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Understanding Behavioral and Physiological Changes Associated with Repetitive Lifting and Vibration Exposure

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Understanding Behavioral and Physiological Changes Associated with Repetitive Lifting and Vibration Exposure Understanding Behavioral and Physiological Changes associated with Repetitive Lifting and Vibration Exposure DISSERTATION Presented in Partial Fulfillment of the Requirements for the Degree Doctor of Philosophy in the Graduate School of The Ohio State University By Jay Paresh Mehta Graduate Program in Industrial and Systems Engineering The Ohio State University 2013 Dissertation Committee: Steven A. Lavender, Advisor Carolyn M. Sommerich Richard J. Jagacinski Copyright by Jay Paresh Mehta 2013 Abstract Repetitive manual lifting and whole body vibration (WBV) exposure encountered in manual handling and delivery type jobs lead to muscle fatigue and are documented risk factors for low back disorder (LBD). The increased rate of muscle fatigue with WBV exposure in delivery occupations is thought to increase the rate of fatigue development during the lifting components of these jobs. In order to compensate for muscle fatigue, people in these occupations may adapt their working strategy to prevent an injury, however, little is known about these adaptive strategies and their effects on LBD risk. Hence, the goal of this dissertation research was to identify the interactive effects of WBV and repetitive lifting exposures on muscle fatigue and changes in lifting mechanics. Study 1 investigated the effects of prolonged repetitive asymmetric lifting task on behavioral adaptations, measures of tissue oxygenation, and spine kinematics during a controlled flexion-extension motion task. Seventeen healthy volunteers repeatedly lifted a box (normalized to 15% of the participant’s lifting capacity) positioned in front of them at ankle level to a location on their left side at waist level at the rate of 10 lifts/minute for a period of 60 minutes. The results showed that this prolonged asymmetric lifting task lead to the development of muscle fatigue observed as a decrease in tissue oxygenation measures (objective) and an increase in the level of perceived exertion (subjective) over ii time. Behavioral changes with repetitive lifting task included an increase in forward bending motions and velocities in the sagittal and coronal plane. Additionally, the overall lift duration and lateral bending moment of the spine decreased with the repetitive lifting task. Further, significant correlations between muscle physiology measures and changes in spine kinematics and moment measures suggest these behavioral strategies were associated with the development of muscle fatigue. Behavioral measures that increased over time have also been documented to increase the risk of back injury. Study 2 investigated the interactive effects of seated vibration exposure and lifting task precision demands on behavioral and physiological changes experienced during a repetitive lifting task. This study was a 2 x 2 repeated measures design with two levels of vibration exposure (WBV and no-WBV) and two levels of lifting task precision demands (High and Low). The initial analyses from study 2 showed no significant interaction between WBV exposure and task precision demands during the repetitive lifting task. Thus, the data was separately analyzed in study 2a and 2b to understand changes in the physiological and behavioral responses associated with each of these physical factors. Study 2a focused on the changes in the physiological and behavioral responses to repetitive asymmetric lifting activity after seated exposure to a 5 Hz sinusoidal WBV for one-hour. Seventeen healthy individuals performed the same repetitive asymmetric lifting task as used in study 1 during two experimental sessions. However, prior to initiating the lifting, the participants were seated on a vibrating platform for 60 minutes. In one of the two sessions the platform did not vibrate. The changes in muscle physiology and behavioral measures observed over the 60 minute sessions replicated the findings from iii study 1. Following exposure to WBV, participants twisted more and did so at a higher movement velocity as they performed the lifting task. In addition to the changes in the magnitude of these responses, the variability (standard deviations) in the lateral bending moment and extension velocity of the spine increased during the lifting that followed WBV exposure. While the increased variability may suggest compensatory mechanisms to prolong the fatigue development process, the larger spine kinematic and moment response indicated these changes would increase the risk of back injury. Study 2b focused on the effect of task precision demands during a repetitive asymmetric lifting task on muscle physiology and behavioral measures. Seventeen healthy individuals performed the repetitive lifting task for 60 minutes where the task precision demands on the lifting task were varied by changing the width of the destination conveyor. High precision demands resulted in significantly higher movement times that were largely due to significantly longer placement periods. With high task precision demands, larger sustained twisting motions and lateral bending moments on the spine were observed when placing the box on the conveyor. These behavioral changes suggest that the risk to low back injury is elevated while performing a repetitive asymmetric lifting activity under high task precision demands. In summary, this research has shown that the risk of low back injury while performing a fatiguing repetitive asymmetric lifting activity is likely due to changes in the adopted behavior. Specifically, the increase in spine laxity, along with a shift towards ballistic movement behavior may increase spinal loading, strains on specific tissues, and thereby increase the risk of injury. Moreover, this risk is further elevated when people are iv exposed to WBV prior to lifting, and when the lifting requires the object be placed in precise location at its destination. v Dedication This document is dedicated to my grandparents. vi Acknowledgments This dissertation research would not have been possible without the guidance I received from my advisor and committee members, support from colleagues, friends and family. I would like to take this opportunity to thank several people that have been an integral part of this journey. I would like to sincerely thank my advisor Dr. Steven A. Lavender for his patience, and providing me with an excellent environment for conducting research. This dissertation could not have been completed without his continual guidance, support and motivation that he provided throughout the years. I would like to express my sincere gratitude to my committee members Dr. Carolyn M. Sommerich and Dr. Richard J. Jagacinski for their constant feedback, criticism and advice they provided throughout the completion of this research. I am grateful to Dr. Sue Ferguson for being available and providing her expertise on the Near-Infrared Spectroscopy system. I am thankful to Joshua Hassenzahl for his input and assistance in designing the conveyor system and mount for the vibration chair assembly. vii I believe labmates are work family and I would like to thank Sanghyun Park and Radin Zaid Radin Umar for their assistance in collecting data for pilot work and more importantly being there in my academic highs and lows. Finally, I would like to thank my family and friends for their love, support and understanding during the long years of my education and always setting higher goals for me to strive for the better. viii Vita 2002-2006………………………………………….......Bachelor of Engineering, Biomedical Engineering, Mumbai University 2006-2008………………………………………….......Master of Science, Biomedical Engineering, Marquette University 2009-Present…………………………………………...Graduate Research Associate, Integrated Systems Engineering, The Ohio State University Publications Mehta, J.P., Kim, T., Lavender, S.A. (2013). Effects of transfer distance on spine kinematics for de-palletizing tasks. Journal of Occupational & Environmental Hygiene, (accepted for publication). Lavender, S.A., Hedman, G.E., Mehta, J.P., Reichelt, P.A., Conrad, K.M., Park, S. (2013). Evaluating the Physical Demands on Firefighters Using Hand-Carried Stair Descent Devices to Evacuate Mobility-Limited Occupants from High-Rise Buildings. Applied Ergonomics (in press). ix Lavender, S. A., Mehta, J. P., & Allread, W. G. (2013). Comparisons of tibial accelerations when walking on a wood composite vs. a concrete mezzanine surface. Applied Ergonomics, 44 (5), 824-827. Sommerich, Carolyn M., Steven A. Lavender, Radin Zaid Radin Umar, Peter Le, Jay Mehta, Pei-Ling Ko, Rafael Farfan, Mohini Dutt, and SangHyun Park. (2012). A biomechanical and subjective assessment and comparison of three ambulance cot design configurations. Ergonomics, 55 (11), 1350-1361. Mehta, J, Verber, M., Wieser, J, Schmit, B., Schindler-Ivens, S. (2012). The Effect of Movement Rate and Complexity on Functional Magnetic Resonance Signal Change during Pedaling. Motor Control, 16, 158-175. Mehta J, Verber M, Wieser J, Schmit BD, Schindler-Ivens S. (2009). A novel technique for examining brain activity associated with pedaling using fMRI. Journal of Neuroscience Methods, 179 (2), 230-239. Fields of Study Major Field: Industrial and Systems Engineering x Table of Contents Abstract ............................................................................................................................... ii Dedication .......................................................................................................................... vi Acknowledgments............................................................................................................
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