Collectively handling of patients is among the riskiest jobs that one can find. Everyone knows that lifting a patient is not an easy task as it poses a risk to your low back. However, a new study has shown that pushing patients in a wheelchair can also lead to spinal injuries. The major concern is that many people do not know when to stop pushing hence they always exceed the limits.
A research was conducted by researchers from The Ohio State University’s Spine Research Institute. In this research different forces applied on the low back while pushing a wheelchair were measured. The results showed that many people have no idea of how much they should safely push the wheelchairs to protect their spines.
Besides, the results showed that there is a significant risk of experiencing a low back injury which is associated with lifting of patients as well as pushing them on wheelchairs.
A review of the research results
The research team assessed 62 volunteers whereas 31 of them were men and 31 were women where their average age was around 25 years. These volunteers were pushing against a stimulated wheelchair which was connected to a braking system that had adjustable resistance.
The resistance was set to start at low level and then it was increased to reach a level where the volunteers said that they could no longer move that stimulated wheelchair. Throughout the test, researchers were evaluating the forces which were applied upon their intervertebral discs.
The researchers were able to identify that the volunteers, pushed 17-18 percent past the set limit they should have quit. The also researchers found out that wheelchair pushing poses a great risk of causing low back injuries especially for relatively low patient weights. Under normal conditions, the risk of injury upon the low back will occur when pushing patients with weight capacity of 220lb and the risk increases significantly with an increase in weight.
With a rise in obesity, patients are gaining weight and getting heavier thus making it harder to lift and push. Many patients are expected to weigh more than 100 kg.
Besides, the researchers identified that turning a wheelchair was dangerous to the spine as compared to pushing it in a straight line. Turning requires extreme force and energy from the abdominal so as to stabilize the muscles. Besides, the turning motion is responsible for an additional 40% increase in the spinal forces.
The researchers also expect that the risk upon the low back would increase when exposed to non-ideal conditions which were not tested in that particular study. These include activities like pushing a ramp across a carpet or upstairs.
How do wheelchair pushing affect your spine?
Pushing against a heavy load will lead to the compression of your spine. Repetition of the activity will speed up the rate of tear and wear upon your intervertebral discs. This will degenerate your discs.
What you should know is that the intervertebral discs are located between each of the spinal vertebrae. These are the biggest structures within the human body which are not directly supplied by blood. When the disc is healthy, it will diffuse nutrients via the endplates located along each disc. However, if extreme loads are continuously applied upon the low back, they lead to the formation of tiny micro-fractures as well as tissue scars upon the endplates which affect the process of diffusion.
A drop in the supply of nutrients to the disc leads its degeneration. When the spinal discs undergo degeneration, they shrink and might start applying pressure upon your spinal nerves causing you to experience back pain.
What do these results mean?
For now, there is little or nothing you can do to so as to safely condition yourself while pushing a wheelchair. However, using your body weight by positioning your body in a way that your lean forward while pushing a wheelchair might help in reducing the loads upon your low back. But you have to keep in mind that, leaning forward increases your risk to slip and fall.
Researchers recommend that, wheelchair designers should put much emphasis on the wheelchair design enhancing the pushing and turning wheelchair mechanics. For example, Dr. Marras who is the director of Ohio State University’s Spine Research Institute recommends a wheelchair design with a motor that would propel the wheelchair when the required pushing forces start to exceed the limits.
In addition to that, he recommends a sight improve in handles by widening them. This will help in reducing the torques needed in turning patients sitting in wheelchairs.
Besides, there is a need for a technology that will help in reducing injuries especially when it comes to lifting the patients. This can include a floor-based or a ceiling based mechanical lift that will reduce the task of the caregiver. This will also reduce the caregiver’s risk of being exposed repetitive use injuries.
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