Spinal Compressive Forces in Adolescent Idiopathic Scoliosis With and Without Carrying Loads: A Musculoskeletal Modeling Study

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dc.contributor.authorSchmid, Stefanen
dc.contributor.authorBurkhart, Katelyn A.en
dc.contributor.authorAllaire, Brett T.en
dc.contributor.authorGrindle, Daniel M.en
dc.contributor.authorBassani, Titoen
dc.contributor.authorGalbusera, Fabioen
dc.contributor.authorAnderson, Dennis E.en
dc.contributor.departmentBiomedical Engineering and Mechanicsen
dc.date.accessioned2020-05-13T13:29:09Zen
dc.date.available2020-05-13T13:29:09Zen
dc.date.issued2020-03-03en
dc.description.abstractThe pathomechanisms of curve progression in adolescent idiopathic scoliosis (AIS) remain poorly understood and biomechanical data are limited. A deeper insight into spinal loading could provide valuable information toward the improvement of current treatment strategies. This work therefore aimed at using subject-specific musculoskeletal full-body models of patients with AIS to predict segmental compressive forces around the curve apex and to investigate how these forces are affected by simulated load carrying. Models were created based on spatially calibrated biplanar radiographic images from 24 patients with mild to moderate AIS and validated by comparing predictions of paravertebral muscle activity with reported values from in vivo studies. Spinal compressive forces were predicted during unloaded upright standing as well as standing with external loads of 10, 15, and 20% of body weight (BW) applied to the scapulae to simulate carrying a backpack in the regular way on the back as well as in front of the body and over the shoulder on the concave and convex sides of the scoliotic curve. The predicted muscle activities around the curve apex were higher on the convex side for the erector spinae (ES) and multifidi (MF) muscles, which was comparable to the EMG-based in vivo measurements from the literature. In terms of spinal loading, the implementation of spinal deformity resulted in a 10% increase of compressive force at the curve apex during unloaded upright standing. Apical compressive forces further increased by 50-62% for a simulated 10% BW load and by 77-94% and 103-128% for 15% and 20% BW loads, respectively. Moreover, load-dependent compressive force increases were the lowest in the regular backpack and the highest in the frontpack and convex conditions, with concave side-carrying forces in between. The predictions indicated increased segmental compressive forces during unloaded upright standing, which could be ascribed to the scoliotic deformation. When carrying loads, compressive forces further increased depending on the carrying mode and the weight of the load. These results can be used as a basis for further studies investigating segmental loading in AIS patients during functional activities. Models can thereby be created using the same approach as proposed in this study.en
dc.description.notesThis work was funded by the Swiss National Science Foundation (SNSF, grant no. 178427) and the National Center for Simulation in Rehabilitation Research (NCSRR, sub-award of NIH grant no. 5P2CHD065690).en
dc.description.sponsorshipSwiss National Science Foundation (SNSF)Swiss National Science Foundation (SNSF) [178427]; National Center for Simulation in Rehabilitation Research (NCSRR, sub-award of NIH) [5P2CHD065690]en
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.3389/fbioe.2020.00159en
dc.identifier.issn2296-4185en
dc.identifier.other159en
dc.identifier.pmid32195239en
dc.identifier.urihttp://hdl.handle.net/10919/98235en
dc.identifier.volume8en
dc.language.isoenen
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectOpenSimen
dc.subjectinverse dynamicsen
dc.subjectvalidationen
dc.subjectspinal loadingen
dc.subjectAISen
dc.subjectmuscle asymmetryen
dc.subjectsubject-specific modelingen
dc.subjectbackpack carryingen
dc.titleSpinal Compressive Forces in Adolescent Idiopathic Scoliosis With and Without Carrying Loads: A Musculoskeletal Modeling Studyen
dc.title.serialFrontiers in Bioengineering and Biotechnologyen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.dcmitypeStillImageen

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