Effects of load carrying techniques on gait parameters, dynamic balance, and physiological parameters during a manual material handling task

PurposeSince construction workers often need to carry various types of loads in their daily routine, they are at risk of sustaining musculoskeletal injuries. Additionally, carrying a load during walking may disturb their walking balance and lead to fall injuries among construction workers. Different load carrying techniques may also cause different extents of physical exertion. Therefore, the purpose of this paper is to examine the effects of different load-carrying techniques on gait parameters, dynamic balance, and physiological parameters in asymptomatic individuals on both stable and unstable surfaces.Design/methodology/approachFifteen asymptomatic male participants (mean age: 31.5 ± 2.6 years) walked along an 8-m walkway on flat and foam surfaces with and without a load thrice using three different techniques (e.g. load carriage on the head, on the dominant shoulder, and in both hands). Temporal gait parameters (e.g. gait speed, cadence, and double support time), gait symmetry (e.g. step time, stance time, and swing time symmetry), and dynamic balance parameters [e.g. anteroposterior and mediolateral center of pressure (CoP) displacement, and CoP velocity] were evaluated. Additionally, the heart rate (HR) and electrodermal activity (EDA) was assessed to estimate physiological parameters.FindingsThe gait speed was significantly higher when the load was carried in both hands compared to other techniques (Hand load, 1.02 ms vs Head load, 0.82 ms vs Shoulder load, 0.78 ms). Stride frequency was significantly decreased during load carrying on the head than the load in both hands (46.5 vs 51.7 strides/m). Step, stance, and swing time symmetry were significantly poorer during load carrying on the shoulder than the load in both hands (Step time symmetry ration, 1.10 vs 1.04; Stance time symmetry ratio, 1.11 vs 1.05; Swing time symmetry ratio, 1.11 vs 1.04). The anteroposterior (Shoulder load, 17.47 mm vs Head load, 21.10 mm vs Hand load, −5.10 mm) and mediolateral CoP displacements (Shoulder load, −0.57 mm vs Head load, −1.53 mm vs Hand load, −3.37 ms) significantly increased during load carrying on the shoulder or head compared to a load in both hands. The HR (Head load, 85.2 beats/m vs Shoulder load, 77.5 beats/m vs No load, 69.5 beats/m) and EDA (Hand load, 14.0 µS vs Head load, 14.3 µS vs Shoulder load, 14.1 µS vs No load, 9.0 µS) were significantly larger during load carrying than no load.Research limitations/implicationsThe findings suggest that carrying loads in both hands yields better gait symmetry and dynamic balance than carrying loads on the dominant shoulder or head. Construction managers/instructors should recommend construction workers to carry loads in both hands to improve their gait symmetry and dynamic balance and to lower their risk of falls.Practical implicationsThe potential changes in gait and balance parameters during various load carrying methods will aid the assessment of fall risk in construction workers during loaded walking. Wearable insole sensors that monitor gait and balance in real-time would enable safety managers to identify workers who are at risk of falling during load carriage due to various reasons (e.g. physical exertion, improper carrying techniques, fatigue). Such technology can also empower them to take the necessary steps to prevent falls.Originality/valueThis is the first study to use wearable insole sensors and a photoplethysmography device to assess the impacts of various load carrying approaches on gait parameters, dynamic balance, and physiological measures (i.e. HR and EDA) while walking on stable and unstable terrains.

[1]  J. Scholz,et al.  Neuromuscular coordination of squat lifting, I: Effect of load magnitude. , 1995, Physical therapy.

[2]  Stuart M McGill,et al.  Low back loads while walking and carrying: comparing the load carried in one hand or in both hands , 2013, Ergonomics.

[3]  K. Holt,et al.  How do load carriage and walking speed influence trunk coordination and stride parameters? , 2003, Journal of biomechanics.

[4]  Hugo F Posada-Quintero,et al.  Innovations in Electrodermal Activity Data Collection and Signal Processing: A Systematic Review , 2020, Sensors.

[5]  Heng Li,et al.  Proactive Safety Measures: Quantifying the Upright Standing Stability after Sustained Rebar Tying Postures , 2018 .

[6]  Stewart A Birrell,et al.  The effect of load distribution within military load carriage systems on the kinetics of human gait. , 2010, Applied ergonomics.

[7]  The effects of backpack load carrying on dynamic balance as measured by limits of stability. , 2001, Work.

[8]  Sang D Choi,et al.  Fatal falls and PFAS use in the construction industry: Findings from the NIOSH FACE reports. , 2017, Accident; analysis and prevention.

[9]  R. Iqbal,et al.  The Influence of Three Different Load Carrying Methods on Gait Parameters of Indian Construction Workers , 2017 .

[10]  Panagiotis Antoniou,et al.  Pushing, pulling and manoeuvring an industrial cart: a psychophysiological study , 2019, International journal of occupational safety and ergonomics : JOSE.

[11]  Denys Denis,et al.  Biomechanical differences between expert and novice workers in a manual material handling task , 2010, Ergonomics.

[12]  Karlheinz Schaub Ergonomics of Manual Handling - Part 1: Lifting and Carrying , 2006 .

[13]  J M Mur,et al.  Falls and working individuals: role of extrinsic and intrinsic factors , 2001, Ergonomics.

[14]  Giovanni Morone,et al.  Development and Decline of Upright Gait Stability , 2014, Front. Aging Neurosci..

[15]  Tzu-Hsien Lee The effects of load magnitude and lifting speed on the kinematic data of load and human posture , 2015, International journal of occupational safety and ergonomics : JOSE.

[16]  M. Just,et al.  Neuroindices of cognitive workload: Neuroimaging, pupillometric and event-related potential studies of brain work , 2003 .

[17]  Birgitte M Blatter,et al.  Factors associated with the ability and willingness to continue working until the age of 65 in construction workers , 2011, International Archives of Occupational and Environmental Health.

[18]  J. Knapik,et al.  Load carriage using packs: a review of physiological, biomechanical and medical aspects. , 1996, Applied ergonomics.

[19]  Tao Cheng,et al.  Data Fusion of Real-Time Location Sensing and Physiological Status Monitoring for Ergonomics Analysis of Construction Workers , 2013, J. Comput. Civ. Eng..

[20]  Thomas Lachmann,et al.  Physical and cognitive demands of work in building construction , 2019, Engineering, Construction and Architectural Management.

[21]  J. Steele,et al.  Effect of load mass on posture, heart rate and subjective responses of recreational female hikers to prolonged load carriage. , 2011, Applied ergonomics.

[22]  Elaheh Kabir-Mokamelkhah,et al.  Factors associated with the severity of fatal accidents in construction workers , 2016, Medical journal of the Islamic Republic of Iran.

[23]  Noora Nenonen,et al.  Analysing factors related to slipping, stumbling, and falling accidents at work: Application of data mining methods to Finnish occupational accidents and diseases statistics database. , 2013, Applied ergonomics.

[24]  Barbara L Shay,et al.  Relationship Between Dynamic Balance Measures and Functional Performance in Community-Dwelling Elderly People , 2010, Physical Therapy.

[25]  G E Stelmach,et al.  Postural sway characteristics of the elderly under normal and altered visual and support surface conditions. , 1991, Journal of gerontology.

[26]  Bryan Reimer,et al.  The impact of cognitive workload on physiological arousal in young adult drivers: a field study and simulation validation , 2011, Ergonomics.

[27]  Ruwini Edirisinghe,et al.  Digital skin of the construction site , 2018, Engineering, Construction and Architectural Management.

[28]  Alan R Hargens,et al.  Asymmetric Loads and Pain Associated With Backpack Carrying by Children , 2008, Journal of pediatric orthopedics.

[29]  Jaap H. Buurke,et al.  Gait and Dynamic Balance Sensing Using Wearable Foot Sensors , 2019, IEEE Transactions on Neural Systems and Rehabilitation Engineering.

[30]  Joo Chuan Yeo,et al.  Effects of load carriage and fatigue on gait characteristics. , 2011, Journal of biomechanics.

[31]  M. Pal,et al.  Cardiorespiratory changes with compact backpack system and distributed mode of load carriage. , 2012, Indian journal of physiology and pharmacology.

[32]  Toshiyo Tamura,et al.  Wearable Photoplethysmographic Sensors—Past and Present , 2014 .

[33]  P. Harstela,et al.  Introduction to ergonomics in forestry in developing countries. , 1992 .

[34]  R G Soule,et al.  Energy cost of loads carried on the head, hands, or feet. , 1969, Journal of applied physiology.

[35]  Guozhong Zheng,et al.  Experimental study on physiological and psychological effects of heat acclimatization in extreme hot , 2011 .

[36]  G. Irion,et al.  Cardiovascular Responses to Carrying Groceries in Bags With and Without Handles , 2010 .

[37]  Benedicte Vanwanseele,et al.  Concurrent validity and reliability of wireless instrumented insoles measuring postural balance and temporal gait parameters. , 2017, Gait & posture.

[38]  K. Sato,et al.  Regional and individual variations in the function of the human eccrine sweat gland. , 1970, The Journal of investigative dermatology.

[39]  T A Bentley,et al.  Identification of risk factors and countermeasures for slip, trip and fall accidents during the delivery of mail. , 2001, Applied ergonomics.

[40]  Semra Comu,et al.  Exploring the relations between the physiological factors and the likelihood of accidents on construction sites , 2021 .

[41]  Min Liu,et al.  Construction fatalities in Singapore , 2009 .

[42]  C Collet,et al.  Measuring workload with electrodermal activity during common braking actions , 2014, Ergonomics.

[43]  T. Lockhart,et al.  Age related effects of transitional floor surfaces and obstruction of view on gait characteristics related to slips and falls. , 2000, International journal of industrial ergonomics.

[44]  Rohit Y. Dhume,et al.  EFFECT OF CARRYING SYMMETRIC AND ASYMMETRIC WEIGHTS ON GAIT PARAMETERS AND LATERAL SPINAL FLEXION , 2012 .

[45]  Misha Pavel,et al.  Evaluation of the accuracy and reliability for photoplethysmography based heart rate and beat-to-beat detection during daily activities , 2017 .

[46]  Johnny Wong,et al.  Sensing and warning-based technology applications to improve occupational health and safety in the construction industry , 2019, Engineering, Construction and Architectural Management.

[47]  Wei Lu,et al.  Development of a tool to monitor static balance of construction workers for proactive fall safety management , 2018, Automation in Construction.

[48]  Michael N. Sawka,et al.  Thermoregulatory Responses to Acute Exercise‐Heat Stress and Heat Acclimation , 2011 .

[49]  R. Mehrdad,et al.  Epidemiology of Occupational Accidents in Iran Based on Social Security Organization Database , 2014, Iranian Red Crescent medical journal.

[50]  David J. Edwards,et al.  Effects of different weights and lifting postures on balance control following repetitive lifting tasks in construction workers , 2017 .

[51]  Y. Pai,et al.  Center of mass velocity-position predictions for balance control. , 1997, Journal of biomechanics.

[52]  G1-2 Influence of different modes of load carriage on lower limb biomechanics of industrial workers , 2017 .

[53]  J. Mäkelä,et al.  Brachial Plexus Lesions after Backpack Carriage in Young Adults , 2006, Clinical orthopaedics and related research.

[54]  Kara K. Patterson,et al.  Changes in Gait Symmetry and Velocity After Stroke: A Cross-Sectional Study From Weeks to Years After Stroke , 2010, Neurorehabilitation and neural repair.

[55]  Shihab S Asfour,et al.  The effects of different carrying methods on locomotion stability, gait spatio-temporal parameters and spinal stresses , 2018 .

[56]  S. Anwer,et al.  Cardiorespiratory and Thermoregulatory Parameters Are Good Surrogates for Measuring Physical Fatigue during a Simulated Construction Task , 2020, International journal of environmental research and public health.

[57]  M. A. Holbein,et al.  Postural Stability While Walking and Carrying Loads in Various Postures , 1994 .

[58]  Chien-Chi Chang,et al.  The effect of gait speed and load carrying on the reliability of ground reaction forces , 2002 .

[59]  Jack T Dennerlein,et al.  Balance control during lateral load transfers over a slippery surface , 2011, Ergonomics.

[60]  Tamer M. Khalaf,et al.  Influence of Shopping Bags Carrying on Human Responses While Walking , 2018, Journal of healthcare engineering.

[61]  Prakriti Parijat,et al.  Effects of lower extremity muscle fatigue on the outcomes of slip-induced falls , 2008, Ergonomics.

[62]  W. Johnson,et al.  Soldier performance and strenuous road marching: influence of load mass and load distribution. , 1997, Military medicine.

[63]  D. J. Knowles,et al.  The metabolic cost of backpack and shoulder load carriage. , 1992, Ergonomics.

[64]  G. Szeto,et al.  The prevalence of musculoskeletal symptoms in the construction industry: a systematic review and meta-analysis , 2018, International Archives of Occupational and Environmental Health.

[65]  D. P. Manning,et al.  Occupational slip, trip, and fall-related injuries can the contribution of slipperiness be isolated? , 2001, Ergonomics.

[66]  Maxwell Fordjour Antwi-Afari,et al.  Fall risk assessment of construction workers based on biomechanical gait stability parameters using wearable insole pressure system , 2018, Adv. Eng. Informatics.

[67]  K. Stuempfle,et al.  Effect of load position on physiological and perceptual responses during load carriage with an internal frame backpack , 2004, Ergonomics.

[68]  Hsien-Yu Tseng,et al.  Effects of load carrying methods and stair slopes on physiological response and postures during stairs ascending and descending. , 2011, Industrial health.

[69]  Alexander Aruin,et al.  Carrying loads and postural sway in standing: the effect of load placement and magnitude. , 2008, Work.

[70]  G. Dalleau,et al.  Effects of Changing Body Weight Distribution on Mediolateral Stability Control during Gait Initiation , 2017, Front. Hum. Neurosci..

[71]  Mark S. Redfern,et al.  Gait adaptations during load carrying on level and inclined surfaces , 2004 .

[72]  B J Kim,et al.  Postural control and detection of slip/fall initiation in the elderly population , 2005, Ergonomics.

[73]  M. Pal,et al.  Effect of heavy load carriage on cardiorespiratory responses with varying gradients and modes of carriage , 2018, Military Medical Research.

[74]  A. Rosado,et al.  Enhance Sport Performance of Elite Athletes: The Mindfulness-Based Interventions , 2018 .

[75]  D. Abe,et al.  Effects of load carriage, load position, and walking speed on energy cost of walking. , 2004, Applied ergonomics.

[76]  Sukyung Park,et al.  Computational evaluation of load carriage effects on gait balance stability , 2016, Computer methods in biomechanics and biomedical engineering.

[77]  Nir Milstein,et al.  Validating Measures of Electrodermal Activity and Heart Rate Variability Derived From the Empatica E4 Utilized in Research Settings That Involve Interactive Dyadic States , 2020, Frontiers in Behavioral Neuroscience.

[78]  Maxwell Fordjour Antwi-Afari,et al.  Quantifying workers’ gait patterns to identify safety hazards in construction using a wearable insole pressure system , 2020 .

[79]  Michael E. Smith,et al.  Neurophysiological measures of cognitive workload during human-computer interaction , 2003 .

[80]  Samuele M. Marcora,et al.  Mental fatigue impairs physical performance in humans. , 2009, Journal of applied physiology.

[81]  Tim Kiemel,et al.  A unified view of quiet and perturbed stance: simultaneous co-existing excitable modes , 2005, Neuroscience Letters.

[82]  Thomas Stöggl,et al.  Validation of Moticon’s OpenGo sensor insoles during gait, jumps, balance and cross-country skiing specific imitation movements , 2016, Journal of sports sciences.

[83]  Jack T Dennerlein,et al.  The effect of load weight on balance control during lateral box transfers , 2010, Ergonomics.

[84]  Maxwell Fordjour Antwi-Afari,et al.  Validity and reliability of a wearable insole pressure system for measuring gait parameters to identify safety hazards in construction , 2020 .

[85]  L. Stallones,et al.  Same‐level fall injuries in US workplaces by age group, gender, and industry , 2018, American journal of industrial medicine.

[86]  S. Anwer,et al.  Evaluation of Physiological Metrics as Real-Time Measurement of Physical Fatigue in Construction Workers: State-of-the-Art Review , 2021 .

[87]  Heng Li,et al.  Automated detection and classification of construction workers' loss of balance events using wearable insole pressure sensors , 2018, Automation in Construction.

[88]  J A Balogun,et al.  Ergonomic comparison of three modes of load carriage , 1986, International archives of occupational and environmental health.

[89]  Julien Epps Task Load and Stress , 2017 .

[90]  Dhurjati Majumdar,et al.  Effects of military load carriage on kinematics of gait , 2010, Ergonomics.

[91]  G. Moonen,et al.  A corrected version of the Timed-25 Foot Walk Test with a dynamic start to capture the maximum ambulation speed in multiple sclerosis patients. , 2012, NeuroRehabilitation.

[92]  Susan E Kotowski,et al.  Understanding the ergonomic risk for musculoskeletal disorders in the United States agricultural sector. , 2007, American journal of industrial medicine.

[93]  R Andersson,et al.  Accident data in the new Swedish information system on occupational injuries. , 1983, Ergonomics.

[94]  Xinyao Hu,et al.  Effects of Fatigue on Balance Recovery From Unexpected Trips , 2020, Hum. Factors.

[95]  Kara K. Patterson,et al.  Evaluation of gait symmetry after stroke: a comparison of current methods and recommendations for standardization. , 2010, Gait & posture.

[96]  Leigh J. Allin,et al.  Effects of Manual Material Handling Workload on Measures of Fall Risk , 2020 .

[97]  J. D. Lee,et al.  SlipS and FallS , 2014 .

[98]  Sang D Choi A study of trade-specific occupational ergonomics considerations in the U.S. construction industry. , 2012, Work.

[99]  Heng Li,et al.  Associations between physical or psychosocial risk factors and work-related musculoskeletal disorders in construction workers based on literature in the last 20 years: A systematic review , 2021 .