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Biomedical subjects

K P Granata

Publications and source records attributed to K P Granata.

At least 19 recordsLinked to original sources

Gender differences in active musculoskeletal stiffness. Part II. Quantification of leg stiffness during functional hopping tasks.

Leg stiffness was compared between age-matched males and females during hopping at preferred and controlled frequencies. Stiffness was defined as the linear regression slope between the vertical center of mass (COM) displacement and ground-reaction forces recorded from a force plate during the stance phase of the hopping task. Results demonstrate that subjects modulated the vertical displacement of the COM during ground contact in relation to the square of hopping frequency. This supports the accuracy of the spring-mass oscillator as a representative model of hopping. It also maintained peak vertical ground-reaction load at approximately three times body weight. Leg stiffness values in males (33.9+/-8.7 kN/m) were significantly (p<0.01) greater than in females (26.3+/-6.5 kN/m) at each of three hopping frequencies, 3.0, 2.5 Hz, and a preferred hopping rate. In the spring-mass oscillator model leg stiffness and body mass are related to the frequency of motion. Thus male subjects necessarily recruited greater leg stiffness to drive their heavier body mass at the same frequency as the lighter female subjects during the controlled frequency trials. However, in the preferred hopping condition the stiffness was not constrained by the task because frequency was self-selected. Nonetheless, both male and female subjects hopped at statistically similar preferred frequencies (2.34+/-0.22 Hz), therefore, the females continued to demonstrate less leg stiffness. Recognizing the active muscle stiffness contributes to biomechanical stability as well as leg stiffness, these results may provide insight into the gender bias in risk of musculoskeletal knee injury.

Adult↗

Response of trunk muscle coactivation to changes in spinal stability.

The goal of this effort was to assess the neuromuscular response to changes in spinal stability. Biomechanical models suggest that antagonistic co-contraction may be related to stability constraints during lifting exertions. A two-dimensional biomechanical model of spinal equilibrium and stability was developed to predict trunk muscle co-contraction as a function of lifting height and external load. The model predicted antagonistic co-contraction must increase with potential energy of the system even when the external moment was maintained at a constant value. Predicted trends were compared with measured electromyographic (EMG) data recorded during static trunk extension exertions wherein subjects held weighted barbells at specific horizontal and vertical locations relative to the lumbo-sacral spine junction. The task was designed to assure the applied moment was identical during each height condition, thereby changing potential energy without influencing moment. Measured EMG activity in the trunk flexors increased with height of the external load as predicted by the model. Gender difference in spinal stability were also noted. Results empirically demonstrate that the neuromuscular system responds to changes in spinal stability and provide insight into the recruitment of trunk muscle activity.

Abdominal Muscles↗

Female and male trunk geometry: size and prediction of the spine loading trunk muscles derived from MRI.

OBJECTIVE: Develop a gender specific database of trunk muscle cross-sectional areas across multiple levels of the thoracic and lumbar spine and develop prediction equations for the physiological cross-sectional area as a function of gender and anthropometry. DESIGN: This study quantified trunk muscle cross-sectional areas of male and female spine loading muscles. BACKGROUND: There is a lack of comprehensive data regarding the female spine loading muscle size. Although biomechanical models often assume females are the same as males, little is known regarding gender differences in terms of trunk muscle areas and no data exist regarding the prediction of trunk muscle physiological cross-sectional areas from commonly used external anthropometric measures. METHODS: Magnetic resonance imaging scans through the vertebral bodies from T(8) through S(1) were performed on 20 females and 10 males. Muscle fiber angle corrected cross-sectional areas were recorded at each vertebral level. Linear regression techniques taking into account anthropometric measures were utilized to develop prediction equations for the physiological cross-sectional area for each muscle of interest, as well as tests for differences in cross-sectional areas due to gender and side of the body. RESULTS: Significant gender differences were observed for the prediction of the erector spinae, internal and external obliques, psoas major and quadratus lumborum physiological cross-sectional areas. Anthropometric measures about the xyphoid process and combinations of height and weight resulted in better predictions of cross-sectional areas than when using traditional anthropometry. CONCLUSIONS: This study demonstrates that the trunk muscle geometry of females and males are different, and that these differences should be considered in the development of biomechanical models of the torso. Relevance. The prediction of physiological cross-sectional areas from external anthropometric measures provide gender specific equations to assist in estimation of forces of muscles which load the spine for biomechanical purposes.

Adult↗

MRI-derived moment-arms of the female and male spine loading muscles.

OBJECTIVE: Develop a comprehensive gender-specific database of trunk muscle moment-arms across multiple levels of the lower thoracic and lumbar spine, determine if gender differences exist across the different vertebral levels, and develop prediction equations for the moment-arms as a function of external anthropometric measures. DESIGN: This study quantified trunk muscle moment-arms relative to the spine from T(8) to S(1) of male and female spine loading muscles. BACKGROUND: Knowledge of trunk muscle geometry is important for biomechanical modeling of the low back and for understanding of spinal loading. However, there currently is a lack of comprehensive data regarding the moment-arms of the female spine loading muscles. Additionally, little is known regarding gender differences in moment-arms for the same muscles. METHODS: Magnetic resonance imaging scans through the vertebral bodies from T(8) through S(1) were performed on 20 females and 10 males. Moment-arms in the coronal and sagittal plane between the muscle centroid and vertebral body centroid were recorded at each vertebral level. Linear regression techniques taking into account anthropometric measures were utilized to develop prediction equations for the moment-arms for each muscle. RESULTS: Anthropometric measures were better predictors of coronal plane moment-arms than sagittal plane moment-arms for both genders. Measures consisting of height and weight were consistent predictors of female moment-arms. Measures about the xyphoid process and combinations of height and weight were consistent predictors of coronal plane moment-arms for males at several lower lumbar levels. Males exhibited larger moment-arms than for females, for most muscles at most levels. CONCLUSIONS: Trunk muscle moment-arms of females and males are different, and should be considered in the development of biomechanical models of the torso. Similar to other studies, external anthropometric measures were better predictors of coronal plane moment-arms than sagittal plane moment-arms.

Adult↗

Trunk posture and spinal stability.

OBJECTIVE: The influence of trunk posture on musculoskeletal stability of the spine was investigated. DESIGN: A biomechanical model was developed to evaluate the influence of posture on spinal stability. Model performance was assessed by comparing predicted muscle recruitment patterns with measured EMG activity from the trunk muscles during static lifting exertions. METHOD: An inverted double-pendulum model of the spine controlled by 12 muscle equivalents of the trunk was implemented to determine spinal load and stability. Model input included trunk posture and lifted mass, output included muscle recruitment patterns necessary to achieve stability of the spine and spinal load. EMG activity recorded from the trunk muscles of 10 subjects were recorded during static exertions in various trunk flexion and asymmetric postures to compare with model output. Stable spinal load was examined as a function of trunk flexion and asymmetry during the lifting exertions. RESULTS: Antagonistic co-contraction was necessary to achieve spinal stability, particularly in upright postures. Stable spinal load was increased in asymmetric postures as a result of antagonistic muscle recruitment, suggesting greater neuromuscular control is necessary to maintain stability in asymmetric lifting postures. As trunk flexion angle increased, stability improved but spinal load was greater. CONCLUSIONS: Results illustrate that muscle recruitment patterns are more accurately explained by stability than by equilibrium alone. Spinal stability is influenced by posture. Specifically, control of spinal stability is reduced in asymmetric postures associated with low-back disorder risk. RELEVANCE: Traditional assessment of low-back disorder risk have focussed on spinal loading. Results illustrate that postural risk factors for low-back pain may be partially attributable to stability considerations.

Adult↗

Trunk muscle coactivation in preparation for sudden load.

Biomechanical stability of the lumbar spine is an important factor in the etiology and control of low-back disorders. A principle component of biomechanical stability is the musculoskeletal stiffening generated by preparatory muscle coactivation. The goal of this investigation was to quantify preparatory behavior, evaluating trunk muscle activity immediately prior to sudden trunk flexion loading during static extension tasks compared to activity observed when subjects were informed no sudden load would occur. Coactive excitation was also examined as a function of fatigue and gender. Results demonstrated increased extensor muscle and flexor muscle coactivation following static fatiguing exertions, potentially compensating for reduced trunk stiffness. Female subjects produced greater flexor antagonism than in the males. No difference in the preparatory coactive muscle recruitment patterns were observed when subjects were expecting a sudden flexion load compared to recruitment patterns observed in similar static postures when subjects were informed no sudden load would be applied. This indicates the neuromuscular system relies greatly on response characteristics for the maintenance of stability in dynamic loading conditions.

Adult↗

Cost-benefit of muscle cocontraction in protecting against spinal instability.

STUDY DESIGN: Lifting dynamics and electromyographic activity were evaluated using a biomechanical model of spinal equilibrium and stability to assess cost-benefit effects of antagonistic muscle cocontraction on the risk of stability failure. OBJECTIVES: To evaluate whether increased biomechanical stability associated with antagonistic cocontraction was capable of stabilizing the related increase in spinal load. SUMMARY OF BACKGROUND DATA: Antagonistic cocontraction contributes to improved spinal stability and increased spinal compression. For cocontraction to be considered beneficial, stability must increase more than spinal load. Otherwise, it may be possible for cocontraction to generate spinal loads that cannot be stabilized. METHODS: A biomechanical model was developed to compute spinal load and stability from measured electromyography and motion dynamics. As 10 healthy men performed sagittal lifting tasks, trunk motion, reaction loads, and electromyographic activities of eight trunk muscles were recorded. Spinal load and stability were evaluated as a function of cocontraction and trunk flexion angle. Stability was quantified in terms of the maximum spinal load the system could stabilize. RESULTS: Cocontraction was associated with a 12% to 18% increase in spinal compression and a 34% to 64% increase in stability. Spinal load and stability increased with trunk flexion. CONCLUSIONS: Despite increases in spinal load that had to be stabilized, the margin between stability and spinal compression increased significantly with cocontraction. Antagonistic cocontraction was found to be most beneficial at low trunk moments typically observed in upright postures. Similarly, empirically measured antagonistic cocontraction was recruited less in high-moment conditions and more in low-moment conditions.

Adult↗

Lumbar-pelvic coordination is influenced by lifting task parameters.

STUDY DESIGN: Low back kinematics, including relative lumbar and pelvic motions, were quantified during controlled lifting tasks. OBJECTIVES: To evaluate the influence of load and lifting velocity on lumbar-pelvic (LP) coordination. SUMMARY OF BACKGROUND DATA: Sagittal trunk extension is achieved through the coordinated motion of the pelvis and lumbar spine. There are no data to indicate whether lifting task design influences lumbar-pelvic coordination. METHODS: Lumbar and pelvic motions were recorded from 18 healthy subjects while performing isokinetic lifting tasks of 0.1 kg and 10 kg. Coordinated motions of the pelvis (sacral spine) and low-thoracic spine were evaluated using eigenvector analyses and a ratio of lumbar and pelvic angles (L/P). RESULTS: Eigenvector models of the lumbar-pelvic coordination accurately represented empirical coordination profiles. Weight significantly influenced lumbar-pelvic coordination. Trunk extension velocity demonstrated a small but statistically significant influence on lumbar-pelvic coordination. Weight and trunk flexion angle significantly influenced lumbar/pelvic angle ratios. CONCLUSIONS: Trunk extension was achieved through simultaneous but nonlinear contributions from both the pelvis and lumbar spine throughout the range of motion. The lumbar spine accounted for 70% of the total, with increased pelvic contributions in flexed postures. Task weight increased the lumbar contribution to total trunk motion. When performing clinical evaluations of spinal kinematics, it is necessary to recognize that unloaded motions may not fully represent loaded behavior of spinal coordination.

Adult↗

Assessment of neuromuscular response characteristics at the knee following a functional perturbation.

Previous research indicates that both the extent and timing of muscular activation at the knee can be influenced by muscle activity state, joint angle, weight-bearing status and trunk position. However, little research to date has evaluated protective neuromuscular response times and activation patterns to an imposed perturbation with the knee joint in a functional, weight-bearing stance. Hence, we designed a lower extremity perturbation device to produce a sudden, forward and either internal or external rotation moment of the trunk and femur relative to the weight-bearing tibia. Surface electromyography (EMG) recorded long latency reflex times of the medial and lateral quadriceps, hamstring and gastrocnemius muscles in 64 intercollegiate lacrosse and soccer players in response to both internal and external rotation perturbation. We found the gastrocnemius fired significantly faster that the hamstring, which in turn fired significantly faster than the quadriceps. There was also a significant difference in activation times of the medial and lateral hamstring not found for the quadriceps or gastrocnemius muscles. Our findings confirmed that reactive neuromuscular responses following this functional perturbation differ markedly from those previously reported using seated, partial weight-bearing and/or uni-planar models under relaxed conditions.

Adult↗

Electromechanical delay and reflex response in spastic cerebral palsy.

OBJECTIVE: Electromechanical delay (EMD) and reflex response in patients with spastic cerebral palsy (CP) were quantified and compared with those in normally developing individuals. It was hypothesized that the increased muscle stiffness associated with spasticity must make EMD shorter than the EMD of normally functioning muscles. DESIGN: Electromechanical reflex behavior was assessed in a case-control study. SETTING: Motion Analysis and Motor Performance Laboratory, University of Virginia, a tertiary clinical referral center and research facility. PARTICIPANTS: A volunteer sample of 12 children diagnosed with spastic CP and 12 age-matched, normally developing children recruited from the local community and clinical services. RESULTS: EMD in the patients with spasticity was significantly shorter than in the normally developing subjects, 40.5 msec and 54.7 msec, respectively. The spastic group also had greater reflex activity, rate of force development, and antagonistic muscle activation. Knee flexion angle did not influence EMD in either group. CONCLUSIONS: Increased biomechanical stiffness in spastic muscle results in abnormally reduced EMD. Reciprocal excitation of antagonistic cocontraction was uniquely observed in the spastic group, but did not explain the reduced EMD.

Adolescent↗

Muscle force production and functional performance in spastic cerebral palsy: relationship of cocontraction.

OBJECTIVE: To determine cocontraction's relation to strength and motor function in children with spastic cerebral palsy (CP). DESIGN: Prospective evaluation with a convenience sample of 10 subjects. SETTING: Pediatric rehabilitation center at a tertiary care hospital. PATIENTS: Ten ambulatory children with spastic CP, mean age 5 to 14yrs. MAIN OUTCOME MEASURES: A single comprehensive assessment of hamstring and quadriceps muscle strength; gait analysis while monitoring electromyographic (EMG) activity in those muscles; administration of the Gross Motor Function Measure (GMFM); heart-rate monitoring during quiet rest versus gait to compute an energy expenditure index (EEI). Cocontraction ratios and magnitudes were determined for the gait and strength testing trials using the EMG data. RESULTS: Cocontraction ratios during strength tests correlated directly with those during free gait. Cocontraction magnitude and total EMG magnitude had an inverse relationship to EEI; children with more muscle activity in the agonist and antagonist tended to be more energy efficient. Knee extensor muscle strength correlated positively with the GMFM and gait velocity. Neither cocontraction ratio nor magnitude during gait was related to strength. CONCLUSIONS: Children with CP used a similar muscle activation strategy across two different motor tasks. Strength and cocontraction were uniquely related to different aspects of motor function. Further research is needed to quantify more precisely cocontraction and force to EMG relations in this population.

Adolescent↗

Joint angular velocity in spastic gait and the influence of muscle-tendon lengthening.

BACKGROUND: Joint angular velocity (the rate of flexion and extension of a joint) is related to the dynamics of muscle activation and force generation during walking. Therefore, the goal of this research was to examine the joint angular velocity in normal and spastic gait and changes resulting from muscle-tendon lengthening (recession and tenotomy) in patients who have spastic cerebral palsy. METHODS: The gait patterns of forty patients who had been diagnosed with spastic cerebral palsy (mean age, 8.3 years; range, 3.7 to 14.8 years) and of seventy-three age-matched, normally developing subjects were evaluated with three-dimensional motion analysis and electromyography. The patients who had cerebral palsy were evaluated before muscle-tendon lengthening and nine months after treatment. RESULTS: The gait patterns of the patients who had cerebral palsy were characterized by increased flexion of the knee in the stance phase, premature plantar flexion of the ankle, and reduced joint angular velocities compared with the patterns of the normally developing subjects. Even though muscle-tendon lengthening altered sagittal joint angles in gait, the joint angular velocities were generally unchanged at the hip and knee. Only the ankle demonstrated modified angular velocities, including reduced dorsiflexion velocity at foot-strike and improved dorsiflexion velocity through mid-stance, after treatment. Electromyographic changes included reduced amplitude of the gastrocnemius-soleus during the loading phase and decreased knee coactivity (the ratio of quadriceps and hamstring activation) at toe-off. Principal component analyses showed that, compared with joint-angle data, joint angular velocity was better able to discriminate between the gait patterns of the normal and cerebral palsy groups. CONCLUSIONS: This study showed that muscle-tendon lengthening corrects biomechanical alignment as reflected by changes in sagittal joint angles. However, joint angular velocity and electromyographic data suggest that the underlying neural input remains largely unchanged at the hip and knee. Conversely, electromyographic changes and changes in velocity in the ankle indicate that the activation pattern of the gastrocnemius-soleus complex in response to stretch was altered by recession of the complex.

Adolescent↗

Variation in spinal load and trunk dynamics during repeated lifting exertions.

OBJECTIVES: To quantify the variability in lifting motions, trunk moments, and spinal loads associated with repeated lifting exertions and to identify workplace factors that influence the biomechanical variability. DESIGN: Measurement of trunk dynamics, moments and muscle activities were used as inputs into EMG assisted model of spinal loading. BACKGROUND: Traditional biomechanical models assume repeated performance of a lifting task produces little variability in spinal load because the assessments overlook variability in lifting dynamics and muscle coactivity. METHODS: Five experienced and seven inexperienced manual materials handlers performed 10 repeated lifts at each combination of load weight, task asymmetry and lifting velocity. RESULTS: Box weight, task asymmetry and job experience influenced the magnitude and variability of spinal load during repeated lifting exertions. Surprisingly, experienced subjects demonstrated significantly greater spinal loads and within-subject variability in spinal load than inexperienced subjects. Trial-to-trial variability accounted for 14% of the total variation in compression overall and 32% in lateral shear load. Although the mean spinal load was safely below the NIOSH recommended limit; due to variability about the mean, more than 20% of the lifts exceeded the recommended limit. CONCLUSION: Spinal load changed markedly from one exertion to the next despite identical task requirements. Trial-to-trial variability in kinematics, kinetics, and spinal load were influenced by workplace factors, and may play a role in the risk of low-back pain. RELEVANCE: Ergonomic assessments considering only the mean value of spinal load overlook the fact that a large fraction of the lifts may exceed recommended levels.

Adult↗

Spine loading and trunk kinematics during team lifting.

Two-person or team lifting is a popular method for handling materials under awkward or heavy lifting conditions. While many guidelines and standards address safe lifting limits for individual lifting, there are no such limits for team lifting, and these lifts are poorly understood. The literature associated with team lifting offers some interesting paradoxes. Many studies have indicated that people lift less per individual under team conditions compared with one-person lifting. Yet, at least one study has reported an increase in team-lifting capacity when subjects were height-matched. The current study explored the spine loading characteristics of one- and two-person lifting teams when subjects lifted under several sagittally symmetric and asymmetric conditions. Spine compression was lower for two person lifts for a given weight, while lifting in sagittally symmetric conditions whereas lateral shear became much greater for two-person lifts under asymmetric lifting conditions. This study has linked these changes to differences in trunk kinematic patterns adopted during one- versus two-person lifting.

Adult↗

Relation between spinal load factors and the high-risk probability of occupational low-back disorder.

Spinal compression is traditionally assumed the principal biomechanical mechanism associated with occupationally related low-back disorders (LBD). However, there is little conclusive evidence demonstrating that compression is related to occupational LBD. The objective of this research was to examine whether axial compression in the lumbar spine can predict the probability that a lifting task should be classified as high risk for LBD. Furthermore, the improvement in predictive ability was examined when analyses include 3-D, dynamic biomechanical factors. Ten experienced warehouse workers transferred 12 pallet loads of boxes in a simulation of warehouse working conditions. Biomechanical estimates of 2-D static and 3-D dynamic spinal compression, shear loads and tissue strains were achieved from the subjects during each lifting exertion. Each lift was also assessed for probability of high LBD risk classification. Regression analyses were performed to examine the relationship between biomechanical and epidemiological factors. Results indicate 2-D static estimates of spinal compression describe approximately 13% of the probability of high LBD risk variability. Dynamic estimates of spinal compression describe > 44% of the variability. A multifactor regression model including 3-D spinal loads and tissue strains further improved the predictive ability, but the improvement was not statistically significant. This research demonstrates the biomechanical source of low-back pain is dynamic, multifaceted and multidimensional. Significant improvements in ergonomics assessments can be achieved by examining interactions of dynamic biomechanical factors. Unfortunately, this improved predictive ability is generated at the high cost of computational complexity. However, less realistic biomechanical representations may ignore the injury mechanisms associated with the greater number of workplace injuries. Thus, improved understanding of the dynamic biomechanical interactions influencing the tolerance and injury mechanisms of the spine may permit more accurate assessments of workplace injury factors associated with LBD and reduced incidence of occupationally related low-back pain.

Adult↗

Effects of box features on spine loading during warehouse order selecting.

Low back disorders in distribution centres or warehouses have been identified as an area of elevated risk in many industries. The task of an order selector requires workers manually to lift boxes from storage bins to a mobile pallet. This study explored the effect of box features and box location when lifting from a pallet in a storage bin upon spine loading. Ten experienced warehouse workers were asked to lift boxes from a pallet while the size, weight, handle features and location of the box on a pallet were changed. An EMG-assisted model was employed to assess spine compression, lateral shear and anterior-posterior shear during the lifts. The position from which the worker lifted a box on a pallet had the most profound effect on spine loading while the lower level of the pallet represented the greatest loadings on the spine. Box weight did not appear to be a feasible means of controlling spine loading unless its position on the pallet could also be controlled. The inclusion of handles had an effect similar to reducing the box weight by 4.5 kg, whereas box size did not effectively affect spine loading. The mechanisms by which these factors affect spine loading are discussed.

Adult↗

Effect of electromyogram-force relationships and method of gain estimation on the predictions of an electromyogram-driven model of spinal loading.

STUDY DESIGN: An experimental study of fatiguing isometric trunk extension was conducted to investigate the spinal loading estimated from an electromyogram-assisted biomechanical model. OBJECTIVE: To evaluate the sensitivity of the model outputs to two crucial assumptions: electromyogram-force relationship and method of gain estimation. SUMMARY OF BACKGROUND DATA: In the proposed electromyogram-assisted models of the trunk, the nature of the electromyogram-force relationship and the wide variation in reported muscle gains can result in a wide variation in estimates of spinal loading. Given the absence of any gold standard for validation of muscle forces, the delineation of confidence intervals for the estimated loads has become critical. METHODS: Ten subjects performed a fatiguing isometric trunk extension while the net muscular torque output and trunk muscular activity were measured. An electromyogram-assisted model was used to estimate the torque output and spinal loading. Linear and nonlinear erector spinae electromyogram-force relationships and three methods for gain estimation were investigated: constant gain determined from an initial maximum extension exertion, constant gain based on the fatiguing exertion, and a time-varying gain from the fatigue test. RESULTS: The predicted torque was not sensitive to the electromyogram-force relationship; the nonlinear model produced 10% lower estimates of peak spinal compression force and 14% higher estimates of peak anterior shear force. The gain determined from an initial calibration exertion underestimated the external torque and underpredicted the peak compression force by 20%, compared with gains calculated in the fatigue test. CONCLUSION: The nature of the electromyogram-force relationship and of the method for estimating the gain significantly affect the outcomes of an electromyogram-assisted model of spinal loading.

Adult↗

Trunk muscle activities during asymmetric twisting motions.

Axial twisting of the torso has been identified via epidemiologic studies as a significant risk factor for occupationally-related low back disorders. However, only recently have biomechanical studies been able to describe how twisting is accomplished through the use of the trunk musculature. These studies have been performed on subjects whose torso twists were performed in an upright posture. In this study, the electromyographic activity of ten trunk muscles was observed while 12 subjects performed twisting exertions in three different trunk postures. These postures included upright twisting, twisting while the trunk was flexed in the sagittal plane, and twisting while the trunk was flexed and rotated asymmetrically. In addition, twisting velocity and direction of motion were changed under the experimental conditions. Under upright twisting conditions, the twisting torque was generated easily and relatively efficiently through the employment of the oblique (internal and external) and latissimus dorsi muscles. When the trunk was flexed the activity of erector spinae muscles increased (about 10-15%) while the external oblique activity decreased (about 3-5%). Twisting while in asymmetric bent postures was accomplished with a reduction in oblique and latissimus dorsi muscle activities (approximately 5%) while the erector spinae muscle activity remained elevated. The change in muscle activity needed to balance the torso during twisting while bending also increased the amount of lateral torque that was produced by the trunk. These findings suggest that studies observing trunk muscle activities and trunk loading while subjects were in upright postures should be interpreted with caution when evaluating the activity of the trunk during occupational activities. Since many occupational twisting tasks are performed in awkward, asymmetric postures, application of results from upright twisting studies might underestimate the risk of these activities.

Abdominal Muscles↗