Spinal loads and trunk muscles forces during level walking - A combined in vivo and in silico study on six subjects.

During level walking, lumbar spine is subjected to cyclic movements and intricate loading of the spinal discs and trunk musculature. This study aimed to estimate the spinal loads (T12-S1) and trunk muscles forces during a complete gait cycle. Six men, 24-33years walk barefoot at self-selected speed (4-5km/h). 3D kinematics and ground reaction forces were recorded using a motion capturing system and two force plates, implemented in an inverse dynamic musculoskeletal model to predict the spinal loads and trunk muscles forces. Additionally, the sensitivity of the intra-abdominal pressure and lumbar segment rotational stiffness was investigated. Peak spinal loads and trunk muscle forces were between the gait instances of heel strike and toe off. In L4-L5 segment, sensitivity analysis showed that average peak compressive, antero-posterior and medio-lateral shear forces were 130-179%, 2-15% and 1-6%, with max standard deviation (±STD) of 40%, 6% and 3% of the body weight. Average peak global muscles forces were 24-55% (longissimus thoracis), 11-23% (iliocostalis thoracis), 12-16% (external oblique), 17-25% (internal oblique) and 0-8% (rectus abdominus) of body weight whereas, the average peak local muscles forces were 11-19% (longissimus lumborum), 14-31% (iliocostalis lumborum) and 12-17% (multifidus). Maximum±STD of the global and local muscles forces were 13% and 8% of the body weight. Large inter-individual differences were found in peak compressive and trunk muscles forces whereas the sensitivity analysis also showed a substantial variation.