Modelling the effect of repositioning on the evolution of skeletal muscle damage in deep tissue injury

A survey of deep tissue injury in elite female wheelchair basketball players

OBJECTIVE

To investigate deep tissue injuries (DTIs) in elite female wheelchair basketball players and identify factors associated with their occurrence.

METHODS

Study participants were 22 female wheelchair basketball players on the Japanese national team. The sacral and bilateral ischial regions of each participant were examined using ultrasonography to detect DTIs.

RESULTS

DTIs were found in 15 players (68.2%). DTIs were more frequent in players with a central nervous system disorder (CNSd) (85.7%) than in those with skeletal system disease (SSd) (37.5%, p = 0.020), and in players using a wheelchair in daily life (84.6%) than those using a wheelchair only for basketball (44.4%, p = 0.046). Players with pelvic instability were more likely to have DTIs (90.9% vs. 45.5%, p = 0.017). DTIs were deeper in the ischial region than the sacral region (p = 0.022). Players with CNSd had more DTIs in sacral regions (90% vs. 10%, p = 0.014). Players with DTIs had lower systolic blood pressure (sBP), red blood cell (RBC) count, and serum creatinine levels (sCr) (all p < 0.05).

CONCLUSIONS

Ischial DTIs were deeper than sacral DTIs. Players with CNSd had more sacral DTIs than those with SSd. CNSd, wheelchair use in daily life, pelvic instability, and lower sBP, RBC, and sCr increased the risk of DTIs.

Characteristics of a volume-adjustable compression chamber for transradial prosthetic interface

In the transradial limb–socket contact interface, the physiological properties and prosthetic operating habits of the residual limb might affect the comfort and functionality of the prosthesis. To enhance the comfort and functionality of the interface, a frame-type socket with four volume-adjustable compression chambers was proposed for the transradial amputation level. The contact pressure of the limb–socket interface was adjusted by the volume changes in the chambers and controlled by a vacuum pump and the corresponding control system. The parameters of the chamber were designed in accordance with the biomechanics of the forearm soft tissue. The chamber with a negative stiffness characteristic was theoretically compared with the chamber with a positive stiffness characteristic. The results showed that the former had a superior performance to the latter in safety and pump performance requirements. A physical model of the transradial frame-type prosthetic interface was also manufactured with four negative stiffness chambers. The experimental results showed that this new prosthetic interface achieved more fitting time and better performance in comfort and functionality than the fixed frame-type socket. This new prosthetic interface with volume-adjustable compression chambers might be an alternative choice for transradial amputees.

On the anisotropy of skeletal muscle tissue under compression

This paper deals with the role of the muscle fibres and extracellular matrix (ECM) components when muscle tissue is subjected to compressive loads. To this end, dissected tissue samples were tested in compression modes which induced states of fibres in compression (I), in tension (II) or at constant length (III), respectively. A comparison of the stress responses indicated that the tissue behaviour is significantly different for these modes, including differences between the modes (I) and (III). This contradicts the paradigm of many constitutive models that the stress response can be decomposed into an isotropic part relating to the ECM and an anisotropic fibre part the contribution of which can be neglected under compression. Conversely, the results provide experimental evidence that there is an anisotropic contribution of the fibre direction to the compressive stress. Interpreting these results in terms of recent microscopical studies, potential connections between the observed behaviour and the structure of muscle ECM are established.