Quantifying Segmental Spinal Motion during Activities of Daily Living

158 Pages·2013·1.78 MB·English

QUANTIFYING SEGMENTAL SPINAL MOTION DURING ACTIVITIES OF DAILY
LIVING

by

SCOTT PATRICK BRELOFF

A DISSERTATION

Presented to the Department of Human Physiology
and the Graduate School of the University of Oregon
in partial fulfillment of the requirements
for the degree of
Doctor of Philosophy

June 2013
DISSERTATION APPROVAL PAGE

Student: Scott Patrick Breloff

Title: Quantifying Segmental Spinal Motion during Activities of Daily Living

This dissertation has been accepted and approved in partial fulfillment of the
requirements for the Doctor of Philosophy degree in the Department of Human
Physiology by:

Dr. Li-Shan Chou Chairperson
Dr. Richard Robertson Member
Dr. Andrew Karduna Member
Dr. Louis Osternig Member
Dr. Arthur Farley Outside Member

and

Kimberly Andrews Espy Vice President for Research & Innovation/Dean of the
Graduate School

Original approval signatures are on file with the University of Oregon Graduate School.

Degree awarded June 2013

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© 2013 Scott Patrick Breloff

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DISSERTATION ABSTRACT

Scott Patrick Breloff

Doctor of Philosophy

Department of Human Physiology

June 2013

Title: Quantifying Segmental Spinal Motion during Activities of Daily Living

Back pain is a very common musculoskeletal impairment in most Americans.
Average annual occurrence of back pain is reported around 30% of the population and is
the most common cause of activity limitation in people younger than 45 years old. Eighty
percent of the back pain presents in the lumbar spine. Although this ailment is very
prevalent in the American population, there is a lack of empirical evidence supporting the
common clinical diagnosis and intervention back pain strategies. The frequency of back
pain and the lack of treatment methods were the motivation for this investigation. It is
important to better understand spine dynamics during ambulatory tasks of daily activities to
identify possible biomechanical mechanisms underlying back pain.
Current biomechanical quantification methods for spine dynamics are either too
invasive or not detailed enough to fully comprehend detailed spinal movement. Therefore,
a non-invasive but detailed procedure to calculate spine dynamics was developed and
tested. In this study, multi-segmented spine dynamics (kinematics and kinetics) were
calculated during four activities of daily living (level walking (W), obstacle crossing (OC),
stair ascent (SA) and stair descent (SD)).
Our findings suggested an in-vivo multi-segmented spine surface marker set is able
to detect different and repeatable motion patterns during walking among various spinal
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segments. The sacrum to lower lumbar (SLL) joint had the largest range of motion (ROM)
when compared to the other more superior joints (lower lumbar to upper lumbar and upper
lumbar to lower thoracic). Furthermore, SA task demonstrated more flexion ROM than
both W and SD tasks. In addition to task influence, joints at different spine levels also
demonstrated different ROMs, where SLL had a greater ROM than upper lumbar to lower
thoracic (ULLT) in the transverse plane. Age was found to not significantly affect the
segmental spinal ROM or peak angles. The vertical segmental joint reaction forces were
different between tasks, where SD yielded larger vertical reaction forces than W.
Overall, findings from this dissertation work were able to show that a multi-
segment spine marker system could be an effective tool in determining different spinal
dynamics during various activities of daily living.
This dissertation includes unpublished co-authored material.

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CURRICULUM VITAE

NAME OF AUTHOR: Scott Patrick Breloff

GRADUATE AND UNDERGRADUATE SCHOOLS ATTENDED:

University of Oregon, Eugene, OR
University of Mississippi, Oxford, MS
University of Pittsburgh, Pittsburgh, PA

DEGREES AWARDED:

Doctor of Philosophy, Human Physiology, 2013, University of Oregon
Master of Science, Exercise Science, 2008, University of Mississippi
Bachelor of Science, 2006, University of Pittsburgh

AREAS OF SPECIAL INTEREST:

Biomechancis of the Spine
Ergonomics
Low Back Pain

PROFESSIONAL EXPERIENCE:

Research Assistant, Department of Human Physiology, University of Oregon,
Eugene, 2008-12

Graduate Teaching Fellow, Department of Human Physiology, University of
Oregon, Eugene, 2008-12

Research Assistant, Department of Health, Exercise Science and Recreation
Management, University of Mississippi, Oxford, 2006-08

Teaching Assistant, Department of Health, Exercise Science and Recreation
Management, University of Mississippi, Oxford, 2006-08

Undergraduate Research Assistant, Department of BioEngineering, University of
Pittsburgh, Pittsburgh, 2003-06

GRANTS, AWARDS, AND HONORS:

Eugene and Clarissa Evonuk Memorial Graduate Fellowship, University of
Oregon 2011

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Ursula (Sue) Moshberger Scholarship, University of Oregon, 2010

Jan Broekhoff Graduate Scholarship, University of Oregon, 2009

PUBLICATIONS:

Wade C., Redfern, M.S., Andres, R.O. & Breloff, S.P.. “Joint Kinetics and
Muscle Activity While Walking on Ballast.” Human Factors. 2010 Oct;52(5):560-73.

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ACKNOWLEDGMENTS

I would like to first thank my wife, Andrea. From the time we met all she has
given me is love and support and for that I am truly grateful. Also, all the
encouragement, love and support my family (Mom, Dad, Erin & Kaitlyn) has shown
during my entire academic career, not just my time at the University of Oregon.
I would like to express my sincere thanks to Dr. Li-Shan Chou for his guidance,
leadership, friendship, patience and mentoring over the past four and a half years.
Without all of his insight and encouragement, this project would have never gotten off
the ground. In addition, I am grateful to the members of my committee, Drs. Richard
Robertson, Andrew Karduna, Louis Osternig and Arthur Farley for their knowledge and
dedication throughout the duration of the project.
To my friends and colleges in the lab (James Becker, Vipul Lugade, David
Howell, Tzurei ‘Betty’ Chen, Masahiro Fujimoto, Shiu-Ling Chiu, On-Ye ‘Amy Lo, Chi-
Wei Chou), these past years have been unforgettable and I will certainly cherish our
friendships for many years to come.
This research has been supported by the Eugene and Clarissa Evonuk Memorial
Graduate Fellowship. Support from this foundation was invaluable during the pursuit of my
research goals.

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I would like to dedicate this to everyone who, at some point, has assisted, encouraged and
supported this long and arduous academic endeavor.

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TABLE OF CONTENTS
Chapter Page

I. INTRODUCTION .................................................................................................... 1
Causation of Back Pain .......................................................................................... 4
Back Injuries in Workplace and during Activities of Daily Living ....................... 5

Spine Biomechancis during Lifting and Locomotion ............................................ 7

In-Vivo Motion Capture of Spinal Motion ............................................................ 10
Aging and Spinal Motion ....................................................................................... 14
Joint Reaction Forces ............................................................................................. 16
Empirical Evidence to Clinical Application .......................................................... 17
Overall Goals and Specific Aims ........................................................................... 18
Summary ................................................................................................................ 19
Flow of Dissertation ............................................................................................... 21

II. QUANTIFICATION OF MULTI-SEGMENTAL SPINE MOVEMENT
DURING GAIT ........................................................................................................... 23
Introduction ............................................................................................................ 23
Methods.................................................................................................................. 26
Subjects ............................................................................................................ 26
Experimental Protocol ..................................................................................... 27
Experimental Instrument .................................................................................. 27
Definition of the Inter-Segment Angles ........................................................... 29
Data Analysis ................................................................................................... 30
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