VACUUMING

INTRODUCTION

Vacuuming: nearly everyone is doing it! Unlike jumping a horse or throwing a curve-ball, vacuuming does not discriminate or limit itself to highly trained individuals or athletes. A vacuum cleaner, or commonly known as a vacuum, is typically an electric device that by means of suction collects dirt and small particles from a variety of surfaces. All it functionally requires is electricity, a vacuum cleaner appliance and a willing and able individual. This common invention is everywhere; household closets, hotels, general workplaces, restaurants and just about any other place that has carpeting or accumulates dust.
700 B.C. was the first noted appearance of woven forms of floor coverings and one could debate that primitive cleaning methods were developed thereafter (carpetandrugpedia.com). A cleaning method other than the traditional “carpet beater” was born in the mid-1800s. This time is known as the industrial revolution and was a critical in the invention of the vacuum cleaner. Factories were producing thousands of manufactured items and with it came an overwhelming amount of dust, soot and industrial pollution. This was also during the same time that infectious disease was being linked to germs. The need for hygiene and cleanliness was born and gave birth to the idea of the vacuum cleaner. By a patent issue date in 1860, Daniel Hess appears to have invented the first device to have the some of the basic principles of the modern vacuum. The machine, called a carpet sweeper, was unique in that it not only had the addition of suction but also had two water-filled chambers that collected fine particles. The next few decades were littered with inventors jumping on the suction/chamber bandwagon and many variations of the vacuum were produced but the invention was still considered a luxury item. At a point during the turn of the 20th century, vacuuming was sold as a door-to-door service rather than a product. After World II, the cleaner finally gained a common place among the middle-class. Advertising campaigns ran heavily in newspapers and magazines. The ads cleverly targeted the household matriarch, and for a short period the cleaner stood out as a prime showpiece in a home. This invention is also one of the few that can be advertised that it ‘sucks’ and successfully sell products. The standard of wall-to-wall carpeting in the last 40-50 years is what paved the road to universal accessibility of the vacuum.
As it was in the 1800s, modern vacuum cleaner manufactures are ever evolving the appliance in a multitude of shapes, sizes and portability options. They range in design from your everyday upright, canister, cordless, hand held and central domestic units to commercial backpack, industrial stationary appliances and self-propelled trucks. The cleaner can be used on nearly any surface or setting. Most commonly is carpet, hardwood floors and tile, but many can even suck-up wet or oily substances and sharp objects. Some equipped with fancy accessories, such as allergen reducing collectors, extension wands and brushes. Each attachment adds to its versatility.
The act of functionally moving a vacuum cleaner requires the operator to maneuver the appliance with unilateral upper extremity reach and grip, repetitious shoulder flexion and extension with slight trunk rotation. The range of force is graded as low to medium as the subject must use 20-40% of their maximum voluntary contraction (Marshall). The operator and the appliance must employ an ergonomic strategy and design. For purposes of analyzing the kinesics used in operating the appliance, the upright model shall be evaluated.

BIOMECHANICAL ANALYSIS

There are four basic phases of muscle function to execute the pushing and pulling motions necessary in the operation of a standard upright vacuum cleaner in a closed kinetic chain. The phases are subsequently explored and charts are included to break down the contractions each joint encounter as the body operates the appliance.
PHASE 1: PREPARING TO PUSH

The art of suction cleaning begins with the appliance placed in a ready position on the user’s dominant side laterally (the right side shall hereinafter be assumed the dominant side) and the ipsilateral hand grips the handle to initiate the process. The legs are in a walking-stride position: the dominant leg is situated posteriorly to the appliance while the opposite leg will remain anterior and create a visual pathway for the vacuum. This posture may vary between operators as the starting position and actual operation may slightly vary between different models and users as size and shape play an important role in position. For example, a shorter stature operator’s scapula may be elevated due to the height of the upright; this is not considered a functional contraction as the scapular elevation would be supported by the vacuum and gravity would cause the depression reaction. The fingers are isometrically flexed to maintain a cylindrical grip on the handle and will remain in that position until the activity is complete. The neck is primarily in a gravity assisted flexed position but controlled by the cervical extensors. In this pre-push phase, the neck position is for visual placing of the lower extremity.
In phase 1, the user must eccentrically load their muscles by static positioning. This allows the user overcome inertia and friction to functionally push the weighted vacuum cleaner. Once the cyclic pattern has been established, the initial external forces shall be less burdensome as this phase becomes dynamic and the muscles can optimally load. The dominant side hip is pronated to allow for the forward movement of the center of gravity and to load the Gluteus Maximus. Phase 1 not only prepares to push the machine but also stop the pull.
Phase 1 Analysis of pre-push JOINT | JOINT MOTION | MUSCLE(S) | TYPE OF CONTRACTION | (R) ANKLE | Dorsiflexion | Gastrocnemius & Soleus | Eccentric | (R) KNEE | Flexion Internal Rotation | Quadriceps Biceps Femoris | Eccentric | (R) HIP | FlexionInternal Rotation | Gluteus Maximus Anterior Gluteus Medius TFL | Eccentric | TRUNK | (R) Rotation | (R) External Oblique (L) Internal Oblique (L) Erector Spinae (R) Transversospinalis | Eccentric | SCAPULA | Retraction | Serratus Anterior Pectoralis Minor sdas | Eccentric | (R) SHOULDER (GH) | Extension | Anterior Deltoid & Pectoralis Major | Eccentric | (R) ELBOW | Flexion | Triceps, Anconeus | Eccentric | WRIST | Radial Deviation | ECU & FCU | Eccentric | FINGERS | Flexion | FDP & FDS | Isometric | HEAD/NECK | Flexion | Splenius Capitus Splenius Cervicis | Eccentric |

PHASE II: PUSH PERFORMANCE

Since the “push” muscles have been stretched to optimal length for a concentric contraction, Phase 2 begins and the operator is able to propel the weighted vacuum cleaner forward. Two of Newton’s Laws are employed: 1. Inertia will be greatest when the push begins from a static position and 2. The horizontal force applied to the handle must be reacted to by an equal force at the foot/floor interface. Plantarflexion is necessary for the lower extremity to gain traction. The pushing phase will require the most amount of muscle activity because the second class level force system created is one of power (McLaughin). The handler is able use part of their own body weight to generate force (if necessary) as the hip goes into extension but the Erector Spinae prevent the trunk from succumbing to gravity. Functionally, this phase uses larger muscle groups to perform the movement, thus reducing injury risk. The opposite or anterior stance leg is loading the hip and knee extensors eccentrically in preparation for the pull and acting as a stabilizer as the body weight is shifted from posterior-anterior sway. This sway allows the person’s center of gravity to travel in a straight line, therefore reducing energy expenditure and maintaining proper body mechanics. As the Pectoralis Major is already loaded in Phase 1, the shoulder joint in this phase may also enter into horizontal adduction in addition to flexion to allow for a repositioning of the vacuum for maximal surface area coverage.

Phase 2 Analysis of push JOINT | JOINT MOTION | MUSCLE(S) | TYPE OF CONTRACTION | (R) ANKLE | Plantarflexion | Gastrocnemius & Soleus | Concentric | (R) KNEE | Extension | Quadriceps Biceps Femoris | Concentric | (R) HIP | ExtensionExternal Rotation | Gluteus Maximus Anterior Gluteus Medius TFL | Concentric | TRUNK | Rotation | (R) External Oblique (L) Internal Oblique (L) Erector Spinae (R) Transversospinalis | Concentric | SCAPULA | Protraction | Serratus Anterior Pectoralis Minor sdas | Concentric | (R) SHOULDER | Flexion | Anterior Deltoid & Pectoralis Major | Concentric | (R) ELBOW | Extension | Triceps, Anconeus | Concentric | WRIST | Ulnar deviation | ECU & FCU | Concentric | FINGERS | Flexion | FDP & FDS | Isometric |

PHASE III: PUSH TO PULL TRANSITION

In the third phase, the user must now stop the momentum and convert the muscle contraction to pull backwards. During the push, the lower extremity muscles were eccentrically loading as the center of mass is advanced over the opposite leg. It is not only the muscle action that makes the decision to transition, but also the vacuum operator’s decision. Furthermore, the device weight and resistance can stop the forward movement of the vacuum when muscle power is no longer applied: instead the eccentrically loaded muscles are now preventing body propulsion. The art of operating a vacuum cleaner requires reciprocal muscles to rhythmically prepare for the repetitious and alternating pattern of pushing and pulling. In this pre-pull phase, the neck flexion is still functional for visual placing but now gives the operator the chance to marvel in the spotlessness of the cleaned surface.
Phase 3 Analysis pre-pull JOINT | JOINT MOTION | MUSCLE(S) | TYPE OF CONTRACTION | (L) ANKLE | Dorsiflexion | Gastrocnemius & Soleus | Eccentric | (L) KNEE | FlexionInternal Rotation | Quadriceps Biceps Femoris | Eccentric | (L) HIP | FlexionInternal Rotation | Gluteus Maximus Anterior Gluteus Medius TFL | Eccentric | TRUNK | (L) Rotation | (L) External Oblique (R) Internal Oblique(R) Erector Spinae(L) Transversospinalis | Eccentric | SCAPULA | Protraction | Middle Trapezius &Rhomboids | Eccentric | (R) SHOULDER (GH) | Flexion | PPosterior Deltoid & Latissimus Dorsi | Eccentric | (R) ELBOW | Extension | Brachialis &Biceps Brachii | Eccentric | WRIST | Ulnar deviation | FCR & ECRB | Eccentric | FINGERS | Flexion | FDP & FDS | Isometric | HEAD/NECK | Flexion | Splenius Capitus Splenius Cervicis | Eccentric |

PHASE 4 : PULL

Once again the muscles that were eccentrically loaded in the opposite leg are now firing concentrically to execute the pull. A major muscle milestone that occurs here is the knee being brought into extension while the elbow is flexed. This created a horizontal center of mass momentum that parallels the linear pull. Because the foot is planted, this is performed as a closed chain activity. The leg (distal segment) is fixed and the thigh (proximal segment) becomes the moveable part creating a reversal of muscle action as the femur is pulled posteriorly (Lippert). The body on machine lever is now efficient for movement as it is a third class lever (McLaughin). Simultaneously, the dominant leg is eccentrically loading, therefore, pull phase is then ended by looping back to Phase 1. The four phase cycle continuously repeats until the operator deems the task to be satisfactory.
Phase 4 Analysis pull JOINT | JOINT MOTION | MUSCLE(S) | TYPE OF CONTRACTION | (L) ANKLE | Plantarflexion | Gastrocnemius & Soleus | Concentric | (L) KNEE | ExtensionExternal Rotation | Quadriceps Biceps Femoris | Concentric | (L) HIP | ExtensionExternal Rotation | Gluteus Maximus Anterior Gluteus Medius TFL | Concentric | TRUNK | Rotation | (L) External Oblique (R) Internal Oblique(R) Erector Spinae(L) Transversospinalis | Concentric | SCAPULA | Retraction | Middle Trapezius &Rhomboids | Concentric | (R) SHOULDER (GH) | Extension | PPosterior Deltoid & Latissimus Dorsi | Concentric | (R) ELBOW | Flexion | Brachialis &Biceps Brachii | Concentric | WRIST | Radial deviation | FCR & ECRB | Concentric | FINGERS | Flexion | FDP & FDS | Isometric |

THE PAINFUL PART TO PUSHING AND PULLING
The movement of pushing and pulling is physically demanding, vulnerable and repetitive; exposing the performer to awkward body postures and musculoskeletal disorders. Musculoskeletal disorders are impairments of body structures such as muscles, joints, tendons, ligaments, nerves, bones. A panel was formed by the National Research Council and the Institute of Medicine stated that, “Musculoskeletal disorders of the low back and upper extremities are an important and costly national health problem.” Appropriate posture, body mechanics, incorporation of ergonomics and a well-tuned vacuum, injuries can be prevented.
LOW BACK PAIN: Back disorders can develop gradually as a result of micro trauma brought about by repetitive activity over time. Maneuvering a vacuum may require the user to adopt awkward or twisted trunk postures, placing them at high risk for back pain. Pain and stress in the lumber region is common because it is the mid-point bridge of the body and bears a large portion of body weight. Those who experience lumbar radiculitis may be suffering from Sciatica which is a compression of the sciatic nerve.
Proper posture and body mechanics are essential to decrease stresses on the tissues of the spine thus avoiding low back pain when vacuum cleaning. Since load tolerance in the spine is greatly reduced when the trunk is in flexion or torsion is applied along the axis, the torso should be held in a neutral, upright position and the lumbar spine held in natural lordosis. The legs should create the movement while the trunk is user to stabilize. To reduce forces required for pushing and pulling the operator should walk with the vacuum, use body weight as a catalyst for movement and appropriately adjust the vacuum’s settings, thus reducing the repetitive nature of the task.

CARPAL TUNNEL SYNDROME (CTS): CTS is a peripheral entrapment neuropathy effecting the hand and fingers and one of the most common repetitive strain impairments. The Carpal Tunnel is a small passage in the wrist which houses the Median Nerve and tendons of the finger flexors. Prolonged or excessive forces such as strong grips, vibrations and/or unnatural positioning can cause swelling and inflammation around the flexor tendon synovium or the thenar eminence. The swelling causes the median nerve to be compressed and lead to paresthesia, weakness, and pain most noticeably in the thumb and first 3 fingers. Individuals who engage in the task of vacuuming can have compression of the Median nerve occur from the hypertrophy of the thenar muscles, repeated pressure and bending of the wrist while holding the handle of the vacuum cleaner tightly.
Modifications to the task are simple and effect to reduce the amount of compression and repetitive stress placed on the wrist. Choosing a vacuum cleaner with an ergonomic grip design that allows for a neutral wrist position or adjusting the height of the handle so that the working hand is level with the forearm (ACleanSweep). Many people completely overlook the obvious choice to take adequate breaks in between tasks, alternating grip hands and simply not gripping too tightly. If the operator decides to switch hands, it is the perfect time to reposition the body and the device to complete the cleaning activity.

SHOULDER & ELBOW STRAINS: The distraction and compression forces created in conjunction with the pushing and pulling motions can place undue stress on non-contractile tissues in the elbow and shoulder. Furthermore, the repetitive nature of the task exposes the operator to cumulative trauma disorders. Two common impairments are elbow bursitis and rotator cuff tendonitis. Ensuring that the elbows and arms are kept near the trunk minimizes shoulder movements and encourages neutral posture and consciously makes the user aware of overreaching. Ergonomically your gripping hand should be held at about hip height. Also, changing or emptying the vacuum bag or canister frequently can reduce 10-20 pounds to the weight of the vacuum.

Musculoskeletal disorders from repetitive stresses are avoidable. Research may be limited for vacuuming but it is a commonly referenced topic in research journals and governmental agency publications on ergonomics/safety for service occupation. All of the MSDs listed put an emphasis on ergonomics, posture, body mechanics and upkeep of the appliance itself. Quick warm-ups, stretching before and after the task, alternating similar tasks out for fresh movement patterns and rest periods can be instituted to guarantee that the sucking up doesn’t burn you out.

FUNCTIONAL EXERCISES TO REFINE YOUR VACUUM CRAFT

Pushing and pulling a vacuum may seem to be a work-out itself, but improving your overall physical health promotes a safer work environment. Stability and strength of the trunk and limbs along with application of good postural habits have the ability to improve performance in functional activities and prevent injury. The following are functional exercises that can be implemented to enhance performance of this task and reduce the risk of musculoskeletal injuries.
FULL SQUAT

This exercise teaches the cleaner to strengthen and engage their Gluteus maximus, hamstrings and quad muscles eccentrically. The Gluteus maximus is the largest muscle in the body and is located right behind our center of gravity. It acts to stabilize the trunk over the legs, the knee, the lower lumbar spine and sacroiliac joint. A weak Gluteus maximus causes symptoms of low back pain by through synergistic dominance. Activation of this muscle and the front thigh muscles will aid in the prevention of strain injuries of the lower back while cleaning. 1. Stand with your feet shoulder width apart. Look straight ahead and keep your chest up. 2. Shift your hips backwards, lower yourself down 3. Hold your arms extended, straight out in front of you 4. Push your knees out—they should track over your second or third toe. 5. Lift yourself back to the original position pushing through the heel.

* Keep your spine long and neutral * Your heels should remain on the floor for the entire move.
Complete 3 sets of 12 repetitions.

CROSS-BODY CHOP

Working the body in the transverse plane is the ultimate real-world way to train the muscles. The act of a low reach to the opposite side of the body is simulating and strengthening the synergistic muscles and soft tissues that are needed for most pulling activities. The incorporate of the body twist put an emphasis on the hamstrings.

1. Stand with your feet slightly further than shoulder width apart. 2. With both hands, extend the ball over your left shoulder 3. With a chopping motion, bring the ball down and across to your left foot. Shift your hips backwards and push your knees out to achieve this position. 4. Keep your arms extended and your chest high as you chop 5. Rapidly and rhythmically complete all of the reps and then alternate sides. * Keep your spine long and neutral * You can modify this exercise to for stability by starting with arms at waist level and only chopping to your knee level. Add additional repetitions and faster movements.
Complete 3 sets of 12 repetitions.

QUADRUPED ALTERNATING SUPERMANS

Retraining the body to hold itself in a neutral alignment is the basis of good posture management. Dynamic stabilization is created by simultaneously activating the serratus anterior, trapezius and the core muscles of the trunk. This exercise also stabilizes the lumbar spine.

1. Start by assuming a four point position on hands and knees. 2. Align the hands below the shoulders and the knees below the hips. 3. Extend your left arm out in and right leg behind you. 4. Hold this position for 20 seconds 5. Alternate limb extension and hold again for 20 seconds.

* To advance this exercise you can place the hands on an unstable surface or support the body weight with one arm while you alternate extending the legs. * To make this easier, you can place a Swiss ball unde r your torso for additional support. * Keep your spine long and neutral * Place an object, like a broom stick or Kleenex box, in line with your spine as you perform this activity to ensure trunk neutrality.
Repeat 3 times

WALL PUSH UP PLUS

Performing this exercise helps to improve functional strength in the serratus anterior, activate the lower trapezoids and aid in rotator cuff stabilization. As added benefit, the core is also worked thereby increasing both functions of the shoulder movements and trunk rotations involved in the vacuuming.

1. Stand facing a few feet away from wall. Put your hands on the wall at shoulder height and width.
2. Toe pointing straight, knees unlocked and your head, neck and shoulders in a neutral position.
3. Keep your arms fixed and slightly dip your body weight downwards through your shoulders. Don’t let the shoulders dip together.
4. Keep your arms fixed and press into the wall, keeping the shoulder blades wide and push between your shoulder blades to round the back.

* You can advance this activity by lower your position to the counter-top, couch and then the floor.

Complete 2 set of 10 repetitions.

AQUATICS

The functionality of aquatic therapy and exercise is heavily debated, but it is renowned as a therapeutic exercise. It provides three-dimensional access for movement, initiates use of full range of motions in all joints, facilitates cardiopulmonary endurance and enhances relaxation. The buoyant and turbulent forces of the water cause the trunk to stabilize by co-contraction. After a long day of monotonous vacuuming and other cleaning activities, a day at the pool can provide you with an all-encompassing health benefit of physical fitness.

* Stand on one-leg (or two to decrease difficulty) and move your arms around for trunk stabilization. * Swim on your back or face down and perform the swimmer’s kick to improve lumbar strength. Incorporate your arms for a functional workout.

REFERENCES

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Samani, A., Holtermann, A., Søgaard, K., & Madeleine, P. (2012). Following ergonomics guidelines decreases physical and cardiovascular workload during cleaning tasks. Ergonomics, 55(3), 295. Retrieved April 14, 2014 from http://search.proquest.com/docview/929069973?accountid=28126

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" Biomechanics ." Musculoskeletal Disorders and the Workplace: Low Back and Upper Extremities . Washington, DC: The National Academies Press, 2001 .