Identifying personal determinants of paramedic lifting strategy


Keywords: Low back; compression; shear; kinematics; musculoskeletal disorders

Timeline: 2021-2022

Researchers: Daniel P. Armstrong (University of Waterloo), Steven L. Fischer (University of Waterloo)

Funder: CRE-MSD

Project type: Seed grant

Partners: Region of Waterloo Paramedic Services; Conestoga College Paramedic Program

Sector/workplace type: Healthcare; Paramedicine


In paramedic work lift training interventions are needed to curb high injury rates, but to date have been ineffective. By quantifying how personal factors influence the movement strategy used in work, evidence-informed training programs can be developed to proactively reduce low back exposures, and therefore injury risk, in paramedic work.

Objectives/research question

Our objective is to identify whether personal factors influence the magnitude of low back loads in paramedic-specific lifting tasks. Secondly, we aim to identify whether personal factor groups with lower corresponding low back loads have corresponding differences in whole-body movement strategy to minimize resultant low back loads.


A cross-sectional between subjects experimental design will be used. A sample of 80 participants will be recruited to perform a lifting protocol consisting of paramedic-specific lifting tasks while whole-body motion and ground reaction forces are collected. Purposive sampling will be used to recruit participants with a range of experience and demographics. Flexibility will be quantified using a sit and reach apparatus. Maximum isometric lift force will be used to measure strength capacity. Ability to perceive sensory feedback will be assessed using lift force and posture matching tests. Both resultant low back loads and kinematic features of whole-body movement strategy during lifting will be quantified. Forward stepwise multiple regression models will be used to determine whether personal factors are associated with peak low back loads or whole-body movement strategy in either backboard lifting or stretcher loading tasks.

Research team roles

Daniel Armstrong is a PhD Candidate at the University of Waterloo. Mr. Armstrong will be responsible for research design, data collection, analysis, and interpretation. Dr. Steven Fischer is an associate professor at the University of Waterloo. He will be responsible for project oversight and providing insight on study design and interpretation.

Collaboration and partnerships

Our research team is partnering with the Region of Waterloo Paramedic Service and the Conestoga College Paramedic Program for this project. Both external partners will help in the recruitment of participants from their workforce and student body respectively.

Knowledge transfer strategies

The knowledge transfer strategy for this project will be conducted at the end-of-grant. This will include the dissemination of findings through peer-reviewed publications in journals (e.g., Applied Ergonomics or Ergonomics) and conference presentations (e.g., Association of Canadian Ergonomists National Conference). We also plan to present our findings in a webinar format to the CRE-MSD client/patient handling community of practice as well directly to our stakeholder groups.

Impacts and implications

This project will inform the development of lift training programs that aim to minimize injury risk within the paramedic sector. Paramedics experience the greatest incidence of musculoskeletal disorders by work sector and have several essential tasks that cannot be eliminated or modified to reduce physical demands. Interventions for the worker are therefore needed, but training has proven ineffective to reduce injury incidence. This project aims to quantify how personal factors influence lifting strategy and corresponding exposure to inform the development of evidence-based lift training programs. We anticipate that such training programs will have greater potential to reduce injury risk in paramedic work.