The effect of flooring on musculoskeletal symptoms in the lower extremities and low back among female nursing assistants

This study examines the effect of changing the floor from a 2-mm homogenous vinyl floor to a 4-mm heterogeneous vinyl floor (1.5-mm wear layer and 2.5-mm foam layer) on musculoskeletal symptoms in the lower extremities and low back among nursing assistants in a geriatric care centre. A pre-post design with a reference group consisting of nursing assistants from a similar geriatric care centre was used. Follow-up measurements were carried out 12 and 24 months after the intervention by means of questionnaires. At the 1-year follow-up, the pain intensity score in the feet of the intervention group had decreased compared with the baseline value and remained statistically significant at the 2-year follow-up. The decrease in pain intensity score of the feet in the intervention group was statistically significantly different from the reference group, both after 1 and 2 years. Practitioner Summary: The results show the importance of flooring in the workplace with regard to reducing musculoskeletal symptoms. Appropriate flooring is especially important in the female-dominated health care sector, where workers must stand or walk for long periods.

[1]  B. Jonsson,et al.  Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. , 1987, Applied ergonomics.

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

[3]  S. Dworkin,et al.  Grading the severity of chronic pain , 1992, Pain.

[4]  C. Wiktorin,et al.  Validity of self-reported exposures to work postures and manual materials handling. Stockholm MUSIC I Study Group. , 1993, Scandinavian journal of work, environment & health.

[5]  J. Coste,et al.  Clinical course and prognostic factors in acute low back pain: an inception cohort study in primary care practice , 1994, BMJ.

[6]  A. M. Harvey.  Classification of Chronic Pain—Descriptions of Chronic Pain Syndromes and Definitions of Pain Terms , 1995 .

[7]  Pascal Madeleine,et al.  Subjective, physiological and biomechanical responses to prolonged manual work performed standing on hard and soft surfaces , 1997, European Journal of Applied Physiology and Occupational Physiology.

[8]  K. Jørgensen,et al.  Significance of mat and shoe softness during prolonged work in upright position: based on measurements of low back muscle EMG, foot volume changes, discomfort and ground force reactions. , 1998, Applied ergonomics.

[9]  W. E. Hoogendoorn,et al.  Physical load during work and leisure time as risk factors for back pain. , 1999, Scandinavian journal of work, environment & health.

[10]  W. E. Hoogendoorn,et al.  Systematic Review of Psychosocial Factors at Work and Private Life as Risk Factors for Back Pain , 2000, Spine.

[11]  M S Redfern,et al.  The influence of flooring on standing comfort and fatigue. , 2000, AIHAJ : a journal for the science of occupational and environmental health and safety.

[12]  Mark S. Redfern,et al.  Effect of Flooring on Standing Comfort and Fatigue , 2001, Hum. Factors.

[13]  A Kilbom,et al.  Standing and very slow walking: foot pain-pressure threshold, subjective pain experience and work activity. , 2001, Applied ergonomics.

[14]  Christina Wiktorin,et al.  Validity of a Self-Administered Questionnaire for Assessing Physical Work Loads in a General Population , 2002, Journal of occupational and environmental medicine.

[15]  Phyllis M King,et al.  A comparison of the effects of floor mats and shoe in-soles on standing fatigue. , 2002, Applied ergonomics.

[16]  I. Houtman,et al.  Gender issues in safety and health at work : a review , 2003 .

[17]  S. Knardahl,et al.  Work factors as predictors of intense or disabling low back pain; a prospective study of nurses’ aides , 2004, Occupational and Environmental Medicine.

[18]  A. Silman,et al.  The Cheshire Foot Pain and Disability Survey: a population survey assessing prevalence and associations , 2004, Pain.

[19]  Alfred Franzblau,et al.  Review of Epidemiologic Studies on Occupational Factors and Lower Extremity Musculoskeletal and Vascular Disorders and Symptoms , 2005, Journal of Occupational Rehabilitation.

[20]  K. Messing,et al.  Validation of questions on working posture among those who stand during most of the work day , 2005 .

[21]  Eva Bernmark,et al.  Awkward work postures: association with occupational gender segregation. , 2005, American journal of industrial medicine.

[22]  M. Tulder,et al.  Low back pain (non-specific) , 2007 .

[23]  M. V. van Tulder,et al.  Strategies for prevention and management of musculoskeletal conditions. Low back pain (non-specific). , 2007, Best practice & research. Clinical rheumatology.

[24]  Jill L Cook,et al.  Impact of chronic plantar heel pain on health-related quality of life. , 2008, Journal of the American Podiatric Medical Association.

[25]  Karen Messing,et al.  Distal lower-extremity pain and work postures in the Quebec population. , 2008, American journal of public health.

[26]  H. Menz,et al.  Prevalence and correlates of foot pain in a population-based study: the North West Adelaide health study , 2008, Journal of foot and ankle research.

[27]  Ingvar Demker.  Determination of mechanical comfort properties of floor coverings , 2009 .

[28]  J. Burns,et al.  Understanding the nature and mechanism of foot pain , 2009, Journal of foot and ankle research.

[29]  K. Messing,et al.  Studying the relationship between low back pain and working postures among those who stand and those who sit most of the working day , 2009, Ergonomics.

[30]  W. M. Keyserling,et al.  Risk Factors for Plantar Fasciitis Among Assembly Plant Workers , 2010, PM & R : the journal of injury, function, and rehabilitation.