A Comparison of Three-dimensional Spine Kinematics during Multidirectional Trunk Movement between Elderly Subjects with Degenerative Spine Disease and Healthy Young Adults

Wearable Motion Analysis System for Thoracic Spine Mobility With Inertial Sensors

This study presents a wireless wearable portable system designed for the automatic quantitative spatio-temporal analysis of continuous thoracic spine motion across various planes and degrees of freedom (DOF). This includes automatic motion segmentation, computation of the range of motion (ROM) for six distinct thoracic spine movements across three planes, tracking of motion completion cycles, and visualization of both primary and coupled thoracic spine motions. To validate the system, this study employed an Inter-days experimental setting to conduct experiments involving a total of 957 thoracic spine movements, with participation from two representatives of varying age and gender. The reliability of the proposed system was assessed using the Intraclass Correlation Coefficient (ICC) and Standard Error of Measurement (SEM). The experimental results demonstrated strong ICC values for various thoracic spine movements across different planes, ranging from 0.774 to 0.918, with an average of 0.85. The SEM values ranged from 0.64° to 4.03°, with an average of 1.93°. Additionally, we successfully conducted an assessment of thoracic spine mobility in a stroke rehabilitation patient using the system. This illustrates the feasibility of the system for actively analyzing thoracic spine mobility, offering an effective technological means for non-invasive research on thoracic spine activity during continuous movement states.

The shape and mobility of the thoracic spine in asymptomatic adults - A systematic review of in vivo studies

A comprehensive knowledge of the thoracic shape and kinematics is essential for effective risk prevention, diagnose and proper management of thoracic disorders and assessment of treatment or rehabilitation strategies as well as for in silico and in vitro models for realistic applications of boundary conditions. After an extensive search of the existing literature, this study summarizes 45 studies on in vivo thoracic kyphosis and kinematics and creates a systematic and detailed database. The thoracic kyphosis over T1-12 determined using non-radiological devices (34°) was relatively less than measured using radiological devices (40°) during standing. The majority of kinematical measurements are based on non-radiological devices. The thoracic range of motion (RoM) was greatest during axial rotation (40°), followed by lateral bending (26°), and flexion (21°) when determined using non-radiological devices during standing. The smallest RoM was identified during extension (13°). The lower thoracic level (T8-12) contributed more to the RoM than the upper (T1-4) and middle (T4-8) levels during flexion and lateral bending. During axial rotation and extension, the middle level (T4-8) contributed the most. Coupled motion was evident, mostly during lateral bending and axial rotation. With aging, the thoracic kyphosis increased by about 3° per decade, whereas the RoM decreased by about 5° per decade for all load directions. These changes with aging mainly occurred in the lower region (T6-12). The influence of sex on thoracic kyphosis and the RoM has been described as partly contradictory. Obesity was found to decrease the thoracic RoM. Studies comparing standing, sitting and lying reported the effect of posture as significant.

Continuous lumbar spine rhythms during level walking, stair climbing and trunk flexion in people with and without lumbar disc herniation

Low back pain(LBP) is one of the most prevalent diseases afflicting people today. Abnormal musculoskeletal loadings during activities of daily living (ADLs) have been deemed to be associated with spine rhythm. But no studies have reported abnormal continuous spine rhythms during ADLs in LBP patients. Therefore, the objective of this study was to investigate the continuous lumbar spine rhythms and their difference between people with and without lumbar disc herniation (LDH). Twenty-six healthy people and seven patients with LDH were recruited in this study. They performed level walking, stair climbing, and trunk flexion. Active optical markers placed on the landmark of the spinous process and pelvis were captured using motion analysis system to drive a musculoskeletal model to calculate the continuous lumbar spine rhythms. It was found that the lumbar spine rhythm was roughly constant throughout the analyzed cycle in both healthy people and LDH patients during trunk flexion. LDH patients displayed fluctuant lumbar spine rhythms during level walking and stair climbing and significantly higher segmental contributions of the lumbar segments in the lower lumbar region during stair climbing and trunk flexion. In conclusion, there were different compensatory responses to LDH in the continuous lumbar spine rhythms during different ADLs. This study provides a new insight into the abnormal spinal motion in LDH patients.

Multi-segmental thoracic spine kinematics measured dynamically in the young and elderly during flexion

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.