Page 64 - Petelin Ana. Ur. 2022. Zdravje otrok in mladostnikov / Health of children and adolescents. Proceedings. Koper: Založba Univerze na Primorskem/University of Primorska Press
P. 64
avje otrok in mladostnikov | health of children and adolescents 64 velopment of LBP (Gupta et al., 2015). In the education part of the exergame, we
inform the patient of the correct sitting postures and load handling techniques.
Trunk movements cannot be performed without the presence of the ac-
tive system. The stability is first provided by deep trunk muscles, while the su-
perficial muscles are primarily engaged during large movements of the spine.
Several studies have shown changes in muscle activation of trunk muscles in
people with LBP compared to healthy subjects (Cholewicki et al., 2005; Carpes
et al., 2008). There are little prospective studies regarding the effect of maximal
trunk strength on the incidence of LBP and their findings are contradictory
(Lee et al., 1999; Cho et al., 2014). Literature highlights that the maximum hip
strength is superior to the maximum trunk strength for LBP prevention (Coyle
et al., 2021; Alsufiany et al., 2020). Furthermore, decreased local endurance of
trunk muscles and impaired trunk strength ratio in sagittal plane represents
a risk factor for future LBP (Biering-Sorensen, 1984; Lee et al., 1999). The lat-
ter suggests that local muscle endurance has a significant impact on the spine
health which is in line with recent studies (Pilz et al. 2020). In addition, the
exergame content regarding the volume/intensity of trunk flexors and exten-
sors should be well balanced. Isolated maximal trunk strength and endurance
of trunk muscles (assessed by the Biering-Sorensen test) are not significantly
correlated (Conway et al., 2016). The latter indicates the importance of pelvic
muscles in controlling the pelvic position and consequently the lumbar region
of the spine. In a novel exergame it will be important to include exercises to
strengthen the entire kinetic chain and not just individual muscle groups. The
third subsystem, the nervous system, controls muscle activity. In cases where
perturbations affect the spine, the human body automatically ensures spine
stability. Reflex postural adjustments are the reactions of trunk muscles, which
are important to maintain the correct position of vertebrae during unexpect-
ed trunk loading (Santos et al., 2010; Cholewicki et al., 2005). Koch and Hansel
(2019) found out significant difference between healthy participants and LBP
patients in the CoP sway during upright standing in situations with higher pos-
tural demands. This indicates that exercises should be performed in conditions
of instability.
In order to successfully carry out an exercise intervention by playing an
exergame, it is essential that information received by the therapist/coach from
the device is valid and reliable. The current gold standard for non-invasive mo-
tion capture is radiography, which measures bone movement via X-rays (Kes-
sler et al., 2019). Systems that track human motion with markers placed on
specific anatomical locations are the best approximation to the gold standard.
Movement tracking based on markers is risky due to errors in the setting of
markers, and their installation is time-consuming, which is an important ob-
stacle in clinical or sporting environments (Gorton and Hebert 2009; Whittle,
1996). On the other hand, systems without markers such as Microsoft Kinect,
Intel Realsense and StereoLabs Zed have been developed, which are supposed
to accurately detect body segments during movement. Investigators performed
inform the patient of the correct sitting postures and load handling techniques.
Trunk movements cannot be performed without the presence of the ac-
tive system. The stability is first provided by deep trunk muscles, while the su-
perficial muscles are primarily engaged during large movements of the spine.
Several studies have shown changes in muscle activation of trunk muscles in
people with LBP compared to healthy subjects (Cholewicki et al., 2005; Carpes
et al., 2008). There are little prospective studies regarding the effect of maximal
trunk strength on the incidence of LBP and their findings are contradictory
(Lee et al., 1999; Cho et al., 2014). Literature highlights that the maximum hip
strength is superior to the maximum trunk strength for LBP prevention (Coyle
et al., 2021; Alsufiany et al., 2020). Furthermore, decreased local endurance of
trunk muscles and impaired trunk strength ratio in sagittal plane represents
a risk factor for future LBP (Biering-Sorensen, 1984; Lee et al., 1999). The lat-
ter suggests that local muscle endurance has a significant impact on the spine
health which is in line with recent studies (Pilz et al. 2020). In addition, the
exergame content regarding the volume/intensity of trunk flexors and exten-
sors should be well balanced. Isolated maximal trunk strength and endurance
of trunk muscles (assessed by the Biering-Sorensen test) are not significantly
correlated (Conway et al., 2016). The latter indicates the importance of pelvic
muscles in controlling the pelvic position and consequently the lumbar region
of the spine. In a novel exergame it will be important to include exercises to
strengthen the entire kinetic chain and not just individual muscle groups. The
third subsystem, the nervous system, controls muscle activity. In cases where
perturbations affect the spine, the human body automatically ensures spine
stability. Reflex postural adjustments are the reactions of trunk muscles, which
are important to maintain the correct position of vertebrae during unexpect-
ed trunk loading (Santos et al., 2010; Cholewicki et al., 2005). Koch and Hansel
(2019) found out significant difference between healthy participants and LBP
patients in the CoP sway during upright standing in situations with higher pos-
tural demands. This indicates that exercises should be performed in conditions
of instability.
In order to successfully carry out an exercise intervention by playing an
exergame, it is essential that information received by the therapist/coach from
the device is valid and reliable. The current gold standard for non-invasive mo-
tion capture is radiography, which measures bone movement via X-rays (Kes-
sler et al., 2019). Systems that track human motion with markers placed on
specific anatomical locations are the best approximation to the gold standard.
Movement tracking based on markers is risky due to errors in the setting of
markers, and their installation is time-consuming, which is an important ob-
stacle in clinical or sporting environments (Gorton and Hebert 2009; Whittle,
1996). On the other hand, systems without markers such as Microsoft Kinect,
Intel Realsense and StereoLabs Zed have been developed, which are supposed
to accurately detect body segments during movement. Investigators performed
