1. Lifting Analysis-2
Dr Hafiz Sheraz Arshad

2. Review of last lecture Stoop lift Squat Lift Semi-Squat Lift
Freestyle Lift
Trunk Kinetic Lift
Load Kinetic Lift
Stoop lift for normal individual
Lifting technique does not cause back pain
In LBP stoops lift may increase pain

3. It is important for therapists to critically appraise lifting techniques
Recommend those that match the client’s capacities to the task that is to be performed

4. Dependency of lifting
The semi-squat lift allows for closer placement of the load to the body, thus creating a smaller moment arm and less compressive force

5. Frequency & rate of lifting
If lighter loads are to be handled but at a higher frequency than four per minute, the stoop lift would be a viable option
The rate at which any lift is performed is extremely important
Compressive forces increase by 15% when lifting is performed quickly, as compared with using a steady, smooth approach when lifting identical loads

6. Effective Grasp
Effective hand grip and couple in the practice of safe lifting
Secure grasp when handling an unstable load
Instability resulting from the lack of an effective grasp can adversely affect stability (of the load)
 the involuntary increased recruitment of the core-trunk muscle groups (rectus and external and internal obliques)
 increased lumbar compressive forces

7. Other Considerations
Compression at the L5/S1 joint was a poor indicator of the potential for injury
Lateral shear and torsion (side bending and twisting in coupled and uncoupled movements
Velocity
Acceleration
Worker experience and attitudes toward the job

8. Slope of surface
Lumbosacral moments were considerably larger when lifting from an inclined slope compared with a declined surface
Subsequent increase in angulation resulted in an increased moment arm of the trunk, hydrostatic pressure of the disc, and torque at the L5/S1 segment.

9. Stability of the Load
Unstable loads carried significantly higher risks for poor mechanics and low back injury

10. What Physical Therapist need to concern?
A major goal for the therapist is to reduce the risk of lift-related injuries at both the work site and at home
The primary concern is to recognize the presence of risk factors and understand how each factor influences the pathologic process

11. Standards Keep the load close
Ensure the placement of a secure hand couple
Maintain a degree of lumbar Lordosis at the initiation and during the lift

12. Standards Techniques
Semi –squat ideal lift for heavy loads performed on an occasional basis
Squat lift: To be used as an alternative to the semi-squat when space is limited and load size does not allow for foot placement to the side of the object to be lifted
This also is the lift preferred by individuals experiencing acute and chronic low back pain

13. Stoop lift: Lifting scenarios requiring light loads (20 pounds and below) on a frequent basis are more efficiently managed using this technique

14. Uneven sloped surface
When lifting on an uneven-sloped surface, face down the slope to negotiate the lift
When lifting, do so as much as is possible in the sagittal plane

15. Pushing & Pulling
Seemingly less menacing and more biomechanically efficient, namely pushing and pulling
Resultant vectors changed from the vertical to the horizontal axis, added the component of frictional resistance to the equation when pushing or pulling

17. Effect on shoulder
Net joint torques at the shoulder were minimal during pushing maneuvers but greatly increased during pulling efforts
Horizontal force, as opposed to torque, at the shoulder was significant during both activities

18. Handle height & hand placement
Optimal pushing height for the best performance appeared to be at or about waist level
Comparing pulling with pushing, the vector of force is substantially higher at the L5/S1 joint when pulling as compared with pushing.
This comes as a direct result of the increased moment and flexed posture (at the waist) inherent with pulling as opposed to pushing

19. What should be preferred: Pushing & Pulling
If possible, pushing should be the preferred method of material transport over pulling

20. Foot Placement
The final consideration when evaluating pushing and pulling tasks is foot placement and the avoidance of slippage resulting from a poor coefficient of friction (COF).
Injuries secondary to these conditions can be serious and usually result from the loss of balance and uncontrolled acceleration of the whole body

21. Coefficient of friction
Adding water, oil, or other contaminants to the surface, however, greatly decreased the COF and resulted in decreased balance and sway patterns
Once the risk factors have been identified, it is the therapist’s mission to control the frequency, severity, and, if possible, the very presence of the risk

22. THANKS