Thoracic and Lumbar Spine Biomechanics

胸椎和腰椎生物力学

• 批准号: 355689-2012
• 负责人: Drake, Janessa
• 金额: $ 2.11万
• 依托单位: York University
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2014
• 资助国家: 加拿大
• 起止时间: 2014-01-01 至 2015-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=549802
• 关键词: Thoracic; Lumbar; Spine; Biomechanics

Low back pain continues to cost Canadian industries billions of dollars despite numerous research studies, which suggests that we do not yet adequately understand the spine. Given that the spine is a flexible multisegment column that requires active muscle and passive tissues to maintain its form, it is logical that there would be interplay across regional biomechanics and neuromuscular control. However, very few studies have investigated the thoracic spine influences the development of pain and injury in the lumbar spine. Complex loading, such as axial rotation with non-neutral flexion/extension postures, is the typical type of lumbar spine loading experienced in-vivo when performing routine activities of daily living and work tasks yet rarely used in research. These types of exposures have been recognized as risk factors for developing low back injuries in epidemiological studies. Often work must be performed in a prolonged seated or standing postures. Recent evidence demonstrates that these exposures can elicit pain, likely from altered neuromuscular control (i.e. co-activation). This work also notes a difference between the responses of men and women. While it is acknowledged that tolerance values may be modified non-linearly by these factors, current biomechanical models do not mitigate the risk with these parameters likely, due to a lack of usable data. My research that has shown complex loading increases risk of injury, and that lumbar spine motion, muscle activity, and load instability cannot fully explain lumbar responses, has led me to the long term objective of my research program: to reduce the incidence of work-related musculoskeletal disorders, particularly those associated with repetitive complex spine loading exposures; and to provide an improved characterization of the spine that industrial engineers, ergonomists, and health care providers can integrate into workplace design methods, risk identification and assessment tools, and more effective treatment and rehabilitative programs.

尽管有大量的研究表明，我们对脊柱的了解还不够充分，但腰痛仍在继续耗费加拿大工业数十亿美元。鉴于脊柱是一个灵活的多节段柱，需要主动肌肉和被动组织来维持其形状，因此在区域生物力学和神经肌肉控制之间存在相互作用是合乎逻辑的。然而，很少有研究调查胸椎对腰椎疼痛和损伤发展的影响。复杂负荷，如轴向旋转和非中性屈曲/伸展姿势，是在日常生活和工作任务中进行常规活动时在体内经历的典型腰椎负荷类型，但在研究中很少使用。在流行病学研究中，这些类型的暴露已被认为是发生腰背部损伤的危险因素。通常工作必须以长时间的坐姿或站立姿势进行。最近的证据表明，这些暴露可能引起疼痛，可能是由于神经肌肉控制的改变（即共同激活）。这项研究还注意到男性和女性的反应存在差异。虽然人们认识到这些因素可能会非线性地改变容差值，但由于缺乏可用的数据，目前的生物力学模型可能无法减轻这些参数的风险。我的研究表明，复杂的负荷增加了受伤的风险，腰椎运动、肌肉活动和负荷不稳定不能完全解释腰椎的反应，这使我的研究计划的长期目标：减少与工作有关的肌肉骨骼疾病的发病率，特别是那些与重复性复杂的脊柱负荷暴露有关的疾病；并提供脊柱的改进特征，工业工程师、人体工程学专家和卫生保健提供者可以将其整合到工作场所设计方法、风险识别和评估工具以及更有效的治疗和康复计划中。