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Fray M, Davis KG. Effectiveness of Safe Patient Handling Equipment and Techniques: A Review of Biomechanical Studies. HUMAN FACTORS 2024; 66:2283-2322. [PMID: 37947221 PMCID: PMC11382441 DOI: 10.1177/00187208231211842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2023]
Abstract
OBJECTIVE This review aimed to evaluate all studies that have evaluated the biomechanical effects when using assistive devices. INTRODUCTION The physical demands of patient handling activities are well known. One safety strategy for the reduction of the physical risks is use of assistive devices. METHOD The search process identified articles published in English-speaking journals through Google Scholar, Medline, and ISI Web of Science. The included 56 studies contained a biomechanical assessment of a patient handling activity with assistive devices. RESULTS The biomechanical effects included four groups: changes in body posture (spinal, other joints), subjective assessment (force, effort, discomfort), measured force (hand force, ground reaction force, spine force, joint torque), and physiological measures. The evidence showed caregivers benefited from using lift hoists, air-assisted devices, and to a lesser extent friction reducing devices for lateral transfers and repositioning, while floor and ceiling lifts were most effective for patient transfers. Some gaps were noted in the evidence and other handling tasks such as sit-to-stand, turning patient in bed, limb lifting, and repositioning and some more high hazard activities like supporting people with limited balance and those that fall need to be investigated with respect to biomechanical outcomes. CONCLUSION There is a growing level of biomechanical evidence to support the use of assistive devices for many patient-handling tasks, but the benefits of equipment use in some transfers remain uninvestigated. PRACTICAL APPLICATION Evidence indicates the best way to lift patients safely is with floor or ceiling lifts, and air-assisted devices for lateral and repositioning tasks.
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Affiliation(s)
- Mike Fray
- Loughborough University, Loughborough, Leicestershire, UK
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Carnegie DR, Hirsch SM, Howarth SJ, Beach TAC. Can we enable individuals to reach further down without rounding their backs before beginning a lift? Examining the influence of starting foot and trunk position on reach depth. ERGONOMICS 2024; 67:1097-1107. [PMID: 37955653 DOI: 10.1080/00140139.2023.2282953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/09/2023] [Indexed: 11/14/2023]
Abstract
There is disagreement regarding the efficacy of 'safe' lifting recommendations for reducing low back disorder risk. These recommendations commonly focus on minimising lumbar spine flexion, which limits the range of allowable starting lift positions for that person. This study evaluated whether starting postural adaptations could allow a person to reach down further without rounding their lumbar spine before beginning a lift. Reach displacement was measured as participants performed a series of maximal reach tasks under different combinations of stance width, foot orientation and trunk inclination, with their lumbar spine motion restricted. There were no interactions between any of the three postural adaptations or any effect of stance width or trunk inclination. Seventy-nine percent of participants achieved their greatest reach displacement with their feet externally rotated, which contributed to a 4 cm greater reach displacement compared to a neutral foot orientation (p < 0.001).Practitioner summary: This study examined whether aspects of initial posture could influence the ability to adhere to 'safe' lifting recommendations across a range of lift heights. As a component of lifting (re)training interventions, practitioners should consider starting lift posture adaptations (e.g. manipulating foot external rotation) to improve capacity to adhere to recommendations.
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Affiliation(s)
- Danielle R Carnegie
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Canada
| | - Steven M Hirsch
- Faculty of Kinesiology & Physical Education, University of Toronto, Toronto, Canada
| | - Samuel J Howarth
- Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, Canada
| | - Tyson A C Beach
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Canada
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Armstrong DP, Beach TAC, Fischer SL. Quantifying how functional and structural personal factors influence biomechanical exposures in paramedic lifting tasks. ERGONOMICS 2024; 67:925-940. [PMID: 37830870 DOI: 10.1080/00140139.2023.2270728] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/12/2023] [Indexed: 10/14/2023]
Abstract
It is unknown how structural (sex, stature, body mass) and functional (strength, flexibility) personal factors influence lifting strategy in paramedic work. We explored whether variance in peak low back forces and kinematic coordination patterns could be explained by structural and functional personal factors in paramedic lifting tasks. Seventy-two participants performed backboard and stretcher lifts. Peak low back forces normalised to body mass, as well as kinematic coordination patterns, were calculated as dependent variables. Being female, stronger, shorter, having higher body mass, and/or having greater lower body range of motion (ROM) were all independently associated with lower normalised low back forces across backboard and stretcher lifting. Females and stronger individuals seemed to define a movement objective to consistently minimise compressive forces, while individuals with greater hip ROM consistently minimised anteroposterior shear forces. The efficacy of improving strength and hip ROM to reduce low back forces in paramedic lifting should be investigated.Practitioner summary: Females, stronger individuals, and individuals with greater hip range of motion consistently exhibited lower normalised low back forces in paramedic lifting. Improving strength and hip range of motion via training is a potential proactive ergonomics approach to reduce peak low back forces in paramedic lifting tasks.
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Affiliation(s)
- Daniel P Armstrong
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada
| | - Tyson A C Beach
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada
| | - Steven L Fischer
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada
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Armstrong DP, Davidson JB, Fischer SL. Determining whether biomechanical variables that describe common 'safe lifting' cues are associated with low back loads. J Electromyogr Kinesiol 2024; 75:102867. [PMID: 38325138 DOI: 10.1016/j.jelekin.2024.102867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 01/17/2024] [Accepted: 01/25/2024] [Indexed: 02/09/2024] Open
Abstract
Lift technique training programs have been implemented to help reduce injury risk, but the underlying content validity of cues used within these programs is not clear. The objective of this study was to determine whether biomechanical variables, that commonly used lifting cues aim to elicit, are associated with resultant low back extensor moment exposures. A sample of 72 participants were recruited to perform 10 repetitions of a floor-to-waist height barbell lift while whole-body kinematics and ground reaction forces were collected. Kinematic, kinetic, and energetic variables representative of characteristics commonly targeted by lifting cues were calculated as predictor variables, while peak and cumulative low back moments were calculated as dependent measures. Multiple regression revealed that 56.6-59.2% of variance in low back moments was explained by predictor variables. From these regression models, generating motion with the legs (both greater hip and knee work), minimizing the horizontal distance of the body to the load, maintaining a stable body position, and minimizing lift time were associated with lower magnitudes of low back moments. These data support that using cues targeting these identified variables may be more effective at reducing peak low back moment exposures via lift training.
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Affiliation(s)
- Daniel P Armstrong
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada
| | - Justin B Davidson
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada
| | - Steven L Fischer
- Department of Kinesiology, Faculty of Health Sciences, University of Waterloo, Waterloo, Canada.
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Banks JJ, Quirk DA, Chung J, Cherin JM, Walsh CJ, Anderson DE. The effect of a soft active back support exosuit on trunk motion and thoracolumbar spine loading during squat and stoop lifts. ERGONOMICS 2024:1-14. [PMID: 38389220 PMCID: PMC11339243 DOI: 10.1080/00140139.2024.2320355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 02/13/2024] [Indexed: 02/24/2024]
Abstract
Back support exosuits aim to reduce tissue demands and thereby risk of injury and pain. However, biomechanical analyses of soft active exosuit designs have been limited. The objective of this study was to evaluate the effect of a soft active back support exosuit on trunk motion and thoracolumbar spine loading in participants performing stoop and squat lifts of 6 and 10 kg crates, using participant-specific musculoskeletal models. The exosuit did not change overall trunk motion but affected lumbo-pelvic motion slightly, and reduced peak compressive and shear vertebral loads at some levels, although shear increased slightly at others. This study indicates that soft active exosuits have limited kinematic effects during lifting, and can reduce spinal loading depending on the vertebral level. These results support the hypothesis that a soft exosuit can assist without limiting trunk movement or negatively impacting skeletal loading and have implications for future design and ergonomic intervention efforts.
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Affiliation(s)
- Jacob J. Banks
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, United States
| | - David A. Quirk
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - Jinwon Chung
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - Jason M. Cherin
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - Conor J. Walsh
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - Dennis E. Anderson
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States
- Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, United States
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Kugler HL, Taylor NF, Brusco NK. Patient handling training interventions and musculoskeletal injuries in healthcare workers: Systematic review and meta-analysis. Heliyon 2024; 10:e24937. [PMID: 38371982 PMCID: PMC10873653 DOI: 10.1016/j.heliyon.2024.e24937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 02/20/2024] Open
Abstract
Workplace injuries are a serious issue for the health and social care industry, with the sector accounting for 20 % of all serious claims reported. The aim of this systematic review was to determine whether patient handling training interventions that included instruction on patient transfer techniques are effective in preventing musculoskeletal injuries in healthcare workers. Methods: Electronic databases MEDLINE (Ovid), EMBASE (Ovid), CINAHL (EBSCO) and Health and Safety Science Abstracts (ProQuest) were searched for controlled trials from January 1996-August 2022. Risk of bias was evaluated using the PEDro scale and overall certainty of evidence assessed using the Grading of Recommendations, Assessment, Development and Evaluation for each meta-analysis. Results: A total of nine studies (3903 participants) were included. There is moderate certainty evidence that could not conclude whether patient handling training affects the 12-month incidence of lower back pain (OR = 0.83, 95 % CI [0.59, 1.16]). There is low certainty evidence that patient handing training does not prevent lower back pain in health professionals without pre-existing pain (MD = -0.06, 95 % CI [-0.63, 0.52]) but may reduce lower back pain in those with pre-existing pain (MD = -2.92, 95 % CI [-5.44, -0.41]). The results also suggest that there may be a positive effect of training incorporating risk assessment on musculoskeletal injury rates; however the evidence is of very low certainty. There is low certainty evidence from a single study that training may have a short-term effect on sickness absences.) Conclusions: There is a lack of evidence to support patient handling training when delivered to all healthcare staff. Training in its current form may be an ineffective strategy for reducing musculoskeletal injuries and pain. High quality disinvestment studies or trials incorporating risk assessment strategies are warranted. Practical Applications: This review suggests health service managers question the effectiveness of current patient handling training practices and consider evaluating current practices before allocating resources to meet employee risk reduction obligations.
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Affiliation(s)
- Helen L. Kugler
- Clinical Education and Research Institute, Cabrini Health, Australia
- School of Allied health, Human Services and Sport, La Trobe University, Australia
| | - Nicholas F. Taylor
- School of Allied health, Human Services and Sport, La Trobe University, Australia
- Allied Health Clinical Research Office, Eastern Health, Australia
| | - Natasha K. Brusco
- Clinical Education and Research Institute, Cabrini Health, Australia
- School of Allied health, Human Services and Sport, La Trobe University, Australia
- Rehabilitation, Aging and Independent Living (RAIL) Research Centre, Monash University, Australia
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Saraceni N, Campbell A, Kent P, Ng L, Straker L, O’Sullivan P. An Exploration of the Influence of Non-Biomechanical Factors on Lifting-Related LBP. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1903. [PMID: 36767270 PMCID: PMC9914774 DOI: 10.3390/ijerph20031903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/12/2023] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
Objective: The primary objective was to compare non-biomechanical factors between manual workers with and without a history of LBP related to lifting. A secondary objective was to investigate associations between the change in pain intensity during repeated lifting (termed pain ramp) and non-biomechanical factors tested in the LBP group. Methods: Manual workers currently in lifting occupations with and without a history of lifting-related LBP were recruited (21 LBP and 20 noLBP) and took part in a repeated (100) lift task. A series of non-biomechanical factors, including psychological, work-related, lifestyle, whole health and psychophysical factors, were collected. Psychophysical factors (pressure pain thresholds (PPTs) and fatigue) were also measured at different time points. Associations between pain ramp during lifting and non-biomechanical factors were investigated with linear regression. Results: The LBP group reported worse perceived sleep quality, more musculoskeletal pain sites other than LBP and greater symptoms related to gastrointestinal complaints and pseudo-neurology compared to the group with no history of LBP. The group with LBP were also slightly more worried about the lifting task and felt more fatigued at the end of the lifting task. The feeling of fatigue during lifting was positively associated with pain ramp in the LBP group. Anxiety and gastrointestinal complaints were weakly negatively associated with pain ramp during lifting. Conclusions: The group differences of poorer perceived sleep, greater non-specific health complaints, slightly more worry about the lifting task and more perceived fatigue in the LBP group highlight the complex and multi-factorial nature of LBP related to lifting. The feeling of fatigue was positively associated with pain ramp in the LBP group, suggesting a close relationship with pain and fatigue during lifting that requires further exploration.
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Affiliation(s)
- Nic Saraceni
- Curtin School of Allied Health, Curtin University, Bentley 6845, Western Australia, Australia
| | - Amity Campbell
- Curtin School of Allied Health, Curtin University, Bentley 6845, Western Australia, Australia
| | - Peter Kent
- Curtin School of Allied Health, Curtin University, Bentley 6845, Western Australia, Australia
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark Campusvej 55, 5230 Odense, Denmark
| | - Leo Ng
- Curtin School of Allied Health, Curtin University, Bentley 6845, Western Australia, Australia
| | - Leon Straker
- Curtin School of Allied Health, Curtin University, Bentley 6845, Western Australia, Australia
| | - Peter O’Sullivan
- Curtin School of Allied Health, Curtin University, Bentley 6845, Western Australia, Australia
- Body Logic Physiotherapy, Shenton Park 6008, Western Australia, Australia
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SUZUKI N, SATONAKA A, TERADA K. Grip strength of family caregivers of people with severe cerebral palsy rated to GMFCS level IV and V. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.20.04548-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Saraceni N, Campbell A, Kent P, Ng L, Straker L, O'Sullivan P. Does intra-lumbar flexion during lifting differ in manual workers with and without a history of low back pain? A cross-sectional laboratory study. ERGONOMICS 2022; 65:1380-1396. [PMID: 35098885 DOI: 10.1080/00140139.2022.2036819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 01/13/2022] [Indexed: 06/14/2023]
Abstract
Advice to limit or avoid a flexed lumbar curvature during lifting is widely promoted to reduce the risk of low back pain (LBP), yet there is very limited evidence to support this relationship. To provide higher quality evidence this study compared intra-lumbar flexion in manual workers with (n = 21) and without a history of LBP (n = 21) during a repeated lifting task. In contrast to common expectations, the LBP group demonstrated less peak absolute intra-lumbar flexion during lifting than the noLBP group [adjusted difference -3.7° (95%CI -6.9 to -0.6)]. The LBP group was also further from the end of range intra-lumbar flexion and did not use more intra-lumbar range of motion during any lift condition (both symmetrical and asymmetrical lifts and different box loads). Peak absolute intra-lumbar flexion was more variable in the LBP group during lifting and both groups increased their peak absolute intra-lumbar flexion over the lift repetitions. This high-quality capture of intra-lumbar spine flexion during repeated lifting in a clinically relevant cohort questions dominant safe lifting advice.Practitioner summary: Lifting remains a common trigger for low back pain (LBP). This study demonstrated that people with LBP, lift with less intra-lumbar flexion than those without LBP. Providing the best quality in-vivo laboratory evidence, that greater intra-lumbar flexion is not associated with LBP in manual workers, raising questions about lifting advice.
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Affiliation(s)
- Nic Saraceni
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Amity Campbell
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Peter Kent
- Curtin School of Allied Health, Curtin University, Perth, Australia
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Leo Ng
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Leon Straker
- Curtin School of Allied Health, Curtin University, Perth, Australia
| | - Peter O'Sullivan
- Curtin School of Allied Health, Curtin University, Perth, Australia
- Body Logic Physiotherapy Clinic, Perth, Australia
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Rialet-Micoulau J, Lucas V, Demoulin C, Pitance L. Misconceptions of physical therapists and medical doctors regarding the impact of lifting a light load on low back pain. Braz J Phys Ther 2022; 26:100385. [PMID: 35063698 PMCID: PMC8784290 DOI: 10.1016/j.bjpt.2021.100385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 10/28/2021] [Accepted: 12/17/2021] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND A common misconception about low back pain (LBP) is that the spine is weak and that lumbar flexion should be avoided. Because the beliefs of health-care professionals (HCPs) influence patients, it is important to understand the attitudes of health care professionals towards LBP and lifting. OBJECTIVES To assess and compare the perceptions of different categories of HCPs regarding the safety of specific movement strategies used to lift a light load, and their beliefs regarding back pain. The secondary aim was to determine whether certain factors influenced the beliefs of HCPs. METHODS Data were collected via an electronic survey. Student and qualified physical therapists (PTs), medical students, and general practitioner (GP) trainees were included. The questionnaire included eight photographs, depicting eight different strategies to lift a light load. Respondents were requested to select the strategy(s) they considered as "unsafe" to use for asymptomatic people with a previous history of LBP and people with chronic LBP. Beliefs and attitudes towards LBP were evaluated using the Back Pain Attitudes Questionnaire (Back-PAQ). RESULTS Questionnaires from 1005 participants were included. Seventy percent of qualified PTs considered none of the strategies as harmful (versus 32% of PT students, 9% of GP trainees and 1% of medical students). Qualified PTs had higher Back-PAQ scores (mean ± SD: 13.6 ± 5.5) than PT students (8.7 ± 5.7), GP trainees (5.9 ± 5.9) and medical students (4.1 ± 5.2), indicating less misconceptions regarding LBP. Having LBP negatively influenced beliefs while taking a pain education course positively influenced beliefs. CONCLUSION Misconceptions regarding LBP and the harmfulness of lifting a light load with a rounded back remain common among HCPs, particularly medical doctors.
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Affiliation(s)
- Joséphine Rialet-Micoulau
- Clinical Research Institute, Neuro-musculo-skeletal Lab (NMSK), Université Catholique de Louvain, Brussels, Belgium
| | - Valoris Lucas
- Clinical Research Institute, Neuro-musculo-skeletal Lab (NMSK), Université Catholique de Louvain, Brussels, Belgium
| | - Christophe Demoulin
- Clinical Research Institute, Neuro-musculo-skeletal Lab (NMSK), Université Catholique de Louvain, Brussels, Belgium; Department of Sport and Rehabilitation Sciences, University of Liege, Liege, Belgium
| | - Laurent Pitance
- Clinical Research Institute, Neuro-musculo-skeletal Lab (NMSK), Université Catholique de Louvain, Brussels, Belgium; Oral and Maxillofacial Surgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
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Ferrone A, Napier C, Menon C. Wearable Technology to Increase Self-Awareness of Low Back Pain: A Survey of Technology Needs among Health Care Workers. SENSORS (BASEL, SWITZERLAND) 2021; 21:8412. [PMID: 34960502 PMCID: PMC8706463 DOI: 10.3390/s21248412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/10/2021] [Accepted: 12/13/2021] [Indexed: 12/30/2022]
Abstract
Low back pain (LBP) is a leading contributor to musculoskeletal injury worldwide and carries a high economic cost. The healthcare industry is the most burdened, with nurses, in particular, being highly prone to LBP. Wearable technologies have the potential to address the challenges of monitoring postures that contribute to LBP and increase self-awareness of workplace postures and movements. We aimed to gain insight into workers' perceptions of LBP and whether they would consider using wearable monitoring technologies to reduce injury risks. We conducted a cross-sectional survey to gather information from a selected population of nurses. Sixty-four participants completed the survey, and data were analyzed with the support of Machine Learning techniques. Findings from this study indicate that the surveyed population (64 nurses) is interested in these new approaches to monitor movement and posture in the workplace. This technology can potentially change the way ergonomic guidelines are implemented in this population.
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Affiliation(s)
- Andrea Ferrone
- Menrva Research Group, Schools of Mechatronic Systems & Engineering Science, Simon Fraser University, Vancouver, BC V5A 1S6, Canada; (A.F.); (C.M.)
| | - Christopher Napier
- Menrva Research Group, Schools of Mechatronic Systems & Engineering Science, Simon Fraser University, Vancouver, BC V5A 1S6, Canada; (A.F.); (C.M.)
- Department of Physical Therapy, Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada
| | - Carlo Menon
- Menrva Research Group, Schools of Mechatronic Systems & Engineering Science, Simon Fraser University, Vancouver, BC V5A 1S6, Canada; (A.F.); (C.M.)
- Biomedical and Mobile Health Technology Laboratory, Department of Health Sciences and Technology, ETH Zurich, 8092 Zurich, Switzerland
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Gideon Asuquo E, Tighe SM, Bradshaw C. Interventions to reduce work-related musculoskeletal disorders among healthcare staff in nursing homes; An integrative literature review. INTERNATIONAL JOURNAL OF NURSING STUDIES ADVANCES 2021. [DOI: 10.1016/j.ijnsa.2021.100033] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Kamachi M, Owlia M, Dutta T. Evaluating a wearable biofeedback device for reducing end-range sagittal lumbar spine flexion among home caregivers. APPLIED ERGONOMICS 2021; 97:103547. [PMID: 34365286 DOI: 10.1016/j.apergo.2021.103547] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 07/12/2021] [Accepted: 08/01/2021] [Indexed: 06/13/2023]
Abstract
Caregivers who work in the home environment are at risk of back injury due to the awkward postures they have to adopt while providing care. Real-time biofeedback provided by a recently developed wearable device (PostureCoach) may be able to reduce this risk. The effectiveness of a two-day training intervention (including PostureCoach and an educational video) was evaluated for its ability to decrease the amount of time spent in end-range spine flexion. Twenty novice caregivers repeated a series of simulated care tasks. Real-time auditory biofeedback was provided to the intervention group (n = 10) when participants' sagittal lumbar spine flexion exceeded a preset threshold during training trials. Participants in the control group (n = 10) received no feedback. Participants repeated the tasks again two weeks and two months post-intervention. The intervention group maintained decreased end-range (80th and 95th percentile) spine flexion compared to controls at both post-intervention time points.
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Affiliation(s)
- Megan Kamachi
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave., Toronto, ON, M5G 2A2, Canada; Institute of Biomedical Engineering, University of Toronto, Rosebrugh Building, 164 College Street, Room 407, Toronto, ON, M5S 3G9, Canada
| | - Mohammadhasan Owlia
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave., Toronto, ON, M5G 2A2, Canada
| | - Tilak Dutta
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, 550 University Ave., Toronto, ON, M5G 2A2, Canada; Institute of Biomedical Engineering, University of Toronto, Rosebrugh Building, 164 College Street, Room 407, Toronto, ON, M5S 3G9, Canada.
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14
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Exploring lumbar and lower limb kinematics and kinetics for evidence that lifting technique is associated with LBP. PLoS One 2021; 16:e0254241. [PMID: 34288926 PMCID: PMC8294511 DOI: 10.1371/journal.pone.0254241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 06/22/2021] [Indexed: 02/06/2023] Open
Abstract
Purpose To investigate if lumbar and lower limb kinematics or kinetics are different between groups with and without a history of LBP during lifting. Secondly, to investigate relationships between biomechanical variables and pain ramp during repeated lifting. Methods 21 LBP and 20 noLBP participants completed a 100-lift task, where lumbar and lower limb kinematics and kinetics were measured during lifting, with a simultaneous report of LBP intensity every 10 lifts. Lifts were performed in a laboratory setting, limiting ecological validity. Results The LBP group used a different lifting technique to the noLBP group at the beginning of the task (slower and more squat-like). Kinetic differences at the beginning included less peak lumbar external anterior shear force and greater peak knee power demonstrated by the LBP group. However, at the end of the task, both groups lifted with a much more similar technique that could be classified as more stoop-like and faster. Peak knee power remained greater in the LBP group throughout and was the only kinetic difference between groups at the end of the lifting task. While both groups lifted using a more comparable technique at the end, the LBP group still demonstrated a tendency to perform a slower and more squat-like lift throughout the task. Only one of 21 variables (pelvic tilt at box lift-off), was associated with pain ramp in the LBP group. Conclusions: Workers with a history of LBP, lift with a style that is slower and more squat-like than workers without any history of LBP. Common assumptions that LBP is associated with lumbar kinematics or kinetics such as greater lumbar flexion or greater forces were not observed in this study, raising questions about the current paradigm around ‘safe lifting’.
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Marcotte JV, Muller A, Robert-Lachaine X, Fecteau V, Denis D, Plamondon A, Corbeil P. New taxonomy for assessing manual material handlers' footstep patterns. APPLIED ERGONOMICS 2021; 94:103424. [PMID: 33862307 DOI: 10.1016/j.apergo.2021.103424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 03/24/2021] [Accepted: 03/29/2021] [Indexed: 06/12/2023]
Abstract
Current taxonomies for assessing foot strategies in manual material handling lack exhaustive classification of foot movements and foot positioning. They also fail to consider different instants of the task as checkpoints to relate foot strategies. The goal of the study was first to develop a new taxonomy to assess foot positions and motions considering those limitations. The second goal was to assess reliability and reproducibility using raw agreement percentages, Cohen's kappa, prevalence-adjusted, bias-adjusted kappa and Gwet's AC1. A filmed task consisted of transferring boxes from one pallet to another. Intra- and inter-rater reliability were assessed reviewing 23% and 10%, respectively, of video data. Reproducibility and reliability results are substantial and almost perfect on average. In comparison to similar studies, reproducibility and reliability were considered acceptable.
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Affiliation(s)
- Jasmin Vallée Marcotte
- Department of Kinesiology, Université Laval, Québec, Québec, Canada; Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Canada.
| | - Antoine Muller
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 boul. De Maisonneuve Ouest, Montréal, Québec, Canada H3A 3C2
| | - Xavier Robert-Lachaine
- Department of Kinesiology, Université Laval, Québec, Québec, Canada; Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Canada; Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 boul. De Maisonneuve Ouest, Montréal, Québec, Canada H3A 3C2
| | | | - Denys Denis
- Université du Québec à Montréal (UQAM), Montréal, Québec, Canada
| | - André Plamondon
- Institut de Recherche Robert-Sauvé en Santé et en Sécurité du Travail (IRSST), 505 boul. De Maisonneuve Ouest, Montréal, Québec, Canada H3A 3C2
| | - Philippe Corbeil
- Department of Kinesiology, Université Laval, Québec, Québec, Canada; Centre Interdisciplinaire de Recherche en Réadaptation et Intégration Sociale (CIRRIS), Centre Intégré Universitaire de Santé et de Services Sociaux de la Capitale-Nationale (CIUSSS-CN), Québec, Canada.
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Wiggermann N, Zhou J, McGann N. Effect of Repositioning Aids and Patient Weight on Biomechanical Stresses When Repositioning Patients in Bed. HUMAN FACTORS 2021; 63:565-577. [PMID: 31999485 PMCID: PMC8114440 DOI: 10.1177/0018720819895850] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 11/25/2019] [Indexed: 05/25/2023]
Abstract
OBJECTIVE The aim of the study was to estimate the risk of injury when repositioning patients of different weight with commonly used repositioning aids. BACKGROUND Repositioning dependent patients in bed is the most common type of patient handling activity and is associated with high rates of musculoskeletal disorders in healthcare workers. Several studies have evaluated repositioning aids, but typically for a single patient weight and often without estimating risk of injury based on biomechanical analysis. METHOD Ten nurses performed four repositioning activities on three participants (50, 77, 141 kg) using three repositioning aids (pair of friction-reducing sheets [FRS], turn and position glide sheet, air-assisted transfer device) and a draw sheet. Motion capture, hand forces, and ground reaction forces were recorded. Spine loading was estimated using a dynamic biomechanical model. RESULTS Hand forces and spine compression exceeded recommended limits for most patient weights and repositioning tasks with the draw sheet. FRS and glide sheet reduced these loads but still exceeded recommended limits for all but the 50-kg patient. Only the air-assisted transfer device reduced forces to accepted levels for all patient weights. Physical stresses were relatively low when turning patients. CONCLUSION Most repositioning aids are insufficient to properly mitigate risk of musculoskeletal injury in healthcare workers. Only the air-assisted transfer device was sufficient to adequately mitigate the risk of injury when moving patients of average or above-average weight. APPLICATION To safely move dependent patients, a robust solution requires mechanical lifts and may utilize air-assisted transfer devices for patient transfers.
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Mawston G, Holder L, O'Sullivan P, Boocock M. Flexed lumbar spine postures are associated with greater strength and efficiency than lordotic postures during a maximal lift in pain-free individuals. Gait Posture 2021; 86:245-250. [PMID: 33799053 DOI: 10.1016/j.gaitpost.2021.02.029] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 02/10/2021] [Accepted: 02/25/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Inspite of common lifting advice to maintain a lordotic posture, there is debate regarding optimal lumbar spine posture during lifting. To date, the influence of lumbar posture on trunk muscle recruitment, strength and efficiency during high intensity lifting has not been fully explored. RESEARCH QUESTION How do differences in lumbar posture influence trunk extensor strength (moment), trunk muscle activity, and neuromuscular efficiency during maximal lifting? METHODS Twenty-six healthy participants adopted three lumbar postures (maximal extension (lordotic), mid-range (flat-back), and fully flexed) in a free lifting position. Motion analysis and force measurements were used to determine the back extensor, hip and knee moments. Surface electromyography (EMG) of three trunk extensors and the internal obliques were recorded. Neuromuscular efficiency (NME) was expressed as a ratio of normalised extensor moment to normalised EMG. RESULTS Significantly higher back extensor moments were exerted when moving from an extended to mid-range, and from a mid-range to fully flexed lumbar posture. This was accompanied by a decrease in activity across all three back extensor muscles (P < 0.001) resulting in a higher NME of these muscles in more flexed postures. Change in lumbar posture did not influence hip or knee moments or internal oblique activation. SIGNIFICANCE A flexed-back posture is associated with increased strength and efficiency of the back muscles compared to a lordotic posture. These findings further question the manual handling advice to lift with a lordotic lumbar spine.
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Affiliation(s)
- Grant Mawston
- Health and Rehabilitation Research Institute, Department of Physiotherapy, Auckland University of Technology, New Zealand.
| | - Laura Holder
- Health and Rehabilitation Research Institute, Department of Physiotherapy, Auckland University of Technology, New Zealand
| | - Peter O'Sullivan
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - Mark Boocock
- Health and Rehabilitation Research Institute, Department of Physiotherapy, Auckland University of Technology, New Zealand
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18
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Islam F, Sabbe M, Heeren P, Milisen K. Consistency of decision support software-integrated telephone triage and associated factors: a systematic review. BMC Med Inform Decis Mak 2021; 21:107. [PMID: 33743697 PMCID: PMC7981379 DOI: 10.1186/s12911-021-01472-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 03/14/2021] [Indexed: 11/12/2022] Open
Abstract
Background In the recent decades, the use of computerized decision support software (CDSS)-integrated telephone triage (TT) has become an important tool for managing rising healthcare demands and overcrowding in the emergency department. Though these services have generally been shown to be effective, large gaps in the literature exist with regards to the overall quality of these systems. In the current systematic review, we aim to document the consistency of decisions that are generated in CDSS-integrated TT. Furthermore, we also seek to map those factors in the literature that have been identified to have an impact on the consistency of generated triage decisions. Methods As part of the TRANS-SENIOR international training and research network, a systematic review of the literature was conducted in November 2019. PubMed, Web of Science, CENTRAL, and the CINAHL database were searched. Quantitative articles including a CDSS component and addressing consistency of triage decisions and/or factors associated with triage decisions were eligible for inclusion in the current review. Studies exploring the use of other types of digital support systems for triage (i.e. web chat, video conferencing) were excluded. Quality appraisal of included studies were performed independently by two authors using the Methodological Index for Non-Randomized Studies. Results From a total of 1551 records that were identified, 39 full-texts were assessed for eligibility and seven studies were included in the review. All of the studies (n = 7) identified as part of our search were observational and were based on nurse-led telephone triage. Scientific efforts investigating our first aim was very limited. In total, two articles were found to investigate the consistency of decisions that are generated in CDSS-integrated TT. Research efforts were targeted largely towards the second aim of our study—all of the included articles reported factors related to the operator- (n = 6), patient- (n = 1), and/or CDSS-integrated (n = 2) characteristics to have an influence on the consistency of CDSS-integrated TT decisions. Conclusion To date, some efforts have been made to better understand how the use of CDSS-integrated TT systems may vary across settings. In general, however, the evidence-base surrounding this field of literature is largely inconclusive. Further evaluations must be prompted to better understand this area of research. Protocol registration The protocol for this study is registered in the PROSPERO database (registration number: CRD42020146323). Supplementary Information The online version contains supplementary material available at 10.1186/s12911-021-01472-3.
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Affiliation(s)
- Farah Islam
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000, Leuven, Belgium
| | - Marc Sabbe
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000, Leuven, Belgium.,Department of Emergency Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium
| | - Pieter Heeren
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000, Leuven, Belgium.,Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.,Research Foundation Flanders, Egmontstraat 5, 1000, Brussels, Belgium
| | - Koen Milisen
- Department of Public Health and Primary Care, KU Leuven, Kapucijnenvoer 35, 3000, Leuven, Belgium. .,Department of Geriatric Medicine, University Hospitals Leuven, Herestraat 49, 3000, Leuven, Belgium.
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Zakerian SA, Afzalinejhad M, Mahmodi M, Sheibani N. Determining the Efficiency of Ergonomic Belt During Patient Handling and its Effect on Reducing Musculoskeletal Disorders in Nurses. SAGE Open Nurs 2021; 7:23779608211057939. [PMID: 34888415 PMCID: PMC8649436 DOI: 10.1177/23779608211057939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 10/14/2021] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Nursing personnel are always at risk for work-related musculoskeletal disorders, and patient transportation is one of the major risk factor for these disorders. OBJECTIVE The aim of this study was to evaluate the ergonomic belt to improve patient transferring conditions. METHODS The subjects included 60 health care workers (HCW) of a hospital with patient transfer experience. The ergonomic belt was examined to help move the patient from one bed to another. The prevalence of musculoskeletal disorders was assessed through the Nordic questionnaire, the degree of perceived exertion through the Borg criterion, and the patient's movement through the MAPO index before and after the intervention. RESULTS The results showed a significant decrease in Borg scale scores and MAPO index in two factors of education and auxiliary tools and overall scores of this index. We also saw a significant reduction in musculoskeletal disorders in the neck, shoulders and arms, waist, hands and wrists, thighs, knees and legs. There were no significant differences in the elbow and forearm before and after using the ergonomic belt. CONCLUSION In general, it can be concluded that the use of ergonomic belt had helped to reduce the risk of musculoskeletal disorders, as well as reducing the perceived exertion of nurses and other relevant personnel.
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Affiliation(s)
- Seyed Abolfazl Zakerian
- Department of Occupational Health, School of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansooreh Afzalinejhad
- Department of Occupational Health, School of Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahmood Mahmodi
- Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Niloofar Sheibani
- Department of Occupational Health, School of Health, Tehran University of Medical Sciences, Tehran, Iran
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20
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Kranz C, Lee K, Jadhav P, Vestlin L, Barker M, Jacques A, Falkmer T, Netto J, Netto K. Kinematic and perceptual responses in heavy lifting and pulling: Are there differences between males and females? APPLIED ERGONOMICS 2021; 90:103274. [PMID: 32979817 DOI: 10.1016/j.apergo.2020.103274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
This study investigated kinematic and perceptual differences between the sexes in a heavy lifting and pulling task. A 20 kg box was lifted from floor to chest height, and a 70 kg mannequin pulled across 20m. The effect of height, mass and average grip strength on kinematics and perceived workload was examined in 42 (19 females, 23 males) healthy individuals. A univariate linear regression analysis found females lifted with greater lumbar extension compared to males (p < 0.001), and adopted more hip (p = 0.006) and knee flexion (p = 0.036) in the pulling task. Females reported a greater perceived workload in both tasks (p < 0.001). After the multivariable analysis, only grip strength remained significant for perceived workload in the lift (p = 0.04), and height for knee flexion in the pull (p = 0.009). This highlights that height and strength are important factors driving kinematics and perceived workload. Clinicians may consider these factors in heavy manual tasks, more so than sex.
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Affiliation(s)
- Courtney Kranz
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Kellyn Lee
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Parnashree Jadhav
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Linda Vestlin
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Mike Barker
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Angela Jacques
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia
| | - Torbjörn Falkmer
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Julie Netto
- School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
| | - Kevin Netto
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Australia.
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21
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Armstrong DP, Fischer SL. Understanding individual differences in lifting mechanics: Do some people adopt motor control strategies that minimize biomechanical exposure. Hum Mov Sci 2020; 74:102689. [PMID: 33130385 DOI: 10.1016/j.humov.2020.102689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 07/08/2020] [Accepted: 09/29/2020] [Indexed: 11/19/2022]
Abstract
The movement strategy an individual uses to complete a lift can influence the resultant biomechanical exposure on their low back. We hypothesize that some lifters may choose a motor control strategy to minimize exposure to the low back, where others may not. Lower magnitudes of exposure to the low back coupled with less variability in lift-to-lift exposure and in features of movement strategy related to biomechanical exposure would support that such lifters consider minimizing exposure in their motor control strategy. We tested this hypothesis by investigating if differences in variability of low back exposure measures, as well as features of movement strategy related to resultant low back exposures differed across lifters. Twenty-eight healthy adults participated in the study where ten repetitions of a lifting task with the load scaled to 75% of participant's one-repetition maximum were completed. In all trials, whole-body kinematics and ground reaction forces were collected. Lifters were grouped as low, moderate or high relative exposure based on low back flexion angles and normalized L4/L5 extensor moments when lifting. Principal component analysis was used to identify independent movement strategy features, and statistical testing determined which features differed between high and low exposure lifts. Variability in low back exposures and movement features associated with relative biomechanical exposure were compared across lifter classifications. Significantly less variability was observed in low back exposures among the low exposure lifter group. Additionally, a trend towards lower variability in movement features associated with relative biomechanical exposure was also observed in low exposure lifters. These findings provide initial support for the hypothesis that some lifters likely define a motor control strategy that considers minimizing biomechanical exposure in addition to completing the lift demands. Future work should explore how state and trait-based factors influence an individual to consider biomechanical exposure within their motor control strategy in lifting.
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Affiliation(s)
- Daniel P Armstrong
- Department of Kinesiology, University of Waterloo, 200 University Ave West, Waterloo, Ontario N2L 3G1, Canada
| | - Steven L Fischer
- Department of Kinesiology, University of Waterloo, 200 University Ave West, Waterloo, Ontario N2L 3G1, Canada.
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22
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Karimi A, Dianat I, Barkhordari A, Yusefzade I, Rohani-Rasaf M. A multicomponent ergonomic intervention involving individual and organisational changes for improving musculoskeletal outcomes and exposure risks among dairy workers. APPLIED ERGONOMICS 2020; 88:103159. [PMID: 32678778 DOI: 10.1016/j.apergo.2020.103159] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 03/10/2020] [Accepted: 05/14/2020] [Indexed: 06/11/2023]
Abstract
A field intervention study was implemented to evaluate the effects of individual (physical exercise programme and worker ergonomics training) and organisational changes (optimising work-rest schedule and revised task procedure) on musculoskeletal outcomes and their exposure risks among milking workers in a dairy plant. A questionnaire survey (including the Cornell Musculoskeletal Discomfort Questionnaire [CMDQ]) and direct observations of working postures by using the Quick Exposure Check (QEC) method were used at baseline and 12-month follow-up. Shoulder, lower back and neck discomfort were found to be the most common problems. The results showed significant improvements in the frequency (neck, shoulder, lower back, forearm and knee symptoms), severity (shoulder, lower back and knee symptoms) and interference with work (particularly due to lower back symptoms) as well as in the exposure risks to musculoskeletal problems (using the QEC method) after the intervention. The findings support the effectiveness of implemented multiple component intervention for improving musculoskeletal health and exposure risks in the studied occupational group.
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Affiliation(s)
- Azim Karimi
- Department of Occupational Health Engineering, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
| | - Iman Dianat
- Department of Occupational Health and Ergonomics, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Abdullah Barkhordari
- Department of Occupational Health Engineering, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
| | - Iman Yusefzade
- Faculty of Education and Psychology, University of Isfahan, Isfahan, Iran.
| | - Marzieh Rohani-Rasaf
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
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23
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To Flex or Not to Flex? Is There a Relationship Between Lumbar Spine Flexion During Lifting and Low Back Pain? A Systematic Review With Meta-analysis. J Orthop Sports Phys Ther 2020; 50:121-130. [PMID: 31775556 DOI: 10.2519/jospt.2020.9218] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate whether lumbar spine flexion during lifting is a risk factor for low back pain (LBP) onset/persistence or a differentiator of people with and without LBP. DESIGN Etiology systematic review with meta-analysis. LITERATURE SEARCH Database search of ProQuest, CINAHL, MEDLINE, and Embase up to August 21, 2018. STUDY SELECTION CRITERIA We included peer-reviewed articles that investigated whether lumbar spine position during lifting was a risk factor for LBP onset or persistence or a differentiator of people with and without LBP. DATA SYNTHESIS Lifting-task comparison data were tabulated and summarized. The meta-analysis calculated an n-weighted pooled mean ± SD of the results in the LBP and no-LBP groups. If a study contained multiple comparisons (ie, different lifting tasks that used various weights or directions), then only 1 result from that study was included in the meta-analysis. RESULTS Four studies (1 longitudinal study and 3 cross-sectional studies across 5 articles) included in meta-analysis measured lumbar flexion with intralumbar angles and found no difference in peak lumbar spine flexion when lifting (1.5°; 95% confidence interval [CI]: -0.7°, 3.7°; P = .19 for the longitudinal study and -0.9°; 95% CI: -2.5°, 0.7°; P = .29 for the cross-sectional studies). Seven cross-sectional studies measured lumbar flexion with thoracopelvic angles and found that people with LBP lifted with 6.0° less lumbar flexion than people without LBP (95% CI: -11.2°, -0.9°; P = .02). Most (9/11) studies reported no significant between-group differences in lumbar flexion during lifting. The included studies were of low quality. CONCLUSION There was low-quality evidence that greater lumbar spine flexion during lifting was not a risk factor for LBP onset/persistence or a differentiator of people with and without LBP. J Orthop Sports Phys Ther 2020;50(3):121-130. Epub 28 Nov 2019. doi:10.2519/jospt.2020.9218.
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Kox JHAM, Bakker EJM, Bierma-Zeinstra S, Runhaar J, Miedema HS, Roelofs PDDM. Effective interventions for preventing work related physical health complaints in nursing students and novice nurses: A systematic review. Nurse Educ Pract 2020; 44:102772. [PMID: 32222492 DOI: 10.1016/j.nepr.2020.102772] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 08/27/2019] [Accepted: 03/14/2020] [Indexed: 10/24/2022]
Abstract
From the start of their career, nursing students and novice nurses are at risk of developing physical health problems due to high physical workload, which may lead to early exit from nursing. To provide an overview of interventions preventing physical health problems in early career, a systematic review was performed. A comprehensive search of the literature was conducted up to December 2017. Primary outcome of interest was education/work dropout. Secondary outcomes were musculoskeletal symptoms. Independent authors selected studies, appraised quality and extracted data. After screening 7111 titles and abstracts, eleven studies were included. Seven studies evaluated interventions for moving/handling training. Four evaluated other interventions. None focused on our primary outcome education/work dropout. All studies reported on physical complaints among student nurses only. Overall, risk of bias was high and clinical heterogeneity prohibited pooling of data. Intervention effects were small and inconsistent. In conclusion, evidence for the effectiveness of interventions in the nursing curricula for the prevention/treatment of physical complaints is scarce and where available conflicting. We recommend high quality research on dropout due to physical health problems, as well as on the prevention/treatment of physical complaints.
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Affiliation(s)
- Jos H A M Kox
- Rotterdam University of Applied Sciences, Center of Expertise, Innovations in Care, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands; Erasmus University Medical Center Rotterdam, Department of General Practice, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
| | - Ellen J M Bakker
- Rotterdam University of Applied Sciences, Center of Expertise, Innovations in Care, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands; Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Van der Boechorststraat 7, 1081 BT, Amsterdam, the Netherlands.
| | - Sita Bierma-Zeinstra
- Erasmus University Medical Center Rotterdam, Department of General Practice, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands; Erasmus University Medical Center Rotterdam, Department of Orthopaedics, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
| | - Jos Runhaar
- Erasmus University Medical Center Rotterdam, Department of General Practice, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
| | - Harald S Miedema
- Rotterdam University of Applied Sciences, Center of Expertise, Innovations in Care, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands.
| | - Pepijn D D M Roelofs
- Rotterdam University of Applied Sciences, Center of Expertise, Innovations in Care, P.O. Box 25035, 3001 HA, Rotterdam, the Netherlands; Erasmus University Medical Center Rotterdam, Department of General Practice, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands.
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Nolan D, O’Sullivan K, Newton C, Singh G, Smith BE. Are there differences in lifting technique between those with and without low back pain? A systematic review. Scand J Pain 2019; 20:215-227. [DOI: 10.1515/sjpain-2019-0089] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 10/17/2019] [Indexed: 12/19/2022]
Abstract
Abstract
Background and aims
To systemically review the literature to compare freestyle lifting technique, by muscle activity and kinematics, between people with and without low back pain (LBP).
Methods
Five databases were searched along with manual searches of retrieved articles by a single reviewer. Studies were included if they compared a freestyle lifting activity between participants with and without LBP. Data were extracted by two reviewers, and studies were appraised using the CASP tool for case-control studies.
Results
Nine studies were eligible. Heterogeneity did not allow for meta-analysis. Most studies (n = 8 studies) reported that people with LBP lift differently to pain-free controls. Specifically, people with LBP lift more slowly (n = 6 studies), use their legs more than their back especially when initiating lifting (n = 3 studies), and jerk less during lifting (n = 1 studies). Furthermore, the four larger studies involving people with more severe LBP also showed that people with LBP lift with less spinal range of motion and greater trunk muscle activity for a longer period.
Conclusions
People with LBP move slower, stiffer, and with a deeper knee bend than pain-free people during freestyle lifting tasks. Interestingly, such a lifting style mirrors how people, with and without LBP, are often told how to lift during manual handling training. The cross-sectional nature of the comparisons does not allow for causation to be determined.
Implications
The changes described may show embodiment of cautious movement, and the drive to protect the back. There may be value in exploring whether adopting a lifting style closer to that of pain-free people could help reduce LBP.
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Affiliation(s)
- David Nolan
- Sheffield Teaching Hospitals NHS Foundation Trust , PhysioWorks, Firth Park Clinic, North Quadrant , Sheffield , UK , Phone: 07725854140
| | - Kieran O’Sullivan
- Sports Spine Centre, Aspetar Orthopaedic and Sports Medicine Hospital , Doha , Qatar
- School of Allied Health , University of Limerick , Limerick , Ireland
- Health Research Institute , University of Limerick , Limerick , Ireland
| | - Chris Newton
- Physiotherapy Department , University Hospitals of Leicester NHS Trust , Leicester , UK
- Division of Rehabilitation and Ageing, School of Medicine , University of Nottingham , Nottingham , UK
| | - Gurpreet Singh
- Physiotherapy Department , University Hospitals of Leicester NHS Trust , Leicester , UK
| | - Benjamin E. Smith
- Division of Rehabilitation and Ageing, School of Medicine , University of Nottingham , Nottingham , UK
- University Hospitals of Derby and Burton NHS Foundation Trust , Derby , UK
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Baracco A, Coggiola M, Bosio D, Perrelli F, Garzaro G, Turcu V, Pira E. Whole body biomechanical burden of healthcare workers: proposal for a complementary risk assessment and management tool (HOARA). LA MEDICINA DEL LAVORO 2019; 110:372-388. [PMID: 31659994 PMCID: PMC7810019 DOI: 10.23749/mdl.v110i5.7624] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 08/01/2019] [Indexed: 11/17/2022]
Abstract
Introduction: We have developed a new tool, named Holistic Approach Risk Assessment (HOARA), to support occupational safety and health professionals (OSH) in risk assessment and management when evaluating the biomechanical load of healthcare workers. Objectives: The primary aim of the HOARA is to support OSH in risk assessment and management of biomechanical hazards in healthcare facilities. This tool ensures a superior level of analysis by targeting independently various body compartments during all activities completed throughout the work shift. These include: head, neck, back and upper and lower limbs. Methods: For each body segment, ergonomic determinants were defined on the basis of previous literature, according to which task and job analyses were performed. Upon direct observation, ergonomic factors were given a score based on their temporal extent. Subsequently, action-body segment raw indices and weighted indices were calculated. Results: Results of the application of the method are shown. Of note, a relational database was set up to improve its usability. Conclusions: From an occupational health perspective, the HOARA, integrated with other methods, is expected to allow a more effective management of human resources, especially when assigning workers to specific jobs or tasks. Overall, the HOARA will be instrumental in assessing the impact of fitness for work judgments on work organization and its resources, in compliance with the guidelines from the Società Italiana di Medicina del Lavoro (SIML).
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Larouche D, Corbeil P, Bellemare M, Authier M, Prairie J, Hegg-Deloye S. To what extent do paramedics apply safe handling principles when transferring patients from stair chairs to stretchers? ERGONOMICS 2019; 62:1313-1326. [PMID: 31282825 DOI: 10.1080/00140139.2019.1641629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 07/03/2019] [Indexed: 06/09/2023]
Abstract
The efficiency of training programmes in handling designed to prevent injuries has rarely been demonstrated by studies in the workplace. This study aimed to identify factors that may favour or inhibit the application of safe handling principles by paramedics performing full-body transfers of patients from a stair chair to a stretcher. In an observational field study, handling methods used in 45 patient transfers from a stair chair to stretcher were characterised. Principles concerning the physical environment seem to be applied frequently, but those applicable during the transfer are neglected. Principles taught during training may not be applied due to the physical constraints of the workplace and the underestimation of risk exposure. The results suggest that training should be enhanced, not by focussing on handling techniques but by focussing on compromise and the capacity to adapt work techniques based on the working context and the team-mate.
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Affiliation(s)
- Dominique Larouche
- Department of kinesiology, Faculty of medicine, Université Laval , Quebec City , Canada
| | - Philippe Corbeil
- Department of kinesiology, Faculty of medicine, Université Laval , Quebec City , Canada
- Centre for interdisciplinary research in rehabilitation and social integration (CIRRIS), Centre intégré universitaire de santé et de services sociaux de la Capitale-Nationale (CIUSSS-CN) , Quebec City , Canada
| | - Marie Bellemare
- Department of industrial relations, Faculty of social sciences, Université Laval , Quebec City , Canada
| | | | - Jérôme Prairie
- Department of kinesiology, Faculty of medicine, Université Laval , Quebec City , Canada
| | - Sandrine Hegg-Deloye
- Department of kinesiology, Faculty of medicine, Université Laval , Quebec City , Canada
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Armstrong DP, Ross GB, Graham RB, Fischer SL. Considering movement competency within physical employment standards. Work 2019; 63:603-613. [DOI: 10.3233/wor-192955] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
| | - Gwyneth B. Ross
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
| | - Ryan B. Graham
- School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada
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Abdoli-Eramaki M, Agababova M, Janabi J, Pasko E, Damecour C. Evaluation and comparison of lift styles for an ideal lift among individuals with different levels of training. APPLIED ERGONOMICS 2019; 78:120-126. [PMID: 31046942 DOI: 10.1016/j.apergo.2019.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2017] [Revised: 01/29/2019] [Accepted: 02/24/2019] [Indexed: 06/09/2023]
Abstract
Training for safe lifting techniques is used by employers to lower their workers' exposure to risk of workplace injuries. To determine effectiveness of training, 266 attendees at two professional conferences were asked to identify and demonstrate their preferred lift technique with the demonstration being an ideal floor-to-waist height lift of a10-kg weighted crate. 'Bend your knees' was the most frequent preferred cue for each of the self-reported participant groups: untrained (n = 65), trained (n = 86), and trainers (n = 115) according to safe lifting techniques. The demonstrations showed that this cue was incorporated into the skill of lifting by all groups. Trained participants showed a stronger conformity for depth of squat; but, the overall variability suggested a lack of consensus on the ideal depth of squat. The trained group experienced less loading at L5/S1 (p = .021) compared to untrained that was countered by higher loading of the knee (p = .046). Trainers showed lower knee (p = .006) and shoulder (p = .03) loading with similar L5/S1 loading as the trained participants suggesting a broader set of criteria for safe lifting. While the study population was likely biased towards a common understanding of safe lifting techniques given the conferences were for ergonomists and safety professionals, the results provided valuable insight into potential knowledge gaps, and key messaging that is being delivered and integrated into one's knowledge; a program review of lift training is recommended.
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Affiliation(s)
- Mohammad Abdoli-Eramaki
- School of Occupational and Public Health, Faculty of Community Services, Ryerson University, Toronto, ON, Canada.
| | - Milena Agababova
- School of Occupational and Public Health, Faculty of Community Services, Ryerson University, Toronto, ON, Canada
| | - Joseph Janabi
- School of Occupational and Public Health, Faculty of Community Services, Ryerson University, Toronto, ON, Canada
| | - Elena Pasko
- School of Occupational and Public Health, Faculty of Community Services, Ryerson University, Toronto, ON, Canada
| | - Caroline Damecour
- School of Occupational and Public Health, Faculty of Community Services, Ryerson University, Toronto, ON, Canada
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Kusma B, Pietsch A, Riepenhof H, Haß S, Kuhn D, Fischer K, Nienhaus A. The Back College for nurses - an evaluation of intermediate effects. J Occup Med Toxicol 2019; 14:19. [PMID: 31249605 PMCID: PMC6584993 DOI: 10.1186/s12995-019-0239-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Accepted: 06/10/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Nursing staff and care workers run an increased risk of work related musculoskeletal disorders such as low back pain. The Institution for Statutory Accident Insurance and Prevention in the Health and Welfare Services (BGW) offers its insured persons the opportunity to participate in a three-week Back College with the aim of preventing them having to abandon their profession due to back problems. The aim of the study was to record the effectiveness and sustainability of the Back College on an intermediate basis (6 months). METHODS As part of a single-group pre-post measurement on three survey dates - at the start (T0) and end (T1) of rehabilitation and 6 months later (T2) - in 2013 all participants in the Back College at three locations were surveyed using a standard questionnaire. Wilcoxon signed-rank tests were performed to evaluate statistically significant changes. RESULTS For measurement dates T0 to T2 we had 570 complete datasets (response rate 70.81%). There was a significant decrease in reported back pain and the general state of health and quality of life index improved. Participants' emotional strain decreased and they showed an improved understanding of illness as well as of having acquired knowledge-based abilities and skills for dealing with the disease. After training, they recorded back-friendly behaviour in everyday life and opportunities to relieve strain on the spinal column were utilised at work more often. Participants' subjective assessment of their ability to work (Work Ability Index) improved. CONCLUSION The present study proved the intermediate effectiveness of the Back College curriculum. Whether these effects remain stable in the long term will be tested on the subsequent measurement date (T3, after 24 months).
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Affiliation(s)
- Bianca Kusma
- Institution for Statutory Accident Insurance in the Health and Welfare Services, Pappelallee 35/37, 22089 Hamburg, Germany
| | - Aki Pietsch
- BG Hospital Hamburg, Bergedorfer Straße 10, 21033 Hamburg, Germany
| | - Helge Riepenhof
- BG Hospital Hamburg, Bergedorfer Straße 10, 21033 Hamburg, Germany
| | - Sören Haß
- BG Nordsee Reha-Klinik, Wohldweg 7, 25826 St. Peter-Ording, Germany
| | - Daniel Kuhn
- BG Hospital Bergmannstrost Halle, Merseburger Straße 165, 06112 Halle (Saale), Germany
| | - Klaus Fischer
- BG Hospital Bergmannstrost Halle, Merseburger Straße 165, 06112 Halle (Saale), Germany
| | - Albert Nienhaus
- Institution for Statutory Accident Insurance in the Health and Welfare Services, Pappelallee 35/37, 22089 Hamburg, Germany
- Competence Centre for Epidemiology and Health Services Research for Healthcare Professionals (CVcare), University Medical Centre Hamburg-Eppendorf (UKE), Martinistrasse 52, 20246 Hamburg, Germany
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Hegewald J, Berge W, Heinrich P, Staudte R, Freiberg A, Scharfe J, Girbig M, Nienhaus A, Seidler A. Do Technical Aids for Patient Handling Prevent Musculoskeletal Complaints in Health Care Workers?-A Systematic Review of Intervention Studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E476. [PMID: 29522440 PMCID: PMC5877021 DOI: 10.3390/ijerph15030476] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Revised: 02/28/2018] [Accepted: 03/05/2018] [Indexed: 01/25/2023]
Abstract
The physical load ensuing from the repositioning and moving of patients puts health care workers at risk of musculoskeletal complaints. Technical equipment developed to aid with patient handling should reduce physical strain and workload; however, the efficacy of these aids in preventing musculoskeletal disorders and complaints is still unclear. A systematic review of controlled intervention studies was conducted to examine if the risk of musculoskeletal complaints and disorders is reduced by technical patient handling equipment. MEDLINE®/PubMed®, EMBASE®, Allied and Complementary Medicine Database (AMED), and Cumulative Index of Nursing and Allied Health Literature (CINAHL®) were searched using terms for nursing, caregiving, technical aids, musculoskeletal injuries, and complaints. Randomized controlled trials and controlled before-after studies of interventions including technical patient handling equipment were included. The titles and abstracts of 9554 publications and 97 full-texts were screened by two reviewers. The qualitative synthesis included one randomized controlled trial (RCT) and ten controlled before-after studies. A meta-analysis of four studies resulted in a pooled risk ratio for musculoskeletal injury claims (post-intervention) of 0.78 (95% confidence interval 0.68-0.90). Overall, the methodological quality of the studies was poor and the results often based on administrative injury claim data, introducing potential selection bias. Interventions with technical patient handling aids appear to prevent musculoskeletal complaints, but the certainty of the evidence according to GRADE approach ranged from low to very low.
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Affiliation(s)
- Janice Hegewald
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Wera Berge
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Philipp Heinrich
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Ronny Staudte
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Alice Freiberg
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Julia Scharfe
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Maria Girbig
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
| | - Albert Nienhaus
- Institute for Health Service Research in Dermatology and Nursing, University Clinics Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany.
- Department of Occupational Health Research, German Social Accident Insurance Institution for the Health and Welfare Service, Pappelallee 33-37, 22089 Hamburg, Germany.
| | - Andreas Seidler
- Institute and Policlinic of Occupational and Social Medicine, Faculty of Medicine, Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
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Coman RL, Caponecchia C, McIntosh AS. Manual Handling in Aged Care: Impact of Environment-related Interventions on Mobility. Saf Health Work 2018; 9:372-380. [PMID: 30559984 PMCID: PMC6284187 DOI: 10.1016/j.shaw.2018.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 01/06/2018] [Accepted: 02/20/2018] [Indexed: 11/17/2022] Open
Abstract
The manual handling of people (MHP) is known to be associated with high incidence of musculoskeletal disorders for aged care staff. Environment-related MHP interventions, such as appropriate seated heights to aid sit-to-stand transfers, can reduce staff injury while improving the patient's mobility. Promoting patient mobility within the manual handling interaction is an endorsed MHP risk control intervention strategy. This article provides a narrative review of the types of MHP environmental controls that can improve mobility, as well as the extent to which these environmental controls are considered in MHP risk management and assessment tools. Although a range of possible environmental interventions exist, current tools only consider these in a limited manner. Development of an assessment tool that more comprehensively covers environmental strategies in MHP risk management could help reduce staff injury and improve resident mobility through auditing existing practices and guiding the design of new and refurbished aged care facilities.
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Affiliation(s)
- Robyn L Coman
- Work Health and Safety (WHS) Academic Program, School of Health & Society, Faculty of Social Sciences, University of Wollongong, NSW, Australia
| | - Carlo Caponecchia
- School of Aviation, University of New South Wales (UNSW), Sydney, NSW, Australia
| | - Andrew S McIntosh
- Monash University Accident Research Centre, Monash University, Melbourne, Australia.,Australian Collaboration for Research into Injury in Sports and its Prevention, Federation University, Ballarat, Vic., Australia
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Nolan D, O'Sullivan K, Stephenson J, O'Sullivan P, Lucock M. What do physiotherapists and manual handling advisors consider the safest lifting posture, and do back beliefs influence their choice? Musculoskelet Sci Pract 2018; 33:35-40. [PMID: 29078081 DOI: 10.1016/j.msksp.2017.10.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 10/16/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND It is commonly believed lifting is dangerous and the back should be straight during lifting. These beliefs may arise from healthcare professionals, yet no study has evaluated the lifting and back beliefs of manual handling advisors (MHAs) and physiotherapists (PTs). OBJECTIVES To evaluate (i) what lifting technique MHAs and PTs perceive as safest, and why, and (ii) the back pain beliefs of MHAs and PTs. DESIGN Data was collected via an electronic survey. METHOD Participants selected the safest lifting posture from four options: two with a straight back and two with a more rounded back, with justification. Back beliefs were collected via the Back-Pain Attitudes Questionnaire (Back-PAQ). Relationships were investigated using multiple linear and logistic regression models. RESULTS 400 PTs and MHAs completed the survey. 75% of PTs and 91% of MHAs chose a straight lifting posture as safest, mostly on the basis that it avoided rounding of the back. MHAs scored significantly higher than PTs on the Back-PAQ instrument (mean difference = 33.9), indicating more negative back beliefs. Those who chose the straight back position had significantly more negative back beliefs (mean 81.9, SD 22.7) than those who chose a round back lift (mean 61.7, SD 21.1). CONCLUSION Avoiding rounding the back while lifting is a common belief in PTs and MHAs, despite the lack of evidence that any specific spinal posture is a risk factor for low back pain. MHAs, and those who perceived a straight back position as safest, had significantly more negative back beliefs.
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Affiliation(s)
- David Nolan
- Occupational Health, South West Yorkshire Partnership NHS Foundation Trust, Fieldhead Hospital, Outchthorpe Lane, Wakefield, WF1 3SP, UK.
| | - Kieran O'Sullivan
- Department of Clinical Therapies, University of Limerick, Limerick, Ireland; Sports Spine Centre, Aspetar Orthopaedic and Sports Medicine Hospital, Doha, Qatar
| | - John Stephenson
- Department of Health Sciences, University of Huddersfield, Huddersfield, HD1 3DH, UK
| | - Peter O'Sullivan
- School of Physiotherapy and Exercise Science, Curtin University, Bentley, Australia; Body Logic Physiotherapy Clinic, Shenton Park, Australia
| | - Michael Lucock
- Centre for Applied Research in Health, University of Huddersfield, HD1 3DH, UK; South West Yorkshire Partnership NHS Foundation Trust, UK
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The efficacy of interventions for low back pain in nurses: A systematic review. Int J Nurs Stud 2018; 77:222-231. [DOI: 10.1016/j.ijnurstu.2017.10.015] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 10/19/2017] [Accepted: 10/23/2017] [Indexed: 12/13/2022]
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35
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White-Heisel R, Canfield JP, Young-Hughes S. Examining the Factor Structure and Reliability of the Safe Patient Handling Perception Scale: An Initial Validation Study. Rehabil Nurs 2017; 42:164-171. [PMID: 29244044 DOI: 10.1002/rnj.262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE Perceiving imminent safe patient handling and movement (SPH&M) dangers may reduce musculoskeletal (MSK) injuries for nurses in the workplace. The purpose of this study is to develop and validate the 17-item Safe Patient Handling Perception Scale (SPHPS) as an evaluation instrument assessing perceptual risk of MSK injury based on SPH&M knowledge, practice, and resource accessibility in the workplace. METHODS Data were collected from a convenience sample (N = 117) of nursing employees at a Veteran Affairs Medical Center. Factor analysis identified three factors: knowledge, practice, and accessibility. FINDINGS The SPHPS demonstrated high levels of reliability, supported by acceptable alpha scores (SPHM knowledge [α = .866], SPHM practices [α = .901], and access to SPHM resources [α = .855]), in addition to the relatively low standard error of measurement scores (SEM). CONCLUSION The study outcomes suggest that the SPHPS is a valid and reliable tool that can measure participants' perceived risk factors for MSK injuries.
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Affiliation(s)
- Regina White-Heisel
- 1 Cincinnati Veterans' Affairs Medical Center CBOC, Hamilton, OH, USA2 University of Cincinnati, Cincinnati, OH, USA3 Cincinnati Veterans' Affairs Medical Center, Cincinnati, OH, USA
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Villarroya A, Arezes P, Díaz de Freijo S, Fraga F. Validity and reliability of the HEMPA method for patient handling assessment. APPLIED ERGONOMICS 2017; 65:209-222. [PMID: 28802441 DOI: 10.1016/j.apergo.2017.06.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 05/03/2017] [Accepted: 06/24/2017] [Indexed: 05/23/2023]
Abstract
Specific methods currently exist to assess occupational hazards resulting from patient handling in the healthcare sector, according to ISO/TR 12296. They are all similar in nature, but with a different analysis perspective; for that reason a comparison of the most relevant methods was performed in a previous research. As a result, a basis of a new tool that integrates the complementary aspects of those methods was proposed. To verify the validity and reliability of that method, a study within a hospital setting was carried out in five medical and surgical units of a public health institution. Based on the obtained results, the analysed method (called HEMPA) proved to be valid and reliable. Also, this method reflects a positive correlation between risk and damage and correctly quantifies risks regarding patient's dependence.
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Affiliation(s)
- A Villarroya
- Lucus Augusti Hospital, Servizo Galego de Saúde, Rúa Dr. Ulises Romero, nº 1, 27004 Lugo, Spain.
| | - P Arezes
- Research Centers for Industrial and Technology Management & Algoritmi, School of Engineering, University of Minho, 4800-058 Guimarães, Portugal.
| | - S Díaz de Freijo
- Department of Applied Physics, Faculty of Science, University of Santiago de Compostela, Lugo, Spain.
| | - F Fraga
- Department of Applied Physics, Faculty of Science, University of Santiago de Compostela, Lugo, Spain.
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Ngo BPT, Yazdani A, Carlan N, Wells R. Lifting Height as the Dominant Risk Factor for Low-Back Pain and Loading During Manual Materials Handling: A Scoping Review. IISE Trans Occup Ergon Hum Factors 2017. [DOI: 10.1080/24725838.2017.1338633] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Affiliation(s)
| | - Amin Yazdani
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Nicolette Carlan
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
| | - Richard Wells
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, ON N2L 3G1, Canada
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Perceptions of Nursing and Physical Therapy Students Toward Peer-Led Interprofessional Education in Manual Handling. Nurse Educ 2017; 42:E1-E6. [DOI: 10.1097/nne.0000000000000319] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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The BASE-Program-A Multidimensional Approach for Health Promotion in Companies. Healthcare (Basel) 2016; 4:healthcare4040091. [PMID: 27941643 PMCID: PMC5198133 DOI: 10.3390/healthcare4040091] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/16/2016] [Accepted: 12/05/2016] [Indexed: 11/17/2022] Open
Abstract
Multidimensional assessments for conducting interventions are needed to achieve positive health effects within companies. BASE is an acronym, consisting of B = "Bedarfsbestimmung" (requirements); A = "Arbeitsplatzorganisation" (organisation of work); S = "Schulung des belastungsverträglichen Alltagshandelns" (coaching preventive behaviour at work); E = "Eigenverantwortung und Selbstwirksamkeit" (self-responsibility and self-efficacy). It is a prevention program designed to avoid and reduce work-related musculoskeletal diseases. It was developed to support prevention strategies within companies. It comprises aspects of health protection, ergonomics, exercise and self-efficacy. A comprehensive assessment will identify strain e.g., musculoskeletal discomforts due to body positions or psychological stress. Moreover, the general health status, preferences and barriers for participating in health promotion programs are evaluated. This analysis leads to practical and goal-oriented recommendations and interventions which suit the needs of companies and employees. These are executed onsite in real workplace situations and involve the introduction of first-hand experience in behavioural change. Therefore, this practical approach enhances the employees' acceptance and self-efficacy for health promotion. This can result in long-term health promoting behaviour. This article presents the outcome and sustainability effects of BASE in three different application fields (logistic, industrial and office workers).
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Vieira ER, Schneider P, Guidera C, Gadotti IC, Brunt D. Work-related musculoskeletal disorders among physical therapists: A systematic review. J Back Musculoskelet Rehabil 2016; 29:417-28. [PMID: 26577282 DOI: 10.3233/bmr-150649] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Physical therapists (PTs) perform demanding tasks that can lead to work-related musculoskeletal disorders (WMSD), but the rates and characteristics of WMSD among PTs are not well known. The objective of this systematic review of the literature was to integrate the information published on the prevalence, types, and risks for WMSD among PTs. Four databases were searched using combinations and synonyms for WMSD, discomfort, symptoms, and PTs. Two reviewers independently searched and screened peer-reviewed articles published in English evaluating WMSD in PTs; agreement between reviewers was evaluated. From 867 unduplicated articles, 32 were eligible and included. Up to 90% of PTs have WMSD during their careers; 50% experience WMSD within 5 years of practice. Low back was the body part most commonly affected. Female PTs and PTs working in hospitals have higher prevalence of WMSD. WMSD are associated with PTs' age, gender, specialty and job tasks. Performing manual therapy, lifting and transferring patients are tasks commonly associated with PTs' developing WMSD. The body parts affected differed by specialty and tasks. The findings presented in this review are useful to inform future research, quality improvement, and educational programs to reduce the rates of WMSD among PTs.
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41
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Palesy D. Australian Home Care Workers’ Learning of Safe Manual Handling. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2016. [DOI: 10.1177/1084822316636617] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
How home care workers adapt what they learn in manual handling classroom training sessions to their workplaces (i.e., their clients’ homes) is central to their own safety, as their musculoskeletal injuries continue to occur at unacceptably high rates. For this inquiry, new workers were directly observed in their workplaces following classroom training. Findings from these observations propose three environmental considerations for supporting new workers to learn safe manual handling techniques: (1) The physical setting for manual handling is important, (2) clients and their significant others may offer a valuable form of learning support, and (c) when initially learning the requirements for their roles, new workers should be encouraged to focus only on the manual handling tasks at hand.
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Affiliation(s)
- Debra Palesy
- University of Technology Sydney, New South Wales, Australia
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Abstract
How home healthcare aides (HHAs) adapt their classroom training to their workplaces is central to their own safety and that of their care recipients. A qualitative approach was adopted for this inquiry, where new workers were interviewed in-depth following their classroom training. Findings suggest a perceived lack of supervisor support for classroom training and lack of follow-up in the workplace. Moreover, the need for more peer support was contended, and more comprehensive written materials in clients' homes may also assist workers' learning and enacting safe manual handling techniques in the workplace. The article concludes with recommendations for supporting HHAs' learning, and includes suggestions for future research.
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Sheppard PS, Stevenson JM, Graham RB. Sex-based differences in lifting technique under increasing load conditions: A principal component analysis. APPLIED ERGONOMICS 2016; 54:186-195. [PMID: 26851478 DOI: 10.1016/j.apergo.2015.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 08/25/2015] [Accepted: 12/04/2015] [Indexed: 06/05/2023]
Abstract
The objective of the present study was to determine if there is a sex-based difference in lifting technique across increasing-load conditions. Eleven male and 14 female participants (n = 25) with no previous history of low back disorder participated in the study. Participants completed freestyle, symmetric lifts of a box with handles from the floor to a table positioned at 50% of their height for five trials under three load conditions (10%, 20%, and 30% of their individual maximum isometric back strength). Joint kinematic data for the ankle, knee, hip, and lumbar and thoracic spine were collected using a two-camera Optotrak motion capture system. Joint angles were calculated using a three-dimensional Euler rotation sequence. Principal component analysis (PCA) and single component reconstruction were applied to assess differences in lifting technique across the entire waveforms. Thirty-two PCs were retained from the five joints and three axes in accordance with the 90% trace criterion. Repeated-measures ANOVA with a mixed design revealed no significant effect of sex for any of the PCs. This is contrary to previous research that used discrete points on the lifting curve to analyze sex-based differences, but agrees with more recent research using more complex analysis techniques. There was a significant effect of load on lifting technique for five PCs of the lower limb (PC1 of ankle flexion, knee flexion, and knee adduction, as well as PC2 and PC3 of hip flexion) (p < 0.005). However, there was no significant effect of load on the thoracic and lumbar spine. It was concluded that when load is standardized to individual back strength characteristics, males and females adopted a similar lifting technique. In addition, as load increased male and female participants changed their lifting technique in a similar manner.
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Affiliation(s)
- P S Sheppard
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - J M Stevenson
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada
| | - R B Graham
- School of Kinesiology and Health Studies, Queen's University, Kingston, Ontario, Canada; School of Human Kinetics, University of Ottawa, Ottawa, Ontario, Canada.
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Suni JH, Rinne M, Kankaanpää M, Taulaniemi A, Lusa S, Lindholm H, Parkkari J. Neuromuscular exercise and back counselling for female nursing personnel with recurrent non-specific low back pain: study protocol of a randomised controlled trial (NURSE-RCT). BMJ Open Sport Exerc Med 2016; 2:e000098. [PMID: 27900169 PMCID: PMC5117067 DOI: 10.1136/bmjsem-2015-000098] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/01/2016] [Indexed: 12/19/2022] Open
Abstract
Introduction Nursing personnel have high risk for incidence of low back pain (LBP) followed by development of chronic pain and disability. Multiple risk factors such as patient handling, night shift work and lack of supporting work culture have been identified. In subacute LBP, high-fear avoidance is prognostic for more pain, disability and not returning to work. Lack of leisure-time physical activity predicts long-term sickness absence. The purpose of this study is to compare effectiveness of 6-month neuromuscular exercise and counselling in treating back pain in female nursing personnel with recurrent non-specific LBP pain compared with either (exercise or counselling) alone and a non-treatment control group. Methods and analysis The design is of a double-blinded four-arm randomised controlled trial with cost-effectiveness evaluation at 12 and 24 months. The study is conducted in 3 consecutive substudies. The main eligibility criteria are experience of LBP during the past 4 weeks with intensity of at least 2 (Numeric Rating Scale 0–10) and engagement in patient handling. Sample size was estimated for the primary outcome of pain intensity (visual analogue scale). Study measurements are outlined according to the model of International Classification of Functioning, Disability and Health, which incorporates the biopsychosocial processes assessed. Ethics and dissemination This study is carried out conforming to the guidelines of good scientific practice and provisions of the declaration of Helsinki. Increasing physical and mental capacity with interventions taking place immediately after working hours near the worksite may reduce development of chronic LBP and work disability in female nursing personnel with recurrent non-specific LBP. Trial registration number NCT04165698.
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Affiliation(s)
- Jaana H Suni
- UKK Institute for Health Promotion Research , Tampere , Finland
| | - Marjo Rinne
- UKK Institute for Health Promotion Research , Tampere , Finland
| | - Markku Kankaanpää
- Pirkanmaa Hospital District, Physical and Rehabilitation Medicine Outpatient Clinic , Tampere , Finland
| | | | - Sirpa Lusa
- Finnish Institute of Occupational Medicine , Helsinki , Finland
| | - Harri Lindholm
- Finnish Institute of Occupational Medicine , Helsinki , Finland
| | - Jari Parkkari
- UKK Institute for Health Promotion Research , Tampere , Finland
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Yoo IG, Yoo WG. Effects of different lifting and lowering heights on upper arm, shoulder and back muscle activity during a manual material handling task. Work 2015; 53:175-9. [PMID: 26409400 DOI: 10.3233/wor-152157] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Previous research has suggested eliminating certain types of manual material handling (MMH) work by recommending specific arm angles and postures to avoid, such as arm flexion or abduction over 90°. MMH with arm flexion over 90° can require lifting objects as well as lowering objects. However, few studies have evaluated MMH work while lowering objects in detail. OBJECTIVE This study investigated the effects of different lifting and lowering heights on upper arm, shoulder, and back muscle activity during a MMH task. METHODS The participants performed a MMH task that involved stoop lowering and lifting. The participants transferred the box to shelves positioned 30 cm in front of them under various conditions. Conditions 1 to 4 involved transferring the box to 1) ankle-, 2) knee-, 3) waist-, and 4) shoulder-high shelves, respectively. Surface electrodes were attached to the biceps brachii, upper trapezius, rhomboid minor, and L4 erector spinae. RESULTS The activity of the biceps brachii was decreased significantly in Conditions 1 and 2 compared to Conditions 3 and 4. The upper trapezius activity was increased significantly in Conditions 1 and 4 compared to Conditions 2 and 3. The rhomboid minor activity increased significantly in Condition 1 compared to Conditions 2 to 4. The L4 erector spinae activity decreased significantly in Condition 1 compared to Conditions 2 to 4 CONCLUSIONS:A low-lowering MMH work could contribute to neck, shoulder, and back pain. Therefore, further studies must examine a height below-knee MMH work in detail.
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Affiliation(s)
- In-gyu Yoo
- Department of Occupational Therapy, College of Medical Sciences, Jeonju University, Republic of Korea
| | - Won-gyu Yoo
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Gimhae, Republic of Korea
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Schaafsma FG, Anema JR, van der Beek AJ. Back pain: Prevention and management in the workplace. Best Pract Res Clin Rheumatol 2015; 29:483-94. [PMID: 26612243 DOI: 10.1016/j.berh.2015.04.028] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Despite all the efforts in studying work-related risk factors for low back pain (LBP), interventions targeting these risk factors to prevent LBP have no proven cost-effectiveness. Even with adequate implementation strategies for these interventions on group level, these did not result in the reduction of incident LBP. Physical exercise, however, does have a primary preventive effect on LBP. For secondary prevention, it seems that there are more opportunities to cost-effectively intervene in reducing the risk of long-term sickness absence due to LBP. Starting at the earliest moment possible with proper assessment of risk factors for long-term sickness absence related to the individual, the underlying mechanisms of the LBP, and also factors related to the workplace by a well-trained clinician, may increase the potential of effective return to work (RTW) management. More research on how to overcome barriers in the uptake of these effective interventions in relation to policy-specific environments, and with regard to proper financing of RTW management is necessary.
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Affiliation(s)
- Frederieke G Schaafsma
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Research Centre for Insurance Medicine, Collaboration Between AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands.
| | - Johannes R Anema
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Research Centre for Insurance Medicine, Collaboration Between AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Research Centre for Insurance Medicine, Collaboration Between AMC-UMCG-UWV-VUmc, Amsterdam, The Netherlands; Body@Work, Research Center Physical Activity, Work and Health, TNO-VU University Medical Center, Amsterdam, The Netherlands
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Abstract
This paper reviews scientific research on occupational back pain and focuses on prevention of this problem. It discusses some of the challenges of translating the evidence of this multi-factorial condition into policy. Medical science is currently unable to clearly distinguish between back pain caused by work and that possibly due to other causes but which affects the individual's capacity to work. Back pain affects the vast majority of people at some point in their lives and is very costly to both the health care system and the industry. Evidence suggests that heavy lifting, driving, and vibration of the whole body are linked to occupational back pain. Once the risk factors for occupational back pain are identified, an otherwise chronic and disabling condition can be prevented in the majority of patients. As explained in this article, three levels of prevention for occupational back pain have been reported as effective. Failure to implement preventive measures may lead to a high incidence of occupational back pain.
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Affiliation(s)
- Sultan T Al-Otaibi
- Department of Family and Community Medicine, University of Dammam, College of Medicine, Dammam, Kingdom of Saudi Arabia
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Swiss ball enhances lumbar multifidus activity in chronic low back pain: A letter to the editor. Phys Ther Sport 2015; 16:202-3. [PMID: 25840522 DOI: 10.1016/j.ptsp.2015.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 03/03/2015] [Indexed: 11/21/2022]
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Mc Grath M, Taaffe C, Gallagher A. An exploration of knowledge and practice of patient handling among undergraduate occupational therapy students. Disabil Rehabil 2015; 37:2375-81. [PMID: 25738909 DOI: 10.3109/09638288.2015.1019012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To explore knowledge and practice relating to patient handling among final year occupational therapy students in the Republic of Ireland. METHOD We conducted a survey of final year students in three out of four occupational therapy programs in the Republic of Ireland (n = 81). The survey measured students' knowledge of manual handling principles and techniques and explored their experiences and ability to apply this knowledge to clinical situations. RESULTS All students (n = 81) had undertaken training in patient handling. Just under half of students (n = 35, 43.2%) had received additional training outside of the university setting. Overall knowledge of safe patient handling principles techniques and risk assessment was low (Mean Score = 15.71/28; SD = 3.81). Participants who received additional training achieved a lower mean total score (M = 13.89, SD = 3.54) than those who only undertook university-based training (M = 18.11; SD = 2.66; t(79) = -5.87; p < 0.05). The majority of participants reported intermittent use of taught principles while on clinical practice placements (n = 50, 61.8%) Reasons for not using taught principles included; selection of alternative technique by supervisor (n = 30, 56.6%); lack of available equipment (n = 13, 24.5%) and lack of time (n = 13, 24.5%). CONCLUSIONS While occupational therapy students in Ireland receive training in safe patient handling they appear to have limited knowledge of best practice and experience difficulties in applying their learning to clinical situations. There is an urgent need to consider the effectiveness of current educational strategies in this area. Implications for Rehabilitation Safe patient handling is a key component in preventing musculoskeletal injury among rehabilitation professionals The extent to which pre-professional training prepares rehabilitation professionals to practice safe patient handling is unclear Occupational therapy students in this study had limited knowledge of safe patient handling and had difficulty applying their learning to clinical practice Alternative education models are required to support development of safe patient handling skills. Educators may wish to consider how safe patient handling can be embedded across curricula to avoid the challenges of once off instruction and massed practice.
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Affiliation(s)
- Margaret Mc Grath
- a Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine , Nursing and Health Sciences, National University of Ireland , Galway , Ireland and
| | - Ciara Taaffe
- a Discipline of Occupational Therapy, School of Health Sciences, Faculty of Medicine , Nursing and Health Sciences, National University of Ireland , Galway , Ireland and
| | - Aideen Gallagher
- b Ryde Community Mental Health , Eastwood , New South Wales , Australia
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Varcin L, Claus A, van den Hoorn W, Hodges P. Manual handling: differences in perceived effort, success rate and kinematics between three different pushing techniques. ERGONOMICS 2014; 58:268-277. [PMID: 25343518 DOI: 10.1080/00140139.2014.970586] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
This study examined the perceived effort, success rates and kinematics for three push strategies in a simulated lateral patient transfer (horizontal slide). Thirteen healthy subjects (four males) completed three repetition pushing loads of 6, 10 and 14 kg in random order; with a spontaneous push strategy, then with a straight-back bent-knees (squat) strategy and the preparatory pelvic movement ('rockback') strategy in random order. Perceived effort and kinematic parameters measured at the onset of movement and at maximum push excursion were compared between strategies and between loads with repeated measures ANOVA. The spontaneous and 'rockback' strategies achieved the pushing task with less perceived effort across all loads than the squat push (P < 0.001). Only 3/13 participants were successful on all attempts at pushing the 14 kg load using a squat strategy, which contrasted with 12/13 participants when the spontaneous strategy or the 'rockback' strategy was used. Forward movement of the pelvis and forward trunk inclination may be positively associated with lower perceived effort in the push task. Practitioner Summary: In a manual-handling task that simulated a lateral patient transfer (horizontal slide), perceived effort and success rates of three push strategies were compared. A straight-back bent-knees push (squat) strategy demonstrated greater perceived effort and lower success rates than a spontaneous push strategy, or a push strategy with preparatory 'rockback' pelvic movement.
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Affiliation(s)
- Lynn Varcin
- a School of Health and Rehabilitation Sciences, Centre of Clinical Research Excellence in Spinal Pain, Injury and Health, The University of Queensland , Brisbane , Australia
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