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An electromyographic analysis of two techniques for squat lifting and lowering.

The purpose of this study was to examine the effects of two different alignments of the pelvis and three different loads on electromyographic (EMG) activity of the erector spinae and oblique abdominal muscles during squat lifting and lowering. Each of 15 healthy subjects lifted and lowered loads with the pelvis aligned both in an anterior tilt and in a posterior tilt. Based on total duration, both the lift and the lower were divided into two equal phases. The EMG activity of each muscle was quantified for each half of both the lift and the lower and was normalized to the total EMG produced by the muscle during a maximal voluntary isometric contraction. The results indicate (1) that the EMG activity of the erector spinae muscles was greater when subjects maintained an anterior tilt than when they maintained a posterior tilt; (2) that the EMG activity of the oblique abdominal muscles was greater in the first half of the lift than in the second half for both lifting styles, although the opposite was true for both lowering styles; and (3) that the EMG activity increased with increasing loads. The results suggest that the greater trunk muscle activity occurring with the anterior tilt position may ensure optimal muscular support for the spine while handling loads, thereby reducing the risk for low back injury.

Adult↗

Anticipatory postural adjustments in the back and leg lift.

This study examined anticipatory postural adjustments in a dynamic multi-joint action in which a relatively fast voluntary movement is being executed while balance is maintained in the field of gravity. In a bi-manual whole body lifting task, the pickup of the load induces a forward shift in the position of the center of mass, challenging the dynamic balance regulation while simultaneously impeding the ongoing extension movement. We investigated whether anticipatory postural adjustments are an addition to a voluntary motor command or an inherent component of this command. Using a global mechanical analysis of the movement, we found that anticipatory postural adjustments are present in bimanual lifting, both in back lifting and leg lifting, and that lifting technique had a significant influence on the pattern of the adjustments. If the mass of the object was reduced unexpectedly, balance was disturbed in 92% of the mass-reduced trials. These findings suggest that the anticipatory postural adjustments to be performed are specified in advance such that the expected changes in the mechanical interaction with the environment are taken into account. The observations lend support to the hypothesis that the control of the observed anticipatory postural adjustments is an integral part of the control of the lifting movement itself. Consequently, the strict dichotomy in the control of posture and movement is being questioned.

Adult↗

Effect of lumbar posture on lifting.

Twenty laborers assumed specific lumbar spine postures and lifted a 157 N crate to three different hand heights to determine if lumbar spine flexion moments or trunk muscle activity were affected by the lifting postures. Lumbar flexion moments were lowest when the workers used the lordotic and straight back postures, while the average erector spinae muscle activity tended to be highest in the lordotic and straight back postures. The kypohotic posture regularly reduced the activity of the erector spinae to bursts of activity while lifting and caused more discomfort during the lifting tasks than any other posture. Therefore, the lumbar lordotic posture is recommended as the posture of choice while lifting, particularly when lifting from the floor level.

Adult↗

Electromyographic activity of selected trunk and hip muscles during a squat lift. Effect of varying the lumbar posture.

Electromyographic (EMG) activity of selected hip and trunk muscles was recorded during a squat lift, and the effects of two different lumbar spine postures were examined. Seven muscles were analyzed: rectus abdominis (RA), abdominal obliques (AO), erector spinae (ES), latissimus dorsi (LD), gluteus maximus (GM), biceps femoris (BF), and semitendinosus (ST). The muscles were chosen for their attachments to the thoracolumbar fascia and their potential to act on the trunk, pelvis, and hips. Seventeen healthy male subjects participated in the study. Each subject did three squat lifts with a 157-N crate, with the spine in both a lordotic and kyphotic posture. The lift was divided into four equal periods. EMG activity of each muscle was quantified for each period and normalized to the peak amplitude of a maximal voluntary isometric contraction (MVIC). A two-way analysis of variance (ANOVA) for repeated measures was used to analyze the effects of posture on the amplitude and timing of EMG activity during the lift. Two patterns of EMG activity were seen: a trunk muscle pattern (RA, AO, ES, and LD) and a hip extensor pattern (GM, BF, ST). In the trunk muscle pattern (TP), EMG activity was greatest in the first quarter and decreased as the lift progressed. In the hip extensor pattern (HP), EMG activity was least in the first quarter, increased in the second and third quarters, and decreased in the final phase of the lift. Differences (P < .05) were seen among subjects and in the timing of the muscle activity in all muscles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

A test to measure lift capacity of physically impaired adults. Part 1--Development and reliability testing.

STUDY DESIGN: Two laboratory studies and one field study evaluated the safety and test-retest reliability of a new test of lift capacity. The first two studies were conducted in a carefully controlled laboratory setting. The first study investigated the safety and intra-rater reliability of the EPIC Lift Capacity test protocol with healthy adult subjects. The second study assessed the safety and inter-rater reliability of the test with disabled subjects. The third study was conducted in the field with 65 evaluators and investigated the safety and intra-rater reliability of the test with healthy adult subjects. OBJECTIVE: To assess the safety and reliability of a new test of lift capacity. SUMMARY OF BACKGROUND DATA: A new test of lift capacity has been developed. Test development occurred within the context of ergonomic standards and guide-lines of the major professional associations and public agencies that govern test development in the United States. METHODS: In study no. 1, 26 healthy subjects participated. In study no. 2, 14 disabled subjects participated. In study no. 3, 318 healthy subjects participated. After subjects underwent basic screening and warm-up, the EPIC Lift Capacity test was administered. One to 2 weeks later, the test was administered again. Correlations between the times of testing were calculated. RESULTS: No subjects were injured. Hamstring soreness the next day that resolved without complication was reported by some healthy subjects. None of the disabled subjects reported new symptoms. CONCLUSION: The safety and reliability of the EPIC Lift Capacity test was adequately demonstrated in a laboratory setting and across multiple field sites with evaluators who have varying types and degrees of professional preparation.

Adult↗

The effect of back belt use on isometric lifting force and fatigue of the lumbar paraspinal muscles.

STUDY DESIGN: A repeated measures multivariate design to assess the effect of back belts on isometric lifting force and lumbar paraspinal muscle fatigue. OBJECTIVE: To determine the efficacy of lumbar back belts in minimizing a loss in isometric force production and fatigue of lumbar paraspinal muscles. SUMMARY OF BACKGROUND DATA: Increased prevalence of back belts in industry and lack of scientific evidence supporting them suggested additional research was needed. There has been no conclusive research to substantiate manufacturer claims that use of belts reduces fatigue of lumbar paraspinals. METHODS: Twenty-four subjects, 13 men and 11 women, were tested twice: once with and once without a belt. All subjects performed a dynamic lifting task at a rate of 10 lifts per minute for 20 minutes. Surface electromyograms from the lumbar paraspinals and isometric force measurements were recorded during a static maximal isometric lift at 0, 10, and 20 minutes. Load during the dynamic task was determined as 20% of initial maximum isometric force. Electromyographic data were used to detect changes in median power spectral frequencies. Muscular fatigue was indicated by a reduction in median power spectral frequency values or a decrease in isometric force-generating capacity. RESULTS: Multivariate and univariate analyses suggest that there is no effect on lumbar paraspinal muscle fatigue or isometric lifting force production as a result of back belt use. CONCLUSIONS: These findings do not support the use of back belts for the purpose of minimizing either lumbar paraspinal muscle fatigue or a loss in isometric lifting force production.

Adult↗

Interaction between voluntary and postural motor commands during perturbed lifting.

STUDY DESIGN: An experimental study was conducted to evaluate the effect of an unexpected postural perturbation during a lifting task. OBJECTIVES: To investigate electromyographic responses in the erector spinae to a postural perturbation, simulating slipping, during an ongoing voluntary lifting movement. It was hypothesized that specific combinations of voluntary movement and postural perturbation present a situation in which injury caused by a rapid switch between conflicting motor commands can occur. SUMMARY OF BACKGROUND DATA: Studies of postural perturbations have mainly focused on behavior during static tasks such as quiet, upright standing. To date, there are no published studies of the effect of a perturbation during an ongoing voluntary lifting movement. METHODS: Subjects standing on a movable platform were exposed to random perturbations while lifting a 20-kg load. Muscle activity was recorded from flexor and extensor muscles of the trunk and hip. Trunk flexion angle in the sagittal plane was recorded with a video system. RESULTS: Perturbations forward were followed by an increased activity in erector spinae superimposed on the background activation present during the lift, indicating that both the voluntary and postural motor programs caused an activation of erector spinae. During backward perturbation, however, there was a sudden cessation of erector spinae activity followed by an extended period of rapid electromyographic amplitude fluctuations while the trunk was flexing, indicating an eccentric contraction of the erector spinae. CONCLUSIONS: This erratic behavior with large electromyographic amplitude fluctuations in the erector spinae after a backward slip during lifting may indicate a rapid switch between voluntary and postural motor programs that require conflicting functions of the back muscles. This may cause rapid force changes in load-carrying tissue, particularly in those surrounding the spine, thus increasing the risk of slip-and-fall-related back injuries.

Adult↗

Sensitivity and specificity of the indicators of sincere effort of the EPIC lift capacity test on a previously injured population.

STUDY DESIGN: Randomized control post-test only. OBJECTIVES: To investigate the reliability and validity of the EPIC Lift Capacity test's indicators of sincere effort. SUMMARY OF BACKGROUND DATA: The EPIC Lift Capacity test (ELC) (Employment Potential Improvement Corp., Santa Ana, CA) is a functional evaluation tool used to identify physical limitations involved in lifting and manual materials handling. Identification of insincere effort is an integral component of such functional testing because of the potential secondary gain issues surrounding the various populations typically involved in this form of testing. The purpose of this study was to determine the sensitivity and specificity of the "indicators of sincere effort" of the EPIC Lift Capacity test when used on a previously injured population typical of subjects for which the test is designed. METHODS: Subjects consisted of 41 volunteers (age 22 to 58 years) with a previously diagnosed musculoskeletal pathology of the spine or extremities. Volunteers were randomized into either the control group, instructed to give a sincere maximum effort, or the experimental group, instructed to give an insincere effort at 50% of their perceived maximum effort. All tests were administered by certified clinical evaluators according to the standardized EPIC Lift Capacity test protocol.- RESULTS: Overall accuracy in identifying participants' level of effort was 86.84%. The indicators of valid effort exhibited both high positive (94.44%) and negative (80.00%) predictive values. The indicators of valid effort accounted for 94.9% of the total variance in the determination of the subjects' overall effort level. Interrater reliability for agreement of subjects' overall effort was good (interclass correlation coefficient = 0.82). CONCLUSIONS: Through use of standardized indicators of sincere effort, certified EPIC Lift Capacity test evaluators were able to predict sincerity of effort with a high degree of reliability and validity. The rater's systematicobservational evaluation of effort was shown to be the single best indicator of sincere effort.

Adult↗

Biomechanics of changes in lumbar posture in static lifting.

STUDY DESIGN: In vivo measurements and model studies are combined to investigate the role of lumbar posture in static lifting tasks. OBJECTIVES: Identification of the role of changes in the lumbar posture on muscle forces, internal loads, and system stability in static lifting tasks with and without load in hands. SUMMARY OF BACKGROUND DATA: Despite the recognition of the causal role of lifting in spinal injuries, the advantages of preservation or flattening of the lumbar lordosis while performing lifting tasks is not yet clear. METHODS: Kinematics of the spine and surface EMG activity of selected muscles were measured in 15 healthy subjects under different forward trunk flexion angles and load cases. Apart from the freestyle lumbar posture, subjects were instructed to take either lordotic or kyphotic posture as well. A kinematics-based method along with a nonlinear finite element model were interactively used to compute muscle forces, internal loads and system stability margin under postures, and loads considered in in vivo investigations. RESULTS.: In comparison with the kyphotic postures, the lordotic postures increased the pelvic rotation, active component of extensor muscle forces, segmental axial compression and shear forces at L5-S1, and spinal stability margin while decreasing the passive muscle forces and segmental flexion moments. CONCLUSION: Alterations in the lumbar lordosis in lifting resulted in significant changes in the muscle forces and internal spinal loads. Spinal shear forces at different segmental levels were influenced by changes in both the disc inclinations and extensor muscle lines of action as the posture altered. Considering internal spinal loads and active-passive muscle forces, the current study supports the freestyle posture or a posture with moderate flexion as the posture of choice in static lifting tasks.

Adult↗

Feature extraction and quantification of the variability of dynamic performance profiles due to the different sagittal lift characteristics.

Investigation of manual material handling (MMH) tasks, such as lifting, requires the quantification of the various kinematic and kinetic parameters of performance for assessment of the functional capacity and/or task demand profiles. Traditional statistical descriptive analyses usually involve computing the summary statistics (maximum, minimum, mean, and/or range) of the resulting performance parameters over the cycle duration (i.e., lifting/lowering cycle). Consequently, the significant information content of the time-varying signals is diminished, limiting the sensitivity of subsequent hypothesis testing procedures. The present study developed a methodology for representing and quantifying performance data variability of the kinematic and kinetic motion profiles due to the different lift characteristics (load, mode, and speed) during MMH tasks while capturing the temporal characteristics. Using a database of motion profiles from a manual lifting experiment, the Karhunen-Loeve Expansion (KLE) feature extraction technique was shown to be quite effective for representing the various motion profiles. The number of basis vectors (eigenvectors) and corresponding coefficients needed for accurate representation were substantially smaller than the original data set, resulting in data compression. Moreover, the effects of lift characteristics were investigated using analysis of variance techniques that recognize the vectorial constitution of the waveforms. The application of these techniques will enable the quantification of highly phasic profiles and enhance the ability to document the effect of intervening measures such as educational or physical training/exercise on the kinematic and kinetic patterns of performance. Additionally, the differential influence of lift characteristics on the variability of performance during different phases of lifting and lowering provides added resolution in the analysis of MMH tasks.

Adult↗

The effect of eumenorrheic menstrual cycle phase on physiological responses to a repeated lifting task.

Cyclic variations in physiological and endocrinological baselines are known to be consistent with the eumenorrheic (healthy) menstrual cycle. The aim of this study was to examine the interaction of these variations with the physiological responses to repeated lifting. Sixteen females visited the laboratory in each of five phases of their menstrual cycle. During each visit, subjects performed a repetitive lifting task, lifting a weighted box, from knee to shoulder height, at six repetitions per minute for 10 min. Oxygen consumption, minute ventilation, heart rate (HR), and perceived exertion were monitored throughout the task. The variation in physiological and subjective responses to lifting with menstrual cycle phase did not reach statistical significance (p > .05). However, the HR response to lifting was elevated by approximately 10 beats x min-1 in the postovulatory phases of the cycle (effect size > 0.61). Although the impact of the menstrual cycle upon lifting performance is minimal, alterations in HR must be taken into account in determining new international standards for manual handling.

Adolescent↗

The effect of lifting and lowering an external load on repositioning error of trunk flexion-extension in subjects with and without low back pain.

OBJECTIVE: To determine whether the repositioning error of trunk flexion-extension in individuals with low back pain is different from that in those not experiencing low back pain when lifting and lowering external loads. DESIGN: A case-control study. SETTING: Physical therapy department of a medical centre. SUBJECTS: Twenty subjects with subacute low back pain and 20 control subjects without low back pain. INTERVENTIONS: Tasks with and without lifting and lowering an external load. MAIN OUTCOME MEASURES: The trunk repositioning errors were measured with Measurand Shape Tape. RESULTS: In subjects with low back pain, trunk repositioning errors were significantly reduced when lifting and lowering an external load in the direction of flexion (3.77 +/- 1.26 degrees in a loaded condition versus 4.82 +/- 2.97 degrees in an unloaded condition; P < 0.05) and extension (3.17 +/- 2.15 degrees in a loaded condition versus 5.03 +/- 3.74 degrees in an unloaded condition; P < 0.05). In control subjects, trunk repositioning errors were not significantly changed when lifting and lowering an external load in the direction of flexion (2.80 +/- 1.39 degrees in a loaded condition versus 2.63 +/- 1.24 degrees in an unloaded condition; P > 0.05) and extension (2.87 +/- 11.40 degrees in a loaded condition versus 3.15 +/- 11.50 degrees in an unloaded condition; P > 0.05). The direction of motion (trunk flexion or extension) was not shown to be significant in this study. CONCLUSION: Performing the task whilst lifting or lowering a submaximal load showed a reduced trunk repositioning error in subjects with subacute low back pain. Lifting and lowering a submaximal load might be considered as one of the rehabilitative strategies to hasten a return to work.

Adult↗

Self-selected manual lifting technique: functional consequences of the interjoint coordination.

The pattern of movement self-selected by 39 subjects to lift light loads from 9 cm above the ground is described in kinematic and electromyographic terms. Hamstring length changes were estimated from hip and knee angular kinematics. Subjects adopted a posture at the start of the lift intermediate between stoop and full-squat postures. A consistent coordination between knee, hip, and lumbar vertebral joints during lifting was described through calculation of the relative phase between adjacent joints and found to be exaggerated with increases in load mass. During the early phase of lifting, knee extension leads hip extension, which in turn leads extension of the lumbar vertebral joints. Early in the lifting movement, when load acceleration is greatest, the erectores spinae are thus relatively long and shortening slowly. Both of these factors produce greater back extensor strength. Rapid hamstring shortening is also delayed, which enhances their strength, and coactivation of the monoarticular knee extensors and biarticular hamstring observed early in the lifting movement suggested that the knee extensors contribute to hip extension through a tendinous action of the hamstrings.

Adult↗

Influence of lift moment in determining MAWL.

An experiment was performed to determine whether maximum acceptable weight of lift (MAWL) estimates were consistent with previously reported values when the MAWL was determined without visual feedback during the weight adjustment period. Twelve healthy male students performed four lifting tasks similar to those often performed in previous psychophysical studies: floor to knuckle at 1 lift per min, floor to knuckle at 4.3 lifts per min, knuckle to shoulder at 1 lift per min, and knuckle to shoulder at 4.3 lifts per min. When compared with the previous studies with similar box dimensions, similar trends between the conditions were present, but a slight reduction in weight was usually chosen by the participant in this study. However, the results of this study agreed with previous psychophysical studies when the distance of the load from the spine (moment arm) was taken into consideration by either comparing the MAWLs with those of a large box or by comparing load moments. Hence this study shows that eliminating visual feedback during the adjustment periods did not significantly alter the MAWLs from previous studies. It also indicates that one must use caution when applying the MAWL in the workplace because the MAWL is very sensitive to moment arm.

Analysis of Variance↗

The relationship between low back discomfort ratings and the NIOSH lifting index.

An epidemiological study was performed to evaluate the relation between low-back discomfort ratings and use of the revised NIOSH lifting guide to assess the risk of manual material handling (MMH) tasks. We surveyed 97 MMH workers on site in 15 factories and designed a questionnaire to systematically collect job-related information. Approximately 90% of the workers had suffered various degrees of lower back discomfort, and 80% had sought medical treatment. The survey showed that 42 of the 97 jobs analyzed had a recommended weight limit of 0, which was attributed to either a horizontal distance or a lifting frequency that exceeded the bounds of the NIOSH lifting index. Apparently, the limits for horizontal distance and maximum allowable frequency are too stringent to accommodate many existing MMH jobs. For the remaining 55 jobs, the significant positive correlation obtained between the lifting index and the severity of low-back discomfort suggests that the lifting index is reliable in assessing the potential risk of low-back injury in MMH. These findings provide useful information on the application of the NIOSH lifting guide to the assessment of low-back pain.

Adolescent↗

Maximum isometric lifting strengths of men in teamwork.

This study reexamined the additivity of maximum isometric teamwork lifting strength using experienced and height-matched young male participants. The maximum isometric lifting strength was measured for four exertion heights (45, 75, 105, and 140 cm) and four lifting styles (one-, two, three-, and four-person exertions). The results showed that actual teamwork strength could be greater or lower than the sum of individual strengths. If it was greater, the difference between the two could be either significant or nonsignificant, but if it was lower, there was no significant difference between the two. Actual teamwork strength ranged from 90.0% to 134.8% of the sum of individual strengths, indicating that experienced and height-matched participants could overcome the problem of lack of coordination in isometric teamwork lifting. The results also showed that some teamwork members, especially weaker members, might be forced to exert strengths higher than their maximum individual voluntary strengths in teamwork lifting. To avoid such overexertion in teamwork, it is recommended that the weight of the handled load be controlled and lower than the sum of all members' strengths. Additionally, members with significantly different strength abilities should not be assigned to the same team. Actual or potential applications of this research include designing member assignments in teamwork lifting tasks.

Adult↗

Effect of two different videotaped instructional models on motor and verbal behaviors of adults' lifting: a pilot study.

This study examined two different videotaped instructional models on subsequent motor and verbal behaviors of adults (N=9) learning how to lift properly. The correct model group viewed a narrated videotape of a skilled individual demonstrating lifting; the learning model group viewed a videotape of an unskilled individual being taught lifting by an instructor, and the controls received no intervention. Adults lifted from floor to waist a plastic crate during 15 acquisition and 3 retention trials and lowered the crate from waist to floor during 3 transfer trials. Learning and correct model motor performances were similar yet higher than those of controls during acquisition and transfer trials. Verbal reports indicated learning, and correct models generated more extensive and associated mechanical concepts than controls yet rarely monitored such concepts during performance. A single presentation of videotapes of proper lifting using either correct or learning models is effective in enhancing motor performance and proper lifting knowledge.

Adolescent↗

Effect of soft lumbar support belt on abdominal oblique muscle activity in nonimpaired adults during squat lifting.

STUDY DESIGN: A counterbalanced repeated measures design. OBJECTIVE: To determine the effect of a soft lumbar support on abdominal oblique muscle electromyography (EMG) during lifting. BACKGROUND: Use of a soft lumbar back support is a common preventive measure to reduce the incidence of back injuries. Because the abdominal oblique muscles stabilize the spine during lifting, wearing this support may alter the activity level of these muscles. METHODS AND MEASURES: Twenty nonimpaired subjects (14 women and 6 men, mean age 28.9 +/- 8.1 years) were tested using surface electrodes to record the EMG of the right abdominal oblique muscles during lifting with and without the support. RESULTS: A paired t test revealed a significant decrease in activity of the abdominal oblique muscles during lifting with the support (29.7 +/- 3.13 mV) compared to without it (33.3 +/- 3.05 mV). Of the 20 subjects, the 14 women showed decreased EMG amplitude during the lift with the lumbar support compared to without the support, while 5 of the men showed increased EMG amplitude with the support and 1 man showed no change. CONCLUSION: This finding suggests that the soft lumbar support may play some role in the stabilization of the lumbar region during lifting.

Abdominal Muscles↗