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Biomedical subjects

A Kilbom

Publications and source records attributed to A Kilbom.

At least 55 records · Page 3Linked to original sources
PubMed1993

Sensitivity of the hand to surface pressure.

A new method of measuring pain-pressure threshold (PPT) of the hand has been developed. Externally applied surface pressure (EASP) was exerted at a certain rate of increase and the level where the feeling of pressure turned into pain was recorded. Also, the effects of sustained EASP were elucidated. Sixteen healthy right-handed subjects (eight female, eight male) participated. The distribution of the hand's sensitivity to EASP is presented. The most sensitive areas were the thenar area, the skinfold between thumb and index finger and the area around os pisiforme. When the hand was repeatedly exposed to EASP, the PPT decreased with increasing number of pressure incidents. For sustained EASP, the time of exposure was found to be important also for the quality of the sensation. Our results show that sustained EASP does not hurt at once, but becomes painful after a short time. On average, the female PPT corresponded to two-thirds of the male PPT. Females experienced pain faster than males when exposed to sustained EASP, and chose lower levels when estimating acceptable sustained EASP.

Journal Article↗
PubMed1993

An approach to ergonomics evaluation of hand tools.

Based on current knowledge of cumulative trauma disorders in the hand and forearm, related to the use of hand tools, an analysis was undertaken of variables to be considered in ergonomics evaluation of hand tools. Measurement methods were developed and an evaluation station was implemented. Measurement methods are physical, physiological or psychophysical. They focus on the tool, and on the effect of typical use of the tool on the operator. The evaluation station serves as a resource in the development, selection, and testing of tools for a given purpose.

Journal Article↗
PubMed1993

A cube model for the classification of work with hand tools and the formulation of functional requirements.

In an interdisciplinary research project, a model, visualized as a cube, was developed for the classification and analysis of work with hand tools and for communication of different ways of solving problems related to manual handling. The dimensions of the cube are demands of force, precision and time. Each dimension is divided into three levels of low, moderate and high demands respectively. Preliminary limits are proposed for acceptable and non-acceptable use situations and for situations that have to be investigated further. Using a case study of plate shears as a starting point, various measures of improving the position in the cube are discussed. The hand tool, the workplace, the work organization as well as the user of the hand tool are included in the analysis.

Journal Article↗
PubMed1993

Tool design, user characteristics and performance: a case study on plate-shears.

Performance, grip forces and fatigue were studied in six male and six female subjects while cutting with plate-shears. Three types of plate-shears were used, one standard and two modified, either with a spring grip, or with a spring grip in combination with a reduced grip span. In addition, three types of plate - easy, moderately difficult and difficult to cut - were used. Male subjects used around 40% of their maximal grip force and female subjects around 60% with the moderately difficult plate; the male subjects produced more than twice as long a cutting distance as the females. Neither EMG analysis (frequency shifts) nor subjective exertion or reduction of handgrip MVC indicated a more pronounced fatigue in women than in men, probably because the female subjects used about a 50% lower cutting rate than the men. Productivity (in cm cut per min) was strongly related to measures of hand size and to the relative grip force used. Thus in a multiple regression analysis using metacarpal hand circumference and relative grip force as independent variables, R2 was 0.77. The two types of modified plate-shears were preferred by all and gave a roughly 30% higher productivity in the male subjects but did not improve productivity in the females. However, with a spring grip and reduced grip span, the female subjects reduced the relative grip forced used from around 65 to 50%. The total work (force-time integral) per cm cut was not influenced by type of plate-shear.

Journal Article↗
PubMed1993

A conceptual model for work-related neck and upper-limb musculoskeletal disorders.

This paper presents a conceptual model for the pathogenesis of work-related musculoskeletal disorders. The model contains sets of cascading exposure, dose, capacity, and response variables, such that response at one level can act as dose at the next. Response to one or more doses can diminish or increase the capacity for responding to successive doses. The model is used as a framework for discussing the development of work-related muscle, tendon, and nerve disorders. It is intended as a beginning, to be modified to explain new findings as they become available. In research, it can help to identify areas needing additional data for the development and expression of work-related musculoskeletal disorders. Researchers can use it to design laboratory and field studies. In practice, it demonstrates the relationship between common exposure factors and different responses. This information can be used to evaluate and design jobs for the prevention of work-related musculoskeletal disorders.

Arm Injuries↗
PubMed1993

A three-year follow-up of 195 reported occupational over-exertion injuries.

Three years after reporting occupational over-exertion injuries, 181 persons took part in a follow-up study by questionnaire. The objective was to study these persons with respect to their current status of health, well-being and functional capacity and when possible compare collected data to reference data from the "normal population". The studied group reported more physical and psychological symptoms than the reference groups. More than 50% reported difficulties in activities of daily living. Long sick-leaves in the year following the reported injury were associated with remaining pain and low rate of employment. Three years after the injury, 109 persons were in employment. Almost one third of these had changed occupations and now had more varied tasks than at the time of the report. Those whose work loads had been reduced after the injury, did not report less musculoskeletal disorders than others. However, access to social support was positively related with health and psychological well-being.

Activities of Daily Living↗
PubMed1992

One-handed load carrying--cardiovascular, muscular and subjective indices of endurance and fatigue.

A group of 5 women and 11 men walked on a treadmill, each carrying a weight in the right hand. In separate experiments, the mass was varied to give total exhaustion within 3 min, 5 min, 9 min, and 13 min. In additional experiments 50% and 25% of the masses leading to exhaustion after 5 min were used, and these were stopped after 16 min. Heart rate (fc) and systolic blood pressure (BPs) were measured noninvasively. There was a consistent increase in fc x BPs during the experiments leading to exhaustion, while steady-states were obtained in the nonexhausting trials. An electromyogram (EMG) was recorded with cutaneous electrodes over the flexor carpi ulnaris and flexor digitorum superficialis muscles and the number of zero crossings (ZC) of the EMG signal per time unit were analysed. As the subjects approached exhaustion, the number of ZC declined exponentially, reaching approximately 50% of their initial values. In the nonexhausting experiments, however, the decline was slower and less marked, and during the second half of the experiment the number of ZC increased again. Subjectively, endurance was underestimated by all the subjects. It was concluded that cardiovascular and muscle criteria of fatigue in carrying coincided. Prolonged carrying in one hand of more than 6 kg or 10 kg for young healthy women and men respectively should not be recommended, since it could lead to cardiovascular non steady-states and EMG signs of fatigue.

Adult↗
PubMed1991

Electrical stimulation of human forearm extensor muscles as an indicator of handgrip fatigue and recovery.

A set-up for percutaneous electrical stimulation of the forearm extensor muscles and measurement of wrist extension force is described. The frequency-force relationship and pulse duration-force relationship are described together with an experimental protocol showing that brief electrical test stimulations do not produce fatigue. In another set of experiments carried out a few weeks later, the subjects performed handgrip contractions: protocol A at 25% of maximal voluntary contraction (MVC) continuously until exhaustion, protocol B at 25% MVC intermittent (contraction + relaxation = 10 + 2 s) until exhaustion, and protocol C at 25% MVC intermittent until half the time to exhaustion. In all experiments, brief electrical stimulations were used to test the degree of fatigue during and up to 24 h after the experiments. There were marked changes in the force during stimulation at 20 and 100 Hz and these changes did not correlate with the increase in intramuscular temperature. Low frequency fatigue persisted for at least 24 h after protocol A and 1 h after protocols B and C. The significance of this is discussed and it is suggested that low frequency fatigue could be used as a sensitive indicator of muscle dysfunction after low and medium intensity exercise.

Adult↗
PubMed1991

An electromyographic study of dental work.

Musculoskeletal disorders are common among dentists, and have been ascribed to the demands of high precision work and sustained static loading in the neck-shoulder region, combined with a flexed and rotated cervical spine. In order to determine muscular load levels during dentistry, activity in neck, shoulder, and arm muscles was recorded using an electromyography technique (EMG). Normalized mean, median, 10th and 90th percentile EMG amplitude levels (% maximal reference contraction, %max-RVC) were calculated during ordinary dental work. Among the muscles investigated, the trapezius muscle on both sides had the highest mean (the right trapezius 9.0% and the left 7.6% of max-RVC) and 10th percentile amplitude levels (both about 2% of max-RVC). The trapezius muscles showed similar myoelectric activity on the right and left side, probably because of similar muscular static load on the both sides. The right extensor carpi radialis muscle had a significantly higher muscular load level than the left one, possibly due to stabilization demands on the dominant wrist during demanding precision work. The infraspinatus muscle had low activity level on both sides, reflecting that the dentists worked with a small degree of arm elevation and external rotation. The dentistry work thus seems to generate relatively high muscular load on both trapezius and dominant extensor-carpi-radialis, and relatively low load on the infraspinatus muscle.

Adult↗
PubMed1990

Physiological response in the forearm during and after isometric intermittent handgrip.

The aim of the present paper was to study the development of fatigue during isometric intermittent handgrip exercise. Using a handgrip dynamometer, four combinations of contraction-relaxation periods were studied (10 + 10, 10 + 5, 10 + 2 s and continuous contraction) at three contraction intensities (10, 25 and 40% maximum voluntary contraction, MVC). Local blood flow (BF) in the forearm (venous occlusion plethysmography) was followed before, during and after the exercise period. Electromyography (EMG) (frequency analysis) and the perceived effort and pain were recorded during the exercise period. Forearm BF is insufficient even at isometric contractions of low intensity (10% MVC). The results indicate that vasodilating metabolites play an active role for BF in low-intensity isometric contractions. It is shown that maximal BF in the forearm during relaxation periods (25-30 ml.min-1.100 ml-1) is already reached at 25% MVC. Only intermittent exercise at 10% MVC and (10 + 5 s) and (10 + 10 s) at 25% MVC was considered acceptable with regard to local fatigue, which was defined as a switch of local BF to the post-exercise period, a decrease in the number of zero-crossings (EMG) and marked increases in subjective ratings.

Adult↗
PubMed1989

Occupational lifting by nursing aides and warehouse workers.

Nursing aides (18 women and six men) at one traditional and one modern geriatric ward, and warehouse workers (16 men) at two different types of warehouse departments were studied during occupational work. The vertical load during manual handling was measured using strain gauges built into wooden shoes. The warehouse workers performed four times as many lifts as the nursing aides and transferred five times as great a mass per unit time. Less than 25% of the lifts were carried out with the load evenly distributed on both feet during both the upward lift and lowering. In the warehouses the lifts were short, while the nursing aides were exposed both to lifts of longer duration and to carrying, as well as a greater frequency of unexpected, sudden and high peak load. The heart rate and oxygen uptake values recorded were relatively low, and both groups utilized approximately 25% of their maximum aerobic power. According to official occupational injury statistics, both warehouse workers and nursing aides belong to risk groups with a high frequency of reported back injuries. However, more injuries are reported by nursing aides than by warehouse workers. Greater muscle strength in male workers may partly explain this difference. Qualitative differences in the design of the lifting work, with more lifts of long duration in awkward work postures, more carrying, more exertion of horizontal forces and a greater frequency of unexpected rapid lifts in the nursing aides may also contribute to the differences in risk of injury between these occupational groups. Considerable differences were found between the two hospital wards as regards lifting frequency, force, duration and the proportion of lifts with an even distribution of load on both feet during upward lift. The lifting work was approximately 50% less in the modern ward, which has easily maneuvered electric overhead hoists, spacious premises and better work organization than in the traditional ward, even though the patient handling needs were equivalent. In the warehouse department at which the wares were stored with easy access, the frequency of lifts with an even distribution of load on both feet was approximately 25%, compared to 7% in the other warehouse department. In conclusion, evaluations of occupational lifting work should include a quantitative assessment of the duration and load distribution of lifting, as well as of postures. Workstation design, technical aids and work organization have a profound effect on the lifting work load even in jobs with equal manual handling demands.

Accidents, Occupational↗
PubMed1988

Isometric strength and occupational muscle disorders.

In two longitudinal studies, initial muscle strength and endurance of the shoulder-forearm muscles were related to deterioration of shoulder-neck-arm disorders after one year. Group I (n = 32) worked in the automobile industry assembling car motors. Their work was performed when standing and walking, and implied varied postures and exertion of external forces. Group II (n = 96) worked in the electronics industry assembling printed circuit boards. They worked sitting down and were exposed mainly to postural static loads. Muscle strength was negatively related to deterioration in group I but no such relationship was found in group II. The mechanism of occupational muscular injury is discussed, and it is suggested that mechanical overstress of the musculoskeletal system causes injury in occupations where external forces are exerted. The mechanism of injury in static, postural loads remains to be explained.

Adult↗
PubMed1988

Health hazards related to ergonomic work conditions.

Health hazards related to unsuitable ergonomic work conditions among female employees in Sweden are reviewed. The statistics on reported occupational strain injuries form an important source of information on prevention. The report rate is higher among men than among women, but in some high risk occupations the figures are similar. Reported cases concerning neck, arm and shoulder disorders constitute a larger proportion among women. This finding probably reflects differences in work load characteristics, women more often performing repetitive monotonous work tasks in the manufacturing industry. Serious ergonomic problems exist for women in the service sector although the statistical evidence for increased morbidity is not yet available.

Accidents, Occupational↗
PubMed1987

Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms.

Standardised questionnaires for the analysis of musculoskeletal symptoms in an ergonomic or occupational health context are presented. The questions are forced choice variants and may be either self-administered or used in interviews. They concentrate on symptoms most often encountered in an occupational setting. The reliability of the questionnaires has been shown to be acceptable. Specific characteristics of work strain are reflected in the frequency of responses to the questionnaires.

Journal Article↗
PubMed1987

An experimental evaluation of psychophysical criteria for repetitive lifting work.

Two experiments were performed to test the reliability and validity of psychophysically determined maximum acceptable workloads for setting lifting standards. The perceived workload in a repetitive diagonal lifting task was found to be a positively accelerated function of the weight lifted and of the work pace respectively. A twofold increase in objective workload resulted in a four- to fivefold increase in perceived workload. This relation was independent of previous occupational experience of lifting work. The psychophysically assessed maximum acceptable workloads for this type of lifting task appeared to be satisfactorily reproducible when subjects had to adjust work pace or when they were left free to adjust both the weight and the work pace. However, the results raised several questions concerning the applicability of the psychophysical assessment of maximum acceptable lifting work. Slight changes in the instructions given to the subjects had a definite effect on the selection of workloads. Furthermore, the workloads selected by subjects with previous occupational experience of lifting work - i e, warehouse workers - were systematically lower than those selected by subjects without such previous experience - i e, office employees. At the same time, the warehouse workers rated perceived exertion higher than the office employees, indicating that previous occupational experience of lifting work enhanced the subjective assessment of physical effort. There were no consistent relations between the workloads found acceptable by the subjects and their physical characteristics and performance capacity.

Journal Article↗