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Romero-Flores CF, Bustamante-Bello R, Moya Bencomo M, Martinez-Ríos EA, Montesinos L. Optical Marker-Based Motion Capture of the Human Spine: A Scoping Review of Study Design and Outcomes. Ann Biomed Eng 2024:10.1007/s10439-024-03567-0. [PMID: 39023832 DOI: 10.1007/s10439-024-03567-0] [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: 04/23/2024] [Accepted: 06/19/2024] [Indexed: 07/20/2024]
Abstract
Biomechanical analysis of the human spine is crucial to understanding injury patterns. Motion capture technology has gained attention due to its non-invasive nature. Nevertheless, traditional motion capture studies consider the spine a single rigid segment, although its alignment changes during movement. Moreover, guidelines that indicate where markers should be placed for a specific exercise do not exist. This study aims to review the methods used to assess spine biomechanics using motion capture systems to determine the marker sets used, the protocols used, the resulting parameters, the analysed activities, and the characteristics of the studied populations. PRISMA guidelines were used to perform a Scoping Review using SCOPUS and Web of Science databases. Fifty-six journal and conference articles from 1997 to 2023 were considered for the analysis. This review showed that Plug-in-Gait is the most used marker set. The lumbar spine is the segment that generates the most interest because of its high mobility and function as a weight supporter. Furthermore, angular position and velocity are the most common outcomes when studying the spine. Walking, standing, and range of movement were the most studied activities compared to sports and work-related activities. Male and female participants were recruited similarly across all included articles. This review presents the motion capture techniques and measurement outcomes of biomechanical studies of the human spine, to help standardize the field. This work also discusses trends in marker sets, study outcomes, studied segments and segmentation approaches.
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Affiliation(s)
- Claudia F Romero-Flores
- Tecnologico de Monterrey, School of Engineering and Sciences, Ave. Eugenio Garza Sada 2501, Monterrey, N.L., México, 64849
| | - Rogelio Bustamante-Bello
- Tecnologico de Monterrey, School of Engineering and Sciences, Ave. Eugenio Garza Sada 2501, Monterrey, N.L., México, 64849
| | - Marcos Moya Bencomo
- Tecnologico de Monterrey, School of Engineering and Sciences, Ave. Eugenio Garza Sada 2501, Monterrey, N.L., México, 64849.
| | - Erick Axel Martinez-Ríos
- Tecnologico de Monterrey, School of Engineering and Sciences, Ave. Eugenio Garza Sada 2501, Monterrey, N.L., México, 64849
| | - Luis Montesinos
- Tecnologico de Monterrey, School of Engineering and Sciences, Ave. Eugenio Garza Sada 2501, Monterrey, N.L., México, 64849
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Farhart P, Beakley D, Diwan A, Duffield R, Rodriguez EP, Chamoli U, Watsford M. Intrinsic variables associated with low back pain and lumbar spine injury in fast bowlers in cricket: a systematic review. BMC Sports Sci Med Rehabil 2023; 15:114. [PMID: 37730648 PMCID: PMC10512628 DOI: 10.1186/s13102-023-00732-1] [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: 02/24/2023] [Accepted: 09/12/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND Lumbar spine injuries in fast bowlers account for the greatest missed playing time in cricket. A range of extrinsic and intrinsic variables are hypothesised to be associated with low back pain and lumbar spine injury in fast bowlers, and an improved understanding of intrinsic variables is necessary as these may alter load tolerance and injury risk associated with fast bowling. This review critically evaluated studies reporting intrinsic variables associated with low back pain and lumbar spine injury in fast bowlers and identified areas for future investigation. METHODS OVID Medline, EMBASE, SPORTDiscus, CINAHL, Web of Science and SCOPUS databases were last searched on 3 June 2022 to identify studies investigating intrinsic variables associated with low back pain and lumbar spine injury in cricket fast bowlers. Terms relevant to cricket fast bowling, and intrinsic variables associated with lumbar spine injury and low back pain in fast bowlers were searched. 1,503 abstracts were screened, and 118 full-text articles were appraised to determine whether they met inclusion criteria. Two authors independently screened search results and assessed risk of bias using a modified version of the Quality in Prognostic Studies tool. RESULTS Twenty-five studies met the inclusion criteria. Overall, no included studies demonstrated a low risk of bias, two studies were identified as moderate risk, and twenty-three studies were identified as high risk. Conflicting results were reported amongst studies investigating associations of fast bowling kinematics and kinetics, trunk and lumbar anatomical features, anthropometric traits, age, and neuromuscular characteristics with low back pain and lumbar spine injury. CONCLUSION Inconsistencies in results may be related to differences in study design, injury definitions, participant characteristics, measurement parameters, and statistical analyses. Low back pain and lumbar spine injury occurrence in fast bowlers remain high, and this may be due to an absence of low bias studies that have informed recommendations for their prevention. Future research should employ clearly defined injury outcomes, analyse continuous datasets, utilise models that better represent lumbar kinematics and kinetics during fast bowling, and better quantify previous injury, lumbar anatomical features and lumbar maturation. TRIAL REGISTRATION Open Science Framework https://doi.org/10.17605/OSF.IO/ERKZ2 .
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Affiliation(s)
- Patrick Farhart
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia.
- Spine Labs, Discipline of Surgery, St. George and Sutherland Campus of the Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, NSW, 2217, Australia.
- Cricket New South Wales, 161 Silverwater Road, Sydney Olympic Park, Sydney, NSW, 2127, Australia.
- Delhi Capitals, JSW GMR Cricket Private Limited, Bahadurshah Zafar Marg, New Delhi, 110002, India.
| | - David Beakley
- Deakin University, Burwood Highway, Burwood, VIC, 3125, Australia
| | - Ashish Diwan
- Spine Labs, Discipline of Surgery, St. George and Sutherland Campus of the Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, NSW, 2217, Australia
- Spine Service, Department of Orthopaedic Surgery, St. George Hospital Campus, Kogarah, NSW, 2217, Australia
| | - Rob Duffield
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia
| | - Elizabeth Pickering Rodriguez
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia
| | - Uphar Chamoli
- Spine Labs, Discipline of Surgery, St. George and Sutherland Campus of the Clinical School, Faculty of Medicine, University of New South Wales, Kogarah, NSW, 2217, Australia
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Broadway, NSW, 2007, Australia
| | - Mark Watsford
- School of Sport, Exercise and Rehabilitation, Faculty of Health, Human Performance Research Centre, Moore Park Precinct, University of Technology Sydney, Broadway, NSW, 2007, Australia
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Robinault L, Niazi IK, Kumari N, Amjad I, Menard V, Haavik H. Non-Specific Low Back Pain: An Inductive Exploratory Analysis through Factor Analysis and Deep Learning for Better Clustering. Brain Sci 2023; 13:946. [PMID: 37371424 DOI: 10.3390/brainsci13060946] [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: 04/12/2023] [Revised: 06/08/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023] Open
Abstract
Non-specific low back pain (NSLBP) is a significant and pervasive public health issue in contemporary society. Despite the widespread prevalence of NSLBP, our understanding of its underlying causes, as well as our capacity to provide effective treatments, remains limited due to the high diversity in the population that does not respond to generic treatments. Clustering the NSLBP population based on shared characteristics offers a potential solution for developing personalized interventions. However, the complexity of NSLBP and the reliance on subjective categorical data in previous attempts present challenges in achieving reliable and clinically meaningful clusters. This study aims to explore the influence and importance of objective, continuous variables related to NSLBP and how to use these variables effectively to facilitate the clustering of NSLBP patients into meaningful subgroups. Data were acquired from 46 subjects who performed six simple movement tasks (back extension, back flexion, lateral trunk flexion right, lateral trunk flexion left, trunk rotation right, and trunk rotation left) at two different speeds (maximum and preferred). High-density electromyography (HD EMG) data from the lower back region were acquired, jointly with motion capture data, using passive reflective markers on the subject's body and clusters of markers on the subject's spine. An exploratory analysis was conducted using a deep neural network and factor analysis. Based on selected variables, various models were trained to classify individuals as healthy or having NSLBP in order to assess the importance of different variables. The models were trained using different subsets of data, including all variables, only anthropometric data (e.g., age, BMI, height, weight, and sex), only biomechanical data (e.g., shoulder and lower back movement), only neuromuscular data (e.g., HD EMG activity), or only balance-related data. The models achieved high accuracy in categorizing individuals as healthy or having NSLBP (full model: 93.30%, anthropometric model: 94.40%, biomechanical model: 84.47%, neuromuscular model: 88.07%, and balance model: 74.73%). Factor analysis revealed that individuals with NSLBP exhibited different movement patterns to healthy individuals, characterized by slower and more rigid movements. Anthropometric variables (age, sex, and BMI) were significantly correlated with NSLBP components. In conclusion, different data types, such as body measurements, movement patterns, and neuromuscular activity, can provide valuable information for identifying individuals with NSLBP. To gain a comprehensive understanding of NSLBP, it is crucial to investigate the main domains influencing its prognosis as a cohesive unit rather than studying them in isolation. Simplifying the conditions for acquiring dynamic data is recommended to reduce data complexity, and using back flexion and trunk rotation as effective options should be further explored.
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Affiliation(s)
- Lucien Robinault
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
| | - Imran Khan Niazi
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
- Faculty of Health and Environmental Sciences, Health and Rehabilitation Research Institute, AUT University, Auckland 1010, New Zealand
- Department of Health Science and Technology, Aalborg University, 9220 Aalborg, Denmark
| | - Nitika Kumari
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
| | - Imran Amjad
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
- Faculty of Rehabilitation and Allied Health Sciences and Department of Biomedical Engineering, Riphah International University, Islamabad 46000, Pakistan
| | - Vincent Menard
- M2S Laboratory, ENS Rennes, University of Rennes 2, 35065 Rennes, France
| | - Heidi Haavik
- Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland 1060, New Zealand
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Christe G, Benaim C, Luthi F, Jolles BM, Favre J. Reduction in pain-related fear is not associated with improvement in spinal biomechanics but with decrease in movement-evoked pain in patients with chronic low back pain. Pain Pract 2023; 23:290-300. [PMID: 36479806 DOI: 10.1111/papr.13191] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/10/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS While a causal relationship between pain-related fear and spinal movement avoidance in patients with chronic low back pain (CLBP) has frequently been postulated, evidence supporting this relationship is limited. This study aimed to test if decreases in pain-related fear or catastrophizing were associated with improvements in spinal biomechanics, accounting for possible changes in movement-evoked pain. METHODS Sixty-two patients with CLBP were assessed before and after an interdisciplinary rehabilitation program (IRP). Pain-related fear was assessed with general and task-specific measures. Lower and upper lumbar angular amplitude and velocity as well as paraspinal muscle activity were recorded during five daily-life tasks to evaluate spinal biomechanics. Relationships were tested with multivariable linear regression analyses. RESULTS The large decreases in pain-related fear and catastrophizing following the IRP were scarcely and inconsistently associated with changes in spinal biomechanics (< 3% of the models reported a statistically significant association). Results remained comparable for activities inducing more or less fear, for specific or general measures of pain-related fear, and for analyses performed on the entire population or limited to subgroups of patients with higher levels of task-specific fear. In contrast, reductions in task-specific pain-related fear were significantly associated with decreases in movement-evoked pain in all tasks (r = 0.26-0.62, p ≤ 0.02). CONCLUSION This study does not support an association between pain-related fear and spinal movement avoidance. However, it provides evidence supporting a direct relationship between decreased pain-related fear and decreased movement-evoked pain, possibly explaining some mechanisms of the rehabilitation programs.
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Affiliation(s)
- Guillaume Christe
- Department of Physiotherapy, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland.,Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Charles Benaim
- Department of Physical Medicine and Rehabilitation, Orthopedic Hospital, Lausanne University Hospital, Lausanne, Switzerland.,Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland
| | - François Luthi
- Department of Physical Medicine and Rehabilitation, Orthopedic Hospital, Lausanne University Hospital, Lausanne, Switzerland.,Department of Musculoskeletal Rehabilitation, Clinique Romande de Réadaptation, Sion, Switzerland
| | - Brigitte M Jolles
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,Institute of Microengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.,The Sense Innovation and Research Center, Lausanne and Sion, Switzerland
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Haimerl M, Nebel I, Linkerhägner A, Konradi J, Wolf C, Drees P, Betz U. Consistency of vertebral motion and individual characteristics in gait sequences. Hum Mov Sci 2023; 87:103036. [PMID: 36395570 DOI: 10.1016/j.humov.2022.103036] [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: 08/25/2022] [Revised: 10/21/2022] [Accepted: 11/08/2022] [Indexed: 11/15/2022]
Abstract
Vertebral motion reveals complex patterns, which are not yet understood in detail. This applies to vertebral kinematics in general but also to specific motion tasks like gait. For gait analysis, most of existing publications focus on averaging characteristics of recorded motion signals. Instead, this paper aims at analyzing intra- and inter-individual variation specifically and elaborating motion parameters, which are consistent during gait cycles of particular persons. For this purpose, a study design was utilized, which collected motion data from 11 asymptomatic test persons walking at different speed levels (2, 3, and 4 km/h). Acquisition of data was performed using surface topography. The motion signals were preprocessed in order to separate average vertebral orientations (neutral profiles) from basic gait cycles. Subsequently, a k-means clustering technique was applied to figure out, whether a discrimination of test persons was possible based on the preprocessed motion signals. The paper shows that each test sequence could be assigned to the particular test person without additional prior information. In particular, the neutral profiles appeared to be highly consistent intra-individually (across the gait cycles as well as speed levels), but substantially different between test persons. A full discrimination of test persons was achieved using the neutral profiles with respect to flexion/extension data. Based on this, these signals can be considered as individual characteristics for the particular test persons.
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Affiliation(s)
- Martin Haimerl
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Germany.
| | - Iman Nebel
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Germany
| | - Alina Linkerhägner
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Germany
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Philipp Drees
- Department of Orthopedics and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Germany
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Fayad J, Eltes PE, Lazary A, Cristofolini L, Stagni R. Stereophotogrammetric approaches to multi-segmental kinematics of the thoracolumbar spine: a systematic review. BMC Musculoskelet Disord 2022; 23:1080. [PMID: 36503435 PMCID: PMC9743750 DOI: 10.1186/s12891-022-05925-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 10/12/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Spine disorders are becoming more prevalent in today's ageing society. Motion abnormalities have been linked to the prevalence and recurrence of these disorders. Various protocols exist to measure thoracolumbar spine motion, but a standard multi-segmental approach is still missing. This study aims to systematically evaluate the literature on stereophotogrammetric motion analysis approaches to quantify thoracolumbar spine kinematics in terms of measurement reliability, suitability of protocols for clinical application and clinical significance of the resulting functional assessment. METHODS Electronic databases (PubMed, Scopus and ScienceDirect) were searched until February 2022. Studies published in English, investigating the intersegmental kinematics of the thoracolumbar spine using stereophotogrammetric motion analysis were identified. All information relating to measurement reliability; measurement suitability and clinical significance was extracted from the studies identified. RESULTS Seventy-four studies met the inclusion criteria. 33% of the studies reported on the repeatability of their measurement. In terms of suitability, only 35% of protocols were deemed suitable for clinical application. The spinous processes of C7, T3, T6, T12, L1, L3 and L5 were the most widely used landmarks. The spine segment definitions were, however, found to be inconsistent among studies. Activities of daily living were the main tasks performed. Comparable results between protocols are however still missing. CONCLUSION The literature to date offers various stereophotogrammetric protocols to quantify the multi-segmental motion of the thoracolumbar spine, without a standard guideline being followed. From a clinical point of view, the approaches are still limited. Further research is needed to define a precise motion analysis protocol in terms of segment definition and clinical relevance.
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Affiliation(s)
- Jennifer Fayad
- grid.6292.f0000 0004 1757 1758Department of Industrial Engineering, Alma Mater Studiorum – Università di Bologna, Bologna, Italy ,National Centre for Spinal Disorders, Budapest, Hungary
| | - Peter Endre Eltes
- National Centre for Spinal Disorders, Budapest, Hungary ,In Silico Biomechanics Laboratory, National Centre for Spinal Disorders, Budapest, Hungary
| | - Aron Lazary
- National Centre for Spinal Disorders, Budapest, Hungary
| | - Luca Cristofolini
- grid.6292.f0000 0004 1757 1758Department of Industrial Engineering, Alma Mater Studiorum – Università di Bologna, Bologna, Italy
| | - Rita Stagni
- grid.6292.f0000 0004 1757 1758Department of Electrical, Electronic and Information Engineering “Guglielmo Marconi”, Alma Mater Studiorum – Università Di Bologna, Bologna, Italy
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Zhou X, Kong L, Ren J, Song P, Wu Z, He T, Lv Z, Zhang S, Sun W, Zhang J, Cai J, Zhu Q, Fang M. Effect of traditional Chinese exercise combined with massage on pain and disability in patients with lumbar disc herniation: A multi-center, randomized, controlled, assessor-blinded clinical trial. Front Neurol 2022; 13:952346. [PMID: 36158965 PMCID: PMC9490580 DOI: 10.3389/fneur.2022.952346] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 08/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Herniation of the nucleus pulposus caused by disc degeneration and other reasons can cause low back pain and disability. In China, traditional Chinese exercises (TCEs) and traditional Chinese massage (TCM) are widely used to improve symptoms of pain and disability in patients with lumbar disc herniation (LDH). The safety and efficacy of combination therapy have not been studied. Objectives To assess the effect of traditional Chinese exercise combined with massage vs. traditional Chinese massage alone on pain, disability, lumbar mobility and gait performance in patients with LDH. Methods Multi-center, randomized clinical trial conducted at 4 hospitals in China and enrolling 272 patients with LDH. Participants were randomly assigned to TCEs plus TCM group or TCM alone group. The combined therapy group received 18 Tai Chi training sessions (30-min sessions 3 times a week) and regular TCM treatments over 6 weeks. The control group received TCM therapy alone and was instructed to maintain their usual daily physical activity. Outcome variables measured included Visual Analog Scale (VAS), Short Form of McGill Pain Questionnaire (SF-MPQ), Oswestry Disability Index (ODI), lumbar spine range of motion (ROM) and gait performance. Results Among the 272 randomized participants, 259 completed the study. The mean VAS score was 51.77 mm at baseline in the TCEs plus TCM group, and 50.93 mm for the TCM alone group. The reduction in the VAS score at week 6 was greater in the TC group than in the TCM group with a mean difference of 4.05 (95% CI, 2.15-5.95; P < 0.001), and the ODI score with between-group differences of 3.57 points (95% CI, 2.84-4.30 points; P < 0.001). Similar significantly different results were observed in SF-MPQ, walking speed, cadence, and lumbar ROM. No serious adverse events were reported throughout the study period. Conclusion Compared with TCM alone, TCEs combined with TCM treatment performed better in reducing pain and improving disability. The combination therapy could be considered a valuable treatment option for LDH patients, with potential therapeutic utility for middle-aged and elderly patients with LDH.
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Affiliation(s)
- Xin Zhou
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Lingjun Kong
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Jun Ren
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Pengfei Song
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhiwei Wu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Tianxiang He
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zhizhen Lv
- The Third Clinical School of Medicine, Zhejiang University of Traditional Chinese Medicine, Zhejiang, China
| | - Shuaipan Zhang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Wuquan Sun
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiafu Zhang
- Shanghai First People's Hospital, Shanghai, China
| | - Junhao Cai
- Shanghai Traditional Chinese Medicine Hospital, Shanghai, China
| | - Qingguang Zhu
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
| | - Min Fang
- Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Institute of Tuina, Shanghai Institute of Traditional Chinese Medicine, Shanghai, China
- Shuguang Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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Xi X, Ling Z, Wang C, Gu C, Zhan X, Yu H, Lu S, Tsai TY, Yu Y, Cheng L. Lumbar segment-dependent soft tissue artifacts of skin markers during in vivo weight-bearing forward–Backward bending. Front Bioeng Biotechnol 2022; 10:960063. [PMID: 36061441 PMCID: PMC9428558 DOI: 10.3389/fbioe.2022.960063] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Accepted: 07/18/2022] [Indexed: 12/03/2022] Open
Abstract
Traditional optical motion capture (OMC) with retroreflective markers is commonly used to measure joint kinematics but was also reported with unavoidable soft tissue artifacts (STAs) when quantifying the motion of the spine. Additionally, the patterns of the STA on the lumbar spine remain unclear. This study aimed to 1) quantify the in vivo STAs of the human lower back in three-dimensional directions during weight-bearing forward–backward bending and 2) determine the effects of the STAs on the calculated flexion angles between the upper and lower lumbar spines and adjacent vertebrae by comparing the skin marker (SM)- and virtual bone marker (VM)-based measurements. Six healthy volunteers were imaged using a biplanar radiographic system, and thirteen skin markers were mounted on every volunteer’s lower back while performing weight-bearing forward–backward bending. The STAs in the anterior/posterior (AP), medial/lateral (ML), and proximal/distal (PD) directions were investigated. The flexion angles between the upper and lower lumbar segments and adjacent intervertebral segments (L2–L5) throughout the cycle were calculated. For all the participants, STAs continuously increased in the AP direction and exhibited a reciprocal trend in the PD direction. During flexion, the STA at the lower lumbar region (L4–L5: 13.5 ± 6.5 mm) was significantly higher than that at the upper lumbar (L1–L3: 4.0 ± 1.5 mm) in the PD direction (p < 0.01). During extension, the lower lumbar (L4–L5: 2.7 ± 0.7 mm) exhibited significantly less STAs than that exhibited by the upper lumbar region (L1–L3: 6.1 ± 3.3 mm) (p < 0.05). The STA at the spinous process was significantly lower than that on both sides in the AP direction (p < 0.05). The present results on STAs, based on dual fluoroscopic measurements in healthy adult subjects, presented an anatomical direction, marker location, and anatomic segment dependency, which might help describe and quantify STAs for the lumbar spine kinematics and thus help develop location- and direction-specific weighting factors for use in global optimization algorithms aimed at minimizing the effects of STAs on the calculation of lumbar joint kinematics in the future.
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Affiliation(s)
- Xin Xi
- Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Zhi Ling
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Cong Wang
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
| | - Chunya Gu
- Department of Spinal Rehabilitation, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Xuqiang Zhan
- Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Haixin Yu
- Department of Orthopedic Surgery, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Siqi Lu
- Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Tsung-Yuan Tsai
- School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
- TAOiMAGE Medical Technologies Corporation, Shanghai, China
- *Correspondence: Tsung-Yuan Tsai, ; Yan Yu,
| | - Yan Yu
- Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Tsung-Yuan Tsai, ; Yan Yu,
| | - Liming Cheng
- Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration, Ministry of Education, Department of Spine Surgery, Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
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Control of structural redundancy from the head to trunk in the human upright standing revealed using a data-driven approach. Sci Rep 2022; 12:13164. [PMID: 35915210 PMCID: PMC9343422 DOI: 10.1038/s41598-022-17322-9] [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: 12/28/2021] [Accepted: 05/09/2022] [Indexed: 11/08/2022] Open
Abstract
The human being dynamically and highly controls the head-trunk with redundant mechanical structures to maintain a stable upright standing position that is inherently unstable. The posture control strategies are also affected by the differences in the conditions of sensory inputs. However, it is unclear how the head-trunk segmental properties are altered to respond to situations that require appropriate changes in standing posture control strategies. We used a data-driven approach to conduct a multipoint measurement of head-trunk sway control in a quiet standing position with differences in the conditions of sensory inputs. Healthy young subjects with 22 accelerometers attached to their backs were evaluated for head-trunk vibration during quiet standing under two conditions: one with open eyes and one with closed eyes. The synchronization of the acceleration and the instantaneous phase was then calculated. The results showed that the synchronization of acceleration and instantaneous phase varied depending on the visual condition, and there were some continuous coherent patterns in each condition. Findings were that the structural redundancy of the head-trunk, which is multi-segmental and has a high mass ratio in the whole body, must be adjusted adaptively according to the conditions to stabilize upright standing in human-specific bipeds.
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Smith JA, Stabbert H, Bagwell JJ, Teng HL, Wade V, Lee SP. Do people with low back pain walk differently? A systematic review and meta-analysis. JOURNAL OF SPORT AND HEALTH SCIENCE 2022; 11:450-465. [PMID: 35151908 PMCID: PMC9338341 DOI: 10.1016/j.jshs.2022.02.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/04/2021] [Accepted: 12/17/2021] [Indexed: 05/05/2023]
Abstract
BACKGROUND The biomechanics of the trunk and lower limbs during walking and running gait are frequently assessed in individuals with low back pain (LBP). Despite substantial research, it is still unclear whether consistent and generalizable changes in walking or running gait occur in association with LBP. The purpose of this systematic review was to identify whether there are differences in biomechanics during walking and running gait in individuals with acute and persistent LBP compared with back-healthy controls. METHODS A search was conducted in PubMed, CINAHL, SPORTDiscus, and PsycINFO in June 2019 and was repeated in December 2020. Studies were included if they reported biomechanical characteristics of individuals with and without LBP during steady-state or perturbed walking and running. Biomechanical data included spatiotemporal, kinematic, kinetic, and electromyography variables. The reporting quality and potential for bias of each study was assessed. Data were pooled where possible to compare the standardized mean differences (SMD) between back pain and back-healthy control groups. RESULTS Ninety-seven studies were included and reviewed. Two studies investigated acute pain and the rest investigated persistent pain. Nine studies investigated running gait. Of the studies, 20% had high reporting quality/low risk of bias. In comparison with back-healthy controls, individuals with persistent LBP walked slower (SMD = -0.59, 95% confidence interval (95%CI): -0.77 to -0.42)) and with shorter stride length (SMD = -0.38, 95%CI: -0.60 to -0.16). There were no differences in the amplitude of motion in the thoracic or lumbar spine, pelvis, or hips in individuals with LBP. During walking, coordination of motion between the thorax and the lumbar spine/pelvis was significantly more in-phase in the persistent LBP groups (SMD = -0.60, 95%CI: -0.90 to -0.30), and individuals with persistent LBP exhibited greater amplitude of activation in the paraspinal muscles (SMD = 0.52, 95%CI: 0.23-0.80). There were no consistent differences in running biomechanics between groups. CONCLUSION There is moderate-to-strong evidence that individuals with persistent LBP demonstrate differences in walking gait compared to back-healthy controls.
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Affiliation(s)
- Jo Armour Smith
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA.
| | - Heidi Stabbert
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA
| | - Jennifer J Bagwell
- Department of Physical Therapy, California State University, Long Beach, CA 90840, USA
| | - Hsiang-Ling Teng
- Department of Physical Therapy, California State University, Long Beach, CA 90840, USA
| | - Vernie Wade
- Department of Physical Therapy, Chapman University, Irvine, CA 92618, USA
| | - Szu-Ping Lee
- Department of Physical Therapy, University of Nevada, Las Vegas, NV 89154, USA
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Christe G, Jolles BM, Favre J. Between/within-session reliability of spinal kinematic and lumbar muscle activity measures in patients with chronic low back pain and asymptomatic individuals. Gait Posture 2022; 95:100-108. [PMID: 35468488 DOI: 10.1016/j.gaitpost.2022.04.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/29/2022] [Accepted: 04/11/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Longitudinal research is required to better understand the role of spinal movement alterations in chronic low back pain (CLBP). To this end, it is critical to assess the between-session reliability of spinal movement measures. RESEARCH QUESTION What is the within/between-session reliability of spinal movement measures in patients with CLBP and asymptomatic controls? METHODS Spinal movement was recorded prospectively during two sessions, a week apart, for 20 patients with CLBP (60% male; 40.0 ± 12.3 years old) and 20 asymptomatic individuals (55% male; 38.2 ± 10.9 years old). Sagittal-plane angular amplitude and angular velocity at the lower lumbar, upper lumbar, lower thoracic and upper thoracic joints, as well as maximal erector spinae activity were measured during five daily-activity tasks. In addition, task-independent measures were obtained by averaging the measures across tasks. The Intraclass Correlation Coefficient (ICC 2,1) and the minimal detectable change (MDC) were calculated. Pearson correlation was used to compare task-independent and task-specific measures. RESULTS Between-session ICCs in patients with CLBP were mostly moderate to good for maximal angular amplitude and erector spinae activity measures. Lower ICCs were observed for range of angular motion and angular velocity measures (42% of ICCs < 0.5). Median MDCs were 9.6°, 18.3°/s and 1.0% for angular amplitude, angular velocity and erector spinae activity measures, respectively. The reliability of task-independent and task-specific measures was strongly correlated (r = 0.91, p < 0.001). SIGNIFICANCE Sagittal-plane maximal angular amplitude and erector spinae activity measures during various daily-activity tasks demonstrated mostly moderate to good between-session ICCs. However, relatively large MDCs suggested that important changes are needed to be detectable. Task-independent measures reported similarly acceptable ICCs than task-specific measures, supporting their use to describe spinal movement.
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Affiliation(s)
- Guillaume Christe
- Department of Physiotherapy, HESAV School of Health Sciences, HES-SO University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland; Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.
| | - Brigitte M Jolles
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland; Institute of Microengineering, Ecole Polytechnique Fédérale de Lausanne, Lausanne, Switzerland
| | - Julien Favre
- Swiss BioMotion Lab, Department of Musculoskeletal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Acasio JC, Butowicz CM, Dearth CL, Bazrgari B, Hendershot BD. Trunk Muscle Forces and Spinal Loads while Walking in Persons with Lower Limb Amputation: Influences of Chronic Low Back Pain. J Biomech 2022; 135:111028. [DOI: 10.1016/j.jbiomech.2022.111028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 02/24/2022] [Accepted: 02/25/2022] [Indexed: 10/19/2022]
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Zander T, Firouzabadi A, Bashkuev M, Schmidt H. Optimal assessment of upper body motion - Which and how many landmarks need to be captured for representing rigid body orientation? J Biomech 2022; 132:110952. [PMID: 35030364 DOI: 10.1016/j.jbiomech.2022.110952] [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: 12/01/2020] [Revised: 12/31/2021] [Accepted: 01/03/2022] [Indexed: 11/25/2022]
Abstract
In biomechanical studies, the thorax is often considered rigid. Since it's a well-known simplification, usually more than three markers are used to describe its movement in motion analyses. However, there is uncertainty about how many markers are advisable and which landmarks should be used. The results of the present study describe the expected error depending on the number of markers used. Furthermore, a recommendation is given for the landmarks with the least errors. This recommendation is valid for men and women as well as for different movements. The recommendations roughly reduce the error to about 50% and are beneficial especially in case only a small number of markers were used. For general motion capture, we recommend to use at least six thoracic markers.
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Affiliation(s)
- Thomas Zander
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Ali Firouzabadi
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Maxim Bashkuev
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
| | - Hendrik Schmidt
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
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Haimerl M, Nebel I, Linkerhägner A, Konradi J, Wolf C, Drees P, Betz U. Comprehensive visualization of spinal motion in gait sequences based on surface topography. Hum Mov Sci 2022; 81:102919. [PMID: 34979480 DOI: 10.1016/j.humov.2021.102919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 10/26/2021] [Accepted: 12/21/2021] [Indexed: 11/19/2022]
Abstract
Analysis of spinal motion is considered to be important to assess function of the human spine. Surface topography (ST) is a method to record the vertebral orientation in 3D. Such measurements can be performed in static but also in dynamic situations like gait or other motion tasks. However, dynamic ST measurements are hard to interpret due to their complexity. The main goal of this paper is to provide comprehensive visualization tools which allow a more intuitive and comprehensive interpretation n of such measurements. In particular, juxtaposition and superimposition techniques are utilized to emphasize differences in motion characteristics. The method was applied to a test series of 12 healthy volunteers walking on a treadmill at various speed levels. It could be shown that the visualization tools are helpful to compare different motion sequences including an analysis of intra- and interindividual variation. Based on these techniques, it could be shown that the profiles of vertebral orientation remain considerable constant when one person was walking at different speed levels whereas they differed substantially between the different individuals. In contrast, the motion amplitudes contained high intra- and interindividual variation, i.e. between speed levels and different test persons. In summary, the paper demonstrates that appropriate visualization tools are helpful to interpret ST measurements and cope with the complexity of these data sets. In particular, they can be used to compare different motion sequences in a more comprehensive way.
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Affiliation(s)
- Martin Haimerl
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Kronenstraße 16, 78532 Tuttlingen, Germany.
| | - Iman Nebel
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Kronenstraße 16, 78532 Tuttlingen, Germany
| | - Alina Linkerhägner
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Kronenstraße 16, 78532 Tuttlingen, Germany
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
| | - Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
| | - Philipp Drees
- Department of Orthopedics and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
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Hagins M, Swain CTV, Orishimo KF, Kremenic IJ, Liederbach M. Motion of the multi-segmented spine in elite dancers during passé and arabesque. Gait Posture 2021; 88:198-202. [PMID: 34116396 DOI: 10.1016/j.gaitpost.2021.05.032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 05/11/2021] [Accepted: 05/30/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND The spinal biomechanics of dance tasks have received little study and no studies have used a multi-segmented spinal model. Knowledge of how the segments of the spine move may be useful to the dance clinician and dance educator. RESEARCH QUESTION What is the direction and amount of motion of the primary segments of the spine in elite dancers during an arabesque and a passé? METHODS This observational study examined 59 elite dancers performing an arabesque and a passé using a three-dimensional motion analysis system with the trunk divided into a series of five segments: pelvis, lower lumbar, upper lumbar, lower thoracic and upper thoracic spine. RESULTS For the arabesque, all spinal segments moved in the same direction within each plane and the majority of total spinal motion occurred in the thoracic spine. Thoracic segments were at or near end range position at completion of the arabesque. For the passé, the spinal segments moved in different directions within each plane and the majority of total spinal motion occurred in the lumbar spine. SIGNIFICANCE Dance clinicians and dance educators may benefit from the knowledge that thoracic hypomobility in any plane may limit arabesque performance and that attempts to instruct dancers to achieve a position of passé without flexion of the lumbar spine may be a valid aesthetic ideal but also an unrealistic functional expectation.
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Affiliation(s)
- Marshall Hagins
- Harkness Center for Dance Injuries, NYU Langone Health, 614 2ndAv, Suite G, 2nd Floor, New York, NY 10016, USA.
| | - Christopher T V Swain
- School of Behavioural and Health Sciences, Australian Catholic University, Daniel Mannix Building, 17 Young St, Fitzroy, VIC 3065, Australia.
| | - Karl F Orishimo
- Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, 210 East 64th St, 5th Floor, New York, NY 10065, USA.
| | - Ian J Kremenic
- Nicholas Institute of Sports Medicine and Athletic Trauma, Lenox Hill Hospital, 210 East 64th St, 5th Floor, New York, NY 10065, USA.
| | - Marijeanne Liederbach
- Harkness Center for Dance Injuries, NYU Langone Health, 614 2ndAv, Suite G, 2nd Floor, New York, NY 10016, USA.
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Saito H, Watanabe Y, Kutsuna T, Futohashi T, Kusumoto Y, Chiba H, Kubo M, Takasaki H. Spinal movement variability associated with low back pain: A scoping review. PLoS One 2021; 16:e0252141. [PMID: 34029347 PMCID: PMC8143405 DOI: 10.1371/journal.pone.0252141] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 05/10/2021] [Indexed: 11/19/2022] Open
Abstract
Objective To identify suggestions for future research on spinal movement variability (SMV) in individuals with low back pain (LBP) by investigating (1) the methodologies and statistical tools used to assess SMV; (2) characteristics that influence the direction of change in SMV; (3) the methodological quality and potential biases in the published studies; and (4) strategies for optimizing SMV in LBP patients. Methods We searched literature databases (CENTRAL, Medline, PubMed, Embase, and CINAHL) and comprehensively reviewed the relevant papers up to 5 May 2020. Eligibility criteria included studies investigating SMV in LBP subjects by measuring trunk angle using motion capture devices during voluntary repeated trunk movements in any plane. The Newcastle-Ottawa risk of bias tool was used for data quality assessment. Results were reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Results Eighteen studies were included: 14 cross-sectional and 4 prospective studies. Seven linear and non-linear statistical tools were used. Common movement tasks included trunk forward bending and backward return, and object lifting. Study results on SMV changes associated with LBP were inconsistent. Two of the three interventional studies reported changes in SMV, one of which was a randomized controlled trial (RCT) involving neuromuscular exercise interventions. Many studies did not account for the potential risk of selection bias in the LBP population. Conclusion Designers of future studies should recognize that each of the two types of statistical tools assesses functionally different aspects of SMV. Future studies should also consider dividing participants into subgroups according to LBP characteristics, as three potential subgroups with different SMV characteristics were proposed in our study. Different task demands also produced different effects. We found preliminary evidence in a RCT that neuromuscular exercises could modify SMV, suggesting a rationale for well-designed RCTs involving neuromuscular exercise interventions in future studies.
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Affiliation(s)
- Hiroki Saito
- Department of Physical Therapy, Tokyo University of Technology, Ota-ku, Tokyo, Japan
- * E-mail:
| | - Yoshiteru Watanabe
- Department of Physical Therapy, Tokyo University of Technology, Ota-ku, Tokyo, Japan
| | - Toshiki Kutsuna
- Department of Physical Therapy, Tokyo University of Technology, Ota-ku, Tokyo, Japan
| | - Toshihiro Futohashi
- Department of Physical Therapy, Tokyo University of Technology, Ota-ku, Tokyo, Japan
| | - Yasuaki Kusumoto
- Department of Physical Therapy, Tokyo University of Technology, Ota-ku, Tokyo, Japan
| | - Hiroki Chiba
- Department of Physical Therapy, Secomedic Hospital, Funabashi, Chiba, Japan
- Postgraduate School, Saitama Prefectural University, Koshigaya, Saitama, Japan
| | - Masayoshi Kubo
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Niigata, Japan
| | - Hiroshi Takasaki
- Department of Physical Therapy, Saitama Prefectural University, Koshigaya, Saitama, Japan
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Deane JA, Papi E, Phillips ATM, McGregor AH. Reliability and minimal detectable change of the 'Imperial Spine' marker set for the evaluation of spinal and lower limb kinematics in adults. BMC Res Notes 2020; 13:495. [PMID: 33092633 PMCID: PMC7579883 DOI: 10.1186/s13104-020-05295-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/17/2020] [Indexed: 01/04/2023] Open
Abstract
Objectives As a step towards the comprehensive evaluation of movement in patients with low back pain, the aim of this study is to design a marker set (three rigid segment spine, pelvic and lower limb model) and evaluate the reliability and minimal detectable change (MDC) of this marker set in healthy adults during gait and sit to stand (STS) tasks using three dimensional motion capture. Results The ‘Imperial Spine’ marker set was used to assess relative peak angles during gait and STS tasks using the minimum recommended sample size (n = 10) for reliability studies with minimum Intraclass Correlation Coefficient (ICC) of 0.70, optimum ICC 0.90 and 9 trials replicated per subject per task. Intra- and inter-tester reliability between an experienced and inexperienced user was examined. ICC, mean, standard error (SEM), Bland Altman 95% limits of agreement (LOA) and MDC were computed. ICC values demonstrated excellent intra- and inter-tester reliability in both tasks, particularly in the sagittal plane (majority ICCs > 0.80). SEM measurements were lower in gait (0.8–5.5°) than STS tasks (1°-12.6°) as were MDC values. LOA demonstrated good agreement. The ‘Imperial Spine’ marker set is reliable for use in healthy adults during functional tasks. Future evaluation in patients is required.
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Affiliation(s)
- J A Deane
- Sackler MSK LAB, Sir Michael Uren Hub, Imperial College London, White City Campus, 86 Wood Lane, London, W12 0BZ, UK.
| | - E Papi
- Sackler MSK LAB, Sir Michael Uren Hub, Imperial College London, White City Campus, 86 Wood Lane, London, W12 0BZ, UK
| | - A T M Phillips
- Structural Biomechanics, Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - A H McGregor
- Sackler MSK LAB, Sir Michael Uren Hub, Imperial College London, White City Campus, 86 Wood Lane, London, W12 0BZ, UK
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Simonet E, Winteler B, Frangi J, Suter M, Meier ML, Eichelberger P, Baur H, Schmid S. Walking and running with non-specific chronic low back pain: What about the lumbar lordosis angle? J Biomech 2020; 108:109883. [PMID: 32635997 DOI: 10.1016/j.jbiomech.2020.109883] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/25/2020] [Accepted: 06/06/2020] [Indexed: 01/02/2023]
Abstract
Non-specific chronic low back pain (NSCLBP) is a major health problem, affecting about one fifth of the population worldwide. To avoid further pain or injury, patients with NSCLBP seem to adopt a stiffer movement pattern during everyday living activities. However, it remains unknown how NSCLBP affects the lumbar lordosis angle (LLA) during repetitive activities such as walking or running. This pilot study therefore aimed at exploring possible NSCLBP-related alterations in LLAs during walking and running by focusing on discrete parameters as well as continuous data. Thirteen patients with NSCLBP and 20 healthy pain-free controls were enrolled and underwent a full-body movement analysis involving various everyday living activities such as standing, walking and running. LLAs were derived from markers placed on the spinous processes of the vertebrae L1-L5 and S1. Possible group differences in discrete (average and range of motion (ROM)) and continuous LLAs were analyzed descriptively using mean differences with confidence intervals ranging from 95% to 75%. Patients with NSCLBP indicated reduced average LLAs during standing, walking and running and a tendency for lower LLA-ROM during walking. Analyses of continuous data indicated the largest group differences occurring around 25% and 70% of the walking and 25% and 75% of the running cycle. Furthermore, patients indicated a reversed movement pattern during running, with increasing instead of a decreasing LLAs after foot strike. This study provides preliminary evidence that NSCLBP might affect LLAs during walking and running. These results can be used as a basis for future large-scale investigations involving hypothesis testing.
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Affiliation(s)
- Edwige Simonet
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Balz Winteler
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland; Bern University Hospital, Inselspital, Department of Physiotherapy, Bern, Switzerland
| | - Jana Frangi
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Magdalena Suter
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland; Balgrist University Hospital, Department of Chiropractic Medicine, Integrative Spinal Research, Zurich, Switzerland
| | - Michael L Meier
- Balgrist University Hospital, Department of Chiropractic Medicine, Integrative Spinal Research, Zurich, Switzerland
| | - Patric Eichelberger
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Heiner Baur
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Stefan Schmid
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland.
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Which is the best-suited landmark to assess the thoracic orientation? J Biomech 2020; 102:109545. [PMID: 31787259 DOI: 10.1016/j.jbiomech.2019.109545] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2019] [Revised: 10/29/2019] [Accepted: 11/20/2019] [Indexed: 11/22/2022]
Abstract
Several skin surface-based techniques exist to non-invasively determine the spinal kinematics. However, the accuracy of these techniques is limited by soft-tissue artefacts. Furthermore, structures like the thorax are frequently assumed to be rigid but display considerable mobility within itself. This study aimed to quantify the accuracy at different thoracic landmarks for measuring mobility in healthy individuals during different activities to provide a recommendation for the best suited measurement location. The locations of 29 landmarks were continuously captured on 19 individuals (age: 25-59 years) during sitting, standing, walking, jumping, intra-thoracic motions, and different breathing depths using reflective markers. Marker triplets were used at every landmark to calculate their orientations by first backtracking the rigid-body motion (RBM) of the thorax in general, and subsequently calculating the RBM of each rigid marker triplet. Of the latter, the maximum axis angle for each exercise was statistically evaluated. Landmarks at the middle of the clavicles displayed the largest overall errors (approximately 90° during worst case scenario). However, the variability of errors among the investigated exercises was large. Landmarks at the cranial sternal region (particularly at the "Louis angle") and at the T3 spinous process showed the smallest errors for all subjects and tasks (e.g., <5° and <11°, respectively, during normal breathing). When only one sensor is to be used, it is recommended to use the cranial sternal region to assess the thoracic orientation. Study results highly sensitive to thoracic orientation should be considered with care or performed using more appropriate methods.
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Does manual therapy affect functional and biomechanical outcomes of a sit-to-stand task in a population with low back pain? A preliminary analysis. Chiropr Man Therap 2020; 28:5. [PMID: 31998472 PMCID: PMC6979331 DOI: 10.1186/s12998-019-0290-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Accepted: 12/23/2019] [Indexed: 11/10/2022] Open
Abstract
Introduction Manual therapy (MT) hypothetically affects discrepant neuromuscular control and movement observed in populations with low back pain (LBP). Previous studies have demonstrated the limited influence of MT on movement, predominately during range of motion (ROM) testing. It remains unclear if MT affects neuromuscular control in mobility-based activities of daily living (ADLs). The sit-to-stand (STS) task represents a commonly-performed ADL that is used in a variety of clinical settings to assess functional and biomechanical performance. Objective To determine whether MT affects functional performance and biomechanical performance during a STS task in a population with LBP. Methods Kinematic data were recorded from the pelvis and thorax of participants with LBP, using an optoelectronic motion capture system as they performed a STS task before and after MT from November 2011 to August 2014. MT for each participant consisted of two high-velocity low-amplitude spinal manipulations, as well as two grade IV mobilizations of the lumbar spine and pelvis targeted toward the third lumbar vertebra and sacroiliac joint in a side-lying position; the order of these treatments was randomized. Pelvis and thorax kinematic data were used to derive the time-varying lumbar angle in the sagittal plane for each STS trial. The difference between the maximum and minimum lumbar angles during the STS trial determined the sagittal ROM that was used as the biomechanical outcome. Time to complete each STS trial was used as a functional measure of performance. Pre-MT and post-MT values for the lumbar sagittal ROM and time to completion were statistically analysed using paired samples t-tests. Results Data were obtained from 40 participants with 35 useful datasets (NRS = 3.3 ± 1.2; 32.4 ± 9.8 years; 16 females, 19 males). After MT, lumbar sagittal ROM increased by 2.7 ± 5.5 degrees (p = 0.007). Time to complete the STS test decreased by 0.4 ± 0.4 s (p < 0.001). Discussion These findings provide preliminary evidence that MT might influence the biomechanical and functional performance of an STS task in populations with LBP. The MT intervention in this study involved a combination of spinal manipulations and mobilizations. Future work will expand upon these data as a basis for targeted investigations on the effects of either spinal manipulation and mobilization on neuromuscular control and movement in populations with LBP.
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Breen A, Breen A. Dynamic interactions between lumbar intervertebral motion segments during forward bending and return. J Biomech 2020; 102:109603. [PMID: 31964520 DOI: 10.1016/j.jbiomech.2020.109603] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Revised: 11/26/2019] [Accepted: 12/31/2019] [Indexed: 12/17/2022]
Abstract
Continuous dynamic multi-segmental studies of lumbar motion have added depth to our understanding of the biomechanics of back pain, but few have attempted to continuously measure the proportions of motion accepted by individual levels. This study attempted to compare the motion contributions of adjacent lumbar levels during an active weight bearing flexion and return protocol in chronic, non-specific low back pain (CNSLBP) patients and controls using quantitative fluoroscopy (QF). Eight CNSLBP patients received QF during guided standing lumbar flexion. Dynamic motion sharing of segments from L2 to S1 were calculated and analysed for interactions between levels. Eight asymptomatic controls were then matched to the 8 patients for age and sex and their motion sharing patterns compared. Share of intersegmental motion was found to be consistently highest at L2-L3 and L3-L4 and lowest at L5-S1 throughout the motion in both groups, with the exception of maximum flexion where L4-L5 received the greatest share. Change in motion sharing occurred throughout the flexion and return motion paths in both participant groups but tended to vary more at L4-L5 in patients (p < 0.05). In patients, L5-S1 provided less angular range (p < 0.05) and contributed less at maximum bend (p < 0.05), while L3-L4, on average over the bending sequence, provided a greater share of motion (p < 0.05). Intervertebral motion sharing inequality is therefore a normal feature during lumbar flexion. However, in patients, inequality was more pronounced, and variability of motion share at some levels increased. These effects may result from differences in muscular contraction or in the mechanical properties of the disc.
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Affiliation(s)
- Alexander Breen
- Centre for Biomechanics Research, AECC University College, UK.
| | - Alan Breen
- Faculty of Science and Technology, Bournemouth University, UK
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22
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Papi E, Bull AMJ, McGregor AH. Alteration of movement patterns in low back pain assessed by Statistical Parametric Mapping. J Biomech 2019; 100:109597. [PMID: 31928738 PMCID: PMC7001037 DOI: 10.1016/j.jbiomech.2019.109597] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/16/2019] [Accepted: 12/21/2019] [Indexed: 11/25/2022]
Abstract
Changes in movement pattern in low back pain (LBP) groups have been analysed by reporting predefined discrete variables. However, this approach does not consider the full kinematic data waveform and its dynamic information, potentially exposing the analysis to bias. Statistical Parametric Mapping (SPM) has been introduced and applied to 1 dimensional (D) kinematic variables allowing the assessment of data over time. The aims of this study were to assess differences in 3D kinematics patterns in people with and without LBP during functional tasks by using SPM and to investigate if SPM analysis was consistent with standard 3D range of motion (RoM) assessments. 3D joints kinematics of the spine and lower limbs were compared between 20 healthy controls and 20 participants with non-specific LBP during walking, sit-to-stand and lifting. SPM analysis showed significant differences in the 3Dkinematics of the lower thoracic segment, upper and lower lumbar segment and knee joint during walking and lifting mostly observed at the beginning and/or towards the end of the tasks. ROMs differed between groups in the lower thoracic segment (walking/sit-to-stand), upper and lower lumbar segments (walking/sit-to-stand/lifting), hip and knee (sit-to-stand/lifting). Based on these results, the two approaches can yield different data interpretations. SPM analysis allows the identification of differences in movement that occur over time. This adds value to LBP movement analysis as it allows an understanding of the LBP strategies adopted during motion that may not be conveyed by simple discrete parameters such as ROMs.
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Affiliation(s)
- Enrica Papi
- Department of Surgery and Cancer, Imperial College London, London, UK; Department of Bioengineering, Imperial College London, London, UK.
| | - Anthony M J Bull
- Department of Bioengineering, Imperial College London, London, UK
| | - Alison H McGregor
- Department of Surgery and Cancer, Imperial College London, London, UK
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Suter M, Eichelberger P, Frangi J, Simonet E, Baur H, Schmid S. Measuring lumbar back motion during functional activities using a portable strain gauge sensor-based system: A comparative evaluation and reliability study. J Biomech 2019; 100:109593. [PMID: 31898974 DOI: 10.1016/j.jbiomech.2019.109593] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/15/2019] [Accepted: 12/18/2019] [Indexed: 11/30/2022]
Abstract
Quantifying lumbar back motion during functional activities in real-life environments may contribute to a better understanding of common pathologies such as spinal disorders. The current study therefore aimed at the comparative evaluation of the Epionics SPINE system, a portable device for measuring sagittal lumbar back motion during functional activities. Twenty healthy participants were therefore evaluated with the Epionics SPINE and a Vicon motion capture system in two identical separate research visits. They performed the following activities: standing, sitting, chair rising, box lifting, walking, running and a counter movement jump (CMJ). Lumbar lordosis angles were extracted as continuous values as well as average and range of motion (ROM) parameters. Agreement between the systems was evaluated using Bland-Altman analyses, whereas within- and between-session reliability were assessed using intraclass correlation coefficients (ICC) and minimal detectable changes (MDC). The analysis showed excellent agreement between the systems for chair rising, box lifting and CMJ with a systematic underestimation of lumbar lordosis angles during walking and running. Reliability was moderate to high for all continuous and discrete parameters (ICC ≥ 0.62), except for ROM during running (ICC = 0.29). MDC values were generally below 15°, except for CMJ (peak values up to 20° within and 25° between the sessions). The Epionics SPINE system performed similarly to a Vicon motion capture system for measuring lumbar lordosis angles during functional activities and showed high consistency within and between measurement sessions. These findings can serve researchers and clinicians as a bench mark for future investigations using the system in populations with spinal pathologies.
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Affiliation(s)
- Magdalena Suter
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Patric Eichelberger
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Jana Frangi
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Edwige Simonet
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Heiner Baur
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Stefan Schmid
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland.
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24
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Amelard R, Lam JH, Hill B, Durkin A, Cutler K, Tromberg BJ. Monocular 3D Probe Tracking for Generating Sub-Surface Optical Property Maps From Diffuse Optical Spectroscopic Imaging. IEEE Trans Biomed Eng 2019; 67:1872-1881. [PMID: 31670661 DOI: 10.1109/tbme.2019.2950004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Diffuse optical spectroscopic imaging (DOSI) is a promising biophotonic technology for clinical tissue assessment, but is currently hampered by difficult wide area assessment. A co-integrative optical imaging system is proposed for dense sub-surface optical property spatial assessment. METHODS The proposed system fuses a co-aligned set of camera frames and diffuse optical spectroscopy measurements to generate spatial sub-surface optical property maps. A 3D rigid body motion estimation model was developed by fitting automatically detected target features to an a priori geometric model using a single overhead camera. Point-wise optical properties were measured across the tissue using frequency domain photon migration DOSI. The 3D probe trajectory and temporal optical property data were fused to generate 2D spatial optical property maps, which were projected onto the tissue image using pre-calibrated camera parameters. RESULTS The system demonstrated sub-millimeter positional accuracy (error 0.24 ± 0.35 mm) across different probe speeds (1.0-3.8 cm/s), and displacement accuracy in overhead ([Formula: see text] mm) and tilted (0.51 ± 0.51 mm) camera orientations. Unstructured scans on a tumor inclusion phantom showed strong contrast under different probe paths, and significant ( ) changes in optical properties in an in vivo leg cuff occlusion protocol with spatial anatomy localization. CONCLUSION The proposed co-integrative optical imaging system generated dense sub-surface optical property distributions across wide tissue areas with sub-millimeter accuracy at different probe speeds and trajectories, and does not require pre-planned probe route for tissue assessment. SIGNIFICANCE This system provides a valuable tool for real-time non-invasive tissue health and cancer screening, and enables longitudinal disease progression assessment through unstructured probe-based optical tissue assessment.
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