The Effect of an on Body Personal Lift Assist Device (Jaipur Belt) on Trunk Muscle Fatiguability During a Repetitive Lifting Task in Manual Material Handlers – A Non-Randomized Single-Group Trial

Background: An on body personal lift assist device (OBPLAD) is a non-motorized, passive device in which the elastic elements act as an external muscle power generator to assist lifting thereby offloading the trunk muscles. Though there is enough evidence for the use of OBPLAD generated through laboratory studies, we found a scarcity of evidence on the use of OBPLAD in real-life work settings, especially in the Indian population. This study investigates the effect of the Jaipur belt, an OBPLAD, on trunk muscle fatiguability while performing repetitive lifting task in manual material handlers. Methods:70 subjects engaged in manual material handling were recruited from industries in and around Mangalore, Karnataka in this non-randomized single group trial. Subjects were made to perform a repetitive lifting task over a period of 15 minutes with and without an OBPLAD. Electromyographic data were recorded from rectus abdominis, transverse abdominis, quadratus lumborum, and erector spinae from either side of the body, and the onset of fatigue was deduced from the changes in electromyographic parameters. Results: We found a delay in the onset of fatigue in all the muscle groups studied while the lift was performed wearing the Jaipur belt. However, the findings were statistically significant only for right erector spinae, right rectus abdominis, left transverse abdominis, and left quadratus lumborum. It was found also that number of repetitions as well as time for which a task would be sustained were both found to be significantly better wearing an OBPLAD.Conclusion: The findings of the study imply that the Jaipur belt could potentially delay the onset of fatigue in the trunk muscles while performing repetitive lifting task and hence, is proved to be useful in the prevention of fatigue-related musculoskeletal disorders of the lower back.CTRI Registration date: 10/02/2020 Trial registration number: CTRI/2020/02/023219

P008: Care of palliative patients by paramedics in the 911 system

Introduction: Palliative Care aims to relieve suffering and improve the quality of living and dying in patients with life-limiting, progressive conditions. Many patients and families prefer to stay at home at end of life. Despite this, many access 911 in times of apparent crisis. It has been noted in the literature that a well functioning palliative care system includes considering Emergency Medical Services as part of the patients’ circle of care. Training in palliative care is traditionally limited or absent for prehospital clinicians, including Paramedics and Emergency Medical Services Physicians. Furthermore, in our region, there are currently no medical directives available to Paramedics within the 911 system specifically addressing the needs of palliative care patients. Methods: A feasibility study (Expanding Care by Paramedics for Palliative Patients – EC3P) was designed to evaluate implementation of a new palliative care medical directive with trained teams of Paramedics available to respond to 911 calls. As part of this study, a pre-implementation retrospective chart review was performed. Patient care records were screened for “palliative” within the past medical history and text fields. Information about dispatch and scene times, patient demographics, details of patient encounter, and disposition of the patient were recorded. Descriptive statics were used. Results: Data was reviewed for all calls in 2018. Call data was reviewed to exclude those that were pediatric (<18yo) and those whose palliative status was unknown or unclear. There was a total of 318 calls. The majority of the calls (83%) were between 7am and 8pm, with peaks at 10 am and 6pm. The majority were transported to hospital (74%), 16% were transferred to hospital initiated by their palliative care physician, 20% “refused” transport, and 6% were declared dead and not transported. The most common reasons for calling 911 were new symptoms or a sudden worsening of chronic symptoms, followed by needs exceeding caregiver capacity; the third most common was lift assist without apparent injury. Conclusion: Much is unknown about the palliative patient population as it intersects with prehospital emergency care. This study will help provide information needed to guide further research and implementation.

Effects of lift-assist device on trunk and shoulder kinematics

Background: Repetitive handling of heavy concrete blocks has been associated with the risk of low back and shoulder injuries among the masons. Several interventions have been proposed to reduce the risk of musculoskeletal disorders among the masons. A new intervention, a lift-assist handle, was tested in this study. Objective: The effectiveness of the lift-assist handle in masonry work was assessed using the shoulder and low back kinematics during block lifting/lowering tasks performed at two heights. Methods: In a laboratory setting, seven male subjects performed with- and without-lift handle assisted block lifting tasks at two different heights. Optical motion capture system and biomechanical modeling software were used to record and model each dynamic trial. Effect of lifting height and use of a lift-assist handle on range of motion of the shoulder and trunk were tested. Results: The use of lift-assist handle significantly reduced trunk motion and increased shoulder motion. Lifting height had a significant effect on shoulder kinematics only. When height was increased from 17to 29 inches, the ranges of motion of shoulder abduction-adduction and internal rotation significantly increased. Additionally, block lifting/lowering task duration decreased by 26% when the lift-assist handle was used. Conclusions: While potential benefits to lower back health were found with the lift-assist handle, increased shoulder motion may increase the risk of shoulder injuries. The findings of this study emphasize the need for an in-depth analysis of assistive devices prior to implementation to ensure that there are no unintended consequences of their use that could negate their benefit.