Quantifying Segmental Spinal Motion during Activities of Daily Living

Back pain is a very common musculoskeletal impairment in most Americans. Average annual occurrence of back pain is reported around 30% of the population and is the most common cause of activity limitation in people younger than 45 years old. Eighty percent of the back pain presents in the lumbar spine. Although this ailment is very prevalent in the American population, there is a lack of empirical evidence supporting the common clinical diagnosis and intervention back pain strategies. The frequency of back pain and the lack of treatment methods were the motivation for this investigation. It is important to better understand spine dynamics during ambulatory tasks of daily activities to identify possible biomechanical mechanisms underlying back pain. Current biomechanical quantification methods for spine dynamics are either too invasive or not detailed enough to fully comprehend detailed spinal movement. Therefore, a non-invasive but detailed procedure to calculate spine dynamics was developed and tested. In this study, multi-segmented spine dynamics (kinematics and kinetics) were calculated during four activities of daily living (level walking (W), obstacle crossing (OC), stair ascent (SA) and stair descent (SD)). Our findings suggested an in-vivo multi-segmented spine surface marker set is able to detect different and repeatable motion patterns during walking among various spinal segments. The sacrum to lower lumbar (SLL) joint had the largest range of motion (ROM) when compared to the other more superior joints (lower lumbar to upper lumbar and upper lumbar to lower thoracic). Furthermore, SA task demonstrated more flexion ROM than both W and SD tasks. In addition to task influence, joints at different spine levels also demonstrated different ROMs, where SLL had a greater ROM than upper lumbar to lower thoracic (ULLT) in the transverse plane. Age was found to not significantly affect the segmental spinal ROM or peak angles. The vertical segmental joint reaction forces were different between tasks, where SD yielded larger vertical reaction forces than W. Overall, findings from this dissertation work were able to show that a multi-segment spine marker system could be an effective tool in determining different spinal dynamics during various activities of daily living. This dissertation includes unpublished co-authored material