Optimization of the Impact Attenuation Capability of Three-Dimensional Printed Hip Protector Produced by Fused Deposition Modeling Using Response Surface Methodology.

Fused deposition modeling has provided a cheap and effective method for the rapid production of prototypes and functional products in many spheres of life. In this study, three-dimensional (3D) printing techniques to produce and optimize a hip protector that will assure clinical efficacy are presented. The I-Optimal design was used to optimize the hip protector's significant parameters (infill density, shell thickness, and material shore hardness) to obtain maximum femoral neck force attenuation of the 3D-printed hip protector. A drop impact tower device simulates the impact force at the hip's parasagittal plane during a fall. The results show that the infill density has the most significant influence on attenuation properties, followed by the infill density combined with the material shore hardness. By maximizing all the parameters, it is demonstrated that using an additive manufacturing technique to print hip protectors could be an effective strategy in curbing hip fractures.

Efficacy of Interventions in Reducing the Risks of Work-Related Musculoskeletal Disorders Among Healthcare Workers: A Systematic Review and Meta-Analysis.

BACKGROUND: Work-related musculoskeletal disorders (WMSDs) are prevalent among healthcare professionals, including nurses, therapists, doctors, and paramedics, due to the potential injuries incurred during patient transfer and handling. This review aimed to assess the effectiveness of existing interventions in reducing the risks of WMSDs in this population. METHODS: Four databases including PubMed/MEDLINE, Web of Science, Scopus, and ScienceDirect were searched to identify randomized and nonrandomized controlled trials, as well as studies with pre-post design. Two reviewers independently extracted data and assessed the quality of the included studies using the Effective Public Health Practice Project criteria. A meta-analysis was performed to obtain quantitative results. RESULTS: A total of 40 studies were included in the review. Among the interventions, motorized assistive devices showed the most significant relative reduction in WMSD risks (p < .0000; standardized mean difference [SMD] = -3.32, 95% confidence interval [CI] = [-4.53, -2.12]), followed by combined interventions of cognitive and exercise (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), combined intervention of cognitive and assistive device intervention (p = .02; SMD = -0.77, 95% CI = [-1.42, -0.12]), nonmotorized assistive device (p = .02; SMD = -0.63, 95% CI = [-1.15, -0.12]), cognitive intervention (p < .0001; SMD = -0.62, 95% CI = [-0.91, -0.33]), and physical exercise (p = .06; SMD = -0.16, 95% CI = [-0.32, 0.00]) intervention. CONCLUSION: The overall evidence indicates that interventions have a significant effect in reducing the risk of WMSDs among healthcare workers, with motorized assistive devices showing the most promising results. The findings from this review can provide valuable guidance for hospital administrators, policymakers, and other experts in implementing effective strategies to prevent WMSDs among healthcare professionals.

Near-1: the evaluation of usability and task load demand of a motorized lifter for patient transfer.

PURPOSE: Despite the proven benefits of motorized lifting devices in reducing the physical stresses experienced by nurses during patient transfers, the low adoption of these devices remains limited. The study aimed to assess the perceptions of nurses regarding the new motorized lifting device (NEAR-1) in terms of their perceived workload and usability during patient transfers. MATERIALS AND METHODS: A cross-sectional study was conducted to evaluate the perceptions of nurses (n = 45) and students (n = 6) when performing patient transfers from bed to wheelchair and vice versa using the NEAR-1 compared to an existing floor lift, walking belt, and manual transfer. Participants filled out surveys evaluating the perceived task demands and usability of the NEAR-1, as well as open-ended interviews. RESULTS: The use of the NEAR-1 significantly reduced the mean of all NASA-TLX constructs (p < 0.001) when compared to manual transfer. When comparing with other existing lifting devices, the NEAR-1 (24.4 ± 3.0) recorded the lowest overall score of NASA-TLX perceived workload, followed by the existing floor lift (26.1 ± 11.6), a robotic-assisted transfer device (28.3 ± 6.8) and mechanical floor lift (31.5 ± 9.3). The participants recorded a usability score of 76.86, indicating positive perceptions of the nurses towards the technology. CONCLUSIONS: Overall, the NEAR-1 has the potential to reduce the physical stresses on nurses and decrease the likelihood of work-related musculoskeletal disorders (WMSDs). The NEAR-1 may represent a promising new intervention for transferring patients that is capable of minimizing the nurses' perceived workload in clinical and non-clinical settings.IMPLICATIONS FOR REHABILITATION:The NEAR-1 motorized lifting device reduced perceived workload for nurses while handling and transferring patients between a bed and wheelchair.The nurses recorded a usability score of 76.86 for the NEAR-1, reflecting their positive perceptions towards the technology.The new device has the potential to reduce the physical stress on nurses and decrease the incidence of work-related musculoskeletal disorders.

Effects of patient transfer devices on the risk of work-related musculoskeletal disorders: a systematic review.

Objectives. This study aimed to evaluate the efficacy of patient transfer assistive devices in reducing the risk of work-related musculoskeletal disorders (WMSDs) among nurses. Methods. PubMed, Scopus, Google Scholar and the Cochrane Database of Systematic Reviews were searched to identify studies with a quantitative assessment of the efficacy of patient transfer assistive devices on the incidence and injury claims of WMSDs as compared to the manual lifting of patients. A health impact analysis of the pre-post intervention of assistive device implementation was performed. The percentage of the reduction of forces, incidence of WMSDs, number of missed workdays and injury compensation claims were calculated, pooled and presented as boxplots. Results. A total of 25 studies met the inclusion criteria. The best post-intervention outcomes of assistive devices deployment in the healthcare setting included a reduction in WMSD incidence by 59.8%, missed workdays by 90.0% and workers' compensation claims by 95.0%. Additionally, hand force declined by 71% (p < 0.05) and 70% (p < 0.05) with the use of air-assisted devices and ceiling lifts respectively. Conclusions. Overall, the evidence suggests that patient transfer assistive devices, notably ceiling lifts and air-assisted devices, are effective in reducing the risk of WMSDs among nurses.

Evaluation of a motorised patient transfer device based on perceived workload, technology acceptance, and emotional states.

PURPOSE: The high prevalence of musculoskeletal disorders (MSDs) among healthcare workers is partly attributed to the low adoption of patient transfer assistive devices. This study aimed to evaluate the nurses' perceived workload, technology acceptance, and emotional states during the use of the sliding board (SB) and mechanical intervention in the form of a Motorised Patient Transfer Device (MPTD). METHODS: The SB and MPTD activities were performed by seven nurses on a simulated patient. The nurses' facial expressions were recorded during the trial. The NASA Task Load Index and technology acceptance questionnaire were also assessed. RESULTS: The MPTD significantly reduced the mean overall NASA-TLX score by 68.7% (p = 0.004) and increased the overall acceptance score (median = 8.30) by 21.2% (p = 0.016) when compared to the SB (median = 6.85). All the subjects reported positive feelings towards MPTD. However, facial expression analysis showed that the nurses had a significantly higher peak density of fear while using MPTD (p = 0.016). Besides, there was no improvement in the negative valence and contempt emotion compared to the SB. CONCLUSION: Overall, nurses showed positive perceptions and acceptance of MPTD even when they experienced negative emotions.IMPLICATIONS FOR REHABILITATIONThe Motorised Patient Transfer Device (MPTD) reduced the perceived workload of nurses and showed a higher acceptance level compared to the commonly used baseline device (SB).Factors that attributed to the nurses' negative emotions can be used to improve technology and patient transfer processes.More training should be given to familiarise the health practitioners with the new assistive device to reduce their fear of technology.

Femoral fracture type can be predicted from femoral structure: A finite element study validated by digital volume correlation experiments.

Proximal femoral fractures can be categorized into two main types: Neck and intertrochanteric fractures accounting for 53% and 43% of all proximal femoral fractures, respectively. The possibility to predict the type of fracture a specific patient is predisposed to would allow drug and exercise therapies, hip protector design, and prophylactic surgery to be better targeted for this patient rendering fracture preventing strategies more effective. This study hypothesized that the type of fracture is closely related to the patient-specific femoral structure and predictable by finite element (FE) methods. Fourteen femora were DXA scanned, CT scanned, and mechanically tested to fracture. FE-predicted fracture patterns were compared to experimentally observed fracture patterns. Measurements of strain patterns to explain neck and intertrochanteric fracture patterns were performed using a digital volume correlation (DVC) technique and compared to FE-predicted strains and experimentally observed fracture patterns. Although loaded identically, the femora exhibited different fracture types (six neck and eight intertrochanteric fractures). CT-based FE models matched the experimental observations well (86%) demonstrating that the fracture type can be predicted. DVC-measured and FE-predicted strains showed obvious consistency. Neither DXA-based BMD nor any morphologic characteristics such as neck diameter, femoral neck length, or neck shaft angle were associated with fracture type. In conclusion, patient-specific femoral structure correlates with fracture type and FE analyses were able to predict these fracture types. Also, the demonstration of FE and DVC as metrics of the strains in bones may be of substantial clinical value, informing treatment strategies and device selection and design. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:993-1001, 2018.