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Biomedical subjects

M P de Looze

Publications and source records attributed to M P de Looze.

At least 19 recordsLinked to original sources

Fatigue effects on tracking performance and muscle activity.

It has been suggested that fatigue affects proprioception and consequently movement accuracy, the effects of which may be counteracted by increased muscle activity. To determine the effects of fatigue on tracking performance and muscle activity in the M. extensor carpi radialis (ECR), 11 female participants performed a 2-min tracking task with a computer mouse, before and immediately after a fatiguing wrist extension protocol. Tracking performance was significantly affected by fatigue. Percentage time on target was significantly lower in the first half of the task after the fatigue protocol, but was unaffected in the latter half of the task. Mean distance to target and the standard deviation of the distance to target were both increased after the fatigue protocol. The changed performance was accompanied by higher peak EMG amplitudes in the ECR, whereas the static and the median EMG levels were not affected. The results of this study showed that subjects changed tracking performance when fatigued in order to meet the task instruction to stay on target. Contrary to our expectations, this did not lead to an overall higher muscle activity, but to a selective increase in peak muscle activity levels of the ECR.

Adult↗

Association between objective and subjective measurements of comfort and discomfort in hand tools.

In the current study, the relationship between objective measurements and subjective experienced comfort and discomfort in using handsaws was examined. Twelve carpenters evaluated five different handsaws. Objective measures of contact pressure (average pressure, pressure area and pressure-time (P-t) integral) in static and dynamic conditions, muscle activity (electromyography) of five muscles of the upper extremity, and productivity were obtained during a sawing task. Subjective comfort and discomfort were assessed using the comfort questionnaire for hand tools and a scale for local perceived discomfort (LPD). We did not find any relationship between muscle activity and comfort or discomfort. The P-t integral during the static measurement (beta=-0.24, p<0.01) was the best predictor of comfort and the pressure area during static measurement was the best predictor of LPD (beta=0.45, p<0.01). Additionally, productivity was highly correlated to comfort (beta=0.31, p<0.01) and discomfort (beta=-0.49, p<0.01).

Adult↗

Identifying predictors of comfort and discomfort in using hand tools.

The aim of the study was to identify predictors of comfort and discomfort in using hand tools. For this purpose, the comfort questionnaire for hand tools (CQH) was developed based on the results of a previous study. In the current study, four screwdrivers were evaluated on comfort (expected comfort at first sight and comfort after short time use) using the CQH and discomfort (local perceived discomfort). The results showed that expected comfort at first sight was predicted by aesthetics. Additionally, functionality and physical interaction, and adverse body effects were the major predictors of overall comfort after short time use. Discomfort was predicted by adverse body effects only. It is concluded that comfort and discomfort in using hand tools have partly the same underlying factors: discomfort feelings also affect the comfort experience.

Adult↗

Identifying factors of comfort in using hand tools.

To design comfortable hand tools, knowledge about comfort/discomfort in using hand tools is required. We investigated which factors determine comfort/discomfort in using hand tools according to users. Therefore, descriptors of comfort/discomfort in using hand tools were collected from literature and interviews. After that, the relatedness of a selection of the descriptors to comfort in using hand tools was investigated. Six comfort factors could be distinguished (functionality, posture and muscles, irritation and pain of hand and fingers, irritation of hand surface, handle characteristics, aesthetics). These six factors can be classified into three meaningful groups: functionality, physical interaction and appearance. The main conclusions were that (1) the same descriptors were related to comfort and discomfort in using hand tools, (2) descriptors of functionality are most related to comfort in using hand tools followed by descriptors of physical interaction and (3) descriptors of appearance become secondary in comfort in using hand tools.

Consumer Behavior↗

Effects of dynamic office chairs on trunk kinematics, trunk extensor EMG and spinal shrinkage.

Seated work has been shown to constitute a risk factor for low-back pain. This is attributed to the prolonged and monotonous low-level mechanical load imposed by a seated posture. To evaluate the potential health effects with respect to the low back of office chairs with a movable seat and back rest, trunk kinematics, erector spinae EMG, spinal shrinkage and local discomfort were assessed in 10 subjects performing simulated office work. On three separate occasions subjects performed a 3 h task consisting of word processing, computer-aided design and reading. Three chairs were used, one with a fixed seat and back rest and two dynamic chairs, one with a seat and back rest movable in a fixed ratio with respect to each other, and one with a freely movable seat and back rest. Spinal shrinkage measurements showed a larger stature gain when working on the two dynamic chairs as compared with working on the chair with fixed seat and back rest. Trunk kinematics and erector spinae EMG were strongly affected by the task performed but not by the chair type. The results imply that dynamic office chairs offer a potential advantage over fixed chairs, but the effects of the task on the indicators of trunk load investigated were more pronounced than the effects of the chair.

Adult↗

Towards successful physical stress reducing products: an evaluation of seven cases.

Lifting, carrying, pushing and pulling at work are assumed to be related to increased risks of musculoskeletal injury, mainly in the low back and shoulder region. The implementation of products to reduce the physical load in heavy work is a well-known strategy to attack this problem. The success of these products depends not only on the product itself, but also on the process of product development and implementation. In this paper, seven cases are described where products have been developed to reduce the physical load on scaffolders, bricklayers, bricklayer's assistants, roofworkers, aircraft loaders, glaziers and assembly line workers. These products are described with special reference to the physical load problem in the occupational task, the process of product development, the nature of the product, the potential effects on physical load and the opinion of workers. From these cases, a list of key factors in product development contributing to the success of a product is composed. These concern among others a direct participation of workers, a wide analysis of risks, an analysis of potential negative side effects, and a systematic stepwise approach.

Equipment Design↗

Lumbar loading during lifting: a comparative study of three measurement techniques.

Low back loading during occupational lifting is thought to be an important causative factor in the development of low back pain. In order to regulate spinal loading in the workplace, it is necessary to measure it accurately. Various methods have been developed to do this, but each has its own limitations, and none can be considered a "gold standard". The purpose of the current study was to compare the results of three contrasting techniques in order to gain insight into possible sources of error to which each is susceptible. The three techniques were a linked segment model (LSM), an electromyographic (EMG)-based model, and a neural network (NN) that used both EMG and inertial sensing techniques. All three techniques were applied simultaneously to calculate spinal loading when eight volunteers performed a total of eight lifts in a laboratory setting. Averaged results showed that, in comparison with the LSM, the EMG technique calculated a 25.5+/-33.4% higher peak torque and the NN technique a 17.3+/-10.5% lower peak torque. Differences between the techniques varied with lifting speed and method of lifting, and could be attributed to differences in anthropometric assumptions, antagonistic muscle activity, damping of transient force peaks by body tissues, and, specific to the NN, underestimation of trunk flexion. The results of the current study urge to reconsider the validity of other models by independent comparisons.

Adult↗

Mechanisms of action of lumbar supports: a systematic review.

STUDY DESIGN: A systematic review and meta-analysis of studies on the putative mechanisms of action of lumbar supports in lifting activities. OBJECTIVE: To summarize the evidence bearing on the putative mechanisms of action of lumbar supports. SUMMARY OF BACKGROUND DATA: A restriction of trunk motion and a reduction in required back muscle forces in lifting are two proposed mechanisms of action of lumbar supports. Available studies on these putative mechanisms of action of lumbar supports have reported contradictory results. METHODS: A literature search for controlled studies on mechanisms of action of lumbar supports was conducted. The methodologic quality of the studies was assessed. The evidence for the two proposed mechanisms of action of lumbar supports was determined in meta-analyses. RESULTS: Thirty-three studies were selected for the review. There was evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending, with overall effect sizes of 0.70 (95% confidence interval [CI] 0.39-1. 01) and 1.13 (95% CI 0.17-2.08), respectively. The overall effect size for rotation was not statistically significant (0.69; 95% CI -0. 40-4.31). There was no evidence that lumbar supports reduce the electromyogram activity of erector spinae muscles (effect size of 0. 09; 95% CI -0.41-0.59) or increase the intra-abdominal pressure (effect size of 0.26; 95% CI -0.07-0.59). CONCLUSION: There is evidence that lumbar supports reduce trunk motion for flexion-extension and lateral bending. More research is needed on the separate outcome measures for trunk motion before definite conclusions can be drawn about the work conditions in which lumbar supports may be most effective. Studies of trunk motion at the workplace or during specified lifting tasks would be especially useful in this regard.

Back Injuries↗

Trunk muscle activation and low back loading in lifting in the absence of load knowledge.

People who know the actual mass of an object to be lifted normally prepare themselves before attempting a lift to control the movement and to minimize low back loading. In this study, the trunk muscular reactions and low back torque were investigated in the situation in which the individual did not know the actual mass but only had some idea of the range within which the mass lay. Nine males lifted boxes weighing 6.5 or 16.5 kg under the condition in which they knew the actual mass before attempting a lift (the 'known' condition) and the condition in which they only had the information that the mass would be within the range of 6.5-16.5 kg (the 'unknown' condition). The ground reaction forces and body movements were measured in the trials and, from these, the L5/S1 torques were calculated. The activation of back and abdominal muscles was also measured. For the 6.5 kg weight, a higher (16%) back muscle activation in grasping the box and a higher (10%) peak L5/S1 torque in actual lifting were observed in the 'unknown' compared with the 'known' weight condition. For the 16.5 kg weight, the back muscle activation was lower (10%) during grasping, and higher (10%) during lifting in the 'unknown' compared with the 'known' weight condition. Knowledge of the load had no effect on the activation of the abdominal muscles. It was concluded that in the so-called 'unknown' conditions, the risks of low back injury were increased in comparison with the conditions where the actual weight was known in advance.

Abdominal Muscles↗

Force direction and physical load in dynamic pushing and pulling.

In pushing and pulling wheeled carts, the direction of force exertion may, beside the force magnitude, considerably affect musculoskeletal loading. This paper describes how force direction changes as handle height and force level change, and the effects this has on the loads on the shoulder and low back. Eight subjects pushed against or pulled on a stationary bar or movable cart at various handle heights and horizontal force levels while walking on a treadmill. The forces at the hands in the vertical and horizontal direction were measured by a force-transducer. The forces, body movements and anthropometric data were used to calculate the net joint torques in the sagittal plane in the shoulder and the lumbosacral joint. The magnitudes and directions of forces did not differ between the cart and the bar pushing and pulling. Force direction was affected by the horizontal force level and handle height. As handle height and horizontal force level increased, the pushing force direction changed from 45 degrees (SD 3.3 degrees) downward to near horizontal, while the pulling force direction changed from pulling upward by 14 degrees (SD 15.3 degrees) to near horizontal. As a result, it was found that across conditions the changes in force exertion were frequently reflected in changes in shoulder torque and low back torque although of a much smaller magnitude. Therefore, an accurate evaluation of musculoskeletal loads in pushing and pulling requires, besides a knowledge of the force magnitude, knowledge of the direction of force exertion with respect to the body.

Adult↗

Dynamic forces acting on the lumbar spine during manual handling. Can they be estimated using electromyographic techniques alone?

STUDY DESIGN: Compressive loading of the lumbar spine was analyzed using electromyographic, movement analysis, and force-plate techniques. OBJECTIVES: To evaluate the inertial forces that cannot be detected by electromyographic techniques alone. SUMMARY OF BACKGROUND DATA: Links between back pain and manual labor have stimulated attempts to measure spine compressive loading. However, direct measurements of intradiscal pressure are too invasive, and force plates too cumbersome for use in the workplace. Electromyographic techniques are noninvasive and portable, but ignore certain inertial forces. METHODS: Eight men lifted boxes weighing 6.7 and 15.7 kg from the ground, while joint moments acting about L5-S1 were quantified 1) by using a linked-segment model to analyze data from Kistler force plates and a Vicon movement-analysis system, and 2) by measuring the electromyographic activity of the erector spinae muscles, correcting it for contraction speed and comparing it to moment generation during static contractions. The linked-segment model was used to calculate the "axial thrust," defined as the component of the L5-S1 reaction force that acts along the axis of the spine and that is unrelated to trunk muscle activity or static body weight. RESULTS: Peak extensor moments predicted by the two techniques were similar and equivalent to spinal compressive forces of 2.9-4.8 kN. The axial thrust "hidden" from the electromyographic technique was negligible during slow lifts, and remained below 4% of peak spinal compression even during fast heavy lifts. Peak axial thrust was proportional to the peak vertical ground reaction (R2 = 0.74). CONCLUSIONS: Electromyographic techniques can measure dynamic spinal loading, but additional force-plate data would improve accuracy slightly during lifts requiring a vigorous upward thrust from the legs.

Adult↗

Directionality of anticipatory activation of trunk muscles in a lifting task depends on load knowledge.

We investigated to what extent subjects base anticipatory activity patterns of trunk muscles before lifting a load on knowledge of the inertial properties of the load. Eight healthy male subjects performed rapid arm lifts of a load with a varying center of mass position in the frontal plane. In one set of trials subjects were familiar with the center of mass position, in another set of trials they were not. In both cases trunk extensor muscles were active before the onset of lift force applied to the load. In the trials with load knowledge this anticipatory activity was specific with respect to center of mass position. In the absence of load knowledge left and right extensor muscles were equally active before the lift and the rate of lifting was reduced. Thus anticipatory control of trunk muscles appears specifically tuned to counteract the expected perturbation. In the absence of load knowledge trunk stiffness is increased by bilateral activity and the perturbation is attenuated since the rate of lifting is reduced.

Abdominal Muscles↗

Sensitivity of single-equivalent trunk extensor muscle models to anatomical and functional assumptions.

Single-equivalent muscle models are often used to estimate loads on the lumbosacral joint after net extension moments have been calculated by means of inverse dynamics. These models usually ignore the effects trunk flexion has on the extensor lever arm. In addition, no systematic analysis of the sensitivity to the anatomical and functional assumptions made in these models is available. In the present study a series of single-equivalent models incorporating trunk flexion dependence was derived from a detailed description of the trunk musculature. Each model was based on different anatomical and functional assumptions. The differences of estimates of compression and shear forces on the lumbosacral disc during a lifting movement resulting from these models were analysed. The results show that these load estimates heavily depend on assumptions regarding anthropometry, lumbar curvature and coactivity of abdominal muscles and only moderately on assumptions regarding force sharing between extensor muscles. Fairly simple single-equivalent models with the net moment and thorax orientation as input can be used to predict lumbosacral compression and shear.

Biomechanical Phenomena↗

Abdominal muscles contribute in a minor way to peak spinal compression in lifting.

In lifting, the abdominal muscles are thought to be activated to stabilize the spine. As a detrimental effect, they contribute to spinal compression. The existing literature is not conclusive about the biological relevance of this effect. From biological, mechanical and anatomical considerations it was hypothesised that the relative abdominal contribution to compression would be minor in the beginning of the lift, that the relative and absolute abdominal contribution to compression would rise throughout the lift, and that the obliques would contribute to a larger extent than the rectus abdominis. To investigate these hypotheses, 10 subjects lifted 0.5, 10.5 and 22.5 kg. EMG levels obtained from the rectus abdominis and the obliques were converted into force using normalized EMG, muscle potential and area values, and modulating factors for muscle length and contraction velocity. An anatomical model was applied to compute the abdominal effects on spinal compression in three consecutive phases within a lift. If expressed relative to the total spinal compression, the abdominal contribution for the three weight conditions was 7.1% (SD, 1.7), 10.4% (4.7) and 12.5% (4.4) in the begin and 21.0% (5.8), 19.0% (5.3) and 22.2% (6.6) in the end phase. Thus, the relative abdominal contribution to compression was minor in the beginning and increased towards the end. The absolute abdominal contribution was constant throughout the lift. The contributions could be retraced to the obliques rather than the rectus, while during the lift a shift in activation from the obliquus externus to internus was observed.

Abdominal Muscles↗

When is a lifting movement too asymmetric to identify low-back loading by 2-D analysis?

In ergonomics research, two-dimensional (2-D) biomechanical models are often used to study the mechanical loading of the low back in lifting movements. When lifting movements are asymmetric, errors of unknown size may be introduced in a 2-D analysis. In the current study, an estimation of these errors was made by comparing the outcome of a 2-D analysis to the results of a recently developed and validated 3-D model. Four subjects made two repetitions of five lifting movements, differing in the amount of asymmetry. The results showed a significant underestimation of the peak torque by 20, 36 and 61% when the initial position of a box was rotated 30, 60 and 90 degrees with respect to the sagittal plane of the subject. The main cause of this underestimation was a pelvic twist, resulting in an erroneous projection of a pelvic marker on to the sagittal plane due to pelvic twist. It is suggested that from 30 degrees box rotation a 2-D analysis may easily lead to wrong conclusions when it is used to study asymmetric lifting.

Adult↗

Muscle strength, task performance and low back load in nurses.

Poor muscle strength, relative to the physical demands of specific jobs, is considered a risk factor for low back pain. To gain an understanding of the underlying mechanisms, this study questioned whether muscle strength was related to task performance and low back load in nursing tasks. Trunk extension, elbow flexion and knee extension strength were therefore measured in 17 nurses. The independent effects of muscle strength on task duration, jerkiness of effort and L5-S1 torque were investigated as the nurses performed several patient handling tasks. Despite a large variation in muscle strength within the subject population, no effect of strength on task duration, jerkiness or L5-S1 torques was observed. In conclusion, poor muscle strength was found not to be related to increased low back load. If 'weaker' nurses were to be at a higher risk, it would be due to a reduced capability to withstand the mechanical load, rather than to an increased mechanical load.

Adult↗

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↗

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↗