Adaptations to isolated shoulder fatigue during simulated repetitive work. Part II: Recovery

The shoulder allows kinematic and muscular changes to facilitate continued task performance during prolonged repetitive work. The purpose of this work was to examine changes during simulated repetitive work in response to a fatigue protocol. Participants performed 20 one-minute work cycles comprised of 4 shoulder centric tasks, a fatigue protocol, followed by 60 additional cycles. The fatigue protocol targeted the anterior deltoid and cycled between static and dynamic actions. EMG was collected from 14 upper extremity and back muscles and three-dimensional motion was captured during each work cycle. Participants completed post-fatigue work despite EMG manifestations of muscle fatigue, reduced flexion strength (by 28%), and increased perceived exertion (∼3 times). Throughout the post-fatigue work cycles, participants maintained performance via kinematic and muscular adaptations, such as reduced glenohumeral flexion and scapular rotation which were task specific and varied throughout the hour of simulated work. By the end of 60 post-fatigue work cycles, signs of fatigue persisted in the anterior deltoid and developed in the middle deltoid, yet perceived exertion and strength returned to pre-fatigue levels. Recovery from fatigue elicits changes in muscle activity and movement patterns that may not be perceived by the worker which has important implications for injury risk.     

Dependence of mean duration of heart period and of arrhythmia during dynamic muscular work on the greatness and differences of work load and during static muscular work on the greatness of work load (author's transl)]

Mean duration of heart period (DHP chi) and its standard deviation (SD), indicating heart arrhythmia and significantly correlating with DHP chi, decreased with stepwise increase of dynamic muscular work on a bicycle ergometer and static muscular work of the right upper arm flexor beyond the limit of permanent performance. This correlation, however, can be understood globally only, since the decrease of DHP chi and SD was not always continuous, but frequently changing, with alterations of increase and decrease from step to step of dynamic work load and from minute to minute of static muscular strain. This concerned particularly SD. A continuous decrease of DHP chi in dynamic muscular work was obtained only by load differences of 40 W, not by differences of 10 or 20 W. A more continuous decrease of SD was also noted during greater load-differences. The significant correlation of DHP chi and SD was lost at a load-difference of 10 W on the 60 W-step and at a load-difference of 40 W on the 180 W-step. Great loads caused at the same load-step less frequent variations of DHP chi, not of SD, than little loads. If no preceding work took place, a contary reaction of DHP chi and SD was noted often at the first load-step. Static work with greater holding force caused a more continuous decrease of DHP chi, in a lower degree of SD, than static work with lower holding force. DHP chi decreased mainly in the first minute of strain. The adjustment of mean heart rate and heart arrhythmia on a level corresponding to increase of load is influenced essentially by the difference of muscular strain appearing between two periods of work load or periods of holding. The regulation of the mean duration of heart period and of heart arrhythmia does not necessarily depend on each other.     

Sensitivity of trapezius electromyography to differences between work tasks - influence of gap definition and normalisation methods.

Surface electromyography (EMG) has been used extensively to estimate muscular load in studies of work related musculoskeletal disorders, especially for the trapezius muscle. The occurrences of periods of EMG silence (gaps), the time below a predetermined threshold level (muscular rest) and various percentiles of the amplitude distribution (APDF) are commonly used summary measures. However, the effects of the criteria used to calculate these measures (e.g., gap duration, threshold level, normalisation method) on the sensitivity of these measures to accurately differentiate work loads is not well known.Bilateral trapezius EMG was recorded, for a full workday, for 58 subjects following both maximal (MVE) and submaximal (RVE) reference contractions. Gap frequency, muscular rest, and percentiles were derived for eight fundamental work tasks. The calculations were performed using different gap duration criteria, threshold levels and normalisation methods.A gap duration of less than 1/2 s, and threshold level approximately 0.3% MVE for gap frequency, and approximately 0.5% MVE for muscular rest, were the criteria that optimised sensitivity to task differences. Minimal sensitivity to tasks and a high sensitivity to individuals was obtained using gap frequency with a threshold level of approximately 1% MVE. Normalisation to RVE, rather than MVE, improved sensitivity to differences between tasks, and reduced undesirable variability. Muscular rest was more sensitive to task differences than APDF percentiles.     

Normalization of electromyogram in the neck-shoulder region

Linear and curvilinear electromyogram (EMG) normalization methods were compared among ten healthy men during a simulated work cycle demanding attention and static holding of the arm (Solitaire test). Maximal voluntary contractions (MVC) and gradually increasing contractions up to 70% of MVC were used for normalization in different arm postures. The test contractions studied included inward and outward rotations, abduction, shoulder elevation, and flexion in different arm positions. The shoulder load moment was calculated for the flexion tests using a simple two-dimensional model. The effect of arm posture on the EMG versus shoulder load moment relationship was studied on the following muscles: supraspinatus, infraspinatus, trapezius (three parts), deltoid (two parts) and pectoralis major. All muscles participated in the MVC tests performed, and its was not possible to suggest a single recommended test for each muscle. Differences in normalized EMG median values ranging up to 30% of MVC were found between linear and curvilinear normalization methods. Short-term repeatability of normalization based on a contraction with gradually increasing force was good. Arm posture affected the relationships between shoulder load moment and EMG activity of all muscles studied. Arm posture did not, however, have a significant effect on the estimated amplitude probability distribution functions during the simulated work task. Therefore, at least for the tasks studied, the principle of normalizing in the middle position of the range of movement was deemed acceptable.     

The role of biceps brachii and brachioradialis for the control of elbow flexion and extension movements

How do synergistic muscles interact, when their contraction aims at stabilizing and fine-tuning a movement, which is induced by the antagonistic muscle? The aim of the study was to analyze the interaction of biceps and brachioradialis during fine-tuning control tasks in comparison to load bearing ones. The surface electromyogram of biceps, brachioradialis and triceps were examined in 15 healthy subjects in dynamic flexion and extension movements with different combinations of contraction levels, joint angles and angular velocities. The measurements were conducted in two configurations, where the torque due to an external load opposes the rotational direction of the elbow flexion (load bearing tasks) or the elbow extension (fine-tuning tasks).Whereas during load bearing control tasks, similar muscular activation of biceps and brachioradialis was observed for all joint angles, angular velocities and external loads, during fine-tuning control tasks a significant difference of the muscular activation of both flexors was observed for 1 kg, F(3.639, 47.305) = 2.864, p = 0.037, and 5 kg of external load, F(1.570, 21.976) = 6.834, p = 0.008.The results confirm the synergistic muscular activation of both flexors during load bearing tasks, but suggest different control strategies for both flexors when they comprise a fine-tuning control task.     

Upper trapezius muscle activity patterns during repetitive manual material handling and work with with a computer mouse.

Firstly, upper trapezius EMG activity patterns were recorded on the dominant side of 6 industrial production workers and on the side operating a computer mouse of 14 computer-aided design (CAD) operators to study differences in acute muscular response related to the repetitiveness of the exposure. The work tasks were performed with median arm movement frequencies ranging from 5 min(-1) to 13 min(-1) and were characterized by work cycle times ranging from less than 30 sec to several days. However, the static and median EMG levels and EMG gap frequencies were similar for all work tasks indicating that shoulder muscle loads may be unaffected by large variations in arm movement frequencies and work cycle times. An exposure variation analyses (EVA) showed that the EMG activity patterns recorded during production work were more repetitive than during CAD work, whereas CAD work was associated with more static muscle activity patterns, both may be associated with a risk of developing musculoskeletal symptoms. Secondly, upper trapezius EMG activity patterns recorded on the mouse side of the CAD operators were compared with those recorded on the non-mouse side to study differences in muscular responses potentially related to the risk of developing shoulder symptoms which were more prevalent on the mouse side. The number of EMG gaps on the mouse side were significantly lower than the values for the upper trapezius on the non-mouse side indicating that more continuous activity was present in the upper trapezius muscle on the mouse side and EVA analyses showed a more repetitive muscle activity pattern on the mouse side. These findings may be of importance to explain differences in the prevalence of shoulder symptoms.     

Methodologies for evaluating electromyographic field data in ergonomics.

Surface electromyography (SEMG) is an important tool for work load assessment in ergonomics. Several different approaches using amplitude as well as frequency parameters give fruitful information depending on question at issue in the laboratory as well as in field studies. One basic factor determining the choice of analysis method is whether the SEMG is interpreted as an indicator of forces/torques or pure muscular activation. Two methods for occupational SEMG data reduction representing two different approaches to SEMG applications in ergonomics, Exposure Variation Analysis (EVA), and Joint Analysis of EMG Spectrum and Amplitude (JASA), applied on the same SEMG recording from three muscles during urology surgeon work, have been compared. The EVA method categorised the three muscle recordings as too static with no EMG gaps while the JASA method identifies fatigue in two of the three recordings. The practical relevance of these findings is discussed.     

Physiological effects of dynamic work on a bicycle ergometer combined with different types of static contraction.

The effects on heart rate, oxygen uptake, and pulmonary ventilation of muscular exercises, including both dynamic contractions, either simple or combined, were studied in 4 male subjects, aged 21 to 23 years. The dynamic work consisted in cycling on an ergometric bicycle at three power levels: 40, 80, and 100 W. The static work consisted in pushing against, pulling and holding with the arms a 6, 9, 12, or 18 kg load. The physiological effects are expressed as cardiac cost (delta HR), oxygen cost (delta VO2) and ventilation cost (delta V). The physiological cost of the combined work increases according to the cycling power and to the isometric load developed. A statistical analysis shows that the costs of combined work are not different from the sum of the costs of the static and dynamic contractions measured separately. Thus, the physiological responses to the combinations investigated are of an additive type.     

静态姿势图在飞行任务负荷所致的疲劳评估中的作用

目的:研究静态姿势图在飞行任务负荷所致疲劳评估中的作用。方法:30名符合条件的男性大学生被要求持续进行4小时的模拟飞行任务负荷,其静态姿势图及任务负荷成绩将在每小时末进行重复测量。根据变化敏感的参数,静态立位平衡指数将通过主成分分析法进行计算。随后,该指数与任务负荷水平的相互关系将通过曲线拟合进行分析。结果:在模拟飞行任务负荷影响下,被试静态姿势控制能力明显下降。静态立位平衡指数随着任务负荷时间的持续而明显增大,并与任务负荷时间存在线性关系(R~2=0.949);多重任务成绩与任务负荷持续时间之间存在二次曲线的关系(R~2=0.968),与静态立位平衡指数也呈现相似的二次方曲线关系(R~2=0.976)。结论:静态姿势图与飞行任务负荷水平具有线性关系,能够反映任务负荷所致疲劳水平的大小。     

Lower-limb joint work and power are modulated during load carriage based on load configuration and walking speed

Soldiers regularly transport loads weighing >20 kg at slow speeds for long durations. These tasks elicit high energetic costs through increased positive work generated by knee and ankle muscles, which may increase risk of muscular fatigue and decrease combat readiness. This study aimed to determine how modifying where load is borne changes lower-limb joint mechanical work production, and if load magnitude and/or walking speed also affect work production. Twenty Australian soldiers participated, donning a total of 12 body armor variations: six different body armor systems (one standard-issue, two commercially available [cARM1-2], and three prototypes [pARM1-3]), each worn with two different load magnitudes (15 and 30 kg). For each armor variation, participants completed treadmill walking at two speeds (1.51 and 1.83 m/s). Three-dimensional motion capture and force plate data were acquired and used to estimate joint angles and moments from inverse kinematics and dynamics, respectively. Subsequently, hip, knee, and ankle joint work and power were computed and compared between armor types and walking speeds. Positive joint work over the stance phase significantly increased with walking speed and carried load, accompanied by 2.3–2.6% shifts in total positive work production from the ankle to the hip (p < 0.05). Compared to using cARM1 with 15 kg carried load, carrying 30 kg resulted in significantly greater hip contribution to total lower-limb positive work, while knee and ankle work decreased. Substantial increases in hip joint contributions to total lower-limb positive work that occur with increases in walking speed and load magnitude highlight the importance of hip musculature to load carriage walking.     

Isometric Arm Strength and Subjective Rating of Upper Limb Fatigue in Two-Handed Carrying Tasks

Sustained carrying could result in muscular fatigue of the upper limb. Ten male and ten female subjects were recruited for measurements of isometric arm strength before and during carrying a load for a period of 4 minutes. Two levels of load of carrying were tested for each of the male and female subjects. Exponential function based predictive equations for the isometric arm strength were established. The mean absolute deviations of these models in predicting the isometric arm strength were in the range of 3.24 to 17.34 N. Regression analyses between the subjective ratings of upper limb fatigue and force change index (FCI) for the carrying were also performed. The results indicated that the subjective rating of muscular fatigue may be estimated by multiplying the FCI with a constant. The FCI may, therefore, be adopted as an index to assess muscular fatigue for two-handed carrying tasks.     

Analysis of muscle movement during frequency-modulated activation of efferents

The basic principles governing trajectories of change in muscle length (henceforth referred to as "movement") were analyzed at varying rates of distributed afferent stimulation during experiments on the soleus and plantaris muscles in unanesthetized cats. The theoretical possibility of describing evoked movements within the context of a model having nonlinear hysteresis properties and dependence of dynamic parameters on direction of movement were demonstrated. A difference in static transitions between muscle contraction and lengthening was found and vice versa and retardation of movement at the start of lengthening reaction (induced by a reduced efferent stimulation rate) was more pronounced. Interaction was discovered between two disruptive influences: changes in the rate of efferent stimulation and external load, mainly due to hysteresis effects of muscle contraction. The trajectory of movement produced by alteration in one of the inputs at work (external load or afferent stimulation) is associated with the lead-up to the muscle motion, irrespective of the reason inducing the foregoing movement. Functional implications of the nonlinear dynamics of muscular contraction are discussed.A. A. Bogomolets Institute of Physiology, Academy of Sciences of the Ukrainian SSR, Kiev. Translated from Neirofiziologiya, Vol. 21, No. 4, pp. 443–450, July–August, 1989.     

Mechanical muscular power output and work during ergometer cycling at different work loads and speeds

The aim of the study was to calculate the magnitude of the instantaneous muscular power output at the hip, knee and ankle joints during ergometer cycling at different work loads and speeds. Six healthy subjects pedalled a weight-braked cycle ergometer at 0, 120 and 240 W at a constant speed of 60 rpm. The subjects also pedalled at 40, 60, 80 and 100 rpm against the same resistance, giving power outputs of 80, 120, 160 and 200 W respectively. The subjects were filmed with a cine-film camera, and pedal reaction forces were recorded from a force transducer mounted in the pedal. The muscular work for the hip, knee and ankle joint muscles was calculated using a model based upon dynamic mechanics and described elsewhere. The total work during one pedal revolution significantly increased with increased work load but did not increase with increased pedalling rate at the same braking force. The relative proportions of total positive work at the hip, knee and ankle joints were also calculated. Hip and ankle extension work proportionally decreased with increased work load. Pedalling rate did not change the relative proportion of total work at the different joints.     

Muscular mechanical energy expenditure as a process for detecting potential risks in manual materials handling

The problem of injuries in manual materials handling remains a big concern in industrialized countries. It has become imperative in occupational biomechanics to extend the analyses to all pertinent factors involved in working tasks and to adopt an experimental approach leading to the understanding of the relative demands imposed simultaneously on all body joints. The evaluation of joint muscular work and the processes of energy generation, absorption and transfer appears promising as a tool in the detection of risk factors in working tasks. The present study consisted of evaluating two tasks (lifting and lowering) performed at five different heights (from 15 to 185 cm) with five different loads (from 3.3 to 22.0 kg). The subjects were eight experienced workers from a food product warehouse. Cinematography techniques and two AMTI force platforms were used to collect the data. Dynamic and planar segmental analyses were performed to calculate the net muscular moments at the joints, and work was calculated from the integration of muscular power. Factorial analyses of variance with repeated measures were performed on the dependent variables to evaluate the main effects of tasks, loads, and heights (for lifting and for lowering) and the interactions. The results revealed the adoption of different movement strategies in the handling of heavier loads. In the first, a larger emphasis of energy transfer and movement economy; in the second, a reduction in the relative contribution of the shoulders to the detriment of an increased participation of the lower back and hips was found. The comparison between lifting and lowering tasks indicated that lifting was only slightly more demanding than lowering for maximum muscular moments (about 15%) but much more so for mechanical work (about 40%); however, the nature of the efforts in eccentric contractions suggests that the lowering of heavy loads may be risky. Finally, the results revealed the deviation of height of handling from the waist level to be a significant factor. Handling at lower heights was considerably more demanding but the work was shared by several joints, mainly by the hips and lower back (about 70%); on the other hand, in handling above the waist, the work efforts were concentrated on the upper limbs (about 80%). In most cases, the participation of lower limbs was minimal and some movement strategies are suggested for future research.     

Shoulder muscle load and muscle fatigue among industrial sewing-machine operators

Physiological responses to physical work were assessed for 29 female industrial sewing-machine operators during an 8-h working day under ordinary working conditions. During sewing-machine work, the average (left and right) static load in the trapezius muscle was 9% of the maximal electromyogram (EMG) amplitude (% EMG_max), while the average mean load was 15% EMG_max, and the average peak load was 23% EMG_max. The static load level was unrelated to the muscle strength of the sewing-machine operators, which for the group as a whole was within the normal range. The load levels remained unchanged during the working day, while changes in the EMG mean power frequency and zero crossing frequency rate occurred, both indicating the development of muscle fatigue in left and right trapezius muscle during the working day. In line with this, the rating of perceived exertion in the shoulder and neck region increased during. the working day. Dividing the group of sewing-machine operators into two groups, those with the highest frequency and those with the lowest frequency of shoulder/neck troubles showed that the former group had significantly lower muscle strength, despite the fact that no differences in the surface EMG during sewing were found between the two groups. It was concluded that industrial sewing-machine work involves a pattern of shoulder muscle activity which induces fatiguing processes in the shoulder and neck regions. Furthermore, since the static shoulder muscle load was independent of muscle strength, factors other than working posture may be of significance for the static shoulder muscle load.     

The amplitude distribution of surface EMG in static and intermittent static muscular performance.

A measure of the variation of load on individual muscles or parts of muscles may be obtained by estimating the amplitude probability distribution function (APDF) of the myoelectric signal. In a study of elbow flexor muscular performance in static and intermittent static low level muscular contractions, the APDF was computed from the surface EMG obtained from the belly of the brachial biceps muscle. The APDF was also computed from the simultaneously recorded force signal. The APDF of the myoelectric signal and of the force signal were similar, indicating that the APDF of the myoelectric signal closely reflects the muscular load in non-fatiguing muscular contractions. The effect of the time constant in lowpass filtering when processing the surface EMG-signals was also studied. A suitable time constant appears to be in the range of 50-100 ms.     

静态负荷诱发肌肉疲劳后恢复期sEMG信号变化规律

目的:探讨肌肉疲劳过程中sEMG功率谱变化与H 的关系以及可能存在的其它影响因素.方法:利用肌肉进行疲劳收缩结束后,短时间内肌肉pH值尚无明显改变的特性,观察恢复期30 s内s EMG功率谱的变化规律.八名男性受试者,以肱二头肌为目标肌肉,负荷强度为60%MVC,静态持续负荷至疲劳点后,在恢复期以同样负荷分别观察2 s、4 s、6 s、8 s、10 s、20 s、30 s时的sEMG信号特征.结果:肱二头肌在以60%MVC静态疲劳负荷过程中MPF呈线性下降.在疲劳负荷后的恢复期,MPF恢复极其迅速,运动结束后仅2 s,MPF已恢复到整个下降范围的26.5%;至30 s,MPF已恢复到整个下降范围的87.7%.结论:由[H ]增加引起的肌纤维动作电位传导速度下降不是决定sEMG功率谱左移的唯一因素,提示sEMG功率谱左移可能与神经源性的中枢机制的作用有关.     

Muscular performance modeling of the upper limb in static postures

The purpose of the present paper is to describe and evaluate the polynomial models for predicting the muscular work capacity of the upper limb during sustained holding tasks. This research was concerned with the relationship between indicators of performance, i.e., specific posture or specific level of maximum voluntary contraction (MVC), and then modeling the functional data based on experimental results to estimate factors that may have an effect on task performance. To this end, we designed an experiment using 10 subjects in which each subject performed sustained isometric shoulder and elbow flexion endurance exercise under 27 conditions [3 shoulder angles (SA)x3 elbow angles (EA)x3 levels of %MVC]. Throughout all experiments, subjective perception of effort was assessed using the Borg scale, every 60, 30, and 10 s during the 20%, 40%, and 60% MVC tests, respectively. Proposal models were represented by three approaches: model A: estimation of endurance time (ET), with input variables such as SA, EA, and %MVC; model B: estimation of recommendation time (RT, the time during which the operator was able to maintain a position under the desired condition), with input variables such as SA, EA, %MVC, and required rate on the Borg scale; and model C: estimation of limit strength or %MVC, with input variables such as SA, EA, request limit time for work (LT), and required rate on the Borg scale. Statistical analysis indicated that the three proposal estimation models based on polynomial regression functions showed high significance (p<0.0001). The proposal models suggested and recommended the possibility of finding the best positions entailing the reduction and minimization of total muscular strain from manual material handling tasks in different work situations, with the consequent increase in work efficiency.     

Intramuscular pressure and EMG relate during static contractions but dissociate with movement and fatigue.

Intramuscular pressure (IMP) and electromyography (EMG) mirror muscle force in the nonfatigued muscle during static contractions. The present study explores whether the constant IMP-EMG relationship with increased force may be extended to dynamic contractions and to fatigued muscle. IMP and EMG were recorded from shoulder muscles in three sessions: 1). brief static arm abductions at angles from 0 to 90 degrees, with and without 1 kg in the hands; 2). dynamic arm abductions at angular velocities from 9 to 90 degrees /s, with and without 1 kg in the hands; and 3). prolonged static arm abduction at 30 degrees for 30 min followed by recovery. IMP and EMG increased in parallel with increasing shoulder torque during brief static tasks. During dynamic contractions, peak IMP and EMG increased to values higher than those during static contractions, and EMG, but not IMP, increased significantly with speed of abduction. In the nonfatigued supraspinatus muscle, a linear relationship was found between IMP and EMG; in contrast, during fatigue and recovery, significant timewise changes of the IMP-to-EMG ratio occurred. The results indicate that IMP should be included along with EMG when mechanical load sharing between muscles is evaluated during dynamic and fatiguing contractions.     

Cruciate ligament reflexes.

The idea of muscular reflexes elicited from sensory nerves of the cruciate ligaments is more than 100 years old, but the existence of such reflexes has not been proven until the recent two decades. First in animal experiments, a muscular excitation could be elicited in the hamstrings when the anterior cruciate ligament (ACL) was pulled, and tension in the ligament caused activity of the gamma motor neurones of the muscles around the knee. Impulses from the sensory nerves in ACL were activated during motion of the knee, in particular overstretching and combined extension and rotation. In humans, proprioception in the knee is decreased after ACL rupture. By mechanical or electrical stimulation of the ACL, an excitation in the hamstrings muscles can be elicited. During muscular activity, stimulation of the ACL or PCL results in a clear inhibition of the ongoing activity, both during static isometric and isokinetic muscle work, and also during dynamic activity (gait). This inhibitory reflex subjectively resembled giving way. The latency of the reflex was short in animals (about 3 ms) and long in humans (60-120 ms), probably caused by differences in the experimental setup and between species. The long latency in humans makes it unlikely that it is a directly protective reflex. Instead it may be involved in the updating of motor programs. Further research may characterize the reflex in details and map its pathways. The existence of this reflex indicate that the cruciate ligaments have an afferent function, which influences knee dynamics.