Low back demands from assisting a patient with an unexpected loss of balance

Abstract

Background

To combat the high incidence of lower back musculoskeletal injuries in healthcare workers, it is important to identify potentially injurious tasks. Although risk of injury has been estimated for many clinical tasks, assisting a patient following an unexpected loss of balance or sudden fall has not been assessed. This study aimed to quantify the lower back forces of healthcare workers when assisting a patient from a standing loss of balance.

Methods

Peak L5/S1 intervertebral joint forces were estimated from thirteen healthcare workers in a laboratory setting as they assisted a patient from a standing loss of balance to a nearby wheelchair. The patient was a healthy male (64 kg) who simulated a loss of balance by buckling at the knees. An additional condition with 18 % of the patient's body weight unloaded was also tested.

Findings

In a minority of trials, lower back demands exceeded ergonomic guidelines of 3400 and 1000 N for compression and shear, respectively. Patient body weight affected both compression and resultant shear forces (p-values < .001).

Interpretation

The lower back demands when assisting a 64-kg patient during a simulated loss of balance did not consistently exceed ergonomic safety guidelines. However, the results imply a high-risk task for heavier patients in simulated settings, or potentially all patients in realistic clinical settings. Several experimental design considerations and limitations may have created a best-case scenario that underestimated the lack of injury risk during the task studied. Use of safe patient handling and mobility equipment is advisable to minimize risk when ambulating patients.