Low back pain and lumbar multifidus cross-sectional area, multifidus activation, and low back force in healthcare workers

• Published in: International journal of industrial ergonomics Vol. 88; p. 103279
• Main Authors: Larson, Robert E., Johnson, A.Wayne, Bruening, Dustin, Ridge, Sarah T., Mitchell, Ulrike H.
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 01.03.2022; Elsevier BV
• Subjects: Back pain; Cross-sections; Electromyography; Force plates; Health care; Low back force; Low back pain; Lumbar spine; Medical personnel; Motion capture; Multifidus activation; Multifidus cross-sectional area; Musculoskeletal diseases; Pain; Pain management; Patients; Multifidus activation; Lumbar spine; Low back force; Low back pain; Multifidus cross-sectional area
• ISSN: 0169-8141; 1872-8219
• DOI: 10.1016/j.ergon.2022.103279

Healthcare workers are required to engage in repetitive actions when handling patients which leads to widespread low back pain in this population. Many variables are related to low back pain including repetitive motions and abnormal multifidus size and activation. This research sought to observe the relationship between low back pain and three variables in healthcare workers specifically: peak low back force when boosting a patient, multifidus cross-sectional area, and multifidus activation. This cross-sectional, correlational study included 35 healthcare workers who currently work in inpatient hospital, acute hospital, or skilled nursing settings, and engage in patient handling as part of their job. Force and motion data were collected with motion capture and in-ground force plates and processed to estimate low back forces. Multifidus cross-sectional area was measured with ultrasound while activation was measured using surface electromyography. There was not a significant difference in peak low back force between pain and nonpain groups. There was a significant difference in multifidus cross-sectional area at 2 of the 3 levels measured (L5 and S1). Lastly, there was not a significant difference in multifidus activation. Peak low back force during patient handling and lumbar multifidus activation do not seem to be a factor in pain in healthcare workers. Multifidus cross-sectional area is correlated with pain in this population indicating smaller multifidus may increase the likelihood of experiencing pain. Further work should be done to confirm this finding and offer potential solutions. Discovering factors in and ways to alleviate low back pain in healthcare workers is essential to the longevity of these professionals in their respective careers. •Low back pain is a frequent problem among healthcare workers that is exacerbated by manual patient handling.•Healthcare workers with low back pain tend to have smaller lumbar multifidus than those without pain.•Multifidus activation does not seem to be different between those who have pain and those who do not.•Low back force during a patient boosting task is not greater in those with pain compared to those without pain.