Safe Maximal Lift

FCEase Manual

Dynamic Loaded Activities - (See Equations p. 57)

This test is 1) to determine only maximal lifting with the emphasis on safe abilities to perform lifting functions and 2) to evaluate the client's reasons for inability to attain work requirements for manual handling tasks.

This section of testing is carried out without rest breaks to simulate work environment and to ensure endurance factors are taken into consideration.

Reason for performing test: To determine a safe maximum occupational weight limit at predetermined heights.

Bench height - observing the technique of lifting at low levels including observation of lumbosacral stability and lower extremity strength, balance, and endurance.

Shoulder height - observing the recruitment of upper extremity strength for the ability to control the lift from waist to shoulder level. Ability to stabilize the lumbosacral spine without allowing hyperextension to occur is also observed.

Overhead height - observing control and upper extremity strength above the line of vision. Total body control of balance and rotational factors to maintain safety while lifting is closely monitored.

Procedure (detail)

Floor to bench height - bench height defined as 750-900 mm to handle height. The bench height should be as close to workstation height as possible.

Shoulder height - represents lifting a load to eye level approximately 1400-1700 mm. This height can be determined by having the hands completing the lift just below shoulder height.

Overhead height - hands should reach a point just above head height and above line of vision. The height can be determined by having the hands completing the lift just above head height. Actual heights will vary based on the lifting equipment used during the evaluation.

Set boxes or shelving at appropriate height for lift being performed

Start with an empty crate or box (approximately 5-10kg (10 - 20 lbs)).

Take Baseline Heart Rate

Demonstrate the type of lift to be performed both visually and verbally (see safe manual handling for directions )

Have the client perform three (3) lifts before another weight is added and review heart rate reading.

Weights should be added in 2.5 kg increments until an additional 2.5 kg is too much, then use .5 kg weights to get as close to max as possible.

The client is asked prior to beginning the next weight, "I have increased the weight, would you like to continue?"

This is repeated until:

The client refuses to continue with the reason then being recorded.

The evaluator ceases the test due to inherent dangers developing during the test. (i.e., unsafe lifting, heart rate or blood pressure exceeds predetermined limits for the individual’s safety, or compensatory lifting techniques are observed).

The successful lift is one that is lifted three (3) times consecutively using safe lifting techniques.

Hint:

It is convenient to take the heart rate for B.A.B.I. at the completion of each weight increment. (i.e., after each three (3) successful lifts).

Use of equipment during testing:

A variety of equipment can be used including adjustable shelving, benches, stepped bench, or boxes created of different sizes and shapes to be combined to produce varying heights and lift surfaces.

Note: Plastic crates should not be used for weights over 10 kgs.
Boxes or wire crates should be sturdy, well sanded, covered or uncovered. Handles should be comfortable to grasp.
Weights should not move around in box or crate. You do not need weights less than .5 kg. Increments of weight should be approximately .5kg, 2.5 kg, 5 kgs. Total weight available should be around 80 kgs to 100 kgs depending on increments used.

Data collection and correlation (what is being measured, observed, and how):

The maximal weight achieved and successfully lifted three (3) times consecutively is reported as the maximal safe lift for this client.

Expected results or normally viewed patterns:

Most clients will achieve 75% - 85% of maximal heart rate during maximal weight lifted prior to stopping or being stopped by the evaluator.

Clients with lower pain scales will continue to the point where the evaluator stops them.

Clients with consistently high pain scales or inconsistent pain reports are more likely to self terminate the procedure. These clients also tend to demonstrate abnormal pain behaviors, but can continue to reach the satisfactory level of success as determined by the evaluator.

Hints:

Make sure to monitor heart rates during the evaluation as well as pain reports, exertion levels, blood pressure if required, and manual materials handling techniques.

The evaluator should be aware of all these observations in order to accurately determine the termination of the procedure using objective rather than subjective information.

Use of BABI monitoring is very useful in obtaining more accurate correlational information.

Monitor client to prevent the use of Valsalva Maneuver during lifting.

Contraindications:

Excessive hypertension

Heart rate above 85% of predicted maximum if no other coronary risks factors are present.

Aggravation of nerve root or radicular symptoms.

Equipment required:

Boxes

Shelving

Weights

Heart Rate Monitor

Stopwatch

Special agency reports needed or required:

Clinicians’ or Therapists' opinion of lifting style or manual handling procedures with emphasis placed on safety and reproducibility to prevent further injury or re-injury at the job site upon return to work - true correlative limits to actual work requirements.

What information needs to be included in report:

Noted changes in heart rate during evaluation

Noted ability to safely lift a certain amount of weight

Any breakdown in performance of lifting over time or with additional weight

Noted pain issues

Noted inconsistencies observed during the evaluation.