Relative Contribution of Lower Body Work as a Biomechanical Determinant of Spine Sparing Technique During Common Paramedic Lifting Tasks

in Journal of Applied Biomechanics
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Paramedics represent a unique occupational group where the nature of their work, providing prehospital emergency care, makes workplace modifications to manage and control injury risks difficult. Therefore, the provision of workplace education and training to support safe lifting remains a viable and important approach. There is, however, a lack of evidence describing movement strategies that may be optimal for paramedic work. The purpose of this study was to determine if a strategy leveraging a greater contribution of work from the lower body relative to the torso was associated with lower biomechanical exposures on the spine. Twenty-five active duty paramedics performed 3 simulated lifting activities common to paramedic work. Ground reaction forces and whole body kinematics were recorded to calculate: peak spine moment and angle about the L4/L5 flexion-extension axis as indicators of biomechanical exposure; and, joint work, integrated from net joint power as a measure of technique inclusive of movement dynamics. Paramedics generating more work from the lower body, relative to the trunk, were more likely to experience lower peak L4/L5 spine moments and angles. These data can inform the development of workplace training and education on safe lifting that focuses on paramedics generating more work from the lower body.

Makhoul, Sinden, and Fischer are with the School of Kinesiology and Health Studies, Queen’s University, Kingston, Ontario, Canada. MacPhee is with Health Sciences and Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, Ontario, Canada. Fischer is also with the University of Waterloo, Department of Kinesiology, Waterloo, Ontario, Canada.

Address author correspondence to Steven Fischer at steven.fischer@uwaterloo.ca.