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医疗保健中的人体工程学挑战:使用肌电图场测量法绘制患者转移过程中的身体负荷情况。

Ergonomic challenges in healthcare: mapping physical load during patient transfers using electromyographic field measurements.

作者信息

Vinstrup Jonas, Jakobsen Markus Due, Nielsen Anders Bruun, Andersen Lars Louis

机构信息

National Research Centre for the Working Environment, Copenhagen, Denmark.

Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.

出版信息

Front Public Health. 2024 Nov 25;12:1459595. doi: 10.3389/fpubh.2024.1459595. eCollection 2024.

Abstract

PURPOSE

Work-related musculoskeletal disorders are prevalent among healthcare workers. These workers experience high rates of low-back pain; partly due to the high physical demands of patient transfers. Understanding the specific transfer scenarios that contribute to high physical loads is therefore crucial for developing strategies to improve working conditions.

METHODS

This study utilized electromyography to measure muscle activity in the erector spinae muscles during patient transfers, performing measurements in real-life hospital settings to identify the physical load associated with different transfer scenarios. Using linear mixed models, the 95th percentile ranks of the normalized root mean square (nRMS) values were analyzed for a range of different patient transfers.

RESULTS

The results revealed significant differences in physical load across various patient transfer scenarios. High-load activities included sitting to lying down or lying down to sitting (nRMS 32.7, 95% CI: 28.9-36.6) and lifting the upper body (32.4, 95% CI: 28.8-35.9), while low-load activities such as supporting patients while walking or standing (21.9, 95% CI: 18.6-25.1) and mobilizing in bed (19.9, 95% CI: 16.1-23.8) required less muscle activation. Moderate-load activities included bed to chair transfers (28.1, 95% CI: 24.9-31.3) and lifting the head (26.3, 95% CI: 22.7-29.9).

CONCLUSION

Understanding the physical load associated with different patient transfer scenarios allows for better organization of work in healthcare settings. These novel findings emphasize the need for effective task allocation, rotational schedules, and the use of assistive devices to distribute physical load and reduce injury risk.

摘要

目的

与工作相关的肌肉骨骼疾病在医护人员中很普遍。这些工作人员腰痛发生率很高;部分原因是患者转移对体力要求很高。因此,了解导致高体力负荷的具体转移场景对于制定改善工作条件的策略至关重要。

方法

本研究利用肌电图测量患者转移过程中竖脊肌的肌肉活动,在实际医院环境中进行测量,以确定与不同转移场景相关的体力负荷。使用线性混合模型,分析了一系列不同患者转移情况下归一化均方根(nRMS)值的第95百分位数。

结果

结果显示,不同患者转移场景的体力负荷存在显著差异。高负荷活动包括从坐姿到躺姿或从躺姿到坐姿(nRMS 32.7,95%置信区间:28.9 - 36.6)以及抬起上半身(32.4,95%置信区间:28.8 - 35.9),而低负荷活动如在行走或站立时支撑患者(21.9,95%置信区间:18.6 - 25.1)以及在床上活动(19.9,95%置信区间:16.1 - 23.8)所需的肌肉激活较少。中等负荷活动包括从床到椅子的转移(28.1,95%置信区间:24.9 - 31.3)以及抬起头部(26.3,95%置信区间:22.7 - 29.9)。

结论

了解与不同患者转移场景相关的体力负荷有助于更好地组织医疗机构的工作。这些新发现强调了有效任务分配、轮岗安排以及使用辅助设备以分散体力负荷和降低受伤风险的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c394/11625819/1e81f1080285/fpubh-12-1459595-g001.jpg

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