Development of a multiscale model of the human lumbar spine for investigation of tissue loads in people with and without
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ORIGINAL PAPER
Development of a multiscale model of the human lumbar spine for investigation of tissue loads in people with and without a transtibial amputation during sit‑to‑stand Jasmin D. Honegger1 · Jason A. Actis1 · Deanna H. Gates2 · Anne K. Silverman1 · Ashlyn H. Munson3 · Anthony J. Petrella1 Received: 29 January 2020 / Accepted: 19 September 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Quantification of lumbar spine load transfer is important for understanding low back pain, especially among persons with a lower limb amputation. Computational modeling provides a helpful solution for obtaining estimates of in vivo loads. A multiscale model was constructed by combining musculoskeletal and finite element (FE) models of the lumbar spine to determine tissue loading during daily activities. Three-dimensional kinematic and ground reaction force data were collected from participants with ( n = 4 ) and without ( n = 4 ) a unilateral transtibial amputation (TTA) during 5 sit-to-stand trials. We estimated tissue-level load transfer from the multiscale model by controlling the FE model with intervertebral kinematics and muscle forces predicted by the musculoskeletal model. Annulus fibrosis stress, intradiscal pressure (IDP), and facet contact forces were calculated using the FE model. Differences in whole-body kinematics, muscle forces, and tissue-level loads were found between participant groups. Notably, participants with TTA had greater axial rotation toward their intact limb ( p = 0.029 ), greater abdominal muscle activity ( p < 0.001 ), and greater overall tissue loading throughout sit-to-stand ( p < 0.001 ) compared to able-bodied participants. Both normalized (to upright standing) and absolute estimates of L4–L5 IDP were close to in vivo values reported in the literature. The multiscale model can be used to estimate the distribution of loads within different lumbar spine tissue structures and can be adapted for use with different activities, populations, and spinal geometries. Keywords Computational biomechanics · Multiscale model · Finite element analysis · Lumbar spine
1 Introduction Low back pain (LBP) is common in the general population and is the leading cause of disability worldwide (Vos et al. 2016). In certain subpopulations who experience more extreme repetitive spine kinematics (e.g., gymnasts, cyclists, and people with a lower-limb amputation), the prevalence of LBP is often attributed to biomechanical factors (Swärd * Anthony J. Petrella [email protected] 1
Department of Mechanical Engineering, Colorado School of Mines, Golden, CO 80401, USA
2
School of Kinesiology, University of Michigan, Ann Arbor, MI 48109, USA
3
Department of Applied Mathematics and Statistics, Colorado School of Mines, Golden, CO 80401, USA
et al. 1991; Wilber et al. 1995; Morgenroth et al. 2010). Repetitive loading of the spine during lumbar movements produces lesions, fractures, injury, and abnormal stresses in innervated elements known to be sources of pain, with examples in
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