搬运护理时脊柱承载风险特征及影响因素

Injury risks and affecting factors of spinal loads for caregiver's manual patient handling tasks

目的研究多种人力搬运任务中护理人员脊柱腰背部第5腰椎第1骶椎(L5/S1)的承载风险特征及其影响因素,探索减缓风险的合理搬运方式。方法采集9名护理人员对3名不同体重代理患者操作6种搬运护理任务的动力学数据,建立多刚体三维模型,计算L5/S1关节峰值力,研究其承载风险特征,针对性分析L5/S1关节峰值力与6个影响因素的相关性。结果所有任务的峰值正压力均超过安全阈值3.4 kN;挪移类任务的前后向峰值剪切力超过阈值0.5 kN。各任务的承载风险特征和影响因素不同,其中L5/S1载荷与重心移动距离及地面反作用力呈显著相关(P<0.01)。结论人力搬运护理导致脊柱腰背部承受较高的载荷与损伤风险,且风险特征各异。在搬运时采取减小脊柱整体活动范围、避免过急过猛的动作,将有助于减缓该风险。

Objective To assess the injury risks and affecting factors of spinal loads at L5/S1 joint for caregivers during manual patient-handling tasks, so as to find a suitable handling way to effectively reduce such risks. Meth- ods Kinetic data were collected from nine female caregivers performing six patient handling tasks on three agent ＇patients＇ with different weight. Peak L5/S1 force was calculated based on a multi-segment three-dimensional model to investigate the characteristics of injury risks, and the correlations between the peak LS/S1 force and six affecting factors were specifically analyzed. Results Peak compression of the tasks all exceeded the safe thresholds of 3.4 kN; Peak anterior-posterior force for those repositioning tasks were above the threshold of 0.5 kN. Different tasks showed different biomechanical characteristics for risk of injury and affecting factors, and there was a significant correlation between the L5/S1 loads and the moving distance of center of gravity, and the ground reaction force as well （ P 〈 0.01 ）. Conclusions Manual patient handling tasks could cause different injury risks by high loads on spinal low back. Decreasing the range of motion of the whole body and avoiding jerk move- ment durinQ the patient handlinq tasks would help careqiver to reduce the injury risks.