By Stephan Tomlow, Head Ergonomics at Liantis, external service provider for health and safety at work

Many healthcare workers eventually suffer from musculoskeletal complaints in the lower back and shoulders because they often have to position and tilt patients manually. A study by UZ Gent and Liantis, Belgian most famous external service for health and safety at work, shows that the physical strain is remarkably reduced when care workers use compressed air for proning.


In the operating room, healthcare professionals often have to manually tilt and position patients. This is the case, for example, in surgery in prone position, where a patient is positioned from supine to prone on support. This procedure, called “proning,” is very burdensome for the lower back.

The consequences of this heavy physical load are significant. It can cause employees not working at full capacity, to drop out for sick leave, or even to leave the organization. Together with Ghent University Hospital, Liantis investigated whether the use of compressed air and inflatable cushions could reduce the physical load for healthcare workers.

Comparing three methods of proning

In the study, we compared three different types of proning. Six subjects had to move a patient from supine to prone position in three different ways.

The first method used compressed air and inflatables. In this method, the subject had to roll the patient from the bed to the operating table via an inflatable board (IBO). Beforehand, an inflatable cushion (IPS) was placed at the level of the patient’s thorax and pelvis. This cushion was then inflated after proning to complete the positioning.

The other methods were manual operations. The second method required the subject to move the patient from the bed to the operating table using a rolling board. On the table, the patient was tilted using gliding sheets. Afterwards, he was lifted and foam supports were placed under the patient. Finally, in the third method, he had to roll the patient from supine position in bed on the operating table directly onto the supports or frame.

In each of the three methods, we measured the muscle tone of the subject’s shoulder muscles and low back muscles to see which method was the least physically demanding.

Inflatable cushions reduce physical strain

“The compressed air method resulted in a significant lower muscle load for the test subjects compared to the other, manual methods. The inflatable cushions not only caused less shoulder strain, but this method was also significant less stressful for the back muscles.

-Stephan Tomlow, Head Ergonomics at Liantis (external service provider for health and safety at work)

In short: avoiding manual handling can ensure that employees in the care sector are less likely to suffer from lower back pain.

Importance of this research

So what is the importance of this type of research? Filip Buckens, ergonomist at Ghent University Hospital, explains that this research is valuable for several reasons:

“First and foremost, the results clearly indicate that certain manual techniques must be banned from the operating room. They are far too stressful for the healthcare workers and there are good alternatives available to avoid that physical stress.”

“If you want to to convert a theory based on gut feeling into practice, you need results that confirm the theory in black and white. If you want to convince surgeons to use this new technique in their operating room, you need to come up with positive results. And that is certainly the case with this study. The added value of using the air cushions is really demonstrated by the study here.”

-Filip Buckens, ergonomist at Ghent University Hospital