Foot Placement and Arm Movement Combination while Turning Patients to Prevent Lower Back Pain

Abstract

Nurses and caregivers experienced lower back pain (LBP) as a result of patient handling motions to assist in wheelchair or bed transfer and repositioning. Therefore, previous studies provided assistive tools and devices to reduce lumbar loads while these patients handling motions. However, these devices and tools could not be used in several facilities because these facilities require comfortability, time efficiency, and low cost. Therefore, from these backgrounds, LBP prevention is required for any facility and situation without assistive devices and tools. Low load posture and movement of patient handling motions should be provided for LBP prevention without devices and tools. In our previous study, we explored suitable foot placement to reduce the lumbar load during turning a patient on a bed because patient repositioning on a bed is a serious cause of LBP. However, our previous study indicates that lumbar loads while turning patients cannot be improved only by foot placement adjustment. Postural asymmetry is related to lumbar load and cannot be avoided with only suitable foot placement. On the other hand, adjustment of both arm movement and foot placement has a possibility that reduces lumbar loads due to asymmetry posture. This study aims to explore a suitable combination of foot placement and arm movement order while turning patients for LBP prevention. A total of nine lumbar load combinations consisting of three foot placements (parallel stance, left forward, and right forward) and three arm movement orders (parallel, right first, and left first) were investigated via surface electromyography (sEMG) measurement during patient turning. The results of sEMG showed that a combination using anteroposterior foot placement (right forward) and parallel arm movement (both left and right arm operated at the same time) performed turning patient with the smallest activity for both left and right erector spinae muscles. These results indicate that a combination of anteroposterior foot placement and parallel arm movement could provide a suitable posture to reduce lumbar loads during patient turning.