Low back stress, muscle usage, and the appearance of transient load movement during manual lifting

Neuromuscular involvement should be considered in biomechanical evaluations of a worker's job-related stresses as a potential aid to understanding and reducing the rising incidence of low back problems in industry. Because such interactions have seldom been investigated in multisegmental movements, the present study was undertaken to determine the effects of the involvement of the neuromuscular system during lifting by creating conditions in which subjects had prior knowledge (PK) of a load's magnitude as well as when they had no prior knowledge (NK). Two groups of subjects, experienced and inexperienced lifters (N=40), lifted loads varying from 6.8 to 13.6 kg under both the PK and NK conditions. Results indicated that two general patterns of load movement were used by the subjects: smooth and oscillatory (irregular transient), with higher peak L4/L5 forces and higher peak trunk movements found in the oscillatory pattern. Significant differences on all stress values were demonstrated by the inexperienced lifters. The inclusion of lift preparation and load knowledge considerations in training programmes and biomechanical models is recommended.     

Psychophysical and physiological responses to lifting symmetrical and asymmetrical loads symmetrically and asymmetrically

Eighteen adult males (mean age 22·6 years, weight 78·6kg and height 176·6cm) participated in a study designed to investigate the effects of symmetrical and asymmetrical lifting on the maximum acceptable weight of lift and the resulting physiological cost. Each subject performed sixty different lifting tasks involving two lifting heights, three lifting frequencies and five containers. For each lifting task, the load was lifted either symmetrically (sagittal lifting) or asymmetrically (turning 90^° while continuing to lift). The heart rate and oxygen uptake of the individuals at the maximum acceptable weight of lift were measured. At the end of the experiment, subjects also verbally indicated their preference for symmetrical and asymmetrical lifting. When lifting asymmetrically, subjects accepted approximately 8·5% less weight. There was, however, no difference in the physiological costs when lifting symmetrically or asymmetrically. Lifting asymmetrical loads also resulted in lower maximum acceptable weights. No difference in either oxygen uptake or heart rate was observed when the centre of gravity of the load was offset by 10·16 or 20·32 cm from the mid-sagittal plane in the frontal plane towards the preferred hand. All subjects indicated, verbally, that asymmetrical lifting tasks were physically more difficult to perform.     

A biomechanical analysis of industrial manual materials handlers

Resultant forces and torques on the joints of 11 females were studied as the subjects performed two manual materials handling tasks in their industrial environment. The subject's activities were recorded by high speed (102 frames per second) 16mm cinematography and the data analysed by a static and dynamic biomechanical model.

Statistically significant differences were found between the results of the static and dynamic analyses. Slower filming rates were simulated and were found to show fewer significant differences between the static and dynamic analysis as the data sampling rate decreased. A kinematic analysis of the experienced and inexperienced lifters revealed a great deal of intra-subject variability as well as inter-subject variability indicating that the subjects varied their motion patterns as they lifted or lowered several 14 kg loads. For submaximal tasks such a variation in lifting patterns would allow the subjects to develop muscular load sharing which would help reduce localized muscle fatigue associated with repetitive lifting activities.     

Psychophysical lifting capabilities for overreach heights

Overreach height, in this study, is defined as the maximum reach height of individuals measured to the top of the cut-out box-handles while subjects stand with their heels raised. Since such postures are inherently unstable, knowing how much weight individuals are willing to lift across overreach lifting heights is important. Ten young adult male students (mean age 25·9 years, mean weight 70·8 kg and mean height 175 cm) voluntarily participated in a study designed to investigate the effect of lifting heights above reach height on the maximum acceptable weights of lift. The weight was lifted using a ‘free-style’ technique in the mid-sagittal plane from the floor, knuckle and shoulder heights to overreach heights (individuals stand with their heels raised to deposit the load). The maximum acceptable weight of lift, on the average, declined by approximately 14%, compared with the maximum acceptable weight of lift for reach heights, when the box was lifted to overreach heights. The magnitude of decline in the maximum acceptable weight was highest for the floor to overreach height compared with the knuckle to overreach and shoulder to overreach lifting heights.     

The effects of speed,frequency, and load on measured hand forces for a floor to knuckle lifting task

The purpose of this study was to describe and quantify measured hand forces during floor to knuckle lifting of various loads. Hand forces of five subjects were measured with a strain gauge apparatus for normal and fast speeds of lifting at 1,4, and 8 l/min. The pattern of hand force over time exhibited peaks in force in the shape of a spike for all fast lifts, indicating that subjects did not lift smoothly. For normal speed of lift, only one of the five subjects executed some lifts smoothly, indicating that it may be possible to lift smoothly, but most lifters probably do not. Peaks of horizontal and vertical components of hand force were tabulated by speed of lift, frequency, and load.     

Comparative analysis of the workload in seated and standing horizontal submaximal lifting tasks

The objective of the present laboratory study was to analyse physiological responses of horizontal lifting tasks when they were performed in sitting and standing positions. Heart rate and blood pressure were used as indices of circulatory strain. Lifting tasks were performed under four lifting positions: sitting-forward lift, sitting-twist lift, standing-forward lift, and standing-twist lift. The weights of the loads were 3, 5 and 7 kg and the frequencies of handling were 1, 4 and 6 lifts/min. This study supports the idea that heart rate is a sensitive measure for evaluating the effects of seated horizontal lifting tasks. The lifting positions and workload (frequency × load × distance) are important parameters in the design of these types of tasks. It appears that within the experimental values examined in this study, a seated position could be recommended while performing horizontal lifting tasks at workloads ≤4·6 kg.m.min ^?1;. The results are supported by smaller physiological responses.     

The effects of speed, frequency, and load on measured hand forces for a floor to knuckle lifting task.

The purpose of this study was to describe and quantify measured hand forces during floor to knuckle lifting of various loads. Hand forces of five subjects were measured with a strain gauge apparatus for normal and fast speeds of lifting at 1, 4, and 8 l/min. The pattern of hand force over time exhibited peaks in force in the shape of a spike for all fast lifts, indicating that subjects did not lift smoothly. For normal speed of lift, only one of the five subjects executed some lifts smoothly, indicating that it may be possible to lift smoothly, but most lifters probably do not. Peaks of horizontal and vertical components of hand force were tabulated by speed of lift, frequency, and load.     

A physiological study of manual lifting of loads in Indians

The employment of workers solely for lifting of loads is common in the developing countries. This task can be described in terms of its three principal variables, viz. the weight of the load, the height of the lift and the rate of lifting, but Jew attempts to quantitate the contributions of these variables in determining its strenuousness have been made.

Based on the observed range of variation in an industrial lifting operation, a total of 525 lifting experiments comprising combinations of three different weights of compact loads, lifts to three separate heights from the ground level and three different rates of lifting were carried out on 21 subjects selected from amongst the load lifters.

Comparison of the observed energy expenditures of these tasks with the maximum working capacities of the subjects showed that many of the tasks were unduly heavy. Regression equations depicting the relation between the energy expenditure of lifts of different heights with the other two variables are given. A chart linking these variables has also been prepared; this may be helpful in adjusting those lifting tasks which are continued for prolonged periods so that they are of ‘acceptable’ heaviness.     

Metabolic and perceptual responses while carrying external loads on the head and by yoke

Abstract

The purpose of this study was to determine the metabolic efficiency and perceptual acceptability of transporting external loads on the head and by yoke. Ten young males (24·2 ±3·9 years) of average physical fitness ([Vdot]O_2max=49·8 ± 6·5ml kg^-1 min^-1) walked for 6min on a level motor-driven treadmill at 53·6, 73·8 and 93·9m min^-1. Subsequently, all subjects carried external loads (11·6, 16·1 and 20·6 kg) at the same speeds using the headpack (HP), transverse yoke (TY) and frontal yoke (FY) modes of load carriage. Measurements were obtained for oxygen uptake ([Vdot]O₂ l min^-1), local ratings of perceived exertion (RPE-L) and the overall perceived exertion (RPE-O). The [Vdot]O₂ was used in the computation of the metabolic efficiency ([Vdot]O₂ ml kg total weight^-1 min^-1).

Significant main effects (mode, load and speed) and three interaction effects (mode × load, mode × speed and load × speed) were obtained for metabolic efficiency. Scheffé post hoc analysis revealed that the metabolic efficiency for the TY and HP were greater than the FY while transporting the 16·1 and 20·6kg loads at all walking speeds (p <0·05). No significant loss in metabolic efficiency was found while carrying the 20·6kg load at 53·6 m min^-1. At 93·9 m min^-1, all external loads transported were associated with a loss in metabolic efficiency. The RPE-L for the HP was lower than the FY (p < 0·05). Both the RPE-0 and RPE-L increased as the walking speeds and external loads were increased. The findings suggest that load transportation using the FY system is both physiologically and perceptually unacceptable.     

Two linear regression models predicting cumulative dynamic L5/S1 joint moment during a range of lifting tasks based on static postures

Previous studies have indicated that cumulative L5/S1 joint load is a potential risk factor for low back pain. The assessment of cumulative L5/S1 joint load during a field study is challenging due to the difficulty of continuously monitoring the dynamic joint load. This study proposes two regression models predicting cumulative dynamic L5/S1 joint moment based on the static L5/S1 joint moment of a lifting task at lift-off and set-down and the lift duration. Twelve men performed lifting tasks at varying lifting ranges and asymmetric angles in a laboratory environment. The cumulative L5/S1 joint moment was calculated from continuous dynamic L5/S1 moments as the reference for comparison. The static L5/S1 joint moments at lift-off and set-down were measured for the two regression models. The prediction error of the cumulative L5/S1 joint moment was 21±14 Nm × s (12% of the measured cumulative L5/S1 joint moment) and 14±9 Nm × s (8%) for the first and the second models, respectively.

Practitioner Summary: The proposed regression models may provide a practical approach for predicting the cumulative dynamic L5/S1 joint loading of a lifting task for field studies since it requires only the lifting duration and the static moments at the lift-off and/or set-down instants of the lift.     

Effect of lifting height and load mass on low back loading

The objective of this study was to quantify the effect of lifting height and mass lifted on the peak low back load in terms of net moments, compression forces and anterior–posterior shear forces. Ten participants had to lift a box using four handle heights. Low back loading was quantified using a dynamic 3-D linked segment model and a detailed electromyographic driven model of the trunk musculature. The effects of lifting height and lifting mass were quantified using a regression technique (GEE) for correlated data. Results indicate that an increase in lifting height and a decrease in lifting mass were related to a decrease in low back load. It is argued that trunk flexion is a major contributor to low back load. For ergonomic interventions it can be advised to prioritise optimisation of the vertical location of the load to be lifted rather than decreasing the mass of the load for handle heights between 32 cm and 155 cm, and for load masses between 7.5 and 15 kg. Lifting height and load mass are important determinants of low back load during manual materials handling. This paper provides the quantitative effect of lifting height and mass lifted, the results of which can be used by ergonomists at the workplace to evaluate interventions regarding lifting height and load mass.     

Maximum acceptable repetitive lifting workloads for an 8-hour work-day using psychophysical and subjective rating methods

The psychophysical method used by Snook (1978) to determine maximum acceptable workloads for repetitive lifting during an 8-hour work-day in industrial populations was evaluated for application in military ergonomics. Under the conditions ofthe present experiment, the mean load selected by 10 soldiers (17·5 kg) was lower than reported by Snook (1978) for industrial workers and by Garg and Saxena (1979) for college students. When the soldiers lifted and lowered their selected load for an 8-hour work-day, the average heart rate was 92 beats min^?1 and the mean oxygen cost was 21% of their maximum oxygen uptake (determined for uphill treadmill running). There was no evidence of cardiovascular, metabolic or subjective fatigue. A subjective rating method tended to identify slightly lower loads than the psychophysical method. The results indicate that with good subject cooperation and firm experimental control in a laboratory, the psychophysical method can identify loads that soldiers can lift repetitively for an 8-hour work-day without metabolic, cardiovascular or subjective evidence of fatigue     

The physical and physiological workload of refuse collectors

In order to secure a safer and healthy work situation, the heavy physical loads imposed on 23 refuse collectors (aged 26-54) working in the city of Haarlem, in The Netherlands, were studied in a series of three experiments between 1984 and 1987. The aims were respectively (1) to study the load for workers collecting dustbins or polythene bags; (2) to introduce changes to reduce the load to avoid exceeding the overload criteria by individual refuse collectors; and (3) to investigate the effects of interventions to improve the efficiency of refuse collecting. The maximal isometric lifting force (F_max) and the maximal aerobic power( [Vdot]O_2max of 23 refuse collectors were measured in the laboratory. F_max was measured with an isometric dynamometer pulling with one arm from the floor; the mean value was 912 (± 127)N. VO_2max was measured running on a treadmill; the mean value was 43-3 (±0-8) ml O₂ per kg body mass per min. The physical load on the oxygen transport system was measured through work analysis and by a continuous registration of the heart rate over three working days. Criteria for overload were set at a mean external load of 20% Fm? and a mean energy expenditure of 30% VO_2max and an energy expenditure of 50% VO_2max or more for a maximum of 60 min per day. Replacement of dustbins by polythene bags resulted in a 70% increase in the total amount of refuse collected, an increase in throwing frequency, but a lower mean load per throw, and no significant differences in the mean heart rate over the working day. When polythene bags were used the mean values did not exceed the overload criteria, but 39% of the individual collectors did have a workload that was too high with respect to one of the criteria. In the last experiment the collectors were advised to reduce their work load by (a) lifting no more than two bags at a time; (b) reducing their walking pace; and (c) taking more breaks. Although compliance with the recommendations was good, and the weight lifted and the walking speed decreased, the physiological load remained the same. This may have been caused by a 15% increase in the total amount of refuse that had to be collected at that time.     

Biomechanically and electromyographieally assessed load on the spine in self-paced and force-paced lifting work

The purpose of this study was to measure dose of spinal load when different pacing methods were applied to lifting work and to develop methodology for such measurements. The compressive load on the spine computed by a dynamic biomechanical model and the electromyographic activity of back muscles were used for describing the spinal load. Five men and five women worked in a laboratory on two days lifting a box up and down for 30 min on both days, on one day force-paced (4 lifts/min), and on the other self-paced in random order. The weight of the box was rated by the subjects to be acceptable for the work done. The lift rate of our female subjects was higher and that of the male subjects lower in self-paced than in force-paced work. There were no significant differences in peak lumbosacral compressions nor in the amplitude distributions of electromyography between the two pacing methods. The biomechanically-calculated compressive forces on the spine were lower (about 2·7 kN for the men and 2·3 kN for women) than the biomechanical recommendations for safe lifting, but the EMG activity showed quite high peaks so that for 1% of work time the activity was on women above 60% and on men above 40% of the activity during maximum isometric voluntary test contraction.     

Psychophysical acceptability and perception of load heaviness by females

The objective of the study was to evaluate subjective perceptions of load heaviness, and relate these perceptions to the maximal acceptable weights of lift. Ten female college students experienced in manual lifting participated in the study. In the first experiment, subjects were asked to select one of the seven linguistic values of load heaviness (very light, light, less-than-medium, medium, more-than-medium, heavy, and very heavy), which would best describe the lifted loads. Seven boxes, ranging in weight between 2.3 kg and 22.7 kg, were used for that purpose. In the second experiment, subjects were asked to fill empty boxes to the level they felt would best reflect a given load heaviness category. In the third experiment, the psychophysical methodology was used to determine the maximal acceptable weight of lift for an 8-hour day. The results showed that 50% of the subjects considered a 20.4 kg box (45 lbs) as very heavy, while another 50% believed that such a load was heavy. The average load selected as maximal acceptable weight of lift (MAWL) for an 8-hour day was 16.4 kg (standard deviation (SD) = 5.3 kg). When asked to determine the weights that would best describe a given category of load heaviness, the subjects selected 22.5 kg (SD = 3.7 kg) and 18.4 kg (SD = 2.7 kg) for very heavy and heavy categories, respectively. Further analysis revealed that only 30% of the subjects selected MAWL values that were larger than the pre-weighted boxes independently judged by them as very heavy or heavy categories. Also, 10% and 30% of the subjects selected MAWL values that were larger than the weights chosen during the self-classification procedure as representative of heavy or very heavy categories of load heaviness, respectively. It was shown that the loads selected as the maximum acceptable weights for an 8 h shift were independently judged by the female subjects as being in the more-than-moderate or heavy weight categories. Comparison of the results for females and males led to a conclusion that female subjects were more realistic, with respect to subjective perception of load heaviness, in selecting the MAWL values than were male subjects.     

Lift performance and lumbar loading in standing and seated lifts

This study investigated the effect of posture on lifting performance. Twenty-three male soldiers lifted a loaded box onto a platform in standing and seated postures to determine their maximum lift capacity and maximum acceptable lift. Lift performance, trunk kinematics, lumbar loads, anthropometric and strength data were recorded. There was a significant main effect for lift effort but not for posture or the interaction. Effect sizes showed that lumbar compression forces did not differ between postures at lift initiation (Standing 5566.2?±?627.8 N; Seated 5584.0?±?16.0) but were higher in the standing posture (4045.7?±?408.3 N) when compared with the seated posture (3655.8?±?225.7 N) at lift completion. Anterior shear forces were higher in the standing posture at both lift initiation (Standing 519.4?±?104.4 N; Seated 224.2?±?9.4 N) and completion (Standing 183.3?±?62.5 N; Seated 71.0?±?24.2 N) and may have been a result of increased trunk flexion and a larger horizontal distance of the mass from the L5-S1 joint.

Practitioner Summary: Differences between lift performance and lumbar forces in standing and seated lifts are unclear. Using a with-in subjects repeated measures design, we found no difference in lifted mass or lumbar compression force at lift initiation between standing and seated lifts.     

IEA Newsletter

The aim of this study was to develop a practical and reliable test to predict the maximum lifting capacity of an individual. Dynamic strength during ‘isokinetic’ motion was measured on a device that allowed movement at either 0·73 or 0·97 ms^?1. For the ten men and ten women used as subjects, peak dynamic strength was compared with the maximum dynamic lift (MDL), the maximum load that an individual was able to lift once, from the floor to a shelf 113 cm high, without risk of injury. A step-wise multiple regression analysis indicated that the ‘isokinetic’ dynamic lifting strength (DLS) measured at 0·73 ms^?1 and sex accounted for 94·1% of the variance in MDL. The following equation was derived to predict MDL: MDL = 295 + 0·66 (DLS)? 148 (SEX), where DLS was measured in newtons, and SEX= 1 for men and 2 for women. Maximum acceptable load (MAL) selected for repetitive lifting at a frequency of six per minute was 22% of the MDL for both men and women. A simple test using a portable ‘isokinetic’ dynamic strength measuring device and involving one measurement was thus found to be a good predictor of maximum dynamic lift.     

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

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

Ergonomics International News and Information—Winter 1992

Abstract

The purpose of this study was to analyse the influence of load knowledge on lifting technique. Ten men lifted a box containing either no weight or weights of 150, 250 or 300 N with and without knowledge of what was inside the box. The kinetics and kinematics of the HA were analysed using a force plate, an optoelectronic motion analysis system, and a rigid body link model. At ON lifting, the unknown load resulted in a jerk–like motion and a significantly increased peak L5–S1 flexion–extension moment. At 150N there was also a significant increase in the speed of trunk extension with unknown weights, but the L5–S1 moment remained unchanged. At higher load levels there were only minor differences between lifting techniques when knowing and not knowing the load. We conclude that lifts are approached assuming a certain weight, and that when the assumption is wrong and the load lighter than anticipated lifting is performed with a ‘jerking’ motion, creating unnecessary loads on the lower back.