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BACK INJURY CONTROL MEASURES FOR MANUAL LIFTING AND SEAT DESIGN

机译:用于手动提升和座椅设计的后损伤控制措施

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The mining industry has long been associated with a high incidence of low back disorders and pain (Klein et al. 1984, Leigh and Sheetz 1989, Brinckmann et al. 1998). It is believed that the higher incidence of these injuries among miners is the result of high exposures to postural demands, heavy manual work, and exposure to whole-body vibration (WBV). Recent work has indicated that miners involved with heavy lifting (especially in restricted spaces or on uneven ground) or who have been exposed to whole-body vibration in undamped seats experience noticeable changes in their spines that are consistent with degeneration of the intervetebral discs of the spine (Brinckmann et al. 1998). As will be described shortly, there is mounting evidence that disc degeneration plays a large role in the development of low back pain, particularly chronic back pain. Until fairly recently, medical doctors generally assumed that back pain was the result of muscle strain, ligament pain, or so-called "trigger points" (Bogduk, 1997). However, research supporting these mechanisms of pain has been very scant. When subjected to scientific scrutiny, none of these mechanisms has been shown to relate to back pain in a convincing manner. On the other hand, there are three mechanisms that have been shown to be highly associated with back pain in controlled scientific studies: sacroiliac pain (present in 13 percent of back pain sufferers) (Maigne et al. 1996), facet joint pain (present in 15 percent of back pain sufferers) (Schwarzer et al 1994), and disc disruption and degeneration (present in 39 percent of chronic back pain sufferers) (Moneta et al. 1994). The latter mechanism, which bears the highest relationship to back pain that has been objectively demonstrated, will be the focus of this section.
机译:采矿业长期以来一直与低患病疾病和痛苦的发病率很高(Klein等人。1984年,Leigh和Sheetz 1989,Brinckmann等1998)。据信,矿工之间这些伤害的发病率较高是灾害灾害,沉重的手动工作和全身振动(WBV)的暴露率。最近的工作表明,参与沉重升降的矿工(特别是在受限制的空间或不平坦的地面上)或者已经暴露于无法透明的座位上的全身振动,其刺的明显变化是与跨越的间歇性椎间盘的变性一致脊柱(Brinckmann等人1998)。如将稍后描述的,有证据表明盘变性在低腰疼痛的发展中发挥着重要作用,特别是慢性背部疼痛。直到最近,医生普遍认为背痛是肌肉菌株,韧带疼痛或所谓的“触发点”(Bogduk,1997)。然而,支持这些痛苦机制的研究非常令人勉强。当受到科学审查时,这些机制都没有被证明以令人信服的方式与背痛有关。另一方面,有三种机制已被证明与受控科学研究中的背部疼痛有高度相关:骶髂痛(以13%的背部疼痛患者提供)(Maigne等,1996),方面关节疼痛(现在在15%的背痛患者中)(Schwarzer等1994),以及椎间盘破坏和退化(以39%的慢性背痛患者提供)(Moneta等,1994)。后一种机制,其具有客观展示的背部疼痛的最高关系将是本节的重点。

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