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Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_15 | Pages 43 - 43
7 Aug 2024
Johnson K Pavlova A Swinton P Cooper K
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Purpose and background

Work-related musculoskeletal disorders, particularly back pain, are a significant issue for healthcare workers, with patient handling being the most frequently reported risk factor. Patient handling is often performed without assistive devices or equipment, which can cause healthcare staff to maintain awkward postures or experience high loads. This review aimed to comprehensively map the literature surrounding manual patient handling (without assistive devices) by healthcare practitioners to identify the current evidence-base on moving and handling of patients and explore what primary research had been conducted.

Methods and results

JBI methodology for scoping reviews and an a priori registered protocol (DOI 10.17605/OSF.IO/8PR7A) was followed and AMED, CINAHL, MEDLINE, SPORTDiscus and EMBASE databases were searched. Literature published in English between 2002 and 2021 was included.

Forty-nine records were included: 36 primary research studies, 1 systematic review and 12 ‘other’ including narrative and government reports. Primary research predominantly used observational cross-sectional designs (n = 21 studies). Most studies took place in hospitals (n = 13) and laboratories (n = 12). Nurses formed the largest population group (n = 13), with very little research on physiotherapists and other allied health professionals.


Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_15 | Pages 41 - 41
7 Aug 2024
Pavlova A Cooper K Deane J Hart-Winks E Hemming R Johnson K
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Purpose and background

Nearly 70% of UK physiotherapists experience work-related musculoskeletal disorders (WRMSDs) during their career, with a significant proportion occurring in the back and being attributed to patient handling tasks. Evidence suggests that manual handling training alone is ineffective and interventions among nurses indicate that a tailored approach, including targeted exercise (TE), can reduce WRMSD rates. This study aimed to explore physiotherapists’ perspectives of WRMSDs, patient handling, and the role of TE in reducing WRMSDs among physiotherapists.

Methods and Results

Key informant interviews were conducted with 4 physiotherapy operational leads and 1 manual handling trainer from NHS Grampian. Interviews were transcribed and Framework Analysis was utilised to identify key themes, including challenges, barriers, and facilitators. Following this, two online focus groups were conducted with 7 qualified NHS physiotherapists across the UK. Views of manual handling training varied across specialities, with some finding it comprehensive and adaptable, and others finding it less applicable to patients in their speciality or community setting. Physiotherapist views on fitness for work varied, with some highlighting the necessity of TE to ensure workforce health whilst others considered exercise to be a personal matter. Facilitators to implementation identified by participants were having support from management and a strong justification for the exercise content. Varied work schedules and facilities were identified as barriers to implementation of a work-based TE intervention.


Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_15 | Pages 13 - 13
7 Aug 2024
Johnson K Pavlova A Swinton P Cooper K
Full Access

Purpose and Background

Work-related musculoskeletal disorders (WRMSD) can affect 56–80% of physiotherapists. Patient handling is reported as a significant risk factor for developing WRMSD with the back most frequently injured. Physiotherapists perform therapeutic handling to manually assist and facilitate patients’ movement to aid rehabilitation, which can increase physiotherapists risk of experiencing high forces during patient handling.

Methods and Results

A descriptive cross-sectional study was completed to explore and quantitatively measure the movement of ten physiotherapists during patient handling, over one working day, in a neurological setting. A wearable 3-dimensional motion analysis system, Xsens (Movella, Henderson, NV), was used to measure physiotherapist movement and postures in the ward setting during patient treatment sessions. The resulting joint angles were reported descriptively and compared against a frequently used ergonomic assessment tool, the Rapid Upper Limb Assessment (RULA).

Physiotherapists adopted four main positions during patient handling tasks: 1) kneeling; 2) half-kneeling; 3) standing; and 4) sitting. Eight patient handling tasks were identified and described: 1) Lie-to-sit; 2) sit-to-lie; 3) sit-to-stand; facilitation of 4) upper limb; 5) lower limb; 6) trunk; and 7) standing treatments; and 8) walking facilitation. Kneeling and sitting positions demonstrated greater neck extension and greater lumbosacral flexion during treatments which scores highly with the RULA.


Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_15 | Pages 40 - 40
7 Aug 2024
Herbert T Malone M Rhind N Cooper K
Full Access

Background

Chronic pain is a significant burden and represents a major issue for world healthcare systems. Interventions include medication, surgery, pain management programmes, and social support through peer support groups. These groups are often informal, providing informational, emotional, and social support to members. The aim of this project is to co-produce guidance on how to establish a peer support programme for people living with chronic, non-cancer pain that is informed by evidence, theory, and stakeholder experience.

Methods

This project is using Steps 1–4 of the Intervention Mapping (IM) approach to inform the research. Online workshops consisting of people living with chronic pain, third sector representatives, healthcare professionals, and researchers are being used to co-produce the guidance.


Orthopaedic Proceedings
Vol. 98-B, Issue SUPP_6 | Pages 19 - 19
1 Feb 2016
Pavlova A Cooper K Meakin J Barr R Aspden R
Full Access

Purpose and Background:

Healthy adults with a curvy (lordotic) lumbar spine were shown to lift a load from the floor by stooping, while straight (flat) spines squatted. Since skin-surface motion capture often misrepresents internal curvature this study calculated internal lumbar curvature during lifting in the same cohort and compared lumbosacral motion.

Methods:

Magnetic resonance imaging (MRI) was performed in standing and bending forward to 30, 45 and 60°, with markers on the skin at L1, L3, L5 and S1. Lumbar spine shape was characterised using statistical shape modelling and participants grouped into ‘curvy’ and ‘straight’ spine sub-groups (N=8). On a separate day participants lifted a box (6–15 kg) from the floor without instruction while Vicon cameras tracked sagittal movement of L1, L3 and L5 skin markers. Sacral angle (to horizontal) was calculated from pelvic markers. Matching markers during MRI and lifting sessions allowed vertebral centroid positions (L1, L3, L5, S1) during lifting to be calculated using custom MATLAB code.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_2 | Pages 21 - 21
1 Feb 2015
Pavlova A Bint-E-Siddiq A Cooper K Barr R Meakin J Aspden R
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Background and Aim

Spinal stability is associated with low back pain and affects the spines ability to support loads. Stability can be achieved if the applied force follows the curvature of the spine, passing close to the vertebral centroids. Previously we showed that calculated muscle forces required for stability in an idealised model increased with increasing and more evenly distributed lumbar curvatures. The purpose of this study was to calculate the muscle forces required for stability in standing in a group of healthy adults.

Methods

Positional MRI was used to acquire sagittal images of the lumbar spine in a standing posture in 30 healthy adults. Sacral inclination was measured and active shape modelling used to characterise lumbar spine shape. A two-dimensional model of the lumbar spine was constructed using vertebral centroid positions and a simplified representation of the lumbar extensor muscles. The muscle forces required at each level to produce a follower load were calculated using a force polygon.


Orthopaedic Proceedings
Vol. 97-B, Issue SUPP_2 | Pages 25 - 25
1 Feb 2015
Pavlova A Eseonu O Jeffrey J Barr R Cooper K Aspden R
Full Access

Purpose and Background

Low birth weight is related to decreased lumbar spine vertebral canal size and bone mineral content later in life, suggesting that antenatal factors affect spine development. The purpose of this study was to explore associations between antenatal factors and lumbar spine morphology in childhood.

Methods

Antenatal data and supine MR images of the lumbar spine were available for 161 children. Shape modelling, using principle components analysis, was performed on mid-sagittal images to quantify different modes of variation in lumbar spine shape. Previously collected measures of spine canal dimensions were analysed.


Orthopaedic Proceedings
Vol. 96-B, Issue SUPP_4 | Pages 17 - 17
1 Feb 2014
Pavlova AV Meakin JR Cooper K Barr RJ Aspden RM
Full Access

Background and Aim

Low back pain is highly prevalent, particularly in manual occupations. We previously showed that the lumbar spine has an intrinsic shape, identifiable in lying, sitting and standing postures, that affects the spine's response to load. Its effects on motion are unknown. Here we investigate whether intrinsic spinal shape is detectable throughout a greater range of postures and its effect on how healthy adults lift a weighted box.

Methods

The lumbar spine was imaged using a positional MRI with participants (n=30) in 6 postures ranging from extension to full flexion. Active shape modelling was used to identify and quantify ‘modes’ of variation in lumbar spine shape. 3D motion capture analysed participants' motion while lifting a box (6–15 kg, self-selected).


Orthopaedic Proceedings
Vol. 95-B, Issue SUPP_1 | Pages 169 - 169
1 Jan 2013
Quah C Yeoman M Cizinauskas A Cooper K McNally D Boszczyk B
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Background

Spondylolysis (SL) of the lower lumbar spine is frequently associated with spina bifida occulta (SBO). There has not been any study that has demonstrated biomechanical or genetic predispositions to explain the coexistence of these two pathologies.

Purpose

To test the hypothesis that fatigue failure limits will be exceeded in the case of a bifid arch, but not in the intact case, when the segment is subjected to complex loading corresponding to normal sporting activities.


Orthopaedic Proceedings
Vol. 94-B, Issue SUPP_XXVI | Pages 65 - 65
1 Jun 2012
Quah C Yeoman MS Cizinauskas A Cooper K König MA McNally D Boszczyk BM
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Introduction

Lumbar spondylolysis is a fatigue fracture of the pars interarticularis and correlates with Spina Bifida Oculta (SBO) in 67%.

Hpothesis

Load is normally transferred across the arch in axial rotation. Bifid arch results in increased strain across the isthmus of the loaded inferior articular process.