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Amjad M, Badshah S, Ahmad S, Badshah M, Jan S, Yasir M, Akram W, Alam Shah I, Muhammad R, Khan MI, Yasmeen T. Finite element modeling of stress distribution and safety factors in a Ti-27Nb alloy hip implant under real-world physiological loading scenarios. PLoS One 2024; 19:e0300270. [PMID: 39106270 DOI: 10.1371/journal.pone.0300270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Accepted: 02/25/2024] [Indexed: 08/09/2024] Open
Abstract
Total hip arthroplasty (THA) is one of the most successful orthopaedic interventions globally, with over 450,000 procedures annually in the U.S. alone. However, issues like aseptic loosening, dislocation, infection and stress shielding persist, necessitating complex, costly revision surgeries. This highlights the need for continued biomaterials innovation to enhance primary implant integrity and longevity. Implant materials play a pivotal role in determining long-term outcomes, with titanium alloys being the prominent choice. However, emerging evidence indicates scope for optimized materials. The nickel-free β titanium alloy Ti-27Nb shows promise with excellent biocompatibility and mechanical properties. Using finite element analysis (FEA), this study investigated the biomechanical performance and safety factors of a hip bone implant made of nickel-free titanium alloy (Ti-27Nb) under actual loading during routine day life activities for different body weights. The FEA modelled physiological loads during walking, jogging, stair ascent/descent, knee bend, standing up, sitting down and cycling for 75 kg and 100 kg body weights. Comparative analyses were conducted between untreated versus 816-hour simulated body fluid (SBF) treated implant conditions to determine in vivo degradation effects. The FEA predicted elevated von Mises stresses in the implant neck for all activities, especially stair climbing, due to its smaller cross-section. Stresses increased substantially with a higher 100 kg body weight compared to 75 kg, implying risks for heavier patients. Safety factors were reduced by up to 58% between body weights, although remaining above the desired minimum value of 1. Negligible variations were observed between untreated and SBF-treated responses, attributed to Ti-27Nb's excellent biocorrosion resistance. This comprehensive FEA provided clinically relevant insights into the biomechanical behaviour and integrity of the Ti-27Nb hip implant under complex loading scenarios. The results can guide shape and material optimization to improve robustness against repetitive stresses over long-term use. Identifying damage accumulation and failure risks is crucial for hip implants encountering real-world variable conditions. The negligible SBF effects validate Ti-27Nb's resistance to physiological degradation. Overall, the study significantly advances understanding of Ti-27Nb's suitability for reliable, durable hip arthroplasties with low revision rates.
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Affiliation(s)
- Muhammad Amjad
- Department of Mechanical Engineering, International Islamic University, Islamabad, Pakistan
| | - Saeed Badshah
- Department of Mechanical Engineering, International Islamic University, Islamabad, Pakistan
| | - Sajjad Ahmad
- Department of Mechanical Engineering, International Islamic University, Islamabad, Pakistan
| | - Mujahid Badshah
- Department of Mechanical Engineering, International Islamic University, Islamabad, Pakistan
| | - Sakhi Jan
- Department of Mechanical Engineering, International Islamic University, Islamabad, Pakistan
| | - Muhammad Yasir
- Department of Materials Science & Engineering, Institute of Space Technology, Islamabad, Pakistan
| | - Waseem Akram
- Department of Mechanical Engineering, International Islamic University, Islamabad, Pakistan
| | - Imtiaz Alam Shah
- Department of Mechanical Engineering, International Islamic University, Islamabad, Pakistan
| | - Riaz Muhammad
- Mechanical Engineering Department, College of Engineering, University of Bahrain, Zallaq, Bahrain
| | - Muhammad Imran Khan
- Department of Mechanical Engineering, College of Engineering, Prince Mohammad Bin Fahd University (PMU), Al-Khobar, Saudi Arabia
| | - Tabassam Yasmeen
- Aerospace Engineering Department, King Fahd University of Petroleum and Minerals, Dhahran, Saudi Arabia
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Jiang L, Qu F, Yang Z, Chen X, Gao X, Sun Q, Huo B. Heel-to-toe drop effects on biomechanical and muscle synergy responses during uphill walking. Front Bioeng Biotechnol 2024; 12:1385264. [PMID: 38798954 PMCID: PMC11116729 DOI: 10.3389/fbioe.2024.1385264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 04/26/2024] [Indexed: 05/29/2024] Open
Abstract
Uphill walking is a common task encountered in daily life, with steeper inclines potentially imposing greater biomechanical and neuromuscular demands on the human body. The heel-to-toe drop (HTD) in footwear may influence the biomechanical and neuromuscular pattern of uphill walking; but the impact remains unclear. Adjustments in HTD can modulate biomechanical and neuromuscular patterns, mitigating the demands and optimizing the body's response to different inclinations. We hypothesize that adjustments in HTD can modulate biomechanical and neuromuscular patterns, mitigating the demands and optimizing the body's response to different inclinations. Nineteen healthy men walked on an adjustable slope walkway, with varied inclinations (6°, 12°, 20°) and HTD shoes (10mm, 25mm, 40 mm), while the marker positions, ground reaction forces and electromyography data were collected. Our study reveals that gait temporo-spatial parameters are predominantly affected by inclination over HTD. Inclination has a more pronounced effect on kinematic variables, while both inclination and HTD significantly modulate kinetic and muscle synergy parameters. This study demonstrates that an increase in the inclination leads to changes in biomechanical and neuromuscular responses during uphill walking and the adjustment of HTD can modulate these responses during uphill walking. However, the present study suggests that an increased HTD may lead to elevated loads on the knee joint and these adverse effects need more attention.
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Affiliation(s)
- Liang Jiang
- School of Aerospace Engineering, Beijing Institute of Technology, Beijing, China
| | - Feng Qu
- Biomechanics Laboratory, Department of Kinesiology, Beijing Sport University, Beijing, China
| | - Zihan Yang
- Fashion Accessory Art and Engineering College, Beijing Institute of Fashion Technology, Beijing, China
| | - Xue Chen
- School of Aerospace Engineering, Beijing Institute of Technology, Beijing, China
| | - Xianzhi Gao
- School of Aerospace Engineering, Beijing Institute of Technology, Beijing, China
| | - Qing Sun
- School of Aerospace Engineering, Beijing Institute of Technology, Beijing, China
| | - Bo Huo
- Sport Biomechanics Center, Institute of Artificial Intelligence in Sports, Capital University of Physical Education and Sports, Beijing, China
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Pamukoff DN, Holmes SC, Heredia CE, Shumski EJ, Garcia SA, Montgomery MM. Cartilage deformation following a walking bout in individuals with anterior cruciate ligament reconstruction. J Orthop Res 2024; 42:349-359. [PMID: 37772457 DOI: 10.1002/jor.25694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 08/16/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023]
Abstract
The purpose was to (1) compare the effect of a walking bout on femoral cartilage deformation between limbs with and without anterior cruciate ligament reconstruction (ACLR) and (2) examine the association between gait kinetics and the magnitude of cartilage deformation. A total of 30 individuals with primary unilateral ACLR completed this study [14 male, 16 female; age = 22.57 (3.78) years; body mass index (BMI) = 25.88 (5.68) kg/m2 ; time since ACLR = 61.00 (16.43) months]. Overground walking biomechanics were assessed on day 1, and a 30-min walking bout or 30-min resting bout (control) were completed on days 2 and 3 (counterbalanced order). Femoral cartilage thickness was measured using ultrasound before, immediately following, and 30-min following each intervention. Linear mixed effects models compared the effect of walking on cartilage thickness between the ACLR and contralateral limbs after adjusting for sex, BMI, speed, and the number of steps. Stepwise regression examined the association between the external knee flexion and adduction moments and cartilage deformation following walking. There was a significant limb × time interaction for medial cartilage thickness. Post hoc analyses indicated that cartilage thickness decreased immediately following walking in the contralateral but not ACLR limb. Main effects of limb were observed for medial, central, and lateral cartilage thickness indicating thicker cartilage in the ACLR compared with contralateral limb. A higher knee adduction moment was associated with greater cartilage deformation in the ACLR limb. Femoral cartilage in the ACLR limb exhibited a less dynamic response to walking than the uninvolved limb, which may be due to habitual underloading during gait.
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Affiliation(s)
- Derek N Pamukoff
- School of Kinesiology, Western University, London, Ontario, Canada
| | - Skylar C Holmes
- Department of Kinesiology, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | | | - Eric J Shumski
- Department of Kinesiology, University of Georgia, Athens, Georgia, USA
| | - Steven A Garcia
- School of Kinesiology, University of Michigan, Ann Arbor, Michigan, USA
| | - Melissa M Montgomery
- Department of Kinesiology, California State University, Fullerton, Fullerton, California, USA
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Chevalier T, Colard T. Inferring the mobility of a middle Upper Paleolithic female skeleton from Caviglione (Liguria, Italy): Impact of trauma and mountainous terrain. J Hum Evol 2023; 184:103428. [PMID: 37741140 DOI: 10.1016/j.jhevol.2023.103428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 08/25/2023] [Accepted: 08/26/2023] [Indexed: 09/25/2023]
Abstract
Mobility and territory occupation, the participation of injured individuals in group activities, and the role of women in early human groups are crucial issues in human evolution. Previously, a biomechanical study showed evidence of several traumas to the upper limb of the well-preserved middle Upper Paleolithic (UP) female skeleton from Caviglione (Caviglione 1, Liguria, Italy) but did not characterize their impact on locomotor behavior. Furthermore, mobility in the European UP context is thoroughly documented in males but not in females. Therefore, we examined whether this trauma-affected female skeleton shows bone adaptation to high mobility, as expected in UP groups, and to frequent foot eversion and inversion, as expected, given the mountainous area in which it was discovered. This study investigated the structural properties of the femur, tibia, fibula, and first metatarsal to infer the mobility level and pattern of Caviglione 1. We analyzed the diaphyseal 'shape', robusticity, fibular cortical distribution, and relative robusticity (fibula versus tibia). No substantial findings were derived from the first metatarsal. The fibular cortical distribution can discriminate 'active' (nomadic or settled) and recent sedentary human groups; these findings indicated Caviglione 1 belonged to the former. Interestingly, compared with ancient and recent sedentary humans and some UP individuals, Caviglione 1 had femurs with strong relative anteroposterior rigidity and robust tibias and fibulas reflecting an adaptation to extremely high levels of mobility. The very high relative fibular robusticity of Caviglione 1, higher than that of Middle UP males, is consistent with bone adaptation to frequent travel through mountainous terrain. Such fibular robusticity may also be a consequence of imbalance, due to upper limb traumas, when traveling downhill. These findings indicate that injured individuals may have participated in subsistence activities in past populations and describe an UP female with bone adaptations to habitual high mobility, notably in mountainous terrain.
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Affiliation(s)
- Tony Chevalier
- UMR 7194 HNHP, University of Perpignan via Domitia, EPCC-CERP de Tautavel, Avenue Léon Jean Grégory, Tautavel 66720, France.
| | - Thomas Colard
- UMR 5199 PACEA, University of Bordeaux, CNRS, MCC; Bâtiment B8, Allée Geoffroy Saint-Hilaire, CS50023, Pessac F-33615, France; Department of Oral and Maxillofacial Radiology, University of Lille, CHU Lille, Lille F-59000, France
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Liu H, Gong H, Chen P, Zhang L, Cen H, Fan Y. Biomechanical effects of typical lower limb movements of Chen-style Tai Chi on knee joint. Med Biol Eng Comput 2023; 61:3087-3101. [PMID: 37624535 DOI: 10.1007/s11517-023-02906-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 08/09/2023] [Indexed: 08/26/2023]
Abstract
The load and stress distribution on cartilage and meniscus of the knee joint in typical lower limb movements of Chen-style Tai Chi (TC) and deep squat (DS) were analyzed using finite element (FE) analysis. The loadings for this analysis consisted of muscle forces and ground reaction force (GRF), which were calculated through the inverse dynamic approach based on kinematics and force plate measurements obtained from motion capture experiments. Thirteen experienced practitioners performed four typical TC movements, namely, single whip (SW), brush knee and twist step (BKTS), stretch down (SD), and part the wild horse's mane (PWHM), which exhibit lower posture and greater lower limb force compared to other TC styles. The results indicated that TC required greater lower limb muscle strength than DS, resulting in greater knee joint forces. The stress on the medial cartilage in SW and BKTS fell within a range conductive to maintaining the balance between anabolism and catabolism of cartilage matrix. This was due to the fact that SW and BKTS reduce the medial to total tibiofemoral contact force ratios through knee abduction, which may effectively alleviate mild medial knee osteoarthritis (KOA). However, the greater medial contact force ratios observed in SD and PWHM resulted in great contact stresses that may aggravate the pain of patients with KOA. To mitigate these effects, practitioners should consider elevating their postures appropriately to reduce knee flexion angles, especially during the single-leg support phase. This adjustment can decrease the required muscle strength, load and stress on the knee joint.
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Affiliation(s)
- Haibo Liu
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - He Gong
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China.
| | - Peng Chen
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Le Zhang
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Haipeng Cen
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
| | - Yubo Fan
- Key Laboratory for Biomechanics and Mechanobiology (Beihang University) of Ministry of Education, Beijing Advanced Innovation Center for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, No.37, Xueyuan Road, Haidian District, Beijing, 100083, People's Republic of China
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Wang B, Mao Z, Guo J, Yang J, Zhang S. The non-invasive evaluation technique of patellofemoral joint stress: a systematic literature review. Front Bioeng Biotechnol 2023; 11:1197014. [PMID: 37456733 PMCID: PMC10343958 DOI: 10.3389/fbioe.2023.1197014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 06/20/2023] [Indexed: 07/18/2023] Open
Abstract
Introduction: Patellofemoral joint stress (PFJS) is an important parameter for understanding the mechanism of patellofemoral joint pain, preventing patellofemoral joint injury, and evaluating the therapeutic efficacy of PFP rehabilitation programs. The purpose of this systematic review was to identify and categorize the non-invasive technique to evaluate the PFJS. Methods: Literature searches were conducted from January 2000 to October 2022 in electronic databases, namely, PubMed, Web of Science, and EBSCO (Medline, SPORTDiscus). This review includes studies that evaluated the patellofemoral joint reaction force (PJRF) or PFJS, with participants including both healthy individuals and those with patellofemoral joint pain, as well as cadavers with no organic changes. The study design includes cross-sectional studies, case-control studies, and randomized controlled trials. The JBI quality appraisal criteria tool was used to assess the risk of bias in the included studies. Results: In total, 5016 articles were identified in the database research and the citation network, and 69 studies were included in the review. Discussion: Researchers are still working to improve the accuracy of evaluation for PFJS by using a personalized model and optimizing quadriceps muscle strength calculations. In theory, the evaluation method of combining advanced computational and biplane fluoroscopy techniques has high accuracy in evaluating PFJS. The method should be further developed to establish the "gold standard" for PFJS evaluation. In practical applications, selecting appropriate methods and approaches based on theoretical considerations and ecological validity is essential.
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Alexander N, Schwameder H. A forefoot strike pattern during 18° uphill walking leads to greater ankle joint and plantar flexor loading. Gait Posture 2023; 103:44-49. [PMID: 37087807 DOI: 10.1016/j.gaitpost.2023.04.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/06/2023] [Accepted: 04/13/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND The ankle joint is one of the most involved joints in uphill walking. Furthermore, it is well known that toe walking increases the external dorsiflexion moment in the first half of stance during level walking. However, the effects of different foot-strike patterns on plantar flexor muscle forces, ankle joint forces, and other lower limb joint and muscle forces are unknown. RESEARCH QUESTION Do foot-strike patterns during 18° uphill walking affect lower limb sagittal joint angles and moments, as well as joint contact and muscle forces? METHODS This study was based on a data subset from previous publications, analysing uphill walking on an 18° ramp at a preset speed of 1.1 m/s in 18 male participants (34 limbs analyzed, 27 ± 5 years). Participants were divided into two groups based on their foot-strike pattern at initial contact: heel (HC) and forefoot (FC). Lower limb sagittal joint angles and moments as well as joint contact and muscle forces were assessed. Differences between the groups were assessed using two-sample t-tests. RESULTS FC showed increased soleus and gastrocnemius muscle forces as well as ankle joint forces during loading response and mid stance compared to HC. The soleus muscle force impulse was 51.1% higher in the FC group than in the HC group (p < 0.001). On the other hand, FC had a lower absolute centre of mass vertical displacement and reduced knee and hip joint, as well as iliopsoas and hamstring muscle force impulses. SIGNIFICANCE In terms of plantar flexor and ankle joint loading, it is advantageous to exhibit a heel strike pattern. The current results can be used to recommend foot-strike patterns for uphill walking, particularly in the presence or prevention of musculoskeletal issues.
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Affiliation(s)
- Nathalie Alexander
- Department of Sport Science and Kinesiology, Paris Lodron University of Salzburg, Salzburg, Austria; Laboratory for Motion Analysis, Department of Paediatric Orthopaedics, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland.
| | - Hermann Schwameder
- Department of Sport Science and Kinesiology, Paris Lodron University of Salzburg, Salzburg, Austria
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Almajid R, Appiah-Kubi KO, Cipriani D, Goel R. Dual-tasking interference is exacerbated outdoors: A pilot study. Front Sports Act Living 2023; 5:1077362. [PMID: 36891128 PMCID: PMC9986320 DOI: 10.3389/fspor.2023.1077362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 01/31/2023] [Indexed: 02/22/2023] Open
Abstract
Introduction Walking while texting can create gait disturbances that may increase fall risk, especially in outdoors environment. To date, no study has quantified the effect of texting on motor behavior using different dynamic tasks in outdoor environments. We aimed to explore the impact of texting on dynamic tasks in indoor and outdoor environments. Methods Twenty participants (age 38.3 ± 12.5 years, 12 F) had a Delsys inertial sensor fixed on their back and completed walk, turn, sit-to-stand, and stand-to-sit subtasks with and without texting in both indoor and outdoor environments. Results While there was no difference in texting accuracy (p = 0.3), there was a higher dual-tasking cost in walking time with texting outdoors than indoors (p = 0.008). Discussion Dual tasking has a greater impact on walking time outdoors compared to an indoor environment. Our findings highlight the importance of patient education concerning dual-tasking and pedestrian safety in clinical settings.
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Affiliation(s)
- Rania Almajid
- Department of Physical Therapy, Stockton University, Galloway, United States
- Department of Physical Therapy, West Coast University, Los Angeles, CA, United States
| | | | - Daniel Cipriani
- Department of Physical Therapy, West Coast University, Los Angeles, CA, United States
| | - Rahul Goel
- Department of Neuroscience, Baylor College of Medicine, Houston, TX, United States
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Thorsen T, Wen C, Porter J, Reinbolt J, Weinhandl JT, Zhang S. Tibiofemoral compressive force during downhill walking in patients with primary total knee arthroplasty: A statistical parametric mapping approach. Clin Biomech (Bristol, Avon) 2023; 102:105900. [PMID: 36739666 DOI: 10.1016/j.clinbiomech.2023.105900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 01/09/2023] [Accepted: 01/26/2023] [Indexed: 02/07/2023]
Abstract
BACKGROUND Downhill walking is a necessary part of daily life and an effective activity in post-operative rehabilitation following total knee arthroplasty. The purpose of this study was to determine differences in the behavior of total, medial, and lateral tibiofemoral compressive forces as well as knee extensor and flexor muscle forces between different limbs of patients with total knee arthroplasty (replaced, non-replaced) during downhill and level walking. METHODS Musculoskeletal modeling and simulation were implemented to determine muscle forces and tibiofemoral compressive forces in 25 patients with total knee arthroplasty. A 2 × 2 [Limb (replaced, non-replaced) × Slope (0°, 10°)] Statistical parametric mapping repeated measures analysis of variance was conducted on selected variables. FINDINGS Statistical parametric mapping did not identify any between-limb differences for compressive or muscle forces. Differences in joint compressive and muscle forces persisted throughout different intervals of stance-phase between level and downhill walking. Knee extensor muscle forces were distinctly greater during level walking for nearly all of stance phase. Knee flexor muscle force was greater during downhill walking for >60% of stance. Statistical parametric mapping did identify regions of significance between level and downhill walking that coincided temporally (near loading response and push off) with peak joint moment and joint compressive forces traditionally reported using discrete variable analyses. INTERPRETATION Downhill walking may be a safe and useful rehabilitation tool for post-knee arthroplasty rehabilitation that will not disproportionally load either the replaced or the non-replaced joint and where the quadriceps muscles can be strengthened during a gait-specific task.
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Affiliation(s)
- Tanner Thorsen
- School of Kinesiology and Nutrition, The University of Southern Mississippi, Hattiesburg, MS, USA
| | - Chen Wen
- Department of Kinesiology, Recreation and Sport Studies, The University of Tennessee, Knoxville, TN, USA
| | - Jared Porter
- Department of Kinesiology, Recreation and Sport Studies, The University of Tennessee, Knoxville, TN, USA
| | - Jeffery Reinbolt
- Department of Mechanical, Aerospace, and Biomedical Engineering, The University of Tennessee, Knoxville, TN, USA
| | - Joshua T Weinhandl
- Department of Kinesiology, Recreation and Sport Studies, The University of Tennessee, Knoxville, TN, USA
| | - Songning Zhang
- Department of Kinesiology, Recreation and Sport Studies, The University of Tennessee, Knoxville, TN, USA.
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Simulation Analysis and Study of Gait Stability Related to Motion Joints. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8417089. [PMID: 35937395 PMCID: PMC9355770 DOI: 10.1155/2022/8417089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 07/07/2022] [Accepted: 07/15/2022] [Indexed: 11/18/2022]
Abstract
Gait stability in exercise is an inevitable and vexing problem in mechanics, artificial intelligence, sports, and rehabilitation medicine research. With the rapid development and popularization of science and technology, it becomes a reality for researchers to obtain large-scale human motion data sets in real time with higher efficiency. However, at present, the analysis of gait stability of moving joints is still based on image recognition technology, which is ten times less accurate and inefficient. In this paper, Vicon 3D motion capture system, dynamometer, and surface electromyography system were used to obtain the parameters of the lower limbs of the subjects. Using Anywhere modeling and simulation system, simulation experiments were carried out, and the reaction force data of lower limb joints under two environments were obtained. The gait characteristics of human gait were analyzed from the angle of internal and external adjustment mechanism. Combining one-way ANOVA and incremental occupancy rate, the adjustment process of gait stability is described comprehensively. The findings of this study can provide a theoretical basis for the research of lower limb con-assistive devices and can guide the design and development of bipedal anthropomorphic robots.
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Alexander N, Brunner R, Cip J, Viehweger E, De Pieri E. Increased Femoral Anteversion Does Not Lead to Increased Joint Forces During Gait in a Cohort of Adolescent Patients. Front Bioeng Biotechnol 2022; 10:914990. [PMID: 35733525 PMCID: PMC9207384 DOI: 10.3389/fbioe.2022.914990] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/13/2022] [Indexed: 11/13/2022] Open
Abstract
Orthopedic complications were previously reported for patients with increased femoral anteversion. A more comprehensive analysis of the influence of increased femoral anteversion on joint loading in these patients is required to better understand the pathology and its clinical management. Therefore, the aim was to investigate lower-limb kinematics, joint moments and forces during gait in adolescent patients with increased, isolated femoral anteversion compared to typically developing controls. Secondly, relationships between the joint loads experienced by the patients and different morphological and kinematic features were investigated. Patients with increased femoral anteversion (n = 42, 12.8 ± 1.9 years, femoral anteversion: 39.6 ± 6.9°) were compared to typically developing controls (n = 9, 12.0 ± 3.0 years, femoral anteversion: 18.7 ± 4.1°). Hip and knee joint kinematics and kinetics were calculated using subject-specific musculoskeletal models. Differences between patients and controls in the investigated outcome variables (joint kinematics, moments, and forces) were evaluated through statistical parametric mapping with Hotelling T2 and t-tests (α = 0.05). Canonical correlation analyses (CCAs) and regression analyses were used to evaluate within the patients’ cohort the effect of different morphological and kinematic predictors on the outcome variables. Predicted compressive proximo-distal loads in both hip and knee joints were significantly reduced in patients compared to controls. A gait pattern characterized by increased knee flexion during terminal stance (KneeFlextSt) was significantly correlated with hip and knee forces, as well as with the resultant force exerted by the quadriceps on the patella. On the other hand, hip internal rotation and in-toeing, did not affect the loads in the joints. Based on the finding of the CCAs and linear regression analyses, patients were further divided into two subgroups based KneeFlextSt. Patients with excessive KneeFlextSt presented a significantly higher femoral anteversion than those with normal KneeFlextSt. Patients with excessive KneeFlextSt presented significantly larger quadriceps forces on the patella and a larger posteriorly-oriented shear force at the knee, compared to patients with normal KneeFlextSt, but both patients’ subgroups presented only limited differences in terms of joint loading compared to controls. This study showed that an altered femoral morphology does not necessarily lead to an increased risk of joint overloading, but instead patient-specific kinematics should be considered.
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Affiliation(s)
- Nathalie Alexander
- Laboratory for Motion Analysis, Department of Paediatric Orthopaedics, Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland
- Department of Orthopaedics and Traumatology, Cantonal Hospital St. Gallen, St. Gallen, Switzerland
| | - Reinald Brunner
- Laboratory for Movement Analysis, University of Basel Children’s Hospital, Basel, Switzerland
- Department of Paediatric Orthopaedics, University of Basel Children’s Hospital, Basel, Switzerland
- Dpartment of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Johannes Cip
- Department of Paediatric Orthopaedics, Children’s Hospital of Eastern Switzerland, St. Gallen, Switzerland
| | - Elke Viehweger
- Laboratory for Movement Analysis, University of Basel Children’s Hospital, Basel, Switzerland
- Department of Paediatric Orthopaedics, University of Basel Children’s Hospital, Basel, Switzerland
- Dpartment of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Enrico De Pieri
- Laboratory for Movement Analysis, University of Basel Children’s Hospital, Basel, Switzerland
- Dpartment of Biomedical Engineering, University of Basel, Basel, Switzerland
- *Correspondence: Enrico De Pieri,
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Effect of Assistance Using a Bilateral Robotic Knee Exoskeleton on Tibiofemoral Force Using a Neuromuscular Model. Ann Biomed Eng 2022; 50:716-727. [PMID: 35344119 DOI: 10.1007/s10439-022-02950-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 03/13/2022] [Indexed: 11/01/2022]
Abstract
Tibiofemoral compression forces present during locomotion can result in high stress and risk damage to the knee. Powered assistance using a knee exoskeleton may reduce the knee load by reducing the work required by the muscles. However, the exact effect of assistance on the tibiofemoral force is unknown. The goal of this study was to investigate the effect of knee extension assistance during the early stance phase on the tibiofemoral force. Nine able-bodied adults walked on an inclined treadmill with a bilateral knee exoskeleton with assistance and with no assistance. Using an EMG-informed neuromusculoskeletal model, muscle forces were estimated, then utilized to estimate the tibiofemoral contact force. Results showed a 28% reduction in the knee moment, which resulted in approximately a 15% decrease in knee extensor muscle activation and a 20% reduction in subsequent muscle force, leading to a significant 10% reduction in peak and 9% reduction in average tibiofemoral contact force during the early stance phase (p < 0.05). The results indicate the tibiofemoral force is highly dependent on the knee kinetics and quadricep muscle activation due to their influence on knee extensor muscle forces, the primary contributor to the knee load.
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13
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Wang Y, Chen D, Zhang Y, Niu Y, Yang X. Effect of plantar pressure on stepping friction under cross‐slope condition. BIOSURFACE AND BIOTRIBOLOGY 2022. [DOI: 10.1049/bsb2.12032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Yanzhao Wang
- National United Engineering Laboratory for Advanced Bearing Tribology Henan University of Science and Technology Henan Luoyang China
- School of Materials Science and Engineering Henan University of Science and Technology Henan Luoyang China
| | - Deqiang Chen
- National United Engineering Laboratory for Advanced Bearing Tribology Henan University of Science and Technology Henan Luoyang China
| | - Yongzhen Zhang
- National United Engineering Laboratory for Advanced Bearing Tribology Henan University of Science and Technology Henan Luoyang China
| | - Yongping Niu
- National United Engineering Laboratory for Advanced Bearing Tribology Henan University of Science and Technology Henan Luoyang China
| | - Xiaohui Yang
- Department of Neurology The First Affiliated Hospital of Henan University of Science and Technology Henan Luoyang China
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14
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Strutzenberger G, Leutgeb L, Claußen L, Schwameder H. Gait on slopes: Differences in temporo-spatial, kinematic and kinetic gait parameters between walking on a ramp and on a treadmill. Gait Posture 2022; 91:73-78. [PMID: 34653877 DOI: 10.1016/j.gaitpost.2021.09.196] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 09/20/2021] [Accepted: 09/24/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND Inclined treadmills or static ramp constructions can be used to investigate downhill gait in a standardised laboratory condition. There is a lack of information how the gait patterns are affected when walking on a ramp or an inclined treadmill during uphill and downhill walking. RESEARCH QUESTION Is there a difference in temporo-spatial parameters, sagittal ankle, knee and hip joint angle as well as ground reaction force when walking uphill and downhill on a ramp and a treadmill. METHODS Uphill and downhill gait of 15 healthy participants was assessed during walking on a treadmill and on a ramp with slope gradients of 12 °, 6 ° and 0 °. Participants were instructed to walk with the same speed on each slope-system. Kinematic and temporo-spatial paramters were collected using a 3D motion capture system (Qualisys, Gothenburgh, Sweden), kinetic data were collected using pressure insoles (loadsol®, Novel, Germany). Temporo-spatial parameters were analysed using a Friedman ANOVA, time series of kinematic and kinetic data were compared using statistical parametric mapping with a sigificance level of 5%. RESULTS On the treadmill participants walked with significantly shorter steps and shorter contact times, while they significantly increased step frequency compared to walking on a ramp, regardless of slope gradient. In uphill conditions, treadmill gait increased hip and knee flexion angles during the stance phase and increased the forward tilt of the thorax during the entire gait cycle. During downhill walking a significant decrease in dorsiflexion during initial contact, midstance and the second half of the swing phase was observed. Peak resultant forces remained similar compared to walking on the ramp. These alterations might be due to mechanical and psychological effects. SIGNIFICANCE Knowledge about these differences is important in future study design and data interpretation from existing literature.
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Affiliation(s)
- Gerda Strutzenberger
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Schlossalee 49, 5400, Hallein-Rif, Salzburg, Austria; Sports Medical Research Group, Department of Orthopaedics, Balgrist University Hospital, University of Zurich, Forchstraße 345, 8008, Zürich, Switzerland; Motion Analysis Zurich, Department of Orthopaedics, Balgrist University Hospital, Children's Hospital, University of Zurich, Forchstraße 345, 8008, Zürich, Switzerland.
| | - Lara Leutgeb
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Schlossalee 49, 5400, Hallein-Rif, Salzburg, Austria.
| | - Lisa Claußen
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Schlossalee 49, 5400, Hallein-Rif, Salzburg, Austria; Institute of Sports and Sport Science, University of Kassel, Damaschkestraße 25, 34121, Kassel, Hesse, Germany.
| | - Hermann Schwameder
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Schlossalee 49, 5400, Hallein-Rif, Salzburg, Austria.
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15
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Logerstedt DS, Ebert JR, MacLeod TD, Heiderscheit BC, Gabbett TJ, Eckenrode BJ. Effects of and Response to Mechanical Loading on the Knee. Sports Med 2021; 52:201-235. [PMID: 34669175 DOI: 10.1007/s40279-021-01579-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2021] [Indexed: 11/30/2022]
Abstract
Mechanical loading to the knee joint results in a differential response based on the local capacity of the tissues (ligament, tendon, meniscus, cartilage, and bone) and how those tissues subsequently adapt to that load at the molecular and cellular level. Participation in cutting, pivoting, and jumping sports predisposes the knee to the risk of injury. In this narrative review, we describe different mechanisms of loading that can result in excessive loads to the knee, leading to ligamentous, musculotendinous, meniscal, and chondral injuries or maladaptations. Following injury (or surgery) to structures around the knee, the primary goal of rehabilitation is to maximize the patient's response to exercise at the current level of function, while minimizing the risk of re-injury to the healing tissue. Clinicians should have a clear understanding of the specific injured tissue(s), and rehabilitation should be driven by knowledge of tissue-healing constraints, knee complex and lower extremity biomechanics, neuromuscular physiology, task-specific activities involving weight-bearing and non-weight-bearing conditions, and training principles. We provide a practical application for prescribing loading progressions of exercises, functional activities, and mobility tasks based on their mechanical load profile to knee-specific structures during the rehabilitation process. Various loading interventions can be used by clinicians to produce physical stress to address body function, physical impairments, activity limitations, and participation restrictions. By modifying the mechanical load elements, clinicians can alter the tissue adaptations, facilitate motor learning, and resolve corresponding physical impairments. Providing different loads that create variable tensile, compressive, and shear deformation on the tissue through mechanotransduction and specificity can promote the appropriate stress adaptations to increase tissue capacity and injury tolerance. Tools for monitoring rehabilitation training loads to the knee are proposed to assess the reactivity of the knee joint to mechanical loading to monitor excessive mechanical loads and facilitate optimal rehabilitation.
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Affiliation(s)
- David S Logerstedt
- Department of Physical Therapy, University of the Sciences in Philadelphia, Philadelphia, PA, USA.
| | - Jay R Ebert
- School of Human Sciences (Exercise and Sport Science), University of Western Australia, Perth, WA, Australia.,Orthopaedic Research Foundation of Western Australia, Perth, WA, Australia.,Perth Orthopaedic and Sports Medicine Research Institute, Perth, WA, Australia
| | - Toran D MacLeod
- Department of Physical Therapy, Sacramento State University, Sacramento, CA, USA
| | - Bryan C Heiderscheit
- Orthopedics and Rehabilitation, University of Wisconsin-Madison, Madison, WI, USA
| | - Tim J Gabbett
- Gabbett Performance Solutions, Brisbane, QLD, Australia.,Centre for Health Research, University of Southern Queensland, Ipswich, QLD, Australia
| | - Brian J Eckenrode
- Department of Physical Therapy, Arcadia University, Glenside, PA, USA
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16
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Alexander N, Schwameder H, Baker R, Trinler U. Effect of different walking speeds on joint and muscle force estimation using AnyBody and OpenSim. Gait Posture 2021; 90:197-203. [PMID: 34509042 DOI: 10.1016/j.gaitpost.2021.08.026] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/23/2021] [Accepted: 08/30/2021] [Indexed: 02/02/2023]
Abstract
BACKGROUND To be able to use muscluloskeletal models in clinical settings, it is important to understand the effect of walking speed on joint and muscle force estimations in different generic musculoskeletal models. RESEARCH QUESTION The aim of the current study is to compare estimated joint and muscle forces as a function of walking speed between two standard approaches offered in two different modelling environments (AnyBody and OpenSim). METHODS Experimental data of 10 healthy participants were recorded at three different walking speeds (self-selected, 25 % slower, 25 % faster) using a ten-camera motion capture system together with four force plates embedded into a ten-meter walkway. Joint compression forces and muscle forces were calculated with a generic model in AnyBody and OpenSim. Trend analyses, mean absolute error (MAE) and correlation coefficients were used to compare joint compression forces and muscle forces between the two approaches. A one-way and two-way ANOVA with repeated measures were used to compare MAE and trend analysis changes, respectively (α = 0.05, Bonferroni corrected post-hoc tests). RESULTS Trend analyses showed the same speed effect for AnyBody and OpenSim. MAEs increased significantly from slow to fast walking for knee joint compression forces, biceps femoris long head, gluteus maximus, gluteus medius and vastus intermedius. Lower correlation coefficients during slower walking were found for quadriceps muscles, gluteus maximus and biceps femoris compared to normal and faster walking. SIGNIFICANCE Lower correlation coefficients during slower walking are assumed to be due to a higher amount of solutions solving the muscle recruitment in musculoskeletal models. This indicates that decreasing walking speed is more prone to speed dependent differences regarding variability, while the absolute error increased with increasing walking speed. To conclude, different modelling environments can react differently to changes in walking speed, but overall results are promising regarding the generalization across different generic musculoskeletal models.
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Affiliation(s)
- Nathalie Alexander
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria; Laboratory for Motion Analysis, Department of Paediatric Orthopaedics, Children's Hospital of Eastern Switzerland, St. Gallen, Switzerland; Department of Orthopaedics and Traumatology, Cantonal Hospital, St. Gallen, Switzerland.
| | - Hermann Schwameder
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Richard Baker
- School of Health Science, University of Salford, Manchester, United Kingdom
| | - Ursula Trinler
- School of Health Science, University of Salford, Manchester, United Kingdom; Andreas Wentzensen Research Institut, BG Unfallklinik Ludwigshafen, Germany
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17
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Taghizadeh Y, Chitsazan A, Pezeshki S, Taghizadeh H, Rouhi G. Total ankle replacement along with subtalar joint arthrodesis: In-vitro and in-silico biomechanical investigations. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2021; 37:e3514. [PMID: 34313397 DOI: 10.1002/cnm.3514] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 06/05/2021] [Accepted: 07/07/2021] [Indexed: 06/13/2023]
Abstract
Total ankle replacement (TAR) and subtalar joint (STJ) fusion, are popular treatments for ankle osteoarthritis (OA). Short endurance limits the former, and movement disability comes with the latter. It is hypothesized here that fusion of the STJ can improve the longevity of the TAR prosthesis. In this study, a fresh human cadaver's ankle joint underwent TAR surgery, and strain patterns in the vicinity of prosthesis were recorded after the application of axial compressive load on tibia, resembling stance phase of the gait. Then, STJ of the same sample fused (FTAR), and a similar test procedure was pursued. The obtained strains in the FTAR were smaller than those of the TAR (p < .01). Finite element models of the tested samples were also made, and validated by experimental strains. The validated FE models were then employed to find stress distribution on the tibial plateau and prosthesis compartments. FTAR demonstrated more regular stress profiles in bone-prosthesis interface. Also, maximum von Mises stress in the talar component of the FTAR is approximately half of that in the TAR (8 and 15 MPa, respectively). Based on the results of this study, having a more symmetric load distribution on the prosthesis after STJ fusion, longevity of the TAR may likely increase.
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Affiliation(s)
- Yousef Taghizadeh
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Ahmad Chitsazan
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
| | - Saeid Pezeshki
- Faculty of Medical Sciences, Islamic Azad University of Tehran, Tehran, Iran
| | - Hadi Taghizadeh
- Tissue Mechanics Laboratory, Biomedical Engineering Department, Sahand University of Technology, Tabriz, Iran
| | - Gholamreza Rouhi
- Faculty of Biomedical Engineering, Amirkabir University of Technology, Tehran, Iran
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18
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Kersting UG, Støttrup N, Larsen FG. The influence of shaft stiffness on joint kinematics and kinetics during hiking. J Biomech 2021; 126:110643. [PMID: 34358901 DOI: 10.1016/j.jbiomech.2021.110643] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 06/12/2021] [Accepted: 07/05/2021] [Indexed: 11/15/2022]
Abstract
Hiking boots provide an interface for walking in challenging environments, typically equipped with a shaft to provide ankle joint stability in rough terrains. Currently it is unclear if the ankle joint is stabilized to an extent that protects against ankle injuries, and if so, to what degree this added ankle stability sacrifices ankle mobility and hence decreases efficient gait propulsion. The aim of the present study was to compare the effect of shaft construction and stiffness on lower extremity kinematics and kinetics during level and step-down walking to simulate hiking conditions. Thirteen healthy males walked in one low-cut and three shafted commercially available hiking shoes with varying shaft stiffness. Lower extremity kinematics and ground reaction forces were recorded simultaneously. During level walking, ankle plantar-dorsiflexion range of motion was significantly reduced for the stiffest shaft hiking shoe compared to the low-cut shoe. A reduction in the muscle contribution to ankle joint work was found for all shafted shoes compared to the low-cut shoe. The reduced ankle joint work for the shafted shoes conversely increased eccentric knee joint work. Kinematic and kinetic differences between shoes diminished during box step-down walking. The present study shows that shaft height and stiffness can influence ankle joint range of motion, and ankle and knee joint work, with the high-shaft shoes redistributing load from the ankle to the knee joint. This may have implications for gait efficiency and increase the risk of knee joint loading or injuries.
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Affiliation(s)
- Uwe G Kersting
- Sport Sciences, Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark; Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Cologne, Germany.
| | - Nicolai Støttrup
- Sport Sciences, Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark
| | - Frederik G Larsen
- Sport Sciences, Department of Health, Science and Technology, Aalborg University, Aalborg, Denmark
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19
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Widhalm K, Durstberger S, Putz P. Effects of real-time feedback during decline walking on kinematic and kinetic gait parameters in a healthy population: study protocol for a randomized trial - up and down. Trials 2021; 22:477. [PMID: 34294137 PMCID: PMC8295626 DOI: 10.1186/s13063-021-05422-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 07/05/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The control of the dynamic functional leg alignment (dFLA) and biomechanical load are important joint-related aspects regarding the development of osteoarthritis (OA). Research on level walking with feedback on load-related parameters has provided innovative treatment possibilities. With regard to walking on sloped surfaces, fundamental biomechanical knowledge exists. However, comprehensive data on the agreement of kinematics and kinetics of self-paced ramp versus sloped treadmill walking is lacking. Further, deeper insights into the control of the dFLA during decline walking and the usefulness of real-time feedback are missing. METHODS/DESIGN Thirty healthy participants aged between 18 and 35 years will be included. They will complete a three-dimensional gait analysis walking self-paced up and down on a 5-m ramp with a 10° inclination. Subsequently, speed-matched to ramp-up walking and self-paced 10° incline split-belt treadmill walking will be assessed. Afterwards, the participants will be observed under four different conditions of 10° declined walking on the same treadmill (a) self-paced walking, (b) self-paced walking with an internal focus of attention, (c) self-paced walking with real-time feedback, and (d) condition c speed-matched walking. The primary outcome parameter will be the frontal knee range of motion (fKROM). Secondary outcomes include the ground reaction force loading rate, spatial-temporal parameters, as well as sagittal, frontal and transversal kinematics, and kinetics for the lower extremities. DISCUSSION The findings aim at improving the understanding of the effects of real-time feedback on the control of the dFLA and lower limb loading. Following clinical practicable methods for effective feedback devices can be developed and evaluated. Additionally, the first dataset comparing kinematic and kinetic parameters for decline and incline ramp walking versus walking on an instrumented treadmill will be available for appropriate intervention planning. TRIAL REGISTRATION ClinicalTrials.gov NCT04763850 . Prospectively registered on 21 February 2021.
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Affiliation(s)
- Klaus Widhalm
- FH Campus Wien, Health Sciences, Favoritenstrasse 226, 1100, Vienna, Austria.
| | | | - Peter Putz
- FH Campus Wien, Health Sciences, Favoritenstrasse 226, 1100, Vienna, Austria
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20
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Gaffney BM, Van Dillen LR, Foody JN, Burnet PE, Clohisy JC, Chen L, Harris MD. Multi-joint biomechanics during sloped walking in patients with developmental dysplasia of the hip. Clin Biomech (Bristol, Avon) 2021; 84:105335. [PMID: 33812201 PMCID: PMC8845490 DOI: 10.1016/j.clinbiomech.2021.105335] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 01/22/2021] [Accepted: 03/19/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND Developmental dysplasia of the hip is characterized by abnormal acetabular and femoral geometries that alter joint loading and increase the risk of hip osteoarthritis. Current understanding of biomechanics in this population remains isolated to the hip and largely focused on level-ground walking, which may not capture the variable loading conditions that contribute to symptoms and intra-articular damage. METHODS Thirty young adult females (15 with dysplasia) underwent gait analysis during level, 10° incline, and 10° decline walking while whole-body kinematics, ground reaction forces, and electromyography (EMG) were recorded. Low back, hip, and knee joint kinematics and internal joint moments were calculated using a 15-segment model and integrated EMG was calculated within the functional phases of gait. Dependent variables (peak joint kinematics, moments, and integrated EMG) were compared across groups with a one-way ANOVA with multiple comparisons controlled for using the Benjamini-Hochberg method (α = 0.05). FINDINGS During level and incline walking, patients with developmental dysplasia of the hip had significantly lower trunk flexion angles, lumbar and knee extensor moments, and erector spinae activity than controls. Patients with developmental dysplasia of the hip also demonstrated reduced rectus femoris activity during loading of level walking and increased gluteus maximus activity during mid-stance of decline walking. INTERPRETATION Patients with developmental dysplasia of the hip adopt compensations both proximal and distal to the hip, which vary depending on the slope of walking. Furthering the understanding of multi-joint biomechanical compensations is important for understanding the mechanism of osteoarthritis development as well as secondary conditions.
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Affiliation(s)
- Brecca M.M. Gaffney
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Linda R. Van Dillen
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO, USA,Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Jacqueline N. Foody
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - Paige E. Burnet
- Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA
| | - John C. Clohisy
- Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA
| | - Ling Chen
- Division of Biostatistics, Washington University in St. Louis, St. Louis, MO, USA
| | - Michael D. Harris
- Program in Physical Therapy, Washington University in St. Louis School of Medicine, St. Louis, MO, USA,Department of Orthopaedic Surgery, Washington University in St. Louis School of Medicine, St. Louis, MO, USA,Department of Biomedical Engineering, Washington University in St. Louis, St. Louis, MO, USA,Division of Biostatistics, Washington University in St. Louis, St. Louis, MO, USA,Department of Mechanical Engineering and Materials Science, Washington University in St. Louis, St. Louis, MO, USA,Corresponding author at: Program in Physical Therapy, Washington University School of Medicine, 4444 Forest Park Ave., Suite 1101, St. Louis, MO 63108, United States. (M.D. Harris)
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21
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Deng C, Gillette JC, Derrick TR. Measuring femoral neck loads in healthy young and older adults during stair ascent and descent. PLoS One 2021; 16:e0245658. [PMID: 33497416 PMCID: PMC7837459 DOI: 10.1371/journal.pone.0245658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 01/05/2021] [Indexed: 11/19/2022] Open
Abstract
Understanding the hip loading environment for daily activities is useful for hip fracture prevention, rehabilitation, and the design of osteogenic exercises. Seventeen older adults (50–70 yrs) and twenty young adults (18–30 yrs) were recruited. A rigid body model combined with a musculoskeletal model was used to estimate lower extremity loading. An elliptical cross-section model of the femoral neck was used to estimate femoral neck stress during stair ascent and descent. Two peaks were identified in the stress curves, corresponding to the peaks in the vertical ground reaction force. During stair ascent, significantly higher tension on the superior femoral neck was found for the young group at peak 1 (young: 13.5±6.1 MPa, older: 4.2±6.5 MPa, p<0.001). Also during stair ascent, significantly higher compression on the posterior femoral neck was found for the older group at peak 2 (young: -11.4±4.9 MPa, old: -18.1±8.6 MPa, p = 0.006). No significant difference was found for stair descent. Components of stress (muscle vs. reaction forces; axial forces vs. bending moments) were also examined for each trial of stair ascent and descent. The stresses and their components provided loading magnitude and locations of higher stress on the femoral neck during stair ascent and descent. Understanding femoral neck stresses may be used to help prevent hip fractures, reduce pain, improve rehabilitation, and design osteogenic exercises.
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Affiliation(s)
- Chen Deng
- Division of Sport Biomechanics, School of Sport Science, Beijing Sport University, Beijing, P.R China
- * E-mail:
| | - Jason C. Gillette
- Department of Kinesiology, Iowa State University, Ames, IA, United States of America
| | - Timothy R. Derrick
- Department of Kinesiology, Iowa State University, Ames, IA, United States of America
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22
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Strutzenberger G, Claußen L, Schwameder H. Analysis of sloped gait: How many steps are needed to reach steady-state walking speed after gait initiation? Gait Posture 2021; 83:167-173. [PMID: 33152612 DOI: 10.1016/j.gaitpost.2020.09.030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 09/06/2020] [Accepted: 09/29/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Gait initiation in level walking is suggested to take three steps before reaching steady-state walking speed. In sloped gait, it is not clear if the general recommendation of level gait can be used. RESEARCH QUESTION The aim of this study was to investigate (1) if steady-state walking speed is reached within four steps in sloped gait, and (2) to what extent the number of initial steps cause differences in step length, cadence and ground reaction force (GRF). METHODS Fourteen healthy participants walked on an instrumented ramp at inclinations of 0°, ±6°, ±12°, and ±18°, covering slight (clinical application) to steep (hiking and mountaineering) slopes. The starting position on the ramp was adjusted to collect each of the first to fourth step using a 12 infrared-camera motion capture system and two force plates. For each slope condition steady-state walking speed was determined using the ratio of the braking and propulsion impulse (ratio pap;pbrakingppropulsion) and the resultant Centre of Mass (CoM) speed (velCoM). Statistical differences between steps were calculated by using a Friedman ANOVA and pairwise post-hoc Wilcoxon tests. RESULTS In all inclinations, ≥90 % (uphill) and ≥95 % (downhill) of steady-state speed regarding ratio pap and maximum velCoM was reached with the 3rd step. In the level and uphill condition the 4th step showed a slight decrease in velCoM. In uphill and downhill condition, the acceleration was mainly generated due to the increase in cadence with significant increases between the 1st and 2nd step as well as between the 2nd and 3rd step. A significant increase in step length was only observed in the uphill conditions. SIGNIFICANCE Steady-state walking speed was reached with the 3rd step and thus, walkways which allow for two initial steps seem to be appropriate for uphill and downhill gait analysis for inclinations up to ±18°.
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Affiliation(s)
- Gerda Strutzenberger
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Schlossalee 49, 5400 Hallein-Rif, Salzburg, Austria; Bewegungsanalyse Zürich Cooperation of the Children's Hospital and University Hospital, Balgrist Forchstraße 340, Zürich, 8008, Switzerland.
| | - Lisa Claußen
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Schlossalee 49, 5400 Hallein-Rif, Salzburg, Austria; Institute of Sports and Sport Science, University of Kassel, Damaschkestraße 25, 34121 Kassel, Hesse, Germany.
| | - Hermann Schwameder
- Department of Sport and Exercise Science, Paris Lodron University of Salzburg, Schlossalee 49, 5400 Hallein-Rif, Salzburg, Austria.
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23
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Kawada M, Takeshita Y, Miyazaki T, Nakai Y, Hata K, Nakatsuji S, Kiyama R. Contribution of hip and knee muscles to lateral knee stability during gait. J Phys Ther Sci 2020; 32:729-734. [PMID: 33281288 PMCID: PMC7708004 DOI: 10.1589/jpts.32.729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 08/19/2020] [Indexed: 12/26/2022] Open
Abstract
[Purpose] Lateral knee instability is frequently observed in patients with knee injury
or risk factors associated with knee osteoarthritis. Physical exercises can strengthen
muscles that stabilize the knee joint. The purpose of this study was to define the
contribution of the knee and hip muscles to lateral knee stability by comparing the muscle
forces, as assessed by musculoskeletal simulation using one or two degrees-of-freedom
(1-DOF and 2-DOF) knee models. [Participants and Methods] We evaluated the normal gait of
15 healthy subjects. We conducted a three-dimensional gait analysis using a motion
analysis system and a force plate. We considered a muscle as a lateral knee stabilizer
when the calculated muscle force was greater with the 2-DOF model than with the 1-DOF
model. [Results] During early and late stance, the muscle forces of the lateral knee and
hip joint increased in the 2-DOF model as opposed to in the 1-DOF model. In contrast, the
forces of the medial knee muscles decreased. Furthermore, hip muscle forces increased
during the late stance. [Conclusion] Our results show that the lateral knee and hip
muscles contribute to lateral knee stability. Thus, exercises to strengthen these muscles
could improve lateral knee stability.
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Affiliation(s)
- Masayuki Kawada
- School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8544, Japan
| | | | - Takasuke Miyazaki
- School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8544, Japan
| | - Yuki Nakai
- School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8544, Japan
| | | | | | - Ryoji Kiyama
- School of Health Sciences, Faculty of Medicine, Kagoshima University: 8-35-1 Sakuragaoka, Kagoshima-shi, Kagoshima 890-8544, Japan
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24
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Breloff SP, Carey RE, Wade C, Waddell DE. Inclination angles during cross-slope roof walking. SAFETY SCIENCE 2020; 132:10.1016/j.ssci.2020.104963. [PMID: 34552309 PMCID: PMC8455154 DOI: 10.1016/j.ssci.2020.104963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Residential roofers have the highest rate of falls in the construction sector with injuries and fatalities costing billions of dollars annually. The sloped roof surface is the most predominant component within the residential roof work environment. Postural stability on a sloped work environment is not well studied. Calculating inclination angles (IAs) using the lateral ankle marker could be a quality measure to determine how cross-slope roof walking will influence stability. Will cross-slope roof-walking effect anterior-posterior (AP) and medial-lateral (ML) IAs in adult males? Eleven adult males participated in two testing sessions-level and cross-slope roof gait session on a 6/12 pitched roof segment. Changes in AP and ML IAs between conditions were compared at: heel strike (HS) and toe off (TO). Legs were analyzed separately due to the cross-slope walking. The left foot was 'higher' on the sloped roof and the right was 'lower.' Significant increases (p ≤ 0.006) in IAs were observed due to the sloped roof in all conditions except the AP 'lower' leg (p = 0.136). Increases in IA suggest a decrease in postural stability as the body will result in greater sway compared to a natural posture. Increases in AP IAs may cause slipping in the anterior or posterior direction as the normal force will decrease during HS and TO. In the ML direction, fall risk is increased and more stress is placed on the hip abductors in order to reduce falling. Thus traversing a sloped roof surface reduces stability of healthy workers and escalates injury/fall risk factors.
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Affiliation(s)
- Scott P. Breloff
- National Institute for Occupation Safety & Health, Centers for Disease Control and Prevention, Health Effects Laboratory Division, 1095 Willowdale Rd., Morgantown, WV 26505, United States
| | - Robert E. Carey
- National Institute for Occupation Safety & Health, Centers for Disease Control and Prevention, Health Effects Laboratory Division, 1095 Willowdale Rd., Morgantown, WV 26505, United States
| | - Chip Wade
- Department of Biomedical Engineering, University of Mississippi, University, MS 38677, United States
| | - Dwight E. Waddell
- Department of Biomedical Engineering, University of Mississippi, University, MS 38677, United States
- Department of Electrical Engineering, University of Mississippi, University, MS 38677, United States
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Hu X, Pickle NT, Grabowski AM, Silverman AK, Blemker SS. Muscle Eccentric Contractions Increase in Downhill and High-Grade Uphill Walking. Front Bioeng Biotechnol 2020; 8:573666. [PMID: 33178672 PMCID: PMC7591807 DOI: 10.3389/fbioe.2020.573666] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 09/21/2020] [Indexed: 01/26/2023] Open
Abstract
In Duchenne muscular dystrophy (DMD), one of the most severe and frequent genetic diseases in humans, dystrophic muscles are prone to damage caused by mechanical stresses during eccentric contractions. Eccentric contraction during walking on level ground likely contributes to the progression of degeneration in lower limb muscles. However, little is known about how the amount of muscle eccentric contractions is affected by uphill/downhill sloped walking, which is often encountered in patients’ daily lives and poses different biomechanical demands than level walking. By recreating the dynamic musculoskeletal simulations of downhill (−9°, −6°, and −3°), uphill (+3°, +6°, and +9°) and level walking (0°) from a published study of healthy participants, negative muscle mechanical work, as a measure of eccentric contraction, of 35 lower limb muscles was quantified and compared. Our results indicated that downhill walking overall induced more (32% at −9°, 19% at −6°, and 13% at −3°) eccentric contractions in lower limb muscles compared to level walking. In contrast, uphill walking led to eccentric contractions similar to level walking at low grades (+3° and +6°), but 17% more eccentric contraction at high grades (+9°). The changes of muscle eccentric contraction were largely predicted by the changes in both joint negative work and muscle coactivation in sloped walking. As muscle eccentric contractions play a critical role in the disease progression in DMD, this study provides an important baseline for future studies to safely improve rehabilitation strategies and exercise management for patients with DMD and other similar conditions.
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Affiliation(s)
- Xiao Hu
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States
| | - Nathaniel T Pickle
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, United States
| | - Alena M Grabowski
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, United States.,Department of Veterans Affairs, VA Eastern Colorado Healthcare System, Denver, CO, United States
| | - Anne K Silverman
- Department of Mechanical Engineering, Colorado School of Mines, Golden, CO, United States
| | - Silvia S Blemker
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, United States.,Department of Orthopedic Surgery, University of Virginia, Charlottesville, VA, United States.,Department of Mechanical and Aerospace Engineering, University of Virginia, Charlottesville, VA, United States
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Scherpereel KL, Bolus NB, Jeong HK, Inan OT, Young AJ. Estimating Knee Joint Load Using Acoustic Emissions During Ambulation. Ann Biomed Eng 2020; 49:1000-1011. [PMID: 33037511 DOI: 10.1007/s10439-020-02641-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 09/26/2020] [Indexed: 01/26/2023]
Abstract
Quantifying joint load in activities of daily life could lead to improvements in mobility for numerous people; however, current methods for assessing joint load are unsuitable for ubiquitous settings. The aim of this study is to demonstrate that joint acoustic emissions contain information to estimate this internal joint load in a potentially wearable implementation. Eleven healthy, able-bodied individuals performed ambulation tasks under varying speed, incline, and loading conditions while joint acoustic emissions and essential gait measures-electromyography, ground reaction forces, and motion capture trajectories-were collected. The gait measures were synthesized using a neuromuscular model to estimate internal joint contact force which was the target variable for subject-specific machine learning models (XGBoost) trained based on spectral, temporal, cepstral, and amplitude-based features of the joint acoustic emissions. The model using joint acoustic emissions significantly outperformed (p < 0.05) the best estimate without the sounds, the subject-specific average load (MAE = 0.31 ± 0.12 BW), for both seen (MAE = 0.08 ± 0.01 BW) and unseen (MAE = 0.21 ± 0.05 BW) conditions. This demonstrates that joint acoustic emissions contain information that correlates to internal joint contact force and that information is consistent such that unique cases can be estimated.
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Affiliation(s)
- Keaton L Scherpereel
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
| | - Nicholas B Bolus
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Hyeon Ki Jeong
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Omer T Inan
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
| | - Aaron J Young
- Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA
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Hawke AL, Jensen RL. Are Trekking Poles Helping or Hindering Your Hiking Experience? A Review. Wilderness Environ Med 2020; 31:482-488. [PMID: 32980249 DOI: 10.1016/j.wem.2020.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 05/21/2020] [Accepted: 06/16/2020] [Indexed: 11/28/2022]
Abstract
Hiking is a common recreational activity that provides numerous health benefits, such as reduced risk of heart disease, reduced blood pressure, and improved cardiorespiratory fitness. The use of specifically designed trekking poles has become popular among participants seeking to alleviate sore knees and increase balance and stability while walking. This review provides an overview of physiologic and biomechanical responses elicited when trekking poles are used during outdoor activities, such as hiking or Nordic walking, and discusses the clinical implications of the use of trekking poles. Google Scholar, PubMed, and ScienceDirect databases, as well as university library catalogues, were searched for literature published between 1980 and 2019. The keywords used to search the literature were hiking poles, trekking poles, and Nordic walking and their combination with physiological responses, ground reaction forces, joint forces, spatiotemporal parameters, kinematics, electromyography, and/or balance. The related topics included the academic disciplines of biomechanics, sports science, and wilderness medicine. Reference lists of located studies were also reviewed for additional sources. During free, unloaded walking, users should compare the cost and benefit of using poles: Trekking poles decrease lower extremity loading and forces but increase cardiovascular demand. When carrying a large external load, trekking poles may offer benefit by decreasing lower extremity muscle activity and increasing balance and stability.
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Affiliation(s)
- Ashley L Hawke
- School of Health and Human Performance, Northern Michigan University, Marquette, MI.
| | - Randall L Jensen
- School of Health and Human Performance, Northern Michigan University, Marquette, MI
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Effects of Backpack Loads on Leg Muscle Activation during Slope Walking. APPLIED SCIENCES-BASEL 2020. [DOI: 10.3390/app10144890] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Hikers and soldiers usually walk up and down slopes with a load carriage, causing injuries of the musculoskeletal system, especially during a prolonged load journey. The slope walking has been reported to lead to higher leg extensor muscle activities and joint moments. However, most of the studies investigated muscle activities or joint moments during slope walking without load carriage or only investigated the joint moment changes and muscle activities with load carriages during level walking. Whether the muscle activation such as the signal amplitude is influenced by the mixed factor of loads and grades and whether the influence of the degrees of loads and grades on different muscles are equal have not yet been investigated. To explore the effects of backpack loads on leg muscle activation during slope walking, ten young male participants walked at 1.11 m/s on a treadmill with different backpack loads (load masses: 0, 10, 20, and 30 kg) during slope walking (grade: 0, 3, 5, and 10°). Leg muscles, including the gluteus maximus (GM), rectus femoris (RF), hamstrings (HA), anterior tibialis (AT), and medial gastrocnemius (GA), were recorded during walking. The hip, knee, and ankle extensor muscle activations increased during the slope walking, and the hip muscles increased most among hip, knee, and ankle muscles (GM and HA increased by 46% to 207% and 110% to 226%, respectively, during walking steeper than 10° across all load masses (GM: p = 1.32 × 10−8 and HA: p = 2.33 × 10−16)). Muscle activation increased pronouncedly with loads, and the knee extensor muscles increased greater than the hip and ankle muscles (RF increased by 104% to 172% with a load mass greater than 30 kg across all grades (RF: p = 8.86 × 10−7)). The results in our study imply that the hip and knee muscles play an important role during slope walking with loads. The hip and knee extension movements during slope walking should be considerably assisted to lower the muscle activations, which will be useful for designing assistant devices, such as exoskeleton robots, to enhance hikers’ and soldiers’ walking abilities.
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Zhang L, Liu G, Han B, Wang Z, Yan Y, Ma J, Wei P. Knee Joint Biomechanics in Physiological Conditions and How Pathologies Can Affect It: A Systematic Review. Appl Bionics Biomech 2020; 2020:7451683. [PMID: 32322301 PMCID: PMC7160724 DOI: 10.1155/2020/7451683] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/01/2020] [Indexed: 01/17/2023] Open
Abstract
The knee joint, as the main lower limb motor joint, is the most vulnerable and susceptible joint. The knee injuries considerably impact the normal living ability and mental health of patients. Understanding the biomechanics of a normal and diseased knee joint is in urgent need for designing knee assistive devices and optimizing a rehabilitation exercise program. In this paper, we systematically searched electronic databases (from 2000 to November 2019) including ScienceDirect, Web of Science, PubMed, Google Scholar, and IEEE/IET Electronic Library for potentially relevant articles. After duplicates were removed and inclusion criteria applied to the titles, abstracts, and full text, 138 articles remained for review. The selected articles were divided into two groups to be analyzed. Firstly, the real movement of a normal knee joint and the normal knee biomechanics of four kinds of daily motions in the sagittal and coronal planes, which include normal walking, running, stair climbing, and sit-to-stand, were discussed and analyzed. Secondly, an overview of the current knowledge on the movement biomechanical effects of common knee musculoskeletal disorders and knee neurological disorders were provided. Finally, a discussion of the existing problems in the current studies and some recommendation for future research were presented. In general, this review reveals that there is no clear assessment about the biomechanics of normal and diseased knee joints at the current state of the art. The biomechanics properties could be significantly affected by knee musculoskeletal or neurological disorders. Deeper understanding of the biomechanics of the normal and diseased knee joint will still be an urgent need in the future.
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Affiliation(s)
- Li Zhang
- Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Geng Liu
- Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Bing Han
- Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Zhe Wang
- Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Yuzhou Yan
- Shaanxi Engineering Laboratory for Transmissions and Controls, Northwestern Polytechnical University, Xi'an 710072, China
| | - Jianbing Ma
- Hong-Hui hospital, Xi'an Jiaotong University College of Medicine, Xi'an 710054, China
| | - Pingping Wei
- State Key Laboratory for Manufacturing Systems Engineering, Xi'an Jiaotong University, Xi'an 710054, China
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Lee D, Kwak EC, McLain BJ, Kang I, Young AJ. Effects of Assistance During Early Stance Phase Using a Robotic Knee Orthosis on Energetics, Muscle Activity, and Joint Mechanics During Incline and Decline Walking. IEEE Trans Neural Syst Rehabil Eng 2020; 28:914-923. [PMID: 32054583 DOI: 10.1109/tnsre.2020.2972323] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The knee joint performs a significant amount of positive or negative mechanical work during gradient walking, and targeted assistance during periods of high mechanical work could yield strong human augmentation benefits. This paper explores the biomechanical effects of providing knee extension assistance during the early stance phase of the gait cycle using a powered unilateral knee exoskeleton during gradient walking on able-bodied subjects. Twelve subjects walked on 15% gradient incline and decline surfaces with the exoskeleton providing knee extension assistance during the early stance phase of the gait cycle. For both incline and decline walking, the exoskeleton assistance reduced the muscle activation of the knee extensors on the assisted leg ( ). However, only approximately half the individuals responded to exoskeleton assistance positively by reducing their metabolic cost of walking for both incline and decline tasks. The results indicate that, unlike the individuals who did respond, the individuals who did not respond to the assistance may have penalized their metabolic cost by their biomechanical compensatory behaviors from the unassisted leg.
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31
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Yang Z, Qu F, Liu H, Jiang L, Cui C, Rietdyk S. The relative contributions of sagittal, frontal, and transverse joint works to self-paced incline and decline slope walking. J Biomech 2019; 92:35-44. [PMID: 31153623 DOI: 10.1016/j.jbiomech.2019.05.027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 05/07/2019] [Accepted: 05/16/2019] [Indexed: 10/26/2022]
Abstract
Positive and negative work are generated at the lower limb joints in order to locomote over various terrains. Joint work quantifies the changes in energy that are necessary to adapt gait to environmental demands. The aim of this study was to quantify 3D joint work at the hip, knee, and ankle during slope walking. Work was calculated for ten males (23.9 ± 1.1 years) walking at a self-selected speed on inclines and declines (-20, -12, -6, 0, 6, 12, 20 degrees). Sagittal positive work significantly increased at the hip, knee, and ankle for incline walking (for example, hip positive work increased 153%, 280%, and 453% for 6, 12, and 20 degrees, respectively; knee and ankle positive work also increased) (p ≤ 0.05), in order to raise and propel the body forward. Sagittal negative work increased significantly at the hip, knee and ankle for decline walking (for example, knee negative work increased 193%, 355%, and 496% for -6, -12, and -20 degrees, respectively; hip and ankle negative work also increased) (p ≤ 0.05), in order to control body descent. These substantial changes in work will be especially challenging for people with compromised strength due to age and disease. Furthermore, changes in work were not limited to the sagittal plane: 46% of the total hip joint work occurred in the frontal and transverse planes for six degree decline walking. Thus, decline walking placed greater demands on the hip ab/adductors and rotators, and this may be related to the greater risk of falls observed for descent versus ascent.
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Affiliation(s)
- Zihan Yang
- Biomechanics Laboratory, Beijing Sport University, Beijing, China; Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Feng Qu
- Biomechanics Laboratory, Beijing Sport University, Beijing, China
| | - Hui Liu
- Biomechanics Laboratory, Beijing Sport University, Beijing, China
| | - Liang Jiang
- Li Ning (China) Sports Goods Co., Ltd, Li Ning Sports Science Research Center, Beijing, China
| | - Chuyi Cui
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States
| | - Shirley Rietdyk
- Department of Health and Kinesiology, Purdue University, West Lafayette, IN, United States.
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32
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Trinler U, Schwameder H, Baker R, Alexander N. Muscle force estimation in clinical gait analysis using AnyBody and OpenSim. J Biomech 2019; 86:55-63. [DOI: 10.1016/j.jbiomech.2019.01.045] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 01/22/2019] [Accepted: 01/22/2019] [Indexed: 11/17/2022]
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33
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Suzuki Y, Inoue T, Nomura T. A Simple Algorithm for Assimilating Marker-Based Motion Capture Data During Periodic Human Movement Into Models of Multi-Rigid-Body Systems. Front Bioeng Biotechnol 2018; 6:141. [PMID: 30406090 PMCID: PMC6201167 DOI: 10.3389/fbioe.2018.00141] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 09/17/2018] [Indexed: 11/24/2022] Open
Abstract
Human movement analysis is often performed with a model of multi-rigid-body system, whereby reflective-marker-based motion capture data are assimilated into the model for characterizing kinematics and kinetics of the movements quantitatively. Accuracy of such analysis is limited, due to motions of the markers on the skin relative to the underlying skeletal system, referred to as the soft tissue artifact (STA). Here we propose a simple algorithm for assimilating motion capture data during periodic human movements, such as bipedal walking, into models of multi-rigid-body systems in a way that the assimilated motions are not affected by STA. The proposed algorithm assumes that STA time-profiles during periodic movements are also periodic. We then express unknown STA profiles using Fourier series, and show that the Fourier coefficients can be determined optimally based solely on the periodicity assumption for the STA and kinematic constraints requiring that any two adjacent rigid-links are connected by a rotary joint, leading to the STA-free assimilated motion that is consistent with the multi-rigid-link model. To assess the efficiency of the algorithm, we performed a numerical experiment using a dynamic model of human gait composed of seven rigid links, on which we placed STA-affected markers, and showed that the algorithm can estimate the STA accurately and retrieve the non-STA-affected true motion of the model. We also confirmed that our STA-removal processing improves accuracy of the inverse dynamics analysis, suggesting the usability of the proposed algorithm for gait analysis.
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Affiliation(s)
- Yasuyuki Suzuki
- Division of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Takuya Inoue
- Division of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
| | - Taishin Nomura
- Division of Mechanical Science and Bioengineering, Graduate School of Engineering Science, Osaka University, Osaka, Japan
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34
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De Pieri E, Lund ME, Gopalakrishnan A, Rasmussen KP, Lunn DE, Ferguson SJ. Refining muscle geometry and wrapping in the TLEM 2 model for improved hip contact force prediction. PLoS One 2018; 13:e0204109. [PMID: 30222777 PMCID: PMC6141086 DOI: 10.1371/journal.pone.0204109] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 09/04/2018] [Indexed: 11/29/2022] Open
Abstract
Musculoskeletal models represent a powerful tool to gain knowledge on the internal forces acting at the joint level in a non-invasive way. However, these models can present some errors associated with the level of detail in their geometrical representation. For this reason, a thorough validation is necessary to prove the reliability of their predictions. This study documents the development of a generic musculoskeletal model and proposes a working logic and simulation techniques for identifying specific model features in need of refinement; as well as providing a quantitative validation for the prediction of hip contact forces (HCF). The model, implemented in the AnyBody Modeling System and based on the cadaveric dataset TLEM 2.0, was scaled to match the anthropometry of a patient fitted with an instrumented hip implant and to reproduce gait kinematics based on motion capture data. The relative contribution of individual muscle elements to the HCF and joint moments was analyzed to identify critical geometries, which were then compared to muscle magnetic resonance imaging (MRI) scans and, in case of inconsistencies, were modified to better match the volumetric scans. The predicted HCF showed good agreement with the overall trend and timing of the measured HCF from the instrumented prosthesis. The average root mean square error (RMSE), calculated for the total HCF was found to be 0.298*BW. Refining the geometries of the muscles thus identified reduced RMSE on HCF magnitudes by 17% (from 0.359*BW to 0.298*BW) over the whole gait cycle. The detailed study of individual muscle contributions to the HCF succeeded in identifying muscles with incorrect anatomy, which would have been difficult to intuitively identify otherwise. Despite a certain residual over-prediction of the final hip contact forces in the stance phase, a satisfactory level of geometrical accuracy of muscle paths has been achieved with the refinement of this model.
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Affiliation(s)
- Enrico De Pieri
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- * E-mail:
| | | | | | | | - David E. Lunn
- Leeds Teaching Hospitals National Health Service Trust, Leeds, United Kingdom
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35
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Mononen ME, Tanska P, Isaksson H, Korhonen RK. New algorithm for simulation of proteoglycan loss and collagen degeneration in the knee joint: Data from the osteoarthritis initiative. J Orthop Res 2018; 36:1673-1683. [PMID: 29150953 DOI: 10.1002/jor.23811] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 11/11/2017] [Indexed: 02/04/2023]
Abstract
Osteoarthritis is a harmful joint disease but prediction of disease progression is problematic. Currently, there is only one modeling framework which can be applied to predict the progression of knee osteoarthritis but it only considers degenerative changes in the collagen fibril network. Here, we have developed the framework further by considering all of the major tissue changes (proteoglycan content, fluid flow, and collagen fibril network) occurring in osteoarthritis. While excessive levels of tissue stresses controlled degeneration of the collagen fibril network, excessive levels of tissue strains controlled the decrease in proteoglycan content and the increase in permeability. We created four knee joint models with increasing degrees of complexity based on the depth-wise composition. Models were tested for normal and abnormal, physiologically relevant, loading conditions in the knee. Finally, the predicted depth-wise compositional changes from each model were compared against experimentally observed compositional changes in vitro. The model incorporating the typical depth-wise composition of cartilage produced the best match with experimental observations. Consistent with earlier in vitro experiments, this model simulated the greatest proteoglycan depletion in the superficial and middle zones, while the collagen fibril degeneration was located mostly in the superficial zone. The presented algorithm can be used for predicting simultaneous collagen degeneration and proteoglycan loss during the development of knee osteoarthritis. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:1673-1683, 2018.
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Affiliation(s)
- Mika E Mononen
- Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio, 70211, Finland
| | - Petri Tanska
- Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio, 70211, Finland
| | - Hanna Isaksson
- Department of Biomedical Engineering, Lund University, Lund, Sweden
| | - Rami K Korhonen
- Department of Applied Physics, University of Eastern Finland, POB 1627, Kuopio, 70211, Finland.,Diagnostic Imaging Centre, Kuopio University Hospital, Kuopio, Finland
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36
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Pickle NT, Grabowski AM, Jeffers JR, Silverman AK. The Functional Roles of Muscles, Passive Prostheses, and Powered Prostheses During Sloped Walking in People With a Transtibial Amputation. J Biomech Eng 2018; 139:2654845. [PMID: 28975280 DOI: 10.1115/1.4037938] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Indexed: 11/08/2022]
Abstract
Sloped walking is challenging for individuals with transtibial amputation (TTA) due to the functional loss of the ankle plantarflexors. Prostheses that actively generate ankle power may help to restore this lost function. The purpose of this study was to use musculoskeletal modeling and simulation to quantify the mechanical power delivered to body segments by passive and powered prostheses and the remaining muscles in the amputated and intact legs during sloped walking. We generated walking simulations from experimental kinematic and kinetic data on slopes of 0, ±3 deg and ±6 deg in eight people with a TTA using powered and passive prostheses and eight nonamputees. Consistent with our hypothesis, the amputated leg hamstrings generated more power to both legs on uphill slopes in comparison with nonamputees, which may have implications for fatigue or overuse injuries. The amputated leg knee extensors delivered less power to the trunk on downhill slopes (effect size (ES) ≥ 1.35, p ≤ 0.02), which may be due to muscle weakness or socket instability. The power delivered to the trunk from the powered and passive prostheses was not significantly different (p > 0.05), However, using the powered prosthesis on uphill slopes reduced the contributions from the amputated leg hamstrings in all segments (ES ≥ 0.46, p ≤ 0.003), suggesting that added ankle power reduces the need for the hamstrings to compensate for lost ankle muscle function. Neither prosthesis replaced gastrocnemius function to absorb power from the trunk and deliver it to the leg on all slopes.
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Affiliation(s)
- Nathaniel T Pickle
- Department of Mechanical Engineering, Colorado School of Mines, 1500 Illinois St, Golden, CO 80401 e-mail:
| | - Alena M Grabowski
- Department of Integrative Physiology, University of Colorado, 354 UCB, Boulder, CO 80309.,VA Eastern Colorado Healthcare System, Denver, CO 80220 e-mail:
| | - Jana R Jeffers
- Department of Integrative Physiology, University of Colorado, 354 UCB, Boulder, CO 80309 e-mail:
| | - Anne K Silverman
- Department of Mechanical Engineering, Colorado School of Mines, 1500 Illinois St, Golden, CO 80401 e-mail:
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Alexander N, Strutzenberger G, Ameshofer LM, Schwameder H. Lower limb joint work and joint work contribution during downhill and uphill walking at different inclinations. J Biomech 2017; 61:75-80. [DOI: 10.1016/j.jbiomech.2017.07.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Revised: 05/30/2017] [Accepted: 07/03/2017] [Indexed: 10/19/2022]
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Strutzenberger G, Alexander N, Bamboschek D, Claas E, Langhof H, Schwameder H. Uphill walking: Biomechanical demand on the lower extremities of obese adolescents. Gait Posture 2017; 54:20-26. [PMID: 28242569 DOI: 10.1016/j.gaitpost.2017.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 02/15/2017] [Accepted: 02/17/2017] [Indexed: 02/02/2023]
Abstract
The number of obesity prevalence in adolescents is still increasing. Obesity treatment programs typically include physical activity with walking being recommended as appropriate activity, but limited information exists on the demand uphill walking places on the joint loading and power of obese adolescents. Therefore, the purpose of this study was to investigate the effect of different inclinations on step characteristics, sagittal and frontal joint angles, joint moments and joint power of obese adolescents in comparison to their normal-weight peers. Eleven obese (14.5±1.41 years, BMI: 31.1±3.5kg/m2) and eleven normal-weight adolescents (14.3±1.86 years, BMI: 19.0±1.7kg/m2) walked with 1.11m/s on a ramp with two imbedded force plates (AMTI, 1000Hz) at three inclinations (level, 6°, 12°). Kinematic data were collected via an infrared-camera motion system (Vicon, 250Hz). The two-way (inclination, group) ANOVA indicated a significant effect of inclination on almost all variables analysed, with the hip joint being the most affected by inclination, followed by the knee and ankle joint. The obese participants additionally spent less time in swing phase, walked with an increased knee flexion and valgus angle and an increased peak hip flexion and adduction moment. Hip joint power of obese adolescents was especially in the steepest inclination significantly increased compared to their normal-weight peers. Obese adolescents demonstrate increased joint loading compared to their normal-weight peers and in combination with a musculoskeletal malalignment they might be prone to an increased overuse injury risk.
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Affiliation(s)
- Gerda Strutzenberger
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria.
| | - Nathalie Alexander
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Dominik Bamboschek
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria
| | - Elisabeth Claas
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria; IBO, German Sport University Cologne, Germany
| | | | - Hermann Schwameder
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria
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Alexander N, Schwameder H. Effect of sloped walking on lower limb muscle forces. Gait Posture 2016; 47:62-7. [PMID: 27264405 DOI: 10.1016/j.gaitpost.2016.03.022] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 03/17/2016] [Accepted: 03/23/2016] [Indexed: 02/02/2023]
Abstract
Lower limb joint loadings are increased during sloped walking compared to level walking and muscle forces are major contributors to lower limb joint forces. Therefore, the aim of this study was to analyze lower limb muscle forces during sloped walking at different inclinations. Eighteen healthy male participants (27.0±4.7y, 1.80±0.05m, 74.5±8.2kg) walked at a pre-set speed of 1.1m/s on a ramp at the inclinations of 0°, ±6°, ±12° and ±18°. Kinematic data were captured with a motion capture system and kinetic data were recorded with two force plates imbedded into the ramp. A musculoskeletal model was used to compute lower limb muscle forces (normalized to body weight and gait cycle duration). During downhill walking gluteus maximus, quadriceps, soleus, peroneus and tibialis anterior muscle forces increased (p≤0.002) compared to level walking, while gluteus minimus, piriformis, adductor, iliopsoas, hamstrings and gastrocnemii muscle forces decreased (p≤0.002). Uphill walking decreased gluteus minimus, iliopsoas and tibialis anterior muscle forces (p≤0.002), while all other muscle forces increased (p≤0.002, except gluteus medius). Joint-muscle-force waveforms provided information on possible muscle contributions to joint compression forces. The most important muscles were: gluteus medius for hip forces, quadriceps and gastrocnemii for tibiofemoral forces, quadriceps for patellofemoral forces and triceps surae for ankle forces. The contribution of each muscle changed with the inclination during sloped walking compared to level walking. The current study provided important information on muscle forces during sloped walking that can be useful for rehabilitation and training procedures.
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Affiliation(s)
- Nathalie Alexander
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria.
| | - Hermann Schwameder
- Department of Sport Science and Kinesiology, University of Salzburg, Salzburg, Austria.
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