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Arauz PG, Garcia MG, Chiriboga P, Okushiro V, Vinueza B, Fierro K, Zuñiga J, Taco-Vasquez S, Kao I, Sisto SA. In-vivo 3-dimensional spine and lower body gait symmetry analysis in healthy individuals. Heliyon 2024; 10:e28345. [PMID: 38689989 PMCID: PMC11059545 DOI: 10.1016/j.heliyon.2024.e28345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 05/02/2024] Open
Abstract
Background Numerous research studies have delved into the biomechanics of walking, focusing on the spine and lower extremities. However, understanding the symmetry of walking in individuals without health issues poses a challenge, as those with normal mobility may exhibit uneven movement patterns due to inherent functional differences between their left and right limbs. The goal of this study is to examine the three-dimensional kinematics of gait symmetry in the spine and lower body during both typical and brisk overground walking in healthy individuals. The analysis will utilize statistical methods and symmetry index approaches. Furthermore, the research aims to investigate whether factors such as gender and walking speed influence gait symmetry. Methods Sixty young adults in good health, comprising 30 males and 30 females, underwent motion capture recordings while engaging in both normal and fast overground walking. The analysis focused on interlimb comparisons and corresponding assessments of side-specific spine and pelvis motions. Results Statistical Parametric Mapping (SPM) predominantly revealed gait symmetries between corresponding left and right motions in the spine, pelvis, hip, knee, and ankle during both normal and fast overground walking. Notably, both genders exhibited asymmetric pelvis left-right obliquity, with women and men showing an average degree of asymmetry between sides of 0.9 ± 0.1° and 1.5 ± 0.1°, respectively. Furthermore, the analysis suggested that neither sex nor walking speed appeared to exert influence on the 3D kinematic symmetry of the spine, pelvis, and lower body in healthy individuals during gait. While the maximum normalized symmetry index (SInorm) values for the lower thorax, upper lumbar, lower lumbar, pelvis, hip, knee, and ankle displayed significant differences between sexes and walking speeds for specific motions, no interaction between sex and walking speed was observed. Significance The findings underscore the potential disparities in data interpretations between the two approaches. While SPM discerns temporal variations in movement, these results offer valuable insights that may enhance our comprehension of gait symmetry in healthy individuals, surpassing the limitations of straightforward discrete parameters like the maximum SInorm. The information gleaned from this study could serve as reference indicators for diagnosing and evaluating abnormal gait function.
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Affiliation(s)
- Paul G. Arauz
- Department of Orthopaedics, Stony Brook University, Stony Brook, NY, United States
| | - Maria-Gabriela Garcia
- Colegio de Ciencias e Ingenierías “El Politécnico”, Universidad San Francisco de Quito USFQ, Quito, Pichincha, Ecuador
| | - Patricio Chiriboga
- Colegio de Ciencias e Ingenierías “El Politécnico”, Universidad San Francisco de Quito USFQ, Quito, Pichincha, Ecuador
| | - Vinnicius Okushiro
- Colegio de Ciencias e Ingenierías “El Politécnico”, Universidad San Francisco de Quito USFQ, Quito, Pichincha, Ecuador
| | - Bonnie Vinueza
- Colegio de Ciencias e Ingenierías “El Politécnico”, Universidad San Francisco de Quito USFQ, Quito, Pichincha, Ecuador
| | - Kleber Fierro
- Colegio de Ciencias e Ingenierías “El Politécnico”, Universidad San Francisco de Quito USFQ, Quito, Pichincha, Ecuador
| | - José Zuñiga
- Colegio de Ciencias e Ingenierías “El Politécnico”, Universidad San Francisco de Quito USFQ, Quito, Pichincha, Ecuador
| | - Sebastian Taco-Vasquez
- Departamento de Ingeniería Química, Escuela Politécnica Nacional, Quito, Pichincha, Ecuador
| | - Imin Kao
- Department of Mechanical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Sue Ann Sisto
- Department of Rehabilitation Science, University at Buffalo, Buffalo, NY, United States
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Madinei S, Nussbaum MA. Estimating lumbar spine loading when using back-support exoskeletons in lifting tasks. J Biomech 2023; 147:111439. [PMID: 36638578 DOI: 10.1016/j.jbiomech.2023.111439] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 12/14/2022] [Accepted: 01/06/2023] [Indexed: 01/09/2023]
Abstract
Low-back pain (LBP) continues as the leading cause of work-related musculoskeletal disorders, and the high LBP burden is attributed largely to physical risk factors prevalent in manual material handling tasks. Industrial back-support exoskeletons (BSEs) are a promising ergonomic intervention to help control/prevent exposures to such risk factors. While earlier research has demonstrated beneficial effects of BSEs in terms of reductions in superficial back muscle activity, limited evidence is available regarding the impacts of these devices on spine loads. We evaluated the effects of two passive BSEs (BackX™ AC and Laevo™ V2.5) on lumbosacral compression and shear forces during repetitive lifting using an optimization-based model. Eighteen participants (gender-balanced) completed four minutes of repetitive lifting in nine different conditions, involving symmetric and asymmetric postures when using the BSEs (along with no BSE as a control condition). Using both BSEs reduced estimated peak compression and anteroposterior shear forces (by ∼8-15%). Such reductions, however, were task-specific and depended on the BSE design. Laevo™ use reduced mediolateral shear forces during asymmetric lifting (by ∼35%). We also found that reductions in composite measures of trunk muscle activity may not correspond well with changes in spine forces when using a BSE. These results can help guide the proper selection and application of BSEs during repetitive lifting tasks. Future work is recommended to explore the viability of different biomechanical models to assess changes in spine mechanical loads when using BSEs and whether reasonable estimates would be obtained using such models.
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Affiliation(s)
- Saman Madinei
- Department of Industrial and Systems Engineering, Virginia Tech, 250 Durham Hall (0118), Blacksburg, VA 24061, USA
| | - Maury A Nussbaum
- Department of Industrial and Systems Engineering, Virginia Tech, 250 Durham Hall (0118), Blacksburg, VA 24061, USA.
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Gaffney BMM, Vandenberg NW, Davis-Wilson HC, Christiansen CL, Roda GF, Schneider G, Johnson T, Stoneback JW. Biomechanical compensations during a stand-to-sit maneuver using transfemoral osseointegrated prostheses: A case series. Clin Biomech (Bristol, Avon) 2022; 98:105715. [PMID: 35839740 DOI: 10.1016/j.clinbiomech.2022.105715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 04/24/2022] [Accepted: 07/05/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with transfemoral amputation and socket prostheses are at a heightened risk of developing musculoskeletal overuse injuries, commonly due to altered joint biomechanics. Osseointegrated prostheses, which involve direct anchorage of the prosthesis to the residual limb through a bone anchored prosthesis, are a novel alternative to sockets yet their biomechanical effect is largely unknown. METHODS Four patients scheduled to undergo unilateral transfemoral prosthesis osseointegration completed two data collections (baseline with socket prosthesis and 12-months after prosthesis osseointegration) in which whole-body kinematics and ground reaction forces were collected during stand-to-sit tasks. Trunk, pelvis, and hip kinematics, and the surrounding muscle forces, were calculated using subject-specific musculoskeletal models developed in OpenSim. Peak joint angles and muscle forces were compared between timepoints using Cohen's d effect sizes. FINDINGS Compared to baseline with socket prostheses, patients with osseointegrated prostheses demonstrated reduced lateral trunk bending (d = 1.46), pelvic obliquity (d = 1.09), and rotation (d = 1.77) toward the amputated limb during the stand to sit task. This was accompanied by increased amputated limb hip flexor, abductor, and rotator muscle forces (d> > 0.8). INTERPRETATION Improved lumbopelvic movement patterns and stabilizing muscle forces when using an osseointegrated prosthesis indicate that this novel prosthesis type likely reduces the risk of the development and/or progression of overuse injuries, such as low back pain and osteoarthritis. We attribute the increased muscle hip muscle forces to the increased load transmission between the osseointegrated prosthesis and residual limb, which allows a greater eccentric ability of the amputated limb to control lowering during the stand-to-sit task.
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Affiliation(s)
- Brecca M M Gaffney
- Department of Mechanical Engineering, University of Colorado Denver, Denver, CO, United States of America; Center for Bioengineering, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America.
| | - Nicholas W Vandenberg
- Department of Mechanical Engineering, University of Colorado Denver, Denver, CO, United States of America
| | - Hope C Davis-Wilson
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America; VA Eastern Colorado Healthcare System, Aurora, CO, United States of America
| | - Cory L Christiansen
- Physical Therapy Program, Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America; VA Eastern Colorado Healthcare System, Aurora, CO, United States of America
| | - Galen F Roda
- Department of Mechanical Engineering, University of Colorado Denver, Denver, CO, United States of America
| | - Gary Schneider
- University of Colorado Hospital, Aurora, CO, United States of America
| | - Tony Johnson
- University of Colorado Hospital, Aurora, CO, United States of America
| | - Jason W Stoneback
- Department of Orthopedics, University of Colorado Anschutz Medical Campus, Aurora, CO, United States of America
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Chan VCH, Welsh TN, Tremblay L, Frost DM, Beach TAC. A comparison of augmented feedback and didactic training approaches to reduce spine motion during occupational lifting tasks. APPLIED ERGONOMICS 2022; 99:103612. [PMID: 34743974 DOI: 10.1016/j.apergo.2021.103612] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 09/04/2021] [Accepted: 10/14/2021] [Indexed: 06/13/2023]
Abstract
Manual handling training may be improved if it relied on the provision of individualized, augmented feedback about key movement features. The purpose of this study was to compare the reduction in sagittal spine motion during manual lifting tasks following two training approaches: didactic (DID) and augmented feedback (AUG). Untrained participants (n = 26) completed lifting tests (box, medication bag, and paramedic backboard) and a randomly-assigned intervention involving 50 practice box lifts. Lifting tests were performed immediately before and after training, and one-week after interventions. Both groups exhibited reductions in spine motions immediately and one-week after the interventions. However, the AUG intervention group elicited significantly greater reductions in 5 of 12 between-group comparisons (3 tasks × 4 spine motion variables). The results of the current study support the use of augmented feedback-based approaches to manual handling training over education-based approaches.
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Affiliation(s)
- Victor C H Chan
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada; School of Human Kinetics, University of Ottawa, Ottawa, ON, Canada
| | - Timothy N Welsh
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada; Centre for Motor Control, University of Toronto, Toronto, ON, Canada
| | - Luc Tremblay
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada; Centre for Motor Control, University of Toronto, Toronto, ON, Canada
| | - David M Frost
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, ON, Canada
| | - Tyson A C Beach
- Centre for Motor Control, University of Toronto, Toronto, ON, Canada; Department of Kinesiology & Health Sciences, University of Waterloo, Waterloo, ON, Canada.
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Asahi R, Nakamura Y, Kanai M, Watanabe K, Yuguchi S, Kamo T, Azami M, Ogihara H, Asano S. Stand-up test predicts occurrence of non-traumatic vertebral fracture in outpatient women with osteoporosis. J Bone Miner Metab 2021; 39:883-892. [PMID: 33988756 DOI: 10.1007/s00774-021-01229-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 04/08/2021] [Indexed: 01/30/2023]
Abstract
INTRODUCTION The purpose of this retrospective study was to clarify the incidence of non-traumatic vertebral fracture among outpatient women with osteoporosis and to determine whether the stand-up test predicted the occurrence of non-traumatic vertebral fracture. MATERIALS AND METHODS A total of 242 postmenopausal women over 60 years of age who received outpatient osteoporosis treatment at our hospital between November 2013 and July 2020 were longitudinally evaluated in this study. We obtained medical information and radiographic parameters, including sagittal vertical axis, thoracic kyphosis, pelvic incidence, lumbar lordosis, pelvic tilt, and sacral slope at baseline. Additionally, we measured physical parameters, including height, weight, body mass index, lumbar bone mineral density, visual analog scale score for pain, and the stand-up test. RESULTS Vertebral fractures occurred in 20 of 242 participants (8.3%), and accounted for 48.8% the 41 total fractures in the study group. Among vertebral fractures, eight (40.0%) were traumatic, resulting from falls, and 12 (60.0%) were non-traumatic. Cox multivariate logistic regression analysis adjusted for age, body mass index, lumbar bone mineral density, and the time to non-traumatic vertebral fracture showed that the sagittal vertical axis (HR = 1.013, 95% CI 1.001-1.026), stand-up test score (HR = 3.977, 95% CI 1.156-13.683), and presence of difficulty with standing from a 20-cm-high seat using both legs (HR = 3.329, 95% CI 1.625-6.82) were independent risk factors for the occurrence of non-traumatic vertebral fracture. CONCLUSION The stand-up test may be useful as a simple screening tool for non-traumatic vertebral fracture in patients with osteoporosis.
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Affiliation(s)
- Ryoma Asahi
- School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte City, Saitama, 340-0145, Japan.
| | - Yutaka Nakamura
- Saitama Spine Center, Higashi Saitama General Hospital, 517-5, Yoshino, Satte City, Saitama, 340-0153, Japan
| | - Masayoshi Kanai
- Saitama Spine Center, Higashi Saitama General Hospital, 517-5, Yoshino, Satte City, Saitama, 340-0153, Japan
| | - Kento Watanabe
- Saitama Spine Center, Higashi Saitama General Hospital, 517-5, Yoshino, Satte City, Saitama, 340-0153, Japan
| | - Satoshi Yuguchi
- School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte City, Saitama, 340-0145, Japan
| | - Tomohiko Kamo
- School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte City, Saitama, 340-0145, Japan
| | - Masato Azami
- School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte City, Saitama, 340-0145, Japan
| | - Hirofumi Ogihara
- School of Health Sciences, Japan University of Health Sciences, 2-555, Hirasuka, Satte City, Saitama, 340-0145, Japan
| | - Satoshi Asano
- Saitama Spine Center, Higashi Saitama General Hospital, 517-5, Yoshino, Satte City, Saitama, 340-0153, Japan
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Increased Trunk Kinetics Observed During Dose-Specific Trunk Lean Gait Modification. J Appl Biomech 2021; 37:425-431. [PMID: 34426557 DOI: 10.1123/jab.2020-0308] [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: 09/25/2020] [Revised: 05/03/2021] [Accepted: 06/04/2021] [Indexed: 11/18/2022]
Abstract
Trunk modification is associated with knee abduction moment reduction in both healthy groups and individuals with knee osteoarthritis. Ambulatory-related changes in trunk kinematics have been implicated in increased trunk moment. The purpose of this study was to investigate the effect of dose-specific lateral trunk lean on trunk kinetics during ipsilateral and contralateral stance phases. Nineteen healthy participants completed 10 baseline walking trials, followed by 10 trials employing lateral trunk lean. Trunk modification magnitudes were determined based on the average baseline trunk angle. Five trials of both small and large trunk modification magnitudes were completed. Visual real-time biofeedback was projected as a line graph displaying the trunk angle during stance, and a highlighted bandwidth was designated the target range. A 1-factor repeated-measures analysis of variance or Friedman test was used to assess differences between the conditions (P < .05) in trunk dependent measures. Trunk kinetics displayed significant increases, even during modest modifications to the trunk angle. The participants experienced increased peak frontal plane trunk moment and angular impulse during ipsilateral stance. The observed increase in the peak lateral joint reaction force is suggestive of a compromised loading environment at the spine. Implementing trunk modification might result in unintended secondary changes along the kinetic chain, but further investigation is required.
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Fan X, Lind CM, Rhen IM, Forsman M. Effects of Sensor Types and Angular Velocity Computational Methods in Field Measurements of Occupational Upper Arm and Trunk Postures and Movements. SENSORS 2021; 21:s21165527. [PMID: 34450967 PMCID: PMC8401405 DOI: 10.3390/s21165527] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/05/2021] [Accepted: 08/12/2021] [Indexed: 12/15/2022]
Abstract
Accelerometer-based inclinometers have dominated kinematic measurements in previous field studies, while the use of inertial measurement units that additionally include gyroscopes is rapidly increasing. Recent laboratory studies suggest that these two sensor types and the two commonly used angular velocity computational methods may produce substantially different results. The aim of this study was, therefore, to evaluate the effects of sensor types and angular velocity computational methods on the measures of work postures and movements in a real occupational setting. Half-workday recordings of arm and trunk postures, and movements from 38 warehouse workers were compared using two sensor types: accelerometers versus accelerometers with gyroscopes-and using two angular velocity computational methods, i.e., inclination velocity versus generalized velocity. The results showed an overall small difference (<2° and value independent) for posture percentiles between the two sensor types, but substantial differences in movement percentiles both between the sensor types and between the angular computational methods. For example, the group mean of the 50th percentiles were for accelerometers: 71°/s (generalized velocity) and 33°/s (inclination velocity)-and for accelerometers with gyroscopes: 31°/s (generalized velocity) and 16°/s (inclination velocity). The significant effects of sensor types and angular computational methods on angular velocity measures in field work are important in inter-study comparisons and in comparisons to recommended threshold limit values.
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Affiliation(s)
- Xuelong Fan
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
| | - Carl Mikael Lind
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57 Huddinge, Sweden
- Correspondence:
| | - Ida-Märta Rhen
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
- Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden
- Department of Industrial and Materials Science, Chalmers University of Technology, SE-412 96 Gothenburg, Sweden
| | - Mikael Forsman
- IMM Institute of Environmental Medicine, Karolinska Institutet, SE-171 77 Stockholm, Sweden; (X.F.); (I.-M.R.); (M.F.)
- Division of Ergonomics, School of Engineering Sciences in Chemistry, Biotechnology and Health, KTH Royal Institute of Technology, Hälsovägen 11C, SE-141 57 Huddinge, Sweden
- Centre for Occupational and Environmental Medicine, Stockholm County Council, SE-113 65 Stockholm, Sweden
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Puntumetakul R, Saiklang P, Tapanya W, Chatprem T, Kanpittaya J, Arayawichanon P, Boucaut R. The Effects of Core Stabilization Exercise with the Abdominal Drawing-in Maneuver Technique versus General Strengthening Exercise on Lumbar Segmental Motion in Patients with Clinical Lumbar Instability: A Randomized Controlled Trial with 12-Month Follow-Up. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157811. [PMID: 34360103 PMCID: PMC8345381 DOI: 10.3390/ijerph18157811] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 12/19/2022]
Abstract
Trunk stability exercises that focus on either deep or superficial muscles might produce different effects on lumbar segmental motion. This study compared outcomes in 34 lumbar instability patients in two exercises at 10 weeks and 12 months follow up. Participants were divided into either Core stabilization (deep) exercise, incorporating abdominal drawing-in maneuver technique (CSE with ADIM), or General strengthening (superficial) exercise (STE). Outcome measures were pain, muscle activation, and lumbar segmental motion. Participants in CSE with ADIM had significantly less pain than those in STE at 10 weeks. They showed significantly more improvement of abdominal muscle activity ratio than participants in STE at 10 weeks and 12 months follow-up. Participants in CSE with ADIM had significantly reduced sagittal translation at L4-L5 and L5-S1 compared with STE at 10 weeks. Participants in CSE with ADIM had significantly reduced sagittal translations at L4-L5 and L5-S1 compared with participants in STE at 10 weeks, whereas STE demonstrated significantly increased sagittal rotation at L4-L5. However, at 12 months follow-up, levels of lumbar sagittal translation were increased in both groups. CSE with ADIM which focuses on increasing deep trunk muscle activity can reduce lumbar segmental translation and should be recommended for lumbar instability.
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Affiliation(s)
- Rungthip Puntumetakul
- Research Center of Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen 40002, Thailand;
- Department of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen 40002, Thailand
- Correspondence: ; Tel.: +66-834196186
| | - Pongsatorn Saiklang
- Faculty of Physical Therapy, Srinakharinwirot University, Nakhon Nayok 26120, Thailand;
| | - Weerasak Tapanya
- Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao 56000, Thailand;
| | - Thiwaphon Chatprem
- Research Center of Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Jaturat Kanpittaya
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Preeda Arayawichanon
- Department of Rehabilitation Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand;
| | - Rose Boucaut
- iCAHE (International Centre for Allied Health Evidence), School of Health Sciences (Physiotherapy), University of South Australia, Adelaide, SA 5001, Australia;
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Changes in the Trunk and Lower Extremity Kinematics Due to Fatigue Can Predispose to Chronic Injuries in Cycling. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073719. [PMID: 33918282 PMCID: PMC8038191 DOI: 10.3390/ijerph18073719] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/30/2021] [Accepted: 03/31/2021] [Indexed: 11/24/2022]
Abstract
Kinematic analysis of the cycling position is a determining factor in injury prevention and optimal performance. Fatigue caused by high volume training can alter the kinematics of the lower body and spinal structures, thus increasing the risk of chronic injury. However, very few studies have established relationships between fatigue and postural change, being these in 2D analysis or incremental intensity protocols. Therefore, this study aimed to perform a 3D kinematic analysis of pedaling technique in a stable power fatigue protocol 23 amateur cyclists (28.3 ± 8.4 years) participated in this study. For this purpose, 3D kinematics in hip, knee, ankle, and lumbar joints, and thorax and pelvis were collected at three separate times during the protocol. Kinematic differences at the beginning, middle, and end of the protocol were analyzed for all joints using one-dimensional statistical parametric mapping. Significant differences (p < 0.05) were found in all the joints studied, but not all of them occur in the same planes or the same phase of the cycle. Some of the changes produced, such as greater lumbar and thoracic flexion, greater thoracic and pelvic tilt, or greater hip adduction, could lead to chronic knee and lumbar injuries. Therefore, bike fitting protocols should be carried out in fatigue situations to detect risk factor situations.
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Šarabon N, Vreček N, Hofer C, Löfler S, Kozinc Ž, Kern H. Physical Abilities in Low Back Pain Patients: A Cross-Sectional Study with Exploratory Comparison of Patient Subgroups. Life (Basel) 2021; 11:life11030226. [PMID: 33802214 PMCID: PMC8000067 DOI: 10.3390/life11030226] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/06/2021] [Accepted: 03/07/2021] [Indexed: 11/29/2022] Open
Abstract
An abundance of literature has investigated the association between low back pain (LBP) and physical ability or function. It has been shown that LBP patients display reduced range of motion, decreased balance ability, impaired proprioception, and lower strength compared to asymptomatic persons. The aim of this study was to investigate the differences between LBP patients and healthy controls in terms of several physical abilities. Based on the premised that different biomechanical and physiological causes and consequences could be related to different types of LBP, a secondary exploratory attempt of the study was to examine the differences between LBP subgroups based on the pain location (local or referred) or type of pathology (discogenic or degenerative) on the level of impairment of function and ability. Participants performed range of motion tests, trunk maximal voluntary contraction force tests, a sitting balance assessment, the timed up-and-go test, the chair rise test, and the trunk reposition error test. Compared to the control group, symptomatic patients on average showed 45.7% lower trunk extension (p < 0.001, η2 = 0.33) and 27.7 % lower trunk flexion force (p < 0.001, η2 = 0.37) during maximal voluntary contraction. LBP patients exhibited decreased sitting balance ability and lower scores in mobility tests (all p < 0.001). There were no differences between groups in Schober’s test and trunk repositioning error (p > 0.05). No differences were observed among the LBP subgroups. The exploratory analyses are limited by the sample size and uncertain validity of the diagnostic procedures within this study. Further studies with appropriate diagnostic procedures and perhaps a different subgrouping of the LBP patients are needed to elucidate if different types of LBP are related to altered biomechanics, physiology, and function.
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Affiliation(s)
- Nejc Šarabon
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (N.V.); (Ž.K.)
- Laboratory for Motor Control and Motor Behaviour, S2P, Science to Practice Ltd., 1000 Ljubljana, Slovenia
- Human Health Department, InnoRenew CoE, 6310 Izola, Slovenia
- Correspondence:
| | - Nace Vreček
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (N.V.); (Ž.K.)
| | - Christian Hofer
- Ludwig Boltzmann Institute for Rehabilitation Research, 3100 St. Pölten, Austria; (C.H.); (S.L.)
| | - Stefan Löfler
- Ludwig Boltzmann Institute for Rehabilitation Research, 3100 St. Pölten, Austria; (C.H.); (S.L.)
- Institute for Physical Medicine, Physiko und Rheumatherapie, 3100 St. Pölten, Austria;
| | - Žiga Kozinc
- Faculty of Health Sciences, University of Primorska, 6310 Izola, Slovenia; (N.V.); (Ž.K.)
- Andrej Marušič Institute, University of Primorska, 6000 Koper, Slovenia
| | - Helmut Kern
- Institute for Physical Medicine, Physiko und Rheumatherapie, 3100 St. Pölten, Austria;
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Fiani B, Jarrah R, Wong A, Alamah A, Runnels J. Repetitive Traumatic Discopathy in the Modern-Era Tennis Player. Cureus 2020; 12:e9783. [PMID: 32953299 PMCID: PMC7491697 DOI: 10.7759/cureus.9783] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Degenerative disc disease is more prevalent among athletes than the general population. Repetitive traumatic discopathy is a pattern of injury that has been described in athletes participating in sports that impart repetitive mechanical forces on the lumbar spine. Hence, tennis players may be particularly susceptible to repetitive traumatic discopathy due to the fast-paced nature of the modern tennis match. Recent biomechanical studies have identified the lumbar spine as the focal point of motion during tennis strokes, and the lumbar spine is notably the most frequent location of injury observed in tennis players. In this comprehensive review, we examine current evidence and discuss the epidemiology, pathophysiology, biomechanics, diagnosis, and treatment of repetitive traumatic discopathy in tennis players. Additionally, we outline considerations for rehabilitation and return to the tennis court after operative management.
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Baltrusch SJ, Houdijk H, van Dieën JH, van Bennekom CAM, de Kruif AJTCM. Perspectives of End Users on the Potential Use of Trunk Exoskeletons for People With Low-Back Pain: A Focus Group Study. HUMAN FACTORS 2020; 62:365-376. [PMID: 31914327 DOI: 10.1177/0018720819885788] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
OBJECTIVE The objective of this study was to identify criteria to be considered when developing an exoskeleton for low-back pain patients by exploring the perceptions and expectations of potential end users. BACKGROUND Psychosocial, psychological, physical load, and personality influence incidence of low-back pain. Body-worn assistive devices that passively support the user's trunk, that is exoskeletons, can decrease mechanical loading and potentially reduce low-back pain. A user-centered approach improves patient safety and health outcomes, increases user satisfaction, and ensures usability. Still, previous studies have not taken psychological factors and the early involvement of end users into account. METHOD We conducted focus group studies with low-back pain patients (n = 4) and health care professionals (n = 8). Focus group sessions were audio-recorded, transcribed, and analyzed, using the general inductive approach. The focus group discussions included trying out an available exoskeleton. Questions were designed to elicit opinions about exoskeletons, desired design specifications, and usability. RESULTS Important design characteristics were comfort, individual adjustability, independency in taking it on and off, and gradual adjustment of support. Patients raised concerns over loss of muscle strength. Health care professionals mentioned the risk of confirming disability of the user and increasing guarded movement in patients. CONCLUSION The focus groups showed that implementation of a trunk exoskeleton to reduce low-back pain requires an adequate implementation strategy, including supervision and behavioral coaching. APPLICATION For health care professionals, the optimal field of application, prevention or rehabilitation, is still under debate. Patients see potential in an exoskeleton to overcome their limitations and expect it to improve their quality of life.
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Affiliation(s)
- Saskia J Baltrusch
- 100506 Rehabilitation Center Heliomare, Wijk aan Zee and Vrije Universiteit Amsterdam, The Netherlands
| | - Han Houdijk
- 100506 Rehabilitation Center Heliomare, Wijk aan Zee and Vrije Universiteit Amsterdam, The Netherlands
| | | | - Coen A M van Bennekom
- Rehabilitation Center Heliomare, Wijk aan Zee and University of Amsterdam, The Netherlands
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Fethke NB, Schall MC, Chen H, Branch CA, Merlino LA. Biomechanical factors during common agricultural activities: Results of on-farm exposure assessments using direct measurement methods. JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HYGIENE 2020; 17:85-96. [PMID: 32069181 PMCID: PMC8256625 DOI: 10.1080/15459624.2020.1717502] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Agricultural work is associated with increased risk of adverse musculoskeletal health outcomes. The purpose of this study was to quantify exposure to biomechanical factors among a sample (n = 55) of farmers in the Midwest region of the U.S. while they performed a variety of routine agricultural activities, and to compare exposure levels between these activities. Surface electromyography was used to estimate activity levels of the erector spinae, upper trapezius, forearm flexor, and forearm extensor muscle groups. Simultaneously, inertial sensors were used to measure kinematics of the trunk, upper arm, and wrist. In general, lower muscle activity levels, less extreme postures, and slower movement speeds were observed during activities that involved primarily the use of agricultural machinery in comparison to manual activities, suggesting a potential advantage of mechanization relative to musculoskeletal health. Median wrist movement speeds exceeding recently proposed exposure thresholds were also observed during many manual activities, such as milking animals and repairing equipment. Upper arm postures and movement speeds did not appear to confer excessive risk for shoulder-related outcomes (on the whole), but interpretation of the results is limited by a sampling approach that may not have captured the full extent of exposure variation. Not surprisingly, substantial variation in exposure levels were observed within each agricultural activity, which is related to substantial variation in the equipment, tools, and work practices used by participants. Ultimately, the results of this study contribute to an emerging literature in which the physical demands of routine agricultural work have been described on the basis of sensor-based measurements rather than more common self-report or observation-based approaches.
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Affiliation(s)
- Nathan B Fethke
- Occupational and Environmental Health, University of Iowa, Iowa City, Iowa
| | - Mark C Schall
- Industrial & Systems Engineering, Auburn University, Auburn, Alabama
| | - Howard Chen
- Mechanical Engineering, Auburn University, Auburn, Alabama
| | | | - Linda A Merlino
- Occupational and Environmental Health, University of Iowa, Iowa City, Iowa
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Butowicz CM, Krupenevich RL, Acasio JC, Dearth CL, Hendershot BD. Relationships between mediolateral trunk-pelvic motion, hip strength, and knee joint moments during gait among persons with lower limb amputation. Clin Biomech (Bristol, Avon) 2020; 71:160-166. [PMID: 31765911 DOI: 10.1016/j.clinbiomech.2019.11.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 07/24/2019] [Accepted: 11/12/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Repeated exposures to larger lateral trunk-pelvic motion and features of knee joint loading likely influence the onset of low back pain and knee osteoarthritis among persons with lower-limb amputation. Decreased hip abductor strength can also influence frontal plane trunk-pelvic motion and knee moments; however, it is unclear how these are inter-related post-amputation. METHODS Twenty-four participants with unilateral lower-limb amputation (14 transtibial; 10 transfemoral) and eight uninjured controls walked at 1.3 m/s while full-body biomechanical data were captured. Multiple linear regression and Cohen's f2 predicted (P < 0.05) the influences of mediolateral trunk and pelvic ranges of motion and angular accelerations, and bilateral isometric hip abductor strength on peak (intact) knee adduction moment and loading rate. FINDINGS There were no group differences in hip strength, peak knee adduction moment or pelvis acceleration (p > 0.06). The combination of hip strength, and mediolateral trunk and pelvic motion did not predict (F(5,29) = 2.53, p = 0.06, adjusted R2 = 0.27, f2 = 0.08) peak knee adduction moment. However, the combination of hip strength and trunk and pelvis acceleration predicted knee adduction moment loading rate (F(7,29) = 3.59, p = 0.008, adjusted R2 = 0.45, f2 = 0.25), with peak trunk acceleration (β = 0.72, p = 0.008) and intact hip strength (β = 0.78, p = 0.008) significantly contributing to the model. INTERPRETATION These data suggest increased hip abductor strength counteracts increased lateral trunk acceleration, concomitantly influencing the rate at which the ground reaction force vector loads the intact knee joint. Persons with lower-limb amputation perhaps compensate for increased intact limb loading by increasing trunk motion, thereby increasing demand on hip abductors to attenuate this preferential loading.
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Affiliation(s)
- Courtney M Butowicz
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Rebecca L Krupenevich
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Kinesiology, University of Maryland, College Park, MD, USA
| | - Julian C Acasio
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Christopher L Dearth
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; DoD-VA Extremity Trauma & Amputation Center of Excellence, USA; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Brad D Hendershot
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; DoD-VA Extremity Trauma & Amputation Center of Excellence, USA; Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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Acasio JC, Shojaei I, Banerjee R, Dearth CL, Bazrgari B, Hendershot BD. Trunk-Pelvis motions and spinal loads during upslope and downslope walking among persons with transfemoral amputation. J Biomech 2019; 95:109316. [PMID: 31471112 DOI: 10.1016/j.jbiomech.2019.109316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 07/28/2019] [Accepted: 08/14/2019] [Indexed: 11/27/2022]
Abstract
Larger trunk and pelvic motions in persons with (vs. without) lower limb amputation during activities of daily living (ADLs) adversely affect the mechanical demands on the lower back. Building on evidence that such altered motions result in larger spinal loads during level-ground walking, here we characterize trunk-pelvic motions, trunk muscle forces, and resultant spinal loads among sixteen males with unilateral, transfemoral amputation (TFA) walking at a self-selected speed both up ("upslope"; 1.06 ± 0.14 m/s) and down ("downslope"; 0.98 ± 0.20 m/s) a 10-degree ramp. Tri-planar trunk and pelvic motions were obtained (and ranges-of-motion [ROM] computed) as inputs for a non-linear finite element model of the spine to estimate global and local muscle (i.e., trunk movers and stabilizers, respectively) forces, and resultant spinal loads. Sagittal- (p = 0.001), frontal- (p = 0.004), and transverse-plane (p < 0.001) trunk ROM, and peak mediolateral shear (p = 0.011) and local muscle forces (p = 0.010) were larger (respectively 45, 35, 98, 70, and 11%) in upslope vs. downslope walking. Peak anteroposterior shear (p = 0.33), compression (p = 0.28), and global muscle (p = 0.35) forces were similar between inclinations. Compared to previous reports of persons with TFA walking on level ground, 5-60% larger anteroposterior and mediolateral shear observed here (despite ∼0.25 m/s slower walking speeds) suggest greater mechanical demands on the low back in sloped walking, particularly upslope. Continued characterization of trunk motions and spinal loads during ADLs support the notion that repeated exposures to these larger-than-normal (i.e., vs. level-ground walking in TFA and uninjured cohorts) spinal loads contribute to an increased risk for low back injury following lower limb amputation.
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Affiliation(s)
- Julian C Acasio
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, MD, USA
| | - Iman Shojaei
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
| | - Rajit Banerjee
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Christopher L Dearth
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; DoD-VA Extremity Trauma & Amputation Center of Excellence, USA; Department of Surgery, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Babak Bazrgari
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
| | - Brad D Hendershot
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; DoD-VA Extremity Trauma & Amputation Center of Excellence, USA; Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
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Changes in Trunk and Pelvis Motion Among Persons With Unilateral Lower Limb Loss During the First Year of Ambulation. Arch Phys Med Rehabil 2019; 101:426-433. [PMID: 31542398 DOI: 10.1016/j.apmr.2019.08.476] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 08/19/2019] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To retrospectively investigate trunk-pelvis kinematic outcomes among persons with unilateral transtibial and transfemoral limb loss with time from initial independent ambulation with a prosthesis, while secondarily describing self-reported presence and intensity of low back pain. Over time, increasing trunk-pelvis range of motion and decreasing trunk-pelvis coordination with increasing presence and/or intensity of low back pain were hypothesized. Additionally, less trunk-pelvis range of motion and more trunk-pelvis coordination for persons with more distal limb loss was hypothesized. DESIGN Inception cohort with up to 5 repeated evaluations, including both biomechanical and subjective outcomes, during a 1-year period (0, 2, 4, 6, 12 months) after initial ambulation with a prosthesis. SETTING Biomechanics laboratory within military treatment facility. PARTICIPANTS Twenty-two men with unilateral transtibial limb loss and 10 men with unilateral transfemoral limb loss (N=32). INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Triplanar trunk-pelvis range of motion and intersegmental coordination (continuous relative phase) obtained at self-selected (∼1.30m/s) and controlled (∼1.20m/s) walking velocities. Self-reported presence and intensity of low back pain. RESULTS An interaction effect between time and group existed for sagittal (P=.039) and transverse (P=.009) continuous relative phase at self-selected walking velocity and transverse trunk range of motion (P=.013) and sagittal continuous relative phase (P=.005) at controlled walking velocity. Trunk range of motion generally decreased, and trunk-pelvis coordination generally increased with increasing time after initial ambulation. Sagittal trunk and pelvis range of motion were always less and frontal trunk-pelvis coordination was always greater for persons with more distal limb loss. Low back pain increased for persons with transtibial limb loss and decreased for persons with transfemoral limb loss following the 4-month time point. CONCLUSIONS Temporal changes (or lack thereof) in features of trunk-pelvis motions within the first year of ambulation help elucidate relationships between (biomechanical) risk factors for low back pain after limb loss.
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Haj A, Weisman A, Masharawi Y. Lumbar axial rotation kinematics in men with non-specific chronic low back pain. Clin Biomech (Bristol, Avon) 2019; 61:192-198. [PMID: 30594767 DOI: 10.1016/j.clinbiomech.2018.12.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Revised: 12/19/2018] [Accepted: 12/20/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND Lumbar flexion, coupled with rotation, is a dominant factor in the etiology and exacerbation of low back pain. Yet, no study has examined its kinematics in patients with non-specific chronic low back pain (NSCLBP). The aim of the study was to evaluate the lumbar rotation kinematics in neutral standing and with full flexion in men with NSCLBP. METHODS ROM, average velocity, maximum velocity and maximal acceleration of lumbar rotation in neutral standing and with full flexion were measured using an industrial lumbar motion monitor in 50 men (25 with NSCLBP and 25 controls). VAS and Rolland Morris questionnaire were also included. FINDINGS All examined kinematical parameters were significantly lower in men with NSCLBP compared with controls (↓ROM = 29%-45%; ↓AV = 40%-68%; ↓MV = 25%-50%; ↓MA = 20%-37%). Left rotation manifested smaller kinematic values (except for MA) than right rotation (Δ ROM = 35%; Δ AV = 66%; Δ MV = 19%) in NSCLBP. Most kinematical parameters significantly decreased from neutral standing to standing with flexion (right rotation: ↓ROM = 43%-45%, ↓AV = 38%-45%, ↓MV = 24%-27%, ↓MA for the NSCLBP group = 21%; left rotation: ↓ROM = 25%-38%, ↓AV in the control group: =34%, ↓MV in the control group: =23%, ↓MA in the control group = 25%). No correlations were found between all measured kinematical parameters, VAS and RMQ total score in the NSCLBP group. INTERPRETATION The kinematic parameters of lumbar rotation were reduced in men with NSCLBP compared with controls both in neutral standing and with fully forward bending. Most lumbar rotation kinematics decreased from neutral standing to standing with flexion.
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Affiliation(s)
- Alaa Haj
- The Spinal Research Laboratory, Department of Physical Therapy, the Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel; Clalit Health Services, Department of Physical Therapy, Haifa and Western Galilee District, 104 Sderot HaMeginim, Haifa, Israel
| | - Asaf Weisman
- The Spinal Research Laboratory, Department of Physical Therapy, the Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel; Clalit Health Services, Department of Physical Therapy, Tel Aviv-Jaffa District, 16 Naomi Shemer Street, Holon, Israel
| | - Youssef Masharawi
- The Spinal Research Laboratory, Department of Physical Therapy, the Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Ramat Aviv, Tel Aviv 69978, Israel.
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The Use of Negative Acceleration as Accessory Force during Lifting. Adv Orthop 2018; 2018:9164590. [PMID: 30631604 PMCID: PMC6304531 DOI: 10.1155/2018/9164590] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2017] [Revised: 07/13/2018] [Accepted: 10/03/2018] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVES Injury associated with lifting, especially low back injury, is a big problem in industry that accounts for loss of work and high medical expenses. Studies of biomechanics of lifting provide a basis for optimization of lifting. The aim of the study was to further investigate the role of the upward force due to negative acceleration during a lift. METHODS Nine healthy subjects lifted an empty box and a box with additional load of 10, 20, and 25 lb. Kinematic data were recorded during the lifts and accelerations were calculated, and angular positions of the trunk and knee were obtained during the lifting when negative accelerations were used. RESULTS Negative acceleration assisted the quadriceps when the thighs were at approximately 90° and the hips when the trunk was rotating toward standing position. Negative acceleration was present during lifts of different loads. CONCLUSION The outcome of the study suggests that enhancing the use of negative acceleration could be a strategy to improve the quality of lifting and minimize a probability of low back injury.
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Hendershot BD, Shojaei I, Acasio JC, Dearth CL, Bazrgari B. Walking speed differentially alters spinal loads in persons with traumatic lower limb amputation. J Biomech 2018; 70:249-254. [PMID: 29217090 DOI: 10.1016/j.jbiomech.2017.11.026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Revised: 09/28/2017] [Accepted: 11/22/2017] [Indexed: 10/18/2022]
Abstract
Persons with lower limb amputation (LLA) perceive altered motions of the trunk/pelvis during activities of daily living as contributing factors for low back pain. When walking (at a singular speed), larger trunk motions among persons with vs. without LLA are associated with larger spinal loads; however, modulating walking speed is necessary in daily life and thus understanding the influences of walking speed on spinal loads in persons with LLA is of particular interest here. Three-dimensional trunk-pelvic kinematics, collected during level-ground walking at self-selected (SSW) and two controlled speeds (∼1.0 and ∼1.4 m/s), were obtained for seventy-eight participants: 26 with transfemoral and 26 with transtibial amputation, and 26 uninjured controls (CTR). Using a kinematics-driven, non-linear finite element model of the lower back, the resultant compressive and mediolateral/anteroposterior shear loads at the L5/S1 spinal level were estimated. Peak values were extracted and compiled. Despite walking slower at SSW speeds (∼0.21 m/s), spinal loads were 8-14% larger among persons with transfemoral amputation vs. CTR. Across all participants, peak compressive, mediolateral, and anteroposterior shear loads increased with increasing walking speed. At the fastest (vs. slowest) controlled speed, these increases were respectively 24-84% and 29-77% larger among persons with LLA relative to CTR. Over time, repeated exposures to these increased spinal loads, particularly at faster walking speeds, may contribute to the elevated risk for low back pain among persons with LLA. Future work should more completely characterize relative risk in daily life between persons with vs. without LLA by analyzing additional activities and tissue-level responses.
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Affiliation(s)
- Brad D Hendershot
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA; Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Iman Shojaei
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
| | - Julian C Acasio
- Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA
| | - Christopher L Dearth
- DoD-VA Extremity Trauma and Amputation Center of Excellence, Bethesda, MD, USA; Research and Development Section, Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD, USA; Department of Rehabilitation Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Babak Bazrgari
- F. Joseph Halcomb III, M.D. Department of Biomedical Engineering, University of Kentucky, Lexington, KY, USA
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Sasaki E, Sasaki S, Chiba D, Yamamoto Y, Nawata A, Tsuda E, Nakaji S, Ishibashi Y. Age-related reduction of trunk muscle torque and prevalence of trunk sarcopenia in community-dwelling elderly: Validity of a portable trunk muscle torque measurement instrument and its application to a large sample cohort study. PLoS One 2018; 13:e0192687. [PMID: 29471310 PMCID: PMC5823615 DOI: 10.1371/journal.pone.0192687] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 01/29/2018] [Indexed: 12/02/2022] Open
Abstract
Trunk muscle weakness and imbalance are risk factors for postural instability, low back pain, and poor postoperative outcomes. The association between trunk muscle strength and aging is poorly understood, and establishing normal reference values is difficult. We aimed to establish the validity of a novel portable trunk muscle torque measurement instrument (PTMI). We then estimated reference data for healthy young adults and elucidated age-related weakness in trunk muscle strength. Twenty-four university students were enrolled to validate values for PTMI, and 816 volunteers from the general population who were recruited to the Iwaki Health Promotion Project were included to estimate reference data for trunk muscle strength. Trunk flexion and extension torque were measured with PTMI and KinCom, and interclass correlation coefficients (ICC) were estimated to evaluate the reliability of PTMI values. Furthermore, from the young adult reference, the age-related reduction in trunk muscle torque and the prevalence of sarcopenia among age-sex groups were estimated. The ICC in flexion and extension torque were 0.807 (p<0.001) and 0.789 (p<0.001), respectively. The prevalence of sarcopenia increased with age, and the prevalence due to flexion torque was double that of extension torque. Flexion torque decreased significantly after 60 years of age, and extension torque decreased after 70 years of age. In males over age 80, trunk muscle torque decreased to 49.1% in flexion and 63.5% in extension. In females over age 80, trunk muscle torque decreased to 60.7% in flexion and 68.4% in extension. The validity of PTMI was confirmed by correlation with KinCom. PTMI produced reference data for healthy young adults, and demonstrated age-related reduction in trunk muscle torque. Trunk sarcopenia progressed with aging, and the loss of flexion torque began earlier than extension torque. At age 80, trunk muscle torque had decreased 60% compared with healthy young adults.
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Affiliation(s)
- Eiji Sasaki
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
- * E-mail:
| | - Shizuka Sasaki
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Daisuke Chiba
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yuji Yamamoto
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Atsushi Nawata
- Medical Engineering Laboratory, ALCARE Co., Ltd., Tokyo, Japan
| | - Eiichi Tsuda
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Shigeyuki Nakaji
- Department of Social Medicine, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Yasuyuki Ishibashi
- Department of Orthopedic Surgery, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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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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Gaffney BMM, Christiansen CL, Murray AM, Davidson BS. Trunk kinetic effort during step ascent and descent in patients with transtibial amputation using angular momentum separation. Clin Biomech (Bristol, Avon) 2017; 48:88-96. [PMID: 28797673 PMCID: PMC5593790 DOI: 10.1016/j.clinbiomech.2017.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Revised: 06/07/2017] [Accepted: 07/27/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Patients with transtibial amputation adopt trunk movement compensations that alter effort and increase the risk of developing low back pain. However, the effort required to achieve high-demand tasks, such as step ascent and descent, remains unknown. METHODS Kinematics were collected during bilateral step ascent and descent tasks from two groups: 1) seven patients with unilateral transtibial amputation and 2) seven healthy control subjects. Trunk kinetic effort was quantified using translational and rotational segmental moments (time rate of change of segmental angular momentum). Peak moments during the loading period were compared across limbs and across groups. FINDINGS During step ascent, patients with transtibial amputation generated larger sagittal trunk translational moments when leading with the amputated limb compared to the intact limb (P=0.01). The amputation group also generated larger trunk rotational moments in the frontal and transverse planes when leading with either limb compared to the healthy group (P=0.01, P<0.01, respectively). During step descent, the amputation group generated larger trunk translational and rotational moments in all three planes when leading with the intact limb compared to the healthy group (P<0.017). INTERPRETATION This investigation identifies how differing trunk movement compensations, identified using the separation of angular momentum, require higher kinetic effort during stepping tasks in patients with transtibial amputation compared to healthy individuals. Compensations that produce identified increased and asymmetric trunk segmental moments, may increase the risk of the development of low back pain in patients with amputation.
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Affiliation(s)
| | - Cory L Christiansen
- University of Colorado Denver, Dept. of Physical Medicine & Rehabilitation, Aurora, CO, USA; VA Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center, Aurora, CO, USA
| | - Amanda M Murray
- University of Colorado Denver, Dept. of Physical Medicine & Rehabilitation, Aurora, CO, USA; VA Eastern Colorado Health Care System, Geriatric Research Education and Clinical Center, Aurora, CO, USA
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Farrokhi S, Mazzone B, Schneider M, Gombatto S, Mayer J, Highsmith MJ, Hendershot BD. Biopsychosocial risk factors associated with chronic low back pain after lower limb amputation. Med Hypotheses 2017; 108:1-9. [DOI: 10.1016/j.mehy.2017.07.030] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Revised: 07/18/2017] [Accepted: 07/21/2017] [Indexed: 11/27/2022]
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Vazirian M, Shojaei I, Agarwal A, Bazrgari B. Lumbar contribution to the trunk forward bending and backward return; age-related differences. ERGONOMICS 2017; 60:967-976. [PMID: 27633627 DOI: 10.1080/00140139.2016.1237676] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Age-related differences in lumbar contribution to the trunk motion in the sagittal plane were investigated. Sixty individuals between 20-70 years old in five gender-balanced age groups performed forward bending and backward return with slow and fast paces. Individuals older than 50 years old, irrespective of the gender or pace, had smaller lumbar contribution than those younger than this age. The lumbar contribution to trunk motion was also smaller in female participants than male participants, and under fast pace than under the slow pace. Age-related differences in lumbar contributions suggest the synergy between the active and passive lower back tissues is different between those above and under 50 years old, differences that are likely to affect the lower back mechanics. Therefore, detailed modelling should be conducted in future to find the age-related differences in the lower back mechanics for tasks involving large trunk motion. Practitioner Summary: Lumbar contribution to the sagittal trunk motion was observed to be smaller in individuals above 50 years old than those below this age. This could be an indication of a likely change in the synergy between the active and passive lower back tissues, which may disturb the lower back mechanics.
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Affiliation(s)
- Milad Vazirian
- a Department of Biomedical Engineering , University of Kentucky , Lexington , KY , USA
| | - Iman Shojaei
- a Department of Biomedical Engineering , University of Kentucky , Lexington , KY , USA
| | - Anuj Agarwal
- a Department of Biomedical Engineering , University of Kentucky , Lexington , KY , USA
- b Signal Solutions LLC , Lexington , KY , USA
| | - Babak Bazrgari
- a Department of Biomedical Engineering , University of Kentucky , Lexington , KY , USA
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Ignasiak D, Rüeger A, Ferguson SJ. Multi-segmental thoracic spine kinematics measured dynamically in the young and elderly during flexion. Hum Mov Sci 2017; 54:230-239. [PMID: 28535435 DOI: 10.1016/j.humov.2017.05.011] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 05/09/2017] [Accepted: 05/15/2017] [Indexed: 11/18/2022]
Abstract
In contrast to the cervical and lumbar region, the normal kinematics of the thoracic spine have not been thoroughly investigated. The aim of this study was to characterize normal multi-segmental continuous motion of the whole thoracolumbar spine, during a flexion maneuver, in young and elderly subjects. Forty-two healthy volunteers were analyzed: 21 young (age=27.00±3.96) and 21 elderly (age=70.1±3.85). Spinal motion was recorded with a motion-capture system and analyzed using a 3rd order polynomial function to approximate spinal curvature throughout the motion sequence. The average motion profiles of the two age groups were characterized. Flexion timing of the thoracic region of the spine, as compared to the lumbar spine and hips, was found to be different in the two age groups (p=0.011): a delayed/sequential motion type was observed in most of the young, whereas mostly a simultaneous motion pattern was observed in the elderly subjects. A similar trend was observed in flexion of the lower thoracic segments (p=0.017). Differences between age groups were also found for regional and segmental displacements and velocities. The reported characterization of the thoracic spine kinematics may in the future support identification of abnormal movement or be used to improve biomechanical models of the spine.
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D'Agostin F, Negro C. Symptoms and musculoskeletal diseases in hospital nurses and in a group of university employees: a cross-sectional study. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2016; 23:274-284. [PMID: 27277971 DOI: 10.1080/10803548.2016.1198092] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Most studies have shown that nurses have a higher risk of developing musculoskeletal symptoms compared with other occupational groups. AIM A cross-sectional study was performed to gain more insight into the prevalence rates of musculoskeletal disorders (MSDs) in nurses. METHODS The presence of musculoskeletal symptoms was revealed by personal interviews in a sample of 177 hospital nurses and in a reference group of 185 university employees. Musculoskeletal diseases were based on radiological examinations in all subjects. RESULTS Lower back pain (61% vs 42.2%) was the most frequently reported symptom, followed by neck pain (48.6% vs 38.4%) and shoulder pain (36.7% vs 25.9%), with a significantly higher prevalence in nurses. Women had about a 2-fold risk of upper limb region and neck pain compared with men. The most common abnormal findings on radiological examinations were disc herniations (n = 40). CONCLUSIONS Nurses showed a significantly higher risk of MSDs. Prevalence rates in nurses increased significantly with age. Musculoskeletal symptoms were also common in university employees. This suggests the need for effective intervention strategies involving workers' active participation, in order to improve the process and organization of work and promote a positive psychosocial work environment.
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Trafimow J, Xaygnaraj J, Trafimow D, Aruin AS. THE IMPORTANCE OF NEGATIVE ACCELERATION OF THE LOAD IN FREE-STYLE LIFTING. Percept Mot Skills 2015; 121:163-9. [PMID: 26302192 DOI: 10.2466/26.25.pms.121c14x9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Lifters may use negative acceleration in lifting a very light load. Body kinematic data were recorded in 10 participants lifting a 114 g box. Vertical position and acceleration of the center of mass and angle of the thigh to a vertical line were calculated. Acceleration data between the positions of the body when the thighs were horizontal and as the knees extended to an angle of 45° indicated that negative acceleration was present at 68.9% of time points, more than predicted by chance.
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Affiliation(s)
- Jordan Trafimow
- 1 Department of Physical Therapy, University of Illinois at Chicago, USA
| | - Joseph Xaygnaraj
- 1 Department of Physical Therapy, University of Illinois at Chicago, USA
| | - David Trafimow
- 2 Department of Psychology, New Mexico State University, Las Cruces, New Mexico, USA
| | - Alexander S Aruin
- 1 Department of Physical Therapy, University of Illinois at Chicago, USA
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Barbado D, Elvira JLL, Moreno FJ, Vera-Garcia FJ. Effect of Performance Speed on Trunk Movement Control During the Curl-Up Exercise. J Hum Kinet 2015; 46:29-37. [PMID: 26240646 PMCID: PMC4519219 DOI: 10.1515/hukin-2015-0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Trunk exercise speed has significant effects on neuro-mechanical demands; however, the influence of a variety of exercise speeds on motor control of the trunk displacement remains unknown. The aim of this study was to assess the effect of performance speed on trunk motion control during the curl-up exercise by analyzing the kinematic variance about the sagittal trajectory. Seventeen subjects volunteered to perform curl-ups at different cadences controlled by a metronome. Standard deviation (SD) and range (RG) of shoulder girdle medial-lateral displacement (SGML) and detrended fluctuation analysis (DFA) of SGML were calculated to examine linear variability and long range autocorrelation of medial-lateral upper trunk displacements, respectively. In addition, SD, RG and DFA of centre of pressure medial-lateral displacement (COPML) were performed to analyze the behavior of the motor system while controlling trunk displacement. Although SD and RG of COPML increased as speed increased, the curl-up cadence did not have significant effects on SD and RG of SGML. These results suggest that although high speed curl-ups challenged participants' ability to carry out medial-lateral adjustments, an increase of performance speed did not modify the linear variability about the sagittal trajectory. Regarding DFA, the scaling exponent α of SGML and COPML was higher for the fastest movements, mainly in long term fluctuations. Therefore, to maintain the target trajectory, participants used different strategies depending on performance speed. This is to say, there were less trajectory changes when participants performed the fastest exercises.
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Affiliation(s)
- David Barbado
- Sports Research Centre, Miguel Hernandez University of Elche, Elche (Alicante), Spain
| | - Jose Luis L Elvira
- Sports Research Centre, Miguel Hernandez University of Elche, Elche (Alicante), Spain
| | - Francisco J Moreno
- Sports Research Centre, Miguel Hernandez University of Elche, Elche (Alicante), Spain
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Abstract
In this study, a hybrid dynamic model for lifting motion simulation is presented. The human body is represented by a two-dimensional (2D) five-segment model. The lifting motions are predicted by solving a nonlinear optimisation problem, the objective function of which is defined based on a minimal-effort performance criterion. In the optimisation procedure, the joint angular velocities are bounded by time-functional constraints that are determined by actual motions. Symmetric lifting motions performed by younger and older adults under varied task conditions were simulated. Comparisons between the simulation results and actual motion data were made for model evaluation. The results showed that the mean and median joint angle errors were less than 10°, which suggests the proposed model is able to accurately simulate 2D lifting motions. The proposed model is also comparable with the existing motion simulation models in terms of the prediction accuracy. Strengths and limitations of this hybrid model are discussed. Practitioner Summary: Human motion simulation is a useful tool in assessing the risks of occupational injuries. Lifting motions are associated with low-back pain. A hybrid model for lifting motion simulation was constructed. The model was able to accurately simulate 2D lifting motions in varied task scenarios for younger and older subjects.
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Affiliation(s)
- Jiahong Song
- a School of Mechanical and Aerospace Engineering, Nanyang Technological University , Singapore , Singapore
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Boocock MG, Mawston GA, Taylor S. Age-related differences do affect postural kinematics and joint kinetics during repetitive lifting. Clin Biomech (Bristol, Avon) 2015; 30:136-43. [PMID: 25576019 DOI: 10.1016/j.clinbiomech.2014.12.010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 11/19/2014] [Accepted: 12/19/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND Age is considered a risk factor for manual handling-related injuries and older workers incur higher injury-related costs than younger co-workers. This study investigated the differences between the kinematics and kinetics of repetitive lifting in two groups of handlers of different ages. METHODS Fourteen younger (mean 24.4 yr) and 14 older (mean 47.2 yr) males participated in the study. Participants repetitively lifted a box weighing 13 kg at a frequency of 10 lifts/min for a maximum of 20 min. Postural kinematics (joint and lumbosacral angles and angular velocities) and kinetics (joint moments) were measured throughout the lifting task using motion analysis and ground reaction forces. Muscle fatigue of the erector spinae was assessed using electromyography. FINDINGS Peak lumbosacral, trunk, hip and knee flexion angles differed significantly between age groups over the duration of the task, as did lumbosacral and trunk angular velocities. The younger group increased peak lumbar flexion by approximately 18% and approached 99% of maximum lumbosacral flexion after 20 min, whereas the older group increased lumbar flexion by 4% and approached 82% maximum flexion. The younger group had a larger increase in peak lumbosacral and trunk angular velocities during extension, which may be related to the increased back muscle fatigue observed among the younger group. INTERPRETATION Older participants appeared to control the detrimental effects of fatigue associated with repetitive lifting and limit lumbar spine range of motion. The higher rates of musculoskeletal injury among older workers may stem from a complex interaction of manual handling risk factors.
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Affiliation(s)
- Mark G Boocock
- Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand.
| | - Grant A Mawston
- Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand
| | - Steve Taylor
- Health and Rehabilitation Research Institute, Auckland University of Technology, New Zealand
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31
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Mendes CS, Rajendren SV, Bartos I, Márka S, Mann RS. Kinematic responses to changes in walking orientation and gravitational load in Drosophila melanogaster. PLoS One 2014; 9:e109204. [PMID: 25350743 PMCID: PMC4211655 DOI: 10.1371/journal.pone.0109204] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2014] [Accepted: 09/10/2014] [Indexed: 11/19/2022] Open
Abstract
Walking behavior is context-dependent, resulting from the integration of internal and external influences by specialized motor and pre-motor centers. Neuronal programs must be sufficiently flexible to the locomotive challenges inherent in different environments. Although insect studies have contributed substantially to the identification of the components and rules that determine locomotion, we still lack an understanding of how multi-jointed walking insects respond to changes in walking orientation and direction and strength of the gravitational force. In order to answer these questions we measured with high temporal and spatial resolution the kinematic properties of untethered Drosophila during inverted and vertical walking. In addition, we also examined the kinematic responses to increases in gravitational load. We find that animals are capable of shifting their step, spatial and inter-leg parameters in order to cope with more challenging walking conditions. For example, flies walking in an inverted orientation decreased the duration of their swing phase leading to increased contact with the substrate and, as a result, greater stability. We also find that when flies carry additional weight, thereby increasing their gravitational load, some changes in step parameters vary over time, providing evidence for adaptation. However, above a threshold that is between 1 and 2 times their body weight flies display locomotion parameters that suggest they are no longer capable of walking in a coordinated manner. Finally, we find that functional chordotonal organs are required for flies to cope with additional weight, as animals deficient in these proprioceptors display increased sensitivity to load bearing as well as other locomotive defects.
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Affiliation(s)
- César S. Mendes
- Department of Biochemistry and Molecular Biophysics, Columbia University, New York, New York, United States of America
| | - Soumya V. Rajendren
- Department of Biochemistry and Molecular Biophysics, Columbia University, New York, New York, United States of America
- Neuroscience and Behavior at Barnard College, Columbia University, New York, New York, United States of America
| | - Imre Bartos
- Department of Physics, Columbia University, New York, New York, United States of America
| | - Szabolcs Márka
- Department of Physics, Columbia University, New York, New York, United States of America
| | - Richard S. Mann
- Department of Biochemistry and Molecular Biophysics, Columbia University, New York, New York, United States of America
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Yoo WG. Comparison of the forward head angle and the lumbar flexion and rotation angles of computer workers using routine and individually fixed computer workstations. J Phys Ther Sci 2014; 26:421-2. [PMID: 24707097 PMCID: PMC3976016 DOI: 10.1589/jpts.26.421] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2013] [Accepted: 10/10/2013] [Indexed: 11/24/2022] Open
Abstract
[Purpose] This study compared the forward head angle and the lumbar flexion and rotation
angles of computer workers using routine and fixed computer workstations. [Subjects] Ten
male workers voluntarily consented to participate in the study. [Methods] A 3-D motion
analysis system was used to measure the angles of the forward head and lumbar flexion. All
subjects performed computer work for 30 minutes using both types of workstation. [Results]
When working at the fixed workstation, the forward head angle was less than that observed
when the routine workstation was used. At the fixed workstation, the lumbar flexion and
rotation angles were less than that at the routine workstation. [Conclusion] The computer
workstation individually fixed for standard posture may have prevented poor sitting
posture.
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Affiliation(s)
- Won-Gyu Yoo
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University, Republic of Korea
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33
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Hendershot BD, Wolf EJ. Three-dimensional joint reaction forces and moments at the low back during over-ground walking in persons with unilateral lower-extremity amputation. Clin Biomech (Bristol, Avon) 2014; 29:235-42. [PMID: 24393361 DOI: 10.1016/j.clinbiomech.2013.12.005] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Revised: 10/16/2013] [Accepted: 12/05/2013] [Indexed: 02/07/2023]
Abstract
BACKGROUND Abnormal mechanics of locomotion following lower-extremity amputation are associated with increases in trunk motion, which in turn may alter loads at the low back due to changes in inertial and gravitational demands on the spine and surrounding trunk musculature. METHODS Over-ground gait data were retrospectively compiled from two groups walking at similar self-selected speeds (~1.35m/s): 40 males with unilateral lower-extremity amputation (20 transtibial, 20 transfemoral) and 20 able-bodied male controls. Three-dimensional joint reaction forces and moments at the low back (L5/S1 spinal level) were calculated using top-down and bottom-up approaches. Peak values and the timings of these were determined and compared between and within (bilaterally) groups, and secondarily between approaches. FINDINGS Peak laterally-directed joint reaction forces and lateral bend moments increased with increasing level of amputation, and were respectively 83% and 41% larger in prosthetic vs. intact stance among persons with transfemoral amputation. Peak anteriorly-directed reaction forces and extension moments were 31% and 55% larger, respectively, among persons with transtibial amputation compared to controls. Peak vertical reaction forces and axial twist moments were similar between and within groups. Peak joint reaction forces and moments were larger (3-14%), and the respective timing of these sooner (11-62ms), from the bottom-up vs. top-down approach. INTERPRETATION Increased and asymmetric peak reaction forces and moments at the low back among persons with unilateral lower-extremity amputation, particularly in the frontal plane, suggest potential mechanistic pathways through which repeated exposure to altered trunk motion and spinal loading may contribute to low-back injury risk among persons with lower-extremity amputation.
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Affiliation(s)
- Brad D Hendershot
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA; Center for Rehabilitation Sciences Research, Department of Physical Medicine and Rehabilitation, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA.
| | - Erik J Wolf
- Department of Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA; DOD - VA Extremity Trauma and Amputation Center of Excellence, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
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Mehta JP, Lavender SA, Jagacinski RJ. Physiological and biomechanical responses to a prolonged repetitive asymmetric lifting activity. ERGONOMICS 2014; 57:575-588. [PMID: 24552498 DOI: 10.1080/00140139.2014.887788] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
This study investigated the effects of a prolonged repetitive asymmetric lifting task on behavioural adaptations during repetitive lifting activity, measures of tissue oxygenation and spine kinematics. Seventeen volunteers repeatedly lifted a box, normalised to 15% of the participant's maximum lifting strength, at the rate of 10 lifts/min for a period of 60 min. The lifts originated in front of the participants at ankle level and terminated on their left side at waist level. Overall, perceived workload increased during the repetitive lifting task. Erector spinae oxygenation levels, assessed using near-infrared spectroscopy, decreased significantly over time. Behavioural changes observed during the repetitive lifting task included increases in the amount of forward bending, the extension velocity and the lateral bending velocity, and a reduced lateral bending moment on the spine. These changes, with the exception of the reduced lateral bending moment, are associated with increased risk of low back disorder.
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Affiliation(s)
- Jay P Mehta
- a Integrated Systems Engineering, The Ohio State University , 1971 Neil Avenue, Rm. 210, Columbus , OH 43210 , USA
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Donath L, Roth R, Hohn Y, Zahner L, Faude O. The effects of Zumba training on cardiovascular and neuromuscular function in female college students. Eur J Sport Sci 2013; 14:569-77. [DOI: 10.1080/17461391.2013.866168] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Hendershot BD, Nussbaum MA. Altered flexion-relaxation responses exist during asymmetric trunk flexion movements among persons with unilateral lower-limb amputation. J Electromyogr Kinesiol 2013; 24:120-5. [PMID: 24332679 DOI: 10.1016/j.jelekin.2013.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2013] [Revised: 11/12/2013] [Accepted: 11/17/2013] [Indexed: 11/18/2022] Open
Abstract
Repetitive exposures to altered gait and movement following lower-limb amputation (LLA) have been suggested to contribute to observed alterations in passive tissue properties and neuromuscular control in/surrounding the lumbar spine. These alterations, in turn, may affect the synergy between passive and active tissues during trunk movements. Eight males with unilateral LLA and eight non-amputation controls completed quasi-static trunk flexion-extension movements in seven distinct conditions of rotation in the transverse plane: 0° (sagittally-symmetric), ±15°, ±30°, and ±45° (sagittally-asymmetric). Electromyographic (EMG) activity of the bilateral lumbar erector spinae and lumbar kinematics were simultaneously recorded. Peak lumbar flexion and EMG-off angles were determined, along with the difference ("DIFF") between these two angles and the magnitude of peak normalized EMG activities. Persons with unilateral LLA exhibited altered and asymmetric synergies between active and passive trunk tissues during both sagittally-symmetric and -asymmetric trunk flexion movements. Specifically, decreased and asymmetric passive contributions to trunk movements were compensated with increases in the magnitude and duration of active trunk muscle responses. Such alterations in trunk passive and active neuromuscular responses may result from repetitive exposures to abnormal gait and movement subsequent to LLA, and may increase the risk for LBP in this population.
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Affiliation(s)
- Brad D Hendershot
- Virginia Tech - Wake Forest School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, VA 24061, USA
| | - Maury A Nussbaum
- Virginia Tech - Wake Forest School of Biomedical Engineering and Sciences, Virginia Tech, Blacksburg, VA 24061, USA; Industrial and Systems Engineering, Virginia Tech, Blacksburg, VA 24061, USA.
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Elvira JLL, Barbado D, Flores-Parodi B, Moreside JM, Vera-Garcia FJ. Effect of movement speed on trunk and hip exercise performance. Eur J Sport Sci 2013; 14:547-55. [PMID: 24261903 DOI: 10.1080/17461391.2013.860483] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The influence of speed on trunk exercise technique is poorly understood. The aim of this study was to analyse the effect of movement speed on the kinematics and kinetics of curl-up, sit-up and leg raising/lowering exercises. Seventeen healthy, recreationally trained individuals (13 females and 4 males) volunteered to participate in this study. Four different exercise cadences were analysed: 1 repetition/4 s, 1 repetition/2 s, 1 repetition/1.5 s and 1 repetition/1 s. The exercises were executed on a force plate and recorded by three cameras to conduct a 3D photogrammetric analysis. The cephalo-caudal displacement of the centre of pressure and range of motion (ROM) of six joints describing the trunk and hip movements were measured. As sit-up and curl-up speed increased, hip and knee ROM increased. Dorsal-lumbar and upper trunk ROM increased with speed in the curl-up. Faster cadence in the sit-up exercise had minimal effect on trunk ROM: only the upper trunk ROM decreased significantly. In the leg raising/lowering exercise there was a decrease in the pelvic tilt and hip ROM, and increased knee flexion ROM. During higher speed exercises, participants modified their technique to maintain the cadence. Thus, professionals would do well to monitor and control participants' technique during high-speed exercises to maintain performance specificity. Results also suggest division of speed into two cadence categories, to be used as a reference for prescribing exercise speed based on preferred outcome goals.
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Affiliation(s)
- Jose L L Elvira
- a Sports Research Centre , Miguel Hernandez University of Elche , Alicante , Spain
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Nolte K, Krüger PE, Els PS, Nolte H. Three dimensional musculoskeletal modelling of the abdominal crunch resistance training exercise. J Sports Sci 2013; 31:264-75. [DOI: 10.1080/02640414.2012.729077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Yoon J, Shiekhzadeh A, Nordin M. The effect of load weight vs. pace on muscle recruitment during lifting. APPLIED ERGONOMICS 2012; 43:1044-1050. [PMID: 22475433 DOI: 10.1016/j.apergo.2012.03.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 03/05/2012] [Accepted: 03/06/2012] [Indexed: 05/31/2023]
Abstract
The purpose of this study was to compare the effect on the trunk and upper extremity muscle recruitment when controlling the lifting pace and the lifting weight. Thirty nine healthy subjects performed a total of 12 lifts (3 lifting trials per condition, 2 lifting weights, and 2 lifting paces), from waist height to shoulder height. Kinematics of upper extremity and the box and electromyography of trunk and upper extremity muscles were collected. Temporal muscle recruitment pattern varied between muscles based on their function. Heavier lifting weight evenly increased the muscle recruitment throughout the lifting period without changing their temporal pattern. In contrary, lifting pace affected the temporal recruitment pattern in most of muscles. The faster lifting pace increased the muscle recruitment at the beginning phase but decreased at the terminal phase of lifting. It is important to educate the workers about the effect of lifting pace and weight on the biomechanical load to control the mechanical load on the muscles and spine.
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Affiliation(s)
- Jangwhon Yoon
- Department of Physical Therapy, Dongshin University, Naju, Jeonnam, Republic of Korea.
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Cheng CH, Lin KH, Lin JJ, Wang JL. CERVICAL ELECTROMYOGRAPHIC ACTIVITIES DURING NECK MOVEMENTS AT DIFFERENT SPEEDS IN HEALTHY SUBJECTS: VOLUNTARY RESPONSE INDEX ANALYSIS. BIOMEDICAL ENGINEERING-APPLICATIONS BASIS COMMUNICATIONS 2012. [DOI: 10.4015/s1016237207000458] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The assessment of cervical muscle control patterns is important for the diagnosis of cervical dysfunction. Voluntary response index (VRI), including the similarity index (SI) and the magnitude (MAG), provides quantitative analysis of the surface electromyography (sEMG) pattern and total muscle voluntary activities respectively. This study was to investigate the effect of movement directions and speeds of the VRI response of cervical muscles in healthy subjects. The sEMG of bilateral sternocleidomastoid, semispinalis capitis, and splenius capitis were measured in thirteen asymptomatic young subjects. The subjects performed voluntary neck movements in flexion, extension, left and right side bending at fast, medium, and slow speeds. The results showed that SI ranged from 1–0.8 and MAG was generally less than 40 μV. The SI was significantly smallest and the MAG was largest at fast speed. The MAG was also significantly different among directions but the effect of direction on SI was only significant at fast speed. In conclusion, the movement speed and direction could affect the magnitude and control pattern of cervical muscles, such that both the speed and direction of the examined tasks should be carefully monitored during the assessment of cervical muscle activation.
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Affiliation(s)
- Chih-Hsiu Cheng
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
| | - Kwan-Hwa Lin
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jiu-Jenq Lin
- School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Jaw-Lin Wang
- Institute of Biomedical Engineering, College of Medicine and College of Engineering, National Taiwan University, Taipei, Taiwan
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Zeinali-Davarani S, Shirazi-Adl A, Dariush B, Hemami H, Parnianpour M. The effect of resistance level and stability demands on recruitment patterns and internal loading of spine in dynamic flexion and extension using a simple trunk model. Comput Methods Biomech Biomed Engin 2011; 14:645-56. [DOI: 10.1080/10255842.2010.493511] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Moriguchi CS, Carnaz L, Alencar JFD, Miranda Júnior LC, Granqvist L, Hansson GÅ, Gil Coury HJC. Postures and movements in the most common tasks of power line workers. INDUSTRIAL HEALTH 2011; 49:482-491. [PMID: 21697620 DOI: 10.2486/indhealth.ms1252] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The repair and maintenance of electrical power lines involves awkward postures, which are known risk factors for developing musculoskeletal disorders. The aim of the present study was to quantify postures and movements of upper arm, head, upper back and neck in the main tasks performed by line workers. Posture of twelve right-handed line workers was recorded by inclinometry and presented as percentiles of angular and angular velocity distributions. All tasks involved considerable upper-arm elevation, ranging from 73° to 115° for the 90th percentile. Upper-arm elevation showed significant differences between tasks, but no consistent differences between right and left sides. Regarding velocity, the right arm presented higher levels than the left arm. All tasks required significant extension of head, upper back and neck, ranging from 7° to 67° for head (10th percentile). All tasks, except the one performed with a continuous extension, also involved pronounced flexion, ranging from 33° to 60° for the head (90th percentile). Work which required highly elevated arms also required significant head extension (r(2)=0.56). Awkward postures of upper arms, head, upper back and neck were identified by inclinometry, demonstrating the need for preventative interventions to reduce musculoskeletal disorders among line workers.
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Affiliation(s)
- Cristiane Shinohara Moriguchi
- Department of Physical Therapy, Federal University of São Carlos, Washington Luís Road, São Carlos, São Paulo, Brazil
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Wunderlich M, Jacob R, Stelzig Y, Rüther T, Leyk D. [Analysis of spinal stress during surgery in otolaryngology]. HNO 2011; 58:791-8. [PMID: 20544171 DOI: 10.1007/s00106-010-2091-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Back pain is a common cause of sick leave in industrialized countries. Performing surgery is often associated with considerable cervical spine disorders. However, only a few studies have examined to what extent working posture or individual surgical techniques can be seen as stress indicators. MATERIAL AND METHODS Posture and movement of the spine and trunk were assessed by means of a newly developed analysis system (3-D-SMG). The individual-case study was carried out during six sinus operations using varying techniques (microscope, endoscope or headlamp only). RESULTS Spine and trunk deviation from neutral position (upright standing) was strongest in the sagittal plane. Awkward distortions were primarily observed in the cervical and lumbar spine. The analysis of work characteristics revealed static postures in 65-90% of sinus operations. Isometric positions were mainly related to microscopic surgery. CONCLUSIONS The data from this explorative individual-case study indicate that prevalence and magnitude of forced isometric and awkward postures are strongly associated with work-related spinal stress in sinus surgery. The new measurement device enables not only the recommendation of individual preventive strategies but also the objective evaluation of ergonomics.
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Affiliation(s)
- M Wunderlich
- Institut für Physiologie und Anatomie, Deutsche Sporthochschule Köln, Am Sportpark Müngersdorf 6, 50933, Köln, Deutschland.
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Park SY, Yoo WG. Effects of a Posture Sensing Composite Display Device (PSCD) on Lumbopelvic Motion during Computer Work. J Phys Ther Sci 2011. [DOI: 10.1589/jpts.23.181] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Se-Yeon Park
- Department of Physical Therapy, The Graduate School, Inje University
| | - Won-gyu Yoo
- Department of Physical Therapy, College of Biomedical Science and Engineering, Inje University
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AbouHassan J, Milosavljevic S, Carman A. Can postural modification reduce kinetic and kinematic loading during the bowing postures of Islamic prayer? ERGONOMICS 2010; 53:1446-1454. [PMID: 21108081 DOI: 10.1080/00140139.2010.532881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
As stooped postures are known to increase kinematic and kinetic loading on the lumbar spine they can be problematic for people with low back pain and postural task modification is often recommended. For the Muslim with low back pain, the bowing postures during prayer can aggravate low back symptoms. The aims of this study were to describe lumbo-sacral and pelvic tilt kinematics and lumbo-sacral kinetics during the standard bowing postures of Islam and to compare these to kinematic and kinetic data gathered during a clinically recommended modified bowing posture. The study was a repeated measures within subject cross-over design with 33 healthy male Muslim participants. 3-D motion analysis data were gathered to calculate body joint angles during the two bowing postures. A 3-D biomechanical model was then used to calculate spinal loads. Paired t-test analyses showed that the use of the modified posture resulted in significantly less pelvic tilt range of motion and anterior shear force and compressive force L5/S1, at stages 1 and 5 of bowing. Although this study was conducted with healthy young Muslim males, the use of this modified bent knee posture is recommended for all Muslims with low back pain. Clinical trials are being considered to determine the clinical utility of this postural manoeuvre as an intervention. STATEMENT OF RELEVANCE: The presence of low back pain may hinder a Muslim's ability to use the traditional Islamic bowing posture. Muslims who have low back pain may benefit from adopting a modification to the traditional bowing posture, which has been found to reduce the loads and postural demands on the lower back.
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Affiliation(s)
- J AbouHassan
- Physiotherapy Centre for Research, University of Otago, Dunedin, New Zealand
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Shin G, D’Souza C. EMG activity of low back extensor muscles during cyclic flexion/extension. J Electromyogr Kinesiol 2010; 20:742-9. [DOI: 10.1016/j.jelekin.2010.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2009] [Revised: 02/10/2010] [Accepted: 03/03/2010] [Indexed: 10/19/2022] Open
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The effect of exertion level on activation patterns and variability of trunk muscles during multidirectional isometric activities in upright posture. Spine (Phila Pa 1976) 2010; 35:E443-51. [PMID: 20173682 DOI: 10.1097/brs.0b013e3181bc34b5] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN An experimental design to investigate activation patterns of trunk muscles during multidirectional exertions. OBJECTIVES To evaluate trunk muscle activation patterns in varying directions and moment magnitudes during an isometric task, and to investigate the effects of angle and level of isometric exertion on the electromyography (EMG) variability of trunk muscles in upright posture. SUMMARY OF BACKGROUND DATA Few studies have investigated trunk muscle activation patterns in multidirectional exertions with different moment magnitudes. METHODS A total of 12 asymptomatic male subjects were participated in the study. The EMG activity of 10 selected trunk muscles was collected in the 3 seconds end point matching tasks in 8 angles and 3 magnitudes of exertion. Trunk muscle activation patterns were examined using EMG tuning curves and measuring preferred direction (mean vector direction) and the index of spatial focus. The effect of exertion level on these measures was investigated by Rao test. The effects of angle and level of exertion on the EMG variability of trunk muscles were tested by analysis of variance with repeated measures design. RESULTS No significant difference in EMG tuning curves, preferred direction, and the index of spatial focus was found for each muscle studied across exertion levels (P > 0.05). The index of spatial focus of most muscles studied was not changed with increasing moment magnitude. EMG variability of trunk muscles was significantly affected by angle and level of exertion and their interaction effect (P < 0.001). CONCLUSION Consistent activation patterns of trunk muscles were found within and among subjects in different moment magnitudes. The index of spatial focus indicated that probably no shift to a higher co-contraction strategy has been adapted with increasing moment magnitude. The results suggested that increased EMG variability of trunk muscles in asymmetric exertions may be associated with lower trunk controllability during combined exertions.
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Musculoskeletal injuries among operating room nurses: results from a multicenter survey in Rome, Italy. J Public Health (Oxf) 2010. [DOI: 10.1007/s10389-010-0327-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Hess JA, Kincl LD, Davis K. The impact of drywall handling tools on the low back. APPLIED ERGONOMICS 2010; 41:305-12. [PMID: 19733834 DOI: 10.1016/j.apergo.2009.08.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2009] [Revised: 08/08/2009] [Accepted: 08/11/2009] [Indexed: 05/16/2023]
Abstract
Carpenters and other construction workers who install drywall have high rates of strains and sprains to the low back and shoulder. Drywall is heavy and awkward to handle resulting in increased risk of injury. The purpose of this study was to evaluate several low-cost coupling tools that have the potential to reduce awkward postures in drywall installers. Five coupling tools were evaluated using the Lumbar Motion Monitor that measures trunk kinematics and predicts probability of low back disorder group membership risk (LBD risk). Workers answered surveys about their comfort while using each tool. The results indicate that use of the 2-person manual lift and the J-handle provide the best reduction in awkward postures, motions, low back sagittal moment, and LBD risk. The two-person manual lift appears to be the safest method of lifting and moving drywall, though using the two-person J-handle also significantly reduces injury risk. Given that carpenters are skeptical about using equipment that can get in the way or get lost, a practical recommendation is promotion of two-person manual lifting. For single-person lifts, the Old Man tool is a viable option to decrease risk of MSDs.
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Affiliation(s)
- Jennifer A Hess
- Labor Education and Research Center, 1289 University of Oregon, Eugene, OR 97403-1289, USA.
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50
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Chow JW, Park SA, Tillman MD. Lower trunk kinematics and muscle activity during different types of tennis serves. BMC Sports Sci Med Rehabil 2009; 1:24. [PMID: 19825184 PMCID: PMC2770553 DOI: 10.1186/1758-2555-1-24] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2009] [Accepted: 10/13/2009] [Indexed: 11/10/2022]
Abstract
BACKGROUND To better understand the underlying mechanisms involved in trunk motion during a tennis serve, this study aimed to examine the (1) relative motion of the middle and lower trunk and (2) lower trunk muscle activity during three different types of tennis serves - flat, topspin, and slice. METHODS Tennis serves performed by 11 advanced (AV) and 8 advanced intermediate (AI) male tennis players were videorecorded with markers placed on the back of the subject used to estimate the anatomical joint (AJ) angles between the middle and lower trunk for four trunk motions (extension, left lateral flexion, and left and right twisting). Surface electromyographic (EMG) techniques were used to monitor the left and right rectus abdominis (LRA and RRA), external oblique (LEO and REO), internal oblique (LIO and RIO), and erector spinae (LES and RES). The maximal AJ angles for different trunk motions during a serve and the average EMG levels for different muscles during different phases (ascending and descending windup, acceleration, and follow-through) of a tennis serve were evaluated. RESULTS The repeated measures Skill x Serve Type x Trunk Motion ANOVA for maximal AJ angle indicated no significant main effects for serve type or skill level. However, the AV group had significantly smaller extension (p = 0.018) and greater left lateral flexion (p = 0.038) angles than the AI group. The repeated measures Skill x Serve Type x Phase MANOVA revealed significant phase main effects in all muscles (p < 0.001) and the average EMG of the AV group for LRA was significantly higher than that of the AI group (p = 0.008). All muscles showed their highest EMG values during the acceleration phase. LRA and LEO muscles also exhibited high activations during the descending windup phase, and RES muscle was very active during the follow-through phase. CONCLUSION Subjects in the AI group may be more susceptible to back injury than the AV group because of the significantly greater trunk hyperextension, and relatively large lumbar spinal loads are expected during the acceleration phase because of the hyperextension posture and profound front-back and bilateral co-activations in lower trunk muscles.
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Affiliation(s)
- John W Chow
- Center for Neuroscience and Neurological Recovery, Methodist Rehabilitation Center, Jackson, Mississippi, USA
| | - Soo-An Park
- Department of Orthopedic Surgery, Asan Medical Center, University of Ulsan, Seoul, South Korea
| | - Mark D Tillman
- Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, Florida, USA
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