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PubMed1994

[Subperiosteal face lift or "mask-lift"].

The subperiosteal facelift is, as its name indicates, a deep technique essentially adapted to the upper two-thirds of the face. It is performed via a bicoronal incision, often associated with a vestibular incision, which allows frontal, maxillary, malar, zygomatic and orbital dissection. Section of the superficial leaflet of the temporal aponeurosis reveals the DMAS (Deep Musculo Aponeurotic System) which can be used to raise all of the soft tissues of the face while protecting the frontal branch of the facial nerve. Elevation of the tissues of the face is essentially vertical and acts on the forehead, temporal region, gaze and cheekbones. Current incisions allow maximal preservation of hair and avoid ascension of the sideburns. This technique is particularly indicated in relatively young subjects.

Anesthesia, General↗
PubMed1996

Effects of asymmetric dynamic and isometric liftings on strength/force and rating of perceived exertion.

A laboratory study was undertaken to determine the postural and physical characteristics and subjective stress during dynamic lifting of a usual load (10 kg) compared with during isometric lifting. The authors also aimed to clarify the effects of asymmetric lifting on these parameters. The subjects were thirteen male college students. They were asked to lift a box weighing 10 kg. They performed sixteen different lifting tasks from the floor to a height of 71 cm, involving a combination of three independent factors: two lifting modes (isometric lifting and dynamic lifting), four lifting angles in relation to the sagittal plane (sagittal plane, right 45 degree, right 90 degree and left 90 degree planes) and two lifting postures (squat and stoop). For each lifting task, strengths or forces and ground reaction forces were measured. At the end of each task, the authors asked the subjects to rate their perceived exertion (RPE) during lifting at ten sites of the body. Angle factor had a significant effect on isometric strengths and dynamic peak forces. Isometric strengths during the maximum 3 s were highest in lifting in the right 45 degree plane, followed by that in the sagittal plane, while those in the right 90 degree and left 90 degree planes were the lowest. However, peak forces in dynamic lifting were the highest in the lifting in the sagittal plane, followed by that in the right 45 degree plane, while those in the right 90 degree and left 90 degree planes were the lowest. Postural factor had a significant effect on height at peak force, which is higher in squat lifting than in stoop lifting. RPEs for the left arm, the backs and the right whole body in isometric lifting were significantly higher than in dynamic lifting of 10 kg. There were remarkably high RPEs for the ipsilateral thigh to the box in right 90 degree and left 90 degree planes during both isometric and dynamic liftings. Locations of the resultant force consisting of three component forces on the force plate were closer to the foot on the same side as the box in asymmetric lifting. Thus, some similarities and differences were found between isometric lifting and dynamic liftings regarding the indexes of strength used in this experiment. The authors consider that the subjects used the foot nearer to the box as a fulcrum during asymmetric lifting. Dynamic measurement using the 10 kg weight is less stressful than the conventional isometric measurement. It was possible to obtain the height data at peak force and time-based changes in the force and the box location during lifting only through dynamic lifting measurement. The results provide new knowledge about the biomechanical features of dynamic lifting tasks.

Adolescent↗
PubMed2005

Texas passes first law for safe patient handling in America: landmark legislation protects health-care workers and patients from injury related to manual patient lifting.

On June 17,2005, Texas Governor Rick Perry (R) signed into law Senate Bill 1525, making Texas the first state in the nation to require hospitals and nursing homes to implement safe patient handling and movement programs. Governor Perry is to be commended for this heroic first stand for safe patient handling in America. The landmark legislation will take effect January 1, 2006, requiring the establishment of policy to identify, assess, and develop methods of controlling the risk of injury to patients and nurses associated with lifting, transferring, repositioning, and movement of patients; evaluation of alternative methods from manual lifting to reduce the risk of injury from patient lifting, including equipment and patient care environment; restricting, to the extent feasible with existing equipment, manual handling of all or most of a patient's weight to emergency, life-threatening, or exceptional circumstances; and provision for refusal to perform patient handling tasks believed to involve unacceptable risks of injury to a patient or nurse. Manually lifting patients has been called deplorable, inefficient, dangerous to nurses, and painful and brutal to patients; manual lifting can cause needless suffering and injury to patients, with dangers including pain, bruising, skin tears, abrasions, tube dislodgement, dislocations, fractures, and being dropped by nursing staff during attempts to manually lift. Use of safe, secure, mechanical lift equipment and gentle friction-reducing devices for patient maneuvering tasks could eliminate such needless brutality. Research has proven that manual patient lifting is extremely hazardous to health-care workers, creating substantial risk of low-back injury, whether with one or two patient handlers. Studies on the use of mechanical patient lift equipment, by either nursing staff or lift teams, have proven repeatedly that most nursing staff back injury is preventable, leading to substantial savings to employers on medical and compensation costs. Because the health-care industry has relied on people to do the work of machines, nursing work remains the most dangerous occupation for disabling back injury. Back injury from patient lifting may be the single largest contributor to the nursing shortage, with perhaps 12% of nurses leaving or being terminated because of back injury. The US health-care industry has not kept pace with other industries, which provide mechanical lift equipment for lifting loads equivalent to the weight of patients, or with other countries, such as Australia and England, which are more advanced in their use of modern technology for patient lifting and with no-lifting practices in compliance with government regulations and nursing policies banning manual lifting. With Texas being the first state to succeed in passing legislation for safe patient handling, other states are working toward legislative protection against injury with manual patient lifting. California re-introduced safe patient handling legislation on February 17, 2005, with CA SB 363, Hospitals: Lift Teams, following the September 22, 2004, veto of CA AB 2532 by Governor Arnold Schwarzenegger, who said he believes existing statutory protection and workplace safety standards are sufficient to protect health care workers from injury. Massachusetts HB 2662, Relating to Safe Patient Handling in Certain Health Facilities, was introduced December 1, 2004. Ohio HB 67, signed March 21, 2005 by Governor Bob Taft (R), creates a program for interest-free loans to nursing homes for implementation of a no-manual-lift program. New York companion bills AB 7641 and SB 4029 were introduced in April, 2005, calling for creation of a 2-year study to establish safe patient handling programs and collect data on nursing staff and patient injury with manual patient handling versus lift equipment, to determine best practices for improving health and safety of health-care workers and patients during patient handling. Washington State is planning re-introduction of safe patient handling legislation, after WA HB 1672, Relating to reducing injuries among patients and health care workers, was stalled in committee in February, 2005. Language from these state initiatives may be used as models to assist other states with drafting safe patient handling legislation. Rapid enactment of a federal mandate for Safe Patient Handling No Manual Lift is essential and anticipated.

Back Injuries↗
PubMed1995

Influence of weight and frequency on thigh and lower-trunk motion during repetitive lifting employing stoop and squat techniques.

Changes in kinematics as a function of lifting weight and frequency was investigated in sagittal symmetric repetitive lifting. For every lift cycle (lowering and lifting) the motion range between the upright position (0 degrees ) and the maximum angular displacement of the thigh and lower-trunk body segments was recorded. Ten subjects performed five repetitive lifting bouts with different weight/frequency combinations, using both stoop and squat lifting techniques. In total, 6384 lifts were analysed. The lifting weight or frequency did not influence the motion ranges in stoop lifting. In squat lifting the weight lifted did not appear to have any influence on the motion ranges, while the thigh motion range was significantly smaller at lifting frequency of 20 lifts min(-1) than at a frequency of 10. A significant gradual decrease in the thigh motion range and corresponding increase in the lower-trunk motion range were seen for a majority of the subjects during squat lifting at frequency 20. These changes suggest that quadriceps muscle strength is the limiting factor in repetitive squat lifting. Also the variation in motion ranges was greater in squat lifting than in stoop lifting. RELEVANCE: Forestry work involves frequent lifting. However, compliance in using squat lifting technique, which is recommended for safe lifting, is sometimes poor. Fatigue may be one of the determinants for changes in kinematics and choice of technique in lifting tasks.

Journal Article↗
PubMed2004

The application of surface electromyography in the assessment of ergonomic risk factors associated with manual lifting tasks.

The purpose of this study was to evaluate the ergonomic risk factors associated with manual lifting tasks using surface electromyography (EMG). 13 volunteers lifted loads of 6 and 13 kg at two speeds and at two horizontal distances in 3 different postures and three boxes of different sizes, from floor to knuckle height, performing 72 lifting tasks. For each lift, the surface electromyography signals from the erector spinae muscles, bilaterally at T10 and L3, was recorded. The ergonomic risk factors associated with manual lifting tasks were evaluated by comparing the average amplitude of EMG signals from the erector spinae muscles. The EMG average amplitude for lifting the load of 13 kg was 14.3% greater than that for lifting the load of 6 kg (t=-10.93, P<0.01). The EMG average amplitude at the site of L3 was 10.3% greater than that at the site of T10 (t=-7.98, P<0.01). The EMG average amplitude when performing "fast" lift was 5.9% greater than the "slow" lift (t=-4.63, P<0.01). The posture of lifting affected the EMG average amplitude. It was lowest with semi-squat posture and greatest with squat posture (F=27.76, P<0.01). The result of multiple stepwise regression analysis showed that the loads of lifting, the size of box, horizontal distance, posture of lifting, the site of the spine subjected to force, lifting speed were the factors affecting the EMG average amplitude. The most significant factor was the loads of lifting, followed by the site of the spine subjected to force and the lifting speed in terms of risk. The ergonomic risk factors associated with manual lifting tasks includes the loads, posture, lifting speed, horizontal distance, the site of the spine subjected to force etc. The results of signal amplitude of EMG from the erector spinae muscles showed that semi-squat posture is the best posture for lifting tasks.

Adult↗
PubMed1999

Spine loading and trunk kinematics during team lifting.

Two-person or team lifting is a popular method for handling materials under awkward or heavy lifting conditions. While many guidelines and standards address safe lifting limits for individual lifting, there are no such limits for team lifting, and these lifts are poorly understood. The literature associated with team lifting offers some interesting paradoxes. Many studies have indicated that people lift less per individual under team conditions compared with one-person lifting. Yet, at least one study has reported an increase in team-lifting capacity when subjects were height-matched. The current study explored the spine loading characteristics of one- and two-person lifting teams when subjects lifted under several sagittally symmetric and asymmetric conditions. Spine compression was lower for two person lifts for a given weight, while lifting in sagittally symmetric conditions whereas lateral shear became much greater for two-person lifts under asymmetric lifting conditions. This study has linked these changes to differences in trunk kinematic patterns adopted during one- versus two-person lifting.

Adult↗
PubMedDate not supplied

An electromyographic analysis of seated and standing lifting tasks.

The objective of this project was to compare the muscular effort exerted during manual lifting tasks performed in standing versus seated posture. Six male undergraduate and graduate students performed 12 different static and dynamic lifts in both sitting and standing positions. During each effort electromyographic (EMG) data were collected on four muscles groups (low back, upper back, shoulder, and abdominals). Four contractions were designed to elicit maximum muscular effort in the four groups being monitored. The remaining data were then expressed as a percentage of maximum EMG. Each subject performed the following: maximum static lift when sitting; maximum static lift when standing; sitting, static lift with 15.9 kg; standing, static lift with 15.9 kg; dynamic sit-forward lift with 15.9 kg, dynamic stand-forward lift with 15.9 kg, dynamic sit-twist with 15.9 kg, dynamic stand-vertical lift with 15.9 kg. Each of the lifts was performed with a wooden tray with slotted handles. Root mean square (RMS) values of the EMG data were calculated for three second periods. EMG activity in the low back, upper back, and shoulder was greater during sitting lifting than during standing lifting. The sit-twist lift resulted in the highest EMG in the abdominal muscles. Dynamic lifts resulted in more muscle activity than did static lifts. From these data it was concluded that sitting-lifting results in greater stress in the low back, upper back, and shoulders than does lifting while standing.

Adult↗