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Differentiation of labor-related activity by means of musculoskeletal markers

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Title:
Differentiation of labor-related activity by means of musculoskeletal markers
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Book
Language:
English
Creator:
Doying, Annette
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University of South Florida
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Tampa, Fla
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Subjects

Subjects / Keywords:
Forensic anthropology
Occupation
Robusticity
Osteolytic
Osteophytic
Bioarchaeology
Enthesopathies
MSM
Dissertations, Academic -- Anthropology -- Masters -- USF   ( lcsh )
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non-fiction   ( marcgt )

Notes

Abstract:
ABSTRACT: This study tests whether musculoskeletal markers are attributable to occupational categories. It is hypothesized that individuals over the age of 30 years with a lifetime occupation as a laborer will demonstrate a significantly different pattern of activity markers from individuals in the white collar classifications. A sample of n=69 from the Maxwell Museum's Documented Skeletal Collection are investigated. Upper and lower extremities were scored for MSM type (robusticity, stress lesions, and ossification exostoses) and severity (grades 0 - 3) following Hawkey and Merbs (1995) visual reference system. To evaluate methodological approaches to MSM scoring, ossification exostoses and stress lesions were also scored using the Mariotti et al. (2004) proposed methods. Upper limb muscle insertion sites on the humerus, radius, and ulna and lower limb insertion sites on the femur, fibula, patella, calcaneus, and tibia were studied. The Kruskal Wallis test was used to predict occupational class according to an individual's aggregate MSM z-score. The Mann-Whitney test was used for comparison of aggregate MSM z-scores between the two occupational categories and for comparison of aggregate MSM z-scores between males and females. The Spearman correlation was used for non-parametric correlation analysis of aggregate MSM z-scores and the occupational categories of white collar and labor. The data were analyzed using the statistical software program SPSS (version 17.0). Results of this study show that musculoskeletal markers cannot statistically predict, nor can they be used to distinguish between, occupational categories of white collar and labor. Comparison of MSM shows no significant difference in the overall patterns of enthesopathies between individuals who report an occupation of white collar or those who report an occupation of laborer as defined by the U.S. Office of Personnel. Comparison of MSM in this population shows no significant difference between males and females, regardless of occupational category, a finding which runs counter to many earlier studies. Using dichotomous data it is revealed that laborers develop MSM symmetrically, evidence of whole-body activity. Further, white collar MSM can be associated with sitting and elevating the arm. Laborer's MSM are associated with lifting, twisting, pushing, squatting, walking, running and standing. Recommendations on methodology are provided.
Thesis:
Thesis (M.A.)--University of South Florida, 2010.
Bibliography:
Includes bibliographical references.
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Mode of access: World Wide Web.
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by Annette Doying.
General Note:
Title from PDF of title page.
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Document formatted into pages; contains X pages.

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ABSTRACT: This study tests whether musculoskeletal markers are attributable to occupational categories. It is hypothesized that individuals over the age of 30 years with a lifetime occupation as a laborer will demonstrate a significantly different pattern of activity markers from individuals in the white collar classifications. A sample of n=69 from the Maxwell Museum's Documented Skeletal Collection are investigated. Upper and lower extremities were scored for MSM type (robusticity, stress lesions, and ossification exostoses) and severity (grades 0 3) following Hawkey and Merbs (1995) visual reference system. To evaluate methodological approaches to MSM scoring, ossification exostoses and stress lesions were also scored using the Mariotti et al. (2004) proposed methods. Upper limb muscle insertion sites on the humerus, radius, and ulna and lower limb insertion sites on the femur, fibula, patella, calcaneus, and tibia were studied. The Kruskal Wallis test was used to predict occupational class according to an individual's aggregate MSM z-score. The Mann-Whitney test was used for comparison of aggregate MSM z-scores between the two occupational categories and for comparison of aggregate MSM z-scores between males and females. The Spearman correlation was used for non-parametric correlation analysis of aggregate MSM z-scores and the occupational categories of white collar and labor. The data were analyzed using the statistical software program SPSS (version 17.0). Results of this study show that musculoskeletal markers cannot statistically predict, nor can they be used to distinguish between, occupational categories of white collar and labor. Comparison of MSM shows no significant difference in the overall patterns of enthesopathies between individuals who report an occupation of white collar or those who report an occupation of laborer as defined by the U.S. Office of Personnel. Comparison of MSM in this population shows no significant difference between males and females, regardless of occupational category, a finding which runs counter to many earlier studies. Using dichotomous data it is revealed that laborers develop MSM symmetrically, evidence of whole-body activity. Further, white collar MSM can be associated with sitting and elevating the arm. Laborer's MSM are associated with lifting, twisting, pushing, squatting, walking, running and standing. Recommendations on methodology are provided.
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Robusticity
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Enthesopathies
MSM
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Differentiation of Labor-Related Activity by Means of Musculoskeletal Markers by Annette Doying A thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts Department of Anthropology College of Arts and Sciences University of South Florida Major Professor: Erin Kimmerle, Ph.D. Lorena Madrigal, Ph.D. David Himmelgreen, Ph.D. Date of Approval: March 23, 2010 Keywords: Forensic anthropology, occupation, r obusticity, osteolytic, osteophytic, bioarchaeology, enthesopathies, MSM Copyright 2010, Annette Doying

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Dedication Rick and Keeley and KerriThis small thing is dedicated to the three of you. .a.

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Acknowledgments The Pasco County (Florida) Board of C ounty Commissioners lent their financial support, and Michele Baker and Jim Ma rtin kept the door open. Thank you. The University of South Florida Anth ropology Department faculty and staff who inspired and guided me include Dr. Curtis Weinker, Dr. Lori Collins, Dr. Lorena Madrigal, Dr. David Himmelgreen, Dr. Rebecca Zarger, Dr. Robert Tykot, Dr. Kevin Yelvington, and my major advi sor, Dr. Erin Kimmerle. Daisy Matos, Debbie Roberson, and Sue Rhinehart kept me on course; helping me dot the i’s, cross the t’s, and always encouraging me to keep moving ahead. Dr. Heather Edgar and her students at the University of New Mexico lent me their time, advice, and access to the rema ins of the Maxwell Museum’s Documented Skeletal Collection. Dr. Ri chard Jantz, Dr. Kate Spra dley, Dr. Bruce Anderson, Dr. Giselle Garcia, and Dr. Elizabeth Weiss grac iously responded to my emails and helped me figure out my focus. Thank you. The USF Grace Allen Women’s Club honored me with their esteem. I swear I’ll pay it all forward.

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i Table of Contents List of Tables................................................................................................................. ....iii List of Figures................................................................................................................ ...vii Abstract....................................................................................................................... .........x Chapter One Introduction....................................................................................................1 Problem Statement...................................................................................................3 Chapter Two Literature Review...........................................................................................5 Musculoskeletal markers in the literature................................................................5 Frost’s Mechanostat...............................................................................................10 Labor and musculoskeletal stress...........................................................................11 Chapter Three Materials and Methods...............................................................................14 Sample-The Maxwell Museum Documented Skeletal Collection.........................14 The Classification of Indivi duals into Occupational Groups.................................16 Part I White Colla r Occupational Groups..................................................16 Part II Trade, Craft, or Labor Occupational Series....................................16 Selection of MSM sites for study...........................................................................21 The Hawkey and Merbs and Mariotti et al. methods.............................................21 Statistical Analysis.................................................................................................30 Applying the Principal of Aggregation..................................................................32 Chapter Four Results ........................................................................................................36 Comparison of right-limb, left-limb scores in order to establish breadth of data set used in core statistical analysis....................................36 Data exploration using dichotomous scores only..................................................45 Non-parametric statistical an alyses central to this study.......................................51 Chapter Five Discussion....................................................................................................64 The MSM literature in light of study findings.......................................................67 Observations on the application of the Hawkey and Merbs and Mariotti et al methods...............................................................................71 Chapter Six Conclusions and Recommendations..............................................................84 The Use of the Hawkey and Merbs and Mariotti et al Visual Reference Systems..........................................................................85

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ii References Cited............................................................................................................... .89 Appendices..................................................................................................................... ....93 Appendix A: The Handbook of Occu pational Groups and Families.....................94 Appendix B: Reference Images...........................................................................106 Appendix C: Data used in Analysis.....................................................................115 Appendix D: MSM Raw Scores..........................................................................120

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iii List of Tables Table 3.1. The muscle/bone insertion sites of the upper and lower extremities used in this study and their re lationship to activity.........................................17 Table 3.2. Number of male and fema le white collar and labor workers...........................20 Table 3.3. Hawkey and Merbs visual refe rence scoring system categories and grades used in this study (1995).......................................................................25 Table 3.4. Mariotti et al. (2004) c ategories and grades used in scoring osteolytic and osteophytic activity in the current study...................................................27 Table 4.1. Paired Samples Correlations between Right and Left Upper Limb and Right and Left Lower Limb......................................................................37 Table 4.2. Paired Samples Correlations between Right and Left Upper Limb and Right and Left Lower Limb among Wh ite Collar Individuals..................37 Table 4.3. Paired Samples Correlations between Right and Left Upper Limb and Ri ght and Left Lower Limb among Laborers...........................................37 Table 4.4. Paired Samples Test of Diffe rences between Right and Left Upper Limb and Right and Left Lower Limb.............................................................38 Table 4.5. Paired Samples Test of Diffe rences between Right and Left Upper Limb and Right and Left Lower Limb among White Collar Individuals........39 Table 4.6. Paired Samples Test of Diffe rences between Right and Left Upper Limb and Right and Left Lower Limb among Laborers..................................40 Table 4.7. Paired Samples Correlation Between Each Insertion Site...............................42

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iv Table 4.8. Paired Samples Correlation Between Each Insertion Site among White Collar Individuals..................................................................................43 Table 4.9. Paired Samples Correlation Between Each Insertion Site among Laborers..................................................................................................... ......44 Table 4.10. Right upper limb comparison of fre quency scores at each site, by method..................................................................................................... .......48 Table 4.11. Right lower limb comparison of frequency scores at each site, by method. .....................................................................................................49 Table 4.12. Chi-square analysis of abse nt/present data for each site where p > 0.05................................................................................................... .......50 Table 4.13. Prediction of Occupationa l Class Based on Aggregate MSM z-scorea,b.........................................................................................................53 Table 4.14. Prediction of Occupational Class Based on Right Upper Limb Insertion Site Aggregate MSM z-score using Hawkey & Merbs/Mariotti et al. data combined.......................................................................................53 Table 4.15. Prediction of Occupational Class Based on Right Upper Limb Insertion Site Aggregate MSM z-score using Mariotti et al. data only. ........54 Table 4.16. Prediction of Occupational Class Based on Right Upper Limb Insertion Site Aggregate MSM z-score using Hawkey & Merbs data only. .54 Table 4.17. Prediction of Occupational Class Based on Right Lower Limb Insertion Site Aggregate MSM z-score using Hawkey & Merbs/Mariotti et al. data combined. ..................................................................................... 55 Table 4.18. Prediction of Occupational Class Based on Right Lower Limb

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v Insertion Site Aggregate MSM z-score using Mariotti et al. data only. ....... 55 Table 4.19. Prediction of Occupational Class Based on Right Lower Limb Insertion Site Aggregate MSM z-score using Hawkey & Merbs data only. 56 Table 4.20. Prediction of Sex base d on Aggregate MSM z-scores .................................56 Table 4.21. Comparison of Aggregate MS M z-scores Between Occupational Categoriesa.....................................................................................................57 Table 4.22. Comparison of Right Upper Limb Insert ion Site Aggregate MSM Score.................................................................................................. ..57 Table 4.23. Comparison of Right Lower Limb Insertion Site Aggregate MSM Score.................................................................................................. ..58 Table 4.24. Comparison of Aggregat e MSM z-scores Between Sexesa...........................58 Table 4.25. Ranks of Aggregate MSM z-scor es for Males Of Both Occupational Categories................................................................................................. .....58 Table 4.26. Comparison of Aggregate MS M z-scores for Males Of Both Occupational Categories................................................................................59 Table 4.27. Ranks of Aggregate MSM z-scores for Females Of Both Occupational Categories.................................................................................59 Table 4.28. Comparison of Aggregate MS M z-scores for Females Of Both Occupational Categories................................................................................59 Table 4.29. Correlations between Occupa tional Category and Aggregate MSM z-scores ..........................................................................................................60 Table 4.30. Correlations between Occ upational Category and Right Upper Limb Aggregate MSM z-scores.....................................................................61

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vi Table 4.31. Correlations between Occ upational Category and Right Lower Limb Aggregate MSM z-scores .....................................................................62 Table 4.32. Correlations between Se x and Aggregate MSM z-scores.............................63

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vii List of Figures Figure 3.1. Workspace at the Maxwell Muse um, University of New Mexico, 2009.......18 Figure 3.2. Maxwell Museum D onated Collection, UNM 2009......................................19 Figure 3.3. Sample size displayi ng age and sex distribution ...........................................20 Figure 3.4. Right radius, medial view, proximal shaft of an 95 year old female Administrative Di rector of the Arts (White collar) showing continuum between the robusticity (RM=3) and st ress lesion (SL=1) grades at the radial tuberosity........................................................................................... ...24 Figure 3.5. Reprinted with permission fr om Hawkey and Merbs (1995) (from top to bottom) Robusticity, Stress Lesion, and Ossification Exostosis visual references.......................................................................................... ...26 Figure 3.6. Visual reference system used by Mariotti et al. (2004) to establish osteolytic forma tion (OL) Grades 1 – 3a/b (top to bottom with Grade 1 shown twice, Grade 2 shown three times, and Grade 3a/b shown together in one photo) (Reprinted with permission)....................................................28 Figure 3.7. Visual referen ces used by Mariotti et al. (2004) to establish osteophytic formation (OF) Grades 1 – 3 (top to bottom with Grade 3 shown twice) (Reprinted with permission)....................................................29 Figure 3.8. Right ulna, me dial view, proximal head showing sail-shaped exostoses on a 69 year old male with a repor ted lifetime occupation of “bottler” (Labor)........................................................................................... ..34

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viii Figure 3.9. Left humerus, anterior view, proximal head showing ossification exostoses at th e Teres major/minor inserti on sites (associated with twisting/pulling) of a 93 year old, male auto mechanic (Labor)....................35 Figure 4.1. Presence of Right Upper and Lower Limb MSM by Insertion Site for White Collar and Labor Workers (n=69)..................................................47 Figures 5.1. Left ulna, lateral view, proxi mal head of a 93 year old male auto mech anic (Labor) with sail-shaped exostoses...............................................73 Figure 5.2. Left ulna, lateral view, proximal head of an 81 year old female nurse (White collar) showing exostoses...................................................................73 Figure 5.3. Right and Left Patellae, anterior view, showing ossification exostoses/osteophytic formations, grades 0 – 3, clockwise from upper left with grades 0 and 1 from a 68 year old female teacher (White collar) and grades 2 a nd 3 from a 94 year old male construction supervisor (Labor)..................................................................................................... .......74 Figures 5.4. Left femur, pos terior view, proximal shaft, showing varying forms of exostoses from an 94 year old female homemaker (Labor).....................77 Figure 5.5. Right humerus, an terior view, proximal head, showing exostosis from an 88 year old male machinist (Labor)..................................................77 Figure 5.6. Right and left radii, fibulae, and humeri, superior view, proximal shafts showing featur es that were not observable (graded “absent”) due to animal gnawing.............................................................................................. .78 Figure 5.7. Right and left fi bulae, superior view, distal head, showing features that were no t observable (graded “nr”) due to lytic activity...........................78

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ix Figure 5.8. Right humerus, an terior view, proximal hea d, showing various size “pits” and “furro ws” on a 90 year old male professor (White collar)............79 Figure 5.9a. Left and right femora, po sterior view, proximal shaft showing osteophytic fo rmation at the Gluteus maximus (squatting/lifting) insertion site of a 59 year old, male rancher (Labor)....................................80 Figure 5.9b. Left femur, poste rior view, proximal shaft showing ridging exostoses at the Gluteus maximus insertion site of a 71 year old male school teacher (White collar)...................................................................................8 0 Figure 5.10a. Left calcaneous, posterior vi ew, showing ossification exostosis on a 51 year old, female account ant (White collar).........................................81 Figure 5.10b. Left tibia, anterior view, proximal head, showing Semitendinous insertion s ite on a 73 year old, female county clerk (white collar) associated with walking, squatting, and standing.......................................81 Figure 5.11a. Left radius, medial view, proximal shaft showing Robusticity Marker Grade 3 on a 59 year old male rancher (Labor).............................82 Figure 5.11b. Right radius, medial view proximal shaft showing Robusticity Marker Grade 1 on a 54 year old female accountant (White collar).........82 Figure 5.12a. Left radius, lateral view, mid-shaft showing Robusticity Marker Grade 3 at th e Pronator insertion site of a 93 year old male auto mechanic (Labor)........................................................................................ 83 Figure 5.12b. Left radius, lateral view, mid-shaft showing Robusticity Marker Grade 1 on the Pronator insertion site of a 54 year old female accountant (White collar)............................................................................83

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x Differentiation of Labor-Related Activity by Means of Musculoskeletal Markers Annette Doying ABSTRACT This study tests whether musculoskeletal ma rkers are attributable to occupational categories. It is hypothesized that individuals ov er the age of 30 years with a lifetime occupation as a laborer will demonstrate a significantly different pattern of activity markers from individuals in the white collar classifications. A sample of n=69 from the Maxwell Museum’s Documented Skelet al Collection are investigated. Upper and lower extremities were scor ed for MSM type (robusticity, stress lesions, and ossification exosto ses) and severity (grades 0 – 3) following Hawkey and Merbs (1995) visual reference system. To evaluate methodological approaches to MSM scoring, ossification exostoses and stress lesions were also sc ored using the Mariotti et al. (2004) proposed methods. Upper limb muscle insertion si tes on the humerus, radius, and ulna and lower limb insertion sites on the femu r, fibula, patella, calcaneus, and tibia were studied. The Kruskal Wallis test was used to predict occupational class according to an individual’s aggregate MSM zscore. The Mann-Whitney test was used for comparison of aggregate MSM z-scores between the tw o occupational categories and for comparison of aggregate MSM z-scores between males and females. The Spearman correlation was used for non-parametric correlation analys is of aggregate MSM z-scores and the occupational categories of white collar and la bor. The data were analyzed using the

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xi statistical software progr am SPSS (version 17.0). Results of this study show that muscul oskeletal markers ca nnot statistically predict, nor can they be used to distingui sh between, occupational categories of white collar and labor. Comparison of MSM show s no significant difference in the overall patterns of enthesopathies betw een individuals who report an occupation of white collar or those who report an occupation of laborer as defined by the U.S. Office of Personnel. Comparison of MSM in this population show s no significant difference between males and females, regardless of occupational cate gory, a finding which runs counter to many earlier studies. Using dichotomous data it is revealed that laborers develop MSM symmetrically, evidence of whole-body activity. Further, white collar MSM can be associated with sitting and elevating the arm. Laborer’s MSM are associated with lifting, twisting, pushing, squatting, walki ng, running and standing. Recommendations on methodology are provided.

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1 Chapter One Introduction The anthropological study of the sk eleton provides an understanding of the individual as a functioning, living human being and member of a population. Human skeletal and dental tissues are remarkably sensitive to the envir onment, providing what Garn (1976) referred to as ‘a rich storehouse of individual hi storical events’ in Larsen (1997). From the skeleton we can learn about the human condition across time and space. Skeletal remains provide evidence of ancestry, stature, age, sex, health and nutritional status, and unique identifying f eatures which reveal life history as it is recorded in the bones. This history, known as the biological profile uses professionally accepted approaches to categorize this evidence and ultimately, describe characteristics about the individual. When studying an unknown individual’s remains, general descriptive statements such as “pronounced muscle markings”, “large muscle markings”, “lipping, bony spurs, porosity, osteophytes”, and “evident muscle markings on all bones” are routinely included as part of the biological profile, indicating the observer’s casual notice of the markers left behind by lifetime physi cal activity. In the forensic context, as with bioarchaeology, these markings are a ssociated with specific muscles and by extension, certain lifetime activities. Bioarchaeological research has focused on relating certain markings to particular activities and habitual motions base on et hnographic or archaeol ogical evidence (e.g.,

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2 Hawkey and Merbs, 1995; Steen and Lane, 1998; Kennedy, 1998; Weiss, 2002; 2007; Mariotti, 2004; Molnar, 2006). In these studies, researcher s have shown that age is a significant factor in the produc tion of muscle markings. Ol der individuals demonstrate more pronounced markings than do younger individuals. Sex has also been noted as a factor as males have been found to be more likely to manifest muscle markings, but this evidence is confounded by size differences between the sexes. Throughout life, repetitive, intense activity is known to produce a response in bone at the sites where muscle, ligament, or tendons attach to the blood-supplying periosteum and underlying bony cortex. As a re sult of this activity blood flow increases stimulating bone cell growth, bone becomes hype rtrophic, and distinct markings such as crests, ridges or mounds, pits, furrows and bony projections known as exostoses are formed (Hawkey and Merbs, 1995; Churchil l, 1997; Weiss, 2003; 2007). Alternately known as enthesopathies, markers of occupa tional stress (MOS), robusticity markers (RM), or musculoskeletal stress markers (M SM), these bony lesions can be useful in analyzing the degree of habitu al activity-induced stress placed on a specific muscle. During muscle stress, the bone cells react to support the increased strain, and the surface of the attachment is modified. In MSM analysis, focus is t ypically on the sites of muscle origin, muscle insertion, and ligament attach ments. Throughout this paper, the term MSM will be used to refer to all manifestati ons of bone response at the site of muscle insertion.

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3 Problem Statement The full utility of MSM to expand the range of descriptive characteristics being used to establish the biological profile of skeletal remains in the forensic context has not been determined. In particular, the correla tion of specific MSM patterns to the general modern occupational categories of white collar and labor has not been established. Sporting and occupational medicine studi es abound which indicate that specific enthesopathies are correlated with specific activ ities such as skiing and kayaking. Studies of activity-induced markers have also been well-documented in the anthropological literatu re. J. Lawrence Angel revived and called for a strengthening of this area of scientific endeavor in 1960 and in 1998 Kennedy pointed out that much of the earlier literature on the subj ect of MSM and their relation to specific lifetime activities was anecdotal and earlier unteste d interpretations persisted in the scientific literature (Kennedy 1998). In compliance with federal law as descri bed in Title 5, United States Code, the Office of Personnel Management (OPM) appr oves and issues position classification standards for most occupations. Classificati on criteria for similar or related kinds of work are provided to allow for the evaluation of occupations not specifically described in the standard. The format of the standards is designed to allow for analysis and classification based on the essential characteri stics of a position (U.S. Office of Personnel Management 2008). The current study tests wh ether musculoskeletal stress markers are directly attributable to cert ain position classifications set forth in the U.S. Office of Personnel Management standards (2008). It is hypothesized that in dividuals over the age of 30 known to have worked in

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4 strenuous occupations such as construction and farming will demonstrate a significantly different pattern of activity markers than indi viduals in less labor in tensive occupational classes such as accounting or sale s. The implication is for this research to relate labor practices and skeletal traits in a way th at can contribute to identity resolution for unknown remains in the forensic anthropological context.

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5 Chapter Two Literature Review Musculoskeletal markers in the literature In his 1986 article, Enthesopathies (Lesions of Musc ular Insertions) as Indicators of the Activities of Ne olithic Saharan Populations, Dutour provides a definition of enthesopathies as bony lesions involving the site s of insertion of mu scles or ligaments. Dutour relies upon a simplistic methodology wh ich involves macroscopic observation of rough patches, areas of irregularity, and the display of osteophytes. Classification of these observations is based upon comparison with radiological data from modern subjects suffering from enthesopathies of known e tiology which allows for differentiation between those caused by hyperactivity of the re levant muscles and those of metabolic or inflammatory origin. Dutour points out that studies within the disc iplines of sporting and occupational medicine indicate that specific en thesopathies are correlated with different activities. The 1995 Hawkey and Merbs’ study of upper extremity musculoskeletal stress markers (MSM) of ancient Thule Eskimos demons trates that distinct pattern differences between adult males and females are the result of different habitual activity patterns which are not always discernible from th e archaeological record alone. The study includes 136 individuals with skeletons that were incomp lete excluded. Individuals with evidence of healed fractures or severe de generative joint disease are not included, because these conditions could increase the amount of stress placed on the non-

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6 pathological side. Also excl uded are adult skeletons that could not be aged or sexed reliably. By 1998, MSM had garnered enough intere st to result in a symposium on Activity patterns and musculoskeletal markers organized by K.A.R. Kennedy at the 66th annual Association of American P hysical Anthropologists m eeting. New methodological procedures and statistical approaches were being applied to ear lier hypotheses regarding the skeletal evidence of habitual patterns of activity. Papers presented for the symposium offered a reorientation of met hodology in defining MOS. It was realized that researchers could no longer attribute bone modification to a single patter n of activity however useful this practice might be in es tablishing individuation in th e context of a medical-legal investigation. Rather, it became clearer to symp osium participants that it is the overall pattern of stress which best de scribes the habitual activitie s in which an individual may have engaged in life. Kennedy concludes that in some cases diagnosis must be restricted to stating that an individual had engaged in some form of strenuous la bor and that at best we may be able to isolate markers of habitual stress to certain anatom ical regions, such as the bones of the upper or lower extremities. Further, the use of archaeological or historical records to inform these observations might suggest a range of cultural practices which may have wrought these skeletal modifica tions. In short, MOS must be interpreted in relation to the entire individual, viz the skeleton, and not as isolated phenomena. Kennedy, acting as symposium discussant, round s out the discussions with a call for the development of reliable standard s for the recognition of MSM. Steen and Lane (1998) discuss the misuse of the term enthesopathy to describe the remodeling of bone resulting from normal activities. The authors describe

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7 musculoskeletal stress markers, or MSMs, as referring specifica lly to bony changes produced during normal, habitual use of muscle s and ligaments at their attachment sites, where ‘normal’ implies any amount of daily activity over an individual’s lifetime. A detailed overview of MSM manifestation is provided and methods for conducting data analysis are discussed. Churchill and Morris (1998) test the utility of MSM for determining subsistence labor intensity among prehistoric Khoisan skel etons from distinctly different biomes. MSM scores for seventy-five Khoisan forage rs indicate that these biome differences evidence diversity in upper limb labor cost among males while among females MSM scores do not differ significantly in either upper or lower limb. These finding are suggestive of both sexual division of labor and among group differences in male foraging strategies. Churchill and Morris further evidence that MS M might reflect certain types of muscle activity such as loading intensity bette r than others such as loading frequency and duration. Using fifty-six adult skeletons from Iron Age Italy, Robb (1998) applies an alternative analytical approach to MSM an alysis. By focusing on the organization of activity, rather than the identif ication of specific activities, Robb finds that: (1) skeletal development of muscle sites is related to an individual’s age; (2) variations in muscle marking within and between skeletons may be linked to activities performed; and (3) even when specific activities cannot be deduced, statistica l patterns with in a group may inform us about past lifeways and th e social organization of activities. In the decade since these studies were conducted, research related to MSM continues to inform both bioarchaeology and forensic anthropology. Weiss (2003)

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8 recognizes that individual MSM fail to corr elate with cross-sectional properties and levels of exercise and are confounded by body size. Using the principle of aggregation to sum MSM over seven insertion sites, Weiss examin es the effects of body size, age, sex, and cross-sectional properties on ninety-one archaeological a nd historical skeletons from British Columbia and Quebec. Her findings provide evidence that no single MSM under study correlate with age, size, sex or crosssection. Further, aggregate MSM do correlate with age, size, sex and cross-section with olde r individuals, larger individuals, males, and those with more robust cross-s ections, all found to exhibit greater MSM. Age is shown to be the best overall predictor of aggregate MSM. Mariotti et al. (2004) propose a standardized method to score the degree of development of rugosity, osteophytic and osteol ytic enthesopathies. Earlier testing had shown that intraand interobserver errors for this method were found to be less than 5.0%. Applying the standard to the study of n=113, late 19th and early 20th century individuals of Italian ancestry results demonstrate an effect of age on the form and degree of development of enthesopath ies. Sex and occupation could not be excluded and the authors suggest that age, sex, and distribution of lesions with in a single skeleton must be taken into account in applying the method for functional interpretations. Molnar (2006) uses the Hawkey and Merbs techniques associated with MSM analysis to assess prospects of identifying ge neral levels of physical activity in skeletal remains through statistical te sting, to include frequency analysis and two-sample Wilcoxon rank sum tests. Statistical analysis of certain MSM patte rns is performed in order to investigate potentia l relationships between MSM and plausible prehistoric activities, such as archery, ka yaking, and harpooning or speari ng. Since a different set of

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9 muscles is used for each of these activities, a nd certain muscles are essentially needed to mechanically perform each movement the expectation was that MSM would correlate with activity. Significant positive correlati ons were observed in male individuals in muscle groups associated with archery and to some extent harpooning, an indication that these activities would mainly have been pe rformed by men. Correla tions in kayaking muscles were not evidently consistent w ith the kayaking motion. Furthermore, the costoclavicular ligament, often referred to in connection with ‘‘kayaker’s clavicle,’’ showed no positive statistical correl ation with the kayaking muscles. Weiss (2007) also provides a detailed ove rview of the biological processes that lead to the development of MSM. This ar ticle discusses the an thropological use of muscle markers over the last two decades to address issues regardi ng sexual division of labor, group differences in spec ific activities related to culture, and effects of agriculture on past populations. Some clear patterns in muscle marker research are shown to have emerged regardless of the population examined. Researchers consiste ntly find that older individuals, males, and larg er individuals have more pr onounced muscle markers than do younger individuals, females, or smaller i ndividuals. Weiss stresses that these differences may disappear if one employs aggr egate variables in the studies. Earlier studies conducted by Weiss are used to substa ntiate the use of aggregation to improve muscle marker studies by enhancing construc t validity and reducing error variance in the data. The present study uses both aggregat ed muscle markers and separate muscle markers with size and age controls to a ttempt an activity reconstruction using the remaining significant sex differences.

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10 Molnar (2008) studies pa tterns from 52 upperand lo wer-body MSM to compare with ten selected artifact categ ories found in graves in Gotland, Sweden. No significant correlation between patterns for specific ac tivities such as archery and harpooning and corresponding grave goods are found and Molnar concludes that the individual in each grave is clearly visible as seen through examin ation of artifacts, but not as a performer of the specific activities su ggested by the grave goods. Frost’s Mechanostat According to Currey (2002), one of the ma ny strange things about bone remodeling is that it takes place mainly on the inside of the cortex of the long bones, rather than on the outside. That the shapes of bones could re sult merely from mechanical adaptation to loads placed on them is shown to be the case by many experiments starting in the 1920s. Bones, therefore, develop at least partly without reference to the load they experience, however, their final architect ure is dependent in some way on the mechanical environment in which they are shaped, either during development or in maturity. Currey believes there are many gaps in our understand ing of how the shape and size of bones are affected by the forces acting on them during li fe. If the actual strains deviate from the optimal strain, either at all, or by some th reshold amount, bone is added to surfaces or removed from them. This reconstruction alte rs the build of the bone so that the same forces will now result in different and, if the reconstruction has been correct, more appropriate strains in the bone. By the late -1980’s Harold Frost had attempted to flesh out the mechanisms which underlie this con cept. Frost’s “mecha nostat” model (Currey 2002:340) involves:

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11 o Modeling usually adds bone over a large surface, therefore increased modeling increases overall bone mass. o Remodeling does not quite replace all the bone taken away. Overall, increased remodeling reduces bone mass. o Strong activity, leading to large strain s in the bone, incr eases modeling and decreases remodeling, so bone mass increases. o Very low activity prevents modeling, and remodeling activity in creases, therefore bone mass reduces. o Between these set points, is a zone of strains where rather little happens. o Drugs, hormone imbalances, and so on a lter the set points with respect to the strains, so that the bone “feels” according to Frost’s proposed feedback mechanism, the mechanostat, to be less (for instance, in th e case of flouride treat ment) or more (for instance, in the case of postmenopausal estrogen openia) robust than it actually is. As a result, inappropriate modeling or remodeling takes place. Labor and musculoskeletal stress Chapman and Meyers (1997) reviewed the re sults of a series of National Health Interview Survey studies taking place between 1988 and 1999. The original study, conducted by Chapman and Meyers following the 1988 Survey, had demonstrated that workers in production agriculture are the most likely to report daily exposures to a variety of musculoskeletal repetitive stress injury (R SI) hazards. Data from a 1992 NHIS followup study by Leigh and Fries reports that farming was the occupation most often associated with RSI disability in females and the second most often in males. A 1999

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12 reanalysis of this data by Guo et al. showed that the reported one year period prevalence rate of back pain among individuals worki ng in production agriculture was about one and one-half times higher than the average for all U.S. industries. According to Leigh and Fries (1992), th e female broad occupations ranking from highest to lowest association with RSI disability, were as follows: farming, no occupation, laborers, service, technicians, operatives, professionals, sales workers, administrative support, and managers. The male broad occupations ranking was as follows: no occupation, farming, operatives, cr afts workers, service, technicians, manager, administrative support, sales and pr ofessionals. The highe st levels of RSI disability for women and men occurred among non-construction laborers, farm workers, twisting machine operators, servants, mining machine ope rators, and bus drivers. Baron (2001) provided a summary on ergonomics for farm workers which detailed anatomical locations of musculoskele tal stress. Farm work ers get backaches and pains in the shoulders, arms, and hands more than any other health problem. This study revealed that despite mechanical and scien tific advances over the years, many kinds of farm work have not changed much at all. Fiel d work is still done in a stooped position. Workers carry heavy weights in awkward posit ions, kneel often, work with their arms above shoulder level, or move their hands and wrists repetitively. Overexertion intensifies all the other risk factors. Prolonged kneeling to harvest, transplant, or weed puts small scale growers in one of the highe st risk groups for occupational injuries. There are a number of possible ways of presenting, for purposes of analysis and classification, the essential characteristics of work. Fo r this reason, classification standards and guides have different formats a nd include a variety of evaluation elements.

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13 The Handbook of Occupational Groups a nd Families (U.S. Office of Personnel Management, 2008) sets forth a system for the classification of white collar, trade, craft and labor jobs in the federal government. The White Collar Occupational Series defines occupations and lists the series names and c odes used in classifying white collar jobs. The Trade, Craft, or La bor Occupational Series defines occupations and lists the occupation names and codes used in classifying trade, craft or labor jobs. This standard provides a framework for differentiating indivi duals involved in strenuous labor practices from those involved in more sedentary labor practices in the United States of America.

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14 Chapter Three Materials and Methods Sample The Maxwell Museum Do cumented Skeletal Collection The Maxwell Museum’s Documented Skeletal Collection housed at the University of New Mexico was established in 1984 and includes n=345 individuals (as of September 2008) of both sexes, between th e ages of 30 and 100 years and from many population groups. The skeletal remains ar e obtained by donation. Known information on the sex, age, population affinity, and cause of death is available for the majority of these individuals. Since 1995, prospective donors or their families have also been asked to provide health and occupational data. Based on the strong consensus in the liter ature that age matters, and that older individuals more consistently show evid ence of MSM, sample selection focused on individuals over the age 30 years of known occupation and sex. Individuals with evidence of healed fractures and severe dege nerative joint disease were excluded in total as these conditions are known to increas e the amount of stress placed on the nonpathological side. A records search allowed Carmen Mosle y, Biological Anthropology major at the University of New Mexico (UNM), to pr e-identify n=97 individuals with a high probability of suitability for this study base d on the above sample selection criteria. Using the provided UNM Identification number, this researcher identified n=94 complete skeletons which were free of skeletal pathologies.

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15 MSM data was collected on individuals w ithin the sample, the only associative data known being the UNM identification numbe r. For each indivi dual, all five MSM scores (Hawkey & Merbs 1995 and Mariotti et al. 2004) were noted for each of the fourteen insertion sites (Table 3.1), on both ri ght and left limbs, resulting in one hundred and forty data points for each individual. Careful macroscopic evaluation was conducted, utilizing a lighted, overhead sw ingarm magnifying lens and a hand lens. Enlarged glossy photo reprints of the Hawkey and Merbs (1995) and Mariotti et al. (2004) visual references, and color graphic representations of muscle-to-bone insertion sites from Gray’s Anatomy (original 1918) were used as technical sources of information. Standard osteological measuring devi ces were used to categor ize observations, including a Mitutoyo digital sliding calip er which measured in m illimeters, a Siber Hegner & Company depth gage which measured in cen timeters (recorded in mm), and a cloth measuring tape which measured in centimeters (recorded in mm). Other tools used in the analysis include a laptop with a custom designed Microsoft Excel spreadsheet and a Kodak 5.1 mp digital 35mm camera for data capture at the work site (Figures 3.1 and 3.2). Demographic data for the sample popul ation was provided by the collection curator via electronic mail following the co mpletion of MSM analysis. This data included mostly complete records on indivi dual’s sex, age, ances try, reported lifetime occupation, handedness, height, weight, other skeletal hea lth comments, and general comments. Of the 94 individuals analyze d, n=69 reported occupation which could be classified using the U.S. Personnel Office’s standard. Those who reported occupations such as student, transient, a nd prisoner were excluded resulti ng in a final research sample

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16 (n = 69) was made up of n=29 females a nd n=40 males ranging in age from 30 to 100 years old (Figure 3.1). Within the sample, th ere were n=22 females classified as white collar, n=7 females classified as laborers, n= 20 males classified as white collar, and n=20 males classified as laborers (Table 3.2). The Classification of Individuals into Occupational Groups The U.S. Office of Personnel Manage ment’s Handbook of Occupational Groups and Families (2008) was used to classify individuals by reported occupation. The Handbook is divided into two parts: Part I Wh ite Collar Occupational Series and Part II Trade, Craft, or Labor Occupational Series. PART I White Collar Occupational Series, defines occupations a nd lists the series names and codes used in classifying white coll ar jobs. A position is considered “white collar” if its primary duty requi res knowledge or experience of an administrative, clerical, scientific, artistic, or technical nature not re lated to trade, craft, or manual-labor work. PART II Trade, Craft, or Labor Occupational Series, defines occupations and lists the occupation names and codes used in classi fying trade, craft or labor jobs. If a position clearly requires trades, craft, or laboring experience and knowledge as a requirement for the performance of its prim ary duty, and this requirement is paramount, the position is in a trade, craft, or labo r occupation regardless of its organizational location or the nature of the activit y in which it exists (Appendix A).

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17 Activity1 Lifting Pushing/pulling Twisting/pulling Lifting/pulling Lifting Throwing/pulling Twisting/lifting Twisting Squatting/lifting Squatting/walking Walking/squatting/standing Squatting/lifting/standing Squatting/lifting/standing Walking/standing Insertion Site Intertubercular groove Floor of the inte rtubercular groove Intertubercular sulcus Deltoid tuberosity Radial tuberosity Olecranon process Medial 1/3 of lateral radius Lateral proximal radial shaft Gluteal tuberostity Head of the fibula Pes anserinus of the tibia Medial border of patella Lateral patella & tibial tuberosity Medial posterior calcaneus Bone Humerus Humerus Humerus Humerus Ulna Ulna Radius Radius Femur Fibula Tibia Patella Patella/Tibia calcaneus Muscle Pectoralis major Latissimus dorsi Teres major & mino r Deltoideus Biceps brachii Triceps brachii Pronator teres Supinator Gluteus maximus Biceps femoris Semitendinosus Vastus medialis Vastus lateralis Soleus Table 3.1. The muscle/bone insertion sites of the upper and lower extremities used in this study and their relationship to acti vity. 1 2 3 4 5 6 7 8 9 10 11 12 13 14 1Gray’s Anatomy (1918)

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18 Figure 3.1. Workspace at the Maxwell Muse um, University of New Mexico, 2009.

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19 Figure 3.2. Maxwell Museum D onated Collection, UNM 2009.

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20 0 5 10 15 20 25Age Ranges Count Females (n=29) Males (n=40) Total (n=69) Females (n=29) 30482632 Males (n=40) 558126213 Total (n=69) 8512208845 30 – 3940 – 4950 – 5960 – 6970 – 7980 – 8990 100unknown Figure 3.3. Sample size displa ying age and sex distribution. Table 3.2. Number of male and fema le white collar and labor workers. Sex Occupational Category F M Total Count 22 20 42 White Collar % of Total 31.9% 29.0% 60.9% Count 7 20 27 Labor % of Total 10.1% 29.0% 39.1% Count 29 40 69 Total % of Total 42.0% 58.0% 100.0%

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21 Selection of MSM sites for study Skeletal muscle is anchored by tendons to bone at origin and insertion locations. The insertion of the muscle is the end of the muscle attach ing to the freely moving bone of its joint (Appendix B). The origin of the mu scle is the end of the muscle attaching to the relatively fixed bone of its joint. F ourteen insertion sites of the upper and lower extremities (Table 3.1) were examined visual ly and scored for MSM type and severity following Hawkey and Merbs visual reference system (Hawkey and Merbs, 1995). These sites were chosen because they have been used consistently in previous MSM studies (e.g., Hawkey and Merbs 1995; Churchill and Morris 1998; Robb 1998; Weiss 2003, 2004, 2007). The Hawkey and Merbs and Mariotti et al. methods The MSM visual scoring methods of Hawk ey and Merbs (1995) and the proposed standards for scoring enthesopathies by Mariotti et al. (2004) were used in this study. Both the Hawkey and Merbs and the Mariotti et al. scoring methods have been demonstrated to have low interobserver a nd intraobserver error rates and provide the researcher with both descriptive and photogr aphic examples for comparative guidance. Both methods provide the observer with phot ographic examples of various grades of MSM. The Hawkey and Merbs method has been used in a significant number of previous studies. The phot ographs provided by Mariotti et al. are of better quality overall and more examples are provided. In both systems, grades are described us ing ranges of depth, width, and length. The use of terms such as <1 mm and between 3 5mm might imply that metric data could

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22 be collected for use in analysis. However, since features such as porosity, furrows, and exostoses exhibit multiple occurrences at a single insertion site, establishing a single “metric” for each feature becomes nearly impo ssible. The use of an ordinal grading system allows the observer to evaluate the multiple occurrences and then determine which grade best describes the insertion site. The MSM categories of robus ticity, osteolytic forma tion, and exostoses most often form a continuum. When an insertion site reaches the high end of the robusticity marking grade, it often becomes obliterated with osteolytic activity or exostotic outcroppings. This phenomenon informs th e data collection technique, further discouraging the researcher from attempti ng metric measurement techniques. Sites which produce grades on the high end of one category and the low end of the next allow the observer to analyze the occurrences of the continuum within an individual and the patterns which these occurrences produce. Using the Hawkey and Merbs method, thr ee categories, each with four grades, were used to score MSM expres sion bilaterally (Table 3.3). Robusticity describes the normal reaction of the skeleton to habitual mu scle usage and reflects daily activities that produce rugged markings at the musculoske letal site of attach ment (Figure 3.4, top photo). Stress lesions are defined as a pitting or ‘furrow’ into the cortex to the degree that it superficially re sembles a lytic lesion (Figure 3.4, middle photo). Ossification exostoses are usually due to an abrupt macrot rauma (Figure 3.4, bottom photo). When a bone avulsion injury occurs, new bone forma tion may be incorporated into the ligament or muscle tissue, and result in an exostosis, or bony 'spur'. A continuum often occurs between the robusticity and st ress lesion markers with so me individuals exhibiting a

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23 combination of the strongest robusticity scor e (R3=strong), and the faintest stress lesion grade (S1=faint) at a single insertion site suggesting a severe us e pattern (Hawkey and Merbs, 1995). The use of Mariotti et al. ’s (2004) proposed methods for the scoring of enthesopathies was also used to assess the stress lesion category and the ossification exostoses category (Table 3.5). Here, the term enthesis is used to indicate both muscle and ligament attachment sites, which are al ways identifiable on bones as irregular or rough surfaces, sometimes elevat ed or depressed, or as remodeled surfaces. In their study, Mariotti et al. propose that the term enthesopathy be reserved for an enthesis with areas of erosion or exostosis. Enthesopath ies have been divided into an erosive, osteolytic form (OL), charac terized by pitting or eroded areas (equal to Hawkey and Merbs Stress Lesion category) (Figure 3.6) a nd a proliferative, os teophytic form (OF), characterized by the presence of enthes ophytes (equal to Hawkey and Merbs’ Ossification Exostoses category) (Figure 3.7).

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24 Figure 3.4. Right radius, medial view, proximal shaft of an 95 year old female Administrative Director of the Arts (White collar) showing continuum between the robusticity (RM=3) and stress lesion (SL= 1) grades at the radial tuberosity.

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25 Table 3.3. Hawkey and Merbs visual refere nce scoring system categories and grades used in this study (1995). Robusticity Marker (RM) Stress Lesion (SL) Ossification Exostoses (OS) O=absent Rl=faint. The cortex is only slightly rounded, and often not visible without viewing under a strong light. The elevation is, however, apparent to the touch, although no distinct crests or ridges have formed O=absent Sl=faint. There is a shallow 'furrow', a pitting into the cortex that has a lytic-like appearance. It is less than 1 mm in depth. O=absent OSl=faint. A slight exostosis occurs, usually rounded in appearance, and extends less than 2 mm from the cortical surface. R2=moderate. The cortical surface is uneven, with a moundshaped elevation that is easily observable. No sharp ridges or crests have formed S2=moderate. The pitting is deeper and covers more surface area. It is greater than 1 mm, but less than 3 mm in depth. It may vary in length, but not longer than 5 rnm OS2=moderate. There is a distinct exostosis, varied in shape, that extends more than 2 rnm, but less than 5 mm from the surface of the cortex R3=strong. Distinct, sharp crests or ridges have formed. Often there may be a slight depression between two crests (especially noticeable between pectoralis major and teres major insertions), but the depression does not extend into the cortex S3=strong. The pitting is marked, and greater than 3 rnm in depth, or more than 5 mm in length OS3=strong. The exostosis extends more than 5 mm from the surface of the bone, or else covers an extensive amount of cortical surface

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26 Figure 3.5. Reprinted with permission from Hawkey and Merbs (1995) (from top to bottom) Robusticity, Stress Lesion, and Ossi fication Exostosis visual references. Robusticity Stress Lesion Ossification Exostoses

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27 Table 3.4. Mariotti et al. (2004) c ategories and grades used in scoring osteolytic and osteophytic activity in the current study. Osteolytic formation (OL) Osteophytic formation (OF (modified from Crubzy) 0=absence 0=absence of exostotic formations 1=presence of fine porosity (holes <1 mm in diameter) 1=minimal exostosis (<1 mm) 2=diffuse porosity, with holes ca. 1 mm in diameter, or presence of a small area of erosion (ca. 4 mm in length or diameter) 2=clear exostosis (1–4 mm) 3a=presence of several small areas of erosion (ca. 4 mm in length or diameter); 3b=at least one extensive and deep osteolytic area (>4 mm in length or diameter) 3=substantial exostosis (>4 mm) nr=trait not recordable: when the enthesis is missing or in a poor state of preservation (more than 50% of the area is illegible) or when the alterations are so weak their effective presence is in doubt. nr=trait not recordable: when the enthesis is missing or in a poor state of preservation (more than 50% of the area is illegible) or when the alterations are so weak their effective presence is in doubt or in cases of doubtful interpretation). Note: exostoses of the enthesis can have different morphologi es: small elevated areas or crests, digitiform enthesophytes, or sail-shaped enthesophytes.

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28 Figure 3.6. Visual reference system used by Mariotti et al. (2004) to establish osteolytic formation (OL) Grades 1 – 3a/b (top to bottom with Grade 1 shown twice, Grade 2 shown three times, and Grade 3a/b shown together in one photo). Grade 1 Grade 1 Grade 2 Grade 2 Grade 2 Grades 3a & b

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29 Figure 3.7. Visual refere nces used by Mariotti et al. (2004) to establish osteophytic formation (OF) Grades 1 – 3 (top to bottom w ith Grade 3 shown twice) (Reprinted with permission). Grade 2 Grade 1 Grade 3 Grade 3

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30 Statistical Analysis A total of fourteen musculoskeletal mark ers from insertion sites at the humerus (n=4), the radius (n=3), the ulna (n=1), the femur (n=1), the fibula (n=1), the tibia (n=1), the patella (n=2), and the calcaneous (n=1) were scored in the five categories of robusticity, stress lesions, ossification exostoses, osteophyt ic and osteolytic activity. These insertion sites were chosen because: 1) they are easily distinguishable, 2) they have been associated with specif ic activities in th e literature and, 3) they are used biomechanically for actions related to s quatting, lifting, twisting, pulling and pushing. Both right and left upper and lower limbs were evaluated. An aggregate muscle marker composite was created by adding the z-scores (transformed from raw MSM scores) for the 140 component variable s (14 locations x 2 sides of the body x 5 categories). This aggregate z-score was fi rst used to test correlation and differences between right and left upper a nd lower limb insertion sites. These tests were conducted to determine whether or not a side preference is exhibited by individuals within the sample. Frequency analysis was used to examin e patterns within the data. Raw MSM scores were first converted to absent or present (where absence is indicated by a raw score of 0 and presence is indicated by any raw score greater than 0) across all scoring categories to simplify pattern analysis. The proportion of absent-to-present MSM among white collar workers and laborers were anal yzed separately in order to compare the expression of MSM between these two groups. The dichotomous data set produced by re ducing MSM scores to absent/present

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31 was subjected to chi-square analysis. The question this analysis sought to answer was whether or not MSM scores were a result of chance or due to the individual’s classification as white collar/labor worker. Variables used in this study are catego rical (sex and occupation) and ordinal (MSM scores). Based on this, non-parametric tests were used to conduct analyses to determine if there are significant differen ces in MSM scores between white collar and labor workers. Additionally, non-parametric testing was used to evaluate whether there was correlation between individuals MSM scor es and their occupational category as well as whether there was correlation between i ndividuals MSM scores and their sex. All non-parametric tests made use of the aggregate z-scores. The Kruskal Wallis test is used when one independent variable with two or more levels and an ordinal dependent variable are being analyzed. In other words, it is the nonparametric version of ANOVA and a generalized form of the Mann-Whitney test method since it pe rmits two or more groups to be compared (UCLA 2009). The Kruskal Wallis test asks whether we can differentiate occupational class according to an individual’s aggreg ate MSM z-score. The Mann-Whitney test is a non-parametric an alog to the independent samples t-test and can be used when there is not an assumpti on that the dependent va riable is a normally distributed interval variable (t he assumption is that the variab le is at least ordinal) (UCLA 2009). The Mann-Whitney test was used for comparison of aggregate MSM z-scores between the two occupational categories of white collar and labor and then again for comparison of aggregate MSM z-scores be tween males and females. A Spearman correlation is used when one or both of th e variables are not assumed to be normally distributed and interval (but are assumed to be ordinal) (UCLA 2009). The Spearman

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32 correlation is used for non-parametric correl ation analysis of a ggregate MSM z-scores and the occupational categories of white collar and labor. Th e data were analyzed using the statistical software progr am SPSS (version 17.0). Analyses included tests to determine si gnificant differences in the aggregate zscore of MSM between labor and white collar occupations, differences in the aggregate zscore of MSM between males and females, and differences in occupational categories between males and females. These tests ar e intended to help clarify whether data collected using the combined Hawkey and Merbs Visual Reference System and the Mariotti et al. proposed standards supports earl ier claims that activity can be differentiated by the comparison of musculoskeletal markers (MSM). Applying the Principal of Aggregation Weiss (2003) and Stirland (1998) pres ent strong arguments for applying the principle of aggregation to the analyses of muscle mark ings. According to Stirland (1998), the actual way that muscles work is often forgotten in the rush to make associations between muscle insertions and activities since muscles do not work alone but in groups. Any subjective scori ng or other attempts at measur ements of their individual insertion sites obscures patterns of co-opera tive activity. Therefore, such evaluation should not be used to propose specific activities by individual muscles. Weiss (2003) acknowledges that while the use of aggr egation is not common in anthropology, the principle of aggregation rests on familiar procedures. Although not based on numbers, composite portraits used in forensics are based on aggregation; the whole face is more than the pieces (e.g., chin, nose, or eyes). The aggregate use of multiple methodologies

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33 (e.g., radiocarbon dating, the principle of stra tification, dendochronology) to establish the date for an archaeological site or feature pr ovides greater confidence than the use of any one of these methods. Because muscles work in groups, the use of a single muscle marker to reconstruct activity patterns must be viewed critically as unacceptable. By aggregating over several measures, error variance and specificity or idiosyncratic variance can be averaged out, leaving only “true score variance” (if there is any) to cumulate. Weiss (2003) states that Spearman’s formulization of aggregation asse rts that every actual measurement, call it X is composed of two parts: a “true score,” t and an error variance, e ; both t and e cannot be directly observed. Thus, X= t + e Since e can have either a pos itive or negative sign and because e is random, e ’s value tends towards zero as more measurements of X are averaged in. In other words, by adding a large number of X s, e is averaged out, leaving only t or the “true score” to accumulate.

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34 Figure 3.8. Right ulna, medial view, proximal head showing sail-shaped exostoses on a 69 year old male with a reported life time occupation of “bottler” (Labor).

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35 Figure 3.9. Left humerus, ante rior view, proximal head showing ossification exostoses at the Teres major/minor insertion sites (associat ed with twisting/pulli ng) of a 93 year old male auto mechanic (Labor).

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36 Chapter Four Results Comparison of right-limb, left-limb scores in order to establish breadth of data set used in core statistical analysis All fourteen insertion sites were subjected to paired t-tests where the aggregate zscores for right/left upper lim b and right/left lower limb were compared to determine whether there was a significant difference in aggregate z-scores between left and right limbs. Table 4.1 provides results which indi cate that left and right upper and lower limbs correlate significantly, but that the corr elations are not very strong indicating that asymmetry may be present. Table 4.2 isolat es the aggregate z-scores for white collar workers and Table 4.3 isolates the aggregate z-sc ores for laborers. Isolating scores based on occupation does not change the findings th at left and right upper and lower limbs correlate significantly. Tables 4.4 – 4.6 show the results of the test of differences. To maintain a consistent perspective on the sample, tests were run for the whole group (Table 4.4) and for each of the occupational categories, separa tely (Tables 4.5 and 4.6). When viewed as a whole group, differences were found to be non-significant ( p=0.227 for upper limbs and p=0.216 for lower limbs ) Isolating white collar work ers from laborers acts to strengthen this finding ( p=0.627 and p=0.617 for white collar workers ; p=0.691 and p=0.678 for laborers )

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37 Table 4.1. Paired Samples Correlations between Right and Left Upper Limb and Right and Left Lower Limb. N Correlation Sig. Pair 1 Aggregate Z-Score Right Upper Limb & Aggregate Z-Score Left Upper Limb 69 .717 .000 Pair 2 Aggregate Z-Score Right Lower Limb & Aggregate Z-Score Left Lower Limb 69 .734 .000 Table 4.2. Paired Samples Correlations between Right and Left Upper Limb and Right and Left Lower Limb am ong White Collar Individuals. N Correlation Sig. Pair 1 Aggregate Z-Score Right Upper Limb and Aggregate Z-Score Left Upper Limb 40 .827 .000 Pair 2 Aggregate Z-Score Right Lower Limb & Aggregate Z-Score Left Lower Limb 40 .726 .000 Table 4.3. Paired Samples Correlations between Right and Left Upper Limb and Right and Left Lowe r Limb among Laborers. N Correlation Sig. Pair 1 Aggregate Z-Score Right Upper Limb and Aggregate Z-Score Left Upper Limb 29 .833 .000 Pair 2 Aggregate Z-Score Right Lower Limb & Aggregate Z-Score Left Lower Limb 29 .709 .000

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38 Table 4.4. Paired Samples Test of Differences between Ri ght and Left Upper Limb and Right and Left Lower Limb. Paired Differences 95% Confidence Interval of the Difference Mean Std. Deviation Std. Error Mean Lower Upper t df Sig. (2tailed) Pair 1 Aggregate ZScore Right Upper Limb – Aggregate ZScore Left Upper Limb -.471 3.238 .387 -1.244 .301 -1.218 68 .227 Pair 2 Aggregate ZScore Right Lower Limb – Aggregate ZScore Left Lower Limb -.522 3.467 .417 -1.355 .311 -1.250 68 .216

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39 Table 4.5. Paired Samples Test of Differences between Right a nd Left Upper Limb and Right an d Left Lower Limb among White Collar Individuals. Paired Differences 95% Confidence Interval of the Difference Mean Std. Deviation Std. Error Mean Lower Upper t df Sig. (2tailed) Pair 1 Aggregate ZScore Right Upper Limb – Aggregate ZScore Left Upper Limb .65475 8.46367 1.33822 -2.05206 3.36156 .489 39 .627 Pair 2 Aggregate ZScore Right Lower Limb – Aggregate ZScore Left Lower Limb -.67256 8.33524 1.33471 -3.37454 2.02941 -.504 39 .617

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40 Table 4.6. Paired Samples Test of Differences between Right and Left Upper Limb and Right and Le ft Lower Limb among Laborers. Paired Differences 95% Confidence Interval of the Difference Mean Std. Deviation Std. Error Mean Lower Upper t df Sig. (2tailed) Pair 1 Aggregate ZScore Right Upper Limb – Aggregate ZScore Left Upper Limb -.68828 9.21851 1.71183 -4.19481 2.81826 -.402 28 .691 Pair 2 Aggregate ZScore Right Lower Limb – Aggregate ZScore Left Lower Limb .77400 10.10631 1.84515 -2.99976 4.54776 .419 28 .678

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41 To test further for evidence of asymmetry, each paired insertion site was subjected to paired samples T-test. Table 4.7 supports the findings of the aggregate zscore T-test but demonstrates th at the Pectoralis major inserti on site correlation is weakly non-significant. Table 4.8 examines correla tions between insertion sites among white collar workers alone. Approximately half of the paired insertion sites show nonsignificant correlation; the other half displa y weakly significant correlation. When compared to Table 4.9 which examines co rrelations between insertion sites among laborers, asymmetry within the white collar group becomes more pronounced. In both groups, where p 0.05 correlation is between 0.020 and 0.325; where p 0.05 correlation is between 0.300 and 0.800. In all further analys es right side variables were used for all individuals, regardless of occupational category.

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42 Table 4.7. Paired Samples Correlation Between Each Insertion Site. N Correlation Sig. Pair 1 Aggregate Z-Score Right Pectoralis & Aggregate Z-Score Left Pectoralis 69 .226 .060 Pair 2 Aggregate Z-Score Right Latissimus dorsi & Aggregate Z-Score Left Latissimus dorsi 69 .701 .000 Pair 3 Aggregate Z-Score Right Teres major & Aggregate Z-Score Left Teres major 69 .333 .005 Pair 4 Aggregate Z-Score Right Deltoid & Aggregate Z-Score Left Deltoid 69 .599 .000 Pair 5 Aggregate Z-Score Right Bicep & Aggregate Z-Score Left Bicep 69 .402 .001 Pair 6 Aggregate Z-Score Right Supinator & Aggregate Z-Score Left Supinator 69 .466 .000 Pair 7 Aggregate Z-Score Right Pronator & Aggregate Z-Score Left Pronator 69 .663 .000 Pair 8 Aggregate Z-Score Right Tricep & Aggregate Z-Score Left Tricep 69 .399 .001 Pair 9 Aggregate Z-Score Right Gluteus maximus & Aggregate Z-Score Left Gluteus maximus 69 .567 .000 Pair 10 Aggregate Z-Score Right Biceps femoris & Aggregate Z-Score Left Biceps femoris 69 .459 .000 Pair 11 Aggregate Z-Score Right Semitendinous & Aggregate Z-Score Left Semitendinous 69 .243 .043 Pair 12 Aggregate Z-Score Right Vastus medialis & Aggregate Z-Score Left Vastus medialis 69 .425 .000 Pair 13 Aggregate Z-Score Right Vastus lateralis & Aggregate Z-Score Left Vastus lateralis 69 .579 .000 Pair 14 Aggregate Z-Score Right Soleus & Aggregate Z-Score Left Soleus 69 .622 .000

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43 Table 4.8. Paired Samples Correlation Be tween Each Insertion Site among White Collar Individuals. N Correlation Sig. Pair 1 Aggregate z-score Right Pectoralis & Aggregate z-score Left Pectoralis 42 -.051 .750 Pair 2 Aggregate z-score Right Latissimus dorsi & Aggregate z-score Left Latissimus dorsi 42 -.021 .896 Pair 3 Aggregate z-score Right Teres major & Aggregate z-score Left Teres major 42 .067 .671 Pair 4 Aggregate z-score Right Deltoid & Aggregate z-score Left Deltoid 42 -.112 .480 Pair 5 Aggregate z-score Right Bicep & Aggregate z-score Left Bicep 42 .533 .000 Pair 6 Aggregate z-score Right Supinator & Aggregate z-score Left Supinator 42 .127 .421 Pair 7 Aggregate z-score Right Pronator & Aggregate z-score Left Pronator 42 .601 .000 Pair 8 Aggregate z-score Right Tricep & Aggregate z-score Left Tricep 42 .318 .040 Pair 9 Aggregate z-score Right Gluteus maximus & Aggregate z-score Left Gluteus maximus 42 .546 .000 Pair 10 Aggregate z-score Right Biceps femoris & Aggregate z-score Left Biceps femoris 42 -.117 .461 Pair 11 Aggregate z-score Right Semitendinous & Aggregate z-score Left Semitendinous 42 .656 .000 Pair 12 Aggregate z-score Right Vastus medialis & Aggregate z-score Left Vastus medialis 42 .376 .014 Pair 13 Aggregate z-score Righ t Vastus lateralis & Aggregate z-score Left Vastus lateralis 42 .068 .667 Pair 14 Aggregate z-score Right Soleus & Aggregate z-score Left Soleus 42 .572 .000

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44 Table 4.9. Paired Samples Correlation Between Each Insertion Site among Laborers. N Correlation Sig. Pair 1 Aggregate z-score Right Pectoralis & Aggregate z-score Left Pectoralis 28 .324 .093 Pair 2 Aggregate z-score Ri ght Latissimus dorsi & Aggregate z-score Left Latissimus dorsi 28 .629 .000 Pair 3 Aggregate z-score Right Teres major & Aggregate z-score Left Teres major 28 .296 .126 Pair 4 Aggregate z-score Right Deltoid & Aggregate z-score Left Deltoid 28 .644 .000 Pair 5 Aggregate z-score Right Bicep & Aggregate z-score Left Bicep 28 .790 .000 Pair 6 Aggregate z-score Right Supinator & Aggregate z-score Left Supinator 28 .653 .000 Pair 7 Aggregate z-score Right Pronator & Aggregate z-score Left Pronator 28 .770 .000 Pair 8 Aggregate z-score Right Tricep & Aggregate z-score Left Tricep 28 .671 .000 Pair 9 Aggregate z-scoreRight Gluteus maximus & Aggregate z-score Left Gluteus maximus 28 .109 .581 Pair 10 Aggregate z-scoreRight Biceps femoris & Aggregate z-score Left Biceps femoris 28 .074 .710 Pair 11 Aggregate z-score Right Semitendinous & Aggregate z-score Left Semitendinous 28 .752 .000 Pair 12 Aggregate z-score Right Vastus medialis & Aggregate z-score Left Vastus medialis 28 .689 .000 Pair 13 Aggregate z-score Right Vastus lateralis & Aggregate z-score Left Vastus lateralis 28 .694 .000 Pair 14 Aggregate z-score Right Soleus & Aggregate z-score Left Soleus 28 .258 .185

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45 Data exploration using dichotomous scores only The dichotomous data set (absence or presence of MSM ) wa s also used to compare the expression of MSM between white collar workers and laborers. Examination of the pattern expressed in the resulting Figure 4.1 shows that white collar workers demonstrate a slightly higher percentage of MSM scoring “present” at those insertion sites associated with sitting (s emitendinosus) and elevating the arm (deltoid, biceps brachii, and supinator). Laborers dem onstrate a slightly higher percentage of MSM scoring “present” at the upper body insert ion sites associated with lifting, twisting, and pushing (pectoralis major, latissimus dorsi teres major, pronator and triceps and at the lower body insertion sites associated with squatting, lifting, walking, running and standing (gluteus maximus, biceps femoris, va stus medialis & lateralis, and soleus). Further exploration of the absent/p resent frequency data provided a straightforward approach for comparing the Hawkey & Merbs and Mariotti et al. methods. Table 4.10 shows the absence/presence of MSM at each right upper limb insertion site for both occupational cate gories combined. Table 4.11 displays the absence/presence of MSM at each right lower limb insertion site for both occupational categories combined. Since the Mariotti et al. method was not used to evaluate robusticity, no robusticity data is reported for that method. However, the tables are useful in considering how Hawkey and Merb s classify robusticity. Using the more simplified absent/present dichotomy, we s ee that the Hawkey and Merbs method almost always classifies robusticity as present. For the stress lesion/ost eolytic category, we see that the Mariotti et al. method tends to classify MSM as absent with a higher frequency than the Hawkey & Merbs method. However, both methods produce nearly equal results

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46 when viewing the ossification exostoses/osteophytic form. A chi-square analysis was used to study the dichotomous (absent/present) data recorded for each trait for all individuals. Of the seventy variables evaluated, eleven yielded non-significant results (Table 4.12). The Mariotti et al. method generated nine of the eleven non-significant results. Hawk ey & Merbs’ method produced two results which represent traits correspond ing to two of the Mariotti et al. traits which yielded nonsignificant results (Gluteus maximus OS & OF and Soleus OS & OF).

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47 Comparison of percentage of MSM present between White Collar & Labor Workers 67% 60% 77% 52% 68% 29% 41% 76% 73% 66% 68% 59% 69% 72% 73% 68% 89% 50% 64% 28% 41% 81% 74% 68% 66% 62% 70% 83%0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%Right Pectoralis major Right Latissimus dorsi Right Teres major & minor Right Deltoideus Right Biceps brachii Right Supinator Right Pronator Right Triceps brachii Right Gluteus maximus Right Biceps femoris Right Semitendinosus Right Vastus medialis Right Vastus lateralis Right SoleusMusculoskeletal Insertion SitePercentage of Traits Scoring "present" Percentage of all MSM traits scoring "present" among white collar workers Percentage of all MSM traits scoring "present" among labor workers Figure 4.1. Presence of Right U pper and Lower Limb MSM by Insertion Site for White Collar and Labor Workers (n=69).

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48 Table 4.10. Comparison of Hawkey a nd Merbs (H&M) (1995) and Mariotti et al. ( M. et al. ) (2004) frequency scores at each site. Right Pectoralis Major Right Latissimus Dorsi Right Teres Major & Minor Right Deltoideus H&M M. et al. H&M M. et al. H&M M. et al. H&M M. et al. RM absent 2 RM absent 2 RM absent 1 RM absent 0 RM present 68 RM present 68 RM present 69 RM present 70 SL/OL absent 9 10SL/OL absent 2 22SL/OL absent 5 13SL/OL absent 3 39 SL/OL present 61 60SL/OL present 68 48SL/OL present 65 57SL/OL present 67 31 OS/OF absent 44 42OS/OF absent 55 49OS/OF absent 22 22OS/OF absent 65 63 OS/OF present 26 28OS/OF present 15 21OS/OF present 48 48OS/OF present 5 7 Right Biceps Brachii Right Supinator Right Pronator Right Triceps Brachii H&M M. et al. H&M M. et al. H&M M. et al. H&M M. et al. RM absent 0 RM absent 2 RM absent 0 RM absent 1 RM present 70 RM present 68 RM present 70 RM present 69 SL/OL absent 2 34SL/OL absent 45 66SL/OL absent 16 60SL/OL absent 4 20 SL/OL present 68 36SL/OL present 25 4 SL/OL present 54 10SL/OL present 66 50 OS/OF absent 45 37OS/OF absent 69 69OS/OF absent 66 64OS/OF absent 26 25 OS/OF present 25 33OS/OF present 1 1 OS/OF present 4 6 OS/OF present 44 45

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49 Table 4.11. Comparison of Hawkey a nd Merbs (H&M) (1995) and Mariotti et al. ( M. et al. ) (2004) frequency scores at each site. Right Gluteus Maximus Right Biceps Femoris Right Semitendinous H&M M. et al H&M M. et al. H&M M. et al. RM absent 2 RM absent 10 RM absent 1 RM present 68 RM present 60 RM present 69 SL/OL absent 4 23 SL/OL absent 6 12 SL/OL absent 11 7 SL/OL present 66 47 SL/OL present 64 58 SL/OL present 59 63 OS/OF absent 32 31 OS/OF absent 44 45 OS/OF absent 48 49 OS/OF present 38 39 OS/OF present 26 25 OS/OF present 22 21 Right Vastus Medialis Right Vastus Lateralis Right Soleus H&M M. et al. H&M M. et al. H&M M. et al. RM absent 4 RM absent 4 RM absent 2 RM present 66 RM present 66 RM present 68 SL/OL absent 11 34 SL/OL absent 10 41 SL/OL absent 7 18 SL/OL present 59 36 SL/OL present 60 29 SL/OL present 63 52 OS/OF absent 45 45 OS/OF absent 25 27 OS/OF absent 28 28 OS/OF present 25 25 OS/OF present 45 43 OS/OF present 42 42 RM: Robusticity Marker SL: Stress Lesion OL: Osteolytic Ac tivity OS: Ossification Exos toses OF: Osteophytic Activity

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50 Table 4.12. Chi-square analysis of absen t/present data for eac h site where p > 0.05. Right Pectoralis Major OF Score Right Deltoideus (posterior & anterior) OL Score Right Biceps Brachii OF Score Right Biceps Brachii OL Score Right Gluteus maximus OS Score Right Gluteus maximus OF Score Right Vastus medialis OL Score Right Vastus lateralis OF Score Right Vastus lateralis OL Score Right Soleus OS Score Right Soleus OF Score ChiSquare 2.800a .914a .229a .057a .514a .914a .014b 3.657a 2.057a 2.800a 2.800a df 1 1 1 1 1 1 1 1 1 1 1 Asymp. Sig. .094 .339 .633 .811 .473 .339 .904 .056 .151 .094 .094

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51 Non-parametric statistical analys es central to this study Non-parametric tests of MSM make us e of the aggregate z-score for each individual. This variable was used to test whether there is a significant difference in musculoskeletal markers between white collar wo rkers and laborers. It was also used to test differences between males and females as much of the MSM literature provides corresponding statistical evidence of a relations hip of MSM to the sex of the individual. Further, the aggregate variable was used to analyze MSM z-score differences between males of both occupational classes and MSM z-score differences between females of both occupational classes to test wh ether there may be variation be tween the sexes that are not otherwise differentiated when analyzing the whole group. The Kruskal Wallis test was used to determine whether occupational class can be predicted according to an indi vidual’s aggregate MSM z-scores Table 4.13 indicates that MSM score cannot predict occupa tional category. This test was run using the total body aggregate score. When right side uppe r (Tables 4.14, 4.15, and 4.16). and lower (Tables 4.17, 4.18, and 4.19) limb insertion sites were us ed, results of non-significance further substantiate that MSM scor e cannot predict o ccupational category. Here, aggregate zscores were analyzed for both methods combined, and then by the Mariotti et al. and Hawkey & Merbs’ methods separately in orde r to examine how the results are affected by each method and the combination of both methods Kruskal Wallis was also used to test whether MSM aggregate z-scores could predict an individual’s sex; th e resultant value of p = 0.602 indicates MSM aggregate z-scores are non-significant in predicting sex of the individual (Table 4.20).

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52 The Wilcoxon-Mann-Whitney test was used to compare aggregate MSM z-scores between the two occupational categories of white collar and labor. Table 4.21 indicates that comparisons of total body aggregate MS M z-scores between white collar and labor occupations is non-significant, as p = 0.074 When right side upper (Table 4.22) and lower (Table 4.23) limb insertion sites were us ed, analysis remains c onsistent in revealing that comparisons of MSM scores between white collar and labor occupations is nonsignificant. Further, comparisons of the a ggregate MSM z-scores to males and females reveals non-significant ( p = 0.602) scores, as well (Table 4.24). In an effort to more fully explore possible differences between and among the sexes, Mann-Whitney tests were run to co mpare the aggregate MSM z-scores between males of both occupational classes, and betw een females of both o ccupational classes. Tables 4.25 and 4.26 provide the results of the test on males. Since p = 0.166 comparisons of aggregate MSM z-scores be tween male white collar and labor class individuals remains non-significan t. Tables 4.27 and 4.28 provid e the results of the test on females. Since p = 0.348 comparisons of aggregate MSM z-scores between female white collar and labor class individuals also remains non-significant. The Spearman correlation was used for non-parametric correlation analysis of aggregate MSM z-scores and the occupational ca tegories of white collar and labor. Table 4.29 provides the results of this analysis, with correlation between th e variables shown to be non-significant ( p = 0.073 ). Table 4.30 analyzes non-parametric correlation of right upper limb aggregate MSM z-scores and occupa tional categories. Table 4.31 repeats this analysis for the right lower limb. In Tabl e 4.32 we again see that there is no correlation between aggregate MSM scores and sex, within this sample population, where p = 0.606

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53 Appendix C provides an overview of the data used in the current study (exclusive of MSM scores). Appendix D provides the raw MSM scores for the n=69 individuals included in this study. Table 4.13. Prediction of Occupational Class Based on Aggregate MSM z-score Aggregate Zscore Chi-Square 3.198 df 1 Asymp. Sig. .074 a. Kruskal Wallis Test b. Grouping Variable: White collar (1), Labor (2) Table 4.14. Prediction of Occupational Class Based on Right Upper Limb Insertion Site Aggregate MSM z-score using Hawkey & Merbs/Mariotti et al. data combined. ChiSquare df Asymp. Sig. Aggregate z-score Right Triceps Brachii.0221 .882 Aggregate z-score Right Pronator.9171 .338 Aggregate z-score Right Supinator.1651 .684 Aggregate z-score Right Biceps Brachii.0001 .995 Aggregate z-score Right Deltoideus1.1141 .291 Aggregate z-score Right Teres Major/Minor 1.9361 .164 Aggregate z-score Right Latissimus Dorsi 1.0271 .311 Aggregate z-score Right Pectoralis Major.5071 .477 a. Kruskal Wallis Test b. Grouping Variable: white collar (1), Labor (2)

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54 Table 4.15. Prediction of Occupational Class Based on Right Upper Limb Insertion Site Aggregate MSM z-score using Mariotti et al. only. ChiSquare df Asymp. Sig. Aggregate z-score Right Triceps Brachii .0111 .916 Aggregate z-score Right Pronator1.0141 .239 Aggregate z-score Right Supinator.3691 .544 Aggregate z-score Right Biceps Brachii.2161 .642 Aggregate z-score Right Deltoideus1.8711 .171 Aggregate z-score Right Teres Major/Minor .9271 .336 Aggregate z-score Right Latissimus Dorsi 1.0851 .298 Aggregate z-score Right Pectoralis Major .0511 .821 a. Kruskal Wallis Test b. Grouping Variable: white collar (1), Labor (2) Table 4.16. Prediction of Occupational Class Based on Right Upper Limb Insertion Site Aggregate MSM z-score using Hawkey & Merbs data only. ChiSquare df Asymp. Sig. Aggregate z-score Right Triceps Brachii .0541 .748 Aggregate z-score Right Pronator.9071 .341 Aggregate z-score Right Supinator.4571 .499 Aggregate z-score Right Biceps Brachii.0091 .926 Aggregate z-score Right Deltoideus.3911 .532 Aggregate z-score Right Teres Major/Minor .3211 .321 Aggregate z-score Right Latissimus Dorsi .0611 .805 Aggregate z-score Right Pectoralis Major .6721 .412 a. Kruskal Wallis Test b. Grouping Variable: white collar (1), Labor (2)

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55 Table 4.17. Prediction of Occupational Class Based on Right Lower Limb Insertion Site Aggregate MSM z-score using Hawkey & Merbs/Mariotti et al. data combined. ChiSquare df Asymp. Sig. Aggregate z-score Right Gluteus maximus 2.6651 .103 Aggregate z-score Right Biceps femoris .3861 .534 Aggregate z-score Right Semitendinous .0011 .980 Aggregate z-score Right Vastus medialis 1.0071 .316 Aggregate z-score Right Vastus lateralis 3.8031 .051 Aggregate z-score Right Soleus 1.3231 .250 a. Kruskal Wallis Test b. Grouping Variable: white collar (1), Labor (2) Table 4.18. Prediction of Occupational Class Based on Right Lower Limb Insertion Site Aggregate MSM z-score using Mariotti et al. data only. ChiSquare df Asymp. Sig. Aggregate z-score Right Gluteus maximus 1.8871 .170 Aggregate z-score Right Semitendinous .0451 .840 Aggregate z-score Right Vastus medialis 1.2161 .270 Aggregate z-score Right Vastus lateralis 4.0181 .045 Aggregate z-score Right Soleus 1.1731 .279 a. Kruskal Wallis Test b. Grouping Variable: white collar (1), Labor (2) c. Biceps femoris omitted due to insufficient number of cases.

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56 Table 4.19. Prediction of Occupational Class Based on Right Lower Limb Insertion Site Aggregate MSM z-score using Hawkey & Merbs data only. ChiSquare df Asymp. Sig. Aggregate z-score Right Gluteus maximus 3.5521 .059 Aggregate z-score Right Semitendinous .0011 .970 Aggregate z-score Right Vastus medialis 1.0531 .305 Aggregate z-score Right Vastus lateralis 2.0081 .156 Aggregate z-score Right Soleus 2.6791 .102 a. Kruskal Wallis Test b. Grouping Variable: white collar (1), Labor (2) c. Biceps femoris omitted due to insufficient number of cases. Table 4.20. Prediction of Sex based on Aggregate MSM z-scorea,b. Aggregate Z-score Chi-Square .272 df 1 Asymp. Sig. .602 a. Kruskal Wallis Test b. Grouping Variable: Sex (coded)

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57 Table 4.21. Comparison of Aggregate MSM z-scores Between Occupational Categoriesa. Aggregate Zscore Mann-Whitney U 394.000 Wilcoxon W 1255.000 Z -1.788 Asymp. Sig. (2tailed) .074 a. Grouping Variable: White collar (1), Labor (2) Table 4.22. Comparison of Right Upper Limb Insertion Site Aggregate MSM z-score. MannWhitney U Wilcoxon W Z Asymp. Sig. (2tailed) Aggregate z-score Right Triceps Brachii 555.0001458.000-.148 .882 Aggregate z-score Right Pronator495.000873.000-.958 .338 Aggregate z-score Right Supinator537.5001440.500-.407 .684 Aggregate z-score Right Biceps Brachii566.500944.500-.066 .995 Aggregate z-score Right Deltoideus485.500863.500-1.055 .291 Aggregate z-score Right Teres Major/Minor 454.0001357.000-1.392 .164 Aggregate z-score Right Latissimus Dorsi 485.5001388.500-1.013 .311 Aggregate z-score Right Pectoralis Major 509.5001412.500-.712 .477 a. Grouping Variable: white collar (1), Labor (2)

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58 Table 4.23. Comparison of Right Lower Limb Insertion Site Aggregate MSM z-score. MannWhitney U Wilcoxon W Z Asymp. Sig. (2tailed) Aggregate z-score Right Gluteus maximus 434.5001337.500-1.633 .103 Aggregate z-score Right Biceps femoris 517.0001420.000-.621 .534 Aggregate z-score Right Semitendinous 565.000943.000-.025 .980 Aggregate z-score Right Vastus medialis 485.500 1388.500-1.004 .316 Aggregate z-score Right Vastus lateralis 408.5001311.500-1.950 .051 Aggregate z-score Right Soleus 473.5001376.500-1.150 .250 a. Grouping Variable: white collar (1), Labor (2) Table 4.24. Comparison of Aggregate MSM z-scores Between Sexesa. Aggregate Zscore Mann-Whitney U 505.000 Wilcoxon W 911.000 Z -.521 Asymp. Sig. (2tailed) .602 a. Grouping Variable: sex_coded Table 4.25. Ranks of Aggreg ate MSM z-scores for Males Of Both Occupational Categories. Males Only N Mean Rank Sum of Ranks White Collar 20 17.50 350.00 Labor 19 22.63 430.00 Aggregate Z-score Total 39

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59 Table 4.26. Comparison of Aggregate MSM zscores for Males Of Both Occupational Categories. Aggregate Zscore Mann-Whitney U 140.000 Wilcoxon W 350.000 Z -1.405 Asymp. Sig. (2-tailed) .160 Exact Sig. [2*(1-tailed Sig.)] .166a a. Not corrected for ties. b. Grouping Variable: Males/White Collar & Labor Table 4.27. Ranks of Aggr egate MSM z-scores for Females Of Both Occupational Categories. Females Only N Mean Rank Sum of Ranks White Collar 21 13.62 286.00 Labor 7 17.14 120.00 Aggregate Z-score Total 28 Table 4.28. Comparison of A ggregate MSM z-scores for Females Of Both Occupational Categories. Aggregate Z-score Mann-Whitney U 55.000 Wilcoxon W 286.000 Z -.982 Asymp. Sig. (2-tailed) .326 Exact Sig. [2*(1-tailed Sig.)] .348a a. Not corrected for ties. b. Grouping Variable: Females/White Collar & Labor

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60 Table 4.29. Correlations between Occupationa l Category and Aggregate MSM z-scores White collar (1), Labor (2) Aggregate Z-score Correlation Coefficient 1.000 .220 Sig. (2-tailed) .073 White collar (1), Labor (2) N 69 67 Correlation Coefficient .220 1.000 Sig. (2-tailed) .073 Spearman's rho Aggregate Z-score N 67 68

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61 Table 4.30. Correlations between Occupa tional Category and Right Upper Limb Aggregate MSM z-scores white collar (1), Labor (2) Correlation Coefficient 1.000 Sig. (2-tailed) white collar (1), Labor (2) N 69 Correlation Coefficient .086 Sig. (2-tailed) .481 Aggregate z-score Right Pectoralis Major N 69 Correlation Coefficient .123 Sig. (2-tailed) .314 Aggregate z-score Right Latissimus Dorsi N 69 Correlation Coefficient .169 Sig. (2-tailed) .166 Aggregate z-score Right Teres major & minor N 69 Correlation Coefficient -.128 Sig. (2-tailed) .295 Aggregate z-score Right Deltoideus N 69 Correlation Coefficient .000 Sig. (2-tailed) .995 Aggregate z-score Right Biceps Brachii N 69 Correlation Coefficient .049 Sig. (2-tailed) .687 Aggregate z-score Right Supinator N 69 Correlation Coefficient -.116 Sig. (2-tailed) .342 Aggregate z-score Right Pronator N 69 Correlation Coefficient .018 Sig. (2-tailed) .883 Spearman's rho Aggregate z-score Right Triceps Brachii N 69 *. Correlation is significant at the 0.05 level (2-tailed). **. Correlation is significant at the 0.01 level (2-tailed).

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62 Table 4.31. Correlations between Occupa tional Category and Right Lower Limb Aggregate MSM z-scores white collar (1), Labor (2) Correlation Coefficient 1.000 Sig. (2-tailed) white collar (1), Labor (2) N 69 Correlation Coefficient .198 Sig. (2-tailed) .103 Aggregate z-score Right Gluteus Maximus N 69 Correlation Coefficient .075 Sig. (2-tailed) .538 Aggregate z-score Right Biceps Femoris N 69 Correlation Coefficient -.003 Sig. (2-tailed) .981 Aggregate z-score Right Semitendinous N 69 Correlation Coefficient .122 Sig. (2-tailed) .319 Aggregate z-score Right Vastus Medialis N 69 Correlation Coefficient .236 Sig. (2-tailed) .050 Aggregate z-score Right Vastus Lateralis N 69 Correlation Coefficient .139 Sig. (2-tailed) .253 Spearman's rho Aggregate z-score Right Soleus N 69 *. Correlation is significant at the 0.05 level (2-tailed). **. Correlation is significant at the 0.01 level (2-tailed).

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63 Table 4.32. Correlations between Se x and Aggregate MSM z-scores. Sex Aggregate Zscore Correlation Coefficient 1.000 -.064 Sig. (2-tailed) .606 Sex N 69 67 Correlation Coefficient -.064 1.000 Sig. (2-tailed) .606 Spearman's rho Aggregate Z-score N 67 68

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64 Chapter Five Discussion Tests for asymmetry reveal that the la bor category develops MSM symmetrically indicating that labor i nvolves both sides of the body. In c ontrast, within the white collar group asymmetric patterns are demonstrated. Frequency analysis revealed that white collar and labor work er classifications demonstrate similar relative proportions in their exhibition of MSM. Laborers tend to exhibit MSM at slightly highe r frequencies at more insertion sites than white collar workers, and the site-specific pattern is consistent with the use of muscles in a way which is closely associated with movement (adduc tion) towards the midline of the body (Teres major/minor, Latissimus dorsi, Pectoralis major, and Triceps brachii). Laborers also use muscles associated with walking/standing (Sol eus, Vastus lateralis, Vastus medialis) and sitting/squatting (Biceps femoris and Glut eus maximus). White collar worker’s frequency of MSM at insertion sites rela ted to sitting (Semitendinous), arm raising without strenuous lifting (Deltoideus and Bicep s brachii), and twisting of the forearm (Pronator and Supinator) tends hi gher than laborers; a findi ng which is consistent with the image of most non-labor positions. Other patterns that emerged through freque ncy analysis relate to the two methods used to evaluate MSM. Hawkey & Merbs’ (1995) highly freque nt classification of robusticity as present is consistent with th e idea that robusticity is the result of everyday activity. Since this study c ontrolled for age, it is not surprising to see that the

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65 accumulation of activity is presen t in the majority of individua ls regardless of occupation. Hawkey & Merbs’ stress lesions, call ed osteolytic formations by Mariotti et al. (2004), are described as a continuum of robusticity. This trait exhibits noteworthy pattern differences between the two methods. Mariotti et al. tend to classify this trait as absent more often than Hawkey & Merbs. The two methods’ vary in their description of this trait, with Mariotti et al. focusing on porosity and/or erosion and Hawkey & Merbs focusing on furrowing. The pattern that result ed from this simple analysis could be interpreted in a number of ways. Perh aps furrowing and porosity are different characteristics of this trait and furrows routin ely appear before porosity or erosion begins. Another explanation might be that the conti nuum between robusticity and stress lesion as described by Hawkey & Merbs is such that if robusticity is present, then stress lesions are present as well. With the exception of supi nation and pronation, all insertion sites score stress lesions as present in nearly the same number of cases as robusticity using the Hawkey & Merbs method. If further studies are shown to demonstr ate consistency with this finding, the number of traits observe d when using the Hawkey & Merbs method might be reduced by eliminating the scoring of robusticity altogether. Both methods scored ossification exostoses/osteophytic form ations equally. It is notable that the description of this trait diffe rs very little between methods – if osteophytic activity is visible at the smallest scale, bot h methods score it as present. Chi-square analysis employed the dichot omous absent/present data for further pattern analysis, relating the presence of MSM is to o ccupational category. For the majority of traits (59 of 70), occupational ca tegory does have a significant relationship to the expression of MSM, however this findi ng does not reveal the strength of this

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66 relationship. This analysis, which eval uates the relationship between occupational category and the absent/present dichotomy yields results that are markedly different than those realized when aggregated z-scores ar e used. The statistical strength of the dichotomized data must be viewed as weak. To validate this premise, the observer need only consider how the use of an ordinal MSM scoring system helps to differentiate the extent of the biological response to a range of activity. Two individua ls who “express” a musculoskeletal marking may exhi bit significantly different vari ation in that expression. A dichotomous data collection method, where the observer simply notes MSM as absent or present, does not allow us to account for th is variation. Statistical analyses using this framework would not effectively allow us to examine the differences among individual’s expression of MSM. The results of the non-parametric tests wh ich used the aggregated z-scores show that musculoskeletal markers cannot predic t, nor can they be used to correlate, occupational categories of white collar and la bor. Further, comp arison of MSM shows no significant difference betw een all individuals who repor t a lifetime occupation of white collar or those who report a lifetime occ upation of laborer. Even when the sample population is segregated by sex, there is no sign ificant difference in MSM scores; this is true when comparing men of both occupationa l categories, as well as when comparing women of both occupational categories. Co mparison of MSM in this population shows no significant difference between males and fe males, regardless of occupational category. This finding runs counter to other published studies. Each non-parametric test was run using th e aggregated z-scores of both methods combined, and then by each method separatel y. This allowed for consideration of how

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67 the methods themselves act to produce statis tical outcomes. Only the results of the Kruskal Wallis tests (by method) are include d in this study, as all other results are redundant. Regardless of which non-parametr ic test was run, the outcome of the exploration of the methods was the same. While p values differed under the conditions where both methods were combined and each method was analyzed separately, they remained consistently on the side of non-signi ficance. No distinct pattern emerged to make clear assumptions on the two methods. In about half of the cases, Mariotti et al. values were higher than the Hawkey & Merbs va lues, in the other half they were lower. When both methods are combined resultant va lues are between the values of either method in about two thirds of the cases and are higher than either method in the other third. The general thrust of the wo rk of people like Frost (Cu rrey 2002) is that bones are adapted to the loads exerted on them, so that the strains they e xperience are brought to some reasonable level-in fact, that they have some safety factor. If this is accepted, the subtlety of the process becomes apparent, because different bones in the same skeleton will need to have different strains as the “desir ed” level. This is because the variability of loading is different for different bones. If indeed remodeling takes place mainly on the inside of the cortex of the long bones, rath er than on the outside, the results found here are not surprising. The MSM literature in light of study findings Deeper consideration of the l iterature reviewed in prepar ation of this study reveals that correlation of MSM to act ivity is approximate at best. Often, MSM studies are

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68 embedded with ethnographic and/ or archaeological evidence of activity and researchers build the case for correlation of MSM to th e activity implied by items such as grave goods or historical accounts of the activities ascribed to a group of people by an outside observer. Because of the complex interface of such things as disease, nutrition, genetics, injury, activity and culture, applying MSM analysis towards the understanding of the individual’s lifetime occupation must be viewed as a generali zation, at best. To support these claims, a review of specific aspects of papers discussed earlier is presented. Dutour’s 1986 article focuses in part on differentiating enthesopathies resulting from hyperactivity of certain muscles and thos e resulting from metabolic or inflammatory origin. Enthesopathies caused by muscular hyperactivity are genera lly isolated lesions and may be readily distinguished from t hose caused by metabolic or inflammatory causes. While the observed lesions may confid ently be ascribed to the extensive use of certain specific groups of muscles, the id entification of the act ivity involved remains more speculative. Dutour (1986) finishes this article by statin g that the study of enthesopathies present on ancient skeletons ma y provide additional data that, taken with other archaeological findings, can help in interpreting the activities of ancient man. Steen and Lane (1998) state that MSM ar e produced during normal, habitual use of muscles and ligaments at their attachment sites as a result of daily activity over an individual’s lifetime. Based on the MSM data collected and analyzed in their study, the patterns of rightor left-sid e preference were not detected in either the Golovin or Nunivak populations. They conclude that MS Ms created by unilateral activities such as throwing a harpoon, casting a net, or sewing sk ins may be overridden by those activities performed using bilateral actions and that a layering of MSMs crea ted by both unilateral

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69 and bilateral use may obscure the signs of side preference, if they existed in life. This article provides a good argument for limiting the application of MSM analysis to compare the use of specific muscles between contemporaneous populations rather than comparison of activity between individuals. Churchill and Morris (1998) provide evidence that MS M might reflect certain types of muscle activity (i.e., loading intensity ) better than others (i.e., loading frequency and duration). Their data suggest that some stressful activities, su ch as those requiring peak muscle loading, might create greater rugosity than lower stress (lower muscle tension) activities. This raises the possi bility that future analyses of MSMs may potentially infer not just muscle use patterns, but the nature (episodic peak loading versus consistent moderate loading) of the muscular activity that produce them. This is yet another example of how MSM studies conclu de, over and over, that muscle use, not specific activity, is what can be truly understood through MSM analysis. Robb (1998) concludes that even when specific activities cannot be deduced, statistical patterns w ithin a group may inform us about past lifeways and the social organization of activities. Patterns in musc le surface markings are recognizable through statistical analysis. Th is approach avoids some of the li mitations encountered in inferring specific activities from muscle development, and can be useful wherever anthropologists have adequate samples of well-preserved skeletons and want to learn about the organization of physical effort. It is possible to identify subgroups within the sample which experienced different activ ity regimes and health conditions. Molnar (2006) finds that s ignificant positive correlations were observed in male individuals in muscle groups associated with archery and to some extent harpooning but

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70 that correlations in kayaking muscles were not evidently consistent with the kayaking motion. Furthermore, the cost oclavicular ligament, often re ferred to in connection with ‘‘kayaker’s clavicle,’’ showed no positive st atistical correlation with the kayaking muscles. Molnar concludes that it may not be surprising that some specific activities are not detectable through MSM an alysis. Assuming the same individuals performed many different activities, the amount of muscle activ ity and the differences that are visible may well be obscured by the multiple activity patterns. It is suggested that the large variety of activity patterns, and the m ode in which they were performed, may be a better explanation than me thodological issues. Molnar (2008) finds no significant co rrelation between patterns for specific activities such as archery and harpo oning and corresponding grave goods as physical aspect and grave goods were not analogous. Molnar concludes that this may imply that the objects themselves do not mirror the indivi dual, but are rather an expression of the community, and perhaps those present at the interment. Had the grave goods been a means of exclusively reflecting the person in the gr ave, it is likely that a stricter division of grave goods would have been visible betw een males and females, and also between children and adults. Molnar concludes that the individual in each gr ave is clearly visible, but not necessarily as a performer of the spec ific activities suggested by the grave goods. The association of grave goods to strengthen association of specific MSM patterns to activity is brought into question by these finding.

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71 Observations on the application of the Ha wkey and Merbs and Mariotti et al. methods For evaluating stress lesions (SL), or os teolytic (OL) areas, Hawkey and Merbs (1995) and Mariotti et al. (2004) use the terms “shallow furro w, a pitting into the cortex that has a lytic-like appearance” and “diffuse porosity or presence of a small area of erosion” respectively. This observer noted th at Mariotti’s Osteol ytic formation (OL) category was easier to operationalize since it allowed for evaluation of porosity AND/OR erosion across all grades as opposed to Hawk ey and Merbs’ Stress Lesion (SL) category which required that erosion be present for a ll grades except 0. As a result, the Hawkey and Merbs classification of the feature was omitte d (scored as a 0) in the event that there was evident (grades 1 – 4) porosity without erosion. For scoring the stress le sion category (Mariotti et al. ’s Osteolytic Formation/OL category), Hawkey and Merbs system require s the observer to measure depth and/or length of furrows or pits. Mariotti et al. focus the observer on porosity and require the measurement of diameter or length of indivi dual holes or area of erosion. This observer found that the measurement of “depth” was much more difficult to achieve than the measurement of diameter and a greater le vel of confidence in assigning scores was realized through th e use of Mariotti et al. ’s method. Since depth is relative to surface, and bone most often has an irregular and/or rounded surface, depth proved to be a very subjective measure. It was observed that most entheses disp lay a range of different forms: from a smooth or rough protrusion, i.e., excess bone formation, to a cavity of varying size and shape (loss of bone mass). A combination of protuberance and cav ity was also noted. The cavities can be relatively evenly shaped in the form of a ridge, circle, or semi-circle,

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72 or they can have a very rugged appearance as described by Molnar (2006). Sail-shaped and “spiking” entheses occurred most of ten on the ulna (Figures 5.1 and 5.2) and proximal patella (Figure 5.3). It is notable to observe th at the photo array in Figure 5.3 suggests an outcome where white collar worker s express MSM at the lowest end of the methods’ grading systems and that laborers express MSM at the higher end of the methods’ grading systems. This is in contra st to the statistical outcomes of this study however, the image was produced to show the range of expression of osteophytic activity without intending to suggest th is dichotomy. These images were selected from among hundreds of images of patellae from the sample used in this study based more on their quality than their association with the individuals occupational class.

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73 Figures 5.1. Left ulna, lateral view, proximal head of a 93 year old male auto mechanic (Labor) with sail-shaped exostoses. Figure 5.2. Left ulna, lateral view, proximal h ead of an 81 year old female nurse (White collar) showing exostoses.

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74 Figure 5.3. Right and Left Patellae, anterior view, showing ossification exostoses/osteophytic formations, grades 0 – 3, clockwise from upper left with grades 0 and 1 from a 68 year old female teacher (W hite collar) and grades 2 & 3 from a 94 year old male construction supervisor (Labor).

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75 Hawkey and Merbs (1995) ossification e xostosis (OS) category defines exostoses (Figures 5.4 and 5.5) based on the distance th ey extend from the bony surface. Mariotti et al. (2004) describe exostoses (OF) as havi ng differing morphologies In scoring the exostoses category (Mariotti et al. ’s OF category), this ob server found that the two systems were equal when an exostosis exte nded less than 1mm or greater than 5mm from the cortical surface. However, a measurem ent >1mm but <2mm would score higher in the Mariotti et al. method, as would a measurement >4mm but <5mm. In effect, Hawkey and Merbs categorize more exostoses as fain t/minimal or moderate /clear and Mariotti et al. categorize more exostoses as mode rate/clear or strong/substantial. Mariotti et al. (2004) suggest the use of “nr’ for “trait not recordable”. Hawkey and Merbs (1995) suggest a grad e of “0” for “absent”. In evaluating robusticity, this observer noted that at sites with moderate to extreme osteolytic activity, “absent” seemed less applicable than “nr”. Throughout this st udy, therefore, absent is used to indicate a true absence of a feature (Fi gure 5.6), while “nr” is used to denote areas made obscure by lytic-like activity (Figure 5.7). The trai t most often found to be non-recordable was robusticity. Consideration of the SL, OS, OF, and OL category’s association to specific numerical measures (e.g., 1 – 4 mm), caused th is observer to consider the possible use of metric data rather than ordinal data for anal ytical purposes. In practice, however, it was discovered that within a give n category there may be many traits (pits, furrows, pores, exostoses) present at a given insertion s ite, each with its own measure (Figure 5.8). While in general like-traits were found to be of like size at a given site, there was enough variance that establishing a single metric for the trait would not have defined the trait as

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76 well as the ordinal grade, and so metric da ta was not collected. Figures 5.9 through 5.12b offer examples of MSM manifesta tion within the sample population.

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77 Figures 5.4. Left femur, pos terior view, proximal shaft, showing varying forms of exostoses from an 94 year old female homemaker (Labor). Figure 5.5. Right humerus, ante rior view, proximal head, s howing exostosis from an 88 year old male machinist (Labor).

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78 Figure 5.6. Right and left radii, fibulae, and humeri, superior view, proximal shafts showing features that were not observable (graded “absent ”) due to animal gnawing. Figure 5.7. Right and left fibulae, superior view, distal head, showing features that were not observable (graded “nr” ) due to lytic activity.

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79 Figure 5.8. Right humerus, anteri or view, proximal head, show ing various size “pits” and “furrows” on a 90 year old male professor (White collar).

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80 Figure 5.9a. Left and right femora, poster ior view, proximal shaft showing osteophytic formation at the Gluteus maximus (squatting/lift ing) insertion site of a 59 year old, male rancher (Labor). Figure 5.9b. Left femur, posteri or view, proximal shaft show ing ridging exostoses at the Gluteus maximus insertion site of a 71 year old male school teacher (White collar).

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81 Figure 5.10a. Left calcaneous, posterior vi ew, showing ossification exostosis on a 54 year old, female accountant (White collar). Figure 5.10b. Left tibia, anteri or view, proximal head, showing Semitendinous insertion site on a 73 year old, female county clerk (white collar) associ ated with walking, squatting, and standing.

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82 Figure 5.11a. Left radius, me dial view, proximal shaft showing Robusticity Marker Grade 3 on a 59 year old male rancher (Labor). Figure 5.11b. Right radius, medial view, proximal shaft showing Robusticity Marker Grade 1 on a 54 year old fema le accountant (W hite collar).

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83 Figure 5.12a. Left radius, lateral view, midshaft showing Robusticity Marker Grade 3 at the Pronator insertion site of a 93 year old male auto mechanic (Labor). Figure 5.12b. Left radius, lateral view, mi d-shaft showing Robusticity Marker Grade 1 on the Pronator insertion site of a 54 year old female accountant (White collar).

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84 Chapter Six Conclusions and Recommendations The skeletal remains of n=69 adults of both sexes ranging in age from 30 to 100 years were analyzed for this study. The ai m was to study whether musculoskeletal stress markers are directly attributab le to certain position classifi cations set forth in the U.S. Office of Personnel Management standards (200 8) to explore the possible utilization of MSM to relate labor practices and skeletal traits in a way that can contribute to identification for the unknown individual in the forensic anthropological context. It was hypothesized that individuals over the age of 30 years known to have worked in strenuous occupations such as construction and farming would demonstrate a significantly different pattern of activity markers than individuals in sedentary occupational classes such as accounting and sales. Earlier studies provide evidence of th e limitations of MSM in understanding activity. Rather, the application of MSM towards unders tanding muscle use patterns within and among individuals and populations can inform the researcher regarding the differences and similarities be tween two or more subjects. This comparative approach is not uncommon in Bioarchaeological and/or Forensic Anthropologi cal studies and is proven to have utilization. However, the usef ulness of evaluating muscle use patterns in an individual to inform the biological profile must be limited to generalized statements that steer clear of conclusively implying specific lifetime activities. Aggregate MSM scores cannot predict, nor do they co rrelate with, occupational

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85 category or sex. The utility of MSM to statistic ally differentiate labor-related activities is not proven in this study. However, when ordi nal data is reduced to an absent/present dichotomy, muscle use patterns emerge to reve al that the labor category tends to have a more symmetrical distribution of MSM than th e white collar category. Further, distinct muscle insertion sites were found to have MSM present at slightly higher frequencies in the labor category as well as in the white collar category. While the two occupational categories cannot be statistically isolated fr om each other using either data collection method, further exploration of the relations hip between MSM and activity are suggested. Another outcome of the study results from the applica tion of two separate but similar methods which allowed for comparison of existing approaches to MSM research. Each of the grading systems offers the re searcher a fairly straightforward way of categorizing observations, however subjectiv e they may be. The Hawkey and Merbs system has become a default standard due to its repeated use in the field. Mariotti et al. ’s proposed standards offer a higher quality of comparative photographs along with some refinements to the grading system. Used t ogether, they provide the researcher with greater confidence in evaluating and scor ing MSM. However, heavy reliance upon ethnographic and archaeological evidence to sup port the outcomes of statistical analyses in the majority of studies brings into ques tion the ability of eith er method to accurately allow researchers to statistica lly correlate lifetim e activity to observations without such evidence. The use of the Hawkey & Merbs and Mari otti et al. visual reference systems In applying both the Hawkey and Merbs and the Mariotti et al. visual reference

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86 systems it became clear that they are compliment ary to each other and aid in refining the observer’s ability to categorize the musculoskeletal markings. The Hawkey and Merbs system describe s osteolytic activity with a focus on pitting and furrows; Mariotti et al. provide a grade that eval uates porosity without the presence of erosion/furrows. Sometimes the feature evidences only fine porosity and the availability of this grade allows for the recording of that level of lytic activity. Hawkey and Merbs rely on the measurement of “depth” of the lytic feature for grading; Mariotti et al. focus on diameter and length. Pores, pits and furrows are three-dimensional features and most often will present as a group rather than a single manifestation. Evaluation of depth, length and diameter prov ides the researcher with the greatest understanding of the true morphology of the osteolytic formation. Mariotti et al. ’s osteophytic formation category allows for the grading of both ridging exostoses and bony spurs while Hawkey and Merbs’ system allows for a finer gradation of bony spur exostoses. Using Hawkey and Merbs’ grade 1 and Mariotti et al. ’s grade 0, the observer is able to ca pture the frequently observed small, round exostoses that are not yet ridging exostoses. Robb (1998) presents a system of five grades for each MSM category. Hawkey and Merbs’ and Mariotti et al. ’s three grade system cause the observer to classify features which are at either end of the range for that grade as the same when in actuality, they were quite different in their appearance. Th e effect of reducing the number of grades is shown in this study to reduce th e observer’s ability to statistic ally identify the extent of variation in the e xhibition of MSM. Within MSM research there has been a fr equent call to standardize the system

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87 used to categorize observations (Kennedy 1998, Robb 1998, Mariotti et al. 2004). By repeated application, the Hawkey and Merbs (1995) visual reference system acts as a default standard. The quality of the photos us ed for visual reference, the “lumping” of variability into three grades, the omission of certain manifestations such as porosity, length and breadth, and ridging all act to li mit the observers recording of the true morphology of MSMs using this method. It is th e recommendation of th is researcher that MSM researchers, in the absence of a formally established standard, utilize a combination of systems to accurately record and analy ze their findings. The difficulty with this recommendation lies in the ability of resear chers to then conduct truly comparative studies. To resolve this, practitioners shoul d collaborate and agree on a model standard which makes use of the best features of the systems that are presented in the MSM literature. A best-practice standard would use an e xpanded five-grade system. For osteolytic activity, combining Mariotti et al. ’s descriptions with Hawkey and Merbs’ descriptions would allow the observer to distinguish be tween fine porosity, pitting, furrows, and erosion. For this trait, Hawkey and Merbs’ suggested use of depth to measure furrows should be eliminated. For osteophytic activit y, this observer found th at there are three types of formation: small, round exostoses, ridging exostoses, and bony spurs. The use of a five grade system would allow the observer to identify both the type and extent of these formations. One final note about method focu ses on the use of the visual references (photos). This observer believes that each visual reference produ ced in a standardized methodology should identify the robusticity marker grade, the osteolyt ic activity grade, and the osteophytic grade. As it is, photos used by Hawkey and Merbs and Mariotti et al.

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88 provide a (literally) one-dimensional frame of reference for a method that is evaluating three aspects of a single site.

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89 References Cited Baron, S, Estill, CF, Steege, A, and Lalich, N (2001) Simple Solutions: Ergonomics for Farm Workers. National Institut e for Occupational Safety and Health (NIOSH). 1-22. Buikstra, JE, and Ubelaker, DH (1994) Sta ndards for data collection from human skeletal remains. Fayette ville: Archaeology Survey. Chapman, L, and Meyers, J (2004) Ergonomic s and Musculoskeletal Injuries in Agriculture: Recognizing and Preventi ng the Industry's Most Widespread Health and Safety Problem. National Institute for Occupational Safety and Health (NIOSH). Churchill, SE, and Morris, AG (1998) Muscle Marking Morphology and Labour Intensity in Prehistoric Khoisan Fo ragers. Int. J. Osteoarchaeol. 8 :390–411. Curry, JD (2002) Bones: Structure and Mechan ics. New Jersey: Princeton University Press. Dutour, O (1986) Enthesopathies (Lesions of Muscular Insertions) as Indicators of the Activities of Neolithic Saharan Populations. Am J Phys Anthropol. 71 :221224. Enlow, DH (1976) The remodelling of bone. Yearbook of Physical Anthropology, 20 :19-34.

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90 Gray's Anatomy of the Human Body. Philadelphia: Lea & Febiger, 1918 New York: Bartleby.com 2000 Hawkey, DE, and Merbs, CF (1995) Ac tivity-induced Musculoskeletal Stress Markers (MSM) and Subsistence St rategy Changes among Ancient Hudson Bay Eskimos. Int. J. Osteoarchaeol. 5 :324-338. Kennedy, KAR (1998) Markers of Occupationa l Stress: Conspectus and Prognosis of Research. Int. J. Osteoarchaeol. 8 :305–310. Larsen, CS (1997) Bioarcheol ogy: Interpreting Behavior from the Human Skeleton. New York: Cambridge University Press. Leigh, JP and Fries, JF (1992) Disability in Occupations in a National Sample. American Journal of Public Health. 82 (11):1517-1524. Lovejoy, CO (1971) Methods for the Detection of Census Error in Palaeodemography. American Anthropologist, New Series. 73 (1):101-109. Madrigal, L (1998) Statistics for Anthr opology. New York: Cambridge University Press. Mariotti, V, Facchini, F, and Bellcastro, MG (2004) Enthesopathies – Proposal of a Standardized Scoring Method and Applications. Coll. Antropol. 28 (1): 145– 159. Molnar, P (2006) Tracing prehistoric activ ities: musculoskeletal stress marker analysis of a stone-age p opulation on the island of Go tland in the Baltic sea. Am J Phys Anthropol 129 :12–23.

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91 Molnar, P (2008) Patterns of Physical Activity and Material Culture on Gotland, Sweden, During the Middle Neolithic. Int. J. Osteoarchaeol. http://dx.doi.org/10.1002/oa.1000 Robb, JE (1998) The Interpretation of Skeletal Muscle Sites: A St atistical Approach. Int. J. Osteoarchaeol. 8 :363-377. Steen, SL and Lane, R (1998) Evaluation of Habitual Activities among Two Alaskan Eskimo Populations Based on Muscul oskeletal Markers. Int. J. Osteoarchaeol. 8 : 341–353 Stirland, AJ (1998) Musculoskeletal Evid ence for Activity: Problems of Evaluation. Int. J. Osteoarchaeol 8 :354–362. UCLA: Academic Technology Services, St atistical Consulting Group. (2009). What Statistical Analysis Should I Use? Statistical Analyses using SPSS. http://www.ats.ucla.edu/stat/S pss/whatstat/whatstat.htm Accessed June 23, 2009. U.S. Department of Labor (2005) Survey of Occupational Injuries and Illnesses, 2003. Bureau of Labor Statistics. U.S. Department of Labor.(2007) Workplace In juries and Illnesses in 2006. Bureau of Labor Statistics. U.S. Office of Personnel Management (2008) Handbook of Occupational Groups and categories. Washington, D.C.: U. S. Office of Personnel Management. Warner, RM (2008) Applied Statistics: from bivariate through multivariate techniques. Thousand Oaks, Calif ornia: Sage Publications.

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92 Weinker, C Using Biological Data to Cha llenge the Reality of Race. Perspectives Electronic Journal of the American A ssociation of Behavioral and Social Sciences: 8 (Fall). http ://www-cf.usc.edu/~renold/AABSS05/Perspectives.htm Weiss, E (2003) Understanding Muscle Markers: Aggrega tion and Construct Validity. Am J Phys Anthropol 121 :230–240. Weiss, E (2004) Understanding Muscle Markers: Lower Limbs. Am J Phys Anthropol 125 :232–238. Weiss, E (2007) Muscle Markers Revisite d: Activity Pattern Reconstruction With Controls in a Central California Amer ind Population. Am J Phys Anthropol 133 :931–940.

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93 Appendices

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94 Appendix A: The Handbook of Occupational Groups and Families (2008) (Reprinted exactly with permission from the U.S. Office of Personnel Management)

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95 Appendix A: (Continued)

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96 Appendix A: (Continued)

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97 Appendix A: (Continued)

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98 Appendix A: (Continued)

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99 Appendix A: (Continued)

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100 Appendix A: (Continued)

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101 Appendix A: (Continued)

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102 Appendix A: (Continued)

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103 Appendix A: (Continued)

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104 Appendix A: (Continued)

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105 Appendix A: (Continued)

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106 Appendix B: Reference Images (Gray’s Anatomy 1918) (Reprinted with permission from Bartlebys.com) Upper Limb Muscles/Ligments (8): Pectoralis Major Insertion at the intert ubercular groove of the humerus Action: Clavicular head flexes the humerus; Sternocostal head: extends the humerus; As a whole, adducts and medially rotates the humerus. It also draws the scapula anteriorly and inferiorly Latissimus dorsi Insertion at the floor of intertubercular groove of the humerus Action: adducts, extends, and internally rotates the arm

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107 Appendix B: (Continued) Teres major and Teres minor Muscles on the dorsum of the scapula, and the Triceps brachii muscle: #5 is Teres major muscle #6 is Teres minor muscle Insertion at the medial lip of the intertubercular sulcus of the humerus Action: Internal rotation of the humerus Deltoideus (posterior and anterior) Insertion at the deltoid tuberosity of humerus Action: shoulder abduction, flexion and extension Biceps brachii Insertion at the radial tuberosity Action: flexes elbow and supinates forearm

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108 Appendix B: (Continued) Triceps brachii Insertion at the olecranon process of ulna Action: extends forearm, caput longum adducts shoulder Supinator Insertion at the Lateral proximal radial shaft Action: supinates forearm

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109 Appendix B: (Continued) Pronator teres Insertion at the radius Action: pronation of fo rearm, flexes elbow

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110 Appendix B: (Continued) Lower Limb Muscles/Ligaments(6): Gluteus maximus Insertion at the Gluteal tuberosity of the femur, iliotibial tract Action: external rotatio n and extension of the hip joint, supports th e extended knee through the iliotibial tract, chie f antigravity muscle in sitting Biceps femoris Insertion at the head of the fibula which articulates with the back of the lateral tibial condyle Action: flexes knee joint, laterally rotates knee joint (when knee is flexed), extends hip joint (long head only)

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111 Appendix B: (Continued) Semitendinosus Insertion at the pes anserinus Action: flex knee, extend hip joint Vastus medialis Insertion at the patella Action: extends leg

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112 Appendix B: (Continued) Vastus lateralis Insertion at the Patella and Tibial tuberosity via the Patellar ligament Action: Extends and stabilizes knee Soleus Insertion at the tendo calcaneus Action: plantarflexion

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113 Appendix B: (Continued)

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114 Appendix B: (Continued)

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115 Appendix B: (Continued)

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116 Appendix C: Data Used in Analysis (excludes MSM scores) UNM ID # Sex Age white collar (1), Labor (2) Occupation Occupation (U.S. Office of Personnel Management Position Classification) 4 M 52 1 engineer 800 6 M 41 2 cook 7404 17 M 41 1 USAF, teacher 1700 29 F 36 1 sales, jewelry 2091 31 M 57 1 freelance writer 1000 35 M 69 2 bottler 5034 47 M 69 2 fork operator 4741 48 F 53 1 sales mgmt 2091 56 M 51 2 laborer 3502 63 M 59 2 rancher 5035 81 M 73 1 organic chemist 1320 88 M 67 1 history prof. 1700 99 M 69 1 Presbyterian minister 60 110 F 35 1 research scientist 400 113 M 41 1 HS teacher 1700 114 F 68 2 homemaker 3500 115 M 71 1 physician 600 117 F 56 1 nurse 600 118 M 63 USAF 123 M 66 2 farm worker 5002

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117 Appendix C (Continued): UNM ID # Sex Age white collar (1), Labor (2) Occupation Occupation (U.S. Office of Personnel Management Position Classification) 128 M 80 2 boilermaker 3808 132 F 69 1 book keeper & shop owner 500 141 M 30 2 landscape & sprinkler 3502 145 M 66 2 railroader 5737 146 M 71 1 insurance supervisor 100 147 M 36 1 astrologer 100 149 F 68 2 housewife 3500 152 F 54 1 accountant 500 159 F 72 1 nurse 600 160 F 68 1 teacher 1700 163 M 34 2 welder 3703 169 M 77 1 nat resources prod 400 173 F 73 1 county clerk 945 176 M 34 1 security guard 85 191 M 39 1 UNM grad student 99 193 M 77 1 physician 600 194 F 68 1 teacher 1700 196 F 83 2 housewife 3500 198 F 39 2 housewife 3500 207 M 71 1 professor 1700 208 F 82 1 ret dental assistant 600

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118 Appendix C (Continued): UNM ID # Sex Age white collar (1), Labor (2) Occupation Occupation (U.S. Office of Personnel Management Position Classification) 210 F 94 2 housewife 3500 211 M 56 2 truck driver 5703 212 F 68 1 secretary 318 213 F 83 1 home healthcare aide 600 216 F 81 1 secretary 318 217 F 81 1 nurse 600 220 F 85 2 homemaker 3500 221 F 100 2 domestic engineer 3500 225 M 93 2 automotive mechanic 5823 231 F 92 1 book keeper 500 232 M 94 2 construction superintendent 3600 234 M 46 2 mechanic 5823 235 F 68 1 student 99 237 M 88 2 machinist 9959 240 M 61 2 printer 4400 241 F 61 1 stenographer/secretary 318 242 M 52 1 draftsman, musician (guitarist) 1021 243 M 63 1 computer programmer 332 245 M 78 2 salesman, painter 4100 246 M 59 2 carpenter, ski instructor 4600 250 F 95 1 Administrative Director of the Arts 1001

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119 Appendix C (Continued): UNM ID # Sex Age white collar (1), Labor (2) Occupation Occupation (U.S. Office of Personnel Management Position Classification) 252 M 62 1 Radiation Health Physicist 600 253 F 95 1 Secretary 318 254 M 90 1 Professor 1700 257 M 2 construction 3600 259 F 1 security guard 85 261 F 1 doctor 602 262 M 1 business executive 1100

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120 Appendix D: MSM Raw Scores Appendix D (Continued): Pectoralis major UNM ID # Right/Left Pectoralis Major RM Score Right/Left Pectoralis Major SL Score Right/Left Pectoralis Major OS Score Right/Left Pectoralis Major OF Score Right/Left Pectoralis Major OL Score 4 2 2 2 1 1 1 1 1 2 2 6 2 2 1 1 0 2 0 2 2 2 17 2 2 1 1 0 0 0 0 2 2 29 2 2 1 1 0 0 0 0 1 1 31 2 2 1 1 0 1 0 1 2 1 35 2 9 1 9 1 9 1 9 3 9 47 3 3 1 1 1 1 1 2 1 1 48 2 2 1 1 0 0 0 0 1 1 56 2 2 1 1 0 0 0 0 1 1 63 3 2 2 1 0 0 0 0 2 1 81 2 2 1 1 1 0 1 0 1 0 88 2 2 0 0 1 1 0 1 1 2 99 3 3 2 2 1 1 1 1 2 2 110 2 2 1 1 0 0 0 0 1 1 113 2 3 1 1 0 0 0 0 2 2 114 3 3 1 1 0 1 0 1 1 1 115 2 2 1 1 0 0 0 0 0 1 117 2 2 1 1 0 1 0 1 0 1 118 2 2 1 1 0 0 0 0 1 0

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121 Appendix D (Continued): Pectoralis major UNM ID # Right/Left Pectoralis Major RM Score Right/Left Pectoralis Major SL Score Right/Left Pectoralis Major OS Score Right/Left Pectoralis Major OF Score Right/Left Pectoralis Major OL Score 123 1 3 1 1 0 0 0 0 0 2 128 3 3 1 2 1 1 1 1 2 3 132 nr 3 3 2 0 1 0 1 4 2 141 2 3 1 2 0 0 0 0 2 2 145 2 2 1 1 0 0 0 0 1 2 146 2 2 1 1 0 0 0 0 2 1 147 3 2 3 1 1 1 1 1 3 2 149 3 2 2 1 0 0 0 0 3 2 152 1 2 1 2 0 1 0 1 1 1 159 3 3 2 3 0 0 1 0 2 2 160 3 3 3 1 1 0 1 0 3 3 163 2 2 1 1 0 0 0 0 1 1 169 2 2 1 1 0 1 0 1 1 1 173 2 2 0 1 0 0 0 0 1 1 176 2 2 1 1 0 0 0 0 0 1 191 2 2 1 1 0 1 0 1 0 0 193 2 2 1 1 0 0 0 0 0 2 194 3 3 1 1 1 0 1 0 1 3 196 2 2 1 1 1 1 1 1 1 1 198 2 2 1 1 0 0 0 0 0 0

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122 Appendix D (Continued): Pectoralis major UNM ID # Right/Left Pectoralis Major RM Score Right/Left Pectoralis Major SL Score Right/Left Pectoralis Major OS Score Right/Left Pectoralis Major OF Score Right/Left Pectoralis Major OL Score 207 3 3 1 1 1 1 1 1 2 2 208 2 2 1 1 0 0 0 0 1 1 210 3 3 3 1 2 1 2 2 2 1 211 3 2 1 1 1 0 1 0 0 2 212 2 2 1 1 0 0 0 0 1 1 213 2 1 1 1 1 1 1 1 1 1 216 3 3 1 2 1 1 1 1 1 2 217 2 2 1 1 0 0 0 0 1 1 220 3 3 1 1 1 1 1 1 1 2 221 3 3 1 1 1 1 1 1 0 1 225 3 3 3 1 2 3 3 3 4 4 231 2 3 0 0 1 1 1 1 2 1 232 1 3 0 1 0 2 0 2 1 2 234 2 2 1 1 1 0 1 0 1 1 235 2 2 1 1 0 0 0 0 2 2 237 3 3 1 1 1 1 1 1 1 1 240 2 2 1 1 1 0 1 0 1 1 241 3 2 1 1 1 1 1 1 1 1 242 2 2 1 1 0 0 0 0 1 1 243 2 3 0 1 2 2 2 2 1 1

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123 Appendix D (Continued): Pectoralis major UNM ID # Right/Left Pectoralis Major RM Score Right/Left Pectoralis Major SL Score Right/Left Pectoralis Major OS Score Right/Left Pectoralis Major OF Score Right/Left Pectoralis Major OL Score 245 3 3 2 1 1 1 1 1 2 2 246 2 3 0 1 0 2 0 2 2 1 250 3 3 2 1 1 1 1 1 4 2 252 3 2 1 1 0 0 1 1 1 1 253 99 2 99 1 99 0 99 1 99 1 254 3 2 3 2 1 0 1 0 4 4 257 1 1 0 0 0 1 0 0 1 1 259 2 2 1 1 0 0 0 0 1 1 261 3 3 0 1 1 1 1 1 1 1 262 2 1 0 1 0 1 1 1 1 1

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124 Appendix D (Continued): Latissimus dorsi UNM ID # Right/Left Latissimus dorsi RM Score Right/Left Latissimus dorsi SL Score Right/Left Latissimus dorsi OS Score Right/Left Latissimus dorsi OF Score Right/Left Latissimus dorsi OL Score 4 2 2 1 1 0 0 0 0 1 2 6 1 2 2 1 1 0 0 0 2 2 17 2 2 1 1 0 0 0 0 0 0 29 2 2 1 1 0 0 0 0 0 1 31 3 3 1 1 1 0 1 1 1 2 35 2 3 1 2 0 1 1 2 1 2 47 2 3 1 1 1 1 1 1 2 0 48 2 2 1 1 0 0 0 0 1 1 56 3 3 1 1 0 1 0 1 0 1 63 2 2 1 1 0 0 0 0 1 1 81 2 2 2 1 0 0 0 0 0 0 88 3 2 2 1 1 0 1 0 2 0 99 3 3 2 1 0 0 0 0 2 0 110 2 2 1 1 0 0 0 0 1 1 113 2 2 1 1 0 0 0 0 1 1 114 3 3 1 1 0 0 1 1 1 1 115 3 2 2 1 0 0 0 0 2 1 117 3 3 2 1 1 1 1 1 0 0 118 2 2 1 1 0 0 0 0 1 0

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125 Appendix D (Continued): Latissimus dorsi UNM ID # Right/Left Latissimus dorsi RM Score Right/Left Latissimus dorsi SL Score Right/Left Latissimus dorsi OS Score Right/Left Latissimus dorsi OF Score Right/Left Latissimus dorsi OL Score 123 2 2 1 1 0 0 1 0 0 0 128 3 3 3 3 1 1 1 1 4 2 132 1 3 1 1 1 1 1 1 0 0 141 2 3 1 2 0 0 0 0 1 1 145 2 3 2 2 0 0 0 0 1 2 146 3 2 1 1 0 0 0 0 1 1 147 0 0 0 0 0 0 0 0 0 0 149 2 2 1 1 0 0 0 0 1 0 152 2 2 1 2 0 1 0 1 1 2 159 3 3 1 2 1 1 1 1 2 2 160 3 3 2 1 2 1 2 2 2 2 163 3 3 1 1 0 0 0 0 1 1 169 2 3 1 1 0 0 0 0 1 1 173 1 2 1 1 0 0 1 1 1 1 176 2 2 1 1 0 0 0 0 0 0 191 2 2 1 1 0 0 0 0 0 0 193 3 3 2 2 0 0 0 0 2 2 194 2 3 1 1 0 0 0 0 0 2 196 2 2 1 1 0 0 0 0 1 1 198 1 2 1 1 0 0 0 0 0 0

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126 Appendix D (Continued): Latissimus dorsi UNM ID # Right/Left Latissimus dorsi RM Score Right/Left Latissimus dorsi SL Score Right/Left Latissimus dorsi OS Score Right/Left Latissimus dorsi OF Score Right/Left Latissimus dorsi OL Score 207 2 3 1 2 0 1 0 1 1 1 208 2 2 1 1 0 0 0 0 1 1 210 2 3 1 2 1 2 2 2 1 1 211 2 2 2 1 0 0 0 0 0 0 212 2 2 1 1 0 0 0 0 1 1 213 2 2 1 1 0 0 0 0 1 1 216 2 3 1 1 0 0 0 0 1 1 217 3 3 1 1 0 1 0 1 1 1 220 3 3 1 2 1 1 1 1 1 2 221 2 2 2 1 0 0 1 1 0 0 225 3 3 3 3 2 2 2 2 4 4 231 2 1 1 1 0 0 0 0 2 2 232 2 3 1 1 1 0 1 2 1 2 234 2 2 1 1 0 0 0 0 1 0 235 2 2 1 1 0 0 0 0 0 0 237 3 3 2 1 1 0 1 0 1 0 240 3 3 1 1 0 0 0 0 2 2 241 3 2 1 1 0 0 0 0 0 1 242 3 2 1 1 0 0 1 1 2 1 243 2 2 1 1 2 1 2 1 1 0

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127 Appendix D (Continued): Latissimus dorsi UNM ID # Right/Left Latissimus dorsi RM Score Right/Left Latissimus dorsi SL Score Right/Left Latissimus dorsi OS Score Right/Left Latissimus dorsi OF Score Right/Left Latissimus dorsi OL Score 245 3 3 2 1 0 0 0 0 2 2 246 1 2 1 2 1 0 1 1 1 1 250 3 3 1 0 2 1 2 1 1 1 252 2 2 1 1 0 0 0 0 1 0 253 99 3 99 1 99 0 99 0 99 0 254 2 2 1 1 0 0 0 0 2 1 257 1 1 1 1 0 0 0 0 1 1 259 2 2 1 1 0 0 0 0 0 0 261 3 3 1 1 0 0 1 1 1 1 262 3 3 1 2 1 1 1 1 1 1

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128 Appendix D (Continued): Teres major UNM ID # Right/Left Teres major & minor RM Score Right/Left Teres major & minor SL Score Right/Left Teres major & minor OS Score Right/Left Teres major & minor OF Score Right/Left Teres major & minor OL Score 4 2 2 1 1 1 0 1 0 1 1 6 2 2 1 1 1 0 0 0 1 2 17 2 2 1 1 0 0 0 0 1 1 29 2 2 1 1 0 0 0 0 0 1 31 3 3 1 1 0 0 0 1 1 1 35 2 9 2 9 1 9 1 9 3 9 47 3 3 1 1 1 1 2 1 2 1 48 2 2 2 2 0 0 0 0 2 2 56 2 3 1 1 1 1 1 1 0 1 63 3 3 2 1 1 1 1 1 2 2 81 3 2 2 1 2 1 2 1 2 2 88 3 3 2 1 1 1 1 1 2 1 99 3 3 2 3 1 1 1 1 2 4 110 2 2 1 1 0 0 0 0 1 1 113 3 3 1 1 1 1 1 1 1 2 114 3 3 1 1 1 1 1 1 1 1 115 2 2 1 1 0 0 0 0 2 1 117 2 2 1 1 0 1 0 1 1 0 118 3 3 1 2 0 0 0 0 0 0

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129 Appendix D (Continued): Teres major UNM ID # Right/Left Teres major & minor RM Score Right/Left Teres major & minor SL Score Right/Left Teres major & minor OS Score Right/Left Teres major & minor OF Score Right/Left Teres major & minor OL Score 123 3 3 1 1 1 1 1 1 0 1 128 3 3 1 1 2 2 2 2 2 2 132 3 3 3 2 1 1 1 2 4 2 141 2 3 1 1 0 0 0 0 1 1 145 3 3 2 2 1 1 1 1 1 2 146 3 2 1 1 0 0 0 0 1 1 147 1 0 0 0 1 0 1 0 0 1 149 3 2 1 1 0 0 0 0 2 0 152 2 1 1 0 1 0 1 0 1 0 159 3 3 2 3 1 0 1 0 2 3 160 3 3 2 2 0 2 0 2 3 3 163 3 3 2 2 1 0 1 0 1 1 169 3 3 2 3 1 1 1 1 2 3 173 3 3 0 1 1 1 1 1 0 0 176 2 2 1 1 0 0 0 0 0 0 191 2 2 1 1 1 1 1 1 0 0 193 2 2 1 1 1 1 1 1 1 1 194 3 2 1 2 1 0 1 0 1 2 196 2 2 1 1 1 1 1 1 1 1

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130 Appendix D (Continued): Teres major UNM ID # Right/Left Teres major & minor RM Score Right/Left Teres major & minor SL Score Right/Left Teres major & minor OS Score Right/Left Teres major & minor OF Score Right/Left Teres major & minor OL Score 198 2 2 1 1 0 0 0 0 0 0 207 3 3 2 2 1 1 2 1 2 2 208 3 3 1 1 1 1 1 1 2 1 210 3 3 3 3 2 2 2 2 2 1 211 3 2 2 1 1 0 1 0 2 0 212 2 3 1 1 1 1 1 1 0 2 213 2 2 1 1 1 2 1 2 2 2 216 3 3 1 1 0 1 0 1 1 1 217 3 2 1 1 1 0 1 0 2 1 220 3 3 1 1 2 1 2 1 1 1 221 3 2 2 1 2 1 2 0 1 1 225 3 3 2 1 2 3 3 3 4 4 231 3 3 2 2 2 2 2 2 2 3 232 3 3 1 3 2 2 3 3 2 4 234 3 3 1 2 1 2 1 2 2 2 235 2 2 1 1 0 0 0 0 1 1 237 3 3 1 1 2 2 2 2 1 0 240 2 3 1 1 1 1 1 1 1 2 241 3 2 1 1 0 1 0 1 0 0

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131 Appendix D (Continued): Teres major UNM ID # Right/Left Teres major & minor RM Score Right/Left Teres major & minor SL Score Right/Left Teres major & minor OS Score Right/Left Teres major & minor OF Score Right/Left Teres major & minor OL Score 242 2 2 1 1 0 0 1 1 1 1 243 2 2 1 1 2 1 2 1 1 1 245 3 3 2 1 1 0 1 0 3 2 246 2 2 0 0 1 2 1 2 2 2 250 3 1 3 2 0 0 0 0 4 2 252 2 2 1 1 0 0 0 0 1 0 253 99 3 99 1 99 1 99 1 99 1 254 3 3 3 3 1 1 1 1 4 4 257 1 1 0 0 0 1 0 0 2 3 259 2 2 1 1 1 0 1 0 1 1 261 3 3 2 2 1 1 1 1 2 2 262 3 1 2 1 1 1 1 2 1 2

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132 Appendix D (Continued): Deltoideus UNM ID # Right/Left Deltoideus (posterior & anterior) RM Score Right/Left Deltoideus (posterior & anterior) SL Score Right/Left Deltoideus (posterior & anterior) OS Score Right/Left Deltoideus (posterior & anterior) OF Score Right/Left Deltoideus (posterior & anterior) OL Score 4 2 2 1 1 0 1 0 1 1 1 6 1 2 1 1 0 0 0 1 1 0 17 2 99 1 99 0 99 0 99 0 99 29 2 2 1 1 0 0 0 0 0 0 31 2 2 1 1 0 0 0 0 1 1 35 1 1 1 1 0 0 0 0 1 0 47 2 2 1 1 0 0 0 0 0 0 48 2 2 1 1 0 0 0 0 1 1 56 2 2 1 1 0 0 0 0 0 0 63 2 2 0 1 0 0 0 0 0 0 81 2 2 1 1 0 0 0 0 0 0 88 2 2 1 1 0 0 0 0 0 0 99 2 2 1 1 0 0 0 0 1 1 110 2 2 1 1 0 0 0 0 1 1 113 2 2 1 1 0 0 0 0 1 1 114 2 3 1 1 0 1 0 1 1 1 115 2 2 1 1 0 0 0 0 0 0 117 2 2 1 1 0 0 0 0 0 0 118 2 2 1 1 0 0 0 0 0 0

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133 Appendix D (Continued): Deltoideus UNM ID # Right/Left Deltoideus (posterior & anterior) RM Score Right/Left Deltoideus (posterior & anterior) SL Score Right/Left Deltoideus (posterior & anterior) OS Score Right/Left Deltoideus (posterior & anterior) OF Score Right/Left Deltoideus (posterior & anterior) OL Score 123 2 2 1 1 0 0 0 0 0 0 128 3 3 1 1 0 1 0 1 1 1 132 3 2 1 1 0 0 0 0 2 1 141 2 2 1 1 0 0 0 0 0 0 145 2 2 1 1 0 0 0 0 0 1 146 3 2 1 1 0 0 0 0 1 1 147 1 0 1 0 0 0 0 0 1 0 149 2 1 1 1 0 0 0 0 0 0 152 2 1 0 1 1 0 2 0 0 1 159 2 2 1 1 0 0 0 0 1 1 160 2 2 1 1 0 0 0 0 1 1 163 2 2 1 1 0 0 0 0 0 0 169 2 2 1 1 0 0 0 0 1 1 173 2 2 1 0 0 0 0 0 0 1 176 2 2 1 1 0 0 0 0 0 0 191 2 2 1 1 0 0 0 0 0 0 193 2 2 1 1 0 0 0 0 1 1 194 1 2 1 1 0 0 0 0 0 1 196 2 2 1 1 0 0 0 0 1 1 198 2 2 1 1 0 0 0 0 0 0

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134 Appendix D (Continued): Deltoideus UNM ID # Right/Left Deltoideus (posterior & anterior) RM Score Right/Left Deltoideus (posterior & anterior) SL Score Right/Left Deltoideus (posterior & anterior) OS Score Right/Left Deltoideus (posterior & anterior) OF Score Right/Left Deltoideus (posterior & anterior) OL Score 207 2 2 1 1 0 0 0 0 0 0 208 2 2 1 1 0 0 0 0 0 0 210 3 3 1 1 1 1 1 1 2 1 211 2 2 1 1 0 0 0 0 0 0 212 2 2 1 1 0 0 0 0 0 0 213 2 1 1 0 0 0 0 0 1 0 216 2 2 1 1 0 0 0 0 1 1 217 2 2 1 1 0 0 0 0 1 1 220 3 3 1 1 0 0 0 0 0 0 221 2 2 2 1 0 0 0 0 0 0 225 3 3 1 1 1 1 1 1 1 2 231 2 2 1 0 0 0 0 0 1 1 232 2 3 0 1 0 0 0 1 1 1 234 2 2 1 1 0 0 0 0 1 1 235 2 2 1 1 0 0 0 0 0 0 237 3 3 1 1 1 0 1 0 1 1 240 3 2 1 1 0 0 0 0 1 1 241 3 3 1 1 0 0 0 0 0 1 242 3 1 0 1 1 1 2 0 0 0 243 2 2 1 1 0 0 1 1 0 0

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135 Appendix D (Continued): Deltoideus UNM ID # Right/Left Deltoideus (posterior & anterior) RM Score Right/Left Deltoideus (posterior & anterior) SL Score Right/Left Deltoideus (posterior & anterior) OS Score Right/Left Deltoideus (posterior & anterior) OF Score Right/Left Deltoideus (posterior & anterior) OL Score 245 2 2 1 1 0 0 0 0 0 0 246 3 2 1 1 0 0 1 0 1 1 250 3 2 2 1 1 1 1 1 4 2 252 2 2 1 1 0 0 0 0 1 1 253 2 2 1 1 1 1 1 1 1 1 254 2 2 1 1 0 0 0 0 0 0 257 1 1 1 0 0 0 0 0 0 0 259 2 2 1 1 0 0 0 0 0 0 261 2 2 1 1 0 0 0 0 1 1 262 2 3 1 1 0 1 0 1 1 1

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136 Appendix D (Continued): Biceps Brachii UNM ID # Right/Left Biceps Brachii RM Score Right/Left Biceps Brachii SL Score Right/Left Biceps Brachii OS Score Right/Left Biceps Brachii OF Score Right/Left Biceps Brachii OL Score 4 2 2 1 1 1 0 1 0 0 1 6 2 2 1 1 0 0 0 1 0 0 17 2 2 1 1 0 0 0 0 0 0 29 2 2 1 1 0 0 0 0 1 0 31 2 2 1 1 0 0 0 0 0 1 35 1 1 1 1 1 1 1 1 1 1 47 3 3 1 1 0 1 1 2 0 0 48 2 2 1 1 0 0 0 0 1 1 56 2 2 1 1 0 0 0 0 1 1 63 3 3 3 3 1 1 1 1 4 4 81 3 3 2 2 1 0 1 0 2 2 88 2 3 1 2 0 1 1 1 0 2 99 3 2 1 1 1 0 1 0 1 2 110 2 2 1 1 0 0 0 0 1 1 113 2 3 1 2 0 1 0 1 1 1 114 2 3 1 1 0 0 0 0 1 1 115 2 3 1 2 0 0 0 0 1 2 117 3 2 2 1 1 1 1 1 1 0 118 2 2 1 1 0 0 0 0 2 2

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137 Appendix D (Continued): Biceps Brachii UNM ID # Right/Left Biceps Brachii RM Score Right/Left Biceps Brachii SL Score Right/Left Biceps Brachii OS Score Right/Left Biceps Brachii OF Score Right/Left Biceps Brachii OL Score 123 2 2 1 1 0 0 1 1 0 0 128 3 3 1 2 1 1 1 1 1 2 132 2 3 0 1 0 1 0 1 0 3 141 2 2 1 1 0 0 0 0 1 1 145 3 3 2 2 0 1 0 1 0 1 146 3 3 1 1 1 1 1 1 1 1 147 1 2 1 1 0 0 1 1 1 0 149 2 2 1 1 0 0 0 0 0 1 152 2 2 0 0 0 1 0 1 0 1 159 3 3 1 2 1 1 1 1 1 2 160 3 3 1 1 1 1 1 1 2 2 163 2 2 1 1 0 0 0 0 0 0 169 2 2 1 1 0 0 0 0 1 0 173 2 3 1 1 1 1 1 0 0 0 176 2 2 1 1 0 0 0 0 0 1 191 2 2 1 1 0 0 0 0 0 0 193 3 2 2 1 1 1 2 1 1 1 194 2 2 1 1 0 1 0 1 1 1 196 2 2 1 1 1 1 1 1 1 0 198 2 2 1 1 0 0 0 0 0 0

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138 Appendix D (Continued): Biceps Brachii UNM ID # Right/Left Biceps Brachii RM Score Right/Left Biceps Brachii SL Score Right/Left Biceps Brachii OS Score Right/Left Biceps Brachii OF Score Right/Left Biceps Brachii OL Score 207 2 2 1 0 0 0 0 0 0 0 208 2 2 1 1 0 1 0 1 0 1 210 3 3 2 1 0 0 1 1 0 1 211 2 2 1 1 0 0 0 1 0 1 212 2 2 1 1 0 0 0 0 0 1 213 3 3 2 2 2 2 2 2 2 1 216 2 2 1 1 0 0 0 0 1 1 217 3 2 1 1 1 0 1 0 1 1 220 2 2 1 1 0 1 0 1 1 1 221 2 2 1 1 0 1 0 1 2 1 225 3 3 3 3 1 1 1 1 0 2 231 3 3 1 1 1 2 2 2 1 2 232 3 3 2 1 2 1 2 1 1 0 234 3 3 1 1 0 1 1 1 0 1 235 2 2 1 1 0 0 0 0 1 2 237 3 3 2 1 1 0 1 0 0 1 240 2 3 2 2 1 0 1 0 2 2 241 2 2 1 1 1 1 1 1 0 1 242 3 2 1 1 0 1 0 0 1 0 243 2 2 1 0 2 1 2 1 0 0

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139 Appendix D (Continued): Biceps Brachii UNM ID # Right/Left Biceps Brachii RM Score Right/Left Biceps Brachii SL Score Right/Left Biceps Brachii OS Score Right/Left Biceps Brachii OF Score Right/Left Biceps Brachii OL Score 245 2 3 1 1 1 0 1 0 2 2 246 2 2 1 0 0 1 0 1 1 1 250 3 3 1 1 0 1 1 2 2 4 252 2 2 1 1 0 0 0 0 0 0 253 2 2 1 1 0 0 0 0 0 0 254 3 3 2 2 2 2 2 2 4 4 257 2 2 1 1 1 0 1 0 0 0 259 2 2 1 1 0 1 0 1 0 0 261 3 3 1 1 1 1 2 1 1 0 262 2 3 1 1 0 0 1 1 0 0

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140 Appendix D (Continued): Supinator UNM ID # Right/Left Supinator RM Score Right/Left Supinator SL Score Right/Left Supinator OS Score Right/Left Supinator OF Score Right/Left Supinator OL Score 4 1 1 0 0 0 0 0 0 0 0 6 1 1 0 0 0 0 0 0 0 0 17 1 1 1 1 0 0 0 0 0 0 29 2 2 1 1 0 0 0 0 0 0 31 1 1 0 0 0 0 0 0 0 0 35 1 2 0 0 0 0 0 0 0 0 47 1 1 0 0 0 0 0 0 0 0 48 1 1 0 0 0 0 0 0 0 0 56 1 1 0 0 0 0 0 0 0 0 63 1 1 1 1 0 0 0 0 0 0 81 1 1 1 1 0 0 0 0 0 0 88 1 1 0 1 0 0 0 0 0 0 99 1 1 1 1 0 0 0 0 0 0 110 1 1 0 0 0 0 0 0 0 0 113 1 1 0 0 0 0 0 0 1 0 114 1 1 0 0 0 0 0 0 0 0 115 1 1 1 1 0 0 0 0 0 0 117 2 2 1 1 0 1 0 1 0 1 118 1 1 0 0 0 0 0 0 0 0

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141 Appendix D (Continued): Supinator UNM ID # Right/Left Supinator RM Score Right/Left Supinator SL Score Right/Left Supinator OS Score Right/Left Supinator OF Score Right/Left Supinator OL Score 123 1 1 0 0 0 0 0 0 0 0 128 2 1 0 0 0 0 0 0 0 0 132 1 1 0 0 0 0 0 0 0 0 141 2 2 1 1 0 0 0 0 1 0 145 1 1 0 1 0 0 0 0 0 0 146 1 2 0 1 0 0 0 0 0 0 147 0 0 0 0 0 0 0 0 0 0 149 1 1 0 0 0 0 0 0 0 0 152 1 0 0 0 1 0 1 0 1 0 159 1 1 1 1 0 0 0 0 1 0 160 1 1 0 0 0 0 0 0 0 0 163 1 1 1 1 0 0 0 0 0 0 169 1 1 1 1 0 0 0 0 0 0 173 1 1 0 0 0 0 0 0 0 0 176 1 1 0 1 0 0 0 0 0 0 191 1 2 0 1 0 0 0 0 0 0 193 1 1 1 1 0 0 0 0 0 0 194 2 1 1 1 0 0 0 0 0 0 196 1 1 1 0 0 0 0 0 0 0 198 1 1 0 0 0 0 0 0 0 0

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142 Appendix D (Continued): Supinator UNM ID # Right/Left Supinator RM Score Right/Left Supinator SL Score Right/Left Supinator OS Score Right/Left Supinator OF Score Right/Left Supinator OL Score 207 2 2 1 1 0 0 0 0 0 0 208 1 1 0 0 0 0 0 0 0 0 210 2 2 1 2 0 0 0 0 0 0 211 1 1 0 0 0 0 0 0 0 0 212 1 1 1 1 0 0 0 0 0 0 213 1 2 1 1 0 1 0 1 0 1 216 1 1 0 1 0 0 0 0 0 0 217 1 1 1 1 0 0 0 0 0 0 220 1 1 0 0 0 0 0 0 0 0 221 2 2 1 1 0 0 0 0 0 0 225 1 1 1 0 0 0 0 0 1 0 231 1 1 0 0 0 0 0 0 0 0 232 2 2 0 0 0 0 0 0 0 0 234 2 2 1 1 0 0 0 0 0 0 235 1 1 0 0 0 0 0 0 0 0 237 1 2 0 1 0 0 0 0 0 0 240 2 2 1 1 0 0 0 0 0 0 241 1 1 0 0 0 0 0 0 0 0 242 1 1 0 0 0 0 0 0 0 0 243 1 1 0 0 0 0 0 0 0 0

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143 Appendix D (Continued): Supinator UNM ID # Right/Left Supinator RM Score Right/Left Supinator SL Score Right/Left Supinator OS Score Right/Left Supinator OF Score Right/Left Supinator OL Score 245 1 1 0 0 0 0 0 0 0 0 246 1 1 0 0 0 0 0 0 0 0 250 1 1 0 0 00 0 0 0 0 0 252 1 1 1 1 0 0 0 0 0 0 253 1 1 0 1 0 0 0 0 0 0 254 1 2 1 1 0 0 0 0 0 0 257 0 1 0 0 0 0 0 0 0 0 259 1 1 0 1 0 0 0 0 0 0 261 1 1 0 0 0 0 0 0 0 0 262 1 1 0 0 0 0 0 0 0 0

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144 Appendix D (Continued): Pronator UNM ID # Right/Left Pronator RM Score Right/Left Pronator SL Score Right/Left Pronator OS Score Right/Left Pronator OF Score Right/Left Pronator OL Score 4 2 2 0 1 0 1 0 0 0 0 6 1 1 0 0 0 0 0 0 0 0 17 1 1 1 1 0 1 0 0 0 0 29 2 2 1 1 0 1 0 1 0 0 31 2 2 0 0 0 0 0 0 0 0 35 1 2 1 1 0 1 0 1 1 0 47 2 2 0 0 0 0 0 0 0 0 48 2 2 1 1 0 1 0 0 0 1 56 2 2 1 1 0 1 0 0 0 0 63 2 2 1 1 0 1 0 0 1 1 81 2 2 1 1 0 1 0 0 0 0 88 3 3 1 1 0 1 1 1 0 0 99 1 2 1 1 1 1 1 1 0 1 110 1 1 1 1 0 1 0 0 0 0 113 2 2 1 1 0 1 0 0 1 1 114 3 3 1 1 0 1 0 0 1 1 115 2 2 1 1 0 1 0 0 0 0 117 2 2 1 1 0 1 0 0 0 0 118 2 2 1 1 0 1 0 0 0 0

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145 Appendix D (Continued): Pronator UNM ID # Right/Left Pronator RM Score Right/Left Pronator SL Score Right/Left Pronator OS Score Right/Left Pronator OF Score Right/Left Pronator OL Score 123 2 2 0 0 0 0 0 0 0 0 128 3 2 1 1 1 1 1 1 2 2 132 1 1 1 0 0 0 0 0 0 0 141 1 1 1 1 0 1 0 0 0 0 145 2 2 1 1 0 1 0 0 0 0 146 2 2 1 1 0 1 0 0 0 0 147 1 1 0 1 0 1 0 0 1 1 149 1 2 0 1 0 1 0 0 0 0 152 2 2 0 0 1 0 1 0 0 0 159 2 2 1 1 0 1 0 0 1 1 160 2 2 1 1 0 1 0 0 1 1 163 1 2 1 1 0 1 0 0 0 0 169 2 2 1 1 0 1 0 0 0 0 173 1 1 0 0 0 0 0 0 0 0 176 2 2 1 1 0 1 0 0 0 0 191 2 2 1 1 0 1 0 0 0 0 193 2 2 1 1 0 1 0 0 1 1 194 2 1 1 1 0 1 0 0 0 0 196 2 2 0 1 0 1 0 0 0 0 198 2 2 1 1 0 1 0 0 0 0

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146 Appendix D (Continued): Pronator UNM ID # Right/Left Pronator RM Score Right/Left Pronator SL Score Right/Left Pronator OS Score Right/Left Pronator OF Score Right/Left Pronator OL Score 207 2 2 1 1 0 0 0 0 0 0 208 2 2 1 1 0 1 0 0 0 0 210 2 2 1 1 1 1 1 0 1 1 211 2 2 1 1 0 1 0 0 0 0 212 2 2 1 1 0 1 0 0 0 0 213 2 2 1 1 0 1 0 0 0 1 216 2 2 1 1 0 1 0 0 0 1 217 2 2 1 1 0 0 0 0 0 0 220 2 2 0 0 0 0 0 0 0 0 221 2 2 1 1 0 1 0 0 0 0 225 3 3 1 1 1 1 1 1 1 1 231 2 2 0 1 0 1 0 0 0 0 232 2 2 1 1 0 0 1 1 1 0 234 2 2 1 1 0 1 0 0 0 0 235 2 2 1 1 0 1 0 0 0 0 237 2 2 1 1 0 1 0 0 0 0 240 2 2 1 1 0 1 0 0 0 0 241 2 2 1 1 0 1 0 0 0 0 242 2 2 1 1 0 1 0 0 0 0 243 2 2 0 0 0 0 0 0 0 0

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147 Appendix D (Continued): Pronator UNM ID # Right/Left Pronator RM Score Right/Left Pronator SL Score Right/Left Pronator OS Score Right/Left Pronator OF Score Right/Left Pronator OL Score 245 2 2 1 1 0 1 0 0 0 0 246 2 2 0 1 0 1 0 1 0 0 250 3 1 1 1 0 1 1 1 2 1 252 2 2 1 1 0 1 0 0 0 0 253 2 2 1 1 0 1 0 0 0 0 254 2 2 1 1 0 0 0 0 0 0 257 1 1 0 0 0 0 0 0 0 0 259 2 2 1 1 0 1 0 0 0 0 261 1 1 0 1 0 1 0 0 0 0 262 2 2 1 0 0 0 1 0 0 0

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148 Appendix D (Continued): Triceps brachii UNM ID # Right/Left Triceps Brachii RM Score Right/Left Triceps Brachii SL Score Right/Left Triceps Brachii OS Score Right/Left Triceps Brachii OF Score Right/Left Triceps Brachii OL Score 4 2 2 1 1 0 0 0 0 0 1 6 3 3 1 1 0 0 1 1 1 2 17 2 2 1 1 0 1 0 1 1 1 29 2 2 1 1 0 0 0 0 1 1 31 2 2 1 1 0 1 0 1 1 0 35 3 3 1 1 2 2 3 2 1 1 47 2 2 1 1 0 0 0 0 0 1 48 2 2 1 1 1 0 1 0 1 1 56 2 1 1 1 1 1 1 1 1 1 63 2 2 1 1 1 1 1 1 1 1 81 2 2 1 1 2 1 2 1 0 0 88 3 3 2 2 1 2 1 2 2 2 99 3 2 1 1 1 1 2 1 1 1 110 2 2 1 1 0 0 0 0 1 2 113 1 1 1 0 2 0 2 2 0 0 114 3 2 1 1 1 0 1 0 2 2 115 2 2 2 2 0 0 0 0 3 3 117 2 2 1 1 0 0 0 0 0 0 118 2 2 1 1 0 1 0 2 0 1

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149 Appendix D (Continued): Triceps brachii UNM ID # Right/Left Triceps Brachii RM Score Right/Left Triceps Brachii SL Score Right/Left Triceps Brachii OS Score Right/Left Triceps Brachii OF Score Right/Left Triceps Brachii OL Score 123 1 2 0 1 1 2 1 2 0 0 128 2 2 1 1 0 1 0 1 1 4 132 3 3 1 1 1 1 2 1 1 1 141 3 3 3 3 1 1 1 1 4 4 145 3 3 2 2 1 0 1 0 1 1 146 3 2 1 1 1 0 2 0 1 1 147 3 3 1 1 1 1 1 1 2 1 149 2 2 1 2 1 0 1 0 0 3 152 nr 3 1 1 0 0 0 0 4 2 159 3 2 2 1 1 0 1 0 2 1 160 3 3 2 1 1 1 1 1 3 2 163 3 3 1 1 1 1 2 2 1 1 169 2 3 1 1 1 1 1 1 1 0 173 2 2 2 1 0 0 0 0 2 1 176 2 2 1 1 1 0 1 0 0 0 191 2 2 1 1 0 0 0 0 0 0 193 2 2 1 1 1 1 1 1 1 1 194 2 2 1 1 0 0 0 0 2 2 196 2 3 1 1 0 1 0 2 1 2 198 2 2 1 1 0 0 0 0 1 1

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150 Appendix D (Continued): Triceps brachii UNM ID # Right/Left Triceps Brachii RM Score Right/Left Triceps Brachii SL Score Right/Left Triceps Brachii OS Score Right/Left Triceps Brachii OF Score Right/Left Triceps Brachii OL Score 207 3 3 1 2 1 1 1 1 1 1 208 2 2 1 1 1 0 1 0 0 1 210 2 2 1 1 1 1 1 1 1 1 211 2 2 1 1 1 0 1 0 0 0 212 3 2 1 1 0 0 0 0 2 1 213 2 2 1 2 1 1 2 1 2 2 216 3 3 1 1 1 1 1 1 1 2 217 3 3 1 3 2 3 2 3 2 4 220 1 1 1 1 0 0 0 0 1 1 221 2 2 1 1 1 0 1 1 1 0 225 1 3 1 1 1 3 1 3 2 1 231 2 1 0 0 2 1 2 1 1 1 232 1 1 1 0 2 0 2 0 1 0 234 3 3 1 1 1 0 1 0 1 1 235 2 2 1 1 0 1 0 1 0 1 237 3 3 1 1 1 1 2 2 0 0 240 3 3 1 1 1 1 1 2 1 1 241 2 3 1 1 0 1 0 1 0 0 242 3 2 1 1 1 0 1 0 0 1 243 2 2 0 1 1 1 1 1 1 1

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151 Appendix D (Continued): Triceps brachii UNM ID # Right/Left Triceps Brachii RM Score Right/Left Triceps Brachii SL Score Right/Left Triceps Brachii OS Score Right/Left Triceps Brachii OF Score Right/Left Triceps Brachii OL Score 245 3 3 1 1 2 1 2 1 0 2 246 2 2 1 1 1 1 1 1 1 1 250 3 2 1 1 0 1 0 1 4 4 252 3 2 1 1 2 1 2 1 1 0 253 1 1 1 1 0 1 0 1 1 1 254 2 2 1 1 1 0 1 0 1 1 257 1 1 0 0 0 0 0 0 0 0 259 2 2 1 1 1 0 2 0 1 0 261 2 2 1 1 1 1 0 0 1 1 262 1 1 1 1 1 2 1 2 1 1

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152 Appendix D (Continued): Gluteus maximus UNM ID # Right/Left Gluteus maximus RM Score Right/Left Gluteus maximus SL Score Right/Left Gluteus maximus OS Score Right/Left Gluteus maximus OF Score Right/Left Gluteus maximus OL Score 4 3 3 1 1 1 2 2 2 1 1 6 3 3 2 1 1 0 2 2 1 1 17 2 2 1 1 0 0 0 0 0 0 29 2 3 1 1 0 1 0 1 0 1 31 3 3 1 1 2 2 2 2 1 1 35 3 3 1 1 2 2 2 2 0 1 47 3 3 1 1 1 2 1 1 0 0 48 2 2 1 1 0 0 0 0 1 1 56 3 3 1 1 3 3 3 3 1 1 63 2 2 1 1 0 0 0 0 1 1 81 3 3 1 2 1 1 2 2 1 2 88 3 3 2 1 2 2 2 2 2 1 99 3 3 2 1 1 1 2 1 2 2 110 2 2 1 1 0 0 0 0 1 1 113 3 3 1 1 2 1 3 2 1 2 114 3 3 2 2 2 2 2 2 3 2 115 2 3 1 1 0 1 0 1 0 1 117 3 3 1 1 0 0 0 0 0 0 118 2 2 1 1 0 0 0 0 0 0

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153 Appendix D (Continued): Gluteus maximus UNM ID # Right/Left Gluteus maximus RM Score Right/Left Gluteus maximus SL Score Right/Left Gluteus maximus OS Score Right/Left Gluteus maximus OF Score Right/Left Gluteus maximus OL Score 123 3 3 1 1 1 1 1 1 1 1 128 99 3 99 3 99 1 99 2 99 2 132 3 3 2 2 0 0 0 0 4 4 141 2 2 1 1 0 0 0 0 0 0 145 3 3 1 1 0 0 0 0 1 1 146 3 3 1 2 1 0 1 1 1 1 147 1 1 0 0 0 0 0 0 1 1 149 3 3 1 1 1 0 1 0 1 1 152 2 3 1 3 0 1 0 1 1 2 159 3 3 2 2 1 1 1 1 1 0 160 3 3 2 2 2 2 2 2 3 3 163 3 3 1 1 0 0 0 0 1 1 169 3 3 1 1 1 1 2 1 2 1 173 2 2 1 1 0 0 1 0 1 1 176 2 2 1 1 0 0 0 0 0 0 191 2 2 1 1 0 0 0 0 0 0 193 2 2 1 1 1 1 1 1 1 1 194 2 2 1 1 0 0 0 0 2 2 196 2 2 1 1 2 1 2 1 1 1 198 2 2 1 1 0 0 0 0 0 1

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154 Appendix D (Continued): Gluteus maximus UNM ID # Right/Left Gluteus maximus RM Score Right/Left Gluteus maximus SL Score Right/Left Gluteus maximus OS Score Right/Left Gluteus maximus OF Score Right/Left Gluteus maximus OL Score 207 3 3 1 1 0 0 0 0 1 1 208 3 3 1 1 0 0 0 0 1 1 210 3 3 1 1 0 2 0 2 0 0 211 99 3 99 2 99 3 99 3 99 2 212 2 2 1 1 0 0 0 0 0 0 213 3 3 1 1 0 0 0 0 0 0 216 3 3 1 1 2 2 2 2 0 0 217 9 9 9 9 9 9 9 9 9 9 220 3 3 1 1 2 1 2 1 1 2 221 3 3 2 2 2 2 2 3 2 2 225 9 9 9 9 9 9 9 9 9 9 231 2 2 1 1 1 1 2 2 0 0 232 2 2 0 0 0 0 0 0 1 1 234 2 2 0 0 0 0 0 0 1 1 235 3 3 1 1 3 2 3 2 0 1 237 3 3 1 1 0 0 0 0 1 0 240 3 3 2 2 2 2 2 3 1 1 241 3 3 1 1 1 0 1 0 1 1 242 3 3 1 1 0 0 0 0 1 0 243 3 3 1 1 3 3 3 3 1 0

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155 Appendix D (Continued): Gluteus maximus UNM ID # Right/Left Gluteus maximus RM Score Right/Left Gluteus maximus SL Score Right/Left Gluteus maximus OS Score Right/Left Gluteus maximus OF Score Right/Left Gluteus maximus OL Score 245 3 3 1 1 2 2 3 2 1 1 246 3 3 1 1 1 0 1 0 1 1 250 9 9 9 9 9 9 9 9 9 9 252 3 3 1 1 0 0 0 0 0 0 253 2 2 1 1 1 0 1 0 1 1 254 2 2 1 1 2 1 2 1 1 1 257 2 2 1 1 2 1 2 1 1 1 259 3 2 1 1 1 1 1 1 0 0 261 3 3 1 1 2 1 2 2 1 1 262 3 3 1 1 2 2 2 2 2 2

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156 Appendix D (Continued): Biceps femoris UNM ID # Right/Left Biceps femoris RM Score Right/Left Biceps femoris SL Score Right/Left Biceps femoris OS Score Right/Left Biceps femoris OF Score Right/Left Biceps femoris OL Score 4 2 3 1 3 0 2 0 3 1 4 6 3 3 1 1 0 0 0 0 2 1 17 2 2 1 1 0 0 0 0 1 1 29 3 3 1 3 1 0 1 0 1 4 31 3 2 2 1 0 0 0 0 1 3 35 3 3 1 1 1 0 1 0 1 4 47 3 3 1 2 1 1 1 1 2 2 48 2 3 2 3 0 0 0 0 3 4 56 2 2 1 1 1 0 1 0 2 0 63 3 3 1 3 1 0 1 0 2 4 81 99 2 99 1 99 0 99 0 99 1 88 3 2 2 1 1 1 1 1 2 0 99 3 2 3 1 1 1 1 1 4 1 110 99 3 3 3 99 0 99 0 4 4 113 3 2 3 1 1 0 1 0 4 2 114 99 99 3 99 0 99 0 99 4 99 115 99 99 3 3 0 0 0 0 4 4 117 2 2 1 1 0 0 0 0 1 1 118 2 2 3 1 0 0 0 0 4 1

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157 Appendix D (Continued): Biceps femoris UNM ID # Right/Left Biceps femoris RM Score Right/Left Biceps femoris SL Score Right/Left Biceps femoris OS Score Right/Left Biceps femoris OF Score Right/Left Biceps femoris OL Score 123 3 3 2 2 0 0 0 0 4 4 128 99 3 99 3 99 2 99 2 99 4 132 9 9 3 3 0 0 0 0 4 4 141 9 9 9 9 9 9 9 9 9 9 145 3 3 3 3 0 0 0 0 4 4 146 9 9 9 9 9 9 9 9 9 9 147 1 1 2 1 0 1 0 1 4 2 149 99 99 3 3 0 0 0 0 4 4 152 2 9 0 9 0 9 0 9 0 9 159 3 3 1 1 1 0 1 0 2 1 160 3 3 2 2 0 0 0 0 4 4 163 2 2 3 3 0 0 0 0 4 4 169 nr 3 3 2 nr 1 nr 1 4 2 173 3 3 1 1 1 0 0 0 2 2 176 2 2 1 1 0 0 0 0 1 2 191 2 2 1 1 0 0 0 0 0 0 193 3 3 1 1 1 1 1 2 1 1 194 3 3 2 2 0 0 0 0 3 3 196 2 2 2 2 1 1 1 1 2 2 198 2 2 1 1 0 0 0 0 0 0

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158 Appendix D (Continued): Biceps femoris UNM ID # Right/Left Biceps femoris RM Score Right/Left Biceps femoris SL Score Right/Left Biceps femoris OS Score Right/Left Biceps femoris OF Score Right/Left Biceps femoris OL Score 207 3 3 3 3 1 1 1 1 4 4 208 3 3 3 3 1 1 1 1 4 4 210 2 2 1 1 0 0 0 0 1 0 211 3 3 2 2 1 1 1 1 3 2 212 3 3 1 1 1 1 1 1 0 0 213 3 3 1 1 1 0 2 0 1 1 216 3 3 1 1 1 1 1 1 0 0 217 9 9 9 9 9 9 9 9 9 9 220 3 3 3 1 0 0 0 0 4 2 221 2 2 1 1 0 0 0 0 1 1 225 9 9 9 9 9 9 9 9 9 9 231 3 3 1 1 0 0 0 0 2 1 232 3 3 1 1 1 1 1 1 0 1 234 3 3 1 1 1 1 1 1 0 1 235 2 2 1 1 1 1 1 1 2 2 237 2 3 1 1 0 0 0 0 1 1 240 2 3 1 1 1 0 1 0 1 0 241 2 2 1 1 0 1 0 1 2 1 242 2 2 1 3 0 0 0 0 1 4 243 2 2 1 1 1 0 0 1 1 1

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159 Appendix D (Continued): Biceps femoris UNM ID # Right/Left Biceps femoris RM Score Right/Left Biceps femoris SL Score Right/Left Biceps femoris OS Score Right/Left Biceps femoris OF Score Right/Left Biceps femoris OL Score 245 3 3 1 1 1 2 1 2 1 1 246 3 3 1 1 0 0 0 0 1 2 250 9 9 9 9 9 9 9 9 9 9 252 3 3 1 1 0 0 0 0 2 1 253 3 3 1 1 0 0 0 0 1 1 254 3 3 1 1 0 0 0 0 1 1 257 3 3 1 1 0 0 0 0 1 1 259 2 2 1 1 0 0 1 1 0 1 261 3 3 1 1 0 0 0 0 1 1 262 1 3 0 1 0 1 0 1 1 1

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160 Appendix D (Continued): Semitendinous UNM ID # Right/Left Semitendinous RM Score Right/Left Semitendinous SL Score Right/Left Semitendinosus OS Score Right/Left Semitendinous OF Score Right/Left Semitendinous OL Score 4 1 2 0 0 0 1 0 1 1 1 6 2 3 0 0 0 0 0 0 2 2 17 2 2 1 1 0 0 0 0 1 1 29 2 2 1 1 0 0 0 0 2 2 31 2 2 1 1 1 0 0 0 1 1 35 1 1 0 1 1 0 1 0 3 4 47 2 1 1 1 2 2 2 2 2 1 48 2 2 3 3 0 0 0 0 4 4 56 2 3 1 1 0 1 0 1 1 1 63 2 2 1 1 0 0 0 0 1 1 81 2 2 1 1 2 1 2 1 1 1 88 3 2 1 1 1 1 1 1 1 0 99 3 2 3 3 1 0 1 0 4 4 110 3 3 1 1 1 1 1 1 1 2 113 2 2 1 1 0 1 0 1 2 1 114 3 99 2 99 1 99 1 99 4 99 115 2 2 3 3 0 0 0 0 4 4 117 2 2 1 1 0 0 0 0 0 0 118 2 2 1 1 0 1 0 1 2 2

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161 Appendix D (Continued): Semitendinous UNM ID # Right/Left Semitendinous RM Score Right/Left Semitendinous SL Score Right/Left Semitendinosus OS Score Right/Left Semitendinous OF Score Right/Left Semitendinous OL Score 123 1 2 0 1 0 1 0 1 1 2 128 1 1 0 0 3 0 3 0 2 2 132 9 2 3 1 0 0 0 0 4 3 141 2 2 3 3 0 0 0 0 4 4 145 3 3 1 1 0 1 0 1 1 1 146 2 2 1 1 0 0 0 0 1 1 147 2 3 1 0 1 1 1 1 2 1 149 2 2 1 1 0 0 0 0 1 1 152 2 9 1 9 0 9 0 9 2 9 159 3 3 1 2 0 1 0 1 2 2 160 2 2 1 1 1 0 1 0 2 2 163 2 2 1 1 0 0 0 0 1 1 169 2 2 1 1 0 0 0 0 2 1 173 1 3 0 0 0 2 0 2 0 2 176 2 2 1 1 0 0 0 0 1 1 191 2 2 1 1 0 0 0 0 0 0 193 2 2 1 1 1 0 2 0 1 2 194 2 2 1 1 0 0 0 0 2 2 196 2 2 1 1 0 1 0 1 1 2 198 2 2 1 1 0 0 0 0 0 0

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162 Appendix D (Continued): Semitendinous UNM ID # Right/Left Semitendinous RM Score Right/Left Semitendinous SL Score Right/Left Semitendinosus OS Score Right/Left Semitendinous OF Score Right/Left Semitendinous OL Score 207 2 3 1 1 1 1 1 1 0 1 208 2 3 1 1 1 1 1 1 0 1 210 2 3 1 1 0 0 0 0 1 1 211 3 3 3 2 1 1 1 1 2 3 212 2 2 1 1 1 1 1 1 0 0 213 2 2 1 1 0 0 0 0 1 1 216 2 2 1 1 0 1 0 1 2 2 217 9 9 9 9 9 9 9 9 9 9 220 2 2 1 1 0 0 0 0 1 1 221 3 3 1 1 0 0 0 0 2 2 225 9 9 9 9 9 9 9 9 9 9 231 3 3 1 1 2 2 2 2 1 1 232 1 1 0 0 0 0 0 0 1 1 234 1 1 0 0 0 0 0 0 1 1 235 3 3 2 1 0 1 0 2 3 2 237 3 3 3 3 1 1 2 2 1 1 240 2 3 1 1 0 1 0 1 0 1 241 3 2 1 1 1 0 1 0 1 1 242 2 2 1 1 0 0 0 0 2 1 243 1 2 1 1 0 1 0 1 3 1

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163 Appendix D (Continued): Semitendinous UNM ID # Right/Left Semitendinous RM Score Right/Left Semitendinous SL Score Right/Left Semitendinosus OS Score Right/Left Semitendinous OF Score Right/Left Semitendinous OL Score 245 1 1 0 0 0 0 0 0 1 1 246 2 2 1 1 0 1 0 2 1 1 250 9 9 9 9 9 9 9 9 9 9 252 2 2 1 1 0 0 0 0 2 2 253 2 2 1 1 0 0 0 0 1 1 254 3 3 1 1 2 1 2 1 2 2 257 3 3 1 1 2 1 2 1 2 2 259 1 1 0 1 0 1 0 0 1 1 261 2 2 1 1 1 1 1 1 1 1 262 1 1 2 1 0 0 0 0 1 1

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164 Appendix D (Continued): Vastus medialis UNM ID # Right/Left Vastus medialis RM Score Right/Left Vastus medialis SL Score Right/Left Vastus medialis OS Score Right/Left Vastus medialis OF Score Right/Left Vastus medialis OL Score 4 1 2 0 0 0 1 0 1 0 1 6 1 1 0 1 0 0 0 0 0 1 17 2 2 1 1 1 0 1 0 0 0 29 1 99 1 99 1 99 1 99 1 99 31 3 1 1 0 1 1 2 0 0 0 35 1 2 1 1 0 0 0 0 1 2 47 2 2 1 0 2 0 2 0 0 0 48 1 1 1 1 0 0 0 0 1 1 56 2 2 1 1 0 1 0 1 0 0 63 3 3 1 1 1 1 1 1 1 1 81 3 3 1 1 2 0 2 0 1 1 88 99 3 99 1 99 2 99 3 99 1 99 2 2 1 1 0 1 0 1 0 1 110 2 2 1 1 0 0 0 0 1 1 113 2 2 1 1 0 0 0 0 1 0 114 99 99 99 99 99 99 99 99 99 99 115 2 2 1 1 0 0 0 0 2 0 117 2 3 1 1 0 0 0 0 0 0 118 3 3 1 1 1 1 1 1 0 1

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165 Appendix D (Continued): Vastus medialis UNM ID # Right/Left Vastus medialis RM Score Right/Left Vastus medialis SL Score Right/Left Vastus medialis OS Score Right/Left Vastus medialis OF Score Right/Left Vastus medialis OL Score 123 1 2 0 0 0 2 0 2 0 0 128 3 3 1 1 2 2 2 2 2 2 132 3 3 1 1 1 1 1 2 2 1 141 2 2 0 0 0 0 0 0 0 0 145 3 3 1 1 0 0 0 0 1 1 146 3 3 1 1 1 2 2 2 1 1 147 1 0 1 0 0 0 0 0 1 1 149 3 2 1 1 0 0 0 0 2 1 152 99 99 99 99 99 99 99 99 99 99 159 3 3 1 1 1 1 1 1 1 1 160 3 3 1 1 2 2 3 2 1 2 163 2 2 1 1 0 0 0 0 0 0 169 2 2 1 1 0 0 0 0 0 0 173 2 3 1 1 0 1 0 1 0 0 176 2 2 1 1 0 0 0 0 0 0 191 1 1 1 1 0 0 0 0 0 0 193 3 3 1 1 0 0 0 0 1 1 194 1 2 1 1 0 0 0 0 1 0 196 3 3 1 1 1 1 2 2 1 1 198 99 2 99 0 99 0 99 0 99 0

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166 Appendix D (Continued): Vastus medialis UNM ID # Right/Left Vastus medialis RM Score Right/Left Vastus medialis SL Score Right/Left Vastus medialis OS Score Right/Left Vastus medialis OF Score Right/Left Vastus medialis OL Score 207 3 3 1 1 0 1 0 1 1 1 208 3 3 1 1 0 1 0 1 1 1 210 2 2 1 1 1 0 1 0 0 1 211 2 2 0 1 1 0 1 0 1 1 212 3 3 1 1 0 1 0 1 0 0 213 2 99 1 99 0 99 0 99 1 99 216 3 3 1 1 1 1 1 1 1 1 217 9 9 9 9 9 9 9 9 9 9 220 2 3 1 1 0 2 0 2 1 2 221 2 2 1 1 1 0 1 0 1 1 225 9 9 9 9 9 9 9 9 9 9 231 2 3 1 1 0 1 0 2 0 0 232 3 3 1 1 2 2 2 2 1 1 234 3 3 1 1 2 2 2 2 1 1 235 2 2 1 1 0 0 0 0 1 1 237 3 2 2 1 1 1 2 1 0 1 240 3 3 1 1 2 2 3 3 0 0 241 1 3 1 1 0 0 0 0 0 2 242 3 3 1 1 0 0 0 0 1 1 243 1 1 1 1 0 1 0 1 0 0

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167 Appendix D (Continued): Vastus medialis UNM ID # Right/Left Vastus medialis RM Score Right/Left Vastus medialis SL Score Right/Left Vastus medialis OS Score Right/Left Vastus medialis OF Score Right/Left Vastus medialis OL Score 245 1 2 1 1 1 1 1 1 0 0 246 2 2 1 1 0 0 0 0 0 1 250 9 9 9 9 9 9 9 9 9 9 252 1 2 1 1 0 0 0 0 0 0 253 2 2 1 1 0 0 0 0 1 1 254 3 3 1 1 0 1 0 1 1 1 257 3 3 1 1 0 1 0 1 1 1 259 1 1 0 0 0 0 0 0 0 0 261 2 2 1 1 0 0 0 0 1 1 262 2 2 1 1 1 0 1 0 1 1

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168 Appendix D (Continued): Vastus lateralis UNM ID # Right/Left Vastus lateralis RM Score Right/Left Vastus lateralis SL Score Right/Left Vastus lateralis OS Score Right/Left Vastus lateralis OF Score Right/Left Vastus lateralis OL Score 4 2 2 1 1 0 1 0 1 0 0 6 1 3 1 3 1 1 1 1 1 4 17 3 3 1 1 1 1 2 1 2 0 29 1 99 1 99 0 99 0 99 0 99 31 3 2 1 1 2 0 2 0 2 0 35 1 3 1 1 0 2 0 2 0 0 47 2 2 1 1 2 1 2 2 2 0 48 2 2 1 1 1 1 1 2 1 1 56 2 2 1 1 0 1 0 1 0 0 63 3 3 1 1 1 1 2 2 2 1 81 3 3 1 1 3 2 3 2 3 1 88 99 3 99 2 99 3 99 3 99 1 99 2 2 1 1 0 1 0 1 0 1 110 3 2 1 1 1 0 1 0 1 1 113 3 3 1 1 1 1 1 1 1 1 114 99 99 99 99 99 99 99 99 99 99 115 2 2 1 1 1 1 1 1 1 1 117 2 3 1 1 0 0 0 0 0 0 118 2 3 1 1 1 0 1 0 1 0

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169 Appendix D (Continued): Vastus lateralis UNM ID # Right/Left Vastus lateralis RM Score Right/Left Vastus lateralis SL Score Right/Left Vastus lateralis OS Score Right/Left Vastus lateralis OF Score Right/Left Vastus lateralis OL Score 123 2 2 1 0 1 1 0 1 0 0 128 3 3 1 1 3 2 3 2 3 2 132 3 3 1 1 1 1 2 1 2 2 141 2 2 0 0 0 0 0 0 0 0 145 3 3 1 1 0 1 0 1 0 1 146 3 3 2 2 2 2 2 2 2 1 147 2 2 0 1 1 0 1 1 1 1 149 3 3 1 1 0 0 0 0 0 2 152 99 99 99 99 99 99 99 99 99 99 159 3 3 1 1 1 2 2 3 2 2 160 3 3 1 1 3 2 3 2 3 2 163 2 2 1 1 0 0 0 0 0 0 169 3 2 1 1 0 0 0 0 0 0 173 3 3 1 1 1 2 1 2 1 1 176 3 2 1 1 0 0 0 0 0 0 191 2 2 1 1 0 0 0 0 0 0 193 3 3 1 1 1 2 2 2 2 1 194 1 3 1 1 0 2 0 2 0 1 196 3 3 1 2 2 2 2 2 2 0 198 99 2 99 1 99 0 99 0 99 0

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170 Appendix D (Continued): Vastus lateralis UNM ID # Right/Left Vastus lateralis RM Score Right/Left Vastus lateralis SL Score Right/Left Vastus lateralis OS Score Right/Left Vastus lateralis OF Score Right/Left Vastus lateralis OL Score 207 3 3 2 2 2 2 2 2 1 1 208 3 3 2 2 2 2 2 2 2 1 210 3 2 1 1 0 0 0 0 0 0 211 3 3 1 1 2 1 2 1 2 1 212 3 3 1 1 1 1 1 1 1 0 213 3 99 1 99 1 99 1 99 1 99 216 3 3 1 1 2 2 3 3 3 0 217 9 9 9 9 9 9 9 9 9 9 220 2 3 1 1 1 0 1 0 1 0 221 3 3 1 1 2 3 3 3 3 1 225 9 9 9 9 9 9 9 9 9 9 231 3 3 1 1 2 2 3 3 3 0 232 3 3 1 1 2 2 3 2 0 0 234 3 3 1 1 2 2 3 2 3 0 235 3 3 1 1 1 1 1 1 1 0 237 3 3 2 2 2 1 3 2 3 1 240 3 3 1 1 3 3 3 3 3 0 241 1 2 1 1 0 0 0 0 0 1 242 3 3 1 1 1 2 2 2 2 0 243 2 2 0 1 0 1 0 1 0 0

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171 Appendix D (Continued): Vastus lateralis UNM ID # Right/Left Vastus lateralis RM Score Right/Left Vastus lateralis SL Score Right/Left Vastus lateralis OS Score Right/Left Vastus lateralis OF Score Right/Left Vastus lateralis OL Score 245 1 2 0 1 1 1 1 1 1 0 246 3 3 1 1 1 1 1 1 1 0 250 9 9 9 9 9 9 9 9 9 9 252 2 99 1 99 0 99 0 99 0 99 253 3 3 1 1 1 1 1 1 1 1 254 3 3 1 1 2 1 2 1 1 1 257 3 3 1 1 2 1 2 1 2 1 259 1 1 0 0 1 1 2 2 2 0 261 3 2 1 1 0 0 0 0 0 1 262 3 3 2 2 2 2 2 2 2 0

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172 Appendix D (Continued): Soleus UNM ID # Right/Left Soleus RM Score Right/Left Soleus SL Score Right/Left Soleus OS Score Right/Left Soleus OF Score Right/Left Soleus OL Score 4 3 3 1 0 0 0 0 0 3 3 6 3 3 1 1 2 1 2 1 1 1 17 3 3 1 1 1 1 2 2 1 1 29 2 2 1 1 0 0 0 0 1 1 31 99 99 99 99 99 99 99 99 99 99 35 3 3 1 1 1 1 1 1 2 2 47 2 2 0 1 0 1 0 0 1 1 48 3 3 1 1 0 1 0 1 1 1 56 2 2 1 1 1 1 1 1 1 0 63 3 3 1 1 2 1 3 2 1 1 81 2 2 1 1 1 1 1 1 1 1 88 3 3 1 1 3 1 3 1 1 1 99 2 2 1 1 1 0 1 0 1 2 110 3 3 1 1 1 2 1 2 1 1 113 3 3 1 1 1 2 2 2 1 1 114 3 99 1 99 1 99 1 99 3 99 115 3 3 1 1 0 0 0 0 2 2 117 3 3 1 1 0 0 0 0 1 1 118 2 3 1 1 0 1 0 1 1 1

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173 Appendix D (Continued): Soleus UNM ID # Right/Left Soleus RM Score Right/Left Soleus SL Score Right/Left Soleus OS Score Right/Left Soleus OF Score Right/Left Soleus OL Score 123 1 2 0 0 1 1 1 1 0 0 128 3 3 2 1 1 1 2 1 2 1 132 3 3 2 1 1 1 2 2 1 2 141 2 2 0 0 0 0 0 0 0 0 145 3 3 1 1 1 1 1 1 1 1 146 2 2 1 1 0 0 0 0 1 1 147 1 1 0 0 1 1 1 1 1 1 149 3 3 1 2 0 0 0 0 2 2 152 3 3 1 1 1 1 1 1 1 1 159 3 3 1 1 1 1 1 1 1 2 160 3 3 1 1 1 0 1 0 3 3 163 3 3 1 1 1 0 1 0 1 1 169 3 3 1 1 0 1 0 1 1 0 173 2 3 1 1 1 2 1 3 1 1 176 2 2 1 1 0 0 0 0 1 0 191 2 2 1 1 0 0 0 0 0 0 193 2 2 1 1 0 0 0 0 1 1 194 1 2 1 1 0 1 0 1 0 1 196 3 3 1 1 1 2 2 2 1 1 198 2 2 1 1 0 0 0 0 0 0

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174 Appendix D (Continued): Soleus UNM ID # Right/Left Soleus RM Score Right/Left Soleus SL Score Right/Left Soleus OS Score Right/Left Soleus OF Score Right/Left Soleus OL Score 207 99 99 99 99 99 99 99 99 99 99 208 99 99 99 99 99 99 99 99 99 99 210 2 3 1 1 0 0 0 0 0 1 211 3 3 2 1 2 1 3 1 2 2 212 3 3 1 1 1 1 1 1 1 1 213 3 3 1 1 1 1 1 1 1 1 216 3 3 1 1 1 2 2 2 1 2 217 9 9 9 9 9 9 9 9 9 9 220 3 3 1 1 0 1 0 1 1 1 221 3 3 2 2 2 2 3 3 1 1 225 9 9 9 9 9 9 9 9 9 9 231 3 3 1 1 2 2 3 3 0 0 232 3 3 1 1 2 1 2 1 0 0 234 3 3 1 1 2 1 2 1 0 0 235 2 2 1 1 1 0 1 0 1 0 237 2 2 1 1 1 0 1 0 0 0 240 3 3 1 1 2 2 3 2 0 0 241 2 2 1 1 1 1 1 1 1 1 242 2 2 1 1 0 0 0 0 1 1 243 2 2 1 1 0 0 0 0 1 1

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175 Appendix D (Continued): Soleus UNM ID # Right/Left Soleus RM Score Right/Left Soleus SL Score Right/Left Soleus OS Score Right/Left Soleus OF Score Right/Left Soleus OL Score 245 2 2 1 0 1 1 1 1 1 1 246 2 2 1 1 1 1 1 1 0 0 250 9 9 9 9 9 9 9 9 9 9 252 2 2 1 1 0 0 0 0 0 0 253 2 2 1 1 0 0 0 0 1 1 254 3 2 2 1 3 0 3 0 4 1 257 3 2 2 1 3 0 3 0 3 1 259 1 1 0 0 1 1 1 1 0 0 261 2 2 1 1 0 0 0 0 0 0 262 2 2 1 1 0 1 0 1 0 1 RM Score Robusticity Marker Category (from Hawkey & Merbs 1995) four grades: 0=Absent; R1=Faint; R2=Moderate; R3=Strong SL Score Stress Lesion Category (from Hawkey & Merbs 1995) four grades: 0=Absent; S1=Faint;S2=Moderate;S3=Strong OS Score Ossification Category (from Hawkey & Merb s 1995) four grades: 0=Absent; OS1=Faint; OS2=Moderate; OS3=Strong OF Score Osteophytic Formation (from Mariotti 2004) four degrees: 0=Absent; 1=minimal exostosis (<1mm diameter); 2=clear exostosis (1-4mm diameter); 3=substantial exostosis(>4mm diameter); nr=trait not recordable OL Score Osteolytic Formation (from Mariotti 2004) f our degrees: 0=Absent; 1=presence of fine porosity (holes <1mm diameter); 2=diffuse poro sity (ca.1mm diameter) or area of erosion (ca. 4mm in length or diameter); 3a=several areas of erosion (ca. 4mm in length or diameter) or 3b=at least one extensive and de ep osteolytic area (>4mm in length or diameter) and ; nr=trait not recordable 3a CODED AS 3; 3b CODED AS 4 0/nr used to grade features which are physi cally absent or unavailable for analysis CODED AS 99 nr used to grade features which ar e obscured by lytic-like activity CODED AS 9 path/fx/mod Pathological/fracture/modification