Morphological variables as possible risk factors for the drivers of rubber tyred gantry cranes at the port of Felixstowe, UK

Watson, Estelle Dorothy (2007-12)

Thesis (MSpor)--University of Stellenbosch, 2007.

Thesis

ENGLISH ABSTRACT: The prevalence of lower back disorders and the high costs involved are an ongoing problem in industrialised countries. Research indicates an estimated 70-80% of all individuals will experience lower back pain (LBP) during the course of their lives (Manek & MacGregor, 2005; Kent & Keating, 2005; Dunn & Croft, 2004; Takeyachi et al., 2003; Carter & Birrel, 2000:6; Nourbakhsh & Arab, 2003; Bernard, 1997:374). It is widely accepted that occupational demands and physical work contribute greatly towards onset, recovery and recurrence of symptoms (Carter & Birrel, 2000:6). Rubber Tyred Gantry (RTG) crane drivers are particularly at risk, as their working posture forces them into various prolonged non-neutral trunk positions (Fehrsen-Du Toit, 2005:24; Rohlmannt et al., 2001; Nachemson, 1963) and extreme trunk flexion (Seider et al., 2003; Hoogendoorn et al., 2000). Intrinsic factors such as trunk strength (O'Sullivan et al., 2005; Bayramoglu et al., 2001) and trunk stability (Hitt & Lie, 2006; MacDonald et al., 2006; Barker et al., 2006; Hodges et al., 2005; Hodges, 2003; Hodges & Richardson, 1996) as well as anthropometric variables (Franklin et al., 2000:64), can play different roles in incidences of lumbar pain or injury. A job such as RTG crane driving is dependant on a certain amount of strength or physical fitness. A deficit in on or more of these areas can lead to compensation, overload and eventually symptoms and injury. Research has yet to identify factors that predispose certain drivers to injury, and factors determining a quick, safe recovery and return to work. The purpose of this study was to investigate possible morphological variables as risk factors for RTG crane drivers, for Hutchison Whampoa, at the Port of Felixstowe, UK. The study design was based on a cross sectional, analytical epidemiological study. A sample of 43 RTG drivers completed testing. They were divided into a group of drivers who had never had lower back pain or symptoms (n=22), and a group of drivers who had had a previous history of lower back pain (n=21). All subjects were asymptomatic at the time of testing. Although not significant (p > 0.05), the results of the study showed that average performance deficit (the power needed to maintain or repetitively produce a force) tended to be higher in those subjects without a previous history of pain. The flexion/extension ratio also tended to be better for this group. The subjects without a past history of lower back pain were, surprisingly, found to be older than the other group. This explains the higher body weight, waist-to-hip-circumference, body mass index, and fat percentage for this group, as these measurements all tend to increase with age. It also explains the lower peak torque to body weight values for that group, as peak torque would decrease with increased body weight. This is the first study to look at morphological variables and isokinetic testing of RTG crane drivers, and the relationship between these variables and lower back pain.

AFRIKAANSE OPSOMMING: Die hoë koste verbonde aan, asook die hoeveelheid voortdurende lae-rug beserings in industriële lande, is ‘n aaneenlopende probleem. Navorsing toon dat 70-80% van alle individue laer-rugpyn sal ervaar deur die loop van hul lewens (Manek & MacGregor, 2005; Kent & Keating, 2005; Dunn & Croft, 2004; Takeyachi et al., 2003; Carter & Birrel, 2000:6; Nourbakhsh & Arab, 2003; Bernard, 1997:374). Dit is aanvaar dat werksvereistes en fisiese werk grootliks bydra tot die oorsaak, herstel en herhaling van simptome (Carter & Birrel, 2000:6). RTG hyskraan bestuurders is veral individue wat ‘n groter risiko toon ten opsigte van laer-rug beserings weens werkspostuur wat hul noodsaak om verskeie langdurige nie-neutrale mid-rug posisies (Fehrsen-Du Toit, 2005:24; Rohlmannt et al., 2001; Nachemson, 1963), asook ekstreme mid-rug fleksie handhaaf (Seider et al., 2003; Hoogendoorn et al., 2000). Sekere individuele intrinsieke faktore soos mid-rug krag (O'Sullivan et al., 2005; Bayramoglu et al., 2001) mid-rug stabiliteit (Hitt & Lie, 2006; MacDonald et al., 2006; Barker et al., 2006; Hodges et al., 2005; Hodges, 2003; Hodges & Richardson, 1996), en antrpometriese veranderlikes (Franklin et al., 2000:64), kan ‘n aansienlike verhoging in moontlike laer-rug pyn of –beserings meebring. ‘n Werk soos RTG hyskraan bestuur is afhanklik van sekere hoeveelheid krag of fisiese fiksheid. ‘n Tekortkoming in enige van hierdie areas kan lei tot oorkompensering, oorbelading en uiteindelike simptome van besering. Vrae wat navorsing nog moet antwoord is onder andere die faktore wat aanleiding gee tot beserings asook wat vinnige en veilige terugkeer na werk vir bestuurders bepaal. Die doel van die studie was om moontlike morfologiese veranderlikes en risiko faktore te bestudeer vir RTG hyskraan bestuurders, vir Hutcinson Whampoa, te Felixstowe hawe, VK. Die rol wat hierdie faktore speel in die oorsaak en ontwikkeling van rugpyn word ook ondersoek. ‘n Protokol van toetse is gekies om moontlike morfologiese risiko faktore uit te lig en daardeur bestuurders wat meer geneig is om laer-rugpyn te ontwikkel te identifiseer. ‘n Totaal van 43 RTG bestuurders het die toets voltooi. Hierdie bestuurders is verdeel in ‘n groep wat nog nooit laer-rugpyn of simptome getoon het nie (n=22) en ‘n groep bestuuders wat wel vorige geskiedenis van laer-rugpyn het (n=21). Alle deelnemers was asimptomaties met die aanvang van die toetsing. Alhoewel resultate van die toets nie noemenswaardig was nie (p>0.05), het dit wel getoon dat algemene prestasie tekortkoming (spierkrag benodig om kraguitset te handhaaf of om herhaaldelik uit te voer) geneig was om hoër te wees in individue sonder ‘n vorige geskiedenis van rug besering. Die fleksie/ekstensie verhouding het ook beter vertoon in hierdie groep. Individue sonder vorige geskiedenis van laer-rugpyn is interessant genoeg, ouer as die met geskiedenis van laer-rug beserings. Dit verduidelik die hoër liggaamsgewig, middelheup- verhouding en liggaamsmassa indeks en vet persentasie van hierdie groep weens die feit dat al reedsgenoemde geneig is om met ouderdom toe te neem. Dit kan ook piekkraguitset tot liggaamsmassa waardes van hierdie groep verduidelik omdat piekkraguitset sal verminder met toename in liggaamsmassa. Hierdie is die eerste studie wat die uitkyk bied op morfologiese veranderlikes tesame met isokinetiese toetsing van RTG hyskraan bestuurders en die verhouding tussen hierdie veranderlikes en laer-rugpyn.

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