title: Capability and recruitment patterns of trunk during isometric uniaxial and biaxial upright exertion.
abstract: BACKGROUND
  Work-related risk factors of low back disorders have been identified to be external moments, awkward postures, and asymmetrical dynamic lifting amongst others. The distinct role of asymmetry of load versus posture is hard to discern from the literature. Hence, the aim of this study is to measure isometric trunk exertions at upright standing posture at different exertion level and degree of asymmetry to further delineate the effects of exertion level and asymmetry on neuromuscular capability response.
  
  
  METHODS
  Fifteen healthy volunteers randomly performed trunk exertions at three levels (30%, 60%, and 100% of maximum voluntary exertion and five different angles (0 degrees , 45 degrees , 90 degrees , 135 degrees , and 180 degrees ) of normalized resultant moments. During each trial, the normalized EMG activity of 10 selected trunk muscles was quantified.
  
  
  RESULTS
  The EMG activity of the 10 trunk muscles was significantly (P<0.001) affected by the level of exertion and angle of normalized resultant moment, and their interactions. The controllability of the torque generation was reduced in biaxial exertions. The capability to generate and control the required trunk moments is significantly lowered during biaxial trunk exertions, while all muscles present higher EMG activity. These results suggest that the trunk muscles will be taxed higher while performing biaxial exertion tasks, increasing muscle fatigue possibly leading to a higher probability of low back injury.
  
  
  CONCLUSIONS
  The prediction of biaxial trunk performance based on uniaxial data will result in an overestimation of capability and controllability of the trunk during physically demanding tasks. This study provides a better understanding of the potential mechanisms of injury during asymmetrical and biaxial trunk exertion during work-related tasks.
authors.affiliation: The Occupational and Industrial Orthopaedic Center and Program of Ergonomics and Biomechanics, New York University, NYU Hospital for Joint Diseases, 63 Downing Street, New York, NY 10014, USA. ali.sheikhzadeh@nyu.edu
authors.forename: Ali
authors.initials: A
authors.lastname: Sheikhzadeh
authors.forename: Mohamad
authors.initials: M
authors.lastname: Parnianpour
authors.forename: Margareta
authors.initials: M
authors.lastname: Nordin
mesh_terms: D000005:Abdomen / Q000502:physiology*; D000328:Adult; D001415:Back / Q000502:physiology; D005260:Female; D006801:Humans; D007537:Isometric Contraction / Q000502:physiology*; D008297:Male; D009068:Movement / Q000502:physiology; D018482:Muscle, Skeletal / Q000502:physiology*; D005082:Physical Exertion / Q000502:physiology*; D011187:Posture / Q000502:physiology*; D011999:Recruitment, Neurophysiological / Q000502:physiology*; D013647:Task Performance and Analysis; D013909:Thorax / Q000502:physiology*