1
|
Balint NT, Antohe BA, Uysal HS, Cristuță AM, Rață M. Relationship between Spinal Range of Motion and Functional Tests in University Students: The Role of Demographic Factors. Healthcare (Basel) 2024; 12:1029. [PMID: 38786439 PMCID: PMC11121651 DOI: 10.3390/healthcare12101029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 05/10/2024] [Accepted: 05/12/2024] [Indexed: 05/25/2024] Open
Abstract
Spinal disorders are some of the most prevalent health concerns, especially among students. Based on student demographics, this cross-sectional study evaluated the correlation between functional tests (FTs) and spinal range of motion (ROM). This study included 206 students (age = 19.85 ± 1.80 years) from the Vasile Alecsandri University of Bacău. Participants' assessments were conducted using the following tests: (i) Ott, (ii) Schober, (iii) Stibor, (iv) finger-to-floor distance, (v) lateral flexion of the cervical and lumbar spine, and (vi) flexion of the cervical spine. Correlation analyses were evaluated using the Spearman correlation coefficient analysis. The results indicated a very strong relationship between lateral flexion of the lumbar spine on the left (LFLSL) and right (LFLSR) for all departments (r = 0.85 to 0.97, p < 0.05). There was a stronger relationship between FT results and spinal ROM for physical-education-department students compared to students from other departments (n = 17, r = -0.38 to 0.93, p < 0.05). There was no statistically significant correlation between FTs and spinal ROM based on age (p > 0.05). The study results provide evidence of the primary risk factors that predispose students to postural deviations. Practitioners and physiotherapists can utilize these values as a reference for potential therapeutic interventions.
Collapse
Affiliation(s)
- Nela Tatiana Balint
- Faculty of Movement, Sports and Health Science, “Vasile Alecsandri” University of Bacău, 600115 Bacău, Romania; (N.T.B.); (M.R.)
| | - Bogdan Alexandru Antohe
- Faculty of Movement, Sports and Health Science, “Vasile Alecsandri” University of Bacău, 600115 Bacău, Romania; (N.T.B.); (M.R.)
| | - Huseyin Sahin Uysal
- Faculty of Sport Science, Burdur Mehmet Akif Ersoy University, 15500 Burdur, Turkey;
| | - Alina Mihaela Cristuță
- Faculty of Movement, Sports and Health Science, “Vasile Alecsandri” University of Bacău, 600115 Bacău, Romania; (N.T.B.); (M.R.)
| | - Marinela Rață
- Faculty of Movement, Sports and Health Science, “Vasile Alecsandri” University of Bacău, 600115 Bacău, Romania; (N.T.B.); (M.R.)
| |
Collapse
|
2
|
Taheri N, Becker L, Reitmaier S, Muellner M, Schömig F, Pumberger M, Schmidt H. Schober test is not a valid assessment tool for lumbar mobility. Sci Rep 2024; 14:5451. [PMID: 38443445 PMCID: PMC10915146 DOI: 10.1038/s41598-024-54787-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 02/16/2024] [Indexed: 03/07/2024] Open
Abstract
The Schober test is considered reliable in evaluating lumbar mobility and its impairment. Especially in patients with chronic low back pain (cLBP) identification of functional restriction is important. We aimed to investigate whether the 5 cm Schober cut-off provides a valid distinction between unrestricted and restricted mobility in participants with and without cLBP (18-65 years). cLBP is defined as LBP persisting for ≥ 12 weeks. We analyzed agreement between the Schober test with two measurement devices (Epionics SPINE®; Idiag M360®) and the influence of lumbar lordosis (LL) on their agreement. Also, the sensitivity and specificity of the Schober test was evaluated. For 187 participants (49.6%) Epionics SPINE® RoF and Schober test matched (either ≥ 5 cm; > 40.8° RoF or ≤ 5 cm; < 40.8° RoF), for 190 participants (50.4%) the two measurements did not. Idiag M360® RoF of 190 participants (50.4%) showed corresponding results (either ≥ 5 cm; > 46.0° RoF or ≤ 5 cm; < 46.0° RoF). Non-agreement was seen in 187 participants (49.6%). LL differed significantly in the Epionics SPINE® cohort (p < 0.001). Regarding the Epionics SPINE® cohort, Schober test showed a sensitivity of 79.6% with a specificity of 36.1%. For the Idiag M360® cohort, Schober test showed a sensitivity of 68.2% and a specificity of 46.6%. Our results do not establish a consistent matching between Schober test and the device measurements. Therefore, Schober test may not be valid to predict impairment of lumbar mobility. We recommend Schober test as an add-on in monitoring of an individual relative to its case.
Collapse
Affiliation(s)
- Nima Taheri
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany.
- Berlin Institute of Health, Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, Germany.
| | - Luis Becker
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Berlin Institute of Health, Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Sandra Reitmaier
- Berlin Institute of Health, Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Maximilian Muellner
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Friederike Schömig
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
- Berlin Institute of Health, Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Matthias Pumberger
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - Hendrik Schmidt
- Berlin Institute of Health, Julius Wolff Institute for Biomechanics and Musculoskeletal Regeneration, Charité-Universitätsmedizin Berlin, Berlin, Germany
| |
Collapse
|
3
|
Kiefer D, Schneider L, Braun J, Kiltz U, Kolle N, Andreica I, Tsiami S, Buehring B, Sewerin P, Herbold S, Baraliakos X. Impact of daily physical therapy over 2 weeks on spinal mobility including objective electronic measurements and function in patients with axial spondyloarthritis. Ther Adv Musculoskelet Dis 2024; 16:1759720X231224212. [PMID: 38404654 PMCID: PMC10894534 DOI: 10.1177/1759720x231224212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 12/11/2023] [Indexed: 02/27/2024] Open
Abstract
Background Patients with axial spondyloarthritis (axSpA) are often compromised by impaired function and mobility. The standardized 2-week inpatient program 'multimodal rheumatologic complex treatment' (MRCT) was designed for patients with axSpA. The Epionics SPINE (ES) is an objective tool validated to assess mobility. Objective To investigate the impact of MRCT on physical function and mobility including range of motion (RoM) and kinematics (RoK). Design Single-center interventional, observational trial. Methods Patients with axSpA presenting with high disease activity and impaired physical function were consecutively recruited to undergo MRCT. Assessments performed before (V1) and after (V2) the intervention included Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis functional index (BASFI), Bath Ankylosing Spondylitis Metrology Index (BASMI), the ankylosing spondylitis physical performance index (ASPI), the Short Physical Performance Battery (SPPB), and ES measurements. Results At baseline, the 80 patients included had: BASDAI 5.5 ± 1.5, BASFI 5.6 ± 2.0, BASMI 4.2 ± 1.8, SPPB 13.8 ± 1.8, and ASPI 37.3 ± 18.1 s. Clinically relevant improvements between V1 versus V2 were noted for BASFI, BASMI, and all other assessments (p < 0.001), and also for ES measures of RoK (all p < 0.003) and RoM (all p < 0.04), while a positive trend was seen for flexion and extension (RoM). There was no significant effect of changes in medication (all p > 0.05). Conclusion The 2-weeks MRCT was associated with definite improvements of function and mobility. Importantly, the effect of this extensive physical activity was confirmed by using the ES as an objective tool to assess spinal mobility. The ES demonstrated for the first time that the RoK of spinal mobility can significantly improve related to an exercise intervention. Trial registration Ethical Committee: Ruhr-Universität (reference-number: 19-6735-BR).
Collapse
Affiliation(s)
- David Kiefer
- Ruhr-University Bochum, Bochum, Rheumazentrum Ruhrgebiet, Claudiusstrasse 45, Herne 44649, Germany
| | - Lucia Schneider
- Ruhr-Universität Bochum, Herne, Rheumazentrum Ruhrgebiet, Germany
| | - Juergen Braun
- Ruhr-Universität Bochum, Herne, Rheumazentrum Ruhrgebiet, Germany
| | - Uta Kiltz
- Ruhr-Universität Bochum, Herne, Rheumazentrum Ruhrgebiet, Germany
| | - Niklas Kolle
- Ruhr-Universität Bochum, Herne, Rheumazentrum Ruhrgebiet, Germany
| | - Ioana Andreica
- Ruhr-Universität Bochum, Herne, Rheumazentrum Ruhrgebiet, Germany
| | - Styliani Tsiami
- Ruhr-Universität Bochum, Herne, Rheumazentrum Ruhrgebiet, Germany
| | - Bjoern Buehring
- Bergisches Rheuma-Zentrum Wuppertal, Ruhr-Universität Bochum, Herne, Nordrhein-Westfalen, Germany
| | - Philipp Sewerin
- Rheumazentrum Ruhrgebiet, Ruhr-Universität Bochum, Herne, Germany Hiller Research Center, University Hospital Düsseldorf, Medical Faculty of Heinrich Heine University Düsseldorf, Germany
| | - Susanne Herbold
- Ruhr-Universität Bochum, Herne, Rheumazentrum Ruhrgebiet, Germany
| | | |
Collapse
|
4
|
García-Luna MA, Jimenez-Olmedo JM, Pueo B, Manchado C, Cortell-Tormo JM. Concurrent Validity of the Ergotex Device for Measuring Low Back Posture. Bioengineering (Basel) 2024; 11:98. [PMID: 38275578 PMCID: PMC10812927 DOI: 10.3390/bioengineering11010098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024] Open
Abstract
Highlighting the crucial role of monitoring and quantifying lumbopelvic rhythm for spinal curvature, the Ergotex IMU, a portable, lightweight, cost-effective, and energy-efficient technology, has been specifically designed for the pelvic and lumbar area. This study investigates the concurrent validity of the Ergotex device in measuring sagittal pelvic tilt angle. We utilized an observational, repeated measures design with healthy adult males (mean age: 39.3 ± 7.6 y, body mass: 82.2 ± 13.0 kg, body height: 179 ± 8 cm), comparing Ergotex with a 3D optical tracking system. Participants performed pelvic tilt movements in anterior, neutral, and posterior conditions. Statistical analysis included paired samples t-tests, Bland-Altman plots, and regression analysis. The findings show minimal systematic error (0.08° overall) and high agreement between the Ergotex and optical tracking, with most data points falling within limits of agreement of Bland-Altman plots (around ±2°). Significant differences were observed only in the anterior condition (0.35°, p < 0.05), with trivial effect sizes (ES = 0.08), indicating that these differences may not be clinically meaningful. The high Pearson's correlation coefficients across conditions underscore a robust linear relationship between devices (r > 0.9 for all conditions). Regression analysis showed a standard error of estimate (SEE) of 1.1° with small effect (standardized SEE < 0.26 for all conditions), meaning that the expected average deviation from the true value is around 1°. These findings validate the Ergotex as an effective, portable, and cost-efficient tool for assessing sagittal pelvic tilt, with practical implications in clinical and sports settings where traditional methods might be impractical or costly.
Collapse
Affiliation(s)
- Marco A. García-Luna
- Health, Physical Activity, and Sports Technology Research Group, Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.A.G.-L.); (B.P.), (J.M.C.-T.)
| | - Jose M. Jimenez-Olmedo
- Health, Physical Activity, and Sports Technology Research Group, Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.A.G.-L.); (B.P.), (J.M.C.-T.)
| | - Basilio Pueo
- Health, Physical Activity, and Sports Technology Research Group, Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.A.G.-L.); (B.P.), (J.M.C.-T.)
| | - Carmen Manchado
- Sports Coaching and Performance Research Group, Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain;
| | - Juan M. Cortell-Tormo
- Health, Physical Activity, and Sports Technology Research Group, Faculty of Education, University of Alicante, 03690 San Vicente del Raspeig, Spain; (M.A.G.-L.); (B.P.), (J.M.C.-T.)
| |
Collapse
|
5
|
Kiefer D, Schneider L, Braun J, Kiltz U, Kolle N, Andreica I, Tsiami S, Buehring B, Sewerin P, Herbold S, Baraliakos X. Clinically relevant differences in spinal mobility related to daytime performance in patients with axial spondyloarthritis. RMD Open 2024; 10:e003733. [PMID: 38191214 PMCID: PMC10806495 DOI: 10.1136/rmdopen-2023-003733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 11/30/2023] [Indexed: 01/10/2024] Open
Abstract
OBJECTIVE Patients with axial spondyloarthritis (axSpA) suffer from clinical symptoms like morning stiffness and back pain. Mobility of patients with axSpA is often impaired. The aim of this study is to compare the performance of patients with axSpA regarding mobility measures including performance-based tests and objective electronic assessments with the Epionics SPINE device (ES) at different times of the day compared with healthy controls (HC). METHODS Observational trial, consecutive inpatients with axSpA (n=100) and 20 HCs were examined in the morning (V1: before 10:00 am) and in the afternoon (V2: after 02:00 pm) by the Bath Ankylosing Spondylitis Metrology Index (BASMI), the AS physical performance index (ASPI), the Short Physical Performance Battery (SPPB) and ES measurements, including range of motion (RoM) and range of kinematics (RoK). RESULTS The assessments of patients with axSpA performed in the morning clearly differed from those in the afternoon, especially regarding performance-based tests. Significant improvements were seen for BASMI (4.0±3.8 to 3.8±1.9; p<0.001), ASPI (36.2±18.3 to 28.8±11.9 s; p<0.001), SPPB (10.1±1.5 to 10.7±1.4 points; p<0.001) and for ES measures of speed (RoK; p<0.018) but not for RoM, except for lateral flexion (13.3±7.4 to 14.7±8.2°; p=0.002). This time of assessment-related variability was not observed in HC. CONCLUSION The spinal mobility of patients with axSpA was worse in the morning but significantly improved in the afternoon. This was captured best by performance-based measures and was not seen in HC. The diurnal variation of mobility has implications for clinical studies, suggesting that the time of assessments needs to be standardised.
Collapse
Affiliation(s)
- David Kiefer
- Rheumatologie, Ruhr-Universitat Bochum, Bochum, Germany
- Rheumatologie, Rheumazentrum Ruhrgebiet, Herne, NRW, Germany
| | - Lucia Schneider
- Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Jürgen Braun
- Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Uta Kiltz
- Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
- Rheumazentrum Ruhrgebiet, Herne, Nordrhein-Westfalen, Germany
| | - Niklas Kolle
- Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Ioana Andreica
- Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
- Rheumazentrum Ruhrgebiet, Herne, Nordrhein-Westfalen, Germany
| | - Styliani Tsiami
- Rheumazentrum Ruhrgebiet, Herne, Nordrhein-Westfalen, Germany
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Herne, Germany
| | | | - Philipp Sewerin
- Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | - Susanne Herbold
- Ruhr University Bochum, Bochum, Nordrhein-Westfalen, Germany
| | | |
Collapse
|
6
|
Schäfer H, Schäfer R, Platen P. A novel motorized office chair causes low-amplitude spinal movements and activates trunk muscles: A cross-over trial. PLoS One 2023; 18:e0294778. [PMID: 38134012 PMCID: PMC10745177 DOI: 10.1371/journal.pone.0294778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 11/08/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION Inactivity and long periods of sitting are common in our society, even though they pose a health risk. Dynamic sitting is recommended to reduce this risk. The purpose of this study was to investigate the effect of continuous passive motion (CPM) conducted by a novel motorized office chair on lumbar lordosis and trunk muscle activation, oxygen uptake and attentional control. STUDY DESIGN Randomized, single-session, crossover with two periods/conditions. METHODS Twenty office workers (50% women) sat for one hour on the motorized chair, one half with CPM, the other not. The starting condition (CPM/no CPM) was switched in half of the sample. The participants were equipped with a spirometric cart, surface EMG, the Epionics SPINE system and performed a computer-based test for attentional control (AX-CPT). Outcomes were lumbar sagittal movements and posture, number of trunk muscle activations, attentional control and energy expenditure. RESULTS The CPM of the chair causes frequent low-amplitude changes in lumbar lordosis angle (moved: 498 ± 133 vs. static: 45 ± 38) and a higher number of muscle activations. A periodic movement pattern of the lumbar spine according to the movement of the chair was observed in every participant, although, sitting behavior varied highly between individuals. Attentional control was not altered in the moved condition (p = .495; d = .16). Further, oxygen uptake did not increase higher than 1.5 MET. CONCLUSION The effects of the motorized chair can be particularly useful for people with static sitting behavior. Further studies should investigate, whether CPM provides the assumed beneficial effects of dynamic sitting on the spine.
Collapse
Affiliation(s)
- Hendrik Schäfer
- Department of Sports Medicine and Sports Nutrition, Faculty of Sports Science, Ruhr University Bochum, Bochum, Germany
- Department of Rehabilitation Sciences, Faculty of Health, University of Witten/Herdecke, Witten, Germany
- DRV Clinic Königsfeld, Center for Medical Rehabilitation, Ennepetal, Germany
| | - Robin Schäfer
- Department of Sports Medicine and Sports Nutrition, Faculty of Sports Science, Ruhr University Bochum, Bochum, Germany
- Division of Physiotherapy, Department of Applied Health Sciences, University of Applied Sciences, Bochum, Germany
| | - Petra Platen
- Department of Sports Medicine and Sports Nutrition, Faculty of Sports Science, Ruhr University Bochum, Bochum, Germany
| |
Collapse
|
7
|
Kiefer D, Braun J, Chatzistefanidi V, Kiltz U, Adolf D, Schwarze I, Kabelitz M, Lange U, Brandt-Jürgens J, Stemmler E, Sartingen S, Baraliakos X. Clinical Relevance of Axial Radiographic Damage in Axial Spondyloarthritis: Evaluation of Functional Consequences by an Objective Electronic Device. J Rheumatol 2023; 50:1422-1429. [PMID: 37061230 DOI: 10.3899/jrheum.2022-1240] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/04/2023] [Indexed: 04/17/2023]
Abstract
OBJECTIVE Axial spondyloarthritis (axSpA) is associated with decreased function and mobility of patients as a result of inflammation and radiographic damage. The Epionics SPINE device (ES), an electronic device that objectively measures spinal mobility, including range of motion (RoM) and speed (ie, range of kinematics [RoK]) of movement, has been clinically validated in axSpA. We investigated the performance of the ES relative to radiographic damage in the axial skeleton of patients with axSpA. METHODS A total of 103 patients with axSpA, 31 with nonradiographic axSpA (nr-axSpA) and 72 with radiographic axSpA (r-axSpA), were consecutively examined. Conventional radiographs of the spine (including presence, number, and location of syndesmophytes) and the sacroiliac joints (SIJs; rated by the modified New York criteria) were analyzed with the ES. Function and mobility were assessed using analyses of covariance and Spearman correlation. RESULTS The number of syndesmophytes correlated positively with Bath Ankylosing Spondylitis Metrology Index scores (r 0.38, P = 0.02) and correlated negatively with chest expansion (r -0.39, P = 0.02) and ES measurements (-0.53 ≤ r ≤ -0.34, all P < 0.03), except for RoM and RoK regarding rotation and RoK for extension of the lumbar and thoracic spines. In the radiographic evaluation of the SIJs, the extent of damage correlated negatively with ES scores and metric measurements (-0.49 ≤ r ≤ -0.33, all P < 0.001). Patients with r-axSpA, as compared to those with nr-axSpA, showed significantly worse ES scores for RoM, RoK, and chest expansion. CONCLUSION The ES scores, in accordance with mobility measurements, correlated well with the presence and extent of radiographic damage in the spine and the SIJs. As expected, patients with r-axSpA had more severe impairments than those with nr-axSpA.
Collapse
Affiliation(s)
- David Kiefer
- D. Kiefer, MD, J. Braun, MD, V. Chatzistefanidi, MD, U. Kiltz, MD, X. Baraliakos, MD, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Bochum;
| | - Jürgen Braun
- D. Kiefer, MD, J. Braun, MD, V. Chatzistefanidi, MD, U. Kiltz, MD, X. Baraliakos, MD, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Bochum
| | - Varvara Chatzistefanidi
- D. Kiefer, MD, J. Braun, MD, V. Chatzistefanidi, MD, U. Kiltz, MD, X. Baraliakos, MD, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Bochum
| | - Uta Kiltz
- D. Kiefer, MD, J. Braun, MD, V. Chatzistefanidi, MD, U. Kiltz, MD, X. Baraliakos, MD, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Bochum
| | - Daniela Adolf
- D. Adolf, PhD, M. Kabelitz, StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH, Magdeburg
| | | | - Maria Kabelitz
- D. Adolf, PhD, M. Kabelitz, StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH, Magdeburg
| | - Uwe Lange
- U. Lange, MD, Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen, Gießen
| | | | - Edgar Stemmler
- E. Stemmler, PhD, S. Sartingen, PhD, Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
| | - Sabine Sartingen
- E. Stemmler, PhD, S. Sartingen, PhD, Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany
| | - Xenofon Baraliakos
- D. Kiefer, MD, J. Braun, MD, V. Chatzistefanidi, MD, U. Kiltz, MD, X. Baraliakos, MD, Rheumazentrum Ruhrgebiet, Ruhr-University Bochum, Bochum
| |
Collapse
|
8
|
McMullin P, Emmett D, Gibbons A, Clingo K, Higbee P, Sykes A, Fullwood DT, Mitchell UH, Bowden AE. Dynamic segmental kinematics of the lumbar spine during diagnostic movements. Front Bioeng Biotechnol 2023; 11:1209472. [PMID: 37840657 PMCID: PMC10568473 DOI: 10.3389/fbioe.2023.1209472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 09/15/2023] [Indexed: 10/17/2023] Open
Abstract
Background: In vivo measurements of segmental-level kinematics are a promising avenue for better understanding the relationship between pain and its underlying, multi-factorial basis. To date, the bulk of the reported segmental-level motion has been restricted to single plane motions. Methods: The present work implemented a novel marker set used with an optical motion capture system to non-invasively measure dynamic, 3D in vivo segmental kinematics of the lower spine in a laboratory setting. Lumbar spinal kinematics were measured for 28 subjects during 17 diagnostic movements. Results: Overall regional range of motion data and lumbar angular velocity measurement were consistent with previously published studies. Key findings from the work included measurement of differences in ascending versus descending segmental velocities during functional movements and observations of motion coupling paradigms in the lumbar spinal segments. Conclusion: The work contributes to the task of establishing a baseline of segmental lumbar movement patterns in an asymptomatic cohort, which serves as a necessary pre-requisite for identifying pathological and symptomatic deviations from the baseline.
Collapse
Affiliation(s)
- Paul McMullin
- Department of Mechanical Engineering, Brigham Young University, Provo, UT, United States
| | - Darian Emmett
- Department of Mechanical Engineering, Brigham Young University, Provo, UT, United States
| | - Andrew Gibbons
- Department of Mechanical Engineering, Brigham Young University, Provo, UT, United States
| | - Kelly Clingo
- Department of Mechanical Engineering, Brigham Young University, Provo, UT, United States
| | - Preston Higbee
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Andrew Sykes
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - David T. Fullwood
- Department of Mechanical Engineering, Brigham Young University, Provo, UT, United States
| | - Ulrike H. Mitchell
- Department of Exercise Sciences, Brigham Young University, Provo, UT, United States
| | - Anton E. Bowden
- Department of Mechanical Engineering, Brigham Young University, Provo, UT, United States
| |
Collapse
|
9
|
Fagbemigun RO, Cavallo M, Brown SHM. The Effects of Posture and Dynamic Stretching on the Electromechanical Delay of the Paraspinal Muscles. J Appl Biomech 2023; 39:179-183. [PMID: 37105546 DOI: 10.1123/jab.2022-0271] [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: 11/03/2022] [Revised: 02/10/2023] [Accepted: 03/21/2023] [Indexed: 04/29/2023]
Abstract
Electromechanical delay (EMD) of muscle is influenced in part by its in-series arrangement with connective tissue. Therefore, studying EMD might provide a better understanding of the muscle-connective tissue interaction. Here, EMD of the thoracic and lumbar erector spinae muscles were investigated under conditions that could influence muscle-connective tissue interaction. A total of 19 participants performed isometric back extension contractions in 3 different postures that influence lumbar spine angle: sitting, standing, and kneeling. They then performed a 15-minute dynamic stretching routine and repeated the standing contractions. Mean lumbar flexion angles of 0.5°, 9.9°, and 19.8° were adopted for standing, kneeling, and sitting, respectively. No statistically significant differences in the thoracic erector spinae EMD were found between the different postures. Lumbar erector spinae EMD was significantly longer in the sitting (94.1 ms) compared to the standing (69.9 ms) condition, with no differences compared to kneeling (79.7 ms). There were no statistically significant differences of the thoracic or lumbar erector spinae EMDs before and after dynamic stretching. These results suggest that dynamic stretching does not affect the mechanical behavior of the muscle-tendon-aponeurosis units in a way that alters force generation and transmission, but a sitting posture can alter how force is transmitted through the musculotendinous complex of the lumbar erector spinae.
Collapse
Affiliation(s)
- Richard O Fagbemigun
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, ON,Canada
| | - Melissa Cavallo
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, ON,Canada
| | - Stephen H M Brown
- Department of Human Health & Nutritional Sciences, University of Guelph, Guelph, ON,Canada
| |
Collapse
|
10
|
Haghi M, Ershadi A, Deserno TM. Recognizing Human Activity of Daily Living Using a Flexible Wearable for 3D Spine Pose Tracking. SENSORS (BASEL, SWITZERLAND) 2023; 23:2066. [PMID: 36850664 PMCID: PMC9961818 DOI: 10.3390/s23042066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/07/2023] [Accepted: 02/10/2023] [Indexed: 06/18/2023]
Abstract
The World Health Organization recognizes physical activity as an influencing domain on quality of life. Monitoring, evaluating, and supervising it by wearable devices can contribute to the early detection and progress assessment of diseases such as Alzheimer's, rehabilitation, and exercises in telehealth, as well as abrupt events such as a fall. In this work, we use a non-invasive and non-intrusive flexible wearable device for 3D spine pose measurement to monitor and classify physical activity. We develop a comprehensive protocol that consists of 10 indoor, 4 outdoor, and 8 transition states activities in three categories of static, dynamic, and transition in order to evaluate the applicability of the flexible wearable device in human activity recognition. We implement and compare the performance of three neural networks: long short-term memory (LSTM), convolutional neural network (CNN), and a hybrid model (CNN-LSTM). For ground truth, we use an accelerometer and strips data. LSTM reached an overall classification accuracy of 98% for all activities. The CNN model with accelerometer data delivered better performance in lying down (100%), static (standing = 82%, sitting = 75%), and dynamic (walking = 100%, running = 100%) positions. Data fusion improved the outputs in standing (92%) and sitting (94%), while LSTM with the strips data yielded a better performance in bending-related activities (bending forward = 49%, bending backward = 88%, bending right = 92%, and bending left = 100%), the combination of data fusion and principle components analysis further strengthened the output (bending forward = 100%, bending backward = 89%, bending right = 100%, and bending left = 100%). Moreover, the LSTM model detected the first transition state that is similar to fall with the accuracy of 84%. The results show that the wearable device can be used in a daily routine for activity monitoring, recognition, and exercise supervision, but still needs further improvement for fall detection.
Collapse
Affiliation(s)
- Mostafa Haghi
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, 38106 Braunschweig, Lower Saxony, Germany
- Ubiquitous Computing Lab, Department of Computer Science, Konstanz University of Applied Sciences, 78462 Konstanz, Baden-Württemberg, Germany
| | - Arman Ershadi
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, 38106 Braunschweig, Lower Saxony, Germany
| | - Thomas M. Deserno
- Peter L. Reichertz Institute for Medical Informatics of TU Braunschweig and Hannover Medical School, 38106 Braunschweig, Lower Saxony, Germany
| |
Collapse
|
11
|
Finger-Floor Distance Is Not a Valid Parameter for the Assessment of Lumbar Mobility. Diagnostics (Basel) 2023; 13:diagnostics13040638. [PMID: 36832125 PMCID: PMC9955021 DOI: 10.3390/diagnostics13040638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/02/2023] [Accepted: 02/07/2023] [Indexed: 02/11/2023] Open
Abstract
Low back pain (LBP) could be associated with a reduced lumbar mobility. For the evaluation of lumbar flexibility, parameters such as finger-floor distance (FFD) are historically established. However, the extent of the correlation of FFD to lumbar flexibility or other involved joint kinematics such as pelvic motion, as well as the influence of LBP, is not yet known. We conducted a prospective cross-sectional observation study with 523 participants included (167 with LBP > 12 weeks, 356 asymptomatic). LBP-participants were matched for sex, age, height, and body-mass-index with an asymptomatic control cohort, resulting in two cohorts with 120 participants each. The FFD in maximal trunk flexion was measured. The Epionics-SPINE measurement-system was used to evaluate the pelvic and lumbar Range-of-Flexion (RoF), and the correlation of FFD to pelvic- and lumbar-RoF was evaluated. In an asymptomatic sub-cohort of 12 participants, we examined the individual correlation of FFD to pelvic- and lumbar-RoF under gradual trunk flexion. Participants with LBP showed a significantly reduced pelvic-RoF (p < 0.001) and lumbar-RoF (p < 0.001) as well as an increased FFD (p < 0.001) compared to the asymptomatic control cohort. Asymptomatic participants exhibited a weak correlation of FFD to pelvic-RoF and lumbar-RoF (r < 0.500). LBP patients revealed a moderate correlation of FFD to pelvic-RoF (male: p < 0.001, r = -0.653, female: p < 0.001, r = -0.649) and sex-dependent to lumbar-RoF (male: p < 0.001, r = -0.604, female: p = 0.012, r = -0.256). In the sub-cohort of 12 participants, gradual trunk flexion showed a strong correlation of FFD to pelvic-RoF (p < 0.001, r = -0.895) but a moderate correlation to lumbar-RoF (p < 0.001, r = -0.602). The differences in FFD in an individual patient, assuming consistent hip function, may be attributed partially to the differences in lumbar flexibility. However, the absolute values of FFD do not qualify as a measure for lumbar mobility. Rather, using validated non-invasive measurement devices should be considered.
Collapse
|
12
|
Comparison of three validated systems to analyse spinal shape and motion. Sci Rep 2022; 12:10222. [PMID: 35715438 PMCID: PMC9205914 DOI: 10.1038/s41598-022-13891-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 05/30/2022] [Indexed: 11/17/2022] Open
Abstract
The assessment of spinal shape and mobility is of great importance for long-term therapy evaluation. As frequent radiation should be avoided, especially in children, non-invasive measurements have gained increasing importance. Their comparability between each other however stays elusive. Three non-invasive measurement tools have been compared to each other: Idiag M360, raster stereography and Epionics SPINE. 30 volunteers (15 females/15 males) have each been assessed by each system, investigating lumbar lordosis, thoracic kyphosis and spinal range-of-motion in the sagittal plane. Lumbar lordosis differed significantly (p < 0.001) between measurement devices but correlated significant to each other (Pearson’s r 0.5–0.6). Regarding thoracic kyphosis no significant difference and a high correlation (r = 0.8) could be shown between Idiag M360 and raster stereography. For lumbar mobility resulting measurements differed significantly and correlated only moderate between Idiag M360 and Epionics SPINE. Although the different measurement systems are moderate to high correlated to each other, their absolute agreement is limited. This might be explained by differences in their angle definition for lordotic and kyphotic angle, their measurement placement, or their capturing of mobility (static vs. dynamic assessment). Therefore, for long-term evaluation of the back profile, inter-modal comparison of values between different non-invasive devices should be avoided.
Collapse
|
13
|
Jamison M, Glover M, Peterson K, DeGregorio M, King K, Danelson K, O'Gara T. Lumbopelvic postural differences in adolescent idiopathic scoliosis: A pilot study. Gait Posture 2022; 93:73-77. [PMID: 35093665 DOI: 10.1016/j.gaitpost.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 12/14/2021] [Accepted: 01/04/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND A primary etiology of adolescent idiopathic scoliosis (AIS) is currently unknown, but poor postural control of the spinal extensor musculature has been identified as an AIS risk factor. Identifiable postural differences would aid in advancing the precise postural behaviors that should be modified during Physiotherapy Scoliosis Specific Exercise (PSSE) to help limit the progression of AIS. RESEARCH QUESTION Are there any determinable differences in lumbopelvic posture or range of motion between subjects with AIS and controls? METHODS This prospective cohort pilot study consisted of 53 subjects (27 AIS and 26 control) aged 11-17 years. Subjects had their lumbopelvic posture assessed and monitored using the ViMove DorsaVi sensor package. All subjects underwent a live assessment to obtain initial lumbopelvic (LP) range of motion (ROM) measurements. Subjects were then monitored while continuing with normal activities of daily living (ADLs) for 12 h. With an alpha level of 0.05, nonparametric analyses were performed for each variable via a Mann-Whitney U-test. RESULTS During the live assessment, controls exhibited a significantly greater anterior pelvic tilt ROM in the sitting position than the AIS group (p = 0.0433). When compared to female controls, females with AIS had a sitting pelvic tilt ROM that was significantly more retroverted (p = 0.0232) and less anteverted (p = 0.0010). During ADLs, female controls exhibited a higher total number of extension events than their female with AIS (p = 0.0263). These associations did not strengthen with greater spinal deformity. SIGNIFICANCE This work demonstrates postural differences between patients with AIS and controls. Further study is necessary to determine why patients with AIS adopt these postures, and if PSSEs can be utilized to limit the progression of AIS.
Collapse
Affiliation(s)
- Matthew Jamison
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Mark Glover
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Keyan Peterson
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Michael DeGregorio
- Department of Mechanical Engineering, Grand Canyon University, 3300W Camelback Rd, Phoenix, AZ 85017, USA
| | - Kamryn King
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Kerry Danelson
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA
| | - Tadhg O'Gara
- Department of Orthopaedic Surgery, Wake Forest School of Medicine, 1 Medical Center Blvd, Winston-Salem, NC 27157, USA.
| |
Collapse
|
14
|
Frediani G, Vannetti F, Bocchi L, Zonfrillo G, Carpi F. Monitoring Flexions and Torsions of the Trunk via Gyroscope-Calibrated Capacitive Elastomeric Wearable Sensors. SENSORS 2021; 21:s21206706. [PMID: 34695926 PMCID: PMC8539866 DOI: 10.3390/s21206706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 10/01/2021] [Accepted: 10/04/2021] [Indexed: 11/16/2022]
Abstract
Reliable, easy-to-use, and cost-effective wearable sensors are desirable for continuous measurements of flexions and torsions of the trunk, in order to assess risks and prevent injuries related to body movements in various contexts. Piezo-capacitive stretch sensors, made of dielectric elastomer membranes coated with compliant electrodes, have recently been described as a wearable, lightweight and low-cost technology to monitor body kinematics. An increase of their capacitance upon stretching can be used to sense angular movements. Here, we report on a wearable wireless system that, using two sensing stripes arranged on shoulder straps, can detect flexions and torsions of the trunk, following a simple and fast calibration with a conventional tri-axial gyroscope on board. The piezo-capacitive sensors avoid the errors that would be introduced by continuous sensing with a gyroscope, due to its typical drift. Relative to stereophotogrammetry (non-wearable standard system for motion capture), pure flexions and pure torsions could be detected by the piezo-capacitive sensors with a root mean square error of ~8° and ~12°, respectively, whilst for flexion and torsion components in compound movements, the error was ~13° and ~15°, respectively.
Collapse
Affiliation(s)
- Gabriele Frediani
- Department of Industrial Engineering, University of Florence, 50121 Florence, Italy; (G.F.); (G.Z.)
| | | | - Leonardo Bocchi
- Department of Information Engineering, University of Florence, 50121 Florence, Italy;
| | - Giovanni Zonfrillo
- Department of Industrial Engineering, University of Florence, 50121 Florence, Italy; (G.F.); (G.Z.)
| | - Federico Carpi
- Department of Industrial Engineering, University of Florence, 50121 Florence, Italy; (G.F.); (G.Z.)
- IRCCS Fondazione don Carlo Gnocchi ONLUS, 50143 Florence, Italy;
- Correspondence:
| |
Collapse
|
15
|
Kiefer D, Baraliakos X, Adolf D, Chatzistefanidi V, Schwarze I, Lange U, Brandt-Jürgens J, Stemmler E, Sartingen S, Braun J. Successful evaluation of spinal mobility measurements with the Epionics SPINE device in patients with axial spondyloarthritis compared to controls. J Rheumatol 2021; 49:44-52. [PMID: 34393107 DOI: 10.3899/jrheum.201470] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate ES for quantification of spinal mobility in patients with axSpA. METHODS A total of 153 individuals, 39 females and 114 males, were examined:134 axSpA patients, 40 non-(nr-) and 94 radiographic (r)-axSpA, and 19 healthy controls (HC), respectively. The results were compared using mean ES scores and modeling was performed using multivariable logistic regression models resulting in good validity and high discriminative power. RESULTS ES measurements showed meaningful differences between axSpA patients and HC (all p<0.001) as well as between r- and nr-axSpA (p<0.01). In axSpA patients a negative correlation between ES and BASMI values was found: -0.76≤r≤-0.52 (p<0.05). BASFI scores showed a similar trend (r > -0.39). Patients with r-axSpA had a more limited and slower spinal mobility than those with nr-axSpA. Other patient reported outcomes did almost not correlate. CONCLUSION This study shows that the ES is an objective performance measure and a valid tool to assess spinal mobility in axSpA, also based on OMERACT criteria. RoK and RoM scores provide additional information on physical function of axSpA patients.
Collapse
Affiliation(s)
- David Kiefer
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Xenofon Baraliakos
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Daniela Adolf
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Varvara Chatzistefanidi
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Ilka Schwarze
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Uwe Lange
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Jan Brandt-Jürgens
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Edgar Stemmler
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Sabine Sartingen
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| | - Jürgen Braun
- Rheumazentrum Ruhrgebiet, Ruhr-University Bochum; StatConsult, Gesellschaft für klinische und Versorgungsforschung mbH Magdeburg, Germany; Praxis für Rheumatologie, Leipzig; Rheumatologie und klinische Immunologie Campus Kerckhoff, Bad Nauheim, Universität Gießen; Rheumatologische Schwerpunktpraxis, Berlin; Medical Immunology, AbbVie Deutschland GmbH & Co. KG, Germany. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. D. Kiefer, X. Baraliakos, D. Adolf, V. Chatzistefanidi, I. Schwarze, U. Lange, J. Brandt-Jürgens, and J. Braun received speaker or consulting fees from AbbVie. E. Stemmler, and S. Sartingen are employees of AbbVie and may own AbbVie stock. AbbVie sponsored this study and contributed to the design, study conduct, and analysis. AbbVie participated in the interpretation of data, review, and approval of the Manuscript. Corresponding author: David Kiefer, MD, Rheumazentrum Ruhrgebiet Herne, Ruhr-University Bochum, Claudiusstrasse 45, 44649 Herne, Germany.
| |
Collapse
|
16
|
Frediani G, Bocchi L, Vannetti F, Zonfrillo G, Carpi F. Wearable Detection of Trunk Flexions: Capacitive Elastomeric Sensors Compared to Inertial Sensors. SENSORS 2021; 21:s21165453. [PMID: 34450895 PMCID: PMC8398997 DOI: 10.3390/s21165453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Revised: 08/07/2021] [Accepted: 08/09/2021] [Indexed: 01/04/2023]
Abstract
Continuous monitoring of flexions of the trunk via wearable sensors could help various types of workers to reduce risks associated with incorrect postures and movements. Stretchable piezo-capacitive elastomeric sensors based on dielectric elastomers have recently been described as a wearable, lightweight and cost-effective technology to monitor human kinematics. Their stretching causes an increase of capacitance, which can be related to angular movements. Here, we describe a wearable wireless system to detect flexions of the trunk, based on such sensors. In particular, we present: (i) a comparison of different calibration strategies for the capacitive sensors, using either an accelerometer or a gyroscope as an inclinometer; (ii) a comparison of the capacitive sensors’ performance with those of the accelerometer and gyroscope; to that aim, the three types of sensors were evaluated relative to stereophotogrammetry. Compared to the gyroscope, the capacitive sensors showed a higher accuracy. Compared to the accelerometer, their performance was lower when used as quasi-static inclinometers but also higher in case of highly dynamic accelerations. This makes the capacitive sensors attractive as a complementary, rather than alternative, technology to inertial sensors.
Collapse
Affiliation(s)
- Gabriele Frediani
- Department of Industrial Engineering, University of Florence, 50121 Florence, Italy; (G.F.); (G.Z.)
| | - Leonardo Bocchi
- Department of Information Engineering, University of Florence, 50121 Florence, Italy;
| | | | - Giovanni Zonfrillo
- Department of Industrial Engineering, University of Florence, 50121 Florence, Italy; (G.F.); (G.Z.)
| | - Federico Carpi
- Department of Industrial Engineering, University of Florence, 50121 Florence, Italy; (G.F.); (G.Z.)
- IRCCS Fondazione don Carlo Gnocchi ONLUS, 50143 Florence, Italy;
- Correspondence:
| |
Collapse
|
17
|
Snow JC, Simpson K, Rahman P, Howarth S, De Carvalho D. Spinal mobility in radiographic axial spondyloarthritis: criterion concurrent validity of classic and novel measurements. BMC Musculoskelet Disord 2021; 22:464. [PMID: 34020625 PMCID: PMC8140455 DOI: 10.1186/s12891-021-04352-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/10/2021] [Indexed: 01/21/2023] Open
Abstract
Background Limitations in spinal mobility are a characteristic feature of Axial Spondyloarthritis. Current clinical measurements of spinal mobility have shown low criterion-concurrent validity. This study sought to evaluate criterion-concurrent validity for a clinically feasible measurement method of measuring spine mobility using tri-axial accelerometers. Methods Fifteen radiographic-Spondyloarthritis patients were recruited for this study. Two postural reference radiographs, followed by three trials in forward, left and right lateral bending were taken. For all trials, three measurements were collected: tape (Original Schober’s, Modified Schober’s, Modified-Modified Schober’s, Lateral Spinal Flexion Test and Domjan Test), followed immediately by synchronized radiograph and accelerometer measurements at end range of forward and bilateral lateral flexion. The criterion-concurrent validity of all measurement methods was compared to the radiographic measures using Pearson’s correlation coefficients. A Bland-Altman analysis was conducted to assess agreement. Results In forward bending, the accelerometer method (r = 0.590, p = 0.010) had a stronger correlation to the radiographic measures than all tape measures. In lateral bending, the Lateral Spinal Flexion tape measure (r = 0.743, p = 0.001) correlated stronger than the accelerometer method (r = 0.556, p = 0.016). The Domjan test of bilateral bending (r = 0.708, p = 0.002) had a stronger correlation to the radiographic measure than the accelerometer method. Conclusions Accelerometer measures demonstrated superior criterion-concurrent validity compared to current tape measures of spinal mobility in forward bending. While a moderate correlation exists between accelerometer and radiographs in lateral bending, the Lateral Spinal Flexion Test and Domjan Test were found to have the best criterion-concurrent validity of all tests examined in this study.
Collapse
Affiliation(s)
- John Charles Snow
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Dr, St. John's, NL, A1B 3V6, Canada
| | - Kyle Simpson
- Private Practice, Kitchener, ON, N2M 1Y5, Canada
| | - Proton Rahman
- Discipline of Medicine, Division of Rheumatology, Faculty of Medicine, Memorial University of Newfoundland, St. John's, NL, A1B 3V6, Canada
| | - Samuel Howarth
- Division of Research and Innovation, Canadian Memorial Chiropractic College, Toronto, ON, M2H 3J1, Canada
| | - Diana De Carvalho
- Division of Community Health and Humanities, Faculty of Medicine, Memorial University of Newfoundland, 300 Prince Philip Dr, St. John's, NL, A1B 3V6, Canada.
| |
Collapse
|
18
|
Pan F, Zhu R, Zander T, Lu S, Schmidt H. The sagittal sways of back lordosis and sacral orientation during still standing at different arm positions. J Biomech 2020; 114:110149. [PMID: 33271471 DOI: 10.1016/j.jbiomech.2020.110149] [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: 08/29/2020] [Revised: 10/29/2020] [Accepted: 11/21/2020] [Indexed: 11/25/2022]
Abstract
Lumbo-pelvic parameters in the sagittal plane are normally measured from lateral radiographs obtained at a single time point during upright standing with arms held forward to expose anatomical bony structures. However, the human trunk naturally sways during still standing, which potentially alters the targeted parameters. We therefore aimed to investigate the effect of postural sway on lumbo-pelvic parameters during still standing at different arm positions. A non-radiological back measurement device was used to determine the absolute changes of back lordosis and sacral orientation during one-minute still standing while participants (10 males and 10 females without low back pain) held their arms at eight different positions. When the arms were freely hanging down at both sides, males displayed median values of 25.2° (range: 15.6-45.0°) and 7.4° (range: 2.0-26.7°) for back lordosis and sacral orientation, which were smaller than those of 33.1° (range: 11.9-41.9°) and 16.1° (range: 0.8-22.8°) for females, respectively (P < 0.05). At the same arm position, the median values were 2.7° (range: 1.3-5.2°) and 2.9° (range: 1.6-4.5°) for change of back lordosis and change of sacral orientation, respectively. Sex displayed no significant influence for both measures. Different arm positions non-significantly affected the change of back lordosis. When hands rested on horizontal bars, the change of sacral orientation was significantly less than during other arm positions (P < 0.05). Hence, back lordosis and sacral orientation inherently change during still standing, independently of sex and arm position, which could compromise the reliability of measurements at a single time point. When categorizing subjects into groups with normal or abnormal lumbo-pelvic balance, this variability should be taken into consideration.
Collapse
Affiliation(s)
- Fumin Pan
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China; Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration (Tongji University), Ministry of Education, 389 Xincun Road, 200065 Shanghai, China; Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Rui Zhu
- Key Laboratory of Spine and Spinal Cord Injury Repair and Regeneration (Tongji University), Ministry of Education, 389 Xincun Road, 200065 Shanghai, China
| | - Thomas Zander
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Shibao Lu
- Department of Orthopedics, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Hendrik Schmidt
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
| |
Collapse
|
19
|
Russell BS, Muhlenkamp-Wermert KA, Hoiriis KT. Measurement of Lumbar Lordosis: A Comparison of 2 Alternatives to the Cobb Angle. J Manipulative Physiol Ther 2020; 43:760-767. [PMID: 32888701 DOI: 10.1016/j.jmpt.2020.05.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 04/10/2020] [Accepted: 05/17/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The purpose of this study was to compare 2 alternative methods, the radiologic Harrison Posterior Tangent Method (HPTM) and the nonradiologic Spinal Mouse (SM), to the Cobb angle for measuring lumbar lordosis. METHODS Sixteen participants with previously existing lateral lumbopelvic radiographs underwent nonradiographic lordosis assessment with a Spinal Mouse. Then 2 investigators analyzed each radiograph twice using the Harrison Posterior Tangent Method and Cobb angle. Correlations were analyzed between HPTM, the Cobb angle, and SM using the Spearman rank correlation coefficient; intraexaminer and interexaminer agreement were analyzed for HPTM and the Cobb angle using intraclass correlation coefficients. RESULTS The HPTM correlated highly with the Cobb angle (Spearman ρ = 0.936, P < .001); SM had moderate to strong correlations with the Cobb angle (ρ = 0.737, P = .002) and HPTM (ρ = 0.707, P = .003). Intraexaminer and interexaminer agreement for the Cobb angle and HPTM were excellent (all intraclass correlation coefficients > 0.90). One participant had slight kyphosis according to HPTM and SM analyses (which consider the entire lumbar region), whereas the Cobb angle, based only on L1 and L5, reported mild lordosis for that participant. CONCLUSION In this sample, HPTM measurements showed high correlation with the commonly used Cobb angle, but this method requires more time and effort, and normal values have not been established. The SM may be an alternative when radiographs are inappropriate, but it measures soft tissue contours rather than lordosis itself.
Collapse
Affiliation(s)
- Brent S Russell
- Dr. Sid E. Williams Center for Chiropractic Research, Life University, Marietta, Georgia.
| | | | - Kathryn T Hoiriis
- Dr. Sid E. Williams Center for Chiropractic Research, Life University, Marietta, Georgia
| |
Collapse
|
20
|
Effects of open-label placebo on pain, functional disability, and spine mobility in patients with chronic back pain: a randomized controlled trial. Pain 2020; 160:2891-2897. [PMID: 31479068 DOI: 10.1097/j.pain.0000000000001683] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Chronic back pain (CBP) is a major global health problem, while its treatment is hampered by a lack of efficacy and restricted safety profile of common frontline therapies. The present trial aims to determine whether a 3-week open-label placebo treatment reduces pain intensity and subjective and objective functional disability in patients with CBP. This randomized controlled trial, following a pretest-posttest design, enrolled 127 patients with CBP (pain duration >12 weeks) from the Back Pain Center, Neurology, University Hospital Essen, Germany. Patients randomized to the open-label placebo group received a 3-week open-label placebo treatment. Patients in the treatment as usual (TAU) group received no intervention. Both groups continued TAU. Primary outcome was the change in pain intensity. Secondary outcomes included patient-reported functional disability and objective measures of spine mobility and depression, anxiety, and stress. One hundred twenty two patients with CBP were randomized to the open-label placebo group (N = 63) or TAU group (N = 59). Open-label placebo application led to a larger reduction of pain intensity (-0.62 ± 0.23 vs 0.11 ± 0.17, all M ± SE, P = 0.001, d = -0.44) as well as patient-reported functional disability (3.21 ± 1.59 vs 0.65 ± 1.15, P = 0.020, d = -0.45) and depression scores (-1.07 ± 0.55 vs 0.37 ± 0.39, P = 0.010, d = -0.50) compared with TAU only. Open-label placebo treatment did not affect objective mobility parameters, anxiety and stress. Our study demonstrates that a 3-week open-label placebo treatment is safe, well tolerated and reduces pain, disability, and depressive symptoms in CBP. Trial registration: German Clinical Trials Register, DRKS00012712.
Collapse
|
21
|
Vu LQ, Kim KH, Schulze LJH, Rajulu SL. Lumbar posture assessment with fabric strain sensors. Comput Biol Med 2020; 118:103624. [PMID: 32174329 DOI: 10.1016/j.compbiomed.2020.103624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 01/08/2020] [Accepted: 01/17/2020] [Indexed: 11/19/2022]
Abstract
Astronauts are at risk for low back pain and injury during extravehicular activity because of the deconditioning of the lumbar region and biomechanical demands associated with wearing a spacesuit. To understand and mitigate injury risks, it is necessary to study the lumbar kinematics of astronauts inside their spacesuit. To expand on previous efforts, the purpose of this study was to develop and test a generalizable method to assess complex lumbar motion using 10 fabric strain sensors placed on the torso. Anatomical landmark positions and corresponding sensor measurements were collected from 12 male study participants performing 16 static lumbar postures. A multilayer principal component and regression-based model was constructed to estimate lumbar joint angles from the sensor measurements. Good lumbar joint angle estimation was observed (<9° mean error) from flexion and lateral bending joint angles, and lower accuracy (13.7° mean error) was observed from axial rotation joint angles. With continued development, this method can become a useful technique for measuring suited lumbar motion and could potentially be extrapolated to civilian work applications.
Collapse
Affiliation(s)
- Linh Q Vu
- MEI Technologies, 2101 E NASA Pkwy, Houston, TX, 77058, USA.
| | - K Han Kim
- Leidos Innovations, 2101 E NASA Pkwy, Houston, TX, 77058, USA
| | | | - Sudhakar L Rajulu
- NASA Johnson Space Center, 2101 E NASA Pkwy, Houston, TX, 77058, USA
| |
Collapse
|
22
|
Masharawi Y, Haj A, Weisman A. Lumbar Axial Rotation Kinematics in an Upright Sitting and With Forward Bending Positions in Men With Nonspecific Chronic Low Back Pain. Spine (Phila Pa 1976) 2020; 45:E244-E251. [PMID: 32032339 DOI: 10.1097/brs.0000000000003265] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN A controlled cross-sectional study. OBJECTIVE The aim of this study was to compare the kinematics of lumbar axial rotation while sitting in an upright and forward bending position in men suffering with and without nonspecific chronic low back pain (NSCLBP). SUMMARY OF BACKGROUND DATA Lumbar rotation while sitting is an important factor in the mechanism of low back pain. Nevertheless, its kinematics has scarcely been investigated. METHODS Range of motion (ROM in), average velocity (AV), maximum velocity (MV), and maximal acceleration (MA) of lumbar rotation while sitting in an upright (UP-sitting) and full forward bending position (FFB-sitting) were examined using an industrial lumbar motion monitor in 50 men (25 with NSCLBP and 25 controls). Pain level and the Rolland Morris questionnaire (RMQ) were also included. RESULTS All examined kinematical parameters were significantly lower in men with NSCLBP compared with the controls (↓ROM = 16%-29%; ↓AV = 35%-53%; ↓MV = 3%-46%; ↓MA = 7%-44%) and significantly decreased when moving from UP-sitting to FFB-sitting. In the UP-sitting, the ROM and AV in both groups and the right rotation-MV in the NSCLBP group were always greater during the right rotation compared to the left (NSCLBP = ROM: Δ3.92°, AV: Δ2.74°, MV:Δ3.61°; controls = ROM: Δ3.46°, AV: Δ1.72°). The left rotation-MV was significantly greater compared to the right only in FFB-sitting in the controls (Δ3.03°). In all kinematical parameters in the NSCLBP group, no correlations were found in the visual analogue scale (VAS) levels (4.43 ± 1.47) or RMQ total score (12.32 ± 5.44). CONCLUSION The kinematic parameters of lumbar rotation were reduced in men with NSCLBP compared with controls both in an UP-sitting and FFB-sitting. In both groups, NSCLBP and controls, asymmetry in lumbar rotation kinematics was indicated as well as a decrease when moving from UP-sitting to FFB-sitting. LEVEL OF EVIDENCE 3.
Collapse
Affiliation(s)
- Youssef Masharawi
- Department of Physical Therapy, The Spinal Research Laboratory, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Alaa Haj
- Department of Physical Therapy, The Spinal Research Laboratory, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- Department of Physical Therapy, Clalit Health Services, Haifa and Western Galilee District, Haifa, Israel
| | - Asaf Weisman
- Department of Physical Therapy, The Spinal Research Laboratory, The Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| |
Collapse
|
23
|
Suter M, Eichelberger P, Frangi J, Simonet E, Baur H, Schmid S. Measuring lumbar back motion during functional activities using a portable strain gauge sensor-based system: A comparative evaluation and reliability study. J Biomech 2019; 100:109593. [PMID: 31898974 DOI: 10.1016/j.jbiomech.2019.109593] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 12/15/2019] [Accepted: 12/18/2019] [Indexed: 11/30/2022]
Abstract
Quantifying lumbar back motion during functional activities in real-life environments may contribute to a better understanding of common pathologies such as spinal disorders. The current study therefore aimed at the comparative evaluation of the Epionics SPINE system, a portable device for measuring sagittal lumbar back motion during functional activities. Twenty healthy participants were therefore evaluated with the Epionics SPINE and a Vicon motion capture system in two identical separate research visits. They performed the following activities: standing, sitting, chair rising, box lifting, walking, running and a counter movement jump (CMJ). Lumbar lordosis angles were extracted as continuous values as well as average and range of motion (ROM) parameters. Agreement between the systems was evaluated using Bland-Altman analyses, whereas within- and between-session reliability were assessed using intraclass correlation coefficients (ICC) and minimal detectable changes (MDC). The analysis showed excellent agreement between the systems for chair rising, box lifting and CMJ with a systematic underestimation of lumbar lordosis angles during walking and running. Reliability was moderate to high for all continuous and discrete parameters (ICC ≥ 0.62), except for ROM during running (ICC = 0.29). MDC values were generally below 15°, except for CMJ (peak values up to 20° within and 25° between the sessions). The Epionics SPINE system performed similarly to a Vicon motion capture system for measuring lumbar lordosis angles during functional activities and showed high consistency within and between measurement sessions. These findings can serve researchers and clinicians as a bench mark for future investigations using the system in populations with spinal pathologies.
Collapse
Affiliation(s)
- Magdalena Suter
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Patric Eichelberger
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Jana Frangi
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Edwige Simonet
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Heiner Baur
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland
| | - Stefan Schmid
- Bern University of Applied Sciences, Department of Health Professions, Division of Physiotherapy, Spinal Movement Biomechanics Group, Bern, Switzerland.
| |
Collapse
|
24
|
Pan F, Zander T, Reitmaier S, Bashkuev M, Schmidt H. How reproducible do we stand and sit? Indications for a reliable sagittal spinal assessment. Clin Biomech (Bristol, Avon) 2019; 70:123-130. [PMID: 31484098 DOI: 10.1016/j.clinbiomech.2019.08.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 08/21/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Currently, an upright standing posture is normally adopted for evaluations of spinal alignment, which is however sensitive to posture variations. Thus, finding a reproducible reference is essential. This study aimed to evaluate the reproducibility of standing and sitting postures at different arm positions in five consecutive repetitions. METHODS 22 asymptomatic subjects (11 males; 11 females) aged 20-35 years were included. Subjects were repeatedly asked to adopt different arm positions in standing and sitting. The absolute reposition errors of lumbar lordosis and sacral orientation between two consecutive repetitions were assessed with a non-radiological back measurement system. FINDINGS During standing at the relaxed arm position, the median absolute reposition errors of lumbar lordosis and sacral orientation were 1.14° (range 0.23°-3.80°) and 0.92° (range 0.17°-3.27°), respectively, which increased to 1.75° (range 0.21-4.97°) and 1.36° (range 0.35°-4.08°) during sitting (P < 0.01). The absolute reposition error of lumbar lordosis was non-significantly lower at the relaxed and clasped arm positions than at other arm positions. Between the first two repetitions, the absolute reposition errors of both, lumbar lordosis and sacral orientation, were greater than between the remaining two consecutive repetitions (P < 0.01). Both during standing and sitting, lumbar lordosis was smallest when hands holding two bars (P < 0.05). INTERPRETATION Sitting showed a worse reproducibility than standing. When assessing sagittal spinal balance, the clasped arm position during standing is recommended and an initial trial can help to reduce inception irreproducibility.
Collapse
Affiliation(s)
- Fumin Pan
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Germany
| | - Thomas Zander
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Germany
| | - Sandra Reitmaier
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Germany
| | - Maxim Bashkuev
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Germany
| | - Hendrik Schmidt
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin (corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health), Germany.
| |
Collapse
|
25
|
Desseauve D, Pierre F, Fernandez A, Panjo H, Decatoire A, Lacouture P, Fradet L. Assessment of Pelvic-Lumbar-Thigh Biomechanics to Optimize The Childbirth Position: An "In Vivo" Innovative Biomechanical Study. Sci Rep 2019; 9:15968. [PMID: 31685875 PMCID: PMC6828717 DOI: 10.1038/s41598-019-52338-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 10/15/2019] [Indexed: 01/20/2023] Open
Abstract
The study aimed to assess the associations between the pelvis orientation, lumbar curve and thigh postures throughout pregnancy in a population of healthy women. Additionally, optimal mechanical birth conditions in terms of the pelvic inlet and lumbar curve were researched. The individuals' posture was assessed with three-dimensional motion analysis and the lumbar curve with the Epionics SPINE system. The association between the hip joint angles (flexion and abduction), the pelvis external conjugate, and lumbar curve position was assessed with a generalized linear mixed model (GLMM) adjusted to individuals' characteristics. Joint laxity was assessed with a modified Jobbin's extensometer. For all of the subjects, hip flexion and hip abduction were significantly associated with the angle between the external conjugate and spine, with higher correlation in the multivariate regression model. The association between hip flexion and the lumbar curve was less significant in multivariate than univariate regression analysis. Optimal birth conditions were never reached. The findings contribute to the understanding of the association between the hip position (flexion and abduction), pelvic orientation, and lumbar curve adjusted for joint laxity in healthy pregnant women. They lay the groundwork for future research in the field of obstetrical biomechanics.
Collapse
Affiliation(s)
- David Desseauve
- Department of Obstetrics and Gynecology and Reproductive Medicine, University Hospital, Poitiers University, Poitiers, France. .,Pprime Institute - CNRS UPR 3346, Axis RoBioSS, Poitiers University, Poitiers, France.
| | - Fabrice Pierre
- Department of Obstetrics and Gynecology and Reproductive Medicine, University Hospital, Poitiers University, Poitiers, France
| | - Anna Fernandez
- Department of Obstetrics and Gynecology, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, CH, Switzerland
| | - Henri Panjo
- Gender, Sexual and Reproductive Health, Centre for Research in Epidemiology and Population Health, (CESP), F-94807, Villejuif, France.,INED, F-75020, Paris, France
| | - Arnaud Decatoire
- Pprime Institute - CNRS UPR 3346, Axis RoBioSS, Poitiers University, Poitiers, France
| | - Patrick Lacouture
- Pprime Institute - CNRS UPR 3346, Axis RoBioSS, Poitiers University, Poitiers, France
| | - Laetitia Fradet
- Pprime Institute - CNRS UPR 3346, Axis RoBioSS, Poitiers University, Poitiers, France
| |
Collapse
|
26
|
Weerts J, Bashkuev M, Pan F, Schmidt H. Association between hamstring flexibility and lumbopelvic posture and kinematics during ergometer rowing. TRANSLATIONAL SPORTS MEDICINE 2019. [DOI: 10.1002/tsm2.106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Jeronimo Weerts
- Julius Wolff Institute, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Maxim Bashkuev
- Julius Wolff Institute, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Fumin Pan
- Julius Wolff Institute, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| | - Hendrik Schmidt
- Julius Wolff Institute, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin Humboldt‐Universität zu Berlin, and Berlin Institute of Health Berlin Germany
| |
Collapse
|
27
|
Kiefer D, Baraliakos X, Bühring B, Kiltz U, Braun J. [Epionics SPINE-use of an objective method to examine spinal mobility in patients with axial spondyloarthritis]. Z Rheumatol 2019; 79:143-152. [PMID: 31468167 DOI: 10.1007/s00393-019-00692-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Axial spondylarthritis (axSpA) is a chronic inflammatory disease of the spine that can be associated with loss of physical function, mobility and upright postural impairment. Established tools for the assessment of function that are largely based on subjective perception are semiquantitatively recorded by standardized questionnaires (Bath ankylosing spondylitis functional index, BASFI), while measurement of spinal mobility of patients with axSpA is based on physical examination of various movement regions particularly the axial skeleton (Bath ankylosing spondylitis metrology index, BASMI). Recently, a performance test has been added to assess the range of motion and speed of certain tasks (AS performance-based improved test, ASPI); however, since these tests have limited reliability and reproducibility, more objective tests would be desirable. In this study the spinal mobility of patients with axSpA was quantified using the Epionics SPINE device (ES) and data were evaluated using the outcome measures in rheumatology (OMERACT) criteria. The ES automatically measures various patterns of spinal movements using electronic sensors, which also assess the range and speed of carrying out movements. Patients with back pain from other causes and persons without back pain served as controls. The measurement results obtained with ES differed between the groups and correlated with BASMI values (r = 0.53-0.82, all p = <0.03). Patients with radiographically detectable axSpA had more limited and slower mobility than those with non-radiographically detectable axSpA. Overall, the results presented here suggest that ES measurements represent a valid and objective measurement procedure of spinal mobility for axSpA patients.
Collapse
Affiliation(s)
- D Kiefer
- Rheumazentrum Ruhrgebiet, Herne und Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - X Baraliakos
- Rheumazentrum Ruhrgebiet, Herne und Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - B Bühring
- Rheumazentrum Ruhrgebiet, Herne und Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - U Kiltz
- Rheumazentrum Ruhrgebiet, Herne und Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - J Braun
- Rheumazentrum Ruhrgebiet, Herne und Ruhr-Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland.
| |
Collapse
|
28
|
Stollenwerk K, Müller J, Hinkenjann A, Krüger B. Analyzing Spinal Shape Changes During Posture Training Using a Wearable Device. SENSORS 2019; 19:s19163625. [PMID: 31434320 PMCID: PMC6721329 DOI: 10.3390/s19163625] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 08/08/2019] [Accepted: 08/16/2019] [Indexed: 11/24/2022]
Abstract
Lower back pain is one of the most prevalent diseases in Western societies. A large percentage of European and American populations suffer from back pain at some point in their lives. One successful approach to address lower back pain is postural training, which can be supported by wearable devices, providing real-time feedback about the user’s posture. In this work, we analyze the changes in posture induced by postural training. To this end, we compare snapshots before and after training, as measured by the Gokhale SpineTracker™. Considering pairs of before and after snapshots in different positions (standing, sitting, and bending), we introduce a feature space, that allows for unsupervised clustering. We show that resulting clusters represent certain groups of postural changes, which are meaningful to professional posture trainers.
Collapse
Affiliation(s)
- Katharina Stollenwerk
- Hochschule Bonn-Rhein Sieg, Institute of Visual Computing, 53757 Sankt Augustin, Germany.
| | - Jonas Müller
- Gokhale Method Institute, Stanford, CA 94305, USA
| | - André Hinkenjann
- Hochschule Bonn-Rhein Sieg, Institute of Visual Computing, 53757 Sankt Augustin, Germany
| | - Björn Krüger
- Gokhale Method Institute, Stanford, CA 94305, USA
| |
Collapse
|
29
|
Cortell-Tormo JM, Garcia-Jaen M, Ruiz-Fernandez D, Fuster-Lloret V. Lumbatex: A Wearable Monitoring System Based on Inertial Sensors to Measure and Control the Lumbar Spine Motion. IEEE Trans Neural Syst Rehabil Eng 2019; 27:1644-1653. [PMID: 31283484 DOI: 10.1109/tnsre.2019.2927083] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Measuring the curvature of the lumbar spine is an important challenge in disciplines related to physical therapy, rehabilitation, and sports medicine seeking to solve the incidence of the low back pain and other spinal disorders in the population. In clinical practice, most of the methods used are manual or depend on the trained eye of the specialist who is measuring. We have developed Lumbatex: an integrated system based on inertial sensors integrated into a wearable textile device. This device is connected via Bluetooth to software, which interprets data from the sensors and provides real-time biofeedback to users in a graphical way and also a quantitative measure of the curvature and spinal motion. The system is tested in two ways: first, checking the accuracy detecting changes in curvatures; second, evaluating the usability and comfort from the user standpoint. The accuracy is checked through a static method getting curvature values from the device placed on curved platforms and a dynamic validation with volunteers performing different exercises. The results obtained showed a high accuracy measuring changes in curvature with an error lower than 1° in the static test and good usability and comfort according to the opinion of the volunteers.
Collapse
|
30
|
Deneuville JP, Germaneau A, Fradet L, Monnet T, Aubert K, Roulaud M, Nivole K, Vendeuvre T, Rigoard P. Assessment of movement and pain variation before and after a MDT treatment for patient with low back pain. Comput Methods Biomech Biomed Engin 2019. [DOI: 10.1080/10255842.2020.1714991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- J.-P. Deneuville
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
| | - A. Germaneau
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
| | - L. Fradet
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
| | - T. Monnet
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
| | - K. Aubert
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- ANSYS FRANCE, Villeurbanne, France
| | - M. Roulaud
- Spine & Neuromodulation Function Unit, PRISMATICS Lab CHU, Poitiers, France
| | - K. Nivole
- Spine & Neuromodulation Function Unit, PRISMATICS Lab CHU, Poitiers, France
| | - T. Vendeuvre
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- Spine & Neuromodulation Function Unit, PRISMATICS Lab CHU, Poitiers, France
| | - P. Rigoard
- Institut Pprime, UPR 3346 CNRS – Université de Poitiers – ISAE-ENSMA, Poitiers, France
- Spine & Neuromodulation Function Unit, PRISMATICS Lab CHU, Poitiers, France
| |
Collapse
|
31
|
Solana-Tramunt M, Morales J, Cabedo-Sanromà J, Guerra-Balic M. The use of an electrogoniometer to assess both lumbar range of movement and its conscious control: a comparison between healthy subjects and elite swimmers. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2019. [DOI: 10.23736/s0393-3660.18.03752-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
32
|
Zhang H, Zhu W. The Path to Deliver the Most Realistic Follower Load for a Lumbar Spine in Standing Posture: A Finite Element Study. J Biomech Eng 2019; 141:2720655. [DOI: 10.1115/1.4042438] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Indexed: 11/08/2022]
Abstract
A spine is proven to be subjected to a follower load which is a compressive load of physiologic magnitude acting on the whole spine. The path of the follower load approximates the tangent to the curve of the spine in in vivo neutral standing posture. However, the specific path location of the follower load is still unclear. The aim of this study is to find out the most realistic location of the follower load path (FLP) for a lumbar spine in standing. A three-dimensional (3D) nonlinear finite element model (FEM) of lumbosacral vertebrae (L1-S1) with consideration of the calibrated material properties was established and validated by comparing with the experimental data. We show that the shape of the lumbosacral spine is strongly affected by the location of FLP. An evident nonlinear relationship between the FLP location and the kinematic response of the L1-S1 lumbosacral spine exists. The FLP at about 4 and 3 mm posterior to the curve connecting the center of the vertebral bodies delivers the most realistic location in standing for healthy people and patients having low back pains (LPBs), respectively. Moreover, the “sweeping” method introduced in this study can be applicable to all individualized FEM to determine the location of FLP.
Collapse
Affiliation(s)
- Han Zhang
- Shanghai Institute of Applied Mathematics and Mechanics, Shanghai University, Shanghai, 200072, China
| | - Weiping Zhu
- Shanghai Institute of Applied Mathematics and Mechanics, Shanghai University, Shanghai, 200072, China e-mail:
| |
Collapse
|
33
|
Arshad R, Pan F, Reitmaier S, Schmidt H. Effect of age and sex on lumbar lordosis and the range of motion. A systematic review and meta-analysis. J Biomech 2018; 82:1-19. [PMID: 30503255 DOI: 10.1016/j.jbiomech.2018.11.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 11/12/2018] [Accepted: 11/12/2018] [Indexed: 12/19/2022]
Abstract
Lumbar lordosis (LL) and the range of motion (RoM) are important physiological measurements when initiating any diagnosis and treatment plan for patients with low back pain. Numerous studies reported differences in LL and the RoM due to age and sex. However, these findings remain contradictory. A systematic review and meta-analysis were performed to synthesize mean values and the differences in LL and the RoM because of age and sex. The quality assessment tool for quantitative studies was applied to assess the methodological quality of the studies included. We identified 2372 papers through electronic (2309) and physical (63) searches. We assessed 218 full-text studies reporting measurements of LL or the RoM. In total, 65 studies were included, and a normative database for LL and the RoM is provided as supplementary material. Among these, 11 were included in the meta-analysis. LL and the RoM displayed non-monotonic variations with significant age and sex differences. Young females showed a significantly greater LL and the range of extension (RoE), whereas young males exhibited a greater range of flexion (RoF). Sex differences in the range of lateral bending (RoLB) were small but were significant for the axial rotation (RoAR). For the RoF, RoE and RoLB, differences because of age were significant among most of the age groups in both sexes, whereas for the RoAR, differences were significant only between the 20s vs the 30s-40s (males) and 40s vs 50s (females). Significant differences because of age/sex were identified. However, the age-dependent reduction in LL and the RoM was non-monotonic and differed in both sexes. These findings will help to better distinguish between functional deficits caused by spinal disorders and natural factors/conditions related to age and sex.
Collapse
Affiliation(s)
- Rizwan Arshad
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Fumin Pan
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Sandra Reitmaier
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany
| | - Hendrik Schmidt
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Germany.
| |
Collapse
|
34
|
Gizzi L, Röhrle O, Petzke F, Falla D. People with low back pain show reduced movement complexity during their most active daily tasks. Eur J Pain 2018; 23:410-418. [PMID: 30246275 DOI: 10.1002/ejp.1318] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/15/2018] [Accepted: 09/11/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND Actigraphy is a quantitative method for the investigation of human physical activity and is normally based on accelerometric and/or kinematic data. METHODS A multichannel actigraphy system, able to record both acceleration and spine angles, was employed in this study to measure the quality of movement in 17 individuals with chronic low back pain (LBP) and 18 healthy individuals during unrestricted daily activities. An indication of movement complexity was computed by means of non-negative matrix factorization throughout the 24 hr period and in the 60 min of highest activity. RESULTS Movement complexity differed only when the 60 min of highest activity was taken into account, with the LBP group showing reduced complexity (e.g., for dimensionality = 8, over 90% of the comparisons showed a significant reduction in the LBP group). CONCLUSIONS The results are compatible with the hypothesis that pain induces a reduction in the available kinematic trajectories and degrees of freedom during natural movements, which becomes more evident when more demanding tasks are performed. A reduced movement complexity suggests a persistent alteration of the descending neural pathways and/or a disrupted somatosensory information processing, which could be possibly contrasted by administering highly variable motor tasks. SIGNIFICANCE People with chronic pain move differently. Movement quality is difficult to evaluate during daily activities, yet it may prove more informative than quantitative measurements. We proposed a new approach for computing movement complexity and found out that patients' movements get more stereotyped when higher spinal acceleration is required.
Collapse
Affiliation(s)
- Leonardo Gizzi
- Institute of Applied Mechanics (Civil Engineering), Chair II, Continuum Biomechanics and Mechanobiology Research Group, University of Stuttgart, Stuttgart, Germany.,Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany
| | - Oliver Röhrle
- Institute of Applied Mechanics (Civil Engineering), Chair II, Continuum Biomechanics and Mechanobiology Research Group, University of Stuttgart, Stuttgart, Germany
| | - Frank Petzke
- Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany
| | - Deborah Falla
- Pain Clinic, Center for Anesthesiology, Emergency and Intensive Care Medicine, University Hospital Göttingen, Göttingen, Germany.,Centre of Precision Rehabilitation for Spinal Pain (CPR Spine), School of Sport, Exercise and Rehabilitation Sciences, College of Life and Environmental Sciences, University of Birmingham, Birmingham, UK
| |
Collapse
|
35
|
Matthew RP, Seko S, Bajcsy R, Lotz J. Kinematic and Kinetic Validation of an Improved Depth Camera Motion Assessment System Using Rigid Bodies. IEEE J Biomed Health Inform 2018; 23:1784-1793. [PMID: 30281504 DOI: 10.1109/jbhi.2018.2872834] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
The study of joint kinematics and dynamics has broad clinical applications, including the identification of pathological motions or compensation strategies and the analysis of dynamic stability. High-end motion capture systems, however, are expensive and require dedicated camera spaces with lengthy setup and data processing commitments. Depth cameras, such as the Microsoft Kinect, provide an inexpensive, marker-free alternative at the sacrifice of joint-position accuracy. In this work, we present a fast framework for adding biomechanical constraints to the joint estimates provided by a depth camera system. We also present a new model for the lower lumbar joint angle. We validate key joint position, angle, and velocity measurements against a gold standard active motion-capture system on ten healthy subjects performing sit to stand (STS). Our method showed significant improvement in mean absolute error and intraclass correlation coefficients for the recovered joint angles and position-based metrics. These improvements suggest that depth cameras can provide an accurate and clinically viable method of rapidly assessing the kinematics and kinetics of the STS action, providing data for further analysis using biomechanical or machine learning methods.
Collapse
|
36
|
Review of existing measurement tools to assess spinal motion during prehospital immobilization. Eur J Emerg Med 2018; 25:161-168. [DOI: 10.1097/mej.0000000000000467] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
|
37
|
Schmidt H, Bashkuev M, Weerts J, Altenscheidt J, Maier C, Reitmaier S. What does the shape of our back tell us? Correlation between sacrum orientation and lumbar lordosis. Spine J 2018; 18:655-662. [PMID: 29174457 DOI: 10.1016/j.spinee.2017.11.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 10/05/2017] [Accepted: 11/02/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Sacral slope and lumbar lordosis (LL) have been studied extensively in recent years via X-ray examinations and strongly correlate with each other. This raises, first, the question of the reproducibility of this correlation in multiple standing phases and, second, if this correlation can be achieved using non-radiological measurement tools. PURPOSE This study aimed (1) to determine the extent to which the back-shape measurements correspond to the correlations between the sacral slope and LL found in previous radiological investigations, (2) to identify a possible effect of age and gender on this correlation, and (3) to evaluate the extent to which this correlation is affected by repeated standing phases. STUDY DESIGN/SAMPLE This is an observational cohort study. PATIENT SAMPLE A total of 410 asymptomatic subjects (non-athletes), 21 asymptomatic soccer players (athletes), and 176 patients with low back pain (LBP) were included. OUTCOME MEASURES The correlation between sacrum orientation (SO) and LL was determined in six repetitive upright standing postures. MATERIALS AND METHODS A non-invasive strain-gauge based measuring system was used. RESULTS Back-shape measurements yielded a similar correlation to that measured in previous X-ray examinations. The coefficient of determination (R2) between SO and LL ranged between 0.76 and 0.79 for the asymptomatic cohort. Athletes showed the strongest correlation (0.76≤R2≤0.84). For patients with LBP, the correlation substantially decreased (0.18≤R2≤0.39). R2 was not strongly affected by repeated standing phases. CONCLUSIONS The correlation between SO and LL can be assessed by surface measurements of the back shape and is not influenced by natural variations in the standing posture.
Collapse
Affiliation(s)
- Hendrik Schmidt
- Julius Wolff Institut, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Germany.
| | - Maxim Bashkuev
- Julius Wolff Institut, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Germany
| | - Jeronimo Weerts
- Julius Wolff Institut, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Germany
| | - Joern Altenscheidt
- Department of Pain Management, BG-University Hospital Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Christoph Maier
- Department of Pain Management, BG-University Hospital Bergmannsheil, Bürkle-de-la-Camp-Platz 1, 44789, Bochum, Germany
| | - Sandra Reitmaier
- Julius Wolff Institut, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Germany
| |
Collapse
|
38
|
Zander T, Bashkuev M, Schmidt H. Are there characteristic motion patterns in the lumbar spine during flexion? J Biomech 2018; 70:77-81. [DOI: 10.1016/j.jbiomech.2017.09.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Revised: 08/15/2017] [Accepted: 09/04/2017] [Indexed: 11/30/2022]
|
39
|
Papi E, Koh WS, McGregor AH. Wearable technology for spine movement assessment: A systematic review. J Biomech 2017; 64:186-197. [PMID: 29102267 PMCID: PMC5700811 DOI: 10.1016/j.jbiomech.2017.09.037] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 09/11/2017] [Accepted: 09/25/2017] [Indexed: 12/20/2022]
Abstract
Continuous monitoring of spine movement function could enhance our understanding of low back pain development. Wearable technologies have gained popularity as promising alternative to laboratory systems in allowing ambulatory movement analysis. This paper aims to review the state of art of current use of wearable technology to assess spine kinematics and kinetics. Four electronic databases and reference lists of relevant articles were searched to find studies employing wearable technologies to assess the spine in adults performing dynamic movements. Two reviewers independently identified relevant papers. Customised data extraction and quality appraisal form were developed to extrapolate key details and identify risk of biases of each study. Twenty-two articles were retrieved that met the inclusion criteria: 12 were deemed of medium quality (score 33.4-66.7%), and 10 of high quality (score >66.8%). The majority of articles (19/22) reported validation type studies. Only 6 reported data collection in real-life environments. Multiple sensors type were used: electrogoniometers (3/22), strain gauges based sensors (3/22), textile piezoresistive sensor (1/22) and accelerometers often used with gyroscopes and magnetometers (15/22). Two sensors units were mainly used and placing was commonly reported on the spine lumbar and sacral regions. The sensors were often wired to data transmitter/logger resulting in cumbersome systems. Outcomes were mostly reported relative to the lumbar segment and in the sagittal plane, including angles, range of motion, angular velocity, joint moments and forces. This review demonstrates the applicability of wearable technology to assess the spine, although this technique is still at an early stage of development.
Collapse
Affiliation(s)
- Enrica Papi
- Department of Surgery and Cancer, Imperial College London, London, UK; Department of Bioengineering, Imperial College London, London, UK.
| | - Woon Senn Koh
- Department of Surgery and Cancer, Imperial College London, London, UK
| | - Alison H McGregor
- Department of Surgery and Cancer, Imperial College London, London, UK
| |
Collapse
|
40
|
Schmidt H, Bashkuev M, Weerts J, Graichen F, Altenscheidt J, Maier C, Reitmaier S. How do we stand? Variations during repeated standing phases of asymptomatic subjects and low back pain patients. J Biomech 2017; 70:67-76. [PMID: 28683929 DOI: 10.1016/j.jbiomech.2017.06.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/09/2017] [Accepted: 06/13/2017] [Indexed: 11/15/2022]
Abstract
An irreproducible standing posture can lead to mis-interpretation of radiological measurements, wrong diagnoses and possibly unnecessary treatment. This study aimed to evaluate the differences in lumbar lordosis and sacrum orientation in six repetitive upright standing postures of 353 asymptomatic subjects (including 332 non-athletes and 21 athletes - soccer players) and 83 low back pain (LBP) patients using a non-invasive back-shape measurement device. In the standing position, all investigated cohorts displayed a large inter-subject variability in sacrum orientation (∼40°) and lumbar lordosis (∼53°). In the asymptomatic cohort (non-athletes), 51% of the subjects showed variations in lumbar lordosis of 10-20% in six repeated standing phases and 29% showed variations of even more than 20%. In the sacrum orientation, 53% of all asymptomatic subjects revealed variations of >20% and 31% of even more than 30%. It can be concluded that standing is highly individual and poorly reproducible. The reproducibility was independent of age, gender, body height and weight. LBP patients and athletes showed a similar variability as the asymptomatic cohort. The number of standing phases performed showed no positive effect on the reproducibility. Therefore, the variability in standing is not predictable but random, and thus does not reflect an individual specific behavioral pattern which can be reduced, for example, by repeated standing phases.
Collapse
Affiliation(s)
- Hendrik Schmidt
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Germany.
| | - Maxim Bashkuev
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Germany
| | - Jeronimo Weerts
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Germany
| | - Friedmar Graichen
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Germany
| | - Joern Altenscheidt
- Department of Pain Management, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Christoph Maier
- Department of Pain Management, BG-University Hospital Bergmannsheil, Bochum, Germany
| | - Sandra Reitmaier
- Julius Wolff Institut, Charité - Universitätsmedizin Berlin, Germany
| |
Collapse
|
41
|
Spinal kinematics during gait in healthy individuals across different age groups. Hum Mov Sci 2017; 54:73-81. [PMID: 28410535 DOI: 10.1016/j.humov.2017.04.001] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 04/03/2017] [Accepted: 04/04/2017] [Indexed: 11/24/2022]
Abstract
Most studies investigating trunk kinematics have not provided adequate quantification of spinal motion, resulting in a limited understanding of the healthy spine's biomechanical behavior during gait. This study aimed at assessing spinal motion during gait in adolescents, adults and older individuals. Fourteen adolescents (10-18years), 13 adults (19-35years) and 15 older individuals (≥65years) were included. Using a previously validated enhanced optical motion capture approach, sagittal and frontal plane spinal curvature angles and general trunk kinematics were measured during shod walking at a self-selected normal speed. Postural differences indicated that lumbar lordosis and thoracic kyphosis increase throughout adolescence and reach their peak in adulthood. The absence of excessive thoracic kyphosis in older individuals could be explained by a previously reported subdivision in those who develop excessive kyphosis and those who maintain their curve. Furthermore, adults displayed increased lumbar spine range of motion as compared to the adolescents, whereas the increased values in older individuals were found to be related to higher gait speeds. This dataset on the age-related kinematics of the healthy spine can serve as a basis for understanding pathological deviations and monitoring rehabilitation progression.
Collapse
|
42
|
Desseauve D, Pierre F, Gachon B, Decatoire A, Lacouture P, Fradet L. New approaches for assessing childbirth positions. J Gynecol Obstet Hum Reprod 2017; 46:189-195. [PMID: 28403977 DOI: 10.1016/j.jogoh.2016.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2016] [Revised: 10/24/2016] [Accepted: 10/27/2016] [Indexed: 12/28/2022]
Abstract
BACKGROUND An overview of labor based only on epidemiological data cannot identify or explain the mechanisms involved in childbirth. Data about the position that women should take in giving birth are discordant. None of the studies of birth positions adequately define or describe them or their biomechanical impact (pelvic orientation, position of the back). The measurement of the effect of one position relative to that of another requires precise definitions of each position and of their maternal biomechanical consequences, as well as safe measurement methods. METHODOLOGY We have developed a system to analyze the position of labor by quantifying the posture of the woman's body parts (including thighs, trunk, and pelvis), using an optoelectronic motion capture device (Vicon™, Oxford Metrics) widely used in human movement analysis and a system for measuring the lumbar curve (Epionics spine system). A specific body model has also been created to conduct this biomechanical analysis, which is based on external markers. With this methodology and model, it should be possible to define: (1) the hip joint angles (flexion/extension, abduction/adduction, internal/external rotation); (2) the ante/retroversion of the pelvis; (3) the lumbar curve. DISCUSSION This methodology could become a reference for assessing delivery postures, one that makes it possible to describe the relation between the postures used in the delivery room and their impact on the pelvis and the spine in an integrated and comprehensive model. TRIAL REGISTRATION No. Eudract 2013-A01203-42.
Collapse
Affiliation(s)
- D Desseauve
- Department of obstetrics and gynecology and reproductive medicine, university hospital of Poitiers, university of Poitiers, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France; Institut PPRIME UP3346 CNRS-Université de Poiters-ENSMA, Team Robotics, Biomechanics Sport and Health, 86360 Chasseneuil du Poitou-Futuroscope, France.
| | - F Pierre
- Department of obstetrics and gynecology and reproductive medicine, university hospital of Poitiers, university of Poitiers, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France
| | - B Gachon
- Department of obstetrics and gynecology and reproductive medicine, university hospital of Poitiers, university of Poitiers, CHU de Poitiers, 2, rue de la Milétrie, BP 577, 86021 Poitiers, France
| | - A Decatoire
- Institut PPRIME UP3346 CNRS-Université de Poiters-ENSMA, Team Robotics, Biomechanics Sport and Health, 86360 Chasseneuil du Poitou-Futuroscope, France
| | - P Lacouture
- Institut PPRIME UP3346 CNRS-Université de Poiters-ENSMA, Team Robotics, Biomechanics Sport and Health, 86360 Chasseneuil du Poitou-Futuroscope, France
| | - L Fradet
- Institut PPRIME UP3346 CNRS-Université de Poiters-ENSMA, Team Robotics, Biomechanics Sport and Health, 86360 Chasseneuil du Poitou-Futuroscope, France
| |
Collapse
|
43
|
Measurement and Geometric Modelling of Human Spine Posture for Medical Rehabilitation Purposes Using a Wearable Monitoring System Based on Inertial Sensors. SENSORS 2016; 17:s17010003. [PMID: 28025480 PMCID: PMC5298576 DOI: 10.3390/s17010003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 11/28/2016] [Accepted: 12/11/2016] [Indexed: 12/03/2022]
Abstract
This paper presents a mathematical model that can be used to virtually reconstruct the posture of the human spine. By using orientation angles from a wearable monitoring system based on inertial sensors, the model calculates and represents the curvature of the spine. Several hypotheses are taken into consideration to increase the model precision. An estimation of the postures that can be calculated is also presented. A non-invasive solution to identify the human back shape can help reducing the time needed for medical rehabilitation sessions. Moreover, it prevents future problems caused by poor posture.
Collapse
|
44
|
Kim SH, Kwon OY, Park KN, Hwang UJ. Leg lateral reach test: The reliability and correlation with thoraco-lumbo-pelvic rotation range. J Sci Med Sport 2016; 20:2-5. [PMID: 27210501 DOI: 10.1016/j.jsams.2016.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Revised: 04/12/2016] [Accepted: 04/14/2016] [Indexed: 11/28/2022]
Abstract
OBJECTIVES The aim of the present study was to examine the intra- and inter-rater reliabilities of the leg lateral reach test as a screening tool for thoraco-lumbo-pelvic rotation and to assess the relationship between leg lateral reach distance and thoraco-lumbo-pelvic rotation range in a supine position. DESIGN Controlled laboratory study. METHODS Thirty-six physically active participants were recruited. The leg lateral reach test was performed over 2 days. In the first session, two testers measured the distance of the leg lateral reach to determine the within-day inter-rater reliability, and one tester repeated the measurement on day 2 to determine the intra-rater reliability between days. The leg lateral reach test was performed three times per leg, and the mean value was used for data analysis. Reliability was determined using the intraclass correlation coefficient, standard error of measurement, and minimal detectable change. The correlation between leg lateral reach distance and thoraco-lumbo-pelvic rotation range was determined using Pearson correlation. RESULTS Almost perfect intra- and inter-rater reliabilities were shown for the test [intraclass correlation coefficient2,3=0.97 (95% confidence interval=0.914-0.984) and 0.99 (0.974-0.996), respectively]. The within-day inter-rater standard error of measurement was 1.40cm, and the minimal detectable change was 3.87cm. The between-day intra-rater standard error of measurement was 2.66cm, and the minimal detectable change was 7.37cm. The Pearson correlation showed a moderate to good correlation between the leg lateral reach distance and the thoraco-lumbo-pelvic rotation range (r=0.73). CONCLUSIONS The leg lateral reach screening test is reliable for measuring thoraco-lumbo-pelvic rotation range and allows for practical measurement of the thoraco-lumbo-pelvic rotation range in a supine position.
Collapse
Affiliation(s)
- Si-Hyun Kim
- Department of Physical Therapy, College of Tourism & Health, Joongbu University, South Korea
| | - Oh-Yun Kwon
- Department of Physical Therapy, College of Health Science, Laboratory of Kinetic Ergocise Based on Movement Analysis, Yonsei University, South Korea.
| | - Kyue-Nam Park
- College of Medical Science, Department of Physical Therapy, Jeonju University, South Korea
| | - Ui-Jae Hwang
- Department of Physical Therapy, Graduate School, Yonsei University, South Korea
| |
Collapse
|
45
|
Dreischarf M, Pries E, Bashkuev M, Putzier M, Schmidt H. Differences between clinical "snap-shot" and "real-life" assessments of lumbar spine alignment and motion - What is the "real" lumbar lordosis of a human being? J Biomech 2016; 49:638-644. [PMID: 26900033 DOI: 10.1016/j.jbiomech.2016.01.032] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 12/27/2015] [Accepted: 01/28/2016] [Indexed: 11/27/2022]
Abstract
The individual lumbar lordosis and lumbar motion have been identified to play an important role in pathogenesis of low back pain and are essential references for preoperative planning and postoperative evaluation. The clinical "gold-standard" for measuring lumbar lordosis and its motion are radiological "snap-shots" taken while standing and during upper-body flexion and extension. The extent to which these clinically assessed values characterise lumbar alignment and its motion in daily life merits discussion. A non-invasive measurement-system was employed to measure lumbar lordosis and lumbar motion in 208 volunteers (age: 20-74yrs; ♀/♂: 115/93). For an initial short-term measurement, comparable with the clinical "snap-shot", lumbar lordosis and its motion were assessed while standing and during flexion and extension. Subsequently, volunteers were released to their daily lives while wearing the device, and measurements were performed during the following 24h. The average lumbar lordosis during 24h (8.0°) differed significantly from the standardised measurement while standing (33.3°). Ranges of motion were significantly different throughout the day compared to standing measurements. The influence of the factors age and gender on lordosis and its motion resulted in conflicting results between long- and short-term-measurements. In conclusion, results of short-term examinations differ considerably from the average values during real-life. These findings might be important for surgical planning and increase the awareness of the biomechanical challenges that spinal structures and implants face in real-life. Furthermore, long-term assessments of spinal alignment and motion during daily life can provide valid data on spinal function and can reveal the importance of influential factors.
Collapse
Affiliation(s)
- Marcel Dreischarf
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Germany.
| | - Esther Pries
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Germany
| | - Maxim Bashkuev
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Germany
| | - Michael Putzier
- Center for Musculoskeletal Surgery - Universitätsmedizin Berlin, Germany
| | - Hendrik Schmidt
- Julius Wolff Institute, Charité - Universitätsmedizin Berlin, Germany
| |
Collapse
|
46
|
Vaisy M, Gizzi L, Petzke F, Consmüller T, Pfingsten M, Falla D. Measurement of Lumbar Spine Functional Movement in Low Back Pain. Clin J Pain 2015; 31:876-85. [DOI: 10.1097/ajp.0000000000000190] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
47
|
The effects of age and gender on the lumbopelvic rhythm in the sagittal plane in 309 subjects. J Biomech 2015; 48:3080-7. [DOI: 10.1016/j.jbiomech.2015.07.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Revised: 07/07/2015] [Accepted: 07/19/2015] [Indexed: 11/30/2022]
|
48
|
Pries E, Dreischarf M, Bashkuev M, Schmidt H. Application of a novel spinal posture and motion measurement system in active and static sitting. ERGONOMICS 2015; 58:1605-1610. [PMID: 25712870 DOI: 10.1080/00140139.2015.1019938] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The quantification of work-related musculoskeletal risk factors is of great importance; however, only a few tools allow objective, unrestricted measurements of spinal posture and motion in workplaces. This study was performed to evaluate the applicability of the Epionics system in a sedentary workplace. The system is mobile and wireless and assesses lumbar lordosis, pelvic orientation and spinal motion, without restricting subjects in their movements. In total, 10 males were monitored while sitting for 2 h on static and dynamic office chairs and on an exercise ball, to evaluate the effect of dynamic sitting. The volunteers were able to perform their work unhampered. No differences among the tested furniture could be detected with respect to either the lordosis or the number of spinal movements after habituation to the furniture; however, differences in pelvic orientation were statistically significant. The results of the present study indicate that Epionics may be useful for the quantitative assessment of work-related risk factors. Practitioner Summary: Only a few tools allow objective, unrestricted measurements of spinal posture and motion in the workplace. Epionics SPINE measures lumbar lordosis, pelvic orientation and spinal motion under nearly unrestricted conditions and can be used to quantify work-related musculoskeletal risk factors. We demonstrated the use of this tool in the workplace-analysis.
Collapse
Affiliation(s)
- Esther Pries
- a Julius Wolff Institute , Charité - Universitätsmedizin Berlin , Campus Virchow-Klinikum, AugustenburgerPlatz 1, 13353 Berlin , Germany
| | | | | | | |
Collapse
|
49
|
Age-related loss of lumbar spinal lordosis and mobility--a study of 323 asymptomatic volunteers. PLoS One 2014; 9:e116186. [PMID: 25549085 PMCID: PMC4280226 DOI: 10.1371/journal.pone.0116186] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Accepted: 12/03/2014] [Indexed: 11/22/2022] Open
Abstract
Background The understanding of the individual shape and mobility of the lumbar spine are key factors for the prevention and treatment of low back pain. The influence of age and sex on the total lumbar lordosis and the range of motion as well as on different lumbar sub-regions (lower, middle and upper lordosis) in asymptomatic subjects still merits discussion, since it is essential for patient-specific treatment and evidence-based distinction between painful degenerative pathologies and asymptomatic aging. Methods and Findings A novel non-invasive measuring system was used to assess the total and local lumbar shape and its mobility of 323 asymptomatic volunteers (age: 20–75 yrs; BMI <26.0 kg/m2; males/females: 139/184). The lumbar lordosis for standing and the range of motion for maximal upper body flexion (RoF) and extension (RoE) were determined. The total lordosis was significantly reduced by approximately 20%, the RoF by 12% and the RoE by 31% in the oldest (>50 yrs) compared to the youngest age cohort (20–29 yrs). Locally, these decreases mostly occurred in the middle part of the lordosis and less towards the lumbo-sacral and thoraco-lumbar transitions. The sex only affected the RoE. Conclusions During aging, the lower lumbar spine retains its lordosis and mobility, whereas the middle part flattens and becomes less mobile. These findings lay the ground for a better understanding of the incidence of level- and age-dependent spinal disorders, and may have important implications for the clinical long-term success of different surgical interventions.
Collapse
|
50
|
Measurement of the number of lumbar spinal movements in the sagittal plane in a 24-hour period. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2014; 23:2375-84. [DOI: 10.1007/s00586-014-3588-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 09/15/2014] [Accepted: 09/16/2014] [Indexed: 10/24/2022]
|