Sharif Digital Repository

Study Design. A cross-sectional study to quantify trunk motor control during multidirectional isometric tracking tasks.Objective. To investigate the effect of chronic low back pain (LBP) on trunk neuromuscular performance while participants performed isometric exertions of trunk muscles to track targets in different angles with various magnitudes.Summary of Background Data. Tracking tasks especially in multidirectional activities are among the common research methods to quantify human motor control in different conditions. However, little information is available on trunk motor control during these tasks. There is no study investigating trunk accuracy during multidirectional isometric... 

Background The ratio of total lumbar rotation over pelvic rotation (lumbopelvic rhythm) during trunk sagittal movement is essential to evaluate spinal loads and discriminate between low back pain and asymptomatic population. Methods Angular rotations of the pelvis and lumbar spine as well as their sagittal rhythm during forward flexion and backward extension in upright standing of eight asymptomatic males are measured using an inertial tracking device. The effect of variations in the lumbopelvic ratio during trunk flexion on spinal loads is quantified using a detailed musculoskeletal model. Findings The mean of peak voluntary flexion rotations of the thorax, pelvis, and lumbar was 121 (SD... 

This paper focuses on characterization of intervertebral disc behavior upon fatigue stress. It consists in in-vitro experiments to measure intervertebral disc deformation with regard to forces applied to produce fatigues test. In this paper, a system modeling based non-invasive method to assess back pain is proposed which may be used for designing of prediction model to predict the failure of intervertebral disc (IVD) experiencing fatigue loading. An artificial compression fracture was simulated in the lower level of vertebra followed by a poly(methyl methacrylate) (PMMA) bone cement injection. Fatigue loading was applied on the specimens and the load was incrementally increased form 650 N... 

This paper presents recent developments on effects of rest and fatigue loading on properties of healthy vertebra discs. A comparison of different approaches used in literature to study the properties of intervertebral disc is presented. The major achievements in this area so far are discussed in the context of their advantages and disadvantages. The past approaches are based on bio-mechanical models which mostly used statistical techniques for the analysis and estimation of fatigue loaded Intervertebral Disc (IVD). However, those modeling techniques were not flexible enough for analysis of customized tests. In this paper, we applied System Identification (SI) based NLARX modeling technique... 

Sit-to-stand (STS) is an important functional task affected by low back pain (LBP). It requires fundamental coordination among all segments of the body to control important performance variables such as body's center of mass (CM) and head positions. This study was conducted to determine whether LBPs could coordinate their multiple joints to achieve the task stability to the same extent as healthy controls. About 11 non-specific chronic LBP and 12 healthy control subjects performed STS task at three postural difficulty levels: rigid surface - open eyes (RO), rigid surface - closed eyes (RC) and narrow surface - closed eyes (NC). Motion variability of seven body segments, CM and head positions... 

A previous review concluded that postural sway is increased in patients with low back pain (LBP). However, more detailed analysis of the literature shows that postural deficit may be dependent on experimental conditions in which patients with LBP have been assessed. The research question to be answered in this review was: " Is there any difference in postural sway between subjects with and without LBP across several sensory manipulation conditions?" A literature search in Pubmed, Scopus, Embase and PsychInfo was performed followed by hand search and contact with authors. Studies investigating postural sway during bipedal stance without applying external forces in patients with specific and... 

This paper presents the background of low back problem caused by repetitive fatigue loading. We emphasize on mechanism of Intervertebral Disc (IVD) and conditions for which the disc does not recover its original status under repetitive work and cause low back pain. The objective of this study is to identify structural changes in system parameters for fatigue loaded intervertebral disc. Principal component analysis (PCA) is used for studying the behavioral change of spine against cyclic loading as a function of time. Percentage difference and similarity factor was calculated for the analysis. Specimens were applied with impulse testing to measure the stiffness and acceleration after fracture,... 

Objectives: Previous research has shown inconsistent findings regarding muscle endurance in chronic low back pain (CLBP). Questions also remain about muscle endurance in patients with clinical instability. The aim of this study was to investigate trunk muscles strength and endurance in CLBP patients with and without clinical instability. Methods: 32 CLBP patients (15 with and 17 without clinical instability) and 39 matched healthy subjects participated in this study. The standing extension test was performed to assess the strength and endurance of the lumbar extensors while recording their electromyographic activity. The patients' disability was evaluated using the Oswestry and Roland-Morris... 

Background: Asymmetric lifting activities are associated with low back pain. Methods: A finite element biomechanical model is used to estimate spinal loads during one- and two-handed asymmetric static lifting activities. Model input variables are thorax flexion angle, load magnitude as well as load sagittal and lateral positions while response variables are L4-L5 and L5-S1 disc compression and shear forces. A number of levels are considered for each input variable and all their possible combinations are introduced into the model. Robust yet user-friendly predictive equations that relate model responses to its inputs are established. Findings: Predictive equations with adequate... 

Sit to stand (STS) task requires variability of all body segments to achieve the stability of the important control variables (i.e., center of mass (CM) and head positions). In this study, the possible differences in the variability patterns of various body segments were investigated between 11 chronic low back pain (LBP) and 12 control subjects during STS task through two types of variability analyses; first by calculating the variability of seven limb angles, CM and head positions across 15 trials and second by principal component analysis (PCA) of seven limb angles. Participants performed the task at 3 postural difficulty levels: rigid surface, open eyes (RO), rigid surface, close eyes... 

The most prevalent musculoskeletal condition and one of the most disabilities are caused by low back pain. In the low back pain, a large variety of evaluation tools is presented to assess the results of the treatment; therefore, it is important to measure the trunk angle in order to determine the progress during patient's treatment. In this project, we developed a low cost prototype system for flexion-extension movement to measure the angle of the trunk in sagital plane. The system consists of clothing that is stretchable; a Rubbery Ruler sensor (RRs) attached on clothing, data acquisition system. Inertial Magnetic Unit (IMU) sensor installed on spine is used to calibrate the orientation for... 

Sit to stand (STS) is one of the most important activities of daily living that is shown to be affected in low back pain (LBP) patients. It requires a fundamental coordination action among all segments (DOFs) of the body in order to control important performance variables such as body's center of mass (CM) within base of support (BOS). In this study, possible differences in joint coordination and variability patterns between chronic LBP and healthy control subjects were investigated during STS task. Eleven adults with nonspecific chronic LBP and 12 healthy controls were recruited in the study. The participants performed the task in 3 exerimental conditions including: rigid surface, open eyes... 

Response surface methodology is used to establish robust and user-friendly predictive equations that relate responses of a complex detailed trunk finite element biomechanical model to its input variables during sagittal symmetric static lifting activities. Four input variables (thorax flexion angle, lumbar/pelvis ratio, load magnitude, and load position) and four model responses (L4-L5 and L5-S1 disc compression and anterior-posterior shear forces) are considered. Full factorial design of experiments accounting for all combinations of input levels is employed. Quadratic predictive equations for the spinal loads at the L4-S1 disc mid-heights are obtained by regression analysis with adequate... 

Study Design.: A descriptive overview of the literature. Objective.: To present a comprehensive descriptive overview of the published papers about epidemiologic features, burden, and current management of low back pain (LBP) in Iran. Summary OF Background Data.: Little is known about the epidemiology, burden, and management of LBP in developing and low- to middle-income countries, such as Iran. Methods.: A literature search was carried out using MEDLINE database to assess existing literature about prevalence, disease burden, impact, and current management of nonspecific LBP in Iran. Results.: Twenty-six articles matched inclusion criteria and included in the study. The findings related to... 

It has been suggested that the central nervous system simplifies muscle control through basic units, called synergies. In this study, we have developed a novel target-matching protocol and used non-negative matrix factorization (NMF) technique to extract trunk muscle synergies and corresponding torque synergies. Isometric torque data at the L5/S1 level and electromyographic patterns of twelve abdominal and back muscles from twelve healthy participants (five females) were simultaneously recorded. Each participant performed a total number of 24 isometric target-matching tasks using 12 different angular directions and 2 levels of uniaxial and biaxial exertions. Within- and between-subject... 

Background: Comparison of the kinematic variability and dynamic stability of the trunk between healthy and low back pain patient groups can contribute to gaining valuable information about the movement patterns and neuromotor strategies involved in various movement tasks. Methods: Fourteen chronic low back pain patients with mild symptoms and twelve healthy male volunteers performed repeated trunk flexion-extension movements in the sagittal plane at three different speeds: 20 cycles/min, self-selected, and 40 cycles/min. Mean standard deviations, coefficient of variation and variance ratio as variability measures; maximum finite-time Lyapunov exponents and maximum Floquet multipliers as... 

Introduction: Therapeutic exercises are regarded as one of most important therapeutic interventions for patients with chronic low back pain. Stabilization exercises are among the most practical ones for these patients. Effects of these exercises on psychological factors associated with pain and consequential functional disabilities are still remained unknown. The purpose of this study was to assess the effect of stabilization exercises on fear of pain, movement and disability in patients with low back pain. Materials and Methods: Twenty one patients with recurrent non-specific low back pain (14 in experimental, 7 in control group) were participated in this study. The scores for fear of pain,... 

The role of motor control in development of low back pain is subject of many researches both in theoretical and experimental fields. In this work flexion-extension movement of lumbar spine have been controlled by three different methods, including feedback linearization (FBL), PD control and their combinations. The model involves 7 links: 1 link for pelvis, 5 links for lumbar vertebrae and 1 link for trunk. Torque actuators have been used on each joint to make them follow desired trajectory. In linear control method, equations of motion have been linearized with respect to upright position and then control signals have been applied in the direction of eigenvectors. Robustness of each method... 

In biomechanical modeling of spine, the prediction of spinal loading during occupational activities is crucial in assessment of the risk of low back pain and injury of spine. Current biomechanical models are based on the average data. Hence, they are unable to predict the effects of the observed natural anatomical variations on muscles moment arms and lines of action, while these variations ultimately influence the required muscular forces for balancing the external moments of any given task. In this work, a methodology based on the Monte Carlo technique has been developed to simulate spine geometry from T12 to S1 vertebrae for males. The lordosis of the assembled spine ranged between 21° to... 

From an ergonomic point of view, quantitative assessment of the feasibility of the task performance is an intricate process, which combines the multidimensional task demand profile with the individual's multidimensional performance capacity profile. Trunk muscle strength is affected by the trunk posture but it is not clear how the variability of trunk muscle is affected by the trunk posture or exertion level. A validated triaxial dynamometer, Sharif-LIST, was used for to model the surface response of trunk muscle extension strength variability as a function of trunk posture in the sagittal, coronal and transverse planes in standing position. Fifteen healthy males with no history of low back...