Does Proper Patient Handling Technique, Coupled With New Technology, Help Reduce Musculoskeletal Demands of Health Care Workers
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 28
- 试验地点
- 3
- 主要终点
- Motion Capture: To assess postural changes in patient handling technique.
研究概览
简要总结
Patient handling is a major risk-factor for the development of musculoskeletal injuries in healthcare providers. To have a significant impact on injury reduction related to patient handling will require the incorporation of technology. This project is to investigate a piece of technology that has been designed to facilitate in-bed patient handling: The Vendlet.
The purpose of this research project is to assess the ability of the Vendlet system outfitted on a Span-America Medical Systems (SAMS) bed to reduce the physical load on healthcare providers performing patient handling tasks. This evidence-based outcomes will be used to support the mitigation of the Vendlet from the European market into the Canadian market. The SAMS bed is currently available in North America and has several adjustable features to support patient transfer activities.
The project will provide a biomechanical comparison of commonly used patient handling techniques performed using a SAMS bed outfitted with and without a Vendlet patient transfer device. This Vendlet technology has the potential to significantly reduce the musculoskeletal and joint strain of healthcare providers while handling patients.
详细描述
The General Objectives of this project are as followed:
- The first research objective is to build complex movement waveform models to help assess kinematic, neuromuscular and force demands related to patient handling and the associated human movement patterns. These waveform models will then be used to best answer our two main research questions.
- The second research objective is to build a biomechanical shoulder and back model to determine the cumulative load (joint stresses) demands related to patient handling as a means to quantify the risk of injury at these highly vulnerable joints. These cumulative loading models will then be used to best answer our two main research questions.
- The third and last research objective is to determine the margin of error of a markerless motion capture system compared to a gold standard marker-based motion capture system; to determine the feasibility for future research to be conducted in a health care setting and thus increasing the ecological validity of the assessment during a typical working day.
This project has the following Research Questions:
- What are the movement technique patterns and physical demands associated with performing patient handling techniques with and without the use of medical bed assistive technology?
- What effect does training have on patient handling techniques? Specifically, does training help improve the healthcare worker's movement patterns as well as reduce physical load demands?
This project has the following Research hypotheses:
研究设计
- 研究类型
- Interventional
- 分配方式
- Na
- 干预模型
- Single Group
- 主要目的
- Basic Science
- 盲法
- None
盲法说明
Participants will be masked of the proper technique/training during the pre-intervention session (with and without the use of technology). Specifically, on how to manually move the patient in both beds.
入排标准
- 年龄范围
- 17 Years 至 40 Years（Child, Adult）
- 性别
- All
- 接受健康志愿者
- 是
入选标准
- •- One-month history of no pain or injury in the low back or shoulder region.
排除标准
- •- Participant received a training on proper patient handling techniques.
研究组 & 干预措施
Nursing Student
The study involves 1 single arm. A single group of participants will experience all experimental conditions. From an ergonomic standpoint, it has been recognized that providing patient-handling ergonomics training is crucial to their safety. This project will compare the same group performing patient handling tasks without training versus training while utilizing both long term care beds.
干预措施: Ergonomic Training on Patient Handling Techniques (Other)
结局指标
主要结局
Motion Capture: To assess postural changes in patient handling technique.
时间窗: Pre-Intervention and Post-intervention (within 2 weeks after intervention)
Kinematic coordinates of markers will be gap filled (spline smoothing algorithm) and then filtered using a 2nd order Butterworth low pass filter (cut off frequency of 10Hz). Visual 3D, C-motion software will be used to filter raw kinematic data as well as calculate specific joint angles. 3D movement (flexion/extension, lateral bend, and twist) of the neck, both arms, pelvis, trunk-pelvis, hips, knees, and trunk-thigh will be used in Visual 3D to calculate three-axis joint angles. Visual 3D software will be used to calculate kinematic and kinetic values. The kinematics (joint angles) and kinetics (inverse dynamics) will be compared for each patient handling technique between 1- SAMS bed (with the Vendlet) vs the SAMS bed (without the Vendlet), and 2- Pre vs Post Intervention.
Motion Capture: To assess cumulative load forces
时间窗: Pre-Intervention and Post-intervention (within 2 weeks after intervention)
Kinematic coordinates of markers will be gap filled (spline smoothing algorithm) and then filtered using a 2nd order Butterworth low pass filter (cut off frequency of 10Hz). Visual 3D, C-motion software will be used to filter raw kinematic data as well as calculate specific joint angles. 3D movement (flexion/extension, lateral bend, and twist) of the neck, both arms, pelvis, trunk-pelvis, hips, knees, and trunk-thigh will be used in Visual 3D to calculate three-axis joint angles. Visual 3D software will be used to calculate kinematic and kinetic values. Visual 3D will also be used to calculate the inverse dynamics of the participants; calculating kinetics will help us determine the force and cumulative load demands of the participant while they handle a patient. The kinematics (joint angles) and kinetics (inverse dynamics) will be compared for each patient handling technique between 1- SAMS bed (with the Vendlet) vs the SAMS bed (without the Vendlet), and 2- Pre vs Post Intervention.
Motion Capture: To assess joint angles
时间窗: Pre-Intervention and Post-intervention (within 2 weeks after intervention)
Kinematic coordinates of markers will be gap filled (spline smoothing algorithm) and then filtered using a 2nd order Butterworth low pass filter (cut off frequency of 10Hz). Visual 3D, C-motion software will be used to filter raw kinematic data as well as calculate specific joint angles. 3D movement (flexion/extension, lateral bend, and twist) of the neck, both arms, pelvis, trunk-pelvis, hips, knees, and trunk-thigh will be used in Visual 3D to calculate three-axis joint angles. Visual 3D software will be used to calculate kinematic and kinetic values. The kinematics (joint angles) and kinetics (inverse dynamics) will be compared for each patient handling technique between 1- SAMS bed (with the Vendlet) vs the SAMS bed (without the Vendlet), and 2- Pre vs Post Intervention.
Neuromuscular Activity - Average muscle activation
时间窗: Pre-Intervention and Post-intervention (within 2 weeks after intervention)
Eight bilateral muscles will be examined: anterior deltoid \[AD\], trapezius descendens \[TD\], biceps brachii \[BB\], thoracic erector spinae \[TES\] located at the level of the T9 spinous process, lumbar erector spinae \[LES\] located at the level of the L3 spinous process, external oblique \[EO\], rectus femoris \[RF\], and biceps femoris \[BF\]. The raw EMG signal will be rectified, and Butterworth low passed filtered (RMS converted) using MATLAB. Peak activity will be found for each muscle during the maximum voluntary contraction (MVC) trials and used to normalize all subsequent EMG data. Therefore, the EMG data will represent a percent change from the participants' MVCs for each muscle, during each patient handling trial. An analysis of the neuromuscular activation changes (%MVC) will be compared during each patient handling technique between 1- SAMS bed (with the Vendlet) vs the SAMS bed (without the Vendlet), and 2- Pre vs Post Intervention.
Neuromuscular Activity - Peak muscle activation
时间窗: Pre-Intervention and Post-intervention (within 2 weeks after intervention)
Eight bilateral muscles will be examined: anterior deltoid \[AD\], trapezius descendens \[TD\], biceps brachii \[BB\], thoracic erector spinae \[TES\] located at the level of the T9 spinous process, lumbar erector spinae \[LES\] located at the level of the L3 spinous process, external oblique \[EO\], rectus femoris \[RF\], and biceps femoris \[BF\]. The raw EMG signal will be rectified, and Butterworth low passed filtered (RMS converted) using MATLAB. Peak activity will be found for each muscle during the maximum voluntary contraction (MVC) trials and used to normalize all subsequent EMG data. Therefore, the EMG data will represent a percent change from the participants' MVCs for each muscle, during each patient handling trial. An analysis of the neuromuscular activation changes (%MVC) will be compared during each patient handling technique between 1- SAMS bed (with the Vendlet) vs the SAMS bed (without the Vendlet), and 2- Pre vs Post Intervention.
Foot Pressure Distribution: Contact area will be the outcome measure of interest to assess postural balance and stability of the participant performing the patient handling technique.
时间窗: Post-intervention (within 2 weeks after intervention)
The Xsensor FOOT and GAIT software (Xsensor, Calgary, AB, Canada) will be used to measure the peak pressure in each section of the patient's sole and plantar contact area during each patient handling techniques. To study the pressure variations in greater detail, the foot data will be subdivided into the following : 1- the toe (T); 2- the metatarsals (M) separated into three parts (metatarsal 1: M1, metatarsal 2\&3: M2, metatarsal 4\&5: M3); 3- the midfoot (MF); and 4- the heel (H) separated into two parts (medial heel: MH, and lateral heel: LH). Peak pressure values will also be assessed for each section of the foot during each patient handling techniques. The foot pressure distribution outcomes will be compared between each patient handling technique between 1- SAMS bed (with the Vendlet) vs the SAMS bed (without the Vendlet), and 2- Pre vs Post Intervention.
Bed Pressure Distribution: Peak pressure distribution will be outcome measures to assess the safe placement of the patient.
时间窗: Pre-Intervention and Post-intervention (within 2 weeks after intervention)
Bed Pressure Distribution will be considered in four body regions at two-time points on both beds. The body regions include the right and left regions of the back (including the shoulders and upper back) and the right and left areas of the pelvis (hips). These regions will be compared at two separate time points: the initial participant position (lying supine prior to any patient handling technique) and the final participant position (once the patient handling technique is completed). At each timepoint, pressure-related outcome measures will be computed for each task. Contact area (in2), average pressure on contact area (mmHg), and peak pressure will be among the outcome measures (mmHg). The bed pressure distribution outcomes will be compared between each patient handling technique between 1- SAMS bed (with the Vendlet) vs the SAMS bed (without the Vendlet), and 2- Pre vs Post Intervention.
Foot Pressure Distribution: Peak pressure will be the outcome measure of interest to assess postural balance and stability of the participant performing the patient handling technique.
时间窗: Post-intervention (within 2 weeks after intervention)
The Xsensor FOOT and GAIT software (Xsensor, Calgary, AB, Canada) will be used to measure the peak pressure in each section of the patient's sole and plantar contact area during each patient handling techniques. To study the pressure variations in greater detail, the foot data will be subdivided into the following : 1- the toe (T); 2- the metatarsals (M) separated into three parts (metatarsal 1: M1, metatarsal 2\&3: M2, metatarsal 4\&5: M3); 3- the midfoot (MF); and 4- the heel (H) separated into two parts (medial heel: MH, and lateral heel: LH) . Peak pressure values will also be assessed for each section of the foot during each patient handling techniques. The foot pressure distribution outcomes will be compared between each patient handling technique between 1- SAMS bed (with the Vendlet) vs the SAMS bed (without the Vendlet), and 2- Pre vs Post Intervention.
Bed Pressure Distribution: Average pressure distribution will be outcome measures to assess the safe placement of the patient.
时间窗: Pre-Intervention and Post-intervention (within 2 weeks after intervention)
Bed Pressure Distribution will be considered in four body regions at two-time points on both beds. The body regions include the right and left regions of the back (including the shoulders and upper back) and the right and left areas of the pelvis (hips). These regions will be compared at two separate time points: the initial participant position (lying supine prior to any patient handling technique) and the final participant position (once the patient handling technique is completed). At each timepoint, pressure-related outcome measures will be computed for each task. Contact area (in2), average pressure on contact area (mmHg), and peak pressure will be among the outcome measures (mmHg). The bed pressure distribution outcomes will be compared between each patient handling technique between 1- SAMS bed (with the Vendlet) vs the SAMS bed (without the Vendlet), and 2- Pre vs Post Intervention.
次要结局
- Rating of Perceived Exertion (RPE)(Pre-Intervention and Post-intervention (within 2 weeks after intervention))
- Self Reported Questionnaires(Pre-Intervention and Post-intervention (within 2 weeks after intervention))
- Exit Survey(Pre-Intervention and Post-intervention (within 2 weeks after intervention))