The CSP (2016) suggests bending, twisting and heavy physical work should be minimised and a balanced approach should be implemented whereby carers consider the needs of the patient and the goal of care, but where they do not overlook themselves in the process.
The aim of proper posture is to reduce the physical stresses and strains on the lumbar spine but also the entire musculoskeletal system (HSE 2013). For tasks that involve handling patients, these principles can be adapted to include the following:
- keeping a walk-step stance (i.e. as if taking a step: legs apart, knees flexed, etc.)
- transferring bodyweight using the strong leg muscles
- avoiding over reaching by getting the person to move closer, or only handling the side of the person closest to you
- raising the bed height or sinking down at the hips and knees (Smith, 2013).
Take for example, the process of showering a person in a tilt in space shower chair. The turning circle of the chair is large and the carer may be required to move the chair during the showering process to ensure that water can rinse the entire body. This may mean that space in a bathroom is at a premium. Showering the lower half may involve bending and twisting movements when directing the shower head at the intimate parts of the body and lower limbs.
Shower screens are useful for keeping water within a shower tray or a dedicated showering area in the bathroom however, consider that a carer may have to over reach out of their centre of gravity and adopt a posture that may put strain in the lumbar spine. Removing a shower screen or curtain could cause the carer to become wet and to avoid this, they may in turn adopt unfavourable postures by flexing from the waist to keep their feet dry.
Anecdotally, parents will sometimes enter the shower with their child, as showering them and trying to remain dry and avoid over reaching is impossible. This then has implications for privacy and dignity of the parents and may not be appropriate in the long term for the child.
Devices that are height adjustable are advantageous for carers as the person can be raised and lowered to an optimal height for the carer, therefore reducing the risk of carer injury.
Backcare.org.uk (2016) retrieved from: www.backcare.org.uk/news/caring-carers-backcare-awareness-week/ accessed on 15.09.2020
CSP (Chartered Society of Physiotherapy) (2016) Back Pain Myth Busters. Available at: www.csp.org.uk/public-patient/back-pain-myth-busters
HSE (Health and Safety Executive) (2013) Ergonomics and Human Factors at Work: A Brief Guide. Available at:
Smith, J. (2011) Guide to the Handling of People: A Systems Approach, 6th edn. Teddington, UK: Backcare.