Review of: “ Systems Documentation: Techniques of persuasion in large organizations”. By FRANK WHITEHOHSE, ( London: Business Books, 1973.) [Pp. viii + 191.] £450.

The use of back belts in industry has increased despite the lack of scientific evidence supporting their efficacy. The purpose of this study was to investigate the effect of a semi-rigid lumbosacral orthosis (SRLSO) on oxygen consumption during 6-min submaximal repetitive lifting bouts of 10 kg at a lifting frequency of 20 repetitions min^-1. Fifteen healthy subjects (13 men, two women) participated in this study. Each subject performed squat and stoop lifting with and without an SRLSO for a total of four lifting bouts. Lifting bouts were performed in random order. Oxygen consumption during the final minute of each lifting bout was used for analysis. A two-way analysis of variance with repeated measures was used to analyse the effects of lift and belt conditions. The stoop and squat methods were significantly different, with the squat lift requiring 23% more oxygen on average than the stoop lift for equal bouts of work. No significant difference was found between the belt and no belt condition within the same lifting technique and no interaction was present. These data suggest that an SRLSO does not passively assist the paravertebral muscles (PVM) in stabilizing the spine during submaximal lifting bouts.     

How to lift a box that is too large to fit between the knees

Many studies compared lifting techniques such as stoop and squat lifting. Results thus far show that when lifting a wide load, high back loads result, irrespective of the lifting technique applied. This study compared four lifting techniques in 11 male subjects lifting wide loads. One of these techniques, denoted as the weight lifters' technique (WLT), is characterised by a wide foot placement, moderate knee flexion and a straight but not upright trunk. Net moments were calculated with a 3-D linked segment model and spinal forces with an electromyographic-driven trunk model. When lifting the wide box at handles that allow a high grip position, the WLT resulted in over 20% lower compression forces than the free, squat and stoop lifting technique, mainly due to a smaller horizontal distance between the l5S1 joint and the load. When lifting the wide box at the bottom, none of the lifting techniques was clearly superior to the others.

Statement of Relevance: Lifting low-lying and large objects results in high back loads and may therefore result in a high risk of developing low back pain. This study compares the utility of a WLT, in terms of back load and lumbar flexion, to more familiar techniques in these high-risk lifting tasks.     

Lumbosacral compression in maximal lifting efforts in sagittal plane with varying mechanical disadvantage in isometric and isokinetic modes

Nine normal male subjects (mean age 28·2 years and mean weight 72·6 kg) performed 20 standardized maximal effort lifting tasks. They were asked to perform stoop and squat lifts at half, three-quarters and full individual horizontal reach distances in mid-sagittal plane in isometric and isokinetic modes (fixed velocity 60 cm/s). Both stoop and squat lifts were initiated at the floor level and terminated at the individual's knuckle height keeping the horizontal distance constant throughout the lift. The isometric stoop lifts were performed with hip at 60° and 90° of flexion with hands at preselected reach distances. The isometric squat lifts were performed with knees at 90° and 135° of flexion with hands at similarly preselected reach distances. The force was measured using a Static Dynamic Strength Tester with load cell (SM1000). The postures were recorded using a two-dimensional Peak Performance System with an event synchronizing unit. The load cell was sampled at 60 Hz and the video filming was done at 60 frames per second. The force and postural data were fed to a biomechanical model (Cheng and Kumar 1991) to extract external moment and lumbosacral compression. The strengths generated in different conditions were significantly different (p < 0·01). The strength variation ranged by up to 73% whereas the lumbosacral compression varied by only up to 15%. A high level of lumbosacral compression was maintained in all conditions.     

Progressive fatigue effects on manual lifting factors

The purpose of this study was to evaluate the effect of progressive fatigue on factors that previously have been associated with increased risk of low back pain in various occupational settings, during a repetitive lifting task where a freestyle lifting technique was used. A laboratory experiment was conducted to evaluate electromyography amplitude, kinematic, and kinetic parameters of repetitive freestyle lifting during a 2‐hour lifting period. Subjective fatigue rating increased over time, indicating that the participant “felt” increasingly fatigued as the experiment progressed. Static composite strength decreased an average of 20% from the beginning to the end of the experiment. Effect of lifting posture (semi‐squat, semi‐stoop, and stoop) was observed on peak trunk flexion angle, trunk flexion angle at initiation of the lift, and knee angle at initiation of the lift indicating that, in freestyle lifting, participants assume quantitatively different lifting techniques. A significant effect of the time–posture interaction was observed on the dynamic leg lift floor to knuckle height strength, indicating that dynamic strength may change over time depending on lifting posture selected. © 2009 Wiley Periodicals, Inc.     

Foot positioning instruction, initial vertical load position and lifting technique: effects on low back loading

This study investigated the effects of initial load height and foot placement instruction in four lifting techniques: free, stoop (bending the back), squat (bending the knees) and a modified squat technique (bending the knees and rotating them outward). A 2D dynamic linked segment model was combined with an EMG assisted trunk muscle model to quantify kinematics and low back loading in 10 subjects performing 19 different lifting movements, using 10.5 kg boxes without handles. When lifting from a 0.05 m height with the feet behind the box, squat lifting resulted in 19.9% (SD 8.7%) higher net moments (p < 0.001) and 17.0% (SD 13.2%) higher compression forces (p < 0.01) than stoop lifting. This effect was reduced to 12.8% (SD 10.7%) for moments and a non-significant 7.4% (SD 16.0%) for compression forces when lifting with the feet beside the box and it disappeared when lifting from 0.5 m height. Differences between squat and stoop lifts, as well as the interaction with lifting height, could to a large extent be explained by changes in the horizontal L5/S1 intervertebral joint position relative to the load, the upper body acceleration, and lumbar flexion. Rotating the knees outward during squat lifts resulted in moments and compression forces that were smaller than in squat lifting but larger than in stoop lifting. Shear forces were small ( < 300 N) at the L4/L5 joint and substantial (1100 - 1400 N) but unaffected by lifting technique at the L5/S1 joint. The present results show that the effects of lifting technique on low back loading depend on the task context.     

Foot positioning instruction,initial vertical load position and lifting technique: effects on low back loading

This study investigated the effects of initial load height and foot placement instruction in four lifting techniques: free, stoop (bending the back), squat (bending the knees) and a modified squat technique (bending the knees and rotating them outward). A 2D dynamic linked segment model was combined with an EMG assisted trunk muscle model to quantify kinematics and low back loading in 10 subjects performing 19 different lifting movements, using 10.5 kg boxes without handles. When lifting from a 0.05 m height with the feet behind the box, squat lifting resulted in 19.9% (SD 8.7%) higher net moments (p < 0.001) and 17.0% (SD 13.2%) higher compression forces (p < 0.01) than stoop lifting. This effect was reduced to 12.8% (SD 10.7%) for moments and a non-significant 7.4% (SD 16.0%) for compression forces when lifting with the feet beside the box and it disappeared when lifting from 0.5 m height. Differences between squat and stoop lifts, as well as the interaction with lifting height, could to a large extent be explained by changes in the horizontal L5/S1 intervertebral joint position relative to the load, the upper body acceleration, and lumbar flexion. Rotating the knees outward during squat lifts resulted in moments and compression forces that were smaller than in squat lifting but larger than in stoop lifting. Shear forces were small ( < 300 N) at the L4/L5 joint and substantial (1100 – 1400 N) but unaffected by lifting technique at the L5/S1 joint. The present results show that the effects of lifting technique on low back loading depend on the task context.     

Significance of biomechanical and physiological variables during the determination of maximum acceptable weight of lift.

The aim was to identify which biomechanical and physiological variables were associated with the decision to change the weight of lift during the determination of the maximum acceptable weight of lift (MAWL) in a psychophysical study. Fifteen male college students lifted a box of unknown weight at 4.3 lifts/min, and adjusted the weight until their MAWL was reached. Variables such as heart rate, trunk positions, velocities and accelerations were measured during the lifting, as well as estimated spinal loading in terms of moments and spinal forces in three dimensions using an EMG-assisted biomechanical model. Multiple logistic regression techniques identified variables associated with the decision to change the weights up and down prior to a subsequent lift. Results indicated that heart rate, predicted sagittal lift moment and low back disorder (LBD) risk index were associated with decreases in the weight prior to the next lift. Thus, historical measures of LBD risk (e.g. compression, shear force) were not associated with decreases in weight prior to the next lift. Additionally, the magnitudes of the predicted spinal forces and LBD risk were all very high at the MAWL when compared with literature sources of tolerance as well as observational studies on LBD risk. Our findings indicate that the psychophysical methodology may be useful for the decision to lower the weight of loads that may present extreme levels of risk of LBD; however, the psychophysical methodology does not seem to help in the decision to stop changing the weight at a safe load weight.     

Development of predictive equations for lifting strengths

The purpose of the study was to determine relationship between lifting strengths of male and female subjects and body posture, type of lift (stoop or squat) and velocity of lift. Thirty normal young adults (18 males and 12 females) volunteered for the study. All subjects were required to perform a total of 56 tasks. Of these, 28 were stoop lifts and 28 were squat lifts. In each of the categories of stoop and squat lifts, the strengths were tested in standard posture, isokinetic (linear velocity of 500 mm/s), and isometric modes at half, three-quarters and full horizontal individual reach distances in sagittal, 30 degrees lateral and 60 degrees lateral planes. The strengths were measured using a static dynamic strength tester with a load cell and an IBM microcomputer with an A/D card. The peak and average strength values were extracted and statistically compared across conditions and gender (ANOVA). Finally a multiple regression analysis was carried out to predict strength as a function of reach, posture and velocity of lift. The ANOVA revealed a highly significant effect of gender, reach, plane and velocity (p < 0.01). All regression equations (108) were significant (p < 0.01), and more than 70% of variance in lifting strength was accounted for by the anthropometric variables and sagittal plane strength values. Such an established relationship allows one to predict the human lifting strength capabilities for industrial application based on simple anthropometric and strength characteristics.     

Significance of biomechanical and physiological variables during the determination of maximum acceptable weight of lift

The aim was to identify which biomechanical and physiological variables were associated with the decision to change the weight of lift during the determination of the maximum acceptable weight of lift (MAWL) in a psychophysical study. Fifteen male college students lifted a box of unknown weight at 4.3 lifts/min, and adjusted the weight until their MAWL was reached. Variables such as heart rate, trunk positions, velocities and accelerations were measured during the lifting, as well as estimated spinal loading in terms of moments and spinal forces in three dimensions using an EMG-assisted biomechanical model. Multiple logistic regression techniques identified variables associated with the decision to change the weights up and down prior to a subsequent lift. Results indicated that heart rate, predicted sagittal lift moment and low back disorder (LBD) risk index were associated with decreases in the weight prior to the next lift. Thus, historical measures of LBD risk (e.g. compression, shear force) were not associated with decreases in weight prior to the next lift. Additionally, the magnitudes of the predicted spinal forces and LBD risk were all very high at the MAWL when compared with literature sources of tolerance as well as observational studies on LBD risk. Our findings indicate that the psychophysical methodology may be useful for the decision to lower the weight of loads that may present extreme levels of risk of LBD; however, the psychophysical methodology does not seem to help in the decision to stop changing the weight at a safe load weight.     

Efficiency and effectiveness of stoop and squat lifting at different frequencies

The study investigated the effects of frequency (10 and 20 lifts/min) and technique (squat and stoop) of repetitive lifting of a barbell (19 kg) on the relationship between mean power output (Pm) and energy cost in 9 male power-lifters. Oxygen uptake (VO2) was measured directly and continuously and power output was deduced from film analysis using an inverse dynamic analysis. Power output and VO2 were significantly greater for squat than for stoop lifting at the same frequency. The mechanical efficiency (ME), defined as Pm divided by the energy equivalence of VO2, increased from 12% at rate 10 to 18.5% at rate 20, but there was no significant difference between the two techniques. The effectiveness (EF), defined as the productive external power output (only work done on the barbell) divided by the energy equivalence of VO2, was significantly higher for the stoop lift than for the squat lift. EF is judged as a more useful measure than ME for characterizing the relative energy cost of a lifting task.     

Static and dynamic lifting strength at different reach distances in symmetrica] and asymmetrical planes

Postural and therefore biomechanical standardization in strength testing has not been rigorously and consistently applied. To develop a quantitative relationship between strength and posture (body position, symmetry, and reach) 30 normal subjects (18 male and 12 females) were required to stoop and squat lift or exert in the relevant posture against a standardized instrumented handle. The isometric lifting efforts and isokinetic lifts were studied. The isokinetic lifts were done at a linear velocity of 50cm/s of the hand displacement from the floor to the knuckle heights of the respective subjects in stoop and squat postures. The isometric stoop lifting efforts were exerted in two standardized postures: (a) with 60° hip flexion; and (b) with 90° hip flexion. The isometric squat lifting efforts were also exerted in two standardized postures: (a) with 90° knee flexion; and (b) with 135° knee flexion. All isometric lifting efforts and isokinetic lifts were performed at half, three-quarters, and full horizontal reach in sagitally symmetrical, 30° left lateral, and 60° left lateral planes. Isometric stoop and squat lifting efforts were also measured in self-selected optimal postures. These 56 conditions were tested in random order. The analysis of variance revealed that the gender, the mode of lifting, the postural asymmetry and reach of lifting affected the strength significantly (p<0·0001). Most two-way and three-way interactions were significant (p<0·01). Of 108 prediction regression equations, 103 were significant with up to 90% of the variation explained by anthropometric variables and sagittal plane strength. The reach affected the strength most profoundly followed by postural asymmetry and the mode of lifting.     

Static and dynamic lifting strength at different reach distances in symmetrical and asymmetrical planes.

Postural and therefore biomechanical standardization in strength testing has not been rigorously and consistently applied. To develop a quantitative relationship between strength and posture (body position, symmetry, and reach) 30 normal subjects (18 male and 12 females) were required to stoop and squat lift or exert in the relevant posture against a standardized instrumented handle. The isometric lifting efforts and isokinetic lifts were studied. The isokinetic lifts were done at a linear velocity of 50cm/s of the hand displacement from the floor to the knuckle heights of the respective subjects in stoop and squat postures. The isometric stoop lifting efforts were exerted in two standardized postures: (a) with 60 degrees hip flexion; and (b) with 90 degrees hip flexion. The isometric squat lifting efforts were also exerted in two standardized postures: (a) with 90 degrees knee flexion; and (b) with 135 degrees knee flexion. All isometric lifting efforts and isokinetic lifts were performed at half, three-quarters, and full horizontal reach in sagitally symmetrical, 30 degrees left lateral, and 60 degrees left lateral planes. Isometric stoop and squat lifting efforts were also measured in self-selected optimal postures. These 56 conditions were tested in random order. The analysis of variance revealed that the gender, the mode of lifting, the postural asymmetry and reach of lifting affected the strength significantly (p less than 0.0001). Most two-way and three-way interactions were significant (p less than 0.01). Of 108 prediction regression equations, 103 were significant with up to 90% of the variation explained by anthropometric variables and sagittal plane strength. The reach affected the strength most profoundly followed by postural asymmetry and the mode of lifting.     

Review of:“Sex Differences in Human PerformanceEdited by M. A. BAKER (Chichester,England: John Wiley, 1987.) [Pp. xvi + 202.] £22·00. ISBN 0-471-91119-4.

An experiment was conducted to examine the role that maximal lifting power has in predicting maximum acceptable weight of lift (MAWL) for a frequency of one lift per 8 h. The secondary aim of the study was to compare the ability of power to predict MAWL to previously used measures of capacity including two measures of isometric strength, five measures of isokinetic strength, and isoinertial capacity on an incremental lifting test. Twenty-five male subjects volunteered to participate in the experiment. The isometric tests involved maximum voluntary contractions for composite lifting strength at vertical heights of 15 and 75 cm. Peak isokinetic strength was measured at velocities of 0.1, 0.2, 0.4, 0.6 and 0.8 m s^?1 using a modified CYBEX® II isokinetic dynamometer. Isoinertial lifting capactity was measured on the X-factor incremental lifting machine and peak power was measured on the incremental lifting machine by having subjects lift a 25 kg load as quickly as possible. The results indicate that peak isoinertial power is significantly correlated with MAWL, and this correlation was higher than any of the correlations between the other predictor variables and MAWL. The relationships between the isokinetic strength measures and MAWL were stronger than the relationships between the isometric measures and MAWL. Overall, the results suggest that tests used to predict MAWL should be dynamic rather than static.     

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.     

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.     

Prediction of the maximum acceptable weight of lift from the frequency of lift

It is known that maximum acceptable weight of lift (MAWL) decreases as the frequency of lifting increases. The purpose of this study was to quantify the relationship between lifting frequency and the MAWL, and to generate models for predicting the mean MAWLs for males and females from frequency of lifting. Published experimental studies that have reported the MAWL at different lifting frequencies were identified and regression methods were used to evaluate the relationship between the frequency of lifting and the MAWL. The best fitting models were logarithmic but they accounted for less than 50% of the variance. This reflects the heterogeneity of the experiments included. Normalising the MAWL to the MAWL at one lift per minute improved the predictive power of the models, accounting for more than 80% of the variance. Linear and power models for predicting work rate in kg/min showed even higher levels of accuracy.     

Effect of an on-body ergonomic aid on oxygen consumption during a repetitive lifting task

The purpose of this study was to determine if an on-body personal lift assistive device (PLAD)¹ affected oxygen consumption during a continuous lifting task and to investigate if any effect could be explained by differences in muscle activity or lifting technique. The PLAD, worn like a back-pack, contains a spring-cable mechanism that assists the back musculature during lifting, lowering, and forward bending tasks. Males (n = 15) lifted and lowered a box loaded to 10% of their maximum back strength at 6 times/minute for 15-minutes using a free-style technique under two conditions: wearing and not wearing the PLAD. Oxygen consumption was collected continuously for the first condition; then the participants rested until their heart rates returned to resting levels before repeating the protocol for the second condition. Knee flexion was monitored using Liberty sensors at the hip, knee, and ankle. EMG of the thoracic and lumbar erector spinae (TES, LES), biceps femoris, rectus femoris and gluteus maximus were gathered using a Bortec AMT-8 channel system. VO2 measures were averaged across the duration (15 min) for each condition. Results showed no differences between oxygen consumption during the PLAD and no PLAD conditions. When wearing the PLAD, the TES demonstrated an 8.4% EMG reduction when lowering the box while the biceps femoris showed a 14% reduction while lifting the box. Knee angles, used as a proxy for stoop or squat lifts, were highly variable for both conditions. In conclusion, the PLAD had no effect on oxygen consumption and, therefore, neither workers nor employers should increase the tasks demands when wearing this ergonomic aid.     

Biomechanical evaluation of lift postures in adult Koli female labourers

Three lift-postures, back straight and knees bent, back bent and knees straight and squatting were evaluated biomechanically based on data from 100 Koli female labourers, when lifting loads from the floor to hold them at knee height. The maximum weight was lifted with the back bent and the knees straight which is a posture commonly used by Indian labourers for lifting a load. Squatting (a posture used by Indians for performing household chores) produced the least physical strain in terms of moment and moment ratio (moment per kilogramme of load lifted). Consequently, squatting was found to be the best posture for lifting a load, specifically for the Indian labourers who are accustomed to squatting when working.     

The effects of load knowledge on stresses at the lower back during lifting

This study investigated the effects of load uncertainty on the lifting characteristics of 40 male volunteers during the initial portion of a lift. Twenty subjects were experienced weightlifters while another 20 were subjects who had never lifted weights nor held a job that required them to on a regular basis. The subjects each lifted a container 20 × 45 × 40 cm, with handles, from floor to waist height 12 times with loads of 68, 10·2 or 13·6 kg. The loads were lifted under conditions of either havingor not having verbal and visual knowledge of the load magnitude prior to the lift. The subjects were allowed to perform the lift in a manner of their choosing. A 2 (groups) × 3 (loads) × 2 (load knowledge) ANOVA was performed on the data. Maximim force (F_max) value analysis revealed group and technique differences. The experienced lifters had lower stress levels at L4/L5 and utilized two technique strategies that were dependent upon the load knowledge condition, whereas the non-lifters used the same strategy for all lifts. Maximum moment values (M_max were significantly higher for the inexperienced lifters under all conditions, indicating a greater dependence on the low back musculature for initiating the lifting of a load.     

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.