Stabilographic analysis of unconstrained standing

Natural standing is characterized by postural changes and several hypotheses have been proposed to explain these changes. In this paper, four hypotheses were investigated by quantifying the number of postural changes in the centre of pressure data from unconstrained standing in different experimental conditions, studying the effects of mechanical loading, visual conditions, and type of support surface and sole of the shoes. The subjects stood for 30 min with no specific instructions other than not to step off a force plate. There were no significant effects on the number of centre of pressure patterns associated with the postural changes due to load, vision, surface and shoes during standing; on average, approximately two centre of pressure patterns per minute were observed in all conditions. The analysis of the centre of pressure data by the commonly used statistical parameters (standard deviation, velocity, and mean frequency of the centre of pressure displacement and area of the stabilogram) also did not reveal any effect of the different conditions.     

Control of standing balance while using constructions stilts: comparison of expert and novice users

This study examined the control of standing balance while wearing construction stilts. Motion capture data were collected from nine expert stilt users and nine novices. Three standing conditions were analysed: ground, 60 cm stilts and an elevated platform. Each task was also performed with the head extended as a vestibular perturbation. Both expert and novice groups exhibited lower displacement of the whole body centre of mass and centre of pressure on construction stilts. Differences between the groups were only noted in the elevated condition with no stilts, where the expert group had lower levels of medial–lateral displacement of the centre of pressure. The postural manipulation revealed that the expert group had superior balance to the novice group. Conditions where stilts were worn showed lower levels of correspondence to the inverted pendulum model. Under normal conditions, both expert and novice groups were able to control their balance while wearing construction stilts.     

THE STATIC MUSCLE LOAD IN DIFFERENT WORK POSITIONS: AN ELECTROMYOGRAPHIC STUDY∗

Abstract

In order to ascertain which muscles and muscle groups are engaged in various standing work positions an electromyographic study was performed.About twenty muscles or muscle groups were examined. Both coaxial needle electrodes and surface electrodes were employed.

The analysis of the muscle activity for different postures was based on action potentials recorded in a normal symmetric standing rest position. Among the different postures the rest position appears to require the least muscular effort for counterbalancing the effect of gravity on the various parts of the body. This state of equilibrium seems to be maintained by certain muscle groups, referred to hero a.s the “ prime postural muscles ”. Only a part of the potential power of the postural muscles is utilized in maintaining the standing symmetric rest position. Some persons engage other muscles besides the prime postural muscles, possibly because they stand in such a way that the load distribution is not optimal, or thoy havo weak prime postural muscles or because of poor muscular co-ordination as a consequence of “ non-physiologic” postural habits.

When changing from the rest position to most of the other standing positions the load on the prime postural muscles is increased, and in many cases other muscle groups arc activated as well. The sacrospiualis appears to be particularly susceptible to change in the load distribution. The muscles of the lower leg, which control the foot articulation, are also very susceptible to changes in body posture. However, a change in the position of the- trunk need not result in an appreciable increase in the load on the muscles of the lower legs if the displacement of the centre of gravity of the trunk is compensated by a postural adjustment at the ankle, such that the point of intersection of tho line of gravity of the body and the supporting area will be the same as in the symmetric standing rest position.

A change in posture of the hip- and knee-joints does not result in such a wide variation in activity of the muscles rogulating the position of these joints as a postural change in the foot articulation and the vertebrae.     

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.     

Effects of simulated occupational task parameters on balance

The effects of single-handed load holding, length of the base of support, and standing surface condition (narrow and wide construction beams) on balance were investigated in twenty-three healthy men between the ages of 18 and 55 years old. Balance during quiet standing was evaluated from postural sway measurements derived from center of pressure (COP) displacement. These measurements included the range or maximal displacement of the COP in the anteroposterior (AP) and mediolateral (ML) directions, the elliptical area, and mean sway velocity. Holding a load in the hand did not significantly affect postural sway measures (p > 0.05), although the effect of surface condition was significant on all COP measures (p < 0.001). Lengthening the base of support did not affect the ranges or elliptical area, but increased the mean velocity of sway (p = 0.001). Changes in the dimensional characteristics of the surface condition and length of base of support affected postural sway, possibly by requiring adjustments to balance and motor control strategies. Further research is required to determine if these changes are detrimental to maintaining balance and increase the risk of falls for workers in similar environments.     

Is active sitting as active as we think?

The aim of this study was to compare the biomechanical characteristics of sitting on a stool without a backrest (so as to encourage active sitting), sitting on a conventional office chair and standing in healthy participants. Thirteen healthy participants performed a keyboard-writing task during four (stable and unstable) sitting conditions and standing. Body segment positions and posture, postural sway and muscle activity of neck and trunk muscles were assessed with a motion capture system, a force plate and surface electromyography. The results showed that body segment positions, postural sway and trunk muscle activity were relatively similar for the stools without backrests compared with standing. All sitting conditions showed lower vertical upper body alignment, less anterior pelvic tilt and larger hip angles, compared with standing (p = 0.000). Unexpectedly, the muscle activity levels and total postural sway, sway velocity and sway in M/L and A/P directions were lower (p = 0.000) for the conditions that encouraged active sitting and standing, compared with the conventional office chair conditions.

Practitioner Summary: Thirteen healthy participants performed a keyboard-writing task during different sitting conditions and standing and were analysed regarding posture, postural sway and trunk muscle activity. Surprisingly, less postural sway and less muscle activity were observed during the conditions that encourage active sitting, compared with sitting on a conventional office chair.     

Control and perception of balance at elevated and sloped surfaces

Understanding roof-work-related risk of falls and developing low-cost, practical engineering controls for reducing this risk remain in high demand in the construction industry. This study investigated the effects of the roof work environment characteristics of surface slope, height, and visual reference on standing balance in construction workers. The 24 participants were tested in a laboratory setting at 4 slopes (0 degrees, 18 degrees, 26 degrees, and 34 degrees), 2 heights (0, 3 m), and 2 visual conditions (with and without visual references). Postural sway characteristics were calculated using center of pressure recordings from a force platform. Workers' perceptions of postural sway and instability were also evaluated. The results indicated that slope and height synergistically increased workers' standing postural instability. Workers recognized the individual destabilizing effects of slope and height but did not recognize the synergistic effect of the two. Visual references significantly reduced the destabilizing effects of height and slope. Actual and potential applications of this research include the use of temporary level work surfaces and proximal vertical reference structures as postural instability control measures during roofing work.     

An air-spring standing platform does not increase overall movement or metabolic cost during simulated work tasks

Due to the increased popularity of standing-based occupational work stations there is a growing need to understand the impact of ergonomic aids such as standing mats. In particular, while standing mats have been studied in relation to musculoskeletal discomfort and pain, there have been no studies exploring the effects of their use on metabolism and caloric expenditure. The purpose of this study was to examine the metabolic, biomechanical, and pain/discomfort responses to the use of an air-spring standing mat over a 2-h work-simulated standing period. Sixteen participants visited the lab on two separate occasions, each to perform a 2-h standing simulated-work session, once with and once without a standing mat. Metabolic data were recorded at the start, midpoint, and end of the standing sessions. Force plate centre of pressure (COP) and visual analog discomfort score (VAS) measurements were taken every 15 min. Results demonstrated that there was no difference in caloric expenditure between the two sessions. COP variables demonstrated less movement on the standing mat compared to the control day; however, only one of the eight variables (root-mean-square velocity in the medial-lateral direction) was statistically significant (p = 0.02). VAS scores showed no clear benefit of the standing mat on low back or lower limb discomfort. The short-term introduction of an air-spring standing mat during simulated work tasks appears to have no clear benefits on energy expenditure, biomechanical centre of pressure variables, or for alleviating musculoskeletal discomfort. Whether longer term exposure to this type of mat has differential effects remains to be addressed.     

Effect of safety boots with toe spring on foot clearance features during walking

Tripping is a primary cause of occupational injury falls, especially among aging workers. This study investigated changes in foot clearance features during the normal walking swing phase affected by adding a toe spring height to safety boots. Gait data were obtained from nine male participants wearing experimental and control shoes via a motion capture system. A principal component analysis was conducted on three-dimensional foot segment trajectories and angles, and plantar surface motions were compared between conditions. Statistical analysis revealed significant principal component score differences between conditions in principal component vectors 1, 3, 5, 6, 8, and 9. The related swing phase three-dimensional plantar surface motion patterns were reconstructed. The results revealed two characteristics of the shoe-plantar surface three-dimensional motion of experimental shoes: higher foot clearance and a relatively straighter forward leg path. It was thus concluded that utilizing safety boots with toe springs may reduce falls in older workers due to occupational trips in industries.     

Postural muscle responses in the spinal cord injured persons during forward reaching.

To compensate for postural muscle function loss spinal cord injured (SCI) people have to use parts of the sensorimotor system which are still intact. In this study, postural control was investigated in high and low thoracic SCI people and in able-bodied controls, using a bimanual forward-reaching task. Muscle activity was recorded bilaterally from the erector spinae (ES) at level L3, T9 and T3, latissimus dorsi (LD), ascending part of the trapezius muscle (TPA), serratus anterior (SA), sternocostal head of the pectoralis major (PM) and the oblique abdominal muscles (OA) by means of surface electromyography. Sitting balance was monitored by measuring the changes in the location of the centre of pressure (CP) using a force platform. Muscle activity analyzed in different phases of the movement showed that SCI people adopt different postural adjustments to face the balance changes due to the reaching movement. SCI people make alternative use of non-postural muscles like the LD and TPA to maintain their sitting balance.     

The effect of load mass and its placement on postural sway

The purpose of this study was to investigate the effects of increasing load on postural sway in two different carrying positions: backpack and waist jacket. Potential differences between males and females were additionally evaluated. 60 young college students participated in this study, and were assigned to backpack and waist jacket groups. The loads in both groups were 12, 21 and 30 kg. Stabilometry was used to assess the amount of postural sway. The medio-lateral and antero-posterior mean sway, mean velocity, medio-lateral and antero-posterior path length and sway area of the centre of pressure position were calculated.In the backpack group all analyzed sway parameters linearly increased with additional load, the differences were significant at p < 0.001. However no significant change of the analyzed parameters was found when the subjects carried additional load in the waist jacket.Our results indicate that postural sway depends on the amount of the load carried in a backpack. Additionally, the position of the load is of significant importance. Carrying weight in a backpack increases postural sway with increasing weight whereas carrying weight in a waist jacket does not influence the amount of postural sway. There are no significant differences in the response to the amount and configuration of the load between male and female subjects.     

The influence of moving auditory stimuli on standing balance in healthy young adults and the elderly

The maintenance of postural balance depends on effective and efficient feedback from various sensory inputs. The importance of auditory inputs in this respect is not, as yet, fully understood. The purpose of this study was to analyse how the moving auditory stimuli could affect the standing balance in healthy adults of different ages. The participants of the study were 12 healthy volunteers, who were divided into two age categories: the young group (mean = 21.9 years) and the elderly group (mean = 68.9 years). The instrument used for evaluation of standing balance was a force plate for measuring body sway parameters. The toe pressure was measured using the F-scan Tactile Sensor System. The moving auditory stimulus produced a white-noise sound and binaural cue using the Beachtron Affordable 3D Audio system. The moving auditory stimulus conditions were employed by having the sound come from the right to left or vice versa at the height of the participant's ears. Participants were asked to stand on the force plate in the Romberg position for 20 s with either eyes opened or eyes closed for analysing the effect of visual input. Simultaneously, all participants tried to remain in the standing position with and without auditory stimulation that the participants heard from the headphone. In addition, the variables of body sway were measured under four conditions for analysing the effect of decreased tactile sensation of toes and feet soles: standing on the normal surface (NS) or soft surface (SS) with and without auditory stimulation. The participants were asked to stand in a total of eight conditions. The results showed that the lateral body sway of the elderly group was more influenced than that of the young group by the lateral moving auditory stimulation. The analysis of toe pressure indicated that all participants used their left feet more than their right feet to maintain balance. Moreover, the elderly had the tendency to be stabilized mainly by use of their heels. The young group were mainly stabilized by the toes of their feet. The results suggest that the elderly may need a more appropriate stimulus of tactile and auditory sense as a feedback system than the young for maintaining and control of their standing postures.     

The influence of moving auditory stimuli on standing balance in healthy young adults and the elderly

The maintenance of postural balance depends on effective and efficient feedback from various sensory inputs. The importance of auditory inputs in this respect is not, as yet, fully understood. The purpose of this study was to analyse how the moving auditory stimuli could affect the standing balance in healthy adults of different ages. The participants of the study were 12 healthy volunteers, who were divided into two age categories: the young group (mean = 21.9 years) and the elderly group (mean = 68.9 years). The instrument used for evaluation of standing balance was a force plate for measuring body sway parameters. The toe pressure was measured using the F-scan Tactile Sensor System. The moving auditory stimulus produced a white-noise sound and binaural cue using the Beachtron Affordable 3D Audio system. The moving auditory stimulus conditions were employed by having the sound come from the right to left or vice versa at the height of the participant's ears. Participants were asked to stand on the force plate in the Romberg position for 20 s with either eyes opened or eyes closed for analysing the effect of visual input. Simultaneously, all participants tried to remain in the standing position with and without auditory stimulation that the participants heard from the headphone. In addition, the variables of body sway were measured under four conditions for analysing the effect of decreased tactile sensation of toes and feet soles: standing on the normal surface (NS) or soft surface (SS) with and without auditory stimulation. The participants were asked to stand in a total of eight conditions. The results showed that the lateral body sway of the elderly group was more influenced than that of the young group by the lateral moving auditory stimulation. The analysis of toe pressure indicated that all participants used their left feet more than their right feet to maintain balance. Moreover, the elderly had the tendency to be stabilized mainly by use of their heels. The young group were mainly stabilized by the toes of their feet. The results suggest that the elderly may need a more appropriate stimulus of tactile and auditory sense as a feedback system than the young for maintaining and control of their standing postures.     

Effects of shoe inserts and heel height on foot pressure, impact force, and perceived comfort during walking

Studying the impact of high-heeled shoes on kinetic changes and perceived discomfort provides a basis to advance the design and minimize the adverse effects on the human musculoskeletal system. Previous studies demonstrated the effects of inserts on kinetics and perceived comfort in flat or running shoes. No study attempted to investigate the effectiveness of inserts in high heel shoes. The purpose of this study was to determine whether increasing heel height and the use of shoe inserts change foot pressure distribution, impact force, and perceived comfort during walking. Ten healthy females volunteered for the study. The heel heights were 1.0cm (flat), 5.1cm (low), and 7.6cm (high). The heel height effects were examined across five shoe-insert conditions of shoe only; heel cup, arch support, metatarsal pad, and total contact insert (TCI). The results indicated that increasing heel height increases impact force (p<0.01), medial forefoot pressure (p<0.01), and perceived discomfort (p<0.01) during walking. A heel cup insert for high-heeled shoes effectively reduced the heel pressure and impact force (p<0.01), an arch support insert reduced the medial forefoot pressure, and both improved footwear comfort (p<0.01). In particular, a TCI reduced heel pressure by 25% and medial forefoot pressure by 24%, attenuate the impact force by 33.2%, and offered higher perceived comfort when compared to the non-insert condition.     

Postural adaptations to workbench modifications in standing workers

Surveys have shown that many workers operate under conditions that require constrained standing. The aim of this study was to investigate postural adaptations in constrained standing to facilitate the development of design guidelines for standing workspaces. Standing postures were observed in six different workspaces that were designed using combinations of task distance (which was either constrained or unconstrained) and foot position (which was constrained, unconstrained or employed a footrest). Subjects at work were recorded stereopho-togrammetrically and postural variables were obtained in three dimensions. Postural adaptation to increased task distance was found to be characterized by increased trunk flexion and increased hip flexion while adaptation to close work was found to be characterized by increased neck flexion and increased thoracic kyphosis. Constrained foot position resulted in increased hip flexion accompanied by increased plantar flexion. Although use of the footrest resulted in some reduced lumbar lordosis, it increased trunk flexion and was not associated with significantly less discomfort than any of the other workspaces.     

Evaluation of two instruments for recording sitting and standing postures and number of foot steps

The study evaluates two simple instruments that may be used to describe aspects of physical workload in almost any occupation: a pedometer, which measures the number of steps taken by the subject wearing it, and a posimeter, which quantifies the time spent sitting and the number of changes between sitting and a The present data showed that the pedometer registers the correct number of steps at 'ordinary' walking speed independent of type of floor (plastic carpet and stone floor), shoes (wooden shoes and sneakers) and gender. At 'slow' walking (2.4 km/h) a reduced number of steps was recorded. In a field study the median difference between pedometer registration and observation was 6% (range 1-27) of the observed obtained for the five investigated pedometers was 0-15%. The posimeter was found to give a good estimate of the percentage time spent sitting (mean deviation 3%, range 0-15%). The number of changes between sitting and standing was overestimated by the posimeter (median deviation 63% of the observed). Some extreme working postures can be misread by the posimeter.     

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

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

Postural and trunk muscle response to sudden release during stoop lifting tasks before and after fatigue of the trunk erector muscles

The effect of fatigue on the muscular and postural response to sudden release of different stoop lifting loads was studied. Ten male volunteers performed a series of stoop lifting trials before and after fatigue of the erector spinae. Trials were performed using loads of 20, 40, 60, and 80 N, and sudden release of load was triggered randomly on one of the repetitions using an electromagnetic release. The onset of release was registered by an accelerometer, centre of pressure (COP) motion was recorded via a forceplate, and EMG activities of the latissimus dorsi (LD), erector spinae (ES), rectus abdominus (RA), external oblique (EO) and internal oblique (IO) muscles were recorded. A slightly reduced lifting speed was seen after fatigue, particularly at the higher loads, but this had little effect on the perturbing force at release, which was dominated by the release load. A significant effect of fatigue was seen on the antero-posterior COP motion, with the postural disturbance being decreased after fatigue. Fatigue resulted in a significant increase in ES (p = 0.029) and LD (p = 0.015) relaxation times and, while the response patterns (relaxation, contraction or no response) of the anterior trunk muscles (RA, EO, IO) were not always consistent, the proportion of response by relaxation was greater after fatigue. This resulted in a lower incidence but longer duration of co-contraction of the ES-RA, ES-EO and ES-EO muscle groups following fatigue, such that the mean co-contraction duration of these groups showed no significant differences before and after fatigue. The response to sudden release is a balance between maintaining postural stability and at the same time preventing the trunk musculature from overloading the spine and risking tissue injury. While fatigue of the trunk extensors does not appear to increase either the risk of fall or stumble or the incidence of co-contraction following sudden release of stoop lifting tasks, the duration of co-contraction appears to increase following fatigue. Further study is required to quantify the loading on the spine during sudden release of different lifting tasks before and after more realistic fatigue conditions.     

The impact of a sloped surface on low back pain during prolonged standing work: A biomechanical analysis

Background

Occupations that require prolonged periods of standing have been associated with increased reports of musculoskeletal disorders including low back pain. Previous work has utilized a prospective design of functionally inducing low back pain in previously asymptomatic individuals during a prolonged standing task. Increased trunk and gluteus medius muscle co-activation has been found in previously asymptomatic individuals who developed pain during standing compared with individuals who did not develop pain.

Purpose

The purpose of this study was to investigate the subjective and biomechanical responses of known pain developers and non-pain developers (previously determined during level standing) when exposed to the same prolonged standing task protocol completed while standing on a ±16° sloped surface.

Results

Overall low back pain scores were reduced by 59.4% for the pain development group, identified in level standing, when using the sloped surface. There was a marked decrease in the co-activation of the bilateral gluteus medius muscles in the known pain developers when standing on the sloped surface compared with level standing. However the non-pain developer group responded in the opposite direction by having an increase in the co-activation of these muscles, although they did not have a commensurate increase in low back pain. There were changes in both the postural and joint-loading variables examined. These changes were minimal and in most cases the sloped surface produced responses that bracketed the postures and loading magnitudes found in level standing depending on whether the participant was standing on the +16° or −16° surface.

Conclusions

The sloped surface resulted in decreased subjective low back pain during prolonged standing. There were also associated biomechanical changes resulting from using a sloped surface during prolonged standing. These positive findings were supported in an exit survey satisfaction rating with 87.5% indicating that they would use the sloped surface if they were in an occupational setting that required prolonged standing work.     

Posture and performance: sitting vs. standing for security screening

A classification of the literature on the effects of workplace posture on performance of different mental tasks showed few consistent patterns. A parallel classification of the complementary effect of performance on postural variables gave similar results. Because of a lack of data for signal detection tasks, an experiment was performed using 12 experienced security operators performing an X-ray baggage-screening task with three different workplace arrangements. The current workplace, sitting on a high chair viewing a screen placed on top of the X-ray machine, was compared to a standing workplace and a conventional desk-sitting workplace. No performance effects of workplace posture were found, although the experiment was able to measure performance effects of learning and body part discomfort effects of workplace posture. There are implications for the classification of posture and performance and for the justification of ergonomics improvements based on performance increases.