Relative Contribution of Lower Body Work as a Biomechanical Determinant of Spine Sparing Technique During Common Paramedic Lifting Tasks

Abstract

Paramedics represent a unique occupational group where the nature of their work, providing prehospital emergency care, makes workplace modifications to manage and control injury risks difficult. Therefore, the provision of workplace education and training to support safe lifting remains a viable and important approach. There is, however, a lack of evidence describing movement strategies that may be optimal for paramedic work. The purpose of this study was to determine if a strategy leveraging a greater contribution of work from the lower body relative to the torso was associated with lower biomechanical exposures on the spine. Twenty-five active duty paramedics performed 3 simulated lifting activities common to paramedic work. Ground reaction forces and whole body kinematics were recorded to calculate: peak spine moment and angle about the L4/L5 flexion-extension axis as indicators of biomechanical exposure; and, joint work, integrated from net joint power as a measure of technique inclusive of movement dynamics. Paramedics generating more work from the lower body, relative to the trunk, were more likely to experience lower peak L4/L5 spine moments and angles. These data can inform the development of workplace training and education on safe lifting that focuses on paramedics generating more work from the lower body.

Deliberate Practice and Motor Learning Principles to Underpin the Design of Training Interventions for Improving Lifting Movement in the Occupational Sector: A Perspective and a Pilot Study on the Role of Augmented Feedback

“…In other words, participants bent their knee more and tilted their hip forward when provided with the augmented feedback. This redistribution of spine flexion along the lower body, known as spine sparing technique (Makhoul et al, 2017 ), allows people to flex their trunk and lower their center of mass to grab a box from the ground while reducing flexion of the lumbar spine. This feedback strategy does not prescribe individuals how to specifically change movement coordination to reduce spine flexion, but rather provides information on how much they are bending the spine.…”

Simulate and sense force exertions during virtual patient transfer tasks

“…The EMG signals of the 12 muscle groups from the physical lifting task also served as threshold values of which the participants needed to reach and maintain in order to "move" the virtual patient during the virtual lifting task. The virtual lifting task was the same three-step lifting task but performed in the CAVE against a virtual patient, which represented a standard three-part emergency lift performed during patient transport (Makhoul, Sinden, MacPhee, & Fischer, 2017).…”

The effects of protective footwear on spine control and lifting mechanics

“…Alternatively, companies or groups can approach a research team to investigate unique occupational characteristics such as paramedic lifting techniques/physical demands (e.g Coffey, MacPhee, Socha, & Fischer, 2016;Makhoul, Sinden, MacPhee, & Fischer, 2017),. firefighter fitness and injury identification (e.g Beach, Frost, McGill, & Callaghan, 2014;Frost, Beach, Crosby, & McGill, 2015),.…”