Asymmetric Lifting Research Articles

Effects of Volitional Spine Stabilization on Trunk Control During Asymmetric Lifting Task in Patients With Recurrent Low Back Pain.

Study Design:Prospective, concurrent-cohort study.Objectives:To determine the effects of volitional preemptive abdominal contraction (VPAC) on trunk control during an asymmetric lift in patients with recurrent low back pain (rLBP) and compare with matched controls.Methods:Thirty-two rLBP patients and 37 healthy controls performed asymmetric lifting with and without VPAC. Trunk, pelvis, and hip biomechanical along with neuromuscular activity parameters were obtained using 3-dimensional motion capture and electromyography system. Hypotheses were tested using analysis of variance.Results:The VPAC resulted in significantly reduced muscle activity across all trunk extensor muscles in both groups (M ± SD, 6.4% ± 8.2% of maximum contraction; P ≤ .005), and reduced trunk side flexion (1.4° ± 5.1° smaller; P ≤ .005) and hip abduction (8.1° ± 21.1° smaller; P ≤ .003). rLBP patients exhibited reduced muscle activity in external oblique (12.3% ± 5.5% of maximum contraction; P ≤ .012), as well as decreased hip flexion (4.7°, P ≤ .008) and hip abduction (5.2°, P ≤ .001) at the final position of lifting in comparison with healthy controls.Conclusions:The results of this study defend the recommendation that the use of a VPAC increase spine stability during an asymmetrical loading task. Our results provide an indication that a VPAC strategy that is achieved during an asymmetric lifting decreases exposure for lumbar spine injury and instability. Spine care providers and ergonomists can use this information when designing neuromuscular control training programs, both for healthy individuals aimed at prevention of injury, as well as those with a history of rLBP, aimed at full functional recovery and protection from future injury.

The effects of load weight and load starting height on variability of lifting kinematics and kinetics

Trunk kinematic variables have been used to understand the risk of low back injuries in the workplace. Variability in the trunk kinematics as an individual performs a repetitive lifting task is an underexplored area of research. In the current study, it was hypothesized that workplace variables (starting height of lift and load weight) would have an impact on the variance in the kinematic and kinetic variables. Twenty participants performed 60 repetitions of an asymmetric lifting task under four different conditions representing two levels of load weight (5% or 10% of the participant's body weight) and two levels of starting height (80% or 120% of the participant's knee height). The Lumbar Motion Monitor was used to capture trunk kinematic variables from the concentric range of lifting motion while ground reaction forces were collected using a force platform. The primary dependent variables were the variance of kinematic and kinetic variables across these 60 repetitions. The results showed a significant effect of starting height on the variance of sagittal plane trunk kinematics with the lower starting height generating an increased variance (sagittal range of motion increased by 55%, average sagittal velocity increased by 95%, peak sagittal velocity increased by 105%, and peak sagittal acceleration increased by 130%). There was no consistent significant main effect of either independent variable on the variance of the transverse plane kinematics. Additionally, there was no significant effect of load weight on the variance of any trunk kinematic variables tested. In terms of ground reaction forces, it was shown that the starting height of the load had a significant effect on the variance of peak vertical ground reaction force, while the weight of the load had a significant effect on the variance of the peak shear force.

Exploration of different classes of metrics to characterize motor variability during repetitive symmetric and asymmetric lifting tasks

The substantial kinematic degrees-of-freedom available in human movement lead to inherent variations in a repetitive movement, or motor variability (MV). Growing evidence suggests that characterizing MV permits a better understanding of potential injury mechanisms. Several diverse methods, though, have been used to quantify MV, but limited evidence exists regarding the merits of these methods in the occupational context. In this work, we explored different classes of methods for characterizing MV during symmetric and asymmetric box lifting tasks. Kinematic MV of both the whole-body center-of-mass (COM) and the box were quantified, using metrics derived from a linear method (Standard Deviation), a non-linear method (Sample Entropy; an index of movement regularity), and a novel application of an equifinality method (Goal Equivalent Manifold; an index related to the set of effective motor solutions). Our results suggest that individuals manipulate regularity and the set of effective motor solutions to overcome unwanted motor noises related to the COM. These results, together with earlier evidence, imply that individuals may prioritize stability over variability with increasing task difficulty. Task performance also appeared to deteriorate with decreasing variability and regularity of the COM. We conclude that diverse metrics of MV may be complimentary to reveal differences in MV.

A passive exoskeleton reduces peak and mean EMG during symmetric and asymmetric lifting

The VT-Lowe’s exoskeleton is a novel passive lift-assistive device designed to offload the back muscles during repetitive lifting. In this study, the effect of the exoskeleton on electromyographic (EMG) signals was investigated in four different lifting types (stoop, squat, freestyle and asymmetric) and two box weights (0% and 20% of body weight). Twelve young healthy adults ages 18–31 years (mean = 22.75, SD = 4.35) were participants. The EMG signals for twelve muscles (iliocostalis erector spinae (IL), longissimus erector spinae (LT), multifidus (MF), bicep femoris (BF), vastus lateralis (VL) and abdominal external oblique (AEO) muscles) were measured. The exoskeleton significantly decreased the peak and mean activity of back muscles (IL and LT) by 31.5% and 29.3%, respectively, for symmetric lifts and by 28.2% and 29.5%, respectively, for asymmetric lifts. The peak and mean EMG of leg muscles were significantly reduced by 19.1% and 14.1% during symmetric lifts, and 17.4% and 14.6% during asymmetric lifts. Although the exoskeleton reduced the activation of back and leg muscles, it slightly increased the activity of external oblique muscles, although this was not statistically significant. In conclusion, the exoskeleton is promising as a lift-assist device for manual material handlers and workers performing repetitive lifting.

Validation of an OpenSim full-body model with detailed lumbar spine for estimating lower lumbar spine loads during symmetric and asymmetric lifting tasks

There is currently no validated full-body lifting model publicly available on the OpenSim modelling platform to estimate spinal loads during lifting. In this study, the existing full-body-lumbar-spine model was adapted and validated for lifting motions to produce the lifting full-body model. Back muscle activations predicted by the model closely matched the measured erector spinae activation patterns. Model estimates of intradiscal pressures and in vivo measurements were strongly correlated. The same spine loading trends were observed for model estimates and reported vertebral body implant measurements. These results demonstrate the suitability of this model to evaluate changes in lumbar loading during lifting.

The Effects of Load Stability and Visual Access During Asymmetric Lifting Tasks on Back and Upper Extremity Biomechanical Responses

To explore the change of muscular and biomechanical responses in different load stability and visual access conditions during an asymmetric lifting task. Previous studies found that lifting unstable loads resulted in changes to the biomechanical loads experienced by the spine and upper extremities. However, researchers have not extensively investigated behaviors when people lift potentially unstable loads. It was hypothesized that lifting a potentially unstable load can lead to changes in lifting behavior, which may be mitigated by visual access to the load. Fourteen volunteers lifted either a stable load or a potentially unstable load that could move within the container during the lifting task. In half of the lifting conditions, the box was covered to restrict visual access when lifting. Spine kinematic and kinetic measures and surface electromyographic (EMG) signals from back, shoulder, and arm muscles were obtained. Lifts of the stable load were faster and generally had higher peak muscle activations than lifts of the potentially unstable load. Participants had less spine flexion when handling the potentially unstable load without visual access. When lifting and moving a potentially unstable load that could lead to a perturbation, people tended to lift the container more slowly comparing with lifting a stable load, which in turn reduced the peak muscle activities. In industry, there are many work situations where workers need to lift or carry unstable loads that can shift during transport. Providing visual access to the load may help mitigate some of these effects.

Biomechanical Assessment of the NIOSH Lifting Equation in Asymmetric Load-Handling Activities Using a Detailed Musculoskeletal Model.

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. 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. 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. 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. The NLE failed to control spinal loads below the recommended limits during asymmetric lifting tasks performed near the floor. The NLE should be used with caution for extreme tasks involving load handling near the floor with large load asymmetry.

Analysis of internal torso loading in asymmetric and dynamic lifting tasks

Analysis of internal torso loading in asymmetric and dynamic lifting tasks

The effect of isolating the paretic limb on weight-bearing distribution and EMG activity during squats in hemiplegic and healthy individuals

Background: Neural reorganization for movement therapy after a stroke is thought to be an important mechanism that facilitates motor recovery. However, there is a lack of evidence for the effectiveness of exercise programs in improving the lower limbs.Objective: We investigated the immediate effect of isolating the paretic limb using different foot positions ((i) foot parallel; both feet parallel, (ii) foot asymmetry; paretic foot backward by 10 cm, and (iii) foot lifting; nonparetic foot lifting by normalization to 25% of knee height) on weight-bearing distribution and electromyography (EMG) of the thigh muscle during squats.Methods: In total, 20 patients with hemiplegia and 16 healthy subjects randomly performed three squat conditions in which the knee joint was flexed to 30°. Weight distribution was measured using the BioRescue system. Muscle activity was measured using a surface EMG system.Results: Patients with hemiplegia exhibited significantly decreased weight bearing on the paretic foot at 0° and 30° knee flexion compared with the nondominant foot of a healthy subject. The muscle activity of the quadriceps was significantly lower in patients with hemiplegia compared to healthy subjects. Weight bearing and EMG activity of the quadriceps femoris on the paretic or nondominant side significantly increased during a knee flexion of 30° with under the foot asymmetry and foot lifting positions compared with the parallel foot position.Conclusion: Isolating the paretic limb using the asymmetric foot positions and lifting of the foot during squats might help patients with hemiplegia to improve weight-bearing and achieve greater activation of the quadriceps muscle in the paretic limb.

Muscular Activation Pattern of Bilateral Extensors Response to Asymmetric Hand Lifting During Trunk Flexion–extension Performance

ABSTRACTThe authors' purpose was to test the effect of asymmetric hand lifting on muscular activation patterns of 3 bilateral extensors. Eighteen male university students without back pain were volunteered. Each performed flexion–extension randomly with conditions of right lifting, left lifting, and nonlifting. Surface electromyography from bilateral thoracic, lumbar erector spinae, and hamstring was recorded. The cross-correlation and relative intensity in paired muscles of bilateral extensors was calculated in flexion as well as extension period. The results showed that the cross-correlation coefficient was decreased and the phase lag as well as the relative intensity of bilateral extensors was increased significantly in thoracic level. The phase lag as well as the relative intensity of bilateral extensors was increased significantly in lumbar level. It was concluded that asymmetric lifting has a significant effect on muscular activation of bilateral extensors in thorax level, which causes the ipsilateral extensor to activate larger and longer. Asymmetric lifting also has some effect on muscular activation of bilateral extensors in lumbar level but with less extent than in thorax level, which causes contralateral extensor to activate larger and longer. Asymmetric lifting seems to have no significant effect on muscular activation of bilateral hamstring.

Estimation of lumbar spinal loading and trunk muscle forces during asymmetric lifting tasks: application of whole-body musculoskeletal modelling in OpenSim

Large spinal compressive force combined with axial torsional shear force during asymmetric lifting tasks is highly associated with lower back injury (LBI). The aim of this study was to estimate lumbar spinal loading and muscle forces during symmetric lifting (SL) and asymmetric lifting (AL) tasks using a whole-body musculoskeletal modelling approach. Thirteen healthy males lifted loads of 7 and 12 kg under two lifting conditions (SL and AL). Kinematic data and ground reaction force data were collected and then processed by a whole-body musculoskeletal model. The results show AL produced a significantly higher peak lateral shear force as well as greater peak force of psoas major, quadratus lumborum, multifidus, iliocostalis lumborum pars lumborum, longissimus thoracis pars lumborum and external oblique than SL. The greater lateral shear forces combined with higher muscle force and asymmetrical muscle contractions may have the biomechanical mechanism responsible for the increased risk of LBI during AL.Practitioner Summary: Estimating lumbar spinal loading and muscle forces during free-dynamic asymmetric lifting tasks with a whole-body musculoskeletal modelling in OpenSim is the core value of this research. The results show that certain muscle groups are fundamentally responsible for asymmetric movement, thereby producing high lumbar spinal loading and muscle forces, which may increase risks of LBI during asymmetric lifting tasks.

Analysis of Difference in Center-of-Pressure Positions Between Experts and Novices During Asymmetric Lifting.

Although numerous studies have analyzed the relationship between manual material handling (MMH) and the forces acting on the lumbar spine, the difference in the MMH between experts and novices through the analysis of measured data has not been well studied. The purpose of this paper was to analyze the difference in the MMH positions between ten skilled experts working at a freight transport company (Group 1) and five unskilled novices without any experience (Group 2) during asymmetric lifting. All the human subjects performed asymmetric lifting experiments with closed eyes; the experiments involved moving loads (6 and 18 kg) to the left side. Time series data of the vertical ground reaction force were measured, using a Wii Balance Board, and then, the center-of-pressure (CoP) trajectories were calculated. The balance board was used for the measurement, because it was reliable, inexpensive, and portable and provided good repeatability even on rough surfaces, and all the information pertaining to the load and worker under various conditions was captured without any omissions. Under the 18 kg load condition, the CoP positions for Group 2 were located on the same side during left asymmetric lifting; however, those for Group 1 were located on the opposite side during left asymmetric lifting (n}{}P <0.001n). Furthermore, under the 6 kg load condition, the load weight influenced asymmetric lifting for most subjects of Group 2 such that the CoP positions were located on the opposite side (n}{}P <0.001n). Based on the simulation and electromyography measurement results, we inferred that the difference in the CoP positions between the two different groups could be attributed to the difference in the hip positions. Most skilled experts position their hips in such a way that their CoP trajectories move toward the opposite side during left asymmetric lifting. Although the skillful characteristics of experts may be responsible for the lightening of the burden on the waist during asymmetric lifting, there are still two points that this paper does not clarify: the relationship between the experts’ adjustment of the hip position and the load of the weight, and the influence of an imbalance of the CoP position on the forces acting on the lumbar spine.

Comparison of trunk muscle activities in lifting and lowering tasks at various heights

[Purpose] Biomechanical data for manual material handling are important for appropriate engineering design. The goal of this study was to investigate differences in trunk muscle activity in lifting and lowering tasks at various heights. [Subjects and Methods] Thirty healthy, young adult subjects performed 6 asymmetrical lifting and lowering tasks at various heights. Trunk muscle activity of the abdominal external oblique muscle (EO), rectus abdominis muscle (RA), and lumbar erector spinae muscles (ES) were recorded using surface electromyography (EMG). [Results] The EMG activities of the bilateral ES differed significantly among heights. The left EO activity in the ankle to knee lifting task was significantly increased compared with that of the knee to ankle lowering task. However, there were no significant differences in the right EO, bilateral ES, or RA between lifting and lowering tasks. [Conclusion] The results show that the optimal range for manual material handling was at trunk height, not only for lifting but also for lowering tasks.

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 Gender and Recurrent Low Back Pain on Lifting Style

Objective: The purpose of this study was to examine the influence of gender and existing, recurrent low back pain (rLBP) on lower extremity and trunk mechanics, as well as neuromuscular control, during a lift task. Design: A multivariate design was used to examine the effects of gender and group on biomechanical and neuromuscular control variables in randomized symmetric and asymmetric lifting. Methods: 68 Males and females with rLBP and healthy performed symmetric and asymmetric weighted box lifting trials to a 1 meter height table. Results: Lifting style was different between gender and between the rLBP versus healthy groups during a 1m box lifting. A significant two-way interaction effect between gender and group was observed for multifidus muscle activity and knee rotation in asymmetric lifting. Several gender and group main effects were observed in pelvis obliquity, trunk flexion and side flexion, knee abduction angles in symmetric lifting; and in pelvis obliquity and rotation, trunk flexion and side flexion, hip abduction, knee abduction angles, external oblique and internal oblique muscles activity in asymmetric lifting. Conclusions: Females and individuals with rLBP appear to use different lifting styles that emphasize movement at the pelvis accompanied by poor kinematic control features at the hip, trunk and knee. Clinicians should be mindful of these changes when developing prevention and rehabilitation programs aimed at improving trunk control in preparation for lifting tasks during domestic and occupational activities.

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

This study investigated the effects of task precision demands on behavioral and physiological changes during repetitive asymmetric lifting. Repetitive lifting encountered in manual material handling leads to muscle fatigue and is a documented risk factor for low back disorder. 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. 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. 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. Understanding behavioral changes to repetitive asymmetric lifting, especially for tasks requiring greater precision can be used to support injury prevention efforts.

Effects of Seated Whole Body Vibration Exposure on Repetitive Asymmetric Lifting Tasks

This study investigated physiological and behavioral changes to 60 minutes of repetitive asymmetric lifting activity after exposure to whole body vibrations (WBV). Our results demonstrated that behavioral changes when liftinSg after exposure to WBV would increase the risk of low back disorder.

Age-related biomechanical differences during asymmetric lifting

This study investigated age-related biomechanical differences during asymmetric lifting. Eleven younger and twelve older participants were instructed to lift loads of different weights to an asymmetric destination. The trunk kinematics and low back moments were examined. The results showed that older adults adopted safer lifting strategies compared with younger adults. Specifically, the peak trunk sagittal flexion angle was 32% lower and the peak trunk transverse twisting angle was 22% lower in older adults compared with those in younger adults. It was also found that the average low back moment in the deposit phase was 32% higher in older adults than that in younger adults, most probably due to the age-related increased body weight. Based on these findings and the fact of age-related decreased muscle strengths, physical exercise programs were suggested to be more effective than instructions of safe lifting strategies in LBP risk reduction during asymmetric lifting for older adults. For younger adults, safe lifting strategy instructions might be effective to reduce risks of LBP. Relevance to industryLifting tasks are very common in occupational settings which are often associated with low back pain (LBP). The findings from the present study can aid in better understanding differences in LBP risks of asymmetric lifting between older and younger adults. Implications on ergonomic interventions for reducing LBP risks of asymmetric lifting have been discussed as well based on these findings.

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.

Biomechanical Technique Changes in Males and Females during a Prolonged Asymmetrical Lifting Task

The purpose of this study was to examine biomechanical differences between genders during a prolonged fatiguing asymmetric lifting task. Thirty-seven participants performed an asymmetrical lifting task over a period of 75 minutes at a rate of six lifts per minute. The lift envelope started from the floor directly in front of the participant to a shelf 60 degrees to the right of the sagittal plane at a normalized height to the participant’s anterior superior iliac spine (ASIS). A handled box weighing 10% of the participants’ predetermined maximum lifting capacity was used as the lifting object. Electromagnetic tracking sensors were used to provide kinetic and kinematic data. Eleven sensors were affixed bilaterally to the participant’s hands, arms, and trunk. Strong indicators for fatigue were found after the lifting task. Ratings of Perceived Exertion (RPE) increased over time and maximal voluntary exertion in back and shoulder extension decreased post lifting. Kinematic changes were altered over time, more markedly in females than males, suggesting that biomechanical differences exist during similar tasks due to factors associated with gender. Males and females differ in their response to a fatigued state during the same asymmetric lifting task. Given that current ergonomic practice is based on gender neutralized or androcentric design, the difference in response between males and females to the same stimuli suggests that current workplace interventions may not be equally effective for both sexes.