How New Motion-Sensing Technology May Help Standardize Back-Pain Care?
August 27, 2022

Digital health systems can tell doctors when someone’s risk of heart disease warrants a cholesterol-lowering drug or whether insulin injections are warranted for a person with type 2 diabetes. But for the millions of people with low back pain, care decisions rely heavily on subjective measurements of patient discomfort—often leading to expensive tests and treatments (back pain is the third-highest health care expense in the U.S., after diabetes and heart disease ), which do not. does not necessarily offer a permanent solution.

Ohio State University engineering and medical researchers are developing a digital health system approach designed to improve clinical decision-making about back pain. After completing a series of studies testing the precise, objective measurements they’ve perfected in the lab, the team is looking to apply data-driven approaches to evaluating and correcting back problems caused by spinal dysfunction.

Wearable motion-sensing to assess low back function;

In a recent study published in Clinical Biomechanics, researchers combined self-reported measures of pain and disability with data from a wearable motion-sensing system to assess low back function in lumbar fusion surgery patients. While postoperative pain relief and lower disability were self-reported within six weeks, objective metrics did not detect true functional improvement in the spine for at least six months after surgery.

These precise motion-based measures, and their inclusion in a growing national database of patient spine function scores and other medical data, could form the basis of more objective clinical decision-making for surgical patients, the researchers concluded.

For back pain, people are asked to rate how they feel on a scale of 1 to 10. But since you don’t have pain receptors in your disc, what does that mean? Our technology tries to bring objective metrics to the problem and look not only at how people experience back pain, but also quantitatively measure how their movements differ and what that means in terms of biomechanics.

Conity; a clinical lumbar motion monitor

For decades, Marras’ lab has studied the daily life forces on the spine, and 30 years ago developed the first wearable back sensor to assess how the movements of a range of tasks in a variety of settings affect the back. Recently, his team retrofitted these devices with commercially available chips—typically found in cell phones—that tell us where we are in space.

Called “Conity,” the system includes a clinical lumbar motion monitor that is equipped with chip sensors mounted on the upper back and waist that capture a person’s three-dimensional “motion signature” as they perform a series of standardized movements. The combined technologies provide quantitative data not only on range of motion, but also on speed of motion and acceleration—data that Marras’ research found are more informative for understanding spinal function.

For the 121 lumbar fusion surgery patients in the study, forward and backward bending, side-to-side bending, and spinal rotation were assessed once before and five times after surgery. To determine their functional performance score, their individual data were compared to a composite measure based on data collected from healthy controls. Participants also completed questionnaires assessing their pain, disability, fear-avoidance behavior, and quality of life at baseline and postoperative visits.

The first significant improvement in functional performance based on motion sensing data was observed in these patients as late as six months after surgery, with function progressing smoothly over the following 18 months. But patients self-reported significant improvements in pain, ability, and fear avoidance as early as six weeks after surgery.

While pain relief is important, the researchers noted that an objective functional assessment may be a better measure of when it is safe to return to normal activities after spinal fusion surgery.

Marras’ use of motion monitors;

Marras’ use of motion monitors in an earlier study piqued military interest in the technology and generated Department of Defense funding for the technology so it could be used to assess spinal function in aircrew — a group of service members known to suffer from low back pain. .

“In the world of lower back disorders, it’s about not letting it go on for months or years until it gets really bad, because then it’s really hard to deal with,” Marras said. “Military leaders we’ve talked to think it could get aircrews on the right track and prevent problems.

We are creating a systematic computing platform that we could distribute anywhere across the country, they said. By working with different universities, we hope to be able to build a large enough database that we can use AI and machine learning to break through and find out what matters most. We think we know, but sophisticated analysis of tons and tons of data could help us find anything we might be missing.