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1.	Nilsson, Kerstin, et al. (author) 54 forskare: Inte alla klarar höjd pensions-ålder 2017 In: Svenska Dagbladet, Stockholm. - 1101-2412. Journal article (pop. science, debate, etc.)abstract Ett hållbart och acceptabelt pensionssystem måste utformas utifrån personliga förutsättningar och förhållanden i arbetslivet, så att fler klarar att arbeta i högre ålder. Att enbart genom ekonomiska åtgärder höja pensionsåldern är inte långsiktigt hållbart, skriver 54 forskare.DEBATT \| PENSIONForskning visar att cirka var fjärde har en diagnos eller skada orsakad av sitt arbete. Detta gör arbetsorsakad sjukdom och skada till ett betydelsefullt folkhälsoproblem. Att då enbart genom ekonomiska åtgärder höja pensionsåldern för samtliga (yrkes)grupper utifrån deras kronologiska ålder är inte långsiktigt hållbart när individers biologiska ålder är så olika bland annat till följd av arbetslivet. Detta är en demokratifråga. Forskning om äldre i arbetslivet och hållbart arbete visar att man då främst flyttar individer från pensionssystemet till sjukförsäkringssystemet och ökar klyftorna i samhället.Debatt Det här är en argumenterande text med syfte att påverka. Åsikterna som uttrycks är skribentens egna.Vi är 54 forskare som nu gemensamt har skrivit denna debattartikel. Anledningen är att vi är oroade över att cirka var fjärde blir sjuk av sitt arbete samtidigt som man i det förslag som ligger om att senarelägga ålderspensionen i princip utgår ifrån att arbetskraftsdeltagande enbart styrs av ekonomin. Vi vill trycka på betydelsen av åtgärder i arbetslivet för att komma tillrätta med ohälsan, det vill säga inte enbart ekonomiska restriktioner som tvingar folk som inte kan, vill och orkar att stanna kvar i arbetslivet till en högre kronologisk ålder.Pensionssystemet bygger på att vi ska arbeta en viss del av våra liv för att förtjäna möjligheter till pension. Vi bör dock inte enbart utgå ifrån antalet år sedan en person föddes, då korttidsutbildade generellt träder in på arbetsmarknaden tidigare än långtidsutbildade. De har alltså varit en del av arbetskraften från en yngre ålder. Människor med kortare utbildning har oftare ett arbete som innebär påfrestningar som kan inverka negativt på hälsotillståndet och som till och med kan påskynda det biologiska åldrandet. Dessutom lever korttidsutbildade generellt sett inte lika länge som långtidsutbildade, vilket delvis även avspeglar skilda livs- och arbetsvillkor.Den svenska sjukförsäkringsreformen 2008 avsåg att få tillbaka människor i arbete. Men studien fann att den faktiskt bidrog till att fler gick i tidig ålderspension av dem som var i åldern 55–64 år. Ökningen var störst bland korttidsutbildade. Mer än 5 procent fler gick i tidig ålderspension då det blev svårare att få sjukpenning och sjukersättning. Vi kan notera att det är vanligare att manliga chefer tar ut tidig ålderspension, jämfört med kvinnliga maskinskötare inom tillverkningsindustrin. I vissa yrken är det dessutom vanligare att människor, trots pension, både orkar och faktiskt ges möjlighet att arbeta vidare om de har en specialkompetens som efterfrågas. Om vi endast kombinerar ekonomiska morötter med piskor finns en stor risk att vi ökar klyftan mellan grupper som både kan och vill fortsätta att yrkesarbeta och personer som av olika skäl inte längre kan eller orkar.Ta nytta av den forskning som vi har tagit fram. Ett hållbart och acceptabelt pensionssystem måste utformas utifrån personliga förutsättningar och förhållanden i arbetslivet. Ett hållbart arbetsliv för allt fler i vår åldrande befolkning fordrar att vi samtidigt beaktar faktorer som relaterar till biologisk/kroppslig ålder, mental/kognitiv ålder samt social ålder/livsloppsfas och våra attityder som är kopplade till ålder. Vi måste ta större hänsyn till olika förutsättningar och varierande funktionsförmåga och utifrån detta anpassa de åtgärder som gör att arbetslivet blir möjligt och hållbart för allt fler även i högre ålder.”Morötter” är viktigare för en god arbetshälsa och hög produktivitet än en piska i form av oron för en dålig ekonomi.Forskning visar att pedagogik som bygger på ”morötter” oftast är betydligt bättre än ”piskor” för att nå framgångsrika och långsiktiga mål. ”Morötter” i samhället, för organisationer, företag och individer är därför viktiga för god arbetshälsa och fortsatt produktivitet och kan bidra till ett längre arbetsliv även för grupper som tidigare inte ens klarat av att arbeta fram till pensionsåldern. Genom forskning inom området har bland annat swage-modellen utarbetats. Detta är ett verktyg som visar på komplexiteten i ett hållbart arbetsliv och tillsammans med systematiskt arbetsmiljöarbete, handlingsplaner och åtgärder syftar till ett mer hållbart arbetsliv. Morötter är enligt forskningen i detta sammanhang åtgärder för en god fysisk och mental arbetsmiljö, avpassad arbetsbelastning, stödjande teknik, att man kan anpassa arbetstakten, alternativa arbetstidsmodeller vid behov. Det är viktigt att man känner sig trygg och förväntas och tillåts vara delaktig, att man blir sedd av chefen och arbetskamraterna. Att de egna arbetsuppgifterna upplevs som meningsfulla och behövda av andra skapar självförverkligande och tillfredsställelse i arbetet. Att man känner att ens arbetsuppgifter och man själv är viktig för organisationen och företaget. Att man trots högre ålder inkluderas i olika nysatsningar och får tillgång till kompetensutveckling och inte blir åsidosatt eller åldersdiskriminerad. Utvärderingar visar att de äldre medarbetarna som fick några av dessa anpassningar och möjligheter var mer effektiva, utvilade, stimulerade när de var på arbetet samtidigt som sjukfrånvaron minskade. Vilket i sin tur bidrar till ett längre arbetsliv för grupper som tidigare inte klarat av att arbeta fram till pensionsåldern. I organisationer som bygger på en deltagar- och lärandekultur rustas de anställda för att klara omställningar, nya arbetsuppgifter och vid behov även yrkesbyten.Med en åldrande befolkning där allt fler lever allt längre behöver vi arbeta till en högre ålder i framtiden för att pensionssystemet ska hålla. Men ”morötter” är viktigare för en god arbetshälsa och hög produktivitet än en piska i form av oron för en dålig ekonomi. Det kräver också att vi ändrar våra attityder och förhållningssätt till äldre på arbetsmarknaden, vilket vi bäst gör genom att organisationer och företag får incitament till och erbjuder mer individanpassade arbetsvillkor, särskilt för personer i högre ålder. Låt oss därför använda den framtagna kunskapen i praktiken för att göra arbetslivet friskt och hållbart för alla åldrar.
2.	Nilsson, Kerstin, et al. (author) Vi är oroade över senare ålderspension 2017 In: Dagens Samhälle. - 1652-6511. Journal article (pop. science, debate, etc.)abstract Var fjärde person blir i dag sjuk till följd av sitt arbete. Att höja pensionsåldern för alla yrkesgrupper, utan konkreta åtgärder för att minska ohälsan, är därför problematiskt och mycket oroande. Det är, enligt forskarna, inte långsiktigt samhällsekonomiskt lönsamt att utan andra åtgärder höja pensionsåldern för alla. Vi – 54 forskare – är mycket oroade över konsekvenserna av att, som föreslagits, senarelägga ålderspensionen.Förslaget utgår i princip från arbetskraftsdeltagande i princip enbart styrs av ekonomin, medan forskningen visar att det bara är en av flera faktorer som styr hur länge och hur mycket människor väljer att arbeta.Det här sättet att lösa problemet med en åldrande befolkning och ett sviktande pensionssystem är inte samhällsekonomiskt lönsamt på lång sikt, utan riskerar bara att flytta runt folk mellan olika ersättningssystem. Pensionssystemet bygger på att vi ska arbeta en viss del av våra liv för att tjäna in vår pension. Vi bör dock inte enbart utgå ifrån ålder eller antalet år sedan en person föddes då korttidsutbildade generellt träder in på arbetsmarknaden tidigare än långtidsutbildade. De med kortare utbildningstid har alltså varit en del av arbetskraften från en yngre ålder. Människor med kortare utbildning har också oftare ett arbete som innebär påfrestningar som kan inverka negativt på hälsotillståndet och som till och med kan påskynda det biologiska åldrandet. Dessutom lever korttidsutbildade generellt sett inte lika länge som långtidsutbildade, vilket delvis även avspeglar skilda livs- och arbetsvillkor.Ta nytta av den forskning som vi har tagit fram. Ekonomin är självklart viktigt för att vi ska vilja arbeta, men den är som sagt enbart en av flera faktorer med betydelse vårt arbetsliv.Hälsotillståndet, både det fysiska och det mentala, har en avgörande betydelse för hur länge och hur mycket vi orkar arbeta. Ett fysiskt och mentalt belastande arbete är en stark riskfaktor för en nedsatt hälsa i slutet av arbetslivet. Arbetstid, arbetstakt och möjlighet till återhämtning spelar en allt större roll ju äldre vi blir. Andra aspekter är arbetsinnehåll, hur meningsfulla och stimulerande arbetsuppgifterna är, balansen mellan arbete och familjesituation och fritidsaktiviteter. Organisationskultur, ledarskapet, stöd i arbetet och kompetens har stor betydelse för om vi ska kunna och vilja arbeta till en högre ålder. Vi måste ta större hänsyn till olika förutsättningar och varierande funktionsförmåga och utifrån detta anpassa de åtgärder som gör att arbetslivet blir möjligt och hållbart för allt fler även i högre ålder.Ett hållbart och acceptabelt pensionssystem måste därför utformas utifrån personliga förutsättningar och förhållanden i arbetslivet. Ett hållbart arbetsliv för allt fler i vår åldrande befolkning fordrar att vi samtidigt beaktar faktorer som relaterar till biologisk/kroppslig ålder, mental/kognitiv ålder samt social ålder/livsloppsfas samt de attityder som är kopplade till ålder.
3.	Elcadi, Guilherme H., et al. (author) A Strong Correlation Between Dorsolateral Prefrontal Cortex And Vastus Lateralis Activity During Running To Fatigue 2016 In: Medicine and science in sports and exercise. - : Ovid Technologies (Wolters Kluwer Health). - 0195-9131 .- 1530-0315. ; 48:5, s. 854-854 Journal article (peer-reviewed)abstract Fatigue is a phenomenon of pronounced importance in sports. Recently, there is strong evidence of interplay between the prefrontal cortex and motor output during fatiguing contractions. The dorsolateral prefrontal cortex (DLPC) due to its large involvement in cognitive and motor activities is believed to be involved but this requires physiological clarification. AIM: We investigated the relationship between DLPC activity - responses in oxyhemoglobin (HbO2) and total hemoglobin (HbT) measured by near-infrared spectroscopy (NIRS), and the vastus lateralis muscle (VL) activity - quantified as root-mean-square (RMS) of the EMG signal, during a fatigue protocol.METHODS: Four male runners (32±12 yrs) with probes for NIRS over the DLPC and EMG over the VL performed a track running test at a constant speed to fatigue (exhaustion). The running speed was individually determined as the average speed of a 1200-m time trial performed ~3 days prior to testing. For NIRS changes in μmole/L of HbO2 and HbT were computed. The VL EMG-RMS of the contraction of each step was normalized as a percent of a submaximal reference contraction (%RMS), thus removing the non-activity between steps. Data of 10s epochs at 20, 40, 60, 80 and 100% of time for each lap were averaged for analyses. Regression analyses performed with HbO2 and with HbT as dependent variables and %RMS as the independent variable.RESULTS: Over time there was an increase in HbO2 and HbT in the DLPC, and in VL-%RMS. Both HbO2 and HbT correlated strongly with EMG-RMS during running to fatigue (see figures below); p<0.001 for both.CONCLUSION: The strong relationship between DLPC and VL activities during running to fatigue suggests the involvement of the DLPC in the central processing of fatigue.
4.	Elcadi, Guilherme H, et al. (author) A Strong Correlation Between Dorsolateral Prefrontal Cortex And Vastus Lateralis Activity During Running To Fatigue : 3025 Board# 90 June 3, 2: 00 PM-3: 30 PM 2016 In: Medicine & Science in Sports & Exercise. - : LWW. - 0195-9131 .- 1530-0315. ; 48:5S Journal article (peer-reviewed)
5.	Fan, Xuelong, et al. (author) Effects of sensor types and angular velocity computational methods in field measurements of occupational upper arm and trunk postures and movements 2021 In: Sensors. - : MDPI AG. - 1424-8220. ; 21:16 Journal article (peer-reviewed)abstract Accelerometer-based inclinometers have dominated kinematic measurements in previous field studies, while the use of inertial measurement units that additionally include gyroscopes is rapidly increasing. Recent laboratory studies suggest that these two sensor types and the two commonly used angular velocity computational methods may produce substantially different results. The aim of this study was, therefore, to evaluate the effects of sensor types and angular velocity computational methods on the measures of work postures and movements in a real occupational setting. Half-workday recordings of arm and trunk postures, and movements from 38 warehouse workers were compared using two sensor types: accelerometers versus accelerometers with gyroscopes—and using two angular velocity computational methods, i.e., inclination velocity versus generalized velocity. The results showed an overall small difference (<2° and value independent) for posture percentiles between the two sensor types, but substantial differences in movement percentiles both between the sensor types and between the angular computational methods. For example, the group mean of the 50th percentiles were for accelerometers: 71°/s (generalized velocity) and 33°/s (inclination velocity)—and for accelerometers with gyroscopes: 31°/s (generalized velocity) and 16°/s (inclination velocity). The significant effects of sensor types and angular computational methods on angular velocity measures in field work are important in inter-study comparisons and in comparisons to recommended threshold limit values.
6.	Forsman, Mikael, Professor, et al. (author) Mind the gap – development of conversion models between accelerometer- and IMU-based measurements of arm and trunk postures and movements in warehouse work 2022 In: Applied Ergonomics. - : Elsevier BV. - 0003-6870 .- 1872-9126. ; 105 Journal article (peer-reviewed)abstract Sensor type (accelerometers only versus inertial measurement units, IMUs) and angular velocity computational method (inclination versus generalized velocity) have been shown to affect the measurements of arm and trunk movements. This study developed models for conversions between accelerometer and IMU measurements of arm and trunk inclination and between accelerometer and IMU measurements of inclination and generalized (arm) velocities. Full-workday recordings from accelerometers and IMUs of arm and trunk postures and movements from 38 warehouse workers were used to develop 4 angular (posture) and 24 angular velocity (movement) conversion models for the distributions of the data. A power function with one coefficient and one exponent was used, and it correlated well (r2 > 0.999) in all cases to the average curves comparing one measurement with another. These conversion models facilitate the comparison and merging of measurements of arm and trunk movements collected using the two sensor types and the two computational methods.
7.	Lind, Carl Mikael, et al. (author) Development and evaluation of RAMP II - a practitioner’s tool for assessing musculoskeletal disorder risk factors in industrial manual handling 2020 In: Ergonomics. - : Informa UK Limited. - 0014-0139 .- 1366-5847. ; 63:4, s. 477-504 Journal article (peer-reviewed)abstract RAMP II is an observation-based tool developed for assessing a wide range of musculoskeletal disorder risk factors related to industrial manual handling. RAMP II, which is part of the RAMP tool, is based on research studies and expert judgments. The assessment relies mainly on direct or video observations of the work being assessed, but additionally on measured push/pull forces and weights of handled objects, and on perceived workload and discomfort. Over 80 practitioners participated in the development of the tool. According to the evaluations, 73% of the assessment items evaluated had acceptable reliability, and the majority of the potential end-users reported that RAMP II is usable for assessing risks and as a decision base. It is concluded that this study provides support that RAMP II is usable for risk assessment of musculoskeletal disorder risk factors in industrial manual handling. Practitioner summary: RAMP II is an observation-based assessment tool for screening and assessing major musculoskeletal exposures in industrial manual handling jobs. Over 80 practitioners participated in the development of the tool. This study provides support that RAMP II is usable for risk assessment of musculoskeletal disorder risk factors in industrial manual handling. Abbreviations: CTS: carpal tunnel syndrome; HARM: the Hand Arm Risk Assessment method; IMP: intramuscular pressure; κw: linearly weighted kappa; LBD: lower back disorders; LBP: lower back pain; MAWL: maximum acceptable weight of lift; MHO: manual handling operations; MSD: musculoskeletal disorder; MNSD: neck-shoulder disorder; NSP: neck-shoulder pain; OCRA: the Occupational Repetitive Action methods; OHS: occupational health and safety; PABAK: prevalence and bias adjusted kappa; p0: proportion of agreement; RAMP: Risk Assessment and Management tool for manual handling Proactively; ROM: range of motion; RPL: risk and priority level; RSI: the Revised Strain Index; RULA: the Rapid Upper Limb Assessment; SWEA: Swedish Work Environment Authority; UEMSDs: upper-extremity work-related musculoskeletal disorders; WMSD: work-related musculoskeletal disorder; WRMSD: work-related musculoskeletal disorder; workday8h: eight hours workday.
8.	Lind, Carl Mikael, et al. (author) Prevention of work-related ill-health 2018 In: 40th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). Conference paper (peer-reviewed)abstract This paper presents strategies targeting prevention of work-related ill-health, and how the use of smart workwear (wearables) can facilitate these strategies
9.	Lind, Carl Mikael, et al. (author) Prevention of Work: Related Musculoskeletal Disorders Using Smart Workwear – The Smart Workwear Consortium 2019 In: Human Systems Engineering and Design. - Cham : Springer. - 9783030020521 - 9783030020538 ; 876, s. 477-483 Conference paper (peer-reviewed)abstract Adverse work-related physical exposures such as repetitive movements and awkward postures have negative health effects and lead to large financial costs. To address these problems, a multi-disciplinary consortium was formed with the aim of developing an ambulatory system for recording and analyzing risks for musculoskeletal disorders utilizing textile integrated sensors as part of the regular workwear. This paper presents the consortium, the Smart Workwear System, and a case study illustrating its potential to decrease adverse biomechanical exposure by promoting improved work technique.
10.	LIND, Carl Mikael, et al. (author) Reducing postural exposure in manual handling–effects of vibrotactile feedback and verbal instructions 2019 In: Human Factors Society Conference. Conference paper (peer-reviewed)
11.	Lind, Carl Mikael, et al. (author) Reducing postural load in order picking through a smart workwear system using real-time vibrotactile feedback Other publication (other academic/artistic)abstract Vibrotactile feedback training may be one possible method for interventions that target at learning better work technique and improving postures in manual handling. The aim of this study was to evaluate the effect of real-time vibrotactile feedback using a smart workwear system for work postures intervention in industrial order picking. Fifteen workers at an industrial manufacturing plant performed order-picking tasks, in which the vibrotactile feedback was used for postural training at work. The trunk and upper arm postures were recorded by the system. Questionnaires and semi-structured interviews were conducted about the users’ experience of the system. The results showed reduced time in adverse postures for the trunk and upper arms when the workers received feedback, and for trunk postures also after feedback withdrawal. The workers perceived the system as usable, comfortable and supportive for learning.
12.	Lind, Carl Mikael, et al. (author) Wearable Motion Capture Devices for the Prevention of Work-Related Musculoskeletal Disorders in Ergonomics-An Overview of Current Applications, Challenges, and Future Opportunities 2023 In: Sensors. - : MDPI AG. - 1424-8220. ; 23:9 Research review (peer-reviewed)abstract Work-related musculoskeletal disorders (WMSDs) are a major contributor to disability worldwide and substantial societal costs. The use of wearable motion capture instruments has a role in preventing WMSDs by contributing to improvements in exposure and risk assessment and potentially improved effectiveness in work technique training. Given the versatile potential for wearables, this article aims to provide an overview of their application related to the prevention of WMSDs of the trunk and upper limbs and discusses challenges for the technology to support prevention measures and future opportunities, including future research needs. The relevant literature was identified from a screening of recent systematic literature reviews and overviews, and more recent studies were identified by a literature search using the Web of Science platform. Wearable technology enables continuous measurements of multiple body segments of superior accuracy and precision compared to observational tools. The technology also enables real-time visualization of exposures, automatic analyses, and real-time feedback to the user. While miniaturization and improved usability and wearability can expand the use also to more occupational settings and increase use among occupational safety and health practitioners, several fundamental challenges remain to be resolved. The future opportunities of increased usage of wearable motion capture devices for the prevention of work-related musculoskeletal disorders may require more international collaborations for creating common standards for measurements, analyses, and exposure metrics, which can be related to epidemiologically based risk categories for work-related musculoskeletal disorders.
13.	Mahdavian, Nafise, et al. (author) Effect of Giving Feedback on Postural Working Techniques 2018 In: Advances in Manufacturing Technology XXXII. - Amsterdam, Netherlands : IOS Press. - 9781614999010 - 9781614999027 ; , s. 247-252, s. 247-252 Conference paper (peer-reviewed)abstract Working postures and movements affect work efficiency and musculoskeletal health. To reduce the biomechanical exposure in physically demanding settings, working techniques may be improved by giving instant ergonomic feedback to the operator. This study investigates if feedback can be used to decrease adverse postures and movements in assembly work. A prototype solution of a smart textile workwear was used on a trainee assembly line. Posture and movement signals of 24 trainee operators were sampled via the workwear, transferred to a tablet for analyses and used to provide feedback suggesting improvements of work technique. Two modes of feedback were tested. Every participant’s work technique was measured before and after receiving the feedback and the results were compared. For upper arm elevation angle ≥60, behaviour change is indicated, supporting a positive work technique change, and indicated a future usefulness of technical automatic feedback for operators.
14.	Abtahi, Farhad, 1981-, et al. (author) Big Data & Wearable Sensors Ensuring Safety and Health @Work 2017 In: GLOBAL HEALTH 2017, The Sixth International Conference on Global Health Challenges. - 9781612086040 Conference paper (peer-reviewed)abstract —Work-related injuries and disorders constitute a major burden and cost for employers, society in general and workers in particular. We@Work is a project that aims to develop an integrated solution for promoting and supporting a safe and healthy working life by combining wearable technologies, Big Data analytics, ergonomics, and information and communication technologies. The We@Work solution aims to support the worker and employer to ensure a healthy working life through pervasive monitoring for early warnings, prompt detection of capacity-loss and accurate risk assessments at workplace as well as self-management of a healthy working life. A multiservice platform will allow unobtrusive data collection at workplaces. Big Data analytics will provide real-time information useful to prevent work injuries and support healthy working life
15.	Abtahi, Farhad, 1981-, et al. (author) Wearable Sensors Enabling Personalized Occupational Healthcare 2018 In: Intelligent Environments 2018. - Amsterdam : IOS Press. - 9781614998730 - 9781614998747 ; , s. 371-376 Book chapter (other academic/artistic)abstract This paper presents needs and potentials for wearable sensors inoccupational healthcare. In addition, it presents ongoing European and Swedishprojects for developing personalized, and pervasive wearable systems for assessingrisks of developing musculoskeletal disorders and cardiovascular diseases at work.Occupational healthcare should benefit in preventing diseases and disorders byproviding the right feedback at the right time to the right person. Collected datafrom workers can provide evidence supporting the ergonomic and industrial tasksof redesigning the working environment to reduce the risks.
16.	Aptel, M, et al. (author) Une méthode-outil dâ€™aide à la prévention des TMS pour les petites entreprises 2008 In: Documents Pour Le Médecin Du Travail, DMT. ; 114, s. 221-231 Journal article (peer-reviewed)
17.	Barkstedt, Vanda, et al. (author) Sophämtares fysiska och psykosociala arbetsbelastning 2016 Reports (other academic/artistic)abstract Arbetet som sophämtare inkluderar manuell hantering som hämtning och hantering av hushållsavfall i kärl och säckar. Det finns tidigare studier som visat att arbetet kan vara tungt med en hög helkroppsbelastning. Tungt arbete förknippas ofta med besvär i rörelseorganen. Psykologiska påfrestningar i arbetet kan också bidra till besvärsuppkomst.Biltrafikens arbetsgivarförbund och Svenska Transportarbetareförbundet tog gemensamt initiativ till det här projektet ”Sophämtarnas arbetsmiljö - allas ansvar”. Projektet har utförts av Transportfackens Yrkes- och Arbetsmiljönämnd (TYA) i samarbete med Karolinska Institutet (KI) och Centrum för belastningsskadeforskning (CBF) vid Högskolan i Gävle. I den här delen av projektet var syftet att kartlägga branschens förekomst av arbetsrelaterade besvär och undersöka den fysiska och psykosociala arbetsbelastningen hos sophämtare vid arbete med insamling av hushållsavfall.Samtliga Sveriges sophämtare som arbetar med insamling av hushållsavfall, knappt 2000, erbjöds att fylla i ett omfattande frågeformulär avseende arbete och hälsa. Sextiosex procent svarade. Inom projektetet genomfördes också heldagsmätningar av puls och arbetsställningar för rygg och armar på 56 sophämtare som arbetade med baklastande sopbil. På 12 sophämtare som arbetade med sidlastande sopbil genomfördes dessutom mätningar av muskelbelastning i skulder- och underarmsmuskulatur under en hel arbetsdag. I samband med heldagsmätningarna observerades sophämtarnas arbete av en observatör från en efterföljande bil, eller via en personburen videokamera. För att få fram ytterligare information om belastning på skuldror, rygg och knän genomfördes även biomekaniska fältexperiment där sophämtare fick utföra typiska arbetssituationer samtidigt som förekommande skjut- och drag-krafter registrerades.Enligt enkätundersökningen ansåg 17 procent av sophämtarna att deras fysiska arbetsförmåga var låg, vilket är samma procentandel som tidigare har registrerats hos flygplanslastare, men något bättre än vad man brukar se bland män med kort utbildningstid.Det var vanligare med kroppsliga besvär bland sophämtare än generellt i befolkningen. Andelen med besvär för olika kroppsdelar som skuldror (60 procent), ländrygg (62 procent), nacke (49 procent), händer/handleder (44 procent), motsvarade situationen för flygplanslastare; det fanns dock en skillnad för knän, där 52 procent av sophämtarna hade besvär mot 44 procent av flyglastarna.Sophämtarnas psykosociala arbetsbelastning liknade i stort den hos flygplanslastare, och motsvarar generellt förhållandena i den arbetande befolkningen. I genomsnitt rapporterar sophämtarna även samma upplevda stöd ifrån ledningen som andra yrkesgrupper, men sophämtare på arbetsställen med särskilt lågt stöd ifrån ledningen rapporterade fler olyckstillfällen, hade högre förekomst av kroppsliga besvär och lägre arbetsförmåga än sophämtare på arbetsställen med högt stöd. Mycket talande var att många fler, 27 procent skattade låg psykisk arbetsförmåga av dem på arbetsställen med generellt lågt upplevt stöd från ledningen jämfört med 8 procent av dem på arbetsställen med högt stöd.Det var vanligare med olycksfallstillbud bland de som angav ett ständigt högt arbetstempo, vilka återfanns både bland de som svarade att de, 64 procent av sophämtarna, som fick och bland de som inte fick gå hem tidigare om de var klara med dagens uppgifter.Fyrtiofyra procent av sophämtarna svarade att de en eller flera gånger hade råkat ut för olycksfall som lett till sjukskrivning. Halkolyckor var klart vanligast. Bland de som rapporterade ett ständigt högt arbetstempo var det vanligare med olyckor.De 41 kvinnor som ingick i enkätstudien rapporterade generellt högre upplevd fysisk och psykosocial belastning, samt sämre hälsa och arbetsförmåga än sina manliga kollegor.Heldagsmätningarna visade att baklastarnas genomsnittliga arbetstid utanför depån var drygt 6½ timma, varav 43 procent utgjordes av bilkörning. Pulsmätningarna visade, liksom enkäterna, att hämtning från flerbostadhus var mera belastande än hämtning i villaområden och på landsbygden. Pulsen var stundtals hög, men i genomsnitt var den för de flesta sophämtare acceptabel enligt internationella rekommendationer.De biomekaniska analyserna visade att krafterna vid dragning av sopkärl ibland var höga, speciellt på snöunderlag, men de föreföll inte att innebära några tydliga risker för ländryggen enligt amerikanska rekommendationer för acceptabla nivåer. Det finns dock forskning som indikerar att upprepad exponering för höga dragkrafter kan innebära risk för skulderbesvär. Att hoppa eller att gå framlänges ned från styrhytt var förknippat med knäbesvär, och kan enligt de biomekaniska analyserna även ge höga ländryggsbelastningar.Mot bakgrund av dessa resultat kan några rekommendationer/frågeställningar i syfte att förbättra arbetsmiljön vara följande:Kan man öka stödet från ledningen? Ledarskaps- och arbetsmiljöutbildning för första linjens chefer? Strategi vid chefsrekrytering?Kan man påverka sophämtarna att inte arbeta i ett ”onödigt” högt tempo, om det egentligen inte är bråttom?Kan man se till att det finns tid (eller om det redan finns tid, att få sophämtarna att använda denna tid) att arbeta i ett rimligt tempo, och kanske hjälpas åt vid hantering av mycket tunga kärl?Kan man få alla att ta sig ner från hytten på "rätt sätt"? Kan man i större utsträckning använda sopbilar med låga insteg?
18.	Bergman Bruhn, Åsa, 1972-, et al. (author) Ergonomi och arbetsställningar hos anställda på ridskolor : en ny mätmetod med smarta arbetskläder 2024 Conference paper (peer-reviewed)
19.	Bergman Bruhn, Åsa, 1972-, et al. (author) Ergonomi och arbetsställningar hos anställda på ridskolor : en ny mätmetod med smarta arbetskläder 2024 Conference paper (other academic/artistic)
20.	Bernmark, Eva, et al. (author) Head movements during two computer work tasks assessed by accelerometry 2011 In: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 42:2, s. 309-313 Journal article (peer-reviewed)abstract We investigated whether potential differences in head inclinations and accelerations for two highly similar computer work tasks could be detected using (1) a triaxial accelerometer and (2) a simulated uniaxial accelerometer.Ten subjects’ head movements were registered with a triaxial accelerometer system for two similar document-management tasks at their work place: a fully electronic document-management task and one also involving paper documents.In situations where head movements were small, a triaxial accelerometer was able to discriminate between the different degrees of static work of the neck in terms of range of head inclinations and accelerations. A difference in head acceleration was also found by using a simulated uniaxial accelerometer. Thus, in terms of head movement and for work similar to this office work, potential dynamic differences in observationally similar work tasks can be investigated by using a triaxial accelerometer. For acceleration alone, a uniaxial accelerometer can also be used.
21.	Bernmark, Eva, et al. (author) Validity of heart-rate based measurements of oxygen consumption during work with light and moderate physical activity 2012 In: Work. - : IOS Press. - 1051-9815. ; 4141 Suppl 1, s. 5475-5476 Journal article (peer-reviewed)abstract For ergonomic purposes it is useful to quantify the energy expenditure and the level of physical activity imposed on workers. Oxygen consumption (VO₂) is often used to calculate energy expenditure and can be used as an indication of physical activity. Twenty-five subjects participated in the study. Oxygen consumption (VO₂) in L O₂/min and heart-rate (HR) in beats per minute (bpm) were simultaneously measured during different work tasks at each individual's workplace. Ninety-one different work tasks with light or moderate physical activity were included (physical activity was classified by the VO₂ measurements). Estimated oxygen consumption (L O₂/min) was then calculated by using the HR measurements in bpm combined with individual HR-VO₂ equations established in a laboratory. Although heart-rate based estimations of individual oxygen consumption showed relatively low precision, heart-rate measurements in combination with individual exponential HR-VO₂ equations can be used to discriminate between work involving light physical activity and work involving moderate physical activity.
22.	Bodin, Theo, et al. (author) Activity in neck-shoulder and lower arm muscles during computer and smartphone work 2019 In: International Journal of Industrial Ergonomics. - : ELSEVIER. - 0169-8141 .- 1872-8219. ; 74 Journal article (peer-reviewed)abstract Relevance to industry: There is emerging evidence of musculoskeletal problems related to smartphone work and a rapid transition to mobile workplaces, where smartphones are key working tools. Aim: The study's aim was to compare muscle activity during computer work with smartphone work and to see what possible effects ergonomic recommendations for smartphone usage have on muscle activity. Methods: Activity was measured bilaterally from the upper trapezius muscle and from lower arm muscles on the right hand side, on twelve participants with surface electromyography who performed e-mail work on the computer using ergonomic recommendations, smartphone in a self-chosen way of working and on smartphone with ergonomic recommendations. Effects on productivity was not assessed in this study. Results: Activity in m. trapezius and m. extensor digitorum was significantly higher during computer work (p < 0.05) than during the two smartphone usages and activity in m. interossei dorsalis 1 was, vice versa, significantly higher during smartphone work fp < 0.05). Comparison of smartphone in self-chosen way of working and smartphone with ergonomic recommendations showed no significant differences. Conclusions: Previous research has highlighted the benefits of variation of work postures. This paper indicates that replacing the computer with a smartphone gives the trapezius muscle an opportunity to rest.
23.	Christmansson, Marita, et al. (author) A case study of a principally new way of materials kitting—an evaluation of time consumption and physical workload 2002 In: International Journal of Industrial Ergonomics. - : Elsevier. - 0169-8141 .- 1872-8219. ; 30:1, s. 49-65 Journal article (peer-reviewed)abstract This article presents a materials kitting case study, using an alternative method for materials kitting: the traditional picker-to-material principle was replaced with a material-to-picker approach. The study was made in a materials supply workshop of an automobile plant shortly after this kitting process had been introduced. The materials kitting was video recorded and the material pickers’ physical exposure was assessed using ambulatory equipment to make an integrated registration of muscular activity, work postures and movements. The material pickers assessed work situations perceived as physically stressful. The materials kitting showed improved productivity as compared with other kitting methods. The study indicated that the work situation offered pickers low levels of physical exposure. The picking work was rather light but involved great repetitiveness in arm movements. The material pickers experienced the work as repetitive and having some physically stressful work situations. The integrated analyses showed: (1) that exposure in picking operations was similar to, but could be distinguished from, other work activities and (2) that picking from one type of storage package, Euro pallets, resulted in higher exposure than picking from plastic containers. More studies are needed on the implications of exposure levels in materials picking.
24.	Christmansson, Marita, et al. (author) Modified method time measurements for ergonomic planning of production systems in the manufacturing industry 2000 In: International Journal of Production Research. - : Taylor & Francis. - 0020-7543 .- 1366-588X. ; 38:17, s. 4051 - 4059 Journal article (peer-reviewed)abstract The paper reports on an evaluation of a method called ErgoSAM. This method is based on SAM, a higher-level method-time-measurement (MTM) system, and is for use by production planners, e.g. production engineers. In addition to the SAM information, the ErgoSAM method considers information on weight handled or forces applied, and work zone. The method is designed to predict the physical demands of work postures, force and repetitivity, according to a scientific model, the Cube model. In co-operation with the Volvo Car Corporation, six workstations of an assembly line, were analysed by a production engineer using ErgoSAM. The total assembly time analysed was about 17 minutes. The results were compared to results from ergonomic analyses made by an ergonomist using the Volvo Car Corporations standards. The results showed that ErgoSAM predicts work situations of high physical stress for the workers. However, the method does not consider stressful positions for the hand, wrist and neck or mental stress. The production engineer judged the ErgoSAM analyses to require about 5% more time than SAM analyses alone. It is concluded that the method shows considerable promise for predicting physically stressful work situations, but needs to be further evaluated and refined.
25.	Collins, Justin, et al. (author) Assessing intra-operative ergonomics and workload in robotic surgery using inertia measuring unit sensors and validated questionnaires 2016 In: The Journal of Urology. - : Elsevier. - 0022-5347 .- 1527-3792. ; 195:4S, s. e218-e219 Journal article (peer-reviewed)
26.	Collins, J.W., et al. (author) Assessing intra-operative ergonomics and workload in robotic surgery using inertia measuring unit sensors and validated questionnaires 2016 In: European urology. Supplement. - : Elsevier BV. - 1569-9056 .- 1878-1500. ; 15:7, s. 247-247 Journal article (peer-reviewed)abstract INTRODUCTION & OBJECTIVES: Robotic approaches have revolutionized radical prostatectomy surgery. The 3D vision and 10 fold magnification provide surgeons improved anatomical vision and more precise instrument control compared to open or laparoscopic techniques. However, the potential benefits of robotic techniques may have trade-offs in increased mental and physical demands for the surgeons. The assisting surgeon, also has the added workload of maintaining working postures that do not impede the robotic arms. This study implemented an innovative motion tracking tool along with validated workload questionnaires to assess the ergonomics and workload for both assisting and console surgeons during robotic surgery. MATERIAL & METHODS: Ten individual surgeons (6 console surgeons and 4 assistant surgeons) performed 15 robotic prostatectomy cases while wearing inertia measurement units (IMUs) to track neck, shoulder, and torso motion during each case. Postoperatively, participants completed a validated workload questionnaire (NASA-TLX). Analysis of variance was performed on all response variables that do not violate the assumption of normality to identify the impact of surgeon role (Console vs Assistant). RESULTS: Twenty-six questionnaires were completed from 13 assisting and 13 console surgeons over the 15 cases. Selfreported mental demand was 41% higher for surgeons at the console than assisting (p<0.05), but physical demand was not statistically different. Post-operative pain was reported highest for the right shoulder and neck and this was more frequently seen in the console surgeons. On IMU readings, the assisting surgeon experienced high neck flexion (>10 degrees) duration over 42% of the procedure compared to only 24% in the console surgeon. In general, surgeons posture on the console was primarily static resulting in fewer movements compared to assisting surgeons. Table 1 summarizes posture movements and durations of static postures. CONCLUSIONS: Postures were more ergonomic during console tasks than assisting by the operating table. However, the console constrains postures leading to static postural loads that have been associated with musculoskeletal symptoms for the neck, torso and shoulders.
27.	Cyrén, Henrik, et al. (author) Task Specific Exposure Information as a Basis for Production System Design 1998 Conference paper (other academic/artistic)abstract This publication was written during a period of time when the authors were engaged in an extensive research programme financed by the National Institute for Working Life in Solna (Cooperative for Optimisation of industrial production systems regarding Productivity and Ergonomics COPE).
28.	Dahlgren, Gunilla, et al. (author) Correlations between Ratings and Technical Measurements in Hand-Intensive Work 2023 In: Bioengineering. - : MDPI AG. - 2306-5354. ; 10:7 Journal article (peer-reviewed)abstract An accurate rating of hand activity and force is essential in risk assessment and for the effective prevention of work-related musculoskeletal disorders. However, it is unclear whether the subjective ratings of workers and observers correlate to corresponding objective technical measures of exposure. Fifty-nine workers were video recorded while performing a hand-intensive work task at their workplace. Self-ratings of hand activity level (HAL) and force (Borg CR10) using the Hand Activity Threshold Limit Value(& REG;) were assessed. Four ergonomist observers, in two pairs, also rated the hand activity and force level for each worker from video recordings. Wrist angular velocity was measured using inertial movement units. Muscle activity in the forearm muscles flexor carpi radialis (FCR) and extensor carpi radialis (ECR) was measured with electromyography root mean square values (RMS) and normalized to maximal voluntary electrical activation (MVE). Kendall's tau-b correlations were statistically significant between self-rated hand activity and wrist angular velocity at the 10th, 50th, and 90th percentiles (0.26, 0.31, and 0.23) and for the ratings of observers (0.32, 0.41, and 0.34). Significant correlations for force measures were found only for observer-ratings in five of eight measures (FCR 50th percentile 0.29, time > 10%MVE 0.43, time > 30%MVE 0.44, time < 5% -0.47) and ECR (time > 30%MVE 0.26). The higher magnitude of correlation for observer-ratings suggests that they may be preferred to the self-ratings of workers. When possible, objective technical measures of wrist angular velocity and muscle activity should be preferred to subjective ratings when assessing risks of work-related musculoskeletal disorders.
29.	Dahlgren, Gunilla, et al. (author) Ratings of Hand Activity and Force Levels among Women and Men Who Perform Identical Hand-Intensive Work Tasks 2022 In: International Journal of Environmental Research and Public Health. - : MDPI AG. - 1661-7827 .- 1660-4601. ; 19:24, s. 16706- Journal article (peer-reviewed)abstract We compared hand activity and force ratings in women and men doing identical hand-intensive work tasks. Musculoskeletal disorders are more common in women and hand-intensive work leads to an increased risk of these disorders. Knowledge of the gender influence in the rating of work exposure is lacking. The aim of this study was to investigate whether women and men performing identical hand-intensive work tasks were equally rated using hand activity and normalized peak force levels with the Hand Activity Threshold Limit Value((R)). Fifty-six workers participated, comprising 28 women-men pairs. Four observers-two woman-man pairs-were also involved. Self-ratings and observers' ratings of hand activity and force level were collected. The results of these ratings showed no significant gender differences in self-rated hand activity and force, as well as observer-rated hand activity. However, there was a significant gender difference in the observer-rated force, where the women were rated higher (mean (SD): women 3.9 (2.7), men 3.1 (1.8) (p = 0.01)). This difference remained significant in the adjusted model (p = 0.04) with grip strength and forearm-finger anthropometrics. The results provide new insights that observers' estimates of force can be higher in women compared with men in the same work tasks. Force should be further investigated and preferably compared to objective measurements.
30.	Dahlqvist, Camilla, et al. (author) Arbetsbelastning vid städning av hotellrum 2017 Reports (other academic/artistic)abstract Enligt Arbetsmiljöverkets rapport ”Arbetsmiljön 2013” har 40 procent av alla hotell- och kontorsstädare ont i nacke, rygg, axlar eller armar varje vecka. 60 procent av dem känner sig uttröttade i kroppen. Arbets- och miljömedicin (AMM) Syd har tagit fram åtgärdsnivåer för ett antal belastningsmått, ”AMM Syds åtgärdsnivåer för ergonomisk belastning”, och om man överstiger dessa, anser vi att risken för belastningsskada är stor. Vi har studerat hotellrumsstädares belastning och jämfört med våra åtgärdsnivåer.Vi mätte den fysiska arbetsbelastningen hos fjorton kvinnliga hotellrumsstädare under en vanlig arbetsdag, på en deltagare åt gången. De arbetade på sju olika hotell i södra Sverige. Några var anställda av städföretag och några direkt av hotellen.Vi fann att hotellrumsstädare har en väldigt hög arbetsbelastning i övre delen av kroppen, både vad gäller rörelsehastighet, arbetsställningar och muskelansträngning (se Tabell på sid 3). Samtliga deltagare hade för hög rörelsehastighet i överarm och handled och för lite vila i underarmens muskler i jämförelse med våra åtgärdsnivåer. Även vad gäller framåtböjningen av huvudet, överarmens arbetsställning och underarmens muskelbelastning fann vi för höga nivåer. Hotellrumsstädning överskrider nio av våra elva åtgärdsnivåer för ergonomisk belastning. Detta betyder att hotellrumsstädare har en väldigt hög risk att drabbas av belastningsskador.RekommendationerFör att minska risken för belastningsskador bland hotellrumsstädare måste arbetstempot sänkas, genom att minska antalet rum som ingår i en hotellrumsstädares arbetsdag.Personalen bör erbjudas regelbundna medicinska kontroller avseende ergonomiskt belastande arbete så att man tidigt sätter in åtgärder för den arbetstagare eller grupp av arbetstagare som är på väg att utveckla skada i muskler och/eller leder. Arbetsplatsen rekommenderas att ha företagshälsovård knuten till sig, som kan genomföra de medicinska kontrollerna och som kontinuerligt gör riskbedömningar av arbetet. De bör också ha som uppgift att utbilda städpersonalen i ergonomi.
31.	Dahlqvist, Camilla, et al. (author) Arbetsbelastning vid städning av hotellrum 2017 Reports (peer-reviewed)
32.	Dahlqvist, Camilla, et al. (author) Comparing two methods to record maximal voluntary contractions and different electrode positions in recordings of forearm extensor muscle activity : refining risk assessments for work-related wrist disorders 2018 In: Work. - : IOS Press. - 1051-9815. ; 59:2, s. 231-242 Journal article (peer-reviewed)abstract Background: Wrist disorders are common in force demanding industrial repetitive work. Visual assessment of force demands have a low reliability, instead surface electromyography (EMG) may be used as part of a risk assessment for work-related wrist disorders. For normalization of EMG recordings, a power grip (hand grip) is often used as maximal voluntary contraction (MVC) of the forearm extensor muscles. However, the test-retest reproducibility is poor and EMG amplitudes exceeding 100% have occasionally been recorded during work. An alternative MVC is resisted wrist extension, which may be more reliable.Objective: To compare hand grip and resisted wrist extension MVCs, in terms of amplitude and reproducibility, and to examine the effect of electrode positioning.Methods: Twelve subjects participated. EMG from right forearm extensors, from four electrode pairs, was recorded during MVCs, on three separate occasions.Results: The group mean EMG amplitudes for resisted wrist extension were 1.2-1.7 times greater than those for hand grip. Resisted wrist extension showed better reproducibility than hand grip.Conclusions: The results indicate that the use of resisted wrist extension is a more accurate measurement of maximal effort of wrist extensor contractions than using hand grip and should increase the precision in EMG recordings from forearm extensor muscles, which in turn will increase the quality of risk assessments that are based on these.
33.	Dahlqvist, Camilla, et al. (author) Mätning av arbetsbelastning för höger överarm vid kontorsstädning 2016 Reports (other academic/artistic)
34.	Dahlqvist, Camilla, et al. (author) Self-recordings of upper arm elevation during cleaning - comparison between analyses using a simplified reference posture and a standard reference posture 2018 In: BMC Musculoskeletal Disorders. - : BMC. - 1471-2474. ; 19 Journal article (peer-reviewed)abstract Background To reduce ergonomic risk factors in terms of awkward and constrained postures and high velocities, it is important to perform adequate risk assessments. Technical methods provide objective measures of physical workload. These methods have so far mainly been used by researchers. However, if written instructions how to apply the sensors and how to adopt the reference posture are provided, together with triaxial accelerometers, it may be possible for employees to record their own physical workload. The exposure in terms of e.g. upper arm elevations could then easily be assessed for all workers in a workplace. The main aims of this study were: 1) to compare analyses for self-recording of upper arm elevation during work using a simplified reference posture versus using a standard reference posture, and 2) to compare the two reference postures.MethodsTwenty-eight cleaners attached an accelerometer to their dominant upper arm and adopted a simplified reference according to a written instruction. They were thereafter instructed by a researcher to adopt a standard reference. Upper arm elevations were recorded for 2 or 3 days. Each recording was analysed twice; relative to the simplified reference posture and relative to the standard reference posture. The group means of the differences in recorded upper arm elevations between simplified and standard reference analyses were assessed using Wilcoxon signed ranks test. Furthermore, we calculated the group mean of the differences between the simplified reference posture and the standard reference posture.ResultsFor arm elevation during work (50(th) percentile), the group mean of the differences between the two analyses was 0.2 degrees (range-7 - 10 degrees). The group mean of the differences between the two references was 9 degrees (range 1-21 degrees). The subjects were able to follow the instructions in the protocol and performed self-recording of upper arm elevation and velocity.ConclusionsThe small difference between the two analyses indicates that recordings performed by employees themselves are comparable, on a group level, with those performed by researchers. Self-recordings in combination with action levels would provide employers with a method for risk assessment as a solid basis for prevention of work-related musculoskeletal disorders.
35.	Dahlqvist, Camilla, et al. (author) Validity of a small low-cost triaxial accelerometer with integrated logger for uncomplicated measurements of postures and movements of head, upper back and upper arms 2016 In: Applied Ergonomics. - : Elsevier. - 0003-6870 .- 1872-9126. ; 55, s. 108-116 Journal article (peer-reviewed)abstract Repetitive work and work in constrained postures are risk factors for developing musculoskeletal disorders. Low-cost, user-friendly technical methods to quantify these risks are needed. The aims were to validate inclination angles and velocities of one model of the new generation of accelerometers with integrated data loggers against a previously validated one, and to compare meaurements when using a plain reference posture with that of a standardized one. All mean (n = 12 subjects) angular RMS-differences in 4 work tasks and 4 body parts were <2.5° and all mean median angular velocity differences <5.0 °/s. The mean correlation between the inclination signal-pairs was 0.996. This model of the new generation of triaxial accelerometers proved to be comparable to the validated accelerometer using a data logger. This makes it well-suited, for both researchers and practitioners, to measure postures and movements during work. Further work is needed for validation of the plain reference posture for upper arms.
36.	Davies Forsman, Lina, et al. (author) Fatal bupivacaine overdose through intrathecally positioned epidural catheter 2013 In: Scandinavian Journal of Forensic Science. - : Walter de Gruyter. - 1503-9552. ; 19:1, s. 10-12 Journal article (peer-reviewed)abstract We describe a fatality due to an intrathecally positioned epidural catheter and an infusion rate of bupivacaine set 10 times higher than planned. The undetected misplacement, despite safety routines, is discussed along with the toxicological findings and new information on the intrathecal distribution of bupivacaine. From a clinical point of view, the human factor, in combination with an indistinct decimal point on the pump, was considered as the reason for the unfortunate overdose. In continuous epidural infusion of local anesthetics, the importance of guidelines and informed staff in managing complications of epidural lumbar infusion as well as careful monitoring of the vital functions is essential. Guidelines are also vital during the procedure of insertion of epidural catheters. When using combined spinal and epidural anaesthesia, we believe that an epidural catheter should be inserted, and its position tested, prior to spinal anesthesia. The case also illustrates the need of innovative investigation techniques to confirm the suspicion of unusual manifestations of inadvertent drug effects. Segmental analysis, together with analyses in a control case, enabled us to elucidate the high and varying tissue concentrations in the central nervous system.
37.	Davies Forsman, Lina, et al. (author) Minimum Inhibitory Concentrations of Fluoroquinolones and Pyrazinamide Susceptibility Correlate to Clinical Improvement in Multidrug-resistant Tuberculosis Patients: A Nationwide Swedish Cohort Study Over 2 Decades 2019 In: Clinical Infectious Diseases. - : OXFORD UNIV PRESS INC. - 1058-4838 .- 1537-6591. ; 69:8, s. 1394-1402 Journal article (peer-reviewed)abstract Background. Minimum inhibitory concentration (MIC) testing, unlike routine drug susceptibility testing (DST) at a single critical concentration, quantifies drug resistance. The association of MICs and treatment outcome in multidrug-resistant (MDR)-tuberculosis patients is unclear. Therefore, we correlated MICs of first- and second-line tuberculosis drugs with time to sputum culture conversion (tSCC) and treatment outcome in MDR-tuberculosis patients. Methods. Clinical and demographic data of MDR-tuberculosis patients in Sweden, including DST results, were retrieved from medical records from 1992 to 2014. MIC determinations were performed retrospectively for the stored individual Mycobacterium tuberculosis (Mtb) isolates using broth microdilution in Middlebrook 7H9. We fitted Cox proportional hazard models correlating MICs, DST results, and clinical variables to tSCC and treatment outcome. Results. Successful treatment outcome was observed in 83.5% (132/158) of MDR-tuberculosis patients. Increasing MICs of fluoroquinolones, diabetes, and age amp;gt;40 years were significantly associated with unsuccessful treatment outcome. Patients treated with pyrazinamide (PZA) had a significantly shorter tSCC compared to patients who were not (median difference, 27 days). Conclusions. Increasing MICs of fluoroquinolones were correlated with unsuccessful treatment outcome in MDR-tuberculosis patients. Further studies, including MIC testing and clinical outcome data to define clinical Mtb breakpoints, are warranted. PZA treatment was associated with shorter tSCC, highlighting the importance of PZA DST.
38.	Dellve, Lotta, et al. (author) Myofeedback training and intensive muscular strength training to improve work ability and decrease pain among female workers on long term sick leave with neck pain : A Randomized Controlled Trial 2011 In: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 84:3, s. 335-346 Journal article (peer-reviewed)abstract The theoretical framework is that muscle tension in the neck is related to insufficient muscular rest and is a risk factor for chronic pain and reduced work ability. Promoting muscle strength and muscle rest may increase work ability and reduce neck pain. To test whether myofeedback training or intensive strength training leads to decreased pain and increased work ability in women on long-term sick leave. This is a randomized controlled trial of two 1-month interventions with myofeedback or muscular strength training in the home environment. Female human service organization workers (n = 60) on long-term (> 60 days) sick leave and with chronic neck pain were followed with self-reported and laboratory-observed data of health, pain, muscular activation, and work ability, at baseline, immediately after the intervention and 3 months after baseline. For both intervention groups, pain was lowered over time compared with the control group. Decreased pain and muscular activity was associated with increased self-rated work ability and with laboratory-observed work ability at 3-month follow-up. Decreased pain was also associated with increased self-rated work ability at 1-month follow-up. Muscular strength training was associated with increased self-rated work ability and mental health. Myofeedback was associated with increased observed work ability and self- rated vitality. The two interventions showed positive results, suggesting that they could be developed for use in health care practice to address pain and work ability. The intensive muscular strength training program, which is both easy to conduct at home and easy to coach, was associated with increased work ability.
39.	Domkin, Dmitry, et al. (author) Ciliary muscle contraction force and trapezius muscle activity during manual tracking of a moving visual target 2016 In: Journal of Electromyography and Kinesiology. - : Elsevier BV. - 1050-6411 .- 1873-5711. ; 28, s. 193-198 Journal article (peer-reviewed)abstract Previous studies have shown an association of visual demands during near work and increased activity of the trapezius muscle. Those studies were conducted under stationary postural conditions with fixed gaze and artificial visual load. The present study investigated the relationship between ciliary muscle contraction force and trapezius muscle activity across individuals during performance of a natural dynamic motor task under free gaze conditions. Participants (N = 11) tracked a moving visual target with a digital pen on a computer screen. Tracking performance, eye refraction and trapezius muscle activity were continuously measured. Ciliary muscle contraction force was computed from eye accommodative response. There was a significant Pearson correlation between ciliary muscle contraction force and trapezius muscle activity on the tracking side (0.78, p < 0.01) and passive side (0.64, p < 0.05). The study supports the hypothesis that high visual demands, leading to an increased ciliary muscle contraction during continuous eye–hand coordination, may increase trapezius muscle tension and thus contribute to the development of musculoskeletal complaints in the neck–shoulder area. Further experimental studies are required to clarify whether the relationship is valid within each individual or may represent a general personal trait, when individuals with higher eye accommodative response tend to have higher trapezius muscle activity.
40.	Domkin, Dmitry, et al. (author) Effect of ciliary-muscle contraction force on trapezius muscle activity during computer mouse work 2019 In: European Journal of Applied Physiology. - : SPRINGER. - 1439-6319 .- 1439-6327. ; 119:2, s. 389-397 Journal article (peer-reviewed)abstract The present study aimed to identify whether or not an increase in ciliary-muscle contraction force, when the eye-lens is adjusted for viewing at a near distance, results in an increase in trapezius muscle activity, while performing a natural work task. Twelve participants, ranging in age from 21 to 32years, performed a computer-mouse work task during free gaze conditions. A moving visual target was tracked with a computer mouse on a screen placed at two different distances from the eyes, 25cm and 50cm. Tracking performance, eye accommodation, and bilateral trapezius muscle activity were measured continuously. Ciliary-muscle contraction force was computed according to a formula which takes into account the age-dependent, non-linear relationship between the contraction force of the ciliary muscle and the produced level of eye accommodation. Generalized estimating equations analyses were performed. On the dominant hand side and for the nearest screen distance, there was a significant effect of ciliary-muscle contraction force on the trapezius muscle activity (p<0.001). No other effects were significant (p>0.05). The results support the hypothesis that high visual demands, during computer mouse work, increase ciliary muscle contraction force and contribute to a raise of the sustained level of trapezius muscle activity. The current study specifically clarifies the validity of the relationship between ciliary-muscle contraction force and trapezius muscle activity and demonstrates that this relationship is not due to a general personality trait. We conclude that a high level of ciliary muscle contraction force can contribute to a development of musculoskeletal complaints in the neck-shoulder area.
41.	Domkin, Dmitry, et al. (author) Relationship between eye-lens accomodative response and trapezius muscle activity during manual tracking of a visual target 2014 In: 11th International Symposium on Human Factors in Organisational Design and Management (ODAM 2014)and 46th Annual Nordic Ergonomics Society. - : Technical University of Denmark. ; , s. 1073-1074 Conference paper (peer-reviewed)
42.	Dong, Yidan, et al. (author) Association between long-term static postures exposure and musculoskeletal disorders among university employees : A viewpoint of inflammatory pathways 2022 In: Frontiers In Public Health. - : FRONTIERS MEDIA SA. - 2296-2565. ; 10 Journal article (peer-reviewed)abstract BackgroundMusculoskeletal disorders (MSDs) are critical occupational and social problems. With the improvement of production mechanization and automation, and the widespread application of computers, more occupations are exposed to static postures and load. This study explored the role of inflammation in the association between static postures exposure and MSDs. MethodsThis study adopted a prospective nested case-control design in which 66 lower back MSDs cases and 66 healthy controls were selected from a cohort study of university employees. The personal information, postural load, musculoskeletal symptoms, pressure pain thresholds (PPTs), and inflammatory cytokines were collected. Logistic and linear regressions were used to investigate the association among postural load, inflammatory cytokines, and lower back MSDs. Mediation analysis was used to calculate the mediation effect. ResultsThe results of logistic and linear regressions showed that postural load and inflammatory cytokines were positively associated with lower back MSDs (P < 0.05), and postural load was positively associated with inflammatory cytokines (P < 0.05). Further, mediation analysis showed that the mediation effect of postural load on the lower back MSDs through TNF-alpha was 0.073 (95%CI: 0.025-0.128), and the mediation effect of posture load on the lower back MSDs through IL-6 was 0.098 (95%CI: 0.041-0.179), respectively. ConclusionStatic postures were associated with the occurrence of MSDs through inflammatory cytokines, and low-level inflammation may be a critical early event in the generation of MSDs. This study may help bridge the gap of potential mechanisms linking static postures to increased risks of MSDs, and provide new evidence for targeted protection against the global increasing MSDs.
43.	Dong, Yidan, et al. (author) Derived patterns of musculoskeletal symptoms and their relationships with ergonomic factors among electronic assembly workers : A latent class analysis 2022 In: Journal of Safety Research. - : Elsevier BV. - 0022-4375 .- 1879-1247. ; 82, s. 293-300 Journal article (peer-reviewed)abstract Introduction: Multi-site musculoskeletal symptoms (MSS) are considered to be more common and have more serious consequences than single-site MSS. This study aimed to determine whether derived patterns of MSS may be identified in electronic assembly workers and if extracted MSS classes are associated with personal and work-related factors. Method: A cross-sectional questionnaire study was performed with 700 participating electronic assembly workers. The questionnaire included individual factors, psychosocial and physical exposures, and MSS. The derived patterns of MSS and their relationships with ergonomic factors were analyzed using latent class analysis (LCA) and multinomial logistic regression models (MLRM). Results: The 1-year prevalence of MSS affecting only one body site or two or more body sites was 14.9% and 32.7%, respectively. The results of LCA showed three distinct classes of MSS patterns, which were labelled 'MSS in most sites' (5.0%), 'MSS in neck and shoulder' (27.0%), and 'MSS in one or no site' (68.0%). The results of MLRM showed that the 'MSS in neck and shoulder' was associated with job tenure (OR 5.579, 95% CI 2.488-12.511), excessive dynamic and static loads (OR 3.868, 95% CI 1.702- 8.793 and OR 5.270, 95% CI 2.020-13.747, respectively); while the 'MSS in most sites' was associated with high job demands (OR 4.528, 95% CI 1.647-12.445) and excessive dynamic loads (OR 111.554, 95% CI 4.996-2490.793). Conclusions: The results showed unique patterns of MSS among electronic assembly workers that were associated with personal and work-related factors. Practical applications: The findings highlight that the high prevalence of multi-site MSS in this group should be a focus. It also provides further evidence that LCA considering the number and location of anatomical sites involving MSS can be used to determine distinct classes of MSS patterns, which is of great significance for the epidemiological study and management of MSS in the future.
44.	Dong, Yidan, et al. (author) Study on the Associations of Individual and Work-Related Factors with Low Back Pain among Manufacturing Workers Based on Logistic Regression and Structural Equation Model 2021 In: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 18:4 Journal article (peer-reviewed)abstract Work-related musculoskeletal injuries are one of the major occupational health issues of the workers, especially low back pain (LBP). The aim of this study was to survey the prevalence of LBP among manufacturing workers and to identify associations of individual and work-related factors with LBP. A cross-sectional questionnaire study was performed with 1173 participating manufacturing workers. The questionnaire included individual factors, psychosocial and physical exposures, and musculoskeletal discomfort. It was analyzed by logistic regression and structural equation modeling (SEM). The 1-year prevalence of LBP among Chinese manufacturing workers was 33.6%. Logistic regression analysis showed that job tenure, awkward postures, vibration and job demand were positively-while social support and job control were negatively associated with LBP (p < 0.05). The SEM results indicated that, as shown in other studies, job types, job tenure, postural load, high job demand, low job control and vibration were directly associated with LBP, but also that job types, high job demand, low social support and vibration may have indirect effects on LBP-mediated by postural load.
45.	Eklund, Jörgen, et al. (author) Smart work clothes give better health - Through improved work technique, work organization and production technology 2019 In: 20th Congress of the International Ergonomics Association, IEA 2018. - Cham : Springer. - 9783319960821 ; , s. 515-519 Conference paper (peer-reviewed)abstract Musculoskeletal disorders (MSDs) constitute a major health problem for employees, and the economic consequences are substantial for the individuals, companies and the society. The ageing population creates a need for jobs to be sustainable so that employees can stay healthy and work longer. Prevention of MSD risks therefore needs to become more efficient, and more effective tools are thus needed for risk management. The use of smart work clothes is a way to automate data collection instead of manual observation. The aim of this paper is to describe a new smart work clothes system that is under development, and to discuss future opportunities using new and smart technology for prevention of work injuries. The system consists of a garment with textile sensors woven into the fabric for sensing heart rate and breathing. Tight and elastic first layer work wear is the basis for these sensors, and there are also pockets for inertial measurement units in order to measure movements and postures. The measurement data are sent wireless to a tablet or a mobile telephone for analysis. Several employees can be followed for a representative time period in order to assess a particular job and its workplace. Secondly, the system may be used for individuals to practice their work technique. The system also gives relevant information to a coach who can give feedback to the employees of how to improve their work technique. Thirdly, the data analysis may also give information to production engineers and managers regarding the risks. The information will support decisions on the type of actions needed, the body parts that are critical and the emergency of taking action.
46.	Elcadi, Guilherme H., et al. (author) Gender differences in the forearm for the oxygenation and myoelectric activity relation, muscle blood flow and oxygen consumption 2010 In: Seventh International Conference on Prevention of Work-Related Musculoskeletal Disorders, Angers, France, August 29-September 2. - Angers, France. Conference paper (peer-reviewed)
47.	Elcadi, Guilherme H. (author) Near infrared spectroscopy for assessing oxygenation and hemodynamics in the upper extremities of healthy subjects and patients with work-related muscle pain 2012 Doctoral thesis (other academic/artistic)abstract The prevalence of work-related muscle pain (WRMP) is large in the general population in the industrialized world. Despite significant advances over recent years in some research areas, the mechanisms of why WRMP occurs and the pathophysiological mechanisms behind the disorders are still unclear. One suggested explanation is that WRMP is caused initially by a limitation of the local muscle circulation and oxidative metabolism. There is a lack of objective methods to gauge the development and diagnosis of WRMP. Near infrared spectroscopy (NIRS) is a non-invasive technique that allows for determinations of oxygenation and blood flow. The purpose of this thesis was to evaluate NIRS (1) as a method for measuring muscle oxygenation and hemodynamics for the extensor carpi radialis (ECR) and trapezius descendens muscles (TD), and (2) to investigate whether variables measured by NIRS differed between patients diagnosed with WRMP and healthy subjects. Several variables of NIRS were produced and investigated. These included muscle oxygenation (StO2%), changes during contractions (∆StO2%) and StO2% recovery (Rslope), total hemoglobin (HbT) as an indication of blood volume and its changes during contractions (∆HbT). In addition, for the ECR, by applying an upper arm venous occlusion (VO) HbTslope increase as a surrogate of blood flow, and for both VO and arterial occlusion (AO) HHbslope increase (i.e. deoxyhemoglobin slope) as a surrogate of oxygen consumption were variables of interest. A first objective was to determine how StO2% and HbT responded to various contraction forces and how it related to muscle activation measured by electromyography (EMG). For both muscles isometric contractions of 10, 30, 50 and 70% of maximal voluntary contraction (MVC) were maintained for 20 s each by healthy males and females; additionally a 10% MVC contraction was sustained for 5 min. For the different contraction levels, predictable relationships were seen between ∆StO2% and force, and between ∆StO2% and EMG RMS amplitude. The general trend was a decrease in ∆StO2% with increasing force and increasing EMG. Females showed a tendency for a higher oxygen use (i.e., drop in StO2%) for the ECR over force levels than males and a higher RMS% MVC for the TD. For the 10% MVC contraction sustained for 5 min gender specific changes over time for HbT and RMS for the ECR, and for StO2% for the TD muscle were seen. A second objective was to determine the day-to-day reliability of NIRS variables for the ECR and TD muscles at group level (Pooled data) and at gender level (males and females). Measurements were performed on two occasions separated by 4-6 days and intraclass correlation coefficients (ICC) and limits of agreement (LOA) were determined as reliability and reproducibility indicators, respectively. Variables tested were ∆StO2% during submaximal isometric contractions of 10, 30, 50 and 70% MVC and StO2% recovery (Rslope) after contractions and after AO. For the ECR, HbTslope as an indication of blood flow (using VO) and HHbslope as a surrogate of oxygen consumption for both VO and AO were computed. For ∆StO2% for the ECR the highest ICC was at 30% MVC for both the pooled data and at gender level. For the TD ICCs were comparably high for 30, 50, 70 % MVC (for both muscles the ∆StO2% at 10% MVC showed the lowest ICC). Further, females showed a higher ICC than males for contraction levels of 50 and 70% MVC. For both muscles, LOA for ∆StO2% was lowest at 10% and highest at 50 and 70% MVC. For the ECR Rslope ICCs were high for all contraction levels, but was lower for AO; LOA was lowest at 70% MVC. For the TD, Rslope ICCs were also high for all contraction levels and LOA was lowest at 30 % MVC. ICC for HbTslope was the lowest of all variables tested. For HHbslope ICC was higher for AO than for VO, and LOA was lower for AO. A third objective was to determine if there were differences between healthy subjects and patients diagnosed with WRMP in ∆StO2% and ∆HbT responses during varying submaximal contractions (10, 30, 50 and 70% MVC), and StO2% recovery (Rslope) immediately after contractions and AO. Additional variables tested in the ECR at rest were HHbslope to indicate oxygen consumption (using AO) and HbTslope as an indication of blood flow. There were no differences between groups in ∆StO2% and ∆HbT variables during the contractions or Rslope in the recovery after contractions or AO. Furthermore, HbTslope was not different between groups However, oxygen consumption for the ECR and StO2% for the TD at rest were significantly greater for healthy subjects compared to patients. A fourth objective was to determine if there were differences in StO2% and HbT between healthy subjects and WRMP patients during a 12 min sustained contraction of 15 % MVC. In addition, the protocol included a recovery period of 30 min. Prior to contraction, as well as during the recovery period, HbTslope as a surrogate of blood flow was determined for the ECR. Neither the ECR nor the TD exhibited significant differences between groups for StO2% and HbT during the contraction. For the TD patients showed a lower StO2% value at rest and throughout the contraction than healthy subjects. For the ECR HbT during the sustained contraction the general trend was an initial decrease with gradual increase throughout the contraction for both groups. For HbTslope no differences were seen between patients and healthy subjects before the sustained contraction and during the recovery period for both muscles.NIRS is deemed a suitable technique for assessing physiological measurements of the upper extremity, including for day-to-day testing.NIRS was not able to distinguish between the patients with WRMP and controls. A concern in the thesis is the characteristics of the patient group in being equally active in recreational sports, actively working, and similar in muscle strength as controls. Thus, applying NIRS for studying a more severe patient group could yield different results.
48.	Elcadi, Guilherme H, 1966-, et al. (author) No differences in oxygenation in the forearm and shoulder of patients with work-related muscle pain and healthy subjects during a low-load sustained contraction Other publication (other academic/artistic)abstract A frequently ascribed symptom associated to work-related muscle pain (WRMP) is muscle fatigue. Studies investigating oxygenation and hemodynamics in association to fatigue development in the muscles of patients with WRMP are sparse. Inadequate oxygen consumption and/or inadequate blood supply can influence the ability of the muscles to withstand fatigue. In this study we applied near-infrared spectroscopy (NIRS) and electromyography (EMG) to investigate oxygenation, hemodynamics and muscle activity in the extensor carpi radialis (ECR) and trapezius (TD) muscles of patients with WRMP and healthy controls. Eighteen patients with diffuse neck-shoulder-arm pain and 17 controls (matched in age and sex) were equipped with NIRS and EMG probes. After determination of maximal voluntary contraction (MVC) a sustained contraction of 15% MVC was performed with a cutoff for the maximum time of 12 min. Variables generated were StO2% and HbT from NIRS and RMS%max and MPF from EMG during the contraction. T tests and Mann-Whitney tests were used for analyzes of differences in MVC and endurance times. Full factorial repeated measures analyses of variance (ANOVA) were used to assess differences between patients and controls in NIRS and EMG parameters over time. Results showed no differences in MVC between patients and controls. We found, however, a shorter endurance time for patients compared to controls. There were no significant differences in StO2%, HbT, RMS and MPF responses during contraction between groups for the ECR. For the TD there was a group effect for StO2% with patients showing a lower level at rest and throughout the contraction. For the ECR and TD oxygenation, hemodynamics, RMS and MPF there were no straightforward differences between patients and controls that could explain the differences in endurance time. Therefore, we conclude that the shorter endurance time seen in the present study was not measurable by physiological indicators investigated in this group of patients.
49.	Elcadi, Guilherme H, et al. (author) No differences in oxygenation in the forearm and shoulder of patients with work-related muscle pain and healthy subjects during a low-load sustained contraction 2013 Other publication (other academic/artistic)abstract A frequently ascribed symptom associated to work-related muscle pain (WRMP) is muscle fatigue. Studies investigating oxygenation and hemodynamics in association to fatigue development in the muscles of patients with WRMP are sparse. Inadequate oxygen consumption and/or inadequate blood supply can influence the ability of the muscles to withstand fatigue. In this study we applied near-infrared spectroscopy (NIRS) and electromyography (EMG) to investigate oxygenation, hemodynamics and muscle activity in the extensor carpi radialis (ECR) and trapezius (TD) muscles of patients with WRMP and healthy controls. Eighteen patients with diffuse neck-shoulder-arm pain and 17 controls (matched in age and sex) were equipped with NIRS and EMG probes. After determination of maximal voluntary contraction (MVC) a sustained contraction of 15% MVC was performed with a cutoff for the maximum time of 12 min. Variables generated were StO2% and HbT from NIRS and RMS%max and MPF from EMG during the contraction. T tests and Mann-Whitney tests were used for analyzes of differences in MVC and endurance times. Full factorial repeated measures analyses of variance (ANOVA) were used to assess differences between patients and controls in NIRS and EMG parameters over time. Results showed no differences in MVC between patients and controls. We found, however, a shorter endurance time for patients compared to controls. There were no significant differences in StO2%, HbT, RMS and MPF responses during contraction between groups for the ECR. For the TD there was a group effect for StO2% with patients showing a lower level at rest and throughout the contraction. For the ECR and TD oxygenation, hemodynamics, RMS and MPF there were no straightforward differences between patients and controls that could explain the differences in endurance time. Therefore, we conclude that the shorter endurance time seen in the present study was not measurable by physiological indicators investigated in this group of patients.
50.	Elcadi, Guilherme H., 1966-, et al. (author) Oxygenation and Hemodynamics Do Not Underlie Early Muscle Fatigue for Patients with Work-Related Muscle Pain 2014 In: PLOS ONE. - : PLOS (Public library of science). - 1932-6203. ; 9:4 Journal article (peer-reviewed)abstract Patients suffering from work-related muscle pain (WRMP) fatigue earlier during exercise than healthy controls. Inadequate oxygen consumption and/ or inadequate blood supply can influence the ability of the muscles to withstand fatigue. However, it remains unknown if oxygenation and hemodynamics are associated with early fatigue in muscles of WRMP patients. In the present study we applied near-infrared spectroscopy (NIRS) on the extensor carpi radialis (ECR) and trapezius (TD) muscles of patients with WRMP (n = 18) and healthy controls (n = 17). Our objective was to determine if there were group differences in endurance times for a low-level contraction of 15% maximal voluntary contraction (MVC) -sustained for 12-13 min, and to see if these differences were associated with differences in muscle oxygenation and hemodynamics. At baseline, oxygen saturation (StO(2)%) was similar between groups for the ECR, but StO2% was significantly lower for TD for the WRMP patients (76%) compared to controls (85%) (P < 0.01). Also, baseline ECR blood flow was similar in the two groups. For both muscles there were a larger number of patients, compared to controls, that did not maintain the 15% MVC for the allotted time. Consequently, the endurance times were significantly shorter for the WRMP patients than controls (medians, ECR: 347 s vs. 582 s; TD: 430 s vs. 723 s respectively). Responses in StO(2)% during the contractions were not significantly different between groups for either muscle, i.e. no apparent difference in oxygen consumption. Overall, we interpret our findings to indicate that the early fatigue for our WRMP patients was not associated with muscle oxygenation and hemodynamics.

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