Automated Analysis of Lumbar Spine Kinematics from Dynamic Videofluoroscopy

通过动态视频透视自动分析腰椎运动学

• 批准号: 7301821
• 负责人: KAI-NAN AN
• 金额: $ 23.33万
• 依托单位: MAYO CLINIC ROCHESTER
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-01 至 2009-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7301821
• 关键词: Address; Articular Range of Motion; Automation; Biomechanics; Characteristics; Chronic low back pain; Clinical; Clinical Research; Complementary therapies; Computer software; Condition; Custom; Data; Decompression Sickness; Detection; Devices; Diagnostic Imaging Program; Disease; Dose; Environment; Future; Image; In Vitro; Individual; Information Systems; Label; Lateral; Lead; Link; Location; Low Back Pain; Manipulative Therapies; Manuals; Measurement; Measures; Methods; Motion; Outcome Measure; Patients; Pattern; Persons; Pilot Projects; Process; Radiation; Randomized Controlled Clinical Trials; Range of motion exercise; Relative (related person); Research; Research Personnel; Review, Systematic (PT); Rotation; Sampling; Spinal; System; Technology; Testing; Time; Translations; Variant; Vertebral column; Weight-Bearing state; analog; base; clinical effect; clinically relevant; computerized data processing; day; image processing; improved; in vivo; instrument; interest; kinematics; novel; programs; sensor; spine bone structure; theories; tool; trend; two-dimensional

DESCRIPTION (provided by applicant): Spinal manipulative therapy (SMT) is a complementary therapy frequently used to treat low back pain (LBP). Current theories propose that SMT corrects abnormal lumbar intersegmental motion, but the detection and characterization of in vivo intersegmental motion are not well established. Thus, the effect of SMT on intersegmental motion is unknown. Our broad, long term objective is to investigate the effect of SMT on lumbar intersegmental motion and to determine the relationship between the clinical effects of SMT and intersegmental motion changes. To accomplish this, it is necessary to develop an efficient, accurate and reliable method of measuring in vivo intersegmental motion. Videofluoroscopy holds promise of providing continuous motion data with low radiation exposure but data processing methods have not reached a level of sophistication that enables efficient clinical use; they still require manual identification of landmarks and explicit vertebral segmentation. We hypothesize that 2-D intersegmental kinematics of the lumbar spine can be efficiently and accurately quantified from videofluoroscopic images. We propose to test this hypothesis by addressing the following Specific Aims: 1) Develop an automated software application to quantify 2-D intersegmental kinematics in the lumbar spine from dynamic videofluoroscopic images. This application, based on existing modules within the Analyze biomedical imaging programming environment, will quantify intersegmental rotation and translation of the center of rotation, and global (L2-L5) lumbar motion. 2) Conduct dynamic in vitro spine testing to establish the accuracy and limitations of assessing 2-D intersegmental kinematics using an automated software application (Aim 1). Fluoroscopic images of in vitro lumbar motion will be obtained simultaneously with kinematic parameters from an optoelectric tracking system of known accuracy. Kinematic data from the automated software will be compared to the optoelectric tracking system data. 3) Assess the reliability of measuring in vivo lumbar intersegmental motion parameters from videofluoroscopic images of active lumbar flexion, extension, and lateral bending in asymptomatic subjects and subjects with chronic LBP using an automated software application (Aim 1). Videofluoroscopic images of 10 asymptomatic subjects and 10 subjects with chronic LBP will be obtained at two time points. Reliability of kinematic parameters from the software application will be determined. Parameter means and variation (among and within subjects) will be calculated. Trends that might lead to new hypotheses of the effects of SMT on intersegmental motion will be examined. The novel software application developed and tested in this project will enable studies that directly test the primary biomechanical rationale for treating low back pain with SMT. It will also enable us to conduct clinical studies that refine the application of SMT in terms of location, type and dose.

描述（由申请人提供）：脊柱手法治疗（SMT）是一种经常用于治疗腰痛（LBP）的补充疗法。目前的理论认为 SMT 可以纠正异常的腰椎节间运动，但体内节间运动的检测和表征尚未建立。因此，SMT 对节间运动的影响尚不清楚。我们广泛的长期目标是研究 SMT 对腰椎节段间运动的影响，并确定 SMT 的临床效果与节段间运动变化之间的关系。为了实现这一目标，有必要开发一种有效、准确和可靠的测量体内节段间运动的方法。视频透视有望提供低辐射暴露的连续运动数据，但数据处理方法尚未达到能够有效临床使用的复杂程度；它们仍然需要手动识别地标和明确的椎骨分割。我们假设可以从视频荧光图像中有效、准确地量化腰椎的二维节间运动学。我们建议通过解决以下具体目标来检验这一假设：1）开发自动化软件应用程序，以根据动态视频透视图像量化腰椎中的二维节间运动学。该应用程序基于分析生物医学成像编程环境中的现有模块，将量化节段间旋转和旋转中心的平移以及全局（L2-L5）腰椎运动。 2) 进行动态体外脊柱测试，以确定使用自动化软件应用程序评估二维节间运动学的准确性和局限性（目标 1）。体外腰椎运动的荧光图像将与来自已知精度的光电跟踪系统的运动学参数同时获得。来自自动化软件的运动数据将与光电跟踪系统数据进行比较。 3) 使用自动化软件应用程序评估无症状受试者和患有慢性 LBP 受试者的主动腰椎屈曲、伸展和侧弯的视频荧光镜图像测量体内腰椎节段间运动参数的可靠性（目标 1）。将在两个时间点获得 10 名无症状受试者和 10 名慢性 LBP 受试者的视频荧光镜图像。将确定软件应用程序运动学参数的可靠性。将计算参数平均值和变化（受试者之间和受试者内）。将研究可能导致 SMT 对节间运动影响的新假设的趋势。该项目中开发和测试的新型软件应用程序将使研究能够直接测试 SMT 治疗腰痛的主要生物力学原理。它还将使我们能够开展临床研究，在位置、类型和剂量方面完善 SMT 的应用。