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1.
《Ergonomics》2012,55(12):1539-1552
Abstract

Sustained joint load in extreme positions (namely maximally flexed or extended positions) has been described as causing pain. The aim of the present study is to analyse eight different sitting work postures with respect to extreme positions, and to assess the mechanical load and the levels of muscular activity arising in defined extreme positions of the cervical spine. Ten healthy female workers from an electronics plant took part in laboratory experiments. For seven of these, levels of neck and shoulder muscular activity in sitting postures with the cervical spine in different manually-adjusted extreme positions were recorded using surface electrodes. Loading moments of force about the bilateral motion axis of the atlanto-occipital joint (Occ-C1) and the spinal cervico-thoractc motion segments (C7-T1) were calculated. Extreme or almost extreme positions occurred in sitting postures with the thoracolumbar back inclined slightly backwards or with the whole spine flexed. Electromyographic (EMG) activity levels were very low in the manually-adjusted extreme positions. The load moment for the Occ-Cl joint when the whole neck was flexed was only 1·2 times the value for the neutral position of the head, but for C7-T1 it increased to 3·6 times. It is concluded that extreme positions of the cervical spine do occur in sitting work postures, and that the levels of muscular activity in such positions are low. Thus, recordings of muscle activity and calculations of load moment alone are not a sufficient basis for evaluating work postures: thorough recordings of spine positions should be included.  相似文献   

2.
Callaghan JP  McGill SM 《Ergonomics》2001,44(3):280-294
The aim was to examine lumbar spine kinematics, spinal joint loads and trunk muscle activation patterns during a prolonged (2 h) period of sitting. This information is necessary to assist the ergonomist in designing work where posture variation is possible -- particularly between standing and various styles of sitting. Joint loads were predicted with a highly detailed anatomical biomechanical model (that incorporated 104 muscles, passive ligaments and intervertebral discs), which utilized biological signals of spine posture and muscle electromyograms (EMG) from each trial of each subject. Sitting resulted in significantly higher (p<0.001) low back compressive loads (mean +/- SD 1698 +/- 467 N) than those experienced by the lumbar spine during standing (1076 +/- 243 N). Subjects were equally divided into adopting one of two sitting strategies: a single 'static' or a 'dynamic' multiple posture approach. Within each individual, standing produced a distinctly different spine posture compared with sitting, and standing spine postures did not overlap with flexion postures adopted in sitting when spine postures were averaged across all eight subjects. A rest component (as noted in an amplitude probability distribution function from the EMG) was present for all muscles monitored in both sitting and standing tasks. The upper and lower erector spinae muscle groups exhibited a shifting to higher levels of activation during sitting. There were no clear muscle activation level differences in the individuals who adopted different sitting strategies. Standing appears to be a good rest from sitting given the reduction in passive tissue forces. However, the constant loading with little dynamic movement which characterizes both standing and sitting would provide little rest/change for muscular activation levels or low back loading.  相似文献   

3.
《Ergonomics》2012,55(3):280-294
The aim was to examine lumbar spine kinematics, spinal joint loads and trunk muscle activation patterns during a prolonged (2 h) period of sitting. This information is necessary to assist the ergonomist in designing work where posture variation is possible—particularly between standing and various styles of sitting. Joint loads were predicted with a highly detailed anatomical biomechanical model (that incorporated 104 muscles, passive ligaments and intervertebral discs), which utilized biological signals of spine posture and muscle electromyograms (EMG) from each trial of each subject. Sitting resulted in significantly higher (p< 0.001) low back compressive loads (mean±SD 1698±467 N) than those experienced by the lumbar spine during standing (1076±243 N). Subjects were equally divided into adopting one of two sitting strategies: a single ‘static’ or a ‘dynamic’ multiple posture approach. Within each individual, standing produced a distinctly diVerent spine posture compared with sitting, and standing spine postures did not overlap with flexion postures adopted in sitting when spine postures were averaged across all eight subjects. A rest component (as noted in an amplitude probability distribution function from the EMG) was present for all muscles monitored in both sitting and standing tasks. The upper and lower erector spinae muscle groups exhibited a shifting to higher levels of activation during sitting. There were no clear muscle activation level diVerences in the individuals who adopted diVerent sitting strategies. Standing appears to be a good rest from sitting given the reduction in passive tissue forces. However, the constant loading with little dynamic movement which characterizes both standing and sitting would provide little rest/change for muscular activation levels or low back loading.  相似文献   

4.
Sit-stand stools are available for use in industrial settings, but there is a lack of quantitative evidence demonstrating benefits for lower limb, back and/or neck/shoulder outcomes. In this paper we describe an experiment conducted to compare and contrast posture and time-related differences in muscular and vascular outcomes during 34 min of manual repetitive work performed in either standing or sit-standing work posture. We measured vascular parameters in the lower limbs, and muscular parameters in the trunk and neck/shoulder, and discomfort in the three regions as participants accomplished a repetitive box-folding task. Results show that blood flow in the foot (p = 0.022) and ankle mean arterial pressure (p < 0.001) were greater during standing. Left gluteus medius and external oblique activation was higher during standing, while sit-standing work resulted in higher levels of co-activation between the left erector spinae and external oblique muscle pair (p = 0.026). Neck/shoulder muscle activity was not significantly different between the conditions. Reported discomfort did not differ significantly for the trunk and neck/shoulder region, but standing resulted in higher level of reported discomfort in the lower limb. The sit-stand posture used in this experiment appears to prevent the undesirable lower limb outcomes associated with static standing work posture.Relevance to industryThis work demonstrates quantitative evidence to support the potential use of a sit-stand stool for industrial work operations, at least over relatively short durations.  相似文献   

5.
The influence of whole body sitting posture on cervico-thoracic posture, mechanical load and extensor muscle activity was examined in 23 asymptomatic adults. Cervical and upper thoracic extensor muscle activity measured in guided slouched and lumbo-pelvic neutral postures was normalised to that measured in a self-selected habitual posture. Head and neck posture and gravitational load moment measurements were obtained in each posture. Sagittal head translation, upper cervical extension and load moment were significantly greater in the slouched posture (p < 0.001). Contrasting patterns of cervical and thoracic extensor activity were observed in the slouched and neutral postures, with cervical extensor activity 40% higher in the slouched posture (p < 0.0001). Thoracic extensor activity was significantly higher in the lumbo-pelvic neutral posture than the habitual posture (p = 0.002). The significant changes in extensor muscle activity with postural modification appear to be induced by the associated change in mechanical load moment of the head. STATEMENT OF RELEVANCE: More neutral sitting postures reduce the demand on the cervical extensor muscles and modify the relative contribution of cervical and thoracic extensors to the control of head and neck posture. Postures that promote these patterns of muscular activity may reduce cervical spine loading and the development of posture-related neck pain.  相似文献   

6.
《Ergonomics》2012,55(6):539-546
Neck/shoulder pain is a common complaint, with evidence suggesting rates in adolescence have increased in line with increased computer use. The study aimed to examine the influence of gender on relationships between computer use, habitual posture and neck/shoulder pain. Adolescents (n = 1483) participating in the 14 year follow-up of the Raine Study cohort were surveyed for computer use, habitual sitting posture and neck/shoulder pain. Females used computers less than males (52% vs. 45% used for up to 7 h per week). Females sat much more upright than males with greater anterior pelvic tilt (9.4° vs. 0.4°). Females reported a higher 1 month prevalence of neck/shoulder pain (34.7%) than males (23.1%). A multivariate model showed neck/shoulder pain risk was increased in females (OR 2.61, 95% CI 1.70–4.00) and with computer use (OR 1.19, CI 1.01–1.40). Computer use is related to neck/shoulder pain and posture in adolescents but this relationship is different in boys and girls.

Statement of Relevance: This study showed the confounding effect of gender on the relationships among computer use, posture and neck/shoulder pain and thus the need to consider genders separately in research and practice aiming to optimise young people's use of computers.  相似文献   

7.
J W Yates  W Karwowski 《Ergonomics》1992,35(7-8):889-898
The objective of this project was to compare the muscular effort exerted during manual lifting tasks performed in standing versus seated posture. Six male undergraduate and graduate students performed 12 different static and dynamic lifts in both sitting and standing positions. During each effort electromyographic (EMG) data were collected on four muscles groups (low back, upper back, shoulder, and abdominals). Four contractions were designed to elicit maximum muscular effort in the four groups being monitored. The remaining data were then expressed as a percentage of maximum EMG. Each subject performed the following: maximum static lift when sitting; maximum static lift when standing; sitting, static lift with 15.9 kg; standing, static lift with 15.9 kg; dynamic sit-forward lift with 15.9 kg, dynamic stand-forward lift with 15.9 kg, dynamic sit-twist with 15.9 kg, dynamic stand-vertical lift with 15.9 kg. Each of the lifts was performed with a wooden tray with slotted handles. Root mean square (RMS) values of the EMG data were calculated for three second periods. EMG activity in the low back, upper back, and shoulder was greater during sitting lifting than during standing lifting. The sit-twist lift resulted in the highest EMG in the abdominal muscles. Dynamic lifts resulted in more muscle activity than did static lifts. From these data it was concluded that sitting-lifting results in greater stress in the low back, upper back, and shoulders than does lifting while standing.  相似文献   

8.
《Ergonomics》2012,55(7-8):889-898
The objective of this project was to compare the muscular effort exerted during manual lifting tasks performed in standing versus seated posture. Six male undergraduate and graduate students performed 12 different static and dynamic lifts in both sitting and standing positions. During each effort electromyographic (EMG) data were collected on four muscles groups (low back, upper back, shoulder, and abdominals). Four contractions were designed to elicit maximum muscular effort in the four groups being monitored. The remaining data were then expressed as a percentage of maximum EMG. Each subject performed the following: maximum static lift when sitting; maximum static lift when standing; sitting, static lift with 15·9 kg; standing, static lift with 15·9 kg; dynamic sit-forward lift with 15·9 kg, dynamic stand-forward lift with 15·9 kg, dynamic sit-twist with 15·9 kg, dynamic stand-vertical lift with 15·9 kg. Each of the lifts was performed with a wooden tray with slotted handles. Root mean square (RMS) values of the EMG data were calculated for three second periods. EMG activity in the low back, upper back, and shoulder was greater during sitting lifting than during standing lifting. The sit-twist lift resulted in the highest EMG in the abdominal muscles. Dynamic lifts resulted in more muscle activity than did static lifts. From these data it was concluded that sitting-lifting results in greater stress in the low back, upper back, and shoulders than does lifting while standing.  相似文献   

9.
《Ergonomics》2012,55(3):339-353
Electromyographic activity of the upper trapezius muscles was recorded over the workday for two groups of service workers, shopping centre (n = 22) and healthcare workers (n = 44), both with low observed biomechanical exposure. Static and median EMG activity level, number of EMG gaps and gap time were determined. The variability of these variables over the workday was examined by calculating the coefficient of variation (CV) and the intraclass correlation coefficient (ICC) of 1-h consecutive recording periods. All variables except gap time showed acceptable reliability (ICC = 0.69-0.78), i.e. the largest fraction of variance in the data set was due to intersubject variance, despite relatively large hour-to-hour variation (CV = 0.21-0.62). The EMG activity level in the trapezius muscles was low (static activity level < 1% EMGmax), despite the high prevalence of shoulder and neck pain for both groups of workers. In addition to the work recordings, tests were performed to determine intersubject variation in muscle activity when adopting a standardized resting posture, and in a dynamic muscle activity pattern during paced arm movement. Neither the EMG variables from the work recordings nor the tests with EMG recording indicated higher trapezius EMG activity levels for workers with pain in the shoulders and neck in this study. The low EMG levels are interpreted to indicate a low risk of developing shoulder and neck complaints due to biomechanical exposure for both groups of workers. The possibility of pain-initiating mechanisms, associated with stress and not mediated through muscle activity, is considered in the discussion.  相似文献   

10.
《Ergonomics》2012,55(7):1147-1158
In order to examine the effects of work surface height (WSH) on muscle activity, posture and discomfort during simulated pipetting, an experimental study was conducted using electromyography, electrogoniometry, video techniques and also qualitative data. The experimental design consisted of one independent variable (WSH with six heights) and 13 dependent variables. The levels of muscle strain and discomfort were significantly lower at the shoulder when the WSHs were low but thumb muscle activities and neck flexion levels were markedly higher at these WSHs compared to higher WSHs. To reduce shoulder strain, without raising thumb and neck strain beyond acceptable limits, the findings suggest that the height of a laboratory workbench should be at the level of the pipette tip when held in a standing position with the hand at elbow height. It was also found that pipetting should not be done in a seated posture.

Practitioner Summary: An experimental study was conducted to examine the effects of work surface height on upper extremity muscle activity, posture and discomfort during simulated pipetting. The findings suggest that the laboratory workbench height should be at the pipette-tip level when held in a standing position with the hand at elbow height.  相似文献   

11.
《Ergonomics》2012,55(9):1932-1940
The purpose of the study was to compare muscular activity levels and sitting posture displayed by 10 children (mean age =4·7 years) when performing tracing tasks while seated at a traditional work station (level desk top, 5° backward sloping seat) and at an ergonomically designed work station (15° sloping desk top, 15° forward sloping seat). EMG profiles of latissimus dorsi (LD), erector spine (ES), and superior trapezius (ST) were sampled using Medi-trace disposable surface electrodes for 10min on the non-dominant side. Muscle activity was sampled (1000 Hz) every 2min for 5000 ms while the subjects performed the tracing tasks at each station. Raw EMG signals of the five trials for each muscle were processed by removing signal offset, full-wave rectification, and integration. The subjects' posture was monitored from a lateral view using a Panasonic VHS video camera while the children were seated at each work station. Neck flexion angle and the angle between the torso and thigh (hip angle) were manually sampled from the video images each 1 min as an indication of the posture adopted by the subjects during the tracing tasks. Use of f-tests for dependent means indicated that there was no significant difference in either mean ES or ST muscle activity as a function of work station design. However, subjects demonstrated significantly less LD activity when seated at the ergonomic work station (mean = 20·9 V ms) compared with the traditional work station (mean = 24·4 V ms, t = ? 2·88, p = 0·018). When seated at the ergonomically designed work station, subjects demonstrated less neck flexion (mean = 34·4°) and a significantly larger hip angle (mean = 107·8°, t= ? 3·46, p = 0·003) than when seated at the traditional work station (neck flexion = 38·7°, hip angle = 95·5°). It was concluded that use of the ergonomic work station could assist in maintaining a more efficient anatomical alignment of young children when sitting and writing.  相似文献   

12.
《Ergonomics》2012,55(5):853-863
Abstract

We examined the effects of posture, weight and frequency on trunk muscular activity and fatigue during repetitive dynamic lifting. Electromyographic (EMG) signals from eight primary trunk muscles were collected during 120 min for four different task conditions. The patterns of muscle recruitment and the levels of relative activation were analysed using the normalized EMG data. Median power frequency (MPF) shift patterns were analysed to examine muscular fatigue. The muscles in the dorsal part of the trunk were activated at the symmetric posture, while the muscles on the contralateral side to the workload were more strongly activated at the asymmetric posture. Decreasing trends of MPFs were found in some active muscles, and they were more pronounced for the asymmetric posture than for the symmetric posture. It was also seen that the muscles became fatigued faster for the light load-high frequency task than for the heavy load-low frequency task.  相似文献   

13.
An electromyographic study of dental work   总被引:1,自引:0,他引:1  
Musculoskeletal disorders are common among dentists, and have been ascribed to the demands of high precision work and sustained static loading in the neck-shoulder region, combined with a flexed and rotated cervical spine. In order to determine muscular load levels during dentistry, activity in neck, shoulder, and arm muscles was recorded using an electromyography technique (EMG). Normalized mean, median, 10th and 90th percentile EMG amplitude levels (% maximal reference contraction, %max-RVC) were calculated during ordinary dental work. Among the muscles investigated, the trapezius muscle on both sides had the highest mean (the right trapezius 9.0% and the left 7.6% of max-RVC) and 10th percentile amplitude levels (both about 2% of max-RVC). The trapezius muscles showed similar myoelectric activity on the right and left side, probably because of similar muscular static load on the both sides. The right extensor carpi radialis muscle had a significantly higher muscular load level than the left one, possibly due to stabilization demands on the dominant wrist during demanding precision work. The infraspinatus muscle had low activity level on both sides, reflecting that the dentists worked with a small degree of arm elevation and external rotation. The dentistry work thus seems to generate relatively high muscular load on both trapezius and dominant extensor-carpi-radialis, and relatively low load on the infraspinatus muscle.  相似文献   

14.
Electromyographic activity of the upper trapezius muscles was recorded over the workday for two groups of service workers, shopping centre (n = 22) and healthcare workers (n = 44), both with low observed biomechanical exposure. Static and median EMG activity level, number of EMG gaps and gap time were determined. The variability of these variables over the workday was examined by calculating the coefficient of variation (CV) and the intraclass correlation coefficient (ICC) of 1-h consecutive recording periods. All variables except gap time showed acceptable reliability (ICC = 0.69-0.78), i.e. the largest fraction of variance in the data set was due to intersubject variance, despite relatively large hour-to-hour variation (CV = 0.21 0.62). The EMG activity level in the trapezius muscles was low (static activity level < 1% EMGmax), despite the high prevalence of shoulder and neck pain for both groups of workers. In addition to the work recordings, tests were performed to determine intersubject variation in muscle activity when adopting a standardized resting posture, and in a dynamic muscle activity pattern during paced arm movement. Neither the EMG variables from the work recordings nor the tests with EMG recording indicated higher trapezius EMG activity levels for workers with pain in the shoulders and neck in this study. The low EMG levels are interpreted to indicate a low risk of developing shoulder and neck complaints due to biomechanical exposure for both groups of workers. The possibility of pain-initiating mechanisms, associated with stress and not mediated through muscle activity, is considered in the discussion.  相似文献   

15.
《Ergonomics》2012,55(12):1591-1607
Abstract

Ten professional milkers simulated 20 different machine-milking postures related to different vertical distances between milker and cow. The loading moment with respect to the shoulder joint bilateral axes was calculated, and EMGs from four shoulder muscles were recorded. The loading moments were related to isometric strength and EMG was standardized against an isometric maximum contraction. Muscle activity was low to moderate. Load moment increased with increasing level difference between milker and cow, but the simultaneous increase in strength utilization and muscular activation was lower than expected. About 25% of maximum shoulder flexor strength was required. The study illustrates some effects of the interaction between shoulder loading moment, trunk inclination and shoulder flexion. The method used gives load both in absolute form (loading moment) and in relation to individual capacity (strength utilization and normalized EMG).  相似文献   

16.
Prolonged use of the smartphone for texting was studied on a sample of 17 healthy young adult participants (11 females), who were asked to type interactively on a handheld device while standing and sitting. Upper body kinematics ad upper trapezius surface EMG were recorded to capture parameters of joint kinematics and muscular activity, which were then compared with self-reported indicators of discomfort through the Borg's CR 10 scale questionnaire. The results indicated that, while showing a similar postural strategy in both conditions that is assumed to be controlled by the visual system to maintain a constant viewing distance from the device, the participants adopted a “stiffer” posture of the head and neck during standing than when sitting, with a direct correlation between upper trapezius muscle activity, neck angle and perceived discomfort. The evidence obtained in this study highlights the importance of monitoring muscle activity and head and neck kinematics, to assess the biomechanical risk factors of neuromuscular disorders associated with smartphone overuse.  相似文献   

17.
While using their smartphone, users tend to adopt awkward neck and shoulder postures for an extended duration. Such postures impose the risk of MSDs on those body parts. Numerous studies have been undertaken to examine neck posture; however, few studies have investigated shoulder postures. This study examined various shoulder postures during smartphone use and their effect on neck and shoulder kinematics, muscle loading, and neck/shoulder discomfort. Thirty-two asymptomatic young adult smartphone users randomly performed texting tasks for 3 min at four different shoulder flexion angles (15°, 30°, 45°, and 60°), while maintained a neck posture in the neutral position (0° neck flexion angle). Measures were taken of neck and shoulder muscle activity of the cervical erector spinae (CES), anterior deltoid (AD), upper trapezius (UT) and lower trapezius (LT), and kinematic data (angle, distance and gravitational moment). Results showed AD and LT muscle activity significantly increased when the shoulder flexion angle increased with an opposite effect on CES and UT. A recommended shoulder posture was identified as 30° flexion, as this yielded the best compromise between activation levels of the four muscles studied. This angle also induced the lowest neck/shoulder discomfort score. The findings suggest smartphone users hold their device at approximately 30° shoulder flexion angle with their neck in a neutral posture to reduce the risk of shoulder and neck musculoskeletal disorders when smartphone texting.Relevance to industrySmartphone use in the manufacturing and service industries is an integral part of work and useful means of communication tool. Awkward postures during extensive smartphone use impose an increased risk of both neck and shoulder musculoskeletal disorders. Shoulder flexion angles need consideration when making recommendations about safe work postures during smartphone use.  相似文献   

18.
《Ergonomics》2012,55(11):1412-1419

Use of forearm support is known to reduce physical stress of computer users, but research about how to properly position the forearm support is insufficient. This study was aimed to determine whether the height of forearm support influences muscular loads during typing. Twenty four subjects performed a typing task with a pair of articulating forearm support at three different heights as well as without any support, while shoulder, neck and forearm muscle activities and posture data were recorded. Typing with the support at resting elbow height produced significantly (p < 0.05) lower shoulder and neck muscle activities than that of no support condition. Typing with the support at heights higher than the resting elbow height produced significantly greater shoulder and neck muscle activities compared to the no support condition. Results suggest that forearm support can help computer users lessen physical stress in typing, but only when the supports are positioned at resting elbow height.

Practitioner Summary: Use of forearm support is known to alleviate physical stress of PC users in computer works such as typing. This experimental study addressed the importance of proper positioning of forearm support by comparing neck and upper extremity muscle activities between conditions with varying heights of forearm support in keyboard typing.  相似文献   

19.
PurposeThe purpose of this study was to explore posture deviation variability caused by load carriages depending on natural posture imbalance to provide information about a carrying habit exaggerating an individual's posture imbalance. All people exhibit some imbalance from the standard anatomical pose which assumes alignment with the frontal and median planes. In this study natural posture imbalance is the starting point for determining posture deviation which is posture imbalance resulting from an activity, carrying an item.MethodsSeventeen female participants, 19–37 years old, were recruited from university staff, faculty members, and students. Participants were each scanned wearing their own underwear (bra and panties) in: (a) the anatomical pose (P1) face forward and feet placed at shoulder width without carrying an item, (b) carrying a backpack (P2), (c) carrying a shoulder bag on the right shoulder (P3R) and the left shoulder (P3L), (d) carrying a bag cross-body with a strap placed on the left shoulder to place the weight at the hip level on the right side (P4R) and the strap and handbag placed in the opposite direction (P4L), and (e) carrying a bag with the right hand (P5R) and the left hand (P5L). The bag weight was approximately 10% of a participant's body weight. Five body angles were obtained in each scanning position (eight positions total) for all participants and statistical analyses were conducted for posture assessment. Three statistical test methods were used: (a) Paired t-test to determine posture changes in each loaded position compared to natural posture in P1. (b) Paired t-test to identify differences of the degree of posture changes between right-side load (R) and left-side load (L) positions to determine a posture deviation tendency with asymmetrical load carriages. (c) Bivariate (Pearson) correlation test to examine how natural posture imbalance and posture deviation co-vary.Results(a) Asymmetrical load positions exhibited greater changes on shoulder and spine posture than a symmetrical load position, exhibiting obvious changes in P3 and P4 rather than P5. (b) The degrees and directions of posture deviation resulting from an asymmetrical load carriage varied depending on those of an individual's natural posture imbalance. When a participant exhibited great posture imbalance in P1, significant differences of posture deviation on the shoulder and spine between R and L positions were observed in P3 and P4. (c) Significant correlations between natural posture imbalance and posture deviation resulting from load carriages were found for most body angles.ConclusionsPeople need to be aware of their natural posture imbalance and try to avoid carrying heavy handbags or any type of carriages making their posture imbalance worse to prevent possible further distortion.Relevance to IndustryAlthough this study used handbags and a backpack as the load carrying devices, the way a person carries a load of any type is relevant in many industries and in the military.  相似文献   

20.
BackgroundHome, public transport, work, the number of environmental positions constraining the use of smartphones is significant.Research questionHow can the presence of an upper limb support influence the sitting posture of smartphone users under fixed illumination and brightness?MethodsTwelve subjects (21,6 ± 5,5 years old) performed web browsing under two environmental positions (POSITION): sitting with and without support (table). The users' postures were evaluated through relative kinematics joint angles analysis. A repeated measure analysis of variance and Tukey post-hoc tests were performed to test the effect of POSITION on posture.ResultsIn sitting position in front of a table, neck is less stressed (flexion < 10°) and trunk and shoulder are supported which suggests less constrains for the joints.Relevance to industryTo prevent injury or pain, the use of an upper limb support (to lean on) should be considered for people/workers who use the smartphone frequently.  相似文献   

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