Age-related biomechanical differences during asymmetric lifting

This study investigated age-related biomechanical differences during asymmetric lifting. Eleven younger and twelve older participants were instructed to lift loads of different weights to an asymmetric destination. The trunk kinematics and low back moments were examined. The results showed that older adults adopted safer lifting strategies compared with younger adults. Specifically, the peak trunk sagittal flexion angle was 32% lower and the peak trunk transverse twisting angle was 22% lower in older adults compared with those in younger adults. It was also found that the average low back moment in the deposit phase was 32% higher in older adults than that in younger adults, most probably due to the age-related increased body weight. Based on these findings and the fact of age-related decreased muscle strengths, physical exercise programs were suggested to be more effective than instructions of safe lifting strategies in LBP risk reduction during asymmetric lifting for older adults. For younger adults, safe lifting strategy instructions might be effective to reduce risks of LBP.     

Dynamic biomechanical modelling of symmetric and asymmetric lifting tasks in restricted postures

This article describes investigations of dynamic biomechanical stresses associated with lifting in stooping and kneeling postures. Twelve subjects volunteered to participate in two lifting experiments each having two levels of posture (stooped or kneeling), two levels of lifting height (350 or 700 mm), and three levels of weight (15,20, or 25 kg). One study examined sagitally symmetric lifting, the other examined an asymmetric task. In each study, subjects lifted and lowered a box every 10 s for a period of 2 min in each treatment combination. Electromyography (EMG) of eight trunk muscles was collected during a specified lift. The EMG data, normalized to maximum extension and flexion exertions in each posture, was used to predict compression and shear forces at the L3 level of the lumbar spine. A comparison of symmetric and asymmetric lifting indicated that the average lumbar compression was greater in sagittal plane tasks; however, both anterior-posterior and lateral shear forces acting on the lumbar spine were increased with asymmetric lifts. Analysis of muscle recruitment indicated that the demands of lifting asymmetrically are shifted to ancillary muscles possessing smaller cross-sectional areas, which may be at greater risk of injury during manual materials handling (MMH) tasks. Model estimates indicated increased compression when kneeling, but increased shear forces when stooping. Increasing box weight and lifting height both significantly increased compressive and shear loading on the lumbar spine. A multivariate analysis of variance (MANOVA) indicated complex muscle recruitment schemes—each treatment combination elicited a unique pattern of muscle recruitment. The results of this investigation will help to evaluate safe loads for lifting in these restricted postures.     

Lower back muscle forces in pushing and pulling

Abstract

In the investigation of lower back stress, the muscle forces of the erector spinae and the rectus abdominis are often calculated using the two-dimensional biomechanical model. These muscle forces are used to estimate the compressive forces at L5/S1 disc This paper presents a study of the muscle forces predicted by a two-dimensional biomechanical model during pushing and pulling and myoelectric activity from the corresponding muscles. The goal was to investigate whether a simple two muscle torso model would reasonably estimate the muscle actions in pushing and pulling tasks. Six subjects participated in the experiment. EMG (rms) value was used as an indicator of muscle forces. The results show high correlation between the predicted muscle forces and the measured root-mean-square EMG values in trunk pushing and pulling (r²=0.93) and hand pushing and pulling (r²=0.96) in an erect posture with hips braced but low in hand pushing and pulling using a free posture (r²=0.37).     

Coactivation of the trunk muscles during asymmetric loading of the torso.

Materials handling tasks in industry are rarely performed in the midsagittal plane. Often these tasks, labeled nonsagittally symmetric or asymmetric lifting tasks, can be expected to lead to an unequal distribution of forces between the left and right sides of the body. Because of the large number of muscles capable of resisting loads in the torso, researchers are forced to make simplifications when using biomechanical models to estimate mechanical loading of the spine during such tasks. Simplifications and assumptions regarding the coactivation of antagonistic muscles are frequently used because sufficient experimental data do not exist. The present study was designed to quantify coactivation of the trunk musculature in response to applied asymmetric loads. This load was varied in direction from an anterior midsagittal plane orientation to a posterior midsagittal plane orientation in 15-deg increments. The results showed little coactivation when the applied load directions were anterior and within 45 deg of the midsagittal orientation. When load directions were greater than 45 deg, coactivation was quantifiable in ipsilateral and posterior muscle groups.     

The effects of obesity on lifting performance

Obesity in the workforce is a growing problem worldwide. While the implications of this trend for biomechanical loading of the musculoskeletal system seem fairly straightforward, the evidence of a clear link between low back pain (LBP) and body mass index (BMI) (calculated as whole body mass in kilograms divided by the square of stature in meters) has not been shown in the epidemiology literature addressing this topic. The approach pursued in the current study was to evaluate the lifting kinematics and ground reaction forces of a group of 12 subjects -- six with a BMI of less than 25 kg/m(2) (normal weight) and six with a BMI of greater than 30 kg/m(2) (obese). These subjects performed a series of free dynamic lifting tasks with varied levels of load (10% and 25% of capacity) and symmetry (sagittally symmetric and 45 degrees asymmetric). The results showed that BMI had a significant effect (p<0.05) on trunk kinematics with the high BMI group exhibiting higher peak transverse plane (twisting) velocity (59% higher) and acceleration (57% higher), and exhibiting higher peak sagittal plane velocity (30% higher) and acceleration (51% higher). When normalized to body weight, there were no significant differences in the ground reaction forces between the two groups. This study provides quantitative data describing lifting task performance differences between people of differing BMI levels and may help to explain why there is no conclusive epidemiological evidence of a relationship between BMI and LBP.     

Effects of posture on dynamic back loading during a cable lifting task

This study evaluated spinal loads associated with lifting and hanging heavy mining cable in a variety of postures. This electrical cable can weigh up to 10 kg per metre and is often lifted in restricted spaces in underground coal mines. Seven male subjects performed eight cable lifting and hanging tasks, while trunk kinematic data and trunk muscle electromyograms (EMGs) were obtained. The eight tasks were combinations of four postures (standing, stooping, kneeling on one knee, or kneeling on both knees) and two levels of cable load (0 N or 100 N load added to the existing cable weight). An EMG-assisted model was used to calculate forces and moments acting on the lumbar spine. A two-way split-plot ANOVA showed that increased load (p<0.05) and changes in lifting posture (p<0.05) independently affected trunk muscle recruitment and spinal loading. The increase in cable load resulted in higher EMG activity of all trunk muscles and increased axial and lateral bending moments on the spine (p<0.05). Changes in posture caused more selective adjustments in muscle recruitment and affected the sagittal plane moment (p<0.05). Despite the more selective nature of trunk EMG changes due to posture, the magnitude of changes in spinal loading was often quite dramatic. However, average compression values exceeded 3400 N for all cable lifting tasks.     

Effect of lifting belts on trunk muscle activation during a suddenly applied load

The National Institute for Occupational Safety and Health suggests there is insufficient biomechanical or epidemiological evidence to recommend the use of back belts in industry. From a biomechanical perspective, previous work suggests that lifting belts stiffen the torso, particularly in the frontal and transverse planes. To determine whether lifting belts stiffen the torso and alter the trunk muscle response during a sudden loading event, we tested the hypotheses that (a) lifting belts alter peak muscle activity recorded with electromyography (EMG) during sudden loading and (b) lifting belts have a larger impact on trunk muscle response when sudden loads are applied asymmetric to the torso's midsagittal plane. A sudden load was delivered to 10 men and 10 women without history of low back disorder via a cable attached to a thoracic harness; motion was restricted to the lumbar spine. Results indicate that gender was not a significant factor in this study. The lifting belt reduced the peak normalized EMG of the erector spinae muscles on average by 3% during asymmetric loading, though peak normalized EMG was increased by 2% during symmetric loading. Lifting belts have been shown to slightly reduce peak erector spinae activity during asymmetric sudden loading events in a constrained paradigm; however, the effects of lifting belts are too small to provide effective protection of workers. Actual or potential applications include the assessment of lifting belts as protective devices in workers based on the effects of lifting belts on the trunk muscle activity.     

Effects of posture on dynamic back loading during a cable lifting task

This study evaluated spinal loads associated with lifting and hanging heavy mining cable in a variety of postures. This electrical cable can weigh up to 10 kg per metre and is often lifted in restricted spaces in underground coal mines. Seven male subjects performed eight cable lifting and hanging tasks, while trunk kinematic data and trunk muscle electromyograms (EMGs) were obtained. The eight tasks were combinations of four postures (standing, stooping, kneeling on one knee, or kneeling on both knees) and two levels of cable load (0 N or 100 N load added to the existing cable weight). An EMG-assisted model was used to calculate forces and moments acting on the lumbar spine. A two-way split-plot ANOVA showed that increased load (p < 0.05) and changes in lifting posture (p < 0.05) independently affected trunk muscle recruitment and spinal loading. The increase in cable load resulted in higher EMG activity of all trunk muscles and increased axial and lateral bending moments on the spine (p < 0.05). Changes in posture caused more selective adjustments in muscle recruitment and affected the sagittal plane moment (p < 0.05). Despite the more selective nature of trunk EMG changes due to posture, the magnitude of changes in spinal loading was often quite dramatic. However, average compression values exceeded 3400 N for all cable lifting tasks.     

Modification of an EMG-assisted biomechanical model for pushing and pulling

Pushing and pulling tasks using carts and material handling devices have become more prevalent in occupational environments in an attempt to reduce the musculoskeletal risks associated with lifting. However, little change in low back disorder rates have been noted as tasks change from lifting to pushing and pulling indicating that we do not understand the mechanics of pushing and pulling well. Biomechanical assessments of pushing and pulling tasks using person-specific biologically assisted models offer a means to help understand how the spine is loaded under pushing and pulling conditions. However, critical components of these models must be adjusted so that they are sensitive to the different physiologic responses in the torso muscles expected during pushing and pulling compared to lifting tasks.The objective of this study was to modify an electromyography (EMG)-assisted biomechanical model designed to evaluate lifting tasks so that it can better represent the biomechanical forces expected during pushing and pulling tasks. Several key modifications were made. Based upon a literature review, changes in muscle cross-sectional area and muscle origins and insertions were made to better represent the geometry of the torso muscles. It was also necessary to adjust the length–force and velocity–force muscle relationships. Empirically derived length–force and velocity–force relationships were developed to independently represent the flexor and extensor musculature. These modifications were then systematically incorporated into the model.The model was exercised over several pushing and pulling conditions to assess the effect of these modifications on its ability to predict externally measured spinal moments. Results indicated that the alterations made to the preexisting EMG-assisted model resulted in acceptable model performance for pushing, pulling, and lifting activities.

Relevance to industry

The use of carts and material handling devices has become increasingly prevalent in industry, though little research has been done to examine the body's response. The modifications made to the biomechanical model would enable its use in the evaluation and design of material handling devices and pushing and pulling tasks.     

Comparison of prediction models for the compression force on the lumbosacral disc

The main objective of this research was to compare three representative methods of predicting the compressive forces on the lumbosacral disc: LP-based model, double LP-based model, and EMG-assisted model. Two subjects simulated lifting tasks that are frequently performed in the refractories industry of Korea, in which vertical and lateral distances, and weight of load were varied. To calculate the L5/ SI compressive forces, EMG signals from six trunk muscles were measured, and postural data and locations of load were recorded using the Motion Analysis System. The EMG-assisted model was shown to reflect well all three factors considered here, whereas the compressive forces from the two LP-based models were only significantly affected by weight of load. In addition, low lifting index (LI) values were observed for relatively high L5/S1 compressive forces from the EMG-assisted model, suggesting that the 1991 NIOSH lifting equations may not fully evaluate the risk of dynamic asymmetric lifting tasks.     

The effects of task execution variables on the musculature activation strategy of the lower trunk during squat lifting

The main objective of this study was to investigate the innervation behavior of lower trunk musculature to determine the muscular activation strategy during free dynamic squat lifting. This may clarify how lower trunk musculature activation compliments task execution variables to control motion during labor and industrial lifting tasks. In total, 12 healthy men volunteered to perform symmetric squat lifting of boxes of various masses (4, 8 and 12 kg) at slow and fast speeds. Eight-channel electromyography was performed on two pairs of abdominal (rectus abdominis and external oblique) and lower back muscles (iliocostalis lumborum and multifidus). Movement patterns were extracted using a 3D-linked segment model and a Vicon system. The results indicated that there were significant increases (all p-values < 0.05) in the mean muscle activation of the right and left multifidus and iliocostalis lumborum with increases in the lift speed and box weight. Furthermore, the results indicated that there were significant decreases (all p-values < 0.05) in the time required for the peak activation of the right and left multifidus, iliocostalis lumborum and external oblique with increases in the lift speed and box weight. Finally, the lower trunk musculature activation strategy was revealed to be compatible with different task execution variables, controlling motion in a manner that compensated for the effects of task execution variables. The findings of this study may effectively be applied to ergonomics, particularly to symmetric squat lifting.     

Temporal patterns of trunk muscle activity throughout a dynamic, asymmetric lifting motion.

This study examined the effects of trunk speed and exertion level on temporal aspects of trunk muscle activity patterns during dynamic, asymmetric lifting. Electromyographic (EMG) data from eight trunk muscles were collected along with trunk torque output, position, and velocity data during several repetitions of four speed/loading combination conditions. During analysis, each muscle's EMG record was reduced to three key events: a start, a peak, and an end point. For each subject, temporally ordered event lists were constructed for each test condition. Networks of events that consistently occurred regardless of loading or speed levels were constructed for each subject. Two event pairs occurred consistently for all subjects under all conditions, whereas some pairs occurred in association with specific speed or resistance levels. Temporal information related to muscle activity could be used in biomechanical models in order to predict changes in spinal loading during the course of workplace tasks.     

Lower back muscle forces in pushing and pulling

In the investigation of lower back stress, the muscle forces of the erector spinae and the rectus abdominis are often calculated using the two-dimensional biomechanical model. These muscle forces are used to estimate the compressive forces at L5/S1 disc. This paper presents a study of the muscle forces predicted by a two-dimensional biomechanical model during pushing and pulling and myoelectric activity from the corresponding muscles. The goal was to investigate whether a simple two muscle torso model would reasonably estimate the muscle actions in pushing and pulling tasks. Six subjects participated in the experiment. EMG (rms) value was used as an indicator of muscle forces. The results show high correlation between the predicted muscle forces and the measured root-mean-square EMG values in trunk pushing and pulling (r2 = 0.93) and hand pushing and pulling (r2 = 0.96) in an erect posture with hips braced but low in hand pushing and pulling using a free posture (r2 = 0.37).     

The influence of skill and low back pain on trunk postures and low back loads of shearers

Shearing is a rural occupation developing considerable spinal loads and carrying a high risk of low back pain (LBP). Although the workforce has a skill structure, interaction between skill, spinal loads and LBP is unknown. We examined whether skill and LBP influenced trunk postures and loads within a sample of 80 shearers representing shear skill levels. A progression from junior to open class demonstrated a 100% increase in productivity, less time in severe flexion, more time in neutral lateral bend, and more time in axially twisted postures, with no increase in cumulative compressive and anterior shear forces. LBP prevalence increased linearly from 10% for junior through to 76% for open class shearers. Shearers with a history of LBP generated greater cumulative right medio-lateral shear forces, greater left lateral bend and left axial twist moments. Skill-based training that reduces asymmetric forces may help reduce such high prevalence levels of LBP.

Statement of Relevance: Shearing is an important and physically demanding rural occupation. It requires sustained flexed postures that generate considerable spinal loads and a high risk of LBP. This research examines how skill and a history of LBP it carries interact to influence trunk postures and spinal loads within a sample of shearers.     

Risk of neck musculoskeletal disorders among males and females in lifting exertions

Work-related neck disorders are common among various occupational groups. Despite clear epidemiological evidence for the association of these disorders with forceful arm exertions, the effect of such exertions on the biomechanical behavior of the neck muscles is currently not well understood. In this study, the effect of lifting tasks on the biomechanical loading of neck muscles was investigated for males and females. Twenty-six participants (13 males and 13 females) performed bi-manual isometric lifting tasks at knuckle, elbow, shoulder, and overhead heights by exerting 25%, 50%, and 75% of their maximum strength. The activity of the cervical trapezius and sternocleidomastoid muscles was recorded bilaterally using surface electromyography. Higher activity of the cervical trapezius muscle (10% MVC–43% MVC) compared to the sternocleidomastoid muscle (4% MVC–18% MVC) was observed. Females tend to use the sternocleidomastoid muscle to a greater extent than males, whereas, higher cervical trapezius muscle activation was observed for males than females. The main effect of weight and height, and weight by height interaction on the activity of neck muscles was statistically significant (all p < 0.001). The results of this study demonstrate that the neck muscles play an active role during lifting activities and may influence development of musculoskeletal disorders due to resulting physiological changes.     

The effect of load weight vs. pace on muscle recruitment during lifting

The purpose of this study was to compare the effect on the trunk and upper extremity muscle recruitment when controlling the lifting pace and the lifting weight. Thirty nine healthy subjects performed a total of 12 lifts (3 lifting trials per condition, 2 lifting weights, and 2 lifting paces), from waist height to shoulder height. Kinematics of upper extremity and the box and electromyography of trunk and upper extremity muscles were collected. Temporal muscle recruitment pattern varied between muscles based on their function. Heavier lifting weight evenly increased the muscle recruitment throughout the lifting period without changing their temporal pattern. In contrary, lifting pace affected the temporal recruitment pattern in most of muscles. The faster lifting pace increased the muscle recruitment at the beginning phase but decreased at the terminal phase of lifting. It is important to educate the workers about the effect of lifting pace and weight on the biomechanical load to control the mechanical load on the muscles and spine.     

Morphological investigation of low back erector spinae muscle: Historical data populations

Accurate and reliable low back morphological data such as the cross-sectional area (CSA) of the erector spinae muscle (ESM) is vital for biomechanical modeling of the lumbar spine to estimate spinal loading and enhance the understanding of injury mechanisms. The objective of the present study is to enhance the current database regarding ESM sizes by studying with larger sample sizes, collecting data from live subjects, using high resolution MRI scans, using computerized, reliable, and repeatable measurement techniques, and analyzing data from three inter-vertebral disc (IVD) levels for both genders. A total of 163 subjects (82 males and 81 females) were included in the study. CSAs of both right and left ESMs were measured from axial-oblique MRI scans using architectural design software. The average CSA of the ESM was 23.50, 24.22, and 24.33 cm² for females and 30.00, 28.28, and 24.60 cm² for males at the L3/L4, L4/L5, and L5/S1 levels, respectively. Results agree with some studies, but generally larger than most previous studies, possibly due to differences in sampling (sample size, subject characteristics: age, anthropometrics, cadavers, etc.), measurement techniques (scanning technology, scanning plane, scanning posture, different IVD levels), or muscle definitions.Relevance to industryLifting tasks are very common in occupational settings and associated with low back pain. Accurate and reliable low back muscle size data is of importance to produce more efficient low back biomechanical models to better understand the loading mechanism in lifting tasks and to minimize low back pain risk regarding the lifting task. However, available low back muscle size data are quite limited. This study fills part of this gap by providing data from a large sample population of live subjects, multiple levels, both genders, high resolution MRI scans, reliable and repeatable measurement technique. The updated low back muscle size data presented in this paper can be used by biomechanical modelers to improve current low back biomechanical models.     

The effects of horizontal load speed and lifting frequency on lifting technique and biomechanics

Lifting loads that have a horizontal velocity (e.g. lifting from a conveyor) is often seen in industry and it was hypothesised that the inertial characteristics of these loads may influence lifting technique and low back stress. Seventeen male participants were asked to perform lifting tasks under conditions of four horizontal load speeds (0 m/s, 0.7 m/s, 1.3 m/s and 2.4 m/s) and two lifting frequencies (10 and 20 lifts/min) while trunk motions and trunk muscle activation levels were monitored. Results revealed that increasing horizontal load speed from 0 m/s to 2.4 m/s resulted in an increase in peak sagittal angle (73° vs. 81°) but lower levels of peak sagittal plane angular acceleration (480°/s² vs. 4°/s²) and peak transverse plane angular acceleration (200°/s per s vs. 140°/s per s) and a consistent increase in trunk muscle co-activation. Participants used the inertia of the load to reduce the peak dynamics of the lifting motion at a cost of increased trunk flexion and higher muscle activity.

Statement of Relevance: Conveyors are ubiquitous in industry and understanding the effects of horizontal load speed on the lifting motions performed by workers lifting items from these conveyors may provide some insight into low back injury risk posed by these tasks.     

Curved muscles in biomechanical models of the spine: a systematic literature review

Abstract

Early biomechanical spine models represented the trunk muscles as straight-line approximations. Later models have endeavoured to accurately represent muscle curvature around the torso. However, only a few studies have systematically examined various techniques and the logic underlying curved muscle models. The objective of this review was to systematically categorise curved muscle representation techniques and compare the underlying logic in biomechanical models of the spine. Thirty-five studies met our selection criteria. The most common technique of curved muscle path was the ‘via-point’ method. Curved muscle geometry was commonly developed from MRI/CT database and cadaveric dissections, and optimisation/inverse dynamics models were typically used to estimate muscle forces. Several models have attempted to validate their results by comparing their approach with previous studies, but it could not validate of specific tasks. For future needs, personalised muscle geometry, and person- or task-specific validation of curved muscle models would be necessary to improve model fidelity.

Practitioner Summary: The logic underlying the curved muscle representations in spine models is still poorly understood. This literature review systematically categorised different approaches and evaluated their underlying logic. The findings could direct future development of curved muscle models to have a better understanding of the biomechanical causal pathways of spine disorders.     

The changes of lumbar muscle flexion–relaxation response due to laterally slanted ground surfaces

Lifting tasks performed on uneven ground surfaces are common in outdoor industries. Previous studies have demonstrated that lifting tasks performed on laterally slanted ground surfaces influence lumbar muscle activation and trunk kinematics. In this study, the effect of laterally slanted ground surfaces on the lumbar muscle flexion–relaxation responses was investigated. Fourteen participants performed sagittal plane, trunk flexion–extension tasks on three laterally slanted ground surfaces (0° (flat ground), 15° and 30°), while lumbar muscle activities and trunk kinematics were recorded. Results showed that flexion–relaxation occurred up to 6.2° earlier among ipsilateral lumbar muscles with an increase in laterally slanted ground angle; however, the contralateral side was not affected as much. Our findings suggest that uneven ground alters the lumbar tissue load-sharing mechanism and creates unbalanced lumbar muscle activity, which may increase the risk of low back pain with repeated exposure to lifting on variable surfaces.

Practitioner Summary: Uneven ground surfaces are ubiquitous in agriculture, construction, fishing and other outdoor industries. A better understanding of the effects of laterally slanted ground surfaces on the interaction between passive and active lumbar tissues during lifting tasks could provide valuable knowledge in the design of preventive strategies for low back injuries.