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Raising the height of the bed before performing care is the most effective action for preventing back strain for a nurse aide. When the bed is at an appropriate height, the nurse aide can maintain a neutral spine and use their body more efficiently. This positioning allows the aide to perform tasks without bending excessively or twisting, which are common movements that can lead to back injuries.

When the bed is elevated, the aide can keep their center of gravity closer to the task at hand, minimizing the need to reach down and potentially strain their back. This practice designs the work environment to promote ergonomic safety, reducing the risk of musculoskeletal injuries that can occur over time from poor lifting techniques.

While using a back support, stretching before lifting, and keeping one knee on the floor may contribute to overall safety and comfort, they do not directly address the critical factor of body positioning when providing care. Raising the height of the bed becomes a proactive measure to ensure a safer lifting posture, enhancing the aide's ability to perform their duties without risk of injury.