biomechanics and load in the workhab functional capacity
TRANSCRIPT
![Page 1: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/1.jpg)
Biomechanics and Load in the
WorkHab Functional Capacity
Evaluation: An Update
Dr Carole James
School of Health Sciences,
The University of Newcastle, Australia.
FCE: 2018
![Page 2: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/2.jpg)
FCE 2018
School of Health Sciences
2
Effect of Load on Biomechanics in the WorkHab FCE
• Safe Maximal Lift = maximum load that an individual is able to safely lift.
Purpose:
• To evaluate any change in biomechanics between
safe minimum and safe maximum lifts during the
WorkHab FCE.
![Page 3: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/3.jpg)
FCE 2014
School of Health Sciences
3
Effect of Load on Biomechanics in the WorkHab FCE
Method:
Experimental laboratory
based study
Sample: 30
healthy volunteers
Health Questionnaire,
BP 3 min step test Joints marked – foam ball/
ink
Wrist, Elbow, Shoulder, Hip, Knee, Ankle,
Spinous processes:
C7,T7,L3,S2
Darfish ProSuite
Min + Max lift Lift ÷ 1/3rds Calculation of joint angles
•Data analysis: Descriptive + Paired t-test
Digital recording of
lifting component
Rear Coronal + Right
sagittal planes
![Page 4: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/4.jpg)
Angles 4
Ankle Knee Hip Lumbar Elbow Shoulder
Spine
![Page 5: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/5.jpg)
School of Health Sciences
5
Effect of Load on Biomechanics in the WorkHab FCE
Results – Overhead lift
Green = Overhead (P values)
Joint 0/3 1/3 2/3 3/3
Ulnar deviation 0.007 0.016 0.004 <0.001
Elbow flexion 0.023 0.005 0.004 #
Shoulder 0.007 0.0036 # 0.038
Thoracic
extension
# 0.05 # 0.001
Lumbar extension # # 0.027 0.003
![Page 6: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/6.jpg)
FCE 2018
School of Health Sciences
6
Effect of Load on Biomechanics in the WorkHab FCE
Results – Floor to Bench Lift
Red = Floor to Bench (P values)
Joint 0/3 1/3 2/3 3/3
Lumbar flexion 0.001(d) # # #
Hip flexion <0.001(d) 0.021(a) <0.007(d) <0.001(d)
Knee flexion 0.027(a) 0.005(d) # 0.004(d)
Ankle <0.001(a) 0.019(d) 0.001(d) <0.001(d+a)
![Page 7: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/7.jpg)
FCE 2018
School of Health Sciences
7
Effect of Load on Biomechanics in the WorkHab FCE
Results – Bench to Shoulder Lift
Blue = Bench to Shoulder (P values)
Joint 0/3 1/3 2/3 3/3
Lumbar extension # # # #
Elbow 0.000 (d) 0.008 (a) # 0.009 (a)(d)
Shoulder 0.000 (d) # # 0.000 (a)
Thoracic
extension
# # # 0.004(a)
![Page 8: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/8.jpg)
FCE 2018
School of Health Sciences
8
Ulnar deviation:
• peaked at 36.16 degrees two thirds of the way through the lift
• participants reaching end range during their safe maximal lift
Elbow:
• Participants inclined to keep the load closer to their body when it
was heavier by increasing elbow flexion
Shoulder:
• Shoulder flexion increased despite the overhead lift height remaining the same
Thoracic and Lumbar Spines
• Both in increased extension in parts of the maximum lift
Hip, Knee and Ankle
• Lack of findings
Effect of Load on Biomechanics in the WorkHab FCE
Discussion – Overhead lift
![Page 9: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/9.jpg)
FCE 2018
School of Health Sciences
9
Lumbar
• less hyperextended when lifting maximum weights.
• start point of the descending phase where weights were being lifted
off the bench = significant difference
The hip
• ↑ flexion when lifting the load from the bench (0/3 point of the
descending phase) and placing the load back on the bench (2/3
and 3/3 points of the ascending phase).
• more likely to be in hyperextension when lifting min vs max wgts.
Knee
• minimal changes are noticed in knee joint angle between minimum
and maximum lift.
Ankle joint
• reduction in dorsiflexion when lifting maximum weights
Effect of Load on Biomechanics in the WorkHab FCE
Discussion – Floor to bench lift
![Page 10: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/10.jpg)
School of Health Sciences
10
Lumbar
• No significant difference in lumbar spine extension ascending or
descending
Elbow
• ↓ flexion at 1/3 ascending
• ↑ flexion 3/3 ascending and 0/3 descending – highest point, harder
to keep close to body
Shoulder
• ↑ flexion 3/3 ascending and 0/3 descending – highest point, harder
to keep close to body
Thoracic
• ↑ extension at 3/3 ascending – longer lever arm
Effect of Load on Biomechanics in the WorkHab FCE
Discussion –Bench to Shoulder
![Page 11: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/11.jpg)
School of Health Sciences
11
Kinematic changes important in determining SML
Elbow and shoulder flexion – OH
Hip, Ankle, lumbar – FB
Elbow and shoulder – BS
Changes in joint angles support assessors clinical reasoning and observations of SML
Consideration of handle placement with lifting
Effect of Load on Biomechanics in the WorkHab FCE
Discussion
![Page 12: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/12.jpg)
FCE 2018
School of Health Sciences
12
Burgess-Limerick, R. (2003). "Squat, stoop, or something in between?" International Journal of Industrial Ergonomics 31: 143-
148.
West, N., Snodgrass, S. J., & James, C. (2018). The effect of load on biomechanics of the back and upper limb in a bench to
shoulder lift during the WorkHab Functional Capacity Evaluation. Work, 59(2), 201-210. doi:10.3233/WOR-172677
Melino, N. L., James, C.L., & Snodgrass, S. J. (2013). The effect of load in a floor-to-bench lift during the WorkHab Functional
Capacity Evaluation. Work: A Journal of Prevention, Assessment and Rehabilitation, ePub. doi:10.3233/WOR-131698
Allen, J. L., James, C.L., & Snodgrass, S. J. (2012). The effect of load on biomechanics during an overhead lift in the WorkHab
Functional Capacity Evaluation. Work, 43(4), 487-496. doi:10.3233/WOR-2012-1386
Gardener, L. and K. McKenna (1999). "Reliability of occupational therapists in determining safe, maximal lifting capacity."
Australian Occupational Therapy Journal 46: 110-119.
Gross, D. and M. Battie (2002). "Reliability of safe maximum lifting determinations of a functional capacity evaluation." Physical
Therapy 82(4): 364-372.
Isernhagen, S. (1992). "Functional capacity evaluation: rationale, procedure, utility of the kinesiophysical approach." Journal of
Occupational Rehabilitation 2(3): 157-168.
James, C., L. Mackenzie, et al. (2010). "Test-retest reliability of the manual handling component of the Workhab functional
capacity evaluation in healthy adults." Disability and Rehabilitation 32(22): 1863-1869.
Straker, L. (2003). Evidence to support using a squat, semi-squat and stoop techniques to lift low-lying objects. International
Journal of Industrial Ergonomics, 31(3).
Schipplein, O., Trafimow, J., Andersson, G., & Andriacchi, T. (1990). Relationship between moments at the L5/S1 level, hip and
knee joint when lifting. Journal of Biomechanics, 23(9), 907-912.
Arjmand, N., Shirazi-Adl, A. (2005). Biomechanics of Changes in Lumbar Posture in Static Lifting. Spine, 30, 2637-2648
Bonato, P., Ebenbichler, G., ROy, S. H., Lehr, S., Posch, M., Kollmitzer, J., et al. (2003). Muscle Fatigue and Fatigue-Related
Biomechanical Changes During a Cyclic Lifting Task. Spine, 28(16), 1810-1820..
Nielson, P. K., Andersen, L., & Jorgensen, K. (1998). The muscular load on the lower back and shoulders due to lifting at different
lifting heights and frequencies. Applied Ergonomics(29), 45-50.
Snook, S. H., & Ciriello, V. M. (1991). The design of manual handling tasks: revised tables of maximum acceptable weights and
forces. Ergonomics, 34(9), 1197-1213
Effect of Load on Biomechanics in the WorkHab FCE
References:
![Page 13: Biomechanics and Load in the WorkHab Functional Capacity](https://reader031.vdocuments.net/reader031/viewer/2022012504/617f334e780e5e32904279da/html5/thumbnails/13.jpg)