Localized muscle fatigue (LMF) is a complex, multifactorial phenomenon that involves exercise-induced decrements in the ability to generate force or power. LMF can adversely affect performance and may increase the risk of work-related musculoskeletal disorders (WMSDs), and is thus of contemporary occupational relevance. Despite considerable progress in understanding and predicting muscle fatigue, there are many uncertainties and unresolved issues that are principally associated with the physiological complexity of LMF and the diverse mechanisms that underlie LMF development. This research thus aimed to address some of the theoretical and practical issues related to muscle fatigue and recovery. Regarding the theoretical aspects, two specific muscle fatigue models (MFMs) were directly compared and some important differences in their predictions were identified. These differences were used, in part, as a basis for developing testable hypotheses and designing associated experiments. Further theoretical evaluations were conducted to explore the sensitivity of these models to the model parameters and their ability to predict endurance time in both prolonged and intermittent exertions. Sensitivity to inherent model parameters was quantified, which was relatively high in conditions involving lower to moderate levels of effort. Further assessments indicated substantial variability related to model recovery parameters, which might be related to the inability of these MFMs in simulating the recovery process. From a practical viewpoint, the effect of cycle time on the development and consequences of LMF was determined during intermittent isometric exertions. A shorter cycle time led to less fatigue development as reflected by rates of change in perceived discomfort, performance, and muscle capacity. Lastly, the dependency of muscle recovery on these different histories of fatiguing muscle contractions was explored. How a muscle recovers appeared to depend only on the state from which it starts to recover, though not the exertion history that led to that state. In summary, results of these studies may help in enhancing our understanding of fatigue and recovery processes, and in improving existing models of muscle fatigue and recovery. More accurate predictions of LMF development may help in enhancing muscle performance and in reducing the risk of musculoskeletal injuries and their associated healthcare costs. / Ph. D.

Falls are the leading cause of injuries among older adults (>65) and frequently result in reduced mobility, loss of independence, decreased quality of life, injury, and death.  Extensive research has been conducted regarding postural coordination and control, and other mechanisms/processes involved in maintaining postural stability.  However, there is relatively limited knowledge regarding the patterns of joint coordination, the underlying postural controller, and efficient methods to assess passive and active musculoskeletal properties relevant to balance.  In the current work, three new methods were developed to address these limitations and also to better understand the effects of localized ankle muscle fatigue, gender, and aging on postural coordination and control. First, two methods were used to evaluate postural coordination.  A wavelet coherence approach was developed and applied to assess the level and pattern of coordination between pairs of joints (i.e., ankle-knee, ankle-trunk, and ankle-head).  In addition, the uncontrolled manifold method was implemented for evaluation of potential whole-body coordination control goals.  Clear patterns of intermittent wavelet coherence were evident, indicating that joint coordination is intermittently executed.  Both in-phase and anti-phase coherence were detected over frequencies of 2.5 -- 4.0 Hz.  Shoulder and head kinematics appeared more likely than the whole-body center of mass as control goals for whole body coordination.  Both aging and ankle muscle fatigue led to a reduction of joint coordination. Second, an intermittent sliding mode controller was developed to model quiet upright stance.  In contrast to most previous postural controllers, which assume continuous control, an intermittent controller was considered more consistent with recent evidence on muscle activity and the results of the first study on postural coordination.  The sliding mode controller was able to accurately track kinematics and kinetics, and generated passive and active ankle torques comparable with previous results.  Ankle fatigue led to an increase in active ankle torque especially among young adults and males. Third, a new method was developed to estimate passive and active mechanical properties at the ankle (e.g., stiffness and damping).  This method was inspired from intermittent control theory, and the earlier results noted.  As opposed to conventional methods, this new method is computationally efficient and does not require external mechanical or sensory perturbations.  The method yielded a ratio of passive to active ankle torques consistent with earlier evidence, and larger passive and active ankle torques among males and older adults.  A post-fatigue increase of active ankle torque was estimated, especially among males and young adults. In addition to providing new analytical methods, the noted studies suggest that older adults have decreased joint coordination and increased ankle stiffness.  As a practical implication of this, fall prevention training programs may benefit from seeking to develop appropriate joint coordination strategies and ankle stiffness magnitudes.  To expand on the current work, future research should consider measuring muscle contraction characteristics at multiple joints and in different postures or activities. / Ph. D.

Work-related musculoskeletal disorders (WMSDs) are prevalent in the workplace, and epidemiology studies show that these problems do not tend to diminish. While the use of new and advanced technology has substantially reduced the amount of physical workload, repetitive manual activities are still typically observed in various work settings. Despite their fairly low workload intensity, prolonged repetitive tasks have been associated with the development of musculoskeletal complaints and problems. Research on localized muscle fatigue (LMF) has been viewed as a viable endeavor toward understanding the processes and mechanisms associated with WMSDs. A mounting of evidence on local fatigue during sustained static work has been presented, but much less is known with respect to muscle fatigue during more complex activities. A study was conducted with the primary objectives of determining the repeatability of several commonly used fatigue measures, and to evaluate the presence of long-lasting effects of fatigue from different recovery periods. Based on low-level intermittent arm abductions, findings from this study demonstrated that the use of perceptions of muscular discomfort and muscle strength as fatigue measures was satisfactory. In contrast, electromyography (EMG)-based measures were characterized by a fairly low repeatability. The study also suggested that, whenever practical, two days of recovery should be allotted in studies involving multiple exposures to fatiguing protocols. Long lasting effects of fatigue could be present when shorter amounts of recovery period were assigned. A second study was also carried out to investigate the effects of work parameters (force-level, work-rest ratio, and work cycle) on muscular fatigue during intermittent static efforts. It was suggested that work conditions with muscular contraction level less than 12% MVE was non-fatiguing, irrespective of the values of the work parameters selected. Intermittent work with higher levels of muscle contraction might be acceptable, but it was dependent upon interactions of the other two parameters. The effects of dynamic work conditions on muscle fatigue were investigated in another study. Findings from this third study suggested that muscles responded differently under dynamic conditions and the use of typical EMG measures (dynamic EMG) could be less sensitive. This study further demonstrated that fatigue evaluations during such conditions were difficult, and only a limited number of EMG-based measures could be potentially employed. / Ph. D.

Human postural control is a complex process, but that is critical to understand in order to reduce the prevalence of occupational falls. Localized muscle fatigue (LMF), altered sensory input, and inter-individual differences (e.g. age and gender) have been shown to influence postural control, and numerous methods have been developed in order to quantify such effects. Recently, methods based on statistical mechanics have become popular, and when applied to center of pressure (COP) data, appear to provide new information regarding the postural control system. This study addresses in particular the stabilogram diffusion and Hurst exponent methods. An existing dataset was employed, in which sway during quiet stance was measured under different visual and surface compliance conditions, among both genders and different age groups, as well as before and after induction of localized muscle fatigue at the ankle, knee, torso, and shoulder. The stabilogram diffusion method determines both short-term and long-term diffusion coefficients, which correspond to open- and closed-loop control of posture, respectively. To do so, a "critical point" (or critical time interval) needs to be determined to distinguish between the two diffusion regions. Several limitations are inherent in existing methods to determine this critical point. To address this, a new algorithm was developed, based on a wavelet transform of COP data. The new algorithm is able to detect local maxima over specified frequency bands within COP data; therefore it can identify postural control mechanisms correspondent to those frequency bands. Results showed that older adults had smaller critical time intervals, and indicating that sway control of older adults was essentially different from young adults. Diffusion coefficients show that among young adults, torso LMF significantly compromised sway stability. In contrast, older adults appeared more resistance to LMF. Similar to earlier work, vision was found to play a crucial role in maintaining sway stability, and that stability was worse under eyes-closed (EC) than eyes-opened (EO) conditions. It was also found that the short-term Hurst exponent was not successful at detecting the effects of LMF on sway stability, likely because of a small sample size. The new critical point identification algorithm was verified to have better sensitivity and reliability than the traditional approach. The new algorithm can be used in future work to aid in the assessment of postural control and the mechanisms underlying this control. / Master of Science

This study is a subset of a larger body of research that examined shoulder time to fatigue during overhead work in an attempt to reduce the prevalence and impact of work-related musculoskeletal problems in the shoulder associated with overhead work, particularly during automobile assembly. Existing evidence suggests that shoulder injuries are diverse in terms of tissues affected and symptoms presented. Furthermore, the cause of these injuries is multifactorial. The work presented here assumes that musculoskeletal injuries of the shoulder mechanism are at least related to, if not caused by, fatigue localized to the shoulder musculature. While the exact relationship between fatigue and injury has not been clearly established, there is consensus among researchers that fatigue plays and important role. Muscular fatigue, therefore, is viewed as a surrogate measure of risk, and task design to avoid fatigue is seen as a rational method to minimize this risk. An experiment to determine the effects of tool weight on shoulder fatigue and performance during overhead work with work/rest cycles was performed. Times to fatigue were derived based on dependent measures including total task duration, controlled maximum muscle contractions, subjective ratings based on Borg's CR-10 RPE scale, electromyogram behavior (MdPF), and hand force performance measures. Experimental findings indicated that duty cycle (percentage of total task cycle time spent working) significantly affected task duration (p<0.0001), changes in maximum voluntary contraction values for the infraspinatus (p<0.05), and the minimum time for any shoulder muscle to fatigue as determined by changes in the EMG power spectrum (p<0.05). Time to fatigue for the mid deltoid as determined by changes in the median frequency of the EMG power spectrum was shown to change significantly (p<0.05) with change in tool weight. Large intersubject variation was observed for the dependent measures, which showed subjects experiencing different levels of fatigue while performing the same task. Limitations of the study and recommendations for future direction are also discussed. / Master of Science

Application of pressure in the form of taping and bracing has been shown to improve proprioception, and inducing localized muscle fatigue at various musculatures has been shown to adversely affect postural control. However, the potential for pressure application to mitigate the effects of localized muscle fatigue on postural control has not yet been determined. This study investigated specifically the effects of circumferential ankle pressure (CAP) and induced ankle fatigue on postural control. Fourteen young participants (seven males and seven females) performed fatiguing sub-maximal isotonic plantar flexion exercises on an isokinetic dynamometer, in the absence and presence of a pressure cuff (60 mm Hg) used to apply CAP. Proprioceptive acuity (PA) was determined using a passive-active joint position sense test, with categorical scores (low or high PA) used as a covariate. Postural sway during quiet standing was assessed using a force platform both pre- and post-fatigue as well as in the absence and presence of CAP. Application of CAP resulted in larger postural sway in individuals with low PA, and reduced postural sway in individuals with high PA. Fatigue effects on postural sway in individuals with low PA were more substantial as compared to individuals with high PA. CAP was found to be ineffective in mitigating the effects of fatigue on postural sway in individuals with lower PA. As a whole, the results suggest a potential for CAP as an ergonomic intervention in controlling fatigue-related fall incidents, though conclusive recommendations for use are not justified. / Master of Science

Localized muscle fatigue (LMF) has been proposed as a surrogate measure to injury, since the onset of fatigue is rapid rather than months or years required to the onset of work related musculoskeletal disorders (WMSDs). The objectives of this study were to estimate LMF and quantify muscle activity of select forearm muscles during simulations of high pressure cleaning lance tasks common in the chemical production industry. Twenty participants, twelve males and eight females, with no musculoskeletal injuries and meeting criteria for upper extremity fitness, performed the simulated task. Independent variables studied include work height (shoulder, waist, and knuckle), lance orientation (parallel to the operator and parallel to the ground), and duty cycle (33, 50, and 67%) based on task analyses of actual work tasks. Dependent variables included mean RMS and rates of change in mean RMS, mean and median power frequency, MVE, and subjective ratings of fatigue. Repeated measures ANOVA was used to test the main effects of the independent variables and appropriate interactions. In general it was found that working at waist height, at higher duty cycles, and with the lance oriented parallel to the operator resulted in higher fatigue measures. Subjective ratings of fatigue were not well correlated with objective measures, similar to findings in previous studies. The simulated task was found to be extremely fatiguing and modifications to task design or job rotation schedules are required to reduce risk associated with injury development. / Master of Science