Sharif Digital Repository

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... 

The purpose of this work is to develop a computational model to describe the task of sit to stand (STS). STS is an important movement skill which is frequently performed in human daily activities, but has rarely been studied from the perspective of optimization principles. In this study, we compared the recorded trajectories of STS with the trajectories generated by several conventional optimization-based models (i.e., minimum torque, minimum torque change and kinetic energy cost models) and also with the trajectories produced by a novel multi-phase cost model (MPCM). In the MPCM, we suggested that any complex task, such as STS, is decomposable into successive motion phases, so that each... 

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... 

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... 

The objective of this study was to investigate the effects of Abdominal Hollowing (AH) maneuver on External Oblique (EO), Internal Oblique (IO) and Transversus Abdominis (TrA) muscles in both healthy men and women during the two postures of supine and upright standing. The study was conducted on 43 asymptomatic volunteers (22 males and 21 females) aged 19-44 (27.8 ± 6.4) years. Rehabilitative Ultrasonic Imaging (RUSI) was simultaneously performed to measure muscle thickness in both rest and during AH maneuvers while activation of the TrA during AH was controlled by Pressure Biofeedback (PBF) device. Mixed-model ANOVA with repeated measures design, and Pearson correlation tests were used to... 

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... 

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... 

Knowledge about the non-linear dynamical pattern of postural sway may provide important insights into the adaptability (flexibility) of human postural control in response to everyday stresses imposed on the body. A commonly used non-linear tool, i.e. recurrence quantification analysis, was chosen to investigate the effect of prior anterior cruciate ligament injury on the deterministic pattern of postural sway under different conditions of postural and cognitive difficulty. In double leg stance, as postural difficulty increased from open-eyes to closed-eyes and rigid-surface to foam-surface, the centre of pressure regularity (%determinism) increased as well. In comparison to healthy... 

Background: Foot orthoses are used to optimize lower extremity function and can improve postural stability by enhancing the afferent somatosensory feedback available to the central nervous system. Objective: The aim of this review was to evaluate the effect of foot orthoses on balance control in older subjects. Study design: Systematic review. Methods: The search strategy was based on the Population Intervention Comparison Outcome method. A search was performed in PubMed, Science Direct, Google Scholar, and ISI Web of Knowledge databases by using selected keywords. A total of 22 articles were selected for final evaluation. Results: The results demonstrated that older people should be advised... 

Background Although anxiety is a common non-motor outcome of Parkinson's disease (PD) affecting 40% of patients, little attention has been paid so far to its effects on balance impairment and postural control. Improvement of postural control through focusing on the environment (i.e. external focus) has been reported, but the role of anxiety, as a confounding variable, remains unclear. Objectives This study aimed to investigate the influence of anxiety and attentional focus instruction on the standing postural control of PD patients. Methods Thirty-four patients with PD (17 with high anxiety (HA-PD) and 17 with low anxiety (LA-PD)), as well as 17 gender- and age-matched healthy control... 

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... 

Background: Impaired postural control in Parkinson's disease (PD) seriously compromises life quality. Although balance training improves mobility and postural stability, lack of quantitative studies on the neurophysiological mechanisms of balance training in PD impedes the development of patient-specific therapies. We evaluated the effects of a balance-training program using functional balance and mobility tests, posturography, and a postural control model. Methods: Center-of-pressure (COP) data of 40 PD patients before and after a 12-session balance-training program, and 20 healthy control subjects were recorded in four conditions with two tasks on a rigid surface (R-tasks) and two on foam.... 

The characteristics of postural sway were assessed in quiet standing under three different postural task conditions in 14 patients with nonspecific chronic low back pain and 12 healthy subjects using linear and nonlinear center of pressure parameters. The linear parameters consisted of area, the mean total velocity, sway amplitude, the SD of velocity, and the phase plane portrait. The nonlinear parameters included the Lyapunov exponent, sample entropy, and the correlation dimension. The results showed that the amount of postural sway was higher in the patients with low back pain compared with the healthy subjects. Assessing the nonlinear parameters of the center of pressure showed a lower... 

Spinal posture including thorax/pelvis orientations as well as loads on the intervertebral discs are crucial parameters in biomechanical models and ergonomics to evaluate the risk of low back injury. In vivo measurement of spinal posture toward estimation of spine loads requires the common motion capture techniques and laboratory instruments that are costly and time-consuming. Hence, a closed loop algorithm including an artificial neural network (ANN) and fuzzy logic is proposed here to predict the L5–S1 segment loads and thorax/pelvis orientations in various 3D reaching activities. Two parts namely a fuzzy logic strategy and an ANN from this algorithm; the former, developed based on the... 

Irrespective of the lifting technique (squat or stoop), the lumbar spine posture (more kyphotic versus more lordotic) adopted during lifting activities is an important parameter affecting the active-passive spinal load distribution. The advantages in either posture while lifting remains, however, a matter of debate. To comprehensively investigate the role on the trunk biomechanics of changes in the lumbar posture (lordotic, free or kyphotic) during forward trunk flexion, validated musculoskeletal and finite element models, driven by in vivo kinematics data, were used to estimate detailed internal tissue stresses-forces in and load-sharing among various joint active-passive tissues. Findings... 

Central nervous system (CNS) uses vision, vestibular, and somatosensory information to maintain body stability. Research has shown that there is more lumbar proprioception error among low back pain (LBP) individuals as compared to healthy people. In this study, two groups of 20 healthy people and 20 non-specific low back pain (NSLBP) participants took part in this investigation. This investigation focused on somatosensory sensors and in order to alter proprioception, a vibrator (frequency of 70 Hz, amplitude of 0.5 mm) was placed on the soleus muscle area of each leg and two vibrators were placed bilaterally across the lower back muscles. Individuals, whose vision was occluded, were placed... 

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°,... 

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... 

Although the application of nonlinear tools including recurrence quantification analysis (RQA) has increasingly grown in the recent years especially in balance-disordered populations, there have been few studies which determine their measurement properties. Therefore, a methodological study was performed to estimate the intersession and intrasession reliability of some dynamic features provided by RQA for nonlinear analysis of center of pressure (COP) signals recorded during quiet standing in a sample of patients with musculoskeletal disorders (MSDs) including low back pain (LBP), anterior cruciate ligament (ACL) injury and functional ankle instability (FAI). The subjects completed postural... 

Motor abundance allows reliability of motor performance despite its variability. The nature of this variability provides important information on the flexibility of control strategies. This feature of control may be affected by low back pain (LPB) and trunk flexion/extension conditions. Goal equivalent manifold (GEM) analysis was used to quantify the ability to exploit motor abundance during repeated trunk flexion/extension in healthy individuals and people with chronic non-specific LBP (CNSLBP). Kinematic data were collected from 22 healthy volunteers and 22 CNSLBP patients during metronomically timed, repeated trunk flexion/extension in three conditions of symmetry, velocity, and loading;...