Musculoskeletal associated with manual handling of patients.

Musculoskeletal system is the system that contains bones, joints, and muscles. It has many functions such as protectetion of vital organs such as brain and spinal cord. The main functions are movement and support the body to be erected. Musculoskeletal and nervous systems contribute together in an effort to keep balance and posture in every day activity such as walking, praying, sitting, and pushing (Akhtar, Afzal, Kousar, Gilani 2017 and Se-wonkan 2017). Jaafar & Ghazali (2014) stated that, musculoskeletal disorders (MSD) are an important public health problem. MSD known as injuries that affect body movement, among them are back conditions such as disk, joint injures and back pain.

Low back pain (LBP) is mostly caused by musculoskeletal problems e.g. acute lumbosacral strain, unstable lumbosacral ligaments and weak muscles, wrong postures, unnecessary strain and fatigue of back muscles. LBP incidence is approximately 84% worldwide (Balague, Mannion, Pellise, & Cedraschi, 2012; and Kochitty& Devi, 2015).Akhtar et al (2017) reported that back pain is consider as a major MSD that affect all health care worker; specially nurses. This as a result of providing nursing care which is associated with extension and flexion of the body with major physical activity and demand on nurses which end up with injury. The most common activity is lifting, transfer patient from bed to toilet, and frequent reposition the patient. (Ghazali 2014; and Ibrahim& Elsaay 2015).

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Many studies show that the prevalence of low back pain is the highest among nursing staff more than any kind of other health care worker. Because nurses are the main hospital staff in frequent close contacts with patients. They injure their backs from the physical burden associated with manual handling of patients. For example, if patient is immobilized, nurses will try to turn him every two hours to prevent bedsores. If the nurse`s shift is 12 hours, the amount of lifting in one shift adds up a lot, and you can see how the job could be very hard to manage physically (Kochitty& Devi, 2015; and Shieh, Sung, Su, Tsai, & Hsieh 2016).In this regard, the risk factors for LBP especially in nursing is lifting heavy objects, transfers patients from bed to wheel chair, work alone; reposition the patient hourly and inappropriate use of body mechanism that can lead to spine sprain and strain.

Also, the prolonged use of poor body mechanics leads to muscle injury and abnormal stress in spinal and it’s surrounding muscles, nerves, and blood vessels which prevent nurses from doing many things (Ibrahim ; Elsaay 2015; and Akhtar et al. 2017). In addition, the effects of back pain on nurses can be a leading cause of absence, being stopped for period in order to recover their back (Attar 2014; and Shieh, Sung, Su, Tsai, Hsieh 2016). Also, researches on nursing activities and body mechanics in clinical situations have been mostly related to backaches. It has been reported that most nurses who experienced backaches rarely used the body mechanics principle.

The use of body mechanics and defensive posture will end up with strong back and relived pain that comes from sprains and strains (Awaji 2016; and Kang, 2016). Moreover, Kang (2016) mentioned that nursing students participate in nursing practices such as patient transfers and position changes as a part from their clinical practice. Which consider an essential part of their curriculum that connects theories with real situations, and allows nursing students to experience various nursing situations and gain nursing competency, which meets the needs of a rapidly changing contemporary society. Also, nursing students may experience psychological anxiety from an unfamiliar ward environment during the clinical practice, psychological and physical fatigue due to long-term practice, sleep disorder, or chronic fatigue syndrome due to difficulties with taking breaks in time (Lee ; Noh, 2016; Sun et al., 2016). In this regard, nurses and nursing students, can complain from back pain as a side effect from their work with patients. Also, it can be related to difict knolwge about using the propper body mechanics (Ibrahim; Elsaay 2015; and Akhtar et al.

2017)Body mechanics are the coordinated effort of the musculoskeletal and nervous systems to maintain balance, posture and body alignment during lifting bending, moving and performing activities of daily living. It describe the ways we move as we go about our daily lives. It includes how we hold our bodies when we sit, stand, lift, carry, bend, and sleep. Also, The proper use of body mechanics means using the most safe and efficient ways to move objects for example, lowering self to pick up the object instead of bending your back (Kochitty; Devi, 2015; and Akhtar et al. 2017).

Proper body mechanics are vitally important for keeping our spine healthy. And it is easy to incorporate these principals into our daily life. It may seem unnatural at first, but if we keep at it, they will easily become routine and our back will thank us for it. Good body mechanics means using the safest and most efficient methods to lift and move patients or heavy items (Jaafar ; Ghazali, 2014).

In addition, body mechanics benefits that is used as protective postures and that will result in mimnimizes the chance of problems in muscloskeletal system, remove muslces strain, and strenthening the back. If the activity done correctly that help to keep body in good physical condition without problems (Ghazali 2014; and ibrahim; Elsaay 2015).In this regard there are some studies that was done in saudi arabia to assess prevelance of low back pain among patients, found that low back pain prevelance were between 53.2% to 79.17%, and the patients age were in range of 15 to 52 years (Awaji 2016). But there are a few studies about back pain among health care workers and body mechanics.

So, the purpose of this study is to assess knowledge and practice of body mechanics in undergraduate nursing students in King Saud bin Abdulaziz university for Health Sciences – Jeddah


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