Effects of asymmetrical stance and movement on body rotation in pushing

Pushing objects in the presence of body asymmetries could increase the risk of back injury. Furthermore, when the object is heavy, it could exacerbate the effects induced by asymmetrical posture. We investigated how the use of asymmetrical posture and/or upper extremity movement affect vertical torque (Tz) and center of pressure (COP) displacement during pushing. Ten healthy volunteers were instructed to push objects of three different weights using two hands (symmetrical hand use) or one hand (asymmetrical hand use) while standing in symmetrical or asymmetrical foot-positions. The peak values of Tz and COP displacement in the medial-lateral direction (COPML) were analyzed. In cases of isolated asymmetry, changes in the Tz were mainly linked with effects of hand-use whereas effects of foot-position dominated changes in the COPML displacement. In cases of a combined asymmetry, the magnitudes of both Tz and COPML were additive when asymmetrical hand-use and foot-position induced the rotation of the lower and upper body in the same direction or subtractive when asymmetries resulted in the rotation of the body segments in the opposite directions. Moreover, larger Tz and COP displacements were seen when pushing the heavy weight. The results point out the importance of using Tz and COPML to describe the isolated or combined effects of asymmetrical upper extremity movement and asymmetrical posture on body rotation during pushing. Furthermore, it suggests that a proper combination of unilateral arm movement and foot placements could help to reduce body rotation even when pushing heavy objects.

It’s not about the hoist: A narrative literature review of manual handling in healthcare

The manual handling of people and objects is integral to the provision of nursing care to patients globally. Despite over 30 years of research intended to guide improvements for nurses’ safety, substantial rates of manual handling injuries persist internationally within the nursing profession. This paper reviews the contemporary international literature regarding manual handling interventions noting the unique context for injury prevention strategies within healthcare. The review includes the recognition of underlying assumptions inherent in the conceptualisation of manual handling and its management, and the preponderance of the post-positivist paradigm in this field.

The complexity of manual handling in healthcare has resulted in a theoretical shift from single factor interventions based on technique training towards an emerging multidimensional approach. However the key elements for sustainable solutions to reduce nurses’ manual handling injuries have not yet been identified and consensus is lacking regarding the implementation and appropriate evaluation of injury prevention programmes. Furthermore, whilst the literature is replete with data derived from surveys or insurance industry records of compensation claims, there is a dearth of literature exploring nurses’ manual handling experiences. The in-depth investigation of nurses’ perspectives on manual handling may uncover new knowledge critical to improvement of the manual handling issues.

Causal assessment of occupational pushing or pulling and low back pain: results of a systematic review

BACKGROUND CONTEXT

Low back pain (LBP) is a prevalent and expensive musculoskeletal condition that predominantly occurs in working-age individuals of industrialized nations. Although numerous occupational physical activities have been implicated in its etiology, determining the causation of occupational LBP still remains a challenge.

PURPOSE

To conduct a systematic review evaluating the causal relationship between occupational pushing or pulling and LBP.

STUDY DESIGN

Systematic review of the literature.

SAMPLE

Studies reporting an association between occupational pushing or pulling and LBP.

OUTCOME MEASURES

Numerical association between exposure to pushing or pulling and the presence of LBP.

METHODS

A systematic review was performed to identify, evaluate, and summarize the literature related to establishing a causal relationship, according to Bradford-Hill criteria for causation for occupational pushing or pulling and LBP. A search was conducted using Medline, EMBASE, CINAHL, Cochrane Library, and OSH-ROM, gray literature, hand-searching occupational health journals, reference lists of included studies, and expert knowledge. Methodological quality was assessed using a modified Newcastle-Ottawa Scale.

RESULTS

This search yielded 2,766 citations. Thirteen studies met the inclusion criteria. Eight were high-quality studies and five were low-quality studies. There was conflicting evidence with one high-quality study demonstrating a positive association between occupational pushing or pulling and LBP and five studies showing no relationship. One study reported a nonstatistically significant dose-response trend, four studies discussed temporality of which one indicated a positive finding, two studies discussed the biological plausibility of a causal link between occupational pushing or pulling and LBP, and no evidence was uncovered to assess the experiment criterion.

CONCLUSIONS

A qualitative summary of existing studies was not able to find any high-quality studies that fully satisfied any of the Bradford-Hill causation criteria for occupational pushing or pulling and LBP. Based on the evidence reviewed, it is unlikely that occupational pushing or pulling is independently causative of LBP in the populations of workers studied.