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Haptic Feedback to Training for Patient-Handling Tasks

Project Full Title:

Experimental Biomechaincal Analyses of Manual Patient-handling Tasks

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Project Description:

Hope Students Only: This interdisciplinary project will incorporate the disciplines of engineering, nursing, and pre-health professions. However the project is specifically housed within the Engineering Department at Hope College. Nurses who perform manual patient-handling tasks are at a greater risk of experiencing musculoskeletal pain and injury. These tasks entail lifting, pulling, turning, and repositioning patients and are often performed in awkward postures, placing high mechanical loads at the low back. Recent work has explored wearable inertial measurement unit (IMU) sensing [1] and haptic feedback systems [2, 3] to train proper posture and reduce postural load in ergonomic interventions for manual materials handlers. These studies suggest wearable haptic feedback systems may be effective in training proper work technique and are well-received by participants. The literature has not addressed this application for training nurses on proper posture during manual patient-handling. A survey completed by 2011-2014 registered nurse graduates suggested that 39% of participants had a musculoskeletal injury and an additional 35% sustained an unreported injury [4]. Given this concerning injury rate and the likelihood of injury over a nurse's career [4], developing interventions for nursing students before they enter the workforce is imperative. The goal of this novel pilot project is to determine the effectiveness of wearable haptic feedback sensors to train nursing students on proper posture while performing manual patient-handling tasks. It is hypothesized that training with haptic feedback will reduce time spent in awkward postures and will reinforce performance of tasks by adopting safer postures (e.g., trunk flexion less than or equal to 20° during tasks). The study will consist of four experimental sessions with 15 nursing students: a baseline, two intervention, and a follow-up. For the baseline and follow-up sessions, wireless IMUs will be mounted on participants’ whole-body and wireless pressure insoles will be fitted in their shoes. IMUs will record joint angles and the insoles will record the pressures exerted while performing the following tasks (10 times each): connecting a sling to a Hoyer lift for patient transfers; lifting a patient’s leg while lying bed; repositioning a patient from lying to sitting position; transferring a patient from a bed to a chair; and turning a patient in bed. Outcome measures include trunk and knee flexion angles, center of pressure excursion, time to complete task, participant perceptions of effort (Usability Rating Scale [5]), perceived stresses at the low back (Modified Borg CR-10: [6]), and comfort and safety (5-point Likert-type scales). A Wilcoxon Signed Rank Test will be conducted to compare the median perceived stress, effort, comfort, and safety scores reported during sessions. During the intervention sessions, participants will perform tasks while wearing wireless IMUs, insoles, and haptic feedback nodes. These sensors will pulse whenever trunk flexion angle exceeds 20° [7, 8] and cease pulsing once participants use a neutral trunk posture. To assess participant feelings of comfort, perceived change, movement, and anxiety with this training, the Comfort Rating Scale [9] will be administered. The System Usability Scale [10] will assess ease of use, complexity, credibility, difficulty, and time to learn with haptic feedback training. A within-subject statistical test with pairwise comparisons will test the learning effect of the haptic feedback training.

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