Characterization of cashier shoulder and low back muscle demands

Cashiers commonly report musculoskeletal discomfort in their shoulders, neck, and low back. This may result from excessive loading, awkward postures, insufficient rest, or task repetition. Recently, widespread introduction of reusable, consumer-supplied bags has introduced challenges in assessing exposures in this occupational group. Limited information exists on the physical demands associated with cashier work, particularly in the context of multiple bagging formats; this study was thus designed to generate a novel data set describing standard grocery packaging tasks. Twenty-five experienced cashiers completed 36 grocery packaging tasks consisting of twice performing all combinations of workload intensity (6, 20 items), workstation height (low, medium, high), and packaging type (plastic bags, reusable bags, bins). Surface electromyography (EMG) was measured bilaterally for 5 shoulder and 3 low back muscles and processed to generate integrated muscle demand for each combination evaluated. A mixed effect ANOVA was used to assess the influences of gender, intensity, package type, side, (muscles on the right or left side of the body) and workstation height on individual and total muscular demands. High workload intensity combined with several other factors to increase muscle demands, including using plastic or reusable bags for packaging and increasing workstation height. Gender and side also interacted with workload intensity to influence muscle activity. Encouraging rest breaks, the use of bins for packaging, and decreasing cashier workstation height may help reduce potentially injurious muscular effort for cashiers.     

Effects of changes in sitting work posture on static neck and shoulder muscle activity

Abstract

In order to analyse the effect of changing the sitting posture on the level of neck and shoulder muscular activity, an electromyographic (EMG) study of ten healthy experienced female workers from an electronics plant was undertaken. A standardized, simulated task was performed in eight different sitting work postures. Using surface electrodes, the level of muscular activity was recorded as normalized, full-wave rectified low-pass filtered EMG. The results showed that the whole spine flexed sitting posture gave higher levels of static activity in several neck and shoulder muscles than the posture with a straight and vertical spine, which in turn gave higher levels than the posture with slightly backward-inclined thoraco-lumbar spine.     

Examining kinematics and muscle activity of the upper extremity while performing cleaning tasks: A pre-post shift evaluation

Custodians engage in strenuous manual labour throughout their workday. Uncertainty exists on whether kinematics or muscle activation changes as workers progress through their shift. The purpose of this study was to examine muscle activation and upper extremity kinematics during typical custodial tasks performed at the start and end of the work shift. Electromyography (EMG) of 8 torso and upper extremity muscles and motion capture of the corresponding region were collected for 10 custodial participants while they completed garbage removal, dry mopping, and vacuuming tasks at the start and end of a work shift. The start of shift assessment demonstrated larger anterior deltoid, posterior deltoid and extensor digitorum activation by up to 12.6 %maximal voluntary contraction (%MVC) (p < 0.001–0.023). Task affected mean and peak EMG in all muscles except flexor digitorum (p < 0.001–0.0293), and the greatest activation was found during vacuuming (peak <55%MVC in anterior and middle deltoid) and the heaviest garbage removal task (84% MVC peak in upper trapezius). Mopping created the lowest amounts of activation for almost all muscles. Joint range of motion (p < 0.001–0.031) in the shoulder was highest in vacuuming, while trunk flexion was largest in garbage removal tasks. This work replicated common custodial tasks in a laboratory, using actual custodial workers at times relevant to their typical work shifts. The information presented is useful for ergonomists, work tasks designers and custodial administration staff to develop guidelines for injury prevention.     

An imperceptible barcode can reduce the muscle activity required to scan common consumer packaged goods

While the Universal Product Code (UPC) has remained unchanged since its implementation in the 1970s, new technology and consumer package good layouts have started to change the UPC layout. The purpose of this study was to compare how upper extremity muscle activity was altered when scanning consumer packaged goods enhanced with an imperceptible barcode or a multi-sided UPC layout. Seventeen experienced cashiers participated in this study. Electromyography of four bilateral upper extremity muscles was recorded when scanning individual consumer packaged goods and a mock grocery cart. Scanning time and integrated electromyography were compared between the packages enhanced with an imperceptible barcode or the multi-sided barcodes versus the traditional barcodes. Participants were more efficient when scanning packages with the altered barcodes compared to the traditional barcode. Scanning the individual consumer packaged goods resulted in lower peak muscle activity for the shoulder muscles and elbow flexors when using packages enhanced with the imperceptible barcode. When extrapolated over a 4-h shift, the packages enhanced with the imperceptible barcode lowered upper extremity cumulative muscle activity measured muscles; however, the multi-sided layout only demonstrated a reduced muscular activity for the trapezius and left forearm. Future work must continue to assess grocery scanning practices, training, and other alternative scanning practices, such as hand scanners and self-checkout stands.     

Impact of pulling direction and magnitude of force exertion on the activation of shoulder muscles

Shoulder musculoskeletal disorders (MSD) are frequently associated with the work activities that demand forceful arm exertions in pushing and pulling directions. Considering the ability of shoulder joint to exert forces in nearly any direction, our understanding of the shoulder muscles activation as affected by pushing and pulling exertions is limited. In this study the activation of seven shoulder muscles were studied for 10 male participants during pulling exertions performed in five directions (pull right, pull left, pull back, pull down and pull up) using three force levels (22.24 N, 33.36 N and 44.48 N). Exertions performed in pulling right and pulling up directions produced higher activation and received higher perceived exertion ratings than the exertions performed in the other directions. Rotator cuff and middle deltoid muscles activation were consistently higher during pulling up and pulling right exertions compared to the other muscles. A high correlation was found between the activation of rotator cuff and deltoid muscles and the perceived exertion ratings. The rotator cuff and middle deltoid muscles activation observed during the pulling up and pulling right exertions can be explained by the concavity compression mechanism which stabilizes the glenohumeral joint of shoulder.Relevance to industryThe muscle activation data expressed in terms of Maximum Voluntary Contraction (MVC) and perceived exertion ratings are widely used by the ergonomic practitioners to design and/or evaluate workplace exertions. This study provides such data for several shoulder muscles during pulling exertions performed under different conditions.     

Effects of shoulder rotation combined with elbow flexion on discomfort and EMG activity of ECRB muscle

Work related MusculoSkeletal Disorders (WMSDs) are injuries or dysfunctions caused by occupational or non occupational tasks involving bad postures, high frequency of exertions or high force levels. In the present study, the effects of shoulder flexion/extension combined with elbow flexion angle on discomfort score were investigated for repetitive gripping task. A laboratory experimental simulation was conducted. Ten male participants volunteered in this study. Four levels of shoulder flexion/extension (−45° extension, 0° neutral, 45° & 90° flexion) with three levels of elbow flexion angle (45°, 90° & 135°) were taken as levels of independent variables. There were 12 combinations available for each participant and the experiment was conducted on the basis of random order of experimental combinations for each participant. Discomfort score on 100 mm visual analogue scale (VAS) and Electromyography (EMG) activity of Extensor Carpi Radialis Brevis (ECRB) muscle were dependent variables for the analyses. The task for the experiment was of 150N ± 5N grip force at a frequency of 15 exertions/minute for five minutes duration. After performing the MANOVA on the recorded data, the results showed that the shoulder flexion/extension and elbow flexion both were highly significant (p < 0.001). Also it was found that −45° shoulder extension combined with 45° elbow flexion angle was the most discomfort posture. The practical relevance of the study is that, in industrial tasks such posture should be avoided to minimize risk of WMSDs.Relevance to industryThe findings in terms of relationship between discomfort/EMG vs. shoulder rotation combined with elbowflexion are important to design Industrial tasks with the reduced risk of WMSDs. Such as, sheet metal cutting, fabrication of sheet metal work, die casting, and drilling operations may require the shoulder movements in extenion/flexion combined with elbowflexion.     

Neck and shoulder muscle activity during standardized work-related postural tasks

The aim of the present study was to assess the activity levels of the sternocleidomastoid muscle and upper trapezius muscle during static postures under controlled and standardized conditions, and to determine whether the muscle activity differed between sexes. Electromyographic (EMG) activity was recorded unilaterally from the sternocleidomastoid and upper trapezius muscle in 17 participants whilst they were performing various postural tasks. EMG amplitude was measured by the root mean square values of the raw signals and normalized to peak maximum contractile values for each muscle (%MVC). The intensity of muscle activity was ranked as light (<3%MVC), moderate (3%MVC ≤ EMG ≤ 8%MVC), and substantial (>8%MVC). During most tasks the two muscles contracted light to moderately. Head leaning and shoulder shrugging postures yielded substantial muscle activity in both muscles. Muscle activity did not differ significantly between male and female participants (F = 3.1; p = 0.078). Our findings provided normative values, which will enhance future studies of muscle activity during work in a natural, unrestrained environment.     

Comparison of Indicator Components and Push-Button Recommendations

Four consoles were designed identical in every respect except for the display and control components used in their construction. Two levels of illumination were employed. Sixteen fit male subjects, age range 19 to 50, were tested. Subjects were asked to respond to signals presented in a predetermined order by operating a control, e.g. a push-button or Post Office key. Reaction times weretaken using a simple time event recorder producing five-hole punched paper tape output. A note was taken of errors of operation. Some 30,000 reaction times were taken and analysed using a five-factor analysis of variance computer program. A similar rank order of the components was found for speed of response and accuracy of operation. Within the limits of the experiment a trans-illuminated push-button was operated with the lowest reaction time and with least error. Some factors affecting the design of push-button controls and their associated displays are discussed.     

Neck and shoulder muscle activity among ophthalmologists during routine clinical examinations

Muscular demands during common clinical ophthalmologic activities may contribute to the high prevalence of musculoskeletal health outcomes observed among ophthalmologists and other eye care physicians. Characterizations of the muscle activation patterns in the live ophthalmologic environment are lacking. This study was conducted to (i) characterize the frequencies and durations of common activities performed by ophthalmologists during routine clinical examinations, (ii) characterize neck and shoulder muscle activation patterns during the whole clinical work day, and (iii) explore differences in neck and shoulder muscle activation patterns between common clinical activities. Fifteen ophthalmologists performed routine patient examinations in an outpatient ophthalmology clinic while continuous surface electromyography measurements of the upper trapezius and anterior deltoid muscles were obtained. Results indicated that while computer use was the most frequently performed clinical activity, use of the indirect ophthalmoscope, followed by use of the slit lamp biomicroscope, required greater muscular demands than computer use or other clinical activities. Results provide evidence that the clinical activities of indirect ophthalmoscope and slit lamp biomicroscope use are appropriate for ergonomic intervention.     

Posture,muscle activity and muscle fatigue in prolonged VDT work at different screen height settings

With the increasing use of video display terminals (VDTs), there is growing concern over the corresponding increase in the number of health problems reported. Although much research has focused on identifying the optimal screen height, there is to date no consensus. This study aimed to investigate the effect of prolonged (89 min) VDT work at four different screen heights on head-neck posture, muscle activity and the development of muscle fatigue. The results show that lowering screen height, starting from 15 cm above the baseline (i.e. top of the screen level with eye height while sitting), decreased the ear-eye angle, increased the viewing angle, increased the viewing angle relative to the ear-eye line, and increased the muscle activity of the neck extensor muscles. There were also some significant time effects on postural angles and muscle activity. In this study there were only rare occurrences of muscle fatigue, defined as a simultaneous increase in EMG amplitude and a shift of the EMG power spectrum to lower frequencies. Muscle activity increased significantly in some muscles and for certain screen heights.     

Load moments and myoelectric activity when the cervical spine is held in full flexion and extension

Abstract

Sustained joint load in extreme positions (namely maximally flexed or extended positions) has been described as causing pain. The aim of the present study is to analyse eight different sitting work postures with respect to extreme positions, and to assess the mechanical load and the levels of muscular activity arising in defined extreme positions of the cervical spine. Ten healthy female workers from an electronics plant took part in laboratory experiments. For seven of these, levels of neck and shoulder muscular activity in sitting postures with the cervical spine in different manually-adjusted extreme positions were recorded using surface electrodes. Loading moments of force about the bilateral motion axis of the atlanto-occipital joint (Occ-C1) and the spinal cervico-thoractc motion segments (C7-T1) were calculated. Extreme or almost extreme positions occurred in sitting postures with the thoracolumbar back inclined slightly backwards or with the whole spine flexed. Electromyographic (EMG) activity levels were very low in the manually-adjusted extreme positions. The load moment for the Occ-Cl joint when the whole neck was flexed was only 1·2 times the value for the neutral position of the head, but for C7-T1 it increased to 3·6 times. It is concluded that extreme positions of the cervical spine do occur in sitting work postures, and that the levels of muscular activity in such positions are low. Thus, recordings of muscle activity and calculations of load moment alone are not a sufficient basis for evaluating work postures: thorough recordings of spine positions should be included.     

Effects of arm support on shoulder and arm muscle activity during sedentary work

The aim of this study was to evaluate different arm supports by comparing the activity of shoulder and arm muscles during various work tasks, with and without the lower arm supported. Twelve female subjects, aged between 23 and 37 years, were asked to perform three types of tasks: typing, simulated assembly work (in two different positions), and pipetting. The supports used were: fixed arm support (FIX), horizontal movable arm support (HOR), and spring-loaded arm support (SLA). During the experiments, the electromyograms (EMG) of four muscles were simultaneously recorded: m. deltoideus anterior and lateralis, m. trapezius pars descendens and m. extensor carpi radialis brevis. Normalization was made against maximum isometric contraction. The mean values of the normalized EMG levels showed a reduced EMG level of the shoulder muscles when using arm supports in all the tasks, and for all muscles but the wrist extensor, compared to the EMG levels without arm supports. The horizontal movable support was more effective in reducing the EMG levels of the shoulder muscles than other arm supports, in tasks at table height. Thus, it is possible to reduce muscle activity of the shoulder region by using arm supports. Further research is needed to make biomechanical calculations to compare the EMG level of these muscles using suspension and the effects of inclination of work task.     

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.     

Quantification of the static load component in muscle work using nonlinear filtering of surface EMG

Prolonged static strain on the muscles of the neck-shoulder region is believed to be linked to the development of musculoskeletal problems. To quantify the static strain on the basis of EMG, the level as well as the duration of the muscle load should be analysed on temporal basis. In this paper, some methods for the temporal analysis of EMG recordings are proposed with an aim of quantifying the long-term static strain on the muscle. The use of nonlinear median prefilters for decomposing the EMG activity according both to amplitude level and duration of the activity at different levels is proposed. The prefiltering methods were also evaluated using laboratory studies. The main aim of the studies was to compare the estimation errors between EMG and force for different types of prefilters especially when the static load component was analysed. The average estimation error for sequences having a duration longer than 1 s was found to be 8% of MVC in the case of trapezius muscle and 14% of MVC in the case of biceps brachii muscle. Linear relation was found on the basis of linear least squares curve fitting to give the largest correlation coefficients between EMG and force, when the static load component was analysed.     

Interfering effects of the task demands of grip force and mental processing on isometric shoulder strength and muscle activity

The purpose of this study was to examine the interfering effects of physical and mental tasks on shoulder isometric strength in different postures. Fifteen volunteers (seven women, eight men) performed a series of isometric shoulder exertions at 30°, 60° and 90° of both shoulder flexion and abduction alone and with the addition of a 30% grip force, a mental task (Stroop test) and both additional tasks simultaneously. The shoulder tasks were completed either at maximal intensity, or while maintaining a shoulder posture without any additional effort. Surface electromyography (EMG) from seven muscles of the shoulder girdle and shoulder moment were collected for each 6 s shoulder exertion. When normalized to maximum exertion, no differences were found between genders and no differences existed between conditions when subjects maintained each posture without exerted force. In the maximal shoulder exertion trials, an increase in shoulder angle (in either plane) resulted in an increase in EMG in most muscles, while shoulder moment decreased in flexion and remained constant in abduction. Shoulder moments and muscle activation were greatest in the shoulder exertion alone condition followed by adding a 30% grip and the Stroop test, with the addition of both tasks further reducing the exerted shoulder moment and EMG. However, muscle activity did not always decrease with shoulder strength and remained elevated, indicating a complex coactivation pattern produced by an interfering role of the tasks. Overall, it was found that a mental task can have the same or greater effect as a concurrent grip and should be considered when assessing muscular loading in the workplace, as typical biomechanical modelling may underestimate internal loads. The results not only provide valuable shoulder strength data but also practical strength values, depending on additional tasks.     

Muscle fatigue during intermittent isokinetic shoulder abduction: Age effects and utility of electromyographic measures

Most existing evidence regarding the effects of age on muscular fatigue has focused on prolonged isometric contractions, repeated maximum dynamic contractions and individuals beyond traditional retirement age (>65 years). In the present study, age-related differences in muscle fatigue during submaximal dynamic efforts were examined. There were 24 younger (18–25 years) and 24 older (55–65 years) participants, all of whom were healthy and active, with equal numbers of each gender within each age group. Participants performed repetitive, intermittent shoulder abductions until exhaustion, at peak moments of 30% and 40% of individual maximum voluntary isokinetic contraction (MVIC) and with cycle durations of 20 and 40 s. Fatigue development was determined based on changes in MVIC, electromyographic (EMG) signals and ratings of perceived discomfort (RPD). Following the exhaustive exercises, strength recovery was monitored using a series of MVICs over a 15-min period. Results indicated the existence of an age-related fatigue resistance, with the older group demonstrating significantly slower rates of MVIC decline and RPD increase and smaller modifications in EMG-based fatigue measures. These age effects were generally more pronounced at the higher effort level. Main effects of effort level and cycle duration were also significant, while gender effects appeared to be marginal. Rates of strength recovery were not significantly influenced by age. In addition, the utility of standard EMG-based fatigue measures was assessed. Findings indicated that time-dependent changes in static and dynamic EMG-based measures were roughly comparable in terms of sensitivity and variability, supporting the use of standard EMG analyses for fatigue monitoring during intermittent dynamic contractions.     

Electromyographic fatigue in neck/shoulder muscles and endurance in women with repetitive work

EMG was recorded with surface electrodes from the trapezius and deltoid muscles during a static endurance test at approximately 20% of maximal voluntary contraction. Objective parameters for localized muscular fatigue were derived from the time course of the root mean square (RMS) and mean power frequency (MPF) of the EMG recordings. Isotonic regression is introduced as a tool for assessment of such parameters. The most pronounced sign of fatigue for trapezius was an increase in the RMS values, while for deltoid it was a decrease in the MPF values. This could be explained by the different functions of the two muscles. The endurance time for a group of 11 women in industrial work with repetitive short-cycled work tasks who were diagnosed with neck/shoulder disorders (tension neck) was significantly shorter (p<0·05) than for a group with the same work, but without neck/shoulder disorders (n=ll), and shorter than for a control group (n=ll). Regarding the EMG fatigue measures, there were no significant differences between the three groups. We did not find any relationships between endurance time and the EMG parameters. The results indicate that neck/shoulder disorders were not associated with divergent mechanisms for developing fatigue in the muscles, as recorded with surface EMG.     

Subjective and objective evaluation of shoulder muscle fatigue

In order to relate EMG signs of localized muscle fatigue to subjectively perceived muscle fatigue, a study was undertaken on 20 healthy volunteers exposing their right trapezius muscle by raising the arm to 90° of abduction. Every person performed two contractions: 0 kg hand load during 5 min and 2 kg hand load during 2.5 min. Surface EMG was recorded and analysed with respect to RMS amplitude and mean power frequency (MPF). Subjective muscle fatigue was estimated with a psychophysical rating scale (Borg's CR-10 Scale). At high load level we found a significant correlation between MPF and the CR-scores (r = ? 0.46), but at low load level there was no correlation. At high load level there was a linear decrease of MPF with increasing load dose, but at low load level the MPF did not change, despite significant subjective fatigue. There was a linear rise of the CR-score with increasing load dose, more pronounced at high load level. It was concluded, that at low load levels common in working life, MPF and subjective scores seem to provide different fatigue information. Moreover, the MPF did not seem to work as a valid estimator of muscle fatigue at this low load level. Caution is recommended if it is to be used in static low-load situations.     

Evaluation of upper body kinematics and muscle activity during milking attachment task

The objective of the study was to evaluate the effects of udder height on upper body kinematics and muscle activity during a simulated attachment task in a parallel parlor set up, and the effects of udder access method (back or side) on the task biomechanics. Twenty males performed the task under conditions that simulated three udder heights and two udder access methods. The muscular load and kinematics during the task confirmed that milking is a physically demanding task. Trunk flexion angle increased with decreasing udder height, and the erector spinae activation was higher when the udder was below shoulder height compared to at or above. Compared to accessing the udder from side of the cow (herringbone parlor style), accessing from behind (Parallel parlor style) was associated with lower trunk flexion, greater shoulder horizontal adduction, lower shoulder elevation, and greater anterior deltoid activation. Milking in herringbone parlor style and with the udder at or above shoulder level may help reduce strain on the trunk/neck.     

The effect of an ergonomic computer device on muscle activity of the upper trapezius muscle during typing

OBJECTIVE: Investigate whether an ergonomic computer device, characterised by an inclined working area and keyboard localisation close to the screen (the Up-Line), decreases the muscle activity of the upper trapezius muscle. METHODS: In a crossover design 19 healthy subjects and 19 patients with Whiplash Associated Disorder (WAD) typed during 10 min at the Up-Line and at a standard workstation with 15 min of rest in between. During typing surface EMG was measured of the trapezius muscle. The subjects were asked to rate sitting comfort and complaints. RESULTS: Although most subjects subjectively preferred the Up-Line, on average no significant differences were found in muscle activity between the two workstations for both patients and healthy subjects. Individually in 5 healthy subjects (25%) and in 6 patients (31%) muscle activity was lower when working at the Up-Line. CONCLUSION: Although some subjects subjectively prefer the Up-Line in sitting comfort, on average the Up-Line did not decrease the muscle activity, both in healthy subjects as in patients with WAD.