Back Belts

There continues to be a serious debate over the merits of back belts. Some rate back belts as very effective while others rate them as having no benefit whatsoever. However, when back belts are used with an overall program of injury prevention which includes the correct application of ergonomics, back injuries can be reduced, 

Some of the comments regarding the improper use of back support belts include  

Several recent smdies were conducted on the use of back belts, and the results were surprising. In the March 1997 issue of Material Handling Engineering, back supports proved effective in an extensive study at Home Depot. This six-year study took place from January 1, 1989, through December 31, 1994. Details of the study indicate that  

Note the data from this study in Tables I, II, and III (Courtesy of Material Handling Engineering). 

Home Depot Stores Low-Back Injury Study 1989-94 Table I - Reduction in the Rate of Low-Back Injuries Was 34% 

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The major user concern at the plant level was time devoted to ergonomics by providers. At the corporate level, the need was seen for more rapid job-analysis methods and corporate policies, such as on back belts or good chairs. Overall, 94% of users made positive comments about the ergonomics program. 

The purpose of the Centers for Disease Control and Prevention (CDC) is to promote health and quality of life by preventing and controlling disease, injury, and disability. The CDC provides limited information on occupational safety and health. For example, their web page has information about accident causes and prevention, back belts, cancer—occupational exposure, effects of workplace hazards on male reproductive health, latex allergies, needle stick, occupational injiuies, teen workers, and violence in the workplace (see website http //www.cdc.gov). The Center for Health Statistics is located within CDC and provides basic health statistics on the U.S. population. This information is used to identify potential occupational health risks by occupational health researchers (see website http / / WWW.cdc.gov/nchs). 

Stress can be caused by social factors, both on and off the job. Supports for the body (armrests, back belts, wrist splints, etc.) are an appealmg concept, but evidence is lacking concerning their benefits. 

Related Standards — Revised NIOSH Equation for the Design Evaluation of Manual Lifting Tasks — Workplace Use of Back Belts, Review and Recommendations, NIOSH Study. 

National Institute of Occupational Safety and Health, Workplace use of back belts Review and recommendations , U.S. Department of Health and Human Services, Public Health Service, Centers for Disease control and Prevention 1994. 

Even with the best training, there are some factors which contribute to back problems that many may not even realize. They include, among other things, poor physical condition, stress, back belts, and heavy equipment operations. 

What about back belts — Wearing a back belt can give a false sense of security. You may think you can lift more weight than you are able to. If employees use back belts, you... 

Transback Belts, Profiled backings. Belt Technologies... 

Using any nonrigid means of support, such as elastic bandages, wraps, nonrigid back belts, etc. 

Medical back belt with neuromuscular electrical stimulation... 

The medical back belt with integrated neuromuscular electrical stimulation (NMES) is an orthopaedic device that is able to stabilize the back after lumbar disk herniation and stimulate the muscles to make back muscle growth possible and to prevent the back from having on-going pain (Fig. 6.1). 

For the back belt, materials were selected to develop a strong and flexible product. The main properties of the chosen materials included flexibility, breathability, antistatic, hydrophUic and pleasant to the skin. For the first and second layers a cotton twUl material is used because this material is strong, breathable, antistatic and pleasant to the skin. Because of its properties, the material is used in the inner surface of the medical back belt where it is directly applied onto the skin. The third layer is a nonwoven polyester filling, which gives extra stability and comfort. As a fourth layer, cotton DreU material is used because of its outstanding strength and flexible properties. This material is often used in orthopaedic devices such as orthopaedic corsets and for temporary trunk orthosis because it can support and stabilize the parts of the body where it is applied. In the medical back belt it is applied in both sides of the product so that a straight posture can be achieved. Furthermore, PES tricot is used for more support and flexibility. Because of the combination of these four different materials, the stabilization and comfort can be realized by the back belt. 

The construction of the back belt and material that is used is shown in Fig. 6.2 and Table 6.1. 

The medical back belt is 160 cm long and 40 cm wide. The outer surface consists out of five different components on the left hand side is the hook-and-loop fastener... 

Table 6.1 Construction of material in medical back belt...

The inner surface of the medical back belt consists of cotton twill because it is directly applied onto the skin. In the centre of the inner surface the orthopaedic pad, called pelotte, is attached, which consists of foam or silicone material. These orthopaedic pads are often used because they can put pressure on dehned parts of the body to give these parts extra support. They are frequently attached in orthosis or artihcial limbs to prevent the product from shifting during use. This is a very important aspect for the medical back belt because on top of this pad the textile electrodes are embroidered, which have to stay in place, otherwise the treatment will not be effective enough. In the back belt a foam pelotte is used with a protective cover of 100% unbleached cotton. 

On the right-hand side of the belt the hook-and-loop fastener is inserted to close the medical back belt. Velcro closures are frequently used in orthopaedic devices because they can be employed very easily. Most of the orthopaedic devices have to be custom-made because they have to ht very precisely. With a Velcro closure the medical back belt can be closed individually, and only general sizes like s, m, 1, xl and xxl have to be produced. The whole construction of the outer and inner surface is shown in Fig. 6.4. 

Figure 6.3 Outer surface of the medical back belt.

Whilst testing and selecting the NMES device it was clear that the NMES device has to be able to transmit the electrical impulses to the textile electrodes so that the therapy can be as effective and comfortable as possible. The NMES therapy stimulates the muscles, which produces muscle growth. A balance had to be achieved so that on the one hand the electrodes can work as effectively as possible and on the other hand the treatment is as comfortable as possible for the patient. During the research three different NMES devices were tested the SaneoSport NMES device, the Beurer EM 41 NMES device and the Beurer EM 35 NMES device. Finally, the Beurer EM 35 device was applied in the medical back belt because it has the required feamres and got the best testing results. The NMES device Beurer EM 35 is shown in Fig. 6.5 [3]. 

The NMES device is connected to the electrodes by soldering and stitching and transmits an electrical impulse to the textile electrodes. The three electrodes on the left side of the pad and the three electrodes on the right side of the pad are connected to each other. A line of embroidered Shieldex silver-plated nylon 117/17 2-ply yam in between the three electrodes makes sure that every electrode will get the impulses that are transmitted from the NMES device. At the back of the orthopaedic pad the electrodes are connected to wires that are interconnected to the NMES device by soldering and stitching. Eurthermore, the orthopaedic pad is hxed by a hook-and-loop fastener to the medical back belt to make sure that it will not slip out... 

The tests have shown that neuromuscular electrical stimulation has the opportunity to prickle the muscles so that they will not get weaker. The tests have shown that Shieldex silver-plated nylon 2-ply can be applied direcfly onto the skin. Usually electrodes are used in combination with liquid or gel to make them more conductive and to prevent any irritations or wounds. The applied textile electrodes were used without any liquid or gel and the tests have shown that the textile electrodes did not have any negative influences on the skin. The electrical impulse can easily be transmitted and electrodes have the possibility to prickle the muscles whilst conducting electricity. To conclude, a lumbar back belt was made with the function to stabilize the back and make straight posture possible, and the muscles in the back can be stimulated by the integrated neuromuscular electrical stimulation. 

Such requirements vary - for example, for seated and standing work. The spinal coluttm itself is actually quite weak. The reason it can take considerable loads is that it is part of a whole system - a surrotmd of muscle l ers together with what is in the chest and abdomen. When a person leans forward, the muscles in the back become mote active, then when they lean back the muscles to the front respond. However, when a person leans to lift a load the muscles towards the front also squeeze to increase the pressure in the abdomen and so provide extra support. It should be noted that use of back belts can adversely increase pressure ittside the abdomen, and continual use m weaken supportive muscles. 

Using any non-rigid means of support, such as elastic bandages, wraps, non-rigid back belts, etc. (devices with rigid stays or other systems designed to immobilize parts of the body are considered medical treatment) ... 

Both OSHA and The National Institute for Occupational Safety and Health (NIOSH) have said that there is insufficient evidence to recommend the use of back belts as a back injury prevention measure. In fact, If workers falsely believe they are protected when wearing belts, they may attempt to lift more than they would without a belt, posing a risk of injury to the worker. If employers want to employ the use of back belts, they should consult a medical professional or an ergonimist for additional information. 

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