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PubMed1988

Coordinated isometric muscle commands adequately and erroneously programmed for the weight during lifting task with precision grip.

Small objects were lifted from a table, held in the air, and replaced using the precision grip between the index finger and thumb. The adaptation of motor commands to variations in the object's weight and sensori-motor mechanisms responsible for optimum performance of the transition between the various phases of the task were examined. The lifting movement involved mainly a flexion of the elbow joint. The grip force, the load force (vertical lifting force) and the vertical position were measured. Electromyographic activity (e.m.g.) was recorded from four antagonist pairs of hand/arm muscles primarily influencing the grip force or the load force. In the lifting series with constant weight, the force development was adequately programmed for the current weight during the loading phase (i.e. the phase of parallel increase in the load and grip forces during isometric conditions before the lift-off). The grip and load force rate trajectories were mainly single-peaked, bell-shaped and roughly proportional to the final force. In the lifting series with unexpected weight changes between lifts, it was established that these force rate profiles were programmed on the basis of the previous weight. Consequently, with lifts programmed for a lighter weight the object did not move at the end of the continuous force increase. Then the forces increased in a discontinous fashion until the force of gravity was overcome. With lifts programmed for a heavier weight, the high load and grip force rates at the moment the load force overcame the force of gravity caused a pronounced positional overshoot and a high grip force peak, respectively. In these conditions the erroneous programmed commands were automatically terminated by somatosensory signals elicited by the start of the movement. A similar triggering by somatosensory information applied to the release of programmed motor commands accounting for the unloading phase (i.e. the parallel decrease in the grip and load forces after the object contacted the table following its replacement). These commands were always adequately programmed for the weight.

Adolescent↗
PubMed1983

The distance between the load and the body with three bi-manual lifting techniques.

Studies were made of two different techniques of bi-manual lifting with bent legs (A and B) and a technique of lifting with the back bent and the Knees almost extended (C). With technique A, the trunk was almost vertical, while with B it was erect and more forward inclined and the heel of the front foot kept in contact with the support. Two healthy subject samples (n = 18 and n = 16 respectively) were studied, both employing a force platform; with the second sample the back muscles were also evaluated by electromyography. The distance Delta L between the lines of gravity of the body and the load at the start of the lifts was shortest with technique A and longest with C. This was true whether the position of the feet was chosen spontaneously or was identical for all three techniques. The distance of the load from the body during the lifting movement was directly related to the distance at the start of the lift: the further away the load was at initiation of the lift, the further away it remained throughout the rest of the lift. A request to lift as close to the load as possible had a positive effect in shortening Delta L , but the amount of previously received instruction in lifting technique did not correlate with the spontaneously chosen Delta L.

Journal Article↗
PubMed1995

Development of predictive equations for lifting strengths.

The purpose of the study was to determine relationship between lifting strengths of male and female subjects and body posture, type of lift (stoop or squat) and velocity of lift. Thirty normal young adults (18 males and 12 females) volunteered for the study. All subjects were required to perform a total of 56 tasks. Of these, 28 were stoop lifts and 28 were squat lifts. In each of the categories of stoop and squat lifts, the strengths were tested in standard posture, isokinetic (linear velocity of 500 mm/s), and isometric modes at half, three-quarters and full horizontal individual reach distances in sagittal, 30 degrees lateral and 60 degrees lateral planes. The strengths were measured using a static dynamic strength tester with a load cell and an IBM microcomputer with an A/D card. The peak and average strength values were extracted and statistically compared across conditions and gender (ANOVA). Finally a multiple regression analysis was carried out to predict strength as a function of reach, posture and velocity of lift. The ANOVA revealed a highly significant effect of gender, reach, plane and velocity (p < 0.01). All regression equations (108) were significant (p < 0.01), and more than 70% of variance in lifting strength was accounted for by the anthropometric variables and sagittal plane strength values. Such an established relationship allows one to predict the human lifting strength capabilities for industrial application based on simple anthropometric and strength characteristics.

Journal Article↗
PubMed1996

Spinal compression at peak isometric and isokinetic exertions in simulated lifting in symmetric and asymmetric planes.

OBJECTIVE: To determine if the spinal compression can be used as a criterion for the safety of the back. DESIGN: Various lifting strength activities were analysed using a 3-D biomechanical model to determine spinal compression forces. BACKGROUND: Despite many standards being set and the use of varied strategies, low-back injuries continue to be common in our society. Since the injuries occur to the tissues in the body, it may be more appropriate to investigate the effects of external loads on the tissues. Therefore it was decided to determine the spinal compression in standardized lifting tasks. METHODS: Twenty young adults (12 males and 8 females) performed maximal stoop and squat lifts in sagittal, 30 degrees lateral, and 60 degrees lateral planes at half, three-quarters, and full horizontal reach distances. The stoop lifts were performed in isokinetic and isometric modes; the isometric mode was performed with the hip at 60 degrees and 90 degrees. The squat lifts were also performed in isokinetic and isometric modes; the isometric mode consisted of postures with knee at 90 degrees and 135 degrees of flexion. In addition, the subjects also performed isometric lifts in stoop and squat postures at a self-selected optimum posture. During these activities the strength was measured using a static dynamic strength tester employing a load cell and force monitor. Three-dimensional postural recording was made using a 3-D Peak Performance Technologies imaging system. Using the postural and force data as input to a 3-D biomechanical model, the lumbosacral spinal compression was calculated. The values of strength and spinal compression were analysed and compared. RESULTS: The strength was significantly affected by the gender, the type of lift, plane of lift and reach of lift (P < 0.01); whereas the spinal compression was not affected by the reach at all. Two-way and three-way interactions were significant for strength (P < 0.02) but not for spinal compression. CONCLUSION: It was concluded that the spinal compression was the ultimate cost function in the safety of the back and as such preventative strategies should be based on this. RELEVANCE: The use of an appropriate cost function in a manner in which it can maximize the safety of the back will be of considerable value. Since injuries are biomechanical perturbation of the tissues, it is argued that the cost function be used in a manner where tissue load be considered as the primary factor.

Journal Article↗
PubMed2002

Ergonomics study on the handle length and lift angle for the culinary spatula.

The culinary spatula (turning shovel) is one of the most common cooking tools used in the kitchen in Asia. However, the culinary spatula has seldom been ergonomically investigated. When a person uses a spatula to cook food, the operations involve repetitive bent-wrist motions, such as dorsiflexion, palmary flexion, and radial and ulnar deviations. These movements may cause cumulative trauma disorders in the upper extremities, and in particular carpal tunnel syndrome. A poorly designed culinary spatula will be ergonomically inefficient and cause injury to the hand and wrist. The purpose of this study was to investigate the effects of spatula handle length and lift angle on food-frying, food-turning, and food-shoveling performance. Eight female subjects were tested using 16 different culinary spatulas, with four different handle lengths (20, 25, 30 and 35 cm) and four different lift angles (15 degrees, 25 degrees, 35 degrees and 45 ). The criterion measures included cooking performance, and rating of perceived exertion. The subjects ranked their preference after all of the tasks in the tests were completed. The results showed that: (1) The handle length had a significant influence on the cooking performance, and rating of perceived exertion. The optimal handle lengths for frying food, turning food, and shoveling food were 20, 25 and 25 cm, respectively. (2) The lift angle significantly affected the cooking performance, and rating of perceived exertion. The optimal lift angles for frying food, turning food, and shoveling food were 15 degrees, 15 degrees and 25 degrees, respectively. (3) Both the handle length and lift angle had significant effects on subjective preference. For the handle length, the 20 cm length was the best. For the lift angle, the 25 angle was the best. (4) In general, a spatula with a 20 cm handle length and 25 degrees lift angle was the best. A spatula with a 25 cm handle length and 15 lift angle was the second most preferred. (5) However, to prevent subjects from touching the edge of a hot pan, a spatula with a 25 cm handle length and 25 lift angle is suggested.

Adult↗
PubMed1993

Revised NIOSH equation for the design and evaluation of manual lifting tasks.

In 1985, the National Institute for Occupational Safety and Health (NIOSH) convened an ad hoc committee of experts who reviewed the current literature on lifting, recommend criteria for defining lifting capacity, and in 1991 developed a revised lifting equation. Subsequently, NIOSH developed the documentation for the equation and played a prominent role in recommending methods for interpreting the results of the equation. The 1991 equation reflects new findings and provides methods for evaluating asymmetrical lifting tasks, lifts of objects with less than optimal hand-container couplings, and also provides guidelines for a larger range of work durations and lifting frequencies than the 1981 equation. This paper provides the basis for selecting the three criteria (biomechanical, physiological, and psychophysical) that were used to define the 1991 equation, and describes the derivation of the individual components (Putz-Anderson and Waters 1991). The paper also describes the lifting index (LI), an index of relative physical stress, that can be used to identify hazardous lifting tasks. Although the 1991 equation has not been fully validated, the recommended weight limits derived from the revised equation are consistent with or lower than those generally reported in the literature. NIOSH believes that the revised 1991 lifting equation is more likely than the 1981 equation to protect most workers.

Biomechanical Phenomena↗
PubMed1997

Load knowledge affects low-back loading and control of balance in lifting tasks.

This study investigated the effect of the presence or absence of load knowledge on the low-back loading and the control of balance in lifting tasks. Low-back loading was quantified by the net sagittal plane torque at the lumbo-sacral joint. The control of balance was studied by the position of the centre of gravity relative to the base of support, the horizontal and vertical momentum of the centre of gravity and the angular momentum of the whole body. In a first experiment, 8 male subjects lifted a rather heavy load (22% of body mass), using a leglift and a backlift, while they were familiar with the load mass. To counteract the threat to balance, imposed by picking up a load in front of the body, the subjects performed specific preparations, based upon the known load mass; prior to load pick-up, profound changes in the horizontal and angular momentum were found. The preparations were technique specific. Preserving balance seemed easier while picking up a load with a backlift than with a leglift. In the second experiment, 25 male subjects lifted a 6 kg box, which they expected to be 16 kg, because, in a series of lifts, the load mass was changed from 16 to 6 kg without their knowledge. Despite the 10 kg difference in actual load mass, the net torque at the lumbo-sacral joint was not different between lifting 6 and 16 kg, until 150 ms after box lift-off. Moreover, lifting of the overestimated load mass caused a disturbance of balance in 92% of the trials. The postural reactions aimed at regaining balance were not accompanied by an increased low-back loading. It was concluded that the absence of load knowledge, and the following overestimation of the load mass to be lifted, lead to an increased mechanical load on the lumbar spine and to an increased risk of losing balance in lifting tasks. Both events may contribute to a higher risk of low-back injury in manual materials handling tasks.

Adult↗
PubMed2006

Brow lift via the direct and trans-blepharoplasty approaches.

Brow ptosis occurs as part of the aging process, and as a complication of facial nerve paresis. The article addresses the options available for correction of brow ptosis. The direct brow lift is effective for medial and central brow ptosis, and additional lift laterally may occasionally be needed. This is achieved with either a temporal external lift or an internal lift combined with blepharoplasty. The direct brow lift is suitable for any degree and pattern of brow ptosis, usually in males. It is also suitable for older females as well as male patients with facial paresis or marked involutional brow ptosis. The trans-blepharoplasty brow lift is suitable for relatively small degrees of brow ptosis affecting mainly the lateral two-thirds of the brow in any age group. It is often combined with upper lid blepharoplasty and is performed through the same incision. Complications associated with the direct brow lift include a cosmetically disturbing scar, granuloma formation due to the use of braided absorbable sutures rather than monofilament sutures, and the brow descending again. There may be temporary patches of reduced sensation in the forehead which normally recover in a few months. Complications associated with the trans-blepharoplasty brow lift include less lift than desired, and sutures causing dimpling of the skin. These two techniques are useful additions to the approaches for patients with brow ptosis.

Blepharoplasty↗
PubMed1979

Effects of lifting frequency and technique on physical fatigue with special reference to psychophysical methodology and metabolic rate.

A laboratory study was conducted (1) to evaluate the effects of lifting frequency and technique on maximum acceptable work loads using psychophysical measurement technique, and (2) to compare the physiological fatigue criteria of 5 Kcal/min with the psychophysical fatigue criteria by measuring the metabolic rates at maximum acceptable work loads determined by subjective estimates of physical fatigue. Six male college students were required to lift from the floor to a 0.5 m height for 40 minutes. Four levels of lifting frequency (3, 6, 9 and 12 lifts/min) and three different lifting techniques (free sytle, stooped back and straight-back, bent-knee) were employed. Oxygen consumption rates were measured at maximum acceptable work loads (and were reduced to STPD). Statistical analysis showed that the maximum work loads acceptable to the workers were significantly affected by both lifting frequency and technique. Maximum acceptable work loads increased with an increase in lifting frequency. Both the subjective estimates of physical fatigue and the metabolic energy expenditure rate favored the free style lifting technique. The measured metabolic rates were in agreement with the physiological fatigue criteria of 5 Kcal/min only for six of the twelve combinations of lifting frequency and technique. Use of the physiological fatigue criteria will result in more liberal standards of work load at low work paces, especially for the stooped back and the free style lifting techniques.

Energy Metabolism↗
PubMed1989

An evaluation of the NIOSH guidelines for manual lifting, with special reference to horizontal distance.

A laboratory study was conducted to determine the percentage of subjects capable of lifting loads at the maximum permissible limit (MPL) and the corresponding energy expenditure, heart rate, compressive force on the L5/S1 disc, and ratings of perceived exertion. A second objective was to compare MPLs based on measured horizontal distances with those based on the rule of thumb proposed in the National Institute for Occupational Safety and Health (NIOSH) guide (H = 15 + w/2 cm). Thirteen male subjects were required to lift three different boxes (25, 38, and 51 cm wide) at four different frequencies (0.2, 3, 6, and 9 lifts/min) and at two heights (floor level to bench height [0.8 m] and bench height to 1.5 m). Each lift was performed for 1 hr, and horizontal distances for all 13 subjects were measured at the origin of the lifts. MPLs were computed for all lifting tasks. A psychophysical method was used to determine the maximum acceptable weight of a lift. This weight, however, was not allowed to exceed the corresponding MPL. Maximum acceptable weights for all 13 subjects were equal to the MPLs. Of 13 subjects, 9 indicated that they could lift weights significantly greater than the MPLs. MPLs for the bench to 1.5-m height were significantly greater than the corresponding MPLs for the floor to 0.8-m height. The mean heart rate for 1-hr lifting tasks ranged from 104 to 114 beats/min. The estimated compressive force on the L5/S1 disc ranged from 340 to 598 kg. The mean ratings of perceived exertion for floor level to bench height and bench height to 1.5-m lifts were 12 and 9.6 for the back and 9.3 and 13 for the shoulder, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2004

Subperiosteal brow lifts without fixation.

Most surgeons today advocate an endoscopic subperiosteal brow lift for surgical correction of the upper third of the face. At the author's clinic, this operation has been performed since 1994 and the subgaleal bicoronal brow lift is no longer used. In earlier investigations, the author showed that the subperiosteal approach (n = 60) gives a better result than the subgaleal method (n = 60) when compared 1 year after surgery. In the literature, however, there are no published data regarding the long-term results of subperiosteal brow lifts. The author took material from his earlier investigations and looked at the same patients 5 years postoperatively. He compared the subperiosteal approach (n = 30) with the subgaleal brow lift (n = 15) and found that after 5 years the brows of the subgaleal patients were on the same level as they were before surgery, but in the group of subperiosteal brow lifts, almost all of the brows were higher 5 years after surgery than they were 1 year after surgery, with a mean increase in height of 2.5 mm. These findings led the author to the question whether scalp fixation was necessary at all when performing a subperiosteal brow lift. He performed 20 subperiosteal endoscopic brow lifts where scalp fixation was not used at all, relying only on changing the balance of muscle vectors around the eyebrows. Using a computerized instrument, measurements were made of the distance between the medial canthus and the top of the eyebrow, the midpupil and the top of the eyebrow, and the lateral canthus and the top of the eyebrow. All patients were measured before and 1 year after surgery. The author found an increase of the vertical height from the midpupil to the top of the brow, with an average increase of 3.9 mm. There were no differences between patients who had only a brow lift and those who had a brow lift and an upper blepharoplasty at the same time. The author concludes that for most cases where an increased vertical height of the brows of more than 4 mm is not needed, it is not necessary to use scalp fixation to achieve a natural result.

Adult↗
PubMed2001

Lift generation by the avian tail.

Variation with tail spread of the lift generated by a bird tail was measured on mounted, frozen European starlings (Sturnus vulgaris) in a wind tunnel at a typical air speed and body and tail angle of attack in order to test predictions of existing aerodynamic theories modelling tail lift. Measured lift at all but the lowest tail spread angles was significantly lower than the predictions of slender wing, leading edge vortex and lifting line models of lift production. Instead, the tail lift coefficient based on tail area was independent of tail spread, tail aspect ratio and maximum tail span. Theoretical models do not predict bird tail lift reliably and, when applied to tail morphology, may underestimate the aerodynamic optimum tail feather length. Flow visualization experiments reveal that an isolated tail generates leading edge vortices as expected for a low-aspect ratio delta wing, but that in the intact bird body-tail interactions are critical in determining tail aerodynamics: lifting vortices shed from the body interact with the tail and degrade tail lift compared with that of an isolated tail.

Animals↗
PubMed2002

Lift and power requirements of hovering flight in Drosophila virilis.

The lift and power requirements for hovering flight in Drosophila virilis were studied using the method of computational fluid dynamics. The Navier-Stokes equations were solved numerically. The solution provided the flow velocity and pressure fields, from which the unsteady aerodynamic forces and moments were obtained. The inertial torques due to the acceleration of the wing mass were computed analytically. On the basis of the aerodynamic forces and moments and the inertial torques, the lift and power requirements for hovering flight were obtained. For the fruit fly Drosophila virilis in hovering flight (with symmetrical rotation), a midstroke angle of attack of approximately 37 degrees was needed for the mean lift to balance the insect weight, which agreed with observations. The mean drag on the wings over an up- or downstroke was approximately 1.27 times the mean lift or insect weight (i.e. the wings of this tiny insect must overcome a drag that is approximately 27% larger than its weight to produce a lift equal to its weight). The body-mass-specific power was 28.7 W kg(-1), the muscle-mass-specific power was 95.7 W kg(-1) and the muscle efficiency was 17%. With advanced rotation, larger lift was produced than with symmetrical rotation, but it was more energy-demanding, i.e. the power required per unit lift was much larger. With delayed rotation, much less lift was produced than with symmetrical rotation at almost the same power expenditure; again, the power required per unit lift was much larger. On the basis of the calculated results for power expenditure, symmetrical rotation should be used for balanced, long-duration flight and advanced rotation and delayed rotation should be used for flight control and manoeuvring. This agrees with observations.

Animals↗
PubMed2004

Compliance wearing a heel lift during 8 weeks of military training in cadets with limb length inequality.

STUDY DESIGN: Retrospective descriptive study. OBJECTIVES: To examine compliance in wearing heel lifts during 8 weeks of military training in cadets identified with limb length inequalities. BACKGROUND: Lack of compliance can be blamed for countless poor outcomes in the medical community. Reported compliance with intervention protocols has been reported to range from 11% to 95%. All 1100 new cadets in the class of 2005 were screened for a limb length inequality One hundred ninety-eight out of 1100 cadets were identified to have a limb length inequality on physical exam and volunteered to participate. Cadets were randomly assigned to a heel lift or control group. Cadets in the heel lift group were instructed to wear a heel lift at all times throughout cadet basic training to attempt to prevent overuse injuries. There was no difference (P > .05) between the heel lift group or the control group on injury rate or excusal days. METHODS AND MEASURES: In an attempt to discern whether the preventive intervention was ineffective by design or if noncompliance was to blame, investigators asked cadets via electronic mail survey to report compliance with heel lift wear as a percentage (0%-100%). RESULTS: Seventy-six out of 99 (76.8%) cadets in the heel lift group responded to the electronic mail survey. Mean reported compliance was 38%. Eighteen cadets reported between 70% and 100% compliance. The remaining 58 cadets reported less than 70% compliance. CONCLUSIONS: Cadet compliance was poor with the use of a heel lift. Physical therapists throughout the military often prescribe heel lifts, therapeutic exercises, or medication and assume good to excellent compliance. This study reminds providers that good compliance should not be assumed in any setting.

Adolescent↗
PubMed2002

Complete denture with a removable palatal lift prosthesis: a case report and clinical evaluation.

The palatal lift prosthesis is used to alleviate rhinopharyngeal closure dysfunction. It is generally problematical to use in edentulous patients, because the palatal lift prosthesis requires secure retention of the denture base and is difficult for the patient to retain while eating. This article describes the fabrication of a complete denture with a removable palatal lift prosthesis and a clinical evaluation of the denture's stability. A sprue pin and tube were used as a connecting attachment between the removable palatal lift prosthesis and the denture base. The force required for lifting the soft palate and the denture's stability were measured in the clinical evaluation. The prosthesis required an average retentive force of 0.26 N for each 1 mm of soft palate lift. The force required to dislodge the denture was measured with and without the palatal lift prosthesis in place. The force required to dislodge the conventional complete dentures of five healthy individuals was also measured as a reference. The denture was 24.4% less stable when the palatal lift prosthesis was in place and was generally easier to dislodge than were conventional dentures. This denture with a removable palatal lift prosthesis is useful for patients with dysfunction of the soft palate involving hypernasal speech who have difficulty in retaining the prosthesis while eating.

Adult↗
PubMed2003

The effect on wear of lift-off in total knee arthroplasty.

Femoral lift-off has been reported in total knee arthroplasty using dynamic fluoroscopic analysis. However, the effect of femoral lift-off on ultra-high-molecular-weight polyethylene (UHMWPE) is not clear. The objective of this study was to evaluate the effect of lift-off movement on the wear of UHMWPE using a pin-on-disc testing machine. Using oxidised UHMWPE, delamination was observed in 70% of the discs with lift-off movement, as against none in without lift-off movement (p=0.0603). In non-oxidised UHMWPE the depth of the wear track was increased in the impact area after lift-off, but there was no delamination and no increase in wear as measured by weight loss. UHMWPE can sustain the impact of after lift-off with neither delamination nor wear by other mechanisms. In contrast, degraded (i.e., oxidised) UHMWPE undergoes delamination after lift-off. Since it is probable that lift-off cannot be prevented, oxidised UHMWPE should never be used in TKA.

Arthroplasty, Replacement, Knee↗
PubMed1993

Lower body lift with superficial fascial system suspension.

Multiple body contour deformities of the trunk and thighs are commonly treated in separate stages to limit postoperative complications and disability. Recent advances in the surgical design of the medial thigh lift and the lateral thigh/buttock lift along with an understanding of the functional anatomy of the superficial fascial system have significantly improved results and decreased complications of trunk/thigh lifts. The enhanced safety of current trunk/thigh lifts has allowed new combinations to treat multiple body contour deformities in a single stage. Laxity of the entire lower trunk and thigh regions can be treated in one stage in selected patients. The lower body lift combines the transverse flank/thigh/buttock lift and the fascial anchoring medial thigh lift in one operation. In addition to the expected tightening of the flank, buttocks, and total thighs, this procedure results in a surprising degree of epigastric and hypogastric tightening of mild to moderate abdominal laxity without direct surgical undermining or umbilical transposition. Ten patients having the lower body lift alone or in combination with liposuction and other body contouring procedures were followed for 6 to 24 months. The primary indication for surgery is moderate to severe soft-tissue laxity of the lower trunk and thighs with minimal or mild residual fat deposits. Skin contour irregularities due to skin laxity (cellulite of laxity) or to postliposuction adhesions are frequently present and may be severe. Patients with significant fat deposits may be treated initially with liposuction 3 to 4 months earlier to become candidates for this procedure. Key technical elements of this procedure include (1) both supine and lateral decubitus positioning with the hip flexed and abducted to allow overcorrection, (2) appropriate direct surgical undermining through superficial fascial system zones of adherence in the superior thigh while avoiding the lymphatics of the femoral triangle, (3) more distal undermining of the thighs with an atraumatic undermining cannula, (4) resection of redundant lower trunk and thigh tissues with incisional closure within high-cut bikini lines, and (5) complete superficial fascial system and dermal suspension throughout the repair. The lower body lift requires 5 to 6 hours of operating time, 2 units of autologous blood, 2 nights of nursing care, and 3 weeks off work. Although no major complications occurred, minor complications were significantly higher than with the component procedures alone and occurred in 50 percent of patients. Technical changes and improved patient selection have significantly improved the rate of complications in subsequent patients. Results have been consistent, and patient satisfaction has remained high.

Adipose Tissue↗
PubMed2001

Effect of elbow flexion contractures on the ability of people with C5 and C6 tetraplegia to lift.

BACKGROUND AND PURPOSE: It is commonly assumed that minor elbow flexion contractures prevent people with C5-C6 tetraplegia and paralysis of the triceps brachii muscles from bearing full body weight through their upper limbs. The aim of the present study was to determine the effect of simulated bilateral elbow flexion contractures on the ability of these individuals to bear weight through their upper limbs and to determine whether full passive elbow extension is truly critical for lifting body weight. METHOD: A biomechanical study was performed. Body weight lifted was measured under conditions that simulated bilateral elbow flexion contractures. Five people with motor complete C6 tetraplegia and one person with motor complete C5 tetraplegia, all with bilateral paralysis of the triceps brachii muscles, were recruited to the study. Subjects were fitted with bilateral elbow splints that restricted elbow extension but did not restrain elbow flexion nor prevent the elbow from collapsing, and were seated on an instrumented platform that measured vertical forces under the buttocks. Subjects pushed down through their hands and lifted under five different conditions, namely: with no elbow splints; with bilateral elbow splints adjusted to restrict elbow extension by 5-10 degrees; by 15-20 degrees; by 25-30 degrees and with bilateral elbow splints adjusted to allow unrestricted movement of the elbow joint. Maximal weight lifted from under the buttocks, for each condition, was expressed in relation to weight under the buttocks during unsupported sitting (that is, 'seated body weight'). RESULTS: Subjects lifted progressively less weight from under their buttocks as passive elbow restriction was progressively restricted. However, one subject lifted all his seated body weight when elbow extension was restricted by 5-10 degrees and another lifted all his seated body weight when elbow extension was restricted by 5-10 degrees and 15-20 degrees. CONCLUSIONS: Minor elbow flexion contractures will not alone prevent people with tetraplegia and paralysis of the triceps brachii muscles from lifting. Full passive elbow extension is not critical for the performance of this task.

Adult↗