A kinetic comparison of back-loading and head-loading in Xhosa women

The purpose of this study was to compare the kinetic responses associated with ground reaction force measurements to both head-loading and back-loading in a group of Xhosa women. Altogether, 16 women were divided into two groups based on their experience of head-loading. They walked over a force plate in three conditions: unloaded or carrying 20 kg in either a backpack or on their head. The most striking finding was that there was no difference in kinetic response to head-loading as a consequence of previous experience. Considering the differences between the load carriage methods, most changes were consistent with increasing load. Head-loading was, however, associated with a shorter contact time, smaller thrust maximum and greater vertical force minimum than back-loading. Both loading conditions differed from unloaded walking for a number of temporal variables associated with the ground contact phase, e.g. vertical impact peak was delayed whilst vertical thrust maximum occurred earlier. STATEMENT OF RELEVANCE: Consideration of the kinetics of head and back load carriage in African women is important from a health and safety perspective, providing an understanding of the mechanical adaptations associated with both forms of load carriage for a group of people for whom such load carriage is a daily necessity.     

Effect of load mass on posture, heart rate and subjective responses of recreational female hikers to prolonged load carriage

Load carriage has been associated with a risk of upper and lower limb musculoskeletal disorders with women suffering significantly higher injury rates than their male counterparts. Despite this injury risk, there are limited evidence-based guidelines for recreational hikers, particularly female recreational hikers, regarding safe backpack loads. The purpose of the present study was to determine how variations in load mass affected the heart rate, posture and subjective responses of women during prolonged walking to provide evidence for a load mass limit for female recreational hikers. Heart rate (HR), posture and ratings of perceived exertion (RPE) and discomfort were collected for 15 female experienced recreational hikers (22.3 ± 3.9 years) while they hiked for 8 km at a self-selected pace under four different load conditions (0%, 20%, 30% and 40% of body weight (BW)). Although HR was not significantly affected by load mass or walking distance, increasing load mass and distance significantly affected posture, RPE and discomfort of the upper body. Carrying a 20% BW load induced significant changes in trunk posture, RPE and reported shoulder discomfort compared to the unloaded condition. The 20% BW load also resulted in a mean RPE rating of ‘fairly light’, which increased to ‘hard’ when carrying a 40% BW load. As load carriage distance increased participants reported significantly increased shoulder, neck and upper back discomfort. Based on the changes to posture, self-reported exertion and discomfort when carrying loads of 20%, 30% and 40% BW over 8 km, it was concluded that a backpack load limit of 30% BW should be recommended for female recreational hikers during prolonged walking.     

Integrating a hip belt with body armour reduces the magnitude and changes the location of shoulder pressure and perceived discomfort in soldiers*

Soldiers carry heavy loads that may cause general discomfort, shoulder pain and injury. This study assessed if new body armour designs that incorporated a hip belt reduced shoulder pressures and improved comfort. Twenty-one Australian soldiers completed treadmill walking trials wearing six different body armours with two different loads (15 and 30 kg). Contact pressures applied to the shoulders were measured using pressure pads, and qualitative assessment of comfort and usability were acquired from questionnaires administered after walking trials. Walking with hip belt compared to no hip belt armour resulted in decreased mean and maximum shoulder pressures (p < 0.005), and 30% fewer participants experiencing shoulder discomfort (p < 0.005) in best designs, although hip discomfort did increase. Laterally concentrated shoulder pressures were associated with 1.34-times greater likelihood of discomfort (p = 0.026). Results indicate body armour and backpack designs should integrate a hip belt and distribute load closer to shoulder midline to reduce load carriage discomfort and, potentially, injury risk.

Practitioner Summary: Soldiers carry heavy loads that increase their risk of discomfort and injury. New body armour designs are thought to ease this burden by transferring the load to the hips. This study demonstrated that designs incorporating a hip belt reduced shoulder pressure and shoulder discomfort compared to the current armour design.     

Self-reported discomfort when using commercially targeted virtual reality equipment in discomfort distraction

Commercially targeted virtual reality (VR) equipment is gaining popularity and might be a viable tool for pain distraction. This experimental research aimed to discover whether active distraction techniques (such as commercially targeted VR and video games) result in reduced subjective discomfort relative to passive distraction techniques. The study examined a healthy adult population who experienced an experimentally induced discomfort task. Participants were 27 adults, 14 females and 13 males. Participants completed four tasks, a baseline measure of physical discomfort, video clip distraction (passive distraction), video game distraction (active distraction) and exploring a VR world using an Oculus Rift head-mounted display (active distraction). In all four test conditions, participants were asked to sit on a chair holding their non-dominant leg at a height of approximately 30 cm from the floor, up to a maximum of 5 min. Counterbalancing of task order was conducted to reduce effects of participant fatigue. The participants indicated significantly reduced self-reported discomfort in the active distraction tasks when compared to the passive distraction tasks. While the findings demonstrate the effectiveness of a commercially targeted VR technology in increasing pain tolerance, the relative benefits of this technology over non-immersive video games are not apparent.     

A comparison of economy and sagittal plane trunk movements among back-, back/front- and head-loading

It has been suggested that freedom of movement in the trunk could influence load carriage economy. This study aimed to compare the economy and sagittal plane trunk movements associated with three load carriage methods that constrain posture differently. Eighteen females walked at 3?km^.h^?1 with loads of 0, 3, 6, 9, 12, 15 and 20?kg carried on the back, back/front and head. Load carriage economy was assessed using the Extra Load Index (ELI). Change in sagittal plane trunk forward lean and trunk angle excursion from unloaded to loaded walking were assessed. Results show no difference in economy between methods (p?=?.483), despite differences in the change in trunk forward lean (p?=?.001) and trunk angle excursion (p?=?.021) from unloaded to loaded walking. We conclude that economy is not different among the three methods of load carriage, despite significant differences in sagittal plane trunk movements.

Practitioner summary: This article shows, based on mean data, that there is no difference in economy among back, back/front and head-loading, despite differences in trunk movement. It is possible a combination of factors align to influence individual economy, rather than a single set of factors, applicable to all individuals for each method.     

Rating of acceptable loads: Lifting with and without handles

Rating of acceptable load (RAL) was used to determine the load-handling capacity of women (n = 54) and men (n = 49) and the effects of handles on the acceptable weight. The RAL test was administered using 30×30×30 cm boxes, one without handles and the other with handles 20 cm above the base. Subjects were asked to fill a box with the weight that they considered would be acceptable for lowering from table (72 cm) to floor and again lifting back to the table at 5-min intervals over an 8-hour working day. The tests were done in their actual place of work.

Subjects selected heavier acceptable loads for the box with handles. The overall means for women and men for the box with handles were 8.8 kg for women and 19.1 kg for men and for the box without handles 7.5 kg and 14.9 kg, respectively. The greater difference of the selected weight of two the boxes for men than for women suggests that the heavier the box more important it is to have it equipped with handles.     

Prevalence of occupation-related pain among baristas and an examination of low back and shoulder demand during the preparation of espresso-based beverages

Many baristas complain of low back pain (LBP) and upper extremity discomfort while at work. This study documented the prevalence of LBP and shoulder pain, via questionnaire, among a population of baristas to determine whether cumulative low back loads and shoulder moments are associated with pain reporting. Fifty-nine baristas completed the questionnaire; ten were also video-recorded for biomechanical analysis while making espresso beverages and cumulative and peak low back loads and shoulder moments were calculated. Seventy-three percent of those who completed the questionnaire reported having experienced LBP, and half attributed this pain to their job as a barista. Furthermore, 68% reported having experienced shoulder pain and half also attributed this pain to their job. Those who suffered from LBP had higher peak low back compression and those with shoulder pain had, in general, higher moments about their dominant shoulder.     

A comparison of the effects of floor mats and shoe in-soles on standing fatigue

In assembly line positions and other occupations, employees experience pain and discomfort associated with long periods of standing. Modifying flooring is a common intervention method used to alleviate problems associated with constrained standing. This study investigated the effects of four different standing conditions upon assembly workers' perception of general fatigue and discomfort associated with various body parts following 1 week of 8-h days of exposure to each condition. The four standing conditions were (1) on hard floor, (2) on a floor mat, (3) wearing shoe in-soles, and (4) wearing shoe in-soles while standing on a floor mat. Questions were asked regarding general fatigue and discomfort. In general, the mat, in-soles and combined conditions were more comfortable than standing on hard floor. Moderately strong correlations were found for the variables of height, age and job tenure. Shorter individuals experienced greater discomfort in the upper leg and low back when standing on a mat and when wearing in-soles. The older workers and those with more job seniority reported greater discomfort associated with body joints when standing on the hard floor and when standing on the floor mat. No significant differences in fatigue or discomfort were found when comparing the overall effects of using the floor mat to wearing the shoe in-soles or the combined condition.     

Comparison of perceived comfort differences between standard and experimental load carriage systems

The current popularity of backpack-type load carriage systems (LCS) by students has precipitated a prevalence of postural abnormalities and pain. This study compared subjective perceptual comfort in standard and vertically loaded LCSs. Sixteen females ages 18–23 years rated their personal LCSs for perceived shoulder, neck, and lower back comfort and for overall comfort, each day for two weeks using 100 mm visual analogue scales (VAS). Each scale contained polar extremities of ‘very comfortable’ to ‘very uncomfortable’ and a vertical mark placed on the 100 mm line by the participants indicated their perception of comfort. Following two weeks, participants were given LCSs that distributed the weight vertically and were asked to rate the system in the same way for an additional two-week period. Statistical analysis revealed significant differences in shoulder (p=0.015), neck (p=0.005), and lower back (p=0.036) comfort and overall comfort (p=0.001) between the participants' personal LCSs and the experimental LCS. In conclusion, vertical load placement may redistribute the load in a manner that reduces symptoms of selected anatomical discomfort.     

Influence of school bag loads and carrying methods on body strain among young male students

This study examined the influences of schoolbag carrying modes combined with carrying weights on the body posture alterations, muscle activations, and subjective discomfort scores of participants. Twelve male university students were recruited as participants and executed nine test combinations of three carrying methods (2-strap backpack, 1-strap side backpack, and 1-strap crossbody carrying) generally used by Taiwanese young students and three loads (5%, 10%, and 15% of their respective body weights [BWs]). The results revealed that carried load and method significantly affected body posture and trapezius activation. Side backpack carrying should be avoided because of the relatively high lateral shoulder tilt, trunk flexion, right trapezius activation, and low lumbosacral angle observed compared with other two carrying methods. The unbalanced load of side backpack carrying may cause an uneven shoulder posture, thus resulting in extra body strains. Furthermore, carrying loads at 10% of BW was recommended when carrying a 2-strap backpack.Relevance to industryThe daily carriage of a schoolbag or backpack on the musculoskeletal health of young students has been a permanent concern. The findings suggest that carrying a load weighing 15% of BW and using the unbalanced side backpack carrying method should be avoided.     

Comparison of perceived comfort differences between standard and experimental load carriage systems

The current popularity of backpack-type load carriage systems (LCS) by students has precipitated a prevalence of postural abnormalities and pain. This study compared subjective perceptual comfort in standard and vertically loaded LCSs. Sixteen females ages 18-23 years rated their personal LCSs for perceived shoulder, neck, and lower back comfort and for overall comfort, each day for two weeks using 100 mm visual analogue scales (VAS). Each scale contained polar extremities of 'very comfortable' to 'very uncomfortable' and a vertical mark placed on the 100 mm line by the participants indicated their perception of comfort. Following two weeks, participants were given LCSs that distributed the weight vertically and were asked to rate the system in the same way for an additional two-week period. Statistical analysis revealed significant differences in shoulder (p=0.015), neck (p=0.005), and lower back (p=0.036) comfort and overall comfort (p=0.001) between the participants' personal LCSs and the experimental LCS. In conclusion, vertical load placement may redistribute the load in a manner that reduces symptoms of selected anatomical discomfort.     

Effectiveness of leg movement in reducing leg swelling and discomfort in lower extremities

Various occupations required that workers stand for long periods, causing discomfort and pain. This study considered the effectiveness of three leg movements in relieving discomfort of the lower extremities during long periods of standing at work. Ten paid male subjects with no history of problems of the lower extremities were enrolled in this study. They performed three leg movements on a hard floor while standing for 4 h in a laboratory setting. Each 1 h experimental test had two phases - 50 min of standing, followed by 10 min of rest. During the period of standing, one the following leg movements was made. No movement (no change in posture), ankle movement (twice, for 2 min each time), and hip movement (twice, for 2 min each time). Observations revealed that the three leg movements yielded different degrees of lower limb swelling. The percentage changes in thigh (1.22%) and shank (1.32%) circumferences were largest during prolonged standing without any movement and lowest during prolonged standing with ankle movement (0.61%) and hip movement (0.80%). The relationship between perceived discomfort and standing time was determined. The subjects perceived the most shank discomfort (5.8) during the 4 h test without any movement. Leg movement greatly influenced perceived discomfort of the shank. The results of this study suggested that workers should move their ankles and hips for a short period following prolonged standing for 30 min to reduce lower extremity discomfort.     

Discomfort and load on the upper trapezius muscle when operating a word processor

Abstract

Surface electromyogram recordings from the descending part of the trapezius muscle and discomfort ratings were assessed for six female VDT wordprocessor operators during their work. Each operator was studied during three work periods of 3 to 5 hours on different days. During one of the work periods, short pauses (15 s) were introduced every sixth minute. A static local muscular load of 32 and 30% of the maximal voluntary contraction was found on the right and the left side, respectively. The median and peak muscular loads during work were low. There was a significant negative correlation between pauses and static load on the right upper trapezius muscle. The rating of perceived discomfort was less after the work periods with short pauses than after the work periods without.     

The effect of carried loads on the walking patterns of men and women

In order to determine the effect of loads worn or carried on walking mechanics, 11 men and 11 women were filmed using high speed cinematography as they performed overground walking at 1·78 m/s under five load conditions. The loads included a baseline condition in which subjects carried no added load, and additional loads of approximately 9, 17, 29 and 36 kg consisting of standard military items. The latter two loads were added in the form of a framed rucksack system. Values for several variables frequently used to described temporal and kinematic characteristics of walking were quantified from the film. These included stride length, stride rate, single leg support time, double-support time, swing time and the forward inclination of the trunk. The results of the study demonstrated that the males and females displayed significantly different gait patterns under all load conditions. Not unexpectedly, the females required a higher rate of stepping than the males because of their shorter stride lengths. The results also demonstrated that the walking patterns of both the male and female subjects were affected by the increases in carried load. In general, stride length and swing time decreased while stride rate and double-support time increased with increases in load. There was also an increased forward inclination of the trunk but only for the two heaviest loads which were carried in a rucksack. While the changes in gait characteristics were relatively small for the male subjects, the females were affected to a greater extent thereby demonstrating a greater sensitivity to load magnitude. It was concluded that careful consideration must be given to the absolute loads carried by males and females. Not only is it important for load requirements to be lower for females because of the physiological implications but also because of biomechanical implications and the associated mechanical stresses which must be endured during locomotion. While this study was directed primarily towards military applications, the results should also have implications for load carrying in a variety of situations and environments, including industrial and recreational applications.     

Vertical vibration frequency and sitting posture effects on muscular loads and body balance

This study examined the effects of whole body vibration and sitting posture on muscular load, body balance and discomfort. An electric vibrator, a surface electromyography measurement system and a balance evaluation system were used in the experiment. Nine test conditions were studied consisting of three vertical frequencies (no vibration, 20 and 40 Hz) and three sitting postures (erect, bent-forward and twisted). Study results showed that whole body vibration had significant effects on the muscular loads in the torso muscles, body balance and perceived discomfort. Adverse effects generally increased with high-frequency vibration. No significant muscular load difference and balance difference were observed among sitting postures at any frequency. Significant discomfort differences between the erect and twisted postures were found with no vibration or at low frequency.Relevance to industryAttention should be paid to the negative effects of vibration transmission on the human body at worksites. The results from this study should be useful for whole body vibration risk assessment and control measures.     

The relationship between foot pain, anthropometric variables and footwear among older people

Objective

To verify the prevalence of pain among older people when wearing shoes, and the relationships between foot pain, high-heeled shoes and anthropometric variables.

Method

Both feet of 227 older women and 172 older men were evaluated with respect to anthropometric variables, arch index and foot posture index. The participants were also asked about the presence of foot pain while wearing high-heeled shoes. The data were analyzed using the Chi-square test, Pearson's correlation, MANOVA, multiple regression analysis, t test, and analysis of probability.

Findings

The prevalence of foot pain when wearing shoes was high and was associated with the female gender, however wearing high-heeled shoes was not associated with pain. The women with foot pain presented larger values for the circumferences of the metatarsal heads and the instep (after normalization with the foot length) than those without pain. The men with pain did not present different measurements from those without pain.     

Spinal shrinkage,sagittal alignment and back discomfort changes in manufacturing company workers during a working day

Abstract

Prolonged standing and lifting heavy loads are risk factors for the appearance of low back pain in work. The aim of this study was to observe changes in the height, spinal sagittal alignment, and the lumbar and dorsal discomfort perception in assembly line workers. Cross-sectional study, 40 assembly line workers (6 females). Height, sitting height, grades of thoracic kyphosis and lumbar lordosis and perceived spine discomfort, before and after the working day, were determined. Thoracic and lumbar sagittal alignment was compared between discomfort developers and no developers. There was a significant decrease in the height and sitting height of the workers at the end of the day. Thoracic and lumbar curvature increased significantly, as did the perceived lumbar discomfort. Workers on the assembly line, in a prolonged standing work, suffer an increase in lumbar discomfort, and changes in height and thoracic and lumbar curvatures.

Practitioner summary: Spinal shrinkage, sagittal alignment and back discomfort (upper and lower back), were analysed in assembly line workers in prolonged standing during a workday. Assembly line workers suffer a decrease in height, an increase in their thoracic and lumbar curvature, and in lumbar discomfort throughout their workday.     

Fatigue and recovery during and after static loading

Subjectively assessed endurance time (ET), resumption time (RT) and perceived discomfort, pain or fatigue (PD), and objectively measured maximum force-exerting capacity were investigated for varying loads and durations of a pushing task with two repeated trials. Beyond the main results quantifying how the load scenario affected ET, RT and PD, three additional results are of note: (1) although the maximum pushing force did not change between trials, shorter ET, longer RT and higher PD indicated accumulation of fatigue in Trial 2; (2) the PD ratings showed a trend with a linear increase during loading and a curvilinear decrease during recovery; and (3) the RT and the load level for different relative loading times were found to have an unexpected U-shaped relationship, indicating lowest fatigue at the intermediate load level. These results can be used to model a more sustainable and productive work-recovery ratio.     

The design of hand gestures for human–computer interaction: Lessons from sign language interpreters

The design and selection of 3D modeled hand gestures for human–computer interaction should follow principles of natural language combined with the need to optimize gesture contrast and recognition. The selection should also consider the discomfort and fatigue associated with distinct hand postures and motions, especially for common commands. Sign language interpreters have extensive and unique experience forming hand gestures and many suffer from hand pain while gesturing. Professional sign language interpreters (N=24) rated discomfort for hand gestures associated with 47 characters and words and 33 hand postures. Clear associations of discomfort with hand postures were identified. In a nominal logistic regression model, high discomfort was associated with gestures requiring a flexed wrist, discordant adjacent fingers, or extended fingers. These and other findings should be considered in the design of hand gestures to optimize the relationship between human cognitive and physical processes and computer gesture recognition systems for human–computer input.     

Back muscle strength, lifting, and stooped working postures

When lifting loads and working in a forward stooped position, the muscles of the back rather than the ligaments and bony structures of the spine should overcome the gravitational forces. Formulae, based on measurements of back muscle strength, for prediction of maximal loads to be lifted, and for the ability to sustain work in a stooped position, have been worked out and tested in practical situations. From tests with 50 male and female subjects the simplest prediction formulae for maximum loads were: max. load = 1.10 x isometric back muscle strength for men; and max. load = 0.95 x isometric back muscle strength - 8 kg for women. Some standard values for maximum lifts and permissible single and repeated lifts have been calculated for men and women separately and are given in Table 1. From tests with 65 rehabilitees it was found that the maximum isometric strength of the back muscles measured at shoulder height should exceed 2/3 of the body weight, if fatigue and/or pain in the back muscles is to be avoided during work in a standing stooped position.