Muscle Activity, Internal Loads, and Stability of the Human Spine in Standing Postures: Combined Model and In Vivo Studies.

摘要

STUDY DESIGN.: The load in active and passive spinal components as well as the stability margin in standing postures +/- load in hands are studied using both computational model and in vivo studies. OBJECTIVE.: To investigate muscle activity, spinal loads, and system stability in standing postures. SUMMARY OF BACKGROUND DATA.: Study of the human trunk yields a redundant system, the satisfactory solution of which remains yet to be done. Existing biomechanical models are often oversimplified or attempt to solve the problem by equilibrium of loads at only one cross section along the spine. METHODS.: In vivo measurements are performed to obtain kinematics (by skin markers) as input data into model and EMG activity (by surface electrodes) for validation of predictions. A thoracolumbar model, while accounting for nonlinear ligamentous properties and trunk musculature, solved the redundant active-passive system by a novel kinematics-based approach that used both the posture and gravity/external loads as inputdata. In both studies, neutral standing posture was considered with weights up to 380 N held in hands with arms extended close to the body either in front or on sides. RESULTS.: Predicted muscle forces were in satisfactory agreement with measured EMG activities. The activity in extensor muscles significantly increased with the load magnitude when held in front, a trend that disappeared as loads were held on sides. Abdominal muscles remained relatively silent. Large compression forces of approximately 2000 N were computed in lower lumbar levels when 380 N was held in front. Coactivity in abdominal muscles markedly increased internal loads and stability margin. CONCLUSION.: A tradeoff exists between lower loads in passive tissues (i.e., tissue risk of failure) and higher stability margins as both increase with greater muscle coactivation. Greater muscle activity observed under load held in front did not necessarily yield larger stability margin as the position of load appeared to play an important role as well.The strength of the proposed model is in realistic consideration of both passive-active structures under postures and gravity/external loads, yielding results that satisfy kinematics, equilibrium, and stability requirements in all directions along the spine.