Vision-Language Models for Ergonomic Assessment of Manual Lifting Tasks: Estimating Horizontal and Vertical Hand Distances from RGB Video

Manual lifting tasks are a major contributor to work-related musculoskeletal disorders, and effective ergonomic risk assessment is essential for quantifying physical exposure and informing ergonomic interventions. The Revised NIOSH Lifting Equation (RNLE) is a widely used ergonomic risk assessment tool for lifting tasks that relies on six task variables, including horizontal (H) and vertical (V) hand distances; such distances are typically obtained through manual measurement or specialized sensing systems and are difficult to use in real-world environments. We evaluated the feasibility of using innovative vision-language models (VLMs) to non-invasively estimate H and V from RGB video streams. Two multi-stage VLM-based pipelines were developed: a text-guided detection-only pipeline and a detection-plus-segmentation pipeline. Both pipelines used text-guided localization of task-relevant regions of interest, visual feature extraction from those regions, and transformer-based temporal regression to estimate H and V at the start and end of a lift. For a range of lifting tasks, estimation performance was evaluated using leave-one-subject-out validation across the two pipelines and seven camera view conditions. Results varied significantly across pipelines and camera view conditions, with the segmentation-based, multi-view pipeline consistently yielding the smallest errors, achieving mean absolute errors of approximately 6-8 cm when estimating H and 5-8 cm when estimating V. Across pipelines and camera view configurations, pixel-level segmentation reduced estimation error by approximately 20-30% for H and 35-40% for V relative to the detection-only pipeline. These findings support the feasibility of VLM-based pipelines for video-based estimation of RNLE distance parameters.