Training in handling: an evaluative study

Abstract

Training programmes in handling have been one of the most used means of preventing work-related backache. The effectiveness of these programmes has not yet been demonstrated however, since they have rarely been evaluated. The purpose of this study was precisely to assess one of these programmes in the hospital sector which specifically dealt with the handling of patients. A field study was conducted and handling methods used by 32 trained orderlies were characterized using an observational grid developed and validated specifically to describe patient handling operations. The extent to which these orderlies used the handling methods taught was determined, and the observed deviations from these methods were characterized and interpreted. The results show that the handling principles taught (working with a straight back using the legs) were not frequently used in the workplace. Furthermore, the use of training was closely related to the type of handling carried out. In handling operations in which the effort includes a horizontal component (mainly those carried out in bed) the training was hardly used, while in vertical handling operations the taught principles were more frequently used. These results suggest that actual training is not well adapted to the handling of patients, particularly to horizontal handling carried out in the bed. Two main deficiencies in the actual programmes are pointed out. First, it is shown that, for reasons of physical constraints, training could not always be applied; second, the rationale of the taught principles could also be questioned, particularly the emphasis given to the use of the legs.

Choosing a Lifting Posture: Squat, Semi-Squat or Stoop

“…Within the literature [1][2][3]10,11 there is considerable debate as to which is the best technique to employ when lifting low-lying objects off the floor; "Stoop" or "Squat." The most commonly advised lifting technique is the "Squat technique or leg lift," which is characterized by a starting position of deep knee flexion with the trunk close to erect, quantitatively this can define by knee flexion of 45° and trunk flexion less than 30° when lifting from the floor level.…”

“…The most commonly advised lifting technique is the "Squat technique or leg lift," which is characterized by a starting position of deep knee flexion with the trunk close to erect, quantitatively this can define by knee flexion of 45° and trunk flexion less than 30° when lifting from the floor level. 2,10 The "Stoop" technique involves spinal flexion, defined as raising a low lying object with a knee flexion angle greater than 135° with trunk flexion around 90°.…”

“…1 Training in safe handling techniques is a recommended way to reduce risk factors associated with manual handling within the working environment, particularly the lifting of low-lying objects as this has long been associated with an increased risk of lower back injuries. 2 However, manual handling training programs have not proven to be successful in reducing musculoskeletal problems in an industrial environment, often attributed to inadequate training methods. 2 The majority of safe handling training including lifting techniques for low-lying objects is not adaptable to employees, workplaces and the variety of tasks found within an industrial environment.…”

“…2 However, manual handling training programs have not proven to be successful in reducing musculoskeletal problems in an industrial environment, often attributed to inadequate training methods. 2 The majority of safe handling training including lifting techniques for low-lying objects is not adaptable to employees, workplaces and the variety of tasks found within an industrial environment. In a broad consensus most governing bodies favor the promotion of sound biomechanical principals associated with manual handling tasks; however, they do not appear to be easily applicable to the wide range and complexity of manual handling situations that occur in an industrial environment.…”

“…For example, lower back injuries are among the most common type of injury associated with lifting tasks. 2 Lower back injuries occur because of the large extensor moments about the joints of the lumbar vertebrae that are produced during lifting by the paravertebral musculature to overcome the flexor moment caused by the weight of the upper body and load. 4 These high forces also result in large compressive and shear forces acting between each pair of vertebra.…”