1
|
Rauber C, Lüscher D, Poux L, Schori M, Deml MC, Hasler CC, Bassani T, Galbusera F, Büchler P, Schmid S. Predicted vs. measured paraspinal muscle activity in adolescent idiopathic scoliosis patients: EMG validation of optimization-based musculoskeletal simulations. J Biomech 2024; 163:111922. [PMID: 38220500 DOI: 10.1016/j.jbiomech.2023.111922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 11/16/2023] [Accepted: 12/31/2023] [Indexed: 01/16/2024]
Abstract
Musculoskeletal (MSK) models offer great potential for predicting the muscle forces required to inform more detailed simulations of vertebral endplate loading in adolescent idiopathic scoliosis (AIS). In this work, simulations based on static optimization were compared with in vivo measurements in two AIS patients to determine whether computational approaches alone are sufficient for accurate prediction of paraspinal muscle activity during functional activities. We used biplanar radiographs and marker-based motion capture, ground reaction force, and electromyography (EMG) data from two patients with mild and moderate thoracolumbar AIS (Cobb angles: 21° and 45°, respectively) during standing while holding two weights in front (reference position), walking, running, and object lifting. Using a fully automated approach, 3D spinal shape was extracted from the radiographs. Geometrically personalized OpenSim-based MSK models were created by deforming the spine of pre-scaled full-body models of children/adolescents. Simulations were performed using an experimentally controlled backward approach. Differences between model predictions and EMG measurements of paraspinal muscle activity (both expressed as a percentage of the reference position values) at three different locations around the scoliotic main curve were quantified by root mean square error (RMSE) and cross-correlation (XCorr). Predicted and measured muscle activity correlated best for mild AIS during object lifting (XCorr's ≥ 0.97), with relatively low RMSE values. For moderate AIS as well as the walking and running activities, agreement was lower, with XCorr reaching values of 0.51 and comparably high RMSE values. This study demonstrates that static optimization alone seems not appropriate for predicting muscle activity in AIS patients, particularly in those with more than mild deformations as well as when performing upright activities such as walking and running.
Collapse
Affiliation(s)
- Cedric Rauber
- Spinal Movement Biomechanics Group, School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland; Computational Bioengineering Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Dominique Lüscher
- Spinal Movement Biomechanics Group, School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland; Computational Bioengineering Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Lucile Poux
- Spinal Movement Biomechanics Group, School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Maria Schori
- Physiotherapie Maria Schori Bern, Bern, Switzerland
| | - Moritz C Deml
- Department of Orthopaedic Surgery and Traumatology, Inselspital, University Hospital Bern, University of Bern, Bern, Switzerland
| | - Carol-Claudius Hasler
- Orthopaedic Department and Spine Surgery, University Children's Hospital Basel, Basel, Switzerland
| | - Tito Bassani
- IRCCS Istituto Ortopedico Galeazzi, Milan, Italy
| | - Fabio Galbusera
- Spine Research Group, Schulthess Klinik, Zürich, Switzerland
| | - Philippe Büchler
- Computational Bioengineering Group, ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Stefan Schmid
- Spinal Movement Biomechanics Group, School of Health Professions, Bern University of Applied Sciences, Bern, Switzerland; Faculty of Medicine, University of Basel, Basel, Switzerland.
| |
Collapse
|
2
|
Roy S, Grünwald AT, Alves-Pinto A, Lampe R. Automatic analysis method of 3D images in patients with scoliosis by quantifying asymmetry in transverse contours. Biocybern Biomed Eng 2020. [DOI: 10.1016/j.bbe.2020.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
|
3
|
Keenan BE, Izatt MT, Askin GN, Labrom RD, Bennett DD, Pearcy MJ, Adam CJ. Sequential Magnetic Resonance Imaging Reveals Individual Level Deformities of Vertebrae and Discs in the Growing Scoliotic Spine. Spine Deform 2017; 5:197-207. [PMID: 28449963 DOI: 10.1016/j.jspd.2016.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2015] [Revised: 09/28/2016] [Accepted: 10/04/2016] [Indexed: 11/19/2022]
Abstract
STUDY DESIGN The aim of this study was to measure contributions of individual vertebra and disc wedging to coronal Cobb angle in the growing scoliotic spine using sequential magnetic resonance imaging (MRI). Clinically, the Cobb angle measures the overall curve in the coronal plane but does not measure individual vertebra and disc wedging. It was hypothesized that patients whose deformity progresses will have different patterns of coronal wedging in vertebrae and discs to those of patients whose deformities remain stable. METHODS A group of adolescent idiopathic scoliosis (AIS) patients each received two to four MRI scans (spaced 3-12 months apart). The coronal plane wedge angles of each vertebra and disc in the major curve were measured for each scan, and the proportions and patterns of wedging in vertebrae and discs were analyzed for subgroups of patients whose spinal deformity did and did not progress during the study period. RESULTS Sixteen patients were included in the study; the mean patient age was 12.9 years (standard deviation 1.7 years). All patients were classified as right-sided major thoracic Lenke Type 1 curves (9 type 1A, 4 type 1B, and 3 type 1C). Cobb angle progression of ≥5° between scans was seen in 56% of patients. Although there were measurable changes in the wedging of individual vertebrae and discs in all patients, there was no consistent pattern of deformity progression between patients who progressed and those who did not. The patterns of progression found in this study did not support the hypothesis of wedging commencing in the discs and then transferring to the vertebrae. CONCLUSION Sequential MRI data showed complex patterns of deformity progression. Changes to the wedging of individual vertebrae and discs may occur in patients who have no increase in Cobb angle; therefore, the Cobb method alone may be insufficient to capture the complex mechanisms of deformity progression.
Collapse
Affiliation(s)
- Bethany E Keenan
- Paediatric Spine Research Group, Queensland University of Technology and Mater Health Services Brisbane Ltd, Level 5, Centre for Children's Health Research, 62 Graham St, South Brisbane, Q4104,, Australia.
| | - Maree T Izatt
- Paediatric Spine Research Group, Queensland University of Technology and Mater Health Services Brisbane Ltd, Level 5, Centre for Children's Health Research, 62 Graham St, South Brisbane, Q4104,, Australia
| | - Geoffrey N Askin
- Paediatric Spine Research Group, Queensland University of Technology and Mater Health Services Brisbane Ltd, Level 5, Centre for Children's Health Research, 62 Graham St, South Brisbane, Q4104,, Australia
| | - Robert D Labrom
- Paediatric Spine Research Group, Queensland University of Technology and Mater Health Services Brisbane Ltd, Level 5, Centre for Children's Health Research, 62 Graham St, South Brisbane, Q4104,, Australia
| | - Damon D Bennett
- MRI Department, Mater Health Services, Raymond Terrace, South Brisbane, Q4104, Australia
| | - Mark J Pearcy
- Paediatric Spine Research Group, Queensland University of Technology and Mater Health Services Brisbane Ltd, Level 5, Centre for Children's Health Research, 62 Graham St, South Brisbane, Q4104,, Australia
| | - Clayton J Adam
- Paediatric Spine Research Group, Queensland University of Technology and Mater Health Services Brisbane Ltd, Level 5, Centre for Children's Health Research, 62 Graham St, South Brisbane, Q4104,, Australia
| |
Collapse
|
4
|
A new method to approximate load–displacement relationships of spinal motion segments for patient-specific multi-body models of scoliotic spine. Med Biol Eng Comput 2016; 55:1039-1050. [DOI: 10.1007/s11517-016-1576-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 09/17/2016] [Indexed: 10/20/2022]
|
5
|
Finding line of action of the force exerted on erect spine based on lateral bending test in personalization of scoliotic spine models. Med Biol Eng Comput 2016; 55:673-684. [DOI: 10.1007/s11517-016-1550-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 07/11/2016] [Indexed: 12/01/2022]
|
6
|
Data Mining in Medicine: Relationship of Scoliotic Spine Curvature to the Movement Sequence of Lateral Bending Positions. ACTA ACUST UNITED AC 2016. [DOI: 10.1007/978-3-319-41561-1_3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register]
|
7
|
Keenan BE, Pettet GJ, Izatt MT, Askin GN, Labrom RD, Pearcy MJ, Adam C. Gravity-induced coronal plane joint moments in adolescent idiopathic scoliosis. SCOLIOSIS 2015; 10:35. [PMID: 26681978 PMCID: PMC4682283 DOI: 10.1186/s13013-015-0060-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 12/02/2015] [Indexed: 01/09/2023]
Abstract
Background Adolescent Idiopathic Scoliosis is the most common type of spinal deformity, and whilst the isk of progression appears to be biomechanically mediated (larger deformities are more likely to progress), the detailed biomechanical mechanisms driving progression are not well understood. Gravitational forces in the upright position are the primary sustained loads experienced by the spine. In scoliosis they are asymmetrical, generating moments about the spinal joints which may promote asymmetrical growth and deformity progression. Using 3D imaging modalities to estimate segmental torso masses allows the gravitational loading on the scoliotic spine to be determined. The resulting distribution of joint moments aids understanding of the mechanics of scoliosis progression. Methods Existing low-dose CT scans were used to estimate torso segment masses and joint moments for 20 female scoliosis patients. Intervertebral joint moments at each vertebral level were found by summing the moments of each of the torso segment masses above the required joint. Results The patients’ mean age was 15.3 years (SD 2.3; range 11.9–22.3 years); mean thoracic major Cobb angle 52° (SD 5.9°; range 42–63°) and mean weight 57.5 kg (SD 11.5 kg; range 41–84.7 kg). Joint moments of up to 7 Nm were estimated at the apical level. No significant correlation was found between the patients’ major Cobb angles and apical joint moments. Conclusions Patients with larger Cobb angles do not necessarily have higher joint moments, and curve shape is an important determinant of joint moment distribution. These findings may help to explain the variations in progression between individual patients. This study suggests that substantial corrective forces are required of either internal instrumentation or orthoses to effectively counter the gravity-induced moments acting to deform the spinal joints of idiopathic scoliosis patients. Electronic supplementary material The online version of this article (doi:10.1186/s13013-015-0060-9) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Bethany E Keenan
- Paediatric Spine Research Group, Institute of Health and Biomedical Innovation, Queensland University of Technology and Mater Health Services, Brisbane, 4101 Queensland Australia
| | - Graeme J Pettet
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, QLD Australia
| | - Maree T Izatt
- Paediatric Spine Research Group, Institute of Health and Biomedical Innovation, Queensland University of Technology and Mater Health Services, Brisbane, 4101 Queensland Australia
| | - Geoffrey N Askin
- Paediatric Spine Research Group, Institute of Health and Biomedical Innovation, Queensland University of Technology and Mater Health Services, Brisbane, 4101 Queensland Australia
| | - Robert D Labrom
- Paediatric Spine Research Group, Institute of Health and Biomedical Innovation, Queensland University of Technology and Mater Health Services, Brisbane, 4101 Queensland Australia
| | - Mark J Pearcy
- Paediatric Spine Research Group, Institute of Health and Biomedical Innovation, Queensland University of Technology and Mater Health Services, Brisbane, 4101 Queensland Australia
| | - Clayton Adam
- Paediatric Spine Research Group, Institute of Health and Biomedical Innovation, Queensland University of Technology and Mater Health Services, Brisbane, 4101 Queensland Australia
| |
Collapse
|