Modeling the effect of variation in sagittal curvature on the force required to produce a follower load in the lumbar spine

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The lumbar spine has an intrinsic shape specific to each individual that remains a characteristic throughout flexion and extension

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Designing Competition in Urban Bus Passenger Transport Lessons from Uzbekistan

Institute of Transport and Logistics Studies. Faculty of Economics and Business. The University of Sydne

The effect of axial load on the sagittal plane curvature of the upright human spine in vivo

Copyright © 2008 Elsevier. NOTICE: this is the author’s version of a work that was accepted for publication in Pattern Recognition . Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Journal of Biomechanics, Vol. 41 Issue 13 (2008), DOI: 10.1016/j.jbiomech.2008.06.035Determining the effect of load carriage on the human spine in vivo is important for determining spinal forces and establishing potential mechanisms of back injury. Previous studies have suggested that the natural curvature of the spine straightens under load, but are based on modelling and external measurements from the surface of the back. In the current study, an upright positional MRI scanner was used to acquire sagittal images of the lumbar and lower thoracic spine of 24 subjects. The subjects were imaged in standing whilst supporting 0, 8 and 16 kg of load which was applied axially across the shoulders using an apron. An active shape model of the vertebral bodies from T10 to S1 was created and used to characterise the effect of load. The results from the shape model showed that the behaviour of the average-shaped spine was to straighten slightly. However, the shape model also showed that the effect of load exhibited systematic variation between individuals. Those who had a smaller than average curvature before loading straightened under load, whereas those who had a greater than average curvature before loading showed an increase in curvature under load. The variation in behaviour of differently shaped spines may have further implications for the effects of load in lifting manoeuvres and in understanding the aetiology of back pain

The lumbar spine has an intrinsic shape specific to each individual that remains a characteristic throughout flexion and extension.

The final publication is available at Springer via http://dx.doi.org/10.1007/s00586-013-3162-1PURPOSE: We have previously shown that the lumbar spine has an intrinsic shape specific to the individual and characteristic of sitting, standing and supine postures. The purpose of this study was to test the hypothesis that this intrinsic shape is detectable throughout a range of postures from extension to full flexion in healthy adults. METHODS: Sagittal images of the lumbar spine were taken using a positional MRI with participants (n = 30) adopting six postures: seated extension, neutral standing, standing with 30, 45 and 60° and full flexion. Active shape modelling (ASM) was used to identify and quantify 'modes' of variation in the shape of the lumbar spine. RESULTS: ASM showed that 89.5% of the variation in the shape of the spine could be explained by the first two modes; describing the overall curvature and the distribution of curvature of the spine. Mode scores were significantly correlated between all six postures (modes 1-9, r = 0.4-0.97, P < 0.05), showing that an element of intrinsic shape was maintained when changing postures. The spine was most even in seated extension (P < 0.001) and most uneven between 35 and 45° flexion (P < 0.05). CONCLUSIONS: This study shows that an individual's intrinsic lumbar spine shape is quantifiable and detectable throughout lumbar flexion and extension. These findings will enable the role of lumbar curvature in injury and low back pain to be assessed in the clinic and in the working and recreational environments.AVP is supported by a PhD studentship kindly donated by Roemex Ltd. to the Aberdeen Centre of the Oliver Bird Rheumatism Programme at the Nuffield Foundation

Variation in lifting kinematics related to individual intrinsic lumbar curvature:An investigation in healthy adults

Objective Lifting postures are frequently implicated in back pain. We previously related responses to a static load with intrinsic spine shape, and here we investigate the role of lumbar spine shape in lifting kinematics. Methods Thirty healthy adults (18-65 years) performed freestyle, stoop and squat lifts with a weighted box (6-15 kg, self-selected) while being recorded by Vicon motion capture. Internal spine shape was characterised using statistical shape modelling (SSM) from standing mid-sagittal MRIs. Associations were investigated between spine shapes quantified by SSM and peak flexion angles. Results Two SSM modes described variations in overall lumbar curvature (mode 1 (M1), 55% variance) and the evenness of curvature distribution (mode 2 (M2), 12% variance). M1 was associated with greater peak pelvis (r=0.38, p=0.04) and smaller knee flexion (r=-0.40, p=0.03) angles; individuals with greater curviness preferred to lift with a stooped lifting posture. This was confirmed by analysis of those individuals with very curvy or very straight spines (|M1|&gt;1 SD). There were no associations between peak flexion angles and mode scores in stoop or squat trials (p&gt;0.05). Peak flexion angles were positively correlated between freestyle and squat trials but not between freestyle and stoop or squat and stoop, indicating that individuals adjusted knee flexion while maintaining their preferred range of lumbar flexion and that 'squatters' adapted better to different techniques than 'stoopers'. Conclusion Spinal curvature affects preferred lifting styles, and individuals with curvier spines adapt more easily to different lifting techniques. Lifting tasks may need to be tailored to an individual's lumbar spine shape.</p

A longitudinal study of muscle rehabilitation in the lower leg after cast removal using Magnetic Resonance Imaging and strength assessment

Acknowledgements We thank the A&E nurses and plaster technicians for identifying suitable patients, the MRI radiographers for performing the scanning, Dr Scott Semple for invaluable help in some of the pilot studies and Mr E. C. Stevenson for constructing the footrest used in the scanner. We are very grateful to the dedicated patients themselves who gave considerable amounts of time to come in for scanning, exercise and assessment during the course of this study.Peer reviewedPublisher PD

The accuracy of active shape modelling and end-plate measurements for characterising the shape of the lumbar spine in the sagittal plane

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Living with and dying from cancer: a humanities special study module

Abstract We describe a humanities-based, special studies module (SSM

Sex differences in the associations between L-arginine pathway metabolites, skeletal muscle mass and function, and their responses to resistance exercise, in old age

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Objectives The current study was designed to explore the associations between L-arginine metabolites and muscle mass and function in old age, which are largely unknown. Design The study used a randomised, double-blind, placebo-controlled design. Setting The study was carried out in a laboratory setting. Participants 50 healthy older adults [median age 70 years (IQR 67-73); 27 males]. Intervention Participants undertook an 18-week resistance exercise program, and a nutritional intervention (fish oil vs. placebo). Measurements Serum homoarginine, ornithine, citrulline, asymmetric dimethylarginine (ADMA), NG-monomethyl-L-arginine (L-NMMA), and symmetric dimethylarginine (SDMA), maximal voluntary contraction (MVC) and isokinetic torque of the knee extensors at 30° s-1 (MIT), muscle cross sectional area (MCSA) and quality (MQ) were measured at baseline and after the intervention. Results No significant exercise-induced changes were observed in metabolite concentrations. There were significant sex differences in the associations between metabolites and muscle parameters. After adjusting for age, glomerular filtration rate and fish oil intervention, citrulline (P=0.002) and ornithine (P=0.022) were negatively associated with MCSA at baseline in males but not females. However, baseline citrulline was negatively correlated with exercise-induced changes in MVC (P=0.043) and MQ (P=0.026) amongst females. Furthermore, amongst males, baseline homoarginine was positively associated with exercise-induced changes in MVC (P=0.026), ADMA was negatively associated with changes in MIT (P=0.026), L-NMMA (p=0.048) and ornithine (P<0.001) were both positively associated with changes in MCSA, and ornithine was negatively associated with changes in MQ (P=0.039). Conclusion Therefore, barring citrulline, there are significant sex differences in the associations between L-arginine metabolites and muscle mass and function in healthy older adults. These metabolites might enhance sarcopenia risk stratification, and the success of exercise programs, in old age