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Quirk DA, Chung J, Schiller G, Cherin JM, Arens P, Sherman DA, Zeligson ER, Dalton DM, Awad LN, Walsh CJ. Reducing Back Exertion and Improving Confidence of Individuals with Low Back Pain with a Back Exosuit: A Feasibility Study for Use in BACPAC. PAIN MEDICINE (MALDEN, MASS.) 2023; 24:S175-S186. [PMID: 36794907 PMCID: PMC10403307 DOI: 10.1093/pm/pnad003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/04/2023] [Accepted: 01/10/2023] [Indexed: 02/17/2023]
Abstract
OBJECTIVE Low back pain (LBP) is hallmarked by activity limitations, especially for tasks involving bending. Back exosuit technology reduces low back discomfort and improves self-efficacy of individuals with LBP during bending and lifting tasks. However, the biomechanical efficacy of these devices in individuals with LBP is unknown. This study sought to determine biomechanical and perceptual effects of a soft active back exosuit designed to assist individuals with LBP sagittal plane bending. To understand patient-reported usability and use cases for this device. METHODS Fifteen individuals with LBP performed two experimental lifting blocks once with and without an exosuit. Trunk biomechanics were measured by muscle activation amplitudes, and whole-body kinematics and kinetics. To evaluate device perception, participants rated task effort, low back discomfort, and their level of concern completing daily activities. RESULTS The back exosuit reduced peak back extensor: moments by 9%, and muscle amplitudes by 16% when lifting. There were no changes in abdominal co-activation and small reductions maximum trunk flexion compared to lifting without an exosuit. Participants reported lower task effort, back discomfort, and concern about bending and lifting with an exosuit compared to without. CONCLUSIONS This study demonstrates a back exosuit not only imparts perceptual benefits of reduced task effort, discomfort, and increased confidence in individuals with LBP but that it achieves these benefits through measurable biomechanical reductions in back extensor effort. The combined effect of these benefits implies back exosuits might be a potential therapeutic aid to augment physical therapy, exercises, or daily activities.
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Affiliation(s)
- D Adam Quirk
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| | - Jinwon Chung
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
| | - Gregory Schiller
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Jason M Cherin
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - Philipp Arens
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
| | - David A Sherman
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Emma R Zeligson
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Diane M Dalton
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Lou N Awad
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
- College of Health & Rehabilitation Sciences: Sargent College, Boston University, Boston, MA, United States
| | - Conor J Walsh
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Boston, MA, United States
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, MA, United States
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Multi-Output Sequential Deep Learning Model for Athlete Force Prediction on a Treadmill Using 3D Markers. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12115424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Reliable and innovative methods for estimating forces are critical aspects of biomechanical sports research. Using them, athletes can improve their performance and technique and reduce the possibility of fractures and other injuries. For this purpose, throughout this project, we proceeded to research the use of video in biomechanics. To refine this method, we propose an RNN trained on a biomechanical dataset of regular runners that measures both kinematics and kinetics. The model will allow analyzing, extracting, and drawing conclusions about continuous variable predictions through the body. It marks different anatomical and reflective points (96 in total, 32 per dimension) that will allow the prediction of forces (N) in three dimensions (Fx, Fy, Fz), measured on a treadmill with a force plate at different velocities (2.5 m/s, 3.5 m/s, 4.5 m/s). In order to obtain the best model, a grid search of different parameters that combined various types of layers (Simple, GRU, LSTM), loss functions (MAE, MSE, MSLE), and sampling techniques (down-sampling, up-sampling) helped obtain the best performing model (LSTM, MSE, down-sampling) achieved an average coefficient of determination of 0.68, although when excluding Fz it reached 0.92.
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Survey on Video-Based Biomechanics and Biometry Tools for Fracture and Injury Assessment in Sports. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12083981] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
This work presents a survey literature review on biomechanics, specifically aimed at the study of existent biomechanical tools through video analysis, in order to identify opportunities for researchers in the field, and discuss future proposals and perspectives. Scientific literature (journal papers and conference proceedings) in the field of video-based biomechanics published after 2010 were selected and discussed. The most common application of the study of biomechanics using this technique is sports, where the most reported applications are american football, soccer, basketball, baseball, jumping, among others. These techniques have also been studied in a less proportion, in ergonomy, and injury prevention. From the revised literature, it is clear that biomechanics studies mainly focus on the analysis of angles, speed or acceleration, however, not many studies explore the dynamical forces in the joints. The development of video-based biomechanic tools for force analysis could provide methods for assessment and prediction of biomechanical force associated risks such as injuries and fractures. Therefore, it is convenient to start exploring this field. A few case studies are reported, where force estimation is performed via manual tracking in different scenarios. This demonstration is carried out using conventional manual tracking, however, the inclusion of similar methods in an automated manner could help in the development of intelligent healthcare, force prediction tools for athletes and/or elderly population. Future trends and challenges in this field are also discussed, where data availability and artificial intelligence models will be key to proposing new and more reliable methods for biomechanical analysis.
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Hammerberg AG, Kramer PA. Consistent inconsistencies in braking: a spatial analysis. Interface Focus 2021; 11:20200058. [PMID: 34938429 DOI: 10.1098/rsfs.2020.0058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2021] [Indexed: 11/12/2022] Open
Abstract
The dynamic system that is the bipedal body in motion is of interest to engineers, clinicians and biological anthropologists alike. Spatial statistics is more familiar to public health researchers as a way of analysing disease clustering and spread; nonetheless, this is a practical approach to the two-dimensional topography of the foot. We quantified the clustering of the centre of pressure (CoP) on the foot for peak braking and propulsive vertical ground reaction forces (GRFs) over multiple, contiguous steps to assess the consistency of the location of peak forces on the foot during walking. The vertical GRFs of 11 participants were collected continuously via a wireless insole system (MoticonReGo AG) across various experimental conditions. We hypothesized that CoPs would cluster in the hindfoot for braking and forefoot for propulsion, and that braking would demonstrate more consistent clustering than propulsion. Contrary to our hypotheses, we found that CoPs during braking are inconsistent in their location, and CoPs during propulsion are more consistent and clustered across all participants and all trials. These results add to our understanding of the applied forces on the foot so that we can better predict fatigue failures and better understand the mechanisms that shaped the modern bipedal form.
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Affiliation(s)
- Alexandra G Hammerberg
- Primate Evolutionary Biomechanics Laboratory, University of Washington, Seattle, WA 98195-3100, USA
| | - Patricia Ann Kramer
- Primate Evolutionary Biomechanics Laboratory, University of Washington, Seattle, WA 98195-3100, USA
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Li W, Xiong Z, Dong C, Song J, Zhang L, Zhou J, Wang Y, Yi P, Yang F, Tang X, Tan M. Distribution and imaging characteristics of spina bifida occulta in young people with low back pain: a retrospective cross-sectional study. J Orthop Surg Res 2021; 16:151. [PMID: 33618758 PMCID: PMC7898417 DOI: 10.1186/s13018-021-02285-w] [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: 10/04/2020] [Accepted: 02/08/2021] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Spina bifida occulta (SBO) is one of the most common congenital spinal deformities. Although many studies have demonstrated the influence of lumbosacral dysplasia on low back pain (LBP) in young athletes, there have been few studies on SBO among young people in other occupations. The purpose of this study is to investigate the distribution of SBO in young people with LBP and to classify SBO from the perspective of lamina development. METHODS The X-ray films of 148 young patients with LBP were analyzed to quantify the distribution of SBO and classify abnormal laminae. RESULTS Of the 148 patients, 93 (61.49%) had SBO: 83 cases involved S1 alone, 2 involved L5-S1, 5 involved S1-2, 2 involved S1-4, and 1 involved L4-S4. According to the degree of the defect, the patients with SBO were divided on the basis of five grades: 9 patients with grade I, 53 with grade II, 23 with grade III, and 8 with grade IV. The cases were classified by the shape of the laminae into 4 types: 15 cases of type a, 11 cases of type b, 37 cases of type c, and 30 cases of type d. CONCLUSION Among the young people with LBP that we surveyed, SBO is the most common lumbosacral dysplasia, which frequently involves the S1 segment. Most laminae in SBO are in the developmental stage of the spinous process, and an abnormal laminar growth direction and laminar stenosis are the most common laminar morphologies in SBO.
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Affiliation(s)
- Wenhao Li
- Beijing University of Chinese Medicine, Beijing, 100029, China.,Orthopaedic Department II, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Zhencheng Xiong
- Institute of Medical Technology, Peking University Health Science Center, Beijing, 100191, China.,Peking University Third Hospital, Beijing, 100191, China
| | - Chunke Dong
- Beijing Hospital of Traditional Chinese Medicine, Capital Medical University, Beijing, China
| | - Jipeng Song
- Orthopaedic Department II, China-Japan Friendship Hospital, Beijing, 100029, China.,Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Liubo Zhang
- Beijing University of Chinese Medicine, Beijing, 100029, China.,Orthopaedic Department II, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Jun Zhou
- Beijing University of Chinese Medicine, Beijing, 100029, China.,Orthopaedic Department II, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Yanlei Wang
- Beijing University of Chinese Medicine, Beijing, 100029, China.,Orthopaedic Department II, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Ping Yi
- Orthopaedic Department II, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Feng Yang
- Orthopaedic Department II, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Xiangsheng Tang
- Orthopaedic Department II, China-Japan Friendship Hospital, Beijing, 100029, China
| | - Mingsheng Tan
- Orthopaedic Department II, China-Japan Friendship Hospital, Beijing, 100029, China.
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Hell AK, Braunschweig L, Grages B, Brunner R, Romkes J. [The influence of backpack weight in school children: gait, muscle activity, posture and stability]. DER ORTHOPADE 2020; 50:446-454. [PMID: 33296024 PMCID: PMC8189948 DOI: 10.1007/s00132-020-04047-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/04/2020] [Indexed: 12/01/2022]
Abstract
Hintergrund Das tägliche Tragen eines schweren Schulrucksacks kann möglicherweise Haltungsstörungen hervorrufen, die sich auf das Gangbild und die Standstabilität der Kinder und Jugendlichen auswirken. Ziel der Arbeit (Fragestellung) Ziel der vorliegenden Studie war es, den Einfluss einer Rucksacklast von 4 kg auf das Gangbild und die Standstabilität bei Grundschulkindern zu analysieren. Material und Methoden In der prospektiven Arbeit wurde ein Kollektiv von zwölf Grundschulkindern zwischen 7 und 10 Jahren ohne neurologische oder orthopädische Probleme untersucht. Die Messungen beinhalteten eine klinische Untersuchung, eine dreidimensionale Ganganalyse mit elektromyografischen Aufzeichnungen und die Prüfung des ruhigen Stehens auf einer Kraftmessplatte. Ergebnisse Die Rucksacklast von durchschnittlich 15 % des Körpergewichts führte zu reduzierter Ganggeschwindigkeit, verkürzter Schrittlänge und verlängerter Doppelunterstützungsphase. Zudem kam es zu einer erhöhten Oberkörpervorneigung, Beckenkippung und Hüftbeugung. Auch die Muskelaktivität und Stabilität der Kinder wurde durch die erhöhte Traglast beeinflusst. Diskussion Schulrucksäcke mit einem Gewicht von 4 kg führten bei Grundschulkindern zu Änderungen von Gang, Muskelaktivität, Haltung und Standstabilität. Das Gewicht des Rucksacks verlagert den Körperschwerpunkt nach hinten und führt zur Instabilität. Dies wird beim Gehen durch eine vermehrte Oberkörpervorneigung, Beckenkippung nach vorne und vermehrte Hüftbeugung kompensiert. Die verminderte Paraspinalmuskelaktivität deutet darauf hin, dass der Rucksack passiv getragen wird. Dies könnte sich im Langzeitverlauf negativ auswirken.
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Affiliation(s)
- Anna K Hell
- Kinderorthopädie, Operatives Kinderzentrum, Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland.
| | - Lena Braunschweig
- Kinderorthopädie, Operatives Kinderzentrum, Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
| | - Birgit Grages
- Kinderorthopädie, Operatives Kinderzentrum, Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Straße 40, 37075, Göttingen, Deutschland
| | - Reinald Brunner
- Universitäts-Kinderspital beider Basel (UKBB), Spitalstrasse 33, 4056, Basel, Schweiz
| | - Jacqueline Romkes
- Universitäts-Kinderspital beider Basel (UKBB), Spitalstrasse 33, 4056, Basel, Schweiz
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