An EMG technique for measuring spinal loading during asymmetric lifting

Bilateral Back Extensor Exosuit for multidimensional assistance and prevention of spinal injuries

Lumbar spine injuries resulting from heavy or repetitive lifting remain a prevalent concern in workplaces. Back-support devices have been developed to mitigate these injuries by aiding workers during lifting tasks. However, existing devices often fall short in providing multidimensional force assistance for asymmetric lifting, an essential feature for practical workplace use. In addition, validation of device safety across the entire human spine has been lacking. This paper introduces the Bilateral Back Extensor Exosuit (BBEX), a robotic back-support device designed to address both functionality and safety concerns. The design of the BBEX draws inspiration from the anatomical characteristics of the human spine and back extensor muscles. Using a multi-degree-of-freedom architecture and serially connected linear actuators, the device's components are strategically arranged to closely mimic the biomechanics of the human spine and back extensor muscles. To establish the efficacy and safety of the BBEX, a series of experiments with human participants was conducted. Eleven healthy male participants engaged in symmetric and asymmetric lifting tasks while wearing the BBEX. The results confirm the ability of the BBEX to provide effective multidimensional force assistance. Moreover, comprehensive safety validation was achieved through analyses of muscle fatigue in the upper and the lower erector spinae muscles, as well as mechanical loading on spinal joints during both lifting scenarios. By seamlessly integrating functionality inspired by human biomechanics with a focus on safety, this study offers a promising solution to address the persistent challenge of preventing lumbar spine injuries in demanding work environments.

The Influence of External Additional Loading on the Muscle Activity and Ground Reaction Forces during Gait

Asymmetrical external loading acting on the musculoskeletal system is generally considered unhealthy. Despite this knowledge, carrying loads in an asymmetrical manner like carrying on one shoulder, with one hand, or on the strap across the torso is a common practice. This study is aimed at presenting the effects of the mentioned load carrying methods on muscle activity assessed by using thermal field and ground reaction forces. Infrared thermography and pedobarographic force platform (ground reaction force/pressure measurement) were used in this study. Experimental results point out an increased load-dependent asymmetry of temperature distribution on the chosen areas of torso and the influence of external loading on ground reaction forces. Results point out that wearing an asymmetrical load should be avoided and are showing which type of carrying the external load is potentially less and the most harmful.

COMPARING METHODS FOR 3D INVERSE DYNAMICS ANALYSIS OF SQUAT LIFTING USING A FULL BODY LINKED SEGMENT MODEL

Objective: The main objective of this study was to assess the accuracy of bottom-up solution for three-dimensional (3D) inverse dynamics analysis of squat lifting using a 3D full body linked segment model. Least squares solution was used in this study as reference for assessment of the accuracy of bottom-up solution. Findings of this study may clarify how much the bottom-up solution can be reliable for calculating the joint kinetics in 3D inverse dynamics problems. Methods: Ten healthy males volunteered to perform squat lifting of a box with a load of one-tenth of their body weights. The joint moments were calculated using 110 reflective passive markers (46 anatomical markers and 64 tracking markers) and a 3D full body linked segment model. Ground reaction forces and kinematics data were recorded using a Vicon system with two parallel Kistler force plates. Three-dimensional Newton–Euler equations of motion with bottom-up and least squares solutions were applied to calculate joint moments. The peak and mean values of the joint moments were determined to check the quantitative differences as well as the time-to-peak value of the moment curves was determined to check the temporal differences between the two inverse dynamics solutions. Results: Significant differences (all [Formula: see text]-[Formula: see text]) between the two inverse dynamics solutions were detected for the peak values of the hip (right and left sides) and L5–S1 joint moments in the lateral anatomical direction as well significant differences (all [Formula: see text]-[Formula: see text]) were detected for the peak and mean values of the L5–S1 joint moment in all anatomical directions. Moreover, small differences (all [Formula: see text]) were detected between the two inverse dynamic solutions for the calculated lower body joint moments. Conclusions: The findings of this study clarified the disadvantages of the straightforward solutions and demonstrated that the bottom-up solution may not be accurate for more distal measures from the force plate (for hip and S1–L5) but it may be accurate for more proximal joints (ankle and knee) in 3D inverse dynamics analysis.

COMPARING METHODS FOR 3D INVERSE DYNAMICS ANALYSIS OF SQUAT LIFTING USING A FULL BODY LINKED SEGMENT MODEL

Objective: The main objective of this study was to assess the accuracy of bottom-up solution for three-dimensional (3D) inverse dynamics analysis of squat lifting using a 3D full body linked segment model. Least squares solution was used in this study as reference for assessment of the accuracy of bottom-up solution. Findings of this study may clarify how much the bottom-up solution can be reliable for calculating the joint kinetics in 3D inverse dynamics problems. Methods: Ten healthy males volunteered to perform squat lifting of a box with a load of one-tenth of their body weights. The joint moments were calculated using 110 reflective passive markers (46 anatomical markers and 64 tracking markers) and a 3D full body linked segment model. Ground reaction forces and kinematics data were recorded using a Vicon system with two parallel Kistler force plates. Three-dimensional Newton–Euler equations of motion with bottom-up and least squares solutions were applied to calculate joint moments. The peak and mean values of the joint moments were determined to check the quantitative differences as well as the time-to-peak value of the moment curves was determined to check the temporal differences between the two inverse dynamics solutions. Results: Significant differences (all [Formula: see text]-values [Formula: see text]) between the two inverse dynamics solutions were detected for the peak values of the hip (right and left sides) and L5–S1 joint moments in the lateral anatomical direction as well significant differences (all [Formula: see text]-values [Formula: see text]) were detected for the peak and mean values of the L5–S1 joint moment in all anatomical directions. Moreover, small differences (all RMSEs [Formula: see text]%) were detected between the two inverse dynamic solutions for the calculated lower body joint moments. Conclusions: The findings of this study clarified the disadvantages of the straightforward solutions and demonstrated that the bottom-up solution may not be accurate for more distal measures from the force plate (for hip and S1–L5) but it may be accurate for more proximal joints (ankle and knee) in 3D inverse dynamics analysis.

Inter-segmental coordination of the spine is altered during lifting in patients with ankylosing spondylitis: A cross-sectional study

The abnormal inter-segmental coordination of the spine during lifting could be used to monitor disease progression and rehabilitation efficacy in patients with ankylosing spondylitis (AS). This study aimed to compare the inter-segmental coordination patterns and variability of the spine during lifting between patients with AS (n = 9) and control (n = 15) groups.Continuous relative (CRP) and deviation (DP) phases between each segment of the spine (two lumbar and three thorax segments) and lumbosacral joint were calculated. The CRP and DP curves among participants were decomposed into few functional principal components (FPC) via functional principal component analysis (FPCA). The FPC score of CRP or DP of the two groups were compared, and its relationship with the indexes of spinal mobility was investigated.Compared with the control group, the AS patients showed more anti-phase coordination patterns in each relative upper spine segment and lumbosacral joint. In addition, either less or more variation was found in the coordination of each relative lower spine segment and lumbosacral joint during different time periods of lifting for these patients. Some cases were considerably related to spinal mobility.the inter-segmental coordination of the spine was altered during lifting in AS patients to enable movement, albeit inefficient and might cause spinal mobility impairment.

Obesity effects on muscular activity during lifting and lowering tasks

Obesity is an emerging health problem and its incidence has been increasing throughout the workforce. In industrial workstations, vertical handling tasks (VHT), including lifting and lowering, are very common and can cause a significant muscular overload for the involved workers. During these tasks, muscular activity may be considerably affected by workers' body conditions. This study aims to analyze and compare the muscular activity in subjects with different obesity levels, using surface electromyography (EMG), during predefined VHT. Six different VHT (combining 5, 10 and 15-kg loads with two task styles) were performed. EMG data normalization was based on the percentage of maximum contraction during each task (MCT%). The results show that obesity influences the MCT%, which in turn increases the muscular effort during VHT. The current investigation demonstrates that obesity is a relevant musculoskeletal risk factor regarding VHT. The engineering analysis and design implications of this work can thus be perceived.

Identifying interactive effects of task demands in lifting on estimates of in vivo low back joint loads

This investigation examined interactions between the magnitude of external load, movement speed and (a)symmetry of load placement on estimates of in vivo joint loading in the lumbar spine during simulated occupational lifting. Thirty-two participants with manual materials handling experience were included in the study. Three-dimensional motion data, ground reaction forces, and activation of six bilateral trunk muscle groups were captured while participants performed lifts with two loads at two movement speeds and using two load locations. L4-L5 joint compression and shear force-time histories were estimated using an EMG-assisted musculoskeletal model of the lumbar spine. Results from this investigation provide strong evidence that known mechanical low back injury risk factors should not be viewed in isolation. Rather, injury prevention efforts need to consider the complex interactions that exist between external task demands and their combined influence on internal joint loading.

Estimation of lumbar spinal loading and trunk muscle forces during asymmetric lifting tasks: application of whole-body musculoskeletal modelling in OpenSim

Large spinal compressive force combined with axial torsional shear force during asymmetric lifting tasks is highly associated with lower back injury (LBI). The aim of this study was to estimate lumbar spinal loading and muscle forces during symmetric lifting (SL) and asymmetric lifting (AL) tasks using a whole-body musculoskeletal modelling approach. Thirteen healthy males lifted loads of 7 and 12 kg under two lifting conditions (SL and AL). Kinematic data and ground reaction force data were collected and then processed by a whole-body musculoskeletal model. The results show AL produced a significantly higher peak lateral shear force as well as greater peak force of psoas major, quadratus lumborum, multifidus, iliocostalis lumborum pars lumborum, longissimus thoracis pars lumborum and external oblique than SL. The greater lateral shear forces combined with higher muscle force and asymmetrical muscle contractions may have the biomechanical mechanism responsible for the increased risk of LBI during AL. Practitioner Summary: Estimating lumbar spinal loading and muscle forces during free-dynamic asymmetric lifting tasks with a whole-body musculoskeletal modelling in OpenSim is the core value of this research. The results show that certain muscle groups are fundamentally responsible for asymmetric movement, thereby producing high lumbar spinal loading and muscle forces, which may increase risks of LBI during asymmetric lifting tasks.

Measurement of muscle length-related electromyography activity of the hip flexor muscles to determine individual muscle contributions to the hip flexion torque

This study aimed to investigate muscle length-related electromyography (EMG) of the iliopsoas (IL) and other hip flexor muscles to determine individual muscle contributions to the hip flexion torque. Ten healthy sedentary young men participated in the EMG experiment. A subgroup of six subjects underwent a magnetic resonance imaging (MRI) measurement to confirm the region of the skin over the IL. Surface EMG signals were sampled from the IL, rectus femoris (RF), sartorius (SA), and tensor fasciae latae (TFL) using an active electrode. The subjects performed maximum voluntary isometric hip flexion with the right hip joint set at -10°, 0°, 30°, and 60°. The root mean square (RMS) value for the TFL at 30° (0.81 ± 0.19, p <0.005) and 60° (0.66 ± 0.17, p <0.001) and the SA at 60° (0.62 ± 0.24, p <0.005) were significantly decreased compared with those at 0°. However, the RMS value for the IL and RF did not change significantly. The RMS value and muscle length changes were significantly correlated in the IL (r =0.39, p <0.05), SA (r =0.51, p <0.001), and TFL (r =0.70, p <0.001), but not in the RF (r =0.22, p =0.180). We conclude that, in a hip joint flexed position, the contribution of the IL to hip flexion movement is relatively larger than that of the other hip flexor muscles.

Anatomy and biomechanics of the back muscles in the lumbar spine with reference to biomechanical modeling

STUDY DESIGN

This article describes the development of a musculoskeletal model of the human lumbar spine with focus on back muscles. It includes data from literature in a structured form.

OBJECTIVE

To review the anatomy and biomechanics of the back muscles related to the lumbar spine with relevance for biomechanical modeling.

SUMMARY OF BACKGROUND DATA

To reduce complexity, muscle units have been incorporated in an abridged manner, reducing their actions more or less to a single force equivalent. In early models of the lumbar spine, this may have been a necessary step to reduce complexity and, thereby, calculation time. The muscles of the spine are well described in the literature, but mainly qualitatively. Most of the literature provides a description of the structures without precise data of fiber length, muscle length, cross-sectional areas, moment arms, forces, etc. The predicted output of musculoskeletal models is very much dependent on the input parameters. The information needed to improve models consists of better approximations of the attachments to the vertebrae, and more precise data.

METHOD

Review of literature.

RESULTS

The predicted output of musculoskeletal models is very much dependent on the input parameters. Moderate changes in the assumed muscle line-of-action (i.e., moment arm) could substantially alter the magnitudes of predicted muscle and spinal forces, while the choice of optimization formulation is less sensitive.

CONCLUSIONS

Input parameters, moment arms, as well as physiologic cross-sectional areas have a profound effect on the predicted muscle forces. Therefore, it is important to choose the values for moment arm and physiologic cross-sectional area carefully because they are essential input parameters to biomechanical models.

Intramuscular hemodynamics in bilateral erector spinae muscles in symmetrical and asymmetrical postures with and without loading

BACKGROUND

Although attention has been paid to the relationship between the changes in blood circulation in erector spinae muscles and back pain, little is known about their hemodynamics in several various comparable postures with and without loading. Studies on hemodynamics of erector spinae muscles using near-infrared spectroscopy have been performed on subjects and patients mainly in forward flexion positions.

METHODS

Two near-infrared spectroscopes were used to measure oxygenated hemoglobin, deoxygenated hemoglobin, and total hemoglobin in bilateral erector spinae muscles at L2-3 in subjects in 9 postures, and holding no load, 10 kg or 20 kg in maximum flexed and lateral bending. Those three values in each posture and loading condition were expressed as a percentage of their corresponding values obtained in the standing upright position, and designated and statistically analyzed as %Oxy-Hb, %Deoxy-Hb and %Total-Hb, respectively.

FINDINGS

%Total-Hb and %Oxy-Hb in maximum flexion were the most decreased. In maximum lateral bending, %Oxy-Hb only in the contralateral erector spinae muscles was decreased. When the load was 20 kg, the decreases in %Oxy-Hb were the largest in maximum flexion and lateral bendings.

INTERPRETATION

Using two near-infrared spectroscopes allowed us to measure simultaneously the hemodynamics of bilateral muscles. They demonstrated different responses in each side. Asymmetrical posture and loading were accompanied by asymmetrical changes of the bilateral erector spinae muscles. Stretched muscle had less blood volume and oxygenation, both of which decreased with increasing load. These results showed that these postures and conditions might lead to fatigue of the ES muscles.

The Effect of a Repetitive, Fatiguing Lifting Task on Horizontal Ground Reaction Forces

There are many outdoor work environments that involve the combination of repetitive, fatiguing lifting tasks and less-than-optimal footing (muddy/slippery ground surfaces). The focus of the current research was to evaluate the effects of lifting-induced fatigue of the low back extensors on lifting kinematics and ground reaction forces. Ten participants performed a repetitive lifting task over a period of 8 minutes. As they performed this task, the ground reaction forces and whole body kinematics were captured using a force platform and magnetic motion tracking system, respectively. Fatigue was verified in this experiment by documenting a decrease in the median frequency of the bilateral erector spinae muscles (pretest-posttest). Results indicate significant (p< 0.05) increases in the magnitude of the peak anterior/posterior (increased by an average of 18.3%) and peak lateral shear forces (increased by an average of 24.3%) with increasing time into the lifting bout. These results have implications for work environments such as agriculture and construction, where poor footing conditions and requirements for considerable manual materials handling may interact to create an occupational scenario with an exceptionally high risk of a slip and fall.

Muscular and centre of pressure response to sudden release of load in symmetric and asymmetric stoop lifting tasks

Sudden changes in load during asymmetric lifting may be associated with a particularly high risk of loss of balance and spinal injury. Centre of pressure (COP) motions and electromyographic responses of trunk and lower limb muscles were studied in 10 normal male volunteers during sudden release of 20, 40, 60 and 80N stoop lifting loads in symmetric and asymmetric postures. Similar overall COP responses and muscular response strategies to sudden release of load were seen in both postures, although the asymmetric posture showed a larger medio-lateral COP displacements and greater co-contraction asymmetries. While sudden release of load in asymmetric stoop lifting does not seem to involve a greater risk of fall than symmetric lifting, the muscular response results in more complex and asymmetric loading of the trunk, indicating greater localised segmental loading and therefore increased risk of tissue injury.

Less is more: high pass filtering, to remove up to 99% of the surface EMG signal power, improves EMG-based biceps brachii muscle force estimates

It is generally assumed that raw surface EMG (sEMG) should be high pass filtered with cutoffs of 10-30 Hz to remove motion artifact before subsequent processing to estimate muscle force. The purpose of the current study was to explore the benefits of filtering out much of the raw sEMG signal when attempting to estimate accurate muscle forces. Twenty-five subjects were studied as they performed rapid static, anisotonic contractions of the biceps brachii. Biceps force was estimated (as a percentage of maximum) based on forces recorded at the wrist. An iterative approach was used to process the sEMG from the biceps brachii, using progressively greater high pass cutoff frequencies (20-440 Hz in steps of 30 Hz) with first and sixth order filters, as well as signal whitening, to determine the effects on the accuracy of EMG-based biceps force estimates. The results indicate that removing up to 99% of the raw sEMG signal power resulted in significant and substantial improvements in biceps force estimates. These findings challenge previous assumptions that the raw sEMG signal power between about 20 and 500 Hz should used when estimating muscle force. For the purposes of force prediction, it appears that a much smaller, high band of sEMG frequencies may be associated with force and the remainder of the spectrum has little relevance for force estimation.