Manifestations of shoulder fatigue in prolonged activities involving low-force contractions

Respiratory Inductance Plethysmography to Assess Fatigability during Repetitive Work

Cumulative fatigue during repetitive work is associated with occupational risk and productivity reduction. Usually, subjective measures or muscle activity are used for a cumulative evaluation; however, Industry 4.0 wearables allow overcoming the challenges observed in those methods. Thus, the aim of this study is to analyze alterations in respiratory inductance plethysmography (RIP) to measure the asynchrony between thorax and abdomen walls during repetitive work and its relationship with local fatigue. A total of 22 healthy participants (age: 27.0 ± 8.3 yrs; height: 1.72 ± 0.09 m; mass: 63.4 ± 12.9 kg) were recruited to perform a task that includes grabbing, moving, and placing a box in an upper and lower shelf. This task was repeated for 10 min in three trials with a fatigue protocol between them. Significant main effects were found from Baseline trial to the Fatigue trials (p < 0.001) for both RIP correlation and phase synchrony. Similar results were found for the activation amplitude of agonist muscle (p < 0.001), and to the muscle acting mainly as a joint stabilizer (p < 0.001). The latter showed a significant effect in predicting both RIP correlation and phase synchronization. Both RIP correlation and phase synchronization can be used for an overall fatigue assessment during repetitive work.

The role of at home workstation ergonomics and gender on musculoskeletal pain

BACKGROUND

The recent mandate for university faculty and staff to work-from-home (WFH) during the COVID-19 pandemic has forced employees to work with sub-optimal ergonomic workstations that may change their musculoskeletal discomfort and pain. As women report more work-related musculoskeletal discomfort (WMSD), this effect may be exacerbated in women.

OBJECTIVE

The purpose of this study was to describe university employee at-home office workstations, and explore if at-home workstation design mediates the effect of gender on musculoskeletal pain.

METHODS

University employees completed a survey that focused on the WFH environment, at home workstation design and musculoskeletal pain. Descriptive statistics and regression analysis were used to analyze the responses.

RESULTS

61% of respondents reported an increase in musculoskeletal pain, with the neck, shoulders and lower back being reported most frequently. Women reported significantly greater musculoskeletal pain, but this relationship was significantly mediated by poor ergonomic design of the home workstation. Improper seat-height and monitor distance were statistically associated with total-body WMSD.

CONCLUSIONS

WFH has worsened employee musculoskeletal health and the ergonomic gap between women and men in the workspace has persisted in the WFH environment, with seat height and monitor distance being identified as significant predictors of discomfort/pain.

Fatigue, Stress, and Performance during Alternating Physical and Cognitive Tasks-Effects of the Temporal Pattern of Alternations

In occupational life, performing cognitive work tasks in between fatiguing physical work tasks may allow recovery and reduce stress without losing productive working time. The temporal pattern of such alternations is likely a determinant of the recovery effect, influencing both stress and fatigue; the difficulty of the cognitive task (CT) would also be a likely determinant. The aim of this study was to determine to what extent the temporal pattern of alternations between a repetitive physical task and a CT of different difficulties influenced perceived fatigability, performance fatigability, stress-related outcomes, and performance. Fifteen women performed four work sessions comprising 110 min of repeated bouts of a repetitive physical task (pipetting), alternating with a CT (n-back). Sessions differed in bout cycle time (short: 7 + 3 min versus long: 14 + 6 min) and CT difficulty (CTdiff; easy versus difficult). Fatigue was assessed from recordings of maximal voluntary contraction force in shoulder elevations and handgrip pre- and post-work, electromyography (EMG) from the right trapezius and right forearm extensors during work, and repeated self-ratings of fatigue and pain throughout the session. Stress was assessed using electrocardiography (heart rate variability), salivary alpha-amylase, and self-reports. Perceived fatigue increased significantly over time for all protocols and more in long-cycle than short-cycle conditions. EMG activity did not increase markedly over time in any condition. Neither objective nor subjective indicators suggested that stress increased over time, regardless of the temporal pattern. Pipetting performance remained stable in all conditions. Cognitive performance, measured by the proportions of correct positive and false positive answers, differed between CTdiff levels but remained stable over time, with no significant difference between temporal patterns. In summary, temporal patterns of alternating tasks influenced fatigue to some extent but had no obvious influence on stress indicators or performance. Thus, designing job rotation with alternating physical and cognitive work should consider the temporal patterns of alternations to minimize fatigue.

Sex Differences in Rotator Cuff Muscles' Response to Various Work-Related Factors

Occupational ApplicationsDespite the frequency and cost of rotator cuff injuries among male and female workers, very little is known about the strength, endurance, and perceived exertion and electromyographic response of rotator cuff muscles to different exertion levels. In this study, sex differences were studied using muscle-specific maximal and submaximal exertions of the supraspinatus, infraspinatus, and teres minor muscles. Females showed lower strength and endurance, but higher muscle activity and perceived exertion compared to males. The baseline data presented in this paper can assist ergonomic practitioners in determining the worker capacity to ensure that physically-demanding shoulder exertions can be performed without incurring injurious stress. Such data is also essential to establish population norms for the better design of workplace tasks.

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.

Consistent individual motor variability traits demonstrated by females performing a long-cycle assembly task under conditions differing in temporal organisation

Research suggests an association between motor variability (MV) during repetitive work and work-related musculoskeletal disorders (MSDs). However, whether MV is a consistent individual trait, even across working conditions or tasks, remains unknown. This study assessed whether individual MV traits were consistent during complex work performed under different temporal conditions. Fifteen women performed cyclic assembly under four conditions differing in pace and organisation (line-type, batch-type). MV of trapezius muscle activity and upper arm elevation was quantified and partitioned into variance components. For all MV metrics, a non-zero between-subjects variance was found, indicating consistent individual MV traits across conditions. Variance between subjects was higher for electromyography (EMG) MV metrics compared with kinematic metrics. Our results showed individuals exhibited consistent MV traits across working conditions differing in pace and production process. Further research is needed to understand whether MV is an individual predictive factor for MSD onset or progression.

Wearable Monitoring Devices for Biomechanical Risk Assessment at Work: Current Status and Future Challenges-A Systematic Review

Background: In order to reduce the risk of work-related musculoskeletal disorders (WMSDs) several methods have been developed, accepted by the international literature and used in the workplace. The purpose of this systematic review was to describe recent implementations of wearable sensors for quantitative instrumental-based biomechanical risk assessments in prevention of WMSDs. Methods: Articles written until 7 May 2018 were selected from PubMed, Scopus, Google Scholar and Web of Science using specific keywords. Results: Instrumental approaches based on inertial measurement units and sEMG sensors have been used for direct evaluations to classify lifting tasks into low and high risk categories. Wearable sensors have also been used for direct instrumental evaluations in handling of low loads at high frequency activities by using the local myoelectric manifestation of muscle fatigue estimation. In the field of the rating of standard methods, on-body wireless sensors network-based approaches for real-time ergonomic assessment in industrial manufacturing have been proposed. Conclusions: Few studies foresee the use of wearable technologies for biomechanical risk assessment although the requirement to obtain increasingly quantitative evaluations, the recent miniaturization process and the need to follow a constantly evolving manual handling scenario is prompting their use.

A machine learning approach to detect changes in gait parameters following a fatiguing occupational task

The purpose of this study is to provide a method for classifying non-fatigued vs. fatigued states following manual material handling. A method of template matching pattern recognition for feature extraction ($1 Recognizer) along with the support vector machine model for classification were applied on the kinematics of gait cycles segmented by our stepwise search-based segmentation algorithm. A single inertial measurement unit on the ankle was used, providing a minimally intrusive and inexpensive tool for monitoring. The classifier distinguished between states using distance-based scores from the recogniser and the step duration. The results of fatigue detection showed an accuracy of 90% across data from 20 recruited subjects. This method utilises the minimum amount of data and features from only one low-cost sensor to reliably classify the state of fatigue induced by a realistic manufacturing task using a simple machine learning algorithm that can be extended to real-time fatigue monitoring as a future technology to be employed in the manufacturing facilities. Practitioner Summary: We examined the use of a wearable sensor for the detection of fatigue-related changes in gait based on a simulated manual material handling task. Classification based on foot acceleration and position trajectories resulted in 90% accuracy. This method provides a practical framework for predicting realistic levels of fatigue.

Determining Changes in Electromyography Indices when Measuring Maximum Acceptable Weight of Lift in Iranian Male Students

BACKGROUND

In spite of the increasing degree of automation in industry, manual material handling (MMH) is still performed in many occupational settings. The aim of the current study was to determine the maximum acceptable weight of lift using psychophysical and electromyography indices.

METHODS

This experimental study was conducted among 15 male students recruited from Tehran University of Medical Sciences. Each participant performed 18 different lifting tasks which involved three lifting frequencies, three lifting heights and two box sizes. Each set of experiments was conducted during the 20 min work period using free-style lifting technique and subjective as well as objective assessment methodologies. SPSS version 18 software was used for descriptive and analytical analyses by Friedman, Wilcoxon and Spearman correlation techniques.

RESULTS

The results demonstrated that muscle activity increased with increasing frequency, height of lift and box size (P<0.05). Meanwhile, MAWLs obtained in this study are lower than those in Snook table (P<0.05). In this study, the level of muscle activity in percent MVC in relation to the erector spine muscles in L3 and T9 regions as well as left and right abdominal external oblique muscles were at 38.89%, 27.78%, 11.11% and 5.55% in terms of muscle activity is more than 70% MVC, respectively. The results of Wilcoxon test revealed that for both small and large boxes under all conditions, significant differences were detected between the beginning and end of the test values for MPF of erector spine in L3 and T9 regions, and left and right abdominal external oblique muscles (P<0.05). The results of Spearman correlation test showed that there was a significant relation between the MAWL, RMS and MPF of the muscles in all test conditions (P<0.05).

CONCLUSION

Based on the results of this study, it was concluded if muscle activity is more than 70% of MVC, the values of Snook tables should be revisited. Furthermore, the biomechanical perspective should receive special attention in determining the standards for MMH.

Can exposure variation be promoted in the shoulder girdle muscles by modifying work pace and inserting pauses during simulated assembly work?

This study investigated the acute effects of changing the work pace and implementing two pause types during an assembly task. Eighteen healthy women performed a simulated task in four different conditions: 1) slow or 2) fast work pace with 3) passive or 4) active pauses every two minutes. The root mean square (RMS) and exposure variation analysis (EVA) from the trapezius and serratus anterior muscles, as well as the rate of perceived exertion (RPE) from the neck-shoulder region, were observed. Decreased RMS and RPE as well as more variable muscle activity (EVA) were observed in the slow work pace compared with the fast one. The pause types had a limited effect, but active pauses resulted in increased RMS of the clavicular trapezius. The findings revealed the importance of work pace in the reduction of perceived exertion and promotion of variation in muscle activation during assembly tasks. However, the pause types had no important effect on the evaluated outcomes.

A data-driven approach to modeling physical fatigue in the workplace using wearable sensors

Wearable sensors are currently being used to manage fatigue in professional athletics, transportation and mining industries. In manufacturing, physical fatigue is a challenging ergonomic/safety "issue" since it lowers productivity and increases the incidence of accidents. Therefore, physical fatigue must be managed. There are two main goals for this study. First, we examine the use of wearable sensors to detect physical fatigue occurrence in simulated manufacturing tasks. The second goal is to estimate the physical fatigue level over time. In order to achieve these goals, sensory data were recorded for eight healthy participants. Penalized logistic and multiple linear regression models were used for physical fatigue detection and level estimation, respectively. Important features from the five sensors locations were selected using Least Absolute Shrinkage and Selection Operator (LASSO), a popular variable selection methodology. The results show that the LASSO model performed well for both physical fatigue detection and modeling. The modeling approach is not participant and/or workload regime specific and thus can be adopted for other applications.

Myoelectric manifestation of muscle fatigue in repetitive work detected by means of miniaturized sEMG sensors

Upper limb work-related musculoskeletal disorders have a 12-month prevalence ranging from 12 to 41% worldwide and can be partly caused by handling low loads at high frequency. The association between the myoelectric manifestation of elbow flexor muscle fatigue and occupational physical demand has never been investigated. It was hypothesized that an elbow flexor muscle fatigue index could be a valid risk indicator in handling low loads at high frequency. This study aims to measure the myoelectric manifestation of muscle fatigue of the three elbow flexor muscles during the execution of the work tasks in different risk conditions. Fifteen right-handed healthy adults were screened using a movement analysis laboratory consisting of optoelectronic, dynamometer and surface electromyographic systems. The main result indicates that the fatigue index calculated from the brachioradialis is sensitive to the interaction among risk classes, session and gender, and above all it is sensitive to the risk classes.

Relationship Between BMI and Fatigability Is Task Dependent

OBJECTIVE

The objective of the current study was to determine the effect of body mass index (BMI) on fatigability of three different muscle groups at four different work intensities.

METHODS

Forty-nine normal-weight, 50 overweight, and 43 obese adults (32.1 ± 9.2 years; 50% males) performed fatiguing handgrip, shoulder flexion, and trunk extension exertions at 20%, 40%, 60%, and 80% of the associated maximum voluntary contractions.

RESULTS

Obese adults demonstrated 22% to 30% shorter endurance times than normal-weight adults, but this was only observed at lower intensities and with larger and more postural muscles of the shoulder and low back. Strength and fatigue-related strength loss remained comparable across BMI groups in both males and females in these task-specific conditions. Obesity was associated with faster progression in perception of effort at low-intensity shoulder and trunk exertions. While males were stronger than females across all muscle groups, females exhibited greater shoulder fatigue resistance than males at lower intensity levels.

CONCLUSION

Findings indicate that the relationship between obesity and fatigability is task dependent.

APPLICATION

These findings provide initial evidence on the impact of obesity on worker capacity. Future work that extends the current investigation to include more occupationally relevant scenarios are needed to facilitate occupational task (re)design and assessment practices, such that altered work capacities of two-thirds of the working population are accommodated.

Sensitivity, reliability and the effects of diurnal variation on a test battery of field usable upper limb fatigue measures

Fatigue has been linked to deficits in production quality and productivity and, if of long duration, work-related musculoskeletal disorders. It may thus be a useful risk indicator and design and evaluation tool. However, there is limited information on the test-retest reliability, the sensitivity and the effects of diurnal fluctuation on field usable fatigue measures. This study reports on an evaluation of 11 measurement tools and their 14 parameters. Eight measures were found to have test-retest ICC values greater than 0.8. Four measures were particularly responsive during an intermittent fatiguing condition. However, two responsive measures demonstrated rhythmic behaviour, with significant time effects from 08:00 to mid-afternoon and early evening. Action tremor, muscle mechanomyography and perceived fatigue were found to be most reliable and most responsive; but additional analytical considerations might be required when interpreting daylong responses of MMG and action tremor. Practitioner Summary: This paper presents findings from test-retest and daylong reliability and responsiveness evaluations of 11 fatigue measures. This paper suggests that action tremor, muscle mechanomyography and perceived fatigue were most reliable and most responsive. However, mechanomyography and action tremor may be susceptible to diurnal changes.

Responsive upper limb and cognitive fatigue measures during light precision work: an 8-hour simulated micro-pipetting study

Many contemporary occupations are characterised by long periods of low loads. These lower force levels, which are relevant to the development of work-related musculoskeletal disorders, are usually not the focus of fatigue studies. In studies that did measure fatigue in light manual or precision work, within and between measurement responses were inconsistent. The aim of this study was to identify fatigue measures that were responsive at lower force levels (<10% MVC) over the course of an 8-h period. A complementary set of fatigue measures, reflecting both neuromuscular and cognitive mechanisms, was measured during a light precision micro-pipetting task performed by 11 participants. Nine measures were found to be significantly responsive over the 8-h period, including: ratings of perceived fatigue, postural tremor, blink frequency and critical flicker fusion frequency threshold. Common field measures, specifically electromyography RMS amplitude and maximum voluntary contractions, did not lead to extraordinary time effects. Practitioner summary: The findings provide insight towards the responsiveness of a complementary set of field usable fatigue measures at low work intensities Although commonly used measures did not reveal significant increases in fatigue, nine alternative measures were significantly responsive over the 8-h period.

Trapezius muscle activity and body movement at the beginning and the end of a workday and during the lunch period in female office employees

The aim of this study was to analyze the activity of the trapezius muscle and the arm acceleration during the course of a workday in office employees. It was examined if there are significant changes in trapezius muscle activity in the afternoon compared to the morning work period and relationships to the level of arm acceleration during lunchtime. Nineteen female office employees were recruited. A one hour period of the work in the morning, afternoon, and lunchtime were compared. The measures of the trapezius muscle activity and muscle rest time (TR) did not significantly differ between working in the morning (TR: median 10%; range 1%-49) or working in the afternoon (TR: median 18%; range 2%-34%). The 90^th percentile of arm acceleration during lunch time significantly correlated with less trapezius muscle activity in the afternoon compared to the morning values (RT: Spearman R=0.80; p<0.01). Differences in the duration and level of trapezius muscle activity were bigger between the subjects than between different work periods or between lunchtime and work. Furthermore it seems that higher arm accelerations during lunch may be beneficial in reducing trapezius activity in the afternoon compared to the morning values.

Differences in the activation and co-activation ratios of the four subdivisions of trapezius between genders following a computer typing task

The aim of this study was to provide a description of gender differences of the activation patterns of the four subdivisions of the trapezius (clavicular, upper, middle, lower) following a 60min computer work task. Surface EMG was collected from these subdivisions from 21 healthy subjects during bilateral arm elevation pre-/post- task. Subjects completed a standardized 60min computer work task at a standard, ergonomic workstation. Normalized activation and activation ratios of each trapezius subdivision were compared between genders and condition with repeated measures ANOVAs. The interaction effect of Gender×Condition for upper trapezius% activation approached significance at p=0.051with males demonstrating greater activation post-task. The main effect of Condition was statistically significant for% activation of middle and lower trapezius (p<0.05), with both muscles demonstrating increase activation post-task. There was a statistically significant interaction effect of Gender×Condition for the Middle Trapezius/Upper Trapezius ratio and main effect of Condition for the Clavicular Trapezius/Upper Trapezius ratio, with a decreased ratio post-typing. Gender differences exist following 60min of a low force computer typing task. Imbalances in muscle activation and activation ratios following computer work may affect total shoulder kinematics and should be further explored.

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.

The effects of obesity, age, and relative workload levels on handgrip endurance

The purpose of the study was to examine obesity and age effects on handgrip endurance across a range of relative workload levels. Forty-five non-obese and obese younger and older females performed fatiguing handgrip exercises at 20, 40, 60, and 80% of relative handgrip strength. The younger obese group demonstrated ∼7% greater strength, 32% shorter endurance times, and ∼34% faster rate of strength loss, accompanied by heightened perception of effort, than the younger non-obese group. However, these obesity-related differences were not observed in the older age group. Moreover, there were no interactions between relative workload levels, obesity, and age on any of the fatigue measures. Findings obtained here suggest that work-rest schedules computed from existing force endurance prediction models may not be protective of the younger obese working population.

Difference in Motor Fatigue between Patients with Stroke and Patients with Multiple Sclerosis: A Pilot Study

Fatigue is often reported in stroke patients. However, it is still unclear if fatigue in stroke patients is more prominent, more frequent or more "typical" than in patients with multiple sclerosis (MS) and if the pathophysiology differs between these two populations. The purpose of this study was to compare motor fatigue and fatigue-induced changes in kinematic gait parameters between stroke patients, MS patients, and healthy persons. Gait parameters at the beginning and end of a treadmill walking test were assessed in 10 stroke patients, 40 MS patients, and 20 healthy subjects. The recently developed Fatigue index Kliniken Schmieder (FKS) based on change of the movement's attractor and its variability was used to measure motor fatigue. Six stroke patients had a pathological FKS. The FKS (indicating the level of motor fatigue) in stroke patients was similar compared to MS patients. Stroke patients had smaller step length, step height and greater step width, circumduction with the right and left leg, and greater sway compared to the other groups at the beginning and at the end of test. A severe walking impairment in stroke patients does not necessarily cause a pathological FKS indicating motor fatigue. Moreover, the FKS can be used as a measure of motor fatigue in stroke and MS and may also be applicable to other diseases.

Effect of Treatment Table Height on Shoulder Muscles during Ultrasound Therapy Work

[Purpose] The purpose of this study was to propose a table height that can reduce shoulder muscle fatigue by analyzing and comparing median frequencies of shoulder muscles at different table heights when performing therapeutic ultrasounds work. [Subjects and Methods] The subjects were 63 healthy male adults who were equally and randomly assigned to a standard height group (SHG), a high height group (HHG), and a low height group (LHG). The standard table height was set at the level of the elbow joint when the subjects flexed their elbow while in a sitting position. High height and low height were set 10 cm higher and 10 cm lower, respectively, than the standard height. Muscle fatigue of the upper trapezius, middle deltoid, rhomboid, and infraspinatus of the subjects was measured during ultrasound treatment work at each table height. [Results] Median frequencies of the upper trapezius, middle deltoid, rhomboid, and infraspinatus muscles were significantly lower in the HHG than in to the LHG. [Conclusion] When therapeutic ultrasound is performed using a table that has a height lower than that of the elbow joint, the median frequency of the shoulder muscle increases, hence decreasing muscle fatigue. This way, musculoskeletal pain as a result of performing therapeutic ultrasound can be prevented.

Influences of Obesity on Job Demands and Worker Capacity

Evidence suggests that the growing prevalence of obesity in the workforce has resulted in an increase in the incidence and cost of musculoskeletal injuries. Obesity can modify job demands and affect worker capacity in terms of anthropometry and occupational biomechanics, which may place workers at greater risk of injury. This paper presents a review of studies quantifying the work-relevant impacts of obesity, specifically related to work task demands, capacities, and their potential imbalance. The increased body fat that accompanies obesity leads to larger anthropometric dimensions and inertial parameters, particularly in the trunk and thigh areas. Consequently, individuals who are obese adjust their work postures and motions as an accommodation. These changes may affect the biomechanical demands on the joints and increase the burden on the musculoskeletal system. Independent of job demands, obesity-related differences also occur with respect to strength, fatigue, and task performance. Directions for future research are provided, focusing on the need for workplace redesign to account for changing workforce demographics.

Shoulder muscle fatigue development in young and older female adults during a repetitive manual task

Age may modify the association between occupational physical demand and muscle loading, and ultimately increase the risk of musculoskeletal disorders. The goal of this study was to investigate age-related differences in shoulder muscle fatigue development during a repetitive manual task. Twenty participants in two age groups completed an 80-minute simulated low-intensity assembly task. Electromyographic (EMG) manifestation of muscle fatigue was observed in the upper trapezius, deltoid and infraspinatus muscles in both age groups, and coincided with an increase in the subjective ratings of perceived exertions. Compared with the younger group, older group showed a more monotonic decrease in EMG power frequency in the upper trapezius and deltoid muscles. However, the age-related difference in EMG amplitude was less consistent. Relative rest time of the upper trapezius muscle in the older group was less than the young group throughout the task. The observed patterns of EMG measures suggest that older participants may have disadvantages in fatigue resistance in the upper trapezius and posterior deltoid muscles during the simulated repetitive manual task.

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.

The influences of obesity and age on functional performance during intermittent upper extremity tasks

In this study, the main and interactive effects of obesity and age on functional performance were assessed during intermittent exertions involving the upper extremity. The prevalence of obesity has doubled over the past 30 years and this increase is associated with higher health care costs, rates of workplace injury, and lost workdays. Obesity and aging can modify job demands and affect worker capacity in terms of muscular and psychomotor function. However, there is a lack of empirical studies quantifying the work-relevant (or ergonomic) impacts related to task demands, capacities, and their potential imbalance. Eight obese and eight non-obese participants from each of two age groups (18-25 and 50-65 years) completed three endurance tasks involving fixed levels of task demands: hand grip, shoulder flexion, and a simulated assembly task using the upper extremity. Measures of functional performance including endurance, discomfort, motor control, and task performance were recorded for each of the task conditions. Endurance times were ∼60% longer for the non-obese group, and older participants had longer endurance times; however there was no evidence of interactive effects of obesity and age. Obesity also impaired functional performance, as indicated by higher rates of strength loss, increases in discomfort, and declines in task performance. These observed impairments may reflect underlying physiological differences among individuals who are obese, but that are independent of age. Obesity-related impairments may have implications for the design of work duration and demand level to prevent fatigue development for workers who are obese.

Shoulder muscle fatigue during repetitive tasks as measured by electromyography and near-infrared spectroscopy

OBJECTIVE

The objective of this study was to quantify shoulder muscle fatigue during repetitive exertions similar to motions found in automobile assembly tasks.

BACKGROUND

Shoulder musculoskeletal disorders (MSDs) are a common and costly problem in automotive manufacturing.

METHOD

Ten subjects participated in the study. There were three independent variables: shoulder angle, frequency, and force. There were two types of dependent measures: percentage change in near-infrared spectroscopy (NIRS) measures and change in electromyography (EMG) median frequency. The anterior deltoid and trapezius muscles were measured for both NIRS and EMG. Also, EMG was collected on the middle deltoid and biceps muscles.

RESULTS

The results showed that oxygenated hemoglobin decreased significantly due to the main effects (shoulder angle, frequency, and force). The percentage change in oxygenated hemoglobin had a significant interaction attributable to force and repetition for the anterior deltoid muscle, indicating that as repetition increased, the magnitude of the differences between the forces increased. The interaction of repetition and shoulder angle was also significant for the percentage change in oxygenated hemoglobin. The median frequency decreased significantly for the main effects; however, no interactions were statistically significant.

CONCLUSIONS

There was significant shoulder muscle fatigue as a function of shoulder angle, task frequency, and force level. Furthermore, percentage change in oxygenated hemoglobin had two statistically significant interactions, enhancing our understanding of these risk factors.

APPLICATION

Ergonomists should examine interactions of force and repetition as well as shoulder angle and repetition when evaluating the risk of shoulder MSDs.

Obesity-related differences in muscular capacity during sustained isometric exertions

Over one-third of the world adult population is overweight or obese, and the prevalence continues to increase. Obesity is a risk factor for injury, and the growing prevalence may be associated with increases in the future incidence and cost of injuries. In this study, we examined obesity-related differences in muscular capacity during sustained isometric exertions involving hand grip, shoulder flexion, and trunk extension. Thirty-six young individuals who were obese or not obese (aged 18-29) completed these exertions at fixed levels of absolute loads involving low-moderate levels of effort. Individuals who were obese had an overall ∼20% higher absolute strength, but ∼20% lower relative strength. These differences were most evident in the hand grip and shoulder exertions. Parameters of fitted exponential relationships between endurance time and task demands (as a percentage of strength) were similar in both groups. Perceptual and performance responses were also consistent between groups. Accordingly, we conclude that obesity may not substantially influence muscular capacity for these tasks.

Motor variability in occupational health and performance

Several recent reviews have reported that 'repetitive movements' constitute a risk factor for occupational musculoskeletal disorders in the neck, shoulder and arm regions. More variation in biomechanical exposure is often suggested as an effective intervention in such settings. Since increasing variation using extrinsic methods like job rotation may not always be possible in an industrial context, the intrinsic variability of the motor system may offer an alternative opportunity to increase variation. Motor variability refers to the natural variation in postures, movements and muscle activity observed to different extents in all tasks. The current review discusses research appearing in motor control, sports sciences and occupational biomechanics literature to answer whether motor variability is important to consider in an occupational context, and if yes, whether it can be manipulated by training the worker or changing the working conditions so as to increase biomechanical variation without jeopardizing production. The review concludes that motor variability is, indeed, a relevant issue in occupational health and performance and suggests a number of key issues for further research.

Force, frequency and gripping alter upper extremity muscle activity during a cyclic push task

Factors, such as high repetition, high force and gripping play a role in the development of upper extremity work-related musculoskeletal disorders. The purpose of this study was to systematically examine the effects of push load and frequency on muscle activity with and without concurrent gripping. A total of 10 men and 10 women performed a cyclic bimanual pushing task. All combinations of three push loads (1 kg, 2 kg, 4 kg), three frequencies (4/min, 8/min, 16/min) and two grip conditions (no required grip and 30% of maximum grip force) were performed in randomised order. The muscle activity of the upper arm and shoulder complex reflected both frequency and load, often with significant interactions, thus may be better described by workload, the product of force and frequency. In the forearm, muscle activities were generally low but adding a submaximal grip superseded the effects of push load, with the activity reflecting frequency and grip.

PRACTITIONER SUMMARY

Force and frequency are important risk factors for upper extremity disorders. We found that upper extremity muscle activity responds to workload (force × frequency) in a complex way which may be superseded if a grip is present. This electromyographic study provides physiological insights to muscular loading as basis for a variety of workplace disorders.

Variation of force amplitude and its effects on local fatigue

Trends in industry are leaning toward stereotyped jobs with low workloads. Physical variation is an intervention to reduce fatigue and potentially musculoskeletal disorders in such jobs. Controlled laboratory studies have provided some insight into the effectiveness of physical variation, but very few have been devoted to force variation without muscular rest as a component. This study was undertaken to determine multiple physiological responses to five isometric elbow extension protocols with the same mean amplitude (15% maximum voluntary contraction, MVC), cycle time (6 s), and duty cycle (50 %). Sustained (15 %Sus) and intermittent contractions including zero force (0-30 %Int) differed significantly in 19 of 27 response variables. Contractions varying by half the mean force (7.5-22.5 %Int) led to 8 and 7 measured responses that were significantly different from 0-30 %Int and 15 %Sus, respectively. A sinusoidal condition (0-30 %Sine) resulted in 2 variables that were significantly different from 0-30 %Int, and 16 different from 15 %Sus. Finally, ten response variables suggested that varying forces with 1 % as the lower contraction level was significantly less fatiguing than 15 %Sus, while no responses were significantly different from 0-30 %Int. Sustained contractions led to decreased twitch force 24-h post-exercise, whereas recovery was complete within 60 min after intermittent contractions. This suggests that time-varying force may be a useful intervention to reduce local fatigue in workers performing low-load tasks, and also that rest per se did not seem to cause any extraordinary effects beyond those predictable from the force variation amplitude.

The effect of work pace on workload, motor variability and fatigue during simulated light assembly work

This study investigated the effect of work pace on workload, motor variability and fatigue during light assembly work. Upper extremity kinematics and electromyography (EMG) were obtained on a cycle-to-cycle basis for eight participants during two conditions, corresponding to "normal" and "high" work pace according to a predetermined time system for engineering. Indicators of fatigue, pain sensitivity and performance were recorded before, during and after the task. The level and variability of muscle activity did not differ according to work pace, and manifestations of muscle fatigue or changed pain sensitivity were not observed. In the high work pace, however, participants moved more efficiently, they showed more variability in wrist speed and acceleration, but they also made more errors. These results suggest that an increased work pace, within the range addressed here, will not have any substantial adverse effects on acute motor performance and fatigue in light, cyclic assembly work. STATEMENT OF RELEVANCE: In the manufacturing industry, work pace is a key issue in production system design and hence of interest to ergonomists as well as engineers. In this laboratory study, increasing the work pace did not show adverse effects in terms of biomechanical exposures and muscle fatigue, but it did lead to more errors. For the industrial engineer, this observation suggests that an increase in work pace might diminish production quality, even without any noticeable fatigue being experienced by the operators.