A study of spinal kinematics in community nurses performing nursing tasks

Nurses are known to be a group at high risk of developing work-related musculoskeletal disorders due to the heavy physical demands of their work. Community nurses are a special group within the profession whose work is different from that carried out in hospital settings. In Hong Kong, community nursing teams are responsible for visiting elderly patients in their homes or in residential institutions where the nursing care provided is inadequate. One of the tasks they commonly perform on such patients is wound care. The present study aimed to examine community nurses' movements and postures when performing wound-dressing tasks in nursing homes. Nineteen female community nurses (age range = 26–50) agreed to participate. Motion sensors were attached to their back at the thoracic and lumbar spine regions to capture the three-dimensional motion when they performed wound-dressing tasks at the patients' bedsides. The low, median, and peak joint angles in the thoracic region (torso segment) and the lumbar region (pelvic segment) during these tasks were recorded. The results showed that the mean extent of movement was 27.64° (±7.36°) with 28.49° (±10.64°) of flexion at the torso and pelvic segments. This amounts to nearly 60° of flexion in the spine, in addition to about 20° of side flexion and 42° of rotation from side to side. The movement data measured when dressing the wounds of real patients were very similar to those recorded in a further, simulated task involving moving cotton-wool balls from a high to a low surface. Another such simulation was performed using a high benchtop only, and this showed markedly reduced movement ranges. The results illustrate the potential risks to community nurses of performing such frequent and large-amplitude trunk movements, which may contribute towards the development of low back disorders. Such biomechanical data can provide objective evidence for the introduction of ergonomic interventions for community nurses.Relevance to industryThis study examined the physical movements involved in a frequently performed task of wound dressing by community nurses, and illustrated the use of biomechanical measurement devices in a field setting to estimate the nurses' physical workloads.

► The study examined the physical work demands for community nurses.
► Three-dimensional spinal movements were measured when nurses performed wound-dressing.
► Nurses showed significant bending up to 60° in the torso and pelvic regions.
► Similar extent of bending was reproduced in simulation with a high and a low benchtop.