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Bariatrics: Wheelchair push-pull forces for bariatric patients

Question

I have a 20 stone client who uses a wheelchair when going for an outing. I am 5ft 2 inches tall and 9.5 stones in weight. As I push the wheelchair, I feel a strain on my lower back and pain on the following day. What is the ideal weight and height of a carer who can safely push this bariatric patient. Thanks in advance.
(20 stone is 280 lbs, 9.5 stone is 133 lbs)

Agnes Alcaras
St. Joseph's Centre Ireland


Answer

Dear Agnes:

Assuming the wheelchair is being pushed over uneven surfaces (as can be encountered during an outing), you may wish to consider obtaining an electric assist device, or at a minimum enlist assistance from one of your colleagues.

While we are not able to determine the exact size and weight of this carer, you may be able to utilize the calculator below to estimate the suggested limitations for an average size female. That will tell you whether you are working within or above the suggested guidelines. The calculator is maintained by a Canadian organization called WorkSafe BC. Click on http://www.healthandsafetycentre.org/ppcc/footer/about.htm and visit the 'push' icon, and then the female scenario. Enter your data accordingly and note the suggested limits for an average female.

If you wish to measure the actual forces you are exerting while pushing this patient, we suggest you obtain a force gauge or use a bathroom scale. Simply load the wheelchair with 20 stones of weight and observe the scale's readings while you attempt to push the chair over the same type of surface your normally encounter when pushing your client on the outing. You will then be able to compare the results of your actual test to the suggested guidelines. I might also suggest you read their 'MSI Prevention Guidance Sheet' for general advice on prevention of injuries while pushing or pulling at work.

Please note: There are certainly some general rules of thumb that you should adhere to in order to avoid injuring yourself. Avoid floors that are in poor shape (cracked, etched, uneven); avoid transitions from hard surfaces (e.g. concrete or tile) to soft surfaces (e.g. carpet); avoid ramps; avoid complicated maneuvering; and don't transport the patient for more than 200 feet. Also, if unable to recruit an assistant, always employ accepted ergonomic techniques while pushing or pulling (e.g. maintain good balance at all times, use the strength of your legs as much as possible, and avoid twisting or reaching under stress).

Stay safe,
The Lift Doctor*