Measurement of Action Forces and Posture to Determine the Lumbar Load of Healthcare Workers During Care Activities with Patient Transfers

Abstract

Moving patients or other care activities with manual patient handling is characterized by high mechanical load on the lumbar spine of healthcare workers (HCWs). During the patient transfer activity, the caregivers exert lifting, pulling, and pushing forces varying over time with respect to amplitude and direction. Furthermore, the caregivers distinctly change their posture and frequently obtain postures asymmetrical to the median sagittal plane, including lateral bending and turning the trunk. This paper describes a procedure to determine lumbar load during patient transfer supported by measurement techniques and an exemplary application; this methodology represents the basis of a complex research project, the third 'Dortmund Lumbar Load Study (DOLLY 3)'. Lumbar load was determined by simulation calculations using a comprehensive biomechanical model ('The Dortmunder'). As the main influencing factors, the hand forces of the caregiver exerted during typical patient transfers and the posture and movements of the HCW were recorded in laboratory studies. The action forces were determined three-dimensionally with the help of a newly developed 'measuring bed', two different 'measuring chairs', a 'measuring bathtub', and a 'measuring floor'. To capture the forces during transfers in or at the bed, a common hospital bed was equipped with an additional framework, which is attached to the bedstead and connected to the bedspring frame via three-axial force sensors at the four corners. The other measuring systems were constructed similarly. Body movements were recorded using three-dimensional optoelectronic recording tools and video recordings. The posture and force data served as input data for the quantification of various lumbar-load indicators.

Posture and Mechanical Load Assessment During Patient Transfers

“…Movement and posture analysis systems based on different types of sensors can be used to identify harmful postures and to estimate the stresses and strains that occur in the musculoskeletal system of both the carer and the person being cared for. Theilmeier et al captured postures via an optoelectronic motion capturing system and video cameras [17]. Additionally, a care bed was equipped with a framework attached to the bedstead and connected to the bedspring frame via force sensors at the four bed-corners.…”

Work-related fear-avoidance beliefs and risk of low-back pain: Prospective cohort study among healthcare workers

“…However, the character of the work and its associated health-related consequences stand out as signi cant driving forces [2], [3]. Healthcare work is physically strenuous, involving frequent exposure to sudden and high loadings of the spine during patient transfer, often requiring twisting and bending of the back [4], [5]. This demanding nature of healthcare work increase the risk of low-back pain (LBP) [6]- [9], [10, s. 2], [11], long term sickness absence [12], [13] and disability pension [14]- [16].…”

Effects of asymmetrical stance and movement on body rotation in pushing

“…Many activities involving pushing an object with only one hand are associated with loading body segments asymmetrically. Furthermore, health care workers frequently adopt asymmetrical postures, including lateral bending and trunk turning, laterally positioned arms and sideward force exertion during patients handling activities (Theilmeier et al, 2010). Turning the patient in bed or repositioning in the seat of the wheelchair are performed while standing asymmetrically (Skotte et al, 2002), which may induce high load on the spine and lead to health-related absenteeism (Theilmeier et al, 2010; Videman et al, 2005).…”