Aging, Neuromuscular Behavior, and Risk of Occupational Low Back Pain

衰老、神经肌肉行为和职业性腰痛的风险

• 批准号: 8384076
• 负责人: Babak Bazrgari
• 金额: $ 20.65万
• 依托单位: UNIVERSITY OF KENTUCKY
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8384076
• 关键词: Aging; Neuromuscular; Behavior; Risk; Occupational

DESCRIPTION (provided by applicant): Low back disorders, and low back pain (LBP) in particular, remain as the most common and debilitating work-related musculoskeletal disorder. An increasing LBP prevalence with aging, along with an increasing participation of older individuals at work, motivates a better understanding of underlying mechanisms linking aging with LBP. Abnormal mechanics of the spinal column (i.e., higher spinal loads and lower stability) under various work activities/events can eventually result in LBP. Spine biomechanics depend on the physical demands of a task/event (e.g., external loading), passive trunk mechanical characteristics (e.g., stiffness, and damping), and active mechanical neuromuscular response to equilibrium and stability requirements. Despite current knowledge on the age-related degradation of trunk tissues, the overall resultant changes in trunk mechanical behaviors (TMB - both active and passive) are unknown. It is also unknown how changes in TMB with age can influence spine biomechanics under various work activities/events. On the basis of contemporary causal biomechanical theory and our pilot data, two hypotheses were shaped and will be investigated in the present application. Particularly, linking aging with LBP via causal biomechanical theory suggests that: 1) there are age-related changes in TMB and 2) that these changes adversely affect spine biomechanics. Adverse effects on spine biomechanics are increases in spinal loads and decreases in spine stability for a given task/event (e.g., lifting/slp). Changes in TMB that could adversely affect spine biomechanics may include stiffer trunk, reduced damping, increased reflex latency, and decreased reflex response. The aim of present application is to explore such relationships between aging and spine biomechanics by addressing two specific aims: Aim 1: How does TMB change with age? Aim 2: Do such age-related changes in TMB adversely affect spine biomechanics? TMB and spine biomechanics will be evaluated using a novel set of in vivo experimental methods, including passive torso tests (i.e., stress-relaxation) and sudden loading experiments, coupled with finite element modeling and a series of system identification techniques. The emphasis here is on aspects of the biomechanical theory that link a risk factor (i.e., aging) to abnormal spine mechanics, specifically via the influences of the risk factor on TMB and spine mechanics, and which have not yet been explored. Availability of a new set of powerful tools to comprehensively assess TMB and spine biomechanics will enable us to explore these facets of the causal biomechanical theory for the first time. A better understanding of potential causal mechanisms not only contributes to prevention, but also is critical for efficient rehabilitation and safe return-to-wor of workers with occupational LBP. By quantifying age-related alterations in TMB and the resultant effects on spine biomechanics, we expect to establish a foundation from which to develop and implement age-appropriate controls for LBP. PUBLIC HEALTH RELEVANCE: The potential role of age-related changes in mechanical behaviors of the human trunk, and in the development of low back pain via their adverse effects on spine biomechanics, will be explored in this application. Consistent with the research objectives of NIOSH, the project seeks to investigate and identify the relationships between a risk factor, here aging, and associated occupational diseases and injuries. It also addresses the strategic goal to reduce the incidence and severity of low back pain, which is present within most sectors in the recent National Occupational Research Agenda, and with particular emphasis on older workers.

描述（由申请人提供）：下背部疾病，特别是下背部疼痛（LBP），仍然是最常见的和使人衰弱的工作相关的肌肉骨骼疾病。随着年龄的增长，LBP患病率增加，沿着，老年人越来越多地参与工作，促使人们更好地了解衰老与LBP的潜在机制。脊柱的异常力学（即，更高的脊柱负荷和更低的稳定性）在各种工作活动/事件下可能最终导致LBP。脊柱生物力学取决于任务/事件的身体需求（例如，外部负载），被动躯干机械特性（例如，刚度和阻尼），以及对平衡和稳定性要求的主动机械神经肌肉响应。尽管目前对躯干组织的年龄相关性退化有了解，但躯干力学行为（TMB -主动和被动）的总体变化尚不清楚。还不清楚TMB随年龄的变化如何影响各种工作活动/事件下的脊柱生物力学。在当代因果生物力学理论和我们的试点数据的基础上，形成了两个假设，并将在本申请中进行调查。特别是，通过因果生物力学理论将衰老与LBP联系起来表明：1）TMB存在与年龄相关的变化，2）这些变化对脊柱生物力学产生不利影响。对脊柱生物力学的不利影响是对于给定的任务/事件（例如，提升/slp）。可能对脊柱生物力学产生不利影响的TMB变化可能包括躯干僵硬、阻尼降低、反射潜伏期增加和反射反应降低。本申请的目的是通过解决两个具体目标来探索老化和脊柱生物力学之间的这种关系：目标1：TMB如何随年龄变化？目的2：这种年龄相关的TMB变化是否会对脊柱生物力学产生不利影响？TMB和脊柱生物力学将使用一套新的体内实验方法进行评价，包括被动躯干测试（即，应力松弛）和突然加载实验，再加上有限元建模和一系列的系统识别技术。这里的重点是生物力学理论的各个方面，这些理论将风险因素（即，老化）与脊柱力学异常的关系，特别是通过危险因素对TMB和脊柱力学的影响，这些尚未被探索。一套新的强大的工具来全面评估TMB和脊柱生物力学的可用性将使我们能够首次探索因果生物力学理论的这些方面。更好地了解潜在的因果机制不仅有助于预防，而且对于职业性LBP工人的有效康复和安全返回工作岗位至关重要。通过量化与年龄相关的TMB变化及其对脊柱生物力学的影响，我们期望建立一个基础，以制定和实施与年龄相适应的LBP控制措施。 公共卫生相关性：本申请将探讨年龄相关变化在人体躯干力学行为中的潜在作用，以及通过其对脊柱生物力学的不良影响导致腰痛的发生。与NIOSH的研究目标一致，该项目旨在调查和确定风险因素（此处为衰老）与相关职业病和伤害之间的关系。它还涉及减少腰背痛的发病率和严重程度的战略目标，在最近的国家职业研究议程中，腰背痛存在于大多数部门，特别强调老年工人。