However, this is less obvious with skeletal health and an understanding of how these activities can be influential in maintaining lumbar spine bone health is lacking.įinite element modelling is a computational method that can be used to predict bone architecture under particular loading conditions if coupled with an optimisation algorithm. It is intuitive to understand how activities recruiting specific muscle groups will help maintaining muscular health. To maintain a healthy musculoskeletal system, lifting, and carrying activities recruiting the erector spinae and the abdominal muscles are deemed to be of importance. More demanding physical activities such as heavy gardening, carrying heavy shopping or resistance exercise, involving the major muscle groups, should be practised at least twice a week. Moderate intensity activities usually refer to walking or cycling for a minimum of 20 min everyday. While these guidelines are generally promoted for an aging population, they are also pertinent for a younger population who may be sedentary due to home confinement as a consequence of the current COVID-19 pandemic ( Narici et al., 2020). Public health organisations typically recommend a combination of daily moderate intensity activities and regular more demanding physical activities to maintain musculoskeletal health ( Davies et al., 2019). Following this principle, sedentary behaviours and low physical activity levels may be considered as a cause of osteoporosis ( Lau and Guo, 2011), and exercise is usually recommended for the management of this condition ( Nelson et al., 2007 Sinaki et al., 2010 Rossini et al., 2016 Benedetti et al., 2018). This process is called bone remodelling, and was theorised by Frost (1987, 2003) as the Mechanostat principle. Bone apposition occurs when the structure is over stimulated, while bone resorption is observed when bone is under stimulated. It is widely accepted that bone adapts its structure, effectively the thickness of the cortex and the orientation and size of the trabeculae, to withstand the mechanical loads it is subjected to. More demanding physical activities are essential to maintain bone health in the lumbar spine.īone health relates to its capacity to resist the loads applied to it. Moderate intensity activities alone were found to be insufficient in providing a mechanical stimulus to prevent bone degradation. When more demanding activities were removed from the simulations, areas at risk of bone degradation were observed at all lumbar levels in the anterior part of the vertebral body, the transverse processes and the spinous process. For a combination of moderate and more demanding activities, the finite element model predicted a trabecular and cortical bone architecture representative of a healthy vertebra. Activities of interest for the simulations include moderate intensity activities involving limited spine movements in all directions such as, walking, stair ascent and descent, sitting down and standing up, and more demanding activities with large spine movements during reaching and lifting tasks. These loading conditions were obtained with a previously developed full-body musculoskeletal model for a range of daily living activities representative of a healthy lifestyle. A predictive structural finite element modelling approach using a strain-driven algorithm was developed to study mechanical stimulus and bone adaptation in the lumbar spine under various physiological loading conditions. However, an understanding of how these different activities are influential in maintaining vertebral bone health is lacking. For populations at risk of bone loss in the lumbar spine, these guidelines are particularly relevant. Public health organisations typically recommend a minimum amount of moderate intensity activities such as walking or cycling for two and a half hours a week, combined with some more demanding physical activity on at least 2 days a week to maintain a healthy musculoskeletal condition. 2Musculoskeletal Lab, Department of Surgery and Cancer, Imperial College London, London, United Kingdom.1Structural Biomechanics, Department of Civil and Environmental Engineering, Imperial College London, London, United Kingdom.
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