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  • in reply to: PT’s use of mechanical lift devices. #39938

    glen_smith
    Participant

    One consideration I always had was for the cognitive level of your patients. E.g. patients with dementia etc can tend to lift their arms and drop tot the ground with standing machines. I was always a bit averse to using them in aged care for this reason as clientele could be variable during the course of the day and carer where often agency etc. Would you be better of with O/head tracking for the PT use as you probably are looking at ambulation etc? Does the removable foot plate capture the clients foot when it is not in place?

     

    Cheers Glen


    glen_smith
    Participant

    The workability tool form Finland developed by Juhani illmarinen. It is currently being adapted for Australia by people at Swinburne University due to differing populations etc. The tool considers the physical and psychosocial "fit" of the workplace for an ageing population.

     

    Cheers Glen


    glen_smith
    Participant

     

    As already highlighted trialling various surfaces and the forces required for wheeled equipment to be used on them will help you clarify the most ‘efficient’ floor surfaces.

    What you may well find is that equipment such as beds will require the use of powered tugs. One of the more effective ways I have seen this engineered is through the powered tug being fitted to the head of the bed and this end also being used as the steering end as it allows greater manoeuvrability in the limited space of a room.

     

    The issue of hygiene and cleaning may well be two different issues. The transmission of disease from floor surfaces (nosocomial infection) is usually limited as people generally do not crawl on the floor and then deal directly with patients and if they washed their hands correctly the transmission of disease from the floor would be limited. The issue of cleaning a floor surface may be more about dirt/dust/stains/spillage general appearance etc.

     

    Cheers Glen
    in reply to: Anthropometrics of Joints/Areas #40773

    glen_smith
    Participant

    Have you looked at the WEAR site, World Engineering Anthropometry Research

    http://wear.io.tudelft.nl/

     

    Cheers Glen


    glen_smith
    Participant

     

    All good advice above another good read is the Mayo clinic book on chronic pain. Have you looked around for a clinic that specialises in chronic pain management? Depending upon the ‘type’ of chronic pain that you have can depend upon the treatment modality.

    E.g. (grossly simplified)

    1 myosfascial=muscle and fascia winding up

    2 central sensitisation=changes in the brain resulting in the brain ‘misinterpreting’ the signals it receives

    3 Neuropathic =damaged nerve

    4 Etc

    If you treat central sensitisation the same as myofascial pain you can exacerbate the pain.

    Research has identified acceptance as the biggest factor with chronic pain, if you cannot find any other way to manage the pain. E.g. myofascial treatment works and the pain goes away.

    Grading of task so that you do not have the all or nothing situation occurs is also important. Frequently people with chronic pain will perform a task in excess of what their body is now capable of and then spend a number of days in bed in pain.

    The Mayo book explains the problems quite well as this is a very complex area to treat with other issues the often need to be addressed. There is also a good book that is available her in Australia if you want the title I can see if I can find it.

     

    Cheers Glen

    glen_smith
    Participant

    Hi Eva Swinburne University in Melbourne is modifying the Workability tool from Finland. They found the origninal tool did not fit the Australian/Victorian population. If you want the contact persons name there I will check whether it is appropriatte to pass on her details to you. Very interesting group and work

     

    Cheers Glen


    glen_smith
    Participant

     

    The document below may be of benfit to you also as it has a simplified version of snook and cirello and variety of other guidance on various matters

    http://www.worksafe.vic.gov.au/wps/wcm/connect/wsinternet/worksafe/home/forms+and+publications/publications/import_designing+workplaces+for+safer+handling+of+patients+and+residents

    Designing workplaces for safer handling of people

    Designing workplaces for safer handling of people formerly known as Designing workplaces for safer handling of patients and residents is a publication for planners, facility managers and direct care staff. The publication is intended for those who have design and layout of a current workplace contributing to injuries, organisations designing new facilities or planning renovations, and for workers involved in the

    Cheers Glen

    in reply to: falsely advertised ‘ergonomic’ products #39587

    glen_smith
    Participant

    Unfortunately the word is can be misused by consultants in reports and is used in quite a misleading way. Another of my favourites is "ergonomics problems". The problems result from poor desing and hopefully ergonomics should resolve the problem. (Unless they resulted from a poor ergonomic design in the first place).

    A while ago I bought a bass clarinet. Its top selling feature was its ergonomic design. From what I can see that may well be true. But without a reference point iti is hard to tell.

    Have a Merry Christmas

     

    Cheers Glen


    glen_smith
    Participant

    Unfortunately you are correct for the way in which problems get dealt with. It is usually dealt with training etc first as it is a cheap option.

     

    Have a good Christmas

    Cheers Glen


    glen_smith
    Participant

    I think that Peter has described ergonomics beautifully and I could not agree with him more. I think that every modality has its strengths and limitations and it is more about recognisiing these and utilising the appropriatte modality to achieve the best outcome. Myofascial techniques and ergonoimcs and many others all have things to offer. The weakness that I have found is more often found in the practitioner  and on the limitations that they place on seeing the strenghts and weakeness than in the modality. I recently discussed with an Alexander technique (I personally think Alexander technique is fantastic) practitioner ergonomics and alexander technique. The example they used was they could ensure that a person sat on wooden chair well and in a healthy manner irregardless of the type of chair. For me my perspective was  that the chair should allow/encourage/promote the "best posture". I feel that both should be complimentary e.g. the best environment (chair) will enhance outcomes from the treatment modality. Rather than having a person trying to perform their best despite having an environment that creates obstacles.

     

    Cheers Glen

    in reply to: exercise balls as office chairs #39489

    glen_smith
    Participant

    Any sitting posture has advantages and disadvantages and all require rotation through standing sitting, walking etc. A fit ball, appropriatte chair, or kneeler provide varying degrees of support and are suitable for sitting or exercise in various amounts. I would tend to believe for many reasons that a fit ball is not a suitable office chair and is generally more tiring and offers less support and ability to alternate posture and the obvious OH&S considerations than some of the other options available. 

    To use a fit ball for 8-10 hours which in most cases offers less back support, ability to rest or rotate your movement patterns or postures is probably not the best option. My understanding is that they engage the core muscles and the constant small movements of the ball develop "core strength". "If a ball is used as an office chair" (which I am not recommending) It seems counter intuitive to stop the ball moving by placing it on a donut etc 

    Cheers Glen

    in reply to: Birthing, bariatric patients #40455

    glen_smith
    Participant

    Steve I have sent you through a private email as I have a lot of potentially relevant information so feel free to contact me.

    Cheers Glen

    Glen Smith Ergonomist

    Ergonomics Unit

    Hazard Management Division

    Level 18

    Mob 0408 412 923

    WorkSafe Victoria

    in reply to: Michigan’s Draft Ergonomics Standard #39340

    glen_smith
    Participant

    There are a number of documents e.g. red meat
    http://www.worksafe.vic.gov.au/wps/wcm/resources/file/ebe0060d3023f99/manualhandling_redmeat.pdf

    Office work
    http://www.worksafe.vic.gov.au/wps/wcm/resources/file/ebcb9c435c881f7/officewise.pdf

    Sawmilling
    http://www.worksafe.vic.gov.au/wps/wcm/resources/file/ebe0050d301b469/sawmilling.pdf

    Automotive chemical manual handling
    http://www.worksafe.vic.gov.au/wps/wcm/resources/file/eb274b4fec79465/safe_handling_chemicals_automotive_industry.pdf
    There a large number of other document that provide more specific solutions.

    The challenge is the regulations etc that support this kind of document. Which I do not know enough about your specific regulations etc. If the emphais has been placed upon cost rather than reduction in injury. It may be very hard for a document written like this to get much traction given the US’s current financial environment?

    The OHS laws/regulations need to interlink to get the appropriatte result, so it would be hard to come up with a direct comparison given the many variables.

    Cheers Glen

    in reply to: Michigan’s Draft Ergonomics Standard #40681

    glen_smith
    Participant

    Thanks for putting the documents up on line Peter. It is good to see where other countries are evolving in their legislation re: health and safety.  Victoria in Australia where I live has this document (see below) and a national standard that is based upon this document. It is interesting to see the use of the word "ergonomic" like this. It was also interesting to read in the second attachment that worker health is listed third after quality and productivity. The prioirties in the document are mixed between productivity, quality and health safety. In some cases the financial aspect is placed first as a deciding factor.

    http://www.worksafe.vic.gov.au/wps/wcm/resources/file/ebd8d543a0693d5/COP25_manualhandling.pdf

    Cheers Glen

    in reply to: PT’s use of mechanical lift devices. #40566

    glen_smith
    Participant

    Ron here is a link to one of the studies that I mentioned. The cost benfits a clear.                             http://www.health.vic.gov.au/ohs/forum0508/index.htm

    Cheers Glen

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