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Williams B, Johnson D. Effects of the NeuroHAB Program on Low Back Pain and Oswestry Disability Index Scores: A Retrospective Wait-List Control Study. J Funct Morphol Kinesiol 2024; 9:118. [PMID: 39051279 PMCID: PMC11270219 DOI: 10.3390/jfmk9030118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Revised: 06/28/2024] [Accepted: 06/28/2024] [Indexed: 07/27/2024] Open
Abstract
Movement theory and the study of movement dysfunction mark a paradigm shift in the treatment of low back pain symptoms, the majority of which are mechanical in origin at the outset. Treating movement dysfunction centers around unified and consistent rehabilitation that defines proficient movement for the lumbopelvic spine. The purpose of this study is to document the improvement in pain and disability of 290 patients who underwent NeuroHAB Functional Movement Therapy to reverse their lumbopelvic movement dysfunction attributed to causing their back pain symptoms between 2019 and 2023. Oswestry Disability Index (ODI) scores were collected from each participant on three occasions: the first consultation, after a waiting period/pre-intervention, and after the eight-week intervention. A single-factor ANOVA of all three ODI data sets was conducted, along with supporting descriptive statistics. A post-hoc t-test pairwise comparison was conducted for accuracy. The average ODI 1 score (taken at the first consultation) was 15.26 ± 6.1% (CI: 14.3-16.2); ODI 2 (after a waiting period, before NeuroHAB) was 14.71 ± 6.0% (CI: 13.82-15.59); and ODI 3 (post-intervention) was 9.09 ± 8.6% (CI: 8.305-9.875). There was no significant change from ODI 1 to ODI 2 (between the consultation and waitlist control periods). However, a significant reduction between ODI 2 and ODI 3 was observed (pre- and post-intervention) (mean difference: 5.62, p ≤ 0.001), and a 40.41% reduction was observed between ODI 1 (the ODI score taken at the first consultation) and ODI 3 (the ODI score taken after NeuroHAB, post-intervention) (mean difference: 6.17, p ≤ 0.001). A 50% ODI reduction was reported in the "Crippled" category (mean difference 16.15, p ≤ 0.001). The inclusion of functional movement proficiency and stability in future guidelines is a necessary step towards meaningful improvement in epidemic levels of back pain-related clinical and economic morbidity.
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Affiliation(s)
- Brogan Williams
- The Back Pain and Functional Movement Training Centre, Brisbane, QLD 4102, Australia
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Carayannopoulos A, Johnson D, Lee D, Giuffrida A, Poply K, Mehta V, Amann M, Santillo D, Ghandour Y, Koch A, Langhorst M, Heros R. Precision Rehabilitation After Neurostimulation Implantation for Multifidus Dysfunction in Nociceptive Mechanical Chronic Low Back Pain. Arch Rehabil Res Clin Transl 2024; 6:100333. [PMID: 39006113 PMCID: PMC11240036 DOI: 10.1016/j.arrct.2024.100333] [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] [Indexed: 07/16/2024] Open
Abstract
Chronic low back pain (CLBP) is a debilitating, painful, and costly condition. Implantable neuromuscular electrical stimulation targeting the multifidus musculature is growing as a non-pharmacologic option for patients with recalcitrant nociceptive mechanical CLBP who have failed conservative treatments (including medications and physical therapy) and for whom surgery is not indicated. Properly selecting patients who meet specific criteria (based on historical results from randomized controlled trials), who diligently adhere to implant usage and precisely implement neuromuscular rehabilitation, improve success of significant functional recovery, as well as pain medication reductions. Patients with nociceptive mechanical CLBP who underwent implanted multifidus neurostimulation have been treated by physicians and rehabilitation specialists who have honed their experience working with multifidus neurostimulation. They have collaborated on consensus and evidence-driven guidelines to improve quality outcomes and to assist providers when encountering patients with this device. Physicians and physical therapists together provide precision patient-centric medical management with quality neuromuscular rehabilitation to encourage patients to be experts of both their implants and quality spine motion to help override long-standing multifidus dysfunction related to their CLBP.
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Affiliation(s)
- Alexios Carayannopoulos
- Departments of Neurosurgery and Neurology, Brown University/Warren Alpert Medical School, Providence, RI
| | - David Johnson
- A City to Coast Neurosurgery, Brisbane, Queensland, Australia
| | - David Lee
- Fullerton Orthopedic Surgery Medical Group, Fullerton, CA
| | - Anthony Giuffrida
- Cantor Spine Center, Paley Orthopedic & Spine Institute, Fort Lauderdale, FL
| | - Kavita Poply
- Queen Mary University of London/St. Bartholomew's Hospital/Health NHS Trust, London, UK
| | - Vivek Mehta
- St. Bartholomew's Hospital/Health NHS Trust, London, UK
| | - Marco Amann
- Orthopädische Klinik Schloss Werneck, Germany
| | | | - Yousef Ghandour
- Physical Rehabilitation Network/University of St. Augustine for Health Sciences, San Diego, CA
| | - Amy Koch
- Methodist Health System, Omaha, NE
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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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Kolber MJ, Hanney WJ, Burleigh C, Ramirez J, Bennett J. Application of a nonlinear periodization program among firefighters returning to full duty from an injury: A case series. Physiother Theory Pract 2024; 40:418-429. [PMID: 36093847 DOI: 10.1080/09593985.2022.2117580] [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: 03/16/2022] [Accepted: 08/19/2022] [Indexed: 10/14/2022]
Abstract
OBJECTIVE The purpose of this case series was to observe physical performance changes following an 8-week nonlinear periodization training program on firefighters currently on light duty who were cleared to participate in full physical activities. METHODS Two firefighters underwent an 8-week nonlinear periodization program. Participant 1 was returning from anterior cruciate ligament reconstruction and participant 2 from a non-surgical low back injury. The Incumbent Physical Ability Test (IPAT), 2-minute push-up test, 300-yard shuttle, and Gerkin protocol testing were assessed at baseline, week 4, and week 8. OUTCOMES Both participants demonstrated improvement in assessments of physical performance and fitness across each assessment point, with exception of the Gerkin protocol, and were able to return to full duty at the conclusion of their rehabilitation training program. CONCLUSION The physical demands of tactical professionals such as firefighters exceed those of the general population. As such, these individuals require both job-specific programming and assessments when transitioning from an injury to full duty. An 8-week nonlinear periodization program yielded improvements in performance of firefighting tasks and physical fitness in two firefighters returning to full duty after injury and highlighted effective interprofessional collaboration between the physical therapy and fitness team.
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Affiliation(s)
- Morey J Kolber
- Department of Physical Therapy, Nova Southeastern University , Fort Lauderdale
| | - William J Hanney
- School of Kinesiology and Physical Therapy, University of Central Florida, Orlando
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Armstrong DP, Beach TAC, Fischer SL. The Influence of Contextual and Theoretical Expertise on Generic and Occupation-Specific Lifting Strategy. HUMAN FACTORS 2024:187208231223429. [PMID: 38299447 DOI: 10.1177/00187208231223429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
OBJECTIVE To determine whether (i) low back loads and/or (ii) kinematic coordination patterns differed across theoretical expert, contextual expert and novice groups when completing both generic and occupation-specific lifts. BACKGROUND Experience has been proposed as a factor that could reduce biomechanical exposures in lifting, but the literature reports mixed effects. The inconsistent relationship between experience and exposures may be partially attributable to the broad classification of experience and experimental lifting protocols not replicating the environment where experience was gained. METHODS Purposive sampling was used to recruit 72 participants including theoretical experts (formal training on lifting mechanics), contextual experts (paramedics), and novices. Participants performed 10 barbell and crate (generic) lifts, as well as backboard and stretcher (occupation-specific) lifts while whole-body kinematics and ground reaction forces were collected. Peak low back compression and anteroposterior shear loads normalized to body mass, as well as kinematic coordination patterns, were calculated as dependent variables. RESULTS No significant differences in low back loads were observed across expertise groups. However, significant differences were seen in kinematic coordination patterns across expertise groups in occupation-specific lifts, but not in generic lifts. CONCLUSION Increasing expertise is unlikely to minimize low back loads in lifting. However, contextual expertise did influence lifting kinematics, but only when performing occupationally specific lifts. APPLICATION Contextual expertise may help lifters adopt lifting kinematics that enhance the tolerance of their musculoskeletal system to withstand applied loads, but does not seem to reduce the applied low back loads relative to noncontextual expert groups.
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Gerstner GR, Trivisonno AJ, Laffan MR, Giuliani-Dewig HK, Mota JA, Register-Mihalik JK, Ryan ED. Impact of Age on the Affective Responses Following Worksite Resistance Exercise in Career Firefighters. Med Sci Sports Exerc 2023; 55:2263-2270. [PMID: 37443454 DOI: 10.1249/mss.0000000000003253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/15/2023]
Abstract
INTRODUCTION The purpose of this study was to examine the impact of age on the affective responses (attitude, feelings, self-efficacy, intention, enjoyment, and fondness) after a worksite circuit-style resistance exercise routine in career firefighters. METHODS Nineteen young (25.5 ± 3.3 yr) and 19 middle-aged male career firefighters (50.3 ± 3.5 yr) completed 2 d of physical testing at local fire stations. Participants were familiarized with the resistance training exercises (deadlift, shoulder press, lunge, and upright row) at visit 1 and performed a multirepetition maximum (RM) assessment to prescribe the appropriate loads for the resistance exercise bout on visit 2. The resistance training session included three sets of 8 to 10 repetitions per exercise at 80% 1-RM. Participants completed a postexercise questionnaire examining affective responses and a rating of perceived exertion (RPE). Mann-Whitney U tests and an independent t-test were used to determine differences between the young and middle-aged firefighters' affective responses and RPE, respectively. RESULTS There were no significant differences between groups for any of the six affective responses ( P = 0.062-0.819) or RPE ( P = 0.142). CONCLUSIONS Age did not influence the perceived effort or affective responses following an acute bout of worksite resistance exercise. Firefighters reported overall positive attitudes, feelings, and fondness paired with high self-efficacy and intention at a training frequency of twice per week. However, confidence, intention, and enjoyment decreased at higher training frequencies (i.e., 3-4x per week). Circuit-style resistance training performed twice per week may be a feasible and practical worksite exercise routine across ages in the fire service.
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Affiliation(s)
| | - Abigail J Trivisonno
- Neuromuscular Assessment Laboratory, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Megan R Laffan
- Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | | | - Jacob A Mota
- Department of Kinesiology and Sport Management, Texas Tech University, Lubbock, TX
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Kajaks T, Ziebart C, Galea V, Vrkljan B, MacDermid JC. Posture Evaluation of Firefighters During Simulated Fire Suppression Tasks. Workplace Health Saf 2023; 71:606-616. [PMID: 37997916 PMCID: PMC10676042 DOI: 10.1177/21650799231214275] [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] [Indexed: 11/25/2023]
Abstract
BACKGROUND Posture mechanics during fire suppression tasks are associated with musculoskeletal injuries in firefighters. METHODS This study uses the Ovako Working Posture Analyzing System (OWAS) ergonomics tool to describe and evaluate the postures of 48 firefighters during 3 simulated tasks: (a) hose drag, (b) hose pull, and (c) high-rise pack lift. Ergonomics intervention prioritizations based on the OWAS action classification (AC) scores were identified using Wilcoxon signed-rank tests. Chi-square analyses identified associations between firefighter characteristics and OWAS AC scores. FINDINGS The initial hose pick-up phase of each task was identified as a high priority for ergonomics intervention (OWAS AC = 4) in 45.8%, 54.2%, and 45.8% of cases for Tasks 1, 2, and 3, respectively. Lower BMI was associated with higher AC scores for the initial hose pick-up during Task 3 (likelihood ratio = 9.20, p value = .01). CONCLUSION The results inform ergonomics priorities for firefighter training based on the tasks analyzed. Application to Practice: This study evaluates the posture mechanics of three commonly performed firefighting tasks. The results help inform an ergonomics training intervention focused on posture mechanics during occupational activities for firefighters.
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Affiliation(s)
- Tara Kajaks
- Department of Kinesiology, McMaster University
| | | | - Vickie Galea
- School of Rehabilitation Science, McMaster University
| | | | - Joy C. MacDermid
- School of Physical Therapy, Western University
- School of Rehabilitation Science, McMaster University
- McFarlane Hand and Upper Limb Centre, St. Joseph’s Health Care London
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Eastman AQ, Rous B, Langford EL, Tatro AL, Heebner NR, Gribble PA, Lanphere R, Abel MG. Etiology of Exercise Injuries in Firefighters: A Healthcare Practitioners' Perspective. Healthcare (Basel) 2023; 11:2989. [PMID: 37998481 PMCID: PMC10671663 DOI: 10.3390/healthcare11222989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/14/2023] [Accepted: 11/16/2023] [Indexed: 11/25/2023] Open
Abstract
The purpose of this study was to query healthcare practitioners (HCPs) who treat firefighter injuries to identify risk factors and mechanisms associated with musculoskeletal injuries during exercise. A phenomenological design was utilized to understand the experiences of HCPs while treating firefighters' musculoskeletal injuries due to exercise. Semi-structured interviews were conducted with 14 HCPs. Two interviews were pilot-tested with HCPs to ensure reliability and validity. Interviews were transcribed and uploaded to a qualitative analysis software program. Although the study inquired about injuries incurred by any exercise modality (e.g., endurance and resistance training), injuries induced during resistance training were prominent among HCPs as resistance training emerged as a primary exercise injury mechanism. HCPs indicated that the back and shoulder were prevalent anatomical exercise injury locations. Risk factors for exercise injuries included age, immobility, movement proficiency, and factors associated with fatigue. Exercise injury mechanisms included poor resistance training technique and overexertion. These findings could guide exercise program design, use of movement assessments, and the identification of other countermeasures to decrease the risk of resistance training exercise injuries among firefighters.
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Affiliation(s)
- Alyssa Q. Eastman
- First Responder Research Laboratory, University of Kentucky, Lexington, KY 40506, USA
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA;
- Department of Clinical Genomics Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Beth Rous
- Department of Educational Leadership Studies, University of Kentucky, Lexington, KY 40508, USA;
| | - Emily L. Langford
- First Responder Research Laboratory, University of Kentucky, Lexington, KY 40506, USA
- Department of Health and Human Sciences, University of Montevallo, Montevallo, AL 35115, USA
| | - Anne Louise Tatro
- First Responder Research Laboratory, University of Kentucky, Lexington, KY 40506, USA
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA;
| | - Nicholas R. Heebner
- Sports Medicine Research Institute, University of Kentucky, Lexington, KY 40536, USA
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY 40536, USA
| | - Phillip A. Gribble
- Sports Medicine Research Institute, University of Kentucky, Lexington, KY 40536, USA
- Department of Athletic Training and Clinical Nutrition, University of Kentucky, Lexington, KY 40536, USA
| | - Rosie Lanphere
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA;
| | - Mark G. Abel
- First Responder Research Laboratory, University of Kentucky, Lexington, KY 40506, USA
- Department of Kinesiology and Health Promotion, University of Kentucky, Lexington, KY 40506, USA;
- Sports Medicine Research Institute, University of Kentucky, Lexington, KY 40536, USA
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Liu M, Zhou K, Li B, Guo Z, Chen Y, Miao G, Zhou L, Liu H, Bao D, Zhou J. Effect of 12 weeks of complex training on occupational activities, strength, and power in professional firefighters. Front Physiol 2022; 13:962546. [PMID: 36060691 PMCID: PMC9428679 DOI: 10.3389/fphys.2022.962546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 07/25/2022] [Indexed: 11/28/2022] Open
Abstract
Objective: This study examined the effects of 12-week complex training (CT) programs on professional firefighters’ occupational activities, strength, and power. Methods: Thirty men professional firefighters were randomly assigned to the CT group (n = 15) and control group (n = 15). The CT group performed complex training and the control group completed resistance training (RT) twice a week over 12 weeks. The occupational activities, strength, and power were assessed at baseline and immediately after the intervention by measuring the performance of 100 m load-bearing run (100 m LR), 60 m shoulder ladder run (60 m SLR), 5 m × 20 m shuttle run (5 m × 20 m SR), 4th-floor climbing rope (4th-floor CR), countermovement jump with arm swing (CMJas), seated medicine-ball throw (SMT), one-repetition maximum bench press (1RM BP), and one-repetition maximum back squat (1RM BS). Results: The results showed that compared to RT, CT induced significantly greater improvements in 60 m SLR (p = 0.007), 4th-floor CR (p = 0.020), CMJas (p = 0.001), and SMT (p < 0.001). Conclusion: These findings suggest that CT is a novel intervention with great promise of improving professional firefighters’ occupational activities, strength, and power.
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Affiliation(s)
- Meng Liu
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Kaixiang Zhou
- College of Sports and Health, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Bin Li
- Cycling and Fencing Sports Administrative Center Under the General Administration of Sport of China, Beijing, China
| | - Zhenxiang Guo
- Department of Physical Education, Nanjing University of Aeronautics and Astronautics, Nanjing, China
| | - Yan Chen
- Sports Coaching College, Beijing Sport University, Beijing, China
| | - Guozhen Miao
- Hebrew SeniorLife Hinda and Arthur Marcus Institute for Aging Research, Harvard Medical School, Bos-ton, MA, United States
- Maranatha High School, Pasadena, CA, United States
| | - Limingfei Zhou
- School of Strength and Conditioning Training, Beijing Sport University, Beijing, China
| | - Haoyang Liu
- Sports Coaching College, Beijing Sport University, Beijing, China
- *Correspondence: Haoyang Liu, ; Dapeng Bao,
| | - Dapeng Bao
- China Institute of Sport and Health Science, Beijing Sport University, Beijing, China
- *Correspondence: Haoyang Liu, ; Dapeng Bao,
| | - Junhong Zhou
- Maranatha High School, Pasadena, CA, United States
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10
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Carr-Pries NJ, Killip SC, MacDermid JC. Scoping review of the occurrence and characteristics of firefighter exercise and training injuries. Int Arch Occup Environ Health 2022; 95:909-925. [PMID: 35266040 DOI: 10.1007/s00420-022-01847-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 02/24/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To summarize the current research on the occurrence of firefighter exercise and training injuries and to describe the nature of these injuries. METHODS Scoping review methods were used to identify articles and extract information relevant to firefighter exercise and training injuries. Relevant articles were identified from MEDLINE, Web of Science, CINAHL, Embase, PubMed, and through hand-searching. RESULTS A total of 1053 articles were identified, and 23 met the inclusion criteria. Nine studies were retrospective analyses of injury data, 13 studies used surveys to identify injuries in the past year, and 1 study reviewed U.S. firefighter injury reports. Three studies included both career and volunteer firefighters, 2 studies included career firefighters, 2 studies include volunteer firefighters, 1 study include recruits and 16 studies did not specify the career status. The occurrence of exercise and training injuries from 22 of the 23 studies ranged from 8.1 to 55.3% of reported injuries. One study found that 3 out of 15 fire departments identified exercise and training as the most common cause of their firefighter injuries. The 13 articles that reported the type of injuries identified musculoskeletal disorders as the most common type of injury (32% to 79% of reported injuries). The ankle, knee and leg were identified as the most commonly injured areas of the body. CONCLUSIONS Training injuries are common in firefighters and must be prevented. Future research is needed to identify root causes of training injuries to guide prevention strategies.
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Affiliation(s)
- Noah J Carr-Pries
- Department of Kinesiology, Ivor Wynne Centre, McMaster University, 1280 Main Street West, Hamilton, ON, L8S 4L8, Canada.,Temerty Faculty of Medicine, University of Toronto, Medical Sciences Building Room 2109, Dean's Office 1 King's College Circle, Toronto, ON, M5S 1A8, Canada
| | - Shannon C Killip
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada.
| | - Joy C MacDermid
- School of Rehabilitation Science, McMaster University, 1400 Main Street West, IAHS 403, Hamilton, ON, L8S 4L8, Canada.,Physical Therapy and Surgery, Western University, Elborn College Room 1011, 1151 Richmond Street, London, ON, N6A 3K7, Canada.,Clinical Research Lab, Hand and Upper Limb Centre, St. Joseph's Health Centre, 268 Grosvenor Street, London, ON, N6A 4L6, Canada
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Chan VCH, Welsh TN, Tremblay L, Frost DM, Beach TAC. A comparison of augmented feedback and didactic training approaches to reduce spine motion during occupational lifting tasks. APPLIED ERGONOMICS 2022; 99:103612. [PMID: 34743974 DOI: 10.1016/j.apergo.2021.103612] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 09/04/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
Manual handling training may be improved if it relied on the provision of individualized, augmented feedback about key movement features. The purpose of this study was to compare the reduction in sagittal spine motion during manual lifting tasks following two training approaches: didactic (DID) and augmented feedback (AUG). Untrained participants (n = 26) completed lifting tests (box, medication bag, and paramedic backboard) and a randomly-assigned intervention involving 50 practice box lifts. Lifting tests were performed immediately before and after training, and one-week after interventions. Both groups exhibited reductions in spine motions immediately and one-week after the interventions. However, the AUG intervention group elicited significantly greater reductions in 5 of 12 between-group comparisons (3 tasks × 4 spine motion variables). The results of the current study support the use of augmented feedback-based approaches to manual handling training over education-based approaches.
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Affiliation(s)
- Victor C H Chan
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada; School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Timothy N Welsh
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada; Centre for Motor Control, University of Toronto, Toronto, ON, Canada
| | - Luc Tremblay
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada; Centre for Motor Control, University of Toronto, Toronto, ON, Canada
| | - David M Frost
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Tyson A C Beach
- Centre for Motor Control, University of Toronto, Toronto, ON, Canada; Department of Kinesiology & Health Sciences, University of Waterloo, Waterloo, ON, Canada.
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Cavaggioni L, Gilardini L, Redaelli G, Croci M, Capodaglio P, Gobbi M, Bertoli S. Effects of a Randomized Home-Based Quality of Movement Protocol on Function, Posture and Strength in Outpatients with Obesity. Healthcare (Basel) 2021; 9:healthcare9111451. [PMID: 34828497 PMCID: PMC8618132 DOI: 10.3390/healthcare9111451] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 01/20/2023] Open
Abstract
The aim of this study was to determine the effects of two different home-based training interventions on functional parameters and body composition in obese patients. Sixty-four obese patients were recruited at the IRCCS Istituto Auxologico Italiano and randomly assigned into a movement quality group (MQ) and a conventional training group (CT). In the MQ, the training protocol combined various stimuli based on whole-body movement patterns, mobility, motor control and diaphragmatic breathing. The CT included traditional bodyweight resistance-training exercises. All patients were tested for movement efficiency (Functional Movement Screen, FMS), postural control (Modified Balance Error Scoring System, M-BESS), breathing pattern (Total Faulty Breathing Scale, TFBS), muscular strength (Handgrip Strength Test, HST and Five Repetition Sit to Stand, FRSTS) and body composition (Waist Circumference, WC, Body Mass Index, BMI, Body fat mass percentage, Fat Mass) before and after a 6-week period of training. Significant interactions and main effects of time (p < 0.0001) were found in MQ compared to CT in the FMS, M-BESS and TFBS parameters, while muscular strength (HST, FRSTS) and body composition parameters improved similarly in both groups with a main effect of time (p < 0.05). These findings suggest that a 6-week movement quality training is effective in ameliorating postural control and movement efficiency with similar improvements in muscular strength and body composition compared with a mere traditional home-based training. Fitness coaches and practitioners might consider the MQ intervention as a valuable alternative to conventional training when treating obesity.
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Affiliation(s)
- Luca Cavaggioni
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, 20129 Milan, Italy
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy; (L.G.); (G.R.); (M.C.); (S.B.)
- Correspondence: ; Tel.: +39-02-619111
| | - Luisa Gilardini
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy; (L.G.); (G.R.); (M.C.); (S.B.)
| | - Gabriella Redaelli
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy; (L.G.); (G.R.); (M.C.); (S.B.)
| | - Marina Croci
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy; (L.G.); (G.R.); (M.C.); (S.B.)
| | - Paolo Capodaglio
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, 28824 Verbania, Italy; (P.C.); (M.G.)
- Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, 10124 Turin, Italy
| | - Michele Gobbi
- Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital, 28824 Verbania, Italy; (P.C.); (M.G.)
| | - Simona Bertoli
- Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, Istituto Auxologico Italiano IRCCS, 20145 Milan, Italy; (L.G.); (G.R.); (M.C.); (S.B.)
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy
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14
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Chen J, Zhang C, Chen S, Zhao Y. Effects of functional correction training on injury risk of athletes: a systematic review and meta-analysis. PeerJ 2021; 9:e11089. [PMID: 33828917 PMCID: PMC8005292 DOI: 10.7717/peerj.11089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background We explored functional correction training using the Functional Movement Screen (FMS™) tool. We also analyzed the effects of training on the injuries of athletes in a systematic review and meta-analysis of non-randomized clinical trials. Methodology We collected twenty-four articles from PubMed, CENTRAL, Scopus, ProQuest, Web of Science, EBSCOhost, SPORTDiscus, Embase, WanFang, and CNKI that were published between January 1997 to September 2020. Articles were selected based on the following inclusion criteria: randomized and non-randomized controlled trials, studies with functional correction training screened by FMS™ as the independent variable, and studies with injury risk to the athlete as the dependent variable. Data conditions included the sample size, mean, standard deviation, total FMS™ scores, number of injuries, and asymmetry movement patterns after interventions in the experimental and control groups. Exclusion criteria included: conference abstracts, cross-sectional studies, articles with retrospective study design. Results Twelve non-randomized trials were included in the meta-analysis. The injury risk ratio of athletes after functional correction training was 0.39 RR (95 CI [1.50–1.93]; Z = 15.53; P < 0.0001; I2 = 2.6%), indicating an improvement of athletes functional patterns. Conclusion Grade B evidence indicates that functional correction training based on FMS™ may improve the functional patterns of athletes and Grade D evidence indicates that it may reduce the risk of sports injury. However, the true effect is likely to be different from the estimate of the effect. Therefore, further studies are needed to explore the influence of functional correction training on the injury risks of athletes. Protocol registration: CRD42019145287.
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Affiliation(s)
- Junxia Chen
- P.E School, Hubei University, Wuhan City, Hubei Province, P.R. China
| | - Chunhe Zhang
- P.E School, Hubei University, Wuhan City, Hubei Province, P.R. China
| | - Sheng Chen
- P.E School, Hubei University, Wuhan City, Hubei Province, P.R. China
| | - Yuhua Zhao
- P.E School, Hubei University, Wuhan City, Hubei Province, P.R. China
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Functional Movement Screen Composite Scores in Firefighters: Effects of Corrective Exercise Training. J Sport Rehabil 2021; 29:102-106. [PMID: 30526266 DOI: 10.1123/jsr.2018-0080] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 10/24/2018] [Accepted: 10/28/2018] [Indexed: 11/18/2022]
Abstract
PURPOSE Firefighters require a high level of functional fitness to operate safely, effectively, and efficiently. The authors studied the distribution of functional movement screen (FMS) scores in firefighters and examined whether an 8-week corrective exercise program based on National Academy of Sport Medicine guidelines could improve them. METHODS All 524 active firefighters of a city completed the baseline FMS testing. Those who obtained a score of 14 or less, a sign of movement dysfunction, and volunteered to continue their participation were randomly assigned to either an experimental (n = 51) or a control (n = 45) group. Both groups participated in an 8-week training program. The control group used their own usual training routine, but the experimental group used the specific protocol designed for the study. RESULTS The FMS scores of 43% of the population were less than 14. Repeated-measures analysis of variance revealed a significant interaction between FMS scores of the groups (F1,94 =165, P < .001). The experimental group showed a 69% improvement from pretest (10.6) to posttest (17.8), whereas the control group showed only a 3% improvement from pretest (11.8) to posttest (12.1). CONCLUSIONS Preceding studies have shown that FMS scores less than 14 increase the injury risk. The findings showed that using our proposed training protocol, low FMS scores could be improved to 14 and higher. Considering the high injury rate of firefighters, the authors suggest administering FMS periodically and to use a training protocol such as ours, to increase functional fitness and reduce injury risk.
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B. Le A, McNulty LA, Dyal MA, DeJoy DM, Smith TD. Firefighter Overexertion: A Continuing Problem Found in an Analysis of Non-Fatal Injury Among Career Firefighters. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217906. [PMID: 33126593 PMCID: PMC7663299 DOI: 10.3390/ijerph17217906] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/19/2020] [Accepted: 10/26/2020] [Indexed: 11/25/2022]
Abstract
Traditionally, safety-related research on firefighting has focused on fires and fireground smoke as the primary source of non-fatal firefighter injury. However, recent research has found that overexertion and musculoskeletal disorders may be the primary source of firefighter injury. This study aimed to provide an update on injury occurrence among career firefighters. Injury data were collected over a two-year period from two large metropolitan fire departments in the U.S. Injury data were categorized based on the Bureau of Labor Statistics’ Occupational Injury and Illness Classification System. Cross-tabulations and Chi-square tests were used to determine the primary causes of injury, as well as the injury region. Between the two fire departments, there were 914 firefighters included in the analysis. The median age was 40.7 years old with those aged 40–49 as the largest age group for injury cases (38.3%). The most frequently reported cause of injury was ‘overexertion and bodily reaction’ (n = 494; 54.1%). The most reported injury region was in ‘multiple body parts’ (n = 331; 36.3%). To prevent subsequent musculoskeletal disorders that may arise due to overexertion, initiatives that promote enhanced fitness and ergonomics based on an analysis of the physical demands of firefighting are suggested.
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Affiliation(s)
- Aurora B. Le
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA
- Correspondence: ; Tel.: +1-(734)-615-7105
| | - Lily A. McNulty
- Department of Applied Health Science, Indiana University School of Public Health–Bloomington, Bloomington, IN 47405, USA; (L.A.M.); (T.D.S.)
| | - Mari-Amanda Dyal
- Department of Health Promotion & Physical Education, Kennesaw State University, Kennesaw, GA 30144, USA;
| | - David M. DeJoy
- Department of Health Promotion & Behavior, University of Georgia College of Public Health, Athens, GA 30602, USA;
| | - Todd D. Smith
- Department of Applied Health Science, Indiana University School of Public Health–Bloomington, Bloomington, IN 47405, USA; (L.A.M.); (T.D.S.)
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Taulaniemi A, Kankaanpää M, Rinne M, Tokola K, Parkkari J, Suni JH. Fear-avoidance beliefs are associated with exercise adherence: secondary analysis of a randomised controlled trial (RCT) among female healthcare workers with recurrent low back pain. BMC Sports Sci Med Rehabil 2020; 12:28. [PMID: 32391158 PMCID: PMC7197113 DOI: 10.1186/s13102-020-00177-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Accepted: 04/20/2020] [Indexed: 12/19/2022]
Abstract
Background Exercise is recommended for the treatment and management of low back pain (LBP) and the prevention of chronicity. Exercise adherence has been only modest in intervention studies among people with musculoskeletal pain. Fear-avoidance beliefs (FABs) are known to affect exercise adherence. The purpose was twofold: to examine which bio-psycho-social factors contributed to exercise adherence during a 6-month neuromuscular exercise intervention among female healthcare workers with recurrent LBP, and to investigate how exercising affects FABs at 6 and 12 months’ follow-up. Methods Some 219 healthcare workers aged 30–55 years with mild-to-moderate re-current non-specific LBP were originally allocated into: 1) exercise, 2) counselling, 3) combined exercise and counselling, and 4) control groups. In the present secondary analysis, groups 1 and 3 (exercise only and exercise+counselling) were merged to be exercisers and groups 2 and 4 were merged to be non-exercisers. Baseline variables of the exercise compliers (≥24 times over 24 weeks; n = 58) were compared to those of the non-compliers (< 1 time/week, 0–23 times; n = 52). The effects of the exercise programme on FABs were analysed by a generalised linear mixed model according to the intention-to-treat principle (exercisers; n = 110 vs non-exercisers; n = 109) at three measurement points (baseline, 6, and 12 months). A per-protocol analysis compared the more exercised to the less exercised and non-exercisers. Results A low education level (p = 0.026), shift work (p = 0.023), low aerobic (p = 0.048) and musculoskeletal (p = 0.043) fitness, and high baseline physical activity-related FABs (p = 0.019) were related to low exercise adherence. The exercise programme reduced levels of both physical activity- and work-related FABs, and there was a dose response: FABs reduced more in persons who exercised ≥24 times compared to those who exercised 0–23 times. Conclusion Healthcare workers who had lower education and fitness levels, worked shifts, and had high physical activity-related FABs had a lower adherence to the 6-month neuromuscular exercise programme. Exercising with good adherence reduced levels of FABs, which have been shown to be linked with prolonged LBP. Motivational strategies should be targeted at persons with low education and fitness levels and high FABs in order to achieve better exercise adherence.
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Affiliation(s)
| | - Markku Kankaanpää
- 2Department of Physical and Rehabilitation Medicine, Tampere University Hospital, Tampere, Finland
| | - Marjo Rinne
- 1UKK Institute for Health Promotion Research, Tampere, Finland
| | - Kari Tokola
- 1UKK Institute for Health Promotion Research, Tampere, Finland
| | - Jari Parkkari
- 1UKK Institute for Health Promotion Research, Tampere, Finland
| | - Jaana H Suni
- 1UKK Institute for Health Promotion Research, Tampere, Finland
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Beach TAC, Frost DM, Zehr JD, Howarth SJ, McGill SM, Callaghan JP. Spine loading during laboratory-simulated fireground operations - inter-individual variation and method of load quantification. ERGONOMICS 2019; 62:1426-1438. [PMID: 31424329 DOI: 10.1080/00140139.2019.1657183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 08/07/2019] [Indexed: 06/10/2023]
Abstract
Spine loading data are needed to design low-back health-preserving ergonomic interventions for firefighters. Study objectives were to quantify spine loads during simulated fireground operations using simple (polynomial) and advanced (EMG-assisted musculoskeletal model) methods and to describe the variation in spine loads between performers (N = 20). Spine compression forces differed by as much as 5.5 times bodyweight between individuals performing identical tasks. Anteroposterior and mediolateral shear forces varied by as much 3.2 and 2.1 times bodyweight between individuals performing the same tasks, respectively. Large variations in spine load magnitudes were documented regardless of whether simple or advanced quantification methods were used. Results suggest that low-back loading demands on the fireground would vary widely depending on the physical characteristics of individual firefighters, movement strategies employed, and tasks performed. Thus, personalised ergonomic interventions are warranted to regulate spine loading and load tolerance in firefighters. Practitioner summary: Even when performing the same work, the associated spine loading demands will vary widely across people due to differences in their body sizes, shapes, and movement strategies. Therefore, personalised interventions are needed to regulate spine loading and load tolerance in workers (e.g. obesity prevention, physical capacity-building exercise, and movement [re]training).
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Affiliation(s)
- Tyson A C Beach
- Faculty of Kinesiology and Physical Education, University of Toronto , Toronto , ON , Canada
| | - David M Frost
- Faculty of Kinesiology and Physical Education, University of Toronto , Toronto , ON , Canada
| | - Jackie D Zehr
- Department of Kinesiology, University of Waterloo , Waterloo , ON , Canada
| | - Samuel J Howarth
- Faculty of Kinesiology and Physical Education, University of Toronto , Toronto , ON , Canada
- Department of Research, Canadian Memorial Chiropractic College , North York , ON , Canada
| | - Stuart M McGill
- Department of Kinesiology, University of Waterloo , Waterloo , ON , Canada
| | - Jack P Callaghan
- Department of Kinesiology, University of Waterloo , Waterloo , ON , Canada
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Taulaniemi A, Kankaanpää M, Tokola K, Parkkari J, Suni JH. Neuromuscular exercise reduces low back pain intensity and improves physical functioning in nursing duties among female healthcare workers; secondary analysis of a randomised controlled trial. BMC Musculoskelet Disord 2019; 20:328. [PMID: 31301741 PMCID: PMC6626624 DOI: 10.1186/s12891-019-2678-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 06/12/2019] [Indexed: 02/06/2023] Open
Abstract
Background Low back pain (LBP) is common among healthcare workers, whose work is physically strenuous and thus demands certain levels of physical fitness and spinal control. Exercise is the most frequently recommended treatment for LBP. However, exercise interventions targeted at sub-acute or recurrent patients are scarce compared to those targeted at chronic LBP patients. Our objective was to examine the effects of 6 months of neuromuscular exercise on pain, lumbar movement control, fitness, and work-related factors at 6- and 12-months’ follow-up among female healthcare personnel with sub-acute or recurrent low back pain (LBP) and physically demanding work. Methods A total of 219 healthcare workers aged 30–55 years with non-specific LBP were originally allocated to four groups (exercise, counselling, combined exercise and counselling, control). The present study is a secondary analysis comparing exercisers (n = 110) vs non-exercisers (n = 109). Exercise was performed twice a week (60 min) in three progressive stages focusing on controlling the neutral spine posture. The primary outcome was intensity of LBP. Secondary outcomes included pain interfering with work, lumbar movement control, fitness components, and work-related measurements. Between-group differences were analysed with a generalised linear mixed model according to the intention-to-treat principle. Per-protocol analysis compared the more exercised to the less exercised and non-exercisers. Results The mean exercise attendance was 26.3 (SD 12.2) of targeted 48 sessions over 24 weeks, 53% exercising 1–2 times a week, with 80% (n = 176) and 72% (n = 157) participating in 6- and in 12-month follow-up measurements, respectively. The exercise intervention reduced pain (p = 0.047), and pain interfering with work (p = 0.046); improved lumbar movement control (p = 0.042), abdominal strength (p = 0.033) and physical functioning in heavy nursing duties (p = 0.007); but had no effect on other fitness and work-related measurements when compared to not exercising. High exercise compliance resulted in less pain and better lumbar movement control and walking test results. Conclusion Neuromuscular exercise was effective in reducing pain and improving lumbar movement control, abdominal strength, and physical functioning in nursing duties compared to not exercising. Electronic supplementary material The online version of this article (10.1186/s12891-019-2678-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Annika Taulaniemi
- UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500, Tampere, Finland.
| | - Markku Kankaanpää
- Department of Physical and Rehabilitation Medicine, Tampere University Hospital, Tampere, Finland
| | - Kari Tokola
- UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500, Tampere, Finland
| | - Jari Parkkari
- UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500, Tampere, Finland
| | - Jaana H Suni
- UKK Institute for Health Promotion Research, Kaupinpuistonkatu 1, 33500, Tampere, Finland
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Armstrong DP, Sinden KE, Sendsen J, MacPhee RS, Fischer SL. Evaluating the effect of a strength and conditioning program to improve paramedic candidates' physical readiness for duty. Work 2019; 63:623-633. [PMID: 31282455 DOI: 10.3233/wor-192953] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The Ottawa Paramedic Physical Ability Test (OPPAT™) is a physical employment standard for the paramedic sector. If a candidate is unsuccessful in meeting the OPPAT™ performance standard they should be provided with an appropriate accommodation, such as a strength and conditioning program, to improve performance. OBJECTIVE Develop, implement and evaluate the effectiveness of a 4-week strength and conditioning program on improving OPPAT™ performance and associated fitness measures in paramedic candidates. METHODS A 4-week strength and conditioning program was developed to focus on strength and power improvements. Based on initial OPPAT™ performance, participants were divided into high and low performing groups; only the low performing group received the training intervention. OPPAT™ completion times and relevant fitness measures were compared pre- to post- intervention and between groups. RESULTS Over the 4-weeks, peak lower body power and grip strength did not significantly improve in the intervention group, however OPPAT™ performance improved by 10%. The control group had significantly lower OPPAT™ completion times both pre- and post-intervention (19% and 11% lower respectively), as well as greater grip strength and peak lower body power. CONCLUSIONS Implementation of a targeted strength and conditioning program successfully improved OPPAT™ performance in low performing candidates.
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Affiliation(s)
- Daniel P Armstrong
- Department of Kinesiology, University of Waterloo, Waterloo, ONT, Canada
| | - Kathryn E Sinden
- School of Kinesiology, Lakehead University, Thunder Bay, ONT, Canada
| | - Jonathan Sendsen
- Department of Kinesiology, University of Waterloo, Waterloo, ONT, Canada
| | - Renée S MacPhee
- Kinesiology & Physical Education and Health Sciences, Wilfrid Laurier University, Waterloo, ONT, Canada
| | - Steven L Fischer
- Department of Kinesiology, University of Waterloo, Waterloo, ONT, Canada
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21
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Chan VCH, Welsh TN, Frost DM, Beach TAC. Using visual aids to influence manual lifting techniques: acute effects of viewing static images on spine motion. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2019; 27:605-612. [PMID: 31112070 DOI: 10.1080/10803548.2019.1620489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose. This study aimed to determine whether untrained observers alter their spine as directed via static images of different lifting techniques. Methods. Ten men and eight women, who had no lifting or visual observation training, performed box lifts. Following a self-selected lifting technique trial, participants performed four experimental lifting trials (in randomized order) wherein they were instructed to execute lifts in accordance with the techniques pictured. These techniques differed by the amount of knee, trunk and spine flexion modeled. Peak lumbar flexion angles and flexion/extension velocities were quantified, and then statistically analyzed via general linear models with two within-participant factors (condition = technique; phase = lift/lower). Results. Lumbar flexion angles and flexion/extension velocities differed between conditions (p < 0.001), although the effects depended on the combination of postural characteristics pictured. A main effect of phase was observed for peak lumbar flexion velocity only (p = 0.001). No condition × phase interaction effects were detected for any dependent variables (p > 0.050). Conclusions. Acute changes in lifting mechanics can be elicited via visual observation of pictured techniques. However, if using pictures to attenuate peak lumbar flexion displacements and velocities when lifting, auxiliary instruction may be needed to direct observers' attention to the spine curvature displayed.
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Affiliation(s)
- Victor C H Chan
- Faculty of Kinesiology and Physical Education, University of Toronto, Canada
| | - Timothy N Welsh
- Faculty of Kinesiology and Physical Education, University of Toronto, Canada.,Centre for Motor Control, University of Toronto, Canada
| | - David M Frost
- Faculty of Kinesiology and Physical Education, University of Toronto, Canada
| | - Tyson A C Beach
- Faculty of Kinesiology and Physical Education, University of Toronto, Canada.,Centre for Motor Control, University of Toronto, Canada
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22
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Wiszomirska I, Iwańska D, Tabor P, Karczewska-Lindinger M, Urbanik C, Mastalerz A. Postural stability pattern as an important safety factor of firefighters. Work 2019; 62:469-476. [PMID: 30909262 DOI: 10.3233/wor-192881] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Firefighting is a hazardous profession that involves high fall risk and is crucial component for the safety of people. OBJECTIVE The aim of this study was to identify factors that impact on postural stability patterns of firefighters. METHODS The study examined 177 Polish firefighters from the National Firefighting and Rescue System (NFRS) aged 31.9±10.1 years, with body height of 179.6±5.93, body mass of 83.9±11.0 and BMI of 26.0±3.03. Postural stability was evaluated by means of the Balance System SD (Biodex USA) set at the level 12 of instability, in a sportswear, bunker gear, with and without visual input. The fall risk test (FRI) was also performed. Four indices were analysed: overall stability index (OSI), anterior-posterior stability index (APSI), medial-lateral stability index (MLSI), and fall risk index (FRI). RESULTS Mean results for fall risk index (FRI) were in the normal range for all age groups regardless of the type of clothing the firefighters were wearing. Individual results obtained in the fall risk test, 128 firefighters were in the normal range for their age, furthermore, 10 firefighters obtained better results than the normal range, 34 firefighters had worse results and 5 people failed to complete the test. Postural stability with eyes closed was found to decline with age. Wearing bunker gear did not have an effect on postural stability. CONCLUSIONS Balance tests should be integrated into the firefighting training routines in order to improve balance and support fall prevention. Exercises with reduced visual input should also be incorporated into the training methodology.
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Affiliation(s)
- Ida Wiszomirska
- Faculty of Rehabilitation, Józef Piłsudski University of Physical Education in Warsaw, Poland
| | - Dagmara Iwańska
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw, Poland
| | - Piotr Tabor
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw, Poland
| | | | - Czesław Urbanik
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw, Poland
| | - Andrzej Mastalerz
- Faculty of Physical Education, Józef Piłsudski University of Physical Education in Warsaw, Poland
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Kim HD, An YS, Kim DH, Jeong KS, Ahn YS. An overview of compensated work-related injuries among Korean firefighters from 2010 to 2015. Ann Occup Environ Med 2018; 30:57. [PMID: 30186612 PMCID: PMC6122217 DOI: 10.1186/s40557-018-0268-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/29/2018] [Indexed: 11/10/2022] Open
Abstract
Background Although one in two firefighters in South Korea have experienced work-related injuries, there are few studies which show the overview description on work-related injuries and its analysis regarding such causes. Therefore, we aimed to show the overview of compensated work-related injuries in order to serve fundamental data for establishing prevention policies on work-related injuries for Korean firefighters. Methods We requested the all claimed work-related injury data of Korean firefighters from 2010 to 2015 to the Korean National Fire Agency (NFA). The data from NFA including 2457 claimed cases was analyzed and we confirmed, 2154 approved work-related injuries for the kinds of job activities, cause of accident and type of injuries. Among 2154 approved cases, we analyzed more variables for the sex, age, and job duration of 1344 compensated cases through served text file on summary of accident. Results The Government Employees Pension Service (GEPS) recognized 2154 (87.7%) approved work-related injuries among 2457 claimed cases. The incidence of work-related injuries per 1000 firefighters was 9.8 persons. By region, the incidence of work-related injuries per 1000 firefighters ranged from a maximum of 14.5 to a minimum of 4.0. The most common job activity caused the accident was fire suppression (18.0%), followed by Emergency medical services (EMS) (17.5%) and training (10.7%). The most common cause of these accident was movement imbalance (30.3%), followed by falls (18.9%) and traffic accident (13.4%). In these work-related injuries, sprains and bruises were the most common type of injury (27.2%), and the most commonly injured body site was the upper and lower back (25.3%). Data from identified 1344 firefighters showed that 1264 (94.0%) were male and 80 (6.0%) were female. Age group was the highest in the 40s with 623 cases (46.4%), and job duration was the highest with 650 cases in 5-10 years (48.4%). Conclusion In this study, we could obtain the preliminary data necessary to establish preventive measures, including the cause of accident and region with high accident rates. However, the number of applications for compensated injuries was very small compared to the frequency of injuries found in previous studies. The lack of appropriate treatment suggested that many firefighter injuries can become chronic. In this study, we suggest that it is necessary to introduce an injury monitoring system and improve the accessibility of compensated injuries. Trial registration CR318031. Registered 20 June 2018.
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Affiliation(s)
- Hyung Doo Kim
- 2Department of Occupational and Environmental Medicine, Inha University Hospital, 27 Inhang-ro, Jung-gu, Incheon, 22332 Republic of Korea
| | - Yon Soo An
- 3Department of Occupational and Environmental Medicine, Soonchunhyang University Cheonan Hospital, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do 31151 Republic of Korea
| | - Dong Hyun Kim
- 4Department of Occupational and Environmental Medicine, Dongguk University Ilsan Hospital, 27 Dongguk-ro, Ilsandong-gu, Goyang, 10326 Republic of Korea
| | - Kyung Sook Jeong
- 5Department of Occupational and Environmental Medicine, Hallym University Sacred Heart Hospital, 22 Gwanpyeong-ro 170beon-gil, Dongan-gu, Anyang-si, Gyeonggi-do 14068 Republic of Korea
| | - Yeon Soon Ahn
- 1Department of Preventive Medicine and Institute of Occupational and Environmental Medicine, Wonju College of Medicine, Yonsei University, 20 Ilsan-ro, Wonju, Gangwon-do 26426 Republic of Korea
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Pinto BL, Beaudette SM, Brown SHM. Tactile cues can change movement: An example using tape to redistribute flexion from the lumbar spine to the hips and knees during lifting. Hum Mov Sci 2018; 60:32-39. [PMID: 29772412 DOI: 10.1016/j.humov.2018.05.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 05/10/2018] [Accepted: 05/10/2018] [Indexed: 10/16/2022]
Abstract
Given the appropriate cues, kinematic factors associated with low back injury risk and pain, such as spine flexion, can be avoided. Recent research has demonstrated the potential for tactile sensory information to change movement. In this study an athletic strapping tape was applied bilaterally along the lumbar extensor muscles to provide continuous tactile feedback information during a repeated lifting and lowering task. The presence of the tape resulted in a statistically significant reduction in lumbar spine flexion when compared to a baseline condition in which no tape was present. This reduction was further increased with the explicit instruction to pay attention to the sensations elicited by the tape. In both cases, the reduction in lumbar spine flexion was compensated for by increases in hip and knee flexion. When the tape was then removed and participants were instructed to continue lifting as if it was still present, the reduction in lumbar flexion and increases in hip and knee flexion were retained. Thus this study provides evidence that tactile cues can provide vital feedback information that can cue human lumbar spine movement to reduce kinematic factors associated with injury risk and pain.
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Affiliation(s)
- Brendan L Pinto
- Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Shawn M Beaudette
- Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Stephen H M Brown
- Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada.
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Beach TAC, Stankovic T, Carnegie DR, Micay R, Frost DM. Using verbal instructions to influence lifting mechanics - Does the directive "lift with your legs, not your back" attenuate spinal flexion? J Electromyogr Kinesiol 2017; 38:1-6. [PMID: 29107836 DOI: 10.1016/j.jelekin.2017.10.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 08/02/2017] [Accepted: 10/19/2017] [Indexed: 11/15/2022] Open
Abstract
"Use your legs" is commonly perceived as sound advice to prevent lifting-related low-back pain and injuries, but there is limited evidence that this directive attenuates the concomitant biomechanical risk factors. Body segment kinematic data were collected from 12 men and 12 women who performed a laboratory lifting/lowering task after being provided with different verbal instructions. The main finding was that instructing participants to lift "without rounding your lower back" had a greater effect on the amount of spine flexion they exhibited when lifting/lowering than instructing them to lift "with your legs instead of your back" and "bend your knees and hips". It was concluded that if using verbal instructions to discourage spine flexion when lifting, the instructions should be spine- rather than leg-focused.
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Affiliation(s)
- Tyson A C Beach
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario M5S 2W6, Canada
| | - Tatjana Stankovic
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario M5S 2W6, Canada
| | - Danielle R Carnegie
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario M5S 2W6, Canada
| | - Rachel Micay
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario M5S 2W6, Canada
| | - David M Frost
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario M5S 2W6, Canada.
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A random-perturbation therapy in chronic non-specific low-back pain patients: a randomised controlled trial. Eur J Appl Physiol 2017; 117:2547-2560. [PMID: 29052033 DOI: 10.1007/s00421-017-3742-6] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Accepted: 10/10/2017] [Indexed: 10/18/2022]
Abstract
The purpose of the study was to assess the effectiveness of a specific rehabilitation therapy for chronic non-specific low-back pain patients, based on a random/irregular functional perturbation training induced by force disturbances to the spine. Forty patients (20 controls and 20 in the perturbation-based group) finished the whole experimental design. A random-perturbation exercise, which included variable and unpredictable disturbances, was implemented in the therapy of the perturbation-based group (13 weeks, two times per week and 1.5 h per session). The participants of the control group did not receive any specific training. Low-back pain, muscle strength, and neuromuscular control of spine stability were investigated before and after the therapy using the visual analog scale, maximal isometric and isokinetic contractions, nonlinear time series analysis, and by determining the stiffness and damping of the trunk after sudden perturbations. The perturbation-based therapy reduced patient's low-back pain (35%), increased muscle strength (15-22%), and trunk stiffness (13%), while no significant changes were observed in the control group. It can be concluded that the proposed therapy has the potential to enhance trunk muscle capability as well as sensory information processing within the motor system during sudden loading and, as a consequence, improve the stabilization of the trunk.
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Frost DM, Beach TAC, Crosby I, McGill SM. The cost and distribution of firefighter injuries in a large Canadian Fire Department. Work 2017; 55:497-504. [PMID: 27768003 DOI: 10.3233/wor-162420] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND There is limited data available regarding the cost of firefighter injuries. This information is necessary to develop targeted injury prevention strategies. OBJECTIVE To categorize the cost of injuries filed in 2012 by firefighters from a from a large department by job duty, injury type, body part affected, and the general motion pattern employed at the time of injury. METHODS Data were taken from reports filed by CFD personnel and claims filed with the Workers' Compensation Board (WCB) of Alberta between January 1, 2012 and December 31, 2012. RESULTS Of the 244 injuries reported, 65% were categorized as sprains and strains, the most frequent of which affected the back (32%). The total cost of all claims was $555,955; 77% were sprain/strain-related. Knee and back injuries were most costly ($157,383 and $100,459). Categorized by job duty, most sprains/strains (31%) were sustained while attending to fire station responsibilities, although physical training was associated with the highest costs (34%). Fireground operations were attributed to 18% of sprains/strains and 16% of costs. Lifting injuries were more frequent (23%) and costly (20%) than all injuries. CONCLUSIONS The most common and costly injuries occurred while attending to fire station-related responsibilities and during physical training.
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Affiliation(s)
- D M Frost
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - T A C Beach
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - I Crosby
- Calgary Fire Department, Calgary, AB, Canada
| | - S M McGill
- Department of Kinesiology, University of Waterloo, Waterloo, ON, Canada
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Abstract
BACKGROUND Perceived task complexity can impact participation in an exercise programme and the level of skill acquisition resulting from participation. Although trunk stability exercises are commonly included in the management of people with low back pain, potential differences in perceived task complexity between those exercises have not been investigated previously. OBJECTIVE To investigate the perceived task complexity following first time instruction of two common stability exercises: the abdominal brace and abdominal hollow. DESIGN Cross-sectional. METHODS Twenty-four naïve healthy participants received instruction in the performance of an abdominal brace and an abdominal hollow with feedback. Participants rated their perceived task complexity (mental, physical, and temporal demand, performance, effort, frustration) for each exercise on the NASA-Task Load Index. RESULTS The abdominal hollow was associated with higher perceived mental demand than the abdominal brace (p = 0.01), and required more time to learn (p < 0.01). The abdominal brace was associated with greater mental demand and frustration when performed after the abdominal hollow than before. CONCLUSIONS This study has provided the first evidence for differences in perceived task complexity between two commonly used trunk stability exercises. Those differences in perceived task complexity may influence the selection of exercises intended to enhance the robustness of spinal stability.
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Frost DM, Beach TAC, Campbell TL, Callaghan JP, McGill SM. Can the Functional Movement Screen™ be used to capture changes in spine and knee motion control following 12 weeks of training? Phys Ther Sport 2016; 23:50-57. [PMID: 27693921 DOI: 10.1016/j.ptsp.2016.06.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 06/03/2016] [Accepted: 06/05/2016] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To examine whether objective measures of spine and frontal plane knee motion exhibited during Functional Movement Screen™ (FMS) task performance changed following a movement-guided fitness (MOV) and conventional fitness (FIT) exercise intervention. DESIGN Secondary analysis of a randomized controlled experiment. Before and after 12 weeks of exercise, participants' kinematics were quantified while performing the FMS and a series of general whole-body movement tasks. SETTING Biomechanics laboratory. PARTICIPANTS Fifty-two firefighters were assigned to MOV, FIT, or a control (CON) group. OUTCOME MEASURES Peak lumbar spine flexion/extension, lateral bend and axial twist, and frontal plane knee motion. RESULTS The post-training kinematic changes exhibited by trainees while performing the FMS tasks were similar in magnitude (effect size < 0.8) to those exhibited by CON. However, when performing the battery of general whole-body movement tasks, only MOV showed significant improvements in spine and frontal plane knee motion control (effect size > 0.5). CONCLUSIONS Whether graded qualitatively, or quantitatively via kinematic analyses, the FMS may not be a viable tool to detect movement-based exercise adaptations. Amendments to the FMS tasks and/or scoring method are needed before it can be used for reasons beyond appraising the ability to move freely, symmetrically, and without pain.
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Affiliation(s)
- David M Frost
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario M5S 2W6, Canada.
| | - Tyson A C Beach
- Faculty of Kinesiology and Physical Education, University of Toronto, 55 Harbord Street, Toronto, Ontario M5S 2W6, Canada.
| | - Troy L Campbell
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada
| | - Jack P Callaghan
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada.
| | - Stuart M McGill
- Department of Kinesiology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario N2L 3G1, Canada.
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