biomechanics and load in the workhab functional capacity

Biomechanics and Load in the

WorkHab Functional Capacity

Evaluation: An Update

Dr Carole James

School of Health Sciences,

The University of Newcastle, Australia.

FCE: 2018

FCE 2018

School of Health Sciences

2

Effect of Load on Biomechanics in the WorkHab FCE

• Safe Maximal Lift = maximum load that an individual is able to safely lift.

Purpose:

• To evaluate any change in biomechanics between

safe minimum and safe maximum lifts during the

WorkHab FCE.

FCE 2014


3


Method:

Experimental laboratory

based study

Sample: 30

healthy volunteers

Health Questionnaire,

BP 3 min step test Joints marked – foam ball/

ink

Wrist, Elbow, Shoulder, Hip, Knee, Ankle,

Spinous processes:

C7,T7,L3,S2

Darfish ProSuite

Min + Max lift Lift ÷ 1/3rds Calculation of joint angles

•Data analysis: Descriptive + Paired t-test

Digital recording of

lifting component

Rear Coronal + Right

sagittal planes

Angles 4

Ankle Knee Hip Lumbar Elbow Shoulder

Spine


5


Results – Overhead lift

Green = Overhead (P values)

Joint 0/3 1/3 2/3 3/3

Ulnar deviation 0.007 0.016 0.004 <0.001

Elbow flexion 0.023 0.005 0.004 #

Shoulder 0.007 0.0036 # 0.038

Thoracic

extension

# 0.05 # 0.001

Lumbar extension # # 0.027 0.003

FCE 2018


6


Results – Floor to Bench Lift

Red = Floor to Bench (P values)

Joint 0/3 1/3 2/3 3/3

Lumbar flexion 0.001(d) # # #

Hip flexion <0.001(d) 0.021(a) <0.007(d) <0.001(d)

Knee flexion 0.027(a) 0.005(d) # 0.004(d)

Ankle <0.001(a) 0.019(d) 0.001(d) <0.001(d+a)

FCE 2018


7


Results – Bench to Shoulder Lift

Blue = Bench to Shoulder (P values)

Joint 0/3 1/3 2/3 3/3

Lumbar extension # # # #

Elbow 0.000 (d) 0.008 (a) # 0.009 (a)(d)

Shoulder 0.000 (d) # # 0.000 (a)

Thoracic

extension

# # # 0.004(a)

FCE 2018


8

Ulnar deviation:

• peaked at 36.16 degrees two thirds of the way through the lift

• participants reaching end range during their safe maximal lift

Elbow:

• Participants inclined to keep the load closer to their body when it

was heavier by increasing elbow flexion

Shoulder:

• Shoulder flexion increased despite the overhead lift height remaining the same

Thoracic and Lumbar Spines

• Both in increased extension in parts of the maximum lift

Hip, Knee and Ankle

• Lack of findings


Discussion – Overhead lift

FCE 2018


9

Lumbar

• less hyperextended when lifting maximum weights.

• start point of the descending phase where weights were being lifted

off the bench = significant difference

The hip

• ↑ flexion when lifting the load from the bench (0/3 point of the

descending phase) and placing the load back on the bench (2/3

and 3/3 points of the ascending phase).

• more likely to be in hyperextension when lifting min vs max wgts.

Knee

• minimal changes are noticed in knee joint angle between minimum

and maximum lift.

Ankle joint

• reduction in dorsiflexion when lifting maximum weights


Discussion – Floor to bench lift


10

Lumbar

• No significant difference in lumbar spine extension ascending or

descending

Elbow

• ↓ flexion at 1/3 ascending

• ↑ flexion 3/3 ascending and 0/3 descending – highest point, harder

to keep close to body

Shoulder

• ↑ flexion 3/3 ascending and 0/3 descending – highest point, harder

to keep close to body

Thoracic

• ↑ extension at 3/3 ascending – longer lever arm


Discussion –Bench to Shoulder


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Kinematic changes important in determining SML

Elbow and shoulder flexion – OH

Hip, Ankle, lumbar – FB

Elbow and shoulder – BS

Changes in joint angles support assessors clinical reasoning and observations of SML

Consideration of handle placement with lifting


Discussion

FCE 2018


12

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References:

http://doi.org/10.3233/WOR-172677

http://doi.org/10.3233/WOR-172677

http://doi.org/10.3233/WOR-172677

http://dx.doi.org/10.3233/WOR-131698



http://dx.doi.org/10.3233/WOR-2012-1386





biomechanics and load in the workhab functional capacity

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