Gibbons Andrew, McMullin Paul, Emmett Darian, Mitchell Ulrike H, Fullwood David T, Bowden Anton E
Mechanical Engineering Department, Brigham Young University, United States.
Exercise Science Department, Brigham Young University, United States.
J Mech Behav Biomed Mater. 2025 Dec;172:107161. doi: 10.1016/j.jmbbm.2025.107161. Epub 2025 Aug 13.
There has been an influx of skin-adhered wearables that have begun to show promise for their ability to continuously monitor spinal kinematics based on skin deformation for assessing spine-related problems including low-back pain. However, a lack of information regarding the amount of stretch (or strain) that lumbar skin experiences when wearers perform uniplanar or multiplanar movements makes the designing of these wearables difficult. In this study, skin motion was measured using a relatively dense grid of small reflective markers during 6 uniplanar, 4 multiplanar, and 1 activity of daily living (ADL) movements of increasing functionality. These data were used to compute dynamic, inhomogeneous, anisotropic strain fields of lumbar skin based on large deformation strain theory. Of particular note, macroscopic principal strains were highest in Flexion, reaching averages as high as 103 %, with strain rates up to 151 % per second. Principal strain orientations were movement dependent. Males exhibited higher principal strains than females during Flexion (p = 0.0027) and Sit To Stand (p = 0.0453) motions. Repeatability was high between repetitions, ranging from 71.1 % (extension) to 97.2 % (Sit To Stand motion). Skin strain fields were sensitive to both underlying spinal geometry and dermal collagen fiber orientations. The results of this study are relevant to the precision of spinal-specific wearables when placed on different regions of the lumbar skin and may also have clinical relevance to choice of surgical incision orientation and wound care in the lumbar region.
目前，出现了一批基于皮肤变形来持续监测脊柱运动学以评估包括腰痛在内的脊柱相关问题的皮肤贴合式可穿戴设备，这些设备已初显成效。然而，由于缺乏关于佩戴者进行单平面或多平面运动时腰部皮肤所经历的拉伸（或应变）量的信息，使得这些可穿戴设备的设计变得困难。在本研究中，在6种单平面、4种多平面以及1种功能逐渐增强的日常生活活动（ADL）运动过程中，使用相对密集的小反光标记网格来测量皮肤运动。基于大变形应变理论，利用这些数据计算腰部皮肤的动态、非均匀、各向异性应变场。特别值得注意的是曲度时的宏观主应变最高，平均高达103%，应变率每秒高达151%。主应变方向取决于运动。在曲度（p = 0.0027）和从坐到站（p = 0.0453）运动中，男性表现出比女性更高的主应变。重复测量之间的重复性很高，范围从71.1%（伸展）到97.2%（从坐到站运动）。皮肤应变场对潜在的脊柱几何形状和真皮胶原纤维方向都很敏感。本研究结果与脊柱专用可穿戴设备放置在腰部皮肤不同区域时的精度相关，也可能与腰椎区域手术切口方向的选择和伤口护理具有临床相关性。
