Andrew D Holmes

The Hong Kong Polytechnic University, Hong Kong, Hong Kong

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Publications (31)59.76 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Although spinal manipulation is widely used in the management of neck and pain, its exact mechanisms and biomechancial effects are not clear. A porcine model was used to study the relative movements of intervertebral joints under spinal rotation maneuvers with different input angular displacements and thrust velocities. Ten porcine spines (C2/4) were fixed and mounted in a material testing machine. Rotational maneuvers with different input angular displacements (0.8, 1.5, 2 and 3 degrees) and thrust velocities (0.1 - 200 degrees/s) were applied to C2 with C4 fixed. Angular displacement induced at the adjacent level was measured and expressed as percentage of the applied angular displacement. For all the tested conditions, angular deformation at the adjacent level could not be avoided when an angular thrust was applied to the target level. The percentage of the angular displacement induced at the adjacent level was found to be dependent on both the input angular displacement and thrust velocity. If rapid thurst of manipulation is used to direct the input energy and motion at the target level with minimal interference at the adjacent levels, the applied angular displacement should not be too large and the thrust velocity should be within a medium velocity range.
    Prosthetics & Orthotics International 04/2009; 33(1):89-98. · 0.56 Impact Factor
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    ABSTRACT: Both balance control dysfunction and dysfunction of the central nervous system have been proposed as being causative factors in adolescent idiopathic scoliosis (AIS), yet the relationship between these factors has not been investigated in detail. An intergroup comparative study was conducted to investigate the effect of abnormal somatosensory function on the dynamic balance parameters of girls with AIS. The relationship between dynamic balance control and abnormal somatosensory function seen in AIS patients was examined by studying the dynamic balance parameters in normal controls, in AIS patients with normal posterior tibial nerve somatosensory cortical evoked potentials (PTN-SCEPs), and in AIS patients with abnormal PTN-SCEPs. Gait parameters were recorded in 18 AIS girls (8 showing abnormal PTN-SCEPs and 10 showing normal PTN-SCEPs). Eight healthy age-matched volunteers served as a control group. No significant left-right asymmetry of gait parameters was found for the controls or the AIS patients with normal PTN-SCEPs, whereas significantly higher gait parameters were found on the side of the curvature in the AIS patients with abnormal PTN-SCEPs. Somatosensory dysfunction in AIS patients shows to have an impact on dynamic balance control. Further studies to examine the association between somatosensory dysfunction and balance control and how they may be related to the etiology of AIS are recommended. Diagnostic study, level IV (case-control study).
    Journal of pediatric orthopedics 01/2009; 28(8):846-9. · 1.23 Impact Factor
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    ABSTRACT: Electroacupuncture (EA) has long been used as conservative treatment for low back pain (LBP). Its effect on relief of back pain has been demonstrated in many clinical studies. However, whether it has any effect on the biological properties of an intervertebral disc, which is one of the major causes of LBP, is still unclear. The aim of this study was, therefore, to investigate the effects of EA with different simulation frequencies on an intervertebral disc with simulated degeneration using an in-vivo rat-tail model. In this study, 33 rats were used. Disc degeneration was simulated in the rat caudal 8-9 disc via continuous static compressive loading of 11 N for 2 weeks. EA with a frequency of 2 or 100 Hz was then applied to the degenerated disc for 3 weeks with 3 sessions/week and 20 min/session. The intervertebral disc height was measured before and after compression as well as after EA intervention for 3 weeks. The static compression was found to result in a reduction in the disc height of about 22 per cent. There was no evidence that this change could be reversed after resting or the EA intervention. However, EA at 100 Hz was found to induce a further decrease in disc height, which was not shown for the rats after resting or EA at 2 Hz. The results of this study showed that effects of EA on disc degeneration are frequency dependent and adverse effects could result if EA at a certain frequency was used.
    Proceedings of the Institution of Mechanical Engineers Part H Journal of Engineering in Medicine 03/2008; 222(2):241-8. · 1.42 Impact Factor
  • D H K Chow, K T Y Leung, A D Holmes
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    ABSTRACT: Despite evidence linking backpack carriage and back pain, previous studies to examine the effects of backpack carriage have focused on changes in physical performance rather than the direct effects on the spine itself. Spinal curvature and proprioception (in terms of spinal repositioning consistency) of 15 schoolboys during normal upright stance without a backpack and while carrying a specially adapted backpack loaded at 10, 15 and 20% of their bodyweight were measured and compared using repeated measures ANOVA. A significant flattening of the lumbar lordosis and the upper thoracic kyphosis was found with increasing backpack load, as well as a significant decrease in the thoraco-lumbar and lumbar repositioning consistencies. Carriage of a loaded backpack causes immediate changes in spinal curvature and appears to have a direct effect on the repositioning consistency. Further investigation of the changes in spinal curvature and repositioning consistency over time with prolonged backpack carriage is warranted. Daily carriage of a school backpack on the musculoskeletal health of children and adolescents has become an area of concern due to the association between backpack carriage and back pain. Data regarding the direct effect of backpack carriage on the spine in children are limited.
    Ergonomics 01/2008; 50(12):2148-56. · 1.67 Impact Factor
  • Source
    Daniel H K Chow, Dawn S S Leung, Andrew D Holmes
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    ABSTRACT: The balance function of children is known to be affected by carriage of a school backpack. Children with adolescent idiopathic scoliosis (AIS) tend to show poorer balance performance, and are typically treated by bracing, which further affects balance. The objective of this study is to examine the combined effects of school backpack carriage and bracing on girls with AIS. A force platform was used to record center of pressure (COP) motion in 20 schoolgirls undergoing thoraco-lumbar-sacral orthosis (TLSO brace) treatment for AIS. COP data were recorded with and without brace while carrying a backpack loaded at 0, 7.5, 10, 12.5 and 15% of the participant's bodyweight (BW). Ten participants stood on a solid base and ten stood on a foam base, while all participants kept their eyes closed throughout. Sway parameters were analyzed by repeated measures ANOVA. No effect of bracing was found for the participants standing on the solid base, but wearing the brace significantly increased the sway area, displacement and medio-lateral amplitude in the participants standing on the foam base. The medio-lateral sway amplitude of participants standing on the solid base significantly increased with backpack load, whereas significant increases in antero-posterior sway amplitude, sway path length, sway area per second and short term diffusion coefficient were found in participants standing on the foam base. The poorer balance performance exhibited by participants with AIS when visual and somatosensory input is challenged appears to be exacerbated by wearing a TLSO brace, but no interactive effect between bracing and backpack loading was found.
    European Spine Journal 10/2007; 16(9):1351-8. · 2.13 Impact Factor
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    ABSTRACT: Quantification of changes in intervertebral disc height is critical for studying intervertebral disc degeneration. Reliability of disc height measurement is therefore especially important for in vivo studies using animal models of disc degeneration. In this study, the effects of image intensity and percentage of disc width used for disc height measurement from radiographic images were evaluated in a rat-tail model. Radiographs were taken for 10 Sprague-Dawley rats using a standardized protocol. Average disc heights of the caudal 8-9 discs were determined using original and intensity adjusted images with different percentages of disc width. The average disc height was found to be significantly affected by both the image intensity and the percentage of disc width measured. A higher reliability was found in the measurement for image with adjusted intensity and using smaller disc width. Image intensity is suggested to be controlled and the disc width should be taken into account in quantifying the disc height.
    Medical Engineering & Physics 10/2007; 29(7):814-9. · 1.78 Impact Factor
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    ABSTRACT: Concerns have been raised regarding the effect of carrying a backpack on adolescent posture and balance, but the effect of backpack loading combined with other factors affecting balance, such as adolescent idiopathic scoliosis (AIS), has not been determined. This study examines the effects of backpack load on the posture and balance of schoolgirls with AIS and normal controls. The standing posture of 26 schoolgirls with mild AIS (mean age 13, Cobb angle 10-25 degrees ) and 20 age-matched normal schoolgirls were recorded without a backpack and while carrying a standard dual-strap backpack loaded at 7.5%, 10%, 12.5% and 15% of the subject's bodyweight (BW). Kinematics of the pelvis, trunk and head were recorded using a motion analysis system and centre of pressure (COP) data were recorded using a force platform. Reliable COP data could only be derived for 13 of the subjects with AIS. Increasing backpack load causes a significantly increased flexion of the trunk in relation to the pelvis and extension of the head in relation to the trunk, as well as increased antero-posterior range of COP motion. While backpack load appears to affect balance predominantly in the antero-posterior direction, differences between groups were more evident in the medio-lateral direction, with AIS subjects showing poor balance in this direction. Overall, carrying a backpack causes similar sagittal plane changes in posture and balance in both normal and AIS groups. Load size or subject group did not influence balance, but the additive effect of backpack carrying and AIS on postural control alters the risk of fall in this population. Therefore, load limit recommendations based on normal subjects should not be applicable to subjects with AIS.
    Gait & Posture 11/2006; 24(2):173-81. · 1.97 Impact Factor
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    ABSTRACT: A high degree of gait symmetry is characteristic of healthy gait. The aim of this study is to examine the symmetry of various gait parameters in subjects with unilateral trans-tibial amputation over a range of acceptable anteroposterior translational and tilt alignments, and further to examine if a consistent alignment of highest symmetry can be found. Acceptable alignments were determined by bench, static and dynamic testing on level and non-level surfaces. A total of 15 kinetic and kinematic parameters were then measured in the seven subjects participating in this study. Results indicate that some parameters show consistently higher symmetries, particularly the vertical ground reaction force parameters and the stance duration, step length and time to full knee flexion during the swing phase. Symmetries in other parameters such as knee flexion at loading response, acceleration impulse, and peak anteroposterior propulsive force seem to have little relevance in determining whether the gait pattern for that prosthetic alignment is acceptable or not. While analysis of the symmetry of more relevant gait parameters may assist the prosthetist in consistently and objectively identifying a most symmetrical alignment within the acceptable range, further clinical study is required before any conclusions can be drawn regarding evaluation of symmetry as a tool in defining any optimum alignment.
    Prosthetics and Orthotics International 09/2006; 30(2):114-28. · 0.62 Impact Factor
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    ABSTRACT: Poor posture has been suggested as one of the main factors contributing to the high prevalence of neck pain in video display unit (VDU) users, but no clear association between pain and any particular resting neck posture has been found. Postural awareness of the neck, as indicated by the repositioning accuracy, may therefore be an appropriate measure and potentially useful assessment tool. The objective of this study is to examine whether posture and fatigue affect the head repositioning ability in typical VDU usage. A group of 20 healthy participants reproduced a normal comfortable posture for forward, upright and backward chair back inclinations in random order both before and after fatigue of the upper trapezius muscles. Ten repetitions of the posture were recorded for 2 s each, and the angular and translational deviations from the original head position were measured with regard to the external environment (head in space repositioning) and with regard to the trunk (head on trunk repositioning). Analysis by repeated measures ANOVA showed significant effects and interactions of fatigue and chair back inclination on the repositioning errors in the sagittal plane, which typically showed systematic trends towards certain postures rather than random errors around a mean position. While further work is required to examine the ergonomic impact of impaired repositioning ability, head repositioning is sensitive to ergonomic factors such as seating configuration and fatigue, and may therefore be a useful tool for evaluation of static working postures.
    Ergonomics 08/2006; 49(9):860-73. · 1.67 Impact Factor
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    ABSTRACT: Adolescent idiopathic scoliosis (AIS) and load-bearing both appear to place similar demands on gait, but no data regarding the combined effects of load-bearing gait in subjects with AIS could be found. The gait patterns of 22 normal adolescent girls and 28 girls with mild AIS (Cobb angle<25 degrees ) were recorded at backpack loads of 0, 7.5, 10, 12.5 and 15% body weight. Temporal-distance and joint kinematic, moment and power parameters were analyzed by repeated measures ANOVA. Findings showed that backpack carriage places an increased demand on the musculature of the lower limb and results in a gait characterized by reduced pelvic motion and greater hip flexion-extension. AIS has a generally similar effect on gait kinematics as backpack carriage, with AIS subjects having significantly longer double support durations, shorter single support durations and lower knee joint power generation and absorption than normal subjects. No interaction between backpack load and AIS was found however, although investigation of parameters indicating a critical response to load showed that this typically occurred at lower backpack loads (7.5% body weight) in the AIS group. Overall, both AIS and load-bearing place increased demands on gait, but carriage of a loaded backpack does not appear to cause any greater demand on subjects with AIS than normal controls.
    Medical Engineering & Physics 06/2006; 28(5):430-7. · 1.78 Impact Factor
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    ABSTRACT: A prospective evaluation of the effects of backpack carriage on the pulmonary function of schoolgirls without spinal deformity versus those with adolescent idiopathic scoliosis (AIS). To establish if recommended backpack load limits for normal schoolchildren are also appropriate for study participants with AIS. The weight of schoolchildren's backpacks are of concern because of effects including compromise of pulmonary function. Impaired pulmonary function is also found with AIS, but the effect of backpack carriage on the respiratory parameters of schoolchildren with AIS has not previously been examined. Forced vital capacity (FVC), forced expiratory volume (FEV1), peak expiratory flow (PEF), and forced expiratory flow (FEF25-75%) were recorded in 17 girls (mean age, 12 years) with moderate AIS (Cobb angle, 26 degrees-50 degrees) and 18 girls (mean age, 11 years) without musculoskeletal deformity during carriage of a backpack loaded at 0%, 5%, 7.5%, 10%, 12.5%, and 15% body weight in random order. Absolute values and proportions of reference values were analyzed by repeated-measures analysis of variance. RESULTS.: No interaction between load and group was found, indicating that backpack loading has a similar effect on the pulmonary function of both normal and AIS groups. However, all recorded pulmonary parameters were found to be significantly lower in the AIS than normal group, significantly so for the referenced FVC and PEF. A significant decrease in FVC and FEV1 was found with increasing backpack load, and the load at which these changes were found to be significant was lower than those established in previous studies. Pulmonary function may be more sensitive to backpack load than previously considered, especially when study participants with AIS are being considered, and the recommended loading limit of 10% body weight may not be applicable to schoolgirls with AIS.
    Spine 12/2005; 30(21):E649-54. · 2.16 Impact Factor
  • Jim M W Ngan, Daniel H K Chow, Andrew D Holmes
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    ABSTRACT: The aim of this study was to determine the in vivo kinematics of cervical rotational manipulation in normal subjects and examine the consistency of this technique within and between therapists. A four camera motion analysis system operating at 120 Hz was used to measure the head on trunk angular displacements during manipulation performed by three therapists on eight subjects. One of the therapists performed the manipulation twice for each subject over separate sessions. A consistent pattern of de-rotation prior to thrust was found with little motion other than axial rotation during de-rotation and thrust. The pooled mean de-rotation displacement was 4.8 degrees and the pooled mean thrust angle was 11.3 degrees , but these varied widely, and none of the kinematic parameters recorded proved to be consistent within or between therapists. Most of the kinematic parameters were correlated with the exception of thrust duration. Qualitative analysis shows a consistent technique in cervical rotational manipulation. Pre-manipulation positioning of the head relative to the trunk was fairly consistent for a single therapist over separate sessions, but other than this, the kinematic parameters in cervical rotational manipulation are generally inconsistent within and between therapists.
    Medical Engineering & Physics 07/2005; 27(5):395-401. · 1.78 Impact Factor
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    ABSTRACT: Squat and stoop lifting have been examined in some detail, but limited data exist regarding the sudden release of load during such lifting. Ten participants performed squat and stoop lifting trials with loads of 20, 40, 60 and 80N, and sudden release was randomly included in one of the lifting cycles. Postural perturbation was recorded via centre of pressure displacement using a force platform and the electromyographic response of trunk and lower limb muscles was recorded. Results indicated that irrespective of lifting posture, an 'ankle' response strategy to sudden release was elicited, where the anterior muscles of the lower limb contracted first, followed by the anterior trunk muscles, relaxation of the posterior trunk muscles and, finally, relaxation of the posterior lower limb muscles. The latency of muscles responding by contraction tended to decrease slightly with increasing load for both postures, while the latency of muscles responding by relaxation increased, resulting in increased trunk muscle co-contraction durations. The postural disturbance appeared to be greater for squat lifting than stoop lifting at the higher loads of 60 and 80N, as the centre of pressure moves significantly closer to the posterior limit of static stability (the line joining the heels).In terms of stability and muscular response, squat lifting may not be the most appropriate strategy if a sudden release of loads greater than approximately 50N is likely.
    Ergonomics 06/2005; 48(6):591-607. · 1.67 Impact Factor
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    ABSTRACT: Concerns regarding the effects of load carriage have led to recommendations that backpacks be limited to 10?-?15% of body weight, based on significant changes in physical performance. However, gait responses to backpack loads are not entirely consistent and there is a particular lack of data regarding load-bearing gait in adolescent females. Gait patterns of 22 normal adolescent girls were recorded at backpack loads of 0, 7.5, 10.0, 12.5 and 15.0% body weight. Temporal-distance, ground reaction force and joint kinematic, moment and power parameters were analysed by repeated measures ANOVA with factors of backpack load and side (left or right). Walking speed and cadence decreased significantly with increasing backpack load, while double support time increased. Kinematic changes were most marked at the proximal joints, with a decreased pelvic motion but a significant increase in the hip sagittal plane motion. Increased moments and power at the hip, knee and ankle showed increasing demand with backpack load. Parameters showed different responses to increasing load, and those that suggested a critical load indicated this to be approximately 10% body weight. While this may be due to a change in gait due to increased demand, further work is required to verify this and also to examine the cumulative effects of backpack load on the musculoskeletal system, which may be more appropriate in determining recommended load limits.
    Ergonomics 06/2005; 48(6):642-56. · 1.67 Impact Factor
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    ABSTRACT: An in vitro biomechanical study on lumbar intervertebral joints. To examine the mechanical properties of lumbar motion segments under pure shear loading and establish whether a simple model for functional differentiation between the anterior column and the posterior elements is applicable. Anteroposterior shear has been implicated as a major factor in spinal instability. There is a substantial amount of data on shear motion as a coupled part of flexion-extension; data on the pure shear properties of intervertebral joints is limited. Eighteen human cadaver lumbar motion segments were subject to nondestructive testing under pure shear loads (anterior shear and posterior shear). An MTS standard testing machine was used to record the load-deformation characteristics of specimens subject to deformation at a constant rate to a maximum shear load of approximately 250 N. Tissue sectioning was then performed with the specimen mounted in the testing machine. Eight specimens were sectioned through the intervertebral disc, including the anterior and posterior longitudinal ligaments, and 8 specimens were sectioned through the pedicles to remove the posterior elements. The same deformation pattern applied to the intact specimen was then reapplied to the sectioned specimen, and the load-deformation characteristics following sectioning were evaluated. The shear stiffness of the intact segments were found to be higher in anterior shear (mean group A = 583.8, B = 607 N/mm) than in posterior shear (mean group A = 469, B = 438.4 N/mm). Section of the anterior column and adjacent longitudinal ligaments resulted in a mean stiffness decreased by 22.8% of the intact value under anterior shear and 23.9% under posterior shear. Much larger change in shear stiffness was seen, and the mean sectioned stiffness dropped by 77.7% in anterior shear and 79% in posterior shear after removal of the posterior elements. After the anterior column was sectioned, 12% and 18% increases in the deformation for anterior and posterior directions were seen, whereas a distinct increase in the deformations was found after posterior elements sectioned. The posterior elements of the lumbar spine are more efficient in resisting anterior and posterior shear loads. However, the anterior column will exhibit similar load-displacement characteristics if subject to greater deformations. The sum of the normalized mean shear loads of the anterior column and posterior elements sustained at maximum intact deformation is significantly different from the shear load sustained by the intact spine at the same deformation. A simple concept of load sharing between the anterior column and the posterior elements may not be valid.
    Spine 05/2005; 30(8):E204-9. · 2.16 Impact Factor
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    ABSTRACT: Sudden changes in load during asymmetric lifting may be associated with a particularly high risk of loss of balance and spinal injury. Centre of pressure (COP) motions and electromyographic responses of trunk and lower limb muscles were studied in 10 normal male volunteers during sudden release of 20, 40, 60 and 80N stoop lifting loads in symmetric and asymmetric postures. Similar overall COP responses and muscular response strategies to sudden release of load were seen in both postures, although the asymmetric posture showed a larger medio-lateral COP displacements and greater co-contraction asymmetries. While sudden release of load in asymmetric stoop lifting does not seem to involve a greater risk of fall than symmetric lifting, the muscular response results in more complex and asymmetric loading of the trunk, indicating greater localised segmental loading and therefore increased risk of tissue injury.
    Applied Ergonomics 02/2005; 36(1):13-24. · 1.73 Impact Factor
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    ABSTRACT: While in vitro studies have shown that mechanical loading can result in changes in the composition of intervertebral disc matrix, the effects of cyclic loading in vivo have not been considered. The objective of this study was to assess the effect of static and cyclic compression of different frequencies on the nuclear composition of the intervertebral disc. Thirty-six Sprague-Dawley rats were randomly divided into a control group (no pin insertion, no loading), a sham group (pins inserted in sixth and seventh caudal vertebrae, no loading), a static loading group (compression applied via pins) and cyclic loading groups (loading at 0.5, 1.5 or 2.5 Hz). Loading was applied for 1 h each day from the third to 17th day following pin insertion, and the caudal 5-6, 6-7 and 7-8 discs harvested to quantify proteoglycan content, collagen content and chondrocyte density in the nucleus pulposus. Static compression resulted in a significant reduction in total proteoglycan content as compared with the adjacent control disc, but this effect was not seen in any of the cyclic loading groups. However, comparison with the sham group appears to indicate an overall decrease in total proteoglycan content at the targeted and adjacent levels following cyclic loading. The 0.5 Hz loading group showed a significantly greater total proteoglycan content than all other compression groups, and also showed a lower total collagen content than the sham group. Results suggest that frequency dependent changes in composition occur in response to cyclic loading, but are not limited to the directly loaded disc alone. Further studies are required to verify this, but the choice of control appears to need careful consideration in all studies of this nature.
    Medical Engineering & Physics 10/2004; 26(7):587-94. · 1.78 Impact Factor
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    ABSTRACT: The effect of fatigue on the muscular and postural response to sudden release of different stoop lifting loads was studied. Ten male volunteers performed a series of stoop lifting trials before and after fatigue of the erector spinae. Trials were performed using loads of 20, 40, 60, and 80 N, and sudden release of load was triggered randomly on one of the repetitions using an electromagnetic release. The onset of release was registered by an accelerometer, centre of pressure (COP) motion was recorded via a forceplate, and EMG activities of the latissimus dorsi (LD), erector spinae (ES), rectus abdominus (RA), external oblique (EO) and internal oblique (IO) muscles were recorded. A slightly reduced lifting speed was seen after fatigue, particularly at the higher loads, but this had little effect on the perturbing force at release, which was dominated by the release load. A significant effect of fatigue was seen on the antero-posterior COP motion, with the postural disturbance being decreased after fatigue. Fatigue resulted in a significant increase in ES (p = 0.029) and LD (p = 0.015) relaxation times and, while the response patterns (relaxation, contraction or no response) of the anterior trunk muscles (RA, EO, IO) were not always consistent, the proportion of response by relaxation was greater after fatigue. This resulted in a lower incidence but longer duration of co-contraction of the ES-RA, ES-EO and ES-EO muscle groups following fatigue, such that the mean co-contraction duration of these groups showed no significant differences before and after fatigue. The response to sudden release is a balance between maintaining postural stability and at the same time preventing the trunk musculature from overloading the spine and risking tissue injury. While fatigue of the trunk extensors does not appear to increase either the risk of fall or stumble or the incidence of co-contraction following sudden release of stoop lifting tasks, the duration of co-contraction appears to increase following fatigue. Further study is required to quantify the loading on the spine during sudden release of different lifting tasks before and after more realistic fatigue conditions.
    Ergonomics 06/2004; 47(6):607-24. · 1.67 Impact Factor
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    ABSTRACT: To assess the changes in the multi-planar bending properties of intervertebral joints following cyclic bending along different directions. An in vitro biomechanical study using porcine lumbar motion segments. Repeated bending has been suggested as part of the etiology of gradual prolapse of the intervertebral disc, but the multi-planar changes in bending properties following cyclic loading have not been examined in detail. Porcine lumbar motion segments were subject to 1500 cycles of bending along directions of 0 degrees (flexion), 30 degrees, 60 degrees, or 90 degrees (right lateral bending). The multi-planar bending moments and hysteresis energies were recorded before loading and after various cycle numbers. Repeated bending at 30 degrees and 60 degrees resulted in greater decreases in mean bending moment and hysteresis energy than bending at 0 degrees or 90 degrees. No significant differences were seen between loading groups for the change in bending moment along the anterior testing directions, but significant differences were observed in the posterior and lateral testing directions, with bending at 30 degrees causing a significantly greater decrease in bending moment in the postero-lateral directions. The change in mechanical properties of porcine intervertebral joints due to cyclic bending depend on the direction of loading and the direction in which the properties are measured. Loading at 30 degrees provokes the most marked changes in bending moment and hysteresis energy.
    Clinical Biomechanics 03/2004; 19(2):99-106. · 1.87 Impact Factor
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    ABSTRACT: Sudden release of load during lifting threatens postural stability and is countered by trunk muscle response, which can generate high loads on the spine, and may be a cause of tissue injury. The postural threat following sudden release and the consequent muscular response are likely to depend on the posture at the time of release. This study investigates the effects of sudden release of load at two release heights of one- and three-quarters of the knee to shoulder distance during stoop lifting. Ten normal southern Chinese male volunteers were subject to sudden release of 20, 40, 60 and 80 N loads during stoop lifting trials. The release was randomly selected to be on the third, fourth or fifth cycle of a trial and was triggered at heights of one- and three-quarters of the total knee to shoulder lifting distance. The subjects stood on a force platform to allow the postural disturbance to be recorded by monitoring the center of pressure (COP), and electromyographic (EMG) data were collected from the rectus abdominus, internal oblique, external oblique, erector spinae and latissimus dorsi muscle groups. The COP excursion moved closer to the posterior limit of stability with increasing release load, and this effect was significantly more marked for release from the lower of the two heights. The minimum posterior COP separation from the posterior limit of stability was significantly less for the lower release height at all loads (p<0.001 in all cases). EMG data showed that the agonist-antagonist co-contraction durations were higher for the lower release height, and unlike sudden release from the higher level, showed a significant increase with increasing load. Sudden release at lower release height during stoop lifting results in significantly greater postural disturbance and spinal loading. The mean load predicted to result in fall or stumble at the lower release height (133 N) is significantly less than that predicted at the higher of the two release heights (245 N). A more marked effect of release load is also seen in the postural disturbance and trunk muscle co-contraction time for the lower release height, and particular care should therefore be taken when handling potentially unstable loads under these conditions. If the security of the load cannot be guaranteed, storage at a higher level may reduce the risk of injury due to sudden release of the load.
    Applied Ergonomics 11/2003; 34(6):611-9. · 1.73 Impact Factor

Publication Stats

388 Citations
59.76 Total Impact Points

Institutions

  • 2003–2009
    • The Hong Kong Polytechnic University
      • Department of Health Technology and Informatics
      Hong Kong, Hong Kong
  • 2000–2003
    • The University of Hong Kong
      • Department of Orthopaedics and Traumatology
      Hong Kong, Hong Kong
    • Southern Medical University
      • Key Laboratory for Medical Biomechanics of PLA
      Shengcheng, Guangdong, China