Can a New Behaviorally Oriented Training Process to Improve Lifting Technique Prevent Occupationally Related Back Injuries Due to Lifting?

Study Design. A prospective randomized control trial. Objective. To determine the degree to which a new behavior-based lift training program (LiftTrainer™; Ascension Technology, Burlington, VT) could reduce the incidence of low back disorder in distribution center jobs that require repetitive lifting. Summary of Background Data. Most studies show programs aimed at training lifting techniques to be ineffective in preventing low back disorders, which may be due to their conceptual rather than behavioral learning approach. Methods. A total of 2144 employees in 19 distribution centers were randomized into either the LiftTrainer™ program or a video control group. In the LiftTrainer™ program, participants were individually trained in up to 5, 30-minute sessions while instrumented with motion capture sensors to quantify the L5/S1 moments. Twelve months following the initial training, injury data were obtained from company records. Results. Survival analyses (Kaplan-Meier) indicated that there was no difference in injury rates between the 2 training groups. Likewise, there was no difference in the turnover rates. However, those with a low (<30 Nm) average twisting moment at the end of the first session experienced a significantly (P < 0.005) lower rate of low back disorder than controls. Conclusions. While overall the LiftTrainer™ program was not effective, those with twisting moments below 30 Nm reported fewer injuries, suggesting a shift in focus for “safe” lifting programs.

[1]  M. McCauley,et al.  The effect of body mechanics instruction on work performance among young workers. , 1990, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[2]  M. de Looze,et al.  Joint moments and muscle activity in the lower extremities and lower back in lifting and lowering tasks. , 1993, Journal of biomechanics.

[3]  Robin Burgess-Limerick Squat, stoop, or something in between? , 1999 .

[4]  W S Marras,et al.  A Comprehensive Evaluation of Trunk Response to Asymmetric Trunk Motion , 1992, Spine.

[5]  B R Umberger,et al.  Reliability and validity of first metatarsophalangeal joint orientation measured with an electromagnetic tracking device. , 1999, Clinical biomechanics.

[6]  J. Kelsey,et al.  An epidemiological study of acute prolapsed cervical intervertebral disc. , 1984, The Journal of bone and joint surgery. American volume.

[7]  Eric P. Lorenz,et al.  Determining what should be taught during lift-training instruction , 2002 .

[8]  B. Bernard,et al.  Musculoskeletal disorders and workplace factors: a critical review of epidemiologic evidence for work-related musculoskeletal disorders of the neck, upper extremity, and low back , 1997 .

[9]  Eric P. Lorenz,et al.  HandlingManual Materials Handling Training in Lifting Do good lifting techniques adversely affect case-handling times ? , 2022 .

[10]  R W Norman,et al.  A simple polynomial that predicts low-back compression during complex 3-D tasks. , 1996, Ergonomics.

[11]  T. Andriacchi,et al.  Influence of Dynamic Factors and External Loads on the Moment at the Lumbar Spine in Lifting , 1988, Spine.

[12]  W S Marras,et al.  Electromyographic studies of the lumbar trunk musculature during the generation of low‐level trunk acceleration , 1993, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[13]  Steven A. Lavender,et al.  Does Training on Lifting Techniques Adversely Affect Case Handling Times? , 2001 .

[14]  M Gagnon,et al.  The efficacy of training for three manual handling strategies based on the observation of expert and novice workers. , 2003, Clinical biomechanics.

[15]  Christian Larivière,et al.  Comparison between two dynamic methods to estimate triaxial net reaction moments at the L5/S1 joint during lifting. , 1998, Clinical biomechanics.

[16]  T P Leskinen,et al.  A dynamic analysis of spinal compression with different lifting techniques. , 1983, Ergonomics.

[17]  R W Norman,et al.  Dynamically and statically determined low back moments during lifting. , 1985, Journal of biomechanics.

[18]  W S Marras,et al.  Spine loading during asymmetric lifting using one versus two hands. , 1998, Ergonomics.

[19]  Micheline Gagnon,et al.  Load Acceleration and Footstep Strategies in Asymmetrical Lifting and Lowering. , 1996, International journal of occupational safety and ergonomics : JOSE.

[20]  J H van Dieën,et al.  Stoop or squat: a review of biomechanical studies on lifting technique. , 1999, Clinical biomechanics.

[21]  W. G. Allread,et al.  The Role of Dynamic Three-Dimensional Trunk Motion in Occupationally-Related Low Back Disorders: The Effects of Workplace Factors, Trunk Position, and Trunk Motion Characteristics on Risk of Injury , 1993, Spine.

[22]  G B Andersson,et al.  Trunk muscle activation and cocontraction while resisting applied moments in a twisted posture. , 1993, Ergonomics.

[23]  이수정 해외산업간호정보 - 미국 산업안전보건연구원(National Institute for Occupational Safety and Health) 소개 , 2009 .

[24]  R W Norman,et al.  Effects of an anatomically detailed erector spinae model on L4/L5 disc compression and shear. , 1987, Journal of biomechanics.

[25]  Idsart Kingma,et al.  Foot positioning instruction, initial vertical load position and lifting technique: effects on low back loading , 2004, Ergonomics.

[26]  S. McGill Electromyographic activity of the abdominal and low back musculature during the generation of isometric and dynamic axial trunk torque: Implications for lumbar mechanics , 1991, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[27]  S L Amosun,et al.  Low back pain--back care through proper lifting technique. , 1991, The Central African journal of medicine.

[28]  G. Andersson,et al.  The epidemiology of spinal disorders , 1997 .

[29]  O. Schipplein,et al.  The Influence of Initial Horizontal Weight Placement on the Loads at the Lumbar Spine While Lifting , 1995, Spine.

[30]  A L Hof,et al.  Neck mobility measurement by means of the 'Flock of Birds' electromagnetic tracking system. , 2003, Clinical biomechanics.

[31]  G. Andersson,et al.  The Role of Prerotation of the Trunk in Axial Twisting Efforts , 1987, Spine.

[32]  G B Andersson,et al.  Trunk muscle cocontraction: The effects of moment direction and moment magnitude , 1992, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[33]  M. Liang,et al.  A controlled trial of an educational program to prevent low back injuries. , 1997, The New England journal of medicine.

[34]  J D Troup,et al.  Dynamic factors in the analysis of stoop and crouch lifting methods: a methodological approach to the development of safe materials handling standards. , 1977, The Orthopedic clinics of North America.

[35]  W S. Marras,et al.  The development of an EMG-assisted model to assess spine loading during whole-body free-dynamic lifting. , 1997, Journal of electromyography and kinesiology : official journal of the International Society of Electrophysiological Kinesiology.

[36]  M E Danz,et al.  The effects of speed, frequency, and load on measured hand forces for a floor to knuckle lifting task. , 1992, Ergonomics.

[37]  G B Andersson,et al.  The Effects of Lateral Trunk Bending on Muscle Recruitments When Resisting Nonsagittally Symmetric Bending Moments , 1995, Spine.

[38]  K P Granata,et al.  Effects of box features on spine loading during warehouse order selecting. , 1999, Ergonomics.

[39]  M Gagnon,et al.  The influence of dynamic factors on triaxial net muscular moments at the L5/S1 joint during asymmetrical lifting and lowering. , 1992, Journal of biomechanics.

[40]  A Magora,et al.  Investigation of the relation between low back pain and occupation. IV. Physical requirements: bending, rotation, reaching and sudden maximal effort. , 1973, Scandinavian journal of rehabilitation medicine.

[41]  Don B. Chaffin,et al.  An evaluation of the effect of a training program on worker lifting postures , 1986 .

[42]  T P Andriacchi,et al.  Influence of dynamic factors on the lumbar spine moment in lifting. , 1988, Ergonomics.

[43]  F. Fathallah,et al.  The effect of feedback training on lumbosacral compression during simulated occupational lifting , 2004, Ergonomics.

[44]  J Atha,et al.  Reducing the biomechanical stress of lifting by training. , 1994, Applied ergonomics.

[45]  K P Granata,et al.  Biomechanical assessment of lifting dynamics, muscle activity and spinal loads while using three different styles of lifting belt. , 1997, Clinical biomechanics.

[46]  Simon M. Hsiang,et al.  Low back pain (LBP) and lifting technique — A review , 1997 .

[47]  Yi-Chun Li,et al.  Trunk Muscle Use during Pulling Tasks: Effects of a Lifting Belt and Footing Conditions , 1998, Hum. Factors.

[48]  L M Bouter,et al.  Lumbar supports and education for the prevention of low back pain in industry: a randomized controlled trial. , 1998, JAMA.