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Kia K, Hwang J, Kim JH. The effects of target sizes on biomechanical and cognitive load and task performance of virtual reality interactions. ERGONOMICS 2024:1-15. [PMID: 39193884 DOI: 10.1080/00140139.2024.2396038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 08/19/2024] [Indexed: 08/29/2024]
Abstract
This study evaluated the effects of target sizes on biomechanical and cognitive load and the performance of virtual reality (VR) interactions. In a repeated-measures laboratory study, each of the twenty participants performed standardised VR tasks with three different target sizes: small, medium, and large. During the VR tasks, biomechanical load in the neck and shoulders (joint angles, joint moments, and muscle activity), cognitive load (perceived workload and cognitive stress), and task performance (completion time) were collected. The neck and shoulder joint angles, joint moments, and muscle activities were greater with the large targets compared to the medium and small targets. Moreover, the larger VR targets caused greater temporal demand and longer task completion time compared to the other target sizes. These findings indicate that target sizes in VR interfaces play important roles in biomechanical and cognitive load as well as task performance.
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Affiliation(s)
- Kiana Kia
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR
| | - Jaejin Hwang
- Department of Industrial and Systems Engineering, College of Engineering and Engineering Technology, Northern Illinois University, DeKalb, IL
| | - Jeong Ho Kim
- Department of Environmental and Occupational Health, School of Public Health Texas A&M University, College Station, TX
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Ager AL, Cools AM, Borms D, Roy JS. How does a motor or cognitive dual-task affect our sense of upper limb proprioception? PLoS One 2024; 19:e0299856. [PMID: 38507455 PMCID: PMC10954121 DOI: 10.1371/journal.pone.0299856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 02/15/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Daily upper limb activities require multitasking and our division of attention. How we allocate our attention can be studied using dual-task interference (DTi). Given the vital role proprioception plays in movement planning and motor control, it is important to investigate how conscious upper limb proprioception is impacted by DTi through cognitive and motor interference. PURPOSE To examine how dual-task interference impacts conscious upper limb proprioception during active joint repositioning tasks (AJRT). METHODS Forty-two healthy participants, aged between 18 and 35, took part in this cross-sectional study. Participants completed two AJRT during three conditions: baseline (single task), dual-cognitive task (serial subtractions), and dual-motor task (non-dominant hand movements). The proprioceptive error (PE; difference between their estimation and targeted position) was measured using an AJRT of 75% and 90% of maximum internal rotation using the Biodex System IIITM and the Upper Limb Proprioception Reaching Test (PRO-Reach). To determine if PEs differed during dual-task interference, interference change scores from baseline were used with one sample t-tests and analyses of variance. RESULTS The overall mean PE with the Biodex was 4.1° ± 1.9 at baseline. Mean change scores from baseline reflect a mean improvement of 1.5° ± 1.0 (p < .001) during dual-cognitive task and of 1.5° ± 1.2 (p < .001) during dual-motor task. The overall mean PE with the PRO-Reach was 4.4cm ± 1.1 at baseline. Mean change scores from baseline reflect a mean worsening of 1.0cm ± 1.1 (p < .001) during dual-cognitive task and improvement of 0.8cm ± 0.6 (p < .001) during dual-motor task. Analysis of variance with the Biodex PEs revealed an interference effect (p < .001), with the cognitive condition causing greater PEs compared to the motor condition and a criterion position effect (p = .006), where 75% of maximum IR produced larger PEs during both interference conditions. An interference effect (p = .022) with the PRO-Reach PEs was found highlighting a difference between the cognitive and motor conditions, with decreased PEs during the contralateral motor task. CONCLUSION Interference tasks did impact proprioception. Cognitive interference produced mixed results, whereas improved proprioception was seen during motor interference. Individual task prioritization strategies are possible, where each person may choose their own attention strategy when faced with dual-task interference.
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Affiliation(s)
- Amanda L. Ager
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Ann M. Cools
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Dorien Borms
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- Department of Human Structure and Repair, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Jean-Sébastien Roy
- Center for Interdisciplinary Research in Rehabilitation and Social Integration (CIRRIS), Quebec City, Quebec, Canada
- School of Rehabilitation Sciences, Faculty of Medicine, Université Laval, Quebec City, Quebec, Canada
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Zhou C, Xu X, Huang T, Kaner J. Effect of different postures and loads on joint motion and muscle activity in older adults during overhead retrieval. Front Physiol 2024; 14:1303577. [PMID: 38304288 PMCID: PMC10830688 DOI: 10.3389/fphys.2023.1303577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 12/14/2023] [Indexed: 02/03/2024] Open
Abstract
Introduction: Pain is a common health problem among older adults worldwide. Older adults tend to suffer from arm, lumbar, and back pain when using hanging cabinets. Methods: This study used surface electromyography to record muscle activity and a motion capture system to record joint motion to research effects of different loads and retrieval postures on muscle activity and joint range of motion when older adults retrieve objects from a high place, to provide optimised feedback for the design of hanging cabinet furniture. Results: We found that: 1) The activity of BB (Biceps brachii) on the side of the body interacting with the cabinet door was greater than that of UT (Upper trapezius) and BR (Brachial radius) when retrieving objects from a high place, the activity of UT on the side of the body interacting with a heavy object was greater than that of BB and BR. 2) The activity of UT decreases when the shoulder joint angle is greater than 90°, but the activity of BB increases as the angle increases. In contrast, increasing the object's mass causes the maximum load on the shoulder joint. 3) Among the different postures for overhead retrieval, alternating between the right and left hand is preferable for the overhead retrieval task. 4) Age had the most significant effect on overhead retrieval, followed by height (of person), and load changes were significantly different only at the experiment's left elbow joint and the L.BR. 5) Older adults took longer and exerted more effort to complete the task than younger adults, and static exercise in older adults may be more demanding on muscle activity in old age than powered exercise. Conclusion: These results help to optimise the design of hanging cabinet furniture. Regarding the height of hanging cabinets, 180 cm or less is required for regular retrieval movements if the human height is less than 150 cm. Concerning the depth of the hanging cabinets, different heights chose different comfort distances, which translated into the depth of the hanging cabinets; the greater the height, the greater the depth of the hanging cabinets to use.
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Affiliation(s)
- Chengmin Zhou
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing, Jiangsu, China
- Jiangsu Co-Innovation Center of Efficient Processing and Utilization of Forest Resources, Nanjing, China
| | - Xue Xu
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing, Jiangsu, China
| | - Ting Huang
- College of Furnishings and Industrial Design, Nanjing Forestry University, Nanjing, Jiangsu, China
| | - Jake Kaner
- School of Art and Design, Nottingham Trent University, Nottingham, United Kingdom
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Kia K, Hwang J, Kim JH. Effects of error rates and target sizes on neck and shoulder biomechanical loads during augmented reality interactions. APPLIED ERGONOMICS 2023; 113:104107. [PMID: 37523813 DOI: 10.1016/j.apergo.2023.104107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 07/07/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023]
Abstract
Augmented reality (AR) interactions have been associated with increased biomechanical loads on the neck and shoulders. To provide a better understanding of the factors that may impact such biomechanical loads, this repeated-measures laboratory study evaluated the effects of error rates and target sizes on neck and shoulder biomechanical loads during two standardized AR tasks (omni-directional pointing and cube placing). Twenty participants performed the two AR tasks with different error rates and target sizes. During the tasks, angles, moments, and muscle activity in the neck and shoulders were measured. The results showed that the target sizes and error rates significantly affected angles, moments, and muscle activity in the neck and shoulder regions. Specifically, the presence of errors increased neck extension, shoulder flexion angles and associated moments. Muscle activity in the neck (splenius capitis) and shoulder (anterior and medial deltoids) also increased when the errors were introduced. Moreover, interacting with larger targets resulted in greater neck extension moments and shoulder abduction angles along with higher muscle activity in the splenius capitis and upper trapezius muscles. These findings indicate the importance of reducing errors and incorporating appropriate target sizes in the AR interfaces to minimize risks of musculoskeletal discomfort and injuries in the neck and shoulders.
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Affiliation(s)
- Kiana Kia
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Jaejin Hwang
- Department of Industrial and Systems Engineering, College of Engineering and Engineering Technology, Northern Illinois University, DeKalb, IL, USA
| | - Jeong Ho Kim
- School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
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Mixter S, Mathiassen SE, Jahncke H, Hygge S, Lyskov E, Hallman DM, Lewis C. Effects of Combining Occupationally Relevant Physical and Cognitive Tasks. A Systematic Review. Ann Work Expo Health 2023; 67:303-319. [PMID: 36469430 PMCID: PMC10015802 DOI: 10.1093/annweh/wxac082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 10/24/2022] [Accepted: 11/03/2022] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVES Physical and cognitive tasks occur together in many occupations. Previous reviews of combined tasks have mainly focused on their effects in a sports context. This review investigated to which extent combinations (concurrent or alternating) of occupationally relevant physical and cognitive tasks influence responses reflecting biomechanical exposure, stress, fatigue, performance, and well-being. METHODS We searched Scopus, Pubmed, Cinahl, and Psychinfo for controlled experiments investigating the effects of combinations of occupationally relevant physical and cognitive tasks in participants aged 18 to 70. In total, we identified 12 447 records. We added recent papers that had cited these studies (n = 573) to arrive at a total of 13 020 publications. After screening for relevance, 61 studies remained, of which 57 were classified to be of medium or high quality. Of the 57 studies, 51 addressed concurrent tasks, 5 alternating tasks, and 1 both concurrent and alternating tasks. RESULTS Most studies of concurrent physical and cognitive tasks reported negative effects, if numerically small, on indicators of biomechanical exposure, fatigue, and performance, compared to a physical task alone. Results were mixed for stress indicators, and well-being was too little studied to justify any conclusions. Effects depended on the tasks, including their intensity and complexity. Alternating physical and cognitive tasks did not appear to influence outcomes much, compared to having passive breaks in-between physical tasks. CONCLUSIONS The reviewed evidence indicated that concurrent physical and cognitive work tasks have negative, yet small effects on biomechanical indicators, fatigue and performance, compared to performing the physical task alone, but only if the physical task is intense, and the cognitive task is complex. Alternating between physical and cognitive tasks may have similar effects as breaking up physical tasks by passive breaks, but studies were few. Future studies should address ecologically valid combinations of physical and cognitive tasks, in particular in controlled field studies devoted to the long-term effects of combined work.
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Affiliation(s)
- Susanna Mixter
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden
| | - Helena Jahncke
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden
| | - Staffan Hygge
- Department of Building, Energy, and Environmental Engineering, University of Gävle, 801 76 Gävle, Sweden
| | - Eugene Lyskov
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden
| | - David M Hallman
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden
| | - Charlotte Lewis
- Department of Public Health and Clinical Medicine, Umeå University, 901 85 Umeå, Sweden
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Mannella K, Forman GN, Mugnosso M, Zenzeri J, Holmes MWR. The effects of isometric hand grip force on wrist kinematics and forearm muscle activity during radial and ulnar wrist joint perturbations. PeerJ 2022; 10:e13495. [PMID: 35646483 PMCID: PMC9138088 DOI: 10.7717/peerj.13495] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 05/04/2022] [Indexed: 01/17/2023] Open
Abstract
The purpose of this work was to investigate forearm muscle activity and wrist angular displacement during radial and ulnar wrist perturbations across various isometric hand grip demands. Surface electromyography (EMG) was recorded from eight muscles of the upper extremity. A robotic device delivered perturbations to the hand in the radial and ulnar directions across four pre-perturbation grip magnitudes. Angular displacement and time to peak displacement following perturbations were evaluated. Muscle activity was evaluated pre- and post-perturbation. Results showed an inverse relationship between grip force and angular displacement (p ≤ 0.001). Time to peak displacement decreased as grip force increased (p ≤ 0.001). There was an increase in muscle activity with higher grip forces across all muscles both pre-and post-perturbation (p ≤ 0.001) and a greater average muscle activity in ulnar as compared to radial deviation (p = 0.02). This work contributes to the wrist joint stiffness literature by relating wrist angular displacement to grip demands during novel radial/ulnar perturbations and provides insight into neuromuscular control strategies.
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Affiliation(s)
- Kailynn Mannella
- Department of Kinesiology, Brock University, St. Catharines, Canada
| | | | - Maddalena Mugnosso
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
| | - Jacopo Zenzeri
- Robotics, Brain and Cognitive Sciences, Istituto Italiano di Tecnologia, Genoa, Italy
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Kia K, Hwang J, Kim IS, Ishak H, Kim JH. The effects of target size and error rate on the cognitive demand and stress during augmented reality interactions. APPLIED ERGONOMICS 2021; 97:103502. [PMID: 34167014 DOI: 10.1016/j.apergo.2021.103502] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 04/20/2021] [Accepted: 06/09/2021] [Indexed: 06/13/2023]
Abstract
This study investigated the effects of target size and error rate on cognitive demand during augmented reality (AR) interactions. In a repeated-measures laboratory study, twenty participants performed two AR tasks (omni-directional pointing and cube placing) with different target sizes and error rates. During the AR tasks, we measured cerebral oxygenation using functional near-infrared spectroscopy (fNIRS), perceived workload using the NASA-TLX questionnaire, stress using the Short Stress State Questionnaire, and task performance (task completion time). The results showed that the AR tasks with more interaction errors increased cerebral oxygenation, perceived workload, and task completion time while the target size significantly affected physical demand and task completion time. These results suggest that appropriate target sizes and low system errors may reduce potential cognitive demand in AR interactions.
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Affiliation(s)
- Kiana Kia
- School of Mechanical, Industrial, Manufacturing Engineering, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Jaejin Hwang
- Department of Industrial and Systems Engineering, College of Engineering and Engineering Technology, Northern Illinois University, DeKalb, IL, USA
| | - In-Sop Kim
- School of Allied Health and Communicative Disorders, College of Health and Human Sciences, Northern Illinois University, DeKalb, IL, USA
| | - Hakim Ishak
- School of Mechanical, Industrial, Manufacturing Engineering, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Jeong Ho Kim
- School of Mechanical, Industrial, Manufacturing Engineering, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA; School of Biological and Population Health Sciences, College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA.
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Stets A, Smith SL, Helton WS. Dual-Task Interference Between Swimming and Verbal Memory. HUMAN FACTORS 2020; 62:1132-1140. [PMID: 31513440 DOI: 10.1177/0018720819871743] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE A dual-task study was performed to explore the performance effects for swimming, word recall, and the combination of the two tasks performed simultaneously. BACKGROUND Dual-task interference studies have been performed for a variety of tasks; however, there has not been much dual-task interference research where one of the tasks is a naturalistic physically strenuous task. Swimming is a unique physical task that requires spatial orientation on three dimensional axes, similar to that of flying, but has no risk of falling. Previous studies have been conducted in other activity combinations with word-free recall, such as running and climbing, but swimming has yet to be explored. METHOD A verbal memory recall task and swimming task were performed in isolated (single-task) and simultaneous conditions. A comparison of effects across these different activities was also explored. RESULTS Swimming and the word-recall task resulted in significant dual-task interference: almost as much as when word recall was paired with another verbal task, but more than running and less than climbing. CONCLUSION Consistent with other dual-task studies, this study observed dual-task interference between the physical swimming task and the cognitive verbal memory task. APPLICATION Future technologies and training for personnel who engage in water rescue or commercial diving, such as underwater welding and fiber optic cable, may be improved by these findings.
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Abstract
Current psychological theories of performance anxiety focus heavily on relating performers' physiological and mental states to their abilities to maintain focus and execute learned skills. How task-specific expertise and past experiences moderate the degree to which individuals become anxious in a given performance context are not well accounted for within these theories. This review considers how individual differences arising from learning may shape the psychobiological, emotional, and cognitive processes that modulate anxious states associated with the performance of highly trained skills. Current approaches to understanding performance anxiety are presented, followed by a critique of these approaches. A connectionist model is proposed as an alternative approach to characterising performance anxiety by viewing performers' anxious states at a specific time point as jointly determined by experience-dependent plasticity, competition between motivational systems, and ongoing cognitive and somatic states. Clarifying how experience-dependent plasticity contributes to the emergence of socio-evaluative anxiety in challenging situations can not only help performers avoid developing maladaptive emotional responses, but may also provide new clues about how memories of past events and imagined future states interact with motivational processes to drive changes in emotional states and cognitive processing.
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Affiliation(s)
- Karen Chow
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Eduardo Mercado
- Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY, USA
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Choi J, Yeoh WL, Loh PY, Muraki S. Force and electromyography responses during isometric force release of different rates and step-down magnitudes. Hum Mov Sci 2019; 67:102516. [PMID: 31539754 DOI: 10.1016/j.humov.2019.102516] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 08/27/2019] [Accepted: 09/04/2019] [Indexed: 11/26/2022]
Abstract
This study investigated motor responses of force release during isometric elbow flexion by comparing effects of different ramp durations and step-down magnitudes. Twelve right-handed participants (age: 23.1 ± 1.1) performed trajectory tracking tasks. Participants were instructed to release their force from the reference magnitude (REF; 40% of maximal voluntary contraction force) to a step-down magnitude of 67% REF or 33% REF and maintain the released magnitude. Force release was guided by ramp durations of either 1 s or 5 s. Electromyography of the biceps brachii and triceps brachii was performed during the experimental task, and the co-contraction ratio was evaluated. Force output was recorded to evaluate the parameters of motor performance, such as force variability and overshoot ratio. Although a longer ramp duration of 5 s decreased the force variability and overshoot ratio than did shorter ramp duration of 1 s, higher perceived exertion and co-contraction ratio were followed. Force variability was greater when force was released to the step-down magnitude of 33% REF than that when the magnitude was 67% REF, however, the overshoot ratio showed opposite results. This study provided evidence proving that motor control strategies adopted for force release were affected by both duration and step-down magnitude. In particular, it implies that different control strategies are required according to the level of step-down magnitude with a relatively short ramp duration.
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Affiliation(s)
- Jeewon Choi
- Department of Human Science, Graduate School of Design, Kyushu University, 4-9-1 Shiobaru, Minami-ku, Fukuoka 815-8540, Japan.
| | - Wen Liang Yeoh
- Department of Human Science, Graduate School of Design, Kyushu University, 4-9-1 Shiobaru, Minami-ku, Fukuoka 815-8540, Japan
| | - Ping Yeap Loh
- Department of Human Science, Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minami-ku, Fukuoka 815-8540, Japan
| | - Satoshi Muraki
- Department of Human Science, Faculty of Design, Kyushu University, 4-9-1 Shiobaru, Minami-ku, Fukuoka 815-8540, Japan
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Guillery E, Mouraux A, Thonnard JL, Legrain V. Mind Your Grip: Even Usual Dexterous Manipulation Requires High Level Cognition. Front Behav Neurosci 2017; 11:220. [PMID: 29163091 PMCID: PMC5672141 DOI: 10.3389/fnbeh.2017.00220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 10/23/2017] [Indexed: 11/13/2022] Open
Abstract
Simultaneous execution of cognitive and sensorimotor tasks is critical in daily life. Here, we examined whether dexterous manipulation, a highly habitual and seemingly automatic behavior, involves high order cognitive functions. Specifically, we explored the impact of reducing available cognitive resources on the performance of a precision grip-lift task in healthy participants of three age groups (18-30, 30-60 and 60-75 years). Participants performed a motor task in isolation (M), in combination with a low-load cognitive task (M + L), and in combination with a high-load cognitive task (M + H). The motor task consisted in grasping, lifting and holding an apparatus instrumented with force sensors to monitor motor task performance. In the cognitive task, a list of letters was shown briefly before the motor task. After completing the motor task, one letter of the list was shown, and participants reported the following letter of the list. In M + L, letters in the list followed the alphabetical order. In M + H, letters were presented in random order. Performing the high-load task thus required maintaining information in working memory. Temporal and dynamic parameters of grip and lift forces were compared across conditions. During the cognitive tasks, there was a significant alteration of movement initiation and a significant increase of grip force (GF) throughout the grip-lift task. There was no interaction with "age". Our results demonstrate that planning and the on-line control of dexterous manipulation is not an automatic behavior and, instead, that it interacts with high-level cognitive processes such as those involved in working memory.
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Affiliation(s)
- Erwan Guillery
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - André Mouraux
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - Jean-Louis Thonnard
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.,Department of Physical and Rehabilitation-Medicine, Saint-Luc University Hospital, Université catholique de Louvain, Brussels, Belgium
| | - Valéry Legrain
- Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium.,Psychological Sciences Research Institute, Université catholique de Louvain, Louvain-la-Neuve, Belgium
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Zadry HR, Dawal SZM, Taha Z. Development of statistical models for predicting muscle and mental activities during repetitive precision tasks. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2016; 22:374-83. [PMID: 27053140 DOI: 10.1080/10803548.2016.1150094] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study was conducted to develop muscle and mental activities on repetitive precision tasks. A laboratory experiment was used to address the objectives. Surface electromyography was used to measure muscle activities from eight upper limb muscles, while electroencephalography recorded mental activities from six channels. Fourteen university students participated in the study. The results show that muscle and mental activities increase for all tasks, indicating the occurrence of muscle and mental fatigue. A linear relationship between muscle activity, mental activity and time was found while subjects were performing the task. Thus, models were developed using those variables. The models were found valid after validation using other students' and workers' data. Findings from this study can contribute as a reference for future studies investigating muscle and mental activity and can be applied in industry as guidelines to manage muscle and mental fatigue, especially to manage job schedules and rotation.
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Ngo BP, Wells RP. Evaluating protocols for normalizing forearm electromyograms during power grip. J Electromyogr Kinesiol 2016; 26:66-72. [DOI: 10.1016/j.jelekin.2015.10.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 08/01/2015] [Accepted: 10/27/2015] [Indexed: 02/06/2023] Open
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Srinivasan D, Mathiassen SE, Hallman DM, Samani A, Madeleine P, Lyskov E. Effects of concurrent physical and cognitive demands on muscle activity and heart rate variability in a repetitive upper-extremity precision task. Eur J Appl Physiol 2015; 116:227-39. [DOI: 10.1007/s00421-015-3268-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2015] [Accepted: 09/15/2015] [Indexed: 11/30/2022]
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Fewster K, Potvin J. Maximum forces and joint stability implications during in-line arm pushes. THEORETICAL ISSUES IN ERGONOMICS SCIENCE 2014. [DOI: 10.1080/1463922x.2014.984012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Mathiassen SE, Hallman DM, Lyskov E, Hygge S. Can cognitive activities during breaks in repetitive manual work accelerate recovery from fatigue? A controlled experiment. PLoS One 2014; 9:e112090. [PMID: 25375644 PMCID: PMC4222971 DOI: 10.1371/journal.pone.0112090] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2014] [Accepted: 10/13/2014] [Indexed: 11/18/2022] Open
Abstract
Neurophysiologic theory and some empirical evidence suggest that fatigue caused by physical work may be more effectively recovered during “diverting” periods of cognitive activity than during passive rest; a phenomenon of great interest in working life. We investigated the extent to which development and recovery of fatigue during repeated bouts of an occupationally relevant reaching task was influenced by the difficulty of a cognitive activity between these bouts. Eighteen male volunteers performed three experimental sessions, consisting of six 7-min bouts of reaching alternating with 3 minutes of a memory test differing in difficulty between sessions. Throughout each session, recordings were made of upper trapezius muscle activity using electromyography (EMG), heart rate and heart rate variability (HRV) using electrocardiography, arterial blood pressure, and perceived fatigue (Borg CR10 scale and SOFI). A test battery before, immediately after and 1 hour after the work period included measurements of maximal shoulder elevation strength (MVC), pressure pain threshold (PPT) over the trapezius muscles, and a submaximal isometric contraction. As expected, perceived fatigue and EMG amplitude increased during the physical work bouts. Recovery did occur between the bouts, but fatigue accumulated throughout the work period. Neither EMG changes nor recovery of perceived fatigue during breaks were influenced by cognitive task difficulty, while heart rate and HRV recovered the most during breaks with the most difficult task. Recovery of perceived fatigue after the 1 hour work period was also most pronounced for the most difficult cognitive condition, while MVC and PPT showed ambiguous patterns, and EMG recovered similarly after all three cognitive protocols. Thus, we could confirm that cognitive tasks between bouts of fatiguing physical work can, indeed, accelerate recovery of some factors associated with fatigue, even if benefits may be moderate and some responses may be equivocal. Our results encourage further research into combinations of physical and mental tasks in an occupational context.
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Affiliation(s)
- Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden
- * E-mail:
| | - David M. Hallman
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden
| | - Eugene Lyskov
- Centre for Musculoskeletal Research, Department of Occupational and Public Health Sciences, University of Gävle, Gävle, Sweden
| | - Staffan Hygge
- Department of Building, Energy and Environmental Engineering, University of Gävle, Gävle, Sweden
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18
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Tat J, Holmes MWR, Keir PJ. Cycle to cycle variability in a repetitive upper extremity task. ERGONOMICS 2014; 57:1405-1415. [PMID: 24927401 DOI: 10.1080/00140139.2014.926396] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
UNLABELLED The purpose of this study was to examine the variability in muscle activity at rest and work during a repetitive task. A total of 20 participants performed a bimanual push task using three frequencies (4, 8, 16 pushes/min), three loads (1 kg, 2 kg, 4 kg) and two grip conditions (no grip, 30% maximum). The coefficient of variation (CoV) of muscle activity was determined for the anterior deltoid, biceps brachii, extensor digitorum and flexor digitorum superficialis. Faster push frequencies and heavier loads had lower work-rest ratio CoV and higher mean muscle activity (p < 0.01). Sixteen pushes per minute produced the lowest CoV for the anterior deltoid (p < 0.01), while the 1- kg load produced the lowest CoV for the extensor digitorum and flexor digitorum superficialis (p < 0.01). Changes were driven by the rest phase rather than by the work phase, except for grip decreasing forearm muscle CoV. These findings underscore the importance of variability at rest and indicate that low variability of muscle activity is associated with ergonomic risk factors. PRACTITIONER SUMMARY Decreased motor variability has been associated with pain and injury. A cyclical push task, evaluated in terms of work and rest phases, found that greater workloads increased variability primarily due to changes in the rest phase. Muscle variability, especially for the rest phase, may provide insight into injury risk.
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Affiliation(s)
- Jimmy Tat
- a Department of Kinesiology, Occupational Biomechanics Laboratory , McMaster University , Hamilton , Canada
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19
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Muscle Contributions to Elbow Joint Rotational Stiffness in Preparation for Sudden External Arm Perturbations. J Appl Biomech 2014; 30:282-9. [DOI: 10.1123/jab.2013-0135] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Understanding joint stiffness and stability is beneficial for assessing injury risk. The purpose of this study was to examine joint rotational stiffness for individual muscles contributing to elbow joint stability. Fifteen male participants maintained combinations of three body orientations (standing, supine, sitting) and three hand preloads (no load, solid tube, fluid filled tube) while a device imposed a sudden elbow extension. Elbow angle and activity from nine muscles were inputs to a biomechanical model to determine relative contributions to elbow joint rotational stiffness, reported as percent of total stiffness. A body orientation by preload interaction was evident for most muscles (P< .001). Brachioradialis had the largest change in contribution while standing (no load, 18.5%; solid, 23.8%; fluid, 26.3%). Across trials, the greatest contributions were brachialis (30.4 ± 1.9%) and brachioradialis (21.7 ± 2.2%). Contributions from the forearm muscles and triceps were 5.5 ± 0.6% and 9.2 ± 1.9%, respectively. Contributions increased at time points closer to the perturbation (baseline to anticipatory), indicating increased neuromuscular response to resist rotation. This study quantified muscle contributions that resist elbow perturbations, found that forearm muscles contribute marginally and showed that orientation and preload should be considered when evaluating elbow joint stiffness and safety.
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20
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Finneran A, O'Sullivan L. Self-selected duty cycle times for grip force, wrist flexion postures and three grip types. ERGONOMICS 2014; 57:589-601. [PMID: 24734971 DOI: 10.1080/00140139.2014.889762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Performance and health issues are common in industry. On-the-job productivity gains related to good design, which could help justify ergonomics intervention, are often not considered. More quantitative data are needed to model the discomfort/productivity relationship for upper limb activity in simulated repetitive assembly type work. Eighteen participants completed an experiment, simulating a repetitive upper limb task with force, posture and grip type recorded as independent variables. Duty cycle time and discomfort were recorded as dependent variables. Participants performed 18 experiment combinations (block designed around force); each treatment lasted 35 min, including breaks. Analysis indicated a significant two-way interaction between posture and grip type. Results from this experiment were used to model the effect of these variables on operator discomfort and performance.
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Affiliation(s)
- Aoife Finneran
- a School of Civil and Building Engineering, Loughborough University , Loughborough , UK
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21
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Joseph C, Beach TAC, Callaghan JP, Dickerson CR. The influence of precision requirements and cognitive challenges on upper extremity joint reaction forces, moments and muscle force estimates during prolonged repetitive lifting. ERGONOMICS 2014; 57:236-246. [PMID: 24437984 DOI: 10.1080/00140139.2013.869359] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Accepted: 11/09/2013] [Indexed: 06/03/2023]
Abstract
UNLABELLED Prolonged repetitive lifting is a whole-body exertion. Despite this, the roles and physical exposures of the upper extremities are frequently neglected. The influence of precision requirements and cognitive distractions on upper extremity responses when lifting was evaluated by quantifying several biomechanical upper extremity quantities. Nine participants completed four 30-min lifting tasks with and without simultaneous cognitive distractions and/or precision placement constraints. Specific metrics evaluated were joint reaction forces and moments (wrist, elbow and shoulder) and modelled shoulder muscle forces (38 defined shoulder muscle mechanical elements). The addition of a precision requirement increased several metrics by up to 43%, while the addition of the cognitive distraction task had minimal influence. Furthermore, several metrics decreased by up to 14% after the first 10 min of lifting, suggesting a temporal change of lifting strategy. PRACTITIONER SUMMARY Lifting tasks often include precision placements and cognitive demands. This study shows that precision placement during prolonged repetitive lifting increases upper extremity forces and moments, while the addition of a cognitive task is benign. Furthermore, field assessments of repetitive lifting should include observations longer than 10 min, as adaptive strategies appear to be adopted.
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Affiliation(s)
- Caroline Joseph
- a Department of Kinesiology, Faculty of Applied Health Science , University of Waterloo , Waterloo , ON , Canada
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22
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Mehta RK, Agnew MJ. Exertion-Dependent Effects of Physical and Mental Workload on Physiological Outcomes and Task Performance. ACTA ACUST UNITED AC 2013. [DOI: 10.1080/21577323.2011.632488] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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23
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Mehta RK, Nussbaum MA, Agnew MJ. Muscle- and task-dependent responses to concurrent physical and mental workload during intermittent static work. ERGONOMICS 2012; 55:1166-1179. [PMID: 22849301 DOI: 10.1080/00140139.2012.703695] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
UNLABELLED Many workers experience combined physical and mental demands in their jobs, yet the contribution of these demands to the development of musculoskeletal disorders is unclear. The purpose of this study was to investigate muscle- and task-dependent responses to concurrent demands during intermittent static work. Twenty-four participants performed shoulder, wrist, and torso exertions at three levels of physical workload (PWL) in the absence (control) and presence (concurrent) of a mental arithmetic task. Compared to the control, concurrent demand conditions resulted in decreased muscle activity (4-9% decrease), increased cardiovascular load (2-4% increase), and impaired motor co-ordination (9-24% increase in force fluctuation). Furthermore, these outcomes were more prominent at higher PWL levels and within postural (shoulder and torso) muscles. Mental task performance exhibited greater interference with the physical task at low and high PWL levels. Thus, it may be important to consider these muscle- and task-specific interactions of concurrent demands during job design to address worker health and performance issues. PRACTITIONER SUMMARY Occupational tasks place both physical and mental demands on workers. These demands can adversely affect physiological responses and performance, and are muscle- and task-dependent. Findings from this research may facilitate the development of ergonomics interventions, such as task redesign and tool/workstation design, that may help reduce risk of workplace injuries.
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Affiliation(s)
- Ranjana K Mehta
- Department of Cognitive & Learning Sciences, Michigan Technological University, Houghton, MI, USA
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24
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Keir PJ, Brown MM. Force, frequency and gripping alter upper extremity muscle activity during a cyclic push task. ERGONOMICS 2012; 55:813-824. [PMID: 22506613 DOI: 10.1080/00140139.2012.668947] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
UNLABELLED Factors, such as high repetition, high force and gripping play a role in the development of upper extremity work-related musculoskeletal disorders. The purpose of this study was to systematically examine the effects of push load and frequency on muscle activity with and without concurrent gripping. A total of 10 men and 10 women performed a cyclic bimanual pushing task. All combinations of three push loads (1 kg, 2 kg, 4 kg), three frequencies (4/min, 8/min, 16/min) and two grip conditions (no required grip and 30% of maximum grip force) were performed in randomised order. The muscle activity of the upper arm and shoulder complex reflected both frequency and load, often with significant interactions, thus may be better described by workload, the product of force and frequency. In the forearm, muscle activities were generally low but adding a submaximal grip superseded the effects of push load, with the activity reflecting frequency and grip. PRACTITIONER SUMMARY Force and frequency are important risk factors for upper extremity disorders. We found that upper extremity muscle activity responds to workload (force × frequency) in a complex way which may be superseded if a grip is present. This electromyographic study provides physiological insights to muscular loading as basis for a variety of workplace disorders.
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Affiliation(s)
- Peter J Keir
- McMaster Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON, Canada.
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25
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Hodder JN, Keir PJ. Targeted gripping reduces shoulder muscle activity and variability. J Electromyogr Kinesiol 2012; 22:186-90. [DOI: 10.1016/j.jelekin.2011.11.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2010] [Revised: 11/14/2011] [Accepted: 11/14/2011] [Indexed: 12/01/2022] Open
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26
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Holmes MW, Keir PJ. Posture and hand load alter muscular response to sudden elbow perturbations. J Electromyogr Kinesiol 2012; 22:191-8. [PMID: 22137184 DOI: 10.1016/j.jelekin.2011.11.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Revised: 11/08/2011] [Accepted: 11/08/2011] [Indexed: 10/14/2022] Open
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27
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Alizadehkhaiyat O, Fisher A, Kemp G, Vishwanathan K, Frostick S. Shoulder muscle activation and fatigue during a controlled forceful hand grip task. J Electromyogr Kinesiol 2011; 21:478-82. [DOI: 10.1016/j.jelekin.2011.03.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Revised: 03/08/2011] [Accepted: 03/09/2011] [Indexed: 10/18/2022] Open
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28
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Effects of posture, movement and hand load on shoulder muscle activity. J Electromyogr Kinesiol 2010; 20:191-8. [DOI: 10.1016/j.jelekin.2009.04.010] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2008] [Revised: 04/22/2009] [Accepted: 04/22/2009] [Indexed: 11/22/2022] Open
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29
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Di Domizio J, Keir PJ. Forearm posture and grip effects during push and pull tasks. ERGONOMICS 2010; 53:336-343. [PMID: 20191408 DOI: 10.1080/00140130903389076] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Direction of loading and performance of multiple tasks have been shown to elevate muscle activity in the upper extremity. The purpose of this study was to evaluate the effects of gripping on muscle activity and applied force during pushing and pulling tasks with three forearm postures. Twelve volunteers performed five hand-based tasks in supinated, neutral and pronated forearm postures with the elbow at 90 degrees and upper arm vertical. All tasks were performed with the right (dominant) hand and included hand grip alone, push and pull with and without hand grip. Surface EMG from eight upper extremity muscles, hand grip force, tri-axial push and pull forces and wrist angles were recorded during the 10 s trials. The addition of a pull force to hand grip elevated activity in all forearm muscles (all p < 0.017). During all push with grip tasks, forearm extensor muscle activity tended to increase when compared with grip only while flexor activity tended to decrease. Forearm extensor muscle activity was higher with the forearm pronated compared with neutral and supinated postures during most isolated grip tasks and push or pull with grip tasks (all p < 0.017). When the grip dynamometer was rotated so that the push and pull forces could act to assist in creating grip force, forearm muscle activity generally decreased. These results provide strategies for reducing forearm muscle loading in the workplace. STATEMENT OF RELEVANCE: Tools and tasks designed to take advantage of coupling grip with push or pull actions may be beneficial in reducing stress and injury in the muscles of the forearm. These factors should be considered in assessing the workplace in terms of acute and cumulative loading.
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Affiliation(s)
- Jennifer Di Domizio
- School of Kinesiology & Health Science, York University, Toronto, ON, Canada
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30
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Smets MPH, Potvin JR, Keir PJ. Constrained handgrip force decreases upper extremity muscle activation and arm strength. ERGONOMICS 2009; 52:1144-1152. [PMID: 19606369 DOI: 10.1080/00140130902919113] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Many industrial tasks require repetitive shoulder exertions to be performed with concurrent physical and mental demands. The highly mobile nature of the shoulder predisposes it to injury. The purpose of this study was to determine the effects of simultaneous gripping, at a specified magnitude, on muscle activity and maximal arm force in various directions. Ten female subjects performed maximal arm exertions at two different heights and five directions using both specified (30% maximum voluntary grip) and preferred (self-selected) grip forces. Electromyography was recorded from eight muscles of the right upper extremity. The preferred grip condition produced grip forces that were dependent on the combination of arm height and force direction and were significantly greater (arm force down), lower (to left, up and push forward), or similar to the specified grip condition. Regardless of the magnitude of the preferred grip force, specifying the grip resulted in decreased maximal arm strength (by 18-25%) and muscle activity (by 15-30%) in all conditions, indicating an interfering effect when the grip force was specified by visual target force-matching. Task constraints, such as specific gripping demands, may decrease peak force levels attainable and alter muscle activity. Depending on the nature of task, the amount of relative demand may differ, which should be considered when determining safety thresholds.
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Affiliation(s)
- Martin P H Smets
- McMaster Occupational Biomechanics Laboratory, Department of Kinesiology, McMaster University, Hamilton, ON, Canada
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31
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Yoshie M, Kudo K, Murakoshi T, Ohtsuki T. Music performance anxiety in skilled pianists: effects of social-evaluative performance situation on subjective, autonomic, and electromyographic reactions. Exp Brain Res 2009; 199:117-26. [PMID: 19701628 DOI: 10.1007/s00221-009-1979-y] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2009] [Accepted: 08/05/2009] [Indexed: 11/25/2022]
Abstract
Music performance anxiety (MPA), or stage fright in music performance, is a serious problem for many musicians, because performance impairment accompanied by MPA can threaten their career. The present study sought to clarify on how a social-evaluative performance situation affects subjective, autonomic, and motor stress responses in pianists. Measurements of subjective state anxiety, heart rate (HR), sweat rate (SR), and electromyographic (EMG) activity of upper extremity muscles were obtained while 18 skilled pianists performed a solo piano piece(s) of their choice under stressful (competition) and non-stressful (rehearsal) conditions. Participants reported greater anxiety in the competition condition, which confirmed the effectiveness of stress manipulation. The HR and SR considerably increased from the rehearsal to competition condition reflecting the activation of sympathetic division of the autonomic nervous system. Furthermore, participants showed higher levels of the EMG magnitude of proximal muscles (biceps brachii and upper trapezius) and the co-contraction of antagonistic muscles in the forearm (extensor digitorum communis and flexor digitorum superficialis) in the competition condition. Although these responses can be interpreted as integral components of an adaptive biological system that creates a state of motor readiness in an unstable or unpredictable environment, they can adversely influence pianists by disrupting their fine motor control on stage and by increasing the risk of playing-related musculoskeletal disorders.
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Affiliation(s)
- Michiko Yoshie
- Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Meguro-ku, Tokyo, 153-8902, Japan.
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