Lower limb postures resembling sitting and standing alter lumbar angles along the passive stiffness curve.

In vivo lumbar passive stiffness is often used to assess time-dependent changes in lumbar tissues and to define the neutral zone. We tested the hypothesis that flexing the hips would alter tension in hip and spine musculature, leading to a more extended passive stiffness curve (i.e., right-shifted), without changes in lumbar stiffness. Twenty participants underwent side-lying passive testing with the lower limbs positioned in Stand, Kneel, and Sit representative postures. Moment-angle curves were constructed from the lumbar angles and the moment at L4/5 and partitioned into three zones. Partially supporting our hypothesis, lumbar stiffness within the low and transition stiffness zones was similar between the Stand and Sit. Contrary to our hypothesis, lumbar angles were significantly larger in the Sit compared to the Stand and Kneel postures at the first and second breakpoints, with average differences of 9.3° or 27.2% of passive range of motion (%PassRoM) in flexion and 5.6° or 16.6 %PassRoM in extension. Increased flexion in the Sit may be linked to increased posterior pelvic tilt and associated lower lumbar vertebrae flexion. Investigators must ensure consistent pelvis and hip positioning when measuring lumbar stiffness. Additionally, the adaptability of the neutral zone to pelvis posture, particularly between standing and sitting, should be considered in ergonomic applications.

Defining the lumbar and trunk-thigh neutral zone from the passive stiffness curve: application to hybrid sit-stand postures and chair design.

Minimal data exist on the neutral position for the lumbar spine, trunk, and thighs when adopting a hybrid posture. This study examined sex differences in the neutral zone lumbar stiffness and the lumbar and trunk-thigh angle boundaries of the neutral zone, and determined if the standing lumbar angle fell within the neutral zone. Passive lumbar flexion and extension moment-angle curves were generated for 31 participants (13 M, 18 F), pooled from two datasets, with trunk-thigh angles available for 10 participants. The neutral zone was defined as the low stiffness zone from both the flexion and extension curves. Males demonstrated significantly greater extensor stiffness. Neutral lumbar and trunk-thigh angles ranged on average -22.2 to 0.2° and 124.2 to 159.6° for males and -17.8 to -1.3° and 143.2 to 159.5° for females, respectively. Standing lumbar angles fell outside the neutral zone for 44% of participants. These neutral zone boundaries may inform kinematics for hybrid chair designs.Practitioner summary: Adoption of a neutral spinal posture may be achieved through hybrid chair design, yet minimal data exists on a physiologically defined neutral zone. Using measures of in vivo lumbar stiffness, the lumbar and trunk-thigh angular boundaries of the neutral zone were defined for both males and females.Abbreviations: EMG: electromyography; MVC: maximal voluntary contraction.

Moving Toward Individual-Specific Automotive Seat Design: How Individual Characteristics and Time Alter the Selected Lumbar Support Prominence.

OBJECTIVE: To explore how individual characteristics influence selected lumbar support prominence (LSP), seated lumbar flexion, seatback average pressure, contact area, and center of pressure (CoP) location before and after 1 hr of driving. BACKGROUND: An LSP can alter posture and may reduce low back pain during prolonged driving. Although LSP preference varies across individuals and may change over time, few investigations have explored the time-varying response to individually selected adjustable seat parameters. METHOD: Forty individuals selected LSP settings in an automotive seat through a series of systematic adjustment trials. The average LSP setting was fixed for a 1-hr driving simulation, followed by one final adjustment trial. Regressions were performed between individual characteristics and selected LSP, lumbar posture, and measures of seatback pressure from the initial adjustment trials. ANOVAs were performed to determine the effect of time and sex on these dependent variables. Discomfort was also monitored throughout the protocol. RESULTS: Individual's standing lumbar lordosis, selected LSP, and height and mass were significant predictors for seated lumbar flexion, seatback average pressure, and contact area, respectively. Discomfort levels remained low; however, following the driving protocol, individuals altered their posture to decrease lumbar flexion and increase seatback average pressure without significant adjustments to the LSP. CONCLUSION: These findings highlight individual characteristics to consider in automotive seat design and that the method for determining LSP settings may facilitate appropriate LSP selection. APPLICATION: A systematic method to determine LSP settings may reduce discomfort and automate seat adjustments, such that only short-term postural adjustments may be required.

Can Anthropometry be Used to Dictate Participant-Specific Thigh Marker Placements Which Minimize Error in Hip Joint Center Estimation?

Specific participant characteristics may be leveraged to dictate marker placements which reduce soft tissue artifact; however, a better understanding of the relationships between participant characteristics and soft tissue artifact are first required. The purpose of this study was to assess the accuracy in which measures of whole-body and thigh anthropometry could predict mislocation error of the hip joint center, tracked using skin-mounted marker clusters. Fifty participants completed squatting and kneeling, while pelvis and lower limb motion were recorded. The effect of soft tissue artifact was estimated from 6 rigid thigh marker clusters by evaluating their ability to track the position of the hip joint center most like the pelvis cluster. Eighteen backward stepwise linear regressions were performed using 10 anthropometric measures as independent variables and the mean of the peak difference between the thigh and pelvis cluster-tracked hip joint centers. Fourteen models significantly predicted error with low to moderate fit (R = .38-.67), explaining 14% to 45% of variation. Partial correlations indicated that soft tissue artifact may increase with soft tissue volume and be altered by local soft tissue composition. However, it is not recommended that marker placement be adjusted based on anthropometry alone.

Does sitting on a stability ball increase fall risk during ergonomic reaching tasks?

Although sitting on a stability ball has become an alternative to using an office chair, little is known about the increased potential for a fall on the deformable seat. This study examined differences in stability between sitting on a seat pan of a backless office chair and a stability ball during reaching tasks. Sixteen participants performed forward and lateral reaching tasks on a backless and armless office chair and stability ball while whole-body motion and force data under the seat were recorded. Even with participants placing their feet 16.5 cm wider when seated on the ball, the perceived fall risk was significantly greater. Centre of pressure displacement tended to be smaller under the ball for lateral reach directions, but larger during far anterior reaches. While not statistically significant, the medial-lateral margin of stability was on average 3.4 cm smaller on the ball. Despite attempts to increase stability by widening their stance, stability ball fall risk remained higher.

Quantifying high flexion postures in occupational childcare as they relate to the potential for increased risk of knee osteoarthritis.

High knee flexion postures, despite their association with increased incidences of osteoarthritis, are frequently adopted in occupational childcare. This study sought to define and quantify high flexion postures typically adopted in childcare to evaluate any increased likelihood of knee osteoarthritis development. Through video analysis of eighteen childcare workers caring for infant, toddler, and preschool-aged children, eight high knee flexion postures were identified and quantified by duration and frequency. An analysis of postural adoption by task was subsequently performed to determine which might pose the greatest risk for cumulative joint trauma. Childcare workers caring for children of all ages were found to adopt kneeling and seated postures for extended durations and at elevated frequencies, exceeding proposed thresholds for incidences of knee osteoarthritis development. Structured activities, playing, and feeding tasks demanded the greatest adoption of high flexion postures and should be evaluated to minimise the potential childcare-related risks of osteoarthritis. Practitioner summary: High knee flexion postures (kneeling, squatting, etc.) have been associated with increased incidences of knee injury yet are commonly adopted in childcare. Childcare workers' postures were examined through video analysis revealing that proposed adoption thresholds for knee health are commonly exceeded when caring for children of all ages. Abbreviations: OA: osteoarthritis; WSIB: workplace safety insurance board; CAD: Canadian Dollar; DK: dorsiflexed kneeling; PK: plantarflexed kneeling; SAK: single arm supported kneeling; DAK: double arm supported kneeling; FS: flatfoot squatting; HS: heels up squatting; FLRS: floor sitting; SS: side sitting or leaning; STLS: stool sitting; BR: bending and reaching.

Regulating Movement Frequency and Speed: Implications for Lumbar Spine Load Management Strategies Demonstrated Using an In Vitro Porcine Model.

The relationship between internal loading dose and low-back injury risk during lifting is well known. However, the implications of movement parameters that influence joint loading rates-movement frequency and speed-on time-dependent spine loading responses remain less documented. This study quantified the effect of loading rate and frequency on the tolerated cumulative loading dose and its relation to joint lifespan. Thirty-two porcine spinal units were exposed to biofidelic compression loading paradigms that differed by joint compression rate (4.2 and 8.3 kN/s) and frequency (30 and 60 cycles per minute). Cyclic compression testing was applied until failure was detected or 10,800 continuous cycles were tolerated. Instantaneous weighting factors were calculated to evaluate the cumulative load and Kaplan-Meier survival probability functions were examined following nonlinear dose normalization of the cyclic lifespan. Significant reductions in cumulative compression were tolerated when spinal units were compressed at 8.3 kN/s (P < .001, 67%) and when loaded at 30 cycles per minute (P = .008, 45%). There was a positive moderate relationship between cumulative load tolerance and normalized cyclic lifespan (R2 = .52), which was supported by joint survivorship functions. The frequency and speed of movement execution should be evaluated in parallel to loading dose for the management of low-back training exposures.

Estimating soft tissue artifact of the thigh in high knee flexion tasks using optical motion Capture: Implications for marker cluster placement.

Soft tissue artifact in motion capture is widely accepted as a significant source of error in kinematic and kinetic measurements. Non-invasive methods of estimating soft tissue artifact, those requiring only motion capture, provide a feasible method to evaluate marker placement on a segment and enable recommendations for marker configurations which can minimize soft tissue artifact. The purpose of this study was to investigate the effect of thigh marker cluster location on soft tissue artifact during high knee flexion (>120 deg) as unique deformation of soft tissue occurs in this range (e.g. thigh-calf contact). Motion of the pelvis and lower limbs were recorded during squatting and kneeling in fifty participants. Six rigid marker clusters were affixed to the skin on the anterior, lateral, and anterolateral aspect, at the distal and middle third of the thighs. To estimate soft tissue artifact, the functional hip joint center was reconstructed relative to the pelvis cluster and each of the six thigh clusters throughout motion. The difference in the position of these two points was input into Bland-Altman analyses and compared between the thigh clusters. Across the tasks, the total mean difference ranged from 2.81 to 8.95 cm while the lower and upper limits of agreement ranged from -0.79 to 2.54 cm and 5.04 to 17.65 cm, respectively. Using this non-invasive method, the mid-anterolateral cluster was least susceptible to soft tissue artifact and thus would be recommended, while the lateral clusters were most susceptible and should avoided in high knee flexion and similar tasks.

Reconstructing an accelerometer-based pelvis segment for three-dimensional kinematic analyses during laboratory simulated tasks with obstructed line-of-sight.

Close interface between humans and inanimate objects (furniture, assistive devices, and external loads) can obstruct line-of-sight in biomechanics studies that utilize optoelectronic motion capture systems. This specific problem is frequently encountered with the pelvis segment. This study sought to compare joint and pelvis angles computed from a pelvis-fixed local coordinate system (LCS) that was constructed from optically tracked pelvis landmarks (gold standard) and landmarks derived from angular deviations calculated from triaxial accelerometer data. One participant performed seven tasks: sitting, forward bend, sit-to-stand-to-sit, forward lunge, symmetrical squat, asymmetrical squat, and gait. The root mean square error (RMSE) and coefficient of determination (R2) were examined for the pelvis, lumbar spine, and hip joint angles calculated using the standard and accelerometer-based methods for creating a LCS. The RMSE values for global pelvis angles ranged from 2.2° (gait; R2 = 0.47) to 4.9° (sit-to-stand-to-sit; R2 = 0.98), 0.6° (sitting; R2 = 0.88) to 7.4° (gait; R2 = 0.39), and 1.5° (forward bend; R2 = 0.99) to 2.9° (sit-to-stand-to-sit; R2 = 0.99) for motion about the X, Y, and Z axes, respectively. The magnitude of error observed for adjacent joint motion was lowest about the Z axis for all tasks. In conclusion, the accelerometer-based LCS offers an alternative method for computing pelvis and adjacent joint angles without the reliance on a visual line-of-sight. For motion about the X and Y axes, time-series data derived with the accelerometer-based method may be less representative of discrete events, particularly for gait and lunging tasks.

Lower Limb Movement Pattern Differences Between Males and Females in Squatting and Kneeling.

Movement pattern differences may contribute to differential injury or disease prevalence between individuals. The purpose of this study was to identify lower limb movement patterns in high knee flexion, a risk factor for knee osteoarthritis, and to investigate kinematic differences between males and females, as females typically develop knee osteoarthritis more commonly and severely than males. Lower extremity kinematic data were recorded from 110 participants completing 4 variations of squatting and kneeling. Principal component analysis was used to identify principal movements associated with the largest variability in the sample. Across the tasks, similar principal movements emerged at maximal flexion and during transitions. At maximal flexion, females achieved greater knee flexion, facilitated by a wider base of support, which may alter posterior and lateral tibiofemoral stress. Principal movements also detected differences in movement temporality between males and females. When these temporal differences occur due to alterations in movement velocity and/or acceleration, they may elicit changes in muscle activation and knee joint stress. Movement variability identified in the current study provides a framework for potential modifiable factors in high knee flexion, such as foot position, and suggests that kinematic differences between the sexes may contribute to differences in knee osteoarthritis progression.

Joint fatigue-failure: A demonstration of viscoelastic responses to rate and frequency loading parameters using the porcine cervical spine.

Fatigue-failure in low back tissues is influenced by parameters of cyclic loading. Therefore, this study quantified the effect of loading rate and frequency on the number of tolerated compression cycles. Energy storage and vertical deformation were secondarily examined. Thirty-two porcine spinal units were randomly assigned to experimental groups that differed by loading rate (4.2 kN/s, 8.3 kN/s) and loading frequency (0.5 Hz, 1 Hz). Following preload and range-of-motion tests, specimens were cyclically loaded in a neutral posture until fatigue-failure occurred or 10800 cycles were tolerated. Macroscopic dissection was performed to identify the fracture morphology, and measurements of energy storage and vertical displacement were calculated throughout the specimen lifespan (1%, 10%, 50%, 90%, 99%). Given the differences in compression dose-force-time integral-between experimental conditions, the number of sustained cycles were assessed following linear and nonlinear dose-normalization via correction factors calculated from existing risk-exposure approximations. Without dose-normalization, an 8.3 kN/s loading rate and 0.5 Hz loading frequency reduced the fatigue lifetime by 3541 and 5977 cycles, respectively (p < 0.001). Linear and nonlinear dose-normalization resulted in a significant rate × frequency interaction (p < 0.001). For a 1 Hz loading frequency, the number of sustained loading cycles did not differ between loading rates (padj ≥ 0.988), but at 0.5 Hz, spinal units compressed at 8.3 kN/s sustained 99% (linear) and 97% (nonlinear) fewer cycles (padj < 0.001). These findings demonstrate that the interacting effects of loading frequency and loading rate on spinal fatigue-failure depend on the normalization of dose discrepancies between experimental groups.