Back Care Basics• Introductions

• Housekeeping itemsWashrooms

Refreshment breaks

• Overview of lab styleDiscuss

DemonstrateDo

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LEARNING OBJECTIVES• Explains the principles

of good body mechanics

• Demonstrates back care knowledge and injury prevention techniques

• Describes guidelines for footwear, clothing and safety

• Demonstrates assisted walking using transfer belt, safely.

• Demonstrates pivot transfers

• Identifies core strengthening exercises using center of gravity principles

• Demonstrates position principles when assisting students

• Discusses ways to prevent injuries

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BACK CARE BASICSMusculoskeletal injuries (MSI) account for approximately 30% of all lost time injuries to workers in British Columbia. (http://www2.worksafebc.com/Topics/Ergonomics/MSIPreventionProcess.asp )

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WORKSAFE BC FACTS• Patient handling

is the top cause of injury among healthcare workers.

• Care workers who manually transfer or reposition patients are at significant risk of musculoskeletal injuries

Causes of back injury

•Improper lifting•Poor posture•Overexertion•Slips and falls•Excessive weight•Lack of exercise

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INJURY PREVENTIONEducation Identify risk factors:

◦ Lifting, reaching, overexertion, pushing, pulling, kneeling, repetitive movements, unexpected movements of students, leaning…

Understand steps to prevention of injury:◦ Ask for help◦ Use your professionals (Occupational Therapists-

OT, Physiotherapists-PT, NSS Coordinators-Nurses)◦ Work Safe BC (

http://www2.worksafebc.com/Topics/Ergonomics/Resources-General.asp )

◦ Free PDF files that include: 1.Understanding the Risks of Musculoskeletal

Injury (MSI): An Educational Guide for Workers, on Sprains, Strains, and Other MSIs BK78

2.Back Talk: An Owner's Manual for Backs BK4 5

BASIC PRINCIPLES• Prepare the setting and equipment before

starting any lift or move.• Encourage student to assist as much as

possible!• Use good posture:

– Feet apart (wide base of support) or walking stance.– Keep back straight, bend with your knees.– Keep your chin tucked in.– Elbows slightly bent, at your sides, closest to your

body.• Your shoes must have adequate support with

non-slip soles:– No sandals, no open toe shoes, no heels.

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CLOTHINGGroup Discussion

Consider the following questions:• Jewelry concerns? Risk to student?

Yourself?• What is appropriate clothing?• Why is this important in back care?• What things need to be considered

when dressing for work?• Are student age and gender

factors?7

Disc Protrusion VideoWorkSafeBC

http://www2.worksafebc.com/Publications/Multimedia/Videos.asp?ReportID=35330

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Discover your center of gravityPelvic tilt principle Activity

1. Sitting to Stand2. Standing to Sitting

• What happens to your body during this? How do you sit?

• Think arms, thighs, shoulders, abdomen, pelvis, back, knees

3. Now try both without using your arms• What happened?

4. Assist person into sitting position• Have your partner

discuss their comfort level. Where were their knees? Buttocks? Shoulders?

• Review the body mechanics of sitting to stand and stand to sit.

• Discuss point of ‘no return’ when sliding forward on chair.

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Injury Prevention• Hold weight close to your body.• Use your legs and thigh muscles, as

they are stronger than arms and trunk.• Avoid twisting of trunk, use pivot or step

motion.• Use momentum, gravity and

mechanical devices.• Use both hands to avoid twisting.• Palm up grip gives stronger movement.• ASK for ASSISTANCE if weight is too

heavy, don’t be intimidated!• Co-ordinate move by saying, “1-2-3 Lift”

(ensure you discuss with partner, BEFORE move/lift).

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Core Strengthening

Pelvic Floor Muscles

• Kegel exercises strengthen the pelvic floor

Abdominal Wall Strengthen the

oblique's (side abdominal muscles)

Upper and lower abdominal exercise

Quadriceps/Back Wall squats with good

back posture Leg lifts and arm

raises

Warm-up exercises• Not warming up before

stretching leaves your back susceptible to injuries. Warm muscles are more flexible than cold muscles and are less likely to tear.

Balancing Exercises

• also help to strengthen the core muscles (back. abs, hips and buttocks), which are used in balancing.

http://www.bigbackpain.com/back_exercises.html#backstrengtheningexercises

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ONE PERSON PIVOT TRANSFER

Used When:• Student is able to bear weight.• Rehabilitation therapist (OT, PT) has

determined student is safe to transfer.• EA can safely manage pivot, after considering

height and weight of self and height and weight of student.

• Student is able to participate in transfer.

*NOTE: This is a pivot, not a LIFT of the student, if the student requires lifting then alternative mechanical device is required*

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ONE PERSON PIVOT TRANSFER

Discuss principle of pivot transfer

DEMONSTRATEBREAK INTO GROUPS OF TWO

PRACTICE

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ONE PERSON PIVOT TRANSFER1. EA ensures safety of

area 2. EA explains transfer to

student3. EA ensures brakes are

on (if wheelchair or mobile chair)

4. Position chair parallel to toilet (or alternate chair)

5. Remove footrests (if applicable)

6. Position transfer belt securely

7. Position students arms around EA’s waist (not your neck area)

8. Ensure students feet are on floor

9. Face student with hips and knees slightly bent

10. Unlock safety belt (if used)11. Block student’s knees and

feet if required12. Lean student forward from

the hips13. Grasp transfer belt with

both hands at students waist

14. Count 1-2-3 STAND.15. Pivot student towards

destination, slowly16. Lean student’s shoulders

slightly forward while lowering hips to the chair or toilet.

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ASSISTED WALKINGUsed When:Student can take steps.Student requires assistance for safety.

Rehabilitation therapist (PT, OT) has assessed and approved the safety of assisted walking.

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ASSISTED WALKINGDEMONSTRATEBREAK INTO GROUPS OF TWOPRACTICE ASSISTED WALKINGPRACTICE SLIDE TO GROUND

(FALL)

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ASSISTED WALKING1. Ensure area is free of

obstacles2. Ensure enough space

for two people3. Apply transfer belt

securely to student4. Ensure student’s feet

are firmly on floor5. Ensure student is

aware of movements and is ready

6. Grasp transfer belt at waist

7. Count 1-2-3 STAND 8. Assist student to

standing position9. Maintain firm grasp on

transfer belt at back and side position

10. Slowly walk with student, EA is slightly behind supporting self in walking stance (one foot forward) to ensure good center of gravity

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ASSISTED WALKINGPoints to remember during assisted

walking:• Ensure a good center of balance for EA at all

times.• DO NOT ATTEMPT TO CATCH A FALLING

STUDENT!• If you can:

– Place your body behind the student, place your arms around their torso, pull them closer to your center.

– Widen your base of support by placing one foot behind the other.

– Allow the student to slide down your body toward the floor.

– As they slide down, gently lower them to the floor.18

Review of Principles• ABC’s

–Alignment = Good posture• Proper alignment is necessary to ensure no

excess strain on joints and muscles.–Balance

• Holding your center of gravity, close to your base of support.

• Moving your feet further apart, increases your base.

–Coordinated body movement• using your weight to help with movement. (often

the momentum, rocking that gets you going!)

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QUESTIONS?REMEMBER It is up to you to identify the risk factors and request help to prevent risk to YOU and YOUR studentDon’t be afraid to ask for help!

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