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.     

Fatigue during prolonged intermittent overhead work: reliability of measures and effects of working height

Shoulder pain is prevalent among industrial workers and existing evidence supports that overhead work is an important specific risk factor. Existing guidelines are limited, with overhead work typically recommended to be avoided, and research on overhead work has been mixed in terms of the effects of increasing arm reach. A laboratory-based simulation of overhead work was conducted, at three working heights, in order to facilitate improved guidelines and to identify potential non-linear effects of overhead work height. Several indicators of shoulder fatigue served as outcome measures and a preliminary study was performed to assess the reliability of several of these measures. Fatigue measures based on electromyography (EMG) generally had low reliability, whereas excellent reliability was exhibited for ratings of perceived discomfort (RPD). Consistent with this, no effects of overhead work height were found on EMG-based measures, yet clear non-linear effects were found on RPD and task performance. The source of the effects of work height appeared to be related to a combination of muscle activation levels and demands on precision/control at the highest location. These results support the utility of subjective measures for relatively low-level intermittent exertions and demonstrate increasingly detrimental fatigue and performance effects at extremes in reach during overhead work.     

The influence of age on isometric endurance and fatigue is muscle dependent: a study of shoulder abduction and torso extension

The present study examined differences in isometric muscle capacity between older (55–65 years) and younger (18 – 25 years) individuals. A total of 24 younger and 24 older participants (gender balanced within each group) performed sustained shoulder abductions and torso extensions to exhaustion at 30%, 50% and 70% of individual maximal voluntary contraction (MVC). Along with endurance time, manifestations of localized fatigue were determined based on changes in surface electromyographic signals obtained from the shoulder (middle deltoid) and the torso (multifidus and longissimus thoracis) muscles. Strength recovery was monitored using post-fatigue MVCs over a 15-min period. Compared to the younger group, older individuals exhibited lower muscular strength, longer endurance time and slower development of local fatigue. Age effects on fatigue were typically moderated by effort level, while effects of gender appeared to be marginal. Non-linear relationships between target joint torque and endurance time were observed, with effects of age differing between shoulder abduction and torso extension. Overall, the effects of age on endurance and fatigue were more substantial and more consistent for the shoulder muscle than for the torso muscles and were likely related to differences in muscle fibre type composition. For strength recovery rates, no significant age or gender effects were found in either experiment. In summary, this study suggests that differences in isometric work capacity do exist between older and younger individuals, but that this effect is influenced by effort level and the muscle tested.     

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.     

The effects of shoulder posture on neck and shoulder musculoskeletal loading and discomfort during smartphone usage

While using their smartphone, users tend to adopt awkward neck and shoulder postures for an extended duration. Such postures impose the risk of MSDs on those body parts. Numerous studies have been undertaken to examine neck posture; however, few studies have investigated shoulder postures. This study examined various shoulder postures during smartphone use and their effect on neck and shoulder kinematics, muscle loading, and neck/shoulder discomfort. Thirty-two asymptomatic young adult smartphone users randomly performed texting tasks for 3 min at four different shoulder flexion angles (15°, 30°, 45°, and 60°), while maintained a neck posture in the neutral position (0° neck flexion angle). Measures were taken of neck and shoulder muscle activity of the cervical erector spinae (CES), anterior deltoid (AD), upper trapezius (UT) and lower trapezius (LT), and kinematic data (angle, distance and gravitational moment). Results showed AD and LT muscle activity significantly increased when the shoulder flexion angle increased with an opposite effect on CES and UT. A recommended shoulder posture was identified as 30° flexion, as this yielded the best compromise between activation levels of the four muscles studied. This angle also induced the lowest neck/shoulder discomfort score. The findings suggest smartphone users hold their device at approximately 30° shoulder flexion angle with their neck in a neutral posture to reduce the risk of shoulder and neck musculoskeletal disorders when smartphone texting.Relevance to industrySmartphone use in the manufacturing and service industries is an integral part of work and useful means of communication tool. Awkward postures during extensive smartphone use impose an increased risk of both neck and shoulder musculoskeletal disorders. Shoulder flexion angles need consideration when making recommendations about safe work postures during smartphone use.     

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.     

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.     

Real-time indicators and influence factors of muscle fatigue in push-type work

Muscle fatigue is a significant cause of musculoskeletal injury and can easily induce unsafe behaviour. Push-type work is a common type of physical work, and if not designed appropriately, may lead to muscle fatigue. Previous studies on muscle fatigue mainly focus on investigating continuous force exertion, and in most of them, a constant muscle force is assumed, thereby ignoring the fluctuations present in exertion. In this study, bolt hole drilling was chosen to represent typical push-type work, and the muscle fatigue from this work was examined. The experimental system designed in this study monitored the muscle force in real time. In the experiments, different thrust angles (15°, 45°, and 75°), different relative force values (20% MVC, 40% MVC, and 60% MVC; MVC: maximum voluntary contraction) and different working time intervals (0 s, 30 s, 60 s, and 90 s) were considered. The results demonstrate that there is a significant positive correlation between the rating of perceived exertion (RPE) and muscle force attenuation (r = 0.786, p = 0). The cubic regression model (Y = − 0.00071x³ − 0.024x² − 0.334x + 1.146, R² = 0.639) fits the data most closely. Therefore, force attenuation can be used as a real-time indicator of muscle fatigue. In addition, the relative force value and thrust angle have a significant impact on the RPE score, whereas the working time interval has no major effect on it. This study provides a new method for evaluating muscle fatigue and a basis for the design of push-type work to reduce fatigue-induced accidents and musculoskeletal injuries.     

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.     

Evaluation of a dynamic arm support for seated and standing tasks: a laboratory study of electromyography and subjective feedback

The goal of this study was to determine whether a new dynamic arm support system reduced shoulder and arm muscle load for seated and standing hand/arm tasks. The new system provides support for both horizontal and vertical arm motion. A total of 11 participants performed ten tasks (five seated and five standing) both with and without the arm support. Outcomes were assessed with electromyography and subjective feedback. Muscle activity was measured over the dominant side supraspinatus, triceps and forearm extensor muscles. Significant (p < 0.01) reductions in static muscle activity were observed in one of ten tasks performed with the support device for the supraspinatus muscle, in five tasks for the triceps and in one task for forearm extensor muscles. Likewise, a significant improvement in subjective measures was reported with the support device for ‘ease of task’ for two of ten tasks, for ‘forearm comfort’ for three of ten tasks and for ‘shoulder effort’ for six of ten tasks. The results suggest that a dynamic forearm support may improve subjective comfort and reduce static muscle loads in the upper extremity for tasks that involve horizontal movement of the arms. For rapid motions, the value of the support is limited due to internal inertia and friction.     

Muscle fatigue modelling: Solving for fatigue and recovery parameter values using fewer maximum effort assessments

A three-compartment controller model (3CC) predicts muscle fatigue development. Determination of fatigue (F) and recovery (R) model parameters is critical for model accuracy. Numerical methods can be used to determine parameter values using maximum voluntary contractions (MVCs) as input. We tested the effects of using reduced MVC data on parameter solutions using twenty published datasets of intermittent, isometric contractions. The work here examines three sampling variations using approximately half of the MVCs: MVC measurements distributed equally (dMVC), split between the initial and final times (sMVC), and only during the first half (fMVC). Furthermore, solved F and R parameters were used to model fatigue development for three hypothetical task scenarios. Both model parameters and predictions were statistically insensitive to measured data reduction using dMVC, followed closely by sMVC. However, using the fMVC reduction frequently resulted in overestimated parameter values and produced significantly larger prediction errors. We conclude that parameter solutions are robust when using fewer MVCs as long as they are sampled in a manner that captures later fatigue behavior.     

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

This paper reviews results of comparisons between novice and expert operators in the supervision of dynamic environments. Firstly, the characteristics of expertise and its operational definitions are discussed. Secondly, the main dimensions of the complexity of these environments are described and the difficulties operators have in coping with complexity are examined. Research work carried out in field studies is then overviewed in order to assess the role of expertise in the three components of process control: monitoring, diagnosis and decision-making and executive control. The discussion stresses the convergent results of various studies. In spite of the diversity of task domains and of novice-expert definitions, results converge on three points: experts are better at producing inference, in anticipating, and have a more functional view of the process. Divergent results on directionality of reasoning, depth of knowledge in relation to performance and synchronization of actions are also discussed. Finally, further research trends are outlined.     

Strength,endurance and fatigue response of rotator cuff muscles during isometric exertions

Among the shoulder musculoskeletal disorders (MSDs), rotator cuff disorders are prevalent and known to substantially limit an individual's strength and ability to work. Despite the frequency and cost of rotator cuff injuries, very little research has been done on understanding the load response relationship of rotator cuff muscles. Therefore, this study was aimed at evaluating the strength, endurance and fatigue response of rotator cuff muscles. As a first step, strengths of Supraspinatus, Infraspinatus, and Teres Minor were measured for ten healthy male participants using muscle specific Maximum Voluntary Contractions (MVC). Then, endurance time and surface Electromyography (EMG) data were recorded during 15%, 30%, 45%, and 60% MVC exertions. Infraspinatus exhibited the highest strength followed by Teres Minor and Supraspinatus. Despite the strength differences, small variations were observed in the endurance time between the muscles. The effect of %MVC exertions on endurance time, average muscle activity and muscle fatigue were statistically significant. Median frequency decreased and muscle activation increased with an increase in force exertion levels; however, the changes observed for an increase in the exertion level from 15% to 30% MVC were much higher than the changes observed for an increase in the exertion level from 45% to 60% MVC.Relevance to industryResults of this study indicate that the rotator cuff muscles have different strengths but exhibit very similar endurance and fatigue behavior. These findings can assist ergonomic practitioners with the design and/or evaluation of workplace upper extremity exertions to reduce/manage stress on the rotator cuff muscles and shoulder.     

Effects of lumbar extensor fatigue and surface inclination on postural control during quiet stance

A number of work environments require workers to perform tasks on inclined surfaces. Such tasks, along with muscle fatigue, can impair postural control and increase falling risks. The objective of this study was to determine the effects of surface inclination angle, standing direction, and lumbar extensor fatigue on postural control during quiet standing. A group of 16 young, healthy participants were tested while standing on inclined surfaces before and after lumbar extensor fatigue (induced by repetitive isotonic exercise). Three inclination angles (0°, 18° and 26°) and three standing directions (uphill, downhill, and lateral facing) were examined. Postural control was assessed using several measures derived from center-of-pressure time series and subjectively perceived stability. Significant main and interactive effects of inclination angle and standing direction were found for all dependent measures. The adverse effects of standing on inclined surfaces were found to differ between the three standing directions. In general, dose-response relationships with inclination angle were evident, particularly in the lateral-facing direction. Fatigue-related effects differed between conditions, suggesting that the adverse effect of lumbar extensor fatigue on postural control depend on inclination angle and standing direction. These findings may facilitate the development of fall prevention interventions for work involving inclined surfaces.     

Responsive upper limb and cognitive fatigue measures during light precision work: an 8-hour simulated micro-pipetting study

Abstract

Many contemporary occupations are characterised by long periods of low loads. These lower force levels, which are relevant to the development of work-related musculoskeletal disorders, are usually not the focus of fatigue studies. In studies that did measure fatigue in light manual or precision work, within and between measurement responses were inconsistent. The aim of this study was to identify fatigue measures that were responsive at lower force levels (<10% MVC) over the course of an 8-h period. A complementary set of fatigue measures, reflecting both neuromuscular and cognitive mechanisms, was measured during a light precision micro-pipetting task performed by 11 participants. Nine measures were found to be significantly responsive over the 8-h period, including: ratings of perceived fatigue, postural tremor, blink frequency and critical flicker fusion frequency threshold. Common field measures, specifically electromyography RMS amplitude and maximum voluntary contractions, did not lead to extraordinary time effects.

Practitioner summary: The findings provide insight towards the responsiveness of a complementary set of field usable fatigue measures at low work intensities Although commonly used measures did not reveal significant increases in fatigue, nine alternative measures were significantly responsive over the 8-h period.     

The effect of a resistance-training program on muscle strength, physical workload, muscle fatigue and musculoskeletal discomfort: An experiment

The aim of the study was to investigate the effectiveness of a resistance-training program on muscle strength of the back and neck/shoulder muscles, relative physical workload, muscle fatigue and musculoskeletal discomfort during a simulated assembly and lifting task. Twenty-two workers were randomized over an 8-week resistance-training group, and a control group. Isokinetic muscle strength was assessed using the Cybex dynamometer, muscle fatigue was measured using EMG, and perceived discomfort was measured using a 10-point scale. At the follow-up, we found no effect of the resistance-training program on isokinetic muscle strength of the back and shoulder muscles. Furthermore, we did not find any effect on EMG data, nor on musculoskeletal discomfort during the simulated work tasks. However, trained workers performed the lifting tasks for a longer time before reporting considerable discomfort than those in the control group.     

Fatigue during prolonged intermittent overhead work: reliability of measures and effects of working height

Shoulder pain is prevalent among industrial workers and existing evidence supports that overhead work is an important specific risk factor. Existing guidelines are limited, with overhead work typically recommended to be avoided, and research on overhead work has been mixed in terms of the effects of increasing arm reach. A laboratory-based simulation of overhead work was conducted, at three working heights, in order to facilitate improved guidelines and to identify potential non-linear effects of overhead work height. Several indicators of shoulder fatigue served as outcome measures and a preliminary study was performed to assess the reliability of several of these measures. Fatigue measures based on electromyography (EMG) generally had low reliability, whereas excellent reliability was exhibited for ratings of perceived discomfort (RPD). Consistent with this, no effects of overhead work height were found on EMG-based measures, yet clear non-linear effects were found on RPD and task performance. The source of the effects of work height appeared to be related to a combination of muscle activation levels and demands on precision/control at the highest location. These results support the utility of subjective measures for relatively low-level intermittent exertions and demonstrate increasingly detrimental fatigue and performance effects at extremes in reach during overhead work.     

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.