Evaluating the Effect of Crutch-using on Trunk Muscle Loads

As a traditional tool of external assistance, crutches play an important role in society. They have a wide range of applications to help either the elderly and disabled to walk or to treat certain illnesses or for post-operative rehabilitation. But there are many different types of crutches, including shoulder crutches and elbow crutches. How to choose has become an issue that deserves to be debated. Because while crutches help people walk, they also have an impact on the body. Inappropriate choice of crutches or long-term misuse can lead to problems such as scoliosis. Previous studies were mainly experimental measurements or the construction of dynamic models to calculate the load on joints with crutches. These studies focus only on the level of the joints, ignoring the role that muscles play in this process. Although some also take into account the degree of muscle activation, there is still a lack of quantitative analysis. The traditional dynamic model can be used to calculate the load on each joint. However, due to the activation of the muscle, this situation only causes part of the load transmitted to the joint, and the work of the chair will compensate the other part of the load. Analysis at the muscle level allows a better understanding of the impact of crutches on the body. By comparing the levels of activation of the trunk muscles, it was found that the use of crutches for walking, especially a single crutch, can cause a large difference in the activation of the back muscles on the left and right sides, and this difference will cause muscle degeneration for a long time, leading to scoliosis. In this article taking scoliosis as an example, by analyzing the muscles around the spine, we can better understand the pathology and can better prevent diseases. The objective of this article is to analyze normal walking compared to walking with one or two crutches using OpenSim software to obtain the degree of activation of different muscles in order to analyze the impact of crutches on the body.

[1]  Sigmund Epstein Art, History and the Crutch* The writer’s collection of prints, illustrating “The crutch and other aids to locomotion in art,” was recently exhibited at the Graduate Fortnight of the New York Academy of Medicine. , 1937, Annals of medical history.

[2]  T E Shoup,et al.  Biomechanics of crutch locomotion. , 1974, Journal of biomechanics.

[3]  John P. Sarwark,et al.  The influence of forearm crutches on pelvic and hip kinematics in children with myelomeningocele: don't throw away the crutches , 1997, Developmental medicine and child neurology.

[4]  J. Russell,et al.  Trends and differential use of assistive technology devices: United States, 1994. , 1997, Advance data.

[5]  S. Li,et al.  Three-point gait crutch walking: variability in ground reaction force during weight bearing. , 2001, Archives of physical medicine and rehabilitation.

[6]  A. Jackson,et al.  A demographic profile of new traumatic spinal cord injuries: change and stability over 30 years. , 2004, Archives of physical medicine and rehabilitation.

[7]  J. Perry,et al.  Upper extremity kinetics during Lofstrand crutch-assisted gait. , 2005, Medical engineering & physics.

[8]  Brooke A. Slavens,et al.  An upper extremity inverse dynamics model for pediatric Lofstrand crutch-assisted gait. , 2011, Journal of biomechanics.

[9]  A. Mündermann,et al.  Forearm pressure distribution during ambulation with elbow crutches: a cross-sectional study , 2014, Journal of NeuroEngineering and Rehabilitation.

[10]  Ayman Habib,et al.  OpenSim: Simulating musculoskeletal dynamics and neuromuscular control to study human and animal movement , 2018, PLoS Comput. Biol..

[11]  Fouad Bennis,et al.  A Full-Chain OpenSim Model and Its Application on Posture Analysis of an Overhead Drilling Task , 2019, HCI.