Sharif Digital Repository

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... 

Background: Low back pain (LBP) is known as one of the most common workrelated musculoskeletal disorders. Spinal cumulative loads (CLs) during manual material handling (MMH) tasks are the main risk factors for LBP. However, there is no valid and reliable quantitative lifting analysis tool available for quantifying CLs among Iranian workers performing MMH tasks. Objective: This study aimed to investigate the validity and inter-rater reliability of a posture-matching load assessment tool (PLAT) for estimating the L5-S1 static cumulative compression (CC) and shear (CS) loads based on predictive regression equations. Material and Methods: This experimental study was conducted among six... 

Manual material handling (MMH) is considered as one of the main contributors to low back pain. While males traditionally perform MMH tasks, recently the number of females who undertake these physically-demanding activities is also increasing. To evaluate the risk of mechanical injuries, the majority of previous studies have estimated spinal forces using different modeling approaches that mostly focus on male individuals. Notable sex-dependent differences have, however, been reported in torso muscle strength and anatomy, segmental mass distribution, as well as lifting strategy during MMH. Therefore, this study aimed to use sex-specific models to estimate lumbar spinal and muscle forces during... 

Excessive loads on the human spine is recognized as a risk factor for back injuries/pain. Various lifting analysis tools such as musculoskeletal models, regression equations and NIOSH (National Institute for Occupational Safety and Health) lifting equation (NLE) have been proposed to evaluate and mitigate associated risks during manual material handling activities. Present study aims to compare predicted spinal loads from 5 different lifting analysis tools as well as to critically evaluate the NIOSH recommended weight limit (RWL). Spinal loads were estimated under different symmetric/asymmetric lifting tasks in which hand-load mass at each task was set based on RWL from NLE. Estimated... 

Workplace safety assessment, personalized treatment design and back pain prevention programs require accurate subject-specific estimation of spinal loads. Since no noninvasive method can directly estimate spinal loads, easy-to-use regression equations that are constructed based on the results of complex musculoskeletal models appear as viable alternatives. Thus, we aim to develop subject-specific regression equations of L4-L5 and L5-S1 shear and compression forces during various symmetric/asymmetric tasks using a nonlinear personalized finite element musculoskeletal trunk model. Kinematics and electromyography (EMG) activities of 19 young healthy subjects were collected during 64 different... 

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... 

Maximum voluntary exertion (MVE) tasks quantify trunk strength and maximal muscle electromyography (EMG) activities with both clinical and biomechanical implications. The aims here are to evaluate the performance of an existing trunk musculoskeletal model, estimate maximum muscle stresses and spinal forces, and explore likely differences between males and females in maximum voluntary exertions. We, therefore, measured trunk strength and EMG activities of 19 healthy right-handed subjects (9 females and 10 males) in flexion, extension, lateral and axial directions. MVEs for all subjects were then simulated in a subject-specific trunk musculoskeletal model, and estimated muscle activities were... 

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... 

Epidemiological studies are divided over the causative role of body weight (BW) in low back pain. Biomechanical modeling is a valuable approach to examine the effect of changes in BW on spinal loads and risk of back pain. Changes in BW have not been properly simulated by previous models as associated alterations in model inputs on the musculature and moment arm of gravity loads have been neglected. A detailed, multi-joint, scalable model of the thoracolumbar spine is used to study the effect of BW (varying at five levels, i.e., 51, 68, 85, 102, and 119kg) on the L5-S1 spinal loads during various static symmetric activities while scaling moment arms and physiological cross-sectional areas of... 

Various hybrid EMG-assisted optimization (EMGAO) approaches are commonly used to estimate muscle forces and joint loads of human musculoskeletal systems. Use of EMG data and optimization enables the EMGAO models to account for inter- and intra-individual variations in muscle recruitments while satisfying equilibrium requirements. Due to implications in ergonomics/prevention and rehabilitation/treatment managements of low-back disorders, there is a need to evaluate existing approaches. The present study aimed to compare predictions of three different EMGAO and one stability-based optimization (OPT) approaches for trunk muscle forces, spinal loads, and stability. Identical measured... 

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... 

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... 

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... 

Background: Activities involving axial trunk rotations/moments are common and are considered as risk factors for low back disorders. Previous biomechanical models have failed to accurately estimate the trunk maximal axial torque exertion. Moreover, the trunk stability under maximal torque exertions has not been investigated. Methods: A nonlinear thoracolumbar finite element model along with the Kinematics-driven approach is used to study biomechanics of maximal axial torque generation during upright standing posture. Detailed anatomy of trunk muscles with six distinct fascicles for each abdominal oblique muscle on each side is considered. While simulating an in vivo study of maximal axial... 

In spite of earlier experimental and modeling studies, the relative role of the intra-abdominal pressure (IAP) in spine mechanics has remained controversial. This study employs simple analytical and finite element (FE) models of the spine and its surrounding structures to investigate the contribution of IAP to spinal loading and stability. The analytical model includes the abdominal cavity surrounded by muscles, lumbar spine, rib cage and pelvic ring. The intra-abdominal cavity and its surrounding muscles are represented by a thin deformable cylindrical membrane. Muscle activation levels are simulated by changing the Young's modulus of the membrane in the direction of muscle fibers, yielding... 

Background Iatrogenic injuries to paraspinal muscles during posterior lumbar surgery cause a reduction in their contractile cross-sectional area and thus presumably their postoperative activation. This study investigates the effect of such intraoperative injuries on postoperative patterns of muscle activations and spinal loads during various activities using a combined modeling and in vivo MR imaging approach. Methods A three-dimensional, multi-joint, musculoskeletal model was used to estimate pre- and postoperative muscle forces and spinal loads under various activities in upright and flexed postures. According to our in vivo pre- and postoperative (∼ 6 months) measurements in six patients...