Part 3 BIOMEKANIKA

9.3 Work-related Musculoskeletal

Disorder (WMSD) /
Gangguan Otot Rangka
Auditya Purwandini Sutarto, Ph.D
Learning Outcomes
1. Memahami konsep dasar biomekanika sebagai bagian
dari analisis suatu sistem kerja
2. Memahami konsep manual handling
3. Menentukan beban kerja manual sesuai rekomendasi
4. Memahami berbagai jenis gangguan otot rangka (work
musculoskeletal disorder/WMSD)
5. Melakukan identifikasi faktor resiko terjadinya WMSD
6. Melakukan perbaikan perancangan sistem kerja untuk
mengurangi terjadinya cedera
 TOPIK
 Fakta dan Data tentang WMSD
 Penyebab WMSD
 Tipe-tipe WMSD
 Faktor Resiko WMSD
 Penilaian WMSD
 Perbaikan Posisi/Teknik dan Penggunaan Alat Bantu
 Studi Kasus
FAKTA DAN DATA TENTANG WMSD
 Keluhan Otot Rangka/Muskuloskeletal
 Kontributor utama penyebab kecacatan di dunia dengan nyeri tulang
WHO belakang (low back pain) menjadi penyebab nomor satu di dunia
 Menimpa semua usia. Antara 1 dalam 3 orang atau 1 dalam 5 orang
(termasuk anak-anak) mengalami kondisi nyeri muskuloskeletal
 Pergerakan dan ketangkasan terbatas signifikan sehingga berakibat
pada pensiun atau berhenti kerja lebih awal yang selanjutnya
mempengaruhi kesejahteraan seseorang dan mengurangi
kemampuannya terlibat dalam aktivitas sosial
 Keluhan otot rangka mengakibatkan nyeri yang menduduki proporsi
terbesar untuk nyeri yang tidak disebabkan kanker.
 Keluhan muskuloskeletal berkaitan erat dengan depresi dan peningkatan
resiko masalah kesehatan kronis lainnya
Indonesia .... WMSD in numbers

Survei Departemen Kesehatan di 12

kabupaten pada 9.482 pekerja menunjukkan
sekitar 40,5% penyakit yang diderita pekerja
berhubungan dengan pekerjaan
Gangguan muskuloskeletal (16%)
Gangguan kardiovaskular (8%)
Gangguan saraf (5%)
Gangguan pernapasan (3%)
Gangguan THT (1.5%)
Penyebab WMSD

1. Kelelahan dan keletihan terus menerus yang

disebabkan oleh frekuensi atau periode waktu yang
lama dari usaha, otot yang dihubungkan dengan
pengulangan atau usaha yang terus menerus dari
bagian tubuh yang sama meliputi posisi tubuh yang
statis .
 Kata kunci: frekuensi, durasi, besar gaya, repetisi, terus-
menerus/kontinu, statis
2. Kerusakan tiba-tiba yang disebabkan oleh aktivitas
yang sangat kuat/berat atau pergerakan yang tak
terduga.
Tahapan terjadinya Cedera MSD yang Kronis
TIPE-TIPE WMSD
 Sakit Leher (Neck Pain)

 Peningkatan tegangan otot

atau myalgia, leher miring
atau kaku leher.
Low Back Pain (Nyeri Tulang Belakang)

 Low Back Pain (LBP) terjadi

apabila ada penekanan
pada daerah lumbal yaitu L5
dan S1. Apabila dalam
pelaksanaan pekerjaan
posisi tubuh membungkuk ke
depan maka akan terjadi
penekanan pada discus
 Carpal Tunnel Syndrome (CTS)

 kumpulan gejala yang

mengenai tangan dan
pergelangan tangan yang
diakibatkan iritasi dan
nervus medianus.
 Tangan mengalami sensasi
kesemutan, mati rasa, nyeri,
atau lemah
 De Quervain’s Tenosynovitis

 Mengenai pergelangan
tangan, ibu jari, dan terkadang
lengan bawah, disebabkan
oleh inflamasi tenosinovium dan
dua tendon yang berasa di ibu
jari pergelangan tangan.
 Terjadi akibat overuse
 Gejala mirip CTS namun tanpa
mati rasa, kesemutan, dan
tanpa nyeri muncul bertahap
Thoracic Outlet Syndrome

 Merupakan keadaan yang

mempengaruhi bahu,
lengan, dan tangan yang
ditandai dengan nyeri,
kelemahan, dan mati rasa
pada daerah tersebut
 Tennis Elbow

 keadaan inflamasi tendon

ekstensor, tendon yang
berasal dari siku lengan
bawah dan berjalan keluar ke
pergelangan tangan.
 Tejadi akibat overloaded,
biasanya Gerakan berulang
pada pergelangan tangan
dan lengan.
FAKTOR RESIKO WMSD
 Faktor Resiko WMSD

- Gaya
Faktor Resiko
- Repetisi
Ergonomi
- Postur

Seiring waktu, paparan faktor resiko ini akan

mengakibatkan MSD
MSD
- Teknik pelaksanaan kerja buruk
Faktor Resiko - Profil Kesehatan kurang baik
Individu - Tidak mengenali adanya
tanda bahaya dari awal
3 Faktor Risiko Utama WMSD

1. Pekerjaan yang membutuhkan gaya

kuat (forceful exertion)
2. Pekerjaan dengan repetisi tinggi
3. Postur yang tidak natural (awkward)
yang cukup lama atau berulang
1. Forceful Exertion (1)

High hand force A power grip is 5 times stronger

than a pinch grip

=
 1. Forceful Exertion (2)
Gripping with the whole hand 10 lbs. of weight or force for
more than 2 hours per day
 1. Forceful Exertion (3)
Pinching with the fingertips 2 lbs. of weight or 4 lbs. of force for
more than 2 hours per day
1. Forceful Exertion (4)

Effort required to support Concern: more effort to ‘engage’

tool weight and keep it the tool?
from twisting out of the
hand
1. Forceful Exertion (5)
 Tool use example

Use tools that let

Working with bent you keep your
wrists decreases wrist straight
grip strength
 1. Forceful Exertion (6)

Heavy Lifting • Lifting 75 lbs. once

per day
• Lifting 55 lbs. more
than 10 times per
day
Reducing heavy lifting

 Take smaller loads at

one time
 Use mechanical
assistance -
handtrucks, carts,
hoists, conveyors
 Get help from a co-
worker
 2. Repetitive Motions (1)

Assembly Task Highly repetitive if the

cycle time is 30 seconds
or less.
 2. Repetitive Motions (2)

Intensive Keying For more than 4

hours per day
Reducing intensive keying

 Spread keyboard work throughout the day

 Use macros for common functions
 Take stretch pauses
 Improve your posture and move around as much as
possible
 2. Repetitive Motion (3)

Frequent Lifting Lifting more than 10

lbs., more than twice
per minute, for more
than 2 hours per day
Reducing frequent lifting

 Use mechanical assistance

 Slide objects instead of lifting them
 Rotate lifting tasks with co-workers if possible
 3. Sustained/Frequent Awkward
Posture (1)
Awkward Lifting Lifting more than 25 lbs. above the shoulders,
below the knees or at arms’ length more than 25
times per day
Avoiding awkward lifts

 Store items where you

won’t have to bend or
reach to lift them
 Use ladders to get
items down from high
shelves
PENILAIAN WMSD
Job Hazard Analysis
Hazard Identification

 Observation/Walkthrough survey
 Interview
 Document Review
 Musculoskeletal Pain/Discomfort Survey
 Risks Assessment of Manual Handling Tasks
Risk Prioritization Process
What and Why Analysis

 Tasks or steps involved

 Body parts affected
 Risk factors Assess the task
 Frequency/duration of task
 Why is it done this way?

 Potential solutions
 Cost of solutions Prevent & Control
 Barriers
Ergonomics Checklist
 Ergonomics Solution
Personal
Effectiveness
control
Equipment or Engineering

Job organization

Personal protective
equipment

Bodymechanics
Strategi Mengurangi Resiko WMSD

1. Minimize required hand forces

 design for power grip
 keep handle diameters > 1.5"
 use tool balancing
2. Minimize postural deviations
 keep hand and forearm aligned
 shape the tool to match the task
 change work piece orientation
 Strategi Mengurangi Resiko WMSD

3. Minimize Repetition
 allow for tissue recovery and circulation
 rotate workers among tasks
 job enlargement
4. Design Work Practices
 train workers to rest (esp. hands)
 stretching exercises or warm-up
 allow for slow-down with gloves
5. Recognize that these strategies will likely increase
productivity in the long run
PERBAIKAN POSISI/TEKNIK DAN
PENGGUNAAN ALAT BANTU
Proper Technique (1)
Proper Technique (2)
Proper Technique (3)
Wrist Posture

Which tool shape

is best??

Depends on: location,

orientation, task, etc.
Use Turntable

Table with a turntable inset Turntable on a cart

 Raise the Worker

Use a step stool Use portable steps Use portable waveform

 Raise or Lower Work Surface

Provide variable-height work surfaces Stack pallets to create a higher work surface.
Support the Container
Wear Gloves, Provide Clamp-on Handle
Use Hand Truck

This specialty hand truck Another type of hand truck

with brakes will allow more converts to four wheels for
control when heavy loads moving unstable loads
are on inclines
 Use Hand Pallet Truck, Stacker

For unstable pallet This stacker is well suited for

loads, wrap straps moving loads up to 3,000
around the load. pounds for short distances.
Use a Conveyor, Slide, or Chute

An expandable skate-wheel
Use slides or chutes to do the conveyor is portable and
work if containers are always excellent where work needs
moving in one direction. to have a flexible layout.
STUDI KASUS
 Isu: Repetitive Motion
Before After
 To provide the PCB components,
the employee repetitively had to
carry the trolley from the
warehouse to assembly lines: The
trolley was transported more than
50 meters (8 cycles per hour, 400
meters in total)
 The mobile robot following
magnetic guide tapes on the floor
is used for carrying the PCB part
trolley, resulting in time, manpower
and space savings within the PCB
assembly line
 Isu: Repetitive Motion and Awkward Posture

Before
After

 To pick up components, the employee  The rotating mechanism allows

repetitively leaned forward and the employee to keep a more
reached his arm above the shoulder. neutral posture for easy access
He also often moved the part bins from to components and storage
the floor to a chest height stand. bins
 Isu: Prolonged Standing
Before
 The assembly-line employees
stood for long periods on the
same spot and thus could not
have chances to move around
and have a seat at the
workstation.
After
 With back support, footrest and
stable design, this in-house made
chair can prevent the employees
from fatigue from long period of
standing on the floor.
Referensi

 https://www.cdc.gov/niosh/docs/2014-131/pdfs/2014-131.pdf
 https://ergo-plus.com/wp-content/uploads/Ergonomic-Risk-Factors.pdf
 https://www.dosh.gov.my/index.php/competent-person-
form/occupational-health/regulation/guidelines/ergonomic/2959-
guidelines-for-manual-handling-at-workplace-2018/file
 https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-
conditions