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: 2017
• 资助国家: 加拿大
• 起止时间: 2017-01-01 至 2018-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=630166
• 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.

尽管有许多研究表明我们还没有充分了解脊椎，但下腰痛继续给加拿大的工业带来数十亿美元的损失。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，局部生物力学和神经肌肉控制之间的相互作用是合乎逻辑的。然而，很少有研究研究胸椎对腰椎疼痛和损伤发展的影响。复杂的负荷，如轴向旋转的非中性屈/伸姿势，是在执行日常生活和工作任务时在体内经历的典型类型的腰椎负荷，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下腰部损伤的危险因素。通常，工作必须以长时间的坐姿或站姿进行。最近的证据表明，这些暴露会引起疼痛，可能是因为改变了神经肌肉控制(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。虽然人们承认，耐受值可能会被这些因素非线性地修改，但由于缺乏可用的数据，目前的生物力学模型并不能降低这些参数可能存在的风险。我的研究表明，复杂的负荷会增加受伤的风险，腰椎运动、肌肉活动和负荷不稳定不能完全解释腰椎反应，这让我实现了研究计划的长期目标：降低与工作相关的肌肉骨骼疾病的发生率，特别是与重复的复杂脊柱负荷暴露相关的疾病；提供更好的脊柱特征，以便工业工程师、人体工程学家和医疗保健提供者可以将其整合到工作场所的设计方法、风险识别和评估工具以及更有效的治疗和康复计划中。