Preventive measures aimed at minimising the occurrence of work-related musculo-skeletal disorders... more Preventive measures aimed at minimising the occurrence of work-related musculo-skeletal disorders of the upper limbs (WMSDs) associated with repetitive tasks can be divided into 3 categories: structural, organisational and educational. Whenever specific risk and injury assessments have shown the need for preventive action, this is most often implemented within the framework of a range of assorted measures. In particular, structural measures pertain to optimising the layout of the work area and furnishings, and the "ergonomic" properties of work tools and equipment. Such measures serve to alleviate the problems caused by the use of excessive force and improper postures. The authors refer to the principles guiding such structural measures, in the light of the extensive literature that has been published on the subject. Organisational (or re-organisational) measures essentially relate to job design (i.e. distribution of tasks, speeds and pauses). They serve to alleviate problems connected with highly repetitive and frequent actions, excessively lengthy tasks and inadequate recovery periods. Very few relevant findings are available: the authors therefore illustrate in some detail a practical trial conducted in a major engineering firm. The objective was to lower to acceptable limits the frequency of certain repetitive tasks performed by workers using their upper limbs. The trial made it possible to identify a suitable plan and schedule of measures taking into due consideration the impact of the plan on production levels (and costs). The fundamental principles guiding the adoption of specific educational and training programmes for the workers and their supervisors are presented and discussed.
The authors discuss the value and significance of symptoms in WMSDs, considering that the anamnes... more The authors discuss the value and significance of symptoms in WMSDs, considering that the anamnestic threshold proposed in epidemiological investigations cannot be used as clinical and diagnosing criteria. Some useful clinical procedures are suggested for cases where there is a suspicion of musculo-skeletal disorders of the cervical spine and upper limbs, bearing in mind that they are to be applied within the framework of health surveillance programmes undertaken by health care practitioners who are not specialists in orthopaedics, physiatrics or neurology. The recommendations for instrumental tests and specialist referrals are also discussed for the various disorders. The authors also provide flow charts for the diagnostic procedures pertaining to WMSDs. The Appendix shows a sample patient chart illustrating the proposed procedures; it also permits the findings to be encoded so that they can be stored in a dedicated database. The codes for diagnosing WMSDs are also reported for the same epidemiological purposes.
The aim of the study was to measure the occurrence (prevalence and incidence) of episodes of acut... more The aim of the study was to measure the occurrence (prevalence and incidence) of episodes of acute low back pain (definite effect) in a wide sample of health workers assisting disabled patients. A questionnaire was used for the study both of true acute low back pain and of episodes of ingravescent low back pain controlled pharmacologically at the onset. The questionnaire identified overall acute and pharmacologically controlled episodes occurring in the previous 12 months, both in the course of work and over the whole life of the subject. Appropriately trained operators administered the questionnaire to 551 subjects; 481 valid answer cards were obtained from 372 females and 109 males working in medical, orthopaedic and geriatric departments. 75.4% of the sample had high exposure index levels for patient lifting. The prevalence of true acute low back pain was 9% in males and 11% in females referred to the previous 12 months. Taking acute true and pharmacologically controlled low back pain together the prevalences rose to 13.8% for males and 26.9% in females. Data from the reference populations showed that acute low back pain did not exceed 3% on average in the previous year. Since work seniority in the hospital wards was known, the incidences were calculated, giving 7.9% in females and 5.29% in males for acute low back pain, and 19% in females and 3.49% in males for pharmacologically controlled low back pain. Considering the number of episodes in 100 workers/year, acute low back pain alone reached prevalences of 13-14%. This therefore appears to confirm the positive ratio between episodes of low back pain and duties involving assistance to disabled patients.
Since a method for quantifying exposure to patient handling in hospital wards is lacking, the aut... more Since a method for quantifying exposure to patient handling in hospital wards is lacking, the authors describe and propose a model for identifying the main risk factors in this type of occupational exposure: presence of disabled patients, staff engaged on manual handling of patients, structure of the working environment, equipment and aids for moving patients, training of workers according to the specific risk. For each factor a procedure for identification and assessment is proposed that is easily applicable in practice. The authors also propose a formula for the calculation of a condensed exposure index (MAPO Index), which brings together the various factors. The exposure index, which requires further, detailed study and validation, makes it possible, in practice, to plan the preventive and health measures according to a specific order of priority, thus complying with the requirements of Chapter V of Law 626/94. From a practical point of view, in the present state of knowledge, it can be stated that for MAPO Index values between 0 and 1.5, risk is deemed negligible, average for values between 1.51 and 5, and high for values exceeding 5.
Following a brief review of the principal clinical characteristics of musculoskeletal disorders o... more Following a brief review of the principal clinical characteristics of musculoskeletal disorders of the upper limbs, the authors propose a protocol for a structured anamnestic examination featuring a series of set questions. The anamnestic model is based on a detailed listing of the symptoms to be analysed, which are divided into four categories: pain, paraesthesia, symptoms attributable to hyposthenia, and neurovegetative disorders. Regarding pain and paraesthesia, the authors list the localization, pattern of onset, duration and number of episodes, irradiation and treatment. The patients can thus be classified as anamnestic cases based on the following criteria: presence of pain or paraesthesia during the last 12 months, with episodes lasting for at least 1 week or occurring at least once a month, with no previous acute trauma. For hyposthenia, the authors report on the conditions under which the disorder may develop. The neurovegetative disorders considered are modifications in colour of the fingers and reaction to exposure to low temperatures. The structure of the proposed anamnestic chart permits all findings to be easily encoded for subsequent storage in a dedicated database. The appendix contains an annotated facsimile of the anamnestic chart.
A total of 306 employees of the hospitals of the Leno/Manerbio health area underwent clinical and... more A total of 306 employees of the hospitals of the Leno/Manerbio health area underwent clinical and anamnestic examination in order to ascertain the existence of degenerative diseases of the spine associated with "manual handling of loads" risk. The prevalences obtained for positive anamnestic threshold concerning the lumbosacral spine, the trend of total acute low back pain and of low back pain in the last year showed lower values compared to the entire national group and in any case lower or only slightly above the values for the reference group of non-exposed subjects. Therefore, in order to assess the real prevalences of disorders due to incorrect load handling in hospital environments, it is important to assess the presence of associated disorders of the spine also and especially in outpatients departments. In fact, unsuitable or unfit staff had recently been transferred from the wards to outpatients departments. 56 workers from outpatients departments underwent physical-anamnestic examination: 16 workers (4.5% of the entire group under study) from average-to-high risk wards were identified as suffering from degenerative disorders of the lumbosacral spine. Therefore the prevalence of unfit subjects from hospital wards, cancelling the effect of the turnover factor on outpatients departments, led to an almost twofold total frequency, which rose from 6.9% to 11.4%.
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2000
The authors describe and propose a model for identifying the main risk factors in this type of oc... more The authors describe and propose a model for identifying the main risk factors in this type of occupational exposure: presence of disabled patients, staff engaged on manual handling of patients, working environment, aids for moving patients, training of workers. For each factor a procedure for assessment is proposed that is easily applicable in practice. The authors also propose a formula for the calculation of a exposure index (MAPO Index), which brings together the various factors. From a practical point of view, in the present state of knowledge, it can be stated that for MAPO Index values between 0 and 1.5, risk is deemed negligible, average for values between 1.51 and 5, and high for values exceeding 5.
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2000
This paper presents a longitudinal study on the return to the workforce of employers with WMSDs o... more This paper presents a longitudinal study on the return to the workforce of employers with WMSDs of the upper limbs and their reallocation to jobs with “low exposure”. The study started 5 years ago with 100 workers affected by WMSDs and includes now 180 affected workers operating in the same factory. The trial involved: definition of criteria for characterising jobs for affected workers; classifying WMSDs workers according to the type and severity of the disorders. The results, 5 years after the start of the trial, are encouraging and show that when the affected workers return in jobs that full meet the defined criteria, a significant prevalence of improvements are reported.
Following a brief review of the principal clinical characteristics of musculoskeletal disorders o... more Following a brief review of the principal clinical characteristics of musculoskeletal disorders of the upper limbs, the authors propose a protocol for a structured anamnestic examination featuring a series of set questions. The anamnestic model is based on a detailed listing of the symptoms to be analysed, which are divided into four categories: pain, paraesthesia, symptoms attributable to hyposthenia, and neurovegetative disorders. Regarding pain and paraesthesia, the authors list the localization, pattern of onset, duration and number of episodes, irradiation and treatment. The patients can thus be classified as anamnestic cases based on the following criteria: presence of pain or paraesthesia during the last 12 months, with episodes lasting for at least 1 week or occurring at least once a month, with no previous acute trauma. For hyposthenia, the authors report on the conditions under which the disorder may develop. The neurovegetative disorders considered are modifications in colour of the fingers and reaction to exposure to low temperatures. The structure of the proposed anamnestic chart permits all findings to be easily encoded for subsequent storage in a dedicated database. The appendix contains an annotated facsimile of the anamnestic chart.
Patient manual handling (MHP) and an increase in the average age of the healthcare workforce incr... more Patient manual handling (MHP) and an increase in the average age of the healthcare workforce increase the risk of musculoskeletal disorders and diseases, leading to sickness absence. Targeted interventions, supported by management, have been proven effective for workplace safety and can lead to improved quality of care.
Since a method for quantifying exposure to patient handling in hospital wards is lacking, the aut... more Since a method for quantifying exposure to patient handling in hospital wards is lacking, the authors describe and propose a model for identifying the main risk factors in this type of occupational exposure: presence of disabled patients, staff engaged on manual handling of patients, structure of the working environment, equipment and aids for moving patients, training of workers according to the specific risk. For each factor a procedure for identification and assessment is proposed that is easily applicable in practice. The authors also propose a formula for the calculation of a condensed exposure index (MAPO Index), which brings together the various factors. The exposure index, which requires further, detailed study and validation, makes it possible, in practice, to plan the preventive and health measures according to a specific order of priority, thus complying with the requirements of Chapter V of Law 626/94. From a practical point of view, in the present state of knowledge, it can be stated that for MAPO Index values between 0 and 1.5, risk is deemed negligible, average for values between 1.51 and 5, and high for values exceeding 5.
An investigation was carried out by teams from various centres coordinated by the EPM (Ergonomics... more An investigation was carried out by teams from various centres coordinated by the EPM (Ergonomics of Posture and Movement) Research Unit on 54 different hospitals in various regions of northern and central Italy. The teams examined a total of 3341 health workers whose job involved manual handling of patients (553 male and 2788 females, 1568 working in hospitals and 1773 in geriatric residences). Numerous meetings were held to ensure that the methods of assessing the exposure indexes and spinal impairment were identical in the various teams. The final data were processed centrally at the EPM Research Unit. The sample analyzed may be considered as representative of the situation in hospitals in Italy, at least for northern and central Italy. The mean age was 36 years, mean length of service in the department 6 years and mean length of job duration not exceeding 10 years; staff turnover was high. Physical examination revealed that 8.4% of the workers had had at least one episode of acu...
« Alterations of the spine in working populations. 2: Referente values for motility of the verteb... more « Alterations of the spine in working populations. 2: Referente values for motility of the vertebral column in aduli male subjects ». The angular ranges of the movements of the head and trunk (flexion, extension, lateral bending, rotation) were studied in two male groups noi suffering from diseases of the cervical spine (Group A: No. 167) and thoracic and lumbo sacral spine (Group B: No. 155). Each group was stratified finto 4 age sub-groups (16-25; 26-35; 36-45; 46-55 years). In addition, the angles of thoracic kyphosis and lumbar lordosis were studied in Group B. The data collected in the study were processed in order to estimate, for each age sub-group, the reference values of the different parameters that were examined. In addition to the 95% confidente limits of the mean values, the values corresponding to the 5° percentile of the sample distribution were computed by means of tolerance limits. On the basis of these values, using a conventional criterion, new data collected are judged as "reduced" or "normal". The availability of such reference values is of an advantage in improving the diagnostic criteria of the clinical method for screening spinal disease proposed by the Authors elsewhere.
To enable different research groups to make a standardized collection of clinical data on alterat... more To enable different research groups to make a standardized collection of clinical data on alterations of the lumbar region of the spine, protocols were used for the collection and classification of data that were proposed and thoroughly validated by the authors. The protocols include a clinical/functional examination of the spine, checking for positive anamnestic threshold, for pain on pressure/palpation of the spiny apophyses and paravertebral muscles, for painful movements, in order to classify 1st, 2nd and 3rd grade functional spondylarthropathy (for different regions of the spine). An ad hoc questionnaire was also prepared for the quantitative and qualitative study of true acute low back pain and the ingravescent low back pain controlled at the onset pharmacologically. The results of this questionnaire make it possible to calculate the incidence of acute low back pain (true and pharmacologically controlled).
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2000
A fundamental part of the prevention strategies aimed at reducing risk due to manual handling of ... more A fundamental part of the prevention strategies aimed at reducing risk due to manual handling of patients is the use of appropriate aids. This paper defines the basic types of aids for hospital wards and also proposes a procedure for choice of the type of aid. The procedure uses a specific protocol and also analyses work organisation and the environmental features of the ward. The proposed criteria for choice concern at first place the fundamental requirements of the equipment: safety for operator and patient, simplicity of use and comfort for the patient. Secondly the basic determinants for the choice of the type of aid are the kind of disabled patient usually present in the ward, and the analysis of the movements done during patients handling.
Preventive measures aimed at minimising the occurrence of work-related musculo-skeletal disorders... more Preventive measures aimed at minimising the occurrence of work-related musculo-skeletal disorders of the upper limbs (WMSDs) associated with repetitive tasks can be divided into 3 categories: structural, organisational and educational. Whenever specific risk and injury assessments have shown the need for preventive action, this is most often implemented within the framework of a range of assorted measures. In particular, structural measures pertain to optimising the layout of the work area and furnishings, and the "ergonomic" properties of work tools and equipment. Such measures serve to alleviate the problems caused by the use of excessive force and improper postures. The authors refer to the principles guiding such structural measures, in the light of the extensive literature that has been published on the subject. Organisational (or re-organisational) measures essentially relate to job design (i.e. distribution of tasks, speeds and pauses). They serve to alleviate problems connected with highly repetitive and frequent actions, excessively lengthy tasks and inadequate recovery periods. Very few relevant findings are available: the authors therefore illustrate in some detail a practical trial conducted in a major engineering firm. The objective was to lower to acceptable limits the frequency of certain repetitive tasks performed by workers using their upper limbs. The trial made it possible to identify a suitable plan and schedule of measures taking into due consideration the impact of the plan on production levels (and costs). The fundamental principles guiding the adoption of specific educational and training programmes for the workers and their supervisors are presented and discussed.
The authors discuss the value and significance of symptoms in WMSDs, considering that the anamnes... more The authors discuss the value and significance of symptoms in WMSDs, considering that the anamnestic threshold proposed in epidemiological investigations cannot be used as clinical and diagnosing criteria. Some useful clinical procedures are suggested for cases where there is a suspicion of musculo-skeletal disorders of the cervical spine and upper limbs, bearing in mind that they are to be applied within the framework of health surveillance programmes undertaken by health care practitioners who are not specialists in orthopaedics, physiatrics or neurology. The recommendations for instrumental tests and specialist referrals are also discussed for the various disorders. The authors also provide flow charts for the diagnostic procedures pertaining to WMSDs. The Appendix shows a sample patient chart illustrating the proposed procedures; it also permits the findings to be encoded so that they can be stored in a dedicated database. The codes for diagnosing WMSDs are also reported for the same epidemiological purposes.
The aim of the study was to measure the occurrence (prevalence and incidence) of episodes of acut... more The aim of the study was to measure the occurrence (prevalence and incidence) of episodes of acute low back pain (definite effect) in a wide sample of health workers assisting disabled patients. A questionnaire was used for the study both of true acute low back pain and of episodes of ingravescent low back pain controlled pharmacologically at the onset. The questionnaire identified overall acute and pharmacologically controlled episodes occurring in the previous 12 months, both in the course of work and over the whole life of the subject. Appropriately trained operators administered the questionnaire to 551 subjects; 481 valid answer cards were obtained from 372 females and 109 males working in medical, orthopaedic and geriatric departments. 75.4% of the sample had high exposure index levels for patient lifting. The prevalence of true acute low back pain was 9% in males and 11% in females referred to the previous 12 months. Taking acute true and pharmacologically controlled low back pain together the prevalences rose to 13.8% for males and 26.9% in females. Data from the reference populations showed that acute low back pain did not exceed 3% on average in the previous year. Since work seniority in the hospital wards was known, the incidences were calculated, giving 7.9% in females and 5.29% in males for acute low back pain, and 19% in females and 3.49% in males for pharmacologically controlled low back pain. Considering the number of episodes in 100 workers/year, acute low back pain alone reached prevalences of 13-14%. This therefore appears to confirm the positive ratio between episodes of low back pain and duties involving assistance to disabled patients.
Since a method for quantifying exposure to patient handling in hospital wards is lacking, the aut... more Since a method for quantifying exposure to patient handling in hospital wards is lacking, the authors describe and propose a model for identifying the main risk factors in this type of occupational exposure: presence of disabled patients, staff engaged on manual handling of patients, structure of the working environment, equipment and aids for moving patients, training of workers according to the specific risk. For each factor a procedure for identification and assessment is proposed that is easily applicable in practice. The authors also propose a formula for the calculation of a condensed exposure index (MAPO Index), which brings together the various factors. The exposure index, which requires further, detailed study and validation, makes it possible, in practice, to plan the preventive and health measures according to a specific order of priority, thus complying with the requirements of Chapter V of Law 626/94. From a practical point of view, in the present state of knowledge, it can be stated that for MAPO Index values between 0 and 1.5, risk is deemed negligible, average for values between 1.51 and 5, and high for values exceeding 5.
Following a brief review of the principal clinical characteristics of musculoskeletal disorders o... more Following a brief review of the principal clinical characteristics of musculoskeletal disorders of the upper limbs, the authors propose a protocol for a structured anamnestic examination featuring a series of set questions. The anamnestic model is based on a detailed listing of the symptoms to be analysed, which are divided into four categories: pain, paraesthesia, symptoms attributable to hyposthenia, and neurovegetative disorders. Regarding pain and paraesthesia, the authors list the localization, pattern of onset, duration and number of episodes, irradiation and treatment. The patients can thus be classified as anamnestic cases based on the following criteria: presence of pain or paraesthesia during the last 12 months, with episodes lasting for at least 1 week or occurring at least once a month, with no previous acute trauma. For hyposthenia, the authors report on the conditions under which the disorder may develop. The neurovegetative disorders considered are modifications in colour of the fingers and reaction to exposure to low temperatures. The structure of the proposed anamnestic chart permits all findings to be easily encoded for subsequent storage in a dedicated database. The appendix contains an annotated facsimile of the anamnestic chart.
A total of 306 employees of the hospitals of the Leno/Manerbio health area underwent clinical and... more A total of 306 employees of the hospitals of the Leno/Manerbio health area underwent clinical and anamnestic examination in order to ascertain the existence of degenerative diseases of the spine associated with "manual handling of loads" risk. The prevalences obtained for positive anamnestic threshold concerning the lumbosacral spine, the trend of total acute low back pain and of low back pain in the last year showed lower values compared to the entire national group and in any case lower or only slightly above the values for the reference group of non-exposed subjects. Therefore, in order to assess the real prevalences of disorders due to incorrect load handling in hospital environments, it is important to assess the presence of associated disorders of the spine also and especially in outpatients departments. In fact, unsuitable or unfit staff had recently been transferred from the wards to outpatients departments. 56 workers from outpatients departments underwent physical-anamnestic examination: 16 workers (4.5% of the entire group under study) from average-to-high risk wards were identified as suffering from degenerative disorders of the lumbosacral spine. Therefore the prevalence of unfit subjects from hospital wards, cancelling the effect of the turnover factor on outpatients departments, led to an almost twofold total frequency, which rose from 6.9% to 11.4%.
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2000
The authors describe and propose a model for identifying the main risk factors in this type of oc... more The authors describe and propose a model for identifying the main risk factors in this type of occupational exposure: presence of disabled patients, staff engaged on manual handling of patients, working environment, aids for moving patients, training of workers. For each factor a procedure for assessment is proposed that is easily applicable in practice. The authors also propose a formula for the calculation of a exposure index (MAPO Index), which brings together the various factors. From a practical point of view, in the present state of knowledge, it can be stated that for MAPO Index values between 0 and 1.5, risk is deemed negligible, average for values between 1.51 and 5, and high for values exceeding 5.
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2000
This paper presents a longitudinal study on the return to the workforce of employers with WMSDs o... more This paper presents a longitudinal study on the return to the workforce of employers with WMSDs of the upper limbs and their reallocation to jobs with “low exposure”. The study started 5 years ago with 100 workers affected by WMSDs and includes now 180 affected workers operating in the same factory. The trial involved: definition of criteria for characterising jobs for affected workers; classifying WMSDs workers according to the type and severity of the disorders. The results, 5 years after the start of the trial, are encouraging and show that when the affected workers return in jobs that full meet the defined criteria, a significant prevalence of improvements are reported.
Following a brief review of the principal clinical characteristics of musculoskeletal disorders o... more Following a brief review of the principal clinical characteristics of musculoskeletal disorders of the upper limbs, the authors propose a protocol for a structured anamnestic examination featuring a series of set questions. The anamnestic model is based on a detailed listing of the symptoms to be analysed, which are divided into four categories: pain, paraesthesia, symptoms attributable to hyposthenia, and neurovegetative disorders. Regarding pain and paraesthesia, the authors list the localization, pattern of onset, duration and number of episodes, irradiation and treatment. The patients can thus be classified as anamnestic cases based on the following criteria: presence of pain or paraesthesia during the last 12 months, with episodes lasting for at least 1 week or occurring at least once a month, with no previous acute trauma. For hyposthenia, the authors report on the conditions under which the disorder may develop. The neurovegetative disorders considered are modifications in colour of the fingers and reaction to exposure to low temperatures. The structure of the proposed anamnestic chart permits all findings to be easily encoded for subsequent storage in a dedicated database. The appendix contains an annotated facsimile of the anamnestic chart.
Patient manual handling (MHP) and an increase in the average age of the healthcare workforce incr... more Patient manual handling (MHP) and an increase in the average age of the healthcare workforce increase the risk of musculoskeletal disorders and diseases, leading to sickness absence. Targeted interventions, supported by management, have been proven effective for workplace safety and can lead to improved quality of care.
Since a method for quantifying exposure to patient handling in hospital wards is lacking, the aut... more Since a method for quantifying exposure to patient handling in hospital wards is lacking, the authors describe and propose a model for identifying the main risk factors in this type of occupational exposure: presence of disabled patients, staff engaged on manual handling of patients, structure of the working environment, equipment and aids for moving patients, training of workers according to the specific risk. For each factor a procedure for identification and assessment is proposed that is easily applicable in practice. The authors also propose a formula for the calculation of a condensed exposure index (MAPO Index), which brings together the various factors. The exposure index, which requires further, detailed study and validation, makes it possible, in practice, to plan the preventive and health measures according to a specific order of priority, thus complying with the requirements of Chapter V of Law 626/94. From a practical point of view, in the present state of knowledge, it can be stated that for MAPO Index values between 0 and 1.5, risk is deemed negligible, average for values between 1.51 and 5, and high for values exceeding 5.
An investigation was carried out by teams from various centres coordinated by the EPM (Ergonomics... more An investigation was carried out by teams from various centres coordinated by the EPM (Ergonomics of Posture and Movement) Research Unit on 54 different hospitals in various regions of northern and central Italy. The teams examined a total of 3341 health workers whose job involved manual handling of patients (553 male and 2788 females, 1568 working in hospitals and 1773 in geriatric residences). Numerous meetings were held to ensure that the methods of assessing the exposure indexes and spinal impairment were identical in the various teams. The final data were processed centrally at the EPM Research Unit. The sample analyzed may be considered as representative of the situation in hospitals in Italy, at least for northern and central Italy. The mean age was 36 years, mean length of service in the department 6 years and mean length of job duration not exceeding 10 years; staff turnover was high. Physical examination revealed that 8.4% of the workers had had at least one episode of acu...
« Alterations of the spine in working populations. 2: Referente values for motility of the verteb... more « Alterations of the spine in working populations. 2: Referente values for motility of the vertebral column in aduli male subjects ». The angular ranges of the movements of the head and trunk (flexion, extension, lateral bending, rotation) were studied in two male groups noi suffering from diseases of the cervical spine (Group A: No. 167) and thoracic and lumbo sacral spine (Group B: No. 155). Each group was stratified finto 4 age sub-groups (16-25; 26-35; 36-45; 46-55 years). In addition, the angles of thoracic kyphosis and lumbar lordosis were studied in Group B. The data collected in the study were processed in order to estimate, for each age sub-group, the reference values of the different parameters that were examined. In addition to the 95% confidente limits of the mean values, the values corresponding to the 5° percentile of the sample distribution were computed by means of tolerance limits. On the basis of these values, using a conventional criterion, new data collected are judged as "reduced" or "normal". The availability of such reference values is of an advantage in improving the diagnostic criteria of the clinical method for screening spinal disease proposed by the Authors elsewhere.
To enable different research groups to make a standardized collection of clinical data on alterat... more To enable different research groups to make a standardized collection of clinical data on alterations of the lumbar region of the spine, protocols were used for the collection and classification of data that were proposed and thoroughly validated by the authors. The protocols include a clinical/functional examination of the spine, checking for positive anamnestic threshold, for pain on pressure/palpation of the spiny apophyses and paravertebral muscles, for painful movements, in order to classify 1st, 2nd and 3rd grade functional spondylarthropathy (for different regions of the spine). An ad hoc questionnaire was also prepared for the quantitative and qualitative study of true acute low back pain and the ingravescent low back pain controlled at the onset pharmacologically. The results of this questionnaire make it possible to calculate the incidence of acute low back pain (true and pharmacologically controlled).
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2000
A fundamental part of the prevention strategies aimed at reducing risk due to manual handling of ... more A fundamental part of the prevention strategies aimed at reducing risk due to manual handling of patients is the use of appropriate aids. This paper defines the basic types of aids for hospital wards and also proposes a procedure for choice of the type of aid. The procedure uses a specific protocol and also analyses work organisation and the environmental features of the ward. The proposed criteria for choice concern at first place the fundamental requirements of the equipment: safety for operator and patient, simplicity of use and comfort for the patient. Secondly the basic determinants for the choice of the type of aid are the kind of disabled patient usually present in the ward, and the analysis of the movements done during patients handling.
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