Do technical aids for patient handling prevent musculoskeletal complaints in health care workers? – A systematic review of intervention studies

Background:

The physical load ensuing from the repositioning and moving of patients puts health care workers at risk for musculoskeletal complaints. Technical equipment developed to aid with patient handling should reduce physical strain and workload; however, the efficacy of these aids in preventing musculoskeletal disorders and complaints is still unclear.

Methods:

A systematic review of controlled intervention studies was conducted to examine if the risk for musculoskeletal complaints and disorders is reduced by technical patient handling equipment. MEDLINE, EMBASE, AMED, and CINAHL were searched through Feb. 2018. RCTs and controlled before-after studies of interventions including technical patient handling equipment were included. Two independent reviewers conducted study selection, data extraction, and appraisal of methodological quality.

Results:

The titles and abstracts of 9554 publications and 97 full-texts were screened. The qualitative synthesis included one RCT and 10 controlled before-after studies. A meta-analysis of four studies resulted in a pooled risk ratio (RR) for musculoskeletal injury claims (post-intervention) of 0.78 (95%-confidence interval, CI 0.68 – 0.90; I2 = 51%). Overall, the methodological quality of the studies was poor and results often based on administrative injury claim data, introducing potential selection bias.

Conclusion:

Interventions with technical patient handling aids appear to prevent musculoskeletal complaints, but the body of evidence lacks certainty. As a consequence of the very low level of existing evidence, quality research is still needed. However, this evidence may need to come from high quality observational studies, as technical aids are already widely available in workplaces where frequent patient handling is required.