Project

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Using subject-specific musculoskeletal spine models to predict segmental loading and individual muscle forces during functional activities in adolescents with idiopathic scoliosis

Applicant Schmid Stefan
Number 178427
Funding scheme Early Postdoc.Mobility
Research institution Beth Israel Deaconess Medical Center Harvard Medical School
Institution of higher education Institution abroad - IACH
Main discipline Structural Research
Start/End 01.08.2018 - 31.07.2019
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Keywords (7)

Simulation; Modeling; AIS; Biomechanics; OpenSim; Activities of daily living; Spinal deformity

Lay Summary (German)

Lead
Wirbelsäulendeformationen wie die idiopathische Adoleszentenskoliose können für die Betroffenen erhebliche funktionelle Einschränkungen im Alltag darstellen. Bis zum heutigen Zeitpunkt sind Ursprung und Verlauf dieser Erkrankung jedoch grösstenteils unklar, was negative Auswirkungen auf die Effektivität von konservativen Behandlungsansätzen hat. Dieses Projekt trägt dazu bei, die Biomechanik solcher Deformationen besser zu verstehen.
Lay summary

Inhalt und Ziele des Forschungsprojekts

Die idiopathische Adoleszentenskoliose ist eine Deformation der Wirbelsäule, die bei ca. 5% der Bevölkerung zu Beginn des Jugendalters auftritt. Ursprung und Verlauf bleiben bis heute grösstenteils ungeklärt. Bei der Behandlung liegt das Aufhalten der Deformation mittels gezielten physiotherapeutischen Übungen im Zentrum. Vielfach sind diese Übungen jedoch aufgrund des mangelnden Grundlagewissens nicht effektiv genug und es folgen aufwändige Korsett-Therapien und chirurgische Stabilisierungen.

Dieses Projekt zielt darauf ab, ein besseres Verständnis der Biomechanik solcher Deformationen zu erlangen. In einer ersten Phase werden dazu patientenspezifische Computermodelle erstellt, welche es erlauben, Bewegungen, Belastungen und individuelle Muskelkräfte in der Wirbelsäule zu analysieren. In einer zweiten Phase werden die Modelle dann verwendet, um die Wirbelsäule von 10 Patienten während alltäglichen Aktivitäten zu untersuchen.

 

Wissenschaftlicher und gesellschaftlicher Kontext des Forschungsprojekts

Dieses Projekt wird einen Beitrag zum besseren Verständnis von Ursprung und Verlauf der idiopathischen Adoleszentenskoliose leisten. Dies ist wichtig um konservative Behandlungsansätze zu optimieren sowie aufwändige Korsett-Therapien und operative Eingriffe zu verhindern.
Direct link to Lay Summary Last update: 18.12.2017

Responsible applicant and co-applicants

Publications

Publication
Musculoskeletal full-body models including a detailed thoracolumbar spine for children and adolescents aged 6-18 years
Schmid Stefan, Burkhart Katelyn A., Allaire Brett T., Grindle Daniel, Anderson Dennis E. (2019), Musculoskeletal full-body models including a detailed thoracolumbar spine for children and adolescents aged 6-18 years, in Journal of Biomechanics.

Collaboration

Group / person Country
Types of collaboration
I.R.C.C.S. Istituto Ortopedico Galeazzi, Milan, Italy Italy (Europe)
- in-depth/constructive exchanges on approaches, methods or results

Scientific events

Active participation

Title Type of contribution Title of article or contribution Date Place Persons involved
Conference of the European Society of Biomechanics (ESB) 2019 Talk given at a conference Musculoskeletal full-body models including a detailed thoracolumbar spine for children and adolescents 07.07.2019 Wien, Austria Schmid Stefan;
3rd Spine Loading and Deformation Workshop Talk given at a conference Predicting intervertebral disc loading and trunk muscle activity in healthy adolescents using musculoskeletal full-body models 04.07.2019 Berlin, Germany Schmid Stefan;


Use-inspired outputs

Abstract

Given the poorly understood pathogenesis of adolescent idiopathic scoliosis (AIS), a complex three-dimensional deformity of the spine, as well as the controversial evidence on conservative treatment methods such as scoliosis-specific exercises (SSEs), this research project aims at the identification of complex biomechanical parameters that might contribute to a better understanding of the pathomechanics of curve progression using muscle-driven simulations of AIS patients during different functional movements.In the first part of my project, an OpenSim-based multibody thoracolumbar musculoskeletal spine model, previously developed and validated in the Bouxsein laboratory for adults, will be adapted in order to enable predictions of segmental loading and individual muscle forces in healthy adolescents. To allow simulations in patients with AIS, the generic healthy-adolescent-model will then be further adapted by incorporating spinal deformation characteristics derived from simultaneously captured and spatially paired AP and lateral X-ray images (EOS scan). Due to a lack of in vivo measures of spinal loading in adolescents with and without AIS, a validation of the adapted models will be performed based on available MRI-derived deformation measures of the axially loaded spine as well as on the paravertebral myoelectric activity of different static body positions.In the second part of my project, segmental loading and individual muscle forces of the AIS spine during functional activities such as standing, sitting, bending forward/backward, chair rising, lifting an object, vertical jumping and walking/running will be investigated by driving subject-specific AIS- and generic healthy-adolescent-models with real motion capture data obtained from 10 patients with AIS as well as 10 healthy adolescents. Participants will be invited to the motion analysis laboratory at Beth Israel Deaconess Medical Center & Harvard Medical School (AIS patients within one week of a scheduled routine EOS scan) and assessed using a Vicon motion analysis system while performing the aforementioned functional activities. Subject-specific AIS-models will be created by incorporating the individual EOS scan-derived spinal deformation characteristics into the generic healthy-adolescent-model. Both subject-specific AIS- and generic healthy-adolescent-models will then be used together with the experimentally acquired data to conduct dynamic simulations, which include the calculation of segmental loading as well as muscle excitations and muscle forces. Continuous model output data will be parameterized appropriately and group comparisons will be conducted using independent samples t-tests. The sample size of 10 subjects per group was derived from effect size estimates found by posing the existing adult-model with appropriate lateral curvatures.The outcomes of this study will contribute to a better understanding of the pathomechanics of curve progression in AIS patients, which can be directly used by clinicians to adapt current treatment approaches such as SSEs. Moreover, the outcomes of this project will form a solid methodological basis for future investigations on the functional biomechanics of patients with structural deformities of the spine. Research groups around the world can use this method to evaluate and further develop treatment approaches as well as preventive strategies in patients with spinal pathologies.
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