Browsing by Author "Nussbaum, Maury A."

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    Age-related strength loss affects non-stepping balance recovery
    Koushyar, Hoda; Bieryla, Kathleen A.; Nussbaum, Maury A.; Madigan, Michael L. (Public Library of Science, 2019-01-18)
    Aging is associated with a higher risk of falls, and an impaired ability to recover balance after a postural perturbation is an important contributing factor. In turn, this impaired recovery ability likely stems from age-related decrements in lower limb strength. The purpose of this study was to investigate the effects of age-related strength loss on non-stepping balance recovery capability after a perturbation while standing, without constraining movements to the ankle as in prior reports. Two experiments were conducted. In the first, five young adults (ages 20–30) and six community-dwelling older adults (ages 70–80) recovered their balance, without stepping, from a backward displacement of a support surface. Balance recovery capability was quantified as the maximal backward platform displacement that a subject could withstand without stepping. The maximal platform displacement was 27% smaller among the older group (11.8±2.1 cm) vs. the young group (16.2±2.6 cm). In the second experiment, forward dynamic simulations of a two-segment, rigid-body model were used to investigate the effects of manipulating strength in the hip extensors/flexors and ankle plantar flexors/dorsiflexors. In these, typical age-related reductions in strength were included. The model predicted lower maximal platform displacements with age-related reductions only in plantar flexion and hip flexion strength. These findings support the previously reported age-related loss of balance recovery ability, and an important role for plantar flexor strength in this ability. © 2019 Koushyar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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    Alterations and Asymmetries in Trunk Mechanics and Neuromuscular Control among Persons with Lower-Limb Amputation: Exploring Potential Pathways of Low Back Pain
    Hendershot, Bradford Donald (Virginia Tech, 2012-08-02)
    Low back pain (LBP) is a substantial secondary disability among persons with lower-limb amputation (LLA). Abnormal mechanics of movement subsequent to LLA may increase the stability demands on the spinal column, and repetitive exposures to such abnormal movements may alter trunk passive properties and/or the coordination of surrounding trunk muscle responses. Further, preferential use of the sound limb may lead to asymmetries in these behaviors. Spine biomechanics (e.g., loading and stability) are substantially influenced by trunk passive properties and neuromuscular control, and alterations in these behaviors are associated with abnormal mechanics of the spinal column and an increased LBP risk. However, there is limited evidence regarding whether prolonged repeated exposures to abnormal gait and movement resulting from LLA and subsequent repeated use of a prosthetic device affect these trunk behaviors. Eight males with unilateral LLA and a matched sample of non-amputation controls completed three studies in which several measures of trunk passive properties, neuromuscular control, and spine biomechanics were quantified using laboratory experiments and biomechanical analyses. Each study involved a distinct task to investigate potential alterations and/or asymmetries in trunk passive properties and neuromuscular control. The first study used a seated balance task to assess trunk postural control and stability. The second study used multidirectional trunk perturbations to assess trunk mechanical and neuromuscular behaviors. Finally, the third study used controlled quasi-static trunk movements to assess load-sharing mechanisms between active and passive low back tissues. Significant alterations and asymmetries in trunk passive properties and trunk neuromuscular responses were present among participants with LLA, specifically reduced and asymmetric trunk stiffness and reflex response; decreased and asymmetric passive contributions to trunk movements; and increased trunk muscle activities. Significant increases in trunk postural sway and trunk muscle activities were also present during seated stability measures. Such alterations in these behaviors may be a result of repetitive exposures to abnormal gait and movement subsequent to LLA and the use of a prosthetic device, and could play a contributing role in the development of LBP in this population. Future work should investigate the temporal relationship between altered trunk behaviors and repeated exposure to abnormal gait and movement subsequent to LLA, to better identify critical years for rehabilitation and preventative care.
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    Analysis of Performance Resulting from the Design of Selected Hand-Held Input Control Devices and Visual Displays
    Spencer, Ronald Allen (Virginia Tech, 2000-08-18)
    Since the introduction of graphical user interfaces (GUI), input control devices have become an integral part of desktop computing. When interfacing with GUIs, these input control devices have become the human's primary means of communicating with the computer. Although there have been a number of experiments conducted on pointing devices for desktop machine, there is little research on pointing devices for wearable computer technology. This is surprising because pointing devices are a major component of a wearable computer system, allowing the wearer to select and manipulate objects on the screen. The design of these pointing devices will have a major impact on the ease with which the operator can interact with information being displayed (Card, English, and Burr, 1978). As a result, this research is the first in a series to investigate design considerations for pointing devices and visual displays that will support wearable computer users. Twenty soldiers participated in an experiment using target acquisition software with five pointing devices and two visual displays. The findings of the research strongly support the use of a relative mode-pointing device with rotational characteristics (i.e. trackball or thumbwheel) over other designs. Furthermore, the results also suggest that there is little difference between pointing devices operated with the thumb and index finger for target acquisition tasks. This study has also showed that there were little differences in pointing and homing time for pointing devices across the two visual displays. Finally, the study demonstrated that the Fitts' law model could be applied to hand-operated pointing devices for wearable computers. This is important because it allows the future development of pointing devices to be compared with the devices tested in this research using the Fitts' Law Index of Performance calculations.
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    Analytic Assessment of Collision Avoidance Systems and Driver Dynamic Performance in Rear-End Crashes and Near-Crashes
    McLaughlin, Shane Brendan (Virginia Tech, 2007-10-30)
    Collision avoidance systems (CASs) are being developed and fielded to reduce the number and severity of rear-end crashes. Kinematic algorithms within CASs evaluate sensor input and apply assumptions describing human-response timing and deceleration to determine when an alert should be presented. This dissertation presents an analytic assessment of dynamic function and performance CASs and associated driver performance for preventing automotive rear-end crashes. A method for using naturalistic data in the evaluation of CAS algorithms is described and applied to three algorithms. Time-series parametric data collected during 13 rear-end crashes and 70 near-crashes are input into models of collision avoidance algorithms to determine when the alerts would have occurred. Algorithm performance is measured by estimating how much of the driving population would be able to respond in the time available between when an alert would occur and when braking was needed. A sensitivity analysis was performed to consider the effect of alternative inputs into the assessment method. The algorithms were found to warn in sufficient time to permit 50–70% of the population to avoid collision in similar scenarios. However, the accuracy of this estimate was limited because the tested algorithms were found to alert too frequently to be feasible. The response of the assessment method was most sensitive to differences in assumed response-time distributions and assumed driver braking levels. Low-speed crashes were not addressed by two of the algorithms. Analysis of the events revealed that the necessary avoidance deceleration based on kinematics was generally less than 2 s in duration. At the time of driver response, the time remaining to avoid collision using a 0.5g average deceleration ranged from â 1.1 s to 2.1 s. In 10 of 13 crashes, no driver response deceleration was present. Mean deceleration for the 70 near-crashes was 0.37g and maximum was 0.72g. A set of the events was developed to measure driver response time. The mean driver response time was 0.7 s to begin braking and 1.1 s to reach maximum deceleration. Implications for collision countermeasures are considered, response-time results are compared to previous distributions and future work is discussed.
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    Applications of Motor Variability for Assessing Repetitive Occupational Tasks
    Sedighi, Alireza (Virginia Tech, 2017-06-07)
    The human body has substantial kinetic and kinematic degrees-of-freedoms, so redundant solutions are available for the central nervous system (CNS) to perform a repetitive task. Due to these redundancies, inherent variations exist in human movement, called motor variability (MV). Current evidence suggests that MV can be beneficial, and that there is an inverse association between MV and risk of injury. To better understand how the CNS manipulates MV to reduce injury risks, we investigated the effects of individual differences, task-relevant aspects, and psychological factors as modifiers of MV. Earlier work found that experienced workers adapted more stable movements than novices in repetitive lifting tasks. To expand on this, we quantified how MV differs between experienced workers and novices in different lifting conditions (i.e., lifting asymmetry and fatigue). Three different measures (cycle-to-cycle SD, sample entropy, and the goal equivalent manifold) were used to quantify MV. In a symmetric lifting task, experienced workers had more constrained movement than novices, and experienced workers exhibited more consistent behavior in the asymmetric condition. Novices constrained their movements, and could not maintain the same level of variability in the asymmetric condition. We concluded that experienced workers adapt stable or flexible strategies depending on task difficulty. In a prolonged lifting task, both groups increased their MV to adapt to fatigue; they particularly increased variability in a direction that had no effects on their main task goal. Developing fatigue also makes it difficult for individuals maintain the main goal. Based on these results, we conclude that increasing variability is an adaptive strategy in response to fatigue. We also assessed variability in gait parameters to compare gait adaptability using a head-worn display (HWD) compared with head-down displays for visual information presentation. An effective strategy we observed for performing a cognitive task successfully during walking was to increase gait variability in the goal direction. In addition, we found that head-up walking had smaller effects on MV, suggesting that HWDs are a promising technology to reduce adverse events during gait (e.g., falls). In summary, these results suggest that MV can be a useful indicator for evaluating some occupational injury risks.
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    An Approach to Identify Effective Learning Outcomes for a Training Program
    Lee, Yoon Suk (Virginia Tech, 2007-12-14)
    Low back disorders (LBDs) are one of the most commonly occurring injuries in industry. To attempt to reduce these work-related injuries, billions of dollars are being budgeted for formal training in the U.S. However, the outcomes of this training are below a satisfactory level. The majority of organizations utilize the Four-level Evaluation Model to evaluate their training program. However, previous studies have pointed out some limitations regarding this evaluation model. Moreover, most organizations collect only trainee reaction, the first level of the Four-level Evaluation Model, to determine the effectiveness of their training program. Many studies reveal that trainee reaction is an invalid indicator to determine the effectiveness of a training program, and further suggest multi-dimensional categorization within each level of the Four-level Evaluation. Therefore, in this study, the Revised Bloom's Taxonomy was employed to enable multidimensional categorization of learning outcomes in a lifting and lowering training program. The learning outcomes of interest in such a training program relate to procedural knowledge and the cognitive process involved are categorized as remembering, understanding, applying, and evaluating the contents of the training program. Two research questions were asked. What types of learning outcomes are most predictive of training performance? How do the learning outcomes predict training performance compared to affective and utility type reactions? The ability of different types of learning outcomes to predict training performance was tested by multiple regression analyses. The results revealed that apply-procedural learning outcomes and the interaction variable of understand-procedural and apply-procedural learning outcomes were the most predictive of training performance. Further, these learning outcomes were more predictive of training performance than the trainee reactions (affective and utility type reactions) to explain training performance. The results of this study yielded a set of recommendations that may be useful in designing and evaluating lifting and lowering training programs. Moreover, this study examined the Revised Bloom's Taxonomy as a novel method of considering the multidimensional nature of learning and provided a potential application of the Revised Bloom's Taxonomy in the training discipline.
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    Artificial Intelligence Applications in the Diagnosis of Power Transformer Incipient Faults
    Wang, Zhenyuan (Virginia Tech, 2000-08-08)
    This dissertation is a systematic study of artificial intelligence (AI) applications for the diagnosis of power transformer incipient fault. The AI techniques include artificial neural networks (ANN, or briefly neural networks - NN), expert systems, fuzzy systems and multivariate regression. The fault diagnosis is based on dissolved gas-in-oil analysis (DGA). A literature review showed that the conventional fault diagnosis methods, i.e. the ratio methods (Rogers, Dornenburg and IEC) and the key gas method, have limitations such as the "no decision" problem. Various AI techniques may help solve the problems and present a better solution. Based on the IEC 599 standard and industrial experiences, a knowledge-based inference engine for fault detection was developed. Using historical transformer failure data from an industrial partner, a multi-layer perceptron (MLP) modular neural network was identified as the best choice among several neural network architectures. Subsequently, the concept of a hybrid diagnosis was proposed and implemented, resulting in a combined neural network and expert system tool (the ANNEPS system) for power transformer incipient diagnosis. The abnormal condition screening process, as well as the principle and algorithms of combining the outputs of knowledge based and neural network based diagnosis, were proposed and implemented in the ANNEPS. Methods of fuzzy logic based transformer oil/paper insulation condition assessment, and estimation of oil sampling interval and maintenance recommendations, were also proposed and implemented. Several methods of power transformer incipient fault location were investigated, and a 7Ã 21Ã 5 MLP network was identified as the best choice. Several methods for on-load tap changer (OLTC) coking diagnosis were also investigated, and a MLP based modular network was identified as the best choice. Logistic regression analysis was identified as a good auditor in neural network input pattern selection processes. The above results can help developing better power transformer maintenance strategies, and serve as the basis of on-line DGA transformer monitors.
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    Assessing the Effects of Exoskeleton Use on Balance and Postural Stability
    Park, Jangho (Virginia Tech, 2021-09-30)
    There is emerging evidence for the potential of occupational back-support exoskeletons (BSEs) to reduce physical demands, and thereby help control/prevent the risk of overexertion injuries associated with manual material handling. However, it is important to understand whether BSEs also introduce any unintended safety challenges. One potential risk associated with BSE use is increased risk of falls, since their extra weight, rigid structure, and external hip extension torque may increase demands on the postural control system. However, there is currently limited evidence on whether, and to what extent, BSE use alters postural stability and/or fall risk. The primary goal of this work was to understand the effects of exoskeleton use, and quantify the effects of exoskeleton design parameters, on balance and postural stability, with a focus on passive BSEs used for repetitive lifting work. A comprehensive evaluation of BSE use was performed under controlled laboratory conditions, focusing on three classes of human activity that form the basis of maintaining postural balance in diverse real-life scenarios: maintenance of a specified posture, voluntary movement, and reaction to an external perturbation. The first study demonstrated that during quiet bipedal stance, BSE use increased median frequency and velocity of the center of pressure in the anterior-posterior direction. In the second study on level walking, BSE use caused an increase in gait step width and gait variability, and decrease in the margin of stability. BSE use with high supportive torque led to adapted gait patterns in early-stance phase. Hip range of motion and peak hip flexion velocity also decreased, and participants exhibited different strategies to increase mechanical energy for propelling the leg in late-stance phase: these effects increased with increasing torque applied by the exoskeleton. In the final study, BSE use did not alter the maximal lean angle from which individuals could successfully execute single step balance recovery, following a forward loss of balance. However, several recovery responses were negatively affected by BSE use, including increased reaction time, impeded hip flexion, and reduced margin of stability in the high-torque condition. This is the first systematical investigation to quantify the effects of passive BSEs with multiple supportive torque levels on balance and postural stability. While exoskeleton effects on static balance were minimal, more substantial changes in gait spatiotemporal parameters, hip joint kinematics, and dynamic margins of stability were observed in the later studies. Our results indicate that postural stability deteriorated with exoskeleton use in dynamic conditions, and provide mechanistic insight into how stability is altered by different exoskeleton design factors such as added mass, restricted range of motion, and external hip extension torque. While our results are suggestive of increased fall risk, especially in the high-torque condition, fall risk in real life is moderated by a complex combination of individual and environmental conditions. Future work should consider more complex, realistic tasks and also include a more diverse sample that is studied under longer exposure durations, to further elucidate these findings. Our characterizations of a wide variety of postural responses as a function of exoskeleton torque settings are expected to contribute to improving both design and practice guidelines to facilitate the safe adoption of BSEs in the workplace.
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    Assessing the Relationship between Occupational Injury Risk and Performance: the Efficacy of Adding Adjustability and Using Exoskeletons in the Context of a Simulated Drilling Task
    Alabdulkarim, Saad A. (Virginia Tech, 2017-11-16)
    Work-related musculoskeletal disorders (WMSDs) continue to occur despite an increasing understanding of the risk factors that initiate these disorders. Ergonomics is commonly seen as a health and safety approach that has no influence on performance, a perspective potentially hindering intervention proposals in practice. Highlighting potential performance benefits can facilitate intervention cost-justification, along with the traditional focus on reducing exposure to injury risk. The main objective of this research was to examine the dual influences (i.e., on performance and injury risk) of two distinct types of interventions: adding adjustability, as a commonly advocated approach when considering ergonomics early in the (re)design phase to change task demands; and using exoskeletons to enhance worker capacity. A simulated drilling task was used, which was considered informative as it entailed diverse demands (precision, strength, and speed) and permitted quantifying two dimensions of task performance (productivity and quality). The dual influences of three levels of workstation adjustability were examined first; increasing adjustability improved performance, with this benefit occurring only when a given level of adjustability also succeeded in reducing ergonomic risk. Across examined conditions, several significant linear associations were found between risk (e.g., Strain Index score) and performance metrics (e.g., completion time), further supporting an inverse relationship between these two outcomes. The dual influences of three distinct passive exoskeletal designs were investigated/compared subsequently, in a simulated overhead drilling task and considering the potential moderating effects of tool mass and precision requirements. Specific designs were: full-body (Full) and upper-body (Arm) exoskeletons with attached mechanical arms; and an upper-body (Shl) exoskeleton providing primarily shoulder support. Both designs with mechanical arms increased static and median total muscle activity while deteriorating quality. The Shl design reduced shoulder loading while increasing dominant upper arm loading and deteriorating quality in the highest precision requirements. Influences of both increasing precision and tool mass were fairly consistent across the examined designs. As such, no single design was obviously superior in both physical demands and performance. Although future work is needed under more diverse/realistic scenarios, these results may be helpful to (re)design interventions that achieve dual benefits on performance and injury risks.
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    Assistive Intervention in the Characterization of Muscle Activity During Bed Rising and Assessment of Self-Perceived Recovery Measures for Abdominal Surgery Patients in Postoperative Care
    Tran, Grace My-Linh (Virginia Tech, 2004-06-03)
    Previous literature has indicated that nursing personnel face the second highest rate of occupational injury and illness. Assistive equipment, such as lift and transfer aids, has helped lower work task demands and reduce back stress on patient handlers. However, limited attention has been paid to the safety, comfort and dignity of the patient in postoperative care. Research on the efficacy of self-transfer aids for patients who require limited or no assistance by nursing personnel is insufficient. Ratings of comfort and security have only been evaluated for nursing home residents in a pilot field study, in which residents rated assistive devices as generally equal to or more secure and comfortable than manual transfer methods. The first study reports the laboratory evaluation of bed rising with the use of two self-transfer aids and bed rising unassisted. The objective was to determine muscle activity during bed rising tasks with and without the use of a bed assistive device using surface electromyography (EMG). Twenty male (n = 9; age, 33.7 ± 8.0 years) and female (n = 11; age, 34.5 ± 23.9 years) participants, with normal body mass index (BMI) ranging from 18.4 to 24.9, took part in the study. Mean and peak activity was recorded from three abdominal muscle sites. The results indicated bed rising with the use of a self-transfer device significantly reduced muscle activity compared to bed rising unassisted. Anchoring the devices at a higher height and elevating the torso further reduced muscle activity. Although no differences were observed between devices using EMG, results from the usability survey and final ranking indicated favorable ratings for the ABNOSTRAINTM prototype compared to the Bed Pull-up. A second study was conducted to determine the efficacy of a bed assistive device in a patient population. The objective was to compare self-perceived recovery measures and usage of pain medication between patients in the control (n = 8; age, 34.0 ± 6.3years) and device (n = 7; 40.7 ± 12.4) groups. A total of fifteen female participants undergoing either abdominal hysterectomy (n = 6) or Cesarean-section (n = 9) procedures were recruited for the study. Both groups completed a total of twelve questionnaires over a five-week recovery period. Responses to self-perceived recovery measures were significantly different. In general, the device group reported higher levels of energy, less pain interference, lower perceived pain, less reliance on pain medication and returned to activities of daily living faster than the control group. The results from the study provide clinicians or other practitioners information on the benefits of bed assistive devices for patients during postoperative recovery. Age and surgery differences should be considered when suggesting bed movement patterns with assistive intervention.
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    Behavioral Monitoring to Identify Self-Injurious Behavior among Children with Autism Spectrum Disorder
    Garside, Kristine Dianne Cantin (Virginia Tech, 2019-03-25)
    Self-injurious behavior (SIB) is one of the most dangerous behavioral responses among individuals with autism spectrum disorder (ASD), often leading to injury and hospitalization. There is an ongoing need to measure the triggers of SIB to inform management and prevention. These triggers are determined traditionally through clinical observations of the child with SIB, often involving a functional assessment (FA), which is methodologically documenting responses to stimuli (e.g., environmental or social) and recording episodes of SIB. While FA has been a "gold standard" for many years, it is costly, tedious, and often artificial (e.g., in controlled environments). If performed in a naturalistic environment, such as the school or home, caregivers are responsible for tracking behaviors. FA in naturalistic environments relies on caregiver and patient compliance, such as responding to prompts or recalling past events. Recent technological developments paired with classification methods may help decrease the required tracking efforts and support management plans. However, the needs of caregivers and individuals with ASD and SIB should be considered before integrating technology into daily routines, particularly to encourage technology acceptance and adoption. To address this, the perspectives of SIB management and technology were first collected to support future technology design considerations (Chapter 2). Accelerometers were then selected as a specific technology, based on caregiver preferences and reported preferences of individuals with ASD, and were used to collect movement data for classification (Chapter 3). Machine learning algorithms with featureless data were explored, resulting in individual-level models that demonstrated high accuracy (up to 99%) in detecting and classifying SIB. Group-level classifiers could provide more generalizable models for efficient SIB monitoring, though the highly variable nature of both ASD and SIB can preclude accurate detection. A multi-level regression model (MLR) was implemented to consider such individual variability (Chapter 4). Both linear and nonlinear measures of motor variability were assessed as potential predictors in the model. Diverse classification methods were used (as in Chapter 3), and MLR outperformed other group level classifiers (accuracy ~75%). Findings from this research provide groundwork for a future smart SIB monitoring system. There are clear implications for such monitoring methods in prevention and treatment, though additional research is required to expand the developed models. Such models can contribute to the goal of alerting caregivers and children before SIB occurs, and teaching children to perform another behavior when alerted.
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    Biodynamic Analysis of Human Torso Stability using Finite Time Lyapunov Exponents
    Tanaka, Martin L. (Virginia Tech, 2008-03-25)
    Low back pain is a common medical problem around the world afflicting 80% of the population some time in their life. Low back injury can result from a loss of torso stability causing excessive strain in soft tissue. This investigation seeks to apply existing methods to new applications and to develop new methods to assess torso stability. First, the time series averaged finite time Lyapunov exponent is calculated from data obtained during seated stability experiments. The Lyapunov exponent is found to increase with increasing task difficulty. Second, a new metric for evaluating torso stability is introduced, the threshold of stability. This parameter is defined as the maximum task difficulty in which dynamic stability can be maintained for the test duration. The threshold of stability effectively differentiates torso stability at two levels of visual feedback. Third, the state space distribution of the finite time Lyapunov exponent (FTLE) field is evaluated for deterministic and stochastic systems. Two new methods are developed to generate the FTLE field from time series data. Using these methods, Lagrangian coherent structures (LCS) are found for an inverted pendulum, the Acrobot, and planar wobble chair models. The LCS are ridges in the FTLE field that separate two inherently different types of motion when applied to rigid-body dynamic systems. As a result, LCS can be used to identify the boundaries of the basin of stability. Finally, these new methods are used to find the basin of stability from time series data collected from torso stability experiments. The LCS and basins of stability provide a richer understanding into the system dynamics when compared to existing methods. By gaining a better understanding of torso stability, it is hoped this knowledge can be used to prevent low back injury and pain in the future. These new methods may also be useful in evaluating other biodynamic systems such as standing postural sway, knee stability, or hip stability as well as time series applications outside the area of biomechanics.
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    Biomarkers of Physiological Damage and their Potential for Work-Related Musculoskeletal Disorder Risk Assessment
    Christian, Marc (Virginia Tech, 2014-03-11)
    Work-related musculoskeletal disorders (WMSDs) continue to present a substantial personal and economic burden. Biomarkers, in providing objective measures of physiological changes, may offer advantages over current tools for WMSD risk assessment. Existing work has identified biomarkers of cartilage and muscle damage, and demonstrated responsiveness to various forms of physical activity and biomechanical loading. Here, three studies were complete to further assess the occupational relevance/utility of three selected biomarkers: Cartilage Oligomeric Matrix Protein (COMP), Interleukin-6 (IL6), and Creatine Kinase (CK). First, the effects of age, obesity, gender, and diurnal variation was investigated. Significant effects of time, age, and gender were evident, as well as some interactive effects, for COMP and CK, but not IL6. Second, biomarker levels were compared between individuals in occupations having relatively high and low WMSD risk. IL6 levels were greater in the high-risk group, while COMP levels demonstrated an oscillatory pattern, and CK levels did not vary between groups. Third, physical demands were imposed on the lumbar spine during a repetitive flexion/extension task, under conditions with different loading and frequency. IL6 levels varied significantly over time and between added load levels, while CK levels varied over time and was influenced by load and frequency. These studies demonstrate important features of biomarkers; that personal confounding factors need to be considered, that select biomarkers may be sensitive to occupational risk factor exposure, and particularly to task parameters in lifting activities involving the lower back. Further, these studies reveal important information concerning the relevance of the selected biomarkers, favorable time points for biomarker collection, and approximate biomarker levels expected between occupations and exposure to common risk factors. These results support the use of biomarkers in occupational settings for assessing exposure and WMSD risk imposed by common risk factors. Sensitivity to exposure levels is an important precursor to risk prediction, however prospective work is needed to verify predictive validity.
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    Biomechanical Analysis and Modeling of Back-Support Exoskeletons for Use in Repetitive Lifting Tasks
    Madinei, Seyed Saman (Virginia Tech, 2022-01-07)
    Low back pain (LBP) remains the most prevalent and costly work-related disability worldwide and is directly associated with "physical" risk factors prevalent in manual material handling (MMH) tasks. Back-support exoskeletons (BSEs) are a promising ergonomic intervention to mitigate LBP risk, by reducing muscular exertion and spine loading. The purpose of this work was to help better understand both the "intended" and "unintended" consequences of BSE use on physical risk factors for LBP, as an essential prerequisite for the safe and effective implementation of this technology in actual workplaces. The first study assessed the effects of using two BSEs on objective and subjective responses during repetitive lifting involving symmetric and asymmetric postures. Wearing both BSEs significantly reduced peak levels of trunk extensor muscle activity and reduced energy expenditure. Such reductions, though, were more pronounced in the symmetric conditions and differed between the two BSEs tested. The second study quantified the assistive torque profiles of two passive BSEs using a computerized dynamometer, with both human subjects and a mannequin. Clear differences in torque magnitudes were evident between the BSEs, though both generated more assistive torques during flexion than extension. The third study estimated the effects of BSE use on lumbosacral compressive and shear forces during repetitive lifting using an optimization-based model. Using both BSEs reduced peak compression and anteroposterior shear forces, but these effects differed between tasks and BSE designs. Reductions in composite measures of trunk muscle activity did not correspond consistently with changes in spine forces when using a BSE. The fourth study quantified the effects of two passive BSEs on trunk stability and movement coordination during repetitive lifting. Some adverse effects on stability were evident for pelvis and thorax movements and coupling of these body segments, suggesting that caution is needed in selecting a BSE for a given MMH task. Overall, we found that the efficacy of BSEs is design- and task-specific. Important safety features of the exoskeletons were also identified, providing insights on their performance boundaries. Overall, the BSEs tested were more effective and safer in tasks closer to the mid-sagittal plane and with moderate degrees of trunk flexion.
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    Biomechanical Assessment and Metabolic Evaluation of Passive Lift-Assistive Exoskeletons During Repetitive Lifting Tasks
    Alemi, Mohammad Mehdi (Virginia Tech, 2019-09-16)
    Work-related musculoskeletal disorders (WMSDs) due to overexertion and consequently the low back pain (LBP) are one of the most prevalent sources of nonfatal occupational injuries and illnesses in all over the world. In the past several years, the industrial exoskeletons especially the passive ones have been proposed as alternative intervention and assistive devices, which are capable of reducing the risk of WMSDs and LBP. However, more research is warranted to validate the applicability of these exoskeletons. In addition, because the majority of previous studies have been limited to specific lifting tasks using only one type of lift assistive exoskeleton, more research is needed to examine the effect of alteration of different lift-assistive exoskeletons on reducing the activity of back muscles and metabolic reduction. The main objective of this dissertation is to render an overview of three studies that attempt to improve the literature by providing comprehensive biomechanical evaluations and metabolic assessments of three passive lift-assistive exoskeletons (VT-Lowe's Exoskeleton (developed in ARLab at VT), Laevo and SuitX). This dissertation has been composed of three related studies. The first study aimed to investigate and examine the capability of a novel lift assistive exoskeleton, VT-Lowe's exoskeleton, in reducing the peak and mean activity of back and leg muscles. Findings revealed that the exoskeleton significantly decreased the peak and mean activity of back muscles (IL(iliocostalis lumborum) and LT(longissimus thoracis)) by 31.5% and 29.3% respectively for symmetric lifts, and by 28.2% and 29.5% respectively for asymmetric lifts. Furthermore, the peak and mean EMG of leg muscles were significantly reduced by 19.1% and 14.1% during symmetric lifts, and 17.4% and 14.6% during asymmetric lifts. Interestingly, the VT-Lowe's exoskeleton showed higher reduction in activity of back and leg muscles compared to other passive lift-assistive exoskeletons available in the literatures. In the second study, the metabolic cost reduction associated with the use of VT-Lowe's exoskeleton during freestyle lifting was theoretically modelled, validated and corresponding metabolic savings were reported. The metabolic cost and the oxygen consumption results supported the hypothesis that the VT-Lowe's exoskeleton could significantly reduce the metabolic demands (~7.9% on average) and oxygen uptake (~8.7% on average) during freestyle lifting. Additionally, we presented a prediction model for the metabolic cost of exoskeleton during repetitive freestyle lifting tasks. The prediction models were very accurate as the absolute prediction errors were small for both 0% (< 1.4%) and 20% (< 0.7%) of body weight. In the third study, the biomechanical evaluation, energy expenditure and subjective assessments of two passive back-support exoskeletons (Laevo and SuitX) were examined in the context of repetitive lifting tasks. The experimental lifting tasks in this study were simulated in a laboratory environment for two different levels of lifting symmetry (symmetric vs. asymmetric) and lifting posture (standing vs. kneeling). Results of this study demonstrated that using both exoskeletons during dynamic lifting tasks could significantly lower the peak activity of trunk extensor muscles by ~10-28%. In addition, using both exoskeletons could save the energy expenditure by ~4-13% in all conditions tested by partially offsetting the weight of the torso. Such reductions were, though, task-dependent and differed between the two tested exoskeletons. Overall, the results of all three studies in this dissertation showed the capability of passive lift-assistive exoskeletons in reducing the activity of back and leg muscles and providing metabolic savings during repetitive lifting tasks.
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    Biomechanical Evaluation of Lumbar Extensor Fatigue Effects on the Postural Control System
    Davidson, Bradley Steven (Virginia Tech, 2005-01-07)
    Falls from heights are the fourth leading cause of occupational injury and fatality in the United States. In particular, construction workers such as roofers are often exposed to high risk environments. Recent research has reported that a leading cause of falls among workers is a loss of balance. Therefore, in moving towards reducing the number of occupational falls, further investigation of balance and factors that influence postural control is necessary. The effect of neuromuscular fatigue has been addressed by many investigators; however, few studies have examined the effect of localized fatigue in muscles not located in the lower extremities. Because low back fatigue is so prevalent during manual labor, this investigation determined to study the effects of lumbar extensor fatigue on balance. Chapter 1 includes a complete review of current literature addressing the effects of muscular fatigue on measures of balance. Chapter 2 details an initial investigation of lumbar extensor fatigue on center of pressure (COP) based measures of postural sway and examines the effect of fatiguing rate. Chapter 3 examines the effects of different levels of lumbar extensor fatigue and expands on the previous investigation by examining center of mass (COM) movement and incorporating additional measures of postural control. The results of these investigations indicate that lumbar extensor fatigue affects both COP and COM measures of postural sway, and might also lead to an increased reliance on feedforward postural control mechanisms. These findings contribute to understanding of effects of fatigue on balance and may aid the future design of interventions aimed at fall prevention.
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    Changes in forklift driving performance and postures among novices resulting from training using a high-fidelity virtual reality simulator: An exploratory study
    Islam, Md Shafiqul; Zahabi, Saman Jamshid Nezhad; Kim, Sunwook; Lau, Nathan; Nussbaum, Maury A.; Lim, Sol (Elsevier, 2024-11-01)
    Virtual reality (VR) has emerged as a promising tool for training. Our study focused on training for forklift driving, to address an ongoing worker shortage, and the unknown impact of repeated VR training on task performance and kinematic adaptations. We trained 20 novice participants using a VR forklift simulator over two days, with two trials on each day, and including three different driving lessons of varying difficulties. Driving performance was assessed using task completion time, and we quantified kinematics of the head, shoulder, and lumbar spine. Repeated training reduced task completion time (up to ∼29.8% of initial trial) and decreased both kinematic variability and peak range of motion, though these effects were larger for lessons requiring higher precision than simple driving maneuvers. Our results highlight the potential of VR as an effective training environment for novice drivers and suggest that monitoring kinematics could help track skill acquisition during such training.
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    Changes in kinematics and muscle activity when learning to use a whole-body powered exoskeleton for stationary load handling
    Park, Hanjun; Kim, Sunwook; Nussbaum, Maury A.; Srinivasan, Divya (SAGE, 2022-10-11)
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    Changes in Kinematics and Muscle Activity When Learning to Use a Whole-Body Powered Exoskeleton for Stationary Load Handling
    Park, Hanjun; Kim, Sunwook; Nussbaum, Maury A.; Srinivasan, Divya (SAGE Publications, 2022-10-27)
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    Changes in lower-limb joint torques when using a passive back-support exoskeleton for level walking
    Park, Jang-Ho; Kim, Sunwook; Nussbaum, Maury A.; Srinivasan, Divya (SAGE, 2021-09)