Use your legs, not your back: An investigation into the links between lower body work and spine angles and moments during paramedic related lifting tasks
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Background: Paramedics commonly suffer back injuries as a result of lifting. Improving lifting technique is often cited as an injury prevention approach; however traditional postural-based technique classifications have yet to identify an optimal technique. Instead, this thesis explored the hypothesis that an increased contribution of work done by the lower body relative to the trunk will be associated with lower peak sagittal plane trunk angles and moments experienced by paramedics while performing common paramedic lifting – a spine sparing strategy. Additionally this thesis explored whether higher peak lower body power capacity (calculated using vertical jump scores) was associated with reduced trunk angles and moments during lifting. Methods: Thirty-three healthy paramedics performed three lifting tasks and completed a vertical jump test. A 3D linked-segment model computed sagittal plane trunk moments and angles, as well as joint power and the corresponding work done by the ankle, knee, hip, and trunk during lifting. Peak lower body power capacity was computed using vertical jump height. A correlational analysis determined the associations between lower body work contribution, lower body power capacity (calculated from the vertical jump score), and peak sagittal trunk angles and moments. Results: Paramedics that completed the lifting tasks with an increased contribution of work from the lower body also experienced lower peak spine angles and moments in the sagittal plane. Peak lower body power capacity was not associated with any variable. Conclusion: These results provide partial support for the overarching thesis, where an increased contribution of work from the lower body provided a spine sparing lifting strategy. This finding supports the need to continue coaching and training paramedics to generate more work from the lower body while lifting, as a spine sparing tactic. However, future work should try to identify relevant screening tools that can quickly determine if a paramedic is likely to adopt this strategy, or if they should be re-directed for more coaching and training.