Arm-support exoskeleton reduces shoulder muscle activity in ceiling construction.

The objective of this study was to assess the efficacy and user's impression of an arm-support exoskeleton in complex and realistic ceiling construction tasks. 11 construction workers performed 9 tasks. We determined objective and subjective efficacy of the exoskeleton by measuring shoulder muscle activity and perceived exertion. User's impression was assessed by questionnaires on expected support, perceived support, perceived hindrance and future intention to use the exoskeleton. Wearing the exoskeleton yielded persistent reductions in shoulder muscle activity of up to 58% and decreased perceived exertion. Participants reported limited perceived hindrance by the exoskeleton, as also indicated by no increase in antagonistic muscle activity. The findings demonstrate the high potential of an arm-support exoskeleton for unloading the shoulder muscles when used in the dynamic and versatile working environment of a ceiling construction worker, which is in line with the consistent intention of the workers to use the exoskeleton in the future.Practitioner Summary: The majority of research focuses on the effect of using an arm-support exoskeleton during isolated postures and prescribed movements. We investigated the efficacy of an exoskeleton during a complex and realistic work, namely ceiling construction. Shoulder muscle activity was lower in almost all tasks when wearing the exoskeleton.

Field study on the use and acceptance of an arm support exoskeleton in plastering.

Exoskeleton use in day-to-day plastering may face several challenges. Not all plasterer's tasks comprise of movements that will be supported by the exoskeleton and might even be hindered. Furthermore, use in practice might be jeopardised by time pressure, colleagues being negative, discomfort, or any other hindrance of the exoskeleton. We set up a field study, in which 39 plasterers were equipped with an exoskeleton for six weeks, to study exoskeleton usage. Moreover, we studied workload and fatigue, behaviour, productivity and quality, advantages and disadvantages, and acceptance. Exoskeleton use was dependent on the task performed but did not change over the course of the six weeks. For three tasks, higher exoskeleton use was associated with lower perceived loads, although differences were small. Advantages outweighed disadvantages for the majority of our population. This study shows that a majority of plasterers will wear the exoskeleton and is enthusiastic about the load reducing effect. Practitioner summary: For exoskeletons to make an impact on the health and well-being of workers, they need to be applicable in real work situations and accepted by the users. This study shows that 65% of the plasterers in this study want to use the exoskeleton in the future, for specific tasks.

What about the human in human robot collaboration?

In this review we address the human in human robot collaboration (HRC). Although there are different hypotheses on potential effects of HRC on job quality, defined as the quality of the working environment and its effect on the employee's well-being, a comprehensive theory is still lacking. How does HRC influence job quality on an individual level and how can we adapt HRC to boost positivity at work? We identified four job quality related factors that are of relevance in HRC: (1) Cognitive Workload, (2) Collaboration Fluency, (3) Trust, and (4) Acceptance and Satisfaction. Increasing awareness and being able to adapt the robot to the individual operator are crucial to improve the aforementioned factors. Implementing predictable robots, that offer a clear advantage to the human and take into account operators' preferences, will bring us closer to a human-centered collaboration. Practitioner Summary: The effect of human robot collaboration (HRC) on job quality is still under debate. Design characteristics of HRC, such as collaboration design, robot design, and workplace design affect job quality related factors. Using a participatory design approach, as to align robot capabilities to end-users' preferences, will enhance HRC and improve job quality. Abbreviations: HRC: human robot collaboration; OECD: organisation for economic co-operation and development.

Effect of horizontal pick and place locations on shoulder kinematics.

In this study the effects of horizontal bin locations in an order picking workstation on upper arm elevation, trunk inclination and hand use were investigated. Eight subjects moved (self-paced) light or heavy products (0.2 and 3.0 kg) from a central product bin to an inner or outer order bin (at 60 or 150 cm) on the left or right side of the workstation, while movements were recorded. The outer compared to inner bin location resulted in more upper arm elevation and trunk inclination per work cycle, both in terms of number of peak values and in terms of time integrals of angles (which is a dose measure over time). Considering the peak values and time integrals per minute (instead of per work cycle), these effects are reduced, due to the higher cycle times for outer bins. Hand use (left, right or both) was not affected by order bin locations.

The effect of back muscle fatigue on EMG and kinematics based estimation of low-back loads and active moments during manual lifting tasks.

This study investigated the effects of back muscle fatigue on the estimation of low-back loads and active low-back moments during lifting, using an EMG and kinematics based model calibrated with data from an unfatigued state. Fourteen participants performed lifting tasks in unfatigued and fatigued states. Fatigue was induced through semi-static forward bending. EMG, kinematics, and ground reaction forces were measured, and low-back loads were estimated using inverse dynamics and EMG-driven muscle model. A regression model was developed using data from a set of calibration lifts, and its accuracy was evaluated for unfatigued and fatigued lifts. During the fatigue-inducing task, the EMG amplitude increased by 2.8 %MVC, representing a 38% increase relative to the initial value. However, during the fatigued lifts, the peak EMG amplitude was found to be 1.6 %MVC higher than that observed during the unfatigued lifts, representing a mere 4% increase relative to the baseline unfatigued peak EMG amplitude. Kinematics and low-back load estimates remained unaffected. Regression model estimation errors remained unaffected for 5 kg lifts, but increased by no more than 5% of the peak active low-back moment for 15 kg lifts. We conclude that the regression-based estimation quality of active low-back moments can be maintained during periods of muscle fatigue, although errors may slightly increase for heavier loads.

Temporal strategy and performance during a fatiguing short-cycle repetitive task.

This study investigated temporal changes in movement strategy and performance during fatiguing short-cycle work. Eighteen participants performed six 7-min work blocks with repetitive reaching movements at 0.5 Hz, each followed by a 5.5-min rest break for a total duration of 1 h. Electromyography (EMG) was collected continuously from the upper trapezius muscle, the temporal movement strategy and timing errors were obtained on a cycle-to-cycle basis, and perceived fatigue was rated before and after each work block. Clear signs of fatigue according to subjective ratings and EMG manifestations developed within each work block, as well as during the entire hour. For most participants, timing errors gradually increased, as did the waiting time at the near target. Changes in temporal movement strategy were negatively correlated with changes in the level and variability of EMG, suggesting that an adaptive temporal strategy offset the development of unstable motor solutions in this fatiguing, short-cycle work. PRACTITIONER SUMMARY: Sustained performance of operators is essential to maintain competitiveness. In this study of repetitive work, participants gradually changed their temporal movement strategy, for possibly alleviating the effects of fatigue. This suggests that in order to effectively counteract fatigue and sustain performance, industrial production should allow extensive spatial and temporal flexibility.

What is the evidence for less shift work tolerance in older workers?

This paper explores the suggestion that older people would be less tolerant to shift work. Field studies on age-shift work interaction effects on sleep, fatigue, performance, accidents and health were reviewed. Studies on age-shift (morning, afternoon, night) and age-shift system (roster) interactions were also reviewed. In nine studies, shift and day workers were compared and interactions with age were addressed. Two studies reported more problems in older people, four studies reported opposite results, while in five studies no significant age-shift work interaction was observed. From across-shift comparisons (six studies), it was deduced that older compared with younger workers have more sleep problems with night shifts, while the opposite is true for morning shifts. This review did find some differences between older and younger workers, but did not find evidence for the suggestion of more shift work problems in older workers. STATEMENT OF RELEVANCE: This systematic review reveals the limited evidence that exists concerning shift work tolerance in older workers, highlighting an area for future research. Some interactions between age and shift type and shift system have been found, however. In view of these, it is argued that age-specific aspects should be considered in shift work planning.

The effect of work pace on workload, motor variability and fatigue during simulated light assembly work.

This study investigated the effect of work pace on workload, motor variability and fatigue during light assembly work. Upper extremity kinematics and electromyography (EMG) were obtained on a cycle-to-cycle basis for eight participants during two conditions, corresponding to "normal" and "high" work pace according to a predetermined time system for engineering. Indicators of fatigue, pain sensitivity and performance were recorded before, during and after the task. The level and variability of muscle activity did not differ according to work pace, and manifestations of muscle fatigue or changed pain sensitivity were not observed. In the high work pace, however, participants moved more efficiently, they showed more variability in wrist speed and acceleration, but they also made more errors. These results suggest that an increased work pace, within the range addressed here, will not have any substantial adverse effects on acute motor performance and fatigue in light, cyclic assembly work. STATEMENT OF RELEVANCE: In the manufacturing industry, work pace is a key issue in production system design and hence of interest to ergonomists as well as engineers. In this laboratory study, increasing the work pace did not show adverse effects in terms of biomechanical exposures and muscle fatigue, but it did lead to more errors. For the industrial engineer, this observation suggests that an increase in work pace might diminish production quality, even without any noticeable fatigue being experienced by the operators.

Fatigue effects on tracking performance and muscle activity.

It has been suggested that fatigue affects proprioception and consequently movement accuracy, the effects of which may be counteracted by increased muscle activity. To determine the effects of fatigue on tracking performance and muscle activity in the M. extensor carpi radialis (ECR), 11 female participants performed a 2-min tracking task with a computer mouse, before and immediately after a fatiguing wrist extension protocol. Tracking performance was significantly affected by fatigue. Percentage time on target was significantly lower in the first half of the task after the fatigue protocol, but was unaffected in the latter half of the task. Mean distance to target and the standard deviation of the distance to target were both increased after the fatigue protocol. The changed performance was accompanied by higher peak EMG amplitudes in the ECR, whereas the static and the median EMG levels were not affected. The results of this study showed that subjects changed tracking performance when fatigued in order to meet the task instruction to stay on target. Contrary to our expectations, this did not lead to an overall higher muscle activity, but to a selective increase in peak muscle activity levels of the ECR.

Association between objective and subjective measurements of comfort and discomfort in hand tools.

In the current study, the relationship between objective measurements and subjective experienced comfort and discomfort in using handsaws was examined. Twelve carpenters evaluated five different handsaws. Objective measures of contact pressure (average pressure, pressure area and pressure-time (P-t) integral) in static and dynamic conditions, muscle activity (electromyography) of five muscles of the upper extremity, and productivity were obtained during a sawing task. Subjective comfort and discomfort were assessed using the comfort questionnaire for hand tools and a scale for local perceived discomfort (LPD). We did not find any relationship between muscle activity and comfort or discomfort. The P-t integral during the static measurement (beta=-0.24, p<0.01) was the best predictor of comfort and the pressure area during static measurement was the best predictor of LPD (beta=0.45, p<0.01). Additionally, productivity was highly correlated to comfort (beta=0.31, p<0.01) and discomfort (beta=-0.49, p<0.01).

Relationships between energy expenditure and positive and negative mechanical work in repetitive lifting and lowering.

Determining the separate energy costs of the positive and negative mechanical work in repetitive lifting or lowering is quite complex, as a mixture of both work components will always be involved in the up- and downward motion of the lifter's body mass. In the current study, a new method was tested in which coefficients specifically related to the positive and negative work were estimated by multiple regression on a data set of weight-lifting and weight-lowering tasks. The energy cost was obtained from oxygen uptake measurements. The slopes of the regression lines for energy cost and mechanical work were steeper for positive than for negative work. The cost related to the negative work was approximately 0.3-0.5 times the cost of the positive work. This finding is well in line with data obtained directly from other isolated activities of either positive or negative work (e.g., ladder climbing vs. descending). However, the intercept values of the regression lines were not significantly different from zero or were even negative. This was most likely due to the metabolic energy not related to processes that yield mechanical work (e.g., isometric muscle actions) that was not constant among trials.

Sensitivity of single-equivalent trunk extensor muscle models to anatomical and functional assumptions.

Single-equivalent muscle models are often used to estimate loads on the lumbosacral joint after net extension moments have been calculated by means of inverse dynamics. These models usually ignore the effects trunk flexion has on the extensor lever arm. In addition, no systematic analysis of the sensitivity to the anatomical and functional assumptions made in these models is available. In the present study a series of single-equivalent models incorporating trunk flexion dependence was derived from a detailed description of the trunk musculature. Each model was based on different anatomical and functional assumptions. The differences of estimates of compression and shear forces on the lumbosacral disc during a lifting movement resulting from these models were analysed. The results show that these load estimates heavily depend on assumptions regarding anthropometry, lumbar curvature and coactivity of abdominal muscles and only moderately on assumptions regarding force sharing between extensor muscles. Fairly simple single-equivalent models with the net moment and thorax orientation as input can be used to predict lumbosacral compression and shear.

Joint moments and muscle activity in the lower extremities and lower back in lifting and lowering tasks.

The mechanical loading on the body during the act of lifting has been estimated frequently. The opposite act of lowering has received much less attention. The aim of the present study was to compare the mechanical loading of the musculoskeletal system in lifting and lowering. Eight subjects repetitively lifted and lowered a load, using two different techniques (a leg and a back technique). The ankle, knee, hip and lumbosacral joint moments were estimated and the myoelectrical (EMG) activity of seven (leg and back) muscles was recorded. The differences between the lifting and lowering phase for the leg technique were similar to those observed when the back technique was applied. The joint moment curves in lifting showed a high level of agreement with the (time-reversed) moment curves in lowering. Peak moments in lowering were only slightly lower than in lifting (peak lumbar moments were 5.4% lower). These small differences were related to different acceleration profiles at the centre of gravity of the body/load complex. The EMG activity was considerably lower in lowering than in lifting. The mean EMG in lowering (average for seven muscles) was only about 69% of the EMG in lifting. This was attributed to the different types of muscle actions involved in lifting (mainly concentric) and lowering (mainly eccentric). Furthermore, the EMG results suggest that similar inter-muscular coordination is involved in lowering and lifting. The results give rise to the assumption that in lifting and lowering similar muscle forces are produced to meet the (nearly) equal joint moments, but in lowering these forces are distributed over a smaller cross-sectional area of active muscle, which might imply a higher risk of injury.

Abdominal muscles contribute in a minor way to peak spinal compression in lifting.

In lifting, the abdominal muscles are thought to be activated to stabilize the spine. As a detrimental effect, they contribute to spinal compression. The existing literature is not conclusive about the biological relevance of this effect. From biological, mechanical and anatomical considerations it was hypothesised that the relative abdominal contribution to compression would be minor in the beginning of the lift, that the relative and absolute abdominal contribution to compression would rise throughout the lift, and that the obliques would contribute to a larger extent than the rectus abdominis. To investigate these hypotheses, 10 subjects lifted 0.5, 10.5 and 22.5 kg. EMG levels obtained from the rectus abdominis and the obliques were converted into force using normalized EMG, muscle potential and area values, and modulating factors for muscle length and contraction velocity. An anatomical model was applied to compute the abdominal effects on spinal compression in three consecutive phases within a lift. If expressed relative to the total spinal compression, the abdominal contribution for the three weight conditions was 7.1% (SD, 1.7), 10.4% (4.7) and 12.5% (4.4) in the begin and 21.0% (5.8), 19.0% (5.3) and 22.2% (6.6) in the end phase. Thus, the relative abdominal contribution to compression was minor in the beginning and increased towards the end. The absolute abdominal contribution was constant throughout the lift. The contributions could be retraced to the obliques rather than the rectus, while during the lift a shift in activation from the obliquus externus to internus was observed.

Segment inertial parameter evaluation in two anthropometric models by application of a dynamic linked segment model.

The estimation of segment inertial parameters (SIPs) is an important source of error in inverse dynamic analysis. In most individual cases SIPs are derived from extrapolation of known SIPs of a certain population through regression equations (proportional models). Another well-known method is the use of mathematical approximation of the shape of human body segments combined with estimations of segment densities (geometric models). In the current study five males and five females performed four different lifting movements in the sagittal plane. A full body linked segment model was applied twice to the same data set, once using a proportional and once using a geometric anthropometric model. As a full body linked segment model is an overdetermined system of equations, four equations could be formed to test the summed effect of SIP errors on the inverse dynamic analysis. The overall performance in terms of coefficients of correlation was better for the geometric model as compared to the proportional model. When a back lifting movement was performed, the equations indicated systematic errors in the proportional model. However, when a leg lifting movement was performed, the equations indicated systematic errors in the geometric model. Therefore, analyzing only one kind of movement does not suffice to draw conclusions with respect to the reliability of an anthropometric model.

Different methods to estimate total power and its components during lifting.

A more fundamental understanding about the act of manual lifting can be provided by the assessment of the total production of power and the power generated in joints. The present study is concerned with the validity of the estimations of these parameters. Four subjects lifted an 18.8 kg load while they were filmed and ground reaction forces were measured. The total generated power was calculated in three ways: (1) by summation of joint powers, (2) on the basis of the rate of change of the summed energy contents of human body segments, and (3) on the basis of the rate of change of the body energy estimated from ground reaction forces. The results were compared. Furthermore, at a segmental level the power supplied to or absorbed from a segment was compared to the rate of change of its energy content. The resulting instantaneous power curves from the three different methods showed a high level of agreement, which supports their validity. However, some minor discrepancies were observed. The major cause of the observed difference between the rate of change of the summed segmental energy contents and the summed joint powers was found at a segmental level. It was observed that segmental link lengths (i.e. distances between proximal and distal markers) changed during movement, which yielded discrepancies between the power flow to or from a segment and the rate of change of its energy content.

Flexion relaxation during lifting: implications for torque production by muscle activity and tissue strain at the lumbo-sacral joint.

During the full flexion phase of the back lift movement the lumbar part of the erector spinae muscle exhibits a reduced activity level (flexion relaxation). This study addresses the question how the required extension torque in the lumbo-sacral joint (L5/S1 joint) is balanced during the period in which apparently the lumbar erector spinae ceases to take its share. Six subjects participated in the experiment in which they performed seven lifting tasks. The load, the range of movement, and the phase in which the load was handled (lifting or lowering) were varied. A dynamic linked segment model was applied to determine the momentary torques acting at the L5/S1 joint, while the EMGs of the lumbar and thoracic part of the erector spinae muscle were measured. Furthermore, the lengths between markers on the lumbar and thoracic part of the trunk were determined to reveal changes in length during the movement. The dynamic EMGs were normalized to trunk angle-dependent maximal levels. The L5/S1 joint torques were analysed and combined with the normalized EMG data and the kinematics of the trunk, which are assumed to indicate the elongation of passive tissues. Although in the normalization procedure the change of the length-force relationship of the erector spinae was taken into account, the dynamic lumbar EMG activity decreased to a low-activity level (the phenomenon of flexion relaxation). This coincided with a 25% increase in lumbar length suggesting that passive tissue strain provided part of the required extension torque. In the tasks where a barbell was handled a significant increase in EMG level of the thoracic part of the erector spinae occurred just before the flexion relaxation at the lumbar level. Apparently, the extensor function of the lumbar part is then taken over by the thoracic part of the erector spinae muscle. This suggests that an intricate coordinating mechanism is operative that apportions the load to be balanced over active--(lumbar and thoracic part of the erector spinae) and passive structures (post vertebral ligaments).

Weight and frequency effect on spinal loading in a bricklaying task.

In manual materials handling jobs a reduction in the weight of materials often concurs with an increase in handling frequency. The effect of weight and inversely related frequency on spinal load was studied in two bricklaying tasks: building the skin and the floor of a steel ladle. In both tasks five subjects laid bricks of varying weight and frequency (obtained from field observations). The load parameters investigated were peak values and time integrals of the compressive force on the L5-S1 motion segment and stature loss, which is assumed to reflect motion segment creep due to compression. Peak compression was found to increase at higher brick weights. No differences in integrated compression were observed among four out of five combinations of weight and frequency (both in skin and floor building). Laying bricks for a fixed period of 47 min yielded average stature losses of 2.0 3.6 mm. Differences in stature loss among weight-frequency conditions were not significant. In conclusion, at lower weights peak loads decrease, but the benefit of this should be doubted because the frequency of exposure to these peak loads was found to increase. Moreover, this increase was such that no effects were found on spinal load estimates that incorporate both magnitude and time aspects of the load, like time-integrated compression and stature loss.

Coordination of the leg muscles in backlift and leglift.

Net joint moments are often used to quantify the loading of structures (e.g. the intervertebral disc at L5S1) during lifting. This quantification method is also used to evaluate the loading of the knee, for instance, to determine the effect of backlifting as opposed to leglifting. However, the true loading of the joint as derived from net joint moments can be obscured by a possible co-contraction of antagonists. To unravel the mechanisms that determine the net joint moments in the knee, the leglift was compared to the backlift. Although a completely different net knee moment curve was found when comparing the two lifting techniques, it appeared to be closely related to the ground reaction force vector and its orientation with respect to the joint centre of rotation (R > 0.995). This close relation was established by co-contraction of both flexors and extensors of the knee. Furthermore, a close relation appeared to exist between the joint moment difference between hip and knee and the activity difference between rectus femoris muscle and hamstring (R = 0.72 and 0.83 in leglift and backlift, respectively). The knee-ankle joint moment difference and the activity of the gastrocnemius showed a close relation as well (R = -0.89 and 0.96 in leglift and backlift, respectively). These relations can be interpreted as a mechanism to distribute net moments across joints. It is concluded that during lifting tasks the intermuscular coordination is aimed at coupling of joint moments, such that the ground reaction force points in a direction that provides balance during the movement. The use of net joint moments as direct indicators for joint loading (e.g. knee) seems, therefore, questionable.

Mechanisms of action of lumbar supports: a systematic review.

STUDY DESIGN: A systematic review and meta-analysis of studies on the putative mechanisms of action of lumbar supports in lifting activities. OBJECTIVE: To summarize the evidence bearing on the putative mechanisms of action of lumbar supports. SUMMARY OF BACKGROUND DATA: A restriction of trunk motion and a reduction in required back muscle forces in lifting are two proposed mechanisms of action of lumbar supports. Available studies on these putative mechanisms of action of lumbar supports have reported contradictory results. METHODS: A literature search for controlled studies on mechanisms of action of lumbar supports was conducted. The methodologic quality of the studies was assessed. The evidence for the two proposed mechanisms of action of lumbar supports was determined in meta-analyses. RESULTS: Thirty-three studies were selected for the review. There was evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending, with overall effect sizes of 0.70 (95% confidence interval [CI] 0.39-1. 01) and 1.13 (95% CI 0.17-2.08), respectively. The overall effect size for rotation was not statistically significant (0.69; 95% CI -0. 40-4.31). There was no evidence that lumbar supports reduce the electromyogram activity of erector spinae muscles (effect size of 0. 09; 95% CI -0.41-0.59) or increase the intra-abdominal pressure (effect size of 0.26; 95% CI -0.07-0.59). CONCLUSION: There is evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending. More research is needed on the separate outcome measures for trunk motion before definite conclusions can be drawn about the work conditions in which lumbar supports may be most effective. Studies of trunk motion at the workplace or during specified lifting tasks would be especially useful in this regard.