Spinal loads during activities of daily living: Influences of unilateral lower-limb amputation

日常生活活动中的脊柱负荷：单侧下肢截肢的影响

• 批准号: 9350381
• 负责人: Babak Bazrgari
• 金额: $ 7.28万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2016
• 资助国家: 美国
• 起止时间: 2016-09-10 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9350381
• 关键词: Accounting; Activities of Daily Living; Adopted; Adverse effects; Amputation; Assessment tool; Back; Balance training; Behavior; Biomechanics; Clinical; Complex; Computer Simulation; Data; Data Analyses; Data Collection; Data Set; Databases; Development; Electromyography; Elements; Equilibrium; Ethics; Failure; Fatigue; Foundations; Frequencies; Future; General Population; High Prevalence; Individual; Intervention; Kinetics; Laboratories; Letters; Living Wills; Locomotion; Low Back Pain; Low Prevalence; Lower Extremity; Measurement; Measures; Medical center; Military Personnel; Modeling; Monitor; Motion; Motor; Movement; Muscle; Pathway interactions; Pattern; Persons; Physical activity; Pilot Projects; Play; Population; Probability; Protocols documentation; Quality of life; Recruitment Activity; Rehabilitation therapy; Research; Risk; Role; Speed; Spinal; Standardization; Techniques; Time; Tissues; Training; Translating; Translations; Variant; Vertebral column; Walking; Weight; base; chronic pain; computerized tools; design; effective intervention; experience; in vivo; kinematics; limb amputation; neuromuscular; novel; secondary analysis; service member; vector

Project Summary Despite the higher prevalence of low back pain (LBP) among persons with unilateral lower limb amputation (ULLA) compared to able-bodied individuals, relatively little is known about the fundamental mechanisms underlying this condition. Our research represents a first step toward investigating lower back biomechanics using advanced computational modeling techniques to inform the future design of effective interventions for LBP. Specifically, the impact of trunk neuromuscular patterns adopted by persons with ULLA while performing activities of daily living on spinal loads and the risk of spinal tissue damage will be investigated. This will be achieved via secondary biomechanical analyses of a large set of high-quality kinematics data obtained from individuals with and without ULLA performing the following tasks: 1) walking at self-selected and controlled speeds, 2) sit-to-stand and stand-to-sit, and 3) stairs-up and stairs-down. Our central hypothesis is that, compared to able-bodied individuals, trunk movement strategies adopted by persons with ULLA to cope with physical demands of common daily activities are associated with a complex pattern of internal muscle forces that result in larger loads on the spine and a higher probability for spinal tissue damage. Our dataset draws from the Biomechanics Laboratory at Walter Reed National Military Medical Center (WRNMMC) which has unprecedented access to a large population of service members with ULLA. Using this unique database, we will implement our novel finite element modeling approach to estimate the internal muscle forces (i.e., adopted neuromuscular patterns) needed to perform daily physical activities on the basis of satisfying equilibrium and stability across the entire lumbar spine. Completion of this project will enable us to determine differences in muscle recruitment, as well as the resultant effects on spinal loads and the risk of spinal tissue damage, between persons with and without ULLA. Hence, this pilot project is expected to establish the initial groundwork for future research involving the design of highly specific interventions aimed at trunk neuromuscular behaviors during post-amputation rehabilitation to lessen adverse effects on lower back biomechanics and the potential for LBP.

项目摘要 尽管单侧下肢截肢患者的腰痛（LBP）患病率较高， （ULLA）与身体健全的人相比，对基本机制的了解相对较少 在这种情况下。我们的研究代表了调查下背部生物力学的第一步 使用先进的计算建模技术，为未来设计有效的干预措施提供信息， LBP。具体来说，ULLA患者在表演时采用的躯干神经肌肉模式的影响 将研究日常生活活动对脊柱负荷的影响以及脊柱组织损伤的风险。这将是 通过对大量高质量运动学数据进行二次生物力学分析， 具有和不具有ULLA的个体执行以下任务：1）以自我选择和控制的速度行走 速度，2）坐到站和站到坐，和3）楼梯上和楼梯下。我们的核心假设是， 与身体健全的人相比，ULLA患者采用的躯干运动策略 日常活动的身体需求与复杂的内部肌肉力量模式有关 这导致脊柱上的更大负荷和脊柱组织损伤的更高可能性。我们的数据集 来自沃尔特里德国家军事医学中心（WRNMMC）的生物力学实验室， 前所未有地接触到大量患有ULLA的服役人员。利用这个独特的数据库，我们 将实施我们的新的有限元建模方法来估计内部肌肉力（即，通过 神经肌肉模式）需要在满足平衡的基础上进行日常身体活动， 整个腰椎的稳定性。该项目的完成将使我们能够确定 肌肉募集，以及对脊柱负荷的最终影响和脊柱组织损伤的风险， 有和没有ULLA的人之间。因此，预计该试点项目将建立初步的 为今后的研究奠定基础，包括设计针对躯干的高度具体的干预措施。 截肢后康复过程中的神经肌肉行为，以减少对下背部的不良影响 生物力学和腰痛的可能性。

项目成果

Evolution of Fatigue Damage in the L5-S1 Intervertebral Disc Resulting from Walking Exposures Among Persons with Lower Limb Loss.

下肢丧失者步行暴露导致 L5-S1 椎间盘疲劳损伤的演变。

• DOI: 10.1007/s10439-020-02481-5
• 发表时间: 2020
• 期刊: Annals of biomedical engineering
• 影响因子: 3.8
• 作者: Hendershot,BradD;Bazrgari,Babak
• 通讯作者: Bazrgari,Babak

Trunk muscle forces and spinal loads in persons with unilateral transfemoral amputation during sit-to-stand and stand-to-sit activities.

单侧股骨截肢者在坐站和站站活动期间的躯干肌肉力量和脊柱负荷。

• DOI: 10.1016/j.clinbiomech.2019.02.021
• 发表时间: 2019
• 期刊: Clinical biomechanics (Bristol, Avon)
• 作者: Shojaei,Iman;Hendershot,BradD;Acasio,JulianC;Dearth,ChristopherL;Ballard,Matthew;Bazrgari,Babak
• 通讯作者: Bazrgari,Babak

A model-based approach for estimation of changes in lumbar segmental kinematics associated with alterations in trunk muscle forces.

一种基于模型的方法，用于估计与躯干肌肉力量变化相关的腰椎节段运动学变化。

• DOI: 10.1016/j.jbiomech.2017.09.024
• 发表时间: 2018
• 期刊: Journal of biomechanics
• 影响因子: 2.4
• 作者: Shojaei,Iman;Arjmand,Navid;Meakin,JudithR;Bazrgari,Babak
• 通讯作者: Bazrgari,Babak

Trunk-Pelvis motions and spinal loads during upslope and downslope walking among persons with transfemoral amputation.

股骨截肢者上坡和下坡行走时的躯干-骨盆运动和脊柱负荷。

• DOI: 10.1016/j.jbiomech.2019.109316
• 发表时间: 2019
• 期刊: Journal of biomechanics
• 影响因子: 2.4
• 作者: Acasio,JulianC;Shojaei,Iman;Banerjee,Rajit;Dearth,ChristopherL;Bazrgari,Babak;Hendershot,BradD
• 通讯作者: Hendershot,BradD