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Callihan ML, McCoy T, Reed C, Morley C, Law E, Philipps T. Save Your Back: Comparison of the Compressive Force on the Lower Back Based on Differences in the Training Techniques. J Emerg Nurs 2024:S0099-1767(23)00345-8. [PMID: 38310495 DOI: 10.1016/j.jen.2023.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 11/21/2023] [Accepted: 12/24/2023] [Indexed: 02/05/2024]
Abstract
INTRODUCTION Musculoskeletal injury prevention for nurses is aimed at removing the need to manually position patients. In the ED, this is not always possible or practical. The purpose of this study is to compare the calculated estimated compressive force on the lumbar spine between recommended lifting techniques and the SHAPE lifting method during the horizontal transfer of a patient. METHODS Twenty-one student nurses completed the horizontal transfer of a simulated patient while motion was collected using inertial measurement units. Motion data were analyzed to calculate an estimated compressive force on the lumbar spine while completing the movement based on current recommended lifting methods and while using the SHAPE lifting method. RESULTS A significant reduction in estimated peak and average compressive force at the lumbar spine was found during both the push and the pull portions (P < .001) of the horizontal transfer. DISCUSSION While the optimal way to limit musculoskeletal injury among nurses is to eliminate the need for manual handling of a patient, this is not always possible in the ED. It is critical that when emergency nurses must reposition a patient, they perform the movement in the most biomechanically sound method while using a friction reduction. These findings, coupled with the previous biomechanical risk factor reduction related to the SHAPE lifting intervention, gives promise to a safer lifting strategy for emergency nurses moving forward.
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Xiang X, Tanaka M, Umeno S, Kikuchi Y, Kobayashi Y. Dynamic assessment for low back-support exoskeletons during manual handling tasks. Front Bioeng Biotechnol 2023; 11:1289686. [PMID: 38026894 PMCID: PMC10667710 DOI: 10.3389/fbioe.2023.1289686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/01/2023] [Indexed: 12/01/2023] Open
Abstract
Exoskeletons can protect users' lumbar spine and reduce the risk of low back injury during manual lifting tasks. Although many exoskeletons have been developed, their adoptability is limited by their task- and movement-specific effects on reducing burden. Many studies have evaluated the safety and effectiveness of an exoskeleton using the peak/mean values of biomechanical variables, whereas the performance of the exoskeleton at other time points of the movement has not been investigated in detail. A functional analysis, which presents discrete time-series data as continuous functions, makes it possible to highlight the features of the movement waveform and determine the difference in each variable at each time point. This study investigated an assessment method for exoskeletons based on functional ANOVA, which made it possible to quantify the differences in the biomechanical variables throughout the movement when using an exoskeleton. Additionally, we developed a method based on the interpolation technique to estimate the assistive torque of an exoskeleton. Ten men lifted a 10-kg box under symmetric and asymmetric conditions five times each. Lumbar load was significantly reduced during all phases (flexion, lifting, and laying) under both conditions. Additionally, reductions in kinematic variables were observed, indicating the exoskeleton's impact on motion restrictions. Moreover, the overlap F-ratio curves of the lumbar load and kinematic variables imply that exoskeletons reduce the lumbar load by restricting the kinematic variables. The results suggested that at smaller trunk angles (<25°), an exoskeleton neither significantly reduces the lumbar load nor restricts trunk movement. Our findings will help increasing exoskeleton safety and designing effective products for reducing lumbar injury risks.
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Affiliation(s)
- Xiaohan Xiang
- Institute of Agricultural Machinery, National Agriculture and Food Research Organization (NARO), Saitama, Japan
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Zhou G, Lu ML, Yu D. Investigating gripping force during lifting tasks using a pressure sensing glove system. APPLIED ERGONOMICS 2023; 107:103917. [PMID: 36279645 DOI: 10.1016/j.apergo.2022.103917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 09/30/2022] [Accepted: 10/06/2022] [Indexed: 06/16/2023]
Abstract
Lifting tasks remain one of the leading causes of musculoskeletal disorders (MSDs), primarily in the low back region. Lifting analysis tools are, therefore, designed for assessing the risk of low back pain. Shoulder musculoskeletal problems have emerged as common MSDs associated with manual handling tasks. It is hypothesized that gripping force is related to lifting conditions and may be used as a supplementary risk metric for MSDs in the shoulder and low back regions, because it measures additional hand exertions for coupling the lifted object during lifting. We assessed the capability tactile gloves for measuring the gripping force during lifting as a means for assessing different task conditions (lifting weight, lifting height, lifting direction, body rotation, and handle). Thirty participants wore the tactile gloves and performed simulated lifting tasks. Regression models were used to analyze the effects of the task variables on estimating the measured gripping force. Results demonstrated that 58% and 70% of the lifting weight variance were explained by the measured gripping force without and with considering the individual difference, respectively. In addition to the lifting risk measures commonly used by practitioners, this study suggests a potential for using gripping force as a supplementary or additional risk metric for MSDs.
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Affiliation(s)
| | - Ming-Lun Lu
- National Institute for Occupational Safety and Health, Cincinnati, OH, USA
| | - Denny Yu
- Purdue University, West Lafayette, IN, USA.
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Golmohammadpour H, Garosi E, Taheri M, Dehghan N, Ezbarami SM, Karanikas N. Redesign and ergonomic assessment of a chest-support baby walker. Work 2023; 76:737-747. [PMID: 37066957 DOI: 10.3233/wor-220440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
BACKGROUND Parents often use baby walkers (BWs) as assistive devices to improve their infants' independent movement and motor skill acquisition. However, the literature suggests that conventional baby walkers (CBW) may cause delays in an infant's ability to walk independently and musculoskeletal burden on parents. OBJECTIVE In the current study, a baby walker (RBW) with chest support was redesigned and ergonomically assessed during an infant-walking task. METHODS The anthropometric dimensions of 90 infants aged 7-11 months were measured in the city of Urmia, northwestern Iran. Following redesigning based on the results from expert panel meetings and prototyping of the RBW, 18 mothers (age: 28.33±4.27 and height: 163.75±5.32 and weight: 59.45±5.99) with their infants (9 boys and 9 girls) performed a simulated infant walking task in two experimental sessions using the CBW and RBW over a repeated measurements design. The infants' feet track patterns, including the number of steps and step distances were assessed via the image analysis of the footprints. The mothers' body posture and lower back spinal load were evaluated using Rapid Upper Limb Assessment (RULA) technique and 3D Static Strength Prediction Program (3DSSPP), respectively. RESULTS Wilcoxon signed-rank tests showed infants walked more steps with the RBW (p = 0.002). Similarly, the distance between the infants' left heel strike (p = 0.008) and their right and left toe-off (p = 0.03 and 0.02 respectively) was also significantly lower in the RBW use. Additionally, the body posture of mothers was improved (RULA final score from 7 for CBW to 5 for RBW). Moreover, lower back compression and shear forces were reduced significantly (p = 0.002) by the RBW use. CONCLUSION According to the feet track pattern, infants took more balanced steps when the RBW was used. In addition, mothers were subjected to less pressure on the lumbar region when they placed and lifted their infant from the RBW. However, further work is necessary to investigate potential long-term effects of the RBWs use.
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Affiliation(s)
- Hamedeh Golmohammadpour
- Department of Industrial and System Engineering, The State University of New York at Buffalo, Getzville, NY, USA
| | - Ehsan Garosi
- Department of Ergonomics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Mostafa Taheri
- Department of Architecture, Faculty of Arts and Architecture, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Naser Dehghan
- Ambient Intelligence Laboratory (AMI-Lab), Computer Science Department, Faculty of Science, University of Sherbrooke, Sherbrooke, QC, Canada
| | | | - Nektarios Karanikas
- School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD, Australia
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Banks JJ, Alemi MM, Allaire BT, Lynch AC, Bouxsein ML, Anderson DE. Using static postures to estimate spinal loading during dynamic lifts with participant-specific thoracolumbar musculoskeletal models. APPLIED ERGONOMICS 2023; 106:103869. [PMID: 36055036 DOI: 10.1016/j.apergo.2022.103869] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 06/06/2022] [Accepted: 08/09/2022] [Indexed: 06/15/2023]
Abstract
Static biomechanical simulations are sometimes used to estimate in vivo kinetic demands because they can be solved efficiently, but this ignores any potential inertial effects. To date, comparisons between static and dynamic analyses of spinal demands have been limited to lumbar joint differences in young males performing sagittal lifts. Here we compare static and dynamic vertebral compressive and shear force estimates during axial, lateral, and sagittal lifting tasks across all thoracic and lumbar vertebrae in older men and women. Participant-specific thoracolumbar full-body musculoskeletal models estimated vertebral forces from recorded kinematics both with and without consideration of dynamic effects, at an identified frame of peak vertebral loading. Static analyses under-predicted dynamic compressive and resultant shear forces, by an average of about 16% for all three lifts across the thoracic and lumbar spine but were highly correlated with dynamic forces (average r2 > .95). The study outcomes have the potential to enable standard clinical and occupational estimates using static analyses.
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Affiliation(s)
- Jacob J Banks
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Mohammad Mehdi Alemi
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Brett T Allaire
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Andrew C Lynch
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Mary L Bouxsein
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Dennis E Anderson
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States.
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Kazemi Z, Mazloumi A, Arjmand N, Keihani A, Karimi Z, Ghasemi MS, Kordi R. A Comprehensive Evaluation of Spine Kinematics, Kinetics, and Trunk Muscle Activities During Fatigue-Induced Repetitive Lifting. HUMAN FACTORS 2022; 64:997-1012. [PMID: 33497290 DOI: 10.1177/0018720820983621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
| | | | | | | | | | | | - Ramin Kordi
- 48439 Tehran University of Medical Sciences, Iran
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Beliveau PJ, Johnston H, Van Eerd D, Fischer SL. Musculoskeletal disorder risk assessment tool use: A Canadian perspective. APPLIED ERGONOMICS 2022; 102:103740. [PMID: 35344795 DOI: 10.1016/j.apergo.2022.103740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/02/2022] [Accepted: 03/03/2022] [Indexed: 06/14/2023]
Abstract
Canadian ergonomics professionals from the Association of Canadian Ergonomists (ACE) and Board of Canadian Registered Safety Professionals (BCRSP) participated in a web-based survey of their awareness, use, and factors influencing use of ergonomics musculoskeletal disorder (MSD) risk assessment tools. A total of 791 respondents (21.0% response rate) participated in the survey. Certified ergonomics professionals represented an important subpopulation of MSD risk assessment tool users, however; the vast majority (86.4%) of users within Canada were certified safety professionals. Average tool use varied between ACE and BCRSP groups, where ACE respondents on average use more tools than BCRSP respondents, however the top 10 tools used were similar between the groups. Over 45% of assessment tools were learned at school and average tool use was not influenced by years of experience or continuing education.
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Affiliation(s)
- Peter Jh Beliveau
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada.
| | | | | | - Steven L Fischer
- Faculty of Health, University of Waterloo, Waterloo, Ontario, Canada.
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Zelik KE, Nurse CA, Schall MC, Sesek RF, Marino MC, Gallagher S. An ergonomic assessment tool for evaluating the effect of back exoskeletons on injury risk. APPLIED ERGONOMICS 2022; 99:103619. [PMID: 34740072 PMCID: PMC9827614 DOI: 10.1016/j.apergo.2021.103619] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 09/14/2021] [Accepted: 10/20/2021] [Indexed: 06/01/2023]
Abstract
Low back disorders (LBDs) are a leading injury in the workplace. Back exoskeletons (exos) are wearable assist devices that complement traditional ergonomic controls and reduce LBD risks by alleviating musculoskeletal overexertion. However, there are currently no ergonomic assessment tools to evaluate risk for workers wearing back exos. Exo-LiFFT, an extension of the Lifting Fatigue Failure Tool, is introduced as a means to unify the etiology of LBDs with the biomechanical function of exos. We present multiple examples demonstrating how Exo-LiFFT can assess or predict the effect of exos on LBD risk without costly, time-consuming electromyography studies. For instance, using simulated and real-world material handling data we show an exo providing a 30 Nm lumbar moment is projected to reduce cumulative back damage by ∼70% and LBD risk by ∼20%. Exo-LiFFT provides a practical, efficient ergonomic assessment tool to assist safety professionals exploring back exos as part of a comprehensive occupational health program.
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Affiliation(s)
- Karl E Zelik
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA; Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA; Department of Physical Medicine and Rehabilitation, Vanderbilt University, Nashville, TN, USA; HeroWear, LLC, Nashville, TN, USA.
| | - Cameron A Nurse
- Department of Mechanical Engineering, Vanderbilt University, Nashville, TN, USA
| | - Mark C Schall
- Department of Industrial and Systems Engineering, Auburn University, Auburn, AL, USA
| | - Richard F Sesek
- Department of Industrial and Systems Engineering, Auburn University, Auburn, AL, USA
| | | | - Sean Gallagher
- Department of Industrial and Systems Engineering, Auburn University, Auburn, AL, USA
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Kitagawa K, Gorordo Fernandez I, Nagasaki T, Nakano S, Hida M, Okamatsu S, Wada C. Foot Position Measurement during Assistive Motion for Sit-to-Stand Using a Single Inertial Sensor and Shoe-Type Force Sensors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910481. [PMID: 34639781 PMCID: PMC8508461 DOI: 10.3390/ijerph181910481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/29/2021] [Accepted: 10/03/2021] [Indexed: 11/17/2022]
Abstract
Assistive motion for sit-to-stand causes lower back pain (LBP) among caregivers. Considering previous studies that showed that foot position adjustment could reduce lumbar load during assistive motion for sit-to-stand, quantitative monitoring of and instructions on foot position could contribute toward reducing LBP among caregivers. The present study proposes and evaluates a new method for the quantitative measurement of foot position during assistive motion for sit-to-stand using a few wearable sensors that are not limited to the measurement area. The proposed method measures quantitative foot position (anteroposterior and mediolateral distance between both feet) through a machine learning technique using features obtained from only a single inertial sensor on the trunk and shoe-type force sensors. During the experiment, the accuracy of the proposed method was investigated by comparing the obtained values with those from an optical motion capture system. The results showed that the proposed method produced only minor errors (less than 6.5% of body height) when measuring foot position during assistive motion for sit-to-stand. Furthermore, Bland–Altman plots suggested no fixed errors between the proposed method and the optical motion capture system. These results suggest that the proposed method could be utilized for measuring foot position during assistive motion for sit-to-stand.
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Affiliation(s)
- Kodai Kitagawa
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, 2–4 Hibikino, Wakamatsu-ku, Kitakyushu 808-0196, Japan; (I.G.F.); (M.H.); (S.O.); (C.W.)
- Correspondence:
| | - Ibai Gorordo Fernandez
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, 2–4 Hibikino, Wakamatsu-ku, Kitakyushu 808-0196, Japan; (I.G.F.); (M.H.); (S.O.); (C.W.)
| | - Takayuki Nagasaki
- Department of Rehabilitation, Tohoku Bunka Gakuen University, 6-45-1 Kunimi, Aoba-ku, Sendai 981-8551, Japan;
| | - Sota Nakano
- Department of Rehabilitation, Kyushu University of Nursing and Social Welfare, 888 Tomio, Tamana 865-0062, Japan;
| | - Mitsumasa Hida
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, 2–4 Hibikino, Wakamatsu-ku, Kitakyushu 808-0196, Japan; (I.G.F.); (M.H.); (S.O.); (C.W.)
- Department of Physical Therapy, Osaka Kawasaki Rehabilitation University, 158 Mizuma, Kaizuka 597-0104, Japan
| | - Shogo Okamatsu
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, 2–4 Hibikino, Wakamatsu-ku, Kitakyushu 808-0196, Japan; (I.G.F.); (M.H.); (S.O.); (C.W.)
- Department of Physical Therapy, Kitakyushu Rehabilitation College, 1575 Kamikatashima, Kanda-machi, Miyako-gun 800-0343, Japan
| | - Chikamune Wada
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, 2–4 Hibikino, Wakamatsu-ku, Kitakyushu 808-0196, Japan; (I.G.F.); (M.H.); (S.O.); (C.W.)
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Marker-less versus marker-based driven musculoskeletal models of the spine during static load-handling activities. J Biomech 2020; 112:110043. [DOI: 10.1016/j.jbiomech.2020.110043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 08/13/2020] [Accepted: 09/01/2020] [Indexed: 12/15/2022]
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Zhang Y, Ke J, Wu X, Luo X. A Biomechanical Waist Comfort Model for Manual Material Lifting. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5948. [PMID: 32824371 PMCID: PMC7459927 DOI: 10.3390/ijerph17165948] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 11/17/2022]
Abstract
Low back pain (LBP) is a common disorder that affects the working population worldwide. LBP causes more disability than any other conditions all around the world. Most existing studies focus on the occupational physical factors in association with LBP, while few focus on individual factors, especially the lack of quantitative calculation of waist comfort in biomechanics. Based on the physical statistics of Chinese men, this research used human posture analysis (HPA) to establish the waist strength formula and analyzed the waist strength during a manual material handling. It also explored the influence of weight and height of lifting objects on the L5-S1 spinal load. On this basis, a waist comfort model was proposed in combination with the recommended weight limit (RWL) recommended by NIOSH, and the parameter selection and waist comfort value were verified by Jack simulation software. The results show that pulling force of the Erector Spinae of the waist is closely related to the weight and lifting height of the object. Parameter verification and Jack software simulation results show that the force of L5-S1 is less than 3400 N, which proves that the waist force under this posture is acceptable. The developed waist comfort model can be applied to evaluate work risk, to adjust working intensity and powered exoskeleton design, aiming to decrease the prevalence of LBP.
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Affiliation(s)
- Yongbao Zhang
- School of Engineering and Technology, China University of Geosciences (Beijing), Beijing 100083, China;
| | - Jinjing Ke
- Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong 999077, China; (J.K.); (X.L.)
| | - Xiang Wu
- School of Engineering and Technology, China University of Geosciences (Beijing), Beijing 100083, China;
| | - Xiaowei Luo
- Department of Architecture and Civil Engineering, City University of Hong Kong, Hong Kong 999077, China; (J.K.); (X.L.)
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12
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Hung IYJ, Shih TTF, Chen BB, Liou SH, Ho IK, Guo YL. The roles of lumbar load thresholds in cumulative lifting exposure to predict disk protrusion in an Asian population. BMC Musculoskelet Disord 2020; 21:169. [PMID: 32178650 PMCID: PMC7077115 DOI: 10.1186/s12891-020-3167-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 02/26/2020] [Indexed: 11/29/2022] Open
Abstract
Background The purpose of this study was to determine whether a specific threshold per lifting movement, the accumulation above which best predicts lumbar disk protrusion, exists or the total lifting load should be considered. Methods This was a retrospective study. Subjects with various lifting exposures were recruited. Disk protrusion was assessed by magnetic resonance imaging. The cumulative lifting load was defined as the sum of the time-weighed lumbar load for each job and was calculated using a biomechanical software system. The effectiveness of accumulation above different thresholds in predicting disk protrusion were compared using four statistical methods. Results A total of 252 men and 301 women were included in the final analysis. For the men, 3000 Newtons for each lifting task was the optimal threshold for predicting L4-S1 disk protrusion, whereas for the women, 2800 Newtons was optimal. Conclusions Our findings suggested that for cumulative lifting exposure, including the total lifting load without defining a minimal exposure limit might not be the optimal method for predicting disk protrusion. The NIOSH 3400 Newton recommended limits do not appear to be the optimal thresholds for preventing disk protrusion. Different lifting thresholds might be needed for men and women in the workplace for their safety.
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Affiliation(s)
- Isabella Y-J Hung
- Department of Nursing, Chung Hwa University of Medical Technology, Tainan, Taiwan
| | - Tiffany T-F Shih
- Department of Medical Imaging and Radiology, National Taiwan University Hospital and National Taiwan University (NTU), College of Medicine, Taipei, Taiwan
| | - Bang-Bin Chen
- Department of Medical Imaging and Radiology, National Taiwan University Hospital and National Taiwan University (NTU), College of Medicine, Taipei, Taiwan
| | - Saou-Hsing Liou
- National Institute of Environmental Health Sciences, National Health Research Institute (NHRI), Miaoli, Taiwan
| | - Ing-Kang Ho
- Center for Drug Abuse and Addiction, China Medical University Hospital, Taichung, Taiwan.,Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan
| | - Yue Leon Guo
- National Institute of Environmental Health Sciences, National Health Research Institute (NHRI), Miaoli, Taiwan. .,Department of Environmental and Occupational Medicine, College of Medicine, National Taiwan University (NTU) and NTU Hospital, Taipei, Taiwan. .,Graduate Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University (NTU), Taipei, Taiwan.
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Lowe BD, Dempsey PG, Jones EM. Ergonomics assessment methods used by ergonomics professionals. APPLIED ERGONOMICS 2019; 81:102882. [PMID: 31422255 DOI: 10.1016/j.apergo.2019.102882] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/21/2019] [Indexed: 06/10/2023]
Abstract
A web-based survey was conducted of ergonomics practitioners holding certifications in the U.S., Canada, Great Britain, Australia, and New Zealand. The survey follows 12 years after an earlier initial survey reported by Dempsey et al. (2005). Approximately 1221 eligible participants were invited by e-mail to participate, and 405 surveys were included in the final analysis. The survey queried use of basic instruments relevant to ergonomic practice as well as more specific analytical tools such as observational techniques for assessing postural demands of work and instrumentation for direct measurement of such demands. Some ergonomic assessment methods appear to have increased in their overall use by U.S. ergonomists compared to 2005 data. This was observed for: RULA, REBA, Psychophysical Upper Extremity Data, Strain Index, and ACGIH TLV for Hand Activity Level. There is minimal evidence of increased overall use of direct measurement approaches in the U.S. There appear to be geographic differences between countries/continents in terms of use of various methods. The use of mobile device/smart phone "apps" by ergonomists was queried and these technologies presently appear to be in early adoption phase with 24-28% of practitioners reporting use of an app in their ergonomics practice.
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Affiliation(s)
- Brian D Lowe
- National Institute for Occupational Safety and Health, USA.
| | | | - Evan M Jones
- National Institute for Occupational Safety and Health, USA
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14
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Aghazadeh F, Arjmand N, Nasrabadi AM. Coupled artificial neural networks to estimate 3D whole-body posture, lumbosacral moments, and spinal loads during load-handling activities. J Biomech 2019; 102:109332. [PMID: 31540822 DOI: 10.1016/j.jbiomech.2019.109332] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 08/25/2019] [Accepted: 09/08/2019] [Indexed: 10/26/2022]
Abstract
Biomechanical modeling approaches require body posture to evaluate the risk of spine injury during manual material handling. The procedure to measure body posture via motion-analysis techniques as well as the subsequent calculations of lumbosacral moments and spine loads by, respectively, inverse-dynamic and musculoskeletal models are complex and time-consuming. We aim to develop easy-to-use yet accurate artificial neural networks (ANNs) that predict 3D whole-body posture (ANNposture), segmental orientations (ANNangle), and lumbosacral moments (ANNmoment) based on our measurements during load-handling activities. Fifteen individuals each performed 135 load-handling activities by reaching (0 kg) or handling (5 and 10 kg) weights located at nine different horizontal and five vertical (0, 30, 60, 90, and 120 cm from the floor) locations. Whole-body posture was measured via a motion capture system and lumbosacral moments were calculated via a 3D top-down eight link-segment inverse-dynamic model. ANNposture, ANNangle, and ANNmoment were trained (RMSEs = 6.7 cm, 29.8°, and 16.2 Nm, respectively) and their generalization capability was tested (RMSE = 7.0 cm and R2 = 0.97, RMSE = 29.9° and R2 = 0.85, and RMSE = 16.5 Nm and R2 = 0.97, respectively). These ANNs were subsequently coupled to our previously-developed/validated ANNload, which predicts spinal loads during 3D load-handling activities. The results showed outputs of the coupled ANNs for L4-L5 intradiscal pressure (IDPs) during a number of activities were in agreement with measured IDPs (RMSE = 0.37 MPa and R2 = 0.89). Hence, coupled ANNs were found to be robust tools to evaluate posture, lumbosacral moments, spinal loads, and thus risk of injury during load-handling activities.
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Affiliation(s)
- F Aghazadeh
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - N Arjmand
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran.
| | - A M Nasrabadi
- Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
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Behjati M, Arjmand N. Biomechanical Assessment of the NIOSH Lifting Equation in Asymmetric Load-Handling Activities Using a Detailed Musculoskeletal Model. HUMAN FACTORS 2019; 61:191-202. [PMID: 30222936 DOI: 10.1177/0018720818795038] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To assess adequacy of the National Institute for Occupational Safety and Health (NIOSH) Lifting Equation (NLE) in controlling lumbar spine loads below their recommended action limits during asymmetric load-handling activities using a detailed musculoskeletal model, that is, the AnyBody Modeling System. BACKGROUND The NIOSH committee employed simplistic biomechanical models for the calculation of the spine compressive loads with no estimates of the shear loads. It is therefore unknown whether the NLE would adequately control lumbar compression and shear loads below their recommended action limits during asymmetric load-handling activities. METHOD Twenty-four static stoop lifting tasks at different load asymmetry angles, heights, and horizontal distances were performed by one normal-weight (70 kg) and one obese (93 kg) individual. For each task, the recommended weight limit computed by the NLE and body segment angles measured by a video-camera system (VICON) were prescribed in the participant-specific models developed in the AnyBody Modeling System that estimated spinal loads. RESULTS For both individuals, the NLE adequately controlled L5-S1 loads below their recommended action limits for all activities performed in upright postures. Both individuals, however, experienced compressive and/or shear L5-S1 loads beyond the recommended action limits when lifting was performed near the floor with large load asymmetry. CONCLUSION The NLE failed to control spinal loads below the recommended limits during asymmetric lifting tasks performed near the floor. APPLICATION The NLE should be used with caution for extreme tasks involving load handling near the floor with large load asymmetry.
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KITAGAWA KODAI, NISHISAKO YOSHIKI, NAGASAKI TAKAYUKI, NAKANO SOTA, WADA CHIKAMUNE. MUSCULOSKELETAL SIMULATION OF THE RELATIONSHIP BETWEEN FOOT POSITION AND STRESS OF THE L4–L5 JOINT IN SUPPORTING STANDING-UP MOTION TO PREVENT LOW BACK PAIN AMONG CAREGIVERS. J MECH MED BIOL 2019. [DOI: 10.1142/s0219519419400165] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Most caregivers have low back pain which results from frequent care activities such as assistance motion that supports transfer and standing-up. Various parameters are associated with the caregiver’s lumbar load. In this study, we focus on the foot position of the caregiver as one of the subjective adjustable parameters. This study aimed to analyze the relationship between foot position and stresses of the L4–L5 joint as lumbar load during supporting standing-up via musculoskeletal simulation. The musculoskeletal model was tasked with simulating supported standing-up motions based on a specific pelvic position and angular variation of each joint. The anterior foot (left foot) was fixed, and the posterior foot (right foot) was moved to three backward positions and three rightward positions, thus obtaining nine posterior foot positions. Compressive, anteroposterior shear, and lateral shear stresses of the L4–L5 joint were compared for nine foot positions. The results showed that as the anteroposterior distance and lateral widths between both feet increased, the average value of compressive/shear stress of the L4–L5 joint during motions decreased. From our findings, we hypothesized that the foot position may reduce the lumbar load and prevent low back pain.
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Affiliation(s)
- KODAI KITAGAWA
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Kitakyushu, Japan
| | - YOSHIKI NISHISAKO
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Kitakyushu, Japan
| | - TAKAYUKI NAGASAKI
- Department of Rehabilitation, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Sendai, Japan
| | - SOTA NAKANO
- Department of Rehabilitation, Faculty of Nursing and Welfare, Kyushu University of Nursing and Social Welfare, Tamana, Japan
| | - CHIKAMUNE WADA
- Graduate School of Life Science and Systems Engineering, Kyushu Institute of Technology, Kitakyushu, Japan
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Azari F, Arjmand N, Shirazi-Adl A, Rahimi-Moghaddam T. A combined passive and active musculoskeletal model study to estimate L4-L5 load sharing. J Biomech 2018; 70:157-165. [DOI: 10.1016/j.jbiomech.2017.04.026] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 04/13/2017] [Accepted: 04/24/2017] [Indexed: 10/19/2022]
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Dreischarf M, Shirazi-Adl A, Arjmand N, Rohlmann A, Schmidt H. Estimation of loads on human lumbar spine: A review of in vivo and computational model studies. J Biomech 2016; 49:833-845. [DOI: 10.1016/j.jbiomech.2015.12.038] [Citation(s) in RCA: 101] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2015] [Accepted: 12/18/2015] [Indexed: 01/09/2023]
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Rajaee MA, Arjmand N, Shirazi-Adl A, Plamondon A, Schmidt H. Comparative evaluation of six quantitative lifting tools to estimate spine loads during static activities. APPLIED ERGONOMICS 2015; 48:22-32. [PMID: 25683528 DOI: 10.1016/j.apergo.2014.11.002] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2014] [Revised: 10/25/2014] [Accepted: 11/07/2014] [Indexed: 06/04/2023]
Abstract
Different lifting analysis tools are commonly used to assess spinal loads and risk of injury. Distinct musculoskeletal models with various degrees of accuracy are employed in these tools affecting thus their relative accuracy in practical applications. The present study aims to compare predictions of six tools (HCBCF, LSBM, 3DSSPP, AnyBody, simple polynomial, and regression models) for the L4-L5 and L5-S1 compression and shear loads in twenty-six static activities with and without hand load. Significantly different spinal loads but relatively similar patterns for the compression (R(2) > 0.87) were computed. Regression models and AnyBody predicted intradiscal pressures in closer agreement with available in vivo measurements (RMSE ≈ 0.12 MPa). Due to the differences in predicted spinal loads, the estimated risk of injury alters depending on the tool used. Each tool is evaluated to identify its shortcomings and preferred application domains.
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Affiliation(s)
- Mohammad Ali Rajaee
- Department of Mechanical Engineering, Sharif University of Technology, Tehran 11155-9567, Iran
| | - Navid Arjmand
- Department of Mechanical Engineering, Sharif University of Technology, Tehran 11155-9567, Iran.
| | - Aboulfazl Shirazi-Adl
- Division of Applied Mechanics, Department of Mechanical Engineering, École Polytechnique, Montréal, Québec, Canada
| | - André Plamondon
- Institut de recherche Robert Sauvé en santé et en sécurité du travail, Montréal, Québec, Canada
| | - Hendrik Schmidt
- Julius Wolff Institut Charité - Universitätsmedizin Berlin, Germany
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Effect of body weight on spinal loads in various activities: A personalized biomechanical modeling approach. J Biomech 2015; 48:276-82. [DOI: 10.1016/j.jbiomech.2014.11.033] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 11/17/2014] [Accepted: 11/23/2014] [Indexed: 11/18/2022]
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The dose-response relationship between cumulative lifting load and lumbar disk degeneration based on magnetic resonance imaging findings. Phys Ther 2014; 94:1582-93. [PMID: 24970094 DOI: 10.2522/ptj.20130095] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
BACKGROUND Lumbar disk degeneration (LDD) has been related to heavy physical loading. However, the quantification of the exposure has been controversial, and the dose-response relationship with the LDD has not been established. OBJECTIVE The purpose of this study was to investigate the dose-response relationship between lifetime cumulative lifting load and LDD. DESIGN This was a cross-sectional study. METHODS Every participant received assessments with a questionnaire, magnetic resonance imaging (MRI) of the lumbar spine, and estimation of lumbar disk compression load. The MRI assessments included assessment of disk dehydration, annulus tear, disk height narrowing, bulging, protrusion, extrusion, sequestration, degenerative and spondylolytic spondylolisthesis, foramina narrowing, and nerve root compression on each lumbar disk level. The compression load was predicted using a biomechanical software system. RESULTS A total of 553 participants were recruited in this study and categorized into tertiles by cumulative lifting load (ie, <4.0 × 10(5), 4.0 × 10(5) to 8.9 × 10(6), and ≥8.9 × 10(6) Nh). The risk of LDD increased with cumulative lifting load. The best dose-response relationships were found at the L5-S1 disk level, in which high cumulative lifting load was associated with elevated odds ratios of 2.5 (95% confidence interval [95% CI]=1.5, 4.1) for dehydration and 4.1 (95% CI=1.9, 10.1) for disk height narrowing compared with low lifting load. Participants exposed to intermediate lifting load had an increased odds ratio of 2.1 (95% CI=1.3, 3.3) for bulging compared with low lifting load. The tests for trend were significant. LIMITATIONS There is no "gold standard" assessment tool for measuring the lumbar compression load. CONCLUSIONS The results suggest a dose-response relationship between cumulative lifting load and LDD.
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Ouaaid ZE, Shirazi-Adl A, Plamondon A, Arjmand N. Elevation and orientation of external loads influence trunk neuromuscular response and spinal forces despite identical moments at the L5–S1 level. J Biomech 2014; 47:3035-42. [DOI: 10.1016/j.jbiomech.2014.06.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 06/10/2014] [Accepted: 06/27/2014] [Indexed: 11/16/2022]
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Effect of changes in orientation and position of external loads on trunk muscle activity and kinematics in upright standing. J Electromyogr Kinesiol 2014; 24:387-93. [DOI: 10.1016/j.jelekin.2014.02.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 02/13/2014] [Accepted: 02/15/2014] [Indexed: 11/20/2022] Open
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Arjmand N, Ekrami O, Shirazi-Adl A, Plamondon A, Parnianpour M. Relative performances of artificial neural network and regression mapping tools in evaluation of spinal loads and muscle forces during static lifting. J Biomech 2013; 46:1454-62. [DOI: 10.1016/j.jbiomech.2013.02.026] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2013] [Revised: 02/27/2013] [Accepted: 02/28/2013] [Indexed: 10/27/2022]
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Prediction of peak back compressive forces as a function of lifting speed and compressive forces at lift origin and destination - a pilot study. Saf Health Work 2012; 2:236-42. [PMID: 22953207 PMCID: PMC3430905 DOI: 10.5491/shaw.2011.2.3.236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Revised: 06/08/2011] [Accepted: 06/08/2011] [Indexed: 11/29/2022] Open
Abstract
Objectives To determine the feasibility of predicting static and dynamic peak back-compressive forces based on (1) static back compressive force values at the lift origin and destination and (2) lifting speed. Methods Ten male subjects performed symmetric mid-sagittal floor-to-shoulder, floor-to-waist, and waist-to-shoulder lifts at three different speeds (slow, medium, and fast), and with two different loads (light and heavy). Two-dimensional kinematics and kinetics were captured. Linear regression analyses were used to develop prediction equations, the amount of predictability, and significance for static and dynamic peak back-compressive forces based on a static origin and destination average (SODA) back-compressive force. Results Static and dynamic peak back-compressive forces were highly predicted by the SODA, with R2 values ranging from 0.830 to 0.947. Slopes were significantly different between slow and fast lifting speeds (p < 0.05) for the dynamic peak prediction equations. The slope of the regression line for static prediction was significantly greater than one with a significant positive intercept value. Conclusion SODA under-predict both static and dynamic peak back-compressive force values. Peak values are highly predictable and could be readily determined using back-compressive force assessments at the origin and destination of a lifting task. This could be valuable for enhancing job design and analysis in the workplace and for large-scale studies where a full analysis of each lifting task is not feasible.
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Arjmand N, Plamondon A, Shirazi-Adl A, Larivière C, Parnianpour M. Predictive equations to estimate spinal loads in symmetric lifting tasks. J Biomech 2011; 44:84-91. [DOI: 10.1016/j.jbiomech.2010.08.028] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2010] [Revised: 08/21/2010] [Accepted: 08/24/2010] [Indexed: 10/19/2022]
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