Evaluation of a Novel Passive Back-Support Exosuit (BSE) for Back Injury Prevention in Older Adults

新型被动式背部支撑外装（BSE）预防老年人背部损伤的评估

• 批准号: 10154322
• 负责人: Mohammad Mehdi Alemi
• 金额: $ 6.85万
• 依托单位: BETH ISRAEL DEACONESS MEDICAL CENTER
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-04-05 至 2024-04-04
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10154322
• 关键词: 3-Dimensional; Accounting; Activities of Daily Living; Address; Adult; Affect; Age-Years; Area; Attention; Back; Back Injuries; Back Pain; Biomechanics; Body Size; Coupled; Data; Development; Effectiveness; Elderly; Electromyography; Equilibrium; Evaluation; Exertion; Exposure to; Generations; Goals; Health; Health Expenditures; High Prevalence; Hip region structure; Incidence; Individual; Intervention; Knowledge; Laboratories; Life Expectancy; Lifting; Low Back Pain; Lower Back Injury; Measurement; Measures; Metabolic; Methods; Modeling; Modification; Monitor; Morphology; Motion; Muscle; Musculoskeletal; Musculoskeletal Pain; Older Population; Osteoporosis; Outcome; Play; Rehabilitation therapy; Reporting; Risk; Role; Spinal; Spinal Curvatures; Spinal Fractures; Testing; Time; Tissues; Vertebral column; Weight; Work; Workplace; X-Ray Computed Tomography; aged; cost; cost effective intervention; design; disability; effective intervention; efficacy evaluation; exoskeleton; exosuit; functional independence; injury prevention; insight; kinematics; musculoskeletal injury; novel; response; spine bone structure; usability; vertebra body; young adult

ABSTRACT Low back pain (LBP) is a major cause of disability in older adults, leading to reduced functional independence, work capacity, and life expectancy. Exposure to repetitive lifting and lowering tasks is a risk for low back injury. Given that the number individuals aged 65 years and older in the workforce will grow by 60% from 8.3 to 13.4 million between 2014 and 2024, it is essential to develop effective interventions to reduce the incidence of back injury in older adults during workplace lifting/lowering tasks. Recently, wearable passive back-support exoskeletons (BSEs) have been proposed as a promising, cost-effective intervention to reduce the risk of back injuries by offloading the weight of the wearer's torso. Although we and others have reported the potential efficacy of passive BSEs in younger adults during lifting, assembly and static holding tasks, no studies have examined the efficacy and suitability of passive BSEs in older adults, who are generally weaker and may have more mobility limitations. Furthermore, no studies have reported whether BSEs reduce spinal loading during lifting tasks, an important concern given the potential for vertebral fracture in older adults with osteoporosis. Thus, to address these knowledge gaps, the overall objective of this proposal is to conduct a comprehensive biomechanical evaluation of a novel passive BSE to quantify its utility for back injury prevention in older adults during simulated workplace tasks and other routine activities. In Aim 1 we will determine the impact of the BSE on muscle activity (using electromyography), kinematics (using 3D motion analysis), and subject-reported outcomes (i.e., perceived exertion, balance, comfort, and usability) during lifting and static holding tasks in 12 older adults. In Aim 2, we will employ a novel multibody musculoskeletal model of the thoracolumbar spine developed in our laboratory to calculating trunk muscle forces as well as spinal loading. We will create and validate new versions of these subject-specific musculoskeletal models that incorporate the BSE to predict trunk muscle forces and compressive spinal loading for all tasks in Aim 1. These models will be generated using the kinematic data, spine curvature, and muscle morphology measurements obtained via CT scan of subjects from Aim 1. Findings of this project will inform our long-term goal to develop the new generation of passive BSEs for older adults that are comfortable and effective for injury prevention and conduct of workplace tasks and routine activities requiring greater strength.

抽象的 腰痛 (LBP) 是老年人残疾的主要原因，导致功能独立性降低， 工作能力和预期寿命。从事重复性的举起和放下的任务可能会导致腰部受伤。 鉴于劳动力中 65 岁及以上的人数将从 8.3 人增加到 13.4 人，增长 60% 2014 年至 2024 年间，有必要制定有效的干预措施来减少背部疾病的发生 老年人在工作场所升降任务中受伤。最近，可穿戴式被动背部支撑 外骨骼（BSE）已被提议作为一种有前景、具有成本效益的干预措施，以降低背部损伤的风险 由于减轻佩戴者躯干的重量而受伤。尽管我们和其他人已经报告了潜在的 被动疯牛病对年轻人在举起、组装和静态保持任务中的功效，尚无研究 研究了被动疯牛病对老年人的有效性和适用性，老年人通常身体较弱，可能患有 更多的流动性限制。此外，没有研究报告疯牛病是否会减少脊柱负荷 考虑到患有骨质疏松症的老年人可能发生椎骨骨折，举重任务是一个重要的问题。 因此，为了解决这些知识差距，本提案的总体目标是进行全面的 对新型被动 BSE 进行生物力学评估，以量化其预防老年人背部损伤的效用 在模拟工作场所任务和其他日常活动期间。在目标 1 中，我们将确定 BSE 的影响 关于肌肉活动（使用肌电图）、运动学（使用 3D 运动分析）和受试者报告 12 项举重和静态保持任务期间的结果（即感知的用力、平衡、舒适度和可用性） 老年人。在目标 2 中，我们将采用一种新型的胸腰椎多体肌肉骨骼模型 我们实验室开发的用于计算躯干肌肉力量以及脊柱负荷。我们将创造并 验证这些特定于主题的肌肉骨骼模型的新版本，其中包含 BSE 来预测 目标 1 中所有任务的躯干肌肉力量和压缩脊柱负荷。将生成这些模型 使用通过 CT 扫描获得的运动学数据、脊柱曲率和肌肉形态测量值 目标 1 的主题。该项目的研究结果将为我们开发新一代的长期目标提供信息 针对老年人的被动疯牛病，对于伤害预防和工作场所行为来说是舒适且有效的 需要更大力量的任务和日常活动。