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A comparative study of eight different lumbar belts, which are representative of the French market, was carried out on four typical morphologies of patients to assess their therapeutic effects and identify the correlation between the therapeutic parameters and mechanical ones. Four typical morphologies were chosen among 15 patients that had been chosen for the clinical study: tall-large, small-large, tall-thin, and small-thin. Simplified 3D finite elements (FE) models of the trunk according to each patient's morphology were used for numerical analyses using Abaqus SimuliaTM. The same material properties of the body structures and boundary conditions were taken for all models to only focus on morphological variations. The material properties of eight lumbar belts were obtained by mechanical testing. The pressure applied by the belt to the trunk was modelled by Laplace's law. The influences of belt types on typical morphologies were analyzed and synthetized to show which parameters are significant for biomechanical efficacy and attendance to the therapeutic effects. Finally, we found the following belt effects: (i) the lumbar belt is more efficient on the thin morphology than the large one, (ii) all mechanical values checked on the vertebral disks and vertebrae have a strong correlation with the correction of lordosis angle, and (iii) the belt's global stiffness is an important parameter for generating the pressure applied to the trunk. [ABSTRACT FROM AUTHOR]

Low back pain represents a major economic and societal challenge due to its high prevalence. Lumbar orthoses are one of the recommended treatments. Even if previous results showed their clinical effects, the detailed mode of action is still poorly known, making the device design difficult. A renewed instrumentation and experimental protocol should bring better insight into the lumbar brace–trunk mechanical interaction. This instrumentation should give detailed information on the basic physical or geometrical parameters: the pressure applied on the trunk, the body shape and the strain in the belt. The principal objective of this study was to propose and validate a new measurement protocol, based on pressure mapping systems and full-field shape and strain measurement. The feasibility of the protocol was tested along with its validity and repeatability. The influence of various parameters, which could cause changes in the measurements, was tested with six different belt configurations on one subject. Measurements were also performed to study the impact of posture on pressure and strain. Both pressure and strain appeared to be asymmetric from left to right. The pressure applied by the lumbar belt on the back varies with breathing and with posture. This study showed that full-field measurements were necessary to render the high variability of pressure or strain around the trunk, under recommendations of their use to guarantee a satisfying repeatability. [ABSTRACT FROM AUTHOR]