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.

尽管进行了许多研究，但腰痛仍继续使加拿大行业数十亿美元，这表明我们尚未充分理解脊柱。鉴于脊柱是一个灵活的多段柱，需要活跃的肌肉和被动组织才能保持其形式，因此逻辑上会在区域生物力学和神经肌肉控制之间进行相互作用。但是，很少有研究研究胸椎影响腰椎疼痛和损伤的发展。复杂的载荷，例如具有非中性屈曲/延伸姿势的轴向旋转，是典型的腰椎载荷类型，当时在进行日常生活和工作任务的常规活动中，但很少在研究中使用。在流行病学研究中，这些类型的暴露被认为是发展下背部损伤的危险因素。通常必须在长时间或站立的姿势中进行工作。最近的证据表明，这些暴露会引起疼痛，这可能是由于神经肌肉对照改变（即共激活）。这项工作还指出了男女反应之间的区别。尽管人们承认，这些因素可能会非线性地修改公差值，但由于缺乏可用的数据，当前的生物力学模型不会通过这些参数降低风险。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性无法完全解释腰椎反应，这使我达到了研究计划的长期目标：减少与工作相关的肌肉骨骼疾病的发生率，尤其是与重复性复杂的脊柱复杂脊柱负荷相关的那些；为了改善工业工程师，人体工程师和医疗保健提供者可以融入工作场所设计方法，风险识别和评估工具以及更有效的治疗和康复计划中的脊柱表征。