Naturalistic data collection of head posture during smartphone use

Association between smartphone use and head-down tilt posture has not yet been quantitatively evaluated in natural settings. This study aimed to objectively assess the angle and duration of head-down tilt posture of smartphone users during a typical working day via naturalistic data collection. Thirty-one college students conducted their typical school activities while their head posture and smartphone-app usage records were collected simultaneously for 8?hours. Participants spent 125.9?minutes (median usage duration) on their smartphones with significantly larger head-down tilt (p?<?.05) than when they were not using the phone. Head tilt angle greater than 30° was found to be more common when using the phone, while head tilt less than 20° was more common when they were not using the phone. Study findings provide empirical evidence that supports an association between the duration of smartphone use and the intensity of head-down tilt posture.

Practitioner Summary: Head postures of young smartphone users were quantified for 8?hours continuously during a typical workday using a wearable sensor. Participants spent more time in larger head-down tilt postures (greater than 30°) when they were using their smartphones as compared to when they were not using them.     

The effect of age on in-vivo spine stiffness,postures and discomfort responses during prolonged sitting exposures

Many industrialised working populations are ageing and prolonged sitting exposures are prevalent across occupational sectors. The purpose of this work was to determine the effect of age and sex on passive spine stiffness, postures and discomfort in response to seated work. A total of 34 participants were recruited, with 17 older adults with an average age of (standard deviation) 63.7 (±3.9) years and 17 younger adults aged 23.8 (±5.0) years. Participants were asked to sit continuously for 90?min while typing. Baseline passive spine stiffness was higher in older adults at 40% flexion compared to younger adults (p?=?.0233). Older adults sat in less normalised flexion, at 33.4% (±16.4) compared to 60.9% (±20.2) in the younger group (p?=?.0003). Discomfort was higher among older adults in the neck, right shoulder and middle back regions (p?<?.0086). An understanding of age-specific responses to workplace exposures is essential to determine whether age-specific interventions are warranted.

 

Practitioner summary: Older adults had higher passive spine stiffness and sat with less flexion during prolonged sitting. Discomfort was higher among older adults and occurred earlier in the simulation compared to younger participants, indicating that interventions, such as walking breaks may need to be implemented earlier during sitting for aged workers.     

Gravitational demand on the neck musculature during tablet computer use

Tablet computer use requires substantial head and neck flexion, which is a risk factor for neck pain. The goal of this study was to evaluate the biomechanics of the head–neck system during seated tablet computer use under a variety of conditions. A physiologically relevant variable, gravitational demand (the ratio of gravitational moment due to the weight of the head to maximal muscle moment capacity), was estimated using a musculoskeletal model incorporating subject-specific size and intervertebral postures from radiographs. Gravitational demand in postures adopted during tablet computer use was 3–5 times that of the neutral posture, with the lowest demand when the tablet was in a high propped position. Moreover, the estimated gravitational demand could be correlated to head and neck postural measures (0.48 < R ² < 0.64, p < 0.001). These findings provide quantitative data about mechanical requirements on the neck musculature during tablet computer use and are important for developing ergonomics guidelines.

Practitioner Summary: Flexed head and neck postures occur during tablet computer use and are implicated in neck pain. The mechanical demand on the neck muscles was estimated to increase 3–5 times during seated tablet computer use versus seated neutral posture, with the lowest demand in a high propped tablet position but few differences in other conditions.     

Are hybrid sit–stand postures a good compromise between sitting and standing?

Potential alternatives for conventional sitting and standing postures are hybrid sit-stand postures (i.e. perching). The purposes of this study were (i) to identify where lumbopelvic and pelvic angles deviate from sitting and standing and (ii) to use these breakpoints to define three distinct postural phases: sitting, perching, and standing, in order to examine differences in muscle activations and ground reaction forces between phases. Twenty-four participants completed 19 1-min static trials, from sitting (90°) to standing (180°), sequentially in 5°trunk–thigh angle increments. The perching phase was determined to be 145–175° for males and 160–175° for females. For both sexes, knee extensor activity was lower in standing compared to perching or sitting (p < .01). Anterior–posterior forces were the highest in perching (p < .001), requiring ～15% of body-weight. Chair designs aimed at reducing the lower limb demands within 115–170° trunk–thigh angle may improve the feasibility of sustaining the perched posture.

Practitioner summary: Individuals who develop low back pain in sitting or standing may benefit from hybrid sit-stand postures (perching), yet kinematic and kinetic changes associated with these postures have not been investigated. Perching can improve lumbar posture at a cost of increased lower limb demands, suggesting potential avenues for chair design improvement.

Abbreviations: A/P: anterior-posterior; M/L: medial-lateral; LBP: low back pain; EMG: electromyography; TES: thoracic erector spinae; LES: lumbar erector spinae; VMO: vastus medialis obliquus; MVC: maximum voluntary contraction; ASIS: anterior superior iliac spine; PSIS: posterior superior iliac spine; BW: body weight; RMSE: root mean square error; SD: standard deviation; ROM: range of motion     

Influence of smartphone use styles on typing performance and biomechanical exposure

Twenty-seven subjects completed 2-min typing tasks using four typing styles: right-hand holding/typing (S-thumb) and two-hand typing at three heights (B-low, B-mid and B-high). The styles had significant effects on typing performance, neck and elbow flexion and muscle activities of the right trapezius and several muscles of the right upper limb (p < 0.0001 by repeated-measure analysis of variance). The subjects typed the fewest words (error-adjusted characters per minute: 78) with the S-thumb style. S-thumb style resulted in similar flexion angles of the neck, elbow and wrist, but significantly increased muscle activities in all tested muscles compared with the B-mid style. Holding the phone high or low reduced the flexion angles of the neck and right elbow compared with the B-mid style, but the former styles increased the muscle activity of the right trapezius. Right-hand holding/typing was not a preferable posture due to high muscle activities and slow typing speed.

Practitioner Summary: Right-hand holding/typing was not favoured, due to increased muscle activities and slower typing speed. Holding the phone high or low reduced the flexion angles of the neck and right elbow, but the former styles increased the muscle activity of the right trapezius compared with holding the phone at chest level.     

Notebook computer use on a desk,lap and lap support: Effects on posture,performance and comfort

This study quantified postures of users working on a notebook computer situated in their lap and tested the effect of using a device designed to increase the height of the notebook when placed on the lap. A motion analysis system measured head, neck and upper extremity postures of 15 adults as they worked on a notebook computer placed on a desk (DESK), the lap (LAP) and a commercially available lapdesk (LAPDESK). Compared with the DESK, the LAP increased downwards head tilt 6° and wrist extension 8°. Shoulder flexion and ulnar deviation decreased 13° and 9°, respectively. Compared with the LAP, the LAPDESK decreased downwards head tilt 4°, neck flexion 2°, and wrist extension 9°. Users reported less discomfort and difficulty in the DESK configuration. Use of the lapdesk improved postures compared with the lap; however, all configurations resulted in high values of wrist extension, wrist deviation and downwards head tilt.

Statement of Relevance: This study quantifies postures of users working with a notebook computer in typical portable configurations. A better understanding of the postures assumed during notebook computer use can improve usage guidelines to reduce the risk of musculoskeletal injuries     

The effects of shoulder posture on neck and shoulder musculoskeletal loading and discomfort during smartphone usage

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.     

Mobile technology dominates school children’s IT use in an advantaged school community and is associated with musculoskeletal and visual symptoms

This paper describes the contemporary use of information technology devices by children in a socio-educationally advantaged school. A sample of 924 children (50% girls) from grades 5 to 12 (ages 10–19 years) completed an online survey in class. Total daily technology use was high and similar for girls (mean 219 (SD 148) mins/day) and boys (207 (142), p=.186). Tablet computer was the dominant device used in grades 5–9, with laptop computer the dominant device in grades 10–12. Patterns of exposure were influenced by gender, device, grade and purpose of use interactions. For example, girls used mobile phones more than boys for social purposes for grades 10 and 11, but not grade 12. Whilst children’s attitudes to technology use were positive, musculoskeletal and visual symptoms were commonly reported. Hours/day tablet and phone use was related to neck/shoulder discomfort (OR = 1.07; 1.13) and visual symptoms (OR = 1.10; 1.07).

Practitioner Summary: Technology use by children appears to be quite different now to a decade ago. This paper describes contemporary school children’s use of various devices for various purposes. The survey of >900 children found high technology use, dominated by new mobile technologies, and associations with musculoskeletal and visual symptoms.     

Glasses-type wearable computer displays: usability considerations examined with a 3D glasses case study

This study presents usability considerations and solutions for the design of glasses-type wearable computer displays and examines their effectiveness in a case study. Design countermeasures were investigated by a four-step design process: (1) preliminary design analysis; (2) design idea generation; (3) final design selection; and (4) virtual fitting trial. Three design interventions were devised from the design process: (1) weight balance to reduce pressure concentrated on the nose, (2) compliant temples to accommodate diverse head sizes and (3) a hanger mechanism to help spectacle users hang their wearable display on their eye glasses. To investigate their effectiveness, in the case study, the novel 3D glasses adopting the three interventions were compared with two existing 3D glasses in terms of neck muscle fatigue and subjective discomfort rating. While neck muscle fatigue was not significantly different among the three glasses (p = 0.467), the novel glasses had significantly smaller discomfort ratings (p = 0.009).

Relevance to Industry: A four-step design process identified usability considerations and solutions for the design of glasses-type wearable computer displays. A novel 3D glasses was proposed through the process and its effectiveness was validated. The results identify design considerations and opportunities relevant to the emerging wearable display industry.     

Three-dimensional finger joint angles by hand posture and object properties

The objective of this study was to identify three-dimensional finger joint angles for various hand postures and object properties. Finger joint angles were measured using a VICON system for 10 participants while they pinched objects with two, three, four and five fingers and grasped them with five fingers. The objects were cylinders and square pillars with diameters of 2, 4, 6 and 8 cm and weights of 400, 800, 1400 and 1800 g. Hand posture and object size more significantly affected the joint flexion angles than did object shape and weight. Object shape affected only the metacarpophalangeal (MCP) joint angle of the index finger and the flexion angle of the MCP joint of the little finger. Larger flexion angles resulted when the hand posture was grasping with five fingers. The joint angle increased linearly as the object size decreased. This report provides fundamental information about the specific joint angles of the thumb and fingers.

Practitioner Summary: Three-dimensional finger joint angles are of special interest in ergonomics because of their importance in handheld devices and musculoskeletal hand disorders. In this study, the finger joint angles corresponding to various hand postures and objects with different properties were determined.     

Lift performance and lumbar loading in standing and seated lifts

This study investigated the effect of posture on lifting performance. Twenty-three male soldiers lifted a loaded box onto a platform in standing and seated postures to determine their maximum lift capacity and maximum acceptable lift. Lift performance, trunk kinematics, lumbar loads, anthropometric and strength data were recorded. There was a significant main effect for lift effort but not for posture or the interaction. Effect sizes showed that lumbar compression forces did not differ between postures at lift initiation (Standing 5566.2?±?627.8 N; Seated 5584.0?±?16.0) but were higher in the standing posture (4045.7?±?408.3 N) when compared with the seated posture (3655.8?±?225.7 N) at lift completion. Anterior shear forces were higher in the standing posture at both lift initiation (Standing 519.4?±?104.4 N; Seated 224.2?±?9.4 N) and completion (Standing 183.3?±?62.5 N; Seated 71.0?±?24.2 N) and may have been a result of increased trunk flexion and a larger horizontal distance of the mass from the L5-S1 joint.

Practitioner Summary: Differences between lift performance and lumbar forces in standing and seated lifts are unclear. Using a with-in subjects repeated measures design, we found no difference in lifted mass or lumbar compression force at lift initiation between standing and seated lifts.     

Towards exposure limits for working postures and musculoskeletal symptoms – a prospective cohort study

Occupational postures are considered to be an important group of risk factors for musculoskeletal pain. However, the exposure-outcome association is not clear yet. Therefore, we aimed to determine the exposure-outcome association of working postures and musculoskeletal symptoms. Also, we aimed to establish exposure limits for working postures. In a prospective cohort study among 789 workers, intensity, frequency and duration of postures were assessed at baseline using observations. Musculoskeletal pain was assessed cross-sectionally and longitudinally and associations of postures and pain were addressed using logistic regression analyses. Cut-off points were estimated based on ROC-curve analyses. Associations were found for kneeling/crouching and low-back pain, neck flexion and rotation and neck pain, trunk flexion and low-back pain, and arm elevation and neck and shoulder pain. The results provide insight into exposure-outcome relations between working postures and musculoskeletal symptoms as well as evidence-based working posture exposure limits that can be used in future guidelines and risk assessment tools.

Practitioner Summary: Our study gives insight into exposure-outcome associations of working postures and musculoskeletal symptoms (kneeling/crouching and low-back pain, neck flexion/rotation and neck pain, trunk flexion and low-back pain, and arm elevation and neck and shoulder pain). Results furthermore deliver evidence-based postural exposure limits that can be used in guidelines and risk assessments.     

Stand up: comparison of two electrical screed levelling machines to reduce the work demands for the knees and low back among floor layers

Electrical screed levelling machines are developed to reduce kneeling and trunk flexion of sand–cement-bound screed floor layers. An observational intervention study among 10 floor layers was performed to assess the differences between a self-propelled and a manually moved machine. The outcome measures were work demands, production time, perceived load, discomfort and applicability. Compared to the self-propelled machine, the duration of kneeling (?13 min; p = 0.003) and trunk flexion (?12 min; p < 0.001) was shorter using the manually moved machine, and the duration of pushing and pulling increased (?39 min; p < 0.001). No significant or relevant differences were found for production time, perceived load and discomfort. Nine out of ten floor layers found the manually moved machine applicable and three out of ten found the self-propelled machine applicable. When compared with the traditional manner of floor laying, both electrical machines reduced the exposure towards kneeling and trunk flexion.

Practitioner Summary: Electrical machines may help to reduce high physical work demands on floor layers. A manually moved machine is better applicable for the installation of screed floors in residences with smaller floor areas. A self-propelled machine is better applicable on large floor areas with a minimum width of 4 m.     

A Review of :“Leu Accidents du Travail.” By JACQUES LEPLAT et XAVIER CUNY. (Paris: Presses Universities de France, 1974.( [Pp.128. £0·00.

Police officers spend large amounts of time performing duties within a police cruiser and report a high prevalence of musculoskeletal problems. This study evaluated the effects of driver seat and duty belt design on posture, pressure and discomfort. Ten male and 10 female university students attended two sessions involving simulated driving in a standard police seat (CV) and an active lumbar support (ALS) seat. Participants wore a full duty belt (FDB) or reduced duty belt (RDB) in each seat. Lumbar postures, driver-seat and driver-duty belt pressures and perceived discomfort were measured. Gender × Seat interactions were found for pelvic (p = 0.0001) and lumbar postures (p = 0.003). Females had more lumbar flexion than males and were more extended in the ALS seat (?9.8 ± 11.3°) than CV seat (?19.8 ± 9.6°). The FDB had greater seat pressure than the RDB (p < 0.0001), which corresponded to increased pelvis discomfort. This study supports the use of an ALS seat and RDB to reduce injury risk associated with prolonged sitting in police officers.

Practitioner Summary: Police officers report a high prevalence of musculoskeletal problems to the lower back, associated with prolonged driving and further investigation is needed to reduce injury risk. This simulated driving study investigated seat and duty belt configuration on biomechanical measures and discomfort. Seat design had the greatest impact, regardless of gender and males benefited more from a reduced belt configuration.     

The hybrid personal cooling system (PCS) could effectively reduce the heat strain while exercising in a hot and moderate humid environment

This study aimed to examine the effectiveness of a hybrid personal cooling system (PCS) in mitigating body heat stain while exercising in a hot environment. Eight subjects underwent two trials: PCS and CON (i.e. no cooling). All trials were conducted at an air temperature of 36 ± 0.5 °C and RH = 59 ± 5%. The key findings demonstrated that the PCS could significantly reduce the core temperature, mean skin temperature, heart rate and physiological strain index during both exercise and recovery periods (p < 0.05). Subjective perceptions were also significantly alleviated in PCS at the end of the exercise and during the recovery (p < 0.05). Besides, the PCS could also bring remarkable benefits in lowering local skin temperatures and in improving perceptual sensations in both upper and lower body during both exercise and recovery periods (p < 0.05). It was thus concluded that the hybrid PCS is effective in mitigating body heat strain while exercising in a hot environment.

Practitioner Summary: In hot and humid environments, body heat dissipation through sweating is greatly restricted. Our newly developed hybrid PCS could effectively alleviate heat strain while exercising in hot environments. The findings contribute to the body of knowledge in improving the health and well-being of sportsmen while exercising in hot environments.     

Upper limb discomfort profile due to intermittent isometric pronation torque at different postural combinations of the shoulder-arm system

Twenty-seven right-handed male university students participated in this study, which comprised a full factorial model consisting of three forearm rotation angles (60% prone and supine and neutral range of motion), three elbow angles (45°, 90° and 135°), three upper arm angles (45° flexion/extension and neutral), one exertion frequency (15 per min) and one level of pronation torque (20% maximum voluntary contraction (MVC) relative to MVC at each articulation). Discomfort rating after the end of each 5 min treatment was recorded on a visual analogue scale. Results of a repeated measures analysis of covariance on discomfort score, with torque endurance time as covariate, indicated that none of the factors was significant including torque endurance time (p = 0.153). An initial data collection phase preceded the main experiment in order to ensure that participants exerted exactly 20% MVC of the particular articulation. In this phase MVC pronation torque was measured at each articulation. The data revealed a significant forearm rotation angle effect (p = 0.001) and participant effect (p = 0.001). Of the two-way interactions, elbow?participant (p = 0.004), forearm?participant (p = 0.001) and upper arm?participant (p = 0.005) were the significant factors. Electromyographic activity of the pronator teres and biceps brachii muscles revealed no significant change in muscle activity in most of the articulations. Industrial jobs involving deviated upper arm postures are typical in industry but have a strong association with injury. Data from this study will enable better understanding of the effects of deviated upper arm postures on musculoskeletal disorders and can also be used to identify and control high-risk tasks in industry.     

Thermal and cardiovascular strain imposed by motorcycle protective clothing under Australian summer conditions

Motorcycle protective clothing can be uncomfortably hot during summer, and this experiment was designed to evaluate the physiological significance of that burden. Twelve males participated in four, 90-min trials (cycling 30 W) across three environments (25, 30, 35 °C [all 40% relative humidity]). Clothing was modified between full and minimal injury protection. Both ensembles were tested at 25 °C, with only the more protective ensemble investigated at 30 and 35 °C. At 35 °C, auditory canal temperature rose at 0.02 °C min^?1 (SD 0.005), deviating from all other trials (p < 0.05). The thresholds for moderate (>38.5 °C) and profound hyperthermia (>40.0 °C) were predicted to occur within 105 min (SD 20.6) and 180 min (SD 33.0), respectively. Profound hyperthermia might eventuate in ~10 h at 30 °C, but should not occur at 25 °C. These outcomes demonstrate a need to enhance the heat dissipation capabilities of motorcycle clothing designed for summer use in hot climates, but without compromising impact protection.

Practitioner’s Summary:

Motorcycle protective clothing can be uncomfortably hot during summer. This experiment was designed to evaluate the physiological significance of this burden across climatic states. In the heat, moderate (>38.5 °C) and profound hyperthermia (>40.0 °C) were predicted to occur within 105 and 180 min, respectively.     

A shirt containing multistage phase change material and active cooling components was associated with increased exercise capacity in a hot,humid environment

Recent advances in clothing design include the incorporation of phase change materials (PCM) and other active cooling components (ACC) to provide better body heat dissipation. The purpose of this study was to determine the effect of wearing a shirt containing multistage PCM/ACC on exercise capacity at low (5.0), moderate–high (7.5) and extreme (9.0) levels of the physiological strain index (PSI). Fourteen individuals tested two shirts (control vs. cooling) during 45-min of interval running in a hot, humid (35 ± 1 °C; 55 ± 6% RH) environment. The cooling shirt resulted in an 8% improvement in exercise capacity at a PSI of 7.5 (p < 0.05). The observed increase in exercise capacity would likely translate to a significant improvement in exercise performance. More research is needed to determine a best practice approach for the use of cooling clothing as a counter to exercise-induced heat exposure.

Practitioner Summary: In this report, we demonstrate that when forced to exercise in a hot, humid environment, an individual’s exercise capacity may increase by as much as 8% when wearing a shirt composed of multistage phase change material and active cooling components.     

Can an off-the-rack orthotic stiletto alter pressure and comfort scores in the forefoot,arch and heel?

The study sought to investigate whether an orthotic stiletto could modulate the pressure and comfort under the forefoot, arch and heel that stiletto wearers experience. Twenty-two women participated. We measured the peak pressure and pressure-time integral for orthotic stilettos with built-in metatarsal pad, heel cup and arch support; standard stilettos without inlays; and trainers. Comfort was recorded during 3 × 3 working days. The orthotic stiletto exhibited lower metatarsal head1 (MTH) and MTH2+3 and heel pressures than the standard stiletto (p < .01), and a long second metatarsal increased MTH2+3 pressure (p < .01). The comfort in the forefoot and heel was higher in the orthotic stiletto than in the standard one (p < .01), and comfort in the forefoot was correlated to the pressure-time integral of MTH2+3 (p = .03) and not peak pressure. Off-the-rack orthotic stilettos can notably reduce plantar pressures and improve forefoot and heel comfort during everyday use.

Practitioner Summary: Off-the-rack orthotic stilettos with built-in metatarsal pad, arch support and heel caps can lower the pressure under the heel and forefoot in comparison with a standard stiletto and can improve comfort during everyday use. Having a long second metatarsal is a risk factor for increased forefoot pressure.     

Accuracy and feasibility of using an electrogoniometer for measuring simple thumb movements

The aim of this study was to determine the accuracy and feasibility of using an electrogoniometer (Model SG 110; Biometrics, Gwent, UK) for measuring simple thumb movements. Thumb disorders have been associated with the use of hand held devices such as mobile phones and these devices have become an integral part of modern life. In 15 young subjects, the measurements of eight flexion/extension (Flex/Ext) and adduction/abduction (Ad/Ab) thumb positions were compared between a thumb-mounted electrogoniometer and manual goniometer (which was taken as the benchmark). Group mean electrogoniometric measurement errors were below 4° and 5° for Ad/Ab and Flex/Ext measurements, respectively. During mobile phone use, the electrogoniometers measured differences in maximal joint angle postures, which appeared to be related to differences in mobile phone size. High movement velocities may increase the risk of musculoskeletal injury and the results indicated that Ad/Ab movements were twice the speed of Flex/Ext movements during mobile phone use. Electrogoniometers have utility for studying thumb movements during mobile phone use and may be used to evaluate other thumb-based input devices.