Quantifying foot deformation using finite helical angle

Foot intrinsic motion originates from the combination of numerous joint motions giving this segment a high adaptive ability. Existing foot kinematic models are mostly focused on analyzing small scale foot bone to bone motions which require both complex experimental methodology and complex interpretative work to assess the global foot functionality. This study proposes a method to assess the total foot deformation by calculating a helical angle from the relative motions of the rearfoot and the forefoot. This method required a limited number of retro-reflective markers placed on the foot and was tested for five different movements (walking, forefoot impact running, heel impact running, 90° cutting, and 180° U-turn) and 12 participants. Overtime intraclass correlation coefficients were calculated to quantify the helical angle pattern repeatability for each movement. Our results indicated that the method was suitable to identify the different motions as different amplitudes of helical angle were observed according to the flexibility required in each movement. Moreover, the results showed that the repeatability could be used to identify the mastering of each motion as this repeatability was high for well mastered movements. Together with existing methods, this new protocol could be applied to fully assess foot function in sport or clinical contexts.

Quantification of finger joint loadings using musculoskeletal modelling clarifies mechanical risk factors of hand osteoarthritis

Owing to limited quantitative data related to the loadings (forces and pressures) acting upon finger joints, several clinical observations regarding mechanical risk factors of hand osteoarthritis remain misunderstood. To improve the knowledge of this pathology, the present study used musculoskeletal modelling to quantify the forces and pressures acting upon hand joints during two grasping tasks. Kinematic and grip force data were recorded during both a pinch and a power grip tasks. Three-dimensional magnetic resonance imaging measurements were conducted to quantify joint contact areas. Using these datasets as input, a musculoskeletal model of the hand and wrist, including twenty-three degrees of freedom and forty-two muscles, has been developed to estimate joint forces and joint pressures. When compared with the power grip task, the pinch grip task resulted in two to eight times higher joint loadings whereas the grip forces exerted on each finger were twice lower. For both tasks, joint forces and pressures increased along a disto-proximal direction for each finger. The quantitative dataset provided by the present hand model clarified two clinical observations about osteoarthritis development which were not fully understood, i.e., the strong risk associated to pinch grip tasks and the high frequency of thumb-base osteoarthritis.

Effect of hold depth and grip technique on maximal finger forces in rock climbing

The aim of this study was to understand how the commonly used climbing-specific grip techniques and hold depths influence the finger force capacities. Ten advanced climbers performed maximal voluntary force on four different hold depths (from 1 to 4 cm) and in two force directions (antero-posterior and vertical) using three grip techniques (slope, half crimp and full crimp). A specially designed platform instrumented with a 6-degrees-of-freedom (DoF) force/torque sensor was used to record force values. Results showed that the maximal vertical forces differed significantly according to the hold depth and the grip technique (ranged from 350.8 N to 575.7 N). The maximal vertical forces increased according to the hold depth but the form of this increase differed depending on grip technique. These results seemed to be more associated with finger-hold contact/interaction than with internal biomechanical factors. Similar results were revealed for antero-posterior forces (ranged from 69.9 N to 138.0 N) but, it was additionally noted that climbers have different hand-forearm posture strategies with slope and crimp grip techniques when applying antero-posterior forces. This point is important as it could influence the body position adopted during climbing according to the chosen grip technique. For trainers and designers, a polynomial regression model was proposed in order to predict the mean maximal force based on hold depth and adopted grip technique.

Characterisation of forces exerted by the entire hand during the power grip: effect of the handle diameter

The objective of this study was to analyse the effect of the handle diameter on the grip forces exerted by the hand during a maximal power grip task. A handle ergometer, combining six instrumented beams and a pressure map, was used to determine the forces exerted by the palm side of the hand regrouping data from 10 anatomical sites (fingertips, phalanges, thumb, palm…). This methodology provided results giving new insight into the effect of the handle diameter on the forces exerted by the hand. First, it appeared that the relationship between the hand length/handle diameter ratio and the maximal grip force fit a U-inverted curve with maximal values observed for a handle diameter measuring 17.9% of the hand length. Second, it was showed that the handle diameter influenced the forces exerted on the anatomical sites of the hand. Finally, it was showed that the handle diameter influenced the finger force sharing particularly for the index and the little fingers. Practitioner Summary: This study analysed the effect of the handle diameter on the grip forces exerted by the hand during a maximal power grip force. This study showed that measurement of the totality of the forces exerted at the hand/handle interface is needed to better understand the ergonomics of handle tools. Our results could be re-used by designers and clinicians in order to develop handle tools which prevent hand pathologies.

An EMG-driven biomechanical model that accounts for the decrease in moment generation capacity during a dynamic fatigued condition

Although it is well known that fatigue can greatly reduce muscle forces, it is not generally included in biomechanical models. The aim of the present study was to develop an electromyographic-driven (EMG-driven) biomechanical model to estimate the contributions of flexor and extensor muscle groups to the net joint moment during a nonisokinetic functional movement (squat exercise) performed in nonfatigued and in fatigued conditions. A methodology that aims at balancing the decreased muscle moment production capacity following fatigue was developed. During an isometric fatigue session, a linear regression was created linking the decrease in force production capacity of the muscle (normalized force/EMG ratio) to the EMG mean frequency. Using the decrease in mean frequency estimated through wavelet transforms between dynamic squats performed before and after the fatigue session as input to the previous linear regression, a coefficient accounting for the presence of fatigue in the quadriceps group was computed. This coefficient was used to constrain the moment production capacity of the fatigued muscle group within an EMG-driven optimization model dedicated to estimate the contributions of the knee flexor and extensor muscle groups to the net joint moment. During squats, our results showed significant increases in the EMG amplitudes with fatigue (+23.27% in average) while the outputs of the EMG-driven model were similar. The modifications of the EMG amplitudes following fatigue were successfully taken into account while estimating the contributions of the flexor and extensor muscle groups to the net joint moment. These results demonstrated that the new procedure was able to estimate the decrease in moment production capacity of the fatigued muscle group.

Determination of passive moment-angle relationships at the trapeziometacarpal joint

While modeling the trapeziometacarpal (TMC) joint for determination of tendon forces, the TMC has been considered frictionless and passive moments created by soft tissues neglected. This, however, becomes inaccurate when reaching the joint end range of motion and considering that the TMC is entirely crossed by a complex network of skin, ligaments, soft tissues, and tendons. The objective of this study was to evaluate the passive moments with respect to joint posture in order to further include this relationship in biomechanical modeling. An experimental method was proposed to estimate in vivo a global passive moment including the sum of the actions of each passive anatomical structure. An external force was applied at the level of the metacarpophalangeal joint in various directions ranging from neutral position to full extension and full adduction to full abduction. The passive moment was computed and expressed as a function of the adopted joint angles. An exponential regression was then developed to fit the experimental data and to propose a generic passive moment model. Results showed a good agreement between the proposed exponential regression model and the experimental measures. Moreover, it was shown that joint stiffness could represent more than 60% of the net joint moment during a typical pulp grip task. These results showed the necessity to include the data in biomechanical modeling. The results may help predict more realistic tendons force especially in abduction/adduction muscles.

Comparison of tendon tensions estimated from two biomechanical models of the thumb

Despite the paramount function of the thumb in daily life, thumb biomechanical models have been little developed and studied. Moreover, only two studies provided quantitative anthropometric data of tendon moment arms. To investigate thumb tendon tensions, biomechanicians and clinicians have to know the performances and the limits of these two data sets. The aim of this study was thus to compare the results of these two models and evaluate their performances in regard to prior electromyographic measurements (EMG). Thumb posture was recorded during the classical key pinch and pulp pinch grips. Various fingertip forces applied at the distal segment were simulated in a range including extension, adduction, flexion, abduction. Input data of thumb postures and fingertip forces were used to compute tendon tensions with both models. Tendon tensions obtained using these two models were then compared and correlated to EMG measurements provided in the literature. The results showed that both models predicted relevant muscle coordination for five of the nine muscles modelled. Opponent and abductor longus muscle coordinations were badly estimated by both models. Each model was sensible to kinematic errors but not in the same proportion. This study pointed out the advantages/limits of the two models to use them more appropriately for clinical and/or research purposes.

Effect of object width on precision grip force and finger posture

This study aimed to define the effect of object width on spontaneous grasp. Participants held objects of various masses (0.75 to 2.25 kg) and widths (3.5 to 9.5 cm) between thumb and index finger. Grip force, maximal grip force and corresponding finger postures were recorded using an embedded force sensor and an optoelectronic system, respectively. Results showed that index finger joints varied to accommodate the object width, whereas thumb posture remained constant across conditions. For a given object mass, grip force increased as a function of object width, although this result is not dictated by the laws of mechanics. Because maximal grip force also increased with object width, we hypothesise that participants maintain a constant ratio between grip force and their maximal grip force at each given width. Altogether we conclude that when the task consists in manipulating objects/tools, the optimal width is different than when maximal force exertions are required.

Middle and ring fingers are more exposed to pulley rupture than index and little during sport-climbing: a biomechanical explanation

BACKGROUND

Finger pulley injury is a common incident observed during sport-climbing. The total rupture of one or several pulleys is highly debilitating and requires surgical reconstruction and/or rehabilitation programs. Literature reports show that fingers are not equally exposed to this injury. The ring and middle fingers are usually injured while the index and little fingers are less exposed. The objective of this study was to determine the biomechanical factors leading to the enhanced exposure of ring and middle finger pulleys.

METHOD

Eight subjects were required to exert maximal four-finger force in a specific sport-climbing finger posture. External fingertip forces and finger joint postures were used as input data of a specifically developed biomechanical model of the four fingers (i.e., index, middle, ring and little). This model was based on classical Newton static laws and used an optimization process to quantify the flexor tendon tensions and the pulley forces in each finger. Passive participation of ligaments was also considered into mechanical equations.

FINDINGS

Results showed that two main factors could explain the enhanced exposure of ring and middle fingers. Firstly, the fingertip force intensities applied by these two fingers were higher than those observed for the index and little fingers. Secondly, results show that the pulley forces of the ring and middle fingers were close to their rupture thresholds, while it was not the case for the two other fingers. This could be explained by a specific localisation of the finger pulleys of the ring and middle fingers leading to enhanced pulley forces.

INTERPRETATION

These results are relevant and could help clinicians to understand finger pulley pathologies and adapt the surgical interventions to reconstruct the fingers pulleys.

Using EMG data to constrain optimization procedure improves finger tendon tension estimations during static fingertip force production

Determining tendon tensions of the finger muscles is crucial for the understanding and the rehabilitation of hand pathologies. Since no direct measurement is possible for a large number of finger muscle tendons, biomechanical modelling presents an alternative solution to indirectly evaluate these forces. However, the main problem is that the number of muscles spanning a joint exceeds the number of degrees of freedom of the joint resulting in mathematical under-determinate problems. In the current study, a method using both numerical optimization and the intra-muscular electromyography (EMG) data was developed to estimate the middle finger tendon tensions during static fingertip force production. The method used a numerical optimization procedure with the muscle stress squared criterion to determine a solution while the EMG data of three extrinsic hand muscles serve to enforce additional inequality constraints. The results were compared with those obtained with a classical numerical optimization and a method based on EMG only. The proposed method provides satisfactory results since the tendon tension estimations respected the mechanical equilibrium of the musculoskeletal system and were concordant with the EMG distribution pattern of the subjects. These results were not observed neither with the classical numerical optimization nor with the EMG-based method. This study demonstrates that including the EMG data of the three extrinsic muscles of the middle finger as inequality constraints in an optimization process can yield relevant tendon tensions with regard to individual muscle activation patterns, particularly concerning the antagonist muscles.

Biomechanical model for the determination of the forces acting on the finger pulley system

A mathematical model proposed by Hume et al., 1991. Journal of Hand Surgery-American Volume 16, 722-730 for the determination of the forces acting on the A2 and A4 pulley was used. The parameters necessary for this determination include the angle of flexion, the positioning of the pulley with respect to the centre of rotation in the proximal interphalangeal joint (PIP), the relative mismatch between bone and tendon width at the location of the respective pulleys as well as the tendon height at this position. This model was further developed to include the stiffness of the respective pulley, as well as the fact, that there are two flexor tendons of which only one passes through both pulleys. Each parameter was then evaluated using a sensitivity analysis proposed by Fasham et al., 1990. Journal of Marine Research 48, 591-639 in order to determine their relative importance for the outcome of the model. The most important parameter proofed to be the positioning of the pulley with respect to the centre of rotation in the PIP joint. This observation enabled us to give the best possible placement for a pulley graft after pulley rupture.

Fingertip force and electromyography of finger flexor muscles during a prolonged intermittent exercise in elite climbers and sedentary individuals

The aim of this study was to characterize forearm muscle fatigue identified by the decrease in electromyogram median frequency and/or fingertip force during intermittent exercise. Nine elite climbers (international competitive level, USA 5.14a on sight) and ten non-climbers were instructed to maintain a fingertip force of 80% of their maximal voluntary contraction force on a dynamometer mimicking a rock climbing grip during a 5 s effort/5 s rest cycle for 36 repetitions (i.e. 6 min of exercise). Elite climbers lasted twice as long as non-climbers (climbers: 3 min; non-climbers: 1 min 30 s) before the force could no longer be maintained (i.e. the failure point). After this moment, fingertip force decreased and stabilized until the end of the exercise around 50% maximum voluntary contraction force in non-climbers and 63% in elite climbers. Electromyogram median frequency showed a greater decrease in non-climbers than in elite climbers before the failure point. No change in median frequency was observed after the failure point in elite climbers or in non-climbers. These results confirm that elite climbers are better adapted than non-climbers for performing the intermittent fingertip effort before the failure point. After this point, the better fingertip force of elite climbers suggests different forearm muscle properties, while the electromyography results do not provide any indication about the fatigue process.