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PubMed2004

Effect of floor slope on submaximal lifting capacity.

In order to reduce injuries due to lifting a box from the floor, maximal acceptable weights of lift (MAWL) have been established for a level surface. However, an inclined surface condition may be encountered on a jobsite. The purpose of this investigation was to determine if facing up or down a sloped surface affects MAWL. After obtaining university-approved informed consent, 20 apparently healthy men (age = 22.4 +/- 1.4 yrs) and 20 women (age = 22.0 +/- 1.9 yrs) determined floor to knuckle height MAWL using the psychophysical approach. After a familiarization day, two data collection days were completed with the uphill and level (+20, +10 and 0 degree) or downhill and level (-20, -10 and 0 degree) lifting capacities determined. A cadence of four lifts/min was used after starting with an unknown load that participants adjusted after each lift. No differences (p > 0.05) in level MAWL were found on the downhill day compared to the uphill day. While the men lifted significantly more than the women in every condition (p < 0.001), no differences were found across the lifting conditions (p > 0.05). The men averaged a MAWL of 24.7 kg across the five conditions (average standard deviation (SD) = 7.4 kg), the women averaged 14.8 kg (average SD = 3.1 kg). While these findings would suggest no changes in lifting guidelines for a sloped surface within 20 degrees of level, other factors such as lifting technique and the stress placed on the low-back should be examined to assess risk of injury in these different conditions.

Adaptation, Physiological↗
PubMedDate not supplied

[Use of subjective perception of exertion in the evaluation of the tolerance to repetitive lifting: a pilot study].

This preliminary study was conducted to validate subjective perception of effort as indicator of the tolerable workload for prolonged lifting tasks. Three healthy male subjects underwent endurance and incremental lifting tests. Cardiorespiratory parameters (HR, VO2) were monitored with a portable telemetric oxygen uptake analyzer, mechanical parameters were calculated from a lift dynamometer. Rating of perceived exertion was given on Borg's CR-10 scale. Individual fitness profiles for lifting tasks were obtained from the individual relationships between oxygen consumption and heart rate at different lifting frequencies. Physiological responses to repetitive lifting were matched with subjective perceptions. The relationship between perception of exertion and time was described by power functions, Y = a.Xn, in which 0 < n < 1. A single-variable statistical regression for power functions was performed to obtain the individual "iso-perception" curves. The iso-perception curve corresponding to a "moderate effort" (CR3) identified the individual tolerable threshold for prolonged lifting tasks. The individually tolerable power output over time for lifting tasks was calculated.

Adult↗
PubMed1984

An epidemiologic study of lifting and twisting on the job and risk for acute prolapsed lumbar intervertebral disc.

An epidemiologic case-control study undertaken in Connecticut during 1979-1981 indicated that persons with jobs requiring lifting objects of more than 11.3 kg (25 lb) an average of more than 25 times per day had over three times the risk for acute prolapsed lumbar intervertebral disc as people whose jobs did not involve lifting objects of this weight. If the body was usually twisted while the lifting was done, this elevation in risk was apparent with less frequent lifting. An especially high risk for prolapsed lumbar disc was associated with jobs involving lifting objects of more than 11.3 kg with the body usually twisted and the knees not bent while the lifting was done. Neither lifting objects of less than 11.3 kg nor twisting without lifting was associated with an increase in risk.

Adult↗
PubMed1999

Comparison between CO2 insufflation and abdominal wall lift in laparoscopic cholecystectomy. A prospective multiinstitutional study in Japan.

BACKGROUND: Abdominal wall lift (AWL) was developed mainly in Japan to avoid insufflation-related complications and to improve cost performance. AWL, however, has been criticized for its poor visibility in obese patients, the complexity of preparing the lifting instruments, and increased inflammatory reactions. As experience with AWL has increased, proponents of the procedure have come to believe that AWL is simple enough to qualify as a standard method of laparoscopic surgery even in obese patients. Postoperatively, issues such as pain, changes in body temperature, and time before returning to work do not appear to be much different from those after CO2 insufflation. METHODS: Twenty-three institutions participated in a prospective study to compare the effects of insufflation and AWL on surgical performance and postoperative course of laparoscopic surgery. Biochemical markers were also investigated including inflammatory responses. The patients were allocated to the participants to prevent experience-biases. A total of 144 patients were reviewed. RESULTS: Background factors such as male-female ratio, age and body-mass index were similar in each group. The incidence of conversion-to-open was not significantly different between insufflation and AWL. Preparation time and operating time were not significantly different, either. Serum CPK showed a significantly higher value one day after peritoneal lift than after subcutaneous lift. CPK level after insufflation was between that of peritoneal lift and after subcutaneous lift. Differences in changes of plasma interleukin 6 and other surgical stress markers were not observed. CONCLUSIONS: This prospective study, although not randomized, suggests that, except for invasiveness to the muscular layers of the abdominal wall, there may be no substantial difference between AWL and insufflation or among subcutaneous lift, peritoneal lift or insufflation in terms of morbidity, mortality, preparation time, operating time, inflammatory reactions, and postoperative clinical course.

Abdominal Muscles↗
PubMed2001

Acute postural adaptations induced by a shoe lift in idiopathic scoliosis patients.

The objective of this study was to identify acute spinal and three-dimensional postural adaptations induced by a shoe lift in a population of idiopathic scoliosis (IS) patients. Forty-six IS patients (mean age: 12 +/- 2 years) were evaluated radiologically and with a stereovideographic system for pelvic obliquity. Based on the initial postural and radiological evaluation, a pertinent shoe lift height was chosen for each with the result that 12 patients were tested with 5-mm (S5) lifts, 20 patients were tested with 10-mm (S10) lifts, and 14 patients with 15-mm (S15) lifts. The posture for all 46 patients was then re-evaluated and a spinal radiograph obtained for 14 patients. The implementation of a shoe lift independent of the type of curve and amplitude significantly decreased the Cobb angle. As expected there was a change in the vertical height of the left tibial plateau and greater trochanter that induced a change in pelvic tilt. There was also a significant increase in the vertical height of S1 and T1. There was a significant change in the left and right iliac bone version, as well as a decrease in the difference in version between these two bones. The implementation of the shoe lifts also changed the lateral shift of the pelvis. A relative change between the shoulders and pelvis for tilt and anteroposterior shift was also found to be significant. In conclusion, using a shoe lift resulted in acute postural adaptations which specifically affected the spine and the three-dimensional position and orientation of the pelvis and shoulder girdle.

Adaptation, Physiological↗
PubMed1987

An experimental evaluation of psychophysical criteria for repetitive lifting work.

Two experiments were performed to test the reliability and validity of psychophysically determined maximum acceptable workloads for setting lifting standards. The perceived workload in a repetitive diagonal lifting task was found to be a positively accelerated function of the weight lifted and of the work pace respectively. A twofold increase in objective workload resulted in a four- to fivefold increase in perceived workload. This relation was independent of previous occupational experience of lifting work. The psychophysically assessed maximum acceptable workloads for this type of lifting task appeared to be satisfactorily reproducible when subjects had to adjust work pace or when they were left free to adjust both the weight and the work pace. However, the results raised several questions concerning the applicability of the psychophysical assessment of maximum acceptable lifting work. Slight changes in the instructions given to the subjects had a definite effect on the selection of workloads. Furthermore, the workloads selected by subjects with previous occupational experience of lifting work - i e, warehouse workers - were systematically lower than those selected by subjects without such previous experience - i e, office employees. At the same time, the warehouse workers rated perceived exertion higher than the office employees, indicating that previous occupational experience of lifting work enhanced the subjective assessment of physical effort. There were no consistent relations between the workloads found acceptable by the subjects and their physical characteristics and performance capacity.

Journal Article↗
PubMed2005

Comparison of cumulative low back loads of caregivers when transferring patients using overhead and floor mechanical lifting devices.

BACKGROUND: Mechanical lifting devices are recommended as an important intervention for reducing lifting injuries among nursing personnel; previous research suggests that spinal loads are not minimized for all device types. The purpose of this study was to describe the spinal loading pattern while performing a bed to chair transfer comparing Overhead and Floor powered lifting devices. METHODS: A Latin Square design was employed to evaluate five lifting devices while performing a heavy patient transfer. The primary outcomes were spinal compression, and anterior shear (across median and cumulative loading conditions), and ratings of perceived exertion. An inverse dynamic approach was used to calculate the net joint forces and moments about the L5/S1 spinal level. The transfer was partitioned into seven distinct phases for biomechanical analysis. FINDINGS: The proportion of time spent and the mean loads sustained in each phase of the transfer were described. Significant differences in loads were observed between the differing lifting devices, particularly during the transport phases for the Overhead devices. Nurse subjects consistently ranked Overhead lifting devices as most preferred. INTERPRETATION: A large proportion of the time to complete the transfer and cumulative loads occurred during phases that involved only the sling and not the mechanical component of the device. Overhead lifting devices were shown to have lower spinal loads during the transport phases. The results of this study have implications for the use and selection of mechanical lifting devices as part of a strategy to reduce back injuries.

Adult↗
PubMed2003

Deaths in construction related to personnel lifts, 1992-1999.

PROBLEM: This study examined deaths of construction workers due to personnel lifts (boom-supported and scissor lifts, suspended scaffolds, and crane platforms). METHODS: Deaths of construction workers for 1992-1999 were examined using data from the Census of Fatal Occupational Injuries, a Bureau of Labor Statistics database. RESULTS: The study identified 339 deaths: 42% from boom-supported lifts; 26% from suspended scaffolds; 19% from scissor lifts; 5% from crane platforms; and 7% from unapproved lifts (e.g., forklift platforms). The main causes of death were falls (36%), collapses/tipovers (29%), and electrocutions (21%). DISCUSSION: Recommendations include: following OSHA regulations, wearing personal fall protection equipment, adequate maintenance, inspection before use, and training on the model of lift used. Precautions are also needed to prevent contact with overhead power lines. IMPACT ON INDUSTRY: The increasing popularity of boom-supported lifts and scissor lifts, both in construction and other industries, make their safety an important issue.

Accidents, Occupational↗
PubMed1998

Evaluation of spinal loading during lowering and lifting.

OBJECTIVE: To estimate the three-dimensional spinal loads during various lifting and lowering tasks. DESIGN: The in vivo measurements of the trunk dynamics, moments, and myoelectric activity were used as inputs into an electromyographic-assisted model used to predict the three-dimensional spinal loads. BACKGROUND: Previous studies of eccentric motions have investigated muscle activity, trunk strength, and trunk moments. A void in the body of knowledge exists in that none of these studies investigated spinal loading. METHODS: Ten subjects lifted (40 degrees of flexion to 0 degrees ) and lowered (0 degrees of flexion to 40 degrees ) boxes while positioned in a structure that restrained the pelvis and hips. The tasks were performed under isokinetic trunk velocities of 5, 10, 20, 40, and 80 deg s(-1) while holding a box with weights of 9.1, 18.2, and 27.3 kg. RESULTS: Lowering strength was found to be 56% greater than lifting strength. The lowering tasks produced significantly higher compression forces but lower anterior-posterior shear forces than the lifting tasks. The differences in the spinal loads produced by the two lifting tasks were attributed to differences in coactivity and unequal lifting moments (i.e. holding the box farther away from the body). CONCLUSIONS: The nature of the spinal loads that occur during lowering and lifting were significantly different. The difference in spinal loads may be explained by different lifting styles.

Journal Article↗
PubMed2003

Pneumoperitoneum versus abdominal wall lift: effects on central haemodynamics and intrathoracic pressure during laparoscopic cholecystectomy.

BACKGROUND: It has been shown repeatedly that laparoscopic cholecystectomy using pneumoperitoneum (CO2 insufflation) may be associated with increased cardiac filling pressures and an increase in blood pressure and systemic vascular resistance. In the present study, the effects on the central circulation during abdominal wall lift (a gasless method of laparoscopic cholecystectomy) were compared with those during pneumoperitoneum. The study was also aimed at elucidating the relationships between the central filling pressures and the intrathoracic pressure. METHODS: Twenty patients (ASA I), scheduled for laparoscopic cholecystectomy, were randomised into two groups, pneumoperitoneum or abdominal wall lift. Measurements were made by arterial and pulmonary arterial catheterization before and during pneumoperitoneum or abdominal wall lift with the patient in the horizontal position. Measurements were repeated after head-up tilting the patients as well as after 30 min head-up tilt. The intrathoracic pressure was monitored in the horizontal position before and during intervention using an intraesophageal balloon. RESULTS: After pneumoperitoneum or abdominal wall lifting there were significant differences between the two groups regarding MAP, SVR, CVP, CI, and SV. Analogous to previous studies, in the pneumoperitoneum group CVP, PCWP, MPAP, and MAP as well as SVR were increased after CO2 insufflation (P < 0.01), while CI and SV were not affected. In contrast, in the abdominal wall lift group, CI and SV were significantly increased (P < 0.01), as was MAP (P < 0.01), while CVP, PCWP, MPAP, and SVR were not significantly affected. There was a significant difference in intraesophageal pressure between the two groups. In the pneumoperitoneum group, the intraesophageal pressure was increased by insufflation (P < 0.01) while, in the abdominal wall lift group, it was unaffected. In the pneumoperitoneum group the mean increases in cardiac filling pressures were of the same magnitude as the mean increase in the intraesophageal pressure. CONCLUSIONS: In healthy patients, abdominal wall lift increased cardiac index while pneumoperitoneum did not. Cardiac filling pressures and systemic vascular resistance were increased by pneumoperitoneum but unaffected by abdominal wall lift. The recorded elevated cardiac filling pressures during pneumoperitoneum may be only a reflection of the increased intra-abdominal pressure.

Abdominal Muscles↗
PubMed1990

Maximum acceptable repetitive lifting workload by Chinese subjects.

This study used psychophysical methods to determine the acceptable mean maximum lifting workload for eight Chinese young male subjects, and examined the effects of lifting technique (including freestyle, stoop and squat), lifting frequency (including 2, 3, 4, 5 and 6 lifts/min) and physical characteristics on the maximum acceptable workload. The results are described as follows: (1) The maximum acceptable weights selected by subjects varied from 11.34 to 18.33 kg with changes in lifting technique and frequency. These data were lower than those previously obtained; (2) The upper limit of physiological tolerance over an 8 h workday was also generally lower than previously suggested. However, this upper limit varied with changes in lifting technique and frequency, and in some circumstances it was the same as or even higher than previous limit; (3) Lifting efficiency was affected significantly by technique and frequency. The rank order of efficiency for three lifting techniques were freestyle, stoop and squat. Efficiency was greatest when lifting frequency was between 5 and 6 lifts/min; and (4) The correlations between the maximum acceptable workloads selected by subjects and anthropometric sizes were significant, but those between maximum acceptable workload and isometric strength were not.

Adult↗
PubMedDate not supplied

The effects of speed, frequency, and load on measured hand forces for a floor to knuckle lifting task.

The purpose of this study was to describe and quantify measured hand forces during floor to knuckle lifting of various loads. Hand forces of five subjects were measured with a strain gauge apparatus for normal and fast speeds of lifting at 1, 4, and 8 l/min. The pattern of hand force over time exhibited peaks in force in the shape of a spike for all fast lifts, indicating that subjects did not lift smoothly. For normal speed of lift, only one of the five subjects executed some lifts smoothly, indicating that it may be possible to lift smoothly, but most lifters probably do not. Peaks of horizontal and vertical components of hand force were tabulated by speed of lift, frequency, and load.

Adolescent↗
PubMed1979

Predicint lifting capacity.

As science and technology become more sophisticated and with the rapid computation capabilities of the modern computer available, it becomes both possible and economically feasible to scientifically study man and his interaction with his working environment. It is now possible for a person seeking employment to expect and obtain a position which will not be unnecessarily hazardous to his immediate health or have detrimental effects over the long run. Manual materials handling is the contributor of over 400,000 back injuries suffered in the U.S. each year. This research is directed at determining the appropriate operator variables to measure for predicting the permissible weight of lift for three ranges of lift: floor to knuckle height, knuckle height to shoulder height, and shoulder height to reach height. A modified psychophysical procedure was used during which the subjects were instructed to adjust the weight in a tote box to the maximum weight they could lift repetitively without excessive strain or fatique. The task consisted of lifting loads under different conditions of task variables, namely, height of lift, frequency of lift, and load size. Industrial workers as well as students of both sexes were used as subjects. Based on the data obtained, the lifting capacity of the worker was determined for the different ranges of lift. In addition, predictive models were developed based on the operator variables and the task variables investigated.

Accident Prevention↗
PubMed1984

A manual materials handling study of bag lifting.

Physiological and psychophysical research approaches were employed to determine the effects of two levels of fullness (70% and 95%) and the use of handles on bag lifting tasks. A comparison of bag lifting and box lifting was also conducted. Neither the level of bag fullness nor the availability of handles on the bag resulted in a significant change in physiological response for a 20.4 kg load. The maximum acceptable weight lifted was significantly higher when performing a bag lifting task either with handles or when the bag was 95% full. The maximum acceptable weight of lift for bag lifting tasks was higher (2.21 kg) than for box lifting tasks under the conditions of this experiment.

Adolescent↗
PubMed2001

Deep venous thrombosis and pulmonary embolus after face lift: a study of incidence and prophylaxis.

Deep venous thrombosis and pulmonary embolus are known risks of surgery. However, the incidence of these conditions in face lift is unknown. In this study, the incidence of deep venous thrombosis/pulmonary embolus after face lift is studied and factors associated with thromboembolic complications are evaluated. One-third of the active members of the American Society for Aesthetic Plastic Surgery were randomly selected. Participating surgeons completed a one-page survey providing information on face-lift procedures during a 12-month study period. A response rate of 80 percent was achieved, with 273 of the 342 surgeons responding to the survey. A total of 9937 face-lift procedures were reported in the 1-year study period. There were 35 patients with deep venous thrombosis (0.35 percent), 14 patients with pulmonary embolus (0.14 percent), and 1 patient death in the series. Although 43.5 percent of patients underwent face lift under general anesthesia, 83.7 percent of deep venous thrombosis/pulmonary embolus events occurred with general anesthesia. For prophylaxis for deep venous thrombosis/pulmonary embolus, 19.7 percent of the surgeons used intermittent compression devices, 19.6 percent used thromboembolic disease hose or Ace wraps, and 60.7 percent used no prophylaxis. Of patients developing deep venous thrombosis/pulmonary embolus, 4.1 percent were treated prophylactically with intermittent compression devices, 36.7 percent with thromboembolic disease hose/Ace wraps, and 59.2 percent with no prophylaxis. It was found that deep venous thrombosis/pulmonary embolus after face lift is a measurable complication experienced by one of nine surgeons surveyed. Deep venous thrombosis/pulmonary embolus is more likely to occur when the procedure is performed under general anesthesia. The majority of plastic surgeons surveyed used no prophylaxis for deep venous thrombosis when performing face-lift procedures. Intermittent compression devices were associated with significantly fewer thromboembolic complications, whereas Ace wrap/thromboembolic disease hose afforded no protection against deep venous thrombosis/pulmonary embolus when used alone. In conclusion, aesthetic surgeons should consider adopting intermittent compression devices when performing face lift under general anesthesia.

Bandages↗
PubMed2003

Submental suction-assisted lipectomy without platysmaplasty: pushing the (skin) envelope to avoid a face lift for unsuitable candidates.

Patients with submental fullness may not be candidates for a full or short-scar face lift because of medical contraindications, uncontrolled hypertension, a refractory nicotine habit, or anticoagulant medications, or patients may disqualify themselves because of cost, unavailable recovery time, or emotional resistance. Submental suction-assisted lipectomy has traditionally been reserved for younger patients. For older patients, suction-assisted lipectomy is typically used as an adjunct for face/neck lifts. This report describes experiences with suction-assisted lipectomy for older patients who were not face lift candidates, for the aforementioned reasons. The study goals were to better delineate the indications for submental suction-assisted lipectomy, as opposed to a face lift, and to obtain improved results with a less-invasive procedure. A 6-year study involving 132 patients (21 to 73 years of age), of whom 4.5 percent were men, was performed. Eighty-eight patients (67 percent), the primary focus of this study, were more than 40 years of age. Of those 88 patients, 24 patients (18 percent of the 132 patients in this series) were in their forties, 45 (34 percent) were in their fifties, 16 (12 percent) were in their sixties, and three (2.3 percent) were at least 70 years of age. The median follow-up time in this series was more than 1 year. The results were assessed with the five criteria for facial rejuvenation described by Ellenbogen and Karlin. All patients demonstrated improvement, with three to five of the Ellenbogen-Karlin neck rejuvenation criteria being met for each patient. All patients demonstrated an improved submandibular border, a more visible anterior sternocleidomastoid muscle border, and an improved neck angle (as determined with angle measurements). For many patients, all five of the Ellenbogen-Karlin criteria were met. A visible subhyoid depression and a visible thyroid cartilage bulge were the two criteria most often not met. A retrospective evaluation using Baker's preoperative classification of patient types for short-scar face lifts was performed. Results for patients more than 64 years of age (11 patients) were less satisfactory, often with redundant or crepe paper-like skin. Submental suction-assisted lipectomy, as opposed to a face lift, was observed to be a reasonable alternative for older patients who were unable or unwilling to undergo a face lift. Localized fullness in the midline was observed to be the best predictor of a good outcome (even better than age or skin tone). A crepe paper appearance of the skin preoperatively was the best predictor of failure. The surgical anatomical features, technique, advantages, disadvantages, and principles are discussed. Complications and their treatment are addressed. It is concluded that submental suction-assisted lipectomy alone, without platysmaplasty, can be helpful for patients with submental fullness who are unsuitable candidates for a face lift and who accept the limitations of liposuction without platysmaplasty. Suction-assisted lipectomy can sufficiently contract and smooth the skin envelope for selected patients, with less consideration for age than previously proposed.

Adult↗
PubMed1992

Independent control of human finger-tip forces at individual digits during precision lifting.

1. Subjects lifted an object with two parallel vertical grip surfaces and a low centre of gravity using the precision grip between the tips of the thumb and index finger. The friction between the object and the digits was varied independently at each digit by changing the contact surfaces between lifts. 2. With equal frictional conditions at the two grip surfaces, the finger-tip forces were about equal at the two digits, i.e. similar vertical lifting forces and grip forces were used. With different frictions, the digit touching the most slippery surface exerted less vertical lifting force than the digit in contact with the rougher surface. Thus, the safety margins against slips were similar at the two digits whether they made contact with surfaces of similar or different friction. 3. During digital nerve block, large and variable safety margins were employed, i.e. the finger-tip forces did not reflect the surface conditions. Slips occurred more frequently than under normal conditions (14% of all trials with nerve block, <5% during normal conditions), and they only occasionally elicited compensatory adjustments of the finger-tip forces and then at prolonged latencies. 4. The partitioning of the vertical lifting force between the digits was thus dependent on digital afferent inputs and resulted from active automatic regulation and not just from the mechanics of the task. 5. The safety margin employed at a particular digit was mainly determined by the frictional conditions encountered by the digit, and to a lesser degree by the surface condition at the same digit in the previous lift (anticipatory control), but was barely influenced by the surface condition at the other digit. 6. It was concluded that the finger-tip forces were independently controlled for each digit according to a 'non-slip strategy'. The findings suggest that the force distribution among the digits represents a digit-specific lower-level neural control establishing a stable grasp. This control relies on digit-specific afferent inputs and somatosensory memory information. It is apparently subordinated to a higher-level control that is related to the total vertical lifting and normal forces required by the lifting task and the relevant physical properties of the manipulated object.

Adolescent↗
PubMed1975

Lifting burden for a nursing aide during patient care in a geriatric ward.

The lifting burden of a nursing aide during work in a geriatric ward was determined by using a force-plate. Three lifting operations were performed for all patients needing lifting assistance. At the same time as the forces obtained from the force-plate were recorded, the lifts were photographed. The lifting burden during nursing often equalled or exceeded the recommendations of various authors concerning permissible maximum weight loads during different types of lifts. The lifts were often performed under unfavourable conditions and seldom with an "ideal" lifting technique.

Aged↗