Range-of-Motion

and
Strength

Evaluating Work Capacity

Work-capacity is generally used to describe an individuals
(dis)ability to complete a task.
Although similar to anthropometric measurements, work
capacity dimensions usually reflect the ability of the
human body to physically function as opposed to the size
and shape.
Physical work capacity is especially important in
rehabilitation engineering.
Components of work-capacity evaluation ???

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 Why Evaluate Work Capacity?
Identify high risk workers
fit tasks to human capacity
additional risks for persons with limited capacities?
Improve organizational performance
design tasks < or = to population capacity (D<C)
Assess "Return to Work" status
determine physical capacity after injury
determine whether full recovery has occurred
adapt work for any decreased capacity or residual deficits
Affirmative Action for:
women
older workers
physically impaired workers

Joint Range of Motion (ROM)

Why measure ROM?
Define norms for populations at extremes (reach)
Define extent or results of physical impairment
(ROM may be predictive of injury or disease)
Workplace and tool design to prevent awkward,
difficult, or physically demanding postures

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ROM
Example
Application

Describing Joint Motions

May be simple (planar) or complex (3-D)
May be single or multi-joint motions in same or
opposite directions
Thus,
reference postures are needed
different planes of motion must be identified
consistent terminology must be adopted
testing conditions must be standardized
existing data may be difficult to interpret, or not
applicable to a given circumstance

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 Standard Anatomical Position
Sagittal Plane
flexion and extension
motions
Horizontal (Transverse)
Plane
rotational motions
Coronal (Frontal) Plane
abduction and adduction
motions

From Chaffin, DB et al (1999) Occupational

Biomechanics, Fig 4.1

Anatomical Terms for

Position/Orientation
Anterior - in front of, toward the front of the body
Posterior - behind, toward the back of the body
Ventral - toward the abdominal surface
Dorsal - toward the back or spine
Medial - near or toward the mid-line
Lateral - to the side, away from the mid-line
Superior - above, toward the top
Cranial - towards head
Inferior - below, towards the bottom
Caudal - towards feet
Proximal* - near the point of reference
Distal* - away from the point of reference
Superficial - on or near the surface
Deep - away from or below the surface
* Proximal and Distal usually refer to limbs, where the point of reference is the
attachment to the body.

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 Anatomical Terms Related to
Movement
Flexion - a decrease in the angle formed by two bones.
Extension - an increase in the angle formed by two bones.
Hyper-extension - extension beyond normal ROM
Supination - rotation of the forearm toward anatomical position.
Pronation - rotation of the forearm away from anatomical
position.
Abduction - movement away from the mid-line.
Adduction - movement toward the mid-line.

Population Joint ROM Values

From Chaffin, DB et al (1999) Occupational Biomechanics, Fig 4.4

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 Sample Joint
ROM Data

From Chaffin, DB et al (1999)

Occupational Biomechanics, Table 4.2

Factors Affecting ROM

Age (little change 16-70 in asymptomatic active
population)
Gender
Anthropometric Dimensions
stature and weight not well correlated with ROM
small correlation of obesity with lower ROMs
Training
stretching and changes in flexibility
Joint or Muscle Pathology
2-Joint Muscle Effect
implications for precise specification of posture
measurement problems

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 Joint ROM: Gender
Women are
more
flexible on
average
than men.
Greatest
difference
at wrist,
least at
knee,
unclear
why...
From Chaffin, DB et al (1999) Occupational
Biomechanics, Table 4.3

SUMMARY: ROM
Different measurement methods exist. Best method is
situation dependent.
ROM data for population is not as prevalent as
anthropometric or strength data. Existing data often on
young males. Limited data for older populations.
ROM at one joint is not independent of adjacent joint
angles and presence of external loads. Care needed
when interpreting or using data.

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Need For Strength Measurement
Worker Selection low strength people may be at
increased risk in high stress jobs (though mixed
evidence exists).
Large inter-individual variability (7:1 to 10:1)
Injury Diagnosis and Rehabilitation injured muscles
will produce substantially lower force.
Strength required for tasks is specific to kinematic
(posture and motion) requirements
Biomechanical Modeling if the strength (capacity) is
close to the task requirements (demands), higher risk of
musculo-skeletal injury exists (D<C).

Muscle Strength Measurement

Types of strength
Isometric (static): variable force, no motion
Isokinetic (dynamic): constant velocity
Isoinertial (dynamic): constant mass
Free Dynamic (dynamic): constant task
Psychophysical (dynamic): subjective limit
Static and Dynamic tests can be localized (1 joint) or
whole-body (e.g. pull or lift)
Measures include: force; moment; duration
Strength depends on what is measured and how!

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 Maximum Voluntary Exertions
Maximum physical capacity is often higher than maximum
voluntary exertion. Involuntary reflexes, lack of practice,
and lack of motivation are likely involved.
Values depend on tolerance to pain, motivation,
training
Value can be sensitive to testing conditions (e.g. feedback)
Interpolated twitch method
While participant is exerted maximally, apply an external shock
Well-training, and motivated participants typically give voluntary
exertions > 90-95% of voluntary + involuntary value
Differences can be indicative of central fatigue and/or
motivation

Static vs. Dynamic Strength Testing

The main advantage of static (isometric) testing is its
simplicity. A person is simply placed in several 'fixed'
positions and asked to generate a force in a given direction
for few seconds.
since postures are unchanged, the physical conditions are simple.
instrumentation is relatively cheap and easily used
unfortunately, static tests often have a poor association with
dynamic performance capability (R2<0.5)
Dynamic strength testing has the advantage that it is more
similar to actual manual lifting tasks.
real lifting is almost always done in motion
testing is much more difficult given the range of potential
postures and velocities, and the problems in experimentally
controlling these variables. Constant velocity (isokinetic) is the
most common.

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 Strength Measurement
Procedures - AIHA
From Chaffin (1975) An Ergonomic Guide for the Assessment of Human Static
Strength, American Industrial Hygiene Association; See also L.S. Caldwell
et.al. (1974) A proposed standard procedure for static muscle strength testing,
AIHA Journal.
An exertion duration of 4 to 6 seconds (although common, this
may not be task relevant)
A measuring device that can:
Record peak and 3 second time average.
Be applied to a person without creating discomfort due to localized
pressure.
Be easily adjusted for different types of exertions and different
anthropometries.
Adequate rest between exertions - from 30 seconds to 2 minutes.

Strength Measurement
Procedures - AIHA
Carefully stated instructions to:
Avoid coercion of subject.
Inform subject of potential risks involved.
Allow subject to control pace/rest if extra time is needed.
Inform subject of future reporting of data and potential consequences.
Provide positive, general verbal feedback to the subject, but during testing
withhold specific performance values from the subject to avoid uncontrolled
competition when groups of people are tested together.
Minimize all environmental distractions.
Standardization of test postures, body supports and restraints.
Complete reporting of test conditions, subject biographic data, and
resulting statistics.

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 Aging and Muscle Strength
100 males

Decrease in strength 80
with age females
60
Composite results of
%
localized (gripping 40
and twisting with the
hand) and global 20
(two-handed pushing
and one-handed 0
0 10 20 30 40 50 60 70 80 90
pulling) tasks
Age (years)

Males: y = 49.77 + 49.86/(1+(x/70.52)6.79)

Females: y = -136.7 + 202.13/(1+(x/136.9)3.62)

From: Voorbij and Steenbekkers (2001) Applied Ergon 32:287-292

X
Sample Static Strength Data
Primary Joint
10:1 Range !
Secondary Joint

From Chaffin, DB et al (1999) Occupational Biomechanics, Table 4.4

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X
Sample Static Strength Data

Note:
1) Effects of Gender, Posture, Motion
2) Large sample sizes, large SDs
From Chaffin, DB et al (1999) Occupational Biomechanics, Table 4.5

X
Sample Dynamic Strength Data
Female Male

Note:
1) Effects of posture and gender
From: Knapick et al. (1983) Physical
Therapy 63:938-947
2) Static vs. Isokinetic

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 SUMMARY: Strength
Why measure strength?
Strength is usually measured using maximum voluntary exertions
and psychophysical methods (limited use of external stimulation).
Types of strength tests: definitions, uses.
Criteria for functional strength testing.
Effects of posture and motion on strength.
Muscle strength varies with gender, age, and anthropometry, but
the relationships are not very strong (about 30-50% of variance
explained by anthropometry).
Both gender and age differences can be substantial.

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