A biomechanical analysis of anterior load carriage.

Front load carriage is a common occupational task in some industries (e.g. agriculture, construction), but, as compared to lifting tasks, relatively little research has been conducted on the biomechanical loading during these activities. The focus of this study was to explore the low back biomechanics during these activities and, specifically, to examine the effects of load height and walking speed on trunk muscle activity and trunk posture. Eleven male participants participated in two separate front load-carriage experiments. The first experiment called for carrying a barbell (with weight corresponding to 20% of elbow flexion strength) at three heights (knuckle height, elbow height and shoulder height) at a constant horizontal distance from the spine. The second experiment called for participants to carry a bucket of potatoes weighing 14 kg at the same three heights, but with no further restrictions in technique. In both experiments, the participants performed this task while either standing still or walking at a self-selected speed. As they performed these tasks, the activity levels of the right-side muscle of the rectus abdominis, external oblique, biceps brachii, anterior deltoid and three levels (T9, T12 and L3) of the erector spinae were sampled. Mid-sagittal plane trunk posture was also quantified using three magnetic field-based motion sensors at T9, T12 and L3. The results showed a significant effect of both walking speed and load height on trunk posture and trunk muscle activity levels in both the barbell and bucket experiments. In the barbell experiment, the walking trials generated 43% more trunk muscle activity than the standing trials. Trials at shoulder height produced 11% more muscle activity than trials at elbow height in the T9 erector spinae muscles and 71% more muscle activity in the anterior deltoid. In the bucket experiment, trunk muscle activity responded in a similar fashion, but the key result here was the quantification of the natural hyperextension posture of the spine used to balance the bucket of potatoes. These results provide insight into muscle activation patterns in dynamic settings, especially (load) carrying biomechanics, and have implications in industrial settings that require workers to carry loads in front of their bodies.

A field evaluation of monitor placement effects in VDT users.

Appropriate visual display terminal (VDT) location is a subject of ongoing debate. Generally, visual strain is associated with higher placement, and musculoskeletal strain is associated with lower placement. Seeking resolution of the debate, this paper provides a comparison of results from previous lab-based monitor placement studies to recommendations and outcomes from viewing preference and neutral posture studies. The paper then presents results from a field study that addressed two outstanding issues: Does monitor placement in a workplace elicit postures and discomfort responses similar to those seen in laboratory settings? Results showed placements in the workplace elicited postures similar to those in lab studies. Additionally, preferred VDT location generally corresponded to the location in which less neck discomfort was reported, though that trend requires further investigation. Overall, there seems to be consistent evidence to support mid-level or somewhat higher placement, as a rule-of-thumb, considering preferred gaze angle and musculoskeletal concerns. However, optimal placement may be lower for some individuals or tasks.

The use of mirrors during an assembly task: a study of ergonomics and productivity.

Industrial assembly tasks often require awkward, sustained neck and/or shoulder postures that can lead to increased musculoskeletal discomfort and reduced productivity. The aim of this study was to investigate the effects of mirror and periscope visual aids as ergonomic interventions designed to eliminate awkward postures of the cervicobrachial region during assembly tasks. Participants simulated a simple assembly task by using a cordless screwdriver to drive screws into a pre-tapped aluminium block. Trials of 15 min were run for each of four distinct assembly workstation configurations: industry standard (in-line screwdriver, work at elbow height, no visual aid); pistol grip (pistol grip screwdriver, work at shoulder height, no visual aid); mirror (in-line screwdriver, work at elbow height, single mirror visual aid); and periscope (in-line screwdriver, work at elbow height, two-mirror visual aid system). Muscular activity, discomfort, body posture, productivity and operator subjective assessment were recorded to determine the effects of the visual aid interventions. The results show that when comparing the interventions to the industry standard condition, there was a 45% reduction in average cervical erector spinae activity, a 90% reduction in average neck flexion angle and a 72% reduction in neck discomfort with the interventions. When comparing these interventions to the pistol grip condition there was an 80% reduction in activity of the dominant side deltoid, a 92% reduction in shoulder flexion angle and an 81% decrease in shoulder discomfort with the interventions. Productivity was greatest in the industry standard configuration followed by the pistol grip (9% lower), the periscope (13% lower) and the mirror (23% lower) configurations. A follow-up study that compared the productivity of the periscope configuration with that of the industry standard configuration showed that within a 4-h work period this productivity differential decreased by over 33%.

Effects of semi-rigid arch-support orthotics: an investigation with potential ergonomic implications.

For many years, arch-support orthotics have been prescribed for individuals with discomfort and/or abnormal skeletal alignments in the structures of the lower extremity. Recently there has been an increased interest in promoting semi-rigid orthotics as an ergonomic aid for asymptomatic workers who must stand all day at their workplace. A laboratory study was performed to assess the biomechanical impact of prefabricated semi-rigid orthotics on asymptomatic individuals. Ten subjects wore semi-rigid arch-support orthotics (experimental condition) for two months and flexible polyurethane/Sorbothane shoe inserts (control condition) for two months. Throughout this 18-week testing period, the subjects returned to the lab to perform a battery of assessment tests at regularly scheduled intervals. These tests examined subject strength, standing posture, stability, fatigue effects, and body part discomfort. The results of this study showed no significant changes in the strength, posture, or stability as a function of insert type. The subjects reported a reduction in low-back discomfort along with an increase in foot discomfort during a fatiguing exertion task while wearing the semi-rigid orthotics as compared to the control condition.

Continuous assessment of back stress (CABS): a new method to quantify low-back stress in jobs with variable biomechanical demands.

Jobs with a high degree of variability in manual materials handling requirements expose limitations in current low-back injury risk assessment tools and emphasize the need for a probabilistic representation of the biomechanical stress in order to quantify both acute and cumulative trauma risk. We developed a hybrid assessment methodology that employs established assessment tools and then represents their evaluations in a way that emphasizes the distributions of biomechanical stress. Construction work activities in the home building industry were evaluated because of the high degree of variability in the manual material handling requirements. Each task was evaluated using the Revised NIOSH Lifting Equation, The University of Michigan Three-Dimensional Static Strength Prediction Program, and the Ohio State University Lumbar Motion Monitor Model. The output from each model was presented as time-weighted histograms of low-back stress, and the assessments were compared. The results showed considerable differences in what were considered high-risk activities, indicating that these 3 assessment tools consider the risk of low-back injury from different perspectives. The time-weighted distribution aspect of this methodology also contributed vital information toward the identification of high-risk activities. These results illustrate the necessity for more advanced low-back injury risk assessment techniques for jobs with highly variable manual materials handling requirements.

An empirical approach to characterizing trunk muscle coactivation using simulation input modeling techniques.

Accurately describing trunk muscle coactivation is fundamental to quantifying the spine reaction forces that occur during lifting tasks and has been the focus of a great deal of research in the spine biomechanics literature. One limitation of previous approaches has been a lack of consideration given to the variability in these coactivation strategies. The research presented in this paper is an empirical approach to quantifying and modeling trunk muscle coactivation using simulation input modeling techniques. Electromyographic (EMG) data were collected from 28 human subjects as they performed controlled trunk extension exertions. These exertions included isokinetic (10 and 45 degrees /s) and constant acceleration (50 degrees /s/s) trunk extensions in symmetric and asymmetric (30 degrees ) postures at two levels of trunk extension moment (30 and 80Nm). The EMG data were collected from the right and left pairs of the erector spinae, latissimus dorsi, rectus abdominis, external obliques and internal obliques. Each subject performed nine repetitions of each combination of independent variables. The data collected during these trials were used to develop marginal distributions of trunk muscle activity as well as a 10x10 correlation matrix that described how the muscles cooperated to produce these extension torques. These elements were then combined to generate multivariate distributions describing the coactivation of the trunk musculature. An analysis of these distributions revealed that increases in extension moment, extension velocity and sagittal flexion angle created increases in both the mean and the variance of the distributions of the muscular response, while increases in the rate of trunk extension acceleration decreased both the mean and variance of the distributions of activity across all muscles considered. Increases in trunk asymmetry created a decrease in mean of the ipsi-lateral erector spinae and an increase in the mean of all other muscles considered, but there was little change in the variance of these distributions as a function of asymmetry.

Transverse-contour modeling of trunk muscle-distributed forces and spinal loads during lifting and twisting.

STUDY DESIGN: An electromyography-assisted biomechanical model was developed using electromyographic (surface and in-dwelling) data collected during asymmetric lifting and twisting activities. OBJECTIVES: To develop a biomechanical model of the lumbar region that considers the ability of the broad, flat muscles of the trunk (external obliques, internal obliques and latissimus dorsi) to activate different anatomic regions at different intensity levels and then uses this information to describe the spine reaction forces that result during lifting and twisting tasks. SUMMARY OF BACKGROUND DATA: Many biomechanical models of the lumbar region use single-vector representations for the external oblique, internal oblique, and latissimus dorsi muscles. This simplification limits the description of the complexity of the resultant forces produced by these muscles and does not consider their differential activation capacity. METHODS: Human subjects performed lifting and twisting exertions while muscle electromyographic activities were sampled at one location on the rectus abdominis and erector spinae muscles and at multiple locations on the latissimus dorsi, external oblique, and internal oblique muscles. These data were used in conjunction with in vivo digitized muscle origin and insertion points to predict muscle forces and spine loads through the use of the electromyography-assisted modeling method. RESULTS: The measures of model performance such as percentage of error (6-21%) in the prediction of the external torques, correlations (0.83-0.98) between internal and external torques and the values of predicted muscle force capacity were all similar to data collected in previous electromyography-assisted models, but the predictions of spinal loading, particularly shear forces, were quite different. The results have shown that by modeling the broad, flat muscles of the torso using multiple-force vectors, the calculated shear forces in the spine were reduced. CONCLUSIONS: The multivector, transverse-contour model developed in this research illustrates the importance of realistic multiple-vector modeling and the importance of considering the selective-activation capacity of the abdominal oblique musculature.

The effect of personality type on muscle coactivation during elbow flexion.

A great deal of interest has been generated recently regarding the influence that psychosocial factors may have on the reporting of and disability associated with work-related musculoskeletal disorders. The current study considers the potential influence of one psychosocial factor--personality type--on basic neuromuscular control strategies and biomechanical loading. The study investigated the hypothesis that Type A people exhibit increased muscular antagonism relative to their Type B counterparts. Volunteers participated in an EMG-based biomechanical study to investigate the coactivation patterns of the major muscles that span the elbow joint during elbow flexion exertions. Results showed that, averaging across all conditions, the antagonist muscle activity was significantly higher for Type A individuals than for their Type B counterparts (10% of maximum for Type A, 5.5% of maximum for Type B). Although the study was somewhat limited in its size and scope, the results indicate that certain psychosocial factors may be more than a filter in postinjury response and may directly influence biomechanical loading. A potential application of this research is an increased awareness that certain individuals may be at greater risk of developing work-related musculoskeletal disorders.

The effects of video display terminal height on the operator: a comparison of the 15 degree and 40 degree recommendations.

Prolonged use of video display terminals (VDTs) has been shown to be a risk factor for musculoskeletal and visual discomfort. A standard workplace design recommendation is to position the centre of the VDT 15 degrees below horizontal eye level. Recently a viewing angle of 40 degrees below horizontal has been suggested based on studies that have indicated that this is the preferred viewing angle for visually intensive tasks. The goal of this study was to investigate the effects of these two VDT positions on muscular activity, muscular fatigue, head/neck posture, visual acuity, operator performance (productivity and quality), heart rate and operator subjective assessment. The experimental task consisted of reading text from a computer screen and answering reading comprehension questions using a mouse and a keyboard. Each experimental session lasted 2 h. The 40 degree VDT position showed significantly greater head tilt angles and higher muscle activity levels for six of the 10 neck, shoulder and back muscles sampled. No significant differences in visual acuity, operator performance or heart rate were detected as a result of monitor location. Seven of the 12 subjects preferred the 15 degree monitor position.

Intra-abdominal pressure during trunk extension motions.

OBJECTIVE: This study was designed to help interpret the biomechanical role of intra-abdominal pressure during lifting type motions of the trunk. DESIGN: An in vivo study was performed in which intra-abdominal pressure was observed as subject trunks were subjected to different dynamic trunk loading conditions common during industrial lifting. BACKGROUND: There is a little consensus as to the biomechanical role of intra-abdominal pressure during lifting. Previous studies have suggested that: it may assist in load relief when lifting, may be involved in trunk stability, and/or may be used as a measure fo spine loading. Thus, in general, our understanding of intra-abdominal pressure is rather poor. METHODS: In this study intra-abdominal pressure was monitored using a radio pill in 114 subjects over a series of four experiments. Subject's trunks were subjected to different dynamic trunk symmetric and asymmetric trunk loading conditions that are common during industrial lifting tasks. RESULTS: The results indicated that (1) intra-abdominal pressure increased to significant levels (above 10 mmHg) only when more than 54 Nm of trunk torque were supported; (2) intra-abdominal pressure increases monotonically (up to 150 mmHg) as a function of trunk velocity; and (3) under concentric conditions intra-abdominal pressure increases as a function of greater asymmetry, whereas, under eccentric conditions the response changes to a much lesser extent as asymmetry changes. CONCLUSIONS: These findings suggest that intra-abdominal pressure appears to be more a by-product of trunk muscle coactivation. Any mechanical advantage gained from intra-abdominal pressure might be in the form of a preparatory action resulting from muscle coactivation that stiffens the trunk just prior to a rapid trunk extension exertion. This function may reinforce previous hypotheses regarding the stability role of intra-abdominal pressure. RELEVANCE: Intra-abdominal pressure has been observed during lifting for several decades, yet the biomechanical role of intra-abdominal pressure is poorly understood. This study has attempted to describe how intra-abdominal pressure behaves during lifting motions as the components of lifting are changed. The findings place in doubt biomechanical significance of intra-abdominal pressure. Thus, based upon this study, clinicians need not worry about interpreting intra-abdominal pressure, since it appears to be a by-product of muscle contraction and cocontraction.

Electromyographic studies of the lumbar trunk musculature during the generation of low-level trunk acceleration.

An understanding of how the support mechanisms of the spine behave during lifting may yield insight into the loading of the spine under occupational conditions and help shed light on the etiology of low-back disorders. Previous controlled laboratory studies of spinal loadings have been limited to isometric and isokinetic conditions. To evaluate the behavior of the trunk during acceleration, we recorded intra-abdominal pressure and trunk muscle activities during low-level acceleration. Twenty subjects performed controlled accelerations of the trunk under different trunk loading conditions. Muscle activity decreased as acceleration increased; however, the rate of decrease differed among muscles (mean decrease, < or = 1% of maximum per 10 degrees/s2 increase in acceleration), with the activity of the erector spinae muscles decreasing the most (1.88% of the maximum per 10 degrees/s2 increase in acceleration). No changes in intra-abdominal pressure were found as a function of acceleration. Relative coactivation of the muscles increased; however, this was a function of increases in trunk velocity and torque.

A stochastic model of trunk muscle coactivation during trunk bending.

Biomechanical models of the spine have traditionally assumed that workplace lifting conditions (weight, posture, motion, etc.) precisely dictate the magnitude of individual muscle forces necessary to maintain a biomechanical balance within the trunk. However, because there are a large number of muscle groups within the trunk there is also an infinite number of possible combinations of muscle forces that can satisfy this biomechanical balance requirement for a given condition. Currently there are no methods available to predict this possible variability in muscle activity. Such variability in a multiple muscle system can result in variations in spinal loading. To quantitatively capture this trunk muscle variability during bending motions, such as those involved in lifting, a stochastic (probabilistic) model of trunk muscle activation was developed. The model was based on a simulation of experimentally derived data and predicted the possible combinations of time-dependent trunk muscle coactivations that could be expected given a set of trunk bending conditions. These simulated muscle activities were then used as input to an electromyographically assisted biomechanical model so that the magnitude and variability of the spine reaction forces could be estimated. This procedure allows one to assess the range of spinal loads that would be expected with a particular task. Significant variability in muscle activities was observed for each specific lifting condition and explained biomechanically. The results indicated that the variability in trunk muscle force had a small effect on spinal compression variability (+/- 7% of the mean compression), but greatly influenced both lateral (+/- 90% of mean) and anteroposterior shear forces (+/- 40% of mean). A validation study confirmed that the model predictions were reasonable estimates of muscle activity variability under previously untested conditions. This work could help explain how some repetitive lifting motions could increase the risk of acquiring a low back disorder and the simulation model could help drive electromyographically assisted models without the need for recording actual electromyographic activity.

A comprehensive evaluation of trunk response to asymmetric trunk motion.

An experiment was performed to determine the reaction of the trunk muscles, using electromyography, and intra-abdominal pressure to components of trunk loading commonly seen in the workplace during manual materials handling. These components included angular trunk velocity, trunk position in three-dimensional space and trunk torque exertion level. The experiment was performed using 44 subjects. Subjects produced constant trunk extension torque about the lumbosacral junction while moving the trunk under constant angular velocity (isokinetic) conditions. Significant reactions to trunk angular velocity, trunk torque level, and unique combinations of trunk position and velocity were seen in all muscles of the trunk. The other components affected the muscles selectively according to function. Intra-abdominal pressure only reacted significantly to trunk angle and some unique trunk angle-asymmetry positions. The biomechanical implications of these findings are discussed. The reactions of the muscles to the various workplace components also were described quantitatively through equations that predict muscle activity levels.

The quantification of EMG normalization error.

Electromyography (EMG) and normalized EMG have been accepted as methods of quantifying the activity level of a muscle. Normalized EMG, in conjunction with the EMG/force relationship and muscle cross-sectional area data, allows researchers to estimate the amount of muscle force exerted across a joint. An accurate description of this muscle force is a critical input to models designed to describe the risk of injury of a task. In order to be able to make statements about the relative intensity of an EMG signal, researchers who use normalization procedures take a given EMG activity level, at a known joint angle, and relate it to some reference activity level obtained at that particular joint angle. However, there have been studies where the EMG activity of an unrestricted dynamic task, such as walking, cycling, performing an occupational task, etc., has been normalized with respect to an EMG value taken during a single maximum voluntary contraction performed at one reference joint angle. This practice will render inaccurate results because at different joint angles there are changes in the portion of the muscle within the viewing area of the electrode, as well as changes in the length/tension relationship of the muscle which would cause changes in the maximum EMG value. The present study was an attempt to quantify the errors associated with normalization relative to a reference EMG value collected at an arbitrary joint position. Four subjects performed a series of controlled trunk extension exertions. As they performed these exertions the EMG activities were collected for eight trunk muscles. The task EMG values that resulted were then: (1) all normalized with respect to the maximum EMG at a single arbitrary trunk angle and (2) each normalized with respect to that specific trunk angle's maximum EMG. The results show that for the primary trunk extensors (erector spinae) large errors (greater than 75%) resulted from normalization using a single reference point and the magnitude of these errors followed consistent patterns within subjects as a function of trunk angle.

Muscle activities during asymmetric trunk angular accelerations.

The objective of this study was to characterize trunk muscle and intra-abdominal pressure behavior during extensions of the trunk when angular trunk acceleration levels and trunk twist were varied during lifting exertions. Since force is related to acceleration, it was believed that changes in trunk acceleration would cause activity changes in the muscles and abdominal cavity pressurization mechanics that load the spine during manual materials handling tasks. The electromyographic activity of 10 trunk muscles and intra-abdominal pressure were studied in 39 subjects as they moved their trunks under high, medium, and low constant angular acceleration conditions. The results indicated that almost all the muscles were affected by acceleration and asymmetry. Muscle activities of up to 50% of maximum were observed even though a minimal amount of torque was being produced by the back. Coactivation of muscles was also apparent. Muscles located at the greatest distances from the spine, such as the latissimus dorsi and oblique groups, increased their activities the most as trunk acceleration increased. Muscles located farthest from the spine also played an important role as the trunk became more asymmetric. Intra-abdominal pressure changed minimally over the test conditions. The nature of these responses and their impact on spine loading are discussed.

Lumbar motion response to a constant load velocity lift.

An experiment was performed to evaluate the motions of the lumbar spine during a constant load velocity lift. For the purposes of this study, a constant load velocity refers to the linear vertical velocity of the load. This vertical load velocity was controlled using a modified angular isokinetic dynamometer, which produced linear isokinetic motion during a lift. A lumbar monitor was used to observe the position, velocity, and acceleration changes that occurred in the lumbar spine during the lifting task. The results indicate that under constant load velocity conditions, significant angular accelerations occur at the lumbar level. The nature of these accelerations was found to depend on several variables associated with a lifting task, such as the load velocity and the asymmetry of the lift. The physical significance of these results would be increased spinal loading above that which would be predicted using a static model.

Trunk strength during asymmetric trunk motion.

It is important to understand how trunk strength varies as a function of workplace factors so that the work environment can be designed to minimize the risk of low back injury. In this study maximal trunk torque production around the lumbosacral junction was measured in 44 subjects as trunk concentric and eccentric isokinetic velocity and trunk asymmetric line of action were varied. Trunk torque decreased by approximately 8.5% of maximum for every 15 deg of asymmetric trunk angle. Increases in concentric velocity decreased trunk strength, whereas increases in eccentric trunk velocity increased strength. Significant interactions were also found, and it was determined that the common finding that eccentric strength exceeds concentric strength is true only for forward trunk angles at all asymmetric angles. These results should have significant implications for the design of manual materials handling tasks.

The effects of preview and task symmetry on trunk muscle response to sudden loading.

The effect of warning time (preview) and task symmetry on the trunk muscular response to sudden loading conditions was investigated. Eleven subjects were asked to catch falling weights with four levels of preview (0, 100, 200, and 400 ms) in saggitally symmetric posture and asymmetric posture. For each of the eight muscles sampled with surface electrodes, the integrated electromyographic (EMG) signal was interpreted in terms of its peak value, mean value, onset rate, and lead/lag time with reference to the weight drop. Results show linear relationships between preview times and peak EMG, preview times and mean EMG, and preview times and lead times. The results show significant change when going from symmetric to asymmetric conditions across most dependent measures. Analysis of peak changes in compression were performed across all conditions but yielded unexpected results.