The ability of individuals to lift heavy loads without injury to the vertebral elements has led to the formulation of several explanations of this phenomenon. In this article, the existing literature on lifting is reviewed and mechanisms of back support during lifting are described. These mechanisms include the intra-abdominal pressure mechanism, the thoracolumbar fascia mechanism, and combinations of these mechanisms with the use of the erector spinae, multifidus, and psoas muscles. Physical therapists are often responsible for teaching patients and workers "proper" lifting techniques; however, controversy exists concerning the proper lift. Although lifting with the lower back in flexion and lifting in extension have been proposed, there are indications for each depending on individual circumstances. Lifting instructions for workers without low back injuries should be distinguished from instructions for patients with low back pain. General rules for lifting include: plan the lift, avoid twisting, keep the load close to the body, and bend at the knees.

The use of back support belts by industrial workers has become common in recent years. The rationale for the use of these belts is based on the theory that they increase intra-abdominal pressure. Raised intra-abdominal pressure is believed to reduce compression forces on the spinal column and to assist the back extensor muscles in producing extension torque. The assistance of the belt is believed to protect the spine from injury. Thirty males and thirty females participated in this study which assessed the effect of two different back support belts (one synthetic and one leather) on isometric muscle-force production of individuals performing a static leg lift (SLL). A Latin Square double cross-over design was employed. Analysis of variance tests revealed that in males the use of the synthetic belt allowed for greater force production than a control trial, but no difference could be detected between the leather belt and either the synthetic belt or the control. In the female group, no difference in force production occurred across the three conditions. Implications and suggestions for further study are discussed.

SummaryA reproducible method is described for quantitating either spontaneous or ADP- induced platelet aggregation in circulating dog blood after heparinization. An extra- corporeal shunt containing screen material with openings 53 microns square was placed in the dog’s arterial circulation. The blood pressure was measured proximal to this filter. The blood pressure decreased upon opening the shunt to the circulation and increased when the filter became occluded. The degree and rate of aggregation was determined by means of measuring these blood pressure changes. Phase and electron microscopy demonstrated platelet aggregates occluding the filters. Platelet aggregation on the filter was experimentally accelerated by infusing ADP before the filter. The administration of ADP in concentrations between 0.625 and 10 μg/ml until occlusion, produced a dose response relationship between log of ADP concentration and rate of filter occlusion. Macrodex, a known inhibitor of platelet aggregation was given intravenously and was found to delay filter occlusion. Similar results were obtained with high intravenous doses of phenylbutazone. The method was used to compare the drug effects with their in vitro effects measured photometrically. It would appear that this technique can be used for demonstrating and quantitating the effects of drugs on the process of platelet adhesion and aggregation in vivo.