Biomechanics and Load in the WorkHab Functional Capacity ...
Transcript of Biomechanics and Load in the WorkHab Functional Capacity ...
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
FCE 2018
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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.
FCE 2014
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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
Angles 4
Ankle Knee Hip Lumbar Elbow Shoulder
Spine
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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
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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)
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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)
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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
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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
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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
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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
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Effect of Load on Biomechanics in the WorkHab FCE
References: