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.     

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.     

The spatial dependency of shoulder muscular demands during upward and downward exertions

Lifting and lowering are common occupational tasks contributing to shoulder injury risk. Quantifying task interaction with physical demand can precipitate better workstation designs. Nineteen university-aged males performed one-handed, submaximal upward/downward manual force exertions at 70 hand locations; unilateral electromyography (EMG) of 14 muscles was recorded. EMG across planes was evaluated with ANOVA. Predictive equations for muscle activity throughout the reach envelope were developed with stepwise regression. Total muscle activity (sum of individual muscle activity) was most sensitive to vertical hand location for upward exertions, where activation at superior locations was 192% of values for inferior locations. For upward exertions, activation differences for hand location occurred along all anatomical axes, and along anterior/posterior and superior/inferior axes for downward exertions. Predictive equations were non-linear, reflecting complex muscular demand with three-dimensional hand location. This work details foundational exposure data for lifting/lowering exertions. Results are applicable to workstation design to minimise occupational shoulder muscular demands.

Practitioner Summary: Lifting and lowering in the workplace contribute to shoulder injury risk. Shoulder muscle activity magnitudes revealed a dependence on three-dimensional hand location in the reach envelope for a defined hand force. This information can inform evidence-based workstation designs that reduce shoulder muscular demands for numerous materials handling scenarios.     

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).     

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).     

An ergonomic study on plate shears, applying physical, physiological and psychophysical methods

An ergonomic evaluation model for hand tools was developed and applied in a project aiming at assessment of work with plate shears. Measurement variables were physical, physiological and psychophysical. They included tool force and opening angle, wrist movements, muscular strain and fatigue, subjective rating of symptoms, and localization of symptoms, in a group of male professional platers. Different hand grips were studied in a series of cutting tasks (4.2 m cutting length). Results showed that working with conventional plate shears is extremely physically demanding. The peak force required was in the range of 26 to 72 per cent of the subjects' maximal hand grip force. There was ample localized muscle fatigue in the forearm. Psychophysical and electrophysiological data agreed with respect to aspects of muscular strain and fatigue. Workers' preferences in the short run seemed to focus on productivity rather than on ergonomic quality. There is a need for development of improved tools, based on formulated requirements.     

An evaluation of off-axis manual forces and upper extremity joint moments during unilateral pushing and pulling exertions

This study quantified changes in off-axis manual force production and upper extremity joint moments during sub-maximal one-handed push and pull tasks. Off-axis forces in the up/down and left/right directions were quantified in the presence or absence of constraints placed upon the direction of manual force application and/or arm posture. Resultant off-axis forces of 13.1% and 9.4% were produced for pulls and pushes, respectively. Off-axis forces during pulling were oriented downwards and to the right and were associated with a decreased should flexion moment when posture was constrained. Off-axis forces in the up/down direction were minimized with increased on-axis force level. Off-axis forces during pushing tended to be oriented to the left and were associated with increased elbow flexion moment when off-axis forces were allowed. By not accounting for these off-axis forces, we may not be accurately reflecting actionable muscle- and joint-level loading characteristics derived from biomechanically-based proactive ergonomics assessment approaches.

Practitioner Summary: Constrained arm postures and directions of manual force application influence the production of off-axis forces. As inaccurate estimation of true manual forces can markedly influence actionable outcomes of proactive ergonomic assessments, this study suggests that simplification of these estimates is insufficient and potentially misleading.     

The effect of handle height and cart load on the initial hand forces in cart pushing and pulling

The objective of this study was to measure the three-dimensional hand forces people exert to initiate a cart push or pull for two cart loads: 73 and 181 kg, and three handle heights: knuckle, elbow, and shoulder heights. The cart used was equipped with 15.24 cm (6 in) diameter wheels. The floor was covered with carpet tiles. The laboratory-measured hand force exertions were compared to the minimum forces needed to push/pull the cart under the same conditions and to the psychophysical initial push/pull force limits. For pushing and pulling, the measured anterior-posterior hand forces were 2–2.4 times the minimum required forces. For the heavier cart load, lower forces were applied as handle height increased. Pull forces were 7% higher than push forces. The smallest vertical forces were measured at elbow height. Strength capability and gender did not have an effect on the applied forces. The mean strength percentile for the male sample was 64%, while the mean strength percentile for the female sample was 13% as determined from the Adjusted Torso Lift Strength Test and population strength data for this test. The comparison with the psychophysical limits indicated that the tasks were well within the maximum acceptable initial forces for males, but not for females.     

The effect of tool handle shape on hand muscle load and pinch force in a simulated dental scaling task

Work-related upper extremity musculoskeletal disorders, including carpal tunnel syndrome, are prevalent among dentists and dental hygienists. An important risk factor for developing these disorders is forceful pinching which occurs during periodontal work such as dental scaling. Ergonomically designed dental scaling instruments may help reduce the prevalence of carpal tunnel syndrome among dental practitioners. In this study, eight custom-designed dental scaling instruments with different handle shapes were used by 24 dentists and dental hygienists to perform a simulated tooth scaling task. The muscle activity of two extensors and two flexors in the forearm was recorded with electromyography while thumb pinch force was measured by pressure sensors. The results demonstrated that the instrument handle with a tapered, round shape and a 10 mm diameter required the least muscle load and pinch force when performing simulated periodontal work. The results from this study can guide dentists and dental hygienists in selection of dental scaling instruments.     

The effects of using a single display screen versus dual screens on neck-shoulder muscle activity during computer tasks

The present study compared the effects of using one versus two display screens on cervical muscle activity of computer users. Healthy pain-free university students were recruited (11 males and 11 females), and surface electromyography in bilateral cervical erector spinae and upper trapezius (UT) muscles was measured. Each subject performed standardized text editing tasks for 15 min using a single screen and dual screens in a randomized order. In the dual screen condition, the primary screen was placed directly in front while the secondary screen was angled to the right of the user. Significant reductions of the 50th and 90th percentile amplitudes, representative of dynamic muscle loading, were found in the right UT muscle for dual screen condition. The 10th percentile muscle activity was similar in all muscles in the two conditions. These results suggest that viewing dual screens may be associated with different postural muscle activity compared to single screen.     

Estimation of hand force in ergonomic job evaluations

The aims of the present study were: (1) to collect normative data of pinch and power grip strength with a newer digital dynamometer; (2) to study the ability of hand grip force matching using a hand dynamometer where the validity and reliability issues were studied; and (3) to study the relationship between hand grip force matching and muscle activities of three forearm and hand muscles. This study consisted of two experiments. One hundred and twenty subjects volunteered in the first experiment, where hand grip strength and hand force estimation data were collected. The second experiment had 14 volunteers, where muscle activities of the hand and forearm were collected during the tests of hand grip strength and hand force matching estimations. Results showed that the power grip and pinch grip strengths collected with a newer digital dynamometer were comparable to similar studies using older equipment. At the group level, the force matching method was largely accurate and consistent. Instructions to the subjects about force matching estimation were important to the accuracy and consistency of the estimated forces. Estimation in force matching might depend on perceptions of several major muscle activities.     

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

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

Force direction and physical load in dynamic pushing and pulling

In pushing and pulling wheeled carts, the direction of force exertion may, beside the force magnitude, considerably affect musculoskeletal loading. This paper describes how force direction changes as handle height and force level change, and the effects this has on the loads on the shoulder and low back. Eight subjects pushed against or pulled on a stationary bar or movable cart at various handle heights and horizontal force levels while walking on a treadmill. The forces at the hands in the vertical and horizontal direction were measured by a forcetransducer. The forces, body movements and anthropometric data were used to calculate the net joint torques in the sagittal plane in the shoulder and the lumbosacral joint. The magnitudes and directions of forces did not differ between the cart and the bar pushing and pulling. Force direction was affected by the horizontal force level and handle height. As handle height and horizontal force level increased, the pushing force direction changed from 45° (SD 3.3°) downward to near horizontal, while the pulling force direction changed from pulling upward by 14° (SD 15.3°) to near horizontal. As a result, it was found that across conditions the changes in force exertion were frequently reflected in changes in shoulder torque and low back torque although of a much smaller magnitude. Therefore, an accurate evaluation of musculoskeletal loads in pushing and pulling requires, besides a knowledge of the force magnitude, knowledge of the direction of force exertion with respect to the body.     

The area of glenoid asymmetry identified as important contributor to shoulder strength during pushing and pulling in the coronal plane

The geometrical dimensions of the bones that make up the glenohumeral joint could be a key factor in strength predictability. Understanding the mechanical influence of these dimensions (individually or in combination) on shoulder strength could help explain the mechanism of musculoskeletal disorders. The following study shows how a recently discovered geometric parameter, the area of glenoid asymmetry (AGA), is a good indicator of shoulder strength. A comprehensive study was conducted to test whether glenohumeral geometry, as measured through MRI scans, is correlated with upper arm strength. The isometric shoulder strength of 12 subjects during one-handed arm abduction and adduction in the coronal plane, in a range from 5 to 30 degrees , was correlated with the geometries of their glenoid fossae. All subjects were stronger during adduction than abduction for all arm positions. The results revealed a high correlation in the coronal plane between the AGA and mean maximum force and mean maximum moment when an arm was abducted and adducted in a range from 5 degrees to 30 degrees (0.80, p 相似文献   

The effect of different surfaces on biomechanical loading of shoulder and lumbar spine during pushing and pulling of two-wheeled containers

Seven waste collectors pushed and pulled a two-wheeled container on three different surfaces: flagstones, paving stones, grass. Net torques at the shoulder joint and the lumbar spine as well as the compression and shear forces in the lumbar spine at the L4/L5 level were calculated for the tilting, initial and sustained phases. The lumbar spine compression force was below 1800N and the shear force was below 200 N in all situations. The shoulder torque when pulling with one hand was up to 80 N m. The container weight affected the magnitude of the push/pull forces and the load on the shoulders but not the load on the lumbar spine. The type of surface affected the magnitude of the push/pull forces during initial and sustained phases, and affected the load on the shoulder in the sustained phase. However, it did not affect the compression in the lumbar spine.     

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

Abstract

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

Effect of handle height on lower-back loading in cart pushing and pulling

This paper presents results of a study conducted to estimate lower back loadings in cart pushing and pulling. Experiments were conducted in the laboratory using a cart. Six subjects with different weights (ranging from 50 to 80 kg) were tested for three different pushing and pulling forces (98, 196 and 294 newtons), three different heights of exertion (660, 1090 and 1520 mm high) and two different moving speeds (1.8 and 3.6 km/h). It was found that, in general, pushing a cart results in lesser lower-back loading than pulling. Subject body weight affected the lower-back loadings more significantly in pulling (50% increase as body weight increased from 50 kg to 80 kg) than in pushing (25% increase). Handle height of 1090 mm was found to be better than other handle heights in pushing while 1520 mm handle height was better for pulling in reducing lower-back loadings.     

A different approach for the ergonomic evaluation of pushing and pulling in practice

Recent epidemiological studies show that pushing and pulling increase the risks of shoulder complaints and not necessarily of low back complaints. Moreover, the magnitude of the exerted hand forces during pushing and pulling is poorly related to the magnitude of the mechanical loading of the low back and the shoulder. In light of that, this paper combines results of several studies to present an approach for evaluating not only the exerted hand forces, but also the low back and shoulder load during pushing and pulling in practice. The approach specifies, based on scientific evidence, that (1) in order to validly obtain exposure (frequency and duration) to pushing and pulling, 10 workers should be observed during eight periods of 30 min; (2) how the exerted hand forces and the load of the low back and shoulder can be estimated in practice based solemnly on the weight of the object, one-handed or two-handed pushing or pulling, and the height of the handle; and finally, (3) how these outcomes can be evaluated in combination with existing guidelines regarding exerted hand forces, compression forces on the low back and the moments at the shoulder. Two cases will be presented here to illustrate the application of the approach.

Relevance to industry

The presented approach is the first to offer practitioners a fairly simple method for the ergonomic evaluation of pushing and pulling carts and four-wheeled containers in practice, especially as regarding the shoulder load.     

Physical workload of flight attendants when pushing and pulling trolleys aboard aircraft

The musculoskeletal loads from moving trolleys aboard aircraft were assessed by observation of trolley handling on planes and by physical workload analyses of pushing and pulling of trolleys in a laboratory set up. Trolley handling by a total of 15 female flight attendants was observed on 10 short- and medium-distance flights in different types of aircraft. About 25 selected flight attendants (22 females; 3 males) of five German airlines took part in the laboratory study, which comprised three-dimensional (3D) measurements of posture and hand forces during pushing and pulling of trolleys in a variety of configurations. From the on-flight observations performed, between 150 and 250 trolley movements can be projected for a work shift. The greatest physical workload is to be expected at the beginning of service: The trolleys are fully laden then, and the cabin floor can still be inclined up to 8°, as the aircraft is still climbing, particularly on short-distance flights. The laboratory investigation revealed that the musculoskeletal workload from pushing and pulling depends essentially on the trolley load and on the gradient of the cabin floor. In addition, the degree of stressing depends significantly on the trolley type, mode of handling and personal dexterity. The up/down force component perpendicular to the direction of motion often achieved considerable amplitudes-in some cases equal to or exceeding the force in the direction of movement. The posture analysis demonstrated that pulling forced the flight attendants to adopt ergonomically unfavourable postures such as pronounced flexion of the back, particularly among female subjects. The highest values for flexion of the back occurred while pulling the half-size trolley. The results demonstrate that female flight attendants are likely to overload themselves if they frequently have to move heavily laden trolleys unaided on an inclined cabin floor.

Relevance to industry

On short distance flights, flight attendants have been complaining increasingly of high physical workload from manoeuvring trolleys. On the basis of the presented data airline companies may improve the trolley handling skills of their flight attendances by practical trainings and may ergonomically optimize the general service procedures aboard aircrafts.