Hot off the presses! Aug 11 J Biomech

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Latest Articles Include:

• Editorial Board and Publication Information
  - J Biomech 44(12):IFC (2011)
  
• Fluid-structure interaction based study on the physiological factors affecting the behaviors of stented and non-stented thoracic aortic aneurysms
  - J Biomech 44(12):2177-2184 (2011)
  Endovascular aneurysm repair (EVAR) is considered as a promising alternative technique for the treatment of aortic aneurysm. However, complications often occur after EVAR. In this paper, the influence of the physiological factors on the biomechanical behaviors of stented and non-stented thoracic aortic aneurysm (TAA) were presented. Representative TAA models with different intraluminal thrombus (ILT) volume before and after stent-graft (SG) implantation were built. Fluid-structure interaction effect was taken into account. The relative sliding between the SG wall and the aortic wall was allowed. Results showed that the cardiac cycle and ILT volume should be given much more consideration than previously thought in future investigations on TAA compliance. The time-averaged longitudinal displacement of SG necks were not uniformly distributed along circumferential direction of the aortic wall. Drag force increased with the increase of the cardiac cycle and decreased with t! he decrease of ILT volume. Computational results of TAA wall stress, sac and lumen pressure indicated that patient with faster heart rate might be at great risk of aneurysm rupture. The stress absorption effect of the SG was influenced by both ILT and cardiac cycle, which was also found to have strong impact on flow pattern. We believe that this study will bring new insights into further researches on the relevant issues and provide mechanics-based implications for clinical management of EVAR for TAA patient.
• An open source lower limb model: Hip joint validation
  - J Biomech 44(12):2185-2193 (2011)
  Musculoskeletal lower limb models have been shown to be able to predict hip contact forces (HCFs) that are comparable to in vivo measurements obtained from instrumented prostheses. However, the muscle recruitment predicted by these models does not necessarily compare well to measured electromyographic (EMG) signals. In order to verify if it is possible to accurately estimate HCFs from muscle force patterns consistent with EMG measurements, a lower limb model based on a published anatomical dataset (Klein Horsman et al., 2007. Clinical Biomechanics. 22, 239–247) has been implemented in the open source software OpenSim. A cycle-to-cycle hip joint validation was conducted against HCFs recorded during gait and stair climbing trials of four arthroplasty patients (Bergmann et al., 2001. Journal of Biomechanics. 34, 859–871). Hip joint muscle tensions were estimated by minimizing a polynomial function of the muscle forces. The resulting muscle activation patterns obtained by assessing multiple powers of the objective function were compared against EMG profiles from the literature. Calculated HCFs denoted a tendency to monotonically increase their magnitude when raising the power of the objective function; the best estimation obtained from muscle forces consistent with experimental EMG prof! iles was found when a quadratic objective function was minimized (average overestimation at experimental peak frame: 10.1% for walking, 7.8% for stair climbing). The lower limb model can produce appropriate balanced sets of muscle forces and joint contact forces that can be used in a range of applications requiring accurate quantification of both. The developed model is available at the website https://simtk.org/home/low_limb_london.
• Effects of reduced plantar cutaneous afferent feedback on locomotor adjustments in dynamic stability during perturbed walking
  - J Biomech 44(12):2194-2200 (2011)
  This study examined the effects of reduced plantar cutaneous afferent feedback on predictive and feedback adaptive locomotor adjustments in dynamic stability during perturbed walking. Twenty-two matched participants divided between an experimental-group and a control-group performed a gait protocol, which included surface alterations to one covered exchangeable gangway-element (hard/soft). In the experimental-group, cutaneous sensation in both foot soles was reduced to the level of sensory peripheral neuropathy by means of intradermal injections of an anaesthetic solution, without affecting foot proprioception or muscles. The gait protocol consisted of baseline trials on a uniformly hard surface and an adaptation phase consisting of nineteen trials incorporating a soft gangway-element, interspersed with three trials using the hard surface-element (2nd, 8th and 19th). Dynamic stability was assessed by quantifying the margin of stability (MS), which was calculated as the! difference between the base of support (BS) and the extrapolated centre of mass (CM). The horizontal velocity of the CM and its vertical projection in the anterior–posterior direction and the eigenfrequency of an inverted pendulum determine the extrapolated-CM. Both groups increased the BS at the recovery step in response to the first unexpected perturbation. These feedback corrections were used more extensively in the experimental-group, which led to a higher MS compared to the control-group, i.e. a more stable body-position. In the adaptation phase the MS returned to baseline similarly in both groups. In the trial on the hard surface directly after the first perturbation, both groups increased the MS at touchdown of the disturbed leg compared to baseline trials, indicating rapid predictive adjustments irrespective of plantar cutaneous input. Our findings demonstrate that the locomotor adaptational potential does not decrease due to the loss of plantar sensation.
• Role of the acetabular labrum in load support across the hip joint
  - J Biomech 44(12):2201-2206 (2011)
  The relatively high incidence of labral tears among patients presenting with hip pain suggests that the acetabular labrum is often subjected to injurious loading in vivo. However, it is unclear whether the labrum participates in load transfer across the joint during activities of daily living. This study examined the role of the acetabular labrum in load transfer for hips with normal acetabular geometry and acetabular dysplasia using subject-specific finite element analysis. Models were generated from volumetric CT data and analyzed with and without the labrum during activities of daily living. The labrum in the dysplastic model supported 4–11% of the total load transferred across the joint, while the labrum in the normal model supported only 1–2% of the total load. Despite the increased load transferred to the acetabular cartilage in simulations without the labrum, there were minimal differences in cartilage contact stresses. This was because the load supported by! the cartilage correlated with the cartilage contact area. A higher percentage of load was transferred to the labrum in the dysplastic model because the femoral head achieved equilibrium near the lateral edge of the acetabulum. The results of this study suggest that the labrum plays a larger role in load transfer and joint stability in hips with acetabular dysplasia than in hips with normal acetabular geometry.
• The effects of initial conditions and takeoff technique on running jumps for height and distance
  - J Biomech 44(12):2207-2212 (2011)
  This study used a subject-specific model with eight segments driven by joint torques for forward dynamics simulation to investigate the effects of initial conditions and takeoff technique on the performance of running jumps for height and distance. The torque activation profiles were varied in order to obtain matching simulations for two jumping performances (one for height and one for distance) by an elite male high jumper, resulting in a simulated peak height of 1.98 m and a simulated horizontal distance of 4.38 m. The peak height reached/horizontal distance travelled by the mass centre for the same corresponding initial conditions were then maximised by varying the activation timings resulting in a peak height of 2.09 m and a horizontal distance of 4.67 m. In a further two optimizations the initial conditions were interchanged giving a peak height of 1.82 m and a horizontal distance of 4.04 m. The four optimised simulations show that even with similar approach speed! s the initial conditions at touchdown have a substantial effect on the resulting performance. Whilst the takeoff phase is clearly important, unless the approach phase and the subsequent touchdown conditions are close to optimal then a jumper will be unable to compensate for touchdown condition shortcomings during the short takeoff phase to achieve a performance close to optimum.
• Frailty assessment based on wavelet analysis during quiet standing balance test
  - J Biomech 44(12):2213-2220 (2011)
  Background A standard phenotype of frailty was independently associated with an increased risk of adverse outcomes including comorbidity, disability and with increased risks of subsequent falls and fractures. Postural control deficit measurement during quiet standing has been often used to assess balance and fall risk in elderly frail population. Real time human motion tracking is an accurate, inexpensive and portable system to obtain kinematic and kinetic measurements. The aim of this study was to examine orientation and acceleration signals from a tri-axial inertial magnetic sensor during quiet standing balance tests using the wavelet transform in a frail, a prefail and a healthy population. Methods Fourteen subjects from a frail population (79±4 years), eighteen subjects from a prefrail population (80±3 years) and twenty four subjects from a healthy population (40±3 years) volunteered to participate in this study. All signals were analyzed using time–frequency information based on wavelet decomposition and principal component analysis. Findings The absolute sum of the coefficients of the wavelet details corresponding to the high frequencies component of orientation and acceleration signals were associated with frail syndrome. Interpretation These parameters could be of great interest in clinical settings and improved rehabilitation therapies and in methods for identifying elderly population with frail syndrome.
• Large Eddy Simulation of the pharyngeal airflow associated with Obstructive Sleep Apnea Syndrome at pre and post-surgical treatment
  - J Biomech 44(12):2221-2228 (2011)
  Obstructive Sleep Apnea Syndrome (OSAS) is the most common sleep-disordered breathing medical condition and a potentially life-threatening affliction. Not all the surgical or non-surgical OSAS therapies are successful for each patient, also in part because the primary factors involved in the etiology of this disorder are not completely understood. Thus, there is a need for improving both diagnostic and treatment modalities associated with OSAS. A verified and validated (in terms of mean velocity and pressure fields) Large Eddy Simulation approach is used to characterize the abnormal pharyngeal airflow associated with severe OSAS and its interaction with the airway wall in a subject who underwent surgical treatment. The analysis of the unsteady flow at pre- and post-treatment is used to illustrate the airflow dynamics in the airway associated with OSAS and to reveal as well, the changes in the flow variables after the treatment. At pre-treatment, large airflow velocity ! and wall shear stress values were found at the obstruction site in all cases. Downstream of obstruction, flow separation generated flow recirculation regions and enhanced the turbulence production in the jet-like shear layers. The interaction between the generated vortical structures and the pharyngeal airway wall induced large fluctuations in the pressure forces acting on the pharyngeal wall. After the surgery, the flow field instabilities vanished and both airway resistance and wall shear stress values were significantly reduced.
• Mitral leaflet modeling: Importance of in vivo shape and material properties
  - J Biomech 44(12):2229-2235 (2011)
  The anterior mitral leaflet (AML) is a thin membrane that withstands high left ventricular (LV) pressure pulses 100,000 times per day. The presence of contractile cells determines AML in vivo stiffness and complex geometry. Until recently, mitral valve finite element (FE) models have neglected both of these aspects. In this study we assess their effect on AML strains and stresses, hypothesizing that these will differ significantly from those reported in literature. Radiopaque markers were sewn on the LV, the mitral annulus, and AML in sheep hearts, and their four-dimensional coordinates obtained with biplane video fluoroscopy. Employing in vivo data from three representative hearts, AML FE models were created from the marker coordinates at the end of isovolumic relaxation assumed as the unloaded reference state. AML function was simulated backward through systole, applying the measured trans-mitral pressure on AML LV surface and marker displacements on AML boundaries. Simulated AML displacements and curvatures were consistent with in vivo measurements, confirming model accuracy. AML circumferential strains were mostly tensile (1–3%), despite being compressive (−1%) near the commissures. Radial strains were compressive in the belly (−1 to −0.2%), and tensile (2–8%) near the free edge. These results differ significantly from those of previous FE models. They reflect the synergy of high tissue stiffness, which limits tensile circumferential strains, and initial compound curvature, which forces LV pressure to compress AML radially. The obtained AML shape may play a role not only in preventing mitral regurgitation, but also in optimizing LV outflow fluid dynamics.
• Markerless analysis of front crawl swimming
  - J Biomech 44(12):2236-2242 (2011)
  Research on motion analysis of swimmers is commonly based on video recordings of the subject's motion, which are analyzed by manual digitization of feature points by an operator. This procedure has two main drawbacks: it is time-consuming, and it is affected by low repeatability. Therefore, the application of video-based, automatic approaches to motion analysis was investigated. A video-based, markerless system for the analysis of arm movements during front crawl swimming was developed. The method proposed by Corazza et al. (2010) was modified in order to be used into water environment. Three dimensional coordinates of shoulder, elbow and wrist joints centers of 5 sprint swimmers performing front crawl swimming were determined. Wrist joint velocity was also calculated. Accuracy and reliability of the proposed technique were evaluated by means of comparison with traditional manual digitization (SIMI Reality Motion Systems GmbH). Root mean square distance (RMSD) values between trajectories estimated with the two techniques were determined. Results show good accuracy for wrist joint (RMSD<56 mm), and reliability, evaluated on one subject, comparable to ! the inter-operator variability associated with the manual digitization procedure. The proposed technique is therefore very promising for quantitative, wide-scale studies on swimmers' motion.
• Automatic recognition of falls in gait-slip training: Harness load cell based criteria
  - J Biomech 44(12):2243-2249 (2011)
  Over-head-harness systems, equipped with load cell sensors, are essential to the participants' safety and to the outcome assessment in perturbation training. The purpose of this study was to first develop an automatic outcome recognition criterion among young adults for gait-slip training and then verify such criterion among older adults. Each of 39 young and 71 older subjects, all protected by safety harness, experienced 8 unannounced, repeated slips, while walking on a 7 m walkway. Each trial was monitored with a motion capture system, bilateral ground reaction force (GRF), harness force, and video recording. The fall trials were first unambiguously indentified with careful visual inspection of all video records. The recoveries without balance loss (in which subjects' trailing foot landed anteriorly to the slipping foot) were also first fully recognized from motion and GRF analyses. These analyses then set the gold standard for the outcome recognition with load cell ! measurements. Logistic regression analyses based on young subjects' data revealed that the peak load cell force was the best predictor of falls (with 100% accuracy) at the threshold of 30% body weight. On the other hand, the peak moving average force of load cell across 1 s period, was the best predictor (with 100% accuracy) separating recoveries with backward balance loss (in which the recovery step landed posterior to slipping foot) from harness assistance at the threshold of 4.5% body weight. These threshold values were fully verified using the data from older adults (100% accuracy in recognizing falls). Because of the increasing popularity in the perturbation training coupling with the protective over-head-harness system, this new criterion could have far reaching implications in automatic outcome recognition during the movement therapy.
• Pulse wave propagation in a model human arterial network: Assessment of 1-D visco-elastic simulations against in vitro measurements
  - J Biomech 44(12):2250-2258 (2011)
  The accuracy of the nonlinear one-dimensional (1-D) equations of pressure and flow wave propagation in Voigt-type visco-elastic arteries was tested against measurements in a well-defined experimental 1:1 replica of the 37 largest conduit arteries in the human systemic circulation. The parameters required by the numerical algorithm were directly measured in the in vitro setup and no data fitting was involved. The inclusion of wall visco-elasticity in the numerical model reduced the underdamped high-frequency oscillations obtained using a purely elastic tube law, especially in peripheral vessels, which was previously reported in this paper [Matthys et al., 2007. Pulse wave propagation in a model human arterial network: Assessment of 1-D numerical simulations against in vitro measurements. J. Biomech. 40, 3476–3486]. In comparison to the purely elastic model, visco-elasticity significantly reduced the average relative root-mean-square errors between numerical and experi! mental waveforms over the 70 locations measured in the in vitro model: from 3.0% to 2.5% (p<0.012) for pressure and from 15.7% to 10.8% (p<0.002) for the flow rate. In the frequency domain, average relative errors between numerical and experimental amplitudes from the 5th to the 20th harmonic decreased from 0.7% to 0.5% (p<0.107) for pressure and from 7.0% to 3.3% (p<10−6) for the flow rate. These results provide additional support for the use of 1-D reduced modelling to accurately simulate clinically relevant problems at a reasonable computational cost.
• The human proximal femur behaves linearly elastic up to failure under physiological loading conditions
  - J Biomech 44(12):2259-2266 (2011)
  It has not been demonstrated whether the human proximal femur behaves linearly elastic when loaded to failure. In the present study we tested to failure 12 cadaveric femurs. Strain was measured (at 5000 Hz) on the bone surface with triaxial strain gages (up to 18 on each femur). High-speed videos (up to 18,000 frames/s) were taken during the destructive test. To assess the effect of tissue preservation, both fresh-frozen and formalin-fixed specimens were tested. Tests were carried out at two strain-rates covering the physiological range experienced during daily motor tasks. All specimens were broken in only two pieces, with a single fracture surface. The high-speed videos showed that failure occurred as a single abrupt event in less than 0.25 ms. In all specimens, fracture started on the lateral side of the neck (tensile stress). The fractured specimens did not show any sign of permanent deformation. The force–displacement curves were highly linear (R2>0.98) up to 99! % of the fracture force. When the last 1% of the force–displacement curve was included, linearity slightly decreased (minimum R2=0.96). Similarly, all force–strain curves were highly linear (R2>0.98 up to 99% of the fracture force). The slope of the first part of the force–displacement curve (up to 70% fracture force) differed from the last part of the curve (from 70% to 100% of the fracture force) by less than 17%. Such a difference was comparable to the fluctuations observed between different parts of the curve. Therefore, it can be concluded that the proximal femur has a linear-elastic behavior up to fracture, for physiological strain-rates.
• Effect of heel height on in-shoe localized triaxial stresses
  - J Biomech 44(12):2267-2272 (2011)
  Abnormal and excessive plantar pressure and shear are potential risk factors for high-heeled related foot problems, such as forefoot pain, hallux valgus deformity and calluses. Plantar shear stresses could be of particular importance with an inclined supporting surface of high-heeled shoe. This study aimed to investigate the contact pressures and shear stresses simultaneously between plantar foot and high-heeled shoe over five major weightbearing regions: hallux, heel, first, second and fourth metatarsal heads, using in-shoe triaxial force transducers. During both standing and walking, peak pressure and shear stress shifted from the lateral to the medial forefoot as the heel height increased from 30 to 70 mm. Heel height elevation had a greater influence on peak shear than peak pressure. The increase in peak shear was up to 119% during walking, which was about five times that of peak pressure. With increasing heel height, peak posterolateral shear over the hallux at mi! dstance increased, whereas peak pressure at push-off decreased. The increased posterolateral shear could be a contributing factor to hallux deformity. It was found that there were differences in the location and time of occurrence between in-shoe peak pressure and peak shear. In addition, there were significant differences in time of occurrence for the double-peak loading pattern between the resultant horizontal ground reaction force peaks and in-shoe localized peak shears. The abnormal and drastic increase of in-shoe shear stresses might be a critical risk factor for shoe-related foot disorders. In-shoe triaxial stresses should therefore be considered to help in designing proper footwear.
• Turbulence downstream of subcoronary stentless and stented aortic valves
  - J Biomech 44(12):2273-2278 (2011)
  Regions of turbulence downstream of bioprosthetic heart valves may cause damage to blood components, vessel wall as well as to aortic valve leaflets. Stentless aortic heart valves are known to posses several hemodynamic benefits such as larger effective orifice areas, lower aortic transvalvular pressure difference and faster left ventricular mass regression compared with their stented counterpart. Whether this is reflected by diminished turbulence formation, remains to be shown. We implanted either stented pericardial valve prostheses (Mitroflow), stentless valve prostheses (Solo or Toronto SPV) in pigs or they preserved their native valves. Following surgery, blood velocity was measured in the cross sectional area downstream of the valves using 10 MHz ultrasonic probes connected to a dedicated pulsed Doppler equipment. As a measure of turbulence, Reynolds normal stress (RNS) was calculated at two different blood pressures (baseline and 50% increase). We found no diffe! rence in maximum RNS measurements between any of the investigated valve groups. The native valve had significantly lower mean RNS values than the Mitroflow (p=0.004), Toronto SPV (p=0.008) and Solo valve (p=0.02). There were no statistically significant differences between the artificial valve groups (p=0.3). The mean RNS was significantly larger when increasing blood pressure (p=0.0006). We, thus, found no advantages for the stentless aortic valves compared with stented prosthesis in terms of lower maximum or mean RNS values. Native valves have a significantly lower mean RNS value than all investigated bioprostheses.
• Age-related changes in human trabecular bone: Relationship between microstructural stress and strain and damage morphology
  - J Biomech 44(12):2279-2285 (2011)
  Accumulation of microdamage in aging and disease can cause skeletal fragility and is one of several factors contributing to osteoporotic fractures. To better understand the role of microdamage in fragility fracture, the mechanisms of bone failure must be elucidated on a tissue-level scale where interactions between bone matrix properties, the local biomechanical environment, and bone architecture are concurrently examined for their contributions to microdamage formation. A technique combining histological damage assessment of individual trabeculae with linear finite element solutions of trabecular von Mises and principal stress and strain was used to compare the damage initiation threshold between pre-menopausal (32–37 years, n=3 donors) and post-menopausal (71–80 years, n=3 donors) femoral cadaveric bone. Strong associations between damage morphology and stress and strain parameters were observed in both groups, and an age-related decrease in undamaged trabecular ! von Mises stress was detected. In trabeculae from younger donors, the 95% CI for von Mises stress on undamaged regions ranged from 50.7–67.9 MPa, whereas in trabeculae from older donors, stresses were significantly lower (38.7–50.2, p<0.01). Local microarchitectural analysis indicated that thinner, rod-like trabeculae oriented along the loading axis are more susceptible to severe microdamage formation in older individuals, while only rod-like architecture was associated with severe damage in younger individuals. This study therefore provides insight into how damage initiation and morphology relate to local trabecular microstructure and the associated stresses and strains under loading. Furthermore, by comparison of samples from pre- and post-menopausal women, the results suggest that trabeculae from younger individuals can sustain higher stresses prior to microdamage initiation.
• Lateral wedges decrease biomechanical risk factors for knee osteoarthritis in obese women
  - J Biomech 44(12):2286-2291 (2011)
  Obesity is the primary risk factor for the development and progression of medial compartment knee osteoarthritis. Laterally wedged insoles can reduce many of the biomechanical risk factors for disease development in osteoarthritis patients and lean individuals but their efficacy is unknown for at-risk, obese women. The purpose was to determine how an 8° laterally wedged insole influenced kinetic and kinematic gait parameters in obese women. Gait analysis was performed on fourteen obese (average 29.3 years; BMI 37.2 kg/m2) and 14 lean control women (average 26.1 years; BMI 22.4 kg/m2) with and without a full-length, wedged insole. Peak joint angles, the external knee adduction moment and its angular impulse were calculated during preferred and standard 1.24 m/s walking speeds. Statistical significance was assessed using a 2-way ANOVA (α=0.05). The insole significantly reduced the peak external knee adduction moment (mean decrease of 3.6±3.9 Nm for obese and 1.9±1.8 ! Nm for controls) and its angular impulse in both groups. The wedged insoles also produced small changes in ankle dorsiflexion (obese: 1.2±1.4° increase; control: 1.5±1.4° increase) and eversion range of motion (obese: 1.3±1.9° decrease; control: 1.5±1.2° decrease) but did not alter peak angles of superior joints. Although the majority of obese women may develop knee osteoarthritis during their lifetime, a prophylactic insole intervention could allow obese women with no severe knee malalignments to be active while preventing or delaying disease onset. However, the long-term effects of the insole have not yet been examined.
• Modeling leaflet correction techniques in aortic valve repair: A finite element study
  - J Biomech 44(12):2292-2298 (2011)
  In aortic valve sparing surgery, cusp prolapse is a common cause of residual aortic insufficiency. To correct cusp pathology, native leaflets of the valve frequently require adjustment which can be performed using a variety of described correction techniques, such as central or commissural plication, or resuspension of the leaflet free margin. The practical question then arises of determining which surgical technique provides the best valve performance with the most physiologic coaptation. To answer this question, we created a new finite element model with the ability to simulate physiologic function in normal valves, and aortic insufficiency due to leaflet prolapse in asymmetric, diseased or sub-optimally repaired valves. The existing leaflet correction techniques were simulated in a controlled situation, and the performance of the repaired valve was quantified in terms of maximum leaflets stress, valve orifice area, valve opening and closing characteristics as well a! s total coaptation area in diastole. On the one hand, the existing leaflet correction techniques were shown not to adversely affect the dynamic properties of the repaired valves. On the other hand, leaflet resuspension appeared as the best technique compared to central or commissural leaflet plication. It was the only method able to achieve symmetric competence and fix an individual leaflet prolapse while simultaneously restoring normal values for mechanical stress, valve orifice area and coaptation area.
• Contractile and non-contractile tissue volume and distribution in ankle muscles of young and older adults
  - J Biomech 44(12):2299-2306 (2011)
  Magnetic resonance imaging (MRI) enables accurate in vivo quantification of human muscle volumes, which can be used to estimate subject-specific muscle force capabilities. An important consideration is the amount of contractile and non-contractile tissue in the muscle compartment, which will influence force capability. We quantified age-related differences in the proportion and distribution of contractile and non-contractile tissue in the dorsiflexor and plantar flexor (soleus, and medial and lateral heads of gastrocnemius) muscles, and examined how well these volumes can be estimated from single MRI cross-sections. Axial MRIs of the left leg for 12 young (mean age 27 years) and 12 older (72 years) healthy, active adults were used to compute muscle volumes. Contractile tissue distribution along the leg was characterized by mathematical functions to allow volume prediction from single-slice cross-sectional area (CSA) measurements. Compared to young, older adults had les! s contractile volume and a greater proportion of non-contractile tissue. In both age groups the proportion of non-contractile tissue increased distally, with the smallest proportion near the maximum compartment CSA. A single CSA measurement predicted contractile volume with 8–11% error, with older adults in the higher end of this range. Using multiple slices improved volume estimates by roughly 50%, with average errors of about 3–4%. These results demonstrate significant age-related differences in non-contractile tissue for the dorsi- and plantar-flexor muscles. Although estimates of contractile volume can be obtained from single CSA measurements, multiple slices are needed for increased accuracy due to inter-individual variations in muscle volume and composition.
• Changes in articular cartilage mechanics with meniscectomy: A novel image-based modeling approach and comparison to patterns of OA
  - J Biomech 44(12):2307-2312 (2011)
  Meniscectomy is a significant risk factor for osteoarthritis, involving altered cell synthesis, central fibrillation, and peripheral osteophyte formation. Though changes in articular cartilage contact pressure are known, changes in tissue-level mechanical parameters within articular cartilage are not well understood. Recent imaging research has revealed the effects of meniscectomy on the time-dependent deformation of physiologically loaded articular cartilage. To determine tissue-level cartilage mechanics that underlie observed deformation, a novel finite element modeling approach using imaging data and a contacting indenter boundary condition was developed. The indenter method reproduces observed articular surface deformation and avoids assumptions about tangential stretching. Comparison of results from an indenter model with a traditional femur–tibia model verified the method, giving errors in displacement, solid and fluid stress, and strain below 1% (RMS) and 7% (! max.) of the absolute maximum of the parameters of interest. Indenter finite element models using real joint image data showed increased fluid pressure, fluid exudation, loss of fluid load support, and increased tensile strains centrally on the tibial condyle after meniscectomy—patterns corresponding to clinical observations of cartilage matrix damage and fibrillation. Peripherally there was decreased consolidation, which corresponds to reduced contact and fluid pressure in this analysis. Clinically, these areas have exhibited advance of the subchondral growth front, biological destruction of the cartilage matrix, cartilage thinning, and eventual replacement of the cartilage via endochondral ossification. Characterizing the changes in cartilage mechanics with meniscectomy and correspondence with observed tissue-level effects may help elucidate the etiology of joint-level degradation seen in osteoarthritis.
• Stretch along the craniocaudal axis improves shape recoverability of the spinal cord
  - J Biomech 44(12):2313-2315 (2011)
  The spinal cord is physiologically stretched along the craniocaudal axis, and is subjected to tensile stress. The purpose of this study was to examine the effect of the tensile stress on morphological plasticity of the spinal cord under compression and decompression condition. The C1–T2 spinal column was excised from 4 rabbits. The laminae and lateral masses were removed. After excision of surrounding structures, a small rod was placed on the spinal cord. The rod was connected with a pan of the scale balance. Varying the weight between 0 and 20 g on the other scalepan, the indentation of the rod was measured. Then, the spinal cord was cut transversely to remove longitudinal tensile stress. The samples were measured again with the same protocol at point 10 mm caudal to each pre-measured point on the spinal cord. The shape recovery rate was calculated. The length of the spinal cord decreased by 9.7% after the separation. The maximum indentation was 2.1 mm (mean) at 20 ! g, and did not differ between the separated and un-separated cords. The recovery rate was not significantly different between the separated and un-separated cords until 3 g. At the load under 3 g, the recovery rate after the separation was significantly lower than that before the separation. The tensile stress along the craniocaudal axis in the spinal cord did not affect the spinal cord deformation in response to the compression, but it did affect the shape recoverability after the decompression.
• Non-uniform shrinkage for obtaining computational start shape for in-vivo MRI-based plaque vulnerability assessment
  - J Biomech 44(12):2316-2319 (2011)
  Background Critical mechanical conditions, such as stress within the structure and shear stress due to blood flow, predicted from in-vivo magnetic resonance image (MRI)-based computational simulations have shown to be potential in assessing carotid plaque vulnerability. Plaque contours obtained from in-vivo MRI are a result of a pressurized configuration due to physiological loading. However, in order to make accurate predictions, the computational model must be based on the loading-free geometry. A shrinkage procedure can be used to obtain the computational start shape. Method In this study, electrocardiograph (ECG)-gated MR-images of carotid plaques were obtained from 28 patients. The contours of each plaque were segmented manually. Additional to a uniform shrinkage procedure, a non-uniform shrinkage refinement procedure was used. This procedure was repeated until the pressurized lumen contour and fibrous cap thickness had the best match with the in-vivo image. Results Compared to the uniform shrinkage procedure, the non-uniform shrinkage significantly reduced the difference in lumen shape and in cap thickness at the thinnest site. Results indicate that uniform shrinkage would underestimate the critical stress in the structure by 20.5±10.7%. Conclusion For slices with an irregular lumen shape (the ratio of the maximum width to the minimum width is more than 1.05), the non-uniform shrinkage procedure is needed to get an accurate stress profile for mechanics and MRI-based carotid plaque vulnerability assessment.
• An induced acceleration index for examining joint couplings
  - J Biomech 44(12):2320-2322 (2011)
  A muscle produces moments at the joints it crosses, but these moments can also cause accelerations at joints not crossed by the muscle. This phenomenon, the acceleration of a joint caused by a muscle not crossing the joint, is referred to as induced acceleration. For a system of rigid bodies this study examines how system configuration, and segmental inertial properties dictate the potential of one joint to cause the acceleration of other joints in the system. From the equations of motion for a series of rigid bodies, an induced acceleration index (IAI) was developed. The IAI permits quantification of the relative potential of moments produced at joints in the kinematic chain to accelerate other joints in the kinematic chain. The IAI is a function of system orientation, segment lengths, and inertial properties. The IAI was used to examine the roles of the ankle and hip joints in quiet standing. The ankle joint had over 12 times the ability to accelerate the hip joint, ! than the hip had to accelerate the ankle joint. These results in part explain the relative merits of the two strategies predominantly used to maintain upright stance: the ankle and hip strategies. This index permits an understanding of how the induced accelerations are dependent on system configuration and inertial properties. The IAI is also useful in situations where the inertial properties of the system under investigation changes, for example due to the fitting of a new prostheses to a trans-tibial amputee.
• Optimised loads for the simulation of axial rotation in the lumbar spine
  - J Biomech 44(12):2323-2327 (2011)
  Simplified loading modes (pure moment, compressive force) are usually applied in the in vitro studies to simulate flexion-extension, lateral bending and axial rotation of the spine. The load magnitudes for axial rotation vary strongly in the literature. Therefore, the results of current investigations, e.g. intervertebral rotations, are hardly comparable and may involve unrealistic values. Thus, the question 'which in vitro applicable loading mode is the most realistic' remains open. A validated finite element model of the lumbar spine was employed in two sensitivity studies to estimate the ranges of results due to published load assumptions and to determine the input parameters (e.g. torsional moment), which mostly affect the spinal load and kinematics during axial rotation. In a subsequent optimisation study, the in vitro applicable loading mode was determined, which delivers results that fit best with available in vivo measurements. The calculated results varied widely for loads used in the literature with potential high deviations from in vivo measured values. The intradiscal pressure is mainly affected by the magnitude of the compressive force, while the torsional moment influences mainly the intervertebral rotations and facet joint forces. The best agreement with results measured in vivo were found for a compressive follower force of 720 N and a pure moment of 5.5 Nm applied to the unconstrained vertebra L1. The results reveal that in many studies the assumed loads do not realistically simulate axial rotation. The in vitro applicable simplified loads cannot perfectly mimic the in vivo situation. However, the optimised values lead to the best agreement with in vivo measured values. Their consequent application would lead to a better comparability of different investigations.
• Technique for chestband contour shape-mapping in lateral impact
  - J Biomech 44(12):2328-2332 (2011)
  The chestband transducer permits noninvasive measurement of transverse plane biomechanical response during blunt thorax impact. Although experiments may reveal complex two-dimensional (2D) deformation response to boundary conditions, biomechanical studies have heretofore employed only uniaxial chestband contour quantifying measurements. The present study described and evaluated an algorithm by which source subject-specific contour data may be systematically mapped to a target generalized anthropometry for computational studies of biomechanical response or anthropomorphic test dummy development. Algorithm performance was evaluated using chestband contour datasets from two rigid lateral impact boundary conditions: Flat wall and anterior-oblique wall. Comparing source and target anthropometry contours, peak deflections and deformation-time traces deviated by less than 4%. These results suggest that the algorithm is appropriate for 2D deformation response to lateral impact! boundary conditions.
• A method to characterize in vivo tendon force–strain relationship by combining ultrasonography, motion capture and loading rates
  - J Biomech 44(12):2333-2336 (2011)
  The ultrasonography contributes to investigate in vivo tendon force–strain relationship during isometric contraction. In previous studies, different methods are available to estimate the tendon strain, using different loading rates and models to fit the tendon force–strain relationship. This study was aimed to propose a standard method to characterize the in vivo tendon force–strain relationship. We investigated the influence on the force–strain relationship for medialis gastrocnemius (MG) of (1) one method which takes into account probe and joint movements to estimate the instantaneous tendon length, (2) models used to fit the force–strain relationship for uniaxial test (polynomial vs. Ogden), and (3) the loading rate on tendon strain. Subjects performed ramp-up contraction during isometric contractions at two different target speeds: 1.5 s and minimal time with ultrasound probe fixed over the muscle–tendon junction of the MG muscle. The used method requir! es three markers on ultrasound probe and a marker on calcaneum to take into account all movements, and was compared to the strain estimated using ultrasound images only. The method using ultrasound image only overestimated the tendon strain from 40% of maximal force. The polynomial model showed similar fitting results than the Ogden model (R²=0.98). A loading rate effect was found on tendon strain, showing a higher strain when loading rate decreases. The characterization of tendon force–strain relationship needs to be standardized by taking into account all movements to estimate tendon strain and controlling the loading rate. The polynomial model appears to be appropriate to represent the tendon force–strain relationship.
• Comparison of hexahedral and tetrahedral elements in finite element analysis of the foot and footwear
  - J Biomech 44(12):2337-2343 (2011)
  Finite element analysis has been widely used in the field of foot and footwear biomechanics to determine plantar pressures as well as stresses and strains within soft tissue and footwear materials. When dealing with anatomical structures such as the foot, hexahedral mesh generation accounts for most of the model development time due to geometric complexities imposed by branching and embedded structures. Tetrahedral meshing, which can be more easily automated, has been the approach of choice to date in foot and footwear biomechanics. Here we use the nonlinear finite element program Abaqus (Simulia, Providence, RI) to examine the advantages and disadvantages of tetrahedral and hexahedral elements under compression and shear loading, material incompressibility, and frictional contact conditions, which are commonly seen in foot and footwear biomechanics. This study demonstrated that for a range of simulation conditions, hybrid hexahedral elements (Abaqus C3D8H) consistentl! y performed well while hybrid linear tetrahedral elements (Abaqus C3D4H) performed poorly. On the other hand, enhanced quadratic tetrahedral elements with improved stress visualization (Abaqus C3D10I) performed as well as the hybrid hexahedral elements in terms of contact pressure and contact shear stress predictions. Although the enhanced quadratic tetrahedral element simulations were computationally expensive compared to hexahedral element simulations in both barefoot and footwear conditions, the enhanced quadratic tetrahedral element formulation seems to be very promising for foot and footwear applications as a result of decreased labor and expedited model development, all related to facilitated mesh generation.