Relationship between perceived exertion and mean power frequency of the EMG signal from the upper trapezius muscle during isometric shoulder elevation

The Impact of Physiological and Psychological Fatigue on Work Efficiency: A Case Study of Parcel Sorting Work

The popularity of online shopping in China has increased significantly, creating new development opportunities for the express delivery industry. However, the rapid expansion of the express industry has also created challenges in the parcel sorting process. The demanding nature of parcel sorting work, which is characterized by intense and prolonged repetitive tasks, makes individuals particularly vulnerable to the effects of fatigue. Fatigue is a complex condition that encompasses both physiological and psychological exhaustion. It often results in reduced energy levels and diminished functionality, significantly impacting an individual's performance at work and their overall well-being. This study aimed to investigate how physiological and psychological fatigue affects sorting efficiency and to identify appropriate rest periods that will allow employees to maintain their performance levels. The research involved fifteen participants who took part in a 60 min continuous sorting experiment and a similar experiment with scheduled breaks. During both trials, we collected data on participants' electromyography (EMG) and electrodermal activity (EDA), as well as subjective fatigue ratings (RPE). Signal features such as the median frequency (MF) of EMG and the skin conductance level (SCL) were analyzed to assess physiological and psychological fatigue, respectively. The results show that physiological fatigue mainly affects sorting efficiency in the first 30 min, while psychological fatigue becomes more influential in the following half-hour period. In addition, subjective fatigue levels during the first 30 min are primarily determined by psychological factors, while beyond that point, both physiological and psychological fatigue contribute to subjective fatigue. Rest periods of 415-460 s, based on EDA recovery times, effectively support sorting efficiency and participants' recovery. This study highlights the complex ways in which fatigue affects parcel sorting performance and provides valuable theoretical and practical insights for establishing labor quotas and optimizing work schedules in the parcel sorting industry.

Boys-men mean-power-frequency differences in progressive exercise to exhaustion, confounded by variability and adiposity

BACKGROUND

Only scant research has compared children's mean power frequency (MPF) to adults', with a clear overview still lacking. A significant obstacle has been MPF's high variability, which this study aimed to overcome by elucidating the MPF characteristics distinguishing boys from men in progressive exhaustive exercise.

METHODS

Electromyographic (EMG) data of 20 men (23.5 ± 2.5yrs) and 17 boys (10.2 ± 1.0 yrs), who performed progressively exhausting, intermittent isometric knee extensions, were subjected to secondary MPF analysis. Participants' vastus lateralis MPF data series were transformed to third-order polynomial regressions and expressed as percentages of the peak polynomial MPF values (%MPFpeak). The resulting curves were compared at 5-% time-to-exhaustion (TTE) intervals, using repeated-measures ANOVA. Raw MPFpeak values were adiposity corrected to 0% fat and used to convert the %MPFpeak data back to absolute MPF values (Hz) for estimating muscle-level MPF.

RESULTS

No overall interaction or group effects could be shown between the %MPFpeak plots, but pairwise comparisons revealed significantly higher men's values at 50-70%TTE and lower at 100%TTE, i.e. boys' shallower MPF rise and decline. The adiposity-corrected boys' and men's composite MPF values peaked at 125.7 ± 2.5 and 166.0 ± 2.4 Hz, respectively (110.7 ± 1.7 and 122.5 ± 2.1 Hz, uncorrected), with a significant group effect (p < 0.05) and pairwise differences at all %TTE points.

CONCLUSIONS

The boys were lower than the men in both the observed and, more so, in the adiposity-corrected MPF values that presumably estimate muscle-level MPF. The boys' shallower MPF rise and decline conform to children's claimed type-II motor-unit activation and/or compositional deficits and their related known advantage in muscular endurance.

Evaluation Methods and Measurement Challenges for Industrial Exoskeletons

In recent years, exoskeleton test methods for industrial exoskeletons have evolved to include simulated laboratory and field environments. Physiological, kinematic, and kinetic metrics, as well as subjective surveys, are used to evaluate exoskeleton usability. In particular, exoskeleton fit and usability can also impact the safety of exoskeletons and their effectiveness at reducing musculoskeletal injuries. This paper surveys the state of the art in measurement methods applied to exoskeleton evaluation. A notional classification of the metrics based on exoskeleton fit, task efficiency, comfort, mobility, and balance is proposed. In addition, the paper describes the test and measurement methods used in supporting the development of exoskeleton and exosuit evaluation methods to assess their fit, usability, and effectiveness in industrial tasks such as peg in hole, load align, and applied force. Finally, the paper includes a discussion of how the metrics can be applied towards a systematic evaluation of industrial exoskeletons, current measurement challenges, and future research directions.

Perceptions of fatigue and neuromuscular measures of performance fatigability during prolonged low-intensity elbow flexions

NEW FINDINGS

What is the central question of this study? What is the predictive relationship between self-reported scales to quantify perceptions of fatigue during exercise and gold standard measures used to quantify the development of neuromuscular fatigue? What is the main finding and its importance? No scale was determined to be substantively more effective than another. However, the number of ongoing contractions performed was shown to be a better predictor of fatigue in the motor system than any of the subjective scales.

ABSTRACT

The purpose of this study was to determine the relationship between transcranial magnetic stimulation (TMS) measures of performance fatigability and commonly used scales that quantify perceptions of fatigue during exercise. Twenty healthy participants (age 23 ± 3 years, 10 female) performed 10 submaximal isometric elbow flexions at 20% maximal voluntary contraction (MVC) for 2 min, separated by 45 s of rest. Biceps brachii muscle electromyography and elbow flexion torque responses to single-pulse TMS were obtained at the end of each contraction to assess central factors of performance fatigability. A rating of perceived exertion (RPE) scale, Omnibus Resistance scale, Likert scale, Rating of Fatigue scale and a visual analogue scale (VAS) were used to assess perceptions of fatigue at the end of each contraction. The RPE (root mean square error (RMSE) = 0.144) and Rating of Fatigue (RMSE = 0.145) scales were the best predictors of decline in MVC torque, whereas the Likert (RMSE= 0.266) and RPE (RMSE= 0.268) scales were the best predictors of electromyographic amplitude. Although the Likert (RMSE = 7.6) and Rating of Fatigue (RMSE = 7.6) scales were the best predictors of voluntary muscle activation of any scale, the number of contractions performed during the protocol was a better predictor (RMSE = 7.3). The ability of the scales to predict TMS measures of performance fatigability were in general similar. Interestingly, the number of contractions performed was a better predictor of TMS measures than the scales themselves.

Commonly Used Subjective Effort Scales May Not Predict Directly Measured Physical Workloads and Fatigue in Hispanic Farmworkers

In North America, Hispanic migrant farmworkers are being exposed to occupational ergonomic risks. Due to cultural differences in the perception and reporting of effort and pain, it was unknown whether standardized subjective ergonomic assessment tools could accurately estimate the directly measured their physical effort. This study investigated whether the subjective scales widely used in exercise physiology were associated with the direct measures of metabolic load and muscle fatigue in this population. Twenty-four migrant apple harvesters participated in this study. The Borg RPE in Spanish and the Omni RPE with pictures of tree-fruit harvesters were used for assessing overall effort at four time points during a full-day 8-h work shift. The Borg CR10 was used for assessing local discomfort at the shoulders. To determine whether there were associations between the subjective and direct measures of overall exertion measures, we conducted linear regressions of the percentage of heart rate reserve (% HRR) on the Borg RPE and Omni RPE. In terms of local discomfort, the median power frequency (MPF) of trapezius electromyography (EMG) was used for representing muscle fatigue. Then full-day measurements of muscle fatigue were regressed on the Borg CR10 changes from the beginning to the end of the work shift. The Omni RPE were found to be correlated with the % HRR. In addition, the Borg RPE were correlated to the % HRR after the break but not after the work. These scales might be useful for certain situations. In terms of local discomfort, the Borg CR10 were not correlated with the MPF of EMG and, therefore, could not replace direct measurement.

Variability of Time- and Frequency-Domain Surface Electromyographic Measures in Non-Fatigued Shoulder Muscles

OCCUPATIONAL APPLICATIONSLocalized Muscle Fatigue (LMF) can be monitored or predicted based on the relative change in the values of surface electromyography (sEMG) measures with respect to the "fresh" or no-fatigue condition. Quantification of LMF based on relative change, though, relies on the assumption that the sEMG measures recorded in a no-fatigue condition can serve as an appropriate reference. Results of this study indicate that sEMG measures in a no-fatigue condition are affected by various work-related factors and provide further guidance on the variability of commonly used time- and frequency-domain sEMG measures to assist the ergonomist in improving the accuracy of LMF assessment.

ANALYSIS OF INDUCED ISOMETRIC FATIGUING CONTRACTIONS IN BICEPS BRACHII MUSCLES USING MYOTONOMETRY AND SURFACE ELECTROMYOGRAPHIC MEASUREMENTS

Viscoelastic properties of skeletal muscle tissue are known to be impacted by fatiguing contractions. In this study, an attempt has been made to utilize myotonometry for analyzing the relationship between muscle viscoelasticity and contractile behaviors in a fatiguing task. For this purpose, thirteen young healthy volunteers are recruited to perform the fatiguing isometric task and the time to task failure (TTF) is recorded. Myotonometric parameters and simultaneous surface electromyographic (sEMG) signals are recorded from the Biceps Brachii muscle of the flexed arm. The correlation between myotonometric parameters and TTF is further analyzed. Cross-validation with sEMG features is also performed. Stiffness of muscle has a positive correlation with TTF in the left hand ([Formula: see text]). Damping property of the nonfatigued muscle is positively associated with the fatigue-induced changes in amplitude features of sEMG signal in the right hand ([Formula: see text]). The normalized rate of change of mean frequency of sEMG signal has a positive correlation with stiffness values in both of the hands ([Formula: see text]). Muscle viscoelasticity is demonstrated to influence the progression of fatigue, although the difference in motor control due to handedness is also found to be an important factor. The results are promising to improve the understanding of the effect of muscle mechanics in fatigue-induced task failure.

Convergent Validity of Ratings of Perceived Exertion During Resistance Exercise in Healthy Participants: A Systematic Review and Meta-Analysis

Background

The validity of ratings of perceived exertion (RPE) during aerobic training is well established; however, its validity during resistance exercise is less clear. This meta-analysis used the known relationships between RPE and exercise intensity (EI), heart rate (HR), blood lactate (BLa), blood pressure (BP) and electromyography (EMG) to determine the convergent validity of RPE as a measure of resistance exercise intensity and physiological exertion, during different forms of resistance exercise. Additionally, this study aims to assess the effect of several moderator variables on the strength of the validity coefficients, so that clearer guidance can be given on the use of RPE during resistance exercise.

Methods

An online search of 4 databases and websites (PubMed, Web of Science SPORTDiscus and ResearchGate) was conducted up to 28 February 2020. Additionally, the reference lists of the included articles were inspected manually for further unidentified studies. The inclusion criteria were healthy participants of any age, a rating scale used to measure RPE, resistance exercise of any type, one cohort receiving no other intervention, and must present data from one of the following outcome measures: EI, HR, BP, EMG or BLa. Weighted mean effect sizes (r) were calculated using a random-effects model. Heterogeneity was assessed using the τ² and I² statistics. Moderator analysis was conducted using random-effects meta-regression.

Results

One-hundred and eighteen studies were included in the qualitative synthesis, with 75 studies (99 unique cohorts) included in the meta-analysis. The overall weighted mean validity coefficient was large (0.88; 95% CI 0.84–0.91) and between studies heterogeneity was very large (τ² = 0.526, I² = 96.1%). Studies using greater workload ranges, isometric muscle actions, and those that manipulated workload or repetition time, showed the highest validity coefficients. Conversely, sex, age, training status, RPE scale used, and outcome measure no significant effect.

Conclusions

RPE provides a valid measure of exercise intensity and physiological exertion during resistance exercise, with effect sizes comparable to or greater than those shown during aerobic exercise. Therefore, RPE may provide an easily accessible means of prescribing and monitoring resistance exercise training.

Trial Registration The systematic review protocol was registered on the PROSPERO database (CRD42018102640).

Supplementary Information

The online version contains supplementary material available at 10.1186/s40798-021-00386-8.

Shoulder electromyography-based indicators to assess manifestation of muscle fatigue during laboratory-simulated manual handling task

Muscle fatigue is a risk factor for developing shoulder musculoskeletal disorders. The aim of this study was to identify shoulder electromyographic indicators that are most indicative of muscle fatigue during a laboratory simulated manual handling task. Thirty-two participants were equipped with electromyographic electrodes on 10 shoulder muscles and moved boxes for 45-minutes. The modified rate of perceived exertion (mRPE) was assessed every 5-minutes and multivariate linear regressions were performed between myoelectric manifestation of fatigue (MMF) and the mRPE scores. During a manual handling task representative of industry working conditions, spectral entropy, median frequency, and mobility were the electromyographic indicators that explained the largest percentage of the mRPE. Overall, the deltoids, biceps and upper trapezius were the muscles that most often showed significant changes over time in their electromyographic indicators. The combination of these three indicators may improve the accuracy for the assessment of MMF during manual handling. Practitioner Summary: To date, muscle fatigue has primarily been assessed during tasks done to exhaustion, which are not representative of typical working conditions. During a manual handling task representative of industry working conditions, EMG-derived spectral entropy, and median frequency, both extracted from time-frequency analysis, and mobility extracted from time domain, were the best indicators of the manifestation of muscle fatigue.

Relationship Between Tasked Vocal Effort Levels and Measures of Vocal Intensity

Purpose Patients with voice problems commonly report increased vocal effort, regardless of the underlying pathophysiology. Previous studies investigating vocal effort and voice production have used a range of methods to quantify vocal effort. The goals of the current study were to use the Borg CR100 effort scale to (a) demonstrate the relation between vocal intensity or vocal level (dB) and tasked vocal effort goals and (b) investigate the repeated measure reliability of vocal level at tasked effort level goals. Method Three types of speech (automatic, read, and structured spontaneous) were elicited at four vocal effort level goals on the Borg CR100 scale (2, 13, 25, and 50) from 20 participants (10 females and 10 males). Results Participants' vocal level reliably changed approximately 5 dB between the elicited effort level goals; this difference was statistically significant and repeatable. Biological females produced a voice with consistently less intensity for a vocal effort level goal compared to biological males. Conclusions The results indicate the utility of the Borg CR100 in tracking effort in voice production that is repeatable with respect to vocal level (dB). Future research will investigate other metrics of voice production with the goal of understanding the mechanisms underlying vocal effort and the external environmental influences on the perception of vocal effort.

Effects of Vertical Lifting Distance on Upper-Body Muscle Fatigue

Manual material handling (MMH) is commonly demanded in the manufacturing industry. Occupational muscle fatigue of the arm, shoulder, and back, which arise from MMH tasks, can cause work absences and low efficiency. The available literature presents the lack of the fatigue comparison between targeted muscles, on the same part or on different parts. The main aim of the present study was to evaluate and compare the fatigue of upper-body muscles during repetitive bending tasks, an experiment involving 12 male subjects has been conducted to simulate material handling during furniture board drilling. The vertical lifting distance was chosen to be the single independent variable, and the three levels were 0, 250, and 500 mm. Surface electromyography (sEMG) was used to measure the muscle fatigue of the biceps brachii, upper trapezius, and multifidus, while the sEMG parameters, including the normalized electromyographic amplitude (Normalized EA) and mean power frequency (MPF), of the target muscles were analyzed. The experimental results reveal that during the manual handling tasks, the biceps brachii was the most relaxed muscle, contributing the least muscle tension, while the multifidus was the most easily fatigued muscle. Furthermore, the EMG MPF fatigue threshold (MPFFT) of multifidus muscle tension was tested to estimate its maximum workload in the long-term muscle contraction. In conclusion, bending angle should be maintained to a small range or bending should even be avoided during material-handling tasks.

Electromyographic Evaluation of the Shoulder Muscle after a Fatiguing Isokinetic Protocol in Recreational Overhead Athletes

The goal of our study was to examine the muscle activity of the shoulder girdle after isokinetic fatigue, which may simulate muscle activities commonly occurring during specific sport-related activities in recreational overhead asymptomatic athletes. We hypothesized that exercise-induced fatigue, reported after isokinetic protocols, may cause a decrease in the median frequency (MF) of the upper trapezius (UT), infraspinatus (IS), and deltoid muscles. Twenty-four male overhead volleyball (n = 8), handball (n = 8), and tennis (n = 8) athletes participated in this study. All subjects were without shoulder injury history. The surface electromyography (SEMG) was collected on the right (dominant) side of the shoulder girdle muscles in the following order: UT, IS and anterior (DA), and posterior deltoideus (DP). The fatigue protocol consisted of three sets of 32 maximum isokinetic concentric contractions while performing shoulder internal and external rotation at an isokinetic speed of 120 o/s. The resultant difference in median frequency (ΔMF) values consistently dropped after the fatiguing tasks across all recorded muscles, in terms of the initial MF (MFINI = 65.1 ± 1.1 Hz) and final MF (MFFIN = 57.9 ± 0.9 Hz), and the main effect of time was significant (F(1,22) = 43.15, p < 0.001). MF values decreased mostly for IS (ΔMFIS = -9.9 ± 1.6 Hz) and DP (ΔMFPD = -9.5 ± 1.9 Hz) muscles, while DA and UT showed smaller changes (ΔMFDA = -6.9 ± 1.5 Hz) and (ΔMFUT = -3.2 ± 1.3 Hz). The results of our study show a meaningful contribution in determining increased fatigue of the shoulder girdle muscles during repeated isokinetic internal-external rotation protocols. We have also demonstrated a significant decrease in MF in all examined muscles, especially IS and DA.

Validity of different EMG analysis methods to identify aerobic and anaerobic thresholds in speed skaters

PURPOSE

This study aimed to assess the validity of the first (EMGth1) and second (EMGth2) breakpoints in the EMG signal during skating.

SCOPE

Ten well-trained long track speed skaters performed a maximal incremental skating test on a slide board. EMG signals from six lower limb muscles were recorded during the last 15 s of each stage and converted to Root Mean Square for determination EMGth1 and EMGth2 using mathematical (2 and 3 linear regressions) and visual methods.

CONCLUSIONS

EMGth1 had a low detection rate (<50%) while EMGth2 could be identified visually in > 80% of cases, in 85% of cases using 2-lines and 63% using 3-lines regression. Quads (VL + VM) and Gluts (GM + GMd) had the highest EMGth2 detection rate for all methods (>70%). EMGth2 from Quads and Gluts detected by the 2-lines and 3-lines regression were not different than the second ventilatory threshold (VT2) (p > 0.05), while the visual method overestimated VT2 (p < 0.01). EMGth2 detected from Quads by the 2-lines regression method presented better correlation with VT2 stage (r = 0.91), lowest bias, and limit of agreement. We conclude that EMG is a valid non-invasive method to detect VT2 during skating when using a mathematical method to determine EMGth2.

Active recovery has a positive and acute effect on recovery from fatigue induced by repeated maximal voluntary contractions of the plantar flexors

This study investigated the acute effect of active recovery (AR) following fatigue induced by 80 three-second maximal voluntary isometric plantar flexion contractions (MVICs) in 12 young men. AR consisted of a total of 180 voluntary isometric ramp contractions of the plantar flexors (0.75-s contraction/relaxation) targeting 10% of MVIC torque. MVIC torque, voluntary activation and root mean square values of electromyographic signals for the triceps surae normalized by each peak-to-peak amplitude of compound motor action potential were determined before, and immediately, 10, 20 and 30 min after the fatiguing task. Evoked torques were similarly assessed except for immediately after it. The AR and passive recovery were randomly performed on two days by each participant between 5 min and 10 min after the fatiguing task. For all the parameters other than MVIC torque, there was no significant difference between the conditions at any time point. MVIC torque decreased significantly immediately after the fatiguing task regardless of condition (P < 0.05), and the corresponding decrease in MVIC torque recovered 30 min after the fatiguing task only in AR (P < 0.05). These results suggest an acute positive effect of AR on recovery of neuromuscular function and/or contractile properties after fatigue.

Changes in movement variability and task performance during a fatiguing repetitive pointing task

Changes in neuromuscular strategies employed with fatigue during multi-joint movements are still poorly understood. Studies have shown that motor variability of individual joints increases when performing upper limb tasks to fatigue, while movement parameters related to the task goal remain constant. However, how the inter-limb coordination and its variability change during specific movement phases with fatigue is still unclear. The aim of this study was to assess the effects of neck-shoulder fatigue on shoulder and elbow kinematic variabilities, shoulder-elbow coordination and its variability, and endpoint characteristics during different phases of a forward pointing movement. Nineteen healthy young adults continuously performed a repetitive pointing task until fatigue (Borg rating of 8/10). Changes in elbow-shoulder coordination through the movement were assessed using the continuous relative phase and statistical nonparametric mapping methods. At the end of the task, muscle fatigue was evidenced by significant increases in anterior deltoid (+13%) and biceps brachii (+30%) activity. Shoulder horizontal abduction, elbow flexion variability and shoulder-elbow coordination variability were increased with fatigue at different moments of the movement cycle (shoulder: during the first 17% and most of the second half movement, elbow: from 73% to 91%, coordination: almost the whole movement). However, movement timing errors and endpoint spatial variability were mostly preserved, even with fatigue. We showed that increased variability with fatigue is not only observed in the fatigued joint (shoulder), but also in the elbow and shoulder-elbow coordination, and may have a goal of preserving global task performance.

Assessment of Whole Body and Local Muscle Fatigue Using Electromyography and a Perceived Exertion Scale for Squat Lifting

This research study aims at addressing the paradigm of whole body fatigue and local muscle fatigue detection for squat lifting. For this purpose, a comparison was made between perceived exertion with the heart rate and normalized mean power frequency (NMPF) of eight major muscles. The sample consisted of 25 healthy males (age: 30 ± 2.2 years). Borg’s CR-10 scale was used for perceived exertion for two segments of the body (lower and upper) and the whole body. The lower extremity of the body was observed to be dominant compared to the upper and whole body in perceived response. First mode of principal component analysis (PCA) was obtained through the covariance matrix for the eight muscles for 25 subjects for NMPF of eight muscles. The diagonal entries in the covariance matrix were observed for each muscle. The muscle with the highest absolute magnitude was observed across all the 25 subjects. The medial deltoid and the rectus femoris muscles were observed to have the highest frequency for each PCA across 25 subjects. The rectus femoris, having the highest counts in all subjects, validated that the lower extremity dominates the sense of whole body fatigue during squat lifting. The findings revealed that it is significant to take into account the relation between perceived and measured effort that can help prevent musculoskeletal disorders in repetitive occupational tasks.

Perceived exertion during muscle fatigue as reflected in movement-related cortical potentials: an event-related potential study

The aim of this study was to explore the mechanism on perceived exertion during muscle fatigue. A total of 15 individuals in the fatigue group and 13 individuals in the nonfatigue group were recruited into this study, performing 200 intermittent handgrip contractions with 30% maximal voluntary contraction. The force, surface electromyography (sEMG), movement-related cortical potentials (MRCPs), and rating perception of effort (RPE) were combined to evaluate the perceived exertion during muscle fatigue. The maximal handgrip force significantly decreased (P<0.01), the root mean square of sEMG over each block significantly increased (P<0.01), and SD of force at plateau increased (P<0.01) during muscle fatigue. The RPE scores reported by the individuals and the motor potential amplitude of MRCPs in the fatigue group significantly increased (P<0.001). However, as for the individuals in the nonfatigue group, the other indexes showed no significant changes except for a little increase in the RPE. The within-subject correlation coefficients showed that there were significant correlations between RPE and motor potential amplitude of MRCPs at the C1 site (r=-0.609, P<0.001) and between RPE and root mean square of sEMG (r=0.541, P<0.001). Our results substantiate that the perceived exertion correlates with the central motor command during movement execution rather than the preparatory process. The perceived exertion not only reflects central fatigue but could also reflect the peripheral local muscle fatigue.

Analysis of comfort and ergonomics for clinical work environments

Work related musculoskeletal disorders (WMSD) are a serious risk to workers' health in any work environment, and especially in clinical work places. These disorders are typically the result of prolonged exposure to non-ergonomic postures and the resulting discomfort in the workplace. Thus a continuous assessment of comfort and ergonomics is necessary. There are different techniques available to make such assessments, such as self-reports on perceived discomfort and observational scoring models based on the posture's relevant joint angles. These methods are popular in medical and industrial environments alike. However, there are uncertainties with regards to objectivity of these methods and whether they provide a full picture. This paper reports on a study about these methods and how they correlate with the activity of muscles involved in the task at hand. A wearable 4-channel electromyography (EMG) and joint angle estimation device with wireless transmission was made specifically for this study to allow continuous, long-term and real-time measurements and recording of activities. N=10 participants took part in an experiment involving a buzz-wire test at 3 different levels, with their muscle activity (EMG), joint angle scores (Rapid Upper Limb Assessment - RULA), self-reports of perceived discomfort (Borg scale) and performance score on the buzz-wire being recorded and compared. Results show that the Borg scale is not responsive to smaller changes in discomfort whereas RULA and EMG can be used to detect more detailed changes in discomfort, effort and ergonomics.

Motor unit firing frequency of lower limb muscles during an incremental slide board skating test

This study investigated how the combination of workload and fatigue affected the frequency components of muscle activation and possible recruitment priority of motor units during skating to exhaustion. Ten male competitive speed skaters performed an incremental maximal test on a slide board. Activation of six muscles from the right leg was recorded throughout the test. A time-frequency analysis was performed to compute overall, high, and low frequency bands from the whole signal at 10, 40, 70, and 90% of total test time. Overall activation increased for all muscles throughout the test (p < 0.05 and ES > 0.80). There was an increase in low frequency (90 vs. 10%, p = 0.035, ES = 1.06) and a decrease in high frequency (90 vs. 10%, p = 0.009, ES = 1.38, and 90 vs. 40%, p = 0.025, ES = 1.12) components of gluteus maximus. Strong correlations were found between the maximal cadence and vastus lateralis, gluteus maximus and gluteus medius activation at the end of the test. In conclusion, the incremental skating test lead to an increase in activation of lower limb muscles, but only gluteus maximus was sensitive to changes in frequency components, probably caused by a pronounced fatigue.

Impact of task design on task performance and injury risk: case study of a simulated drilling task

Existing evidence is limited regarding the influence of task design on performance and ergonomic risk, or the association between these two outcomes. In a controlled experiment, we constructed a mock fuselage to simulate a drilling task common in aircraft manufacturing, and examined the effect of three levels of workstation adjustability on performance as measured by productivity (e.g. fuselage completion time) and quality (e.g. fuselage defective holes), and ergonomic risk as quantified using two common methods (rapid upper limb assessment and the strain index). The primary finding was that both productivity and quality significantly improved with increased adjustability, yet this occurred only when that adjustability succeeded in reducing ergonomic risk. Supporting the inverse association between ergonomic risk and performance, the condition with highest adjustability created the lowest ergonomic risk and the best performance while there was not a substantial difference in ergonomic risk between the other two conditions, in which performance was also comparable. Practitioner Summary: Findings of this study supported a causal relationship between task design and both ergonomic risk and performance, and that ergonomic risk and performance are inversely associated. While future work is needed under more realistic conditions and a broader population, these results may be useful for task (re)design and to help cost-justify some ergonomic interventions.

Investigation of Fatigability during Repetitive Robot-Mediated Arm Training in People with Multiple Sclerosis

BACKGROUND

People with multiple sclerosis (MS) are encouraged to engage in exercise programs but an increased experience of fatigue may impede sustained participation in training sessions. A high number of movements is, however, needed for obtaining optimal improvements after rehabilitation.

METHODS

This cross-sectional study investigated whether people with MS show abnormal fatigability during a robot-mediated upper limb movement trial. Sixteen people with MS and sixteen healthy controls performed five times three minutes of repetitive shoulder anteflexion movements. Movement performance, maximal strength, subjective upper limb fatigue and surface electromyography (median frequency and root mean square of the amplitude of the electromyography (EMG) signal of the anterior deltoid) were recorded during or in-between these exercises. After fifteen minutes of rest, one extra movement bout was performed to investigate how rest influences performance.

RESULTS

A fifteen minutes upper limb movement protocol increased the perceived upper limb fatigue and induced muscle fatigue, given a decline in maximal anteflexion strength and changes of both the amplitude and the median frequency of EMG the anterior deltoid. In contrast, performance during the 3 minutes of anteflexion movements did not decline. There was no relation between changes in subjective fatigue and the changes in the amplitude and the median frequency of the anterior deltoid muscle, however, there was a correlation between the changes in subjective fatigue and changes in strength in people with MS. People with MS with upper limb weakness report more fatigue due to the repetitive movements, than people with MS with normal upper limb strength, who are comparable to healthy controls. The weak group could, however, keep up performance during the 15 minutes of repetitive movements.

DISCUSSION AND CONCLUSION

Albeit a protocol of repetitive shoulder anteflexion movements did not elicit a performance decline, fatigue feelings clearly increased in both healthy controls and people with MS, with the largest increase in people with MS with upper limb weakness. Objective fatigability was present in both groups with a decline in the muscle strength and increase of muscle fatigue, shown by changes in the EMG parameters. However, although weak people with multiple sclerosis experienced more fatigue, the objective signs of fatigability were less obvious in weak people with MS, perhaps because this subgroup has central limiting factors, which influence performance from the start of the movements.

Effects of task precision demands on behavioral and physiological changes during a repetitive asymmetric lifting activity

OBJECTIVE

This study investigated the effects of task precision demands on behavioral and physiological changes during repetitive asymmetric lifting.

BACKGROUND

Repetitive lifting encountered in manual material handling leads to muscle fatigue and is a documented risk factor for low back disorder.

METHOD

A total of 17 healthy volunteers performed repetitive asymmetric lifting for 60 min (10 lifts/min). Task precision demands were imposed by varying the entry width onto the destination conveyor. Physiological changes were assessed using near-infrared spectroscopy obtained from the erector spinae muscles. Three-dimensional spine kinematics and moment responses were quantified to understand behavioral changes during the lifting activity.

RESULTS

Task precision demands showed no effect on erector spinae muscle oxygenation levels. Behavioral changes associated with repetitive lifting included increases in the overall lift duration, peak forward bending motion, and three-dimensional movement velocities of the spine, along with a decrease in the lateral bending moment. Relative to low precision demands, high precision demands resulted in 20% longer placement periods, which, in turn, resulted in a 12% increase in the time-integrated twisting postures and a 10% increase in the time-integrated lateral bending moments during load placement.

CONCLUSION

The elevated risk of low back injury when lifting under greater precision demands is likely due to the sustained spine twisting and the sustained lateral bending moment on the spine in the final phase of these lifts.

APPLICATION

Understanding behavioral changes to repetitive asymmetric lifting, especially for tasks requiring greater precision can be used to support injury prevention efforts.

Exploring the effects of seated whole body vibration exposure on repetitive asymmetric lifting tasks

This study investigated changes in the physiological and behavioral responses to repetitive asymmetric lifting activity after exposure to whole body vibrations. Seventeen healthy volunteers repeatedly lifted a box (15% of lifter's capacity) positioned in front of them at ankle level to a location on their left side at waist level at the rate of 10 lifts/min for a period of 60 minutes. Prior to lifting, participants were seated on a vibrating platform for 60 minutes; in one of the two sessions the platform did not vibrate. Overall, the physiological responses assessed using near-infrared spectroscopy signals for the erector spinae muscles decreased significantly over time during the seating and the lifting tasks (p < 0.001). During repetitive asymmetric lifting, behavioral changes included increases in peak forward bending motion, twisting movement, and three-dimensional movement velocities of the spine. The lateral bending movement of the spine and the duration of each lift decreased significantly over the 60 minutes of repetitive lifting. With exposure to whole body vibration, participants twisted farther (p = 0.046) and twisted faster (p = 0.025). These behavioral changes would suggest an increase in back injury risk when repetitive lifting tasks are preceded by whole body vibration exposure.

Physiological and biomechanical responses to a prolonged repetitive asymmetric lifting activity

This study investigated the effects of a prolonged repetitive asymmetric lifting task on behavioural adaptations during repetitive lifting activity, measures of tissue oxygenation and spine kinematics. Seventeen volunteers repeatedly lifted a box, normalised to 15% of the participant's maximum lifting strength, at the rate of 10 lifts/min for a period of 60 min. The lifts originated in front of the participants at ankle level and terminated on their left side at waist level. Overall, perceived workload increased during the repetitive lifting task. Erector spinae oxygenation levels, assessed using near-infrared spectroscopy, decreased significantly over time. Behavioural changes observed during the repetitive lifting task included increases in the amount of forward bending, the extension velocity and the lateral bending velocity, and a reduced lateral bending moment on the spine. These changes, with the exception of the reduced lateral bending moment, are associated with increased risk of low back disorder.

Muscle fatigue in fibromyalgia is in the brain, not in the muscles: a case-control study of perceived versus objective muscle fatigue

OBJECTIVE

To investigate relationships between perceived and objectively measured muscle fatigue during exhausting muscle contractions in women with fibromyalgia (FM) compared with healthy controls (HC).

METHODS

Women with FM and HC completed an isometric muscle exhaustion task at 90° shoulder abduction. Surface electromyographic (EMG) activity in the deltoid muscle was recorded together with self-reported level of muscle fatigue.

RESULTS

25 participants with FM and 23 HC were included. Average time to exhaustion was 254 s shorter in participants with FM than in HC. Participants with FM did not exhibit the same level of objective signs of muscle fatigue, seen as fewer changes in the EMG activity, as the HC during the exhaustion task. The task did not provoke pain in the HC, while participants with FM reported a doubling of pain.

CONCLUSIONS

Women with FM had shorter exhaustion times and showed fewer objective signs of muscle fatigue during an exhausting isometric shoulder abduction compared with younger HC. This indicates that perceived muscle fatigue may be of central origin and supports the notion of central nervous dysfunction as basic pathological changes in FM.

The neurophysiology of central and peripheral fatigue during sub-maximal lower limb isometric contractions

Fatigue has been defined as an exercise-induced decline in force generation capacity because of changes at both the peripheral and central levels. Movement is preceded and accompanied by brain activities related to the preparation and execution of movement (movement related cortical potentials, MRCP), which have been correlated with the perception of effort (RPE). We combined force measurements, surface electromyography (sEMG), peripheral electrical stimulation (maximal twitch, MT) and MRCP analysis to further our understanding of the neural correlates of peripheral and central changes during a fatiguing task involving the lower limbs. Eighteen healthy volunteers performed 4 blocks of isometric knee extensions at 40% of the maximal voluntary contraction (MVC) for a total of 240 2-s contractions. At the baseline and after each block, we measured RPE, MT and MVC. We simultaneously recorded the force of the knee extensor muscles, root mean square (RMS) of the sEMG of the vastus lateralis muscle, and electroencephalography (EEG) from 64 channels. The MRCPs were extracted from the EEG recordings and averaged in the early (Block 1-2) and late (Block 3-4) blocks. Two cohorts were obtained by cluster analysis based on the RPE (i.e., perception of effort) and MT (i.e., peripheral fatigue). We observed a significant decline in both the MVC (-13%) and RMS (-25%) of the sEMG signal over the course of the task; thus, muscle fatigue had occurred in all of the participants regardless of the cohort. The MRCP amplitude was larger in the fatigued than the non-fatigued MT cohort in the supplementary and premotor areas, whereas the MRCP amplitude was larger in the fatigued than the non-fatigued RPE cohort in the aforementioned areas, and also in the primary motor and prefrontal cortices (PFC). The increase in the positive activity of the PFC, along with the perception of effort, represents a novel result, suggesting that it is modulated more by the perception of effort than peripheral fatigue.

Endurance and fatigue characteristics of the neck flexor and extensor muscles during isometric tests in patients with postural neck pain

Sustained postural loading of the cervical spine during work or recreational tasks may contribute to the development of neck pain. The aim of this study was to compare neck muscle endurance and fatigue characteristics during sub-maximal isometric endurance tests in patients with postural neck pain, with asymptomatic subjects. Thirteen female patients with postural neck pain and 12 asymptomatic female control subjects completed timed sub-maximal muscle endurance tests for the neck flexor and extensor muscles. Muscle fatigue, defined as the time-dependent decrease in median frequency electromyography (EMG), was examined using surface EMG analysis during the tests. The median extensor test holding time was lower but not significantly different in the neck pain group (165 s) that the control group (228 s) (p = 0.17). There was no difference between groups in the flexor test holding time (neck pain = 36 s, controls = 38 s) (p = 0.96). The neck pain group was characterised by greater variability in neck flexor (p = 0.03) and extensor (p = 0.006) muscle endurance. For both tests, the rate of decrease in median frequency EMG was highly variable within and between groups with no significant difference between groups for the flexor or extensor test (p = 0.05-0.82). Patients with postural neck pain did not have significant impairment of neck muscle endurance or accelerated fatigue compared to control subjects. However, the greater variability in these indices of muscle function may reflect patient-specific changes in muscle function associated with neck pain disorder.

The specificity of fatiguing protocols affects scapular orientation: Implications for subacromial impingement

BACKGROUND

shoulder impairments are often associated with altered scapular kinematics. As muscles control scapular movement, functionally altering muscle performance through fatigue may produce scapular kinematics that mimic those of injured patients. The aim of this study was to examine if changes in scapular tilt, rotation and pro/retraction following two different upper extremity fatiguing protocols have any implications with respect to subacromial impingement.

METHODS

scapular orientation was monitored during posturally constrained static holds (at 0°, 45° and 90° of humeral elevation) before and after two fatiguing protocols, one global and one local. Both protocols are associated with producing changes in shoulder skeletal arrangement.

FINDINGS

following the global fatiguing protocol, there was significantly more scapular posterior tilt (P<0.01) and upward rotation (P<0.02), particularly at 90° humeral elevation. No changes in scapular orientation occurred following the local fatiguing protocol.

INTERPRETATION

scapular orientation changes following muscle fatigue acted to increase the subacromial space. Thus, the rotator cuff muscles, not the scapular stabilizers, have more influence on actively preventing mechanical subacromial impingement. The lack of evidence of reduction of the subacromial space thus implicates superior humeral head translation as a more likely primary mechanism of the initiation of subacromial impingement.

Superior humeral head migration occurs after a protocol designed to fatigue the rotator cuff: a radiographic analysis

HYPOTHESIS

Awkward postures and repetitive work have been suggested to lead to shoulder fatigue, which may in turn decrease the subacromial space. The aim of this study was to quantify changes in humeral head position relative to the glenoid after rotator cuff fatigue. We hypothesized that the humeral head would migrate superiorly with fatigue due to the inability of the rotator cuff muscles to balance the upward pull of the deltoid.

MATERIALS AND METHODS

Four anterior-posterior radiographs (at 0°, 45°, 90°, and 135° of elevation in the scapular plane) of the glenohumeral joint were taken before and after a fatiguing task. The fatiguing task was a simulated job task intended to exhaust the entire rotator cuff.

RESULTS

The position of the humeral head with respect to the glenoid cavity was significantly affected both by arm elevation angle and fatigue state. In the prefatigued state, increasing arm elevation angle was related to superior translation until 90°, after which the humeral head moved inferiorly to a more central position. In the postfatigued state, the inability of the rotator cuff to centralize the humeral head led to increasing translations with higher elevations.

DISCUSSION

Superior humeral head migration was associated with the fatigued state. This implies that overhead or repetitive work, or both, may accelerate the development of subacromial impingement through reduction of the subacromial space.

CONCLUSIONS

Continuous overhead work demonstrably created rotator cuff fatigue, which apparently inhibited the ability of the shoulder musculature to resist upward humeral translation.

Scapula kinematic alterations following a modified push-up plus task

Scapular kinematic and muscle activity alterations have been identified in individuals with subacromial impingement syndrome of the shoulder, including workers and athletes who regularly perform overhead activities. Serratus anterior fatigue is a proposed mechanism for these kinematic alterations, although no direct evidence supports such a relationship. The purpose of this study was to examine three-dimensional scapula kinematics in asymptomatic participants before and after a task intended to preferentially fatigue serratus anterior. Twenty-eight participants completed the study. The experimental task consisted of five repetitions of scapular plane arm elevation and the fatigue task was the isometric hold of scapular protraction in the push-up position. Electromyography of four shoulder muscles was collected during the task to determine level of muscle fatigue, and the Borg CR10 scale was used to assess subjective fatigue. The fatigue task resulted in decreased median power frequency in all four muscles and significantly increased Borg scores. Scapula posterior tilting and internal rotation were most impacted by muscle fatigue, with decreased posterior tilting and increased internal rotation after the task. There was no effect on scapular upward rotation. Effect sizes were low to moderate (.13-.51) where these kinematic alterations reached statistical significance. Shoulder muscle fatigue contributes to scapular kinematic alterations and is a plausible risk factor for subacromial impingement syndrome.

Assessment of force and fatigue in isometric contractions of the upper trapezius muscle by surface EMG signal and perceived exertion scale

Quantifying muscle force and fatigue is important in designing ergonomic work stations, in planning appropriate work-rest patterns, and in preventing/assessing the progress of disorders. In 14 subjects (seven males, seven females), muscle force and fatigue were estimated by subjective perception (based on Borg scale CR10) and objective indexes extracted from surface electromyogram (EMG). The experimental protocol consisted of an isometric task selective for the upper trapezius muscle at different force levels (10-80% of maximal voluntary contraction--MVC, in steps of 10%MVC) and one fatiguing contraction (constant force level at 50%MVC until exhaustion). Surface EMG signals were detected by a two-dimensional (2D) array of electrodes placed half way between C7 and the acromion. The following variables were calculated from EMG signals: muscle fibre conduction velocity (CV), root mean square value (RMS), mean frequency of the power spectrum (MNF), fractal dimension (FD), and entropy. All detected signals were also used to build topographical maps of RMS. Both subjective and objective indications of force and fatigue can provide information on exerted force and endurance time (ET). In particular, Borg ratings, RMS, and entropy were significantly related to force, and the rate of change of CV, MNF, FD, and Borg ratings were predictive of the endurance time. Moreover, significant differences were found in Borg ratings between males and females. The correlation coefficient of pairs of topographical maps of RMS was high (of the order of 0.8). This reflects a characteristic spatial-temporal recruitment of upper trapezius motor units that is not affected by force levels or fatigue.

Characteristics of power spectrum density function of EMG during muscle contraction below 30%MVC

The aim of the study was to quantify changes in PSDF frequency bands of the EMG signal and EMG parameters such as MF, MPF and zero crossing, with an increase in the level of muscle contractions in the range from 0.5% to 30% RMS(max) and to determine the frequency bands with the lowest dependency on RMS level so that this could be used in investigating muscle fatigue. Sixteen men, aged from 23 to 33 years old (mean 26.1), who participated in the study performed two force exertion tests. Fragments of EMG which corresponded to the levels of muscle contraction of 0.5%, 1%, 2.5%, 5%, 10%, 15%, 20%, 25%, 30% RMS(max) registered from left and right trapezius pars descendents (TP) and left and right extensor digitorum superficialis (ED) muscles were selected for analysis. The analysis included changes in standard parameters of the EMG signal and changes in PSDF frequency bands, which occurred across muscle contraction levels. To analyze changes in PSDF across the level of muscle contraction, the spectrum was divided into six frequency bandwidths. The analysis of parameters focused on the differences in those parameters between the analyzed muscles, at different levels of muscle contraction. The study revealed that, at muscle contraction levels below 5% RMSmax, contraction level influences standard parameters of the EMG signal and that at such levels of muscle contraction every change in muscle contraction level (recruitment of additional MUs) is reflected in PSDF. The frequency band with the lowest dependency on contraction level was 76-140 Hz for which in both muscles no contraction level effect was detected for contraction levels above 5% RMS(max). The reproducibility of the results was very high, since the observations in of the left and right muscles were almost equal. The other factor, which strongly influences PSDF of the EMG signal, is probably the examined muscle structure (muscle morphology, size, function, subcutaneous layer, cross talk). It seems that low frequency bands up to 25 Hz are especially feasible for type of muscle.

EMG amplitude and frequency parameters of muscular activity: effect of resistance training based on electromyographic fatigue threshold

The present study aimed to evaluate the effect of a resistance training program based on the electromyographic fatigue threshold (EMG(FT), defined as the highest exercise intensity performed without EMG alterations), on the EMG amplitude (root mean square, RMS) and frequency (median frequency, MF) values for biceps brachii (BB), brachioradialis (BR), triceps brachii (TB) and multifidus (MT). Twenty healthy male subjects, (training group [TG], n=10; control group [CG], n=10), firstly performed isometric contractions, and after this, dynamic biceps curl at four different loads to determine the EMG(FT). The TG training program used the BB EMG(FT) value (8 weeks, 2 sessions/week, 3 exhaustive bouts/session, 2 min rest between bouts). No significant differences were found for the isometric force after the training. The linear regression slopes of the RMS with time during the biceps curl presented significant decrease after training for the BB, BR and TB muscles. For the MT muscle, the slope and MF intercept values changed with training. The training program based on the EMG(FT) influenced EMG the amplitude more than EMG frequency, possibly related to the recruitment patterns of the muscles, although the trunk extensor muscles presented changes in the frequency parameter, showing adaptation to the training program.

Fatigue-induced changes of impedance and performance in target tracking

Kinematic variability is caused, in part, by force fluctuations. It has been shown empirically and numerically that the effects of force fluctuations on kinematics can be suppressed by increasing joint impedance. Given that force variability increases with muscular fatigue, we hypothesized that joint impedance would increase with fatigue to retain a prescribed accuracy level. To test this hypothesis, subjects tracked a target by elbow flexion and extension both with fatigued and unfatigued elbow flexor and extensor muscles. Joint impedance was estimated from controlled perturbations to the elbow. Contrary to the hypothesis, elbow impedance decreased, whereas performance, expressed as the time-on-target, was unaffected by fatigue. Further analysis of the data revealed that subjects changed their control strategy with increasing fatigue. Although their overall kinematic variability increased, task performance was retained by staying closer to the center of the target when fatigued. In conclusion, the present study reveals a limitation of impedance modulation in the control of movement variability.