Multi-segment trunk kinematics during a loaded lifting task for elderly and young subjects

The trunk is frequently modelled as one fixed segment ignoring possible multi-segmental contributions during manual handling. This study compared segmental trunk motion in a young and older population during a lifting task. Twelve elderly and 19 young subjects repeatedly lifted a 5 kg box from bench to shelf under two stance conditions. Displacement and angular trunk segment kinematics were recorded with an electromagnetic tracker system and then analysed. The elderly subjects displayed significantly increased pelvic and trunk displacement and significantly reduced pelvic and lower thorax (T10–L1) range of motion in both stance conditions. Upper thorax (C7–T10) motion was at times greater than lumbar motion and opposite to the lower segments and was related to the task while the lower segments contributed to both equilibrium and task requirements. Decreased segmental trunk angular kinematics may contribute to increased displacement kinematics and place the elderly at increased risk of injury and falling. The pelvis, lumbar spine, low thorax (T10–L1), upper thorax (C7–10) contributed uniquely and synchronously to trunk (C7–S2) mechanics during a lifting task. Reduced angular kinematics of the pelvis and low thorax contributed to increased displacement kinematics and hence increased the risk of falling in the elderly compared to the young. Investigations of trunk mechanics should include multi-segment analysis.     

A history of low back pain affects pelvis and trunk mechanics during a sustained lift/lower task

This study compared three-dimensional trunk and pelvis range of motion (ROM) during a sustained asymmetric box lift/lower task between a group with a history of low back pain (HBP, n = 9) and a group with no history of low back pain (NBP, n = 9). Participants lifted an 11-kg box for 10 min at 12 cycles/min from ankle height in front to shelves 45 deg off-centre at waist height. Kinematic data were collected at the beginning (min1), middle (min5) and end of the bout (min9). Two-way analyses of variance were performed for all variables. Pelvis and trunk transverse ROM were similar at min1. By min9, HBP group did not change (31.9 ± 9 deg); however, ROM decreased in NBP group (21.6 ± 6 deg, p < 0.05). Therefore, despite no current pain, the HBP group demonstrated protective lifting mechanics compared to controls. Also discussed are implications for studying lifting paradigms at sub-maximal effort over longer periods of time.

Practitioner summary: Differences between groups over time demonstrate residual consequences of low back pain (LBP) in a manual materials handling scenario. Individuals with a history of LBP (pain free for 6 months) demonstrated more conservative lifting mechanics towards the end of the bout compared to controls with no history of LBP.     

Performance evaluation of a wearable inertial motion capture system for capturing physical exposures during manual material handling tasks

With a long-term goal of improving quantification of physical exposures in the workplace, this study examined the ability of a commercially available inertial motion capture (IMC) system in quantifying exposures during five different simulated manual material handling tasks. Fourteen participants repeated all these tasks in three 20 min sequential time blocks. Performance of the IMC system was compared against an optical motion capture (OMC) system (‘gold standard’) in terms of joint angles, angular velocities and moments at selected body parts. Though several significant changes in performance over time were found, the magnitudes of these were relatively small and may have limited practical relevance. The IMC system yielded peak kinematic values that differed by up to 28% from the OMC system. The IMC system, in some cases, incorrectly reflected the actual extremity positions of a participant, and which can cause relatively large errors in joint moment estimation. Given the potential limitations, practical recommendations are offered and discussed.

Practitioner Summary: Use of an inertial motion capture system can advance the quantification of physical exposures in situ. Results indicate a good potential capacity for capturing physical exposure data in the field for an extended period, while highlighting potential limitations. Future system application can help provide better understandings of dose-exposure relationships.     

Trunk kinematics of one-handed lifting,and the effects of asymmetry and load weight

Abstract

This study investigated trunk kinematic differences between lifts performed using either one hand (unsupported) or two hands. These effects were studied while beginning the lifts from different asymmetric starting positions and while lifting different load weights. Each subject lifted a box from a lower to an upper platform under one- and two-handed lifting conditions. Subjects wore a lumbar spine electrogoniometer, from which relative motion components were calculated in the trunk's three cardinal planes. Results of this study showed that one-handed lifting resulted in significantly higher ranges of motion in the lateral and transverse planes and greater flexion in the sagittal plane. Back motion characteristics previously found to be associated with low back disorders were all significantly higher for one-handed lifts. The two-handed lift technique, on the other hand, produced overall faster trunk motions in the sagittal plane and equal or larger acceleration and deceleration magnitudes in all planes of motion. Increases in load asymmetry affected trunk kinematics, in that magnitude values for range of motion, velocity and acceleration became much greater with increasingly asymmetric load positions. Increasing the load weight appeared to have less of an effect on trunk kinematics, with increases in position mostly occurring during sagittal and lateral bending. These results suggest that unsupported one-handed lifting loads the spine more than two-handed lifts, due to the added coupling. Applying these results to a previously developed model, one-handed lifting was also found to increase one's risk of suffering a low back disorder.     

The effect of handle design on upper extremity posture and muscle activity during a pouring task

In this study, the effect of container handle parameters on shoulder and upper limb muscle activity and joint posture during a pouring task is investigated. Results indicated that a low handle position and a vertical handle slope minimised the loading of the shoulder muscles. A high and sloped handle minimised the muscle activity and wrist deviation of the lower arm. The effects of diameter were not significant for most dependent variables during the lifting phase of the task; however, beneficial effects were seen with the smallest handle diameter during the pouring phase. A trade-off existed between the shoulder and the hand/wrist posture with the different handles. The findings of significance with relatively small effect size suggest a high sensitivity of the system to any changes. In the real world, speed, space and work conditions are important factors that influence how a task is performed. This emphasises the importance of proper handle design.

Practitioner Summary: In this study, the effect of container handle design on the muscle activity and postures of the upper extremity during a pouring task were analyzed using the experimental data collected from electromyography and motion tracking systems. The low handle height and vertical handle slope design yielded the lowest shoulder muscle activity.     

The effect of pallet distance on torso kinematics and low back disorder risk

Intervention research for prevention of occupational low back injuries has focused on the effects of reducing extreme torso flexion and the external moment. Little is known about prevention strategies for torso twisting and lateral bending. The objective of this study was to assess the effect of pallet distance with regard to a constant lift origin on the torso kinematics and a measure of low back disorder risk. Fifteen male participants transferred 11.3?kg boxes from a constant origin to six different regions on a pallet. Two pallet distances with regard to the lift origin were investigated. ANOVA indicated that increasing the pallet distance resulted in increases in torso kinematics (velocities and accelerations) as well as a measure of risk of low back disorder. The increases in torso kinematics (e.g. twisting and lateral awkward postures and bending velocities) occurred mostly at the lower height regions on the pallet. It is concluded that increasing the pallet distance with regard to the lifting origin, with the intention to influence the participant to take a step during a palletizing task does not appear to be an effective intervention strategy to reduce the risk of low back disorder associated with torso kinematics.     

Sex differences in glenohumeral muscle activation and coactivation during a box lifting task

Abstract

Manual material handling is associated with shoulder musculoskeletal disorders, especially for women. Sex differences in glenohumeral muscle activity may contribute to women’s higher injury risk by affecting shoulder load and stability. We assessed the effects of sex (25 women vs 26 men) and lifting load (6?kg vs 12?kg) on muscle activation during box lifting from hip to eye level. Surface and intramuscular electromyography were recorded from 10 glenohumeral muscles. Most muscles were more activated for the heavier box and for women. These effects were larger for ‘prime movers’ than for stabilisers and antagonists. Despite their apparently heterogeneous effects on muscle activity, sex and mass did not affect Muscle Focus, a metric of coactivation. This may be partly related to the limited sensitivity of the Muscle Focus. Nevertheless, sex differences in strength, more than in coactivation patterns, may contribute to the sex imbalance in the prevalence of musculoskeletal disorders.

Practitioner summary: We studied sex differences in glenohumeral muscle activity in a lifting task to eye level. Women lifting a 6-kg box activated their muscles similarly to men lifting a 12-kg box, i.e. up to 48% of their maximum capacity. Interventions minimising shoulder load should be implemented, especially for women.

Abbreviations: BB: biceps brachii; DeltA: anterior deltoid; DeltL: lateral deltoid; DeltP: posterior deltoid; DoF: degrees of freedom; ED: effect duration; EMG: electromyography; ES: effect size; Infra: infraspinatus; Lat: latissimus dorsi; MF: muscle focus; MMH: manual material handling; MVA: maximal voluntary activation; Pect: pectoralis major; Subscap: subscapularis; Supra: supraspinatus; TB: triceps brachii     

An on-line microcomputer-based respiratory monitor for manual materials handling

The main objective of the present study is to develop a low cost microcomputer-based respiratory system that is capable of computing the oxygen consumption and minute ventilation of individuals engaged in manual materials handling on an on-line basis. The design, specifications, and merits of the system are given. The software package developed was written in assembly language for the IBM AT personal computer.     

The influence of external load configuration on trunk biomechanics and spinal loading during sudden loading

Abstract

Sudden loading is a major risk factor for work-related lower back injuries among occupations involving manual material handling (MMH). The current study explored the effects of external weight configuration on trunk biomechanics and trunk rotational stiffness in the sagittal plane during sudden loading. Fifteen asymptomatic volunteers experienced sudden loadings using the same magnitude of weight (9?kg) with two different configurations (medially- or laterally-distributed) at three levels of height (low, middle and high). Results of this study showed that the medially distributed weight resulted in a significantly higher peak L5/S1 joint compression force (2861 N vs. 2694 N) and trunk rotational stiffness (2413?Nm/rad vs. 1785?Nm/rad) compared to the laterally distributed weight. It was concluded that when experiencing sudden loading, a more laterally distributed weight could increase the load’s resistance to physical perturbations and alleviate spinal loading during sudden loading events.

Practitioner summary: Increased trunk rotational stiffness and peak L5/S1 joint compression force were observed when undergoing a sudden load release of a medially distributed load compared to a laterally distributed load revealing a less stable hand load condition due to the reduced moment of inertia. The laterally distributed load could increase the load’s resistance to physical perturbations and mitigate spinal loading during sudden loading events.     

Effects of restrictive clothing on lumbar range of motion and trunk muscle activity in young adult worker manual material handling

The objective of this study was to examine the effect of wearing restrictive trousers on lumbar spine movement, trunk muscle activity and low back discomfort (LBD) in simulations of manual material handling (MMH) tasks. Twenty-eight young adults participated in the study performing box lifting, liquid container handling while squatting, and forward reaching while sitting on a task chair when wearing tight pants (sizes too small for the wearer) vs. fit pants (correct size according to anthropometry). Each task was repeated three times and video recordings were used as a basis for measuring lumbar range of motion (LRoM). The response was normalized in terms on baseline hip mobility. Trunk muscle activity of rectus abdominis (RA) and erector spinae (ES) muscles were also measured in each trial and normalized. At the close of each trial, participants rated LBD using a visual analog scale. Results revealed significant effects of both pants and task types on the normalized LRoM, trunk muscle activity and subjective ratings of LBD. The LRoM was higher and trunk muscle (ES) activity was lower for participants when wearing tight pants, as compared to fit pants. Discomfort ratings were significantly higher for tight pants than fit. These results provide guidance for recommendations on work clothing fit in specific types of MMH activities in order to reduce the potential of low-back pain among younger workers in industrial companies.     

Effects of the weight configuration of hand load on trunk musculature during static weight holding

The performance of manual material handling tasks is one major cause of lower back injuries. In the current study, we investigated the influence of the weight configuration of hand loads on trunk muscle activities and the associated spinal stability. Thirteen volunteers each performed static weight-holding tasks using two different 9 kg weight bars (with medial and lateral weight configurations) at two levels of height (low and high) and one fixed horizontal distance (which resulted in constant spinal joint moment across conditions). Results of the current study demonstrated that holding the laterally distributed load significantly reduced activation levels of lumbar and abdominal muscles by 9–13% as compared with holding the medially distributed load. We believe such an effect is due to an elevated rotational moment of inertia when the weight of the load is laterally distributed. These findings suggest that during the design and assessment of manual material handling tasks, such as lifting and carrying, the weight configuration of the hand load should be considered.

Practitioner summary: Elevated trunk muscle activities were found when holding a medially distributed load vs. a laterally distributed load (with an equivalent external moment to the spine), indicating a reduced spinal stability due to the reduced rotational moment of inertia. The configuration of the hand load should be considered when evaluating manual material handling tasks.     

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.     

Balance control during lateral load transfers over a slippery surface

Few studies have measured balance control during manual material handling, and even fewer with environmental cofactors. This study examined the effect of different surface frictions during a stationary manual material handling task. Thirty-six healthy participants completed 180° lateral transfer tasks of a load over high- and low-friction surfaces (μ = 0.86 and μ = 0.16, respectively). Balance measures, stance kinematics and lower extremity muscle activities were measured. Success during the novel slippery surface dichotomised our population, allowing us to investigate beneficial techniques to lateral load transfers over the slippery surface. Stance width reduction by 8 cm and 15° of additional external foot rotation towards the load were used to counter the imbalance created by the slippery surface. There was no clear alteration to lower extremity muscular control to adapt to a slippery surface. Changes in stance seemed to be used successfully to counter a slippery surface during lateral load transfers.

Statement of Relevance: Industries requiring manual material handling where slippery conditions are potentially present have a noticeable increase in injuries. This study suggests stance configuration, more so than any other measure of balance control, differentiates vulnerability to imbalance during material handling over a slippery surface.     

Spine loading and trunk kinematics during team lifting

Two-person or team lifting is a popular method for handling materials under awkward or heavy lifting conditions. While many guidelines and standards address safe lifting limits for individual lifting, there are no such limits for team lifting, and these lifts are poorly understood. The literature associated with team lifting offers some interesting paradoxes. Many studies have indicated that people lift less per individual under team conditions compared with one-person lifting. Yet, at least one study has reported an increase in team-lifting capacity when subjects were height-matched. The current study explored the spine loading characteristics of one- and two-person lifting teams when subjects lifted under several sagittally symmetric and asymmetric conditions. Spine compression was lower for two person lifts for a given weight, while lifting in sagittally symmetric conditions whereas lateral shear became much greater for two-person lifts under asymmetric lifting conditions. This study has linked these changes to differences in trunk kinematic patterns adopted during one- versus two-person lifting.     

The effects of military body armour on trunk and hip kinematics during performance of manual handling tasks*

Musculoskeletal injuries are reported as burdening the military. An identified risk factor for injury is carrying heavy loads; however, soldiers are also required to wear their load as body armour. To investigate the effects of body armour on trunk and hip kinematics during military-specific manual handling tasks, 16 males completed 3 tasks while wearing each of 4 body armour conditions plus a control. Three-dimensional motion analysis captured and quantified all kinematic data. Average trunk flexion for the weightiest armour type was higher compared with control during the carry component of the ammunition box lift (p?<?0.001) and sandbag lift tasks (p?<?0.001). Trunk rotation ROM was lower for all armour types compared with control during the ammunition box place component (p?<?0.001). The altered kinematics with body armour occurred independent of armour design. In order to optimise armour design, manufacturers need to work with end-users to explore how armour configurations interact with range of personal and situational factors in operationally relevant environments.

Practitioner Summary: Musculoskeletal injuries are reported as burdening the military and may relate to body armour wear. Body armour increased trunk flexion and reduced trunk rotation during military-specific lifting and carrying tasks. The altered kinematics may contribute to injury risk, but more research is required.     

Step scaling and behaviour selection in a constrained set of manual material handling transfers

Predictive biomechanical analysis of manual material handling (MMH) transfers is dependent on accurate prediction of foot locations relative to the task. Previous studies have classified common acyclic stepping patterns used during those transfer tasks, but the influence of walking distance prior to the transfer is not well understood. Twenty men and women performed transfers for a minimum of six different delivery distance conditions. The number of steps used by the participants ranged from two to seven. A theoretical framework for idealised step-scaling strategies is proposed and compared with the experimental data. The maximum observed increase in step length prior to delivery was 1.43 times the nominal step length calculated for each participant. The data suggest that although participants can scale their steps to facilitate the use of a single terminal stance at the transfer, the majority of participants chose to utilise a combination of stepping strategies if the preferred contralateral lead foot strategy could not be easily implemented.

Practitioner summary: Accurate foot placements are needed for predictive biomechanical analysis of MMH. A laboratory study investigated the influence of previous step positions on MMH. A flexible step-scaling strategy, in which step lengths and strategy were varied, suggests that analysis based on simulated movements should consider multiple lifting postures.     

Handle height and expectation of cart movement affect the control of trunk motion at movement onset in cart pushing

As unexpected sudden unloading of the trunk may cause low-back injury, the objective of the present study was to investigate whether handle height and the expectation of cart movement in pushing affect trunk control at movement onset. Eleven healthy male participants pushed a 200-kg cart with handles at shoulder and hip heights. The cart would suddenly move when externally released (externally triggered condition) or when static friction was overcome (self-initiated condition). Before self-initiated cart movement, trunk stiffness and muscle activity were significantly higher than before an externally triggered onset at comparable pushing force. Lower muscle activity and trunk stiffness at shoulder height compared with the hip height before the onset resulted in higher trunk inclination after the onset. In conclusion, higher preparatory activation of trunk muscles serves to increase trunk stiffness in anticipation of cart movement and may reduce the impact of the perturbation associated with the onset of cart movement.

Statement of Relevance: Sudden cart movement in pushing causes an unexpected unloading perturbation to the trunk. This perturbation was shown to cause uncontrolled trunk movement, which may explain how pushing tasks can be associated with low-back injury. Effects of handle height and awareness of the subjects of the possible cart movement suggest directions for prevention.     

Oxygen consumption prediction models for individual and combination materials handling tasks

An experiment was conducted to develop models to predict oxygen consumption of males and females engaged in common materials handling tasks including lifting, lowering, pushing, pulling, (de)palletising and combination tasks involving lifting or lowering a box and carrying it a set distance and lifting or lowering it to the destination. Nineteen male and 19 female subjects participated in the study. A psychophysical approach was used to set load limits for individual subjects for the oxygen consumption protocol. The 8398 oxygen consumption values collected were entered into the initial regression analyses and 168 potential outliers were removed before the final models were run. In addition to relevant task variables, body weight was a significant predictor variable in all models. The r² values for the final models ranged from 0.54 to 0.82 and the root mean square errors ranged from 90.2 ml to 294.8 ml.     

Foot motions in manual material handling transfer tasks: A taxonomy and data from an automotive assembly plant

Ergonomic job analysis commonly applies static postural and biomechanical analysis tools to particular postures observed during manual material handling (MMH) tasks, usually focusing on the most extreme postures or those involving the highest loads. When these analyses are conducted prospectively using digital human models, accurate prediction of the foot placements is critical to realistic postural analyses. In automotive assembly jobs, workers frequently take several steps between task elements, for example, picking up a part at one location and moving to another location to place it on the vehicle. A detailed understanding of the influence of task type and task sequence on the stepping pattern is necessary to accurately predict the foot placements associated with MMH tasks. The current study examined the patterns of foot motions observed during automotive assembly tasks. Video data for 529 pickup and delivery tasks from 32 automotive assembly jobs were analysed. A minimum of five cycles was analysed for each task. The approach angle, departure angle, hand(s) used, manipulation height and patterns of footsteps were coded from the video. Object mass was identified from the job information sheet provided by the assembly plant. Three independent raters coded each video and demonstrated an intraclass correlation coefficient of 0.54 for identification of the configuration of the lower extremities during terminal stance. Based on an analysis of the distribution of stepping behaviours during object transitions (pickups or deliveries), a transition classification system (TRACS) was developed. TRACS uses a compact notation to quantify the sequence of steps associated with a MMH transition. Five TRACS behaviour groups accounted for over 90% of the transition stepping behaviours observed in the assembly plant. Approximately two-thirds (68.4%) of the object transfers observed were performed with only one foot in contact with the ground during the terminal posture. The results from this paper suggest that a predictive model for choosing a transition stepping behaviour, coupled with a model to scale the selected foot behaviours, is needed to facilitate accurate prospective ergonomic analyses. This study proposes a method for categorising the stepping patterns associated with MMH tasks. The influence of task type and task sequence on the stepping patterns observed during several automotive assembly tasks is discussed. For prospective postural analyses conducted using digital human models, accurate prediction of the foot placements is critical to realistic postural analyses.