Sharif Digital Repository

Due to the complexity of the human spinal motion segments, the intervertebral joints are often simulated in the musculoskeletal trunk models as pivots thus allowing no translational degrees of freedom (DOFs). This work aims to investigate, for the first time, the effect of such widely used assumption on trunk muscle forces, spinal loads, kinematics, and stability during a number of static activities. To address this, the shear deformable beam elements used in our nonlinear finite element (OFE) musculoskeletal model of the trunk were either substantially stiffened in translational directions (SFE model) or replaced by hinge joints interconnected through rotational springs (HFE model). Results... 

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... 

In this study the effects of using different musculoskeletal models on load-displacement behavior of FE models of the human lumbar spine under external loads and moments have been analyzed in terms of equilibrium and clinical stability. A simplified and a complex architecture of muscles have been integrated to FE based models of lumbar spine and were loaded to simulate the load carrying behavior of human lumbar spine in flexion, extension and lateral bending. The displacement values as well as muscle forces have been computed and compared in both cases using optimization methods with different cost functions. The models showed similar kinematics in pure flexion but the simplified model... 

Adjacent segment disorders are prevalent in patients following a spinal fusion surgery. Postoperative alterations in the adjacent segment biomechanics play a role in the etiology of these conditions. While experimental approaches fail to directly quantify spinal loads, previous modeling studies have numerous shortcomings when simulating the complex structures of the spine and the pre/postoperative mechanobiology of the patient. The biomechanical effects of the L4–L5 fusion surgery on muscle forces and adjacent segment kinetics (compression, shear, and moment) were investigated using a validated musculoskeletal model. The model was driven by in vivo kinematics for both preoperative (intact or... 

Purpose: This study exploits a novel musculoskeletal finite element (MS-FE) spine model to evaluate the post-fusion (L4–L5) alterations in adjacent segment kinetics. Methods: Unlike the existing MS models with idealized representation of spinal joints, this model predicts stress/strain distributions in all passive tissues while organically coupled to a MS model. This generic (in terms of musculature and material properties) model uses population-based in vivo vertebral sagittal rotations, gravity loads, and an optimization algorithm to calculate muscle forces. Simulations represent individuals with an intact L4–L5, a preoperative severely degenerated L4–L5 (by reducing the disc height by ~... 

Biomechanical models of the spine either simplify intervertebral joints (using spherical joints or deformable beams) in musculoskeletal (MS) or overlook musculature in geometrically-detailed passive finite element (FE) models. These distinct active and passive models therefore fail to determine in vivo stresses and strains within and load-sharing among the joint structures (discs, ligaments, and facets). A novel hybrid active–passive spine model is therefore developed in which estimated trunk muscle forces from a MS model for in vivo activities drive a mechanically-equivalent passive FE model to quantify in vivo T12–S1 compression/shear loads, intradiscal pressures (IDP), centers of rotation... 

Traditional load-control musculoskeletal and finite element (FE) models of the spine fail to accurately predict in vivo intervertebral joint loads due mainly to the simplifications and assumptions when estimating redundant trunk muscle forces. An alternative powerful protocol that bypasses the calculation of muscle forces is to drive the detailed FE models by image-based in vivo displacements. Development of subject-specific models, however, both involves the risk of extensive radiation exposures while imaging in supine and upright postures and is time consuming in terms of the reconstruction of the vertebrae, discs, ligaments, and facets geometries. This study therefore aimed to introduce a... 

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... 

Spine musculoskeletal (MS) models make simplifying assumptions on the intervertebral joint degrees-of-freedom (rotational and/or translational), representation (spherical or beam-like joints), and properties (linear or nonlinear). They also generally neglect the realistic structure of the joints with disc nuclei/annuli, facets, and ligaments. We aim to develop a novel MS model where trunk muscles are incorporated into a detailed finite element (FE) model of the ligamentous T12-S1 spine thus constructing a gold standard coupled MS-FE model. Model predictions are compared under some tasks with those of our earlier spherical joints, beam joints, and hybrid (uncoupled) MS-FE models. The coupled... 

An essential input to the musculoskeletal (MS) trunk models that estimate muscle and spine forces is kinematics of the thorax, pelvis, and lumbar vertebrae. While thorax and pelvis kinematics are usually measured via skin motion capture devices (with inherent errors on the proper identification of the underlying bony landmarks and the relative skin-sensor-bone movements), those of the intervening lumbar vertebrae are commonly approximated at fixed proportions based on the thorax-pelvis kinematics. This study proposes an image-based kinematics measurement approach to drive subject-specific (musculature, geometry, mass, and center of masses) MS models. Kinematics of the thorax, pelvis, and... 

Recent advances in medical imaging techniques have allowed pure displacement-control trunk models to estimate spinal loads with no need to calculate muscle forces. Sensitivity of these models to the errors in post-imaging evaluation of displacements (reported to be ∼0.4–0.9° and 0.2–0.3 mm in vertebral displacements) has not yet been investigated. A Monte Carlo analysis was therefore used to assess the sensitivity of results in both musculoskeletal (MS) and passive finite element (FE) spine models to errors in measured displacements. Six static activities in upright standing, flexed, and extended postures were initially simulated using a force-control hybrid MS-FE model. Computed vertebral... 

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... 

Two artificial neural networks (ANNs) are constructed, trained, and tested to map inputs of a complex trunk finite element (FE) model to its outputs for spinal loads and muscle forces. Five input variables (thorax flexion angle, load magnitude, its anterior and lateral positions, load handling technique, i.e., one- or two-handed static lifting) and four model outputs (L4-L5 and L5-S1 disc compression and anterior-posterior shear forces) for spinal loads and 76 model outputs (forces in individual trunk muscles) are considered. Moreover, full quadratic regression equations mapping input-outputs of the model developed here for muscle forces and previously for spine loads are used to compare the... 

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... 

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... 

Muscle force partitioning methods and musculoskeletal system simplifications are key modeling issues that can alter outcomes, and thus change conclusions and recommendations addressed to health and safety professionals. A critical modeling concern is the use of single-joint equilibrium to estimate muscle forces and joint loads in a multi-joint system, an unjustified simplification made by most lumbar spine biomechanical models. In the context of common occupational tasks, an EMG-assisted optimization method (EMGAO) is modified in this study to simultaneously account for the equilibrium at all lumbar joints (M-EMGAO). The results of this improved approach were compared to those of its... 

The 1991 NIOSH Lifting Equation (NLE) is widely used to assess the risk of injury to spine by providing estimates of the recommended weight limit (RWL) in hands. The present study uses the predictive equations developed based on a detailed trunk musculoskeletal biomechanical model to verify whether the RWL generates L5-S1 loads within the limits (e.g., 3400N for compression recommended by NIOSH and 1000N for shear recommended in some studies). Fifty lifting activities are simulated here to evaluate the RWL by the NLE and the L5-S1 loads by the predictive equations. In lifting activities involving moderate to large forward trunk flexion, the estimated RWL generates L5-S1 spine loads exceeding... 

A novel optimisation algorithm is developed to predict coactivity of abdominal muscles while accounting for both trunk stability via the lowest buckling load (Pcr) and tissue loading via the axial compression (Fc). A nonlinear multi-joint kinematics-driven model of the spine along with the response surface methodology are used to establish empirical expressions for Pcr and Fc as functions of abdominal muscle coactivities and external load magnitude during lifting in upright standing posture. A two-component objective function involving Fc and Pcr is defined. Due to opposite demands, abdominal coactivities that simultaneously maximise Pcr and minimise Fc cannot exist. Optimal solutions are... 

A number of geometrically-detailed passive finite element (FE) models of the lumbar spine have been developed and validated under in vitro loading conditions. These models are devoid of muscles and thus cannot be directly used to simulate in vivo loading conditions acting on the lumbar joint structures or spinal implants. Gravity loads and muscle forces estimated by a trunk musculoskeletal (MS) model under twelve static activities were applied to a passive FE model of the L4-L5 segment to estimate load sharing among the joint structures (disc, ligaments, and facets) under simulated in vivo loading conditions. An equivalent follower (FL), that generates IDP equal to that generated by muscle...