Horizontal lifting--physiological and psychological responses

Reaction force exposure for tightening tool users: A psychophysical based experimental study of electric right-angle nutrunners

Reaction forces from nutrunner tools constitute a risk of developing MSDs. However, recommendations for sustainable reaction force levels are lacking. The aim of this study was to inform recommendations regarding reaction load exposures from right-angle nutrunners. Through a psychophysics approach, experienced assembly workers subjectively assessed reaction loads when using a nutrunner in six combinations of tool tightening strategy, work-pace and screw-joint stiffness. Electromyography, tool and joint parameters were measured. Regardless of tightening strategy, joint stiffness and work-pace combinations, no large differences in acceptable tightening torque, peak reaction force, and handle displacement were observed. However, acceptable jerk and impulse differed substantially between the TurboTight® (high-acceleration) and QuickStep® (conventional) tightening strategies. Although the TurboTight® strategy overall showed reduced peak muscular activities compared to the QuickStep®, the participant-rated acceptable torque levels were similar, plausibly due to TurboTights' high jerk levels. Jerk and impulse are hypothesized to influence the perception of reaction loads.

Psychophysical Assessment of Simulated Assembly Line Work: Combinations of Transferring and Screw Driving Tasks

Upper extremity cumulative trauma disorders have been linked to the repeated and/or forceful exertions and/or awkward postures sometimes required by upper extremity intensive work. The combined effect of these physical stressors can be evaluated using psychophysical methods. The purpose of this study was to examine different combinations of repetitive upper extremity work using established psychophysical methods to determine design recommendations for upper extremity tasks. The tasks studied simulated assembly line type work where a part is transferred from a storage bin and attached with a pneumatic tool to another larger part.

Twenty-four experienced industrial workers performed five combination tasks of transferring an object along a conveyor and screw driving using a pistol shaped pneumatic screwdriver: 100% transfer; 75% transfer and 25% screw drive; 50% transfer and 50% screw drive; 25% transfer and 75% screw drive; and 100% screw drive. The cycle time was 24 seconds. Each combination task was performed for an hour. Overall, transferring, and screw driving perceived exertions were measured using 10 cm visual analog scales (VAS) with verbal descriptions at the endpoints. The left and right sides corresponded to “Easiest imaginable work” at 0 cm, and “Hardest imaginable work” at 10 cm, respectively. Body part discomfort surveys were utilized to assess discomfort from each of the tasks.

The overall perceived exertion (VAS) rating increased, as the task utilized more of one upper extremity than the other and involved more of either the transferring or screw driving tasks. The mean overall VAS ratings were 5.3, 4.3, 3.5, 4.4, and 5.3 for the five combination tasks, respectively. As the transferring (or screw driving) proportion of the task increased, the transferring (or screw driving) VAS increased. A repeated measures ANOVA showed that the combination task effect was significant (p<0.01). This psychophysical data can provide guidance in the analysis and design of upper extremity work. Since less varied work which utilized more of one upper extremity than the other had greater overall perceived exertion, upper extremity tasks should be designed as varied as possible utilizing as many body parts as possible. Body part discomfort surveys verified that this decreased discomfort severity and distributed the discomfort more evenly throughout the different body parts. This study provides evidence of the positive effects of work enlargement.

Predictors of perceived effort in the shoulder during load transfer tasks

The mechanism of muscular effort perception in the shoulder was examined in this experiment. Two shoulder biomechanical models and experimental muscle activity data were used to assess physical exposure for a series of reaching tasks. Effort perception was quantitatively correlated to these measures of physical loading, both at the resultant torque (r(2) = 0.50) and muscle activity model-based muscle force predictions (MFPs): r(2) = 0.42, electromyography (EMG): r(2) = 0.26) levels. Muscle data did not explain variation in effort perception more fully than torque data. The inclusion of subject and task variables improved the ability of each model to explain variability in effort perception (torque: r(2) = 0.74; MFP: r(2) = 0.67, EMG: r(2) = 0.64). These results suggest that effort perception may not be fully explained by only an image of the motor command, but is rather a complex integrative quantity that is affected by other factors, such as posture and task goals, which may be dependent on sensory feedback.

Modelling of shoulder and torso perception of effort in manual transfer tasks

The aim of the present study was to develop statistical models of perceived effort at the shoulder and torso levels associated with manual load transfer tasks. The motions were directed from a home location toward one of twenty-two target shelves distributed in the right hemisphere. A total of 2149 ratings were obtained from 31 subjects for effort perception at the selected joints, using a ten-point modified Borg scale. Regression models, developed for the perception associated with each body part, included target locations (azimuth, height and distance), posture constraints (standing or sitting), task types (one or two handed transfer conditions), and demographic and anthropometric measures (stature, body weight, gender, and age) as parameters. The models provide a prediction of effort perception with adjusted r-square coefficients of 0.41 and 0.50 for the shoulder and torso, respectively. The results indicate that space and posture interact in a complex way to affect the rating of perceived effort, and are in agreement with the hypothesis that the 'sense of effort' is primarily associated with the efference copy of the descending motor command. Since a level of effort is not associated with a unique pattern of motor command, it is proposed that effort perception is likely to result from a summation of the components of the motor command. The models can be applied to optimize the spatial organization of the work environment in an attempt to reduce the risk of musculoskeletal injury.

Verbal estimation of peak exertion intensity

The objectives of this research were to investigate the accuracy and precision with which trained and untrained participants estimate the magnitude of forceful exertion and to evaluate the mathematical relationship between actual and estimated exertion. Three groups of participants estimated, as a percentage of maximum voluntary contraction (%MVC), the magnitude of submaximal exertion for 12 simulated tasks. In addition to the control group, one group was exposed to one physical benchmark (100% MVC) and another to three benchmarks (25%, 75%, and 100% MVC) prior to force estimation. Error (estimated minus actual) significantly decreased (p < .0001) from 14% MVC to 4% MVC with one benchmark and to -3% MVC with three benchmarks, as compared with the control group. Furthermore, the standard deviation decreased significantly (p < .0001 ) from the control group (16.6% MVC) to the one-benchmark group (13.8% MVC) to the three-benchmark group (11.6% MVC), indicating improved precision. Significant interaction effects were observed, but their impact on main effects was negligible. Also, linear, power, and logarithmic regression models described the relationship between perceived and actual exertion equally well (R2 = .64-.81). Applications of this research include improving the accuracy and precision of field-based psychophysical estimates of forceful exertion for epidemiological research and other field-based analyses.

Determination and evaluation of acceptable force limits in single-digit tasks

Acceptable limits derived from psychophysical methodologies have been proposed, measured, and employed in a range of applications. There is little existing work, however, on such limits for single-digit exertions and relatively limited evidence on several fundamental issues related to data collection and processing of a sequence of self-regulated exertion levels. An experimental study was conducted using 14 male and 10 female participants (age range 18-31 years) from whom maximal voluntary exertions and maximal acceptable limits (MALs) were obtained using the index finger and thumb. Moderate to high levels of consistency were found for both measures between sessions separated by one day. Single MAL values, determined from a time series of exertions, were equivalent across three divergent processing methods and between values obtained from 5- and 25-min samples. A critical interpretation of these and earlier results supports continued use of acceptable limits but also suggests that they should be used with some caution and not equated with safe limits. This research can be applied toward future development of exertion limits based on perceived acceptability.

Interview versus questionnaire for assessing physical loads in the population-based MUSIC-Norrtälje Study

BACKGROUND

MUSIC-Norrtälje study is a case-referent study, the aim of which is to find risk and health factors for low back and neck/shoulder disorders. In this part of the study, the interview technique and the self-administered questionnaire used for assessment of physical loads are described and the inter-method reliability of parts of the self-administered questionnaire is estimated. The distribution of exposure levels in a general population is also described.

METHODS

The study period was three years from November 1993 to November 1996, and the study subjects totaled 2,480 persons (813 female and 610 male referents, 380 female and 315 male low back cases, 252 female and 106 male neck/shoulder cases). The interview concerned "a typical working day" during the preceding 12 months and comprised assessment of energy expenditure, work postures, and manual materials handling for work and leisure time, including regular sport activities. The self-administered questionnaire comprised 18 questions, each covering 5 different points of time: right now, 5, 10, 15, 20 years ago. The answers to eight of the questions about current conditions were compared to corresponding interview responses. The interview was considered as the "gold standard."

RESULTS

Ninety-eight percent of the subjects completed the interview without any great difficulties. According to the interview, the distributions of different exposure levels were generally positively skewed, i.e., the frequency of highly exposed subjects was low in the study base. The correlation between interview and questionnaire responses among the referents was high for time spent "sitting at work" (r = 0.82), "VDU work" (r = 0.87), and work related "motor vehicle driving" (r = 0.80). The correlation was moderate for work-related "hands above shoulder level" (rs = 0.63), and "hands below knee level (trunk flexion)" (rs = 0.66). The correlation was lower for leisure time activities such as "domestic work" (r = 0.55), "time for own activities" (r = 0.39), and "sitting during leisure time" (r = 0.38). Subjects seeking care for low back or neck/shoulder disorder estimated equally correctly or not, as had the referents. However, non-differential misclassification was present in all questions, which will attenuate observed estimates of the relative risk.

CONCLUSIONS

Even though interview data are preferable, questionnaire data may be useful for assessing well-defined work tasks and for "sitting at work."

Beyond psychophysics: the need for a cognitive engineering approach to setting limits in manual lifting tasks

The classical psychophysical approach to setting limits in manual lifting tasks is discussed in view of experimental procedures used, non-linearity of human perception of load heaviness, and the related experimental outcomes. The results of two studies investigating the human assessment of load acceptability and safety are presented. The first study compares the classical concept of the maximum acceptable weight of lift (MAWL) to the alternative concept of the maximum safe weight of lift (MSWL). The second study utilizes the linguistic magnitude estimation (LME) method to mathematically model human assessment of four categories of lifted loads, including the concepts of acceptable, safe, not-too-heavy, and too-heavy loads for continuous lifting. It is shown that the concepts of the lifted load acceptability and safety are non-linear, and can be modelled with great accuracy using the third degree polynomials. This study also introduces and investigates the concept of the load indifference in assessment of load heaviness, and shows that lack of a cognitive benchmark introduces inconsistency in subjects' perception of load acceptability and safety compared to the concept of too-heavy load for continuous lifting. It is concluded that a new research approach to manual lifting tasks based on cognitive engineering is needed to improve the quality of research methodologies currently utilized in this field. This unexplored area of research should lead to greater understanding of human capacities and limitations in manual lifting tasks in the context of cultural and linguistic anthropology.

Rating of acceptable load in manual sorting of postal parcels

The psychophysical test, the rating of acceptable load (RAL) were used to assess acceptable weights for dynamic lifting in postal workers engaged in sorting parcels. The standard test (RALSt) and a work-simulating test (RALW) were administered to 103 volunteers: all experienced male sorters. In the RALSt, subjects selected the weight which would be acceptable for lifting in a box with handles from table to floor and back to the table once every 5 min for the working day. for the RALW, the box was without handles and the weight was chosen to be acceptable for transfer 4-6 times/min from a table to the parcel container and back to the table. Both tests were made during normal working hours at postal sorting centres. The overall means for RALSt and RALW were 16.4 kg and 9.4 kg respectively (p < 0.001): both being substantially higher than the average parcel weight of 4 kg. The RALSt and RALW tests proved to be repetitive and sensitive for differentiating the effects of load and task variable in actual manual material handling. Thus they appear to be applicable to the evaluation of manual materials handling problems.

Evaluation of perceived and self-reported manual forces exerted in occupational materials handling

The main objective of the study was to evaluate the ability of workers to reproduce simulated manual work forces correctly and to quantify these forces in Newtons (N) by means of self-reports. Fourteen male and 14 female workers participated in the study. Three experiments were carried out. In the first experiment, the ability to reproduce the magnitudes of simulated manual forces occurring in daily work and to estimate these forces in Newtons was tested. A specially designed force-measuring device was used for this purpose. In the second experiment, the subjects estimated the weights of five boxes ranging from 1 to 30 kg. In the third experiment, the subjects were asked to produce five predetermined push and pull forces ranging in magnitude from 10 to 300 N on to the handle of the force-measuring device. The ability to reproduce the magnitudes of manual forces when simulating four familiar work tasks was good (the intraclass correlation coefficients ranged from 0.75 to 0.95). The ability to quantify these forces in Newtons was not as good (the product moment correlation coefficients ranged from 0.21 to 0.69). When the subjects estimated the weights of boxes they underestimated the weights. When they produced predetermined push and pull forces they exerted higher forces than expected when low force levels were requested and lower forces when high force levels were requested. However, the forces were correctly ranked. In summary, simulation of the manual push/pull forces used in familiar work tasks seemed to offer sufficient reproducibility to be worth testing for validity. Self-reports, used without previous training or without known 'reference forces', seemed to be very rough when the aim was to estimate in kg or Newtons. However, the fact that individuals could rank the forces correctly opens a potential for refinement of self-reports as a method for quantifying manual forces in objective terms, e.g. kg or Newtons.

A comparison of risk assessment of single and combination manual handling tasks: 1. maximum acceptable weight measures

Many manual handling activities involve combinations of pull, lift, carry, lower and push, yet few studies have investigated how to assess the risk of such combination tasks. Most recommendations assume that a combination task can be split into its components for assessment. The aim of this study was to compare the risks assessed in single manual handling tasks with those in combination tasks. Nine male and nine female students participated in a study to determine Maximum Acceptable Weights (MAWs) in single and combination tasks at different frequencies (1 min-1 and 3 min-1 for combination tasks and 3 min-1 and 6 min-1 for single tasks) and heights (floor, knuckle, shoulder). Combination tasks consisted of one each of the single tasks (pull, lift, carry, lower and push). The MAW of each combination task was compared to the MAWs of the single tasks of which it was composed using repeated measures analysis of variance with specified contrasts. In at least one of the 12 comparisons each single task MAW was found to be different from its related combination task MAW. It was concluded that the current use of single task MAWs to estimate the risk in combination tasks was unacceptable. Prediction models for combination task MAWs based on single tasks MAWs were also developed, using step-wise regression. Although coefficients of determination of around 0.8 were achieved it was argued that owing to their situation-specific nature the prediction of combination task risk using single task MAWs was likely to result in unacceptable risk errors.

The handling of objects other than boxes: univariate analysis of handling techniques in a large transport company

The purpose of this study, carried out on handlers in the distribution centre of a large transport company, was to identify the techniques used for handling objects other than boxes. Thirty-one workers, with experience varying from one month to 17 years, were each filmed during one shift. A grid with 36 variables allowed the successive operations to be described: the type of grip, the nature and the direction of the efforts by the upper limbs, the use of the back and the lower limbs, and the displacement of the object. Nine hundred and forty-four handlings carried out in 3217 distinct movements were analysed. These observations revealed the complexity of the handling techniques and the tendency to favour some of them. Seventy-nine per cent of the handlings observed included pre-transfer and/or post-placement phases in addition to the transfer itself. Essentially horizontal phases (pulling, pushing) are more frequent than essentially vertical ones (lifting, lowering); asymmetry is generalized, whether it involves the back position (torsion), the direction and the type of effort, the position of the hands on the object, etc. More than half of the efforts are used to move an object resting on a surface (sliding, pivoting, turning, rolling); resistive efforts downwards (e.g., lowering) are avoided in favour of 'throwing' or 'dropping'.

Perception of heavy work operations by tank truck drivers

Seven male tank truck drivers were followed for about 3 h during ordinary work. They rated the perception of heavy work operations on Borg's CR-10 scale. The heart rates were monitored every minute. The hose was pulled out an average of 22.3 m and the corresponding mean rating was 3.2, a little above 'Moderate' on the CR-10 scale. The heart rate averaged 137 beats/min at the end of this operation. When transforming the physiological parameter heart rate to a subjective strain intensity, surprisingly high agreement was obtained between the results from the field study and the predicted ratings. By transforming ordinally scaled data from another study to a scale with ratio properties, the results could be compared with this study. Good agreement was found between the variables.

Perceived exertion and discomfort associated with driving screws at various work locations and at different work frequencies

Eighteen subjects drove screws with air-powered tools into perforated sheet metal at three vertical and two horizontal work locations using three different work paces (8, 10, and 12 screws/min). Subjects drove screws with a pistol-shaped tool on the vertical orientation at knee, elbow, and shoulder height. They used an in-line tool to drive screws on the horizontal surface. A horizontal beam was placed just below each subject's elbow height and they drove screws into it with the lower arm perpendicular to the torso and with the arms fully extended. Subjects drove screws for 10 min at each work location and frequency combination before they assessed the condition using the Borg ten-point ratio rating scale. Subjects also ranked seven body areas according to discomfort for each work location. A two-factor ANOVA (and comparable non-parametric statistics) showed that both work location and frequency were significant factors in determining the Borg ratings. As work pace increased, so did the Borg ratings of perceived exertion for each work location. For each incremental increase in work pace, the Borg ratings of perceived exertion increased 12% to 25%, depending on the work location. Driving screws at elbow height on the vertical surface and with the lower arm close to the body on the horizontal surface were the work locations with the smallest ratings of perceived exertion. The ratings of perceived exertion for driving screws at elbow height on the vertical surface were 18% to 50% lower than the ratings for driving screws at knee or shoulder height and the ratings of perceived exertion for driving screws with the lower arm close to the body on the horizontal surface were 21% to 24% lower than driving screws with the arms fully extended. No significant difference was found among the discomfort ranks given to the various body parts for the two horizontal work locations. Differences were found among the body part discomfort rankings for the vertical work locations. While driving screws at knee height, the torso was most stressed; the wrist and hand were most stressed while driving screws at elbow height, and the shoulder and upper arm were the body parts that were stressed the most while driving screws at shoulder height.

Endurance limits in different modes of load holding

This study examines the influence of different modes of load holding on the isometric strength exertion and endurance capacity. Six healthy males underwent longitudinal testing with the trunk, knee and elbow in 10 different (straight and bent) postures. The load heights (LH) of 320, 440, 850 and 1250 mm from the floor level with subject-load-distance (S-L-D) of 120 and 320 mm were used. It was noted that the level and duration of force exertion were higher when the load was placed closer to the body. The endurance times were consistently high with the increase in LH, highest being recorded in Position 9 - i e, with the load placed at the shoulder level and S-L-D of 120 mm. As evident from MVC and endurance times, the back straight/knee bent postures may not be preferred to back bent postures.

An experimental evaluation of psychophysical criteria for repetitive lifting work

Two experiments were performed to test the reliability and validity of psychophysically determined maximum acceptable workloads for setting lifting standards. The perceived workload in a repetitive diagonal lifting task was found to be a positively accelerated function of the weight lifted and of the work pace respectively. A twofold increase in objective workload resulted in a four- to fivefold increase in perceived workload. This relation was independent of previous occupational experience of lifting work. The psychophysically assessed maximum acceptable workloads for this type of lifting task appeared to be satisfactorily reproducible when subjects had to adjust work pace or when they were left free to adjust both the weight and the work pace. However, the results raised several questions concerning the applicability of the psychophysical assessment of maximum acceptable lifting work. Slight changes in the instructions given to the subjects had a definite effect on the selection of workloads. Furthermore, the workloads selected by subjects with previous occupational experience of lifting work - i e, warehouse workers - were systematically lower than those selected by subjects without such previous experience - i e, office employees. At the same time, the warehouse workers rated perceived exertion higher than the office employees, indicating that previous occupational experience of lifting work enhanced the subjective assessment of physical effort. There were no consistent relations between the workloads found acceptable by the subjects and their physical characteristics and performance capacity.

Maximum acceptable lifting loads during seated and standing work positions

The psychophysical method was used to determine the maximal acceptable load that eight males (age 22-30 years) would lift in each of four different positions: (1) seated, two-handed, symmetrical lift from a table, to a position 38 cm forward of the edge, (2) a seated lift from a position at the subject's side, on to a table in front of the subject involving a 90 degree twist of the torso, (3) standing, two-handed, symmetrical lift from the table, to a position 38 cm forward of the edge, and (4) standing, vertical lift from 86 above the floor. Subsequent to a training period, subjects lifted a tray with slotted handles at the rate of 1 or 4 lifts/min. Each subject chose the weight of the tray which was acceptable to him by adding or removing flat pieces of lead over a 45 min period. The weight of the tray, heart rate, and the perceived exertion were measured at 15, 30 and 45 min. Oxygen consumption was measured during the last 5 min of the 45 min experiment. Statistical analysis revealed a significant frequency and position effect. An increase in frequency from 1 to 4 lifts/min resulted in a decrease of 1.6 to 2.1 kg in the maximum acceptable weight for the various tasks. On average, the maximum acceptable weight of lift for standing positions was 16% greater than for sitting positions. Oxygen consumption and heart rate were significantly higher for 4 lifts/min than for 1 lift/min; however, the rating of perceived exertion did not differ for any factor.

Maximum frequencies acceptable to males for one-handed horizontal lifting in the sagittal plane

Male volunteers participated in an experiment to determine the maximum frequencies they could maintain for 2 h while lifting in the horizontal-sagittal plane using the preferred hand. The psychophysical approach was used to determine the maximum acceptable frequencies of lift for sitting and standing postures at two reach distances. Subjects were trained for six weeks. During the experiment, heart rate, ratings of perceived exertion of the back, shoulder, and arm, and the maximum acceptable frequency of lift were recorded every 15 min for 2 h. Results of this study indicate that subjects, for two hours, can maintain frequency of lifting equivalent to 51% of the maximum frequency acceptable to them for a 4-min period. Although heart rate did stabilize over the 2-h period, ratings of perceived exertion showed continuous increase. Due to training, the maximum acceptable frequency of lift increased on the average by 7.23%. Subjects accepted maximum work rate for a 4.54-kg load. Data were also collected on three females, and these were compared with data from a past study. Differences in the two studies were observed.

Physiological and psychological indices of fatigue during static contractions

The development of fatigue and the relationship between psychological and physiological indices of fatigue were studied in a group of 18 male subjects during static contractions. Exercise was performed as a static elbow flexion at 25% MVC. Heart rate (HR), intraarterial blood pressure (BP) and surface EMG [mean amplitude (MA) and central frequency (CF)] were studied during contractions sustained until exhaustion. The amount of effort expended (relative to total exhaustion) and the rating of perceived pain were recorded following contractions interrupted after 20, 30 . . . 80, and 100% of endurance time. HR, BP and EMG amplitude responses were similar to those previously recorded. The decline in CF occurred in two phases, possibly related to a change in motor unit recruitment after the initial 70% of endurance time. The subjects overestimated the amount of effort expended and thus underestimated their endurance capacity. The best correlation between perceived effort and physiological responses was obtained using blood pressure data, whereas changes in EMG data did not parallel the psychological responses. It is concluded that the perception of effort during a static contraction is produced through a complex process, in which several influences of peripheral and central origin are integrated.