1
|
McFarland DC, Brynildsen AG, Saul KR. Sensitivity of Neuromechanical Predictions to Choice of Glenohumeral Stability Modeling Approach. J Appl Biomech 2020; 36:249-258. [PMID: 32369767 DOI: 10.1123/jab.2019-0088] [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: 03/23/2019] [Revised: 02/05/2020] [Accepted: 03/12/2020] [Indexed: 11/18/2022]
Abstract
Most upper-extremity musculoskeletal models represent the glenohumeral joint with an inherently stable ball-and-socket, but the physiological joint requires active muscle coordination for stability. The authors evaluated sensitivity of common predicted outcomes (instability, net glenohumeral reaction force, and rotator cuff activations) to different implementations of active stabilizing mechanisms (constraining net joint reaction direction and incorporating normalized surface electromyography [EMG]). Both EMG and reaction force constraints successfully reduced joint instability. For flexion, incorporating any normalized surface EMG data reduced predicted instability by 54.8%, whereas incorporating any force constraint reduced predicted instability by 43.1%. Other outcomes were sensitive to EMG constraints, but not to force constraints. For flexion, incorporating normalized surface EMG data increased predicted magnitudes of joint reaction force and rotator cuff activations by 28.7% and 88.4%, respectively. Force constraints had no influence on these predicted outcomes for all tasks evaluated. More restrictive EMG constraints also tended to overconstrain the model, making it challenging to accurately track input kinematics. Therefore, force constraints may be a more robust choice when representing stability.
Collapse
|
2
|
Nichols CW, Brismée JM, Hooper TL, Bertrand-Grenier A, Gilbert KK, St-Pierre MO, Kapila J, Sobczak S. Glenohumeral joint capsular tissue tension loading correlates moderately with shear wave elastography: a cadaveric investigation. Ultrasonography 2019; 39:114-120. [PMID: 31786904 PMCID: PMC7065991 DOI: 10.14366/usg.19032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Accepted: 08/01/2019] [Indexed: 12/23/2022] Open
Abstract
Purpose The purpose of this study was to investigate changes in the mechanical properties of capsular tissue using shear wave elastography (SWE) and a durometer under various tensile loads, and to explore the reliability and correlation of SWE and durometer measurements to evaluate whether SWE technology could be used to assess tissue changes during capsule tensile loading. Methods The inferior glenohumeral joint capsule was harvested from 10 fresh human cadaveric specimens. Tensile loading was applied to the capsular tissue using 1-, 3-, 5-, and 8-kg weights. Blinded investigators measured tissue stiffness and hardness during loading using SWE and a durometer, respectively. Intraobserver reliability was established for SWE and durometer measurements using intraclass correlation coefficients (ICCs). The Pearson product-moment correlation was used to assess the associations between SWE and durometer measurements. Results The ICC3,5 for durometer measurements was 0.90 (95% confidence interval [CI], 0.79 to 0.96; P<0.001) and 0.95 (95% CI, 0.88 to 0.98; P<0.001) for SWE measurements. The Pearson correlation coefficient values for 1-, 3-, and 5-kg weights were 0.56 (P=0.095), 0.36 (P=0.313), and -0.56 (P=0.089), respectively. When the 1- and 3-kg weights were combined, the ICC3,5 was 0.72 (P<0.001), and it was 0.62 (P<0.001) when the 1-, 3-, and 5-kg weights were combined. The 8-kg measurements were severely limited due to SWE measurement saturation of the tissue samples. Conclusion This study suggests that SWE is reliable for measuring capsular tissue stiffness changes in vitro at lower loads (1 and 3 kg) and provides a baseline for the non-invasive evaluation of effects of joint loading and mobilization on capsular tissues in vivo.
Collapse
Affiliation(s)
- Charles W Nichols
- Department of Physical Therapy, School of Health Professions, University of North Texas Health Science Center, Ft. Worth, TX, USA
| | - Jean-Michel Brismée
- Department of Rehabilitation Sciences, Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Troy L Hooper
- Department of Rehabilitation Sciences, Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Antony Bertrand-Grenier
- Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec (CIUSSS MCQ), TroisRivières, Québec, Canada.,Centre Hospitalier Affilié Universitaire Régional, Centre Intégré Universitaire de Santé et de Services Sociaux de la Mauricie-et-du-Centre-du-Québec (CIUSSS MCQ), Trois-Rivières, Québec, Canada.,Département de Chimie, Biochimie et Physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Kerry K Gilbert
- Department of Rehabilitation Sciences, Center for Rehabilitation Research, Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Marc-Olivier St-Pierre
- Département d'Anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Jeegisha Kapila
- Texas Tech University Health Sciences Center, Lubbock, TX, USA
| | - Stéphane Sobczak
- Département d'Anatomie, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada.,Unité de Recherche en Anatomie Clinique et Fonctionnelle (URACEF), Trois-Rivires, Québec, Canada
| |
Collapse
|
3
|
Parameterization of proximal humerus locking plate impingement with in vitro, in silico, and in vivo techniques. J Shoulder Elbow Surg 2019; 28:1183-1192. [PMID: 30770316 DOI: 10.1016/j.jse.2018.11.062] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 11/16/2018] [Accepted: 11/19/2018] [Indexed: 02/01/2023]
Abstract
BACKGROUND Locked plating of displaced proximal humeral fractures is common, but rates of subacromial impingement remain high. This study used a multidisciplinary approach to elucidate the relationships between common surgical parameters, anatomic variability, and the likelihood of plate impingement. METHODS The experiment was completed in 3 phases. First, a controlled in vitro experiment was conducted to simulate impingement. Second, a dynamic in silico musculoskeletal model modeled changes to implant geometry, surgical techniques, and acromial anatomy, where a collision detection algorithm was used to simulate impingement. Finally, in vivo shoulder kinematics were recorded for 9 activities of daily living. Motions that created a high likelihood of impingement were identified. RESULTS Of simulated impingement events, 73.9% occurred when the plate was moved proximally, and 84% occurred when acromial tilt was 20° or 25°. Simulations of impingement occurred at cross-body adduction angles between 10° and 50°. Impingement occurred at an average of 162.0° ± 14.8° abduction with 10 mm distal plate placement, whereas the average was 72.1° ± 11.4° with 10 mm proximal placement. A patient may encounter these shoulder angles when performing activities such as combing one's hair, lifting an object overhead, and reaching behind one's head. DISCUSSION AND CONCLUSION Proximal implant placement and decreases in acromial tilt play major roles in the likelihood of impingement, whereas plate thickness and humeral head center of rotation should also be considered. Careful preoperative planning that includes these factors could help guide operative decision making and improve clinical outcomes.
Collapse
|
4
|
McFarland DC, McCain EM, Poppo MN, Saul K. Spatial Dependency of Glenohumeral Joint Stability during Dynamic Unimanual and Bimanual Pushing and Pulling. J Biomech Eng 2019; 141:2727818. [PMID: 30835272 DOI: 10.1115/1.4043035] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Indexed: 11/08/2022]
Abstract
Degenerative wear to the glenoid from repetitive loading can reduce effective concavity depth and lead to future instability. Workspace design should consider glenohumeral stability to prevent initial wear. While stability has been previously explored for activities of daily living including push-pull tasks, whether stability is spatially dependent is unexplored. We simulated bimanual and unimanual push-pull tasks to 4 horizontal targets (planes of elevation: 0º, 45º, 90º, and 135º) at 90º thoracohumeral elevation and 3 elevation targets (thoracohumeral elevations: 20º, 90º, 170º) at 90º plane of elevation. The 45º horizontal target was most stable regardless of exertion type and would be the ideal target placement when considering stability. This target is likely more stable because the applied load acts perpendicular to the glenoid, limiting shear force production. The 135º horizontal target was particularly unstable for unimanual pushing (143% less stable than the 45º target), and the applied force acts parallel to the glenoid, likely creating shear forces. Pushing was less stable than pulling (all targets except sagittal 170º for both task types and horizontal 45º for bimanual) (p<0.01), which is consistent with prior reports. For example, unimanual pushing at the 90º horizontal target was 197% less stable than unimanual pulling. There were limited stability benefits to task placement for pushing, and larger stability benefits may be seen from converting pushing to pulling rather than optimizing task layout. There was no difference in stability between bimanual and unimanual tasks, suggesting no stability benefit to bimanual operation.
Collapse
Affiliation(s)
| | - Emily M McCain
- North Carolina State University, 911 Oval Drive, Raleigh, NC 27606
| | - Michael N Poppo
- North Carolina State University, 911 Oval Drive, Raleigh, NC 27606
| | - Kate Saul
- North Carolina State University, 911 Oval Drive, Raleigh, NC 27606
| |
Collapse
|
5
|
Crabolu M, Pani D, Raffo L, Conti M, Cereatti A. Functional estimation of bony segment lengths using magneto-inertial sensing: Application to the humerus. PLoS One 2018; 13:e0203861. [PMID: 30208109 PMCID: PMC6135500 DOI: 10.1371/journal.pone.0203861] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 08/27/2018] [Indexed: 11/21/2022] Open
Abstract
Inertial sensor technology has assumed an increasingly important role in the field of human motion analysis. However, the reliability of the kinematic estimates could still be critical for specific applications in the field of functional evaluation and motor rehabilitation. Within this context, the definition of subject-specific multi-body kinematic models is crucial since it affects the accuracy and repeatability of movement reconstruction. A key step for kinematic model calibration is the determination of bony segment lengths. This study proposes a functional approach for the in vivo estimation of the humerus length using a single magneto-inertial measurement unit (MIMU) positioned on the right distal posterior forearm. The humerus length was estimated as the distance between the shoulder elevation axis and the elbow flexion-extension axis. The calibration exercise involved five shoulder elevations in the sagittal plane with the elbow completely extended and five elbow flexion-extensions with the upper arm rigidly aligned to the trunk. Validation of the method was conducted on five healthy subjects using the humerus length computed from magnetic resonance imaging as the gold standard. The method showed mean absolute errors of 12 ± 9 mm, which were in the estimate of the humerus length. When using magneto-inertial technology, the proposed functional method represents a promising alternative to the regressive methods or manual measurements for performing kinematic model calibrations. Although the proposed methodology was validated for the estimation of the humerus length, the same approach can be potentially extended to other body segments.
Collapse
Affiliation(s)
- Michele Crabolu
- Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy
| | - Danilo Pani
- Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy
| | - Luigi Raffo
- Department of Electrical and Electronic Engineering, University of Cagliari, Cagliari, Italy
| | - Maurizio Conti
- Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy
| | - Andrea Cereatti
- Department POLCOMING, University of Sassari, Sassari, Italy
- Interuniversity Centre of Bioengineering of the Human Neuromusculoskeletal System, Sassari, Italy
- Department of Electronics and Telecommunications, Politecnico di Torino, Torino, Italy
| |
Collapse
|
6
|
Borotikar B, Lempereur M, Lelievre M, Burdin V, Ben Salem D, Brochard S. Dynamic MRI to quantify musculoskeletal motion: A systematic review of concurrent validity and reliability, and perspectives for evaluation of musculoskeletal disorders. PLoS One 2017; 12:e0189587. [PMID: 29232401 PMCID: PMC5726646 DOI: 10.1371/journal.pone.0189587] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Accepted: 11/29/2017] [Indexed: 11/30/2022] Open
Abstract
Purpose To report evidence for the concurrent validity and reliability of dynamic MRI techniques to evaluate in vivo joint and muscle mechanics, and to propose recommendations for their use in the assessment of normal and impaired musculoskeletal function. Materials and methods The search was conducted on articles published in Web of science, PubMed, Scopus, Academic search Premier, and Cochrane Library between 1990 and August 2017. Studies that reported the concurrent validity and/or reliability of dynamic MRI techniques for in vivo evaluation of joint or muscle mechanics were included after assessment by two independent reviewers. Selected articles were assessed using an adapted quality assessment tool and a data extraction process. Results for concurrent validity and reliability were categorized as poor, moderate, or excellent. Results Twenty articles fulfilled the inclusion criteria with a mean quality assessment score of 66% (±10.4%). Concurrent validity and/or reliability of eight dynamic MRI techniques were reported, with the knee being the most evaluated joint (seven studies). Moderate to excellent concurrent validity and reliability were reported for seven out of eight dynamic MRI techniques. Cine phase contrast and real-time MRI appeared to be the most valid and reliable techniques to evaluate joint motion, and spin tag for muscle motion. Conclusion Dynamic MRI techniques are promising for the in vivo evaluation of musculoskeletal mechanics; however results should be evaluated with caution since validity and reliability have not been determined for all joints and muscles, nor for many pathological conditions.
Collapse
Affiliation(s)
- Bhushan Borotikar
- Laboratoire de Traitement de l’Information Médicale, INSERM U1101, Brest, France
- IMT Atlantique, Brest, France
- * E-mail:
| | - Mathieu Lempereur
- Laboratoire de Traitement de l’Information Médicale, INSERM U1101, Brest, France
- CHRU de Brest, Hôpital Morvan, Service de Médecine Physique et de Réadaptation, Brest, France
| | | | - Valérie Burdin
- Laboratoire de Traitement de l’Information Médicale, INSERM U1101, Brest, France
- IMT Atlantique, Brest, France
| | - Douraied Ben Salem
- Laboratoire de Traitement de l’Information Médicale, INSERM U1101, Brest, France
- Université de Bretagne Occidentale, Brest, France
- CHRU de Brest, Neuroradiologie, Imagerie Médico-Légale, Brest, France
| | - Sylvain Brochard
- Laboratoire de Traitement de l’Information Médicale, INSERM U1101, Brest, France
- CHRU de Brest, Hôpital Morvan, Service de Médecine Physique et de Réadaptation, Brest, France
- Université de Bretagne Occidentale, Brest, France
| |
Collapse
|
7
|
Rathi S, Taylor NF, Green RA. The effect of in vivo rotator cuff muscle contraction on glenohumeral joint translation: An ultrasonographic and electromyographic study. J Biomech 2016; 49:3840-3847. [DOI: 10.1016/j.jbiomech.2016.10.014] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2016] [Revised: 10/10/2016] [Accepted: 10/11/2016] [Indexed: 12/22/2022]
|
8
|
Moor BK, Kuster R, Osterhoff G, Baumgartner D, Werner CML, Zumstein MA, Bouaicha S. Inclination-dependent changes of the critical shoulder angle significantly influence superior glenohumeral joint stability. Clin Biomech (Bristol, Avon) 2016; 32:268-73. [PMID: 26577866 DOI: 10.1016/j.clinbiomech.2015.10.013] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Revised: 10/29/2015] [Accepted: 10/29/2015] [Indexed: 02/07/2023]
Abstract
BACKGROUND The critical shoulder angle combines the acromion index and glenoid inclination and has potential to discriminate between shoulders at risk for rotator cuff tear or osteoarthritis and those that are asymptomatic. However, its biomechanics, and particularly the role of the glenoid inclination, are not yet fully understood. METHODS A shoulder simulator was used to analyze the independent influence of glenoid inclination during abduction from 0 to 60°. Spindle motors transferred tension forces by a cable-pulley on human cadaveric humeri. A six-degree-of-freedom force transducer was mounted directly behind the polyethylene glenoid to measure shear and compressive joint reaction force and calculate the instability ratio (ratio of shear and compressive joint reaction force) with the different force ratios of the deltoid and supraspinatus muscles (2:1 and 1:1). A stepwise change in the inclination by 5° increments allowed simulation of a critical shoulder angle range of 20° to 45°. FINDINGS Tilting the glenoid to cranial (increasing the critical shoulder angle) increases the shear joint reaction force and therefore the instability ratio. A balanced force ratio (1:1) between the deltoid and the supraspinatus allowed larger critical shoulder angles before cranial subluxation occurred than did the deltoid-dominant ratio (2:1). INTERPRETATION Glenoid inclination-dependent changes of the critical shoulder angle have a significant impact on superior glenohumeral joint stability. The increased compensatory activity of the rotator cuff to keep the humeral head centered may lead to mechanical overload and could explain the clinically observed association between large angles and degenerative rotator cuff tears.
Collapse
Affiliation(s)
- B K Moor
- Department of Orthopaedic Surgery and Traumatology, University of Berne, Insel Hospital, Switzerland.
| | - R Kuster
- School of Engineering, Institute of Mechanical Systems, ZHAW Zurich University of Applied Sciences, Switzerland
| | - G Osterhoff
- Division of Trauma Surgery, Zurich University Hospital, Zurich, Switzerland
| | - D Baumgartner
- School of Engineering, Institute of Mechanical Systems, ZHAW Zurich University of Applied Sciences, Switzerland
| | - C M L Werner
- Division of Trauma Surgery, Zurich University Hospital, Zurich, Switzerland
| | - M A Zumstein
- Department of Orthopaedic Surgery and Traumatology, University of Berne, Insel Hospital, Switzerland
| | - S Bouaicha
- Division of Trauma Surgery, Zurich University Hospital, Zurich, Switzerland
| |
Collapse
|