Association between Trunk Flexion and Physical Activity in Patient Care Unit Workers

The purpose of this pilot study was to characterize the direct measure of physical activity levels and the trunk posture (as a proxy for physical load) among a convenience sample of 49 Patient Care Unit workers (nurses and patient care assistants) for a single work shift. We tested the hypotheses that Patient Care Unit (PCU) worker’s increased trunk posture is associated with their direct measure of physical activity levels during one work-shift. To assess the physical activity and physical load component all participants wore an accelerometer and an inclinometer respectively. A correlation analysis was performed to assess the association between parameters of physical activity (minutes in sedentary activity, minutes in lifestyle activity, minutes in light activity and minutes in moderate activity) with parameters of physical load (number of forward trunk bends to 20° per shift, number of forward trunk bends to 45° per shift). Workers were recruited from two hospitals in Boston, Massachusetts. Eleven participants spent 86% of the time at work with a trunk flexion lower than 15°, they were considered at low exposure for back disorders. Seven PCU workers spent 33% of their work time with a trunk flexion higher than 20°, they were considered at high exposure. Twenty-one workers were classified at a medium exposure for back disorders. A high correlation was found between number of forward trunk bending to 20° per shift (spearman’s correlation: 0.56, p<0.001) with minutes in lifestyle activity. In addition, a high correlation was found among number of forward trunk bending to 45° per shift with minutes in lifestyle activity and minutes in light activity (spearman’s correlation: 0.41, p=0.005 and 0.37, p=0.01 respectively). These results suggest that physical load at work during a single shift does not contribute to meet moderate or vigorous activity levels which are the activity levels that have substantial health benefits. Further studies with a bigger sample size would be recommended to assess the association between physical loads and physical activities for more than one shift to corroborate our findings.

[1]  H. Burr,et al.  Physical demands at work, physical fitness, and 30-year ischaemic heart disease and all-cause mortality in the Copenhagen Male Study. , 2010, Scandinavian journal of work, environment & health.

[2]  M. Huuskonen,et al.  Relative risk of mesothelioma associated with different levels of exposure to asbestos. , 1991, Scandinavian journal of work, environment & health.

[3]  G. Borg Psychophysical scaling with applications in physical work and the perception of exertion. , 1990, Scandinavian journal of work, environment & health.

[4]  W. Marras,et al.  The Role of Complex, Simultaneous Trunk Motions in the Risk of Occupation‐Related Low Back Disorders , 1998, Spine.

[5]  W. M. Keyserling,et al.  A checklist for evaluating ergonomic risk factors resulting from awkward postures of the legs, trunk and neck , 1992 .

[6]  D A Stubbs,et al.  Back pain in the nursing profession. I. Epidemiology and pilot methodology. , 1983, Ergonomics.

[7]  W. M. Keyserling,et al.  Back disorders and nonneutral trunk postures of automobile assembly workers. , 1991, Scandinavian journal of work, environment & health.

[8]  Vera Yin Bing Yip,et al.  New low back pain in nurses: work activities, work stress and sedentary lifestyle. , 2004, Journal of advanced nursing.

[9]  P S Freedson,et al.  Calibration of the Computer Science and Applications, Inc. accelerometer. , 1998, Medicine and science in sports and exercise.

[10]  Kay Teschke,et al.  Measuring posture for epidemiology: Comparing inclinometry, observations and self-reports , 2009, Ergonomics.

[11]  W S Marras,et al.  An Assessment of Complex Spinal Loads During Dynamic Lifting Tasks , 1998, Spine.

[12]  P. Blackman Actual causes of death in the United States. , 1994, JAMA.

[13]  W. Marras,et al.  A comprehensive analysis of low-back disorder risk and spinal loading during the transferring and repositioning of patients using different techniques. , 1999, Ergonomics.

[14]  J. Gerberding,et al.  Actual causes of death in the United States, 2000. , 2004, JAMA.

[15]  A. Yassi,et al.  Electromyography as a measure of peak and cumulative workload in intermediate care and its relationship to musculoskeletal injury: an exploratory ergonomic study. , 2005, Applied ergonomics.

[16]  Roger C. Jensen,et al.  Back Injuries among Nursing Personnel Related to Exposure , 1990 .

[17]  G. O. Lignac [Actual causes of death]. , 1951, Nederlands tijdschrift voor geneeskunde.

[18]  J. Ilmarinen,et al.  Prevalence and incidence rates of diseases and work ability in different work categories of municipal occupations. , 1991, Scandinavian Journal of Work, Environment and Health.

[19]  Matthias Egger,et al.  Domains of physical activity and all-cause mortality: systematic review and dose-response meta-analysis of cohort studies. , 2011, International journal of epidemiology.