Spatial dependency of shoulder muscle demands in horizontal pushing and pulling

Pushing and pulling account for nearly half of all manual material handling tasks. The purpose of this investigation was to develop a 3-D spatial muscle activity map for the right upper extremity during pushing and pulling tasks. Nineteen males performed 140 ramped directional hand exertions (70 push; 70 pull) at locations along three axes aligned with the anatomical planes. Electromyography (EMG) of 14 sites on the right upper extremity was recorded. Two directional 3-way repeated measures ANOVAs assessed the influence of hand position on EMG. Hand position and exertion direction influenced total and individual muscle demand. During pulling exertions, all three hand location parameters influenced total muscle activity (p < 0.001) and similarly in pushing exertions (p < 0.002), though less pronounced than in pulling. Data were used to create equations to predict the muscle activity of untested hand locations for novel work design scenarios.     

Ergonomic evaluation of a wearable assistive device for overhead work

Overhead work is an important risk factor for upper extremity (UE) musculoskeletal disorders. We examined the potential of a mechanical arm and an exoskeletal vest as a wearable assistive device (WADE) for overhead work. Twelve participants completed 10 minutes of simulated, intermittent overhead work, using each of three payloads (1.1, 3.4 and 8.1 kg) and with/without the WADE. Ratings of perceived discomfort (RPDs) and electromyography (EMG) were obtained for the upper arms, shoulders and low back. Using the WADE, UE RPDs decreased by ～50% with the heavier payloads, whereas smaller (～25%) and non-significant increases in low-back RPDs were found and were relatively independent of payload. Changes in RPDs with WADE use were consistent with physical demands indicated by EMG, though EMG-based differences in fatigue were less apparent. Participants generally preferred using the WADE, particularly with heavier payloads. These results supported the potential utility of a WADE as an intervention for overhead work.     

Effect of different handgrip angles on work distribution during hand cycling at submaximal power levels

The effect of different handle angles on work distribution during hand cycling was determined. Able-bodied subjects performed hand cycling at 20% of maximum power level (mean (SD) power level: 90.0 (25.8) W) at a cadence of 70 rpm using handle angles of ±30°, ±15° and 0°. The handle angle had a significant effect on work during the pull down (p < 0.001) and lift up (p = 0.005) sector, whereby the highest work was performed with handle angles of +30° and ?15° respectively. The cycle sector had a significant effect on work (p < 0.001) and significantly (p = 0.002) higher work was performed in the pull down sector (25% higher than mean work over one cycle) as compared to the lift up sector (30% lower than mean work over one cycle). Therefore, a fixed handle angle of +30° is suggested to be optimal for power generation. The results of this study help to optimise the handbike–user interface. A more pronated handle angle compared to the one conventionally used was found to improve the performance of hand cycling and thereby the mobility of disabled people.     

Forearm posture and grip effects during push and pull tasks

Direction of loading and performance of multiple tasks have been shown to elevate muscle activity in the upper extremity. The purpose of this study was to evaluate the effects of gripping on muscle activity and applied force during pushing and pulling tasks with three forearm postures. Twelve volunteers performed five hand-based tasks in supinated, neutral and pronated forearm postures with the elbow at 90° and upper arm vertical. All tasks were performed with the right (dominant) hand and included hand grip alone, push and pull with and without hand grip. Surface EMG from eight upper extremity muscles, hand grip force, tri-axial push and pull forces and wrist angles were recorded during the 10 s trials. The addition of a pull force to hand grip elevated activity in all forearm muscles (all p < 0.017). During all push with grip tasks, forearm extensor muscle activity tended to increase when compared with grip only while flexor activity tended to decrease. Forearm extensor muscle activity was higher with the forearm pronated compared with neutral and supinated postures during most isolated grip tasks and push or pull with grip tasks (all p < 0.017). When the grip dynamometer was rotated so that the push and pull forces could act to assist in creating grip force, forearm muscle activity generally decreased. These results provide strategies for reducing forearm muscle loading in the workplace.

Statement of Relevance: Tools and tasks designed to take advantage of coupling grip with push or pull actions may be beneficial in reducing stress and injury in the muscles of the forearm. These factors should be considered in assessing the workplace in terms of acute and cumulative loading.     

Effect of work station design on sitting posture in young children

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.     

Effect of horizontal position of the computer keyboard on upper extremity posture and muscular load during computer work

The distance of the keyboard from the edge of a work surface has been associated with hand and arm pain; however, the variation in postural and muscular effects with the horizontal position have not been explicitly explored in previous studies. It was hypothesized that the wrist approaches more of a neutral posture as the keyboard distance from the edge of table increases. In a laboratory setting, 20 adults completed computer tasks using four workstation configurations: with the keyboard at the edge of the work surface (NEAR), 8 cm from the edge and 15 cm from the edge, the latter condition also with a pad that raised the work surface proximal to the keyboard (FWP). Electrogoniometers and an electromagnetic motion analysis system measured wrist and upper arm postures and surface electromyography measured muscle activity of two forearm and two shoulder muscles. Wrist ulnar deviation decreased by 50% (4°) as the keyboard position moved away from the user. Without a pad, wrist extension increased by 20% (4°) as the keyboard moved away but when the pad was added, wrist extension did not differ from that in the NEAR configuration. Median values of wrist extensor muscle activity decreased by 4% maximum voluntary contraction for the farthest position with a pad (FWP). The upper arm followed suit: flexion increased while abduction and internal rotation decreased as the keyboard was positioned further away from the edge of the table. In order to achieve neutral postures of the upper extremity, the keyboard position in the horizontal plane has an important role and needs to be considered within the context of workstation designs and interventions.     

Effects of height and load weight on shoulder muscle work during overhead lifting task

Few musculoskeletal models are available to assess shoulder deeper muscle demand during overhead lifting tasks. Our objective was to implement a musculoskeletal model to assess the effect of lifting height and load on shoulder muscle work. A musculoskeletal model scaled from 15 male subjects was used to calculate shoulder muscle work during six lifting tasks. Boxes containing three different loads (6, 12 and 18 kg) were lifted by the subjects from the waist to shoulder or eye level. After optimisation of the maximal isometric force of the model's muscles, the bio-fidelity of the model was improved by 19%. The latter was able to reproduce the subjects’ lifting movements. Mechanical work of the rotator cuff muscles, upper trapezius and anterior deltoid was increased with lifting load and height augmentation. In conclusion, the use of a musculoskeletal model validated by electromyography enabled to evaluate the muscle demand of deep muscles during lifting tasks.     

Evaluation of the loading of neck and shoulder musculature in overhead pushing and pulling exertions

Despite substantial epidemiological evidence relating overhead exertions with work‐related musculoskeletal disorders (WMSD) of the neck, effects of such exertions on the loading of neck or cervical spine musculature are not well understood. In this study, the effects of overhead pushing and pulling exertions on the loading of the cervical spine were evaluated using electromyography (EMG) and subjective discomfort ratings. Additionally, the role of gender as well as individual strength on the loading of neck musculature during such exertions was evaluated. Twenty‐four healthy individuals (12 men and 12 women) participated in this study. Each participant performed overhead pushing and pulling exertions, exerting 25%, 50%, and 75% of their respective maximum strengths. Overhead pushing exertions were found to be significantly more strenuous to the neck musculature than were the pulling exertions. Gender had no significant effect on the activities of the neck muscles. Participants with high strength, however, were able to exert more force at comparatively low muscle activation levels. Subjective discomfort ratings were strongly correlated with the EMG data. At various workplaces, avoiding overhead exertions is rather impossible due to material, interface, and site constraints. Based on the results of this study, however, during such exertions, an interchange between directions of force application could prevent sustained loading of the neck muscles, fatigue, and consequently the probability of neck WMSD incidents. © 2011 Wiley Periodicals, Inc.     

Effect of working position and cold environment on muscle activation level and fatigue in the upper limb during manual work tasks

Several occupational groups are exposed to periods of low ambient temperatures while performing manual work tasks outdoors. Work tasks typically include heavy lifting, tool handling, and overhead work. This study evaluated the effect of working position and cold environment on muscle activation level (%RMS_max) and fatigue in the upper limb during manual work tasks. Fourteen male participants (25 ± 3 years, 80.9 ± 6.4 kg, 182 ± 5 cm) completed a 2-h test protocol consisting of five test periods alternating with four work periods, wearing identical sets of clothing, under cold (−15 °C) and control (5 °C) conditions. The work periods consisted of manual work at the hip level, manual overhead work, and a lifting exercise. The test periods consisted of isometric maximal voluntary contractions (MVC) and seated rest. Skin temperatures decreased during cold exposure, especially in the extremities. %RMS_max in the forearm was higher in the cold condition both during overhead work and work at the hip level than that for the same work in the control condition, especially at the end of the test when the difference was approximately 25% (equating to 2–3 %RMS_max). For the middle deltoid muscle, the %RMS_max was approximately three times (or 10 %RMS_max) higher during overhead work than work at the hip level, but there was no additional cost of working in the cold. Signs of deltoid muscle fatigue (decrease in electromyography median power frequency and an increase in %RMS_max) were observed during the overhead work periods in both temperature conditions. No decrease in MVC, as a sign of overall muscle fatigue, was observed in either condition.Relevance to industryThis study demonstrated that when wearing suitable cold-weather protective clothing, the adverse effect of work posture is much higher than that of cold on muscle demand and physical strain.     

Pushing and pulling: personal mechanics influence spine loads

This study assessed several mechanical issues related to low back loading during pushing and/or pulling tasks. Nine male participants performed two-handed pushing and pulling tasks at two handle heights with three loads, using a cable pulley system. Four of these men were professional firefighters trained in performing pushing and pulling tasks while the other five were graduate students who lacked manual work experience. The more experienced firefighters produced less spinal compression and shearing forces when compared to the less experienced students under the same conditions. The firefighters were able to create less muscle activation as compared to the students, which indicated a more efficient technique. The main contributing factors to the forces produced on the low back were the quantity of the load being pushed or pulled, handle height, experience level and the technique of the participant. Thus, attempts to set load limits for pushing and pulling tasks are difficult, since technique has such a large influence on back loading. In order to create safer working environments, education on proper pushing and pulling techniques is very important – more important than the physical variables in many cases.     

Postural and muscular adaptations to repetitive simulated work

Abstract

Complex repetitive tasks are common in the workplace and have been associated with upper extremity disorders. The purpose of this study was to examine the progressive effects of highly repetitive work on joint kinematics and muscle activity of the trunk and upper extremity. Fifteen healthy men performed 60 one-minute cycles of 4 simulated automotive-related tasks. Electromyography of eight muscles and kinematics of the trunk and right upper extremity were collected. Data were analysed at 12-min intervals and divided into a complete work cycle. The time to complete the work cycle decreased by 6.3?s over the trials. Peak shoulder flexion decreased and peak elbow flexion increased during the work cycle. Muscle activity magnitude and variability was influenced by time during the repetitive tasks. This study found adaptations to highly repetitive but light work in only 1?h; redistributing muscle demands within the shoulder over time may reduce muscle fatigue development.

Practitioner Summary: While the work was not strenuous, we were able to demonstrate muscular and postural adaptations in a single hour of simulated work. By evaluating both the whole work cycle and the sub-tasks, we aim to develop new methods for evaluating the risk of complex tasks in prolonged repetitive work.     

Effects of office innovation on office workers' health and performance

The implementation of an innovative office concept (e.g. open-plan, flexible workplaces and a paperless office concept) on health and productivity among office workers was evaluated with questionnaires of 138 workers at baseline and 6 and 15 months afterwards. Work-related fatigue, general health, change in health status, upper extremity complaints and perceived productivity were outcomes. No short-term significant differences were found in most outcomes except for quantity of performed work (decrease from 96% to 92%, p = 0.008). In the long-term, no significant differences were found in most outcomes except for an increase in general health (p = 0.011) and a decrease in prevalences of upper extremity complaints (33% to 22%, p = 0.021). Perceived productivity increased significantly 15 months after the implementation. It is concluded that innovative office concepts had no or limited effects on work-related fatigue, health changes and productivity but some positive effects on workers' general health and upper extremity complaints in the long term. Office innovation is being administered often but up to now seldom evaluated on workers' health and productivity.     

The natural angle between the hand and handle and the effect of handle orientation on wrist radial/ulnar deviation during maximal push exertions

The purpose of this experiment was to quantify the natural angle between the hand and a handle, and to investigate three design factors: handle rotation, handle tilt and between-handle width on the natural angle as well as resultant wrist radial/ulnar deviation (‘RUD’) for pushing tasks. Photographs taken of the right upper limb of 31 participants (14 women and 17 men) performing maximal seated push exertions on different handles were analysed. Natural hand/handle angle and RUD were assessed. It was found that all of the three design factors significantly affected natural handle angle and wrist RUD, but participant gender did not. The natural angle between the hand and the cylindrical handle was 65 ± 7°. Wrist deviation was reduced for handles that were rotated 0° (horizontal) and at the narrow width (31 cm). Handles that were tilted forward 15° reduced radial deviation consistently (12–13°) across handle conditions.

Practitioner summary: Manual materials handling (MMH) tasks involving pushing have been related to increased risk of musculoskeletal injury. This study shows that handle orientation influences hand and wrist posture during pushing, and suggests that the design of push handles on carts and other MMH aids can be improved by adjusting their orientation to fit the natural interface between the hand and handle.     

Effects of dynamic,static and combined work on heart rate and oxygen consumption

The effects upon heart rate and oxygen consumption of muscular exercises including simultaneous dynamic and static contractions were studied in three male subjects. Dynamic work consisted of walking at four speeds (0·56, 0·83, 1·11, 1·39 m s^?) on a horizontal treadmill; static work consisted of pushing against, pulling and holding 6, 9, 12, 18 and 24?kg; combined work associated walking with each one of the forms of static work. Physiological load is expressed in terms of cardiac cost (ΔHR) and oxygen cost (Δ[Vdot]_o2). The physiological cost of combined work increases with both the walking speed and the static load. For each parameter (HR and [Vdot]_o2) the extra-cost of combined work has been determined by computing the difference between the cost of combined work and the sum of the costs observed during static and dynamic exercises separately performed. The paired t-test shows significant differences for all of the walking-pushing tests, but only for 8 pulling tests and 2 holding tests. Linear relationships are observed between the oxygen extra-cost and load when walking at 0·56 or 0·83 ms^?1, with correlation coefficients statistically significant for pushing and pulling (p < 0·01) but not significant for holding tests. The present results show that, when the static work is combined with walking, the physiological response varies with the type of static work considered.     

Shoulder muscle activity in off-axis pushing and pulling tasks

Workspace design can often dictate the muscular efforts required to perform work, impacting injury risk. Within many environments, industrial workers often use sub-maximal forces in offset directions in to accomplish job tasks. The purpose of this research was to develop methods to estimate shoulder muscle activation during seated, static, sub-maximal exertions in off-axis (non-cardinal) directions. Surface EMG signals were recorded from 14 upper extremity muscles in 20 right-handed university aged, right-handed males (age: 22 ± 3 years, weight: 77.5 ± 11.1 kg, height 179.0 ± 7.0 cm) participated in this study. Each participant performed 60 submaximal exertions (40N) directed at 4 off-axis phase angles of 45° (45°, 135°, 225°, and 315°) in 3 planes (frontal, sagittal, and transverse) in 5 hand locations within a right handed reach envelope. The influence of hand location and force direction on muscle activity was evaluated with a forced-entry stepwise regression model. The ability of previously published on-axis prediction equations to predict muscle activity during these off-axis exertions was also evaluated. Within each muscle, activity levels were affected by both hand location and three-dimensional force direction and activation levels ranged from <1 to 37 %MVE. For each force direction there were 75 predictive equations selected and used, and the specific equation that best predicted activation depended on the muscle, exertion direction and hand location evaluated. This work assists ergonomic workplace design to minimize muscle demands during commonly performed off-axis exertions. These estimated demands can be employed to improve workplace design to reduce workplace injuries and enhance worker productivity.     

Force direction and physical load in dynamic pushing and pulling

In pushing and pulling wheeled carts, the direction of force exertion may, beside the force magnitude, considerably affect musculoskeletal loading. This paper describes how force direction changes as handle height and force level change, and the effects this has on the loads on the shoulder and low back. Eight subjects pushed against or pulled on a stationary bar or movable cart at various handle heights and horizontal force levels while walking on a treadmill. The forces at the hands in the vertical and horizontal direction were measured by a forcetransducer. The forces, body movements and anthropometric data were used to calculate the net joint torques in the sagittal plane in the shoulder and the lumbosacral joint. The magnitudes and directions of forces did not differ between the cart and the bar pushing and pulling. Force direction was affected by the horizontal force level and handle height. As handle height and horizontal force level increased, the pushing force direction changed from 45° (SD 3.3°) downward to near horizontal, while the pulling force direction changed from pulling upward by 14° (SD 15.3°) to near horizontal. As a result, it was found that across conditions the changes in force exertion were frequently reflected in changes in shoulder torque and low back torque although of a much smaller magnitude. Therefore, an accurate evaluation of musculoskeletal loads in pushing and pulling requires, besides a knowledge of the force magnitude, knowledge of the direction of force exertion with respect to the body.     

Predicted endurance times during overhead work: influences of duty cycle and tool mass estimated using perceived discomfort

Abstract

A need for overhead work remains in several industries and such work is an important risk factor for shoulder musculoskeletal problems. In this study, we evaluated the effects of duty cycle and tool mass on endurance times during overhead work. A psychophysical approach was used, via a new methodology that was implemented to more efficiently estimate endurance times (rather than through direct measurements). Participants performed a simulated overhead task in specified combinations of tool mass and duty cycle. Both duty cycle and tool mass have substantial effects on the development of fatigue and estimated endurance times, though the former was more substantial and an interactive effect was evident. Gender differences were not substantial, except when using the largest tool mass. We recommend that, for two-hour periods of overhead work, tool masses greater than 1.25 kg should be avoided, as should duty cycles greater than 50%.

Practitioner Summary: The current results may facilitate enhanced design and evaluation of overhead work tasks. In addition, the new estimation approach that was employed may enhance the efficiency of future studies using a psychophysical approach (ie using extrapolation of patterns of reported discomfort to predict longer term outcomes).     

Effects of work experience on work methods during dynamic pushing and pulling

Pushing and pulling are potential risk factors for work-related low back disorders (WRLBDs). While several studies have evaluated differences in work methods related to work experience, such evidence for dynamic pushing and pulling is limited. Eight novices and eight experienced workers completed dynamic push/pull tasks using a cart weighted to 250% of individual body mass in two different configurations (preferred vs. elbow handle heights). Multiple measures [hand forces, torso kinematics and kinetics, and required coefficient of friction (RCOF)] were obtained to assess WRLBD and slip risks. Experienced workers generated higher medio-lateral hand forces, during both pulls and pushes, though with a more substantial difference during pushes (∼74%), and which involved the use of hand force components other than to move the cart in an anterior-posterior direction. Experienced workers also had lower peak torso kinematics in flexion/extension and lateral bending, and lower torso flexion/extension kinetics. The latter is suggestive of a lower risk for WRLBDs, though levels of exposures to WRLBD risk were low to moderate in both groups and were often relatively small and inconsistent across the task configurations. Group-level differences in RCOF were quite small, indicating a comparable slip risk between the two groups. Thus, it was considered inconclusive whether the work methods used by experienced workers during dynamic pushing and pulling are advantageous regarding WRLBD and slip risks.     

The relationship between shoulder torques and the perception of muscular effort in loaded reaches

The objective of this study was to define the quantitative relationship between external dynamic shoulder torques and calibrated perceived muscular effort levels for load delivery tasks, for application in job analyses. Subjects performed a series of loaded reaches and, following each exertion, rated their perceived shoulder muscular effort. Motion and task physical requirements data were processed with a biomechanical upper extremity model to calculate external dynamic shoulder torques. Calculated torque values were then statistically compared to reported calibrated perceived muscular effort scores. Individual subject torque profiles were significantly positively correlated with perceived effort scores (r² = 0.45–0.77), with good population agreement (r² = 0.50). The accuracy of the general regression model improved (r² = 0.72) with inclusion of factors specific to task geometry and individual subjects. This suggests two major conclusions: 1) that the perception of muscular shoulder effort integrates several factors and this interplay should be considered when evaluating tasks for their impact on the shoulder region; 2) the torque/perception relationship may be usefully leveraged in job design and analysis.