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Ward JS. Influence of a Sacroiliac Belt on Pain and Functional Impairment in Patients With Low Back Pain: A Randomized Trial. J Chiropr Med 2022; 21:141-148. [PMID: 36118104 PMCID: PMC9479175 DOI: 10.1016/j.jcm.2022.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 06/03/2022] [Accepted: 06/08/2022] [Indexed: 10/17/2022] Open
Abstract
Objective The purpose of this study was to assess the protective influence of the Serola Sacroiliac Belt on pain and functional impairment in individuals with low back pain (LBP) during 5 days of strenuous manual labor. Methods Thirty-three participants (mean ± standard deviation: age, 43.2 ± 11.4 years; height, 1.74 ± 0.11 m; body mass index, 88.3 ± 16.7 kg) with LBP were randomized to either condition A (wearing the Serola Sacroiliac Belt during a 10-minute daily repeated strenuous lifting task) during week 1 or condition B (not wearing a Serola Sacroiliac Belt during the same lifting task) in week 2 or vice versa. All 33 participants completed 1 week under condition A and 1 week under condition B for comparison. At the beginning and end of each week, the following dependent variables were measured: lumbar spine pain on a 0 to 10 Numeric Rating Scale (NRS), spine and thigh discomfort on a Nordic Musculoskeletal Questionnaire, and completion of a toe-touch surface electromyography flexion relaxation phenomenon test. Results During the week that participants used the Serola Sacroiliac Belt, spine pain increased 0.2 compared with 0.9 on the NRS for those who did not use the belt. No statistically significant difference was observed for Nordic Musculoskeletal Questionnaire data or the flexion relaxation phenomenon test in this study. Conclusion The findings of this preliminary study suggest participants using the Serola Sacroiliac Belt while performing a daily repeated lifting task had less progression of their LBP. However, this protective value did not meet the recommended NRS for minimally clinically important difference, and there was no effect on functional impairment.
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Affiliation(s)
- John S. Ward
- Corresponding author: John S. Ward, DC, MA, MS, 5912 Spencer Highway, Pasadena, TX 77504
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Im SC, Cho HY, Lee JH, Kim K. Analysis of the Effect of Wearing Extensible and Non-Extensible Lumbar Belts on Biomechanical Factors of the Sit-to-Stand Movement and Pain-Related Psychological Factors Affecting Office Workers with Low Back Pain. Healthcare (Basel) 2021; 9:healthcare9111601. [PMID: 34828646 PMCID: PMC8624328 DOI: 10.3390/healthcare9111601] [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] [Received: 10/18/2021] [Revised: 11/12/2021] [Accepted: 11/19/2021] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the effects of wearing extensible and non-extensible lumbar belt (LB) on biomechanical factors of the sit-to-stand (STD) movement and pain-related psychological factors affecting office workers with low back pain. Among 30 office workers, 15 with low back pain (LBP) were assigned to the experimental group and 15 healthy adults were assigned to the control group. The participants performed STD movement in random order of three different conditions: without LB (Condition 1), with extensible LB (Condition 2), and with non-extensible LB (Condition 3). Biomechanical variables of STD movement in each condition were measured using a three-dimensional motion analysis system and force plate. Pain-related psychological factors were measured only in the experimental group. Among the biomechanical factors of STD movement, an interaction effect was found in the maximum anterior pelvic tilt angle and total-phase range of motion of the trunk (p < 0.05). Pain intensity, pain-related anxiety, and pain catastrophizing were decreased in the conditions with lumbar belts (Conditions 2 and 3) compared to the condition without LB (Condition 1) (p < 0.05). Extensible and non-extensible lumbar belts engender biomechanically beneficial effects during STD movement in both office workers with LBP and healthy office workers. Further, pain intensity, pain-related anxiety, and pain catastrophizing were decreased in office workers with LBP. Therefore, both types of extensible lumbar belts may be helpful in the daily life of patients with LBP and office workers.
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Affiliation(s)
- Sang-Cheol Im
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Gyeongsan 38453, Korea; (S.-C.I.); (H.-Y.C.)
| | - Ho-Young Cho
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Gyeongsan 38453, Korea; (S.-C.I.); (H.-Y.C.)
| | - Jae-Hong Lee
- Department of Physical Therapy, Daegu Health College, Daegu 41453, Korea;
| | - Kyoung Kim
- Department of Physical Therapy, College of Rehabilitation Science, Daegu University, Gyeongsan 38453, Korea; (S.-C.I.); (H.-Y.C.)
- Correspondence: ; Tel.: +82-53-850-4351
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Myung E, Neto JD, Murta GA, Vieira A, Gomes de Lima PR, Lessa L, Bernardo WM. ANAMT Technical Guideline (DT 05): prevention of occupational low back pain through back belts, lumbar support or braces. Rev Bras Med Trab 2020; 16:524-531. [PMID: 32754669 DOI: 10.5327/z1679443520180334] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 11/11/2018] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Low back pain is a considerable global public health problem. Use of back belts in occupational settings arises from the expectation of countless biomechanical benefits, which together would contribute to the prevention of this problem. OBJECTIVE To orient students, physicians and health institutions on the use of back belts, lumbar support or braces for prevention of low back pain or injury among asymptomatic workers. METHOD The present guideline was developed based on a systematic literature review; 809 studies were located in database MEDLINE and 571 in EMBASE and Cochrane CENTRAL. Evaluating back-belt use as preventive intervention against low back pain demands quantifying benefits, harms and difficulties to implementation, as well as the methodological quality of primary studies. CONCLUSION Despite the weak benefits reflected in the individual, partial and isolated results of a few studies, there is no consistent evidence for the use of back belts, lumbar supports or braces for primary prevention of low back pain or occupational low back injury among workers. According to the available evidence, back-belt use is not associated with reduction of absenteeism.
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Affiliation(s)
- Eduardo Myung
- Guidelines Unit, Associação Nacional de Medicina do Trabalho - São Paulo (SP), Brazil
| | - José Domingos Neto
- Guidelines Unit, Associação Nacional de Medicina do Trabalho - São Paulo (SP), Brazil
| | | | - Anielle Vieira
- Guidelines Unit, Associação Nacional de Medicina do Trabalho - São Paulo (SP), Brazil
| | | | - Leandro Lessa
- Guidelines Unit, Associação Nacional de Medicina do Trabalho - São Paulo (SP), Brazil
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Bataller-Cervero AV, Rabal-Pelay J, Roche-Seruendo LE, Lacárcel-Tejero B, Alcázar-Crevillén A, Villalba-Ruete JA, Cimarras-Otal C. Effectiveness of lumbar supports in low back functionality and disability in assembly-line workers. INDUSTRIAL HEALTH 2019; 57:588-595. [PMID: 30651407 PMCID: PMC6783285 DOI: 10.2486/indhealth.2018-0179] [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: 09/11/2018] [Accepted: 12/27/2018] [Indexed: 06/07/2023]
Abstract
Low back pain (LBP) is a common problem in manufacturing workers. Several strategies have been proposed in order to reduce the pain and/or improve functionality. Among them, lumbar supports are a common solution prescribed for lumbar pain relief. Most of the studies in the literature only consider subjective sensations of the workers for evaluation assessment. This study applies biomechanical tests (a flexion-relaxation test and a functional movement evaluation test) to analyse the effectiveness of flexible lumbar supports in functionality and disability versus placebo intervention, consisting of kinesiotape placed on the low back without any stress. 28 workers participated in the study, randomised in control and intervention groups with a two months' intervention. None of the biomechanical tests showed statistical differences in between-groups pre-post changes. No benefits of wearing a flexible lumbar support during the workday have been found in these assembly-line workers versus placebo intervention.
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Sowah D, Boyko R, Antle D, Miller L, Zakhary M, Straube S. Occupational interventions for the prevention of back pain: Overview of systematic reviews. JOURNAL OF SAFETY RESEARCH 2018; 66:39-59. [PMID: 30121110 DOI: 10.1016/j.jsr.2018.05.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 02/12/2018] [Accepted: 05/08/2018] [Indexed: 06/08/2023]
Abstract
INTRODUCTION We conducted an overview of systematic reviews of interventions for the prevention of low back pain (LBP) that can be conducted in a workplace setting. METHODS An electronic literature search was performed in Medline, EMBASE, and the Cochrane Library. Published peer-reviewed systematic reviews and meta-analyses, which described interventions for the primary or secondary prevention of LBP applicable to a workplace setting, were eligible for inclusion. The methodological quality of the included systematic reviews was assessed with the AMSTAR tool. The primary outcome of interest was the incidence of LBP; secondary outcomes were LBP-associated absenteeism, activity interference, and costs related to LBP. RESULTS Twenty-eight eligible articles published between 1994 and 2016 were included in a qualitative synthesis following our screening of abstracts and full-text articles. The AMSTAR rating revealed 14 reviews of high, 10 of moderate, and 4 of low methodological quality. The identified interventions included workplace modifications (6 reviews, 10 studies, 6,751 subjects); shoe insoles (4 reviews, 6 studies, 2,356 subjects); and lumbar supports and other assistive devices (15 reviews, 18 studies, 60,678 subjects). Educational interventions investigated were back schools (10 reviews, 30 studies, 9,973 subjects); manual material handling techniques/advice (6 reviews, 24 studies, 10,505 subjects); and other forms of instruction including pamphlets, booklets, and other media (four reviews, 14 studies, 11,991 subjects). Exercise interventions, investigated in 12 reviews (35 studies, 19,330 subjects), showed moderate quality evidence of effectiveness for exercise interventions alone or in conjunction with educational interventions; no other type of intervention was consistently effective in the prevention of LBP or LBP-associated outcomes of interest. CONCLUSIONS Our overview provides evidence of effectiveness for exercise with or without educational interventions in the prevention of LBP. PRACTICAL APPLICATIONS Exercise interventions with or without educational interventions that can be applied in the workplace have the potential to prevent LBP.
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Affiliation(s)
- Daniel Sowah
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | - Robert Boyko
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | - David Antle
- EWI Works International Inc., Edmonton, Alberta, Canada.
| | - Linda Miller
- EWI Works International Inc., Edmonton, Alberta, Canada.
| | - Michael Zakhary
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
| | - Sebastian Straube
- Division of Preventive Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
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Overton M, Du Plessis H, Sole G. Electromyography of neck and shoulder muscles in instrumental musicians with musculoskeletal pain compared to asymptomatic controls: A systematic review and meta-analysis. Musculoskelet Sci Pract 2018; 36:32-42. [PMID: 29727802 DOI: 10.1016/j.msksp.2018.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 03/24/2018] [Accepted: 04/02/2018] [Indexed: 01/08/2023]
Abstract
Musicians report a high prevalence of annual musculoskeletal pain (86-89%), attributed to prolonged playing times consisting of repetitive static and dynamic muscle activity. The aim of this study was to explore, compare and synthesise evidence on electromyographic (EMG) muscle activity in neck, shoulder and spinal musculature between painful and asymptomatic instrumental musicians. Ovid, Wiley, Web of Science and Scopus databases were searched in August 2016 for cross-sectional studies that compared EMG activity of neck, shoulder and spinal musculature between musicians with musculoskeletal pain and asymptomatic comparisons. An updated search was performed in May 2017, adding a further study. Two authors independently assessed papers for inclusion and then quality, determined using a modified Downs and Black Checklist. Means and standard deviations were extracted from each study to calculate effect sizes and compare results. Six studies were found to fulfil inclusion criteria. Five studies were deemed high-quality with one being low-quality. Conflicting evidence was found supporting increases in upper trapezius EMG muscle activity in musicians reporting of pain. Moderate-quality evidence indicates increased SCM activity in musicians reporting pain. There was limited evidence supporting increased activity of deltoids, lower trapezius and the upper cervical extensors in musicians reporting of musculoskeletal pain. Meta-analysis of results of three studies assessing upper trapezius activity were conflicting with these not being statistically significant. Further studies with prospective designs, larger population sizes and on broader instrumental groups are warranted.
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Affiliation(s)
- Mark Overton
- Southern Rehab, 29 Byron Street, Sydenham, Christchurch, 8023, New Zealand; Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand.
| | - Heleen Du Plessis
- Department of Music, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
| | - Gisela Sole
- Centre for Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, PO Box 56, Dunedin, 9054, New Zealand
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Mi J, Ye J, Zhao X, Zhao J. Effects of lumbosacral orthoses on postural control in individuals with or without non-specific low back pain. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2017; 27:180-186. [PMID: 29071410 DOI: 10.1007/s00586-017-5355-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Revised: 10/04/2017] [Accepted: 10/17/2017] [Indexed: 12/18/2022]
Abstract
OBJECTIVE To investigate the effect of lumbosacral orthoses (LSOs) on postural control in individuals with or without non-specific low back pain (NSLBP). METHODS Individuals with NSLBP (n = 28) and healthy controls (n = 28) were enrolled to assess the postural control with or without LSOs. Postural control was tested using the Balance Master® NeuroCom system by the modified clinical test of sensory interaction and balance. RESULTS Relative to controls, patients with NSLBP had deficits in postural control with greater center of pressure (COP) sway velocity when standing on firm surface (with eyes open: p = 0.002; with eyes closed: p = 0.002) and standing on foam surface (with eyes open: p = 0.024; with eyes closed: p < 0.001). In the braced condition, the COP sway decreased in all subjects with or without NSLBP when standing on foam surface. There was no significant difference in the effect of LSOs on postural control between NSLBP group and healthy controls. CONCLUSION Individuals with NSLBP have poorer postural control than controls. LSOs seem to improve postural control when standing on unstable surfaces in subjects with or without NSLBP. The effect of LSOs on postural control may not depend on the level of baseline.
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Affiliation(s)
- Jie Mi
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Jiling Ye
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Xin Zhao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China
| | - Jie Zhao
- Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, People's Republic of China.
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Saito H, Sekiguchi M, Yamada H, Kubota T, Shigihara T, Iwasaki T, Yabuki S, Konno S. Comparison of postural changes and muscle fatigue between two types of lumbar support: a prospective longitudinal study. Fukushima J Med Sci 2014; 60:141-8. [PMID: 25410441 DOI: 10.5387/fms.2014-17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Lumbar supports are used in the management of low back pain (LBP). Although various types of lumbar supports are available, insufficient evidence exists regarding their effectiveness. The aim of this study was to investigate the effect of two types of lumbar support on postural change and muscle fatigue in a prospective longitudinal study. METHODS A total of 144 subjects (9 men and 135 women) with LBP were enrolled in this study. Subjects were divided into 2 groups: a conventional lumbosacral support (LS) group and a wear-type support (SW) group. They filled in questionnaires that included the Short Form 36-Item Health Survey (SF-36), the Roland-Morris Disability Questionnaire (RDQ), and a questionnaire that evaluated the severity of LBP at baseline, 1, 2, and 3 months. The first 40 enrolled subjects were investigated for muscle fatigue and walking efficacy during a gait-loading test, and posture at baseline, 1 month, and 3 months. RESULTS The intensity of LBP and the number of days with LBP significantly decreased over time in both groups. The decrease was similar in both groups at each time point. Wearing either support for 3 months did not induce erector spinae muscle fatigue. Furthermore, walking efficacy improved but spinal alignment was not affected by either support. Subjects in the SW group reported that the support was comfortable to wear for long periods, while subjects in the LS group mentioned that the LS relieved LBP by tightly supporting the lower back. CONCLUSION Both types of support reduced mild LBP and improved walking efficiency without causing muscle fatigue.
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Affiliation(s)
- Hiroharu Saito
- Department of Orthopaedic Surgery, Fukushima Medical University School of Medicine
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Gorman T, Dropkin J, Kamen J, Nimbalkar S, Zuckerman N, Lowe T, Szeinuk J, Milek D, Piligian G, Freund A. Controlling health hazards to hospital workers. New Solut 2014; 23 Suppl:1-167. [PMID: 24252641 DOI: 10.2190/ns.23.suppl] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Eatough EM, Way JD, Chang CH. Understanding the link between psychosocial work stressors and work-related musculoskeletal complaints. APPLIED ERGONOMICS 2012; 43:554-63. [PMID: 21944295 DOI: 10.1016/j.apergo.2011.08.009] [Citation(s) in RCA: 112] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Revised: 07/26/2011] [Accepted: 08/22/2011] [Indexed: 05/21/2023]
Abstract
It is well established that psychosocial work stressors relate to employees' work-related musculoskeletal disorder (WRMSD) symptoms. Using a model investigating psychological strain as a mediator between work stressors and WRMSD complaints, this study demonstrated that high levels role conflict, low job control, and low safety-specific leadership are associated with increased employee strain. Strain, in turn, was related to higher levels of WRMSD symptoms of the wrist/hand, shoulders, and lower back. Partial mediation of some relationships was also found, suggesting that additional meditational mechanisms for the relationships between stressors and musculoskeletal symptoms are plausible. This work supports the notion that psychosocial stressors in the work environment have important links to employee health, especially WRMSDs.
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Affiliation(s)
- Erin M Eatough
- University of South Florida, Department of Psychology, 4202 E. Fowler Avenue, PCD 4118G, Tampa, FL 33620-7200, USA.
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An Ergonomic Protocol for Patient Transfer That Can Be Successfully Taught Using Simulation Methods. Clin Simul Nurs 2012. [DOI: 10.1016/j.ecns.2010.05.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Gropelli TM, Corle K. Nurses' and therapists experiences with occupational musculoskeletal injuries. ACTA ACUST UNITED AC 2010; 58:159-66. [PMID: 20349883 DOI: 10.3928/08910162-20100316-01] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Occupational musculoskeletal injuries are costly to the health care industry. It is estimated that 12% of nurses leave the profession annually because of back injuries. With the use of grounded theory methodology, 15 nursing personnel and physical therapists were interviewed about their perceptions of occupational musculoskeletal injuries. Analysis of the data identified major themes, including feelings of fear and frustration; chronic issue and part of the job; love of the profession and concerns about continuing in the profession; increased risk of injury; compliant with treatment; negative impact on quality of life; negative feelings about the occupational health department; and educational needs. A theory began to emerge in which health care workers accepted occupational injuries as part of the job and took no action or initiated only minor interventions to prevent work-related injuries. The study indicates a need for education and better communication.
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Frost DM, Abdoli-E M, Stevenson JM. PLAD (personal lift assistive device) stiffness affects the lumbar flexion/extension moment and the posterior chain EMG during symmetrical lifting tasks. J Electromyogr Kinesiol 2009; 19:e403-12. [DOI: 10.1016/j.jelekin.2008.12.002] [Citation(s) in RCA: 72] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Revised: 12/16/2008] [Accepted: 12/16/2008] [Indexed: 11/25/2022] Open
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Abstract
BACKGROUND While preliminary laboratory tests indicate that a hip belt reduces the load on the back, neck and shoulders associated with musculoskeletal strain, an orchard trial is needed to more realistically assess both effectiveness and acceptability. OBJECTIVE to evaluate the hip belt's effectiveness in three areas: worker acceptance, worker productivity, and one-day muscle fatigue of the back and shoulder. METHODS Ninety-six New York apple harvest workers were randomly assigned to use the intervention hip belt or placebo belt for one week. In a second week all workers switched conditions. Subjects were interviewed at the end of each week to ascertain intervention acceptance. Employer records were reviewed to determine bushels picked per day. Subjects also underwent muscle fatigue testing at the beginning and again at the end of one workday during each week. RESULTS Ninety-one percent of the subjects favored the intervention hip belt. Use of the intervention did not appreciably slow picking speed (bushels per hour) as compared to placebo (8.8 bu/ hr vs. 8.89 bu/hr). Both were significantly faster than the regular equipment condition (8.13 bu/hr). No significant differences in one-day muscle fatigue were found with intervention use. CONCLUSIONS The belt was acceptable to the workers and did not hinder productivity. However, the anticipated ergonomic benefits were not demonstrable using one-day strength testing.
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Bigos SJ, Holland J, Holland C, Webster JS, Battie M, Malmgren JA. High-quality controlled trials on preventing episodes of back problems: systematic literature review in working-age adults. Spine J 2009; 9:147-68. [PMID: 19185272 DOI: 10.1016/j.spinee.2008.11.001] [Citation(s) in RCA: 101] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2008] [Accepted: 11/05/2008] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Back problems (BPs), with their cost and disability, are a substantial burden for individuals, employers, and society. PURPOSE This systematic review of controlled trials evaluates the effectiveness of interventions to prevent BP episodes in working age adults. DATA SOURCES We searched MEDLINE/EMBASE through May 2007, and COCHRANE/Trials Registry through August 22, 2008 using search terms of back pain, back injuries or sciatica, linked to prevention, control, workplace interventions, or ergonomics and searched article bibliographies. STUDY SELECTION For systematic review inclusion, articles had to describe prospective controlled trials of interventions to prevent BPs in working-age adults, with intervention assignment either to individual participants or preexisting groups. Of 185 articles identified as potentially relevant, 20 trials (11%) met inclusion criteria. DATA EXTRACTION Researchers extracted relevant information from controlled trials and graded methodological quality. Because of heterogeneity of trials, meta-analysis was not performed. RESULTS Only exercise was found effective for preventing self-reported BPs in seven of eight trials (effect size 0.39 to >0.69). Other interventions were not found to reduce either incidence or severity of BP episodes compared with controls. Negative trials included five trials of education, four of lumbar supports, two of shoe inserts, and four of reduced lifting programs. CONCLUSIONS Twenty high-quality controlled trials found strong, consistent evidence to guide prevention of BP episodes in working-age adults. Trials found exercise interventions effective and other interventions not effective, including stress management, shoe inserts, back supports, ergonomic/back education, and reduced lifting programs. The varied successful exercise approaches suggest possible benefits beyond their intended physiologic goals. LEVEL OF EVIDENCE Systematic review Level I evidence.
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Affiliation(s)
- Stanley J Bigos
- Department of Orthopedic Surgery, University of Washington, Seattle, WA, USA.
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Etherton J, Main B, Cloutier D, Christensen W. Reducing risk on machinery: a field evaluation pilot study of risk assessment. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2008; 28:711-721. [PMID: 18643827 DOI: 10.1111/j.1539-6924.2008.01045.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A pilot evaluation of the ANSI B11-TR3 Machinery Risk Assessment/Risk Reduction (RA/RR) Guideline was conducted. The TR3 guideline was introduced into five companies on one machinery system in each company with a second machine system serving as a control. A pre-post investigation was performed with safety conditions measured pre and post in both treatment and control and with risk reduction score measured only in the treatment machine system. NIOSH provided a commercially available risk assessment software to facilitate the process. Evaluation measures included avoided injuries, reduced exposure to machinery hazards, pretest and posttest knowledge demonstration, assessment of group processes following training, correct implementation of the guidelines, and degree to which risk reduction recommendations were implemented. The qualitative results of this pilot effort appear to be the best indicators for the way ahead in industrial machine risk assessment. All companies indicated that they derived value in participating in this study and in conducting risk assessments. Quantitative study results suggest that: (1) as measured by the knowledge of the participants before and after the TR3 training, the guidelines can be effective at enhancing employee knowledge of safe machine operations and (2) although the injury reduction trends appear successful, the small sample size in the study size should be considered in interpreting these early results.
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Affiliation(s)
- John Etherton
- NIOSH, Center for Safer Solutions, Morgantown, WV, USA.
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van Duijvenbode ICD, Jellema P, van Poppel MNM, van Tulder MW. Lumbar supports for prevention and treatment of low back pain. Cochrane Database Syst Rev 2008; 2008:CD001823. [PMID: 18425875 PMCID: PMC7046130 DOI: 10.1002/14651858.cd001823.pub3] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Lumbar supports are used in the treatment of low-back pain patients, to prevent the onset of low-back pain (primary prevention) or to prevent recurrences of a low-back pain episode (secondary prevention). OBJECTIVES To assess the effects of lumbar supports for prevention and treatment of non-specific low-back pain. SEARCH STRATEGY We updated the search in the Cochrane Central Register of Controlled Trials, PubMed, EMBASE, and CINAHL to December 2006. We also screened references given in relevant reviews and identified trials, and contacted experts to identify additional RCTs. SELECTION CRITERIA Randomized controlled trials that reported on any type of lumbar supports as preventive or therapeutic intervention for non-specific low-back pain. DATA COLLECTION AND ANALYSIS One review author generated the electronic search. Two review authors independently identified trials that met the inclusion criteria. One review author extracted data on the study population, interventions, and final results. The methodological quality and the clinical relevance were independently assessed by two review authors. Because it was not possible to perform a quantitative analysis, we performed a qualitative analysis in which the strength of evidence on the effectiveness of lumbar supports was classified as strong, moderate, limited, conflicting, or no evidence. MAIN RESULTS Seven preventive studies (14,437 people) and eight treatment studies (1361 people) were included in this updated review. Overall, the methodological quality of the studies was rather low. Only five of the fifteen studies met 50% or more of the internal validity items. There was moderate evidence that lumbar supports are not more effective than no intervention or training in preventing low-back pain, and conflicting evidence whether lumbar supports are effective supplements to other preventive interventions. It is still unclear if lumbar supports are more effective than no or other interventions for the treatment of low-back pain. AUTHORS' CONCLUSIONS There is moderate evidence that lumbar supports are not more effective than no intervention or training in preventing low-back pain, and conflicting evidence whether they are effective supplements to other preventive interventions. It remains unclear whether lumbar supports are more effective than no or other interventions for treating low-back pain. There is still a need for high quality randomized trials on the effectiveness of lumbar supports. One of the most essential issues to tackle in these future trials seems to be the realization of an adequate compliance. Special attention should be paid to different outcome measures, types of patients and types of lumbar support.
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Affiliation(s)
- I C D van Duijvenbode
- Hogeschool van Amsterdam, Amsterdam School for Health Professions (ASHP), Tafelbergweg 51, Amsterdam-Zuidoost, Netherlands, 1105 BD.
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Mroszczyk JW. Wholesale and retail trade sector. JOURNAL OF SAFETY RESEARCH 2008; 39:199-201. [PMID: 18454970 DOI: 10.1016/j.jsr.2008.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Furlan AD, Tomlinson G, Jadad A(AR, Bombardier C. Methodological quality and homogeneity influenced agreement between randomized trials and nonrandomized studies of the same intervention for back pain. J Clin Epidemiol 2008; 61:209-31. [DOI: 10.1016/j.jclinepi.2007.04.019] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2006] [Revised: 04/02/2007] [Accepted: 04/21/2007] [Indexed: 11/26/2022]
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Oleske DM, Lavender SA, Andersson GBJ, Kwasny MM. Are back supports plus education more effective than education alone in promoting recovery from low back pain?: Results from a randomized clinical trial. Spine (Phila Pa 1976) 2007; 32:2050-7. [PMID: 17762804 DOI: 10.1097/brs.0b013e3181453fcc] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Randomized clinical trial. OBJECTIVES To evaluate the effectiveness of a back support plus education versus education alone in promoting recovery from a work-related low back disorder (WR-LBD) while simultaneously considering personal, health, and occupational factors and the impact of occupational factors on recovery. SUMMARY OF BACKGROUND DATA No randomized studies of active industrial workers with low back disorders exist regarding the effectiveness of back supports plus education. METHODS A total of 433 actively employed hourly union workers who had a recent diagnosis of a WR-LBD: 1) those who wore a specially designed back support plus received education on back health; and 2) those who received education on back health only. Demographic, health, medical, and occupational factors were obtained through interview or abstraction of computer files; individual ergonomic exposures were measured with a lumbar motion monitor. Outcomes evaluated over a 12-month period included: self-reported measures of back pain, back pain disability level, physical health, mental health, and administrative measures of recurrence, lost work time, and medical care utilization. RESULTS There was no difference between the study groups with respect to mental or physical health, low back pain, back pain disability, neurogenic symptoms, lost work time, likelihood of recurrence of an episode of a back disorder, or other administrative measures of healthcare utilization or lost work time. However, significant decreases in low back pain, low back pain disability, neurogenic symptoms, and an increase in physical health were observed over the 12 months of observation in both study groups. The only occupational variable found to influence was plant group whereby service parts operations workers in the back support plus education group experienced a lower likelihood of WR-LBD recurrence. CONCLUSION Although there was no overall effect on self-reported recovery or administrative measures or lost work time between the study groups, a back support plus health education may have some value in preventing recurrent WR-LBD in industrial workers who work in psychosocial environments and perform manual material handling tasks similar to those found in parts distribution centers.
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Affiliation(s)
- Denise M Oleske
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL 60612, USA.
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Ammendolia C, Kerr MS, Bombardier C. Back belt use for prevention of occupational low back pain: a systematic review. J Manipulative Physiol Ther 2006; 28:128-34. [PMID: 15800513 DOI: 10.1016/j.jmpt.2005.01.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Back pain continues to be the leading overall cause of morbidity and lost productivity in the workplace. Recently, there has been a renewed interest in the use of back belts by industry to reduce occupational low back pain (LBP). OBJECTIVES To examine the literature and evaluate the effectiveness of back belt use for the primary prevention of occupational LBP. METHODS MEDLINE, CINAHL, EMBASE, and HEALTHSTAR were searched for relevant articles published up to July 2003. Studies were included if participants were material handlers, and outcomes included the incidence and/or duration of lost time of reported LBP among workers who wore back belts compared with those who did not. The quality of the evidence was scored independently by 2 reviewers using a double rating method, first according to research design followed by an internal validity rating. Final synthesis of the evidence was performed in which the evidence was classified as good, fair, conflicting, or insufficient. RESULTS Ten epidemiologic studies meeting inclusion criteria were identified. Of 5 randomized controlled trials, 3 showed no positive results with back belt use; 2 cohort studies had conflicting results; and 2 nonrandomized controlled studies and 1 survey showed positive results. CONCLUSIONS Currently, because of conflicting evidence and the absence of high-quality trials, there is no conclusive evidence to support back belt use to prevent or reduce lost time from occupational LBP.
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Sizer PS, Phelps V, Brismée JM, Cook C, Dedrick L. Ergonomic Pain--Part 2: Differential Diagnosis and Management Considerations. Pain Pract 2004; 4:136-62. [PMID: 17166197 DOI: 10.1111/j.1533-2500.2004.04209.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Work-related musculoskeletal disorders (MSDs) can produce ergonomic pain in several different regions of the body, including the shoulder, elbow, wrist and hand, lumbar spine, knee, and ankle/foot. Each family of disorders is distinctive in presentation and requires diagnosis-specific interventions. Because of the complex nature of these disorders, management approaches may not always eliminate symptoms and or completely restore patient function to a level found prior to symptom onset. As a consequence, ergonomic measures should be implemented to reduce the overload on tissue and contribute to patient recovery. However, functional limits may persist and the clinician must make further decisions regarding a person's functional status in the chronic stages of the patient's care.
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Affiliation(s)
- Phillip S Sizer
- Texas Tech University Health Science Center, School of Allied Health, Doctorate of Science Program in Physical Therapy, Lubbock, Texas 79430, USA
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Smith DL, Dainoff MJ, Mark LS, Oates SP, Davis NC. Effect of a Back Belt on Reaching Postures. J Manipulative Physiol Ther 2004; 27:186-96. [PMID: 15129201 DOI: 10.1016/j.jmpt.2003.12.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The present study investigated the effect of a back belt on reach actions. SUBJECTS Sixteen undergraduate college students (8 male students, 8 female students) ranging in age from 18 to 22 years. Thirteen subjects were included in the final analysis. SETTING The Department of Psychology at Miami University, Oxford, Ohio METHODS Using a well-established set of procedures developed in our laboratory for studying reaching, seated adult participants reached for and retrieved an object placed at various distances from them. Reach distances included values both closer than and farther than each subject's maximum seated reach. The reach task had 2 conditions: picking up and retrieving a small block and skewering and retrieving a small bead with a needle. For each task condition, each subject either wore the belt or did not use a belt. RESULTS Results indicate that when subjects wore the belt while reaching, they tended to have initial transition points (sitting to nonsitting) closer to their bodies than while not wearing the belt. That is, for a distant object, subjects were more likely to raise their bodies out of the chair rather than perform an extreme seated reach, possibly acting to preserve a greater margin of safety. CONCLUSIONS The back belt consistently modified reaching postures by limiting extreme ranges of motion during a task that required enhanced stability. Furthermore, the methodology and analysis presented in this article when applied to chiropractic will allow us to begin thoughtful investigation of the effects of chiropractic adjustments on postural transitions and margin of safety.
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Affiliation(s)
- Dean L Smith
- Center for Ergonomic Research, Department of Psychology, Miami University, Oxford, Ohio, USA.
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Silverstein B, Clark R. Interventions to reduce work-related musculoskeletal disorders. J Electromyogr Kinesiol 2004; 14:135-52. [PMID: 14759759 DOI: 10.1016/j.jelekin.2003.09.023] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Work-related Musculoskeletal Disorders (WMSDs) continue to present a major challenge to workers and their employers in virtually every industry sector. Many disciplines have been involved in providing advice and working on interventions to prevent WMSDs or reduce their consequences. Since the early 1990s, 15 systematic reviews (excluding specific treatment modalities) have appeared in the peer-reviewed literature addressing musculoskeletal disorder reduction. The National Research Council-Institute of Medicine summarized many of these efforts in 2001. Using a systematic literature search strategy, we identified 20 randomized controlled studies, 17 quasi-experimental studies with control groups, and 36 paper reporting case studies with in the peer-reviewed literature between 1999-2003. Evidence is continuing to build that demonstrates combinations of measures appear to have the greatest effect in reducing WMSDs, although individual engineering and administrative controls can also have positive effects.
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Affiliation(s)
- Barbara Silverstein
- Safety & Health Assessment and Research for Prevention (SHARP), Washington State Department of Labor and Industries, PO Box 44330, Olympia, Washington 98504-4330, USA.
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Johnston JM, Landsittel DP, Nelson NA, Gardner LI, Wassell JT. Stressful psychosocial work environment increases risk for back pain among retail material handlers. Am J Ind Med 2003; 43:179-87. [PMID: 12541273 DOI: 10.1002/ajim.10165] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Back pain is a major source of lost work time. Occupational physical activity only accounts for a fraction of low back pain; therefore, there is growing interest in investigating other possible causes of back pain including the psychosocial work environment. METHODS Material handlers (N = 6,311) in 160 newly opened stores were interviewed at study entry and approximately 6 months later. Factor analysis was used to reduce the 37 psychosocial questionnaire items to seven distinct factors. RESULTS After adjusting for history of back problems and work-related lifting, risk of back pain was moderately increased among employees who reported high job intensity demands (odds ratio (OR) = 1.8), job dissatisfaction (OR = 1.7), and high job scheduling demands (OR = 1.6). CONCLUSIONS Modification of the psychosocial work environment for material handlers in large retail stores may help reduce back pain among employees.
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Affiliation(s)
- Janet M Johnston
- Epidemiology Data Center, University of Pittsburgh, GSPH, 127 Parran Hall, 130 DeSoto St., Pittsburgh, Pennsylvania 15261, USA. ,edu
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Affiliation(s)
- Stuart M McGill
- Professor of Spine Biomechanics; University of Waterloo; Ontario, Canada
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Bobick TG, Belard JL, Hsiao H, Wassell JT. Physiological effects of back belt wearing during asymmetric lifting. APPLIED ERGONOMICS 2001; 32:541-547. [PMID: 11703040 DOI: 10.1016/s0003-6870(01)00041-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
This study investigated the effect of wearing a back belt on subjects' heart rate, oxygen consumption, systolic and diastolic blood pressure, and respiratory frequency during asymmetric repetitive lifting. Thirty subjects with materials-handling experience utilized three different belts (ten subjects per belt). Subjects completed six 30-min lifting sessions--three while wearing a belt and three without. Data analyses were conducted on the second, third, and fourth lifting periods. A 9.4 kg box, without handles, was lifted 3 times/min, starting at 10 cm above the floor, ending at 79 cm, with a 60 degree twist to the right. Data analysis indicates that belt-wearing did not have a significant effect on the overall mean values for heart rate, systolic and diastolic blood pressure, and respiratory frequency. Belt-wearing had a significant effect on the overall mean oxygen consumption of the subjects.
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Affiliation(s)
- T G Bobick
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, WV 26505, USA.
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Rudolph L, Deitchman S, Dervin K. Integrating occupational health services and occupational prevention services. Am J Ind Med 2001; 40:307-18. [PMID: 11598980 DOI: 10.1002/ajim.1105] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Despite the human and monetary costs of occupational injury and illness, occupational health care has focused more on treatment than prevention, and prevention is not part of many clinical occupational health practices. This represents a failure of occupational health care to meet the health care needs of the working patients. METHODS MEDLINE searches were conducted for literature on occupational medical treatment and the prevention of occupational injury and illness were reviewed to for linkages between prevention and treatment. Policy discussions which identify examples of programs that integrated prevention and treatment were included. RESULTS Although examples of the integration of clinical and preventive occupational health services exist, there are challenges and barriers to such integration. These include inaction by clinicians who do not recognize their potential role in prevention; the absence of a relationship between the clinician and an employer willing to participate in prevention; economic disincentives against prevention; and the absence of tools that evaluate clinicians on their performance in prevention. CONCLUSIONS Research is needed to improve and promote clinical occupational health preventive services.
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Affiliation(s)
- L Rudolph
- Division of Workers' Compensation, 455 Golden Gate Ave. 9th Floor, San Francisco, California 94102, USA.
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Giorcelli RJ, Hughes RE, Wassell JT, Hsiao H. The effect of wearing a back belt on spine kinematics during asymmetric lifting of large and small boxes. Spine (Phila Pa 1976) 2001; 26:1794-8. [PMID: 11493853 DOI: 10.1097/00007632-200108150-00015] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A crossover design was used to evaluate kinematic measurements collected with an infrared-based motion measurement system. OBJECTIVES To evaluate belt effects on spine kinematics during asymmetric lifting of large and small boxes and to test for carryover effects between trials from belts. SUMMARY OF BACKGROUND DATA Conflicting evidence in the literature exists regarding whether belts are beneficial or detrimental to manual material handlers. Studies have not examined belt effects when lifting different sized boxes, nor carryover effects from belts. METHODS Twenty-eight subjects with manual-handling experience (17 male and 11 female) were randomly assigned to lift either a large or small box (weighing 9.4 kg), from a sagittally symmetric origin at pallet height to a 79 cm height, 60 degrees to the right. Spine flexion, lateral bending and twisting, hip and knee flexion, and angular velocity measurements of the torso with respect to the pelvis were collected for each of three lifting periods, 50 lifts each at 3 lifts per minute, with 18-minute breaks between periods. RESULTS Belts significantly reduced maximum spine flexion, spine flexion and extension angular velocities, and torso left lateral bending angular velocity, and increased hip and knee flexion, regardless of box size. When lifting large boxes, belts significantly reduced torso right lateral bending and torso left twisting. No significant differential carryover effects were detected from belts. CONCLUSIONS Subjects with belts lifted more slowly and used more of a squat-lift technique, regardless of box size. Belts reduced more torso motions while lifting large boxes.
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Affiliation(s)
- R J Giorcelli
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, West Virginia 26505, USA
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