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- J Biomech 43(11):IFC (2010)
- The relation between increased deltoid activation and adductor muscle activation due to glenohumeral cuff tears
- J Biomech 43(11):2049-2054 (2010)
In patients with rotator cuff tears lost elevation moments are compensated for by increased deltoid activation. Concomitant proximal directed destabilizing forces at the glenohumeral joint are suggested to be compensated for by 'out-of-phase' adductor activation, preserving glenohumeral stability. Aim of this study was to demonstrate causality between moment compensating deltoid activation and stability compensating 'out-of-phase' adductor muscle activation. A differential arm loading with the same magnitude of forces applied at small and large moment arms relative to the glenohumeral joint was employed to excite deltoid activation, without externally affecting the force balance. Musculoskeletal modeling was applied to analyze the protocol in terms of muscle forces and glenohumeral (in)stability. The protocol was applied experimentally using electromyography (EMG) to assess muscle activation of healthy controls and cuff tear patients. Both modeling and experiments demonstrated increased deltoid activation with increased moment loading, which was higher in patients compared to controls. Model simulation of cuff tears demonstrated glenohumeral instability and related 'out-of-phase' adductor muscle activation which was also found experimentally in patients when compared to controls. Through differential moment loading, the assumed causal relation between increased deltoid activation and compensatory adductor muscle activation in cuff tear patients could be demonstrated. 'Out-of-phase' adductor activation in patients was attributed to glenohumeral instability. The moment loading protocol discerned patients with cuff tears from controls based on muscle activation. - Muscle coordination of mediolateral balance in normal walking
- J Biomech 43(11):2055-2064 (2010)
The aim of this study was to describe and explain how individual muscles control mediolateral balance during normal walking. Biomechanical modeling and experimental gait data were used to quantify individual muscle contributions to the mediolateral acceleration of the center of mass during the stance phase. We tested the hypothesis that the hip, knee, and ankle extensors, which act primarily in the sagittal plane and contribute significantly to vertical support and forward progression, also accelerate the center of mass in the mediolateral direction. Kinematic, force plate, and muscle EMG data were recorded simultaneously for five healthy subjects who walked at their preferred speeds. The body was modeled as a 10-segment, 23 degree-of-freedom skeleton, actuated by 54 muscles. Joint moments obtained from inverse dynamics were decomposed into muscle forces by solving an optimization problem that minimized the sum of the squares of the muscle activations. Muscles contribu! ted significantly to the mediolateral acceleration of the center of mass throughout stance. Muscles that generated both support and forward progression (vasti, soleus, and gastrocnemius) also accelerated the center of mass laterally, in concert with the hip adductors and the plantarflexor everters. Gravity accelerated the center of mass laterally for most of the stance phase. The hip abductors, anterior and posterior gluteus medius, and, to a much lesser extent, the plantarflexor inverters, actively controlled balance by accelerating the center of mass medially. - Shock wave therapy for femoral head necrosis—Pressure measurements inside the femoral head
- J Biomech 43(11):2065-2069 (2010)
There is a persisting need for effective therapies of femoral head necrosis, a common bone disease. Promising clinical results have been stated for the treatment with extracorporeal shock waves (ESW). However, the effective remaining pressure in the target region inside the femoral head has never been determined. Aim of this study was to investigate whether ESW are able to propagate through bone without an excessive loss of pressure. The remaining ESW pressure generated by an electromagnetic device after passing a certain intraosseous distance within the femoral head was measured. Standardized holes were drilled in porcine femora and the absorption in relation to reference measurements in degassed water was determined. The results showed continuous attenuation of shock waves in bone. After a clinical relevant intraosseous distance of 10 mm an ESW pressure of 50% remained. In conclusion, ESW have the potential to reach necrotic regions with therapeutic pressure levels and to effectively treat femoral head necrosis. - Mechanical anisotropy of inflated elastic tissue from the pig aorta
Lillie MA Shadwick RE Gosline JM - J Biomech 43(11):2070-2078 (2010)
Uniaxial and biaxial mechanical properties of purified elastic tissue from the proximal thoracic aorta were studied to understand physiological load distributions within the arterial wall. Stress–strain behaviour was non-linear in uniaxial and inflation tests. Elastic tissue was 40% stiffer in the circumferential direction compared to axial in uniaxial tests and100% stiffer in vessels at an axial stretch ratio of 1.2 or 1.3 and inflated to physiological pressure. Poisson's ratio vθz averaged 0.2 and vzθ increased with circumferential stretch from 0.2 to 0.4. Axial stretch had little impact on circumferential behaviour. In intact (unpurified) vessels at constant length, axial forces decreased with pressure at low axial stretches but remained constant at higher stretches. Such a constant axial force is characteristic of incrementally isotropic arteries at their in vivo dimensions. In purified elastic tissue, force decreased with pressure at all axial strains, showi! ng no trend towards isotropy. Analysis of the force–length–pressure data indicated a vessel with vθz≈0.2 would stretch axially 2–4% with the cardiac pulse yet maintain constant axial force. We compared the ability of 4 mathematical models to predict the pressure-circumferential stretch behaviour of tethered, purified elastic tissue. Models that assumed isotropy could not predict the stretch at zero pressure. The neo-Hookean model overestimated the non-linearity of the response and two non-linear models underestimated it. A model incorporating contributions from orthogonal fibres captured the non-linearity but not the zero-pressure response. Models incorporating anisotropy and non-linearity should better predict the mechanical behaviour of elastic tissue of the proximal thoracic aorta. - 3d Mechanical properties of the partially obstructed guinea pig small intestine
- J Biomech 43(11):2079-2086 (2010)
Background and aims Partial obstruction of the small intestine results in severe hypertrophy of smooth muscle cells, dilatation and functional denervation. Hypertrophy of the small intestine is associated with alteration of the wall structure and the mechanical properties. The aims of this study were to determine three dimensional material properties of the obstructed small intestine in guinea pigs and to obtain the 3D stress–strain distributions in the small intestinal wall. Methods Partial obstruction of mid-jejunum was created surgically in five guinea pigs that were euthanized 2 weeks after the surgery. Ten-cm-long segments proximal to the obstruction site were used for the stretch-inflation mechanical test using a tri-axial test machine. The outer diameter, longitudinal force and the luminal pressure during the test were recorded simultaneously. An anisotropic exponential pseudo-strain energy density function was used as the constitutive equation to fit the experimental loading curve and for computation of the stress–strain distribution. Results The wall thickness and the wall area increased significantly in the obstructed jejunum (P<0.001). The pressure—outer radius curves in the obstructed segments were translated to the left of the normal segments, indicating wall stiffening after the obstruction. The circumferential stress and the longitudinal stress through the wall were higher in the obstructed segments (P<0.02). This was independent of whether the zero-stress state or the no-load states were used as the reference state. Conclusion The mechanical behaviour of the obstructed small intestine can be described using a 3D constitutive model. The obstruction-induced biomechanical properties change was characterized by higher circumferential and longitudinal stresses in the wall and altered material constants in the 3D constitutive model. - Three-dimensional registration of histology of human atherosclerotic carotid plaques to in-vivo imaging
Groen HC van Walsum T Rozie S Klein S van Gaalen K Gijsen FJ Wielopolski PA van Beusekom HM de Crom R Verhagen HJ van der Steen AF van der Lugt A Wentzel JJ Niessen WJ - J Biomech 43(11):2087-2092 (2010)
An accurate spatial relationship between 3D in-vivo carotid plaque and lumen imaging and histological cross sections is required to study the relationship between biomechanical parameters and atherosclerotic plaque components. We present and evaluate a fully three-dimensional approach for this registration problem, which accounts for deformations that occur during the processing of the specimens. By using additional imaging steps during tissue processing and semi-automated non-linear registration techniques, a 3D-reconstruction of the histology is obtained. The methodology was evaluated on five specimens obtained from patients, operated for severe atherosclerosis in the carotid bifurcation. In more than 80% of the histology slices, the quality of the semi-automated registration with computed tomography angiography (CTA) was equal to or better than the manual registration. The inter-observer variability was between one and two in-vivo CT voxels and was equal to the manual inter-observer variability. Our technique showed that the angles between the normals of the registered histology slices and the in-vivo CTA scan direction ranged 6–56°, indicating that proper 3D-registration is crucial for establishing a correct spatial relation with in-vivo imaging modalities. This new 3D-reconstruction technique of atherosclerotic plaque tissue opens new avenues in the field of biomechanics as well as in the field of image processing, where it can be used for validation purposes of segmentation algorithms. - Muscle mass in musculoskeletal models
Pai DK - J Biomech 43(11):2093-2098 (2010)
Most current models of musculoskeletal dynamics lump a muscle's mass with its body segment, and then simulate the dynamics of these body segments connected by joints. As shown here, this popular approach leads to errors in the system's inertia matrix and hence in all aspects of the dynamics. Two simplified mathematical models were created to capture the relevant features of monoarticular and biarticular muscles, and the errors were analyzed. The models were also applied to two physiological examples: the triceps surae muscles that plantar flex the human ankle and the biceps femoris posterior muscle of the rat hind limb. The analysis of errors due to lumping showed that these errors can be large. Although the errors can be reduced in some postures, they cannot be easily eliminated in models that use segment lumping. Some options for addressing these errors are discussed. - Muscle contributions to support and progression during single-limb stance in crouch gait
- J Biomech 43(11):2099-2105 (2010)
Pathological movement patterns like crouch gait are characterized by abnormal kinematics and muscle activations that alter how muscles support the body weight during walking. Individual muscles are often the target of interventions to improve crouch gait, yet the roles of individual muscles during crouch gait remain unknown. The goal of this study was to examine how muscles contribute to mass center accelerations and joint angular accelerations during single-limb stance in crouch gait, and compare these contributions to unimpaired gait. Subject-specific dynamic simulations were created for ten children who walked in a mild crouch gait and had no previous surgeries. The simulations were analyzed to determine the acceleration of the mass center and angular accelerations of the hip, knee, and ankle generated by individual muscles. The results of this analysis indicate that children walking in crouch gait have less passive skeletal support of body weight and utilize substa! ntially higher muscle forces to walk than unimpaired individuals. Crouch gait relies on the same muscles as unimpaired gait to accelerate the mass center upward, including the soleus, vasti, gastrocnemius, gluteus medius, rectus femoris, and gluteus maximus. However, during crouch gait, these muscles are active throughout single-limb stance, in contrast to the modulation of muscle forces seen during single-limb stance in an unimpaired gait. Subjects walking in crouch gait rely more on proximal muscles, including the gluteus medius and hamstrings, to accelerate the mass center forward during single-limb stance than subjects with an unimpaired gait. - Dynamic in vivo quadriceps lines-of-action
- J Biomech 43(11):2106-2113 (2010)
Tissue stresses and quadriceps forces are crucial factors when considering knee joint biomechanics. However, it is difficult to obtain direct, in vivo, measurements of these quantities. The primary purpose of this study was to provide the first complete description of quadriceps geometry (force directions and moment arms) of individual quadriceps components using in vivo, 3D data collected during volitional knee extension. A secondary purpose was to determine if 3D quadriceps geometry is altered in patients with patellofemoral pain and maltracking. After obtaining informed consent, cine-phase contrast (PC) MRI sets (x,y,z velocity and anatomic images) were acquired from 25 asymptomatic knees and 15 knees with patellofemoral pain during active knee extension. Using a sagittal-oblique and two coronal-oblique imaging planes, the origins and insertions of each quadriceps line-of-action were identified and tracked throughout the motion by integrating the cine-PC velocity da! ta. The force direction and relative moment (RM) were calculated for each line-of-action. All quadriceps lines-of-action were oriented primarily in the superior direction. There were no significant differences in quadriceps geometry between asymptomatic and subjects with patellofemoral pain. However, patellofemoral kinematics were significantly different between the two populations. This study will improve the ability of musculoskeletal models to closely match in vivo human performance by providing accurate 3D quadriceps geometry and associated patellofemoral kinematics during dynamic knee motion. Furthermore, determination that quadriceps geometry is not altered in patellofemoral pain supports the use of generalized a knee model based on asymptomatic quadriceps architecture. - Development of an active elbow flexion simulator to evaluate joint kinematics with the humerus in the horizontal position
- J Biomech 43(11):2114-2119 (2010)
In-vitro simulation of active joint motion is useful to evaluate rehabilitation protocols and surgical procedures in the laboratory prior to their application in patients. To date, simulated active elbow flexion has been reliably achieved and well established only in the dependent position (humerus vertical with hand down). We have developed and evaluated the performance of a new elbow motion simulator capable of active flexion in the dependent, varus, valgus and horizontal positions. Muscle loading and motion control were achieved via a combination of motors and actuators attached to relevant tendons. Simulated active flexion was compared to passive flexion in terms of repeatability, motion pathways and joint laxity. The joint kinematics of active flexion were significantly more repeatable than passive flexion (p<0.05). Active flexion reduced varus–valgus joint laxity by 29% (supinated p<0.05) and 26% (pronated p<0.05) compared to passive flexion. Greater repeatabil! ity of simulated active flexion suggests that this mode of in-vitro testing should increase statistical power and decrease required sample sizes. - Footwear affects the gearing at the ankle and knee joints during running
Braunstein B Arampatzis A Eysel P Brüggemann GP - J Biomech 43(11):2120-2125 (2010)
The objective of the study was to investigate the adjustment of running mechanics by wearing five different types of running shoes on tartan compared to barefoot running on grass focusing on the gearing at the ankle and knee joints. The gear ratio, defined as the ratio of the moment arm of the ground reaction force (GRF) to the moment arm of the counteracting muscle tendon unit, is considered to be an indicator of joint loading and mechanical efficiency. Lower extremity kinematics and kinetics of 14 healthy volunteers were quantified three dimensionally and compared between running in shoes on tartan and barefoot on grass. Results showed no differences for the gear ratios and resultant joint moments for the ankle and knee joints across the five different shoes, but showed that wearing running shoes affects the gearing at the ankle and knee joints due to changes in the moment arm of the GRF. During barefoot running the ankle joint showed a higher gear ratio in early sta! nce and a lower ratio in the late stance, while the gear ratio at the knee joint was lower during midstance compared to shod running. Because the moment arms of the counteracting muscle tendon units did not change, the determinants of the gear ratios were the moment arms of the GRF's. The results imply higher mechanical stress in shod running for the knee joint structures during midstance but also indicate an improved mechanical advantage in force generation for the ankle extensors during the push-off phase. - Simulation of a balloon expandable stent in a realistic coronary artery—Determination of the optimum modelling strategy
- J Biomech 43(11):2126-2132 (2010)
Computational models of stent deployment in arteries have been widely used to shed light on various aspects of stent design and optimisation. In this context, modelling of balloon expandable stents has proved challenging due to the complex mechanics of balloon–stent interaction and the difficulties involved in creating folded balloon geometries. In this study, a method to create a folded balloon model is presented and utilised to numerically model the accurate deployment of a stent in a realistic geometry of an atherosclerotic human coronary artery. Stent deployment is, however, commonly modelled by applying an increasing pressure to the stent, thereby neglecting the balloon. This method is compared to the realistic balloon expansion simulation to fully elucidate the limitations of this procedure. The results illustrate that inclusion of a realistic balloon model is essential for accurate modelling of stent deformation and stent stresses. An alternative balloon simul! ation procedure is presented however, which overcomes many of the limitations of the applied pressure approach by using elements which restrain the stent as the desired diameter is achieved. This study shows that direct application of pressure to the stent inner surface may be used as an optimal modelling strategy to estimate the stresses in the vessel wall using these restraining elements and hence offer a very efficient alternative approach to numerically modelling stent deployment within complex arterial geometries. The method is limited however, in that it can only predict final stresses in the stented vessel and not those occurring during stent expansion, in which case the balloon expansion model is required. - A model for the blood–brain barrier permeability to water and small solutes
- J Biomech 43(11):2133-2140 (2010)
The blood–brain barrier (BBB) has unique structures in order to protect the central nervous system. In addition to the tight junction of the microvessel endothelium, there is a uniform and narrow matrix-like basement membrane (BM) sandwiched between the vessel wall and the astrocyte foot processes ensheathing the cerebral microvessel. To understand the mechanism by which these structural components modulate permeability of the BBB, we developed a mathematical model for water and solute transport across the BBB. The fluid flow in the cleft regions of the BBB were approximated by the Poiseuille flow while those in the endothelial surface glycocalyx layer (SGL) and BM were approximated by the Darcy and Brinkman flows, respectively. Diffusion equations in each region were solved for the solute transport. The anatomical parameters were obtained from electron microscopy studies in the literature. Our model predicts that compared to the peripheral microvessels with endothel! ium only, the BM and the wrapping astrocytes can reduce hydraulic conductivity (Lp) of the BBB and the permeability to sodium fluorescein (PNaF) by up to 6-fold when the fiber density in the BM is the same as that in the SGL. Even when the SGL and the tight junctions of the endothelium are compromised, the BM and astrocyte foot processes can still maintain the low Lp and PNaF of the BBB. Our model predictions indicate that the BM and astrocytes of the BBB provide a great protection to the CNS under both physiological and pathological conditions. - Strain transfer in the annulus fibrosus under applied flexion
Desrochers J Duncan NA - J Biomech 43(11):2141-2148 (2010)
A detailed understanding of the anatomical and mechanical environment in the intervertebral disc at the scale of the cell is necessary for the design of tissue engineering repair strategies and to elucidate the role of mechanical factors in pathology. The objective of this study was to measure and compare the macroscale to microscale strains in the outer annulus fibrosus in various cellular regions of intact discs over a range of applied flexion. Macroscale strains were measured on the annulus fibrosus surface, and contrasted to in situ microscale strains using novel confocal microscopy techniques for dual labeling of the cell and the extracellular matrix. Fiber oriented surface strains were significantly higher than in situ fiber strains, which implies a mechanism of load redistribution that minimizes strain along the fibers. Non-uniformity of the strains and matrix distortion occurred immediately and most interestingly varied little with increase in flexion (3–16°! ), suggesting that inter-fiber shear is important in the initial stages of strain redistribution. Fiber oriented intercellular strains were significantly larger and compressive compared to in situ strains in other regions of the extracellular matrix indicating that the mechanical environment in this region may be unique. Further examination of the structural morphology in this pericellular region is needed to fully understand the pathway of strain transfer from the tissue to the cell. This study provides new knowledge on the complex in situ micro-mechanical environment of the annulus fibrosus that is essential to understanding the mechanobiological behavior of this tissue. - Automatic segmentation of surface EMG images: Improving the estimation of neuromuscular activity
Vieira TM Merletti R Mesin L - J Biomech 43(11):2149-2158 (2010)
Surface electromyograms (EMGs) recorded with a couple of electrodes are meant to comprise representative information of the whole muscle activation. Nonetheless, regional variations in neuromuscular activity seem to occur in numerous conditions, from standing to passive muscle stretching. In this study, we show how local activation of skeletal muscles can be automatically tracked from EMGs acquired with a bi-dimensional grid of surface electrodes (a grid of 8 rows and 15 columns was used). Grayscale images were created from simulated and experimental EMGs, filtered and segmented into clusters of activity with the watershed algorithm. The number of electrodes on each cluster and the mean level of neuromuscular activity were used to assess the accuracy of the segmentation of simulated signals. Regardless of the noise level, thickness of fat tissue and acquisition configuration (monopolar or single differential), the segmentation accuracy was above 60%. Accuracy values pe! aked close to 95% when pixels with intensity below 70% of maximal EMG amplitude in each segmented cluster were excluded. When simulating opposite variations in the activity of two adjacent muscles, watershed segmentation produced clusters of activity consistently centered on each simulated portion of active muscle and with mean amplitude close to the simulated value. Finally, the segmentation algorithm was used to track spatial variations in the activity, within and between medial and lateral gastrocnemius muscles, during isometric plantar flexion contraction and in quiet standing position. In both cases, the regionalization of neuromuscular activity occurred and was consistently identified with the segmentation method. - Simulation of pulmonary air flow with a subject-specific boundary condition
- J Biomech 43(11):2159-2163 (2010)
We present a novel image-based technique to estimate a subject-specific boundary condition (BC) for computational fluid dynamics (CFD) simulation of pulmonary air flow. The information of regional ventilation for an individual is derived by registering two computed tomography (CT) lung datasets and then passed to the CT-resolved airways as the flow BC. The CFD simulations show that the proposed method predicts lobar volume changes consistent with direct image-measured metrics, whereas the other two traditional BCs (uniform velocity or uniform pressure) yield lobar volume changes and regional pressure differences inconsistent with observed physiology. - Loading of the knee joint during activities of daily living measured in vivo in five subjects
Kutzner I Heinlein B Graichen F Bender A Rohlmann A Halder A Beier A Bergmann G - J Biomech 43(11):2164-2173 (2010)
Detailed knowledge about loading of the knee joint is essential for preclinical testing of implants, validation of musculoskeletal models and biomechanical understanding of the knee joint. The contact forces and moments acting on the tibial component were therefore measured in 5 subjects in vivo by an instrumented knee implant during various activities of daily living. Average peak resultant forces, in percent of body weight, were highest during stair descending (346% BW), followed by stair ascending (316% BW), level walking (261% BW), one legged stance (259% BW), knee bending (253% BW), standing up (246% BW), sitting down (225% BW) and two legged stance (107% BW). Peak shear forces were about 10–20 times smaller than the axial force. Resultant forces acted almost vertically on the tibial plateau even during high flexion. Highest moments acted in the frontal plane with a typical peak to peak range −2.91% BWm (adduction moment) to 1.61% BWm (abduction moment) throughout all activities. Peak flexion/extension moments ranged between −0.44% BWm (extension moment) and 3.16% BWm (flexion moment). Peak external/internal torques lay between −1.1% BWm (internal torque) and 0.53% BWm (external torque). The knee joint is highly loaded during daily life. In general, resultant contact forces during dynamic activities were lower than the ones predicted by many mathematical models, but lay in a similar range as measured in vivo by others. Some of the observed load components were much higher than those currently applied when testing knee implants. - Evaluation of contributions of orthodontic mini-screw design factors based on FE analysis and the Taguchi method
Lin CL Yu JH Liu HL Lin CH Lin YS - J Biomech 43(11):2174-2181 (2010)
This study determines the relative effects of changes in bone/mini-screw osseointegration and mini-screw design factors (length, diameter, thread shape, thread depth, material, head diameter and head exposure length) on the biomechanical response of a single mini-screw insertion. Eighteen CAD and finite element (FE) models corresponding to a Taguchi L18 array were constructed to perform numerical simulations to simulate mechanical responses of a mini-screw placed in a cylindrical bone. The Taguchi method was employed to determine the significance of each design factor in controlling strain. Simulation results indicated that mini-screw material, screw exposure length and screw diameter were the major factors affecting bone strain, with percentage contributions of 63%, 24% and 7%, respectively. Bone strain decreased obviously when screw material had the high elastic modulus of stainless/titanium alloys, a small exposure length and a large diameter. Other factors had no s! ignificanton bone strain. The FE analysis combined with the Taguchi method efficiently identified the relative contributions of several mini-screw design factors, indicating that using a strong stainless/titanium alloys as screw material is advantageous, and increase in mechanical stability can be achieved by reducing the screw exposure length. Simulation results also revealed that mini-screw and bone surface contact can provide sufficient mechanical retention to perform immediately load in clinical treatment. - Foot forces during typical days on the international space station
Cavanagh PR Genc KO Gopalakrishnan R Kuklis MM Maender CC Rice AJ - J Biomech 43(11):2182-2188 (2010)
Decreased bone mineral density (BMD) in astronauts returning from long-duration spaceflight missions has been well documented, but the altered mechanical loading environment experienced by the musculoskeletal system, which may contribute to these changes, has not been well characterized. The current study describes the loading environment of the lower extremity (LE) during typical days on the International Space Station (ISS) compared to similar data for the same individuals living on Earth. Data from in-shoe force measurements are also used as input to the enhanced daily load stimulus (EDLS) model to determine the mechanical "dose" experienced by the musculoskeletal system and to associate this dose with changes in BMD. Four male astronauts on approximately 6-month missions to the ISS participated in this study. In-shoe forces were recorded using capacitance-based insoles during entire typical working days both on Earth and on-orbit. BMD estimates from the hip and spine regions were obtained from dual energy X-ray absorptiometry (DXA) pre- and post-flight. Measurable loading was recorded for only 30% of the time assigned for exercise. In-shoe forces during treadmill walking and running on the ISS were reduced by 25% and 46%, respectively, compared to similar activities on Earth. Mean on-orbit LE loads varied from 0.20 to 1.3 body weight (BW) during resistance exercise and were 0.10 BW during bicycle ergometry. Application of the EDLS model showed a mean decrease of 25% in the daily load experienced by the LE. BMD decreased by 0.71% and 0.83% per month during their missions in the femoral neck and lumbar spine, respectively. Our findings support the conclusion that the measured ISS exercise durations and/or loading were insufficient to provide the loading stimulus required to prevent bone loss. Future trials with EDLS values closer to 100% of Earth values will offer a true test of exercise as a countermeasure to on-orbit bone loss. - Cross-flow at the anterior communicating artery and its implication in cerebral aneurysm formation
Jou LD Lee DH Mawad ME - J Biomech 43(11):2189-2195 (2010)
The anterior communicating artery (ACoA) is an important element of the circle of Willis. While the artery itself is short and small, a large number of intracranial aneurysms can be found at the ACoA. Four subject-specific ACoA models are constructed from 3D rotational angiographic images. The ACoA of these models ranged from 1.7 to 2.7 mm in diameter and 1.5 to 5.7 mm in length. Pulsatile flows through these four ACoA models are studied numerically. Blood is found to move in two opposite directions simultaneously within the ACoA, giving a much higher wall shear at the ACoA. These two opposite flow streams produce a cross-flow that is dependent on the flow rates at the anterior cerebral arteries and internal carotid arteries (ICAs). A larger and shorter ACoA allows flow through the ACoA easily, leading to a greater cross-flow and higher hemodynamic forces on the artery. This cross-flow may disappear when there is a sufficient net flow for a smaller and longer ACoA. Wal! l shear stress can be as high as 185 Pa at smaller ACoAs, but it can be lowered by asymmetric waveforms at the ICAs. A functional circle of Willis also promotes cross-flow at both the ACoA and posterior communicating arteries. - Evaluation of a mixed approach combining stationary and wearable systems to monitor gait over long distance
- J Biomech 43(11):2196-2202 (2010)
Thanks to decades of research, gait analysis has become an efficient tool. However, mainly due to the price of the motion capture systems, standard gait laboratories have the capability to measure only a few consecutive steps of ground walking. Recently, wearable systems were proposed to measure human motion without volume limitation. Although accurate, these systems are incompatible with most of existing calibration procedures and several years of research will be necessary for their validation. A new approach consisting of using a stationary system with a small capture volume for the calibration procedure and then to measure gait using a wearable system could be very advantageous. It could benefit from the knowledge related to stationary systems, allow long distance monitoring and provide new descriptive parameters. The aim of this study was to demonstrate the potential of this approach. Thus, a combined system was proposed to measure the 3D lower body joints angles ! and segmental angular velocities. It was then assessed in terms of reliability towards the calibration procedure, repeatability and concurrent validity. The dispersion of the joint angles across calibrations was comparable to those of stationary systems and good reliability was obtained for the angular velocities. The repeatability results confirmed that mean cycle kinematics of long distance walks could be used for subjects' comparison and pointed out an interest for the variability between cycles. Finally, kinematics differences were observed between participants with different ankle conditions. In conclusion, this study demonstrated the potential of a mixed approach for human movement analysis. - In vitro response of the natural cadaver knee to the loading profiles specified in a standard for knee implant wear testing
- J Biomech 43(11):2203-2207 (2010)
The purpose of this study was to examine how a natural knee responds to the inputs of a total knee replacement testing standard developed by the International Organization for Standardization (ISO). This load control standard prescribes forces to be used for wear testing of knee replacements independent of implant size or design. A parallel ISO standard provides wear testing inputs that are displacement based instead of force based. Eight fresh frozen cadaveric knees were potted and tested in a 6 degree of freedom knee simulator using the load-control standard. The resulting displacements during load-control testing were compared to the prescribed displacements of the ISO displacement standard. At half the tibial torque prescribed by the load standard there was three times more average internal tibial rotation (20.3°) than is prescribed by the displacement standard (5.7°). The AP motion resulting from load testing was much different than is specified by the displacem! ent standard. All eight knees had anterior tibial translation with respect to the femur during swing phase while the displacement standard specifies posterior tibial displacement. The variation in these motions among knees and their difference from the ISO displacement standard may be one factor that explains why wear results of total knee replacements based on ISO load or displacement testing frequently do not agree with each other or with clinical retrievals. - Gait retraining to reduce the knee adduction moment through real-time visual feedback of dynamic knee alignment
- J Biomech 43(11):2208-2213 (2010)
Varus knee alignment is a risk factor for medial knee osteoarthritis and is associated with high knee adduction moments. Therefore, reducing the knee adduction moment in varus-aligned individuals with otherwise healthy knees may reduce their risk for developing osteoarthritis. A gait modification that improves dynamic knee alignment may reduce the adduction moment, and systematic training may lead to more natural-feeling and less effortful execution of this pattern. To test these hypotheses, eight healthy, varus-aligned individuals underwent a gait modification protocol. Real-time feedback of dynamic knee alignment was provided over eight training sessions, using a fading paradigm. Natural and modified gait were assessed post-training and after 1 month, and compared to pre-training natural gait. The knee adduction moment, as well as hip adduction, hip internal rotation and knee adduction angles were evaluated. At each training session, subjects rated how effortful and ! natural-feeling the modified pattern was to execute. Post-training, the modified pattern demonstrated an 8° increase in hip internal rotation and 3° increase in hip adduction. Knee adduction decreased 2°, and the knee adduction moment decreased 19%. Natural gait did not differ between the three visits, nor did the modified gait pattern between the post-training and 1 month visits. The modified pattern felt more natural and required less effort after training. Based on these results, gait retraining to improve dynamic knee alignment resulted in significant reductions in the knee adduction moment, primarily through hip internal rotation. Further, systematic training led to more natural-feeling and less effortful execution of the gait pattern. - Pacemaking activity is regulated by membrane stretch via the CICR pathway in cultured interstitial cells of Cajal from murine intestine
Yu Wang Z Fei Han Y Huang X Zhao P Li Lu H Chul Kim Y Xie Xu W - J Biomech 43(11):2214-2220 (2010)
Membrane stretch is an important stimulus in gastrointestinal (GI) motility regulation, but the relationship between membrane stretch and the pacemaking activity of GI smooth muscle is poorly understood. We examined the effect of intestinal distension on slow waves and the effect of membrane stretch on pacemaker currents in cultured intestinal interstitial cells of Cajal (ICCs) from murine small intestine. At organ level, intestinal distension significantly increased amplitude of slow and fast waves, and enhanced frequencies of fast but not slow waves. At the cellular level, membrane stretch-induced by hyposmotic cell swelling (MSHC) depolarized membrane potential and activated large inward holding current, but suppressed amplitude of pacemaker potential or pacemaking current. External Ca2+-free solution abolished pacemaker current and blocked MSHC-induced inward holding current. However, a sustained inward holding current was activated and the amplitude of pacemaker c! urrent was increased by high ethylene glycol tetraacetic acid (EGTA) in pipette. Then MSHC also potentiated the inward holding current. MSHC significantly increased amplitude of rhythmic Ca2+ transients and basal intracellular Ca2+ concentration ([Ca2+]i). 2-APB blocked both pacemaker current and Ca2+ transients but did not alter the effect of MSHC on pacemaker current and Ca2+ transients. In contrast, ryanodine inhibited Ca2+ transients but not pacemaker current, and completely blocked MSHC-induced inward holding current and MSHC-induced increase of basal [Ca2+]i. These results suggest that intestinal distension potentiates intestinal motility by increasing the amplitude of slow waves. Membrane stretch potentiates pacemaking activity via releasing Ca2+ from calcium-induced calcium release (CICR) in cultured intestinal ICCs. - Mechanical characterization of liver capsule through uniaxial quasi-static tensile tests until failure
Brunon A Bruyère-Garnier K Coret M - J Biomech 43(11):2221-2227 (2010)
Accidentology data showed that liver is often injured in car crashes; three types of injuries occur: hematoma, laceration and vessel failure. This paper focuses on surface laceration, which involves liver capsule and hepatic parenchyma. Liver capsule behavior has been studied but its failure properties are still unclear, particularly on a local point of view. In the present study, tensile quasi-static tests are run on parenchyma and capsule samples until failure to characterize capsule failure. Normalized load as well as failure properties—ultimate load per width unit and ultimate strain—are determined. Digital image correlation is used to measure the full local strain field on the capsule. Mean values of failure characteristics for hepatic capsule are 47±29% for the ultimate local strain and 0.3±0.3 N/mm for the ultimate load per width unit. A comparison between human and porcine tissues is conducted based on Mann–Whitney statistical test; it reveals that caps! ule characteristics are close between these two species; however, freezing preservation significantly affects porcine capsule failure properties. Therefore using porcine instead of human tissue to determine failure characteristics of liver capsule seems satisfactory only on fresh tissues. - Assessment of the bilateral asymmetry of human femurs based on physical, densitometric, and structural rigidity characteristics
Pierre MA Zurakowski D Nazarian A Hauser-Kara DA Snyder BD - J Biomech 43(11):2228-2236 (2010)
The purpose of this study was to perform a comprehensive geometric, densitometric, biomechanical, and statistical analysis of paired femurs for an adult population over a wide age range using three imaging modalities to quantify the departure from symmetry in size, bone mineral density, and cross-sectional structural rigidities. Femur measurements were obtained from 20 pairs of cadaveric femurs. Dimensions of these anatomic sites were measured using calipers directly on the bone and plain radiographs. Dual energy X-ray absorptiometry was used to measure bone mineral density. Bone mineral content and axial and bending rigidities were determined from the CT imaging. No differences were observed between the geometric measurements, DXA based bone mineral density and axial and bending rigidities of left and right femurs (P>0.05 for all cases). Left and right proximal femurs are not significantly different based on geometric, densitometric, and structural rigidity measurements. However, absolute left–right differences for individual patients can be substantial. When using the contralateral femur as a control, the number of femur pairs required to assess significant changes in anatomic dimensions and structural properties induced by a tumor, infection, fracture, or implanted device can range from 3 to 165 pairs depending on the desired effect size or sensitivity (5% or 10% difference). This information is important both for femoral arthroplasty implant design and the use of the contralateral femur as an intra-subject control for clinical assessment and research studies. In addition, our statistical analysis provides sample size estimates for planning future orthopedic research studies. - Traveling-load calibration of grid-array transient contact stress sensors
Kang L Baer TE James Rudert M Pedersen DR Brown TD - J Biomech 43(11):2237-2240 (2010)
Thin, pliant transducers with grid arrays of sensing elements (sensels) have been widely used for transient measurements of intra-articular contact stresses. Conventional calibration procedures for this class of sensors are based upon spatially uniform scaling of sensel output values so as to recover two known fiducial loads, physically applied with the sensor either compressed between platens or mounted in situ. Because of the nonlinearities involved, it is desirable to have the highest of those two calibration loadings be such that all individual sensels are engaged at/near the peak of their expected functional range. However, for many situations of practical interest, impracticably large total calibration forces would be required. We report development of a novel pneumatically actuated wringer-like calibration device, and companion iterative post-processing software, that bypasses this longstanding difficulty. Sensors passed through the rollers of this device experi! ence constant-distribution traveling fiducial loads propagating across their surface, thus allowing efficient calibration of all sensels individually to contact stress levels that would be impracticably high to simultaneously apply to all sensels. Sensel-specific calibration curves are rapidly and easily generated using this new approach and compare favorably to those obtained with less expeditious conventional platen-based protocols. - What gives Bolt the edge—A.V. Hill knew it already!
Beneke R Taylor MJ - J Biomech 43(11):2241-2243 (2010)
The 100 m is the blue ribboned event of world athletics competitions, with the winner crowned as the fastest human on Earth. Currently that fastest human is Usain Bolt, who covers 100 m in 9.58 s, achieving an average velocity of 10.43 m s−1. Bolt is a phenomenal athlete, but what is his trick? Using Hills model, relating muscle force and heat liberation to shortening velocity, we propose that Bolt is at an advantage in relative power development and biomechanical efficiency compared to his contemporaries. - Implantable MEMS compressive stress sensors: Design, fabrication and calibration with application to the disc annulus
- J Biomech 43(11):2244-2248 (2010)
Physiological stresses are fundamental to biomechanical testing, mechanobiological analyses, implant design, and tissue engineering. The purpose of this study was to design, fabricate, and evaluate compressive stress sensors packaged for extended, in vivo implantation in the annulus of the intervertebral disc. A commercial microelectromechanical systems (MEMS) pressure sensor die was selected as the active element for a custom stress sensor. The sensor die was modified and packaged to protect the electrical system from the biochemical and biomechanical environment. Completed sensors were calibrated under hydrostatic pressure and solid contact compression. Calibrations were performed before and after 8 weeks of in vivo implantation in a porcine disc. For the two reported sensors, stress and voltage were linearly correlated over a range of 0–1.8 MPa with less than 5% change in sensitivity. Sensitivity to solid contact stress was within 10% of that from hydrostatic pres! sure. In contrast to most previous studies, in which disc pressure was measured in the fluidic nucleus pulposus, these sensors may be used to measure in vivo dynamic compressive stresses in the annulus at magnitudes typical of the musculoskeletal system in a large animal over a relatively long post-operative time.
