| Abstract [eng] |
The aim of research work: To assess biomechanical loads experienced by physiotherapists in the lumbar spine during patient transfer and to determine the links between physical, functional condition and biomechanical loads. Tasks of work: 1. To assess and analyze physical and functional condition, anthropometric data and occupational characteristics of the subjects. 2. To assess biomechanical loads of the lumbar spine of the subjects using different patient transfer techniques. 3. To determine the links of the biomechanical loads experienced in the lumbar spine with indicators of physical and functional conditions, occupational factors and anthropometry. Methods: A total of 40 subjects participated in the study, who performed three different simulated patient transfers: when the patient doesn’t help at all (1), the patient helps the subject a bit (2) and lift with ergonomic belt (3). For the assessment of physical and functional condition, the following were used: anthropometric characteristics, spinal mobility, muscle strength and torso endurance; patient transfer movements were collected by motion capture system Xsens MVN 17 marker set. Results: The physical and functional performance of physiotherapists didn’t differ statistically significantly (p>0,05) in terms of age, work experience, BMI, but a statistically significant difference was observed between men and women in the assessment of lower limb strength (p<0,05). Comparing biomechanical loads experienced in the lumbar spine during different patient transfers, it was found that transfer with ergonomic belt reduces the loads experienced. The correlation analysis showed that with weaker leg muscles and increased range of motion in the lumbar region, biomechanical loads increase, and the risk of trauma is caused. Conclusions: 1. In our study, most subjects were women (57.5%), with an average work experience of 1.65±3.27 years. The average age of the subjects was 23.68±4.80 years, weight – 74.10 ±13.03 kg, height 177.76±11.24 cm, BMI 23.32±2.61 and other indicators of physical fitness were somewhat in line with the general standards of physical training and did not differ statistically significantly (p>0.05) taking into account the age of the subjects, work experience and BMI indicator, with the exception of statistically significant differences in muscle strength between men and women (p<0.05). 2. The maximum biomechanical loads on the L5-S1 segment during patient transfer have been identified in the active lifting phase between 2.0 and 4.5 s, when the maximum compression of the L5-S1 segment is reached, reaching the cut-off norm of 7,000 N, both when the patient is transferred with and without aids. The use of a lifting belt allows to achieve a biomechanically optimal spinal load stroke: vertical forces and moments rise in a controlled manner, the shear force is reduced to 40% and the rotational components remain significantly lower and the muscle activation is coordinated, while when moving without aids, the biomechanical loads on the spine become significantly more intense, chaotic, less controllable and pose a higher risk of injury. 3. After analysing the factors that can influence biomechanical loads experienced in the lumbar spine, we found that anthropometric data of the subjects do not affect the size of the loads, but physical indicators of the subjects have an impact on the compression and shear loads (p<0.05). Subjects with lower gluteus maximus strength and excessive lumbar stretching experienced greater loads on the lumbar spine. |
