卒中患者腰椎有限元模型的开发与验证OA

Objective To develop and validate a finite element(FE)model of the lumbar spine for stroke patients,providing a biomechanical basis for the formulation of rehabilitation training protocols. Methods A complete lumbar spine FE model was constructed based on CT and MRI images of T12-L5 in stroke patients.Kinematic data were captured using an eight-camera Qualisys three-dimensional motion capture system,and kinetic data were collected with a Kistler three-dimensional force platform to synchronously record the standing-to-flexion movement of stroke patients.A musculoskeletal model in OpenSim was employed to calculate the intervertebral compression force(ICF),intervertebral shear force(ISF),and muscle strength of local lumbar muscles(psoas major,latissimus dorsi,iliocostalis,longissimus thoracis,multifidus,and quadratus lumborum).The ICF,ISF,and muscle strength were applied as inputs to the lumbar spine FE model,and the lumbar spine stress distribution of stroke patients was calculated via FE analysis software. Results A total of 15 male stroke patients were enrolled,with a mean age of(61.5±3.5)years.The lumbar spine FE model analysis demonstrated that the bending and torsion range of motion on the affected side was lower than that on the healthy side in stroke patients.Significant stress distribution asymmetry was observed on the left and right sides of the vertebral bodies from L1 to L5 and the intervertebral nucleus pulposus,with significantly higher stress on the left side compared to the right. Conclusions This study established a lumbar spine FE model based on stroke patients' CT and MRI imaging data and integrated muscle forces and joint reaction forces(ICF+ISF)derived from OpenSim for loading simulation.The model accurately reflects the stress distribution characteristics of the lumbar spine during standing-to-flexion movements in stroke patients,providing a reliable biomechanical foundation for further exploration of lumbar spine loading mechanisms and rehabilitation training strategies in these patients.