Développement d'indicateurs biomécaniques en manutention et leur application dans l'étude des différences entre les sexes lors de levers de charges en hauteur

Work-related upper limb musculoskeletal disorders represent a public health challenge in the material handling industry. In addition to affecting the worker's quality of life, these injuries result in lost work time and increased production costs. While we have epidemiological evidence that more female material handlers suffer from shoulder pain than men, the literature is lacking biomechanical indicators that explain the origin of this difference.  The general objective of this thesis was to improve the evaluation of upper limb handling techniques, with three specific objectives~: (1) to develop synthetic kinematic, electromyographic and musculoskeletal indicators to evaluate and differentiate upper limb handling techniques~; (2) to develop an open source biomechanical analysis software~; and (3) to use the developed indicators and software to describe the biomechanical differences between female and male workers.  We collected kinematics, electromyography and force data on 30 women and 30 men performing a handling task that consisted in lifting a 6 and 12~kg box from hip to eye level. From these data, we developed synthetic indicators~: a kinematic indicator useful to identify poor handling techniques and more generally joint functions~; two electromyographic indicators to quantify the amount of muscle activation and muscle co-contraction~; and two musculoskeletal indicators to estimate total muscle stress and stress applied to the glenohumeral joint.  We have implemented these indicators with pyomeca, our open-source biomechanical analysis software. Available to the biomechanical community, pyomeca provide basic operations useful in the daily workflow of a biomechanical researcher, but also more advanced biomechanical routines geared towards rigid body mechanics and signal processing. pyomeca stands from existing biomechanical software because it is an open-source, user-friendly, specialized and secure solution.  We then applied our synthetic indicators to describe the biomechanical differences between the women and men participating in our experiment. The kinematic indicator showed that women used a poor handling technique, with a higher glenohumeral contribution, a low contribution from the lower limbs and a box further away from the trunk. These differences in technique affected the electromyographic and musculoskeletal indicators, with twice as much muscle activation compared to men and less glenohumeral stability. These results may contribute to the sex difference in the prevalence of upper limb musculoskeletal disorders.  This thesis has enabled the development of biomechanical indicators and an open-source software that could allow ergonomists to assess the upper limb exposure during a dynamic lifting task. Applied to a specific population, these indicators argue for a careful consideration of sex during ergonomics intervention, particularly during overhead work.

Keyphrases: Programmation, Upper limb, Manual material handling, Kinematics, Electromyography, Musculoskeletal modeling, Sex-related differences, Open-source software, Programming