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randomised controlled trial.
Follow up period:
19 distribution centres within a 3 hour drive of Chicago (2 centres were not included in the analysis).
2144 employees who did repetitive lifting in their jobs.
LiftTrainerTM programme (n = 957) or video (n = 1020). Each employee in the LiftTrainerTM group had several 30 minute, individualised training sessions. Up to 5 training sessions were planned for each participant over 10 months. Participation was voluntary, and not all sessions were attended. Participants were fitted with sensors that allowed the bending and twisting forces on the spine to be calculated in real time. These data were used to provide auditory feedback on their lifting technique. This immediate auditory feedback and charts displayed at the completion of a set of lifts helped employees learn lifting techniques that reduced the strain on the lumbar spine. Participants in the control group watched the video Give your back a break or a similar video, which demonstrated various lifting techniques.
back, low back, or mid-back injuries that were not the result of a fall (identified in company injury logs).
Patient follow up:
92% (mean age 34 y, 96% men).
Overall, the groups did not differ in the rate of injury over 12 months (table⇓).
In employees who had jobs that required repetitive lifting, the LiftTrainerTM programme did not reduce back injury more than a video.
Education and training programmes aimed at preventing back injuries among nurses are one of the main occupational health initiatives targeted towards this professional group.1 The study by Lavender et al focuses on particular movements within the process of lifting and the potential relationship between these movements and the occurrence of a back injury.
The participants in the study were from 17 different non-nursing workplaces. Lifting in these contexts may be quite different from what we find in nursing, although types of movement of the spine may be similar. In addition, participants in the study were mainly men, and women comprise the majority of the nursing workforce.
The results of the study are relevant to nurses working in occupational health and to those in direct patient care or teaching “back health” through orientation and in-service. Despite “no lift” policies in hospitals, other tasks that nurses do put strain on their lower backs.2 The study by Lavender et al found that participants who had the lowest twisting moment (or torque) on their spines had the fewest injuries. This finding can increase our focus on twisting motions within lifting and the strain this puts on the lower back.
Although further intervention studies and longer term follow up will be useful, the study suggests that feedback about twisting while lifting may be helpful in back injury prevention programmes.
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