Joint moment loading interplay between the shoulders and the low back during patient handling in nurses

Abstract

BACKGROUND: Manual patient handling completed by nurses can include unexpected or strenuous exertions, potentially leading to injury. Lifting guidelines focus on mitigating primarily limiting low back exposures, and the influence of these techniques on the shoulder is unknown. OBJECTIVE: To quantify shoulder loading during manual patient handling tasks and determine whether approaches intended to limit low back exposures negatively affect shoulder demands. METHODS: Twenty novice university-aged females completed five manual patient handling tasks before and after a training session. Participants simulated handling a partial weight bearing patient, and joint load magnitudes were calculated. Strength demands were interpreted in the context of available population capability ranges. RESULTS: Using recommended techniques decreased peak low back loading in most scenarios (p = 0.01–0.02), but had variable effects on shoulder loading. Peak loading in the shoulders increased by 97–107% in the Sit-to-Chair task following training. Using recommended techniques for Turn Toward decreased mean population strength requirements at the back to 35% of capability while increasing shoulder requirements to 100% capability. CONCLUSIONS: Recommended manual patient handling techniques mitigate low back exposures but likely transfer demands to other body regions, specifically the shoulder.