A biomechanical approach to prevent falls in ergonomic settings

Introduction: Fall-related injuries are exceptionally prevalent in occupational settings. While endangering the workers’ health, falls cause poor productivity and increased economic burden in the workplace. Hence, identifying these threats and training workers to achieve proper postural control is crucial. Purpose: Study 1: To investigate the ankle joint kinematics in unexpected and expected trip responses during single-tasking (ST), dual-tasking (DT), and triple-tasking (TT), before and after a physically fatiguing exercise. Study 2: To investigate the impact of virtual heights, DT, and training on static postural stability and cognitive processing. Methods: Study 1: Twenty collegiate volunteers (10 males and females, one left leg dominant, age 20.35 plus-minus 1.04 years, height 174.83 plus-minus 9.03 cm, mass 73.88 plus-minus 15.55 kg) were recruited. Ankle joint kinematics were recorded while treadmill walking during normal gait (NG), unexpected trip (UT), and expected trip (ET) perturbations with DT and physical fatigue. Study 2: Twenty-eight collegiate volunteers (14 males and females; all right leg dominant; age 20.48 plus-minus 1.26 years; height 172.67 plus-minus 6.66 cm; mass 69.52 plus-minus 13.78 kg; body mass index 23.32 plus-minus 3.54 kg/m2) were recruited. They were exposed to different virtual environments (VEs) over three days with and without DT. Postural sway parameters, lower extremity muscle activity, heart rate, and subjective anxiety parameters were collected. Results: Study 1: Greater maximum ankle angles were observed during UT compared to NG, MDT compared to ST, and TT compared to ST, while greater minimum ankle angles were observed during ET compared to NG and during post-fatigue compared to pre-fatigue. Study 2: Greater postural decrements and poor cognitive processing were observed in high altitudes and DT. Discussion & conclusions: Study 1: Trip recovery responses are different between during DT, TT, and fatigue. Study 2: Static postural stability deteriorates at higher virtual altitudes and with DT, while it improves with a two-day training. Virtual height exposure reduces cognitive performance. Importance: The findings of these studies will provide insights into the biomechanics of falls in ergonomic settings and aid in designing functional and convenient fall prevention programs

Impact of foot type, quadriceps angle, and minimalist footwear on static postural stability

Background: In years 2011-2014, 8.6 million sports-related injuries were reported each year and falls have been identified as a main cause. Purpose: To determine the impact of foot type, quadriceps angle, and Vibram™ footwear on postural stability. Methods: Twentyour males (age 21.38±2.50yr; height 1.74±0.06m; mass 71.24±10.37kg) were categorized as pronated, supinated, and neutral feet using FPI and bilateral quadriceps angles were measured. Participants were tested on barefoot, Vibram™ Bikila and Vibram™ Trek (VT), on stable/unstable, bilateral/unilateral, eyes open/closed conditions. Sway variables were analyzed using 3(foot type) × 3(footwear) repeated measures ANOVA. Pearson product correlation was performed for quadriceps angle with sway variables. Results: Footwear main effect significance was evident in all conditions except stable unilateral eyes open condition, with lower values for barefoot followed by VT. Conclusion: Static balance in BF is superior to shod conditions in all situations except the extremely challenging condition, in which VT showed greater balance

Impact of Prolonged Exposure to a Slippery Surface on Postural Stability

Falls are extremely common in occupational settings. Intrinsic factors such as overexertion and extrinsic factors such as the supporting surface are causative factors of falls. The impact of prolonged exposure to a slippery surface on postural stability has not been previously studied. The purpose of the study was to analyze the effect of extended exposure to a dry and a slippery surface on postural stability. Eighteen males (age: 21.17 ± 3.38 years; height: 1.77 ± 0.08 m; mass: 89.81 ± 14.23 kg) were recruited and subjected to one-hour walking on a dry surface and a slippery surface on two different days. Participants’ balance was assessed using a force platform in stable and unstable conditions at 0, 30, and 60 min. Postural sway variables were analyzed using a 2 (surface) × 3 (time) repeated-measures ANOVA. Significant time main effects were observed in the stable condition with greater balance decrements at 30 and 60 min. Greater balance decrements were observed on the slippery surface compared to the dry surface in the unstable condition. The balance decrements can be attributed to overexertion due to the physiological workload of prolonged walking and to the potential gait modifications due to walking on the slippery surface

The Effects of Concussions on Static Postural Stability

Concussions among the athletic population are extremely common, which could lead to postural instabilities. The purpose of this study was to assess the effect of concussions on postural stability in young healthy adults. The static postural stability of thirty volunteers (age 21.63 ± 2.50 years; height 1.70 ± 0.14 m; weight 75.00 ± 15.58 kg; 17 with a history of concussions) was assessed using a force platform during three tests: baseline stability test, clinical test of sensory interaction and balance test, and unilateral stability test. Postural sway variables during each test were statistically analyzed using an independent t-test between the concussion group (CONC) and no concussion (NO CONC) groups. Two secondary analyses were performed with the CONC group: individuals who had one concussion (ONCE) vs. who had multiple concussions (MULTIPLE) and individuals who had their last concussion in 2023–2018 (RECENT) and in 2017–2011 (OLD). The CONC, MULTIPLE, and RECENT groups demonstrated greater postural sway than the NO CONC, SINGLE, and OLD groups. Concussions cause postural decrements in young healthy adults compared to their counterparts with no history of concussions. The results of the study exhibit that concussions could lead to imbalances, which is decisive in athletes’ performance and injury risk during play

Dual Tasking during Trip Recovery and Obstacle Clearance among Young, Healthy Adults in Human Factors Research

Trip-induced falls are extremely common in ergonomic settings. Such situations can lead to fatal or non-fatal injuries, affecting the workers’ quality of life and earning capacity. Dual tasking (DT) is a leading cause of trips and ineffective obstacle clearance among workers. DT increases their attentional demand, challenging both postural control and concurrent secondary tasks. As the human brain has limited attentional processing capacity, even young, healthy adults need to prioritize duties during DT. This article aimed to analyze these secondary task types and their applications in recent trip-related studies conducted on young, healthy adults. An extensive review of the recent trip-related literature was performed to provide a condensed summary of the dual tasks used. In previous trip-related literature, distinct types of secondary tasks were used. The choice of the concurrent task must be made vigilantly depending on the occupation, environmental context, available resources, and feasibility. DT can be used as a tool to train workers on selective attention, which is a lifesaving skill in ergonomic settings, especially in the occupations of roofers, construction workers, or truck drivers. Such training can result in successful obstacle clearance and trip recovery skills, which eventually minimizes the number of falls at the workplace

Physiological and Subjective Measures of Anxiety with Repeated Exposure to Virtual Construction Sites at Different Heights

Background: Occupational workers at altitudes are more prone to falls, leading to catastrophic outcomes. Acrophobia, height-related anxiety, and affected executive functions lead to postural instabilities, causing falls. This study investigated the effects of repeated virtual height exposure and training on cognitive processing and height-related anxiety. Methods: Twenty-eight healthy volunteers (age 20.48 ± 1.26 years; mass 69.52 ± 13.78 kg) were recruited and tested in seven virtual environments (VE) [ground (G), 2-story altitude (A1), 2-story edge (E1), 4-story altitude (A2), 4-story edge (E2), 6-story altitude (A3), and 6-story edge (E3)] over three days. At each VE, participants identified occupational hazards present in the VE and completed an Attitude Towards Heights Questionnaire (ATHQ) and a modified State-Trait Anxiety Inventory Questionnaire (mSTAIQ). The number of hazards identified and the ATHQ and mSTAIQ scores were analyzed using a 7 (VE; G, A1, A2, A3, E1, E2, E3) x 3 (DAY; DAY 1, DAY 2, DAY 3) factorial repeated measures analysis of variance. Results: The participants identified the lowest number of hazards at A3 and E3 VEs and on DAY 1 compared to other VEs and DAYs. ATHQ scores were lowest at G, A1, and E1 VEs. Conclusion: Cognitive processing is negatively affected by virtual altitudes, while it improves with short-term training. The features of virtual reality, such as higher involvement, engagement, and reliability, make it a better training tool to be considered in ergonomic settings. The findings of this study will provide insights into cognitive dual-tasking at altitude and its challenges, which will aid in minimizing occupational falls

The Walls Are Closing In: Postural Responses to a Virtual Reality Claustrophobic Simulation

Background: Changes in the visual environment and thereby, the spatial orientation, can induce postural instability leading to falls. Virtual reality (VR) has been used to expose individuals to virtual environments (VE) that increase postural threats. Claustrophobia is an anxiety disorder categorized under situational phobias and can induce such postural threats in a VE. Purpose: The purpose of the study was to investigate if VR-generated claustrophobic simulation has any impact on postural threats that might lead to postural instability. Methods: Thirty healthy men and women (age: 20.7 ± 1.2 years; height: 166.5 ± 7.3 cm; mass: 71.7 ± 16.2 kg) were tested for postural stability while standing on a force platform, upon exposure to five different testing trials, including a normal stance (NoVR), in stationary VE (VR), and three consecutive, randomly initiated, unexpected claustrophobia trials (VR CP1, VR CP2, VR CP3). The claustrophobia trials involved all four walls closing in towards the center of the room. Center of pressure (COP)-derived postural sway variables were analyzed with a one-way repeated measures analysis of variance at an alpha level of 0.05. Results: Significant main effect differences existed in all but one dependent COP-derived postural sway variables, at p < 0.05. Post-hoc pairwise comparisons with a Bonferroni correction revealed that, predominantly, postural sway excursions were significantly lower in claustrophobia trials compared to NoVR and VR, but only accomplished with significantly increased sway velocity. Conclusion: The VR CP trials induced lower postural sway magnitude, but with increased velocity, suggesting a bracing and co-contraction strategy when exposed to virtual claustrophobic postural threats. Additionally, postural sway decreased with subsequent claustrophobia trials, suggesting potential motor learning effects. Findings from the study offer insights to postural control behavior under virtual claustrophobic simulations and can aid in VR exposure therapy for claustrophobia

Validation of a Bat Handle Sensor for Measuring Bat Velocity, Attack Angle, and Vertical Angle

Background: Bat velocity, attack angle, and vertical angle are common variables that coaches and players want to evaluate during their baseball or softball swing. Objective: The purpose of this study was to investigate and validate a baseball bat handle sensor against motion capture using recreational baseball and softball athletes for bat velocity, attack angle, and vertical angle. Methods: This single visit cross-sectional experimental design study utilized eighteen recreational baseball and softball players (ten males and eight females, age: 20.70 ± 1.69 years, height: 170.74 ± 5.69 cm, weight: 77.97 ± 12.30 kg) were recruited. Bat velocity, attack angle, and vertical angle from the bat handle sensor and 12-camera motion capture system were collected and compared using a two-tailed paired t-test. Results: Differences were statistically significant, showing that 95% of the time, the bat handle sensor overestimated the bat velocity by 1.92 to 2.77 m/s, underestimated the attack angle by -3.46 to -1.96º, and overestimated the vertical angle by 1.64 to 3.21º, compared to the motion capture system. Conclusion: The bat velocity and vertical angle were overestimated, while the attack angle was underestimated by the bat sensor. The information presented in this study can be viable information for coaches and players when utilizing the baseball bat handle sensor technology for training, practice, or in-game situations

Virtual-Reality-Induced Visual Perturbations Impact Postural Control System Behavior

Background: Virtual reality (VR) is becoming a widespread tool in rehabilitation, especially for postural stability. However, the impact of using VR in a &ldquo;moving wall paradigm&rdquo; (visual perturbation), specifically without and with anticipation of the perturbation, is unknown. Methods: Nineteen healthy subjects performed three trials of static balance testing on a force plate under three different conditions: baseline (no perturbation), unexpected VR perturbation, and expected VR perturbation. The statistical analysis consisted of a 1 &times; 3 repeated-measures ANOVA to test for differences in the center of pressure (COP) displacement, 95% ellipsoid area, and COP sway velocity. Results: The expected perturbation rendered significantly lower (p &lt; 0.05) COP displacements and 95% ellipsoid area compared to the unexpected condition. A significantly higher (p &lt; 0.05) sway velocity was also observed in the expected condition compared to the unexpected condition. Conclusions: Postural stability was lowered during unexpected visual perturbations compared to both during baseline and during expected visual perturbations, suggesting that conflicting visual feedback induced postural instability due to compensatory postural responses. However, during expected visual perturbations, significantly lowered postural sway displacement and area were achieved by increasing the sway velocity, suggesting the occurrence of postural behavior due to anticipatory postural responses. Finally, the study also concluded that VR could be used to induce different postural responses by providing visual perturbations to the postural control system, which can subsequently be used as an effective and low-cost tool for postural stability training and rehabilitation