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Liu M, Quarrington RD, Sandoz B, Robertson WSP, Jones CF. Evaluation of Apparatus and Protocols to Measure Human Passive Neck Stiffness and Range of Motion. Ann Biomed Eng 2024:10.1007/s10439-024-03517-w. [PMID: 38658477 DOI: 10.1007/s10439-024-03517-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 04/11/2024] [Indexed: 04/26/2024]
Abstract
Understanding of human neck stiffness and range of motion (ROM) with minimal neck muscle activation ("passive") is important for clinical and bioengineering applications. The aim of this study was to develop, implement, and evaluate the reliability of methods for assessing passive-lying stiffness and ROM, in six head-neck rotation directions. Six participants completed two assessment sessions. To perform passive-lying tests, the participant's head and torso were strapped to a bending (flexion, extension, lateral bending) or a rotation (axial rotation) apparatus, and clinical bed, respectively. The head and neck were manually rotated by the researcher to the participant's maximum ROM, to assess passive-lying stiffness. Participant-initiated ("active") head ROM was also assessed in the apparatus, and seated. Various measures of apparatus functionality were assessed. ROM was similar for all assessment configurations in each motion direction except flexion. In each direction, passive stiffness generally increased throughout neck rotation. Within-session reliability for stiffness (ICC > 0.656) and ROM (ICC > 0.872) was acceptable, but between-session reliability was low for some motion directions, probably due to intrinsic participant factors, participant-apparatus interaction, and the relatively low participant number. Moment-angle corridors from both assessment sessions were similar, suggesting that with greater sample size, these methods may be suitable for estimating population-level corridors.
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Affiliation(s)
- Mingyue Liu
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, SA, Australia
- Adelaide Spinal Research Group, Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Ryan D Quarrington
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, SA, Australia
- Adelaide Spinal Research Group, Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia
| | - Baptiste Sandoz
- Arts et Métiers Institute of Technology, Université Sorbonne Paris Nord, IBHGC - Institut de Biomécanique Humaine Georges Charpak, HESAM Université, Paris, France
| | - William S P Robertson
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, SA, Australia
| | - Claire F Jones
- School of Electrical and Mechanical Engineering, The University of Adelaide, Adelaide, SA, Australia.
- Adelaide Spinal Research Group, Centre for Orthopaedic & Trauma Research, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA, Australia.
- Department of Orthopaedics & Trauma, Royal Adelaide Hospital, Adelaide, SA, Australia.
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Buchman-Pearle JM, Pinto BL, Barrett JM, Nenadov EM, Callaghan JP. Lower limb postures resembling sitting and standing alter lumbar angles along the passive stiffness curve. J Electromyogr Kinesiol 2023; 69:102752. [PMID: 36746068 DOI: 10.1016/j.jelekin.2023.102752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 12/21/2022] [Accepted: 01/24/2023] [Indexed: 01/29/2023] Open
Abstract
In vivo lumbar passive stiffness is often used to assess time-dependent changes in lumbar tissues and to define the neutral zone. We tested the hypothesis that flexing the hips would alter tension in hip and spine musculature, leading to a more extended passive stiffness curve (i.e., right-shifted), without changes in lumbar stiffness. Twenty participants underwent side-lying passive testing with the lower limbs positioned in Stand, Kneel, and Sit representative postures. Moment-angle curves were constructed from the lumbar angles and the moment at L4/5 and partitioned into three zones. Partially supporting our hypothesis, lumbar stiffness within the low and transition stiffness zones was similar between the Stand and Sit. Contrary to our hypothesis, lumbar angles were significantly larger in the Sit compared to the Stand and Kneel postures at the first and second breakpoints, with average differences of 9.3° or 27.2% of passive range of motion (%PassRoM) in flexion and 5.6° or 16.6 %PassRoM in extension. Increased flexion in the Sit may be linked to increased posterior pelvic tilt and associated lower lumbar vertebrae flexion. Investigators must ensure consistent pelvis and hip positioning when measuring lumbar stiffness. Additionally, the adaptability of the neutral zone to pelvis posture, particularly between standing and sitting, should be considered in ergonomic applications.
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Affiliation(s)
- Jessa M Buchman-Pearle
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Brendan L Pinto
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Jeff M Barrett
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Elizabeth M Nenadov
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Jack P Callaghan
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada.
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Watt AA, Callaway AJ, Williams JM. In vivo through-range passive stiffness of the lumbar spine: a meta-analysis of measurements and methods. Med Biol Eng Comput 2022; 60:2133-2157. [PMID: 35776374 PMCID: PMC9293810 DOI: 10.1007/s11517-022-02609-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 06/07/2022] [Indexed: 11/02/2022]
Abstract
Abstract
Passive spinal stiffness is an important property thought to play a significant role in controlling spinal position and movement. Measuring through-range passive stiffness in vivo is challenging with several methods offered in the literature. Currently, no synthesis of values or methods exists to which to compare literature to. This study aims to provide a contemporary review and quantitative synthesis of the through-range in vivo passive lumbar spinal stiffness values for each of the cardinal planes of movement. A structured systematic search, following PRISMA guidelines, of 28 electronic databases was conducted in 2022. Articles were restricted to peer-reviewed English language studies investigating in vivo through-range passive stiffness of the lumbar spine. Thirteen studies were included, ten relating to flexion/extension, four to lateral bending and five to axial rotation. Average stiffness values, as weighted means and confidence intervals, for each of the four sections of the moment-movement curves were synthesised for all planes of movement. Lateral bending was found to be the comparatively stiffest movement followed by flexion and then axial rotation. Future research should focus on the validity and reliability of measurement techniques. Axial rotation would also benefit from further study of its latter stages of range.
Graphical abstract
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