A practical study at Wit-Gele Kruis West-Vlaanderen

SpineWise
Sep 19, 2025
7 min read

A practical study at Wit-Gele Kruis West-Vlaanderen on the use of sensor technology, participatory training, and a data-driven organizational approach to reduce physical strain.

Introduction

Physical complaints are very common in (home) healthcare. Caregivers perform physically demanding tasks daily: moving patients, putting on support stockings, washing in small bathrooms, and so on. The result? A high incidence of back, shoulder, and neck pain. This is a recurring problem for many caregivers. It not only leads to discomfort but also to absenteeism and work-related illnesses, which only increases the workload for colleagues.

To improve this situation, the ErgoWise project was established. Wearables were used to measure caregivers' movements and postures and provide real-time feedback via vibration. The project was carried out in close collaboration between SpineWise and ErgoSupport. SpineWise was responsible for the measurements, data analysis, and participatory sessions. ErgoSupport contributed expertise in ergonomic training, assistive device use, and work process research. This collaboration resulted in targeted recommendations for improvement.

This white paper describes how the project progressed, what the key results were, and what we can learn from it.

The project in brief

A total of 30 healthcare providers participated in this project. Each participant received two small sensors that they could easily attach to their work clothes. These sensors accurately recorded all their postures and movements.

The project took place in two phases:

In the first five weeks:

Weeks 1-2: Measurements were taken without feedback. This formed the baseline measurement.
- Weeks 3-5: Active coaching phase, in which participants received real-time vibration alerts when they adopted a non-ergonomic posture. After several days of coaching, a group meeting was held to discuss their experiences with the vibration alert. During these sessions, they not only provided tips for increasing their resilience and using assistive devices correctly, but also addressed the design of their work environment. The discussions led to the sharing and comparison of working methods and provided insight into how various care tasks and organizational processes contribute to workload.

After a break of 3 to 4 months, phase 2 followed:

Week 6: measurement with a vibration signal, combined with a second group session focusing on persistent challenges. In addition to discussing posture and movement, broader work organization aspects were also addressed, such as patient onboarding and combining care tasks with other activities.
- Week 7: measurement without vibration signal, to assess whether the effect was maintained without feedback.

Throughout the entire process, the measurements were supplemented with questionnaires to capture the participants' experiences. The data analysis allowed for the evaluation of individual work attitudes and the identification of opportunities for improvement at the organizational level.

Physical complaints at the start

Before the project began, participants were asked if they had experienced any physical complaints in the past year. The response was revealing. All participants indicated they had experienced physical complaints at least once. Complaints in the lower back, neck, and shoulders were particularly common. Together, these three areas accounted for 72% of all reported complaints.

This demonstrates the importance of taking action, not only for the well-being of employees, but also for the quality of care.

What was measured?

The wearables recorded three important things:

How many times someone bent over deeply
How long someone remained in a hunched position (more than 4 seconds)
How much time was spent with a hunched back

These measurements provide a good picture of how demanding the work is and how often healthcare providers adopt postures that can lead to complaints in the long term.

The project in figures

A key part of the project was monitoring how participants' attitudes changed. Two parameters were examined separately for this purpose:

Bending forward with the torso beyond 30° with a back arch of more than 45° (less than 4 seconds)
Prolonged forward bending postures of more than 20° for more than 4 seconds: the deeper the bend and the greater the arch of the back, the more quickly a posture was registered as 'held too long'.

Forward bends (less than 4 seconds)

In weeks 1 and 2 (without vibration signal), this happened 127 and 128 times per person on an average working day.
During week 3 (with vibration signal) this dropped to 90 times, then rose slightly to 116 and 103 in weeks 4 and 5.
After a 3-month break, this dropped further to 87 and 73 in weeks 6 and 7.

This shows that participants worked more consciously and hunched over less often. They actively adjusted their posture.

Prolonged forward bending postures (>4 seconds)

In week 1, participants started exercising an average of 52 times per day.
This dropped sharply to 20 in week 3 and remained low in weeks 4 and 5 (27 and 23 times).
In weeks 6 and 7 it rose slightly to 28 and 32, but remained well below the starting point.

➡️ Standing hunched over for long periods of time is hard on the back. The decrease in this is therefore very positive. Even without the vibration signal, the behavior remained improved.

Number of deep trunk bends (more than 60°)

When we compare this data with the EN 1005-4 standard, we also see a clear decrease in the number of deep forward bends of more than 60 degrees, as well as a decrease in the time spent in these deep postures.

During the first two weeks, participants performed an average of 100 deep trunk bends daily.

Evolution of time spent with a rounded back (>45°)

During weeks 1 and 2, participants spent 7.60% of their time with an arched back.
This dropped sharply to 4.66% in weeks 3 to 5.
In weeks 6 and 7, the percentage rose slightly to 4.16% and 5.12%, respectively. These figures were also better than at the start of the project.

Participants learned to correct their posture when they arched their back too much. The vibration signals provided immediate feedback. Importantly, the effect lasted throughout the last two weeks.

Behavior and awareness

The vibration signal clearly had an effect on behavior. Many participants indicated that they became more aware of their posture and movements. Some of the statements:

“I suddenly noticed how often I was wrong.”
The vibrations made me aware of how I was working. After a while, I stopped feeling it. Then it became a habit.
"It's changed the way I work. I try to vary my posture more often now."

The figures from the survey confirm that:

83% of participants found the sensors useful.
92% adjusted their posture sometimes to always based on the vibration signal.
75% believe there is still room for further improvement.

The project also sparked conversations. Participants reflected on their actions and discussed various working methods during group sessions. For example, they explored the different ways healthcare providers put on support stockings for patients.

What does this mean for absenteeism?

One of the main objectives of this project was to estimate the potential impact on long-term sickness absence. Based on the observed reduction in the number of prolonged, stressful postures and movements, an expected reduction in long-term sickness absence of 1.42% was calculated over four years, using the model developed by Gupta et al. (2022). This equates to approximately 1 to 2 fewer cases of long-term sickness absence (LTSA) per 100 employees. An absolute risk reduction of 1.4% (from 12.5% to 11.1%). At the individual level, this means an average 11.8% reduction in the risk of developing long-term sickness absence.

What does this mean for the patient and the quality of care?

Besides reducing physical strain on caregivers, the ErgoWise project also contributes to the quality of care. Reduced pain and discomfort allow caregivers to focus more on the patient, leading to greater engagement and a lower risk of errors. Furthermore, lower absenteeism ensures greater continuity of care, which strengthens patient trust. The behavioral change brought about by the project therefore benefits not only staff but also patient care as a whole.

Conclusion and next steps

The results show that direct feedback via wearables leads to measurable behavioral change. Participants were less likely to maintain an unfavorable posture for extended periods and moved more consciously. Importantly, this effect was partially maintained even months after the vibration signal was removed, indicating a lasting change in work habits.

The project demonstrates that the combination of technology, coaching and awareness:

improves work postures,
stimulates the use of resources,
and ensures lasting behavioral changes that reduce physical strain.

Wearables alone aren't a panacea, but combined with targeted guidance, they can be a powerful lever for improved ergonomics in healthcare. However, effective ergonomics requires a multifactorial and holistic approach: not only improving individual work techniques, but also optimizing the work environment and organizational processes. This not only reduces the physical burden on employees but also contributes to the quality and continuity of care.

Next steps

The next phase of the project will focus on:

Addressing organizational factors, including a deeper analysis of the patient onboarding flow and its impact on workload.
Data-driven deployment and correct use of tools, so that typical actions in practice are accurately mapped and internal 'best practices' can be developed based on measurement data.
Further rollout of coaching programs using wearables within the organization, to reach more teams and embed behavioral change more broadly.

With these steps, we are moving towards an integrated, sustainable ergonomics policy that strengthens both employee satisfaction and the quality of care.

References

More than 2,600 occupational diseases reported by 690 company doctors in 2024 | Beroepsziekten.nl . (n.d.). https://www.beroepsziekten.nl/content/ruim-2600-beroepsziekten-gemeld-door-690-bedrijfsartsen-2024
Key figures on ergonomics in Belgium 2020 :: VerV. (undated). https://www.verv.be/news/kerncijfers-ergonomie-in-belgie-2020/
Gupta, N., Bjerregaard, S.S., Yang, L., Forsman, M., Rasmussen, C.L., Rasmussen, C.D.N., Clays, E., & Holtermann, A. (2022). Does occupational forward bending of the back increase long-term sickness absence risk? A 4-year prospective register-based study using device-measured compositional data analysis. Scandinavian Journal Of Work Environment & Health, 48(8), 651–661. https://doi.org/10.5271/sjweh.4047
Sluijs, E., Van Beek, S., Mouthaan, I., De Neef, M., Wagner, C., & NIVEL. (2002). In-depth study on the transparency of quality of care. NIVEL. https://www.nivel.nl/sites/default/files/bestanden/transparantie-kwaliteit-zorg.pdf

Download the whitepaper here ⬇️