What do physiotherapists and manual handling advisors consider the safest lifting posture, and do back beliefs influence their choice?

Background: It is commonly believed lifting is dangerous and the back should be straight during lifting. These beliefs may arise from healthcare professionals, yet no study has evaluated the lifting and back beliefs of manual handling advisors (MHAs) and physiotherapists (PTs). Objectives: To evaluate (i) what lifting technique MHAs and PTs perceive as safest, and why, and (ii) the back pain beliefs of MHAs and PTs. Design: Data was collected via an electronic survey. Method: Participants selected the safest lifting posture from four options: two with a straight back and two with a more rounded back, with justification. Back beliefs were collected via the Back-Pain Attitudes Questionnaire (Back-PAQ). Relationships were investigated using multiple linear and logistic regression models. Results: 400 PTs and MHAs completed the survey. 75% of PTs and 91% of MHAs chose a straight lifting posture as safest, mostly on the basis that it avoided rounding of the back. MHAs scored significantly higher than PTs on the Back-PAQ instrument (mean difference = 33.9), indicating more negative back beliefs. Those who chose the straight back position had significantly more negative back beliefs (mean 81.9, SD 22.7) than those who chose a round back lift (mean 61.7, SD 21.1). Conclusion: Avoiding rounding the back while lifting is a common belief in PTs and MHAs, despite the lack of evidence that any specific spinal posture is a risk factor for low back pain. MHAs, and those who perceived a straight back position as safest, had significantly more negative back beliefs

Additional file 1: Figure S1. of The immunological footprint of CMV in HIV-1 patients stable on long-term ART

Senescent T cell gating strategy. Lymphocytes were distinguished from monocytes by their forward and side light scatter (a), gated for expression of CD3 (b), CD4 and CD8 (c). Quadrant gates were then set for expression of CD45RA and CD27 within the CD4+ (d) and CD8+ (e) populations. Gating was further set for expression of CD57+ within the CD45RA+ CD27− CD4+ (f) and CD45RA+ CD27− CD8+ (g) populations. (PDF 261 kb

There was a significantly strong correlation between sCD14 and smoking where HIV-1 smokers have higher sCD14 levels than HIV-1 non-smokers while patients on an integrase inhibitor had significantly lower sCD14 levels than patients on an alternative treatment.

<p>There was a significantly strong correlation between sCD14 and smoking where HIV-1 smokers have higher sCD14 levels than HIV-1 non-smokers while patients on an integrase inhibitor had significantly lower sCD14 levels than patients on an alternative treatment.</p

The median cell surface expression and 95% confidence intervals are shown for CD64 (A), CD163 (B) and CD143 (C) on monocyte subsets in HIV and control subjects.

<p>Expression on classical monocytes is significantly different between HIV and control groups for CD64 (p<0.001) but not for CD163 or CD143. Expression of all cell surface markers on CD16⁺ monocytes, however, are significantly different between the HIV infected and control groups (* p<0.05, ** p<0.01 *** p<0.001).</p

Differing correlation outcomes between the three plasma biomarkers and HIV-1 RNA levels.

<p>A significant correlation was recognised between HIV-1 RNA levels with CXCL10 (A) and sCD163 (B) while there was no significance with sCD14 (C).</p

Demographics and patient characteristics from 474 HIV positive patients who underwent CVD risk assessments in 2010.

<p>Demographics and patient characteristics from 474 HIV positive patients who underwent CVD risk assessments in 2010.</p

Phenotypic identification of monocytes and monocyte subsets.

<p>Whole blood monocytes were identified by a forward scatter and side scatter plot (A). Lymphocytes (a), monocytes (b) and the granulocytes (c) are shown. The three monocyte subsets were identified from the monocyte population (b) by CD14 and CD16 expression (B). Classical monocytes (d-CD14⁺⁺/CD16^-), intermediate monocytes (e-CD14⁺⁺/CD16⁺) and non-classical monocytes (f-CD14⁺/CD16⁺) were gated for further analysis of activation markers. For example figures C, D and E show CD163 expression from d, e and f respectively.</p

HIV viral load status has different influences on monocyte cell surface expression.

<p>Expression of CD64 on intermediate (A) and non-classical (B) monocytes, CD143 on intermediate (C) and non-classical (D) monocytes, and CD163 on intermediate (E) and non-classical (F) monocytes are shown below. (Data presented as mean values and 95% confidence intervals; p-values derived from Kruskal-Wallis tests).</p

Demographic and clinical characteristics of HIV-infected and healthy control subjects.

<p>Demographic and clinical characteristics of HIV-infected and healthy control subjects.</p

Model 2—Multivariate regression results showing significant associations of plasma biomarker with HIV clinical parameters, CVD risk age, gender, ethnicity and smoking after adjusting for CXCL10, sCD163 and sCD14.

<p>Model 2—Multivariate regression results showing significant associations of plasma biomarker with HIV clinical parameters, CVD risk age, gender, ethnicity and smoking after adjusting for CXCL10, sCD163 and sCD14.</p