{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T01:39:23Z","timestamp":1789090763499,"version":"build-2803163510"},"reference-count":41,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,4,15]],"date-time":"2023-04-15T00:00:00Z","timestamp":1681516800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Bioengineering"],"abstract":"<jats:p>Background: The Rapid Upper Limb Assessment (RULA) is used for the risk assessment of workplace-related activities. Thus far, the paper and pen method (RULA-PP) has been predominantly used for this purpose. In the present study, this method was compared with an RULA evaluation based on kinematic data using inertial measurement units (RULA-IMU). The aim of this study was, on the one hand, to work out the differences between these two measurement methods and, on the other, to make recommendations for the future use of the respective method on the basis of the available findings. Methods: For this purpose, 130 (dentists + dental assistants, paired as teams) subjects from the dental profession were photographed in an initial situation of dental treatment and simultaneously recorded with the IMU system (Xsens). In order to compare both methods statistically, the median value of the difference of both methods, the weighted Cohen\u2019s Kappa, and the agreement chart (mosaic plot) were applied. Results: In Arm and Wrist Analysis\u2014area A\u2014here were differences in risk scores; here, the median difference was 1, and the agreement in the weighted Cohen\u2019s kappa test also remained between 0.07 and 0.16 (no agreement to poor agreement). In area B\u2014Neck, Trunk, and Leg Analysis\u2014the median difference was 0, with at least one poor agreement in the Cohen\u2019s Kappa test of 0.23\u20130.39. The final score has a median of 0 and a Cohen\u2019s Kappa value of 0.21\u20130.28. In the mosaic plot, it can be seen that RULA-IMU had a higher discriminatory power overall and more often reached a value of 7 than RULA-PP. Conclusion: The results indicate a systematic difference between the methods. Thus, in the RULA risk assessment, RULA-IMU is mostly one assessment point above RULA-PP. Therefore, future study results of RULA by RULA-IMU can be compared with literature results obtained by RULA-PP to further improve the risk assessment of musculoskeletal diseases.<\/jats:p>","DOI":"10.3390\/bioengineering10040477","type":"journal-article","created":{"date-parts":[[2023,4,17]],"date-time":"2023-04-17T02:26:02Z","timestamp":1681698362000},"page":"477","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Testing the Level of Agreement between Two Methodological Approaches of the Rapid Upper Limb Assessment (RULA) for Occupational Health Practice\u2014An Exemplary Application in the Field of Dentistry"],"prefix":"10.3390","volume":"10","author":[{"given":"Ramona","family":"Nowara","sequence":"first","affiliation":[{"name":"Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1115-131X","authenticated-orcid":false,"given":"Fabian","family":"Holzgreve","sequence":"additional","affiliation":[{"name":"Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rejane","family":"Golbach","sequence":"additional","affiliation":[{"name":"Institute of Biostatistics and Mathematical Modelling, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6011-0613","authenticated-orcid":false,"given":"Eileen M.","family":"Wanke","sequence":"additional","affiliation":[{"name":"Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Maurer-Grubinger","sequence":"additional","affiliation":[{"name":"Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christina","family":"Erbe","sequence":"additional","affiliation":[{"name":"Department of Orthodontics, University Medical Center of the Johannes Gutenberg-University, 55131 Mainz, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Doerthe","family":"Brueggmann","sequence":"additional","affiliation":[{"name":"Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1881-7302","authenticated-orcid":false,"given":"Albert","family":"Nienhaus","sequence":"additional","affiliation":[{"name":"Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), 20246 Hamburg, Germany"},{"name":"Department of Occupational Medicine, Hazardous Substances and Public Health, Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (Berufsgenossenschaft f\u00fcr Gesundheitsdienst und Wohlfahrtspflege-BGW), 22089 Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Groneberg","sequence":"additional","affiliation":[{"name":"Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"Ohlendorf","sequence":"additional","affiliation":[{"name":"Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe-University Frankfurt, 60596 Frankfurt am Main, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,4,15]]},"reference":[{"key":"ref_1","unstructured":"(2022, March 03). 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