Mechanical work and energy transfers while turning patients in bed

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Abstract
The task of pulling and turning a patient in bed using a pique has been identified as potentially risky for female nursing aides and evaluated in terms of its loads on the spine. It was the purpose of the present study to investigate the mechanical work and energy transfers both between and within the body segments, and the relative contribution of the body segments to production of the work. Fifteen female nursing aides took part in the experiment. Different task execution parameters were examined: execution velocity, height of the bed, direction of effort, leg position, support on the bedside. A ‘free’ task and a manual task not involving the use of the pique were also examined. Cinematography and force platforms were used to generate the data. Internal work was calculated on the basis of potential and kinetic segment energy. External work was calculated from the integration of power applied to the patient over time. The results suggest that forces should be applied vertically and at slow speed to minimize energy use; however, speed reduction leads to higher spinal loads and recommendations to this effect should be interpreted with care. The type of task examined was associated with little energy conservation (about 30%). Substantial use of the trunk segment to produce work might account for the back problems female nursing aides encounter with this type of task.