Active workstations: A literature review on workplace sitting.

The purpose of this paper is to further understand current literature on prolonged sitting, sitting posture and active sitting solutions. This paper is divided into three sections: The first section (Part I) is a comprehensive overview of the literature on how a static prolonged seated posture can affect: spinal health, trunk posture, contact pressure/discomfort development and vascular issues. The second section (Part II) reviews and qualitatively compares the four working postures recognized in ANSI/HFES 100-2007: reclined sitting, upright sitting, declined sitting and standing. The final section (Part III) is a summary of research on active chairs that revolves around the two types of movement patterns: 1- sustaining continual movement over a range of postures, occasionally reaching neutral lordosis, and 2- maintaining high frequency and duration of daily light contractile activity in the legs (or lower limbs).

Differential effects of sex on upper body kinematics and kinetics during fatiguing, Asymmetric lifting.

This study quantified sex-specific biomechanical adaptations to fatigue in asymmetric lifting. Twenty-one females and fifteen males performed a prolonged asymmetric lifting protocol while upper body, trunk and pelvis kinematics were collected. Features of movement identified with principal component analysis, and peak joint angular velocities and moments were calculated. Sex-specific kinematic adaptations to fatigue included females adopting a 'stoop-like' lifting strategy to a greater extent than males. Additionally, females exhibited higher vertical elbow positions during load rotation, moved their body toward the destination for load deposit, and did not reduce peak right shoulder flexion velocities, in contrast to male participants. Females also had greater low back and shoulder peak normalized joint moments. When fatigued, females adopted an asymmetric lifting strategy that minimized metabolic demand as supported by smaller decreases in maximum voluntary contractions. However, females' fatigue-related adaptations increased biomechanical exposures associated with injury risk.

The biomechanical benefits of active sitting.

This cross-sectional study examined the biomechanical effects of two active chairs (AC1: had the feature to pedal and slide forward on the seat pan; AC2: a multiaxial motion seat pan) compared to a traditional office chair and standing workstation. Twenty-four healthy participants worked at each of the workstations for 60-min. The following equipment was used: Motion Capture, Electromyography, Ratings of Perceived Discomfort Questionnaire, and Exit Survey. The active protocol had positive effects on the body, including increased neuromuscular activity in the gastrocnemius, increased overall movement, and a more open trunk-thigh angle. Greater discomfort in the buttocks due to the lack of seat pan contour was reported for the AC1 which identified a need for a design modification. While standing, participants' shoulders were less flexed than when sitting in any of the three seats, however, greater discomfort was reported in the lower legs after 1 h of computer work. Practitioner summary: A comparison of four different workstations was conducted to further understand the use of active workstations. Active sitting was found to have positive effects on the body, such as allowing sitters to increase movement while sitting without the high activation of muscular activity. Standing can also provide a positive break from sitting.

Relationship between occupational stress injury score and simulated patient-care scenario performance among experienced paramedics.

BACKGROUND: It is well-known that psychosocial health status of paramedics may be altered by their job demands. However, it is unknown whether psychosocial health status can affect occupational performance. OBJECTIVE: The goal of this study was to explore whether a paramedic's symptom severity of Occupational Stress Injury (OSI) was related to simulated patient-care performance. METHODS: Nineteen paramedics with 15.0±8.7 years of paramedic experience participated in this study. Participants completed both an OSI symptom severity questionnaires, and a patient-care simulation. Vagal activity was also collected during the patient-care simulation. The simulation was used to assess experienced paramedics in a realistic stressful setting. Based on the provincial standard in New Brunswick, an experienced paramedic instructor graded the patient-care simulation using the provincial standard charts, observing performance videos and assessing data from the manikin. RESULTS: The current study suggests that paramedics who self-reported elevated symptoms of OSI were less likely to successfully complete the simulated patient-care scenario. CONCLUSION: This research suggests that the presence of self-reported elevated symptoms of OSI negatively impacts paramedics' performance during a stressful work task simulation. Therefore, to help paramedics maintain optimal performance, it may be important to ensure that paramedics have access to appropriate resources to monitor and improve their psychosocial health.

Does active sitting provide more physiological changes than traditional sitting and standing workstations?

This cross-sectional study examined the physiological effects of two active chairs (AC1: had the feature to pedal and slide forward; AC2: was a multiaxial chair) compared to a traditional office chair and standing workstation. Twenty-four healthy participants computed at each of the workstations for 60 min. The active protocol was to alternate between a pedalling/side-to-side motion and sliding forward/front-to-back motion to the sound of a metronome operating at 40 bpm. The participants' physiological effects were recorded using near-infrared spectroscopy (NIRS); electrodermal activity (EDA) and a heart rate (HR) monitor for each collection period. Statistical analysis was conducted using a repeated measures analysis of variance for within-task and between-workstation comparisons. A Tukey's post hoc analysis was calculated for significant findings. Both active chairs significantly increased oxygenated blood in the gastrocnemius and participants' heart rate and EDA (stress) levels were affected slightly by task and time. However, participants felt more "productive" sitting in the control chair than in either of the active chairs.

A biomechanical analysis of active vs static office chair designs.

The objective of this study was to provide a biomechanical comparison of two different types of active chairs (AC1 & AC2) versus a static chair (NAC). Thirty healthy participants were recruited: fifteen healthy females and fifteen healthy males. Participants worked at a computer workstation (1-h per chair). Equipment included: Pressure pads, Electromyography, Near-Infrared Spectroscopy, and Questionnaires (rate of perceived discomfort, seating discomfort questionnaire and exit survey). A significant increase in anterior-posterior postural sway was found on the seat pan with the use of the AC1. An increase in neuromuscular activity of the external obliques and an increase change in total oxygen index (%TOI) values in the gastrocnemius were also found using the AC1, however the difference was not much higher than the NAC and AC2. Lower discomfort scores in the gluteal area were found with the use of active chair AC1 compared to the NAC. Preliminary findings suggest that having an office chair with a split seat pan design shows potential to yield biomechanical and physiological benefits for the sitter, however further research is needed to better understand the ergonomic benefits of active sitting.

Occupational health profile of Canadian Maritimes truck drivers.

BACKGROUND: There are over 12,000 professional truck drivers in the Canadian Maritime provinces, with the majority being in New Brunswick and Nova Scotia. Previous studies have focused on the health of Canadian and American truck drivers but the occupational health status of truck drivers in the Maritime Provinces remains undocumented. OBJECTIVE: The objective of this cross-sectional study was to provide a general, occupational health and demographic characteristics description of professional truck drivers in the Maritimes. METHODS: One-hundred and four male truck drivers from the Canadian Maritime Provinces volunteered for this study. Nine occupational health indicators were measured (seven were self-reported via questionnaire and two were physical measurements). Participants self-reported their age, years of truck driving experience and education. RESULTS: Only one-quarter of the current sample had no health conditions. In contrast, more than half were obese, one third had back problems, and one-sixth had a high risk of developing cardiovascular disease (CVD). The group comparison analysis showed that the group without health condition was younger and more educated than the group with multiple health conditions. For this study, age and low rate of education were associated with an increased number of health conditions. CONCLUSIONS: Similar to health profiles of other populations of North American truck drivers, this study suggests that the majority of truck drivers in the Canadian Maritime Provinces have at least one poor indicator of occupational health.

Physiological responses during paramedics' simulated driving tasks.

BACKGROUND: Most ambulance collisions happen in emergency driving conditions and are caused by human factors. OBJECTIVE: This study investigated the influence of human factors associated with time pressure, patient-care intervention, and health status on the physiological responses of simulated emergency driving tasks. METHODS: A cohort of seventeen experienced paramedics performed a battery of three simulated diving tasks. The driving tasks were a non-urgent and two urgent driving simulations (one to the scene and one to the hospital). The second urgent driving task was preceded by a patient-care simulation (unstable cardiac patient with cardiopulmonary resuscitation). RESULTS: The physiological responses between the three driving tasks were not significantly different due to time pressure and patient-care intervention. It is postulated that the physiological response of experienced paramedics was influenced by the fact that they are accustomed to handling stressful situations daily. Furthermore, it was observed that paramedics with health conditions were more physiologically aroused during the urgent driving scenarios (pre and post-intervention), suggesting they might have an elevated risk of collision when they drive with urgency. Paramedics with health conditions also had higher physiological responses for the post-intervention baseline, leading to a longer recovery time period, which might represent an elevated risk of developing chronic health problems or amplifying existing ones. CONCLUSIONS: The findings of this research suggest that experienced paramedics manage the influence of time pressure and the impact of challenging patient-care well. Paramedics with health conditions represent an elevated risk of collision.

Exploration of the health status of experienced New Brunswick paramedics.

BACKGROUND: Literature reports that paramedics represent an at-risk occupation for the development of health problems. At least half of the paramedic population presents at least one risk factor associated with a negative health condition. These reports may suffer a "mono-method bias" where most reported outcomes are based on a single screening tool approach (may attenuate or inflate the prevalence). OBJECTIVE: The current study characterizes the health status of a cohort of twenty-five experienced New Brunswick (Canadian province) paramedics. METHODS: To understand possible limitations of past research, health status was characterized using four different methods: two methods using only one health measure and two were combined methods, integrating outcomes from at least two health measures to determine the prevalence of a given health status. RESULTS: Mono-bias was observed when using the single health measure methods. The difference among the four methods highlighted that a third of the cohort seemed unaware of their health condition. This result shed additional light on paramedics' health, where a high proportion of paramedics worked without knowledge of their health conditions. Based on a two health measures combined method, it was observed that only two-fifths of the current sample had no health conditions or could otherwise be considered as a "healthy". CONCLUSIONS: Because the literature has focused on single screening methods, our results were difficult to compare. However, there was a consensus that paramedics represent an at-risk occupation comprised of health problems. This study was exploratory and should be the basis for further research.

Predictors of clinical success with stabilization exercise are associated with lower levels of lumbar multifidus intramuscular adipose tissue in patients with low back pain.

Purpose: Investigate the construct validity of prognostic factors purported to predict clinical success with stabilization exercise for low back pain by exploring their associations with lumbar multifidus composition.Methods: Patients with low back pain were recruited from a hospital imaging department. The presence of fivepredictors (age <40 years, positive prone instability test, aberrant trunk flexion movements, straight leg raise range of motion >91°, spinal hypermobility) were identified by standardized physical examination. Predictors were grouped by total positive findings and status on a clinical prediction rule. The proportion of lower lumbar multifidus intramuscular adipose tissue was measured with 3.0 T magnetic resonance imaging. Univariate and multivariate associations were examined with linear regression and reported with standardized beta coefficients (ß) and 95% confidence intervals.Results: Data from 62 patients (11 female) with mean (SD) age of 45.2 (11.8) years were included. Total number of predictors (ß[95% CI] = -0.37[-0.61,-0.12]; R2 = 0.12), positive prediction rule status (ß[95% CI] = -0.57[-0.79,-0.35]; R2 = 0.30), and age <40 years were associated with lower intramuscular adipose tissue (ß[95% CI] = -0.55[-0.77,-0.33]; R2 = 0.27). No other individual factors were associated with lumbar multifidus intramuscular adipose tissue.Conclusions: These findings support the construct validity of the grouped prognostic criteria. Future research should examine the clinical utility of these criteria. Implications for RehabilitationLow back pain is the single largest cause of disability worldwide and exercise therapy is recommended by international low back pain treatment guidelines.Lower levels of lumbar multifidus intramuscular adipose tissue were associated with predictors of clinical success with stabilization exercise.Higher proportions of lumbar multifidus intramuscular adipose tissue may help identify patients who require longer duration exercise training, or those who are unlikely to respond to stabilization exercise.

Exploring simulated driving performance among varsity male soccer players.

Background: It is documented that male athletes display riskier behaviors while driving (as well as in life in general) than female athletes and nonathletes. However, the literature has reported that athletes show better driving ability than nonathletes. This paradox between behaviors and abilities motivated the present study to further understand the collision risk of varsity athletes. Objective: The current study estimates the performance differences between varsity male soccer players and male undergraduate nonathletes on (1) a driving task and (2) three perceptual-cognitive tasks (associated with collision risk prediction; i.e., Useful Field of View [UFOV] test). Methods: Thirty-five male undergraduate students (15 varsity soccer players, 20 undergraduate nonathletes) took part in this study. Driving performance was assessed during 14 min of urban commuting using a driving simulator. While completing the simulated driving task and UFOV test, the physiological responses were monitored using an electrocardiograph (ECG) to document heart rate variability (HRV). Results: Varsity soccer players showed more risky behaviors at the wheel compared to their nonathlete student peers. Varsity soccer players spent more time over the speed limit, committed more driving errors, and adopted fewer safe and legal behaviors. However, no difference was observed between both groups on driving skill variables (i.e., vehicle control, vehicle mobility, ecodriving). For subtests 1 and 2 of the UFOV (i.e., processing speed, divided attention), both groups performed identically (i.e., 17 ms). The nonathlete group tended to perform better on the selective attention task (i.e., subtest 3 of UFOV test; 63.2 ± 6.2 ms vs. 87.2 ± 10.7 ms, respectively; this difference was not significant, P = .76). Conclusion: Preventive driving measures should be enforced in this high-risk population to develop strategies for risk reduction in male team athletes.

Ergonomic evaluation of a new truck seat design: a field study.

A postural evaluation of commercial licensed truck drivers was conducted to determine the ergonomic benefits of a truck seat prototype in comparison with an industry standard seat. Twenty commercially licensed truck drivers were recruited to perform a 90-min driving task. Postures were assessed using accelerometers and a backrest and seat pan pressure mapping system. Subjective discomfort measurements were monitored using two questionnaires: ratings of perceived discomfort (RPD) and the automotive seating discomfort questionnaire (ASDQ). Participants reported significantly higher discomfort scores when sitting in the industry standard seat. Participants sat with more lumbar lordosis and assumed a more extended thoracic posture when seated in the prototype. Pairing the gluteal backrest panel with the adjustable seat pan also helped reduce the average sitting pressure on both the seat pan and the backrest. The prototype provided several postural benefits for commercially certified truck drivers, as it did for a young and healthy population.

A pre/post evaluation of fatigue, stress and vigilance amongst commercially licensed truck drivers performing a prolonged driving task.

Purpose. The main purpose of this research study was to evaluate changes in fatigue, stress and vigilance amongst commercially licensed truck drivers involved in a prolonged driving task. The secondary purpose was to determine whether a new ergonomic seat could help reduce both physical and cognitive fatigue during a prolonged driving task. Two different truck seats were evaluated: an industrial standard seat and a new truck seat prototype. Methods. Twenty male truck drivers were recruited to attend two testing sessions, on two separate days, with each session randomized for seat design. During each session, participants performed two 10-min simulated driving tasks. Between simulated sessions, participants drove a long-haul truck for 90 min. Fatigue and stress were quantified using a series of questionnaires whereas vigilance was measured using a standardized computer test. Results. Seat interactions had a significant effect on fatigue patterns. Conclusion. The new ergonomic seat design holds potential in improving road safety and vehicle accidents due to fatigue-related accidents.

Biomechanical investigation of prolonged driving in an ergonomically designed truck seat prototype.

A postural evaluation during a prolonged driving task was conducted to determine the ergonomic validity of a new freely adjustable truck seat prototype. Twenty participants were recruited to perform two 2-h simulated driving sessions. Postures were assessed using motion capture, accelerometers and pressure pads. Subjective discomfort was also monitored in 15-min increments using ratings of perceived discomfort (RPD) and the Automotive Seating Discomfort Questionnaire. Participants had a more neutral spine posture during the first hour of the drive and reported lower RPDs while sitting in the prototype. Pairing the gluteal backrest panel with the adjustable seat pan helped reduce the average sitting pressure. The industry-standard truck seat may lead to the development of poor whole body posture, and the proposed ergonomic redesign of a new truck seat helped improve sitting posture and reduce perceived discomfort. Practitioner Summary: A new freely adjustable truck seat prototype was compared to an Industry standard seat to assess hypothesised improvements to sitting posture and discomfort for long haul driving. It was found that the adjustable panels in the prototype helped promote spine posture, reduce sitting pressure and improved discomfort ratings.

Quantifying the postural demands of patrol officers: a field study.

Police officers are at high risk for developing musculoskeletal injuries. This study aimed to determine differences in physical demands of patrol officers during day shifts and night shifts. Sixteen participants were recruited (10 males, 6 females) for in-vehicle observation over one full day shift and one full night shift. Dynamic pressure distribution when seated in the vehicle was assessed and compared between the first and last parts of each shift. Activity characterization and postural analyses were conducted from video that was recorded continuously for the duration of each shift to determine time spent in each task and corresponding postures. Postural analysis and cumulative joint loads were used to identify higher-risk tasks. Several activities caused the officers to adopt non-neutral postures of the neck, shoulders and back. Future work needs to focus on modifying the interior of the vehicle, as well as decreasing exposure time to activities resulting in non-neutral postures.

An ergonomic evaluation of city police officers: an analysis of perceived discomfort within patrol duties.

The purpose of this study was to assess the perceived discomfort of patrol officers related to equipment and vehicle design and whether there were discomfort differences between day and night shifts. A total of 16 participants were recruited (10 males, 6 females) from a local police force to participate for one full day shift and one full night shift. A series of questionnaires were administered to acquire information regarding comfort with specific car features and occupational gear, body part discomfort and health and lifestyle. The discomfort questionnaires were administered three times during each shift to monitor discomfort progression within a shift. Although there were no significant discomfort differences reported between the day and night shifts, perceived discomfort was identified for specific equipment, vehicle design and vehicle configuration, within each 12-h shift.

Posture and Helmet Load Influences on Neck Muscle Activation.

INTRODUCTION: Night vision goggles (NVG) are linked to increased neck muscle activation and pain. Counterweights (NVGcw) are hypothesized to mitigate these effects. The purpose of this study was to investigate the muscular response to varying helmet loads and postures. METHODS: Volunteering from a representative squadron were 16 male helicopter aviators (pilots, N = 9; flight engineers, N = 7). Subjects performed head movements to assume nine different postures (three directions: left, center, and right, at three different levels: down, level, and up) with four different head loads (no helmet; helmet only; NVG; and NVGcw) in randomized order. Subjects were provided real time visual guidance and feedback while assuming the appropriate posture in a cockpit seat in a laboratory setting. Neck muscle activation was assessed with electromyography (EMG) of four different muscle groups, bilaterally, including the sternocleidomastoid, splenius capitis, and mid and lower trapezius. RESULTS: Two- to fourfold increases in muscle activation were observed in postures to the left (down, level, and up) while subjects wore either the NVG or NVGcw as compared to the baseline of no helmet. This was most prevalent in smaller muscle groups (i.e., the sternocleidomastoid and splenius capitis) as compared to larger muscle groups (i.e., the mid and lower trapezius). DISCUSSION: The use of NVGcw did not decrease neck muscle activity as compared to NVG only, particularly when the head posture moved the field of view below the horizon. This suggests interventions to decrease neck muscle activity and fatigue in military helicopter aircrew using NVG should focus on task specific guidelines with respect to countermeasures.

Driving performance on the descending limb of blood alcohol concentration (BAC) in undergraduate students: a pilot study.

Young drivers are overrepresented in collisions resulting in fatalities. It is not uncommon for young drivers to socially binge drink and decide to drive a vehicle a few hours after consumption. To better understand the risks that may be associated with this behaviour, the present study has examined the effects of a social drinking bout followed by a simulated drive in undergraduate students on the descending limb of their BAC (blood alcohol concentration) curve. Two groups of eight undergraduate students (n = 16) took part in this study. Participants in the alcohol group were assessed before drinking, then at moderate and low BAC as well as 24 hours post-acute consumption. This group consumed an average of 5.3 ± 1.4 (mean ± SD) drinks in an hour in a social context and were then submitted to a driving and a predicted crash risk assessment. The control group was assessed at the same time points without alcohol intake or social context.; at 8 a.m., noon, 3 p.m. and 8 a.m. the next morning. These multiple time points were used to measure any potential learning effects from the assessment tools (i.e. driving simulator and useful field of view test (UFOV)). Diminished driving performance at moderate BAC was observed with no increases in predicted crash risk. Moderate correlations between driving variables were observed. No association exists between driving variables and UFOV variables. The control group improved measures of selective attention after the third assessment. No learning effect was observed from multiple sessions with the driving simulator. Our results show that a moderate BAC, although legal, increases the risky behaviour. Effects of alcohol expectancy could have been displayed by the experimental group. UFOV measures and predicted crash risk categories were not sensitive enough to predict crash risk for young drivers, even when intoxicated.

Night vision goggle-induced neck pain in military helicopter aircrew: a literature review.

Neck pain occurs at a significant rate in the military helicopter community. It is often attributed to the use of night vision goggles (NVG) and to a number of additional factors such as anthropometrics, posture, vibration, mission length, physical fitness, and helmet fit or load. A number of research studies have addressed many aspects of this epidemic, but an up-to-date and comprehensive review of the literature is not currently available. This paper reviews the spinal anatomy in general and then summarizes what is known about the incidence and prevalence of neck injuries, how the operational environments and equipment may contribute to these injuries, and what can be done to address them from a prevention and/or rehabilitation perspective. Harrison MF, Coffey B, Albert WJ, Fischer SL. Night vision goggle-induced neck pain in military helicopter aircrew: a literature review.

A simple approach to guide factor retention decisions when applying principal component analysis to biomechanical data.

The use of principal component analysis (PCA) as a multivariate statistical approach to reduce complex biomechanical data-sets is growing. With its increased application in biomechanics, there has been a concurrent divergence in the use of criteria to determine how much the data is reduced (i.e. how many principal factors are retained). This short communication presents power equations to support the use of a parallel analysis (PA) criterion as a quantitative and transparent method for determining how many factors to retain when conducting a PCA. Monte Carlo simulation was used to carry out PCA on random data-sets of varying dimension. This process mimicked the PA procedure that would be required to determine principal component (PC) retention for any independent study in which the data-set dimensions fell within the range tested here. A surface was plotted for each of the first eight PCs, expressing the expected outcome of a PA as a function of the dimensions of a data-set. A power relationship was used to fit the surface, facilitating the prediction of the expected outcome of a PA as a function of the dimensions of a data-set. Coefficients used to fit the surface and facilitate prediction are reported. These equations enable the PA to be freely adopted as a criterion to inform PC retention. A transparent and quantifiable criterion to determine how many PCs to retain will enhance the ability to compare and contrast between studies.