Evidence for a role of antagonistic cocontraction in controlling trunk stiffness during lifting

Activity of the abdominal muscles during symmetric lifting has been a consistent finding in many studies. It has been hypothesized that this antagonistic coactivation increases trunk stiffness to provide stability to the spine. To test this, we investigated whether abdominal activity in lifting is increased in response to destabilizing conditions.

Ten healthy male subjects lifted 35 l containers containing 15 l of water (unstable condition), or ice (stable condition). 3D-kinematics, ground reaction forces, and EMG of selected trunk muscles were recorded. Euler angles of the thorax relative to the pelvis were determined. Inverse dynamics was used to calculate moments about L5S1. Averaged normalized abdominal EMG activity was calculated to express coactivation and an EMG-driven trunk muscle model was used to estimate the flexor moment produced by these muscles and to estimate the L5S1 compression force.

Abdominal coactivation was significantly higher when lifting the unstable load. This coincided with significant increases in estimated moments produced by the antagonist muscles and in estimated compression forces on the L5S1 disc, except at the instant of the peak moment about L5S1. The lifting style was not affected by load instability as evidenced by the absence of effects on moments about L5S1 and angles of the thorax relative to the pelvis. The data support the interpretation of abdominal cocontraction during lifting as subserving spinal stability. An alternative function of the increased trunk stiffness due to cocontraction might be to achieve more precise control over the trajectory of lifted weight in order to avoid sloshing of the water mass in the box and the consequent perturbations.     

Low-back loading in lifting two loads beside the body compared to lifting one load in front of the body

Low-back load during manual lifting is considered an important risk factor for the occurrence of low-back pain. Splitting a load, so it can be lifted beside the body (one load in each hand), instead of in front of the body, can be expected to reduce low-back load. Twelve healthy young men lifted 10 and 20-kg wide and narrow loads in front of the body (the single-load lifts). These single-load lifts were compared to a lifting condition in which two 10-kg loads (a total of 20 kg) were lifted beside the body (the split-load lift). Lifts were performed from an initial hand height of 29 cm with four different lifting techniques (stoop, squat, straddle and kneeling techniques). Using measured kinematics, ground reaction forces, and electromyography, low-back loading (3D net moments and spinal forces at the L5/S1 joint) was estimated. Lifting a 20-kg split-load instead of a 20-kg single-load resulted in most cases in a reduction (8–32%) of peak L5/S1 compression forces. The magnitude of the reduction was roughly comparable to halving the load mass and depended on lifting technique and load width. The effects of load-splitting could largely be explained by changes in horizontal distance between the load and L5/S1.     

Estimation of low back moments from video analysis: a validation study

This study aimed to develop, compare and validate two versions of a video analysis method for assessment of low back moments during occupational lifting tasks since for epidemiological studies and ergonomic practice relatively cheap and easily applicable methods to assess low back loads are needed. Ten healthy subjects participated in a protocol comprising 12 lifting conditions. Low back moments were assessed using two variants of a video analysis method and a lab-based reference method. Repeated measures ANOVAs showed no overall differences in peak moments between the two versions of the video analysis method and the reference method. However, two conditions showed a minor overestimation of one of the video analysis method moments. Standard deviations were considerable suggesting that errors in the video analysis were random. Furthermore, there was a small underestimation of dynamic components and overestimation of the static components of the moments. Intraclass correlations coefficients for peak moments showed high correspondence (>0.85) of the video analyses with the reference method. It is concluded that, when a sufficient number of measurements can be taken, the video analysis method for assessment of low back loads during lifting tasks provides valid estimates of low back moments in ergonomic practice and epidemiological studies for lifts up to a moderate level of asymmetry.     

Lifting over an obstacle: effects of one-handed lifting and hand support on trunk kinematics and low back loading

Mechanical loading of the low back during lifting is a common cause of low back pain. In this study two-handed lifting is compared to one-handed lifting (with and without supporting the upper body with the free hand) while lifting over an obstacle. A 3-D linked segment model was combined with an EMG-assisted trunk muscle model to quantify kinematics and joint loads at the L5S1 joint. Peak total net moments (i.e., the net moment effect of all muscles and soft tissue spanning the joint) were found to be 10+/-3% lower in unsupported one-handed lifting compared to two-handed lifting, and 30+/-8% lower in supported compared to unsupported one-handed lifting. L5S1 joint forces also showed reductions, but not of the same magnitude (18+/-8% and 15+/-10%, respectively, for compression forces, and 15+/-17% and 11+/-14% respectively, for shear forces). Those reductions of low back load were mainly caused by a reduction of trunk and load moment arms relative to the L5S1 joint during peak loading, and, in the case of hand support, by a support force of about 250 N. Stretching one leg backward did not further reduce low back load estimates. Furthermore, one-handed lifting caused an 6+/-8 degrees increase in lateral flexion, a 9+/-5 degrees increase in twist and a 6+/-6 degrees decrease in flexion. Support with the free hand caused a small further increase in lumbar twisting. It is concluded that one-handed lifting, especially with hand support, reduces L5S1 loading but increases asymmetry in movements and moments about the lumbar spine.     

Torque-velocity relationship in isokinetic cycling exercise

Seven healthy female subjects performed brief (less than 10 s) periods of maximal exercise on a constant-velocity cycle ergometer, over the functional range of pedaling velocities, and an isometric contraction with each leg. There was an inverse relationship between peak torque and pedal crank velocity in all subjects; isometric torque was (mean +/- SE) 19.8 +/- 8.3% greater than the torque recorded at the slowest velocity of 11 rpm. The torque-velocity relationship was described best by a single exponential equation: y = 189.6 X e-0.0834x, where y is peak torque in Newton . meters and x is crank velocity in revolutions per minute. Peak power was a parabolic function of crank velocity; the data were fitted suitably by a second-order polynomial equation: y = -0.0589x2 + 14.504x + 47.092, where y is peak power in watts and x is crank velocity in revolutions per minute. Maximal peak power occurred at crank velocities ranging from 120 to 160 rpm, when the torque was 0.36 +/- 0.06 of the maximal isometric tension. These results demonstrate the importance of recording velocity in measurements of dynamic maximal power.     

Computation of trunk equilibrium and stability in free flexion-extension movements at different velocities

Velocity of movement has been suggested as a risk factor for low-back disorders. The effect of changes in velocity during unconstrained flexion-extension movements on muscle activations, spinal loads, base reaction forces and system stability was computed. In vivo measurements of kinematics and ground reaction forces were initially carried out on young asymptomatic subjects. The collected kinematics of three subjects representing maximum, mean and minimum lumbar rotations were subsequently used in the kinematics-driven model to compute results during the entire movements at three different velocities. Estimated spinal loads and muscle forces were significantly larger in fastest pace as compared to slower ones indicating the effect of inertial forces. Spinal stability was improved in larger trunk flexion angles and fastest movement. Partial or full flexion relaxation of global extensor muscles occurred only in slower movements. Some local lumbar muscles, especially in subjects with larger lumbar flexion and at slower paces, also demonstrated flexion relaxation. Results confirmed the crucial role of movement velocity on spinal biomechanics. Predictions also demonstrated the important role on response of the magnitude of peak lumbar rotation and its temporal variation.     

Characteristics and lateral dominance of hand grip and elbow flexion powers in young male adults

This study aimed to clarify the characteristics and the lateral dominance of hand grip power and elbow flexion power. The subjects were 15 healthy young males (mean age 22.1+/-0.7 yr, mean height 171.3+/-3.4 cm, mean mass 64.5+/-4.1 kg). All subjects were right-handed. Peak power was measured by both hands with 6 different loads of 20%-70% of maximum voluntary contraction. The maximum voluntary contraction of hand grip movement and elbow flexion movement was significantly larger in the dominant hand. Peak power of the dominant hand was larger in all loads in hand grip movement and in loads of 20% and 30% of maximum voluntary contraction in elbow flexion movement. In short, lateral dominance was confirmed. Peak power was significantly larger in hand grip movement than in elbow flexion movement in both hands. Peak velocity decreased with increasing loads in both movements, but peak power increased until about 50% of maximum voluntary contraction and then decreased. The peak power ratio of the dominant hand to the nondominant hand was significantly larger in hand grip movement than in elbow flexion movement in all loads and the peak power ratio in elbow flexion movement was more marked in light loads. In conclusion, both powers showed lateral dominance. Lateral dominance is more marked in hand grip power.     

Power produced by maximal velocity elbow flexion

An analysis of horizontal elbow flexion at maximal velocity was made to determine how different loads affected power output. Twenty male subjects operated a specially constructed dynamometer initially performing a maximal effort isometric trial with the elbow fully extended and then three dynamic trials at each of three loads equal to 75, 50, and 25 per cent of the maximal isometric strength. Angular acceleration was used to calculate forearm torque, and power was obtained by taking the product of torque and angular velocity. Power was found to be a cubic function of time and a fourth-order polynomial function of angular displacement reaching a peak early in the movement. The 50 per cent load resulted in a higher peak level of power than either the 25 or 75 per cent loads.     

The effect of control strategies for an active back-support exoskeleton on spine loading and kinematics during lifting

With mechanical loading as the main risk factor for LBP, exoskeletons (EXO) are designed to reduce the load on the back by taking over part of the moment normally generated by back muscles. The present study investigated the effect of an active exoskeleton, controlled using three different control modes (INCLINATION, EMG & HYBRID), on spinal compression forces during lifting with various techniques.Ten healthy male subjects lifted a 15 kg box, with three lifting techniques (free, squat & stoop), each of which was performed four times, once without EXO and once each with the three different control modes. Using inverse dynamics, we calculated L5/S1 joint moments. Subsequently, we estimated spine forces using an EMG-assisted trunk model.Peak compression forces substantially decreased by 17.8% when wearing the EXO compared to NO EXO. However, this reduction was partly, by about one third, attributable to a reduction of 25% in peak lifting speed when wearing the EXO. While subtle differences in back load patterns were seen between the three control modes, no differences in peak compression forces were found. In part, this may be related to limitations in the torque generating capacity of the EXO. Therefore, with the current limitations of the motors it was impossible to determine which of the control modes was best. Despite these limitations, the EXO still reduced both peak and cumulative compression forces by about 18%.     

Reproducibility of power production during sprint arm ergometry

Sprint tests are frequently used to evaluate between-subject differences and can provide a valuable insight into performance capacity. The present study determined the reproducibility of peak and mean power output during upper-body sprints. After familiarization 25 men (mean [+/- SD] age 29 [6] years, body mass 82.8 [12.7] kg and height 1.76 [0.05] m) completed 2 20-second upper-body sprint tests using an adapted cycle ergometer. Mean (+/- SD) values of all power (uncorrected and corrected) measurements achieved during the 2 tests were checked for systematic bias using separate paired t-tests. Test-retest reproducibility was examined using coefficients of variation and single-measure intraclass correlation coefficients, as well as an assessment of the typical (random) error and the 95% limits of agreement. The value of corrected peak power (628 [167] W) was higher (p < 0.05) compared with the uncorrected value (509 [109] W). Values of corrected (465 [95] W) and uncorrected (444 [87] W) mean power were similar (p > 0.05). The mean bias value for all power parameters equated to less than +/-1% of the absolute values of power measured. Intraclass correlation coefficients for all data sets ranged from 0.97 to 0.98. Coefficients of variation for uncorrected and corrected values of peak power were 2.8 and 4.5%, while corresponding values for mean power were 2.9 and 3.2%, respectively. The reproducibility of all power indices was below 5%. The results of this study indicate that both uncorrected and corrected measurements of peak power output and mean power output can be used to assess performance during sprint arm ergometry.     

Statistical power and measurement allocation in ergonomic intervention studies assessing upper trapezius EMG amplitude. A case study of assembly work.

The present study aimed at exploring the statistical power of ergonomic intervention studies using electromyography (EMG) from the upper trapezius muscle. Data from a previous study of cyclic assembly work were reanalyzed with respect to exposure variability between subjects, between days, and within days. On basis of this information, the precision and power of different data collection strategies were explored. A sampling strategy comprising four registrations of about two min each (i.e. two work cycles) for one day per subject resulted in coefficients of variation between subjects on the 10-, 50-, and 90-APDF-percentiles of 0.44, 0.31, and 0.29, respectively. The corresponding necessary numbers of subjects in a study aiming at detecting a 20% exposure difference between two independent groups of equal size were 154, 78, and 68, respectively (p< or = 0.05, power 0.80). Multiple measurement days per subject would improve power, but only to a marginal extent beyond 4 days of recording. Increasing the number of recordings per day would have minor effects. Bootstrap resampling of the data set revealed that estimates of variability and power were associated with considerable uncertainty. The present results in combination with an overview of other occupational studies showed that common-size investigations using trapezius EMG percentiles are at great risk of suffering from insufficient statistical power, even if the expected intervention effect is substantial. The paper suggests a procedure of how to retrieve and use exposure variability information as an aid when studies are planned, and how to allocate measurements efficiently.     

Anthropometry as a predictor of bench press performance done at different loads

The purpose of our study was to examine the ability of anthropometric variables (body mass, total arm length, biacromial width) to predict bench press performance at both maximal and submaximal loads. Our methods required 36 men to visit our laboratory and submit to anthropometric measurements, followed by lifting as much weight as possible in good form one time (1 repetition maximum, 1RM) in the exercise. They made 3 more visits in which they performed 4 sets of bench presses to volitional failure at 1 of 3 (40, 55, or 75% 1RM) submaximal loads. An accelerometer (Myotest Inc., Royal Oak MI) measured peak force, velocity, and power after each submaximal load set. With stepwise multivariate regression, our 3 anthropometric variables attempted to explain significant amounts of variance for 13 bench press performance indices. For criterion measures that reached significance, separate Pearson product moment correlation coefficients further assessed if the strength of association each anthropometric variable had with the criterion was also significant. Our analyses showed that anthropometry explained significant amounts (p < 0.05) of variance for 8 criterion measures. It was concluded that body mass had strong univariate correlations with 1RM and force-related measures, total arm length was moderately associated with 1RM and criterion variables at the lightest load, whereas biacromial width had an inverse relationship with the peak number of repetitions performed per set at the 2 lighter loads. Practical applications suggest results may help coaches and practitioners identify anthropometric features that may best predict various measures of bench press prowess in athletes.     

Mathematical and empirical proof of principle for an on-body personal lift augmentation device (PLAD)

In our laboratory, we have developed a prototype of a personal lift augmentation device (PLAD) that can be worn by workers during manual handling tasks involving lifting or lowering or static holding in symmetric and asymmetric postures. Our concept was to develop a human-speed on-body assistive device that would reduce the required lumbar moment by 20-30% without negative consequences on other joints or lifting kinematics. This paper provides mathematical proof using simplified free body diagrams and two-dimensional moment balance equations. Empirical proof is also provided based on lifting trials with nine male subjects who executed sagittal plane lifts using three lifting styles (stoop, squat, free) and three different loads (5, 15, and 25kg) under two conditions (PLAD, No-PLAD). Nine Fastrak sensors and six in-line strap force sensors were used to estimate the reduction of compressive and shear forces on L4/L5 as well as estimate the forces transferred to the shoulders and knees. Depending on lifting technique, the PLAD applied an added 23-36Nm of torque to assist the back muscles during lifting tasks. The peak pelvic girdle contact forces were estimated and their magnitudes ranged from 221.3+/-11.2N for stoop lifting, 324.3+/-17.2N for freestyle lifts to 468.47+/-23.2N for squat lifting. The PLAD was able to reduce the compression and shear forces about 23-29% and 7.9-8.5%, respectively.     

Force-velocity properties of two avian hindlimb muscles

Recent work has provided measurements of power output in avian skeletal muscles during running and flying, but little is known about the contractile properties of avian skeletal muscle. We used an in situ preparation to characterize the force-velocity properties of two hind limb muscles, the lateral gastrocnemius (LG) and peroneus longus (PL), in Wild Turkeys (Meleagris gallopavo). A servomotor measured shortening velocity for at least six different loads over the plateau region of the length-tension curve. The Hill equation was fit to the data to determine maximum shortening velocity and peak instantaneous power. Maximum unloaded shortening velocity was 13.0+/-1.6 L s(-1) for the LG muscle and 14.8+/-1.0 L s(-1) for the PL muscle (mean+/-S.E.M.). These velocities are within the range of values published for reptilian and mammalian muscles. Values recorded for maximum isometric force per cross-sectional area, 271+/-28 kPa for the LG and 257+/-30.5 kPa for the PL, and peak instantaneous power output, 341.7+/-36.4 W kg(-1) for the LG and 319.4+/-42.5 W kg(-1) for the PL, were also within the range of published values for vertebrate muscle. The force-velocity properties of turkey LG and PL muscle do not reveal any extreme differences in the mechanical potential between avian and other vertebrate muscle.     

Validation of a personalized curved muscle model of the lumbar spine during complex dynamic exertions

Previous curved muscle models have typically examined their robustness only under simple, single-plane static exertions. In addition, the empirical validation of curved muscle models through an entire lumbar spine has not been fully realized. The objective of this study was to empirically validate a personalized biologically-assisted curved muscle model during complex dynamic exertions. Twelve subjects performed a variety of complex lifting tasks as a function of load weight, load origin, and load height. Both a personalized curved muscle model as well as a straight-line muscle model were used to evaluate the model’s fidelity and prediction of three-dimensional spine tissue loads under different lifting conditions. The curved muscle model showed better model performance and different spinal loading patterns through an entire lumbar spine compared to the straight-line muscle model. The curved muscle model generally showed good fidelity regardless of lifting condition. The majority of the 600 lifting tasks resulted in a coefficient of determination (R²) greater than 0.8 with an average of 0.83, and the average absolute error less than 15% between measured and predicted dynamic spinal moments. As expected, increased load and asymmetry were generally found to significantly increase spinal loads, demonstrating the ability of the model to differentiate between experimental conditions. A curved muscle model would be useful to estimate precise spine tissue loads under realistic circumstances. This precise assessment tool could aid in understanding biomechanical causal pathways for low back pain.     

Aging, regularity and variability in maximum isometric moments

This study examined the variability and regularity of maximum isometric moment production of the plantar flexors in young and old subjects. It was hypothesized that in the development of maximum isometric moments there would be greater regularity in the moment profiles for older subjects compared with young subjects, due to the reduced number of motor units present in elderly muscle. Two groups of subjects produced three maximal isometric plantar flexions (young: n=11, mean age 23.8+/-2.8 years, mean mass 81.2+/-10.4 kg, mean height 1.78+/-0.05 m; elderly: n=13, mean age 74.0+/-3.3 years, mean mass 78.5+/-3.4 kg, mean height 1.73+/-0.05 m). The plateau of the moment-time curve was analyzed for each trial. A repeat measures analysis of variance showed the young subjects produced statistically greater peak plantar flexion moments than the elderly subjects, but similar coefficients of variation. Signal regularity was determined by computing the signal's approximate entropy, which demonstrated that the older group had greater regularity in their generation of moment profiles. The hypothesis was accepted, with a potential explanation for this increased regularity in old age being the reduced number of motor units to coordinate.     

Predicting anaerobic capabilities in 11-13-year-old boys

Anaerobic exercise is involved in many recreational and competitive sport activities. This study first established regression equations to predict maximal anaerobic power and then cross-validated these prediction equations. Using stepwise multiple regression analysis prediction equations for relative (watts per kilogram of body mass) and absolute (watts) mean and peak anaerobic power using the 30-second Wingate Test as the power measure were determined for 40 boys (age, 11-13 years). Percentage of body fat, free-fat weight, midthigh circumference, and 30-m dash were the independent predictive variables with the generated regression equations subsequently cross-validated using 20 different boys (age, 11-13 years). Significant correlations (Pearson r) were found for the cross-validation subjects between the measured power outputs and predicted power outputs for relative mean power (r = 0.48, p < 0.05), absolute mean power (r = 0.77, p < 0.01), and absolute peak power (r = 0.76, p < 0.01). Using paired t-tests, no significant mean differences (p > 0.05) were found for the same subjects between actual and predicted power outputs for relative mean power, absolute mean power, and absolute peak power. Prediction of maximal anaerobic power from selected anthropometric measurements and 30-m dash appears tenable in 11-13-year-old boys and can be accomplished in a simple cost- and time-effective manner.     

Validation of an optical encoder during free weight resistance movements and analysis of bench press sticking point power during fatigue

During the concentric movement of the bench press, there is an initial high-power push after chest contact, immediately followed by a characteristic area of low power, the so-called "sticking region." During high-intensity lifting, a decline in power can result in a failed lift attempt. The purpose of this study was to determine the validity of an optical encoder to measure power and then employ this device to determine power changes during the initial acceleration and sticking region during fatiguing repeated bench press training. Twelve subjects performed a free weight bench press, a Smith Machine back squat, and a Smith Machine 40-kg bench press throw for power validation measures. All barbell movements were simultaneously monitored using cinematography and an optical encoder. Eccentric and concentric mean and peak power were calculated using time and position data derived from each method. Validity of power measures between the video (criterion) and optical encoder scores were evaluated by standard error of the estimate (SEE) and coefficient of variation (CV). Seven subjects then performed 4 sets of 6 free weight bench press repetitions progressively increasing from 85 to 95% of their 6 repetition maximum, with each repetition continually monitored by an optical encoder. The SEE for power ranged from 3.6 to 14.4 W (CV, 1.0-3.0%; correlation, 0.97-1.00). During the free weight bench press training, peak power declined by approximately 55% (p < 0.01) during the initial acceleration phase of the final 2 repetitions of the final set. Although decreases in power of the sticking point were significant (p < 0.01), as early as repetition 5 (-40%) they reached critically low levels in the final 2 repetitions (>-95%). In conclusion, the optical encoder provided valid measures of kinetics during free weight resistance training movements. The decline in power during the initial acceleration phase appears a factor in a failed lift attempt at the sticking point.     

Spinal stability and role of passive stiffness in dynamic squat and stoop lifts

The spinal stability and passive-active load partitioning under dynamic squat and stoop lifts were investigated as the ligamentous stiffness in flexion was altered. Measured in vivo kinematics of subjects lifting 180 N at either squat or stoop technique was prescribed in a nonlinear transient finite element model of the spine. The Kinematics-driven approach was utilized for temporal estimation of muscle forces, internal spinal loads and system stability. The finite element model accounted for nonlinear properties of the ligamentous spine, wrapping of thoracic extensor muscles and trunk dynamic characteristics while subject to measured kinematics and gravity/external loads. Alterations in passive properties of spine substantially influenced muscle forces, spinal loads and system stability in both lifting techniques, though more so in stoop than in squat. The squat technique is advocated for resulting in smaller spinal loads. Stability of spine in the sagittal plane substantially improved with greater passive properties, trunk flexion and load. Simulation of global extensor muscles with curved rather than straight courses considerably diminished loads on spine and increased stability throughout the task.     

Results of an international round robin for the quantification of serum non-transferrin-bound iron: Need for defining standardization and a clinically relevant isoform

Non-transferrin-bound iron (NTBI) appears in the circulation of patients with iron overload. Various methods to measure NTBI were comparatively assessed as part of an international interlaboratory study. Six laboratories participated in the study, using methods based on iron mobilization and detection with iron chelators or on reactivity with bleomycin. Serum samples of 12 patients with hereditary (n=11) and secondary (n=1) hemochromatosis were measured during a 3-day analysis using 4 determinations per sample per day, making a total of 144 measurements per laboratory. Bland-Altman plots for repeated measurements are presented. The methods differed widely in mean serum NTBI level (range 0.12-4.32mumol/L), between-sample variation (SD range 0.20-2.13mumol/L and CV range 49.3-391.3%), and within-sample variation (SD range 0.02-0.45mumol/L and CV range 4.4-193.2%). The results obtained with methods based on chelators correlated significantly (R(2) range 0.86-0.99). On the other hand, NTBI values obtained by the various methods related differently from those of serum transferrin saturation (TS) when expressed in terms of both regression coefficients and NTBI levels at TS of 50%. Recent studies underscore the clinical relevance of NTBI in the management of iron-overloaded patients. However, before measurement of NTBI can be introduced into clinical practice, there is a need for more reproducible protocols as well as information on which method best represents the pathophysiological phenomenon and is most pertinent for diagnostic and therapeutic purposes.