To produce objective evidence that lifting is more comfortable in lumbar flexion than lumbar extension. Traditionally, lifting is taught in lumbar extension (“straight back”) but in our experience is more comfortable and stronger in flexion with backward lumbar tilt. 58 subjects performed maximal comfortable static lifts: ‘Natural’ lifting position - hip flexion, knee extension, lumbar extension Traditionally taught position - hip flexion, knee flexion, lumbar extension Backward pelvic tilt - hip flexion, knee flexion, lumbar flexion The order of these lifting methods varied to allow for variation due to fatigue/recruitment. All lifts were measured with a computerised dynamometer. The mean force for natural lifting was 13.4 kgs, for traditionally taught lifting 15.1 kgs and for backward pelvic tilt lifting 22.2 kgs This represented a 13% greater load for traditionally taught lift compared with natural lift, 66% greater for backward pelvic tilt compared with natural lift and 48% greater for backward pelvic tilt compared with traditionally taught lift.Purpose:
Method and results:
Hip fracture is a common cause of hospital admission and is often followed by reduced quality of life, or by death. International experiences indicate there are many benefits to be gained from national hip fracture registries. This pilot project aims to implement a hip fracture registry at three sites, a large metropolitan public hospital (Flinders Medical Centre), a large metropolitan private hospital (Epworth HealthCare) and a rural regional hospital (Goulburn Valley Health) to assess the feasibility of establishing a national registry. Patients undergoing surgery for a hip fracture will be recruited from the three participating hospitals between March and September 2009. A minimum data set will be collected at discharge, from hospital records. Items include patient demographics, fracture descriptors, length of stay, residential status, mobility, health status, surgical details and discharge destination. A phone interview at four months after surgery will measure outcomes by using the Extended Glasgow Outcomes Scale and documenting residential status, mobility, hip pain and readmissions. Re- operations, if any, will be collected. The availability of data from State Health Departments for validation of hospital case data will be reported. The pilot study is in progress at the time of writing. Ethical approval has been obtained, data collection, transmission and storage systems have been developed and deployed, and case data collection is underway. Case data will be summarised to describe hip fracture at the participating hospitals. Analysis will review the data elements in the pilot data set and assess their priority for inclusion in a national register—taking account of the quality of the data obtained and the time and other resources required for their collection. We will also evaluate the four-month review process. Any potential obstacles to a national registry that are identified during the pilot will be described and ways to overcome them will be proposed. A national hip fracture registry will improve the quality of care and safety of patients following hip fracture by developing an efficient mechanism to compare and improve the effectiveness of acute health care delivery by all hospitals involved in the management of hip fractures.
