Handle height and expectation of cart movement affect the control of trunk motion at movement onset in cart pushing.

As unexpected sudden unloading of the trunk may cause low-back injury, the objective of the present study was to investigate whether handle height and the expectation of cart movement in pushing affect trunk control at movement onset. Eleven healthy male participants pushed a 200-kg cart with handles at shoulder and hip heights. The cart would suddenly move when externally released (externally triggered condition) or when static friction was overcome (self-initiated condition). Before self-initiated cart movement, trunk stiffness and muscle activity were significantly higher than before an externally triggered onset at comparable pushing force. Lower muscle activity and trunk stiffness at shoulder height compared with the hip height before the onset resulted in higher trunk inclination after the onset. In conclusion, higher preparatory activation of trunk muscles serves to increase trunk stiffness in anticipation of cart movement and may reduce the impact of the perturbation associated with the onset of cart movement. STATEMENT OF RELEVANCE: Sudden cart movement in pushing causes an unexpected unloading perturbation to the trunk. This perturbation was shown to cause uncontrolled trunk movement, which may explain how pushing tasks can be associated with low-back injury. Effects of handle height and awareness of the subjects of the possible cart movement suggest directions for prevention.