Journal of Biomechanics - Articles in Press

Mechanisms of initial endplate failure in the human vertebral body - Corrected Proof

Aaron J. Fields, Gideon L. Lee, Tony M. Keaveny — 2010-09-07

Abstract: Endplate failure occurs frequently in osteoporotic vertebral fractures and may be related to the development of high tensile strain. To determine whether the highest tensile strains in the vertebra occur in the endplates, and whether such high tensile strains are associated with the material behavior of the intervertebral disc, we used micro-CT-based finite element analysis to assess tissue-level strains in 22 elderly human vertebrae (81.5±9.6 years) that were compressed through simulated intervertebral discs. In each vertebra, we compared the highest tensile and compressive strains across the different compartments: endplates, cortical shell, and trabecular bone. The influence of Poisson-type expansion of the disc on the results was determined by compressing the vertebrae a second time in which we suppressed the Poisson expansion. We found that the highest tensile strains occurred within the endplates whereas the highest compressive strains occurred within the trabecular bone. The ratio of strain to assumed tissue-level yield strain was the highest for the endplates, indicating that the endplates had the greatest risk of initial failure. Suppressing the Poisson expansion of the disc decreased the amount of highly tensile-strained tissue in the endplates by 79.4±11.3%. These results indicate that the endplates are at the greatest risk of initial failure due to the development of high tensile strains, and that such high tensile strains are associated with the Poisson expansion of the disc. We conclude that initial failure of the vertebra is associated with high tensile strains in the endplates, which in turn are influenced by the material behavior of the disc.

Simulated elliptical bioprosthetic valve deformation: Implications for asymmetric transcatheter valve deployment - Corrected Proof

Wei Sun, Kewei Li, Eric Sirois — 2010-09-07

Abstract: The asymmetric, elliptical shape of a transcatheter aortic valve (TAV), after implantation into a calcified aortic root, has been clinically observed. However, the impact of elliptical TAV configuration on TAV leaflet stress and strain distribution and valve regurgitation is largely unknown. In this study, we developed computational models of elliptical TAVs based on a thin pericardial bioprosthetic valve model recently developed. Finite element and computational fluid dynamics simulations were performed to investigate TAV leaflet structural deformation and central backflow leakage, and compared with those of a nominal symmetric TAV. From the results, we found that for a distorted TAV with an elliptical eccentricity of 0.68, the peak stress increased significantly by 143% compared with the nominal circular TAV. When the eccentricity of an elliptical TAV was larger than 0.5, a central backflow leakage was likely to occur. Also, deployment of a TAV with a major calcified region perpendicular to leaflet coaptation line was likely to cause a larger valve leakage. In conclusion, the computational models of elliptical TAVs developed in this study could improve our understanding of the biomechanics involved in a TAV with an elliptical configuration and facilitate optimal design of next-generation TAV devices.

European Society of Biomechanics S.M. Perren Award 2010: An adaptation mechanism for fibrous tissue to sustained shortening - Corrected Proof

Jasper Foolen, Corrinus C. van Donkelaar, Sarita Soekhradj-Soechit, Keita Ito — 2010-09-06

Abstract: The mechanism by which fibrous tissues adapt upon alterations in their mechanical environment remains unresolved. Here, we determine that periosteum in chick embryos resides in an identical mechanical state, irrespective of the developmental stage. This state is characterized by a residual tissue strain that corresponds to the strain in between the pliant and stiffer region of the force-strain curve. We demonstrate that periosteum is able to regain that mechanical equilibrium state in vitro, within three days upon perturbation of that equilibrium state. This adaptation process is not dependent on protein synthesis, because the addition of cycloheximide did not affect the response. However, a functional actin filament network is required, as is illustrated by a lack of adaptation in the presence of cytochalasin D. This led us to hypothesize that cells actively reduce collagen fiber crimp after tissue shortening, i.e. that in time the number of recruited fibers is increased via cell contraction. Support for this mechanism is found by visualization of fiber crimp with multiphoton microscopy before the perturbation and at different time points during the adaptive response.

Structural and functional changes of the articular surface in a post-traumatic model of early osteoarthritis measured by atomic force microscopy - Corrected Proof

Jane Desrochers, Matthias A. Amrein, John R. Matyas — 2010-09-06

Abstract: The functional integrity of the articulating cartilage surface is a critical determinant of joint health. Although a variety of techniques exist to characterize the structural changes in the tissue with osteoarthritis (OA), some with extremely high resolution, most lack the ability to detect and monitor the functional changes that accompany the structural deterioration of this essential bearing surface. Atomic force microscopy (AFM) enables the acquisition of both structural and mechanical properties of the articular cartilage surface, with up to nanoscale resolution, making it particularly useful for evaluating the functional behavior of the macromolecular network forming the cartilage surface, which disintegrates in OA.In the present study, AFM was applied to the articular cartilage surfaces from six pairs of canine knee joints with post-traumatic OA. Microstructure (RMS roughness) and micromechanics (dynamic indentation modulus, E⁎) of medial femoral condyle cartilages were compared between contralateral controls and cruciate-transected knee joints, which develop early signs of OA by three months after surgery.Results reveal a significant increase in RMS roughness and a significant four-fold decrease in E⁎ in cartilages from cruciate-transected joints versus contralateral controls. Compared to previous reports of changes in bulk mechanics, AFM was considerably more sensitive at detecting early cartilage changes due to cruciate-deficiency. The use of AFM in this study provides important new information on early changes in the natural history of OA because of its ability to sensitively detect and measure local structural and functional changes of the articular cartilage surface, the presumptive site of osteoarthritic initiation.

Are allogenic or xenogenic screws and plates a reasonable alternative to alloplastic material for osteosynthesis—A histomorphological analysis in a dynamic system - Corrected Proof

C. Jacobsen, J.A. Obwegeser — 2010-09-03

Abstract: Despite invention of titanium and resorbable screws and plates, still, one of the main challenges in bone fixation is the search for an ideal osteosynthetic material. Biomechanical properties, biocompatibility, and also cost effectiveness and clinical practicability are factors for the selection of a particular material. A promising alternative seems to be screws and plates made of bone. Recently, xenogenic bone pins and screws have been invented for use in joint surgery.In this study, screws made of allogenic sheep and xenogenic human bone were analyzed in a vital and dynamic sheep-model and compared to conventional titanium screws over a standard period of bone healing of 56 days with a constant applied extrusion force. Biomechanical analysis and histomorphological evaluation were performed.After 56 days of insertion xenogenic screws made of human bone showed significantly larger distance of extrusion of on average 173.8μm compared to allogenic screws made of sheep bone of on average 27.8 and 29.95μm of the titanium control group. Severe resorption processes with connective tissue interposition were found in the histomorphological analysis of the xenogenic screws in contrast to new bone formation and centripetal vascularization of the allogenic bone screw, as well as in processes of incorporation of the titanium control group.The study showed allogenic cortical bone screws as a substantial alternative to titanium screws with good biomechanical properties. In contrast to other reports a different result was shown for the xenogenic bone screws. They showed insufficient holding strength with confirmative histomorphological signs of degradation and insufficient osseointegration. Before common clinical use of xenogenic osteosynthetic material, further evaluation should be performed.

Fluid and solid mechanics in a poroelastic network induced by ultrasound - Corrected Proof

Peng Wang, William L. Olbricht — 2010-09-03

Abstract: We made a theoretical analysis on the fluid and solid mechanics in a poroelastic medium induced by low-power ultrasound. Using a perturbative approach, we were able to linearize the governing equations and obtain analytical solutions. We found that ultrasound could propagate in the medium as a mechanical wave, but would dissipate due to frictional forces between the fluid and the solid phase. The amplitude of the wave depends on the ultrasonic power input. We applied this model to the problem of drug delivery to soft biological tissues by low-power ultrasound and proposed a mechanism for enhanced drug penetration. We have also found the coexistence of two acoustic waves under certain circumstances and pointed out the importance of very accurate experimental determination of the high-frequency properties of brain tissue.

Feature selection using a principal component analysis of the kinematics of the pivot shift phenomenon - Corrected Proof

2010-09-02

Abstract: The pivot shift test reproduces a complex instability of the knee joint following rupture of the anterior cruciate ligament. The grade of the pivot shift test has been shown to correlate to subjective criteria of knee joint function, return to physical activity and long-term outcome. This severity is represented by a grade that is attributed by a clinician in a subjective manner, rendering the pivot shift test poorly reliable.The purpose of this study was to unveil the kinematic parameters that are evaluated by clinicians when they establish a pivot shift grade. To do so, eight orthopaedic surgeons performed a total of 127 pivot shift examinations on 70 subjects presenting various degrees of knee joint instability. The knee joint kinematics were recorded using electromagnetic sensors and principal component analysis was used to determine which features explain most of the variability between recordings. Four principal components were found to account for most of this variability (69%), with only the first showing a correlation to the pivot shift grade (r=0.55). Acceleration and velocity of tibial translation were found to be the features that best correlate to the first principal component, meaning they are the most useful for distinguishing different recordings. The magnitudes of the tibial translation and rotation were amongst those that accounted for the least variability. These results indicate that future efforts to quantify the pivot shift should focus more on the velocity and acceleration of tibial translation and less on the traditionally accepted parameters that are the magnitudes of posterior translation and external tibial rotation.

Validation of a posturographic approach to monitor sleepiness - Corrected Proof

Pia Forsman, Anders Wallin, Edward Hæggström — 2010-09-02

Abstract: Sleepiness is a major risk factor in traffic- and occupational accidents. While sleepiness is a persistent concern, there is no convenient test to monitor impending levels of sleepiness. We show that force platform posturographic balance testing addresses this need because it estimates time awake (TA) accurately and precisely. Testing the TA is appropriate because TA drives the sleep homeostatic process, a component in sleepiness. With 12 subjects we evaluated the accuracy and precision of repeated estimates of TA. Our extended study design that allows evaluating the accuracy and precision of posturographic TA-estimates is new. First, we tested the subjects’ balance every 2h during 36h of sustained wakefulness. This comprised the subjects’ reference curves (balance as a function of known and increasing TA). Then, we tested the subjects’ balance once a day over one week. We also tested the subjects’ balance once a week over one month. Finally, to estimate the subjects’ TA, we equated the balance scores with the scores in their reference curves. The accuracy of the estimates was 86%, and the precision was 97%. The high accuracy and precision of the estimates obtained with this one-month protocol validates the method of posturographic monitoring of sleepiness. So far, force platform posturographic balance testing has generally been used for clinical purposes, to quantify balance control and musculoskeletal performance. Our main result is that we now validated that balance testing provides accurate and precise estimates of TA, and hence, also provides an approach towards an automated monitor of sleepiness.

Response to comment on “A biomechanical model of artery buckling” and subsequent comments - Corrected Proof

Hai-Chao Han, Qin Liu, Fangsen Cui — 2010-09-02

Thank you for the opportunity to respond to comments by Kyle Abrahamson, Katie McLean, and Marc Nash on our study () and the subsequent comments by . Here are our responses to their comments.

Determination of toe-off event time during treadmill locomotion using kinematic data - Corrected Proof

John K. De Witt — 2010-09-01

Abstract: Researchers collecting gait kinematic data during treadmill locomotion are often interested in determining the times of toe off and heel strike for each stride. In the absence of additional hardware, only position data collected with motion-capture equipment may be available. Others have published methods for using kinematic data for detecting overground gait events. However, during treadmill locomotion, especially running, overground methods may not possess sufficient accuracy. The purpose of this paper is to describe a method for using kinematic data to determine the time of toe off during treadmill locomotion. Ten subjects walked and ran on a treadmill while a motion-capture system collected positional data from heel and toe markers. The treadmill was equipped with force platforms that allowed an accurate determination of foot-ground contact. The time of toe off was determined using the vertical component of the toe marker, and this method was found to have greater accuracy for event detection than other published methods. Researchers can use the described method to determine times of heel strike and toe off during treadmill locomotion using only kinematic data.

Mechanical skin thinning-to-thickening transition observed in vivo through 2D high frequency elastography - Corrected Proof

2010-09-01

Abstract: This study was based on two dimensional (2D) high frequency elastography to describe quantitatively the mechanical behavior of the human dermis in vivo. The study was conducted on the forearm skin and elastographic tests were performed using a combination of two devices: an extensiometer developed for the in vivo study of the mechanical behavior of the skin using uniaxial stretching stress, and a 20MHz real time sonographer (Dermcup 2020™) for ultrasound skin imaging. The staggered strain estimation algorithm (SSE) was used to produce elastograms. A temporal cumulative technique was applied to improve elastogram quality and to monitor variations in skin strain during stretching. The influence of the natural skin tension controlled by arm bending was studied and distinctive mechanical behavior was observed for low and high mechanical stress levels. In a preliminary analysis, the reproducibility of measurements was assessed by means of coefficient of variation (CV) in 5 selected healthy volunteers.Finally, two hypotheses linked to the geometrical and structural properties of the dermis are proposed to account for the new findings described in this study.

A novel method of studying fascicle architecture in relaxed and contracted muscles - Corrected Proof

Heiko Stark, Nadja Schilling — 2010-09-01

Abstract: A muscle’s architecture, described by geometric variables such as fascicle pennation angles or lengths, plays a crucial role in its functionality. Usually, single parameters are used to estimate force vectors or lengthening rates, thereby assuming that they represent the architecture properly and are constant during contraction. To describe muscle architecture in more detail and compare relaxed and contracted states, we developed and validated a new approach. The m. soleus of the laboratory rat was shock-frozen while relaxed and under isometric contraction, reconstructed three-dimensionally from histological sections, and fascicle lengths, curvatures and pennation angles, as well as the shape of the aponeuroses were analysed. Remarkable differences in volume distribution and the shapes of the aponeuroses as well as locally varying changes in the fascicle architecture were observed. While the mean pennation angle increased by only 2° due to contraction, local changes of up to 4° were observed. Fascicle curvature increased in the distal but remained unchanged in the proximal parts. Our approach may help to identify functional subunits within the muscle, i.e., regions with homogeneous architectural properties. Our results are discussed regarding the input parameters essential for realistic muscle modelling and challenge maximum isometric force estimations that are based on the physiological cross-sectional area or the Hill-model.

Thermal effect on heart rate and hemodynamics in vitelline arteries of stage 18 chicken embryos - Corrected Proof

Jung Yeop Lee, Sang Joon Lee — 2010-09-01

Abstract: We investigated the thermal effects on heart rate, hemodynamics, and response of vitelline arteries of stage-18 chicken embryos. Heart rate was monitored by a high-speed imaging method, while hemodynamic quantities were evaluated using a particle image velocimetry (PIV) technique. Experiments were carried out at seven different temperatures (36–42°C with 1°C interval) after 1h of incubation to stabilize the heart rate. The heart rate increased in a linear manner (r=0.992). Due to the increased cardiac output (or heart rate), the hemodynamic quantities such as mean velocity (Umean), velocity fluctuation (Ufluc), and peak velocity (Upeak) also increased with respect to the Womersley number (Ω) in the manner r=0.599, 0.693, and 0.725, respectively. This indicates that the mechanical force exerting on the vessel walls increases. However, the active response (or regulation) of the vitelline arteries was not observed in this study.

The effect of connective tissue material uncertainties on knee joint mechanics under isolated loading conditions - Corrected Proof

Yasin Y. Dhaher, Tae-Hyun Kwon, Megan Barry — 2010-09-01

Abstract: Although variability in connective tissue parameters is widely reported and recognized, systematic examination of the effect of such parametric uncertainties on predictions derived from a full anatomical joint model is lacking. As such, a sensitivity analysis was performed to consider the behavior of a three-dimensional, non-linear, finite element knee model with connective tissue material parameters that varied within a given interval. The model included the coupled mechanics of the tibio-femoral and patello-femoral degrees of freedom. Seven primary connective tissues modeled as non-linear continua, articular cartilages described by a linear elastic model, and menisci modeled as transverse isotropic elastic materials were included. In this study, a multi-factorial global sensitivity analysis is proposed, which can detect the contribution of influential material parameters while maintaining the potential effect of parametric interactions. To illustrate the effect of material uncertainties on model predictions, exemplar loading conditions reported in a number of isolated experimental paradigms were used. Our findings illustrated that the inclusion of material uncertainties in a coupled tibio-femoral and patello-femoral model reveals biomechanical interactions that otherwise would remain unknown. For example, our analysis revealed that the effect of anterior cruciate ligament parameter variations on the patello-femoral kinematic and kinetic response sensitivities was significantly larger, over a range of flexion angles, when compared to variations associated with material parameters of tissues intrinsic to the patello-femoral joint. We argue that the systematic sensitivity framework presented herein will help identify key material uncertainties that merit further research and provide insight on those uncertainties that may not be as relative to a given response.

Objective grading of the pivot shift phenomenon using a support vector machine approach - Corrected Proof

2010-09-01

Abstract: The pivot shift test is the only clinical test that has been shown to correlate with subjective criteria of knee joint function following rupture of the anterior cruciate ligament. The grade of the pivot shift is important in predicting short- and long-term outcome. However, because this grade is established by a clinician in a subjective manner, the pivot shift’s value as a clinical tool is reduced. The purpose of this study was to develop a system that will objectively grade the pivot shift test based on recorded knee joint kinematics. Fifty-six subjects with different degrees of knee joint stability had the pivot shift test performed by one of eight different orthopaedic surgeons while their knee joint kinematics were recorded. A support vector machine based algorithm was used to objectively classify these recordings according to a clinical grade. The grades established by the surgeons were used as the gold standard for the development of the classifier. There was substantial agreement between our classifier and the surgeons in establishing the grade (weighted kappa=0.68). Seventy-one of 107 recordings (66%) were given the same grade and 96% of the time our classifier was within one grade of that given by the surgeons. Moreover, grades 0 and 1 were distinguished from grade 2 to 3 with 86% sensitivity and 90% specificity.Our results show the feasibility of automatically grading the pivot shift in a manner similar to that of an experienced clinician, based on knee joint kinematics.

A motion-decomposition approach to address gimbal lock in the 3-cylinder open chain mechanism description of a joint coordinate system at the glenohumeral joint - Corrected Proof

Hippolite O. Amadi, Anthony M.J. Bull — 2010-08-30

Abstract: In this study, the standard-sequence properties of a joint coordinate system were implemented for the glenohumeral joint by the use of a set of instantaneous geometrical planes. These are: a plane that is bound by the humeral long axis and an orthogonal axis that is the cross product of the scapular anterior axis and this long axis, and a plane that is bounded by the long axis of the humerus and the cross product of the scapular lateral axis and this long axis. The relevant axes are updated after every decomposition of a motion component of a humeral position. Flexion, abduction and rotation are then implemented upon three of these axes and are applied in a step-wise uncoupling of an acquired humeral motion to extract the joint coordinate system angles. This technique was numerically applied to physiological kinematics data from the literature to convert them to the joint coordinate system and to visually reconstruct the motion on a set of glenohumeral bones for validation.

Corrigendum to “A strain-hardening bi-power law for the nonlinear behaviour of biological soft tissues” [J. Biomech. 43 (2010) 927–932] - Corrected Proof

S. Nicolle, P. Vezin, J.-F. Palierne — 2010-08-27

Dirac functions were inserted inadvertently in Eqs. which should have been written: In our experiments, the term happens to be very weak, hence the large uncertainty given to η∞ in Table 2.

Feedback control from the jaw joints during biting: An investigation of the reptile Sphenodon using multibody modelling - Corrected Proof

N. Curtis, M.E.H. Jones, S.E. Evans, P. O’Higgins, M.J. Fagan — 2010-08-27

Abstract: Sphenodon, a lizard-like reptile, is the only living representative of a group that was once widespread at the time of the dinosaurs. Unique jaw mechanics incorporate crushing and shearing motions to breakdown food, but during this process excessive loading could cause damage to the jaw joints and teeth. In mammals like ourselves, feedback from mechanoreceptors within the periodontal ligament surrounding the teeth is thought to modulate muscle activity and thereby minimise such damage. However, Sphenodon and many other tetrapods lack the periodontal ligament and must rely on alternative control mechanisms during biting. Here we assess whether mechanoreceptors in the jaw joints could provide feedback to control muscle activity levels during biting. We investigate the relationship between joint, bite, and muscle forces using a multibody computer model of the skull and neck of Sphenodon. When feedback from the jaw joints is included in the model, predictions agree well with experimental studies, where the activity of the balancing side muscles reduces to maintain equal and minimal joint forces. When necessary, higher, but asymmetric, joint forces associated with higher bite forces were achievable, but these are likely to occur infrequently during normal food processing. Under maximum bite forces associated with symmetric maximal muscle activation, peak balancing side joint forces were more than double those of the working side. These findings are consistent with the hypothesis that feedback similar to that used in the simulation is present in Sphenodon.

A quantitative comparison of a bone remodeling model with dual-energy X-ray absorptiometry and analysis of the inter-individual biological variability of femoral neck T-score - Corrected Proof

L. Santos, J.C. Romeu, H. Canhão, J.E. Fonseca, P.R. Fernandes — 2010-08-26

Abstract: The development of consistent procedures with the inclusion of patient-specific data is essential in the computational modeling of biological processes, in order to achieve clinical relevant data. In this work, these issues are addressed with the development of a methodology that combines the gold standard technique for bone mineral density measurement and osteoporosis diagnosis, Dual energy X-ray absorptiometry (DXA), with a computational model for bone remodeling simulation. The DXA results were divided in three samples constituted from proximal femur DXA exams of patients in different stages of bone mineral density (normal, osteopenia and osteoporosis). These results were quantitatively compared with computational model results. A correlation study was performed between femoral neck T-score and a parameter from the model to ascertain the hypothesis of adjusting the model accordingly to biological variables. The results evidenced the predictive ability of the computational model in the estimation of femoral neck bone mineral content (BMC), with a maximum relative error of 3.92%. On the other hand, a strong correlation (R=−0.862) was found between the variables in study and a mathematical relationship was obtained to estimate the range of values for a model parameter that leads to biological relevant results. The methodology developed and the results obtained represent a solid and reliable basis to further studies on bone quality, ensuring the validity of the computational model in the simulation of bone remodeling process.

Gait alterations in rats following attachment of a device and application of altered knee loading - Corrected Proof

M.L. Roemhildt, M. Gardner-Morse, C. Rowell, B.D. Beynnon, G.J. Badger — 2010-08-26

Abstract: Animal models are widely used to study cartilage degeneration. Experimental interventions to alter contact mechanics in articular joints may also affect the loads borne by the leg during gait and consequently affect the overall loading experienced in the joint. In this study, force plate analyses were utilized to measure parameters of gait in the rear legs of adult rats following application of a varus loading device that altered loading in the knee. Adult rats were assigned to Control, Sham, or Loaded groups (n≥4/each). Varus loading devices were surgically attached to rats in the Sham and Loaded groups. In the Loaded group, this device applied a controlled compressive overload to the medial compartment of the knee during periods of engagement. Peak ground reaction forces during walking were recorded for each rear leg of each group. Analyses of variance were used to compare outcomes across groups (Control, Sham, and Loaded), leg (contralateral, experimental) and device status (disengaged, engaged) to determine the effects of surgically attaching the device and applying a compressive overload to the joint with the device. The mean peak vertical force in the experimental leg was reduced to 30% in the Sham group in comparison to the contralateral leg and the Control group, indicating an effect of attaching the device to the leg (p<0.01). No differences were found in ground reaction forces between the Sham and Loaded groups with application of compressive overloads with the device. The significant reduction in vertical force due to the surgical attachment of the varus loading device must be considered and accounted for in future studies.

Foot forces during exercise on the International Space Station - Corrected Proof

2010-08-23

Abstract: Long-duration exposure to microgravity has been shown to have detrimental effects on the human musculoskeletal system. To date, exercise countermeasures have been the primary approach to maintain bone and muscle mass and they have not been successful. Up until 2008, the three exercise countermeasure devices available on the International Space Station (ISS) were the treadmill with vibration isolation and stabilization (TVIS), the cycle ergometer with vibration isolation and stabilization (CEVIS), and the interim resistance exercise device (iRED). This article examines the available envelope of mechanical loads to the lower extremity that these exercise devices can generate based on direct in-shoe force measurements performed on the ISS. Four male crewmembers who flew on long-duration ISS missions participated in this study. In-shoe forces were recorded during activities designed to elicit maximum loads from the various exercise devices. Data from typical exercise sessions on Earth and on-orbit were also available for comparison. Maximum on-orbit single-leg loads from TVIS were 1.77 body weight (BW) while running at 8mph. The largest single-leg forces during resistance exercise were 0.72 BW during single-leg heel raises and 0.68 BW during double-leg squats. Forces during CEVIS exercise were small, approaching only 0.19 BW at 210W and 95RPM. We conclude that the three exercise devices studied were not able to elicit loads comparable to exercise on Earth, with the exception of CEVIS at its maximal setting. The decrements were, on average, 77% for walking, 75% for running, and 65% for squats when each device was at its maximum setting. Future developments must include an improved harness to apply higher gravity replacement loads during locomotor exercise and the provision of greater resistance exercise capability. The present data set provides a benchmark that will enable future researchers to judge whether or not the new generation of exercise countermeasures recently added to the ISS will address the need for greater loading.

Three-dimensional motion of the upper extremity joints during various activities of daily living - Corrected Proof

2010-08-23

Abstract: Highly reliable information on the range of motion (ROM) required to perform activities of daily living (ADL) is important to allow rehabilitation professionals to make appropriate clinical judgments of patients with limited ROM of the upper extremity joints. There are, however, no data available that take full account of corrections for gimbal-lock and soft tissue artifacts, which affect estimation errors for joint angles. We used an electromagnetic three-dimensional tracking system (FASTRAK) to measure the three-dimensional ROM of the upper extremity joints of healthy adults (N=20, age range 18–34) during 16 ADL movement tasks. The ROM required for the performance of each movement was shown in terms of the joint angle at the completion of the task, using a new definition of joint angle and regression analysis to compensate for estimation errors. The results of this study may be useful in setting goals for the treatment of upper extremity joint function.

Wall shear over high degree stenoses pertinent to atherothrombosis - Corrected Proof

David L. Bark, David N. Ku — 2010-08-23

Abstract: Atherothrombosis can induce acute myocardial infarction and stroke by progressive stenosis of a blood vessel lumen to full occlusion. Since thrombus formation and embolization may be shear-dependent, we quantify the magnitude of shear rates in idealized severely stenotic coronary arteries (≥75% by diameter) using computational fluid dynamics to characterize the shear environment that may exist during atherothrombosis. Maximum shear rates in severe short stenoses were found to exceed 250,000s−1 (9500dynes/cm2) and can reach a peak value of 425,000s−1 for a 98% stenosis. These high shear rates exceed typical shear used for in vitro blood flow experiments by an order of magnitude, indicating the need to examine thrombosis at very high shear rates. Pulsatility and stenosis eccentricity were found to have minor effects on the maximum wall shear rates in severe stenoses. In contrast, increases in the stenosis length reduced the maximum shear to 107,000s−1 (98% stenosis), while surface roughness could increase focal wall shear rates to a value reaching 610,000s−1 (90% stenosis). The “shear histories” of circulating platelets in these stenoses are far below reported activation thresholds. Platelets may be required to form bonds in 5μs and resist shear forces reaching 8000pN per platelet. Arterial thrombosis occurs in the face of pathological high shear stress, creating rapid and strong bonds without prior activation of circulating platelets.

An activatable molecular spring reduces muscle tearing during extreme stretching - Corrected Proof

T.R. Leonard, V. Joumaa, W. Herzog — 2010-08-23

Abstract: The purpose of this study was to determine failure stresses and failure lengths of actively and passively stretched myofibrils. As expected, myofibrils failed at average sarcomere lengths (about 6–7μm) that vastly exceeded sarcomere lengths at which actin–myosin filament overlap ceases to exist (4μm) and thus actin–myosin-based cross-bridge forces are zero at failure. Surprisingly, however, actively stretched myofibrils had much greater failure stresses and failure energies than passively stretched myofibrils, thereby providing compelling evidence for strong force production independent of actin–myosin-based cross-bridge forces. Follow-up experiments in which titin was deleted and cross-bridge formation was inhibited at high and low calcium concentrations point to titin as the regulator of this force, independent of calcium. The results of this study point to a mechanism of force production that reduces stretch-induced muscle damage at extreme length and limits injury and force loss within physiologically relevant ranges of sarcomere and muscle lengths.

Influence of the change in stem length on the load transfer and bone remodelling for a cemented resurfaced femur - Corrected Proof

Bidyut Pal, Sanjay Gupta, Andrew M.R. New — 2010-08-23

Abstract: The effect of a short-stem femoral resurfacing component on load transfer and potential failure mechanisms has rarely been studied. The stem length has been reduced by approximately 50% as compared to the current long-stem design. Using 3-D FE models of natural and resurfaced femurs, the study is aimed at investigating the influence of a short-stem resurfacing component on load transfer and bone remodelling. Applied loading conditions include normal walking and stair climbing. The mechanical role of the stem along with implant–cement and stem–bone contact conditions was observed to be crucial. Shortening the stem length to half of the current length (long-stem) led to several favourable effects, even though the stress distributions in the implant and the cement were similar in both the cases. The short-stem implant led not only to a more physiological stress distribution but also to bone apposition (increase of 20–70% bone density) in the superior resurfaced head, when the stem–bone contact prevailed. This also led to a reduction in strain concentration in the cancellous bone around the femoral neck–component junction. The normalised peak strain in this region was lower for the short-stem design as compared to that of the long-stem one, thereby reducing the initial risk of neck fracture. The effect of strain shielding (50–75% reduction) was restricted to a small bone volume underlying the cement, which was approximately half of that of the long-stem design. Consequently, bone resorption was considerably less for the short-stem design. The short-stem design offers better prospects than the long-stem resurfacing component.

Simulating avian wingbeat kinematics - Corrected Proof

Ben Parslew, William J. Crowther — 2010-08-23

Abstract: Inverse dynamics methods are used to simulate avian wingbeats in varying flight conditions. A geometrically scalable multi-segment bird model is constructed, and optimisation techniques are employed to determine segment motions that generate desired aerodynamic force coefficients with minimal mechanical power output. The results show that wingbeat kinematics vary gradually with changes in cruise speed, which is consistent with experimental data. Optimised solutions for cruising flight of the pigeon suggest that upstroke wing retraction is used as a method of saving energy. Analysis of the aerodynamic force coefficient variation in high and low speed cruise leads to the proposal that a suitable gait metric should include both thrust and lift generation during each half-stroke.

Calcium phosphate cement augmentation of cancellous bone screws can compensate for the absence of cortical fixation - Corrected Proof

2010-08-23

Abstract: An obvious means to improve the fixation of a cancellous bone screw is to augment the surrounding bone with cement. Previous studies have shown that bone augmentation with Calcium Phosphate (CaP) cement significantly improves screw fixation. Nevertheless, quantitative data about the optimal distribution of CaP cement is not available. The present study aims to show the effect of cement distribution on the screw fixation strength for various cortical thicknesses and to determine the conditions at which cement augmentation can compensate for the absence of cortical fixation in osteoporotic bone. In this study, artificial bone materials were used to mimic osteoporotic cancellous bone and cortical bone of varying thickness. These bone constructs were used to test the fixation strength of cancellous bone screws in different cortical thicknesses and different cement augmentation depths. The cement distribution was measured with microCT. The maximum pullout force was measured experimentally. The microCT analysis revealed a pseudo-conic shape distribution of the cement around the screws. While the maximum pullout strength of the screws in the artificial bone only was 30±7N, it could increase up to approximately 1000N under optimal conditions. Cement augmentation significantly increased pullout force in all cases. The effect of cortical thickness on pullout force was reduced with increased cement augmentation depth. Indeed, cement augmentation without cortical fixation increased pullout forces over that of screws without cement augmentation but with cortical fixation. Since cement augmentation significantly increased pullout force in all cases, we conclude that the loss of cortical fixation can be compensated by cement augmentation.

The epigenetic mechanism of mechanically induced osteogenic differentiation - Corrected Proof

2010-08-23

Abstract: Epigenetic regulation of gene expression occurs due to alterations in chromatin proteins that do not change DNA sequence, but alter the chromatin architecture and the accessibility of genes, resulting in changes to gene expression that are preserved during cell division. Through this process genes are switched on or off in a more durable fashion than other transient mechanisms of gene regulation, such as transcription factors. Thus, epigenetics is central to cellular differentiation and stem cell linage commitment. One such mechanism is DNA methylation, which is associated with gene silencing and is involved in a cell’s progression towards a specific fate. Mechanical signals are a crucial regulator of stem cell behavior and important in tissue differentiation; however, there has been no demonstration of a mechanism whereby mechanics can affect gene regulation at the epigenetic level. In this study, we identified candidate DNA methylation sites in the promoter regions of three osteogenic genes from bone marrow derived mesenchymal stem cells (MSCs). We demonstrate that mechanical stimulation alters their epigenetic state by reducing DNA methylation and show an associated increase in expression. We contrast these results with biochemically induced differentiation and distinguish expression changes associated with durable epigenetic regulation from those likely to be due to transient changes in regulation. This is an important advance in stem cell mechanobiology as it is the first demonstration of a mechanism by which the mechanical micro-environment is able to induce epigenetic changes that control osteogenic cell fate, and that can be passed to daughter cells. This is a first step to understanding that will be vital to successful bone tissue engineering and regenerative medicine, where continued expression of a desired long-term phenotype is crucial.

Subject-specific axes of the ankle joint complex - Corrected Proof

Jessica Leitch, Julie Stebbins, Amy B. Zavatsky — 2010-08-20

Abstract: The aim of this study was to use a two-axis ankle joint model and an optimisation process () to calculate and compare the talocrural and subtalar hinge axes for non-weight-bearing ankle motion, weight-bearing ankle motion, and walking in normal, healthy adult subjects and to see which of the first two sets of axes better fit the walking data. Motion data for the foot and shank were collected on eight subjects whilst they performed the activities mentioned. After choosing the best marker sets for motion tracking, a two-hinge ankle joint model was fit to the motion data. Ankle joint ranges of motion were also calculated. It was found that the model fit the experimental data well, with non-weight-bearing motion achieving the best fit. Despite this, the calculated axis orientations were highly variable both between motion types and between subjects. No significant difference between the fit of the non-weight-bearing and weight-bearing models to the walking data was found, which implies that either set of functional axes is adequate for modeling walking; however, the subtalar deviation angle was significantly closer for the weight-bearing activity and walking than for the non-weight-bearing activity and walking, which suggests that it is marginally better to use the weight-bearing functional motions. The results lead to questions about the appropriateness of the two-hinge ankle model for use in applications in which the behaviour of the individual joints of the ankle complex, rather than simply the relative motion of the leg and foot, is important.

Epidermal differentiation governs engineered skin biomechanics - Corrected Proof

G.C. Ebersole, P.M. Anderson, H.M. Powell — 2010-08-20

Abstract: Engineered skin must be mechanically strong to facilitate surgical application and prevent damage during the early stages of engraftment. However, the evolution of structural properties during culture, the relative contributions of the epidermis and dermis, and any correlation with tissue morphogenesis are not well known. These aspects are investigated by assessing the mechanical properties of engineered skin (ES) and engineered dermis (ED) during a 21-day culture period, including correlations with cellular metabolism, cellular organization and epidermal differentiation. During culture, the epidermis differentiates and begins to cornify, as evidenced by immunostaining and surface electrical capacitance. Tensile testing reveals that the ultimate tensile strength and linear stiffness increase linearly with time for ES, but are relatively unchanged for ED. ES strength correlates significantly with epidermal differentiation (p<0.001) and a composite strength model indicates that strength is largely determined by the epidermis. These data suggest that strategies to improve ES biomechanics should target the dermis. Additionally, time-dependant changes in average ES strength and percent elongation can be used to set upper bound limits on mechanical stimulation profiles to avoid tissue damage.

Ambulatory estimation of foot placement during walking using inertial sensors - Corrected Proof

2010-08-20

Abstract: This study proposes a method to assess foot placement during walking using an ambulatory measurement system consisting of orthopaedic sandals equipped with force/moment sensors and inertial sensors (accelerometers and gyroscopes). Two parameters, lateral foot placement (LFP) and stride length (SL), were estimated for each foot separately during walking with eyes open (EO), and with eyes closed (EC) to analyze if the ambulatory system was able to discriminate between different walking conditions. For validation, the ambulatory measurement system was compared to a reference optical position measurement system (Optotrak). LFP and SL were obtained by integration of inertial sensor signals. To reduce the drift caused by integration, LFP and SL were defined with respect to an average walking path using a predefined number of strides. By varying this number of strides, it was shown that LFP and SL could be best estimated using three consecutive strides. LFP and SL estimated from the instrumented shoe signals and with the reference system showed good correspondence as indicated by the RMS difference between both measurement systems being 6.5±1.0mm (mean ±standard deviation) for LFP, and 34.1±2.7mm for SL. Additionally, a statistical analysis revealed that the ambulatory system was able to discriminate between the EO and EC condition, like the reference system. It is concluded that the ambulatory measurement system was able to reliably estimate foot placement during walking.

Letter to the Editor regarding “All joint moments significantly contribute to trunk angular acceleration” - Corrected Proof

David A. Winter — 2010-08-19

At the outset let me congratulate the authors on their use of recent advancements in 3D measurements and biomechanical modeling to demonstrate the influence of all three lower limb moments on the trunk angular acceleration. Previous analysis by using a “top-down” model of the HAT in the frontal plane showed that the trunk angular was a function of the gravitational moment, the hip ab/abd moment and the hip joint vertical and horizontal accelerations. This model recognized in these two joint accelerations the net contributions of the moments of the two distal joints. A similar top-down sagittal plane model of HAT balance was reported in . The significant contribution in this new paper is that it represents a much more difficult “bottom-up” approach and partitions the contributions of all joint moments and their reaction joint force coupling contributions to the HAT angular accelerations in both planes. Of particular interest is the contribution of the large plantarflexor ankle moment to the trunk’s angular acceleration.

The mechanics of atherosclerotic plaque rupture by inclusion/matrix interfacial decohesion - Corrected Proof

Chien M. Nguyen, Alan J. Levy — 2010-08-19

Abstract: Histological investigation along with finite element analysis of arterial wall/atherosclerotic plaque geometries indicates the paradoxical result that ruptures often occur at sites with predicted stresses of half the plaque cap strength. Recent experiments have revealed calcified cells within the cap suggesting that these inclusions, situated close to the cap/luminal blood surface, precipitate rupture at low nominal loads by concentrating stress. In this paper, we investigate the proposition that rupture at low nominal loads occurs by (possibly brittle) decohesion of the calcification/cap interface followed by tearing of cap tissue. A novel boundary value problem is analyzed consisting of a remotely loaded linear elastic layer (extracellular matrix cap) containing a rigid spherical inclusion (calcified cell) that interacts with it through a nonlinear structural interface which models the binding of the calcified cell to the extracellular matrix via integrin receptor proteins. Equilibrium solutions are obtained from equations derived from the Boussinesq potentials for spherical domains. Results indicate a brittle character to the rupture process with the size of the domains between the inclusion center and the matrix surfaces determining the concentration of stress. For an inclusion close to a surface the abrupt unloading of the interface during brittle decohesion produces a sharp spike in circumferential stress. We conjecture that when this dynamic stress exceeds the cap strength, tearing occurs followed by thrombus formation and possibly infarction.

Partial medial meniscectomy and rotational differences at the knee during walking - Corrected Proof

Nathan A. Netravali, Nicholas J. Giori, Thomas P. Andriacchi — 2010-08-19

Abstract: Loss of meniscal function due to injury or partial meniscectomy is common and represents a significant risk factor for premature osteoarthritis. The menisci can influence the transverse plane movements (anterior–posterior (AP) translation and internal–external (IE) rotation) of the knee during walking. While walking is the most frequent activity of daily living, the kinematic differences at the knee during walking associated with the meniscal injury are not well understood. This study examined the influence of partial medial meniscectomy (PMM) on the kinematics and kinetics of the knee during the stance phase of gait by testing the differences in anterior–posterior translation, internal–external rotation, knee flexion range of movement, peak flexion/extension moments, and adduction moments between the PMM and healthy contralateral limbs. Ten patients (45±9 years old, height 1.75±0.06m, weight 76.7±13.5kg) who had undergone partial medial meniscectomy (33±100 months post-op) in one limb with a healthy contralateral limb were tested during normal walking. The contralateral limb was compared to a matched control group and no differences were found. The primary kinematic difference was a significantly greater external rotation (3.2°) of the tibia that existed through stance phase, with 8 of 10 subjects demonstrating the same pattern. The PMM subjects also exhibited significantly lower peak flexion and extension moments in their PMM limbs. The altered rotational position found likely results in changes of tibio-femoral contact during walking and could cause the type of degenerative changes found in the articular cartilage following meniscal injury.

The role of mineral content in determining the micromechanical properties of discrete trabecular bone remodeling packets - Corrected Proof

Lachlan J. Smith, Jeffrey P. Schirer, Nicola L. Fazzalari — 2010-08-19

Abstract: In trabecular bone, each remodeling event results in the resorption and/or formation of discrete structural units called ‘packets’. These remodeling packets represent a fundamental level of bone’s structural hierarchy at which to investigate composition and mechanical behaviors. The objective of this study was to apply the complementary techniques of quantitative backscattered electron microscopy (qBSEM) and nanoindentation to investigate inter-relationships between packet mineralization, elastic modulus, contact hardness and plastic deformation resistance. Indentation arrays were performed across nine trabecular spicules from 3 human donors; these spicules were then imaged using qBSEM, and discretized into their composite remodeling packets (127 in total). Packets were classified spatially as peripheral or central, and mean contact hardness, plastic deformation resistance, elastic modulus and calcium content calculated for each. Inter-relationships between measured parameters were analysed using linear regression analyses, and dependence on location assessed using Student’s t-tests. Significant positive correlations were found between all mechanical parameters and calcium content. Elastic modulus and contact hardness were significantly correlated, however elastic modulus and plastic deformation resistance were not. Calcium content, contact hardness and elastic modulus were all significantly higher for central packets than for peripheral, confirming that packet mineral content contributes to micromechanical heterogeneity within individual trabecular spicules. Plastic deformation resistance, however, showed no such regional dependence, indicating that the plastic deformation properties in particular, are determined not only by mineral content, but also by the organic matrix and interactions between these two components.

Local dynamic stability of amputees wearing a torsion adapter compared to a rigid adapter during straight-line and turning gait - Corrected Proof

2010-08-18

Abstract: Lower limb amputees have decreased balance during daily ambulation compared to nonamputees. An optimally compliant torsion adapter, which enables transverse plane rotation at the socket–pylon junction may reduce limb asymmetries and improve comfort leading to increased confidence and stability during gait. The purpose of this study was to determine if the presence of a torsion adapter affects amputee sensitivity to local perturbations (local dynamic stability) during straight-line walking and during a turning task. Ten unilateral transtibial amputees were fit with a torsion and rigid adapter in random order and blinded to the condition. After a 3-week acclimation period, kinematic data were collected while subjects walked in a straight-line on a treadmill and around a 1-m radius circular path at constant speed. Maximum finite-time Lyapunov exponents (λ), an estimator of local dynamic stability, were calculated for the amputee’s sagittal plane hip, knee and ankle angles for each condition. The prosthetic limb λ was greater during a turn compared to straight-line walking, suggesting amputees are less stable while turning. There were no statistically significant differences found in λ between adapters during both walking conditions, suggesting the torsion adapter had no effect on amputee stability; however, high inter-subject variability due to the examined population and turning task may have masked a small decrease in prosthetic limb hip and knee stability for the torsion adapter during straight-line gait. Therefore, the torsion adapter’s added degree of freedom may have a small adverse effect on prosthetic limb stability during straight-line walking and no effect on turning.

The biomechanical effects of limb lengthening and botulinum toxin type A on rabbit tendon - Corrected Proof

2010-08-18

Abstract: Numerous studies have examined the effects of distraction osteogenesis (DO) on bone, but relatively fewer have explored muscle adaptation, and even less have addressed the concomitant alterations that occur in the tendon. The purpose herein was to characterize the biomechanical properties of normal and elongated rabbit (N=20) tendons with and without prophylactic botulinum toxin type A (BTX-A) treatment. Elastic and viscoelastic properties of Achilles and Tibialis anterior (TA) tendons were evaluated through pull to failure and stress relaxation tests.All TA tendons displayed nonlinear viscoelastic responses that were strain dependent. A power law formulation was used to model tendon viscoelastic responses and tendon elastic responses were fit with a microstructural model. Distraction-elongated tendons displayed increases in compliance and stress relaxation rates over undistracted tendons; BTX-A administration offset this result. The elastic moduli of distraction-lengthened TA tendons were diminished (p=0.010) when distraction was combined with gastrocnemius (GA) BTX-A administration, elastic moduli were further decreased (p=0.004) and distraction following TA BTX-A administration resulted in TA tendons with moduli not different from contralateral control (p>0.05). Compared to contralateral control, distraction and GA BTX-A administration displayed shortened toe regions, (p=0.031 and 0.038, respectively), while tendons receiving BTX-A in the TA had no differences in the toe region (p>0.05). Ultimate tensile stress was unaltered by DO, but stress at the transition from the toe to the linear region of the stress–stretch curve was diminished in all distraction-elongated TA tendons (p<0.05). The data suggest that prophylactic BTX-A treatment to the TA protects some tendon biomechanical properties.

The effect of altered loading following rotator cuff tears in a rat model on the regional mechanical properties of the long head of the biceps tendon - Corrected Proof

2010-08-18

Abstract: Biceps tendon pathology is a common clinical problem often seen in conjunction with rotator cuff tears. A previous study found detrimental changes to biceps tendons in the presence of rotator cuff tears in a rat model. Therefore, the objective of this study was to utilize this model along with models of altered loading to investigate the effect of altered loading on the initiation of these detrimental changes. We created supraspinatus and infraspinatus rotator cuff tears in the rat and followed these tears with either increased or decreased loading. Mechanical properties were determined along the length of the biceps tendon 4 and 8 weeks following injury. At the insertion site, stiffness increased with decreased loading, while detrimental changes were seen with increased loading 4 weeks following detachments. Increased loading resulted in decreased mechanical properties along the entire tendon length at both time points. Decreased loading resulted in both increased and decreased tendon properties at different regions of the tendon at 4 weeks, but by 8 weeks, there were no differences between decreased loading and detachment alone. We could not conclude where changes begin in the tendon with altered loading, but did demonstrate that regional differences exist. These results support that there is an effect of altered loading, as decreased loading resulted in variable changes at 4 weeks that were no different from detachment alone by 8 weeks, and increased loading resulted in detrimental properties along the entire length at both 4 and 8 weeks.

A three-dimensional mathematical model of the thoracolumbar fascia and an estimate of its biomechanical effect - Corrected Proof

M.L. Gatton, M.J. Pearcy, G.J. Pettet, J.H. Evans — 2010-08-16

Abstract: The thoracolumbar fascia (TLF) provides a means of attachment to the lumbar spine for several muscles including the transverse abdominis, and parts of the latissimus dorsi and internal oblique muscles. Previous biomechanical models of the lumbar spine either tend to omit the TLF on the assumption that its contribution would be negligible or incorporate only part of the TLF. Here, a three-dimensional model of the posterior and middle layers of the TLF is presented to enable its action to be included in future three-dimensional models of the spine. It is used illustratively to estimate the biomechanical influence of this structure on the lumbar spine. The formulation of the model allows the lines of action of the fibres comprising the fascia to be calculated for any posture whilst ensuring that anatomical constraints are satisfied. Application of the model suggests that the TLF produces moments primarily in flexion and extension. The simulated results demonstrate that the abdominal muscles, acting via the TLF, are capable of contributing extension moments comparable to those produced by other smaller muscles associated with the lumbar spine.

Study of an infant brain subjected to periodic motion via a custom experimental apparatus design and finite element modelling - Corrected Proof

J. Cheng, I.C. Howard, M. Rennison — 2010-08-16

Abstract: This paper presents a rig that was specifically designed to simulate the shaking of mechanical models of biological systems, especially those related to shaken baby syndrome (SBS). The scope of this paper includes the testing of an anthropomorphic model that simulates an infant head and provides validation data for complex finite element (FE) modelling using three numerical methods (Lagrangian, Arbitrary-Lagrangian–Eulerian (ALE) and Eulerian method) for fluid structure coupling.The experiments for this study aim to provide an understanding of the influence of two factors on intracranial brain movement of the infant head during violent shaking: (1) the specific paediatric head structure: the anterior fontanelle and (2) the brain–skull interface.The results show that the Eulerian analysis method has significant advantages for the FSI modelling of brain–CSF–skull interactions over the more commonly used methods, e.g. the Lagrangian method. To the knowledge of the authors, this methodology has not been discussed in previous publication.The results indicate that the biomechanical investigation of SBS can provide more accurate results only if the skull with paediatric features and the brain–skull interface are correctly represented, which were overlooked in previous SBS studies.

Computational analysis of bone remodeling during an anterior cervical fusion - Corrected Proof

L.C. Espinha, P.R. Fernandes, J. Folgado — 2010-08-16

Abstract: The anterior cervical fusion is an established surgical procedure for spine stabilization after the removal of an intervertebral disc. However, it is not yet clear which bone graft represents the best choice and whether surgical devices can be efficient and beneficial for fusion. The aim of this work is to study the influence of the spine instrumentation on bone remodeling after a cervical spine surgery and, consequently, on the fusion process. A finite element model of the cervical spine was developed, having computed tomography images as input. Bone was modeled as a porous material characterized by the relative density at each point and the bone remodeling law was derived assuming that bone self-adapts in order to achieve the stiffest structure for the supported loads, with the total bone mass regulated by the metabolic cost of maintaining bone tissue. Apart from the analysis of healthy cervical spine, different surgical scenarios were tested: bone graft with or without a cage and the use of a stabilization plate system. Results showed that the anterior and posterior regions of the disc space are more important to stress transmission and that spinal devices reduce bone growth within bone grafts, being plate systems the most interfering elements. The material of the interbody cages plays a major role in fusion and, therefore, it should be carefully chosen.

Regulation of the patellofemoral contact area: An essential mechanism in patellofemoral joint mechanics? - Corrected Proof

2010-08-16

Abstract: Although the relationship between contact area and pressure under physiological loading has been described in the feline patellofemoral joint, this interaction has only been examined under simplified loading conditions and/or considerably lower forces than those occurring during demanding activities in humans. We hypothesized that patellofemoral contact area increases non-linearly under an increasing joint reaction force to regulate patellofemoral pressure. Eight human cadaveric knees were ramp loaded with muscle forces representative of the stance phase of stair climbing at 30° knee flexion. Continuous pressure data were acquired with a pressure sensitive film that was positioned within the patellofemoral joint. While pressure was linearly dependent upon the resulting joint reaction force, contact area asymptotically approached a maximum value and reached 95% of this maximum at patellofemoral forces of 349–723N (95% CI). Our findings indicate that the regulatory influence of increasing contact area to protect against high patellofemoral pressure is exhausted at relatively low loads.

Is a single or double arm technique more advantageous in triple jumping? - Corrected Proof

S.J. Allen, M.A. King, M.R. Yeadon — 2010-08-16

Abstract: Triple jumpers employ either an asymmetrical ‘single-arm’ action or symmetrical ‘double-arm’ action in the takeoff of each phase of the jump. This study investigated which technique is more beneficial in each phase using computer simulation. Kinematic data were obtained from an entire triple jump using a Vicon automatic motion capture system. A planar 13-segment torque-driven subject-specific computer simulation model was evaluated by varying torque generator activation timings using a genetic algorithm in order to match performance data. The matching produced a close agreement between simulation and performance, with differences of 3.8%, 2.7%, and 3.1% for the hop, step, and jump phases, respectively. Each phase was optimised for jump distance and an increase in jump distance beyond the matched simulations of 3.3%, 11.1%, and 8.2% was obtained for the hop, step, and jump, respectively. The optimised technique used symmetrical shoulder flexion whereas the triple jumper had used an asymmetrical arm technique. This arm action put the leg extensors into slower concentric conditions allowing greater extensor torques to be produced. The main increases in work came at the joints of the stance leg but the largest increases in angular impulse came at the shoulder joints, indicating the importance of both measures when assessing the impact of individual joint actions on changes in technique. Possible benefits of the double-arm technique include: cushioning the stance leg during impact; raising the centre of mass of the body at takeoff; facilitating an increase in kinetic energy at takeoff; allowing a re-orientation of the body during flight.

Influence of simulated neuromuscular noise on movement variability and fall risk in a 3D dynamic walking model - Corrected Proof

Paulien E. Roos, Jonathan B. Dingwell — 2010-08-13

Abstract: People at risk of falling exhibit increased gait variability, which may predict future falls. However, the causal mechanisms underlying these correlations are not well known. Increased neuronal noise associated with aging likely leads to increased gait variability, which could in turn lead to increased fall risk. This paper presents a model of how changes in neuromuscular noise independently affect gait variability and probability of falling, and aims to determine the extent to which changes in gait variability directly predict fall risk. We used a dynamic walking model that incorporates a lateral step controller to maintain lateral stability. Noise was applied to this controller to approximate neuromuscular noise in humans. Noise amplitude was varied between low amplitudes that did not induce falls and high amplitudes for which the model always fell. With increases in noise amplitude, the model fell more often and after fewer steps. Gait variability increased with noise amplitude and predicted increased probability of falling. Importantly, these relationships were not linear. At either low gait variability or very high gait variability, small increases in noise and variability affected probability of falling very little. Conversely, at intermediate noise and/or variability levels, the same small increases resulted in large increases in probability of falling. Our results validate the idea that age-related increases in neuromuscular noise likely play a direct contributing role in increasing fall risk. However, neuromuscular noise remains only one of many important factors that need to be considered. These findings have important implications for fall prevention research and practice.

Strain-energy function and three-dimensional stress distribution in esophageal biomechanics - Corrected Proof

Dimitrios P. Sokolis — 2010-08-12

Abstract: Knowledge of the transmural stress and stretch fields in esophageal wall is necessary to quantify growth and remodeling, and the response to mechanically based clinical interventions or traumatic injury, but there are currently conflicting reports on this issue and the mechanical properties of intact esophagus have not been rigorously addressed. This paper offers multiaxial data on rabbit esophagus, warranted for proper identification of the 3D mechanical properties. The Fung-type strain-energy function was adopted to model our data for esophagus, taken as a thick-walled (1 or 2-layer) tubular structure subjected to inflation and longitudinal extension. Accurate predictions of the pressure–radius–force data were obtained using the 1-layer model, covering a broad range of extensions; the calculated material parameters indicated that intact wall was equally stiff as mucosa–submucosa, but stiffer than muscle in both principal axes, and tissue was stiffer longitudinally, concurring our histological findings (Stavropoulou et al., Journal of Biomechanics. 42 (2009) 2654–2663). Employing the material parameters of individual layers, with reference to their zero-stress state, a reasonable fit was obtained to the data for intact wall, modeled as a 2-layer tissue. Different from the stress distributions presented hitherto in the esophagus literature, consideration of residual stresses led to less dramatic homogenization of stresses under loading. Comparison of the 1- and 2-layer models of esophagus demonstrated that heterogeneity induced a more uniform distribution of residual stresses in each layer, a discontinuity in circumferential and longitudinal stresses at the interface among layers, and a considerable rise of stresses in mucosa, with a reduction in muscle.

Low-level noise affects balance control differently when applied at different body parts - Corrected Proof

Xingda Qu — 2010-08-12

Abstract: The main purpose of this study was to determine which body part is the best position to apply noise at so that balance control can be improved most. Twelve young healthy participants were recruited in this study. Balance control was assessed by center of pressure (COP) measures, which were collected when participants were blindfolded and stood upright quietly on a force platform. Low-level mechanical noise was separately applied at seven body parts during quiet upright stance, including the forehead, neck, shoulder, finger, abdomen, knee, and ankle. Results showed that dependent COP measures as a whole were not improved when noise was at the finger, shoulder, abdomen, knee, and ankle. In contrast, with the application of noise at the forehead and neck, the dependent COP measures as a whole significantly changed. The forehead appeared to be the better position at which noise should be applied, since the ANOVAs revealed that body sway significantly decreased with the application of noise at the forehead. Findings from this study can aid in the development of noise-based intervention strategies aimed at improving balance. A possible intervention solution might be embedding noise-based devices into head belt.

Influence of joint constraints on lower limb kinematics estimation from skin markers using global optimization - Corrected Proof

Sonia Duprey, Laurence Cheze, Raphaël R. Dumas — 2010-08-11

Abstract: In order to obtain the lower limb kinematics from skin-based markers, the soft tissue artefact (STA) has to be compensated. Global optimization (GO) methods rely on a predefined kinematic model and attempt to limit STA by minimizing the differences between model predicted and skin-based marker positions. Thus, the reliability of GO methods depends directly on the chosen model, whose influence is not well known yet.This study develops a GO method that allows to easily implement different sets of joint constraints in order to assess their influence on the lower limb kinematics during gait. The segment definition was based on generalized coordinates giving only linear or quadratic joint constraints. Seven sets of joint constraints were assessed, corresponding to different kinematic models at the ankle, knee and hip: SSS, USS, PSS, SHS, SPS, UHS and PPS (where S, U and H stand for spherical, universal and hinge joints and P for parallel mechanism). GO was applied to gait data from five healthy males.Results showed that the lower limb kinematics, except hip kinematics, knee and ankle flexion–extension, significantly depend on the chosen ankle and knee constraints. The knee parallel mechanism generated some typical knee rotation patterns previously observed in lower limb kinematic studies. Furthermore, only the parallel mechanisms produced joint displacements.Thus, GO using parallel mechanism seems promising. It also offers some perspectives of subject-specific joint constraints.

Muscle contributions to propulsion and support during running - Corrected Proof

Samuel R. Hamner, Ajay Seth, Scott L. Delp — 2010-08-09

Abstract: Muscles actuate running by developing forces that propel the body forward while supporting the body’s weight. To understand how muscles contribute to propulsion (i.e., forward acceleration of the mass center) and support (i.e., upward acceleration of the mass center) during running we developed a three-dimensional muscle-actuated simulation of the running gait cycle. The simulation is driven by 92 musculotendon actuators of the lower extremities and torso and includes the dynamics of arm motion. We analyzed the simulation to determine how each muscle contributed to the acceleration of the body mass center. During the early part of the stance phase, the quadriceps muscle group was the largest contributor to braking (i.e., backward acceleration of the mass center) and support. During the second half of the stance phase, the soleus and gastrocnemius muscles were the greatest contributors to propulsion and support. The arms did not contribute substantially to either propulsion or support, generating less than 1% of the peak mass center acceleration. However, the arms effectively counterbalanced the vertical angular momentum of the lower extremities. Our analysis reveals that the quadriceps and plantarflexors are the major contributors to acceleration of the body mass center during running.

The effect of cement creep and cement fatigue damage on the micromechanics of the cement–bone interface - Corrected Proof

Daan Waanders, Dennis Janssen, Kenneth A. Mann, Nico Verdonschot — 2010-08-09

Abstract: The cement–bone interface provides fixation for the cement mantle within the bone. The cement–bone interface is affected by fatigue loading in terms of fatigue damage or microcracks and creep, both mostly in the cement. This study investigates how fatigue damage and cement creep separately affect the mechanical response of the cement–bone interface at various load levels in terms of plastic displacement and crack formation. Two FEA models were created, which were based on micro-computed tomography data of two physical cement–bone interface specimens. These models were subjected to tensile fatigue loads with four different magnitudes. Three deformation modes of the cement were considered: ‘only creep’, ‘only damage’ or ‘creep and damage’. The interfacial plastic deformation, the crack reduction as a result of creep and the interfacial stresses in the bone were monitored. The results demonstrate that, although some models failed early, the majority of plastic displacement was caused by fatigue damage, rather than cement creep. However, cement creep does decrease the crack formation in the cement up to 20%. Finally, while cement creep hardly influences the stress levels in the bone, fatigue damage of the cement considerably increases the stress levels in the bone. We conclude that at low load levels the plastic displacement is mainly caused by creep. At moderate to high load levels, however, the plastic displacement is dominated by fatigue damage and is hardly affected by creep, although creep reduced the number of cracks in moderate to high load region.

Effect of a pedicle-screw-based motion preservation system on lumbar spine biomechanics: A probabilistic finite element study with subsequent sensitivity analysis - Corrected Proof

Antonius Rohlmann, Hadi Nabil Boustani, Georg Bergmann, Thomas Zander — 2010-08-09

Abstract: Pedicle-screw-based motion preservation systems are often used to support a slightly degenerated disc. Such implants are intended to reduce intradiscal pressure and facet joints forces, while having a minimal effect on the motion patterns.In a probabilistic finite element study with subsequent sensitivity analysis, the effects of 10 input parameters, such as elastic modulus and diameter of the elastic rod, distraction of the segment, level of bridged segments, etc. on the output parameters intervertebral rotations, intradiscal pressures, and facet joint forces were determined. A validated finite element model of the lumbar spine was employed. Probabilistic studies were performed for seven loading cases: upright standing, flexion, extension, left and right lateral bending and left and right axial rotation.The simulations show that intervertebral rotation angles, intradiscal pressures and facet joint forces are in most cases reduced by a motion preservation system. The influence on intradiscal pressure is small, except in extension. For many input parameter combinations, the values for intervertebral rotations and facet joint forces are very low, which indicates that the implant is too stiff in these cases. The output parameters are affected most by the following input parameters: loading case, elastic modulus and diameter of the elastic rod, distraction of the segment, and angular rigidity of the connection between screws and rod.The designated functions of a motion preservation system can best be achieved when the longitudinal rod has a low stiffness, and when the connection between rod and pedicle screws is rigid.