51
|
Abstract
Advancing the knowledge of the biomechanics of the human body is essential to improve the clinical decision-makings of musculoskeletal disorders in the framework of in silico medicine. An impressive number of research projects focused on the development of rigid-body musculoskeletal models have been conducted over the world thanks to the new research directives. However, the application of these models in clinical practices remains a challenging issue. The objective of this review paper was to present the most current rigid-body musculoskeletal models of the human body systems and to analyze their trends and weaknesses for clinical applications. Then, recommendations were proposed for future researches toward fully clinical decision support. A systematic review process was performed. Well-selected studies related to the most current rigid-body 3D musculoskeletal models for each body system component (jaw, cervical spine, upper limbs, lumbar spine, and lower limbs) were summarized and explored. Trends in rigid musculoskeletal modeling are highlighted as personalization, new imaging techniques for specific joint kinematics, and computational efficiency. Weaknesses are highlighted as modeling assumptions, use of generic model, lack of modeling consensus, model validation, and parameter and model uncertainties. Future directions related to joint and muscle modeling, neuro-musculoskeletal modeling, model validation, data and model uncertainty quantification are recommended.
Collapse
Affiliation(s)
- Tien Tuan Dao
- Sorbonne University, Université de technologie de Compiègne, CNRS, UMR 7338 Biomechanics and Bioengineering, BP 20529, 60205 Compiègne cedex, France
| |
Collapse
|
52
|
Bassani T, Ottardi C, Costa F, Brayda-Bruno M, Wilke HJ, Galbusera F. Semiautomated 3D Spine Reconstruction from Biplanar Radiographic Images: Prediction of Intervertebral Loading in Scoliotic Subjects. Front Bioeng Biotechnol 2017; 5:1. [PMID: 28164082 PMCID: PMC5247473 DOI: 10.3389/fbioe.2017.00001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Accepted: 01/04/2017] [Indexed: 11/13/2022] Open
Abstract
The present study proposes a semiautomatic software approach to reconstruct 3D subject-specific musculoskeletal model of thoracolumbar spine from radiographic digitized images acquired with EOS system. The approach is applied to evaluate the intervertebral loads in 38 standing adolescents with mild idiopathic scoliosis. For each vertebra, a set of landmarks was manually identified on radiographic images. The landmark coordinates were processed to calculate the following vertebral geometrical properties in the 3D space (i) location (ii) dimensions; and (iii) rotations. Spherical joints simulated disks, ligaments, and facet joints. Body weight distribution, muscles forces, and insertion points were placed according to physiological-anatomical values. Inverse static analysis, calculating joints' reactions in maintaining assigned spine configuration, was performed with AnyBody software. Reaction forces were computed to quantify intervertebral loads, and correlation with the patient anatomical parameters was then checked. Preliminary validation was performed comparing the model outcomes with that obtained from other authors in previous modeling works and from in vivo measurements. The comparison with previous modeling works and in vivo studies partially fulfilled the preliminary validation purpose. However, minor incongruities were pointed out that need further investigations. The subjects' intervertebral loads were found significantly correlated with the anatomical parameters in the sagittal and axial planes. Despite preliminary encouraging results that support model suitability, future investigations to consolidate the proposed approach are necessary. Nonetheless, the present method appears to be a promising tool that once fully validated could allow the subject-specific non-invasive evaluation of a deformed spine, providing supplementary information to the routine clinical examination and surgical intervention planning.
Collapse
Affiliation(s)
- Tito Bassani
- IRCCS Istituto Ortopedico Galeazzi , Milan , Italy
| | - Claudia Ottardi
- Laboratory of Biological Structure Mechanics, Department of Chemistry, Materials and Chemical Engineering 'Giulio Natta', Politecnico di Milano , Milan , Italy
| | - Francesco Costa
- Department of Neurosurgery, Humanitas Clinical and Research Center , Rozzano , Italy
| | | | - Hans-Joachim Wilke
- Institute of Orthopaedic Research and Biomechanics, Centre for Trauma Research Ulm (ZTF), Ulm University , Ulm , Germany
| | | |
Collapse
|
53
|
Alkalay RN, Harrigan TP. Mechanical assessment of the effects of metastatic lytic defect on the structural response of human thoracolumbar spine. J Orthop Res 2016; 34:1808-1819. [PMID: 26748564 DOI: 10.1002/jor.23154] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 12/29/2015] [Indexed: 02/04/2023]
Abstract
To investigate the effects of a clinical lytic defect on the structural response of human thoracolumbar functional spinal unit. A novel CT-compatible mechanical test system was used to image the deformation of a T12-L1 motion segment and measure the change in strain response under compressive loads ranging from 50 to 750 N. A lytic lesion (LM) with cortex involvement (33% by volume) was introduced to the upper vertebral body and the CT experiments were repeated. Finite element models, established from the CT volumes, were used to investigate the defect's effects on the structural response and the state of principal and shear stresses within the affected and adjacent vertebrae. The lytic lesion resulted in severe loss of the vertebral structural competence, resulting in significant, non-linear, and asymmetric increase in the experimentally measured strains and computed stresses within both vertebrae (p < 0.01). At the cortex, the tensile strains were significantly increased, while compressive strains significantly decreased, (p < 0.05). Both the vertebral bone and cortex regions adjacent to the defect showed significant increase in computed compressive, tensile, and shear stresses (p < 0.01). Changes in stress and strain distribution within the affected and adjacent vertebral bone and the experimentally observed bulging and buckling of the vertebral cortices suggested that initiation of catastrophic vertebral failure may occur under load magnitudes encountered in daily living. Although the effect of LM on the global deformation of the spine was well-predicted, our results show that FE predictions of local strain changes must be carefully assessed for clinical relevance. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1808-1819, 2016.
Collapse
Affiliation(s)
- Ron N Alkalay
- Center for Advanced Orthopedic Studies, Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue, Boston, Massachusetts, 02215.
| | - Timothy P Harrigan
- Applied Physics Laboratory, Johns Hopkins University, 11100 Johns Hopkins Road Laurel, Maryland, 20723
| |
Collapse
|
54
|
Ignasiak D, Ferguson SJ, Arjmand N. A rigid thorax assumption affects model loading predictions at the upper but not lower lumbar levels. J Biomech 2016; 49:3074-3078. [DOI: 10.1016/j.jbiomech.2016.07.006] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Revised: 07/03/2016] [Accepted: 07/08/2016] [Indexed: 10/21/2022]
|
55
|
Dao TT. Enhanced Musculoskeletal Modeling for Prediction of Intervertebral Disc Stress Within Annulus Fibrosus and Nucleus Pulposus Regions During Flexion Movement. J Med Biol Eng 2016. [DOI: 10.1007/s40846-016-0156-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
56
|
Role of muscle damage on loading at the level adjacent to a lumbar spine fusion: a biomechanical analysis. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 25:2929-37. [DOI: 10.1007/s00586-016-4686-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Revised: 04/08/2016] [Accepted: 06/29/2016] [Indexed: 10/21/2022]
|
57
|
Malakoutian M, Street J, Wilke HJ, Stavness I, Fels S, Oxland T. A musculoskeletal model of the lumbar spine using ArtiSynth – development and validation. COMPUTER METHODS IN BIOMECHANICS AND BIOMEDICAL ENGINEERING-IMAGING AND VISUALIZATION 2016. [DOI: 10.1080/21681163.2016.1187087] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Masoud Malakoutian
- Department of Mechanical Engineering, University of British Columbia, Vancouver, Canada
| | - John Street
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| | - Hans-Joachim Wilke
- Institute of Orthopaedic Research and Biomechanics, University of Ulm, Ulm, Germany
| | - Ian Stavness
- Department of Computer Science, University of Saskatchewan, Saskatoon, Canada
| | - Sidney Fels
- Department of Electrical and Computer Engineering, University of British Columbia, Vancouver, Canada
| | - Thomas Oxland
- Department of Mechanical Engineering, University of British Columbia, Vancouver, Canada
- Department of Orthopaedics, University of British Columbia, Vancouver, Canada
| |
Collapse
|
58
|
Meng X, Bruno AG, Cheng B, Wang W, Bouxsein ML, Anderson DE. Incorporating Six Degree-of-Freedom Intervertebral Joint Stiffness in a Lumbar Spine Musculoskeletal Model-Method and Performance in Flexed Postures. J Biomech Eng 2016; 137:101008. [PMID: 26299207 DOI: 10.1115/1.4031417] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Indexed: 11/08/2022]
Abstract
Intervertebral translations and rotations are likely dependent on intervertebral stiffness properties. The objective of this study was to incorporate realistic intervertebral stiffnesses in a musculoskeletal model of the lumbar spine using a novel force-dependent kinematics approach, and examine the effects on vertebral compressive loading and intervertebral motions. Predicted vertebral loading and intervertebral motions were compared to previously reported in vivo measurements. Intervertebral joint reaction forces and motions were strongly affected by flexion stiffness, as well as force-motion coupling of the intervertebral stiffness. Better understanding of intervertebral stiffness and force-motion coupling could improve musculoskeletal modeling, implant design, and surgical planning.
Collapse
|
59
|
Subject-specific biomechanics of trunk: musculoskeletal scaling, internal loads and intradiscal pressure estimation. Biomech Model Mechanobiol 2016; 15:1699-1712. [DOI: 10.1007/s10237-016-0792-3] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 04/25/2016] [Indexed: 10/21/2022]
|
60
|
Sensitivity of lumbar spine loading to anatomical parameters. J Biomech 2016; 49:953-958. [DOI: 10.1016/j.jbiomech.2015.11.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 10/26/2015] [Accepted: 11/07/2015] [Indexed: 02/01/2023]
|
61
|
Arshad R, Zander T, Dreischarf M, Schmidt H. Influence of lumbar spine rhythms and intra-abdominal pressure on spinal loads and trunk muscle forces during upper body inclination. Med Eng Phys 2016; 38:333-8. [DOI: 10.1016/j.medengphy.2016.01.013] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Revised: 01/19/2016] [Accepted: 01/31/2016] [Indexed: 10/22/2022]
|
62
|
Thoracolumbar spine model with articulated ribcage for the prediction of dynamic spinal loading. J Biomech 2016; 49:959-966. [DOI: 10.1016/j.jbiomech.2015.10.010] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 10/09/2015] [Accepted: 10/10/2015] [Indexed: 11/18/2022]
|
63
|
Putzer M, Auer S, Malpica W, Suess F, Dendorfer S. A numerical study to determine the effect of ligament stiffness on kinematics of the lumbar spine during flexion. BMC Musculoskelet Disord 2016; 17:95. [PMID: 26905410 PMCID: PMC4763426 DOI: 10.1186/s12891-016-0942-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Accepted: 02/10/2016] [Indexed: 11/16/2022] Open
Abstract
Background There is a wide range of mechanical properties of spinal ligaments documented in literature. Due to the fact that ligaments contribute in stabilizing the spine by limiting excessive intersegmental motion, those properties are of particular interest for the implementation in musculoskeletal models. The aim of this study was to investigate the effect of varying ligament stiffness on the kinematic behaviour of the lumbar spine. Methods A musculoskeletal model with a detailed lumbar spine was modified according to fluoroscopic recordings and corresponding data files of three different subjects. For flexion, inverse dynamics analysis with a variation of the ligament stiffness matrix were conducted. The influence of several degrees of ligament stiffness on the lumbar spine model were investigated by tracking ligament forces, disc forces and resulting moments generated by the ligaments. Additionally, the kinematics of the motion segments were evaluated. Results An increase of ligament stiffness resulted in an increase of ligament and disc forces, whereas the relative change of disc force increased at a higher rate at the L4/L5 level (19 %) than at the L3/L4 (10 %) level in a fully flexed posture. The same behaviour applied to measured moments with 67 % and 45 %. As a consequence, the motion deflected to the lower levels of the lumbar spine and the lower discs had to resist an increase in loading. Conclusions Higher values of ligament stiffness over all lumbar levels could lead to a shift of the loading and the motion between segments to the lower lumbar levels. This could lead to an increased risk for the lower lumbar parts.
Collapse
Affiliation(s)
- Michael Putzer
- Laboratory of Biomechanics, Ostbayerische Technische Hochschule Regensburg, Josef-Engert-Straße 9, Regensburg, 93053, Germany.,Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Josef-Engert-Straße 9, Regensburg, 93053, Germany
| | - Stefan Auer
- Laboratory of Biomechanics, Ostbayerische Technische Hochschule Regensburg, Josef-Engert-Straße 9, Regensburg, 93053, Germany.,Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Josef-Engert-Straße 9, Regensburg, 93053, Germany
| | - William Malpica
- Ortho Kinematics, 110 Wild Basin Rd., Suite 250, Austin, 78746, TX, USA
| | - Franz Suess
- Laboratory of Biomechanics, Ostbayerische Technische Hochschule Regensburg, Josef-Engert-Straße 9, Regensburg, 93053, Germany.,Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Josef-Engert-Straße 9, Regensburg, 93053, Germany
| | - Sebastian Dendorfer
- Laboratory of Biomechanics, Ostbayerische Technische Hochschule Regensburg, Josef-Engert-Straße 9, Regensburg, 93053, Germany. .,Regensburg Center of Biomedical Engineering, OTH and University Regensburg, Josef-Engert-Straße 9, Regensburg, 93053, Germany.
| |
Collapse
|
64
|
Oxland TR. Fundamental biomechanics of the spine--What we have learned in the past 25 years and future directions. J Biomech 2015; 49:817-832. [PMID: 26706717 DOI: 10.1016/j.jbiomech.2015.10.035] [Citation(s) in RCA: 77] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2015] [Revised: 10/10/2015] [Accepted: 10/23/2015] [Indexed: 12/20/2022]
Abstract
Since the publication of the 2nd edition of White and Panjabi׳s textbook, Clinical Biomechanics of the Spine in 1990, there has been considerable research on the biomechanics of the spine. The focus of this manuscript will be to review what we have learned in regards to the fundamentals of spine biomechanics. Topics addressed include the whole spine, the functional spinal unit, and the individual components of the spine (e.g. vertebra, intervertebral disc, spinal ligaments). In these broad categories, our understanding in 1990 is reviewed and the important knowledge or understanding gained through the subsequent 25 years of research is highlighted. Areas where our knowledge is lacking helps to identify promising topics for future research. In this manuscript, as in the White and Panjabi textbook, the emphasis is on experimental research using human material, either in vivo or in vitro. The insights gained from mathematical models and animal experimentation are included where other data are not available. This review is intended to celebrate the substantial gains that have been made in the field over these past 25 years and also to identify future research directions.
Collapse
Affiliation(s)
- Thomas R Oxland
- Departments of Orthopaedics and Mechanical Engineering, University of British Columbia, Canada; International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Canada.
| |
Collapse
|
65
|
Abstract
The application of mechanical principles to problems of the spine dates to antiquity. Significant developments related to spinal anatomy and biomechanical behaviour made by Renaissance and post-Renaissance scholars through the end of the 19th century laid a strong foundation for the developments since that time. The objective of this article is to provide a historical overview of spine biomechanics with a focus on the developments in the 20th century. The topics of spine loading, spinal posture and stability, spinal kinematics, spinal injury, and surgical strategies were reviewed.
Collapse
Affiliation(s)
- T R Oxland
- Departments of Orthopaedics and Mechanical Engineering, University of British Columbia, Vancouver, Canada.
- International Collaboration on Repair Discoveries (ICORD), University of British Columbia, Room 5460-818 West 10th Ave., V5Z 1M9, Vancouver, BC, Canada.
| |
Collapse
|
66
|
Apportionment of lumbar L2–S1 rotation across individual motion segments during a dynamic lifting task. J Biomech 2015; 48:3709-15. [DOI: 10.1016/j.jbiomech.2015.08.022] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Revised: 08/12/2015] [Accepted: 08/18/2015] [Indexed: 11/17/2022]
|
67
|
Khurelbaatar T, Kim K, Hyuk Kim Y. A Cervico-Thoraco-Lumbar Multibody Dynamic Model for the Estimation of Joint Loads and Muscle Forces. J Biomech Eng 2015; 137:111001. [DOI: 10.1115/1.4031351] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2014] [Indexed: 11/08/2022]
Abstract
Computational musculoskeletal models have been developed to predict mechanical joint loads on the human spine, such as the forces and moments applied to vertebral and facet joints and the forces that act on ligaments and muscles because of difficulties in the direct measurement of joint loads. However, many whole-spine models lack certain elements. For example, the detailed facet joints in the cervical region or the whole spine region may not be implemented. In this study, a detailed cervico-thoraco-lumbar multibody musculoskeletal model with all major ligaments, separated structures of facet contact and intervertebral disk joints, and the rib cage was developed. The model was validated by comparing the intersegmental rotations, ligament tensile forces, facet joint contact forces, compressive and shear forces on disks, and muscle forces were to those reported in previous experimental and computational studies both by region (cervical, thoracic, or lumbar regions) and for the whole model. The comparisons demonstrated that our whole spine model is consistent with in vitro and in vivo experimental studies and with computational studies. The model developed in this study can be used in further studies to better understand spine structures and injury mechanisms of spinal disorders.
Collapse
Affiliation(s)
| | - Kyungsoo Kim
- Department of Applied Mathematics, Kyung Hee University, Yongin 446-701, Korea e-mail:
| | - Yoon Hyuk Kim
- Department of Mechanical Engineering, Kyung Hee University, Yongin 446-701, Korea e-mail:
| |
Collapse
|
68
|
Bruno AG, Bouxsein ML, Anderson DE. Development and Validation of a Musculoskeletal Model of the Fully Articulated Thoracolumbar Spine and Rib Cage. J Biomech Eng 2015; 137:081003. [PMID: 25901907 DOI: 10.1115/1.4030408] [Citation(s) in RCA: 109] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Indexed: 11/08/2022]
Abstract
We developed and validated a fully articulated model of the thoracolumbar spine in opensim that includes the individual vertebrae, ribs, and sternum. To ensure trunk muscles in the model accurately represent muscles in vivo, we used a novel approach to adjust muscle cross-sectional area (CSA) and position using computed tomography (CT) scans of the trunk sampled from a community-based cohort. Model predictions of vertebral compressive loading and trunk muscle tension were highly correlated to previous in vivo measures of intradiscal pressure (IDP), vertebral loading from telemeterized implants and trunk muscle myoelectric activity recorded by electromyography (EMG).
Collapse
|
69
|
Senteler M, Weisse B, Rothenfluh DA, Snedeker JG. Intervertebral reaction force prediction using an enhanced assembly of OpenSim models. Comput Methods Biomech Biomed Engin 2015; 19:538-48. [DOI: 10.1080/10255842.2015.1043906] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
70
|
Dao TT, Pouletaut P, Charleux F, Lazáry Á, Eltes P, Varga PP, Ho Ba Tho MC. Multimodal medical imaging (CT and dynamic MRI) data and computer-graphics multi-physical model for the estimation of patient specific lumbar spine muscle forces. DATA KNOWL ENG 2015. [DOI: 10.1016/j.datak.2015.04.001] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
71
|
Cristofolini L. In vitro evidence of the structural optimization of the human skeletal bones. J Biomech 2015; 48:787-96. [DOI: 10.1016/j.jbiomech.2014.12.010] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2014] [Indexed: 11/17/2022]
|
72
|
Dreischarf M, Albiol L, Zander T, Arshad R, Graichen F, Bergmann G, Schmidt H, Rohlmann A. In vivo implant forces acting on a vertebral body replacement during upper body flexion. J Biomech 2015; 48:560-565. [DOI: 10.1016/j.jbiomech.2015.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Revised: 01/09/2015] [Accepted: 01/13/2015] [Indexed: 10/24/2022]
|
73
|
HAN KAPSOO, YU CHANGHO, KO MYOUNGHWAN, KWON TAEKYU. ANALYSIS OF THE EFFECTS OF SPINE STABILIZATION EXERCISES USING A WHOLE BODY TILT DEVICE ON MUSCLE FORCES IN THE SPINE. J MECH MED BIOL 2014. [DOI: 10.1142/s021951941440003x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The objective of the study was to investigate the effects of 3D stabilization exercises using a whole body tilt device on forces in the trunk, such as individual muscle forces and activation patterns, maximum muscle activities and spine loads. For this sake, a musculoskeletal (MS) model of the whole body was developed, and an inverse dynamics analysis was performed to predict the forces on the spine. An EMG measurement experiment was conducted to validate the muscle forces and activation patterns. The MS model was rotated and tilted in eight different directions: anterior (A), posterior (P), anterior right (AR), posterior right (PR), anterior left (AL), posterior left (PL), right (R) and left (L), replicating the directions of the 3D spine balance exercise device, as performed in the experiment. The anterior directions of the tilt primarily induced the activation of long and superficial back muscles and the posterior directions activated the front muscles. However, deep muscles, such as short muscles and multifidi, were activated in all directions of the tilt. The resultant joint forces in the right and left directions of the tilt were the least among the directions, but higher muscle activations and more diverse muscle recruitments than other positions were observed. Therefore, these directions of tilt may be suitable for the elderly and rehabilitation patients who require muscle strengthening with less spinal loads. In the present investigation, it was shown that 3D stabilization exercises could provide considerable muscle exercise effects with a minimum perturbation of structure. The results of this study can be used to provide safety guidelines for muscle exercises using this type of tilting device. Therefore, the proposed direction of tilt can be used to strengthen targeted muscles, depending on the patients' muscular condition.
Collapse
Affiliation(s)
- KAP-SOO HAN
- Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - CHANG HO YU
- Division of Biomedical Engineering, Chonbuk National University, Jeonju, Republic of Korea
| | - MYOUNG-HWAN KO
- Department of Physical Medicine and Rehabilitation, Chonbuk National University Medical School, Jeonju, Republic of Korea
| | - TAE KYU KWON
- Division of Biomedical Engineering, Chonbuk National University, Jeonju, Republic of Korea
| |
Collapse
|
74
|
Zhu R, Rohlmann A. Discrepancies in anthropometric parameters between different models affect intervertebral rotations when loading finite element models with muscle forces from inverse static analyses. BIOMED ENG-BIOMED TE 2014; 59:197-202. [PMID: 24515995 DOI: 10.1515/bmt-2013-0121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 01/13/2014] [Indexed: 11/15/2022]
Abstract
In only a few published finite element (FE) simulations have muscle forces been applied to the spine. Recently, muscle forces determined using an inverse static (IS) model of the spine were transferred to a spinal FE model, and the effect of methodical parameters was investigated. However, the sensitivity of anthropometric differences between FE and IS models, such as body height and spinal orientation, was not considered. The aim of this sensitivity study was to determine the influence of those differences on the intervertebral rotations (IVRs) following the transfer of muscle forces from an IS model to a FE model. Muscle forces were estimated for 20° flexion and 10° extension of the upper body using an inverse static musculoskeletal model. These forces were subsequently transferred to a nonlinear FE model of the spino-pelvic complex, which includes 243 muscle fascicles. Deviations of body height (±10 cm), spinal orientation in the sagittal plane (±10°), and body weight (±10 kg) between both models were intentionally generated, and their influences on IVRs were determined. The changes in each factor relative to their corresponding reference value of the IS model were calculated. Deviations in body height, spinal orientation, and body weight resulted in maximum changes in the IVR of 19.2%, 26% and 4.2%, respectively, relative to T12-S1 IVR. When transferring muscle forces from an IS to a FE model, it is crucial that both models have the same spinal orientation and height. Additionally, the body weight should be equal in both models.
Collapse
|
75
|
Aiyangar AK, Zheng L, Tashman S, Anderst WJ, Zhang X. Capturing Three-Dimensional In Vivo Lumbar Intervertebral Joint Kinematics Using Dynamic Stereo-X-Ray Imaging. J Biomech Eng 2013; 136:011004. [DOI: 10.1115/1.4025793] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Indexed: 11/08/2022]
Abstract
Availability of accurate three-dimensional (3D) kinematics of lumbar vertebrae is necessary to understand normal and pathological biomechanics of the lumbar spine. Due to the technical challenges of imaging the lumbar spine motion in vivo, it has been difficult to obtain comprehensive, 3D lumbar kinematics during dynamic functional tasks. The present study demonstrates a recently developed technique to acquire true 3D lumbar vertebral kinematics, in vivo, during a functional load-lifting task. The technique uses a high-speed dynamic stereo-radiography (DSX) system coupled with a volumetric model-based bone tracking procedure. Eight asymptomatic male participants performed weight-lifting tasks, while dynamic X-ray images of their lumbar spines were acquired at 30 fps. A custom-designed radiation attenuator reduced the radiation white-out effect and enhanced the image quality. High resolution CT scans of participants' lumbar spines were obtained to create 3D bone models, which were used to track the X-ray images via a volumetric bone tracking procedure. Continuous 3D intervertebral kinematics from the second lumbar vertebra (L2) to the sacrum (S1) were derived. Results revealed motions occurring simultaneously in all the segments. Differences in contributions to overall lumbar motion from individual segments, particularly L2–L3, L3–L4, and L4–L5, were not statistically significant. However, a reduced contribution from the L5–S1 segment was observed. Segmental extension was nominally linear in the middle range (20%–80%) of motion during the lifting task, but exhibited nonlinear behavior at the beginning and end of the motion. L5–S1 extension exhibited the greatest nonlinearity and variability across participants. Substantial AP translations occurred in all segments (5.0 ± 0.3 mm) and exhibited more scatter and deviation from a nominally linear path compared to segmental extension. Maximum out-of-plane rotations (<1.91 deg) and translations (<0.94 mm) were small compared to the dominant motion in the sagittal plane. The demonstrated success in capturing continuous 3D in vivo lumbar intervertebral kinematics during functional tasks affords the possibility to create a baseline data set for evaluating the lumbar spinal function. The technique can be used to address the gaps in knowledge of lumbar kinematics, to improve the accuracy of the kinematic input into biomechanical models, and to support development of new disk replacement designs more closely replicating the natural lumbar biomechanics.
Collapse
Affiliation(s)
- Ameet K. Aiyangar
- EMPA (Swiss Federal Laboratories for Materials Science and Research), Mechanical Systems Engineering (Lab 304), Ueberlandstrasse 129, Duebendorf 8400, Switzerland
- Department of Orthopaedic Surgery, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15203 e-mail:
| | - Liying Zheng
- Department of Orthopaedic Surgery, Musculoskeletal Modeling Laboratory, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15203 e-mail:
| | - Scott Tashman
- Department of Orthopaedic Surgery, Department of Bioengineering, Orthopaedic Biodynamics Laboratory, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15203 e-mail:
| | - William J. Anderst
- Department of Orthopaedic Surgery, Orthopaedic Biodynamics Laboratory, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15203 e-mail:
| | - Xudong Zhang
- Department of Orthopaedic Surgery, Department of Bioengineering, Department of Mechanical Engineering and Materials Science, Musculoskeletal Modeling Laboratory, University of Pittsburgh, 3820 South Water Street, Pittsburgh, PA 15203 e-mail:
| |
Collapse
|
76
|
Computational Biomechanical Modeling of Scoliotic Spine: Challenges and Opportunities. Spine Deform 2013; 1:401-411. [PMID: 27927365 DOI: 10.1016/j.jspd.2013.07.009] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 07/24/2013] [Indexed: 11/21/2022]
Abstract
BACKGROUND Biomechanical computer models of the spine have important roles in the treatment and correction of scoliosis by providing predictive information for surgeons and other clinicians. OBJECTIVES This article reviews computational models of intact and scoliotic spine and its components; vertebra, intervertebral disc, ligament, facet joints, and muscle. Several spine models, developed using multi-body modelling and finite element modelling schemes, and their pros and cons are discussed. CONCLUSIONS The review reveals that scoliosis modelling is performed for 3 main applications: 1) brace simulation; 2) analysis of surgical correction technique; and 3) patient positioning before surgical instrumentation. The models provide predictive information for a priori choice of brace configurations and mechanically effective surgical correction techniques and the expected degree of correction. However, they have many shortcomings: for instance, they do not fully reproduce the active behaviour of the spine and the models' properties are not personalized.
Collapse
|
77
|
Cristofolini L, Brandolini N, Danesi V, Juszczyk MM, Erani P, Viceconti M. Strain distribution in the lumbar vertebrae under different loading configurations. Spine J 2013; 13:1281-92. [PMID: 23958297 DOI: 10.1016/j.spinee.2013.06.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2012] [Revised: 03/01/2013] [Accepted: 06/01/2013] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The stress/strain distribution in the human vertebrae has seldom been measured, and only for a limited number of loading scenarios, at few locations on the bone surface. PURPOSE This in vitro study aimed at measuring how strain varies on the surface of the lumbar vertebral body and how such strain pattern depends on the loading conditions. METHODS Eight cadaveric specimens were instrumented with eight triaxial strain gauges each to measure the magnitude and direction of principal strains in the vertebral body. Each vertebra was tested in a three adjacent vertebrae segment fashion. The loading configurations included a compressive force aligned with the vertebral body but also tilted (15°) in each direction in the frontal and sagittal planes, a traction force, and torsion (both directions). Each loading configuration was tested six times on each specimen. RESULTS The strain magnitude varied significantly between strain measurement locations. The strain distribution varied significantly when different loading conditions were applied (compression vs. torsion vs. traction). The strain distribution when the compressive force was tilted by 15° was also significantly different from the axial compression. Strains were minimal when the compressive force was applied coaxial with the vertebral body, compared with all other loading configurations. Also, strain was significantly more uniform for the axial compression, compared with all other loading configurations. Principal strains were aligned within 19° to the axis of the vertebral body for axial-compression and axial-traction. Conversely, when the applied force was tilted by 15°, the direction of principal strain varied by a much larger angle (15° to 28°). CONCLUSIONS This is the first time, to our knowledge, that the strain distribution in the vertebral body is measured for such a variety of loading configurations and a large number of strain sensors. The present findings suggest that the structure of the vertebral body is optimized to sustain compressive forces, whereas even a small tilt angle makes the vertebral structure work under suboptimal conditions.
Collapse
Affiliation(s)
- Luca Cristofolini
- Laboratory for Medical Technology, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136 Bologna, Italy; Department of Industrial Engineering, School of Engineering and Architecture, University of Bologna, Viale Risorgimento 2, 40136 Bologna, Italy.
| | | | | | | | | | | |
Collapse
|
78
|
Han KS, Rohlmann A, Zander T, Taylor WR. Lumbar spinal loads vary with body height and weight. Med Eng Phys 2013; 35:969-77. [DOI: 10.1016/j.medengphy.2012.09.009] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Revised: 08/24/2012] [Accepted: 09/13/2012] [Indexed: 11/25/2022]
|
79
|
Neidlinger-Wilke C, Galbusera F, Pratsinis H, Mavrogonatou E, Mietsch A, Kletsas D, Wilke HJ. Mechanical loading of the intervertebral disc: from the macroscopic to the cellular level. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2013; 23 Suppl 3:S333-43. [DOI: 10.1007/s00586-013-2855-9] [Citation(s) in RCA: 97] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2012] [Revised: 05/10/2013] [Accepted: 06/03/2013] [Indexed: 12/24/2022]
|
80
|
Zhu R, Zander T, Dreischarf M, Duda GN, Rohlmann A, Schmidt H. Considerations when loading spinal finite element models with predicted muscle forces from inverse static analyses. J Biomech 2013; 46:1376-8. [DOI: 10.1016/j.jbiomech.2013.03.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2012] [Revised: 03/01/2013] [Accepted: 03/05/2013] [Indexed: 10/27/2022]
|
81
|
Han KS, Kim K, Park WM, Lim DS, Kim YH. Effect of centers of rotation on spinal loads and muscle forces in total disk replacement of lumbar spine. Proc Inst Mech Eng H 2013; 227:543-50. [DOI: 10.1177/0954411912474742] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The placement of artificial disks can alter the center of rotation and kinematic pattern; therefore, forces in the spine during the motion will be affected as a result. The relationship between the location of joint center of artificial disks and forces in the spinal components is not investigated. A musculoskeletal model of the spine was developed, and three location cases of center of rotation were investigated varying 5 mm anteriorly and posteriorly from the default center. Resultant joint forces, ligament forces, facet forces, and muscle forces for each case were predicted during sagittal motion. No considerable difference was observed for joint force (maximum 14%). Anterior shift of center of rotation induced the most ligament forces (200 N) and facet forces (130 N) among the three cases. Posterior and anterior shifts of centers of rotation from the default location caused considerable changes in muscle forces, respectively: 108% and 70% of increase in multifidi muscle and 157% and 187% of increase in short segmental muscle. This study showed that the centers of rotation due to the design and the surgical placement of artificial disk can affect the kinetic results in the spine.
Collapse
Affiliation(s)
- Kap-Soo Han
- Department of Mechanical Engineering, College of Engineering, Kyung Hee University, Yongin-si, Republic of Korea
| | - Kyungsoo Kim
- Department of Applied Mathematics, College of Applied Science, Kyung Hee University, Yongin-si, Republic of Korea
| | - Won Man Park
- Department of Mechanical Engineering, College of Engineering, Kyung Hee University, Yongin-si, Republic of Korea
| | - Dae Seop Lim
- Department of Mechanical Engineering, College of Engineering, Kyung Hee University, Yongin-si, Republic of Korea
| | - Yoon Hyuk Kim
- Department of Mechanical Engineering, College of Engineering, Kyung Hee University, Yongin-si, Republic of Korea
| |
Collapse
|