Lumbar erector spinae oxygenation during prolonged contractions: implications for prolonged work

Owing to the recent interest in torso stabilization exercises together with many questions regarding the duration of prolonged isometric holds in occupational settings, the authors attempted to assess the level of back muscle oxygenation during prolonged isometric contractions. Specifically, this study recorded relative oxygen saturation of haemoglobin/myoglobin using Near Infrared Spectroscopy (NIRS) in the L3 erector mass during prolonged isometric contractions at intensities from 2 to 30% of maximum voluntary contraction (MVC). It was hypothesized that available oxygen to these muscles is severely compromised even at moderate levels of activation observed in occupational work. Eight volunteers without a history of lower back pain or injury participated in this study. The exercise task involved isometric contraction of the lower erector spinae at five different levels of each subject's maximal voluntary contraction: 2, 5, 10, 20 and 30% MVC, presented in random order. Subjects were placed in a sitting position, with a curved plastic plate secured horizontally to the pelvis to minimize movement at the hip joint. During extensor exertions, they were restrained with a harness that was attached at chest level to a load cell. Each isometric contraction was performed for 30 s followed by 1 min of rest. All levels of contraction demonstrated reduction in oxygen. Given the concern for motion artefact on the NIRS signal, sham trials were conducted where the subjects went through the procedure of attaching the pulling cable but no active pull was performed. These trials showed no change in the NIRS signal. At this time NIRS appears to be the only non-invasive instrumentation available to indicate total available muscle oxygen during low level, prolonged work. Although the specific tissue volume sampled by NIRS cannot be positively identified, it appears that tissue oxygenation in the lumbar extensor musculature is reduced as a function of contraction intensity, even at levels as low as 2% of MVC. These data have implications for prolonged work where postures requiring isometric contractions are sometimes held for hours, and where musculoskeletal illness has been linked to prolonged contraction levels above 2%MVC--these data suggest a possible biological pathway.     

The effects of lumbar massage on muscle fatigue, muscle oxygenation, low back discomfort, and driver performance during prolonged driving

An increasing dependence of society on automobiles for both work and leisure and the corresponding increase in time spent seated in the car has been correlated with a greater risk of low back pain and absence from work (Porter and Gyi 2002). This study examined the effects of three types of lumbar massage units on seating comfort, muscle fatigue, muscle oxygenation, muscle blood flow and driving performance during a 1 h simulated driving task. Electromyographic (EMG) signals were recorded from the right and left thoracic and lumbar erector spinae musculature. Average EMG (AEMG), mean power frequency (MPF), gaps and amplitude probability distribution function (APDF) parameters were analysed from the three massage seats and compared to a control seat. Near infrared spectroscopy (NIRS) and skin temperature from the right thoracic and lumbar erector spinae were used as an indication of muscle oxygenation and blood flow throughout the driving task. Ratings of perceived discomfort were used to assess driver discomfort, and driving performance was assessed by calculating mean lap times for the duration of each driving trial. The results showed statistically significant increases in skin temperature compared with the control seat after 60 min of driving. The NIRS results reflected these trends although the results were not statistically significant. AEMG and MPF measures showed no significant differences between the seats. MPF measures were found to increase over time, effects attributed to increases in muscle temperature. Gaps and APDF analyses revealed greater rest times and lower activation levels, respectively, with the control seat, which could result in increased loading of passive structures. This study demonstrated the beneficial effects of lumbar massage systems in increasing muscle blood flow and oxygenation. Although EMG parameters were not significantly different, the trends support the significant blood flow results. Future research should include longer driving times and adjustments in EMG measures to account for the effects of increasing muscle temperature on AEMG and MPF measures.     

Effect of grip span on maximal grip force and fatigue of flexor digitorum superficialis.

The aim of this study was to investigate the effect of grip span on isometric grip force and fatigue of the flexor digitorum superficialis (FDS) muscle during sustained voluntary contractions at 60-65% of the maximal voluntary contraction (MVC). Eighteen subjects performed isometric, submaximal gripping contractions using a grip dynamometer at four different grip span settings while the pronated forearm rested on a horizontal surface. Maximal absolute grip force and median power frequency of FDS surface electromyography (EMG) during the submaximal trials were analyzed. Fatigue of FDS, as inferred from EMG frequency shifts, did not change as a function of grip size. However, middle grip sizes allowed for greater absolute forces than the small or large size. When contractions are at 60-65% MVC and the muscle is allowed to fatigue, however, grip size may be less influential than when maximal absolute force is required.     

An exponential model of isometric muscular fatigue as a function of age and muscle groups.

Despite the recommendations that an important design criterion is not to exceed 15% of an operator's maximum voluntary contraction (MVC) with any muscle that must be used for a long period of time, many tasks involve the exertion of much higher forces coupled with long-term contractions. Many studies have investigated the force-time relationship of isometric muscle contractions to determine the endurance time of a given relative force. To date, however, direct studies of muscle performance throughout fatiguing tasks have not been conducted to the same degree. This research was concerned with studying the effects of different muscle groups (biceps vs quadriceps) of subjects with different age groups (20-29 vs 50-59 years of age) on long-term muscular isometric contractions at different levels of %MVC (20%, 40%, 60%, 80%, and 100% MVC), and modelling the functional data to describe the time course of strength decrement. The data revealed that the time course of strength decrement was best modelled by the function: [formula: see text] An experiment, using 20 subjects with each subject performing 10 conditions (two muscle groups x five levels of %MVC), showed that this function accounted for over 95% of the variance of strength decrement. All parameter estimates were statistically significant.     

Measures of localized spinal muscle fatigue

The objective of this study was to determine the best variable, if any, to indicate the level of localized muscle fatigue. Six male and six female subjects were studied while they exerted their maximal voluntary contraction and 40% of maximal voluntary contraction of spinal extensors in an isometric lifting activity. The electromyography (EMG) of erectores spinae at thoracic and lumbar levels was measured bilaterally. Also, the muscle bed blood volume, level of blood oxygenation to erector spinae at L3 level and heart rate were measured. The initial and final values of subjective feelings of fatigue through visual analogue score, rate of perceived exertions and body part discomfort rating were recorded. The mean maximal voluntary contraction forces for males and females were 899 (238) N and 431 (135) N respectively. The mean durations of hold in maximal voluntary fatiguing contraction were 68.1 (39.9) s and 72.3 (37.0) s for men and women respectively. By the end of the hold the force declined to 52% for males and 62% for females. The EMG amplitudes and median frequencies also progressively declined (p < 0.01). ANOVA revealed that the task percentile values of all variables were significantly different (p < 0.01). Gender had a significant main effect (p < 0.01). The correlation coefficients between force and other individual variables were weak to modest, but significant (p < 0.001). None of the single variables predicted fatigue reliably for either gender and levels of contraction. The regression equations developed were highly significant (p < 0.01) and they explained 96 to 98% of variance in both genders and contractions.     

Fatigue induced by static work

Abstract

Despite its low energy cost, isometric contraction can result in the onset of local muscle fatigue. The onset of fatigue occurs more rapidly when the relative force exerted is greater than 15–20% of the maximum voluntary contraction (MVC) of the muscle considered, and when the contraction time is increased. The maximum maintenance time (limit-time) and the corresponding relative force are linked by a hyperbolic relation. Ischaemia promotes accumulation of acid metabolites produced during contraction, and hinders their elimination, thus constituting the main causal factor in the onset of local muscle fatigue. The introduction of rest periods of sufficient duration to ensure restoration of normal blood flow through the muscle is an effective way of delaying, or even preventing, the onset of muscle fatigue. Other factors may also be taken into account, such as the position in which the static work is performed, and the nature and number of muscles used simultaneously, etc. Numerous laboratory and field studies have allowed the development of various models that take into account the conditions relating to isometric contractions during static work.     

Fatigue induced by static work

Despite its low energy cost, isometric contraction can result in the onset of local muscle fatigue. The onset of fatigue occurs more rapidly when the relative force exerted is greater than 15-20% of the maximum voluntary contraction (MVC) of the muscle considered, and when the contraction time is increased. The maximum maintenance time (limit-time) and the corresponding relative force are linked by a hyperbolic relation. Ischaemia promotes accumulation of acid metabolites produced during contraction, and hinders their elimination, thus constituting the main causal factor in the onset of local muscle fatigue. The introduction of rest periods of sufficient duration to ensure restoration of normal blood flow through the muscle is an effective way of delaying, or even preventing, the onset of muscle fatigue. Other factors may also be taken into account, such as the position in which the static work is performed, and the nature and number of muscles used simultaneously, etc. Numerous laboratory and field studies have allowed the development of various models that take into account the conditions relating to isometric contractions during static work.     

An exponential model of isometric muscular fatigue as a function of age and muscle groups

Despite the recommendations that an important design criterion is not to exceed 15% of an operator's maximum voluntary contraction (MVC) with any muscle that must be used for a long period of time, many tasks involve the exertion of much higher forces coupled with long-term contractions. Many studies have investigated the force-time relationship of isometric muscle contractions to determine the endurance time of a given relative force. To date, however, direct studies of muscle performance throughout fatiguing tasks have not been conducted to the same degree. This research was concerned with studying the effects of different muscle groups (biceps vs quadriceps) of subjects with different age groups (20·29 vs 50·59 years of age) on long-term muscular isometric contractions at different levels of %MVC (20%, 40%, 60%, 80%, and 100% MVC), and modelling the functional data to describe the time course of strength decrement. The data revealed that the time course of strength decrement was best modelled by the function:

An experiment, using 20 subjects with each subject performing 10 conditions (two muscle groups × five levels of %MVC), showed that this function accounted for over 95% of the variance of strength decrement. AH parameter estimates were statistically significant.     

Postural load during VDU work: a comparison between various work postures

The aim of this study was to compare the postural load during VDU work in the following work postures: (1) Supporting and not supporting the forearms on the table top, (2) Sitting and standing positons, and (3) Sightline to the centre of the screen at an angle of 15 and 30 below the horizontal. The muscle load from the upper part of musculus trapezius and from the lumbar part of musculus erector spinae (L3 level) was measured by electromyography (EMG). Postural angles of head, upper arm and back were measured by inclinometers. The load on m. trapezius when using the keyboard was significantly less in sitting with supported forearms compared to sitting and standing without forearm support. Further, the time and number of periods when the trapezius load was below 1% MVC was significantly greater with support versus no support. The load on the right erector spinae lumbalis was also significantly less and the time when the load was below 1% MVC was significantly longer in a sitting work position with support versus standing without support. In addition, when using a mouse supporting the forearms reduced the static trapezius load in sitting. The results from this study document clearly the importance of giving the operator the possibility of supporting the forearms on the table top.     

On the assessment of muscle fatigue rate via various EMG frequency spectral parameters

A research study was undertaken to investigate the fatigue process of quadriceps muscle during sustained isometric contraction at several work load levels using root-mean-squared (RMS) voltage and frequency parameters of EMG frequency spectral distribution. Its objective was to evaluate the possibility of using those parameters to indicate muscle fatigue rate. Twelve male subjects participated in an experiment which required them to exert and maintain isometric knee extension forces at 25%, 40%, 55%, and 70% of their maximal voluntary contraction (MVC) force levels. The results showed that both initial mean power frequency (MPF) and median power frequency (MF) (as determined from MPF and MF versus time curves) were not significantly influenced by muscle contraction level (p > 0.1). RMS voltage, MPF, and MF linear slopes, on the other hand, were significantly correlated to muscle contraction level (p < 0.001) which suggested that they could be used to represent muscle fatigue rate. The exponential relationship found in this study showed that quadriceps fatigued at an increasing rate as the work load increased. Further, an improvement in the coefficient of correlation between their linear slopes and muscle work load was found when expressing muscle work load in terms of the ratio of force to body weight. This finding indicated the possibility of using body weight as a basis of determining work load level which could help to improve the quality of quantitative assessment of muscle fatigue.     

Measures of localized spinal muscle fatigue

The objective of this study was to determine the best variable, if any, to indicate the level of localized muscle fatigue. Six male and six female subjects were studied while they exerted their maximal voluntary contraction and 40% of maximal voluntary contraction of spinal extensors in an isometric lifting activity. The electromyography (EMG) of erectores spinae at thoracic and lumbar levels was measured bilaterally. Also, the muscle bed blood volume, level of blood oxygenation to erector spinae at L3 level and heart rate were measured. The initial and final values of subjective feelings of fatigue through visual analogue score, rate of perceived exertions and body part discomfort rating were recorded. The mean maximal voluntary contraction forces for males and females were 899 (238) N and 431 (135) N respectively. The mean durations of hold in maximal voluntary fatiguing contraction were 68.1 (39.9) s and 72.3 (37.0) s for men and women respectively. By the end of the hold the force declined to 52% for males and 62% for females. The EMG amplitudes and median frequencies also progressively declined (p < 0.01). ANOVA revealed that the task percentile values of all variables were significantly different (p < 0.01). Gender had a significant main effect (p < 0.01). The correlation coefficients between force and other individual variables were weak to modest, but significant (p < 0.001). None of the single variables predicted fatigue reliably for either gender and levels of contraction. The regression equations developed were highly significant (p < 0.01) and they explained 96 to 98% of variance in both genders and contractions.     

Low mean level sustained and intermittent grip exertions: Influence of age on fatigue and recovery

The goal of this study was to quantify localised muscle fatigue resulting from low mean levels of exertion in younger (< 40 years) and older (>50 years) adults. Fatigue, elicited in the finger flexor muscles by intermittent (10% mean maximum voluntary contraction (MVC)) and sustained (8% MVC) handgrip exercises, was quantified by a muscle twitch force response before, immediately after and during 3 h following exercise. Despite greater mean loads, recovery time was shorter following intermittent than sustained contractions, which suggests that recovery from fatigue is more sensitive to rest within the work cycle than mean work. The more pronounced effects for younger than older individuals following the sustained exertion indicate that changes in muscle fibre type composition might predispose older individuals to be more resistant to fatigue resulting from sustained contractions of low level. Performing hand exertion tasks requiring low mean force levels contributes to similar long-lasting fatigue effects regardless of gender and age. Intermittent periods of complete rest reduce muscle fatigue. Since fatigue was not perceived during recovery from the tested sustained and intermittent contractions, subjective evaluations may not be a reliable indicator of localised muscle fatigue.     

Effects of combined wrist flexion/extension and forearm rotation and two levels of relative force on discomfort

This study investigated perceived discomfort in an isometric wrist flexion task. Independent variables were wrist flexion/extension (55%, 35% flexion, neutral, 35% and 55% extension ranges of motion (ROM)), forearm rotation (60%, 30% prone, neutral, 30% and 60% supine ROM) and two levels of flexion force (10% and 20% maximum voluntary contraction (MVC)). Discomfort was significantly affected by flexion force, forearm rotation and a two-way interaction of force with forearm rotation (each p < 0.05). High force for 60%ROM forearm pronation and supination resulted in increasingly higher discomfort for these combinations. Flexion forces were set relative to the MVC in each wrist posture and this appears to be important in explaining a lack of significant effect (p = 0.34) for flexion/extension on discomfort. Regression equations predicting discomfort were developed and used to generate iso-discomfort contours, which indicate regions where the risk of injury should be low and others where it is likely to be high. Regression equations predicting discomfort and iso-discomfort contours are presented, which indicate combinations of upper limb postures for which discomfort is predicted to be low, and others where it is likely to be high. These are helpful in the study of limits for risk factors associated with upper limb musculoskeletal injury in industry.     

Book Reviews

It is generally considered that variation in mechanical exposure is beneficial from the viewpoint of preventing musculoskeletal disorders. An approach to quantifying the functional similarity of manual tasks was developed and tested by using three handgrips: power grip (PG); pulp pinch (PP); lateral pinch (LP). Changes in maximal voluntary contraction (MVC) forces were measured during 15 combinations of 2-min duration, 30% MVC isometric contraction in 25 participants. Strength changes in PG were found to be substantially different from LP; when the two grips were alternated, strength dropped to 85.1% MVC whereas after PG alone, strength dropped to 59.3% MVC. The findings suggest that PG and LP are functionally different enough for their alternating use to contribute to increased exposure variation during manual activities.

Statement of Relevance: The paper describes how to determine if two tasks, when performed alternately, are different enough to reduce fatigue, increase work capacity and potentially prevent musculoskeletal disorders. Better understanding of the differences between tasks has the potential to improve job design by allowing better choice of tasks that combine to define a job.     

Cocontraction changes in muscular fatigue at different levels of isometric contraction

Ten normal subjects participated in a study designed to contrast results obtained in pre- and post-fatigue states. The measures contrasted were the IEMG ratios of agonist/antagonist pairs of muscles. The experimental task was an 8 s ramp isometric elbow flexion ranging from 0 to 100% of a maximal voluntary contraction (MVC). IEMG ratios were obtained at levels of 20, 40, 60 and 80% MVC. Records from the following muscles were obtained with surface electrodes: biceps brachii (BB), brachioradialis (BR), triceps brachii (TB) and anconeus (SU). The torque at the elbow joint was measured by a Cybex II dynamometer. Fatigue was induced using a 60% MVC of elbow flexion maintained during 5 minutes. The data were collected on-line at a sampling rate of 1 kHz. The results indicated that the IEMG ratios (BB/TB and BR/SU) presented a tendency, across subjects, toward a decrease at the levels of 40%, 60% and 80% MVC at the post- relative to the pre-fatigue state. The BB/BR ratios remained stable. These changes in the post-fatigue ratios disclose a tendency toward a saturation of the agonist occurring concomitantly with an increased level of contraction of the antagonists.     

The relationship between maximum isometric strength and intramuscular circulatory occlusion

Twenty male college students served as subjects for lhe study which investigated the relationship between maximum isometric strength and the isometric tension necessary to produce total occlusion of intramuscular circulation. Subjects performed a scries of progressively increasing static contractions by squeezing a hand dynamometer and the subsequent blood flow responses were measured. Blood flow was occluded at a mean of 63-5% maximum handgrip strength for the total group tested. To determine whether individuals of different maximum strength occlude at different percentages of their MVC, subjects were divided into high and low strength groups. The high strength group was found to occlude at 51-5% of MVC while the low strength group occluded at 75-5% of MVC. A significant negative correlation (r= -0.58) was found between maximum isometric strength and the per cent of maximum strength necessary to produce intra-muscular occlusion. There was no significant difference between the absolute tension producing occlusion in the high strength group (34-8 kg) and that of the low strength group (34 3 kg).     

The effects of shoulder load and pinch force on electromyographic activity and blood flow in the forearm during a pinch task

The object of the current study was to determine whether static contraction of proximal musculature has an effect on the blood flow more distally in the upper extremity. Static contractions of muscles in the neck shoulder region at three levels (relaxed, shoulders elevated and shoulders elevated loaded with 4.95 kg each) were combined with intermittent pinch forces at 0, 10 and 25% of the maximum voluntary contraction (MVC). Blood flow to the forearm was measured with Doppler ultrasound. Myoelectric activity of the forearm and neck-shoulder muscles was recorded to check for the workload levels. Across all levels of shoulder load, blood flow increased significantly with increasing pinch force (21% at 10% MVC and by 44% at 25% MVC). Blood flow was significantly affected by shoulder load, with the lowest blood flow at the highest shoulder load. Interactions of pinch force and shoulder load were not significant. The myoelectric activity of forearm muscles increased with increasing pinch force. The activation of the trapezius muscle decreased with increasing pinch force and increased with increasing shoulder load. The precise mechanisms accounting for the influence of shoulder load remains unclear. The results of this study indicate that shoulder load might influence blood flow to the forearm.