Low Back Loading Research Articles

Working height, block mass and one- vs. two-handed block handling: the contribution to low back and shoulder loading during masonry work

The goal of this study was to compare the effects of the task variables block mass, working height and one- vs. two-handed block handling on low back and shoulder loading during masonry work. In a mock-up of a masonry work site, nine masonry workers performed one- and two-handed block-lifting and block-placing tasks at varying heights (ranging from floor to shoulder level) with blocks of varying mass (ranging from 6 to 16 kg). Kinematics and ground reaction forces were measured and used in a 3-D linked segment model to calculate low back and shoulder loading. Increasing lifting height appeared to be the most effective way to reduce low back loading. However, working at shoulder level resulted in relatively high shoulder loading. Therefore, it was recommended to organise masonry work in such a way that blocks are handled with the hands at about iliac crest height as much as possible.

External L5–S1 joint moments when lifting wire mesh screen used to prevent rock falls in underground mines

Bolting large sheets of wire mesh screen (WMS) to the roof of underground mines prevents injuries due to rock falls. However, WMS can be heavy and awkward to lift and transport, and may result in significant spinal loading. Accordingly, six male subjects (mean age = 45.8 years + 7.5 SD) were recruited to lift WMS in a laboratory investigation of the biomechanical demands. Biomechanical modeling was used to estimate external moments about L5–S1 for sixteen lifting tasks, using two sizes of WMS. Full-size WMS involved a two-person lift, while half-size WMS involved a one-person lift. Lifts were performed under 168 cm and 213 cm vertical space. Restriction in vertical space increased the maximum L5–S1 extensor moment from 254 to 274 Nm and right lateral bending moment from 195 to 251 Nm. Lifting full sheets of screen (as opposed to half sheets) resulted in an average 33 Nm increase in L5–S1 extensor moment. The L5–S1 extensor moment was increased by an average of 44 Nm (18%) when lifting screens positioned flat on the floor compared to an upright position. Relevance to industry Large flexible materials are commonly lifted in industrial work environments, and may involve the efforts of two or more workers. The current study examines the low back loading associated with lifting large flexible screens and presents recommendations to reduce spine loading.

Loading along the lumbar spine as influence by speed, control, load magnitude, and handle height during pushing

Background Low back loading and risk associated with pushing activities have been poorly understood. Previous studies have demonstrated that increases in anterior/posterior shear forces are primarily initiated by antagonistic coactivity within the torso. Yet, few studies have considered the range of activities that might contribute to the antagonistic coactivation and subsequent spine loading. Methods Twenty subjects were tested to examine how various physical factors might influence spine loads during pushing tasks that workers might experience in industrial settings. Load magnitude, speed of push, required control, and handle height were varied while pushing both carts and overhead suspended loads. A biologically-assisted biomechanical model was used to assess compression, anterior/posterior shear, and lateral shear over the various levels of the lumbar spine. Findings Anterior/posterior shear loads were greatest at the upper levels of the lumbar spine and of a magnitude that would be of concern. Anterior/posterior shear was influenced by all experimental factors to varying degrees except for the nature of the load (cart vs. suspended). Interpretation This study confirms the notion that pushing and pulling is not as simple a task as once believed since it entails a complex biomechanical activity. Spine shear forces result from a complex coactivation of trunk muscle activities and spine orientations that are influenced by several occupational factors. This study may help explain why low back pain rates in some work environments associated with lifting may not be reduced even when lifting interventions (that change the task from lifting to pushing) are employed.

Low-back loading in lifting two loads beside the body compared to lifting one load in front of the body

Low-back load during manual lifting is considered an important risk factor for the occurrence of low-back pain. Splitting a load, so it can be lifted beside the body (one load in each hand), instead of in front of the body, can be expected to reduce low-back load. Twelve healthy young men lifted 10 and 20-kg wide and narrow loads in front of the body (the single-load lifts). These single-load lifts were compared to a lifting condition in which two 10-kg loads (a total of 20 kg) were lifted beside the body (the split-load lift). Lifts were performed from an initial hand height of 29 cm with four different lifting techniques (stoop, squat, straddle and kneeling techniques). Using measured kinematics, ground reaction forces, and electromyography, low-back loading (3D net moments and spinal forces at the L5/S1 joint) was estimated. Lifting a 20-kg split-load instead of a 20-kg single-load resulted in most cases in a reduction (8–32%) of peak L5/S1 compression forces. The magnitude of the reduction was roughly comparable to halving the load mass and depended on lifting technique and load width. The effects of load-splitting could largely be explained by changes in horizontal distance between the load and L5/S1.

Errors associated with bin boundaries in observation-based posture assessment methods

The trunk posture misclassification errors made by novice and experienced operators were quantified as a function of the angular distance from posture bin boundaries, similar to those used in observation-based posture assessment tools such as 3DMatch. The effect that these misclassification errors had on cumulative and peak low back loads was also determined in three simulated lifting scenarios. Ninety subjects in 3 experience groups were randomly presented with images of known trunk angle via a monitor. Subjects were instructed to make quick and accurate bin selections using standardized pictures included below the images on the monitor. Mean % bin misclassification errors were approximately 32% and 22% for the flexion/extension and lateral bend views, respectively. More bin classification errors were made the closer a viewed image was to a posture bin boundary, regardless of expertise level, and the number of errors made decreased as operator experience increased. Approximately 99% of bin selections were made either in the correct bin or in the bins immediately adjacent to the correct bin in both views. Misclassification errors made in the 3 simulated lifting scenarios induced errors in peak and cumulative loads in 66% of the cases assessed, with an average absolute difference of 13.5% across all load variables. Future work is aimed at determining the effect of training and bin size on the error misclassification rate for all body segments and views.

Altered motor control, posture and the Pilates method of exercise prescription

The objectives of this study were to compare the effects of three different Pilates regimes on chronic, mild low back pain symptoms and to determine whether the efficiency of load transfer through the pelvis is improved by those exercises. A between subjects equivalent group experimental design was used. The independent variable was the type of exercise training (three groups) and the two-dependent variables were low back pain symptoms and load transfer through the pelvis. The outcome measures of the first-dependent variable were a comparison between modified Oswestry Disability Questionnaires (one of the standard pain instruments) completed pre- and post-program and frequency, intensity and duration of low back pain. The outcome measure of the second-dependent variable, efficiency of load transfer through the pelvis was the Stork test (one-legged standing test) in weight bearing. Although all groups experienced statistically significant reductions in frequency, intensity and duration of low back pain across the weeks of exercising, there were no significant differences between the groups relative to each other.

Effect of lifting height and load mass on low back loading

The objective of this study was to quantify the effect of lifting height and mass lifted on the peak low back load in terms of net moments, compression forces and anterior–posterior shear forces. Ten participants had to lift a box using four handle heights. Low back loading was quantified using a dynamic 3-D linked segment model and a detailed electromyographic driven model of the trunk musculature. The effects of lifting height and lifting mass were quantified using a regression technique (GEE) for correlated data. Results indicate that an increase in lifting height and a decrease in lifting mass were related to a decrease in low back load. It is argued that trunk flexion is a major contributor to low back load. For ergonomic interventions it can be advised to prioritise optimisation of the vertical location of the load to be lifted rather than decreasing the mass of the load for handle heights between 32 cm and 155 cm, and for load masses between 7.5 and 15 kg. Lifting height and load mass are important determinants of low back load during manual materials handling. This paper provides the quantitative effect of lifting height and mass lifted, the results of which can be used by ergonomists at the workplace to evaluate interventions regarding lifting height and load mass.

Low back injury risk during repositioning of patients in bed: the influence of handling technique, patient weight and disability

The objective of the study was to investigate the low back load during repositioning of patients in bed and to assess the influence of patient's weight and disability. Nine female health care workers (HCWs) carried out six patient-handling tasks with different patient weight (59 ± 1, 83 ± 2 and 110 ± 4 kg) and handicap (hemiplegia, paraplegia and near-paralysis). The tasks were performed with optional use of simple, low-tech assistant devices (draw and sliding sheets). Peak low back compression exceeded the National Institute for Occupational Safety and Health action level of 3400 N in 25% of all trials (418). The influence of the HCW, i.e. the technique and assistive devices used, was higher than the effect of weight and disability in all tasks studied. ANOVA showed that on average for the six tasks 37%, 10% and 6% of the variance in low back loading was caused by variation in the factors HCW, patient's weight and disability, respectively. The result of this study is relevant for HCWs. It is shown that the repositioning technique and use of friction-reducing devices have higher influence on the low back load of the HCW than the patient's weight and disability.

Muscular contribution to low-back loading and stiffness during standard and suspended push-ups

Push-up exercises are normally performed to challenge muscles that span upper extremity joints. However, it is also recognized that push-ups provide an effective abdominal muscle challenge, especially when the hands are in contact with a labile support surface. The purpose of this study was to compare trunk muscle activation levels and resultant intervertebral joint (IVJ) loading when standard and suspended push-ups were performed, and to quantify and compare the contribution of trunk muscles to IVJ rotational stiffness in both exercises. Eleven recreationally trained male volunteers performed sets of standard and suspended push-ups. Upper body kinematic, kinetic, and EMG data were collected and input into a 3D biomechanical model of the lumbar torso to quantify lumbar IVJ loading and the contributions of trunk muscles to IVJ rotational stiffness. When performing suspended push-ups, muscles of the abdominal wall and the latissimus dorsi were activated to levels that were significantly greater than those elicited when performing standard push-ups (p<.05). As a direct result of these increased activation levels, model-predicted muscle forces increased and consequently led to significantly greater mean (p=.0008) and peak (p=.0012) lumbar IVJ compressive forces when performing suspended push-ups. Also directly resulting from the increased activation levels of the abdominal muscles and the latissimus dorsi during suspended push-ups was increased muscular contribution to lumbar IVJ rotational stiffness (p<.05). In comparison to the standard version of the exercise, suspended push-ups appear to provide a superior abdominal muscle challenge. However, for individuals unable to tolerate high lumbar IVJ compressive loads, potential benefits gained by incorporating suspended push-ups into their resistance training regimen may be outweighed by the risk of overloading low-back tissues.

Comparison of low back joint moment using a dynamic 3D biomechanical model in different transferring tasks wearing low back belt

The purpose of this study was to construct a 3D dynamic model to quantify low back load during single person dependent transfer, and to compare the effects of wearing style of a low back belt on low back loading. Of the nine subjects participating in this study, eight adopted the role of caregiver and one was a simulated patient. Tasks were general transfer without either subject wearing a low back belt (WB), transfer with the patient wearing a low back belt (BP), transfer with both subjects wearing low back belts (BB), and transfer with the caregiver wearing a low back belt (BC). Low back lateral and extension moments in BB and BC transfers showed the significantly smaller values than those in WB transfers ( p < 0.01). The results suggest that the wearing of a low back belt by caregivers would reduce low back joint moment during transfers.

Influence of Quadriceps Femoris Fatigue on Low Back Load during Lifting of Loads at Different Distances from the Toes

[Purpose] In this study, the effects of muscle fatigue involving only the quadriceps femoris on low back load during lifting were dynamically and mechanically investigated in relation to the degree of muscle fatigue and distance from a heavy object. [Methods] We measured the joint angle, electromyography and ground reaction force of 18 healthy male students during lifting at 3 fatigue levels of loads placed at 3 distances from the toes. [Results] At 25% fatigue of the quadriceps femoris, at the intermediate point of lifting, the knees were mostly extended and the body trunk was leaning forward, thus altering the mode of lifting. Myoelectrical activity of the quadriceps femoris was also decreased, and myoelectrical activity of the lumbar muscle decreased during the phase from the start of muscle activity to when the object was lifted off the floor. At 50% fatigue of the quadriceps femoris, no change in joint angles was seen during lifting, and as myoelectrical activity of the quadriceps femoris decreased, myoelectrical activity of the lumbar muscle increased during the phase from the start of muscle activity to when the object was lifted off the floor. In terms of ground reaction force, greater distance was associated with greater anterior load. [Conclusion] These results suggest that when the level of quadriceps femoris fatigue is relatively low, altering the mode of lifting somewhat lessens low back load, but when the level of quadriceps femoris fatigue is relatively high, compensatory changes cannot be made and an increase in low back load can increase the risk of lumbar injury.

移乗介助におけるリフトの腰部負担軽減の効果

In Japanese care-work sites, care-workers (CWs) have lacked basic health risk awareness for transferring patients. Knowledge of lifting equipment and skills for transfer of patients have not been disseminated and many CWs have suffered from work-related musculoskeletal disorders, especially low back pain (LBP). In order to find better ways of patient transfer which reduce and prevent LBP, we conducted a study of low back loads and operation time during the transfer of a simulated patient, who was totally dependent from bed to wheelchair, using a mechanical lift (Lift) and manual handling (handling). Moreover we examined the levels of skill which CWs had acquired in transfer by Lift and the effects of acquired skill on low back loads and operation time. We explored low back load using surface electromyography (EMG) of the lumbar paraspinals between L3 and L4 and the trunk inclination angle (TIA) measurement method. The subjects were 5 caregivers who performed the task of transferring a simulated patient from lying on the bed to sitting in a wheelchair using the Lift and by handling. Handling transfer was assisted by two-persons at the head and foot. A 'simulated' patient (a 70 kg healthy male; instructed to keep whole body relaxed) was used in all transfer tasks. When subjects used the Lift, we made an ergonomics checklist for reduction of low back load of caregivers. Subjects performed the task 4 times and were evaluated with the checklist. The level of acquired skill was significantly improved by the guidance of the checklist. TIA was observed to be significantly lower in Lift than in handling, but with EMG no significant differences were seen between Lift and handling. The effects of acquired skill on low back loads showed that TIA was statistically reduced at high skill as compared to low skill. However, there were no significant differences between both skills in Lift and handling by EMG. Operation time of Lift showed significant shortening of operation time with high skill as compared to low skill. Operation time of Lift was about 10 times longer than handling. Thus, we suggest that transfer by Lift is a valid way of reducing the burden on CWs low back. Additionally, this study found that for reduction of LBP risk for CWs, it will be important not only to use the Lift but also to observe proper procedure and raise CW skill levels in patient transfer.

A different approach for the ergonomic evaluation of pushing and pulling in practice

Recent epidemiological studies show that pushing and pulling increase the risks of shoulder complaints and not necessarily of low back complaints. Moreover, the magnitude of the exerted hand forces during pushing and pulling is poorly related to the magnitude of the mechanical loading of the low back and the shoulder. In light of that, this paper combines results of several studies to present an approach for evaluating not only the exerted hand forces, but also the low back and shoulder load during pushing and pulling in practice. The approach specifies, based on scientific evidence, that (1) in order to validly obtain exposure (frequency and duration) to pushing and pulling, 10 workers should be observed during eight periods of 30 min; (2) how the exerted hand forces and the load of the low back and shoulder can be estimated in practice based solemnly on the weight of the object, one-handed or two-handed pushing or pulling, and the height of the handle; and finally, (3) how these outcomes can be evaluated in combination with existing guidelines regarding exerted hand forces, compression forces on the low back and the moments at the shoulder. Two cases will be presented here to illustrate the application of the approach. Relevance to industry The presented approach is the first to offer practitioners a fairly simple method for the ergonomic evaluation of pushing and pulling carts and four-wheeled containers in practice, especially as regarding the shoulder load.

Cart pushing: The effects of magnitude and direction of the exerted push force, and of trunk inclination on low back loading

The primary objective of the present study was to quantify the relative effect of the magnitude and direction of the exerted push force and of trunk inclination on the mechanical load at the low back using a regression analysis for correlated data. In addition, we explored the effects of handle height and type of pushing activity (standing or walking) on the magnitude and direction of exerted forces, trunk inclination, and low back loading when pushing a four-wheeled cart on a treadmill. An experimental setup was designed in which nine participants pushed a four-wheeled cart on a treadmill. Kinematics and reaction forces on the hand were measured to calculate the net moment at the L5–S1 intervertebral disc. Results show that the magnitude and direction of the exerted push force and the trunk inclination significantly and independently affect low back load. It is concluded that for the ergonomic evaluation of pushing tasks, the inclination of the trunk should be considered, in addition to the magnitude and direction of exerted forces. Relevance to industry Pushing carts is a common activity for a considerable part of the workforce and has been associated with musculoskeletal complaints. This paper shows that not only the magnitude of exerted forces determines the low back load but also the direction of the exerted forces and the inclination of the trunk should be considered for ergonomic evaluation.

A validation of a posture matching approach for the determination of 3D cumulative back loads

The purpose of this project was to investigate the amount of error in calculating cumulative lumbar spine kinetics using a posture matching approach (3DMatch) compared to a 3D coordinate electromagnetic tracking approach (FASTRAK™). Six subjects were required to perform five repeats each of two symmetrical and two asymmetrical lifts while being simultaneously recorded from 4 camera views at viewing angles of 0°, 45°, 60° and 90° to the sagittal plane while wearing eight FASTRAK™ sensors to define an 8 segment rigid link model (RLM) of the head, arms, and trunk. Four hundred and eighty lifts (6 subjects ×20 lifts ×4 camera views) were analyzed using the 3DMatch posture-matching program to calculate the following cumulative loads at the L4/L5 joint: compression, anterior shear, posterior shear, reaction shear and extension moment. The errors in cumulative load calculation were determined as the difference between the values calculated for the same lifts using a 3D RLM that used electromagnetic motion tracking sensors (FASTRAK™) positioned at the segment center of masses as model inputs. No significant difference ( p<0.05) in the relative error for any of the cumulative loading variables between the four camera views and the 3D RLM approach was found. Furthermore the relative errors for cumulative compression, joint anterior shear, reaction anterior shear and extension moment were all below 12%. These results suggest that posture matching by trained users can provide reasonable 3D data to calculate cumulative low back loads with a biomechanical model.

An examination of shoulder kinematics and kinetics when using a commercial trunk harness while sheep shearing

Sheep shearing is a very physically demanding occupation, especially on the low back, such that many commercial harnesses have been developed to help reduce the load on the back. Such harnesses have been shown to significantly reduce peak and cumulative low back loads; however, the effect that these harnesses have on the shoulders, which are also highly involved during sheep shearing, has not been previously examined. The purpose of this study was to examine the shoulder postures and cumulative shoulder moments of 12 New Zealand sheep shearers. The use of the trunk harness reduced the percentage of time spent in shoulder flexion greater than 90° and the time spent in shoulder abduction greater than 45° as well as reduced the cumulative net joint flexor, abductor, and adductor shoulder moments by a minimum of 21%, 14%, and 42%, respectively. Therefore, the use of a commercial trunk harness to reduce low back injury may also help to reduce the risk of shoulder injury while sheep shearing.

A case study of serial‐flow car disassembly: Ergonomics, productivity and potential system performance

AbstractA recent European Union (EU) directive increases demands on car recycling. Thus, present craft‐type disassembly systems need reconfiguration in order to be more efficient. A line‐based system tested in the Netherlands was investigated regarding system performance and ergonomics. The system had reduced performance compared to the design specifications due to such factors as system losses, operator inexperience, and teamwork deficiencies. Operators' peak low back loads were lower than in Swedish craft‐type systems. Direct, value‐adding work comprised 30% of the workday, compared to about 70% in the Swedish manufacturing industry. Alternative system configurations were simulated and discussed using a novel combination of flow and human simulations. For example, a smaller variation in cycle time implied higher output in number of cars per week and larger operator cumulative loading on the low back. In all models the cumulative load was high compared to the loads previously recorded in assembly work. © 2007 Wiley Periodicals, Inc. Hum Factors Man 17: 331–351, 2007.

EFFECT OF SHIP MOTION ON LOW BACK MOMENTS DURING MANUAL LIFTING

INTRODUCTION Performing heavy work (such as lifting) on a ship is associated with a high prevalence of musculoskeletal problems [1,2]. Lifting results in high low back loading [3], thereby affecting low back pain risk. Ship motion may have an additional effect on low back loading during lifting [4]. Depending on the timing of a lifting movement, ship motion can either increase (for example when a ship accelerates upwards) or decrease (for example when a ship accelerates downwards) low back loading. The aim of the present study was to find out to what extent ship motion affects the peak low back moment at the L5S1 joint during manual lifting on a ship at sea. Furthermore, it was investigated whether people are able to time their lifting movements in such a way that the effect of ship motion reduces peak low back moments.

個別ケアに取り組む高齢者介護施設の個浴の入浴介助における腰部負担および介護職員と利用者の満足度

Since the public nursing care insurance system was enacted by the Japanese government, a transition from conventional group treatment to the individual care is required. In Japanese nursing homes for the elderly, bathing assistance methods have shifted from use of traditional mechanical bathtubs or a big bathtub to methods using small homestyle bathtubs, known as "individual bathing assistance". A study on the work load of caregivers with individual bathing assistance has never been conducted. Therefore, in a nursing home for the elderly practicing the individual bathing assistance method, we explored low back load using surface electromyography and trunk inclination angle measurement. Moreover, subjective evaluations by not only the caregivers but also the care receivers were investigated. The individual bathing assistance time per person was about 35 min. When caregiver used the mechanical lift equipment to assist getting into and out of the bathtub, trunk inclination angle and muscle load were lower than with manual handling. Mechanical lift equipment had the advantage of reducing low back load. When caregivers gave assistance with dressing and ablution of the lower limbs, and in setting wheelchair footrests, trunk inclination angle and muscle load showed high values. The satisfaction rating of using the mechanical lift equipment showed the best score, and ratings of perceived exertion were about the same. Thus, the importance of safe and comfortable care for both caregivers and care receivers should be stressed to make effective use of assistance products and care equipment.

Low Back Load of Caregiver During Transfer Movement Using Assistive Devices

Low Back Load of Caregiver During Transfer Movement Using Assistive Devices