Iman Shojaei

Persons with unilateral transfemoral amputation experience larger spinal loads during level-ground walking compared to able-bodied individuals

BACKGROUND Persons with lower limb amputation walk with increased and asymmetric trunk motion; a characteristic that is likely to impose distinct demands on trunk muscles to maintain equilibrium and stability of the spine. However, trunk muscle responses to such changes in net mechanical demands, and the resultant effects on spinal loads, have yet to be determined in this population. METHODS Building on a prior study, trunk and pelvic kinematics collected during level-ground walking from 40 males (20 with unilateral transfemoral amputation and 20 matched controls) were used as inputs to a kinematics-driven, nonlinear finite element model of the lower back to estimate forces in 10 global (attached to thorax) and 46 local (attached to lumbar vertebrae) trunk muscles, as well as compression, lateral, and antero-posterior shear forces at all spinal levels. FINDINGS Trunk muscle force and spinal load maxima corresponded with heel strike and toe off events, and among persons with amputation, were respectively 10-40% and 17-95% larger during intact vs. prosthetic stance, as well as 6-80% and 26-60% larger during intact stance relative to controls. INTERPRETATION During gait, larger spinal loads with transfemoral amputation appear to be the result of a complex pattern of trunk muscle recruitment, particularly involving co-activation of antagonistic muscles during intact limb stance; a period when these individuals are confident and likely to use the trunk to assist with forward progression. Given the repetitive nature of walking, repeated exposure to such elevated loading likely increases the risk for low back pain in this population.

Age related differences in mechanical demands imposed on the lower back by manual material handling tasks

The prevalence of low back pain (LBP) increases with age, yet the underlying mechanism(s) responsible for this remains unclear. To explore the role of biomechanical factors, we investigated age-related differences in lower-back biomechanics during sagittally-symmetric simulated manual material handling tasks. For each task, trunk kinematics and mechanical demand on the lower back were examined, from among 60 participants within five equal-sized and gender-balanced age groups spanning from 20 to 70 years old. The tasks involved lowering a 4.5 kg load from an upright standing posture to both knee height and a fixed height and then lifting the load back to the initial upright posture. During these tasks, segmental body kinematics and ground reaction forces were collected using wireless inertial measurement units and a force platform. Overall, older participants completed the tasks with larger pelvic rotation and smaller lumbar flexion. Such adopted trunk kinematics resulted in larger peak shearing demand at the lower back in older vs. younger participants. These results suggest that older individuals may be at a higher risk for developing lower back pain when completing similar manual material handling tasks, consistent with epidemiological evidence for higher risks of occupational low back pain among this cohort.

Analysis of Irregular Structures Composed of Regular and Irregular Parts Using Graph Products

AbstractThe inverse of the stiffness matrices of a large group of repeated and regular structures were previously obtained using graph products. Considering the importance of increasing the speed of the computing process and decreasing the amount of computation and dimension of matrices, this paper presents an efficient algorithm that swiftly solves irregular structures composed of regular and irregular parts. The present method is based on generalizing the solution of regular forms to irregular ones. Here, the irregular structure is a regular structure with some additional nodes (irregular part), in comparison with another kind of irregularity concerned with additional members that was discussed previously. The algorithm is subsequently combined with the algorithm of additional members to allow solving all kinds of irregularity. In addition to irregular structures, the method is practical for design and reanalysis of structures, analyzing the existing structures to which new stories or degrees of freedom...

Age-related differences in trunk intrinsic stiffness

Age-related differences in trunk intrinsic stiffness, as an important potential contributor to spinal stability, were investigated here because of: (1) the role of spinal instability in low back pain (LBP) development; (2) the increasing prevalence of LBP with age, and (3) the increasing population of older people in the workforce. Sixty individuals aged 20-70 years, in five equal-size age groups, completed a series of displacement-controlled perturbation tests in an upright standing posture while holding four different levels of trunk extension efforts. In addition to examining any age-related difference in trunk intrinsic stiffness, the current design assessed the effects of gender, level of effort, and any differences in lower back neuromuscular patterns on trunk intrinsic stiffness. No significant differences in trunk intrinsic stiffness were found between the age groups. However, stiffness was significantly larger among males and increased with the level of extension effort. No influences of differences in neuromuscular pattern were observed. Since the passive contribution of trunk tissues in the upright standing posture is minimal, our values of estimated trunk intrinsic stiffness primarily represent the volitional contribution of the lower back musculoskeletal system to spinal stability. Therefore, it seems unlikely that the alterations in volitional behavior of the lower back musculature, caused by aging (e.g., as reflected in reduced strength), diminish their contributions to the spinal stability.

Viscoelastic Response of the Human Lower Back to Passive Flexion: The Effects of Age

Low back pain is a leading cause of disability in the elderly. The potential role of spinal instability in increasing risk of low back pain with aging was indirectly investigated via assessment of age-related differences in viscoelastic response of lower back to passive deformation. The passive deformation tests were conducted in upright standing posture to account for the effects of gravity load and corresponding internal tissues responses on the lower back viscoelastic response. Average bending stiffness, viscoelastic relaxation, and dissipated energy were quantified to characterize viscoelastic response of the lower back. Larger average bending stiffness, viscoelastic relaxation and dissipated energy were observed among older vs. younger participants. Furthermore, average bending stiffness of the lower back was found to be the highest around the neutral standing posture and to decrease with increasing the lower back flexion angle. Larger bending stiffness of the lower back at flexion angles where passive contribution of lower back tissues to its bending stiffness was minimal (i.e., around neutral standing posture) highlighted the important role of active vs. passive contribution of tissues to lower back bending stiffness and spinal stability. As a whole our results suggested that a diminishing contribution of passive and volitional active subsystems to spinal stability may not be a reason for higher severity of low back pain in older population. The role of other contributing elements to spinal stability (e.g., active reflexive) as well as equilibrium-based parameters (e.g., compression and shear forces under various activities) in increasing severity of low back pain with aging should be investigated in future.

An optimization‐based method for prediction of lumbar spine segmental kinematics from the measurements of thorax and pelvic kinematics

Given measurement difficulties, earlier modeling studies have often used some constant ratios to predict lumbar segmental kinematics from measurements of total lumbar kinematics. Recent imaging studies suggested distribution of lumbar kinematics across its vertebrae changes with trunk rotation, lumbar posture, and presence of load. An optimization-based method is presented and validated in this study to predict segmental kinematics from measured total lumbar kinematics. Specifically, a kinematics-driven biomechanical model of the spine is used in a heuristic optimization procedure to obtain a set of segmental kinematics that, when prescribed to the model, were associated with the minimum value for the sum of squared predicted muscle stresses across all the lower back muscles. Furthermore, spinal loads estimated using the predicted kinematics by the present method were compared with those estimated using constant ratios. Predicted segmental kinematics were in good agreement with those obtained by imaging with an average error of ~10%. Compared with those obtained using constant ratios, predicted spinal loads using segmental kinematics obtained here were in general smaller. In conclusion, the proposed method offers an alternative tool for improving model-based estimates of spinal loads where image-based measurement of lumbar kinematics is not feasible.

Lumbar contribution to the trunk forward bending and backward return; age-related differences

Abstract Age-related differences in lumbar contribution to the trunk motion in the sagittal plane were investigated. Sixty individuals between 20–70 years old in five gender-balanced age groups performed forward bending and backward return with slow and fast paces. Individuals older than 50 years old, irrespective of the gender or pace, had smaller lumbar contribution than those younger than this age. The lumbar contribution to trunk motion was also smaller in female participants than male participants, and under fast pace than under the slow pace. Age-related differences in lumbar contributions suggest the synergy between the active and passive lower back tissues is different between those above and under 50 years old, differences that are likely to affect the lower back mechanics. Therefore, detailed modelling should be conducted in future to find the age-related differences in the lower back mechanics for tasks involving large trunk motion. Practitioner Summary: Lumbar contribution to the sagittal trunk motion was observed to be smaller in individuals above 50 years old than those below this age. This could be an indication of a likely change in the synergy between the active and passive lower back tissues, which may disturb the lower back mechanics.

Age-related differences in the timing aspect of lumbopelvic rhythm during trunk motion in the sagittal plane

Forward bending and backward return of the human trunk in the sagittal plane are associated with a specific lumbopelvic rhythm, which consists of magnitude and timing aspects. In this study, the age-related differences in the timing aspect of lumbopelvic rhythm were investigated using the continuous relative phase method. Specifically, the mean absolute relative phase (MARP) between the thoracic and pelvic motions as well as variation in MARP under repetitive motions, denoted by deviation phase (DP), were characterized in sixty participants between 20 and 70years old. MARP and DP were determined for trunk forward bending and backward return tasks with self-selected slow and fast paces. The MARP and DP were both smaller (p=0.003, p<0.001 respectively) in the older versus younger age participants with no gender-related difference. In fast versus slow pace task, the MARP was smaller (p<0.001) only in forward bending, whereas the DP was smaller (p<0.001) in both the forward bending and backward return. A more in-phase and more stable lumbopelvic rhythm denoted respectively by smaller MARP and DP in older versus younger individuals maybe a neuromuscular strategy to protect the lower back tissues from excessive strain, in order to reduce the risk of injury.

Comparison of lumbo-pelvic kinematics during trunk forward bending and backward return between patients with acute low back pain and asymptomatic controls

Background: Prior studies have reported differences in lumbo‐pelvic kinematics during a trunk forward bending and backward return task between individuals with and without chronic low back pain; yet, the literature on lumbo‐pelvic kinematics of patients with acute low back pain is scant. Therefore, the purpose of this study was set to investigate lumbo‐pelvic kinematics in this cohort. Methods: A case‐control study was conducted to investigate the differences in pelvic and thoracic rotation along with lumbar flexion as well as their first and second time derivatives between females with and without acute low back pain. Participants in each group completed one experimental session wherein they performed trunk forward bending and backward return at self‐selected and fast paces. Findings: Compared to controls, individuals with acute low back pain had larger pelvic range of rotations and smaller lumbar range of flexions. Patients with acute low back pain also adopted a slower pace compared to asymptomatic controls which was reflected in smaller maximum values for angular velocity, deceleration and acceleration of lumbar flexion. Irrespective of participant group, smaller pelvic range of rotation and larger lumbar range of flexion were observed in younger vs. older participants. Interpretation: Reduced lumbar range of flexion and slower task pace, observed in patients with acute low back pain, may be the result of a neuromuscular adaptation to reduce the forces and deformation in the lower back tissues and avoid pain aggravation. HighlightsThe literature on trunk kinematics of patients with acute low back pain is scant.Trunk kinematics in patients with acute low back pain and controls were quantified.Patients had larger pelvic range of rotations and smaller lumbar range of flexions.The adopted trunk kinematics by patients might be a strategy to avoid pain.

A mesh free method using rectangular pre-solved domains using Kronecker products

ABSTRACT In this paper, a mesh free algorithm using large pre-solved domain is developed. Using the largest rectangle inside an arbitrary domain, a pre-solved rectangular domain is established using Kronecker product and graph theory rules. This pre-solved domain is efficiently inserted into the mesh free formulation of partial differential equations (PDEs) and engineering problems to reduce the computational complexity and execution time of the solution. The general solution of the pre-solved rectangular domain is formulated for second-order shape functions. The efficiency of the present algorithm depends on the relative size of the large rectangular domain and the main domain; however, the method remains as efficient as a standard method for even small relative sizes. For adaptive procedures with nonuniform density of distributed points in the domain, smaller (e.g. sub-maximal) rectangular domain can be used. The application of the method is demonstrated using some examples.