Musculoskeletal lower back load of accoucheurs during childbirth – A pilot and feasibility study

  • Introduction: Back problems represent one of the leading causes of accouchers' work-related musculoskeletal morbidities. The correct execution of birth-related maneuvers including manual perineal protection is crucial not only for the mother and child but also for obstetricians and midwives to reduce any strain on their musculoskeletal system. Therefore, the overall aim of this study was to test the feasibility of determining the effect of different accouchers' postures (standing and kneeling) on their musculoskeletal system. Methods: The biomechanical analysis is based on musculoskeletal simulations that included motion recordings of real deliveries as well as deliveries conducted on a birthing simulator. These simulations were then used to determine individual joints' loads. Results: In the kneeling posture, both a low intra-operator variability and a lower average maximum load of the lower back was observed. For the standing position the spine load was reduced by pivoting the elbow on the accouchers' thigh, which in turn was associated with a significantly greater load on the shoulder joint. Conclusion: The study demonstrated the feasibility of our technique to assess joints loads. It also provided initial data indicating that a posture that reduces spinal flexion and tilt, achieved in this study by the kneeling, can significantly reduce the strain on the practitioner's musculoskeletal system.

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Metadaten
Author:Maximilian Melzner, Khaled Ismail, Zdenek Rušavy, Vladimír Kališ, Franz Süß, Sebastian DendorferORCiD
DOI:https://doi.org/10.1016/j.ejogrb.2021.07.042
Parent Title (German):European Journal of Obstetrics & Gynecology and Reproductive Biology
Publisher:Elsevier
Document Type:Article
Language:English
Year of first Publication:2021
Release Date:2021/09/06
Tag:Accoucheur; Musculoskeletal simulation; lower back load
Volume:264
Issue:September
First Page:306
Last Page:313
Institutes:Fakultät Maschinenbau
Regensburg Center of Biomedical Engineering - RCBE
Labor Biomechanik - LBM
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 618 Gynäkologie, Geburtsmedizin, Pädiatrie, Geriatrie