A physiological study of the repetitive lifting capabilities of healthy young males

Spine loading as a function of lift frequency, exposure duration, and work experience

BACKGROUND

Physiological and psychophysical studies of the effects of lifting frequency have focused on whole-body measurements of fatigue or subjective acceptance of the task and have not considered how spine loads may change as a function of lift frequency or lift time exposure. Our understanding of biomechanical spine loading has been extrapolated from short lifting bouts to the entire work day and may have led us to incorrect assumptions. The objective of this project was to document how spine loading changes as a function of experience, lift frequency, and lift duration while repetitively lifting over the course of an 8-h workday.

METHODS

Twelve novice and twelve experienced manual materials handlers performed repetitive, asymmetric lifts at different load and lift frequency levels throughout an 8-h exposure period. Compression, anterior-posterior shear, and lateral shear were evaluated over the lifting period using an EMG-assisted biomechanical model.

RESULTS

Spinal loads increased after the first 2 h of lifting exposure regardless of the lift frequency. Loading was also greater for the inexperienced subjects compared to experienced lifters. The greatest spine loads occurred at those lift frequencies and weights to which the workers were unaccustomed.

INTERPRETATION

Increases in spine loading were tracked back to the changes in muscle recruitment patterns that typically involved increased muscle coactivation. The results emphasize the importance of previous motor programming in defining spine loads during repetitive lifting. These results indicate a very different influence of frequency and lift time exposure compared to physiologic and psychophysical assessments. This study has shown that it is not sufficient to extrapolate from short lift periods to extended exposure periods if the biomechanical loading implications of the task are of interest.

Development of physical selection procedures for the British Army. Phase 2: relationship between physical performance tests and criterion tasks

This paper is the second in a series of three to describe the development of physical selection standards for the British Army. The first paper defined criterion tasks (single lift, carry, repetitive lift and carry, and loaded march tasks) and set standards on the criterion tasks for all British Army trades. The principal objective was to determine which combination of physical performance tests could be best used to predict criterion task performance. Secondary objectives included developing so-called 'gender-free' and 'gender-unbiased' models. The objectives were met by analysing performance data on the criterion tasks and a large battery of physical performance tests collected from 379 trained soldiers (mean age 23.5 (SD 4.45) years, stature 1734 (SD 79.5) mm, body mass 71.4 (SD 10.58) kg). Objective 1 was met: the most predictive physical performance tests were identified for all criterion tasks. Both single lift tasks were successfully modelled using muscle strength and fat free mass scores. The carry model incorporated muscle endurance and body size data, but the errors of prediction were large. The repetitive lift models included measures of muscle strength and endurance, and body size, but errors of prediction were also large. The loaded march tasks were successfully modelled incorporating indices of aerobic fitness, supplemented by measures of strength, endurance or body size and composition. The secondary objectives were partially fulfilled, though limitations in the data hampered the process. Although only one model (a loaded march) was gender-free, three models were gender-related (i.e. contained 'gender' explicitly in the model). The remaining six were gender-specific (i.e. were appropriate for men or for women). Owing to both a lower accuracy of prediction in women's scores and a greater tendency for the women's scores to be distributed around the pass standards, a greater percentage of women than men were misclassified as passing or failing, resulting in indirect discrimination. A validation of the models in a separate sample of the user population of recruits is reported in the third paper in this series.

Work schedule and task factors in upper-extremity fatigue

We tested the combined effects of work schedule and task factors on upper-extremity fatigue in the laboratory during 8-h and 12-h shift schedules. Participants performed a simulated manual assembly task at three repetition rates and three torque loads and self-adjusted their work cycle duration to maintain fatigue at moderate levels. Work cycle durations decreased with increases in both load level and repetition rate. Fatigue was observed more quickly with increasing time on shifts and during night shifts compared with day shifts. Work schedule effects were most apparent at lighter workloads, with minimal differences at higher workloads. The highest fatigue levels were observed during 12-h night shifts, with similar levels reached by the end of both the week of 8-h night shifts and the week of 12-h day shifts. Overall durations were 20%-30% shorter than in previous short-term studies, which was likely a result of the more realistic work schedules used in this study. Results from this study could be applied to the design of work-rest schedules for manual tasks involving the upper extremities.

Revised NIOSH equation for the design and evaluation of manual lifting tasks

In 1985, the National Institute for Occupational Safety and Health (NIOSH) convened an ad hoc committee of experts who reviewed the current literature on lifting, recommend criteria for defining lifting capacity, and in 1991 developed a revised lifting equation. Subsequently, NIOSH developed the documentation for the equation and played a prominent role in recommending methods for interpreting the results of the equation. The 1991 equation reflects new findings and provides methods for evaluating asymmetrical lifting tasks, lifts of objects with less than optimal hand-container couplings, and also provides guidelines for a larger range of work durations and lifting frequencies than the 1981 equation. This paper provides the basis for selecting the three criteria (biomechanical, physiological, and psychophysical) that were used to define the 1991 equation, and describes the derivation of the individual components (Putz-Anderson and Waters 1991). The paper also describes the lifting index (LI), an index of relative physical stress, that can be used to identify hazardous lifting tasks. Although the 1991 equation has not been fully validated, the recommended weight limits derived from the revised equation are consistent with or lower than those generally reported in the literature. NIOSH believes that the revised 1991 lifting equation is more likely than the 1981 equation to protect most workers.

Effects on efficiency in repetitive lifting of load and frequency combinations at a constant total power output

Boxes were lifted and lowered repetitively at three different combinations of load and frequency. These combinations were chosen such that the total mechanical power generated was constant. Effects of the varying load or frequency conditions (but constant total mechanical power) on the rate of energy expenditure (M) and on the mechanical efficiency (ME) were measured. Mechanical power was determined from film analysis and separated into external power (generated to lift the load) and internal power (to raise the lifter's body mass). The M was determined from oxygen consumption measurements. The ME was calculated in two ways, depending on the definition of mechanical power, including either the external power only (MEext) or the total power output (MEtot). Despite a constant total mechanical power, M increased at higher loads and lower frequencies. This might be explained by the increasing isometric force required in postural and load control. The M increase resulted in a decrease of MEtot. However, at higher loads and lower frequencies MEext increased, indicating that more external work can be done at the same energy costs at higher loads or lower frequencies, which could be of interest from the point of view of occupational physiology. It would seem that at higher loads or lower frequencies the increased costs for isometric muscle action do not outweigh the benefit of raising the body less frequently. Furthermore, it was found that the MEext in lifting was much lower than the values reported for other kinds of activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Maximal aerobic capacity for repetitive lifting: comparison with three standard exercise testing modes

A multi-stage, repetitive lifting maximal oxygen uptake (VO2max) test was developed to be used as an occupational research tool which would parallel standard ergometric VO2max testing procedures. The repetitive lifting VO2max test was administered to 18 men using an automatic repetitive lifting device. An intraclass reliability coefficient of 0.91 was obtained with data from repeated tests on seven subjects. Repetitive lifting VO2max test responses were compared to those for treadmill, cycle ergometer and arm crank ergometer. The mean +/- SD repetitive lifting VO2max of 3.20 +/- 0.42 l.min-1 was significantly (p less than 0.01) less than treadmill VO2max (delta = 0.92 l.min-1) and cycle ergometer VO2max (delta = 0.43 l.min-1) and significantly greater than arm crank ergometer VO2max (delta = 0.63 l.min-1). The correlation between repetitive lifting oxygen uptake and power output was r = 0.65. VO2max correlated highly among exercise modes, but maximum power output did not. The efficiency of repetitive lifting exercise was significantly greater than that for arm cranking and less than that for leg cycling. The repetitive lifting VO2max test has an important advantage over treadmill or cycle ergometer tests in the determination of relative repetitive lifting intensities. The individual curves of VO2 vs. power output established during the multi-stage lifting VO2max test can be used to accurately select work loads required to elicit given percentages of maximal oxygen uptake.

Determinants of load carrying ability

The aim of this paper is to review the literature in respect of the main determinants of a person's load carrying ability. Possible determinants of load carriage ability include age, anthropometry, aerobic and anaerobic power, muscle strength, body composition and gender; other relevant factors are the subjective effects perceived during load carriage, the dimensions and placement of the load, biomechanical factors, nature of the terrain and the gradient, the effect of climate and protective clothing. It is important to distinguish between the maximum load carrying capacity and load carriage ability which enables the individual to retain the capability to perform other tasks - eg, observation and navigation, or industrial tasks. The soldier has been used as the worst case example of extremely heavy loads having to be carried for long durations; civilian examples are usually less demanding except in the case of mountaineers, explorers and some occupations. The energy cost of walking with loads has been found to depend primarily upon the walking speed, body weight and load weight, together with terrain factors such as gradient and surface type; equations exist which allow the prediction of energy expenditures from these variables, and they can provide a valuable guide in assessing the physical severity of proposed tasks involving load carriage. Other factors such as the degree of environmental heat stress and protective clothing worn would have to be taken into account, but the level of energy expenditure (or heat production) assumes central importance as it is related to physical exhaustion, heat exhaustion and also less directly to the efficiency of performance of occupational task involving load carriage. This review confirms that there is no obvious definition of a maximal load, because of the widely varying circumstances which might apply, but for healthy young males there appears to be some consensus for the traditional rule of thumb of one-third body weight, or 24 kg on an assumed mean body weight of 72 kg, or in terms of relative work load equivalent to one-third of the VO(2) max for a working day. Renbourn (1954c) considered that the load carried by the soldier will probably always be a compromise between what is physiologically sound and what is operationally essential. Load carriage in industrial and other civilian areas will also involve a similar compromise and may in some circumstances lead to important implications for health and safety.

Physiological ergonomics in nursing

The majority of physiological ergonomic studies of nursing are concerned with shift- and night-work and associated circadian rhythm adjustments and influences on job performance. The aerobic demand of medical nursing has not been extensively studied. The aerobic capacity of nurses has not been assessed systematically. Studies of this type are clearly required within an ergonomic framework with particular emphasis on the flexibility and (upper body) strength components of nurses functional capacities in relation to the physical demands of nursing tasks. As health educators, the nursing profession should seriously consider taking a practical lead in espousing the ergonomic process and advocating the health benefits of exercise (together with good diet and smoking cessation.)

Effects of sustained manual work and partial sleep deprivation on muscular strength and endurance

In a military field artillery trial, the effects of 8 days of sustained manual work and partial sleep loss on isometric right hand grip strength and upper and lower body anaerobic power (using the Wingate test) was investigated in 25 healthy young male soldiers. During the trial, the physical activity of each subject was essentially identical except that an experimental group (n = 18) manually handled a large quantity of artillery shells (weighing 45 kg) and charges (13 kg), whilst a control group (n = 7) merely simulated manual handling activities and did no lifting or loading of shells. The daily amount of sleep obtained by each group was similar (3 to 4 hours), as were their activity patterns and food and fluid intake. Isometric right hand grip strength for both groups fell progressively during the trial and did not return to pre-trial levels during 3 days of recovery. At the end of the 8 day trial, there were statistically significant reductions in the body weight (1.9%, p less than 0.001), % body fat (7.1%, p less than 0.001) and upper body mean power (7.3%, p less than 0.01) of the experimental group but not in the controls. Lower body peak and mean power were significantly increased at the end of the trial in both the experimental (14.7%, p less than 0.001 and 17.0%, p less than 0.001 respectively) and control (14.3%, p less than 0.01 and 15.0%, p less than 0.05 respectively) groups. Lower body power decrease was significantly increased (18.1%, p less than 0.05) in the experimental group but not in the controls.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparison of the effects of mixed static and dynamic work with mainly dynamic work in hot conditions

Current physiological criteria for limiting work in hot conditions are frequently based on responses to mainly dynamic work (eg treadmill walking). Their applicability to industrial situations containing mixed static and dynamic work is questioned, since the physiological responses to static work are different from those of dynamic work. Each of eight subjects attempted a one hour uphill treadmill walk (mainly dynamic work), and an uphill treadmill walk whilst intermittently carrying a 20 kg weight in the arms (mixed static and dynamic work). The external work rates in the two conditions were equal, effected by lowering the treadmill gradient in the loaded condition. Experiments were conducted in a hot climate (33 degrees C dry bulb, 25 degrees C wet bulb). Oxygen consumption, minute ventilation, sweat rate and rated perceived exertion were all significantly higher (p less than 0.001) for the mixed static and dynamic work than for the dynamic work. This was also the case for heart rate and forearm skin temperature (p less than 0.01), and for auditory canal temperature (p less than 0.05). There was no significant difference between the two types of work for mean skin temperature, calf skin temperature and chest skin temperature. These results show that for the same external work, physiological strain and perceived exertion are greater for mixed static and dynamic work (carrying a load in the arms) than for mainly dynamic work (walking on a treadmill). They suggest that it is not appropriate to make direct comparisons of laboratory studies based on dynamic work, with practical situations containing mixed static and dynamic work in the heat.