The Influence of Contextual and Theoretical Expertise on Generic and Occupation-Specific Lifting Strategy.

Abstract

Objective: To determine whether (i) low back loads and/or (ii) kinematic coordination patterns differed across theoretical expert, contextual expert and novice groups when completing both generic and occupation-specific lifts.

Background: Experience has been proposed as a factor that could reduce biomechanical exposures in lifting, but the literature reports mixed effects. The inconsistent relationship between experience and exposures may be partially attributable to the broad classification of experience and experimental lifting protocols not replicating the environment where experience was gained.

Methods: Purposive sampling was used to recruit 72 participants including theoretical experts (formal training on lifting mechanics), contextual experts (paramedics), and novices. Participants performed 10 barbell and crate (generic) lifts, as well as backboard and stretcher (occupation-specific) lifts while whole-body kinematics and ground reaction forces were collected. Peak low back compression and anteroposterior shear loads normalized to body mass, as well as kinematic coordination patterns, were calculated as dependent variables.

Results: No significant differences in low back loads were observed across expertise groups. However, significant differences were seen in kinematic coordination patterns across expertise groups in occupation-specific lifts, but not in generic lifts.

Conclusion: Increasing expertise is unlikely to minimize low back loads in lifting. However, contextual expertise did influence lifting kinematics, but only when performing occupationally specific lifts.

Application: Contextual expertise may help lifters adopt lifting kinematics that enhance the tolerance of their musculoskeletal system to withstand applied loads, but does not seem to reduce the applied low back loads relative to noncontextual expert groups.