Sharif Digital Repository

This paper presents a novel approach for evaluating LBP in various settings. The proposed system uses cost-effective inertial sensors, in conjunction with pattern recognition techniques, for identifying sensitive classifiers towards discriminate identification of LB patients. 24 healthy individuals and 28 low back pain patients performed trunk motion tasks in five different directions for validation. Four combinations of these motions were selected based on literature, and the corresponding kinematic data was collected. Upon filtering (4th order, low pass Butterworth filter) and normalizing the data, Principal Component Analysis was used for feature extraction, while Support Vector Machine... 

The successful clinical application of patient-specific personalized medicine for the management of low back patients remains elusive. This study aimed to classify chronic nonspecific low back pain (NSLBP) patients using our previously developed and validated wearable inertial sensor (SHARIF-HMIS) for the assessment of trunk kinematic parameters. One hundred NSLBP patients consented to perform repetitive flexural movements in five different planes of motion (PLM): 0◦ in the sagittal plane, as well as 15◦ and 30◦ lateral rotation to the right and left, respectively. They were divided into three subgroups based on the STarT Back Screening Tool. The sensor was placed on the trunk of each... 

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... 

Background: Controlling pelvic excursions is the focus of stabilization exercises such as legs loading tasks in rehabilitation of non-specific chronic low back pain (NSCLBP) patients. Progression of these exercises is based on the ability to perform tasks with minimal sagittal pelvic excursions. In spite of emphasis on minimizing pelvic motions, no previous studies have investigated kinematic analysis of the pelvic excursions during leg loading exercises in NSCLBP patients. Objective: This study aims to investigate the sagittal pelvis excursion during performing asymmetric leg loading tasks in individuals with and without NSCLBP. Material and Methods: In this cross-sectional study, kinematic... 

Background Wearing lumbosacral orthosis (LSO) is one of the most common treatments prescribed for conservative management of low back pain. Although the results of randomized controlled trials suggest effectiveness of LSO in reducing pain and disability in these patients, there is a concern that prolonged use of LSO may lead to trunk muscle weakness and atrophy. Purpose The present review aimed to evaluate available evidence in literature to determine whether LSO results in trunk muscle weakness or atrophy. Study Design This is a systematic review. Methods A systematic search of electronic databases including PubMed, Scopus, ScienceDirect, and Medline (via Ovid) followed by hand search of... 

Background: Work-related risk factors of low back disorders have been identified to be external moments, awkward postures, and asymmetrical dynamic lifting amongst others. The distinct role of asymmetry of load versus posture is hard to discern from the literature. Hence, the aim of this study is to measure isometric trunk exertions at upright standing posture at different exertion level and degree of asymmetry to further delineate the effects of exertion level and asymmetry on neuromuscular capability response. Methods: Fifteen healthy volunteers randomly performed trunk exertions at three levels (30%, 60%, and 100% of maximum voluntary exertion and five different angles (0°, 45°, 90°,... 

Background: Poor balance performance and impaired postural control have been frequently reported in patients with low back pain.However, postural control is rarely monitored during the course of treatment even though poor postural control may contribute tochronicity and recurrence of symptoms. Therefore, the present study aimed at investigating the effect of a nonextensible lumbosacralorthosis (LSO) versus routine physical therapy on postural stability of patients with nonspecific chronic low back pain.Methods: This was a randomized controlled trial conducted between November 2015 and May 2016 at the outpatient physical therapyclinic of the School of Rehabilitation Sciences. Patients with... 

Background Motor control exercise was claimed to improve spinal stability in patients with chronic non-specific back pain, but to investigate the effectiveness of this exercise, other outcome measures have been used rather than spinal stability itself. The aim of our study is to assess motor control exercise effects on spinal stability using a biomechanical model. Methods Fifty-one patients were assigned to either motor control or general exercises. Before and after trainings, participants were tested for spinal stability at seven isometric tasks. Electromyography signals were recorded from ten superficial muscles, and a hybrid EMG-driven musculoskeletal model estimated spinal stability... 

Inter-segmental coordination can be influenced by chronic low back pain (CLBP). The sagittal plane lower extremities inter-segmental coordination pattern and variability, in conjunction with the pelvis and trunk, were assessed in subjects with and without non-specific CLBP during free-speed walking. Kinematic data were collected from 10 non-specific CLBP and 10 non-CLBP control volunteers while the subjects were walking at their preferred speed. Sagittal plane time-normalized segmental angles and velocities were used to calculate continuous relative phase for each data point. Mean absolute relative phase (MARP) and deviation phase (DP) were derived to quantify the trunk-pelvis and bilateral... 

Evaluation of spinal loads in patients with low back pain (LBP) is essential to prevent further lumbar disorders. Many studies have investigated the relationship between lifting task variables and lumbar spine loads during manual lifting activities. The nature of the external load (stable versus unstable loads) is an important variable that has received less attention. Therefore, the present study aimed to measure trunk kinematics and estimate compressive-shear loads on the lumbar spine under lifting a 120 N stable load and 120 ± 13.63 N sensual unstable load in 16 healthy and 16 non-specific LBP individuals during lifting activities. The maximal lumbar loads were estimated using a... 

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... 

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... 

Background: Chronic low back pain (CLBP) disability has been particularly frustrating because its treatment has been a great therapeutic challenge. Disability has been suggested to depend on different factors that should be found and considered in the medical management. The inter-segmental coordination is often impaired in CLBP subjects; however, to the best of our knowledge, there is no evidence about the relationship between the existence of coordination problems and disability in CLBP patients. Objective: To evaluate the correlation between sagittal plane trunk-pelvis intersegmental coordination parameters during walking and disability level in CLBP patients. Methods: Kinematic data were... 

The central nervous system (CNS) dynamically employs a sophisticated weighting strategy of sensory input, including vision, vestibular and proprioception signals, towards attaining optimal postural control during different conditions. Non-specific low back pain (NSLBP) patients frequently demonstrate postural control deficiencies which are generally attributed to challenges in proprioceptive reweighting, where they often rely on an ankle strategy regardless of postural conditions. Such impairment could lead to potential loss of balance, increased risk of falling, and Low back pain recurrence. In this study, linear and non-linear indicators were extracted from center-of-pressure (COP) and... 

STUDY DESIGN. Three factors mixed-design with 1 between-subject and 2 within-subject factors. OBJECTIVE. To compare the main effects and interactions of postural and cognitive difficulty on quiet stance between subjects with and without nonspecific low back pain (LBP). SUMMARY OF BACKGROUND DATA. The interference between postural control and cognitive tasks depends on factors such as sensorimotor/cognitive integrity. Changes in peripheral sensory and muscular systems as well as cognitive processes have been observed in LBP patients. It was hypothesized that the effect of cognitive task on postural performance might be different in subjects with nonspecific LBP as compared with healthy... 

Whole-body vibration (WBV) has been identified as one of the serious risk factors leading to spinal disorders, particularly in professional drivers. Although the influential factors in this area have been investigated epidemiologically, finite element (FE) modeling can efficiently help us better understand the problem. In this study, a modified HYBRID III dummy FE model which was enhanced by detailed viscoelastic discs in the lumbar region was utilized to simulate the effect of WBV on lumbar spine loads. Spinal responses to the vertical sinusoidal vibrations of a generic seat were obtained and spinal injury risk factors were calculated. Effects of variation of excitation frequencies, three... 

Background: A few clinical trials have examined the effect of treatment interventions on postural control in patients with chronic low back pain, all of which have exclusively evaluated postural stability using traditional linear measures of postural sway. However, postural control improvement cannot be determined by exclusively relying on linear measurements, because these parameters provide no information on underlying motor control mechanisms. Objective: This study aimed to compare the effect of using lumbosacral orthoses (LSO) together with routine physical therapy, compared to routine physical therapy alone on postural control, using nonlinear analysis techniques. Methods: Forty-four... 

Purpose: The aims of the present study were to examine electromyographic (EMG) activity of six bilateral trunk muscles during maximal contraction in three cardinal planes and to determine the direction of contraction that gives maximal activation for each muscle, both for healthy subjects and back-pain patients. Methods: Twenty-eight healthy subjects and 15 back-pain patients performed maximum voluntary contractions in three cardinal planes. Surface EMG signals were recorded from rectus abdominis, external oblique, internal oblique, latissimus dorsi, iliocostalis lumborum, and multifidus bilaterally. Root mean square values of the EMG data were calculated to quantify the amplitude of EMG... 

Introduction: The flexible-bar with a small amplitude of 5 Hz, which transmits vibrations to the trunk, enables the activation of the core muscles that can be used to rehabilitate subjects with low back pain. Two types of exercise direction that can affect trunk muscles of low back pain subjects similar control group are not known. This study aimed to evaluate and compare exercises with two directions of the oscillating flexible poles in people with and without low back pain (LBP). Materials and Methods: Twelve women with Mean±SD age of 28.75±2.92 years, and body mass index (BMI) of 22.31±2.10 kg/m2 and a history of low back pain, and 12 healthy subjects with Mean±SD age of 28.75±2.49 years... 

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...