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

摘要 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。暴露在重复的抬起和放下的任务中是下背部受伤的风险。 鉴于65岁及以上劳动人口的数量将增长60%，从8.3增加到13.4 在2014至2024年期间，有必要制定有效的干预措施，以减少背痛的发生率 老年人在工作场所升降任务中的受伤情况。最近，可穿戴式被动靠背 外骨骼(BSES)已被认为是一种有前途的、经济有效的降低背部风险的干预措施。 通过减轻佩戴者躯干重量而造成的伤害。尽管我们和其他人报告了潜在的 被动BSES对年轻人在举起、装配和静态握持任务中的疗效，目前还没有研究 检查了被动式BSES在老年人中的有效性和适宜性，老年人通常较弱，可能有 更多的移动性限制。此外，还没有研究报道BSES是否可以减少脊柱负荷 考虑到患有骨质疏松症的老年人脊椎骨折的可能性，搬运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 一种新型被动式BSE的生物力学评估，以量化其在老年人预防背部损伤中的作用 在模拟工作场所任务和其他日常活动期间。在目标1中，我们将确定疯牛病的影响 关于肌肉活动(使用肌电图法)、运动学(使用3D运动分析)和报告对象 在举起和静态握持任务中的结果(即感觉到的用力、平衡、舒适性和可用性) 上了年纪的人。在目标2中，我们将使用一种新的胸腰椎多体肌肉骨骼模型。 由我们实验室开发，用于计算躯干肌力和脊柱负荷。我们将创建和 验证这些特定于受试者的肌肉骨骼模型的新版本，这些模型结合了BSE来预测 目标1中所有任务的躯干肌力和脊柱压缩负荷。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 这个项目的发现将为我们开发新一代 适用于老年人的被动式BSES，对工作场所的伤害预防和行为舒适有效 需要更大力量的任务和例行活动。

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.