Naira Campbell-Kyureghyan

Effects of foot placement, hand positioning, age and climbing biodynamics on ladder slip outcomes

Ladder falls frequently cause severe injuries; yet the factors that influence ladder slips/falls are not well understood. This study aimed to quantify (1) the effects of restricted foot placement, hand positioning, climbing direction and age on slip outcomes, and (2) differences in climbing styles leading to slips versus styles leading to non-slips. Thirty-two occupational ladder users from three age groups (18–24, 25–44 and 45–64 years) were unexpectedly slipped climbing a vertical ladder, while being assigned to different foot placement conditions (unrestricted vs. restricted toe clearance) and different hand positions (rails vs. rungs). Constraining foot placement increased the climbers likelihood of slipping (p < 0.01), while younger and older participants slipped more than the middle-aged group (p < 0.01). Longer double stance time, dissimilar and more variable foot and body positioning were found in styles leading to a slip. Maintaining sufficient toe clearance and targeting ladder safety training to younger and older workers may reduce ladder falls. Practitioner Summary: Ladder falls frequently cause severe occupational fall injuries. This study aims to identify safer ladder climbing techniques and individuals at risk of falling. The results suggest that ladders with unrestricted toe clearance and ladder climbing training programmes, particularly for younger and older workers, may reduce ladder slipping risk.

Biomechanical response to ladder slipping events: Effects of hand placement

Ladder falling accidents are a significant, growing and severe occupational hazard. The factors that contribute to falls from ladders and specifically those that influence the motor response from ladder falls are not well understood. The aims of this research were to determine the effects of hand placement (rung versus rail) on muscle activation onset and peak activity timing in response to slipping on a ladder and to sequence the timing of events following slip initiation. Fifteen unexpected slips from 11 experienced ladder climbers were induced with a freely spinning rung under the foot, while subjects were randomly assigned to a rung versus rail hand grasping strategy. EMG onset time and peak activity time from five bilateral muscles (semitendinosis, vastus lateralis, triceps, biceps and anterior deltoid) were analyzed. Results indicated that significantly slower muscle activation onset and peak response times occurred during rail hand placement, suggesting that grasping ladder rungs may be preferable for improving the speed of the motor response. The triceps muscle activated and reached peak activity earlier in the slip indicating that subjects may initially extend their arms prior to generating hand forces. The study also revealed that slips tended to occur around the time that a foot and hand were in motion and there were just two points of contact (one hand and the slipping foot).

Biomechanics of Lower Limbs during Walking among Candidates for Total Knee Arthroplasty with and without Low Back Pain

The effect of joint pathologies, such as unilateral knee osteoarthritis (UKOA) or low back pain (LBP), on bilateral gait symmetry has gained increased attention during the past decade. This study is the first to compare gait patterns between patients with UKOA and LBP in combination and with UKOA only. Temporal, kinematic, and kinetic variables were measured bilaterally during gait stance phase in 31 subjects with UKOA and LBP (Group I) and 11 subjects with only UKOA (Group II). Group I patients exhibited less hip rotation in the affected limb (A) than in the nonaffected (NA) limb during walking in contrast to Group II patients. Group I patients had minimal bilateral differences in hip abduction and flexion, but Group II patients displayed significantly larger values in the NA limb compared to the A limb for both parameters. Hip flexion patterns were significantly different between Groups I and II. Subjects in both groups adapted gait patterns that minimized vertical ground reaction force, knee flexion motion, and stance time on the UKOA affected limb. The distinct kinematic gait patterns that were revealed in this study may provide clinical value for assessment of patients with UKOA in conjunction with LBP.

Effect of orientation on measured failure strengths of thoracic and lumbar spine segments.

Substantial research has been performed over many years to determine the compressive failure limits of spinal motion segments. However, the majority of studies have not considered the natural alignment of the spine, testing only for pure compression loads. This study tested 27 motion segments, ranging from the T6/T7 to L4/L5 levels, from 13 human cadaveric spines. The segments were oriented in either the neutral position, based on Harrison posterior tangent angles, or in-line axially. Load was applied at a low rate, reducing dynamic effects and in contrast to previous studies, until failure was observed. Force and deformation were measured during testing, with the normalized parameters of stress and strain calculated post-test. Failure forces, adjusted for bone mineral density, were found to decrease by 11% in lumbar segments when oriented while thoracic segment adjusted failure force also decreased by 4.5%. Similarly, orientation decreased failure stress by 12% for lumbar segments and increased it by 25% for thoracic segments. Some correlation was found between failure strength and bone mineral density. After testing, all segments were visually examined to determine the failure mode, and DXA and radiographic scans were performed. Oriented segments exhibited different fracture characteristics than non-oriented segments. The results indicate that segment orientation has a significant effect on failure strength, stress, and strain, and should be considered when determining appropriate load limits.

Ergonomic evaluation of a wheelchair transportation securement system

The Americans with Disabilities Act (ADA) specifies guidelines covering the securement system and environment for wheeled mobility device (WhMD) passengers on the public bus system in the United States, referred to as the wheelchair tiedown and occupant restraint system (WTORS). The misuse or disuse of the WTORS system can be a source of injury for WhMD passengers riding the buses. The purpose of this study was to quantify the risks posed to the bus driver while performing the WTORS procedure using traditional ergonomic analysis methods. Four bus drivers completed the WTORS procedure for a representative passenger seated in three different WhMDs: manual wheelchair (MWC), scooter (SCTR), and power wheelchair (PWC). Potential work-related risks were identified using the four most applicable ergonomic assessment tools: PLIBEL, RULA, REBA, and iLMM. Task evaluation results revealed high levels of risk to be present to drivers during the WTORS procedure. The securement station space design and equipment layout were identified as contributing factors forcing drivers to adopt awkward postures while performing the WTORS task. These risk factors are known contributors to injury and the drivers could opt to improperly secure the passengers to avoid that risk.

A retrospective study of the relationship between back pain and unilateral knee osteoarthritis in candidates for total knee arthroplasty.

The purpose of this study was to determine the presence and temporal relationship between back pain and knee osteoarthritis (OA). All subjects were candidates for unilateral total knee arthroplasty (TKA) to relieve knee pain related to OA, and information regarding the prevalence of back pain was collected via questionnaires. A total of 42 subjects with unilateral knee OA responded to the questionnaires, and 74% of subjects reported chronic back pain, which first occurred approximately 10 years before their becoming candidates for TKA. All but 1 subject reported the onset of back pain prior to TKA candidacy, and less than 15% of subjects felt that their worst back pain occurred after the onset of knee OA. The results of this study are a first step toward quantifying the temporal relationship between back pain and unilateral knee OA, and future studies will look to assess potential risk factors for knee OA such as strength, biomechanical, and anatomical asymmetry.

Can the Revised NIOSH Lifting Equation Predict Low Back Pain Incidence in a '90-day-pain-free-cohort'?

LBP is a major public health concern with enormous human and economic burden. The validity of the Revised NIOSH Lifting Equation (RNLE), a widely used job assessment tool, has not been studied previously in individuals with past LBP. The primary aim of this research was to study the relationship between RNLE measures and incident LBP episode risk after a 90-day pain free period using a prospective study design. One hundred and thirty industrial workers were identified as eligible to become an incident case for LBP. Univariate relationships between RNLE measures and incidence of LBP episode were studied using the Cox proportional hazards model. Significant associations between RNLE measures and incident LBP risk were found. It is concluded that the RNLE is predictive of incident LBP episode risk in individuals with past pain.

Is there a reliable and invariant set of muscle synergy during isometric biaxial trunk exertion in the sagittal and transverse planes by healthy subjects

It has been suggested that the central nervous system simplifies muscle control through basic units, called synergies. In this study, we have developed a novel target-matching protocol and used non-negative matrix factorization (NMF) technique to extract trunk muscle synergies and corresponding torque synergies. Isometric torque data at the L5/S1 level and electromyographic patterns of twelve abdominal and back muscles from twelve healthy participants (five females) were simultaneously recorded. Each participant performed a total number of 24 isometric target-matching tasks using 12 different angular directions and 2 levels of uniaxial and biaxial exertions. Within- and between-subject similarities were assessed by considering both the data of different pairs of participants, where the activation coefficients of one participant were used in the NMF analysis of another participant, and the Pearsons correlation coefficients (R) between muscle synergy vectors. The results showed that, for a healthy person, a set of four muscles (overall variance accounted for (VAF) of 97.9 ± 0.53%) and four corresponding torque synergies (overall VAF of 92.2 ± 3.03%) could efficiently decompose the sagittal and transverse torque planes into their main directions. Furthermore, the correlation coefficients were 0.77 ± 0.12, 0.86 ± 0.08, 0.78 ± 0.12, and 0.93 ± 0.04, for all synergies, reflecting the consistency of muscle synergies across participants. Overall, our results suggest that by taking advantage of muscle synergies we could potentially overcome the redundancy inherent to control strategies of the trunk neuromuscular system. In future studies, the synergies identified in patients with low back pain could be compared with those extracted from healthy participants towards various clinical and rehabilitation applications.

Impact of lightweight and conventional jackhammers on the operator

Jackhammer manufacturers have recently developed lightweight (45-60 lbs) jackhammers intended to reduce the required lifting and pushing forces during operation. However, the vibration characteristics of the lightweight jackhammers and their effect on muscle activity are currently unknown. The objective of this study was to compare the measured vibration and muscle activity between: (i) conventional (90 lb) and light weight (60 lb) jackhammers, (ii) different pavement type/thickness combinations, and (iii) pneumatic and hydraulic jackhammers. Five jackhammers were tested on 4 and 6 inch thick asphalt and concrete pavements by four experienced operators. Analysis of the results revealed that both weight classes averaged 9.7 m/s(2) at the 20 Hz weighted 1/3 octave band frequency, and the TLV of daily exposure for either weight class of jackhammer was less than 1.5 hours/per day. There was an approximately 33% difference in vibration measured on the hand of the operators due to pavement thickness, 30% due pavement type, and no difference due to power source. Conventional jackhammers overall produced higher muscle activity than lightweight jackhammers. Although selection of the correct jackhammer for the job involves many factors including pavement type and thickness, the results of this research can be used to assist in selecting the appropriate jackhammer.

Influence of Jackhammer Weight on Grip Pressure, Muscle Activity, and Hand–Arm Vibration of the Operator

OCCUPATIONAL APPLICATIONS The conventional (41 kg) jackhammer is most commonly used in construction, and it is widely believed that a lighter jackhammer would be less effective or unable to perform certain tasks. We compared the performance of two hammers (conventional and 35% lighter) at breaking a 15 cm reinforced concrete slab, and found that some trade-offs exist between the two. Benefits of using a 35% lighter tool were mainly in reduction of muscle activity, shorter lifts, and some reduction in grip pressure. However, the lighter tool resulted in an elevated vibration dose, mainly due to an increase in task time though there were no major changes in vibration magnitude measured on the hand. Based on these results, a lightweight jackhammer may be suitable for breaking a concrete slab, and could provide a two-fold reduction in low-back injury risk due to lifting, as well as allow a population with a larger range of strength and stature to perform this task. TECHNICAL ABSTRACT Background: Construction and utility workers traditionally use 40 kg jackhammers to break pavement, and this task involves exposures to several injury risk factors. Lighter jackhammers are not commonly utilized, as it is commonly believed that they would not be able to perform the task. While some preliminary research by our team has determined that lightweight jackhammers can perform the wide range of tasks required for breaking pavement, the benefits/limitations of using a lightweight jackhammer have not been fully explored. Purpose: To perform a biomechanical evaluation of and quantify the difference between operating a conventional and a lightweight jackhammer during the lifting and operating phases. Methods: Twelve volunteer jackhammer operators were instructed to break a 0.9 m × 0.9 m section of 15 cm thick reinforced concrete along pre-painted diagonal lines. Two pneumatic jackhammers were used: a lightweight jackhammer (27 kg) and conventional jackhammer (41 kg). Throughout each task, upper-body muscle activity, task time, grip pressure, and vibration magnitude and frequency were measured. Results: Using the lightweight jackhammer resulted in a 58% increase in task time and consequently resulted in increasing the partial vibration dose value by 36%. Nevertheless, 40% less muscle activity was required to lift the lighter jackhammer and 25% less upper-body muscle activity was used during the operational phase. Surprisingly, an inverse relationship was found between grip pressure and hand–arm vibration for both jackhammer weights. Conclusions: A reduction in jackhammer weight offers some potential biomechanical benefits to the operator, specifically reducing the overall muscular effort during task performance and up to two-fold reduction in muscular demands due to lifting, as well as a reduction in grip pressure. Potential adverse effects of the lightweight jackhammer are an increased task time and duration-adjusted vibration dose.