New Ergonomics Research

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1 New Ergonomics Research Preventing Injuries and Safely Returning to Work those with a Low Back Disorder 2015 OAOHN Conference W. Gary Allread, PhD, CPE Institute for Ergonomics Session Topics Ergonomics and the Big Picture Factors related to MSD development in the workplace Recent research findings: Injury risks and dynamic movements Safe push/pull task guidelines New types of office work equipment New equipment and products Safely returning to work those with back injuries 2 1

2 ERGONOMICS: THE BIG PICTURE 3 Ergonomics, Defined The science of work The design of work systems around the capabilities and limitations of people Task People 4 2

3 Factors Contributing to Injury Risk Examples: Forceful exertions Awkward work postures Repetitive actions Physical Factors Work Organization Factors Examples: Low job control Job dissatisfaction Poor coworker or supervisor support Examples: Gender Age Body size Individual Factors 5 Injury Risks Physical Factors Forceful exertions Why? Mechanical disadvantage 6 3

4 Injury Risks Physical Factors Awkward work postures Why? Muscles quickly lose strength when lengthened or shortened 7 Injury Risks Physical Factors Repetitive activities Why? Tolerances of soft tissues can change if used continually over time 8 4

5 Injury Risks Work Organization Factors Job Design Complexity of tasks Skill & effort required Attention requirements Job Control Autonomy Influence over decisions Access to information Reward Structures Pay & benefits Job security Personal recognition Promotion opportunities Work Scheduling Hours of work Pacing Shift work Fluctuations in hours Ability to take breaks Interpersonal Aspects Supervisory styles Employee involvement Communication / feedback Conflict resolution Supervisor & coworker support 9 Injury Risks Work Organization Factors Associated reports of back pain Factor Low Coworker Support Lack of Control over Job Lack of Job Security Low Supervisor Support Job Dissatisfaction Odds Ratio (95% Confidence Interval) 1.2 ( ) 1.3 ( ) 1.4 ( ) 1.5 ( ) 1.6 ( ) Source: Johnson et al., Stressful psychosocial work environment increases risk for back pain among retail material handlers, American Journal of Industrial Medicine,

Injury Risks Work Organization Factors Impact on spinal loading Research study procedure: Un-stressed session Subject performs lifts Interruption Experimenters called out of room Stressed session

6 Injury Risks Work Organization Factors Impact on spinal loading Research study procedure: Un-stressed session Subject performs lifts Interruption Experimenters called out of room Stressed session Subject performs same lifts Source: Marras et al., The influence of psychosocial stress, gender, and personality on mechanical loading of the lumbar spine, Spine, Injury Risks Work Organization Factors Impact on spinal loading Research study results: Compression Force Per Unit Moment (N/Nm) Subject Number Unstressed Stressed Source: Marras et al., The influence of psychosocial stress, gender, and personality on mechanical loading of the lumbar spine, Spine,

7 Injury Risks Work Organization Factors Impact on spinal loading Research study results: 30 Percent Increase Extraverts Introverts Compression Lateral Shear Source: Marras et al., The influence of psychosocial stress, gender, and personality on mechanical loading of the lumbar spine, Spine, Injury Risks Individual Factors Those found to be related to discomfort, pain, or injury Age Gender Strength Body Mass Index Body size / anthropometry History of low back pain or injury Income MMH skill Smoking Personality 14 7

Injury Risks Individual Factors Example: Age Median Number 15 10 5 Lost Work Days from Injuries & Illnesses 4 5 6 9 11 13 14 0 16-19 20-24 25-34 35-44 45-54 55-64 65+ Age Range (years) Source: Bureau

8 Injury Risks Individual Factors Example: Age Median Number Lost Work Days from Injuries & Illnesses Age Range (years) Source: Bureau of Labor Statistics, 2014 (2012 data). 15 Injury Risks Individual Factors Reductions in vertebral strength due to age Compared to your 20 s For males, spine strength: Remains steady into the 50 s Drops ~25% into the 70 s For females, spine strength: Remains steady into the 40 s Drops ~15% into the 50 s Drops ~25% into the 60 s Drops ~30% into the 70 s Drops ~40% into the 80 s Source: Bouxsein et al, Journal of Bone and Mineral Growth,

17 Injury Risks Individual Factors Example: Body Mass Index (BMI) Injury/Illness

9 Injury Risks Individual Factors Vertebral disc failures due to age Source: Evans, 1959 and Sonoda, Injury Risks Individual Factors Example: Body Mass Index (BMI) Injury/Illness Claims per 100 full-time equivalents, by BMI Category Source: Østbye, Dement, and Krause, Archives of Internal Medicine, 167: ,

10 Body Mass Index Obesity* Trends U.S. Adults 1985 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% Source: Source: Centers for Disease Control ( 19 Body Mass Index Obesity* Trends U.S. Adults 1986 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% Source: Source: Centers for Disease Control (

11 Body Mass Index Obesity* Trends U.S. Adults 1987 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% Source: Source: Centers for Disease Control ( 21 Body Mass Index Obesity* Trends U.S. Adults 1988 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% Source: Source: Centers for Disease Control (

12 Body Mass Index Obesity* Trends U.S. Adults 1989 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% Source: Source: Centers for Disease Control ( 23 Body Mass Index Obesity* Trends U.S. Adults 1990 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% Source: Source: Centers for Disease Control (

13 Body Mass Index Obesity* Trends U.S. Adults 1991 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% Source: Source: Centers for Disease Control ( 25 Body Mass Index Obesity* Trends U.S. Adults 1992 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% Source: Source: Centers for Disease Control (

14 Body Mass Index Obesity* Trends U.S. Adults 1993 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% Source: Source: Centers for Disease Control ( 27 Body Mass Index Obesity* Trends U.S. Adults 1994 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% Source: Source: Centers for Disease Control (

15 Body Mass Index Obesity* Trends U.S. Adults 1995 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% Source: Source: Centers for Disease Control ( 29 Body Mass Index Obesity* Trends U.S. Adults 1996 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% Source: Source: Centers for Disease Control (

16 Body Mass Index Obesity* Trends U.S. Adults 1997 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% Source: Source: Centers for Disease Control ( 31 Body Mass Index Obesity* Trends U.S. Adults 1998 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% Source: Source: Centers for Disease Control (

17 Body Mass Index Obesity* Trends U.S. Adults 1999 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% Source: Source: Centers for Disease Control ( 33 Body Mass Index Obesity* Trends U.S. Adults 2000 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% Source: Source: Centers for Disease Control (

18 Body Mass Index Obesity* Trends U.S. Adults 2001 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% Source: Source: Centers for Disease Control ( 35 Body Mass Index Obesity* Trends U.S. Adults 2002 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% Source: Source: Centers for Disease Control (

19 Body Mass Index Obesity* Trends U.S. Adults 2004 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% Source: Source: Centers for Disease Control ( 37 Body Mass Index Obesity* Trends U.S. Adults 2004 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% Source: Source: Centers for Disease Control (

20 Body Mass Index Obesity* Trends U.S. Adults 2005 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% 30-35% Source: Source: Centers for Disease Control ( 39 Body Mass Index Obesity* Trends U.S. Adults 2006 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% 30-35% Source: Source: Centers for Disease Control (

21 Body Mass Index Obesity* Trends U.S. Adults 2007 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% 30-35% Source: Source: Centers for Disease Control ( 41 Body Mass Index Obesity* Trends U.S. Adults 2008 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% 30-35% Source: Source: Centers for Disease Control (

22 Body Mass Index Obesity* Trends U.S. Adults 2009 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% 30-35% Source: Source: Centers for Disease Control ( 43 Body Mass Index Obesity* Trends U.S. Adults 2010 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% 30-35% Source: Source: Centers for Disease Control (

23 Body Mass Index Obesity* Trends U.S. Adults 2011 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% 30-35% Source: Source: Centers for Disease Control ( 45 Body Mass Index Obesity* Trends U.S. Adults 2012 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% 30-35% Source: Source: Centers for Disease Control (

24 Body Mass Index Obesity* Trends U.S. Adults 2013 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% 30-35% >35% Source: Source: Centers for Disease Control ( 47 Body Mass Index Obesity* Trends U.S. Adults 2014 * BMI 30, or ~ 30 lbs. overweight for 5 4 person No Data <10% 10-14% 15-19% 20-24% 25-29% 30-35% >35% Source: Source: Centers for Disease Control (

Risks Individual Factors Impact of lifting 20 lbs Obese female Load on

25 Injury Risks Individual Factors Impact of lifting 20 lbs Normal weight female Load on back: Acceptable Overall strength: Acceptable 49 Injury Risks Individual Factors Impact of lifting 20 lbs Obese female Load on back: Of concern Overall strength: Of concern in hips and knees 50 25

26 Injury Risks Individual Factors Obese workers also: Become fatigued and lose strength earlier when repeatedly applying force/torque (Maffiuletti et al., 2007) Have shorter functional reach (~3 ) (Singh et al., 2009) Make greater postural adjustments to maintain balance when reaching and take longer to reach (Berrigan et al., 2006) 51 Injury Risks Individual Factors Obese workers also: Cannot bend forward as far (trunk flexion) when either sitting or standing (Gilleard & Smith, 2007) Have less overall range of motion (Park et al., 2010) Have more hand and shoulder strength (20%) (Cavuoto & Nussbaum, 2013) 52 26

27 Injury Risks Individual Factors Example: Smoking Factor Smoking for Years Low-Back Symptoms Neck-Shoulder Symptoms Lower Limb Symptoms Smoking for 20+ Years Lower Limb Symptoms Upper Limb Symptoms Odds Ratio (95% Confidence Interval) 2.4 ( ) 3.1 ( ) 3.4 ( ) 2.9 ( ) 2.9 ( ) Source: Leino-Arjas, Smoking and musculoskeletal disorders in the metal industry: A prospective study, Occupational and Environmental Medicine, Factors Contributing to Injury Risk Physical Factors Work Organization Factors Individual Factors 54 27

28 RECENT RESEARCH FINDINGS 55 1 Improved Estimations of Lumbar Spine Loads Shear loads on the lumbar spine can be accurately predicted Compression Lateral Shear Anterior / Posterior (A/P) Shear 56 28

Better of evaluations of pushing/pulling 57 Better of

29 1 Improved Estimations of Lumbar Spine Loads Why is this important? Better of evaluations of pushing/pulling 57 1 Improved Estimations of Lumbar Spine Loads Why is this important? Better of evaluations of other activities 58 29

30 1 Improved Estimations of Lumbar Spine Loads Loads can now be estimated accurately at upper lumbar levels T 12 L 2 L 1 T 12 L 2 L 1 L 3 L 4 L 3 L 4 L 5 L 5 S 1 S Improved Estimations of Lumbar Spine Loads Loads can now be estimated accurately at upper lumbar levels 60 30

31 1 Improved Estimations of Lumbar Spine Loads Why is this important? Virtual surgery 61 2 More Accurate Ergonomics Guidelines For lifting tasks: How far apart should two transfer points be, to reduce spinal loading?? Meters / 0.50? 0.75? 1.00? 1.25? 1.50? 1.75? Feet 1.65? 2.46? 3.28? 4.10? 4.92? 5.74? 62 31

32 2 More Accurate Ergonomics Guidelines For lifting tasks: How far apart should two transfer points be, to reduce spinal loading? Distances of meters ( feet) appears to optimally balance spine kinematics, back injury risk, and productivity Meters / 0.50? 0.75? Feet 1.65? 2.46? More Accurate Ergonomics Guidelines For pushing and pulling tasks: Minimal lumbar disc damage for forces under ~20% of one s body weight Size* 5 th -percentile female 50 th -percentile male 95 th -percentile male Acceptable Push/Pull Force <~22# <~38# <~54# Loads at 40%+ of body weight are risky Size* 5 th -percentile female 50 th -percentile male 95 th -percentile male Unacceptable Push/Pull Force >~44# >~76# >~108# 64 32

2 More Accurate Ergonomics Guidelines For pushing

excessively high at high handle heights 80% of

handles are perpendicular to the push/pull

33 2 More Accurate Ergonomics Guidelines For pushing and pulling tasks: Lumbar shear forces are excessively high at high handle heights 80% of standing ht. 65% of standing ht. 50% of standing ht. Force capability is increased (by >10%) when handles are perpendicular to the push/pull direction > 65 3 Clearer Findings about New Office Equipment Sit-to-Stand Desk Treadmill Desk Exercise Ball Chair 66 33

34 3 New Office Equipment Sit-to-Stand Desk Purpose Allows computer users to alternate standing and sitting work positions Pros Large decreases in reported musculoskeletal discomfort, especially later in work day Can reduce fatigue, may increase productivity Preferred by users 67 3 New Office Equipment Sit-to-Stand Desk Cons Less blood circulation than walking Some only stand for short periods of time (i.e., <15 minutes total/day) Rapid decline in use after ~one month 68 34

3 New Office Equipment Sit-to-Stand Desk Take-home messages If used, all equipment should be on the work surface Alternating between sitting and standing requires continued care, to make sure correct

35 3 New Office Equipment Sit-to-Stand Desk Take-home messages If used, all equipment should be on the work surface Alternating between sitting and standing requires continued care, to make sure correct heights are used Most important way to reduce fatigue from computer use is to move, about every minutes; just standing up may not be enough 69 3 New Office Equipment Treadmill Desk Purpose Provides means to do cardiovascular exercises while in the office Pros Use of a walk and work desk significantly increased energy expenditure in obese individuals Attention & reading comprehension were same as when sitting Increased creativity 70 35

3 New Office Equipment Treadmill Desk Cons Keyboard and mouse performance decreased, compared with sitting in a chair Math problem-solving ability reduced by 11% A 16% reduction in speech

36 3 New Office Equipment Treadmill Desk Cons Keyboard and mouse performance decreased, compared with sitting in a chair Math problem-solving ability reduced by 11% A 16% reduction in speech transcribing productivity 71 3 New Office Equipment Treadmill Desk Take-home messages Employees more likely to exert physical effort and get exercise May be useful for non-computer based office work (e.g., reading, teleconferences) When doing computer work: Productivity will likely be reduced Work postures will likely be more stressful on the body 72 36

37 3 New Office Equipment Exercise Ball Chair Purpose To strengthen core muscles while on a computer at work Pros Anecdotally, less pain among those having back problems Recommended by many chiropractors who treat those with low-back pain Much cheaper ($25-$50) than chairs 73 3 New Office Equipment Exercise Ball Chair Cons Most do not provide back support Increases trunk muscle activity and discomfort Does not transfer heat and moisture away from the body Possible safety issues (i.e., falling off while working) 74 37

3 New Office Equipment Exercise Ball Chair Take-home messages Likely not a replacement for an ergonomic office chair that provides adjustability options May be beneficial for temporary sitting,

38 3 New Office Equipment Exercise Ball Chair Take-home messages Likely not a replacement for an ergonomic office chair that provides adjustability options May be beneficial for temporary sitting, to strengthen the core, but not for long-term use May be effective rehabilitation for those being treated for low back pain, but only under supervised care 75 INNOVATIVE EQUIPMENT & TOOLS 76 38

Materials Handling Tool Balancers Equipois zerog Supports tool, freedom of motion Web: www.

77 Materials Handling Vacuum Hoists Vaculex Flexible maneuverability; user-friendly Web: www.

39 Materials Handling Tool Balancers Equipois zerog Supports tool, freedom of motion Web: Note: The Institute for Ergonomics does not endorse this or any other products. 77 Materials Handling Vacuum Hoists Vaculex Flexible maneuverability; user-friendly Web: Note: The Institute for Ergonomics does not endorse this or any other products

Materials Handling Intelligent Assist Devices Gorbel G-Force

com Note: The Institute for Ergonomics does not endorse this or

79 Materials Handling Casters Caster Concepts Reduced effort to

40 Materials Handling Intelligent Assist Devices Gorbel G-Force Programmable, to reduce handling Web: Note: The Institute for Ergonomics does not endorse this or any other products. 79 Materials Handling Casters Caster Concepts Reduced effort to handle carts Web: Note: The Institute for Ergonomics does not endorse this or any other products

Materials Handling Shipping/Receiving Equipment Destuff-IT and

com Note: The Institute for Ergonomics does not endorse this or any

81 Office Workplaces Sit-to-Stand Desks Varidesk Ability to easily

41 Materials Handling Shipping/Receiving Equipment Destuff-IT and Restuff-IT Positions worker in trailers Web: Note: The Institute for Ergonomics does not endorse this or any other products. 81 Office Workplaces Sit-to-Stand Desks Varidesk Ability to easily vary work postures Web: Note: The Institute for Ergonomics does not endorse this or any other products

Materials Handling Housekeeping EZ Dump Smartcan Reduces

com Note: The Institute for Ergonomics does not endorse

83 Healthcare Patient Handling Patient repositioning

Standing Hospital Bed Web: www.transmotionmedical.

42 Materials Handling Housekeeping EZ Dump Smartcan Reduces trash collection efforts Web: Note: The Institute for Ergonomics does not endorse this or any other products. 83 Healthcare Patient Handling Patient repositioning products Less physical effort for nurses Stretcher-Chair Standing Hospital Bed Web: Note: The Institute for Ergonomics does not endorse this or any other products

most common risk factors for low back pain is previous history of low back pain Costs In

43 SAFE RETURN-TO- WORK FROM BACK INJURIES 85 The Impact of Low- Back Disorders (LBDs) Recurrence Recurrent low back injury rates have been reported as high as 70% One of the most common risk factors for low back pain is previous history of low back pain Costs In Ohio, 80% of costs of back injury claims is due to only 16% of cases These cases are recurrent injury 86 43

44 Current Inability to Accurately Assess LBDs A precise diagnosis is unknown in 80-90% of patients with low back pain Only 10-15% of cases are diagnosed through imaging Evaluations are highly subjective Physicians traditionally assess patients in static (frozen) positions With no objective evidence treatment approach is trial and error Less than 50% of surgeries are successful 87 Personalized Assessments of LBDs Evaluating a patient s motion patterns may be a better approach These measures can help direct appropriate diagnostic tests and treatments as well as evaluate return-to-work readiness 88 44

45 Trunk Motions Underlying Logic LBP patients guard their movements, resulting in irregular motion patterns Asymptomatic (Healthy) Subject Low Back Pain Patient 89 Measuring Trunk Motions Lumbar Motion Monitor (LMM) 90 45

46 Measuring Trunk Motions Sagittal plane 91 Measuring Trunk Motions Transverse plane (twisting) 92 46

47 Assessing Low Back Functional Performance An effective functional performance measure should distinguish between: Those without a history of back pain, from Those with low back pain symptoms 93 Functional Performance Measures Ineffective: Strength Trunk range of motion Effective: Trunk velocity Trunk acceleration Combinations of these motions Functional Performance Recovery Range of Motion Velocity Acceleration 94 47

48 Functional Performance Results Overall impairment Impaired Performance Healthy Performance x x 12/10/2012 2/18/2013 Similar to a blood test 95 Functional Performance Results Muscular or structural impairment Structural Muscular x 12/10/

Functional Performance Results Sincerity of effort Insincere Effort Sincere Effort 0.

0 97 Summary of a Functional Performance Evaluation Impaired Performance Overall

49 Functional Performance Results Sincerity of effort Insincere Effort Sincere Effort Summary of a Functional Performance Evaluation Impaired Performance Overall Impairment Healthy Performance Structural Type of Impairment Muscular Insincere Sincerity of Effort Sincere

50 Case Study 1 Disc Herniation/Successful 57 year old male L4/L5 disc herniation Microdiscectomy Successful surgery Return to normal activities 99 Case Study 1 Disc Herniation/Successful 57 year old male L4/L5 disc herniation Microdiscectomy Successful surgery Return to normal activities

51 Case Study 1 Disc Herniation/Successful 57 year old male L4/L5 disc herniation Microdiscectomy Successful surgery Return to normal activities 101 Case Study 1 Disc Herniation/Successful 57 year old male L4/L5 disc herniation Microdiscectomy Successful surgery Return to normal activities LMM reflected functional recovery progress accurately

52 Case Study 2 Disc Herniation/Relapse 53 year old female nurse, 30 years experience L 5 /S 1 disc herniation Microdiscectomy Returned to full duty after 6 weeks Relapsed soon after return to work 103 Case Study 2 Disc Herniation/Relapse 53 year old female nurse, 30 years experience L 5 /S 1 disc herniation Microdiscectomy Returned to full duty after 6 weeks Relapsed soon after return to work

even though she felt she recovered her function was still problematic 105 Case Study 3 Back Pain, Successful PT 31

53 Case Study 2 Disc Herniation/Relapse 53 year old female nurse, 30 years experience L 5 /S 1 disc herniation Microdiscectomy Returned to full duty after 6 weeks Relapsed soon after return to work LMM assessment indicated that even though she felt she recovered her function was still problematic 105 Case Study 3 Back Pain, Successful PT 31 year old male plumber Muscular back pain Physical therapy Returned to work full-duty one day before six week follow-up

54 Case Study 3 Back Pain, Successful PT 31 year old male plumber Muscular back pain Physical therapy Returned to work full-duty one day before six week follow-up 107 Case Study 3 Back Pain, Successful PT 31 year old male plumber Muscular back pain Physical therapy Returned to work full-duty one day before six week follow-up LMM indicated muscular origin of LBP and that patient was successful for return-towork

55 Case Study 4 Surgery Reconsidered 70 year old male Imaging indicted possible disc problem Was considered for surgery Surgeon decided not to do surgery based on LMM (structural vs. muscular) results 109 Scientific Acceptance Research Publications Archives of Physical Medicine and Rehabilitation Clinical Biomechanics Disability and Rehabilitation European Journal of Physical Medicine IEEE Transactions Journal of Occupational Rehabilitation Spine The Spine Journal

56 What is a Safe Job for One with a LBD to Do? Lifting study 62 low back pain patients 61 healthy low back individuals Lift conditions Load weight Height of load Distance of load from body Amount of trunk twisting 111 What is a Safe Job for One with a LBD to Do? Spine compression force results Compression Force (N) Shoulder * Waist * Knee * Far-Waist * Far-Knee * Asymptomatic Patients

57 What is a Safe Job for One with a LBD to Do? Spine shear force results 1000 A/P Shear Force (N) Shoulder * Waist * Knee * Far-Waist * Far-Knee * Asymptomatic Patients 113 What is a Safe Job for One with a LBD to Do? Conclusions Compared to an asymptomatic group, patients with low back pain: Experienced greater spine compression and shear forces when lifting Produced more guarding (coactivity) of their muscles

Lifting Guidelines Return-to-Work from LBD Inputs Employee: Healthy

60-90 deg 115 Lifting Guidelines Return-to-Work from LBD Available

58 Lifting Guidelines Return-to-Work from LBD Inputs Employee: Healthy or LBD? Reach distance from body Height of load when lifting Weight of load Amount of twisting required View from above + 30 deg deg deg 115 Lifting Guidelines Return-to-Work from LBD Available on-line (free): Safety Services Online Tools and Resources: Lifting Guidelines Lifting Guidelines Look-up

59 Lifting Guidelines Return-to-Work from LBD For little twisting (+ 30 deg) 117 Lifting Guidelines Return-to-Work from LBD For moderate twisting (30-60 deg)

Risk level: Low Lifting more than: 10 lbs.

60 Lifting Guidelines Return-to-Work from LBD For severe twisting (60-90 deg) 119 Lifting Guidelines Example Results Healthy Healthy Worker Lifting from Knees Lifting up to: 10 lbs. Risk level: Low Lifting more than: 10 lbs. Lifting up to 25 lbs. Risk level: Moderate Far Reach Little Twisting

Lifting Guidelines Example Results Healthy Worker had LBD Lifting from Knees Far Reach Lifting up to: Risk level: 10 lbs. Low Lifting more than: 10 lbs. Lifting up to 25 lbs.

61 Lifting Guidelines Example Results Healthy Worker had LBD Lifting from Knees Far Reach Lifting up to: Risk level: 10 lbs. Low Lifting more than: 10 lbs. Lifting up to 25 lbs. Risk level: Moderate Results LBD Lifting more than: 20 lbs. Risk level: High Little Twisting Lifting up to Risk level: 20 lbs. Moderate 121 Wrap-Up Consider several types of factors when addressing MSDs Many new ergo research findings and guidelines are available Lots of new technology; not all new equipment makes sense Exciting new advances in safely returning to work those with back injuries

62 Questions? W. Gary Allread, PhD, CPE Program Director Institute for Ergonomics The Ohio State University e: p: w:

Commonwealth Health Corporation NEXT

Commonwealth Health Corporation This computer-based learning (CBL) module details important aspects of musculoskeletal disorders, body mechanics and ergonomics in the workplace. It examines: what causes