B Samadi, M Raison, S Achiche, C Fortin
Department of Mechanical Engineering, Polytechnique Montreal, Canada.
bTechnopole in Pediatric Rehabilitation Engineering, Sainte-Justine UHC, Montreal, Canada.
Comput Methods Biomech Biomed Engin. 2020 Aug;23(10):664-674. doi: 10.1080/10255842.2020.1758075. Epub 2020 May 13.
The intervertebral efforts, i.e., forces and torques, during gait have been recognized as influencing the progression of scoliosis, due to the mechanical modulations according to the Hueter-Volkmann Law. Therefore, these efforts are key variables for posture correction and to control the progression of scoliosis. Using the intervertebral efforts during gait for the clinical follow-ups has never been performed. For this, it would be necessary to identify amongst all these efforts the most relevant ones, which is the objective of this study. A previously developed dynamical model of the human body was used to compute the 3 D intervertebral efforts during the gait of 15 participants with adolescent idiopathic scoliosis (AIS) and 12 typically developed adolescents (TDA). Kolmogorov-Smirnov and Two-sample t-test were applied on the calculated intervertebral efforts and the graphs of intervertebral efforts were studied. Antero-posterior (AP) forces and torques and medio-lateral (ML) forces are the most relevant intervertebral efforts amongst the other efforts in adolescents with AIS during gait. Discussion: Gait analysis in adolescents with AIS based on the relevant intervertebral efforts could be an effective means to follow-up and evaluate the progression of scoliosis during their treatment period. This study highlights the most relevant intervertebral efforts of individuals with AIS during gait. As future work, the identified intervertebral efforts could be implemented in a quantified and visual feedback tool for therapeutic and performance evaluation or interactive sessions in physiotherapy, e.g., via video games for dynamic posture self-correction.
由于遵循胡特-福尔克曼定律的机械调节作用，步态期间的椎间作用力，即力和扭矩，已被认为会影响脊柱侧弯的进展。因此，这些作用力是姿势矫正和控制脊柱侧弯进展的关键变量。在临床随访中从未使用过步态期间的椎间作用力。为此，有必要在所有这些作用力中识别出最相关的作用力，这就是本研究的目的。使用先前开发的人体动力学模型来计算15名青少年特发性脊柱侧弯（AIS）患者和12名发育正常的青少年（TDA）在步态期间的三维椎间作用力。对计算出的椎间作用力应用柯尔莫哥洛夫-斯米尔诺夫检验和双样本t检验，并研究椎间作用力的图表。在AIS青少年步态期间的其他作用力中，前后（AP）力和扭矩以及内外侧（ML）力是最相关的椎间作用力。讨论：基于相关椎间作用力对AIS青少年进行步态分析可能是在其治疗期间随访和评估脊柱侧弯进展的有效手段。本研究突出了AIS个体在步态期间最相关的椎间作用力。作为未来的工作，识别出的椎间作用力可以应用于量化和视觉反馈工具中，用于治疗和性能评估或物理治疗中的互动环节，例如通过电子游戏进行动态姿势自我矫正。
