Abstract
Introduction
Low back pain (LBP) is the top leading global cause of years lived with disability. In order to examine LBP, researchers have typically viewed the spine in isolation. Clinically, it is imperative that the lower limbs are also considered. The aim of this study was to design a holistic and reliable multi-segmental kinematic model of the spine and lower limbs.
Method
The spine was modelled according to easily identifiable anatomical landmarks, including upper thoracic (T1-T6), lower thoracic (T7-T12) and lumbar (L1-L5) segments. Pelvis, thigh, shank and foot segments were included. A 10-camera 3D motion capture system was used to track retro-reflective markers, which were used to define each segment of 10 healthy participants as they walked 3 times at a comfortable speed over a 6km walkway. The relative peak angles between each segment were calculated using the Joint Coordinate System convention and Intraclass Correlation Coefficients (ICCs) were used to determine intra-rater and inter-rater reliability (between an experienced clinician and biomechanical scientist).
Results
Intra-rater and inter-rater ICCs were good to excellent (0.6–0.99). This implies that the system could be used reliably by one tester or by testers with limited anatomical expertise. Subjective participant reports implied that the system was acceptable and suitable for patient use (average application time of 10 minutes).
Conclusion
The ‘Imperial Spinal Model’ is a holistic and reliable multi-segmental model. It is suitable for the kinematic assessment of the spine and could be used to enhance our understanding of a variety of spinal conditions.
No conflicts of interest.
Funding: Janet Deane is funded by an Allied Health Professional Doctoral Fellowship awarded by Arthritis Research U.K. (ARUK). Enrica Papi is funded by the National Centre of Excellence for Musculoskeletal Health and Work funded by ARUK and the Medical Research Council.
