Surface electromyographic frequency characteristics of the quadriceps differ between continuous high- and low-torque isometric knee extension to momentary failure.

Surface EMG (sEMG) has been used to compare loading conditions during exercise. Studies often explore mean/median frequencies. This potentially misses more nuanced electrophysiological differences between exercise tasks. Therefore, wavelet-based analysis was used to evaluate electrophysiological characteristics in the sEMG signal of the quadriceps under both higher- and lower-torque (70 % and 30 % of MVC, respectively) isometric knee extension performed to momentary failure. Ten recreationally active adult males with previous resistance training experience were recruited. Using a within-session, repeated-measures, randomised crossover design, participants performed isometric knee extension whilst sEMG was collected from the vastus medialis (VM), rectus femoris (RF) and vastus lateralis (VL). Mean signal frequency showed similar characteristics in each condition at momentary failure. However, individual wavelets revealed different frequency component changes between the conditions. All frequency components increased during the low-torque condition. But low-frequency components increased, and high-frequency components decreased, in intensity throughout the high-torque condition. This resulted in convergence of the low-torque and high-torque trial wavelet characteristics towards the end of the low-torque trial. Our results demonstrate a convergence of myoelectric signal properties between low- and high-torque efforts with fatigue via divergent signal adaptations. Further work should disentangle factors influencing frequency characteristics during exercise tasks.

A comparison between measured female linear arm strengths and estimates from the 3D Static Strength Prediction Program (3DSSPP).

This study performed a direct comparison between empirically measured female linear arm strengths and those estimated with the 3D Static Strength Prediction Program (3DSSPP). Linear arm strengths were collected from 15 female participants, at four hand locations and six primary directions (n = 360), and then estimated with 3DSSPP incorporating each participant's own segment lengths, body masses and joint strengths, and the measured arm postures from each trial to optimize the accuracy of 3DSSPP. In spite of this, the errors in 3DSSPP's estimated arm strength values were very high (RMS error = 56.0 N and 40.4%) and poorly correlated (r2 = 29.2%) with measured strengths. These results seriously question the accuracy of 3DSSPP to estimate female linear arm strengths and percent capable values, for the range of conditions tested, likely due to the overly simplified assumptions made to estimate triaxial shoulder strength.

The Liberty Mutual manual materials handling (LM-MMH) equations.

We summarise more than 40 years of Liberty Mutual psychophysical research on lifting, lowering, pushing, pulling and carrying, including the 7 studies used to develop the 1991 Liberty Mutual Tables and 12 subsequent studies. Predictive equations were developed based on 612 mean maximum acceptable loads (MALs), representing 388 unique conditions from 123 female and 149 male participants, starting with a maximum reference load that is scaled based on frequency, height, distance (vertical for lift & lower, horizontal for push, pull and carry tasks) and horizontal reach (for lift & lower tasks). Representative coefficients of variation are provided to allow for the calculation of MALs for any percentile. Each equation performed well and, overall, they explained 90% of the variance in MAL values, with RMS differences of 6.7% and 4.8% of the full range for females and males, respectively. We propose that these equations replace the 1991 Liberty Mutual Tables. Practitioner summary: We propose predictive equations to replace the 14 manual materials handling tables in Snook and Ciriello (1991). These equations are based on 12 more publications, matched the empirical data well, are easier to use and allow for both a wider range and more specific inputs than the tables.

The Effect of Functional Knee Braces on Muscular Contributions to Joint Rotational Stiffness in Anterior Cruciate Ligament-Deficient and -Reconstructed Patients.

Functional knee braces are frequently prescribed by physicians to ameliorate the function of individuals with anterior cruciate ligament (ACL) injuries. These braces have been shown in the literature to potentially enhance knee stability by augmenting muscle activation patterns and the timing of muscle response to perturbations. However, very few techniques are available in the literature to quantify how those modifications in lower-limb muscle activity influence stability of the knee. The aim of the present study was to quantify the effect of an off-the-shelf functional knee brace on muscle contributions to knee joint rotational stiffness in ACL-deficient and ACL-reconstructed patients. Kinematic, electromyography, and kinetic data were incorporated into an electromyography-driven model of the lower extremity to calculate individual and total muscle contributions to knee joint rotational stiffness about the flexion-extension axis, for 4 independent variables: leg condition (contralateral uninjured, unbraced ACL injured, and braced ACL injured); knee flexion (5°-10°, 20°-25°, and 30°-35°); squat stability condition (stable and unstable); and injury status (ACL deficient and ACL reconstructed). Participants had significantly higher (P < .05, η2 = .018) total knee joint rotational stiffness values while wearing the brace compared with the control leg. A 2-way interaction effect between stability and knee flexion (P < .05, η2 = .040) for total joint rotational stiffness was also found.

The influence of hand location and handle orientation on female manual arm strength.

Accurate estimations of manual arm strength (MAS) are crucial in the evaluation of occupational force demands relative to population capacity. Most current strength predictions assume force application with a vertically oriented handle, but it is unknown how uni-manual force capability changes as a function of handle orientation and hand location. This study evaluated the effect of handle orientation on MAS throughout the reach envelope. Fifteen female participants exerted maximum forces in six directions (i.e. superior, inferior, anterior, posterior, medial, lateral), at five different hand locations, and MAS was measured with the handle oriented at 0° (i.e. horizontal), 45°, 90° (i.e. vertical) and 135°. Handle orientation affected MAS in all but the anterior exertion direction, with significant interactions between hand location and grip orientation existing for the superior and inferior directions. These results suggest that handle orientation is important to consider in future predictive models of manual arm strength.

Muscle fibre activation is unaffected by load and repetition duration when resistance exercise is performed to task failure.

KEY POINTS: Performing resistance exercise with heavier loads is often proposed to be necessary for the recruitment of larger motor units and activation of type II muscle fibres, leading to type II fibre hypertrophy. Indirect measures [surface electromyography (EMG)] have been used to support this thesis, although we propose that lighter loads lifted to task failure (i.e. volitional fatigue) result in the similar activation of type II fibres. In the present study, participants performed resistance exercise to task failure with heavier and lighter loads with both a normal and longer repetition duration (i.e. time under tension). Type I and type II muscle fibre glycogen depletion was determined by neither load, nor repetition duration during resistance exercise performed to task failure. Surface EMG amplitude was not related to muscle fibre glycogen depletion or anabolic signalling; however, muscle fibre glycogen depletion and anabolic signalling were related. Performing resistance exercise to task failure, regardless of load lifted or repetition duration, necessitates the activation of type II muscle fibres. ABSTRACT: Heavier loads (>60% of maximal strength) are considered to be necessary during resistance exercise (RE) to activate and stimulate hypertrophy of type II fibres. Support for this proposition comes from observation of higher surface electromyography (EMG) amplitudes during RE when lifting heavier vs. lighter loads. We aimed to determine the effect of RE, to task failure, with heavier vs. lighter loads and shorter or longer repetition durations on: EMG-derived variables, muscle fibre activation, and anabolic signalling. Ten recreationally-trained young men performed four unilateral RE conditions randomly on two occasions (two conditions, one per leg per visit). Muscle biopsies were taken from the vastus lateralis before and one hour after RE. Broadly, total time under load, number of repetitions, exercise volume, EMG amplitude (at the beginning and end of each set) and total EMG activity were significantly different between conditions (P < 0.05); however, neither glycogen depletion (in both type I and type II fibres), nor phosphorylation of relevant signalling proteins showed any difference between conditions. We conclude that muscle fibre activation and subsequent anabolic signalling are independent of load, repetition duration and surface EMG amplitude when RE is performed to task failure. The results of the present study provide evidence indicating that type I and type II fibres are activated when heavier and lighter loads are lifted to task failure. We propose that our results explain why RE training with higher or lower loads, when loads are lifted to task failure, leads to equivalent muscle hypertrophy and occurs in both type I and type II fibres.

Ratings of perceived fatigue predict fatigue induced declines in muscle strength during tasks with different distributions of effort and recovery.

The purpose of this study was to quantify the relationship between ratings of perceived fatigue (RPF), using a modified Borg CR-10 scale, and muscle fatigue accumulation, as defined by maximal voluntary contraction strength (MVC) declines, during two complex MVC-relative tasks (conditions) that cause muscle fatigue and allow recovery. Nine female participants completed the fatiguing tasks, composed of a series of submaximal, isometric efforts (task plateaus) requiring isometric flexion at the distal interphalangeal joint of the thumb. Significant partial correlations between RPF and MVC, while controlling for task plateau intensity (%MVC), were found in 6/9 participants. A significant linear regression model, explaining 86.2% of the variance in mean MVC decline, was obtained with 3 predictor variables: mean RPF (p < 0.001), Task Plateau (p < 0.001), and the interaction between mean RPF and Task Plateau (RPF × Task Plateau; p = 0.014). The observed linear relationship between RPF and MVC declines, both at the participant and group level support, the use of RPF to estimate the instantaneous fatigue status of the muscle in tasks that allow both muscle fatigue and recovery.

Authors' response: Letter to the Editor concerning OCRA as preferred method in ISO standards on biomechanical risk factors.

We thank Drs. Colombini and Occhipinti for their personal reply to our Discussion Paper (1, 2). We share the overall goal of preventing workplace injuries and welcome a discussion of the ISO process on workplace ergonomics standards; this was the primary aim of the Discussion Paper. We hope that other members of the relevant ISO working groups will also participate in the discussion. However, Drs. Colombini and Occipinti misinterpret our paper. Our aim was not to "addresses the scientific basis of ISO standards on biomechanical risk factors and more specifically the OCRA methodology". The purpose was to point out that "while the ISO process has value, it has also clear limitations when it comes to developing occupational health and safety standards that should be based on scientific principles". It is true that our paper discussed the OCRA method, but only as an example, in a single paragraph. We noted that the OCRA method was promoted as the preferred method by the ISO working group even though there were other risk assessment methods which, at the time (and currently), were at least as scientifically valid (3). The discovery that, while on the ISO working group, Drs. Colombini and Occipinti elevated the risk assessment method that they developed (OCRA) over the other methods, demonstrates one of several limitations of the ISO process, namely, the lack of attention to conflict of interest. Finally, we would like to draw attention to the note by Drs. Colombini and Occhipinti that "the ISO standards in question were actually developed by the working group, as mandated by ISO, over the period 2000‒2004". This long-elapsed time, without an update to the standard, should be a concern for all scientists given the large quantity of quality scientific literature published since then (eg, 3‒6). Fourteen years is well beyond what is recommended in the ISO guidelines. References 1. Colombini D, Occhipinti E. Scientific basis of the OCRA method for risk assessment of biomechanical overload of the upper limb, as preferred method in ISO standards on biomechanical risk factors. Scand J Work Environ Health ‒ online first. https://doi.org.10.5271/sjweh.3746 2. Armstrong T J, Burdorf I A, Descatha A, Farioli A, Graf M, Horie S, Marras W S, Potvin J R, Rempel D, Spatari G, Takala E P, Verbeek J, Violante FS. Scientific basis of ISO standards on biomechanical risk factors. Scand J Work Environ Health ‒ online first. https://doi.org/10.5271/sjweh.3718 3. Takala EP, Pehkonen I, Forsman M, Hansson GA, Mathiassen SE, Neumann WP, Sjøgaard G, Veiersted KB, Westgaard RH, Winkel J. Systematic evaluation of observational methods assessing biomechanical exposures at work. Scand J Work Environ Health. 2010;36:3-24. https://doi.org/10.5271/sjweh.2876 4. Paulsen R, Gallu T, Gilkey D, Reiser R, Murgia L, Rosecrance J. The inter-rater reliability of Strain Index and OCRA Checklist task assessments in cheese processing. Applied Ergonomics. 2015; 51,199-204. https://doi.org/10.1016/j.apergo.2015.04.019 5. Kapellusch JM, Gerr FE, Malloy EJ, Garg A, Harris-Adamson C, Bao SS, Burt SE, Dale AM, Eisen EA, Evanoff BA, Hegmann KT, Silverstein BA, Theise MS, Rempel DM. Exposure-response relationships for the ACGIH threshold limit value for hand-activity level: results from a pooled data study of carpal tunnel syndrome. Scand J Work Environ Health. 2014;40:610-20. https://doi.org/10.5271/sjweh.3456 6. Violante FS, Farioli A, Graziosi F, Marinelli F, Curti S, Armstrong TJ, Mattioli S, Bonfiglioli R. Carpal tunnel syndrome and manual work: the OCTOPUS cohort, results of a ten-year longitudinal study. Scand J Work Environ Health. 2016;42:280-90. https://doi.org/10.5271/sjweh.3566.

Scientific basis of ISO standards on biomechanical risk factors.

Among other purposes, companies and regulatory agencies from around the world often adopt International Standard Organization (ISO) standards to determine acceptable practices, equipment and criteria for preventing occupational injuries and illnesses. ISO standards are based on a consensus among individuals who participate in the process. This discussion paper examines the scientific process for the development of several ISO standards on biomechanical factors, comparing it with processes used by other professional organizations, including scientific committees working on the development of clinical guidelines. While the ISO process has value, it also has clear limitations when it comes to developing occupational health and safety standards that should be based on scientific principles.

A musculoskeletal model to estimate the relative changes in wrist strength due to interacting wrist and forearm postures.

Wrist rotations about one wrist axis (e.g. flexion/extension) can affect the strength about another wrist axis (e.g. radial/ulnar deviation). This study used a musculoskeletal model of the distal upper extremity, and an optimization approach, to quantify the interaction effects of wrist flexion/extension (FE), radial/ulnar deviation (RUD) and forearm pronation/supination (PS) on wrist strength. Regression equations were developed to predict the relative changes in strength from the neutral posture, so that the changes in strength, due to complex and interacting wrist and forearm rotation postures, can be incorporated within future ergonomics assessments of wrist strength.

A motor unit-based model of muscle fatigue.

Muscle fatigue is a temporary decline in the force and power capacity of skeletal muscle resulting from muscle activity. Because control of muscle is realized at the level of the motor unit (MU), it seems important to consider the physiological properties of motor units when attempting to understand and predict muscle fatigue. Therefore, we developed a phenomenological model of motor unit fatigue as a tractable means to predict muscle fatigue for a variety of tasks and to illustrate the individual contractile responses of MUs whose collective action determines the trajectory of changes in muscle force capacity during prolonged activity. An existing MU population model was used to simulate MU firing rates and isometric muscle forces and, to that model, we added fatigue-related changes in MU force, contraction time, and firing rate associated with sustained voluntary contractions. The model accurately estimated endurance times for sustained isometric contractions across a wide range of target levels. In addition, simulations were run for situations that have little experimental precedent to demonstrate the potential utility of the model to predict motor unit fatigue for more complicated, real-world applications. Moreover, the model provided insight into the complex orchestration of MU force contributions during fatigue, that would be unattainable with current experimental approaches.

Physiological responses to incremental, interval, and continuous counterweighted single-leg and double-leg cycling at the same relative intensities.

PURPOSE: We compared physiological responses to incremental, interval, and continuous counterweighted single-leg and double-leg cycling at the same relative intensities. The primary hypothesis was that the counterweight method would elicit greater normalized power (i.e., power/active leg), greater electromyography (EMG) responses, and lower cardiorespiratory demand. METHODS: Graded-exercise tests performed by 12 men (age: 21 ± 2 years; BMI: 24 ± 3 kg/m2) initially established that peak oxygen uptake ([Formula: see text]; 76 ± 8.4%), expired ventilation ([Formula: see text]; 71 ± 6.8%), carbon dioxide production ([Formula: see text]; 71 ± 6.8%), heart rate (HRpeak; 91 ± 5.3%), and power output (PPO; 56 ± 3.6%) were lower during single-leg compared to double-leg cycling (main effect of mode; p < 0.05). On separate days, participants performed four experimental trials, which involved 30-min bouts of either continuous (50% PPO) or interval exercise [4 × (5-min 65% PPO + 2.5 min 20% PPO)] in a single- or double-leg manner. RESULTS: Double-leg interval and continuous cycling were performed at greater absolute power outputs but lower normalized power outputs compared to single-leg cycling (p < 0.001). The average EMG responses from the vastus lateralis and vastus medialis were similar across modes (p > 0.05), but semitendinosus was activated to a greater extent for single-leg cycling (p = 0.005). Single-leg interval and continuous cycling elicited lower mean [Formula: see text], [Formula: see text], [Formula: see text], HR and ratings of perceived exertion compared to double-leg cycling (p < 0.05). CONCLUSIONS: Counterweighted single-leg cycling elicits lower cardiorespiratory and perceptual responses than double-leg cycling at greater normalized power outputs.

The biomechanical demands of manual scaling on the shoulders & neck of dental hygienists.

The purpose of this study was to evaluate the postural and muscular demands placed on the shoulders and neck of dental hygienists when performing a simulated manual scaling task. Nineteen healthy female dental hygienists performed 30-min of simulated manual scaling on a manikin head in a laboratory setting. Surface electromyography was used to monitor muscle activity from several neck and shoulder muscles, and neck and arm elevation kinematics were evaluated using motion capture. The simulated scaling task resulted in a large range of neck and arm elevation angles and excessive low-level muscular demands in the neck extensor and scapular stabilising muscles. The physical demands varied depending on the working position of the hygienists relative to the manikin head. These findings are valuable in guiding future ergonomics interventions aimed at reducing the physical exposures of dental hygiene work. Practitioner Summary: Given that this study evaluates the physical demands of manual scaling, a procedure that is fundamental to dental hygiene work, the findings are valuable to identify ergonomics interventions to reduce the prevalence of work-related injuries, disability and the potential for early retirement among this occupational group.

The 'Arm Force Field' method to predict manual arm strength based on only hand location and force direction.

This paper describes the development of a novel method (termed the 'Arm Force Field' or 'AFF') to predict manual arm strength (MAS) for a wide range of body orientations, hand locations and any force direction. This method used an artificial neural network (ANN) to predict the effects of hand location and force direction on MAS, and included a method to estimate the contribution of the arm's weight to the predicted strength. The AFF method predicted the MAS values very well (r2 = 0.97, RMSD = 5.2 N, n = 456) and maintained good generalizability with external test data (r2 = 0.842, RMSD = 13.1 N, n = 80). The AFF can be readily integrated within any DHM ergonomics software, and appears to be a more robust, reliable and valid method of estimating the strength capabilities of the arm, when compared to current approaches.

Multidirectional manual arm strength and its relationship with resultant shoulder moment and arm posture.

Previous work has quantified manual force capabilities for ergonomics design, but the number of studies and range of conditions tested are limited in scope. Therefore, the aims of this study were to collect seated manual arm strength (MAS) data from 24 females in several unique exertion directions (n = 26) and hand locations relative to the shoulder (n = 8), and to investigate the associations between MAS and shoulder/elbow moments. MAS was generally highest when the direction of force application was oriented parallel to the vector from the shoulder to knuckle, and weakest when oriented orthogonal to that vector. Moderate correlations were found between MAS and: (1) resultant shoulder moment (r = 0.34), (2) resultant moment arms (r = -0.545) and (3) elbow flexion/extension moment (r = 0.481). Our strength data will be used in the development of a comprehensive MAS predictive method, so that strength capabilities can be predicted to help design acceptable tasks in the workplace. Practitioner Summary: This study sought to enhance our understanding of one-handed manual arm strength capabilities for ergonomics task evaluations. Our findings provide researchers and practitioners with manual strength data for off-axis force directions, as well as hand locations not previously measured. These data will contribute to future methods for predicting strength capabilities.

Predicting manual arm strength: A direct comparison between artificial neural network and multiple regression approaches.

In ergonomics, strength prediction has typically been accomplished using linked-segment biomechanical models, and independent estimates of strength about each axis of the wrist, elbow and shoulder joints. It has recently been shown that multiple regression approaches, using the simple task-relevant inputs of hand location and force direction, may be a better method for predicting manual arm strength (MAS) capabilities. Artificial neural networks (ANNs) also serve as a powerful data fitting approach, but their application to occupational biomechanics and ergonomics is limited. Therefore, the purpose of this study was to perform a direct comparison between ANN and regression models, by evaluating their ability to predict MAS with identical sets of development and validation MAS data. Multi-directional MAS data were obtained from 95 healthy female participants at 36 hand locations within the reach envelope. ANN and regression models were developed using a random, but identical, sample of 85% of the MAS data (n=456). The remaining 15% of the data (n=80) were used to validate the two approaches. When compared to the development data, the ANN predictions had a much higher explained variance (90.2% vs. 66.5%) and much lower RMSD (9.3N vs. 17.2N), vs. the regression model. The ANN also performed better with the independent validation data (r(2)=78.6%, RMSD=15.1) compared to the regression approach (r(2)=65.3%, RMSD=18.6N). These results suggest that ANNs provide a more accurate and robust alternative to regression approaches, and should be considered more often in biomechanics and ergonomics evaluations.

Wrist rotations about one or two axes affect maximum wrist strength.

Most wrist strength studies evaluate strength about one axis, and postural deviations about that same axis. The purpose of this study was to determine if wrist posture deviations about one axis (e.g. flexion/extension), or two axes (e.g. flexion/extension and pronation/supination), affect the strength about another axis (e.g. ulnar deviation). A custom-built instrumented handle was used to measure maximum static isometric torque exertions at 18 wrist postures (combinations of flexion/extension, radial/ulnar deviation, and pronation/supination). Ulnar deviation torques were highest when the wrist was in neutral. This pattern was not maintained for the other torque directions; the generated torque tended to be highest when the wrist posture was not neutral. The effects were similar for male and female subjects, although male subjects exerted significantly larger torques in all directions. This study illustrates that there is a complex relationship between wrist posture and maximal wrist torques.

Testing the assumption in ergonomics software that overall shoulder strength can be accurately calculated by treating orthopedic axes as independent.

To predict shoulder strength, most current ergonomics software assume independence of the strengths about each of the orthopedic axes. Using this independent axis approach (IAA), the shoulder can be predicted to have strengths as high as the resultant of the maximum moment about any two or three axes. We propose that shoulder strength is not independent between axes, and propose an approach that calculates the weighted average (WAA) between the strengths of the axes involved in the demand. Fifteen female participants performed maximum isometric shoulder exertions with their right arm placed in a rigid adjustable brace affixed to a tri-axial load cell. Maximum exertions were performed in 24 directions, including four primary directions, horizontal flexion-extension, abduction-adduction, and at 15° increments in between those axes. Moments were computed and comparisons made between the experimentally collected strengths and those predicted by the IAA and WAA methods. The IAA over-predicted strength in 14 of 20 non-primary exertions directions, while the WAA underpredicted strength in only 2 of these directions. Therefore, it is not valid to assume that shoulder axes are independent when predicting shoulder strengths between two orthopedic axes, and the WAA is an improvement over current methods for the posture tested.

A modified version of the three-compartment model to predict fatigue during submaximal tasks with complex force-time histories.

The three-compartment model (3CM) was validated previously for prediction of endurance times by modifying its fatigue and recovery rates. However, endurance times do not typically represent work demands, and it is unknown if the current version of the 3CM is applicable for ergonomics analysis of all occupational tasks. The purpose of this study was to add biological fidelity to the 3CM, and validate the model against a series of submaximal force plateaus. The fatigue and recovery rates were modified to represent graded physiological motor unit characteristics (termed 3CM(GMU)). In nine experiments of submaximal efforts, the 3CM(GMU) produced a root-mean squared difference (RMSD) of 4.1 ± 0.5% MVC over experiments with an average strength loss (i.e., fatigue) of 31.0 ± 1.1% MVC. The 3CM(GMU) model performed poorly for endurance tasks. The 3CM(GMU) model is an improvement for evaluating submaximal force patterns consisting of intermittent muscle contractions of the hand and forearm. PRACTITIONER SUMMARY: We modified an existing fatigue model using known physiological properties in order to predict fatigue during nine different submaximal force profiles; consistent with efforts seen in industrial work. We expect this model to be included in digital human modelling software, for the assessment of repetitive work and muscle fatigue in repetitive tasks. SOCIAL MEDIA Summary: The proposed model has applications for estimating task fatigue in proactive ergonomic analyses of complex force patterns using digital human models.

Working position influences the biomechanical demands on the lower back during dental hygiene.

This investigation monitored the biomechanical demands on the lower back during simulated dental hygiene work. A total of 19 female, registered dental hygienists performed 30 continuous minutes of manual scaling (plaque removal) of a manikin's teeth while seated. We monitored the working location and orientation of the dental hygienists, with respect to the manikin, along with their spine kinematics, spine extensor muscle activities and seat pressure, throughout the 30 min. A clock representation was used to express the working location. The location significantly influenced the dental hygienists' pelvic orientation with respect to the manikin, spine posture, erector muscle activity and pressure distribution. Findings from this study suggest that the prevalence of lower back pain amongst dental hygienists may be directly related to low-level tonic activity of the spine's extensor musculature, and the combined flexed and axially rotated spine postures. Practitioner Summary: Low back pain (LBP) is prevalent in dental hygienists, yet occupational demand on the low back has not been investigated. Posture, muscle activity and seat pressure were monitored. Combined spine rotation and flexion, and tonic activity of the extensor musculature may be related to LBP in dental hygienists.