Interface stability influences torso muscle recruitment and spinal load during pushing tasks

Handle or interface design can influence torso muscle recruitment and spinal load during pushing tasks. The objective of the study was to provide insight into the role of interface stability with regard to torso muscle recruitment and biomechanical loads on the spine. Fourteen subjects generated voluntary isometric trunk flexion force against a rigid interface and similar flexion exertions against an unstable interface, which simulated handle design in a cart pushing task. Normalized electromyographic (EMG) activity in the rectus abdominus, external oblique and internal oblique muscles increased with exertion effort. When using the unstable interface, EMG activity in the internal and external oblique muscle groups was greater than when using the rigid interface. Results agreed with trends from a biomechanical model implemented to predict the muscle activation necessary to generate isometric pushing forces and maintain spinal stability when using the two different interface designs. The co-contraction contributed to increased spinal load when using the unstable interface. It was concluded that handle or interface design and stability may influence spinal load and associated risk of musculoskeletal injury during manual materials tasks that involve pushing exertions.     

Interface stability influences torso muscle recruitment and spinal load during pushing tasks

Handle or interface design can influence torso muscle recruitment and spinal load during pushing tasks. The objective of the study was to provide insight into the role of interface stability with regard to torso muscle recruitment and biomechanical loads on the spine. Fourteen subjects generated voluntary isometric trunk flexion force against a rigid interface and similar flexion exertions against an unstable interface, which simulated handle design in a cart pushing task. Normalized electromyographic (EMG) activity in the rectus abdominus, external oblique and internal oblique muscles increased with exertion effort. When using the unstable interface, EMG activity in the internal and external oblique muscle groups was greater than when using the rigid interface. Results agreed with trends from a biomechanical model implemented to predict the muscle activation necessary to generate isometric pushing forces and maintain spinal stability when using the two different interface designs. The co-contraction contributed to increased spinal load when using the unstable interface. It was concluded that handle or interface design and stability may influence spinal load and associated risk of musculoskeletal injury during manual materials tasks that involve pushing exertions.     

Active trunk stiffness during voluntary isometric flexion and extension exertions

OBJECTIVE: Compare muscle activity and trunk stiffness during isometric trunk flexion and extension exertions. BACKGROUND: Elastic stiffness of the torso musculature is considered the primary stabilizing mechanism of the spine. Therefore, stiffness of the trunk during voluntary exertions provides insight into the stabilizing control of pushing and pulling tasks. METHODS: Twelve participants maintained an upright posture against external flexion and extension loads applied to the trunk. Trunk stiffness, damping, and mass were determined from the dynamic relation between pseudorandom force disturbances and subsequent small-amplitude trunk movements recorded during the voluntary exertions. Muscle activity was recorded from rectus abdominus, external oblique, lumbar paraspinal, and internal oblique muscle groups. RESULTS: Normalized electromyographic activity indicated greater antagonistic muscle recruitment during flexion exertions than during extension. Trunk stiffness was significantly greater during flexion exertions than during extension exertions despite similar levels of applied force. Trunk stiffness increased with exertion effort. CONCLUSION: Theoretical and empirical analyses reveal that greater antagonistic cocontraction is required to maintain spinal stability during trunk flexion exertions than during extension exertions. Measured differences in active trunk stiffness were attributed to antagonistic activity during flexion exertions with possible contributions from spinal kinematics and muscle lines of action. APPLICATION: When compared with trunk extension exertions, trunk flexion exertions such as pushing tasks require unique neuromuscular control that is not simply explained by differences in exertion direction. Biomechanical analyses of flexion tasks must consider the stabilizing muscle recruitment patterns when evaluating spinal compression and shear loads.     

Influence of fatigue in neuromuscular control of spinal stability

Lifting-induced fatigue may influence neuromuscular control of spinal stability. Stability is primarily controlled by muscle recruitment, active muscle stiffness, and reflex response. Fatigue has been observed to affect each of these neuromuscular parameters and may therefore affect spinal stability. A biomechanical model of spinal stability was implemented to evaluate the effects of fatigue on spinal stability. The model included a 6-degree-of-freedom representation of the spine controlled by 12 deformable muscles from which muscle recruitment was determined to simultaneously achieve equilibrium and stability. Fatigue-induced reduction in active muscle stiffness necessitated increased antagonistic cocontraction to maintain stability resulting in increased spinal compression with fatigue. Fatigue-induced reduction in force-generating capacity limited the feasible set of muscle recruitment patterns, thereby restricting the estimated stability of the spine. Electromyographic and trunk kinematics from 21 healthy participants were recorded during sudden-load trials in fatigued and unfatigued states. Empirical data supported the model predictions, demonstrating increased antagonistic cocontraction during fatigued exertions. Results suggest that biomechanical factors including spinal load and stability should be considered when performing ergonomic assessments of fatiguing lifting tasks. Potential applications of this research include a biomechanical tool for the design of administrative ergonomic controls in manual materials handling industries.     

Biomechanically determined hand force limits protecting the low back during occupational pushing and pulling tasks

Though biomechanically determined guidelines exist for lifting, existing recommendations for pushing and pulling were developed using a psychophysical approach. The current study aimed to establish objective hand force limits based on the results of a biomechanical assessment of the forces on the lumbar spine during occupational pushing and pulling activities. Sixty-two subjects performed pushing and pulling tasks in a laboratory setting. An electromyography-assisted biomechanical model estimated spinal loads, while hand force and turning torque were measured via hand transducers. Mixed modelling techniques correlated spinal load with hand force or torque throughout a wide range of exposures in order to develop biomechanically determined hand force and torque limits. Exertion type, exertion direction, handle height and their interactions significantly influenced dependent measures of spinal load, hand force and turning torque. The biomechanically determined guidelines presented herein are up to 30% lower than comparable psychophysically derived limits and particularly more protective for straight pushing.

Practitioner Summary: This study utilises a biomechanical model to develop objective biomechanically determined push/pull risk limits assessed via hand forces and turning torque. These limits can be up to 30% lower than existing psychophysically determined pushing and pulling recommendations. Practitioners should consider implementing these guidelines in both risk assessment and workplace design moving forward.     

Association between spinal loads and the psychophysical determination of maximum acceptable force during pushing tasks

The objective of this study was to investigate potential associations between an individual's psychophysical maximum acceptable force (MAF) during pushing tasks and biomechanical tissue loads within the lumbar spine. Ten subjects (eight males, two females) pushed a cart with an unknown weight at one push every two minute for a distance of 3.9 m. Two independent variables were investigated, cart control and handle orientation while evaluating their association with the MAF. Dependent variables of hand force and tissue loads for each MAF determination and preceding push trial were assessed using a validated, electromyography-assisted biomechanical model that calculated spinal load distribution throughout the lumbar spine. Results showed no association between spinal loads and the MAF. Only hand forces were associated with the MAF. Therefore, MAFs may be dependent upon tactile sensations from the hands, not the loads on the spine and thus may be unrelated to risk of low back injury.

Practitioner Summary: Pushing tasks have become common in manual materials handling (MMH) and these tasks impose different tissue loads compared to lifting tasks. Industry has commonly used the psychophysical tables for job assent and decision of MMH tasks. However, due to the biomechanical complexity of pushing tasks, psychophysics may be misinterpreting risk.     

An ergonomic evaluation of handle height and load in maximal and submaximal cart pushing

Awareness of the hazards of repetitive lifting has brought about significant changes in the design of industrial jobs. Pushing and pulling tasks have become increasingly common as the result of the introduction of a variety of carts and other materials-handling assistance devices. In order to predict the peak performance of workers in these tasks, and the biomechanical stresses that can result from them, the exertions involved in cart pushing were studied. Four subjects of various strengths pushed carts with loads from 45 to 450 kg at several heights. Peak push forces reached 500 N for male subjects and 200 N for female subjects. Strong subjects moved a 45 kg cart at velocities of 1.1 m s(-1) and a 450 kg cart at velocities of 0.8 m s(-1). Weaker subjects moved the carts at velocities of 0.5 and 0.4 m s(-1) respectively. Calculated static compression forces at the L5/S1 spinal disc were consistently above the NIOSH Action Limit of 3400 N for strong subjects when the cart load reached 225 kg.     

Effects of handle orientation,gloves, handle friction and elbow posture on maximum horizontal pull and push forces

Biomechanical models were evaluated for effects of handle orientation, handle material, gloves and arm posture on maximal pull/push force. Eight healthy subjects performed maximum pull/push exertions on handles with two different orientations and two different surface materials, using bare hand and two types of glove as well as two arm postures. The empirical data supported the proposed biomechanical models: Pull/push forces for the bare hand on a rubber handle decreased 10% when the handle was parallel to the pull/push direction, compared with when perpendicular to it. For parallel handles, pull/push forces further decreased with decreasing hand–handle friction coefficient (simulated by different handle materials and gloves). Pull force exerted by the bare hand was 29% greater when the elbow was extended than when flexed. Pull force was greater than push force (with bare hand and flexed elbow). The biomechanical models suggest that friction between the hand and handle limits pull/push forces for parallel handles. Elbow strength may be responsible for decreased pull force for the flexed elbow posture and decreased force for pull compared with push in the postures examined.

Statement of Relevance: Biomechanical models presented in this paper provide insights for causes of upper extremity strength limitations during pull/push tasks. Findings in this paper can be used directly in the design of workstation and objects to reduce fatigue and risk of musculoskeletal disorders.     

Biomechanical analysis for handle stability during maximum push and pull exertions

This study investigated the effect of handle stability on maximum push/pull force. It was hypothesised that people apply force in directions deviated from the pure push/pull direction to generate a moment that assists producing greater push/pull force when the handle position is fixed (stable) compared to when it is not fixed (unstable). Eight healthy subjects performed maximum push and pull exertions on a stable and an unstable handle in a seated posture, while maximum push/pull force, vertical force and lateral force were recorded. For the unstable handle, vertical and lateral forces were not different from zero during push and pull. For the stable handle, subjects intuitively applied significant downward force during push and significant upward force during pull exertions. As predicted from biomechanical analysis, this downward and upward force was found to be significantly associated with increased push and pull force, respectively, for the stable handle compared to the unstable handle.     

Effects of posture on dynamic back loading during a cable lifting task

This study evaluated spinal loads associated with lifting and hanging heavy mining cable in a variety of postures. This electrical cable can weigh up to 10 kg per metre and is often lifted in restricted spaces in underground coal mines. Seven male subjects performed eight cable lifting and hanging tasks, while trunk kinematic data and trunk muscle electromyograms (EMGs) were obtained. The eight tasks were combinations of four postures (standing, stooping, kneeling on one knee, or kneeling on both knees) and two levels of cable load (0 N or 100 N load added to the existing cable weight). An EMG-assisted model was used to calculate forces and moments acting on the lumbar spine. A two-way split-plot ANOVA showed that increased load (p < 0.05) and changes in lifting posture (p < 0.05) independently affected trunk muscle recruitment and spinal loading. The increase in cable load resulted in higher EMG activity of all trunk muscles and increased axial and lateral bending moments on the spine (p < 0.05). Changes in posture caused more selective adjustments in muscle recruitment and affected the sagittal plane moment (p < 0.05). Despite the more selective nature of trunk EMG changes due to posture, the magnitude of changes in spinal loading was often quite dramatic. However, average compression values exceeded 3400 N for all cable lifting tasks.     

A study of lifting tasks performed on laterally slanted ground surfaces

Lifting in most industrial environments is performed on a smooth, level ground surface. There are, however, many outdoor work environments (e.g. agriculture and construction) that require manual material handling activities on variable grade ground surfaces. Quantifying the biomechanical response while lifting under these conditions may provide insight into the aetiology of lifting-related injury. The aim of the current study was to quantify the effect of laterally slanted ground surfaces on the biomechanical response. Ten subjects performed both isometric weight-holding tasks and dynamic lifting exertions (both using a 40% of max load) while standing on a platform that was laterally tilted at 0, 10, 20 and 30 degrees from horizontal. As the subject performed the isometric exertions, the electromyographic (EMG) activity of trunk extensors and knee extensors were collected and during the dynamic lifting tasks the whole body kinematics were collected. The whole body kinematics data were used in a dynamic biomechanical model to calculate the time-dependent moment about L5/S1 and the time-dependent lateral forces acting on the body segments. The results of the isometric weight-holding task show a significant (p < 0.05) effect of slant angle on the normalized integrated EMG values in both the left (increase by 26%) and right (increase by 70%) trunk extensors, indicating a significant increase in the protective co-contraction response. The results of the dynamic lifting tasks revealed a consistent reduction in the peak dynamic L5/S1 moment (decreased by 9%) and an increase in the instability producing lateral forces (increased by 111%) with increasing slant angle. These results provide quantitative insight into the response of the human lifter under these adverse lifting conditions.     

Initial force and postural adaptations when pushing and pulling on floor surfaces with good and reduced resistance to slipping

The objective of the present study was to determine whether differences in the frictional properties of a floor surface may affect the kinematics and kinetics of pushing and pulling. Eight male participants were required to push and pull a four-wheeled trolley over two level surfaces, on which were mounted floor coverings with good (safety floor) and reduced (standard floor) frictional properties. A psychophysical approach was used to determine the initial maximum acceptable horizontal force required to move the trolley over a short distance (3 m). Three-dimensional (3D) hand and ground reaction forces and 3D postures were measured during initial force exertions. The results showed that psychophysically derived measures of initial horizontal force and horizontal components of hand forces did not differ significantly between floor surfaces. Despite the ability to exert similar forces, the measured maximum coefficient of friction varied according to floor surface. These changes reflected significant alterations in vertical and horizontal components of ground reaction and vertical hand forces, suggesting that participants had maximized the frictional properties available to them. Postures also changed as a consequence of floor surface, with significant changes occurring in knee flexion and trunk extension. This study has shown that handlers involved in the pushing and pulling of trolleys are capable of adjusting posture and the direction of hand and foot forces in order to compensate for reduced levels of floor friction. This has particular relevance when assessing the musculoskeletal loads imposed on the handler and the likely mechanisms of injury resulting from variations in floor conditions when workers undertake pushing and pulling tasks in the workplace.     

Lower back muscle forces in pushing and pulling

In the investigation of lower back stress, the muscle forces of the erector spinae and the rectus abdominis are often calculated using the two-dimensional biomechanical model. These muscle forces are used to estimate the compressive forces at L5/S1 disc. This paper presents a study of the muscle forces predicted by a two-dimensional biomechanical model during pushing and pulling and myoelectric activity from the corresponding muscles. The goal was to investigate whether a simple two muscle torso model would reasonably estimate the muscle actions in pushing and pulling tasks. Six subjects participated in the experiment. EMG (rms) value was used as an indicator of muscle forces. The results show high correlation between the predicted muscle forces and the measured root-mean-square EMG values in trunk pushing and pulling (r2 = 0.93) and hand pushing and pulling (r2 = 0.96) in an erect posture with hips braced but low in hand pushing and pulling using a free posture (r2 = 0.37).     

Wheelchair pushing and turning: lumbar spine and shoulder loads and recommended limits

Abstract

The objective of this study was to determine how simulated manual wheelchair pushing influences biomechanical loading to the lumbar spine and shoulders. Sixty-two subjects performed simulated wheelchair pushing and turning in a laboratory. An electromyography-assisted biomechanical model was used to estimate spinal loads. Moments at the shoulder joint, external hand forces and net turning torque were also assessed. Multiple linear regression techniques were employed to develop biomechanically based wheelchair pushing guidelines relating resultant hand force or net torque to spinal load. Male subjects experienced significantly greater spinal loading (p < 0.01), and spine loads were also increased for wheelchair turning compared to straight wheelchair pushing (p < 0.001). Biomechanically determined maximum acceptable resultant hand forces were 17–18% lower than psychophysically determined limits. We conclude that manual wheelchair pushing and turning can pose biomechanical risk to the lumbar spine and shoulders. Psychophysically determined maximum acceptable push forces do not appear to be protective enough of this biomechanical risk.

Practitioner Summary: This laboratory study investigated biomechanical risk to the low back and shoulders during simulated wheelchair pushing. Manual wheelchair pushing posed biomechanical risk to the lumbar spine (in compression and A/P shear) and to the shoulders. Biomechanically determined wheelchair pushing thresholds are presented and are more protective than the closest psychophysically determined equivalents.     

Assessment of an EMG-based method for continuous estimates of low back compression during asymmetrical occupational tasks.

Variables, such as peak and accumulated moments and spine compression forces, have been shown to be risk factors for occupational low back pain. Estimates of these forces during prolonged, dynamic, asymmetric tasks using biomechanical models is complex and time-consuming. A simple technique for continuous measurement of these variables over a prolonged period is needed to measure the distribution of spinal loading during both sagittal plane lifts and complex asymmetrical jobs. The aim of this study was to determine whether a linear normalization of erector spinae EMG to spine compression force, called compression normalized EMG (CNEMG), could be used to estimate spinal loading for simulations of asymmetrical occupational tasks. The estimates of spine compression force obtained using the normalized EMG are presented in the form of an amplitude probability distribution function and are compared with estimates of a three-dimensional biomechanical model. The per cent time a worker spends above particular levels of spinal loading of interest, such as the NIOSH action limit for compression, are displayed. Five males performed simulated occupational tasks. The exposure time at a specific level of spine compression force for a combination of three tasks, estimated by CNEMG, was, on average, within 6.5% of the time calculated by the biomechanical model. However, if the task combination was dominated by an axial twisting moment, then the difference was, on average, 13.4%. The difference in magnitude of spine compression at a specific probability was, on average, 14.9% and when axial trunk twist dominated, 30.7%. It is concluded that CNEMG can estimate probability at a specific level of spine compression force when the task combination is characterized by a predominant extensor moment in the sagittal plane. Estimates of spine compression at a specific probability, and estimates obtained during task combinations dominated by an axial twisting moment, are poor.     

Load on the lumbar spine of flight attendants during pushing and pulling trolleys aboard aircraft

Flight attendants report on high physical load and complaints particularly focussing on the lower back. These findings are mainly ascribed to pushing and pulling of trolleys during the ascent and descent flight phases. Within an interdisciplinary experimental study, the load on the lumbar spine of flight attendants during trolley handling aboard aircraft was analysed based on laboratory measurements regarding posture and exerted forces as well as on subsequent biomechanical model calculations. Forces and moments of force at the lumbosacral disc were quantified for 458 manoeuvres performed by 25 flight attendants in total (22 female, 3 male).Lumbar load varies according to handling mode (pushing, pulling), floor gradient (0°, 2°, 5°, 8°), trolley type (half-, full-size trolley), trolley loading (empty, medium, full) and, in addition, according to individual execution technique. For each of the resulting 48 task configurations, lumbar load was evaluated with respect to potential biomechanical overload by applying work-design recommendations for disc compression and moment of force. Irrespective of floor inclination, trolley weight and individual performance, pushing of small trolleys is combined with acceptable lumbar load, pulling with critical load. Pushing or pulling large trolleys occasionally yield to critical lumbar load, in particular, when heavy or heaviest containers are moved on relatively steep or steepest surfaces.To diminish overload risk relevantly, top-edge grasp positions should be avoided for pulling of half-size trolleys, whereas for the other cases, grasping at the upper edge of the trolley is recommended.

Relevance to industry

The provided study illustrates lumbar load of flight attendants during trolley handling aboard aircraft for typical task conditions and individual execution techniques. Specified hints for work design regarding posture and grasp position enable to avoid biomechanical low-back overload for flight attendants. Furthermore, trolley properties may be reconsidered, regular maintenance of rollers should be guaranteed.     

Assessment of an EMG-based method for continuous estimates of low back compression during asymmetrical occupational tasks

Variables, such as peak and accumulated moments and spine compression forces, have been shown to be risk factors for occupational low back pain. Estimates of these forces during prolonged, dynamic, asymmetric tasks using biomechanical models is complex and time-consuming. A simple technique for continuous measurement of these variables over a prolonged period is needed to measure the distribution of spinal loading during both sagittal plane lifts and complex asymmetrical jobs. The aim of this study was to determine whether a linear normalization of erector spinae EMG to spine compression force, called compression normalized EMG (CNEMG), could be used to estimate spinal loading for simulations of asymmetrical occupational tasks. The estimates of spine compression force obtained using the normalized EMG are presented in the form of an amplitude probability distribution function and are compared with estimates of a three-dimensional biomechanical model. The per cent time a worker spends above particular levels of spinal loading of interest, such as the NIOSH action limit for compression, are displayed. Five males performed simulated occupational tasks. The exposure time at a specific level of spine compression force for a combination of three tasks, estimated by CNEMG, was, on average, within 6.5% of the time calculated by the biomechanical model. However, if the task combination was dominated by an axial twisting moment, then the difference was, on average, 13.4%. The difference in magnitude of spine compression at a specific probability was, on average, 14.9% and when axial trunk twist dominated, 30.7%. It is concluded that CNEMG can estimate probability at a specific level of spine compression force when the task combination is characterized by a predominant extensor moment in the sagittal plane. Estimates of spine compression at a specific probability, and estimates obtained during task combinations dominated by an axial twisting moment, are poor.     

Initial force and postural adaptations when pushing and pulling on floor surfaces with good and reduced resistance to slipping

The objective of the present study was to determine whether differences in the frictional properties of a floor surface may affect the kinematics and kinetics of pushing and pulling. Eight male participants were required to push and pull a four-wheeled trolley over two level surfaces, on which were mounted floor coverings with good (safety floor) and reduced (standard floor) frictional properties. A psychophysical approach was used to determine the initial maximum acceptable horizontal force required to move the trolley over a short distance (3 m). Three-dimensional (3D) hand and ground reaction forces and 3D postures were measured during initial force exertions. The results showed that psychophysically derived measures of initial horizontal force and horizontal components of hand forces did not differ significantly between floor surfaces. Despite the ability to exert similar forces, the measured maximum coefficient of friction varied according to floor surface. These changes reflected significant alterations in vertical and horizontal components of ground reaction and vertical hand forces, suggesting that participants had maximized the frictional properties available to them. Postures also changed as a consequence of floor surface, with significant changes occurring in knee flexion and trunk extension. This study has shown that handlers involved in the pushing and pulling of trolleys are capable of adjusting posture and the direction of hand and foot forces in order to compensate for reduced levels of floor friction. This has particular relevance when assessing the musculoskeletal loads imposed on the handler and the likely mechanisms of injury resulting from variations in floor conditions when workers undertake pushing and pulling tasks in the workplace.     

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

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

Lower back muscle forces in pushing and pulling

Abstract

In the investigation of lower back stress, the muscle forces of the erector spinae and the rectus abdominis are often calculated using the two-dimensional biomechanical model. These muscle forces are used to estimate the compressive forces at L5/S1 disc This paper presents a study of the muscle forces predicted by a two-dimensional biomechanical model during pushing and pulling and myoelectric activity from the corresponding muscles. The goal was to investigate whether a simple two muscle torso model would reasonably estimate the muscle actions in pushing and pulling tasks. Six subjects participated in the experiment. EMG (rms) value was used as an indicator of muscle forces. The results show high correlation between the predicted muscle forces and the measured root-mean-square EMG values in trunk pushing and pulling (r²=0.93) and hand pushing and pulling (r²=0.96) in an erect posture with hips braced but low in hand pushing and pulling using a free posture (r²=0.37).