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

摘要 下背痛（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。暴露于重复的升降任务是下背部损伤的风险。 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， 在2014年至2024年期间，必须制定有效的干预措施，以减少背部疾病的发生率。 老年人在工作场所提升/降低任务中受伤。最近，可穿戴被动背部支撑 外骨骼（BSE）已被提出作为一种有前途的，具有成本效益的干预措施，以减少背部疾病的风险。 通过减轻穿戴者躯干的重量来减轻伤害。尽管我们和其他人已经报道了 被动BSE在年轻人在提升，组装和静态保持任务中的有效性，没有研究 检查了被动BSE在老年人中的有效性和适用性，这些老年人通常较弱， 更多的流动性限制。此外，没有研究报道BSE是否会在治疗过程中减少脊柱负荷。 举重任务，考虑到老年骨质疏松症患者椎骨骨折的可能性，这是一个重要的问题。 因此，为了弥补这些知识差距，本提案的总体目标是进行一次全面的 一种新型被动BSE的生物力学评价，以量化其在老年人背部损伤预防中的效用 在模拟工作场所任务和其他日常活动中。在目标1中，我们将确定BSE的影响 肌肉活动（使用肌电图）、运动学（使用3D运动分析）和受试者报告的 结果（即，在12名受试者中， 老年人在目标2中，我们将采用一种新的胸腰椎多体肌肉骨骼模型 在我们的实验室开发的计算躯干肌肉力量以及脊柱负荷。我们将创建并 验证这些受试者特定肌肉骨骼模型的新版本，这些模型包含BSE， 目标1中所有任务的躯干肌肉力量和压缩脊柱负荷。这些模型将生成 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， 目标1的主题。该项目的结果将为我们开发新一代 老年人的被动BSE，对预防伤害和工作场所行为舒适有效 需要更大力量的任务和日常活动。

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.