An optimization-based method for prediction of lumbar spine segmental kinematics from the measurements of thorax and pelvic kinematics.

Given measurement difficulties, earlier modeling studies have often used some constant ratios to predict lumbar segmental kinematics from measurements of total lumbar kinematics. Recent imaging studies suggested distribution of lumbar kinematics across its vertebrae changes with trunk rotation, lumbar posture, and presence of load. An optimization-based method is presented and validated in this study to predict segmental kinematics from measured total lumbar kinematics. Specifically, a kinematics-driven biomechanical model of the spine is used in a heuristic optimization procedure to obtain a set of segmental kinematics that, when prescribed to the model, were associated with the minimum value for the sum of squared predicted muscle stresses across all the lower back muscles. Furthermore, spinal loads estimated using the predicted kinematics by the present method were compared with those estimated using constant ratios. Predicted segmental kinematics were in good agreement with those obtained by imaging with an average error of ~10%. Compared with those obtained using constant ratios, predicted spinal loads using segmental kinematics obtained here were in general smaller. In conclusion, the proposed method offers an alternative tool for improving model-based estimates of spinal loads where image-based measurement of lumbar kinematics is not feasible.

Soft tissue wobbling affects trunk dynamic response in sudden perturbations.

Soft tissue wobbling reduces the transferred impact of external loads on lower limb joints. The present study investigated whether soft tissue wobbling has similar effects on trunk dynamic response to sudden perturbations. Three healthy males were subjected to a series of anteriorly directed trunk position perturbations at three different velocities while trunk kinematics and kinetics were measured. A nonlinear active-passive finite element model of the human trunk was then used to study the effects of soft tissue wobbling on trunk response. Also investigated were the effects on model predictions of including elements simulating the apparatus (rod-harness assembly) transferring motor-generated perturbations to the trunk. Predicted and measured trunk kinematics and kinetics, when accounting for the dynamic effects of both wobbling mass and rod-harness assembly, were in good agreement for all velocities especially early (<120 ms) after the perturbations (ρ>0.97). Root mean square errors in model predictions increased considerably when neglecting the aforementioned modeling considerations. The trunk wobbling mass and connecting elements between the trunk and the perturbing device, particularly during faster perturbations, substantially attenuated the transferred impact of external loads on the spine (by 33-90 N across perturbation velocities). Such reductions in the impacts transferred, in turn, reduced the predicted demands on the neuromuscular system for control and maintenance of spinal loads and stability. As such, these features should be considered in future biodynamic models of the human trunk aimed at estimating trunk neuromuscular behaviors during sudden perturbations.

Trunk response analysis under sudden forward perturbations using a kinematics-driven model.

Accurate quantification of the trunk transient response to sudden loading is crucial in prevention, evaluation, rehabilitation and training programs. An iterative dynamic kinematics-driven approach was used to evaluate the temporal variation of trunk muscle forces, internal loads and stability under sudden application of an anterior horizontal load. The input kinematics is hypothesized to embed basic dynamic characteristics of the system that can be decoded by our kinematics-driven approach. The model employs temporal variation of applied load, trunk forward displacement and surface EMG of select muscles measured on two healthy and one chronic low-back pain subjects to a sudden load. A finite element model accounting for measured kinematics, nonlinear passive properties of spine, detailed trunk musculature with wrapping of global extensor muscles, gravity load and trunk biodynamic characteristics is used to estimate the response under measured sudden load. Results demonstrate a delay of approximately 200ms in extensor muscle activation in response to sudden loading. Net moment and spinal loads substantially increase as muscles are recruited to control the trunk under sudden load. As a result and due also to the trunk flexion, system stability significantly improves. The reliability of the kinematics-driven approach in estimating the trunk response while decoding measured kinematics is demonstrated. Estimated large spinal loads highlight the risk of injury that likely further increases under larger perturbations, muscle fatigue and longer delays in activation.

Transient analysis of trunk response in sudden release loading using kinematics-driven finite element model.

BACKGROUND: Sudden trunk perturbations occur in various occupational and sport activities. Despite numerous measurement studies, no comprehensive modeling simulations have yet been attempted to investigate trunk biodynamics under sudden loading/unloading. METHODS: Dynamic kinematics-driven approach was used to evaluate the temporal variation of trunk muscle forces, internal loads and stability before and after a sudden release of a posterior horizontal load. Measured post-disturbance trunk kinematics, as input, and muscle electromyography (EMG) activities, for qualitative validation, were considered. FINDINGS: Computed agonist and antagonist muscle forces before and after release agreed well with reported EMG activities and demonstrated basic response characteristics such as activation latency and reflex activation. The trunk was found quite stable before release and in early post-release period. Larger applied load substantially increased trunk kinematics, muscle forces and spinal loads. INTERPRETATION: Excessive spinal loads due to large muscle forces in sudden loading conditions is a risk factor as the central nervous system attempts to reflexively control the sudden disturbances, a situation that further deteriorates under larger perturbations and longer latency periods. Predictions indicate the potential of the kinematics-driven model in ergonomics as well as training and rehabilitation programs.

Seated whole body vibrations with high-magnitude accelerations--relative roles of inertia and muscle forces.

Reliable computation of spinal loads and trunk stability under whole body vibrations with high acceleration contents requires accurate estimation of trunk muscle activities that are often overlooked in existing biodynamic models. A finite element model of the spine that accounts for nonlinear load- and direction-dependent properties of lumbar segments, complex geometry and musculature of the spine, and dynamic characteristics of the trunk was used in our iterative kinematics-driven approach to predict trunk biodynamics in measured vehicle's seat vibrations with shock contents of about 4 g (g: gravity acceleration of 9.8m/s2) at frequencies of about 4 and 20 Hz. Muscle forces, spinal loads and trunk stability were evaluated for two lumbar postures (erect and flexed) with and without coactivity in abdominal muscles. Estimated peak spinal loads were substantially larger under 4 Hz excitation frequency as compared to 20 Hz with the contribution of muscle forces exceeding that of inertial forces. Flattening of the lumbar lordosis from an erect to a flexed posture and antagonistic coactivity in abdominal muscles, both noticeably increased forces on the spine while substantially improving trunk stability. Our predictions clearly demonstrated the significant role of muscles in trunk biodynamics and associated risk of back injuries. High-magnitude accelerations in seat vibration, especially at near-resonant frequency, expose the vertebral column to large forces and high risk of injury by significantly increasing muscle activities in response to equilibrium and stability demands.

Computation of trunk equilibrium and stability in free flexion-extension movements at different velocities.

Velocity of movement has been suggested as a risk factor for low-back disorders. The effect of changes in velocity during unconstrained flexion-extension movements on muscle activations, spinal loads, base reaction forces and system stability was computed. In vivo measurements of kinematics and ground reaction forces were initially carried out on young asymptomatic subjects. The collected kinematics of three subjects representing maximum, mean and minimum lumbar rotations were subsequently used in the kinematics-driven model to compute results during the entire movements at three different velocities. Estimated spinal loads and muscle forces were significantly larger in fastest pace as compared to slower ones indicating the effect of inertial forces. Spinal stability was improved in larger trunk flexion angles and fastest movement. Partial or full flexion relaxation of global extensor muscles occurred only in slower movements. Some local lumbar muscles, especially in subjects with larger lumbar flexion and at slower paces, also demonstrated flexion relaxation. Results confirmed the crucial role of movement velocity on spinal biomechanics. Predictions also demonstrated the important role on response of the magnitude of peak lumbar rotation and its temporal variation.

Spinal stability and role of passive stiffness in dynamic squat and stoop lifts.

The spinal stability and passive-active load partitioning under dynamic squat and stoop lifts were investigated as the ligamentous stiffness in flexion was altered. Measured in vivo kinematics of subjects lifting 180 N at either squat or stoop technique was prescribed in a nonlinear transient finite element model of the spine. The Kinematics-driven approach was utilized for temporal estimation of muscle forces, internal spinal loads and system stability. The finite element model accounted for nonlinear properties of the ligamentous spine, wrapping of thoracic extensor muscles and trunk dynamic characteristics while subject to measured kinematics and gravity/external loads. Alterations in passive properties of spine substantially influenced muscle forces, spinal loads and system stability in both lifting techniques, though more so in stoop than in squat. The squat technique is advocated for resulting in smaller spinal loads. Stability of spine in the sagittal plane substantially improved with greater passive properties, trunk flexion and load. Simulation of global extensor muscles with curved rather than straight courses considerably diminished loads on spine and increased stability throughout the task.

Wrapping of trunk thoracic extensor muscles influences muscle forces and spinal loads in lifting tasks.

BACKGROUND: An improved assessment of risk of spinal injury during lifting activities depends on an accurate estimation of trunk muscle forces, spinal loads and stability margin which in turn requires, amongst others, an accurate description of trunk muscle geometries. The lines of action of erector spinae muscles are often assumed to be linear despite the curved paths of these muscles in forward flexion postures. METHODS: A novel approach was introduced that allowed for the proper simulation of curved paths for global extensor muscles in our Kinematics-driven finite element model. The lever arms of global muscles at different levels were restrained either to remain the same or decrease only by 10% relative to their respective values in upright posture. Based on our earlier measurements, static lifting tasks at two trunk flexions (40 degrees and 65 degrees ) and three lumbar postures (free style, lordotic and kyphotic) with 180 N in hands were analyzed. FINDINGS: Muscle forces and spinal compression at all levels substantially decreased as the global extensor muscles took curved paths. In contrast, the shear force at lower levels increased. Allowing for a 10% reduction in these lever arms during flexion increased muscle forces and compression forces at all levels. Despite smaller muscle forces, wrapping of global muscles slightly improved the spinal stability. INTERPRETATION: Consideration of global extensor muscles with curved paths and realistic lever arms is important in biomechanical analysis of lifting tasks. Reduction in the erector spinae lever arms during flexion tasks could vary depending on the lumbar posture. Results advocate small flattening of the lumbar curvature in isometric lifts yielding smaller compression and shear forces at the critical L5-S1 level.