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Changing the Sheets: A New System to Reduce Strain During Patient Repositioning

Theou, Olga; Soon, Zoe; Filek, Sue; Brims, Marjorie; Leach-MacLeod, Karen; Binsted, Gordon; Jakobi, Jennifer

doi: 10.1097/NNR.0b013e318225b8aa

Background: Manually repositioning patients puts healthcare providers at risk for injury; this may be reduced by using low-friction bedsheets.

Objectives: The aim of this study was to evaluate the physical properties and the physiological measures of muscle activity and perceptual participant accounts between a new slider sheet system and traditional hospital bedsheet makeup (soaker pad with a jersey bottom sheet).

Method: Surface electromyography was recorded from the arm and shoulder muscles of five healthcare providers executing a patient repositioning (boosting and turning) in a controlled laboratory setting to gain an indication of muscle activity required for two types of bedsheets (slider system and traditional sheet makeup). The Borg Scale was used to establish rating of perceived exertion for these repositioning tasks on the two types of bedsheet makeup. To evaluate the sheets independent of human interaction and contact, the physical resistive characteristics of the sheets were calculated by determining the coefficient of friction.

Results: Patient repositioning on traditional sheets, compared with the slider system, resulted in 16% greater electromyography burst numbers and 11% longer duration for both boosting and turning. Moreover, ratings of perceived exertion for repositioning patients on traditional sheets versus on slider sheets were more than double. The coefficient of friction of the traditional sheets was 65% less in the slider sheet system.

Discussion: This study suggests that manually repositioning patients on a low-friction slider system reduces muscular and perceived effort. Proper usage of this type of bedsheets may reduce the risks associated with musculoskeletal strain and injuries of the healthcare providers.

Olga Theou, PhD, is Postdoctoral Fellow; and Zoe Soon, PhD, is Assistant Professor, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada.

Sue Filek, BPE, BSc (OT), is Ergonomic Specialist; Marjorie Brims, BPT, MHS, is Manager, Injury Prevention; and Karen Leach-MacLeod, BMR (OT), is Ergonomic Specialist, Interior Heath Authority, Workplace Health, Safety and Wellness Department, Kelowna, British Columbia, Canada.

Gordon Binsted, PhD, is Associate Professor; and Jennifer Jakobi, PhD, is Assistant Professor, Faculty of Health and Social Development, University of British Columbia Okanagan, Kelowna, British Columbia, Canada.

Accepted for publication April 27, 2011.

Thank you to Nancy McGovern, PT Ergonomic Specialist, IHA, and Tom Frame, MIP, for their support.

This research was supported with funds from the Worker's Compensation Board of British Columbia.

There was no financial advantage, and the sheets were purchased by the investigators at market value from the manufacturer.

The authors have no conflicts of interest to disclose.

Corresponding author: Jennifer Jakobi, PhD, Faculty of Health and Social Development, University of British Columbia, 3333 University Way, Kelowna, BC, Canada V1V 1V7 (e-mail:

© 2011 Lippincott Williams & Wilkins, Inc.