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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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Christe G, Aussems C, Jolles BM, Favre J. Patients With Chronic Low Back Pain Have an Individual Movement Signature: A Comparison of Angular Amplitude, Angular Velocity and Muscle Activity Across Multiple Functional Tasks. Front Bioeng Biotechnol 2021; 9:767974. [PMID: 34869281 PMCID: PMC8634715 DOI: 10.3389/fbioe.2021.767974] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 10/26/2021] [Indexed: 11/28/2022] Open
Abstract
Despite a large body of evidence demonstrating spinal movement alterations in individuals with chronic low back pain (CLBP), there is still a lack of understanding of the role of spinal movement behavior on LBP symptoms development or recovery. One reason for this may be that spinal movement has been studied during various functional tasks without knowing if the tasks are interchangeable, limiting data consolidation steps. The first objective of this cross-sectional study was to analyze the influence of the functional tasks on the information carried by spinal movement measures. To this end, we first analyzed the relationships in spinal movement between various functional tasks in patients with CLBP using Pearson correlations. Second, we compared the performance of spinal movement measures to differentiate patients with CLBP from asymptomatic controls among tasks. The second objective of the study was to develop task-independent measures of spinal movement and determine the construct validity of the approach. Five functional tasks primarily involving sagittal-plane movement were recorded for 52 patients with CLBP and 20 asymptomatic controls. Twelve measures were used to describe the sagittal-plane angular amplitude and velocity at the lower and upper lumbar spine as well as the activity of the erector spinae. Correlations between tasks were statistically significant in 91 out of 99 cases (0.31 ≤ r ≤ 0.96, all p < 0.05). The area under the curve (AUC) to differentiate groups did not differ substantially between tasks in most of the comparisons (82% had a difference in AUC of ≤0.1). The task-independent measures of spinal movement demonstrated equivalent or higher performance to differentiate groups than functional tasks alone. In conclusion, these findings support the existence of an individual spinal movement signature in patients with CLBP, and a limited influence of the tasks on the information carried by the movement measures, at least for the twelve common sagittal-plane measures analysed in this study. Therefore, this work brought critical insight for the interpretation of data in literature reporting differing tasks and for the design of future studies. The results also supported the construct validity of task-independent measures of spinal movement and encouraged its consideration in the future.
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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
| | - Camille Aussems
- 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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Seerden SFL, Dankaerts W, Swinnen TW, Westhovens R, De Vlam K, Vanwanseele B. Differences in multi-segmental spine kinematics between patients with different stages of axial spondyloarthritis and healthy controls. Musculoskelet Sci Pract 2021; 53:102368. [PMID: 33780698 DOI: 10.1016/j.msksp.2021.102368] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 02/24/2021] [Accepted: 03/13/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND The effects of inflammation and ankylosis on spinal kinematics of patients with axial spondyloarthritis (axSpA) are poorly understood. Furthermore, existence of (mal)adaptive movement profiles within axSpA, and differences between movement profiles in sensation of pain or fear of movement has never been investigated. OBJECTIVES To investigate differences in range of motion in six spinal regions and the hips between inflammatory and ankylosed patients with axSpA, and to increase insight in different movement profiles of patients with axSpA and their association with pain and fear. DESIGN Observational, cross-sectional. METHODS Three-dimensional motion analysis was performed in 20 patients with axSpA and 23 healthy controls during range of motion tasks in all three planes. We compared patients with inflammatory (n = 8) and ankylosed (n = 12) axSpA, and controls. Patients were also classified into Flexion or Lordotic profile. Questionnaires regarding pain and fear of movement were conducted. RESULTS/FINDINGS Both inflammatory and ankylosed axSpA patients have limited spinal ROM and reduced movement speed compared to healthy controls. Patients with a Lordotic profile showed significantly less ROM in lumbar regions and experienced more pain during forward bending than patients with a Flexion profile. CONCLUSIONS Both inflammation and ankylosis contribute to spinal mobility impairment, and axSpA patients with a lordotic profile experienced more pain. This profile may be a maladaptive movement strategy to prevent further pain increase. Suggesting that pain and fear of movement, might be better variables to specify patients' spinal mobility limitations for individual physical therapy and rehabilitation patient profiling.
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Affiliation(s)
- Stefan F L Seerden
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium.
| | - Wim Dankaerts
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium
| | - Thijs W Swinnen
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium; Division of Rheumatology, UZ Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Belgium
| | - Rene Westhovens
- Division of Rheumatology, UZ Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Belgium
| | - Kurt De Vlam
- Division of Rheumatology, UZ Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Belgium
| | - Benedicte Vanwanseele
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium
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Seerden SFL, Dankaerts W, Swinnen TW, Westhovens R, De Vlam K, Vanwanseele B. Axial Spondyloarthritis is associated with changes in lumbosacral loading during daily activities. Clin Biomech (Bristol, Avon) 2021; 85:105347. [PMID: 33905963 DOI: 10.1016/j.clinbiomech.2021.105347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 03/19/2021] [Accepted: 03/29/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND There is currently little insight in lumbar spine loading during activities of daily living in patients with axial spondyloarthritis. Furthermore, it is unclear how inflammation or ankylosis-related mobility limitations in patients with axial spondyloarthritis affect lumbosacral loading, and if lumbar movement profiles have an effect on lumbosacral loading as well. Therefore, the aim of this study is to get more insight in the differences in peak and cumulative lumbosacral loading in patients with axial spondyloarthritis during activities of daily living. METHODS Three-dimensional motion analysis with integrative force-plates was used to calculate peak lumbosacral moment (peak loading) and lumbosacral moment impulse (cumulative loading), of 19 patients with axial spondyloarthritis and 23 healthy controls during forward bending, sit-to-stand and two lifting tasks (symmetric/asymmetric). We compared inflammatory (n = 7) and ankylosed (n = 12) patients with axial spondyloarthritis and controls. Patients were also classified into Flexion or Lordotic profile. FINDINGS Both inflammatory and ankylosed patients generated significantly larger lumbosacral moment impulses than healthy controls in all movements, except during sit-to-stand, where the inflammatory group showed larger moment impulse than both other two groups. Patients with a Lordotic profile showed lowered peak lumbosacral moments and moment impulses compared to those with a Flexion profile. INTERPRETATION Both inflammatory and ankylosed patients experienced more cumulative loading depending on the activity. But our findings suggest that classification of patients into different movement profiles might be more interesting to clinically target specific loading adaptations related to pain and fear of movement.
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Affiliation(s)
- Stefan F L Seerden
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium.
| | - Wim Dankaerts
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium
| | - Thijs W Swinnen
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Sciences, KU Leuven, Belgium; Division of Rheumatology, UZ Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Belgium
| | - Rene Westhovens
- Division of Rheumatology, UZ Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Belgium
| | - Kurt De Vlam
- Division of Rheumatology, UZ Leuven, Belgium; Skeletal Biology and Engineering Research Center, Department of Development and Regeneration, KU Leuven, Belgium
| | - Benedicte Vanwanseele
- Human Movement Biomechanics Research Group, Department of Movement Sciences, KU Leuven, Belgium
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Zhang Y, Haghighi PD, Burstein F, Yap LW, Cheng W, Yao L, Cicuttini F. Electronic Skin Wearable Sensors for Detecting Lumbar-Pelvic Movements. SENSORS 2020; 20:s20051510. [PMID: 32182928 PMCID: PMC7085722 DOI: 10.3390/s20051510] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 02/26/2020] [Accepted: 03/05/2020] [Indexed: 12/16/2022]
Abstract
Background: A nanomaterial-based electronic-skin (E-Skin) wearable sensor has been successfully used for detecting and measuring body movements such as finger movement and foot pressure. The ultrathin and highly sensitive characteristics of E-Skin sensor make it a suitable alternative for continuously out-of-hospital lumbar–pelvic movement (LPM) monitoring. Monitoring these movements can help medical experts better understand individuals’ low back pain experience. However, there is a lack of prior studies in this research area. Therefore, this paper explores the potential of E-Skin sensors to detect and measure the anatomical angles of lumbar–pelvic movements by building a linear relationship model to compare its performance to clinically validated inertial measurement unit (IMU)-based sensing system (ViMove). Methods: The paper first presents a review and classification of existing wireless sensing technologies for monitoring of body movements, and then it describes a series of experiments performed with E-Skin sensors for detecting five standard LPMs including flexion, extension, pelvic tilt, lateral flexion, and rotation, and measure their anatomical angles. The outputs of both E-Skin and ViMove sensors were recorded during each experiment and further analysed to build the comparative models to evaluate the performance of detecting and measuring LPMs. Results: E-Skin sensor outputs showed a persistently repeating pattern for each movement. Due to the ability to sense minor skin deformation by E-skin sensor, its reaction time in detecting lumbar–pelvic movement is quicker than ViMove by ~1 s. Conclusions: E-Skin sensors offer new capabilities for detecting and measuring lumbar–pelvic movements. They have lower cost compared to commercially available IMU-based systems and their non-invasive highly stretchable characteristic makes them more comfortable for long-term use. These features make them a suitable sensing technology for developing continuous, out-of-hospital real-time monitoring and management systems for individuals with low back pain.
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Affiliation(s)
- Yuxin Zhang
- Faculty of Information Technology, Monash University, Melbourne, VIC 3145, Australia; (Y.Z.); (P.D.H.)
| | - Pari Delir Haghighi
- Faculty of Information Technology, Monash University, Melbourne, VIC 3145, Australia; (Y.Z.); (P.D.H.)
| | - Frada Burstein
- Faculty of Information Technology, Monash University, Melbourne, VIC 3145, Australia; (Y.Z.); (P.D.H.)
- Correspondence: (F.B.); (W.C.); Tel.: +61-3-9903-2011 (F.B.); +61-3-9905-3147 (W.C.)
| | - Lim Wei Yap
- Department of Chemical Engineering, Monash University, Melbourne, VIC 3800, Australia;
| | - Wenlong Cheng
- Department of Chemical Engineering, Monash University, Melbourne, VIC 3800, Australia;
- Correspondence: (F.B.); (W.C.); Tel.: +61-3-9903-2011 (F.B.); +61-3-9905-3147 (W.C.)
| | - Lina Yao
- School of Computer Science and Engineering, The University of New South Wales, Sydney, NSW 2052, Australia;
| | - Flavia Cicuttini
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia;
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