Physical Stresses on Caregivers when Pulling Patients Up in Bed: Effect of Repositioning Aids and Patient Weight

Abstract

Manual patient handling is a major cause of musculoskeletal disorders (MSDs) among caregivers. Pulling patients up in bed (PUIB) is one of the most frequently performed patient handling activities, for which repositioning aids are usually recommended. However, it is not clear how to choose repositioning aids for a patient of a given weight, such that the risk of MSDs can be reduced. The current study investigates the physical stresses on caregivers across three patient weight levels, and for common types of repositioning aids during the PUIB activity. Ten caregivers were recruited to preform PUIB tasks while motion capture, ground reaction force, and hand reaction force were measured. Spinal compressive load (L5/S1) was estimated using AnyBody Modeling System software. Repositioning aids and patient weight significantly affected the physical stresses on caregivers. Peak L5/S1 compressive load, peak pulling force, and perceived exertion were lowest for the air-assisted repositioning devices, second lowest for the friction reducing sheet, second highest for the turn and position systems, and highest for the draw sheet. Except for the air-assisted repositioning device, other tested repositioning aids are not adequate to mitigate the risk of MSDs. A mechanical lift should be considered as a robust alternative to repositioning aids that can safely accommodate all patient regardless of weight.