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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; 52:2373-2387. [PMID: 39023832 PMCID: PMC11329589 DOI: 10.1007/s10439-024-03567-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [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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de Sousa Almeida AP, Matsui EKK, da Silva FN, de Oliveira Vasconcelos FB, de Oliveira MR. Thoracic Spine Mobility and Posture: Correlation and Predictive Values in Physically Independent Older Adults. Eval Health Prof 2024; 47:133-138. [PMID: 38065535 DOI: 10.1177/01632787231220612] [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] [Indexed: 02/12/2024]
Abstract
The posture undergoes changes during aging and may serve as a marker for the evaluation of the thoracic spine. This study aimed to correlate the variables for the evaluation of thoracic spine mobility and propose predictive equation models from the measurements of the thoracic Schober test and the digital inclinometer in older adults. The mobility of thoracic flexion and extension by levels (T1, T8 and T12) of 41 older adult subjects (66 ± 7 years) was quantified with a digital inclinometer (degrees) and Schober's test (cm). There was a moderate positive correlation between the digital inclinometer and the Schober test at T1 (r = .69), T12 (r = .60), and total flexion levels T1 to T12 (r = .74). Simple linear regression equations showed that thoracic Schober predicts thoracic mobility measures for these same levels. Moderate to strong correlations were observed between the inclinometer and the Schober Test measurements. The development of predictive equation models based on the thoracic Schober test could potentially enhance the ability to predict spinal mobility in physically independent older adults.
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3
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Zhu C, Luo L, Li R, Guo J, Wang Q. Wearable Motion Analysis System for Thoracic Spine Mobility With Inertial Sensors. IEEE Trans Neural Syst Rehabil Eng 2024; 32:1884-1895. [PMID: 38753470 DOI: 10.1109/tnsre.2024.3384926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
This study presents a wireless wearable portable system designed for the automatic quantitative spatio-temporal analysis of continuous thoracic spine motion across various planes and degrees of freedom (DOF). This includes automatic motion segmentation, computation of the range of motion (ROM) for six distinct thoracic spine movements across three planes, tracking of motion completion cycles, and visualization of both primary and coupled thoracic spine motions. To validate the system, this study employed an Inter-days experimental setting to conduct experiments involving a total of 957 thoracic spine movements, with participation from two representatives of varying age and gender. The reliability of the proposed system was assessed using the Intraclass Correlation Coefficient (ICC) and Standard Error of Measurement (SEM). The experimental results demonstrated strong ICC values for various thoracic spine movements across different planes, ranging from 0.774 to 0.918, with an average of 0.85. The SEM values ranged from 0.64° to 4.03°, with an average of 1.93°. Additionally, we successfully conducted an assessment of thoracic spine mobility in a stroke rehabilitation patient using the system. This illustrates the feasibility of the system for actively analyzing thoracic spine mobility, offering an effective technological means for non-invasive research on thoracic spine activity during continuous movement states.
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Yan C, Lynch AC, Alemi MM, Banks JJ, Bouxsein ML, Anderson DE. Validity of evaluating spinal kinetics without participant-specific kinematics. J Biomech 2023; 161:111821. [PMID: 37805384 DOI: 10.1016/j.jbiomech.2023.111821] [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: 01/18/2023] [Revised: 09/12/2023] [Accepted: 09/26/2023] [Indexed: 10/09/2023]
Abstract
Musculoskeletal models are commonly used to estimate in vivo spinal loads under various loading conditions. Typically, participant-specific measured kinematics (PSMK) are coupled with participant-specific models, but obtaining PSMK data can be costly and infeasible in large studies or clinical practice. Thus, we evaluated two alternative methods to estimate spinal loads without PSMK: 1) ensemble average kinematics (EAK) based on kinematics from all participants; and 2) using separately measured individual kinematics (SMIK) from multiple other participants as inputs, then averaging the resulting loads. This study compares the dynamic spine loading patterns and peak loads in older adults performing five lifting tasks using PSMK, EAK and SMIK. Median root mean square errors of EAK and SMIK methods versus PSMK ranged from 18 to 72% body weight for compressive loads and from 2 to 25% body weight for shear loads, with median cross-correlations ranging from 0.931 to 0.991. The root mean square errors and cross-correlations between repeated PSMK trials fell within similar ranges. Compressive peak loads evaluated by EAK and SMIK were not different than PSMK in 12 of 15 cases, while by comparison repeated PSMK trials were not different in 13 of 15 cases. Overall, the resulting spine loading magnitudes and profiles using EAK or SMIK were not notably different than using a PSMK approach, and differences were not greater than between two PSMK trials. Thus, these findings indicate that these approaches may be used to make reasonable estimates of dynamic spinal loading without direct measurement of participant kinematics.
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Affiliation(s)
- Chenxi Yan
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Andrew C Lynch
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Mohammad Mehdi Alemi
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Jacob J Banks
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Mary L Bouxsein
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Dennis E Anderson
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States; Department of Orthopedic Surgery, Harvard Medical School, Boston, MA, United States.
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Koch D, Nüesch C, Ignasiak D, Aghlmandi S, Caimi A, Perrot G, Prüfer F, Harder D, Santini F, Schären S, Ferguson S, Mündermann A, Netzer C. The role of muscle degeneration and spinal balance in the pathophysiology of lumbar spinal stenosis: Study protocol of a translational approach combining in vivo biomechanical experiments with clinical and radiological parameters. PLoS One 2023; 18:e0293435. [PMID: 37889898 PMCID: PMC10610482 DOI: 10.1371/journal.pone.0293435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE To describe a study protocol for investigating the functional association between posture, spinal balance, ambulatory biomechanics, paraspinal muscle fatigue, paraspinal muscle quality and symptoms in patients with symptomatic lumbar spinal stenosis (sLSS) before and 1-year after elective surgical intervention. DESIGN Single-centre prospective, experimental, multimodal (clinical, biomechanical, radiological) study with three instances of data collection: baseline (study visit 1), 6-month follow-up (remote) and 1-year follow-up (study visit 2). Both study visits include an in vivo experiment aiming to elicit paraspinal muscle fatigue for postural assessment in a non-fatigued and fatigued state. EXPERIMENTAL PROTOCOL At baseline and 1-year follow-up, 122 patients with sLSS will be assessed clinically, perform the back-performance scale assessment and complete several patient-reported outcome measure (PROMs) questionnaires regarding overall health, disease-related symptoms and kinesiophobia. Posture and biomechanical parameters (joint kinematics, kinetics, surface electromyography, back curvature) will be recorded using an optoelectronic system and retroreflective markers during different tasks including overground walking and movement assessments before and after a modified Biering-Sørensen test, used to elicit paraspinal muscle fatigue. Measurements of muscle size and quality and the severity of spinal stenosis will be obtained using magnetic resonance imaging (MRI) and sagittal postural alignment data from EOS radiographies. After each study visit, physical activity level will be assessed during 9 days using a wrist-worn activity monitor. In addition, physical activity level and PROMs will be assessed remotely at 6-month follow-up. CONCLUSION The multimodal set of data obtained using the study protocol described in this paper will help to expand our current knowledge on the pathophysiology, biomechanics, and treatment outcome of degenerative sLSS. The results of this study may contribute to defining and/or altering patient treatment norms, surgery indication criteria and post-surgery rehabilitation schedules. TRIAL REGISTRATION The protocol was approved by the regional ethics committee and has been registered at clinicaltrials.gov (NCT05523388).
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Affiliation(s)
- David Koch
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Corina Nüesch
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | | | - Soheila Aghlmandi
- Division of Clinical Epidemiology, University of Basel and University Hospital Basel, Basel, Switzerland
| | - Alice Caimi
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Guido Perrot
- Department of Physiotherapy, University Hospital Basel, Basel, Switzerland
| | - Friederike Prüfer
- Department of Pediatric Radiology, University Children’s Hospital Basel, Basel, Switzerland
| | - Dorothee Harder
- Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Francesco Santini
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Radiology, University Hospital Basel, Basel, Switzerland
| | - Stefan Schären
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | | | - Annegret Mündermann
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
- Department of Orthopaedics and Traumatology, University Hospital Basel, Basel, Switzerland
| | - Cordula Netzer
- Department of Spine Surgery, University Hospital Basel, Basel, Switzerland
- Department of Biomedical Engineering, University of Basel, Basel, Switzerland
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The role of individual physical body measurements and activity on spine kinematics during flexion, lateral bending and twist tasks in healthy young adults – Comparing marker(less) data. Biomed Signal Process Control 2023. [DOI: 10.1016/j.bspc.2022.104517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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7
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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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Liu W, Zang L, Kang N, Yang L, An L, Zhu W, Hai Y. Influence of configuration and anchor in ligamentous augmentation to prevent proximal junctional kyphosis: A finite element study. Front Bioeng Biotechnol 2022; 10:1014487. [DOI: 10.3389/fbioe.2022.1014487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Ligament augmentation has been applied during spinal surgery to prevent proximal junctional kyphosis (PJK), but the configuration and distal anchor strategies are diverse and inconsistent. The biomechanics of different ligament augmentation strategies are, therefore, unclear. We aimed to create a finite element model of the spine for segments T6–S1. Model Intact was the native form, and Model IF was instrumented with a pedicle screw from segments T10 to S1. The remaining models were based on Model IF, with ligament augmentation configurations as common (CM), chained (CH), common and chained (CHM); and distal anchors to the spinous process (SP), crosslink (CL), and pedicle screw (PS), creating SP-CH, PS-CHM, PS-CH, PS-CM, CL-CHM, CL-CH, and CL-CM models. The range of motion (ROM) and maximum stress on the intervertebral disc (IVD), PS, and interspinous and supraspinous ligaments (ISL/SSL) was measured. In the PS-CH model, the ROM for segments T9–T10 was 73% (of Model Intact). In the CL-CHM, CL-CH, CL-CM, PS-CM, and PS-CHM models, the ROM was 8%, 17%, 7%, 13%, and 30%, respectively. The PS-CH method had the highest maximum stress on IVD and ISL/SSL, at 80% and 72%, respectively. The crosslink was more preferable as the distal anchor. In the uppermost instrumented vertebrae (UIV) + 1/UIV segment, the CM was the most effective configuration. The PS-CH model had the highest flexion load on the UIV + 1/UIV segment and the CL-CM model provided the greatest reduction. The CL-CM model should be verified in a clinical trial. The influence of configuration and anchor in ligament augmentation is important for the choice of surgical strategy and improvement of technique.
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Effect of Age on Thoracic, Lumbar, and Pelvis Coordination During Trunk Flexion and Extension. J Appl Biomech 2022; 38:170-178. [DOI: 10.1123/jab.2021-0281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 02/11/2022] [Accepted: 04/08/2022] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to investigate normative and age-related differences in trunk and pelvis kinematics and intersegmental coordination during sagittal plane flexion–extension. Trunk and pelvis kinematics were recorded while 76 participants performed a maximal range of motion task in the sagittal plane. Cross-correlation was calculated to determine the phase lag between adjacent segment motion, and coupling angles were calculated using vector coding and classified into one of 4 coordination patterns: in-phase, antiphase, superior, and inferior phase. A 2-way mixed-model multivariate analysis of variance was used to compare lumbar spine and pelvis angular kinematics, phase lags, and cross-correlation coefficients between groups. Young participants exhibited greater trunk range of motion compared with middle-aged participants. The lumbar spine and pelvis were predominantly rotating with minimum phase lag during flexion and extension movement for both age groups, and differences in coordination between the groups were seen during hyperextension and return to upright position. In conclusion, middle-aged adults displayed lower range of motion but maintained similar movement patterns to young adults, which could be attributed to protective mechanisms. Healthy lumbar and pelvis movement patterns are important to understand and need to be quantified as a baseline, which can be used to develop rehabilitation protocols for individuals with spinal ailments.
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Tire Y, Mermer A, Kozanhan B. Abdominal Crunch Position In Spinal Anesthesia: a Novel Sitting Position. Indian J Surg 2021. [DOI: 10.1007/s12262-021-02744-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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11
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Alemi MM, Burkhart KA, Lynch AC, Allaire BT, Mousavi SJ, Zhang C, Bouxsein ML, Anderson DE. The Influence of Kinematic Constraints on Model Performance During Inverse Kinematics Analysis of the Thoracolumbar Spine. Front Bioeng Biotechnol 2021; 9:688041. [PMID: 34395398 PMCID: PMC8358679 DOI: 10.3389/fbioe.2021.688041] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/28/2021] [Indexed: 11/18/2022] Open
Abstract
Motion analysis is increasingly applied to spine musculoskeletal models using kinematic constraints to estimate individual intervertebral joint movements, which cannot be directly measured from the skin surface markers. Traditionally, kinematic constraints have allowed a single spinal degree of freedom (DOF) in each direction, and there has been little examination of how different kinematic constraints affect evaluations of spine motion. Thus, the objective of this study was to evaluate the performance of different kinematic constraints for inverse kinematics analysis. We collected motion analysis marker data in seven healthy participants (4F, 3M, aged 27–67) during flexion–extension, lateral bending, and axial rotation tasks. Inverse kinematics analyses were performed on subject-specific models with 17 thoracolumbar joints allowing 51 rotational DOF (51DOF) and corresponding models including seven sets of kinematic constraints that limited spine motion from 3 to 9DOF. Outcomes included: (1) root mean square (RMS) error of spine markers (measured vs. model); (2) lag-one autocorrelation coefficients to assess smoothness of angular motions; (3) maximum range of motion (ROM) of intervertebral joints in three directions of motion (FE, LB, AR) to assess whether they are physiologically reasonable; and (4) segmental spine angles in static ROM trials. We found that RMS error of spine markers was higher with constraints than without (p < 0.0001) but did not notably improve kinematic constraints above 6DOF. Compared to segmental angles calculated directly from spine markers, models with kinematic constraints had moderate to good intraclass correlation coefficients (ICCs) for flexion–extension and lateral bending, though weak to moderate ICCs for axial rotation. Adding more DOF to kinematic constraints did not improve performance in matching segmental angles. Kinematic constraints with 4–6DOF produced similar levels of smoothness across all tasks and generally improved smoothness compared to 9DOF or unconstrained (51DOF) models. Our results also revealed that the maximum joint ROMs predicted using 4–6DOF constraints were largely within physiologically acceptable ranges throughout the spine and in all directions of motions. We conclude that a kinematic constraint with 5DOF can produce smooth spine motions with physiologically reasonable joint ROMs and relatively low marker error.
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Affiliation(s)
- Mohammad Mehdi Alemi
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Katelyn A Burkhart
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Andrew C Lynch
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Brett T Allaire
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Seyed Javad Mousavi
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Chaofei Zhang
- Department of Automotive Engineering, Tsinghua University, Beijing, China
| | - Mary L Bouxsein
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Dennis E Anderson
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
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12
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D’Amico M, Kinel E, D’Amico G, Roncoletta P. A Self-Contained 3D Biomechanical Analysis Lab for Complete Automatic Spine and Full Skeleton Assessment of Posture, Gait and Run. SENSORS 2021; 21:s21113930. [PMID: 34200358 PMCID: PMC8201118 DOI: 10.3390/s21113930] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 11/16/2022]
Abstract
Quantitative functional assessment of Posture and Motion Analysis of the entire skeleton and spine is highly desirable. Nonetheless, in most studies focused on posture and movement biomechanics, the spine is only grossly depicted because of its required level of complexity. Approaches integrating pressure measurement devices with stereophotogrammetric systems have been presented in the literature, but spine biomechanics studies have rarely been linked to baropodometry. A new multi-sensor system called GOALS-E.G.G. (Global Opto-electronic Approach for Locomotion and Spine-Expert Gait Guru), integrating a fully genlock-synched baropodometric treadmill with a stereophotogrammetric device, is introduced to overcome the above-described limitations. The GOALS-EGG extends the features of a complete 3D parametric biomechanical skeleton model, developed in an original way for static 3D posture analysis, to kinematic and kinetic analysis of movement, gait and run. By integrating baropodometric data, the model allows the estimation of lower limb net-joint forces, torques and muscle power. Net forces and torques are also assessed at intervertebral levels. All the elaborations are completely automatised up to the mean behaviour extraction for both posture and cyclic-repetitive tasks, allowing the clinician/researcher to perform, per each patient, multiple postural/movement tests and compare them in a unified statistically reliable framework.
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Affiliation(s)
- Moreno D’Amico
- SMART Lab (Skeleton Movement Analysis and Advanced Rehabilitation Technologies)—Bioengineering & Biomedicine Company, 65126 Pescara, Italy; (G.D.); (P.R.)
- Department of Neuroscience, Imaging and Clinical Sciences University G. D’Annunzio, 66100 Chieti, Italy
- Correspondence:
| | - Edyta Kinel
- Department of Rehabilitation, University of Medical Sciences, 61-545 Poznan, Poland;
| | - Gabriele D’Amico
- SMART Lab (Skeleton Movement Analysis and Advanced Rehabilitation Technologies)—Bioengineering & Biomedicine Company, 65126 Pescara, Italy; (G.D.); (P.R.)
| | - Piero Roncoletta
- SMART Lab (Skeleton Movement Analysis and Advanced Rehabilitation Technologies)—Bioengineering & Biomedicine Company, 65126 Pescara, Italy; (G.D.); (P.R.)
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13
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Knechtle D, Schmid S, Suter M, Riner F, Moschini G, Senteler M, Schweinhardt P, Meier ML. Fear-avoidance beliefs are associated with reduced lumbar spine flexion during object lifting in pain-free adults. Pain 2021; 162:1621-1631. [PMID: 33323888 PMCID: PMC8120682 DOI: 10.1097/j.pain.0000000000002170] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 11/24/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022]
Abstract
ABSTRACT There is a long-held belief that physical activities such as lifting with a flexed spine is generally harmful for the back and can cause low back pain (LBP), potentially reinforcing fear-avoidance beliefs underlying pain-related fear. In patients with chronic LBP, pain-related fear has been shown to be associated with reduced lumbar range of motion during lifting, suggesting a protective response to pain. However, despite short-term beneficial effects for tissue health, recent evidence suggests that maintaining a protective trunk movement strategy may also pose a risk for (persistent) LBP due to possible pronociceptive consequences of altered spinal motion, potentially leading to increased loading on lumbar tissues. Yet, it is unknown if similar protective movement strategies already exist in pain-free individuals, which would yield potential insights into the role of fear-avoidance beliefs in motor behavior in the absence of pain. Therefore, the aim of this study is to test whether fear-avoidance beliefs influence spinal motion during lifting in a healthy cohort of pain-free adults without a history of chronic pain. The study subjects (N = 57) filled out several pain-related fear questionnaires and were asked to perform a lifting task (5kg-box). High-resolution spinal kinematics were assessed using an optical motion capturing system. Time-sensitive analyses were performed based on statistical parametric mapping. The results demonstrated time-specific and negative relationships between self-report measures of pain-related fear and lumbar spine flexion angles during lifting, indicating potential unfavorable interactions between psychological factors and spinal motion during lifting in pain-free subjects.
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Affiliation(s)
- Deborah Knechtle
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital Zurich, University of Zurich, Switzerland
- Department of Chiropractic Medicine, University of Zurich, Switzerland
| | - Stefan Schmid
- Spinal Movement Biomechanics Group, Division of Physiotherapy, Department of Health Professions, Bern University of Applied Sciences, Bern, Switzerland
| | - Magdalena Suter
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital Zurich, University of Zurich, Switzerland
- Department of Chiropractic Medicine, University of Zurich, Switzerland
| | - Fabienne Riner
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital Zurich, University of Zurich, Switzerland
- Department of Chiropractic Medicine, University of Zurich, Switzerland
| | - Greta Moschini
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Marco Senteler
- Department of Orthopedics, Balgrist University Hospital, University of Zurich, Zurich, Switzerland; Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | - Petra Schweinhardt
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital Zurich, University of Zurich, Switzerland
- Department of Chiropractic Medicine, University of Zurich, Switzerland
- Alan Edwards Center for Research on Pain, McGill University, Montreal, QC, Canada
| | - Michael L. Meier
- Integrative Spinal Research, Department of Chiropractic Medicine, Balgrist University Hospital Zurich, University of Zurich, Switzerland
- Department of Chiropractic Medicine, University of Zurich, Switzerland
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14
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Grindle DM, Mousavi SJ, Allaire BT, White AP, Anderson DE. Validity of flexicurve and motion capture for measurements of thoracic kyphosis vs standing radiographic measurements. JOR Spine 2020; 3:e1120. [PMID: 33015581 PMCID: PMC7524230 DOI: 10.1002/jsp2.1120] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/26/2020] [Accepted: 07/30/2020] [Indexed: 12/25/2022] Open
Abstract
Thoracic kyphosis varies among healthy adults and typically increases with age. Excessive kyphosis (hyperkyphosis) is associated with negative health. Spinal alignment also affects spine loading, with implications for conditions such as vertebral fractures and back pain. Valid measurements of kyphosis are necessary for clinical and research assessment of age-related posture changes, and to support improved biomechanical understating of spine conditions. Independent validation of non-radiographic techniques, however, remains limited. The goal of this study was to compare standing radiographic kyphosis measurements with non-radiographic measurements and predictions of thoracic kyphosis using flexicurve and motion analysis markers, in order to determine their validity. Thirteen non-radiographic measures of thoracic kyphosis were obtained in each of 40 adult subjects who also underwent standing radiographs of the thoracic spine. Measures included estimates derived by fitting of polynomials or circles to the non-radiographic data, as well as predictions calculated using previously published methods. Intra-class correlations (ICC) and root-mean square errors (RMSEs) were calculated between radiographic and non-radiographic measures to determine validity. Most non-radiographic estimates of kyphosis show similar, weak to moderate levels of validity when compared to radiographic measurements, and RMSEs ranging from 8.0° to 20.8°. Unbiased estimates of radiographic measurements with moderate to good ICCs were identified, however, based on marker measurements, and new prediction equations were created with similar validity that also account for age and body habitus. Clinical significance: These non-radiographic measurements of thoracic kyphosis can be applied to clinical practice or to clinical studies with recognition of specific limitations.
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Affiliation(s)
- Daniel M. Grindle
- Department of Biomedical Engineering and MechanicsVirginia Polytechnic Institute and State UniversityBlacksburgVirginiaUSA
| | - Seyed Javad Mousavi
- Department of Orthopaedic SurgeryHarvard Medical SchoolBostonMassachusettsUSA
- Department of Orthopaedic SurgeryBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Brett T. Allaire
- Department of Orthopaedic SurgeryBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Andrew P. White
- Department of Orthopaedic SurgeryHarvard Medical SchoolBostonMassachusettsUSA
- Department of Orthopaedic SurgeryBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
| | - Dennis E. Anderson
- Department of Orthopaedic SurgeryHarvard Medical SchoolBostonMassachusettsUSA
- Department of Orthopaedic SurgeryBeth Israel Deaconess Medical CenterBostonMassachusettsUSA
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15
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Severijns P, Overbergh T, Thauvoye A, Baudewijns J, Monari D, Moke L, Desloovere K, Scheys L. A subject-specific method to measure dynamic spinal alignment in adult spinal deformity. Spine J 2020; 20:934-946. [PMID: 32058084 DOI: 10.1016/j.spinee.2020.02.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 12/19/2019] [Accepted: 02/03/2020] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Two-dimensional static radiography currently forms the golden standard in spinal alignment measurement in adult spinal deformity (ASD). However, these static measurements offer no information on dynamic spinal behavior. To fully understand the functionality and compensation strategies of ASD patients, tools to assess dynamic spinal alignment are needed. PURPOSE Therefore, the aim of this study was to introduce, validate and assess the reliability of a new kinematic model to measure dynamic spinal parameters in ASD based on a polynomial function, taking into account the subject-specific anatomy. STUDY DESIGN Validation and reliability study OUTCOME MEASURES: Radiographic parameters, spinal kinematics and range of motion (ROM), Scoliosis Research Society Outcome Questionnaire (SRS-22), Core Outcome Measures Index (COMI). METHODS Spinal alignment of 23 ASD patients and 18 controls was measured using both x-rays and motion capture. Marker positions were corrected to the underlying anatomy and a polynomial function was fitted through these corrected marker positions. By comparing the polynomial method to x-ray measurements concurrent validity was assessed. Test-retest, inter- and intrarater reliability during standing and sit-to-stand (STS) were assessed on a subsample of eight ASD patients and eight controls. RESULTS The results showed good to excellent correlations (r>0.75) between almost all x-ray and anatomy-corrected polynomial parameters. Anatomy correction consistently led to better correlations than no correction. Intraclass correlation coefficients for the polynomial method were good to excellent (>0.75) between sessions and between and within raters and comparable or even better than radiographic measurements. Also, during STS reliability was excellent. Fair to moderate correlations were found between spinal ROM during STS and quality of life, measured with SRS-22 and COMI. CONCLUSIONS The results of this study indicate the polynomial method, with subject-specific anatomy correction, can measure spinal alignment in a valid and reliable way using motion capture in both healthy and deformed spines. This method makes it possible to extend evaluation in ASD from mainly static, by means of x-ray measurements, to dynamic and functional assessments. CLINICAL SIGNIFICANCE Eventually, this newly obtained dynamic spinal alignment information might lead to new insights in clinical decision-making and new treatment strategies, based and oriented on dynamic parameters and functionality.
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Affiliation(s)
- Pieter Severijns
- Department of Development and Regeneration, Faculty of Medicine, Institute for Orthopaedic Research and Training (IORT), KU Leuven, Leuven, Belgium; Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory (CMAL), University Hospitals Leuven, Leuven, Belgium.
| | - Thomas Overbergh
- Department of Development and Regeneration, Faculty of Medicine, Institute for Orthopaedic Research and Training (IORT), KU Leuven, Leuven, Belgium
| | - Anaïsse Thauvoye
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Jana Baudewijns
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Davide Monari
- Clinical Motion Analysis Laboratory (CMAL), University Hospitals Leuven, Leuven, Belgium; Department of Mechanical Engineering, Faculty of Engineering, KU Leuven, Leuven, Belgium
| | - Lieven Moke
- Department of Development and Regeneration, Faculty of Medicine, Institute for Orthopaedic Research and Training (IORT), KU Leuven, Leuven, Belgium; Division of Orthopaedics, University Hospitals Leuven, Leuven, Belgium
| | - Kaat Desloovere
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium; Clinical Motion Analysis Laboratory (CMAL), University Hospitals Leuven, Leuven, Belgium
| | - Lennart Scheys
- Department of Development and Regeneration, Faculty of Medicine, Institute for Orthopaedic Research and Training (IORT), KU Leuven, Leuven, Belgium; Division of Orthopaedics, University Hospitals Leuven, Leuven, Belgium
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16
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Ignasiak D. A novel method for prediction of postoperative global sagittal alignment based on full-body musculoskeletal modeling and posture optimization. J Biomech 2020; 102:109324. [PMID: 31526589 DOI: 10.1016/j.jbiomech.2019.109324] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 08/18/2019] [Accepted: 08/23/2019] [Indexed: 01/09/2023]
Abstract
Associations between spinal sagittal balance and pain and disability are well documented. Reciprocal changes after spinal surgery might be critical for the outcomes, but assessing their extent remains a challenge. This paper proposes a method for predicting full-body sagittal alignment including reciprocal changes in response to spinal fusion, based on musculoskeletal modeling and inverse-inverse dynamics approach. An established body model (AnyBody) was used, with fused segments modeled as rigid. Posture was optimized based on muscle expenditure minimization, following the concept of the cone of economy. The data of adult spinal fusion patients were obtained retrospectively from an ongoing clinical study. Patient spino-pelvic alignment, body weight and height, age- and pathology-related muscle deterioration, and underwent treatment details were represented in the model. Predicted postural changes were compared to follow-up radiographs to evaluate method validity. Twenty-one cases were analyzed in this preliminary study (age range = 48-74; number of fused segments 1-14). The model predictions correlated well with the radiographic measures at follow-up: TPA, r = 0.83; ΔPILL, r = 0.90; LL, r = 0.90; TK, r = 0.77. The model demonstrated high accuracy in predicting sagittal imbalance (positive predictive value = 1.00, negative predictive value = 0.75). The presented method for patient- and treatment-specific postoperative posture prediction can be used to guide preoperative planning of spinal fusion, but more extensive validation is needed.
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17
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Lin H, Seerden S, Zhang X, Fu W, Vanwanseele B. Inter-segmental coordination of the spine is altered during lifting in patients with ankylosing spondylitis: A cross-sectional study. Medicine (Baltimore) 2020; 99:e18941. [PMID: 32000413 PMCID: PMC7004575 DOI: 10.1097/md.0000000000018941] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The abnormal inter-segmental coordination of the spine during lifting could be used to monitor disease progression and rehabilitation efficacy in patients with ankylosing spondylitis (AS). This study aimed to compare the inter-segmental coordination patterns and variability of the spine during lifting between patients with AS (n = 9) and control (n = 15) groups.Continuous relative (CRP) and deviation (DP) phases between each segment of the spine (two lumbar and three thorax segments) and lumbosacral joint were calculated. The CRP and DP curves among participants were decomposed into few functional principal components (FPC) via functional principal component analysis (FPCA). The FPC score of CRP or DP of the two groups were compared, and its relationship with the indexes of spinal mobility was investigated.Compared with the control group, the AS patients showed more anti-phase coordination patterns in each relative upper spine segment and lumbosacral joint. In addition, either less or more variation was found in the coordination of each relative lower spine segment and lumbosacral joint during different time periods of lifting for these patients. Some cases were considerably related to spinal mobility.the inter-segmental coordination of the spine was altered during lifting in AS patients to enable movement, albeit inefficient and might cause spinal mobility impairment.
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Affiliation(s)
- Huijie Lin
- College of Teacher Education, Taizhou University, Linhai,
Zhejiang, China
| | - Stefan Seerden
- Department of Movement Sciences Group, KU Leuven, Leuven,
Belgium
| | - Xianyi Zhang
- Department of Movement Sciences Group, KU Leuven, Leuven,
Belgium
| | - Weijie Fu
- Key Laboratory of Exercise and Health Sciences of
Ministry of Education, Shanghai University of Sport, Shanghai, China
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18
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Beaudette SM, Zwambag DP, Graham RB, Brown SHM. Discriminating spatiotemporal movement strategies during spine flexion-extension in healthy individuals. Spine J 2019; 19:1264-1275. [PMID: 30742973 DOI: 10.1016/j.spinee.2019.02.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2018] [Revised: 02/04/2019] [Accepted: 02/05/2019] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT The spine is an anatomically complex system with numerous degrees of freedom. Due to this anatomical complexity, it is likely that multiple motor control options exist to complete a given task. PURPOSE To identify if distinct spine spatiotemporal movement strategies are utilized in a homogenous sample of young healthy participants. STUDY DESIGN Kinematic data were captured from a single cohort of male participants (N=51) during a simple, self-controlled spine flexion-extension task. METHODS Thoracic and lumbar flexion-extension data were analyzed to extract the continuous relative phase between each spine subsection. Continuous relative phase data were evaluated using a principal component analysis to identify major sources of variation in spine movement coordination. Unsupervised machine learning (k-means clustering) was used to identify distinct clusters present within the healthy participants sampled. Once distinguished, intersegmental spine kinematics were compared amongst clusters. RESULTS The findings of the current work suggest that there are distinct timing strategies that are utilized, within the participants sampled, to control spine flexion-extension movement. These strategies differentiate the sequencing of intersegmental movement and are not discriminable on the basis of simple participant demographic characteristics (ie, age, height, and body mass index), total movement time or range of motion. CONCLUSIONS Spatiotemporal spine flexion-extension patterns are not uniform across a population of young healthy individuals. CLINICAL SIGNIFICANCE Future work needs to identify whether the motor patterns characterized with this work are driven by distinct neuromuscular activation patterns, and if each given pattern has a varied risk for low back injury.
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Affiliation(s)
- Shawn M Beaudette
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa Ontario, Canada
| | - Derek P Zwambag
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo Ontario, Canada
| | - Ryan B Graham
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa Ontario, Canada
| | - Stephen H M Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph Ontario, Canada.
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19
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Zwambag DP, Beaudette SM, Gregory DE, Brown SHM. Distinguishing between typical and atypical motion patterns amongst healthy individuals during a constrained spine flexion task. J Biomech 2019; 86:89-95. [PMID: 30739768 DOI: 10.1016/j.jbiomech.2019.01.047] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 12/17/2018] [Accepted: 01/25/2019] [Indexed: 11/29/2022]
Abstract
Despite 'abnormal' motion being considered a risk factor for low back injury, the current understanding of 'normal' spine motion is limited. Identifying normal motion within an individual is complicated by the considerable variation in movement patterns amongst healthy individuals. Therefore, the purpose of this study was to characterize sources of variation in spine motion among a sample of healthy participants. The second objective of this study was to develop a multivariate model capable of predicting an expected movement pattern for an individual. The kinematic shape of the lower thoracic and lumbar spine was recorded during a constrained dynamic trunk flexion movement; as this is not a normal everyday movement task, movements are considered 'typical' and 'atypical' for this task rather than 'normal' and 'abnormal'. Variations in neutral standing posture accounted for 85% of the variation in spine motion throughout the task. Differences in total spine range of flexion and a regional re-weighting of range of motion between lower thoracic and lumbar regions explained a further 9% of the variance among individuals. The analysis also highlighted a difference in temporal sequencing of motion between lower thoracic and lumbar regions which explained 2% of the total movement variation. These identified sources of variation were used to select independent variables for a multivariate linear model capable of predicting an individuals' expected movement pattern. This was done as a proof-of-concept to demonstrate how the error between predicted and observed motion patterns could be used to differentiate between 'typical' and 'atypical' movement strategies.
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Affiliation(s)
- Derek P Zwambag
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Shawn M Beaudette
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada
| | - Diane E Gregory
- Department of Kinesiology & Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada; Department of Health Sciences, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Stephen H M Brown
- Department of Human Health and Nutritional Sciences, University of Guelph, Guelph, ON, Canada.
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20
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Arshad R, Pan F, Reitmaier S, Schmidt H. Effect of age and sex on lumbar lordosis and the range of motion. A systematic review and meta-analysis. J Biomech 2018; 82:1-19. [PMID: 30503255 DOI: 10.1016/j.jbiomech.2018.11.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 12/19/2022]
Abstract
Lumbar lordosis (LL) and the range of motion (RoM) are important physiological measurements when initiating any diagnosis and treatment plan for patients with low back pain. Numerous studies reported differences in LL and the RoM due to age and sex. However, these findings remain contradictory. A systematic review and meta-analysis were performed to synthesize mean values and the differences in LL and the RoM because of age and sex. The quality assessment tool for quantitative studies was applied to assess the methodological quality of the studies included. We identified 2372 papers through electronic (2309) and physical (63) searches. We assessed 218 full-text studies reporting measurements of LL or the RoM. In total, 65 studies were included, and a normative database for LL and the RoM is provided as supplementary material. Among these, 11 were included in the meta-analysis. LL and the RoM displayed non-monotonic variations with significant age and sex differences. Young females showed a significantly greater LL and the range of extension (RoE), whereas young males exhibited a greater range of flexion (RoF). Sex differences in the range of lateral bending (RoLB) were small but were significant for the axial rotation (RoAR). For the RoF, RoE and RoLB, differences because of age were significant among most of the age groups in both sexes, whereas for the RoAR, differences were significant only between the 20s vs the 30s-40s (males) and 40s vs 50s (females). Significant differences because of age/sex were identified. However, the age-dependent reduction in LL and the RoM was non-monotonic and differed in both sexes. These findings will help to better distinguish between functional deficits caused by spinal disorders and natural factors/conditions related to age and sex.
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Affiliation(s)
- Rizwan Arshad
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Fumin Pan
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Sandra Reitmaier
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Hendrik Schmidt
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
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21
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Mousavi SJ, Tromp R, Swann MC, White AP, Anderson DE. Between-session reliability of opto-electronic motion capture in measuring sagittal posture and 3-D ranges of motion of the thoracolumbar spine. J Biomech 2018; 79:248-252. [PMID: 30213648 DOI: 10.1016/j.jbiomech.2018.08.033] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 08/28/2018] [Accepted: 08/29/2018] [Indexed: 12/15/2022]
Abstract
This study evaluated between-session reliability of opto-electronic motion capture to measure trunk posture and three-dimensional ranges of motion (ROM). Nineteen healthy participants aged 24-74 years underwent spine curvature, pelvic tilt and trunk ROM measurements on two separate occasions. Rigid four-marker clusters were attached to the skin overlying seven spinous processes, plus single markers on pelvis landmarks. Rigid body rotations of spine marker clusters were calculated to determine neutral posture and ROM in flexion, extension, total lateral bending (left-right) and total axial rotation (left-right). Segmental spine ROM values were in line with previous reports using opto-electronic motion capture. Intraclass correlation coefficients (ICC) and standard error of measurement (SEM) were calculated as measures of between-session reliability and measurement error, respectively. Retroreflective markers showed fair to excellent between-session reliability to measure thoracic kyphosis, lumbar lordosis, and pelvic tilt (ICC = 0.82, 0.63, and 0.54, respectively). Thoracic and lumbar segments showed highest reliabilities in total axial rotation (ICC = 0.78) and flexion-extension (ICC = 0.77-0.79) ROM, respectively. Pelvic segment showed highest ICC values in flexion (ICC = 0.78) and total axial rotation (ICC = 0.81) trials. Furthermore, it was estimated that four or fewer repeated trials would provide good reliability for key ROM outcomes, including lumbar flexion, thoracic and lumbar lateral bending, and thoracic axial rotation. This demonstration of reliability is a necessary precursor to quantifying spine kinematics in clinical studies, including assessing changes due to clinical treatment or disease progression.
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Affiliation(s)
- Seyed Javad Mousavi
- Beth Israel Deaconess Medical Center, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Rebecca Tromp
- Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Matthew C Swann
- Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Andrew P White
- Beth Israel Deaconess Medical Center, Boston, MA, United States; Harvard Medical School, Boston, MA, United States
| | - Dennis E Anderson
- Beth Israel Deaconess Medical Center, Boston, MA, United States; Harvard Medical School, Boston, MA, United States.
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22
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The effect of muscle ageing and sarcopenia on spinal segmental loads. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2018; 27:2650-2659. [DOI: 10.1007/s00586-018-5729-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/09/2018] [Accepted: 08/09/2018] [Indexed: 12/18/2022]
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23
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Pan F, Firouzabadi A, Reitmaier S, Zander T, Schmidt H. The shape and mobility of the thoracic spine in asymptomatic adults - A systematic review of in vivo studies. J Biomech 2018; 78:21-35. [PMID: 30100219 DOI: 10.1016/j.jbiomech.2018.07.041] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 12/29/2022]
Abstract
A comprehensive knowledge of the thoracic shape and kinematics is essential for effective risk prevention, diagnose and proper management of thoracic disorders and assessment of treatment or rehabilitation strategies as well as for in silico and in vitro models for realistic applications of boundary conditions. After an extensive search of the existing literature, this study summarizes 45 studies on in vivo thoracic kyphosis and kinematics and creates a systematic and detailed database. The thoracic kyphosis over T1-12 determined using non-radiological devices (34°) was relatively less than measured using radiological devices (40°) during standing. The majority of kinematical measurements are based on non-radiological devices. The thoracic range of motion (RoM) was greatest during axial rotation (40°), followed by lateral bending (26°), and flexion (21°) when determined using non-radiological devices during standing. The smallest RoM was identified during extension (13°). The lower thoracic level (T8-12) contributed more to the RoM than the upper (T1-4) and middle (T4-8) levels during flexion and lateral bending. During axial rotation and extension, the middle level (T4-8) contributed the most. Coupled motion was evident, mostly during lateral bending and axial rotation. With aging, the thoracic kyphosis increased by about 3° per decade, whereas the RoM decreased by about 5° per decade for all load directions. These changes with aging mainly occurred in the lower region (T6-12). The influence of sex on thoracic kyphosis and the RoM has been described as partly contradictory. Obesity was found to decrease the thoracic RoM. Studies comparing standing, sitting and lying reported the effect of posture as significant.
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Affiliation(s)
- Fumin Pan
- 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
| | - Sandra Reitmaier
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Thomas Zander
- 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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24
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Ignasiak D, Rüeger A, Sperr R, Ferguson SJ. Thoracolumbar spine loading associated with kinematics of the young and the elderly during activities of daily living. J Biomech 2017; 70:175-184. [PMID: 29248192 DOI: 10.1016/j.jbiomech.2017.11.033] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 11/03/2017] [Accepted: 11/26/2017] [Indexed: 01/27/2023]
Abstract
Excessive mechanical loading of the spine is a critical factor in vertebral fracture initiation. Most vertebral fractures develop spontaneously or due to mild trauma, as physiological loads during activities of daily living might exceed the failure load of osteoporotic vertebra. Spinal loading patterns are affected by vertebral kinematics, which differ between elderly and young individuals. In this study, the effects of age-related changes in spine kinematics on thoracolumbar spinal segmental loading during dynamic activities of daily living were investigated using combined experimental and modeling approach. Forty-four healthy volunteers were recruited into two age groups: young (N = 23, age = 27.1 ± 3.8) and elderly (N = 21, age = 70.1 ± 3.9). The spinal curvature was assessed with a skin-surface device and the kinematics of the spine and lower extremities were recorded during daily living tasks (flexion-extension and stand-sit-stand) with a motion capture system. The obtained data were used as input for a musculoskeletal model with a detailed thoracolumbar spine representation. To isolate the effect of kinematics on predicted loads, other model properties were kept constant. Inverse dynamics simulations were performed in the AnyBody Modeling System to estimate corresponding spinal loads. The maximum compressive loads predicted for the elderly motion patterns were lower than those of the young for L2/L3 and L3/L4 lumbar levels during flexion and for upper thoracic levels during stand-to-sit (T1/T2-T8/T9) and sit-to-stand (T3/T4-T6/T7). However, the maximum loads predicted for the lower thoracic levels (T9/T10-L1/L2), a common site of vertebral fractures, were similar compared to the young. Nevertheless, these loads acting on the vertebrae of reduced bone quality might contribute to a higher fracture risk for the elderly.
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Affiliation(s)
| | | | - Ramona Sperr
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
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