Evidence for repetitive load in the trapezius muscle during a tapping task.

Many studies describe the trapezius muscle activation pattern during repetitive key-tapping focusing on continuous activation. The objectives of this study were to determine whether the upper trapezius is phasically active during supported key tapping, whether this activity is cross-correlated with forearm muscle activity, and whether trapezius activity depends on key characteristic. Thirteen subjects (29.7 ± 11.4 years) were tested. Surface EMG of the finger's extensor and flexor and of the trapezius muscles, as well as the key on-off signal was recorded while the subject performed a 2-min session of key tapping at 4 Hz. The linear envelopes obtained were cut into single tapping cycles extending from one onset to the next onset signal and subsequently time-normalized. Effect size between mean range and maximal standard deviation was calculated to determine as to whether a burst of trapezius muscle activation was present. Cross-correlation was used to determine the time-lag of the activity bursts between forearm and trapezius muscles. For each person the mean and standard deviation of the cross-correlations coefficient between forearm muscles and trapezius were determined. Results showed a burst of activation in the trapezius muscle during most of the tapping cycles. The calculated effect size was ≥0.5 in 67% of the cases. Cross-correlation factors between forearm and trapezius muscle activity were between 0.75 and 0.98 for both extensor and flexor muscles. The cross-correlated phasic trapezius activity did not depend on key characteristics. Trapezius muscle was dynamically active during key tapping; its activity was clearly correlated with forearm muscles' activity.

Firing duration of masseter motor units during prolonged low-level contractions.

OBJECTIVE: The study aimed to determine whether motor units (MUs) of the masseter muscle can be continuously active during a prolonged low-level sustained contraction. METHODS: Intramuscular fine-wire EMG activity was recorded unilaterally from the masseter muscles of 13 pain-free volunteers (mean age ± SD = 26.7 ± 7.7 years), during low-level biting tasks performed for 30 min. The stored intramuscular EMG signals were decomposed into individual MU action-potential trains using long-term decomposition software. Depending on relative duration of the MU activity, MUs were classified as sporadically (<50% of the time), intermittently (50% ≤ time ≤ 95%), or continuously active (>95% of the time). RESULTS: The overall number of MUs identified during the low-level biting task was 203. Of these, nine continuously active MUs (4.4%) were found in six of the 13 subjects investigated, whereas 50 intermittent MUs (24.6%) were found in 12 subjects. The remaining MUs (71.0%) were sporadically active and were found in all of the subjects investigated. CONCLUSION: The majority of masseter MUs is sporadically or intermittently active during prolonged low-level contractions, but some of them can also be continuously active. SIGNIFICANCE: Sustained clenching efforts may be accompanied by continuous activity of a few selected muscle fibres.

Correlates of short- and long-term absence due to musculoskeletal disorders.

BACKGROUND: Musculoskeletal disorders (MSD) are a common cause of disability and absence from work. There is no consistent evidence in the literature regarding predictors for short- and long-term absences due to these disorders. AIMS: To investigate work-related factors influencing short- and long-term absences due to MSD in German-speaking countries. METHODS: The study is based on data from the Fourth European Working Conditions Survey. The study population included 2849 workers in German-speaking countries who participated in face-to-face interviews. Logistic regression models were used to determine the associations between possible risk factors and the occurrence of short- or long-term absence due to MSD. RESULTS: A tiring or painful working position was positively correlated with short- and long-term absenteeism due to MSD, whereas the freedom to decide when to take holidays was negatively associated with this phenomenon. Some psychosocial factors, such as the ability to apply one's own ideas at work, the ability to choose or change the speed or rate of work and the emotional demands of the job, had contradictory impacts on short- and long-term absenteeism due to MSD. CONCLUSIONS: The results of this investigation show that it is important to distinguish between predictors of short- and long-term absenteeism due to MSD.

Neuromuscular assessment in elderly workers with and without work related shoulder/neck trouble: the NEW-study design and physiological findings.

Musculoskeletal disorders in the neck and shoulder area are a major occupational concern in the European countries especially among elderly females. The aim was to assess these disorders based on quantitative EMG indicators and functional tests. 252 female computer users (45-68 years) were recruited from four European countries in two contrast groups: (1) 88 neck/shoulder (NS) cases reporting trouble in the neck and/or shoulder region for more than 30 days during the last year, and (2) 164 NS-controls reporting such trouble for no more than 7 days. Questionnaires, functional/clinical tests, and physiological recordings were performed in workplace related field studies. The results showed no differences in anthropometrics but NS-cases reported more strained head positions and more eye problems than controls. The psychosocial working factors were similar, although, NS-controls had slightly better scores on working conditions, general health, and vitality compared to cases. The NS-cases had lower maximal voluntary contraction (MVC) during shoulder elevation (mean (SD) 310 (122) N) compared to the controls (364 (122) N). During 30% MVC electromyography (EMGrms) in the trapezius muscle was lower in NS-cases (194 (105) muV) than in controls (256 (169) muV), while no differences were found regarding endurance time. Estimated conduction velocity was not different between NS-cases and -controls. Four functional computer tests were performed equally well by NS-cases and -controls, and the corresponding EMG variables also did not differ. A major finding in this large-scale epidemiological study is the significantly lower MVC in NS-cases compared with NS-controls together with lower EMGrms value at 30% MVC, while computer tasks were performed at similar relative muscle activation. The study was unable to reveal quantitative EMG indicators and functional tests that could objectively assess disorders in NS-cases.

Comparative assessment of study groups of elderly female computer users from four European countries: questionnaires used in the NEW study.

There is a lack of consistent and comprehensive questionnaire forms for the studies of factors associated with work-related musculoskeletal disorders at the European level. One of the results of the EU-funded project, neuromuscular assessment in the elderly worker (NEW), is a set of questionnaires for the screening of musculoskeletal status and the studies of factors that are believed to affect musculoskeletal health. The questionnaires have been used among elderly women (45+) in different occupations and organisations in Denmark, The Netherlands, Sweden and Switzerland. The aim of this short communication is to present the questionnaires used in the NEW study and to evaluate the appropriateness of pooling data gathered in each participating country into a common database. It is concluded that although differences exist among the study samples, these are not of such a magnitude or pattern that data from the four groups cannot be pooled. The questionnaires are available in Danish, Dutch, English, German and Swedish.

Relationship between perceived exertion and mean power frequency of the EMG signal from the upper trapezius muscle during isometric shoulder elevation.

The aim of the study was to investigate the relationship between a fatigue-induced increase of perceived exertion in the neck with a decrease of mean power frequency (MPF) in the surface electromyography (sEMG) signal during repeated shoulder elevation endurance tasks. About Thirty-two healthy women (age range 20-62) performed two maximum 6-min shoulder elevation endurance tasks at 30% of their maximal voluntary contraction (MVC) level, separated by a rest of 6 min. During these exercises, perceived exertion was estimated using the Borg scale (range 0-10), whereas the MPF of the sEMG signal from the upper trapezius was simultaneously detected. Linear regression analysis was applied over time for each trial and subject for both MPF and Borg scale rating values. The MPF was normalized by the intercept of the linear regression analysis. The resulting slopes of normalized mean power frequency (nMPF) and Borg scale rating were correlated with each other by linear regression for both trials. In order to investigate the individual behavior of fatigue effects between trials, Delta (trial 2-trial 1) slopes of nMPF and Borg scale ratings were calculated for each subject. These slopes of nMPF and Borg scale ratings were correlated with each other as well by linear regression. The increase of Borg scale ratings, as well as the decrease of nMPF, were significantly higher in trial 2 than trial 1 (P<0.01). The results show a linear correlation between slopes of nMPF and Borg scale ratings for both trials 1 and 2 (r=0.76, P<0.01). Trial-to-trial slopes (Delta (trial 2-trial 1)) of nMPF and Borg scale rating, were also significantly correlated (r=0.68, P<0.05). Thus, the individually sensed increase of perceived exertion in the neck during trial 2 was accompanied by a simultaneously higher detected decrease of nMPF. These findings indicate a close relationship between subjective perception of exertion in the neck and objectively assessed muscle fatigue of the upper trapezius.

Course of low back pain among nurses: a longitudinal study across eight years.

AIMS: To describe the course of low back pain (LBP) among nurses across eight years. METHODS: A longitudinal study was performed with a follow up at 1 and 8 years among nurses employed by a large university hospital in Switzerland. A modified version of the Nordic Questionnaire was distributed to obtain information about demographic data, occupational activities, and various aspects of LBP. A clinical examination and several functional tests were used to overcome the problems associated with subjective pain reporting. Nurses having answered the questionnaire on all three occasions (n = 269) were classified into subgroups according to their pain intensity. For each subgroup the course of LBP was recorded. RESULTS: LBP was highly prevalent with an annual prevalence varying from 73% to 76%. A large percentage (38%) indicated the same intensity of LBP on all three occasions. The proportion of nurses reporting repeated increase of LBP (19%) was approximately as large as the proportion who complained about repeated decrease of LBP (17%). CONCLUSION: It became evident that LBP poses a persistent problem among nurses. Over an eight year period almost half of the nurses indicated the same intensity of LBP, thus supporting a recurrent rather than a progressive nature of LBP.

Continuous, intermitted and sporadic motor unit activity in the trapezius muscle during prolonged computer work.

The Cinderella hypothesis postulates the continuous activity of specific motor units (MUs) during low-level muscle contraction. The MUs may become metabolically overloaded, with the subject developing muscle pain and strain. The hypothesis requires MUs that are active for a time long enough to actually damage muscle fibers. The aim of this study was to determine if there are continuously active MUs in the right trapezius muscle during normal computer work using a computer mouse. Fourteen healthy subjects executed an interactive computer-learning program (ErgoLight) for 30 min. Six-channel intramuscular EMG and two-channel surface EMG signals were recorded from two positions of the trapezius muscle. Decomposition was achieved with automated, multi-channel, long-term decomposition software (EMG-LODEC). In two out of the 14 subjects, three MUs were continuously active throughout the 30 min. Although the majority of the MUs were active during only part of the experimental session, an ordered on-off behavior (e.g. substitution) pattern was not observed. As long-lasting activity was verified in some subjects, the results support the Cinderella hypothesis. However, it cannot be concluded here how long the MUs could stay active. If continuous activity overloads low threshold MUs, the potential exists for selective fibre injuries in low threshold MUs of the trapezius muscle in subjects exposed to long-term computer work.

Motor-unit activity in the trapezius muscle during rest, while inputting data, and during fast finger tapping.

The Cinderella hypothesis postulates the continuous activity of specific motor units during low-level muscle contraction and contradicts the concept of motor-unit substitution. Constant trapezius muscle activity has been reported in typical visual-display-unit-related tasks. If it can be shown that constant muscle activity can be caused by the continuous firing of single motor units, this could explain the frequent complaints of muscular neck pain reported by computer users. The present study was undertaken to investigate motor-unit activity in the trapezius muscle during resting with closed eyes, while inputting three-digit numbers with auditory presentation at a rate of 0.5 Hz, and while tapping on a key with the right index finger at a rate of 5 Hz. Electrodes with four fine wires were inserted into the right upper trapezius muscle of six healthy subjects, and three-channel intramuscular electromyography was recorded. The decomposition programme MAPQuest, developed to analyse short-term one-channel signals, was complemented with MAPView, a programme that merges the short-term results of 10 s to a 3-min analysis. The results showed that activity in the trapezius muscle was induced in one subject while resting, in two subjects while inputting data, and in five subjects while finger tapping. Long-lasting single motor-unit firing was observed in two subjects while inputting data and in one subject while finger tapping. Whilst our findings may support the Cinderella hypothesis, the measurement periods are too short to confirm it fully, and for further discussion it is necessary to record and analyse for longer periods.

Co-activity of the trapezius and upper arm muscles with finger tapping at different rates and trunk postures.

In the context of finding a model that describes the pathophysiological mechanisms leading to muscle pain at low-intensity repetitive work, in this study we investigated whether a simplified finger motor task that requires little mental demand can cause increased muscle activity in the upper arms and neck, and examined the impact of the variation of two parameters, finger tapping rate and body posture. Using the 5th and 95th percentiles from the surface electromyogram of six muscles of the fingers, upper arm and neck, we determined the static and dynamic components of the muscle activity. Correlation methods were used to find a component in the muscle activity that originated from the rhythm of the finger tapping. Further investigations included tapping steadiness and finger force. It was found that in many, but not all subjects, low or even high activity was constantly present in the upper arm and trapezius muscles, sometimes even during relaxation. Fast tapping and a forward-leaning body posture caused considerable increases, while a slightly reclined posture helped to reduce co-activity. However, motor control patterns varied strongly between individuals. Since certain subjects showed no co-activity at all we can assume that trapezius and upper-arm activation is not necessarily required for the completion of a task similar to ours. This may explain why some VDU users develop work-related musculoskeletal disorders while others remain healthy.

Isopropanol and methylformate exposure in a foundry: exposure data and neurobehavioural measurements.

OBJECTIVES: The aim of this study was to determine the dose-effect relationship between solvent exposure and acute neurobehavioural effects at the worksite. METHODS: In a balanced design, ten workers in a Swiss foundry were monitored for 15 days at ten different times during work. Urine samples were taken in the morning and at the time of examination, and personal exposure to isopropanol and methylformate was measured with active samplers. Neurobehavioural tests such as postural balance (bipedal, bipedal blind, monopedal), simple reaction time and digit span of the Neurobehavioural Evaluation System (NES2) and a combined memory and reaction-time test, the combi-test, were performed. A rating of well-being, and the last consumption of alcohol, caffeine, nicotine and medication were reported. RESULTS: Average environmental concentrations of isopropanol were at 44 ppm ( +/- 16 ppm), and at 36 ppm (+/-21 ppm) for methylformate. Maximum values of personal exposure to isopropanol reached barely the maximal allowable concentration (MAC) value (400 ppm); the methylformate personal exposure of three workers exceeded the MAC value (100 ppm). Urine concentrations of methanol were high (3.1 +/- 2.3 mg/l in the morning, 7.8 +/- 4.9 mg/l after exposure) compared with the results of other studies; concentrations of isopropanol were rather low (0.88 +/- 0.73 mg/l after exposure). CONCLUSIONS: Nevertheless, between personal exposure and biomonitoring, linear correlation was found. Methylformate exposure correlated with methanol and formic acid concentration in the urine, and isopropanol exposure with its concentration in the urine. With the neurobehavioural tests used, no solvent effect in relation to the dose could be determined.

Experimental exposure to methylformate and its neurobehavioral effects.

OBJECTIVES: The aim of the study was to investigate the acute effects of experimental methylformate exposure on the nervous system. METHODS: In an exposure chamber, 20 subjects were exposed to methylformate at 100 ppm [Swiss maximum allowable concentration (MAC)] for 8 h. The same number of subjects with the same ages (between 20 and 30 years), gender and education level (university) were examined by the same procedure as a control group. The subjects did not know if they were exposed or not. Three times (morning, noon, evening) during these 8 h, mood [Profile of Mood States (POMS)], neurobehavioral performance (reaction, Stroop, nonverbal learning, determination, tracking; Wiener Test System), vision (visual acuity, contrast sensitivity, color sensitivity) and postural sway were tested. During an undemanding test (POMS) and a demanding performance task (determination test), pulse, electromyography (EMG) of the forehead and of the neck were recorded. In the morning and evening spirometry [forced vital capacity (FVC), forced one-second expiration volume (FEV), medium expiration flow (MEF) and peak expiration flow (PEF)] and the odor perception threshold were measured. RESULTS: In the evening, in the exposed group, fatigue was significantly increased and the EMG of the forehead during a demanding task showed a different development during exposure. The other tests showed no significant solvent effect, but 16 of 43 test parameters showed a significant effect of time. CONCLUSIONS: The results of this study indicate a possible effect of methylformate exposure on the subjective feeling of fatigue after 8 h exposure at 100 ppm in young and healthy subjects, without measurable impairment of neurobehavioral performance. We assume that a similar effect in normal work, combined with a heavy workload and shift work, can lead to an impairment of productivity, and increase the risk of accidents.

Urinary methanol and formic acid as indicators of occupational exposure to methyl formate.

OBJECTIVE: To evaluate the validity of methanol (MeOH) and formic acid (FA) in urine as biological indicators of methyl formate (MF) exposure in experimental and field situations. METHODS: The subjects were 28 foundrymen and two groups of volunteers (20 control and 20 exposed). Exposure assessment of the workers was performed by personal air and biological monitoring. Methyl formate vapour collected on charcoal tube was analysed by gas chromatography. The concentration of MF in the exposure chamber (volunteer-study) was monitored by two independent methods [flame ionisation detection (FID) and Fourier transformation infra-red detection (FTIR)]. Urinary metabolites (MeOH and FA) were analysed separately by headspace gas chromatography. RESULTS: The volunteers exposed to 100 ppm MF vapour at rest for 8 h excreted 3.62 +/- 1.13 mg MeOH/l (mean +/- SD) at the end of the exposure. This was statistically different (P < 0.001) from pre-exposure MeOH excretion (2.15 +/- 0.80 mg/1), or from that of controls (1.69 +/- 0.48 mg/l). The urinary FA excretion was 32.2 +/- 11.3 mg/g creatinine after the exposure, which was statistically different (P < 0.001) from pre-exposure excretion (18.0 +/- 9.3 mg/g creatinine) or that of controls (13.8 +/- 7.9 mg/g creatinine). In foundrymen, the urinary FA excretion after the 8 h workshift exposure to a time weighted average (TWA) concentration of 2 to 156 ppm MF showed a dose-dependent increase best modelled by a polynomial function. The highest urinary FA concentration was 129 mg/g creatinine. The pre-shift urinary FA of the foundrymen (18.3 +/- 5.6 mg/g creatinine) did not differ from that of controls (13.8 +/- 7.9 mg/g creatinine). The urinary MeOH excretion of the foundrymen after the shift, varied from < 1 to 15.4 mg/l, while the correlation with the preceding MF exposure was poor. The foundrymen excreted more (P = 0.01) FA (2.12 +/- 3.56 mg/g creatinine) after the workshift than experimentally, once-exposed volunteers (0.32 +/- 0.11 mg/g creatinine) at a similar inhaled MF level of 1 ppm). CONCLUSIONS: In spite of its high background level in non-exposed subjects, urinary FA seems to be a useful biomarker of methyl formate exposure. The question remains as to what is the reason for the differences in chronic and acute exposure respectively.

Neurobehavioural effects of experimental isopropanol exposure.

OBJECTIVES: The study investigated the acute effects of isopropanol exposure at the maximum allowable concentration (MAC) level on the performance of neurobehavioural functions. METHODS: In an exposure chamber 20 healthy subjects aged between 21 and 30 years were exposed to isopropanol at a concentration of 400 ppm (Swiss MAC value) for 8 h. A control group of another 20 subjects of the same age range, gender and education as used in a previous study with methylformate were subjected to the same test procedures without exposure. Mood was measured with the profile of mood states (POMS) in the morning, at noon and in the evening. Neurobehavioural performance tests were administered using the Wiener Test System (Wiener reaction test, Stroop, nonverbal learning, Wiener determination test, "Konturtracking" test), and the digit span test of the Neurobehavioural evaluation system (NES2). A test for postural sway was also conducted. During the POMS and the Wiener determination test the electromyography of the forehead and the left neck muscle as well as the pulse were registered. In the morning and evening spirometry (FVC, FEV, MEF and PEF) and odour threshold were measured. RESULTS: Only postural sway in bipedal standing at noon showed stronger deterioration in the exposed than in the control group when compared with the morning values. The evening values of monopedal standing were also more impaired in the exposed than the control group. In the other tests, no solvent effect could be established. CONCLUSIONS: It can be assumed, that, similar to other alcohols, isopropanol affects postural balance. Our results point to such a disturbance, but because it is the only study so far using the MAC value, any conclusions about safety risks would be premature.

Effects of a low alcohol dose on static balance, fine motor activity, and mental performance.

The effects of a single low alcohol dose (men 0.54 g and women 0.44 g alcohol per kg body weight) were measured by static balance, fine motor activity, and mental performance. In 10 healthy volunteers balance was registered by a temporally and spatially high resolution platform measuring the center of foot pressure and a three-dimensional coordination measurement system. Fine motor activity and mental performance were tested with selected experiments from the NES2 (Neurobehavioral Evaluation System) neuropsychological test battery. Changes of bipedal and monopedal balance could be detected after the alcohol consumption. Neither the fine motor activity nor the mental performance test demonstrated significant effects. Thus, the static balance test proved to be a sensitive, fast, and atraumatic method to identify slight neurotoxic disturbances.

Design of check-out systems including laser scanners for sitting work posture.

Forty-six laser scanner operators were compared with 106 cashiers operating conventional cash registers. The influence of job rotation on the two groups was evaluated, and several design features were examined. For this purpose the prevalence of musculoskeletal disorders was determined by means of a questionnaire and a physical examination. In addition, a three-dimensional movement analysis system was employed. Work postures were analyzed with the Ovako working analysis system. The results indicate that a beneficial effect on the musculoskeletal system is achieved by combining the operation of a laser scanner with job rotation. The study also points out the need for better equipment, including flat scanners and smaller keyboards, and a change in the angle between the scanner and the take-off belt running up to the cashier.

[Assessment of musculoskeletal disorders using a questionnaire]. / Erfassung muskuloskeletaler Beschwerden mittels Fragebogen.

The standardized illustrated questionnaire on musculoskeletal disorders of the Japanese Committee on Occupational Cervico-branchial Disorders was translated into German. This questionnaire, composed of 37 items about the occurrence (never/seldom, occasionally, almost daily) of symptoms (pain, stiffness, fatigue) in twelve body regions, was used together with medical examinations (pressure points), and further information was gathered on the consumption of analgetics and medical visits prompted by musculoskeletal symptoms. The questionnaire's reliability and validity were tested in 644 persons from twelve occupational groups within the service sector. Factor analysis showed that symptoms can be grouped into four distinct regions of occurrence: neck/shoulder/area, back/low back, and both left and right upper extremities. Indices based on these regions are consistent (Cronbach alpha approximately 0.8). Palpation findings steadily increase with increasing index values. The consumption of medicaments and medical visits positively correlate with the indices. Consequently the questionnaire is judged to be a valid instrument for studying musculoskeletal disorders at the workplace.

[National Research Program. Part B: Chronicity of backache]. / Nationales Forschungsprogramm. 26 Teil B: Chronifizierung von Rückenschmerzen.

The main goal of part B of the National Research Program No 26 is to investigate the process leading to chronic low back pain. Starting from epidemiological facts the main risk factors are described from a systemic viewpoint. The rapid increase of disabling low back pain in the past decades makes it clear that factors outside the spine have to be made responsible for this process. There are changes in life-style and interpersonal relations, as well as in society and the health-care system. From these factors means of prevention are derived. Besides psychological factors general fitness and the training condition of the back muscles play an important role in effective prevention.