ArticlePloS one2015
The Effects of Direction of Exertion, Path, and Load Placement in Nursing Cart Pushing and Pulling Tasks: An Electromyographical Study.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Review of EMG Applications for the Characterization of Forearm and Hand Muscle Activity during Activities of Daily Living: Results, Challenges, and Open Issues.Sensors (Basel, Switzerland) · 2021Pooled it
- Quantifying Spatial Shadow Zones and Their Association With Hospital Falls in Acute Care Unit: Real-Time Location System Observational Study.JMIR formative research · 2025Observational
- Fatigue and Recovery of Muscles for Pulling Tasks.International journal of environmental research and public health · 2022Article
- The Effects of Ramp Gradients and Pushing-Pulling Techniques on Lumbar Spinal Load in Healthy Workers.Safety and health at work · 2020Article
- Whole body biomechanical burden of healthcare workers: proposal for a complementary risk assessment and management tool (HOARA).La Medicina del lavoro · 2019Article
- Human Body Mechanics of Pushing and Pulling: Analyzing the Factors of Task-related Strain on the Musculoskeletal System.Safety and health at work · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
The purpose of this study was to explore the effects of direction of exertion (DOE) (pushing, pulling), path (walking in a straight line, turning left, walking uphill), and load placement (LP) (the 18 blocks were indicated by X, Y and Z axis; there were 3 levels on the X axis, 2 levels on the Y axis, and 3 levels on the Z axis) on muscle activity and ratings of perceived exertion in nursing cart pushing and pulling tasks. Ten participants who were female students and not experienced nurses were recruited to participate in the experiment. Each participant performed 108 experimental trials in the study, consisting of 2 directions of exertion (push and pull), 3 paths, and 18 load placements (indicated by X, Y and Z axes). A 23kg load was placed into one load placement. The dependent variables were electromyographic (EMG) data of four muscles collected bilaterally as follows: Left (L) and right (R) trapezius (TR), flexor digitorum superficialis (FDS), extensor digitorum (ED), and erector spinae (ES) and subjective ratings of perceived exertion (RPE). Split-split-plot ANOVA was conducted to analyze significant differences between DOE, path, and LP in the EMG and RPE data. Pulling cart tasks produced a significantly higher activation of the muscles (RTR:54.4%, LTR:50.3%, LFDS:57.0%, LED:63.4%, RES:40.7%, LES:36.7%) than pushing cart tasks (RTR:42.4%, LTR:35.1%, LFDS:32.3%, LED:55.1%, RES:33.3%, LES:32.1%). A significantly greater perceived exertion was found in pulling cart tasks than pushing cart tasks. Significantly higher activation of all muscles and perceived exertion were observed for walking uphill than walking in a straight line and turning left. Significantly lower muscle activity of all muscles and subject ratings were observed for the central position on the X axis, the bottom position on the Y axis, and the posterior position on the Z axis. These findings suggest that nursing staff should adopt forward pushing when moving a nursing cart, instead of backward pulling, and that uphill paths should be avoided in the design of work environments. In terms of distribution of the load in a nursing cart, heavier materials should be positioned at bottom of the cabinet, centered on the horizontal plane and close to the handle, to reduce the physical load of the nursing staff.
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