Abstract
Lower back pain is a major public health problem. Despite claims that lumbar belts change spinal posture due to applied pressure on the trunk, no mechanical model has yet been published to prove this treatment. This paper describes a first model for belt design, based on the one hand on the mechanical properties of the fabrics and the belt geometry, and on the other hand on the trunk geometrical and mechanical description. The model provides the estimation of the pressure applied to the trunk, and a unique indicator of the belt mechanical efficiency is proposed: pressure is integrated into a bending moment characterizing the belt delordosing action on the spine. A first in-silico clinical study of belt efficiency for 15 patients with 2 different belts was conducted. Results are very dependent on the body shape: in the case of high BMI patients, the belt effect is significantly decreased, and can be even inverted, increasing the lordosis. The belt stiffness proportionally increases the pressure applied to the trunk, but the influence of the design itself on the bending moment is clearly outlined. Moreover, the belt/trunk interaction, modeled as sticking contact and the specific way patients lock their belts, dramatically modifies the belt action. Finally, even if further developments and tests are still necessary, the model presented in this paper seems suitable for in-silico pre-clinical trials on real body shapes at a design stage.
Highlights
Among a large series of care strategies for lower back pain, several clinical trials have shown the clinical efficiency of lumbar belts [1, 2]
The models that we developed for the two belts are shown on Fig 5, in which stiffness k1 is the stiffness of fabric 1; k2 the stiffness of fabric 2 and so forth
Mechanical behaviour is a little bit different during the first loading of the sample, but the following repetitions show similar behaviour. These results show that fabrics of lumbar belts must be loaded once before having a stable mechanical behaviour
Summary
Among a large series of care strategies for lower back pain, several clinical trials have shown the clinical efficiency of lumbar belts [1, 2]. Both their mechanical and physiological effects remain unclear. There was no additional external funding received for this study. Thuasne provided support in the form of salaries for authors RB and RC, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section
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