Optical Measurements of the Skin Surface to Infer Bilateral Distinctions in Myofascial Tissue Stiffness

About half the U.S. adult population suffers from chronic neuromusculoskeletal pain. While its evaluation and treatment are widely addressed by therapies using soft tissue manipulation (STM), their efficacy is based upon clinician judgment. Robust biomarkers are needed to quantify the effects of STM on patient outcomes. Among noninvasive methods to quantify the mechanics of myofascial tissue, most are limited to small (<10 mm²), localized regions of interest. In contrast, we develop an approach to optically simultaneously measure a larger (~100 cm²) field of deformation at the skin surface. Biomarkers based on skin lateral mobility are derived to infer distinctions in myofascial tissue stiffness. In specific, three cameras track ink speckles whose fields of deformation and stretch are resolved with digital image correlation. Their ability to differentiate bilateral distinctions of the cervicothoracic region is evaluated with four participants, as a licensed clinician performs STM. The results indicate that the optically derived surface biomarkers can differentiate bilateral differences in skin mobility, with trend directions within a participant similar to measurements with an instrumented force probe. These findings preliminarily suggest skin surface measurements are capable of inferring underlying myofascial tissue stiffness, although further confirmation will require a larger, more diverse group of participants.