Development and evaluation of a participatory ergonomic intervention for the reduction of work-related musculoskeletal disorders among nurses

Guganesan Krishnanmoorthy; Rama Krishna; Faiz Baharudin; Mohd Amirul Asraf Shah Nizamuddin; Nik Hasmumthaj Nik Hassan; Mahmoud Danaee; Victor C W Hoe; Sanjay Rampal; Guganesan Krishnanmoorthy; Rama Krishna; Faiz Baharudin; Mohd Amirul Asraf Shah Nizamuddin; Nik Hasmumthaj Nik Hassan; Mahmoud Danaee; Victor C W Hoe; Sanjay Rampal

doi:10.3934/publichealth.2025063

AIMS Public Health

2025, Volume 12, Issue 4: 1240-1264. doi: 10.3934/publichealth.2025063

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Development and evaluation of a participatory ergonomic intervention for the reduction of work-related musculoskeletal disorders among nurses

1.
Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
2.
Occupational Health Clinic, Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
3.
Occupational Safety, Health and Environment Centre, Universiti Malaya, Kuala Lumpur, Malaysia
4.
Occupational Safety, Health and Environment Unit, Universiti Malaya Medical Centre, Kuala Lumpur, Malaysia
5.
Department of Civil, Environmental and Mining Engineering, University of Western Australia, Western Australia, Australia
6.
Department of Nursing, Universiti Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
7.
Centre for Epidemiology and Evidence-based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia

Received: 26 September 2025 Revised: 01 December 2025 Accepted: 16 December 2025 Published: 22 December 2025

Nurses are highly vulnerable to work-related musculoskeletal disorders (WMSD). This study evaluated the effects of a participatory ergonomic intervention on WMSD, sick absenteeism, and work performance among ward nurses. A multicomponent ergonomic training module, comprising educational ergonomics, health promotional activities, workstation adjustment, use of patient-assisted devices, and progressive muscle relaxation techniques, was developed based on a systematic review, focus group discussion, and discussion with ergonomic experts. A cluster quasi-experimental design was conducted, with nurses allocated into intervention (n = 45) and control (n = 30) groups, and follow-up across baseline, first, third-, and sixth-months post-intervention. The outcomes were assessed using the Nordic Musculoskeletal and Health and Work Performance Questionnaires. The intervention module was effective in reducing self-reported musculoskeletal symptoms among nurses across time, particularly neck pain [adjusted odds ratio (AOR) = 0.42, 95% CI 0.21–0.87], low back pain (AOR = 0.45, 95% CI 0.21–0.97), and shoulder pain (AOR = 0.38, 95% CI 0.17–0.88). However, the effects on relative absenteeism and relative presenteeism were only observed following adjusted analyses. While the ergonomic intervention was effective in reducing specific WMSDs among ward nurses, more research is required to delineate its potential application as a long-term strategy for addressing sick absenteeism and work performance.
- musculoskeletal disorders,
- ergonomics,
- nurses,
- work performance,
- sick absenteeism,
- low back pain
Citation: Guganesan Krishnanmoorthy, Rama Krishna, Faiz Baharudin, Mohd Amirul Asraf Shah Nizamuddin, Nik Hasmumthaj Nik Hassan, Mahmoud Danaee, Victor C W Hoe, Sanjay Rampal. Development and evaluation of a participatory ergonomic intervention for the reduction of work-related musculoskeletal disorders among nurses[J]. AIMS Public Health, 2025, 12(4): 1240-1264. doi: 10.3934/publichealth.2025063

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Abstract

Nurses are highly vulnerable to work-related musculoskeletal disorders (WMSD). This study evaluated the effects of a participatory ergonomic intervention on WMSD, sick absenteeism, and work performance among ward nurses. A multicomponent ergonomic training module, comprising educational ergonomics, health promotional activities, workstation adjustment, use of patient-assisted devices, and progressive muscle relaxation techniques, was developed based on a systematic review, focus group discussion, and discussion with ergonomic experts. A cluster quasi-experimental design was conducted, with nurses allocated into intervention (n = 45) and control (n = 30) groups, and follow-up across baseline, first, third-, and sixth-months post-intervention. The outcomes were assessed using the Nordic Musculoskeletal and Health and Work Performance Questionnaires. The intervention module was effective in reducing self-reported musculoskeletal symptoms among nurses across time, particularly neck pain [adjusted odds ratio (AOR) = 0.42, 95% CI 0.21–0.87], low back pain (AOR = 0.45, 95% CI 0.21–0.97), and shoulder pain (AOR = 0.38, 95% CI 0.17–0.88). However, the effects on relative absenteeism and relative presenteeism were only observed following adjusted analyses. While the ergonomic intervention was effective in reducing specific WMSDs among ward nurses, more research is required to delineate its potential application as a long-term strategy for addressing sick absenteeism and work performance.

Acknowledgments

We express our sincere gratitude to the nurses of Universiti Malaya Medical Centre for their efforts, assistance, valuable input and unwavering support in participating in and completing this survey. We would also like to thank the Director General of Health Malaysia for his permission to publish this article.

Authors' contributions

Conceptualisation: G.K., R.K. and S.R., Data curation: G.K., M.A.A. and N.H., Formal analysis: G.K., M.D., M.A.A. and N.H., Funding acquisition: G.K., R.K., V.C.W.H. and S.R., Investigation: G.K., R.K., F.B. and S.R., Methodology: G.K., R.K. and S.R., Project administration: G.K., R.K., and S.R., Resources: G.K., R.K., and S.R., Supervision: R.K., F.B., V.C.W.H and S.R., Writing - original draft: G.K., R.K., M.D., F.B. and S.R., Writing - review & editing: G.K., R.K., M.A.A., N.H. and S.R.. All authors approved the final draft.

Comflict of interest

The authors declare no competing interests.

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