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  • 1
    Digitale Medien
    Digitale Medien
    Palo Alto, Calif. : Annual Reviews
    Annual Review of Biomedical Engineering 4 (2002), S. 49-68 
    ISSN: 1523-9829
    Quelle: Annual Reviews Electronic Back Volume Collection 1932-2001ff
    Thema: Technik allgemein , Medizin
    Notizen: Abstract Occupational low back pain (LBP) is an immense burden for both industry and medicine. Ergonomic and personal risk factors result in LBP, but psychosocial factors can influence LBP disability. Epidemiologic studies clearly indicate the role of mechanical loads on the etiology of occupational LBP. Occupational exposures such as lifting, particularly in awkward postures; heavy lifting; or repetitive lifting are related to LBP. Fixed postures and prolonged seating are also risk factors. LBP is found in both sedentary occupations and in drivers as well as those involved in manual materials handling. Any prolonged posture will lead to static loading of the soft tissues and cause discomfort. Standing and sitting have specific advantages and disadvantages for mobility, exertion of force, energy consumption, circulatory demands, coordination, and motion control. The seated posture leads to inactivity causing an accumulation of metabolites, accelerating disk degeneration and leading to disk herniation. Driver's postures can also lead to musculoskeletal problems. Workers in a driving environment are often subjected to postural stress leading to back, neck, and upper extremity pain. This exacerbates the problems due to the vibration. Prevention is by far the treatment of choice. Improved muscle function can be preventative. Poor coordination and motor control systems are as important as endurance and strength. Fixed postures should be avoided. Seats offering good lumbar support should be used in the office. A suspension seat should be used in vehicles whenever possible. Heavy and awkward lifting should be avoided and lifting aids should be made available. Workers should report LBP as early as possible and seek medical advice if they think occupational exposure is harming them. The combined effects of the medical community, labor, and management are required to cause some impact on this problem.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 2
    ISSN: 1432-0932
    Schlagwort(e): Key words Lifting ; Surgery ; Return to work ; Low back pain ; NIOSH
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Lifting restrictions postoperatively are quite common but there appears to be little scientific basis for them. Lifting restricitions are inhibitory in terms of return to work and may be a factor in chronicity. The mean changes in functional spinal motion unit (FSU) stiffness with in vitro or computer-simulated discectomies, facetectomies and laminectomies were reviewed from the literature. We modified the NIOSH lifting equation to include another multiplier related to stiffness change post surgery. The new recommended lifts were computed for different lifting conditions seen in industry. The reduction of rotational stiffness ranged from 21% to 41% for a discectomy, 1% to 59% for a facetectomy and 4% to 16% for a partial laminectomy. The recommended lifts based on our modified equation were adjusted accordingly. There is no rational basis for current lifting resctrictions. The risk to the spine is a function of many other variables as well as weight (i.e., distance of weight from body). The adjusted NIOSH guidelines provide a reasonable way to estimate weight restrictions and accomodations such as lifting aids. Such resitrictions should be as liberal as possible so as to facilitate, not prevent, return to work. Patients need more advice regarding lifting activities and clinicians should be more knowledgeable about the working conditions and constraints of a given workplace to effectively match the solution to the patient’s condition.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 3
    ISSN: 1432-0932
    Schlagwort(e): Key words Lifting ; Surgery ; Return to work ; Low back pain ; NIOSH
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Lifting restrictions postoperatively are quite common, but there appears to be little scientific basis for them. Lifting restrictions are inhibitory in terms of return to work and may be a factor in chronicity. The mean functional spinal motion unit stiffness changes with in vitro or computer-simulated discectomies, facetectomies and laminectomies were reviewed from the literature. We modified the NIOSH lifting equation to include another multiplier related to stiffness change post surgery. The new recommended lifts were computed for different lifting conditions seen in industry. The reduction of rotational stiffness ranged from 21% to 41% for a discectomy, 1% to 59% for a facetectomy and 4% to 16% for a partial laminectomy. The recommended lifts based on our modified equation were adjusted accordingly. There is no rational basis for current lifting restrictions. The risk to the spine is a function of many other variables as well as weight (i.e., distance of weight from body). The adjusted NIOSH guidelines provide a reasonable way to estimate weight restrictions and accommodations such as lifting aids. Such restrictions should be as liberal as possible so as to facilitate, not prevent, return to work. Patients need more advice regarding lifting activities and clinicians should be more knowledgeable about the working conditions and constraints of a given workplace to effectively match the solution to the patient’s condition.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
    BibTip Andere fanden auch interessant ...
  • 4
    Digitale Medien
    Digitale Medien
    Hoboken, NJ : Wiley-Blackwell
    Journal of Biomedical Materials Research 38 (1997), S. 267-288 
    ISSN: 0021-9304
    Schlagwort(e): biomaterials ; biomechanics ; spinal implant ; vertebral body ; intervertebral disc ; Chemistry ; Polymer and Materials Science
    Quelle: Wiley InterScience Backfile Collection 1832-2000
    Thema: Medizin , Technik allgemein
    Notizen: Man-made devices have been implanted into the body to relieve pain, to restore function, and to facilitate healing. The subjects of this review are the materials, and to a lesser extent, the design aspects of the numerous implants that are available to the surgeon in dealing with the ailing spine. Often it is the material aspects of such devices that are responsible for their success or failure. It may be that osteoconductive properties are desired for implants to assist fusion, whereas as inert a material as possible would be preferred for interpositional barriers. The materials composing the instrumentation used to facilitate healing of spinal fractures would ideally have properties that optimize strength and biocompatibility, while at the same time minimizing imaging artifacts and allowing a gradual transfer of load from the instrumentation to the vertebral body (i.e., viscoelastic effects). The application of biomaterials and biomechanics to the design of spinal devices is obvious; what may be more subtle though is what the in vivo interactions of these will be. The study of such aspects must continue in order to better evolve the designs and subsequent results of implanted spinal devices. © 1997 John Wiley & Sons, Inc. J Biomed Mater Res (Appl Biomater) 38: 267-288, 1997
    Zusätzliches Material: 16 Ill.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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  • 5
    Digitale Medien
    Digitale Medien
    Hoboken, NJ [u.a.] : Wiley-Blackwell
    Journal of Orthopaedic Research 7 (1989), S. 122-131 
    ISSN: 0736-0266
    Schlagwort(e): Biomechanics ; Lumbar disc ; Deformations ; Denucleation ; Loads ; Life and Medical Sciences
    Quelle: Wiley InterScience Backfile Collection 1832-2000
    Thema: Medizin
    Notizen: Three rows of six evenly spaced 0.5 mm metal beads were implanted midsagittally into the discs of ten L4-5 human lumbar motion segments. The intradiscal bead displacements in response to compression, flexion, and extension loads were obtained by digitizing the bead positions from sagittal plane radiographs taken before and during the load application. Each disc was denucleated and the loading process was repeated. For the intact discs, in compression, the intradiscal bead displacements were predominantly anterior. In flexion, the beads in the center of the disc moved posteriorly whereas the beads closer to the periphery of the disc moved anteriorly. In extension, the central beads moved anteriorly and the beads closer to the periphery of the disc moved posteriorly. After denucleation, the bead displacements for compression and flexion implied an inward bulging of the inner wall of the annulus, despite outward bulging of the disc surface. We hypothesize that the inward bulging causes radial tensile stresses within the disc, leading to disruption of adjacent layers of annulus.
    Zusätzliches Material: 13 Ill.
    Materialart: Digitale Medien
    Bibliothek Standort Signatur Band/Heft/Jahr Verfügbarkeit
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