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Haimerl M, Nebel I, Linkerhägner A, Konradi J, Wolf C, Drees P, Betz U. Consistency of vertebral motion and individual characteristics in gait sequences. Hum Mov Sci 2023; 87:103036. [PMID: 36395570 DOI: 10.1016/j.humov.2022.103036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Revised: 10/21/2022] [Accepted: 11/08/2022] [Indexed: 11/15/2022]
Abstract
Vertebral motion reveals complex patterns, which are not yet understood in detail. This applies to vertebral kinematics in general but also to specific motion tasks like gait. For gait analysis, most of existing publications focus on averaging characteristics of recorded motion signals. Instead, this paper aims at analyzing intra- and inter-individual variation specifically and elaborating motion parameters, which are consistent during gait cycles of particular persons. For this purpose, a study design was utilized, which collected motion data from 11 asymptomatic test persons walking at different speed levels (2, 3, and 4 km/h). Acquisition of data was performed using surface topography. The motion signals were preprocessed in order to separate average vertebral orientations (neutral profiles) from basic gait cycles. Subsequently, a k-means clustering technique was applied to figure out, whether a discrimination of test persons was possible based on the preprocessed motion signals. The paper shows that each test sequence could be assigned to the particular test person without additional prior information. In particular, the neutral profiles appeared to be highly consistent intra-individually (across the gait cycles as well as speed levels), but substantially different between test persons. A full discrimination of test persons was achieved using the neutral profiles with respect to flexion/extension data. Based on this, these signals can be considered as individual characteristics for the particular test persons.
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Affiliation(s)
- Martin Haimerl
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Germany.
| | - Iman Nebel
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Germany
| | - Alina Linkerhägner
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Germany
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Philipp Drees
- Department of Orthopedics and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Germany
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Germany
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Haimerl M, Nebel I, Linkerhägner A, Konradi J, Wolf C, Drees P, Betz U. Comprehensive visualization of spinal motion in gait sequences based on surface topography. Hum Mov Sci 2022; 81:102919. [PMID: 34979480 DOI: 10.1016/j.humov.2021.102919] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Revised: 10/26/2021] [Accepted: 12/21/2021] [Indexed: 11/19/2022]
Abstract
Analysis of spinal motion is considered to be important to assess function of the human spine. Surface topography (ST) is a method to record the vertebral orientation in 3D. Such measurements can be performed in static but also in dynamic situations like gait or other motion tasks. However, dynamic ST measurements are hard to interpret due to their complexity. The main goal of this paper is to provide comprehensive visualization tools which allow a more intuitive and comprehensive interpretation n of such measurements. In particular, juxtaposition and superimposition techniques are utilized to emphasize differences in motion characteristics. The method was applied to a test series of 12 healthy volunteers walking on a treadmill at various speed levels. It could be shown that the visualization tools are helpful to compare different motion sequences including an analysis of intra- and interindividual variation. Based on these techniques, it could be shown that the profiles of vertebral orientation remain considerable constant when one person was walking at different speed levels whereas they differed substantially between the different individuals. In contrast, the motion amplitudes contained high intra- and interindividual variation, i.e. between speed levels and different test persons. In summary, the paper demonstrates that appropriate visualization tools are helpful to interpret ST measurements and cope with the complexity of these data sets. In particular, they can be used to compare different motion sequences in a more comprehensive way.
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Affiliation(s)
- Martin Haimerl
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Kronenstraße 16, 78532 Tuttlingen, Germany.
| | - Iman Nebel
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Kronenstraße 16, 78532 Tuttlingen, Germany
| | - Alina Linkerhägner
- Innovation and Research Center Tuttlingen, Furtwangen University of Applied Science, Kronenstraße 16, 78532 Tuttlingen, Germany
| | - Jürgen Konradi
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
| | - Claudia Wolf
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
| | - Philipp Drees
- Department of Orthopedics and Trauma Surgery, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
| | - Ulrich Betz
- Institute of Physical Therapy, Prevention and Rehabilitation, University Medical Center of the Johannes Gutenberg University Mainz, Langenbeckstr.1, 55131 Mainz, Germany.
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Oppici L, Grütters K, Garofolini A, Rosenkranz R, Narciss S. Deliberate Practice and Motor Learning Principles to Underpin the Design of Training Interventions for Improving Lifting Movement in the Occupational Sector: A Perspective and a Pilot Study on the Role of Augmented Feedback. Front Sports Act Living 2021; 3:746142. [PMID: 34796319 PMCID: PMC8593185 DOI: 10.3389/fspor.2021.746142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 10/12/2021] [Indexed: 11/18/2022] Open
Abstract
Spine posture during repetitive lifting is one of the main risk factors for low-back injuries in the occupational sector. It is thus critical to design appropriate intervention strategies for training workers to improve their posture, reducing load on the spine during lifting. The main approach to train safe lifting to workers has been educational; however, systematic reviews and meta-analyses have shown that this approach does not improve lifting movement nor reduces the risk of low back injury. One of the main limitations of this approach lies in the amount, quality and context of practice of the lifting movement. In this article, first we argue for integrating psychologically-grounded perspectives of practice design in the development of training interventions for safe lifting. Principles from deliberate practice and motor learning are combined and integrated. Given the complexity of lifting, a training intervention should occur in the workplace and invite workers to repeatedly practice/perform the lifting movement with the clear goal of improving their lifting-related body posture. Augmented feedback has a central role in creating the suitable condition for achieving such intervention. Second, we focus on spine bending as risk factor and present a pilot study examining the benefits and boundary conditions of different feedback modalities for reducing bending during lifting. The results showed how feedback modalities meet differently key requirements of deliberate practice conditions, i.e., feedback has to be informative, individualized and actionable. Following the proposed approach, psychology will gain an active role in the development of training interventions, contributing to finding solutions for a reduction of risk factors for workers.
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Affiliation(s)
- Luca Oppici
- Psychology of Learning and Instruction, Department of Psychology, School of Science, Technische Universität Dresden, Dresden, Germany.,Centre for Tactile Internet With Human-in-the-Loop (CeTI), Technische Universität Dresden, Dresden, Germany
| | - Kim Grütters
- Psychology of Learning and Instruction, Department of Psychology, School of Science, Technische Universität Dresden, Dresden, Germany
| | - Alessandro Garofolini
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
| | - Robert Rosenkranz
- Centre for Tactile Internet With Human-in-the-Loop (CeTI), Technische Universität Dresden, Dresden, Germany.,Acoustic and Haptic Engineering, Faculty of Electrical and Computer Engineering, Technische Universität Dresden, Dresden, Germany
| | - Susanne Narciss
- Psychology of Learning and Instruction, Department of Psychology, School of Science, Technische Universität Dresden, Dresden, Germany.,Centre for Tactile Internet With Human-in-the-Loop (CeTI), Technische Universität Dresden, Dresden, Germany
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Alemi MM, Burkhart KA, Lynch AC, Allaire BT, Mousavi SJ, Zhang C, Bouxsein ML, Anderson DE. The Influence of Kinematic Constraints on Model Performance During Inverse Kinematics Analysis of the Thoracolumbar Spine. Front Bioeng Biotechnol 2021; 9:688041. [PMID: 34395398 PMCID: PMC8358679 DOI: 10.3389/fbioe.2021.688041] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/28/2021] [Indexed: 11/18/2022] Open
Abstract
Motion analysis is increasingly applied to spine musculoskeletal models using kinematic constraints to estimate individual intervertebral joint movements, which cannot be directly measured from the skin surface markers. Traditionally, kinematic constraints have allowed a single spinal degree of freedom (DOF) in each direction, and there has been little examination of how different kinematic constraints affect evaluations of spine motion. Thus, the objective of this study was to evaluate the performance of different kinematic constraints for inverse kinematics analysis. We collected motion analysis marker data in seven healthy participants (4F, 3M, aged 27–67) during flexion–extension, lateral bending, and axial rotation tasks. Inverse kinematics analyses were performed on subject-specific models with 17 thoracolumbar joints allowing 51 rotational DOF (51DOF) and corresponding models including seven sets of kinematic constraints that limited spine motion from 3 to 9DOF. Outcomes included: (1) root mean square (RMS) error of spine markers (measured vs. model); (2) lag-one autocorrelation coefficients to assess smoothness of angular motions; (3) maximum range of motion (ROM) of intervertebral joints in three directions of motion (FE, LB, AR) to assess whether they are physiologically reasonable; and (4) segmental spine angles in static ROM trials. We found that RMS error of spine markers was higher with constraints than without (p < 0.0001) but did not notably improve kinematic constraints above 6DOF. Compared to segmental angles calculated directly from spine markers, models with kinematic constraints had moderate to good intraclass correlation coefficients (ICCs) for flexion–extension and lateral bending, though weak to moderate ICCs for axial rotation. Adding more DOF to kinematic constraints did not improve performance in matching segmental angles. Kinematic constraints with 4–6DOF produced similar levels of smoothness across all tasks and generally improved smoothness compared to 9DOF or unconstrained (51DOF) models. Our results also revealed that the maximum joint ROMs predicted using 4–6DOF constraints were largely within physiologically acceptable ranges throughout the spine and in all directions of motions. We conclude that a kinematic constraint with 5DOF can produce smooth spine motions with physiologically reasonable joint ROMs and relatively low marker error.
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Affiliation(s)
- Mohammad Mehdi Alemi
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Katelyn A Burkhart
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Andrew C Lynch
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Brett T Allaire
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States
| | - Seyed Javad Mousavi
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Chaofei Zhang
- Department of Automotive Engineering, Tsinghua University, Beijing, China
| | - Mary L Bouxsein
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
| | - Dennis E Anderson
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, United States.,Department of Orthopaedic Surgery, Harvard Medical School, Boston, MA, United States
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To D, Breen A, Breen A, Mior S, Howarth SJ. Investigator analytic repeatability of two new intervertebral motion biomarkers for chronic, nonspecific low back pain in a cohort of healthy controls. Chiropr Man Therap 2020; 28:62. [PMID: 33228737 PMCID: PMC7685540 DOI: 10.1186/s12998-020-00350-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 10/23/2020] [Indexed: 12/28/2022] Open
Abstract
Background Understanding the mechanisms underlying chronic, nonspecific low back pain (CNSLBP) is essential to advance personalized care and identify the most appropriate intervention. Recently, two intervertebral motion biomarkers termed “Motion Sharing Inequality” (MSI) and “Motion Sharing Variability” (MSV) have been identified for CNSLBP using quantitative fluoroscopy (QF). The aim of this study was to conduct intra- and inter-investigator analytic repeatability studies to determine the extent to which investigator error affects their measurement in clinical studies. Methods A cross-sectional cohort study was conducted using the image sequences of 30 healthy controls who received QF screening during passive recumbent flexion motion. Two independent investigators analysed the image sequences for MSI and MSV from October to November 2018. Intra and inter- investigator repeatability studies were performed using intraclass correlations (ICC), standard errors of measurement (SEM) and minimal differences (MD). Results Intra-investigator ICCs were 0.90 (0.81,0.95) (SEM 0.029) and 0.78 (0.59,0.89) (SEM 0.020) for MSI and MSV, respectively. Inter-investigator ICCs 0.93 (0.86,0.97) (SEM 0.024) and 0.55 (0.24,0.75) (SEM 0.024). SEMs for MSI and MSV were approximately 10 and 30% of their group means respectively. The MDs for MSI for intra- and inter-investigator repeatability were 0.079 and 0.067, respectively and for MSV 0.055 and 0.067. Conclusions MSI demonstrated substantial intra- and inter-investigator repeatability, suggesting that investigator input has a minimal influence on its measurement. MSV demonstrated moderate intra-investigator reliability and fair inter-investigator repeatability. Confirmation in patients with CNSLBP is now required.
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Affiliation(s)
- Daphne To
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada
| | - Alexander Breen
- Centre for Biomechanics Research, AECC University College, Parkwood Campus, Parkwood Road, Bournemouth, Dorset, BH5 2DF, UK
| | - Alan Breen
- Centre for Biomechanics Research, AECC University College, Parkwood Campus, Parkwood Road, Bournemouth, Dorset, BH5 2DF, UK
| | - Silvano Mior
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada
| | - Samuel J Howarth
- Canadian Memorial Chiropractic College, 6100 Leslie Street, Toronto, Ontario, M2H 3J1, Canada.
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Norrie JP, Brown SH. Brace yourself: How abdominal bracing affects intersegmental lumbar spine kinematics in response to sudden loading. J Electromyogr Kinesiol 2020; 54:102451. [DOI: 10.1016/j.jelekin.2020.102451] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/07/2020] [Accepted: 07/11/2020] [Indexed: 12/26/2022] Open
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