Shoulder muscular activity in individuals with low back pain and spinal cord injury during seated manual load transfer tasks.

This study aimed to compare the activity of four shoulder muscles in individuals with low back pain (LBP), spinal cord injuries (SCI) and a control group, during one-handed load transfer trials. Nine individuals with minimum one-year of LBP, eleven with thoracic/lumbar SCI and nine healthy controls participated in this study. The activations of anterior deltoid, upper trapezius, infraspinatus and pectoralis major were recorded by surface EMG during one-handed transferring of a cylinder from a home shelve to six spatially distributed target shelves. The integrated EMG values were compared using repeated measure ANOVA. Both LBPs and SCIs had higher anterior deltoid activation and LBPs required more upper trapezius activation than controls (p < 0.05). The spatial position of the targets also significantly influenced demands for these two muscles. The anterior deltoid and upper trapezius in LBP and SCI individuals are under higher demand during occupational load transfer tasks. Practitioner Summary: This study aimed to compare the activation of four shoulder muscles in individuals with low back pain, spinal cord injuries and healthy condition. EMG analysis showed that the injured groups required more upper trapezius and anterior deltoid activation during load transfer tasks, which may predispose them to muscle overexertion.

The effect of bracing availability on one-hand isometric force exertion capability.

Environmental obstructions that workers encounter can kinematically limit the postures that they can achieve. However, such obstructions can also provide an opportunity for additional support by bracing with the hand, thigh or other body part. The reaction forces on bracing surfaces, which are in addition to those acting at the feet and task hand, are hypothesised to improve force exertion capability, and become required inputs to biomechanical analysis of tasks with bracing. The effects of kinematic constraints and associated bracing opportunities on isometric hand force were quantified in a laboratory study of 22 men and women. Analyses of one-hand maximal push, pull and lift tasks demonstrated that bracing surfaces available at the thighs and non-task hand enabled participants to exert an average of 43% more force at the task hand. Task hand force direction deviated significantly from the nominal direction for exertions performed with bracing at both medium and low task hand locations. PRACTITIONER SUMMARY: This study quantifies the effect of bracing on kinematically constrained force exertions. Knowledge that appropriate bracing surfaces can substantially increase hand force is critical to the evaluation of task-oriented strength capability. Force estimates may also involve large off-axis components, which have clear implications for ergonomic analyses of manual tasks.

A study of the difference between nominal and actual hand forces in two-handed sagittal plane whole-body exertions.

Given a task posture, changes in hand force magnitude and direction with regard to joint locations result in variations in joint loads. Previous work has quantified considerable vertical force components during push/pull exertions. The objective of this work was to quantify and statistically model actual hand forces in two-hand, standing exertions relative to the required nominal horizontal and vertical hand forces for a population of widely varying stature and strength. A total of 19 participants exerted force on a fixed handle while receiving visual feedback on the magnitude of force exerted in the required horizontal or vertical direction. A set of regression equations with adjusted R(2) values ranging from 0.20 to 0.66 were developed to define actual hand force vectors by predicting off-axis forces from the required hand force magnitude. Off-axis forces significantly increase the overall magnitude of force exerted in two-hand push/pull and up/down standing force exertions. STATEMENT OF RELEVANCE: This study quantifies and statistically models actual hand forces in two-hand, standing exertions. Inaccuracies in hand force estimates affect the ability to accurately assess task-oriented strength capability. Knowledge of the relationship between nominal and actual hand forces can be used to improve existing ergonomic analysis tools, including biomechanical simulations of manual tasks.

The development of a model to predict the effects of worker and task factors on foot placements in manual material handling tasks.

Accurate prediction of foot placements in relation to hand locations during manual materials handling tasks is critical for prospective biomechanical analysis. To address this need, the effects of lifting task conditions and anthropometric variables on foot placements were studied in a laboratory experiment. In total, 20 men and women performed two-handed object transfers that required them to walk to a shelf, lift an object from the shelf at waist height and carry the object to a variety of locations. Five different changes in the direction of progression following the object pickup were used, ranging from 45° to 180° relative to the approach direction. Object weights of 1.0 kg, 4.5 kg, 13.6 kg were used. Whole-body motions were recorded using a 3-D optical retro-reflective marker-based camera system. A new parametric system for describing foot placements, the Quantitative Transition Classification System, was developed to facilitate the parameterisation of foot placement data. Foot placements chosen by the subjects during the transfer tasks appeared to facilitate a change in the whole-body direction of progression, in addition to aiding in performing the lift. Further analysis revealed that five different stepping behaviours accounted for 71% of the stepping patterns observed. More specifically, the most frequently observed behaviour revealed that the orientation of the lead foot during the actual lifting task was primarily affected by the amount of turn angle required after the lift (R(2) = 0.53). One surprising result was that the object mass (scaled by participant body mass) was not found to significantly affect any of the individual step placement parameters. Regression models were developed to predict the most prevalent step placements and are included in this paper to facilitate more accurate human motion simulations and ergonomics analyses of manual material lifting tasks. STATEMENT OF RELEVANCE: This study proposes a method for parameterising the steps (foot placements) associated with manual material handling tasks. The influence of task conditions and subject anthropometry on the foot placements of the most frequently observed stepping pattern during a laboratory study is discussed. For prospective postural analyses conducted using digital human models, accurate prediction of the foot placements is critical to realistic postural analyses and improved biomechanical job evaluations.

The effects of insertion method and force on hand clearance envelopes for rubber hose insertion tasks.

OBJECTIVE: The aim of this study was to determine how hand space for manual insertion of flexible hoses is affected by insertion method and force. BACKGROUND: Adequate space is needed during assembly tasks in which workers join parts together with their hands. Hose installations are an example of such a task. Hand clearance envelopes for insertion tasks that involve cylindrical objects, such as a hose, are currently unavailable in the literature. METHODS: Participants inserted a flexible 25-mm rubber hose onto a stationary flange using simulated methods similar to those observed in field studies of automotive assembly tasks. Markers placed on the back of the hand and wrists were used to measure postures during the insertion task. RESULTS: Hand clearance envelopes for high-force insertions were significantly larger across methods by an average of 15% for both male (p < .05) and female (p < .01) participants. Rocking insertions resulted in the largest hand clearance envelopes compared with other insertion methods. Rocking and twisting the hose resulted in mean increases in the cross-sectional area of the hand clearance envelopes of 35% and 24%, respectively, compared with the straight push. Differences were significant (p < .05) for male and female participants for both bead height conditions. CONCLUSION: Both required insertion force and method affect hand clearance envelopes during simulated insertions. APPLICATION: These methods can be used by engineers to determine if there is adequate clearance for the hand to grip selected objects.

The evolving role of biomechanics in prevention of overexertion injuries.

This paper describes occupational biomechanics as an evolving body of knowledge that has required not only a sophisticated development of fundamental biomechanical principles and human failure data, but also has required epidemiological information to enable a more complete understanding of how certain types of musculoskeletal injuries can be caused by specific physical work requirements. It also is argued that even with adequate biomechanical and epidemiological information, the ability to change working conditions and manual task requirements in companies required management and workers to become organised into formal ergonomics teams that could be trained and empowered to reduce the known biomechanical risk factors present in various jobs. It is demonstrated that in the last 35 years occupational biomechanics research continues to provide the intellectual machine that is driving the development of important ergonomics guidelines. Despite these successes, however, some major limitations in contemporary biomechanics knowledge are discussed, particularly related to situations where high-speed motions and repetitions are involved. Finally, the evolving importance and limitations in occupational biomechanical simulation models for proactive ergonomics are presented.

Wrist strength is dependent on simultaneous power grip intensity.

The effect of grip activities on wrist flexion/extension strength was examined. Twelve healthy subjects performed maximum wrist flexion/extension exertions with one of five levels of simultaneous grip effort: minimum effort; preferred effort; 30%, 60% and 100% maximum voluntary contraction. As grip force increased from the minimum to the maximum effort, average wrist flexion strength increased 34% and average wrist extension strength decreased 10%. It appears that the finger flexor tendons on the volar aspect of the wrist act agonistically in wrist flexion and act antagonistically to wrist extension. When an object gripped by the hand is fragile or uncomfortable, the reduced finger flexor activity will limit wrist flexion strength. Gripping a slippery object that requires high grip effort will result in reduced wrist extension strength. Grip force should be controlled during measurement of wrist flexion or extension strength. When analysing a task that involves both grip and wrist exertions, use of grip/wrist strength values that were measured during grip exertions only, or wrist exertions only, may incorrectly estimate the true grip/wrist strength, as grip and wrist activities significantly interact with each other as demonstrated in this paper.

The effect of handle friction and inward or outward torque on maximum axial push force.

OBJECTIVE: To investigate the relationship among friction, applied torque, and axial push force on cylindrical handles. BACKGROUND: We have earlier demonstrated that participants can exert greater contact force and torque in an "inward" movement of the hand about the long axis of a gripped cylinder (wrist flexion/forearm supination) than they can in an "outward" hand movement. METHOD: Twelve healthy participants exerted anteriorly directed maximum push forces along the long axis of aluminum and rubber handles while applying deliberate inward or outward torques, no torque (straight), and an unspecified (preferred) torque. RESULTS: Axial push force was 12% greater for the rubber handle than for the aluminum handle. Participants exerted mean torques of 1.1, 0.3, 2.5, and -2.0 Nm and axial push forces of 94, 85, 75, and 65 N for the preferred, straight, inward, and outward trials, respectively. Left to decide for themselves, participants tended to apply inward torques, which were associated with increased axial push forces. CONCLUSION: Axial push force was limited by hand-handle coupling--not the whole body's push strength. Participants appeared to intuitively know that the application of an inward torque would improve their maximum axial push force. Axial push forces were least when a deliberate torque was requested, probably because high levels of torque exertions interfered with the push. APPLICATION: A low-friction handle decreases maximum axial push force. It should be anticipated that people will apply inward torque during maximum axial push.

Experimental evaluation of a computational shoulder musculoskeletal model.

BACKGROUND: Many evaluations of shoulder biomechanical models have focused on static exertions in constrained postures, but few have considered tasks that are more complex. This study examines model performance in load delivery tasks for a range of target locations. METHODS: The study evaluated an optimization-based muscle force prediction model used to assess dynamic load transfer tasks. Model predictions were compared with experimental electromyographic data for two task phases: (1) static hold and (2) dynamic reach. FINDINGS: Predictions correlated positively over all subjects with electromyographic data for prime movers (deltoid [r=0.53]; infraspinatus [r=0.63]; biceps [r=0.61]), though variations in the correlation existed across subjects and tasks. Conversely, the model predicted electromyographic activity of secondary muscles somewhat less accurately. The model also predicted inactivity for electromyographic inactive muscles. INTERPRETATION: The model provides important insights into activity levels muscles that most actively respond to external moments during manual load transfer tasks.

Inward torque and high-friction handles can reduce required muscle efforts for torque generation.

OBJECTIVE: The effects of handle friction and torque direction on muscle activity and torque are empirically investigated using cylindrical handles. BACKGROUND: A torque biomechanical model that considers contact force, friction, and torque direction was evaluated using different friction handles. METHODS: Twelve adults exerted hand torque in opposite directions about the long axis of a cylinder covered with aluminum or rubber while grip force, torque, and finger flexor electromyography (EMG) were recorded. In addition, participants performed grip exertions without torque, in which they matched the EMG level obtained during previous maximum torque exertions, to allow us to determine how grip force was affected by the absence of torque. RESULTS: (a) Maximum torque was 52% greater for the high-friction rubber handle than for the low-friction aluminum handle. (b) Total normal force increased 33% with inward torque (torque applied in the direction fingertips point) and decreased 14% with outward torque (torque in the direction the thumb points), compared with that with no torque. Consequently, maximum inward torque was 45% greater than maximum outward torque. (c) The effect of torque direction was greater for the high-friction rubber handle than for the low-friction aluminum handle. CONCLUSION: The results support the proposed model, which predicts a large effect of torque direction when high-friction handles are gripped. APPLICATION: Designing tasks with high friction and inward rotations can increase the torque capability of workers of a given strength, or reduce required muscle activities for given torque exertions, thus reducing the risk of fatigue and musculoskeletal disorders.

A mathematical musculoskeletal shoulder model for proactive ergonomic analysis.

Occupational shoulder musculoskeletal injuries and disorders are common. Generally available shoulder work analysis tools do not offer insight into specific muscle load magnitudes that may indicate increased risk, nor do they address many concerns germane to job analysis. To address these issues, a biomechanical model of the shoulder was developed to include several critical components: the systematic inclusion of kinematic and kinetic effects, population scalability, geometric realism, an empirical glenohumeral constraint, and integration with digital ergonomics analysis software tools. This unique combination of features in a single model was explored through examination of both experimental and simulated data with the developed analysis tool. The utility of the model is discussed together with a review of its specific strengths and weaknesses, and the potential for its future use in proactive ergonomic analyses and workplace simulations.

The effect of torque direction and cylindrical handle diameter on the coupling between the hand and a cylindrical handle.

Pheasant and O'Neill's torque model (1975) was modified to account for grip force distributions. The modified model suggests that skin friction produced by twisting an object in the direction of fingertips causes flexion of the distal phalanges and increases grip force and, thus, torque. Twelve subjects grasped a cylindrical object with diameters of 45.1, 57.8, and 83.2 mm in a power grip, and performed maximum torque exertions about the long axis of the handle in two directions: the direction the thumb points and the direction the fingertips point. Normal force on the fingertips increased with torque toward the fingertips, as predicted by the model. Consequently, torque toward the fingertips was 22% greater than torque toward the thumb. Measured torque and fingertip forces were compared with model predictions. Torque could be predicted well by the model. Measured fingertip force and thumb force were, on average, 27% less than the predicted values. Consistent with previous studies, grip force decreased as the handle diameter increased from 45.1 to 83.2 mm. This may be due not only to the muscle length-strength relationship, but also to major active force locations on the hand: grip force distributions suggest that a small handle allows fingertip force and thumb force to work together against the palm, resulting in a high reaction force on the palm, and, therefore, a high grip force. For a large handle, fingertip force and thumb force act against each other, resulting in little reaction force on the palm and, thus, a low grip force.

Kinematics of heelstrike during walking and carrying: implications for slip resistance testing.

Slip resistance measurements of shoes and floors are used to evaluate the potential for slip and fall injuries. These measurements are believed to have increased validity when they more closely reflect actual heelstrike biomechanics during locomotion. The purpose of this study was to describe heelstrike kinematics during load carrying to provide data towards improved slip resistance testing. Foot kinematics during load carrying (unladen and carrying from 0 to 13.5 kg) at various cadences (70, 90, 100 steps/min) was recorded. Measures before, during and after heelstrike were analysed. Cadence was an important predictor for all variables measured, associated with changes from 13% to over 100%. The load carried was an important predictor for only the heel slip distance after heelstrike, but this effect needs to be investigated further. These results can be used to improve the fidelity of slip resistance measurements, which is critical to reduce slip and fall injuries in the workplace or during activities of daily living.

The relationship between shoulder torques and the perception of muscular effort in loaded reaches.

The objective of this study was to define the quantitative relationship between external dynamic shoulder torques and calibrated perceived muscular effort levels for load delivery tasks, for application in job analyses. Subjects performed a series of loaded reaches and, following each exertion, rated their perceived shoulder muscular effort. Motion and task physical requirements data were processed with a biomechanical upper extremity model to calculate external dynamic shoulder torques. Calculated torque values were then statistically compared to reported calibrated perceived muscular effort scores. Individual subject torque profiles were significantly positively correlated with perceived effort scores (r2 = 0.45-0.77), with good population agreement (r2 = 0.50). The accuracy of the general regression model improved (r2 = 0.72) with inclusion of factors specific to task geometry and individual subjects. This suggests two major conclusions: 1) that the perception of muscular shoulder effort integrates several factors and this interplay should be considered when evaluating tasks for their impact on the shoulder region; 2) the torque/perception relationship may be usefully leveraged in job design and analysis.

A computer algorithm for representing spatial-temporal structure of human motion and a motion generalization method.

Inspired by the generalized motor program (GMP) theory, this study presents a symbolic motion structure representation (SMSR) algorithm that identifies a basic spatial-temporal structure of a human motion. The algorithm resolves each joint angle-time trajectory of a multi-joint motion into a sequence of elemental motion segments and labels each motion segment with a symbol representing its shape ("U": monotonically increasing; "D": monotonically decreasing; "S": stationary). By concatenating symbols according to their order in time, the spatial-temporal structure of a joint angle-time trajectory is represented as a symbolic string. The structure of a multi-joint motion is then represented as a set of symbolic strings. A sample motion, whose structure is identified by the SMSR algorithm, can be generalized to produce an infinite number of similar motion variants. To generate a variant of a sample motion, segment boundary points of the sample motion are first relocated to new locations in the angle-time space, and then individual motion segments of the original joint angle trajectories are shifted and proportionally rescaled to fit the new segment boundary points. This motion generalization method provides a basis for developing GMP-based motion simulation models, and exploring ideas and hypotheses related to the GMP theory through simulation. As an application of the motion generalization method, a motion modification (MoM) algorithm is presented, which adapts existing reach motions for new target locations. Some examples generated by the MoM algorithm are illustrated.

Primary prevention of low back pain through the application of biomechanics in manual materials handling tasks.

Biomechanical models of the torso have become quite sophisticated in recent years. This paper describes how injurious stresses on the low back can be predicted by such models during the early phases of designing materials handling tasks in industry. It is shown that these biomechanical models can be used to simulate novel materials handling tasks, and thus be used to guide the design of such tasks to reduce various low back stresses. In addition, biomechanical simulations are described which continue to play a major role in understanding the complex stresses that can cause low back pain. These simulations provide a scientific basis for specific ergonomics guidelines meant to reduce the risk of future low back pain in industry. Limitations in the present biomechanical simulations are also presented to stimulate additional research.

Representing and identifying alternative movement techniques for goal-directed manual tasks.

Differences in motion patterns subserving the same movement goal can be identified qualitatively. These alternatives, which may characterize 'movement techniques' (e.g., the stoop and the squat lifting technique), may be associated with significantly different biomechanical constraints and physiological responses. Despite the widely shared understanding of the significance of alternative movement techniques, quantitative representation and identification of movement techniques have received little attention, especially for three-dimensional whole-body motions. In an attempt to systematically differentiate movement techniques, this study introduces a quantitative index termed joint contribution vector (JCV) representing a motion in terms of contributions of individual joint degrees-of-freedom to the achievement of the task goal. Given a set of uncharacterized (unlabeled) motions represented by joint angle trajectories (motion capture data), the JCV and statistical clustering methods enable automated motion classification to uncover a taxonomy of alternative movement techniques. The results of our motion data analyses show that the JCV was able to characterize and discern stoop and squat lifting motions, and also to identify movement techniques for a three-dimensional, whole-body, one-handed load-transfer task. The JCV index would facilitate consideration of alternative movement techniques in a variety of applications, including work method comparison and selection, and human motion modeling and simulation.