Muscle fatigue and fatigue-related biomechanical changes during a cyclic lifting task

Effect of muscular fatigue on the cumulative lumbar damage during repetitive lifting task: a comparative study of damage calculation methods

Several methods have been put forward to quantify cumulative loads; however, limited evidence exists as to the subsequent damages and the role of muscular fatigue. The present study assessed whether muscular fatigue could affect cumulative damage imposed on the L5-S1 joint. Trunk muscle electromyographic (EMG) activities and kinematics/kinetics of 18 healthy male individuals were evaluated during a simulated repetitive lifting task. A traditional EMG-assisted model of the lumbar spine was modified to account for the effect of erector spinae fatigue. L5-S1 compressive loads for each lifting cycle were estimated based on varying (i.e. actual), fatigue-modified, and constant Gain factors. The corresponding damages were integrated to calculate the cumulative damage. Moreover, the damage calculated for one lifting cycle was multiplied by the lifting frequency, as the traditional approach. Compressive loads and the damages obtained through the fatigue-modified model were predicted in close agreement with the actual values. Similarly, the difference between actual damages and those driven by the traditional approach was not statistically significant (p = 0.219). However, damages based on a constant Gain factor were significantly greater than those based on the actual (p = 0.012), fatigue-modified (p = 0.017), and traditional (p = 0.007) approaches.Practitioner summary: In this study, we managed to include the effect of muscular fatigue on cumulative lumbar damage calculations. Including the effect of muscular fatigue leads to an accurate estimation of cumulative damages while eliminating computational complexity. However, using the traditional approach also appears to provide acceptable estimates for ergonomic assessments.

Exploring Optimal Objective Function Weightings to Predict Lifting Postures Under Unfatigued and Fatigued States

OBJECTIVE

To explore whether the optimal objective function weightings change when using a digital human model (DHM) to predict origin and destination lifting postures under unfatigued and fatigued states.

BACKGROUND

The ability to predict human postures can depend on state-based influences (e.g., fatigue). Altering objective function weightings within a predictive DHM could improve the ability to predict tasks specific lifting postures under unique fatigue states.

METHOD

A multi-objective optimization-based DHM was used to predict origin and destination lifting postures for ten anthropometrically scaled avatars by using different objective functions weighting combinations. Predicted and measured postures were compared to determine the root mean squared error. A response surface methodology was used to identify the optimal objective function weightings, which was found by generating the posture that minimized error between measured and predicted lifting postures. The resultant weightings were compared to determine if the optimal objective function weightings changed for different lifting postures or fatigue states.

RESULTS

Discomfort and total joint torque weightings were affected by posture (origin/destination) and fatigue state (unfatigued/fatigued); however, post-hoc differences between fatigue states and lifting postures were not sufficiently large to be detected. Weighting the discomfort objective function alone tended to predict postures that generalized well to both postures and fatigue states.

CONCLUSION

Lift postures were optimal predicted using the minimization of discomfort objective function regardless of fatigue state.

APPLICATION

Weighting the discomfort objective can predict unfatigued postures, but more research is needed to understand the optimal objective function weightings to predict postures during a fatigued state.

Effect of strengthening and weakening of abdominal and dorsal muscles on lumbar spine loads in parents of disabled children

Pain in the lower part of the back is one of the most common chronic illnesses globally. This work aimed to determine the impact of the reinforcement of particular groups of abdominal and dorsal muscles on the loads exerted on the lumbar section of the spine in 30 mothers of children with motor disabilities. An optical Ariel Performance Analysis System recorded and processed the kinematics data of everyday activities. Tests investigating the effects of the strengthening or weakening of abdominal and dorsal muscles on loading in the lumbar section of the spine utilized the AnyBody Modelling System. Input data for the simulations included mean values of body positions, while the effects of strengthening or weakening of muscles were simulated in the muscle forces model by introducing different values for muscle physiological cross-sectional area (PCSA). Simulations used decreasing or increasing PCSA values of abdominal muscles and the erector spinae. The analysis involved component and resultant force values on the lumbosacral joint (L5-S1) of the spine and intra-abdominal pressure values. The highest reduction of the resultant reaction value in L5-S1 was observed in the simulations that increased the PCSA of the transverse abdominal (TrA). Indeed, a double increase in the TrA cross-section caused a reduction of the resultant reaction in L5-S1 by 30% and the anterior-posterior and proximal-distal forces by approximately 20-30%. Increased PCSA of the erector spinae exerted higher loads on the spine. These results indicate that strengthening weakened abdominal muscles, particularly TrA, in parents of children with motor disabilities reduces lower spinal loads during daily activities.

Fatigue task-dependent effect on spatial distribution of lumbar muscles activity

This study aims to identify how spatial distribution of lumbar muscle activity is modulated by different fatigue tasks. Twenty healthy adults performed two different isometric trunk extension endurance tasks (the modified Sorensen test and the inverted modified Sorensen test) until exhaustion. During these tasks, bilateral superficial lumbar muscle activity was recorded using high-density electromyography. The spatial distribution of activation within these muscles was obtained using the centroid coordinates in the medio-lateral and cranio-caudal directions. The effects of task and endurance time (left and right sides) were investigated using repeated measures ANOVA. Results revealed a significant lateral shift of the centroid throughout the fatigue tasks on both sides and no difference between tasks. Significant task × time interaction effects were found for the cranio-caudal direction on both sides showing a significantly more caudal location of the centroid in the modified Sorensen test compared to the inverted test at the beginning of the tasks. Our findings suggest that spatial distribution of lumbar muscle activity is task-dependent in a pre-fatigue stage while an alternative but similar muscle recruitment strategy is used in both tasks to maintain performance in the later stages of muscle fatigue.

The effect of prolonged walking on leg muscle activity patterns and vulnerability to perturbations

Understanding the consequences and ecological relevance of muscle fatigue is important to guide the development of strategies to preserve independence. However, few studies have examined walking-related fatigue and the effects on walking instability. Our purpose was to investigate the effects of prolonged walking on leg muscle activity and vulnerability to balance perturbations. Eighteen healthy young adults completed a 30-min walking trial at their preferred walking speed while leg muscle activities were recorded. Before and after the 30-min walk, participants responded to five 5% body weight lateral force perturbations. Time-frequency analysis with wavelet transformation and principal component analyses assessed neuromuscular adaptations of muscles to prolonged walking. Following prolonged walking, we observed a time-dependent increase in EMG intensities at slower frequencies for the soleus and tibialis anterior and a decrease in mean amplitudes for the soleus, lateral gastrocnemius, and semitendinosus. Mean mediolateral CoM displacement following perturbations averaged 21% larger after the 30-min walk. Our results suggest that walking for 30 min at a comfortable speed elicits complex neuromuscular adaptations indicative of local muscle fatigue and an increased vulnerability to walking balance perturbations. These findings could inform fatigue monitoring systems or walking assistive devices aimed at reducing walking-related fatigue and maintaining independent mobility.

The effect of back muscle fatigue on EMG and kinematics based estimation of low-back loads and active moments during manual lifting tasks

This study investigated the effects of back muscle fatigue on the estimation of low-back loads and active low-back moments during lifting, using an EMG and kinematics based model calibrated with data from an unfatigued state. Fourteen participants performed lifting tasks in unfatigued and fatigued states. Fatigue was induced through semi-static forward bending. EMG, kinematics, and ground reaction forces were measured, and low-back loads were estimated using inverse dynamics and EMG-driven muscle model. A regression model was developed using data from a set of calibration lifts, and its accuracy was evaluated for unfatigued and fatigued lifts. During the fatigue-inducing task, the EMG amplitude increased by 2.8 %MVC, representing a 38% increase relative to the initial value. However, during the fatigued lifts, the peak EMG amplitude was found to be 1.6 %MVC higher than that observed during the unfatigued lifts, representing a mere 4% increase relative to the baseline unfatigued peak EMG amplitude. Kinematics and low-back load estimates remained unaffected. Regression model estimation errors remained unaffected for 5 kg lifts, but increased by no more than 5% of the peak active low-back moment for 15 kg lifts. We conclude that the regression-based estimation quality of active low-back moments can be maintained during periods of muscle fatigue, although errors may slightly increase for heavier loads.

Data-Driven Approach for Upper Limb Fatigue Estimation Based on Wearable Sensors

Muscle fatigue is defined as a reduced ability to maintain maximal strength during voluntary contraction. It is associated with musculoskeletal disorders that affect workers performing repetitive activities, affecting their performance and well-being. Although electromyography remains the gold standard for measuring muscle fatigue, its limitations in long-term work motivate the use of wearable devices. This article proposes a computational model for estimating muscle fatigue using wearable and non-invasive devices, such as Optical Fiber Sensors (OFSs) and Inertial Measurement Units (IMUs) along the subjective Borg scale. Electromyography (EMG) sensors are used to observe their importance in estimating muscle fatigue and comparing performance in different sensor combinations. This study involves 30 subjects performing a repetitive lifting activity with their dominant arm until reaching muscle fatigue. Muscle activity, elbow angles, and angular and linear velocities, among others, are measured to extract multiple features. Different machine learning algorithms obtain a model that estimates three fatigue states (low, moderate and high). Results showed that between the machine learning classifiers, the LightGBM presented an accuracy of 96.2% in the classification task using all of the sensors with 33 features and 95.4% using only OFS and IMU sensors with 13 features. This demonstrates that elbow angles, wrist velocities, acceleration variations, and compensatory neck movements are essential for estimating muscle fatigue. In conclusion, the resulting model can be used to estimate fatigue during heavy lifting in work environments, having the potential to monitor and prevent muscle fatigue during long working shifts.

Trunk Muscle Activities during Ergometer Rowing in Rowers with and without Low Back Pain

This study aimed to determine the differences in trunk muscle activity during rowing at maximal effort between rowers with and without low back pain (LBP). Ten rowers with LBP and 12 rowers without LBP were enrolled in this study. All rowers performed a 500-m trial using a rowing ergometer at maximal effort. The amplitudes of the activities of the thoracic erector spinae (TES), lumbar erector spinae (LES), latissimus dorsi (LD), rectus abdominis (RA), and external oblique (EO) muscles were analyzed using a wireless surface electromyography (EMG) system. EMG data at each stroke were converted into 10-time series data by recording averages at every 10% in the 100% stroke cycle and normalized by maximum voluntary isometric contraction in each muscle. Two-way repeated measures analysis of variance was performed. Significant interactions were found in the activities of the TES and LES (P < 0.001 and P = 0.047, respectively). In the post hoc test, the TES activity in the LBP group was significantly higher than that in the control group at the 10% to 20% and 20% to 30% stroke cycles (P = 0.013 and P = 0.007, respectively). The LES activity in the LBP group was significantly higher than that in the control group at the 0% to 10% stroke cycle (P < 0.001). There was a main group effect on the LD activity, with significantly higher activity in the LBP group than in the control group (P = 0.023). There were no significant interactions or main effects in the EO and RA activities between the groups. The present study showed that rowers with LBP compared with those without LBP exhibited significantly higher TES, LES, and LD muscle activities. This indicates that rowers with LBP exhibit excessive back muscle activity during rowing under maximal effort.

Biomechanical effects of fatigue on lower-body extremities during a maximum effort kettlebell swing protocol

Kettlebell training provides multiple health benefits, including the generation of power. The primary purpose of this study was to examine the kinematics and kinetics of lower-body joints during a repeated, maximum effort kettlebell swing protocol. Sixteen resistance and kettlebell swing experienced males performed 10 rounds of a kettlebell swing routine (where one round equates to 30s of swings followed by 30s of rest). Kinematic (i.e., swing duration and angular velocities) and kinetic (i.e., normalised sagittal plane ground reaction force, resultant joint moment [RJM] and power) variables were extracted for the early portion and late portion of the round. Average swing duration and the magnitude of normalised ground reaction forces (GRF) increased within rounds, while hip joint power decreased. Changes in swing duration were minimal, but consistent due to an increase in overall fatigue. An increase in the magnitude of GRF was observed at the end of rounds, which is a potential concern for injury. Hip joint power decreased primarily due to a slower angular velocity. This protocol may be an effective routine for those who are resistance trained with kettlebell swing experience, and who want to optimise power in their exercise program.

Exploring the relationship between kinematic variability and fatigue development during repetitive lifting

To investigate the variability-fatigue and repeaters-replacers hypotheses, motor variability (MV) and indicators of fatigue were assessed during repetitive lifting. Eighteen participants performed sequential repetitive bouts of lifting divided into a short bout, and three phases of a prolonged bout until volitional fatigue (or until a 1-h time limit). Whole-body kinematics were collected to calculate variability in three-dimensional joint angles and in continuous relative phase (CRP) of sagittal joint angle couplings, which were summed for the upper and lower body, and whole-body. Excellent individual consistency (ICC = 0.95-0.97) was demonstrated across lifting bouts as fatigue developed. Therefore, strong evidence was obtained for MV as an individual trait in support of the repeaters-replacers hypothesis. Associations were found for endurance and baseline effort with lower body variability, while no associations were found for rate of fatigue. Thus, some support was found for the variability-fatigue hypothesis which suggests that repeaters are less fatigue-resistant than replacers.

A method to quantify the reduction of back and hip muscle fatigue of lift-support exoskeletons

Cumulative back muscle fatigue plays a role in the occurrence of low-back injuries in occupations that require repetitive lifting of heavy loads and working in forward leaning postures. Lift-support exoskeletons have the potential to reduce back and hip muscle activity, thereby delaying the onset of fatigue in these muscles. Therefore, exoskeletons are being considered a potentially important tool to further reduce workload-related injuries. However, today no standards have been established on how to benchmark the support level of lift-support exoskeletons. This work proposes an experimental protocol to quantify the support level of a lift-support exoskeletons on instant changes in muscle activity and fatigue development while maintaining a static forward leaning posture. It then applies the protocol to experimentally assess the effect of the support provided by a commercially available lift-support exoskeleton, the LiftSuit 2.0 (Auxivo AG, Schwerzenbach, Switzerland), on the user. In a sample of 14 participants, the amplitude of the muscle activity of the back muscles and hip muscles () was significantly reduced. Wearing the exoskeleton significantly reduced the amount of fatigue developed during the task (). Changes in muscle fatigue can be objectively recorded and correlated with relevant changes for exoskeleton users: the time a task can be performed and perceived low-back fatigue. Thus, including such measures of fatigue in standardized benchmarking procedures will help quantify the benefits of exoskeletons for occupational use.

Detecting subject-specific fatigue-related changes in lifting kinematics using a machine learning approach

Individual responses to fatigue have been observed in lifting kinematics, suggesting a subject-specific approach is necessary for fatigue identification. One-class support vector machines (OCSVM) may provide an objective method to classify fatigue-related kinematic changes during repetitive lifting. Participants completed a repetitive lifting protocol while motion capture recorded lifting motions. Subject-specific kinematics from participants' first 35% of lifts trained OCSVM decision boundaries. The remaining lifts were separated into test sets and classified against the decision boundary to identify the percentage of outlier lifts within each test set. Spearman's correlation assessed if the test sets' percentage of outlier lifts increased concurrently with participants' rating of perceived exertion (RPE). Significant positive associations were found for participants who demonstrated evidence of fatigue, while no significant associations were found for participants who did not demonstrate evidence of fatigue. These results demonstrate the prospective efficacy of an outlier detection tool for fatigue detection during repetitive lifting.Practitioner Summary: An objective subject-specific fatigue detection method is desired for workplace tasks, such as lifting. An outlier detection machine learning approach was identified when lifting movement patterns changed from baseline throughout a repetitive lifting protocol. Participants who demonstrated an increase in outlier movement patterns had a concurrent increase in self-reported fatigue.

Biomechanical assessment of a passive back-support exoskeleton during repetitive lifting and carrying: Muscle activity, kinematics, and physical capacity

INTRODUCTION

Most people have experienced low back pain (LBP) more or less in their lifetime. Heavier load weight could increase the risk of LBP, especially in repetitive lifting and carrying tasks. The risk could also increase with the frequency of lifting. This study aims to investigate the effects of a passive back-support exoskeleton (PBSE) on trunk muscle activation, kinematics, and physical capacity in a repetitive lifting task and a carrying task in consideration of load weights in a laboratory setting.

RESULTS

Results showed that using the PBSE, the activities of the thoracic erector spinae and lumbar erector spinae muscles were reduced significantly by nearly 7% MVC and 3% MVC in the repetitive lifting task and the carrying task, respectively. There was no significant effect of the PBSE on the spine kinematics and physical capacity.

PRACTICAL APPLICATIONS

This study supports the use of the PBSE to reduce trunk muscle activity in repetitive lifting and carrying tasks.

A Comprehensive Evaluation of Spine Kinematics, Kinetics, and Trunk Muscle Activities During Fatigue-Induced Repetitive Lifting

OBJECTIVE

Spine kinematics, kinetics, and trunk muscle activities were evaluated during different stages of a fatigue-induced symmetric lifting task over time.

BACKGROUND

Due to neuromuscular adaptations, postural behaviors of workers during lifting tasks are affected by fatigue. Comprehensive aspects of these adaptations remain to be investigated.

METHOD

Eighteen volunteers repeatedly lifted a box until perceived exhaustion. Body center of mass (CoM), trunk and box kinematics, and feet center of pressure (CoP) were estimated by a motion capture system and force-plate. Electromyographic (EMG) signals of trunk/abdominal muscles were assessed using linear and nonlinear approaches. The L5-S1 compressive force (Fc) was predicted via a biomechanical model. A two-way multivariate analysis of variance (MANOVA) was performed to examine the effects of five blocks of lifting cycle (C1 to C5) and lifting trial (T1 to T5), as independent variables, on kinematic, kinetic, and EMG-related measures.

RESULTS

Significant effects of lifting trial blocks were found for CoM and CoP shift in the anterior-posterior direction (respectively p < .001 and p = .014), trunk angle (p = .004), vertical box displacement (p < .001), and Fc (p = .005). EMG parameters indicated muscular fatigue with the extent of changes being muscle-specific.

CONCLUSION

Results emphasized variations in most kinematics/kinetics, and EMG-based indices, which further provided insight into the lifting behavior adaptations under dynamic fatiguing conditions.

APPLICATION

Movement and muscle-related variables, to a large extent, determine the magnitude of spinal loading, which is associated with low back pain.

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.

An Open-Source and Wearable System for Measuring 3D Human Motion in Real-Time

OBJECTIVE

Analyzing human motion is essential for diagnosing movement disorders and guiding rehabilitation for conditions like osteoarthritis, stroke, and Parkinson's disease. Optical motion capture systems are the standard for estimating kinematics, but the equipment is expensive and requires a predefined space. While wearable sensor systems can estimate kinematics in any environment, existing systems are generally less accurate than optical motion capture. Many wearable sensor systems require a computer in close proximity and use proprietary software, limiting experimental reproducibility.

METHODS

Here, we present OpenSenseRT, an open-source and wearable system that estimates upper and lower extremity kinematics in real time by using inertial measurement units and a portable microcontroller.

RESULTS

We compared the OpenSenseRT system to optical motion capture and found an average RMSE of 4.4 degrees across 5 lower-limb joint angles during three minutes of walking and an average RMSE of 5.6 degrees across 8 upper extremity joint angles during a Fugl-Meyer task. The open-source software and hardware are scalable, tracking 1 to 14 body segments, with one sensor per segment. A musculoskeletal model and inverse kinematics solver estimate Kinematics in real-time. The computation frequency depends on the number of tracked segments, but is sufficient for real-time measurement for many tasks of interest; for example, the system can track 7 segments at 30 Hz in real-time. The system uses off-the-shelf parts costing approximately $100 USD plus $20 for each tracked segment.

SIGNIFICANCE

The OpenSenseRT system is validated against optical motion capture, low-cost, and simple to replicate, enabling movement analysis in clinics, homes, and free-living settings.

Low Back Biomechanics during Repetitive Deadlifts: A Narrative Review

OCCUPATIONAL APPLICATIONSHeavy deadlifting is used as a screening tool or training protocol for recruitment and retention in physically-demanding occupations, especially in the military. Spinal loads experienced during heavy deadlifts, particularly shearing forces, are well above recommended thresholds for lumbar spine injury in occupational settings. Although members of the noted occupation likely have stronger musculoskeletal systems compared to the general population, experiencing shearing forces that are 2 to 4 times larger than the threshold of injury, particularly under repetitive deadlift, may transform a screening tool or training protocol to an occupationally-harmful physical activity.

The influence of age on spinal and lower limb muscle activity during repetitive lifting

This study investigated the effects of age on upper erector spinae (UES), lower erector spinae (LES) and lower body (gluteus maximus; biceps femoris; and vastus lateralis) muscle activity during a repetitive lifting task. Twenty-four participants were assigned to two age groups: 'younger' (n = 12; mean age ± SD = 24.6 ± 3.6 yrs) and 'older' (n = 12; mean age = 46.5 ± 3.0 yrs). Participants lifted and lowered a box (13 kg) repetitively at a frequency of 10 lifts per minute for a maximum of 20 min. EMG signals were collected every minute and normalised to a maximum voluntary isometric contraction. A submaximal endurance test of UES and LES was used to assess fatigue. Older participants showed higher levels of UES and LES muscle activity (approximately 12-13%) throughout the task, but less fatigue compared to the younger group post-task completion. When lifting, lower-limb muscle activity was generally higher in older adults, although temporal changes were similar. While increased paraspinal muscle activity may increase the risk of back injury in older workers when repetitive lifting, younger workers may be more susceptible to fatigue-related effects. Education and training in manual materials handling should consider age-related differences when developing training programmes.

Immediate effects of using insoles with various wedges on activation and co-contraction indices of selected trunk muscles during load lifting

Trunk muscles play an important role during load lifting and contract to control trunk stability. The aim of present study was to investigate immediate effects of using various insole wedges on activation and co-contraction indices of selected trunk muscles during load lifting. Thirty able-bodied males completed load lifting task using nine various insole wedges. The results showed these significant differences: for normalized mean amplitude of RA muscle between posterior and anterior-medial wedges and for QL muscle between posterior and lateral wedges, for normalized peak amplitude of RA muscle between posterior and anterior-medial wedges, for median frequency of LES muscle between anterior-medial and anterior-lateral wedges, and for co-contraction of RA/TES, RA/LES and RA/MU between posterior and anterior-medial wedges (P = 0.001). These findings should be considered during designation of shoe or insole for work environments. Future studies need to assess other biomechanical aspects of using various insole wedges during work-related tasks.

Age-specific differences in the time-frequency representation of surface electromyographic data recorded during a submaximal cyclic back extension exercise: a promising biomarker to detect early signs of sarcopenia

PURPOSE

Motivated by the goal of developing new methods to detect early signs of sarcopenia, we investigated if surface electromyographic (SEMG) data recorded during the performance of cyclic, submaximal back extensions are marked by age-specific differences in their time and frequency characteristics. Furthermore, day-to-day retest reliability of the EMG measures was examined.

METHODS

A total of 86 healthy volunteers used a back dynamometer to perform a series of three maximal voluntary contractions (MVC) consisting of isometric back extensions, followed by an isometric back extension at 80% MVC, and finally 25 slow cyclic back extensions at 50% MVC. SEMG data was recorded bilaterally at L1, L2, and L5 from the iliocostalis lumborum, longissimus, and multifidus muscles, respectively. Tests were repeated two days and six weeks later. A linear mixed-effects model with fixed effects "age, sex, test number" and the random effect "person" was performed to investigate age-specific differences in both the initial value and the time-course (as defined by the slope of the regression line) of the root mean square (RMS-SEMG) values and instantaneous median frequency (IMDF-SEMG) values calculated separately for the shortening and lengthening phases of the exercise cycles. Generalizability Theory was used to examine reliability of the EMG measures.

RESULTS

Back extensor strength was comparable in younger and older adults. The initial value of RMS-SEMG and IMDF-SEMG as well as the RMS-SEMG time-course did not significantly differ between the two age groups. Conversely, the IMDF-SEMG time-course showed more rapid changes in younger than in older individuals. Absolute and relative reliability of the SEMG time-frequency representations were comparable in older and younger individuals with good to excellent relative reliability but variable absolute reliability levels.

CONCLUSIONS

The IMDF-SEMG time-course derived from submaximal, cyclic back extension exercises performed at moderate effort showed significant differences in younger vs. older adults even though back extension strength was found to be comparable in the two age groups. We conclude that the SEMG method proposed in this study has great potential to be used as a biomarker to detect early signs of sarcopenic back muscle function.

Do Muscle Activities of M. Splenius and M. Brachiocephalicus Decrease Because of Exercise-Induced Fatigue in Thoroughbred Horses?

Muscle activities of the major hindlimb muscles have been reported to decrease with fatigue in horses. However, those in other muscles have been scarcely reported. We aimed to quantify fatigue-induced electromyographic changes in head and neck muscles and muscles around the shoulder joints in horses. Surface electromyographic recording of the splenius, brachiocephalicus, infraspinatus, and deltoid muscles was performed on a total of nine healthy Thoroughbred horses. Horses galloped on a treadmill inclined to 3% at a constant speed (12.7-14.6 m/second) to make them fatigued after approximately 5 minutes. They trotted at 3.5 m/second before and after this exercise. Stride frequency, integrated electromyographic values for a stride, and median frequency of the muscle discharge were calculated every 30 seconds. These parameters were compared at the start and end of the gallop exercise for the lead and trailing limbs and while trotting before and after the exercise using a paired t-test. The stride frequency significantly decreased at the end of the gallop (P < .001), whereas it did not change while trotting. Integrated electromyographic values of the splenius and brachiocephalicus muscles in both lead and trailing limbs at the gallop and those of both left and right sides at the trot significantly decreased with fatigue (P < .05), whereas those of infraspinatus and deltoid muscles did not change at either gallop or trot. No changes were observed in median frequency in any muscles with fatigue. These results suggest that splenius and brachiocephalicus muscle activities can be associated with stride frequency and speed.

Assessing aberrant muscle activity patterns via the analysis of surface EMG data collected during a functional evaluation

BACKGROUND

Surface electromyographic (EMG) recordings collected during the performance of functional evaluations allow clinicians to assess aberrant patterns of muscle activity associated with musculoskeletal disorders. This assessment is typically achieved via visual inspection of the surface EMG data. This approach is time-consuming and leads to accurate results only when the assessment is carried out by an EMG expert.

METHODS

A set of algorithms was developed to automatically evaluate aberrant patterns of muscle activity. EMG recordings collected during the performance of functional evaluations in 62 subjects (22 to 61 years old) were used to develop and characterize the algorithms. Clinical scores were generated via visual inspection by an EMG expert using an ordinal scale capturing the severity of aberrant patterns of muscle activity. The algorithms were used in a case study (i.e. the evaluation of a subject with persistent back pain following instrumented lumbar fusion who underwent lumbar hardware removal) to assess the clinical suitability of the proposed technique.

RESULTS

The EMG-based algorithms produced accurate estimates of the clinical scores. Results were primarily obtained using a linear regression approach. However, when the results were not satisfactory, a regression implementation of a Random Forest was utilized, and the results compared with those obtained using a linear regression approach. The root-mean-square error of the clinical score estimates produced by the algorithms was a small fraction of the ordinal scale used to rate the severity of the aberrant patterns of muscle activity. Regression coefficients and associated 95% confidence intervals showed that the EMG-based estimates fit well the clinical scores generated by the EMG expert. When applied to the clinical case study, the algorithms appeared to capture the characteristics of the muscle activity patterns associated with persistent back pain following instrumented lumbar fusion.

CONCLUSIONS

The proposed approach relies on EMG-based measures to generate accurate estimates of the severity of aberrant patterns of muscle activity. The results obtained in the case study suggest that the proposed technique is suitable to derive clinically-relevant information from EMG data collected during functional evaluations.

The effects of a fatiguing lifting task on postural sway among males and females

Lifting and falls comprise a large proportion of work related injuries. Repetitive lifting to the point of fatigue can affect postural sway, which is associated with fall risk. To investigate the effects of lifting and fatigue on postural sway in males and females, 35 participants (18 male, 17 female) were asked to lift a weighted box in sets of 25 lifts at 5 different incremental weights (10, 15, 20, 25, and 30 kg) until fatigue. Before and after each lifting set, participants performed a single leg balance test on a force platform to assess postural sway by means of center of pressure mean velocity. Analysis of pre-fatigue to post-fatigue postural sway measurements indicated that there were no significant differences in mean velocity when males and females were grouped together. However, when analyzed as separate groups, mean postural sway center of pressure velocity increased for males but did not for females, indicating that males and females use different strategies to maintain balance when fatigued.

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.

Principal components analysis to characterise fatigue-related changes in technique: Application to double under jump rope

The upper extremities play an important role in managing the rope-turning technique required to perform continuous double unders. However, acute adaptions in this technique may occur as a jumper fatigues. The purpose of this study was to examine how turning technique is adapted with fatigue. Three-dimensional kinematic data of the upper extremity were collected from 10 trained athletes as they performed consecutive double unders to volitional fatigue. Time series wrist, elbow and shoulder joint angles were calculated where joint angle waveforms representing 10 unique trials from the beginning ("fresh") and end ("fatigued") of the continuous jumping protocol for all participants were analysed using principal component analysis. Participants reported stopping due to cardiovascular and shoulder muscular fatigue. From a kinematics perspective, with fatigue athletes used a more internally rotated range of motion at the shoulder, which we believe prompted a series of more distal adaptions in order to maintain rope turning, preserving consecutive double under performance. The presence of a maladaptive adaptation at the shoulder may increase the risk of developing shoulder injuries. Coaches should consider helping jumpers develop appropriate shoulder muscle endurance such that they can continue to maximise their training and proficiency, while protecting against potential fatigue-related maladaptation.

Development and Evaluation of Ergonomic Interventions for Bucket Handling on Farms

OBJECTIVE

The aim of this study was to introduce and evaluate two interventions, Ergo Bucket Carrier (EBC) and Easy Lift (EL), for youths (and adults) to handle water/feed buckets on farms.

BACKGROUND

The physical activities of both adult and youth farm workers contribute to the development of low-back disorders (LBDs). Many of the activities youths perform on farms are associated with increased LBD risk, particularly, the handling of water and feed buckets.

METHOD

Seventeen adult and youth participants (10 males and seven females) participated in this study. To assess the risk of LBDs, the participants were instrumented with a three-dimensional spinal electrogonio-meter while lifting, carrying, and dumping water buckets using the traditional method and the two interventions.

RESULTS

For both the adult and youth groups, the results showed that the two interventions significantly decrease the magnitudes of LBD risk in many of the tasks evaluated. Overall, the use of the EBC resulted in a 41% reduction in the level of LBD risk for the carrying task and a reduction of 69% for the dumping task. Using the EL, on the other hand, is especially effective for lifting tasks (55% reduction in LBD risk). Results of the subjective response were consistent with the objective evaluations.

CONCLUSION

This study demonstrated the potential for ergonomic interventions in reducing LBD risk during the common farming task of bucket handling.

APPLICATION

Potential application of this study includes the introduction of the EBC and EL in family farms to reduce the LBD risk among youth and adult farmers.

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.

Age-related differences do affect postural kinematics and joint kinetics during repetitive lifting

BACKGROUND

Age is considered a risk factor for manual handling-related injuries and older workers incur higher injury-related costs than younger co-workers. This study investigated the differences between the kinematics and kinetics of repetitive lifting in two groups of handlers of different ages.

METHODS

Fourteen younger (mean 24.4 yr) and 14 older (mean 47.2 yr) males participated in the study. Participants repetitively lifted a box weighing 13 kg at a frequency of 10 lifts/min for a maximum of 20 min. Postural kinematics (joint and lumbosacral angles and angular velocities) and kinetics (joint moments) were measured throughout the lifting task using motion analysis and ground reaction forces. Muscle fatigue of the erector spinae was assessed using electromyography.

FINDINGS

Peak lumbosacral, trunk, hip and knee flexion angles differed significantly between age groups over the duration of the task, as did lumbosacral and trunk angular velocities. The younger group increased peak lumbar flexion by approximately 18% and approached 99% of maximum lumbosacral flexion after 20 min, whereas the older group increased lumbar flexion by 4% and approached 82% maximum flexion. The younger group had a larger increase in peak lumbosacral and trunk angular velocities during extension, which may be related to the increased back muscle fatigue observed among the younger group.

INTERPRETATION

Older participants appeared to control the detrimental effects of fatigue associated with repetitive lifting and limit lumbar spine range of motion. The higher rates of musculoskeletal injury among older workers may stem from a complex interaction of manual handling risk factors.

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.

Effects of work experience on fatigue-induced biomechanical changes during repetitive asymmetric lifts/lowers

Repetitive lifting/lowering is associated with an increased risk of work-related low back disorders (WRLBDs), and fatigue may exacerbate such risk. Work methods used by experienced workers are potential models for developing worker training to reduce WRLBDs, though whether experience modifies the effects of fatigue on WRLBD risk is largely unknown. Here, six novices and six experienced workers completed 185 cycles of repetitive, asymmetric lifts/lowers. Physical demands, whole-body balance and torso movement stability were assessed using torso kinematics/kinetics, linear/angular momenta and Lyapunov exponents, respectively. Several fatigue-induced changes in movement strategies were evident. Novices decreased and experienced workers increased peak lumbar moments post-fatigue, suggesting lower WRLBD risks among the former in terms of torso kinetics. Other than lumbar moments, though, fatigue substantially reduced group-level differences in torso twisting velocities and accelerations. Post-fatigue movement strategies of experienced workers thus did not appear to be advantageous in terms of WRLBD risk.

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.

Swing kinematics of male and female skilled golfers following prolonged putting practice

Given that males and females respond differently to endurance-based tasks, prolonged putting practice may provide an avenue to examine gender-related differences in golf swing kinematics. The aim of this project was to determine if 40 min of putting affects thorax and pelvis kinematics during the full swing of males and females. Three-dimensional trunk kinematics were collected during the swings of 19 male (age: 26 ± 7 years, handicap: 0.6 ± 1.1) and 17 female (age: 24 ± 7 years, handicap: 1.4 ± 1.7) golfers before and after 40 min of putting. Angular displacement at address, top of backswing and ball contact for the pelvis, thorax, and pelvis-thorax interaction were calculated, in addition to the magnitude of peak angular velocity and repeatability of continuous segment angular velocities. Female golfers had less pelvis and thorax anterior-posterior tilt at address, less thorax and thorax-pelvis axial rotation at top of backswing, and less pelvis and thorax axial rotation and pelvis lateral tilt at ball contact pre- to post-putting. Analysis of peak angular velocities revealed that females had significantly lower thorax-pelvis lateral tilt velocity pre- to post-putting. In conclusion, an endurance-based putting intervention affects females' thorax and pelvis orientation angles and velocities to a greater extent than males.

Frequent bending--an underestimated burden in nursing professions

OBJECTIVES

The aim of the present study was to quantify the total duration per shift in which nurses work in a forward bending position over 20°. Furthermore, the influence of several factors on the occurrence of sagittal trunk inclinations in nurses was investigated.

METHODS

Trunk postures were recorded for nine nursing home nurses from four German nursing homes and 18 hospital nurses from seven hospitals using the CUELA measurement system. A total of 79 shifts, 27 in nursing homes and 52 in hospitals, were analysed. All measurements were supported by video recordings. Specially developed software (WIDAAN 2.75) was used to synchronize the measurement data and video footage.

RESULTS

The total duration of inclinations per shift was significantly affected by the working area (nursing home or hospital) with an increase of 25.3 min in nursing homes (95% confidence interval 2.4-48.2; P = 0.032). Another factor was the extent of personal basic care tasks performed by the nurses (P < 0.001). Nursing home nurses worked about twice as long per shift in a forward bending position compared with hospital nurses (112 versus 63 min; P < 0.001) and they assumed almost one-third more inclinations per shift (1541 versus 1170; P = 0.005).

CONCLUSIONS

Nursing staff perform a large number of inclinations. The amount of time spent by nurses working in a forward bending position was highly dependent on the working area and the extent to which patients were in need of help. It is very likely that future preventive measures, focussing on reducing the huge amount of inclination, would reduce the physical stress in everyday nursing work substantially.

Developing physical exposure-based back injury risk models applicable to manual handling jobs in distribution centers

Using our ultrasound-based "Moment Monitor," exposures to biomechanical low back disorder risk factors were quantified in 195 volunteers who worked in 50 different distribution center jobs. Low back injury rates, determined from a retrospective examination of each company's Occupational Safety and Health Administration (OSHA) 300 records over the 3-year period immediately prior to data collection, were used to classify each job's back injury risk level. The analyses focused on the factors differentiating the high-risk jobs (those having had 12 or more back injuries/200,000 hr of exposure) from the low-risk jobs (those defined as having no back injuries in the preceding 3 years). Univariate analyses indicated that measures of load moment exposure and force application could distinguish between high (n = 15) and low (n = 15) back injury risk distribution center jobs. A three-factor multiple logistic regression model capable of predicting high-risk jobs with very good sensitivity (87%) and specificity (73%) indicated that risk could be assessed using the mean across the sampled lifts of the peak forward and or lateral bending dynamic load moments that occurred during each lift, the mean of the peak push/pull forces across the sampled lifts, and the mean duration of the non-load exposure periods. A surrogate model, one that does not require the Moment Monitor equipment to assess a job's back injury risk, was identified although with some compromise in model sensitivity relative to the original model.

Effect of lead use on back and shoulder postural muscle activity in healthy young adults

OBJECTIVE

The primary goal of this study was to test the hypothesis that wearing the 3.7 kg vest portion of a radiological shielding garment (a "lead") significantly increases lower back and shoulder muscle activity in quasistatic erect and forward-flexed postures. Secondarily, the authors examined the effects of gender and forward-flexed posture as well as their interactions with lead use.

BACKGROUND

The use of a lead is mandatory for interventionalists during surgical procedures. Because the vest portion of a lead weighs considerably more than normal clothing, there is concern that its use increases the risk of developing back and shoulder pain.

METHOD

In a repeated-measures study design, 19 young healthy male and female adults assumed standardized erect or forward-flexed postures, both with and without wearing the vest portion of a lead. Shoulder and lower back muscle activity was measured via surface electromyography, normalized by maximum voluntary contraction values. Data were analyzed using general linear models and repeated-measures ANOVA (significant for p < .05).

RESULTS

Use of the lead did not result in a significant increase in muscle activity in the lower back or shoulders, despite perceived increases in effort and discomfort. Posture proved to be the most significant secondary factor affecting activity in the lower back, and participant gender proved insignificant.

CONCLUSION

Short-term use of the lead does not appear to contribute to the incidence of back pain or injury in interventionalists. Avoiding flexed postures could more directly reduce the likelihood of pain or injury.

APPLICATION

Potential applications include assessing and improving operating room ergonomics for physicians.

Influence of back muscle fatigue on lumbar reflex adaptation during sudden external force perturbations

There is still conflicting evidence about the influence of fatigue on trunk reflex activity. The aim of this study was to measure response latency and amplitude changes of lumbar and abdominal muscles after heavy external force perturbation applied to the trunk in the sagittal plane before and after back muscle fatigue, in expected and unexpected conditions. Ten healthy subjects in a semi-seated position, torso upright in a specific apparatus performed an intermittent back muscle fatigue protocol. EMG reflex activity of erector spinae (ES) and external oblique muscles were recorded in unexpected and in expected (self pre-activation) conditions. After fatigue, the normalized reflex amplitude of ES increased in expected and unexpected conditions (P<0.05) while ES response latency was slightly decreased. Reflexes latencies for ES were systematically shorter (P<0.05) of 25% in expected compared to unexpected conditions. These findings suggest that a large external force perturbation would elicit higher paraspinal magnitude responses and possible earlier activation in order to compensate the loss of muscular force after fatigue. Because of the seated position the postural adjustments were probably not triggered and thus explain the lack of abdominal activation. The self-anticipated pre-activation in order to counteract perturbations was not affected by fatigue illustrating the natural muscular activation to maintain trunk stability.

Trunk muscle activation during sub-maximal extension efforts

Neuromuscular fatigue of the trunk musculature, particularly lumbar paraspinal and abdominal muscles, is important in when evaluating motor control of the trunk. Activation of agonists and antagonists trunk muscles was hypothesized to change during sub-maximal isometric trunk extension efforts. Thirteen women were positioned in 30 degrees of trunk flexion and performed maximal voluntary isometric contraction in trunk extension against an isokinetic dynamometer. One of two sub-maximal efforts (50% and 70%) was performed to induce neuromuscular fatigue on two different days. Surface electromyography of the lumbar paraspinal (LP), rectus abdominis, and external oblique muscles was recorded during each session. Torque output, median frequency of the power density spectrum, and normalized integrated electromyography were analyzed using repeated measures analysis of variance to evaluate trends in the data over time. Paraspinal muscles showed signs of fatigue in both conditions (p<0.05) Abdominal activity did not increase during the 70% condition, but showed a non-significant trend (p=0.07), coinciding with the reduced median frequency of LP muscles. The neuromuscular system modulates its motor control strategy to identify the muscle activation levels necessary to maintain force output. This information is necessary in the evaluation of contributing mechanisms to trunk stability in furthering preventative and rehabilitative treatments.

Dynamic trunk stabilization: a conceptual back injury prevention program for volleyball athletes

The sport of volleyball creates considerable dynamic trunk stability demands. Back injury occurs all too frequently in volleyball, particularly among female athletes. The purpose of this clinical commentary is to review functional anatomy, muscle coactivation strategies, assessment of trunk muscle performance, and the characteristics of effective exercises for the trunk or core. From this information, a conceptual progressive 3-phase volleyball-specific training program is presented to improve dynamic trunk stability and to potentially reduce the incidence of back injury among volleyball athletes. Phase 1 addresses low-velocity motor control, kinesthetic awareness, and endurance, with the clinician providing cues to teach achievement of biomechanically neutral spine alignment. Phase 2 focuses on progressively higher velocity dynamic multiplanar endurance, coordination, and strength-power challenges integrating upper and lower extremity movements, while maintaining neutral spine alignment. Phase 3 integrates volleyball-specific skill simulations by breaking down composite movement patterns into their component parts, with differing dynamic trunk stability requirements, while maintaining neutral spine alignment. Prospective research is needed to validate the efficacy of this program.

The effect of increasing resistance on trunk muscle activity during extension and flexion exercises on training devices

Although progressive resistance training of trunk muscles on devices is very common, today, the effects of increasing resistance on trunk muscle activity during dynamic extension and flexion movements on training devices have not been reported yet. Thirty healthy subjects participated in maximal isometric and submaximal dynamic (at 30%, 50% and 70% of maximum mean torque (MMT)) extension and flexion exercises on Tergumed lumbar training devices. The normalized (as a percentage of maximal voluntary isometric contractions (MVIC)) electromyographic activity of 16 abdominal and back muscles was investigated. The results of the present study indicated that in general, with increasing resistance from 30% MMT to 50% MMT and 70% MMT, the activity of all back muscles during the extension exercises and the activity of all abdominal muscles during the flexion exercises increased significantly. To train strength (>60% of MVIC), low intensities (30% and 50% MMT) appeared sufficient to affect the back muscles, but for the abdominals higher resistance (70% MMT) was required. In contrast to the other back muscles, the lumbar multifidus demonstrated high activity levels during both the extension and the flexion exercises. As the lumbar multifidus is demonstrated to be an important muscle in segmental stabilization of the lumbar spine, this finding may help in understanding the efficacy of rehabilitation programs using specific training devices.

Correlations between short-time Fourier- and continuous wavelet transforms in the analysis of localized back and hip muscle fatigue during isometric contractions

The aims of the current study were to examine the stationarities of surface electromyographic (EMG) signals obtained from eight bilateral back and hip muscles during a modified Biering-Sørensen test, and to investigate whether short-time Fourier (STFT) and continuous wavelet transforms (CWT) provided similar information with regard to EMG spectral parameters in the analysis of localized muscle fatigue. Twenty healthy subjects participated in the study after giving their informed consent. Reverse arrangement tests showed that 91.6% of the EMG signal epochs demonstrated no significant trends (all p>0.05), meaning 91.6% of the EMG signal epochs could be considered as stationary signals. Pearson correlation coefficients showed that STFT and CWT in general provide similar information with respect to the EMG spectral variables during isometric back extensions, and as a consequence STFT can still be used.