","article-title":"Work ability\u2014A comprehensive concept for occupational health research and prevention","volume":"35","author":"Ilmarinen","year":"2009","journal-title":"Scand. J. Work. Environ. Health"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Pierleoni, P., Belli, A., Palma, L., Mercuri, M., Verdini, F., Fioretti, S., Madgwick, S., and Pinti, F. (2019, January 29\u201330). Validation of a Gait Analysis Algorithm for Wearable Sensors. Proceedings of the 2019 International Conference on Sensing and Instrumentation in IoT Era (ISSI), Lisbon, Portugal.","DOI":"10.1109\/ISSI47111.2019.9043647"},{"key":"ref_33","unstructured":"STT-Systems (2023, May 18). iSen Inertial Motion Capture. Available online: https:\/\/motio.stt-systems.com\/isen-inertial-motion-capture-and-analysis\/."},{"key":"ref_34","unstructured":"Roetenberg, D., Luinge, H., and Veltink, P. (2003, January 10). Inertial and magnetic sensing of human movement near ferromagnetic materials. Proceedings of the The Second IEEE and ACM International Symposium on Mixed and Augmented Reality, Tokyo, Japan."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"109278","DOI":"10.1016\/j.mehy.2019.109278","article-title":"A potential factor in the pathophysiology of lateral epicondylitis: The long sarcomere length of the extensor carpi radialis brevis muscle and implications for physiotherapy","volume":"130","author":"Bazancir","year":"2019","journal-title":"Med. Hypotheses"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Mondelo, P.R., Gregori, E., Blasco, J., and Barrau, P. (1999). Ergonom\u00eda 3: Dise\u00f1o de Puestos de Trabajo, Edicions UPC. Available online: http:\/\/direct.awardspace.info\/directoriow\/PedroMondeloErgonomia3DisenoDePuestosDeTrabajo.pdf.","DOI":"10.5821\/ebook-9788498801125"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1016\/0169-8141(94)90006-X","article-title":"Repetitive work of the upper extremity: Part II\u2014The scientific basis (knowledge base) for the guide","volume":"14","author":"Kilbom","year":"1994","journal-title":"Int. J. Ind. Ergon."},{"key":"ref_38","unstructured":"Navidi, W. (2010). Statistics for Engineers and Scientists, McGraw-Hill Education. [3rd ed.]."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"939645","DOI":"10.1100\/2012\/939645","article-title":"Comparison of Effectiveness of Supervised Exercise Program and Cyriax Physiotherapy in Patients with Tennis Elbow (Lateral Epicondylitis): A Randomized Clinical Trial","volume":"2012","author":"Viswas","year":"2012","journal-title":"Sci. World J."},{"key":"ref_40","unstructured":"American Academy of Orthopaedic Surgeons (2023, March 27). Therapeutic Exercise Program for Epicondylitis. Available online: https:\/\/orthoinfo.aaos.org\/en\/recovery\/epicondylitis-therapeutic-exercise-program\/."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"818","DOI":"10.26603\/ijspt20190818","article-title":"A Comprehensive Rehabilitation Program for Treating Lateral Elbow Tendinopathy","volume":"14","author":"Day","year":"2019","journal-title":"Int. J. Sports Phys. Ther."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"677581","DOI":"10.3389\/fphys.2021.677581","article-title":"The Effectiveness of Post-exercise Stretching in Short-Term and Delayed Recovery of Strength, Range of Motion and Delayed Onset Muscle Soreness: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","volume":"12","author":"Afonso","year":"2021","journal-title":"Front. Physiol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.surge.2019.08.003","article-title":"Risk factors of lateral epicondylitis: A meta-analysis","volume":"18","author":"Sayampanathan","year":"2019","journal-title":"Surgeo"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1177\/8756479308315230","article-title":"Ambidextrous Sonographic Scanning to Reduce Sonographer Repetitive Strain Injury","volume":"24","author":"Seto","year":"2008","journal-title":"J. Diagn. Med. Sonogr."},{"key":"ref_45","first-page":"62","article-title":"Effectiveness of workplace interventions in the prevention of upper extremity musculoskeletal disorders and symptoms: An update of the evidence","volume":"73","author":"Munhall","year":"2015","journal-title":"Occup. Environ. Med."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Vitoulas, S., Konstantis, V., Drizi, I., Vrouva, S., Koumantakis, G.A., and Sakellari, V. (2022). The Effect of Physiotherapy Interventions in the Workplace through Active Micro-Break Activities for Employees with Standing and Sedentary Work. Healthcare, 10.","DOI":"10.3390\/healthcare10102073"},{"key":"ref_47","first-page":"38","article-title":"Stretch Flex Programs: Effects on the Reduction of Musculoskeletal Disorders & Injuries","volume":"62","author":"Choi","year":"2017","journal-title":"Prof. Saf. J."},{"key":"ref_48","unstructured":"Lugr\u00eds, U., Michaud, F., Mouzo, F., and Cuadrado, J. (2022, January 5\u20136). Full-body optical motion capture with real-time estimation of muscle efforts. Proceedings of the 2nd Portuguese Conference on Multibody System Dynamics, Guimaraes, Portugal."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1186\/s12984-021-00806-6","article-title":"A fair and EMG-validated comparison of recruitment criteria, musculotendon models and muscle coordination strategies, for the inverse-dynamics based optimization of muscle forces during gait","volume":"18","author":"Michaud","year":"2021","journal-title":"J. Neuroeng. Rehabil."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"604","DOI":"10.3389\/fphys.2023.1167748","article-title":"Applying a muscle fatigue model when optimizing load-sharing between muscles for short-duration high-intensity exercise: A preliminary study","volume":"14","author":"Michaud","year":"2023","journal-title":"Front. Physiol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"503","DOI":"10.1002\/jor.22023","article-title":"Grand challenge competition to predict in vivo knee loads","volume":"30","author":"Fregly","year":"2011","journal-title":"J. Orthop. Res."},{"key":"ref_52","first-page":"184","article-title":"Evaluation of Optimal Control Approaches for Predicting Active Knee-Ankle-Foot-Orthosis Motion for Individuals With Spinal Cord Injury","volume":"15","author":"Fregly","year":"2022","journal-title":"Front. Neurorobotics"}],"container-title":["Sensors"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/11\/5116\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:43:17Z","timestamp":1760125397000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8220\/23\/11\/5116"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5,27]]},"references-count":52,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2023,6]]}},"alternative-id":["s23115116"],"URL":"https:\/\/doi.org\/10.3390\/s23115116","relation":{},"ISSN":["1424-8220"],"issn-type":[{"value":"1424-8220","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5,27]]}}}