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Remus R, Sure C, Selkmann S, Uttich E, Bender B. Soft tissue material properties based on human abdominal in vivo macro-indenter measurements. Front Bioeng Biotechnol 2024; 12:1384062. [PMID: 38854855 PMCID: PMC11157078 DOI: 10.3389/fbioe.2024.1384062] [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: 02/08/2024] [Accepted: 04/22/2024] [Indexed: 06/11/2024] Open
Abstract
Simulations of human-technology interaction in the context of product development require comprehensive knowledge of biomechanical in vivo behavior. To obtain this knowledge for the abdomen, we measured the continuous mechanical responses of the abdominal soft tissue of ten healthy participants in different lying positions anteriorly, laterally, and posteriorly under local compression depths of up to 30 mm. An experimental setup consisting of a mechatronic indenter with hemispherical tip and two time-of-flight (ToF) sensors for optical 3D displacement measurement of the surface was developed for this purpose. To account for the impact of muscle tone, experiments were conducted with both controlled activation and relaxation of the trunk muscles. Surface electromyography (sEMG) was used to monitor muscle activation levels. The obtained data sets comprise the continuous force-displacement data of six abdominal measurement regions, each synchronized with the local surface displacements resulting from the macro-indentation, and the bipolar sEMG signals at three key trunk muscles. We used inverse finite element analysis (FEA), to derive sets of nonlinear material parameters that numerically approximate the experimentally determined soft tissue behaviors. The physiological standard values obtained for all participants after data processing served as reference data. The mean stiffness of the abdomen was significantly different when the trunk muscles were activated or relaxed. No significant differences were found between the anterior-lateral measurement regions, with exception of those centered on the linea alba and centered on the muscle belly of the rectus abdominis below the intertubercular plane. The shapes and areas of deformation of the skin depended on the region and muscle activity. Using the hyperelastic Ogden model, we identified unique material parameter sets for all regions. Our findings confirmed that, in addition to the indenter force-displacement data, knowledge about tissue deformation is necessary to reliably determine unique material parameter sets using inverse FEA. The presented results can be used for finite element (FE) models of the abdomen, for example, in the context of orthopedic or biomedical product developments.
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Affiliation(s)
- Robin Remus
- Chair of Product Development, Department of Mechanical Engineering, Ruhr-University Bochum, Bochum, Germany
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Vergari C, Persohn S, Rohan PY. The effect of breathing on the in vivo mechanical characterization of linea alba by ultrasound shearwave elastography. Comput Biol Med 2023; 167:107637. [PMID: 37897961 DOI: 10.1016/j.compbiomed.2023.107637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/09/2023] [Accepted: 10/24/2023] [Indexed: 10/30/2023]
Abstract
The most common surgical repair of abdominal wall hernia consists in implanting a mesh to reinforce hernia defects during the healing phase. Ultrasound shearwave elastography (SWE) is a promising non-invasive method to estimate soft tissue mechanical properties at bedside through shear wave speed (SWS) measurement. Combined with conventional ultrasonography, it could help the clinician plan surgery. In this work, a novel protocol is proposed to reliably assess the stiffness of the linea alba, and to evaluate the effect of breathing and of inflating the abdomen on SWS. Fifteen healthy adults were included. SWS was measured in the linea alba, in the longitudinal and transverse direction, during several breathing cycle and during active abdominal inflation. SWS during normal breathing was 2.3 [2.0; 2.5] m/s in longitudinal direction and 2.2 [1.9; 2.7] m/s in the transversal. Inflating the abdomen increased SWS both in longitudinal and transversal direction (3.5 [2.8; 5.8] m/s and 5.2 [3.0; 6.0] m/s, respectively). The novel protocol significantly improved the reproducibility relative to the literature (8% in the longitudinal direction and 14% in the transverse one). Breathing had a mild effect on SWS, and accounting for it only marginally improved the reproducibility. This study proved the feasibility of the method, and its potential clinical interest. Further studies on larger cohort should focus on improving our understanding of the relationship between abdominal wall properties and clinical outcomes, but also provide a cartography of the abdominal wall, beyond the linea alba.
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Affiliation(s)
- Claudio Vergari
- Arts et Métiers Institute of Technology, Institut de Biomécanique Humaine Georges Charpak, Université Sorbonne Paris Nord, Paris, France.
| | - Sylvain Persohn
- Arts et Métiers Institute of Technology, Institut de Biomécanique Humaine Georges Charpak, Université Sorbonne Paris Nord, Paris, France
| | - Pierre-Yves Rohan
- Arts et Métiers Institute of Technology, Institut de Biomécanique Humaine Georges Charpak, Université Sorbonne Paris Nord, Paris, France
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Bernier E, Driscoll M. Numerical investigation of intra-abdominal pressure and spinal load-sharing upon the application of an abdominal belt. J Biomech 2023; 161:111863. [PMID: 37977959 DOI: 10.1016/j.jbiomech.2023.111863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 10/04/2023] [Accepted: 11/03/2023] [Indexed: 11/19/2023]
Abstract
Chronic low back pain patients may experience spinal instability. Abdominal belts (ABs) have been shown to improve spine stability, trunk stiffness, and resiliency to spinal perturbations. However, research on the contributing mechanisms is inconclusive. ABs may increase intra-abdominal pressure (IAP) and reduce paraspinal soft tissue contribution to spine stability without increasing spinal compressive loads. A finite element model (FEM) of the spine inclusive of the T1-S1 vertebrae, intervertebral discs (IVDs), ribcage, pelvis, soft tissues, and abdominal cavity, without active muscle forces was developed. An identical FEM with an AB was developed. Both FEMs underwent trunk flexion. Following validation, the models' intervertebral rotation (IVR), IAP, IVD pressure, and tensile stress in the multifidus (MF), erector spinae (ES), and thoracolumbar fascia (TLF) were compared. The inclusion of an AB resulted in a 3.8 kPa IAP increase, but a decreased average soft tissue tensile stress of 0.28 kPa. The TLF withstood the majority of tension being transferred across the paraspinal soft tissues (>70 %). The average IVR in the AB model decreased by 10 %, with the lumbar spine experiencing the largest reduction. The lumbar IVDs of the AB model likewise showed a 31 % reduction in average IVD pressure. Using an AB improved trunk bending stiffness, primarily in the lumbar spine. Wearing an AB had minimal effect on reducing tensile stress in theES. The skewed stress distribution towards the TLF suggests its large contribution to spine stability and the potential advantage in unloading the structure when wearing an AB, measured herein at8 %.
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Affiliation(s)
- Emeric Bernier
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, 845 Sherbrooke St. W, Montréal, H3A 0G4, Québec, Canada; Orthopaedic Research Lab, Research Institute MUHC, Montreal General Hospital, McGill University, Montréal, H3G 1A4, Québec, Canada
| | - Mark Driscoll
- Musculoskeletal Biomechanics Research Lab, Department of Mechanical Engineering, McGill University, 845 Sherbrooke St. W, Montréal, H3A 0G4, Québec, Canada; Orthopaedic Research Lab, Research Institute MUHC, Montreal General Hospital, McGill University, Montréal, H3G 1A4, Québec, Canada.
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Szepietowska K, Troka M, Lichodziejewska-Niemierko M, Chmielewski M, Lubowiecka I. Full-field in vivo experimental study of the strains of a breathing human abdominal wall with intra-abdominal pressure variation. J Mech Behav Biomed Mater 2023; 147:106148. [PMID: 37797556 DOI: 10.1016/j.jmbbm.2023.106148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 09/13/2023] [Accepted: 09/23/2023] [Indexed: 10/07/2023]
Abstract
The presented study aims to assess the mechanical behaviour of the anterior abdominal wall based on an in vivo experiment on humans. Full-field measurement of abdominal wall displacement during changes of intra-abdominal pressure is performed using a digital image correlation (DIC) system. Continuous measurement in time enables the observation of changes in the strain field during breathing. The understanding of the mechanical behaviour of a living human abdominal wall is important for the proper design of surgical meshes used for ventral hernia repair, which was also a motivation for the research presented below. The research refers to the strain field of a loaded abdominal wall and presents the evolution of principal strains and their directions in the case of 12 subjects, 8 male and 4 female. Peritoneal dialysis procedure allows for the measurement of intra-abdominal pressure after fluid introduction. High variability among patients is observed, also in terms of principal strain direction. Subjects exhibit intra-abdominal pressure of values from 11 to 21 cmH2O. However, the strain values are not strongly correlated with the pressure value, indicating variability of material properties.
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Affiliation(s)
- Katarzyna Szepietowska
- Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland
| | - Mateusz Troka
- Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland
| | | | - Michał Chmielewski
- Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland
| | - Izabela Lubowiecka
- Faculty of Civil and Environmental Engineering, Gdańsk University of Technology, Gdańsk, Poland.
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Karkhaneh Yousefi AA, Pierrat B, Le Ruyet A, Avril S. Patient-specific computational simulations of wound healing following midline laparotomy closure. Biomech Model Mechanobiol 2023; 22:1589-1605. [PMID: 37024600 DOI: 10.1007/s10237-023-01708-3] [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: 11/20/2022] [Accepted: 03/01/2023] [Indexed: 04/08/2023]
Abstract
In the current study, we developed a new computational methodology to simulate wound healing in soft tissues. We assumed that the injured tissue recovers partially its mechanical strength and stiffness by gradually increasing the volume fraction of collagen fibers. Following the principles of the constrained mixture theory, we assumed that new collagen fibers are deposited at homeostatic tension while the already existing tissue undergoes a permanent deformation due to the effects of remodeling. The model was implemented in the finite-element software Abaqus® through a VUMAT subroutine and applied to a complex and realistic case: simulating wound healing following midline laparotomy closure. The incidence of incisional hernia is still quite significant clinically, and our goal was to investigate different conditions hampering the success of these procedures. We simulated wound healing over periods of 6 months on a patient-specific geometry. One of the outcomes of the finite-element simulations was the width of the wound tissue, which was found to be clinically correlated with the development of incisional hernia after midline laparotomy closure. We studied the impact of different suturing modalities and the effects of situations inducing increased intra-abdominal pressure or its intermittent variations such as coughing. Eventually, the results showed that the main risks of developing an incisional hernia mostly depend on the elastic strains reached in the wound tissue after degradation of the suturing wires. Despite the need for clinical validation, these results are promising for establishing a digital twin of wound healing in midline laparotomy incision.
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Affiliation(s)
| | - Baptiste Pierrat
- Mines Saint-Étienne, Université Jean Monnet, INSERM, U1059 SAINBIOSE, 42023, Saint-Étienne, France
| | | | - Stéphane Avril
- Mines Saint-Étienne, Université Jean Monnet, INSERM, U1059 SAINBIOSE, 42023, Saint-Étienne, France.
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Soucasse A, Jourdan A, Edin L, Gillion JF, Masson C, Bege T. A better understanding of daily life abdominal wall mechanical solicitation: Investigation of intra-abdominal pressure variations by intragastric wireless sensor in humans. Med Eng Phys 2022; 104:103813. [DOI: 10.1016/j.medengphy.2022.103813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 02/01/2022] [Accepted: 04/25/2022] [Indexed: 10/18/2022]
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Wang B, He K, Zhu Y, Fu X, Yao Q, Chen H, Wang X. Quantitative Analysis of Abdominal Muscles Using Elastography in Female Patients With Incisional Hernia. Front Surg 2022; 9:831184. [PMID: 35495759 PMCID: PMC9039235 DOI: 10.3389/fsurg.2022.831184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to assess the thickness and shear wave speed (SWS) of the anterolateral abdominal wall muscles in female patients with incisional hernias of different widths, in order to analyze the biomechanical properties of abdominal wall muscles. This study included 53 patients with incisional hernia (Group A [hernia width <4 cm]: 21 patients, Group B [hernia width ≥4 cm]: 32 patients). The muscle thickness and SWS values of the external oblique (EO), internal oblique (IO), and transversus abdominis (TrA), and the hernia width were measured using Siemens Acuson S2000 ultrasound systems. Four detection points were labeled on the anterolateral abdominal wall: points 1, 2, 3, and 4, corresponding to the upper right, upper left, lower right, and lower left, respectively. The muscle thickness of the IO at point 3 was significantly different between both groups (p = 0.024). Group B had significantly higher SWS values than Group A, especially for the EO (points 1, 2, and 3), IO (points 1 and 2), and TrA (points 2 and 4) (p < 0.05). Pearson correlation analysis shows no significant correlation between muscle thickness and the SWS values of EO, IO, and TrA (all p > 0.05). Linear correlation analysis showed a significantly positive correlation between hernia width and the mean SWS value of EO, IO, and TrA (p = 0.004, 0.005, and 0.043, respectively). Muscle thickness was not reliable measure to directly reflect the biomechanical changes of the abdominal wall muscles in patients with incisional hernia. Comparatively, SWE can accurately measure the stiffness of the abdominal wall muscles and intuitively evaluate its biomechanical properties.
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Affiliation(s)
- Bo Wang
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Kai He
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yulan Zhu
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaojian Fu
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Qiyuan Yao
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Hao Chen
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
- *Correspondence: Hao Chen
| | - Xiaohong Wang
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
- Xiaohong Wang
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Jourdan A, Rapacchi S, Guye M, Bendahan D, Masson C, Bège T. Dynamic-MRI quantification of abdominal wall motion and deformation during breathing and muscular contraction. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 217:106667. [PMID: 35231757 DOI: 10.1016/j.cmpb.2022.106667] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 01/15/2022] [Accepted: 01/25/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Biomechanical assessment of the abdominal wall represents a major prerequisite for a better understanding of physiological and pathological situations such as hernia, post-delivery recovery, muscle dystrophy or sarcopenia. Such an assessment is challenging and requires muscular deformations quantification which have been very scarcely reported in vivo. In the present study, we intended to characterize abdominal wall deformations in passive and active conditions using dynamic MRI combined to a semiautomatic segmentation procedure. METHODS Dynamic deformations resulting from three complementary exercises i.e. forced breathing, coughing and Valsalva maneuver were mapped in a transversal abdominal plane and so for twenty healthy volunteers. Real-time dynamic MRI series were acquired at a rate of 182 ms per image, then segmented semi-automatically to follow muscles deformation through each exercise. Circumferential and radial strains of each abdominal muscle were computed from the geometrical characteristics' quantification, namely the medial axis length and the thickness. Muscular radial displacement maps were computed using image registration. RESULTS Large variations in circumferential and radial strains were observed for the lateral muscles (LM) but remained low for the rectus abdominis muscles (RA). Contraction phases of each exercise led to LM muscle shortening down to -9.6 ± 5.9% during Valsalva maneuver with a 16.2 ± 9.6% thickness increase. Contraction also led to inward radial displacement of the LM up to 9.9 ± 4.1 mm during coughing. During maximal inhalation, a significant 10.0 ± 6.6% lengthening was quantified for LM while a significant thickness decrease was computed for the whole set of muscles (-14.7 ± 6.6% for LM and -7.3 ± 6.5% for RA). The largest displacement was observed for the medial part of RA (17.9 ± 8.0 mm) whereas the posterior part of LM underwent limited motion (2.8 ± 2.3 mm). Displacement rate and correlation between muscle thickness and medial axis length during each exercise provided insights regarding subject-specific muscle function. CONCLUSIONS Dynamic MRI is a promising tool for the assessment of the abdominal wall motion and deformations. The corresponding metrics which have been continuously recorded during the exercises provided global and regional quantitative information. These metrics offer perspectives for a genuine clinical evaluation tool dedicated to the assessment of abdominal muscles function in both healthy subjects and patients.
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Affiliation(s)
- Arthur Jourdan
- Aix-Marseille Univ, Univ Gustave Eiffel, IFSTTAR, LBA, F-13016 Marseille, France.
| | | | - Maxime Guye
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France; APHM, Hopital Universitaire Timone, CEMEREM, Marseille, France.
| | | | - Catherine Masson
- Aix-Marseille Univ, Univ Gustave Eiffel, IFSTTAR, LBA, F-13016 Marseille, France.
| | - Thierry Bège
- Aix-Marseille Univ, Univ Gustave Eiffel, IFSTTAR, LBA, F-13016 Marseille, France; Department of General Surgery, Aix Marseille Univ, North Hospital, APHM, Marseille, France.
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Haynes AC, Lywood A, Crowe EM, Fielding JL, Rossiter JM, Kent C. A calming hug: Design and validation of a tactile aid to ease anxiety. PLoS One 2022; 17:e0259838. [PMID: 35263344 PMCID: PMC8906645 DOI: 10.1371/journal.pone.0259838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 10/27/2021] [Indexed: 11/19/2022] Open
Abstract
Anxiety disorders affect approximately one third of people during their lifetimes and are the ninth leading cause of global disability. Current treatments focus on therapy and pharmacological interventions. However, therapy is costly and pharmacological interventions often have undesirable side-effects. Healthy people also regularly suffer periods of anxiety. Therefore, a non-pharmacological, intuitive, home intervention would be complementary to other treatments and beneficial for non-clinical groups. Existing at-home anxiety aids, such as guided meditations, typically employ visual and/or audio stimuli to guide the user into a calmer state. However, the tactile sense has the potential to be a more natural modality to target in an anxiety-calming device. The tactile domain is relatively under-explored, but we suggest that there are manifold physiological and affective qualities of touch that lend it to the task. In this study we demonstrate that haptic technology can offer an enjoyable, effective and widely accessible alternative for easing state anxiety. We describe a novel huggable haptic interface that pneumatically simulates slow breathing. We discuss the development of this interface through a focus group evaluating five prototypes with embedded behaviours (‘breathing’, ‘purring’, ‘heartbeat’ and ‘illumination’). Ratings indicated that the ‘breathing’ prototype was most pleasant to interact with and participants described this prototype as ‘calming’ and ‘soothing’, reminding them of a person breathing. This prototype was developed into an ergonomic huggable cushion containing a pneumatic chamber powered by an external pump allowing the cushion to ‘breathe’. A mixed-design experiment (n = 129) inducing anxiety through a group mathematics test found that the device was effective at reducing pre-test anxiety compared to a control (no intervention) condition and that this reduction in anxiety was indistinguishable from that of a guided meditation. Our findings highlight the efficacy of this interface, demonstrating that haptic technologies can be effective at easing anxiety. We suggest that the field should be explored in more depth to capture the nuances of different modalities in relation to specific situations and trait characteristics.
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Affiliation(s)
- Alice C. Haynes
- Engineering Mathematics Department, University of Bristol, Bristol, United Kingdom
- Soft Robotics Group, Bristol Robotics Laboratory, Bristol, United Kingdom
- * E-mail:
| | | | - Emily M. Crowe
- Faculty of Behavioural and Movement Sciences, Vrije Universiteit, Amsterdam, Netherlands
| | - Jessica L. Fielding
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Jonathan M. Rossiter
- Engineering Mathematics Department, University of Bristol, Bristol, United Kingdom
- Soft Robotics Group, Bristol Robotics Laboratory, Bristol, United Kingdom
| | - Christopher Kent
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
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Kirilova-Doneva M, Pashkouleva D. The effects of age and sex on the elastic mechanical properties of human abdominal fascia. Clin Biomech (Bristol, Avon) 2022; 92:105591. [PMID: 35131681 DOI: 10.1016/j.clinbiomech.2022.105591] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 12/19/2021] [Accepted: 01/28/2022] [Indexed: 02/07/2023]
Abstract
BACKGROUND The abdominal hernias become more prevalent with age, that can adversely affect life quality. The mechanical properties of abdominal wall layers are supposed to play a significant role in developing of an abdominal hernia.The objective of this study was to determine the mechanical properties of the human abdominal layer - fascia and the effects of age and sex on it for choosing the proper brand of hernia mesh. METHODS 78 samples harvested from 19 fresh cadavers were subjected to uniaxial tension tests and divided into four groups according to age. Group A corresponds to age up to 60 years, Group B to age 61-70 years, Group C to age 71-80 years and Group D to 81-90 years. Median stress-stretch ratio curves with respect to age, sex and direction of loading were obtained. Median values of the maximum tensile stress, stretch at maximum stress and elastic modulus calculated at 5% strain were determined. FINDINGS The abdominal fascia showed large variations between specimens depending on age and sex. The stiffness of the fascia increased with age. There is statistically significant differences between the median curves of male samples (P = 0.008) and female samples (P = 0.019) according to age in the L direction. Statistically significant differences between the values of maximum stress (P = 0.01) and elastic modulus (P = 0.003) from Group C in the L direction and maximum stress (P = 0.03) from Group D in the T direction was established. INTERPRETATION The female samples are stiffer than male samples especially after 80 years.
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Affiliation(s)
- Miglena Kirilova-Doneva
- Faculty of Pharmacy, Medical University-Sofia, Sofia, Bulgaria; Institute of Mechanics, Bulgarian Academy of Sciences, Sofia, Bulgaria.
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A novel in vivo approach to assess strains of the human abdominal wall under known intraabdominal pressure. J Mech Behav Biomed Mater 2021; 125:104902. [PMID: 34717119 DOI: 10.1016/j.jmbbm.2021.104902] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/23/2022]
Abstract
The study concerns mechanical behaviour of a living human abdominal wall. A better mechanical understanding of a human abdominal wall and recognition of its material properties is required to find mechanically compatible surgical meshes to significantly improve the treatment of ventral hernias. A non-invasive methodology, based on in vivo optical measurements is proposed to determine strains of abdominal wall corresponding to a known intraabdominal pressure. The measurement is performed in the course of a standard procedure of peritoneal dialysis. A dedicated experimental stand is designed for the experiment. The photogrammetric technique is employed to recover the three-dimensional surface geometry of the anterior abdominal wall at the initial and terminal instants of the dialysis. This corresponds to two deformation states, before and after filling the abdominal cavity with dialysis fluid. The study provides information on strain fields of living human abdominal wall. The inquiry is aimed at principal strains and their directions, observed at the level from -10% to 17%. The intraabdominal pressure related to the amount of introduced dialysis fluid measured within the medical procedure covers the range 11-18.5 cmH2O. The methodology leads to the deformation state of the abdominal wall according to the corresponding loading conditions. Therefore, the study is a step towards an identification of mechanical properties of living human abdominal wall.
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Remeniéras JP, Bulot M, Gennisson JL, Patat F, Destrade M, Bacle G. Acousto-elasticity of transversely isotropic incompressible soft tissues: characterization of skeletal striated muscle. Phys Med Biol 2021; 66. [PMID: 34186529 DOI: 10.1088/1361-6560/ac0f9b] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 06/29/2021] [Indexed: 01/02/2023]
Abstract
Using shear wave elastography, we measure the changes in the wave speed with the stress produced by a striated muscle during isometric voluntary contraction. To isolate the behaviour of an individual muscle from complementary or antagonistic actions of adjacent muscles, we select theflexor digiti minimimuscle, whose sole function is to extend the little finger. To link the wave speed to the stiffness, we develop an acousto-elastic theory for shear waves in homogeneous, transversely isotropic, incompressible solids subject to an uniaxial stress. We then provide measurements of the apparent shear elastic modulus along, and transversely to, the fibre axis for six healthy human volunteers of different age and sex. The results display a great variety across the six subjects. We find that the slope of the apparent shear elastic modulus along the fibre direction changes inversely to the maximum voluntary contraction (MVC) produced by the volunteer. We propose an interpretation of our results by introducing the S (slow) or F (fast) nature of the fibres, which harden the muscle differently and accordingly, produce different MVCs. A natural follow-up on this study is to apply the method to patients with musculoskeletal disorders or neurodegenerative diseases.
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Affiliation(s)
| | - Mahé Bulot
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
| | - Jean-Luc Gennisson
- Laboratoire d'imagerie biomédicale multimodale à Paris-Saclay, Université Paris-Saclay, CEA, CNRS UMR 9011, INSERM UMR 1281, France
| | - Frédéric Patat
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,Inserm CIC-IT 1415, Tours, France
| | - Michel Destrade
- School of Mathematics, Statistics and Applied Mathematics, NUI Galway, University Road, Galway, Ireland
| | - Guillaume Bacle
- UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.,Service de chirurgie orthopédique et traumatologique 1A, Unité de chirurgie de la main et du membre supérieur, CHRU de Tours, France
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Guo J, Guo W, Ren G. Embodiment of intra-abdominal pressure in a flexible multibody model of the trunk and the spinal unloading effects during static lifting tasks. Biomech Model Mechanobiol 2021; 20:1599-1626. [PMID: 34050846 DOI: 10.1007/s10237-021-01465-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 05/07/2021] [Indexed: 11/28/2022]
Abstract
The role of intra-abdominal pressure (IAP) in spinal load reduction has remained controversial, partly because previous musculoskeletal models did not introduce the pressure generating mechanism. In this study, an integrated computational methodology is proposed to combine the IAP change with core muscle activations. An ideal gas relationship was introduced to calculate pressure distribution within the abdominal cavity. Additionally, based on flexible multibody dynamics, a muscle membrane element was developed by incorporating the muscular fiber deformation, inter-fiber stiffness, and volume constancy. This element was then utilized in discretizing the diaphragm and transversus abdominis, forming an IAP-muscle coupling system of the abdominal cavity. Based on this methodology, a forward dynamic simulation of spinal flexion was presented to examine the unloading effect of abdominal breathing. The results confirm that core muscle contraction during the abdominal breathing cycle can substantially reduce the forces of spinal compression together with trunk extensor muscles, and this effect is more pronounced when the IAP increase is produced by contraction of the transversus abdominis. This unloading effect still holds even with the co-activation of other abdominal muscles, providing a potential choice when designing trunk movements during weight-lifting tasks.
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Affiliation(s)
- Jianqiao Guo
- MOE Key Laboratory of Dynamics and Control of Flight Vehicle, School of Aerospace Engineering, Beijing Institute of Technology, Beijing, 100081, China.
| | - Wei Guo
- Air Force Medical Center, PLA, Beijing, 100142, China
| | - Gexue Ren
- Department of Engineering Mechanics, Tsinghua University, Beijing, 100084, China
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14
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Linek P, Wolny T, Myśliwiec A, Klepek A. Shear wave elastography for assessing lateral abdominal muscles in thoracolumbar scoliosis: A preliminary study. Biomed Mater Eng 2021; 31:131-142. [PMID: 32474461 DOI: 10.3233/bme-201085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND There are no studies on the scoliotic population in which lateral abdominal muscle (LAM) was measured. OBJECTIVE The aim of the study was to deliver the first results on LAM elasticity assessed by shear wave elastography (SWE) in right-side and left-side thoracolumbar scoliosis patients. METHOD Twelve patients (mean age 12.25) with thoracolumbar scoliosis were included in the study. Muscle thickness and SWE of the obliquus external (OE), obliquus internal, and transversus abdominis (TrA) were measured with an ultrasound scanner. Measurements were taken at rest and during isometric contraction. RESULTS An analysis showed that in right-side scoliosis, the OE muscle on the convex side was stiffer by 7.25 kPa compared to the concave side. The OE muscle on the convex side in right-side scoliosis was also stiffer by 11.6 kPa compared to the convex side in left-side scoliosis. In left-side scoliosis, the TrA muscle on the concave side was stiffer by 7.84 kPa compared to the convex side. CONCLUSION Changes in LAM elasticity of thoracolumbar scoliosis were observed. A different pattern of LAM stiffness in different curve directions may be expected. OE and TrA shear moduli are the most sensitive to change in adolescent spinal deformation.
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Affiliation(s)
- Pawel Linek
- Institute of Physiotherapy and Health Sciences, Musculoskeletal Elastography and Ultrasonography Laboratory, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Tomasz Wolny
- Institute of Physiotherapy and Health Sciences, Musculoskeletal Elastography and Ultrasonography Laboratory, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Andrzej Myśliwiec
- Institute of Physiotherapy and Health Sciences, Laboratory of Physiotherapy and Physioprevention, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Anna Klepek
- Head of the Rehabilitation Department, Stokrotka Health Resort, Goczałkowice-Zdrój, Poland
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15
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Jacobson N, Driscoll M. Design Synthesis and Preliminary Evaluation of a Novel Tool to Noninvasively Characterize Pressurized, Physiological Vessels. J Med Device 2020. [DOI: 10.1115/1.4049088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Abstract
A prolonged increase in intra-abdominal pressure (IAP) is life-threatening, yet commonly seen in intensive care units (ICUs). Despite this, existing clinically accepted IAP measurement techniques are invasive and not inter-rater reliable. As such, it is the effort of this research to develop a direct, noninvasive, handheld tool to measure internal pressures in pressurized, physiological vessels. The novel device uses a localized known pressure (namely, aspiration) to measure resulting tissue deformation, from which internal pressures can be divulged considering the extended Hencky solution. Two male participants were tested with the device to confirm feasibility of the theoretical device function for IAP measurement. Participants' Young's moduli of the abdominal wall were calculated with measured IAP values. Results were consistent with participant body mass indices and overall health. Average measured IAP was 0.42 kPa and 0.46 kPa at supine and inclined positions, respectively. Average measured abdominal wall elasticity was 14.91 kPa and 23.09 kPa at supine and inclined positions, respectively. These preliminary findings suggest the potential use of the device described herein as a measurement system for pressurized vessels, whereas the system will be tested on a larger sample size before recommending clinical use.
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Affiliation(s)
- Natasha Jacobson
- Deparment of Mechanical Engineering, McGill University, 817 Sherbrooke Street West, Montreal, QC H3A 0C3, Canada
| | - Mark Driscoll
- Deparment of Mechanical Engineering, McGill University, 817 Sherbrooke Street West, Montreal, QC H3A 0C3, Canada
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16
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Contributions of Muscle Elasticity and Lateral Slide of the Transversus Abdominis to Lumbar Stability. J Sport Rehabil 2020; 30:582-586. [PMID: 33217731 DOI: 10.1123/jsr.2020-0085] [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: 02/23/2020] [Revised: 07/23/2020] [Accepted: 08/22/2020] [Indexed: 11/18/2022]
Abstract
CONTEXT Lumbar instability can cause lumbar spondylolisthesis and chronic low-back pain in sports situation. Abdominal hollowing is commonly used in clinical practice to preferentially target the transversus abdominis (TrA) to stabilize the lumbar vertebrae; however, the contribution of muscle elasticity and lateral slide of the TrA to lumbar stability has not yet been clarified. OBJECTIVE To clarify the contribution of elasticity and lateral slide of the TrA to lumbar stability and to identify an effective exercise to stabilize the lumbar vertebrae. DESIGN Experimental study. SETTING Laboratory. PATIENTS A total of 29 healthy males participated in this study. INTERVENTIONS The participants performed hollowing during measurement of muscle elasticity of TrA and both knees extension from crook lying position for pelvic stability measurement. MAIN OUTCOME MEASURES Lumbar stability, muscle elasticity change ratio, and lateral slide amount of TrA. RESULTS There was a significant correlation between elasticity of the TrA and lumbar stability; however, no relationship was observed between lateral slide and lumbar stability or elasticity of the TrA. CONCLUSION Elasticity of the TrA and lumbar stability was significantly correlated; therefore, improving the tonicity of the TrA may stabilize the lumbar vertebrae in healthy individuals. Moreover, hollowing with maximum effort may be effective as training aimed to stabilize the lumbar vertebrae for physical dysfunction due to lumbar instability.
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17
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Intrarater Reliability of Shear Wave Elastography for the Quantification of Lateral Abdominal Muscle Elasticity in Idiopathic Scoliosis Patients. J Manipulative Physiol Ther 2020; 43:303-310. [PMID: 32868027 DOI: 10.1016/j.jmpt.2018.11.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2018] [Revised: 11/28/2018] [Accepted: 11/28/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To date, studies evaluating the reliability of shear wave elastography (SWE) measures of the lateral abdominal muscles (LAMs) in adolescent patients with idiopathic scoliosis (AIS) have never been performed. The aim of the study was to assess the intrarater reliability of SWE and thickness of the LAMs at rest and during isometric contraction (10% of maximal voluntary contraction). METHODS This was a single-group, repeated-measures intrarater reliability study. Twenty-four patients with AIS between ages 10 and 17 years took part in the study. Two and 3 repeated SWE measurements were recorded in the supine resting position and during isometric contraction, respectively. Two sessions were performed with a 7-day interval. RESULTS By using the mean of 2 measures in the supine, resting position, intraexaminer reliability point estimates (intraclass correlation coefficient [ICC]3.2) ranged from 0.75 to 0.84 for external oblique, internal oblique, and transversus abdominis muscles. During the isometric contraction, the ICC3.3 results ranged from 0.70 to 0.83. The ICC results for muscle thicknesses in both conditions ranged from 0.89 to 0.96. CONCLUSION Measurements of LAM elasticity are reliable in patients with AIS. The superficial fat layer did not influence the measurement error between 2 sets of measurements in the examined adolescent population. The images extracted from SWE can successfully be used to assess LAM thicknesses with high reliability.
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18
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Wang X, He K, Zhu Y, Fu X, Huang Z, Ding R, Yao Q, Chen H. Use of Shear Wave Elastography to Quantify Abdominal Wall Muscular Properties in Patients With Incisional Hernia. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1651-1657. [PMID: 32402672 DOI: 10.1016/j.ultrasmedbio.2020.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/17/2020] [Accepted: 03/24/2020] [Indexed: 06/11/2023]
Abstract
Shear wave elastography (SWE) is a potential modality that quantitatively measures the elasticity (shear wave speed [SWS]) of musculoskeletal structure. This SWS was bilaterally measured in the rectus abdominis (RA), external oblique (EO) muscle, internal oblique (IO) muscle and transversus abdominis (TrA) using SWE in 28 patients with incisional hernia and 14 healthy controls. The differences in muscle thickness for IO and TrA were significant between the two groups (p < 0.05). The SWS of RA, EO, IO and TrA was significantly higher in the incisional hernia patient group than in the healthy controls (p < 0.05). Significant differences were also observed between the upper and lower points in both groups (p < 0.05). The measurements of SWS help in evaluating the elastic properties of abdominal wall muscles, which could further aid in preparing treatment plans to improve muscle strength.
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Affiliation(s)
- Xiaohong Wang
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Kai He
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yulan Zhu
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaojian Fu
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhifang Huang
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Rui Ding
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Qiyuan Yao
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Hao Chen
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China.
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19
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Cheung WK, Cheung JPY, Lee WN. Role of Ultrasound in Low Back Pain: A Review. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:1344-1358. [PMID: 32192782 DOI: 10.1016/j.ultrasmedbio.2020.02.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 01/27/2020] [Accepted: 02/04/2020] [Indexed: 06/10/2023]
Abstract
Low back pain is one of most common musculoskeletal disorders around the world. One major problem clinicians face is the lack of objective assessment modalities. Computed tomography and magnetic resonance imaging are commonly utilized but are unable to clearly distinguish patients with low back pain from healthy patients with respect to abnormalities. The reason may be the anisotropic nature of muscles, which is altered in function, and the scans provide only structural assessment. In view of this, ultrasound may be helpful in understanding the disease as it is performed in real-time and comprises different modes that measure thickness, blood flow and stiffness. By the use of ultrasound, patients with low back pain have been found to differ from healthy patients with respect to the thickness and stiffness of the transversus abdominis, thoracolumbar fascia and multifidus. The study results are currently still not conclusive, and further study is necessary to validate. Future work should focus on quantitative assessment of these tissues to provide textural, structural, hemodynamic and mechanical studies of low back pain. This review highlights the current understanding of how medical ultrasound has been used for diagnosis and study of low back pain and discusses potential new applications.
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Affiliation(s)
- Wing Ki Cheung
- Department of Orthopaedics and Traumatology, University of Hong Kong, Pokfulam, SAR, China
| | - Jason Pui Yin Cheung
- Department of Orthopaedics and Traumatology, University of Hong Kong, Pokfulam, SAR, China.
| | - Wei-Ning Lee
- Department of Electrical and Electronic Engineering, Biomedical Engineering Programme, University of Hong Kong, Pokfulam, SAR, China
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20
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Kirilova-Doneva M, Pashkouleva D, Stoytchev S. Age-related changes in mechanical properties of human abdominal fascia. Med Biol Eng Comput 2020; 58:1565-1573. [PMID: 32415553 DOI: 10.1007/s11517-020-02172-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 03/26/2020] [Indexed: 11/29/2022]
Abstract
The purpose of this study is to assess and model age-related changes in the mechanical properties of human fascia. The samples were divided into three age groups: group A-up to 60 years (mean age 52.5 ± 6 years), group B-61-80 years (mean age 70.4 ± 5.2 years), and group C-81-90 years (mean age 83.2 ± 2 years). A uniaxial tensile test was applied to fascia specimens cut perpendicular and parallel to fibers. The secant modulus at 5% strain, the maximum stress, and the stretch at maximum stress were calculated from the stress-stretch ratio curves. The results indicated an increase in the secant modulus with the increased age. The trend is clearer in the longitudinal direction. Considering the strain energy function which accounts the isotropic and non-isotropic response of the fascia where isotropic and anisotropic parts are split, we evaluated which material model is the most suitable to present isotropic mechanical behavior of the tissue. The experimental stress-stretch ratio curves were approximated using Mooney-Rivlin, Yeoh, and neo-Hookean strain energy functions and a good match between theoretical and experimental results was obtained. On the basis of objective function values and normalized mean square root error, we recommend using the Yeoh model to describe the isotropic mechanical behavior of human abdominal fascia. Graphical abstract .
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Affiliation(s)
- Miglena Kirilova-Doneva
- Faculty of Pharmacy, Medical University of Sofia, 2 Dunav Str., 1000, Sofia, Bulgaria. .,Institute of Mechanics, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 4, Sofia, Bulgaria.
| | - Dessislava Pashkouleva
- Institute of Mechanics, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 4, Sofia, Bulgaria
| | - Stoyan Stoytchev
- Institute of Mechanics, Bulgarian Academy of Sciences, Acad. G. Bonchev Str., Bl. 4, Sofia, Bulgaria
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21
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A numerical method for guiding the design of surgical meshes with suitable mechanical properties for specific abdominal hernias. Comput Biol Med 2020; 116:103531. [DOI: 10.1016/j.compbiomed.2019.103531] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 10/18/2019] [Accepted: 11/04/2019] [Indexed: 11/19/2022]
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22
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Todros S, de Cesare N, Pianigiani S, Concheri G, Savio G, Natali AN, Pavan PG. 3D surface imaging of abdominal wall muscular contraction. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2019; 175:103-109. [PMID: 31104699 DOI: 10.1016/j.cmpb.2019.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Revised: 04/10/2019] [Accepted: 04/11/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND AND OBJECTIVE The biomechanical analysis of the abdominal wall should take into account muscle activation and related phenomena, such as intra-abdominal pressure variation and abdomen surface deformation. The geometry of abdominal surface and its deformation during contraction have not been extensively characterized, while represent a key issue to be investigated. METHODS In this work, the antero-lateral abdominal wall surface of ten healthy volunteers in supine position is acquired via laser scanning in relaxed conditions and during abdominal muscles contraction, repeating each acquisition six times. The average relaxed and contracted abdominal surfaces are compared for each subject and displacements measured. RESULTS Muscular activation induces raising in the region adjacent to linea alba along the posterior-anterior direction and a simultaneous lowering along lateral-medial direction of the abdominal wall sides. Displacements reach a maximum value of 12.5 mm for the involved subjects. The coefficient of variation associated to the abdomen surface measurements in the same configuration (relaxed or contracted) is below 0.75%. Non-parametric Mann-Whitney U test highlights that the differences between relaxed and contracted abdominal wall surfaces are significant (p < 0.01). CONCLUSIONS Laser scanning is an accurate and reliable method to evaluate surface changes on the abdominal wall during muscular contraction. The results of this experimental activity can be useful to validate numerical models aimed at describing abdominal wall biomechanics.
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Affiliation(s)
- Silvia Todros
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
| | - Niccolò de Cesare
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy.
| | - Silvia Pianigiani
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
| | - Gianmaria Concheri
- Department of Civil, Environmental and Architectural Engineering, Laboratory of Design Tools and Methods in Industrial Engineering, University of Padova, Padova, Italy
| | - Gianpaolo Savio
- Department of Civil, Environmental and Architectural Engineering, Laboratory of Design Tools and Methods in Industrial Engineering, University of Padova, Padova, Italy
| | - Arturo N Natali
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
| | - Piero G Pavan
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, Padova, Italy
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23
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Linek P, Wolny T, Sikora D, Klepek A. Supersonic Shear Imaging for Quantification of Lateral Abdominal Muscle Shear Modulus in Pediatric Population with Scoliosis: A Reliability and Agreement Study. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:1551-1561. [PMID: 31031032 DOI: 10.1016/j.ultrasmedbio.2019.03.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2018] [Revised: 02/16/2019] [Accepted: 03/02/2019] [Indexed: 06/09/2023]
Abstract
The aim of this study was to assess the intra- and inter-rater reliability/agreement of the lateral abdominal muscle (LAM) stiffness and thickness measurements at rest and during contraction and to determine the relationship between the superficial fat thickness and the LAM stiffness measurements. LAM stiffness and thickness were measured using supersonic shear wave elastography (SSI) in pediatric participants. The reliability of LAM stiffness and thickness measurements ranged from moderate to excellent. There was an inverse correlation between fat thickness and between-rater difference in the resting external oblique stiffness (r > -0.37) and the contracted external and internal oblique stiffness (r > -0.40). SSI is a reliable method for assessing LAM stiffness and thickness in pediatric populations. To remove potential systematic errors: (i) the first round of measurements should be performed to familiarize patients with procedures; (ii) the examiner should pay more attention while performing LAM measurements on the opposite side of the body.
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Affiliation(s)
- Pawel Linek
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland; Musculoskeletal Elastography and Ultrasonography Laboratory, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland.
| | - Tomasz Wolny
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Damian Sikora
- Department of Kinesitherapy and Special Methods in Physiotherapy, The Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Anna Klepek
- Rehabilitation Department, Stokrotka Health Resort, Goczałkowice-Zdrój, Poland
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24
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Creze M, Bedretdinova D, Soubeyrand M, Rocher L, Gennisson JL, Gagey O, Maître X, Bellin MF. Posture-related stiffness mapping of paraspinal muscles. J Anat 2019; 234:787-799. [PMID: 30901090 DOI: 10.1111/joa.12978] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2019] [Indexed: 12/20/2022] Open
Abstract
The paraspinal compartment acts as a bone-muscle composite beam of the spine. The elastic properties of the paraspinal muscles play a critical role in spine stabilization. These properties depend on the subjects' posture, and they may be drastically altered by low back pain. Supersonic shear wave elastography can be used to provide quantitative stiffness maps (elastograms), which characterize the elastic properties of the probed tissue. The aim of this study was to challenge shear wave elastography sensitivity to postural stiffness changes in healthy paraspinal muscles. The stiffness of the main paraspinal muscles (longissimus, iliocostalis, multifidus) was measured by shear wave elastography at the lumbosacral level (L3 and S1) for six static postures performed by volunteers. Passive postures (rest, passive flexion, passive extension) were performed in a first shear wave elastography session, and active postures (upright, bending forward, bending backward) with rest posture for reference were performed in a second session. Measurements were repeated three times for each posture. Sixteen healthy young adults were enrolled in the study. Non-parametric paired tests, multiple analyses of covariance, and intra-class correlations were implemented for analysis. Shear wave elastography showed good to excellent reliability, except in the multifidus at S1, during bending forward, and in the multifidus at L3, during bending backward. Yet, during bending forward, only poor quality was recorded for nine volunteers in the longissimus. Significant intra- and inter-muscular changes were observed with posture. Stiffness significantly increased for the upright position and bending forward with respect to the reference values recorded in passive postures. In conclusion, shear wave elastography allows reliable assessment of the stiffness of the paraspinal muscles except in the multifidus at S1 and longissimus, during bending forward, and in the multifidus at L3, during bending backward. It reveals a different biomechanical behaviour for the multifidus, the longissimus, and the iliocostalis.
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Affiliation(s)
- Maud Creze
- Radiology Department, Bicêtre Hospital, APHP, Kremlin-Bicêtre, France.,Complexité, Innovations, Activités Motrices et Sportives, CIAMS (EA4532), Université Paris-Saclay, Orsay, France.,Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, Université Paris-Sud, Université Paris-Saclay, Orsay, France
| | - Dina Bedretdinova
- Centre de recherche en Epidémiologie et Santé des Populations, CESP, INSERM, Université Paris-Saclay, Orsay, France
| | - Marc Soubeyrand
- Department of Orthopedics, Bicêtre Hospital, APHP, Kremlin-Bicêtre, France
| | - Laurence Rocher
- Radiology Department, Bicêtre Hospital, APHP, Kremlin-Bicêtre, France.,Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, Université Paris-Sud, Université Paris-Saclay, Orsay, France
| | - Jean-Luc Gennisson
- Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, Université Paris-Sud, Université Paris-Saclay, Orsay, France
| | - Olivier Gagey
- Complexité, Innovations, Activités Motrices et Sportives, CIAMS (EA4532), Université Paris-Saclay, Orsay, France.,Department of Orthopedics, Bicêtre Hospital, APHP, Kremlin-Bicêtre, France
| | - Xavier Maître
- Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, Université Paris-Sud, Université Paris-Saclay, Orsay, France
| | - Marie-France Bellin
- Radiology Department, Bicêtre Hospital, APHP, Kremlin-Bicêtre, France.,Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, Université Paris-Sud, Université Paris-Saclay, Orsay, France
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25
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Liu J, Qian Z, Wang K, Wu J, Jabran A, Ren L, Ren L. Non-invasive Quantitative Assessment of Muscle Force Based on Ultrasonic Shear Wave Elastography. ULTRASOUND IN MEDICINE & BIOLOGY 2019; 45:440-451. [PMID: 30396600 DOI: 10.1016/j.ultrasmedbio.2018.07.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/03/2018] [Accepted: 07/13/2018] [Indexed: 05/26/2023]
Abstract
The objective of this study was to investigate the feasibility of using shear wave elastography (SWE) to indirectly measure passive muscle force and to examine the effects of muscle mass and scan angle. We measured the Young's moduli of 24 specimens from six muscles of four swine at different passive muscle loads under different scan angles (0°, 30°, 60° and 90°) using SWE. Highly linear relationships between Young's modulus E and passive muscle force F were found for all 24 muscle specimens at 0o scan angle with coefficients of determination R2 ranging from 0.984 to 0.999. The results indicate that the muscle mass has no significant effect on the muscle E-F relationship, whereas E-F linearity decreases disproportionately with increased scan angle. These findings suggest that SWE, when carefully applied, can provide a highly reliable tool to measure muscle Young's modulus, and could be used to assess the muscle force quantitatively.
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Affiliation(s)
- Jing Liu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Zhihui Qian
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Kunyang Wang
- School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, United Kingdom
| | - Jianan Wu
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Ali Jabran
- School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, United Kingdom
| | - Luquan Ren
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China
| | - Lei Ren
- Key Laboratory of Bionic Engineering, Ministry of Education, Jilin University, Changchun, China; School of Mechanical, Aerospace and Civil Engineering, University of Manchester, Manchester, United Kingdom.
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26
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Pavan PG, Todros S, Pachera P, Pianigiani S, Natali AN. The effects of the muscular contraction on the abdominal biomechanics: a numerical investigation. Comput Methods Biomech Biomed Engin 2019; 22:139-148. [DOI: 10.1080/10255842.2018.1540695] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Piero G. Pavan
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, via Venezia 1, I–35131 Padova, Italy
| | - Silvia Todros
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, via Venezia 1, I–35131 Padova, Italy
| | - Paola Pachera
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, via Venezia 1, I–35131 Padova, Italy
| | - Silvia Pianigiani
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, via Venezia 1, I–35131 Padova, Italy
| | - Arturo N. Natali
- Department of Industrial Engineering, Centre for Mechanics of Biological Materials, University of Padova, via Venezia 1, I–35131 Padova, Italy
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27
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Blain M, Bedretdinova D, Bellin MF, Rocher L, Gagey O, Soubeyrand M, Creze M. Influence of thoracolumbar fascia stretching on lumbar back muscle stiffness: A supersonic shear wave elastography approach. Clin Anat 2018; 32:73-80. [DOI: 10.1002/ca.23266] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 08/03/2018] [Accepted: 08/17/2018] [Indexed: 02/06/2023]
Affiliation(s)
- Maxime Blain
- Radiology Department; Bicêtre Hospital; APHP France
| | - Dina Bedretdinova
- Centre de recherche en Epidémiologie et Santé des Populations; CESP, INSERM, Université Paris-Saclay; le Kremlin-Bicêtre France
| | - Marie-France Bellin
- Radiology Department; Bicêtre Hospital; APHP France
- Imagerie par Résonance Magnétique Médicale et Multi-Modalités; IR4M, CNRS, Univ Paris-Sud, Université Paris-Saclay; Orsay France
| | - Laurence Rocher
- Radiology Department; Bicêtre Hospital; APHP France
- Imagerie par Résonance Magnétique Médicale et Multi-Modalités; IR4M, CNRS, Univ Paris-Sud, Université Paris-Saclay; Orsay France
| | - Olivier Gagey
- Orthopedy Department; Bicêtre Hospital; APHP France
- Complexité, Innovations, Activités Motrices et Sportives, CIAMS (EA4532); Univ Paris-Sud, Université Paris-Saclay; Orsay France
| | | | - Maud Creze
- Radiology Department; Bicêtre Hospital; APHP France
- Imagerie par Résonance Magnétique Médicale et Multi-Modalités; IR4M, CNRS, Univ Paris-Sud, Université Paris-Saclay; Orsay France
- Complexité, Innovations, Activités Motrices et Sportives, CIAMS (EA4532); Univ Paris-Sud, Université Paris-Saclay; Orsay France
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Gabrielsen DA, Carney MJ, Weissler JM, Lanni MA, Hernandez J, Sultan LR, Enriquez F, Sehgal CM, Fischer JP, Chauhan A. Application of ARFI-SWV in Stiffness Measurement of the Abdominal Wall Musculature: A Pilot Feasibility Study. ULTRASOUND IN MEDICINE & BIOLOGY 2018; 44:1978-1985. [PMID: 29980451 DOI: 10.1016/j.ultrasmedbio.2018.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 04/09/2018] [Accepted: 05/03/2018] [Indexed: 06/08/2023]
Abstract
The purpose of this study was to assess the feasibility of acoustic radiation force impulse shear wave velocity and textural features for characterizing abdominal wall musculature and to identify subject-related and technique-related factors that can potentially affect measurements. Median shear wave velocity measurements for the right external abdominal oblique were the same (1.89 ± 0.16 m/s) for both the active group (healthy volunteers with active lifestyles) and the control group (age and body mass index-matched volunteers from an ongoing hernia study). When corrected for thickness, the ratio of right external abdominal oblique shear wave velocity -to-muscle thickness was significantly higher in the control group than in the active volunteers (4.33 s-1 versus 2.88 s-1; p value 0.006). From the textural features studied for right external abdominal oblique, 8 features were found to be statistically different between the active and control groups. In conclusion, shear wave velocity is a feasible and reliable technique to evaluate the stiffness of the abdominal wall musculature. Sonographic texture features add additional characterization of abdominal wall musculature.
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Affiliation(s)
- David A Gabrielsen
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Martin J Carney
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Jason M Weissler
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael A Lanni
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Jorge Hernandez
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laith R Sultan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Fabiola Enriquez
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Chandra M Sehgal
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - John P Fischer
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Anil Chauhan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
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29
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Creze M, Nordez A, Soubeyrand M, Rocher L, Maître X, Bellin MF. Shear wave sonoelastography of skeletal muscle: basic principles, biomechanical concepts, clinical applications, and future perspectives. Skeletal Radiol 2018; 47:457-471. [PMID: 29224123 DOI: 10.1007/s00256-017-2843-y] [Citation(s) in RCA: 135] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Revised: 11/20/2017] [Accepted: 11/30/2017] [Indexed: 02/02/2023]
Abstract
Imaging plays an important role in the diagnosis and therapeutic response evaluation of muscular diseases. However, one important limitation is its incapacity to assess the in vivo biomechanical properties of the muscles. The emerging shear wave sonoelastography technique offers a quantifiable spatial representation of the viscoelastic characteristics of skeletal muscle. Elastography is a non-invasive tool used to analyze the physiologic and biomechanical properties of muscles in healthy and pathologic conditions. However, radiologists need to familiarize themselves with the muscular biomechanical concepts and technical challenges of shear wave elastography. This review introduces the basic principles of muscle shear wave elastography, analyzes the factors that can influence measurements and provides an overview of its potential clinical applications in the field of muscular diseases.
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Affiliation(s)
- Maud Creze
- Radiology Department, Bicêtre Hospital, APHP, Le Kremlin-Bicetre, France. .,Laboratory Complexité, Innovations, Activités Motrices et Sportives, CIAMS (EA4532), University Paris-Sud, Université Paris-Saclay, Orsay, France. .,Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, Univ Paris-Sud, Université Paris-Saclay, Orsay, France. .,Service de Radiologie, CHU de Bicêtre, Le Kremlin-Bicetre, France.
| | - Antoine Nordez
- Laboratory "Movement, Interactions, Performance" (EA 4334), Faculty of Sport Sciences, University of Nantes, Nantes Cedex 3, France
| | - Marc Soubeyrand
- Orthopedic Department, Bicêtre Hospital, APHP, Le Kremlin-Bicetre, France
| | - Laurence Rocher
- Radiology Department, Bicêtre Hospital, APHP, Le Kremlin-Bicetre, France.,Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, Univ Paris-Sud, Université Paris-Saclay, Orsay, France
| | - Xavier Maître
- Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, Univ Paris-Sud, Université Paris-Saclay, Orsay, France
| | - Marie-France Bellin
- Radiology Department, Bicêtre Hospital, APHP, Le Kremlin-Bicetre, France.,Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M, CNRS, Univ Paris-Sud, Université Paris-Saclay, Orsay, France
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30
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Deeken CR, Lake SP. Mechanical properties of the abdominal wall and biomaterials utilized for hernia repair. J Mech Behav Biomed Mater 2017; 74:411-427. [DOI: 10.1016/j.jmbbm.2017.05.008] [Citation(s) in RCA: 88] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/26/2017] [Accepted: 05/04/2017] [Indexed: 12/29/2022]
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31
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CREZE MAUD, NYANGOH TIMOH KRYSTEL, GAGEY OLIVIER, ROCHER LAURENCE, BELLIN MARIEFRANCE, SOUBEYRAND MARC. Feasibility assessment of shear wave elastography to lumbar back muscles. Clin Anat 2017; 30:774-780. [DOI: 10.1002/ca.22903] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 04/29/2017] [Accepted: 05/05/2017] [Indexed: 12/13/2022]
Affiliation(s)
- MAUD CREZE
- Radiology Department; Bicêtre Hospital, APHP; Le Kremlin-Bicêtre France
- Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M; CNRS, University Paris-Sud, Université Paris-Saclay; Orsay France
| | - KRYSTEL NYANGOH TIMOH
- Obstetrics and Gynecology Department; Hopital Universitaire de Rennes, University Rennes 1; Rennes France
| | - OLIVIER GAGEY
- Orthopedic Department; Bicêtre Hospital, APHP; Le Kremlin-Bicêtre France
| | - LAURENCE ROCHER
- Radiology Department; Bicêtre Hospital, APHP; Le Kremlin-Bicêtre France
- Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M; CNRS, University Paris-Sud, Université Paris-Saclay; Orsay France
| | - MARIE-FRANCE BELLIN
- Radiology Department; Bicêtre Hospital, APHP; Le Kremlin-Bicêtre France
- Imagerie par Résonance Magnétique Médicale et Multi-Modalités, IR4M; CNRS, University Paris-Sud, Université Paris-Saclay; Orsay France
| | - MARC SOUBEYRAND
- Orthopedic Department; Bicêtre Hospital, APHP; Le Kremlin-Bicêtre France
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32
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Towards the mechanical characterization of abdominal wall by inverse analysis. J Mech Behav Biomed Mater 2017; 66:127-137. [DOI: 10.1016/j.jmbbm.2016.11.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/24/2016] [Accepted: 11/01/2016] [Indexed: 12/31/2022]
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