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Biomedical subjects

H M Toussaint

Publications and source records attributed to H M Toussaint.

At least 37 records · Page 2Linked to original sources

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↗

Anticipatory postural adjustments before load pickup in a bi-manual whole body lifting task.

Balance regulation and movement control were examined in the context of bi-manual lifting. Subjects picked up a load (20% body mass) after several unloaded cycles using the leg-lift technique. The addition of the load to the body caused the system center of mass to shift forward and thus presented the subject with an expected perturbation of balance. To examine whether the disturbances to balance were counteracted by anticipatory postural adjustments, the last cycle, in which the barbell was grasped and lifted, was compared with the preceding unloaded cycle. Using a global mechanical analysis of the movement, we found that anticipatory postural adjustments were present before load pickup in bi-manual lifting. These anticipatory postural adjustments were characterized by a backward directed horizontal momentum, a backward directed horizontal component of the ground reaction force accompanied with a forward shift of the center of pressure, and a backward shift of the center of mass (CoM). These characteristics could all be understood from the mechanical consideration that adding a load in front of the body induces a forward shift of the CoM. However, major compensations of the position of the CoM were also observed after bar grasp. It is therefore proposed that commands giving rise to postural adjustments are closely tied to commands controlling the ongoing movement. On the basis of this insight the strict dichotomy in the control of posture and movement is being questioned.

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↗

Evaluation of the probability of spinal damage caused by sustained cyclic compression loading.

A sensitivity analysis of two alternative models predicting damage to vertebral motion segments (VMS) in cyclic compression was performed to evaluate the relative probability of damage occurring when peak compression force, loading frequency, or duration in a lifting task is changed. The first model is based on the assumption that fatigue failure is the mechanism underlying damage to the VMS in cyclic compression. The second model is based on the assumption that the VMS damage in cyclic compression is determined by the viscoelastic deformation of the segment and that the instant of failure can be predicted on the basis of the energy stored in this process. With both models, we estimated the percentage of the population likely to incur a VMS injury when performing a repetitive lifting task with peak compression forces ranging from 1500 to 4100 N, frequencies from 2 to 12 min-1, and durations between 30 and 120 min. The results indicate a dominant influence of the peak compression force on this outcome over the domain studied. This conclusion holds qualitatively for both models, suggesting that for a comparative analysis they can be considered interchangeable. However, a considerable quantitative difference in the absolute outcomes of the two models was found, which stresses the importance of further study on the validity of these models.

Compressive Strength↗

Dissociated oxygen uptake response to an incremental intermittent repetitive lifting and lowering exercise in humans.

Five subjects performed a maximal exercise test of repetitive lifting and lowering, with a discontinuous protocol of incremental exercise (3 min) and relative rest (2 min). Exercise periods consisted of repetitive lifting and repetitive lifting and lowering at increasing movement frequencies. Relative rest periods consisted of ergometer cycling at a constant, low power output. An unexpected, dissociated, response of cardiovascular and pulmonary parameters was found: during relative rest, values for oxygen uptake, carbon dioxide production, pulmonary ventilation and tidal volume were significantly higher than during the preceding exercise periods, though exercise intensity was much lower. To our knowledge, such a response has not been reported in previous studies. Since the response could not be attributed to methodological or technical factors, it is hypothesized that the type of exercise itself impeded the optimal performance of the oxygen transporting system. The function of the pulmonary system could have been influenced by a high intra-abdominal pressure, the involvement of respiratory muscles in stabilizing trunk and head, a flexed trunk posture and the entrainment of respiratory frequency with movement frequency. More likely, the function of the cardiovascular system was hindered by a high blood pressure and high intramuscular pressures. Since this response occurred at low exercise intensities, optimal functioning of the cardiovascular and pulmonary system during daily activities of repetitive lifting and lowering could similarly be impeded. The hypotheses put forward could also explain the lower peak oxygen uptake reported during repetitive lifting, compared to running and cycling.

Adult↗

The influence of torque and velocity on erector spinae muscle fatigue and its relationship to changes of electromyogram spectrum density.

The influence of contraction force and velocity during isokinetic contractions on the development of fatigue in the erector spinae muscle was studied. Seven male subjects performed a series of 250 contractions at 25% and 50% of their isometric maximal voluntary contraction (MVC) at 40 and 80 degree.s-1. Fatigue defined as a decrease of the contractile capacity of the muscles was studied by means of a 15-s maximal test-contraction following the exercise. Both the initial force and the force decrement during the test-contraction were studied. Surface electromyogram (EMG) signals of the main tracts of the erector spinae muscle were recorded. The frequency content was studied by calculating the zero-crossing rate for the signals obtained during dynamic contractions and by means of fast Fourier transformation for the test contraction. After the 50% MVC dynamic contractions the initial force during the postexercise test-contraction was significantly lower than after the 25% MVC contractions. No significant influence of contraction velocity on fatigue development was found. The force decrement during the test-contraction did not depend on the experimental conditions. The EMG amplitude indicated that the subjects were better able to relax their muscles during the counter movement (flexion) at high forces and high velocities compared to the other experimental conditions. The frequency content of the EMG signals during the dynamic contractions and the postexercise test-contraction showed only very weak relationships with fatigue. Therefore, spectrum EMG parameters as determined in the present study do not seem suitable as indicators of muscle fatigue as a consequence of dynamic contractions of trunk extensor muscles.

Adult↗

Segment inertial parameter evaluation in two anthropometric models by application of a dynamic linked segment model.

The estimation of segment inertial parameters (SIPs) is an important source of error in inverse dynamic analysis. In most individual cases SIPs are derived from extrapolation of known SIPs of a certain population through regression equations (proportional models). Another well-known method is the use of mathematical approximation of the shape of human body segments combined with estimations of segment densities (geometric models). In the current study five males and five females performed four different lifting movements in the sagittal plane. A full body linked segment model was applied twice to the same data set, once using a proportional and once using a geometric anthropometric model. As a full body linked segment model is an overdetermined system of equations, four equations could be formed to test the summed effect of SIP errors on the inverse dynamic analysis. The overall performance in terms of coefficients of correlation was better for the geometric model as compared to the proportional model. When a back lifting movement was performed, the equations indicated systematic errors in the proportional model. However, when a leg lifting movement was performed, the equations indicated systematic errors in the geometric model. Therefore, analyzing only one kind of movement does not suffice to draw conclusions with respect to the reliability of an anthropometric model.

Adolescent↗

Weight and frequency effect on spinal loading in a bricklaying task.

In manual materials handling jobs a reduction in the weight of materials often concurs with an increase in handling frequency. The effect of weight and inversely related frequency on spinal load was studied in two bricklaying tasks: building the skin and the floor of a steel ladle. In both tasks five subjects laid bricks of varying weight and frequency (obtained from field observations). The load parameters investigated were peak values and time integrals of the compressive force on the L5-S1 motion segment and stature loss, which is assumed to reflect motion segment creep due to compression. Peak compression was found to increase at higher brick weights. No differences in integrated compression were observed among four out of five combinations of weight and frequency (both in skin and floor building). Laying bricks for a fixed period of 47 min yielded average stature losses of 2.0 3.6 mm. Differences in stature loss among weight-frequency conditions were not significant. In conclusion, at lower weights peak loads decrease, but the benefit of this should be doubted because the frequency of exposure to these peak loads was found to increase. Moreover, this increase was such that no effects were found on spinal load estimates that incorporate both magnitude and time aspects of the load, like time-integrated compression and stature loss.

Adult↗

Fatigue-related changes in the coordination of lifting and their effect on low back load.

In this study, changes in movement coordination caused by fatigue that developed during repetitive lifting were examined. Five men performed 6 times a 5-min bout of lifting an 8-kg barbell at 15 lifts/min, using two lifting techniques; one minimized trunk rotation (squat lift), and the other minimized rotation in the knee joint (stoop lift). Kinematics and dynamics were studied by means of movement analysis and inverse dynamics, using a two-dimensional linked segment model. Within-subject variation over repetitive lifts of the time course of joint angles was smaller than between-subjects variation on the first analyzed lift. Relative timing between joint rotations did not change significantly across repetitive lifts, except between knee and hip in the squat lift. No change of the lumbosacral torque over repetitive lifts was found. The adaptability of the neural control appeared to be sufficient to accommodate the strong changes of the input-output characteristics of the muscles caused by fatigue so that an essentially constant performance of the movement act was maintained.

Journal Article↗

Application of the maximum energy criterion to describe the strength of the motion segment under axial compression.

STUDY DESIGN: A simulation study of compression of vertebral motion segments to failure was performed. OBJECTIVES: The aim of this study was to determine whether damage of the motion segment under axial compression can be predicted when the load is quantified by means of the elastic energy storage it causes in the segment. SUMMARY OF BACKGROUND DATA: Although in one-cycle loading, motion segment strength can be described by the relationship between the product of the bone density and cross-sectional area of the vertebrae and the maximum force, no single criterion has been found to describe strength in both one-cycle and cyclic compressional loading protocols. METHODS: Input data were derived from in vitro studies by Hansson et al, Keller et al, and by Brinckmann et al. Elastic energy storage at failure was computed using a three-parameter model for a viscoelastic solid with a nonlinear initial response, and related to the product of the bone density and cross-sectional area. RESULTS: The relationship of the product of density and area with the elastic energy appeared to be accurately described by a curvilinear equation. This relationship accounted for 65-93% of the variance in maximum energy. Generalizability of the relationship from cyclic axial loading to one-cycle axial loading was successfully tested. CONCLUSION: The results of the present study have shown that one criterion suffices to describe the strength of the motion segment in different compressional loading modes.

Biomechanical Phenomena↗

Flexion relaxation during lifting: implications for torque production by muscle activity and tissue strain at the lumbo-sacral joint.

During the full flexion phase of the back lift movement the lumbar part of the erector spinae muscle exhibits a reduced activity level (flexion relaxation). This study addresses the question how the required extension torque in the lumbo-sacral joint (L5/S1 joint) is balanced during the period in which apparently the lumbar erector spinae ceases to take its share. Six subjects participated in the experiment in which they performed seven lifting tasks. The load, the range of movement, and the phase in which the load was handled (lifting or lowering) were varied. A dynamic linked segment model was applied to determine the momentary torques acting at the L5/S1 joint, while the EMGs of the lumbar and thoracic part of the erector spinae muscle were measured. Furthermore, the lengths between markers on the lumbar and thoracic part of the trunk were determined to reveal changes in length during the movement. The dynamic EMGs were normalized to trunk angle-dependent maximal levels. The L5/S1 joint torques were analysed and combined with the normalized EMG data and the kinematics of the trunk, which are assumed to indicate the elongation of passive tissues. Although in the normalization procedure the change of the length-force relationship of the erector spinae was taken into account, the dynamic lumbar EMG activity decreased to a low-activity level (the phenomenon of flexion relaxation). This coincided with a 25% increase in lumbar length suggesting that passive tissue strain provided part of the required extension torque. In the tasks where a barbell was handled a significant increase in EMG level of the thoracic part of the erector spinae occurred just before the flexion relaxation at the lumbar level. Apparently, the extensor function of the lumbar part is then taken over by the thoracic part of the erector spinae muscle. This suggests that an intricate coordinating mechanism is operative that apportions the load to be balanced over active--(lumbar and thoracic part of the erector spinae) and passive structures (post vertebral ligaments).

Adult↗

Optimizing the determination of the body center of mass.

The position or trajectory of the body center of mass (COM) is often a parameter of interest when studying posture or movement. For instance, in balance control studies the body COM can be related to the ground reaction force or to the base of support. Since small displacements of the body COM are important in balance control studies, it is essential to obtain valid estimates of the body COM. The main source of error in the determination of the body COM is the estimation of the masses and centers of mass of the body segments. Especially the determination of the trunk COM is prone to error. In the current study five subjects maintained three postures, differing in trunk angle, during a few seconds. The relation between the center of pressure of the ground reaction force and the vertical projection of the body COM during the postures was used to optimize the trunk COM position. Additionally the subjects performed two lifting movements. The validity of the body COM trajectory estimation during the lifting movements, both with and without optimized trunk COM, was checked by relating the external moment of the ground reaction force with respect to the body COM to the rate of change of the angular momentum of the whole body. It was shown that the correspondence between the external moment and the rate of change of the angular momentum improved after optimization of the trunk COM. This suggests that the body COM trajectory estimation can be improved by the proposed optimization procedure.

Adult↗

Mechanical loading on the low back in three methods of refuse collecting.

The mechanical loading on the low back was studied in three different current methods of refuse collecting: in polythene bags, two-wheeled mini-containers and large four-wheeled containers. To this end the most prominent activities of each collecting method were performed in a laboratory. On the basis of movement analysis, force measurements and biomechanical modelling, spinal compressive and shear forces were estimated. From these forces and from the frequency of activities during the working day (assessed in a preliminary field study) the low-back stress in each collecting method was evaluated. In the bag-method, peak forces when throwing the bags ranged from 3341 to 5179 N (average compression) and from 284 to 673 N (shear) among the different conditions studied. The act of picking up bags also showed rather high forces (exceeding the NIOSH limit for disc compression in most cases). The frequency of exposure to these forces in the field is rather high (workers pick up and throw on average 807 times each day). The mini-container method compares favourably to the bags method. Peak compressive and shear force in tilting/pushing and pulling mini-containers ranged from 1657 to 2654 N and from 123 to 248 N respectively. Also, the frequency of stressful events in the field is lower in this method. In the large container method extremely high peak forces (e.g. compression ranged from 4991 to 5810 N) were observed in the task of putting the empty container back from street level to sidewalk level (surmounting the kerb). The frequency of activities like pushing, pulling and lifting the large container in the field is much lower compared with activities in the other methods. On the basis of the frequency and magnitude of spinal forces it was concluded that the mini-containers should be preferred to the bags. If kerbs are removed at container places and tasks are performed by two instead of a single person, the large container method would form another good alternative to the stressful task of collecting refuse in bags.

Adult↗

The validity of visual observation to assess posture in a laboratory-simulated, manual material handling task.

A wide range of methods to evaluate posture in work situations relies on simple, unaided visual observation. In the present study the validity of visual observation to assess posture in a dynamic job was evaluated. Postural aspects were observed and recorded during a manual materials handling job simulated in a laboratory. The results from these observations, concerning gross body posture, torso flexion, arms and legs position, and load to be handled, were compared to the results obtained by direct opto-electronic recording. The agreement on a sample-to-sample basis (expressed by Cohen's kappa) was poor for the variables torso flexion (mean value for kappa = 0.38), position of arms (kappa = 0.43) and legs (kappa = 0.46) and load to be handled (kappa = 0.50) and acceptable only for the gross body posture (kappa = 0.79). Moreover, for each variable except gross body posture, the crude distributions of all observations and recordings across categories (irrespective of time) were significantly different. The results demonstrate that the observations are not valid. It is concluded that dynamic work situations require less simple, more time consuming methods (e.g., analyzing film or video records of the job) than a posture registration method based on direct visual observation.

Adult↗

The evaluation of a practical biomechanical model estimating lumbar moments in occupational activities.

To estimate the mechanical load on the low back in manual materials handling, the Static Strength Prediction Model (SSPM, University of Michigan) is widely used in the occupational field. It requires (for practical reasons) only a small number of input variables (five body segment angles, standing height, total body mass, external load on the hands) on which basis the moment at the lumbo-sacral intervertebral joint (beside other parameters) is computed. The dynamic character of the activities is ignored in the calculations. To evaluate the validity of the SSPM in various situations, lumbar moments in lifting/lowering activities at different lifting techniques and speeds obtained by the SSPM, were compared with those obtained by a more comprehensive dynamic model (DM). An analysis of variance showed significant effects (p = 0.001) of the biomechanical model applied and the lifting speed used on the peak lumbar moment values. No effects of lifting technique were found. The differences in results from the SSPM and DM were dependent on the lifting speed: the SSPM peak lumbar moments were on average 9% (not significant), 21% (significant at p = 0.005) and 42% (p = 0.0001) smaller compared to the DM moments in the slow (mean velocity in a complete lifting/lowering cycle, 0.2 m s-1), normal (0.4 m s-1) and fast (0.8 m s-1) speed condition respectively. The results indicate that the static/dynamic difference between the models is a major source for the different lumbar moments, while other differences between the SSPM and DM are of minor importance.

Adult↗

Relationships between energy expenditure and positive and negative mechanical work in repetitive lifting and lowering.

Determining the separate energy costs of the positive and negative mechanical work in repetitive lifting or lowering is quite complex, as a mixture of both work components will always be involved in the up- and downward motion of the lifter's body mass. In the current study, a new method was tested in which coefficients specifically related to the positive and negative work were estimated by multiple regression on a data set of weight-lifting and weight-lowering tasks. The energy cost was obtained from oxygen uptake measurements. The slopes of the regression lines for energy cost and mechanical work were steeper for positive than for negative work. The cost related to the negative work was approximately 0.3-0.5 times the cost of the positive work. This finding is well in line with data obtained directly from other isolated activities of either positive or negative work (e.g., ladder climbing vs. descending). However, the intercept values of the regression lines were not significantly different from zero or were even negative. This was most likely due to the metabolic energy not related to processes that yield mechanical work (e.g., isometric muscle actions) that was not constant among trials.

Adult↗

Energetics of competitive swimming. Implications for training programmes.

An analysis of the mechanics and energetics of swimming reveals that different factors play key roles in success in competitive swimming events. Knowledge of these performance factors will help the development of optimal training programmes, especially when their relative importance can be identified. One approach to doing this is to evaluate the energy cost of swimming and the energy generating systems that cover these costs. It appears that the rate of energy expenditure is related to the velocity, the gross efficiency, the propelling efficiency and a drag factor. Energy is generated by aerobic and anaerobic processes. A balance should exist between the energy necessary to swim a distance in a certain time and the total energy available in this time from the energy producing system. This balance was used to predict the performance times over difference distances and to predict the effect of a 10% increase in the aerobic capacity, the anaerobic capacity or the propelling efficiency on the performance times, while keeping all other factors constant. The 10% increase in propelling efficiency resulted in both a reduction in time over the short distance as well as an improvement in performance over the long distance which was superior to the gains found when increasing the maximal aerobic or anaerobic power by 10%. It is concluded that for an optimal use of training time and for an optimal use of the capacities of the swimmer, it seems important to determine both the mechanical parameters (technique, drag) and the parameters describing the energy production. By determining the weak and strong points of competitive swimmers, the optimal training distances and what performance factors are the weakest and most likely to improve with training can be determined.

Aerobiosis↗

Effect of individually chosen bed-height adjustments on the low-back stress of nurses.

OBJECTIVES: The effects of height-adjustable beds in hospitals on the subsequent prevalence of low-back problems among nurses depend on the capacity to reduce low-back stress by bed-height adjustment. This capacity was investigated in the present study. METHODS: Professional nurses performed patient-handling tasks at a standard and an individually chosen bed height. Peak values and time integrals of spinal compression and shear forces were estimated with dynamic biomechanical modeling. RESULTS: The bed-height adjustment led to lower values of time-integrated compression (average 8.8% lower), peak shear force (average 9.3% lower), and time-integrated shear force (average 18.1% lower). No significance was found for the effect on peak compression, nor for the results for each individual task. This finding can be explained by the minor adjustments made in comparison with the standard height or by the application of different criteria for bed-height adjustment. CONCLUSIONS: The decreasing time-integrated forces and peak shear force, without a concomitant rise of peak compression, speak in favor of the use of height-adjustable beds in nursing.

Adult↗