1. Safe use and well-being of the human machine

2. Session Aims This session will look at discuss how practitioners can use efficient movement and postural principles when performing common handling actions – in particular PUSHING, PULLING and SUPPORTING loads (and when performing people handling tasks) The session will also consider natural patterns of human movement and good body biomechanics; considering how the body ‘machine’ moves assisting us to understand how we can help the patient/client help themselves with the minimum of effort.

3. Introduction – How is the body a machine? We can think of the human body as a machine ‘an apparatus using mechanical power and having several parts, each with a definite function and together performing a particular task’. Of course just as a machine, we can utilise the body efficiently –or inefficiently, and also we can misuse it to the point of it becoming damaged or injured. A machine is a tool containing one or more parts that uses energy to perform an intended action. Machines are usually powered by mechanical, chemical, thermal, or electrical means, and are often motorized. A simple machine is a device that simply transforms the direction or magnitude of a force.

4. Lets Consider Efficiency ‘Maximum productivity with minimum wasted effort (or expense)’ Well Organised Planned Productive Effective etc. etc.

5. Efficiency of Movement for Sit to Stand

6. Features of the seat that will alter efficiency of movement: Height Arms Arm location Feet position Seat depth Ability to position feet

7. Active hoists – do they promote efficient movement?

8. If we want efficient movement when related to manual handling of people then we have to consider aspects such as: Hand and foot position (of the handler and the person) Relationship of our body to the person and direction of movement Contact with the person Direction of the force exerted Speed of initial and stopping forces Use of body weight Understanding of normal ‘patterns’ of movement For moving of people....................SOFT HUMAN factors also play a part Lets Consider Efficient Movement

9. The idea is that if WE move efficiently we can promote efficiency of movement Encourage the handler to be aware of their own body and actions, and the consequences of their touch on the person being assisted

10. If our intention is ‘to do’ our approach will be direct and we will negate to invite the person to be active, touching them in such a way as to limit the persons mobility and hence function and potential toward independence…….. Not to mention the inefficiency of not working together as a team

11. When part of the body is held in a position for extended periods of time without soft tissue being allowed to relax Restricts blood flow to the muscles and tendons resulting in less opportunity for recovery and metabolic waste removal - HSE 2002 What is Static Load?

12. When does static load become overload?

13. If you hold a part of the body for longer than 3 – 4 seconds in a certain position A harmful static load is a posture held for 30 seconds or more Static Load

14. Force = Load x Distance

15. Example of a standard for the maximum permissible time that static working positions are held General Rules –Dont lean forward more than 30 degrees for more than 1 min Dont work below hip level Working Positions - Mathilde Meidema (1993) Good – 2mins Average – 1min Poor – Avoid

16. Stable stance and dynamic balance Relationship of stance and distance of load from the spine (line of gravity) Ensure a good hold Economical expenditure of energy Comfort and ease of movement L23 Principles of Safe Handling (Delphi Exercise)

17. If we want efficient movement when related to manual handling of people then we have to consider aspects such as: Hand and foot position Relationship of our body to the person and direction of movement Contact with the person Direction of the force exerted Speed of initial and stopping force Use of body weight Understanding of normal ‘patterns’ of movement For moving of people....................SOFT HUMAN factors also play a part Lets Consider Efficient Movement

18. Hand and Foot Position Hands should be placed in a position and in such a way so as to stimulate muscle activity and hence facilitate movement Foot Position should allow easy dynamic balance without the need for rotation. The foot position will indicate the TYPE of force to be exerted. May also indicate a direction of movement for the person being assisted i.e. push and pull = step stance

19. If we want efficient movement when related to manual handling of people then we have to consider aspects such as: Hand and foot position Relationship of our body to the person and direction of movement Contact with the person Direction of the force exerted Speed of initial and stopping force Use of body weight Understanding of normal ‘patterns’ of movement For moving of people....................SOFT HUMAN factors also play a part Lets Consider Efficient Movement

20. Relationship of our body to the person and direction of movement Contact enables effective communication Contact allowing the other person space to move

21. If we want efficient movement when related to manual handling of people then we have to consider aspects such as: Hand and foot position Relationship of our body to the person and direction of movement Contact with the person Direction of the force exerted Speed of initial and stopping force Use of body weight Understanding of normal ‘patterns’ of movement For moving of people....................SOFT HUMAN factors also play a part Lets Consider Efficient Movement

22. Direction of the force to be exerted Face towards the direction of movement (or directly away if pulling) – Do not pull and Push ACROSS your body

23. true/false The bed is always positioned high when assisting with in bed transfers

24. The height of the bed depends upon the action Push HighPull Low

25. true/false Pushing is better than pulling

26. Standards for Pushing and Pulling Pushing norms (Mital, 1993) Occasional pushingMen16kg/1 hand32kg/2hands Women11kg/1hand22kg/2hands Frequent pushingMen11kg/1hand22kg/2hands Women7.5kg/1hand15kg/2hands Pulling norms (Mital, 1993) Occasional pulling of loads Men15kg/1 hand30kg/2hands Women10kg/1hand20kg/2hands Frequent pulling of loads Men10kg/1hand20kg/2hands Women7kg/1hand14kg/2hands

27. If we want efficient movement when related to manual handling of people then we have to consider aspects such as: Hand and foot position Relationship of our body to the person and direction of movement Contact with the person Direction of the force exerted Speed of initial and stopping forces Use of body weight Understanding of normal ‘patterns’ of movement For moving of people....................SOFT HUMAN factors also play a part Lets Consider Efficient Movement

28. true/false Pushing and Pulling actions should always be performed quickly.

29. Use your height and your weight and movement will start within 3 seconds... The Secret: 1-2-3

30. When it comes to assisted transfers...... Let the person initiate the movement to reduce the effort of the caregiver by 50% !!!

31. If we want efficient movement when related to manual handling of people then we have to consider aspects such as: Hand and foot position Relationship of our body to the person and direction of movement Contact with the person Direction of the force exerted Speed of initial and stopping force Use of body weight Understanding of normal ‘patterns’ of movement For moving of people....................SOFT HUMAN factors also play a part Lets Consider Efficient Movement

32. Normal movement In all the possible variations in movement certain common denominators can be found There is a base pattern which we utilise to perform common tasks Principles of ‘normal movement’ are foundation on which ‘assisted transfers’ should be based. Utilising ‘abnormal’ movement will decrease ease, comfort and efficiency of the transfer Effective transfers mean moving normally together!

33. If we want efficient movement when related to manual handling of people then we have to consider aspects such as: Hand and foot position Relationship of our body to the person and direction of movement Contact with the person Direction of the force exerted Speed of initial and stopping force Use of body weight Understanding of normal ‘patterns’ of movement For moving of people....................SOFT HUMAN factors also play a part Lets Consider Efficient Movement

34. If you want to function well....(and safeguard yourself and your patient) Your senses need to be well developed....and you need to be open and responsive to the other person Thank You